Category: Statistics

Discov Oncol. 2025 May 29;16(1):944. doi: 10.1007/s12672-025-02819-2.

ABSTRACT

BACKGROUND: Cervical cancer remains a significant global health concern, with immune system regulation potentially playing a crucial role in disease development. This study investigates potential causal relationships between genetic variants associated with immune cell populations and cervical cancer risk.

METHODS: We employed multiple Mendelian randomization (MR) approaches inverse-variance weighted, MR-Egger, simple median, and weighted median methods to evaluate genetic instrumental variables linked to various T-cell and B-cell subtypes. Differential gene expression was analyzed using single-cell RNA sequencing, while forest plots, scatter plots, and funnel plots facilitated comprehensive MR analysis.

RESULTS: Forest plots consistently demonstrated odds ratios clustered tightly around 1.000 (range: 0.998-1.001), despite some variants reaching statistical significance (p < 0.05). MR analysis of CD69 + LGALS3A + regulatory T-cells, CD8 + T-cell populations, and CD20 + B-cells revealed only weak associations with cervical cancer susceptibility. Comparative analysis across different MR methodologies produced consistent results with minimal horizontal pleiotropy bias.

CONCLUSION: While immune cell genetic factors may contribute to cervical cancer development, their causal effects appear modest. These findings suggest that genetic predisposition through immune cell regulation likely plays a supplementary rather than primary role in cervical cancer pathogenesis.

PMID:40439950 | DOI:10.1007/s12672-025-02819-2

Environ Monit Assess. 2025 May 29;197(6):693. doi: 10.1007/s10661-025-14130-2.

ABSTRACT

To assess the environmental impact of training activities, surface soil was systematically collected at 3 training ranges (designated as A, B1, B2) located along the southeast coast of Guangdong, China. Analytical results of energetic compounds (ECs) in soil revealed that 2,4,6-trinitrotoluene (TNT) was the predominant ECs, with a mean concentration of 234 ng/g. The detection rate for Hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX) was over 50%, peaking at 710 ng/g. Heavy metal analysis demonstrated significant enrichment of cadmium (Cd), mercury (Hg), lead (Pb), copper (Cu), and arsenic (As) in soil. Particularly noteworthy were the Cu and Pb concentrations in range B2, reaching maximum levels of 259 mg/kg and 801 mg/kg, respectively. Metal enrichment was predominantly attributed to metallic components and shrapnel fragments originating from explosive materials. Field investigations indicated that metallic fragments dispersed in surface soils exhibited limited weathering, with iron (Fe) constituting the primary metallic element, accompanied by trace amounts of chromium (Cr). The quantitative analysis of ECs and heavy metals concentrations suggests a clear trend of environmental accumulation. These findings underscore the necessity for implementing long-term environmental monitoring programs and conducting comprehensive risk assessments to evaluate potential ecological risks related to military training activities.

PMID:40439947 | DOI:10.1007/s10661-025-14130-2

Neuroradiology. 2025 May 29. doi: 10.1007/s00234-025-03654-6. Online ahead of print.

ABSTRACT

BACKGROUND: Thalassemia is an inherited hematological disorder characterized by chronic anemia and multisystem involvement, including potential impacts on the central nervous system. Research has suggested a relationship between thalassemia and glymphatic system dysfunction, which may contribute to neurocognitive impairments. However, the exact mechanisms linking thalassemia to changes in glymphatic function remain unclear.

OBJECTIVE: To investigate the relationship between glymphatic system function and thalassemia severity, particularly in patients with transfusion-dependent and non-transfusion-dependent thalassemia.

METHODS: The study included a population of 40 thalassemia patients (TM, n = 40) confirmed through genetic testing, consisting of 19 patients who were transfusion-dependent (TDT, n = 19) and 21 patients who were non-transfusion-dependent (NTDT, n = 21), along with 39 healthy controls (HC, n = 39) matched for age and sex. Glymphatic function was assessed using the index for diffusivity along the perivascular space (ALPS-index), with regions of interest selected from the medullary veins and crossing fibers in the lateral ventricles. Statistical analyses were performed using Analysis of Variance (ANOVA) for intergroup comparisons, supplemented by Bonferroni correction for multiple comparisons. Pearson correlation was utilized to explore the relationships between the diffusion tensor image analysis along the perivascular space (DTI-ALPS) index and demographic factors, while multiple linear regression was employed to adjust for confounding variables. A significance threshold of P less than 0.05 was established for all statistical tests.

RESULTS: The mean DTI-ALPS Index for thalassemia patients were significantly lower than those of healthy controls, indicating impaired glymphatic function. No significant differences in DTI-ALPS Index were found between transfusion-dependent and non-transfusion-dependent groups. Correlation analysis showed minimal influence of age and education on glymphatic function in the study population.

CONCLUSION: This study demonstrates significant impairment in glymphatic system function in thalassemia patients, potentially related to chronic anemia and iron overload. These findings contribute to understanding the mechanisms underlying cognitive dysfunction in thalassemia.

PMID:40439942 | DOI:10.1007/s00234-025-03654-6

Neurosurg Rev. 2025 May 29;48(1):455. doi: 10.1007/s10143-025-03597-9.

ABSTRACT

BACKGROUND: Artificial Intelligence (AI) has emerged as a transformative tool in medicine, particularly addressing neurosurgical challenges such as complex anatomical delineation and intraoperative decision-making. Despite advancements in diagnostic and prognostic algorithms, obstacles including algorithmic bias, data privacy, and model interpretability continue to limit its widespread clinical adoption.

OBJECTIVE: This systematic review aims to evaluate the current applications of AI in neurosurgery, compare the performance of various AI models, and examine the ethical challenges associated with their integration into clinical practice.

METHODS: A systematic literature search was conducted in PubMed, Scopus, and Web of Science databases, following PRISMA guidelines. Studies from 2015 to 2025 focusing on AI applications in diagnostic, prognostic, surgical, and intraoperative neurosurgical contexts were included. Statistical outcomes, model performance metrics, and ethical considerations were analyzed.

RESULTS: Thirteen studies met the inclusion criteria. AI models, particularly ML and DL, demonstrated superior diagnostic accuracy (AUC > 0.90) and improved prognostic predictions by up to 15%. AI-assisted surgical planning enhanced precision and reduced complication rates by 10-20%. However, algorithmic bias, limited transparency, and lack of external validation remain key barriers to clinical adoption.

CONCLUSION: AI improves diagnostic accuracy, prognostic predictions, and surgical precision while reducing complication rates. However, challenges such as bias, limited interpretability, and the need for external validation must be addressed for widespread clinical integration.

PMID:40439939 | DOI:10.1007/s10143-025-03597-9

Indian J Gastroenterol. 2025 May 29. doi: 10.1007/s12664-025-01771-x. Online ahead of print.

ABSTRACT

OBJECTIVE: The potential impact of opium addiction on medical procedures has not been thoroughly investigated. In the present study, we aimed at investigating the potential association between opium addiction and the outcomes of endoscopic retrograde cholangiopancreatography (ERCP).

METHODS: In this retrospective case-control study, patients who underwent ERCP between July 2021 and October 2023 at a tertiary care center were screened and patients with opium addiction were matched with non-addict patients based on age, sex, ERCP indication and the cannulation approach at 1:1 ratio. The analysis compared the ERCP findings and post-ERCP complications between the two groups.

RESULTS: Overall, 276 patients with and without opium addiction were included (n = 138 for each group). The overall complication rate in the opium group was 10.1%, significantly higher than the control group (1.4%) (p = 0.003). Post-ERCP pancreatitis (5.8% vs. 1.4%, p = 0.046), bleeding (2.9% vs. 0%, p = 0.044) and perforation (1.4% vs. 0%, p = 0.156) were more common in the opium group. The procedural success rate of ERCP was 79.0% in opium group, while patients without opium addiction had a success rate of 85.5%, but it was not statistically significant (p = 0.207).

CONCLUSION: ERCP could be associated with higher rate of complications in opium-addict patients. Accurate procedural techniques and appropriate prophylaxis should be considered to reduce the risk of complications.

PMID:40439935 | DOI:10.1007/s12664-025-01771-x

Arch Dermatol Res. 2025 May 29;317(1):786. doi: 10.1007/s00403-025-04282-z.

ABSTRACT

Inflammatory bowel disease (IBD) is a chronic inflammatory disorder, which primarily affects the gut, but is not restricted to the intestinal tract. IBD is result of a complex interplay between a dysfunctional host immune response and environmental triggers. Extraintestinal manifestations (EIMs) are frequently observed in patients with IBD. The aim of this study was to evaluate the prevalence and features of the major cutaneous manifestations and associating factors in patients with IBD. This cross-sectional study was conducted on patients with IBD who were referred to gastroenterology and dermatology outpatient clinics in Imam Khomeini Hospital Complex, in Tehran, Iran, between March 2020 and March 2021. All patients underwent a body examination by a gastroenterologist and dermatologist. We used SPSS (version 25) to run appropriate statistical tests to analyze any relationship between skin diseases, and socio-demographic and disease-related characteristics of the patients, as well as medications used. A total of 226 patients were included in this study of which 59 (26.1%) were diagnosed with CD and 167 (73.9%) with UC. Eighty-six participants (38.1%) of all IBD patients (52.5% of CD patients and 32.9% of UC patients) had skin disease at the time of examination. Patients with CD were significantly more likely to have skin disease at the time of examination or while IBD was active (p = 0.008 and p = 0.019, respectively). Aphthous stomatitis and atopic dermatitis were the most frequent skin disease observed in all IBD patients (11.1% for both) as well as UC patients, whereas perianal fissure was the most frequent cutaneous manifestation in CD patients. Psoriasis and aphthous stomatitis were more common in female patients (p = 0.046 and p = 0.004, respectively). Skin diseases were generally more frequent in female (p = 0.001) and married patients (p = 0.015). Our research revealed that aphthous stomatitis and atopic dermatitis were the most common skin-related extraintestinal manifestations (EIMs) observed in all patients with inflammatory bowel disease (IBD). Furthermore, individuals with Crohn’s disease (CD) were more prone to developing skin manifestations. Women and married individuals are considered high-risk groups for skin lesions, and it is advisable for these patients to undergo regular skin examinations.

PMID:40439921 | DOI:10.1007/s00403-025-04282-z

Gastroenterol Nurs. 2025 May-Jun 01;48(3):191-202. doi: 10.1097/SGA.0000000000000868. Epub 2025 May 28.

ABSTRACT

This study investigated the current occurrence of hypoglycemia during bowel preparation of outpatients undergoing colonoscopy in endoscopy centers. A total of 399 outpatients from an eastern province of China participated in the survey. Participants’ characteristics and health information, colonoscopy information questionnaire and the state-trait anxiety inventory (STAI) were used as the study tools. Terminal blood glucose was measured by trained nurses before and after colonoscopy. The results showed that the incidence of hypoglycemia during bowel preparation was 17%. Mildly coughing when eating food (odds ratio [OR] = 3.821, 95% confidence interval [CI] = 1.570-9.299, p = .003), drinking alcohol 4-6 times per week (OR = 5.776, 95% CI = 1.794-18.600, p = .003), a history of hypoglycemia (OR = 2.275, 95% CI = 1.135-4.557, p = .020), fasting time ≥ 10 h (OR = 2.933, 95% CI = 1.118-7.699, p = .029), waiting time ≥ 12 h (OR = 0.446, 95% CI = 0.226-0.879, p = .020), subjective hunger (OR = 4.742, 95% CI = 2.255-9.972, p < .001), and STAI score (OR = 1.051, 95% CI = 1.012-1.090, p < .001), were the influencing factors of hypoglycemia in outpatients. It is suggested that clinical staff in endoscopy centers should identify the above risk factors as soon as possible, and conduct timely intervention to prevent hypoglycemia and avoid more serious consequences.

PMID:40439905 | DOI:10.1097/SGA.0000000000000868

Gastroenterol Nurs. 2025 May-Jun 01;48(3):174-181. doi: 10.1097/SGA.0000000000000867. Epub 2025 May 28.

ABSTRACT

This randomized clinical trial was conducted with the aim of comparing the effect of self-care education through two methods, a smartphone application (app) and teach-back (TB), on lifestyle and quality of life (QoL) in patients with inflammatory bowel diseases (IBD). This three-stage randomized clinical trial was conducted among 90 patients with IBD in Mashhad, Iran. Eligible patients were allocated to three groups (app, TB, and control) using simple blocked randomization. In each group, data were collected by a demographic checklist, the Crohn’s Disease and Ulcerative Colitis questionnaire, and the Miller-Smith Lifestyle questionnaire. Before the intervention, the results of one-way analysis of variance showed that there was no statistically significant difference between the three groups in terms of the mean scores of lifestyle and QoL (p > .05). However, a significant difference was observed between the three groups after the intervention (p < .05). The results of this study show that self-care education through two methods of an app and TB has a significant effect on improving IBD patients’ lifestyle and QoL, and there is no significant difference between the two methods in terms of effectiveness. Considering the advantages of apps, it is suggested to apply this method for patient education.

PMID:40439903 | DOI:10.1097/SGA.0000000000000867

Gastroenterol Nurs. 2025 May-Jun 01;48(3):153-160. doi: 10.1097/SGA.0000000000000874. Epub 2025 May 28.

ABSTRACT

Colonoscopy is a primary diagnostic method for colorectal cancer screening. Ensuring completeness is critical for its effectiveness. The aim of this study is to explores patient and procedure-related contributors to incomplete colonoscopy in a Danish high volume endoscopy unit. A population-based register study was conducted, using data from electronic health records from a Danish hospital was analyzed, covering all colonoscopies performed between July 2015 and August 2019. The primary outcome assessed was the completeness of the index colonoscopy, with incomplete cases further classified based on the causes for incompleteness that were assessed and documented in real-time by the endoscopist. Data also included patient demographics and comorbidities, and profession of the endoscopist. Among 33,128 colonoscopies, prevalence of incomplete colonoscopies was 6.55%, with inadequate bowel preparation as the leading cause (60.3%). Men were more prone to inadequate bowel preparation, while procedural pain, non-passability, and stenosis were associated with women. Physician endoscopists exhibited higher incomplete colonoscopy rates compared to nurse endoscopists, and patients with higher comorbidity scores were more likely to have incomplete colonoscopy. This study highlights the prevalence of incomplete colonoscopy and recognizes modifiable risk factors like inadequate bowel preparation and procedural pain. Findings underscore the need for personalized interventions, stressing ongoing endoscopist education and targeted strategies to improve colonoscopy effectiveness.

PMID:40439900 | DOI:10.1097/SGA.0000000000000874

Eur J Prev Cardiol. 2025 May 29:zwaf304. doi: 10.1093/eurjpc/zwaf304. Online ahead of print.

ABSTRACT

AIMS: There is an overabundance of cardiovascular disease (CVD) risk-prediction models applicable to patients with Type 2 diabetes (T2D), but most of them still require external validation. Our aim was to assess the performance of 18 CVD risk scores in a Spanish cohort of patients with T2D.

METHODS AND RESULTS: The CARdiovascular Risk in patients with DIAbetes in Navarra (CARDIANA) cohort, which includes 20 793 individuals with T2D and no history of CVD, was used to externally validate 13 models developed in patients with T2D [Action in Diabetes and Vascular Disease (ADVANCE), Atherosclerosis Risk in Communities, Basque Country Prospective Complications and Mortality Study risk engine, Cardiovascular Healthy Study, Diabetes Cohort Study, DIAL2, DIAL2-extended, Fremantle, Kaasenbrood, Swedish National Diabetes Register (NDR), PREDICT1-diabetes, SCORE2-diabetes, and Wan] and 5 models developed in the general population (ASCVD, PREVENT-basic, PREVENT-full, QRISK2, and SCORE2). Harrell’s C-statistic and calibration plots were used as measures of discrimination and calibration, respectively. There were 991 incident CVD events within 5 years of follow-up, resulting in a cumulative incidence of 5.0% (95% confidence interval 4.7-5.3). Discrimination ability was moderate for all the models, with SCORE2-diabetes, NDR, PREDICT1-diabetes, PREVENT-full, Wan, ADVANCE, and both DIAL2 models showing the highest C-index values. All models showed good calibration, although most of them required recalibration, with the exception of ADVANCE-, DIAL2-, and SCORE2-related models.

CONCLUSION: In our context, models derived for or adapted to diabetes patients, as well as models derived in the general population but incorporating diabetes-related metabolic measures (such as Hb1Ac) as predictors, demonstrated better performance than the others. DIAL2, DIAL2-extended, SCORE2-diabetes, and ADVANCE showed optimal calibration even without recalibration, which implies greater applicability, especially for SCORE2-diabetes and ADVANCE because of their simplicity.

PMID:40439899 | DOI:10.1093/eurjpc/zwaf304