Tag: statistics

Thorac Cancer. 2025 Jun;16(12):e70116. doi: 10.1111/1759-7714.70116.

ABSTRACT

BACKGROUND: Repeated anatomical pulmonary resections in second primary nonsmall-cell lung cancer (NSCLC) pose significant challenges due to prior surgery. This study evaluates the feasibility and short-term outcomes of repeated anatomical pulmonary resections for second primary NSCLC.

METHOD: We retrospectively reviewed all consecutive cases of repeated anatomical pulmonary resections for second primary NSCLC performed in our institution from January 2014 to December 2023.

RESULTS: A total of 55 patients (median age 68 years; interquartile range [IQR]: 61.5-72) underwent repeated anatomical pulmonary resections for second primary NSCLC. Adenocarcinoma predominated in both primary (78.2%) and secondary (76.4%) cases. Video-assisted thoracoscopy (VATS) approach was used in 94.5% and 96.4% for first and repeated resection, respectively (p = 0.647). The extent of pulmonary resection differed between first and repeated resection, with a predominance of lobectomy during first resection (56.4%) and segmentectomy during repeated resection (85.5%, p < 0.001). We did not observe any significant difference in postoperative overall morbidity after first and repeated resection (23.6% vs. 40%, p = 0.065). However, there was an increased incidence of atrial fibrillation (16.4% vs. 0%) and prolonged air leak (> 5 days) after repeated resection (25.5% vs. 5.5%, p = 0.008). The median length of hospital stay was similar after first and repeated resection (5 vs. 5 days, p = 0.089). The three-year overall survival (OS) was 73% after first resection and 87% after repeated resection. Overall disease recurrence rate was not statistically different between first and repeated resection (1.8% vs. 3.6%, p = 0.558).

CONCLUSION: Our series demonstrated that second primary NSCLC can be safely managed by VATS segmentectomy, yielding favorable short-term survival and low recurrence rates.

PMID:40563142 | DOI:10.1111/1759-7714.70116

Ren Fail. 2025 Dec;47(1):2520903. doi: 10.1080/0886022X.2025.2520903. Epub 2025 Jun 25.

ABSTRACT

OBJECTIVES: The objectives of this study were to investigate the associations of single and mixed exposure to the environmental pollutants per- and polyfluoroalkyl substances (PFAS) with renal function and mortality in non-dialysis chronic kidney disease (CKD) patients.

METHODS: Non-dialysis CKD1-4 stage patients in the 2003-2018 US National Health and Nutrition Examination Survey (NHANES) who were ≥20 years old were included. Five PFAS were measured and all patients were followed up till 31 December 2019. Multivariate linear, logistic, and Cox regressions were used to evaluate the associations between PFAS exposure and renal function, mortality. Stratified subgroups were analyzed based on baseline characteristics. Bayesian kernel machine regression (BKMR) was used in sensitivity analysis.

RESULTS: Among 1503 CKD patients included, baseline renal function declined in 701 patients (44.4%) and 462 patients (24.9%) died during the follow-up. Single exposure to perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorononanoic acid (PFNA), and perfluorohexane sulfonic acid (PFHxS) was positively associated with renal function decline (p < .05). Mixed exposure to five kinds of PFAS was found to be associated with renal function decline. Restricted cubic spline (RCS) showed only PFOS had an inverted U-shaped association with renal function decline (p non-linear < .05). There was no statistically significant association between PFAS exposure and mortality. Urinary protein and drug use might interact with the associations between PFAS and renal function.

CONCLUSIONS: PFAS single and mixed exposure were closely related to renal function and renal progression in adult CKD patients. There was no statistically significant association between PFAS exposure and mortality.

PMID:40563132 | DOI:10.1080/0886022X.2025.2520903

BMC Public Health. 2025 Jun 25;25(1):2170. doi: 10.1186/s12889-025-23526-1.

ABSTRACT

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a growing public health issue in Egypt. Health literacy (HL) is a modifiable factor influencing diabetes risk (DR), but the pathways through which HL impacts diabetes risk remain unclear. This study aimed to examine the direct and indirect pathways linking HL to DR in a non-diabetic population.

METHODS: A cross-sectional study was conducted from July 2022 to August 2023 among employees in the administrative sectors of 16 faculties at Suez Canal University, Ismailia, Egypt. Each faculty was treated as a cluster for sampling. Eligible participants were those without a diagnosis of T2DM. Exclusion criteria included use of antidiabetic medications, cancer diagnosis, long-term corticosteroid or immunosuppressant use, or pregnancy. Sample size from each sector was determined proportionally based on the number of eligible employees, and participants were randomly selected from a coded list. Data were collected via structured face-to-face interviews using validated tools to assess HL, self-efficacy (SE), diabetes knowledge (DK), preventive health behaviors (PHB), and DR, measured by the ARABRISK score. Statistical analyses included Spearman correlations, non-parametric tests, and Structural Equation Modeling (SEM) via SAS PROC CALIS to assess direct and indirect pathways from HL to DR, controlling for significant covariates.

RESULTS: Of the participants, 59.4% had inadequate/problematic HL, and 54.8% had moderate-to-high DR. HL was positively correlated with DK (r = 0.275), SE (r = 0.379), and PHB (r = 0.514) and negatively correlated with DR (r=-0.542), all with p-values < 0.001. The strongest negative correlation was between PHB and DR (r=-0.957). SEM revealed a weak but significant direct effect of HL on DR (β= – 0.05108, p < 0.001). The most substantial indirect effect was observed through PHB (β= – 0.93663, p < 0.001). Additional indirect pathways through DK and SE also emerged, although SE had no significant effect on PHB.

CONCLUSIONS: HL reduces DR primarily through its effect on PHB. While DK and SE contribute, their effects are less pronounced. Interventions that enhance HL and support healthy behaviors may help prevent T2DM in at-risk populations. Future research should use longitudinal designs, diabetes-specific HL tools, objective risk measures; explore psychosocial mediators; and study diverse populations.

PMID:40563120 | DOI:10.1186/s12889-025-23526-1

Antimicrob Resist Infect Control. 2025 Jun 25;14(1):72. doi: 10.1186/s13756-025-01594-7.

ABSTRACT

BACKGROUND: Antimicrobial resistance (AMR) is a global health concern, particularly in low- and middle-income countries. As human behaviour plays a crucial role in the emergence and spread of resistance, data on the understanding of AMR awareness are very important for assessing the situation and developing effective interventions. The aim of this study was to analyse the knowledge, attitudes and practices (KAP) related to antibiotics and awareness towards antibiotic resistance among community members in two districts in Ghana, and Burkina Faso.

METHODS: A cross-sectional survey was used to collect data on socio-demographic, economic factors, and KAP. In Burkina Faso a simple randomization was carried out, whereas in Ghana we performed a double-stage randomization. The data was collected using an electronic data capture between February and March 2023 in Ghana, and from July to November 2023 in Burkina Faso. Data analysis employed descriptive statistics, and logistic regressions.

RESULTS: A total of 1,114 participants in Ghana and 1,011 in Burkina Faso were included. The majority knew the term “Antibiotic” (Ghana: n = 687, 61.67%; Burkina Faso: n = 767, 75.87%), but only a minority were aware of AMR (Ghana: n = 381, 34.2%; Burkina Faso: n = 270, 26.71%). In both countries, participants had a middle level of knowledge about antibiotics (Ghana: n = 597; 53.59%, Burkina Faso: n = 502, 49.65%), positive attitudes towards antibiotic utilization (Ghana: n = 702, 63.02%; Burkina Faso: n = 510, 50.45%), and most of them reported a responsible use of antibiotics (Ghana: n = 875, 78.55%; Burkina Faso: n = 713, 70.52%).

CONCLUSIONS: Despite familiarity with antibiotics, self-reported responsible use did not align with actual observed behaviours in both countries. Additionally, a significant lack of awareness about AMR highlights the need for a targeted educational intervention to enhance understanding of its risks and increase appropriate practices.

PMID:40563117 | DOI:10.1186/s13756-025-01594-7

Harm Reduct J. 2025 Jun 25;22(1):111. doi: 10.1186/s12954-025-01261-5.

ABSTRACT

BACKGROUND: Opioid agonist treatment (OAT) is the gold standard of care for patients living with opioid use disorder. Since 2016, efforts to expand OAT access have focused on primary care physicians. This study aimed to understand how OAT-prescribing-naïve primary care physicians who began prescribing OAT differed from their peers who did not.

METHODS: We used administrative health data to identify all patients eligible for OAT initiation between 1 January 2016 and 31 December 2019. We matched primary care visits that resulted in an OAT dispensation with visits that did not. We conducted logistic regression with generalized estimating equations to identify physician demographics and practice characteristics associated with becoming an OAT prescriber.

RESULTS: Of the 4253 primary care physicians who were OAT-prescribing-naïve before 2016, 2183 (51.3%) began prescribing OAT. Physicians who practiced in rural settings (aOR = 1.78, 95% CI: 1.32, 2.40) or saw fewer than 16 patients a day (aOR = 1.46, 95% CI: 1.21, 1.75) were more likely to become OAT prescribers. The likelihood of becoming an OAT prescriber declined with the proportion of visits delivered out of office (aOR = 0.20, 95% CI: 0.16, 0.26) and years since graduation (e.g., physicians who graduated between 2000-2009 were 20% less likely to initiate (aOR = 0.80, 95% CI: 0.64, 0.99) compared with peers who graduated since 2010).

CONCLUSIONS: Physicians who saw fewer patients and worked across fewer settings were more likely to become OAT prescribers. However, physicians in rural settings are stepping in to address unmet demand despite resource and time constraints. Understanding the differences between physicians who become OAT prescribers and peers who do not is critical to effectively target interventions to improve OAT access in the future.

PMID:40563109 | DOI:10.1186/s12954-025-01261-5

Hum Genomics. 2025 Jun 25;19(1):71. doi: 10.1186/s40246-025-00780-3.

ABSTRACT

INTRODUCTION: The successful implementation of pharmacogenetics (PGx) in many developed countries has significantly enhanced personalized care and improved both clinical and financial outcomes. This study was designed to evaluate the current knowledge, prevailing attitudes, and perceived ability of pharmacists to actively participate in the integration of PGx into their practice settings.

METHODS: A cross-sectional study was conducted among pharmacists in Yemen using convenience sampling. Data was collected through an online-based questionnaire using the Google Forms platform. Both descriptive and inferential analyses were employed.

RESULTS: With a total of 211 participants involved. Most participants held a bachelor’s degree in pharmacy (45%, n = 95). Approximately 70% of respondents reported having between one and five years of experience in pharmacy practice. About three-quarters of pharmacists showed high knowledge score regarding PGx (74.4%; 95% CI: 68.47 – 80.34), with overall pharmacists’ knowledge score had a median and IQR of 4( 3-5). The score of knowledge exhibited statistical significance in relation to participants’ years of professional experience (p = 0.005). Overall, pharmacists expressed positive attitudes toward PGx. The top two challenges reported for the adoption of PGx in practice were “high cost” and “limited availability of tests”. Additionally, about 70% agreed that they lacked knowledge about the specific PGx tests required.

CONCLUSION: Pharmacists exhibit promising attitudes towards PGx. Nevertheless, there is a clear need to reinforce their foundational knowledge and enhance their confidence in the practical application of PGx principles. Effective integration of personalized medicine will necessitate collaborative efforts among key stakeholders, including the Ministry of Health, academic institutions, and professional pharmacy associations.

PMID:40563094 | DOI:10.1186/s40246-025-00780-3

BMC Oral Health. 2025 Jun 25;25(1):958. doi: 10.1186/s12903-025-06245-2.

ABSTRACT

BACKGROUND: There are no studies investigating the role of COL2A1 genes for mandibular mobility. The aim of this study was investigate the association between mandible mobility with single nucleotide polymorphisms (SNPs) in gene encoding collagen type II alpha 1 chain (COL2A1).

METHODS: Adolescents age from 10 to 14 years old without restrictions in mandibular movement were evaluated. The mandibular mobility was recorded using rule. Genomic DNA was obtained from saliva and the SNPs in COL2A1 gene (rs1793953 and rs2276454) were genotyped by real time polymerase chain reactions. One-way ANOVA with Tukey’s post-test was used to compare the mean values of the mandibular mobility among genotypes in the co-dominant model. A linear regression analysis was also performed.

RESULTS: 99 adolescents were included (53 boys and 46 girls). Gender and age were not associated with mandibular movements. For the rs1793953, unassisted opening, assisted opening and contralateral movements were statistically different among genotypes. The rs2276454 was associated with larger protrusive movements, in patients carrying TT genotype presented higher protrusion mean values than CT and TT individuals (p = 0.0046).

CONCLUSIONS: Our findings suggest that genes may play an essential role for the normal variation in mandibular movement and SNPs rs1793953 and rs2276454 in COL2A1 may explain mandibular mobility variations.

PMID:40563089 | DOI:10.1186/s12903-025-06245-2

Ren Fail. 2025 Dec;47(1):2522327. doi: 10.1080/0886022X.2025.2522327. Epub 2025 Jun 25.

ABSTRACT

BACKGROUND: Albumin is widely used for volume replacement therapy during cardiopulmonary bypass (CPB) including priming fluid, despite significant controversy over its benefits. This study aimed to examine how 20% exogenous albumin affects kidney function in patients with varying preoperative albumin levels.

METHODS: We conducted this single-center, retrospective study in 28,298 adult patients undergoing on-pump cardiac surgery between 2018 and 2023. Patients were stratified according to preoperative albumin values (g/L): ≤35 (N = 1,525), 35.1-37.5 (N = 4,115), 37.6-40 (N = 7,894), and >40 (N = 14,764). Multivariate logistic regression, propensity score matching (PSM), and an inverse probability-weighting (IPW) model were applied to evaluated the impact of 20% albumin infusion on cardiac surgery-associated acute kidney injury (CSA-AKI).

RESULTS: A total of 2,541 pairs were created after PSM: ≤ 35 g/L (307 pairs), 35.1-37.5 g/L (518 pairs), 37.6-40 g/L (743 pairs), and > 40 g/L (973 pairs). Patients with intraoperative 20% albumin infusion had a statistically higher risk of CSA-AKI in the group with preoperative albumin above 40 g/L (OR, 1.29; 95% CI, 1.07-1.57; p = 0.007) in the PSM model. This result remained significant after adjusting for the effects of potential confounding variables (OR, 1.38; 95% CI, 1.19-1.61; p < 0.001 for multivariate logistic regression; OR, 1.63; 95% CI, 1.55-1.72; p < 0.001 for IPW model). However, there was no significant association with Stage 2 and 3 CSA-AKI both for multivariable logistic regression and PSM.

CONCLUSIONS: This analysis highlights that 20% albumin infusion during on-pump cardiac surgery may increase the risk of all stages CSA-AKI in patients with preoperative albumin above 40 g/L.

PMID:40563079 | DOI:10.1080/0886022X.2025.2522327

Obes Surg. 2025 Jun 26. doi: 10.1007/s11695-025-07928-z. Online ahead of print.

ABSTRACT

BACKGROUND: Cardiovascular hemodynamics, electrophysiological characteristics, and heart anatomy are all negatively impacted by obesity. The aim of this study is to compare the impact of sleeve gastrectomy versus single anastomosis sleeve ileal bypass on cardiac functions and rhythm disturbance.

METHODS: The current study included 78 patients who were allocated into two equal groups. Group A (n = 39) underwent laparoscopic sleeve gastrectomy (LSG), while group B (n = 39) underwent single anastomosis sleeve ileal bypass (SASI). Follow-up was designed for 6 and 12 months for cardiac functions and rhythm disturbance.

RESULTS: The patients’ mean age in the current study was 41.6 ± 6.88 and 43.2 ± 7.54 in groups A and B, respectively. There was a statistically significant longer operative time in patients who underwent SASI in comparison with those who underwent LSG (P < 0.001*). The %EWL was significantly higher in the SASI group at 6 and 12 months follow-up (P < 0.001*) QTC m sec and QT dispersion were significantly decreased within and between both groups after 6 and 12 months. There was a statistically significant improvement in the rhythm disturbance in both groups, mainly in group B, reported as a decrease in the overall AF with its subtypes in both groups. There was a statistically significant increase in the E/A ratio in both groups after 6 and 12 months follow-up, with no significant difference between both groups. There was an increase in LVEF in both groups, but it did not reach a significant value.

CONCLUSIONS: LSG and SASI seem to be effective techniques in improving cardiac functions and overall AF in obese patients.

PMID:40563072 | DOI:10.1007/s11695-025-07928-z

Eur J Pediatr. 2025 Jun 26;184(7):448. doi: 10.1007/s00431-025-06260-z.

ABSTRACT

The practice of breastfeeding is universally recommended because of its beneficial short and long-term impact on maternal and child health. UNICEF and WHO are promoting a global call to action to reach the goal of 50% exclusive breastfeeding by 2025. This study aims to show the global epidemiological picture of suboptimal breastfeeding over the years and its impact on health due to diarrhea and lower respiratory tract infections. We explored non-exclusive and discontinued breastfeeding data from the Global Burden of Diseases study 2019. We compared risk-weighted prevalence (summary exposure values) and outcome measures for diarrheal diseases and lower respiratory infections (years lived with disability and years of life lost) across countries and macroareas and over time. In 2019, North America had the highest risk-weighted prevalence for non-exclusive breastfeeding (25.3 SEV) and discontinued breastfeeding (25.3 SEV). By contrast, YLDs were highest in the Middle East and North Africa (37.8 per 100,000) and YLLs in Sub-Saharan Africa (4693.2 per 100,000) due to non-exclusive breastfeeding. From 1990 to 2019, YLLs due to suboptimal breastfeeding in children under 5 years of age decreased by 70%, and the gap between high- and low-income countries also decreased (by 48% for diarrheal diseases and 13% for lower respiratory infections, comparing North America and sub-Saharan Africa). Conclusion: Policymakers around the world should recognize the gap that persists between expectations and goals and work to meet international recommendations and improve child and maternal health. What is Known: • Exclusive and prolonged breastfeeding reduces infant mortality, improves nutrition, and has lasting positive effects on health • Health policies such as the International Code of Marketing of Breastmilk Substitutes and the Baby-Friendly Hospital Initiative have not fully fostered breastfeeding practices What is New: • Over the past 30 years, progress has been made in reducing mortality and disability associated with suboptimal breastfeeding • Suboptimal breastfeeding remains widespread globally and affects high-income countries as much or more than low-income countries.

PMID:40563068 | DOI:10.1007/s00431-025-06260-z