Tag: statistics

BMC Pharmacol Toxicol. 2025 Jul 28;26(1):138. doi: 10.1186/s40360-025-00973-5.

ABSTRACT

Although considered safe and widely used, some natural remedies are responsible for health ailments to their users that deserve to be investigated. SAYE PLUS is one of the most widely used traditional recipes as antimalaria for decades and recently against Covid-19 in Burkina Faso and beyond, and is commonly regarded as safe to use. In the present study, sub-chronic toxicity tests were performed orally in Wistar rats at daily doses of 250, 500, and 1000 mg/kg for 90 days, following the guidelines of the Organization for Economic Cooperation and Development (OECD). The results revealed neither symptoms of toxicity nor mortality. Depending on the dose, time frame, or animal sex, compared with the control, SAYE PLUS powder caused a statistically significant reduction in the water and food consumption of the treated rats. Significantly increases in serum creatinine, total protein, hydrogen phosphate ion (PO₄²), and potassium ion (K⁺) levels were detected in females at all doses. Compared to control values, the male rats’ glucose decreased while its PO₄^2- increased significantly at the daily dose of 1000 mg/kg of SAYE PLUS. Histopathological analysis revealed that the rat heart, lungs, liver, kidneys, and spleen histostructure were unaffected by sub-chronic exposure to SAYE PLUS up to 1000 mg/kg/d. The Findings provide some scientific information on the toxicological profile of the phytomedicine SAYE PLUS when administered in repeated doses for 90 days. However, they are limited by the absence of analysis of the animals’ hematological parameters. Nevertheless, results show that for patient safety, it is not advisable to use SAYE PLUS for more than two consecutive weeks. Furthermore, herbal remedies need careful evaluation before or during their human use, especially when a new form of use other than the traditional one is proposed. Further long-term studies focusing on the hematological parameters and certain kidney and liver functional indicators will add the scientific merit and interest of the present work.

PMID:40721828 | DOI:10.1186/s40360-025-00973-5

J Eat Disord. 2025 Jul 28;13(1):156. doi: 10.1186/s40337-025-01259-1.

ABSTRACT

BACKGROUND: Nomothetic (i.e., on average) eating disorder interventions generally provide insufficient guidance for managing suicidality. The present proof-of-concept study demonstrates how idiographic network models can be used to inform a modular, highly personalized approach to treatment for individuals experiencing suicidality in the context of Anorexia Nervosa spectrum disorders (ANSD).

METHODS: Using 21 days of ecological momentary assessment data (105 assessment points), contemporaneous and temporal idiographic symptom networks were generated for three patients with unique clinical presentations of ANSD. For each patient, we identify the most central symptoms in their network, as well as potentially important bridge symptoms linking eating pathology and suicidality. We then provide guidelines for using this information to guide the delivery of evidence-based intervention strategies.

RESULTS: Intervention strategies may vary substantially depending upon which network statistics are used to guide treatment target selection. Bridge symptoms, or symptoms that serve as links between eating pathology and suicidality, may represent particularly promising intervention targets for individuals experiencing these conditions concurrently. Interventions which target the symptoms with the highest strength centrality may also yield symptom improvement throughout the entire network.

CONCLUSIONS: Although the viability of network-informed, personalized treatment is contingent upon continued intervention development research, this approach has the potential to improve treatment outcomes for individuals with co-occurring eating disorders and suicidality.

PMID:40721825 | DOI:10.1186/s40337-025-01259-1

Sci Rep. 2025 Jul 28;15(1):27389. doi: 10.1038/s41598-025-12746-5.

ABSTRACT

This study examines long-term air temperature trends in Bhubaneswar, a rapidly urbanizing coastal city in eastern India, using data from 1901 to 2023. By analyzing maximum, minimum, and mean temperatures, we assess both natural climate variability and anthropogenic influences, including urban expansion. Statistical techniques such as homogenization, persistence analysis, and low-pass filtering reveal a pronounced warming trend, particularly in minimum temperatures, as an indication of an intensifying urban heat island effect. A weak but positive correlation between minimum temperature and population growth supports the role of urbanization in shaping local climate. These findings contribute to understanding urban climate evolution in tropical coastal settings where natural and human factors interact. Our results underscore minimum temperatures compared to maximum temperatures, indicating a warming trend likely driven by anthropogenic activities. Regression analysis between population growth and minimum temperature affirms a weak but notable positive correlation, indicating the gradual intensification of Bhubaneswar’s local microclimate due to urban development. This study contributes to understanding climate dynamics in tropical, coastal, and urban regions, where natural and human factors converge, shaping distinct local climate patterns. Nonetheless, the climatic trends are less pronounced than the interannual fluctuations in temperature measurements. The little climatic differences across several generations are unlikely to have influenced human activities compared to the substantial impacts of interannual temperature variability.

PMID:40721820 | DOI:10.1038/s41598-025-12746-5

Scand J Trauma Resusc Emerg Med. 2025 Jul 28;33(1):132. doi: 10.1186/s13049-025-01445-9.

ABSTRACT

BACKGROUND: We studied adult hypothermic cardiac arrest (CA) patients admitted to a University Hospital (UH) and a Regional Hospital (RH) for whom Extracorporeal Life Support (ECLS) was implemented. We used the HOPE score to estimate individual survival probabilities and to compare overall results between hospitals.

METHODS: We included hypothermic CA patients who underwent ECLS between 2000 and 2022. We assessed the predicted survival probabilities by calculating the HOPE scores, both at individual and hospital levels. We assessed the performance of a HOPE score cutoff of 10% in predicting survival to hospital discharge, as ECLS rewarming is currently recommended when the HOPE is ≥ 10%. We also assessed the utility of the HOPE score in evaluating and comparing patient management within and between two hospitals.

RESULTS: In the 46 patients with successful ECLS implementation, a HOPE score < 10% would have contraindicated and therefore prevented futile ECLS rewarming procedures for 17 patients (37%) who did not survive, while finding that ECLS was indicated for 100% of survivors. The observed survival rate was 24% (UH: 35%, RH: 11%) whereas the HOPE score predicted a survival rate of 35% (UH: 41%, RH: 26%), suggesting underperformance of ECLS rewarming among both hospitals. The difference of survival between the two hospitals was not statistically significant.

CONCLUSIONS: This study confirmed the utility of the HOPE score in estimating individual survival probabilities. The HOPE score may also be used to estimate the overall survival rate in a patient cohort, enabling internal quality-control and outcome results comparisons between different settings.

PMID:40721803 | DOI:10.1186/s13049-025-01445-9

BMC Surg. 2025 Jul 28;25(1):322. doi: 10.1186/s12893-025-03056-8.

ABSTRACT

BACKGROUND: Intussusception is the leading cause of pediatric abdominal emergencies worldwide, requiring timely diagnosis and intervention to prevent life-threatening complications. In low-resource settings such as Ethiopia, delayed presentation and limited access to non-surgical management often necessitate surgical intervention. However, comprehensive data on surgical outcomes and complications remain scarce. The aim of this study is to evaluate the epidemiology, clinical presentation, surgical management, and postoperative outcomes of pediatric intussusception in Ethiopia.

METHODS: A systematic review was conducted following PRISMA guidelines. Relevant studies were retrieved from PubMed, Scopus, Web of Science, and Google Scholar. Data were extracted on patient demographics, clinical presentation, diagnostic. methods, surgical procedures, complications, and mortality. Quality assessment was performed using the Newcastle-Ottawa Scale. Meta-analysis was conducted using a random-effects model with heterogeneity assessed by I² statistics. Publication bias was evaluated using Egger’s test.

RESULTS: Seven studies with a total of 672 patients were included. The mean age of affected children was 12 months (95% CI: 11.35, 12.67), with a male predominance (66%). Delayed presentation was common, with a mean time of 3.1 days from symptom onset. The classic triad of symptoms-abdominal pain, bloody stools, and a palpable mass-was present in 52% of cases (I² = 96.24%). Ultrasound was the most common diagnostic tool (74%). The most frequent surgical intervention was manual reduction (62%), followed by bowel resection with anastomosis (35%) and stoma creation. The overall complication rate was 26%, with surgical site infections (15%) being the most common. The pooled mortality rate was 9% (95% CI: 5%, 13%), significantly higher than in high-income countries. Egger’s test (p = 0.03) suggested potential publication bias.

CONCLUSION: This study found that surgically managed pediatric intussusception in Ethiopia had a high morbidity and mortality rate. These outcomes may reflect delays in presentation, and advanced disease at intervention. The development and implementation of context-specific clinical guidelines could help optimize care and improve survival rates. In addition, further research is needed to evaluate the impact of non-surgical reduction techniques.

PMID:40721796 | DOI:10.1186/s12893-025-03056-8

J Agromedicine. 2025 Jul 28:1-12. doi: 10.1080/1059924X.2025.2539968. Online ahead of print.

ABSTRACT

OBJECTIVES: Agricultural workers may experience various health problems as a result of exposure to toxic substances, particularly to pesticides. Adequate health literacy is necessary to protect and enhance the well-being of agricultural workers. Agricultural workers have a poor rate of participation in cancer screening. This study aimed to explore the relationship between health literacy levels and participation in cancer screening among agricultural workers.

METHODS: This descriptive study was conducted with 340 agricultural workers between December 2023 and May 2024. The data were collected through face-to-face interviews using the Descriptive Characteristics Questionnaire, Turkey Health Literacy Scale-32 (THLS-32), and Cancer Screening Participation Status Questionnaire.

RESULTS: Participants were found to have a 32.6% adequate health literacy level. In this study, of the female agricultural workers, 37.3% had HPV DNA testing, 35.7% had mammography, 56.7% performed breast self-examination, and 26.3% had clinical breast examination. Among the participants, 27.6% participated in the fecal occult blood test and 21.1% in colonoscopy. An urologist examined 38.8% of male agricultural workers, and 34.9% had their prostate specific antigen levels checked. The health literacy levels of individuals who were older, female, single, of lower education level, had more annual working time and daily working hours in agriculture were significantly lower. A statistically significant relationship was found between participants’ status of performing breast self-examination or participating in prostate cancer screenings and their health literacy levels.

CONCLUSION: Two-thirds of agricultural workers did not have adequate health literacy. The percentage of participants who took part in cancer screening did not exceed one-third. Therefore, qualitative studies should be conducted to investigate why agricultural workers do not participate in cancer screening initiatives to increase health literacy should be planned, and cancer screening should be recommended to agricultural workers by health professionals. Furthermore, future efforts to improve the health literacy of agricultural workers should focus on target individuals who are older, female, single, of lower education level, and more experienced (more daily working hours and years) in agriculture.

PMID:40720903 | DOI:10.1080/1059924X.2025.2539968

Online J Public Health Inform. 2025 Jul 28;17:e66377. doi: 10.2196/66377.

ABSTRACT

BACKGROUND: Socioeconomic and environmental factors influence youth mental well-being. Promoting mental well-being is essential to support youths’ development toward adulthood with good mental health. Different Stockholm municipalities have adopted strategies to promote youth well-being. However, contextualizing and perceiving goals and mechanisms at the local municipal level is difficult. Thus, comparing or tracking their conception, purpose, and characteristics has been challenging.

OBJECTIVE: We aimed to use data visualizations developed from a fusion of data sources to facilitate stakeholder conversations on promoting youth mental well-being within a municipality. We strive to demonstrate our methodology of using data visualizations as “boundary objects,” which are cognitive artifacts that bridge knowledge from various domains to elicit understanding from specialized and siloed parts of a health delivery system.

METHODS: Stakeholders from the municipalities of Lidingö and Nynäshamn participated in the study. A total of 15 workshops were conducted: 6 with only Lidingö participants, 6 with only Nynäshamn participants, and 3 with mixed participants. The sessions were conducted via Microsoft Teams or as physical sessions in Swedish and lasted between 60 and 90 minutes. Interactions were recorded with consent from participants. Recordings were transcribed using Amberscript software. We used matrix factorization with Kullback-Leibler divergence to extract 1000 features and created 10 topic clusters with 20 top words. We used the identified words and phrases to backtrack within the transcripts and to identify dialogues where they were used. We summarized participants’ interactions across all the workshops to identify factors or strategies discussed for youth well-being.

RESULTS: Participants noted that these sessions allowed them to contextualize their local observations from municipalities relative to the status of other municipalities in the national statistics. They indicated that they conceptualized well-being differently in their respective municipalities and between different professional backgrounds, and the sources of stress for youth differed. They noted the differences in the strategy and data collected for tracking youth well-being. Promotion of sports was a common strategy, while options for leisure activities differed between municipalities and professions.

CONCLUSIONS: Based on our observations and analysis of the transcripts from participatory workshops, we observed that the data-driven visualizations helped stakeholders from different departments of Lidingö and Nynäshamn municipalities to identify and bridge knowledge gaps caused by data silos. Participants noted proposals to modify future surveys and identified that this approach to visualizations would help them to share knowledge and maintain a long-term and sustainable collaboration across departments.

PMID:40720884 | DOI:10.2196/66377

JMIR Form Res. 2025 Jul 28;9:e58097. doi: 10.2196/58097.

ABSTRACT

BACKGROUND: Real-world data reported by patients and extracted from electronic health records (EHRs) are increasingly leveraged for research, policy, and clinical decision-making. However, it is not always obvious the extent to which these 2 data sources agree with each other.

OBJECTIVE: This study aimed to evaluate the concordance of variables reported by participants enrolled in an electronic cohort study and data available in their EHRs.

METHODS: Survey data from COVID-19 Citizen Science, an electronic cohort study, were linked to EHR data from 7 health systems, comprising 34,908 participants. Concordance was evaluated for demographics, chronic conditions, and COVID-19 characteristics. Overall agreement, sensitivity, specificity, positive predictive value, negative predictive value, and κ statistics with 95% CIs were calculated.

RESULTS: Of 34,017 participants with complete information, 62.3% (21,176/34,017) reported being female, and 62.4% (21,217/34,017) were female according to EHR data. The median age was 57 (IQR 42-68) years. Out of 34,017 participants, 81.6% (27,744/34,017) of participants reported being White, and 79.5% (27,054/34,017) were White according to EHR data. In addition, 9.2% (3,124/34,017) of participants reported being Hispanic, and 6.6% (2,249/34,017) were Hispanic according to EHR data. Statistically significant discordance between data sources was detected for all demographic characteristics (P<.05) except the female category (P=.57) and the American Indian and Alaska Native (P=.21) and “other” race categories (P=.33). Statistically significant discordance was detected for the 2 COVID-19 traits and all baseline medical conditions except diabetes (P=.17). The starkest absolute difference between data sources was for COVID-19 vaccination, which was 48.4% according to the EHR and 97.4% according to participant report. Overall agreement was high for all demographic characteristics, although chance-corrected agreement (κ) and sensitivity were lower for the “other” race category (κ=0.31, sensitivity =26.6%), Hispanic ethnicity (κ=0.82, sensitivity=74%), and current smoker status (κ=0.54, sensitivity=49.4%). Specificity and negative predictive value (NPV) were higher than corresponding specificity and positive predictive value (PPV) for all baseline medical conditions. Sleep apnea had the highest sensitivity of all medical conditions (83.5%), and anemia had the lowest (32.8%). Chance-corrected agreement (κ) was highly variable for baseline medical conditions, ranging from 0.26 for anemia to 0.71 for diabetes. Overall and chance-corrected agreement between data sources for COVID-19 traits such as infection (84.6%, κ=0.34) and vaccination (51.0%, κ=0.05) was relatively lower than all other evaluated traits. The sensitivity for COVID-19 infection was 32.2%, and the sensitivity for COVID-19 vaccination was 49.7%. Although PPV for COVID-19 vaccination was 99.9%, the NPV was 5%.

CONCLUSIONS: Results suggest the need for improvements to point-of-care capture of patient demographic traits and COVID-19 infection and vaccination history, patient education about their medical conditions, and linkage to external data sources in EHR-only pragmatic research. Further, these results indicate that additional work is required to integrate and prioritize participant-reported data in pragmatic research.

PMID:40720880 | DOI:10.2196/58097

Ann Am Thorac Soc. 2025 Jul 28. doi: 10.1513/AnnalsATS.202501-054OC. Online ahead of print.

ABSTRACT

RATIONALE: Short-term ambient air pollution exposure may worsen asthma health. Effects of longer-term air pollution exposures on asthma exacerbations and risk mitigation by dietary factors are unknown.

OBJECTIVE: To examine associations between 48-month air pollution exposure and asthma exacerbations and whether a plant-based diet modifies these relationships.

METHODS: Women with asthma in the Nurses’ Health Study II were followed from 1997 to 2014. We estimated 48-month time-varying average residential ambient fine particulate matter (PM2.5), nitrogen dioxide (NO2) and ozone (O3) exposures using nationwide spatiotemporal models. Plant-diet index (PDI) scores were calculated based on food frequency questionnaires administered every 4 years. Air pollution and diet assessments were repeated measures within-individuals, while asthma exacerbations in the past year were captured in 1998 and 2014. Average air pollutant exposure was assessed in the 48-months prior to each outcome assessment year. Single and multi-pollutant logistic regression models with generalized estimating equations to account for repeated measures within participants were used to assess the effects of each air pollutant on asthma exacerbation risk. We also evaluated effect measure modification by PDI scores on the effects of each air pollutant on asthma exacerbation risk using two-way interaction terms.

RESULTS: Of 4326 participants, median 48-month PM2.5, NO2 and O3 concentrations were 13.7 ug/m3, 12.0 ppb and 25.5 ppb, respectively, from July 1993 to June 1997 and 8.9 ug/m3, 6.6 ppb and 27.8 ppb, respectively, from July 2009 to June 2013. In adjusted single pollutant models, greater exposures to both PM2.5 and NO2 were associated with higher odds of asthma exacerbation (OR 1.43; 95% CI 1.14-1.80, and OR 1.25; 95% CI 1.12-1.38, respectively). In multi-pollutant models, greater exposure to NO2 was associated with higher odds of asthma exacerbation (OR 1.23; 95% CI 1.06-1.42). There were no statistically significant interactions between pollutants and PDI score on asthma exacerbations.

CONCLUSIONS: Long-term exposure to ambient NO2 and PM2.5 even at low levels, may increase asthma exacerbation risk in women, but is not attenuated by a plant-based diet as measured herein. Further research is needed on long-term effects of inhaled pollutants on asthma health and personal, modifiable strategies to reduce risk.

PMID:40720872 | DOI:10.1513/AnnalsATS.202501-054OC

JMIR Aging. 2025 Jul 28;8:e65374. doi: 10.2196/65374.

ABSTRACT

BACKGROUND: Individuals with probable sarcopenia have shown excess mortality, yet no specific treatment regimen has been established. While lifestyle factors improve health and longevity in general populations, their role in probable patients with sarcopenia remains unclear due to differing lifestyle patterns. Clarifying this could inform strategies to address this unmet need.

OBJECTIVE: We aim to quantify the impact of a healthy lifestyle on all-cause and cause-specific mortality in probable sarcopenic populations using a large-scale prospective cohort study.

METHODS: Participants were selected from the UK Biobank, aged 40-69 years, during 2006-2010. Probable sarcopenia was identified according to EWGSOP2 (European Working Group on Sarcopenia in Older People 2) criteria, resulting in 20,654 participants being included in this study. Death dates and underlying causes were obtained from the National Health Service Information Center. Cox proportional hazard models and population-attributable risk were used to assess the associations between healthy lifestyle factors and premature mortality risk.

RESULTS: A total of 20,654 individuals with probable sarcopenia were included in this study. The median age of the population was 62.0 (IQR 56.0-66.0) years, and 60.6% (n=12,528) were women. During a median follow-up duration of 11.5 (IQR 10.8-12.3) years, 2447 participants died. All healthy lifestyle factors, including nonsmoking (P<.001), moderate alcohol intake (P<.001), regular physical activity (P<.001), a healthy diet (P=.01), limited television-watching time (P<.001), adequate sleep duration (P=.001), and strong social connections (P<.001), were independently associated with lower mortality risk. To evaluate the cumulative associations between modifiable lifestyle factors and mortality outcomes (all-cause and cause-specific) among patients with probable sarcopenia, we developed a healthy lifestyle index. Participants were assigned one point per adherence to each optimal lifestyle factor. Compared with individuals with 0-2 healthy lifestyle scores, hazard ratios of all-cause mortality for those with 3 to 6-7 factors were 0.67 (95% CI 0.59-0.76), 0.51 (95% CI 0.45-0.57), 0.43 (95% CI 0.38-0.49), and 0.33 (95% CI 0.29-0.39), respectively (P for trend <.001). There was also a dose-response relationship between the number of healthy lifestyle factors and mortality from cancer, cardiovascular disease, respiratory disease, digestive disease, and other causes (all P for trend<.001). Population-attributable risk analysis indicated that 25.7% (95% CI 22%-29%) of deaths were attributable to a poor lifestyle (scoring 0-5).

CONCLUSIONS: A healthy lifestyle is associated with a lower risk of all-cause mortality and mortality due to cancer, cardiovascular disease, respiratory disease, and digestive disease among individuals with probable sarcopenia. Adopting a healthy lifestyle (scoring 6-7) could prevent 25.7% of deaths in this population.

PMID:40720868 | DOI:10.2196/65374