Category: Statistics

BJS Open. 2025 Oct 30;9(6):zraf102. doi: 10.1093/bjsopen/zraf102.

ABSTRACT

BACKGROUND: Laparoscopic liver resection has been associated with less morbidity than, and similar global outcomes to, open liver resection. There is no robust evidence that these outcomes lead to similar clinical outcomes in patients aged over 80 years. The aim of this study was to analyse the short-term outcomes between open and laparoscopic liver resection in patients over 80 years old.

METHODS: A retrospective analysis was undertaken. The study population comprised patients aged ≥ 80 years who underwent laparoscopic or open liver resection between January 2014 and December 2019, and who presented with resectable malignant tumours. The primary outcome was postoperative morbidity, according to Dindo-Clavien grading. Cox regression models were used to compute hazard ratios and 95% confidence intervals. Propensity score matching (1 : 1) was performed to balance the two groups according to independent prognostic factors for morbidity.

RESULTS: A total of 988 patients were analysed from 34 centres (16 from Asia, 14 from Europe and 4 from America): 487 in the open group and 501 in the laparoscopic group. Independent risk factors associated with severe morbidity were the open approach (hazard ratio 1.59, 95% confidence interval 1.19 to 2.11; P < 0.001), Charlson Co-morbidity Index score > 7 (HR 1.69, 1.26 to 2.27; P < 0.001), more than one resected tumour (hazard ratio 1.55, 1.13 to 2.11; P = 0.006), major hepatectomy (hazard ratio 1.86, 1.22 to 2.83; P = 0.003), and Iwate score ≥ 7 (hazard ratio 1.43, 1.02 to 2.01; P = 0.03). Before propensity score matching, severe morbidity, length of intensive care unit stay, 90-day mortality, length of hospital stay, and readmission were better in the laparoscopic group (P < 0.050). These observations were confirmed after propensity score matching.

CONCLUSION: The laparoscopic approach is a safe procedure for elderly patients, with better morbidity and mortality outcomes than the open approach, and should be considered as a default option.

PMID:41313746 | DOI:10.1093/bjsopen/zraf102

J Foot Ankle Res. 2025 Dec;18(4):e70104. doi: 10.1002/jfa2.70104.

ABSTRACT

INTRODUCTION: Foot skin xerosis is common, particularly in older people and people with diabetes. Efficacy of emollient treatment of xerosis can be measured using skin hydration measurement devices. None of the devices currently available, however, have been explicitly assessed for their suitability for use on the skin of the foot. The plantar skin has a morphology and composition disparate from non-plantar skin sites, with a stratum corneum (SC) 16 times thicker than non-plantar skin SC. The shallow measurement depth of hydration measurement devices (0.015 mm for the Corneometer CM825) could be collecting data from incommensurate locations within plantar and non-plantar skin. The aim of this study is to examine how data collected using three hydration measurement devices with different measurement depths (Corneometer CM825, MoistureMeter D and MoistureMeter SC) correlate with tissue characteristics known to vary with skin hydration (hardness, elasticity, surface texture and patient perception) to inform their future use.

METHODS: Individuals aged 20-40 were recruited to attend the University of Salford Skin laboratory for data-collection. Following a 15-min acclimatisation period, measures were taken from four skin sites (plantar and non-plantar) using three hydration measurement devices, the SATRA STD 226 Durometer (SATRA Technology, Kettering, UK), Dermalab Elasticity probe (Cortex Technology, Hadsund, Denmark), Visioscan VC98 (Courage and Khazaka, Koln, Germany) and the Foot Skin health Questionnaire. Correlation analyses were conducted using SPSS (IBM SPSS Statistics Version 29.0.1.0).

RESULTS: Thirty-two participants were recruited (mean age ± (SD):27.9 ± 4.8; 53% female). The Corneometer CM825 (n = 20) and MoistureMeter SC (n = 32) demonstrate consistent weak-moderate strength correlations with skin elasticity, hardness and texture for both plantar and non-plantar skin. The MoistureMeter D (n = 32), however, correlated stronger with the physical characteristics of plantar skin than non-plantar skin. The only device that found a statistically significant difference between self-perceived ‘dry’ or ‘not dry’ skin was the Corneometer CM825 (Mann-Whitney U test p = 0.009).

CONCLUSION: The skin site being measured should guide the selection of a hydration measurement device. Future work should include a similar assessment using low-cost devices that are accessible to health care practitioners and expansion of the work to include xerotic skin.

PMID:41313744 | DOI:10.1002/jfa2.70104

IEEE J Biomed Health Inform. 2025 Nov 28;PP. doi: 10.1109/JBHI.2025.3638846. Online ahead of print.

ABSTRACT

Computer audition-based methods have attracted a great deal of attention in the field of disease detection due to their significant advantages, e.g., non invasive and convenient operation. Among them, the introduction of information representations inspired by human auditory perception, e.g., Mel-frequency transformation, gives it great potential to approach and even exceed the limits of the human auditory system. However, according to previous research, it remains challenging to fairly as sess whether information representations inspired by human auditory perception have a significant positive effect on disease detection. Moreover, performance differences among various information representations and their underlying causes are yet to be thoroughly investigated and analyzed. To this end, we propose an interpretable com parative study on information representations inspired by human auditory perception for disease detection. First, the detection accuracy of different information representations are investigated on two sound datasets (a psychological and a physiological disease) based on the classical model and the proposed Temporal-Spatial Multi-Scale Perception Network. Then, the noise robustness of these information representations are compared by introducing Gaussian noise with varying signal-to-noise ratios (SNRs). Finally, by combining the human auditory perception mechanism and explainable AI techniques, we analyze the reasons for performance differences among various information representations from qualitative and quantitative perspectives. Experimental results demonstrate that information representations inspired by human auditory perception can improve the performance of disease detection with statistical significance. Furthermore, Gammatone Frequency Cepstral Coefficients (GFCCs) outperform other information representations by achieving the highest accuracy, particularly under noisy conditions. The interpretable results further reveal the underlying reasons for GFCC’s superior performance, highlighting its ability to capture critical auditory features robustly across varying noise levels. These findings emphasize the potential of auditory perception inspired representations in advancing computer audition based disease detection systems and provide a solid foundation for future research in this domain.

PMID:41313695 | DOI:10.1109/JBHI.2025.3638846

Microb Genom. 2025 Nov;11(11). doi: 10.1099/mgen.0.001572.

ABSTRACT

Infections caused by carbapenem-resistant Acinetobacter baumannii (CRAB) are of great concern, as mortality is high, and treatment options are very limited. Despite having among the highest rates reported worldwide, scarce genomic data are available on CRAB strains from the Middle East. Here, we report the global emergence of a novel International Clone (IC), designated IC12, based on the epidemiological, phenotypic and genome sequencing data (short reads and long reads) of a set of 60 A. baumannii isolates belonging to multilocus sequence type 158 (Pasteur scheme). IC12, prevailing in the Middle East since 2007, has also been found in Europe, Asia and South America. Alleles OXA-65 and ADC-117, coded by the bla _OXA-51-like and bla _ADC A. baumannii-intrinsic genes, respectively, were hallmarks shared by all the isolates. Plasmid pIC12-2 (80,000 bp), which carries a repAci6 replication initiator (RP-T1) and a type IV conjugative transfer system, played a major role in the antimicrobial resistance profile of 54/60 of the IC12 isolates. This resistance was mediated by three mobile genetic elements, namely Tn2008, MITEAb-IC12 and TnaphA6. All four Peruvian IC12 isolates lacked pIC12-2 and carried a different set of plasmids. Two of the Peruvian isolates carried a chromosomal resistance island of 79,396 bp long (designated IC12-RI) marked by the occurrence of tet(X3). The global spread of IC12 is worrying and calls for further studies on the virulence features and clinical impact of this clone.

PMID:41313692 | DOI:10.1099/mgen.0.001572

J Frailty Aging. 2025 Nov 26;14(6):100106. doi: 10.1016/j.tjfa.2025.100106. Online ahead of print.

ABSTRACT

BACKGROUND: Ketone bodies are metabolites produced during fasting or on a ketogenic diet that have pleiotropic effects on the inflammatory and metabolic aging pathways underpinning frailty in vivo models. Ketone esters (KEs) are compounds that induce hyperketonemia without dietary changes and that may impact physical and cognitive function in young adults. The functional effects of KEs have not been studied in older adults.

OBJECTIVES: Our long-term goal is to examine if KEs modulate aging biology mechanisms and clinical outcomes relevant to frailty in older adults. Here, we report the exploratory functional and quality-of-life outcome measures collected during a 12-week safety and tolerability study of KE (NCT05585762).

DESIGN: Randomized, placebo-controlled, double-blinded, parallel-group, pilot trial of 12-weeks of daily KE ingestion.

SETTING: The Clinical Research Unit at the Buck Institute for Research on Aging, California.

PARTICIPANTS: Community-dwelling older adults (≥65 years), independent in activities of daily living, with no unstable acute medical conditions (n = 30).

INTERVENTION: Participants were randomly allocated (1:1) to consume 25 g daily of either KE (bis-octanoyl (R)-1,3-butanediol) or a taste, appearance, and calorie-matched placebo (PLA) containing canola oil.

MEASUREMENTS: Longitudinal change in physical function, cognitive function and quality of life were assessed as exploratory outcomes in n = 23 completers (n = 11 PLA, n = 12 KE). A composite functional outcome intended for interventional frailty trials was derived and calculated. Heart rate and activity was measured throughout the study using digital wearables.

RESULTS: There were no statistically significant longitudinal differences between groups in exploratory functional, activity-based or quality of life outcomes.

CONCLUSION: Daily ingestion of 25 g of KE did not affect exploratory functional or quality-of-life end points in this pilot cohort of healthy older adults. Future work will address these endpoints as primary and secondary outcomes in a larger trial of pre-frail older adults.

PMID:41313689 | DOI:10.1016/j.tjfa.2025.100106

Alzheimers Dement. 2025 Nov;21(11):e70950. doi: 10.1002/alz.70950.

ABSTRACT

INTRODUCTION: Late-life depression symptoms are implicated in dementia. We examined how cumulative burden, duration, trajectory, and variability of depression symptoms are associated with incident dementia.

METHODS: A prospective cohort analysis of 23,305 dementia-free adults from four population studies (English Longitudinal Study of Ageing [ELSA], Health and Retirement Study [HRS], Survey of Health, Ageing and Retirement in Europe [SHARE], China Health and Retirement Longitudinal Study [CHARLS]) with repeated Centre for Epidemiologic Studies of Depression scale (CES-D)/Euro-Depression scale (EURO-D) assessments across three waves and a pooled median follow-up of ≈10.8 years. Exposures included CumSD/cumulative average depression symptom score (CumADS), high-symptom exposure duration, visit-to-visit variability (Standard deviation [SD], coefficient of variation [CV], variation independent of the mean [VIM]), and time-course patterns. Associations were analyzed using multivariable-adjusted Cox regression.

RESULTS: Each 1-unit increase in cumulative score was associated with a 3%-8% higher dementia hazard across cohorts. Highest versus lowest cumulative quartiles showed markedly elevated risk. Sustained high exposure for 4 years conferred ≈2.7-3.9× greater risk. Higher variability and worsening trajectories were also linked to higher incidence. Associations were robust across subgroups.

DISCUSSION: Persistent and unstable depression symptoms independently predict higher dementia risk, supporting longitudinal mood monitoring and sustained management.

HIGHLIGHTS: Multi-cohort study of 23,305 adults (ELSA, HRS, SHARE, CHARLS). Cumulative depression burden shows a dose-response with dementia risk. Highest versus lowest quartile: dementia hazard up to 18× (HRS). Sustained high symptoms (4 years) linked to ≈2.7-3.9× greater risk. Visit-to-visit variability independently associates with higher dementia risk.

PMID:41313677 | DOI:10.1002/alz.70950

J Vet Emerg Crit Care (San Antonio). 2025 Nov 28. doi: 10.1111/vec.70057. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze the effects of co-administering various drugs with canine whole blood (WB), canine fresh frozen plasma (FFP), or canine freeze-dried plasma (FDP), and determine whether alterations to the blood constituents or drugs exist within the admixture.

DESIGN: In vitro experimental study.

SETTING: Government blood and coagulation research laboratory.

INTERVENTIONS: Seven units of commercially acquired canine FFP, 7 units of canine FDP, and 8 units of canine WB were co-administered with multiple drugs, including fentanyl, midazolam, ketamine, hydromorphone, tranexamic acid (TXA), ampicillin/sulbactam, enrofloxacin, ceftriaxone, and ertapenem, and delivered simultaneously into an IV line via infusion pumps using clinically relevant doses. The resultant solutions were analyzed for coagulation factor activities and fibrinogen concentration. Liquid chromatography-tandem mass spectroscopy was used to assess drug concentration, and impedance aggregometry and cell-free hemoglobin were used to evaluate platelet function in the WB samples.

MEASUREMENT AND MAIN RESULTS: Platelet function decreased with each drug co-administered with WB in vitro. Cell-free hemoglobin increased when ketamine, fentanyl, and midazolam were co-administered with WB. Drug loss was seen when enrofloxacin was co-administered with FDP. Drug loss was also seen when hydromorphone was co-administered with FFP. Sulbactam and ertapenem resulted in drug loss when co-administered with FDP and FFP. Drug loss was seen when ceftriaxone, fentanyl, and midazolam were co-administered with each blood product. With each admixture, there were variable changes in coagulation factor activities. A statistically significant decrease in activity <50% was seen only in factors V and VIII when ceftriaxone and enrofloxacin, respectively, were co-administered with FDP.

CONCLUSIONS: Platelet function will likely be adversely affected by the co-administration of any of the selected drugs. Co-administration of ketamine, fentanyl, and midazolam with WB resulted in significant hemolysis and is not recommended. It is reasonable to consider co-administering ampicillin, TXA, and ketamine with FDP and FFP.

PMID:41313672 | DOI:10.1111/vec.70057

Rev Esc Enferm USP. 2025 Nov 17;59:e20250211. doi: 10.1590/1980-220X-REEUSP-2025-0211en. eCollection 2025.

ABSTRACT

OBJECTIVE: To analyze factors associated with the occurrence of COVID-19 in the pediatric population in hospital settings.

METHOD: This was a paired case-control study conducted with medical records of children under 14 years of age. The pediatric population with a positive COVID-19 test was considered a case, and the pediatric population with a negative COVID-19 test was considered a control. For each case, a control was used, totaling 486 medical records. Descriptive analysis, bivariate analysis, and logistic regression were performed.

RESULTS: The variables associated with the occurrence of COVID-19 were brown, black, yellow, and indigenous children, emergency room and Intensive Care Unit admission, use of mask and oxygen catheter, antimicrobials, and corticosteroids. Fever, anorexia, non-eupneic respiratory pattern with saturation between 90% and 95%, cough, runny nose, and comorbidities were associated with the outcome.

CONCLUSION: Advances by providing information on factors associated with COVID-19 in the hospitalized population under 14 years of age, including place of hospitalization, anorexia, runny nose, comorbidity, and corticosteroid use.

PMID:41313640 | DOI:10.1590/1980-220X-REEUSP-2025-0211en

Rev Esc Enferm USP. 2025 Nov 17;59:e20250022. doi: 10.1590/1980-220X-REEUSP-2025-0022en. eCollection 2025.

ABSTRACT

OBJECTIVE: To describe postoperative complications in patients undergoing oncological surgeries, and to analyze adherence to the recommendations of the project Acceleration of Total Postoperative Recovery (ACERTO) in these patients and the risk factors for death.

METHOD: Retrospective longitudinal study. Sample of 229 patients in the immediate postoperative period admitted to the intensive care unit from July to December 2021.

RESULTS: The frequency of complications was 68.5%. There was adherence to the recommendation of fluid resuscitation ≤ 30 mL/kg in 56.6% intraoperatively and greater adherence in the postoperative period (90.4%) and in the prescription of nausea and vomiting prophylaxis in the intraoperative (93%) and postoperative (100%) periods. An association was observed between adherence to recommendations and a reduction in complications. The independent risk factors for death were age (p = 0.031) and the score Sequential Organ Failure Assessment (SOFA) (p = 0.004).

CONCLUSION: A high frequency of complications was observed in the postoperative period and a mortality rate of 11.8%. Adherence to the protocol ACERTO was associated with a reduction in postoperative complications in cancer patients. Age and SOFA score were independent risk factors for death.

PMID:41313639 | DOI:10.1590/1980-220X-REEUSP-2025-0022en

Haemophilia. 2025 Nov 28. doi: 10.1111/hae.70073. Online ahead of print.

ABSTRACT

INTRODUCTION: Assessment of health-related quality of life (HRQoL) is relatively new in von Willebrand disease (VWD). So far, generic questionnaires have mainly been used for HRQoL assessment in VWD.

AIMS: To assess generic and disease-specific HRQoL in adult VWD patients and compare HRQoL with the general German population.

METHODS: Patients presenting with a personal or family history of bleeding and von Willebrand factor (VWF)-specific laboratory parameters were enrolled in the WIL-QoL study. HRQoL was assessed with generic (SF-36) and disease-specific (VWD-QoL) questionnaires. Descriptive and inferential statistical procedures were applied based on a significance level at α ≤ 5%.

RESULTS: In the retrospective, multicentre WIL-QoL study, HRQoL and clinical data in 120 adults with VWD (one adolescent completed the adult questionnaire) from 10 centres in Germany were collected. Compared to the corresponding age group in the general German population, female VWD patients had significantly worse HRQoL in all SF-36 domains and male patients only in the ‘physical functioning’ domain. In the VWD-QoL, highest impairments were seen in all VWD patients in the domains ‘other physicians’, ‘treatment’ and ‘sport & leisure’. VWD patients with a more significant disease burden, such as a bleeding score ≥ 9 (p < 0.0001), long-term prophylaxis (p = 0.003), and VWD-type 3 (p = 0.022), reported significantly worse HRQoL. No HRQoL differences were seen between male and female VWD patients.

CONCLUSION: Female VWD patients showed significant impairments in their HRQoL compared to the age group-related general population. Compared to SF-36, the VWD-QoL identified stronger significant HRQoL differences in most VWD subgroups, confirming the impact of bleeds.

PMID:41313635 | DOI:10.1111/hae.70073