Tag: statistics

Pharmacoecon Open. 2025 Nov 8. doi: 10.1007/s41669-025-00615-w. Online ahead of print.

ABSTRACT

OBJECTIVES: To identify health utility decrements of injection treatment-related attributes among patients with type 2 diabetes mellitus (T2DM) in China.

METHODS: Health states of four attributes (hypoglycemia, dose frequency, flexibility and injection site reaction) were generated using a vignette-based method. Patients with T2DM were recruited from eight cities in China. The sample was broadly consistent with Chinese T2DM population with regard to age and sex distribution. Respondents completed seven time trade-off (TTO) tasks during face-to-face interviews. The ordinary least square (OLS), fixed effects (FE) and random effects (RE) models were used for TTO data. In subgroup analysis, groups were categorized based on whether injection treatment was currently used, number of medications, needle phobia, duration of injectable treatment and travel frequency.

RESULTS: A total of 400 patients (52.75% male, mean [SD] age 50.30 [12.05] years) were included in this study. Severe hypoglycemia had the largest disutility value of all attributes (-0.023, P < 0.001). Three times daily, twice daily and once daily injection (needed to be carried with the patient on short trips) were associated with -0.023 (P < 0.001), -0.018 (P < 0.001) and -0.011 (P = 0.022) disutility values compared with once weekly injection (not required to be carried with the patient on short trips), respectively. The disutility value associated with injection site reaction attribute was -0.013 (P < 0.001). In subgroup analysis, the relative importance of treatment-related attributes was found to depend on patient characteristics.

CONCLUSIONS: This study provides disutility values associated with several injection treatment-related attributes for Chinese patients with T2DM. Hypoglycemia appears to be the most important attribute, followed by dose frequency, flexibility and injection site reaction.

PMID:41205032 | DOI:10.1007/s41669-025-00615-w

Clin Drug Investig. 2025 Nov 8. doi: 10.1007/s40261-025-01497-w. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Anemia is a serious heath concern due to its high prevalence in the global population. Its occurrence in surgical patients varies greatly and correlates with worse outcomes. Higher costs and severe complications could also result from insufficient iron status. An effective way to mitigate the burden of iron deficiency could be the adoption of national patient blood management (PBM) programs. This study aimed to quantify the potential health economic benefits of implementing preoperative anemia management (the first pillar of PBM) with ferric carboxymaltose (FCM) in Romanian hospitals.

METHODS: An already published decision-tree-based health economic model was adapted and populated with Romanian cost and epidemiological data from 2019. Cardiac (coronary artery bypass grafting) and non-cardiac (hip and knee arthroplasty) elective surgery cases were analyzed. Costs of complications per discharged case were assessed on the basis of data from ten local hospitals.

RESULTS: A total of 14,641 cases met the inclusion criteria. On the basis of our sample of ten hospitals, the complication costs per case ranged from €1067.43 (for stroke) to €2896.14 (for sepsis with pneumonia). The health economic model simulated two scenarios. In the first scenario, all cases with anemia received FCM treatment. The total savings at the national level total were at least €1,500,875. In the second scenario half of the cases with anemia received treatment, resulting in savings of €363,779.

CONCLUSIONS: Our results suggest that introducing iron deficiency anemia treatment with FCM in case of elective surgical interventions results in considerable cost reduction for the healthcare system.

PMID:41205029 | DOI:10.1007/s40261-025-01497-w

Odontology. 2025 Nov 8. doi: 10.1007/s10266-025-01249-4. Online ahead of print.

ABSTRACT

Monolithic zirconia has become increasingly popular in prosthodontics due to its favorable mechanical and esthetic properties. However, exposure to acidic conditions, such as simulated gastric acid, may compromise its optical and surface characteristics. This in vitro study aimed to evaluate the effects of three different surface modification technique mechanical polishing, polishing followed by glaze application, and polishing followed by zirconia-silica coating on the color stability and surface roughness of monolithic zirconia under acidic and neutral conditions. Forty-eight monolithic zirconia specimens were randomly assigned to six groups according to the surface modification technique and immersion medium (distilled water or simulated gastric acid). Color differences (ΔE₀₀) were calculated using the CIEDE2000 formula, and surface roughness was assessed using Atomic Force Microscopy (AFM). Data were analyzed using two-way ANOVA and Tukey’s HSD post hoc test (α = 0.05). Surface modification technique significantly affected ΔE₀₀ values (p = 0.00015), whereas neither the immersion medium nor the interaction between the two factors was statistically significant. The mechanically polished group exhibited the highest color change. Regarding surface roughness, exposure to acidic conditions resulted in smoother surfaces in the mechanically polished and polished + glaze groups, whereas an increase in roughness was observed in the zirconia-silica-coated group. Surface modification techniques play a critical role in the esthetic and structural integrity of monolithic zirconia restorations. Glazing and zirconia-silica coating improved color stability and maintained surface characteristics more effectively than mechanical polishing alone. The influence of solution pH was minimal. These findings support the use of appropriate finishing techniques to enhance the clinical longevity of zirconia restorations.

PMID:41205026 | DOI:10.1007/s10266-025-01249-4

Odontology. 2025 Nov 8. doi: 10.1007/s10266-025-01255-6. Online ahead of print.

ABSTRACT

This study aimed to evaluate the influence of root fusion on internal root morphology in maxillary second molars by comparing teeth with fused and independent roots using micro-computed tomography (micro-CT), in terms of inter-orifice distances, lateral and accessory canal distribution, apical anatomy, isthmus prevalence, and type. Three hundred extracted maxillary second molars were classified as having fused or independent roots and scanned using micro-CT. Linear distances between canal orifices, vertical position of MB2, isthmus types, and canal ramifications were analyzed. ROC analysis was performed to determine the diagnostic utility of inter-orifice distances in predicting root fusion. Statistical comparisons between groups were made using independent samples t-tests and Chi-square tests with a significance threshold of 5%. Fused roots showed significantly shorter MB1-P and DB-P distances compared to independent roots (p < 0.05). Cutoff values of 3.87 mm (MB1-P) and 3.38 mm (DB-P) demonstrated high sensitivity and specificity, respectively, for predicting fusion. The MB1-MB2 distance was not diagnostically useful (AUC < 0.5). Fused roots exhibited more bifid apices and a significantly higher number of apical foramina in mesiobuccal roots (p < 0.05). Independent roots had a higher number of accessory canals, particularly in MB roots. Type IV (isthmus without boundaries) isthmuses were more prevalent in the fused roots (p < 0.05). Fused roots exhibit distinct anatomical features compared to independent roots. Inter-orifice distances involving the palatal orifice may assist in identifying root fusion and anticipating complex canal configurations during endodontic treatment. Inter-orifice distances involving the palatal orifice (MB1-P, DB-P) were shorter in fused maxillary second molars in this ex vivo sample. Fused molars also tend to have more intricate anatomy with more bifid apices, higher mesiobuccal apical foramina counts, fewer accessory canals, and a greater prevalence of Type IV isthmuses compared with independent-rooted counterparts in the examined population.

PMID:41205025 | DOI:10.1007/s10266-025-01255-6

Med Biol Eng Comput. 2025 Nov 8. doi: 10.1007/s11517-025-03473-0. Online ahead of print.

ABSTRACT

Monitoring maternal and fetal health during pregnancy is crucial for preventing adverse outcomes. While tests such as ultrasound scans offer high accuracy, they can be costly and inconvenient. Telehealth solutions and more accessible body shape information provide pregnant women with a convenient way to monitor their health. This study explores the potential of 3D body scan data, captured during the 18-24 gestational weeks, to predict adverse pregnancy outcomes and estimate clinical parameters. We developed a novel algorithm with two parallel streams which are used for extract body shape features: one for supervised learning to extract sequential abdominal level circumference information, and the other for unsupervised learning to extract global shape descriptors, alongside a branch incorporating shape-related demographic data. Our results demonstrated that 3D body shapes can support the prediction of preterm labor and gestational diabetes mellitus (GDM), as well as the estimation of fetal weight. Compared to other machine learning models, our algorithm achieved the best performance, with prediction accuracies exceeding 89% and fetal weight estimation accuracy of 72.22% within a 10% error margin, outperforming the conventional anthropometric measurements-based method by 18.18%.

PMID:41205023 | DOI:10.1007/s11517-025-03473-0

Graefes Arch Clin Exp Ophthalmol. 2025 Nov 8. doi: 10.1007/s00417-025-07019-w. Online ahead of print.

ABSTRACT

PURPOSE: To study intricate relationship between drusen volume and evolving dynamics of retinal and choroidal vasculature in dry age-related macular degeneration (AMD).

METHODS: Patients underwent swept-source optical coherence tomography angiography (SS-OCTA) using Plex Elite 9000 device. Retinal thickness, retinal vessel perfusion, drusen volume, choroidal thickness (ChT), choroidal vascularity index (CVI), choroidal vessel diameters (MChVD), and intervessel distance (IVD) were assessed. The Advanced Research and Innovation (ARI) Network, ResUNet model, and Phansalkar thresholding were utilized for image analysis. The linear mixing model was used for the statistical analysis.

RESULTS: We assessed 53 eyes from 40 patients with dry AMD (22 eyes with early-stage, 31 eyes with intermediate-stage eyes). The mean age was 75.25 years and 62.5% were females. The mean LogMar visual acuity was 0.09 ± 0.17 standard deviation (SD) in early-stage and 0.19 ± 0.14 SD in intermediate-stage (p = 0.03). Mean drusen volume was 0.075 ± 0.125 SD mm³ in early-stage and 0.24 ± 0.26 SD mm³ in intermediate-stage (p = 0.005). Mean ChT was thicker, and mean CVI was higher in the early-stage compared to the intermediate-stage (p < 0.05). A decrease of 11.48 μm in MChVD for every 1 mm³ increase in drusen volume was noted.

CONCLUSION: With increase in drusen volume, a reduction in CVI and MChVD was noted, without any significant association with changes in retinal metrics, suggesting that choroidal vessels may exhibit early changes during disease progression.

PMID:41204997 | DOI:10.1007/s00417-025-07019-w

Environ Monit Assess. 2025 Nov 8;197(12):1311. doi: 10.1007/s10661-025-14703-1.

ABSTRACT

This study examines the presence and distribution of persistent organic pollutants (POPs) in the liver tissues of six Procellariiformes species collected from beach-cast individuals along the Rio Grande do Sul coast during their migration in the South Atlantic and the blood of brown booby (Sula leucogaster) sampled from a resident breeding population at the São Pedro and São Paulo Archipelago. POPs, including PCBs, DDTs, and Mirex, pose significant threats to marine ecosystems due to their persistence and bioaccumulative nature. Procellariiformes, such as albatrosses and petrels, and Suliformes, such as Sula leucogaster, are particularly vulnerable due to their high position in the food webs and high longevity. This study assesses the relative contributions of different POPs, identifies shifts in contamination profiles, and explores ecological factors driving variations in POP concentrations. Among Procellariiformes, no statistically significant differences were detected in POP concentrations between the taxonomic groups, suggesting shared exposure pathways in overlapping marine habitats. However, Shearwaters exhibited higher median PCB and Mirex levels compared to other groups. In contrast, S. leucogaster displayed a distinct contamination profile dominated by PCBs and DDTs, reflecting its specific foraging behaviors and tropical habitat. The predominance of highly chlorinated PCB congeners in S. leucogaster and Procellariiformes suggests long-range atmospheric transport as a significant source of contamination. These findings highlight the ecological role of multiple species of seabirds as sentinel species and underscore the need for ongoing monitoring of legacy POPs in tropical and subtropical ecosystems to inform conservation strategies.

PMID:41204991 | DOI:10.1007/s10661-025-14703-1

J Biopharm Stat. 2025 Nov 8:1-27. doi: 10.1080/10543406.2025.2575941. Online ahead of print.

ABSTRACT

This study presents a comprehensive evaluation of Bayesian meta-analysis methods for estimating odds ratios (ORs), with a focus on the impact of heterogeneity and prior distribution choices under varying conditions. Recognizing the limitations of frequentist approaches, especially in small-sample or rare-event scenarios, we implemented a Bayesian framework utilizing four different priors for heterogeneity: half-normal, exponential, half-Cauchy, and inverse-gamma. Simulation studies were conducted across 1,152 scenarios, varying the number of studies, event rarity, randomization ratios, and baseline risks. Results indicate that prior specification and study size substantially influence estimation accuracy, particularly for rare events. To further explore these interactions, CHAID (Chi-square Automatic Interaction Detection) analysis, which effectively identified key factors affecting model performance, is implemented. CHAID revealed that the number of studies included in the meta-analysis (NSMA) is the most significant determinant of estimation reliability, while other variables such as event type and randomization ratio exert notable influence under specific conditions. CHAID also facilitated the categorization of OR estimation quality and heterogeneity levels, offering a powerful visual and interpretive aid. Overall, this study underscores the importance of prior selection in Bayesian meta-analysis and highlights CHAID analysis as a valuable complementary tool for uncovering complex interactions and enhancing result interpretability.

PMID:41204818 | DOI:10.1080/10543406.2025.2575941

Proteins. 2025 Nov 8. doi: 10.1002/prot.70079. Online ahead of print.

ABSTRACT

Biomolecules rely on water and ions for stable folding, but these interactions are often transient, dynamic, or disordered and thus hidden from experiments and evaluation challenges that represent biomolecules as single, ordered structures. Here, we compare blindly predicted ensembles of water and ion structure to the cryo-EM densities observed around the Tetrahymena ribozyme at 2.2-2.3 Å resolution, collected through target R1260 in the CASP16 competition. Twenty-six groups participated in this solvation “cryo-ensemble” prediction challenge, submitting over 350 million atoms in total, offering the first opportunity to compare blind predictions of dynamic solvent shell ensembles to cryo-EM density. Predicted atomic ensembles were converted to density through local alignment and these densities were compared to the cryo-EM densities using Pearson correlation, Spearman correlation, mutual information, and precision-recall curves. These predictions show that an ensemble representation is able to capture information of transient or dynamic water and ions better than traditional atomic models, but there remains a large accuracy gap to the performance ceiling set by experimental uncertainty. Overall, molecular dynamics approaches best matched the cryo-EM density, with blind predictions from bussilab_plain_md, SoutheRNA, bussilab_replex, coogs2, and coogs3 outperforming the baseline molecular dynamics prediction. This study indicates that simulations of water and ions can be quantitatively evaluated with cryo-EM maps. We propose that further community-wide blind challenges can drive and evaluate progress in modeling water, ions, and other previously hidden components of biomolecular systems.

PMID:41204761 | DOI:10.1002/prot.70079

ANZ J Surg. 2025 Nov 7. doi: 10.1111/ans.70374. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to validate the Emergency Surgery Acuity Score (ESAS) in Korean patients who underwent emergency general surgery (EGS) and evaluate its effectiveness in predicting various outcomes.

DESIGN: Retrospective cohort study.

SETTING: Two tertiary hospitals in South Korea.

PARTICIPANTS: This study included 1629 adults who underwent EGS between July 2014 and December 2019.

PRIMARY AND SECONDARY OUTCOME MEASURES: The ESAS and its abbreviated version, the Physiological Emergency Surgery Acuity Score (P-ESAS), were calculated for each patient. Predictive performance was assessed for 28-day mortality, post-operative complications, intensive care unit (ICU) admission, and hospital length of stay (LOS). C-statistics were used to compare ESAS with P-ESAS and other scoring systems, including the Charlson Comorbidity Index (CCI). Logistic regression models were employed to identify independent predictors of 28-day mortality, incorporating clinically relevant covariates such as demographic characteristics, comorbidities, physiological parameters, and surgical factors.

RESULTS: The ESAS and P-ESAS demonstrated superior predictive abilities compared to the Charlson Comorbidity Index (CCI) across clinical outcomes. For 28-day mortality, the c-statistics were 0.917 for ESAS, 0.897 for P-ESAS, and 0.691 for CCI. Both ESAS and P-ESAS outperformed CCI in predicting post-operative complications (c-statistics: 0.701, 0.677, and 0.637, respectively) and ICU admission (c-statistics: 0.777, 0.737, and 0.645, respectively). Linear regression analysis revealed a significant relationship between ESAS and hospital length of stay (LOS = 2.96 × ESAS; p < 0.001, adjR² = 0.430). Both ESAS and P-ESAS were identified as significant independent predictors of 28-day mortality in multivariable analyses.

CONCLUSION: The ESAS is validated as an effective tool for predicting 28-day mortality, post-operative complications, ICU admission, and hospital LOS in Korean patients undergoing emergency general surgery. Its predictive performance compared to other scoring systems highlights its potential to improve risk stratification and resource management in emergency surgery settings.

PMID:41204760 | DOI:10.1111/ans.70374