Tag: statistics

AIDS Behav. 2025 Jan 2. doi: 10.1007/s10461-024-04601-x. Online ahead of print.

ABSTRACT

In the US, gay, bisexual, and other sexual minoritized men (GBSMM) remain disproportionately impacted by HIV, and continue to experience unmet needs for pre-exposure prophylaxis (PrEP). A growing body of literature has underscored the need to consider the geographic factors of HIV prevention, particularly beyond administrative boundaries and towards localized spaces that influence the accessibility and utilization of health-promoting resources. Therefore, the purpose of this study is to examine the associations of driving times from activity spaces to PrEP offering facilities and individual PrEP uptake. A total of 218 GBSMM (ages 18-34) from Connecticut and Georgia were sampled from a longitudinal cohort study. We used the getis-ord-gi statistic to examine the spatial clustering of PrEP offering facilities, and generalized estimating equations (GEE) and post-hoc moderation analyses to explore the state interactions on driving time and PrEP uptake. Our main findings suggest that for participants in Connecticut, state of residence was a significant moderator on driving time and ever hearing of PrEP and ever taking PrEP. Whereas for participants in Georgia, state of residence moderated the likelihood of returning to activity spaces of participants in both Connecticut and Georgia on PrEP uptake. These findings provide important direction for geographic inequities on PrEP use, but also a pragmatic method for co-creating and re-imagining place-health research. These results also offer an avenue to leverage the dynamic nuance of activity spaces as indicators to inform structural interventions for PrEP that are more equitable for GBSMM in small cities and towns in the U.S.

PMID:39745597 | DOI:10.1007/s10461-024-04601-x

Am J Physiol Gastrointest Liver Physiol. 2025 Jan 2. doi: 10.1152/ajpgi.00343.2024. Online ahead of print.

ABSTRACT

This study aimed to determine if local injection of CXCL12 reduces sphincter fibrosis, restores sphincter muscle content, vascularization, and innervation, and recruits progenitor cells in a rabbit model of anal sphincter injury and incontinence. Adult female rabbits were assigned to 3 groups: uninjured/no treatment (control), injured/treated (treated), and injured/no treatment (untreated) (n=4 each). Injured groups were anesthetized and a section of external anal sphincter was removed at the 9:00 o’clock position. The treated sphincters were injected with 200ng of human recombinant CXCL12 six weeks after injury and necropsy was performed six weeks post treatment. The external anal sphincter was removed, fixed, embedded in paraffin, sectioned, and mounted to slides for histologic analysis of collagen and muscle content and fiber characteristics; innervation, vascularization and progenitor cell content. Compared to controls untreated had significantly decreased total skeletal muscle, indistinct muscle layers, and disorganized circumferential and inner longitudinal layers at the injury site. Untreated also had significantly increased collagen fiber density at the injury site compared to treated and controls. Cells staining positive for CD34 within the skeletal muscle layer were increased in treated and untreated compared to controls. Staining density for markers of nerves and vascular endothelium, cells staining positive for CD34 within the mucosa/submucosae, and cells staining positive for PAX7 were similar among all groups. Local injection of CXCL12 reduces post-injury fibrosis and results in statistically similar muscle content and organization between treated animals and controls. Further studies are needed for this promising new treatment for post-parturient anal sphincter injury.

PMID:39745592 | DOI:10.1152/ajpgi.00343.2024

Neurol Sci. 2025 Jan 2. doi: 10.1007/s10072-024-07961-3. Online ahead of print.

ABSTRACT

BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) has shown potential in alleviating hemiplegic shoulder pain (HSP) and improving upper limb function, yet its efficacy remains debated. This study aims to assess the effectiveness of rTMS for HSP through a systematic review and meta-analysis.

METHODS: Four databases were searched with the keywords “rTMS” and “HSP”. Adults aged 18 years and older with post-stroke HSP were included. The primary outcomes were pain scores and upper limb function scores, and the secondary outcomewas the incidence of adverse events. The risk of bias was assessed through the ROB tool in Review Manager 5.4.1, and statistical analysis was primarily conducted through this software.

RESULTS: A total of 52 articles were identified from PubMed, Embase, Cochrane Library, and CNKI. Following literature screening, 11 studies were included in the analysis. The quality of the included studies was moderate.The studies encompassed 584 patients with post-stroke HSP and their average age was 62. The analysis revealed that rTMSwas significantly more effective in relieving pain compared to the control group (SMD = -1.14, p < 0.01), and low-frequency rTMSwas superior to high-frequency rTMS. In terms of improving upper limb function, rTMSwas also significantly more efficacious compared to the control group (SMD = 2.20, p < 0.01), and low-frequency and high-intensity rTMSwere more beneficial.

CONCLUSIONS: This study highlights the potential efficacy of rTMS. However, the heterogeneity among included studies, limited sample sizes, and lack of long-term follow-up data restrict the generalizability of the results.

PMID:39745590 | DOI:10.1007/s10072-024-07961-3

Pediatr Radiol. 2025 Jan 2. doi: 10.1007/s00247-024-06138-6. Online ahead of print.

ABSTRACT

BACKGROUND: Image-defined risk factors (IDRFs) were introduced to provide a consensus approach for pre-treatment risk stratification on computed tomography (CT) and magnetic resonance imaging (MRI) in patients with neuroblastoma.

OBJECTIVE: To assess the intra- and inter-reader agreement of radiologists in identifying IDRFs on CT.

MATERIALS AND METHODS: Approval for this retrospective study was granted by our institutional research ethics board with a waiver of consent. CT studies of pediatric patients with neuroblastoma were assessed by seven radiologists in two rounds. Each CT was accompanied by a standard form to indicate presence or absence of IDRFs for each patient. At least a 4-week period between rounds, randomization, and relabeling of the CT studies was required to minimize recall bias. Finally, three of the seven radiologists conducted a subsequent consensus reading to determine true positive IDRFs in the cohort. Fleiss’ kappa statistic was used to evaluate readers’ agreements and Pearson’s correlation assessed the correlation between years of experiences of radiologists and their performance in accurately (intra-reader agreement) detecting IDRFs.

RESULTS: A total of 31 children with a median age of 2.1 years (interquartile range (IQR) 1.1, 3.0; range 0-18; male=21 (67.7%)) were included and 251 total positive IDRFs were identified on their CT scans. The location of the primary tumor was in the neck in 1 patient (3.2%), within the chest in 2 patients (6.5%), within the abdomen in 27 patients (87.1%), and in the pelvis in 1 patient (3.2%). In determining IDRFs, the inter-reader agreement among radiologists was substantial: 0.65 (95% CI 0.60, 0.69) and the intra-reader agreement for each radiologist was substantial to near perfect, ranging from 0.67 (0.60, 0.70) to 0.86 (0.82, 0.90). The correlation between the number of years of experience of radiologists and their performances in accurately detecting IDRFs (their intra-reader agreements) was respectively low (r=45, P=0.30) for abdomino-pelvic IDRFs and high for organs’ infiltration IDRFs (r=0.74, P=0.05).

CONCLUSION: The determination of IDRFs on CT is reproducible with significant agreement among radiologists. The two IDRF items with the lowest overall inter-reader agreements were “diaphragm infiltration” and “mesenteric infiltration.”

PMID:39745539 | DOI:10.1007/s00247-024-06138-6

Abdom Radiol (NY). 2025 Jan 2. doi: 10.1007/s00261-024-04788-6. Online ahead of print.

ABSTRACT

OBJECTIVE: This study investigates the diagnostic value of Vesical Imaging Reporting and Data System (VI-RADS) in biparametric MRI (bp-MRI) for the detection of muscular infiltration in bladder cancer, and to investigate whether apparent diffusion coefficient (ADC) value can function as a potential indicator of bp-MRI VI-RADS for patient benefit.

MATERIALS AND METHODS: This single-center retrospective study enrolled 81 patients with pathologically confirmed bladder cancer from October 2019 to November 2021. Two readers independently scored the T2-weighted images and diffusion-weighted images of each index lesion based on the VI-RADS criteria, subsequently deriving the bp-MRI VI-RADS scores. Both ADC values and bp-MRI VI-RADS scores were utilized to develop a simple model by logistic regression. Receiver-operating characteristic curve assessed all systems, while decision curve analysis (DCA) and calibration curves evaluated the model’s performance.

RESULTS: The area under the curve (AUC) of bp-MRI VI-RADS was 0.886 (95% confidence interval [CI]: 0.801-0.971), with the diagnostic accuracy, sensitivity, and specificity being 0.753, 0.962, and 0.655 respectively. Regarding the ADC value, its AUC was 0.899 (95% CI: 0.821-0.977), and the diagnostic accuracy, sensitivity, and specificity were 0.877, 0.846, and 0.891. The AUC of the simple combined model achieved 0.942 (95% CI: 0.881-0.999), and the diagnostic accuracy, sensitivity, and specificity were 0.889, 0.885, and 0.891. The DeLong test verified that there was a statistically significant difference in AUC between the model and bp-MRI VI-RADS alone (P < 0.05). The simple model demonstrated excellent clinical applicability via DCA and calibration plots.

CONCLUSIONS: The contrast-free bp-MRI VI-RADS demonstrates commendable diagnostic efficacy for diagnosing muscular infiltration in bladder cancer. Additionally, ADC values can complement bp-MRI VI-RADS, enhancing diagnostic performance.

PMID:39745530 | DOI:10.1007/s00261-024-04788-6

Int J Legal Med. 2025 Jan 2. doi: 10.1007/s00414-024-03404-y. Online ahead of print.

ABSTRACT

This study aimed to test age-related changes in sternal fusion and sternal-rib cartilage ossification on multi-slice computed tomography (MSCT) images of the Croatian population. The additional aim was to develop models to estimate age and provide an interface for the model’s application and validation. This retrospective study was conducted on 144 MSCT images of the sternal region, and the developed models were tested on 36 MSCT images. We scored manubrium-mesosternal joint fusion (FM), xiphoid process and mesosternum fusion (FX), ossification of the first costal cartilage (OF), ossification of the second to seventh costal cartilages at the rib ends (OR), and ossification of the second to seventh costal cartilages at the sternal ends (OS). All sternal-rib cartilage ossification phases and sternal body and xiphoid process fusion scores showed statistically significant age differences (P < 0.001), except manubrium-mesosternal joint fusion. The final model that combined regression and classification using FM, FX, OR, OS, and sex obtained a 95% prediction interval (PI) coverage of 94.46% on the cross-validation (cv) and 91.67% on the test set with an average PI width of 42.29 and 42.95 years respectively. We also developed a Python Flask app called CroSterna: Age estimation from sternal fusion and rib ossification in the Croatian population ( https://crosterna.onrender.com/ ) to facilitate the estimation for professionals.

PMID:39745528 | DOI:10.1007/s00414-024-03404-y

J Neurophysiol. 2025 Jan 2. doi: 10.1152/jn.00490.2024. Online ahead of print.

ABSTRACT

Background: Despite a significant genetic component to insomnia (heritability: 22-25%), the genetic loci that modulate insomnia risk remain limited. Methods: We employed the Unified Test for Molecular Markers (UTMOST) for transcriptome-wide association studies (TWAS) across various tissues, integrating summary statistics from a Genome-Wide Association Study (GWAS) of 462,341 European participants with gene expression data from the Genotype-Tissue Expression (GTEx) project. Three validation methods (FUSION, FOCUS, and MAGMA) were used to confirm important genes. Tissue and functional enrichment analyses of insomnia-related single nucleotide polymorphisms (SNPs) were conducted with MAGMA. Conditional and joint analyses, along with fine mapping, were used to enhance our understanding of insomnia’s genetic architecture. Mendelian randomization was employed to assess causal associations between significant genes and insomnia. Results: Two novel susceptibility genes, VRK2 and MMRN1, were identified as linked to insomnia risk using four TWAS approaches. Mendelian randomization analysis suggests VRK2 increases the risk of insomnia. Tissue enrichment analyses indicated that insomnia-related SNPs were enriched in specific brain regions, including the cerebellum, frontal cortex (BA9), hypothalamus, and hippocampus. Conditional and joint analyses identified two genomic regions (2p16.1 and 4q22.1). Functional enrichment analyses showed that pathways related to insomnia involve the SMAD2/3 pathway, synaptic function, and oxidative stress. Conclusion: This study identifies two new candidate genes, VRK2 and MMRN1, that may contribute to insomnia risk through neurodevelopment, neuroinflammation, and synaptic function, suggesting potential therapeutic targets.

PMID:39745514 | DOI:10.1152/jn.00490.2024

Clin J Sport Med. 2025 Jan 1;35(1):67-74. doi: 10.1097/JSM.0000000000001245. Epub 2024 Jul 9.

ABSTRACT

OBJECTIVE: To determine if any gradual onset running-related injury (GORRI) was associated with any allergies, multiple allergies (allergies to animals, plants, medication), and allergy medication use.

DESIGN: Cross-sectional descriptive study.

SETTING: Two Oceans Marathons (56 km, 21.1 km), South Africa.

PARTICIPANTS: A total of 76 654 race entrants (2012-2015).

INDEPENDENT VARIABLES: The prevalence (%) and prevalence ratios (PR; 95% confidence intervals) for history of (1) any allergies, (2) multiple allergies to broad categories of allergens (animal material, plant material, allergies to medication, and other allergies), and (3) allergy medication use.

MAIN OUTCOME MEASURES: Using a compulsory online screening questionnaire, the outcome was a history of any GORRIs, and subcategories of GORRIs (muscle, tendon) in the past 12 months and history of GORRIs (and subtypes of GORRIs) were reported.

RESULTS: In 68 258 records with injury and allergy data, the following were significantly associated with reporting any GORRIs: a history of any allergy (PR = 2.2; P < 0.0001), a history of allergies to broad categories of allergens (animal, plant, medication allergy, other) ( P < 0.0001), and the use of allergy medication ( P < 0.0001). A history of any allergies (PR = 2.4; P < 0.0001), all broad categories of allergies, and allergy medication use were significantly associated with muscle ( P < 0.0001) and tendon injuries ( P < 0.0001). The risk of reporting a GORRI increased as the number of reported categories of allergies increased ( P < 0.0001).

CONCLUSIONS: A novel finding was the cumulative risk effect with a history of multiple allergies. Further studies should aim to determine the underlying mechanism relating allergies and GORRIs.

PMID:39745513 | DOI:10.1097/JSM.0000000000001245

Clin Trials. 2025 Jan 2:17407745241304059. doi: 10.1177/17407745241304059. Online ahead of print.

ABSTRACT

BACKGROUND: Clinical trials handle a huge amount of data which can be used during the trial to improve the ongoing study conduct. It is suggested by regulators to implement the remote approach to evaluate clinical trials by analysing collected data. Central statistical monitoring helps to achieve that by employing quantitative methods, the results of which are a basis for decision-making on quality issues.

METHODS: This article presents a scoping review which is based on a systematic and iterative approach to identify and synthesise literature on central statistical monitoring methodology. In particular, we investigated the decision-making processes (with emphasis on quality issues) of central statistical monitoring methodology and its place in the clinical trial workflow. We reviewed papers published over the last 10 years in two databases (Scopus and Web of Science) with a focus on data mining algorithms of central statistical monitoring and its benefit to the quality of trials.

RESULTS: As a result, 24 scientific papers were selected for this review, and they consider central statistical monitoring at two levels. First, the perspective of the central statistical monitoring process and its location in the study conduct in terms of quality issues. Second, central statistical monitoring methods categorised into practices applied in the industry, and innovative methods in development. The established methods are discussed through the prism of categories of their usage. In turn, the innovations refer to either research on new methods or extensions to existing ones.

DISCUSSION: Our review suggests directions for further research into central statistical monitoring methodology – including increased application of multivariate analysis and using advanced distance metrics – and guidance on how central statistical monitoring operates in response to regulators’ requirements.

PMID:39744904 | DOI:10.1177/17407745241304059

Environ Sci Process Impacts. 2025 Jan 2. doi: 10.1039/d4em00376d. Online ahead of print.

ABSTRACT

Background: Exposure to particulate matter <2.5 μm (PM_2.5) is linked to chronic obstructive pulmonary disease (COPD), but most studies lack individual PM_2.5 measurements. Seasonal variation and their impact on clinical outcomes remain understudied. Objective: This study investigated the impact of PM_2.5 concentrations on COPD-related clinical outcomes and their seasonal changes. Methods: A multicentre panel study enrolled 105 COPD patients (age range: 46-82) from July 2019 to August 2020. Their mean forced expiratory volume in 1 second after bronchodilation was 53.9%. Individual PM_2.5 levels were monitored continuously with indoor measurements at residences and outdoor data from the National Ambient Air Quality Monitoring Information System. Clinical parameters, including pulmonary function tests, symptom questionnaires (CAT and SGRQ-C), and impulse oscillometry (IOS), were assessed every three months over the course of one year. Statistical analysis was conducted using a linear mixed-effect model to account for repeated measurements and control for confounding variables, including age, sex, smoking status and socioeconomic status. Results: The mean indoor and outdoor PM_2.5 concentrations were 16.2 ± 8.4 μg m^-3 and 17.2 ± 5.0 μg m^-3, respectively. Winter had the highest PM_2.5 concentrations (indoor, 18.8 ± 11.7 μg m³; outdoor, 22.5 ± 5.0 μg m^-3). Higher PM_2.5 concentrations significantly correlated with poorer St. George’s Respiratory Questionnaire for COPD (SGRQ-C) scores and increased acute exacerbations, particularly in winter. Patients of lower socioeconomic status were more vulnerable. Increased PM_2.5 concentrations were also associated with amplified small airway resistance (R5-R20). Conclusions: PM_2.5 concentration changes are positively correlated with poorer SGRQ-C scores and increased acute exacerbations in COPD patients with significant seasonal variations, especially in winter.

PMID:39744880 | DOI:10.1039/d4em00376d