Tag: statistics

Cureus. 2025 Jul 5;17(7):e87322. doi: 10.7759/cureus.87322. eCollection 2025 Jul.

ABSTRACT

Background Helicobacter pyloriis a widespread bacterial infection that is often linked to significant health and economic burdens in affected populations. The rise of antibiotic resistance has reduced the effectiveness of standard triple therapy (TT), highlighting the need for alternative treatment strategies, especially in resource-constrained countries like Pakistan, where comparative research on different H. pylori treatment regimens remains limited. This study aims to compare the efficacy of concomitant therapy (CT) versus TT in the eradication of H. pylori infection. Methods This retrospective study was conducted over a 12-month period (July 2021 to July 2022) in the medicine and gastroenterology departments of Jinnah Hospital, Lahore, Pakistan. A total of 296 patients diagnosed with H. pylori infection via the urea breath test were enrolled using consecutive sampling, following predefined inclusion and exclusion criteria. Patients were divided into two groups of 148 each: Group A received CT (esomeprazole, amoxicillin, clarithromycin, and metronidazole), and Group B received standard TT (esomeprazole, amoxicillin, and clarithromycin). Data were analyzed using IBM SPSS Statistics for Windows, Version 25.0 (Released 2017; IBM Corp., Armonk, NY, USA), applying independent samples t-tests, chi-square tests, and logistic regression analysis. A p-value of less than 0.05 was considered statistically significant. Results Among the 296 patients, the overall H. pylori eradication rate was 82.09%. The eradication rate was significantly higher in the CT group (91.90%) compared to the TT group (72.29%) (p = 0.008). In the CT group, age (OR: 1.57; 95% CI: 1.25-1.98; p = 0.03) and duration of symptoms (OR: 1.42; 95% CI: 1.10-1.77; p = 0.02) were significant predictors of successful eradication, while gender (OR: 1.10; 95% CI: 1.01-1.32; p = 0.06) was not. In the TT group, age (OR: 1.22; 95% CI: 1.05-1.51; p = 0.06), gender (OR: 1.01; 95% CI: 0.71-1.47; p = 0.07), and duration of symptoms (OR: 1.26; 95% CI: 1.17-1.60; p = 0.09) were not significant predictors of eradication. Conclusions This study suggests that CT is more effective than TT in eradicating H. pylori infection. In the CT group, being younger than 45 years and having symptoms for less than six months were significant predictors of treatment success. These findings provide valuable insights into optimal treatment strategies for H. pylori in resource-limited settings and emphasize the need for further research to establish effective eradication protocols.

PMID:40761984 | PMC:PMC12320471 | DOI:10.7759/cureus.87322

Cureus. 2025 Jul 5;17(7):e87350. doi: 10.7759/cureus.87350. eCollection 2025 Jul.

ABSTRACT

BACKGROUND: Metformin is a drug primarily used for the treatment of diabetes mellitus (DM), but it also offers clinical benefits that extend beyond glycemic control. Existing literature provides an unclear conclusion as to whether metformin’s benefits extend to preventing neurodegeneration, such as in Alzheimer’s disease (AD).

METHODS: A retrospective database study was conducted to evaluate the likelihood of developing AD in DM patients taking metformin compared to those taking glucagon-like peptide (GLP-1) analogs, sulfonylureas, and short-acting insulin variants. An analysis was also run to assess whether metformin has a protective benefit for AD and mortality when used in those with DM compared to those without DM.

RESULTS: In analyses totaling greater than 2.5 million patients, those on metformin had lower A1C percentages and a decreased mortality risk when compared to sulfonylureas (HR = 0.519, (CI: (0.493,0.546)), and short-acting insulins (HR = 0.372, (CI: (0.364,0.380)). Metformin use for DM was associated with a statistically significant increased likelihood of AD diagnosis compared to GLP-1 use (HR = 2.228, CI: (1.036,4.794)) but an insignificant difference compared to both sulfonylureas and insulins. Those with DM were at a significantly higher risk of being diagnosed with Alzheimer’s compared to those without DM (HR = 1.826, (CI: 1.579, 2.111)).

CONCLUSIONS: Metformin, previously thought to have significant benefits in preventing neurodegeneration, may not be the optimal pharmacologic agent of choice, particularly in patients with DM, if neurodegeneration is a primary concern in treatment decision-making based on other risk factors.

PMID:40761983 | PMC:PMC12321270 | DOI:10.7759/cureus.87350

Cureus. 2025 Jul 5;17(7):e87344. doi: 10.7759/cureus.87344. eCollection 2025 Jul.

ABSTRACT

BACKGROUND: Medication adherence is vital for successful recovery after a myocardial infarction (MI). Unfortunately, many patients experience depression following an MI, which can negatively affect their ability to stick to prescribed medication plans. It is important to explore how depression influences medication adherence, especially in South Asian clinical environments where cultural factors can significantly impact health outcomes.

METHODS: A cross-sectional study was carried out among 385 post-MI patients who attended outpatient clinics in Islamabad, Pakistan. The Patient Health Questionnaire-9 (PHQ-9) was used to measure depression, and the Morisky Medication Adherence Scale (MMAS-8) was used to quantify medication adherence. Statistical tests involved descriptive statistics, normality tests using Shapiro-Wilk, Spearman correlation, Kruskal-Wallis, chi-square, and linear regression. Data were collected between January and May 2025.

RESULTS: There was also a weak, statistically significant positive relation between the PHQ-9 and the MMAS-8 scores (r = 0.124, p < 0.05). In a linear regression model, PHQ-9 scores were significantly predictive of MMAS-8 scores (B = 0.064, p = 0.002), which means that the higher the depressive symptoms, the more likely medication adherence was. Depression scores worsened over time since MI and heavier medication burden, whereas adherence was highest among patients taking moderate numbers of medications (three to five/day). The rates of adherence and psychological distress also differed significantly depending on the treatment type, with the best rates being in angioplasty patients.

CONCLUSION: This study, unlike the majority of the previous findings, reported a minor positive correlation between self-reported medication adherence and depressive symptoms in post-MI patients. The findings indicate that, in particular, in the cultural backdrop, depressive symptoms can be present alongside more health conscientiousness or planned-out care use. Comorbidities and complexities of treatment should be assessed, and mental health screening and adherence support to medications should be a component of post-MI care strategies.

PMID:40761975 | PMC:PMC12321158 | DOI:10.7759/cureus.87344

Cureus. 2025 Jul 4;17(7):e87290. doi: 10.7759/cureus.87290. eCollection 2025 Jul.

ABSTRACT

Context Early childhood educators (ECEs) are central to the development and care of children, but they often lack adequate access to resources and expert guidance for managing common childhood health issues. These challenges can lead to significant stress for both educators and parents. To address this gap, a pilot intervention involving virtual “coffee chat” sessions was implemented. These sessions aimed to provide ECEs with evidence-based knowledge and practical strategies to handle frequent childhood health concerns. Objective The primary objective of this study was to enhance the knowledge and confidence of ECEs in addressing common health and behavioral issues among children in the New River Valley, USA. The sessions, facilitated by pediatricians and medical students, covered a range of topics identified as high-priority by educators. The goal was to create a sustainable educational model for improving child health management in childcare settings. Methods This study used a self-designed pre- and post-survey format to measure the effectiveness of eight virtual “coffee chat” sessions conducted over two years. The initial sessions focused on educators in the New River Valley, USA, and the final session expanded across Virginia, USA. Topics included common illnesses (e.g., cough, diarrhea), trauma management, obesity, and behavioral issues such as self-regulation and temper tantrums. Each session consisted of a brief evidence-based presentation followed by interactive discussions. Participants were recruited through local and statewide child care organizations, and surveys were used to assess changes in their confidence and knowledge levels. Descriptive statistics and a Wilcoxon Signed Rank test were applied to analyze the data, while qualitative feedback from open-ended responses was categorized thematically. Results Across the eight sessions, 30 registrations were recorded, with 19 participants, some of whom attended multiple sessions. Pre- and post-survey results demonstrated significant improvements in knowledge and confidence, with an overall p-value of <0.001. Six out of eight topics showed increased post-survey scores, with the session on self-regulation and temper tantrums, which had the largest cohort (N=10), yielding a significant improvement (p=0.0041), highlighting its broad impact and relevance. Feedback from participants highlighted the value of practical, evidence-based strategies and the opportunity to engage directly with healthcare professionals. However, variability was observed in some topics, such as diarrhea, where post-survey scores declined slightly, pointing to potential areas for improvement. Conclusion Virtual “coffee chat” sessions proved to be an effective, scalable method for improving the health management skills of ECEs. The intervention’s interactive and accessible format was particularly appreciated by participants and shows promise as a model for ongoing professional development. However, given the study’s design and sample size, these findings should be interpreted as preliminary. Future efforts should focus on refining content, expanding participation, and exploring long-term impacts on both educator practices and child outcomes.

PMID:40761974 | PMC:PMC12320190 | DOI:10.7759/cureus.87290

Cureus. 2025 Jul 4;17(7):e87306. doi: 10.7759/cureus.87306. eCollection 2025 Jul.

ABSTRACT

Introduction Yoga, rooted in Indian tradition, is recognized for its holistic health benefits. With a growing global emphasis on preventive health, yoga has gained attention for its capacity to mitigate stress, improve concentration and enhance general well-being. Burdened with academic pressures, irregular routines and sedentary lifestyles, medical students represent a group that could significantly benefit from incorporating yoga into their daily lives. This study aims to bridge this gap by evaluating MBBS students’ awareness, perceptions, readiness to adopt yoga and the practical challenges they face, along with their views on integrating structured yoga sessions into their curriculum. Methods A cross-sectional study was conducted at AIIMS, Nagpur, among MBBS students, with a total of 155 students (100%) from the 2019 to 2023 batches. A structured, pre-validated questionnaire (Cronbach’s α=0.973) was administered electronically using a Google Form link shared via student WhatsApp groups. The survey comprised five sections: awareness about yoga, perceptions about its preventive role in lifestyle disorders, readiness to integrate it into daily life, barriers to practice and preferences regarding formal integration of yoga practice in the MBBS curriculum. Responses were recorded on 5-point Likert scales. Data analysis was performed using Python (Jupyter) for cleaning, statistics and reliability testing, and Jamovi (v2.3.28) for non-parametric tests due to non-normal distribution. Results The findings revealed a high awareness among participants, with an average awareness score (87.6%), high agreement on yoga’s role in stress reduction (4.45%) and overall health (4.63%). Perception of yoga as preventive and therapeutic for lifestyle disorders was strong (mean=84.0%). Batch-wise differences were noted in yoga awareness scores (p<0.001), and interns were more likely to endorse yoga as a complementary therapy (p=0.037). The readiness score was 68.2%, with only a 3.41/5 average agreement on willingness to integrate yoga daily. A significant gender-based difference was observed for perceived physical preparedness (p=0.035) and preference for educational content in yoga, with males scoring higher. Major barriers included time constraints (112, 72.2%), inconsistency (93, 60%) and lack of motivation to wake up early (84, 54.54%). Overall, 140 (90.3%) agreed that yoga practice should be part of the MBBS curriculum. Most preferred physical sessions (116, 74.84%), held three days a week (63, 40.65%), for 20-30 mins (93, 61.59%), with a focus on postures, breathing, meditation and stress relief. Some students preferred sessions to be optional and scheduled flexibly around academic hours. Conclusion This study highlights a significant gap between high levels of awareness and relatively low readiness to incorporate yoga into daily life among MBBS students. Despite recognizing its benefits, students face notable practical challenges, especially time management and consistency. However, the overwhelming support for integrating structured yoga sessions into the medical curriculum presents an actionable opportunity. Addressing identified barriers through flexible scheduling, optional participation and an emphasis on stress management may enhance adoption. These findings underscore the potential of yoga not just as a wellness tool but as an integral component of medical education aimed at fostering personal resilience and long-term professional well-being.

PMID:40761968 | PMC:PMC12319258 | DOI:10.7759/cureus.87306

Sci Rep. 2025 Aug 4;15(1):28430. doi: 10.1038/s41598-025-12657-5.

ABSTRACT

Strategic hub in Panxi Economic Zone, the Anning River Basin faces fragile ecology and significant land governance issues. This study uses the “Production-Living-Ecological Space” (PLES) theory to assess how land use transformation affects ecosystem service value (ESV) and sustainable development. It draws on 1985-2023 land-use data, statistical yearbooks, the modified equivalent factor method, Geo-information TuPu, improved cross-sensitivity analysis (CICS) and optimal parameter geographic detector. the findings: (1) E-P land expanded by 255,893.21 hectares, with a dynamic degree of 29.05%; (2) E-P land supplies > 90% of total ESV (67% from regulating services). Since 2005, ESV dropped 326 M yuan overall, with E-P land declining 766 M yuan. Hotspots are in high-altitude areas; cold spots, in plains; (3) ecosystem services are most sensitive to E-P land conversions, with conversions between P-E land and other types generally lowering ESV; (4) 500 × 500 m Anning River Basin data show that population density influences ecosystem services (q = 0.602) in univariate analysis, with bivariate interactions boosting explanatory power. Findings reveal complex links between land use, ecosystem services, and socio-economic factors in the Anning River Basin, emphasizing the need to consider multiple factors in land management and ecological protection.

PMID:40760144 | DOI:10.1038/s41598-025-12657-5

Sci Rep. 2025 Aug 4;15(1):28459. doi: 10.1038/s41598-025-13565-4.

ABSTRACT

This study develops a comprehensive inventory model for deteriorating items by incorporating preservation technology and addressing sustainability-driven customer behavior. Demand is modeled as a nonlinear function influenced by three key factors: selling price, green level (reflecting the environmental friendliness of the product and its production), and available inventory level. Recognizing rising environmental consciousness, the green level directly shapes consumer demand, while preservation investment reduces deterioration and extends the shelf life of perishable goods. The objective of the model is to maximize the total profit by jointly optimizing five decision variables: selling price, green level investment, preservation effort, cycle length, and replenishment quantity. The resulting objective function is highly nonlinear and complex. To solve it efficiently, this study employs the Marine Predators Algorithm (MPA)-a newly developed metaheuristic algorithm well-suited for continuous, nonlinear optimization. Model authenticity is established through a combination of sensitivity analysis, convergence behavior examination, and validation against benchmark test problems from existing literature. The robustness of the solution method is further demonstrated by comparing the MPA’s performance with other optimization techniques in terms of solution quality and computational efficiency. Although the study is theoretical in nature, data assumptions are grounded in real-world parameter ranges drawn from validated case studies and academic sources. Parameters such as deterioration rates, green investment cost coefficients, and preservation effectiveness are selected to reflect practical supply chain conditions. This ensures the credibility of the model output and applicability in realistic scenarios. The study offers critical managerial insights, including how to balance sustainability initiatives, pricing decisions, and preservation investments for optimal inventory control. These insights are particularly valuable for supply chains dealing with environmentally sensitive, perishable products, helping businesses enhance operational efficiency while supporting green objectives.

PMID:40760143 | DOI:10.1038/s41598-025-13565-4

J Neurol. 2025 Aug 4;272(9):555. doi: 10.1007/s00415-025-13301-y.

ABSTRACT

BACKGROUND: Parkinson’s disease (PD) is a degenerative disorder of the nervous system. The neurobiological implications of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in modifying PD risk profile remain incompletely characterized.

METHODS: We searched the PubMed, Cochrane Library, and Embase databases for relevant studies up to 27 February 2025 to identify eligible clinical investigations. We conducted meta-analyses of covariate-adjusted data to evaluate the therapeutic efficacy of different GLP-1RAs in ameliorating both motor and non-motor clinical manifestations within PD cohorts.

RESULTS: We identified six studies from the database for inclusion in the analysis. Meta-analysis demonstrated that GLP-1RAs showed potential benefits in alleviating motor symptoms compared to placebo, though the overall effect did not reach statistical significance (MD = – 1.08, 95% CI: – 2.87 to 0.71, P = 0.24, I² = 51%) involving 735 individuals (experiment group n = 413, control group n = 322). Subgroup analysis stratified by pharmacokinetic properties revealed distinct therapeutic responses across GLP-1RA preparations. Short-acting agents significantly improved motor dysfunction (MD = – 2.93, 95% CI: – 4.72 to – 1.14, P = 0.001, I² = 0%), whereas long-acting agents showed no symptomatic improvement (MD = 0.43, 95% CI: – 1.13 to 1.99, P = 0.59, I² = 0%). Non-motor symptom burden, assessed via the Non-Motor Symptoms Scale, HRQoL, MDS-UPDRS Part I, showed no statistically significant improvement in PD patients treated with GLP-1RAs.

CONCLUSION: Short-acting GLP-1RAs could significantly improve motor symptoms, suggesting potential symptomatic benefits. However, the results are not robust enough, and further standardized studies are needed to evaluate their role in disease.

PMID:40760123 | DOI:10.1007/s00415-025-13301-y

Eur Radiol. 2025 Aug 4. doi: 10.1007/s00330-025-11887-5. Online ahead of print.

ABSTRACT

OBJECTIVE: Phantoms are essential for minimizing radiation-intensive experiments on humans and enhancing patient safety through model-based teaching and experimentation. While many phantoms are commercially available, their widespread use is limited by manufacturing complexity and high costs. This study aims to demonstrate a dough-based method to create customizable, realistic CT phantoms using affordable, readily available ingredients.

MATERIALS AND METHODS: For this study, various doughs composed of flour, salt, water, and oil were created, scanned, and evaluated to assess their suitability for CT applications. Additionally, the effects of storage conditions, preservation, and temperature variations were analyzed. As an example, a liver was segmented from a 3D CT scan, scaled to 1:2, and a negative mold was 3D printed. The mold was subsequently filled with the most suitable dough composition to replicate the organ’s anatomy and density.

RESULTS: The evaluation of the scanned ingredients and doughs demonstrated that Hounsfield unit (HU) values ranging from below -200 HU to above 1200 HU can be achieved, enabling the simulation of various human tissue densities. Based on the analysis, simple recipes are proposed to replicate radiodensities of different anatomical structures. Additionally, the results from the liver phantom confirm the feasibility of mimicking liver tissue and morphology.

CONCLUSIONS: CT phantoms with specific radiodensities, mimicking human tissues, can be created using simple dough recipes, as demonstrated with our liver CT phantom. Refrigeration or freezing extends usability for a longer time, but temperature effects must be considered to ensure accurate HU values in CT scans.

KEY POINTS: Question CT phantoms are costly and complex, limiting accessibility for customized imaging studies. Can common ingredients from the kitchen be used to create tissue-mimicking phantoms? Findings The dough-based phantoms simulated radiodensities from -200 to 1200+ HU, enabling the simulation of various human tissue densities. Clinical relevance Affordable, anatomically accurate CT phantoms can be made from kitchen ingredients for training and research, as demonstrated with our liver CT phantom.

PMID:40760118 | DOI:10.1007/s00330-025-11887-5

Eur Radiol. 2025 Aug 4. doi: 10.1007/s00330-025-11905-6. Online ahead of print.

ABSTRACT

OBJECTIVES: Magnetic resonance elastography (MRE) provides multiple quantitative biomarkers for assessing chronic liver disease. This study evaluated the prognostic value of MRE-based long-term liver stiffness (LS) changes in chronic hepatitis C virus (HCV) infection and explored short-term viscosity changes (loss modulus, LM) for monitoring responses to direct-acting antiviral treatment (DAA-Tx).

MATERIALS AND METHODS: One hundred fifty-nine adults were included. We retrospectively analyzed 138 HCV participants with at least two 2D MREs, defining progression as an LS increase ΔLS ≥ 19% above baseline (LS_B), predicting liver-related events (LREs) with Kaplan-Meier plots and Cox proportional hazards regression. We also prospectively analyzed 21 participants, 11 of whom underwent DAA-Tx and ten healthy controls. Dual-frequency 3D MRE-derived LS, LM, and damping ratio (DR) were compared at five time points during DAA-Tx.

RESULTS: Among the 138 HCVs, 38 (27.5%) were progressors, with a ΔLS = 0.393 kPa/year; 11 developed LREs, showing a steeper rise of 0.614 kPa/year. LS_B and the combination of LS_B and ΔLS were significantly associated with LREs. Specifically, each 1 kPa increase in LS_B was associated with doubled risk of developing LREs [adjusted hazard ratio (aHR) = 2.05; C-statistic = 0.831, p < 0.001]. The combination of LS_B and ΔLS further improved predictive performance (aHR = 2.92; C-statistic = 0.883, p < 0.001). Progressors had a hazard ratio (HR) of 15.44 for developing cirrhosis (p < 0.001). LS decreased post-DAA-Tx, while LM initially increased (p < 0.05) and normalized by 12 months post-DAA-Tx.

CONCLUSIONS: Two-dimensional MRE-assessed longitudinal change in LS can predict future clinical events in HCV patients, providing better risk stratification than LS alone. Multiparametric dual-frequency 3D MRE has promise for short-term changes in treatment effects.

KEY POINTS: Question Accurately predicting clinical outcomes and monitoring direct-acting antiviral (DAA) treatment efficacy in HCV patients remains an unmet need. Findings Longitudinal LS changes predict future clinical events in HCV patients. Multiparametric dual-frequency 3D MRE detects short-term inflammatory and treatment-related changes, enhancing disease monitoring. Clinical relevance This study demonstrates longitudinal MRE as a reliable follow-up tool for chronic liver disease, enabling outcome prediction, risk stratification, and treatment monitoring, advancing personalized, non-invasive management for HCV patients.

PMID:40760117 | DOI:10.1007/s00330-025-11905-6