Tag: statistics

BMC Cardiovasc Disord. 2025 Sep 15;25(1):653. doi: 10.1186/s12872-024-04262-7.

ABSTRACT

BACKGROUND: To compare echocardiographic and cardiac magnetic resonance imaging (CMR) measurements of global longitudinal strain (GLS) and global mitral annular plane displacement in women with breast cancer undergoing chemotherapy. The study focused on assessing the mitral annular plane systolic excursion (MAPSE) in echocardiography (ECHO) and atrioventricular plane displacement (AVPD) in CMR as parameters for global mitral annular plane displacement.

MATERIAL AND METHOD: Consecutive breast cancer patients (n = 16) were evaluated with ECHO and CMR before, during and after chemotherapy. Echocardiographic GLS was analyzed using two different software programs (TomTec and QLab). Non-parametric Wilcoxon’s signed-rank test, Bland-Altman plots and Friedman’s test were used for the statistical analyses. A statistical significance level of all analyses was set at a p-value < 0.05. The study was approved by National Ethics Review Board in Sweden (DNR 2019-04588).

RESULTS: No significant differences were found in GLS at baseline between ECHO (median: QLab – 20.4% and TomTec – 22.0%) and CMR (median: -19.5%) (ECHO(QLab) vs. CMR p = 0.733 and ECHO(TomTec) vs. CMR p = 0.093). After chemotherapy significant reductions in GLS were measured with ECHO(TomTec) (median: -20.1, p = 0.035) and CMR (median GLS: -17.4%, p = 0.004). At baseline ECHO-MAPSE (median: 16.8 mm) and CMR-AVPD (median: 14.0 mm) differed significantly (p = 0.015). However, no significant reduction of MAPSE (median: 15.5 mm) or AVPD (median: 13.8 mm) were detected after chemotherapy (p = 0.076 respective p = 0.706). Though ECHO-MAPSE showed a tendency to decrease after chemotherapy, CMR-AVPD did not.

CONCLUSION: ECHO(TomTec)-GLS is as compatible to detect early signs of cardiotoxicity as CMR. ECHO-MAPSE could be more sensitive than CMR-AVPD to detect subtle changes during chemotherapy.

PMID:40954455 | DOI:10.1186/s12872-024-04262-7

BMC Med Inform Decis Mak. 2025 Sep 15;25(Suppl 3):330. doi: 10.1186/s12911-025-03183-5.

NO ABSTRACT

PMID:40954454 | DOI:10.1186/s12911-025-03183-5

Dyslexia. 2025 Nov;31(4):e70013. doi: 10.1002/dys.70013.

ABSTRACT

The multi-deficit framework employed to identify dyslexia requires statistical learning-based models to account for the complex interplay of cognitive skills. Traditional methods often rely on simplistic statistical techniques, which may fail to capture the heterogeneity inherent in dyslexia. This study introduces a model-based clustering framework, employing finite mixtures of contaminated Gaussian distributions, to better understand and classify dyslexia. Using data from a cohort of 122 children in Poland, including 51 diagnosed with dyslexia, we explore the effectiveness of this method in distinguishing between dyslexic and control groups. Our approach integrates variable selection techniques to identify clinically relevant cognitive skills while addressing issues of outliers and redundant variables. Results demonstrate the superiority of multivariate finite mixture models, achieving high accuracy in clustering and revealing the importance of specific variables such as Reading, Phonology, and Rapid Automatized Naming. This study emphasises the value of the multiple-deficit model and robust statistical techniques in advancing the diagnosis and understanding of dyslexia.

PMID:40954446 | DOI:10.1002/dys.70013

Eur Arch Paediatr Dent. 2025 Sep 15. doi: 10.1007/s40368-025-01111-9. Online ahead of print.

ABSTRACT

PURPOSE: To compare sealant retention, patient satisfaction, and operator preference between EasyPrep^® and cotton roll isolation.

METHODS: This university-based, superiority, split-mouth randomised controlled trial enrolled 92 children aged 6-12 years with matched contralateral pairs of maxillary or mandibular permanent first molars (PFMs). Each participant was randomised to receive sealants using either EasyPrep^® or cotton roll isolation on one side, followed by the alternative method on the contralateral side. All sealants were placed by dental students under the faculty supervision and were assessed for retention by two blinded examiners at 6- and 12-month follow-ups. Sealant retention success was compared between groups using risk regression with generalised estimating equations. Patient satisfaction and operator preference were assessed through interview-based questionnaires and summarised using descriptive statistics.

RESULTS: Of the 180 pairs of PFMs included at baseline, 155 and 110 were evaluated at the 6- and 12-month follow-ups, respectively. The relative risks of sealant retention success with EasyPrep^® compared to cotton roll isolation were 0.95 (95% confidence interval [CI] 0.83; 1.09, p > 0.05) at 6 months and 0.96 (95% CI 0.76; 1.23, p > 0.05) at 12 months. These results indicate a slightly lower probability of retention success with EasyPrep^® at both time points, although the differences were not statistically significant. Moreover, children tended to prefer cotton roll isolation (44.6%), whereas operators favoured EasyPrep^® (59.8%).

CONCLUSION: Although most operators preferred EasyPrep^®, its sealant retention was not superior to that of cotton roll isolation. Moreover, patients’ preference was more toward cotton roll isolation.

PMID:40954445 | DOI:10.1007/s40368-025-01111-9

Biol Trace Elem Res. 2025 Sep 15. doi: 10.1007/s12011-025-04826-4. Online ahead of print.

ABSTRACT

This study systematically assessed the impact of bile acids and zinc on the production performance, egg quality, tissue trace element content, and intestinal microorganisms of laying hens, with an initial investigation into their potential interactions. Three hundred healthy 240-day-old Jingfen No. 8 laying hens were assigned into 4 groups, each group contains 75 hens with 5 replicates.The control group was fed with a standard diet, 500 mg/kg bile acids, 120 mg/kg zinc, and 500 mg/kg bile acids + 120 mg/kg zinc were added to the three experimental groups. The experimental procedure included a 7-day acclimation period followed by a 56-day formal trial. Supplementation with 500 mg/kg bile acids significantly increased average daily feed intake (ADFI), laying rate, and egg production, while decreasing both the feed-to-egg ratio (F/E) and Haugh unit values. On the other hand, supplementation with 120 mg/kg zinc notably boosted daily feed intake, egg weight, yolk color and eggshell weight, and elevated Zn²⁺ concentrations in the liver, yolk, and whole egg. Analysis of intestinal microorganisms revealed a high level of similarity between the groups, although not reaching statistical significance. However, when both supplements were combined at 500 mg/kg bile acids and 120 mg/kg zinc, a significant reduction in average egg weight compare to the control group was observed, with no significant variances in other measured parameters. Nonetheless, certain differences and similarities in the composition of intestinal microorganisms were noted. Interaction analysis revealed significant effects between bile acids and zinc on average egg weight, ADFI, laying rate, egg production, yolk color, and eggshell weight. The findings collectively indicate that the individual use of bile acids and zinc significantly enhances production performance, egg quality, tissue zinc content, and influences the composition of intestinal microorganisms in laying hens. Conversely, when these supplements are combined, antagonistic effect emerge, indicating a diminished effectiveness of the combined supplementation. These results offer empirical support for understanding the limitations in formulating feed additives.

PMID:40954425 | DOI:10.1007/s12011-025-04826-4

Dig Dis Sci. 2025 Sep 15. doi: 10.1007/s10620-025-09389-x. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Esophageal food impaction (EFI) resulting in obstruction is a gastrointestinal emergency requiring disimpaction by upper endoscopy. Current guidelines recommend emergent intervention within 24 h to reduce risk of complications. However, limited data exist regarding specific factors affecting practice patterns, including timing and setting of endoscopic intervention for EFI.

METHODS: We conducted a retrospective review of 684 patients who presented with EFI to the emergency department (ED) at three hospitals from 2015-2021. 447 patients met inclusion criteria. We compared hospitalization rates, ED triage-to-endoscopy time, sedation type, endoscopy setting [ED/intensive care unit (ICU), operating room (OR), or endoscopy unit (EU)], and complications for “business hours” (between 8AM and 5PM) and “after hours” procedures (weekends or before 8AM/after 5PM).

RESULTS: Among 509 EFI cases, 67.2% were performed “after hours,” and 56.2% occurred in the EU. “After hours” endoscopies were over fourfold more likely to involve moderate sedation (OR 4.35 [1.64-11.54]). Mean ED triage-to-endoscopy time was significantly longer for “business hours” cases (11.3 ± 21.2 h versus 5.4 ± 10.3 h, adjusted p-value = 0.0002). Patients undergoing endoscopy “after hours” were 74% less likely to be hospitalized (0.26 [0.13-0.55]). Although not statistically significant, “after hours” cases had lower complication rates (2.3 versus 4.8%) and in-hospital mortality (0.0% vs 1.2%) compared to “business hours” (p-value ≤ 0.1367 and ≤ 0.1072, respectively).

CONCLUSIONS: We found that “after hours” endoscopic disimpactions for EFI did not have increased hospitalizations or increased complications relative to “business hours,” contrary to current literature. Our findings underscore the safety, efficacy, and feasibility of “after hours” endoscopic intervention for EFI, which may help shape resource allocation and hospital protocols to improve patient outcomes in the future.

PMID:40954400 | DOI:10.1007/s10620-025-09389-x

Intern Emerg Med. 2025 Sep 15. doi: 10.1007/s11739-025-04115-x. Online ahead of print.

ABSTRACT

Abdominal pain constitutes approximately 10% of all emergency department (ED) presentations, representing a frequent and diagnostically complex complaint. Point-of-care ultrasound (POCUS) has become an essential tool in the ED, supporting resuscitation, interventional procedures, diagnosis, and follow-up. This prospective, randomized-controlled study aimed to assess the impact of POCUS-integrated triage compared to conventional triage (without ultrasound) on diagnostic accuracy, treatment initiation, and ED management in patients with non-traumatic abdominal pain. A total of 262 adult patients were enrolled and randomized in a 1:1 ratio using computer-assisted methods, with 127 allocated to conventional triage and 135 to POCUS triage. The researcher did not intervene in clinical decisions. Primary outcomes included additional imaging requests, time to initial analgesia, consultation requests, ED length of stay, and overall outcome, while the secondary outcome was the effect on triage categorization. Statistical analysis was performed using IBM SPSS Statistics version 21.0. The mean age of participants was 30 years, with 55.7% being female. The POCUS triage group required significantly fewer additional imaging studies (p < 0.001) and had shorter times to analgesia administration, consultation, and ED discharge (all p < 0.001). Moreover, POCUS triage significantly altered patient categorization compared to the Emergency Severity Index (ESI) system (p < 0.001). When compared against final imaging reports, POCUS demonstrated a sensitivity of 87%, specificity of 55%, positive predictive value of 81.6%, and negative predictive value of 64.7%. In conclusion, POCUS triage enhances clinical efficiency by reducing imaging needs and expediting key interventions, offering significant advantages for emergency department workflow and patient care.

PMID:40954383 | DOI:10.1007/s11739-025-04115-x

Surg Endosc. 2025 Sep 15. doi: 10.1007/s00464-025-12148-8. Online ahead of print.

ABSTRACT

BACKGROUND: Under the Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act of 2018, Veterans can obtain Veterans Health Administration (VHA)-funded care in the community; however, there are limited studies on Veteran outcomes following bariatric surgery.

METHODS: We performed a national retrospective study of Veterans undergoing bariatric surgery between fiscal years 2022-2023. Data were collected through VHA administrative databases. Differences in baseline characteristics and length of stay were assessed with two-sided t-tests or Wilcoxon Sign Rank tests for continuous variables and Pearson’s Chi-square or Fisher’s Exact tests for categorical outcomes. Differences in 30-day emergency room visit, 30-day readmissions and both 30-day and 1-year mortality were estimated with log binomial models adjusted for baseline characteristics and expressed as relative risk (RR).

RESULTS: Three thousand three hundred ninety Veterans met inclusion criteria, and 1730 (51%) underwent bariatric surgery within the VHA and 1660 (49%) within the community. VHA Veterans were younger (p = .035), comprised of fewer white (p < .001), more Hispanic (p < .001), more urban-residing individuals (p < .001), had less comorbidities (p = .026), lower BMI (p < .001), and shorter length of stay (p < .001) compared to community care Veterans. Compared to VHA, Veterans in the community were more likely to undergo Roux-en-Y (VHA: 46% vs. Community: 33%, p < .001) and less likely to undergo gastroplasty (VHA: 67% vs. Community: 54%, p < .001). Community care Veterans were less likely to have an emergency department visit within 30 days (Adjusted RR = 0.78, 95% Confidence Interval, 0.63-0.97, p < .001) but did not have statistically significant differences in 30-day readmissions and neither 30-day nor 1-year mortality.

CONCLUSION: Despite the increased risk in 30-day emergency department visits among VHA Veterans following bariatric surgery, morbidity and mortality are comparable between VHA and community care Veterans. Further investigation accounting for consult timeliness and cost should be conducted to fully evaluate differences in quality and access to care.

PMID:40954377 | DOI:10.1007/s00464-025-12148-8

Behav Res Methods. 2025 Sep 15;57(10):287. doi: 10.3758/s13428-025-02746-8.

ABSTRACT

Cohen’s and Fleiss’ kappa are well-known measures of inter-rater agreement, but they restrict each rater to selecting only one category per subject. This limitation is consequential in contexts where subjects may belong to multiple categories, such as psychiatric diagnoses involving multiple disorders or classifying interview snippets into multiple codes of a codebook. We propose a generalized version of Fleiss’ kappa, which accommodates multiple raters assigning subjects to one or more nominal categories. Our proposed κ statistic can incorporate category weights based on their importance and account for hierarchical category structures, such as primary disorders with sub-disorders. The new κ statistic can also manage missing data and variations in the number of raters per subject or category. We review existing methods that allow for multiple category assignments and detail the derivation of our measure, proving its equivalence to Fleiss’ kappa when raters select a single category per subject. The paper discusses the assumptions, premises, and potential paradoxes of the new measure, as well as the range of possible values and guidelines for interpretation. The measure was developed to investigate the reliability of a new mathematics assessment method, of which an example is elaborated. The paper concludes with a worked-out example of psychiatrists diagnosing patients with multiple disorders. All calculations are provided as R script and an Excel sheet to facilitate access to the new κ statistic.

PMID:40954368 | DOI:10.3758/s13428-025-02746-8

J Imaging Inform Med. 2025 Sep 15. doi: 10.1007/s10278-025-01669-2. Online ahead of print.

ABSTRACT

Fractal analysis (FA) is a mathematical method used to evaluate irregular and complex shapes. The numerical result obtained from FA is called fractal dimension (FD). FA can detect subtle bone changes in diseases that affect bone microstructures such as temporomandibular disorder (TMD), even when these changes are not visible on radiographs. It provides objective results that can improve clinical diagnosis without creating extra burden for patients. This study aimed to evaluate the relationship between FD values and both the severity of TMD and degenerative changes in temporomandibular joints (TMJ). Specifically, we aimed to assess the diagnostic capacity of FA for TMD. This study included 161 participants. The presence and severity of TMD in the participants were evaluated using the Fonseca Anamnestic Index (FAI). Degenerative bone changes in the participants’ mandibular condyles were categorized as flattening, osteophytes, and erosion on panoramic radiographic Images. FA was performed using ImageJ 1.49 software on panoramic radiographs. Data were analyzed using independent samples t-test and one-way ANOVA. Post hoc multiple comparisons were evaluated with the least significant difference test (LSD). Statistical significance was considered at p < 0.05. The severe TMD group had the lowest mean FD value (1.36 ± 0.11), whereas the group with no TMD (1.48 ± 0.11) had the highest mean FD value. In each case, the mean FD value was found to be statistically significantly lower in participants with flattening, osteophyte, or erosion than in those without (p < 0.001 for each comparison). Our main findings suggest that FD values were significantly associated with both the severity of TMD and with each type of degenerative bone changes we investigated. FA may provide valuable, quantitative information to improve the diagnosis of TMD. As such, FA may support clinicians in making early and accurate diagnoses and treatment decisions.

PMID:40954366 | DOI:10.1007/s10278-025-01669-2