Category: Statistics

Mol Imaging Radionucl Ther. 2025 Dec 19. doi: 10.4274/mirt.galenos.2025.75768. Online ahead of print.

ABSTRACT

OBJECTIVES: The increasing use of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) imaging has led to the frequent detection of incidentalomas. This study aimed to investigate the prevalence, locations, malignancy rates, and clinical evaluations of incidentalomas detected during preoperative staging with ¹⁸F-FDG PET/CT in patients with surgically relevant primary tumors.

METHODS: A total of 251 patients who underwent preoperative ¹⁸F-FDG PET/CT imaging between January 2019 and December 2023 were retrospectively analyzed. Incidental uptake sites were classified into six anatomical regions: thyroid, colon, rectum, prostate, cervix/uterus, and breast. Data regarding maximum standardized uptake value (SUV_max) values, biopsy status, imaging follow-up, and histopathological outcomes were recorded and compared with population-based incidence data from the literature.

RESULTS: The most frequent incidentalomas were detected in the thyroid (11.6%), followed by cervix/uterus (9.6%), colon (7.6%), prostate (4.4%), breast (2.4%), and rectum (2.0%). Malignancy was confirmed in incidentalomas of the thyroid (85.7%), prostate (83.3%), colon (71.4%), rectum (50.0%), and breast (33.3%). Malignancy rates for the thyroid, breast, colorectal, and prostate groups were significantly higher than population-based estimates (p<0.05). No statistically significant correlation was found between SUV_max and malignancy status across localization groups.

CONCLUSION: Incidental findings on ¹⁸F-FDG PET/CT imaging are common and carry a considerable risk of malignancy, particularly in thyroid, prostate, and colorectal sites. Given the observed diagnostic yield, further clinical evaluation, including tissue diagnosis, should be considered in cases with focal uptake, especially when located in high-risk anatomical regions. Awareness of these findings is essential for timely management and appropriate therapeutic decision-making.

PMID:41416397 | DOI:10.4274/mirt.galenos.2025.75768

Health Expect. 2025 Dec;28(6):e70531. doi: 10.1111/hex.70531.

ABSTRACT

OBJECTIVE: Working directly with young people to understand vaping use is necessary for developing meaningful strategies to support them to quit. We explored a range of aspects about the use of e-cigarettes among young people in regional Tasmania, Australia, to inform local approaches to mitigate vaping.

SETTING: Tasmania is an island state with about two-thirds of its population living in inner-regional areas, and one-third in outer-regional, remote, or very remote areas. There are three regions: North, Northwest, and South.

PARTICIPANTS: Eighteen- to twenty-four-year-old Tasmanians who had tried vaping.

DESIGN: An exploratory qualitative study. Recruitment per region employed purposive snowball sampling. Data collection (2021-2022) included demographics, tobacco and e-cigarette usage, participants’ knowledge, beliefs, and access to e-cigarettes. One-on-one interviews and group discussions were conducted using semi-structured questions. Analysis used a combination of summative and conventional content analysis approaches to develop themes.

RESULTS: Twenty-three qualitative interviews and group discussions were analysed, including 29 participants in the analysis sample, 13 females and 16 males (62% South, 24% North, and 14% Northwest). Six themes were developed: ‘switch, not quit’: smokers are not switching to e-cigarettes to quit nicotine; ‘curiosity and social influence are key reasons why young people tried vaping’; ‘vaping is convenient- easy to get, easy to use and easy to hide’, ‘short-term effects of vaping are experienced’, ‘knowledge about vaping is varied’; and ‘suggestion for actions from young people to address the issue of vaping’. The acceptability of vaping was high, and it was seen as safe.

CONCLUSIONS: Our findings support the recently implemented vaping reforms for Australia and suggest that such reforms will be relevant in regional and rural areas. However, it is crucial to continue working with young people to ensure strategies are locally developed and meaningful.

PATIENT OR PUBLIC CONTRIBUTION: Young people of Tasmania with lived experience were actively engaged throughout this research, to help us understand the underlying drivers of vaping in their communities. They have advised that if adults want to change the behaviour of young people, then we need to co-design solutions with young people. More co-design research is needed to incorporate the voices of young people and their ideas about prevention and cessation need to be considered alongside the implementation of regulatory changes.

PMID:41416393 | DOI:10.1111/hex.70531

Int J Cosmet Sci. 2025 Dec 19. doi: 10.1111/ics.70047. Online ahead of print.

ABSTRACT

AIMS: The physicochemical stability of cosmetic emulsions is crucial for successful commercialization and consumer satisfaction. This study presents an innovative protocol that combines rheology, turbidimetry and granulometry to predict emulsion stability more efficiently.

MATERIALS AND METHODS: Industrial emulsions, including some commercial products, were selected to compare stable and unstable samples with minimal formulation differences. Granulometry, turbidimetry and rheology assessments were used to evaluate physical and structural properties. The collected data were subjected to advanced statistical analysis using experimental design methods.

RESULTS: Granulometry, turbidimetry and rheology each effectively distinguished stable from unstable emulsions. Stable emulsions maintained a constant median particle size, while unstable samples exhibited significant increases. Viscosity changes were observed only in unstable emulsions. Turbidimetry showed a Turbiscan Stability Index (TSI) >3 for unstable emulsions and <3 for stable ones. Notably, this combined protocol identified instability as early as 8 days-much faster than standard ISO methods, which require up to 30 days.

CONCLUSIONS: Integrating granulometry, turbidimetry and rheology with advanced data analysis enables a rapid, reliable and sensitive prediction of cosmetic emulsion stability. This approach overcomes the limitations of traditional testing by allowing earlier detection of instability, improving formulation development, quality control and time-to-market. Future work will assess the protocol’s applicability to a wider range of emulsion types.

PMID:41416386 | DOI:10.1111/ics.70047

J Eur Acad Dermatol Venereol. 2025 Dec 19. doi: 10.1111/jdv.70247. Online ahead of print.

ABSTRACT

BACKGROUND: Psoriasis affects at least 60 million people worldwide, and 80% also live with overweight or obesity. Excess weight increases susceptibility to psoriasis and is associated with more severe disease.

OBJECTIVE: To evaluate the impact of weight-loss interventions on psoriasis severity (Psoriasis Area and Severity Index [PASI], PASI50, PASI75, PASI100 [50%/75%/100% reduction in baseline PASI, respectively]) and quality of life (Dermatology Life Quality Index [DLQI]).

METHODS: We systematically searched five databases and two trial registries (inception to 03/09/2025). Outcomes were informed by patient focus-group discussions. Randomized controlled trials (RCTs) in adults with psoriasis, comparing any weight-loss intervention versus usual care or a lower-intensity weight-loss intervention, were included. Studies had to report a change in weight and ≥1 psoriasis severity or quality-of-life measure. Random effects meta-analyses were used.

RESULTS: Thirteen RCTs (1145 participants) with 14 comparisons were included. Eleven interventions advised dietary changes, of which four included physical activity. Three used weight-loss medications. Across 14 comparisons (n = 1145, mean difference (MD) in weight change: -6.7 kg), weight-loss interventions produced a greater reduction in PASI versus control: MD -2.5 (95%CI: -3.8 to -1.1, I² = 85.2%). We found a significant effect of weight-loss interventions on the likelihood of achieving PASI75 (RR = 1.6, 95%CI: 1.1-2.2, I² = 22.6% [based on six comparisons, n = 681, MD in weight change: -7.3 kg]). There was no statistically significant effect of the interventions on the likelihood of achieving PASI50 (RR = 1.5, 95%CI: 0.9-2.4, I² = 72.8% [based on four comparisons, n = 509, MD in weight change: -4.0 kg]) or PASI100 (RR = 1.6, 95%CI: 0.3-9.7, I² = 0.0% [based on two comparisons, n = 334, MD in weight change: -5.2 kg]), but both analyses were limited by few studies. Across seven comparisons (n = 364; MD in weight change -7.8 kg), weight-loss interventions were associated with a significant improvement in DLQI compared to control: MD -5.0 (95%CI: -9.7 to -0.3, I² = 96.0%).

CONCLUSION: High-certainty evidence suggests weight-loss interventions can improve psoriasis severity and quality of life, and should be considered as part of routine treatment.

PMID:41416383 | DOI:10.1111/jdv.70247

Stroke. 2025 Dec 19. doi: 10.1161/STROKEAHA.125.053004. Online ahead of print.

ABSTRACT

BACKGROUND: Recent research has shown that neuroinflammation progresses rapidly within a few hours after stroke; however, the relationship between its progression and clinical outcomes remains unclear. Therefore, this study aimed to investigate the effect of neuroinflammation, measured by serum GFAP (glial fibrillary acidic protein), on patient outcomes, as well as the influence of baseline peripheral inflammation on the progression of neuroinflammation.

METHODS: This prospective cohort study enrolled patients with acute ischemic stroke who received intravenous thrombolysis (IVT) between September 2016 and April 2023 across 16 centers in China. Serum GFAP levels were measured before (baseline, within 4.5 hours of onset) and at 24 hours after IVT. GFAP changes were determined by subtracting baseline levels from those measured 24 hours post-IVT. Outcome measures included final infarct volume during hospitalization, National Institutes of Health Stroke Scale scores at 24 hours and 7 days post-IVT, early neurological deterioration within 24 hours, delayed neurological deterioration within 7 days, and 3-month modified Rankin Scale scores. A modified Rankin Scale score of ≥2 was classified as an unfavorable outcome. Peripheral inflammation indicators were measured at baseline. Binary logistic and linear regressions were used as the main statistical methods.

RESULTS: Overall, 743 patients were included. A significant increase in GFAP levels was observed, indicating progression of neuroinflammation. Regression analyses revealed that increased GFAP after IVT was independently associated with larger infarct volume (β, 30.965 [95% CI, 19.185-42.745]; P<0.001), higher 24-hour and 7-day National Institutes of Health Stroke Scale scores (24-hour: β, 2.632 [95% CI, 1.644-3.620]; P<0.001; 7-day: β, 3.298 [95% CI, 2.179-4.417]; P<0.001), and unfavorable outcomes (odds ratio, 3.631, [95% CI, 2.159-6.106]; P<0.001). Furthermore, baseline peripheral inflammation, assessed using peripheral inflammation indicators, was significantly associated with elevated GFAP levels.

CONCLUSIONS: The increase in GFAP levels over the first 24 hours after IVT is independently associated with clinical outcomes, with higher baseline peripheral inflammation correlating with greater GFAP elevation during that period.

PMID:41416382 | DOI:10.1161/STROKEAHA.125.053004

J Biomed Mater Res B Appl Biomater. 2026 Jan;114(1):e70011. doi: 10.1002/jbmb.70011.

ABSTRACT

Upconverting nanoparticles (UCNPs) have attracted much attention in nanomedicine due to their ability to upconvert photons. However, their adverse effects hinder the biomedical applications. In this paper, bisphosphonate-modified poly(isobutylene-alt-maleic acid)-graft-poly(N,N-dimethylacrylamide)-coated NaYF₄:Yb,Er,Pr UCNPs (UCNP@PIMAPDMA) nanoparticles were designed, which exhibited luminescence emission simultaneously in the visible and NIR-II regions. The developed UCNPs were characterized by a range of physicochemical methods, including transmission electron and energy dispersive microscopy (TEM and EDAX), dynamic light scattering (DLS), X-ray diffraction analysis (XRD), spectrofluorometry, X-ray photoelectron spectroscopy (XPS), and so forth. The UCNP@PIMAPDMA nanoparticles were also evaluated in cell cultures and experimental animals. The particles showed good biocompatibility with cultured human embryonic kidney HEK293 cells commonly used in toxicological studies. Neat UCNPs were cytotoxic towards these cells, which was confirmed by measuring their viability using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) colorimetric assay. Blood serum proteins adhered to the surface of UCNP@PIMAPDMA particles, forming a protein corona that may contribute to particle biosafety. After intravenous injection of these particles into laboratory mice, there were no statistically significant changes in body mass of the treated animals. Also, no big adverse effects on blood cell profile, enzymatic and metabolic markers of hepatotoxicity and nephrotoxicity were observed. Finally, the application potential of UCNP@PIMAPDMA nanoparticles was confirmed by successfully imaging the cytoplasm of rat mesenchymal stem cells and rat C6 glioblastoma cells using laser scanning confocal microscopy.

PMID:41416380 | DOI:10.1002/jbmb.70011

J Yeungnam Med Sci. 2026;43:3. doi: 10.12701/jyms.2026.43.3. Epub 2025 Dec 18.

ABSTRACT

BACKGROUND: Japan and South Korea, two advanced East Asian nations with universal health coverage and similar demographic challenges, have developed markedly different emergency medical services (EMS) systems. Despite growing interest in international benchmarking, structured, comparative studies that yield policy-relevant insights remain limited.

METHODS: We conducted a multisource comparative health-systems analysis using statutory laws, government publications, academic society reports, peer-reviewed literature, and national statistics. Key domains included EMS governance, workforce, prehospital organization, hospital-based emergency care, legal obligations for EMS patient transport and hospital acceptance, and governance and quality assurance mechanisms. Data were synthesized in comparative tables and narrative summaries to highlight structural and operational differences.

RESULTS: Japan’s EMS operates under decentralized municipal control through 722 fire departments, serving 4,100 designated emergency institutions with 6,139 board-certified emergency physicians. In 2023, over 6.64 million ambulance dispatches occurred, and 8.6% were classified as critical cases (1.3% death and 7.3% severe). Korea’s EMS is centrally governed with 412 designated facilities in a tiered system and 2,464 specialists. Annual ambulance activations exceeded 3.5 million, with severe cases accounting for approximately 5% to 10%. Japan employs dual statutory frameworks (Fire Service Act and Medical Practitioners Act), allowing clinical discretion, whereas Korea enforces unified regulations with stricter obligations and criminal penalties for hospital refusal of emergency patients.

CONCLUSION: The contrasting systems suggest that hybrid governance that combines centralized standard settings with local operational flexibility may optimize EMS performance. These findings provide lessons for EMS reform, cross-border collaboration, and disaster preparedness in high-income nations facing similar demographic and healthcare challenges.

PMID:41416366 | DOI:10.12701/jyms.2026.43.3

Biomed Res Int. 2025 Dec 17;2025:9923869. doi: 10.1155/bmri/9923869. eCollection 2025.

ABSTRACT

BACKGROUND: Despite the increasing incidence of cancer worldwide, the knowledge about the trend of cancer incidence in Ethiopia is limited. The paucity of core cancer diagnostic services like pathology, diagnostic imaging technology, and the absence of a comprehensive national cancer registry masked the exact magnitude of cancer incidence in Ethiopia in general and the Wolaita area in particular. This study is aimed at filling the gap by analyzing diagnostic data from a referral clinic. The clinic used to serve as a primary diagnostic center for patients referred from over 25 healthcare facilities in the region.

METHODS: A pathology sample retrospective analysis-based prevalence study was conducted for the period between December 2017 and February 2022. Records saved in computers were subjected to analysis by using Statistical Package for Social Sciences (SPSS) software Version 22. The data were used to analyze the types and distribution of cancers in the region across age, sex, and diagnosis.

RESULTS AND DISCUSSIONS: The results showed notable gender disparities, with women experiencing a greater prevalence of breast cancer and men mostly receiving diagnoses for soft tissue sarcomas. The most prevalent forms of cancer were determined, along with the locations of each. The study also emphasized how different referral facilities, such as general hospitals, primary hospitals, and medium-sized clinics, had varying cancer incidence rates. Although generalizability may be limited by the study’s clinic-based design, its relevance to comparable healthcare settings in Ethiopia and other low-resource locations is strengthened by the large and diverse sample drawn from a variety of referral institutions. This study emphasizes the necessity of focused screening programs and greater cancer awareness in Wolaita Zone, particularly in rural regions. The results also suggest possible directions for future investigation, such as population-based studies to confirm and build upon these findings.

CONCLUSIONS: This study provides crucial insights into the cancer burden in Wolaita Zone and emphasizes the importance of improving diagnostic and preventive measures. Further research, including broader, population-based studies, is necessary to confirm these findings and inform regional cancer control strategies.

PMID:41416348 | PMC:PMC12709645 | DOI:10.1155/bmri/9923869

Cureus. 2025 Nov 17;17(11):e97096. doi: 10.7759/cureus.97096. eCollection 2025 Nov.

ABSTRACT

BACKGROUND: Rapid cycle deliberate practice (RCDP) is a form of simulation debriefing that incorporates repeated cycles of hands-on practice, characterized by within-simulation directed feedback and repeated practice with the goal of mastering a skill. RCDP debriefing has been shown to improve immediate performance; however, evidence of improved retention and superiority to traditional styles of debriefing is lacking.

OBJECTIVES: To compare RCDP and traditional debriefing for knowledge and skills acquisition and retention as part of a longitudinal residency simulation curriculum.

DESIGN: Participants were first-year pediatrics residents who underwent two simulation scenarios, focusing on basic airway and cardiac arrest management, at the beginning of their intern year. Participants were block randomized to either the RCDP or the traditional debriefing arm. Knowledge was assessed in a pre-post format at time 0 and at 12 months using a multiple-choice quiz. All interns received a repeat simulation teaching session at three, six, nine, or 12 months, remaining in their RCDP or traditional debriefing arm. Skills were assessed via a video-recorded simulated scenario prior to an initial simulation session (RCDP vs. traditional debriefing) at time 0 and three, six, nine, and 12 months, and before and after their repeat simulation teaching session. Videos were scored by two pediatric emergency medicine physicians using a resuscitation skills assessment tool.

RESULTS: There was no statistical difference in overall knowledge (via paired t-test) or skills acquisition (via linear mixed effects model) between residents who received traditional debriefing and those who received RCDP debriefing. The RCDP group showed significant improvement in skills when compared with the traditional group for those who received repeat education at three months; however, there was no difference in the other time groups. There was no difference between groups in skills retention at three months after the repeat teaching session, as assessed via the ANOVA analysis.

CONCLUSION: Overall, we demonstrated similar knowledge and skills gain and retention in traditional debriefing and RCDP groups, with the exception of those residents who received repeat teaching at the three-month time point. This may indicate that a three-month time interval could be the most appropriate timing for repeated RCDP resuscitation teaching. Higher power randomized controlled trials comparing RCDP to traditional simulation and/or qualitative studies assessing the efficacy of RCDP would add to current evidence.

PMID:41416338 | PMC:PMC12711249 | DOI:10.7759/cureus.97096

Cureus. 2025 Nov 17;17(11):e97084. doi: 10.7759/cureus.97084. eCollection 2025 Nov.

ABSTRACT

Pantoprazole is a proton pump inhibitor commonly used to treat gastroesophageal reflux disease (GERD) by reducing stomach acid production. Although widely used for gastrointestinal issues, its effects on embryonic development remain underexplored. This study investigated the impact of pantoprazole on neural tube closure using a chick embryo model. Fertilised chicken eggs were divided into groups and treated with varying doses of pantoprazole. All embryos were collected on the eighth day of incubation. Both macroscopic and microscopic examinations were conducted to assess developmental abnormalities. Macroscopic analysis revealed malformations, particularly in embryos exposed to medium and high doses of pantoprazole. These groups exhibited statistically significant developmental delays compared to controls. Microscopic examination further demonstrated that high-dose pantoprazole resulted in delayed vertebral lamina ossification and midline closure defects-key indicators of neural tube defects. Overall, the study concluded that high levels of pantoprazole exposure during embryonic development can lead to structural malformations and delayed growth. Specifically, neural tube defects were identified, indicating a risk to early neural development. These findings suggest that pantoprazole use during pregnancy may pose teratogenic risks and should be approached with caution. This research highlights the need for further studies on the safety of commonly used medications like pantoprazole during pregnancy, as their use may adversely affect embryonic development, particularly neural tube formation.

PMID:41416336 | PMC:PMC12710982 | DOI:10.7759/cureus.97084