Tag: statistics

J Cachexia Sarcopenia Muscle. 2025 Jun;16(3):e13862. doi: 10.1002/jcsm.13862.

ABSTRACT

BACKGROUND: Ageing is a complex and multi-dimensional process that manifests heterogeneities across different organs/systems, individuals and countries. We aimed to delineate the life-course percentile curves and establish the normative values of multi-systemic (e.g., muscle-skeletal, brain, cardiovascular and pulmonary) ageing metrics for people under distinct sociodemographic contexts (i.e., sex, income and education).

METHODS: Three national datasets, the UKB (the United Kingdom), the NHANES (the United States) and the CHARLS (China) were utilized for the analyses. We selected 14 ageing metrics (e.g., body mass index, grip strength, fat-free mass index, bone mineral content [BMC], bone mineral density [BMD], diastolic blood pressure, cognitive function and frailty index_Lab) that represent the functions of different organs/systems and plotted their sex-, educational- and income-specific percentile curves utilizing the GMALSS model. We also estimated the age-specific normative values for each ageing metric in distinct sociodemographic contexts.

RESULTS: The functions of all metrics, except for cognitive function, manifested a progressive decline or maintained stability after adulthood (20s), especially after middle age (40s-50s). The cognitive function showed an evident decline in old age (70s-75s) (e.g., in the CHARLS: the median [IQR] cognitive function scores were 11.6 [9.1, 13.8], 10.3 [7.5, 12.9], 8.3 [5.5, 11.0] at the ages of 60, 70 and 80 for males, respectively). In the stratified analyses, males and females manifested disparities in percentile curves of ageing metrics involving the muscle-skeletal and cardiovascular systems. For instance, BMC and BMD manifested an evident decline after middle age in females, whereas they showed a slow decline after adulthood in males. Notably, we observed substantial income and educational disparities in percentile curves of several ageing metrics within Chinese participants: the ‘low-income’ and ‘low-education’ subgroups manifested an evident decline in ageing metrics (e.g., grip strength and frailty index_Lab) representative of multiple systems. By contrast, these income or educational disparities were not observed in the British and American participants.

CONCLUSIONS: Our investigation delineated the potential heterogeneities and socioeconomic disparities in percentile curves of multi-systemic ageing metrics and provided their age-specific normative values tailored to different sexes and socioeconomic contexts based on three national datasets. This study may serve as a proof-of-concept for understanding the multi-dimensional signature of systemic ageing and calls for policies to promote health equity across nations when facing dramatic global ageing.

PMID:40511588 | DOI:10.1002/jcsm.13862

J Cachexia Sarcopenia Muscle. 2025 Jun;16(3):e13858. doi: 10.1002/jcsm.13858.

ABSTRACT

BACKGROUND: Postoperative myopenia (acute muscle loss) is a significant concern following major cancer resection surgery, contributing to prolonged recovery, increased dependency and impaired quality of life. Despite its clinical relevance, the mechanisms underlying postoperative myopenia and its potential mediators remain poorly understood. This study aims to evaluate the acute changes in muscle size, strength and activity following major cancer surgery and to explore the role of insulin resistance and selenium deficiency as potential mediators of these alterations.

METHODS: A prospective cohort study was conducted involving 52 patients undergoing elective open major abdominal surgery for cancer. Preoperative and postoperative assessments included measurements of rectus femoris cross-sectional area (RFCSA) via ultrasound, handgrip strength (HGS), sniff nasal inspiratory pressure (SNIP) and physical activity using an accelerometer. Blood samples were analysed for markers of muscle metabolism, systemic inflammation, insulin resistance and selenium levels. Statistical analyses were performed to compare preoperative and postoperative values and to explore correlations between these measures and clinical outcomes.

RESULTS: A significant reduction in RFCSA was observed in 50% of patients, with a median decrease of 10.2% within the first week post-surgery, which persisted at the 6-week follow-up. HGS and SNIP also showed significant declines postoperatively, and reduced physical activity was associated with greater muscle loss. Insulin resistance and postoperative selenium depletion were associated with greater reductions in RFCSA.

CONCLUSION: Major cancer surgery is associated with significant acute muscle loss, which is not fully recovered by 6 weeks postoperatively. Insulin resistance and selenium deficiency may contribute to this muscle loss. Further research is needed to investigate potential interventions to prevent or mitigate postoperative myopenia.

PMID:40511585 | DOI:10.1002/jcsm.13858

J Glob Health. 2025 Jun 13;15:04165. doi: 10.7189/jogh.15.04165.

ABSTRACT

BACKGROUND: The effects of short-term air pollution exposure on hospital admissions for premature rupture of membranes (PROM) were still controversial.

METHODS: Daily data on PROM hospitalisations and air pollutants were collected from 1 January 2015 to 31 December 2021, across five cities in the North China Plain. We investigated the associations between short-term (lag0-7) exposure to air pollutants, including fine particulate matter (PM_2.5), inhalable particulate matter (PM₁₀), nitrogen dioxide (NO₂), sulfur dioxide (SO₂), carbon monoxide (CO), and ozone (O₃), as well as composite air pollution indicators, including air quality index (AQI) and air quality composite index (AQCI). We further assessed the modifying effects of age (<35 and ≥35 years), season (cold and warm seasons), and the ‘Three-Year Action Plan’ (before and after implementation) on the above associations.

RESULTS: A total of 16 503 mothers with PROM were included. For each interquartile range (IQR) increase, the strongest relative risks (RRs) were 1.024 (95% confidence interval (CI) = 1.001-1.047, P < 0.05) in PM_2.5 in lag3 (IQR = 48 μg/m³), RR = 1.036 (95% CI = 1.009-1.063, P < 0.05) in CO in lag4 (IQR = 0.49 mg/m³), RR = 1.024 (95% CI = 1.003-1.044, P < 0.05) in AQI in lag3 (IQR = 53), and RR = 1.026 (95% CI = 1.001-1.050, P < 0.05) in AQCI in lag3 (IQR = 2.9). The effects of exposure to PM_2.5, NO₂, SO₂, CO, AQI, and AQCI on PROM were stronger in mothers aged <35 years, and the effects of exposure to PM₁₀, NO₂, and SO₂ on PROM were stronger during the warm season (all P _modification<0.05).

CONCLUSIONS: Short-term air pollution exposure was related to elevated hospital risk of PROM. The effects were more pronounced among mothers aged <35 years and during the warm season.

PMID:40511528 | DOI:10.7189/jogh.15.04165

Arthritis Care Res (Hoboken). 2025 Jun 13. doi: 10.1002/acr.25582. Online ahead of print.

ABSTRACT

OBJECTIVE: Despite extensive cancer-related research in patients with rheumatoid arthritis (RA), there remains a paucity of studies on thyroid cancer in RA patients. We investigated risk of thyroid cancer in RA patients using updated definitions to identify RA patients and incident cases of thyroid cancer with consideration of RA serologic status.

METHODS: Using a nationwide database, we identified 40,895 patients with newly diagnosed RA between 2010 and 2017, and matched them by sex and age at a 1:5 ratio to a control population of 204,475 non-RA individuals. The association of thyroid cancer and RA with consideration of serostatus was investigated using Cox regression analyses. Stratified analysis by sex and age were conducted using the same Cox modeling.

RESULTS: During 5.5 years of follow-up, compared to the matched control group, the adjusted hazard ratio (aHR) of thyroid cancer in overall RA patients was 0.98 (95% confidence interval [CI] 0.85-1.13). Compared to the seronegative RA patients, seropositive RA patients did not show a significantly different risk of thyroid cancer (aHR 1.03, 95% CI 0.78-1.36). Stratified analyses by age or sex showed no statistical interaction.

CONCLUSION: Patients with newly diagnosed RA did not show a different risk of thyroid cancer compared to a matched control group. The risk of thyroid cancer incidence was not affected by serologic status of RA, sex, or age.

PMID:40511527 | DOI:10.1002/acr.25582

Disaster Med Public Health Prep. 2025 Jun 13;19:e150. doi: 10.1017/dmp.2025.10083.

ABSTRACT

OBJECTIVES: This study aims to investigate the relationship between post-traumatic stress disorder (PTSD) and job-related stress among nurses working in both central and district areas of Adıyaman following the earthquake. Additionally, we assess potential risk factors influencing both PTSD and job-related stress.

METHODS: This cross-sectional study involved 332 nurses. The study considered several independent variables, including age, gender, marital status, place of residence, experience of family loss due to the earthquake, and workplace location. The dependent variables for the study were identified as post-traumatic stress disorder and job stress.

RESULTS: Of the nurses surveyed, 69% showed symptoms of post-traumatic stress disorder.Notably, higher job stress scale scores were identified among women (P = 0.028), married individuals (P = 0.005), those with children (P < 0.001), those who were in Adıyaman during the earthquake (P < 0.001), and those who experienced family loss due to the earthquake (P < 0.001). Furthermore, a significant positive correlation was observed between PTSD scores and job stress scores (r = 0.599; P < 0.001).

CONCLUSIONS: Given the bidirectional impact of PTSD and job stress, prompt and comprehensive interventions are essential for safeguarding nurses’ mental health and professional capacity following major events. These interventions should also consider other risk factors, such as female gender or experiencing a family loss.

PMID:40511523 | DOI:10.1017/dmp.2025.10083

Disaster Med Public Health Prep. 2025 Jun 13;19:e149. doi: 10.1017/dmp.2025.83.

ABSTRACT

OBJECTIVES: A train derailment in East Palestine, Ohio, near the Ohio-Pennsylvania border on February 3, 2023, resulted in the release of hazardous substances and chemical exposures among residents and Pennsylvania first responders. We aimed to analyze data collected from an Assessment of Chemical Exposure (ACE) survey to better understand unique exposures and health symptoms among Pennsylvania first responders and identify additional safety measures to protect responders in future hazardous materials spill events.

METHODS: Descriptive statistics for ACE survey results from 114 Pennsylvania first responders were produced and relationships between exposures, health symptoms, and occupation type were examined using logistical regression models.

RESULTS: First responder occupation title and job duties were determinants of chemical exposure types, and specific chemical exposure types were associated with unique health outcomes. Firefighters and those with a job duty to suppress the fire were more likely to report contact with vapor/gas compared to all other roles and those with a duty of environmental monitoring. Contact with vapor/gas was associated with increased likelihood of reporting 2 or more health symptoms.

CONCLUSIONS: This analysis highlights the necessity of tailoring emergency response action plans and personal protective equipment considering first responder occupation title and to the specific duties conducted within their role.

PMID:40511509 | DOI:10.1017/dmp.2025.83

J Glob Health. 2025 Jun 13;15:04155. doi: 10.7189/jogh.15.04155.

ABSTRACT

BACKGROUND: Some studies suggest a link between allergic rhinitis (AR) and irritable bowel syndrome (IBS), but evidence is insufficient. This meta-analysis aimed to explore the relationship between AR and IBS.

METHODS: We searched the relevant literature in six electronic databases. We included a total of nine articles, seven of which took AR as the research object, two of which took IBS as the research object. We performed a meta-analysis using random effects and estimated the resultant odds ratio (OR).

RESULTS: A total of 10 627 patients with AR were included in seven studies, including 956 patients diagnosed with AR in the IBS population and 9671 patients diagnosed with AR in the non-IBS population. By heterogeneity test, X² = 10.12, F-statistic (F) = 6, P = 0.12, I² = 41%, OR = 2.88, and Z-score (Z) = 21.97 (P < 0.00001), the results were statistically significant. Patients with AR have an increased risk of developing IBS compared to patients without AR. A total of 1099 patients with IBS were included in two studies, including 384 patients with IBS in AR patients and 715 patients with IBS in the healthy population. After the heterogeneity test, X² = 0.11, F = 1, P = 0.74, I² = 0%, OR = 2.15, and Z = 11.81 (P < 0.00001), the results were statistically significant. Patients with IBS have an increased risk of developing AR compared to patients without IBS.

CONCLUSIONS: The bidirectional association between AR and IBS provides a basis for exploring potential new mechanisms between the two.

REGISTRATION: No. INPLASY202440057.

PMID:40511506 | DOI:10.7189/jogh.15.04155

J Esthet Restor Dent. 2025 Jun 13. doi: 10.1111/jerd.13497. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to characterize the microstructural, mechanical, and surface properties of abutment screws with modified surface characteristics.

METHODS: Five anodized abutment screws of different coloration (green, purple, yellow, blue, brown), one Diamond-like carbon (DLC)-coated screw, one gold-alloy screw, one gold-coated screw, and one uncoated screw were used. Surface roughness parameters (S_a, S_q, S_sk, S_ku, S_pk, S_k, and S_vk) were assessed by an optical profiler. Microstructural observations and elemental analysis were conducted with a scanning electron microscope (SEM) equipped with energy dispersive X-ray detector (EDX). Martens Hardness (HM) and Indentation Elastic Modulus (E_IT) were evaluated using Ιnstrumented Ιndentation Testing (IIT) employing a nanoindentation testing device. One-way ANOVA and Tukey post hoc tests were performed for statistical analyses (a = 0.05).

RESULTS: SEM-EDX analysis demonstrated differences in microstructure and elemental composition on the bulk and the surface of abutment screws tested. Statistically significant differences were found for all surface roughness parameters and mechanical properties tested. The green anodized screw demonstrated significantly higher S_a, S_q, S_pk, and S_{v k} values, while the gold-coated screw had significantly higher HM and E_IT.

CONCLUSIONS: The examined abutment screws displayed significant variations in the properties assessed, indicating that these differences may lead to variations in their clinical performance.

PMID:40511499 | DOI:10.1111/jerd.13497

JMIR Form Res. 2025 Jun 12;9:e60789. doi: 10.2196/60789.

ABSTRACT

BACKGROUND: Simulated electronic health records (EHRs) are used in structured teaching for health care students. This partly addresses inconsistent student exposure to EHRs while on clinical placements. However, simulated records are poor replacements for the complexity of data encountered in real EHRs. While routinely collected health care data are often used for research, secondary use does not include education. We are exploring the perceptions, governance, and ethics required to support the use of real patient records within teaching.

OBJECTIVE: The aim of the study is to explore the perspectives of health care professionals regarding the use of real patient records to deliver interprofessional EHR education to undergraduate health care students.

METHODS: We held 90-minute group discussions with 10 health care professionals from nursing, pharmacy, medicine, and allied health disciplines. We used the GRIPP2 (Guidance for Reporting Involvement of Patients and the Public 2) checklist for reporting Patient and Public Involvement and Engagement to present our reflections.

RESULTS: There was consensus on the need to upskill health care students in the use of EHRs. Participants emphasized teaching general EHR competencies and transferable skills to overcome the diversity in EHR systems. They highlighted limitations in current teaching due to accessibility issues, disparities within clinical teaching, and curricular gaps on important topics such as clinical documentation and coding. Highlighted benefits of using real EHRs in teaching included learning from the complexities and inaccuracies of real patient data, grasping real-world time frames, and better appreciation of multidisciplinary interactions. Concerns included exposing individual clinicians to unfounded scrutiny and the potential consequences of incidental findings within EHRs. The ethical implications of overlooking perceived errors within EHRs versus the impracticality of acting on them were discussed. To mitigate concerns, it was suggested that data donors would provide informed consent ensuring they understand that they will not be recontacted should any such errors be found.

CONCLUSIONS: Innovative solutions are needed to realign health care education with clinical practice in rapidly evolving digital environments. Real patient records are optimal for teaching students to handle complex and abundant real-world data. Data within EHRs represent a wealth of clinical knowledge encompassing professional and personal experiences spanning the lifetimes of patients and their caregivers. Drawing experiences and events from real EHRs will prepare health care students to anticipate, confront, and manage real patients in a variety of real-life scenarios. Our reflections highlight the processes and safeguards to consider when using real patient records to deliver EHR education to health care students. These detailed reflections from discussions with health care professionals provide the grounds for a robust framework, with appropriate governance and consent in place to use real health data in training to support preparation for clinical practice.

PMID:40511496 | DOI:10.2196/60789

BJOG. 2025 Jun 13. doi: 10.1111/1471-0528.18254. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the association between ethnicity and severe maternal morbidity (SMM) in England and the mediating effects of neighbourhood-level socio-economic deprivation across detailed ethnic groups.

DESIGN: Population-based nationwide cohort study using English Hospital Episode Statistics Admitted Patient Care (HES APC) data.

SETTING: All hospital births in NHS facilities in England between 1 January 2013 and 31 March 2023.

POPULATION: A cohort of 3 839 156 women aged 10- 55 years with births of ≥ 20 weeks’ gestation.

METHODS: Multivariable fixed and mixed-effects Poisson regression models were used to estimate adjusted risk ratios (RR) for SMM across 10 ethnic groups compared to White women and for each ethnic group in different deprivation quintiles compared to White women in the least deprived neighbourhoods, respectively. Causal mediation analysis was used to calculate the proportion of the association mediated by deprivation.

MAIN OUTCOME MEASURES: The modified English Maternal Morbidity Outcome Indicator (EMMOI), a composite outcome of SMM.

RESULTS: Minoritised ethnic groups experienced higher SMM risks than White women, with the highest risk for Black African women (RR 1.96, 95% CI: 1.82-2.02) and Bangladeshi women (RR 1.97, 95% CI: 1.88-2.07) compared to White women. The strength of the association varied across ethnic subgroups. Most of the effect of ethnicity on SMM was not mediated by deprivation (11%-29%).

CONCLUSIONS: Deprivation plays a minor role in ethnic disparities in SMM. Policies must address the unique challenges faced by minoritised ethnic women.

PMID:40511482 | DOI:10.1111/1471-0528.18254