Category: Statistics

Discov Ment Health. 2025 Apr 1;5(1):45. doi: 10.1007/s44192-025-00175-9.

ABSTRACT

OBJECTIVE: This study examined the prevalence and severity of burnout and depression in first-year medical students at different points in the academic year.

METHODS: U.S. first-year allopathic medical students with a pass/fail preclinical curriculum were emailed through the school’s email list with four rounds of surveys consisting of the full set of questions from the Copenhagen Burnout Inventory and the Patient Health Questionnaire-9, with the question order randomized. The surveys were sent before winter break, during block final exams, the subsequent block’s midpoint, and after the subsequent block’s midterm examinations.

RESULTS: A total of 147 students completed the questionnaire (29.4%; n = 147/500). Most participants (73.5%) reported experiencing symptoms of work-related burnout, and 44.2% reported symptoms of depression. Client-related burnout and PHQ-9 scores were strongly correlated (Spearman r = 0.645, p < 0.001). Work-related burnout was also strongly related to client-related burnout (r = 0.739, p < 0.001) and PHQ-9 scores (r = 0.786, p < 0.001). No statistically significant differences in depression or burnout were noted throughout all four survey rounds.

CONCLUSIONS: Burnout and depression severity in first-year medical students remain statistically similar throughout the academic year despite significant events such as exams or breaks. This may indicate that scheduling exams after breaks reduces any protective effect it may have on burnout/depression. It may also suggest that institutional changes such as a pass-fail preclinical curriculum meant to improve medical students’ mental health have not had the intended positive effect.

PMID:40167940 | DOI:10.1007/s44192-025-00175-9

Radiol Med. 2025 Apr 1. doi: 10.1007/s11547-025-01993-1. Online ahead of print.

ABSTRACT

BACKGROUND: Perineural invasion (PNI) is closely related to the prognosis of gastric cancer (GC) patients. However, a noninvasive tool for accurately and reliably predicting the PNI is lacking.

METHODS: The clinical and imaging data of 278 patients from institution I and 39 patients from institution II were retrospectively analyzed. Radiomic features were extracted from the intratumoral and peritumoral regions. Seven independent machine learning (ML) algorithms are used to develop the models. Kaplan-Meier survival analysis and Cox proportional hazards analysis were carried out to compare 3-year and 5-year overall survival (OS) differences among various subgroups based on PNI and radiomic scores.

RESULTS: T stage and lymphovascular invasion (LVI) were significantly correlated with the PNI (P < 0.01). The OS of patients with different PNI status was significantly different (P < 0.05). Gradient boosting tree is the best ML algorithm. The area-under-the-curve (AUC) values of the optimal radiomics model in the internal test set and external test set were 0.901 and 0.886, respectively. After the introduction of clinical variables T stage and LVI, the performance of the model further improved in predicting the PNI of GC patients, with the AUC of 0.904 in the internal test set and 0.886 in the external test set. The difference in 3-year OS (P = 0.005) and 5-year OS (P = 0.015) among patients with varying radiomic scores was statistically significant.

CONCLUSION: Radiomics combined with intratumoral and peritumoral features is feasible for evaluating the PNI of GC patients. The prognosis of patients with different radiomic scores was statistically significant.

PMID:40167935 | DOI:10.1007/s11547-025-01993-1

Radiol Med. 2025 Apr 1. doi: 10.1007/s11547-025-01986-0. Online ahead of print.

ABSTRACT

PURPOSE: To use simple CT measurements of musculoskeletal and cardiovascular systems to create a CT-based score to predict mortality in patients admitted to the Emergency Department (ED).

METHODS: The study received IRB approval. Non-contrast abdominal CT of > 18 year old patients admitted to the ER between January 2019 and January 2020 were evaluated by a team of twelve radiologists to calculate: (1) diameter of the infrarenal aorta in millimeter; (2) cross sectional area and composition (Hounsfield units) of the psoas muscle at the third lumbar vertebra (LV); (3) bone density, as quantified at the first lumbar vertebra (LV); (4) presence or absence of dilated abdominal aorta. Thirty-day all-cause mortality (ACM) was determined through hospital and electronic records.

RESULTS: N = 1920 unique patients were evaluated. The mean age was 65 ± 19 years and 46% were female. Death occurred in 7.9% of patients by 30 days from admission. The derivation dataset comprised 1462 patients. At multivariable analysis, age (OR 1.02, 95% CI: 1.007-1.04, p = 0.005), psoas cross sectional area (OR 0.99, 95% CI: 0.997-0.999, p < 0.001) and density (OR 0.96, 95% CI: 0.95-0.98, p < 0.001), and dilated infrarenal aorta (OR 1.85, 95% CI: 1-3.28, p = 0.04) were predictors of the outcome. We accordingly derived a 4-item risk score. In the derivation dataset, the score yielded moderate-high discrimination, with an AUC of 0.73 and excellent diagnostic agreement. In the validation dataset (N = 458), discrimination was high (AUC = 0.83).

CONCLUSION: Simple measurements gathered during a standard CT may allow determining the risk of mortality in the heterogeneous patient population admitted to the ED in a cost- and time-effective manner.

PMID:40167933 | DOI:10.1007/s11547-025-01986-0

Int Ophthalmol. 2025 Apr 1;45(1):136. doi: 10.1007/s10792-025-03514-5.

ABSTRACT

PURPOSE: Twitter has become increasingly popular within academia due to ease of use in disseminating accurate medical information, networking with colleagues, and promoting research. Given the rapidly increasing presence of ophthalmologists on social media platforms, we determined how Twitter patterns amongst authors, institutions, and journals affects the academic impact of ophthalmology research articles.

METHODS: Data from 1086 research articles in the top 7 ophthalmology journals as determined by SCimago Journal Rank (SJR) was recorded for 2021 issues. Article citations, article captures, and Twitter metrics were retrospectively recorded using the Scopus database and PlumX Metrics on Scopus.

RESULTS: The number of citations and captures original research articles received had a significant positive correlation with the total tweets and retweets in general as well as self-tweets by authors of the article (p < 0.0001). Furthermore, articles tweeted by at least one author had a 1.7 fold increase in citations (p = 0.0012). While there was no significant effect on citations when a senior author or middle author tweeted about the publication, we observed a significantly greater number of citations when a first author tweeted about the publication (p = 0.0329). Both the author’s affiliated institution and the journal tweeting about a publication were associated with more citations for that article (p < 0.0001 and p = 0.0025, respectively) and captures for that article (p < 0.0001 and p = 0.0025, respectively).

DISCUSSIONS: Twitter mentions of ophthalmology articles may reflect their future academic impact. Authors of recent ophthalmology publications, ophthalmology journals, academic institutions may benefit from promoting research articles on Twitter to increase visibility and citations.

PMID:40167899 | DOI:10.1007/s10792-025-03514-5

J Cancer Educ. 2025 Apr 1. doi: 10.1007/s13187-025-02614-1. Online ahead of print.

ABSTRACT

The aim of the present work was to conduct a descriptive cross-sectional study that consisted on the assessment of videos published in the social platform TikTok about HPV, and its appearance in the head and neck. The first 100 Spanish-language videos suggested by TikTok were selected, as well as the first 100 videos in English. To assess the reliability of the videos, the Modified DISCERN tool was utilized-Global Quality Score (GQS) for quality and modified DISCERN for reliability. Statistically significant differences were found between the variables language, with a significant relationship with objective (p = 0.01), current information (p < 0.01), and balance and objectivity (p = 0.01). The duration of the video was significantly related with the objective (p < 0.01) and clarity and understanding (p < 0.01), but not with other metrics such as the source of information (p = 0.87), or balance and objectivity (p = 0.92). The HPV contents must be verified by experts to avoid the propagation of incorrect information. There is little information available online about the relationship between oropharyngeal cancer and the human papillomavirus (HPV), which makes it difficult to access trustworthy and current resources about the subject.

PMID:40167892 | DOI:10.1007/s13187-025-02614-1

EJNMMI Res. 2025 Apr 1;15(1):31. doi: 10.1186/s13550-025-01226-6.

ABSTRACT

BACKGROUND: This study evaluated mid-treatment changes in intra-tumoural metabolic heterogeneity and quantitative FDG-PET/CT imaging parameters and correlated the changes with treatment outcomes in oropharyngeal squamous cell cancer (OPSCC) patients. 114 patients from two independent cohorts underwent baseline and mid-treatment (week 3) FDG-PET. Standardized uptake value maximum (SUV_max), standardized uptake value mean (SUV_mean), metabolic tumour volume (MTV), and total lesional glycolysis (TLG) were measured. Intra-tumoural metabolic heterogeneity was quantified as the area under a cumulative SUV-volume histogram curve (AUC-CSH). Baseline and relative change (%∆) in imaging features were correlated to locoregional recurrence free survival (LRRFS) using multivariate Cox regression analysis. Patients were stratified into three risk groups utilising ∆AUC-CSH and known prognostic features, then compared using Kaplan-Meier analysis.

RESULTS: Median follow up was 39 months. 18% of patients developed locoregional recurrence at 2 years. A decrease in heterogeneity (∆AUC-CSH: 24%) was observed mid-treatment. There was no statistically significant difference in tumour heterogeneity (AUC-CSH) at baseline (p = 0.134) and change at week 3 (p = 0.306) between p16 positive and p16 negative patients. Baseline imaging features did not correlate to LRRFS. However, ∆MTV (aHR 1.04; 95% CI 1.03-1.06; p < 0.001) and ∆AUC-CSH (aHR 0.96; 95% CI 0.94-0.98; p = 0.004) were correlated to LRRFS. Stratification using ∆AUC-CSH and p16 status into three groups showed significant differences in LRR (2 year LRRFS 94%, 79%, 17%; log rank p < 0.001). Stratification using ∆AUC-CSH and ∆MTV into three groups showed significant differences in LRR (2 year LRRFS 93%, 70%, 17%; log rank p < 0.001).

CONCLUSION: Mid-treatment changes in intra-tumoural FDG-PET/CT heterogeneity correlated with treatment outcomes in OPSCC and may help with response prediction. These findings suggest potential utility in designing future risk adaptive clinical trials.

PMID:40167887 | DOI:10.1186/s13550-025-01226-6

Pharmacol Rep. 2025 Apr 1. doi: 10.1007/s43440-025-00719-4. Online ahead of print.

ABSTRACT

BACKGROUND: The lack of information on drug-drug interactions in the pediatric population significantly complicates making effective therapeutic decisions. Our study aimed to analyze the rate and risk factors as well as present potential drug-drug interactions (pDDIs) specifically for pediatric patients from the pediatric hemato-oncologic unit, including acute lymphoblastic leukemia (ALL) patients.

METHODS: We conducted a six-month prospective study in which clinical pharmacists examined medical records once a week to look for pDDIs using the Lexicomp^® Drug Interactions Checker. Spearman’s rank coefficient, logistic regression, and the U-Mann-Whitney test were used to identify correlations, analyze risk factors for pDDIs, and compare ALL patients with non-ALL patients, respectively. Recommendations were provided for the D and X pDDIs categories.

RESULTS: We identified 507 pDDIs in 119 screened patients, 388 of which were clinically relevant. Nearly 68% of the patients were exposed to at least one significant interaction. The number of pDDIs was positively correlated with the number of medications (r_s=0.75, p < 0.001), off-label used drugs (r_s=0.42, p < 0.001), comorbidities (r_s=0.21, p = 0.019), and hospitalization length (r_s=0.48, p < 0.001). The multivariate analysis revealed that at least 7 administered medications (OR = 8.63; 95% CI = 2.92-25.47) and 13 days in the hospital (OR = 3.47; 95% CI = 1.31-9.19) were risk factors for pDDIs. Furthermore, patients treated for ALL represent an at-risk group with a statistically higher number of drugs taken and pDDIs identified.

CONCLUSIONS: Limited data on drug-drug interactions in the pediatric population emphasizes the need for close collaboration between clinical pharmacists and clinicians to improve the safety and effectiveness of pharmacotherapy.

PMID:40167877 | DOI:10.1007/s43440-025-00719-4

Int Ophthalmol. 2025 Apr 1;45(1):137. doi: 10.1007/s10792-025-03511-8.

ABSTRACT

OBJECTIVE: This study aimed to investigate the effects of recombinant plasmid heat shock protein 47 small interfering ribonucleic acid (HSP47-siRNA) on fibroblast proliferation and collagenous fibre synthesis in the filtering channel after trabeculectomy in rabbit.

METHODS: The recombinant plasmid HSP47-siRNA was constructed successfully to extract sufficient recombinant plasmids. Furthermore, an animal model of anti-glaucoma surgery in rabbit eyes was created to establish the HSP47-siRNA group, empty vector group, mitomycin C (MMC) group and normal saline group. This study further observed the postoperative eye condition, measured the intraocular pressure and carried out histological and immunohistochemical staining analysis.

RESULTS: At different time points after surgery, there were no significant differences in the comparison of filtering bleb morphology, conjunctival congestion, corneal oedema, inflammation and depth of anterior chamber or lens opacity among the HSP47-siRNA, empty vector, MMC and normal saline groups. Within 7 days after surgery, filtering blebs in all groups were bulged and diffused, with no statistically significant difference (p > 0.05). On day 15 and day 30 after surgery, the upper filtering bleb gradually decreased in the empty vector group and the normal saline group compared with the HSP47-siRNA group (p < 0.01). On day 30 after surgery, flat and pale scar tissues were observed in the surgical area of the empty vector and normal saline groups, whereas functional blebs were still observed in the HSP47-siRNA and MMC groups. Within 7 days after surgery, the intraocular pressure significantly decreased in each group, with a statistically significant difference compared with that before surgery (p < 0.01).

CONCLUSION: HSP47-siRNA exhibits application potential concerning its effects on anti-scarring after glaucoma filtration surgery in rabbit.

PMID:40167871 | DOI:10.1007/s10792-025-03511-8

Neurosurg Rev. 2025 Apr 1;48(1):343. doi: 10.1007/s10143-025-03471-8.

ABSTRACT

External ventricular drainage (EVD) is a mainstay for intraventricular hemorrhage (IVH) treatment, improving ventricular clearance and reducing mortality but with suboptimal complications and morbidity. Meanwhile, several studies have shown that neuroendoscopic drainage (NED) provides superior results and is a promising therapy. Thus, we aimed to compare NED and EVD in patients with IVH. A systematic literature review was conducted using Embase, PubMed, and Cochrane databases. The primary outcome was shunt dependency. Secondary outcomes were infection, length of intensive care unit (ICU) and hospital stay, mortality, and functional outcome. Inclusion criteria: studies comparing NED and EVD with predefined outcomes. Exclusion criteria: age < five years. Statistical analysis was performed using RStudio 2024.04.1 + 748. Sensitivity analysis was performed with subgroup analysis. The risk of bias was assessed using ROBINS-I and RoB-2. Of 234 potential articles, 17 met our criteria, involving 1043 patients, with 495 undergoing NED and 548 receiving only EVD. Patients who underwent NED had lower odds of shunt dependency (OR 0.17; 95% CI 0.12,0.25; p < 0.001), infection (OR 0.29; 95% CI 0.16,0.53; p < 0.001), and mortality at one month (OR 0.44; 95% CI 0.20,0.96; p = 0.039) and six months (OR 0.31; 95% CI 0.16,0.58; p < 0.001), shorter hospital (MD -6.02; 95% CI -9.58,-2.45; p < 0.001) and ICU stay (MD -6.64; 95% CI -10.46,-2.83; p < 0.001), and better functional outcomes according to Glasgow Outcome Scale (MD -0.65; 95% CI -0.98,-0.32; p < 0.001) and modified Rankin Scale (MD -1.25; 95% CI -1.90,-0.60; p < 0.001) compared to patients who underwent EVD. To confirm the robustness of the results, we performed sensitivity analyses with subgroups of the RCT, which also showed significant superiority of NED over EVD. Our results suggest that NED has a positive impact on patients with IVH and may be a breakthrough intervention in this scenario.

PMID:40167864 | DOI:10.1007/s10143-025-03471-8

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Apr;39(4):368-375. doi: 10.13201/j.issn.2096-7993.2025.04.014.

ABSTRACT

Objective:To investigate the incidence of collateral circulation in high-risk patients with sleep apnea and stroke treated by continuous positive airway pressure （CPAP） ventilation and to analyze the influencing factors. Methods:A total of 152 patients diagnosed with obstructive sleep apnea-hypopnea syndrome （OSAHS） combined with acute ischemic stroke （AIS） who were admitted to our hospital from January 2020 to June 2022 were selected for this study. Based on the apnea-hypopnea index （AHI）, the patients were divided into three groups: mild （n=44）, moderate （n=72）, and severe （n=36）. After treatment, the patients were further classified into a group without collateral circulation （n=30） and a group with collateral circulation （n=26）, which included those with moderate collateral circulation （n=69） and good collateral circulation （n=27）. Clinical data across the different groups were compared, and multiple factor analysis was performed to identify factors affecting the occurrence of collateral circulation. Results:The AHI and IL-6 levels in the severe group were significantly higher than those in the mild and moderate groups, while the levels of NO and PO2 were significantly lower in the severe group compared to the mild and moderate groups, with statistically significant differences among the three groups （P<0.05）. After treatment, all groups showed improvement, and the proportion of patients with collateral circulation was 84.09% in the mild group, 81.94% in the moderate group, and 72.22% in the severe group. Significant differences in age, AHI, NIHSS, NO, MoCA, and MMSE scores were observed between the groups with and without collateral circulation （P<0.05）. In the group with collateral circulation, the scores for age, AHI, and NIHSS in the good collateral circulation subgroup were significantly lower than those in the poor collateral circulation and moderate collateral circulation subgroups, while the scores for NO, MoCA, and MMSE were significantly higher in the good collateral circulation subgroup. Multi-factor analysis revealed that age, AHI, and NIHSS were independent risk factors for collateral circulation, whereas NO, MoCA, and MMSE served as protective factors that were negatively correlated with collateral circulation. Classification tree model results indicated that AHI had the greatest influence on the occurrence of collateral circulation among the five influencing factors, demonstrating good predictive capability. Conclusion:Most high-risk patients with sleep apnea and stroke are likely to develop collateral circulation following continuous positive airway pressure ventilation. Factors such as age, AHI, NIHSS, NO, MoCA, and MMSE are important determinants affecting the occurrence of collateral circulation.

PMID:40166881 | DOI:10.13201/j.issn.2096-7993.2025.04.014