Tag: statistics

Eur J Med Res. 2025 Nov 8;30(1):1091. doi: 10.1186/s40001-025-03200-3.

ABSTRACT

INTRODUCTION: Bone mineral density (BMD) is a key indicator of bone health, particularly in older populations, where lower BMD is linked to increased risk of osteoporosis and fractures. Metabolic factors like serum uric acid (UA) and high-density lipoprotein cholesterol (HDL-C) have emerged as possible determinants of bone health. The uric acid to HDL cholesterol ratio (UHR) may offer a new perspective on these metabolic influences. This study explores the association between UHR and femoral neck BMD, with a focus on non-linear relationships and subgroup variations by body mass index (BMI), age, and sex.

METHODS: The study used data from 2178 participants from the 2017-2018 National Health and Nutrition Examination Survey (NHANES). UHR was calculated as the ratio of serum UA to HDL-C. BMD measurements were obtained using dual-energy X-ray absorptiometry (DXA) at the femoral neck. A two-piecewise linear regression model was applied to examine the non-linear relationship between UHR and BMD. Stratified analyses were conducted by BMI, gender, and age groups.

RESULTS: A significant inflection point was found at UHR 19. Below this threshold, UHR was positively associated with femoral neck BMD (β = 0.0054, p = 0.013), while above the threshold, the association was negative but not statistically significant (β = – 0.0016, p = 0.478). Stratified analysis revealed that the relationship between UHR and BMD remained significant among Mexican Americans even after adjusting for covariates (β = 0.0145, p = 0.012).

CONCLUSION: This study identifies a non-linear association between UHR and femoral neck BMD, with a key inflection point at UHR 19. These findings suggest that UHR could be a useful biomarker for bone health, especially in populations with higher metabolic risks. Further longitudinal studies are necessary to establish causality and explore potential interventions targeting UHR to improve bone health.

PMID:41206450 | DOI:10.1186/s40001-025-03200-3

J Infect Dis. 2025 Nov 5:jiaf563. doi: 10.1093/infdis/jiaf563. Online ahead of print.

ABSTRACT

The life-course impact of childhood tuberculosis (TB)-including its connection to frailty-remains poorly understood. We analyzed 8,459 adults ≥50 years in ELSI-Brazil (2015-2016), including 74 with self-reported TB before age 15. Frailty (phenotype) was assessed and compared using Poisson models before and after propensity-score matching (1:4; 283 controls); mediation tested chronic obstructive pulmonary disease (COPD). Frailty was more frequent with childhood TB (23.0% vs. 8.8%; p=0.001). After matching, childhood TB was associated with higher frailty prevalence (PR 2.52; 95% CI 1.43-4.44); mediation through COPD was small and not statistically significant. Findings support a life-course approach to TB care.

PMID:41206432 | DOI:10.1093/infdis/jiaf563

Eur J Pediatr. 2025 Nov 8;184(12):740. doi: 10.1007/s00431-025-06578-8.

ABSTRACT

This study aimed to systematically identify the key characteristics of retracted articles in pediatric literature and explore the patterns and reasons of pediatric retraction from 1995 to 2024. We searched PubMed and Retraction Watch databases to identify all retracted publications in the field of pediatrics. After the screening process, data were extracted into Excel. Statistical analysis was conducted using Jamovi and Excel. A correlation matrix was used for the important retraction-related factors. After screening, 590 unique retracted pediatric articles were included, with most of them, 572 (96.9%), having retraction notices available; 516 (87.5%) published as open access; 433 (73.4%) from Asia-mostly China; 348 (59%) retracted by the publisher; 301 (51.0%) published by Hindawi; 275 (46.6%) observational studies; and 221 (37.5%) retracted due to misconduct. Articles with four authors showed the highest retraction rate, and the retraction rate generally decreased as the number of authors increased. Most retractions occurred in 2023. The most common pediatric age group included in the retracted papers was children. The median H-index of authors of retracted papers was 8 for first authors and 10 for senior authors. The median time from submission to acceptance of retracted papers was 50 days and that from publication to retraction was 15 months. Additionally, time to retraction was positively correlated with the journal’s impact factor (r = 0.106, p = 0.015) and the citation count (r = 0.213, p < 0.001) but showed no significant correlation with time to acceptance (r = – 0.019, p = 0.675).

CONCLUSION: The increasing number of retracted pediatric papers reflects a growing concern with a complex pattern and various determinants. Researchers and publishers should adopt strong regulations and guidelines to improve the integrity of scientific research, especially pediatric research.

WHAT IS KNOWN: • Retractions in biomedical research have been increasing over the past decades, often due to research misconduct, plagiarism, or data fabrication. • Previous studies have analyzed retraction patterns across several medical specialties, but pediatric research remains underexplored despite its ethical and clinical sensitivity.

WHAT IS NEW: • This is the most comprehensive analysis of retracted publications in pediatric literature, covering 590 articles from 1995 to 2024 and revealing distinct geographic, temporal, and publisher- and author-related patterns. • The study highlights a strong dominance of retractions from Asia-especially China-and shows that research misconduct and peer-review manipulation are the leading causes, underscoring the urgent need for stricter integrity measures in pediatric research.

PMID:41206416 | DOI:10.1007/s00431-025-06578-8

J Neurol. 2025 Nov 8;272(12):754. doi: 10.1007/s00415-025-13439-9.

ABSTRACT

OBJECTIVE: The objective of this study is to present a report from the Big Multiple Sclerosis Data (BMSD) statistics workshop (Bari – Italy, June 2023) which focused on advanced statistical approaches for real-world data (RWD) analyses in multiple sclerosis (MS). The report emphasises the application of these approaches in predicting individual treatment response, assessing comparative effectiveness and safety of therapies and their sequences, and harmonizing data for large-scale federated analyses.

METHODS: The BMSD network, comprising five national registries and the international MSBase database (> 350,000 total patients), convened in June 2023 in Bari (Italy) to review methodological advances in RWD analysis. Experts discussed strengths, limitations, and regulatory implications of frequentist, Bayesian, and machine learning (ML) approaches, with case studies on treatment response modelling, comparative effectiveness, safety surveillance, and Common Data Model (CDM)-based federated learning.

RESULTS: Bayesian and ML techniques, integrated with causal inference frameworks, can improve personalized predictions of treatment benefit and risk by using high-dimensional longitudinal data. Propensity score-based methods and marginal structural models remain essential for minimizing confounding in comparative analyses, but require rigorous diagnostics and sensitivity analyses. Adoption of a CDM facilitates harmonization of heterogeneous datasets, while federated learning enables privacy-preserving, multi-jurisdictional collaboration. Together, these innovations address key challenges in studying treatment sequences, rare adverse events, and underrepresented patient groups.

CONCLUSIONS: This workshop report highlights how advanced statistical and computational methodologies enhance the robustness, interpretability, and regulatory relevance of MS RWD studies. By promoting the integration of complementary statistical and computational approaches within harmonized data infrastructures, the BMSD network is positioned to accelerate the translation of real-world evidence into precision medicine for MS.

PMID:41206399 | DOI:10.1007/s00415-025-13439-9

J Hum Genet. 2025 Nov 8. doi: 10.1038/s10038-025-01430-1. Online ahead of print.

ABSTRACT

Whole-genome sequence information currently available for large-scale sequencing studies is biased toward European descent populations. Such bias causes difficulties in identifying disease-associated genetic variations in non-European populations, including the Japanese. Here, to comprehensively identify genetic variants, we sequenced 3135 individuals representing the genetic diversity of the Japanese population. Of the 44,757,785 identified variants, 31.0% exhibiting a minor allele frequency of <1% were novel. Using these variants, we constructed a reference haplotype and graph-structured reference sequence to facilitate accurate imputation and variant characterization. Our findings suggest that integrating genetic variations from ethnically diverse populations into the prevailing catalogs is essential to achieve precision medicine for all populations.

PMID:41206389 | DOI:10.1038/s10038-025-01430-1

Environ Monit Assess. 2025 Nov 9;197(12):1317. doi: 10.1007/s10661-025-14710-2.

ABSTRACT

This study investigates the geochronology, distribution, and environmental fate of chemical stressors in a tropical estuarine ecosystem using sediment core analysis. Sediment cores were sampled from two distinct locations in Sepetiba Bay, Brazil, separated by approximately 12 km. The cores revealed differential contamination profiles over time (1990-2016), with low levels of polybrominated diphenyl ethers (PBDEs) and organochlorine pesticides (OCPs), but slight higher concentrations of polychlorinated biphenyls (PCBs). Polycyclic aromatic hydrocarbons (PAHs) exhibited the highest concentrations among the analyzed compounds, with signatures indicating both pyrolytic sources and degraded petrogenic inputs, particularly during the mid-2000s, coinciding with regional industrial expansion. The core located in the coastal area, displayed higher continental inputs, while the core situated in the bay center, reflected average estuarine contamination levels. Fuzzy K-means statistical analysis highlighted distinct contamination processes for each core during overlapping periods, underscoring the complexity of pollutant behavior in tropical coastal systems influenced by multiple drainage basins. These findings emphasize the need for spatially comprehensive sampling strategies to accurately assess environmental risks in complex estuarine ecosystems. The study provides critical insights into the behavior and fate of anthropogenic pollutants in marine and estuarine environments, supporting the development of effective monitoring programs and pollution management strategies in tropical regions impacted by industrial and urban pressures.

PMID:41206388 | DOI:10.1007/s10661-025-14710-2

Dig Dis Sci. 2025 Nov 8. doi: 10.1007/s10620-025-09539-1. Online ahead of print.

ABSTRACT

INTRODUCTION: Metabolic dysfunction-associated steatohepatitis (MASH) is a leading cause of cirrhosis. Vibration Controlled Transient Elastography (VCTE) measurements are often captured in text-based reports and not readily accessible for clinical research. Large language models (LLMs) show promise for curating information from unstructured documentation, but their efficiency for MASH and VCTE extraction are unclear.

METHODS: We used a cohort of 493 patients with compensated MASH cirrhosis. We compared the abilities of GPT-4o and Claude 3.5 Sonnet for identifying the presence of MASH and extracting maximum VCTE stiffness and Controlled Attenuation Parameter (CAP) measurements from clinical documentation. We ran a cost analysis of the LLMs. As exploratory analysis, we used LASSO-Cox to associate LLM-extracted features with death or decompensation.

RESULTS: For identifying MASH in clinical notes, GPT-4o and Claude 3.5 achieved F1-scores of 90.5% and 80.0%. For identifying peak VCTE measurements, GPT-4o achieved 99.3% and 99.1% accuracies for stiffness and CAP, while Claude 3.5 achieved 93.3% and 94.1% accuracies. LLM extraction of one variable required ~ 2000 tokens per note, with a cost of ~ $0.012/note for GPT-4o and ~ $0.014/note for Claude 3.5. In LASSO-Cox regressions, VCTE stiffness (HR 1.03, 95% CI 1.01-1.05, p = 0.016) and CAP score (HR 0.99, 95% CI 0.99-1.00, p = 0.029) were statistically significant predictive variables for death or decompensation.

CONCLUSIONS: LLMs can extract MASH presence and VCTE parameters from documentation with high accuracy and low cost. When incorporated into survival analyses, LLM-extracted variables are associated with important clinical outcomes. Given the growing availability of LLMs, liver diseases researchers should incorporate these methods to facilitate real-world studies.

PMID:41206385 | DOI:10.1007/s10620-025-09539-1

J Thromb Thrombolysis. 2025 Nov 8. doi: 10.1007/s11239-025-03193-0. Online ahead of print.

ABSTRACT

Endovascular thrombectomy (EVT) is the standard of care in acute ischemic stroke (AIS), yet functional outcomes remain suboptimal. Normobaric hyperoxia (NBHO) is a potential neuroprotective strategy. This study is the first systematic review and meta-analysis to assess NBHO as a potential neuroprotective adjunctive to improve outcomes in EVT-treated patients. A comprehensive search of electronic databases, including PubMed, Scopus, Cochrane, and Web of Science, was performed in February 2025. The inclusion criteria targeted randomized controlled trials (RCTs) comparing NBHO and EVT to EVT alone or with sham oxygen therapy. Statistical analyses were performed using RevMan software. Four RCTs comprising 648 patients with AIS due to large vessel occlusion in the anterior circulation were included in the study. For the primary efficacy endpoint of excellent functional outcome, defined as the number of patients who had a Modified Rankin Scale (mRS) score of ≤ 1 at 90 days, the overall odds ratio with a subgroup based on the oxygen delivery duration at 2, 4, and 6 h was in favor of the NBHO group compared to the control (OR = 1.66, 95% CI [1.13, 2.45], P = 0.01, I2 = 0%). The subgroup of 4-hour oxygen delivery duration was the only significant subgroup (OR = 1.6, 95% CI [1.01, 2.51], P = 0.04). Safety outcomes showed no significant differences between the NBHO group and the control group across all reported measures. NBHO as an adjunct to EVT appears to be effective and safe. A 4-hour duration was found to be the most effective. Further RCTs are needed to confirm our results and establish the optimal treatment protocol.

PMID:41206375 | DOI:10.1007/s11239-025-03193-0

Med Phys. 2025 Nov;52(11):e70131. doi: 10.1002/mp.70131.

ABSTRACT

BACKGROUND: Type 2 diabetes mellitus (T2DM) and Alzheimer’s disease (AD) are two major global health challenges, both associated with increased incidence and mortality. Although their pathologies differ, mounting evidence points to a shared vascular dysfunction that may drive the onset and progression of both conditions. Ultrasound localization microscopy (ULM) offers a promising approach for high-resolution imaging and quantification of cerebral microvasculature.

PURPOSE: To investigate changes in cerebral micro-vessels induced by T2DM, AD, and their coexistence, aiming to uncover the underlying interactions between the two diseases.

METHODS: Twenty-four Sprague Dawley (SD) rats were randomly assigned into four groups: (1) normal, (2) DM combined with AD, (3) DM, and (4) AD. Cerebral vascular density in the caudate putamen (CPu), thalamus (TH), and hippocampus (HIP) was quantified using ULM. Statistical analysis was conducted using one-way ANOVA followed by Tukey’s honestly significant difference (HSD) post-hoc test, after confirming normality and homogeneity of variance (Shapiro-Wilk and Levene’s tests). A p-value < 0.05 was considered statistically significant. To validate the model and examine the relationship between T2DM and AD, pathological staining was performed to assess cellular and neuronal changes, as well as Aβ deposition.

RESULTS: Both single diseases and their combination led to a reduction in cerebral vascular density across all three brain regions. The blood glucose-vessel density distributions in the DM and DM&AD groups showed substantial overlap, indicating similar patterns of cerebrovascular changes. In the CPu region, vascular density in diabetic rats decreased by 34.13% compared to controls (p = 0.003), while in the HIP of the DM&AD group, vascular density was reduced by 29.98% (p = 0.002).

CONCLUSION: T2DM triggers an increased risk of AD. ULM provides the possibility to be used as an emerging technological tool to detect early cerebral microangiopathy.

PMID:41206345 | DOI:10.1002/mp.70131

J Prosthet Dent. 2025 Nov 7:S0022-3913(25)00851-0. doi: 10.1016/j.prosdent.2025.10.039. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: The accuracy of dental implant placement influences prosthetic outcomes, biological complications, and long-term success. While guided surgery aims to improve precision, its advantages over conventional freehand techniques regarding survival, marginal bone stability, and complications remain unclear.

PURPOSE: The purpose of this umbrella review was to synthesize evidence from systematic reviews comparing clinical outcomes of guided versus freehand dental implant placement, focusing on accuracy, marginal bone loss, survival, and complications.

MATERIAL AND METHODS: Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and PROSPERO registration, the PubMed, Scopus, Embase, Google scholar, and Cochrane Library databases were searched for studies published between January 2000 and July 2025. Eligible studies were systematic reviews and meta-analyses comparing guided (static or dynamic) and freehand implant placement. Methodological quality was assessed using a measurement tool to assess systematic reviews 2 (AMSTAR-2). Extracted data included implant placement accuracy, marginal bone loss, survival, and complications. Effect sizes and statistical outcomes were extracted directly from the included meta-analyses, and results were synthesized descriptively without conducting a new meta-analysis.

RESULTS: Thirteen systematic reviews were included. Guided and computer-assisted placement showed better accuracy than freehand methods (Standardized mean difference [SMD] for coronal deviation -0.97; 95% Confidence Interval [CI] -2.27 to -0.32; P<.01). Marginal bone loss and implant survival were comparable across techniques (Risk ratio [RR]1.02; 95% CI 0.98-1.06; P=.28), both remaining high. Complication rates were low, with guided techniques potentially reducing iatrogenic risk (RR 0.88; 95% CI 0.74-1.04; P=.11).

CONCLUSIONS: Guided implant surgery was found to improve placement accuracy and may reduce surgical risk in complex treatments. Freehand placement remained reliable with comparable long-term outcomes when performed by experienced clinicians. Selection should consider treatment complexity, clinician expertise, and available resources.

PMID:41206337 | DOI:10.1016/j.prosdent.2025.10.039