Category: Statistics

J Comput Assist Tomogr. 2024 Nov 13. doi: 10.1097/RCT.0000000000001685. Online ahead of print.

ABSTRACT

OBJECTIVE: Discriminating between hemorrhage and iodine extravasation can pose challenges in conventional computed tomography (CCT) images following preoperative embolization for meningioma. This study aimed to assess the efficacy of dual-energy computed tomography (DECT) in differentiating hemorrhage from iodine extravasation after preoperative embolization for meningioma.

METHODS: Twenty-one consecutive meningioma patients who underwent CCT before and DECT immediately after preoperative embolization were included in this study. Two independent observers conducted qualitative assessments on CCT and virtual noncontrast (VNC) images and iodine maps (IMs) to differentiate between hemorrhage and iodine extravasation. One observer recorded CT values of hemorrhage and iodine extravasation on CCT and VNC images. The ratio of maximum attenuation to minimum attenuation on VNC images was defined as the VNC ratio. Statistical analysis included Kappa (κ) statistics, unpaired t tests, and receiver operating characteristic (ROC) analysis.

RESULTS: Interobserver agreement for qualitative assessment was fair (κ = 0.231) for CCT alone and good (κ = 0.723) for CCT plus VNC imaging and IM. The addition of VNC imaging and IM to CCT improved differential confidence in 16 (76%) and 18 (86%) cases of the two observers, respectively, increasing the area under the receiver operating characteristic curve (AUROC) from 0.868 to 0.895 and 0.658 to 0.947, respectively. At a cutoff value of 1.527, the VNC ratio was significantly higher for hemorrhage than iodine extravasation (P < 0.05), with the highest diagnostic performance (AUROC, 1).

CONCLUSIONS: DECT with VNC imaging and IM is useful for differentiating hemorrhage from iodine extravasation in meningiomas with preoperative embolization.

PMID:39761489 | DOI:10.1097/RCT.0000000000001685

J Comput Assist Tomogr. 2024 Nov 13. doi: 10.1097/RCT.0000000000001642. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of the study is to assess the diagnostic performance of quantitative analysis of diffusion-weighted imaging in assessing treatment response in cervical cancer patients.

METHODS: A retrospective analysis was done for 50 patients with locally advanced cervical cancer who received concurrent chemoradiotherapy and underwent magnetic resonance imaging and diffusion-weighted imaging. Treatment response was classified into 4 categories according to RECIST criteria 6 months after therapy completion. Apparent diffusion coefficient (ADC) values were measured using both region of interest (ROI) ADC and whole lesion (WL) ADC histogram for all cases at both baseline pretreatment and posttreatment Magnetic resonance imaging studies. Changes in ADC values were calculated and compared between groups.

RESULTS: The percentage change of ROI-ADCmean at a cutoff value of >20 had excellent discrimination of responders versus nonresponders, while the percentage change of WL-ADCmean, ADCmin, and ADCmax at cutoff values of >12.5, >35.8, and > 19.6 had acceptable discrimination of responders versus nonresponders. Logistic regression analysis revealed that only baseline WL ADCmin was a statistically significant independent predictor of response. Cancer cervix patients with baseline ADCmin < or equal to 0.73 have 12.1 times higher odds of exhibiting a response.

CONCLUSIONS: The percentage change of ROI-ADCmean and WL histogram ADCmean values after concurrent chemoradiotherapy can predict response. Pretreatment WL histogram ADCmin was a statistically significant independent predictor of posttherapy response.

PMID:39761488 | DOI:10.1097/RCT.0000000000001642

J Comput Assist Tomogr. 2024 Nov 18. doi: 10.1097/RCT.0000000000001694. Online ahead of print.

ABSTRACT

BACKGROUND: The latest generation of computed tomography (CT) systems based on photon-counting detector promises significant improvements in several clinical applications, including chest imaging.

PURPOSE: The aim of the study is to evaluate the image quality of ultra-high-resolution (UHR) photon-counting detector CT (PCD-CT) of the lung using four sharp reconstruction kernels.

MATERIAL AND METHODS: This retrospective study included 25 patients (11 women and 14 men; median age, 71 years) who underwent unenhanced chest CT from April to May 2023. Images were acquired in UHR mode on a clinical dual-source PCD-CT scanner and reconstructed with four sharp kernels (Bl64, Br76, Br84, Br96). Quantitative image analysis included the measurement of image noise, and the calculation of signal-to-noise ratio, and contrast-to-noise ratio. Two radiologists independently rated the images on a 5-point Likert scale for image sharpness, image noise, overall image quality, and airway details. The 4 image sets were compared pairwise in the statistical analysis.

RESULTS: Image noise was lowest for Br76 (74.16 ± 22.05, P < 0.001). Signal-to-noise ratio was significantly higher in the Br76 images (13.34 ± 3.47), than in the other 3 image sets (all P < 0.001). The Br76 images demonstrated the highest contrast-to-noise ratio among all reconstructions (1.54 ± 0.86, all P < 0.001). Subjective image sharpness, image noise, overall image quality, and airway detail were best in the Br76 images (all P < 0.001 to P < 0.01, for both readers).

CONCLUSIONS: The use of the Br76 reconstruction kernel provided the best quantitative and qualitative image quality for UHR PCD-CT of the lungs.

PMID:39761487 | DOI:10.1097/RCT.0000000000001694

Harv Rev Psychiatry. 2025 Jan-Feb 01;33(1):1-7. doi: 10.1097/HRP.0000000000000414.

ABSTRACT

LEARNING OBJECTIVE: After participating in this CME activity, the psychiatrist should be better able to:• Explain current understanding of the relationship between chronic benzodiazepine use and dementia.

BACKGROUND: Chronic use of benzodiazepines (BZ) for managing conditions such as anxiety disorders, depression, sleep disorders, and other chronic diseases is widespread; yet, there is considerable controversy regarding its potential links to dementia risk. This systematic review and meta-analysis aims to clarify this relationship by synthesizing and analyzing the available evidence to provide a clearer understanding of whether prolonged BZ use contributes to developing dementia.

METHODS: This study adheres to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered with PROSPERO to ensure methodological rigor and transparency. The research strategy incorporated terms such as “benzodiazepines” OR “benzodiazepine” AND “cognitive dysfunction” OR “dementia” AND “adult” OR “elderly” OR “aged.” We included prospective and retrospective observational studies, as well as case-control studies. Data were meticulously extracted regarding chronic BZ use and dementia risk. Each study’s risk of bias was assessed to ensure result validity. Statistical analysis was performed using hazard ratios (HR) as the primary meta-analysis summary measure to provide a precise evaluation of associated risk.

RESULTS: Analysis of five studies showed that chronic BZ use was associated with a nonsignificant risk of dementia-without specification of cause-with an HR of 1.17 (95% CI: 0.96-1.43). Regarding Alzheimer’s disease, three studies found no significant association with an HR of 1.00 (95% CI: 0.87-1.15).

CONCLUSIONS: Our findings did not reach statistical significance, suggesting no strong link between chronic BZ use and dementia. Further research is needed to clarify this potential association.

PMID:39761441 | DOI:10.1097/HRP.0000000000000414

Top Stroke Rehabil. 2024 Dec 30:1-11. doi: 10.1080/10749357.2024.2448392. Online ahead of print.

ABSTRACT

AIMS: To investigate the association between pre-stroke frailty and discharge destination in hospitalized older adults in China.

METHODS: We conducted this prospective cohort study in a tertiary care hospital in China. We enrolled patients aged 60 years and older admitted to the hospital for acute stroke from January 2022 to May 2022. We used telephone tracking to record the destination of participants after discharge. Generalized estimating equations were used to determine the association between pre-stroke frailty and post-discharge destination.

RESULTS: Among the 230 participants enrolled, the prevalence of pre-stroke frailty was 75.2% and about 75.7% of participants chose to go home at discharge. 70.5% of pre-stroke frail patients chose to go home, compared with 91.2% for non-pre-stroke frail patients. The generalized estimating equation showed a statistical difference between the frailty and non-frailty groups in the post-discharge destination of acute stroke patients between different time points (Waldχ² 36.428 and 13.893, P < 0.001 and 0.008, respectively). After adjustment for the group, the model showed an interaction effect of time and pre-stroke frail status on the post-discharge destination (P < 0.001). The results confirm the importance of pre-stroke frail status in predicting patients’ post-discharge outcomes.

CONCLUSIONS: Pre-stroke frailty is related to the post-discharge destination and stroke prognosis in elderly Chinese. For Chinese families, most acute stroke patients choose to go home when they are discharged from the hospital, even those who are frail before acute stroke occurs. Further research is needed to confirm this finding and to actively intervene in the pre-stroke frail population.

PMID:39761425 | DOI:10.1080/10749357.2024.2448392

Comput Inform Nurs. 2025 Jan 6. doi: 10.1097/CIN.0000000000001247. Online ahead of print.

ABSTRACT

End-of-program predictive examinations have been in existence in nursing education for over 10 years. Nursing schools have used these examinations to prepare students on the testable content from National Council of State Boards of Nursing (NCSBN), which has been delivering the NCLEX-RN since 1994. Nursing students, in the final semester of the nursing program, took the Predictable Ability Measurement Readiness (PAMR) 1 and/or 2. The 100-question exam was developed by nursing subject matter experts following the 2019 NCLEX-RN blueprint content, item types, and scoring. The PAMR scores were examined and compared with the results of the nursing students on the NCLEX-RN. Statistical analysis revealed that the students who passed the NCLEX-RN on their first attempt had higher scores on the PAMR1. A cut-point scale using regression modeling was developed to determine a minimal score compared with the probability of passing NCLEX-RN. Nursing faculty have a reliable and predictable exam to use to prepare students to take the NCLEX-RN. The PAMR 1 and 2 have demonstrated the ability to predict passing on the NCLEX-RN and can be used confidently in nursing programs for licensure examination preparation.

PMID:39761389 | DOI:10.1097/CIN.0000000000001247

Diabetes. 2025 Jan 6:db240380. doi: 10.2337/db24-0380. Online ahead of print.

ABSTRACT

Circulating proteins may be promising biomarkers or drug targets. Leveraging genome-wide association studies of type 1 diabetes (18,942 cases and 501,638 controls of European ancestry) and circulating protein abundances (10,708 European ancestry individuals), Mendelian randomization analyses were conducted to assess the associations between circulating abundances of 1,560 candidate proteins and the risk of type 1 diabetes, followed by multiple sensitivity and colocalization analyses, horizontal pleiotropy examinations, and replications. Bulk tissue and single-cell gene expression enrichment analyses were performed to explore candidate tissues and cell types for prioritized proteins. After validating Mendelian randomization assumptions and colocalization evidence, we found that genetically predicted circulating abundances of CTSH (OR=1.17 per one standard deviation increase; 95% CI:1.10-1.24), IL27RA (OR=1.13; 95% CI:1.07-1.19), SIRPG (OR=1.37; 95% CI:1.26-1.49), and PGM1 (OR=1.66; 95% CI:1.40-1.96) were associated with the risk of type 1 diabetes. These findings were consistently replicated in other cohorts. CTSH, IL27RA, and SIRPG were strongly enriched in immune system-related tissues, while PGM1 was enriched in muscle and liver tissues. Amongst immune cells, CTSH was enriched in B cells and myeloid cells, while SIRPG was enriched in T cells and natural killer cells. These proteins may be explored as biomarkers or drug targets for type 1 diabetes.

PMID:39761376 | DOI:10.2337/db24-0380

Vet Med Sci. 2025 Jan;11(1):e70151. doi: 10.1002/vms3.70151.

ABSTRACT

BACKGROUND: In the United Kingdom, spay surgery is routinely performed in dogs and cats by general practitioners. Data from a decade ago showed that, despite an increased attentiveness of veterinarians to peri-operative pain compared to the past, analgesia could be further improved.

OBJECTIVES: To investigate the current veterinary practice and attitude towards anaesthesia and analgesia for spay surgery in the United Kingdom.

METHODS: An electronic questionnaire composed of 57 questions organised in 6 sections was designed using the Checklist for Reporting Results of Internet E-Surveys (CHERRIES guidelines) and distributed online via a hyperlink. Participants were recruited through both personalised email invitation and publication of the hyperlink on social media. Data were analysed with descriptive statistics, analysis of means and analysis of proportions, using commercially available software.

RESULTS: Entries from 150 participants were used for data analysis. The proportion of participants who were confident in treating pain did differ by decade of graduation, with a lower proportion of confident colleagues graduated before 2001 (6%) and from 2021 (14%), compared to those graduated in the decades 2001-2010 (43%) and 2011-2020 (37%) (p = 0.007). Colleagues reported to implement multimodal analgesia for spay procedures of cats and dogs in 43% and 44% of cases, respectively. The proportions of participants who reportedly used locoregional blocks, mostly with lidocaine, in dogs (82%), were higher than that in cats (43%) (p < 0.001). Post-spay surgery pain was perceived by the participants as more intense in dogs than in cats (p < 0.001).

CONCLUSIONS: Despite an overall good level of attentiveness of British veterinary professionals to feline and canine analgesia during and following spay surgery, this study identified as areas of improvements perception and assessment of feline pain and implementation of locoregional anaesthetic techniques, particularly in cats.

PMID:39761362 | DOI:10.1002/vms3.70151

Comput Inform Nurs. 2025 Jan 6. doi: 10.1097/CIN.0000000000001248. Online ahead of print.

ABSTRACT

The global population is aging, and there is a concomitant increase in surgery for the elderly. In geriatric patients, where postoperative pain assessment is difficult, technological tools that perform automatic pain assessment are needed to alleviate the workload of nurses and to accurately assess patients’ pain. This study offers a more reliable and rapid assessment tool for assessing the pain of elderly patients undergoing surgery. The study aimed to develop a machine learning-based pain assessment application for postoperative geriatric patients. A methodological study was conducted with 68 patients in the general surgery clinic of a hospital between October 2022 and June 2024. Data were collected using a Sociodemographic Data Collection Form, the Numeric Rating Scale, and the Wong-Baker FACES Pain Scale. Then, machine learning was used. Data are summarized using descriptive statistics and presented using narrations, tables, and graphs. The study reveals that nurses assigned lower scores to patients’ pain levels. In the categorical classification, a high level of agreement was observed between the patient and the machine learning for each measurement. A machine learning-based pain assessment application is an efficacious method for assessing pain following geriatric surgery. It facilitates nursing care and supports the advancement of geriatric nursing.

PMID:39761361 | DOI:10.1097/CIN.0000000000001248

Chronobiol Int. 2025 Jan 6:1-14. doi: 10.1080/07420528.2024.2449015. Online ahead of print.

ABSTRACT

Seven-day actigraphy was performed within 1 month in 122 community-dwelling adults (mean age 24.40 y, 31 (25.4%) men) in the same city of Tyumen, Russia. Groups with different COVID-19 status (present, COVID-19(+), n = 79 vs absent, COVID-19(-), n = 43) did not differ in mean age, gender distribution, or body mass index. Vaccination status was equally represented in the COVID groups. We found that COVID-19 status, a history of SARS-CoV-2 infection, was differentially associated with daylight susceptibility. Daylight exposure was estimated using parametric and non-parametric indices: 24-h Amplitude, MESOR or M10 of white and blue light exposure (BLE) and compared between the groups. Distinctively in COVID-19(+) individuals, a smaller normalized 24-h amplitude of BLE (NAbl) was associated with lower circadian robustness, assessed by a smaller relative non-parametric amplitude (RA), a lower circadian function index (CFI), later bedtime, later onset of least active 5 h (L5), shorter total sleep duration, later phase and smaller circadian amplitude of physical motor activity. Such associations were absent in the overall COVID-19(-) population or in the vaccinated COVID(-) group. Considering COVID-status and light hygiene, defined as NAbl ≥ 1 versus NAbl < 1, only those with COVID(+) and NAbl < 1 (poorer light hygiene) had a statistically significantly delayed phase of activity and sleep, reduced circadian amplitude of physical activity, and lower circadian robustness. Accounting for gender and BMI, participants diagnosed with COVID-19 at an earlier date were older and had poorer circadian light hygiene. Altogether, our data suggest that those with COVID-19 were more vulnerable to circadian disruption due to poor circadian light hygiene, manifested as phase delay, small amplitude, a less robust circadian pattern of activity, and as delayed sleep. Our data suggest that the need for optimal circadian light hygiene is greater in individuals with a history of SARS-CoV-2 infection.

PMID:39761104 | DOI:10.1080/07420528.2024.2449015