Tag: statistics

Perioper Care Oper Room Manag. 2025 Sep;40:100518. doi: 10.1016/j.pcorm.2025.100518. Epub 2025 Jun 28.

ABSTRACT

BACKGROUND: Anesthesia services are a major contributor to healthcare sector greenhouse gas emissions. Interventions aimed to reduce waste are necessary. Reusable anesthesia circuits offer a sustainable alternative to single-use circuits. Their adoption in the United States remains limited. The objective of this project was to evaluate the feasibility, cost-effectiveness, and environmental impact of using FDA-approved reusable anesthesia circuits.

METHODS: Supported by the SMART QI framework, we evaluated the impact of switching to reusable circuits on elective electroconvulsive therapy (ECT) procedures. We measured waste generation, room preparation times, material costs, and projected system wide financial and greenhouse gas emissions impact. Greenhouse gas emissions were estimated using the Practice Greenhealth Scope 3 Emissions Accounting Tool. Descriptive statistics compared pre- and post-intervention outcomes, with statistical significance at p < 0.05.

RESULTS: We compared 185 ECT procedures: 98 single-use from pre-intervention and 87 reusable circuits from post-intervention. Preparation times did not change. Daily waste from reusable circuits was significantly lower than single-use circuits (99.2g vs. 357.2g, p < 0.001). Cost analysis revealed 40% reduction in median per-case expenditures with reusable circuits ($4.30 vs. $8.50 per patient, p < 0.001).Scope 3 greenhouse gas emissions per procedure decreased nearly 50% (1.09 kgCO₂ vs. 2.57 kgCO₂, p < 0.001). Modeling of institutional-level data projected an annual cost savings of $108,860 and a reduction of 45,062.4 kgCO₂ if reusable circuits were implemented across all hospitals in the network.

DISCUSSION: Reusable anesthesia circuits can significantly reduce hospital waste, lower costs, and decrease carbon emissions without compromising procedural efficiency.

PMID:40809989 | PMC:PMC12341448 | DOI:10.1016/j.pcorm.2025.100518

Vet Med (Praha). 2025 Jul 25;70(7):242-246. doi: 10.17221/22/2025-VETMED. eCollection 2025 Jul.

ABSTRACT

This study aimed to evaluate the effectiveness of ferric carboxymaltose injection in the prevention of anaemia in suckling piglets. In group A (n = 8), piglets were administered iron in the form of iron carboxymaltose complex (Ferinject^®) at a dose of 200 mg i.m. (neck muscle) at the age of 3 days. In group B (n = 8), piglets were given iron in the form of iron dextran (Ferribion^®) at a dose of 200 mg i.m. (neck muscle) at the age of 3 days. In group C (n = 8, anaemic control group), iron was not administered until the age of 10 days. During the study, no statistically significant differences were observed in the parameters of red blood cell count or blood plasma iron concentration between the group that received iron carboxymaltase and the group that received iron dextran. The results of haematological and biochemical examinations achieved in our study show that the application of iron carboxymaltase was successful in preventing iron deficiency anaemia in piglets. The results indicate comparable efficacy of iron carboxymaltase and iron dextran.

PMID:40809948 | PMC:PMC12342125 | DOI:10.17221/22/2025-VETMED

Toxicol Res (Camb). 2025 Aug 6;14(4):tfaf115. doi: 10.1093/toxres/tfaf115. eCollection 2025 Aug.

ABSTRACT

In this study, zinc oxide nanoparticles (ZnONPs) were synthesized by green synthesis technique using the extract obtained from Sideritis akmanii plant and the obtained ZnONPs were characterized by Ultraviolet-Visible Spectrophotometry (UV-VIS), X-Ray Diffraction (XRD) spectrophotometer, Scanning Electron Microscopy (SEM) and Fourier Transform Infrared Spectroscopy (FT-IR) techniques. Cytotoxic effects of both ZnONPs and Sideritis akmanii plant extract on A549 cells were investigated by MMT assay and genotoxic effects by Comet assay method. It was observed that the cytotoxic activity of ZnONP doses was higher than Sideritis akmanii plant extracts. In the comet test, the highest DNA damage (62.25 ± 10.15) was observed in the 10 mg/mL ZnONP application at 48 h of application, DNA damage did not exceed the negative control group at 3 different plant extract doses. Moreover, the genotoxic effects of 4 different concentrations of ZnONPs (0.1, 1, 5, 10 mM) were evaluated on Drosophila melonagaster with the SMART test. The results obtained as a result of ZnONP application were found to be close to the control group and it was determined that no statistically significant genotoxic effect was observed. The antimicrobial activity of ZnONPs on Escherichia coli (ATCC 25922), Staphylococcus aureus (ATCC 29213), Salmonella enteritidis (ATCC 13076), Klebsiella pneumoniae (ATCC 700603) and Candida albicans (ATCC 90028) microorganisms was analyzed using disk diffusion method. According to the antimicrobial and antifungal activity data, it was determined that the synthesized ZnONPs were effective on all microorganism strains used in the study and the inhibition zone diameters ranged from 8 to 13.67 mm.

PMID:40809917 | PMC:PMC12341928 | DOI:10.1093/toxres/tfaf115

Cardiovasc Intervent Radiol. 2025 Aug 13. doi: 10.1007/s00270-025-04164-x. Online ahead of print.

ABSTRACT

PURPOSE: Our goal was to evaluate the feasibility, safety, and outcomes at 12 months of prostatic artery embolization with Ethylene Vinyl Alcohol Copolymer in patients with benign prostatic hyperplasia-related lower urinary tract symptoms.

MATERIALS AND METHODS: This was a single-centre prospective study from November 2023 to November 2024 registered in clinical trials (IDRCB, 2021-AO29-56-35). Twelve consecutive patients were included. Inclusion criteria were an IPSS > 18 or a QoL score > 2, and prostate volume > 40 mL. Exclusion criteria were prostate cancer, advanced atherosclerosis. Outcomes were assessed at 12 months using the International Prostate Symptoms Score and associated quality-of-life score, prostate volume, and post-void residual volume. The overall evolution was analysed using a mixed-effects model with repeated measures.

RESULTS: Bilateral injection was performed in all patients. No patients experienced major adverse events. Compared to baseline, statistically significant improvements were observed at 12 months for the IPSS (9.3 ± 7.8 vs. 17.9 ± 5.8; P = 0.03), IPSS-QoL (2.1 ± 1.9 vs. 4.8 ± 1.1; P = 0.01). No statistically significant improvements were observed at 12 months for post-void residual volume (41.5 ± 54.96 vs. 57.3 ± 61.3; P = 0.9) and prostate volume (82.7 ± 46.6 mL vs. 89.2 ± 34.1 mL; P = 0.6).

CONCLUSIONS: Prostatic artery embolization with Ethylene Vinyl Alcohol Copolymer is safe. This method provides good outcomes at 12 months, but no effect on the prostate volume and post-void residual volume. It deserves further evaluation in randomised trials with longer follow-up.

TRIAL REGISTRATION: This study was performed according to Good Clinical Practice requirements and the Helsinki Declaration and registered on Clinical Trials.gov (Trial registration: IDRCB, 2021-AO29-56-35. Registered 27 May 2022, http://clinicaltrials.gov/study/NCT05395299?cond=embolization&term&rank=1 ).

PMID:40804546 | DOI:10.1007/s00270-025-04164-x

Nature. 2025 Aug 13. doi: 10.1038/s41586-025-09368-2. Online ahead of print.

ABSTRACT

The Pacific decadal oscillation (PDO)-the leading pattern of climate variability driving changes over the North Pacific and surrounding continents-is now thought to be generated by processes internal to the climate system^1,2. According to this paradigm, the characteristic, irregular oscillations of the PDO arise from a collection of mechanisms involving ocean and atmosphere interactions in the North and tropical Pacific^3-5. Recent variations in the coupled ocean-atmosphere system, such as the 2015 El Niño, ought to have shifted the PDO into its positive phase⁶. Yet, the PDO has been locked in a consistent downward trend for more than three decades, remanding nearby regions to a steady set of climate impacts. Here we show that the main multidecadal variations in the PDO index during the twentieth century, including the ongoing, decades-long negative trend, were largely driven by human emissions of aerosols and greenhouse gases rather than internal processes. This anthropogenic influence was previously undetected because the current generation of climate models systematically underestimate the amplitude of forced climate variability. A new attribution technique that statistically corrects for this error suggests that observed PDO impacts-including the ongoing multidecadal drought in the western United States-can be largely attributed to human activity through externally forced changes in the PDO. These results indicate that we need to rethink the attribution and projection of multidecadal changes in regional climate.

PMID:40804516 | DOI:10.1038/s41586-025-09368-2

Eur Radiol. 2025 Aug 13. doi: 10.1007/s00330-025-11904-7. Online ahead of print.

ABSTRACT

OBJECTIVES: Proliferation marker Ki-67 and immune checkpoint Programmed Cell Death Ligand 1 (PD-L1) are both proteins associated with tumor treatment response. To develop and validate two dynamic nomograms from dual-energy CT (DECT) for noninvasive evaluation of the expression status of these two proteins in advanced gastric cancer (AGC), and explore their associations with treatment response.

MATERIALS AND METHODS: In this multicenter prospective and retrospective study, eligible AGC participants who underwent DECT scans were recruited into two study groups (Ki-67 and PD-L1 groups), with their clinical and DECT characteristics collected and measured. The prediction models (Ki-67 dynamic nomogram (KIDN) and PD-L1 dynamic nomogram (PDDN)) were constructed by logistic regression classifier, respectively, and two online calculators were established based on models. The performance of nomograms was comprehensively evaluated.

RESULTS: In total, 459 and 417 eligible patients were analyzed in the Ki-67 and PD-L1 groups, respectively. The nomograms discriminating Ki-67 and PD-L1 achieved AUCs of 0.755 and 0.726, respectively, in the external validation cohort. Additionally, the two nomograms significantly or slightly outperformed any single predictor in both the training and validation cohorts. In both cohorts, KIDN and PDDN showed favorable calibration (Hosmer-Lemeshow test, all p < 0.05) and clinical utility confirmed by decision curve analysis. Moreover, they demonstrated prognostic performance consistent with actual biomarkers and were associated with clinical response to immuno-chemotherapy (both p < 0.05).

CONCLUSION: The dynamic nomograms, which integrate clinical features and DECT quantitative parameters, enable noninvasive evaluation of treatment-related protein expression in AGC.

KEY POINTS: Question Noninvasive tools for accurately evaluating Ki-67 and PD-L1 expression status in advanced gastric cancer (AGC) are currently inadequate. Findings Dual-energy CT-based nomograms demonstrated favorable performance in evaluating Ki-67 and PD-L1 expression status and were associated with response to immuno-chemotherapy in AGC. Clinical relevance We developed online calculators based on prediction models that may serve as a supplement to current invasive methods (e.g., immunohistochemistry), potentially aiding therapeutic decision-making.

PMID:40804511 | DOI:10.1007/s00330-025-11904-7

Photodermatol Photoimmunol Photomed. 2025 Sep;41(5):e70038. doi: 10.1111/phpp.70038.

ABSTRACT

BACKGROUND/PURPOSE: While biologics and small-molecule inhibitors are first-line systemic treatments for psoriasis, phototherapy remains an alternative for patients unable to access these treatments because of medical or financial constraints. Narrow-band ultraviolet B (NB-UVB) is effective for localized psoriasis but less so for extensive disease. To address this limitation, bathwater delivery of psoralen plus ultraviolet A (bath-PUVA) was introduced in 2004. This study evaluates the efficacy, safety, and patient characteristics associated with bath-PUVA therapy in a large cohort.

METHODS: This retrospective analysis included 229 patients (180 males, 49 females) treated with bath-PUVA from 2004 to September 2021. Baseline characteristics and treatment outcomes were assessed using the psoriasis area and severity index (PASI). Statistical analyses examined relationships between treatment outcomes and factors, including baseline PASI, body mass index (BMI), and smoking status.

RESULTS: The mean baseline PASI score was 24.9. Bath-PUVA achieved PASI 75 in 80.4% of patients, PASI 90 in 44.1%, and PASI 100 in 2.6%, with efficacy comparable to biologics. Patients achieving PASI 90 had significantly higher baseline PASI scores (p = 0.005), while the number of irradiations required did not differ (p = 0.692). Higher baseline PASI scores correlated with elevated BMI (p = 0.002), but BMI did not influence improvement rates (p = 0.094). Smokers had significantly higher baseline PASI scores (p = 0.004) compared with non-smokers, yet smoking status did not affect improvement rates (p = 0.862).

CONCLUSION: Bath-PUVA demonstrates efficacy comparable with biologics for psoriasis, regardless of BMI or smoking status. This analysis supports its use as an effective and accessible treatment option for patients with extensive disease.

PMID:40804484 | DOI:10.1111/phpp.70038

Sci Rep. 2025 Aug 13;15(1):29711. doi: 10.1038/s41598-025-14790-7.

ABSTRACT

Psoriatic arthritis (PsA) is a very heterogeneous disease with significant impact on health-related quality-of-life (HRQoL). Our objective was to assess and identify predictors of HRQoL in a 3-year follow-up period among PsA patients. Patients with PsA included in the Rheumatic Diseases Portuguese Register (Reuma.pt), with HRQoL data measured by the EuroQoL five Dimensions (EQ-5D) with at least two evaluations throughout a 3-year period, were analysed. Statistics included t-tests, logit and linear mixed models and univariable and multivariable linear regression. PsA patients’ (n = 342) mean age 51.0 (12.2) years, 48.5% being female, mean disease duration 11.8 (9.3) years with a follow-up period of 3-years had a mean EQ-5D of 0.53 (0.28), 0.59 (0.29), and 0.58 (0.28) at baseline, 1-year and 3-year evaluations, respectively. During the follow-up period, EQ-5D score and EQ VAS, significantly improved at both time-point assessments, compared to baseline. Poorer HRQoL was significantly associated with older age (β=-0.004; p-value = 0.008), female sex (β=-0.092; p-value = 0.01), non-employment (β=-0.112; p-value = 0.018), higher disease activity (β=-0.005; p-value < 0.001), prior exposure of three or more biologics at baseline and switching of biologic therapy during the study follow-up [(β=-0.182; p-value = 0.04); (β=-0.150; p-value = 0.002), respectively]. Our study provides important insights into the long-term predictors of HRQoL in PsA patients, highlighting the influence of sociodemographic factors, disease activity and therapeutic approach (prior use and switch/cycle of biologic therapies) on HRQoL.

PMID:40804458 | DOI:10.1038/s41598-025-14790-7

Allergy Asthma Clin Immunol. 2025 Aug 13;21(1):34. doi: 10.1186/s13223-025-00979-y.

ABSTRACT

In recent years, the use of monoclonal antibodies directed against interleukin-5 (anti-IL-5) and its receptor alpha (anti-IL-5R) has proven to be an effective therapeutic option for patients with severe asthma by reducing the number of eosinophils, which may promote disease remission. This study aimed to evaluate clinical improvement and remission in patients with severe asthma treated with anti-IL-5 and anti-IL-5R antibodies over a period of 12 months. A cohort study was conducted with 49 patients diagnosed with severe eosinophilic asthma and who did not respond to conventional treatment. During follow-up, medical control was performed every 3 months using spirometry, eosinophil counts, quality of life scales, and disease control. The results revealed an improvement in FEV1 after 3 months of treatment, with statistical significance at 12 months in patients treated with anti-IL-5 and at 9 months in those treated with anti-IL-5R. In addition, better perceptions of asthma control and quality of life were observed, with significant differences at 6 and 12 months. Correlations between spirometry and ACT, ACQ, and AQLQ reflect a progressive recovery of well-being and function. Finally, the remission rate was 41.1% with anti-IL-5 treatment and 47.3% with anti-IL-5R treatment after one year of follow-up. These findings support the efficacy of anti-IL-5 and anti-IL-5R treatment in improving severe asthma control and patients’ quality of life, suggesting their key role in disease remission.

PMID:40804423 | DOI:10.1186/s13223-025-00979-y

Eur J Med Res. 2025 Aug 14;30(1):749. doi: 10.1186/s40001-025-02951-3.

ABSTRACT

BACKGROUND: Epidural fibrosis (EF) is the major complication that develops in the operative region of the spinal vertebrae. This fibrous scar connects the connective tissue around the lateral nerve roots and epidural, resulting in severe pain post-spinal operation and impairment of the nerves’ function.

PURPOSE: This study was conducted to investigate the effect of using platelet-rich fibrin (PRF), chitosan, and their combination in reducing epidural fibrosis after laminectomy in rats.

METHODS: Ninety male Sprague Dawley rats weighing 255 ± 55 g were randomly assigned to five groups, each consisting of 15 rats: the normal group (control), the laminectomy group, the PRF group, the chitosan group, the combination group (PRF/chitosan), and the donor group. All rats, except the control group, had lumbar laminectomy surgeries between L3 and L5. Macroscopic analysis, histological evaluations, and mRNA analysis for TGFβ-1 and IL6 were compared statistically after a 30-day follow-up.

RESULTS: In comparison to the laminectomy group, the EF area was significantly decreased in the PRF, chitosan, and combination groups. Histological study, macroscopic inspection, and mRNA expression of TGFβ-1 (P < 0.0001) and IL6 (P < 0.0001) show that the use of PRF with chitosan topically in dura following laminectomy resulted in a decrease in scar tissue formation, inflammation, and EF post-laminectomy.

CONCLUSION: The combination of chitosan with PRF is a potential therapeutic approach for minimizing EF in rats after laminectomy.

PMID:40804422 | DOI:10.1186/s40001-025-02951-3