Tag: statistics

Ann Clin Biochem. 2025 Jul 29:45632251367280. doi: 10.1177/00045632251367280. Online ahead of print.

ABSTRACT

OBJECTIVES: Chromosomal abnormalities and congenital anomalies have huge impact of infant mortality and morbidity. The combined incidence affects approximately 1 per 1000 pregnancies. Current diagnostic modalities include ultrasonography (USG) and biomarkers like Beta hCG, PAPP-A and Alpha fetoprotein which have limitations due to their poor sensitivity and specificity in aneuploidy and NTD detection. PCSK9, a proprotein converters appears to have an escalating role in neurogenesis, neuronal differentiation and neurological diseases apart from its role in lipid metabolism. This study estimates serum PCSK9 levels in pregnant women with normal gestation and those with high risk for Aneuploidy and NTDs.

METHODS: This prospective case control study included 40 pregnant women with high risk of aneuploidy and NTDs (cases) diagnosed by prenatal screening with ultrasonography findings, Beta HCG, PAPP-A and 40 pregnant women with a healthy singleton pregnancy (controls). Statistical analyses were performed by SPSS software version 16. Fetal and maternal characteristics, serum Beta HCG, PAPP-A, PCSK-9 and aneuploidy risk scores were compared between two groups.

RESULTS: This study observed significant difference in Beta HCG, PAPP-A and PCSK9 levels between the groups (p<0.05). The PCSK9 levels were lower in cases [82.95 (70.41-90.74)] than control group [123.84 (102.515-152.70)]. PCSK9 levels < 96.8 ng/mL had a 85% sensitivity and specificity. Further PCSK9 correlated with Trisomy 21 risk score and Beta HCG (p<0.05).

CONCLUSIONS: Maternal serum PCSK9 is decreased in high-risk pregnancy during first trimester. With 85% sensitivity, the marker could be a reliable screening tool during prenatal screening which needs further validation.

PMID:40728842 | DOI:10.1177/00045632251367280

Sleep Breath. 2025 Jul 29;29(4):254. doi: 10.1007/s11325-025-03405-0.

ABSTRACT

OBJECTIVE: To analyze the effect of mask usage on dry eye symptoms and meibomian gland function in patients with obstructive sleep apnea syndrome (OSAS).

METHODS: OSAS patients who visited our hospital from January 2022 to December 2023 were selected as research subjects. All patients were treated with continuous positive airway pressure (CPAP) therapy. The polysomnography (PSG) results before and after treatment were analyzed, including the apnea-hypopnea index (AHI) and peripheral oxygen saturation (SpO₂). Dry eye conditions and ocular surface analyzer results of patients before and after treatment were evaluated. Pearson correlation was used to assess the relationship between dry eye conditions and ocular surface analyzer results in OSAS patients, and the correlations between PSG results and dry eye conditions as well as ocular surface analyzer results were also analyzed.

RESULTS: AHI levels in 31 OSAS patients were significantly decreased after treatment, while SpO₂ levels significantly increased, with a statistically significant difference (P<0.05). After treatment, the tear breakup time (BUT), palpebral (PL) scores, and Ocular Surface Disease Index (OSDI) scores of patients were significantly higher than those before treatment (P<0.05). Additionally, after treatment, the tear meniscus height of OSAS patients was significantly lower than that before treatment, and the lipid layer thickness and eye redness index were significantly higher than those before treatment, with a statistically significant difference (P<0.05). The results of Pearson correlation analysis showed that BUT was positively correlated with lipid layer thickness and eye redness improvement, while Schirmer’s test (Sit) was positively correlated with tear meniscus height. PL scores were negatively correlated with tear meniscus height but positively correlated with the eye redness index (P<0.05). AHI from PSG results was negatively correlated with BUT, PL scores, and OSDI scores (P<0.05), while SpO₂ was positively correlated with BUT, PL scores, and OSDI scores but negatively correlated with Sit (P<0.05). In the PSG results, AHI was negatively correlated with lipid layer thickness and eye redness index, and positively correlated with meibomian gland opening score (P < 0.05).

CONCLUSION: CPAP mask usage in OSAS patients may negatively impact dry eye symptoms and meibomian gland function, leading to decreased tear film stability and worsening symptoms of eye dryness.

PMID:40728797 | DOI:10.1007/s11325-025-03405-0

JAMA Netw Open. 2025 Jul 1;8(7):e2528532. doi: 10.1001/jamanetworkopen.2025.28532.

ABSTRACT

IMPORTANCE: Although gaming disorder is recognized as a diagnosable behavioral addiction, uncertainty remains regarding its directional association with adolescent psychopathology. Clarifying this association is crucial for refining diagnostic frameworks and developing targeted interventions.

OBJECTIVE: To examine directional longitudinal associations between psychopathology and gaming disorder among adolescents using the Interaction of Person-Affect-Cognition-Execution model as a theoretical framework.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data from the Adolescent Brain Cognitive Development Study (release 5.1), analyzing 4289 adolescents in the US who played video games and completed 3 waves of data collection (at ages 11-12, 12-13, and 13-14 years) between January 1, 2018, and December 31, 2022. Statistical analysis was performed from December 2024 to March 2025.

MAIN OUTCOMES AND MEASURES: Psychopathology was assessed using caregiver reports from the Child Behavior Checklist, which provided measures of depression, attention-deficit/hyperactivity disorder (ADHD), social problems, anxiety, and conduct disorder or aggression. Additional person-centered core characteristics (eg, negative life events, family conflict, bullying, and impulsivity) were incorporated. Gaming disorder was measured using the Video Game Addiction Questionnaire, which aligns with the DSM-5 criteria for internet gaming disorder.

RESULTS: This cohort comprised 4289 adolescents (mean [SD] age, 168.8 [8.2] months; 2391 of 4288 [56%] males). Household income varied widely, with 1374 of 3877 households (35%) reporting an income from $100 000 to $199 000. Cross-lagged panel models (CLPMs) demonstrated that higher baseline levels of psychopathology were associated with an increased risk for subsequent gaming disorder from the 2-year to the 3-year follow-up (β = 0.03 [95% CI, 0.002-0.06]; P = .003) and from 3-year to the 4-year follow-up (β = 0.07 [95% CI, 0.04-0.10]; P < .001). Even when controlling for other personal core characteristics associated with increased risk, there was still a small to medium effect size of psychopathology associated with gaming disorder from the 3-year to the 4-year follow-up (β = 0.04 [95% CI, 0.002-0.07]; P = .04). In contrast, gaming disorder was not associated with later increases in psychopathology. Hierarchical mixed-effects models that accounted for both the panel structure and grouping of the data corroborated the results from the CLPMs.

CONCLUSIONS AND RELEVANCE: The results of this cohort study suggest that psychopathology is significantly associated with the development of gaming disorder among adolescents. Clinical efforts to address underlying mental health issues, particularly for internalizing symptoms such as depression, anxiety, social problems, and ADHD, may reduce the incidence and severity of gaming disorder.

PMID:40728787 | DOI:10.1001/jamanetworkopen.2025.28532

Radiat Environ Biophys. 2025 Jul 29. doi: 10.1007/s00411-025-01139-x. Online ahead of print.

ABSTRACT

The research described in this paper aimed to identify ²²²Rn concentrations in the serum of healthy individuals and lung cancer patients. Additionally, CBC parameters such as WBC (White Blood Cell count), RBC (Red Blood Cells), MCH (Mean Corpuscular Hemoglobin), and PLT (Platelets) were measured and their correlation with the corresponding ²²²Rn concentrations in the serum of the lung cancer patients was investigated. ²²²Rn concentrations in serum samples were measured using a CR-39 detector. The mean ²²²Rn concentration in the serum of the patients was 22.62 ± 3.85 Bq/m³, while that in serum of the healthy individuals was 2.72 ± 0.71 Bq/m³. Also, it was found that the mean WBC, RBC, MCH, and PLT levels in the serum of the patients were 7.15 ± 0.58 cells/L, 4.24 ± 0.17 cells/L, 29.23 ± 0.60 pg, and 285.52 ± 21.78 cells/L, respectively. The results revealed statistically significant differences in ²²²Rn concentrations when comparing the samples of the patients with those of the healthy individuals. In addition, a reasonable correlation was found (p < 0.01) between the ²²²Rn concentrations and MCH levels in serum of the patients. It is concluded that, given the observed correlations, further studies are necessary to investigate whether there is any causal relationship behind the observed correlations.

PMID:40728775 | DOI:10.1007/s00411-025-01139-x

Am J Clin Dermatol. 2025 Jul 29. doi: 10.1007/s40257-025-00964-6. Online ahead of print.

ABSTRACT

BACKGROUND: Psoriasis is a chronic, inflammatory disease requiring long-term therapy. Risankizumab, an anti-interleukin-23 monoclonal antibody, is approved to treat moderate-to-severe plaque psoriasis in adults.

OBJECTIVE: The aim was to assess the long-term safety and efficacy of continuous risankizumab treatment through 6 years in adults with moderate-to-severe plaque psoriasis.

METHODS: LIMMitless, a phase 3, open-label extension study, evaluated the long-term safety and efficacy of risankizumab in patients with moderate-to-severe plaque psoriasis following multiple phase 2/3 base studies. Patients randomized to risankizumab 150 mg at baseline of the base studies (≤ 52 weeks) were eligible to enroll in the LIMMitless study, in which they received risankizumab 150 mg subcutaneously every 12 weeks for an additional 252 weeks. This final analysis assessed safety (treatment-emergent adverse events [TEAEs]) through 324 weeks and efficacy (including proportions of patients who achieved ≥ 90%/100% improvement from baseline in Psoriasis Area and Severity Index [PASI 90/PASI 100], static Physician’s Global Assessment of clear or almost clear [sPGA 0/1], or Dermatology Life Quality Index of no effect on patient’s quality of life [DLQI 0/1]) through 304 weeks.

RESULTS: Of 897 patients enrolled in the LIMMitless study, 661 completed the study for a total of 4921.2 patient years of exposure to risankizumab. Rates of TEAEs, TEAEs leading to discontinuation, and TEAEs of safety interest were low and consistent with rates observed in previous studies. During the base studies, risankizumab treatment demonstrated high rates of rapid and durable efficacy through 52 weeks; risankizumab treatment also maintained or further improved efficacy and quality-of-life outcomes in the LIMMitless study. At week 304, 86.0% of patients achieved PASI 90, 54.2% achieved PASI 100, 84.7% achieved sPGA 0/1, and 76.3% achieved DLQI 0/1 (using modified nonresponder imputation).

CONCLUSIONS: Long-term risankizumab was well tolerated and demonstrated high and durable efficacy through 6 years of continuous treatment.

CLINICAL TRIAL REGISTRATION: NCT03047395.

PMID:40728772 | DOI:10.1007/s40257-025-00964-6

J Clin Monit Comput. 2025 Jul 29. doi: 10.1007/s10877-025-01311-0. Online ahead of print.

ABSTRACT

In critical care settings, continuous vital sign monitoring is crucial to ensure patient safety and timely intervention. While traditional patient monitor threshold alarm systems have been life-saving, they often generate numerous non-actionable alarms, which can overwhelm caregivers and lead to ineffective patient monitoring. We still have these numerous false alarms because we have a gap in understanding the importance of age-specific threshold settings, delay, and critical illness events inclusion in understanding the specificity and sensitivity of the threshold alarms. This study investigated the effect of age-specific thresholds, delay, and critical illness events on the number of threshold alarms to balance their specificity and sensitivity. Secondary data from 772 pediatric patients was extracted from the IMPALA Project conducted in the High Dependency Unit (HDU) at Queen Elizabeth and Zomba Central Hospitals in Malawi. Threshold crossing detector algorithms and age-defining functions were used to generate alarms and impute age-specific thresholds. Z-test was used to determine differences between normal threshold alarms and age-specific threshold alarms. Threshold alarms were categorized into different delays based on their durations to identify an adaptive delay that would minimize the threshold alarms to manageable alarms. Time series analysis was leveraged to extract and compare threshold alarms around patients with and without critical illness events per hour. Additionally, we investigated the variability of threshold alarms during the hour time windows before and after each critical illness event, considering factors such as delay and age. A multi-regression model was used to determine the effects of critical illness events on the number of threshold alarms, with a significance level set at p < 0.05, indicating statistical significance. The age-specific threshold had a positive influence on the threshold alarms by reducing the total number of threshold alarms [31.14% for ECGHR, 17.54% ECGRR and 54.79% for SPO2]. There was a greater significant difference between normal and age-specific threshold alarms (p < 0.00001). A 15-s delay reduced the total number of threshold alarms by 45%. We had more threshold alarms being generated 1 h before critical illness events occurrence, and applying delay and age-specific threshold had more impact on threshold alarms 3 h after the occurrence of critical illness events [Respiratory support (Total threshold alarms (232), 15 s delay (77), 15 s and age-specific threshold (17)] and most threshold alarms 1 h before critical illness events had longer durations. Critical illness [Convulsion (p < 0.0001), Malaria treatment (p < 0.0001), Death (p = 0.053), Respiratory support (p = 0.046), and Sepsis (p = 0.051)] had positive effects on the threshold alarm. There was a drop and increase in the vital sign values during the occurrence of these critical illness events [Bronchodilator support (β = – 0.0030), Death (β = – 0.0374), Malaria treatment (β = – 0.0056), and Inotropic support (β = – 0.0063)] indicating that more threshold alarms were produced during the occurrence of these critical illness events. Age-specific threshold, delay, and critical illness events can be used to strike a balance between the sensitivity and specificity of threshold alarms. In this way, we can reduce the number of non-actionable (false alarms) alarms and increase the number of actionable alarms around critical illness events. It is necessary to look into critical illness event alarm forecasting further.

PMID:40728767 | DOI:10.1007/s10877-025-01311-0

EJNMMI Phys. 2025 Jul 29;12(1):73. doi: 10.1186/s40658-025-00788-7.

ABSTRACT

In clinical nuclear medicine, reconstruction methods incorporating regularization terms have been widely investigated. However, searching for optimal hyperparameters for the entire examination is time-consuming and arduous because the optimal hyperparameters need to be determined experimentally and vary depending on factors, including the acquisition condition, reconstruction condition, and so on. In this study, we propose a row-action type automatic regularized expectation maximization method (RAREM). This method considers the acquisition conditions and object structure for determining the hyperparameters and does not require the user to set the hyperparameters experimentally. This study was conducted using numerical simulations and a real SPECT system METHODS: Total variation-expectation maximization (TV-EM) and modified-block sequential regularized EM (BSREM) were compared with RAREM, with the optimal hyperparameters of the two conventional reconstruction methods determined in advance from normalized root mean square error (NRMSE) results. This simulation examination utilized three types of phantoms with the number of counts and projections being examined in six ways each, resulting in a total of 108 conditions. The NRMSE and structural similarity index measure (SSIM) were used to evaluate of the simulation examination, and the Mann-Whitney U test was used for statistical analysis. In the real examination, two types of phantoms were used, and the number of projections was examined in three ways, for a total of six conditions. Contrast recovery coefficient (CRC) and specific binding ratio (SBR) were used to evaluate the real examination RESULTS: The NRMSE, CRC, and SBR of RAREM were equivalent to those of the conventional methods, and the SSIM of RAREM was equivalent to or better than that of the conventional methods, with significant differences in some cases. The results indicated that RAREM worked well with the evaluated object structure and considered the acquisition conditions CONCLUSION: In this study, an automatically controlled regularization reconstruction method was proposed. The proposed method does not require the user to set hyperparameters experimentally and can avoid the investigation of optimal hyperparameters; it is an alternative to conventional regularized methods in clinical.

PMID:40728756 | DOI:10.1186/s40658-025-00788-7

Eur Radiol. 2025 Jul 29. doi: 10.1007/s00330-025-11913-6. Online ahead of print.

NO ABSTRACT

PMID:40728754 | DOI:10.1007/s00330-025-11913-6

Eur Radiol. 2025 Jul 29. doi: 10.1007/s00330-025-11868-8. Online ahead of print.

ABSTRACT

Unrecognized and untreated injuries of the posteromedial and posterolateral corners of the knee are more common than previously thought and have been linked to poor outcomes after anterior cruciate ligament reconstruction. Amongst imaging modalities, magnetic resonance is currently referred to as the gold standard for the evaluation of these regions, but has several limitations, in particular in the identification of subacute and chronic lesions. Recent technological advancements and the progressive refinement of linear probes have expanded the potential of High-resolution ultrasound in demonstrating the stabilizers of the posteromedial and posterolateral corners in both normal and pathological cases, and now this modality may be considered as a useful complementary tool for the evaluation of these structures. The aim of this work is twofold: (i) to review, also with the support of dedicated dissections and schematic drawings, the normal anatomy and the biomechanical role of the clinically relevant stabilizers of the posteromedial and posterolateral knee, including the distal expansion of the semimembranosus tendon, the popliteus muscle-tendon unit, and the posterior oblique ligament; (ii) to illustrate the normal ultrasound appearance of these structures and the spectrum of pathological findings that this modality may disclose in patients with anterior cruciate ligament tear. KEY POINTS: Question Injuries of the posteromedial and posterolateral knee worsen the outcome after anterior cruciate ligament reconstruction but are often underdiagnosed on imaging. Findings Ultrasound has potential in diagnosing tears of stabilizers of the posteromedial and posterolateral knee and provides complementary information to MRI about ligament status and continuity. Clinical relevance In subacute and chronic injuries, ultrasound has some advantages over MRI as it can disclose subtle abnormalities that might otherwise be unrecognized, thereby improving diagnostic confidence and patient counselling.

PMID:40728753 | DOI:10.1007/s00330-025-11868-8

Nervenarzt. 2025 Jul 29. doi: 10.1007/s00115-025-01842-6. Online ahead of print.

ABSTRACT

With the introduction of the 11th revision of the World Health Organization International Statistical Classification of Diseases and Related Health Problems (ICD-11), structural and content-related adjustments to the diagnostic guidelines for anxiety disorders were made, which are presented in this review article. Previously classified as “phobic disorders” and “other anxiety disorders” within the group “neurotic, stress-related, and somatoform disorders”, in ICD-11 “anxiety- or fear-related disorders” now constitute a separate group. The core diagnoses of agoraphobia, social anxiety disorder, specific phobia, panic disorder and generalized anxiety disorder are retained, with the modification that agoraphobia and panic disorder can now be diagnosed separately and comorbidly. Within the framework of the lifespan perspective, separation anxiety disorder and selective mutism have been moved to the group “anxiety- or fear-related disorders”. The diagnosis “mixed anxiety and depressive disorder” is now classified as “mixed depressive and anxiety disorder” in the group “affective disorders”. In accordance with the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM‑5), it is possible to code isolated panic attacks in addition to other mental or somatic disorders. Overall, ICD-11 follows the DSM‑5 classification of anxiety- and fear-related disorders in many respects. Furthermore, the omission of subcategorizations and a precise minimum number of required symptoms simplify the diagnostic criteria. Future studies will need to address questions regarding the diagnostic accuracy, clinical practicability and further operationalization of the ICD-11 diagnostic criteria for anxiety- or fear-related disorders.

PMID:40728738 | DOI:10.1007/s00115-025-01842-6