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Nevin Manimala Statistics

Creeping fat is associated with transmural healing in patients with Crohn’s disease receiving ustekinumab

Insights Imaging. 2025 Oct 4;16(1):214. doi: 10.1186/s13244-025-02101-7.

ABSTRACT

OBJECTIVES: We investigated whether body composition parameters assessed on baseline computed tomography enterography (CTE) could predict transmural healing (TH) in patients with Crohn’s disease (CD) receiving Ustekinumab (UST).

MATERIALS AND METHODS: Adult patients with active CD treated with standard UST from August 2020 to August 2022 were enrolled. Body composition, including creeping fat (CF, mesenteric creeping fat index (MCFI) and fibrofatty proliferation score), skeletal muscle, visceral adipose, and subcutaneous adipose-related parameters were assessed on baseline CTE. Cox regression analysis was performed to identify independent predictors of TH.

RESULTS: This study included 113 patients, and TH occurred in 26 (23. 0%) patients. The results of the univariable analysis indicated a statistically significant association of the presence of sarcopenia, higher MCFI score, and higher fibrofatty proliferation score with an increased failure rate of TH. We found no evidence that skeletal muscle index, subcutaneous adipose index, visceral adipose index, and visceral adipose/subcutaneous adipose area ratio were associated with TH. Multivariable analysis revealed that sarcopenia (Hazard ratio (HR): 0.35, 95% CI: 0.14-0.87, p = 0.023), MCFI score (HR: 0.67, 95% CI: 0.49-0.91, p = 0.010) and fibrofatty proliferation score (HR: 0.50, 95% CI: 0.29-0.85, p = 0.011) remained significant. MCFI score (χ2-df = 5.58) was the most critical factor for TH prediction, followed by fibrofatty proliferation score (χ2-df = 5.43) and sarcopenia (χ2-df = 4.12).

CONCLUSIONS: Among all the body composition parameters, MCFI and fibrofatty proliferation score assessed on baseline CTE were independently associated with TH, and they demonstrated greater predictive efficacy compared to sarcopenia.

CRITICAL RELEVANCE STATEMENT: Creeping fat on baseline CTE was an important predictive factor for transmural healing in patients with Crohn’s disease receiving Ustekinumab, which enables early risk stratification of patients and has potential implications for decision-making.

KEY POINTS: Identifying predictors of transmural healing may provide insight into earlier dose optimization to improve the rate of transmural healing. Higher creeping fat scores (mesenteric creeping fat index and fibrofatty proliferation) were independently associated with a lower rate of transmural healing. Mesenteric creeping fat index and fibrofatty proliferation score demonstrated greater predictive efficacy compared to sarcopenia.

PMID:41046272 | DOI:10.1186/s13244-025-02101-7

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Nevin Manimala Statistics

The impact of systemic inflammatory markers on EGFR-mutant non-small cell lung cancer

BMC Cancer. 2025 Oct 4;25(1):1510. doi: 10.1186/s12885-025-14915-1.

ABSTRACT

BACKGROUND: High prevalence of EGFRm lung cancer was found in the Asian population. Preclinical data suggest that inflammatory cytokines activated by PM2.5 affected EGFRm clone expansion. Here, we explored the correlation between inflammatory markers and EGFRm NSCLC.

METHODS: Resected NSCLC patients (2016-2023) were enrolled. Tumor tissues and blood serum were retrieved from Ramathibodi tumor biobank. EGFR 19del and L858R mutations were performed by rt-PCR in cancerous tissue and dPCR in normal tissue in the same patient. NF-Kb and STAT3 protein signaling were measured by ELISA in both cancerous and normal tissue. Cytokines (IL-1ß, IL-6, IL-8, IL-10, IL-12 and TNF-α) were explored in serum by flow cytometry.

RESULTS: Among 140 patients, EGFRm prevalence was 58% in cancerous tissue but only 5% in normal tissue. NF-kB and STAT3 were statistically higher in cancerous tissue than normal tissue [NF-kB median O.D.=0.82 (IQR; 0.07-2.82) vs. 0.32 (IQR; 0.05-2.48), P < 0.001; STAT3 median O.D.=0.32 (IQR; 0.10-1.58) vs. 0.17 (IQR; 0.06-1.29, P < 0.001]. STAT3 was significantly increased in EGFRm compared to EGFRwt [median O.D.=0.36 (IQR; 0.234-0.592) vs. 0.23 (IQR; 0.158-0.409), OR = 11.09 (95% CI; 2.17-56.58), P = 0.004]. TNF-α, IL-10, and STAT3 in cancer cells were higher in EGFRm than EGFRwt (P = 0.003, 0.008, and < 0.001, respectively). None of cytokines was statistically different between EGFRm and EGFRwt patients. However, only STAT3 in cancer cells and non-smoker were associated with EGFRm NSCLC in multivariable analysis.

CONCLUSION: Inflammation could be one of the pathogenesis of both NSCLC and EGFRm lung cancer as we demonstrated in our pilot study. STAT3 is a potentially inflammatory-predictive biomarkers. Larger cohort is needed.

PMID:41046266 | DOI:10.1186/s12885-025-14915-1

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Nevin Manimala Statistics

The impact of childhood maltreatment on treatment outcomes for posttraumatic stress symptoms and aggression in male former combatants using narrative exposure therapy [NET] – results from a RCT in Eastern democratic Republic of Congo

Confl Health. 2025 Oct 4;19(1):67. doi: 10.1186/s13031-025-00710-z.

ABSTRACT

OBJECTIVE: This study investigates the impact of childhood maltreatment on treatment outcomes among male ex-combatants in a randomized controlled trial (RCT) of Narrative Exposure Therapy for Forensic Offender Rehabilitation (FORNET), a specialized psychotherapy used to treat trauma sequelae including symptoms of posttraumatic stress disorder (PTSD), compared with treatment as usual (TAU). Specifically, we aim to compare former child and adult male soldiers who experienced childhood sexual abuse (CSA) with those who did not.

METHODS: We conducted a sub-analysis of data from Koebach et al. [J Consult Clin Psychol. 2021], focusing on a sample of male former soldiers in the eastern Democratic Republic of Congo (DRC). Participants were categorized into two groups based on their history of CSA. Outcome measures included the prevalence of lifetime sexual assaults, perpetration of sexual violence against others, appetitive aggression, current violent behavior, symptoms of PTSD and depression and responses to two treatment modalities: TAU and FORNET.

RESULTS: The group with a history of CSA had significantly higher rates of re-experiencing sexually assaults, especially by superiors, and of perpetrating sexual assaults against others. In addition, this group presented elevated baseline scores in all outcomes (appetitive aggression, current violent behavior, symptoms of PTSD and depression). Regarding effectiveness of treatment arms, the FORNET group demonstrated significantly greater reductions in appetitive aggression levels, PTSD symptoms and depressive symptoms compared to the TAU group, with no difference in treatment effectiveness between participants with and without a history of CSA. However, individuals with CSA showed statistically superior improvements in current violent behavior, with similar score levels to those without CSA after 6-9 months.

CONCLUSION: CSA among former soldiers was significantly associated with a higher prevalence of PTSD and increased risk of both sexual revictimization and the perpetration of sexual and other violent acts. FORNET demonstrates effectiveness in reducing appetitive aggression, PTSD symptoms, and violent behavior even in the subgroup highly affected by CSA – showing an even greater impact on current violent behavior. The ability of NET to address trauma and perpetration in a chronological sequence and adapt to the specific challenges of CSA likely account for its effectiveness in treating this complexly traumatized population, ultimately contributing to a reduction of violence in post-conflict communities. Special attention should be paid to revictimization during the rehabilitation process of ex-combatants.

PMID:41046251 | DOI:10.1186/s13031-025-00710-z

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Impact of socioeconomics on recurrences and survival in non-metastasized colorectal cancer

Br J Cancer. 2025 Oct 4. doi: 10.1038/s41416-025-03224-w. Online ahead of print.

ABSTRACT

BACKGROUND: Survival differences between socioeconomic groups in colorectal cancer have been studied for patients diagnosed in the 90s and 00s, but research on recent patients using individual measures of socioeconomic position is limited.

METHODS: CRCBaSe, a database of linked national registry data, was used to analyse stage I-III colorectal cancer patients diagnosed in Sweden between 2008 and 2021. The exposures of interest were income and education. Flexible parametric survival models were fitted and standardised survival probabilities and hazard ratios (HR) were calculated for cancer-specific survival, recurrence, and overall survival.

RESULTS: Analysis of 59,995 patients showed better 5-year standardised cancer-specific survival in the least deprived income group, 77.8% (95%CI 76.9-78.6) vs. 73.2% (95%CI 72.6-73.9) in the most deprived income group, HR 0.93 (95%CI 0.87-0.99). Time to recurrence was not statistically different between socioeconomic groups. Overall survival was better in the least deprived income group, with a 5-year standardised overall survival of 70.0% (95%CI 69.1-70.8) vs. 63.5% (95%CI 62.9-64.1) in the most deprived income group, HR 0.82 (95%CI 0.79-0.86).

CONCLUSION: We found large disparities in cancer-specific and overall survival between the highest and most deprived income and education groups, despite improvements in care and the introduction of guidelines.

PMID:41046246 | DOI:10.1038/s41416-025-03224-w

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Phase transformation and biaxial flexural strength of additively and subtractively manufactured zirconia: Effect of grinding and regeneration firing

J Prosthet Dent. 2025 Oct 3:S0022-3913(25)00750-4. doi: 10.1016/j.prosdent.2025.09.019. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Grinding is often required for the clinical adjustments of zirconia restorations; nevertheless, the effects of following regeneration firing processes on additively manufactured zirconia are still unclear.

PURPOSE: The purpose of this in vitro study was to evaluate the effects of grinding and regeneration firing (RF) on the phase transformation and biaxial flexural strength (BFS) of additively or subtractively manufactured 3 mol% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP).

MATERIAL AND METHODS: A total of 108 disk-shaped (Ø15×1.5 mm) 3Y-TZP specimens (n=54) were fabricated using either subtractive manufacturing (SM) or additive manufacturing (AM) techniques. Grinding was performed using a 150-μm-grit diamond rotary instrument with a high-speed handpiece, and RF was carried out at 1000 °C for 15 minutes in a sintering furnace. The crystalline phases were analyzed using X-ray powder diffraction (XRD). All specimens were loaded until fracture using a universal testing machine for a biaxial flexural strength test at a crosshead speed of 1 mm/minute. Microstructure and fracture surfaces were examined using scanning electron microscopy. BFS data were statistically analyzed using 1-way ANOVA, followed by the Tukey post hoc test for pairwise comparisons. (α=.05). The Weibull modulus and characteristic strength were calculated to assess the reliability of strength data.

RESULTS: Tetragonal-to-monoclinic phase transformation was detected in ground specimens of both AM and SM groups, whereas only the tetragonal phase was observed in their corresponding RF groups. The highest BFS (1427.2 MPa) was observed in ground AM specimens (P<.001). Grinding and RF did not significantly affect the BFS of SM zirconia (P=.927 and P=.999, respectively) but significantly increased the BFS of AM zirconia (P<.001). RF increased the Weibull modulus in both AM (from m=6.98 to 12.25) and SM (from m=5.91 to 8.35) zirconia.

CONCLUSIONS: The implementation of RF after grinding is crucial, particularly for AM zirconia, to improve mechanical strength and structural reliability.

PMID:41046229 | DOI:10.1016/j.prosdent.2025.09.019

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Evaluation of methods for removing stains from a 3D printed resin for denture teeth

J Prosthet Dent. 2025 Oct 3:S0022-3913(25)00751-6. doi: 10.1016/j.prosdent.2025.09.022. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: An efficient protocol for removing stains from 3-dimensionally (3D) printed artificial teeth must also preserve their surface properties.

PURPOSE: The purpose of this in vitro study was to evaluate methods of removing stains from a 3D printed resin (Bio Crown) for artificial teeth submitted to immersion in coffee by using spectrophotometric analysis (CIEDE2000) and analyzing surface roughness with a profilometer and topography with a scanning electron microscope (SEM).

MATERIAL AND METHODS: Disks (Ø10×1.2 mm) were 3D printed and stained in instant coffee simulating 1 year of consumption. Color data (L*, a*, b*) and roughness (Ra, µm) were obtained at T0 (baseline, before staining), T1 (after staining), and T2 (after each stain removal protocol, n=12). The stain removal groups used sodium perborate (SP), 0.25% sodium hypochlorite (SH), conventional polishing with brush and pumice stone + felt wheels and universal paste (CP), and polishing with 3-abrasive tip kit (AP); the control was storage in distilled water (DW). Mixed 2-way ANOVA followed by the Bonferroni test was performed to statistically analyzing data with α=.05.

RESULTS: Roughness increased in all groups between T1 and T2 (P<.05), except for SH. The AP (0.64 ±0.12 µm) and CP (0.52 ±0.17 µm) groups showed similar roughness and higher roughness compared with the other groups (SP 0.40 ±0.22 µm, SH 0.31 ±0.12 µm, and DW 0.34 ±0.11 µm). A significant color difference (ΔE00) was observed between T0 (1.03 ±0.49) and T1 (1.36 ±0.77), (P<.001), and the color remained statistically similar between T1 and T2 (1.48 ±1.02).

CONCLUSIONS: No method was effective in removing coffee stains. The polishing methods resulted in greater roughness, followed by sodium perborate. The only protocol that did not increase the roughness of the 3D printed resin for artificial teeth was 0.25% sodium hypochlorite. Longer application periods of the staining removal protocols are suggested for future studies.

PMID:41046228 | DOI:10.1016/j.prosdent.2025.09.022

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Addressing Uneven Treatment Discontinuation Rate in the Chemotherapy Arm of the EV-302 Phase 3 Randomized Clinical Trial: Implications for Outcome Interpretation

Clin Genitourin Cancer. 2025 Aug 28:102423. doi: 10.1016/j.clgc.2025.102423. Online ahead of print.

ABSTRACT

INTRODUCTION: The EV-302 trial demonstrated a very significant overall survival (OS) benefit for Enfortumab Vedotin plus Pembrolizumab (EVP) relative to standard chemotherapy (CHT) for patients with metastatic urothelial carcinoma. However, questions have been raised regarding the high rate of treatment discontinuation in the CHT arm for reasons unrelated to adverse events or progression (33% vs. 10% with EVP, P < .01), potentially resulting in loss of unaccounted information, or informative censoring, and affecting survival results interpretation.

MATERIALS AND METHODS: We performed a multistep analysis to assess the impact of differential dropout on trial outcomes. First, Kaplan-Meier (KM) curves were reconstructed from published data to estimate time-to-event outcomes. Second, a reverse KM analysis was conducted to evaluate censoring patterns in the overall population and key subgroups (PD-L1 expression; cisplatin eligibility). Third, simulation models were employed to test whether informative censoring could negatively impact survival benefit by EVP. Finally, we compared the CHT arm of EV-302 to those of other contemporary RCTs through reconstructed survival analyses and risk-of-bias assessments.

RESULTS: Overall, no significant imbalance in censoring between the treatment arms of EV-302 was found on reverse KM analysis when assessing OS (P = .73); however, a significant difference was noted for progression-free survival (PFS) (P = .002). Simulation analysis revealed that even under extreme assumptions of informative censoring, the OS benefit of EVP remained statistically significant. Comparison with historical RCTs confirmed that the CHT outcomes in EV-302 were not anomalously poor. Risk of bias was low overall, although deviations from intervention and outcome measurement were flagged for EV-302.

CONCLUSIONS: Despite the high discontinuation rate in the CHT arm, OS benefit with EVP remains robust. These findings support the reliability of EV-302 results and mitigate concerns about informative censoring, thus encouraging the use of EVP in clinical practice.

PMID:41046201 | DOI:10.1016/j.clgc.2025.102423

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Differences in postoperative communication patterns among patients with limited English proficiency following radical cystectomy for bladder cancer

Urol Oncol. 2025 Oct 3:S1078-1439(25)00346-1. doi: 10.1016/j.urolonc.2025.08.027. Online ahead of print.

ABSTRACT

INTRODUCTION: Consistent urologic oncology follow-up after radical cystectomy (RC) improves survival. However, there is scarce literature describing postoperative communication. We aimed to identify differences in postoperative communication patterns and healthcare utilization among English-speaking patients (ESPs) and patients with limited English proficiency (LEP) following RC.

METHODS: We conducted a single-institution, retrospective cohort study, examining patients who underwent RC for bladder cancer. We used propensity score matching to match 50 ESPs and 50 patients with LEP on age and sex. We abstracted patient demographics, postoperative communication and healthcare utilization within 90 days of surgery. We fit multivariable linear regression to investigate factors associated with postoperative communication frequency.

RESULTS: Postoperative communication was common, with 82% of patients placing ≥1 phone call/message. ESPs communicated more than patients with LEP (6.04 vs. 3.80 average calls/messages), though this difference was not statistically significant (P = 0.08). ESPs were more likely to initiate the communication themselves and have postoperative communication result in reassurance from the surgical team (P = 0.03), while patients with LEP were more likely to have a family member communicate on their behalf (P < 0.001) and have postoperative communication result in outpatient evaluation/treatment (P = 0.01). Patients with a neobladder reconstruction placed an increased number of phone calls/messages. There were no differences in postoperative healthcare utilization between the 2 groups.

CONCLUSIONS: Postoperative communication is frequent following RC. ESPs communicated nearly twice as often as patients with LEP, suggesting a clinically relevant difference in patient communication following radical cystectomy. Primary language spoken is not associated with differences in postoperative healthcare utilization.

PMID:41046200 | DOI:10.1016/j.urolonc.2025.08.027

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Nevin Manimala Statistics

Robust and non-asymptotic state estimation for MIMO descriptor systems

ISA Trans. 2025 Sep 26:S0019-0578(25)00527-0. doi: 10.1016/j.isatra.2025.09.022. Online ahead of print.

ABSTRACT

In this research paper, a state estimation framework for a class of descriptor linear systems with MIMO is provided by using auxiliary modulating dynamical systems. First, the considered model is transformed into a simpler form involving the derivatives of inputs and outputs, based on which the auxiliary systems are applied. Then, the state variables are expressed through modulating integrals without the need for initial conditions, guaranteeing non-asymptotic convergence within fixed-time. This framework does not require the calculation of the derivatives of noisy outputs in discrete cases, reducing sensitivity to high-frequency noise in the estimation. Finally, the performance of the proposed method is validated through numerical simulations, which provide practical insights into its effectiveness and enable a comparison with some observers.

PMID:41046198 | DOI:10.1016/j.isatra.2025.09.022

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Optimal off-line generated ϵ-stealthy attacks under the energy constraint in cyber-physical systems

ISA Trans. 2025 Sep 17:S0019-0578(25)00509-9. doi: 10.1016/j.isatra.2025.09.004. Online ahead of print.

ABSTRACT

The malicious attack design helps to accurately assess the vulnerability of cyber-physical systems under attacks. Based on this, an off-line generated attack model with time-varying covariance is proposed under the energy constraint, which aims to maximize the system estimation error while satisfying the ϵ-stealthiness. Subsequently, the problem is equivalently transformed by quantifying the optimization objective based on the derivation of error covariance and deriving the stealthiness condition according to the statistical properties of mutual information and Kullback-Leibler divergence. Due to the coupling relationship between the designed covariance and scheduling, the covariance is derived as a function of the attack scheduling by the Lagrange multiplier method. Then, the optimal attack scheduling is proved to be fixed according to the uniqueness of the optimal parameters. Finally, some numerical simulations are given to validate the effectiveness of results.

PMID:41046197 | DOI:10.1016/j.isatra.2025.09.004