Tag: statistics

J Cancer Surviv. 2025 Jul 30. doi: 10.1007/s11764-025-01782-9. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Allostatic load (AL) significantly impacts patient outcomes. This study aimed to explore the association between AL levels and time to deterioration (TTD) of health-related quality of life (HRQoL) in non-small cell lung cancer (NSCLC) patients.

METHODS: A prospective study (May 2017-September 2022) included 362 NSCLC patients from The First Affiliated Hospital of Fujian Medical University. HRQoL was assessed using EORTC QLQ-C30 and EORTC QLQ-LC13 questionnaires, and AL-related biomarkers were collected. Univariate and multivariate Cox regression analyses evaluated the impact of AL on HRQoL TTD.

RESULTS: TTD events were most common in global health status (QL), physical functioning (PF), and dyspnea (LC-DY). Lower AL levels delayed TTD in emotional functioning (EF) (HR = 2.041, 95% CI: 1.404-2.969, P < 0.001), cognitive functioning (CF) (HR = 1.613, 95% CI: 1.082-2.403, P = 0.019), insomnia (SL) (HR = 1.553, 95% CI: 1.064-2.266, P = 0.022), constipation (CO) (HR = 2.114, 95% CI: 1.179-3.791, P = 0.012), and hemoptysis (LC-HA) (HR = 2.316, 95% CI: 1.037-5.172, P = 0.041). Multivariate analysis confirmed these findings, except for insomnia, which lost significance.

CONCLUSIONS: Lower AL levels delayed TTD in EF, CF, CO, and LC-HA, highlighting AL’s role in preserving HRQoL in NSCLC patients.

IMPLICATIONS FOR CANCER SURVIVORS: HRQoL is critical for cancer survivors. This study underscores the importance of AL to improve HRQoL outcomes in NSCLC patients.

PMID:40736930 | DOI:10.1007/s11764-025-01782-9

Updates Surg. 2025 Jul 30. doi: 10.1007/s13304-025-02328-5. Online ahead of print.

ABSTRACT

This study aims to compare postoperative outcomes of video-assisted thoracoscopic surgery (VATS) and thoracotomy in elderly patients undergoing segmentectomy or lobectomy for primary non-small cell lung cancer (NSCLC). A retrospective analysis was conducted on 129 patients aged 70 years or older who underwent anatomical lung resection (segmentectomy or lobectomy) for NSCLC between January 2016 and June 2021. Patients were divided into two groups based on surgical approach: VATS and thoracotomy. Demographics, tumor characteristics, postoperative complications, chest drainage duration, hospital stay, and short- and mid-term mortality rates were analyzed and compared. The mean age of patients was 73.5 ± 3.2 years, with 55% undergoing surgery via VATS. The VATS group had significantly shorter chest drainage duration (median 4 vs. 6 days, p < 0.001) and hospital stay (median 6 vs. 7 days, p < 0.001). Minor complications were more common in the thoracotomy group (p = 0.022), while no significant differences were found in major complications (p = 0.888). Thirty-day, ninety-day, one-year, and in-hospital mortality rates showed no statistically significant differences between groups. Both VATS and thoracotomy are viable surgical options for elderly NSCLC patients, with similar mortality and major morbidity rates. However, VATS provides advantages in terms of reduced chest drainage duration and shorter hospitalization. Surgical approach should be individualized, taking into account patient characteristics and surgical risk.

PMID:40736929 | DOI:10.1007/s13304-025-02328-5

Coron Artery Dis. 2025 Jul 31. doi: 10.1097/MCA.0000000000001558. Online ahead of print.

ABSTRACT

BACKGROUND: Carotid artery stenosis is a significant predictor of perioperative stroke risk in patients undergoing coronary artery bypass grafting (CABG). Identifying noninvasive, simple, and clinically relevant biomarkers for risk stratification is crucial in this population. The CALLY index, a composite marker reflecting systemic inflammation and nutritional status, has shown prognostic value in various diseases. However, its relationship with carotid artery stenosis in patients undergoing isolated CABG remains unclear. This study aimed to evaluate the relationship between carotid artery stenosis and the CALLY index in patients undergoing isolated CABG.

METHODS: This retrospective, single-center study included 820 patients who underwent isolated CABG and preoperative carotid Doppler ultrasonography between January 2020 and December 2024. The degree of carotid artery stenosis was classified into three groups (<50, 50-70, >70%). CALLY index values were calculated using lymphocyte count, albumin, and C-reactive protein (CRP) levels. Statistical analyses included Kruskal-Wallis H and Spearman’s rank correlation tests.

RESULTS: The CALLY index was significantly lower in patients with higher degrees of carotid artery stenosis (P < 0.001). A strong negative correlation was found between the CALLY index and carotid stenosis severity (Spearman’s rho = -0.831, P < 0.001).

CONCLUSION: Low CALLY index values are significantly associated with the presence and severity of carotid artery stenosis in patients undergoing isolated CABG. The CALLY index may serve as a simple and practical biomarker for preoperative risk assessment, aiding in the identification of high-risk patients and potentially improving surgical outcomes.

PMID:40736922 | DOI:10.1097/MCA.0000000000001558

J Vector Borne Dis. 2025 Jul 30. doi: 10.4103/jvbd.jvbd_16_25. Online ahead of print.

ABSTRACT

BACKGROUND OBJECTIVES: The proportion of asymptomatic malaria is no doubt one of the factors determining the dynamics of its transmission and burden in endemic areas. This research focused on screening for Plasmodium parasitemia and analysing the relationship between proportions of malaria cases among asymptomatic and symptomatic persons in Lokoja, Northcentral Nigeria.

METHODS: Cross-sectional survey and experimental designs were adopted. A semi-structured interview guide was used to collect data on socio-demography and clinical status of the participants. Blood samples were randomly collected from 328 consenting participants during high transmission season (April – October) of malaria within a three-year period (2018-2021), and screened for Plasmodium species by light microscopy (LM). Statistical analyses of related parameters were performed using the Statistical Package for the Social Sciences (SPSS) version 25 software.

RESULTS: A total of 12.4% (25/202) and 85.7% (108/126) asymptomatic and symptomatic individuals were recorded respectively. There was no significant difference (p > 0.05) between the mean distributions of malaria cases among the asymptomatic and those of symptomatic persons. All cases identified were uncomplicated and falciparum-specific; and a 40.5% (133/328) prevalence of P. falciparum malaria with hyperparasitemia was observed in the area. The implications of these findings were discussed in relation to previous rates and other nearby endemic settings.

INTERPRETATION CONCLUSION: As a matter of success towards malaria elimination, a renewed call is made for regular monitoring of malaria prevalence using more efficient means of diagnosis and consideration of control strategies such as regular mass antimalarial administration, particularly targeting the often-neglected asymptomatic reservoir subset.

PMID:40736912 | DOI:10.4103/jvbd.jvbd_16_25

Ophthalmol Ther. 2025 Jul 30. doi: 10.1007/s40123-025-01215-x. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aimed to compare the surgical outcomes of trabeculectomy and glaucoma drainage device (GDD) implantation in patients with congenital aniridia.

METHODS: Eligible studies were retrieved from Embase, MEDLINE (via PubMed), and the Cochrane Central Register of Controlled Trials (CENTRAL) up to December 15, 2024. Studies were included if they reported clinical outcomes following trabeculectomy or GDD implantation in individuals with aniridic glaucoma. Outcomes of interest included success rates, best spectacle-corrected visual acuity (BSCVA), intraocular pressure (IOP), use of glaucoma medications, and postoperative complications. Data extraction and synthesis were conducted according to the Cochrane Handbook. Meta-analyses were performed using a random-effects model. Heterogeneity among studies was evaluated using the Q test and I² statistic.

RESULTS: Twenty-two of the 1039 screened studies were included in the meta-analysis. Pooled complete success rates were not significantly different between trabeculectomy and GDD treatments (p = 0.88). However, the qualified success rate was significantly higher following GDDs compared to trabeculectomy (p < 0.001) in patients with aniridia. Cox frailty regression analysis of individual success data showed similar results: the hazard ratio of failure was significantly higher after trabeculectomy than after GDD (HR 5.684 from 1.46 to 22.14, p = 0.012). No significant differences were observed between the two procedures in terms of IOP reduction (p = 0.53), percentage change in IOP (p = 0.24), or reduction in glaucoma medications (p = 0.56) at final follow-up. Additionally, there was no significant difference in the change in BSCVA between the two groups (p = 0.72).

CONCLUSION: Regarding complete success rates, trabeculectomy does not seem to provide a significant benefit over GDDs in treating aniridic glaucoma. However, the qualified success rate is greater with GDD implantation than with trabeculectomy. Both surgical approaches show similar effectiveness in lowering intraocular pressure, reducing the need for glaucoma medications, and maintaining visual acuity.

PMID:40736869 | DOI:10.1007/s40123-025-01215-x

J Nephrol. 2025 Jul 30. doi: 10.1007/s40620-025-02364-9. Online ahead of print.

ABSTRACT

BACKGROUND: Kidney function declines faster in patients with type 2 diabetes mellitus (T2DM) than in those without, and coronary artery calcification is a risk factor for adverse kidney outcomes. Thus, we examined whether T2DM modified the relationship between coronary artery calcification and chronic kidney disease (CKD) progression.

METHODS: Among 2067 participants from the KoreaN Cohort Study for Outcome in Patients With CKD, the main exposures analyzed were T2DM and coronary artery calcification. The primary outcome was CKD progression, which was a composite of > 50% decline in estimated glomerular filtration rate (eGFR) or kidney failure requiring kidney replacement therapy. A multivariable cause-specific hazard model was used to determine the association between the main exposures and the primary outcome.

RESULTS: During 8633 person-years of follow-up, the primary outcome occurred in 565 (27.3%) participants. After adjusting for confounding factors, T2DM and coronary artery calcification score > 0 were associated with 2.03- and 1.51-fold increased risks of CKD progression, respectively. T2DM and coronary artery calcification showed a significant interaction in terms of the primary outcome. In patients with T2DM, coronary artery calcification score > 0 was associated with a significantly higher risk of CKD progression compared with coronary artery calcification score = 0. However, the significant association of coronary artery calcification score > 0 versus coronary artery calcification score = 0 was lost in patients without T2DM. The slope of eGFR decline was steeper in patients with T2DM and coronary artery calcification score > 0 than in those with T2DM or coronary artery calcification score > 0 alone.

CONCLUSIONS: Coronary artery calcification is more strongly associated with the risk of CKD progression in patients with T2DM than in those without. Therefore, the clinical implications of coronary artery calcification vary depending on the presence of T2DM.

PMID:40736786 | DOI:10.1007/s40620-025-02364-9

Int J Oral Maxillofac Implants. 2025 Jul 30;0(0):1-36. doi: 10.11607/jomi.11469. Online ahead of print.

ABSTRACT

BACKGROUND: Two-piece zirconia implants offer a metal-free alternative to titanium implants, but only limited long-term data are available. The aim of this retrospective study was to evaluate the clinical outcomes of two different, identically designed two-piece zirconia implants (NobelPearl™ and Zeramex XT) in a private dental practice.

MATERIAL AND METHODS: Between 2017 and 2024, 167 implants were placed in 106 patients and followed up to 88 months (Ø 39.1 months). In addition to the implant survival rate, marginal bone loss (MBL), clinical parameters and surface properties were examined using 3D profilometry. The statistical analysis included descriptive evaluations and a survival analysis using the life table method.

RESULTS: Three implants were lost (two fractures, one failed osseointegration), corresponding to an effective survival rate of 98.2%. The mean marginal bone loss varied between -0.14 mm and -0.58 mm. The surface roughness was minimal (Sa ~0.5 µm). No risk factor showed a significant association with implant loss in the univariate analysis.

CONCLUSION: Two-piece, screw-retained zirconia implants showed a high survival rate and stable peri-implant tissue conditions over a period of up to seven years. They represent a promising metal-free alternative to titanium implants. Further prospective long-term studies are needed to validate these results and to better understand potential risk factors.

PMID:40736783 | DOI:10.11607/jomi.11469

Int J Oral Maxillofac Implants. 2025 Jul 30;0(0):1-35. doi: 10.11607/jomi.11408. Online ahead of print.

ABSTRACT

PURPOSE: In full arches, what is the accuracy of dental implants placed by means of static computer-assisted implant surgery (s-CAIS)?

MATERIALS AND METHODS: Two independent and calibrated reviewers selected studies based on pre-defined eligibility criteria and extracted data on study-, population-, intervention- and outcome (accuracy) characteristics. Risk of bias and the quality of evidence assessments of the included articles were performed by an independent and blinded reviewer. The meta-analysis was conducted using the random- effects model at a 5% significance level.

RESULTS: Thirty (5 RCTs, 9 CCTs and 16 Case Series) studies were included. Overall, 2,056 implants distributed among arches in 416 patients (males n=161; females n=188; unclear n = 67) were assessed. Random-effects meta-analysis revealed statistically significant mean horizontal linear distortions at the implant neck and apex levels of 1.18mm (95% CI: 1.00 – 1.35) (p<0.001) and 1.46mm (95% CI: 1.22 – 1.69) (p<0.001), respectively, significant mean vertical linear distortion at implant depth level of 0.58mm (95% CI: 0.18 – 0.98) (p=0.113) and significant mean angular distortion of 3.65° (95% CI: 2.97 – 4.33) (p<0.001). Accuracy did not differ significantly between maxilla and mandible at all parameters assessed (p>0.05).

CONCLUSIONS: The accuracy of s-CAIS in full arches is within a clinically acceptable range and a 2-mm ho rizontal and 1-mm vertical safety margin should always be respected at planning.

PRACTICAL IMPLICATIONS: A safety margin of 2 mm horizontally and 1 mm vertically in the planning for implant placement can ensure better results in full arches with reabsorbed bone.

PMID:40736781 | DOI:10.11607/jomi.11408

Allergy Asthma Immunol Res. 2025 Jul;17(4):505-518. doi: 10.4168/aair.2025.17.4.505.

ABSTRACT

PURPOSE: We aimed to investigate the prevalence of atopic dermatitis (AD) and its associated risk factors in Korean children in 2022, and to compare to our findings with previous results to identify changes or trends over time.

METHODS: A nationwide, cross-sectional study of randomly selected schoolchildren aged 6-7, 9-10, and 12-13 years, respectively, was completed. Information was obtained through the International Study of Asthma and Allergies in Childhood questionnaire, and comparisons between the current and prior surveys performed in 1995, 2000, and 2010 were conducted using a trend test.

RESULTS: In the 2022 survey, the prevalence of “itchy eczema, ever” was 18.3% in 6- to 7-year-olds, 21.6% in 9- to 10-year-olds, and 18.8% in 12- to 13-year-olds. The prevalence of “AD diagnosis, ever” in 6- to 7-year-olds rose from 20.9% in 1995 to 35.4% in 2010, then dropped to 13.6% in 2022 (P < 0.001), while in 12- to 13-year-olds, it increased from 7.1% in 1995 to 23.7% in 2010, then declined to 17.5% in 2022 (P < 0.001). In 6- to 7-year-olds, the prevalence of “AD only” and “AD and asthma” decreased between 1995 and 2022 (all P < 0.001). In 12- to 13-year-olds, the prevalence of “AD only,” “AD and rhinitis,” and “AD and asthma and rhinitis” all increased during the same period (all P < 0.001).

CONCLUSIONS: The prevalence of AD decreased in Korean children aged 6-7 years and increased in those aged 12-13 years, respectively, between 1995 and 2022, with a concomitant rise in allergic comorbidities among adolescents, suggesting age-dependent trends influenced by diverse AD phenotypes.

PMID:40736778 | DOI:10.4168/aair.2025.17.4.505

Biometrics. 2025 Jul 3;81(3):ujaf086. doi: 10.1093/biomtc/ujaf086.

ABSTRACT

Easy-to-interpret effect estimands are highly desirable in survival analysis. In the competing risks framework, one good candidate is the restricted mean time lost (RMTL). It is defined as the area under the cumulative incidence function up to a prespecified time point and, thus, it summarizes the cumulative incidence function into a meaningful estimand. While existing RMTL-based tests are limited to 2-sample comparisons and mostly to 2 event types, we aim to develop general contrast tests for factorial designs and an arbitrary number of event types based on a Wald-type test statistic. Furthermore, we avoid the often-made, rather restrictive continuity assumption on the event time distribution. This allows for ties in the data, which often occur in practical applications, for example, when event times are measured in whole days. In addition, we develop more reliable tests for RMTL comparisons that are based on a permutation approach to improve the small sample performance. In a second step, multiple tests for RMTL comparisons are developed to test several null hypotheses simultaneously. Here, we incorporate the asymptotically exact dependence structure between the local test statistics to gain more power. The small sample performance of the proposed testing procedures is analyzed in simulations and finally illustrated by analyzing a real-data example about leukemia patients who underwent bone marrow transplantation.

PMID:40736766 | DOI:10.1093/biomtc/ujaf086