Category: Statistics

Riv Psichiatr. 2025 Mar-Apr;60(2):71-77. doi: 10.1708/4487.44876.

ABSTRACT

AIM: To assess the utilization rate of a university psychological counselling center in Southern Italy, a retrospective analysis of data collected from September 2018 to December 2023 was conducted.

METHOD: Data were gathered through an online questionnaire, which was distributed to students seeking psychological help (SH) from University Counselling Service (UCS) at their first contact with the service.

RESULTS: The frequency of contacts with UCS (n=639) and the number of SH students who received psychological counselling (n=503) significantly differed over a 6-year period, with the highest number of interviews delivered after the Covid-19 pandemic (contacts: χ2=84.814, p<.0001; interventions: χ2=25.161, p<.0001). More than 40% of the SH students were medical students, followed by approximately 32% of students attending psychological courses. Differences were found across years in the type of course attended by SH students (χ2=54.323, p<.0001) and in dropout rates (χ2=24.427, p<.0001).

DISCUSSION AND CONCLUSIONS: The significantly higher demand for psychological help confirms the increased psychological distress in university students. The shift to online modalities and the broader dissemination of mental health literacy, particularly in the aftermath of the Covid-19 outbreak, may explain the significant increase in service utilization rates. These findings highlight the need for timely interventions to address the needs of SH students.

PMID:40242925 | DOI:10.1708/4487.44876

Int Health. 2025 Apr 17:ihaf028. doi: 10.1093/inthealth/ihaf028. Online ahead of print.

ABSTRACT

Dysmenorrhea is a public health problem worldwide, and affects more than half of reproductive-age females in Ethiopia. Despite dysmenorrhea having being studied, this has not covered the impacts and management of dysmenorrhea. Therefore, this review aimed at critically appraising, synthesizing and presenting the evidence on the burden, impacts and management methods of dysmenorrhea among females in Ethiopia. International databases (SCOPUS, CINAHL, CAB Abstract, EMBASE, PubMed, Web of Science, Google and Google Scholar) and lists of references were employed to search literature in Ethiopia. The overall burden of dysmenorrhea was presented using a random-effects model for the reported proportion by forest plot using STATA version 18. The heterogeneity of the studies was determined using p=0.05 for I2 statistics. In addition, sensitivity analyses were performed to examine the stability of pooled values in the presence of outliers. Furthermore, Egger’s regression test and funnel plot were performed to check for potential publication bias. A total of 20 studies and a population of 8713 were included in the review. The overall burden of dysmenorrhea among females was 73% (95% CI 68 to 77%), with I2=96.04. Psychological problems (59.9%), poor concentration (42.3%) and absenteeism from the class (41.3%) were the common impacts of dysmenorrhea, and bed rest (54%), use of painkillers (41.5%) and hot drinks (41.3%) were commonly practiced treatments by participants. Around three out of four females experienced dysmenorrhea. Enhancing social support may reduce stress; and behavioral interventions such as mind-body awareness and relaxation training are believed to help decrease the risk of depression by alleviating dysmenorrhea. Both pharmacological and non-pharmacological therapy have played a crucial role in its management. But the literature offers controversial scientific proof, and imply that high-quality trials are needed to make conclusive recommendations for better management methods of dysmenorrhea.

PMID:40242920 | DOI:10.1093/inthealth/ihaf028

Clin Exp Rheumatol. 2025 Apr 9. doi: 10.55563/clinexprheumatol/5c7nti. Online ahead of print.

ABSTRACT

OBJECTIVES: This study investigates the relationship between IgG4-related disease (IgG4-RD) and malignancies, focusing on tumour distribution and risk factors for malignancy development during follow-up.

METHODS: We analysed a prospective cohort of 278 IgG4-RD patients, including 22 with malignancies, and calculated standardised incidence ratios (SIRs). Bayesian statistical models were employed to identify risk factors.

RESULTS: Among 278 IgG4-RD patients, 22 (7.9%) developed malignancies. Lung cancer (13.6%) was the most prevalent malignancy, with a significantly higher incidence in the follow-up group compared to the history/concurrent group (19.3% vs. 7.0%; p=0.008). Testicular cancer occurred exclusively in the history/concurrent group (3.5%) and was absent in the follow-up group (p=0.044). The overall SIR was 3.28 (95% CI: 1.31-5.58) and lymphoma exhibited a markedly high SIR of 17.63 (95% CI: 0-52.89). Elevated ESR (estimate: 0.12, 95% CI: 0.04-0.23) and more organ involvements (estimate: 1.94, 95% CI: 0.31-3.93) were identified as significant risk factors for malignancy development.

CONCLUSIONS: IgG4-RD patients exhibit an elevated risk of specific malignancies, particularly lymphoma, with elevated ESR and greater organ involvement identified as significant risk factors for malignancy development during follow-up period.

PMID:40242911 | DOI:10.55563/clinexprheumatol/5c7nti

Acta Orthop. 2025 Apr 17;96:339-347. doi: 10.2340/17453674.2025.43476.

ABSTRACT

BACKGROUND AND PURPOSE: Pooling data on the performance of total knee (TK) implants across registries is only possible if the same TK implant is used across multiple registries and if used in patients with similar characteristics. We assessed to what extent specific TK implants: (i) are used across multiple registries or only in a single registry; and (ii) differ in patient characteristics between registries.

METHODS: All primary TK implants implanted between January 2020 and December 2021 in the Danish, Dutch, German, and Italian registries were included. We determined the number of registries using a specific TK implant (based on combined femoral-tibial component brand name and fixation/congruency/mobile bearing insert/patella usage). Patient characteristics (age/body mass index [BMI]/sex/diagnosis osteoarthritis) were compared across registries for TK implants used in ≥ 2 registries ≥ 100 times.

RESULTS: 813 different TK implants (577,351 procedures) were used across the 4 registries, of which 53 TK implants (7%) were used in 1 registry (8,000 procedures). 760 different TK implants (569,351 procedures; 99%) were used in ≥ 2 registries of which 47 different TK implants (393,954 procedures; 68%) were used in ≥ 2 registries and ≥ 100 times. Statistically and clinically significant differences in age for the same TK implant across registries were observed for 29 TK implants (62%) and 3 TK implants (6%), respectively; for other characteristics these were for BMI 30 (64%) and 0 (0%) TK implants; for male proportion 23 (49%) and 17 (36%) TK implants; and for diagnosis of osteoarthritis 42 (89%) and 34 (72%) TK implants, respectively.

CONCLUSION: Most specific TK implants and TK procedures were used across multiple registries, but they were often used in patients with different characteristics. This has an impact on comparing implant performances between registries.

PMID:40242884 | DOI:10.2340/17453674.2025.43476

NMR Biomed. 2025 Jun;38(6):e70042. doi: 10.1002/nbm.70042.

ABSTRACT

The pathological changes in deep medullary veins (DMVs) have been reported in various diseases. However, accurate modeling and quantification of DMVs remain challenging. We aim to propose and assess an automated approach for modeling and quantifying DMVs at 7 Tesla (7 T) MRI. A multi-echo-input Res-Net was developed for vascular segmentation, and a minimum path loss function was used for modeling and quantifying the geometric parameter of DMVs. Twenty-one patients diagnosed as subcortical vascular dementia (SVaD) and 20 condition matched controls were included in this study. The amplitude and phase images of gradient echo with five echoes were acquired at 7 T. Ten GRE images were manually labeled by two neurologists and compared with the results obtained by our proposed method. Independent samples t test and Pearson correlation were used for statistical analysis in our study, and p value < 0.05 was considered significant. No significant offset was found in centerlines obtained by human labeling and our algorithm (p = 0.734). The length difference between the proposed method and manual labeling was smaller than the error between different clinicians (p < 0.001). Patients with SVaD exhibited fewer DMVs (mean difference = -60.710 ± 21.810, p = 0.011) and higher curvature (mean difference = 0.12 ± 0.022, p < 0.0001), corresponding to their higher Vascular Dementia Assessment Scale-Cog (VaDAS-Cog) scores (mean difference = 4.332 ± 1.992, p = 0.036) and lower Mini-Mental State Examination (MMSE) (mean difference = -3.071 ± 1.443, p = 0.047). The MMSE scores were positively correlated with the numbers of DMVs (r = 0.437, p = 0.037) and were negatively correlated with the curvature (r = -0.426, p = 0.042). In summary, we proposed a novel framework for automated quantifying the morphologic parameters of DMVs. These characteristics of DMVs are expected to help the research and diagnosis of cerebral small vessel diseases with DMV lesions.

PMID:40242874 | DOI:10.1002/nbm.70042

Stroke. 2025 Apr 17. doi: 10.1161/STROKEAHA.124.050171. Online ahead of print.

ABSTRACT

BACKGROUND: Blood-brain barrier (BBB) leakage measured with dynamic susceptibility contrast-enhanced magnetic resonance imaging (MRI) has been associated with hemorrhagic transformation in acute ischemic stroke. However, the influence of prethrombolysis BBB leakage on infarct growth has not been studied. Therefore, we aimed to characterize BBB integrity according to tissue state at admission and tissue fate on follow-up MRI.

METHODS: This is a post hoc analysis of the WAKE-UP trial (Efficacy and Safety of MRI-Based Thrombolysis in Wake-Up Stroke). Ischemic cores were segmented on diffusion-weighted imaging at baseline and on fluid-attenuated inversion recovery images at follow-up (22-36 hours). Dynamic susceptibility contrast-enhanced-MRI provided penumbra masks (time to maximum of the tissue residue function >6 s minus ischemic core) and BBB leakage (extraction fraction [EF], Z scored) maps via automated analysis. EF was averaged within the ischemic core, total penumbra, 2 penumbra subtypes (salvaged/infarcted penumbra), and normal tissue. Adjusted linear mixed-effects models tested for differences between tissue types and associations of EF with clinical/imaging outcomes. Complementary voxel-wise analyses were performed.

RESULTS: Of 503 patients enrolled in the trial, 165 with suitable dynamic susceptibility contrast-enhanced-MRI data were included in this analysis (mean age 66 years, 38% women, median National Institutes of Health Stroke Scale score of 6; 53% receiving alteplase). EF was significantly increased in the ischemic core and penumbra relative to normally perfused tissue, while differences between total penumbra and ischemic core were statistically nonsignificant. Infarcted penumbra exhibited higher EF than salvaged penumbra, even after adjusting for hypoperfusion severity (P<0.001, n=79 with baseline penumbral tissue and follow-up MRI). Voxel-wise analyses showed a significant association between EF and voxel-level infarction in the placebo group only. EF did not predict hemorrhagic transformation or functional outcomes.

CONCLUSIONS: Penumbral BBB leakage may identify tissue at increased risk of infarction. Larger, prospective studies are needed to determine the clinical relevance of BBB leakage as an imaging marker of tissue fate.

REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01525290. Unique identifier: 2011-005906-32.

PMID:40242873 | DOI:10.1161/STROKEAHA.124.050171

Allergy. 2025 Apr 17. doi: 10.1111/all.16558. Online ahead of print.

ABSTRACT

BACKGROUND: Symptom monitoring can improve adherence to daily medication. However, controlled clinical trials on multi-modular allergy apps and their various functions have been difficult to implement. The objective of this study was to assess the clinical benefit of an allergy app with varying numbers of functions in reducing symptoms and improving quality of (QoL) life in grass pollen allergic individuals. The secondary objective was to develop a symptom forecast based on patient-derived and environmental data.

METHODS: We performed a stratified, controlled intervention study (May-August 2023) with grass pollen allergic participants (N = 167) in Augsburg, Germany. Participants were divided into three groups, each receiving the same allergy app, but with increasing numbers of functions.

PRIMARY ENDPOINT: rhinitis-related QoL; Secondary endpoints: symptom scores, relevant behavior, self-reported usefulness of the app, symptom forecast.

RESULTS: Rhinitis-related QoL was increased after the intervention, with no statistical inter-group differences. However, participants with access to the full app version, including a pollen forecast, took more medication and reported lower symptoms and social activity impairment than participants with access to a reduced-function app. Using an XGBoost multiclass classification model, we achieved promising results for predicting nasal (accuracy: 0.79; F1-score: 0.78) and ocular (accuracy: 0.82; F1-score: 0.76) symptom levels and derived feature importance using SHAP as a guidance for future approaches.

CONCLUSION: Our allergy app with its high-performance pollen forecast, symptom diary, and general allergy-related information provides a clinical benefit for allergy sufferers. Reliable symptom forecasts may be created given high-quality and high-resolution data.

PMID:40242867 | DOI:10.1111/all.16558

ASEAN J Psychiatry. 2024 Jul 12;2024. doi: 10.54615/2231-7805.47358.

ABSTRACT

BACKGROUND: Amphetamine and other substances induced psychotic disorder and associated suicidal risk among hospitalized US veterans is not clear.

AIMS: To understand the demographic profile, substance use trends, psychotic disorders and suicide attempts in veterans hospitalized with acute Mental Health Conditions (MHC).

METHODS: Veterans Affairs Informatics and Computing Infrastructure Database (ICD) and codes were used to identify veterans hospitalized with MHC diagnosis between 1999 and 2022. Laboratory records used to determine types of substances used hospitalization frequency, all-cause mortality, suicide attempts and suicide outcomes. SAS was used for statistical analysis.

RESULTS: Among veterans with MHC, psychosis, manic-bipolar and PTSD were common diagnosis. Psychosis was comparatively less among males above 50 years of age, but prevalent among Hispanics. In general, substances use was significantly higher, and amphetamines were most used, followed by cannabis codeine, morphine, cocaine, barbiturates, fentanyl, and PCP among veterans with MHC. Amphetamine induced psychotic disorder persisted in 22.28% and other substance induced psychotic disorder persisted in 77.72% of veterans hospitalized with MHC. Psychosis was associated with higher rates of hospitalization, suicide attempts, and suicide death.

CONCLUSIONS: Among US Veterans with MHC, amphetamine was most used substance associated with higher rates of psychotic disorders, hospitalization, suicide attempts, and death.

PMID:40242831 | PMC:PMC11997896 | DOI:10.54615/2231-7805.47358

J Spine Surg. 2025 Mar 24;11(1):65-73. doi: 10.21037/jss-24-75. Epub 2025 Feb 27.

ABSTRACT

BACKGROUND: Patient-specific spine rods (PSSRs) are custom-designed pre-operatively to align with individual spinopelvic parameters, aiming to optimize post-operative alignment. While effective in correcting adult spinal deformities, their utility in degenerative lumbar fusions remains relatively understudied. This study seeks to assess the outcomes of PSSR utilization in degenerative lumbar fusions by comparing them to a previously published cohort by Leveque et al. in 2018. Through this analysis, we aim to contribute to the understanding of PSSR efficacy and its potential role in improving surgical outcomes in degenerative lumbar conditions.

METHODS: Fifty patients who underwent primary lumbar fusion with PSSRs were included, excluding those with prior lumbar fusion or significant deformities. The study cohort was compared to a historical cohort using conventional rods. Radiographic outcomes were evaluated over a 2-year period, with follow-ups at 6 weeks, 6 months, 1 year, and 2 years postoperatively. Pre-operative and post-operative measurements of pelvic incidence (PI) and lumbar lordosis (LL) were used to assess changes in changes in PI-LL alignment. Statistical analyses included one-way analysis of variance (ANOVA) tests and one/two sample t-tests.

RESULTS: Patients undergoing fusion PSSRs demonstrated a greater degree of change in pre-operative to post-operative PI-LL alignment compared to non-PSSR patients (-4.2° vs. -0.1°, P<0.001). Among the PSSR group, post-operative analysis revealed that 37 patients (74%) were categorized as preserved, indicating maintenance of PI-LL alignment within a predefined range. Additionally, nine patients (18%) were classified as restored, representing an improvement in PI-LL alignment post-operatively. Conversely, two patients (4%) were categorized as not corrected and worsened, indicating no significant change or deterioration in PI-LL alignment post-operatively, respectively. Comparison between the PSSR and non-PSSR groups showed higher restored spinopelvic parameters after surgery in the PSSR group compared to the non-PSSR group (18% vs. 8.7%, P=0.05). Conversely, fewer patients in the PSSR group had not corrected parameters compared to the non-PSSR group (4% vs. 21.3%, P<0.01). These findings suggest that fusion with PSSRs was associated with greater improvement in PI-LL alignment post-operatively and a higher likelihood of achieving restored spinopelvic parameters compared to fusion without PSSRs.

CONCLUSIONS: PSSRs demonstrate significant improvement in spinopelvic parameters, particularly in reducing PI-LL mismatch, in degenerative lumbar fusion surgery. This improvement suggests a potential for enhanced patient outcomes. Follow-up assessments indicate that these improvements are sustained over a 2-year period. However, our findings underscore the need for further research to validate these results on a larger scale and over the long term. Larger-scale studies are necessary to confirm long-term benefits and should aim to explore the specific mechanisms by which PSSRs contribute to improved outcomes and investigate optimal strategies for incorporating PSSRs into clinical practice.

PMID:40242816 | PMC:PMC11998052 | DOI:10.21037/jss-24-75

J Spine Surg. 2025 Mar 24;11(1):65-73. doi: 10.21037/jss-24-75. Epub 2025 Feb 27.

ABSTRACT

BACKGROUND: Patient-specific spine rods (PSSRs) are custom-designed pre-operatively to align with individual spinopelvic parameters, aiming to optimize post-operative alignment. While effective in correcting adult spinal deformities, their utility in degenerative lumbar fusions remains relatively understudied. This study seeks to assess the outcomes of PSSR utilization in degenerative lumbar fusions by comparing them to a previously published cohort by Leveque et al. in 2018. Through this analysis, we aim to contribute to the understanding of PSSR efficacy and its potential role in improving surgical outcomes in degenerative lumbar conditions.

METHODS: Fifty patients who underwent primary lumbar fusion with PSSRs were included, excluding those with prior lumbar fusion or significant deformities. The study cohort was compared to a historical cohort using conventional rods. Radiographic outcomes were evaluated over a 2-year period, with follow-ups at 6 weeks, 6 months, 1 year, and 2 years postoperatively. Pre-operative and post-operative measurements of pelvic incidence (PI) and lumbar lordosis (LL) were used to assess changes in changes in PI-LL alignment. Statistical analyses included one-way analysis of variance (ANOVA) tests and one/two sample t-tests.

RESULTS: Patients undergoing fusion PSSRs demonstrated a greater degree of change in pre-operative to post-operative PI-LL alignment compared to non-PSSR patients (-4.2° vs. -0.1°, P<0.001). Among the PSSR group, post-operative analysis revealed that 37 patients (74%) were categorized as preserved, indicating maintenance of PI-LL alignment within a predefined range. Additionally, nine patients (18%) were classified as restored, representing an improvement in PI-LL alignment post-operatively. Conversely, two patients (4%) were categorized as not corrected and worsened, indicating no significant change or deterioration in PI-LL alignment post-operatively, respectively. Comparison between the PSSR and non-PSSR groups showed higher restored spinopelvic parameters after surgery in the PSSR group compared to the non-PSSR group (18% vs. 8.7%, P=0.05). Conversely, fewer patients in the PSSR group had not corrected parameters compared to the non-PSSR group (4% vs. 21.3%, P<0.01). These findings suggest that fusion with PSSRs was associated with greater improvement in PI-LL alignment post-operatively and a higher likelihood of achieving restored spinopelvic parameters compared to fusion without PSSRs.

CONCLUSIONS: PSSRs demonstrate significant improvement in spinopelvic parameters, particularly in reducing PI-LL mismatch, in degenerative lumbar fusion surgery. This improvement suggests a potential for enhanced patient outcomes. Follow-up assessments indicate that these improvements are sustained over a 2-year period. However, our findings underscore the need for further research to validate these results on a larger scale and over the long term. Larger-scale studies are necessary to confirm long-term benefits and should aim to explore the specific mechanisms by which PSSRs contribute to improved outcomes and investigate optimal strategies for incorporating PSSRs into clinical practice.

PMID:40242816 | PMC:PMC11998052 | DOI:10.21037/jss-24-75