Category: Statistics

JAMA Netw Open. 2025 Dec 1;8(12):e2548715. doi: 10.1001/jamanetworkopen.2025.48715.

ABSTRACT

IMPORTANCE: Associations with chemotherapy, occurrence of multiple meningiomas, and mortality after subsequent meningioma diagnosis among survivors of childhood cancer remain unclear.

OBJECTIVES: To report the incidence of meningioma among childhood cancer survivors, identify novel risk factors for meningiomas, characterize survivors with multiple meningiomas, and describe cause-specific mortality following meningioma occurrence.

DESIGN, SETTING, AND PARTICIPANTS: The Childhood Cancer Survivor Study is a retrospective cohort study with longitudinal prospective follow-up of childhood cancer survivors diagnosed between 1970 to 1999 in the US and Canada. Eligibility included diagnosis of cancer before age 21 years and surviving more than 5 years after diagnosis. Meningiomas were self-reported and confirmed by review of pathology reports. Childhood cancer diagnosis, chemotherapy details, and radiation therapy exposures from up to 5 years from diagnosis were abstracted from medical records.

MAIN OUTCOMES AND MEASURES: Cumulative incidence of meningioma was calculated starting from 5 years from the diagnosis. Overall survival (OS) from diagnosis of the first subsequent meningioma was estimated using Kaplan-Meier methods.

RESULTS: The CCSS cohort included 24 886 survivors initially diagnosed from 1970 to 1999, including 471 survivors (263 female [56%]; median [range] age at last follow-up, 42.5 [19.7-66.3] years; median [range] age at primary cancer diagnosis, 5.6 [0-20.9] years) who were diagnosed with 710 meningiomas. Thirty-five years after primary cancer diagnosis, the cumulative incidence of a subsequent meningioma was 2.3% (95% CI, 2.1%-2.6%). Of the 471 survivors who developed meningioma, 137 (29.0%) had at least 2 meningiomas, and 80 (16%) met criteria for meningiomatosis. An increased risk of meningioma was associated with higher doses of cranial radiation therapy (eg, HR, 125.3 [95% CI, 58.1-270.5]), younger age at primary cancer diagnosis (eg, 0 to 4 years: HR, 4.0 [95% CI, 2.4-6.1]), female sex (HR, 1.6 [95% CI, 1.3-1.9]), and exposure to platinum, 6-mercaptopurine, and intrathecal chemotherapy, and a lower risk was associated with non-Hispanic Black race (HR, 0.5 [95% CI, 0.3-1.0]) and exposure to alkylating agents (HR, 0.6 [95% CI, 0.5-0.8]). The all-cause cumulative mortality was 4.9%, 10.5% and 18.4% at 5, 10, and 15 years from the first subsequent meningioma diagnosis.

CONCLUSIONS AND RELEVANCE: Meningiomas have a relatively high incidence and mortality for childhood cancer survivors. Results from this study could justify screening for meningiomas in high-risk populations.

PMID:41379444 | DOI:10.1001/jamanetworkopen.2025.48715

JAMA Netw Open. 2025 Dec 1;8(12):e2548809. doi: 10.1001/jamanetworkopen.2025.48809.

ABSTRACT

IMPORTANCE: Substance use disorders (SUDs) affect millions of of people worldwide and are marked by high relapse rates. Cue-elicited brain activity may correlate with treatment success, but no meta-analysis has identified which brain regions are consistently associated with outcomes.

OBJECTIVE: To evaluate, across the existing literature, whether functional magnetic resonance imaging (fMRI)-based cue reactivity is associated with SUD treatment response (eg, predictive biomarker) or posttreatment neural changes (eg, response biomarker).

DATA SOURCES: A systematic search of PubMed, PsycINFO, Embase, and Cochrane databases covered studies published from database inception through May 2023.

STUDY SELECTION: Studies were included if they reported fMRI-based cue reactivity and treatment outcomes for adults undergoing SUD treatment.

DATA EXTRACTION AND SYNTHESIS: Data extraction followed PRISMA guidelines. Analyses were conducted from October 2024 to January 2025 using Seed-Based d Mapping With Permutation of Subject Images to quantify the magnitude and extent of activation to substance-related cues across studies. Random-effects models were used to generate statistical activation maps.

MAIN OUTCOMES AND MEASURES: Statistical maps of cue-induced activation during drug cue presentation at baseline correlating with a treatment outcome (for predictive biomarkers) as well as in brain regions exhibiting a significant change after treatment (for response biomarkers). Statistical inference used permutation statistics, with thresholds set at P < .005 and cluster extent of 10 voxels.

RESULTS: Fifty-one studies (1787 participants) were included. Cue-elicited activation was observed across studies in the cingulate gyrus, middle frontal gyrus, caudate, and insula. Predictive biomarker regions (n = 14 studies, 456 participants) included the bilateral insula and cingulate, in which lower baseline cue reactivity was associated with better treatment outcomes. Response biomarkers (pretreatment to posttreatment analyses; n = 25 studies, 609 participants) indicated significant reductions in cue reactivity in the anterior cingulate, caudate, accumbens, and insula. Cue-elicited activation in the insula emerged as both predictive and response biomarkers.

CONCLUSIONS AND RELEVANCE: This meta-analysis of cue-induced brain activation in adults with SUDs identified specific regions consistently engaged during cue exposure that may serve as candidate predictive and response biomarkers for treatment outcomes, highlighting the potential role of brain-based biomarkers in informing interventions for SUD.

PMID:41379443 | DOI:10.1001/jamanetworkopen.2025.48809

Stomatologiia (Mosk). 2025;104(6. Vyp. 2):51-55. doi: 10.17116/stomat202510406251.

ABSTRACT

In certain clinical cases where orthograde treatment of chronic apical periodontitis is either impossible or ineffective, apical surgery with retrograde filling is considered the preferred method. When selecting a retrograde filling material, key factors such as biocompatibility, ability to provide a reliable seal, ease of use, and availability are taken into account. Despite numerous studies investigating the influence of various retrograde filling materials on the outcomes of apical surgery, there is still no consensus on the most effective material. Therefore, further research in this area remains an important and relevant task. The aim of this study was to evaluate the effectiveness of mineral trioxide aggregate (MTA) and glass ionomer cement as retrograde filling materials. The study included 40 patients diagnosed with chronic apical periodontitis (ICD-10 code K04.5). Patients were randomly assigned to two groups: the first group (24 patients) received retrograde filling with the new material Dia-Root BioMTA, while the second group (16 patients) was treated with glass ionomer cement Ketac Cem. Healing dynamics were assessed using the periapical index (PAI) before surgery and at 3, 6, and 12 months postoperatively. The results demonstrated a significant and sustained reduction of inflammation in both groups, with no statistically significant differences between them, indicating comparable effectiveness of the materials used.

PMID:41379411 | DOI:10.17116/stomat202510406251

Stomatologiia (Mosk). 2025;104(6. Vyp. 2):32-37. doi: 10.17116/stomat202510406232.

ABSTRACT

OBJECTIVE: Study of cytocompatibility of hydroxyapatite coating for titanium implants applied by high-frequency magnetron sputtering at low pressures in an inert gas atmosphere.

MATERIALS AND METHODS: Hydroxyapatite was deposited on titanium substrates using the HF magnetron sputtering method. The cytocompatibility of the materials was assessed by incubating with multipotent mesenchymal stromal cells (MSCs) using the MTT assay. Adhesion properties were studied by staining cells with fluorescent dyes and using scanning electron microscopy.

RESULTS: The studied titanium materials possess high cytocompatibility. The number of living cells on the 7th day was 100.0±5.6% and 108.5±8.7% for materials with and without coating, respectively. Furthermore, coating titanium substrates with hydroxyapatite resulted in a statistically significant 1.7±0.4-fold increase in the number of adhered MSCs compared to uncoated materials.

CONCLUSION: The hydroxyapatite coating applied using HF magnetron sputtering significantly improves cell adhesion to titanium materials. Thus, the obtained results provide a basis for the development of new implants with functionalized surfaces.

PMID:41379408 | DOI:10.17116/stomat202510406232

Environ Geochem Health. 2025 Dec 11;48(1):43. doi: 10.1007/s10653-025-02930-x.

ABSTRACT

River water quality in agricultural areas is crucial for human health, ecological well-being, and productivity. Pollution and high concentrations of ions, particularly in developing countries, are caused by both natural and human-induced factors, including the use of chemical fertilizers and pesticides, making prompt action necessary to address pollution. Thus, this work evaluated the hydrogeochemistry and water quality of the Duero River, located in the northwest part of Michoacán State, México. Twelve sites were selected to cover its entire course, from its source to its mouth, passing through the Zamora Valley, known for its high agricultural productivity. Three sample collections were conducted to cover both the dry and rainy seasons. Physicochemical parameters (temperature, pH, electrical conductivity, redox potential, solids, total hardness, total alkalinity, BOD₅, COD, total phosphorus (TP), N-NH₃, NO₃^–), major ions (Ca²⁺, Mg²⁺, Na⁺, HCO₃^–, SO₄^2-, Cl^–), and fecal coliforms (FC) were analyzed. The results indicated that the river water had a slightly alkaline pH. Water from the first part of the river is suitable for agricultural irrigation, and only the water from the first site, which corresponds to the source of the river, is suitable for human use and consumption. The analysis revealed that most of the sites examined are contaminated with fecal matter. Statistical analysis indicates similarities between COD, total phosphorus, TDS, alkalinity, total hardness, N-NH₃, and electrical conductivity (EC). These findings suggest that agricultural activities in the area likely influence the contamination of the Duero River. The chemistry of river water is mainly controlled by the weathering of rocks, dissolution of carbonates, and ion exchange reactions.

PMID:41379371 | DOI:10.1007/s10653-025-02930-x

Mol Imaging Biol. 2025 Dec 11. doi: 10.1007/s11307-025-02068-3. Online ahead of print.

ABSTRACT

BACKGROUND: Pafolacianine (Cytalux^®) represents the first FDA-approved tumor-specific fluorescence imaging agent, demonstrating efficacy in ovarian cancer through folate receptor-α (FR-α) targeting. Given the need for improved intraoperative margin assessment in head and neck squamous cell carcinoma (HNSCC), where positive surgical margins occur in 10-30% of cases, we investigated the potential utility of pafolacianine for fluorescence-guided surgery in HNSCC models.

OBJECTIVE: To evaluate the feasibility of visualizing HNSCC using pafolacianine in vitro, in vivo, and clinical tissue analysis, with comparison to fluorescence-guided surgery agents that have been successful in patients.

METHODS: HNSCC cell lines (FaDu, UMSCC47) were treated with escalating concentrations of pafolacianine (0-500 nM) and assessed for binding at 1 and 24 h. Nude mice bearing HNSCC xenografts (FaDu, UMSCC47) received intraperitoneal injection of pafolacianine (10 nmol) with fluorescence imaging at multiple timepoints. Immunohistochemistry analysis of patient samples (n = 8 tumor, n = 8 normal) evaluated FR-α and FR-β expression. Panitumumab-IRDye800CW served as a positive control for comparison.

RESULTS: In vitro analysis demonstrated minimal pafolacianine binding across all HNSCC cell lines, with fluorescence intensities similar to or lower than the FR-α-negative A549 control cell line. In vivo imaging revealed poor tumor localization with mean fluorescence intensity (MFI) of 7.39 (FaDu) and 6.97 (UMSCC47), substantially lower than non-target tissues including skin. Immunohistochemistry analysis showed no statistically significant difference in FR-α expression between tumor and normal tissue (p > 0.05). For comparison, panitumumab-IRDye800CW demonstrated robust tumor targeting with MFI of 32.14 (FaDu) and 14.98 (UMSCC47).

CONCLUSIONS: This study demonstrates that pafolacianine exhibits limited utility for fluorescence-guided surgery in HNSCC due to insufficient FR-α expression and poor tumor-to-background contrast. These negative findings provide crucial evidence against the clinical translation of pafolacianine for HNSCC applications and highlight the importance of target expression validation in precision medicine approaches.

CLINICAL RELEVANCE: Negative studies such as this are essential for evidence-based clinical decision-making, preventing unnecessary resource allocation and potential patient exposure to ineffective interventions. These findings inform the broader fluorescence-guided surgery field and support continued investigation of alternative targeting strategies for HNSCC.

PMID:41379363 | DOI:10.1007/s11307-025-02068-3

Hernia. 2025 Dec 11;30(1):27. doi: 10.1007/s10029-025-03522-5.

ABSTRACT

PURPOSE: Parastomal hernias are a common complication after ostomy creation with high morbidity. Minimally invasive Sugarbaker mesh-based repairs have shown improved outcomes. Laparoscopic (LPHR) and robotic-assisted (RPHR) Sugarbaker parastomal hernia repairs were compared.

METHODS: Retrospective analysis of the Abdominal Core Health Quality Collaborative (ACHQC) database was conducted for elective, minimally invasive Sugarbaker parastomal hernia repair with permanent synthetic mesh from January 2014 to December 2023. Patients were grouped by surgical approach: RPHR or LPHR. Primary outcome was pragmatic hernia recurrence. Secondary outcomes included average pain intensity, hernia-related quality of life, and 30/90-day complications. Statistical analyses included chi-square, t-tests, and Mann-Whitney U tests.

RESULTS: Three hundred sixty-eight patients were included (RPHR: n = 260; LPHR: n = 108). Demographics and comorbidities were similar. RPHR involved more mesh excisions (37.5% vs. 4.3%; P = .009), hernia with longer lengths (8.3 cm vs. 6.4 cm; P < .001), and more frequent fascial closure (94.4% vs. 48.1%; P < .001). Recurrence within one year was lower after RPHR (20.9% vs. 40.5%; P = .03), but no significant differences were observed between postoperative years one through six. No differences in pain or quality-of-life outcomes were noted between groups, but both groups demonstrated significant improvements in hernia-related quality-of-life over one year.

CONCLUSION: Recurrence within one year was lower after RPHR compared to LPHR. Longer-term recurrence rates were similar between approaches. However, long-term recurrence findings are limited by low follow-up rates. Both approaches significantly improved hernia-related quality-of-life. Over time, recurrence may be more dependent on the altered anatomy and physiology of the stoma-affected abdominal wall rather than the specific minimally invasive approach used.

PMID:41379342 | DOI:10.1007/s10029-025-03522-5

Sleep Breath. 2025 Dec 11;30(1):7. doi: 10.1007/s11325-025-03555-1.

ABSTRACT

PURPOSE: Obstructive sleep apnea (OSA) is a prevalent sleep disorder and has been linked to reduced muscle mass and strength. However, its impact within couples remains poorly understood. This study investigated associations between OSA risk and muscle outcomes at both the individual and couple levels in Korean adults.

METHODS: We analyzed data from 1,597 heterosexual couples aged ≥ 40 years from the 2022-2023 Korea National Health and Nutrition Examination Survey, including 1,020 couples with handgrip strength data. OSA risk was defined as a STOP-Bang score ≥ 3. Muscle mass and strength were assessed using appendicular skeletal muscle mass (ASM) and handgrip strength, each normalized by BMI. Associations were examined using linear regression and the Actor-Partner Interdependence Model, adjusting for sociodemographic, lifestyle, and health-related covariates.

RESULTS: Higher STOP-Bang scores were independently associated with lower ASM/BMI and HGS/BMI in both husbands and wives (all p < 0.001). Partner effects were significant for husbands but not wives. At the couple level, having only one partner at high OSA risk was linked to lower muscle outcomes in that individual, while both partners at high risk exhibited the greatest declines in both outcomes (all p < 0.001).

CONCLUSION: High OSA risk is associated with reduced muscle mass and strength in both genders, with additive adverse effects observed when both partners are affected. These findings underscore the need to incorporate sleep-related risk factors into musculoskeletal health assessment and highlight the potential value of couple-based approaches for OSA screening and intervention in clinical sleep medicine.

PMID:41379339 | DOI:10.1007/s11325-025-03555-1

Environ Monit Assess. 2025 Dec 11;198(1):40. doi: 10.1007/s10661-025-14870-1.

ABSTRACT

Low-cost particulate matter (PM) sensors are increasingly used for personal and environmental air quality monitoring due to their affordability and accessibility. Recent advancements make these sensors suitable for occupational settings, but their accuracy in such settings remains uncertain. This study calibrated the AirBeam 2 and AirBeam 3 against the Thermo Scientific Personal DataRAM PDR-1500 to assess their efficacy at measuring high PM concentrations, such as those in occupational exposure settings, using engine exhaust and biomass smoke as PM sources. Laboratory calibrations were conducted using a sealed chamber. Linear and polynomial regressions assessed agreement with the PDR-1500, while breakpoint analyses identified thresholds where sensor performance shifted. Field calibrations using the AirBeam 2s evaluated real-world performance and user preferences. The AirBeam 2 exhibited a novel issue where PM₁ readings exceeded PM₂.₅ at concentrations > 50 µg/m³, which was corrected through reprogramming. Polynomial models outperformed linear ones for both devices and the AirBeam 3 performed better with engine exhaust than biomass smoke (linear calibration coefficients 0.192 vs 0.102, respectively), while the AirBeam 2 performed better with biomass smoke than engine exhaust (coefficients 0.323 vs 0.274, respectively). Breakpoints suggested the AirBeam 2s may be better for high concentrations, while the AirBeam 3s were more sensitive at lower concentrations. In the field, the AirBeam 2s recorded lower mean PM concentrations than the PDR-1500 and were more influenced by environmental conditions, yet participants (n = 9) who were recruited to perform field calibrations with both devices preferred the AirBeam. While sensor performance can vary by PM source, concentration, and environmental factors, these findings suggest AirBeams can be a useful option for preliminary occupational exposure assessments after careful calibration and validation prior to use.

PMID:41379328 | DOI:10.1007/s10661-025-14870-1

J Math Biol. 2025 Dec 11;92(1):12. doi: 10.1007/s00285-025-02326-6.

ABSTRACT

In biological systems, cooperative behavior forms the foundation for the survival and prosperity of many organisms. However, the finite nature of resources often drives selfish individuals to exploit resources through deceptive tactics, thereby instigating conflicts between collective and individual interests. These strategic interactions not only alter the availability of environmental resources but also feedback on the strategic choices of populations, leading to the co-evolution of environmental resources and behavioral strategies. By integrating population dynamics with replicator dynamics, we develop models for both well-mixed and spatially heterogeneous distributions that incorporate resource feedback mechanisms to analyze the intricate interplay between cooperative behavior and resource dynamics across temporal and spatial scales. Our findings reveal complex evolutionary dynamics, including rich multistability, transcritical and Hopf bifurcations in the temporal system, alongside spatial stability, Turing instability, Turing-Hopf bifurcation, and chaotic behavior in the spatial diffusion system. In homogeneous distributions, payoffs result in stable periodic solutions, while heterogeneous distributions disrupt stable periodicity and lead to chaotic dynamics. Notably, increasing the initial density of cooperators, the rate of resource growth, and reducing the initial resource stock are favorable for sustaining cooperation. Interestingly, high payoffs for cooperators and low payoffs for defectors do not necessarily promote cooperative behavior, as evolutionary outcomes also depend on resource abundance. We provide the conditions that sustain cooperation, revealing the critical role of resource dynamics and spatial diffusion in shaping the evolution of cooperative strategies. Our findings have important implications for studying ecosystem management, conservation biology, and animal social behavior.

PMID:41379322 | DOI:10.1007/s00285-025-02326-6