Tag: statistics

BJS Open. 2025 Sep 8;9(5):zraf096. doi: 10.1093/bjsopen/zraf096.

ABSTRACT

BACKGROUND: Colorectal cancer (CRC) screening programmes aim to detect early, asymptomatic cancers and improve survival. This study aimed to establish the proportion of interval cancers, and the consequences with regard to stage, clinical outcome, and overall survival. Risk factors associated with interval CRCs were investigated.

METHODS: The Scottish Bowel Screening Programme uses faecal immunochemical testing at a threshold of 80 µg haemoglobin per g as a positive trigger for investigation. Screening was offered to all eligible individuals in one region, from November 2017 to October 2021. Cancer registries were cross-checked to ensure complete capture of all cancers including interval CRCs. The primary outcome was rate of interval CRCs among participants with follow-up of 24 months, and its relationship to faecal immunochemical testing results, clinical variables, stage, time to diagnosis, and survival. The secondary outcome was identification of risk factors associated with interval CRCs.

RESULTS: The Scottish Bowel Screening Programme generated 316 583 tests during the study period. Participation was 71.0% of the eligible population (212 664 patients); it was greater among women (71.9 versus 70.0%; P < 0.001) and in higher socioeconomic areas (76.9 versus 58.6%; P < 0.001). In the screened population, 546 CRCs were diagnosed within 2 years of screening. Some 289 of these patients (52.9%) had positive bowel screening. There were 257 patients with interval CRCs, who waited a median of 13 (interquartile range 7-20) months for diagnosis. Of CRCs diagnosed, 24.9% had screening faecal immunochemical test results of < 10 µg haemoglobin per g. The interval CRC rate was greater in women, older patients, and among the least socioeconomically deprived. Interval CRCs were associated with worse 2-year all-cause mortality than screen-detected CRCs (23.0 versus 10.8%; P < 0.001). Importantly, 121 of the 257 interval CRCs (47.1%) had detectable faecal immunochemical test results at 10-79 µg haemoglobin per g.

CONCLUSION: Patients with interval CRCs and a detectable faecal immunochemical test result below the predetermined threshold appear to be significantly disadvantaged with respect to stage at presentation and survival. Almost half of interval CRCs diagnosed within 2 years had detectable haemoglobin on screening faecal immunochemical test and would be a target for lower positivity thresholds.

PMID:41061131 | DOI:10.1093/bjsopen/zraf096

ANZ J Surg. 2025 Oct 8. doi: 10.1111/ans.70308. Online ahead of print.

ABSTRACT

BACKGROUND: The demand for conversion gastric bypass bariatric procedures has increased; however, the ideal procedure remains contentious, and access to government-funded procedures remains limited. This study aimed to determine if the medium-term weight loss, reflux, and safety outcomes are significantly different in patients who receive conversion Roux-en-Y gastric bypass (RYGB) and One Anastomosis Gastric Bypass (OAGB) in an Australian government-funded hospital (GFH).

DESIGN: This was a retrospective observational study of 251 adult participants who received conversion gastric bypass surgery at the Royal Brisbane and Women’s Hospital between January 1, 2015, and April 30, 2023. The primary outcome measure was the annual percentage total weight loss (%TWL) from 12 months to 5 years following conversion to RYGB versus OAGB. Secondary outcome measures were post-operative reflux, hospital length of stay (LOS), and complications within 90 days.

RESULTS: The annual median %TWL from 1 to 5 years post-surgery did not demonstrate a statistically significant difference between conversion RYGB and OAGB. Participants who had previously received a laparoscopic adjustable gastric banding (LAGB) and had a conversion to RYGB for gastro-oesophageal reflux demonstrated statistically significantly better annual %TBWL out to 4 years compared to those who had received a prior sleeve gastrectomy (SG) χ²(1) = 6.4, p = 0.011. Similarly, there was a statistically significant improved %TWL in patients with gastro-oesophageal reflux, who were converted to OAGB from primary LAGB compared to primary SG; however, this was only statistically significant out to 2 years χ²(1) = 4.2, p = 0.041. Pre- and post-operative gastro-oesophageal reflux and LOS were comparable in conversion RYGB and OAGB procedures. RYGB demonstrated a significantly higher incidence of the post-operative complications out to 90 days; p = 0.008.

CONCLUSION: RYGB and OAGB provide durable medium-term weight loss when performed as conversion procedures. Our results suggest that consistent, improved medium-term weight loss can be achieved in participants who undergo conversion gastric bypass in the context of reflux if they have previously received LAGB. There was no significant difference in the incidence of de-novo gastro-oesophageal reflux following either RYGB or OAGB.

PMID:41059548 | DOI:10.1111/ans.70308

J Cosmet Dermatol. 2025 Oct;24(10):e70490. doi: 10.1111/jocd.70490.

ABSTRACT

BACKGROUND: The use of electromagnetic energy as an alternative to surgical procedures for subcutaneous fat reduction has gained popularity in recent years. In this pilot study, the effects of using amplified radio-frequency energy in the medium wave delivery range, in conjunction with exercise intervention, were investigated for their potential reduction of abdominal subcutaneous and visceral fat.

OBJECTIVES: The study aimed to evaluate the effects of combined intervention on the volume of abdominal fat, analyzing changes in lipid profile, metabolic factors, and inflammatory markers.

METHODS: Thirty-four participants were selected and assigned to a 10-day intervention utilizing a Capenergy device every weekday except Saturday and Sunday. This involved the application of amplified energy through a belt covering the abdominal area of 800 cm² followed by a 45-min submaximal aerobic exercise. Measurements were conducted pretreatment and after the intervention. Lipid profile, leptin, insulin, and protein C were measured. Body fat was measured by MRI of the entire abdomen. Follow-up measurements were also taken at the 6-month mark.

RESULTS: A statistically significant decrease was noted in both subcutaneous and visceral fat in the abdominal area, as well as a decrease in weight, waist-to-hip, and all biochemical values, without side effects, just a slight redness. These effects on abdominal fat were maintained at the 6-month follow-up with no reports of regaining fat.

CONCLUSION: The utilization of amplified radiofrequency with an abdominal belt with static electrodes and temperature sensors, together with exercise intervention, has significant potential for reducing abdominal subcutaneous and visceral fat, while also improving associated factors safely and effectively, even after a follow-up period.

TRIAL REGISTRATION: NCT06377358.

PMID:41059542 | DOI:10.1111/jocd.70490

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