Tag: statistics

Magn Reson Med. 2025 Feb 4. doi: 10.1002/mrm.30462. Online ahead of print.

ABSTRACT

PURPOSE: Accurate analysis of metabolite levels from ¹H MRS data is a significant challenge, typically requiring the estimation of approximately 100 parameters from a single spectrum. Signal overlap, spectral noise, and common artifacts further complicate the analysis, leading to instability and reports of poor agreement between different analysis approaches. One inconsistently used method to improve analysis stability is known as regularization, where poorly determined parameters are partially constrained to take a predefined value. In this study, we examine how regularization of frequency and linewidth parameters influences analysis accuracy.

METHODS: The accuracy of three MRS analysis methods was compared: (1) ABfit, (2) ABfit-reg, and (3) LCModel, where ABfit-reg is a modified version of ABfit incorporating regularization. Accuracy was assessed on synthetic MRS data generated with random variability in the frequency shift and linewidth parameters applied to each basis signal. Spectra ( N = 1000 $$ N=1000 $$ ) were generated across a range of SNR values (10, 30, 60, 100) to evaluate the impact of variable data quality.

RESULTS: Comparison between ABfit and ABfit-reg demonstrates a statistically significant (p < 0.0005) improvement in accuracy associated with regularization for each SNR regime. An approximately 10% reduction in the mean squared metabolite errors was found for ABfit-reg compared to LCModel for SNR >10 (p < 0.0005). Furthermore, Bland-Altman analysis shows that incorporating regularization into ABfit enhances its agreement with LCModel.

CONCLUSION: Regularization is beneficial for MRS fitting and accurate characterization of the frequency and linewidth variability in vivo may yield further improvements.

PMID:39902605 | DOI:10.1002/mrm.30462

Afr J Reprod Health. 2025 Jan 31;29(1):15-24. doi: 10.29063/ajrh2025/v29i1.2.

ABSTRACT

This study evaluated the effectiveness of the open glottis breathing technique during the second stage of labor among 600 primigravida women, randomly assigned to either an open glottis group (n=300) or a closed glottis group (n=300). Participants in the open glottis group received training via 3D animated videos. Results demonstrated a significant impact on perineal integrity, with 20.7% of women in the experimental group reporting an intact perineum compared to just 1.7% in the control group. Additionally, the open glottis group experienced shorter labor durations and a decrease in severe neonatal asphyxia, as indicated by improved APGAR scores compared to the closed glottis group. Statistical analysis using the χ² test revealed a highly significant difference in perineal conditions between the two groups, with a χ² value of 65.7 (p < 0.000). The study also identified a significant association between maternal age, residence, and income with the reduction of perineal tears (p < 0.000). Overall, the findings suggest that the modified open glottis breathing technique effectively prevents perineal trauma, shortens the duration of the second stage of labor, and enhances neonatal outcomes. These results highlight the potential benefits of integrating this technique into labor management practices to improve maternal and neonatal health.

PMID:39902604 | DOI:10.29063/ajrh2025/v29i1.2

Circ Cardiovasc Imaging. 2025 Feb 4:e017156. doi: 10.1161/CIRCIMAGING.124.017156. Online ahead of print.

ABSTRACT

BACKGROUND: Infective endocarditis (IE) can be challenging to diagnose. Positron emission tomography/computed tomography (PET/CT) with 2-deoxy-2-[¹⁸F]-fluoro-d-glucose ([¹⁸F]FDG) is recommended as a diagnostic tool in the guidelines, but holds limitations. The aim of this study was to compare the tracer uptake between the novel [⁶⁴Cu]Cu-DOTATATE, which has low cardiac uptake and does not require fasting or dietary restrictions, and [¹⁸F]FDG in patients with IE and examine the sensitivity and specificity.

METHODS: The CuDOS study (Cu-Dotatate Positron Emissions Tomography in Infective Endocarditis) was a prospective study including 20 patients with IE (10 with prosthetic valve endocarditis and 10 with native valve endocarditis) and 20 controls. All participants underwent [⁶⁴Cu]Cu-DOTATATE and [¹⁸F]FDG PET/CT. Scans were read blinded to clinical data. Tracer uptakes were measured as maximum standardized uptake values in each heart valve. Differences were tested with Wilcoxon rank tests.

RESULTS: The median age of the cases and controls was 68 years (interquartile range [IQR], 55.0-75.5) and 61 years (IQR, 57.0-69.5), respectively. [⁶⁴Cu]Cu-DOTATATE uptake (median maximum standardized uptake value [IQR]) in patients with IE was higher than in controls (2.34 [1.40-3.23] versus 1.44 [1.21-1.60]; P =0.008), although this difference was mainly driven by prosthetic valve endocarditis cases (3.23 [2.02-3.86]; P <0.001) and not between native valve endocarditis cases and controls (1.51 [1.23-2.58]; P=0.428). The sensitivity of [⁶⁴Cu]Cu-DOTATATE and [¹⁸F]FDG PET/CT in 20 cases versus 20 controls were equal, and the specificity was 90% and 75%, respectively. The analysis of prosthetic valve endocarditis versus the 20 controls showed equal sensitivity (80%), and a specificity of 90% and 75%, respectively (P =0.38). In addition, a greater proportion of scans achieved diagnostic certainty with [⁶⁴Cu]Cu-DOTATATE PET/CT compared with [¹⁸F]FDG PET/CT for native valve endocarditis, prosthetic valve endocarditis, and controls.

CONCLUSIONS: [⁶⁴Cu]Cu-DOTATATE PET/CT showed uptake in the infected valve in patients with IE, and has major advantage as it does not require any preparation compared with [¹⁸F]FDG. [⁶⁴Cu]Cu-DOTATATE had a numerically higher specificity than [¹⁸F]FDG, although the difference was not statistically significant. Both tracers were limited in the detection of native valve endocarditis.

REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT05432427. www.clinicaltrialsregister.eu; Unique identifier: 2021-005501-27.

PMID:39902600 | DOI:10.1161/CIRCIMAGING.124.017156

Proc Inst Mech Eng H. 2025 Feb 4:9544119251315877. doi: 10.1177/09544119251315877. Online ahead of print.

ABSTRACT

Generative deep learning has emerged as a promising data augmentation technique in recent years. This approach becomes particularly valuable in areas such as motion analysis, where it is challenging to collect substantial amounts of data. The objective of the current study is to introduce a data augmentation strategy that relies on a variational autoencoder to generate synthetic data of kinetic and kinematic variables. The kinematic and kinetic variables consist of hip and knee joint angles and moments, respectively, in both sagittal and frontal plane, and ground reaction forces. Statistical parametric mapping (SPM) did not detect significant differences between real and synthetic data for each of the biomechanical variables considered. To further evaluate the effectiveness of this approach, a long-short term model (LSTM) was trained both only on real data (R) and on the combination of real and synthetic data (R&S); the performance of each of these two trained models was then assessed on real test data unseen during training. The principal findings included achieving comparable results in terms of nRMSE when predicting knee joint moments in the frontal (R&S: 9.86% vs R: 10.72%) and sagittal plane (R&S: 9.21% vs R: 9.75%), and hip joint moments in the frontal (R&S: 16.93% vs R: 16.79%) and sagittal plane (R&S: 13.29% vs R: 14.60%). The main novelty of this study lies in introducing an effective data augmentation approach in motion analysis settings.

PMID:39902572 | DOI:10.1177/09544119251315877

Circ Cardiovasc Imaging. 2025 Feb 4:e016851. doi: 10.1161/CIRCIMAGING.124.016851. Online ahead of print.

ABSTRACT

BACKGROUND: Immune checkpoint inhibitors (ICIs), though revolutionary in cancer treatment, may accelerate atherosclerosis by inducing arterial inflammation. Due to a lack of controlled studies, the capacity of arterial 2-deoxy-2-[¹⁸F]fluoro-D-glucose ([¹⁸F]FDG) uptake in patients with cancer to detect this arterial inflammation remains unclear.

METHODS: Arterial [¹⁸F]FDG uptake at 6 anatomic landmarks was assessed on serial positron emission tomography scans in patients with cancer treated at a German University Hospital between January 2010 and May 2023. Patients aged ≥65 years with at least 4 sequential scans within 30 months were included. Linear mixed regression analyses were used to evaluate the change in arterial tracer uptake in patients who received ICI or not.

RESULTS: Of the 156 patients included, 50 (30.1%) received ICIs after the baseline scan. Baseline arterial [¹⁸F]FDG uptake correlated with traditional cardiovascular risk factors, such as body mass index and male sex. Cross-sectional analyses suggested a negative effect of cholesterol-lowering medication on arterial [¹⁸F]FDG uptake at follow-up. In a time-dependent interaction analysis, arterial [¹⁸F]FDG uptake increased by 0.8% annually in patients without ICIs (95% CI, 0.2%-1.4%), potentially reflecting the background progression of arterial inflammation in patients with cancer. In ICI users, [¹⁸F]FDG uptake increased by 2.5% annually (95% CI, 1.7%-3.3%; P=0.001 for interaction with no ICI). Higher annual increase rates in ICI users were consistent across several anatomic landmarks, preexisting cardiovascular disease status, arterial calcification status, and concomitant chemotherapy or steroid use. However, this effect did not reach statistical significance in patients with melanoma and those with prior irradiation therapy.

CONCLUSIONS: This is the first controlled clinical study supporting the role of ICIs in accelerating atherosclerosis through low-grade arterial inflammation. However, although detectable by repeated [¹⁸F]FDG scans, the increase in tracer uptake associated with ICI use was modest compared with individual variability, questioning whether [¹⁸F]FDG captures the full pathophysiological process of ICI-induced, lymphocyte-driven inflammation.

PMID:39902567 | DOI:10.1161/CIRCIMAGING.124.016851

Ann Surg. 2025 Feb 4. doi: 10.1097/SLA.0000000000006645. Online ahead of print.

ABSTRACT

OBJECTIVE: Although pancreatic ductal adenocarcinoma (PDAC) is still a devastating disease, the survival rate for surgically removed PDACs has significantly improved in recent years. Early detection is essential in managing PDAC.

SUMMARY BACKGROUND DATA: The presence of KRAS mutations in PDAC leads to the initial genetic abnormality and offers a significant timeframe for identifying resectable PDACs. A minimally invasive and highly specific PDAC screening test is necessary to prevent the need for invasive follow-up tests.

METHODS: Between July 2021 and March 2023, 169 cases were enrolled in 7 institutions. By administering secretin before esophagogastroduodenoscopy (EGD), the excretion of pancreatic juice into the papillary fluid can be stimulated, creating a resource for testing. Washing fluid was collected using a specialized catheter from control individuals (n=75) and patients with resectable PDAC (n=89) at the initial diagnosis. A highly sensitive technique was employed to study KRAS gene mutations.

RESULTS: This study obtained an AUC of 0.934 [95%CI: 0.904, 0.964] when using KRAS mutations in duodenal lavage fluid to differentiate between patients with resectable PDAC and healthy controls. The estimated sensitivities were calculated with specificity set at 100%, resulting in a sensitivity of 83.1% [95%CI: 71.7%, 91.2%]. The McNemer test showed a significantly higher sensitivity for KRAS mutations than serum CEA and CA19-9 (P<0.0001).

CONCLUSIONS: We created a method to identify resectable PDACs by analyzing KRAS mutation levels in duodenal fluid collected during EGD with secretin stimulation of pancreatic juice secretion.

PMID:39902566 | DOI:10.1097/SLA.0000000000006645

Int J Lab Hematol. 2025 Feb 4. doi: 10.1111/ijlh.14434. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the significance of cell population data parameters (CPD) in dengue positive individuals.

METHODOLOGY: A retrospective cross-sectional study was conducted at the National Institute of Blood Disease and Bone Marrow Transplantation (NIBD and BMT), Karachi, Pakistan from July 2022 to September 2022 (in a period of 3 months of peak dengue fever outbreak). Dengue fever is a viral infection that is transmitted from mosquitoes to humans. It is more prevalent in tropical and subtropical environments. A total of 389 individuals, who presented with febrile illness at the NIBD clinics, were screened for dengue and malaria with Complete Blood Count (CBC), Dengue nonstructural protein 1 (NS1) antigen test and Malaria Parasite Immunochromatographic test (MP-ICT). Whole blood samples were collected and analyzed for CBC on Sysmex XN hematology analyzers. All 65 CPD and standard CBC parameters were analyzed. Statistical analysis was performed using SPSS version 25.0. Descriptive analysis of all the parameters was performed and a p value < 0.001 was considered significant. Positive and negative correlation was also evaluated within the parameters to assess their significance. Furthermore, cut-off values of CPD parameters were evaluated plotting their receiver operating characteristic (ROC) curves.

RESULTS: Out of the 389 febrile patients, 137 were diagnosed as dengue-positive. Descriptive analysis for mean and median values of parameters revealed statistically significant difference for seven parameters (namely WBC, PLT-F, NEUT, LYMP, MONO, HFLC, and LY-WY) in the comparison of the two groups which were then further assessed for positive and negative correlation. Multivariate logistic regression analysis revealed High Fluorescence Lymphocyte Count (HFLC) to be the distinguishing parameter among dengue positive and negative cases. Compared to all the CPD parameters of our data set, the area under curve for lymphocytes cell size and the width of dispersion (LY-WZ) displayed a borderline value of 0.582.

CONCLUSION: Sysmex XN hematology analyzers can provide extensive information about CPD parameters, allowing for the prompt differentiation among febrile illnesses and dengue infection. HFLC and other significant parameters demonstrate promise as rapid, adjunctive diagnostic tools. Further research is needed to validate these findings and optimize the clinical utility of CPD parameters in dengue management.

PMID:39902547 | DOI:10.1111/ijlh.14434

Recent Pat Anticancer Drug Discov. 2025 Feb 3. doi: 10.2174/0115748928344326240927071620. Online ahead of print.

ABSTRACT

BACKGROUND: miR-1468-5p, a type of microRNA, is acknowledged for its crucial involvement in a variety of cancerous processes. Nonetheless, the specific impact of this microRNA on lung adenocarcinoma (LUAD) has not yet been clearly defined.

OBJECTIVE: Our aim was to investigate how miR-1468-5p influences LUAD.

METHODS: The Cancer Genome Atlas (TCGA) offered specimens for our research. Employing statistical techniques, we assessed the diagnostic and prognostic significance of miR-1468-5p, as well as its association with clinical characteristics. Our analysis delved into the target genes and the regulatory mechanisms influenced by miR-1468-5p. The expression levels of miR-1468-5p in LUAD cell lines were validated through quantitative reverse transcription polymerase chain reaction (qRT-PCR).

RESULTS: The expression of miR-1468-5p varied significantly across different cancer types. The presence of reduced miR-1468-5p levels was correlated with a lower likelihood of overall survival in LUAD patients, with a statistically significant result (p = 0.005). miR-1468-5p demonstrated independent prognostic significance in LUAD and potentially contributes to disease progression via multiple pathways, including the HIF-1 signaling pathway and more. There was a significant reduction in miR-1468-5p expression in LUAD cell lines when compared to cells of the normal lung epithelium.

CONCLUSION: miR-1468-5p may serve as a useful patent as a therapeutic intervention target and a prognostic indicator for LUAD patients.

PMID:39902535 | DOI:10.2174/0115748928344326240927071620

Khirurgiia (Mosk). 2025;(1):47-53. doi: 10.17116/hirurgia202501147.

ABSTRACT

OBJECTIVE: To evaluate the efficacy of fascial dehiscence prevention suture in patients with perioperative risk factors regarding the incidence of this complication after laparotomies in abdominal surgery.

MATERIAL AND METHODS: A retrospective-prospective controlled randomized study included 112 patients with abdominal surgical diseases who underwent surgery between 2013 and 2023. Patients were divided into three groups. In the first group (n=57), fascial dehiscence occurred in early postoperative period. The second group (n=41) retrospectively included random patients without fascial dehiscence in postoperative period. In the third group (n=22), original preventive suturing of laparotomy was applied. The validity of differences in continuous variables was assessed using the Kruskal-Wallis test. Categorical variables were analyzed using chi-square test, as well as Dunn’s and Fisher’s post-hoc tests. Differences were significant at p<0.05. The third group did not statistically differ from the first one.

RESULTS: A comprehensive perioperative assessment of risk factors and original aponeurosis suturing technique prevented fascial dehiscence.

PMID:39902508 | DOI:10.17116/hirurgia202501147

Khirurgiia (Mosk). 2025;(1):22-28. doi: 10.17116/hirurgia202501122.

ABSTRACT

OBJECTIVE: To study the immediate results of spleen-preserving distal pancreatectomy and to compare the outcomes after Kimura and Warshaw procedures.

MATERIAL AND METHODS: A retrospective non-randomized study included 27 patients with benign tumors of pancreatic tail and body who underwent spleen preserving distal pancreatectomy between 2020 and 2024. All patients were divided into 2 groups: 1 – Kimura procedure (n=16), 2 – Warshaw procedure (n=16). We excluded patients who underwent enucleations, central resections, and other interventions instead of distal pancreatectomy.

RESULTS: Mean surgery time was 269.06±70.95 (95% CI 227.74 – 319. 95) and 197.27±42.09 min (95% CI 184.36 – 240.64), respectively (p=0.006). Blood loss, length of hospital day, incidence of laparotomy, splenectomy, splenic infarction, and redo surgeries were similar. Clinically significant postoperative fistula B-C was more common in 1^st group (10 (62.4%) vs. 5 (45.5%) cases, p=0.028). There were no significant between-group differences in the incidence of postoperative complications Clavien-Dindo grade >III and mortality.

CONCLUSION: Laparoscopic spleen preserving distal pancreatectomy is the «gold» standard for benign tumors of pancreatic body and tail. The Warshaw and Kimura techniques are safe and effective surgical approaches with similar results. The Warshaw procedure may be more advantageous regarding less surgical resources without deterioration of immediate postoperative results.

PMID:39902505 | DOI:10.17116/hirurgia202501122