Tag: statistics

Support Care Cancer. 2025 Apr 1;33(4):335. doi: 10.1007/s00520-025-09408-7.

ABSTRACT

PURPOSE: Treatment decisions are often highly complex when the outcomes are uncertain. In Japan, the consultation fees incurred can be reimbursed when physicians and nurses work together with patients to provide shared decision-making (SDM) on treatment plans. However, the extent to which reimbursed consultations are used by clinicians is unclear. This study aimed to determine the extent to which so-called “reimbursed SDM consultations” are used in cancer treatment and to identify the characteristics of patients having these consultations using a nationwide database.

METHODS: This retrospective study used health service utilization data linked to hospital-based cancer registries from 591 hospitals in Japan. Data for patients aged 18 years or above diagnosed with cancer in 2019 were analyzed. Multivariable logistic regression analysis was conducted to analyze the association between reimbursed SDM consultations and patient characteristics.

RESULTS: Overall, 74,828 patients (12.2%) received reimbursed SDM consultations in 533 hospitals. The presence of breast cancer (odds ratio (OR) = 2.00), treatment types of radiotherapy (OR = 1.86) and pharmacotherapy (OR = 1.76), and distant metastasis (OR = 1.49) and the invasion of adjacent organs (regional) (OR = 1.47) were positively associated with reimbursed SDM consultations. Cervical (OR = 0.38) and renal cancers (OR = 0.49) were negatively associated with reimbursed SDM consultations.

CONCLUSION: This study is the first to determine the extent to which reimbursed SDM consultations are used and the characteristics of the patients receiving them. Further studies should investigate the factors influencing the use of reimbursed SDM consultations.

PMID:40164872 | DOI:10.1007/s00520-025-09408-7

Qual Life Res. 2025 Mar 31. doi: 10.1007/s11136-025-03959-2. Online ahead of print.

ABSTRACT

PURPOSE: When confronted with healthy functional impairments, the attribution of disease-induced distress plays a key role in the prognosis of health outcomes. This study examined the effects of an attribution-related intervention, namely WeChat-based EPIC (enter, practice, intensify, consolidate) training, on health-related quality of life (HRQoL), attribution, and life attitude in women newly diagnosed with breast cancer.

METHODS: Eligible patients were recruited using convenience sampling and randomly assigned to the intervention or control group via stratified block randomization. The former received WeChat-based EPIC training plus routine nursing care for 6 months. The latter received only routine nursing care. HRQoL (primary indicator), attribution and life attitude (secondary indicators) were measured using the Functional Assessment of Cancer Therapy-Breast version 4.0 (FACT-Bv4.0), Attributional Style Questionnaire (ASQ) and Life Attitude Self-rating Questionnaire for Breast Cancer (LASQ-BC), respectively. A linear mixed model was used to examine the score fluctuations at the 1-, 3-, and 6-month intervals relative to the baseline.

RESULTS: After 6 months, the intervention group (n = 84) showed statistically significant higher total scores in the FACT-Bv4.0 [mean difference: – 15.01; 95% confidence interval: – 17.96, – 12.07; p < 0.001], ASQ [- 4.16 (- 4.45, – 3.86); p < 0.001], and LASQ-BC [- 6.77 (- 8.27, – 5.27); p < 0.001] than that of the control group (n = 82). The total scores of the three indicators also showed significant group, time, and group-by-time interaction effects (p < 0.001).

CONCLUSION: The WeChat-based EPIC training was an effective intervention for improving HRQoL and psychological health in women newly diagnosed with breast cancer.

TRIAL REGISTRATION: Chinese Clinical Trial Registry www.chictr.org.cn , prospectively registered on 11 April 2020, ChiCTR2000031827.

PMID:40164865 | DOI:10.1007/s11136-025-03959-2

Environ Monit Assess. 2025 Mar 31;197(4):492. doi: 10.1007/s10661-025-13957-z.

ABSTRACT

The spatial distribution of particulate matter pollution in urban areas is as complex as the complexity layout of buildings and streets and the various emission sources. Because of relatively high costs and inflexibility, the traditional fixed station monitoring is not able to satisfy the demand of dynamic particulate monitoring. A particulate sensor (OPC_N3) was installed on a trailer of a bicycle and applied to investigate spatio-temporal distributions of PM_2.5 and PM₁₀ concentrations in summer time of Karlsruhe, Germany. Before that, the sensors were calibrated against a standard instrument (Fidas200). Temporal variations show that PM_2.5 and PM₁₀ mass concentrations in the morning were on average higher 2.7 ± 1.2 µg/m³ than in the afternoon and evening. The highest PM_2.5 and PM₁₀ concentrations were observed in the southern forest of Karlsruhe (segment 9), and the street surface is the primary influencing factor. Walking at 5 km/h has a higher concentration than speed at 5 km/h of riding. When riding at different speeds on the same gravel and potholed path, higher speeds are associated with higher particulate matter (PM) concentrations. Distribution pattern of particulate matter on workday and weekend was also different: Mean PM_2.5 and PM₁₀ concentrations of southern forest (segment 10) in the morning and evening at weekend are on average higher by 11.2 ± 10.3 µg/m³ than at workday. Construction activities on workday also had significant effect on particulate matter concentration. Spatial distribution of aerosol concentrations was highly depending on land use and city structure. These results provide good insights for the application of low-cost sensors in urban environments monitoring and a basis to develop potential mitigation measures.

PMID:40164845 | DOI:10.1007/s10661-025-13957-z

Surg Endosc. 2025 Mar 31. doi: 10.1007/s00464-025-11676-7. Online ahead of print.

ABSTRACT

BACKGROUND: Robotic-assisted and laparoscopic techniques are widely used for inguinal hernia repair. While robotic-assisted transabdominal preperitoneal (rTAPP) repair is believed to offer ergonomic advantages for surgeons, there is limited evidence comparing its ergonomic impact to conventional laparoscopic TAPP (cTAPP) repair. This study aims to assess the ergonomic strain on surgeons during these procedures using subjective and objective measures.

METHODS: This crossover observational study involved four experienced hernia surgeons who performed two procedures using each technique. Ergonomic strain was evaluated through self-reported perceived exertion (using the Borg scale), surface electromyography (sEMG) of select muscle groups, and posture analysis using rapid upper limb assessment (RULA) scores derived from kinematic data collected via Xsens Awinda. Statistical comparisons were conducted using the Wilcoxon rank-sum test, with adjustments for multiple comparisons.

RESULTS: Subjectively, surgeons perceived rTAPP as less physically demanding, with lower postoperative perceived exertion scores (median 1.5 vs. 3.0, p < 0.01). Objective measurements showed higher static muscle activity in the left erector spinae and median activity in the right trapezius during rTAPP (p = 0.016), but overall ergonomic strain, as indicated by RULA scores, was similar across modalities. Median RULA scores for both techniques were 3, and no significant differences were observed in work posture scores. Despite these findings, discomfort during cTAPP was more frequently reported, with surgeons citing the neck, shoulders, and lower back as affected areas.

CONCLUSION: While rTAPP was subjectively perceived as less physically demanding, objective metrics did not corroborate these perceptions, showing comparable ergonomic strain between techniques. These findings highlight a complex relationship between subjective and objective ergonomic measures and suggest a need for further research, incorporating broader assessments of cognitive and physical loads, to optimize surgeon ergonomics in minimally invasive procedures.

PMID:40164838 | DOI:10.1007/s00464-025-11676-7

Ophthalmologie. 2025 Mar 31. doi: 10.1007/s00347-025-02222-w. Online ahead of print.

ABSTRACT

BACKGROUND: Intravitreal injections (IVI) are the most commonly used procedure worldwide in the treatment of retinal vascular diseases.

OBJECTIVE: This study investigates the endophthalmitis rate, the frequency of subjective complaints and potential risk factors associated with IVI.

MATERIAL AND METHODS: In the first part of this monocentric study the number of cases of endophthalmitis and potential risk factors were analyzed based on routine hospital documentation of 123,373 IVI procedures from 2013 to 2022. In the second part, subjective complaints and potential risk factors following IVI were investigated through a survey involving 584 patients.

RESULTS: From 2013 to 2022 a total of 27 cases of endophthalmitis occurred following IVI (0.02%). The analysis of potential risk factors (age, gender, disinfection method, number of prior injections, day of the week, year, bilateral injection) revealed that none of these factors were associated with an increased risk of endophthalmitis. The initial identification of bilateral injection as a risk factor was disproven through further analysis and classified as a statistical artifact. More than 10% of patients reported complaints the day after the injection, such as foreign body sensation (18%), seeing air bubbles (17%), itching (12%) and reddening of the eyes (11%). Subconjunctival hemorrhage (4%) or severe pain the day after the injection (2%) occurred less frequently. Male patients reported severe pain the day after less often (odds ratio 0.18, 95% confidence interval 0.03-0.72). Nearly 2% of patients sought unplanned ophthalmologist visits or considered treatment discontinuation due to the complaints.

CONCLUSION: Subjective complaints are more prevalent than severe complications and can jeopardize treatment adherence. Therefore, providing information about expected discomfort is advisable.

PMID:40164833 | DOI:10.1007/s00347-025-02222-w

Lifetime Data Anal. 2025 Mar 31. doi: 10.1007/s10985-025-09649-y. Online ahead of print.

ABSTRACT

Double truncation commonly occurs in astronomy, epidemiology and economics. Compared to one-sided truncation, double truncation, which combines both left and right truncation, is more challenging to handle and the methods for analyzing doubly truncated data are limited. For the situation, a common approach is to perform conditional analysis conditional on truncation times, which is simple but may not be efficient. Corresponding to this, we propose a pairwise pseudo-likelihood approach that aims to recover some information missed in the conditional methods and can yield more efficient estimation. The resulting estimator is shown to be consistent and asymptotically normal. An extensive simulation study indicates that the proposed procedure works well in practice and is indeed more efficient than the conditional approach. The proposed methodology applied to an AIDS study.

PMID:40164827 | DOI:10.1007/s10985-025-09649-y

Discov Oncol. 2025 Mar 31;16(1):437. doi: 10.1007/s12672-025-02177-z.

ABSTRACT

BACKGROUND: The pathogenesis of hepatocellular carcinoma (HCC) involves a variety of environmental risk factors, some of which have yet to be fully clarified. Using the Mendelian randomization (MR) approach, this study comprehensively investigates the causal effect of genetically predicted modifiable risk factors on HCC.

METHODS: Genetic variants related to the 50 risk factors that had been identified in previous research were derived from genome-wide association studies. Summary statistics for the discovery cohort and validation cohort of HCC were sourced from the FinnGen consortium and the UK Biobank, respectively. Bidirectional MR analysis and sensitivity analysis were performed to establish causative risk factors for HCC.

RESULTS: Through the inverse variance weighted method, the results of the discovery cohort indicated that waist circumference, nonalcoholic fatty liver disease (NAFLD), alanine aminotransferase (ALT) levels, and aspartate aminotransferase (AST) levels were significantly linked to HCC occurrence risk. Furthermore, body fat percentage, glycated hemoglobin (HbA1c), obesity class 1-3, waist-to-hip ratio, iron, ferritin, transferrin saturation, and urate had suggestive associations with HCC. The validation cohort further confirmed that NAFLD and ALT levels were strongly related to HCC. Reverse MR indicated that genetic susceptibility to HCC was connected to NAFLD and transferrin saturation. Sensitivity analyses showed that most of the findings were robust.

CONCLUSION: This MR study delivers evidence of the complex causal relationship between modifiable risk factors and HCC. These findings offer new insights into potential prevention and treatment strategies for HCC.

PMID:40164825 | DOI:10.1007/s12672-025-02177-z

Can J Public Health. 2025 Mar 31. doi: 10.17269/s41997-025-01014-8. Online ahead of print.

ABSTRACT

OBJECTIVE: Using data from a population-based cross-sectional survey, we aim to measure the prevalence, risk factors, and impact of COVID-19 on household food insecurity, housing insecurity, and the double burden of experiencing both.

METHODS: Data were collected from July to November 2022. We used simple and multivariable logistic regression models to investigate the factors contributing to food insecurity, housing insecurity, and the double burden. Additionally, we computed the relative excess risk due to interaction (RERI) to determine whether any significant interactions contributed to the increased risk of experiencing the double burden.

RESULTS: Around 27% of our study participants were food insecure, 54% were housing insecure, and 22% were food and housing insecure (double burden). Respondents’ gender, age, ethnicity, education, and income were associated with experiencing the double burden of food and housing insecurity. Additionally, this study found a significant statistical interaction between residence location and employment status, with both employed and unemployed individuals in urban areas facing higher odds of experiencing the double burden of food and housing insecurity compared to retired individuals in either urban or rural areas; the relative excess risk due to interaction analysis suggests that increasing employment opportunities may have a more substantial impact on reducing this burden in urban areas.

CONCLUSION: Findings from this study provide important insights into addressing the issue of food and housing insecurity, especially through improving employment opportunities for vulnerable populations in Canada. Comprehensive systems-oriented intersectoral policies are much needed to improve households’ experience of multiple need insecurities.

PMID:40164803 | DOI:10.17269/s41997-025-01014-8

Pediatr Surg Int. 2025 Mar 31;41(1):103. doi: 10.1007/s00383-025-06005-x.

ABSTRACT

PURPOSE: To compare the outcomes of transvesicoscopic Cohen ureteral reimplantation (Cohen technique, Cohen group) and transvesicoscopic Politano-Leadbetter ureteral reimplantation (Politano-Leadbetter technique, Politano-Leadbetter group) in the treatment of ureterovesical junction obstruction (UVJO) in children.

METHODS: From March 2008 to January 2024, 105 patients underwent Cohen technique and 87 underwent Politano-Leadbetter technique. The demographic data, perioperative parameters, surgical outcomes, and postoperative complications of the two groups were analyzed and compared.

RESULTS: The operation time in the Cohen group was shorter than that in the Politano-Leadbetter group (128.2 ± 30.7 vs. 143.1 ± 31.5 min, p < 0.05), but the improvement in hydronephrosis 6 months after surgery in the Politano-Leadbetter group was better than that in the Cohen group (1.48 ± 0.73 vs. 1.63 ± 0.57 cm, p < 0.05). The success rates in the two groups were similar (97.1% vs. 96.6%, p = 0.855). There was no statistical difference in postoperative hematuria time, catheter retention time, hospital stay, and improvement in ureteral dilation between the two groups.

CONCLUSIONS: Two minimally invasive surgical methods via the bladder approach for UVJO have a similar results. Compared to Cohen technique, Politano-Leadbetter technique without change the direction of the ureter, but the surgical time is longer.

PMID:40164793 | DOI:10.1007/s00383-025-06005-x

J Assist Reprod Genet. 2025 Mar 31. doi: 10.1007/s10815-025-03446-0. Online ahead of print.

ABSTRACT

PURPOSE: Optimal endometrial preparation is essential for the transfer of a euploid embryo. Recent works have shown advantages of ovulatory cycle frozen-thawed embryo transfer (Ovu-FET) for simplicity, implantation rate, and reduction of hypertensive disorders of pregnancy; however, few women over age 40 years were included in these studies. This study compared pregnancy outcomes in patients aged 40-45 years between Ovu-FET and programmed cycle FET (PC-FET).

METHODS: Retrospective cohort study in a university-affiliated fertility center. Two hundred eighty-seven FET cycles with euploid embryo transfer between 2015 and 2022 were included, with 116 cycles utilizing the PC-FET and 171 the Ovu-FET protocol. The use of letrozole was permitted for patients with irregular cycles. The primary outcome was ongoing pregnancy rate with secondary outcomes including pregnancy rate, clinical pregnancy rate, biochemical rate, and clinical loss rate. Multivariate regression was utilized to adjust for potential covariates.

RESULTS: The ongoing pregnancy rates were similar between the Ovu-FET versus PC-FET groups (62.6% vs. 58.6%, P = 0.50). Pregnancy rates (77.2% vs. 82.8%, P = 0.25) and clinical pregnancy rates (69.5% vs. 68.1%, P = 0.79) were also similar. Clinical loss rates were similar between the two groups (7.0% vs. 9.5%, P = 0.41). Biochemical loss rates were slightly lower for the Ovu-FET versus PC-FET groups (7.6% vs. 14.7%, P = 0.06) without reaching statistical significance.

CONCLUSION: Our study supports the use of Ovu-FET in women aged 40 years and older undergoing euploid embryo transfers. The results should strengthen confidence in the use of Ovu-FET for older patients.

PMID:40164791 | DOI:10.1007/s10815-025-03446-0