Category: Statistics

J Patient Rep Outcomes. 2025 Feb 25;9(1):25. doi: 10.1186/s41687-025-00854-9.

ABSTRACT

BACKGROUND: The important roles of well-being as realization of one’s true potential for healthy aging have been highlighted by literature of the recent decades. The Scales of Psychological Well-being (SPWB) are an internationally recognized measurement tool for psychological well-being. Yet, sound validation of the German SPWB 18-item version has been lacking to date. Therefore, the present study aims to (1) test the psychometric properties of the German SPWB 18-item version in terms of factorial validity and (2) determine construct validity by investigating its correlations with psychosocial variables, mental and physical health. (3) Sociodemographic characteristics of the SPWB in a middle to old age German population was explored.

METHODOLOGY: Data of N = 3,374 participants 45-85 years old of the 10-year follow-up (2017-2022) of the Gutenberg Health Study (GHS) were analyzed. Descriptive analyses and inference statistical analyses were performed to assess construct validity. In order to determine the psychometric properties, item characteristics and reliability coefficients were analyzed. Confirmatory factor analyses tested the proposed theoretical factorial structure.

RESULTS: Construct validity of the SPWB was established with respect to sociodemographic, psychosocial (social support and resilient coping), and health variables (sleeping problems, depression and anxiety symptoms, stress, loneliness, and somatic diseases). Analysis of the psychometric properties of the German SPWB 18-item version rendered support for the theoretically proposed multidimensional structure of psychological well-being in our sample rather than a one factorial structure. Bi-factor models that take the method effects of positively and negatively formulated items into account are highly recommended.

CONCLUSIONS: The German SPWB 18-item version shows comparable psychometric properties to previous large-scale studies from other countries. The SPWB provides psychological indicators for healthy aging.

PMID:39998720 | DOI:10.1186/s41687-025-00854-9

Lasers Med Sci. 2025 Feb 25;40(1):118. doi: 10.1007/s10103-025-04375-1.

ABSTRACT

There is a lack of clinical consensus on the parameter settings of the pulsed-wave thulium fiber laser for soft tissue resection. The aim of this study was to explore the optimal parameter settings of the pulsed-wave thulium fiber laser for soft tissue resection, with a view to providing a reference for future clinical applications. Two different thulium fiber lasers, prototype thulium fiber lasers and Urolase, were used to explore the optimal parameters of thulium fiber laser for soft tissue cutting by evaluating the depth of tissue vaporization and depth of thermal damage in an isolated pig kidney model, and then the optimal parameters of in vitro screening were statistically validated by operation time, coagulation time, intraoperative hemorrhage, smoke level, and depth of thermal damage in an in vivo model using rabbit kidney. In ex vivo animal experiments the depth of tissue vaporization and thermal damage increased with increasing average power, and tissue carbonization occurred at 30 W. In animal use we used 1 J, 25 W for surgery, and there was no statistical difference between the two thulium fiber lasers in terms of surgery time, coagulation time, bleeding, smoke level, and depth of thermal damage. Thulium fiber laser for soft tissue resection is safe and feasible, and we believe that 1 J, 25 W is the optimal laser setting parameter for soft tissue resection, but it needs to be adjusted according to the actual situation.

PMID:39998717 | DOI:10.1007/s10103-025-04375-1

Psychiatr Q. 2025 Feb 25. doi: 10.1007/s11126-025-10123-z. Online ahead of print.

ABSTRACT

Psychological suffering of healthcare professionals, during War times, is ignored in literature. While struggling to provide ultimate care, HCP need support and psychological counseling. The purpose of this study was to examine the moderation effect of resilience on the relationship between life satisfaction, depression, and PTSD controlling for the sociodemographic and personal characteristics among on-duty healthcare professionals in Gaza. A convenience sample of 150 on-duty healthcare professionals filled out an online survey. The sample targeted a convenience sample of HCWs who are currently on duty in Gaza. Data collected regrading satisfaction with life, PTSD, depression, and resilience. Data collected from August to end of Sept 2024. Of the sample, 94.7% (n = 146) met criteria of PTSD, 85.3% (n = 128) reported a severe form of depression, 59.3% (n = 89) have a low level of resilience, and 74.7% (n = 112) reported that they are dissatisfied with their life. The analysis showed that resilience has no significant moderation effect on the relationship between psychological factors and PTSD controlling for demographic and personal characteristics as the R² change of 0.011 in the model was not statistically significant (p = 0.09). Years of experience, age and having mental illness were significant risk factors to develop PTSD. There is a need to provide an urgent psychological counselling to healthcare professionals in Gaza. Online and face-to-face help groups and peer to peer support need to be established.

PMID:39998710 | DOI:10.1007/s11126-025-10123-z

Discov Oncol. 2025 Feb 25;16(1):236. doi: 10.1007/s12672-025-02001-8.

ABSTRACT

BACKGROUND: Pancreatic cancer (PanCa) is one of the most lethal cancers (survival ~ 12%). As the conventional therapeutic interventions are mostly futile, a deep understanding of the disease pathophysiology is an urgent need. Ion channels, located on cell membrane, contribute significantly to cancer hallmarks, through dysregulation of various ion translocation; however, the fundamental mechanisms remain uncertain.

METHODS: To identify these oncochannels in Indian cohort of PanCa, we utilized 450 K data, published in our previous study, and identified potential pathways involved. Their expressions were evaluated using TCGA data and an independent Indian paired patient cohort (n = 20). The top genes were further validated using GEO and ScRNA seq dataset. Potential target ability of KCNJ5 was identified through molecular dynamic based drug designing.

RESULTS: A set of 7 differentially methylated and differentially expressed genes of ion-channel proteins namely KCNJ5, CACNB2, KCNA3, KCNA6, RASA3, GABBR2 and CLIC5 were identified in Indian PanCa cohort only. KCNJ5 was significantly upregulated and associated with worse survival in Indian cohort, whereas downregulated in TCGA and other Caucasians patient populations. Two TFs controlling the KCNJ5 expression are POU2F1 and POU3F1. Few predicted small molecules targeting Kcnj5 are, Amiloride, Vernakalant hydrochloride, Dalfampridine, Glyburide and Levcromakalim. It also showed notable interactions with a steroidal anticancer agent, protodioscin.

CONCLUSION: An onco-channel gene, KCNJ5 significantly upregulated, and showing adverse survival in highly expressed KCNJ5 group in Indian cohort of PanCa, can be targeted with Amiloride, Vernakalant hydrochloride, Dalfampridine, Glyburide Levcromakalim and protodioscin. This understanding can lead to novel target identification for PanCa therapy development.

PMID:39998707 | DOI:10.1007/s12672-025-02001-8

Cancer Immunol Immunother. 2025 Feb 25;74(4):122. doi: 10.1007/s00262-025-03980-x.

ABSTRACT

BACKGROUND: Microsatellite instability-high (MSI-H) cancers are linked to exceptional benefit from immune checkpoint inhibitors (ICIs), but studies on their efficacy across various MSI-H cancer types are limited.

METHODS: Randomized clinical trials (RCTs) comparing ICIs to chemotherapy in advanced MSI-H/dMMR cancers were systematically reviewed. Eligible studies included 13 RCTs with 1633 MSI-H patients across colorectal, gastric, and endometrial cancers. Data were analyzed using hazard ratios for progression-free survival (PFS) and overall survival (OS), with subgroup analyses by tumor type. Statistical heterogeneity was assessed using Cochrane’s Q and I².

RESULTS: Immunotherapy significantly improved PFS and OS in MSI-H patients, with an HR for OS of 0.35 (95% CI 0.27-0.46; p < 0.00001) versus 0.81 for MSS patients. PFS showed a 64% reduced risk of progression (HR = 0.36, 95% CI 0.28-0.46; p < 0.0001). Subgroup analyses highlighted PFS benefits across tumor types: colorectal (HR = 0.28, 95% CI 0.11-0.73), gastric (HR = 0.43, 95% CI 0.27-0.68), and endometrial cancers (HR = 0.34, 95% CI 0.27-0.42).

CONCLUSIONS: This meta-analysis establishes MSI-H as a predictive biomarker for ICIs, supporting its role in therapy selection and underscoring the need for MSI-H/dMMR-focused clinical trials.

PMID:39998698 | DOI:10.1007/s00262-025-03980-x

Eur J Orthop Surg Traumatol. 2025 Feb 25;35(1):76. doi: 10.1007/s00590-025-04183-x.

ABSTRACT

OBJECTIVE: The purpose of this study was to determine the association of hypoalbuminemia with adverse outcomes in patients undergoing surgical repair of nonunions or malunions of upper and lower extremity long bones.

METHODS: DESIGN: Retrospective.

SETTING: Hospitals participating in American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) from 2005 to 2019.

PATIENTS: Patients in the ACS-NSQIP database with upper extremity and lower extremity fractures who underwent nonunion or malunion repairs and had preoperative serum albumin levels. Outcome Measures and Comparisons: Demographic variables, comorbidities and postoperative complications were collected and compared using t tests and chi squared tests. Multivariate linear regression models were used to assess complications, adjusting for variables such as age, sex, BMI, hospital length of stay, and operation time.

RESULTS: Univariate analysis of 1640 total patients (338 [20.6%] with hypoalbuminemia and 1302 [79.4%] with normal albumin) showed patients with hypoalbuminemia had significantly increased 30-day mortality rates, increased lengths of stay, and returns to the operating room. Multivariate analysis showed patients with hypoalbuminemia had significantly greater odds for any complication (OR: 2.62; 95% CI [1.77, 3.84]; p < 0.001), surgical site infections (OR: 2.62; 95% CI [1.34, 4.99]; p = 0.004) and transfusions (OR: 2.77; 95% CI: [1.62, 4.69]; p < 0.001) compared to the normal albumin group.

CONCLUSIONS: There was a significant difference in 30-day postoperative complications between patients with normal albumin levels and those who were hypoalbuminemic after surgical repairs of nonunions or malunions. Albumin level is a risk factor that should be monitored and counseled upon prior to surgical intervention for nonunion or malunion correction.

LEVEL OF EVIDENCE: Level III Retrospective Comparative Study.

PMID:39998685 | DOI:10.1007/s00590-025-04183-x

World J Urol. 2025 Feb 25;43(1):139. doi: 10.1007/s00345-025-05517-4.

ABSTRACT

AIM: This study aims to evaluate the success rate of Shock Wave Lithotripsy (SWL) in treating kidney stones using the Modulith SLK Inline lithotripter, with a focus on the importance of device efficacy as emphasized in EAU guidelines.

PATIENTS AND METHODS: This retrospective single-center study was conducted between June 2023 and June 2024. Inclusion criteria were adult patients (> 18 years) with radiologically confirmed renal stones smaller than 15 mm in diameter. Exclusion criteria included patients with solitary kidneys, significant renal functional deterioration, skeletal deformities, active urinary tract infections, pregnancy, or coagulopathies. Treatment outcomes were collected and analyzed in detail, considering patients’ demographic characteristics (age, gender) and stone parameters (size, location, and hardness [Hounsfield Unit, HU]). The SWL procedures were performed using the Modulith SLK Inline lithotripter (Storz Medical, Switzerland). The success of SWL was defined as achieving complete stone clearance or the presence of clinically insignificant residual fragments (CIRF) (< 4 mm). This study seeks to provide detailed insights into the optimal use cases of SWL as a non-invasive yet effective treatment option for smaller, more manageable stones.

RESULTS: The mean age of the 208 patients included in the study was 42.2 ± 12.7 years (18-75), with a male-to-female ratio of 1.9:1. The mean stone size across all patients was 10.3 mm, and the average HU value was 874.0 ± 283.2. Patients who achieved a completely stone-free status had significantly lower HU values (p = 0.049). The overall success rate of SWL was 78.8%, with 164 patients achieving complete stone clearance. When cases with clinically insignificant residual fragments (CIRF, < 4 mm) were included as successful outcomes, the overall success rate increased to 92.3%. This distinction highlights the inclusion of patients with small residual fragments that are deemed clinically irrelevant in the adjusted success rate. In cases with successful outcomes, the mean stone size was 10.3 mm, whereas it was 12.5 mm in patients with residual fragments or treatment failure. A statistically significant relationship was identified between stone size and treatment success rates (p < 0.001). In contrast, stone localization did not have a significant impact on SWL success rates (p = 0.377).

CONCLUSIONS: SWL has demonstrated its effectiveness in kidney stone treatment with a 78.8% complete stone-free rate using the Modulith SLK Inline lithotripter. Higher success rates were achieved with smaller stones (< 15 mm) and lower HU values. These findings support the significance of advanced lithotripter technology in establishing SWL as a valuable non-invasive option for stones under 15 mm.

PMID:39998683 | DOI:10.1007/s00345-025-05517-4

Prostate. 2025 Feb 25:e24863. doi: 10.1002/pros.24863. Online ahead of print.

ABSTRACT

BACKGROUND: Whole-gland (WG) prostate-specific antigen (PSA) density (PSAD) has proven useful in diagnosing to be beneficial in localized prostate cancer (PCa). This study aimed to evaluate the predictive performance of WG and zonal (transition zone [TZ] and peripheral zone [PZ]) PSAD in predicting PCa and clinically significant PCa (csPCa) in prostate MRI.

METHODS: A retrospective analysis was conducted on consecutive patients who underwent multiparametric MRI and MRI/US fusion-guided biopsy between March 2019 and July 2024. TZ-PSAD, PZ-PSAD, and WG-PSAD were calculated using in-house AI models. Optimal thresholds for TZ-PSAD and PZ-PSAD were determined using the Youden index from receiver operating characteristic (ROC) curve analyses with five-fold cross-validation, whereas 0.15 ng/mL² was applied as the threshold for WG-PSAD. Statistical comparisons were performed using Wilcoxon rank-sum, χ², and Fisher’s exact tests. Logistic regression (LR) and area under the ROC curve (AUC) analyses with DeLong’s test were conducted to evaluate diagnostic performance.

RESULTS: The study cohort included 774 consecutive patients (median age = 67 years [interquartile range {IQR}: 61-71], median WG-PSAD = 0.11 ng/mL² [IQR: 0.07-0.17], median TZ-PSAD = 0.22 ng/mL² [IQR: 0.12-0.41], median PZ-PSAD = 0.13 ng/mL² [IQR: 0.16-0.34]). Among these patients, 475 had PCa and 341 had csPCa. The mean optimal thresholds for TZ-PSAD and PZ-PSAD were 0.20 ng/mL² and 0.21 ng/mL², respectively, for PCa, whereas they were 0.26 and 0.23, respectively, for csPCa. Multivariable LR identified TZ-PSAD (OR = 2.00, p = 0.03) and WG-PSAD (OR = 2.40, p = 0.02) as significant predictors of PCa. For csPCa, TZ-PSAD was the only independent predictor (OR = 2.13, p = 0.02) among PSAD measurements. TZ-PSAD showed a superior AUC for both PCa (0.79 ± 0.05) and csPCa (0.77 ± 0.02) compared to WG-PSAD (0.77 ± 0.06 for PCa, 0.76 ± 0.03 for csPCa) and PZ-PSAD (0.69 ± 0.06 for PCa, 0.70 ± 0.04 for csPCa; p < 0.001).

CONCLUSIONS: Both TZ-PSAD and WG-PSAD are strong predictors of PCa, but TZ-PSAD is a superior predictor of csPCa compared to WG-PSAD and PZ-PSAD. Further prospective studies are warranted to validate these findings.

TRIAL REGISTRATION: NCT03354416.

PMID:39996409 | DOI:10.1002/pros.24863

Clin Cardiol. 2025 Mar;48(3):e70081. doi: 10.1002/clc.70081.

ABSTRACT

BACKGROUND: Disparities in invasive cardiovascular care and outcomes in rural and urban hospitals across the United States have been reported. However, studies investigating disparities regarding leadless pacemaker outcomes and complications based on hospital location are lacking.

OBJECTIVE: To evaluate differences in outcomes and complications related to leadless pacemaker implantations among rural and urban hospitals.

METHODS: The National Inpatient Sample was used to identify patients who underwent leadless pacemaker implantations in the United States from 2016 to 2020. Study endpoints assessed included procedural complications and inpatient outcomes of leadless pacemaker implantations among rural and urban hospitals.

RESULTS: From 2016 to 2020, there were a total of 28 340 and 665 leadless pacemaker implantations in urban and rural hospitals, respectively. Baseline characteristics were similar among both groups, with notable exceptions of higher rates of coagulopathies (13.2% vs. 6.8%, p < 0.001) and peripheral vascular disorders (10.4% vs. 4.5%, p < 0.001) among urban patients. After multivariable adjustment for confounding variables, leadless pacemaker placements occurring in rural hospitals had lower odds of major complications (aOR 0.59, 95% CI 0.41-0.86), but increased odds of inpatient mortality (aOR 1.70, 95% CI 1.21-2.40). Overall, rural leadless pacemaker recipients experienced lower rates of discharge to home, as well as lower costs and length of stay.

CONCLUSIONS: A majority of leadless pacemaker implantations occurred in urban hospitals in the United States. Important differences in outcomes were described based on urban and rural hospital location. Further investigation and policy changes are encouraged to promote improved cardiovascular care and outcomes in rural residents.

PMID:39996401 | DOI:10.1002/clc.70081

BJOG. 2025 Feb 25. doi: 10.1111/1471-0528.18108. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyse global prevalence data for infertility due to endometriosis from 1990 to 2021, emphasising health inequalities.

DESIGN: Population-based study.

SETTING: Data from the Global Burden of Disease (GBD) database.

POPULATION: Individuals diagnosed with infertility due to endometriosis.

METHODS: A statistical method was employed to evaluate changes in disease prevalence over time. We also analysed how disease prevalence varies by age, time period and birth cohort. A model was used to predict future trends. Additionally, we examined the relationship between prevalence and the socio-demographic index (SDI) levels across countries. Finally, we conducted a decomposition analysis to identify key factors driving changes and assessed health inequality.

MAIN OUTCOME MEASURES: The burden of infertility due to endometriosis.

RESULTS: The global burden of infertility due to endometriosis in 2021 showed a downward trend, and the low SDI region had a notably higher burden. High risk was observed in the 25-29 age group in the age effects analysis. Period risks almost kept decreasing over these years, and for cohort effects, the later born individuals showed an overall lower risk than the earlier born individuals. Cross-country inequality analysis revealed significant disparities, with countries in lower SDI categories bearing a higher burden.

CONCLUSIONS: The global burden of infertility due to endometriosis has become a significant public health concern over recent decades. Governments should adapt prevention strategies to fit their specific national contexts.

PMID:39996398 | DOI:10.1111/1471-0528.18108