Category: Statistics

PLoS One. 2025 Nov 11;20(11):e0335187. doi: 10.1371/journal.pone.0335187. eCollection 2025.

ABSTRACT

INTRODUCTION: Hereditary Spastic Paraplegias (HSP) are a group of genetic disorders leading to the degeneration of long motor and sensory tracts in a progressive course. Clinician-reported outcomes (ClinROs) are the most commonly used endpoints for monitoring these diseases, but they have low sensitivity to detect progression. Therefore, identifying new monitoring biomarkers with higher sensitivity to change is crucial. Our objective was to compare the progression of Somatosensory Evoked Potential (SSEP) latencies over time with ClinROs in HSP.

METHODS: A longitudinal study was conducted on 22 individuals with a genetic diagnosis (13 SPG4, 3 SPG5, 3 SPG7, 2 SPG10, and 1 cerebrotendinous xanthomatosis), with two evaluations over a 4-year interval of upper limb (UL) and lower limb (LL) SSEPs and the Spastic Paraplegia Rating Scale (SPRS) total score and motor items only (mSPRS).

RESULTS: In the follow-up time analysis, progression after 4 years was observed only for SPRS and mSPRS, with an annual progression of 1.12 points and 1.02 points, respectively. No statistically significant progression was observed for SSEPs. Disease progression modeled according to disease duration showed worsening in all outcomes. For each additional year of disease, the SPRS worsened by 0.834 points (95% CI 0.62 to 1.04, p < 0.001), mSPRS by 0.758 points (95% CI 0.55 to 0.96, p < 0.001), SSEP-UL latency by 0.164 ms (95% CI 0.03 to 0.3, p < 0.001), and SSEP-LL latency by 1.343 ms (95% CI 0.74 to 1.93, p < 0.001). Results for the SPG4 subgroup were similar to those for the overall HSP group.

CONCLUSION: The neurophysiological progression of sensory long tract dysfunction is even slower than the progression of motor findings measured by COAs in HSP. The low sensitivity to change of SSEPs identified suggests that they should not be used as primary endpoints in future clinical trials for disease-modifying drugs.

PMID:41218046 | DOI:10.1371/journal.pone.0335187

PLoS One. 2025 Nov 11;20(11):e0336700. doi: 10.1371/journal.pone.0336700. eCollection 2025.

ABSTRACT

Pale shrimp disease is an emerging threat in Thailand, characterized by pale body coloration in Pacific white shrimp (Litopenaeus vannamei). Although the etiology had been identified as Photobacterium damselae subsp. damselae, the disease effects on gut microbiome remain poorly understood. This study investigated changes in the gut microbiota of Pacific white shrimp suffering from pale shrimp disease (diseased group) compared to disease-free shrimp (healthy group) collected from Surat Thani Province, Thailand. DNA extracted from the intestinal samples was subjected to 16S rRNA metagenomic sequencing, followed by taxonomic identification, diversity analyses, and functional prediction of the metabolic pathways. Despite a limited number of biological replicates, the occurrence of pale shrimp disease was able to reveal alterations in intestinal microbial composition, diversities, and functional features compared to the healthy shrimp. In most cases, the intestinal microbiota of the diseased shrimp were dominated by only 2 genera of bacteria, i.e., Photobacterium (54.63-70.53%) and Vibrio (24.94-26.12%), which together accounted for 79.58-95.47% of the total bacterial community. α-diversity, as indicated by the observed features, Shannon, and Simpson indices, was significantly decreased, and dominance was significantly increased in the diseased shrimp compared to healthy shrimp. Likewise, β-diversity was significantly different between groups; PCoA of un-weighted and weighted UniFrac clearly distinguished intestinal microbiota of the shrimp into 2 clusters, and ANOSIM of these data revealed statistical differences between groups, suggesting different microbiota communities between healthy and diseased shrimp. Moreover, diseased shrimp had significantly higher predicted functional features associated with bacterial virulence factors and antibacterial resistance. These exploratory findings suggest an association among pale shrimp disease, gut microbiota dysbiosis, and the proliferation of opportunistic taxa, particularly Photobacterium.

PMID:41218045 | DOI:10.1371/journal.pone.0336700

Interv Neuroradiol. 2025 Nov 11:15910199251394570. doi: 10.1177/15910199251394570. Online ahead of print.

ABSTRACT

BackgroundFlow diversion for intracranial aneurysms is indicated for wide-necked aneurysms in non-perforator-rich segments. However, devices are challenging to deploy in distal/tortuous vasculature. LVIS^TM EVO^TM is a braided intermediate-density stent offering greater flexibility and navigability than flow diverters with higher metal-to-surface ratios. We investigated its off-label use as an independent flow diverter for small, complex intracranial aneurysms.MethodsWe retrospectively reviewed patients at a single center who underwent independent stenting with LVIS^TM EVO^TM from December 2023 to September 2024. Demographics, procedural details, and angiographic outcomes were analyzed. Follow-up computed tomography angiography was performed from May 2024 to October 2025. Descriptive statistics were used; non-parametric tests compared aneurysm and parent vessel diameters.ResultsNine patients (median age 59; 89% female) with off-label intracranial aneurysms (median diameter 5 mm) were treated using LVIS^TM EVO^TM (median diameter 3 mm, length 18 mm). Deployment was technically successful in 100% of cases with no peri-procedural complications. One patient experienced delayed hemorrhage with full neurological recovery. At follow-up (available for 6 patients), 83.3% showed complete aneurysm occlusion (Raymond-Roy Occlusion Classification [RROC] class I). All patients demonstrated 100% stent patency and no new neurological deficits.ConclusionLVIS^TM EVO^TM demonstrated technical feasibility and acceptable initial safety as an off-label flow-diverting device for small (as low as 2.5 mm), distal aneurysms in this limited single-center experience. Its favorable deliverability, safety profile, and occlusion rates suggest it as a possible alternative to currently marketed flow diverters in anatomically challenging patients. These findings warrant validation in larger, multicenter studies with extended follow-up.

PMID:41217987 | DOI:10.1177/15910199251394570

Braz J Cardiovasc Surg. 2025 Nov 1;40(6). doi: 10.21470/1678-9741-2024-0446.

ABSTRACT

OBJECTIVE: This study aimed to investigate the frequency of persistent left superior vena cava (PLSVC) and its impact on outcomes in children undergoing congenital heart surgery.

METHODS: The study was conducted retrospectively in cases diagnosed with congenital heart disease who were operated on under the age of 16 years between October 1st, 2021, and October 1st, 2024, at two major tertiary centers. The frequency of PLSVC and its possible impact on surgical outcomes were evaluated in these cases. The results were analyzed statistically.

RESULTS: There were 4,000 cases during the study period, with 52% being male. The median weight was 5.2 kg (interquartile range 4.5 – 6 kg). PLSVC was detected in a total of 260 cases (6.5%). Of these cases, 92.3% (240/260) drained into the coronary sinus, while 7.7% (20/260) drained directly into the left atrium. In 251 (96.5%) of the patients with PLSVC, there was a right SVC, while nine (3.5%) did not have a right SVC. Of the 251 patients with double SVC, 105 (42%) had a normal innominate vein. PLSVC was primarily associated with heterotaxy syndrome, atrioventricular septal defect, and vascular ring defects.

CONCLUSION: There is an increased frequency of PLSVC among certain congenital heart disease groups, and raising awareness during echocardiographic examination can facilitate the diagnosis of PLSVC. Preoperative diagnosis of PLSVC can help in managing complications more effectively.

PMID:41217972 | DOI:10.21470/1678-9741-2024-0446

Sci Prog. 2025 Oct-Dec;108(4):368504251396066. doi: 10.1177/00368504251396066. Epub 2025 Nov 11.

ABSTRACT

ObjectiveTo improve the S.T.O.N.E. nephrolithometry scoring system by applying a factor weighting method derived from odds ratios (ORs) in logistic regression analysis for a more scientific prediction of stone-free rate (SFR) after percutaneous nephrolithotomy (PCNL).MethodsWe conducted a retrospective cohort study of 283 patients undergoing PCNL. The SFR was the primary outcome. Binary logistic regression identified independent predictors among the S.T.O.N.E. components. Statistically significant factors were assigned weighted points based on their ORs. The improved system’s performance was compared to the traditional S.T.O.N.E. score using receiver operating characteristic analysis, Net Reclassification Improvement (NRI), and risk stratification based on Youden index-optimized cutoffs.ResultsStone size, obstruction, and stone density were independent predictors of SFR (all p < .05) and were assigned weighted scores of 2, 3, and 3, respectively, creating a revised score (range 0-11). The improved system demonstrated comparable discriminative ability to the traditional system (AUC: 0.804 vs 0.814, p > .05) but provided significantly superior risk reclassification (NRI = 0.233, p = .007). Using the Youden index-derived cutoff of 5.5, the improved system stratified patients into low-risk (scores 0-5, n = 123) and high-risk (scores 6-11, n = 160) groups. The SFR was 91.9% in the low-risk group versus 51.9% in the high-risk group (p < .001). This low-risk group had a significantly higher SFR than the low-risk group defined by the traditional system (91.9% vs 81.4%, p = .011).ConclusionThe factor-weighted S.T.O.N.E. scoring system provides enhanced clinical risk stratification for PCNL outcomes. It effectively identifies a distinct cohort of low-risk patients with a > 90% probability of stone-free success, offering improved utility for preoperative patient counseling and surgical planning.

PMID:41217967 | DOI:10.1177/00368504251396066

JMIR Res Protoc. 2025 Nov 11;14:e76509. doi: 10.2196/76509.

ABSTRACT

BACKGROUND: Lower limb amputation rates are increasing owing to aging and vascular diseases. However, no standardized rehabilitation protocol has been established for regaining walking ability. Conventional rehabilitation delays prosthetic gait training until 6-8 weeks post amputation, prolonging recovery and increasing medical expenses.

OBJECTIVE: This study aims to evaluate the impact of neurorehabilitation using the Hybrid Assistive Limb (HAL) for Medical Use Lower Limb Type, developed by Japan’s Tsukuba University and the robotics company Cyberdyne, on gait acquisition, improvement in activities of daily living (ADL), and enhancement of quality of life (QOL) in patients with lower limb amputation, and assess the effectiveness of early HAL-assisted gait training before and after amputation.

METHODS: This single-arm trial will include 20 patients undergoing unilateral transfemoral or transtibial amputations. HAL-assisted gait training will be performed 5 days per week (30 minutes per session) until postoperative week 8. The primary outcome is a 2-minute walking distance, while secondary outcomes include muscle strength, balance, gait parameters, and ADL/QOL measures. Statistical analyses will be conducted using SPSS (IBM Corp), and results obtained at the following time points will be compared: preoperative, postintervention, and 6-month follow-up.

RESULTS: The planned sample size is 20 patients, calculated using JMP version 12 (SAS Institute) based on an expected 1.5-fold improvement in 6-minute walk distance (effect size 0.8, α=.05, power=0.8). Analyses will be performed using SPSS version 15.0 (IBM Corp). The 2-minute walk test (primary outcome) and secondary outcomes will be compared at baseline, post intervention, and 6-month follow-up using 1-way analysis of variance or Kruskal-Wallis test, and P values <.05 and 95% CIs will be reported.

CONCLUSIONS: This is the first study to apply HAL-assisted neurorehabilitation to patients with lower limb amputations. Early gait training may increase prosthetic gait acquisition rates, shorten rehabilitation and hospitalization periods, and reduce medical costs. If effective, this study may contribute to the development of a Japan-originated rehabilitation program and provide clinical evidence supporting broader HAL implementation for patients with lower limb amputations.

TRIAL REGISTRATION: Japan Registry of Clinical Trials jRCTs062200031; https://jrct.mhlw.go.jp/latest-detail/jRCTs062200031.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/76509.

PMID:41217815 | DOI:10.2196/76509

Int J Lang Commun Disord. 2025 Nov-Dec;60(6):e70161. doi: 10.1111/1460-6984.70161.

ABSTRACT

PURPOSE: Previous studies conducted in Türkiye (Turkey) have revealed that the level of knowledge and awareness regarding swallowing disorders in neurogenic conditions among speech and language pathology students or graduates is relatively low. Furthermore, differences in curricula across various institutions highlight the need for standardized education in this area. This study aimed to assess changes in the knowledge and awareness levels of speech and language pathologists, as well as their opinions about the training, by organizing an educational programme focused on neurogenic communication and swallowing disorders.

METHOD: A total of 5 days (40 h) of training was carried out over three weekends, with the participation of 40 expert academicians from 20 different institutions. The training was attended by 247 participants on the first day. Before and after the training, a 40-question questionnaire was administered to measure the knowledge and awareness. One hundred and twenty-nine participants filled out both tests. After the training was completed, a 12-question evaluation questionnaire was applied to the participants.

RESULTS: The number of correct answers given by the participants who completed both the pre-test and post-test increased statistically significantly, from 19.09 ± 3.81 to 21.43 ± 3.67 (p < 0.001). The participants stated that their knowledge and awareness levels about the topics increased after the training, with a mean self-reported score of 8.99± 1.18 out of 10.

CONCLUSIONS: This training event was the first of its kind in the field of speech and language pathology in Türkiye. While a statistically significant increase in knowledge and awareness was observed following the training, participants’ overall knowledge levels remained relatively low. These findings underscore the need for additional and ongoing training to address existing gaps and further enhance professional competencies in this area.

WHAT THIS PAPER ADDS: What is already known on this subject Neurological diseases affect individuals of all age groups and may lead to communication, feeding and swallowing disorders. These problems negatively affect the quality of life of affected individuals and their caregivers. There is a deficiency in the knowledge, awareness and self-confidence levels of speech and language pathologists (SLPs) and SLP students regarding neurogenic communication and swallowing disorders. What this paper adds to existing knowledge There is a need for training and support in the field of neurogenic communication or swallowing disorders both in Turkey and in other countries. In order to address this need, training on neurogenic communication and swallowing disorders was provided to 4th-year students in the SLP undergraduate programme and graduated SLPs in Turkey. What are the potential or clinical implications of this work? With this training, the knowledge and awareness levels of 4th-year students in the SLP undergraduate programme and graduate SLPs regarding neurogenic communication and swallowing disorders have increased. However, at the end of the training, there are still deficiencies in the knowledge levels of the participants, and it is thought that more training may be needed to overcome these deficiencies.

PMID:41217808 | DOI:10.1111/1460-6984.70161

Global Spine J. 2025 Nov 11:21925682251395703. doi: 10.1177/21925682251395703. Online ahead of print.

ABSTRACT

Study DesignRetrospective cross-sectional study.ObjectivesTo investigate differences and correlations in multi-planar parameters across severity levels in female Lenke type 1 patients, and to identify key factors, thereby providing a basis for personalized preoperative planning.MethodsFull-spine X-rays of 117 female Lenke type 1 patients (40 mild, 40 moderate, 37 severe; aged 10-18 years) were analyzed. Twelve spinopelvic parameters including Cobb angle, apical vertebral translation (AVT), apical vertebral rotation (AVR), thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), sagittal vertical axis (SVA), and spinal tilt (ST) were measured using Mimics 21.0, followed by statistical analysis.ResultsCobb angle, AVT, and AVR increased significantly with severity (P < 0.001). The severe group had greater SVA and smaller ST (P = 0.011; P = 0.038). Regression analysis identified AVT and AVR as significant predictors for moderate (OR = 1.314; OR = 42.094) and severe groups (OR = 1.470; OR = 241.351) (all P < 0.05). In mild and moderate groups, LL showed positive correlations with TK and PI (r = 0.380-0.591) and negative correlations with SVA (r = -0.558; r = -0.332). No significant correlations existed between LL and PI, TK, or SVA in the severe group.ConclusionsIn female Lenke type 1 patients, correcting AVT and AVR is a central surgical objective, as they are integral to coronal and transverse deformities, and AVR also drives sagittal imbalance. LL serves as a pivotal compensation parameter for sagittal balance in these patients. In mild and moderate patients, sagittal balance can be achieved through LL-centric compensation mechanisms. However, in severe patients, LL loses its compensatory role, necessitating surgical intervention to restore sagittal balance.

PMID:41217807 | DOI:10.1177/21925682251395703

Vopr Kurortol Fizioter Lech Fiz Kult. 2025;102(5):28-38. doi: 10.17116/kurort202510205128.

ABSTRACT

The relevance of the study is due to the important therapeutic role of natural air ionization in the ground atmosphere of heath resorts, which many authors associate with the environment-forming role of forest. However, there are gaps in the investigations of the influence of phytoresources of different elements of tree and shrubbery vegetation on such an important physiological factor as ionization of oxygen molecules in the ground atmosphere under different meteorological and ecological conditions in health resorts and sanatorium-resort facilities.

OBJECTIVE: To study the aeroionization-forming functions of coniferous and deciduous tree plantations and possibilities of optimization of the therapeutic climate at the climatotherapeutic grounds of the sanatorium-resort facilities of the sanatorium-resort complex of the FMBA of Russia, general resort parks and terrain cures.

MATERIAL AND METHODS: The protocols of comprehensive route forest, microbioclimatic and ecological studies in coniferous and deciduous forest park plantations on the territories of SRC of the FMBA of Russia, general resort parks and terrain cures in different natural areas of Moscow and Ivanovo regions, Krasnodar and Stavropol territories for 2017-2024 were investigated. A total of 20 sample plots (SPs), on each of which standard sets of natural factors (indicators) of the therapeutic climate and landscape (air ionization, microclimate factors, finely dispersed aerosol in 9 channels of particle size from 0.2 to 5 μm in the ground atmosphere, elements and volume of phytoresources) were studied, were made. The methodological recommendations №13-21 of the FMBA of Russia for ranking the balneological potential of different indicators of the therapeutic climate were used. The obtained measurement results were statistically processed on the basis of Excel program.

RESULTS: We investigated taxational, environmental and microbioclimatic indicators on the mentioned SPs, according to which models of the dynamics of ion unipolarity coefficient (IUC) under the influence of air temperature (IUC=0.0206X+0.3953, where X – air temperature, °C); air humidity (IUC=-0.0003X²+0.0228X+0.6853, where X – relative humidity, %); illumination intensity (IUC=0.166ln(X)+0.6367, where X – illumination intensity, lux); volume of timber supply plantation (IUC=-0.0014X+1.2885, where X – timber supply plantation, m³/ha); level of finely dispersed aerosol of particle size >5 μm (IUC=0.2243X^{0, 4842}, where X – finely dispersed aerosol, p-s/cm³) in the underplant area of green spaces were developed.

CONCLUSION: The obtained data provide a better understanding of the role of active oxygen in the process of atmospheric carbon deposition by tree vegetation, which is relevant in the presence of global climate change, as well as confirms the influence of timber supply on such an important physiological factor as the ionization of the ground atmosphere, which has important balneological significance. Issues of ecological potential of health resort areas of sanatorium-resort facilities of the Russian Federation require further study.

PMID:41217796 | DOI:10.17116/kurort202510205128

Int J Lang Commun Disord. 2025 Nov-Dec;60(6):e70159. doi: 10.1111/1460-6984.70159.

ABSTRACT

BACKGROUND: Voice disorders are a major cause of difficulties in many areas of social life, as they can disrupt communication. Voice therapy, including vocal hygiene education, has an important role in the treatment of voice disorders, especially if applied in an individualised manner.

AIM: The aim of this study was to develop and validate a reliable and practical self-report tool, the Vocal Health Daily Tracking Form, for use in monitoring patients’ daily compliance with vocal hygiene practices and home-based voice therapy exercises.

METHODS AND PROCEDURES: A total of 266 volunteering participants, including 212 women and 54 men aged 18 and over who were university students from departments of speech and language therapy and audiology, participated in the research. The 12-item Vocal Health Daily Tracking Form, developed based on traditional voice therapy principles, was completed at least once by all 266 participants and twice by 60 of the participants. The validity and reliability of the form were evaluated in line with the statistical analysis of the obtained data.

OUTCOMES AND RESULTS: Statistical analyses confirmed that the Vocal Health Daily Tracking Form is a reliable and valid tool. While the Kaiser-Meyer-Olkin test value of the form was found to be very good at 0.799, the Bartlett test result was 961.473 (p < 0.05), confirming a strong correlation between the items of the form. The Cronbach alpha value of the study was found to be sufficient at 0.809. The total correlation values were between 0.326 and 0.651, and the amount of explained variance was sufficient at 33.28%. These findings confirmed that the scale is well constructed both conceptually and structurally and is a valid and reliable measurement tool.

CONCLUSIONS AND IMPLICATIONS: In addition to vocal hygiene recommendations, the individualisation of the therapy process and the use of methods based on behavioural techniques may contribute positively to the voice rehabilitation processes of individuals with voice disorders. The Vocal Health Daily Tracking Form has high validity and reliability values, confirming that it can be considered an important tool for monitoring and improving voice therapy processes. It may also help patients experience more regular and effective therapy processes by increasing their self-regulation and motivation during voice therapy.

WHAT THIS PAPER ADDS: What is already known on this subject Voice disorders are major health issues that negatively affect individuals’ communication abilities and quality of life (Cohen et al., 2006). These disorders may arise due to organic, neurological, or functional causes and may lead to abnormal changes in voice quality, pitch height, or intensity (Behrman, 2007). Voice therapy and various treatment methods, including vocal hygiene education and training, play an important role in the rehabilitation processes of individuals with voice disorders (Garabet et al., 2024). Homework assigned during the therapy process, including vocal exercises and hygiene practices, is of critical importance in increasing the effectiveness of the treatment (Desjardins et al., 2017). What this paper adds to the existing knowledge This study aimed to develop and validate a reliable and practical self-report tool, the Vocal Health Daily Tracking Form, to monitor patients’ daily compliance with vocal hygiene practices and home-based voice therapy exercises during voice rehabilitation. With that aim, the Vocal Health Daily Tracking Form was developed to allow patients to record their daily engagement with voice hygiene practices and vocal exercises. The validity and reliability of this new form were also evaluated. This study has presented the validity and reliability analysis of a voice monitoring form developed to increase patients’ compliance with voice therapy. Steady compliance with vocal hygiene and prescribed exercises conducted at home significantly affects treatment results, and the voice monitoring form proposed in this study was shown to have high validity (KMO = 0.799, p < 0.001) and reliability, indicating that it can be considered an important tool for monitoring daily practices that affect the outcomes of therapy processes. What are the potential or actual clinical implications for this work? This study is expected to serve as guidance for future research and clinical practices addressing patient compliance and behavioural management throughout the course of voice therapy.

PMID:41217785 | DOI:10.1111/1460-6984.70159