Category: Statistics

Eur Radiol. 2025 Mar 27. doi: 10.1007/s00330-025-11527-y. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the therapeutic effect, adverse events, and hepatic artery injury (HAI) between gelatin spheres (GS) and nonspherical gelatin sponge particles (GP) in conventional transcatheter arterial chemoembolization (C-TACE).

MATERIALS AND METHODS: A total of 368 consecutive patients with hepatocellular carcinoma (HCC) who underwent C-TACE between September 2019 and May 2021 were included in this single center retrospective study. Adverse events, radiologic tumor response, local tumor recurrence, and HAI were evaluated.

RESULTS: Subsegmental C-TACE was performed using biodegradable GS in 165 patients and nonspherical biodegradable GP in 203 patients. No significant differences in patient background existed between the groups, and there was no significant difference in adverse event rate (p = 0.231). The CR and overall tumor response in the GS and GP groups were 73.3% vs 70.9%, and 99.4% vs 98.5%, respectively, with no significant between-group differences (p = 0.642 and p = 0.631). No significant difference in cumulative local tumor recurrence rate existed between the groups (p = 0.558). HAI was observed in 16% (20 of 125 patients) in the GS group and 37.4% (49 of 131 patients) in the GP group. The incidence of HAI was significantly higher in the GP group than in the GS group (p < 0.001). In multiple logistic regression analysis, risk factors for HAI were index tumor size ≥ 3 cm (p = 0.001) and use of GP (p < 0.001).

CONCLUSION: C-TACE with GS resulted in the same therapeutic and adverse effects as C-TACE with nonspherical GP while causing significantly less HAI.

KEY POINTS: Question Comparisons between GS and nonspherical GP are lacking, and the potential advantages of GS over nonspherical GP are not well studied. Findings HAI incidence was higher in the GP than the GS group, and risk factors of HAI were index tumor size ≥ 3 cm and GP use. Clinical relevance C-TACE with GS resulted in the same therapeutic and adverse effects as C-TACE with nonspherical GP while causing significantly less HAI.

PMID:40146423 | DOI:10.1007/s00330-025-11527-y

J Cancer Educ. 2025 Mar 27. doi: 10.1007/s13187-025-02617-y. Online ahead of print.

ABSTRACT

Effective cancer prevention requires early interventions to enhance health literacy, particularly for Opisthorchis viverrini (OV) and cholangiocarcinoma (CCA) in the Greater Mekong Subregion. This study developed and evaluated the Muk-KAMSComD Model, a structured learning management approach, to improve health literacy and preventive behaviors among primary school students in Mukdahan Province, a high-risk area in Thailand. A four-step research and development (R&D) framework was implemented: (1) situation and needs assessment, (2) model development, (3) implementation, and (4) refinement and presentation. Thirty-six Grade 6 students were selected through multi-stage sampling, and a one-group pretest-posttest design assessed health literacy using validated questionnaires. The 12-week intervention integrated the HALO Model (Healthy School, Active Learning, Lesson Study, and Open Class) with six key health literacy skills. Data were analyzed using qualitative content analysis, descriptive statistics, and paired t-tests. The Muk-KAMSComD Model consists of Knowledge provision, Awareness and belief creation, Motivation enhancement, Self-management practice, Communication, and Decision-making and forwarding. Post-intervention, students significantly improved (p < 0.001) in knowledge, communication, self-management, media literacy, information access, and decision-making skills. Information access showed the highest improvement, while self-management remained the lowest. The model was refined to strengthen parental engagement and instructional materials for enhanced effectiveness. The Muk-KAMSComD Model effectively strengthens health literacy and preventive behaviors for OV and CCA among primary school students. Its integration into school curricula and public health programs could contribute to sustainable CCA prevention in endemic regions.

PMID:40146421 | DOI:10.1007/s13187-025-02617-y

Eur J Orthop Surg Traumatol. 2025 Mar 27;35(1):136. doi: 10.1007/s00590-025-04253-0.

ABSTRACT

PURPOSE: The rising demand for primary total shoulder arthroplasty (TSA) has spurred interest in comparing the safety and cost-effectiveness of outpatient TSA in ambulatory surgical centers (ASCs) versus hospital-based centers (HSCs). This study evaluates ASCs and HSCs for medical complications, readmission rates, implant complications, and costs.

METHODS: This retrospective cohort study used the PearlDiver Mariner Database to identify patients undergoing primary TSA in ASCs or HSCs, assessing medical complications, readmissions, implant issues, and costs. ASC patients were matched in a 1:5 ratio to HSC patients by age, sex, region, and Elixhauser Comorbidity Index (ECI). Logistic regression analyzed the impact of ASC versus HSC settings on complications and readmissions, while Welch’s t-tests compared costs. Statistical significance was determined by a P value less than or equal to 0.05.

RESULTS: ASCs showed lower odds of pulmonary embolism (OR = 0.69; P = 0.04), total medical complications (OR = 0.89; P = 0.01), prosthetic joint dislocation (OR = 0.43; P = 0.05), and total implant-related complications (OR = 0.85; P = 0.03), but a higher 90-day readmission rate (OR = 1.22; P < 0.01). ASCs also offered significant cost savings on the day of surgery ($4600 vs. $11,100; P < 0.01) and for 90-day total costs ($6600 vs. $13,500; P < 0.01) compared to HSCs.

CONCLUSION: Outpatient primary TSA in ASCs offers comparable safety with substantially lower costs than HSCs. Despite higher readmission rates, ASCs represent a viable, cost-effective alternative.

PMID:40146416 | DOI:10.1007/s00590-025-04253-0

J Gastrointest Cancer. 2025 Mar 27;56(1):89. doi: 10.1007/s12029-025-01209-9.

ABSTRACT

BACKGROUND AND AIMS: Currently, there are no biomarkers with high accuracy in the detection of pancreatic cancer. This article aims to evaluate the performance of a novel diagnostic model based on a combination of biomarkers in the washing fluid obtained by EUS-FNA with imaging examination in pancreatic cancer.

METHODS: This study included 59 patients with pancreatic lesions who underwent EUS-FNA and were categorized into malignant and benign groups on the basis of pathology diagnosis. The levels of CEA, CA19-9, CA125, CA724, CYFRA 21-1, IMP3, SMAD4, and S100P in EUS-FNA washing fluid were detected by ELISA. We attempted to construct a new diagnostic method by combining the above biomarkers with EUS, CT, MRI, and PET-CT.

RESULTS: CEA, CA19-9, CA724, CA125, and CYFRA 21-1 showed statistical significance in the diagnosis of pancreatic cancer (AUC > 0.7, p < 0.05). CA724 had a specificity of up to 100% in the group with positive EUS diagnosis. If at least two positive imaging results (EUS/CT/MRI/PET-CT) combined with at least one tumor marker (CEA/CA199/CA724) in series, the sensitivity was 88.57% and the specificity was 91.67%.

CONCLUSIONS: Combining the tumor markers CEA, CA19-9, CA724, CA125, and CYFRA 21-1 in the washing fluid of EUS-FNA with commonly used imaging methods can help distinguish benign and malignant pancreatic lesions.

PMID:40146407 | DOI:10.1007/s12029-025-01209-9

Metabolomics. 2025 Mar 27;21(2):45. doi: 10.1007/s11306-025-02244-0.

ABSTRACT

BACKGROUND: Research gaps persist in understanding the interactions between serum 25 (OH)D levels, intestinal fungi, and their metabolites in postmenopausal women.

METHODS: This study, approved by the Ethics Committee of Zhongshan Hospital, Xiamen University, recruited postmenopausal women from Xiamen. Clinical assessments included Body Mass Index (BMI) calculations and blood tests for various bone-related markers using Roche’s electrochemiluminescence system. Bone density was measured via dual-energy X-ray absorptiometry. Fecal DNA was extracted for Internal Transcribed Spacer (ITS) sequencing with a two-stage PCR process and analyzed using high-throughput Illumina sequencing. Metabolites were extracted from fecal samples and analyzed by ultra-high-performance liquid chromatography combined with mass spectrometry. Statistical analyses and data visualization were performed using R, focusing on fungal community structure and correlations with metabolites.

RESULTS: The study analyzed 81 postmenopausal women, categorized into vitamin D deficient (VDD), insufficient (VDI), and sufficient (VDS) groups based on serum 25 (OH)D levels. Other health markers, including age and BMI, were consistent across groups. Notably, Linear discriminant analysis identified distinct fungal communities across VDD, VDI, and VDS groups. In the VDD group, notable fungi included Hanseniaspora occidentalis and Pichia. The VDI group showed enrichment of Candida, while the VDS group had higher abundances Such as Phanerochaete, and Nectriaceae. Alpha diversity metrics, such as the Chao1 index, differed significantly among the groups (p < 0.05). Correlation analysis (Spearman) revealed that fungi like Trichosporon and Penicillium positively associated with 25 (OH)D3, whereas fungi such as Cystofilobasidium were negatively correlated with bone mineral density (BMD). Metabolites like Glutaric acid positively correlated with 25 (OH)D3, while L-Citrulline and Deoxycholic acid were negatively correlated. Additionally, Argininosuccinic acid correlated positively with BMD, whereas Acamprosate and p-Hydroxyphenylacetic acid were negatively associated.

CONCLUSION: In postmenopausal women, fungal community composition varies significantly with vitamin D status, potentially correlating with serum 25 (OH)D levels and BMD, indicating that specific fungal species may be relevant for therapeutic strategies with osteoporosis and offering insights into the broader bone health effects of vitamin D.

PMID:40146404 | DOI:10.1007/s11306-025-02244-0

Neurosurg Rev. 2025 Mar 27;48(1):331. doi: 10.1007/s10143-025-03466-5.

ABSTRACT

There are limited data on the impact of light sedation (LS) on changes in intraoperative hypotension related to carotid artery stenting (CAS). We aimed to investigate intraoperative hypotension and perioperative complications in CAS under LS with intravenous dexmedetomidine (Dex). A retrospective analysis of 140 consecutive patients who underwent CAS at our centre from September 2018 to March 2021 was performed. The primary endpoint was the incidence of intraoperative hypotension associated with CAS, defined as continuous systolic blood pressure < 90 mmHg. The secondary outcomes were perioperative complications, including dysphoria, transient ischaemic attacks (TIA), stroke, myocardial infarction (MI), reperfusion syndrome, and 24-h haemodynamic events after CAS. Eighty-nine patients were treated under LS, and 51 patients were treated under local anaesthesia (LA). Intraoperative haemodynamic instability was observed in 13 of 140 (9.3%) patients; hypotension occurred in 2.2% (2/89) of patients in the LS group, which was significantly lower than the rate in the LA group (2.2% vs. 11.8%, P = 0.027). Dysphoria occurred in 1.1% of the LS cohort and 15.7% of the LA cohort (P < 0.05). TIA was observed in 2.2% of the LS cohort and 15.7% of the LA cohort (P < 0.05), respectively. There were no statistically significant differences in periprocedural stroke, reperfusion syndrome, or 24-h haemodynamic events after CAS between the two groups, and none of the patients exhibited MI. Performing CAS under LS with intravenous Dex was a safe and effective anaesthesia option in terms of inhibiting intraoperative hypotension and could markedly decrease the incidence of dysphoria and TIA.

PMID:40146394 | DOI:10.1007/s10143-025-03466-5

Bull Environ Contam Toxicol. 2025 Mar 27;114(4):54. doi: 10.1007/s00128-025-04033-w.

ABSTRACT

Per- and polyfluoroalkyl substances (PFAS) are persistent environmental contaminants widely detected in water and sediment worldwide. Despite growing concerns about their ecological and health risks, their distribution in African aquatic environments remains understudied. This study addresses the knowledge gap in PFAS contamination by analysing the spatial and temporal distribution of 18 PFAS in Apies River water and sediment in Pretoria, South Africa. Surface water and sediment samples were collected upstream and downstream of the Apies River during dry seasons. The analysis of PFAS concentrations was conducted using liquid chromatography-tandem mass spectrometry. Statistical analysis, including paired t-tests, non-metric multidimensional scaling, and hierarchical cluster analysis, were applied to determine spatial and temporal trends. The study revealed significant spatial variations in PFAS contamination, with upstream locations consistently exhibiting higher concentrations than downstream. In surface water samples, L_PFBS, 4:2 FTS, 6:2 FTS, and L_PFHpS showed statistically significant differences (p < 0.05) between sites. Perfluorocarboxylic acids were the dominant PFAS class in surface water (50.47-57.15%), whereas perfluorosulfonic acids were more prevalent in sediments. Upstream sediment had higher L_PFHpS (43.00 ng/g), L_PFDS (38.89 ng/g), and L_PFHxS (23.91 ng/g) than downstream (31.96, 27.84, and 18.02 ng/g, respectively). The findings reveal contamination sources and partitioning between surface water and sediments, aiding in water quality management and pollution mitigation strategies.

PMID:40146386 | DOI:10.1007/s00128-025-04033-w

Clin Exp Nephrol. 2025 Mar 27. doi: 10.1007/s10157-025-02657-0. Online ahead of print.

ABSTRACT

BACKGROUND: As a joint project with the Ministry of Health, Labour and Welfare (MHLW), the Research Group on Intractable Renal Diseases is examining the feasibility of utilizing its personal clinical records database. We examine the validity of the initial-treatment data from the personal clinical records of patients with new-onset rapidly progressive glomerulonephritis (RPGN).

METHODS: Personal clinical records for patients with either RPGN or anti-glomerular basement membrane (GBM) antibody nephritis were used. The data from 454 newly enrolled RPGN patients were compiled for analysis in 2 cohort studies (CS1 for all case analysis and CS2 for selective analysis of new-onset cases).

RESULTS: In CS1, the serotypes of the 362 registered RPGN cases included 200 myeloperoxidase (MPO)-ANCA-positive, 98 anti-GBM-positive, and 9 proteinase-3 (PR3)-ANCA-positive cases, etc. CS2 included 96 of the MPO-ANCA-positive RPGN and 55 of the anti-GBM antibody-positive RPGN cases. For the initial treatment of MPO-ANCA-positive RPGN, the rates of glucocorticoid (GC) and GC pulse treatment were similar between the personal clinical records database and the nationwide questionnaire survey, but the rates of intravenous cyclophosphamide (CY) or rituximab were statistically significant lower in the personal clinical records database. For the initial treatment of anti-GBM antibody-positive RPGN, the rate of plasma exchange was similar between the two databases, but the rates of GC and per os CY tended to be lower in the personal clinical records database, although not statistically significant.

CONCLUSION: Clear differences in initial treatment for new-onset RPGN patients were found between a personal clinical records database and another reported database.

PMID:40146365 | DOI:10.1007/s10157-025-02657-0

Arch Orthop Trauma Surg. 2025 Mar 27;145(1):213. doi: 10.1007/s00402-025-05753-8.

ABSTRACT

INTRODUCTION: This study presents clinical und functional long-term outcomes up to 10 years after primary total hip arthroplasty (THA) without concomitant surgical intervention and a far proximal cup positioning.

METHODS: 33 patients (44 hips) underwent primary THA for severe dysplastic hip osteoarthritis with a far proximal cup position. Hips were divided into two groups: Group A (n = 27) with cups positioned at 55-65 mm and Group B (n = 17) with cups positioned > 65 mm from the interteardrop line. Functional outcomes were assessed at 114 ± 15 months postoperatively using LEFS, HHS, HOOS, and Tegner Activity Score. Patient satisfaction and leg length difference were also evaluated. Statistical analysis employed the Mann-Whitney U test (p < 0.05 significance level).

RESULTS: The study found no significant differences in the two groups in terms of functional results, as measured by HOOS (89.1 ± 12.1 vs. 89.0 ± 8.3; p = 0.5145), LEFS (66.7 ± 13.1 vs. 68.7 ± 11.5; p = 0.5544), and HHS (95.1 ± 7.4 vs. 94.9 ± 4.4; p = 0.2707). Both groups showed very good functional results. The Tegner Activity Score significantly improved in both groups from preoperative to final follow-up (A: 2.1 ± 1.4 to 4.0 ± 0.7; p = 0.0002; B: 1.8 ± 1.1 to 3.9 ± 1.1; p = 0.0009). There were no significant differences found when comparing the pre- and postoperative leg length differences (p = 0.5793). No complications including dislocation events, impingement or neurological complications were observed. Furthermore, no patient required revision surgery.

CONCLUSION: Primary total hip arthroplasty with far proximal, non-anatomic socket positions is a safe and effective treatment option with excellent functional long-term results in severe dysplastic hip osteoarthritis.

PMID:40146362 | DOI:10.1007/s00402-025-05753-8

Arch Dermatol Res. 2025 Mar 27;317(1):641. doi: 10.1007/s00403-025-04169-z.

ABSTRACT

This study aimed to explore the potential causal relationships between rosacea and Parkinson’s disease, Alzheimer’s disease, anxiety disorders, and depression with MR analysis. Genetic data for rosacea and the four neurodegenerative and neuropsychiatric disorders were sourced from GWAS databases. After completing stringent quality control procedures, SNPs meeting significance thresholds were selected as IVs. Our primary statistical analysis was conducted by IVW approach. To investigate the robustness of results, heterogeneity tests, sensitivity analyses, and pleiotropy assessments were conducted. Reverse MR analyses were subsequently carried out to further substantiate the causal relationships. The present study discovered a positive correlation between rosacea and an elevated risk of depression (OR = 1.0015, 95% CI = 1.0002-1.0027, P = 0.02). There is no causal evidence to support a connection between rosacea and Parkinson’s disease, Alzheimer’s disease, or anxiety disorders. Reverse MR analyses indicated no causal associations between these four disorders and the risk of rosacea. The findings reveal that individuals with rosacea may have an elevated risk of depression.

PMID:40146360 | DOI:10.1007/s00403-025-04169-z