Tag: statistics

Int J Health Geogr. 2025 Dec 21. doi: 10.1186/s12942-025-00441-7. Online ahead of print.

ABSTRACT

BACKGROUND: Suicide remains a major public health concern worldwide, responsible for more than 700,000 deaths in 2021, accounting for approximately 1.1% of all global deaths. While many high-income countries have reported declines in age-standardized suicide rates over the past two decades, recent evidence from Spain indicates increasing mortality among women, whereas suicide rates among men have remained relatively stable. To better understand these patterns and their potential underlying determinants, this study examines the spatial and temporal patterns of age-stratified suicide mortality across Spanish provinces from 2010 to 2022, with particular attention to sex-specific differences.

METHODS: Mixed Poisson models were applied to analyze provincial- and temporal-level suicide mortality rates, stratified by age and sex. The models accounted for spatial and temporal confounding effects and examined associations with various socioeconomic and contextual factors, including rurality and unemployment.

RESULTS: Findings highlight the influence of rurality and unemployment on suicide mortality, with distinct gender-specific patterns. A 10% increase in the proportion of residents living in rural areas was associated with more than a 5% rise in male suicide mortality, while a 1% increase in the annual unemployment rate was linked to a 2.4% increase in female suicide mortality. Although male suicide rates remained consistently higher than female rates, a notable and steady upward trend was observed in female suicide mortality over the study period.

CONCLUSIONS: The use of sophisticated statistical models permits the detection of underlying patterns, revealing both geographic and temporal disparities in suicide mortality across Spanish provinces.

PMID:41423620 | DOI:10.1186/s12942-025-00441-7

Nat Commun. 2025 Dec 21. doi: 10.1038/s41467-025-67800-7. Online ahead of print.

ABSTRACT

The role of the gut microbiota in carcinogenesis is increasingly being acknowledged. Recent studies in multiple breast cancer mouse models have found that antibiotics, by altering the gut microbiota, can accelerate tumour growth. In humans, a recent cohort study restricted to triple negative breast cancer showed that breast cancer patients using a greater number of antibiotics had markedly worse survival. These studies have raised concerns about repeated antibiotic use in breast cancer patients. In this Registered Report, we investigated whether breast cancer patients using oral antibiotics had increased breast cancer-specific mortality. In population-based cohorts (n = 44,452), we did not observe a statistically significant association between antibiotic prescriptions after diagnosis and breast cancer-specific mortality (adjusted HR = 1.07 95% CI 0.87, 1.33) apart from prescriptions of 12 or more antibiotics (adjusted HR = 1.62 95% CI 1.31, 2.01). This association was weaker after adjustment for infections (adjusted HR = 1.44 95% 1.14, 1.81), when restricted to antibiotics within five years (adjusted HR = 1.33 95% 0.95, 1.84), and was similar for deaths from other causes (adjusted HR = 1.69 95% 1.19, 2.41). Frequent antibiotic users had higher cancer-specific mortality but the attenuation of associations in sensitivity analyses, and similar findings for other causes of death, suggest this increase may reflect residual confounding. Protocol registration: The Stage 1 protocol for this Registered Report was accepted in principle on 7 November 2023. The protocol, as accepted by the journal, can be found at https://doi.org/10.6084/m9.figshare.24746721.v1.

PMID:41423616 | DOI:10.1038/s41467-025-67800-7

Clin Rheumatol. 2025 Dec 22. doi: 10.1007/s10067-025-07861-7. Online ahead of print.

ABSTRACT

BACKGROUND: Fibromyalgia syndrome (FMS) and irritable bowel syndrome (IBS) frequently coexist, compounding disease burden and complicating treatment approaches. Despite the prevalence of this comorbidity, evidence on effective management strategies remains scarce.

OBJECTIVE: This systematic review evaluates the efficacy and safety of oral pharmacological and dietary interventions for patients diagnosed with both FMS and IBS, following PRISMA guidelines.

METHODS: A systematic literature search was performed on September 12, 2024, utilizing the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (PubMed), Web of Science, EMBASE, and Ovid to identifying randomized control trials evaluating interventions for FMS comorbid with IBS. The outcome encompassed pain reduction, global well-being, depressive symptoms, health-related quality of life, and safety profiles.

RESULTS: The initial search yielded 784 studies, with 364 retrieved after applying inclusion criteria. Following duplicate removal and further screening, five randomized control trials met eligibility criteria. Of these, three were included in the meta-analysis. These trials investigated the effects of pharmacological agents, dietary modifications, and probiotics on pain and quality-of-life measures in patients with FMS-IBS comorbidity. Meta-analysis showed a statistically significant reduction in pain Visual Analog Scale (VAS) scores in groups receiving cyclobenzaprine and pregabalin, while probiotics demonstrated no significant benefit over placebo. Dietary interventions showed mixed results, providing symptom relief in selected patients. Adverse effects were highest in the cyclobenzaprine 30 mg group but were generally well tolerated in other interventions.

CONCLUSION: Pharmacological treatments appear effective in reducing pain associated with FMS and IBS. Dietary interventions, such as monosodium glutamate (MSG) elimination, may benefit specific subgroups, while probiotics showed limited efficacy.

PMID:41423615 | DOI:10.1007/s10067-025-07861-7

Appl Neuropsychol Adult. 2025 Dec 21:1-9. doi: 10.1080/23279095.2025.2602865. Online ahead of print.

ABSTRACT

BACKGROUND: This study used a network meta-analysis to evaluate the efficacy of transcranial direct current stimulation (tDCS) with different stimulation modes in the treatment of post-stroke aphasia (PSA) and ranked them.

METHODS: The author searched PubMed, EMbase, The Cochrane Library, Web of Science, CBM, CNKI, Wanfang, and VIP databases from database inception to July, 22, 2025, for randomized controlled trials (RCT) of tDCS for patients with PSA. The risk of bias assessment tool for RCT was used. The quality of the literature was independently evaluated and validated.

FINDINGS: The assessment included seven items: random sequence generation, allocation concealment, blinding of participants and investigators, blinding of outcome assessors, completeness of outcome measures, selective reporting, and other bias. Each item was graded as high risk, low risk, or unclear. All study data were well-integrity and no selective reporting occurred; no other bias was reported in any RCT. All included studies used efficacy rate to evaluate efficacy. A meta-analysis was performed on 10 studies, and the heterogeneity test I0 = 0, it was considered that the studies were homogeneous. The effective rate of the treatment group was significantly better than that of the control group, and the difference was statistically significant.

PMID:41422488 | DOI:10.1080/23279095.2025.2602865

J Adv Nurs. 2025 Dec 21. doi: 10.1111/jan.70461. Online ahead of print.

ABSTRACT

AIM: To explore the relationship between social determinants of health and adherence to lifestyle recommendations, and how these determinants can help explain contextual and interpersonal factors contributing to adherence among individuals with prediabetes.

DESIGN: Explanatory sequential mixed methods study integrating a cross-sectional quantitative analysis with an ethnomethodological qualitative approach grounded in critical social paradigm.

METHODS: The quantitative phase used data from the intervention arm (n = 86) of the PREDIPHONE trial, a randomised controlled study evaluating the effectiveness of a nurse-led telephone intervention for lifestyle changes in glycaemic control. Adherence was measured using a composite index, analysed as both a continuous and categorical variable. Correlation analysis examined adherence and age. Chi-square and ANOVA tests were used to analyse differences in participant characteristics across adherence quartiles. The qualitative phase included individual semi-structured interviews and a focus group with participants showing high or low adherence. Thematic content and discourse analysis were employed, ensuring validity through triangulation, reflexivity and discourse saturation.

RESULTS: Employment status was identified as a significant factor, with unemployed or retired participants showing better adherence. Although no statistical differences in adherence were found by social class or gender, lower social class participants reported financial barriers to healthy eating and time constraints limiting physical activity (PA). Women reported facing greater challenges due to caregiving responsibilities, whereas men benefited from household support.

CONCLUSIONS: Employment status emerged as a determinant of time availability for self-care, alongside social class and gender in adherence to lifestyle modifications. Women, especially those from lower social classes, experienced heightened barriers to adherence, underscoring the need for tailored, gender-sensitive and equity-focused interventions.

IMPLICATIONS: Addressing social determinants is essential for effective lifestyle advice among individuals with prediabetes.

IMPACT: The study highlights the role of social class and gender in adherence.

REPORTING METHOD: STROBE and COREQ guidelines.

PATIENT CONTRIBUTION: Through interviews and focus group.

PMID:41422485 | DOI:10.1111/jan.70461

Clin Pharmacol Ther. 2025 Dec 21. doi: 10.1002/cpt.70180. Online ahead of print.

ABSTRACT

In recent years, different national and international regulatory authorities, notably the FDA, have made their adverse event repositories publicly available, offering user-friendly dashboards. This has led to a large increase in low-quality, poorly reported research using adverse event reporting databases (e.g., FDA’s Adverse Event Reporting System [FAERS]). Such publications producing thousands of statistical associations erroneously presented as “safety signals” can create unscientifically grounded alarm with considerable impact on healthcare provider practices and patient behaviors.

PMID:41422480 | DOI:10.1002/cpt.70180

J Community Health. 2025 Dec 21. doi: 10.1007/s10900-025-01546-7. Online ahead of print.

ABSTRACT

Although the Hispanic/Latino/Latina immigrant population group has been documented to use a higher number of herbs, spices and supplements, research findings on this topic are still insufficient. This study aimed to evaluate the supplements chosen by Hispanic/Latino/Latina immigrants in relation to their evidence for use in the literature as well as the number of herbs and spices used. This cross-sectional study utilized convenience sampling to survey 62 Hispanic/Latino/Latina immigrants in central Indiana. The research collected data regarding herbs and spice consumption, supplement usage and beliefs, therapeutic diet practices, disease history, and food frequency information. Dietary supplement use was more prevalent among females and individuals with a high school education. A statistically significant difference between male and female participants was observed regarding the use of green tea supplements, as well as all herbal products and single vitamins combined (p <.001). Significant associations were also found when comparing individuals with bone and joint (p =.030), cardiovascular (p =.024), gastrointestinal (p =.031), and endocrine diseases (p =.020) to those adhering to a special diet. There was a lack of evidence supporting supplement use based on research findings. These results suggest for the need of supplement and therapeutic diet use education in the Hispanic/Latino/Latina population residing in the United States. Further research is needed to advance these findings.

PMID:41422467 | DOI:10.1007/s10900-025-01546-7

Eur Radiol. 2025 Dec 21. doi: 10.1007/s00330-025-12226-4. Online ahead of print.

ABSTRACT

OBJECTIVES: The average wall thickness of a theoretical airway with a lumen perimeter of 10 mm (Pi10) and the slope of the luminal perimeter of airways against their wall thickness (PiSlope) are CT-derived biomarkers of airway remodeling in chronic obstructive pulmonary disease (COPD). However, numerous calculation methods for Pi10 have been used across studies, leading to substantial variability in Pi10 values. This study evaluated reliability among 10 Pi10/PiSlope methodologies and their associations with lung function.

MATERIALS AND METHODS: CanCOLD participants underwent full-inspiration CT scans; CT airway segmentation was performed using VIDA software. Ten literature-based methods were used to calculate Pi10 (regression-derived wall thickness at 10 mm perimeter) and PiSlope (slope of wall area/perimeter plot). The 10 methods varied in their approaches: some focused on specific airway sizes (Patel, Van Tho, Nakano, Telenga), others limited measurements to certain airway generations (Gietema, Park, Dudurych) or covered broader airway size ranges and generations (Bhatt, Jobst, Smith). Reliability was assessed via intraclass correlation (ICC); lung function associations were assessed using regression.

RESULTS: Pi10 and PiSlope were calculated for 1351 participants (67 ± 10 years; 550 women). Pi10 and PiSlope measurement methods with higher airway counts (Patel, Nakano, Smith, Jobst, Bhatt) showed excellent reliability (ICC > 0.90, p < 0.05). Compared to Pi10, PiSlope demonstrated stronger, consistent negative associations with FEV1, FEV1/FVC, and FEF_25-75% across all methods, especially in those with fewer airways.

CONCLUSION: These results provide insight into which Pi10/PiSlope calculation methods may generate more reliable findings and indicate PiSlope may provide a more comprehensive measure of airway remodeling in COPD.

KEY POINTS: Question CT Pi10/PiSlope measures airway remodeling in COPD, but calculation methods vary. Are CT Pi10/PiSlope reliable and provide comparable associations with lung function across various methodologies? Findings Pi10/PiSlope calculation methods that included a higher number of CT airways were more reliable, and PiSlope showed stronger associations with lung function than Pi10. Clinical relevance These results provide insight into which methods may generate more reliable findings, aiding interpretation of results between studies, and support the potential of PiSlope as a reliable biomarker for monitoring airway remodeling in COPD.

PMID:41422440 | DOI:10.1007/s00330-025-12226-4

Eur J Dent Educ. 2025 Dec 21. doi: 10.1111/eje.70081. Online ahead of print.

ABSTRACT

INTRODUCTION: Preformed metal crowns (PMCs) and pulpotomies are established treatments for carious lesions in primary molars. Despite their effectiveness, variability in knowledge and clinical experience amongst dental students has been reported. This study aimed to evaluate the knowledge and perceptions of Dutch dental students at the Academic Centre for Dentistry in the dental school of Amsterdam (ACTA). Regarding PMCs and pulpotomies in primary molars.

MATERIALS AND METHODS: A cross-sectional questionnaire study was conducted amongst second-to-final year dental students at Academic Centre for Dentistry in the dental school of Amsterdam (ACTA). The 23-item questionnaire addressed knowledge, perceived curriculum coverage, and clinical/preclinical experience. Descriptive statistics and Spearman correlation tests were used (α = 0.05).

RESULTS: Out of 120 invited students, 98 (81.6%) responded. While 75.5% of students considered the curriculum adequate for teaching PMCs, 84.7% felt that pulpotomies were insufficiently addressed. All students were familiar with the Hall Technique, and 50% had placed a PMC preclinically. Fewer students had clinical experience: 19.4% had placed a PMC and 9.2% had performed a pulpotomy. A positive correlation was found between preclinical and clinical PMC placement (Spearman’s rho = 0.33, p = 0.0007).

DISCUSSION: Whilst students received appropriate training regarding the use of PMCs, both in theory and practice, exposure to pulpotomy procedures remains limited.

CONCLUSIONS: Most dental students in Amsterdam demonstrated appropriate knowledge, preclinical experience and understanding of indications for PMCs compared to performing a pulpotomy. Therefore, greater emphasis should be placed on both the theoretical and practical aspects of pulpotomy.

PMID:41422420 | DOI:10.1111/eje.70081

Pediatr Emerg Care. 2025 Dec 22. doi: 10.1097/PEC.0000000000003537. Online ahead of print.

ABSTRACT

BACKGROUND: Incision and drainage (I&D) is the standard treatment for pediatric abscesses. However, discrepancies between estimated abscess volume, determined clinically or by point-of-care ultrasound (POCUS), and the actual volume expressed may result from poor ultrasound or I&D technique. These discrepancies may lead to inappropriate management decisions and unnecessary procedures.

OBJECTIVE: To determine the prevalence of discrepancies between estimated and expressed abscess volumes during pediatric I&D.

METHODS: We conducted a cross-sectional chart review at a tertiary care pediatric emergency department (ED) between 2017 and 2023. Patients younger than or qual to 21 years with an attempted I&D were identified using a natural language processing tool. We focused on 2 groups based off of documented abscess diameter: predicted volumes of ≤1 mL and ≥10 mL. Per author discretion, these values correspond with decision-making of ‘not worth pursuing I&D’ and ‘definitely worth pursuing I&D’, respectively. We considered a positive discrepancy if for an expected abscess volume of ≤1 mL, the documented volume expressed was ≥10 mL (underestimated), and if for an expected volume of ≥10 mL, the documented volume was ≤3 mL (overestimated). Prevalence and confidence intervals were calculated using descriptive statistics.

RESULTS: Among 653 patients, 13.2% of sonographic and 7.6% of clinical estimates underestimated abscess volume, whereas 2.3% of sonographic and 19.6% of clinical estimates overestimated abscess volume. Combined assessment reduced discrepancies to 5.2% underestimated and 1.2% overestimated.

CONCLUSIONS: Combining clinical with POCUS assessment of pediatric abscesses provides better prediction of volume than reliance on a single method potentially reducing unnecessary procedures and missed I&D opportunities.

PMID:41422417 | DOI:10.1097/PEC.0000000000003537