Tag: statistics

Neurol Res Pract. 2025 May 19;7(1):35. doi: 10.1186/s42466-025-00384-1.

ABSTRACT

BACKGROUND: Weaning from mechanical ventilation (MV) and tracheal cannula (TC) during neurological early rehabilitation (NER) is mostly successful. However, some patients leave NER with TC/MV, requiring home-based specialized intensive care nursing (HSICN). Data on medical and demographic characteristics and long-term outcomes of these patients are limited.

METHODS: A multicentric retrospective observational study across five German NER hospitals collected data from neurological patients with TC/MV at discharge. The study aimed to assess patients’ health status at NER discharge, and to identify predictors of post-discharge survival. Survival rates were analyzed using Kaplan-Meier estimates; further predictors of survival post-discharge were analyzed using Cox regression.

RESULTS: Among 312 patients, the one-year survival rate was 61.9%, decreasing to 38.1% after approximately 4 years. Older age, higher overall morbidity and discharge with MV were associated with an increased likelihood of death, while a longer stay in NER correlated with survival.

CONCLUSIONS: Patients requiring HSICN after discharge from NER have a high mortality rate. Identifying survival predictors may help to identify patients at risk, and thus could be integrated into the decision-making process for NER discharge. The high mortality post-discharge warrants an evaluation of the current post-hospital care model. Optimizing therapeutic care in the HSICN setting may have the potential to reduce mortality and neuro-disability, and enhance the quality of life in these neurologically severely affected patients.

TRIAL REGISTRATION: The trial OptiNIV – Retrospective study of post-hospital intensive care in neurological patients has been retrospectively registered in the German Clinical Trials Register (DRKS) since 28.10.2022 with the ID DRKS00030580.

PMID:40394723 | DOI:10.1186/s42466-025-00384-1

BMC Nutr. 2025 May 20;11(1):99. doi: 10.1186/s40795-025-01083-5.

ABSTRACT

BACKGROUND: Self-medication, as a self-care practice, increased dramatically during the COVID-19 pandemic. Among the most prevalent medications used for self-medication were vitamins and minerals. Accordingly, this study aimed to estimate the prevalence of self-medication with vitamins or minerals for preventing and treating COVID-19 and its related factors.

MATERIAL AND METHOD: A comprehensive search was performed in four electronic databases (PubMed, Web of Science, Scopus, and ProQuest), two preprint repositories (MedRxiv and SciELO), two grey literature sources (Google and Google Scholar), and the reference lists of eligible studies in January 2024. The search strategy was built on two core concepts: “self-medication” and “COVID-19”. No language, place, and time restrictions were applied. Risk of bias assessment tool was adapted from Hoy checklist. The protocol of this study was registered under the code CRD42023434567 in the open-access online database of the International Prospective Register of Systematic Reviews (PROSPERO). A random effect model was applied to estimate the pooled prevalence of self-medication. Statistical heterogeneity among the studies was assessed using both the I² statistic and the χ2 test. Moreover, subgroup analysis and meta-regression model were used to identify the potential sources of methodological heterogeneity of the studies. A two‑sided P-value < 0.05 was considered statistically significant.

RESULTS: Out of 1424 non-duplicate studies, 56 were included in the meta-analysis. Vitamin C, vitamin D, B complex, multivitamins, and zinc were most commonly used for self-medication. The pooled prevalence of self-medication with vitamins was 29% (95% CI: 22%,37%; I² = 99.62%), with minerals 15% (95% CI: 8%, 23%; I² = 99.68%), and the corresponding value for the concomitant use of minerals and vitamins was 34% (95% CI: 27%, 42%; I² = 98.72%). The subgroup analysis showed people who lived in the American continent practiced self-medication with vitamins less (Pooled prevalence: 12%, 95% CI: 8%,16%; I² = 91.39%), and self-medication with vitamins and minerals was most prevalent in Asia. Besides; according to I² values, the continents in which the studies were conducted could be the reason for the statistical heterogeneity.

CONCLUSION: The reported prevalence of self-medication with vitamins and minerals to prevent and treat COVID-19, especially in Asia, is concerning and needs more public health action. In addition, people should be educated about the possibility of poisoning with vitamins and minerals because awareness of the risks of supplements can reduce self-medication practices at present and even in future pandemics.

PMID:40394722 | DOI:10.1186/s40795-025-01083-5

J Pharm Health Care Sci. 2025 May 20;11(1):43. doi: 10.1186/s40780-025-00450-5.

ABSTRACT

INTRODUCTION: Pharmacists play essential roles in the use of antiepileptic drugs (AEDs), inadequate knowledge among community and hospital pharmacists regarding AEDs poses a significant challenge in ensuring optimal medication management and patient care.

OBJECTIVE: This study aimed to assess the knowledge of pharmacists about antiepileptic drugs in Sudan.

METHOD: This was a cross-sectional analytical study conducted in Atbara, Gadarif, Kassala, and Port Sudan, Sudan. Using stratified, convenience sampling technique. We collected data directly via a modified, validated English questionnaire from the 1st to the 30th of October 2024.

RESULTS: In total, 384 pharmacists were included. Among them, 300 (78.1%) were under 35 years of age, and the majority of participants were male 213 (55.5%), 157 (40.9%) had a basic bachelor’s degree, and 330 (85.9%) received specialized AEDs training. The overall median score of knowledge percentages among participants was 10, with an interquartile range of 30 {25- (-5)}. Only 25 participants (6.5%) demonstrated good knowledge, while a majority of 359 (93.5%) exhibited poor knowledge. There was a statistically significant correlation between years of experience (adjusted odds ratio (AOR) 0.437; 95% CI 0.224-0.855; p value 0.016) and training on AEDs (AOR 0.085; 95% CI 0.031-0.233; p value 0.001) with their level of good knowledge.

CONCLUSION: Our study revealed that the majority of pharmacists in Sudan had a poor level of knowledge about AEDs. The level of knowledge was associated with years of experience and training on AEDs. These results highlight the need for pharmacists to have more training and more exposure to epilepsy and its management.

PMID:40394718 | DOI:10.1186/s40780-025-00450-5

Neurol Res Pract. 2025 May 20;7(1):36. doi: 10.1186/s42466-025-00391-2.

ABSTRACT

BACKGROUND: Despite considerable previous research, to what degree white matter lesions (WML) may be epileptogenic remains unclear. Therefore, the decision of initiating treatment with antiseizure medication (ASM) can be challenging in patients with only WML on neuroimaging. In this prospective study we assessed whether the prevalence, localization or severity of WML impact the risk of seizure recurrence in patients aged 60 years or older after first-time seizures.

METHODS: Data was analyzed from 168 patients, aged ≥ 60 years-old who had experienced a previous unprovoked seizure and had either a potentially epileptogenic lesion or WML on neuroimaging. The frequency of seizure recurrence was documented after 6, 12, and 24 months. Pearson´s chi-square test of independence (categorical variables) and the independent Student´s t-test (continuous variables) were used to analyze intergroup differences. Binary logistic regressions were calculated to examine the influence of WML locations as a predictor of seizure recurrence. Kaplan-Meier survival analyses and log-rank statistics were performed to determine the cumulative recurrence rates between the groups.

RESULTS: Fifteen patients had only potentially epileptogenic lesions on neuroimaging (EPI) and 93 showed WML only (OWML). Sixty patients showed both of them on neuroimaging (EWML). Frontal and parieto-occipital were the predominant WML locations. Neither severity nor location of WML had a significant impact on recurrence rates. The two-year cumulative probability of becoming seizure-free was significantly lower in the EPI group compared to the EWML (χ² [1] = 4.425, p = 0.035) and the OWML group (χ² [1] = 13.094, p < 0.001). A significant association between interictal epileptiform discharges in EEG and seizure recurrence was found in OWML patients (p = 0.004).

CONCLUSION: We could not find any association between prevalence, severity or location of WML and seizure recurrence after first seizures in the elderly. Therefore, treatment with ASM should be started with caution in those patients. Our results show a trend of WML not having epileptogenic potential, but further studies are needed to get better evidence.

TRIAL REGISTRATION: ClinicalTrials.gov Protocol Registration and Results, NCT06836687, AZ 199/17, release: 03/19/2024 retrospectively registered. https://register.

CLINICALTRIALS: gov/prs/beta/studies/S000EBC700000025/recordSummary.

PMID:40394715 | DOI:10.1186/s42466-025-00391-2

Eur J Med Res. 2025 May 20;30(1):406. doi: 10.1186/s40001-025-02650-z.

ABSTRACT

BACKGROUND: Clinical research is based on the parameters at defined time points, such as admission, diagnosis or discharge, for the purpose of risk factor analysis in relation to outcome. However, these parameters are collected with greater frequency in clinical practice. The objective of this study was to demonstrate a correlation between the time course of closely monitored parameters, such as blood gases, ventilatory parameters or routine laboratory values, and the survival of patients with acute respiratory distress syndrome (ARDS) caused by pneumonia.

METHODS: This single-center, retrospective study included 274 ARDS patients with primary pneumonia requiring invasive mechanical ventilation. Patients were treated at a German university hospital between January 2014 and April 2021. Ethical approval was obtained from the local ethics committee (BO-EK-374072021). Longitudinal data on ventilatory and inflammatory parameters were collected during ICU stays. The analysis was conducted using descriptive statistics, cox regression and joint models. Joint modelling was used to integrate the progression of these parameters with survival outcomes, with the modelling of longitudinal data performed using quadratic B-splines.

RESULTS: The cohort included 274 patients, with an ICU mortality rate of 49.6%. Non-survivors were older (67 vs. 62 years, p < 0.001) and had higher SOFA scores at admission (10 vs. 8, p < 0.001). Differences in ventilatory parameters, including driving pressure and the PaO₂/FIO₂ ratio, as well as inflammatory markers such as procalcitonin, were observed between survivors and non-survivors during the ICU stay. The joint model analysis revealed a significant effect of the time course of parameters, such as positive end-expiratory pressure (PEEP), peak airway pressure (Ppeak), driving pressure, minute ventilation, tidal volume, C-reactive protein (CRP) and procalcitonin on mortality. The increase over time (slope-dependent association) for these parameters was strongly associated with mortality. For example, driving pressure was associated with mortality both by its current value (HR 1.16) and by its increase over time (HR 7.10). Similarly, tidal volume (HR 0.72 and 0.07), minute ventilation (HR 0.91 and 0.36), PEEP (HR 1.32 and 13.52), Ppeak (HR 1.20 and 3.28) and CRP (HR 1.14 and 4.25) showed a current value association and a strong slope-dependent association with mortality.

CONCLUSION: This study underscores the importance of analyzing the dynamics of clinical parameters rather than static values for ARDS management. The findings suggest that changes in routine clinical parameters over time provide valuable prognostic information and should be prioritized in risk assessment and therapeutic decision making.

PMID:40394713 | DOI:10.1186/s40001-025-02650-z

Diabetol Metab Syndr. 2025 May 20;17(1):161. doi: 10.1186/s13098-025-01724-6.

ABSTRACT

OBJECTIVE: This study aimed to construct a scientific, accurate, and readily applicable clinical all-cause mortality prediction model for patients with metabolic dysfunction-associated steatotic liver disease (MASLD) to enhance the efficiency of disease management and improve patient prognosis.

METHODS: This study was a retrospective cohort study based on the National Health and Nutrition Examination Survey database. The 17,861 participants diagnosed with MASLD were randomly assigned to either a training cohort (n = 12,503) or a validation cohort (n = 5358). Potential predictors were subjected to LASSO regression analysis, and independent risk factors were subsequently identified through multivariate Cox regression analysis. An all-cause mortality prediction model was constructed based on the significant predictors, and a nomogram was generated to illustrate the survival probability of patients at various time points. The model’s performance was evaluated using receiver operating characteristic (ROC), calibration, and decision curve analysis (DCA) curves.

RESULTS: A multiple Cox regression analysis identified several independent predictors significantly influencing all-cause mortality in patients with MASLD. These included gender, age, smoking status, hypertension, red blood cell count, albumin, glutamyl transpeptidase, glycosylated hemoglobin, and creatinine. The constructed predictive model demonstrated high accuracy in the training and validation cohorts, with AUC values approaching 0.85 at 3, 5, and 10 years, respectively. Calibration and DCA curves were employed to verify the stability and generalizability of the model.

CONCLUSIONS: We successfully constructed and validated an all-cause mortality prediction model for MASLD patients. This model provides a powerful tool for clinical risk assessment and treatment decision-making.

PMID:40394710 | DOI:10.1186/s13098-025-01724-6

Trials. 2025 May 20;26(1):166. doi: 10.1186/s13063-025-08865-z.

ABSTRACT

BACKGROUND: Type 2 diabetes and prediabetes represent significant global health challenges, with physical activity (PA) being essential for disease management and prevention. Despite the well-documented benefits, many individuals with (pre)diabetes remain insufficiently active. General practitioners (GP) provide an accessible platform for delivering interventions; however, integrating PA interventions into routine care is hindered by resource constraints.

OBJECTIVES: The ENERGISED trial aims to address these barriers through an innovative GP-initiated mHealth intervention combining wearable technology and just-in-time adaptive interventions.

METHODS: The ENERGISED trial is a pragmatic, 12-month, multicentre, randomised controlled trial, assessing a GP-initiated mHealth intervention to increase PA and reduce sedentary behaviour in patients with type 2 diabetes and prediabetes. The primary outcome is daily step count, assessed via wrist-worn accelerometry. The primary analysis follows the intention-to-treat principle, using mixed models for repeated measures. Missing data will be handled under the missing-at-random assumption, with sensitivity analyses exploring robustness through reference-based multiple imputation. The trial incorporates the estimand framework to provide transparent and structured treatment effect estimation.

DISCUSSION: This statistical analysis plan outlines a robust approach to addressing participant non-adherence, protocol violations, and missing data. By adopting the estimand framework and pre-specified sensitivity analyses, the plan ensures methodological rigour while enhancing the interpretability and applicability of results.

CONCLUSIONS: The ENERGISED trial leverages innovative mHealth strategies within primary care to promote PA in individuals with (pre)diabetes. The pre-specified statistical framework provides a comprehensive guide for analysing trial data and contributes to advancing best practices in behavioural intervention trials for public health.

TRIAL REGISTRATION: ClinicalTrials.gov NCT05351359 . Registered on April 28, 2022.

PMID:40394706 | DOI:10.1186/s13063-025-08865-z

J Exp Clin Cancer Res. 2025 May 20;44(1):153. doi: 10.1186/s13046-025-03407-6.

ABSTRACT

BACKGROUND: Hepatocellular carcinoma (HCC) is a highly aggressive malignancy with limited treatment options in advanced stages. While c-Met is a promising therapeutic target in HCC, identifying patients who will benefit from c-Met inhibitors remains a significant challenge. This study aimed to investigate the role of HHLA2, a B7 family member, in HCC and its potential as a liquid biopsy marker for c-Met inhibitor therapy.

METHODS: HHLA2 expression was analyzed in clinical HCC samples and public databases. In vitro studies using HCC cell lines assessed HHLA2’s impact on proliferation, migration, invasion, and angiogenesis. In vivo studies using mouse models (orthotopic xenografts and hydrodynamic tail vein injection) evaluated HHLA2’s role in tumor growth and metastasis. Mass spectrometry, co-immunoprecipitation, split-luciferase, and ELISA assays were used to investigate HHLA2-c-Met interactions. Patient-derived organoids (PDOs) were used to assess drug response. Statistical analyses included Student’s t-tests, ANOVA, and Cox regression.

RESULTS: HHLA2 was found to be upregulated in HCC and associated with advanced disease, aggressive clinicopathological features, and poor prognosis. HHLA2 interacted with and constitutively activated c-Met, leading to increased expression of MMP9 and VEGFA, enhancing HCC cell proliferation, invasion, and angiogenesis. HHLA2 also suppressed hepatic natural killer cell infiltration in vivo. Inhibition of c-Met with PHA665752 effectively reversed HHLA2-mediated tumor-promoting effects in vitro and in vivo. HHLA2 expression in HCC tissues correlated with c-Met phosphorylation, and HHLA2 could be detected in the serum of patients with high tumor HHLA2 levels. PDOs with high HHLA2 expression exhibited increased sensitivity to c-Met inhibition.

CONCLUSIONS: HHLA2 acts as an oncogene in HCC by activating c-Met, promoting tumor progression and metastasis. HHLA2 expression correlates with c-Met activation and predicts poor prognosis in HCC patients. Importantly, HHLA2 can serve as a stratification marker for c-Met inhibitor therapy, potentially enabling a personalized approach to improve therapeutic outcomes in this challenging disease.

PMID:40394703 | DOI:10.1186/s13046-025-03407-6

BMC Chem. 2025 May 20;19(1):134. doi: 10.1186/s13065-025-01501-6.

ABSTRACT

Acrylamide (ACM) is a food processing contaminant classified as a probable genotoxic and carcinogenic substance for humans. The rapid and economical determination of ACM in food products poses a major challenge for food safety. This research intended to fabricate a simple, selective, and cost-effective polymeric-coated graphite sensor. This potentiometric sensor is suitable for direct and in situ ACM analysis in food products without tedious sample pretreatment procedures. The sensor was successfully developed based on the ion association complex of the ACM cation with sodium tetraphenylborate (TPB) anion as an ion exchange site, using dibutyl phthalate (DBP) as a plasticizer. The sensor demonstrated a fast, stable, selective, and linear Nernstian response (57.45 mV/decade) over a wide concentration range from 1 × 10^-7 to 1 × 10^-1 M of ACM, with a detection limit of 1 × 10^-8 M. The sensor’s selectivity behavior, response time, lifetime, pH working range, and fundamental validation parameters were assessed. Compared to a published chromatographic method, the developed sensor operated effectively to determine the ACM content in several food products. Greenness and whiteness were also assessed for the developed sensor, confirming that it is an excellent green and cost-effective option. Furthermore, the developed sensor was compared statistically with recently published ACM sensors to ensure optimal performance.

PMID:40394682 | DOI:10.1186/s13065-025-01501-6

Orphanet J Rare Dis. 2025 May 20;20(1):240. doi: 10.1186/s13023-025-03650-2.

ABSTRACT

BACKGROUND: Williams Syndrome (WS) is a neurodevelopmental disorder caused by microdeletion on chromosome 7. Hearing loss (HL) is common in this population but is rarely taken seriously. Previous studies had small sample sizes and mixed conclusions, and few studies have investigated HL in children with WS.

OBJECTIVES: To investigate audiological characteristics of children with WS, analyze the influence factors, and to provide scientific basis for further improvement of ear and hearing care in children with WS.

METHODS: Children with WS aged 0-18yrs, followed up in the Department of Pediatric Healthcare of the Children’s Hospital of Zhejiang University School of Medicine from June 2020 to June 2024 were enrolled in this study. Children aged 0-18yrs who came in the same period for health examination were matched as the control group. Both groups underwent a series of audiological examinations such as tympanogram, distortion product otoacoustic emission (DPOAE), auditory brainstem response (ABR) and pure-tone audiometry (PTA), to analyze the audiological characteristics of WS at different ages, and their difference with control group. Tympanogram and DPOAE were suggested to retest 1 year later and the results of first and second test were also compared.

RESULTS: Tympanogram and DPOAE were completed in 130 WS and control subjects, ranging in age from 1.0 to 12.4 years in the WS group and 0.8-13.1 years in the control group. The passing rate of tympanogram and DPOAE in WS was significantly decreased when compared with control group (p < 0.05), and these differences were found in all age groups. The lower DPOAE passing rate still remain after the tympanogram abnormal data were excluded. The SNR of 2000-5000 Hz were statistically lower in children with WS after tympanogram, DPOAE abnormal data were excluded. Tympanogram and DPOAE were rested in 25 WS 1 year later, and no significant difference was found in the passing rate of these test. ABR tests were completed in 28 WS and 44 control subjects, ranging in age from 0.7 to 5.2 years in the WS group and 0.4-5.2 years in the control group. Threshold of ABR in WS was higher than control group. The latency of wave I, III and the interpeak latency I-III in WS were significantly longer (p < 0.05), and the interpeak latency III-V was significantly shorter than that in control group (p < 0.05). PTA were completed in 20 WS and 28 control subjects, ranging in age from 5.9 to 13.7 years in the WS group and 5.9-12.5 years in the control group. 50% of WS was assessed as HL by PTA, with conductive hearing loss (CHL) in 60%, sensorineural hearing loss (SNHL) in 20% and mixed hearing loss (MHL) in 20%, most were mildly. The threshold of 250-8000 Hz in WS group were significantly higher than that in control group (p < 0.05), either in air or bone conduction.

CONCLUSIONS: This study revealed that children with WS frequently exhibit middle and inner ear dysfunction, often accompanied by HL or subclinical cochlear impairment, which can emerge before age 3. Prolonged ABR latency indicates delayed auditory nerve myelination, while shortened interpeak latency III-V may serve as an electrophysiological marker in this population. Long-term, regular hearing follow-up is recommended to enable early HL detection and timely treatment of contributing conditions.

PMID:40394675 | DOI:10.1186/s13023-025-03650-2