Category: Statistics

EClinicalMedicine. 2025 Apr 9;83:103193. doi: 10.1016/j.eclinm.2025.103193. eCollection 2025 May.

ABSTRACT

BACKGROUND: Haematologic malignancies accounted for 6.6% of total cancer cases and 7.2% of total cancer-related deaths worldwide in 2022. We implemented a novel approach to estimate the lifetime risk of developing and dying from various types of haematologic malignancies at the global, regional and country-specific perspectives in 2022.

METHODS: We retrieved incidence and mortality rates for Hodgkin lymphoma (HL), Non-Hodgkin lymphoma (NHL), multiple myeloma (MM) and leukaemia from GLOBOCAN 2022 of 185 countries, along with the national population statistics and all-cause mortality data sourced from the United Nations. For trend analysis, we obtained consecutive cancer registry data spanning from 2003 to 2017 from the Cancer Incidence in Five Continents (CI5) Plus database. After quality control, datasets from 30 countries were included. We used the “adjusted for multiple primaries (AMP)” method to calculate the lifetime risk of incidence (LRI) and mortality (LRM) by cancer type, selected age interval, sex, country and geographic region.

FINDINGS: In 2022, the global lifetime risk of incidence (LRI) and mortality (LRM) for all haematologic malignancies was 1.67% and 0.98%, respectively. LRI was highest for NHL, whereas the LRM was highest for leukaemia. On a general level, males exhibited higher LRI and LRM compared to females. Both LRI and LRM increased with higher Human Development Index (HDI) levels. The LRI and LRM for haematologic malignancies were notably high in regions such as Australia/New Zealand, Northen America, as well as Northen, Western and Southern Europe, whereas they were comparatively low in Middle, Western and Eastern Africa. We observed about 5-fold regional disparity in the LRI/LRM ratio for HL, ranging from 1.50 in Middle Africa to 7.67 in Western Europe. Individuals aged 60 and above still faced 71.26% and 78.57% remaining risks for developing and dying from all haematologic malignancies. Among the 185 countries studied, NHL was the haematologic malignancy with the highest LRI in 68.65% of the countries. However, leukaemia had the highest LRM in 58.92% of these countries. MM exhibited the highest LRI and LRM particularly in islands surrounding the Caribbean Sea. Out of 30 countries with eligible consecutive cancer surveillance data, 24 exhibited significant upward trends in LRI of all haematologic malignancies, with AAPCs ranging from 0.5% in USA to 4.3% in Latvia. 25 countries showed significant upward trends in LRM, with AAPCs ranging from 1.0% in USA to 5.5% in Republic of Korea.

INTERPRETATION: The global lifetime risks of haematologic malignancies exhibit considerable variations across different world regions, necessitating country-specific and targeted decision-making strategies. In contrast to traditional indicators, the compositive lifetime risks provide intuitive measures with profound public health implications, offering fresh insights into the development of regional disease prevention and control strategies.

FUNDING: CAMS Innovation Funds for Medical Sciences (No. 2021-I2M-1-061, No. 2021-I2M-1-011).

PMID:40256772 | PMC:PMC12008131 | DOI:10.1016/j.eclinm.2025.103193

Cancer Manag Res. 2025 Apr 16;17:815-825. doi: 10.2147/CMAR.S503171. eCollection 2025.

ABSTRACT

BACKGROUND: Immunotherapy has demonstrated potential in the treatment of esophageal cancer (EC); however, the overall response rate (ORR) remains below 30% among EC patients. Herein, the use of peripheral blood lymphocyte subsets as biomarkers was explored to evaluate the efficacy of immunotherapy in this patient population.

METHODS: Sixty-three patients were enrolled. The patients were diagnosed with EC and treated with immune checkpoint inhibitors (ICIs) at The Fourth Hospital of Hebei Medical University from December 2019 to June 2023. Kaplan-Meier (KM) survival curves were used to reflect differences in survival benefit. The prognostic factors of survival were investigated using the Cox proportional hazards regression model for both univariate and multivariate analyses. Two-tailed P values were reported and statistical significance was defined as P < 0.05.

RESULTS: The results of univariate and multifactorial Cox regression analysis for progression-free survival (PFS) revealed that only CD8+ T lymphocytes demonstrated a significant association with PFS (P = 0.034, P = 0.020). Additionally, the multifactorial Cox regression analysis results for overall survival (OS) revealed a significant association between natural killer (NK) cells and OS (P=0.049). Further, a systematic analysis was conducted on the CD8+ T cell biomarker. The KM survival curves indicated that the group with low CD8+ T cell levels experienced a significantly greater PFS benefit compared to the high CD8+ T cell group (P = 0.030).

CONCLUSION: The present study reveals that the reduction of both CD8+ T lymphocytes and NK cells in peripheral blood lymphocyte subsets after immunotherapy can serve as superior predictors for the effectiveness of ICIs in patients diagnosed with EC.

PMID:40256769 | PMC:PMC12009565 | DOI:10.2147/CMAR.S503171

PeerJ. 2025 Apr 15;13:e19223. doi: 10.7717/peerj.19223. eCollection 2025.

ABSTRACT

BACKGROUND: Irritable bowel syndrome (IBS) is a common gastrointestinal disorder with poorly understood mechanisms. Variations in gut microbiota composition are observed in different IBS subtypes. Ginsenosides have shown potential in alleviating IBS symptoms, but their interactions with gut microbiota in different IBS subtypes are not well studied.

METHODS: In this study, we investigated the effects of ginsenosides on the gut microbiota of both healthy participants and participants suffering from IBS characterized by diarrhea (IBS-D) or constipation (IBS-C), using in vitro fermentation alongside 16S rRNA sequencing and bioinformatics analyses.

RESULTS: The analysis demonstrated that there were no statistically significant alterations in α- or β-diversity between the ginsenosides-treated and control groups across all models. However, the microbial composition assessment revealed the presence of 51 shared genera, with notable variations in composition and a significant enrichment of specific taxa. Specifically, the LEfSe analysis revealed that, following ginsenosides treatment, the healthy model groups exhibited significant enrichment of Stenotrophomonas and Achromobacter, while the IBS-D model groups demonstrated significant enrichment of Pseudomonas and Stenotrophomonas.

CONCLUSIONS: The results elucidate the distinctive microbial signatures associated with ginsenosides treatment across both healthy and IBS-D groups, underscoring the potential therapeutic efficacy of ginsenosides in modulating gut microbiota. This study highlights the necessity for further investigation into targeted microbiome therapies for IBS, which may facilitate the development of more personalized and efficacious treatment strategies for gastrointestinal health.

PMID:40256741 | PMC:PMC12007494 | DOI:10.7717/peerj.19223

PeerJ. 2025 Apr 17;13:e19280. doi: 10.7717/peerj.19280. eCollection 2025.

ABSTRACT

PURPOSE: This study aimed to assess the quality, reliability, content, and usefulness of YouTube videos related to anesthesia in geriatric and elderly patients.

METHODS: Using Google Trends, the most popular search terms in the past five years, “geriatric anesthesia” and “anesthesia in the elderly,” were identified. A search on YouTube using these terms initially yielded 200 of the most viewed videos for each term. After applying exclusion criteria, 87 videos were included for detailed analysis. Major themes and topics related to anesthesia in geriatric and elderly patients were identified using a pre-determined qualitative thematic analysis method. The usefulness of the videos was assessed using the specially developed Geriatric and Elderly Anesthesia Usefulness Score (GAEUS). The overall quality and reliability of the videos were evaluated using the Global Quality Scale (GQS) and the Modified DISCERN Scale (M-DISCERN), respectively. The average of the quality, reliability, and usefulness scores calculated by the researchers was used for consistency analysis.

RESULTS: In our study, 48.3% (42) of the videos on geriatric and elderly patients concerning anesthesia on YouTube were created by personal blogs. The quality of the videos was measured using the GQS, with a mean score of 3.34 and a median of 3 (range: 1-5), showing no significant difference according to the video source (p = 0.166). Reliability was assessed using the M-DISCERN scale, with a mean score of 3.37 and a median of 3.50 (range: 1-5), again showing no significant difference according to the video source (p = 0.097). Usefulness was measured using the GAEUS score, with a mean score of 15.30 and a median of 12.5 (range: 2-63), which showed a significant difference according to the video source (p = 0.000). The average duration of videos with low usefulness was 31.59 minutes (range: 5-44), while the average duration of moderately and highly useful videos was 59.37 minutes (range: 19.44-119.05). This duration difference was statistically significant (u = 2.569, p = 0.010).

CONCLUSION: In our study, we examined YouTube videos covering anesthesia topics for geriatric and elderly patients. The highest usefulness scores were obtained from personal blogs; however, all sources generally showed low usefulness. The quality of the videos was assessed using the GQS, and their reliability was evaluated with the M-DISCERN. On both scales, the videos showed moderate performance across all sources. These findings indicate a need for more comprehensive and informative content on YouTube, especially for the education of healthcare professionals and patients. To better address the needs of elderly patients, the richness of content and educational value of these videos should be enhanced.

PMID:40256732 | PMC:PMC12009561 | DOI:10.7717/peerj.19280

PeerJ. 2025 Apr 16;13:e19263. doi: 10.7717/peerj.19263. eCollection 2025.

ABSTRACT

BACKGROUND: As life expectancy rises, age-related decline in mobility and physical function poses challenges for older adults. While traditional exercise can help, limitations and injury risks persist. This study explores low-frequency vibration training as a potential alternative to improve walking ability and body composition in older adults.

METHODS: A lottery was used to randomly assign 50 participants (mean age 80.08 years) to either a vibration group (n = 25, 10 males, 15 females) or a control group (n = 25, 11 males, 14 females). While the control group continued their regular daily schedule, the vibration group completed 8 weeks of low-frequency vibration training (frequency: 4-13 Hz; amplitude: two mm), three sessions per week, with each session lasting 20-30 minutes. The walk ability was assessed using the 30-second Chair Stand Test (30-s CST), Timed Up and Go (TUG), and six-meter (six m) walk speed, while body composition was measured via body mass index (BMI), body fat percentage, and waist circumference (WC), hip circumference (HC), and waist-to-hip ratio (WHR).

RESULTS: Low-frequency vibration training significantly increased walking speed in the six m walk speed (F _(1,36) = 4.50, p = 0.04, η _p ² = 0.11) and TUG (z = – 2.72, p = 0.007), compared with the control group. Observed improvements on the 30-s CST were not statistically significant (F _(1,36) = 0.05, p = 0.81, η _p ² = 0.002). In the WC, the effect of time (F _(1,36) = 7.19, p = 0.01, η _p ² = 0.16) was significant. The main effect of the group for HC (F _(1,36) = 0.06, p = 0.80, η _p ² = 0.002) and WHR (F _(1,36) = 2.00, p = 0.16, η _p ² = 0.05) were not significant, but the interaction effects for HC (F _(1,36) = 6.37, p = 0.01, η _p ² = 0.15) and WHR (F _(1,36) = 9.08, p = 0.005, η _p ² = 0.20) were significant. However, the intervention showed no statistically significant effects on BMI and body fat percentage.

CONCLUSION: Low-frequency vibration training significantly enhanced walking speed and WHR in older adults. This low-intensity intervention is especially beneficial for those with exercise limitations or a high risk of injury. Although its effects on BMI and body fat percentage were limited, the study offers valuable insights for developing personalized vibration training programs.

PMID:40256731 | PMC:PMC12009026 | DOI:10.7717/peerj.19263

PeerJ. 2025 Apr 16;13:e19231. doi: 10.7717/peerj.19231. eCollection 2025.

ABSTRACT

BACKGROUND: Video-assisted thoracoscopic surgery (VATS) is a minimally invasive and safe procedure. However, lung deflation during the operation causes anatomic landmark distortion, complicating small nodules detection. Computed tomography (CT)-guided hookwire localization promotes the success rates of VATS, but faces issues with hookwire dislodgement, potentially losing intraoperative tumor reference. This study was conducted to identify the relative importance ranking of potential factors influencing dislodgement in CT-guided hookwire localization.

METHODS: This retrospective study reviewed 123 cases of CT-guided hookwire localization followed by VATS resection. Variables analyzed included sex, age, nodule size, emphysema, chest wall/muscle/total depth, distance from the nodule (DNP) or wire tip to the pleura (DWP), procedure time, nodule subtypes, multiple localization, post-procedural hemorrhage, pneumothorax, nodule penetration, and time intervals between completion of procedure to initiation of surgery (PS interval). Variables were compared using chi-square tests or Mann-Whitney tests. A random forest model, enhanced with the Synthetic Minority Over-sampling Technique (SMOTE) for oversampling, was employed to determine the relative importance of each variable. The relative importance of variables was presented using the mean decrease Gini and mean decrease accuracy metrics. For sensitivity analysis, relative variable importance was analyzed using extreme gradient boosting (XGBoost) model, and the relative importance of variables was presented using the gain metric.

RESULTS: Among the 123 cases, dislodgement occurred in 15. In univariable analysis, only the PS interval was statistically significant (134.1 ± 73.1 vs. 104.1 ± 46.1 minutes in dislodgement or non-dislodgement, p = 0.031). The random forest and XGBoost model identified the top five important variables as the PS interval, DWP, DNP, total depth, and age. The top five factors demonstrated a distinct difference when compared to the other factors.

CONCLUSIONS: The study identified the PS interval as the most critical factor in hookwire dislodgement, along with DNP, DWP, total depth, and age. These results identified the presence of modifiable factors within the hospital and can assist practitioners and surgeons in recognizing the dislodgement risk of procedures based on various patient factors.

PMID:40256726 | PMC:PMC12009025 | DOI:10.7717/peerj.19231

Chin Herb Med. 2025 Feb 11;17(2):315-321. doi: 10.1016/j.chmed.2025.02.001. eCollection 2025 Apr.

ABSTRACT

OBJECTIVE: The objective of this study was to analyse fungal composition and exploit application potential in the Bantou (BT) agarwood-forming trunk of Aquilaria sinensis.

METHODS: BT agarwood is a naturally formed agarwood that was collected after cutting. Total genomic DNA of the fungi in BT agarwood was extracted by the hexadecyltrimethy ammonium bromide (CTAB) method, followed by PCR amplification and library construction. The effective tags were obtained by the HiSeq2500 platform, and the data were subjected to bioinformatics and statistical analyses.

RESULTS: A total of 7 850 040 effective tags were obtained, Ascomycota was the most abundant fungus at the phylum level, with a relative abundance of 56.36%-61.44%, followed by Basidiomycota, with a relative abundance of 10.49%-20.39%. Dothideomycetes, Agaricomycetes and Sordariomycetes were dominant at the class level, accounting for 26.21%-33.88%, 8.40%-17.66%, and 18.41%-24.11%, respectively. Lignosphaeria, Phaeoacremonium and Hermatomyces were dominant at the genus level, with relative abundances of 6.25%-7.64%, 1.95%-9.05% and 1.5%-5.4%, respectively. Diversity and richness analysis showed that the fungal composition in the agarwood formation sites (agarwood layer, upper agarwood layer and lower agarwood layer) were significantly lower than those in the decomposing layer and the healthy layer. That is, the fungal diversity and richness were significantly reduced during agarwood formation by the action of open wounds. The fungal community structure in the decomposing layer and agarwood formation sites obviously differed from that in the healthy layer. The number of Aspergillus taxa in agarwood formation sites decreased significantly (healthy layer is 0.5%, decomposing layer is 0.022%, upper agarwood layer is 0.012%, agarwood layer is 0.01%, and lower agarwood layer is 0.013%), indicating that agarwood may contain potential substances to inhibit the growth of Aspergillus.

CONCLUSION: Agarwood from agarwood formation sites contains potential substances that inhibit Aspergillus, which provides valuable information for the control of the genus of Aspergillus.

PMID:40256724 | PMC:PMC12009086 | DOI:10.1016/j.chmed.2025.02.001

J Conserv Dent Endod. 2025 Mar;28(3):253-257. doi: 10.4103/JCDE.JCDE_859_24. Epub 2025 Mar 3.

ABSTRACT

CONTEXT: Loop-mediated isothermal amplification (LAMP) may be used in the future to detect infecting microorganisms. LAMP assays exist for the endodontic pathogens Enterococcus faecalis and Fusobacterium nucleatum, but not yet for Porphyromonas endodontalis.

AIM: To develop a LAMP assay for detecting P. endodontalis.

SETTINGS AND DESIGN: It was an in vitro benchtop study.

SUBJECTS AND METHODS: The National Center for Biotechnology Information GenBank Basic Local Alignment Search Tool was used to identify a segment of the dipeptidyl peptidase 11 (DPP11) gene unique to P. endodontalis. A primer design tool was used to generate six primers required for developing the LAMP assay. WarmStart Colorimetric LAMP 2X Master Mix was used to evaluate the LAMP assay, using purified P. endodontalis DNA as a control.

STATISTICAL ANALYSIS USED: Statistical parameters for sensitivity and specificity.

RESULTS: The assay was performed in triplicate on pure DNA from P. endodontalis and P. gingivalis and on the DNA that was extracted from P. endodontalis, P. gingivalis, F. nucleatum, and E. faecalis cells and diluted two-fold from 1/2 to 1/256. Assays for the diluted samples were performed in triplicate, and the contingency tables indicated the LAMP assay to be 82% sensitive and 90% specific for P. endodontalis.

CONCLUSIONS: LAMP assay could be a highly sensitive and specific chairside detection method for P. endodontalis.

PMID:40256705 | PMC:PMC12007742 | DOI:10.4103/JCDE.JCDE_859_24

J Conserv Dent Endod. 2025 Mar;28(3):264-268. doi: 10.4103/JCDE.JCDE_841_24. Epub 2025 Mar 3.

ABSTRACT

OVERVIEW: Residual pathogens lead to treatment failure. Microbes like Enterococcus faecalis, Candida albicans, and Actinomyces israelii are often isolated after failed root canal therapy. Therefore, the antimicrobial efficacy of sealers is critical for treatment outcomes.

AIM: To evaluate the antimicrobial efficacy of endodontic sealers against E. faecalis and C. albicans.

METHODOLOGY: The agar diffusion test was used to evaluate the antibacterial efficacy of four sealers: MTA Fillapex, Bio-C-Sealer, Sealapex, and Seal-Pex. Each microorganism’s bacterial suspension was added to agar plates separately. The sterile discs were then placed on the plates; later, a freshly mixed sealer was coated on the sterile discs. After 24 h of incubation, inhibition zones were measured.

RESULTS: The Kruskal-Wallis test was used to analyze the data, and the Mann-Whitney U-test was used for post hoc pairwise comparison. The results demonstrated that Seal-Pex has potent antibacterial activity against E. faecalis (P < 0.05). Against C. albicans, both MTA Fillapex and Seal-Pex were effective, with MTA Fillapex showing a statistically significant difference compared to Bio-C Sealer and Sealapex.

CONCLUSION: Seal-Pex, an epoxy resin-based sealer, exhibited a significant antimicrobial efficacy against E. faecalis. Conversely, MTA Fillapex demonstrated notable antifungal activity against C. albicans, surpassing other tested sealers. These findings highlight the differential antimicrobial and antifungal properties of the sealers.

PMID:40256703 | PMC:PMC12007748 | DOI:10.4103/JCDE.JCDE_841_24

J Conserv Dent Endod. 2025 Mar;28(3):274-278. doi: 10.4103/JCDE.JCDE_863_24. Epub 2025 Mar 3.

ABSTRACT

CONTEXT: The most common cause for endodontic failures has been ascribed to improper obturation of root canal space. An ideal endodontic filling should approximate the obturation material in close contact with the root canal wall to minimize the sealer content. Voids cause a problem of harboring bacteria leading to treatment failure.

AIMS: The aim of the present study was to compare and analyze filled area after using single cone, cross-linked gutta-percha core-carrier systems, and injection-molded thermoplasticized obturation technique.

SUBJECTS AND METHODS: Thirty-nine human mandibular premolars with a single oval canal were selected. Biomechanical preparation was done using HyFlexCM. Samples were categorized into three groups and filled with single cone, cross-linked gutta-percha core-carrier systems, and injection-molded thermoplasticized obturation technique. Sectioning was done at 3, 6, 9, and 12 mm from the apex. The percentage of gutta-percha-filled areas (PGFAs) and percentage of void areas (PVA) were analyzed using a stereomicroscope.

STATISTICAL ANALYSIS USED: Analysis of variance-one way.

RESULTS: A statistically significant difference was not found in terms of PGFA and PVA at 3 mm among the three groups. However, the cross-linked carrier-based and injection-molded thermoplasticized groups showed overall highly significant differences with the single-cone obturation group at 6, 9, and 12 mm (P < 0.001).

CONCLUSIONS: The cross-linked carrier-based and injection-molded thermoplasticized groups exhibited more gutta-percha filled area than single-cone obturation technique and thus turned out to be more effective in achieving homogenous root canal filling.

PMID:40256701 | PMC:PMC12007746 | DOI:10.4103/JCDE.JCDE_863_24