Category: Statistics

Hernia. 2025 Dec 11;30(1):27. doi: 10.1007/s10029-025-03522-5.

ABSTRACT

PURPOSE: Parastomal hernias are a common complication after ostomy creation with high morbidity. Minimally invasive Sugarbaker mesh-based repairs have shown improved outcomes. Laparoscopic (LPHR) and robotic-assisted (RPHR) Sugarbaker parastomal hernia repairs were compared.

METHODS: Retrospective analysis of the Abdominal Core Health Quality Collaborative (ACHQC) database was conducted for elective, minimally invasive Sugarbaker parastomal hernia repair with permanent synthetic mesh from January 2014 to December 2023. Patients were grouped by surgical approach: RPHR or LPHR. Primary outcome was pragmatic hernia recurrence. Secondary outcomes included average pain intensity, hernia-related quality of life, and 30/90-day complications. Statistical analyses included chi-square, t-tests, and Mann-Whitney U tests.

RESULTS: Three hundred sixty-eight patients were included (RPHR: n = 260; LPHR: n = 108). Demographics and comorbidities were similar. RPHR involved more mesh excisions (37.5% vs. 4.3%; P = .009), hernia with longer lengths (8.3 cm vs. 6.4 cm; P < .001), and more frequent fascial closure (94.4% vs. 48.1%; P < .001). Recurrence within one year was lower after RPHR (20.9% vs. 40.5%; P = .03), but no significant differences were observed between postoperative years one through six. No differences in pain or quality-of-life outcomes were noted between groups, but both groups demonstrated significant improvements in hernia-related quality-of-life over one year.

CONCLUSION: Recurrence within one year was lower after RPHR compared to LPHR. Longer-term recurrence rates were similar between approaches. However, long-term recurrence findings are limited by low follow-up rates. Both approaches significantly improved hernia-related quality-of-life. Over time, recurrence may be more dependent on the altered anatomy and physiology of the stoma-affected abdominal wall rather than the specific minimally invasive approach used.

PMID:41379342 | DOI:10.1007/s10029-025-03522-5

Sleep Breath. 2025 Dec 11;30(1):7. doi: 10.1007/s11325-025-03555-1.

ABSTRACT

PURPOSE: Obstructive sleep apnea (OSA) is a prevalent sleep disorder and has been linked to reduced muscle mass and strength. However, its impact within couples remains poorly understood. This study investigated associations between OSA risk and muscle outcomes at both the individual and couple levels in Korean adults.

METHODS: We analyzed data from 1,597 heterosexual couples aged ≥ 40 years from the 2022-2023 Korea National Health and Nutrition Examination Survey, including 1,020 couples with handgrip strength data. OSA risk was defined as a STOP-Bang score ≥ 3. Muscle mass and strength were assessed using appendicular skeletal muscle mass (ASM) and handgrip strength, each normalized by BMI. Associations were examined using linear regression and the Actor-Partner Interdependence Model, adjusting for sociodemographic, lifestyle, and health-related covariates.

RESULTS: Higher STOP-Bang scores were independently associated with lower ASM/BMI and HGS/BMI in both husbands and wives (all p < 0.001). Partner effects were significant for husbands but not wives. At the couple level, having only one partner at high OSA risk was linked to lower muscle outcomes in that individual, while both partners at high risk exhibited the greatest declines in both outcomes (all p < 0.001).

CONCLUSION: High OSA risk is associated with reduced muscle mass and strength in both genders, with additive adverse effects observed when both partners are affected. These findings underscore the need to incorporate sleep-related risk factors into musculoskeletal health assessment and highlight the potential value of couple-based approaches for OSA screening and intervention in clinical sleep medicine.

PMID:41379339 | DOI:10.1007/s11325-025-03555-1

Environ Monit Assess. 2025 Dec 11;198(1):40. doi: 10.1007/s10661-025-14870-1.

ABSTRACT

Low-cost particulate matter (PM) sensors are increasingly used for personal and environmental air quality monitoring due to their affordability and accessibility. Recent advancements make these sensors suitable for occupational settings, but their accuracy in such settings remains uncertain. This study calibrated the AirBeam 2 and AirBeam 3 against the Thermo Scientific Personal DataRAM PDR-1500 to assess their efficacy at measuring high PM concentrations, such as those in occupational exposure settings, using engine exhaust and biomass smoke as PM sources. Laboratory calibrations were conducted using a sealed chamber. Linear and polynomial regressions assessed agreement with the PDR-1500, while breakpoint analyses identified thresholds where sensor performance shifted. Field calibrations using the AirBeam 2s evaluated real-world performance and user preferences. The AirBeam 2 exhibited a novel issue where PM₁ readings exceeded PM₂.₅ at concentrations > 50 µg/m³, which was corrected through reprogramming. Polynomial models outperformed linear ones for both devices and the AirBeam 3 performed better with engine exhaust than biomass smoke (linear calibration coefficients 0.192 vs 0.102, respectively), while the AirBeam 2 performed better with biomass smoke than engine exhaust (coefficients 0.323 vs 0.274, respectively). Breakpoints suggested the AirBeam 2s may be better for high concentrations, while the AirBeam 3s were more sensitive at lower concentrations. In the field, the AirBeam 2s recorded lower mean PM concentrations than the PDR-1500 and were more influenced by environmental conditions, yet participants (n = 9) who were recruited to perform field calibrations with both devices preferred the AirBeam. While sensor performance can vary by PM source, concentration, and environmental factors, these findings suggest AirBeams can be a useful option for preliminary occupational exposure assessments after careful calibration and validation prior to use.

PMID:41379328 | DOI:10.1007/s10661-025-14870-1

J Math Biol. 2025 Dec 11;92(1):12. doi: 10.1007/s00285-025-02326-6.

ABSTRACT

In biological systems, cooperative behavior forms the foundation for the survival and prosperity of many organisms. However, the finite nature of resources often drives selfish individuals to exploit resources through deceptive tactics, thereby instigating conflicts between collective and individual interests. These strategic interactions not only alter the availability of environmental resources but also feedback on the strategic choices of populations, leading to the co-evolution of environmental resources and behavioral strategies. By integrating population dynamics with replicator dynamics, we develop models for both well-mixed and spatially heterogeneous distributions that incorporate resource feedback mechanisms to analyze the intricate interplay between cooperative behavior and resource dynamics across temporal and spatial scales. Our findings reveal complex evolutionary dynamics, including rich multistability, transcritical and Hopf bifurcations in the temporal system, alongside spatial stability, Turing instability, Turing-Hopf bifurcation, and chaotic behavior in the spatial diffusion system. In homogeneous distributions, payoffs result in stable periodic solutions, while heterogeneous distributions disrupt stable periodicity and lead to chaotic dynamics. Notably, increasing the initial density of cooperators, the rate of resource growth, and reducing the initial resource stock are favorable for sustaining cooperation. Interestingly, high payoffs for cooperators and low payoffs for defectors do not necessarily promote cooperative behavior, as evolutionary outcomes also depend on resource abundance. We provide the conditions that sustain cooperation, revealing the critical role of resource dynamics and spatial diffusion in shaping the evolution of cooperative strategies. Our findings have important implications for studying ecosystem management, conservation biology, and animal social behavior.

PMID:41379322 | DOI:10.1007/s00285-025-02326-6

J Periodontol. 2025 Dec 10. doi: 10.1002/jper.70024. Online ahead of print.

ABSTRACT

BACKGROUND: This first-in-human clinical study aimed to evaluate the safety and efficacy of a bioglass incorporated in a toothpaste, in reducing dentin hypersensitivity (DH) compared to a sodium fluoride (NaF) toothpaste over a 2-week period.

METHODS: A double-blind, randomized, parallel-arm, proof-of-concept clinical trial was conducted with 46 participants experiencing self-reported and clinically confirmed DH. Participants were assigned to 1 of 2 groups: (1) Test toothpaste (5 wt% bioglass with 1425 ppm fluoride as NaF), or (2) NaF toothpaste (1425 ppm fluoride). Outcomes included Schiff Airblast Sensitivity Score (primary endpoint), Visual Analog Scale (VAS) for pain, and Yeaple Probe tactile sensitivity (secondary endpoints). Statistical analyses, including analysis of covariance (ANCOVA) and descriptive statistics, were performed to evaluate intergroup differences.

RESULTS: The Test group exhibited a statistically significant reduction in Schiff Airblast Sensitivity Scores at Day 14 compared to the NaF group (ΔMean: -0.8 vs. -0.5, p = 0.0341). Significant improvements were also observed in VAS pain scores in as little as 2 days (ΔMean: -1.03 vs. 0.04, p = 0.0057). Rapid pain relief was noted within 2 days, indicating both immediate and cumulative effects. The difference in tactile scores was not statistically significant between groups although greater change was seen with Test toothpaste (ΔMean 13 vs. 3 g; p = 0.068). No severe adverse events were reported, and safety profiles were comparable across groups.

CONCLUSION: The toothpaste containing the bioglass demonstrated superior efficacy in alleviating DH symptoms at both early and later time points through its mechanism of rapid tubule occlusion. This innovative approach aligns with World Health Organization (WHO) recommendations for fluoride use and addresses unmet needs in DH management globally. Further research is warranted to explore its long-term applications in preventive and restorative dentistry.

CLINICAL TRIALS REGISTRATION: U.S. National Institutes of Health Clinical Trials Registry (http://www.

CLINICALTRIALS: gov) ID NCT06166745.

PMID:41373067 | DOI:10.1002/jper.70024

J Dent Child (Chic). 2025 Sep 15;92(3):129-136.

ABSTRACT

Purpose: To assess the fracture resistance of prefabricated esthetic crowns for primary molars. Methods: Seventy-two human mandibular second primary molars were divided into three groups: preveneered stainless steel crowns (VSS), prefabricated zirconia crowns (PZ) and BioFlx crowns (BF). Crowns were cemented with glass ionomer cement; for each group, 12 samples were tested for fracture resistance and 12 samples underwent 5,000 thermocycles before testing. The fracture mode was assessed for all the samples. Differences in the fracture resistance values between the groups were tested using analysis of variance (ANOVA), followed by Tukey’s post hoc test, while the distribution of fracture modes was tested using Fisher’s exact test. Statistical significance was set at P =0.05 and analyses were conducted using SPSS version 25.0 software. Results: ANOVA tests indicated a significant difference in fracture resistance among the test groups (P <0.001). The groups were ranked as follows: before thermocycling- (1) PZ group (3,327±1497), (2) BF group (1,694±163) and (3) VSS group (536±12); and after thermocycling-(1) PZ group (3,308±162), (2) BF group (1,579±77) and (3) VSS group (413±16). Tukey’s post hoc analysis indicated that the PZ group exhibited a significantly higher fracture resistance than the BF and VSS groups (P <0.001). The VSS group showed a predominance of minimal cracks (5.6 percent) and loss of less than half of the crown (11.1 percent). Conclusions: PZ yielded the highest resistance, followed by BF crowns. VSS may require caution in high-stress areas due to their susceptibility to esthetic component failure, although the underlying crown remains functional.

PMID:41373045

Stem Cell Res Ther. 2025 Dec 10. doi: 10.1186/s13287-025-04854-w. Online ahead of print.

ABSTRACT

BACKGROUND: There is controversy about the benefits of bone marrow mononuclear cells (BMMC) to improve left ventricular dysfunction (LVD) in patients with coronary artery disease. We sought to evaluate the safety, feasibility and efficacy of the intracoronary infusion of BMMC to improve left ventricular ejection fraction (LVEF) in patients with chronic total coronary artery occlusions (CTO).

METHODS: Prospective, randomized, open-label and controlled study. Patients with a percutaneous revascularization of CTO (CTO-PCI) three months before and persistent LVD (LVEF < 45%) were included and randomized in a 1:1 ratio to receive intracoronary infusion of autologous BMMC plus conventional medical treatment or conventional treatment alone (control group). The primary efficacy endpoint was the absolute change in LVEF by cardiac magnetic resonance imaging (CMR) at 6-month follow-up. The functional capacity status by NYHA class, the overall mortality and the adverse cardiac events rate were also evaluated in the 24-month follow-up period.

RESULTS: Twenty-eight patients were included, 13 received intracoronary infusion of BMMC and 15 received standard care. No major procedural complications occurred during BMMC infusion, and the rates of overall mortality and adverse cardiac events in follow-up were similar. At 6-month follow-up, the absolute change in LVEF was greater in BMMC group, without reaching statistical significance [∆ LVEF 0% ( – 5 to 0) in the control group vs. 2.5% ( – 2.7 to 4) in the BMMC group, median between-groups difference 2.5% ( – 2 to 4.5), p = 0.118)]. The change in NYHA class did not differ between treatment arms at any stage of follow-up.

CONCLUSIONS: The intracoronary infusion of BMMC in patients with previous CTO-PCI and persistent LVD seemed to be safe and feasible. There was a numerical but not statistically significant difference in terms of LVEF recovery favouring the BMMC group. The study offers a novel design for future larger trials to clarify the impact of BMMC therapy in patients with CTO. Trial registration The trial was registered in the European Union Drug Regulating Authorities Clinical Trials Database (EudraCT number: 2013-000915-26).

PMID:41373040 | DOI:10.1186/s13287-025-04854-w

J Intensive Care. 2025 Dec 11. doi: 10.1186/s40560-025-00840-9. Online ahead of print.

ABSTRACT

BACKGROUND: The pharmacokinetics of prolonged remimazolam infusion in patients undergoing long-term mechanical ventilation remain unclear. This study aimed to evaluate the pharmacokinetics of remimazolam administered continuously for 24 h.

METHODS: This open-label pharmacokinetic analysis enrolled patients requiring mechanical ventilation into two groups: the surgical group, which received remimazolam during and after surgery, and the medical ICU group, which received remimazolam in the intensive care unit (ICU). Remimazolam was administered at a fixed rate of 0.1 mg/kg/h for ≥ 24 h, and blood samples were collected at regular intervals. Plasma remimazolam concentrations were measured by tandem mass spectrometry.

RESULTS: Twenty patients (10 in each group) completed the study. The median duration of remimazolam infusion was 24.0 h in the surgical group and 102.0 h in the medical ICU group. The steady-state plasma concentrations in both the surgical and medical ICU groups exhibited modest intrasubject variability (4.46-32.73%) and moderate intersubject variability (16.45-31.71%), with all values falling within clinically acceptable intermediate ranges. The plasma remimazolam concentration at the end of infusion was 130.7 ng/mL (95% confidence interval [CI] 115.2-146.1) in the surgical group and 134.3 ng/mL (95% CI 98.7-170.0) in the medical ICU group. Noncompartmental analysis showed that the clearance was 54.3 L/h (95% CI 47.6-61.8) and 55.6 L/h (95% CI 42.8-72.1) (P = 0.856), while the volume of distribution at steady state was 284 L (95% CI 215-376) and 316 L (95% CI 142-707) (P = 0.780), with no statistically significant differences between the groups.

CONCLUSIONS: In this preliminary study, both the surgical ICU group (approximately 24 h) and the medical ICU group (beyond 24 h) showed no evidence of time-dependent accumulation of plasma remimazolam, indicating a generally stable pharmacokinetic profile under the examined conditions.

TRIAL REGISTRATION: In compliance with the Japanese Clinical Trials Act, the study was classified as a Specified Clinical Trial owing to the use of unapproved pharmaceuticals, which were reviewed by a certified review board (CRB) and registered in the Japan Registry of Clinical Trials (jRCTs041200076) on December 15, 2020.

PMID:41373030 | DOI:10.1186/s40560-025-00840-9

Adv Rheumatol. 2025 Dec 10. doi: 10.1186/s42358-025-00458-3. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate whether the combination of exercise and intra-articular injection (IAI) effectively improves pain, function, and quality of life in patients with knee osteoarthritis (OA) compared to any control group in the short, medium, and long term through a systematic review.

METHODS: A comprehensive search strategy was applied in the databases Embase, PubMed, MEDLINE, CENTRAL, CINAHL, and PEDro. Inclusion criteria focused on randomized controlled trials examining the effects of exercise combined with IAI in patients with knee OA, with outcomes assessed at short-, medium-, and long-term follow-ups. The primary outcomes were pain and function. The quality of the evidence was evaluated using the GRADE system.

RESULTS: Eleven studies, comprising 802 participants, were included. All studies investigated the combination of IAI and exercise. A statistically significant difference in pain was observed: in the short and medium term, the Botulinum toxin IAI group demonstrated superior pain reduction compared to the Hyaluronic acid IAI group (MD -1.32, 95% CI -2.20 to -0.44 and MD -9.09, 95% CI -13.16 to -5.01, respectively). In the medium term, Saline IAI was more effective than Corticosteroid IAI (MD 1.99, 95% CI 0.49 to 1.90). Regarding function, Saline IAI outperformed IAI with any medication in the short term (MD 0.50, 95% CI 0.20 to 0.79). In terms of quality of life, the Corticosteroid IAI group demonstrated superior physical function and mental health outcomes compared to the Saline IAI group in the medium term (MD -0.43, 95% CI -0.77 to -0.08 and MD -0.38, 95% CI -0.76 to -0.01, respectively). In the long term, physical function improved more with IAI combined with exercise compared to exercise alone.

CONCLUSION: Given the very low quality of the evidence, it is not possible to definitively conclude that the combination of IAI and exercise is more effective than IAI or exercise alone in patients with knee OA. Further high-quality studies are needed to establish more definitive conclusions.

REGISTRATION: The International Prospective Register of Systematic Reviews (PROSPERO): CRD42021277729.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:41373020 | DOI:10.1186/s42358-025-00458-3

J Ovarian Res. 2025 Dec 10. doi: 10.1186/s13048-025-01925-7. Online ahead of print.

NO ABSTRACT

PMID:41373018 | DOI:10.1186/s13048-025-01925-7