Category: Statistics

Transplant Proc. 2025 Mar 19:S0041-1345(25)00127-7. doi: 10.1016/j.transproceed.2025.02.046. Online ahead of print.

ABSTRACT

OBJECTIVE: We evaluated the willingness and influencing factors of Chinese medical students to donate an organ.

METHODS: A total of 17 articles on the willingness of Chinese medical students to donate organs and related influencing factors were collected from domestic and foreign databases. The retrieval period was from the inception of the database to August 31, 2023. RevMan5.3 software was used to conduct a meta-analysis of the binary data in the included literature, and meta-integration was performed on the influencing factors of organ donation.

RESULTS: In this study, we found that 52% of medical students in China (95% confidence interval, 39%-66%) were willing to donate organs. A subgroup analysis showed that clinical medical students (69%) had greater willingness to donate than nursing students (27%), and medical students in the western region (58%) had a greater willingness to donate than those in the eastern region (51%). Studies with a small sample size (54%) found a greater willingness to donate than studies with a large sample size (49%), and the difference was statistically significant (P < .001). Fifty influencing factors were summarized in the included study, categorizing them into 10 categories, and further integrating them into 3 factors, namely personal factors, family factors, and social factors.

CONCLUSIONS: The willingness to organs donation among medical students in China remains at a moderate level, and the demonstration effect has not been reflected fully.

PMID:40113493 | DOI:10.1016/j.transproceed.2025.02.046

Transplant Proc. 2025 Mar 19:S0041-1345(25)00138-1. doi: 10.1016/j.transproceed.2025.02.028. Online ahead of print.

ABSTRACT

Alcohol-associated liver disease is now the leading indication for liver transplantation in the United States in the context of liver transplantation for patients with less than 6 months of abstinence from alcohol. To determine whether patients with less than 6 months of sobriety have worse perioperative outcomes than those with standard sobriety requirements, we performed a retrospective cohort study, comparing limited and standard sobriety patients undergoing orthotopic liver transplantation from May 2018 to October 2022 at a single academic tertiary transplant center. The limited sobriety cohort comprised adult patients with end-stage liver disease secondary to alcohol use disorder who presented with their first episode of hepatic decompensation, with less than 6 months of sobriety. This group was compared with a standard sobriety cohort, consisting of patients with alcohol-associated liver disease with more than 6 months of sobriety. A total of 169 patients were selected for analysis, with 58 in the limited sobriety group and 111 in the standard sobriety group. The limited- sobriety group was younger (median 42 years vs 54 years; P < .01) and had more severe liver disease than the standard sobriety group (median Model for End-stage Liver Disease scores of 39 vs 34; P < .01) at the time of transplantation. There were no statistically significant differences in the primary outcomes between the 2 groups. Despite having more severe liver disease, the limited sobriety management pathway was not associated with worse perioperative outcomes than the standard sobriety pathway. Our findings indicate liver transplantation in patients with limited sobriety do not require increased perioperative resources.

PMID:40113492 | DOI:10.1016/j.transproceed.2025.02.028

Cont Lens Anterior Eye. 2025 Mar 19:102392. doi: 10.1016/j.clae.2025.102392. Online ahead of print.

ABSTRACT

PURPOSE: To assess changes in fluid reservoir (FR) thickness and optical quality following the removal and reapplication of a scleral lens worn for 5 h in participants with regular and irregular corneas.

METHODS: Two groups with 10 patients were recruited: IC Group-Irregular Cornea; RC Group-Regular Cornea. Both groups were fitted with a diagnostic 16.4 mm scleral lens (hexafocon A). FR thickness was measured with optical coherence tomography (MOCEAN 4000, MOPTIM, Shenzhen Slton Technology Co. Ltd., China l), high and low contrast visual acuity was measured with ETDRS, whole eye aberrometry was assessed with IRx3 Wavefront Aberrometer (ImaginEyes, Orsay, France) for a 5 mm pupil diameter, and the light disturbance under dim light conditions was assessed with Light Distortion Analyzer (LDA, Binarytarget, Portugal). Measurements were taken at 10 min and after 5 h lens wear, as well as following lens removal and reapplication.

RESULTS: Following lens removal and reapplication, FR thickness significantly increased in RC Group (294.3 ± 137.5 to 337.2 ± 141.4 µm, p = 0.005), and in IC Group (311.5 ± 150.3 to 339.5 ± 150.7 µm, p = 0.005, Wilcoxon). Although minor visual fluctuations of 2 letters were found in high and low contrast visual acuity, no statistically significant differences were observed after lens reapplication. Regarding the size and irregularity of light distortion, no statistically significant differences were observed in either group. The aberrometry results demonstrated significant changes, with an increase in comatic vertical aberrations (p = 0.037, Wilcoxon), observed exclusively in IC Group after lens removal and reapplication.

CONCLUSION: Practitioners should be aware that removing and reapplying a scleral lens with fresh saline solution will increase the FR thickness. However, this increase may not have a significant or clinically meaningful impact on visual acuity, light disturbance size or optical quality as measured by aberrometry.

PMID:40113466 | DOI:10.1016/j.clae.2025.102392

Ann Chir Plast Esthet. 2025 Mar 19:S0294-1260(25)00029-9. doi: 10.1016/j.anplas.2025.02.005. Online ahead of print.

ABSTRACT

INTRODUCTION: The advent of artificial intelligence technologies, such as ChatGPT and Gemini, presents new opportunities to enhance physician-patient communication through tailored patient-facing medical information (PFI). Effective postoperative care is critical to successful patient outcomes in hand surgery, making it essential to deliver information in a clear, comprehensible, and accurate manner. This study aims to evaluate the ability of ChatGPT to generate accessible PFI to enhance patient understanding in hand surgery.

METHODS: A cross-sectional study was conducted involving five French hand surgeons and 28 non-medical individuals. Participants blindly evaluated PFI containing text and images generated by ChatGPT and Gemini compared to those provided by established organizations (EOs). The evaluations focused on three common hand surgeries: carpal tunnel syndrome, Dupuytren’s disease, and synovial cyst. Hand surgeons evaluated PFI based on accuracy, clarity, comprehensiveness, and overall preference. Non-medical participants evaluated PFI based on clarity and overall preference. Surveys were used to capture these evaluations, allowing for a systematic and effective comparison between both sources. Readability was analyzed using six readability formulas, and Likert scale responses were statistically analyzed using paired t-tests.

RESULTS: No significant difference was found in terms of accuracy between ChatGPT-generated text responses and EO-provided text responses. However, text responses provided by EOs were rated significantly higher in terms of comprehensiveness and clarity by hand surgeons. Interestingly, non-medical participants rated the clarity and overall preference of ChatGPT-generated text responses higher than those from EOs. EO-provided images were also significantly favored in terms of comprehensiveness and clarity by hand surgeons. Notably, 65% of non-medical participants preferred EO-provided images over AI-generated ones. Both sources, however, produced information that exceeded the recommended readability levels for patient comprehension.

CONCLUSION: This study underscores the potential of AI-generated medical information to enhance patient understanding, particularly through the comprehensive nature of materials created by tools like ChatGPT. The divergence in preferences between hand surgeons and patients highlights the need to refine the accuracy, clarity, and relevance of AI-generated content to align with the standards upheld by healthcare professionals. Continued exploration in this area is crucial for optimizing patient education and communication, particularly in the context of postoperative care.

PMID:40113462 | DOI:10.1016/j.anplas.2025.02.005

Orthop Surg. 2025 Mar 20. doi: 10.1111/os.70029. Online ahead of print.

ABSTRACT

OBJECTIVE: The degeneration characteristics of adjacent segment disease are complex. Improper surgical planning has caused unnecessary surgical trauma and costs. The purpose of this study was to establish a staging system for adjacent segment disease and evaluate its guiding significance for surgical decisions in adjacent segment disease.

METHODS: A retrospective study was performed on 103 patients with adjacent segment disease who underwent treatment between January 2017 and January 2023. Based on radiological findings, adjacent segment disease was categorized into four stages, with no cases identified in Stage IV. Patients were divided into four intervention groups: Group A (control group, traditional posterior lumbar fusion with rod-screw revision), Group B (Stage I, percutaneous endoscopic decompression), Group C (Stage II, oblique lumbar interbody fusion), and Group D (Stage III, cortical bone trajectory screws with posterior lumbar interbody fusion). Clinical and radiological outcomes were evaluated postoperatively, at 3 months, and at 12 months. Statistical analysis was conducted using t-tests, Mann-Whitney U tests, chi-square tests, and Spearman’s correlation.

RESULTS: Surgical expenses, duration, estimated blood loss, postoperative hospital stays, disc height index, and Pfirrmann grading all demonstrated significant correlations with the established grading system (p < 0.05). Patients achieved favorable clinical outcomes. Specifically, Groups B, C, and D showed earlier functional recovery compared to Group A, with Groups B and C experiencing more rapid relief from low back pain. Furthermore, Groups B, C, and D had shorter surgical times and reduced blood loss, while Groups B and C also incurred lower surgical costs and shorter hospital stays (p < 0.05).

CONCLUSION: The new grading system, developed based on the characteristics of adjacent segment degeneration, showed excellent surgical adaptability, despite varying degrees of correlation across different factors. This system was closely linked to the degree of intervertebral disc degeneration and the intervertebral disc height index. All patients achieved favorable surgical outcomes, suggesting that this grading system could provide valuable guidance in making surgical treatment decisions.

PMID:40113451 | DOI:10.1111/os.70029

Zhonghua Zhong Liu Za Zhi. 2025 Mar 23;47(3):275-282. doi: 10.3760/cma.j.cn112152-20240810-00336.

ABSTRACT

Objective: The 5th edition of the WHO classification of central nervous system (CNS) tumors in 2021 made significant revisions to the nomenclature and grading system of solitary fibrous tumors (SFT). This study aimed to explore the changes in the grading of CNS SFT and its relationship with clinical pathological features and prognosis. Methods: This study retrospectively reviewed the clinical and pathological data of 82 patients with CNS SFT diagnosed at the First Affiliated Hospital of Fujian Medical University from March 2006 to June 2021, reassessed their grading according to the WHO 5th edition CNS tumor classification, and conducted a comprehensive analysis of their histological morphology, immunohistochemical characteristics, and clinical imaging data. Results: The age of the patients ranged from 21 to 83 years, with a median age of 48 years. Follow-up was completed for 82 patients, during which 10 patients died, 24 recurred, and 5 metastasized. MRI imaging showed that SFT exhibited isointense signals on T1-weighted imaging (T1WI) and complex signals on T2-weighted imaging (T2WI), with signal intensity decreasing as the content of collagen fibers increased. According to the 2021 grading criteria, there was a significant change in the grading of SFT, with the number of grade 1 SFT increasing from 10 cases under the 2016 standard to 39 cases, while the number of grade 2 and 3 SFT decreased accordingly. The 2016 grading system was significantly correlated with the overall survival (OS) of patients (P=0.009), while the 2021 grading system did not reach statistical significance. Both grading systems were correlated with histological phenotype, Ki-67 index, mitotic figures, and necrosis (P＜0.05). All cases expressed STAT6, and showed varying degrees of expression of vimentin, CD99, BCL-2, and CD34. The staining intensity of type Ⅳ collagen fibers, as analyzed semi-quantitatively, was correlated with the OS of the patients (P=0.017). Conclusions: The new grading system for CNS SFT has undergone significant changes, and its association with OS requires further validation. In-depth study of the content and fine structure of collagen fibers in SFT may have important clinical significance for the prognosis assessment and the formulation of treatment plans for patients. Moreover, quantitative analysis of T2WI signal intensity may provide a new method for preoperative preliminary assessment of the collagen fiber content in SFT.

PMID:40113429 | DOI:10.3760/cma.j.cn112152-20240810-00336

Zhonghua Zhong Liu Za Zhi. 2025 Mar 23;47(3):237-243. doi: 10.3760/cma.j.cn112152-20240529-00224.

ABSTRACT

Objective: To analysis the prevalence characteristics of cancer mortality among the elderly in Qidong City, Jiangsu Province, from 1972 to 2021, and to provide scientific basis for the development of precise prevention and control strategies for cancer in the elderly. Methods: Data of cancers were obtained from Qidong Cancer Registry, a descriptive study method was used to calculate the crude mortality rate (CMR) of cancer among the elderly (≥60 years old). The China age-standardized rate (ASR-C) was calculated using the age structure of the Chinese population in 2000, and world age-standardized rate (ASR-W) was calculated using Segi’s world standard population. Joinpoint regression analysis was performed using Joinpoint 4.9.1.0 software to calculate the annual percentage change (APC) and average annual percentage change (AAPC) of mortality. Results: From 1972 to 2021, there were 74 723 cancer deaths in the elderly in Qidong, with CMR of 752.08/10⁵, ASR-C of 666.03/10⁵ (994.22/10⁵ for males and 470.29/10⁵ for females) and ASR-W of 681.11/10⁵. The ASR-C showed little fluctuation before 2000, increased rapidly from 2001 to 2011, and then decreased from 2011 to 2021. From 2017 to 2021, the CMR was 791.01/10⁵, the ASR-C was 689.80/10⁵ (956.77/10⁵ for males and 469.98/10⁵ for females), and the ASR-W was 657.53 /10⁵. The CMR for the 60-64, 65-69, 70-74, 75-79, and 80+ age groups from 2012 to 2021 were 385.42/10⁵ 505.51/10⁵, 721.64/10⁵, 1 213.28/10⁵, and 1 705.32/10⁵, respectively. The CMR of elderly under 75 years old were lower from 2012 to 2021 than in other periods, while those of elderly people aged more than 75 years were higher from 2012 to 2021 than in other periods. The AAPC for ASR-C of all cancers over the 50 years was 0.22%, with APC of -1.59% in 2008-2021 (both P＜0.05). Over the 50 years, the top five cancers in terms of mortality were lung cancer, gastric cancer, liver cancer, colorectal cancer, and esophageal cancer. Their AAPCs of ASR-C were 1.61%, -2.36%, -0.10%, 1.44%, and -2.03%, respectively. The increasing trends of mortality rates for lung cancer and colorectal cancer and the decreasing trends for gastric cancer and esophageal cancer were statistically significant (P＜0.05). Conclusions: The mortality of cancers among elderly is at a high level in Qidong. The overall mortality since 2008 have shown a decreasing trend, and the prevention and control of some cancers have been effective.

PMID:40113424 | DOI:10.3760/cma.j.cn112152-20240529-00224

Zhonghua Zhong Liu Za Zhi. 2025 Mar 23;47(3):228-236. doi: 10.3760/cma.j.cn112152-20240110-00019.

ABSTRACT

Objective: With the aggravation of population aging, the burden of malignant tumors in the elderly population is becoming more and more heavy. This study aims to analyze the incidence and mortality of malignant tumors in the elderly population in Hebei Province in the past decade. Methods: The incidence and mortality data of malignant tumors in people aged ≥60 years old in 38 cancer registration areas in Hebei Province from 2011 to 2020 were collected, and the incidence and mortality were analyzed by gender, urban and rural areas, and age groups. The age standardized rates were calculated using the 2000 Chinese population census and Segi’s world population. The trend of incidence and mortality was analyzed using the Joinpoint model and the average annual percent change (AAPC). Results: From 2011 to 2020, 216 200 new cases of malignant tumors were reported in the elderly population in the cancer registration areas of Hebei Province, and 170 700 deaths were reported. The peak ages of incident cases number for males and females were 65-69 years old and 60-64 years old, respectively. The crude incidence rate of malignant tumors in the elderly was 905.42/10⁵, and the crude mortality rate was 714.96/10⁵. In general, the incidence and mortality in rural areas were higher than those in urban areas, and the incidence and mortality in males were higher than those in females. The peak ages of incidence and mortality were 80-84 years old and 85+ years old, respectively. From 2011 to 2020, lung cancer, gastric cancer, esophageal cancer, female breast cancer, and colorectal cancer were the main malignant tumors of incidence rate in the elderly population in Hebei Province, and lung cancer, gastric cancer, liver cancer, esophageal cancer, and colorectal cancer were the main malignant tumors in the mortality rate. From 2011 to 2020, the incidence and mortality of malignant tumors in the elderly population in Hebei Province showed a decreasing trend, and AAPC for the age-standardized incidence and mortality were -4.69% and -5.53%, respectively. The rank of incidence and mortality rate of each cancer had changed, but the top two were still lung cancer and stomach cancer. Conclusions: The incidence and mortality of cancer in the elderly population in Hebei province have decreased, but the burden is still heavy. Lung cancer and stomach cancer are still the focus of prevention and treatment in the elderly population in Hebei province.

PMID:40113423 | DOI:10.3760/cma.j.cn112152-20240110-00019

Zhonghua Yi Xue Za Zhi. 2025 Mar 25;105(12):935-938. doi: 10.3760/cma.j.cn112137-20241128-02670.

ABSTRACT

This retrospective study collected the clinical data of patients with benign prostatic hyperplasia (BPH) treated with Rezūm water vapor thermal therapy system between July 2022 and August 2024 in the Department of Urology at the Second Affiliated Hospital of Soochow University. All patients were over 80 years old with comorbid high-risk diseases. The international prostate symptom score (IPSS), quality of life (QOL) score, maximum urinary flow rate (Q_max), and post-void residual urine volume (PVR) were recorded and compared preoperatively and postoperatively at 3 and 6 months. A total of 34 patients were included, with a mean age of (85.4±5.1) years. All patients had at least two chronic diseases, including hypertension, diabetes, cardiovascular and cerebrovascular disease, and chronic obstructive pulmonary disease. Among them, 10 patients required long-term anticoagulation with aspirin and (or) clopidogrel. The differences in IPSS[(13.5±3.2) scores vs (12.6±2.2) scores], QOL score[(2.3±0.6) scores vs (2.2±0.7) scores], Q_max[(14.7±1.8) ml/s vs (15.0±1.2) ml/s], and PVR[50.0(19.0, 81.0) ml vs 45.2(17.5, 63.5) ml] at both 3 and 6 months postoperatively were not statistically significant (all P>0.05). However, statistically significant differences were observed when compared with the preoperative data (all P<0.05). The results suggest that the Rezūm water vapor thermal therapy is safe and feasible for elderly, high-risk patients with BPH, improving lower urinary tract obstruction symptoms with good short-term efficacy.

PMID:40113420 | DOI:10.3760/cma.j.cn112137-20241128-02670

Zhonghua Yi Xue Za Zhi. 2025 Mar 25;105(12):912-918. doi: 10.3760/cma.j.cn112137-20241115-02564.

ABSTRACT

Objective: To explore the construction and clinical value of a predictive model for malignant ventricular arrhythmias (MVA) in children with viral myocarditis (VMC) based on parameters of ventricular repolarization heterogeneity. Methods: We retrospectively analyzed 99 children with VMC admitted to Henan Provincial People’s Hospital from January 2019 to February 2023 as the training set, and 38 children with VMC admitted from March 2023 to May 2024 as the external validation set in a cross-sectional study. Patients were divided into MVA and non-MVA groups based on the occurrence of MVA. We measured QT interval (QT), corrected QT interval (QTc), T-wave peak-end interval (TpTe), and heart rate-corrected TpTe (TpTec) in all children using conventional electrocardiography and Holter monitoring. Multi-variate logistic regression analysis was used to identify factors influencing the occurrence of MVA in children with VMC and the efficacy of models predicting MVA with cardiac troponin I (cTnI) and different electrocardiographic parameters was evaluated using the receiver operating characteristic (ROC) curve. The predictive power of the models was internally and externally validated through C-index, Hosmer-Lemeshow goodness-of-fit test, ROC curves, and decision curve analysis. Results: There were 99 children in the training set and 38 in the external validation set, with no significant differences in age [(6.9±3.7) vs (6.9±3.4) years] and gender (boys: 46.5% vs 50.0%) between the two groups (all P>0.05). In the training set, there were 47 cases (47.5%) in the MVA group, and there were 20 cases (52.6%) in the MVA group in the external validation set. In both the training and external validation sets, there were statistically significant differences in cTnI, QTc, TpTec, and TpTe/QT between the MVA and non-MVA groups (P<0.01). TpTec [OR (95%CI): 1.123 (1.067-1.183)] and TpTe/QT [OR (95%CI): 1.026 (1.008-1.045)] were both associated with the occurrence of MVA in children with VMC. The Hosmer-Lemeshow goodness-of-fit test showed that there was no statistically significant difference between the predicted and observed values (P=0.294). The area under the ROC curve (AUC) (95%CI) for cTnI to predict MVA in VMC children was 0.651 (0.540-0.763), with a sensitivity of 0.617 and a specificity of 0.865 when the Youden’s index was maximized (2 475.000). For TpTec, the AUC (95%CI) was 0.917 (0.859-0.975), with a sensitivity of 0.723 and a specificity of 0.981 when the Youden’s index was maximized (110.500). For TpTe/QT, the AUC (95%CI) was 0.825 (0.746-0.905), with a sensitivity of 0.745 and a specificity of 0.750 when the Youden’s index was maximized (0.265). The AUC (95%CI) for the combination of TpTec and TpTe/QT was 0.939 (0.892-0.987), with a sensitivity of 0.894 and a specificity of 0.865 when the Youden’s index was maximized (0.472), which was higher than that of TpTe/QT (P<0.01). In the validation set, the accuracy and fit of the TpTec combined with TpTe/QT model were also good (P=0.800), and the AUC (95%CI) for predicting MVA was 0.992 (0.972-1.000), with a sensitivity of 0.936 and a specificity of 0.904 when the Youden’s index was maximized (0.557). Conclusions: TpTec≥110.50 ms and TpTe/QT≥0.265 indicate a potential risk of MVA in children with VMC, requiring close clinical attention. The predictive value of the combined TpTec and TpTe/QT for MVA in children with VMC is higher than that of TpTe/QT alone.

PMID:40113416 | DOI:10.3760/cma.j.cn112137-20241115-02564