Tag: statistics

Int J Cardiovasc Imaging. 2025 Nov 21. doi: 10.1007/s10554-025-03556-x. Online ahead of print.

ABSTRACT

PURPOSE: Exercise stress echocardiography (ExE) includes assessment of regional wall motion and EKG changes and, not uncommonly, discordant results are observed. Though stress induced wall motion abnormalities are widely considered positive for presence of ischemia, EKG-only positive studies are dismissed as equivocal/false positive, in which case, further evaluation is appropriate.

METHODS: Patients who had undergone a clinically indicated ExE and subsequent coronary CT angiogram (CCTA) within one month were identified. They were categorized based on the discordant results of the echocardiographic and electrocardiographic components of the study (EKG+/ECHO-, EKG-/ECHO+). The CCTA results were classified using CAD-RADS 2.0. CT fractional flow assessment was performed for 30-90% stenosis lesions.

RESULTS: 197 patients with discordant ExE results were identified (EKG+/ECHO- n = 159, EKG-/ECHO + n = 38). 35.2% of the EKG+/ECHO- group were classified as CAD-RADS 3 or greater (28.9% left anterior descending, 12.6% left circumflex, and 15.1% right coronary artery moderate/severe stenoses). Of the EKG-/ECHO + patients, 23.7% were classified as CAD RADS 3 or greater (15.8% left anterior descending, 5.3% left circumflex, and 10.5% right coronary artery moderate/severe stenoses). No statistically significant difference was observed between the two groups in the overall degree of coronary artery disease.

CONCLUSIONS: Discordant ExE results with ST segment depressions during exercise without regional wall motion abnormalities (EKG+/ECHO-) and discordant ExE results without ST segment changes with stress-induced regional wall motion abnormalities (EKG-/ECHO+) are both associated with a clinically relevant burden of coronary artery disease, without a statistically significant difference in the degree or severity between the two groups.

PMID:41266719 | DOI:10.1007/s10554-025-03556-x

Sci Rep. 2025 Nov 20;15(1):41093. doi: 10.1038/s41598-025-24989-3.

ABSTRACT

Endoscopic skull base surgery has transformed craniofacial treatment by reducing morbidity and enhancing precision. Traditional outcome measures often overlook the multidimensional aspects of quality of life (QoL) in recovery. Patient-reported tools, such as the anterior skull base questionnaire (ASBQ), offer a comprehensive view of QoL. However, the ASBQ’s effectiveness is limited in non-English-speaking populations without cultural adaptation. This study aims to culturally adapt and psychometrically validate the Persian version of the anterior skull base questionnaire (ASBQ-P) for patients undergoing transnasal transsphenoidal surgery. Translation and cross-cultural adaptation adhered to ISPOR guidelines, encompassing forward and backward translation, expert review, and cognitive debriefing. Internal consistency was evaluated through Cronbach’s α, and test-retest reliability was assessed using intraclass correlation coefficients (ICCs). Convergent validity was assessed using Pearson’s correlation with SNOT-22 scores, while responsiveness was evaluated through effect sizes and standardized response means. Statistical analyses were performed using SPSS version 27, with a significance threshold set at P < 0.05. A total of 36 patients completed the Persian version of the ASBQ and SNOT-22 questionnaires. The ASBQ demonstrated excellent internal consistency (Cronbach’s α = 0.936). Test-retest reliability was high, with an ICC of 0.927 for average measures. Convergent validity was supported by a significant moderate negative correlation between ASBQ and SNOT-22 scores (r=-0.544, P = 0.001). A known-groups validity analysis revealed significant differences in ASBQ scores across SNOT-22 severity categories (P = 0.001), supporting the instrument’s discriminative capacity. Our findings confirm the Persian ASBQ as a reliable and valid tool for assessing outcomes in anterior skull base surgery.

PMID:41266717 | DOI:10.1038/s41598-025-24989-3

Sci Rep. 2025 Nov 20;15(1):41029. doi: 10.1038/s41598-025-24883-y.

ABSTRACT

Perimenopause is a high-risk period for depressive symptoms in women. Investigating the urban-rural differences in key factors associated with depressive symptoms among Chinese perimenopausal women can provide a scientific basis for developing targeted intervention strategies. Using data from the 2020 wave of the China Health and Retirement Longitudinal Study (CHARLS), we employed a random forest model combined with Shapley value decomposition (a cooperative-game-theoretic approach that quantifies each variable’s marginal contribution to model accuracy), supplemented by logistic regression analysis, to systematically explore urban-rural differences in key factors influencing depressive symptoms in perimenopausal women. Among 1,105 perimenopausal women, the overall prevalence of depressive symptoms was 39.3%, with 34.4% in urban areas and 42.4% in rural areas. Life satisfaction, self-rated health, and sleep duration emerged as common factors affecting depressive symptoms in both urban and rural perimenopausal women. Chronic disease, hospitalization history, children’s financial support, and child contact were unique key factors influencing depressive symptoms in urban women. In contrast, activities of daily living (ADL), cognitive function, and total annual household income were unique key factors influencing depressive symptoms in rural women. Significant urban-rural differences exist in the key factors associated with depressive symptoms among Chinese perimenopausal women. Policy makers should therefore design context-specific mental-health programmes. for example, urban initiatives could integrate chronic-disease management with family-based psychosocial support, whereas rural programmes might combine economic-security improvements with community-level cognitive-health screening and rehabilitation of activities of daily living-to maximise intervention effectiveness.

PMID:41266681 | DOI:10.1038/s41598-025-24883-y

Lasers Med Sci. 2025 Nov 21;40(1):489. doi: 10.1007/s10103-025-04747-7.

ABSTRACT

This in vitro study aimed to evaluate the shear bond strength of four different bioactive restorative materials to dentin prepared using either a high-speed bur or Er, Cr: YSGG laser. A total of 120 extracted human molars were divided into two groups (n = 60) based on dentin surface preparation: high-speed diamond bur or Er,Cr:YSGG laser (3 W, 20 Hz, 70% H₂O, 60% air). Each group was further divided into four subgroups (n = 15) according to the restorative material: Group I-glass hybrid (EQUIA Forte HT), Group II-bioactive resin composite (Activa BioActive-Restorative), Group III-giomer (Beautifil II), and Group IV-alkasite (Cention Forte). Materials were applied per manufacturers’ instructions using a standardized Teflon mold system. After 24 h, shear bond strength was tested with a universal testing machine at 1.0 mm/min. One sample per group was examined under SEM to assess the resin-dentin interface. Data were analyzed using two-way ANOVA and Games Howell post hoc test (p < 0.05). Group IV showed the highest bond strength in both surface treatments, while Group I had the lowest (p < 0.05). In Group II, laser treatment resulted in a statistically significant reduction in bond strength compared to bur-prepared surfaces (p < 0.05), whereas surface preparation had no significant effect on the bond strength of the remaining groups. Adhesive failures were most common, though cohesive failures were more frequent in Group II-Bur and Group I-Laser. The bonding performance of bioactive restorative materials was influenced by both their composition and the dentin surface preparation method. Cention Forte showed the most reliable adhesion on both bur- and laser-prepared dentin, whereas EQUIA Forte HT exhibited lower bonding performance.

PMID:41266675 | DOI:10.1007/s10103-025-04747-7

Eur Radiol. 2025 Nov 20. doi: 10.1007/s00330-025-12158-z. Online ahead of print.

ABSTRACT

OBJECTIVES: Severe coronary artery calcification leads to blooming artifacts in conventional coronary CT angiography (CCTA), which may reduce diagnostic accuracy. Ultra-high resolution (UHR) photon-counting detector CT (PCD-CT) reduces calcium blooming. This study aimed to evaluate the diagnostic performance of UHR CCTA with PCD-CT for detecting coronary stenoses in patients with a high coronary calcium burden compared to invasive coronary angiography (ICA).

MATERIALS AND METHODS: In this IRB-approved single-center study, patients with Agatston scores > 600 were included, who underwent ICA and coronary UHR PCD-CT angiography within 2 months. 94% of patients underwent CT prior to transcatheter aortic valve replacement. Coronary arteries were graded for diameter stenosis severity (> 50, > 70%) by two blinded, independent readers. Accuracy, sensitivity, and specificity of CCTA were calculated using ICA as the reference standard. Subgroup analyses were performed across Agatston score groups (600-999, 1000-1999, 2000-2999, and > 3000).

RESULTS: 62 patients (mean age, 76 ± 9 years, 16 women) were included. The median Agatston score was 2423 (IQR: 1085-3340). Across all Agatston categories, CCTA demonstrated high diagnostic accuracy and strong agreement with ICA (Cohen’s kappa 0.71-1.00). In patients with Agatston scores > 3000 (n = 18), the diagnostic performance of coronary UHR PCD-CT angiography for detecting > 50% (sensitivity 92-100%, specificity 83-100%) and > 70% diameter stenosis (sensitivity 88-100%, specificity 89-100%) remained high for both readers. There was no correlation between the Agatston score and diagnostic error (p > 0.05).

CONCLUSION: UHR CCTA with PCD-CT provides high diagnostic performance even in patients with extensive coronary calcifications.

KEY POINTS: Question In patients with severe coronary calcification, conventional coronary CT angiography often suffers from blooming artifacts, reducing accuracy and causing unnecessary invasive procedures. Findings Ultra-high resolution coronary angiography with photon-counting detector CT showed high sensitivity and specificity for detecting stenoses, even at Agatston scores > 3000. Clinical relevance Ultra-high resolution coronary CT angiography enables accurate noninvasive detection of stenoses in heavily calcified vessels, potentially reducing invasive coronary angiography.

PMID:41266671 | DOI:10.1007/s00330-025-12158-z

Eur Radiol. 2025 Nov 20. doi: 10.1007/s00330-025-12026-w. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the diagnostic performance of image-guided puncture in differentiating malignant from benign peritoneal lesions.

MATERIALS AND METHODS: An independent literature search was conducted across multiple English medical databases, including PubMed, Embase, Web of Science, Cochrane Library and Ovid. The diagnostic accuracy of image-guided puncture was compared against postoperative pathology and diagnostic laparoscopy, which served as reference standards. The diagnostic performance of imaging-guided puncture was evaluated by calculating pooled sensitivity, specificity, diagnostic odds ratio (DOR), and the area under the curve (AUC). Subgroup analyses were conducted based on imaging modality, type of puncture, and the risk assessment derived from the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2).

RESULTS: Fifteen eligible studies, comprising a total sample of 1208 patients with 1165 peritoneal lesions, were included in the analysis. The pooled sensitivity of image-guided puncture for differentiating malignant from benign peritoneal lesions was 93% (95% confidence intervals (CI): 91-95%), with a specificity of 95% (95% CI: 92-97%), a DOR of 149.02 (95% CI: 78.47-282.99), and an AUC of 0.97.

CONCLUSION: Overall, this meta-analysis demonstrates that image-guided puncture is a minimally invasive and safe technique with high diagnostic accuracy, regardless of the imaging modality, puncture method, or lesion type (mass or diffuse infiltration). It offers a reliable alternative to invasive biopsy for diagnosing peritoneal lesions. Subgroup analysis revealed no significant differences in diagnostic efficacy across the evaluated parameters.

KEY POINTS: Question The diagnosis of peritoneal lesions remains challenging due to the inherent complexity and invasiveness of traditional diagnostic laparoscopy, as well as overlapping imaging features of routine imaging examinations. Findings Image-guided puncture is a minimally invasive and safe technique with high diagnostic accuracy, irrespective of the imaging modality used, the puncture method, or the type of peritoneal lesion. Clinical relevance Image-guided puncture is recognized as a safe, minimally invasive, and highly sensitive diagnostic tool, which can reduce patient discomfort compared to diagnostic laparoscopy. In most clinical scenarios, it represents a reliable and effective alternative to this invasive procedure.

PMID:41266670 | DOI:10.1007/s00330-025-12026-w

Eur J Radiol. 2025 Nov 17;194:112533. doi: 10.1016/j.ejrad.2025.112533. Online ahead of print.

ABSTRACT

BACKGROUND: Lister’s tubercle (LT) is a palpable bony prominence on the distal radius and is in close proximity to the extensor pollicis longus (EPL) tendon. Despite its clinical relevance, detailed knowledge regarding its morphological variations, anatomical relationships, and developmental aspects remains limited. This study aims to evaluate the morphological variants of LT and its anatomical relationships with EPL using wrist magnetic resonance imaging (MRI), and to propose a novel classification system with potential clinical implications.

MATERIALS AND METHODS: A total of 302 wrist MRI scans (138 males, 164 females; age range 18-44 years) were retrospectively analyzed. Morphometric measurements were recorded, and a five-type classification system with subtypes based on peak prominence and shape was developed. Statistical analyses evaluated morphometric differences by gender, side, and variant type.

RESULTS: Five main LT types were identified: Type 1 (48.34 %) with a dominant radial peak, Type 2 (23.18 %) with a dominant ulnar peak, Type 3 (4.30 %) with only a ulnar peak, Type 4 (20.86 %) with only a radial peak, and Type 5 (3.31 %) with no crest formation. Significant gender-based differences were found in several morphometric parameters, with generally larger measurements in males (p < 0.001). Strong correlations were noted between LT peak heights and EPL positioning, with the groove’s depth and EPL alignment largely determined by the relative height of radial and ulnar peaks.

CONCLUSION: This study highlights previously underappreciated morphological diversity of LT and proposes a clinically relevant classification. These anatomical variations may influence the risk of EPL injury, especially during distal radius fracture management and surgical interventions. Preoperative imaging evaluation of LT type may improve surgical planning and outcomes.

PMID:41264984 | DOI:10.1016/j.ejrad.2025.112533

Eur J Radiol. 2025 Nov 17;194:112541. doi: 10.1016/j.ejrad.2025.112541. Online ahead of print.

ABSTRACT

PURPOSE: To identify an interchangeable pulmonary regurgitant measure in repaired tetralogy of Fallot by comparing pulmonary regurgitant volume and fraction between serial cardiac computed tomography (CT) and magnetic resonance imaging (MRI).

METHODS: A total of 40 patients (42 paired studies, age at CT examination: 18.6 ± 6.0 years) who underwent cardiac CT and MRI for the cardiac function assessment within 1 year were retrospectively evaluated. The pulmonary regurgitant volume and fraction quantified using CT volumetry were compared and correlated with the values quantified using phase-contrast imaging (reference standard). Furthermore, the degree of agreement between the methods was analyzed using Bland-Altman plot.

RESULTS: No statistically significant difference in the indexed pulmonary regurgitant volume was found between CT volumetry and phase-contrast imaging (p > 0.152). Compared with phase-contrast imaging, CT and MRI volumetry significantly underestimated the pulmonary regurgitant fraction (p = 0.001) and significantly overestimated the right ventricular stroke volume (p < 0.001). These parameters demonstrated high correlations between the two methods (R = 0.632-0.742, p < 0.001). With phase-contrast imaging as reference standard, the bias and 95 % limits of agreement in the indexed pulmonary regurgitant volume and fraction were 2.4 mL/m² and -18.7 to 23.5 mL/m² and -6.3 % and -26.5 to 14.0 %, respectively.

CONCLUSION: The indexed pulmonary regurgitant volume is an interchangeable measure of pulmonary regurgitation on serial cardiac CT and MRI enabling monitoring its severity in repaired tetralogy of Fallot.

PMID:41264982 | DOI:10.1016/j.ejrad.2025.112541

Eur J Radiol. 2025 Nov 15;194:112518. doi: 10.1016/j.ejrad.2025.112518. Online ahead of print.

ABSTRACT

OBJECTIVES: Background parenchymal enhancement (BPE) and mammographic density (MD) are imaging biomarkers derived from contrast-enhanced mammography (CEM). However, unlike MD, the consistency of BPE across consecutive examinations in pre- and postmenopausal women has remained unexplored.

MATERIALS AND METHODS: A computational search was conducted for all screening CEM exams performed at our facility between December-2012 and January-2024 to identify patients with at least five consecutive negative annual screenings. BPE grades and MD categories were extracted from the official radiology reports, and their variability parameters were statistically compared both between these factors and across age groups.

RESULTS: Forty-five eligible patients at premenopausal age-group were identified (mean age at first scan 38.2 ± 3.4 years, range: 27-42) and a matched postmenopausal age-group was assembled (mean age at first scan 63.7 ± 3.8 years, range: 60-74), resulting in 450 CEMs analyzed. BPE demonstrated greater variability than MD, including fluctuations of at least one category on the scale (71.1-91.1 %), two-category changes (17.8-22.2 %), and transitions between low and high binary categories (17.8-27.7 %) (P < 0.01 for all). Similar rates of two-category BPE transitions (P = 0.65) and shifts between low and high binary categories (P = 0.32) were observed in pre- and postmenopausal women; however, the latter group had a significantly smaller proportion of cases with five consistent grades (P = 0.02).

CONCLUSION: BPE on CEM demonstrates greater longitudinal variability than MD across all age groups and is not more pronounced in premenopausal compared to postmenopausal women. This highlights its dynamic nature and underscores the need for caution when considering BPE in clinical decision-making or as a biomarker, while also suggesting that strict menstrual cycle phase targeting may be less critical.

PMID:41264977 | DOI:10.1016/j.ejrad.2025.112518

Sci Total Environ. 2025 Nov 19;1008:180964. doi: 10.1016/j.scitotenv.2025.180964. Online ahead of print.

ABSTRACT

Phytomining is a sustainable mineral extraction method that employs metal-tolerant hyperaccumulator plant species to recover metals from surface soils. Our preliminary study explored the survivability and effectiveness of rare earth element (REE) hyperaccumulators of 45 species when grown in naturally occurring REE-rich soil sourced from Idaho, finding that Idaho native grass Pseudoroegneria spicata is an effective REE hyperaccumulator. This study then evaluated the REE hyperaccumulation ability of P. spicata and Phalaris arundinacea, assessing the performance of seven varieties within each species. Plants were grown in a greenhouse and harvested biomass was ashed or pyrolyzed, acid digested, and characterized by elemental analysis. Results showed that P. spicata and P. arundinacea accumulated an average of 26,044 and 27,761 μg/g total mixed REEs in their shoot tissues, respectively. Species and variety were found to mostly have a significant effect on dry biomass yield while tissue type (root vs. shoot) significantly impacted internal plant REE concentration, with roots accumulating more than shoots. This study concludes that using these hyperaccumulating grass species, especially P. spicata, for Idaho-based phytomining has promise and should be further studied and developed.

PMID:41264944 | DOI:10.1016/j.scitotenv.2025.180964