Category: Statistics

Cureus. 2024 Dec 31;16(12):e76667. doi: 10.7759/cureus.76667. eCollection 2024 Dec.

ABSTRACT

Background Artificial Intelligence (AI) is revolutionizing medical science, with significant implications for radiology. Understanding the knowledge, attitudes, perspectives, and practices of medical professionals and residents related to AI’s role in radiology is crucial for effective integration. Methods A cross-sectional survey was conducted among members of the Indian Radiology & Imaging Association (IRIA), targeting practicing radiologists and residents across academic and non-academic institutions. An anonymous, self-administered online questionnaire assessed AI awareness, usage, and perceptions, distributed via medical networks and social media. Descriptive statistics and chi-square tests were used to analyze the data, with statistical analysis performed using R version 4.2.2 (R Core Team (2021). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. https://www.R-project.org/). Results The survey gathered responses from 404 participants nationwide. A significant portion (95.3%) demonstrated a keen interest in expanding their knowledge of AI and recommended implementing educational initiatives that increase exposure to AI. Considerable concern about losing their jobs to AI was observed only in 27.9% of respondents. More than two-thirds (86.6%) of the respondents opined that the AI curriculum should be taught during residency and 75.7% are interested in collaborating with software developers to learn and start AI at their workplace. Conclusion The survey highlights the growing importance of AI in radiology, underscoring the need for enhanced AI education and training in medical curricula.

PMID:39886734 | PMC:PMC11781242 | DOI:10.7759/cureus.76667

Cureus. 2024 Dec 31;16(12):e76662. doi: 10.7759/cureus.76662. eCollection 2024 Dec.

ABSTRACT

INTRODUCTION: Alterations in occlusal relationships in individuals with complete edentulism considerably disrupt the equilibrium of the stomatognathic system. Evaluation of the temporomandibular joint (TMJ) is crucial during the edentulous phase, as it influences both aesthetic and functional outcomes. This investigation sought to assess alterations in condylar positioning one year after the placement of complete dentures in edentulous patients, with additional objectives to examine variations based on sex and side.

MATERIALS AND METHODS: This cross-sectional prospective cohort investigation was carried out in the Department of Prosthodontics, involving 15 participants who were systemically healthy, aged between 45 and 60 years, completely edentulous for a minimum duration of one year, and were first-time denture recipients. Following denture insertion, a one-year follow-up evaluation of condylar positioning was conducted using cone-beam computed tomography (CBCT). Analyses were performed on the intercondylar angle, interocclusal gap, and TMJ space (anterior, posterior, superior, and medial). Statistical evaluations were performed using paired and independent t-tests. The significance threshold was set at P < 0.05.

RESULTS: The mean ages of the male and female participants were 55.43 years and 56.38 years, respectively. Significant changes were observed in the TMJ spaces and condylar dynamics at the one-year follow-up. The posterior, superior, and medial joint spaces decreased significantly (p = 0.001), indicating the posterior, superior, and medial displacement of the condyle. The interocclusal gap increased significantly from 1.47 mm in males and 1.51 mm in females at denture insertion to 1.79 mm and 1.80 mm, respectively, at follow-up (p = 0.001). The intercondylar angle significantly decreased (p = 0.001). Sex-based differences were noted in the medial joint space and condylar angle on the left side, with larger mean changes in males (p < 0.05). Side-based differences revealed greater superior space, medial space, and condylar angle on the right side than on the left (p < 0.05).

CONCLUSION: This investigation revealed substantial morphometric alterations in the TMJ spaces and condylar positioning following one-year post-complete denture placement, characterized by pronounced increases in interocclusal gap and reductions in intercondylar angle. Consistent monitoring and prompt repair or replacement of dentures are essential for preserving the TMJ integrity and occlusal equilibrium in edentulous individuals.

PMID:39886725 | PMC:PMC11780681 | DOI:10.7759/cureus.76662

Cureus. 2024 Dec 30;16(12):e76647. doi: 10.7759/cureus.76647. eCollection 2024 Dec.

ABSTRACT

Background The escalating global obesity epidemic requires comprehensive investigations for effective weight management strategies. Understanding the patterns, barriers, and facilitators of dietary interventions is crucial for developing effective weight management protocols. This research aims to assess dietary modification interventions among weight loss subjects in Tamilnadu, South India. Specific objectives included evaluating various weight loss interventions, analyzing dietary patterns adopted by subjects, and examining characteristics, barriers, and facilitators associated with specific dietary modification approaches. Methodology A cross-sectional study was conducted among 432 participants from Tamilnadu, South India. The research employed a comprehensive data collection approach, gathering information on demographic characteristics, anthropometric measurements, dietary modification patterns, and intervention outcomes. Participants were categorized based on their chosen dietary interventions, particularly distinguishing between intermittent fasting and alternative dietary approaches. The study systematically evaluated various parameters, including regular adherence, physiological effects, psychological impacts, and barriers to maintenance. Statistical analysis utilized chi-square and Fischer’s exact tests for categorical variables, while independent t-tests were employed for continuous variables. Results This study encompassed 432 participants, with demographically diverse participants characterized by a predominance of urban residents (295, 68.3%), highly educated individuals (383, 88.6%), and students (190, 44%). The mean age was 27.93 years, with a mean body mass index of 25.21 kg/m². Regarding dietary intervention objectives, the study revealed that 289 (66.9%) were not engaged in any healthcare intervention, while 102 (23.6%) pursued intermittent fasting and 41 (9.5%) adopted alternative dietary strategies such as Paleo and ketogenic diets. Among participants implementing dietary modifications, the mean intervention duration was 5.21 months, ranging from half a month to 60 months. Intermittent fasting participants exhibited statistically significant characteristics, including a younger mean age (27.09 years) compared with alternative diet groups (37.37 years). Notably, 73 (71.6%) reported significant weight loss, with 69 (67.6%) experiencing weight regain during non-adherence. Psychological and physiological benefits were prominently observed, with 73 (71.6%) reporting mood improvements, 71 (69.6%) experiencing enhanced concentration, and 72 (70.6%) noting improved bowel habits. Barriers to dietary modifications included timing challenges (50, 49%), family mealtime conflicts (43, 42.2%), and work schedule interruptions (39, 38.2%). Conclusion The research provides comprehensive insights into dietary modification patterns among young Indian adults, highlighting intermittent fasting’s potential as an effective weight management strategy. The findings underscore the complex interplay between dietary choices, individual characteristics, and holistic health outcomes. While demonstrating promising weight loss and cognitive benefits, the study emphasizes the necessity of personalized, context-sensitive nutritional interventions. These insights contribute significantly to understanding dietary modification dynamics and inform the development of more effective, tailored weight management strategies.

PMID:39886723 | PMC:PMC11779999 | DOI:10.7759/cureus.76647

Cureus. 2024 Dec 31;16(12):e76676. doi: 10.7759/cureus.76676. eCollection 2024 Dec.

ABSTRACT

AIM: This study aimed to evaluate the impact of using melatonin and vitamin C as adjuncts to the non-surgical treatment of chronic periodontitis.

MATERIALS AND METHODS: This triple-blind randomized clinical trial involved 100 participants with chronic periodontitis. Subjects were randomly assigned to three groups: (1) non-surgical periodontal therapy (NSPT) alone (n = 33); (2) NSPT with melatonin (n = 33); and (3) NSPT with melatonin and vitamin C (n = 34). Clinical parameters, including gingival index (GI), probing depth (PD), and clinical attachment loss (CAL), were assessed at baseline and at one week, one month, and three months post treatment. Statistical significance was set at p ≤ 0.05.

RESULTS: Compared to baseline, all groups showed significant improvements in periodontal parameters (p ≤ 0.001). At three months, the group receiving both melatonin and vitamin C demonstrated the greatest reduction in PD (mean reduction: 1.96 mm, p ≤ 0.001) and CAL (mean reduction: 1.87 mm, p ≤ 0.001). This group also achieved the most significant improvement in GI (mean reduction: 1.74, p ≤ 0.001).

CONCLUSIONS: The combined adjunctive therapy of melatonin and vitamin C demonstrated superior improvements in periodontal indices compared to NSPT alone, supporting its potential as an effective adjunctive treatment for chronic periodontitis.

PMID:39886720 | PMC:PMC11781506 | DOI:10.7759/cureus.76676

Cureus. 2024 Dec 30;16(12):e76607. doi: 10.7759/cureus.76607. eCollection 2024 Dec.

ABSTRACT

AIM: The aim of the study is to test the null hypothesis that the specificities and sensitivities of the p-value-based significance test for differences between baseline variables and the I² test for single trials do not significantly differ in detecting selection bias in randomised controlled trials (RCTs).

METHODS: In MS Excel (Microsoft Corp., Redmond, WA, US), 100 trials were simulated, each consisting of two treatment groups (A and B), with 100 subjects in each group. Fifty trials were biased, while 50 remained non-biased. Both tests were applied to all trials, yielding true positive, false positive, false negative, and true negative per test. Subsequently, sensitivities and specificities with a 95% confidence interval (CI) were calculated and statistically compared using the z-test.

RESULTS: No false positive results were observed, and subsequently, the specificities of both tests were identical (100.00%; 95% CI: 92.89%-100.00%). The sensitivity for the significance test and I² test was 24.00% (95% CI: 13.06%-38.17%) and 76.00% (95% CI: 61.83%-86.94%), respectively. A statistical comparison of the test sensitivities yielded a significant result in favour of the I² test (z = 5.2; p < 0.0001). Consequently, the null hypothesis for the tests’ sensitivities was rejected.

CONCLUSION: The I² test appears to be a more effective method than the p-value-based significance test for detecting selection bias in RCTs.

PMID:39886704 | PMC:PMC11779566 | DOI:10.7759/cureus.76607

Cureus. 2024 Dec 31;16(12):e76669. doi: 10.7759/cureus.76669. eCollection 2024 Dec.

ABSTRACT

Optic nerve disorders significantly contribute to visual impairment with irreversible visual deficits. Current treatments have limited efficacy in resolving chronic visual deficits, necessitating novel therapeutic strategies. Neurorehabilitation techniques, including repetitive transorbital alternating current stimulation (rtACS), have emerged as promising approaches to restore lost visual function through the ability to modulate brain activity. However, the evidence on the effectiveness of rtACS remains inconclusive, warranting a systematic review to assess its potential as a therapeutic intervention for optic nerve-related visual deficits. This study exclusively evaluated the effectiveness of rtACS for visual field restoration in patients with optic nerve damage, including only randomized controlled trials (RCTs) that met the strict eligibility criteria. A thorough screening and data extraction process was conducted by independent reviewers, followed by a meta-analysis to assess the statistical significance and heterogeneity of the included studies. The improvement in the visual field in the rtACS compared to the sham group was the primary outcome, and visual acuity improvement was the secondary outcome. This study included three RCTs that evaluated the effects of rtACS compared to sham control in treating optic nerve damage. In regard to visual field (VF), the results revealed a significant improvement in the detection accuracy of the rtACS group compared to the control group, with a pooled mean difference of 32.06 [95% CI: 19.2, 51.2] (p=0.001, I2= 0%). The near and far vision revealed no statistically significant difference between both groups. Based on the systematic review, the use of rtACS shows a promising effect in improving the detection accuracy of the VF for patients with optic nerve damage, with a significant benefit over sham control. However, the effects on other visual outcomes were minimal, and safety data was limited. Further high-quality trials are needed to corroborate the findings and provide a more comprehensive evaluation of its efficacy and safety for treating optic nerve-related visual deficits.

PMID:39886696 | PMC:PMC11781289 | DOI:10.7759/cureus.76669

Front Oncol. 2025 Jan 16;14:1326355. doi: 10.3389/fonc.2024.1326355. eCollection 2024.

ABSTRACT

INTRODUCTION: This retrospective study aims to evaluate the long-term efficacy and urinary toxicity of LDR-brachytherapy for localized prostate cancer.

MATERIALS AND METHODS: 235 primary prostate cancer patients treated with LDR-brachytherapy and subsequently followed up in our center were included in this study. Biochemical relapse free survival (bRFS), overall survival (OS), and cancer-specific survival (CSS) were evaluated. Additionally, the incidence of late urinary complications was recorded.

RESULTS: Median follow-up time was 11,6 years. 181 patients (77%) were classified as low-risk patients, while 52 patients (22,1%) were intermediate risk. The overall bRFS was 83,8% at 5 years and 72,4% at 10 years. 5- and 10-year OS were 97,8% and 87,8% respectively. There was no statistically significant difference in bRFS or OS between different risk groups. The rate of late urinary complications was 8,9%. Volume of prostate had a statistically significant effect on bRFS, as smaller prostate volumes led to worse bRFS.

CONCLUSIONS: This retrospective study shows that LDR brachytherapy is an effective treatment for low- and intermediate risk prostate cancer patients with relatively low but still significant risk of late urinary complications.

PMID:39886674 | PMC:PMC11779706 | DOI:10.3389/fonc.2024.1326355

Front Oncol. 2025 Jan 16;14:1522009. doi: 10.3389/fonc.2024.1522009. eCollection 2024.

ABSTRACT

OBJECTIVE: To investigate the optimal cut-off value of immunohistochemical marker Ki67 as a prognostic factor to predict the recurrence of non-muscle invasive bladder urothelial carcinoma (NMIBUC).

METHODS: A total of 331 patients diagnosed with NMIBUC who underwent surgery in the Yongchuan Hospital and the Second Affiliated Hospital of Chongqing Medical University from January 2012 to January 2020 were finally included in this study. The optimal cut-off value of Ki67 for predicting recurrence of NMIBUC was calculated by ROC curve and Youden index. According to the cut-off value, the patients were divided into high ratio group and low ratio group, and the clinicopathological data of the two groups were compared. Univariate and multivariate regression analysis were used to analyze the relationship between the expression of Ki67 and postoperative recurrence of NMIBUC. The Kaplan-Meier curve was used for survival analysis.

RESULTS: 18% is the optimal cut-off value of Ki67 for predicting postoperative recurrence of NMIBUC. High Ki67 expression (Ki67>18%) was significantly correlated with tumor stage (P=0.001), tumor grade (P=0.014), immediate postoperative instillation (P=0.001), the expression of P53 (P=0.019) and CK20 (P=0.001). Ki67 expression greater than 18% was an independent risk factor for high recurrence rate of NMIBUC (P=0.001). Moreover, the 1-year and 3-year recurrence-free survival (RFS) of the high Ki67 group were 56.6% (95%CI 51.2%-62%) and 43.6% (95%CI 37.5%-49.7%) respectively, which were significantly lower than those in low Ki67 group which present as 92.9% (95%CI 89.0%-96.8%) and 88.3% (95%CI 82.4%-94.2%) respectively, and the difference was statistically significant (P<0.001).

CONCLUSIONS: 18% is the optimal cut-off value of Ki67 for predicting recurrence of NMIBUC. Ki67>18% is an independent risk factor for high recurrence rate of NMIBUC. This cut-off value can more accurately predict the risk of recurrence and has the potential clinical value for guiding the postoperative adjuvant treatment and follow-up strategy of NMIBUC.

PMID:39886663 | PMC:PMC11779619 | DOI:10.3389/fonc.2024.1522009

Front Oncol. 2025 Jan 16;14:1466159. doi: 10.3389/fonc.2024.1466159. eCollection 2024.

ABSTRACT

BACKGROUND: Colorectal cancer (CRC) is a common malignancy with notable recent shifts in its burden distribution. Current data on CRC burden can guide screening, early detection, and treatment strategies for efficient resource allocation.

METHODS: This study utilized data from the latest Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study. Initially, a series of descriptive statistics were performed on the incident cases, deaths, disability-adjusted life years (DALYs), and age-standardized rates (ASRs) of CRC. Percentage changes and average annual percentage changes (AAPC) were then calculated to understand the trends in CRC disease burden. Decomposition and frontier analyses were conducted, and finally, the Bayesian age-period-cohort (BAPC) model was used to predict changes in ASRs up to 2040.

RESULTS: The GBD 2021 estimates indicate a significant increase in the global incident cases, deaths, and DALYs of CRC from 1990 to 2021. The age-standardized incidence rate (ASIR) increased (AAPC: 0.2), while the age-standardized mortality rate (ASMR) (AAPC: -0.72) and age-standardized DALYs rate (AAPC: -0.73) decreased. Males bore a higher disease burden than females, though the trends in disease burden changes were similar for both sexes. Although developed regions had higher incident cases, deaths, and DALYs, they showed more significant declines in ASRs. Decomposition analysis revealed that population growth and aging were the primary drivers of the increased disease burden. Frontier analysis showed that as the Socio-demographic Index increased, the disparity in CRC ASRs among countries widened, with developed regions having greater potential to reduce these rates. The By 2040, the BAPC model projects significant declines in global ASMR and age-standardized DALYs rates, while ASIR is expected to decrease in females but increase in males and across both sexes.

CONCLUSION: CRC remains a significant public health issue with regional and gender differences, necessitating region- and population-specific prevention strategies.

PMID:39886660 | PMC:PMC11779618 | DOI:10.3389/fonc.2024.1466159

Proc IEEE Int Symp Biomed Imaging. 2024 May;2024. doi: 10.1109/ISBI56570.2024.10635138. Epub 2024 Aug 22.

ABSTRACT

Physics-driven deep learning (PD-DL) methods have gained popularity for improved reconstruction of fast MRI scans. Though supervised learning has been used in early works, there has been a recent interest in unsupervised learning methods for training PD-DL. In this work, we take inspiration from statistical image processing and compressed sensing (CS), and propose a novel convex loss function as an alternative learning strategy. Our loss function evaluates the compressibility of the output image while ensuring data fidelity to assess the quality of reconstruction in versatile settings, including supervised, unsupervised, and zero-shot scenarios. In particular, we leverage the reweighted l 1 norm that has been shown to approximate the l 0 norm for quality evaluation. Results show that the PD-DL networks trained with the proposed loss formulation outperform conventional methods, while maintaining similar quality to PD-DL models trained using existing supervised and unsupervised techniques.

PMID:39886655 | PMC:PMC11779509 | DOI:10.1109/ISBI56570.2024.10635138