Tag: statistics

J Pain Res. 2025 Mar 13;18:1231-1239. doi: 10.2147/JPR.S492380. eCollection 2025.

ABSTRACT

PURPOSE: This retrospective study aimed to explore the effect of erector spinae plane block (ESPB) on the gastrointestinal function in patients after traumatic lumbar fracture surgery and the effects of different levels of block approach.

PATIENTS AND METHODS: Clinical data were retrospectively analyzed from electronic medical records of patients who underwent traumatic lumbar spine fracture surgery (September 2022-June 2023). Eligible patients were divided into three groups: group L (bilateral ESPB at L3 level), group T (bilateral ESPB at T12 level) and group C (no block). The primary outcomes were the incidence and the time of occurrence postoperative bloating. We also recorded the time of the first flatus and bowel movement, postoperative nausea and vomiting (PONV), gastrointestinal medications, enema, intraoperative opioid dosage, number of rescue analgesia within 48 h postoperatively, visual analogue scale (VAS) scores at 24 h and 48 h postoperatively, inflammatory mediators, complications and hospital length of stay (LOS).

RESULTS: 145 patients were included, including 32 in group L, 33 in group T and 80 in group C. Patients in group L and T experienced less bloating compared to group C (P < 0.05). Patients in group T presented bloating significantly later than group L (log rank P < 0.0167). Patients in group L and group T had a significantly shorter time to first flatus and bowel movement, lower incidence of PONV, gastrointestinal medications and enema, and a lower dose of opioid and VAS scores at 24 h postoperatively compared to group C (all P < 0.05), the difference between group L and T was not statistically significant.

CONCLUSION: Bilateral ESPB improved postoperative gastrointestinal function in patients with traumatic lumbar spine fracture, where the T12 level of ESPB was more favorable than the L3 level.

PMID:40099275 | PMC:PMC11912902 | DOI:10.2147/JPR.S492380

Clin Chem Lab Med. 2025 Mar 19. doi: 10.1515/cclm-2024-1360. Online ahead of print.

ABSTRACT

OBJECTIVES: Human tear analysis holds promise for biomarker discovery, but its clinical utility is hindered by the lack of standardized reference values, limiting interindividual comparisons. This study aimed at developing a protocol for normalizing metabolomic data from human tears, enhancing its potential for biomarker identification.

METHODS: Tear metabolomic profiling was conducted on 103 donors (64 females, 39 males, aged 18-82 years) without ocular pathology, using the AbsoluteIDQ™ p180 Kit for targeted metabolomics. A predictive normalization model incorporating age, sex, and fasting time was developed to correct for interindividual variability. Key metabolites from six compound families (amino acids, biogenic amines, acylcarnitines, lysophosphatidylcholines, phosphatidylcholines, and sphingomyelins) were identified as normalization references. The approach was validated using Linear Discriminant Analysis (LDA) to test its ability to classify donor sex based on metabolite concentrations.

RESULTS: Metabolite concentrations exhibited significant interindividual variability. The normalization model, which predicted metabolite concentrations based on a reference “concomitant” metabolite from each compound family, successfully reduced this variability. Using the ratio of observed-to-predicted concentrations, the model enabled robust comparisons across individuals. LDA classification of donor sex using acylcarnitine C4 achieved 78 % accuracy, correctly identifying 92 % of female donors. This approach outperformed traditional statistical and machine learning methods (Lasso logistic regression and Random Forest classification) in sex discrimination based on tear metabolomics.

CONCLUSIONS: This novel normalization protocol significantly improves the reliability of tear metabolomics by enabling standardized interindividual comparisons. The approach facilitates biomarker discovery by mitigating variability in metabolite concentrations and may be extended to other biological fluids, enhancing its applicability in precision medicine.

PMID:40097363 | DOI:10.1515/cclm-2024-1360

Prenat Diagn. 2025 Mar 17. doi: 10.1002/pd.6779. Online ahead of print.

ABSTRACT

OBJECTIVE: We aimed to investigate whether the clinical pregnancy and live birth rates in women undergoing preimplantation genetic testing for two indications (PGT2) differ from PGT for one autosomal dominant indication (PGT1).

METHOD: This retrospective cohort study summarizes data from 44 PGT patients treated between 2015 and 2023. Data were divided into PGT2 (n = 22 patients, 113 treatment cycles) and PGT1 (n = 22 patients, 108 treatment cycles) groups. Statistical analysis included descriptive statistics, independent t-tests, Mann-Whitney U tests, mixed models, and multivariable mixed logistic regressions.

RESULTS: The groups did not differ in clinical pregnancy and live birth rates. PGT2 patients had more fresh embryos per cycle than the PGT1 group (4.84 vs. 3.18 respectively; p = 0.067) and a significantly lower number of frozen embryos after biopsy (0.29 vs. 0.60 respectively; p = 0.037). No difference was found regarding the mean suitable embryos for biopsy. The PGT2 group had fewer embryos to transfer per cycle (1.30 vs.1.89; p = 0.007), yet there was no difference regarding the number of transferred embryos per cycle.

CONCLUSION: Testing for two genetic indications in one biopsy is feasible yet yields a lower proportion of embryos genetically suitable for transfer but with a similar live birth rate.

PMID:40097348 | DOI:10.1002/pd.6779

Psychooncology. 2025 Mar;34(3):e70120. doi: 10.1002/pon.70120.

ABSTRACT

BACKGROUND: Financial toxicity (FT) refers to cancer-related economic distress and hardship, and disproportionately affects adolescent/young adult (AYA) survivors and minoritized groups. This study explored the FT experiences of AYA survivors of childhood cancer and their parents, and the perspective of staff members of a community-based cancer support organization in a rural region with majority Hispanic/Latino (H/L) residents and high rates of non-English language preference.

METHODS: A needs assessment study was conducted in partnership with Jacob’s Heart, a nonprofit organization that serves predominantly H/L families of childhood cancer in a rural region in California. English- and Spanish-speaking AYA survivors, parents, and Jacob’s Heart staff members completed semi-structured interviews. Qualitative data were analyzed using an applied thematic analysis approach.

RESULTS: Participants included 12 AYAs, 11 parents, and 7 organization staff. Material hardship was characterized by direct and indirect medical costs (e.g., time, transportation), which impacted parents’ employment, required balancing caregiving and financial needs, and caused economic strain. Behavioral effects of FT included adaptations to meet basic needs; cost-coping behaviors included skipping medical visits. Parents and survivors experienced financial stress and worry, exacerbated by disruption in parents’ employment and income, transportation pressures of living in a rural area, challenges obtaining or maintaining insurance coverage, and lack of a safety net. Support needs and resources were described.

CONCLUSIONS: AYA survivors of childhood cancer and their parents experience long-lasting FT across multiple domains, which is exacerbated by socioeconomic and structural factors. Interventions targeting FT should partner with community-based organizations to reach vulnerable populations.

PMID:40097346 | DOI:10.1002/pon.70120

Clin Teach. 2025 Jun;22(3):e70075. doi: 10.1111/tct.70075.

ABSTRACT

BACKGROUND: Although medical students receive ample information about cancer screening guidelines, actual hands-on experience providing patient education about breast health and breast self-awareness is lacking. Students at a Florida medical school volunteer at community events to provide breast health education. This study assessed the effectiveness of a training in improving medical students’ perceived knowledge, comfort and interest in breast health education.

APPROACH: Students participated in a 60-min training to serve as breast health educators. The comprehensive and interactive training covered topics including breast cancer risk factors and preventative measures, breast self-awareness and screening. Participants completed pretraining and posttraining surveys to assess perceived knowledge and comfort in delivering breast health education and interest in participating in future events using 5-point Likert scales. A descriptive analysis was performed.

EVALUATION: A total of 104 students completed the training, with 79% and 66% completing the pretraining and posttraining surveys, respectively. Before the training, 21% of students reported adequate or extensive knowledge, compared to 80% of students after the training. Students’ reported comfort level as somewhat or very comfortable was 23% and 74% before and after the training, respectively. Eighty-nine per cent of students reported being somewhat or very interested before the training, compared to 86% after the training.

IMPLICATIONS: Medical students’ knowledge about breast health is limited. Our study demonstrates that a 60-min training enhances medical student perceived knowledge and comfort in delivering breast health education. The knowledge gained from a breast health education training may serve medical students as future physicians, regardless of specialty.

PMID:40097289 | DOI:10.1111/tct.70075

Korean Circ J. 2025 Feb 3. doi: 10.4070/kcj.2024.0240. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: The 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging guidelines report that approximately 20% of diastolic dysfunction is indeterminate and has limited diagnostic accuracy. Left atrial strain may help accurately categorize diastolic dysfunction; however, its exact roles remain unclear. This study investigated the impact of left atrial reservoir strain (LARS) and its association with exercise capacity in patients with indeterminate diastolic function.

METHODS: Among 687 patients who underwent cardiopulmonary exercise tests and supine bicycle stress echocardiography for symptoms including dyspnea, chest pain, valvular heart disease, and other cardiovascular problems, 118 with indeterminate diastolic function were analyzed after excluding those with atrial fibrillation and significant valvular heart disease. Poor exercise tolerance was defined as peak oxygen consumption (pVO₂) <14 mL/kg/min.

RESULTS: Key diastolic dysfunction indices showed no statistical differences between patients with pVO₂ <14 mL/kg/min and ≥14 mL/kg/min. Only LARS was independently associated with pVO₂ (β=0.12 [0.09-0.15], p<0.001) in patients with indeterminate diastolic function. Receiver-operating characteristic curves highlighted LARS as a strong predictor of impaired pVO₂ among all echocardiographic variables (area under the curve: 0.871 [0.776-0.966]), with an optimal cut-off value of 21% after adjusting for clinical variables. Logistic analysis showed that patients with ≤21% LARS had significantly reduced exercise capacity (odds ratio, 12.77; 95% confidence interval, 3.83-48.65; p<0.001).

CONCLUSIONS: LARS is significantly associated with pVO₂ in patients with indeterminate diastolic function. Impaired LARS is a robust predictor of exercise intolerance; measuring LARS enhances diastolic-function assessment accuracy, potentially improving individualized diastolic-dysfunction management and treatment.

PMID:40097277 | DOI:10.4070/kcj.2024.0240

Bioinformatics. 2025 Mar 17:btaf117. doi: 10.1093/bioinformatics/btaf117. Online ahead of print.

ABSTRACT

MOTIVATION: Identifying drug target interactions is a crucial step in drug repurposing and drug discovery. The significant increase in demand and the expensive nature for experimentally identifying drug target interactions necessitate computational tools for automated prediction and comprehension of drug target interactions. Despite recent advancements, current methods fail to fully leverage the hierarchical information in drug target interactions.

RESULTS: Here we introduce H2GnnDTI, a novel two-level hierarchical heterogeneous graph learning model to predict drug target interactions, by integrating the structures of drugs and proteins via a low-level view GNN (LGNN) and a high-level view GNN (HGNN). The hierarchical graph consists of high-level heterogeneous nodes representing drugs and proteins, connected by edges representing known DTIs. Each drug or protein node is further detailed in a low-level graph, where nodes represent molecules within each drug or amino acids within each protein, accompanied by their respective chemical descriptors. Two distinct low-level graph neural networks are first deployed to capture structural and chemical features specific to drugs and proteins from these low-level graphs. Subsequently, a high-level graph encoder is employed to comprehensively capture and merge interactive features pertaining to drugs and proteins from the high-level graph. The high-level encoder incorporates a structure and attribute information fusion module designed to explicitly integrate representations acquired from both a feature encoder and a graph encoder, facilitating consensus representation learning. Extensive experiments conducted on three benchmark datasets have shown that our proposed H2GnnDTI model consistently outperforms state-of-the-art deep learning methods.

AVAILABILITY AND IMPLEMENTATION: The codes are freely available at https://github.com/LiminLi-xjtu/H2GnnDTI.

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

PMID:40097269 | DOI:10.1093/bioinformatics/btaf117

Vox Sang. 2025 Mar 17. doi: 10.1111/vox.70018. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Extracorporeal membrane oxygenation (ECMO) provides cardiopulmonary support to over 4000 neonates and children annually worldwide. Although potentially lifesaving, ECMO carries bleeding and thromboembolic risks, often managed with platelet transfusions to maintain specific thresholds. Platelet transfusions themselves carry many risks. This survey aimed to describe stated prophylactic platelet transfusion practices among paediatric veno-arterial (VA)-ECMO providers and identify factors influencing transfusion decisions.

MATERIALS AND METHODS: This is a cross-sectional electronic survey of paediatric ECMO providers from 10 centres evaluating platelet transfusion thresholds based on six patient scenarios (non-bleeding, minimally bleeding and resolved bleeding in neonates and children). Descriptive statistics were used for analysis.

RESULTS: The survey response rate was 56% (114 of 204). Paediatric intensivists comprised 66% of respondents. The median pre-transfusion platelet count varied across VA-ECMO scenarios, with a threshold of 50 × 10⁹/L (interquartile range [IQR] 45-75) for non-bleeding children and 70 × 10⁹/L (IQR 50-85) for non-bleeding neonates. The threshold for minimally bleeding children, minimally bleeding neonates and resolved bleeding in children was 75 × 10⁹/L (IQR 50-100). The threshold for resolved bleeding in neonates was 80 × 10⁹/L (IQR 50-100). There was significant heterogeneity between and within sites (p < 0.001). Uncertainty about the level of evidence was high (59%), with clinical judgement being the most influential factor in transfusion decisions (85%).

CONCLUSION: Prophylactic platelet transfusion practices in paediatric ECMO vary widely, highlighting uncertainty and the need for clinical trials to improve patient outcomes.

PMID:40097240 | DOI:10.1111/vox.70018

BMJ Open Qual. 2025 Mar 17;14(1):e002908. doi: 10.1136/bmjoq-2024-002908.

ABSTRACT

The ongoing drug toxicity crisis is a growing public health challenge in many countries across the world. Despite the WHO’s recommendation of take-home naloxone (THN) kits as a cost-effective harm reduction strategy to prevent drug toxicity deaths, the Addiction Medicine Consult Team (AMCT) at Burnaby Hospital found that only 51% of their eligible patients were receiving a kit before discharge. In response, the AMCT created a quality improvement (QI) team with the aim of increasing their THN kit distribution rate on two hospital wards from 51% to over 80% within 10 months.Change ideas were implemented with the aim of targeting various components of the THN kit distribution process. Changes included adjusting THN kit inventory on wards, hosting education sessions for nurses, creating just-in-time training using nursing station whiteboards, streamlining the documentation process for nurses and standardising the ordering process for providers. The QI team collaborated with hospital interest holders including senior executives, nursing and pharmacy groups to facilitate change ideas. The project culminated with 4 months of sustained THN kit provision above 80%.The QI team is currently in talks with hospital operations to ensure that an effective documentation system will be integrated into the new electronic medical record system when the hospital transitions away from paper charting in 2025.

PMID:40097234 | DOI:10.1136/bmjoq-2024-002908

BMJ Open. 2025 Mar 17;15(3):e087903. doi: 10.1136/bmjopen-2024-087903.

ABSTRACT

OBJECTIVES: Although both infertility and mental illness are serious public health issues, relatively little is known about the mental health of women seeking fertility help in many lower and middle-income countries. This survey analyses the type of psychological burden that affects women who are unable to access in vitro fertilisation treatment (IVF), the risk factors for depression and anxiety among those seeking IVF treatment in Pakistan, and the existing mental health issues in women who seek help for the treatment of infertility to understand the accessibility and availability of specialist services. The aim of the study was to estimate the prevalence of depression among women seeking fertility treatments in three different settings at the same time.

DESIGN: A cross-sectional survey with convenience sampling.

SETTINGS: Different types of settings: private and public hospitals and traditional clinics in the community.

PRIMARY OUTCOME MEASURE: Screening for depression using HADS (Hospital Anxiety and Depression Scale) and psychiatric interviews of those scoring above the cut-off level on HADS with WHO SCAN (Schedules for Clinical Assessment in Neuropsychiatry).

RESULTS: The study sample consisted of 485 participants. The complete demographic data were available for 477 women. The HADS questionnaire was completed by 466 women, of whom 162 also completed the SCAN interview. Ages ranged from 15 to 60 years, with a mean age of 28.5 years, and 100% were married. According to HADS, 69% of cases of depression and anxiety were diagnosed, whereas 50% of those who were interviewed with SCAN had a diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), varying across settings (63% in government hospital, 42% traditional setting and 36% private hospital, respectively). There was a twofold risk of depression among the participants attending government hospitals (OR=2.4, CI=1.2, 4.7, p=0.03) as compared with women attending traditional clinics, and there was a slightly lower risk among the participants of private hospitals (OR=0.9, CI=0.4, 2.3, p=0.03) than other groups. The main risk factors found were having a traditional previous contact for treatment and attempting time (years). The HADS showed efficient performance with 97% sensitivity and 49% specificity with cut-off score 12. The main risk factors for depression were identified in those who had sought any previous treatment, having very low income and increased time spent attempting, with a clear difference in the risk of depression between those being treated at government hospitals and those following other treatment pathways.

CONCLUSION: In this study of women seeking infertility treatment in Pakistan, there was variation in the proportion meeting diagnostic criteria in different settings (as measured by HADS and WHO SCAN). This variation is likely to be due to the markedly different communities accessing the particular setting as well as the quality of treatment or help provided. It was clear overall that repeated attempts to seek help and length of trying are associated with higher prevalence of depression in this population. It is essential to provide appropriate and affordable fertility treatment in all government hospitals to ameliorate the effects of prolonged treatments and time spent struggling to reach places offering medical fertility care, and to introduce the concept of mental healthcare at fertility clinics within these government hospitals. The high risk of depression among the lower income group shows that providing access to specialist care and assisted reproduction to poor patients is urgently needed.

PMID:40097232 | DOI:10.1136/bmjopen-2024-087903