Tag: statistics

Mol Neurobiol. 2025 Dec 6;63(1):264. doi: 10.1007/s12035-025-05434-y.

ABSTRACT

Depression, a common psychiatric condition, is frequently associated with chronic stress. This research investigates the therapeutic benefit of chamomile (Matricaria chamomilla) against restraint stress (RS)-induced behavioral and neurobiological alterations in male mice. Animals were categorized into control, RS, and RS + chamomile (Cm) groups. Behavioral evaluation (open field, rotarod, catalepsy, memory test), histopathology, integrity of the blood-brain barrier, and gene expression profiling were done. In silico ProTox analysis confirmed the non-toxicity of chamomile compounds, including chamazulene, which also complies with Lipinski’s Rule of Five, indicating drug-like properties. Molecular docking identified robust interactions between chamazulene and prominent stress-related and other relevant targets like IFN-γ, IL-6, caspase-3, BDNF, and GLUT-1. RS exposure interfered with locomotor activity, evoked neuroinflammation, apoptosis, and compromised neuronal-glial function. Treatment with chamomile greatly enhanced locomotor function and posture, decreased catalepsy latency test, and normalized neuronal architecture. Immunofluorescence staining and transcriptional analysis indicated that chamomile suppressed pro-inflammatory cytokines (IFN-γ, IL-6), the apoptotic marker Caspase-3, and increased neurotrophic and neuronal markers (BDNF, NeuN, GFAP) and glycolytic enzymes (GLUT-1, HK-1, LDHA). These results indicate that chamomile has neuroprotective actions by regulating RS-induced inflammation, apoptosis, and metabolic dysfunction. Although no remarkable effects were seen on body or brain-to-body weight ratio, chamomile exhibited powerful behavioral and molecular effects. Overall, the results highlight chamomile, particularly its active constituent chamazulene, as a promising candidate for alleviating restraint stress. However, further clinical validation is required to establish its therapeutic potential in neuropsychiatric disorders.

PMID:41351710 | DOI:10.1007/s12035-025-05434-y

Eur Radiol. 2025 Dec 6. doi: 10.1007/s00330-025-12185-w. Online ahead of print.

ABSTRACT

OBJECTIVES: To address Croatia’s high lung cancer mortality and late-stage diagnoses, the Ministry of Health initiated a multidisciplinary effort to design a national lung cancer screening program.

MATERIALS AND METHODS: Lung cancer remains one of the leading causes of cancer-related mortality both globally and in Croatia. In 2021 alone, Croatia recorded over 3300 new cases of lung cancer and more than 2800 associated deaths, indicating a high mortality burden. In response to this public health concern, the Ministry of Health has established a multidisciplinary Lung Cancer Screening Working Group, tasked with developing a national screening approach. The Program incorporates several innovative elements, including the application of modified International Early Lung Cancer Action Program (I-ELCAP) criteria for nodule management, volumetric analysis assessed by artificial intelligence, complete digitalization, smoking cessation, and nationwide deployment to ensure equitable access.

RESULTS: From October 2020 to August 2025, over 50,000 participants were screened, resulting in more than 70,000 LDCT scans performed. The cohort includes 54% male and 46% female participants, with an average age of 62 years. Among these participants, 4.5% had positive results, which required further follow-up.

CONCLUSION: The Croatian National Lung Cancer Screening Program offers unique features as it has been comprehensively incorporated into the existing healthcare infrastructure and is fully reimbursed. A key aspect of the program is the important role assigned to general practitioners (GPs), who are responsible for identifying and referring individuals at high risk for lung cancer.

KEY POINTS: Question No European Union country has implemented a national lung cancer screening program despite evidence from previous trials showing significant mortality reduction. Findings Croatia successfully launched a fully integrated national lung cancer screening program using LDCT, AI-assisted volumetric analysis, modified I-ELCAP criteria, and GP-centered recruitment. Clinical relevance The Croatian model demonstrates the feasibility of national lung cancer screening within a European public healthcare system with full reimbursement, providing a replicable framework for other EU countries implementing lung cancer screening programs.

PMID:41351704 | DOI:10.1007/s00330-025-12185-w

Environ Monit Assess. 2025 Dec 6;198(1):16. doi: 10.1007/s10661-025-14867-w.

ABSTRACT

Urban forests play a vital role in sustainable cities by providing ecological, social, and climatic benefits. However, tree selection often emphasizes aesthetics and pollution control, overlooking resilience to extreme weather, particularly cyclones in coastal regions. This study proposes a climate-resilient tree selection framework that integrates ecological function and mechanical stability. Thirty-four commonly planted species in Bhubaneswar, a cyclone-prone city in Odisha, India, were evaluated using four indices: Air Pollution Tolerance Index (APTI), Cyclone Tolerance Index (CTI), Use Value Index (UVI), and Morphometric Character Index (MCI). APTI was derived from leaf physio-biochemical traits; CTI from cyclone damage reports and UVI and MCI from ethnobotanical surveys and morphological data. These indices were normalized and combined into an Integrated Resilience and Utility Index (IRUI) to rank species suitability for urban planting. Based on IRUI values, species were categorized into five suitability classes ranging from very high to unsuitable. Azadirachta indica was identified as very highly suitable, while eleven species including Mimusops elengi, Neolamarckia cadamba, Alstonia scholaris, and Ficus religiosa were highly suitable for cyclone-prone polluted urban environments. Regression analysis indicated positive contributions of all four indices to IRUI, ranked as CRI > APTI > MCI > UVI. This framework provides a data-driven basis for urban planners to design multifunctional, climate-resilient green spaces, supporting Sustainable Development Goal 11 (Sustainable Cities and Communities).

PMID:41351643 | DOI:10.1007/s10661-025-14867-w

Environ Monit Assess. 2025 Dec 6;198(1):15. doi: 10.1007/s10661-025-14833-6.

ABSTRACT

The Monterrey Metropolitan Area (MMA) in Northeastern Mexico, already burdened by significant industrial pollution, experienced a severe drought crisis during the 2020-2023 triple-dip La Niña. This prolonged climate anomaly triggered three major fire episodes in the Sierra Madre Oriental (SMO), sharply increasing particulate matter (PM10 and PM2.5) concentrations. To assess the impact of wildfire emissions on urban pollution, this study integrates ground-based air quality and meteorological measurements, satellite-derived data (VIIRS fire radiative power and MODIS aerosol optical depth), drought indicators from the North American Drought Monitor (NADM), and dispersion modeling using Nonparametric Wind Regression (NWR). Fire-attributable contributions increased by up to 53.3 $\mu$ gm $_{}^{–3}$ for PM10 and 12.8 $\mu$ gm $_{}^{–3}$ for PM2.5, frequently exceeding both Mexican and WHO air quality standards. On average, the three wildfires accounted for relative increases of 110% in PM10 and 49% in PM2.5 compared to non-fire conditions. These increases were linked to wind-driven smoke transport from the SMO to the MMA, demonstrating that three megafires substantially degraded urban air quality during a period of extreme drought. As climate change is expected to increase the frequency of multi-year ENSO episodes, thereby prolonging droughts and intensifying wildfire occurrence, our findings underscore the urgent need to incorporate biomass burning aerosol emissions into air quality management strategies and health impact assessments in other regions experiencing similar conditions.

PMID:41351638 | DOI:10.1007/s10661-025-14833-6

Pediatr Cardiol. 2025 Dec 6. doi: 10.1007/s00246-025-04120-z. Online ahead of print.

ABSTRACT

In pediatric cardiac critical care, patients often require specific anesthesia and sedation considerations due to unique physiological vulnerabilities. This study assessed the incidence of propofol-related infusion syndrome (PRIS) in Pediatric Cardiac Intensive Care Unit (PCICU) patients receiving continuous propofol infusion for non-procedural sedation. We conducted a retrospective review of post-operative congenital heart disease patients < 18 years admitted to the PCICU from 1/1/2000-9/30/2024, who received continuous propofol infusions ≥ 12 hours and/or ≥ 2.4 mg/kg/hour. The primary outcome was the incidence of PRIS. Secondary outcomes included intensive care unit (ICU) length of stay and survival to hospital discharge. Statistical analyses included chi-square tests and the Kruskal-Wallis test, stratified by physiological complexity (single vs. double ventricle) and surgical mortality risk scores (The Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery [STAT] score). A total of 641 patients were included. No statistically significant differences in propofol characteristics were found across physiologic or surgical risk groups. The median infusion rate was 1.2 mg/kg/hour, with a median duration of 22.7 hours. No cases of PRIS occurred. Survival to hospital discharge was 97%. The median ICU length of stay was 7.1 days. In this single center, retrospective study of post-operative congenital heart disease patients, continuous propofol infusion was not associated with any cases of PRIS. These findings support the cautious use of propofol in pediatric cardiac critical care. Further prospective studies are needed to evaluate safety across the heterogenous congenital heart disease population, including those with single ventricle physiology.

PMID:41351635 | DOI:10.1007/s00246-025-04120-z

Int J Colorectal Dis. 2025 Dec 6. doi: 10.1007/s00384-025-05048-9. Online ahead of print.

ABSTRACT

PURPOSE: Colorectal cancer (CRC) is becoming increasingly common in adults ≥ 60 years old, yet postoperative prognosis of curative-intent surgery for the advanced elderly (≥ 80 years) remains controversial.

METHODS: A retrospective cohort study included 971 CRC patients aged ≥ 60 years who underwent curative-intent surgery from January 2018 to December 2023 in Beijing Chaoyang Hospital. Patients were stratified into “ordinary elderly group” (OE) (60-79 years, n = 800) and “advanced elderly group” (AE) (≥ 80 years, n = 171). Clinicopathological variables, 30-day morbidity/mortality, disease-free survival (DFS), and overall survival (OS) were collected and analyzed the differences between the two groups. The study was presented in accordance with the STROBE reporting checklist.

RESULTS: The AE had more right-sided CRC (P < 0.001) and higher rate of preoperative obstruction (P < 0.001). They underwent more emergency (P = 0.002) and open procedures (P < 0.001), resulting in longer postoperative stays P = 0.030). Overall, 30-day morbidity was comparable (P = 0.76), but perioperative mortality rate was higher in AE (P = 0.041). The median follow-up was 36.1 ± 22.1 months, and recurrence rates (P = 0.58) and 5-year DFS (log-rank P = 0.42) did not differ between groups. Multivariate analysis identified TNM stage, perineural invasion, vascular invasion, preoperative intestinal obstruction, and proficient Mismatch Repair (pMMR) as independent predictors of DFS; age ≥ 80 years was not prognostic (p = 0.81).

CONCLUSIONS: Despite a higher burden of comorbidities and increased perioperative mortality, no statistically significant difference in long-term oncological outcomes was observed between AE and OE following rigorous patient selection and perioperative management in CRC patients. Advanced age alone should not preclude standard curative resection.

PMID:41351632 | DOI:10.1007/s00384-025-05048-9

J Robot Surg. 2025 Dec 6;20(1):58. doi: 10.1007/s11701-025-03003-y.

ABSTRACT

Distal pancreatectomy (DP) remains a technically challenging procedure associated with substantial morbidity. With the advent of robotic surgery, three primary techniques have emerged: robotic classic distal pancreatectomy (RCDP; including splenectomy), the vessel-preserving Kimura technique (KT), and the vessel-sacrificing Warshaw technique (WT). These approaches differ in splenic vessel management, leading to varying perioperative risks and long-term splenic outcomes. We performed a comprehensive meta-analysis comparing these techniques across multiple clinical endpoints. We systematically searched PubMed, Embase, and Cochrane CENTRAL from inception through December 2023, supplemented by manual citation screening. Eligible studies included randomized trials or comparative observational cohorts reporting ≥ 2 techniques with extractable data on operative time, blood loss, or spleen preservation. Data were pooled using random-effects models. Heterogeneity was assessed via I², with subgroup and sensitivity analyses conducted to explore variability. Twenty-two studies (total N ≈ 3,280), including 3 RCTs and 19 retrospective cohorts, met inclusion criteria. RCDP was associated with longer operative times compared with KT (mean difference [MD] 42.3 min, 95% CI 25.1-59.5) and WT (MD 38.7 min, 95% CI 22.4-55.0), but demonstrated reduced intraoperative blood loss versus KT (MD – 85 mL, 95% CI – 120 to – 50) and WT (MD – 78 mL, 95% CI – 110 to – 46). Spleen preservation was highest with KT (98.2%) and WT (96.5%), compared with RCDP (82.1%). No significant differences were observed in clinically relevant postoperative pancreatic fistula (POPF grade B/C), overall complications, or length of hospital stay. RCDP showed lower conversion rates (OR 0.32 vs. KT; OR 0.29 vs. WT). WT was associated with increased late complications, including gastric varices (8.3%) compared with KT (1.2%). Robotic approaches reduced splenic infarction in WT (7.6% robotic vs. 27.5% laparoscopic), and BMI > 28 kg/m², lesion size > 51 mm, and prior abdominal surgery were identified as independent predictors of conversion. RCDP offers superior hemorrhage control and lower conversion risk, but at the cost of reduced spleen preservation and longer operative time. KT and WT provide excellent spleen salvage with comparable short-term safety, though WT carries higher late splenic complication rates. Robotic platforms appear to mitigate some traditional limitations of WT, particularly splenic infarction. However, KT carries a previously underrecognized risk of splenic venous stenosis (41%), potentially leading to left-sided portal hypertension. Technique selection should be individualized based on tumor characteristics, surgical expertise, and patient-specific factors. Future randomized trials should focus on long-term splenic function and cost-effectiveness.

PMID:41351631 | DOI:10.1007/s11701-025-03003-y

Ann Emerg Med. 2025 Dec 5:S0196-0644(25)01301-0. doi: 10.1016/j.annemergmed.2025.10.007. Online ahead of print.

ABSTRACT

STUDY OBJECTIVE: Diagnosis of deep neck space infections is challenging in children due to subtle symptoms and examination findings. However, delays in diagnosis can contribute to increased morbidity in pediatric deep neck space infection. We aimed to determine (1) the most frequent discharge diagnoses associated with emergency department (ED) visits in the 10 days before deep neck space infection diagnosis and (2) use cohorts of pediatric ED visits with these frequent diagnoses to determine factors associated with return admission with deep neck space infection.

METHODS: Cross-sectional analysis of ED and inpatient visits for ages less than 18 years from the State Emergency Department and State Inpatient Datasets from 2018-2019. We linked deep neck space infection admissions (identified by primary International Classification of Diseases, Tenth Revision diagnosis J390) to 10-day antecedent ED visits and identified the most frequent discharge diagnoses in these visits. We then analyzed cohorts of ED encounters with these frequent discharge diagnoses: 1) localized neck symptoms (pain, mass, or torticollis), and 2) pharyngitis or tonsillitis; and compared patient and hospital characteristics of visits with and without a subsequent 10-day admission for deep neck space infection using descriptive statistics. Firth logistic regression was used to assess patient and hospital predictors of a deep neck space infection revisit.

RESULTS: Among 799 pediatric deep neck space infection admissions included in the study, 146 (18.3%) patients had more than or equal to 1 treat-and-release ED visits in the 10-day window before deep neck space infection admission. In the cohorts of ED treat-and-release visits for pharyngitis/tonsillitis (n=419,660) and localized neck symptoms (n=54,779), 10-day return visits for deep neck space infection were rare, representing 0.01% and 0.07% of visits, respectively. ED visits with neck imaging were associated with deep neck space infection revisit for both cohorts. Predictors of deep neck space infection in the localized neck symptoms cohort also included younger age and an ED diagnosis of fever, whereas in the pharyngitis cohort, deep neck space infection revisit was associated with ED diagnosis of localized neck symptoms, and negatively associated with a diagnosis of upper respiratory infection or respiratory symptoms.

CONCLUSIONS: In ED encounters where patients were discharged with neck pain/mass or torticollis, younger age and a diagnosis of fever were associated with a subsequent deep neck space infection admission. Among ED patients discharged with pharyngitis/tonsillitis, absence of upper respiratory infection/respiratory diagnosis, and neck pain/mass/or torticollis were associated with increased risk of return admission for deep neck space infection. Increased clinical suspicion for deep neck space infection (as manifested by laboratory findings/neck imaging at initial ED visit) was associated with increased risk of deep neck space infection revisit, representing an area for future research. Findings should be validated in datasets with more detailed clinical documentation.

PMID:41351602 | DOI:10.1016/j.annemergmed.2025.10.007

Health Technol Assess. 2025 Dec 3:1-42. doi: 10.3310/GJJL0404. Online ahead of print.

ABSTRACT

BACKGROUND: Behavioural weight management interventions are the primary treatment for obesity in the United Kingdom. These interventions focus on diet, physical activity and behaviour change, and are typically delivered over a period of 12 weeks. Although National Institute for Health and Care Excellence guidance makes recommendations on the content of behavioural weight management interventions, there are substantial variations in practice. As a result, what constitutes the most effective composition of behavioural weight management interventions is unclear.

OBJECTIVE: To determine the effectiveness of different types of behavioural weight management interventions in achieving weight loss, using individual participant data from randomised controlled trials and real-world services.

DESIGN: A network meta-analysis of individual participant data.

SETTING: Behavioural weight management interventions delivered in the community.

PARTICIPANTS: Anonymous individual participant data of adults (> 18 years), living in the United Kingdom and attending behavioural weight management interventions in the real world (n = 76,201) and randomised controlled trial’s (n = 4051).

MAIN OUTCOME MEASURE: Mean change in weight at 12 weeks.

METHODS: Two-staged Bayesian network meta-analysis of individual participant data from included randomised controlled trials and real-world services was performed. Risk of bias was assessed for randomised controlled trials using Cochrane Risk of Bias 2.0. Prior to analysis, received data were checked, for consistency with the requests and cleaned for all anomalies.

RESULTS: All behavioural weight management interventions resulted in weight loss compared to usual care. In the randomised controlled trials, the 52-week weightloss programme referrals for adults in primary care (WRAP) with participants attending intervention achieved the greatest weight reduction at 12 weeks (mean difference = -2.58 kg, 95% credible interval -3.19 to -1.96). However, when a male-only intervention (football fans in training) was included in a sensitivity analysis, it demonstrated the largest short-term weight loss (mean difference = -4.65 kg, credible interval -5.24 to -4.07). In the real-world services, several programmes achieved substantial weight loss, with greater programme attendance associated with improved outcomes.

CONCLUSIONS: The behavioural weight management intervention in both real-world services and randomised controlled trials are effective for weight loss, but there is a variation in the weight loss achieved at the end of active weight loss period depending upon the structure of intervention and participant engagement.

FUTURE WORK: Dismantling the interventions into component parts will help determine which components or combination of components are associated with greater weight loss.

FUNDING: This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number NIHR129523.

PMID:41351599 | DOI:10.3310/GJJL0404

J Phys Chem B. 2025 Dec 6. doi: 10.1021/acs.jpcb.5c05589. Online ahead of print.

ABSTRACT

Flavins (e.g., riboflavin, FMN, and FAD) are biologically ubiquitous molecules widely studied using spectroscopic techniques such as ultraviolet-visible (UV/vis), Fourier-transform infrared (FTIR), and Raman spectroscopies. Those spectroscopic methods typically involve the excitation of flavin’s vibrational modes either on the ground or excited state potential energy surfaces. In the case of UV/vis spectroscopy, this vibrational excitation is coupled to an electronic excitation and leads to a Franck-Condon progression that gives flavin its UV/vis absorption profile. To support experimental spectroscopy measurements, it is desirable to use computations that can accurately predict the vibrational frequencies for flavin’s ground and excited electronic states. However, commonly used computational approaches often rely on a harmonic approximation, which may lead to errors for modes that are not harmonic. By using time-dependent density functional theory (TD-DFT) on lumiflavin, a simplified model system to represent flavins, we mapped the ground- and excited-state potential energy surfaces computed along 3N-6 vibrational modes near the ground equilibrium structure and computed the corresponding excited-state energies along those modes. We fitted these computed potentials with second-order polynomials and used goodness-of-fit statistics as indicators of the harmonicity of vibrational modes. Among the modes that display anharmonic behavior, several are Franck-Condon active modes, which can help explain why flavin’s vertical excitation energies reported in the literature do not typically match well with the experimental wavelength of maximum absorption (λ_max). These calculations help inform future computational and experimental UV/vis, FTIR, and resonance Raman studies of flavins. Some of those potential scans also revealed low-lying conical intersections between the first and second singlet excited states. These intersections constitute potential photophysical deactivation channels that can compete with fluorescence, intersystem crossing, or photoredox chemistry when flavin is in a nonpolar environment.

PMID:41351574 | DOI:10.1021/acs.jpcb.5c05589