Category: Statistics

Anesth Pain Med. 2025 Apr 30;15(2):e161467. doi: 10.5812/aapm-161467. eCollection 2025 Apr 30.

ABSTRACT

BACKGROUND: This is a prospective observational study. Dexamethasone is commonly associated with postoperative hyperglycemia. There is limited data on the glycemic effect of dexamethasone among the diabetic population.

OBJECTIVES: In the current investigation, postoperative glucose levels were measured in both diabetic and non-diabetic individuals, and then a single dose of intraoperative dexamethasone was administered.

METHODS: A total of 86 participants, with ASA I/II, were categorized into two groups: Diabetic and non-diabetic. Each group consisted of 43 individuals. The participants’ ages ranged from 18 to 70 years. During the operation, a single dosage of dexamethasone, with a maximum of 8 milligrams, was provided intraoperatively. “Postoperative nausea and vomiting” (PONV), random blood glucose (RBG), and pain ratings were recorded before surgery, immediately after surgery, after 12 hours, and 24 hours following surgery. Preoperative blood glucose levels were also recorded. The “Chi-square test and the unpaired t-test” were used for comparison and to analyze the data. A significance level of P < 0.05 was deemed significant.

RESULTS: There was a statistically significant variance in RBG levels between diabetics and non-diabetics (P = 0.001). At various time periods, there was no correlation between the severity of PONV and diabetes among the participants. At various time intervals, the length of the procedure and the pain levels were equivalent to one another. In each group, there was a significant rise in RBG up to 12 hours, followed by a decline after 24 hours to a level similar to preoperative values.

CONCLUSIONS: A single dose of intraoperative “dexamethasone” was associated with transient hyperglycemia postoperatively up to 12 hours, which was more pronounced among the diabetic population and without major adverse effects like PONV in either group.

PMID:40454258 | PMC:PMC12125660 | DOI:10.5812/aapm-161467

Anesth Pain Med. 2025 Mar 11;15(2):e156544. doi: 10.5812/aapm-156544. eCollection 2025 Apr 30.

ABSTRACT

BACKGROUND: Postoperative delirium is a significant problem that deteriorates the cognitive state of patients after cardiac surgery, which can be a short- or long-term complication.

OBJECTIVES: This study was conducted to evaluate the efficacy of dexmedetomidine, commenced simultaneously with anesthesia induction and continued throughout the surgical operation, on postoperative delirium after cardiac surgery with cardiopulmonary bypass.

METHODS: This randomized, double-blind, case-control trial was conducted on sixty-one patients undergoing cardiac surgery. The patients were randomly divided into dexmedetomidine (case) and normal saline (control) groups. The primary outcome was the incidence of delirium, as screened by the Confusion Assessment Method for the ICU (CAM-ICU).

RESULTS: There was no distinction in CAM-ICU outcomes between the two groups at 6 and 24 hours postoperatively. However, the difference in non-positive CAM-ICU results was statistically significant at 24 hours for +1 and -1 Richmond Agitation-Sedation Scale scores.

CONCLUSIONS: Starting dexmedetomidine before cardiopulmonary bypass did not significantly affect the delirium rate based on CAM-ICU assessments. Further research examining larger groups is necessary to clarify the efficacy of perioperative dexmedetomidine on postoperative delirium.

PMID:40454256 | PMC:PMC12125664 | DOI:10.5812/aapm-156544

Oncol Lett. 2025 May 21;30(1):356. doi: 10.3892/ol.2025.15102. eCollection 2025 Jul.

ABSTRACT

The present study explored the impact of dual-source dual-energy CT (DECT) quantitative parameters combined with ultrasonography (US) imaging features on the diagnostic value of extrathyroidal extension in papillary thyroid carcinoma (PTC). Analysis was conducted on 136 nodules pathologically confirmed as PTCs in 102 patients who presented to the Affiliated People’s Hospital of Jiangsu University (Zhenjiang, China) between January 2018 and August 2023. All patients underwent DECT and US examinations, and the parameters for nodule examination using DECT included iodine concentration, normalized iodine concentration and energy spectrum curve slope. Gemstone spectral imaging (GSI) and US imaging features of extrathyroidal extension (ETE) and non-ETE groups were statistically examined for diagnostic usefulness. A logistic regression model was then constructed and diagnostic performance was assessed using receiver operating characteristics curves. The area under the curve (AUC) for iodine concentration in identifying ETE was 0.722, with the highest accuracy when 2.88 mg/ml was used as the diagnostic threshold. The corresponding sensitivity and specificity were 58.3 and 85.6%, respectively, with a Youden index of 0.44. The AUC for normalized iodine concentration in identifying ETE was 0.713, with the highest accuracy when 0.285 was used as the diagnostic threshold. The corresponding sensitivity and specificity were 65.7 and 78.6%, respectively, with a Youden index of 0.443. The AUC for slope of Hounsfield unit curve in identifying ETE was 0.738, with the highest accuracy when 3.4 was used as the diagnostic threshold. The corresponding sensitivity and specificity were 68.5 and 78.6%, respectively, with a Youden index of 0.471. The AUC of US (maximum longitudinal diameter >5 mm) was 0.712, with the highest accuracy when 3.845 cm was used as the diagnostic threshold. The corresponding sensitivity and specificity were 46.3 and 89.3%, respectively, with a Youden index of 0.356. The AUC for ETE identification using GSI and US morphological parameters was 0.782, with the highest accuracy when 0.762 was used as the diagnostic threshold. The corresponding sensitivity and specificity were 80.6 and 85.7%, respectively, with a Youden index of 0.663. In conclusion, the accuracy of ultrasound combined with GSI parameters in diagnosing ETE of PTC was improved when compared with that of single DECT and ultrasound morphological examinations.

PMID:40454243 | PMC:PMC12123170 | DOI:10.3892/ol.2025.15102

Front Cardiovasc Med. 2025 May 16;12:1549736. doi: 10.3389/fcvm.2025.1549736. eCollection 2025.

ABSTRACT

BACKGROUND: The optimal cannulation strategy for acute type A aortic dissection (ATAAD) surgery via a minimally invasive approach remains a topic of debate. This study aimed to compare the feasibility and safety of different aortic arch branch cannulation techniques using a single upper hemisternotomy.

METHODS: A retrospective analysis was performed on 207 patients with ATAAD who underwent total arch replacement combined with frozen elephant trunk techniques between December 2019 and July 2023. Patients were categorized into four groups based on the cannulation site: IA group (innominate artery, n = 174), LCA group (left carotid artery, n = 21), RSA group (right subclavian artery, n = 5), and RCA group (right carotid artery, n = 7). Perioperative outcomes, including mortality, complications, and operative times, were compared using appropriate statistical methods.

RESULTS: A total of 207 patients were included and categorized into four groups based on the site of arterial cannulation: IA (n = 174), LCA (n = 21), RSA (n = 5), and RCA (n = 7). Baseline characteristics, including age and preoperative comorbidities, were comparable across the groups. Intraoperative metrics, such as cross-clamp time, circulatory arrest time, selective cerebral perfusion time, and cardiopulmonary bypass (CPB) time, showed no statistically significant differences. Although the CPB time was numerically shorter in the IA group, this difference was not significant (p > 0.05). Perioperative mortality occurred in 25 patients (12.1%), with no statistically significant differences among the groups (IA: 12.6%, LCA: 0%, RSA: 20.0%, RCA: 28.6%; p > 0.05). Postoperative clinical outcomes, including ventilator support duration, ICU stay, and hospital length of stay, were also similar across all groups.

CONCLUSION: Aortic arch branch cannulation is a feasible and safe arterial perfusion strategy for ATAAD surgery via a minimally invasive single upper hemisternotomy. Among the options, the innominate artery demonstrated favorable outcomes and was not inferior to other arch vessels, and may be considered a suitable first choice when feasible.

PMID:40454235 | PMC:PMC12122429 | DOI:10.3389/fcvm.2025.1549736

JRSM Cardiovasc Dis. 2025 May 30;14:20480040251344344. doi: 10.1177/20480040251344344. eCollection 2025 Jan-Dec.

ABSTRACT

BACKGROUND: Branch pulmonary artery flow patterns in the Fontan circulation manifest oscillations reflecting venous pressure changes. The clinical importance of variation in branch pulmonary artery flow patterns and the relationship with the single ventricle performance is not understood. We describe insights gained from simultaneous hemodynamic and phase contrast magnetic resonance using interventional CMR (iCMR) in these patients.

METHOD: Twenty-seven patients with Fontan circulation referred for iCMR were studied using phase-contrast velocity mapping. The isovolumetric relaxation period (IVRT) was assessed using standard or velocity-encoded cine imaging of the atrioventricular valve (AVV) and aortic valve. We qualitatively assessed branch pulmonary artery flows considering four patterns: IVRT flow reversal, IVRT flow reaching baseline, and normal – phasic flow or continuous flow. We further collected comprehensive left and right heart iCMR hemodynamic and flow data, including pressures, aortopulmonary collateral (APC) burden, and degree of AVV regurgitation.

RESULTS: Most patients underwent extracardiac Fontan palliation and did not have significant APC burden. Cardiac cycle analysis demonstrated that flow reversal and flow reaching baseline correlated with IVRT (v-wave timing on SVC pressure). Further analysis showed statistically significant difference in pulmonary capillary wedge pressure (PCWp) v-wave (P = .008) among the described groups. Notably, patients with IVRT flow reversal pattern had higher PCWp v-wave and most had severe AVV regurgitation.

CONCLUSION: Branch pulmonary artery IVRT flow reversal and IVRT baseline patterns in patients with Fontan circulation may represent indirect signs of single ventricle poor performance and severe AVV regurgitation.

PMID:40454231 | PMC:PMC12125515 | DOI:10.1177/20480040251344344

J Asthma Allergy. 2025 May 28;18:827-834. doi: 10.2147/JAA.S513358. eCollection 2025.

ABSTRACT

OBJECTIVE: To assess the efficacy and safety of the combination of N-acetylcysteine and acebrophylline (Combination named Abiways), in patients with moderate to severe COPD and Asthma.

MATERIALS AND METHODS: In this non-randomized, interventional, prospective, single-arm, post-marketing surveillance study, participants were administered Abiways as an add-on therapy for 90 days. The primary endpoint was Quality of Life, evaluated using the COPD Assessment Test (CAT) and Asthma Control Test (ACT) questionnaires. Secondary endpoints included mean FEV1 and FVC changes. Adverse events were recorded throughout the study.

RESULTS: 97 (of 102 subjects enrolled) completed the study (76 COPD and 21 Asthma patients, respectively; mean age 57.9 ± 8.1 years; 33 females, 64 males). Overall, FEV1 improved significantly from 1.287L to 1.484L (p < 0.001) with similar statistical improvements in COPD (1.237 L to 1.414 L; p = 001) and asthma (1.477 L to 1.747 L; p = 0.004) subpopulations. COPD patients showed statistically significant improvements in CAT scores (17.2 ± 1.0 to 10.6 ± 0.9, p = 0.0001); however, such significance was not observed in the ACT scores for asthma patients. FVC remained unchanged in all subgroups. No severe adverse events were reported.

CONCLUSION: The combination of N-acetylcysteine and acebrophylline improves QoL in moderate to severe COPD patients and FEV1 in both COPD and asthma patients with a favorable safety and tolerability profile. The combination appears safe and effective for managing obstructive airway disease.

PMID:40454226 | PMC:PMC12126983 | DOI:10.2147/JAA.S513358

Front Aging Neurosci. 2025 May 16;17:1595336. doi: 10.3389/fnagi.2025.1595336. eCollection 2025.

ABSTRACT

BACKGROUND: The patient’s somatic health status plays an important role in the factors predisposing to the development of depression. Any disease, especially a chronic one, often associated with pain, may contribute to the development of depression. The aim of the study was to assess the impact of functional capacity on the occurrence of depression among elderly cancer patients.

METHODS: The work used the diagnostic survey method and survey technique research tool consisted of standardized questionnaires: the Nurses’ Observation Scale for Geriatric Patients (NOSGER), the Barthel scale, and the Geriatric Depression Scale (GDS). The authors conducted the study among 110 older adults patients with hospitalized at the Lublin Region Oncology Center in 2022.

RESULTS: When assessing patients using the NOSGER scale, the average result for the entire group was 45.98 ± 12.58 points. The examined people functioned best in terms of memory – average of 5.99 ± 1.32 points. The worst functioning was in the instrumental activities of everyday life – average 9.16 ± 3.61 points. In the assessment of the functional status using the Barthel scale, 54.54% of the respondents were classified as light. Based on the assessment of patients using the GDS scale, it was found that as many as 66.36% of the respondents did not experience symptoms of depression. The regression model showed that the NOSGER scale was a statistically significant variable explaining the geriatric depression scale score in the study group (p < 0.001).

CONCLUSION: Most respondents were fully functional. The surveyed seniors suffering from cancer had the greatest difficulties in the areas of moods and emotions as well as instrumental activities of everyday life. The occurrence of depression symptoms was found in over 30.00% of respondents. It is advisable to use research tools that take into account a wider range of aspects when assessing the impact of functional capacity on the possibility of depression among geriatric patients with cancer.

PMID:40454204 | PMC:PMC12122436 | DOI:10.3389/fnagi.2025.1595336

J Travel Res. 2025 Jul;64(6):1449-1463. doi: 10.1177/00472875241253009. Epub 2024 May 31.

ABSTRACT

Practical measures to entice tourists to behave in environmentally sustainable ways are urgently needed. The effectiveness of such measures is typically tested in survey experiments. This study demonstrates that this approach can be misleading. We test two messages aimed at reducing buffet food waste. One builds on established theories of human behavior (theory of planned behavior, value-belief-norm theory); it assumes that changing beliefs by providing information triggers behavior change. The second message builds on hedonic psychology; it attempts to change behavior through humor, presenting the pro-environmental behavior as enjoyable. In the survey experiment, the belief-based message significantly increases intentions to reduce plate waste; but both messages fail to change behavior in a real hotel. These insights have methodological and practical implications: the effectiveness of new practical measures developed to trigger specific tourist behaviors must be tested in the field before reliable managerial recommendations can be derived.

PMID:40454195 | PMC:PMC12121902 | DOI:10.1177/00472875241253009

J Diabetes Metab Disord. 2025 May 30;24(1):131. doi: 10.1007/s40200-025-01605-9. eCollection 2025 Jun.

ABSTRACT

OBJECTIVES: Trimethylamine N-oxide (TMAO) is related to the pathogenesis of Metabolic dysfunction-associated fatty liver disease (NAFLD). However, the molecular mechanism of how TMAO causes MAFLD development is still unclear. The present study attempted to investigate whether TMAO contributes to MAFLD development through HULC in a cellular model of MAFLD.

METHODS: HepG2 cells were cultured and induced in a fatty liver cell model. HULC knockdown was induced using the CRISPR/Cas13 system. Fatty liver cells were exposed to TMAO concentrations (75µM and 300µM) before and after HULC knockdown. RT-qPCR was used to evaluate the expression of the target genes. Apoptosis was assessed using Annexin V-FITC and PI staining. Statistical analyses included ANOVA and post-hoc tests.

RESULTS: TMAO upregulated the expression of HULC, followed by P38MAPK overexpression (P value < 0.05). Upon HULC knockdown, TMAO could not change P3MAPK expression and its downstream targets, including TNFα, IL-6, and PNPPLA3 in fatty liver cells. Additionally, TMAO significantly induced apoptosis in the fatty acid cellular model (P value < 0.05).

CONCLUSION: In conclusion, the results of this study provide evidence of the TMAO/HULC/P38MAPK axis involvement in the pathogenesis of MAFLD by increasing the expression of genes involved in inflammation and fibrosis. Our data suggests that TMAO reduction could be a therapeutic target in MAFLD through gut microbiome modulation.

PMID:40454183 | PMC:PMC12125414 | DOI:10.1007/s40200-025-01605-9

Stat Biosci. 2025;17(2):528-554. doi: 10.1007/s12561-024-09429-6. Epub 2024 May 9.

ABSTRACT

Nearly 15% (37 million) of adults in the United States (US) have chronic kidney disease (CKD). The longitudinal decline of kidney function is intricately related to the development of cardiovascular disease (CVD) and eventual “terminal” event (kidney failure and mortality) in patients with CKD. Understanding the mechanism and risk factors underlying the three key outcome processes, (1) CKD progression, (2) CVD, and (3) subsequent terminal event in the CKD patient population remains incomplete. Thus, in this work, we develop a novel trivariate joint model to study the risk factors associated with the interdependent outcomes of kidney function (as measured by longitudinal estimated glomerular filtration rate), recurrent cardiovascular events, and the terminal event. Efficient estimation and inference is proposed within a Bayesian framework using Markov Chain Monte Carlo and Bayesian P-splines for hazard functions. The proposed Bayesian framework is directly generalizable beyond trivariate outcome processes to accommodate other potential modeling of complex multi-disease processes. The method is applied to study the aforementioned trivariate processes using data from the Chronic Renal Insufficiency Cohort Study, an ongoing prospective cohort study, established by the National Institute of Diabetes and Digestive and Kidney Diseases to address the rising epidemic of CKD in the US.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12561-024-09429-6.

PMID:40454178 | PMC:PMC12122633 | DOI:10.1007/s12561-024-09429-6