Category: Statistics

Head Neck Pathol. 2025 Sep 12;19(1):109. doi: 10.1007/s12105-025-01841-8.

ABSTRACT

PURPOSE: Salivary duct carcinoma (SDC) is the most common malignancy to arise in a pleomorphic adenoma (PA). Intracapsular or non-invasive carcinoma ex PA (CXPA) is defined by the presence of malignant-appearing tumor cells within the PA that do not violate the tumor border. Knowledge regarding the possible morphologic spectrum and prognosis of intratumoral CXPA is scarce. This study aims to evaluate the morphologic, immunohistochemical, and clinical features of PAs with apocrine / salivary-duct-like intratumoral atypia.

METHODS: Surgical pathology databases were queried for in situ or intracapsular/intratumoral SDC ex PAs and PAs with atypical epithelial cells (AEC). Exclusion criteria included recurrent lesions, invasion, positive margins, atypia only in myoepithelial cells, or other morphologic variants. Chromogenic multiplex (androgen receptor (AR) and HER2) and monoplex (p40) assays were performed on all available cases, as well as on a control group of non-atypical benign PAs and overtly invasive SDCs. Clinical outcomes were recorded.

RESULTS: 96 cases were identified: 23 AEC, 6 apocrine metaplasia, 41 benign PA, 8 SDC ex PA. All AEC, apocrine metaplasia, and benign cases were treated with surgery alone, with 3 AEC cases also receiving a neck dissection. No case recurred. Five of 8 SDC ex PA recurred; 3 died of disease. AR and HER2 were respectively expressed in 96% and 22-48% of AEC; 83% and 0% of apocrine metaplasia; 51% and 0% of benign PA; and 86-100% and 38-57% of SDC ex PA. Patients had increasing average age from benign (~ 50 years) to atypical/in situ (60 years) to invasive carcinoma (~ 70 years).

CONCLUSION: The presence of epithelial atypia within a PA (ranging from isolated AR expression to apocrine metaplasia to overtly dysplastic/malignant epithelial cells) does not portend recurrence or metastasis if the atypia is confined within the borders of the adenoma and negative margins are achieved. Therefore, use of the term “in situ/intracapsular/intratumoral salivary duct carcinoma ex pleomorphic adenoma” is discouraged in light of good prognosis and potential for overtreatment by clinical teams. Nomenclature such as pleomorphic adenoma with epithelial “atypia” or “dysplasia” is recommended, followed by a comment regarding the morphologic features and likely indolent behavior.

PMID:40938457 | DOI:10.1007/s12105-025-01841-8

Arch Orthop Trauma Surg. 2025 Sep 12;145(1):447. doi: 10.1007/s00402-025-06062-w.

ABSTRACT

BACKGROUND: Shoulder dislocation is the most common major joint dislocation, with anterior dislocations accounting for 95% of cases. Accurate assessment of bony lesions, such as glenoid bone loss (GBL) and Hill-Sachs lesions, is critical for treatment planning. While computed tomography (CT) is the gold standard for evaluating bony parameters, magnetic resonance imaging (MRI) may serve as a viable alternative, offering no radiation exposure. This study aims to compare the reliability of conventional 2D (two- Dimensional)-MRI with 2D-CT in measuring bony parameters and classifying lesions as on- or off-track. It was hypothesized that there is no difference in evaluation between MRI and conventional CT scans.

METHODS: A retrospective case-control study was conducted on 61 patients (mean age 45 ± 19 years) with anterior shoulder dislocations who underwent both CT and MRI imaging. Radiographic measurements, including glenoid diameter, glenoid defect (in width), Hill-Sachs lesion and bony bridge, were obtained independently from CT and MRI scans. Patients were categorized as on- or off-track based on the glenoid track and Hill-Sachs index. Statistical analyses included correlation tests, Bland-Altman plots, interrater agreement (intraclass correlation coefficient), and sensitivity and specificity analyses for lesion classification.

RESULTS: MRI showed good agreement with CT across most parameters, with mean differences of less than 1 mm for glenoid defect, glenoid diameter, and Hill-Sachs lesions. Correlation coefficients ranged from 0.62 (bony bridge) to 0.93 (glenoid defect). Bland-Altman plots revealed good agreement for glenoid parameters but higher variance for the Hill-Sachs lesion and bony bridge. MRI correctly classified 89% of on-track lesions (sensitivity) and 76% of off-track lesions (specificity). Interrater agreement was excellent for glenoid defect measurements (ICC = 0.962) and lower for the bony bridge (ICC = 0.848).

CONCLUSION: Conventional MRI demonstrates high reliability in measuring bony parameters and good accuracy in classifying on- and off-track lesions compared to CT. MRI is a viable alternative for preoperative evaluation, particularly in cases with minor bony defects. However, in indeterminate defects, a CT scan is recommended to ensure accurate measurements, classification and treatment planning.

LEVEL OF EVIDENCE: Level III.

PMID:40938433 | DOI:10.1007/s00402-025-06062-w

Psychopharmacology (Berl). 2025 Sep 12. doi: 10.1007/s00213-025-06894-9. Online ahead of print.

ABSTRACT

BACKGROUND: The dysregulation of prefrontal synaptic transmission accompanied by γ-aminobutyric acid (GABA) deficit, is crucial in depression. Previously, we have demonstrated that Baihe Dihuang decoction with verbascoside (VB) as one of the main active ingredients attenuates prefrontal interneurons deficits through synthesis and release of GABA negatively regulated by miR-144-3p, but the potential mechanism through which VB reverses the dysfunction of stress-induced aberrant prefrontal GABAergic neurons through miRNAs/Gad-67/VGAT signaling remains elusive.

METHODS: The antidepressant effects and neuroprotective function of VB were observed by a chronic stress-induced depression and corticosterone (CORT)-stimulated nerve cell injury model, respectively. Specific changes in prefrontal GABAergic miR-144-3p expression were used to assess the action of VB acting on GABA release.

RESULTS: High-expression prefrontal miR-144-3p was associated with depression-like behaviors caused by long time stress, reflected by altered GABA tone. Supplementation with VB attenuated chronic stress-induced prefrontal cortex neuron injury and prefrontal GABAergic deficit by downregulating miR-144-3p expression, as well as obviously improved the relative abundance of beneficial GABA-producing bacteria. However, antidepressant-like effects by VB were antagonized by overexpressed miR-144-3p in frontal cortex GABAergic neurons. Similarly, VB administration caused reduced expression of miR-144-3p against impaired GABA production. In the CORT-induced nerve cell injury model, The pharmacological effect of VB promoting GABA release ability and exerting neuroprotection is strongly reversed by overexpression of miR-144-3p.

CONCLUSION: This study elucidated that miR-144-3p down-regulated GABAergic neurons activation in the medial prefrontal cortex was sufficient and necessary for VB antidepressant responses.

PMID:40938419 | DOI:10.1007/s00213-025-06894-9

Disabil Rehabil Assist Technol. 2025 Sep 12:1-15. doi: 10.1080/17483107.2025.2558215. Online ahead of print.

ABSTRACT

PURPOSE: This scoping review aimed to explore and map wheelchair outcome measurement instruments for children in the literature.

MATERIALS AND METHODS: A scoping review was conducted following the Joanna Briggs Institute (JBI) methodology. The review focused on children (≤18 years) manual or motorised wheelchair users, and included primary sources of literature on wheelchair outcome measurement instruments. A search was conducted in nine electronic databases, including grey literature. Data on general characteristics, psychometric properties (validity, reliability, responsiveness) were extracted and analysed descriptively.

RESULTS: A total of 27 studies and 33 instruments were included, mostly focused on manual wheelchair users (n=23). Performance-based outcomes instruments were the most common (n=15). Construct validity (n=19) and test-retest (n=19) were the most assessed psychometric property. Responsiveness (n=3) and intra-rater (n=3) were the least reported. The most frequently conducted statistical analyses were: minimal detectable difference (MDD) (n=12), standard error of measurement (SEM) (n = 12), intraclass correlation coefficient (ICC) (n=16) and Pearson correlation (n=9). The most common construct was propulsion perfomance in a manual wheelchair (n=6).

CONCLUSION: Wheelchair outcome measurement instruments for children mainly assess manual wheelchairs, emphasising propulsion perfomance as the primary outcome. Responsiveness and intra-rater are underreported, highlighting a gap for future research. Standardised methodologies and detailed reporting, including sample size specifications, are essential for advancing research and clinical practice.

PMID:40937612 | DOI:10.1080/17483107.2025.2558215

Public Health Rep. 2025 Sep 12:333549251358671. doi: 10.1177/00333549251358671. Online ahead of print.

ABSTRACT

OBJECTIVE: Nonfatal overdoses provide critical insights into the substance use crisis, offering opportunities for timely interventions and prevention. This study pilots a nonfatal overdose biosurveillance strategy to analyze the demographic, clinical, and toxicological profiles of overdose patients, aiming to identify patterns and risk factors associated with these incidents.

METHODS: We assessed residual urine specimens collected from emergency department patients experiencing a nonfatal overdose at 2 hospitals in Wisconsin from August 2022 through February 2024. We collected data on patient demographic characteristics, results of clinical toxicology screening, manner of overdose, risk factors for overdose, and discharge status. Statistical analyses identified associations and odds ratios (ORs) among patient characteristics, detected drugs, and discharge status.

RESULTS: Of the 79 patients in the study, many had risk factors for overdose, including substance use disorder (48%), history of a mental health condition (43%), and polysubstance use (72%). Synthetic opioids had a strong positive association with a history of overdose (OR = 3.86). The presence of stimulants and antidepressants showed moderate sex-based associations, while race was linked to differing discharge status. Polysubstance use had a positive association with some drug combinations, such as narcotic analgesics and cocaine (OR = 4.00).

CONCLUSIONS: This study highlights the prevalence of polysubstance use and identifies key demographic and clinical factors associated with nonfatal overdoses. These findings underscore the need for comprehensive, real-time biosurveillance to inform targeted public health interventions and improve patient outcomes. Enhanced understanding of these patterns can lead to more effective strategies for overdose prevention and management, addressing a critical gap in current public health approaches.

PMID:40937595 | DOI:10.1177/00333549251358671

Glob Chang Biol. 2025 Sep;31(9):e70484. doi: 10.1111/gcb.70484.

ABSTRACT

Leaf phenology, a critical determinant of plant fitness and ecosystem function, is undergoing rapid shifts due to global climate change, yet its complex genetic and environmental drivers remain incompletely understood. Understanding the genetic basis of phenological adaptation is crucial for forecasting forest responses to a changing climate. Here, we integrate multi-year satellite-derived phenology from 46 Fagus sylvatica (European beech) populations across Germany with a population-based genome-wide association study to dissect the environmental and genetic drivers of leaf-out day (LOD) and leaf shedding day (LSD). We show that environmental factors, particularly temperature forcing and water availability, are the primary drivers of LOD variation, while LSD is influenced by a more complex suite of climatic cues. Our genomic analysis identifies candidate genes associated with LOD and LSD, primarily linked to circadian rhythms and dormancy pathways, respectively. Furthermore, genomic prediction models incorporating these loci accurately reconstruct past phenological dynamics, providing a powerful framework to forecast forest vulnerability and adaptation to future climate change.

PMID:40937575 | DOI:10.1111/gcb.70484

J Med Internet Res. 2025 Sep 5;27:e74052. doi: 10.2196/74052.

ABSTRACT

BACKGROUND: Guilt proneness and shame proneness are interconnected yet distinct personality traits that are gaining attention in addiction research. However, studies examining their differential associations with internet gaming disorder (IGD) and mediation mechanisms explaining these associations remain scarce. Theoretical and empirical evidence suggests that emotional dysregulation could be a potential mediator of the associations between guilt proneness and shame proneness and IGD.

OBJECTIVE: This study aimed to investigate the associations between guilt proneness in cognitive (guilt-negative behavior-evaluations) and behavioral (guilt-repair) domains and shame proneness in cognitive (shame-negative self-evaluations) and behavioral (shame-withdrawal) domains and IGD, as well as related mediation mechanisms via emotional dysregulation.

METHODS: A multicenter, cross-sectional, anonymous online survey was conducted among medical undergraduate students in seven Chinese cities (Wenzhou, Dali, Nanning, Harbin, Baotou, Qiqihar, and Shantou) from December 2023 to February 2024. In total, 12,912 invitations were sent out, of which 8522 eligible cases were included; the mean response rate was 71.0%. The 9-item DSM-5 IGD Checklist was used to screen for IGD cases; the 16-item Guilt and Shame Proneness Scale was used to assess guilt and shame proneness; the Cognitive Emotional Regulation Questionnaire was used to assess emotional dysregulation. Univariate logistic regression analysis was conducted to examine the associations between background factors and IGD. Structural equation modeling (SEM) was performed to test the mediation mechanism, with the adjustment of background factors.

RESULTS: Of all participants, the prevalence of IGD was 7.5%. Background factors of male sex (vs female, OR 2.78, 95% CI 2.36, 3.28) and self-reported poor household financial situation (vs good, odds ratio [OR] 1.96, 95% CI 1.51, 2.55) were significantly associated with a higher risk of IGD; the associations involving study city, year of study, study major, and origin (residency) of students were statistically nonsignificant. SEM showed that shame proneness in both cognitive (β=.29, 95% CI 0.26, 0.33) and behavioral (β=.20, 95% CI 0.18, 0.22) domains and emotional dysregulation of rumination, catastrophizing, and self-blame (β=.36, 95% CI 0.32, 0.40) were positively associated with IGD, while guilt proneness in both cognitive (β=-.08, 95% CI -0.12 to -0.03) and behavioral domains (β=-0.10, 95% CI -0.14 to -0.06) was negatively associated with IGD. Furthermore, emotional dysregulation partially mediated the association between guilt proneness and shame proneness in both domains and IGD (mediation effect size ranged from 22.0% to 45.8%).

CONCLUSIONS: This study observed relatively high prevalence of IGD among medical undergraduate students in China. Furthermore, the associations between shame and guilt proneness and IGD were differential. Shame proneness and guilt proneness in cognitive and behavioral domains were both directly and indirectly (via emotional dysregulation) associated with IGD, suggesting that future intervention studies may reduce maladaptive shame proneness or shift from shame towards adaptive guilt to reduce the risk of IGD.

PMID:40937544 | DOI:10.2196/74052

J Cosmet Dermatol. 2025 Sep;24(9):e70424. doi: 10.1111/jocd.70424.

ABSTRACT

BACKGROUND: Genitourinary syndrome of menopause (GSM) is prevalent among breast cancer survivors (BCS), often exacerbated by oncologic treatments and compounded by contraindications to hormone-based therapies. Vaginal Erbium:YAG laser has emerged as a promising non-hormonal alternative, though long-term safety and efficacy data remain scarce.

METHODS: This prospective pilot study initially enrolled twelve breast cancer survivors (BCS) presenting with moderate to severe genitourinary syndrome of menopause (GSM). The study consisted of two phases: in phase 1, patients underwent 3 monthly sessions of fractional Erbium:YAG (erbium: yttrium-aluminum garnet) laser and were evaluated before the first laser and 1 month after the third session. In Phase 2, patients were evaluated 1 year after the beginning of the treatment (first laser session). Clinical evaluations were carried out at baseline and after each study phase using the Vaginal Health Index (VHI), the Female Sexual Function Index (FSFI), and a customized Symptom Intensity Questionnaire. Vaginal biopsies and cytological samples were obtained at baseline and at the end of the first phase. H&E staining, Picrosirius Red, glycogen deposits, and epithelial thickness were evaluated in all samples. A Likert scale was administered at the end of each phase to assess patient satisfaction. Statistical analyses were performed using paired t-tests, bootstrap resampling techniques, and logistic regression models to evaluate treatment outcomes and response predictors.

RESULTS: 12 patients enrolled in the study, ten completed phase one, and eight completed Phase 2. Mean VHI scores improved significantly from 10.75 ± 2.4 to 23.38 ± 3.1 (p < 0.0001). Symptom severity decreased significantly (p = 0.0078). FSFI scores showed clinical improvement (from 15.52 ± 7.20 to 25.05 ± 6.81), though not statistically significant (p = 0.0889); bootstrap and simulation analyses confirmed robustness. Histological findings indicated epithelial remodeling without adverse tissue effects. All patients gave the best satisfaction scores to the treatment (Likert = 5). No adverse events were reported.

CONCLUSIONS: Vaginal Erbium:YAG laser therapy appears to be a safe and potentially effective option for GSM management in BCS. Further randomized controlled trials are needed to validate these findings.

PMID:40937542 | DOI:10.1111/jocd.70424

Int J Comput Vis. 2025;133(9):6491-6512. doi: 10.1007/s11263-025-02492-6. Epub 2025 Jun 15.

ABSTRACT

Existing level set models employ regularization based only on gradient information, 1D curvature or 2D curvature. For 3D image segmentation, however, an appropriate curvature-based regularization should involve a well-defined 3D curvature energy. This is the first paper to introduce a regularization energy that incorporates 3D scalar curvature for 3D image segmentation, inspired by the Einstein-Hilbert functional. To derive its Euler-Lagrange equation, we employ a two-step gradient descent strategy, alternately updating the level set function and its gradient. The paper also establishes the existence and uniqueness of the viscosity solution for the proposed model. Experimental results demonstrate that our proposed model outperforms other state-of-the-art models in 3D image segmentation.

PMID:40937463 | PMC:PMC12420715 | DOI:10.1007/s11263-025-02492-6

BMJ Public Health. 2025 Sep 8;3(2):e003073. doi: 10.1136/bmjph-2025-003073. eCollection 2025.

ABSTRACT

INTRODUCTION: The WHO Housing and Health Guidelines have highlighted the impact of housing quality on cardiovascular diseases (CVDs), including pathways such as cold-induced hypertension. Major factors influencing housing quality include architectural type (detached houses vs flats) and tenure (owned vs rented), but few studies have examined their effects on CVDs.

METHODS: 46 850 occupants were included during the follow-up period from 1 January 2012 to 31 December 2017 in the Japan Gerontological Evaluation Study. By linking survey data with cause-of-death records, the Kaplan-Meier curves were constructed. Competing risk regression models were applied to calculate the subdistribution HRs (SHRs) for cardiovascular mortality risks across housing statuses, adjusted for demographics, socioeconomic factors and lifestyle behaviours. Sex-stratified analyses and Cox regression analyses were also conducted to calculate the HRs.

RESULTS: A total of 38 731 participants (46.6% men) were analysed, with a mean age of 73.6 years and a median follow-up period of 2091 days. The cardiovascular mortality rate was 3.97 per 1000 person-years, with 2.3% experiencing CVD-related deaths. The Kaplan-Meier curve indicated higher cardiovascular mortality for those living in rental flats and owned detached houses compared with those in owned flats. Competing risk regression models indicated a significantly higher risk of cardiovascular deaths among occupants living in rental flats compared with those in owned flats (SHR=1.78; 95% CI 1.05-3.02). For men, the risk was notably higher (SHR=2.32; 95% CI 1.13-4.75), though not statistically significant in women. Sensitivity analyses using Cox regression supported these findings, showing higher risk estimates for men (HR=2.36; 95% CI 1.16-4.82).

CONCLUSIONS: Rental housing and detached houses are likely to have lower temperatures and greater temperature instabilities, raising blood pressure and increasing CVDs. Improving housing quality can contribute to cardiovascular health at the population level.

PMID:40937432 | PMC:PMC12421178 | DOI:10.1136/bmjph-2025-003073