Tag: statistics

Virol J. 2025 Jun 18;22(1):199. doi: 10.1186/s12985-025-02830-7.

ABSTRACT

BACKGROUND: Cervical cancer ranks as the fourth most common cancer among women globally, mainly linked to persistent high-risk HPV infection. In China, significant challenges persist, notably the low rates of HPV vaccination and a substantial case burden. This study retrospectively examined HPV-related cervical cancer data from a tertiary hospital spanning the years 2013 to 2020, to evaluate annual and age-specific incidence trends and offer insights for prevention and treatment strategies.

METHODS: The retrospective analysis encompassed patients who utilized the gynecological outpatient and inpatient services at the Third Affiliated Hospital of Sun Yat-sen University from 2013 to 2020. HPV genotyping, covering 21 subtypes, was conducted using hybrid capture-based assays. The assessment of cervical biopsy disease etiology was performed by a senior pathologist.

RESULTS: During the study period, a total of 9,194 cases of HPV-positive individuals were identified, among which 479 cases (5.21%) were diagnosed with cervical cancer. From 2013 to 2020, there was a statistically significant decline in the overall incidence of HPV-positive cervical cancer (Z=-4.061, P < 0.001), as well as in the incidence of squamous cell carcinoma (Z=-4.595, P < 0.001). However, the incidence of adenocarcinoma did not exhibit a significant change (Z = 0.118, P = 0.906). Regarding age distribution, a significant decrease in cervical cancer incidence was observed in patients aged 36 to 64 years (Z=-2.658, P = 0.008). In contrast, the incidence remained relatively stable in patients aged 65 years and older (Z = 0.071, P = 0.943). The incidence of squamous cell carcinoma increased with age, peaking at 27.06% in individuals over 65 years.

CONCLUSION: The decline in HPV-positive cervical cancer cases highlights the success of China’s screening and post-2016 vaccination efforts. However, rising HPV infections in younger women and ongoing cancer risks in older groups emphasized the need to broaden adolescent vaccinations, sexual health education, and lifelong screening.

PMID:40533808 | DOI:10.1186/s12985-025-02830-7

Trials. 2025 Jun 18;26(1):212. doi: 10.1186/s13063-025-08903-w.

ABSTRACT

BACKGROUND: No formal assessment of a method to measure the carbon emissions from a clinical trial has been undertaken in the low- and middle-income country setting. We aimed to evaluate the UK-based National Institute of Health Research (NIHR) method for tracking trial emissions for applicability and adaptability to the South African context. Objectives included to (1) identify gaps in trial activity data, (2) locate local emission factor sources, (3) quantify emissions and (4) investigate modifications required to ensure the method was locally applicable.

METHOD: We adopted an application and implementation approach. We established a formal stakeholder structure focused on sustainable clinical trials to guide and support our approach. We selected a large cluster-randomised trial of a health service delivery intervention conducted across multiple urban and rural sites as an exemplar typical of local conditions to test the NIHR method. We created a trial process map outlining ten recommended activity stages for carbon emissions and an Excel workbook to calculate emissions for each stage. We prioritised calculations of those activities for which we had the most complete data: paper usage and printing, local travel between sites, and electricity consumption at the trial head office and at trial sites. We extracted activity data from organisational financial instruments.

RESULTS: The study took place between December 2023 and March 2024. We identified a lack of publicly available local emission factor sources. Paper usage and printing activities took place at trial set-up and during intervention delivery and emitted 2274.88 kgCO₂e. Field staff travel between trial sites during intervention delivery and follow-up resulted in approximately 80,000 km travelled between 2016 and 2019 contributing 17,891 kgCO₂e. Electricity consumption was based on full-time equivalent staff and yielded 12,515 kgCO₂e during the 4-year period. We observed large differences between UK and available SA emission factors with SA emission factors far higher than those in the UK.

CONCLUSION: We found that with minor modifications, the NIHR guidance is applicable to the SA context. It is a highly adaptable framework permitting tracking of activities across trial stages. A lack of locally available emission factors reduces accuracy and emission results should be viewed as indicative.

PMID:40533806 | DOI:10.1186/s13063-025-08903-w

Genome Biol. 2025 Jun 18;26(1):170. doi: 10.1186/s13059-025-03585-8.

ABSTRACT

Here we introduce KPop, a novel versatile method based on full k-mer spectra and dataset-specific transformations, through which thousands of assembled or unassembled microbial genomes can be quickly compared. Unlike MinHash-based methods that produce distances and have lower resolution, KPop is able to accurately map sequences onto a low-dimensional space. Extensive validation on simulated and real-life viral and bacterial datasets shows that KPop can correctly separate sequences at both species and sub-species levels even when the overall genomic diversity is low. KPop also rapidly identifies related sequences and systematically outperforms MinHash-based methods.

PMID:40533801 | DOI:10.1186/s13059-025-03585-8

J Orthop Surg Res. 2025 Jun 18;20(1):601. doi: 10.1186/s13018-025-06018-1.

ABSTRACT

BACKGROUND: In arthroscopic rotator cuff repair, satisfactory postoperative outcomes can be achieved by simplifying the surgical procedure and ensuring proper integration of the deep rotator cuff tissue with the footprint area for tendon reconstruction. The purpose of this study was to evaluate the short-term efficacy of arthroscopic spinal needle sutures for the repair of rotator cuff tears.

METHODS: This retrospective study included a cohort of 81 patients with rotator cuff tears who underwent arthroscopic suture repair using a spinal needle between January 2021 and March 2021, with a minimum follow-up duration of 27 months. Pre- and postoperative Constant-Murley Score (CMS), University of California-Los Angeles Shoulder Score (UCLASS), Visual Analog Scale (VAS) scores, and range of motion (ROM) measurements, including active forward flexion, abduction, and lateral rotation angles, were compared to assess shoulder anatomy, function, strength, and subjective patient satisfaction.

RESULTS: Statistically significant improvements were observed in CMS, UCLASS, VAS, and ROM postoperatively (P = 0.000). The excellent or good outcome rate was 81.48%. Age and preoperative ROM significantly influenced outcomes (P = 0.039 and P = 0.006), respectively, whereas gender and pain duration did not show a significant effect (P > 0.05). Patients older than 30 years demonstrated significantly better results (P < 0.001).

CONCLUSION: The use of a spinal needle for rotator cuff tear repair under direct arthroscopic visualization is a safe, efficient, and clinically effective technique.

LEVEL OF EVIDENCE: IV CLINICAL/CONTROLLED TRIALS: Not applicable.

PMID:40533792 | DOI:10.1186/s13018-025-06018-1

J Cardiothorac Surg. 2025 Jun 18;20(1):264. doi: 10.1186/s13019-025-03508-5.

ABSTRACT

OBJECTIVE: Non-small cell lung cancer (NSCLC) poses great mortality globally. Aberrant microRNA (miRNA/miR) expression is linked to the progression of many cancers. Herein, this study explored the association of miR-196b-5p in NSCLC tissues with the clinical features and prognosis of patients.

METHODS: Totally 166 NSCLC patients were retrospectively enrolled. Cancer and normal adjacent tissues (NAT) were attained for miR-196b-5p expression measurement. Clinical baseline data were attained, followed by the analysis of the relation of miR-196b-5p expression with clinical pathological features of NSCLC patients. The 3-year postoperative mortality risk was assessed in NSCLC patients with different miR-196b-5p levels, and independent risk factors (IRFs) for 3-year postoperative mortality were screened using Kaplan-Meier curves and Cox multivariate regression analysis.

RESULTS: miR-196b-5p levels were higher in cancer tissues than in NAT. Compared with stage I-II patients, miR-196b-5p in cancer tissues was upregulated in stage III patients. Patients with high/low miR-196b-5p expression showed statistically significant differences in age, capsule invasion, lymph node metastasis (LNM), maximum tumor diameter, and clinical staging. The survival and death groups were markedly different regarding age, capsule invasion, LNM, and clinical TNM staging. High miR-196b-5p expression in cancer tissues in NSCLC patients increased 3-year postoperative mortality risk. Age, clinical TNM stage, and miR-196b-5p expression in cancer tissues were IRFs for 3-year postoperative mortality in NSCLC patients.

CONCLUSION: High miR-196b-5p expression in cancer tissues of NSCLC patients was closely linked to capsule invasion, LNM, maximum tumor diameter, and clinical TNM stage and was an IRF for 3-year postoperative mortality in NSCLC patients.

PMID:40533790 | DOI:10.1186/s13019-025-03508-5

Int J Behav Nutr Phys Act. 2025 Jun 18;22(1):79. doi: 10.1186/s12966-025-01784-x.

ABSTRACT

BACKGROUND: Community-based overweight prevention programmes are widely implemented, however, little is known about their effectiveness after scale-up. This study examines the contribution of a scaled up community-based overweight prevention programme in the Netherlands: Healthy Youth, Healthy Future (JOGG) to children’s BMIz, adherence to fruit and/or vegetable consumption guidelines, and minutes of moderate to vigorous physical activity (MVPA) per week.

METHODS: In this observational study we used repeated cross-sectional data from 5 to 11- and 12-18-year-old participants in the annual Dutch national health survey (2006-2019) and applied two analytical methods for more robust inference. First, we applied linear mixed models to assess the association between JOGG exposure for at least 18 months (n = 1,008) vs. no exposure (n = 23,779) and the outcomes and assessed whether this association differed across subgroups defined by age, socioeconomic position (SEP), or migration background. Second, we compared outcome trends in JOGG and non-JOGG municipalities before and after implementation, using a difference-in-differences approach, to account for unobserved time-invariant confounders.

RESULTS: Results showed no significant association between JOGG exposure and BMIz or MVPA. However, JOGG exposure was associated with higher adherence to fruit and/or vegetable consumption guidelines in 12- to 18-year-olds (log odds 1.82, 95%CI 0.23, 3.41). We observed no differential associations across subgroups and no differences in outcome trends between JOGG and non-JOGG municipalities.

CONCLUSIONS: The scale up of JOGG in the Netherlands between 2010 and 2019 potentially contributed to higher fruit and vegetable consumption but not to BMIz or MVPA levels. Further examination of the implementation process may provide insight in underlying mechanisms and contribution of JOGG.

PMID:40533781 | DOI:10.1186/s12966-025-01784-x

Reprod Health. 2025 Jun 18;22(1):101. doi: 10.1186/s12978-025-02058-2.

ABSTRACT

BACKGROUND: Teenage pregnancy remains a pressing public health issue with profound effects on health, education, and socio-economic outcomes. Rural areas, such as parts of Teso, often face higher prevalence of teenage pregnancy due to socioeconomic challenges. This study aimed at determining the prevalence of teenage pregnancy and associated factors in Atutur sub-county, Kumi district.

METHODOLOGY: The authors employed a cross-sectional study design and sampled 444 teenage girls aged 13-19 years from 12 randomly selected villages in Atutur sub-county, Kumi district in April 2024. They were interviewed using structured researcher administered questionnaire. Data was collected using kobo collect tool, downloaded, cleaned and exported to SPPS version 27.0 for further management and analysis. Descriptive statistics was conducted to determine the prevalence of teenage pregnancy. After adjusting for covariates, multivariate analysis was conducted using modified Poisson regression to determine predictors of teenage pregnancy. Results were reported with a 95% confidence interval (CI) and factors whose CI did not contain a null (1.0), with p-value (P < 0.05) for adjusted PR, were considered statistically significant.

RESULTS: Of the 444 teenage girls, the mean age was 17 (standard deviation = 1.9) years. About one third of the participants, 132(29.7%) had ever conceived. Teenage girls in cohabitation were 3.0 times more likely to have conceived (aPR = 3.0, 95% CI: 2.23-4.10, P < 0.001) compared to those staying with their parents. Teenagers with both parents deceased were 1.9 times more likely to conceive (aPR = 1.9, 95% CI: 1.15-3.31, P = 0.032) compared to those whose parents were both alive. Teenage girls who were not satisfied with basic needs provided by parents were 3.3 times more likely to conceive (aPR = 3.3, 95% CI: 2.26-4.85, P < 0.001) compared to those satisfied with the basic needs provided by their parents.

CONCLUSION: Teenage pregnancy rates in Atutur sub-county Kumi district was higher than the national average, due to adverse socio-economic situation. Strengthening parental support of the girl child, with legal and community measures to reduce early marriages in rural settings may reduce teenage pregnancy. There is need to make deliberate efforts to provide socio-economic strengthening for the teenage girls to reduce their vulnerability.

PMID:40533780 | DOI:10.1186/s12978-025-02058-2

Cardiovasc Diabetol. 2025 Jun 18;24(1):258. doi: 10.1186/s12933-025-02808-3.

ABSTRACT

BACKGROUND: The diagnostic criteria for HFpEF remain inconsistently defined, further confounded by comorbidities such as obesity and type 2 diabetes mellitus (T2DM), which are thought to contribute to its pathogenesis via chronic pro-inflammatory mechanisms. This study aimed to evaluate the relationship between advanced cardiac magnetic resonance (CMR) imaging and pro-fibrotic and inflammatory serum biomarkers, assessing their potential to discriminate HFpEF from associated comorbid conditions.

METHODS: This was an exploratory analysis of a prospective cohort study of 35 obese/overweight participants (mean age 64 ± 8 years, 23% females), including 16 with T2DM, 13 with HFpEF (NYHA II-III) and T2DM, and 6 healthy controls. All subjects underwent comprehensive contrast-enhanced CMR at a 3 T scanner (Philips Ingenia, The Netherlands), including assessment of left ventricular and left atrial (LA) volumetry and function, myocardial perfusion reserve (MPR), and diffuse fibrosis imaging (ECV). Obtained serum biomarkers were Pentraxin-3, Galectin-3 and Interleukin-1 Receptor-Like 1 (IL1RL1). Statistical analyses included one-way ANOVA, Tukey test, Pearson’s correlation, regression and receiver operating characteristic analyses, and intra-class correlation.

RESULTS: In multivariable regression, impaired measures of LA structure and function emerged as the only independent discriminators of HFpEF, with LA maximum volume showing an OR of 1.13 (95% CI 1.05-1.28), reservoir strain of 0.71 (95% CI 0.44-0.89), conduit strain of 0.57 (95% CI 0.32-0.82) and booster strain of 0.70 (95% CI 0.48-0.89) per unit increase. No differences in MPR nor ECV were observed between the groups. While serum biomarkers Galectin-3 and Pentraxin-3 were significantly higher in HFpEF vs. obese controls (16.1 ng/ml ± 3.8 ng/ml vs. 10.6 ng/ml ± 3.7 ng/ml, p = 0.011, and 0.84 ng/ml ± 0.67 ng/ml vs. 0.21 ng/ml ± 0.05 ng/ml, p = 0.031, respectively), these biomarkers remained within normal limits and showed only moderate correlations with CMR metrics. Highest inter-study reproducibility was seen in MPR (ICC: 0.94), LA Reservoir Strain (ICC: 0.84) and serum biomarkers (ICC: 0.087-0.93).

CONCLUSION: CMR markers of diffuse fibrosis and microvascular dysfunction may not differentiate HFpEF from obese or diabetic controls. However, left atrial function assessment may evolve to be a reproducible and practical CMR marker, effectively distinguishing HFpEF independent of fibrotic remodeling.

PMID:40533773 | DOI:10.1186/s12933-025-02808-3

Ann Plast Surg. 2025 Jun 4. doi: 10.1097/SAP.0000000000004419. Online ahead of print.

ABSTRACT

BACKGROUND: Painful neuromas are common cause of residual limb pain following lower extremity amputation, yet its incidence in diabetic populations remains unestablished. While diabetes is thought to reduce neuroma risk due to impaired nerve regeneration, the role of metformin on this process remains unclear. This study aims to explore the association of diabetes severity and metformin therapy on painful neuroma formation following lower extremity amputations.

METHODS: This retrospective cohort study used TriNetX Research Network to identify adult patients (≥18 years) who underwent lower extremity amputation between January 2016 to February 2024. Patient cohorts were identified using International Classification of Disease-10 and Current Procedural Terminology codes. Patients were stratified by diabetic status, hemoglobin A1c levels, and metformin use. Propensity score matching was performed and adjusted for demographics, comorbidities, and medications. Risk differences, risk ratios, and odds ratios with corresponding 95% confidence intervals were calculated to quantify the association between the exposure and the outcome. Statistical significance was set at P < 0.05.

RESULTS: A total of 16,090 patients underwent lower extremity amputation, 9994 (62.1%) were diabetic, while 6096 (37.9%) were nondiabetic. The overall incidence of symptomatic neuromas was lower in diabetic patients (0.61%) compared to the nondiabetic group (1.67%). After propensity score matching, 5196 diabetic and 5104 nondiabetic amputees were identified. Diabetes was associated with a significant reduction in neuroma risk [risk difference of -0.893% (95% CI: -1.29% to -0.496%); P < 0.0001]. Patients using metformin at the time of surgery had a higher incidence of painful neuroma (0.718%) compared to nonusers (0.424%) (P = 0.127, odds ratio = 1.69). There was no significant difference in neuroma rates between those with hemoglobin A1c levels 6.5%-8.0%, 8.1%-10%, and >10%.

CONCLUSIONS: Diabetes was associated with a lower painful neuroma risk after amputation, suggesting a possible protective role of hyperglycemia-induced nerve regeneration alterations. Metformin use had no significant impact on painful neuroma rates. These findings challenge assumptions about glycemic control and neuroma formation, highlighting the need for further research on metabolic influences in postamputation nerve healing and pain management.

PMID:40532227 | DOI:10.1097/SAP.0000000000004419

Am J Respir Crit Care Med. 2025 Jun 18. doi: 10.1164/rccm.202505-1134ED. Online ahead of print.

NO ABSTRACT

PMID:40532217 | DOI:10.1164/rccm.202505-1134ED