Tag: statistics

Int J Breast Cancer. 2025 Jun 30;2025:5542692. doi: 10.1155/ijbc/5542692. eCollection 2025.

ABSTRACT

Introduction: The practice of mammography has transitioned from analog to digital with improved accuracy and significant changes to findings. This study was aimed at investigating the current patterns of breast diseases among women presenting for mammography at a major hospital in the Volta region of Ghana. Methods: This descriptive retrospective study reviewed 508 mammography and complimentary breast ultrasound reports conducted between October 2019 and May 2023. Because they were incomplete and had essential patient data missing, 28 reports (n = 28) were excluded. Data extracted from the reports included patients’ age, clinical indication, breast density, imaging impression, and BI-RADS classification for each breast. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) Version 26, and results are presented using descriptive and inferential statistics. Results: The study involved 480 women, aged 40-86 years (mean = 54.6 ± 10.1). The distribution of the breast densities of the women was as follows: almost entirely fatty (n = 79, 16.46%), scattered areas of fibroglandular density (n = 226, 47.08%), heterogeneously dense (n = 145, 30.21%), and extremely dense (n = 30, 6.25%). There was a statistically significant association between age and breast density (p < 0.01). While 30 (6.25%) of the women presented for screening, 450 (93.75%) presented for diagnostic mammography. Breast pain (n = 189, 39.38%), breast lump/mass (n = 155, 32.29%), and suspected breast cancer (n = 47, 9.79%) were the most common clinical indications. The study recorded a total of 960 BI-RADS classifications of which 261 (27.19%) were negative and 699 (72.81%) were positive. Most of the positive findings (n = 521, 74.54%) were BI-RADS 2 and 3. Both benign and suspicious for malignancy or highly suggestive of malignancy lesions were common across women aged 40-50 years. There was a statistically significant association between age and BI-RADS classification (p < 0.01). Conclusion: This study showed that most of the women presented for diagnostic mammography. Attendance for screening mammography was poor among women presenting for mammography at the hospital; hence, women should be encouraged through health education and other campaign strategies to undergo screening mammography more regularly to facilitate more timely detection and diagnosis of breast diseases. A third of the women in our study had dense breasts. The vast majority of the women had positive findings, but the majority of these findings were indicative of benign breast diseases.

PMID:40626282 | PMC:PMC12234167 | DOI:10.1155/ijbc/5542692

Front Endocrinol (Lausanne). 2025 Jun 23;16:1600936. doi: 10.3389/fendo.2025.1600936. eCollection 2025.

ABSTRACT

PURPOSE: This study aims to create and validate a clinical prediction model to determine the optimal gonadotropin (Gn) starting dose in controlled ovarian stimulation (COS) protocols for normal ovarian response (NOR) patients undergoing their first IVF/ICSI-ET cycle.

METHODS: A retrospective analysis was conducted based on the data of the first IVF/ICSI-ET cycles of 535 patients from the Reproductive Medicine Department of the Fourth Hospital of Hebei Medical University between January 2017 and June 2024. The patients were randomly divided into a training group (n=317) and a validation group (n=218) in a 6:4 ratio. Linear regression analysis was applied to screen out the potential factors influencing the Gn starting dose, and the statistically significant factors were selected to construct a nomogram for Gn dosage. We used an internal verification method to ensure the reliability of the nomogram.

RESULTS: The patient’s age, body mass index (BMI), basal follicle-stimulating hormone (bFSH), antral follicle count (AFC), and anti-Müllerian hormone (AMH) were predictive indicators of the Gn starting dose for NOR patients undergoing IVF/ICSI-ET treatment (P<0.05). A predictive model was created based on the above indicators. Finally, the accuracy of this predictive model was validated by comparing the actual Gn starting doses with the predicted doses in both the training and the validation group. The results showed no significant difference between the actual and predicted Gn starting doses in the two groups (P>0.05).

CONCLUSION: Based on age, BMI, bFSH, AMH, and AFC, a clinician could determine the patient’s appropriate Gn starting dose for NOR patients undergoing IVF/ICSI-ET.

PMID:40626242 | PMC:PMC12229836 | DOI:10.3389/fendo.2025.1600936

Front Endocrinol (Lausanne). 2025 Jun 23;16:1548780. doi: 10.3389/fendo.2025.1548780. eCollection 2025.

ABSTRACT

OBJECTIVE: To examine the expression levels of miR-144-3p in the plasma of patients with gestational diabetes mellitus (GDM) and to construct a nomogram for predicting and evaluating factors influencing adverse pregnancy outcomes (APO) in GDM based on plasma miR-144-3p levels.

METHODS: This study included 442 pregnant women, comprising 216 diagnosed with GDM (GDM group) and 226 with normal glucose tolerance (NGT group). Plasma miR-144-3p levels in both groups were measured using reverse transcription real-time polymerase chain reaction (RT-qPCR). The diagnostic performance of plasma miR-144-3p for GDM was assessed by receiver operating characteristic (ROC) curve analysis. During pregnancy, the GDM group was followed, and outcomes were categorized into two groups: 132 with favorable pregnancy outcomes (FPO) and 84 with APO. A random number table method was applied to divide the GDM group into a training set (n=151) and a validation set (n=65) using a 7:3 ratio. Differences in variables across pregnancy outcome subgroups in the training set were examined. Univariate and multivariate logistic regression analyses were performed to identify risk factors for APO in GDM. Based on these factors, a nomogram prediction model was developed to estimate the risk of APO in GDM. The model’s performance was evaluated using area under the curve (AUC) analysis, calibration curve analysis, and decision curve analysis (DCA).

RESULTS: The expression of miR-144-3p was significantly higher in the GDM group than in the NGT group (p < 0.05). miR-144-3p showed an AUC of 0.877, with a sensitivity of 81.09% and a specificity of 91.20% for diagnosing GDM. No statistically significant differences were observed in general clinical characteristics between the training and validation sets. In the training set, gestational weight gain (GWG), the number of OGTT abnormalities, glycaemic control (GC), and miR-144-3p expression varied significantly between the APO and FPO subgroups (p < 0.05). Multivariate logistic regression analysis identified increased GWG, the number of OGTT abnormalities, poor GC, and higher miR-144-3p levels as independent risk factors for APO in GDM. The AUC of the nomogram based on these variables was 0.881 in the training set and 0.855 in the validation set. Calibration curves indicated good agreement between predicted and actual outcomes in both sets. The DCA showed a clear net clinical benefit and stable predictive utility.

CONCLUSION: Elevated plasma miR-144-3p levels in pregnant women with GDM may contribute to the occurrence of APO. The number of OGTT abnormalities and glycaemic control were also identified as independent risk factors. A nomogram incorporating miR-144-3p and these clinical indicators displays strong predictive accuracy and provides a practical tool for assessing APO risk in GDM.

PMID:40626241 | PMC:PMC12229801 | DOI:10.3389/fendo.2025.1548780

Med Devices (Auckl). 2025 Jul 2;18:361-375. doi: 10.2147/MDER.S520191. eCollection 2025.

ABSTRACT

IMPORTANCE: Safety issues leading to patient harm and significant costs have been identified in several post-market medical devices. Recently, powerful learning effects (LE) have been documented in numerous medical devices. Correctly attributing safety signals to learning or device effects allows for appropriate corrective actions and recommendations to improve patient safety.

OBJECTIVE: To develop and assess the statistical performance of an analytic framework to detect the presence of LE and quantify the learning curve (LC).

DESIGN AND SETTING: We generated synthetic datasets based on observed clinical distributions and complex feature correlations among patients hospitalized at US Department of Veterans Affairs facilities. Each dataset represents a hypothetical early experience in the use of high-risk medical devices, with a device of interest and a reference device. The study blinded the analysis team to the data-generation process.

METHODS: We developed predictive models using generalized additive models and estimated LC parameters using the Levenberg-Marqualdt algorithm. We evaluated the performance using sensitivity, specificity, and likelihood ratio (LR) in detecting the presence of LE and, if present, the goodness-of-fit of the estimated LC based on the root-mean squared error.

RESULTS: Among the 2483 simulated datasets, the median (IQR) number of cases was 218,000 (116,000-353,000). LE were detected in 2065 of the 2291 datasets for which learning was specified (sensitivity: 90%; specificity: 88%; LR: 7). We adequately estimated the LC in 1632 (81%) of the 2013 datasets in which LE was detected and estimated LC.

DISCUSSION: This study demonstrated the framework to be robust in disentangling LE from device safety signals and in estimating LC.

CONCLUSION: In medical device safety evaluation, the operator-learning effects associated with the safety of medical devices can be effectively modeled and characterized. This study warrants subsequent framework validation by using real-world clinical datasets.

PMID:40626234 | PMC:PMC12230321 | DOI:10.2147/MDER.S520191

Front Nutr. 2025 Jun 23;12:1560617. doi: 10.3389/fnut.2025.1560617. eCollection 2025.

ABSTRACT

BACKGROUND: Sarcopenia is a systemic disease characterized by a decline in muscle mass and function. It is associated with adverse health outcomes, and younger patients are at higher risk. Thus, early identification and prevention of high-risk factors are crucial. The uric acid to high-density lipoprotein ratio (UHR) is a novel marker of inflammation and metabolism, but studies on its association with sarcopenia are currently lacking.

METHODS: Data from the National Health and Nutrition Examination Survey (NHANES) 2011-2018 were utilized. Weighted multivariate logistic regression analysis was performed to explore the association between UHR and sarcopenia. Causal mediation analysis was conducted to investigate the mediating role of oxidative stress factors and systemic inflammatory markers in the UHR-sarcopenia relationship. Subgroup analysis and interaction tests were performed to identify high-risk populations for the positive association between UHR and sarcopenia. Restricted cubic spline (RCS) explored potential non-linear relationships between UHR and sarcopenia. Weighted multivariate Cox proportional hazards regression analysis assessed the relationship between UHR and all-cause mortality in sarcopenia patients.

RESULTS: A total of 10,308 adult participants aged ≥ 20 years were included in the study, with 901 diagnosed with sarcopenia. The weighted multivariate logistic regression analysis showed a significant positive association between UHR and sarcopenia after adjusting for all confounding factors (OR = 1.057; 95% CI: 1.037-1.077; P < 0.001). Total bilirubin mediated -8.53% of the association between UHR and sarcopenia (95% CI: -13.42% to -5.91%; P < 0.001). The subgroup analysis and interaction test results indicate that the positive association between the two variables is relatively stable across different populations. RCS analysis revealed no significant non-linear relationship between UHR and sarcopenia (P = 0.167). Weighted multivariate Cox proportional hazards regression analysis showed a significant positive association between UHR and all-cause mortality in sarcopenia patients (HR = 1.053; 95% CI: 1.024-1.083; P < 0.001) in the unadjusted model. However, after adjusting for all covariates, UHR maintained a positive association with all-cause mortality in sarcopenia patients (HR = 1.023; 95% CI: 0.990-1.056), though this association did not reach statistical significance (P = 0.173).

CONCLUSION: Elevated UHR shows a significant association with sarcopenia prevalence and exhibits a positive association trend with all-cause mortality among affected individuals. These findings suggest that UHR may serve as a potential indicator for sarcopenia risk assessment. Further prospective studies are warranted to validate its clinical utility for early screening and intervention strategies.

PMID:40626224 | PMC:PMC12229869 | DOI:10.3389/fnut.2025.1560617

Front Nutr. 2025 Jun 20;12:1612021. doi: 10.3389/fnut.2025.1612021. eCollection 2025.

ABSTRACT

BACKGROUND: Coronary heart disease (CHD) is a major global health burden, and emerging evidence suggested that probiotics could improve cardiovascular health by modulating gut microbiota and lipid profiles. However, the efficacy of probiotics remains elusive, indicating the necessity of conducting this meta-analysis.

METHODS: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching PubMed, EMBASE, and Web of Science databases for retrieving randomized controlled trials (RCTs) on probiotics’ effects on lipid profiles (low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides (TG)) in CHD patients. Inclusion and exclusion criteria concentrated on English-language RCTs, and data on study characteristics were extracted. Study quality was assessed using Cochrane and NHLBI tools, and statistical analysis was conducted via R 4.3.2 software.

RESULTS: The literature search identified 263 records, yielding 6 RCTs, 5 of which were included in the meta-analyses. For LDL level (n = 278), both fixed-effects and random-effects models exhibited an overall effect size of 1.25 units [95% confidence interval (CI): -0.62 to 3.12] with a low heterogeneity (I ² = 0%), while probiotics-based monotherapy achieved a mean difference (MD) of 13.4105 (95% CI: -8.0670 to 34.8879) versus an MD of 1.1578 for combination therapy (95% CI: -0.7146 to 3.0302). For HDL level (n = 278), the fixed-effects model yielded an MD of -3.8107 (95% CI: -4.2490 to -3.3724) versus an MD of -2.3119 for the random-effects model (95% CI: -4.2290 to -0.3949) with a moderate heterogeneity (I ² = 61.6%). Combination therapy demonstrated an MD of -2.9848 (95% CI: -4.7965 to -1.1732), while monotherapy exhibited a non-significant MD of 0.9115 (95% CI: -3.5084 to 5.3314). TG analysis yielded a common effect size of 17.95, with a minimal-to-moderate heterogeneity (I ² = 0 to 84.7%).

CONCLUSION: Probiotics, particularly monotherapy for LDL and combination therapy for HDL, exhibited potential to improve lipid profiles in CHD patients. However, further research is needed to address existing limitations and confirm efficacy.

PMID:40626219 | PMC:PMC12231435 | DOI:10.3389/fnut.2025.1612021

Front Nutr. 2025 Jun 23;12:1576705. doi: 10.3389/fnut.2025.1576705. eCollection 2025.

ABSTRACT

BACKGROUND: Recent studies have indicated that vitamin D and folate are essential for muscle health and each is independently linked to the prevalence of sarcopenia. However, the potential synergistic effects of vitamin D and folate on sarcopenia have not been extensively studied. This study aims to investigate both the individual and joint associations of serum 25-hydroxyvitamin D [25(OH)D] and folate concentrations with the risk of sarcopenia.

METHODS: This study conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES), covering the years 2011-2018. Multivariable logistic regression models were used to determine individual and joint associations of serum 25(OH)D and folate with sarcopenia. Additionally, the relative excess risk due to interaction (RERI) was estimated to assess additivity.

RESULTS: A significant inverse relationship was observed between serum 25(OH)D and folate levels in relation to sarcopenia. Specifically, among participants with 25(OH)D levels < 50 nmol/L, the odds ratios (ORs) for sarcopenia were 0.67 [95% confidence interval (CI): 0.56-0.81] for those with 25(OH)D levels between 50 and 75 nmol/L, and 0.61 (95% CI: 0.48, 0.77) for those with levels > 75 nmol/L. Similarly, when comparing participants in the lowest tertile of folate, the ORs for sarcopenia were 0.74 (95% CI: 0.61, 0.89) for the second tertile and 0.72 (95% CI: 0.59, 0.88) for the third tertile. Among individuals with fasting blood glucose levels < 7.0 mmol/L, those with both low levels of 25(OH)D and folate exhibited a significantly higher risk of sarcopenia compared to those with high levels of 25(OH)D and folate. Furthermore, the RERI was statistically significant.

CONCLUSION: In the present study, a synergistic interaction between 25(OH)D and folate was observed in relation to the risk of sarcopenia. These findings contribute new insights into the nutritional factors associated with sarcopenia and pave the way for future longitudinal studies to further explore this association.

PMID:40626218 | PMC:PMC12229844 | DOI:10.3389/fnut.2025.1576705

Front Nutr. 2025 Jun 20;12:1596300. doi: 10.3389/fnut.2025.1596300. eCollection 2025.

ABSTRACT

AIM: Chronic inflammation plays a significant role in the progression of non-alcoholic fatty liver disease (NAFLD). Adopting an anti-inflammatory diet can help prevent or mitigate NAFLD and its associated complications. This meta-analysis builds on previous research by examining the association between the Dietary Inflammatory Index (DII) and NAFLD risk, incorporating additional studies and employing rigorous evidence assessment.

METHODS: We systematically searched major databases (Cochrane Library, PubMed, Web of Science, and Scopus) from inception to June 2024 for English-language observational studies examining the association between DII and NAFLD prevalence. Pooled odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using random-effects models for studies with significant heterogeneity; otherwise, fixed-effects models were applied. Subgroup analyses were conducted to explore heterogeneity based on body mass index (BMI), DII definition, sample size, geographical region, age, and NAFLD diagnostic criteria. Evidence certainty was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. The study was registered in PROSPERO (CRD42023430798).

RESULTS: Eleven studies (9 cross-sectional with 14 effect sizes and 2 cohort with 2 effect sizes) were analyzed. Higher DII scores were significantly associated with increased NAFLD risk, with a pooled OR of 1.56 (95% CI: 1.24-1.95; p < 0.001) in cross-sectional studies and an HR of 0.21 (95% CI: 0.12-0.30; p < 0.0001) in cohort studies. Subgroup analyses confirmed consistency across BMI ≥ 25, energy-adjusted DII or DII, studies in Asia and Europe, and participants <46 years, with reduced heterogeneity (I² < 50%) in these categories. GRADE rated the certainty of evidence as “very low.”

CONCLUSION: Anti-inflammatory diets can reduce NAFLD risk. However, high-quality studies are needed to confirm this association.

PMID:40626217 | PMC:PMC12231496 | DOI:10.3389/fnut.2025.1596300

Nutr Metab (Lond). 2025 Jul 7;22(1):72. doi: 10.1186/s12986-025-00970-9.

ABSTRACT

AIMS: Observational studies have reported an association between dietary factors and endometriosis, but the causality remains unknown. The study aimed to investigate the potential causal association between dietary factors and endometriosis using Mendelian randomization (MR).

METHODS: We performed a two-sample MR analysis to investigate the effects of 18 diet-related exposure factors (alcoholic drinks per week, alcohol intake frequency, processed meat intake, poultry intake, beef intake, non-oily fish intake, oily fish intake, pork intake, lamb/mutton intake, bread intake, cheese intake, cooked vegetable intake, tea intake, fresh fruit intake, cereal intake, salad/raw vegetable intake, coffee intake, dried fruit intake) on the risk of endometriosis using summary statistics from the genome-wide association study (GWAS). The inverse variance weighted (IVW) method was used to deduce the causal association between dietary factors and endometriosis, and sensitivity analyses were further performed.

RESULTS: Processed meat intake (OR = 0.550; 95%CI:0.314-0.965; p = 0.037) and salad / raw vegetable intake (OR = 0.346; 95%CI:0.127-0.943; p = 0.038) were discovered as protective factors for endometriosis. Heterogeneity test revealed no significant heterogeneity (processed meat intake: p_IVW=0.607, p_MR-Egger=0.548; salad / raw vegetable intake: p_IVW=0.678, p_MR-Egger=0.620). MR-Egger regression test didn’t support any evidence for horizontal pleiotropy (processed meat intake: p for intercept = 0.865; salad / raw vegetable intake: p for intercept = 0.725). No causal relationship was found between other dietary intakes and endometriosis.

CONCLUSION: These findings suggest that processed meat intake and salad/raw vegetable intake are associated with a decreased risk of endometriosis, but further investigation is required.

PMID:40624721 | DOI:10.1186/s12986-025-00970-9

J Health Popul Nutr. 2025 Jul 7;44(1):240. doi: 10.1186/s41043-025-00996-y.

ABSTRACT

Violent armed conflict befell Nigeria in 2009 in form of Boko Haram terrorism and insurgency, and has been extended and sustained in all nooks and crannies of the country by banditry, kidnapping for ransom, herder-farmer clash and unknown gunmen attack or ethnic militia. On the other hand, between 2009 and 2024, Nigeria has suffered two economic recessions. This study interrogated the association between the sustained violent armed conflict with the attendant environmental shock and insecurity with the related deaths and economic health in Nigeria (2004-2020), covering the pre-Boko Haram years (2004-2007) and the Boko Haram operation years (2009-2019). The longitudinal study regressed the secondary data on violent armed conflict related deaths in Nigeria against % value added to gross domestic product by agriculture for 2004-2020 and against the prevalence of undernourishment for 2004-2019. Results showed that increase in battle related deaths led to statistically significant decrease in value added to national productivity by agriculture, forestry, and fishing. Prevalence of undernourishment increased significantly with increase in battle-related deaths. The study concluded that violent armed conflicts had significant negative impacts on environmental security in Nigeria and recommended that policymaking and direction be guided as such in order to stem the tide.

PMID:40624711 | DOI:10.1186/s41043-025-00996-y