Category: Statistics

Comput Methods Programs Biomed. 2025 Sep 9;272:109072. doi: 10.1016/j.cmpb.2025.109072. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Coronary Artery Disease (CAD) diagnosis relies heavily on coronary angiography, yet interpretation suffers from variability. Deep learning (DL) offers potential for improvement, particularly in vessel segmentation, a critical step for analysis. This study aims to enhance vessel segmentation accuracy in angiography using a DL framework incorporating advanced preprocessing and texture features.

METHODS: We developed a U-Net architecture integrating Texture Representation of Image (TRI) features (Haralick and Law features) to capture subtle vascular details. Advanced preprocessing (Laplacian Pyramid Restoration, Gaussian Differential Scale-Invariance) was applied to improve image quality. The model was pre-trained on the DRIVE dataset and fine-tuned using 7600 clinical angiography images. Performance was evaluated on a held-out test set (19 patients, ∼1700 images) from the same institution and benchmarked against the public ARCADE dataset. Statistical tests assessed performance improvements. Post-segmentation analysis included branching point detection and vessel diameter visualization using heatmaps.

RESULTS: The proposed method achieved high segmentation performance on the clinical test set (Accuracy: 0.98, Precision: 0.87, Sensitivity: 0.91, F1-score: 0.89, IoU: 0.801, with CIs provided). Ablation studies confirmed statistically significant contributions from both preprocessing and TRI features (p < 0.01 for all metrics). Performance on the ARCADE benchmark was also strong (F1-score: 0.78), considering annotation differences.

CONCLUSIONS: Integrating TRI features and advanced preprocessing with a U-Net architecture significantly improves coronary angiography vessel segmentation. This provides a robust foundation for subsequent quantitative analysis potentially supporting CAD assessment. While limitations exist regarding external validation and direct clinical impact assessment, the enhanced segmentation capability represents a valuable advancement for angiographic image analysis tools.

PMID:40983000 | DOI:10.1016/j.cmpb.2025.109072

J Craniofac Surg. 2025 Sep 22. doi: 10.1097/SCS.0000000000011958. Online ahead of print.

ABSTRACT

BACKGROUND: Rhinoplasty is a frequently performed plastic surgery, but it carries potential short- and long-term complications. Surgeons continuously seek ways to reduce these risks and enhance patient outcomes. Nasal packing is often used postoperatively, but its efficacy in improving recovery remains debated. This study aims to assess the impact of bilateral anterior nasal packing on early postoperative outcomes.

METHODS: In this prospective study, conducted from January to December 2023, 64 rhinoplasty patients were evaluated at Hôtel Dieu de France University Hospital. Twenty patients received short-term nasal packing with paraffin-soaked gauze, while 44 did not. Outcomes were assessed based on periorbital ecchymosis, edema, nasal obstruction, and the occurrence of septal hematomas and epistaxis.

RESULTS: At postoperative day 7, the packing group exhibited significantly more ecchymosis (mean score 3.65 versus 2.47; P = 0.017). However, no significant differences were noted for periorbital edema (P = 0.471) or nasal obstruction (P = 0.172). Postoperative epistaxis and septal hematomas occurred in 10% of patients in the packing group, compared with none in the nonpacking group, though these differences were not statistically significant (P = 0.175).

CONCLUSION: Bilateral anterior nasal packing significantly increases ecchymosis after rhinoplasty without reducing other complications such as edema, nasal obstruction, epistaxis, or septal hematomas. These findings suggest that nasal packing may not be beneficial and should be avoided.

PMID:40982970 | DOI:10.1097/SCS.0000000000011958

Psychiatr Danub. 2025 Sep;37(Suppl 1):99-103.

ABSTRACT

BACKGROUND: This study explores the relationship between cognitive deficits, cognitive reserve (CR), and rehabilitation outcomes in psychiatric offenders and non-offenders. The objective is to analyze how neurocognitive functioning, impulsivity, and CR influence the duration and effectiveness of psychiatric rehabilitation.

METHODS: Fifty-five patients from rehabilitation centers in Southern Italy were assessed using standardized psychiatric and neuropsychological scales. Participants were divided into offenders (n=19) and non-offenders (n=36). Assessments included BPRS, BIS-11, CRIq, T.I.B., and TMT A/B. Statistical analyses involved Pearson’s correlation and t-tests using JASP.

RESULTS: Significant correlations were observed between months of rehabilitation (MoR) and TIQ in non-offenders and CRIq in offenders. A significant correlation between MoR and TMT was observed only in offenders. Offenders with more than 24 months of rehabilitation showed lower impulsivity scores (BIS-11). These findings indicate distinct rehabilitative trajectories and neurocognitive responses in the two groups.

CONCLUSION: Cognitive reserve and neurocognitive assessment can inform individualized rehabilitation strategies in forensic psychiatric populations. Offenders may particularly benefit from longer and more targeted interventions to mitigate impulsivity and enhance cognitive functioning.

PMID:40982968

Psychiatr Danub. 2025 Sep;37(Suppl 1):409-412.

ABSTRACT

BACKGROUND: It is known that youth aged 16 to 23 are more vulnerable to mental distress than other age groups. This vulnerability can be explained by several factors such as the high prevalence of mental illnesses, the changes in the environment, the social expectations and so on. Moreover, in this age group the transition between Child and Adolescent Mental Health Services (CAMHS) and Adult Mental Health Services (AMHS) impacts the continuity of care, leading to a negative impact on the prognosis. This article aims to characterize this population based on risk factors, history of care and care plan.

SUBJECTS AND METHOD: We conducted a retrospective study including patients who attended transition psychiatry consultations between October 2020 and December 2023. Data were collected at a secondary care outpatient service.

RESULTS: The sample (n=122) was predominantly female (70.5%, n=86). Referrals were mostly made by psychologists (35.2%, n=43), although many individuals were self-referred (32%, n=39). In most cases, the consultation request came directly from the young person (60.7%, n=74). Regarding previous mental health support, 79.5% (n=97) had already received psychological care at the time of their transition consultation. In terms of risk factors, many participants had been exposed to adverse childhood experiences (ACE): 60% (n=69) reported a first-degree family history of psychiatric disorders, 28% (n=33) had experienced sexual abuse, and 37.3% (n=44) had been exposed to domestic violence. Among those who received follow-up care, 19.7% (n=24) were scheduled for planned inpatient care. Psychotherapeutic follow-up was offered to 79.6% of patients, and psychotropic medication was recommended for 68.9%.

CONCLUSION: This research highlights the major vulnerability of transition-aged youth (TAY) and reinforces the need for specialized care and continuity between CAMHS and AMHS.

PMID:40982949

Psychiatr Danub. 2025 Sep;37(Suppl 1):391-397.

ABSTRACT

BACKGROUND: Food-related problems in Feeding and Eating Disorders (hereafter referred to as eating disorders – EDs) might be considered as the expression of dysfunctional individual and relational patterns based on emotional and behavioral dysregulation. Dysphoria is a transnosographic syndrome found in a multitude of psychiatric disorders including EDs, our cross-sectional study aims to analyze its presence in Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Binge Eating Disorder (BED) to define its socio-demographic, clinical correlates and phenomenological expression in the three types of EDs.

SUBJECTS AND METHODS: A total of 165 patients were recruited from March 2019 to November 2024. Anamnestic history was collected through a specific form. The Italian version of the Nepean Dysphoria Scale (NDS-I) was used to evaluate Dysphoria. After performing descriptive analyses, one-way ANOVA and Pearson’s r test were performed to respectively assess between-group differences and correlations. Significance was defined as p<0.05.

RESULTS: AN presented the highest degree of Dysphoria than the three, BED the lowest. Older age, physical illnesses and ongoing medical therapy correlated with lower levels of Dysphoria. A Statistically significant positive correlation was found in smoking habits, association with another psychiatric disorder, especially with anxiety disorder, use of benzodiazepines (BDZ) and use of antipsychotics (AP).

CONCLUSIONS: Dysphoria acquires fundamental importance within EDs, possibly having a specific role in the etiology and maintenance of eating behaviors, it might play a core role in this type of mental disorder, with the behavioral aspect aimed at reducing dysphoric anxiety. Understanding these connections could represent a useful tool for the comprehension of EDs, which are increasing and have always represented a great diagnostic and therapeutic challenge.

PMID:40982945

Psychiatr Danub. 2025 Sep;37(Suppl 1):385-390.

ABSTRACT

BACKGROUND: Healthcare workers (HCWs) face significant occupational stressors that increase their risk of psychological symptoms, including anxiety, depression, and burnout. In particular, nurse may experience higher psychological distress due to unique workplace demands. However, direct comparisons between nurses and other HCWs within tertiary care hospitals remain limited. This retrospective study aimed to compare work-related stress levels and mental health outcomes in nurses versus other HCWs seeking psychological or psychiatric support through the Occupational Health Service (OHS) of a tertiary care hospital in central Italy.

SUBJECTS AND METHODS: This is a retrospective cross-sectional study analyzing healthcare workers (HCWs) who accessed psychological or psychiatric support through an Occupational Counseling Service (OCS) over a three-year period. Medical records of 155 HCWs who accessed the OHS from January 2022 to December 2024 were reviewed. Sociodemographic, occupational, clinical, and psychometric data were collected. Subgroup analyses compared nurses (n=79) to other professionals (n=76) regarding psychological distress, psychiatric diagnoses, and treatment. Correlations between personal/family psychiatric history and work-related stress were also assessed.

RESULTS: Nurses exhibited significantly higher levels of depressive symptoms and anxiety compared to other HCWs. A positive personal and/or family history of anxiety and mood disorders was present in 26.5% of the full cohort and correlated significantly with work-related stress and burnout (p<0.001). Burnout and secondary traumatic stress were prevalent across all groups, although compassion satisfaction remained relatively preserved.

CONCLUSIONS: Nurses demonstrated greater vulnerability to affective symptoms and work-related stress compared to other HCWs, underscoring the need for tailored mental health support within occupational health frameworks. Early identification and intervention strategies are crucial to mitigate psychological distress and improve wellbeing among hospital staff.

PMID:40982943

Psychiatr Danub. 2025 Sep;37(Suppl 1):362-367.

ABSTRACT

BACKGROUND: This study aims to analyse certain populations’ sociodemographic factors and to investigate the use of polypharmacy for inpatients assigned to involuntary treatment at the National Center of Mental Health, Riga, Latvia.

METHODS: A retrospective review of clinical data was undertaken in adult inpatients assigned to involuntary psychiatric treatment in the period from December 17th, 2024, till February 4th, 2025. The data about the participants’ sociodemographic factors, hospitalisation duration, diagnosis, and treatment strategies were obtained from the hospital’s databases. Only data from a fixed 30-day window at the time of analysis were considered, irrespective of hospitalization duration, to ensure consistency and avoid bias from ongoing treatment modifications. The Antipsychotic Total Daily Dose Calculator was used to assess polypharmacy load by estimating the BNF (British National Formulary) coefficient relative to the recommended maximum daily dose. All data were collected in MS Excel and analysed using IBM SPSS 29.0.1.0.

RESULTS: The study included 88 inpatients with compulsory medical measures. Results showed a mean age of the participants equal to 41.49±2.41 years, males’ dominance making 86.36% (n=76) of the study group, and schizophrenia (F20, ICD-10) noted as the most dominant diagnostic category. Polypharmacy with more than one antipsychotic medication was observed in 89.77% (n=79) of the inpatients. The most common treatment combination was an antipsychotic with a mood stabilizer, prescribed to 44.32% (n=39) of participants. Treatment was primarily guided by antipsychotics, with haloperidol emerging as the most commonly used drug, representing 72.72% (n=64) of the cases, and mood stabilizers received by 57.95% (n=51) of the inpatients. The analysis revealed that 34.09% (n=30) of participants had a BNF coefficient within the recommended maximum daily dose, while the majority, or 65.9% (n=58), exceeded the recommended threshold.

CONCLUSIONS: This study contributes to existing knowledge of currently available data about polypharmacy in psychiatric practice and certain population groups undergoing involuntary hospitalisation. The results about treatment patterns may support the optimization of treatment practices and warrant closer attention to safety, side effect profiles, and possible long-term outcomes when polypharmacy is used.

PMID:40982939

Psychiatr Danub. 2025 Sep;37(Suppl 1):351-355.

ABSTRACT

BACKGROUND: The rise of synthetic opioids, particularly fentanyl, has intensified the global drug abuse crisis, posing serious challenges to healthcare systems. Nurses and nursing students play a crucial role in prevention, early identification, and emergency management of opioid-related cases. Health Literacy (HL), the ability to access, understand, and use health information, has been proposed as a critical determinant of clinical competence in this context. This study aims to assess the knowledge, awareness, and health literacy of nurses and nursing students in relation to fentanyl and drug abuse, exploring potential associations between HL levels and preparedness to manage substance-related emergencies.

SUBJECTS AND METHODS: A national multicenter cross-sectional study was conducted from October 2024 to January 2025, involving 157 participants (nurses and nursing students) across Italy. A structured questionnaire was administered online, covering four domains: sociodemographic information, health literacy (HL), drug addiction knowledge and specific knowledge of fentanyl. Descriptive and inferential statistics were performed using SPSS.

RESULTS: Participants demonstrated good overall knowledge about fentanyl clinical use and effects. However, misconceptions were identified – particularly regarding lethal dosages and the inability to detect fentanyl with the senses. Notably, HL scores did not consistently correlate with higher knowledge levels; in some cases, participants with lower HL scores showed better understanding of specific topics such as routes of administration and naloxone use. A significant negative correlation was found between HL and knowledge of drug availability (r = -0.35; p < 0.001). No significant differences emerged between students and professionals.

CONCLUSIONS: Findings challenge the assumption that higher HL always predicts better preparedness. Standard HL measures may fail to capture contextual and experiential knowledge essential for managing opioid-related emergencies. Nursing education should incorporate more experiential and clinically focused training on drug abuse, integrating HL as an operational – rather than merely promotional – competency. Further research with larger samples and qualitative methods is recommended.

PMID:40982937

Psychiatr Danub. 2025 Sep;37(Suppl 1):344-350.

ABSTRACT

BACKGROUND: Binge Eating Disorder (BED) is a prevalent and under-recognized eating disorder associated with psychological distress and maladaptive coping. Healthcare professionals are frequently exposed to high levels of occupational stress, which may increase their vulnerability to disordered eating behaviors, including BED. This study aimed to explore the relationship between work-related stress, emotional exhaustion and the risk of developing binge eating symptoms among healthcare professionals in Italy.

METHODS: A cross-sectional online survey was conducted between May and July 2024 among 312 healthcare professionals. Participants completed a structured questionnaire comprising sociodemographic data, stress-related variables, the Emotional Exhaustion subscale of the Maslach Burnout Inventory (MBI) and the Binge Eating Scale (BES).

RESULTS: The sample was predominantly female (81.7%) with a mean age of 37.6 years. Twenty percent reported a history of eating disorders and 60.3% reported stress or anxiety. Significant associations were found between BES scores and stress-related variables, including anxiety, emotional exhaustion, eating during work breaks and vending machine use (p< 0.005). Higher BES scores were correlated with burnout symptoms such as fatigue, emotional drain and inability to cope. A strong association also emerged between BES scores and the perceived impact of stress on eating habits.

CONCLUSIONS: Work-related stress and burnout symptoms are significantly associated with binge eating tendencies among healthcare professionals. Preventive strategies – such as institutional stress management programs and access to healthy food – are essential to promote well-being and prevent maladaptive eating behaviors in high-stress healthcare environments.

PMID:40982936

Psychiatr Danub. 2025 Sep;37(Suppl 1):315-320.

ABSTRACT

BACKGROUND: To evaluate the relationship between cognitive function and the data of volumetric sphygmography and speckle tracking echocardiography in patients with heart arrhythmias.

MATERIALS AND METHODS: Monocentral cohort study with 33 patients. Group 1 – patients with frequent extrasystoles (ES) of II and more class by Lown (n = 12; 47-79 years old), group 2 – with paroxysmal atrial fibrillation (AF) (n = 14; 50-81 years old) and control group – without serious cardiovascular diseases (n = 7; 46-75 years old).

METHODS: lipidograms, 24 hours ECG monitoring, TTE, volumetric sphygmography. For cognitive function evaluation, we used the standard MoCA Test.

RESULTS: Post hoc analysis according to Dunn showed that groups 1 and 2 differed in LA volume (p = 0.002, ε² = 0.34) and MoCA (p = 0.007, ε² = 0.30). Differences between groups 2 and control were also significant for LA volume (p = 0.024) and MoCA (p = 0.045). We observed a decreasing of cognitive function in both main groups, mostly in with paroxysmal AF. Statistically significant differences in GLS between 1 and 2 group – it was lower in group 2, characterizing the decreasing of LV systolic function.

CONCLUSIONS: In patients with frequent ES and paroxysmal AF, develop a cognitive impairment, mostly in the group with paroxysmal AF. Increased arterial stiffness parameters (R-CAVI, L-CAVI) and LA structural changes (increased LA volume, decreased LA strain) are significant predictors of cognitive impairment. The group of patients with paroxysmal AF differed most significantly from the control group in all key parameters.

PMID:40982932