Category: Statistics

J Neurooncol. 2025 Dec 24;176(2):137. doi: 10.1007/s11060-025-05377-3.

ABSTRACT

PURPOSE: Palliative care (PC) remains underutilized among patients with primary brain tumors, despite the life-threatening nature of the disease and the high symptom burden. This study aimed to assess how the timing of a PC decision (i.e., terminate life-prolonging anticancer treatments) is associated with emergency department visits and hospitalizations at the end of life (EOL).

METHODS: This single-center retrospective cohort study included adult patients (≥ 18 years) with primary brain tumor treated at the Comprehensive Cancer Center of Helsinki University Hospital during 2017-2018 who died by the end of 2018. Patients were categorized into “early PC decision” (> 30 days before death) or “late/no PC decision” (≤ 30 days or no decision). We extracted data on hospital resource use from electronic medical records.

RESULTS: Among 162 patients (mean age 66 years, range 24-97; 57% male), 64% had a documented PC decision, with 43% of the total cohort having an early PC decision. Patients with an early PC decision had significantly fewer emergency department visits (10% vs. 25%; p = 0.015) and fewer hospitalizations (4% vs. 29%; p < 0.001) in their final month of life compared to those with a late/no decision. Overall, 34% of patients visited a dedicated PC unit, with a median of 93 days (range 5-619) from the first PC unit visit to death.

CONCLUSIONS: An early PC decision significantly reduced acute hospital resource use at EOL among brain tumor patients. Nonetheless, approximately one-third of patients had no documented PC decision, and similarly low numbers had PC unit visits, highlighting ongoing gaps in timely PC initiation.

PMID:41442055 | DOI:10.1007/s11060-025-05377-3

Cancer Causes Control. 2025 Dec 24;37(1):4. doi: 10.1007/s10552-025-02094-0.

ABSTRACT

PURPOSE: Rhode Island’s 14 Health Equity Zones (HEZ) initiative is an innovative public health approach to improve well-being by uniting community stakeholders to create healthier neighborhoods. We sought to identify the association between HEZ and colorectal cancer (CRC) screening among populations with anticipated vulnerabilities.

METHODS: This study used deidentified health insurance claims data from HealthFacts RI, Rhode Island’s all-payer claims database, to calculate CRC screening rates by race/ethnicity, insurance type, substance use, and/or mental health diagnoses across ZIP codes from 2017 to 2022. ZIP code(s) were matched to the corresponding HEZs and non-HEZs, resulting in a sample size of 973,433 individuals in HEZs and 312,619 in non-HEZs.

RESULTS: Rates of CRC screening were 62.4% in the HEZs versus 64.1% in the non-HEZs (p < 0.01). Among Medicaid beneficiaries, rates of CRC screening were 47.8% in HEZs versus 45.8% in non-HEZs (p < 0.01).

CONCLUSIONS: The population living in HEZs underwent CRC screening at a lower rate overall compared to non-HEZs. We found that individuals with Medicaid insurance coverage had the lowest CRC screening rates, and HEZs appear to mitigate the screening rates in this group of patients. Other Medicaid expansion states should replicate Rhode Island’s HEZ model to improve screening among Medicaid beneficiaries.

PMID:41442050 | DOI:10.1007/s10552-025-02094-0

Bull Math Biol. 2025 Dec 24;88(1):6. doi: 10.1007/s11538-025-01574-3.

ABSTRACT

We present a mathematical model describing the interactions between cancer cells, cytotoxic T lymphocytes (CTLs), and monocytes within the tumor microenvironment. The model incorporates key immunological mechanisms, including tumor antigenicity, the Allee effect, and monocyte-mediated immune activation via MHCI cross-dressing. Using systems of nonlinear ordinary differential equations (ODEs), we derive analytical expressions for equilibrium points, evaluate their stability, and characterize bifurcations, such as saddle-node, Hopf, Bogdanov-Takens, and Bautin. A reduced model via quasi-steady-state approximation (QSSA) is also proposed, preserving the core dynamic structure to facilitate bifurcation analysis. A central finding of our study is the critical role of the monocyte-mediated T cell activation rate, denoted by the parameter $\beta$ , which encapsulates the immunostimulatory potential of inflammatory monocytes presenting tumor antigens via MHCI cross-dressing. Numerical continuation corroborates the existence of multiple codimension-two organizing centers, delineating parameter regimes of tumor clearance, immune-mediated control, bistability, sustained oscillations, and inevitable escape. Our results quantitatively characterize the critical role of the monocyte-T-cell activation rate ( $\beta$ ) and the Allee threshold ( $\gamma$ ) in tipping the balance between immune surveillance and tumor persistence. This framework provides actionable bifurcation-based criteria for designing combination immunotherapies that enhance antigen presentation or monocyte functionality to shift the system toward tumor-eliminating attractors.

PMID:41442045 | DOI:10.1007/s11538-025-01574-3

Dermatol Ther (Heidelb). 2025 Dec 24. doi: 10.1007/s13555-025-01611-y. Online ahead of print.

ABSTRACT

INTRODUCTION: Itch and pain are two of the most common and burdensome symptoms for moderate to severe Chronic Hand Eczema (CHE). Here, we assess changes in itch/pain in patients with moderate to severe CHE treated with delgocitinib cream 20 mg/g or cream vehicle for 16 weeks.

METHODS: In a pooled DELTA 1 (NCT04871711)/DELTA 2 (NCT04872101) analysis (delgocitinib [n = 639]; cream vehicle [n = 321]; twice-daily), the Hand Eczema Symptom Diary captured patient-reported itch/pain severity on a numeric rating scale. Changes in itch/pain from baseline were assessed daily during week 1 and weekly from week 1 to 16.

RESULTS: In delgocitinib-treated patients, a statistically significant least square mean reduction from baseline was observed for itch from day 1 ([delgocitinib cream/cream vehicle] 0.75/0.32; P < 0.001) and pain from day 3 (0.98/0.58; P = 0.001) after the first application. Among patients with ≥ 4-point baseline itch/pain score, a significantly greater percentage of delgocitinib-treated patients achieved ≥ 4-point reduction from week 2 (14.2%/17.3%) versus cream vehicle (6.3%/6.9%; P < 0.001). Reductions were maintained up to week 16 with delgocitinib cream treatment. Delgocitinib cream was well tolerated.

CONCLUSION: Early onset of itch/pain reduction was observed within week 1 for delgocitinib-treated patients, thereby providing further support of the use and efficacy of delgocitinib cream in adults with moderate to severe CHE.

PMID:41442013 | DOI:10.1007/s13555-025-01611-y

Dermatol Ther (Heidelb). 2025 Dec 24. doi: 10.1007/s13555-025-01626-5. Online ahead of print.

ABSTRACT

INTRODUCTION: Fractional microneedle radiofrequency (FMRF) and poly-L-lactic acid (PLLA) each promote dermal remodeling through distinct mechanisms and have demonstrated efficacy as monotherapies for atrophic acne scars (AAS). The objective of this study is to evaluate the efficacy and safety of combining FMRF with transdermal PLLA delivery compared with sterile water in Asian patients with moderate-to-severe AAS.

METHODS: In this randomized, split-face, evaluator-blinded clinical trial, 24 participants underwent two monthly FMRF sessions. Immediately after each session, a reconstituted PLLA suspension was applied to one facial half for transdermal delivery through the FMRF-created microchannels, while sterile water was applied to the contralateral side. Outcomes were assessed using three-dimensional imaging (Antera® 3D), standardized photography, and patient self-assessments over a 6-month follow-up. Safety was monitored throughout the study.

RESULTS: PLLA-treated sides demonstrated statistically significant improvements in skin texture and scar volume at 6 months compared with baseline and with control sides (p < 0.05). Patient-reported outcomes paralleled objective findings, with a higher proportion of participants reporting > 75% improvement on the PLLA-treated side. Adverse events were of low incidence, transient, self-limited, and no serious complications occurred.

CONCLUSIONS: Combining FMRF with transdermal PLLA delivery is a safe and effective approach for moderate-to-severe AAS in Asian patients. The combination produced progressive, sustained, and clinically meaningful improvements compared with FMRF alone.

TRIAL REGISTRATION: Thai Clinical Trials Registry: TCTR20250803007.

PMID:41442012 | DOI:10.1007/s13555-025-01626-5

Radiol Phys Technol. 2025 Dec 24. doi: 10.1007/s12194-025-00998-9. Online ahead of print.

ABSTRACT

Abdominal computed tomography (CT) is normally performed with patients raising their arms over abdominal region to prevent arm-induced artifacts that degrade image quality. This study aimed to evaluate the effects of deep learning-based image reconstruction (DLIR) on arm-induced artifacts and image quality in abdominal CT with arms-down positioning, compared to adaptive statistical iterative reconstruction-Veo (ASIR-V) and filtered-backprojection (FBP). A liver nodule phantom with arms from a PBU-60 phantom was scanned in three arms-down positions: alongside the torso, across the abdomen, and crossed over the pelvis. Abdominal CT images of 10 patients in arms-alongside-torso position were also included. Images were reconstructed using DLIRs (L-low, M-medium, and H-high), ASIR-Vs (50% and 100%), and FBP. Phantom images were assessed for artifact strength (location parameter of the Gumbel distribution and standard deviation), signal-to-noise ratio, and contrast-to-noise ratio. Two radiologists qualitatively evaluated patient images for noise, artifacts, sharpness, and overall quality. DLIR-H significantly reduced streak artifacts by 37% in location parameters and by 43% in SD, while improving SNR by 28% and CNR by 29% compared to ASIR-V50%. DLIR-M performed significantly better than ASIR-V50% in all quantitative metrics, except in the arms-alongside-torso position. FBP performed worst, although sharpness was comparable. DLIR-H received the best qualitative scores (low noise and artifacts, minimal blurring, and excellent overall image quality), although ASIR-V100% had lower subjective noise. DLIR outperformed ASIR-V and FBP in arm-induced artifact reduction and image quality and is a preferable reconstruction method for arms-down abdominal CT.

PMID:41442007 | DOI:10.1007/s12194-025-00998-9

Cardiovasc Toxicol. 2025 Dec 24;26(1):7. doi: 10.1007/s12012-025-10084-6.

ABSTRACT

Accumulating evidence supports the association between endocrine disrupting chemicals (EDCs) exposure and cardiovascular disease (CVD). However, the link between EDCs and cardiovascular health (CVH) prior to CVD onset remains unclear. This study investigates the relationship between individual and combined EDC exposure and Life’s Essential 8 (LE8). We included 9,940 participants from the National Health and Nutrition Examination Survey (NHANES) conducted between 2003 and 2016, excluding adults with known CVD. Twenty-two types of EDCs were detected in urine samples, including three phenols, two phenolic pesticides, eleven phthalates, and six polycyclic aromatic hydrocarbons (PAHs). Weighted generalized linear models (GLM) and weighted quantile sum (WQS) regression to explore the relationship between single/mixed exposure to EDCs and CVH. Overall, 9,940 individuals (weighted mean [SE] age, 42.53 [0.26] years; 5,313 women [weighted 53.7%]) without CVD were included, with a mean score of LE8 at 68.70. The GLM model reveals that specific exposures to EDCs are inversely associated with LE8, serving as independent risk factors contributing to poorer CVH. The WQS index of EDCs was independently associated with overall CVH, with an adjusted odds ratio (OR) of 3.00 (95% confidence interval [CI]: 2.30-3.90; P < 0.001). 2-Fluorenone (2-FLU) emerged as the most heavily weighted component in the overall CVH model. This study emphasizes the association between exposure to EDCs is correlated with a higher odds ratio for decline in CVH among American adults. 2-FLU emerges as a prominent contributor. It provides epidemiologic evidence for the detrimental effects of these chemicals on CVH.

PMID:41442004 | DOI:10.1007/s12012-025-10084-6

Eur Radiol. 2025 Dec 24. doi: 10.1007/s00330-025-12078-y. Online ahead of print.

ABSTRACT

OBJECTIVES: The clinical relevance of computed tomography (CT)-based airway tree structure is unclear. Herein, we used artificial intelligence to segment the airway tree and pneumonia regions, measuring total airway count (TAC) and pneumonia volume to examine whether their combination is more closely associated with clinical outcomes in patients with coronavirus disease (COVID-19) than pneumonia volume alone.

MATERIALS AND METHODS: We examined clinical data and chest CT from 781 hospitalized COVID-19 patients in a multicenter retrospective cohort in Japan, focusing on the percentage of critical outcomes (high-flow oxygen, invasive mechanical ventilation, or death). Additionally, 197 patients were followed up for 3 months to monitor TAC and pneumonia volume.

RESULTS: Critical outcomes were observed in 63 (8.8%) patients, with higher TAC in those patients. Patients were divided into four groups based on cutoff values of 17.6% for pneumonia volume percent and 255 for TAC: Group A (low TAC, low pneumonia volume), Group B (high TAC, low pneumonia volume), Group C (low TAC, high pneumonia volume), and Group D (high TAC, high pneumonia volume). Group D had the worst outcomes, highest levels of inflammation, fibrosis markers, and complications, as well as a significantly higher risk of critical outcomes after adjusting for age, body mass index, sex, total lung volume and comorbidities. In the 3-month longitudinal analysis, pneumonia volume, but not TAC, improved in critical cases.

CONCLUSIONS: The integrated assessment of TAC and pneumonia volume effectively predicted critical outcomes in COVID-19 patients and may be useful for various respiratory diseases, including infectious or interstitial pneumonia.

KEY POINTS: Question Total airway counts (TAC) on computed tomography (CT) scan is associated with respiratory disease progression, but clinical relevance of CT-based airway tree structure is unclear. Findings The integrated assessment of TAC and pneumonia volume effectively predicted critical outcomes in COVID-19 patients. Clinical relevance This metric can potentially be applied to various respiratory diseases, including infectious or interstitial pneumonia.

PMID:41442001 | DOI:10.1007/s00330-025-12078-y

Bone Marrow Transplant. 2025 Dec 23. doi: 10.1038/s41409-025-02765-1. Online ahead of print.

ABSTRACT

Mutations in the DNMT3A gene are not yet classified as a distinct prognostic group in the latest European Leukemia Net (ELN) 2022 genetic risk classification of AML. We analyzed 1888 adult AML patients with ELN 2022 intermediate- or poor-risk cytogenetics who received their first allo-transplant in first complete remission between 2015 and 2022. Among patients with cytogenetically normal AML, the triple-positive mutation group (DNMT3A, NPM1, and FLT3-ITD) was the most frequent (n = 340, 29%), while DNMT3A co-occurrence with either FLT3 or NPM1 mutations alone was less common (4% and 9%, respectively). Patients with DNMT3A mutations were less likely to have a secondary AML (14% versus 24%, p < 0.001). DNMT3A mutations negatively affected post-transplant leukemia-free survival (LFS) in patients with normal karyotype and NPM1 mutation without FLT3-ITD (2-year LFS: 70% versus 90%, hazard ratio [HR]: 3.3, p = 0.006), and increased relapse incidence (RI) in FLT3-ITD and wild-type NPM1 subgroup (2-year RI: 30% versus 18%, HR: 2.32, p = 0.03). Notably, patients with normal karyotype and triple-positive mutation exhibited excellent 2-year LFS and OS (61% and 70%), indicating that allo-transplant overcomes the dismal outcome of this group. The impact of DNMT3A mutations on post-transplant outcomes in AML patients in first remission varies based on karyotype and co-mutations.

PMID:41437149 | DOI:10.1038/s41409-025-02765-1

BMC Sports Sci Med Rehabil. 2025 Dec 23. doi: 10.1186/s13102-025-01476-w. Online ahead of print.

ABSTRACT

BACKGROUND: Volleyball requires repeated explosive actions, agility, and technical precision, demanding contributions from both aerobic and anaerobic energy systems. Time-efficient training methods such as resistance-based high intensity interval training (HIIT) and high intensity functional training (HIFT) have been proposed to enhance multidimensional performance in young athletes. However, direct comparisons of their effects in adolescent female volleyball players are limited.

METHODS: Thirty-two licensed female volleyball players (aged 15-18 years) were randomly assigned to a resistance-based HIIT group (n = 10), a HIFT group (n = 11), or a control group (n = 11). The training interventions lasted 12 weeks with two supervised sessions per week, in addition to regular volleyball practice. The HIIT program consisted of progressive resistance-based high intensity intervals performed at 85-95% HRmax, while the HIFT program comprised multimodal circuit-style functional exercises performed at comparable intensities (~ 85-95% HRmax). Performance assessments were conducted pre- and post-intervention and included the countermovement jump (CMJ), standing long jump (SLJ), medicine ball throw (MBT), pro-agility test, 20 m sprint, repeated sprint fatigue index (RSI), volleyball skill test, Yo-Yo IR1 distance, VO₂max, blood lactate concentration, and maximal heart rate (MaxHR). Data were analyzed using a 3 × 2 mixed-model ANOVA with Tukey post hoc tests, and effect sizes were reported as Cohen’s d and partial eta squared (ηp²).

RESULTS: Significant Group × Time interactions were observed for CMJ (F(2,29) = 9.14, p < 0.001, ηp²=0.39), SLJ (F(2,29) = 12.08, p < 0.001, ηp²=0.45), VO₂max (F(2,29) = 11.53, p < 0.001, ηp²=0.44), MaxHR (F(2,29) = 3.56, p = 0.041, ηp²=0.20), and volleyball skill test (F(2,29) = 7.44, p = 0.002, ηp²=0.34). HIFT produced the greatest improvements in explosive power (CMJ Δ=+5.15 cm; SLJ Δ=+12.82 cm), RSI (Δ=-1.56), and volleyball skill performance (Δ=+13.18 points), with large effect sizes (d = 1.3-3.2). HIIT showed relatively greater improvements in aerobic capacity (VO₂max Δ=+0.90 ml·kg⁻¹·min⁻¹) and endurance (d = 0.7-2.0). No significant between-group differences were observed for lactate.

CONCLUSIONS: Both resistance-based HIIT and HIFT proved effective in improving several physical and volleyball-specific performance components in adolescent female players. HIIT produced slightly greater gains in aerobic capacity, while HIFT showed larger numerical improvements in explosive strength, agility, and technical skill performance; however, these between-intervention differences were not statistically significant. Overall, the findings suggest that each modality offers complementary benefits, and integrating both HIIT and HIFT may provide a balanced conditioning approach for the holistic development of youth volleyball athletes.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT07181031. Registered on September 04, 2025.

PMID:41437127 | DOI:10.1186/s13102-025-01476-w