Category: Statistics

Eur J Epidemiol. 2025 Jul 14. doi: 10.1007/s10654-025-01277-y. Online ahead of print.

ABSTRACT

While previous literature suggests that plant-based diets may be associated with a lower risk of breast cancer, evidence remains inconsistent. In this study, we investigated the association between adherence to plant-based diets and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Overall plant-based diet index (PDI), healthful (hPDI), and unhealthful PDI (uPDI) were calculated, and multivariable Cox models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) of breast cancer for the three indices. Mediation analysis was performed to assess the role of body mass index (BMI) and waist circumference (WC) in the association between hPDI and postmenopausal breast cancer risk. Over a median follow-up of 14.9 years, 10,805 incident invasive breast cancer cases were identified among 258,343 women. In the multivariable model, not adjusted for BMI, higher adherence to hPDI was inversely associated with breast cancer risk, with HR per 1-SD increase [95% (CI)] of 0.97 (0.94, 0.99). The corresponding HRs (95% CI) per 1-SD increase for overall PDI and uPDI were 0.98 (0.96, 1.00) and 1.01 (0.99, 1.03), respectively. The associations between hPDI and postmenopausal breast cancer were partly explained by BMI and WC, which mediated 30% and 52% of this association, respectively. Higher adherence to hPDI was associated with a slightly lower total breast cancer risk. For postmenopausal breast cancer, this association was partly explained by lower BMI or WC. These findings suggest that promoting healthful plant-based diets could support breast cancer risk reduction.

PMID:40658296 | DOI:10.1007/s10654-025-01277-y

Radiol Phys Technol. 2025 Jul 14. doi: 10.1007/s12194-025-00935-w. Online ahead of print.

ABSTRACT

Trigeminal neuralgia (TN) is characterized by severe facial pain and is treated with medications, surgery, percutaneous procedures, and stereotactic radiosurgery (SRS). The Gamma Knife (GK) has historically been the gold standard for SRS in TN, with alternatives such as the CyberKnife (CK) and standard linear accelerator (LA) having recently emerged. This study compared GK, CK, and LA treatments for TN via dosimetric analysis. Twenty patients (10 right- and 10 left-sided) with TN were planned in the three modalities. Dosimetric parameters, including D_Max, D_Min, D_Mean, D_98%, D_90%, D_50%, D_30%, and V_4Gy, were evaluated. The statistical significance was assessed using paired t tests. The CK and LA plans achieved a 60 Gy target coverage comparable to the GK plan. The GK plan exhibited superior brain stem sparing and lower V_4Gy compared with CK (p = 0.0013) and LA (p = 0.0001). Significant differences in D_Min, D_98%, D_90%, D_50%, and D_30% were observed between GK and CK (p < 0.05) and GK and LA (p < 0.05), but not for the CK-LA comparisons. The brain stem dose parameters (D_{0.03 cc}, D_1%, and D_2%) were significantly lower in the GK plan (p < 0.05). The GK exhibited better normal tissue sparing and brain stem dose distribution than CK and LA, attributable partly to its higher beam count. CK and LA require more intricate planning times. Despite the established efficacy of GK, CK and LA offer viable alternatives, underscoring the need for further research on the clinical outcomes of TN treatment in the respective modalities.

PMID:40658293 | DOI:10.1007/s12194-025-00935-w

Head Neck Pathol. 2025 Jul 14;19(1):84. doi: 10.1007/s12105-025-01814-x.

ABSTRACT

BACKGROUND: BCM is an uncommon cytomorphologic variant with the potential to mimic unrelated neoplastic conditions, especially in the absence of a known cutaneous primary lesion or limited access to immunohistochemical stains.

CASE PRESENTATION: A 28-year-old male patient presented with recent onset parotid gland mass. The mass was excised, and the subsequent workup elicited an interpretation of metastatic balloon cell melanoma (BCM). Despite an extensive evaluation, no evidence of a primary tumor site was identified.

DIAGNOSIS: The diagnosis was confirmed based on positive staining for BRAF, HMB45, Melan-A, PRAME, S100, and SOX-10 in the malignant cells.

CONCLUSION: Familiarity with the histologic and immunophenotypic findings may help to ensure an accurate diagnosis.

PMID:40658291 | DOI:10.1007/s12105-025-01814-x

Trop Anim Health Prod. 2025 Jul 14;57(6):298. doi: 10.1007/s11250-025-04546-w.

ABSTRACT

This study aimed to evaluate the effects of including a blend of acid and alkaline proteases in broiler diets on performance parameters, nutrient digestibility, and intestinal morphology. A total of 180 chicks were divided into the following groups: Positive Control (PC), Negative Control (with 8% reduction in crude protein-NC), and NC + blend proteases (BP) at 125 g/t (BP125). On days 1 and 21, the broilers and the feed were weighed for performance analysis, and a digestibility test was performed from days 17 to 21. The highest body weight and weight gain were observed in the broilers of the PC and BP125 groups (P = 0.001). The addition of protease to the diet (BP125) increased the ADC of crude protein, which was statistically similar to the PC group; both were higher than those observed in the NC group. We observed that the BP125 group had more excellent digestibility of the amino acids of serine (P = 0.032), threonine (P = 0.050), valine (P = 0.042), methionine (P = 0.050), cysteine (P = 0.012), arginine (P < 0.001) and tryptophan (P = 0.05) when compared to NC; but similar to PC group. It was also possible to observe a better villus and crypt ratio when protease was used in a low-protein diet (P = 0.05). These findings suggest that protease supplementation improves nutrient utilization and performance in low-protein diets.

PMID:40658273 | DOI:10.1007/s11250-025-04546-w

Int J Colorectal Dis. 2025 Jul 14;40(1):158. doi: 10.1007/s00384-025-04955-1.

ABSTRACT

PURPOSE: Urinary dysfunction (UD) is still a major complication after lower rectal cancer (LRC) surgery. Untreated UD is an independent risk factor for renal dysfunction due to repeated urinary reflux and urinary tract infections. However, the relationship between postoperative UD and renal function following LRC surgery remains unclear. In this study, we investigated the impact of UD on renal function post-surgery.

METHODS: We retrospectively evaluated 83 patients with LRC who underwent curative resection at our tertiary referral center between April 2015 and December 2018. UD was diagnosed as a post-void residual urine volume ≥ 50 mL using uroflowmetry tests after discharge. We compared the estimated glomerular filtration rate (eGFR) and the incidence of chronic kidney disease (CKD)-defined as an eGFR < 60 mL/min/1.73 m²-at 3 years after LRC surgery between the UD and non-UD groups. Patient selection was based on the criteria that excluded those with a history of urogenital interventions or incomplete postoperative follow-up. Statistical analysis used the Mann-Whitney U test for continuous variables, Fisher’s test for categorical data, and multivariate logistic regression to adjust for potential confounders.

RESULTS: Of the 83 patients, 21 (25%) had UD. Patients with UD were older, underwent more extensive surgery, and had significantly longer operation times than those without UD. Within 3 years post-surgery, the UD group experienced a higher incidence of urinary tract complications and CKD, with a notable decrease in eGFR. Additionally, a history of hypertension and UD were identified as independent risk factors for CKD at 3 years post-surgery.

CONCLUSIONS: Patients with UD showed a significant decrease in eGFR and were more likely to progress to CKD at 3 years after LRC surgery. These findings indicated that postoperative UD might adversely affect renal function in patients with LRC.

PMID:40658254 | DOI:10.1007/s00384-025-04955-1

Curr Eye Res. 2025 Jul 14:1-9. doi: 10.1080/02713683.2025.2531524. Online ahead of print.

ABSTRACT

PURPOSE: Determination of the amplitude of accommodation (AoA) is a clinical technique used in ophthalmology and optometry to assess the eye’s ability to focus on near objects. This study compares the reliability of a novel motorized push-up variant with conventional manual push-up and push-down methods for the determination of AoA in 26 emmetropes.

METHODS: The motorized push-up method reduces limitations of the manual methods, such as differences due to varying examiner abilities, ruler placement (forehead, zygomatic bone, spectacle plane), and inconsistent target movement speeds. This is achieved by providing a participant-controlled, constant target movement of 2 cm/s, with the medial zone of the zygomatic bone as the reference point for ruler placement. Additionally, digital image-based and traditional ruler-based AoA measurements were compared. The participants’ impressions of the three methods were assessed based on ease of use, confidence in measurement reliability, and comfort of experience, using a questionnaire.

RESULTS: The comparison of the AoA across the methods revealed no statistically significant differences. However, the concordance correlation coefficient was highest between the motorized and manual push-up method (ρ_c = 0.72). All methods showed good test-retest reliability with the highest ICC found for the motorized push-up method (0.83), which also had the narrowest limits of agreement interval for accommodative demand (3.22 cm). Beyond digital and ruler-based measurements showed underestimation by both rulers, with a mean bias of 0.3 cm for the motorized ruler compared to about 2.0 cm for the conventional ruler. The questionnaire responses suggest that the motorized version outperforms the manual versions being 5 times more likely to score higher for ease of use and 6 times more likely for confidence in measurement reliability.

CONCLUSION: These findings demonstrate that the motorized push-up method effectively measures the AoA, reduces interfering factors, and provides higher reliability without compromising precision, making it a valuable alternative to conventional methods.

PMID:40654173 | DOI:10.1080/02713683.2025.2531524

Acta Crystallogr D Struct Biol. 2025 Aug 1. doi: 10.1107/S2059798325005923. Online ahead of print.

ABSTRACT

Atomic coordinate models are important for the interpretation of 3D maps produced with cryoEM and cryoET (3D electron microscopy; 3DEM). In addition to visual inspection of such maps and models, quantitative metrics can inform about the reliability of the atomic coordinates, in particular how well the model is supported by the experimentally determined 3DEM map. A recently introduced metric, Q-score, was shown to correlate well with the reported resolution of the map for well fitted models. Here, we present new statistical analyses of Q-score based on its application to ∼10 000 maps and models archived in the EMDB (Electron Microscopy Data Bank) and PDB (Protein Data Bank). Further, we introduce two new metrics based on Q-score to represent each map and model relative to all entries in the EMDB and those with similar resolution. We explore through illustrative examples of proteins, nucleic acids and small molecules how Q-scores can indicate whether the atomic coordinates are well fitted to 3DEM maps and also whether some parts of a map may be poorly resolved due to factors such as molecular flexibility, radiation damage and/or conformational heterogeneity. These examples and statistical analyses provide a basis for how Q-scores can be interpreted effectively in order to evaluate 3DEM maps and atomic coordinate models prior to publication and archiving.

PMID:40654171 | DOI:10.1107/S2059798325005923

J Clin Nurs. 2025 Jul 14. doi: 10.1111/jocn.70034. Online ahead of print.

ABSTRACT

AIM: To examine the impact of critical care nurses’ delirium knowledge, self-efficacy and clinical reasoning competency on delirium care difficulties based on the information-motivation-behavioural (IMB) skills model from a behavioural perspective.

DESIGN: Cross-sectional study.

METHODS: A total of 440 critical care nurses from five hospitals in China were selected using convenience sampling and invited to complete an online questionnaire for measurement. Data were collected in November 2024 and analysed using SPSS/AMOS with descriptive statistics, Pearson’s correlation coefficient and multiple regression. Structural equation modelling was constructed to test the hypothesised relationships among the variables, with bootstrapping to assess mediation effects.

RESULTS: The level of delirium care difficulties was moderated. Delirium care difficulties were negatively correlated with delirium knowledge, self-efficacy and clinical reasoning competency. Clinical reasoning competency partly mediated delirium knowledge and self-efficacy with regard to delirium care difficulties.

CONCLUSION: Delirium knowledge, self-efficacy and clinical reasoning competency are essential for improving critical care nurses’ delirium care competencies. The role of clinical reasoning competency in the relationship between the other two variables and delirium care difficulties was highlighted. Establishing multifaceted innovative delirium education programmes, emphasising individuals’ sense of competence and enhancing clinical reasoning competency as behavioural skills were supported. Exploring these pathways using a nurse behaviour change-based perspective is critical.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Critical care managers should value nurses’ delirium care competencies. Enhancing continuing professional development through system-level support with high reliability and multiform professional education, including innovative theoretical and practical training; advancing policies that increase work motivation and self-planning to stimulate self-efficacy; and exercising critical and reflective thinking to improve clinical reasoning competency may enhance nurses’ delirium recognition and care competencies, including prioritisation, potentially improving delirium care dilemmas and patient outcomes.

REPORTING METHOD: The STROBE checklist was used as a guideline.

PATIENT OR PUBLIC CONTRIBUTION: Nurses completed questionnaires.

TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR2400092177). https://www.chictr.org.cn/bin/project/edit?pid=249216.

PMID:40654168 | DOI:10.1111/jocn.70034

Lab Med. 2025 Jul 12:lmaf038. doi: 10.1093/labmed/lmaf038. Online ahead of print.

ABSTRACT

INTRODUCTION: Artificial intelligence is increasingly used in medical education and testing. ChatGPT, developed by OpenAI, has shown mixed results on various medical exams, but its performance in medical laboratory genetics remains unknown.

METHODS: This study assessed ChatGPT-3.5 using 456 publicly available questions from the Polish national specialist exam in medical laboratory genetics. Questions were categorized by topic and complexity (simple vs complex) and submitted to ChatGPT 3 times. Accuracy and consistency were statistically evaluated.

RESULTS: ChatGPT correctly answered 59% of the 456 exam questions, which was statistically significant (P < .001). Accuracy differed by category: 71% for calculation-based questions, approximately 60% for genetic methods and genetic alterations, and only 37% for clinical case-based questions. Question complexity also affected performance: Simple questions had 63% accuracy, while complex questions yielded 43% (P = .001). No statistically significant differences were found across 3 repeated sessions, with performance remaining stable over time (P = .43).

DISCUSSION: ChatGPT-3.5 demonstrated moderate accuracy and stable performance on a specialist exam in medical genetics. Although it may support education in this field, the tool’s limitations in complex, domain-specific reasoning suggest the need for further development before broader implementation.

PMID:40654165 | DOI:10.1093/labmed/lmaf038

Personal Ment Health. 2025 Aug;19(3):e70032. doi: 10.1002/pmh.70032.

ABSTRACT

The LPFS-BF 2.0 (Level of Personality Functioning-Brief Form 2.0) is a brief self-report instrument that was developed in order to gain a quick first impression of personality dysfunction and was designed to align with the Level of Personality Scale as outlined in the DSM-5 Alternative Model for Personality Disorders (AMPD). In the current study, we used a factor analytic framework to evaluate the longitudinal measurement invariance of the Norwegian version of the LPFS-BF 2.0 in a sample of 1030 patients referred for personality disorder treatment with the R package lavaan. Additionally, we estimated item response theory (IRT) parameters for the 12 items, as well as local reliability, in order to facilitate comparisons with other studies. We found support for partial measurement invariance. Three items showed different thresholds across time points. However, these differences were minor and did not have a substantial impact on the estimated factor scores. The discrimination parameters were lower than could be expected for an instrument used in a clinical setting. Taking these findings together, we conclude that although the LPFS-BF 2.0 seems to measure the same latent trait across time, the items do not discriminate well between patients with high and low scores in a Norwegian population of adults seeking treatment for PD. Important next steps would be to estimate IRT parameters for comparable patient samples from other countries to assess the generalizability of our findings and to compare the LPFS-BF 2.0 scores to scores obtained through a clinical interview that aligns with the AMPD.

PMID:40654158 | DOI:10.1002/pmh.70032