Tag: statistics

J Assist Reprod Genet. 2025 Mar 31. doi: 10.1007/s10815-025-03464-y. Online ahead of print.

ABSTRACT

PURPOSE: Changing sperm donors after unsuccessful intrauterine insemination (IUI) cycles is a common yet understudied practice. This study evaluates whether switching sperm donors impacts the number of IUI cycles required to achieve pregnancy.

METHODS: This retrospective cohort study analyzed 312 women undergoing donor sperm IUI at Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, from 1992 to 2020. Participants were divided into two groups: Group A (conceived using only one donor) and Group B (switched donors after initial unsuccessful attempts). The primary outcome was the number of IUI cycles until pregnancy. Statistical analyses included t-tests, ANOVA, and multivariate analysis of covariance (MANCOVA).

RESULTS: Women in Group A required fewer cycles (mean 3.78 ± 1.90) to achieve pregnancy compared to Group B (mean 6.07 ± 2.95, P < .001). However, after switching donors, the mean number of cycles needed in Group B (2.23 ± 1.61) was significantly lower than the total cycles required by Group A (P < .001). Cumulative live birth rates were higher in Group A (50.5% after three cycles; 81.5% after six cycles) compared to Group B (26.0% after three cycles; 61.9% after six cycles).

CONCLUSION: Switching sperm donors after repeated unsuccessful IUI attempts significantly reduces the additional number of cycles needed to achieve pregnancy. These findings suggest that sperm-oocyte compatibility may influence IUI success. Clinicians should consider donor replacement after multiple failures. Prospective studies are required to confirm these results and investigate underlying biological mechanisms.

PMID:40164790 | DOI:10.1007/s10815-025-03464-y

Langenbecks Arch Surg. 2025 Mar 31;410(1):113. doi: 10.1007/s00423-025-03673-0.

ABSTRACT

BACKGROUND: Congenital heart disease (CHD) remains a critical concern in pediatric and adult cardiovascular care, requiring continuous advancements in surgical techniques and perioperative strategies. While survival rates have improved, challenges persist in optimizing long-term neurodevelopmental outcomes, addressing disparities in healthcare access, and overcoming systemic barriers to implementing best practices. This systematic review integrates recent evidence on predictive factors, perioperative innovations, and economic challenges affecting CHD management.

METHODS: A systematic review was conducted, analyzing data from 27 observational studies, including retrospective and prospective cohort studies, as well as case reports, sourced from diverse geographic and clinical settings. Studies were selected based on strict inclusion criteria, emphasizing clear surgical outcomes, perioperative advancements, and neurodevelopmental follow-up. Data were extracted and synthesized to identify key trends in CHD surgery, anesthetic management, and long-term patient care.

RESULTS: Key findings include: • Neurodevelopmental Outcomes: Long-term follow-up studies identified associations between prolonged ICU stays, intraoperative cerebral oxygenation deficits, and developmental delays. Hearing loss was reported in 21.6% of post-surgical patients, significantly impacting cognitive and language abilities. • Predictive Factors for Postoperative Outcomes: Hemoglobin saturation, lactate levels, and platelet counts were statistically associated with adverse postoperative outcomes (p < 0.05), reinforcing the need for preoperative risk stratification. • Fast-Track Extubation and Resource Optimization: Early extubation protocols reduced ICU stays by an average of 20%, with a 15% decrease in postoperative complications. However, financial disincentives and inadequate reimbursement models limited their widespread adoption, particularly in low-resource settings. • Tailored Anesthetic Techniques: Individualized anesthesia strategies, including neuroprotective approaches and blood conservation techniques, improved outcomes in high-risk CHD populations, reducing complication rates by up to 10%. • Global Disparities in CHD Care: Studies from low-income countries revealed significantly higher rates of malnutrition, delayed surgical interventions, and postoperative complications. These disparities highlight the urgent need for global policy reforms to improve healthcare equity in CHD management.

CONCLUSION: This review highlights the necessity of integrating predictive analytics, multidisciplinary approaches, and healthcare system reforms to enhance CHD management. While advancements in surgical techniques and perioperative care yield promising outcomes, persistent challenges-including healthcare disparities, financial constraints, and long-term neurodevelopmental risks-require targeted interventions. Future research should focus on personalized care models, global health policy adjustments, and innovative technologies to optimize CHD patient outcomes.

PMID:40164780 | DOI:10.1007/s00423-025-03673-0

Autism. 2025 Mar 31:13623613251328484. doi: 10.1177/13623613251328484. Online ahead of print.

ABSTRACT

A growing body of research suggests that mindfulness-based interventions may be a valuable method for reducing internalizing symptoms in autistic individuals. The current study extends this work using an effectiveness-implementation hybrid type 1 study. In this parallel randomized controlled trial, we examined a novel telehealth intervention for autistic adolescents and their caregivers. MINDful TIME includes eight weekly group meetings and regular use of a commercially available mindfulness meditation app. Participants were 42 adolescent-parent dyads randomized to the treatment or delayed treatment control (DTC) group. The program was implemented with fidelity (91.24%-94.78%), and 90% of treatment group dyads completed the program. On average, participants attended >90% of sessions and reported high acceptability. Treatment group adolescents demonstrated statistically and clinically significant reductions in parent-reported depression symptoms relative to DTC (F(1, 34) = 7.31, p = 0.01, ${\eta }_p^2$ = 0.18). Female adolescents in the treatment group showed significant reductions in parent-reported anxiety symptoms (F(1, 34) = 4.22, p = 0.05, ${\eta }_p^2$ = 0.11). Exploratory analyses indicated treatment-related improvements in adolescent executive functioning, parent mindfulness and well-being, and adolescent-parent relationship dysfunction. Findings warrant future examination of MINDful TIME to address well-documented challenges with mental health in this population. This trial was registered on clinicaltrials.gov (NCT05685589).Lay abstractPrevious research studies have found that mindfulness (i.e. focused attention on, and acceptance of, the present moment) training programs can reduce stress, depression, and anxiety. However, more research is needed to understand whether mindfulness strategies are helpful for autistic teens. We examined a new telehealth intervention for autistic teens and their caregivers. MINDful TIME is an 8-week group program that meets weekly through Zoom meetings. Participants learn mindfulness strategies through didactic lessons and using a commercially available mindfulness meditation mobile app. We randomly assigned 42 teens (ages 13-18 years) with an autism diagnosis and their parents to complete MINDful TIME or an 8-week wait period before beginning the program. Ninety percent of teens and parents assigned to MINDful TIME completed the program and reported that they found the program to be acceptable. Teens who completed MINDful TIME showed large reductions in depression symptoms, whereas teens in the wait period group did not. Females who completed MINDful TIME also showed reductions in anxiety symptoms, whereas males who completed MINDful TIME and females and males in the wait period group did not. Parents who completed MINDful TIME with their teens showed increased mindfulness traits, well-being, and adolescent-parent relationship functioning. Findings suggest that MINDful TIME is a promising program that may improve accessibility of mindfulness strategies for autistic teens and their caregivers. Future research with a larger sample size is needed to fully understand the benefits of the program.

PMID:40160168 | DOI:10.1177/13623613251328484

Disaster Med Public Health Prep. 2025 Mar 31;19:e77. doi: 10.1017/dmp.2025.3.

ABSTRACT

OBJECTIVE: This study aimed to examine health care workers’ (HCWs) perceptions of hospital disaster planning and preparedness within the context of building resilient health care systems. It also evaluated HCWs’ involvement in the planning process.

METHODS: Thirteen HCWs from 2 Queensland hospitals participated in in-depth, semi-structured interviews. These interviews were audio-recorded with participant consent and transcribed verbatim. Transcripts, recordings, and participant details were coded for confidentiality. Thematic analysis was used to identify essential patterns in the data and make sense of them.

RESULTS: HCWs’ perspectives on disaster planning underscored the importance of comprehensive planning, business continuity, proactive approaches emphasizing anticipation and risk mitigation, and implementation of established plans through training, resource management, and operational readiness. HCWs’ participation in planning ranged from high engagement through collaboration and continuous improvement to moderate or lower levels focusing on regulatory compliance and resource allocation.

CONCLUSIONS: This study highlights HCWs’ views regarding disaster planning and preparedness for building resilient health care systems. HCWs emphasised comprehensive planning and proactive preparedness, aligning with global priorities for disaster risk reduction. They stress the importance of education, training, operational readiness, and continuous improvement. This study underlines the vital role of HCWs’ participation in disaster planning and the need for comprehensive training initiatives.

PMID:40160147 | DOI:10.1017/dmp.2025.3

Ther Hypothermia Temp Manag. 2025 Mar 31. doi: 10.1089/ther.2025.0011. Online ahead of print.

ABSTRACT

Hypoxic-ischemic encephalopathy (HIE) is a constellation of neurological signs as a result of hypoxia, hypercapnia, metabolic acidosis, and cerebral ischemia before birth. The aim was to evaluate risk factors, clinical and laboratory findings, and morbidity and mortality in neonates diagnosed with HIE who underwent therapeutic hypothermia (TH). Between January 2015 and December 2020, neonates diagnosed with HIE were evaluated in the neonatal intensive care unit. Risk factors, sociodemographic characteristics, degree of encephalopathy, clinical and laboratory findings, results of amplitude-integrated electroencephalography (aEEG), electroencephalography (EEG), magnetic resonance imaging (MRI) including diffusion weighted imaging (DWI) and cranial ultrasound (cUS), and mortality were retrospectively recorded. Of the 81 cases, we followed up with a diagnosis of HIE. When the patients were divided into groups and evaluated according to the Sarnat & Sarnat staging system, it was observed that 22 (27.2%) of the patients had mild HIE, 49 (60.5%) of the patients had moderate HIE, and 10 (12.3%) of the patients had severe HIE. The aEEG, EEG, DWI, and renal pathology of patients with seizures were statistically significantly higher than those of patients without seizures (p = 0.004, p = 0.002, p = 0.014, p = 0.025). MRI was performed in 66 patients within the first 7 days of life, and diffusional restriction was found in 22 of them. We found that DWI is superior to cUS in determining the severity of hypoxic injury and that renal involvement may be associated with poor neurodevelopmental outcomes. Due to the abnormal prognostic findings detected in infants with mild HIE, the existence of a standard definition of mild HIE that will determine the efficacy and reliability of therapeutic hypothermia will enable at risk infants to benefit from neuroprotective strategies.

PMID:40160108 | DOI:10.1089/ther.2025.0011

Palliat Support Care. 2025 Mar 31;23:e84. doi: 10.1017/S1478951525000148.

ABSTRACT

OBJECTIVES: The use of palliative care (PC) services from people of Islamic faith is seen limited. There are a fundamental lack of PC services appropriate to the target group and a lack of knowledge and acceptance. The transition from curative to PC is often perceived as problematic. Factors influencing PC use and end-of-life (EOL) decisions and preferences among people of Islamic faith are largely unclear.

METHODS: A scoping review was carried out using the methodology of the Joanna Briggs Institute. Studies of any design, published in English, German, or Arabic, and published by the end of August 2022, were eligible for inclusion. The systematic literature search was conducted in MEDLINE via PubMed, CINAHL, Cochrane Library, and Web of Science. Study statements were analyzed with a clear distinction between PC as EOL care and other EOL decisions, such as euthanasia, withdrawal, or withholding of one or more life-sustaining treatments or medications.

RESULTS: Sixty studies published between 1998 and 2022 were included. Only a few studies made statements about EOL care. The majority of studies focused on forms of euthanasia and indicated negative attitudes toward euthanasia, assisted suicide, and some other EOL decisions. Reasons for rejection include theological arguments, ethical and moral considerations, and others. Reasons for acceptance were principles of good death and dying, medical justifications, and others. The following barriers to the use of PC were identified laws and policies, lack of necessary resources, cultural norms and values, structure of the health-care system, communication and interaction between patients, relatives, and health-care staff, and others.

SIGNIFICANCE OF RESULTS: This review identifies the preferences for and difficulties in making EOL decisions and identifies barriers to specific PC for the Muslim population. Findings suggest how these barriers might be overcome.

PMID:40160101 | DOI:10.1017/S1478951525000148

Future Sci OA. 2025 Dec;11(1):2484159. doi: 10.1080/20565623.2025.2484159. Epub 2025 Mar 31.

ABSTRACT

BACKGROUND: Cancer, influenced by genetics and the environment, involves anoikis, a cell death mechanism upon extracellular matrix detachment crucial for metastasis. Understanding this relationship is key for therapy. We analyze cancer and anoikis trends using bibliometrics.

METHODS: A search was conducted from Web of Science Core, PubMed, Scopus and non-English databases such as the CNKI (inception- 21 December 2024). Data analysis employed Microsoft Excel, VOSviewer, CiteSpace, R software, and the online platform (https://bibliometric.com/).

RESULTS: 2510 publications were retrieved, with a significant increase in the last decade. China led, the University of Texas system was productive, and the Oncogene Journal was popular. Breast, and colorectal cancers were frequently studied. Among them, representative tumor-related mechanisms were identified, commonalities such as (EMT, ECM, autophagy) and respective specific mechanisms were summarized.

CONCLUSION: This bibliometric analysis highlights rapid advances in anoikis research in cancer, emphasizing EMT and FAK pathways’ translational potential, guiding targeted therapies, and improving cancer treatment outcomes.

PMID:40160087 | DOI:10.1080/20565623.2025.2484159

Mymensingh Med J. 2025 Apr;34(2):554-561.

ABSTRACT

High sensitivity C-reactive protein (hs-CRP) is a well-characterized marker of low grade systemic inflammation. Microalbuminuria is an established marker of vascular endothelial damage. There are evidences that nephropathy in type 2 diabetics develops due to sustained chronic low grade inflammation and vascular endothelial dysfunction. The objective of the study was to find out the association of serum high sensitivity C-reactive protein (hs-CRP) levels with microalbuminuria in type 2 diabetic patients. This cross-sectional observational study was carried out in outpatient departments of Nephrology and Endocrinology of Mymensingh Medical College Hospital, Mymensingh. One hundred (100) type 2 diabetic patients in the age group 30 to 70 years with at least one year duration were included in the study. FBS, Serum creatinine, Serum hs-CRP level and Albumin-creatinine ratio (ACR) were measured in these subjects. It was observed that higher level of hs-CRP found in subjects with microalbuminuria. Majority (93.2%) were with microalbuminuria >50mg/gm with hs-CRP >3mg/L. There is statistically significant association between microalbuminuria and hs-CRP (p<0.001). The Pearson correlation test also showed positive correlation between hs-CRP level and microalbuminuria (r=0.876; p<0.001). There were also statistically significant (p<0.05) relationship between microalbuminuria and FBS, HbA1c as well as serum creatinine. This study concludes that microalbuminuria accompanied by elevated hs-CRP in Type 2 diabetic patient suggesting activation of inflammatory pathways. The importance of early detection, monitoring of inflammatory marker hs-CRP and ACR as predictors of diabetic nephropathy can help in modulating diabetes and its complications.

PMID:40160077

Mymensingh Med J. 2025 Apr;34(2):530-537.

ABSTRACT

Cardiac autonomic nerve dysfunction has been found associated with chronic obstructive pulmonary disease (COPD) patients as well as vitamin D₃ deficient patients. Heart rate variability (HRV), one of the markers of cardiac autonomic nerve function which is reduced in Asthma COPD overlap (ACO) patients. Sympathovagal balanced was improved in healthy subjects after administration of vitamin D₃. This randomized clinical trial aimed to observe the therapeutic effect of vitamin D₃ supplementation on non linear measures of HRV in 60 male vitamin D₃ deficient (<30 – 10 ng/ml) ACO patients. Patients were given orally either vitamin D₃ capsule or placebo per week for 6 months and serum vitamin D₃ level and non linear measures of HRV were assessed before and after intervention. HRV was measured by power lab 8/35, AD instruments and vitamin D₃ was assessed by chemiluminescent micro-particle immunoassay (CMA) method by auto analyzer. For statistical analysis paired sample ‘t’ test and independent sample ‘t’ test were done. Before intervention vitamin D₃ level and non linear parameters of HRV were similar in all patients but both these outcome measures significantly increased in vitamin D₃ treated but not in placebo treated patients after 6 months. In conclusion, vitamin D₃ supplementation is effective to improve HRV in vitamin D₃ deficient ACO patients.

PMID:40160074

Mymensingh Med J. 2025 Apr;34(2):519-529.

ABSTRACT

Several studies are being conducted worldwide to find out the prevalence of Retinopathy of prematurity (ROP) and any associated risk factors amongst preterm infants with very low birth weight (VLBW), birth weight ≤1500gm and Extreme low birth weight (ELBW) birth weight ≤1200gm. At the SCABU (Special Care Baby Unit) of Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital, Dhaka, Bangladesh a prospective observational study was conducted from October 2016 to March 2017. Newborns with a gestational age of 35 weeks or less at birth and a birth weight of 1500 gm or less admitted at SCABU in BIRDEM General Hospital were the study subjects. The percentage of newborns with ROP were 30.0% (27) amongst screened infants (n=90), where 81.5% (22) were among VLBW and 18.5% (5) were among ELBW infants. Out of them 22.2% (6) had stage I, 37% (10) at stage II, 29.6% (8) at stage III and 11.1% (3) infants had Aggressive Posterior ROP (APROP). It was also found that other than the common causes of developing ROP, frequent blood transfusion and use of mechanical ventilator may be potential risk factors for developing ROP. Comparable rate of ROP was found between the SCABU of BIRDEM to the other Neonatal care units in Bangladesh. Factors other than prematurity and oxygen supplementation were found to play a role in the development of ROP i.e. blood transfusion and mechanical ventilation. Hence ROP screening should be a part of the routine service for premature babies and the threshold for screening should be lowered.

PMID:40160073