Tag: statistics

J Am Heart Assoc. 2025 Oct 7;14(19):e039197. doi: 10.1161/JAHA.124.039197. Epub 2025 Oct 8.

ABSTRACT

BACKGROUND: Over the past decade, higher blood pressure (BP) variability and postural changes in BP have been associated with lower cognitive function. However, only one study has investigated the specific association between BP postural changes variability and brain health, showing a greater risk of dementia with higher systolic BP (SBP) postural changes variability. We aimed to investigate the association between BP postural changes variability and cognitive function in community-dwelling older adults.

METHODS: Participants from the S.AGES (Sujets ÂGES) cohort underwent clinical examinations every 6 months during 3 years. At each clinical visit, an orthostatic SBP ratio was calculated: (seated SBP/standing SBP)×100. A similar method was used to compute an orthostatic diastolic BP ratio. Then, we assessed the visit-to-visit BP postural changes variability according to several indicators including coefficient of variation. Cognition was evaluated annually using the Mini-Mental State Examination. Statistical analyses were performed with linear mixed models.

RESULTS: We included 2974 patients (mean age, 78 years). After adjustment for demographics, cardiovascular risk factors and disease, seated SBP/diastolic BP, and BP-lowering treatment, visit-to-visit SBP postural changes variability was significantly associated with lower cognition (per 1-SD increase in coefficient of variation: adjusted β=-0.15 [95% CI, -0.27 to -0.04], P=0.01). Similar results were found with visit-to-visit diastolic BP postural changes variability.

CONCLUSIONS: Visit-to-visit SBP and diastolic BP postural changes variability were associated with lower cognition. Further studies are needed to assess whether controlling orthostatic BP instability over time could help preserve cognitive function.

REGISTRATION: URL: https://clinicaltrials.gov; Unique identifier: NCT01065909.

PMID:41059541 | DOI:10.1161/JAHA.124.039197

Front Physiol. 2025 Sep 22;16:1646143. doi: 10.3389/fphys.2025.1646143. eCollection 2025.

ABSTRACT

INTRODUCTION: The supplementation of chicken embryos with bioactive compounds may elicit a beneficial effect on the development of their gut microbiome and enhance protection against infectious agents after hatching. Therefore, this study aimed to evaluate the effect of in ovo co-supplementation with a multi-strain probiotic and zinc-glycine chelate on the levels of pro- and anti-inflammatory cytokines, acute-phase proteins, and immunoglobulins in the peripheral blood and tissues of broiler chickens on the day of hatching and 7 days post hatching. The effect of supplementation on the growth parameters of chickens was assessed as well.

METHODS: The study was conducted on 1,500 hatching eggs from a broiler breeding flock (Ross × Ross 308) at 36 weeks. ELISA kits were used to determine levels of acute-phase proteins and immunoglobulins. Expression of immunoglobulins was determined by means of qRT-PCR.

RESULTS: The results indicate enhanced synthesis of acute-phase proteins in the liver and increased levels of serum amyloid A in the small intestine tissue, as well as IgA and IgM mRNA and suppressed synthesis of pro-inflammatory cytokines IFN-γ and TNF-α. During the cumulative experimental period (days 0-42), the mean body weight gain (BWG) and feed intake (FI) in the group supplemented with a multi-strain probiotic were statistically significantly lower than the control group.

DISCUSSION: It may be concluded that the combined in ovo use of a multi-strain probiotic and Zn-Gly chelate modulates the immune response, helps maintain the balance between the synthesis of Th1 and Th2 cytokines, inhibits inflammatory processes, and stimulates immune system development.

PMID:41059496 | PMC:PMC12497791 | DOI:10.3389/fphys.2025.1646143

Front Physiol. 2025 Sep 22;16:1678866. doi: 10.3389/fphys.2025.1678866. eCollection 2025.

ABSTRACT

BACKGROUND: Badminton requires high-intensity lower limb explosive power and agility for executing rapid lunges, jumps, and directional changes. Complex training (CT) combines heavy resistance exercises with plyometric activities to enhance maximal strength and explosive performance through post-activation performance enhancement (PAPE). However, limited research exists on CT effects in adolescent female badminton players.

OBJECTIVE: To investigate the effects of an 8-week complex training program on lower limb explosive power and movement agility in adolescent female badminton players.

METHODS: Thirty-two adolescent female badminton players were randomly allocated into complex training group (CT group, n = 16, age: 15.69 ± 0.95 years) and resistance training group (RT group, n = 16, age: 15.63 ± 1.15 years). The CT group performed resistance exercises (75%-85% 1RM) paired with plyometric exercises twice weekly for 8 weeks, while the RT group completed traditional resistance training with the same frequency. Pre- and post-intervention assessments included squat jump (SJ), countermovement jump (CMJ), bilateral and unilateral jumps, sprint tests (5 m, 10 m, 15 m, 20 m), hexagon test, modified 505 change of direction (COD) test, on-court COD test, and isometric mid-thigh pull (IMTP). Two-way repeated measures ANOVA was used for statistical analysis (p < 0.05).

RESULTS: Significant group × time interactions were observed for SJ, CMJ, unilateral jumps, sprint performance (5 m, 10 m, 20 m), and agility tests (all p < 0.05). The CT group showed greater improvements compared to RT group: SJ (1.83 cm vs. 0.95 cm, Cohen’s d = 1.196 vs. 0.642), CMJ (3.64 cm vs. 1.27 cm, Cohen’s d = 1.949 vs. 0.681), 5 m sprint (0.18s vs. 0.06s improvement, Cohen’s d = 1.889 vs. 0.667), hexagon test (1.29s vs. 0.03s improvement), and COD performance. Both groups significantly improved IMTP with no between-group differences (p > 0.05).

CONCLUSION: An 8-week complex training program elicited significantly greater improvements in lower limb explosive power, sprint acceleration, and multidirectional agility compared to traditional resistance training in adolescent female badminton players. These findings suggest CT is an effective, sport-specific training intervention that capitalizes on the heightened neuromuscular plasticity of adolescent athletes.

PMID:41059493 | PMC:PMC12497702 | DOI:10.3389/fphys.2025.1678866

Emerg Med Int. 2025 Sep 28;2025:6711086. doi: 10.1155/emmi/6711086. eCollection 2025.

ABSTRACT

Background: An electrocardiogram is a diagrammatic representation of a heart’s electrical activity. This technique can detect life-threatening conditions within minutes. It is one of the major investigative modalities at which emergency physicians should be accurate. The accuracy of emergency residents varies from country to country, with improvement in interpretation as the year of residency increases. There have been no published papers on ECG interpretation among emergency residents until now, but studies on graduating medical students have shown low competency. Methods: A cross-sectional study was conducted on emergency and critical care medicine residents of Tikur Anbessa Specialized Hospital and Saint Paul Millennium Medical College. Data were collected from April 2021 to September 2021 via a structured questionnaire. The data were entered, cleaned, edited, and analyzed via SPSS Version 26.0 statistical analysis software. Descriptive statistics and bivariate and multivariate binary logistic regressions were used to analyze the data. Results: Fifty-seven emergency and critical care medicine residents were able to participate in this study, 33 (57.9%) of whom were from Addis Ababa University and 24 (42.1%) of whom were from Saint Paul Millennium Medical College. The average percentage of EMCC residents who interpreted the ECGs was 29.5%. Only 10 residents (17%) were able to correctly interpret > 50% of the ECGs. Most of the residents who participated in this study were Year 1 residents, followed by Year 2 residents. Among the 15 ECG abnormalities, the commonly identified were polymorphic ventricular tachycardia, normal sinus rhythm, and a double-chamber pacemaker. The year of residency (AOR 3.34) was found to be significantly associated with greater performance in ECG interpretation. Conclusion: According to this study, the interpretation accuracy of ECGs by emergency medicine and critical care residents is low, which is comparable to the findings of studies performed in South Africa and Australia.

PMID:41059469 | PMC:PMC12497519 | DOI:10.1155/emmi/6711086

Front Res Metr Anal. 2025 Sep 22;10:1553928. doi: 10.3389/frma.2025.1553928. eCollection 2025.

ABSTRACT

INTRODUCTION: In a global landscape characterized by intense competition and stringent funding criteria, researchers face the dual challenges of limited resources and high demand for innovation-a challenge that Brazil is no exception to. This study aimed to explore the perceptions, barriers, and challenges faced by researchers during the project submission process for approval by funding agencies, with a focus on schools within the Federal Network of Professional, Scientific, and Technological Education Institutions.

METHODS: A quantitative cross-sectional approach was used to examine the characteristics of researchers at a Brazilian institution in 2023. The sample comprised eighty three researchers who completed an online questionnaire containing eighty three questions on demographic characteristics, factors associated with project submission and approval, and reasons for non-submission or non-approval. The data were analyzed using descriptive statistics, including the Kolmogorov-Smirnov, Pearson’s chi-square, and Mann-Whitney U-tests, followed by post hoc analysis and Yates’ correction. Logistic regression was applied using the backward elimination method, and significant parameters (p < 0.20) free from multicollinearity were selected.

RESULTS: This study revealed that most researchers were men (61.4%) with doctoral degrees (91.6%), highlighted the critical role of proposal clarity and relevance in the project evaluation process. Gender (p = 0.011) and academic level (p = 0.025) were significant factors influencing project submission rates, with Brazilian National Council for Scientific and Technological Development (CNPq) fellows and researchers involved in graduate programs submitting more projects. The participants identified “search for funding” and “desire to expand research impact” as their primary motivations while citing “complex funding calls” and “funding limitations” as major barriers. Additionally, age and the number of children were found to affect project approval (p ≤ 0.018), with “proposal clarity” and “researchers’ experience” having been critical factors for submission approval (p ≤ 0.03).

CONCLUSION: The study results highlighted a gender disparity, with lower participation among women, and identified key factors influencing project submission, including the search for funding, curriculum development, and structural challenges. Additionally, the findings suggest the adoption of gender-sensitive and early-career grant criteria, targeted support for underrepresented researchers, and flexible mechanisms for those with caregiving responsibilities. These findings underscore the importance of public policies and institutional strategies in promoting equitable and inclusive funding opportunities.

PMID:41059466 | PMC:PMC12497820 | DOI:10.3389/frma.2025.1553928

Front Bioeng Biotechnol. 2025 Sep 22;13:1651500. doi: 10.3389/fbioe.2025.1651500. eCollection 2025.

ABSTRACT

BACKGROUND: chronic kidney disease (CKD) remains a global health challenge with limitations in current diagnostic methods, including the invasiveness of biopsies and variability of estimated glomerular filtration rate (eGFR). This study aimed to develop a noninvasive diagnostic model integrating ultrasound viscoelasticity parameters to address these gaps.

METHODS: A prospective cohort of 228 participants underwent standardized renal ultrasound with viscoelastic imaging (Mindray Resona A20) to assess viscoelastic parameters and structural metrics. Key predictors were selected through LASSO regression, and a logistic regression diagnostic model was constructed. Model performance was comprehensively evaluated by analyzing discriminative ability (AUC, sensitivity/specificity), calibration (Brier score, calibration curves), and clinical utility (nomogram development, risk stratification and stage-specific decision curve analysis). Multiclass analysis was implemented to evaluate stage-specific performance (Class 1: normal; Class 2: G1-3; Class 3: G4-5) using one-vs-rest ROC methodology. All statistical analyses incorporated 1000 bootstrap iterations for robust variance estimation.

RESULTS: The diagnostic model demonstrated superior accuracy with an AUC of 0.932 (95% CI 0.908-0.956) in validation sets. Pathological analysis revealed that viscosity values were significantly elevated in CKD patients compared to controls (1.99 vs. 1.64 Pa·s, P < 0.001), while elasticity and shear wave velocity showed increases of 12.7%-13.2% and 5.3% respectively (P < 0.001). For clinical implementation, the model incorporated a visual nomogram that converted scores ranging from 0 to 160 points into CKD probability estimates between 0.1 and 0.9, with an optimal cutoff value of 0.383 providing balanced sensitivity of 88.4% and specificity of 87.8%. Decision curve analysis confirmed clinical utility across probability thresholds of 20%-80%, with peak net benefit at 40% threshold probability. Multiclass analysis revealed stage-dependent performance: Class 3 showed the highest discrimination (AUC = 0.918), followed by Class 1 (AUC = 0.884) and Class 2 (AUC = 0.774), with significant inter-stage differences (DeLong’s test P < 0.001).

CONCLUSION: This study establishes a novel “function-structure” integrated diagnostic paradigm for CKD, combining the accuracy of ultrasound parameters with unique structural insights. The model’s noninvasive nature and stability under physiological variability make it particularly valuable for early detection and longitudinal monitoring.

PMID:41059457 | PMC:PMC12498016 | DOI:10.3389/fbioe.2025.1651500

Front Cardiovasc Med. 2025 Sep 22;12:1600189. doi: 10.3389/fcvm.2025.1600189. eCollection 2025.

ABSTRACT

OBJECTIVE: This study aims to investigate the effect of Yiqi Huoxue Tongluo decoction (YHTD) in combination with conventional medicine therapy on restenosis rates and clinical efficacy in patients with coronary heart disease undergoing percutaneous coronary intervention.

METHODS: A total of 80 patients with coronary artery disease who underwent PCI between August 2019 and February 2021 were selected, and the patients were assigned to either the control group (n = 40) or the observation group (n = 40) according to a randomized numerical table. The control group received conventional medicine treatment, while the observation group took YHTD alongside conventional medicine treatment. Coronary angiography was performed after 6 months of treatment to compare the changes in coronary restenosis, TCM syndrome scores, Seattle Angina Questionnaire (SAQ) scores, cardiac function indexes, and related serum biomarkers between the two groups.

RESULTS: After treatment, the TCM syndrome scores of patients in both groups were lower than those before treatment, and the post-treatment TCM syndrome scores of the observation group were significantly lower than those of the control group. Similarly, the SAQ scores of patients in both groups were significantly higher than those before treatment, and the SAQ scores of the observation group were significantly higher than those of the control group. After treatment, both groups showed significant reductions in the LVEDD and LVESD compared with those before treatment, and the LVEDD and LVESD values of the observation group were significantly lower than those of the control group. Similarly, the LVEF and SV of patients in both groups increased compared with those before treatment; however, the LVEF and SV values of the observation group were significantly higher than those of the control group, and the difference was statistically significant. After treatment, hs-CRP, Hcy, and sST2 were significantly reduced in both groups, and the levels of hs-CRP, Hcy, and sST2 in the observation group were significantly lower than those in the control group.

CONCLUSION: YHTD combined with conventional medicine therapy can significantly reduce the rate of coronary restenosis in post-PCI patients, improve the TCM symptoms, alleviate angina symptoms, enhance cardiac function indexes, and effectively regulate serum biomarker levels, which offers a better choice for the treatment of post-PCI coronary artery disease.

PMID:41059441 | PMC:PMC12498481 | DOI:10.3389/fcvm.2025.1600189

North Clin Istanb. 2025 Aug 26;12(4):461-467. doi: 10.14744/nci.2025.48902. eCollection 2025.

ABSTRACT

OBJECTIVE: Ado-trastuzumab emtansine (T-DM1) is a key treatment for HER2-positive metastatic breast cancer (HER2+ MBC), yet the influence of progression sites and therapy lines on outcomes remains unclear.To assess the relationship between progression sites and the line of T-DM1 therapy with survival outcomes in HER2+ MBC.

METHODS: We retrospectively analyzed 123 patients with HER2+ MBC treated with T-DM1. Data on metastatic progression sites (brain, liver, bone, lung, lymph nodes), line of T-DM1 therapy (2^nd-line vs ≥3^rd-line), and death status were examined. Due to limited survival time data, mortality was used as the primary outcome. Death rates were compared across subgroups using descriptive statistics.

RESULTS: Brain and lung progression were associated with the highest mortality rates (76.7% and 73.1%, respectively). Liver and bone progression also showed elevated death rates (70.0% and 64.3%). Notably, more patients who used T-DM1 as the second-line therapy had a higher mortality rate at 66.7% compared to those treated with it in the third line or after (45.1%).

CONCLUSION: Progression to brain and lung during T-DM1 treatment correlates with higher mortality. Early-line use of T-DM1 may be linked with worse outcomes, possibly due to more aggressive disease biology. The obtained data could inform the decision-making process when treating patients with HER2+ MBC and predict their prognosis.

PMID:41059432 | PMC:PMC12497911 | DOI:10.14744/nci.2025.48902

North Clin Istanb. 2025 Aug 8;12(4):490-495. doi: 10.14744/nci.2024.42890. eCollection 2025.

ABSTRACT

OBJECTIVE: The aim of this study is to radiologically compare area and volume changes in the costoclavicular region with the unaffected side in patients treated nonoperatively after unilateral midshaft clavicle fracture and to evaluate functional outcomes.

METHODS: This study included 16 patients (14 males, 2 females) with midshaft clavicle fractures who were admitted between 2017-2018 and union was achieved with conservative methods. Magnetic resonance imaging (MRI) of the shoulder including the costoclavicular region was performed after union. Area and volume calculations of the fractured and unaffected costoclavicular region of the patients were performed on the standard MR sections under the guidance of a specialist radiologist. The Short Version of Disabilities of the Arm, Shoulder and Hand (QDASH) score was used for functional assessment. Range of motion was measured on the affected and unaffected sides at the last follow-up visit.

RESULTS: The mean age of the patients was 30.4±20.8 years (5-69) and the mean follow-up was 8.3±1.3 (6-10) months. The mean shortening was 14.3 mm±8.2 (3-29). The area measurements of the costoclavicular region were divided into 3 levels in axillary section: acromioclavicular joint, mid 1/3 of the clavicle, and sternoclavicular joint level. The median area measurements were 1115 (364-3675) mm², 1495 (365-4199) mm², and 1201 (197-3812) mm² on the unaffected side and 895.5 (351-3670) mm², 1098.5 (340-3191) mm², and 1037.5 (166-3237) mm² on the fractured side, respectively (p=0.905, p=0.491, p=0.888). In volume measurements, the median volumes of the unaffected side and the fractured side were 34.3 (10.7-69.7) mm³ and 28.9 (8.1-60.9) mm³, respectively (p=0.268). No significant difference was found in the statistical analysis of area and volume measurements. At the end of the follow-up period, the QDASH score and functional outcome of the patients were good.

CONCLUSION: Conservative treatment of midshaft clavicle fractures did not result in significant area and volume changes in the costoclavicular region. The inability to clinically demonstrate the theoretical expectation of decreased area and volume on the fractured site suggests that other biomechanical factors are involved in the healing process of the human body.

PMID:41059429 | PMC:PMC12497898 | DOI:10.14744/nci.2024.42890

North Clin Istanb. 2025 Aug 19;12(4):387-395. doi: 10.14744/nci.2025.43788. eCollection 2025.

ABSTRACT

OBJECTIVE: Laparoscopic techniques have emerged as the preferred approach over traditional open surgery for the treatment of adrenal gland disorders. Right laparoscopic adrenalectomy (RLA) typically requires liver retraction for exposure, and various retractors can be used for this purpose. While studies have been conducted on liver injury during liver retraction in upper abdominal surgeries, no research has specifically addressed liver damage during laparoscopic adrenalectomy (LA). This study aims to evaluate the impact of two retractors used for liver retraction during RLA on liver function test results (LFTs) and their clinical significance.

METHODS: This retrospective study included 87 LA patients who underwent surgery for adrenal gland pathology at our institution between 01/01/2010 and 04/30/2024. The patients were divided into two groups: RLA (n=42) and left LA (LLA) (n=45). The RLA patients were further categorized into two subgroups based on the retractor used: 5-blade retractor (FB) (n=22) and full ring retractor (GF) (n=20). Clinicopathological findings, operative outcomes, and laboratory test results were compared across groups.

RESULTS: Postoperative levels of aspartate aminotransferase (AST), alanine aminotransferase, and alkaline phosphatase were significantly higher in the RLA groups (FB and GF) compared to the LLA group (p<0.001, p<0.001, p=0.001, respectively). Although no statistically significant difference was observed between groups, the median length of stay (LOS) was slightly shorter in the FB group (2 (2-3), p=0.058). There were no significant differences between FB and GF groups in terms of operation time, LFTs, complications, or mortality. Correlation analysis showed a statistically significant positive correlation between postoperative AST levels and lesion size (rho=0.31, p=0.045). Additionally, patients with functional adrenal pathologies had a significantly longer hospital stay compared to those with nonfunctional pathologies (2 (2-2.25) vs. 3 (2-3.5), p<0.001).

CONCLUSION: In RLA procedures, the LFT values were higher compared to LLA procedures. The effects of FB and GF retractors on surgical outcomes and LFT values were similar, indicating both retractors can be safely used during RLA surgeries. While no clinical impact was detected, caution is advised regarding potential liver injury during RLA procedures.

PMID:41059426 | PMC:PMC12497914 | DOI:10.14744/nci.2025.43788