Category: Statistics

Support Care Cancer. 2025 Sep 18;33(10):861. doi: 10.1007/s00520-025-09896-7.

ABSTRACT

PURPOSE: We successfully implemented the American College of Sports Medicine’s (ACSM’s) Exercise is Medicine® (EIM) initiative in a community oncology clinic. This study evaluated the impact of the evidence-based exercise intervention, adhering to ACSM guidelines on patient outcomes.

METHODS: Using a quasi-experimental research design, An experienced ACSM-certified cancer exercise trainer delivered a 12-week biweekly, online group exercise intervention to 19 patients undergoing chemotherapy. Fifteen (78.8%) completed pre/post-self-report surveys on the program’s acceptability and impact, change in physical activity vital signs (PAVS), and health-related quality of life (HRQOL). We also assessed exercise uptake and PAVS at each clinic visit. Data were analyzed using t-tests and content analysis.

RESULTS: On average, participants were 60 years, female (94%), non-Latino/White (60%), had stage IV cancer (92.3%), And had been receiving chemotherapy for An average of 10 months. The intervention was acceptable (86.4% enrollment) and had excellent retention (89.5%), with moderate adherence (68%). No adverse events were reported. Reasons for lack of adherence were medical reasons and treatment side effects. Compared to baseline, participants reported non-statistically significant increased aerobic exercise and improvements in HRQOL post-intervention. Participants rated the intervention as satisfactory, acceptable, and suitable (all > 4 out of 5 on a Likert scale). In open-text comments, six (40%) of the participants appreciated being asked about PAVS at the clinic, while three (20%) did not.

CONCLUSIONS: Patients undergoing chemotherapy, the majority of whom had stage IV cancer, could safely participate in an online group exercise program. Larger studies among different patient populations are needed.

PMID:40968289 | DOI:10.1007/s00520-025-09896-7

Nat Commun. 2025 Sep 18;16(1):8317. doi: 10.1038/s41467-025-63913-1.

ABSTRACT

AI scientists powered by large language models have demonstrated substantial promise in autonomously conducting experiments and facilitating scientific discoveries across various disciplines. While their capabilities are promising, these agents also introduce novel vulnerabilities that require careful consideration for safety. However, there has been limited comprehensive exploration of these vulnerabilities. This perspective examines vulnerabilities in AI scientists, shedding light on potential risks associated with their misuse, and emphasizing the need for safety measures. We begin by providing an overview of the potential risks inherent to AI scientists, taking into account user intent, the specific scientific domain, and their potential impact on the external environment. Then, we explore the underlying causes of these vulnerabilities and provide a scoping review of the limited existing works. Based on our analysis, we propose a triadic framework involving human regulation, agent alignment, and an understanding of environmental feedback (agent regulation) to mitigate these identified risks. Furthermore, we highlight the limitations and challenges associated with safeguarding AI scientists and advocate for the development of improved models, robust benchmarks, and comprehensive regulations.

PMID:40968279 | DOI:10.1038/s41467-025-63913-1

Sci Rep. 2025 Sep 18;15(1):32611. doi: 10.1038/s41598-025-20238-9.

ABSTRACT

Preeclampsia is a multi-factorial disease, with both genetic and environmental factors contributing to its development. The genetic susceptibility in preeclampsia has been determined to be around 50%. STORKHEAD_BOX1 PROTEIN 1 (STOX1), is the gene of interest in this study. The most frequent variant of this gene is c.457T > C (rs1341667). This case-control study was conducted on 96 participants recruited from both the Obstetrics outpatient clinic at Kasr Al Ainy hospital and the High-Risk Pregnancy Department, Cairo University. Patients were divided into 2 groups: (group I: 48 pregnant females with preeclampsia diagnosed on basis of the American College of obstetrics and gynecology criteria, group II: 48 healthy control pregnant females of matching age were included. After collecting the blood sample, DNA was extracted and detection of STOX1(NM_001130161.3): c.457T > C: p. (Tyr153His) gene variant by TaqMan Real-Time PCR were done on all involved individuals. The homozygous CC genotype, previously linked to increased preeclampsia risk, was identified in 27.1% of controls (n = 13) and 31.3% of cases (n = 15), with no statistically significant difference (P = 0.654). The heterozygous CT genotype, associated with moderate risk, was observed in 41.7% of controls (n = 20) and 39.6% of cases (n = 19) (P = 0.835). The inheritance model analysis showed no statistically significant association between the STOX1 c.457T > C variant and preeclampsia under any of the tested models. Genotypic distribution conformed to Hardy-Weinberg equilibrium in both groups, supporting the absence of deviation. These findings suggest no significant association between the STOX1 (NM_001130161.3): c.457T > C (p.Tyr153His) variant and susceptibility to preeclampsia in the studied population.

PMID:40968268 | DOI:10.1038/s41598-025-20238-9

Ann Surg Oncol. 2025 Sep 18. doi: 10.1245/s10434-025-18312-7. Online ahead of print.

ABSTRACT

OBJECTIVE: This study systematically evaluates the effectiveness of chewing gum as a nonpharmacological intervention to facilitate gastrointestinal recovery after gastrointestinal surgery.

METHODS: A literature search was conducted in PubMed, Embase, and Cochrane Library databases up to factor influencing patient recovery. 18, 2025, focusing on randomized controlled trials comparing chewing gum use versus standard care postsurgery. Data were synthesized through systematic review and meta-analysis according to PRISMA guidelines. Key outcomes included time to first postoperative flatus and bowel movement, hospital stay length, and incidence of postoperative bowel obstruction.

RESULTS: Thirty-five trials involving 4,898 patients met the inclusion criteria. Meta-analysis showed significant reductions in time to first postoperative flatus (weighted mean difference [WMD] = -12.19 hours; 95% confidence interval [CI] [-15.41, -8.98]; P < 0.00001), time to first bowel movement (WMD = -19.54 hours; 95% CI [-25.39, -13.68]; P < 0.00001), and hospital stay (WMD = -0.93 days; 95% CI [-1.3, -0.56]; P < 0.00001). A decrease in postoperative bowel obstruction incidence was also noted (relative risk [RR] = 0.7; 95% CI [0.56, 0.89]; P = 0.004). No significant effects on bloating, vomiting, nausea, or time to first feeding were observed.

CONCLUSIONS: Chewing gum is a safe and cost-effective adjunct to postoperative care, enhancing gastrointestinal recovery. Its inclusion in postoperative protocols is recommended for appropriate patients to improve recovery outcomes. Further studies are needed to examine long-term benefits and implementation in clinical settings.

PMID:40968235 | DOI:10.1245/s10434-025-18312-7

Surg Endosc. 2025 Sep 18. doi: 10.1007/s00464-025-12200-7. Online ahead of print.

ABSTRACT

BACKGROUND: High-quality program development in surgical education is essential for ensuring that training initiatives are both effective and scalable. Implementing such programs requires careful consideration of their long-term sustainability and impact on diverse clinical settings. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) developed the Master’s Program as a structured, competency-based online curriculum designed to provide high-quality continuing education for surgeons at various career stages. This study evaluates the pilot phase of the Master’s Program, emphasizing its effectiveness in training surgeons while assessing its scalability and implementation challenges within surgical education frameworks.

METHODS: A mixed-methods approach was used, combining qualitative and quantitative assessments. A purposive sample of U.S.-based surgeons was recruited through SAGES membership outreach and snowball sampling. Participants engaged in video-conferenced usability testing and completed the Theoretical Framework of Acceptability (TFA) questionnaire. Data were collected via semi-structured interviews, which were analyzed using thematic analysis, while quantitative responses were evaluated using descriptive statistics.

RESULTS: A total of 27 surgeons participated. Participant demographics: Of the 27 participants, 16 (59%) were practicing surgeons and 41% were trainees. Sixty-three percent of practicing surgeons were in community hospitals, and half had less than five years of experience. Participants rated the program highly in overall acceptability (mean: 4.7/5), confidence in applying the material (4.6/5), and ease of navigation (2.0/5 indicating low burden). Qualitative themes identified included content accessibility, navigational challenges, and recommendations for deeper, more advanced material for experienced surgeons.

CONCLUSIONS: The SAGES Master’s Program demonstrated strong acceptability, particularly among early-career surgeons. While the modular, structured approach was well received, refinements are needed to better cater to advanced practitioners. To enhance adoption and scale this program, future iterations should focus on the planned expanded content depth, improved navigation, and institutional purchasing models to enhance adoption.

PMID:40968211 | DOI:10.1007/s00464-025-12200-7

Surg Endosc. 2025 Sep 18. doi: 10.1007/s00464-025-12234-x. Online ahead of print.

ABSTRACT

BACKGROUND: Minimally invasive distal pancreatectomy (MIDP) is favored for left-sided pancreatic tumors, but its safety and feasibility in patients with prior upper abdominal surgery (PUAS), especially major PUAS, remain uncertain.

METHODS: This retrospective cohort study analyzed 1713 patients undergoing MIDP at a single tertiary center from 2009 to 2020. Patients were divided into three groups: those with no prior abdominal surgery (no-PAS, n = 1612), those with minor PUAS (n = 58), and those with major PUAS (n = 43). Primary and secondary endpoints included complications of Clavien-Dindo grade III or higher, conversion to open surgery, length of hospital stay, 90-day mortality, and readmission rates.

RESULTS: Among the 1713 patients who underwent MIDP, no significant differences in the rate of severe complications (Clavien-Dindo grade III or higher) were observed between the no-PAS group (9.4%) and either the minor-PUAS (10.3%, p = 0.991) or major-PUAS (7.0%, p = 0.792) groups. Conversion to open surgery occurred in 3.5% of patients in the no-PAS group, with slightly higher rates in the minor-PUAS (5.2%, p = 0.266) and major-PUAS (7.0%, p = 0.202) groups; however, these differences were not statistically significant. Length of hospital stay, 90-day mortality, and readmission rates were comparable across groups.

CONCLUSION: MIDP appears to be a safe and feasible option for selected patients with PUAS, including major procedures, without significantly increasing the risks of severe complications or conversion to open surgery. These findings support the broader use of MIDP in patients with complex surgical histories.

PMID:40968210 | DOI:10.1007/s00464-025-12234-x

Eur Arch Otorhinolaryngol. 2025 Sep 18. doi: 10.1007/s00405-025-09656-7. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to compare the ability of two major language models, ChatGPT-4.0 and Gemini 1.5 Flash, to establish a research methodology based on scientific publications in laryngology.

METHODS: We screened 80 articles selected from five prestigious otolaryngology journals and included 60 articles with a methods section and statistical analysis. These were classified according to six research types: cell culture, animal experiments, prospective, retrospective, systematic review, and artificial intelligence. A total of 30 studies were analyzed, with five articles randomly selected from each group. For each article, both language models were asked to produce research methodologies, and the responses were evaluated by two independent raters.

RESULTS: There was no statistically significant difference between the mean scores of the models (p > 0.05). ChatGPT 4.0 had a higher mean score (5.17 ± 1.12), especially in the data collection and measurement-assessment category. The Gemini model showed relatively more balanced performance in the statistical analysis category. The weighted kappa values were between 0.54 and 0.71, indicating a moderate to high agreement between the raters. In the analysis by article type, Gemini’s performance in Q1 showed significant variation (p = 0.038).

CONCLUSION: Large language models such as ChatGPT and Gemini provide similarly consistent results in establishing the methodology of scientific studies in laryngology. Both models can be considered supportive tools; however, expert supervision is needed, especially for complex constructs such as statistical analysis. This study makes original contributions to the usability of LLMs for study design in laryngology.

PMID:40968205 | DOI:10.1007/s00405-025-09656-7

Eur Arch Otorhinolaryngol. 2025 Sep 18. doi: 10.1007/s00405-025-09647-8. Online ahead of print.

ABSTRACT

PURPOSE: Laryngeal cancer is a major malignancy in head and neck oncology, with total laryngectomy (TL) as a key intervention for advanced and recurrent disease. This systematic review and meta-analysis compare primary total laryngectomy (PTL) and salvage total laryngectomy (STL) in survival, functional outcomes, and complications.

METHODS: A comprehensive search of PubMed, Scopus, Web of Science, and Google Scholar was conducted up to January 18, 2025. Studies comparing PTL and STL were included based on predefined eligibility criteria. Data extraction and quality assessment were performed independently by two reviewers. Random-effects models were used to calculate pooled odds ratios (ORs) and mean differences (MDs), with heterogeneity assessed via I² statistics. Sensitivity analyses ensured result robustness.

RESULTS: Thirteen studies (2,704 patients: 913 STL, 1,791 PTL) met inclusion criteria. PTL showed significantly higher overall survival at 1 year (OR = 2.21; 95% CI: 1.38-3.55), 2 years (OR = 1.95; 95% CI: 1.40-2.71), and 3 years (OR = 1.64; 95% CI: 1.10-2.47). STL had higher risks of pharyngocutaneous fistula (OR = 2.78; 95% CI: 1.96-3.95) and reconstructive surgery (OR = 0.11; 95% CI: 0.02-0.75). PTL significantly reduced swallowing difficulty (OR = 0.12; 95% CI: 0.05-0.28) and hypopharyngeal stricture (OR = 0.14; 95% CI: 0.04-0.49). Speech functional outcomes showed no significant differences.

CONCLUSION: PTL improves survival and swallowing function with fewer complications, making it a preferred upfront treatment. STL remains essential for managing failures. Early identification of high-risk patients may improve clinical decision-making, optimizing survival and functional outcomes.

PMID:40968204 | DOI:10.1007/s00405-025-09647-8

Eur Arch Otorhinolaryngol. 2025 Sep 18. doi: 10.1007/s00405-025-09663-8. Online ahead of print.

ABSTRACT

BACKGROUND: Work-related musculoskeletal disorders (WRMD) are an increasing concern among surgeons, especially otorhinolaryngologists (ENT physicians), due to prolonged static postures and repetitive movements during clinical practice. However, data on the prevalence of WRMD among ENT physicians in Germany are lacking.

METHODS: A nationwide online survey was conducted among members of the German Society for ENT to assess demographic data, work-related factors, and musculoskeletal complaints. Data were analyzed using descriptive statistics.

RESULTS: A total of 751 ENT physicians participated (53% female; mean age 51 years). Lifetime prevalence of neck complaints was 93%, with 82% reporting symptoms in the past 12 months. Shoulders, upper and lower back were also frequently affected. More than a half (53%) reported limitations in professional activities, and 22% had taken sick leave due to these complaints. The prevalence of symptoms increased with years of professional experience. Female physicians reported higher rates of neck and upper back complaints compared to males.

CONCLUSION: This study reveals a high prevalence and significant burden of WRMD among German ENT physicians, particularly in the neck and upper back regions. The findings emphasize the urgent need for preventive measures to improve occupational health and maintain professional longevity in this population.

PMID:40968203 | DOI:10.1007/s00405-025-09663-8

Eur Arch Otorhinolaryngol. 2025 Sep 18. doi: 10.1007/s00405-025-09677-2. Online ahead of print.

ABSTRACT

BACKGROUND: Chronic rhinosinusitis with nasal polyposis (CRSwNP), often Linked to asthma, significantly affects quality of life. While dupilumab 300 mg every two weeks (Q2W) is effective, it is costly. This real-world Saudi study evaluated whether extending dosing to every four weeks (Q4W) maintains effectiveness in patients with or without asthma.

METHODS: In this retrospective single-cohort study, 42 adults with CRSwNP who completed at least one year of stable Q2W dupilumab therapy were transitioned to Q4W and followed for one additional year. Clinical, biomarker, and imaging outcomes were analyzed.

RESULTS: Clinical outcomes between Q2W and Q4W were largely comparable. Eight CRSwNP patients had comorbid asthma (19%). Median nasal polyp scores remained stable, and symptom scores for nasal congestion, discharge, smell loss, and fatigue showed no significant changes. Sino-Nasal Outcome Test (SNOT)-22 and Lund-Mackay scores trended lower in the Q4W group compared to Q2W group but were not statistically significant. Blood eosinophils were modestly reduced, while asthma control remained stable, with high asthma control test scores. Total IgE levels (IU/mL) were significantly lower in the Q4W group (32.5 [10.1-76.4] vs. 52.7 [19.8-215], p<0.001), suggesting immunologic benefit. Fractional exhaled nitric oxide (FeNO) levels were unchanged. Overall, 92.9% maintained symptom control on Q4W for one year; three reverted to Q2W due to worsening of asthma control symptoms.

CONCLUSION: Transitioning from Q2W to Q4W dupilumab dosing is effective for most CRSwNP patients, including those with asthma, after one year of stable therapy. This approach may reduce treatment burden without compromising clinical outcomes.

PMID:40968202 | DOI:10.1007/s00405-025-09677-2