Tag: statistics

JAMA Netw Open. 2025 Feb 3;8(2):e2460012. doi: 10.1001/jamanetworkopen.2024.60012.

ABSTRACT

IMPORTANCE: Mental health problems often arise during adolescence and early adulthood, affecting up to 25% to 30% of young people. Enhancing the ability to identify children and adolescents at increased risk of mental health problems and uncover factors that promote mental health from childhood to adolescence is important.

OBJECTIVE: To investigate if cumulative lifestyle behaviors from childhood to adolescence are associated with perceived stress and depressive symptoms in adolescence.

DESIGN, SETTING, AND PARTICIPANTS: Prospective cohort study in Finland using baseline data collected between October 2007 and November 2009 and 8-year follow-up data collected between December 2015 and December 2017 as part of the Physical Activity and Nutrition in Children (PANIC) study of children aged 6 to 9 years. Data were analyzed from January to February 2024.

EXPOSURES: Cumulative physical activity (PA), sedentary behavior (SB), sleep, and diet quality from childhood to adolescence. PA and screen time (ST) assessed by a questionnaire; PA at different intensities, SB, and sleep duration assessed by a combined movement and heart rate sensor; diet quality assessed by 4-day food records and the Baltic Sea Diet Score computed at baseline, 2-year follow-up, and 8-year follow-up examinations.

MAIN OUTCOMES AND MEASURES: Perceived stress assessed by the Finnish version of the Cohen Perceived Stress Scale, and depressive symptoms by the Beck Depression Inventory at 8-year follow-up examinations. Linear regression analyses were used to evaluate associations between cumulative lifestyle behaviors over 8 years with the outcomes.

RESULTS: Altogether, 187 adolescents (97 boys [51.9%]; mean age, 15.8 [0.4] years) had valid data on self-reported lifestyle behaviors, and 170 adolescents had valid data on device-assessed lifestyle behaviors. Perceived stress scores ranged from 2 to 33 and depressive symptoms scores from 0 to 31. Self-reported total PA and supervised exercise were inversely associated with perceived stress (standardized regression coefficient [β] = -0.15; 95% CI, -0.31 to -0.01 and β = -0.15; 95% CI, -0.29 to -0.01, respectively) and depressive symptoms (β = -0.17; 95% CI, -0.31 to -0.02 and β = -0.14; 95% CI, -0.29 to -0.0, respectively). Total ST (β = 0.27; 95% CI, 0.13 to 0.41), computer use (β = 0.16; 95% CI, 0.01 to 0.30), and mobile device use (β = 0.28; 95% CI, 0.16 to 0.41) were positively associated with perceived stress. Total ST (β = 0.30; 95% CI, 0.15 to 0.44) and mobile device use (β = 0.33; 95% CI, 0.19 to 0.46) were positively associated with depressive symptoms.

CONCLUSIONS AND RELEVANCE: This cohort study of Finnish children and adolescents found that higher PA and lower ST from childhood were associated with perceived stress and depressive symptoms in adolescence. These findings emphasize reducing screen time and increasing PA to promote mental health in youth.

PMID:39951263 | DOI:10.1001/jamanetworkopen.2024.60012

JAMA Netw Open. 2025 Feb 3;8(2):e2460018. doi: 10.1001/jamanetworkopen.2024.60018.

ABSTRACT

IMPORTANCE: Prior studies have revealed gender differences in workplace assessments of physicians, but little is known about differences by physician gender in patients’ online written reviews.

OBJECTIVE: To analyze whether patients’ perceptions of their physicians’ interpersonal manner and technical competence differ by physician gender and practicing specialty and are associated with review star ratings.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study sampled written reviews submitted by patients between October 16, 2015, and May 27, 2020, for physicians across the US from a commercial physician rating and review website. Physicians included primary care physicians (PCPs) listed under family medicine, internal medicine, and pediatrics and surgeons listed under general surgery; orthopedic surgery; and cosmetic, plastic, and reconstructive surgery. Hand-coded reviews were used to fine-tune a natural language processing algorithm to classify all reviews for the presence and valence of patients’ comments of physicians’ interpersonal manner and technical competence. Statistical analyses were performed from July 2022 to December 2024.

EXPOSURE: Female or male physician gender.

MAIN OUTCOMES AND MEASURES: Outcomes included the presence and valence of interpersonal manner and technical competence comments and receipt of high star ratings. Multilevel logistic regressions analyzed differences by female or male physician gender in interpersonal manner and technical competence comments and whether those comments were associated with review star ratings.

RESULTS: The analysis included 345 053 written reviews of 167 150 physicians (mean [SD] age, 55.16 [11.40] years); 60 060 physicians (35.9%) were female, and 36 132 (21.6%) were surgeons. Female physicians overall had higher odds than males of receiving any (odds ratio [OR], 1.19; 95% CI, 1.16-1.22) or negative (OR, 1.22; 95% CI, 1.18-1.26) patient comments for their interpersonal manner. Among PCPs, females had higher odds than males of receiving a negative comment for interpersonal manner (OR, 1.22; 95% CI, 1.18-1.27) and, when receiving that negative comment, had disproportionately lower odds of receiving a high star rating (OR, 0.62; 95% CI, 0.53-0.73). Female physicians overall (OR, 1.09; 95% CI, 1.05-1.13) and female PCPs (OR, 1.08; 95% CI, 1.04-1.13) had higher odds than their male counterparts of receiving a negative comment for their technical competence. When receiving a negative comment for technical competence, both female PCPs (OR, 0.60; 95% CI, 0.50-0.73) and female surgeons (OR, 0.67; 95% CI, 0.50-0.89) had disproportionately lower odds of receiving a high star rating compared with their male counterparts. Female PCPs also had lower odds than male PCPs of receiving a high star rating when receiving a positive comment for technical competence (OR, 0.82; 95% CI, 0.70-0.96).

CONCLUSIONS AND RELEVANCE: In this cross-sectional study of online written reviews, female and male physician gender were differently associated with patients’ perceptions of their physicians’ interpersonal manner and technical competence. The findings suggest that patients harbored negative gender biases about the interpersonal manner of female physicians, especially female PCPs, and also assessed disproportionate penalties related to technical competence for both female PCPs and female surgeons.

PMID:39951262 | DOI:10.1001/jamanetworkopen.2024.60018

J Vet Med Educ. 2025 Feb 14:e20240117. doi: 10.3138/jvme-2024-0117. Online ahead of print.

ABSTRACT

Anatomy is a central pillar of veterinary education, and it is an ongoing goal to optimize teaching methods so that students are well-prepared for their future practice. In the present study, we investigated whether plastinated prosections could serve as valuable supplementary learning tools during organized dissection courses and for self-studies. To enable independent student use, we also created nomenclature charts describing the anatomical structures on the prosections. Our study involved 89 veterinary students in their third semester of veterinary education, studying organ-based anatomy. The teaching intervention took place during four dissection classes, where all students dissected formalin-fixed dog cadavers, and where half of the students had access to additional in-house plastinated prosections with associated nomenclature charts, while the remaining students did not. After each dissection class, the students were given an immediate knowledge test and were asked about their perceived learning benefits. Subsequently, the plastinated prosections and nomenclature charts were available for all students for self-study for exam preparation, in addition to digital access to the nomenclature charts. Our results showed that the students frequently used the learning supplements and expressed high satisfaction with the plastinated prosections and the nomenclature charts but did not perform significantly better on the knowledge tests. A postexam survey revealed that the plastinated prosections and nomenclature charts were among the top three most frequently used learning resources for the exam. In conclusion, plastinated prosections and associated nomenclature charts are valuable learning supplements in veterinary anatomy education, both during organized dissection courses and for self-studies.

PMID:39951257 | DOI:10.3138/jvme-2024-0117

Jpn J Radiol. 2025 Feb 14. doi: 10.1007/s11604-025-01748-y. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the age-related changes in magnetic resonance imaging (MRI) findings of lobular endocervical glandular hyperplasia (LEGH) during long-term follow-up.

MATERIALS AND METHODS: This multicenter study included 91 patients who underwent preoperative MRI and had a histopathological diagnosis of LEGH, atypical LEGH, or adenocarcinoma in situ (AIS) with LEGH after surgical resection. Thirty patients underwent follow-up MRIs at intervals of more than 3 months. According to the age and menopausal status, patients were categorized into four groups: group A, 31-40 years; group B, 41-50 years (premenopausal); group C, more than 50 years (premenopausal); group D, postmenopausal. Differences in the MRI findings (size and morphological pattern) were compared among the four groups.

RESULTS: The lesion volume was the largest in group C and smallest in group D, showing a statistically significant difference (p < 0.05). The typical cosmos pattern was seen in 60.0% of group A, 62.2% of group B, 75.0% of group C, and 29.2% of group D. The cosmos pattern was significantly less frequent in postmenopausal patients compared to premenopausal patients (p < 0.05). During follow-up, five of 12 individuals in group A exhibited the typical cosmos pattern. Among the seven individuals who did not initially show the cosmos pattern, two later developed the typical cosmos pattern. No changes in the lesion pattern were observed in participants in their 40 s up to the premenopausal 50 s. From the premenopausal 50 s to the postmenopausal period, the cosmos pattern changed to a microcystic pattern in one case of atypical LEGH.

CONCLUSIONS: LEGH increases in volume with age until menopause, along with an increasing frequency of the typical cosmos pattern in MRI. However, after menopause, both the volume of the lesion and frequency of the typical cosmos pattern decrease.

PMID:39951245 | DOI:10.1007/s11604-025-01748-y

Jpn J Radiol. 2025 Feb 14. doi: 10.1007/s11604-025-01747-z. Online ahead of print.

ABSTRACT

PURPOSE: To clarify the usefulness of electron density (ED) using dual-energy CT (DECT) parameters for predicting treatment response in patients with pulmonary embolism (PE).

MATERIALS AND METHODS: The study population comprised 30 patients with PE (49 thrombi) who underwent pretreatment DECT. The study coordinator diagnosed PE using contrast-enhanced CT (CECT) as the gold standard and annotated the location of thrombi on CECT prior to the DECT image analyses. CT attenuation values on conventional 120 kVp, 40 keV, and 70 keV virtual monochromatic (VM) images; effective atomic number; and ED of pretreatment pulmonary thrombi were measured on unenhanced CT. Thrombi were classified into dissolved and residual groups according to the findings of posttreatment follow-up CT. DECT parameters were compared between the two groups using the Mann-Whitney U test. For statistically significant parameters, receiver-operating characteristic (ROC) analysis was used to evaluate their performance for differentiating two groups. Diagnostic accuracy for predicting treatment response in patients with PE was determined by calculating the area under the ROC curve (AUC).

RESULTS: ED values, CT values on conventional 120 kVp imaging, and those on 70 keV VM imaging were significantly higher in thrombi in the dissolved group than the residual group (p < 0.001, p = 0.012, p = 0.009, respectively). AUC values for predicting dissolution response by ED, conventional 120 kVp imaging, and 70 keV VM imaging (cut-off value, 3.49 × 10²³/cm³, 53.4 HU, and 50.7 HU, respectively) were 0.856, 0.744, and 0.755, respectively. AUC was significantly higher for ED than for conventional 120 kVp imaging and 70 keV VM imaging (p = 0.032, p = 0.016).

CONCLUSIONS: ED derived from unenhanced DECT may help predict therapeutic efficacy in patients with PE.

PMID:39951244 | DOI:10.1007/s11604-025-01747-z

Curr Rev Musculoskelet Med. 2025 Feb 14. doi: 10.1007/s12178-025-09951-0. Online ahead of print.

ABSTRACT

BACKGROUND: Purpose of review Agili-C® (CartiHeal, Smith & Nephew) is an off-the-shelf aragonite-based (inorganic calcium carbonate) scaffold approved for clinical use in 2022 to treat chondral and osteochondral lesions eventually also in the context of mild to moderate knee osteoarthritis (Kellgren-Lawrence 0-3). The successful preclinical studies justified the subsequent clinical trials which reported both clinical and radiological significant improvements over time as well as superiority over standard surgical techniques for cartilage lesions treatment (i.e. microfractures/debridement). The aim of the present review is to summarize the available preclinical and clinical evidence and to report the current indications, surgical techniques and outcomes of this novel and innovative osteochondral scaffold.

RECENT FINDINGS: A total of six clinical reports, four single cohorts studies and a recent double arm randomized control trial followed by an analysis differentiating between femoral and trochlear lesions, have been published on Agili-C® safety and efficacy. Supported with an excellent safety profile, Agili-C® provided statistically significant clinical benefits at short and medium-term follow up in patients affected by knee joint surface lesions also when presenting in the context of mild to moderate knee osteoarthritis (Kellgren-Lawrence 0-3). Agili-C® (CartiHeal, Smith & Nephew) is an innovative aragonite-based osteochondral scaffold. It is an CE-marked and FDA approved off-the-shelf, cell-free, and cost-effective implant designed to treat knee joint surface lesions in the form of chondral and osteochondral defects. Its indications, supported by consistent clinical evidence, are single or multiple knee joint surface lesions (ICRS grade III or IV), with a total treatable area of 1-7cm², without severe knee OA (Kellgren-Lawrence grade 0-3).

PMID:39951240 | DOI:10.1007/s12178-025-09951-0

Med Biol Eng Comput. 2025 Feb 14. doi: 10.1007/s11517-025-03310-4. Online ahead of print.

ABSTRACT

Left ventricular ejection fraction (LVEF) is a critical indicator of cardiac function, aiding in the assessment of heart conditions. Accurate segmentation of the left ventricle (LV) is essential for LVEF calculation. However, current methods are often limited by small datasets and exhibit poor generalization. While leveraging large models can address this issue, many fail to capture multi-scale information and introduce additional burdens on users to generate prompts. To overcome these challenges, we propose LV-SAM, a model based on the large model SAM-Med2D, for accurate LV segmentation. It comprises three key components: an image encoder with a multi-scale adapter (MSAd), a multimodal prompt encoder (MPE), and a multi-scale decoder (MSD). The MSAd extracts multi-scale information at the encoder level and fine-tunes the model, while the MSD employs skip connections to effectively utilize multi-scale information at the decoder level. Additionally, we introduce an automated pipeline for generating self-extracted dense prompts and use a large language model to generate text prompts, reducing the user burden. The MPE processes these prompts, further enhancing model performance. Evaluations on the CAMUS dataset show that LV-SAM outperforms existing SOAT methods in LV segmentation, achieving the lowest MAE of 5.016 in LVEF estimation.

PMID:39951230 | DOI:10.1007/s11517-025-03310-4

Lasers Med Sci. 2025 Feb 14;40(1):90. doi: 10.1007/s10103-025-04350-w.

ABSTRACT

A port-wine stain (PWS) is a congenital capillary abnormality with an incidence of 0.3-0.5%. Although several other types of lasers have been used to treat PWSs, few studies have focused on the factors that affect the outcome of 577-nm yellow lasers. We aimed to assess the efficacy and prognostic factors affecting the PWS treatment by 577-nm yellow laser. This study was carried out on 42 patients with PWS. Each patient received 6-10 treatment sessions with a 577-nm yellow laser at 4-week intervals. Treatment efficacy was considered adequate when improvement of ≥ 80% of the lesion occurred. After treatment, marked improvement occurred in 7 (16.7%) patients, moderate improvement in 17 (40.5%) patients, mild improvement in 10 (23.8%) and 8 (19%) patients showed poor improvement. There was a significant association between improvement and gender of the patients and site of lesion (p = 0.028, p = 0.001, respectively). However, linear regression analysis showed that the site of the lesion can significantly predict the improvement (p < 0.001), while other baseline characteristics were not associated and cannot act as predictors for improvement. Yellow laser is a successful therapy choice for PWS, with a statistically significant improvement and minimal adverse effects. No significant association was found between improvement following laser therapy and baseline parameters, except for the location of PWS.

PMID:39951218 | DOI:10.1007/s10103-025-04350-w

Echocardiography. 2025 Feb;42(2):e70105. doi: 10.1111/echo.70105.

ABSTRACT

BACKGROUND: There are no established predictors of post-operative atrial fibrillation (POAF) in non-cardiac thoracic surgery. Pre-operative left atrial imaging has been shown to identify patients with POAF undergoing cardiac surgery. The purpose of this study was to determine whether pre-operative left atrial strain (LAS) predicts POAF in patients undergoing lung resection.

METHODS: One hundred forty-nine patients who underwent cancer lung resection were retrospectively analyzed. Pre-operative imaging involved conventional transthoracic echocardiography with comprehensive speckle-tracking strain. The additional advanced LAS analysis involved three components of atrial function: reservoir, conduit, and booster.

RESULTS: POAF occurred in 17 (11.4%) patients. We found no differences in demographics and peri-operative variables. Patients with POAF were more likely to have atrial fibrillation history (6.8% vs. 29.4%, p = 0.003). Preoperative imaging analysis revealed an increased LA volume index in patients with POAF (25.9 ± 8.8 vs. 32.3 ± 11.9 mL/m², p = 0.046). All three components of LAS were reduced in the POAF group. The most prominent reduction was reservoir-compliance strain (35.5% ± 4.6% vs. 24.2% ± 6.6%, p < 0.001), then conduit strain (-18.3% ± 8.7% vs. -12.6% ± 4.7%, p < 0.001), and booster strain (-18.3% ± 8.7% vs. -12.6% ± 4.7%, p < 0.001). On univariable analysis, LAS reservoir strain was associated with POAF status (OR: 0.86 [95% CI: 0.78-0.92]), with a c-index of 0.81. Optimized multivariable model considering left atrial volume index, reservoir LAS, and atrial fibrillation history improved c-statistic to 0.880.

CONCLUSION: Reduced LAS metrics are more specific and sensitive than conventional demographics and standard echocardiography in predicting POAF. Preoperative LA imaging might aid with identifying patients undergoing lung resection who are high-risk and benefit from prophylactic therapy.

PMID:39950391 | DOI:10.1111/echo.70105

Dis Esophagus. 2025 Jan 7;38(1):doaf008. doi: 10.1093/dote/doaf008.

ABSTRACT

Esophageal neuroendocrine carcinoma (ENEC) is an uncommon and highly aggressive tumor with an obscure etiology. Thus, this study aimed to investigate the best treatment option for patients with ENEC. This study identified patients with ENEC from the Surveillance, Epidemiology, and End Results (SEER) database between 1975 and 2021. Clinicopathological characteristics were analyzed using descriptive statistics, and prognostic factors were determined through Cox regression analysis. Kaplan-Meier survival analysis was used to assess five-year overall survival (OS). Patients were divided into a combined radiotherapy and chemotherapy group and a surgery group based on treatment modality. Propensity score matching (PSM) was performed to balance baseline characteristics between the two groups. A total of 604 participants were included; univariate and multivariate analyses indicated that ENEC patients with localized or regional disease had significantly higher survival rates (HR = 0.38, 95% CI 0.29-0.51, P < 0.001 and HR = 0.56, 95% CI 0.44-0.71, P < 0.001) than those with distant metastases. The combination of radiotherapy and chemotherapy (HR = 0.34, 95% CI 0.25-0.46, P < 0.001) and surgical treatment (HR = 0.43, 95% CI 0.31-0.59, P < 0.001) significantly improved survival. Kaplan-Meier analysis showed significant differences in OS among treatments (P < 0.0001), with the combination therapy and surgery groups having similar rates of 7.04% and 8.77%, respectively, and outperforming other methods. The combination therapy group maintained the best survival rate over time. The synergistic application of radiotherapy and chemotherapy has markedly enhanced the five-year survival rate of patients with ENEC, offering invaluable insights for clinical management strategies.

PMID:39950356 | DOI:10.1093/dote/doaf008