Category: Statistics

Ann Hematol. 2025 May 28. doi: 10.1007/s00277-025-06431-w. Online ahead of print.

ABSTRACT

Nucleophosmin 1 (NPM1) mutation is commonly associated with a favorable prognosis in acute myeloid leukemia (AML). Conversely, secondary mutations such as those in ASXL1, RUNX1, EZH2, and SRSF2 are generally linked to poor outcomes. The combined prognostic impact of NPM1 and secondary mutations in AML patients remains unclear. This meta-analysis aimed to evaluate the prognostic significance of secondary mutations in AML patients harboring NPM1 mutation. A systematic literature search was conducted following PRISMA guidelines, identifying studies published up to June 2024 from databases such as PubMed, Web of Science, and the Cochrane Library. The inclusion criteria included adult AML patients with confirmed NPM1 mutation, detailed reporting of secondary mutations, and comparative prognostic outcomes. Fourteen high-quality studies from twelve publications were included, encompassing 4,022 patients who all carried NPM1 mutations; among these, 618 also harbored secondary mutations. Data extraction and quality assessment were performed independently by two researchers via the Newcastle-Ottawa Scale (NOS). Statistical analyses involved fixed-effects models due to low heterogeneity (I²=0% for OS and I²=35% for EFS/RFS). Publication bias and sensitivity analyses confirmed the robustness of the findings. Secondary mutations were not significantly associated with OS (HR = 1.16, 95% CI: 0.99-1.35, p = 0.07) or EFS/RFS (HR = 1.15, 95% CI: 0.96-1.38, p = 0.14) in the overall NPM1-mutated AML population. However, within the European LeukemiaNet (ELN) favorable prognosis group, the presence of secondary mutations was significantly associated with reduced OS (HR = 1.95, 95% CI: 1.39-2.73, p < 0.01). Subgroup analyses based on median age, geographical region, and allogeneic hematopoietic stem cell transplantation (allo-HSCT) rates did not reveal significant modifiers of the prognostic impact of secondary mutations. Secondary mutations do not significantly adversely affect OS or EFS/RFS in the general population of AML patients with NPM1 mutation. Notably, within the ELN favorable prognosis group, secondary mutations are associated with markedly poorer OS, highlighting the need for careful prognostic assessment and potential treatment strategy adjustments in this subset of patients.

PMID:40434717 | DOI:10.1007/s00277-025-06431-w

Support Care Cancer. 2025 May 28;33(6):508. doi: 10.1007/s00520-025-09581-9.

ABSTRACT

PURPOSE: Diarrhea is a common complication that can lead to hospitalization in cancer patients. Few studies evaluated its impact on resource utilization and cost. Our objective was to evaluate the resource utilization and costs associated with hospital admission due to diarrhea in cancer patients.

METHODS: This was a retrospective study at a comprehensive cancer center in Jordan. We included adult cancer patients with primary admission diagnosis of diarrhea, between January 2022 and December 2023. Patients were identified using the International Classification of Diseases, Tenth Revision. Resources evaluated included hospital length of stay and admission to the intensive care unit (ICU). Costs in US$ were estimated based on reports from the finance department, reflecting the payers’ perspective, which provided total admission costs, as well as costs of medications, laboratory tests, and procedures. Descriptive analysis was used to report the results.

RESULTS: During the study period, 390 patients were admitted for diarrhea. Mean age was 56 ± 14 (SD) years and 57% were females. Median(IQR) hospital length of stay was 4 (2-7) days, and 34 (9%) patients required ICU admission. The median (IQR) total cost per admission was US$2636 (1441-6132), while median (IQR) cost for ICU admissions was US$10,628(5759-17,235). Laboratory tests had the highest cost, (US$975, 537-1813), followed by medications (US$552, 241-1621) and procedures (US$251, 139-576).

CONCLUSION: Diarrhea among cancer patients is associated with resource utilization and costs. Laboratory tests and medications accounted for the highest proportion of the cost. Future studies should identify strategies to prevent such complications and to reduce cost.

PMID:40434708 | DOI:10.1007/s00520-025-09581-9

Torture. 2025 May 16;35(1). doi: 10.7146/torture.v35i1.152344.

ABSTRACT

The 2024 student-led job quota reform protests in Bangladesh, initially peaceful, escalated into a nationwide uprising. The government responded with excessive force, leading to widespread violence, including severe eye injuries to hundreds of protesters. This study investigates the causes, consequences, and medical responses to these eye injuries, which resulted in lasting physical, psychological, and economic impacts on the victims using secondary data, including reports from human rights organizations, hospital records, and media sources. Victim testimonies were collected from published sources to assess the immediate and long-term effects. A total of 647 individuals sustained severe eye injuries during the protests. The use of pellet bullets by law enforcement was the primary cause. Hospitals reported over 1,300 eye injury cases, with more than 90% of those who underwent surgery and 550 lost vision in one or both eyes. This movement resulted in devastating eye injuries for hundreds of young men, with long-lasting physical and economic impacts. Victims, many of whom were breadwinners, faced significant challenges in receiving adequate medical treatment and long-term rehabilitation. Immediate governmental intervention is needed to ensure their inclusion in the rebuilding of post-uprising Bangladesh.

PMID:40434700 | DOI:10.7146/torture.v35i1.152344

Osteoporos Int. 2025 May 28. doi: 10.1007/s00198-025-07530-0. Online ahead of print.

ABSTRACT

The purpose of the study was to evaluate trabecular bone score (TBS) technology for orthopedic application (TBSortho) as a predictor of a screw pull-out strength in a cadaveric model. This study finds that TBSortho correlates more strongly with the screw pull-out strength compared to cortical density, computed tomography (CT) Hounsfield units (HU), and dual-energy X-ray absorptiometry (DXA) bone mineral density (BMD).

INTRODUCTION: Patient bone quality impacts the mechanical strength of surgical fixation constructs. Preoperative assessments of bone quality and the potential for a screw pull-out are important for surgical planning as well as postoperative rehabilitation protocols. Previous work has correlated the screw pull-out strength with the screw insertional torque, cortical thickness, and CT HU. TBS is a gray-level textural metric that can be extracted from a two-dimensional DXA scan, improves fracture prediction, and may evaluate the mechanical competence of both the cortical and trabecular bones. The purpose of the study was to evaluate TBS technology for TBSortho as a predictor of the screw pull-out strength in a cadaveric model.

METHODS: Twenty paired, fresh-frozen cadaver femurs stripped of soft tissue were obtained (5 M, 5 F specimens, age range of 56-96 years). Standard clinical femur CT were performed to obtain HU, cortical thickness, and cortical density. DXA was also performed using a novel analysis technique as distal femur DXA is not routinely acquired clinically. DXA data were used to generate TBSortho values in two distal femur regions of interest. All femurs then underwent a screw pull-out testing with five lateral distal femoral 5-mm locking screws (n = 100 screws total). The correlation coefficient from Spearman tests and R-squared of the fixed effects from the linear mixed effects models were calculated.

RESULTS: TBSortho was found to correlate most strongly of CT and DXA measures with the screw pull-out strength, having marginal R² and standardized beta of 0.75 and 0.87 in the proximal screw cluster and 0.67 and 0.83 in the distal screw cluster, respectively. TBSortho accounted for 75% variance in the pull-out strength. CT HU and DXA bone mineral density (BMD) did not have a statistically significant correlation with the screw pull-out strength.

CONCLUSION: This study finds that TBSortho correlates more strongly with the screw pull out strength in a cadaveric distal femur model compared to cortical density, CT HU, and DXA BMD. These preliminary results suggest that TBSortho may be a valuable tool to model mechanical integrity of bone preoperatively.

PMID:40434688 | DOI:10.1007/s00198-025-07530-0

Osteoporos Int. 2025 May 28. doi: 10.1007/s00198-025-07526-w. Online ahead of print.

ABSTRACT

To address cultural relevance in assessing osteoporosis-related quality of life, we validated and assessed the psychometric properties of the Hebrew version of QUALEFFO-41. The tool showed moderate reliability and validity, with diagnostic performance comparable to EQ-5D. This supports its clinical utility in Hebrew-speaking women with postmenopausal osteoporosis and vertebral fractures.

BACKGROUND: Osteoporosis and its associated vertebral fractures significantly impact the quality of life among postmenopausal women. The Quality-of-Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41) is widely used to assess the quality of life in patients with osteoporotic spinal fractures but requires proper cultural adaptation for different populations.

PURPOSE: To translate, culturally adapt, and validate the QUALEFFO-41 questionnaire for Hebrew-speaking Israeli women with osteoporotic vertebral fractures (OVFs) and to compare its validity with the previously validated EQ-5D questionnaire in Israel.

METHODS: The study included 155 postmenopausal women aged 50-90 years: 49 with osteoporotic vertebral fractures (OVF group) and 106 with osteoporosis but no fractures (OPC group). The QUALEFFO-41 was translated following international guidelines and tested for reliability, validity, and sensitivity. Statistical analysis included internal consistency (Cronbach’s alpha), test-retest reliability, discriminant and convergent validity, and ROC curve analysis.

RESULTS: The Hebrew QUALEFFO-41 demonstrated good internal consistency (Cronbach’s alpha = 0.88) and test-retest reliability. Most questions (90% in the OVF group and 97% in the OPC group) showed good to excellent correlations. Both QUALEFFO-41 and EQ-5D questionnaires showed sufficient sensitivity in diagnosing women with osteoporosis and fractures (AUC = 0.767 and 0.756, respectively).

CONCLUSION: The Hebrew version of QUALEFFO-41 demonstrates moderate reliability and validity properties for assessing quality of life in Israeli postmenopausal women with osteoporosis and vertebral fractures. The questionnaire shows satisfactory psychometric properties, though certain domains may benefit from further refinement.

PMID:40434687 | DOI:10.1007/s00198-025-07526-w

Environ Monit Assess. 2025 May 28;197(6):688. doi: 10.1007/s10661-025-14124-0.

ABSTRACT

Industrial development has caused significant environmental damage, especially through potentially toxic element (PTE) pollution. Combining pollution indices, health risk assessment, spatial autocorrelation (Moran’s I), and receptor modeling (APCS/MLR), this study quantified sources and risks of heavy metals in smelting-adjacent farmland soils, facilitating targeted PTE pollution mitigation. Soil analysis revealed significantly elevated mean concentrations of As (326 mg/kg), Cd (23 mg/kg), Cr (104 mg/kg), Cu (106 mg/kg), Ni (73 mg/kg), Pb (274 mg/kg), and Zn (660 mg/kg), all exceeding Yunnan provincial background values. The average total non-carcinogenic risk index (HIadult = 2, HIchild = 11) and total carcinogenic risk index (TCRadult = 5.52 × 10-4, TCRChild = 6.44 × 10-4) for both adults and children exceeded the threshold (HI = 1, TCR = 1 × 10-04). The results of environmental pollution evaluation show that the overall pollution in the study area is a heavy pollution level. The ACPS-MLR model showed that Cd and Zn in soil mainly came from industrial activities (37%). Cu and Pb were derived from motor vehicle emissions and agricultural activities (20%). As may be derived from agricultural and industrial activities. Furthermore, based on the combination of source apportionalization and the spatial distribution of environmental pollution, the northeastern part of the study area and transportation hubs are the key pollution areas and need to be given priority for treatment. PTEs accumulate in the soil, will be enriched through the food chain, and seriously threaten human health and soil ecological environment. Therefore, this study can provide a basis for identifying, preventing, and controlling the risk of PTEs pollution in soil.

PMID:40434684 | DOI:10.1007/s10661-025-14124-0

Neurol Sci. 2025 May 28. doi: 10.1007/s10072-025-08256-x. Online ahead of print.

ABSTRACT

Cerebral venous thrombosis (CVT) accounts for 0.5-1% of all strokes and 24-50% of these patients develop acute symptomatic seizures (AS). Clinical and radiological characteristics have been associated with an increased risk of AS in CVT. We aimed to identify clinical and imaging predictors associated with a higher risk of AS in CVT patients.We conducted a single-centre, retrospective cohort study and included all patients with CVT admitted to our stroke unit between January/2011-December/2022. Our primary outcome was AS occurence. Clinical and radiological characteristics were compared through a logistic binary regression, followed by a multivariable analysis.We included 156 patients, 80.8% female and a mean age of 41.5 ± 15.2 years. Fifty-two patients (33.3%) had a seizure during follow-up, the majority as AS (30.1%). We found an increased risk of AS in patients with focal signs at presentation (OR 5.35), superior longitudinal sinus (SLS) or cortical vein involvement (OR 5.03; OR 3.94), hemorrhagic lesions or oedema (OR 3.88; OR 4.17) and lesions located in the frontal or the parietal lobe (OR 4.61; OR 4.61). A multivariable analysis was also conducted and only SLS involvement (OR 6.06), cortical vein involvement (OR 2.76) and hemorrhagic lesion (OR 3.47) remained statistically significant.Seizures occurred in about a third of our CVT patients, the majority as AS. Haemorrhagic lesions, SLS and cortical vein involvement had a stronger association with AS that may raise our awareness for the risk of seizures in this population during the acute phase.

PMID:40434683 | DOI:10.1007/s10072-025-08256-x

Exp Appl Acarol. 2025 May 28;95(1):7. doi: 10.1007/s10493-025-01030-w.

ABSTRACT

Mass rearing of the predatory mite Euseius scutalis (Athias-Henriot) using natural prey is costly and labor-intensive, limiting its application in biological pest control. Artificial diets may serve as alternative food sources; however, some studies should be previously conducted, to evaluate the possible biological consequences of their adoption. In this study, we compared the suitability of eight artificial diets, including a basic artificial diet (A) consisting of a combination of 10% honey, 10% sucrose, 5% tryptone, 5% yeast extract, 10% egg yolk, and 60% distilled water (w/w), along with seven other diets, each consisting of 80% of diet A enriched with date palm pollen (B), Typha pollen (C), Ephestia kuehniella eggs (D), Helicoverpa armigera hemolymph (E), a mixture of date palm pollen and E. kuehniella eggs (F), Tetranychus turkestani adults (G), and hen’s liver (H). The data showed that E. scutalis was able to complete its development on all tested diets. Oviposition of the predator was observed on all diets, except for diets E and H. Females reared on diets B and F had the shortest adult pre-oviposition period (APOP), while those on diet B had the shortest total pre-oviposition period (TPOP). Furthermore, the number of oviposition days and fecundity were highest on diets B, D and F. Diets B and F resulted in significantly higher intrinsic (r) and finite (λ) rates of increase than the other diets, with values statistically similar to those obtained on D. The lowest values of r and λ were recorded on diet G. Based on our results, date palm pollen, E. kuehniella eggs or their mixture added to the basic diet A are more beneficial than other options for use in artificial diets for the mass rearing of E. scutalis.

PMID:40434679 | DOI:10.1007/s10493-025-01030-w

Bull Math Biol. 2025 May 28;87(7):86. doi: 10.1007/s11538-025-01462-w.

ABSTRACT

Cancer therapeutic vaccines are used to strengthen a patient’s own immune system by amplifying existing immune responses. Intralesional administration of the bacteria-based emm55 vaccine together with the PD1 checkpoint inhibitor produced a strong anti-tumor effect against the B16 melanoma murine model. However, it is not trivial to design an optimal order and frequency of injections for combination therapies. Here, we developed a coupled ordinary differential equations model calibrated to experimental data and used the mesh adaptive direct search method to optimize the treatment protocols of the emm55 vaccine and anti-PD1 combined therapy. This method determined that early consecutive vaccine injections combined with distributed anti-PD1 injections of decreasing separation time yielded the best tumor size reduction. The optimized protocols led to a twofold decrease in tumor area for the vaccine-alone treatment, and a fourfold decrease for the combined therapy. Our results reveal the tumor subpopulation dynamics in the optimal treatment condition, defining the path for efficacious treatment design. Similar computational frameworks can be applied to other tumors and other combination therapies to generate experimentally testable hypotheses in a fairly unrestricted and inexpensive setting.

PMID:40434675 | DOI:10.1007/s11538-025-01462-w

Plast Reconstr Surg. 2025 Jun 1;155(6):1011-1022. doi: 10.1097/PRS.0000000000011871. Epub 2024 Nov 11.

ABSTRACT

BACKGROUND: Masseteric-to-facial nerve transfer excels in dynamic reanimation but is lacking in restoring baseline resting tone. Combining it with fascia lata grafts is expected to more fully enhance facial symmetry. Comprehensive comparison of the results of masseteric-to-facial nerve transfer versus combined static suspension may provide valuable insights into the most appropriate treatment for patients with subacute facial paralysis.

METHODS: In this retrospective study, 104 patients with facial paralysis were categorized by surgical procedure: 39 received masseteric-to-facial nerve transfer (group A), and 65 underwent transfer combined with a fascia lata graft (group B). The groups were further divided by oral commissure drooping, with severity graded as slight (A1, B1) or severe (A2, B2) asymmetry.

RESULTS: Patients in group B2 exhibited significantly better static symmetry than those in group A2, with improvements of 87.87% versus 40%, respectively (P < 0.001). No significant difference was observed between groups A1 and B1 in slight asymmetry. The Terzis Smile Function Grading System showed no dynamic symmetry differences (P > 0.05). On objective evaluation, postoperative outcomes indicated better static symmetry in both B groups, and improved dynamic symmetry in group A1, with no statistical difference between groups A2 and B2.

CONCLUSIONS: Masseteric-to-facial nerve transfer combined with fascia lata grafts significantly enhanced both static and dynamic symmetry for patients with varying degrees of asymmetry, particularly benefitting those with severe asymmetry. Patients with slight asymmetry who underwent the combined procedure achieved satisfactory static symmetry, although with a minor compromise of approximately 1 mm in dynamic symmetry compared with those who underwent masseteric-to-facial nerve transfer alone.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

PMID:40434662 | DOI:10.1097/PRS.0000000000011871