Tag: statistics

Vasa. 2025 Aug 21. doi: 10.1024/0301-1526/a001225. Online ahead of print.

ABSTRACT

Background: We investigated the safety and efficacy of antiplatelet therapy in preventing native arteriovenous fistula (AVF) dysfunction. Patients and methods: A systematic review was conducted in accordance with the PRISMA 2020 guidelines. Randomized controlled trials (RCTs) evaluating the effects of antiplatelet therapy following native AVF creation were eligible for inclusion. The primary endpoint was AVF primary patency. Secondary endpoints included AVF maturation, abandonment, and overall bleeding. Results: Twelve RCTs, comprising 2,491 patients, were incorporated in the analysis. The included studies assessed aspirin, clopidogrel, ticlopidine, and dypiridamole across various dosing regimens. The postoperative administration of antiplatelets, regardless of the specific drug or dose, was associated with improved AVF primary patency compared to controls or placebo, odds ratio (OR) 2.28 (95% CI: 1.42-3.65). Subgroup analysis showed no significant differences for aspirin 100mg daily or clopidogrel 75mg daily compared to controls/placebo, with ORs of 1.08 (95% CI: 0.76-1.54) and 2.16 (95% CI: 0.95-4.91), respectively. In contrast, ticlopidine 250mg twice daily significantly improved patency, OR 3.48 (95% CI: 1.46-8.26). Additionally non-statistically significant differences were identified between the antiplatelet and control/placebo groups in terms of maturation, OR 1.58 (95% CI: 0.81-3.09), AVF abandonment, risk ratio (RR) 0.93 (95% CI: 0.58-1.50), or overall bleeding RR 1.18 (95% CI: 0.77-1.81). Finally, meta-regression analysis of the antiplatelet groups pooled estimates revealed a negative association between maturation and follow-up duration (β =-0.1235, p<.01), and treatment duration and abandonment outcomes (β =-0.065, p<.01). Conclusions: This review demonstrated the safety and efficacy of antiplatelet therapy in preserving AVF patency, with ticlopidine and clopidogrel emerging as the primary contributors to this outcome. These findings suggest the potentially beneficial role of adenosine diphosphate (ADP) receptor antagonists in maintaining AVF patency.

PMID:40838310 | DOI:10.1024/0301-1526/a001225

ANZ J Surg. 2025 Aug 21. doi: 10.1111/ans.70279. Online ahead of print.

ABSTRACT

BACKGROUND: Pelvic exenteration (PE) including en-block resection of two or more adjacent pelvic organs, regional lymph nodes, and pelvic side wall is a major surgical undertaking with associated morbidity. This study aims to assess the rate of urological intervention and complications of PE at an Australian quaternary centre.

METHODS: Patients undergoing PE with a genitourinary component between January 2003 and July 2021 were included. Data were collected prospectively and analyzed retrospectively. Complications were defined as early (< 30 days) or late (≥ 30 days) using the Clavien-Dindo classification.

RESULTS: A total of 424 patients underwent PE, of whom 213 (50.2%) had a genitourinary component. Early post-operative (30-day) mortality was 0.5% and overall survival was 59.6%. Early urological complications occurred in 106 (49.8%) patients, with 11 (5.2%) experiencing an early urine leak and five (2.3%) sustaining ureteric injury. A late urological complication eventuated in 56 (26.3%) patients, with 19 (8.9%) patients developing non-malignant ureteric stricture requiring upper tract intervention. Chronic kidney disease developed post-operatively in 39 (18.3%) patients at the completion of patient follow-up. Female sex and primary (versus recurrent) malignancy were the only statistically significant predictors of new chronic renal impairment (OR [95% CI] 2.86 (1.33-6.16) and 2.18 (1.09-4.34), respectively). No pre-operative clinicopathological factors predicted urine leak.

CONCLUSIONS: Our experience with PE over a long follow-up period demonstrates urological complication rates consistent with the literature associated with urinary diversion and anastomosis, with expected rates of urine leak and ureteric stricture. Further research is required to better delineate and mitigate risk factors for genitourinary complications.

PMID:40838304 | DOI:10.1111/ans.70279

Int J Environ Res Public Health. 2025 Jul 23;22(8):1165. doi: 10.3390/ijerph22081165.

ABSTRACT

In the original publication […].

PMID:40838296 | DOI:10.3390/ijerph22081165

An Sist Sanit Navar. 2025 Aug 21;48(2):e1109. doi: 10.23938/ASSN.1109.

ABSTRACT

BACKGROUND: This study aimed to evaluate the effects of nursing quality control combined with intensified psychological care on negative emotions and health outcomes in patients undergoing blood purification.

METHODS: Patients who underwent blood purification at the Affiliated Hospital of Jiangnan University (China) from January 2021 to December 2023 were enrolled and assigned to either a control or an intervention group using a random number table. Both groups received standard care, while the intervention group additionally received nursing quality control and intensified psychological care. Outcomes compared between groups included negative emotions (assessed by the Hamilton Anxiety Scale and Hamilton Depression Scale scores), quality of life (SF-36), treatment adherence, and complication rates.

RESULTS: Prior to the treatment, both groups (150 patients in each) were comparable in the Hamilton Anxiety Scale, the Hamilton Depression Scale, and SF-36 scores. After the treatment, the intervention group showed significantly greater reduction in the Hamilton Anxiety Scale (15.89 vs. 7.19) and Hamilton Depression Scale (12.22 vs. 4.74) scores, and greater improvements in SF-36 scores, particularly in physical functioning (37.99 vs. 22.61and) and mental health (34.48 vs. 18.95). Moreover, treatment adherence was significantly higher in the intervention group (98.67% vs 70%), while the complication rate was markedly lower (10% vs. 35.33%). All differences were statistically significant (p < 0.001).

CONCLUSIONS: Nursing quality control combined with intensified psychological care significantly improves negative emotional states and quality of life in patients undergoing blood purification, while also enhancing treatment adherence and reducing the incidence of complications.

PMID:40838287 | DOI:10.23938/ASSN.1109

Spine (Phila Pa 1976). 2025 Aug 21. doi: 10.1097/BRS.0000000000005464. Online ahead of print.

ABSTRACT

STUDY DESIGN: Modified Delphi consensus survey.

OBJECTIVE: To survey expert opinion on postoperative return-to-sport (RTS) decisions in athletes requiring cervical spine surgery.

SUMMARY OF BACKGROUND DATA: Postoperative sport participation recommendations for athletes requiring cervical spine surgery are lacking, and management of these athletes remains challenging.

METHODS: A cross-sectional, modified Delphi consensus survey investigating RTS decisions in athletes requiring various cervical spine operations was undertaken. A panel of neurosurgery/orthopedic spine surgeons with sport expertise was identified from the United States and Australia. Single and multi-level cervical spine surgical conditions studied included: anterior cervical discectomy and fusion (ACDF), cervical laminectomy and laminoplasty, posterior cervical fusion, occipito-cervical fusion, C1 fracture, and C1-C2 fusion. A 2×2 scheme was used to classify sport risk based on impact forces and frequency: low impact/low frequency, low impact/high frequency, high impact/low frequency, and high impact/high frequency. Consensus was a-priori defined at ≥70%. Descriptive statistics were performed.

RESULTS: Of the 34 sports spine surgeons invited (56% neurosurgeons and 44% orthopedic surgeons), survey completion was 100%. Consensus was achieved to recommend return to high impact/high frequency sport for individuals with 1-level ACDF, 1-level cervical laminectomy, 1-level posterior cervical fusion, and for a healed C1 fracture treated with open reduction and internal fixation. For individuals with a healed occipito-cervical fusion, consensus was achieved to recommend return to low impact/low frequency sport.

CONCLUSIONS: Consensus was achieved to recommend return to high impact/high frequency sport after surgical treatment of a variety of cervical pathologies in athletes. Certain situations received consensus recommendations to return to low impact/low frequency sport, while many others did not reach a consensus. These results provide useful data that can help spine surgeons navigate challenging postoperative RTS decisions.

PMID:40838273 | DOI:10.1097/BRS.0000000000005464

Front Psychiatry. 2025 Aug 5;16:1636838. doi: 10.3389/fpsyt.2025.1636838. eCollection 2025.

ABSTRACT

BACKGROUND: The prevalence of late-life depression (LLD) is high, and its most dangerous, serious, and fatal comorbidity is suicide. Therefore, the present study systematically investigates the risk factors for suicide in individuals with LLD, offering empirical support for the development of preventive interventions against suicidal behavior.

METHODS: PubMed, Web of Science, the Cochrane Library, PsycInfo, CNKI, Wan Fang Data, VIP, and CBM databases were searched from the inception of each database to February 2025 to identify observational studies of risk factors for suicide in LLD patients. The Newcastle-Ottawa Scale (NOS) and the Agency for Healthcare Research and Quality (AHRQ) were used to ensure study quality. Stata 18.0 software was used to perform a meta-analysis and sensitivity analysis to compute the pooled odds ratio.

RESULTS: A total of 12 studies (eight case-control, two cross-sectional, and two longitudinal studies), with a quality level of medium or above, were included in the analysis. Depression severity (OR = 3.485, 95% CI: 1.385 to 8.769, P = 0.008) was identified as a significant risk factor for suicide in LLD. The age of onset (OR = 0.969, 95% CI: 0.905 to 1.039, P = 0.378) was not statistically significant for the risk of suicide in LLD. The descriptive analysis revealed that suicidal ideation, educational level, N3 sleep duration, odor identification dysfunction, alcohol drinking history, cognitive function, history of major trauma, history of suicide attempts, and high-density lipoprotein were associated with an increased suicide risk in LLD.

CONCLUSION: Our meta-analysis has revealed a variety of factors influencing suicide risk in LLD patients. Clinical staff should strengthen the assessment and screening of risk factors and take timely intervention and targeted treatment to reduce the risk of suicide in LLD.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier CRD420251040029.

PMID:40838257 | PMC:PMC12362716 | DOI:10.3389/fpsyt.2025.1636838

Front Psychiatry. 2025 Aug 5;16:1548282. doi: 10.3389/fpsyt.2025.1548282. eCollection 2025.

ABSTRACT

OBJECTIVE: Depression is a significant global public health issue, and Breakfast habits may be related to its onset. This study conducted a meta-analysis of previous studies to analyze the correlation between breakfast and depression, comprehensively evaluated the association between skipping breakfast and the risk of depression, and explored the potential sources of heterogeneity.

METHODS: PubMed, Embase, and Web of Science databases were searched(the retrieval time limit for all was from the establishment of the databases to September 1, 2024), English documents were selected from the databases(the research type was observational study), and then the data was extracted and the Newcastle-Ottawa Scale(NOS) was evaluated for data analysis of the selected studies. This study followed the guidelines of the Preferred Reporting Project (PRISMA) and Prospero Registration Agreement. The mixed-effects model combines the maximum adjusted estimates and measures heterogeneity using the I² statistic. Sensitivity analysis verified the robustness of the analysis and assessed publication bias.

RESULTS: A meta-analysis of 12 literatures showed that skipping breakfast was positively correlated with the incidence of depression (RR=1.83, [95%CI 1.52-2.20], τ²: 0.09, I²: 96.37%). Egger test was conducted on the relationship between skipping breakfast and depression, P=0.067 > 0.05, and the result suggested that there was no significant publication bias. Subgroup analysis indicates that current studies in different regions still have deficiencies, and the analysis shows that the occurrence of depression is associated with gender and the sample size of the study.

CONCLUSIONS: Skipping breakfast can increase the risk of depression. It suggests that we should pay attention to having a regular and standardized breakfast to reduce the risk of depression. High heterogeneity may stem from differences in dietary culture and assessment methods. In the future, more research is needed to explore the mechanism and increase studies in different regions.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier PROSPERO CRD42024583486.

PMID:40838254 | PMC:PMC12362717 | DOI:10.3389/fpsyt.2025.1548282

Front Psychiatry. 2025 Aug 5;16:1590850. doi: 10.3389/fpsyt.2025.1590850. eCollection 2025.

ABSTRACT

OBJECTIVES: This study aimed to evaluate the utility of P300 event-related potentials (ERPs) as neurophysiological biomarkers for diagnosing attention deficit hyperactivity disorder (ADHD) and to establish preliminary diagnostic thresholds for their use.

METHODS: A total of 106 children diagnosed with ADHD and 66 healthy controls were enrolled. Using a visual Oddball paradigm, P300 parameters were recorded at Fz, Cz, and Pz zones. Key metrics analyzed included P300 amplitude and latency as well as reaction time and correct responses. Statistical tests and logistic regression analysis identified significant group differences, while receiver operating characteristic (ROC) analysis determined the diagnostic performance of these parameters.

RESULTS: Children with ADHD exhibited significantly lower P300 amplitudes and longer latencies across all electrode sites compared to controls. Logistic regression identified Cz amplitude (p = 0.001), Pz amplitude (p = 0.011), maximum reaction time (p = 0.037), and correct response count (p < 0.001) as significant predictors of ADHD. ROC analysis showed that Cz amplitude, Pz amplitude, maximum reaction time, and correct responses achieved AUCs of 0.81, 0.75, 0.72, and 0.86, respectively, with sensitivities ranging from 66% to 80% and specificities from 61% to 95%. These results underscore the diagnostic potential of both electrophysiological and behavioral markers in ADHD assessment.

CONCLUSIONS: Cz and Pz amplitude, maximum reaction time, and correct responses each demonstrated strong diagnostic utility for distinguishing ADHD from typically developing children. The use of these neurophysiological and behavioral indicators as objective complements to traditional clinical assessments.

PMID:40838253 | PMC:PMC12362261 | DOI:10.3389/fpsyt.2025.1590850

North Clin Istanb. 2025 Feb 4;12(1):111-120. doi: 10.14744/nci.2024.61224. eCollection 2025.

ABSTRACT

OBJECTIVE: Medical students try to cope with challenging emotional experiences caused by stress factors specific to medical education during their education. In this process, students’ cognitive emotion regulation (CER) strategies and psychological resilience (PR) act as protective mechanisms to alleviate the impact of challenging emotions. Therefore, it is important for medical students to use adaptive emotion regulation strategies and demonstrate psychological resilience in the face of challenging emotional experiences. This study aimed to reveal the effects of CER strategies and PR on the emotional well-being (EWB) of medical students and the mediating effect of PR in the relationship between CER strategies and EWB.

METHODS: In this study, Structural Equation Modeling (SEM) was used to determine the mediating effect of PR in the relationship between CER strategies and EWB. The sample of the study consisted of 210 students who were randomly selected from the 1^st and 4^th year medical students and volunteered to participate in the study. Cognitive Emotion Regulation Scale, Psychological Resilience Scale and Emotional Well-Being Scale, which are the data collection tools of the study, were administered to the participants face-to-face by the researchers. Descriptive statistics and correlations were analyzed with SPSS 26. The SEM was analyzed with Jamovi 2.3.19 SEM module and R 4.1.1 Iavaan package.

RESULTS: 54.8% (n=115) of the participants were 1^st-grade and 45.2% (n=95) were 4^th-grade students; 54.8% were male and 45.2% were female. The results of SEM analysis showed that the relationship between adaptive CER strategies in the two sub-scales (refocusing on plan; β=0.088, p=0.011 and positive reappraisal; β=0.175, p<0.001) and EWB was found to be mediated by the commitment sub-scale of PR.

CONCLUSION: This study showed that the relationship between positive reappraisal and refocusing on a plan, which are adaptive CER strategies, and EWB was mediated by PR-commitment. These results indicate that CER and PR stand out as concepts that support students’ EWB in medical education.

PMID:40838246 | PMC:PMC12364463 | DOI:10.14744/nci.2024.61224

North Clin Istanb. 2025 Feb 3;12(1):12-20. doi: 10.14744/nci.2023.66891. eCollection 2025.

ABSTRACT

OBJECTIVE: The purpose of this study is to analyze the situation of Methicillin-Resistant Staphylococcus aureus (MRSA) in TRNC by examining the prevalence of Community-acquired Methicillin-Resistant Staphylococcus aureus (CA-MRSA)/Hospital-acquired Methicillin-Resistant Staphylococcus aureus (HA-MRSA) cases, the acceleration of CA-MRSA/HA-MRSA patients from past to present, the impact of pandemic, gender and age on MRSA cases.

METHODS: In order to analyze the trend of MRSA cases and the effects of selected parameters on MRSA cases, statistical tests are employed to the obtained data including ANOVA test, regression analysis tests and Post-hoc Tukey test.

RESULTS: Incidence rate of MRSA carriage in the community has increased over the years to 45.6%. p-value of the relationship between community-acquired MRSA cases and hospital-acquired MRSA cases is less than 0.05. The results also revealed that the p-value of both the relationship between COVID-19 and MRSA cases and the relationship between 50+ age and MRSA cases are significant. On the other hand, p-value of the relationship between gender and MRSA cases is found to be greater than 0.05.

CONCLUSION: It is concluded that MRSA carriage in the community has increased over the years and CA-MRSA and HA-MRSA cases are related since p<0.05. Moreover, it’s revealed that there is an effect of COVID-19 pandemic and 50+ age (66% of the cases) on MRSA cases because of p<0.05 while the gender is not an effect for MRSA cases in the country, since p-value for gender comparison is greater than 0.05.

PMID:40838240 | PMC:PMC12364480 | DOI:10.14744/nci.2023.66891