Category: Statistics

Cardiovasc Eng Technol. 2025 Jan 27. doi: 10.1007/s13239-025-00771-4. Online ahead of print.

ABSTRACT

PURPOSE: The initiation of intracranial aneurysms has long been studied, mainly by the evaluation of the wall shear stress field. However, the debate about the emergence of hemodynamic stimuli still persists. This paper builds on our previous hypothesis that secondary flows play an important role in the formation cascade by examining the relationship between flow physics and vessel geometry.

METHODS: A composite evaluation framework was developed to analyze the simulated flow field in perpendicular cross-sections along the arterial centerline. The velocity field was decomposed into secondary flow components around the centerline in these cross-sections, allowing the direct comparison of the flow features with the geometrical parameters of the centerline. Qualitative and statistical analysis was performed to identify links between morphology, flow, and the formation site of the aneurysms.

RESULTS: The normalized mean curvature and curvature peak were significantly higher in the aneurysmal bends than in other arterial bends. Similarly, a significant difference was found for the normalized mean velocity ( p = 0.0274 ), the circumferential ( p = 0.0029 ), and radial ( p = 0.0057 ) velocity components between the arterial bends harboring the aneurysm than in other arterial bends. In contrast, the difference of means for the normalized axial velocity is insignificant ( p = 0.1471 ).

CONCLUSION: Thirty cases with aneurysms located on the ICA were analyzed in the virtually reconstructed pre-aneurysmal state by an in-silico study. We found that sidewall aneurysm formation on the ICA is more probable in these arterial bends with the highest case-specific curvature, which are accompanied by the highest case-specific secondary flows (circumferential and radial velocity components) than in other bends.

PMID:39871029 | DOI:10.1007/s13239-025-00771-4

J Occup Rehabil. 2025 Jan 28. doi: 10.1007/s10926-025-10270-x. Online ahead of print.

ABSTRACT

PURPOSE: We aimed to develop an online vocational rehabilitation (VR) readiness screening (VRRS) tool for young adults diagnosed with cancer. VR readiness was defined as being physically and cognitively ready to enter or return to work or school.

METHODS: We developed an initial VRRS tool informed by previous studies, a scoping review to determine such a tool had not already been developed, and consultation with subject matter experts. We iteratively refined the tool on the basis of four rounds of interviews with young adults with cancer. The refined VRRS was then administered online to patients before they attended scheduled clinic appointments. We evaluated the VRRS completion rate; the ability of the online VRRS tool to assess patients’ readiness for VR; and the concordance between clinical interview and that of the online VRRS tool, which was determined by using Cohen’s κ or a fitting alternative; κ ≥ .61 suggested clinical utility.

RESULTS: The proportion of study participants completing the VRRS was 72.3% (136/188, 95% CI [65.4%, 78.6%]) and 69.2% (81/117, 95% CI [60.0%, 77.4%]) of participants who completed a clinical interview also completed the online VRRS tool. All clinical interview determinations and 93.8% (76/81) of online VRRS tool indicated participants’ VR readiness. The VRRS-clinical interview agreement rate was 93.8% (95% CI [86.2%, 98.0%]). The prevalence index, bias index, and prevalence- and bias-adjusted κ statistic with 95% CIs were 0.938 [- 0.991, – 0.886], 0.062 [0.009, 0.114], and 0.877 [0.724, 0.959], respectively.

CONCLUSION: The VRRS tool is thus both feasible and effective in this sample of young adults with cancer.

PMID:39871010 | DOI:10.1007/s10926-025-10270-x

Brain Inform. 2025 Jan 27;12(1):3. doi: 10.1186/s40708-024-00249-4.

ABSTRACT

Cognitive resilience (CR) describes the phenomenon of individuals evading cognitive decline despite prominent Alzheimer’s disease neuropathology. Operationalization and measurement of this latent construct is non-trivial as it cannot be directly observed. The residual approach has been widely applied to estimate CR, where the degree of resilience is estimated through a linear model’s residuals. We demonstrate that this approach makes specific, uncontrollable assumptions and likely leads to biased and erroneous resilience estimates. This is especially true when information about CR is contained in the data the linear model was fitted to, either through inclusion of CR-associated variables or due to correlation. We propose an alternative strategy which overcomes the standard approach’s limitations using machine learning principles. Our proposed approach makes fewer assumptions about the data and CR and achieves better estimation accuracy on simulated ground-truth data.

PMID:39871006 | DOI:10.1186/s40708-024-00249-4

Clin Rheumatol. 2025 Jan 27. doi: 10.1007/s10067-025-07341-y. Online ahead of print.

ABSTRACT

To synthesize available evidence on predictive factors associated with systemic lupus erythematosus (SLE) flares during pregnancy, we systematically searched MEDLINE, Embase, and the Cochrane Library through January 2024 for observational studies on risk and protective factors of SLE flares during pregnancy. Odds ratios (OR) and mean differences (MD), as well as their 95% confidence intervals (CI) were used to quantify effect sizes. We employed fixed-effect or random-effect models based on heterogeneity assessments (I² statistics). Sensitivity analyses were performed using the leave-one-out method, and publication bias was assessed through Egger’s test. Thirty-two studies were included in the meta-analysis. Significant baseline SLE characteristics associated with higher risks for flares during pregnancy were identified: thrombocytopenia (with OR [95%CI], 2.29 [1.14-4.58]), hypocomplementemia (1.70 [1.28-2.27]), anti-dsDNA positivity (1.43 [1.16-1.77]), and a history of lupus nephritis (2.34 [1.70-3.21]). Protective factors included achieving remission before pregnancy (0.32 [0.20-0.49]) and antimalarial use at baseline (0.71 [0.55-0.92]) and during pregnancy (0.44 [0.33-0.58]). Additional risk factors included baseline glucocorticoid usage (1.51 [1.17-1.94]), glucocorticoid administration during pregnancy (3.39 [1.90-6.06]), use of other immunosuppressive drugs at baseline (1.46 [1.00-2.12]), and hypertension (2.16 [1.45-3.23]). Furthermore, individuals in the flare group were younger, had higher baseline disease activity, and lower C3/C4 levels compared to the non-flare group. This study highlighted the critical role of managing SLE disease activity prior to pregnancy to minimize flare risks, and identified significant risk and protective factors associated with flares. These evidences facilitate better clinical management strategies for pregnant women with SLE. Key Points • Synthesizes existing evidence on the risk and protective factors associated with SLE flares during pregnancy. • Highlights the critical importance of effectively managing disease activity prior to conception. • Provides insights to enhance risk stratification and management strategies for pregnancies in patients with SLE.

PMID:39870967 | DOI:10.1007/s10067-025-07341-y

Int J Behav Med. 2025 Jan 27. doi: 10.1007/s12529-025-10348-z. Online ahead of print.

ABSTRACT

BACKGROUND: Irritable bowel syndrome (IBS) has been effectively treated with acupuncture, but the significance of quality of life, depression, and anxiety in the assessment of IBS patients has received little consideration. This study examined the impact of acupuncture on depression, anxiety, and quality of life in IBS patients.

METHOD: PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), EMBASE, China Science and Technology Journal Database (VIP), Chinese Biological Medical (CBM, SinoMed) Database, and the Wan Fang Database were among the electronic databases from which relevant randomized controlled trials (RCTs) were systematically retrieved between their inception and July 2023. The outcomes included adverse events, total response rate, anxiety, and symptoms of depression, as well as quality of life. In this study, the heterogeneity, publication bias, standardized mean difference (SMD), and risk ratios (RR) with 95% confidence intervals (CI) were estimated.

RESULTS: In this study, 29 RCTs including 3114 participants for analysis (treatment group, 1730; control group, 1384) were included. Compared to other therapies, acupuncture significantly improved the quality of life (SMD = 0.61, 95% CI = [0.26, 0.96], P < 0.001) and alleviated anxiety (SMD = – 0.72, 95% CI = [- 1.76, 0.32], P = 0.18) and depression (SMD = – 0.74, 95% CI = [- 1.18, – 0.3], P < 0.001) in IBS patients. A statistically significant improvement was recorded in their quality of life, and they also displayed fewer symptoms of depression. The total response rate (RR = 1.18, 95% CI = [1.12, 1.25], P < 0.001) indicated that acupuncture significantly affected IBS treatment in comparison to other methods. Subgroup analysis of primary outcome indicators revealed that acupuncture demonstrated better results regardless of the duration of intervention and was more effective than Western medicine or sham acupuncture. In addition to the total response rate (I² = 0%), the other three outcome indicators showed significant heterogeneity (I² > 50%). No publication bias was noted in RR (P < 0.05); however, a significant publication bias was observed in quality of life (P > 0.05).

CONCLUSION: Acupuncture can enhance the quality of life and relieve anxiety and depression in patients with IBS with apparent safety; however, a large number of high-quality RCTs are still needed.

PMID:39870963 | DOI:10.1007/s12529-025-10348-z

Int J Cardiovasc Imaging. 2025 Jan 27. doi: 10.1007/s10554-025-03337-6. Online ahead of print.

ABSTRACT

The use of conventional contrast agents in computed tomography (CT) and magnetic resonance (MR) imaging is often limited in patients with chronic kidney disease (CKD) due to potential nephrotoxicity. Ferumoxytol, originally developed for iron supplementation, has emerged as a promising alternative MR contrast agent that is safer for patients with CKD. This study aims to present our center’s experience with ferumoxytol as a contrast agent in CKD patients. We retrospectively reviewed 24 MR imaging studies of the chest, abdomen, and pelvis performed in CKD patients at our center. All patients were deemed suitable for ferumoxytol administration, receiving a dose of 4 mg/kg with post-injection monitoring. The imaging quality of the ascending, descending, suprarenal and infrarenal aortic segments was assessed by three independent observers using a qualitative scoring system (nondiagnostic, poor vascular definition, good vascular definition, and excellent vascular definition). Quantitative analyses, including signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and heterogeneity index, were also performed. No adverse reactions to ferumoxytol were observed. Of the 72 vascular segments evaluated, 90.8% of the images were rated as excellent vascular definition, and 9.2% were rated as good vascular definition. Inter-observer agreement was substantial (k = 0.647), with no statistically significant differences in ratings between observers. Ferumoxytol is a safe and effective alternative to conventional contrast agents for MR vascular imaging, particularly in patients with renal insufficiency. These findings support its selective use in appropriate clinical scenarios, offering a reliable imaging option for CKD patients.

PMID:39870959 | DOI:10.1007/s10554-025-03337-6

Eur J Drug Metab Pharmacokinet. 2025 Jan 27. doi: 10.1007/s13318-024-00928-x. Online ahead of print.

ABSTRACT

Caffeine consumption is regarded as a widespread phenomenon, and its usage has continued to increase. In addition, the growing usage of antidepressants worldwide and increase in mental health disorders were shown in recent statistical analyses conducted by the World Health Organisation. The coadministration of caffeine and antidepressants remains a concern due to potential interactions that can alter a patient’s response to therapy. This review investigates the pharmacokinetic and pharmacodynamic interactions between caffeine and the five main classes of antidepressants: selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), serotonin and norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs), and other antidepressants not categorised by class, which we have categorised as ‘miscellaneous’. The interaction between fluvoxamine and caffeine resulted in increased concentrations of caffeine in the body and lowered the renal clearance of fluvoxamine. Other SSRIs such as fluoxetine and escitalopram had augmented antidepressant effects by decreasing their renal clearance and prolonging their effects in the body when coadministered with caffeine. Caffeine may also increase the concentration of paroxetine, potentially affecting its pharmacodynamic effects. TCAs such as clomipramine, imipramine, desipramine, and sertraline, were found to reduce the metabolism of caffeine. However, studies suggest caffeine had no significant effect on the concentration of these medications in blood or brain tissue. The inhibition of caffeine at high doses when used with MAOIs such as tranylcypromine and phenelzine was found to lead to a higher likelihood of experiencing hypertension. Coadministration of caffeine with venlafaxine (SNRIs) suggests minimal interactions between the two substances and the pharmacodynamic effects of venlafaxine were unlikely to be impacted by caffeine consumption. Miscellaneous antidepressants (reboxetine, mianserin, agomelatine, maprotiline, and mirtazapine) displayed varying pharmacodynamic interactions with caffeine, resulting in increased antidepressant effects where vortioxetine, maprotiline, and mirtazapine failed to demonstrate any interactions. In conclusion, caffeine demonstrated varying effects on the pharmacokinetic and pharmacodynamic properties of each class of antidepressants, with several classes of antidepressants demonstrating a similar effect on caffeine.

PMID:39870954 | DOI:10.1007/s13318-024-00928-x

Pediatr Nephrol. 2025 Jan 27. doi: 10.1007/s00467-025-06659-8. Online ahead of print.

ABSTRACT

BACKGROUND: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a notably common complication in pediatrics, with an incidence rate ranging from 15 to 64%. This rate is significantly higher than that observed in adults. Currently, there is a lack of substantial evidence regarding the association between intraoperative blood pressure variability (BPV) during cardiac surgery with cardiopulmonary bypass (CPB) and the development of AKI in pediatric patients.

METHODS: This retrospective observational study encompassed children aged 0-7 years undergoing cardiac surgery with CPB. Intraoperative BPV was calculated using coefficients of variation (CVs) and the area under the curve (AUC). Univariate and multivariate analyses were employed to identify risk factors associated with CSA-AKI.

RESULTS: Among 570 patients (median age 1 year) reviewed, 36.1% developed CSA-AKI (68.9% risk stage, 22.8% injury stage, and 8.3% failure stage). After adjusting for other variables, male gender (OR = 2.044, 95% CI 1.297-3.222, P = 0.002), congenital heart surgery risk assessment grade (RACHS-1) classification ≥ 3 (OR = 0.510, 95% CI 0.307-0.846, P = 0.009), longer CPB time (OR = 1.022, 95% CI 1.007-1.037, P = 0.004) and higher peak value of intraoperative vasoactive inotropic score (VIS) (OR = 1.072, 95% CI 1.026-1.119, P = 0.002) were identified as independent risk factors for CSA-AKI. ± 30% AUCm was different in univariate analysis (P = 0.014), however, not statistically different in multifactor analysis (P = 0.610).

CONCLUSION: Greater BPV, specifically MAP variations exceeding 30% AUC during CPB, may be a potential risk factor for CSA-AKI in pediatric patients. Further large sample clinical studies are warranted to analyze the correlation between BPV and CSA-AKI.

PMID:39870953 | DOI:10.1007/s00467-025-06659-8

Acta Parasitol. 2025 Jan 27;70(1):46. doi: 10.1007/s11686-024-00940-w.

ABSTRACT

INTRODUCTION: Toxocarosis in human beings is currently diagnosed by serological assay based on the detection of antibodies against Toxocara antigens. Toxocara canis larvae do not reach the adult stage in paratenic hosts like humans and mice. Therefore experimental infection in mice, which mimics the biology of human infection, might be relevant to get a better understanding of human toxocarosis.

METHODS: Two recombinant antigens viz. rTc-CTL-1 and rTES-120 were developed by expression of respective genes in Escherichia coli. The Balb/c mice were divided into 3 groups; Group I and group II (n = 8 mice each) were infected orally with 100 and 1000 T. canis embryonated eggs, respectively and Group III, mice served as uninfected control mice. The serum samples were obtained from all mice at 0, 7, 14, 28, 45, 60, 90, 120 and 150 days post infection (dpi) were tested by indirect ELISA for detecting seroreactivity to Toxocara and at 28 dpi sera of mice was used for confirming seropositivity of toxocarosis in experimentally infected mice.

RESULTS: The rTc-CTL-1 antigen based ELISA showed the antibody response in both the infected groups were increased from 7 dpi, reached maximum at 28 dpi, then gradually declined but it was maintained up to 150 dpi where as the rTES-120 antigen based ELISA detected antibody only at 28 dpi with a maximum at 60 dpi, then moderately declined but it was observed up to 150 dpi. The antibody response of group II mice were significantly higher than the group I mice throughout the observation period when compared to control group (P < 0.01). Statistical analysis showed a highly significant difference in the antibody response between the group I and group II mice from 14 to 150 dpi with rTc-CTL-1 ELISA and from 28 to 150 dpi with rTES-120 based ELISA (P < 0.01). The seropositivity in mice sera samples at 28 dpi using rTc-CTL-1 based ELISA revealed 87.5% in group I and 100% in group II mice were positive. The rTES-120 ELISA revealed 12.5% in group I and 25% in group II mice were positive. Statistically highly significant difference in the seropositivity between the recombinant antigens (P < 0.01) was observed, but, there was no significant difference between the infected group of mice.

CONCLUSION: It was concluded that rTc-CTL-1 antigen based ELISA detect antibody in early infections compared to rTES-120 ELISA and also the antibody response was directly proportional to the dosage of infective eggs. The diagnostic efficacy of rTc-CTL-1 antigen based ELISA was better when compared to rTES-120 antigen based ELISA.

PMID:39870949 | DOI:10.1007/s11686-024-00940-w

Obes Surg. 2025 Jan 28. doi: 10.1007/s11695-025-07708-9. Online ahead of print.

ABSTRACT

BACKGROUND: Bariatric surgery is the most long-term effective treatment option for severe obesity. The role of gut microbiome (GM) in either the development of obesity or in response to obesity management strategies has been a matter of debate. This study aims to compare the impact of two of the most popular procedures, sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (GB), on metabolic syndrome parameters and gut bacterial microbiome and in systemic immuno-inflammatory response.

METHODS: A prospective observational study enrolled 24 patients with severe obesity, 14 underwent SG and 10 GB. Evaluations before (0 M) and 6 months (6 M) after surgical procedures included clinical and biochemical parameters, expression of 17 immuno-inflammatory genes in peripheral blood leukocytes, and assessment of gut microbiome profile using 16 s rRNA next-generation sequencing approach. Statistical significance was set to a p value < 0.05 with an FDR < 0.1.

RESULTS: A significant and similar decrease in weight-associated parameters and for most metabolic markers was achieved with both surgeries. Considering the gut microbiome in the whole study population, there was an increase in alpha diversity at family-level taxa. Beta diversity between SG and GB at 6 M showed near significant differences (p = 0.042) at genus levels. Analysis of the relative abundance of individual taxonomic groups highlighted differences between pre- and post-surgical treatment and between both approaches, namely, a higher representation of family Enterobacteriaceae and genera Veillonella and Enterobacteriaceae_unclassified after GB. Increased expression of immune-inflammatory genes was observed mainly for SG patients.

CONCLUSIONS: We conclude that SG and GB have similar clinical and metabolic outcomes but different impacts in the gut bacterial microbiome. Results also suggest reactivation of immune response after bariatric surgery.

PMID:39870942 | DOI:10.1007/s11695-025-07708-9