Tag: statistics

J Orthop Surg Res. 2025 May 20;20(1):489. doi: 10.1186/s13018-025-05877-y.

ABSTRACT

PURPOSE: To quantitatively analyze the structural changes of the knee in patients with neglected developmental dysplasia of the hip (DDH).

METHODS: PubMed, Embase, Web of Science, and Cochrane Library databases were searched to identify studies comparing the morphological parameters of the knee between DDH patients and healthy individuals. Data on rotational and mechanical parameters of the lower limb, rate of occasional anterior knee pain (AKP), and knee morphological parameters, were extracted. Review Manager and R statistic software were used to perform the statistical analysis.

RESULTS: Nine studies with a total of 790 legs in 521 neglected DDH patients and 431 legs in 303 health subjects were included. Patients were predominantly female (88.3%). The Crowe classification is most commonly used to assess the severity of DDH. The total incidence of occasional AKP ranged from 8.6 to 20.6%, with an overall pooled rate of 14.4% (95%CI = 9.8-19.8%). In patients with neglected DDH, significant increases (P < 0.0001) were observed in femoral anteversion (weighted mean: 39.1° vs. 17.7°), knee torsion (weighted mean: 9.0° vs. 1.6°), and the vertical dimension of the medial femoral condyle (weighted mean: 13.8 mm vs. 11.6 mm), along with a significant decrease in the lateral distal femoral angle (weighted mean: 82.1° vs. 84.8°), which can lead to torsion deformity of the lower limb and valgus inclination of the distal femoral articular surface. Compared with the intact subjects, DDH knees demonstrated an increased sulcus angle (weighted mean: 144.9° vs. 137.5°; P < 0.0001), decreased trochlear depth (weighted mean: 3.1 mm vs. 4.5 mm; P < 0.0001), increased lateral shift of the patella (5.1 mm vs. 3.8 mm, P = 0.06), and increased patellar tilt angle (weighted mean: 18.2° vs. 13.2°; P < 0.0001). These findings were associated with developmental dysplasia of femoral trochlear and patellar instability.

CONCLUSION: Developmental dysplasia of the hip leads to patellar malalignment and developmental changes in the bony anatomy of the knee joint, including the development of a valgus deformity of the lower extremity and trochlear dysplasia. These findings may be associated with patellar instability.

LEVEL OF EVIDENCE: III, systematic review.

REGISTRATION: This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42025640292).

PMID:40394669 | DOI:10.1186/s13018-025-05877-y

Radiat Oncol. 2025 May 20;20(1):81. doi: 10.1186/s13014-025-02663-2.

ABSTRACT

INTRODUCTION: Breast cancer-related lymphedema (BCRL) is a debilitating condition that affects a significant proportion of breast cancer survivors, profoundly impacting their quality of life. While many studies have investigated the risk factors for BCRL occurrence, the determinants of its severity remain underexplored.

METHODS: This retrospective observational study evaluated the risk factors associated with BCRL severity among patients treated at the Motamed Cancer Institute, Tehran, Iran. Female patients with unilateral BCRL aged 25-75 years were included. Data were collected over a 10-year period and analyzed for demographic, clinical, and pathological variables. Lymphedema severity was assessed using established clinical staging criteria and categorized into early-stage (stages 1 and 2a) and advanced-stage (stages 2b and 3) groups. Also, presence of fibrosis and non-pitting edema were other indicators of BCRL severity. Statistical analyses included univariate and multivariate logistic regression to identify predictors of advanced-stage BCRL.

RESULTS: A total of 500 participants were analyzed, with a mean age of 41.16 ± 10.20 years and BMI of 28.72 ± 4.78 kg/m². Advanced-stage BCRL was significantly associated with older age (p = 0.00), higher number of excised lymph nodes (p = 0.04), and radiotherapy (p = 0.00). Multivariate analysis identified radiotherapy as the strongest independent predictor of advanced-stage BCRL (OR: 2.12, 95% CI: 1.22-3.67, p = 0.007). Other variables, including tumor grade, molecular subtypes, and type of surgery, did not independently predict BCRL severity.

CONCLUSION: Advanced-stage BCRL is influenced by multiple factors, particularly radiotherapy and the extent of lymph node dissection. These findings underscore the importance of strategies to mitigate risk among breast cancer survivors, especially those undergoing radiotherapy. Further research is warranted to explore targeted interventions for reducing BCRL severity.

PMID:40394662 | DOI:10.1186/s13014-025-02663-2

Reprod Health. 2025 May 21;22(1):88. doi: 10.1186/s12978-025-02030-0.

ABSTRACT

BACKGROUND: Approximately one in six people is experiencing infertility at some point in their lives. In response, health insurance coverage for infertility treatments has been strengthened. However, studies examining lifestyle factors that affect infertility remain lacking, highlighting the need to generate objective evidence to address infertility issues using national-level datasets.

METHODS: The General Healthcare Screening Program dataset from National Health Insurance Service database was employed in this study to examine infertility and childbirth among women aged 22-49 years. In 2020, 25,333 women with infertility and 73,759 women who had given birth were initially identified. After applying propensity score matching for age, Charlson Comorbidity Index score, and income level, the final study population included 24,325 women with infertility and 24,325 women who with childbirth. Employing a case-control study design, lifestyle factors (drinking, smoking, and physical activity) and health checkup outcomes (underweight, overweight, hypertension, diabetes, kidney function, anemia, and menstrual disorders) were assessed in this study. Statistical analyses included chi-squared tests, t-tests, and logistic regression.

RESULTS: This study revealed significant risk factors for infertility: two high-risk lifestyle factors, including heavy drinking and smoking, and five health conditions, comprising underweight, hypertension, diabetes, kidney function loss, and menstrual disorders. Conversely, being overweight, not engaging in vigorous physical activity, and anemia were negatively associated with infertility.

CONCLUSIONS: These findings underscore the need for lifestyle modifications and personalized preconception care to improve fertility outcomes.

TRIAL REGISTRATION: Not available.

PMID:40394661 | DOI:10.1186/s12978-025-02030-0

Infect Agent Cancer. 2025 May 20;20(1):30. doi: 10.1186/s13027-025-00661-3.

ABSTRACT

PURPOSE: To explore the failure patterns, outcomes, and treatment response of differentiated non-keratinizing nasopharyngeal carcinoma (DNKC) and to further investigate the role of plasma Epstein-Barr virus (EBV)-DNA in follow-up monitoring, prognostic prediction, and assessment of treatment efficacy in DNKC.

METHODS: We retrospectively collected data from patients diagnosed with DNKC from January 2015 to February 2022. The life-table method, Kaplan-Meier survival, and Cox proportional hazards analysis were used for statistical analyses.

RESULTS: A total of 102 patients were included. Of the 77 patients with available EBV-DNA levels, 61 patients (79.2%) had EBV-DNA detectable before treatment. Twenty-seven patients (26.5%) experienced disease recurrence, and 88.9% (24/27) relapsed in the first three years. There were 20 patients who experienced disease recurrence and had pre-treatment EBV-DNA status records. At the time of disease progression, 4 patients initially had undetectable EBV-DNA remained undetectable. Among the 16 patients with initially detectable EBV-DNA, 15 (93.8%) had detectable EBV-DNA. Nodal stage and EBV-DNA levels before treatment were found to be independent prognostic factors for distant metastasis-free survival (DMFS) and disease-free survival (DFS). Those with residual EBV-DNA after induction chemotherapy had significantly inferior DMFS (P = 0.003), DFS (P = 0.006), and overall survival (OS) (P = 0.006) than those without residual EBV-DNA after IC. Those with residual EBV-DNA after radiotherapy had significantly inferior local recurrence-free survival (P = 0.003), DMFS (P < 0.001), DFS (P < 0.001), OS (P < 0.006) than those without residual EBV-DNA after radiotherapy.

CONCLUSION: Our study highlights the aggressive nature of DNKC, characterized by early recurrence. EBV-DNA levels may serve as a biomarker to monitor treatment response, prognostic prediction, and recurrence surveillance.

PMID:40394615 | DOI:10.1186/s13027-025-00661-3

Reprod Health. 2025 May 20;22(1):86. doi: 10.1186/s12978-025-02016-y.

ABSTRACT

BACKGROUND: Polycystic ovary syndrome (PCOS) is a chronic, multifaceted condition influenced by epigenetic and environmental factors that is responsible for a significant proportion of anovulatory infertility cases. Here, we analyzed the global, regional, and national burdens of PCOS from 1990 to 2021 using data from the Global Burden of Disease 2021 (GBD 2021).

METHODS: Incidence, prevalence, and Disability-Adjusted Life Years (DALYs) data relevant to PCOS from 204 countries and 21 territories from 1990 to 2021 were obtained from the GBD 2021 study. Here, we considered age-standardized rates (per 100,000 individuals) with 95% uncertainty intervals (95% UIs) obtained from the aforementioned research and presented trends based on age and Socio-demographic Index (SDI) parameters.

RESULTS: In 2021, the global age-standardized incidence and prevalence rates of PCOS were 30.7 per 100,000 and 867.7 per 100,000, respectively, representing an increase of 26.77% and 28.21% since 1990. Additionally, age-standardized disability-adjusted life years stood at 7.6 per 100,000 globally in 2021, marking a 27.58% increase from 1990. Age-standardized prevalence of PCOS varied across countries, ranging from 93.1 to 3978.9 cases per 100,000 women, with Italy (3978.9), Japan (3104.7), and New Zealand (2789.7) having the highest rates. Notably, PCOS prevalence was noted to peak globally among females 15-19 years of age. Regions with a high SDI exhibited the highest age-standardized incidence (70.2), prevalence (1720.7), and DALY (15.2) rates of PCOS. Furthermore, a nonlinear correlation between PCOS burden and SDI was noted, with prevalence rates peaking around an SDI of approximately 0.9.

CONCLUSION: Our findings highlight the growing global impact of PCOS and underscore the need for concerted efforts to attenuate the increasing global prevalence of this condition. Significantly divergent PCOS disease burdens were observed across different age groups and SDI regions, with high SDI regions bearing heavier burdens. The increased disease burden among younger age groups and regional disparities underscore urgency for targeted intervention and formulation of policies to effectively address this public health issue.

PMID:40394609 | DOI:10.1186/s12978-025-02016-y

J Orthop Surg Res. 2025 May 20;20(1):492. doi: 10.1186/s13018-025-05892-z.

ABSTRACT

BACKGROUND: Total knee arthroplasty (TKA) is rising globally, with patellar management impacting outcomes. Resurfacing reduces pain and revision rates but poses complications, while non-resurfacing lowers costs but risks persistent pain. This study updates previous meta-analyses by comparing the functional and economic outcomes of both approaches.

METHODS: This systematic review and meta-analysis followed PRISMA guidelines. Studies comparing patellar resurfacing and non-resurfacing in TKA with functional outcomes in adults were included. Five databases were searched until February 6, 2024. Two authors independently extracted data and assessed risk of bias. Any disagreements were resolved by a third author. Statistical analysis used a random-effects model, reporting mean differences (MD) and odds ratios (OR) with 95% CI. Sensitivity and subgroup analyses were performed to assess heterogeneity and reliability.

RESULTS: A total of 49 studies (34 RCTs, 15 observational) were included from 963 screened records. Analysis of 22 studies found no significant difference in Knee Society Score (KSS) function between resurfacing and non-resurfacing (MD 2.03; 95% CI 0.58-3.48; p = 0.59, I² = 53%). Resurfacing significantly reduced anterior knee pain (OR 0.61; 95% CI 0.42-0.87; p = 0.007, I² = 70%). However, no significant differences were observed in pain scale, range of motion (ROM), or Oxford Knee Score. Three studies assessed economic outcomes using Incremental Net Benefit (INB) and Incremental Cost-Effectiveness Ratio (ICER) showed no significant cost-effectiveness.

CONCLUSIONS: Patellar resurfacing in TKA significantly reduces anterior knee pain but shows no advantage in KSS function, pain scale, Oxford Knee Score, ROM, or cost-effectiveness. Surgical decisions should be individualized to optimize patient outcomes.

PMID:40394607 | DOI:10.1186/s13018-025-05892-z

Chiropr Man Therap. 2025 May 20;33(1):19. doi: 10.1186/s12998-025-00581-4.

ABSTRACT

BACKGROUND: Previous surveys of physicians revealed diverse attitudes towards chiropractic. One of several strategies proposed by leaders in chiropractic to support the advancement of the profession in North America is to increase opportunities for interprofessional collaboration. One area where chiropractic has achieved some degree of integration in Canada is in the field of sports medicine. A result of the increased integration of chiropractic in the field of sports medicine has been more opportunity for interprofessional collaboration, development of interprofessional relationships and increased exposure to chiropractic. The attitudes of Canadian sport and exercise medicine physicians (CSPs) towards chiropractic are unknown. The purpose of this study is to determine the attitudes and their contributing factors of CSPs toward chiropractic and its use for treatment of athletes and/or Canadians who are participating in sports or exercise (ACSE).

METHODS: An invitation to complete the survey was included in a newsletter emailed to active physician members of CASEM (Canadian Academy of Sports and Exercise Medicine) in March and April 2023 and attendees of their symposium. The survey included the Chiropractic Attitude Questionnaire (CAQ), which allowed respondents to indicate their attitudes towards chiropractic care for ACSE using a 5-point Likert scale. The responses to the CAQ were the primary outcome measure. Descriptive statistics, including mean, median, standard deviation, maximum, minimum and range, regression analysis, t-tests, and ANOVAs were used to analyse the data.

RESULTS: Seventy CSPs completed the survey (response rate: 11%). The summed CAQ scores ranged from 0 to 68 with a mean of 39.03 and a standard deviation of 15.30. CSPs who worked with a chiropractor in a multidisciplinary setting hold a more positive opinion of chiropractic. An independent samples t-test indicated that there was a significant difference between CAQ scores for those with experience of working with a chiropractor (M = 42.03, SD = 14.99) and those without (M = 29.41, SD = 13.10); t(58) = 3.27, p < 0.05.

CONCLUSIONS: CSPs attitudes toward chiropractic and its use for treatment of ACSE range from very positive to extremely negative. CSPs who reported to have worked with a chiropractor have more positive attitudes than those that have not.

PMID:40394604 | DOI:10.1186/s12998-025-00581-4

Transfus Apher Sci. 2025 May 15;64(3):104156. doi: 10.1016/j.transci.2025.104156. Online ahead of print.

ABSTRACT

BACKGROUND: Despite the potential of whole blood-derived platelets (WBDP) to mitigate platelet shortages, their underutilization persists globally. This study investigates the perceptions of transfusionists and identifies barriers to the adoption of WBDP within China’s blood supply system for tertiary hospitals.

MATERIALS AND METHODS: A structured questionnaire comprising 16 items was distributed through WeChat to 254 transfusionists working in tertiary hospitals across China. Data regarding demographics, platelet preferences, and operational challenges were analyzed using descriptive statistics for quantitative data and thematic analysis for qualitative responses.

RESULTS: Results indicated a strong preference for AP (95.28 %), primarily attributed to perceived safety (80.99 %), efficacy (75.21 %), and familiarity with its use (76.86 %). In contrast, WBDP adoption was impeded by concerns over transfusion reactions (85.04 %), safety uncertainties (77.20 %), and operational challenges, such as increased workload (74.41 %) and higher labor costs (50.39 %). Despite this, 90.19 % of respondents expressed willingness to use WBDP during AP shortages, primarily due to critical shortages (66.81 %) and institutional mandates (33.19 %). Moreover, the key barriers included the risk of transfusion reactions (85.04 %), uncertainties regarding safety (77.20 %), doubts about efficacy (57.48 %), and increased labor costs (50.39 %).

CONCLUSION: Institutional inertia favoring AP, along with operational costs and workload for transfusionists, limit WBDP utilization. Implementing centralized compatibility testing and subsidy policies could improve contingency preparedness and address operational challenges.

PMID:40393093 | DOI:10.1016/j.transci.2025.104156

Animal. 2025 Apr 17;19(6):101520. doi: 10.1016/j.animal.2025.101520. Online ahead of print.

ABSTRACT

Many studies focus on animal welfare in terms of specific, either behavioural or physiological, indicators or on the impact of a particular management factor. However, an animal’s welfare state results from the individual’s perception of its general environment, which has consequences at both behavioural and physiological levels. Previous research on horses has shown that different riding schools could be characterised by different emotional/cognitive profiles of horses, in relation sometimes with one single management factor. In the present study, we aimed at determining if such facility-specific horse profiles could also be found in terms of welfare, i.e. facility-specific “welfare profiles”, using a multifaceted approach where animals’ welfare state was assessed based on detailed behavioural, health and physiological measurements. A total of 59 horses from three different riding schools, with a very similar global conventional management but differed slightly in terms of turn-out frequency and riding techniques were studied. A principal component analysis and statistical comparisons showed that, despite the close similarity in management between the three sites, the horses’ welfare state was very different and specific to each structure. Thus, this study using behavioural, health and physiological measures, highlights the existence of facility horse welfare profiles and reveals that even apparently minor differences in management practices could have a major impact on the horses’ welfare state. The quality of ridden work, which is often not taken into account in studies on horse welfare, could be a major issue.

PMID:40393084 | DOI:10.1016/j.animal.2025.101520

Genetics. 2025 May 20:iyaf094. doi: 10.1093/genetics/iyaf094. Online ahead of print.

ABSTRACT

Accurate reconstruction of pedigrees from genetic data remains a challenging problem. Many relationship categories (e.g. half-sibships versus avuncular) can be difficult to distinguish without external information. Pedigree inference algorithms are often trained on European-descent families in urban locations. Thus, existing methods tend to perform poorly in endogamous populations for which there may be reticulations within the pedigrees and elevated haplotype sharing. We present a simple, rapid algorithm which initially uses only high-confidence first-degree relationships to seed a machine learning step based on summary statistics of identity-by-descent (IBD) sharing. One of these statistics, our “haplotype score”, is novel and can be used to: (1) distinguish half-sibling pairs from avuncular or grandparent-grandchildren pairs; and (2) assign individuals to ancestor versus descendant generation. We test our approach in a sample of ∼700 individuals from northern Namibia, sampled from an endogamous population called the Himba. Due to a culture of concurrent relationships in the Himba, there is a high proportion of half-sibships. We accurately identify first through fourth-degree relationships and distinguish between various second-degree relationships: half-sibships, avuncular pairs, and grandparent-grandchildren. We further validate our approach in a second African-descent dataset, the Barbados Asthma Genetics Study (BAGS), and a European-descent founder population from Quebec. Accurate reconstruction of relatives facilitates estimation of allele frequencies, tracing allele trajectories, improved phasing, heritability and other population genomic questions.

PMID:40393068 | DOI:10.1093/genetics/iyaf094