Tag: statistics

Adv Wound Care (New Rochelle). 2025 Jul 14. doi: 10.1177/21621918251359558. Online ahead of print.

ABSTRACT

Objective: To investigate the effectiveness of real-time fluorescence imaging (RTFI)-assisted debridement in managing chronic wounds compared with standard surgical debridement. Approach: This study was a patient-blinded, randomized clinical trial conducted from February 17, 2021, to July 30, 2021, on patients with chronic wounds. Patients were randomized to an RTFI group (M group) or conventional group (C group). The primary outcomes were as follows: percentage of residual bacterial area (preoperative and postoperative), number of debridements, high-quality debridement ratio, operation duration, and wound healing duration. Results: A total of 100 patients were enrolled in both groups. No significant difference in the percentage of preoperative residual bacterial area or high-quality debridement ratio was seen. The M group underwent debridement an average of 2.6 times and had a significantly longer duration of operation (33.5 ± 12.7 min) than the C group (29.9 ± 10.4 min; p = 0.031). The postoperative residual bacterial area was significantly lower in the M than in the C group (6.83% ± 1.39% vs. 30.0% ± 12.37%, respectively; p < 0.001). The M group required significantly fewer wound healing days (49.2 ± 25.3 vs. 63.0 ± 27.9, p < 0.001). Secondary outcomes also demonstrated statistically significant differences in total hospitalized days (17.5 ± 9.3 vs. 21.5 ± 12.5, p < 0.01), days of antibiotic use (15.5 ± 8.7 vs. 18.7 ± 6.7, p < 0.01), and reinfection rates (4 of 100 vs. 22 of 100, p < 0.001). Innovation: RTFI can detect signals from normal skin components and bacterial metabolites. Therefore, interpretation of RTFI results should be correlated with the clinical condition. RTFI is associated with high-quality debridement. This technique can also be applied in targeted biopsy and in training young staff to mature debridement procedures. Conclusion: RTFI in debridement is associated with favorable clinical outcomes and may have a positive influence on chronic wound healing.

PMID:40658376 | DOI:10.1177/21621918251359558

Stat Med. 2025 Jul;44(15-17):e70143. doi: 10.1002/sim.70143.

ABSTRACT

Mendelian randomization (MR) uses genetic variants as instrumental variables to infer causal effects of exposures on an outcome. One key assumption of MR is that the genetic variants used as instrumental variables are independent of the outcome conditional on the risk factor and unobserved confounders. Violations of this assumption, that is, the effect of the instrumental variables on the outcome through a path other than the risk factor included in the model (which can be caused by pleiotropy), are common phenomena in human genetics. Genetic variants, which deviate from this assumption, appear as outliers to the MR model fit and can be detected by the general heterogeneity statistics proposed in the literature, which are known to suffer from overdispersion, that is, too many genetic variants are declared as false outliers. We propose a method that corrects for overdispersion of the heterogeneity statistics in uni- and multivariable MR analysis by making use of the estimated inflation factor to correctly remove outlying instruments and therefore account for pleiotropic effects. Our method is applicable to summary-level data.

PMID:40658369 | DOI:10.1002/sim.70143

Trop Anim Health Prod. 2025 Jul 14;57(6):300. doi: 10.1007/s11250-025-04565-7.

ABSTRACT

OBJECTIVE: The objective of this study is to investigate the presence of major genes affecting body weight in hair goats. The application of Bayesian segregation analysis to big data facilitates more precise identification of intricate genetic structures and variations. This approach offers more profound biological insights through the detection of concealed genetic elements within big datasets. The precise quantification of additive genetic effects is fundamental for achieving sustainable genetic progress through targeted selection. Furthermore, the evaluation of dominance effects offers critical insights into heterozygote advantage, elucidating the mechanisms underlying heterosis and resilience in growth-related traits within livestock populations.

METHODS: To rapidly and accurately identify the presence of major genes, pedigree data and phenotypic data were employed in a Bayesian segregation analysis. For this purpose, 4072 records of body weight were analysed, measured at two different time points (birth weight (Time1) and body weight measured at approximately 100-120 days of age (Time2)). The data set comprised 2036 animals (n = 1038 male, n = 998 female). Gibbs sampling was employed to make statistical inferences regarding posterior distributions. These inferences were based on 20 replications of the Markov chain for each trait, with 100,000 samples collected, with each 500th sample retained due to the high correlation among the samples.

RESULTS: In this study, the estimated error variance, major gene variance, polygenic variance, dominance effect, and additive genetic effect were determined through Bayesian segregation analysis. The dominance effect (-1.797) was found to be smaller than the additive genetic effect (3.594) for birth weight, whereas for body weight at 4 months of age, the dominance effect (55.902) was found to be higher than the additive genetic variance (54.988). The polygenic and major gene heritabilities were estimated to be 0.51 (± 0.56) and 0.81 (± 0.91) for body weight, and 0.44 (± 0.55) and 0.86 (± 0.93) for body weight at four months of age, respectively.

CONCLUSION: The results of this study indicate that the 95% highest posterior density regions (HPDs) for the major gene parameter, particularly for the major gene variance, do not include 0, indicating the statistical significance of the major gene component.

PMID:40658343 | DOI:10.1007/s11250-025-04565-7

Clin Drug Investig. 2025 Jul 14. doi: 10.1007/s40261-025-01462-7. Online ahead of print.

ABSTRACT

BACKGROUND: Dapagliflozin and empagliflozin are emerging as promising treatment options for diabetic kidney disease (DKD).

OBJECTIVE: This study sought to evaluate the cost effectiveness of incorporating dapagliflozin and empagliflozin into the standard treatment for DKD in China.

METHODS: A Markov model was constructed to evaluate the cost-effectiveness of dapagliflozin and empagliflozin plus standard treatment versus standard treatment alone for DKD treatment from a healthcare perspective. Costs and utility data was obtained from published literatures within the Chinese context. The primary outcome included total cost, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER). GDP per capita of 2023 in China (¥89,358) was utilized as the willingness-to-pay threshold.

RESULTS: Compared to standard treatment alone, add-on therapy of dapagliflozin or empagliflozin resulted in a higher total cost than those solely receiving standard treatment (+¥19,203.56 and +¥9496.92, respectively). However, both dapagliflozin and empagliflozin also yielded more life-years (+1.72 vs. +1.40) and QALYs (+1.40 vs. +0.88). The ICER per life-year and ICER per QALY was ¥11,178.52 and ¥18,192.50 for dapagliflozin and ¥6773.10 and ¥10,811.64 for empagliflozin, respectively. The incremental net monetary benefit was ¥75,120.54 and ¥68,994.90 for dapagliflozin and empagliflozin, respectively. Sensitivity analysis supported the main findings of the base-case analysis as the cost-effectiveness of dapagliflozin or empagliflozin was sustained for most plausible ranges of parameter values.

CONCLUSIONS: Considering that the ICER falls below the predefined willingness-to-pay threshold, incorporating dapagliflozin and empagliflozin into standard treatment for DKD is likely to be a cost-effective strategy in China.

PMID:40658333 | DOI:10.1007/s40261-025-01462-7

CJEM. 2025 Jul 14. doi: 10.1007/s43678-025-00958-7. Online ahead of print.

ABSTRACT

OBJECTIVES: Early Pregnancy Assessment Clinics provide gold-standard care to patients experiencing complications of early pregnancy, but their impact on emergency department (ED) volumes and consultation practices are largely unknown. The primary objective was to assess the volume of patients experiencing complications of early pregnancy presenting to the ED before and after the opening of an Early Pregnancy Assessment Clinic in Saskatoon, Saskatchewan. Secondary outcomes included inpatient prescribing practices and evaluation of Early Pregnancy Assessment Clinic referral patterns.

METHODS: We performed a health records review including all patients presenting to 3 Saskatoon-area EDs in the 6 months before and after the Early Pregnancy Assessment Clinic opening and examined all referrals to the center in the first 6 months of its opening. Charts were excluded if patients were directly presenting for a specialist service, were admitted, and were presenting with complications unrelated to fetal outcomes. We calculated descriptive statistics and compared using z tests.

RESULTS: We identified 1242 charts, of which 757 met eligibility criteria. There were 393 visits pre-opening and 364 visits post-opening. However, only 33% of eligible patients were referred to the Early Pregnancy Assessment Clinic in the 6-month period after it was opened. Direct referrals to obstetrics decreased 39.9% from 20.1% to 12.1% (p = 0.002).

CONCLUSIONS: While patient visits were only moderately reduced and return visits were the same in the pre- and post- opening periods, the number of inpatient consults to obstetrics and gynecology were significantly reduced. This is clinically important in reducing the burden of in-hospital consults and allowing for greater flow through the ED while providing patient-centered care.

PMID:40658317 | DOI:10.1007/s43678-025-00958-7

Eur J Epidemiol. 2025 Jul 14. doi: 10.1007/s10654-025-01277-y. Online ahead of print.

ABSTRACT

While previous literature suggests that plant-based diets may be associated with a lower risk of breast cancer, evidence remains inconsistent. In this study, we investigated the association between adherence to plant-based diets and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Overall plant-based diet index (PDI), healthful (hPDI), and unhealthful PDI (uPDI) were calculated, and multivariable Cox models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) of breast cancer for the three indices. Mediation analysis was performed to assess the role of body mass index (BMI) and waist circumference (WC) in the association between hPDI and postmenopausal breast cancer risk. Over a median follow-up of 14.9 years, 10,805 incident invasive breast cancer cases were identified among 258,343 women. In the multivariable model, not adjusted for BMI, higher adherence to hPDI was inversely associated with breast cancer risk, with HR per 1-SD increase [95% (CI)] of 0.97 (0.94, 0.99). The corresponding HRs (95% CI) per 1-SD increase for overall PDI and uPDI were 0.98 (0.96, 1.00) and 1.01 (0.99, 1.03), respectively. The associations between hPDI and postmenopausal breast cancer were partly explained by BMI and WC, which mediated 30% and 52% of this association, respectively. Higher adherence to hPDI was associated with a slightly lower total breast cancer risk. For postmenopausal breast cancer, this association was partly explained by lower BMI or WC. These findings suggest that promoting healthful plant-based diets could support breast cancer risk reduction.

PMID:40658296 | DOI:10.1007/s10654-025-01277-y

Radiol Phys Technol. 2025 Jul 14. doi: 10.1007/s12194-025-00935-w. Online ahead of print.

ABSTRACT

Trigeminal neuralgia (TN) is characterized by severe facial pain and is treated with medications, surgery, percutaneous procedures, and stereotactic radiosurgery (SRS). The Gamma Knife (GK) has historically been the gold standard for SRS in TN, with alternatives such as the CyberKnife (CK) and standard linear accelerator (LA) having recently emerged. This study compared GK, CK, and LA treatments for TN via dosimetric analysis. Twenty patients (10 right- and 10 left-sided) with TN were planned in the three modalities. Dosimetric parameters, including D_Max, D_Min, D_Mean, D_98%, D_90%, D_50%, D_30%, and V_4Gy, were evaluated. The statistical significance was assessed using paired t tests. The CK and LA plans achieved a 60 Gy target coverage comparable to the GK plan. The GK plan exhibited superior brain stem sparing and lower V_4Gy compared with CK (p = 0.0013) and LA (p = 0.0001). Significant differences in D_Min, D_98%, D_90%, D_50%, and D_30% were observed between GK and CK (p < 0.05) and GK and LA (p < 0.05), but not for the CK-LA comparisons. The brain stem dose parameters (D_{0.03 cc}, D_1%, and D_2%) were significantly lower in the GK plan (p < 0.05). The GK exhibited better normal tissue sparing and brain stem dose distribution than CK and LA, attributable partly to its higher beam count. CK and LA require more intricate planning times. Despite the established efficacy of GK, CK and LA offer viable alternatives, underscoring the need for further research on the clinical outcomes of TN treatment in the respective modalities.

PMID:40658293 | DOI:10.1007/s12194-025-00935-w

Head Neck Pathol. 2025 Jul 14;19(1):84. doi: 10.1007/s12105-025-01814-x.

ABSTRACT

BACKGROUND: BCM is an uncommon cytomorphologic variant with the potential to mimic unrelated neoplastic conditions, especially in the absence of a known cutaneous primary lesion or limited access to immunohistochemical stains.

CASE PRESENTATION: A 28-year-old male patient presented with recent onset parotid gland mass. The mass was excised, and the subsequent workup elicited an interpretation of metastatic balloon cell melanoma (BCM). Despite an extensive evaluation, no evidence of a primary tumor site was identified.

DIAGNOSIS: The diagnosis was confirmed based on positive staining for BRAF, HMB45, Melan-A, PRAME, S100, and SOX-10 in the malignant cells.

CONCLUSION: Familiarity with the histologic and immunophenotypic findings may help to ensure an accurate diagnosis.

PMID:40658291 | DOI:10.1007/s12105-025-01814-x

Trop Anim Health Prod. 2025 Jul 14;57(6):298. doi: 10.1007/s11250-025-04546-w.

ABSTRACT

This study aimed to evaluate the effects of including a blend of acid and alkaline proteases in broiler diets on performance parameters, nutrient digestibility, and intestinal morphology. A total of 180 chicks were divided into the following groups: Positive Control (PC), Negative Control (with 8% reduction in crude protein-NC), and NC + blend proteases (BP) at 125 g/t (BP125). On days 1 and 21, the broilers and the feed were weighed for performance analysis, and a digestibility test was performed from days 17 to 21. The highest body weight and weight gain were observed in the broilers of the PC and BP125 groups (P = 0.001). The addition of protease to the diet (BP125) increased the ADC of crude protein, which was statistically similar to the PC group; both were higher than those observed in the NC group. We observed that the BP125 group had more excellent digestibility of the amino acids of serine (P = 0.032), threonine (P = 0.050), valine (P = 0.042), methionine (P = 0.050), cysteine (P = 0.012), arginine (P < 0.001) and tryptophan (P = 0.05) when compared to NC; but similar to PC group. It was also possible to observe a better villus and crypt ratio when protease was used in a low-protein diet (P = 0.05). These findings suggest that protease supplementation improves nutrient utilization and performance in low-protein diets.

PMID:40658273 | DOI:10.1007/s11250-025-04546-w

Int J Colorectal Dis. 2025 Jul 14;40(1):158. doi: 10.1007/s00384-025-04955-1.

ABSTRACT

PURPOSE: Urinary dysfunction (UD) is still a major complication after lower rectal cancer (LRC) surgery. Untreated UD is an independent risk factor for renal dysfunction due to repeated urinary reflux and urinary tract infections. However, the relationship between postoperative UD and renal function following LRC surgery remains unclear. In this study, we investigated the impact of UD on renal function post-surgery.

METHODS: We retrospectively evaluated 83 patients with LRC who underwent curative resection at our tertiary referral center between April 2015 and December 2018. UD was diagnosed as a post-void residual urine volume ≥ 50 mL using uroflowmetry tests after discharge. We compared the estimated glomerular filtration rate (eGFR) and the incidence of chronic kidney disease (CKD)-defined as an eGFR < 60 mL/min/1.73 m²-at 3 years after LRC surgery between the UD and non-UD groups. Patient selection was based on the criteria that excluded those with a history of urogenital interventions or incomplete postoperative follow-up. Statistical analysis used the Mann-Whitney U test for continuous variables, Fisher’s test for categorical data, and multivariate logistic regression to adjust for potential confounders.

RESULTS: Of the 83 patients, 21 (25%) had UD. Patients with UD were older, underwent more extensive surgery, and had significantly longer operation times than those without UD. Within 3 years post-surgery, the UD group experienced a higher incidence of urinary tract complications and CKD, with a notable decrease in eGFR. Additionally, a history of hypertension and UD were identified as independent risk factors for CKD at 3 years post-surgery.

CONCLUSIONS: Patients with UD showed a significant decrease in eGFR and were more likely to progress to CKD at 3 years after LRC surgery. These findings indicated that postoperative UD might adversely affect renal function in patients with LRC.

PMID:40658254 | DOI:10.1007/s00384-025-04955-1