Tag: statistics

Diabetol Metab Syndr. 2025 May 14;17(1):153. doi: 10.1186/s13098-025-01715-7.

ABSTRACT

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated steatotic liver disease (MASLD) are common chronic liver diseases worldwide, both of which are closely associated with an increased risk of cardiovascular disease (CVD). Atherogenic index of plasma (AIP), as a biomarker of dyslipidemia, may predict CVD risk and mortality in these patients, but its specific role in patients with NAFLD and MASLD has not been studied in detail. This study adopted a cohort design, using data from the National Health and Nutrition Examination Survey (NHANES, 1988-1994) database, which was conducted by the Centers for Disease Control and Prevention. A total of 12,929 adult participants were analyzed. After participants were grouped according to AIP quartiles, the relationship between AIP levels and CVD risk was explored using multivariate logistic regression models and restricted cubic splines. The relationship between AIP levels and all-cause and CVD mortality was analyzed using multivariate Cox regression models.

RESULTS: Participants with the higher AIP quartiles showed high rates of CVD among participants with NAFLD (Quartile 1: 7.57%; Quartile 2: 10.00%; Quartile 3: 11.63%; Quartile 4: 15.08%). Participants with the higher AIP quartiles showed high rates of CVD among participants with MASLD (Quartile 1: 9.71%; Quartile 2: 11.30%; Quartile 3: 11.14%; Quartile 4: 15.00%). The findings suggested a linear association between the AIP index and the risk of CVD in participants with NAFLD or MASLD. AIP was significantly associated with CVD in the highest quartile of NAFLD or MASLD patients, and the adjusted hazard ratio indicated that high AIP levels were associated with high risk of CVD among participants with NAFLD (HR: 1.77, 95% CI: 1.24, 2.52) and MASLD (HR 1.76, 95% CI: 1.04, 2.98). In addition, higher AIP levels were also associated with increased all-cause mortality and CVD mortality among participants with NAFLD or MASLD.

CONCLUSION: This study showed that AIP is an effective tool for predicting CVD risk and mortality in patients with NAFLD and MASLD. Regular monitoring of AIP levels can help identify high-risk patients early and provide clinical risk assessment before intervention, thereby improving patient management and prognosis. Future studies need to further explore the role of AIP in different ethnic and economic conditions to optimize cardiovascular disease prevention and treatment strategies.

PMID:40369673 | DOI:10.1186/s13098-025-01715-7

J Clin Nurs. 2025 May 14. doi: 10.1111/jocn.17782. Online ahead of print.

ABSTRACT

AIMS AND OBJECTIVE: To evaluate the effects of dietary intervention and the commonly used behaviour change techniques (BCTs) on clinical outcomes in patients with T2DM.

BACKGROUND: Effective dietary management is crucial in the management of diabetes. Behavioural change strategies are important in improving dietary adherence, but limited understanding of available evidence currently exists.

DESIGN: A systematic review and meta analysis using the PRISMA checklist were used to synthesise the evidence.

METHODS: Systematic review of five databases was completed using selected key terms. Meta-analysis was conducted to test the effects of the dietary interventions and to identify effective BCTs.

RESULTS: Nine studies were included in this research. Overall, the dietary interventions showed significant HbA1c reduction, with merits from personalised dietary interventions tailored to patient characteristics. Meanwhile, there was a sustained reduction in HbA1c after three, six, and twelve months post intervention. Moreover, significant improvements in weight and lipid profile were observed by the sixth month. Regarding employed BCTs, ‘Credible Source’ and’Conserving Mental Resources’ were deemed to be both clinically and statistically significant in reducing HbA1c (> 0.3%), while 14 other BCTs were identified as being associated with a clinically meaningful reduction in HbA1c (> 0.3%).

CONCLUSION: Comprehensive dietary interventions incorporating selective BCTs significantly improved HbA1c, weight, and lipid profiles in patients with T2DM. Identified BCTs and the commonly used intervention features tailored to patient characteristics were most effective in dietary behaviour interventions.

RELEVANCE TO CLINICAL PRACTICE: It is suggested that, besides the commonly used BCTs (e.g., ‘Goals and Planning’ and ‘Feedback on Behavior’), the application of ‘Conserving Mental Resources’ and ensuring ‘Credible Source’ should be incorporated into dietary interventions for patients with T2DM in clinical practice.

PATIENT OR PUBLIC CONTRIBUTION: The is no patient or public contribution in this paper.

TRIAL REGISTRATION: This study was registered at the International Prospective Register of Systematic Reviews.

PROSPERO ID: CRD42023459274.

PMID:40369662 | DOI:10.1111/jocn.17782

Pediatr Blood Cancer. 2025 May 14:e31790. doi: 10.1002/pbc.31790. Online ahead of print.

ABSTRACT

Wilms tumor (WT) is the most common pediatric renal tumor, and with multidisciplinary treatment overall outcomes are excellent. However, a small subset of patients with WT will relapse. The ideal treatment of relapsed WT is yet to be defined. Ongoing studies through the Children’s Oncology Group Renal Tumors Committee (COG-RTC) and the International Society of Paediatric Oncology Renal Tumor Study Group (SIOP-RTSG) aim to improve risk stratification and treatment strategies. Members met at the SIOP 55th Annual Congress 2023 to outline available data and knowledge gaps and develop future research priorities.

PMID:40369656 | DOI:10.1002/pbc.31790

J Health Popul Nutr. 2025 May 14;44(1):155. doi: 10.1186/s41043-025-00916-0.

ABSTRACT

BACKGROUND: The prevalence of physical inactivity in India is estimated to be 34%; the highest prevalence in South Asian countries. Physical inactivity has increased the risk of non-communicable diseases among urban Indians. Built environment interventions that aim to enhance physical activity have gained popularity in recent years. The construction of outdoor gymnasiums (hereafter referred to as OGs) in green spaces is one such intervention. The installation of OGs on university campuses is a novel concept. The present study was designed to explore the usage of OGs and the perceptions of the users about OGs in a public university setting.

METHODS: A sequential mixed-methods study design was used to inform this two-fold study. In the first phase (Quantitative), four OGs (i.e. OG-A, OG-B, OG-C, OG-D) were observed between 6.00 am and 8.00 pm for one week per month from December 2022 to March 2023 which corresponds to winter and spring time in Varanasi, India. In the second phase (Qualitative), face-to-face, semi-structured in-depth interviews (N = 66) with a purposive sample of (OG) users were conducted in Hindi. Descriptive statistics and thematic analysis were used to analyze quantitative and qualitative data respectively.

RESULTS: Observational data revealed that the OGs were more frequently used during spring as compared to winter. OG-C emerged as the most popular gym across the four-month period as it hosted the highest number of users (N = 3384) followed by OG-D (N = 2380), OG-B (N = 2004), and OG-A (N = 792). Another major observation was that OGs were more likely to be used by males than females. OGs were more crowded over weekends than weekdays. The thematic analysis of qualitative interview data revealed three main themes and associated sub-themes: (i) Perceived benefits associated with the use of OGs (physical and mental health benefits, proximity to nature, opportunity to socialize, safe environment, economical, ease of access for everyone); (ii) Perceived challenges associated with the use of OGs (lack of time, overcrowding, damaged equipment, laziness); (iii) Feedback for improvement of OGs (regular maintenance of gym equipment, installation of more equipment, installation of drinking water stations and restrooms).

CONCLUSIONS: The emerging findings recognize OGs as viable built environment interventions that encourage people to embrace physical activity. The OGs not only contribute to the revitalization of open green spaces in university campuses where they are installed but also play a significant role towards the fulfilment of social responsibility of educational institutions.

PMID:40369648 | DOI:10.1186/s41043-025-00916-0

Biotechnol Biofuels Bioprod. 2025 May 14;18(1):54. doi: 10.1186/s13068-025-02652-3.

ABSTRACT

BACKGROUND: Biohydrogen production from agricultural waste is a promising strategy to address climate change and energy challenges. This study aimed to optimize the process parameters for biohydrogen production from watermelon peels (WMP) by Clostridium butyricum NE133 using statistical optimization techniques. Initial screening of eight significant variables influencing hydrogen production including, initial pH, incubation temperature, WMP concentration, inoculum volume, yeast extract, tryptone, sodium acetate, and ammonium acetate concentration was conducted by a Plackett-Burman (PB) design.

RESULTS: The results showed that four variables including, initial pH (P < 0.001), WMP concentration (P < 0.001), sodium acetate (P = 0.023), and ammonium acetate (P = 0.048) had statistically significant effects on hydrogen production. The model curvature (P = 0.040) indicated that it was significant. Box-Behnken (BB) design under response surface methodology (RSM) was employed to optimize the four selected variables to maximize hydrogen production. The optimal conditions for maximizing hydrogen production from WMP by C. butyricum were: initial pH of 8.98, WMP concentration of 44.75%, sodium acetate 4.49 gL^-1, and ammonium acetate 1.15 gL^-1 at with predicted H_max of 4703.23 mLL^-1. The determination coefficient R² of the model was 0.9902 with the lack of fit F-value was 1.86.

CONCLUSIONS: The confirmation experiment revealed only a 0.59% difference between the predicted and experimental hydrogen production, indicating that the optimum conditions were actual with the least error. Improvement of about 103.25% in hydrogen production from WMP by C. butyricum NE133 was achieved after the optimization process.

PMID:40369643 | DOI:10.1186/s13068-025-02652-3

Microbiome. 2025 May 14;13(1):119. doi: 10.1186/s40168-025-02108-8.

ABSTRACT

BACKGROUND: In periodontitis, the interplay between the host and microbiome generates a self-perpetuating cycle of inflammation of tooth-supporting tissues, potentially leading to tooth loss. Despite increasing knowledge of the phylogenetic compositional changes of the periodontal microbiome, the current understanding of in situ activities of the oral microbiome and the interactions among community members and with the host is still limited. Prior studies on the subgingival plaque metatranscriptome have been cross-sectional, allowing for only a snapshot of a highly variable microbiome, and do not include the transcriptome profiles from the host, a critical element in the progression of the disease.

RESULTS: To identify the host-microbiome interactions in the subgingival milieu that lead to periodontitis progression, we conducted a longitudinal analysis of the host-microbiome metatranscriptome from clinically stable and progressing sites in 15 participants over 1 year. Our research uncovered a distinct timeline of activities of microbial and host responses linked to disease progression, revealing a significant clinical and metabolic change point (the moment in time when the statistical properties of a time series change) at the 6-month mark of the study, with 1722 genes differentially expressed (DE) in the host and 111,705 in the subgingival microbiome. Genes associated with immune response, especially antigen presentation genes, were highly up-regulated in stable sites before the 6-month change point but not in the progressing sites. Activation of cobalamin, porphyrin, and motility in the microbiome contribute to the progression of the disease. Conversely, inhibition of lipopolysaccharide and glycosphingolipid biosynthesis in stable sites coincided with increased immune response. Correlation delay analysis revealed that the positive feedback loop of activities leading to progression consists of immune regulation and response activation in the host that leads to an increase in potassium ion transport and cobalamin biosynthesis in the microbiome, which in turn induces the immune response. Causality analysis identified two clusters of microbiome genes whose progression can accurately predict the outcomes at specific sites with high confidence (AUC = 0.98095 and 0.97619).

CONCLUSIONS: A specific timeline of host-microbiome activities characterizes the progression of the disease. The metabolic activities of the dysbiotic microbiome and the host are responsible for the positive feedback loop of reciprocally reinforced interactions leading to progression and tissue destruction. Video Abstract.

PMID:40369640 | DOI:10.1186/s40168-025-02108-8

BMC Nurs. 2025 May 14;24(1):531. doi: 10.1186/s12912-025-03206-6.

ABSTRACT

BACKGROUND: School nurses perform a unique role by providing health care to all children and adolescents. In Norway, their activities are regulated by the National Professional Guidelines for Health Promotion and Prevention Work in Health Centers, School Health Services and Youth Health Clinics. However, a large part of their workday involves independently planning and prioritizing activities. Understanding how they allocate this time is limited. Filling this knowledge gap is important, both for central authorities in their planning and staffing of the service, and for the continuous development of school health services. This study aims to describe how school nurses spend their time within the Norwegian school health services.

METHODS: Over a period of 10 days, 104 school nurses documented all activities spent in school health services for a cross-sectional time study. An activity list was developed that encompassed 25 activities, 10 of which were directly devoted to interactions with children, adolescents, and/or their guardians. Time was measured at 10-minute intervals and analysed via descriptive statistics.

RESULTS: Administrative work constituted the largest proportion of the registered time (22.1%), followed by individual consultations (15.9%) and meetings (10.9%). Minimal time was allocated to group activities for pupils and guardians, comprising 2.8%. The time dedicated to direct interaction with children, adolescents, and/or guardians accounted for 36% of the time, whereas the remaining 64% was spent on activities not involving direct interaction.

CONCLUSION: This study provides insights into how school nurses spend their time within Norwegian school health services and indicates a large variation in the time spent on different tasks. Future research should investigate the reasons behind these variations and analyze the content and interventions used in various activities. Although the study is conducted in a Norwegian context, the methods for describing time usage are applicable to other health sectors and countries.

PMID:40369634 | DOI:10.1186/s12912-025-03206-6

J Health Popul Nutr. 2025 May 14;44(1):156. doi: 10.1186/s41043-025-00914-2.

ABSTRACT

BACKGROUND: Metabolic Score for Visceral Fat (METS-VF) is commonly used as an indicator for assessing visceral fat metabolism. However, the relationship between METS-VF, Bone Mineral Density (BMD), and osteoporosis remains unclear in the American population.

METHODS: This study utilized cross-sectional data from the National Health and Nutrition Examination Survey (NHANES), including participants aged 20 years and older, from the survey cycles conducted between 2005 and 2010, 2013-2014, and 2017-2018. Multivariable weighted linear regression and logistic regression analyses were first applied to investigate the associations between the METS-VF, femoral BMD, and osteoporosis. In addition, subgroup interaction analyses were performed to evaluate the robustness of these associations. To address potential non-linear relationships, restricted cubic spline regression was employed. All statistical analyses were conducted using R software version 4.3.3. P values were two-tailed, with P < 0.05 considered statistically significant.

RESULTS: After adjusting for all covariates, the positive correlations between METS-VF and BMD measurements at all sites remained statistically significant (p < 0.001 & p for trend < 0.001). Multivariable logistic regression analysis indicated that, after adjusting for covariates related to osteoporosis, each one-unit increase in METS-VF was associated with a 63.1% reduction in the risk of developing osteoporosis. Moreover, the direction of the associations between METS-VF and both BMD and osteoporosis remained consistent across all subgroups, while restricted cubic spline (RCS) analyses suggested nonlinear relationships. The 5.82-7.35 METS-VF range yielded a mean 51.9% osteoporosis risk reduction (sustained ≥ 30% peak efficacy in 66.7% of participants).

CONCLUSIONS: METS-VF demonstrated a nonlinear positive association with BMD and a nonlinear inverse relationship with osteoporosis risk. Future studies should establish optimal biological thresholds of METS-VF for skeletal health.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40369619 | DOI:10.1186/s41043-025-00914-2

Head Face Med. 2025 May 14;21(1):39. doi: 10.1186/s13005-025-00501-0.

ABSTRACT

BACKGROUND: After surgical procedures involving bone and soft tissue, such as impacted tooth extraction, profen and diclofenac derivatives are commonly prescribed. Diclofenac sodium (DS) and dexketoprofen trometamol (DT), derivatives of diclofenac and profen, exhibit clinical differences from their parent compounds. Despite their widespread use, comparative studies of their effects on postoperative complications remain limited. This randomized controlled trial was performed to compare the analgesic and anti-inflammatory effects of DS and DT following impacted tooth extraction.

METHODS: This split-mouth, randomized clinical study included healthy individuals aged 18 to 40 years with bilaterally impacted third molars. Left and right teeth were randomly assigned to either the DT or DS group. Participants took 25 mg of DS or 36.9 mg of DT twice daily for 7 days, beginning 1 h before extraction. Postoperative pain was assessed using a visual analogue scale at 4, 8, 12, and 24 h postoperatively, as well as on days 2 through 7. Trismus was evaluated by the interincisal distance, and edema was anatomically measured preoperatively and on postoperative days 2 and 7. The surgical duration and rescue analgesic use were also recorded.

RESULTS: In total, 35 patients (28 women, 7 men) aged 18 to 31 years (mean, 21.31 ± 3.19 years) participated. The mean operation duration was 12.94 ± 2.26 min for the DT group and 13.26 ± 2.19 min for the DS group (p > 0.05). No statistically significant difference was observed between the groups regarding pain, edema, or trismus development (p > 0.05). However, from days 2 to 7, the DS group exhibited a greater reduction in edema than did the DT group (p < 0.05). Additionally, the DS group required 10% more frequent use of rescue analgesics than the DT group.

CONCLUSION: Following impacted tooth extraction, administering DT during the initial days-when pain is more intense and the inflammatory response is developing-followed by DS in the later recovery phase may enhance postoperative comfort.

TRIAL REGISTRATION: This clinical trial was retrospectively registered on 03.10.2023 with the number TCTR20231003006.

PMID:40369617 | DOI:10.1186/s13005-025-00501-0

BMC Nutr. 2025 May 14;11(1):96. doi: 10.1186/s40795-025-01079-1.

ABSTRACT

BACKGROUND: Anaemia is a significant global health issue, with adolescents being a particularly vulnerable group. In developing countries, 27% of adolescents are affected by anaemia, compared to a much lower prevalence of 6% in developed countries. This scoping review aims to investigate the intake of junk food and the development of anaemia, providing a foundation for future research in this field.

METHODS: A systematic search was conducted across Scopus, PubMed, EBSCO, CINHAL, WOS and ProQuest using specific keywords. Inclusion criteria comprised all quantitative studies examining the association between nutrition and the development of anaemia. Articles selected for analysis were restricted to those published in English Language between 2014-2024 and available as full-text articles.

RESULTS: Among the articles that were screened, 20 articles met the criteria for data extraction. Four studies did not reveal statistically significant correlations between nutrition and the development of anaemia, while two studies provided evidence for significant associations. The findings indicated increased anaemia was associated with (a) fast food intake, western pattern of diet, poor eating habits, omission of breakfast and (b) diminished consumption of fruits and vegetables, iron intake, seafood, nuts, and seeds.

CONCLUSION: The existing evidence suggests a link between the consumption of junk food and the prevalence of anaemia among adolescents. However, there is a lack of comprehensive studies that thoroughly explore this connection. This gap in research underscores the urgent need for more in-depth studies to understand how modifiable risk factors like junk food consumption contribute to anaemia in adolescents, with the goal of improving prevention and management strategies. Addressing this issue aligns with Sustainable Development Goal (SDG) 3, which aims to ensure healthy lives and promote well-being for all at all ages, which focuses on ending preventable deaths of children and addressing adolescent health. Additionally, this research also contributes to end hunger, achieve food security, and improve nutrition.

PMID:40369615 | DOI:10.1186/s40795-025-01079-1