Tag: statistics

Dig Dis Sci. 2025 Dec 24. doi: 10.1007/s10620-025-09622-7. Online ahead of print.

ABSTRACT

BACKGROUND: Recurrent common bile duct (CBD) stones after endoscopic retrograde cholangiopancreatography (ERCP) is a significant clinical issue. While the association between serum lipid levels and gallstones has been established, its impact on recurrent CBD stone is less clear. This study aims to investigate the association between serum lipid levels and recurrent CBD stone, further subclassified into different subgroups. We also try to explore effective drugs to decrease the occurrence of recurrent CBD stone.

MATERIALS AND METHODS: This multi-institutional study acquired patients’ data from Chang Gung Memorial Hospitals using Chang Gung Research Database (CGRD) from 2002/1/1 to 2020/12/31. We analyzed the association between metabolic risk factors and recurrent CBD stone after ERCP using propensity score matching and then subclassified these patients into cholecystectomy, cirrhosis, and hyperlipidemia. Additionally, medications aimed at controlling serum lipid levels were investigated for their potential to reduce the recurrence rate of CBD stones.

RESULTS: Totally, 5132 patients were enrolled. Our results showed that higher cholesterol level and HbA1C above 6.5% are risk factors of CBD stone recurrence after ERCP when using propensity score matching. However, triglyceride (TG) and high-density lipoprotein (HDL) were presented as protective factors. These metabolic factors may be variable in different subgroups. Additionally, statin and aspirin might be effective drugs to reduce CBD stone recurrence rate.

CONCLUSIONS: Serum lipid level and HbA1C were found to be associated with recurrent CBD stone after ERCP but variable in different subgroups. Statin and aspirin might reduce the risk of CBD stone recurrence.

PMID:41444847 | DOI:10.1007/s10620-025-09622-7

Environ Geochem Health. 2025 Dec 24;48(2):66. doi: 10.1007/s10653-025-02940-9.

ABSTRACT

In recent years, India has witnessed an alarming rise in air pollution levels, raising growing concerns among health and environmental experts. This study evaluates the inhalation cancer risk associated with fine particulate matter (PM_2.5) bound polycyclic aromatic hydrocarbons (PAHs) in two rapidly developing yet under-monitored regions of India. Ambient air samples were analyzed for 16 priority PAHs, and the carcinogenic risk was assessed using Incremental Lifetime Cancer Risk (ILCR) estimates through Monte Carlo simulations for both adults and children. The results indicated season and site-specific variations in PAH concentrations, with winter months showing higher cumulative BaP equivalent (BaPeq) levels. Adults consistently exhibited higher ILCR values than children, exceeding the acceptable risk threshold of 1 × 10^-6 in several scenarios.Global sensitivity analysis using the Sobol’ method revealed that BaPeq concentration, exposure duration, and body weight were the most influential parameters affecting ILCR outcomes. Statistical validation using ANOVA and Tukey’s post-hoc test confirmed significant seasonal and demographic variability. These findings emphasize the need for refined toxicity values and exposure inputs to improve human health risk assessments in India. This work combines field monitoring, probabilistic modelling, and uncertainty-based analysis to support evidence-driven air quality management, aligning with the goals of India’s clean air strategies.

PMID:41444846 | DOI:10.1007/s10653-025-02940-9

Ann Surg Oncol. 2025 Dec 24. doi: 10.1245/s10434-025-18735-2. Online ahead of print.

ABSTRACT

BACKGROUND: Organ preservation is gaining attention, yet primary treatment approaches differ substantially between pT1 and pT2 colon cancer (CC). This study evaluates whether tumor invasion depth affects survival outcomes in patients with pT1-2N0-2 colon cancer.

METHODS: In this nationwide cohort study, patients undergoing surgery for pT1 or pT2 CC between 2014 and 2015 were identified from the Dutch Snapshot Research Group’s SNAPSHOT complex colon cancer database. Five-year disease-free survival (DFS) and overall survival (OS) was analyzed using Kaplan-Meier curves, log-rank tests, and Cox proportional hazard models.

RESULTS: A total of 2312 patients were included (921 pT1 and 1391 pT2). Five-year DFS (83.5% vs. 83.2%, P = 0.79, adjusted HR [HR_adj] pT2 vs. pT1: 0.9; 95% confidence interval [CI] 0.7-1.2) and 5-year OS (84.9% vs. 85.6%, P = 0.72, HR_adj pT2 vs. pT1: 0.8; 95% CI 0.6-1.1) were comparable between pT1N0 and pT2N0 patients. Similarly, in pT1N+ and pT2N+ patients, there was no significant difference in DFS (81% vs. 75.8%, P = 0.31, HR_adj pT2 vs. pT1: 1.3; 95% CI 0.6-2.6) or OS (84% vs. 82.5%, P = 0.73, HR_adj pT2 vs. pT1: 0.9; 95% CI 0.5-1.6). Distant metastases developed in 37 (4%) pT1 patients and 68 (4.9%) pT2 patients (P = 0.33). Among these, 26 of 37 pT1 patients (70.3%) and 40 of 68 pT2 patients (58.8%) did not have lymph node metastases in the initial resection specimen (pN0).

CONCLUSIONS: Tumor invasion depth (pT1 or pT2) had no significant impact on DFS or OS following formal oncological resection. Furthermore, most distant metastases develop in pN0 patients, suggesting a minor influence of surgery on control of distant disease.

PMID:41444843 | DOI:10.1245/s10434-025-18735-2

Tech Coloproctol. 2025 Dec 24. doi: 10.1007/s10151-025-03254-9. Online ahead of print.

ABSTRACT

INTRODUCTION: In sacral neuromodulation (SNM), the stimulation intensity is set at the sensory threshold (ST) level. However, subsensory stimulation as low as 50% of ST has proven effective in reducing faecal incontinence episodes.

AIM: To explore the relationship between functional outcomes and varying subsensory stimulation amplitude in newly implanted patients.

METHOD: This randomised, double-blind study was designed to include patients with ≥ 1 faecal incontinence episodes/week despite maximal conservative therapy. As part of another trial, patients were offered a one-stage procedure. Postoperatively, patients were randomised into two groups. G-1 received stimulation at 0.05 V, at 50% and 90% of the ST in three 4-week periods, followed by 12 weeks of stimulation at the ST. G-2 received stimulation at 90% of the ST in three 4-week periods, followed by 12 weeks of stimulation at ST. Patients were evaluated after each period using St. Marks’s Incontinence Score and a visual analogue scale (VAS) for patient satisfaction regarding social function, bowel function and quality-of-life, along with a bowel habit diary.

RESULTS: In total, 73 patients with a median age of 60 years [interquartile range (IQR: 50-69 years)] completed the trial. Faecal incontinence episodes were significantly reduced at all follow-ups, with no differences between groups. The only statistical difference between groups was deltaVAS for bowel function after 4 weeks. In G-1 with ultra-low stimulation amplitude [0.05 V – equivalent to 9.6% (IQR: 6.5-13.4) of ST], the improvement compared with baseline was 30 points (IQR: 10-50) significantly lower than G-2 with an improvement of 50 points (IQR: 10-70) (p-value: 0.05).

CONCLUSIONS: Subsensory stimulation is feasible in newly implanted patients with faecal incontinence. An amplitude of 0.05 V is as effective on the functional outcomes as stimulation with higher amplitudes.

PMID:41444840 | DOI:10.1007/s10151-025-03254-9

Alzheimers Dement. 2025 Dec;21 Suppl 3:e099806. doi: 10.1002/alz70857_099806.

ABSTRACT

BACKGROUND: Elevated central arterial stiffness is a risk factor for amnestic mild cognitive impairment (aMCI) and dementia, but the pathophysiological mechanisms underlying the relationship between vascular health and cognitive decline in patients with aMCI remain unclear. We examined the cross-sectional relationship between central arterial stiffness, brain default mode network functional connectivity (DMN-FC), and cognitive function in patients with aMCI.

METHOD: Participants aged 55-80 years, either cognitively normal or diagnosed with aMCI, and without major neurological, vascular, metabolic, or psychiatric diseases, were recruited. Data was analyzed from 21 cognitively normal (age 65.9±7.0) and 48 adults with aMCI (age 64.1±5.9). Central arterial stiffness was measured using carotid-femoral pulse wave velocity (cfPWV) and carotid β-stiffness via applanation tonometry and ultrasonography. DMN-FC was assessed with resting-state fMRI and seed-based correlation analysis, using the posterior cingulate cortex (PCC) as the seed. Episodic memory and executive function were evaluated with California Verbal Learning Test (CVLT) and Wisconsin Card Sorting Test (WCST). Data was analyzed using multiple variable linear regression and mediation analysis.

RESULT: Carotid β-stiffness index was slightly higher in aMCI patients (8.9±2.1) compared to cognitively normal older adults (8.0±1.7), but the difference was not statistically significant. Higher carotid β-stiffness index was associated with higher DMN-FC between the PCC and right precentral gyrus (PcG) in the cognitively normal (B=0.02, r² = 0.373, p = 0.003) and aMCI group (r² = 0.260, p = 0.0002). Higher DMN-FC between the PCC and right PcG was associated with worse CVLT performance in the aMCI group (B=-27.10, p = 0.012, 95%CI = -47.91, -6.30). Higher carotid β-stiffness index was associated with worse CVLT performance (B=-1.55, p = 0.045, 95%CI=-3.08, -0.03) and worse WCST performance (B=-2.62, p = 0.068, 95%CI = -5.45, 0.20) in the aMCI group. Higher DMN-FC between the PCC and right PcG mediated the association between higher carotid β-stiffness index and worse CVLT performance in the aMCI group.

CONCLUSION: Our findings suggest that elevated central arterial stiffness may impair cognitive performance in patients with aMCI through alterations in DMN functional connectivity, potentially reflecting compensatory mechanisms. These findings underscore the importance of addressing vascular health as part of efforts to prevent or delay cognitive decline in aging populations, particular those at risk of dementia.

PMID:41444801 | DOI:10.1002/alz70857_099806

Alzheimers Dement. 2025 Dec;21 Suppl 3:e101375. doi: 10.1002/alz70857_101375.

ABSTRACT

BACKGROUND: Neuropsychiatric symptoms (NPS), such as depression and anxiety, are common in the early stages of Alzheimer’s disease (AD). These symptoms often appear before cognitive decline becomes evident, posing significant challenges for patients and caregivers. Despite their prevalence, the underlying mechanisms of NPS remain poorly understood, particularly in underserved populations.

METHOD: A retrospective cohort study will utilize REDGESAM’s electronic clinical records, focusing on patients aged 50 and older diagnosed with mild cognitive impairment (MCI) or subjective cognitive decline (SCD). Data sources include standardized neuropsychiatric scales and brain imaging reports. Advanced statistical analyses, including regression modeling, will assess associations between NPS, imaging findings, and cognitive decline.

RESULT: This study anticipates identifying key correlations between NPS and brain imaging markers such as hippocampal volume and white matter integrity. These findings will provide a deeper understanding of how early psychiatric symptoms align with biological changes in the brain.

CONCLUSION: By leveraging REDGESAM’s robust data, this research will inform targeted interventions for depression and anxiety in AD, improve patient outcomes, and contribute to dementia care strategies worldwide.

PMID:41444800 | DOI:10.1002/alz70857_101375

Sci Rep. 2025 Dec 24. doi: 10.1038/s41598-025-33517-2. Online ahead of print.

ABSTRACT

Short-term rainfall forecasting presents a complex spatiotemporal modeling challenge, critical for adaptation and mitigation of high-impact hydrometeorological events such as flash floods and cloudbursts. This study examines hourly rainfall patterns in the Northwest Himalayan (NWH) region of India, enhancing forecasting accuracy using spatial correlations. The region shows a significant decline in hourly rainfall trends over the period 2019-2024, with approximately 50% of the area exhibiting statistically significant decreasing trends. The analysis reveals that high-elevation regions exhibit stronger initial 1-hour lag correlation (>0.8) and a rapid temporal decay over 9 hours. In contrast, lower-altitude areas (below 600 m) display a more gradual decrease in correlation, suggesting broader spatial influence with less intense propagation. Across all locations, rainfall variability as defined by statistically significant correlations, typically dissipates within 6 to 7 hours. Our analysis further identifies a prominent belt of high rainfall coherence aligned along the central Himalayan zone, highlighting pronounced spatial homogeneity. To improve predictive performance, this study proposes an attention-guided spatial correlation mechanism integrated within a Deformable Convolutional Long Short-Term Memory (DConvLSTM) framework. The proposed model, termed SARITA, processes hourly rainfall and spatial correlations, with the attention mechanism dynamically using spatial dependencies. This integration enhances the model’s ability to generalize across spatial-temporal patterns. Model evaluation using statistical metrics demonstrates that SARITA consistently outperforms baseline models such as ConvLSTM and standard DConvLSTM, achieving a 25% improvement in hourly rainfall forecasts. Furthermore, the model also improves anomaly detection by 3.5% over the standard DConvLSTM model.

PMID:41444798 | DOI:10.1038/s41598-025-33517-2

Sci Rep. 2025 Dec 24;15(1):44547. doi: 10.1038/s41598-025-28320-y.

ABSTRACT

Living with diabetes over an extended period impacts not only physical health but also the psychosocial well-being of patients. Diabetes distress is a widespread concern affecting individuals with diabetes mellitus across all age groups, cultures, and populations. Given its significance in effective disease management, identifying modifiable factors that contribute to diabetes distress is essential for developing targeted interventions. This study was therefore undertaken to examine the prevalence and associated determinants of diabetes distress among patients receiving care at the University of Gondar Comprehensive Specialized Referral Hospital in northwest Ethiopia. An institution-based cross-sectional study was conducted from August to September 2021. A systematic random sampling technique was employed to select 376 diabetes patients. A structured, pretested, interviewer-administered questionnaire was used to collect data. The data was entered in Epi Info version 7, analyzed using SPSS version 21, and presented using frequencies, percentages, tables, and graphs. Bivariable and multivariable analyses were investigated using a binary logistic regression model. Finally, variables with a P value < 0.05 were declared statistically significant. A total of 364 diabetes patients participated in the current study, making a response rate of 96.8%. Of the 364 participants, 45.6% (95% CI (40.1-50.8%)) of them had moderate to high levels of diabetes distress. Having type 1 DM [AOR = 3.03, 95% CI (1.71, 5.37)], rural residency [AOR = 2.73, 95% CI (1.55, 4.79)], insulin injection only [AOR = 2.38, 95% CI (1.73, 4.39)], and poor family support [AOR = 2.76, 95% CI (1.73, 4.39)] were associated with increased odds of diabetes distress. The prevalence of diabetes distress among diabetes patients was high. Having type 1 DM, rural residency, using insulin injection only, and having poor family support were significantly associated with diabetes distress. It is better to combine the assessment for diabetes distress as part of regular actions for diabetes care and give attention to modifiable factors like family support. To improve outcomes, healthcare policies should prioritize integrating psychosocial support into diabetes management programs, especially in rural settings, and train providers to routinely screen for diabetes distress.

PMID:41444790 | DOI:10.1038/s41598-025-28320-y

Sci Rep. 2025 Dec 24. doi: 10.1038/s41598-025-28954-y. Online ahead of print.

ABSTRACT

A newly developed handheld device, the IC01 transpalpebral tonometer, was engineered to determine intraocular pressure (IOP) autonomously through upper eyelid palpation. This study aimed to evaluate the repeatability of the IC01 and to investigate its agreement with a non-contact tonometer (TOPCON CT-800). A comparative design was employed to analyze the agreement in IOP measurements between the innovative IC01 device and both the non-contact (TOPCON CT-800) and rebound (iCare IC200) tonometers, as well as its repeatability. Trained operators recorded measurements from 189 subjects at both the initial and one-month follow-up visits, adhering to a randomized sequence. IOP measurements from the IC01 showed no statistically significant difference from those obtained with the iCare IC200 or TOPCON CT-800. Repeatability, indicated by the intraclass correlation coefficient, averaged 0.77 for right eyes and 0.75 for left eyes. Furthermore, the mean IOP values at the one-month follow-up were 8.65 ± 4.15 mmHg for the right eye and 7.68 ± 2.61 mmHg. No sight-threatening adverse events occurred. Regarding patient preference among a subset of 69 respondents, 46.37% (n = 32) favored the IC01, compared to 17.39% (n = 12) for the TOPCON CT-800, while 36.23% (n = 25) expressed no preference. Gender did not show a significant correlation with outcomes. However, participants aged 50 years or younger demonstrated a greater preference for the IC01 (χ² = 5.68, P = 0.012). The IC01 tonometer demonstrated clinical equivalence to established devices, showing superior repeatability and higher patient acceptance. Its distinctive practical advantages include the avoidance of corneal contact, operational independence from a clinician, and a design suitable for self-monitoring in a home environment.

PMID:41444789 | DOI:10.1038/s41598-025-28954-y

Alzheimers Dement. 2025 Dec;21 Suppl 4:e096332. doi: 10.1002/alz70858_096332.

ABSTRACT

BACKGROUND: Lecanemab, an anti-amyloid monoclonal antibody, modestly slows cognitive decline in early Alzheimer’s disease but may cause adverse events, including amyloid-related imaging abnormalities due to edema (ARIA-E) or hemorrhage (ARIA-H). A small percentage of ARIA-E and ARIA-H cases may be disabling or fatal. As lecanemab becomes available, understanding clinician communication of its benefits and risks to patients and caregivers is crucial. This qualitative study investigates clinician communication of lecanemab’s risks and benefits to support patient and caregiver decision-making.

METHODS: We conducted semi-structured interviews with clinicians who prescribe anti-amyloid therapy at seven academic medical centers. An interdisciplinary research team used hybrid inductive-deductive thematic analysis.

RESULTS: 27 clinicians completed interviews (Women [n = 17], White [n = 19], Neurologists [n = 20]). Three preliminary themes emerged. First, clinicians used varied approaches to describe the therapy’s benefits and risks. They used analogies to explain lecanemab’s mechanisms and discussed statistical outcomes from the CLARITY-AD clinical trial, often stating ‘this is not a cure.’ While all clinicians communicated the risks, they differed in how much they emphasized or de-emphasized their clinical impact, particularly ARIA. Second, patient contextual factors shaped communication. Clinicians personalized conversations based on patients’ comorbidities, caregiver support, treatment hopes and fears, and eligibility criteria fit. Third, For example, while clinicians honor patients’ choices to pursue treatment, many do not routinely ‘recommend’ it (but may recommend against it given particular patient factors).

CONCLUSIONS: Clinicians at the forefront of lecanemab treatment use a variety of communication approaches to discuss benefits and risks. These insights can guide future interventions to improve communication and decision-making for lecanemab.

PMID:41444782 | DOI:10.1002/alz70858_096332