Tag: statistics

Am J Ind Med. 2025 Apr 4. doi: 10.1002/ajim.23719. Online ahead of print.

ABSTRACT

BACKGROUND: Methods of delivering occupational safety and health (OSH) training have shifted from in-person to online. Widespread delivery of a standardized OSH training course in three modalities in the province of Ontario, Canada allowed measurement of differences in their effectiveness.

METHODS: Learners (N = 899) self-selected into face-to-face (F2F) instructor-led learning, online instructor-led synchronous distance learning, or online self-paced e-learning. Pre- and post-training surveys collected information on knowledge and other measures. Multiple regression analyses compared modalities on knowledge achievement (0%-100% scale; the primary outcome), engagement, perceived utility, perceived applicability, self-efficacy, and intention-to-use.

RESULTS: F2F learners achieved a statistically significant 2.5% (95% CI: 0.3%, 4.7%) higher post-training knowledge score than distance learners (Cohen’s d = 0.23, which is considered small). A statistically insignificant difference of 0.4% (95%: -1.4%, 2.3%) was seen between e-learners and distance learners. Collaborating training providers regarded these differences as not meaningful in practice. Statistically significant differences between modalities were seen for engagement, perceived utility, and self-efficacy. Scores of F2F learners were more favorable than scores of distance learners, which were, in turn, more favorable than scores of e-learners.

CONCLUSIONS: This study provides evidence that there are small to no differences among F2F, distance and e-learning in their ability to ensure knowledge achievement among learners. This finding is likely generalizable to other well-designed short-term OSH training aimed at acquiring new knowledge. More research is needed to understand whether there are important differences across these modalities in basic OHS skill acquisition and transfer of learning to the workplace.

PMID:40183197 | DOI:10.1002/ajim.23719

Clin Implant Dent Relat Res. 2025 Apr;27(2):e70014. doi: 10.1111/cid.70014.

ABSTRACT

INTRODUCTION: The present study aimed to evaluate and to compare the influence of anatomical variables such as sinus width (SW), inner maxillary sinus contour length (IMSCL), and residual ridge height (RRH) on new bone formation (%NBF) for deproteinized porcine (DPBM) and bovine bone mineral (DBBM) used for lateral window sinus augmentation (LWSA) grafting.

MATERIAL AND METHODS: For LWSA groups grafted either with DPBM (n = 10) or DBBM (n = 13) a linear- as well as a multivariate-regression analysis was conducted between measured %NBF and radiographically retrospectively assessed anatomical variables (SW/IMSCL/RRH). Correlations as well as regression coefficients (R²) were calculated, evaluating the influence of anatomical variables on %NBF with differentiation between both xenogenic graft materials used.

RESULTS: With no differences for patient-epidemiologic data, for anatomical variables as well as for surgical- and patient-related risk factors, comparison between the two LWSA groups was possible. The linear-regression analysis provided significant correlations between histomorphometrically evaluated %NBF and SW (DPBM: r = -0.660, p = 0.038; DBBM: r = -0.614, p = 0.026) as well as between %NBF and IMSCL (DPBM: r = -0.737; p = 0.015, DBBM: r = -0.573, p = 0.041), but not for RRH. Between SW/IMSCL/RRH and %NBF, regression-coefficients-(R²) of 0.435/0.543/0.258 using DPBM and R² of 0.377/0.328/0.053 using DBBM represented evidently higher influences of anatomical structures when porcine graft material was applied. The multivariate-regression analysis confirmed the different influence between various xenogenic graft materials on % NBF as well with a pronounced effect for porcine material (DPBM: R² = 0.591 [59.1%] vs. DBBM: R² = 0.314 [31.4%]).

CONCLUSION: In LWSA, anatomical structures such as SW and IMSCL significantly affect new bone formation, though with varying effects for different xenogenic (porcine vs. bovine) bone mineral graft materials used.

PMID:40183191 | DOI:10.1111/cid.70014

BJOG. 2025 Apr 4. doi: 10.1111/1471-0528.18158. Online ahead of print.

ABSTRACT

INTRODUCTION: Abnormal placental lesions are commonly identified in stillbirth. Interpreting these lesions and their contribution to fetal demise presents significant challenges. Recommended CODAC classification does not include detailed placental examination results.

OBJECTIVE: This study reports abnormal placental patterns in relation to the distribution of stillbirth causes in order to refine the categories of causes.

DESIGN: Data from the Ille-Et-Vilaine Stillbirth cohort, an exhaustive register of stillbirth cases across the Ille-et-Vilaine French department, were implemented in 2010.

SETTING: All seven maternity wards in the Ille-et-Vilaine department, France.

POPULATION: All cases of stillbirth located in the Ille-et-Vilaine department between 2010 and 2019.

METHODS: Descriptive statistics were used with the chi-squared test.

MAIN OUTCOME MEASURES: All placental examinations were reported following the Amsterdam consensus. Cause of death was ascertained according to the CODAC (Classification of Cause of Death and Associated Conditions) classification during multidisciplinary meetings.

RESULTS: A total of 566 stillbirths were documented. The most frequent stillbirth causes were placental cause (36%), followed by umbilical cord (11%) and infections (9%). Stillbirth remained unexplained in 17% of cases. Small placenta and maternal malperfusion emerged as the most frequent placental lesions within the placental stillbirth group (65%), but also within the maternal cause groups (65%).

CONCLUSION: Placental vascular anomalies were the most frequent cause of stillbirth in this study. Based on the combined use of international classification and observation of histological anomalies, our data suggest the existence of a vascular stillbirth group defined by vascular lesions associated with maternal or fetal expression.

PMID:40183189 | DOI:10.1111/1471-0528.18158

Muscle Nerve. 2025 Apr 4. doi: 10.1002/mus.28407. Online ahead of print.

ABSTRACT

INTRODUCTION/AIMS: Hypermetabolism and weight loss are established negative prognostic factors in amyotrophic lateral sclerosis (ALS). However, the role of individualized body composition parameters in predicting ALS progression has been underexplored. This study aimed to investigate the correlation between nutritional parameters, neurofilament light chain (NfL) levels, and disease progression in ALS patients.

METHODS: The Global Leadership Initiative on Malnutrition criteria were used to define malnutrition in this study. Nutritional status was assessed using body mass index and bioelectrical impedance analysis. The rate of disease progression was defined by the change in the Revised ALS Functional Rating Scale score (ΔFRS). NfL was quantified using single molecule array technology. Spearman’s analyses were used to assess correlations.

RESULTS: Sixty of 110 ALS patients were classified as malnourished. There was a strong positive correlation between NfL and ΔFRS (r = 0.71), and a moderate negative correlation with disease duration (r = -0.55). The correlations between NfL and body composition parameters were statistically significant, although weak. NfL levels were significantly higher in fast progressors (p < 0.0001 compared to slow progressors) and in malnourished patients (p = 0.0001). Of the 34 fast progressor patients, 28 (82%) exhibited some degree of malnutrition.

DISCUSSION: Our findings indicate that poor nutritional status, particularly reduced skeletal muscle mass-both independently and in combination with fat mass loss-is associated with elevated NfL levels and faster ALS progression. NfL, combined with nutritional parameters, could serve as a valuable biomarker for disease severity. Further research is warranted to clarify the role of skeletal muscle abnormalities in ALS progression.

PMID:40183173 | DOI:10.1002/mus.28407

NeuroRehabilitation. 2025 Feb;56(1):78-80. doi: 10.1177/10538135241303581. Epub 2025 Feb 25.

ABSTRACT

BackgroundPrognostic models have the potential to support people with Multiple Sclerosis (pwMS) and clinicians in treatment decision-making, enable stratified and precise interpretation of interventional trials, and offer insights into disease mechanisms. Despite many researchers being involved in developing these models to predict clinical outcomes in multiple sclerosis (MS), no widely accepted prognostic model is currently used in clinical practice.ObjectiveCommentary on the review by Reeve et al. (2023) to identify and summarise multivariable prognostic models, and their validation studies for quantifying the risk of clinical disease progression, worsening, and activity in pwMS.MethodsThis review included studies evaluating statistically developed multivariable prognostic models aiming to predict clinical disease progression, worsening, and activity, as measured by disability, relapse, conversion to definite MS, conversion to progressive MS, or a composite of these in adult individuals with MS.ResultsThe review included 57 studies, comprising 75 model developments, 15 external validations, and six author-reported validations. Only two models were validated multiple times externally, and none by independent researchers. The outcomes evaluated included disease progression (41%), relapses (8%), conversion to definite MS (18%), and conversion to progressive MS (28%). All models required specialist skills, 59% needed specialized equipment, and 52% lacked sufficient details for application or independent validation. Reporting quality was poor, and most models had a high risk of bias. The findings suggest increases in the number of participants on treatment, diverse diagnostic criteria, the use of biomarkers, and machine learning over time.ConclusionsDespite the development of many prognostic prediction models in pwMS, current evidence is insufficient to recommend any of these models for clinical use due to the high risk of bias, poor reporting, and lack of independent validation. The review’s findings necessitate a cautious approach to integrating existing MS prognostic models into rehabilitation practice.

PMID:40183167 | DOI:10.1177/10538135241303581

NeuroRehabilitation. 2025 Feb;56(1):19-29. doi: 10.1177/10538135241296742. Epub 2025 Feb 9.

ABSTRACT

BackgroundThe Covid-19 pandemic has accelerated the adoption of telerehabilitation as a tool to overcome geographical barriers, scarcity of care providers, and improve access to rehabilitation services. However, limited studies exist on its acceptability among care recipients particularly in low-and-middle-income countries.ObjectiveThis mixed-methods study explored the perception and acceptability of telerehabilitation among stroke survivors in Ibadan, Nigeria.MethodsA convenient sample of 44 stroke survivors was surveyed, and six participated in a focus group discussion (FGD). Quantitative data was analyzed using inferential statistics at p < 0.05. Qualitative data was thematically analysed.ResultsParticipants (61.4% males) were aged 60.93 ± 13.10 years. 19(43.3%) of them were favorably disposed to receiving treatment via telerehabilitation. Acceptability differed significantly across marital status, level of education, and socioeconomic status (p < 0.05). Qualitative findings indicated positive perceptions, although participants preferred telerehabilitation as an adjunct to face-to-face physiotherapy. Barriers included unstable internet connectivity, high costs of data, and lack of personal contact with physiotherapists. Facilitators included using telerehabilitation for additional or missed sessions, and the provision of necessary equipment and data by the government.ConclusionOur findings revealed limited acceptability of telerehabilitation among stroke survivors in Ibadan, Nigeria. This underscores the need to address the identified concerns and barriers, to enhance acceptability. A contextualized and multifaceted approach can help create awareness about the effectiveness of telerehabilitation and improve its acceptability.

PMID:40183163 | DOI:10.1177/10538135241296742

Hemodial Int. 2025 Apr 4. doi: 10.1111/hdi.13222. Online ahead of print.

ABSTRACT

OBJECTIVE: Parathyroidectomy is an effective intervention for patients with end-stage renal disease and refractory secondary hyperparathyroidism. This study aimed to assess the long-term clinical outcomes and overall quality of life of patients following parathyroidectomy in real-world clinical practice.

METHODS: The study included 103 patients with refractory secondary hyperparathyroidism treated with parathyroidectomy in a real-world setting (51 males, age 58 ± 10 years). Intact parathyroid hormone (iPTH), serum calcium, and serum phosphorus indices were compared preoperatively and at 6 months, 12 months, and 1 year postoperatively. The proportion of patients with a > 30% decrease in iPTH was evaluated to assess the long-term treatment effect of parathyroidectomy. The EQ-5D-5L scale was utilized to evaluate the long-term postoperative quality of life.

RESULTS: Fifty percent of the patients included in the study had a follow-up time of more than 19 months (19.0 [12.0, 24.0]). The median pretreatment iPTH level was 1796.2 (905.5, 2909.8) pg/mL, with 43.7% of patients exceeding 2000 pg/mL and 19.4% exceeding 3000 pg/mL; 19 (18%) patients had an iPTH level of ≤ 800 pg/mL. The preoperative mean serum calcium level was 2.54 (0.22), 95% CI (2.44, 2.68), and the mean serum phosphorus level was 2.09 (0.48), 95% CI (1.81, 2.19). Approximately 50% of patients underwent total parathyroidectomy. The iPTH levels decreased significantly after surgery (p < 0.001). At 6 months postoperatively, 96.7% of the patients had a decrease in iPTH of more than 30% compared to the preoperative levels, and this percentage was 94.9% at 12 months postoperatively. Mean serum calcium and phosphorus levels decreased significantly after surgery (p < 0.01). More than 60% of patients achieved target serum calcium levels, and more than 40% achieved target serum phosphorus levels at 6 months postoperatively, demonstrating a statistically significant increase compared to preoperative levels (p < 0.001). No significant difference in surgical outcomes was observed between the groups with preoperative iPTH levels > 800 and < 800 pg/mL. The utilization of secondary hyperparathyroidism-related medications decreased following surgical intervention. The median health utility value, as measured using the EQ-5D-5L scale, was 0.897 (0.739, 1.0), with a median VAS score of 80 (60, 90).

CONCLUSIONS: In clinical practice, parathyroidectomy demonstrates efficacy in reducing iPTH levels and facilitating the management of serum calcium and phosphorus levels. Moreover, this surgical intervention significantly decreases medication requirements and enhances the long-term quality of life for patients postoperatively. The evidence suggests that surgical intervention may confer long-term benefits to patients with refractory secondary hyperparathyroidism.

PMID:40183161 | DOI:10.1111/hdi.13222

Can J Infect Dis Med Microbiol. 2025 Mar 27;2025:4426596. doi: 10.1155/cjid/4426596. eCollection 2025.

ABSTRACT

Background: Antimicrobial-resistant Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter (ESKAPE) species pathogens pose a threat to global health by limiting available treatments, escalating the burden of disease, and raising mortality rates. This study investigated the prevalence of ESKAPE pathogens in different infections in a Nepalese hospital and studied their antibiotic resistance pattern. Methodology: The study was performed from September 2022 to February 2023 at Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal. ESKAPE pathogens were isolated in accordance with standard procedures and subjected to antimicrobial susceptibility testing (AST). Identification was done via biochemical testing. The rates of multidrug resistance (MDR), production of extended-spectrum beta-lactamase (ESBL), and methicillin resistance were studied and statistically compared in terms of the type of pathogen, infection, and hospital admission. Result: Altogether, 7429 different clinical samples were cultured and ESKAPE pathogens were isolated from 503/1564 (32.1%) positive samples. The prevalence of these pathogens was significantly higher in admitted patients (p < 0.001). Higher rates of isolation were from urine and sputum samples. Klebsiella pneumoniae was the most prevalent organism while Enterobacter was the least. A total of 52.3% and 7.4% of the isolates were MDR and ESBL producers, respectively. A significant proportion of MDR isolates were from patients admitted to the Intensive Care Unit (ICU). The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) was 36.8%. AST revealed comparatively lower resistance of Gram-negative rods to tigecycline, polymyxin B, and colistin sulfate. Likewise, lower resistance rates to vancomycin and teicoplanin were observed in S. aureus. Conclusion: In various clinical samples, we discovered that ESKAPE pathogens were more prevalent. In order to escape the ESKAPE’s torment of antibiotic resistance, our findings urge the urgent implementation of sensible antibiotic use, training healthcare professionals in antibiotic stewardship, developing effective infection control strategies, and conducting effective surveillance.

PMID:40183111 | PMC:PMC11968158 | DOI:10.1155/cjid/4426596

PeerJ. 2025 Mar 31;13:e19202. doi: 10.7717/peerj.19202. eCollection 2025.

ABSTRACT

BACKGROUND: Radiation therapy (RT) is a primary postsurgical treatment for breast cancer; however, it can cause acute radiation dermatitis (ARD), which can severely impair quality of life. The aim of this study was to identify predictive factors associated with moderate to severe ARD.

MATERIALS AND METHODS: In this retrospective analysis, we utilized data from Chulabhorn Hospital’s Health Information System that was collected between January 2017 and December 2022. A radiation oncology specialist assessed ARD in a cohort of 635 patients using the Radiation Therapy Oncology Group (RTOG) ARD grading scale. The patients were classified into two groups based on the maximum grade recorded: mild (grade < 2) and moderate to severe (grade ≥ 2). Various factors were examined, including demographic characteristics (age, body mass index (BMI), comorbidities) and treatment-related variables (surgical history, adjuvant chemotherapy, hormone therapy, targeted therapy, fractionation, boost treatments, and bolus application). Logistic regression was used to perform the statistical analysis.

RESULTS: Among the 635 patients, the average age was 54.2 ± 10.9 years, and 32% were classified as having moderate to severe ARD. Multiple logistic regression analysis identified BMI ≥ 30 kg/m² (adjusted odds ratio (AOR) = 2.33; 95% confidence interval (CI) [1.36-3.98]; p-value = 0.002), localized boost treatments (AOR = 2.09; 95% CI [1.08-4.06]; p-value = 0.029), and bolus application (AOR = 2.08; 95% CI [1.02-4.24]; p-value = 0.044) as significant risk factors for moderate to severe ARD. Conversely, hypofractionated RT (AOR = 0.31; 95% CI [0.16-0.57]; p < 0.001) and hormonal therapy (AOR = 0.60; 95% CI [0.42-0.86]; p-value = 0.005) were associated with a decreased risk. However, radiation to both the primary site and regional lymph nodes (AOR = 0.81; 95% CI [0.41-1.59]; p-value = 0.538) and targeted therapy (AOR = 0.72; 95% CI [0.43-1.20]; p-value = 0.210) did not significantly affect the risk of moderate to severe ARD.

CONCLUSIONS: We have identified key risk factors for moderate to severe ARD, including obesity and treatment modalities such as localized boost treatments and bolus application. Hormone therapy and hypofractionated RT appear to reduce ARD severity. These findings have implications for the development of treatment plans and the mitigation of the risk of ARD in patients undergoing RT.

PMID:40183060 | PMC:PMC11967412 | DOI:10.7717/peerj.19202

PeerJ. 2025 Mar 31;13:e19145. doi: 10.7717/peerj.19145. eCollection 2025.

ABSTRACT

OBJECTIVES: To develop a model incorporating computed tomography (CT) radiomic features and clinical parameters for predicting bronchiolitis obliterans (BO) with adenovirus pneumonia in children.

METHODS: A total of 165 children with adenovirus pneumonia between October 2013 and February 2020 were enrolled retrospectively. Among them, BO occurred in 70 patients, and the remaining 95 patients did not have BO. These children were stratified into training and testing groups at a ratio of 7:3. Manual segmentation of lesions in baseline CT images during acute pneumonia was performed to extract radiomic features. Multiple statistical methods were used to determine the best radiomic features. Combined models based on radiomic and clinical features were established via logistic regression (LR), random forest (RF), and support vector machine (SVM) algorithms. Model performance was evaluated via the area under the receiver operating characteristic curve (AUC).

RESULTS: A total of 2,264 radiomic features were extracted from the lesions, from which 10 optimal radiomic features were ultimately selected. The length of hospitalization, number of pneumonia lobes, and optimal radiomic features were incorporated into the combined models. In the training group, the AUCs of the combined LR, RF and SVM models were 0.946, 0.977, and 0.971, respectively; while in the testing group, they yielded AUCs of 0.890, 0.859, and 0.885, respectively. The predictive performance of these combined models surpassed that of the radiomic and clinical models.

CONCLUSION: Combining CT-based radiomic features with clinical parameters can offer an effective noninvasive model to predict BO in children with adenovirus pneumonia.

PMID:40183053 | PMC:PMC11967419 | DOI:10.7717/peerj.19145