Category: Statistics

Aging Clin Exp Res. 2025 Nov 14;37(1):324. doi: 10.1007/s40520-025-03210-5.

ABSTRACT

BACKGROUND: Declining estrogen in perimenopausal women reduces bone mineral density and increases bone fragility, elevating fall and fracture risk. This presents major challenges for patients and society, yet prior studies lack systematic analysis of this population. This study is the first to utilize mortality and disability-adjusted life years (DALYs) related to falls among perimenopausal women from the Global Burden of Disease (GBD) 2021 database, and to conduct a comprehensive and systematic analysis of the evolving burden of falls in perimenopausal women from 1990 to 2021, as well as to project trends through 2050. This study offers key guidance for optimizing healthcare resource allocation, enhancing patient management, and developing targeted prevention and intervention strategies.

METHODS: This study used GBD 2021 data to systematically analyze fall-related mortality, DALYs, age-standardized rates (ASRs), and estimated annual percentage change (EAPC) among perimenopausal women, examining their associations with the Socio-demographic Index (SDI) at global, regional, and national levels. Joinpoint regression, decomposition, health inequality, and frontier analyses quantified trends, identified factors, and assessed disparities. This study also explored fall risk factors and utilized the Bayesian Age-Period-Cohort (BAPC) model to project global trends in fall burden among perimenopausal women from 2022 to 2050.

RESULTS: Between 1990 and 2021, global mortality attributable to falls among perimenopausal women surged by 116.99% (from 1.67 to 3.63 per 100,000), while DALYs increased by 38.31% (from 116.50 to 188.85 per 100,000). In contrast, age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) declined by 7.00% (EAPC = – 0.30) and 14.62% (EAPC = – 0.56), respectively. Decomposition analysis identified population growth as the predominant contributor to the escalation in mortality (162.91%), while epidemiological changes were the main reason for the reduction (- 63.63%). Marked heterogeneity was observed across SDI strata: low-middle SDI regions exhibited the steepest rise in mortality (138.00%), whereas high-SDI regions achieved the most pronounced reduction in ASMR (- 21.18%). Notably, high-income North America experienced an 106.62% increase in ASMR. The 50-54-year age cohort consistently represented the highest global burden, with low bone mineral density emerging as the principal risk factor. Projections to 2050 suggest ongoing declines in ASMR and ASDR, yet the absolute burden is expected to remain elevated due to persistent demographic expansion.

CONCLUSIONS: Between 1990 and 2021, the global burden of falls among perimenopausal women has exhibited a persistent upward trend, and projections indicate that this burden will likely remain at a high level in the future. This alarming situation underscores the urgent need for targeted interventions. Identifying key risk factors for falls in perimenopausal women is essential for guiding the allocation of public health resources and formulating precise intervention strategies. It is imperative to implement nationwide, cost-effective measures, such as osteoporosis and fall risk screening, the promotion of exercise programs that enhance muscle strength and balance, and, where appropriate, consideration of pharmacological interventions (such as estrogen) to reduce fall risk. This intervention will significantly reduce the risk of falls and associated burdens among perimenopausal women.

PMID:41236661 | DOI:10.1007/s40520-025-03210-5

Eur Radiol. 2025 Nov 14. doi: 10.1007/s00330-025-12132-9. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the completeness and discordance of outside rectal MRI initial staging reports compared to second-opinion reviews, and to assess the potential clinical impact of major discordance on treatment decisions in patients with rectal adenocarcinoma.

MATERIALS AND METHODS: A retrospective analysis of outside rectal MRI reviews submitted for second-opinion interpretation by subspecialized radiologists from June 2014-March 2020 was conducted. Outside and second review reports were compared side-by-side; cases with discordance (and those with major discordance, i.e., may alter treatment, particularly) were identified. Two colorectal surgeons, blinded to report origins, reviewed cases with major discordance to evaluate their theoretical impact on patient management and rated their confidence level of the reports on a five-point Likert scale (1=lowest confidence).

RESULTS: In 461 patients (median age, 57 years [IQR: 49-67]; 274 male), compared to outside reviews, second reviews demonstrated improved report completeness across tumor characteristics, local extent, and nodal/metastatic disease clinical staging categories. The largest reporting gaps were in tumor morphology (66.4%, 306/461 vs. 98.7%, 455/461) and extramural venous invasion (29.1%, 134/461 vs. 93.9%, 433/461). Overall, 53.8% (248/461) of cases showed discordance, with 56.5% (140/248) classified as major. In this subset, second reviews led to fewer cases with insufficient information, e.g., 18.6% (26/140) to 7.1% (10/140) for Surgeon 1, and changes in surgical planning in 38.1-46.3% (43/113 to 44/95) of patients. Surgeons rated reports from second reviews with higher confidence scores (median, 4 vs. 2-3, p < 0.001).

CONCLUSIONS: Second-opinion reviews may impact patient care and improve surgeons’ confidence for treatment planning.

KEY POINTS: Question Do subspecialist radiologist second-opinion reviews improve rectal MRI report completeness and affect treatment decisions in rectal adenocarcinoma staging? Findings While outside reviews often under-reported key imaging findings, second reviews improved report completeness, which led to increased confidence by our surgeons in treatment planning. Clinical relevance These findings underscore the value of expert interpretation and highlight the need for optimized MRI protocols and broader adoption of structured reporting in rectal cancer staging.

PMID:41236658 | DOI:10.1007/s00330-025-12132-9

Eur Radiol. 2025 Nov 14. doi: 10.1007/s00330-025-12135-6. Online ahead of print.

ABSTRACT

OBJECTIVES: To compare the efficacy and safety of ablation therapy in hepatocellular carcinoma (HCC) patients with hepatitis B-related compensated cirrhosis versus those with recompensated cirrhosis.

MATERIALS AND METHODS: In this multicenter, retrospective cohort study, we enrolled hepatitis B-related HCC patients (73 with recompensated cirrhosis and 666 with compensated cirrhosis) who underwent ablation between January 2009 and February 2024. Propensity score matching was performed to balance baseline characteristics, resulting in 73 matched pairs. Recurrence-free survival (RFS), overall survival (OS), and complications were compared.

RESULTS: A total of 739 patients (median age, 59 years [interquartile range, 53-66 years]; 579 men [78.2%]) were enrolled. Following propensity score matching procedures, no significant difference in major complications was observed between patients with recompensated cirrhosis and those with compensated cirrhosis (6.8% vs. 2.7%, p = 0.438). Critically, no postoperative liver failure or decompensation events occurred after ablation therapy in patients with either recompensated cirrhosis or compensated cirrhosis. Moreover, RFS was comparable between patients with recompensated cirrhosis and those with compensated cirrhosis (73.7% vs. 74.0% at 1 year; 43.3% vs. 43.2% at 3 years; 24.8% vs. 36.9% at 5 years; p = 0.699). The overall survival rates at 1, 3, and 5 years were 97.3%, 84.5%, and 73.4% in patients with recompensated cirrhosis, and 98.6%, 92.7%, and 83.7% in patients with compensated cirrhosis, respectively (p = 0.363).

CONCLUSIONS: Ablation therapy is effective and safe in HCC patients with hepatitis B-related recompensated cirrhosis, representing a viable curative option for these patients.

KEY POINTS: Question Is ablation as safe and effective for patients with hepatitis B-related recompensated cirrhosis as it is for those with compensated cirrhosis? Findings The incidence of major complications and long-term survival did not differ statistical significantly between patients with hepatitis B-related recompensated cirrhosis and those with compensated cirrhosis. Clinical relevance Ablation therapy is effective and safe in hepatocellular carcinoma patients with hepatitis B-related recompensated cirrhosis, representing a viable curative option for these patients.

PMID:41236657 | DOI:10.1007/s00330-025-12135-6

Muscle Nerve. 2025 Nov 14. doi: 10.1002/mus.70059. Online ahead of print.

ABSTRACT

INTRODUCTION/AIMS: Neuralgic amyotrophy (NA, Parsonage-Turner syndrome) is a common, multifocal, autoimmune inflammatory disease that predominantly affects proximal nerve segments of the shoulder girdle. Despite the high incidence of 100/100,000, epidemiologic data based on larger cohorts are still lacking. This study aims to address this issue.

METHODS: A retrospective evaluation of billing data from an average of approximately 26,000,000 insured persons of a large German health insurance company was performed from 2013 to 2022. In addition to descriptive statistical methods, regression analyses were carried out.

RESULTS: The incidence and prevalence of NA were 7.7-12.8 and 19.7-21.6 per 100,000 people, respectively. During the study period, a steady decline in incidence and, to a lesser extent, prevalence was observed. The diagnosis was made significantly more frequently in the first quarter of the year than in any other quarter. The prevalence of a simultaneously coded diaphragmatic paresis (indicating the involvement of the phrenic nerve) was 0.45%.

DISCUSSION: Compared with prospectively collected data, the data in this study revealed an approximately 90% lower incidence of NA. It is likely that the majority of cases are not correctly diagnosed and are therefore not captured in the billing data. The involvement of the phrenic nerve in patients with NA also appears not to be recognized in most cases. According to the current pathophysiological model of NA, an immunological trigger is necessary to initiate the disease process. Our data support the accuracy of this model.

PMID:41235535 | DOI:10.1002/mus.70059

Neoplasma. 2025 Oct;72(5):371-378. doi: 10.4149/neo_2025_250730N330.

ABSTRACT

Radiotherapy (RT) plays a central role in the management of glioblastoma, often in combination with other treatment modalities. While RT can enhance both local and systemic tumor control, especially when used alongside immunotherapy, it is also associated with lymphopenia – a reduction in lymphocyte count – which has been linked to poorer treatment outcomes and reduced survival. This retrospective study aimed to examine the relationship between radiation dose delivered to brain vessels and the severity of lymphopenia in patients with newly diagnosed glioblastoma treated at a tertiary cancer center in 2021. Brain vessels were manually contoured using MRI data, and dose-volume analysis was conducted. Lymphopenia severity was graded according to CTCAE v5.0, and statistical analyses were performed to identify any correlations. Among the 28 patients analyzed, 32% developed grade 1-3 lymphopenia. No significant correlation was found between the radiation dose to brain vessels and the degree of lymphopenia. The median volume of irradiated vessels did not differ significantly between patients with and without lymphopenia. In glioblastoma patients, multiple factors contribute to decreased lymphocyte count – e.g., chemotherapy and corticosteroid use. Although no definitive link was identified, the study underscores the importance of preserving lymphocyte counts during glioblastoma treatment and supports the need for further prospective research to explore strategies like lymphocyte-sparing RT and to better understand the mechanisms behind treatment-related lymphopenia.

PMID:41235529 | DOI:10.4149/neo_2025_250730N330

Ter Arkh. 2025 Nov 11;97(10):859-866. doi: 10.26442/00403660.2025.10.203462.

ABSTRACT

BACKGROUND: Despite the variety of antidiabetic therapies, many patients with type 2 diabetes (T2D) do not achieve optimal glycemic control. Therefore, there is a need to develop additional methods for managing T2D, including ones that regulate the gut microbiome.

AIM: To assess the effect of AntiAGE-Biom probiotic on metabolic parameters in T2D patients during 3 months of therapy.

MATERIALS AND METHODS: A randomized, double-blind, placebo-controlled, single-center study included patients with T2D with glycated hemoglobin – HbA_1c<7,5% on stable antidiabetic therapy. Patients were randomized into groups receiving AntiAGE-Biom and placebo. The primary endpoint was the change in HbA_1c from baseline, secondary endpoints included the dynamics in biochemical and anthropometric parameters, body composition, as well as HOMA-IR index.

RESULTS: The study included 40 patients with T2D (n=20 in each group). There was a trend towards a decrease in HbA_1c in AntiAGE-Biom group, that did not reach statistical significance. The use of the probiotic improved the body composition after 3 months: reduced the percentage of fat in men and a subgroup of patients with an initial HbA_1c≥ 6.5%; also increased skeletal muscle mass and lean mass in the trunk segment in men (р<0,05).

CONCLUSION: AntiAGE-Biom probiotic helps to maintain metabolic control and significantly improve body composition in T2D patients with initial HbA_1c<7.5%.

PMID:41235517 | DOI:10.26442/00403660.2025.10.203462

Ter Arkh. 2025 Nov 11;97(10):844-858. doi: 10.26442/00403660.2025.10.203371.

ABSTRACT

AIM: To investigate the presence of statistically significant correlations between clinical and laboratory characteristics and features of contrast-enhanced computed tomography (CT) images, as well as to assess the possibility of predicting group classification according to the PASS scale based on clinical, laboratory, and contrast-enhanced CT imaging data.

MATERIALS AND METHODS: A retrospective analysis was performed on preoperative four-phase contrast-enhanced CT images of 230 patients with a pathomorphologically verified diagnosis of pheochromocytoma/paraganglioma. Clinical manifestations such as the presence and duration of arterial hypertension, carbohydrate metabolism disorders, and dyslipidemia were assessed. In the first stage, comparative and correlation analyses were conducted between hormonal parameters and contrast-enhanced CT data. In the second stage, based on morphological characteristics, patients were divided into two groups: with PASS scores <4 (n=155) and PASS scores ≥4 (n=56). Logistic regression analysis was conducted to evaluate the possibility of predicting group classification based on clinical, laboratory, and contrast-enhanced CT imaging data.

RESULTS: Pheochromocytomas/paragangliomas with isolated normetanephrine secretion type accumulate significantly more contrast agent in the arterial and venous phases of the study (p<0.001) compared to other secretion types. Correlation analysis revealed statistically significant moderate positive correlations between blood normetanephrine levels and the volume of functioning tumor tissue without necrotic areas, as well as a moderate negative correlation between blood metanephrine levels and the maximum density in the venous phase, the percentage of venous contrast enhancement, and the 90th percentile of X-ray density of the functioning tumor tissue in the venous CT phase. A statistically significant association was also found between the presence/absence of necrosis and tumor size (p<0.001), as well as between structure and tumor size (p=0.004). No statistically significant correlations were identified between laboratory parameters, imaging data, and clinical manifestations (arterial hypertension, carbohydrate metabolism disorders, dyslipidemia, and carotid artery atherosclerosis). CT image characteristics allow for prediction of group classification according to the PASS scale with an AUC of 0.647 (95% confidence interval 0.471-0.797), sensitivity of 0.923 (0.727-1.000), specificity of 0.400 (0.250-0.548), PPV of 0.333 (0.176-0.500), and NPV of 0.941 (0.800-1.000).

CONCLUSION: Pheochromocytomas/paragangliomas are heterogeneous pathologies with diverse clinical, hormonal, and radiological characteristics that are associated with pathomorphological findings (PASS scale).

PMID:41235516 | DOI:10.26442/00403660.2025.10.203371

Ter Arkh. 2025 Nov 11;97(10):830-835. doi: 10.26442/00403660.2025.10.203363.

ABSTRACT

BACKGROUND: Obesity is associated with some types of cancer including breast cancer (BC). But still there are not so much studies on the relationship between the adipose tissue distribution, visceral obesity (VO), and insulin resistance with the development of BC. This study is devoted to the effect of VO and insulin resistance on the development of BC.

AIM: To assess the frequency of VO and insulin resistance in patients with newly diagnosed BC in an outpatient setting.

MATERIALS AND METHODS: An observational retrospective study was conducted, including 160 electronic medical records of women with suspected cancer. The control group (n=103) consisted of women with negative histological results. The study group consisted of patients in whom BC was confirmed histologically. Anthropometric data, glycemia, and lipid profile were studied. Statistical processing of the results was performed using the method of descriptive statistics and calculation of the Spearman correlation coefficient with reliability assessment by the Student’s t-test.

RESULTS: The maximum frequency of BC is observed in women over 60 years old (80%). The average age in the group of participants with confirmed BC was 64.51±10.30, in the control group 55.81±12.20 (p<0.0004%). The average Body Mass Index in patients in the group with BC was 30.50±4.98, in the control group – 25.76±5.70 (p<0.05). The average Body Mass Index in the BC group was 30.50, in the control group – 25.76 (p<0.05). A high level of VO was found in 82% of patients with BC. We have found that in the group of patients with BC the frequency of occurrence of high Total Cholesterol values is 72%, Triglycerides – 61%, Low-Density Lipoprotein – 68%, while in the group of patients with unconfirmed BC 10, 33, 24% respectively. When assessing indirect signs of insulin resistance in patients with BC high values of the indicators were recorded, which indicates the presence of insulin resistance. In the control group, Visceral Adiposity Index was detected in 22% of cases above normal values, the Triglycerides to High-Density Lipoprotein Cholesterol index was detected above normal values in 12% of cases, Metabolic Index – 1%, Lipid Accumulation Product – 14%.

CONCLUSION: The results of the study emphasize the importance of VO and insulin resistance in the pathogenesis of breast cancer, which is important for early diagnosis and prevention of the disease.

PMID:41235514 | DOI:10.26442/00403660.2025.10.203363

J Intellect Disabil. 2025 Nov 14:17446295251392108. doi: 10.1177/17446295251392108. Online ahead of print.

ABSTRACT

The concept of ‘vulnerability’ in children is critical to needs-related planning and risk management. Despite proliferation of measures there is limited evidence-base to support the validity of existing, relevant clinical assessments. The FACE CARAS young person’s risk assessment toolkit includes a measure of vulnerability-the Learning Disability Vulnerability Assessment Scale (LD-VAS). Good inter-rater reliability has been reported but construct validity has not previously been demonstrated. The aims of this study were to assess the construct-validity of the tool by: (i) evaluating the dimensionality of the ratings produced, and (ii) modelling the ability of the scores to quantify the care needs of young people. LD-VAS ratings were available for 143 young people, the dimensionality of the scale ratings was assessed using a parallel analysis and confirmatory factor analysis (CFA). The ability of scores to predict care-level was modelled using discriminant function analysis and multinomial logistic regression. A single factor CFA model showed a good fit to the data. The discriminant function analysis suggested several scoring profiles exist, relating to care-level. On multinomial logistic regression the scores could statistically significantly differentiate between those in the lowest and higher intensity care categories. The LD-VAS appears to have construct validity and is potentially useful in supporting rational decision-making regarding care-provision for children affected by learning disability.

PMID:41235502 | DOI:10.1177/17446295251392108