Category: Statistics

Heart Vessels. 2025 Oct 11. doi: 10.1007/s00380-025-02613-8. Online ahead of print.

ABSTRACT

BACKGROUND: Drug-coated balloons (DCBs) are increasingly being used to treat superficial femoral artery (SFA) lesions during endovascular therapy (EVT). However, the evaluation of paclitaxel distribution following DCB treatment remains challenging. This study aimed to develop a novel criterion to systematically semi-quantitatively grade the degree of paclitaxel distribution using nonobstructive general angioscopy and analyze the clinical factors affecting this criterion.

METHOD AND RESULTS: This study included 18 patients (20 limbs) who underwent EVT for SFA lesions using DCBs. Angioscopic observation of the vessel surface was performed before and after DCB treatment. The amount of paclitaxel distribution was systematically graded using the novel surface observation by nonobstructive general angioscopy of wall drug-distribution (SNOW) grade. Clinical factors were statistically analyzed to determine their relationship with the SNOW grade. Paclitaxel particles were observed on vessel walls after DCB treatment in all patients. A significant relationship was found between the DCB diameter and reference vessel and lumen diameter, measured by intravascular ultrasound; specifically, a same DCB-to-vessel ratio was associated with greater drug distribution.

CONCLUSIONS: The SNOW grading system was successfully developed for systematic evaluation of paclitaxel distribution. Our findings suggest that appropriate DCB sizing is essential for adequate drug application, highlighting that an undersized DCB may provide insufficient coverage. Therefore, a careful DCB selection that balances optimal drug delivery with the imperative to avoid vessel injury is crucial.

PMID:41074993 | DOI:10.1007/s00380-025-02613-8

Ann Hematol. 2025 Oct 11. doi: 10.1007/s00277-025-06645-y. Online ahead of print.

ABSTRACT

Multiple myeloma (MM) is a malignancy characterized by the clonal proliferation of plasma cells. It accounts for approximately 1% of all cancers and is the second most common hematologic malignancy after lymphoma. Infections represent a major cause of morbidity and mortality in patients with newly diagnosed multiple myeloma (NDMM), contributing to approximately 45% of early deaths, particularly in elderly individuals and during the initial months of therapy. Current treatment options for MM, including anti-CD38 monoclonal antibodies (CD38 mAbs), proteasome inhibitors, immunomodulatory drugs (such as lenalidomide and thalidomide), and glucocorticoids, have significantly improved clinical outcomes in NDMM patients. However, these therapies are associated with an increased risk of infections. Daratumumab (Dara), an anti-CD38 monoclonal antibody, is a key component of modern MM treatment and is approved for both NDMM and relapsed/refractory MM (RRMM). While Dara has improved patient outcomes, it has also altered the frequency and epidemiology of infections in this population. We conducted a retrospective analysis of 472 NDMM patients treated with Dara-containing regimens at 10 centers of the European Myeloma Network Italy (EMN-I) between 2020 and 2023 to assess the incidence of infectious events (IEs). Among these patients, 148 (31.3%) experienced infectious complications during therapy. No significant differences in infection rates were observed across the three treatment subgroups analyzed. In our experience, the addition of Dara during the induction phase did not increase the frequency, severity, or duration of infections in any of the three cohorts. Although the difference was not statistically significant, we observed an earlier onset of infections in the D-VTD group compared to the others. Further studies are needed to better define the incidence of infections in this patient population and to identify risk factors for infection. This may also inform the role of prophylactic strategies in the clinical management of NDMM.

PMID:41074984 | DOI:10.1007/s00277-025-06645-y

Neurosurg Rev. 2025 Oct 11;48(1):692. doi: 10.1007/s10143-025-03830-5.

ABSTRACT

The Pipeline is currently the most widely used flow-diverting device worldwide, yet research on its long-term efficacy remains limited, primarily based on small to medium-sized sample cohorts. The objective of this study was to evaluate the long-term safety and efficacy of the Pipeline device in treating intracranial aneurysms. Additionally, the study aimed to analyze the risk factors associated with long-term incomplete occlusion of the aneurysm and stenosis of the parent artery. This multicenter retrospective study included patients with intracranial aneurysms treated with the Pipeline flow-diverting device between 2015 and 2020. The analysis encompassed clinical and imaging outcomes, including clinical presentation, comorbidities, aneurysm characteristics, procedural details, and postoperative follow-up data. This study included 190 patients(122 females)with a mean age of 54.6 ± 11.7 years and 204 aneurysms. At one year postoperatively, the complete aneurysm occlusion rate was 69.9%, parent artery stenosis was 3.7%, and complications occurred in 3.3% of cases. During long-term follow-up, the occlusion rate increased to 93.1%, stenosis rose to 6.4%, and complications decreased to 2.1%. Three perforator occlusions were reported: two during the short-term follow-up and one during the long-term follow-up, resulting in severe impairment (mRS 4). The Pipeline flow-diverting device demonstrated favorable long-term safety and efficacy in the treatment of intracranial aneurysms, with no significant differences in safety or effectiveness between vertebral artery aneurysms and anterior circulation aneurysms. Statistical analysis identified advanced age and male gender as risk factors for long-term incomplete occlusion. Furthermore, the results suggest that postoperative antiplatelet therapy and imaging follow-up were continued for only one year, which is considered safe and effective.

PMID:41074981 | DOI:10.1007/s10143-025-03830-5

J Gastroenterol. 2025 Oct 11. doi: 10.1007/s00535-025-02306-z. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Hepatitis B e antigen (HBeAg) seroclearance is crucial in the natural history of chronic hepatitis B (CHB). Little is known about the role of hepatitis B core-related antigen (HBcrAg) levels in predicting spontaneous HBeAg seroclearance.

METHODS: This retrospective cohort study included 484 treatment-naïve HBeAg-positive CHB patients with an extended follow-up period at National Taiwan University Hospital. The primary endpoint was spontaneous seroclearance of HBeAg. The association between baseline HBcrAg levels and their kinetic patterns with spontaneous HBeAg seroclearance was assessed.

RESULTS: Of 484 patients with a mean follow-up period of 7.80 years, 331 (68.4%) achieved spontaneous HBeAg seroclearance, corresponding to an annual rate of 8.76%. Lower baseline HBcrAg levels correlated with an increased likelihood of HBeAg seroclearance (log-rank P < .001). When HBcrAg kinetics were assessed based on baseline and year 3 levels, patients with HBcrAg levels persistently < 10⁵ KU/mL (HR: 2.66; 95% CI: 1.75-4.04) and those declining to < 10⁵ KU/mL (HR: 2.31; 95% CI: 1.50-3.55) had an increased likelihood of HBeAg seroclearance when compared to those with persistently high HBcrAg levels. This association remained statistically significant in multivariate analysis after adjusting for baseline viral factors. In addition, HBcrAg kinetics were consistently associated with HBeAg seroclearance in immune-tolerant patients.

CONCLUSIONS: HBcrAg < 10⁵ KU/mL, or a decline to this threshold, identified HBeAg-positive CHB patients with higher likelihood of spontaneous HBeAg seroclearance. Persistently high HBcrAg may indicate earlier CHB phases and inform management strategies.

PMID:41074980 | DOI:10.1007/s00535-025-02306-z

Clin Oral Investig. 2025 Oct 11;29(11):502. doi: 10.1007/s00784-025-06566-0.

ABSTRACT

PURPOSE: This study aimed to clarify the relationship between diurnal awake bruxism (AB) awareness, tooth-contacting habit (TCH) awareness, and the electromyographic (EMG) waveform integral value.

MATERIALS AND METHODS: Unilateral masseteric EMG recordings during the daytime were performed on the habitual masticatory side using an ultraminiature wearable EMG device. One hundred and seven participants (50 and 57 with and without diurnal tooth clenching (d-TC) awareness, respectively) were included. d-TC awareness and TCH awareness were assessed using questionnaires. The standardized burst integral (S-integral) value was calculated for each participant.

RESULTS: There was a statistically significant association between d-TC awareness and TCH awareness. The S-integral values were not significantly associated with the awareness d-TC or TCH. The frequency distribution of EMG waveforms of the awareness and non-awareness groups exhibited wide-range overlaps both for d-TC and TCH.

CONCLUSION: d-TC or TCH awareness showed no clear correlation with the S-integral value, suggesting that it is important to evaluate AB and TCH based on objective and quantitative test results, such as the masseter muscle’s EMG data.

CLINICAL RELEVANCE: Diagnosis, treatment, and management of AB and TCH are important issues in dental medicine. The obtained results regarding the actual state of awareness of AB and TCH, and the EMG integral value that was one of the important EMG indices, were considered useful information for establishing diagnostic and assessment methods for AB and TCH in future clinical dentistry.

PMID:41074973 | DOI:10.1007/s00784-025-06566-0

Influenza Other Respir Viruses. 2025 Oct;19(10):e70174. doi: 10.1111/irv.70174.

ABSTRACT

INTRODUCTION: Respiratory syncytial virus (RSV) is increasingly recognized as an important cause of acute respiratory infections (ARI) in older adults. However, primary care data on RSV infections are scarce.

METHODS: We conducted a prospective cohort study over two winter seasons (2022-2023 and 2023-2024) in Italy and the Netherlands (NCT06318936). Older adults (≥ 60 years) presenting to primary care with ARI were tested for RSV and influenza. Clinical and socioeconomic burden was assessed through questionnaires on Days 1, 14, and 30. In secondary analyses, we compared between RSV- and influenza-positive patients and estimated RSV-ARI incidence in Dutch primary care.

RESULTS: Of 703 older adults tested, 93 (13.2%) were RSV-positive and 100 (14.2%) influenza-positive. In RSV patients (mean age: 76 years [SD: 8], 63% ≥ 1 comorbidity), mean illness duration was 17 days (SD: 10). Repeat primary care visits occurred in 38% (33/87), emergency department referral in 5% (4/88), and hospitalization in 2% (2/88) of RSV patients. The mean costs per RSV episode were €78.1 (95%CI: 74.4-81.8) and €279.7 (95%CI: 245.5-318.2) from a healthcare system and societal perspective, respectively. The annual RSV-ARI incidence rate was 10.3 episodes per 1000 person-years. RSV patients were significantly older, and had less often fever, muscle pain, and fatigue than influenza patients, but clinical and socioeconomic burdens were comparable.

CONCLUSIONS: This prospective study is the first sufficiently large to demonstrate that the primary care burden of RSV infections among older adults is substantial and comparable with influenza. These findings are highly relevant for informing public health decisions on novel RSV vaccines.

PMID:41074665 | DOI:10.1111/irv.70174

Biochem Mol Biol Educ. 2025 Oct 11. doi: 10.1002/bmb.70018. Online ahead of print.

ABSTRACT

One type of active learning technique that instructors can incorporate is the use of various drawing activities. This study investigates the impact of drawing during biology lecture classes on student learning. Undergraduate students in two lecture sections of an introductory cellular and molecular biology course completed worksheets that either required them to draw (learner-generated) or required them to interpret a drawing (instructor-generated). The four topics that were assessed were amino acid polymerization, nucleotide polymerization, cellular respiration, and photosynthesis. Student learning was assessed using multiple-choice and short-answer exam questions. Students who completed the learner-generated worksheet related to amino acid polymerization performed significantly better than students who completed the instructor-generated worksheet. Differences in student learning were not statistically significant for the other three topics; however, trends indicated that for some topics, the learner-generated worksheet increased student understanding while for other topics the students who completed the instructor-generated worksheet performed better. These findings indicate that it is important to carefully align the type of drawing activity with the complexity of the topic. When the drawings were too complex, students did not gain as much from creating their own images. Instructors are encouraged to thoughtfully integrate various types of drawing activities into their courses to increase student learning.

PMID:41074661 | DOI:10.1002/bmb.70018

Ann Med. 2025 Dec;57(1):2570798. doi: 10.1080/07853890.2025.2570798. Epub 2025 Oct 11.

ABSTRACT

BACKGROUND: Venous-Origin Chronic Pelvic Pain (VO-CPP), a subgroup of Pelvic Venous Disorders (PeVD) can significantly affect Quality of Life (QoL). Previous papers have highlighted the lack of evaluations measuring QoL of patients before and after embolization. The aim of this study was to evaluate the effectiveness of embolization in reducing a variety of symptoms and improving QoL in patients with VO-CPP.

METHODS: A prospective analysis of 40 female patients (mean 36.9 years) diagnosed with VO-CPP, undergoing venous embolization between June 2020 and May 2023 was conducted. Patients with extrinsic compressions, other pelvic conditions, and S₃V₃ without S₂ in SVP Classification were excluded. Patients were evaluated before and after treatment at mid-term (MT) (9.4 ± 5.1 months) and long-term (LT) (29.6 ± 6.94 months). The severity of 12 different symptoms were assessed using VAS scale (pelvic, postcoital, standing, back, hip, leg and abdominal pain; nausea frequency, urinary discomfort, sleep disturbance and dysmenorrhoea), while QoL was measured using the SF-36 questionnaire. Patient satisfaction was assessed using the Likert scale.

RESULTS: Significant reductions in all measured symptoms were observed between pre-treatment and MT and LT follow-ups (p < 0.0001). No statistically significant differences were found between MT and LT scores, indicating a sustained relief. The greatest benefits were observed in reducing daytime pelvic pain (6.25 ± 1.93 to 2.49 ± 2.47), standing (7.43 ± 1.65 to 3.41 ± 2.43) and postcoital pain (6.40 ± 2.63 to 2.54 ± 2.22). QoL scores in both physical and mental health showed statistically significant and sustained improvement after the procedure. Most patients were satisfied with the procedure (81%), with 86% willing to undergo it again and 89% to recommend it.

CONCLUSION: Embolization provides significant, sustained improvements in symptom relief while enhancing QoL in VO-CPP patients. Randomized controlled trials are needed to confirm these effects and exclude a placebo response.

PMID:41074660 | DOI:10.1080/07853890.2025.2570798

Health Soc Care Deliv Res. 2025 Oct;13(36):1-22. doi: 10.3310/TDAS1298.

ABSTRACT

BACKGROUND: Ethnic minority women face worse maternity outcomes and increased risk of perinatal mental health issues, yet research on the accessibility and acceptability of perinatal mental health services for these groups is limited.

OBJECTIVES: (1) To explore access to and utilisation of mental health services during the perinatal period among ethnic minority women; (2) to explore care pathways to community and inpatient perinatal mental health services; (3) to explore the attitudes, experiences and service improvement suggestions of ethnic minority women with perinatal mental health problems, as well as those of their partners, family members and healthcare professionals and (4) to produce recommendations for improving clinical practice.

METHODS: Mixed-methods study was conducted during 2018-23, encompassing four studies aligned with specific aims: (1) a population-based study of 615,092 women who gave birth in National Health Services hospitals in England, using data from the National Commissioning Data Repository; (2) a retrospective evaluation of patients accessing community perinatal mental health services in Birmingham and London (n = 228) and inpatient services in Birmingham, London and Nottingham (n = 198) using an adapted World Health Organization care pathways questionnaire; (3) a qualitative study with four cohorts across England: service users (n = 37), non-users or those who disengaged (n = 23), partners/family (n = 15) and healthcare professionals (n = 24); (4) findings informed recommendations for practice improvements, coproduced with individuals with lived experience of perinatal mental illness and of being in a minoritised ethnic group. Data were analysed using quantitative and qualitative approaches.

RESULTS: Access issues to mental health services were evident for Black African, Asian and White other women compared to White British women. Variability in patient journeys to community perinatal mental health services seem to stem from service-level factors rather than patient needs. Asian patients had more emergency admissions to Mother and Baby Units, while Black patients were less likely to experience multiple services before Mother and Baby Unit admission. Barriers to access included limited service awareness, fear of child removal, stigma, remote clinical appointments and unresponsive services. Despite these challenges, many women found services helpful. Family members noted gaps in family-focused care. Recommendations for improvement include raising awareness, monitoring access for different ethnic groups and addressing concerns about child removal, with a focus on consistent care, family involvement and cultural sensitivity.

CONCLUSION: These findings shed light on health inequalities in perinatal mental health care for ethnic minority women. The results can be utilised to address existing barriers and improve outcomes for mothers, infants and families.

LIMITATIONS: Diversity within merged ethnic groups; limited sample of non-English-speaking women; reliance on self-reported measures; use of pre-COVID-19 data; under-representation of Black women who did not engage with services, and over-representation of Black and Asian patients in Birmingham and London samples in the study exploring patient pathways to Mother and Baby Units (compared to maternity population).

FUTURE WORK: Implementation of good practices in perinatal mental health care, targeted interventions to address the fear of child removal, innovative strategies to recruit Black and non-English-speaking women and exploring the experiences of ‘White other’ women.

FUNDING: This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number 17/105/14.

PMID:41074656 | DOI:10.3310/TDAS1298

Birth Defects Res. 2025 Oct;117(10):e2536. doi: 10.1002/bdr2.2536.

ABSTRACT

BACKGROUND: Congenital neurosurgical anomalies, such as neural tube defects (NTDs) and hydrocephalus, are prevalent central nervous system disorders. This study investigates their prevalence and factors statistically associated with their occurrence.

METHODS: A retrospective cross-sectional study at Mbeya Zonal Referral Hospital (MZRH) from May 2023 to April 2024 included 978 patients. Data from 145 children with CNS anomalies were analyzed using Microsoft Excel and STATA-15, with binary logistic regression to identify potential risk factors associated with these conditions.

RESULTS: The prevalence of congenital neurosurgical conditions was 14.3% (145/978). Hydrocephalus occurred in 8.3% (81/978), NTDs in 5.01% (49/978), Chiari malformations in 0.92% (9/978), and encephalocele in 0.61% (6/978). Logistic regression found that folate deficiency associated with delayed antenatal care was linked to a higher likelihood of NTDs and hydrocephalus (OR 2.56, p ≤ 0.005). Other factors showing statistical associations included prematurity, low birth weight, pregnancy infections, unprescribed drug use, malnutrition, gestational diabetes, and hypertension.

CONCLUSION: Key factors statistically associated with congenital CNS anomalies in this cohort include low birth weight, prematurity, inadequate folic acid intake, gestational diabetes, maternal hypertension, and unprescribed drug use. These findings highlight the importance of early prenatal care and maternal health optimization to potentially reduce the occurrence of these anomalies.

PMID:41074652 | DOI:10.1002/bdr2.2536