Tag: statistics

Front Health Serv. 2025 Jul 17;5:1604809. doi: 10.3389/frhs.2025.1604809. eCollection 2025.

ABSTRACT

BACKGROUND: International guidelines recommend multidisciplinary intervention programs for addressing childhood obesity. In Western Australia, community-based healthy lifestyle programs for children and young people are insufficient for demand, especially for those over-represented in obesity statistics relating to prevalence. This protocol outlines the implementation and evaluation of an adapted, evidenced, community-based program in Perth, Western Australia.

METHODS: This study follows a multiple-methods hybrid type II design, testing acceptability and feasibility of program scale-out and program participant outcomes. Study (1) Develop the adapted healthy lifestyle program with key partners and Aboriginal and Torres Strait Islander advisors for scale-out. Apply implementation strategies for program realisation. Identify critical elements and outcomes to demonstrate program success with key partners (∼30 workshop participants and ∼80 qualitative proforma respondents). Identify cultural and place-based considerations for program acceptability with Aboriginal and Torres Strait Islander Elders/advisors (∼30 workshop participants). Study (2) Assess acceptability, appropriateness, feasibility, and local clinical outcomes of adapted healthy lifestyle program pilot. Evaluate the program with children and young people aged 4-16 years with obesity or overweight and weight-related comorbidities, seeking healthy lifestyle change. The program will include weight-related assessments at baseline, 6, and 12 months with weekly sessions for 6 months (estimated n = 245 over 22 months, accounting for 30% drop-out). Explore program experience via focus groups with children, young people, and caregivers: ∼8-12 weeks post commencement (∼50 program participants and caregivers), ∼6 months post commencement (∼50 program completers and caregivers), and evaluation survey (e.g., declined/dropped out/completed). Engage with key partners to determine program feasibility for scale-up (∼30 workshop participants and ∼80 qualitative proforma respondents). Mixed model regression will be used to assess within-subject change in outcomes over time. Child health utility instruments will be used for cost-utility analysis. Study (3) Assess program scalability post-pilot. If determined feasible and acceptable, the program will be packaged to assist practitioners and policymakers with scale-up via exploration of currently available packages and key staff interviews. The overarching Replicating Effective Programs framework outlines the implementation stages, and the tools and strategies being applied are presented. Qualitative data will be analysed using Framework Analysis, incorporating the Consolidated Framework for Implementation Research and the Expert Recommendations for Implementing Change.

DISCUSSION: Implementation outcomes will be determined by evaluating acceptability, appropriateness, and feasibility of scale for this healthy lifestyle program. Utilising implementation science, partnership-building, and place-based and cultural considerations, this research will inform potential scale-up of equity-focused healthy lifestyle programs.

PMID:40747434 | PMC:PMC12310583 | DOI:10.3389/frhs.2025.1604809

J Environ Health Sci Eng. 2025 Jul 30;23(2):25. doi: 10.1007/s40201-025-00948-y. eCollection 2025 Dec.

ABSTRACT

Climate change is a global issue that presents significant challenges for countries worldwide, including Iran. Researchers need up-to-date information on climate change within their own country, including statistics on its severity, efforts to address it, and the impacts on the environment, temperatures, extreme weather events, water resources, agriculture, biodiversity, migration, air quality, and human health. This review provides an overview of these topics in the context of Iran, discussing challenges, sustainable practices, renewable energy, government responses, and international collaborations to mitigate climate change effects. It aims to offer a comprehensive perspective on the current and potential future implications of climate change in Iran. Climate change in Iran has resulted in higher temperatures, droughts, and wildfires, impacting agriculture and exacerbating water scarcity. Extreme weather events such as floods and storms are causing damage to infrastructure. Climate change poses a significant threat to global health, with direct consequences including severe storms, heat stress, and deteriorating air quality. Despite this uncertainty, it is imperative to adapt to the adverse effects of climate change. Rising global temperatures are contributing to more frequent and severe extreme weather events, resulting in widespread damage and loss of life. Iran’s efforts to address climate change include investing in renewable energy, and implementing sustainable practices. Collaboration between the government and local communities is crucial for mitigating the effects of climate change through effective policies and initiatives. Iran aims to reduce greenhouse gas emissions and promote sustainability through investments in renewable energy and energy efficiency initiatives.

PMID:40747432 | PMC:PMC12307847 | DOI:10.1007/s40201-025-00948-y

bioRxiv [Preprint]. 2025 Jul 19:2025.07.17.665375. doi: 10.1101/2025.07.17.665375.

ABSTRACT

Machine learning has generated millions of high-quality predicted protein structures, creating a need for computationally efficient structure search algorithms and robust estimates of statistical significance at this scale. We show that unrelated proteins have a universal tendency towards convergent evolution of secondary and tertiary motifs, causing an excess of high-scoring false positive alignments. To address this excess, and to accommodate recent innovations in search algorithm design, we describe a novel method for estimating statistical significance. We implement our approach in Reseek, showing that its E -values are accurate, scale successfully with database size, and are robust against the (generally unknown) diversity of folds in the database. We investigate popular structure search and alignment algorithms, finding that previous methods routinely overestimate significance by up to six orders of magnitude.

PMID:40747427 | PMC:PMC12312179 | DOI:10.1101/2025.07.17.665375

Stoch Environ Res Risk Assess. 2025;39(8):3605-3617. doi: 10.1007/s00477-025-03032-x. Epub 2025 Jun 24.

ABSTRACT

Urbanization affects atmospheric boundary layer dynamics by altering cloud formation and precipitation patterns through the urban heat island (UHI) effect, perturbed wind flows, and urban aerosols, that overall contribute to the urban rainfall effect (URE). This study analyzes an ensemble of numerical simulations with the Weather Research and Forecasting (WRF) model and its version with coupled chemistry and aerosols (WRF-Chem) through a Functional ANalysis Of VAriance (FANOVA) approach to isolate the urban signature from the regional climatology and to investigate the relative contributions of various mechanisms and drivers to the URE. Different metropolitan areas across the United States are analyzed and their urban land cover and anthropogenic emissions are replaced with dominant land-use categories such as grasslands or croplands and biogenic only emissions, as in neighboring regions. Our findings indicate a significant role of the urban land cover in impacting surface temperature and turbulent kinetic energy over the city, and precipitation patterns, both within and downwind of the urban environment. Moreover, simulations of a deep convection event suggest that the aerosols impact dominates the sign and spatial extent of the changes in the simulated precipitation compared to the UHI effect, leading to a significant precipitation enhancement within the urban borders and suppression in downwind regions.

PMID:40747414 | PMC:PMC12307560 | DOI:10.1007/s00477-025-03032-x

J Clin Exp Hepatol. 2025 Nov-Dec;15(6):102633. doi: 10.1016/j.jceh.2025.102633. Epub 2025 Jul 7.

ABSTRACT

BACKGROUND/AIMS: Sorafenib, lenvatinib, and atezolizumab combined with bevacizumab (Atezo/Bev) are approved first-line treatments for unresectable hepatocellular carcinoma (uHCC). However, direct comparisons among these therapies remain limited. This study aims to compare the efficacy and safety of Atezo/Bev versus tyrosine-kinase inhibitors (TKIs) as first-line therapies for uHCC.

METHODS: Two independent authors conducted a literature search using electronic databases (Google Scholar, Medline, and PubMed) and manual reference list reviews up to June 2024. We included studies reporting on overall survival (OS), progression free survival (PFS) or safety data comparing Atezo/Bev versus TKI (sorafenib or lenvatinib) in patients with uHCC, irrespective of study design. Data extraction and statistical analysis were performed using RevMan 5.4.

RESULTS: We included a total of 12 studies (Ten retrospective cohort studies, one prospective study, one randomized controlled trial) involving 9952 patients (3560 received Atezo/Bev combination therapy and 6392 received TKI). Atezo/Bev significantly improved OS and PFS compared to lenvatinib (HR: 0.79, 95% CI: 0.71-0.89, P = 0.0001 for OS; HR: 0.76, 95% CI: 0.64-0.90, P = 0.002 for PFS). Atezo/Bev also improved OS in viral patients (HR: 0.72, 95% CI: 0.60-0.86, P = 0.0004), while lenvatinib improved OS (HR: 1.36, 95% CI: 1.13-1.65, P = 0.001) and PFS (HR: 1.46, 95% CI: 1.04-2.05, P = 0.03) in nonviral patients. Atezo/Bev had fewer grade ≥3 adverse events than lenvatinib (OR: 0.43, 95% CI: 0.36-0.51, P = 0.03). Atezo/Bev also demonstrated superior OS and PFS compared to sorafenib (HR: 0.68, 95% CI: 0.57-0.81, P < 0.00001 for OS; HR: 0.67, 95% CI: 0.57-0.77, P < 0.00001 for PFS).

CONCLUSIONS: Atezo/Bev demonstrates better survival outcomes and safety profile compared to TKI. However, for patients with HCC of nonviral etiology, lenvatinib may be a more suitable alternative.

PMID:40747369 | PMC:PMC12309488 | DOI:10.1016/j.jceh.2025.102633

EClinicalMedicine. 2025 Jul 24;86:103381. doi: 10.1016/j.eclinm.2025.103381. eCollection 2025 Aug.

ABSTRACT

BACKGROUND: Atorvastatin and rosuvastatin are the most widely used statins in patients with ischemic stroke or transient ischemic attack (TIA). However, evidence on their effectiveness and safety during actual use is scarce. This study aims to compare the effectiveness and safety of initiating atorvastatin versus rosuvastatin among patients with ischemic stroke or TIA.

METHODS: This observational study was based on the Third China National Stroke Registry (CNSR-III), which recruited consecutive adult patients with ischemic stroke or TIA within 7 days from the onset of symptoms to enrollment from August 2015 to March 2018. This study identified 3322 adults aged ≥18 years who had a pre-stroke modified Rankin Scale (mRS) score of 0 and initiated atorvastatin or rosuvastatin on the day of onset. The primary outcome was the ideal outcome, as defined by a mRS score of 0, at 3 months. The secondary outcomes included the ideal outcome at discharge, at 6 months, and at 12 months, along with 12-month stroke recurrence, all-cause mortality, cardiovascular mortality, and major adverse cardiovascular events.

FINDINGS: A total of 3322 eligible patients were identified, with 2605 initiating atorvastatin and 717 initiating rosuvastatin. The proportion of patients achieving an ideal outcome, as defined by a modified Rankin Scale of 0, was 44.63% in rosuvastatin initiators, significantly higher than 41.46% in atorvastatin initiators, with a relative rate of 1.12 (95% confidence interval 1.03, 1.22). Also, a greater percentage of rosuvastatin initiators attained the ideal outcome at discharge and at 6 months, compared with atorvastatin initiators. Regarding other secondary outcomes, no statistically significant difference was observed.

INTERPRETATION: Compared with atorvastatin, rosuvastatin was associated with a potentially higher proportion of patients attaining a mRS score of 0 among patients with ischemic stroke or TIA who initiate atorvastatin or rosuvastatin, which was not yet sufficient to guide clinical practice. Further research is needed to validate these findings.

FUNDING: This work was supported by National Key Research and Development Program of China (2022YFC2502400, 2022YFC2502404), Beijing Natural Science Foundation Haidian original innovation joint fund (L222123), and Youth Innovation Fund of Beijing Neurosurgical Institute (2025 Reform and Development-Youth 15).

PMID:40747367 | PMC:PMC12311946 | DOI:10.1016/j.eclinm.2025.103381

Sci Rep. 2025 Jul 31;15(1):27998. doi: 10.1038/s41598-025-12606-2.

ABSTRACT

The world faces ongoing challenges because the increasing number of dengue fever cases has become a major public health concern, with the potential for a pandemic resulting from a lack of attention and neglect. The Hajjah Governorate, located in subtropical regions, has not received any epidemiological studies on the prevalence of dengue fever. Therefore, we designed this study retrospectively to assess the prevalence of dengue fever in Hajjah Governorate over a five-year period (2020-2024). This retrospective study was based on secondary clinical data collected from the Hajjah Governorate Health and Environment Office database between 2020 and 2024. Furthermore, the data were obtained electronically, checked for their completeness and consistency, analyzed statistically, and presented in tables and figures. Of the 10,617 suspected dengue fever cases, 7,784 (73.3%) were classified as dengue fever according to the laboratory diagnosis (4,284; 40.3%) and clinical signs and symptoms (3,500; 33.0%). A higher proportion of DF cases was observed in males (6,994; 74.7%), the age group 5-14 years (1,632; 75.5%), in 2020 (3,756; 81.5%), and in autumn (3,625; 46.6%) and October (2,527; 32.5%). An overall incidence rate of dengue fever was reported at 28.1 cases per 10,000 individuals in Hajjah Governorate, with the highest in males (38.7), the age group of 15-29 years (40.0), in 2020 (16.3), and in Shars District (346.9). The rate of death related to dengue fever was 10 cases (0.13%), with the highest rates observed in males (0.13%), individuals under the age of 5 years (0.57%), and in 2023 (0.48%). The majority of patients experienced fever (99.97%), joint pain (99.1%), headache (98.8%), and muscle pain (73.3%). Additionally, 26 patients (0.03%) displayed symptoms of dengue hemorrhagic fever. These results indicate that the burden of dengue fever is increasing in the study area and poses a significant health challenge to Yemen in the near future if this complex health problem is not addressed. Furthermore, effective vector control, preventive education, targeted vaccination research, and epidemiological surveillance are imperative to address this complex health issue and to minimize its impact.

PMID:40745434 | DOI:10.1038/s41598-025-12606-2

Sci Data. 2025 Jul 31;12(1):1332. doi: 10.1038/s41597-025-05681-7.

ABSTRACT

This work presents the IMPROVE dataset, a multimodal resource designed to evaluate the effects of mobile phone usage on learners during online education. It includes behavioral, biometric, physiological, and academic performance data collected from 120 learners divided into three groups with different levels of phone interaction, enabling the analysis of the impact of mobile phone usage and related phenomena such as nomophobia. A setup involving 16 synchronized sensors-including EEG, eye tracking, video cameras, smartwatches, and keystroke dynamics-was used to monitor learner activity during 30-minute sessions involving educational videos, document reading, and multiple-choice tests. Mobile phone usage events, including both controlled interventions and uncontrolled interactions, were labeled by supervisors and refined through a semi-supervised re-labeling process. Technical validation confirmed signal quality, and statistical analyses revealed biometric changes associated with phone usage. The dataset is publicly available for research through GitHub and Science Data Bank, with synchronized recordings from three platforms (edBB, edX, and LOGGE), provided in standard formats (.csv, .mp4, .wav, and .tsv), and accompanied by a detailed guide.

PMID:40745430 | DOI:10.1038/s41597-025-05681-7

Sci Rep. 2025 Jul 31;15(1):27988. doi: 10.1038/s41598-025-11949-0.

ABSTRACT

Antimicrobial resistance in Mycobacterium tuberculosis (M.tb) strains presents a significant challenge to global tuberculosis (TB) control efforts. This study was conducted to explore the distribution and prevalence of mutations at various sites within the 81 bp Rifampicin (RIF) resistance-determining region (RRDR) of the rpoB gene in M.tb, as detected by the Xpert MTB/RIF assay. This retrospective analysis encompassed 9,867 non-repeating patients diagnosed with TB between 2021 and 2023. Cases with RR detected by the Xpert were included in further detailed analysis. The study utilized Chi-square tests or Fisher’s exact tests to identify statistically significant differences in demographic variables and the prevalence of rpoB gene mutations between RResistant TB (RR-TB) and non-RR-TB groups. Multiple logistic regression analysis was employed to examine the relationship between probe types and demographic variables, with a P-value of less than 0.05 considered statistically significant. Over the three-year study period, M. tb was identified in 2,927 cases, with 485 being RR-TB. While individuals aged ≥ 65 years constituted the largest absolute number of RR-TB cases, the highest relative risk was observed in children aged 5-14 years (OR = 2.68, 95% CI 1.16-6.22, P = 0.02) compared to the ≥ 65 reference group. probe E missing emerged as the predominant mutation site, particularly prevalent in pulmonary specimens and among individuals aged 55-64 years, with a statistically significant difference (P < 0.001). An upward trend in probe B mutations was also observed, reaching statistical significance (χ2 = 6.614, P = 0.037).This molecular epidemiological study has identified the mutation patterns within the rpoB gene that contribute to RR, as identified through the use of Xpert technology over a three-year span in Jiangxi Province. The insights gained are instrumental in informing individualized treatment regimens for RR-TB patients by correlating mutation locations with resistance levels (e.g., probe E mutations confer high-level resistance requiring second-line drugs, while probe B mutations like D435Y may confer low-level “disputed” resistance). This facilitates precision therapy, avoids unnecessary second-line treatments, and reduces transmission. Future advancements in technology, such as large-scale sequencing studies, could build upon these findings to further elucidate the genetic variations at play. Ultimately, these discoveries could be corroborated through rigorous in vitro and in vivo experimental research, reinforcing the foundation of our understanding and response to antimicrobial resistance in M.tb.

PMID:40745428 | DOI:10.1038/s41598-025-11949-0

Eur Spine J. 2025 Jul 31. doi: 10.1007/s00586-025-09128-w. Online ahead of print.

ABSTRACT

PURPOSE: Cervical Total Disc Replacement (CTDR) related periprosthetic osteolysis is inconsistently reported. The purpose of this study is to assess the previously published TDR Osteolysis Grading Scale, a quantitative classification system of CTDR-related osteolysis, and to assess its reliability and utility using Computer Tomography (CT) and X-ray imaging.

METHODS: Participants were assigned to Groups A (CT, 20 participants, 27 implants) and B (X-ray, 20 participants, 26 implants). Four blinded raters independently measured osteolytic cysts and both vertebral endplates, calculated the percentage of osteolysis and assigned osteolysis grades: Grade 0, no osteolysis; Grade 1, < 50% of 1 endplate; Grade 2, < 50% of both endplates; Grade 3, ≥ 50% of 1 endplate; Grade 4, ≥ 50% of both endplates. Inter-rater reliability and sensitivity were assessed using intraclass correlation coefficients (ICC), Fleiss’ and Cohen’s Kappa statistics and sensitivity testing.

RESULTS: Group A had good reliability for osteolytic cyst measurements (ICC = 0.78-0.79), poor reliability for endplate measurements (ICC = 0.41-0.45) and moderate reliability for osteolysis grades (κ-coefficient = 0.42). Group B had moderate reliability for osteolytic cyst (ICC = 0.55-0.57) and endplate measurements (ICC = 0.55-0.64) and fair reliability for osteolysis grades (κ-coefficient = 0.30). Reliability between reference grades and assigned grades was moderate for Group A (κ-coefficient = 0.46-0.60) and fair for Group B (κ-coefficient = 0.08-0.35). Sensitivity was greater for high grade osteolysis (grade 3 and 4) in Group A (0.80-1) than Group B (0.17-0.50).

CONCLUSION: The TDR Osteolysis Grading Scale demonstrated good reliability and sensitivity amongst raters with CT. Implementing this tool may aid in standardising osteolysis reporting, monitoring osteolysis progression and clinical decision-making.

PMID:40745412 | DOI:10.1007/s00586-025-09128-w