Tag: statistics

Pediatr Pulmonol. 2025 Oct;60(10):e71191. doi: 10.1002/ppul.71191.

ABSTRACT

BACKGROUND: Perfluorooctanoic acid (PFOA) is widely used in daily life; however, research has shown its immune suppression effects. This study aimed to investigate the association between prenatal exposure to PFOA and allergic diseases in children.

METHODS: A prospective birth cohort study involving 648 pregnant women was conducted. Prenatal information was collected through interviews with the women and from medical records. Umbilical cord blood was collected at birth, and concentration of PFOA was measured and genotype of IL-13 rs20541 was detected. Children were followed at 6, 12 and 24 months and information on the development of allergic diseases was recorded. Multivariate logistic regression analysis was used to examine the association between PFOA and allergic diseases. Stratified analysis was performed based on child sex and genotype of IL-13 rs20541.

RESULTS: In multivariate adjusted models, the highest PFOA quartile was associated with increased odds of atopic dermatitis (AD) (OR: 1.66, 95% CI: 1.09-2.55), wheezing (OR: 4.06, 95% CI: 1.30-12.68), and allergic diseases (OR: 1.71, 95% CI: 1.15-2.54). Among females, the highest PFOA quartile was associated with higher odds of AD (OR: 2.25, 95% CI: 1.20-4.23) and allergic diseases (OR: 1.93, 95% CI: 1.07-3.46). Although IL-13 rs20541 alone was not associated with allergic outcomes, children with the GG genotype of IL-13 rs20541 and the highest PFOA quartile have higher odds of AD (OR: 2.82, 95% CI: 1.41-5.67), wheezing (OR: 15.16, 95% CI: 1.38-166.59), and allergic diseases (OR: 2.42, 95% CI: 1.27-4.61).

CONCLUSIONS: Prenatal exposure to PFOA is associated with an increased risk of allergic diseases in early childhood, especially for the female children and those with the GG genotype of IL-13 rs20541.

PMID:41147248 | DOI:10.1002/ppul.71191

Psychol Med. 2025 Oct 28;55:e324. doi: 10.1017/S0033291725102146.

ABSTRACT

BACKGROUND: Anorexia nervosa has potential to influence the development and function of the gastrointestinal system. We assessed the association between maternal anorexia nervosa and risk of gastrointestinal morbidity in offspring.

METHODS: We analyzed a longitudinal cohort of 1,269,370 children born in Quebec, Canada, between 2006 and 2022. The exposure was maternal anorexia nervosa. The outcome was hospitalization for pediatric gastrointestinal disorders, including hypertrophic pyloric stenosis, inflammatory bowel disease, and other digestive morbidity. Follow-up ranged from 1 to 17 years. We used adjusted Cox regression models to obtain hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between maternal anorexia nervosa and pediatric gastrointestinal disorders.

RESULTS: A total of 2,447 children (0.2%) had a mother with anorexia nervosa. By age 17 years, the cumulative incidence of gastrointestinal disorders was higher among children whose mothers had anorexia nervosa than other children (165.7 vs. 129.4 per 1,000). Compared with no anorexia, maternal anorexia nervosa was associated with a greater risk of any childhood gastrointestinal disorder (HR: 1.42, 95% CI: 1.26-1.61), particularly hypertrophic pyloric stenosis (HR: 2.51, 95% CI: 1.35-4.66), inflammatory bowel disease (HR: 2.46, 95% CI: 1.67-3.64), and rectal hemorrhage (HR: 3.46, 95% CI: 1.97-6.09). Children whose mothers developed anorexia nervosa after age 20 years or were hospitalized more than once for anorexia had the greatest risk of gastrointestinal morbidity. The associations were not explained by digestive birth defects.

CONCLUSION: Maternal anorexia nervosa is associated with pediatric gastrointestinal disorders that could potentially be mitigated with psychosocial support, nutritional rehabilitation, and breastfeeding.

PMID:41147221 | DOI:10.1017/S0033291725102146

Acta Cardiol. 2025 Oct 28:1-12. doi: 10.1080/00015385.2025.2576446. Online ahead of print.

ABSTRACT

BACKGROUND: Valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) is increasingly used for the treatment of surgical bioprosthetic valve degeneration (sBVD).

METHODS: We investigated clinical outcomes and hemodynamic valve performance in all consecutive patients undergoing ViV-TAVI for sBVD in a single centre and assessed differences in patients who received a balloon-expandable (BEV) versus self-expandable valve (SEV) at 1, 6 and 12 months (m), and annually thereafter.

RESULTS: Between 25 November 2011 and 4 September 2023, 86 patients (mean age 80.3 ± 6.6y; 53.5% female; median STS score 5.1% (3.7%;8.6%) underwent ViV-TAVI with BEV (n = 53) or SEV (n = 33). Overall, the cumulative incidences of all-cause and cardiovascular mortality at 12 m were 7.4% (3.4%;15.8%) and 3.6% (0.9%; 9.3%), respectively (comparison of SEV versus BEV within the first year: p = 0.253 and p = 0.168, and comparison for the entire follow-up (median 2.6 (0.9;4.6) years): p = 0.962 and p = 0.942). Aortic valve area (AVA) and peak and mean transprosthetic gradients (TPG) improved significantly from baseline to 1, 6 and 12 m follow-up (p < 0.001 for all). Peak and mean TPG were 10.5 (1.8;19.2) and 7.1 (1.6;12.7) mmHg lower in SEV as compared with BEV at 1 m (p = 0.019 and 0.012, respectively). Similarly, AVA of SEV was 0.23 (0.03;0.44) and 0.54 (0.28;0.81) cm² larger as compared with BEV at 1 and 6 m (p = 0.027 and p < 0.001, respectively). No significant differences in hemodynamic valve performance between BEV and SEV were observed during further follow-up.

CONCLUSION: ViV-TAVI is a safe and effective treatment for patients presenting sBVD. Improved hemodynamic valve performance with SEV over BEV observed during early follow-up did not translate into long-term lower mortality rates.

PMID:41147217 | DOI:10.1080/00015385.2025.2576446

Can J Psychiatry. 2025 Oct 28:7067437251389872. doi: 10.1177/07067437251389872. Online ahead of print.

ABSTRACT

ObjectivesThe objectives of this study were to quantify the associations between preterm birth and adolescent-to-adult psychiatric disorders in the Quebec (Canada) population and to determine whether sex and socioeconomic status (SES) modified this relationship.MethodsThis was an observational cohort study using administrative data from the province of Quebec, Canada. All eligible children born preterm between 1976 and 1995 were identified (N = 100,040) and matched 1:2 with term-born children. Individuals were followed from age 11 years until either incident diagnosis of a psychiatric disorder (attention-deficit/hyperactivity disorder [ADHD], psychosis, bipolar disorder, anxiety, or depression), death, or December 2019. Preterm birth was considered as a binary (<37 weeks gestational age) and categorical exposure (extreme, <28; very, 28-31; moderate-to-late, 32-36 weeks gestational age), in addition to continuous gestational age in weeks. Cox proportional hazard models were applied. Effect-modifying roles of sex and SES were investigated in interaction analyses.ResultsCompared to term-born children, those born preterm had a higher risk of all outcomes, with magnitudes ranging from HR 1.16 for ADHD (95% confidence interval 1.13, 1.19) to 1.05 for anxiety (1.04, 1.07). A dose-response relationship was observed, with increasing risks of ADHD, psychosis, and anxiety as the degree of preterm birth increased. Despite some statistically significant associations, there was no clinically significant evidence of effect modification by sex or SES.ConclusionsChildren born preterm had an increased risk of psychiatric disorders in adolescence-to-adulthood, with similar risks across sexes and socioeconomic strata of the population. Policies for early and continued mental health surveillance in this susceptible group are important to initiate appropriate interventions.

PMID:41147193 | DOI:10.1177/07067437251389872

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Nov;39(11):1038-1043. doi: 10.13201/j.issn.2096-7993.2025.11.008.

ABSTRACT

Objective:To investigate the clinical efficacy of robotic surgery via the bilateral axillo-breast approach（BABA） in lateral lymph node dissection for papillary thyroid carcinoma（PTC）. Methods:Clinicopathological records of 324 PTC patients receiving unilateral neck dissection in Tianjin Medical University Cancer Institute and Hospital from December 2020 to November 2024 were retrospectively analyzed. Of these patients, 108 underwent robotic surgery via BABA（robotic group）, while the remaining patients underwent conventional open surgery（open group）. The extent of lateral neck lymph node dissection included level Ⅱ, Ⅲ and Ⅳ. The differences in surgical indexes, postoperative complication rates and cosmetic outcomes of incisions were compared between two groups. Results:All study subjects completed the operation successfully, and there was no conversion in the robotic group. The average age of patients in the robotic group was lower than that in the open group, and the proportion of female patients was higher in the robotic group compared to the open group（P<0.05）. Patients in the robotic group had a greater number of dissected lymph nodes in level ⅡB and higher cosmetic scores（P<0.05）. There were no statistically significant differences between the two groups in the average dissection time of lateral cervical lymph nodes, the number of dissected lymph nodes and metastatic lymph nodes in level ⅡA, Ⅲ, and Ⅳ, average postoperative drainage volume, average postoperative hospital stay, and postoperative complication rates（P>0.05）. Conclusion:The application of robotic surgical system via BABA in lateral neck lymph node dissection for PTC is safe and feasible, with superior advantages in level ⅡB dissection and better postoperative cosmetic outcomes.

PMID:41147177 | DOI:10.13201/j.issn.2096-7993.2025.11.008

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Nov;39(11):1022-1027. doi: 10.13201/j.issn.2096-7993.2025.11.005.

ABSTRACT

Objective:To evaluate the feasibility, safety, and short-term efficacy of robot-assisted unilateral axillary approach for partial or total thyroidectomy without inflation. Methods:A retrospective analysis was performed on the clinical data of 98 patients who underwent gasless unilateral axillary approach robot-assisted resection of bilateral thyroid lesions at Sun Yat-sen University Cancer Center between October 2022 and October 2024. Perioperative indicators were recorded and compared among patients undergoing different surgical approaches（total thyroidectomy vs. bilateral partial thyroidectomy） and with different body mass index（BMI） values, including operative time, intraoperative blood loss, number of lymph nodes dissected, incidence of postoperative hoarseness, incidence of postoperative hypocalcemia, and other postoperative complications. Results:A total of 98 patients were included, of whom 78.57% were female, with a median age of 39 years（interquartile range[IQR]: 35-49） and a median BMI of 24.08 kg/m²（IQR: 21.43-25.98）. The median intraoperative blood loss was 32.14 mL（IQR: 20.00-50.00）, the median operative time was 130.0 minutes（IQR: 104.80-150.30）, and the median hospital stay was 2.01 days（IQR: 1.00-2.00）. The most common postoperative complication was transient hypocalcemia, with an incidence of 16.32%. There were no cases of permanent recurrent laryngeal nerve palsy or conversion to open surgery. Compared with the non-total thyroidectomy group, the total thyroidectomy group had a significantly longer operative time（135.10±33.28 min vs 120.30±30.53 min, P=0.033）. Subgroup analysis based on BMI showed no statistically significant differences in operative time, hospital stay, drainage volume, or incidence of hypocalcemia between patients with BMI≥25 kg/m² and those with BMI<25 kg/m². Conclusion:The gasless unilateral axillary approach for robot-assisted partial or total thyroidectomy demonstrates favorable safety, cosmetic outcomes, and feasibility. Appropriate selection of surgical techniques and meticulous protection of critical structures during the procedure can further reduce the risk of complications and optimize therapeutic outcomes.

PMID:41147174 | DOI:10.13201/j.issn.2096-7993.2025.11.005

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Nov;39(11):1009-1015. doi: 10.13201/j.issn.2096-7993.2025.11.003.

ABSTRACT

Objective:To compare the efficacy of gasless robotic surgery via transaxillary approach and combined axillary-retroauricular approach for unilateral N1b PTC, and to explore the safety and effectiveness of gasless robotic surgery via transaxillary approach for unilateral N1b PTC. Methods:Unilateral N1b PTC patients who underwent surgery in the Department of Otolaryngology, Sun Yat Sen Memorial Hospital, Sun Yat sen University between July 2016 and December 2024 were included and analyzed. According to the inclusion and exclusion criteria and the differences of surgical approaches, the patients were divided into the transaxillary approach（TA） group and the combined axillary-retroauricular approach（TARA） group. The demographic data, operation time, intraoperative blood loss, postoperative drainage volume, postoperative complications, shoulder function evaluation, postoperative visual analogue scale（VAS） of neck aesthetics and recurrence of the two groups were statistically analyzed. Results:A total of 88 patients undergoing gasless robotic surgery were included in this study, including 23 cases in the TA group and 65 cases in the TARA group. The proportion of males in the TA group was significantly higher than that in the TARA group（56.5% vs 21.5%, χ²=9.776, P=0.002）. The total operation time in the TA group was significantly lower than that in the TARA Group（180.00[155.00, 220.00]min vs 220.00[177.50, 272.50]min, z=-2.775, P=0.006）, and the postoperative blood loss in the TA group was significantly lower than that in the TARA Group（30.00[20.00, 50.00]ml vs 50.00[30.00, 60.00]ml, Z=-2.127, P=0.033）. The proportion of area Ⅱ-Ⅴ in the TA group and the TARA group was 87.0% and 70.8%, respectively, and there was no significant difference between the two groups（P>0.05）. There was no significant difference in lateral cervical lymph node dissection and central lymph node dissection between the two groups（P>0.05）. During the follow-up period, no recurrence was found in the two groups, and there was no significant difference in the incidence of complications between the two groups（P>0.05）. According to the stratification of dynamic recurrence risk assessment, it can be seen that the proportion of curative effect satisfaction in the TA group was as high as 95.7%, and that in the TARA group was as high as 81.5%, with no significant difference between the two groups. There was no significant difference in VAS score of neck, Constant Shoulder Score and NDⅡ scale between the two groups（P>0.05）. Conclusion:Gasless robotic surgery via transaxillary approach for unilateral N1b PTC is safe and feasible, and the amount postoperative lymph node acquisition is equivalent to that of combined axillary-retroauricular approach, which can provide a new choice for the treatment of unilateral N1b PTC patients.

PMID:41147172 | DOI:10.13201/j.issn.2096-7993.2025.11.003

Glob Chang Biol. 2025 Oct;31(10):e70574. doi: 10.1111/gcb.70574.

ABSTRACT

Global gridded soil temperature datasets are important to understand and explain spatial patterns and processes in many life and environmental sciences, but products based on in situ measurements are still available to a very limited extent. Global maps of soil temperature at a 1-km² resolution for two depth levels of 0-5 cm and 5-15 cm were therefore an important step in bridging this gap. However, there are on average 26% of suspicious grid cells, and 7%-46% for individual considered soil bioclimatic variables, that show reversed patterns between the two depth levels in terms of soil temperature physics, with more pronounced temperature amplitudes, minima, and maxima at the deeper level, which has no reasonable physical explanation. This mismatch is most probably due to the fact that soil temperature grids for the two depth levels were generated independently using machine-learning models based on distinctive and spatially averaged sets of in situ soil temperature measurements for differing time periods. While the application potential of the maps remains enormous, and they can still be used for most soil-related applications, it can definitely be recommended that the two depth levels be used separately. The study also suggests that data consistency should be prioritized over maximizing the volume of data used when producing soil temperature grids at multiple depth levels using statistical learning methods based on in situ measurements.

PMID:41147127 | DOI:10.1111/gcb.70574

J Adv Nurs. 2025 Oct 28. doi: 10.1111/jan.70321. Online ahead of print.

ABSTRACT

AIM (S): To investigate the frequency and associated factors of interruptions initiated by human and environmental sources during the medication administration process among nurses in South Korea.

DESIGN: A cross-sectional descriptive study.

METHODS: Data were collected from January to March 2022 through an online survey administered to nurses working in tertiary hospitals in South Korea. The survey assessed interruptions during the medication administration process, nursing work environments and organisational culture. Descriptive statistics and regression analysis were used to identify factors associated with interruptions.

RESULTS: Human-initiated interruptions were more frequent than those initiated by environmental sources. Human-initiated interruptions increased with a higher patient load and a relation-oriented organisational culture but decreased with adequate staffing and resources, as well as an innovation-oriented culture. Environment-initiated interruptions were more frequent in settings with a task-oriented culture and less frequent among female nurses.

CONCLUSION: The findings highlight the importance of understanding the distinct characteristics of interruptions and developing targeted strategies based on their sources and contributing factors. Creating supportive environments and fostering an organisational culture that actively prevents unnecessary interruptions are essential for enhancing medication safety and workflow efficiency.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: To apply these findings in clinical practice, it is necessary to allocate staffing resources appropriately to reduce interruptions. Providing education on the importance of maintaining uninterrupted medication administration processes is essential to reduce human-initiated interruptions.

IMPACT: This study provides practical evidence that organisational culture and staffing are associated with interruptions in clinical nursing practice. Nurse managers should apply these findings by promoting staffing adequacy and fostering a collaborative, innovative environment that encourages continuous improvement and openness to change. Tailored strategies that reflect the specific characteristics of different types of interruptions can help reduce their occurrence and improve medication safety.

REPORTING METHOD: STROBE checklist.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

PMID:41147089 | DOI:10.1111/jan.70321

Pulm Circ. 2025 Oct 26;15(4):e70184. doi: 10.1002/pul2.70184. eCollection 2025 Oct.

ABSTRACT

The resistance-compliance (RC) relationship between pulmonary vascular resistance (PVR) and pulmonary arterial compliance (PAC) provides an integrative measure of global right ventricular (RV) afterload. However, debate persists regarding the clinical utility of PAC calculated using the empiric formula (PAC_empiric), and the ideal method for calculating PAC. We analysed haemodynamic and pulmonary pressure waveform data from 156 patients with pulmonary hypertension (PH). PAC was calculated using three methods: PAC_empiric, as well as two established waveform analysis methods, area-under-the-curve (PAC_AUC), and diastolic decay (PAC_DD). Generalized linear mixed models were used to evaluate the relationship between PVR and PAC across these three methods. Model performance was assessed using Akaike and Bayesian Information Criteria (AIC/BIC). The diagnostic performance of each method was evaluated using ROC analysis. Cox regression was applied to assess the association with long term mortality. All three PAC methods demonstrated a strong inverse hyperbolic correlation with PVR. PAC_empiric provided stronger model performance (AIC -504.3; R² = 0.968), and best discriminated PH subtypes (AUC = 0.91), outperforming PAC_AUC (AUC = 0.88) and PAC_DD (AUC = 0.75). PAC_empiric was also a stronger predictor of mortality than PAC_AUC, PAC_DD or PVR (c-statistic = 0.747, compared to 0.737, 0.709 and 0.741 respectively). PAC_empiric is a robust and accessible method for assessing the pulsatile component of RV loading. This study supports its use as a physiologically meaningful parameter that together with PVR provides a comprehensive estimation of global RV afterload.

PMID:41147032 | PMC:PMC12554385 | DOI:10.1002/pul2.70184