Tag: statistics

Health Qual Life Outcomes. 2025 May 4;23(1):47. doi: 10.1186/s12955-025-02377-9.

ABSTRACT

BACKGROUND: Hip fractures are a significant public health concern due to increasing numbers, high mortality and negative impact on health-related quality of life (HRQoL). Socioeconomic position (SEP) affects various health outcomes, but the specific impact on HRQoL and satisfaction after hip fracture remains underexplored. This study assesses whether education and household income influence patient-reported outcome measures (PROMs) after hip fractures, measured by three visual analog scales: EQ-VAS, pain-VAS, and satisfaction-VAS.

METHODS: This was a nationwide retrospective cohort study using linked data from the Norwegian Hip Fracture Register and Statistics Norway. PROMs assessed at 4, 12, and 36 months postoperatively in 35,206 hip fracture patients from 2015 to 2018 were included. The SEP data included household income and education levels. Covariance analyses were conducted to evaluate differences in mean VAS scores for general health (EQ-VAS), pain from the operated hip (Pain-VAS), and satisfaction with the result of the operation (Satisfaction-VAS). Analyses adjusted for age, sex, vital status, cognitive impairment, treatment type, and education or income when not used as independent variable.

RESULTS: The study included 23,649 women (67.2%) and 11,557 men (32.8%) with median age 83 years. Lower education was linked to worse EQ-VAS and Pain-VAS scores at all follow-ups and to lower Satisfaction-VAS at 12 and 36 months in both unadjusted and adjusted analyses. Lowest level of income had significant lower EQ-VAS at all follow-ups, lower Pain-VAS at 12 months, and lower Satisfaction-VAS at 4 months. There were increasing differences in mean VAS-scores during follow-up. At 36 months the adjusted differences in mean EQ-VAS between highest and lowest level of income was – 2,51 (-4.04 -0.99). Differences across education levels were even stronger associated; -3.58 (-5.19 to -1.98). Mean differences in Pain-VAS between medium and low education compared to high were 4.30 (2.91 to 5.69) and 5.58 (4.08 to 7.08), respectively. Lower levels of education also had significant negative differences in Satisfaction-VAS at 36 months follow-up -4.06(-5.86 to -2.26).

CONCLUSIONS: Lower education and income were significantly associated with worse HRQoL and satisfaction after hip fracture. The clinical relevance of these findings warrants further investigation. Addressing SEP disparities should be integral to hip-fracture care strategies aiming to improve postoperative outcomes.

PMID:40320519 | DOI:10.1186/s12955-025-02377-9

Probiotics Antimicrob Proteins. 2025 May 5. doi: 10.1007/s12602-025-10544-z. Online ahead of print.

ABSTRACT

Food allergies are common, affecting a sizable portion of children and adults in the Western world. In recent years, a promising treatment known as allergen immunotherapy (AIT) has emerged. This technique aims to address the fundamental immune system dysfunction that underlies food allergies. The study’s objective was to evaluate the safety of combining probiotics with AIT, compared to placebo in treating patients with food allergies. A comprehensive literature search in several databases was conducted. All included studies were randomized controlled trials(RCTs). Meta-analyses were performed using R software. Statistical tests to assess safety outcomes and risk of bias were used. After reviewing 519 studies, three studies were included in the systematic review and meta-analysis, involving a total of 258 patients (141 in the probiotics group, 144 in the placebo group). The evaluation of the safety profile of the integrated probiotic therapy revealed an overall favorable outcome, with no significant differences in adverse events compared to placebo for most organ systems examined. However, a potential increase in oral adverse effects was observed in the probiotics group (RR = 1.7573, 95% CI: 0.3941 to 7.8359), although this result did not reach statistical significance. The combination of probiotics and allergen-specific immunotherapy appears to be generally safe and shows promise as a valuable treatment approach.

PMID:40320506 | DOI:10.1007/s12602-025-10544-z

Support Care Cancer. 2025 May 5;33(5):447. doi: 10.1007/s00520-025-09492-9.

ABSTRACT

PURPOSE: Many cancer patients undergoing radiation therapy report unmet psychosocial needs, which can negatively impact their treatment outcomes and quality of life. This study explored the current practices and perceptions of radiation therapists (RTs) practicing in Canada and Norway with respect to addressing the psychosocial and supportive care (PSSC) needs of their patients.

METHODS: A cross-sectional study was conducted using an online evidence-informed survey of RTs in Canada and Norway that focused on (1) demographics, (2) RTs’ confidence level and perceptions related to PSSC, and (3) RTs’ current practices related to PSSC. Descriptive statistics, chi-square tests, and Mann-Whitney U tests were used to summarize the sample and compare differences between countries.

RESULTS: A total of 210 RTs completed the survey (Canada, n = 79; Norway, n = 131). RTs in both countries identified PSSC as an important aspect of quality care. Canadian RTs expressed a greater desire to expand their scope of practice in PSSC (p = 0.001). Norwegian RTs reported spending more time providing PSSC (mean: 8.3 h vs. 3.8 h; p < 0.001) and were satisfied with their current capacity. Barriers common to both countries included a lack of training and time constraints. Canadian RTs additionally reported limited institutional support.

CONCLUSION: Significant differences exist in the current practices and perceptions of RTs in Canada and Norway regarding PSSC delivery. However, Canadian and Norwegian RTs agree that engaging in PSSC ensures the best care for patients undergoing radiation therapy. With enhanced training, knowledge translation of resources, and institutional support, RTs can better address the PSSC needs of their patients.

PMID:40320500 | DOI:10.1007/s00520-025-09492-9

World J Urol. 2025 May 4;43(1):266. doi: 10.1007/s00345-025-05545-0.

ABSTRACT

OBJECTIVE: To quantify the effect of chemotherapy (CHT) in locally advanced female primary urethral cancer (fPUC).

METHODS: In the Surveillance, Epidemiology and Ends Results (SEER) database (2000-2021), we identified 295 fPUC patients with locally advanced stage treated with local therapy (surgery or radiation or both) with or without CHT. Multivariable Cox regression models addressed cancer specific mortality free survival (CSM). Sample power analyses were computed.

RESULTS: Of 295 fPUC patients, 141 (48%) underwent CHT. CHT rates increased from 40 to 61% (Δ22%) over the study span (2000-2021). Five-year CSM rates of CHT exposed vs. CHT-naïve patients were 58 vs. 43% (Δ15%). In multivariable Cox regression models (age and histology adjusted) CHT independently predicted lower CSM (HR = 0.67, p = 0.027). In squamous cell carcinoma (SCC) subgroup, CHT also independently predicted lower CSM (HR = 0.64, p = 0.01). In urothelial carcinoma (HR = 0.63, p = 0.2) and adenocarcinoma (HR = 0.7, p = 0.7) independent predictor status could not be demonstrated. Small sample sizes in urothelial carcinoma subgroup (UC) and adenocarcinoma subgroup (ADK) undermined the power of the analyses to as low as 48% in UC and 46% in ADK, respectively, versus ideal 80% power.

CONCLUSION: In fPUC patients, CHT independently predicts lower CSM. This effect is generalizable to SCC patients. The same relationship between CHT status and CSM is also operational in UC and ADK subgroups, but limited power undermined confirmation of its’ statistical significance.

PMID:40320496 | DOI:10.1007/s00345-025-05545-0

Virchows Arch. 2025 May 5. doi: 10.1007/s00428-025-04104-7. Online ahead of print.

ABSTRACT

Tubo-ovarian high-grade serous carcinoma (HGSC) with proficient homologous recombination (HR) DNA repair (HRP) accounts for approximately 50% of cases and is associated with platinum-resistance and poor prognosis. We hypothesize that the acquisition of hybrid phenotypes displaying both epithelial and mesenchymal (E/M) features may be involved in the malignant transformation and tumour dissemination in this subgroup. Therefore, we analysed, by digital pathology, the expression and prognostic significance of 3 classic cadherins (E-cadherin, epithelial marker; N-cadherin, mesenchymal marker; and P-cadherin, candidate marker of hybrid E/M) in 577 formalin-fixed paraffin-embedded human samples representing the putative stepwise serous carcinogenesis in the Fallopian tube epithelium (FTE). We observed a non-canonical N-to-P-cadherin switch along the carcinogenic progression, with a statistically significant overexpression of P-cadherin in pre-malignant and malignant samples, compared to the control FTE. Interestingly, this overexpression was most pronounced in precursor lesions and HGSC cells from malignant ascites. Tumours with high P-cadherin expression were significantly associated with worse overall survival, especially in the subgroup without BRCA1/2 mutations. Transient P-cadherin knock-down resulted in in vitro significant reduction of functional hybrid E/M hallmarks, namely decreased anoikis resistance, reduced collective migration and invasion in a representative platinum-resistant HRP cell line. Taken together, our results suggest that P-cadherin overexpression is an early event in the serous carcinogenesis and may be involved in hybrid E/M activation in HRP-HGSC, further supporting this adhesion molecule as a promising biomarker for this poor prognostic subgroup.

PMID:40320493 | DOI:10.1007/s00428-025-04104-7

Exp Brain Res. 2025 May 4;243(6):136. doi: 10.1007/s00221-025-07042-7.

ABSTRACT

The neural processes underlying gait retraining interventions that combine stepping practice with electrical stimulation are poorly understood. The purpose of this study was to compare acute changes in corticomotor excitability measured by motor evoked potential (MEP) amplitude, monosynaptic stretch reflex excitability measured by H/M ratio, and propulsive force generation during gait measured by anterior ground reaction forces (AGRF), induced by 30-minutes of fast walking (Fast) and 30-minutes of fast walking with functional electrical stimulation of the ankle plantarflexors and dorsiflexors (FastFES) in 14 able-bodied young adults. Our results showed that FastFES, but not Fast elicited a significant acute decrease in tibialis anterior MEP amplitude (p = .01). Furthermore, the practice-induced acute decrease in tibialis anterior MEP amplitudes was significantly larger for FastFES than Fast (p = .04). FastFES also elicited a statistically significant increase in the AGRF in the tested limb (p = .01), which was significantly larger than the change induced by Fast (p = .04). Additionally, baseline soleus MEP amplitude was positively correlated with within-session change in AGRF (p = .04, r² = 0.16). Acute decrease in tibialis anterior MEP amplitude for the FastFES condition relative to the Fast condition may be caused by fatigue, while the greater increase in AGRF for the FastFES condition signify that stepping practice facilitated alterations of gait patterns. More research is needed to confirm neural mechanisms and investigate the acute as well as long-term effects of Fast and FastFES on clinical populations.

PMID:40320480 | DOI:10.1007/s00221-025-07042-7

Clin Oral Investig. 2025 May 5;29(5):284. doi: 10.1007/s00784-025-06358-6.

ABSTRACT

OBJECTIVES: This study aimed to evaluate the clinical success and long-term survival of glass hybrid restorations in permanent first molars affected by molar incisor hypomineralization (MIH) following selective caries removal (SCR) over a six-year follow-up period.

MATERIALS AND METHODS: This prospective cohort study included a total of 134 MIH-affected molars in 58 children (mean age 8.94 ± 1.41 years) restored with glass hybrid materials after SCR. Clinical outcomes were assessed at baseline and at 6, 12, 18, 24, and 72 months using modified USPHS criteria. Kaplan-Meier survival analysis and Cox proportional hazards regression with robust standard errors were conducted to evaluate restoration survival and identify potential predictors.

RESULTS: The overall estimated mean survival time of restorations was 59.82 ± 1.50 months. The survival probabilities for mild and severe lesions at six-year were 24.3% and 11.1%, respectively. Multivariate Cox proportional hazards regression with robust standard errors indicated that lesion severity, medium lesion extension, and large lesion extension had a statistically significant impact on restoration survival (p < 0.001 for all). While survival was satisfactory up to 2-3 years, a marked decline was observed over time, particularly in severely affected molars.

CONCLUSIONS: Glass hybrid restorations demonstrated acceptable clinical performance in MIH-affected molars in the short to medium term but showed significant limitations in long-term survival.

CLINICAL RELEVANCE: The need for advancements in restorative materials tailored to the structural challenges of MIH. Glass hybrid materials remain a viable option for managing MIH-affected molars, particularly in young patients where minimally invasive approaches are prioritized.

PMID:40320479 | DOI:10.1007/s00784-025-06358-6

World J Urol. 2025 May 4;43(1):264. doi: 10.1007/s00345-025-05521-8.

ABSTRACT

OBJECTIVE: This study aims to assess the current status of self-management ability in patients with neurogenic bladder resulting from traumatic spinal cord injury (TSCI) and to analyze the factors influencing this ability.

METHOD: A cross-sectional study was conducted from November 2023 to July 2024, a total of 305 patients with neurogenic bladder due to TSCI were recruited from over 30 medical institutions, including rehabilitation centers within tertiary general hospitals, secondary rehabilitation hospitals, and private rehabilitation facilities across Shandong Province, China. Face-to-face interviews were conducted using a general information questionnaire, the patient positive measurement scale, the social support rating scale, and the self-management ability scale. Pearson correlation analysis and multiple linear regression were employed for statistical analysis.

RESULTS: Among 305 patients with neurogenic bladder caused by TSCI, the score of positivemeasurement scale was 40.95 ± 8.26, the score of the social support scale was 38.12 ± 8.35, and the score of self-management ability scale was 118.19 ± 37.16. In univariate analysis, social support (β = 0.364, P < 0.001), positive degree (β = 0.505, P < 0.001) and bladder training (β = -0.349, P < 0.001) positively predicted self-management ability. Age was a negative predictor of self-management ability (β = -0.204, P < 0.001). In multiple linear regression analysis, social support (β = 0.194, P < 0.001), bladder training (β = -0.262, P < 0.001) and positive degree (β = 0.376, P < 0.001) were still positively correlated with self-management ability.

CONCLUSION: Self-management ability in patients with neurogenic bladder secondary to TSCI is moderate, and patient activation is low. The establishment of an effective social support system, the implementation of bladder training and the improvement of patients positive degree can be used as an entry point to improve their self-management behavior ability, so as to reduce the patients’ dependence on others care and prepare for discharge and return to society.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40320459 | DOI:10.1007/s00345-025-05521-8

Sci Rep. 2025 May 4;15(1):15586. doi: 10.1038/s41598-025-99034-4.

ABSTRACT

Plastic materials are widely used because of their strength, light weight, durability, and environmental resistance. However, their decomposition rates are significantly slower than their typical lifespans. The rapid and continuous increase in plastic consumption has caused severe environmental impacts due to the accumulation of plastic waste. We identified potential polyhydroxyalkanoate (PHA)-degrading bacteria from marine environments capable of producing extracellular PHA depolymerases crucial for biodegrading PHAs. Marine debris was collected to screen poly [(R)-3-hydroxybutyric acid] (P(3HB))-degrading bacteria. Six isolates showed the ability to produce clear zones surrounding their colonies by degrading the bioplastic P(3HB). The isolate SS1-2, exhibiting the greatest degradation index of 1.44, was chosen for optimization through the statistical technique. The results indicated that NH₄Cl was the best nitrogen source for enzyme production, and the response surface methodology (RSM) suggested that the greatest P(3HB) depolymerase production could be achieved when the concentrations of substrate loading and NH₄Cl both set at 0.5%. Analysis of the 16S rRNA sequence of isolate SS1-2 revealed similarity to Pseudooceanicola antarcticus CGMCC 1.12662 (97.81% similarity). The findings of this study indicate the potential for further exploitation of this depolymerase in enzyme kinetics studies and its application in PHA degradation experiments.

PMID:40320445 | DOI:10.1038/s41598-025-99034-4

Sci Rep. 2025 May 4;15(1):15582. doi: 10.1038/s41598-025-99538-z.

ABSTRACT

Bacterial meningitis is a significant public health concern, with over 1.2 million cases reported globally each year. Rwanda is at increased risk of meningitis outbreaks due to its proximity to countries that lie in the meningitis belt. Rwanda has been conducting surveillance and recording meningitis outbreak cases across the country since 2012. We evaluated the meningitis surveillance system at Kibogora Level Two Teaching hospital, Nyamasheke district of Rwanda to assess whether the surveillance objectives were being met. The study was cross-sectional, using purposive sampling to select healthcare providers participating in the meningitis surveillance. Rwanda’s bacterial meningitis data from 2017 to 2021 was collected from clinical registers and Rwanda’s electronic integrated disease surveillance system (eIDSR) from Kibogora Level Two Teaching Hospital catchment area, Nyamasheke district, Rwanda. The study area was chosen because a meningitis outbreak was recorded in the area and its bordering country namely Democratic of Republic of Congo (DRC) prior to the current study period. Information on the participant’s demographics, occupation, training, professional experience, and their perception on the surveillance system were gathered using a structured questionnaire. Meningitis surveillance systems attributes including usefulness, acceptability, and flexibility were assessed and categorized as poor (< 50% score), reasonable (50-69%), good (70-90%), or excellent (> 90%) in reference to the study conducted on the evaluation of the meningitis surveillance system in Luanda Province, Angola in March 2017. Data collected from clinical registers and eIDSR were used to assess core functions of the meningitis surveillance system including accuracy in detection of cases, laboratory confirmation of cases, and availability of evaluation reports. Descriptive statistics were analyzed using Microsoft Office Excel. Thirty-one healthcare providers working on meningitis surveillance in the Kibogora Level Two Teaching Hospital were interviewed. During the period under evaluation, 48 suspected cases of meningitis were identified; 43 (90%) met the surveillance case definition, and only 10 (21%) were reported to eIDSR (completeness). Attributes such as flexibility scored good while stability and acceptability scored reasonable. Out of 48 suspected meningitis cases, only 2 (4%) samples were collected from patients and sent to the hospital laboratory for analysis. This study found a good knowledge level of the meningitis surveillance system among healthcare workers; however, the system’s core functions, such as notification rate and laboratory confirmation were found to have gaps. The notification rate could be improved by conducting regular refresher courses for healthcare workers supporting surveillance system. Moreover, MoH could enhance the implementation of a national policy requiring mandatory CSF sample testing to confirm pathogens for all suspected cases. Future studies should explore performance-based incentives to improve reporting completeness. Rwanda’s experience could provide insights for other low-resource settings facing similar surveillance challenges.

PMID:40320439 | DOI:10.1038/s41598-025-99538-z