Category: Statistics

PLoS One. 2025 Mar 27;20(3):e0320689. doi: 10.1371/journal.pone.0320689. eCollection 2025.

ABSTRACT

Elder mistreatment (EM) of older persons with cognitive impairment is thought to be grossly underestimated in part due to communication barriers experienced by victims and a lack of consistent screening and reporting, which can skew current understandings of this problem. To improve EM risk and prevalence screening in relation to cognitive impairment, it is important to understand specific approaches for implementing assessment tools and interventions for members of this population. Accordingly, this scoping review (OSF registration osf.io/759k3) will identify, summarize, and compare methodological considerations adopted in studies assessing EM risk and occurrence among older persons with varying degrees of cognitive impairment. Through mapping out existing strategies and approaches used to develop, test, and implement EM screening tools or interventions, this review will outline previously identified recommendations and challenges pertinent to future EM assessment, reduction, and prevention efforts. We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines and apply the Arksey and O’Malley (2005) scoping review framework. We will identify relevant studies by comprehensively searching electronic databases, including Ovid (Medline), Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane Trials (CENTRAL), and Elsevier’s Scopus. Reference lists of included studies will also be examined. For article selection, we will use Covidence software to guide a two-step process of title/abstract and full article screening, which will allow us to identify eligible studies based on our inclusion and exclusion criteria that follows the Study Design, Data, Methods, Outcomes (SDMO) framework. A standardized data extraction tool will be used to collect information related to authors, year of publication, research objectives, sample and study design characteristics, measures, analysis, outcomes, limitations, and study conclusions and implications related to cognition. Data will be analyzed using a thematic approach and presented through the reporting of descriptive statistics and summaries.

PMID:40146770 | DOI:10.1371/journal.pone.0320689

Ophthalmol Ther. 2025 Mar 27. doi: 10.1007/s40123-025-01128-9. Online ahead of print.

ABSTRACT

INTRODUCTION: Amblyopia is a neurodevelopmental disorder characterized by a reduction in best-corrected visual acuity (BCVA). This meta-analysis aimed to analyze the effectiveness of perceptual learning and video game training for adults with amblyopia.

METHODS: Following Cochrane guidelines (PROSPERO CRD42024504502), we conducted a systematic search across multiple databases. Randomized controlled trials (RCTs) on adults with amblyopia receiving behavioral therapies were included. Data on interventions, sample size, and logMAR visual acuity were extracted and analyzed using Review Manager 5.4 and Stata 17.0.

RESULTS: A total of 6439 studies were identified, with 22 meeting the inclusion criteria after screening. The meta-analysis included 422 adult patients with amblyopia across these studies. Quality assessment revealed that 78% of studies had a low risk of bias. The analysis showed a statistically significant standardized mean difference (SMD) of -0.68 in the experimental group compared with controls, indicating an improvement in visual acuity (P < 0.05). Subgroup analyses indicated that perceptual learning and video game training also resulted in visual improvement (P < 0.05). In addition, the results indicated a significant improvement in visual acuity with dichoptic training or monocular training, reaching visual acuity improvement (P < 0.05).

CONCLUSIONS: These findings indicate that targeted visual training facilitates neural plasticity, reduces interocular suppression, and reinforces neural pathways associated with visual processing. While video game-based interventions represent a viable and engaging rehabilitation strategy, a combined approach may be most effective in enhancing monocular and binocular functions. Future research should focus on refining training protocols to enhance both monocular and binocular visual function more effectively.

PMID:40146483 | DOI:10.1007/s40123-025-01128-9

Clin Oral Investig. 2025 Mar 27;29(4):209. doi: 10.1007/s00784-025-06264-x.

ABSTRACT

OBJECTIVES: The existing literature indicates insufficient conclusive evidence regarding the efficacy of root canal therapy (RCT) in conjunction with third molar autologous tooth transplantation (ATT). This systematic review aims to evaluate the long-term survival rates and complications associated with this method.

MATERIALS AND METHODS: A comprehensive search was conducted across multiple databases, including PubMed, EMBASE (OVID), Web of Science (WOS), EBSCO, SpringerLink, Oxford, and ScienceDirect. This systematic review adhered to the guidelines set forth by the PRISMA and was registered in PROSPERO (CRD42024585817). This study calculated pooled survival rates, root resorption rates, and overall survival metrics. Subgroup analyses were performed to investigate the influence of follow-up duration, sample size, timing of endodontic treatment, and endodontic treatment on outcomes. Statistical significance was determined using an alpha value of 0.05, with 95% confidence intervals (CI) reported for pooled estimates. Heterogeneity was assessed using the I² statistic and Cochran’s Q test.

RESULTS: Among the 17 included studies, the follow-up period ranged from 1 to 29 years. After excluding two studies with 100% survival rates, the overall 1-year survival rate was 96% (P < .0001). Studies with mixed samples showed a higher 20-year survival rate compared to those exclusively involving third molars (46.2% vs. 41.3%; P = 0.029). RCT significantly improved survival and success rates in third molar autotransplantation, though heterogeneity varies across studies. The success rate reflects the completeness of treatment and indicates the restoration of tooth function, whereas the survival rate focuses more on the long-term retention of the tooth. The higher risk difference (RD) observed in the RCT group suggests that RCT enhances both survival and success rates. This finding highlights the potential role of RCT in enhancing the success of ATT. However, significant heterogeneity was observed across studies (I² = 73%), and the difference between the two groups were not statistically significant (P = 0.37, I² = 0%). These results may be influenced by follow-up duration, timing of endodontic treatment, and sample size. Therefore, the conclusions should be read with caution.

CONCLUSION: ATT of third molars with intact root formation represents a reliable approach for the replacement of missing teeth, demonstrating a high survival rate. Furthermore, RCT is associated with reduced complication rates and enhanced long-term survival.

PMID:40146481 | DOI:10.1007/s00784-025-06264-x

Clin Pharmacokinet. 2025 Mar 27. doi: 10.1007/s40262-025-01484-6. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Navitoclax, an orally bioavailable B-cell lymphoma-2 (Bcl-2) family protein inhibitor, inhibits antiapoptotic Bcl-2 family proteins (with high affinity to Bcl-XL, Bcl-2, and Bcl-W). Navitoclax in combination with ruxolitinib has been investigated to treat patients with myelofibrosis (MF).

METHODS: Since navitoclax undergoes hepatic metabolism, we evaluated the pharmacokinetics (PK) and safety of single-dose navitoclax 50 mg in a phase 1 study in participants with mild (N = 6), moderate (N = 6), or severe (N = 1) hepatic impairment and matched participants with normal hepatic function (N = 7). All participants in this study were enrolled per Child-Pugh classification, with demographics matched per age, weight, and race.

RESULTS: Navitoclax maximum plasma concentration (C_max), area under the plasma concentration-time curve for time zero to infinity (AUC_0-∞), and terminal elimination half-life (t_1/2) in participants with mild or moderate hepatic impairment were comparable to participants with normal hepatic function. The change in C_max and AUC_0-∞ values in participants with mild and moderate hepatic impairment were within 25% of normal hepatic function. Overall, 2/20 (10%) participants receiving a 50 mg single dose reported grade 1 treatment-emergent adverse events of nausea (N = 1) and diarrhea (N = 1).

CONCLUSIONS: In summary, no new safety issues were identified. On the basis of the pharmacokinetic results, no dose adjustment is required for patients with MF with mild or moderate hepatic impairment.

PMID:40146460 | DOI:10.1007/s40262-025-01484-6

Discov Oncol. 2025 Mar 27;16(1):411. doi: 10.1007/s12672-025-02126-w.

ABSTRACT

PURPOSE: To investigate the value of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) imaging in interim therapeutic and prognostic evaluation of patients with diffuse large B-cell lymphoma (DLBCL).

MATERIALS AND METHODS: Data of 86 patients with pathologically confirmed DLBCL who underwent ¹⁸F-FDG PET/CT imaging before chemotherapy, radiotherapy, and after interim chemotherapy, were retrospectively analyzed. Receive operating characteristic (ROC) curve analysis was performed to assess the predictive capacity of changes and change rates in PET/CT imaging parameters [maximum standardized uptake value (SUV_max), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and maximum tumor dissemination (D_max)] for progression-free survival (PFS) and to identify optimal cutoff values. Kaplan-Meier survival curves were constructed, and the log-rank test was used to assess intergroup differences. Cox regression analysis was used to explore potential factors influencing PFS.

RESULTS: Among 86 patients [(45 men, 41 women, age: 57.8 ± 12.2 years)], the median PFS was 22.5 (14.5, 46) months. Until the last follow-up date, progression or recurrence occurred in 14 patients, while 9 patients died. The ROC curves indicated that the optimal cutoff values for predicting PFS were 99.10%, 99.72%, and 96.47% for ΔMTV%, ΔTLG%, and ΔD_max%, respectively (area under the curve = 0.786-0.849, all P < 0.05). Cox univariate analysis demonstrated that the alteration rates in metabolic and diffusion parameters before and after treatment, including SUV_max%, MTV%, TLG%, and D_max%, were predictive of PFS (hazard ratio [HR] = 6.213-13.430, all P < 0.05). The Cox multivariate analysis demonstrated that ΔMTV% and ΔD_max% independently predicted PFS, with HRs of 10.727 (95% confidence interval [CI] = 1.928-56.672, P = 0.007) and 7.178 (95%CI = 1.514-34.041, P = 0.013), respectively. We established a new prediction model by combining the ΔMTV% and ΔD_max% parameters, and the results of the model showed statistically significant differences in PFS between the high, intermediate, and low-risk groups. The model predicted higher effects than individual indicators.

CONCLUSION: The rate of change in metabolic and diffusion parameters on interim PET/CT can predict the prognosis of patients with DLBCL.

PMID:40146454 | DOI:10.1007/s12672-025-02126-w

Neurosurg Rev. 2025 Mar 27;48(1):333. doi: 10.1007/s10143-025-03479-0.

ABSTRACT

Deep brain stimulation in the subthalamic nucleus (STN-DBS) is a therapeutic intervention for patients with Parkinson’s disease (PD) primarily aimed at improving motor symptoms. However, the effects of STN-DBS on non-motor symptoms (NMS), such as olfactory dysfunction (OD), remain poorly understood. We performed a systematic review and single-arm meta-analysis to evaluate the effects of STN-DBS on OD in PD patients. We searched Medline, Scopus, and Web of Science databases. Eligible studies included observational studies with ≥ 4 patients reporting the effects of STN-DBS on OD in PD patients. Mean differences (MD) between pre- and post-operative, along with the final mean pooled analysis, olfactory scores values with 95% confidence intervals (CI) with a random effects model were used. The statistical analysis was performed using the software R Studio. The heterogeneity was assessed with I² statistics, and leave-one-out sensitivity analysis was used to address high heterogeneity. A total of seven studies, encompassing 188 PD patients, with a mean age of 60.8 years, were included in our analysis. There was a statistically significant difference between pre- and post-operative value in Odor discrimination (ODI) (MD 2.16; 95% CI 1.37 to 2.96; p < 0.01; I² = 0%) and Unified Parkinson’s Disease Rating Scale part III OFF medication (UPDRS III OFF_MED) (MD -11.96; 95% CI -22.57 to -1.35; p = 0.03; I² = 88%), showing improvement in OD and motor function after DBS, compared to baseline. In contrast, there was no statistically significant difference between the initial and final value in Odor thresholds (OT) (MD 1.54; 95% CI -0.22 to 3.30; p = 0.09; I² = 90%), and the University of Pennsylvania Smell Identification Test (UPSIT) (MD -0.37; 95% CI -3.40 to 2.66; p = 0.81; I² = 0%). Additionally, the pooled analysis for Odor identification (OI) showed a final mean of 7.06 (95% CI 4.39 to 9.72; I² = 100%), and for the TDI score (composite score derived from the sum of OD, OI, and OT results), a final mean of 25.96 (95% CI 17.31 to 34.62; I² = 94%). Despite the prior indication of STN-DBS for motor symptoms, it may improve OD in PD patients. Clinical trial number Not applicable.

PMID:40146437 | DOI:10.1007/s10143-025-03479-0

Breast Cancer Res Treat. 2025 Mar 27. doi: 10.1007/s10549-025-07671-0. Online ahead of print.

ABSTRACT

PURPOSE: Racial disparities exist regarding cardiovascular (CV) toxicities following breast cancer treatment; however, studies on racial differences in cardiac arrhythmias are lacking. This study examined associations between demographic and clinical factors and arrhythmia diagnosis in Black and White breast cancer survivors.

METHODS: This study included a retrospective cohort of Black and White women who were diagnosed with breast cancer and who received potentially cardiotoxic treatment. Cardiac arrhythmia data were captured via International Classification of Diseases, Tenth and Ninth Versions (ICD-10 and ICD-9). Experiences with cardiac arrhythmias were compared across racial groups. The associations of demographic and clinical factors with cardiac arrhythmias were evaluated using logistic regression for all women and in race-stratified models.

RESULTS: Thirty-three percent of the total 860 women in our study sample (mean (standard deviation) age 50.3 (10.7) years) old) experienced cardiac arrhythmias. In bivariate analyses, we observed a statistically discernible association between race and arrhythmia status following a breast cancer diagnosis (p = 0.004); however, this association was no longer significant in the multivariable model. In race-stratified multivariable analysis, the odds of experiencing arrhythmias in Black women over 50 years old are 51% lower than in Black women aged 50 years old or younger (adjusted odds ratio (OR): 0.49; 95% confidence interval (CI): 0.28, 0.86). All else being equal, Black women with hypertension had 2.68 times (95% CI: 1.51, 4.81) higher odds of experiencing arrhythmias than those without hypertension. White women with obesity had higher odds of experiencing arrhythmias than those with normal weight or underweight status. (adjusted OR 1.93: [1.17, 3.20]).

CONCLUSION: Survivors with chronic conditions like hypertension and obesity may require enhanced cardiac surveillance. Further investigation into hypertension management in Black survivors may shed light on its impact on CV toxicities in this group.

PMID:40146434 | DOI:10.1007/s10549-025-07671-0

Eur Radiol. 2025 Mar 27. doi: 10.1007/s00330-025-11489-1. Online ahead of print.

ABSTRACT

OBJECTIVES: Contrast-enhanced ultrasound (CEUS) assesses omental lesion nature, but CEUS-guided biopsy feasibility, effectiveness, and safety are uncertain.

METHODS: From January 2020 to January 2024, patients scheduled for ultrasound-guided omental biopsy at the First Hospital of China Medical University were enrolled. They were divided into CEUS-guided and conventional ultrasound-guided groups, balanced using propensity score matching (PSM). Success rate, diagnostic accuracy, and complication rate were compared. Subgroup analyses considered sonographic features, with significance at p < 0.05.

RESULTS: After PSM, 310 CEUS-guided and 160 conventional ultrasound-guided patients were analyzed. Groups were similar in demographics and omental characteristics (p > 0.05). CEUS-guided biopsy had higher sample acquisition (97.42% vs. 93.13%, p = 0.029) and diagnostic accuracy (96.03% vs. 87.92%, p = 0.002). Overall complication rate was 9.36% (44/470), with distant metastasis in 0.43% (2/470). Complication rates did not differ significantly between groups. In hyperechoic group, dense group, and non-nodule group, CEUS-guided biopsy had higher success (97.99% vs. 92.55%, p = 0.042) and accuracy (96.48% vs. 86.17%, p = 0.002). In non-nodule group, CEUS-guided accuracy was superior (93.41% vs. 84.11%, p = 0.015).

CONCLUSION: Ultrasound-guided omental biopsy is a safe and effective method for obtaining samples. CEUS-guided omental biopsy enhances sample acquisition and diagnostic accuracy, especially in hyperechoic group, dense group, and non-nodule group, suggesting it is a more accurate and effective diagnostic method.

KEY POINTS: Question Selecting a puncture site for diffuse lesions of the greater omentum presents challenges, as conventional ultrasound-guided biopsy often encounters difficulties in avoiding local necrotic tissue. Findings Ultrasound-guided biopsy of the greater omentum is a safe and effective diagnostic method, especially when augmented with CEUS, which can significantly enhance diagnostic accuracy. Clinical relevance CEUS can markedly enhance diagnostic accuracy by providing a robust foundation for selecting the biopsy site and pathway. Therefore, it is advisable to routinely employ CEUS-guided puncture pathways for atypical omental lesions.

PMID:40146426 | DOI:10.1007/s00330-025-11489-1

Eur Radiol. 2025 Mar 27. doi: 10.1007/s00330-025-11524-1. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to assess whether pharmacokinetic parameters derived from DCE-MRI can stratify Programmed Death-Ligand 1 (PD-L1) expression in NSCLC. The secondary aim was to identify a suitable pharmacokinetic model configuration for anisotropic temporally-spaced DCE-MRI sequences, considering Tofts variants, population-averaged arterial input functions (AIF), and bolus arrival time (BAT) estimation methods.

MATERIALS AND METHODS: From April 2021 to May 2023, patients with locally advanced non-small cell lung cancer (NSCLC) were prospectively enrolled. Tumors were categorized based on: PD-L1 absence/presence (threshold 1%) and hyperexpression/hypoexpression (threshold 50%). Pharmacokinetic parameters were extracted using several candidate configurations; fit quality was evaluated using coefficient of determination (R²). Mann-Whitney U-test and ROC-AUC were used to assess correlation with PD-L1 for the best-fit configuration.

RESULTS: Thirty-eight patients (mean age 68 ± 9 years, 28 men) were included. PD-L1 expression was present in 25 patients (66%) and absent in 13 (34%). PD-L1 was hyperexpressed in 13 (34%) patients and hypoexpressed in 25 (66%). Voxel-wise pharmacokinetic parameters were extracted using the best-fit configuration-extended Tofts model (ETM) with Georgiou AIF and Peak-Gradient (PG) BAT estimation (R² = 0.79). K^trans median (0.25 vs. 0.12 min^–¹, p = 0.02), K^trans standard deviation (0.32 vs. 0.23 min^–¹, p = 0.01) and K_ep median (1.09 vs. 0.59 min^–¹, p = 0.02) were significantly higher in PD-L1 < 50% group (ROC-AUC 0.71-0.76).

CONCLUSION: DCE-MRI pharmacokinetic parameters could stratify PD-L1 hypo/hyperexpression in NSCLC. The ETM with PG BAT estimation method and Georgiou AIF was the best-performing pharmacokinetic configuration.

KEY POINTS: Question Could Dynamic Contrast-Enhanced (DCE) MRI offer a safe and non-invasive way to assess Programmed Death-Ligand 1 (PD-L1) expression? Findings Quantitative DCE-MRI parameters K^trans (the volume transfer rate) and K_ep (the efflux rate constant) show potential for distinguishing PD-L1 hyperexpression from hypoexpression. Clinical relevance Preliminary results suggest that DCE-MRI could be a safe method to stratify PD-L1 hypo/hyperexpression in non-small cell lung cancer, potentially optimizing treatment decisions, given the high cost of immunotherapy.

PMID:40146425 | DOI:10.1007/s00330-025-11524-1

Eur Radiol. 2025 Mar 27. doi: 10.1007/s00330-025-11516-1. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the association between plaque characteristics and burden by coronary computed tomography angiography (CCTA) and ischemia determined by invasively measured fractional flow reserve (FFR), and whether the addition of plaque characteristics improves ischemia discrimination beyond coronary stenosis alone.

METHODS: A systematic literature review and meta-analysis of studies from PubMed, EMBASE, and the Cochrane Library databases, published between January 2005 and October 2024 were conducted to assess the relationship between quantitative and qualitative coronary plaque characteristics and invasive FFR. Pooled analyses were performed using weighted mean difference for plaque volumes with 95% confidence intervals and odds ratios for qualitative plaque findings.

RESULTS: A total of 29 studies involving 4416 patients (mean age 63 ± 9 years and 71% male) with predominantly stable coronary artery disease were included. Data on 3923 lesions and 3520 vessels were pooled. Total plaque, non-calcified plaque, and percent aggregate plaque volumes, as well as percent plaque burden, were inversely associated with FFR at both per-lesion and per-vessel levels (all, p-values < 0.05). The presence of high-risk plaque characteristics, including low-attenuation plaque, napkin-ring sign, and spotty calcification, were more frequently observed in lesions and vessels with FFR ≤ 0.80 (all, p-values < 0.05). Among plaque volumes, the percent aggregate plaque volume consistently improved ischemia discrimination independently of stenosis.

CONCLUSION: CCTA-derived quantification of plaque volumes and identification of high-risk plaque characteristics are associated with ischemia and significantly enhance discrimination of ischemia-causing lesions independently of coronary stenosis severity.

KEY POINTS: Question Plaque characteristics have been suggested as the missing link between coronary artery stenosis severity and ischemia. Findings High-risk plaque characteristics and larger coronary plaque volumes are associated with ischemia (FFR ≤ 0.80). Clinical relevance The addition of CCTA-derived plaque assessment improved the discrimination of ischemia compared with stenosis evaluation alone. Combining coronary stenosis and plaque assessment may improve the non-invasive assessment of patients with coronary artery disease and gatekeeping to the catheterization laboratory.

PMID:40146424 | DOI:10.1007/s00330-025-11516-1