Tag: statistics

Sci Rep. 2025 Jul 22;15(1):26513. doi: 10.1038/s41598-025-11995-8.

ABSTRACT

Treatment of complex tibial plateau fractures remains a challenging task in clinical practice. Sufficient and appropriate preoperative decision making is essential for optimal treatment success and ultimately influences patient outcomes. Recently, the novel technique of 3D printing has proven to be beneficial for the preoperative management in other joint regions. To investigate the impact of point-of-care 3D printing on the preoperative management of tibial plateau fractures, we asked 5 students, 10 surgical residents, 3 junior surgeons and 4 senior surgeons, to simulate the preoperative planning of 22 tibial plateau fractures (11 AO B and 11 AO C fractures) regarding the treatment concept, patient positioning, operative approach and implant selection and positioning. First with CT scans only, second with 3D volumetric reconstructions, and finally with 3D printed fracture models. We analyzed the inter- and intraobserver agreement and the subjective perceived confidence of the rater regarding his decision with the different imaging modalities across the different levels of professional experience. Statistics were performed using kappa values, percentage match (PM) analysis and a univariate one-way analysis of variance. The use of 3D printing had no effect on the interobserver reliability of treatment concept selection (PM CT 83% > 3DCT 83% > 3D 82%). However, descriptively higher kappa and percentage match values increased for agreement on patient positioning and surgical approach using 3D printed fracture models. In addition, the raters selected the implants that were actually used to treat the fractures in 63% of the cases. The subjective perceived certainty of the raters increased with the use of 3D printing technology from 45% (CT and 3DCT) to 60% (3D). Additionally, raters changed their treatment plan in 36% of the cases and gained additional information 76% of the time when using the 3D printed specimen. The use of 3D printed fracture models showed a trend toward higher interrater reliability of patient positioning and surgical approach for medical students and surgical residents, while experienced surgeons show less benefit. In addition, 3D-printed models supported implant pre-selection and increased subjective confidence, positively influencing preoperative planning.

PMID:40691693 | DOI:10.1038/s41598-025-11995-8

Cancer Causes Control. 2025 Jul 21. doi: 10.1007/s10552-025-02041-z. Online ahead of print.

ABSTRACT

BACKGROUND: Prostate cancer (PC) is a major health concern and may be influenced by trace elements (TEs) like copper, selenium, manganese, and iron. This study aimed to analyze the difference in serum levels of these TEs in PC patients versus healthy controls.

METHODS: A comprehensive search for relevant literature was conducted across PubMed, Embase, Scopus, and Google Scholar, including studies up to December 2024. Data was analyzed using RevMan software, with standardized mean differences (SMDs) and 95% confidence intervals (CIs) for effect size. Subgroup analysis was carried out based on the method used to measure serum levels.

RESULTS: This study analyzed data from 12 articles, including serum copper levels in 11, selenium in 8, manganese in 4, and iron in 6. Serum copper levels were significantly higher in PC patients compared to controls (SMD: 1.85; 95% CI [0.85, 2.86]; p = 0.0003). In contrast, serum selenium levels were substantially lower in PC patients (SMD: – 2.45; 95% CI [- 3.84, – 1.05]; p = 0.0006). Although alterations were observed in serum manganese (SMD: – 0.57; 95% CI [- 2.61, 1.47]; p = 0.58) and iron (SMD: 0.63; 95% CI [- 1.51, 2.76]; p = 0.57) levels, these changes did not reach statistical significance. Subgroup analysis based on measurement methods revealed statistically significant differences between subgroups for copper, selenium, and iron, while no substantial subgroup difference was found for manganese.

CONCLUSION: The study identified significant changes in serum copper and selenium levels in PC patients, indicating their potential as biomarkers and enhancing our understanding of TE involvement in PC.

PMID:40691674 | DOI:10.1007/s10552-025-02041-z

Perioper Med (Lond). 2025 Jul 21;14(1):75. doi: 10.1186/s13741-025-00562-4.

ABSTRACT

BACKGROUND: Despite advances in treatment, hemorrhage remains one of the leading causes of early death in trauma. Rapid, personalized treatment of coagulopathy in this population should therefore be a priority. The introduction of viscoelastic hemostatic assays may improve transfusion strategies.

METHODS: This prospective observational study aimed to compare the efficacy of a ROTEM-guided hemostatic treatment protocol for trauma patients with a historical control group who had received conventional coagulation testing. The study included adults with multiple trauma requiring transfusion (≥ 1 unit of RBC within 12 h). The aim was to compare transfusion requirements in the operating room, on the 1st and 2nd ICU days, the rate of massive transfusion, and the overall outcome. The data obtained were stored in a database and analyzed using Statistica™ 13.3 (Stat Soft Polska). A p-value < 0.05 was considered significant. Study was registered retrospectively at researchregistry.com (RR10995).

RESULTS: A total of 78 patients were compared. The number of RBC units transfused in the OR and on the 1st ICU day decreased significantly after implementation of the ROTEM treatment protocol (p = 0.01, p = 0.04). Fewer patients in the study group required RBC transfusion on the 1st and 2nd ICU days (p = 0.01, p = 0.003), as well as the number of patients requiring FFP transfusion in all examined periods of time (p = 0.02, p = 0.006, p = 0.01). While FFP use per patient in the OR and on the 1st ICU day was lower, it was not statistically significant. Fibrinogen substitution in the OR remained similar, but more patients from the study group received it on the 1st ICU day (13 vs. 5, p = 0.04). The need for other blood products and coagulation factors remained unchanged. MT incidence decreased significantly in the first 24 h (p = 0.02), while 30-day mortality remained unchanged.

CONCLUSIONS: The introduction of the ROTEM- guided hemostatic treatment protocol in trauma resulted in a changes in transfusion requirements and a reduction in the incidence of MT. ROTEM can be a useful clinical tool in the rapid and targeted management of bleeding trauma patients.

TRIAL REGISTRATION: Researchregistry.com (RR10995).

PMID:40691642 | DOI:10.1186/s13741-025-00562-4

J Cheminform. 2025 Jul 21;17(1):108. doi: 10.1186/s13321-025-01041-0.

ABSTRACT

This study, focusing on predicting Absorption, Distribution, Metabolism, Excretion, and Toxicology (ADMET) properties, addresses the key challenges of ML models trained using ligand-based representations. We propose a structured approach to data feature selection, taking a step beyond the conventional practice of combining different representations without systematic reasoning. Additionally, we enhance model evaluation methods by integrating cross-validation with statistical hypothesis testing, adding a layer of reliability to the model assessments. Our final evaluations include a practical scenario, where models trained on one source of data are evaluated on a different one. This approach aims to bolster the reliability of ADMET predictions, providing more dependable and informative model evaluations.Scientific contributionThis study provided a structured approach to feature selection. We improve model evaluation by combining cross-validation with statistical hypothesis testing, making results more reliable. The methodology used in our study can be generalized beyond feature selection, boosting the confidence in selected models which is crucial in a noisy domain such as the ADMET prediction tasks. Additionally, we assess how well models trained on one dataset perform on another, offering practical insights for using external data in drug discovery.

PMID:40691635 | DOI:10.1186/s13321-025-01041-0

BMC Nutr. 2025 Jul 21;11(1):142. doi: 10.1186/s40795-025-01125-y.

ABSTRACT

BACKGROUND: Obesity is an important public health concern, which has dramatically grown in the last decades. Taste sensation determines food preferences and could contribute to obesity. Considering the conflicting results about the association of gustatory threshold and overweight/obesity status of individuals, this study designed to compare gustatory threshold of five main tastes (sweet, umami, salty, bitter, and sour) among individuals with overweight/obesity and with a normal BMI.

METHODS: In this case-control and population-based study, 100 adults participated, divided into two equal number of normal and overweight/obese groups. To measure gustatory threshold of sweet, umami, salty, bitter, and sour tastes, solutions of sucrose, monosodium glutamate, sodium chloride, quinine hydrochloride and citric acid were prepared respectively. Three millimeters of each solution was dropped on the right side of the posterior tongue, and the same volume of distilled water was dropped on the left side. The concentration at which the participant perceived the taste was considered the gustatory threshold. The data was analyzed in SPSS software version 22 with the Mann-Whitney test and Spearmen correlation coefficient.

RESULTS: No statistically significant differences were observed between the gustatory thresholds of the five main tastes among participants with normal BMI and with overweight/obesity. Moreover, among the numerical value of BMI and perceived concentrations of each of the tastes, no association was found (p value > 0.05).

CONCLUSIONS: According to the findings obtained from this study, no significant statistical difference in gustatory threshold of five main tastes was observed among individuals with overweight/obesity and normal weight.

PMID:40691631 | DOI:10.1186/s40795-025-01125-y

J Foot Ankle Res. 2025 Sep;18(3):e70063. doi: 10.1002/jfa2.70063.

ABSTRACT

BACKGROUND: The decline in podiatry student enrolments at universities across Australia and New Zealand presents a workforce crisis that threatens the profession’s sustainability and the delivery of essential healthcare services to communities. Recent data highlight a limited understanding of the podiatry profession among allied health students. There is now a clear need for strategies to address negative stereotypes and to build knowledge of the profession’s scope of practice, career opportunities, job prospects and earning potential. As part of a larger research initiative, this study explored student perspectives on marketing the podiatry profession to increase student enrolments.

METHODS: A convergent mixed methods study design was employed. Participants included students enrolled in (i) podiatry and (ii) relevant ‘non-podiatry’ health, sport or science programs at nine Australian universities and one New Zealand university. Data were collected via an online survey (278 podiatry students and 553 non-podiatry students responding) and two online workshops with nine first-year podiatry students. Quantitative data were analysed using descriptive statistics and regression models, while qualitative data underwent inductive thematic analysis by three independent assessors. We integrated the data by exploring the connections between the quantitative and qualitative findings.

RESULTS: Findings revealed that over 40% of podiatry students had initial concerns about their course and 34.2% had considered leaving. Instagram and Facebook were identified as the most influential social media platforms for sourcing information about courses and careers. Four over-arching themes emerged as important marketing strategies for increasing student enrolments: (i) enhance the visibility, perception and advocacy of podiatry; (ii) emphasise holistic and diverse practice in podiatry; (iii) enable early exposure and experience of podiatry practice and (iv) improve course entry pathways and flexibility.

CONCLUSIONS: An evidence-based approach is required to enhance the visibility and appeal of podiatry as a career. Strategies should focus on addressing misconceptions about the discipline, expanding promotional efforts to broader audiences, leveraging relevant media platforms, reducing financial and academic barriers for prospective students, and improving study flexibility. Strengthening enrolments and reducing attrition are fundamental to ensuring the sustainability and growth of the podiatry profession in Australia and New Zealand.

PMID:40691626 | DOI:10.1002/jfa2.70063

J Orthop Surg Res. 2025 Jul 21;20(1):689. doi: 10.1186/s13018-025-06110-6.

ABSTRACT

BACKGROUND: Social determinants of health (SDOH) encompass social and economic factors that influence healthcare access and outcomes. In orthopaedic surgery, disparities in SDOH contribute to unequal access to care and differences in post-surgical recovery. Prior studies indicate that an increased number of preoperative shoulder dislocations raises the likelihood of recurrent instability following stabilization procedures. However, limited research explores the association between SDOH and preoperative dislocation frequency. This study examines how SDOH factors influence the number of shoulder dislocations before surgical intervention.

METHODS: Patients that underwent shoulder instability surgery at a single center in a large metropolitan area between January 1, 2021, and April 30, 2023, were identified. Patients’ demographic and social determinant variables were extracted using the electronic medical record. Socioeconomic status was assessed using the Social Vulnerability Index (SVI) and the Area Deprivation Index (ADI), based on patient zip codes. Statistical analyses, including univariate and multivariate regression models, evaluated predictors of multiple dislocations before surgery, focusing on factors such as age, body mass index (BMI), and socioeconomic indicators.

RESULTS: Among 106 patients, 54% identified as White, 29% as Black, and 17% as other. Thirty-eight (35.8%) had a single dislocation before surgery, while 68 (64.2%) experienced multiple instability events. Univariate analysis showed younger age (odds ratio [OR] 0.94, P = 0.02), lower BMI (OR 0.90, P = 0.02), higher SVI (OR 1.21, P = 0.006), and higher ADI (OR 6.04, P = 0.003) were associated with recurrent instability. Multivariate analysis confirmed lower BMI (OR 1.15, P = 0.02) and higher ADI (OR 7.46, P = 0.02) as independent predictors.

CONCLUSIONS: Lower socioeconomic status, as measured by ADI, is an independent predictor of a higher likelihood of recurrent instability before surgery. Recognizing these relationships can motivate surgeons to create pathways to prevent these treatment disparities among shoulder instability patients.

LEVEL OF EVIDENCE: III retrospective cohort study.

PMID:40691624 | DOI:10.1186/s13018-025-06110-6

BMC Med. 2025 Jul 21;23(1):434. doi: 10.1186/s12916-025-04273-x.

ABSTRACT

BACKGROUND: Poor dental health has been linked to an increased risk of gastric cancer (GC), but previous studies were limited by their retrospective design and relatively small sample size.

METHODS: We followed a nationwide cohort of 5,888,034 Swedish adults over the age of 19 who visited a dentist between 2009 and 2016. Additionally, a nested case-control study was conducted by comparing incident GC cases to their siblings. Cox regression analyses, using attained age as the timescale and adjusting for potential confounders, were performed to evaluate the association between various dental health conditions and the risk of GC. In addition, we stratified our analyses by sex and age and conducted various sensitivity analyses to ensure the robustness of our findings.

RESULTS: Over an average follow-up of 6.4 years, we identified 3993 new GC cases, including 1241 cardia GC and 2752 non-cardia GC. Compared to individuals with healthy teeth, those with periodontitis had an 11% and 25% increased risk of GC and cardia GC, respectively. The positive associations between odontogenic inflammation and the risk of GC were consistent in sibling-controlled analyses. We also observed a dose-response relationship between the number of remaining teeth and the risk of GC, with fewer teeth associated with higher risks. Additionally, we did not find significant interactions between dental inflammatory conditions and the number of remaining teeth in relation to the risk of GC or its subtypes. Our findings were consistent across different sex and age subgroups and in sensitivity analyses.

CONCLUSIONS: This study provides the largest prospective cohort study evidence to date, along with the first sibling-controlled comparisons, supporting the association between poor dental health and GC risk. Promoting dental health in the general population could have significant public health implications in preventing this disease.

PMID:40691605 | DOI:10.1186/s12916-025-04273-x

J Orthop Surg Res. 2025 Jul 21;20(1):685. doi: 10.1186/s13018-025-06087-2.

ABSTRACT

BACKGROUND: The aim of this study was to identify the radiographic parameters associated with failure of tension band wiring (TBW) in the treatment of transverse patellar fractures, with the goal of guiding surgical decision-making.

MATERIALS AND METHODS: A total of 76 patients underwent surgical treatment for patellar fractures at Trakya University between January 2013 and December 2022. We retrospectively analyzed 32 patients who met the study’s inclusion criteria for transverse fractures (AO Type 34- C1) treated with TBW. Radiographic parameters assessed included patellar width, inter-K-wire distance, K-wire-to-patella ratios, knot configuration, and K-wire length, all evaluated for their potential association with fixation failure. Failure was defined as cerclage wire slippage or breakage. Statistical analyses were conducted using SPSS and Jamovi software. Descriptive statistics, t-tests, chi-square or Fisher’s exact tests, logistic regression, and ROC analysis were performed. A p-value < 0.05 was considered significant.

RESULTS: The mean age was 50 years ± 15.8 (range 26-80), with 8 women (25%) and 24 men (75%). Nine patients (28.1%) experienced TBW failure. Notably, single-knot constructs had significantly higher failure rates (66.7% vs. 19.2%; OR = 0.119, 95% CI [0.017-0.843], p = 0.038). Increased K-wire length was associated with failure (p = 0.008; cutoff 69.1 mm, AUC = 0.785). Patella-K-wire length ratio was higher in failures (p = 0.035). Lateral K-wire to articular distance and lateral K-wire to articular distance surface to patella thickness ratio were also significant predictors in slippage group (p = 0.046 and p = 0.031).

CONCLUSION: The number of knots, K-wire length, and specific radiographic parameters are important predictors of TBW failure. Attention to construct configuration and K-wire placement is crucial to minimize failure risk.

PMID:40691604 | DOI:10.1186/s13018-025-06087-2

Int J Epidemiol. 2025 Jun 11;54(4):dyaf123. doi: 10.1093/ije/dyaf123.

ABSTRACT

BACKGROUND: Most women diagnosed with breast cancer (BC) survive treatment and become long-term survivors. This study examines the association between long-term survival of female BC patients and clinical factors, socio-economic determinants, healthcare utilization, and drug use.

METHODS: This retrospective population-based survival study uses linked cancer registry data, claims, and social security data at the individual level for all Belgian women diagnosed with invasive BC in 2010 (n = 9982). Ten-year survival probabilities were computed by using Kaplan-Meier and relative survival curves. A Weibull mixture cure model was employed to perform multivariable analysis.

RESULTS: The population consisted of women with early-stage (75.0%), locally advanced (13.1%), and metastatic BC (5.9%). The overall 10-year unadjusted survival was 68.2% [95% confidence interval (CI), 67.1%-69.3%], with decreasing survival in older women. However, survival was lower in women age <40 years compared with those aged 40-60 years. Multivariate analysis revealed that age was associated with long-term survivorship (odds ratio, 0.919; 95% CI, 0.918-0.919). Women receiving multimodal treatment (surgery followed by adjuvant radiotherapy and systemic treatment) were more likely to become long-term survivors compared with women receiving other treatments. Lastly, beneficiaries of increased reimbursement had lower odds of long-term survivorship.

CONCLUSION: Our study highlights the association between long-term survivorship in women diagnosed with invasive BC and factors such as age at diagnosis, treatment scheme, and entitlement to increased reimbursement. It is crucial to inform clinicians and policymakers on the appropriate use of mixture cure models, as their results can substantially impact healthcare decision-making. Furthermore, tailored BC screening strategies are essential to reduce social inequalities and mortality disparities.

PMID:40690797 | DOI:10.1093/ije/dyaf123