Tag: statistics

Neurol India. 2025 Jul 1;73(4):740-745. doi: 10.4103/neurol-india.Neurol-India-D-24-00251. Epub 2025 Jul 24.

ABSTRACT

BACKGROUND: Ictal cognitive assessments carried out in Epilepsy Monitoring Units (EMUs) have been standardized on the Western population which is unable to capture the socioeducational differences present in the Indian population.

OBJECTIVE: This study focuses on modifying and rearranging components of the International League Against Epilepsy’s Ictal Testing Battery (ILAE-ITB) in a local setting at an Indian epilepsy center.

METHODS: The Customizable Ictal Testing Battery (C-ITB) was modified using ILAE-ITB by enabling variable order of item administration, prioritizing items testing the suspect seizure onset region. The consenting participants were assessed using both batteries. The diagnostic performance and localization ability of C-ITB were also measured.

RESULTS: 116 patients with drug-resistant epilepsy were recruited. Association between both batteries was statistically significant using the Chi-square/Fisher’s exact test (P value < 0.001). The Cohen’s kappa was 85.6 and the sensitivity and specificity indices were 100% and 80% respectively. C-ITB demonstrated an inherent validity of 94.8%. There was a significant association between the localization demonstrated by C-ITB and vEEG, MRI. The localization capabilities of C-ITB and ILAE-ITB were comparable.

SIGNIFICANCE: C-ITB is a comprehensive measure of ictal functioning adapted according to the requirements of Indian patients with epilepsy and might facilitate further research into the domain of ictal response deficits.

PMID:40705291 | DOI:10.4103/neurol-india.Neurol-India-D-24-00251

Neurol India. 2025 Jul 1;73(4):721-726. doi: 10.4103/neurol-india.Neurol-India-D-23-00646. Epub 2025 Jul 24.

ABSTRACT

BACKGROUND: The repercussions of inadequate treatment in children with migraine can be disastrous. For this reason, our study aimed to evaluate the pizotifen’s efficacy and tolerance in the control of migraine attacks in children.

METHODS: This research was a cross-sectional, quantitative and retrospective study. The medical records of 65 patients children or adolescents diagnosed with migraine according to the criteria of third edition of the International Classification of Headaches, and treated with pizotifen, were analyzed, considering the follow-up of one year after starting treatment. The correlation between the selected variables was performed using Fisher’s exact test.

RESULTS: This study presents an average age of 10.4 years. The female gender predominated, especially in the pubescent age group, which corresponded to 69%. Migraine was disabling in 57% of cases. There was an improvement in 84.6% of the children with the use of pizotifen, and 18.5% of the patients made irregular use of the medication and 100% of these evolved with recurrent attacks. Side effects occurred in 16.9%, the most common being increased appetite and weight gain. Gender, puberty, frequency of attacks and migraine equivalents did not have a statistically significant influence on migraine control with the use of the drug.

CONCLUSIONS: Pizotifen proved to be effective in reducing the frequency and intensity of migraine attacks and had an acceptable tolerance profile, which makes it a good therapeutic option. Randomized clinical trials with a larger number of participants are needed to confirm our findings.

PMID:40705288 | DOI:10.4103/neurol-india.Neurol-India-D-23-00646

Neurol India. 2025 Jul 1;73(4):716-720. doi: 10.4103/neurol-india.Neurol-India-D-24-00524. Epub 2025 Jul 24.

ABSTRACT

BACKGROUND: The craniovertebral junction (CVJ) is associated with congenital anomalies such as atlanto-axial dislocation (AAD) and basilar invagination (BI). The role of bony anatomy in these pathologies is well studied. The posterior atlanto-occipital membrane complex (PAOMc) (equivalent of ligamentum flavum) is often seen to be forming a tight band-like constricting structure in the CVJ anomalies and has been less studied.

OBJECTIVES: This study aimed to compare the histological characteristics of PAOMc in CVJ anomaly patients with those in patients undergoing surgery for posterior fossa tumors (controls).

METHODS: This observational study included 41 patients, divided into two groups: 22 with congenital CVJ anomalies undergoing C1-C2/occipitocervical fixation and 19 undergoing surgeries for posterior fossa tumors. PAOMc samples from both groups were analyzed using hematoxylin and eosin, Mason Trichrome, Alcian Blue, and Van Gieson stains. Immunohistochemistry for CD34 and CD68 markers was performed. Histological parameters were graded and compared using appropriate statistical test.

RESULTS: Both the groups were comparable with respect to age and gender. Histological and immunohistochemistry comparison revealed no significant differences in all the evaluated parameters between the PAOMc of patients with congenital CVJ anomalies and those of the control group (p- value > 0.05).

CONCLUSION: The present study is the first study to study the role of PAOMc in congenital CVJ anomalies. The findings indicate that PAOMc may not play a significant role in the pathology of these anomalies, contrasting with the ligamentum flavum in other spinal regions.

PMID:40705287 | DOI:10.4103/neurol-india.Neurol-India-D-24-00524

Neurol India. 2025 Jul 1;73(4):678-691. doi: 10.4103/neurol-india.Neurol-India-D-24-00443. Epub 2025 Jul 24.

ABSTRACT

Tuberculous meningitis (TBM) is a critical form of tuberculosis with high morbidity and mortality. Paradoxical reactions (PR) are frequently observed in neurotuberculosis, with diverse manifestations. A selective immune dys/upregulation leads to cytokine surge. The exact immune pathogenesis is not known. This review explores the established literature-based knowledge in PR in HIV-ve TBM to visualize the gray zone in neurotuberculosis and possible immune therapeutic adventures. We undertook this systematic review as per the preferred reporting items for systematic reviews and meta-analyses guidelines and searched PubMed, Scopus, Embase, and Google Scholar database till July 25, 2024, to identify eligible studies focusing on PR in TBM/neurotuberculosis. Quality assessment followed the protocol of Murad MH et al. Data were synthesized narratively and statistically analyzed using Microsoft Excel. The search yielded 112 records describing 617 patients. PR is an immune dys/upregulated state in tuberculosis observed with a median age of 34 years (7-74 years), incidence of 12.7-64.7%, and 9.09-27.8% mortality. The spectrum involved clinical PR (tuberculomas, hydrocephalus, infarcts, arachnoiditis), imaging PR, cerebrospinal fluid PR, or in combinations. Treatment in the form of medical [corticosteroid, thalidomide, intrathecal hyaluronidase, biological (anti-tumor necrosis factor-alpha/TNF-α agents)], surgery (ventriculoperitoneal shunting) has shown good clinical response. Immunological and genetic studies in PR/neurotuberculosis are sparse. Immunological agents like corticosteroid, thalidomide, biologicals like anti-TNF-α have proven benefit in treating PR/neurotuberculosis. Research into the neuroimmunological and genetic aspects of PR is lacking and needs further exploration via predictive models and randomized therapy-based trials.

PMID:40705281 | DOI:10.4103/neurol-india.Neurol-India-D-24-00443

Phys Eng Sci Med. 2025 Jul 24. doi: 10.1007/s13246-025-01594-2. Online ahead of print.

ABSTRACT

Limited patient data availability presents a challenge for efficient machine learning (ML) model development. Recent studies have proposed methods to generate synthetic medical images but lack the corresponding prognostic information required for predicting outcomes. We present a cancer outcomes modelling approach that involves generating a comprehensive synthetic dataset which can accurately mimic a real dataset. A real public dataset containing computed tomography-based radiomic features and clinical information for 132 non-small cell lung cancer patients was used. A synthetic dataset of virtual patients was synthesized using a conditional tabular generative adversarial network. Models to predict two-year overall survival were trained on real or synthetic data using combinations of four feature selection methods (mutual information, ANOVA F-test, recursive feature elimination, random forest (RF) importance weights) and six ML algorithms (RF, k-nearest neighbours, logistic regression, support vector machine, XGBoost, Gaussian Naïve Bayes). Models were tested on withheld real data and externally validated. Real and synthetic datasets were similar, with an average one minus Kolmogorov-Smirnov test statistic of 0.871 for continuous features. Chi-square test confirmed agreement for discrete features (p < 0.001). XGBoost using RF importance-based features performed the most consistently for both datasets, with percent differences in balanced accuracy and area under the precision-recall curve of < 1.3%. Preliminary findings demonstrate the potential application of synthetic radiomic and clinical data augmentation for cancer outcomes modelling, although further validation with larger diverse datasets is crucial. While our approach was described in a lung context, it may be applied to other sites or endpoints.

PMID:40705274 | DOI:10.1007/s13246-025-01594-2

J Int Med Res. 2025 Jul;53(7):3000605251358062. doi: 10.1177/03000605251358062. Epub 2025 Jul 24.

ABSTRACT

ObjectiveThis study aimed to investigate the association of TLR3 single-nucleotide polymorphisms 1337 C/T (rs3775290) and 1234 C/T (rs3775291) with the risk of chronic hepatitis B virus infection.MethodsThis case-control study enrolled 136 participants (66 patients with chronic hepatitis B virus infection (cases) and 70 healthy controls). TLR3 polymorphisms were genotyped using polymerase chain reaction-restriction fragment length polymorphism. Demographic/clinical data were collected via standardized questionnaires and analyzed using Statistical Package for Social Sciences (significance level: p < 0.05).ResultsFor TLR3 1337 C/T polymorphism, the CT genotype prevalence was significantly higher in cases (47.0%) than in controls (31.4%) (odds ratio = 0.42, 95% confidence interval: 0.20-0.87, p = 0.0187), while the CC genotype demonstrated protective effects (39.4% in cases vs. 62.9% in controls; odds ratio = 0.26, 95% confidence interval: 0.07-0.94, p = 0.0314). The C allele frequency showed significant between-group differences (odds ratio = 0.46, p = 0.0044). No associations were observed for 1234 C/T single-nucleotide polymorphism (p = 1.0). Biochemical analysis revealed significantly elevated alanine aminotransferase (p = 0.0044) and aspartate aminotransferase (p < 0.0001) levels in cases than in controls.ConclusionsRegarding TLR3 1337 C/T single-nucleotide polymorphism, the CT genotype increases the risk of chronic hepatitis B virus infection (odds ratio = 0.42), while the CC genotype demonstrates protective effects (odds ratio = 0.26) in Sudanese populations, suggesting its utility as a therapeutic target and prognostic marker. No 1234 C/T associations were observed.

PMID:40704442 | DOI:10.1177/03000605251358062

Environ Sci Process Impacts. 2025 Jul 24. doi: 10.1039/d5em00181a. Online ahead of print.

ABSTRACT

Background: chronic obstructive pulmonary disease (COPD) is a common respiratory disease caused by genetic and environmental factors, but the contribution of urine volatile organic compounds (VOCs) to the risk of COPD remains unclear. This study aims to use the NHANES data to explore the potential value of urine VOCs in predicting COPD. Methods: an epidemiological study including 782 participants from the National Health and Nutrition Examination Survey (NHANES) 2013-2018 was performed to evaluate the association between urine VOCs and COPD. Receiver operating characteristic (ROC) and the area under the ROC curve (AUC) analysis were used to evaluate the diagnostic performance of urine VOCs on COPD. Results: seven urine VOCs were associated with an increased risk of COPD [odds ratio (OR>1; p < 0.05)]. The dose-response relationship was also statistically significant between them. Meanwhile, urine VOCs can lead to the occurrence of COPD through the inflammatory effects. The area under the ROC curves for the combined urine VOC models as a predictor for COPD was 0.90. Conclusions: association between urine VOCs and an increased risk of COPD was found in the NHANES data. Inflammatory factors play an important role in the association of urine VOCs and COPD. In addition, urine VOCs could be useful in predicting COPD risk. More studies are needed to elucidate the mechanisms and clinical application values underlying the association between urine VOCs and COPD.

PMID:40704434 | DOI:10.1039/d5em00181a

Br J Dermatol. 2025 Jul 24:ljaf299. doi: 10.1093/bjd/ljaf299. Online ahead of print.

NO ABSTRACT

PMID:40704386 | DOI:10.1093/bjd/ljaf299

Tanaffos. 2024 Mar;23(3):266-279.

ABSTRACT

BACKGROUND: Using Health-related quality of life (HRQL) in chronic patients with severe respiratory insufficiency (SRI) requires a valid instrument. Hence, this study aimed to translate and validate the Persian version of the Severe Respiratory Insufficiency Questionnaire in chronic patients with severe respiratory insufficiency.

MATERIALS AND METHODS: In this methodological study, the original version of the HRQL questionnaire in chronic patients with SRI was translated based on the approach presented by Wild et al. Face validity, content validity such as content validity index (CVI) and content validity ratio (CVR), convergent, and discriminant validity were evaluated. Moreover, construct validity evaluation was conducted by exploratory and confirmatory factor analyses (EFA & CFA).Reliability was also evaluated by calculating Cronbach’s alpha and test-retest intraclass correlation coefficient (ICC). SPSS-16 and AMOS-24 software were used for data analysis.

RESULTS: The target group approved the face validity of the questionnaire and the content validity index was 0.94. In total, 500 chronic patients with severe respiratory insufficiency participated in the construct validity. Seven factors were extracted in exploratory factor analysis as respiratory complaints, physical functioning, social relationship, anxiety, attendant symptoms and sleep, social functioning, and psychological well-being. These factors explained 73.91% of the total variance of the concept of HRQL in chronic patients with SRI. All factors confirmed in confirmatory factor analysis based on model fit indices [Comparative Fit Index (CFI)=0.94, Goodness of fit index (GFI)=0.94, Minimum Discrepancy Function by Degrees of Freedom divided (CMIN/DF) =2.99, and Root Mean Square Error of Approximation (RMSEA)=0.01]. Convergent and discriminant validity were also confirmed. Moreover, Cronbach’s alpha coefficients of 0.84 and intraclass correlation coefficient of 0.82-0.96 with 15-day intervals confirmed the internal consistency of the instrument.

CONCLUSION: According to the findings of the present study, the Persian version of the SRI questionnaire, with 7 subscales and 40 items, is a valid and reliable instrument to assess the HRQL in chronic patients with SRI.

PMID:40704351 | PMC:PMC12281339

Front Nutr. 2025 Jul 7;12:1477992. doi: 10.3389/fnut.2025.1477992. eCollection 2025.

ABSTRACT

INTRODUCTION: It has been proven that polycystic ovary syndrome (PCOS) is associated with reduced bone mineral density (BMD) and impaired bone metabolism. However, to the best of our knowledge, neither the relationship between indices of bone turnover in adolescent girls was examined, nor were lean and overweight PCOS young females compared in this regard, which were the aims of our study.

METHODS: Thirty-nine PCOS subjects, aged 14-18 years, were assigned to one of the two groups: Ov/Ob (overweight/obese group, n = 14) and lean (non-overweight/non-obese group, n = 25). Fasting blood samples were collected to assess bone turnover, inflammation, oxidative stress, and hormonal markers. Basic anthropometric and biochemical data were also obtained.

RESULTS: In Ov/Ob young females, concentrations of bone turnover markers, GlaOC, GluOC, and CTX-I (selective bone resorption marker), were lower than in lean PCOSs. However, this difference was statistically significant only for GlaOC. The serum activity of bone alkaline phosphatase (BAP), a bone formation index, tended to be higher in the Ov/Ob than in lean PCOS patients, although not significantly. Additionally, we observed an inverse association between low-grade inflammation, oxidative stress, androgen levels (total testosterone and/or DHEA-S), and BAP and/or GlaOC in both lean and Ov/Ob groups, together with a positive association between Total Antioxidant Capacity (TAC) and BAP. Moreover, fasting glucose, insulin, and HOMA-IR positively correlated with GluOC and BAP in lean girls.

DISCUSSION: Our outcomes suggest a potential negative interaction between bone markers and immune-hormonal abnormalities featuring lean and Ov/Ob adolescent PCOS girls. Moreover, these findings suggest a positive interaction between bone metabolism and total antioxidant capacity, and insulin and glucose management exists in the body. Although these findings require further investigation, all possible preventive measures should be taken to lower inflammation, oxidative stress, and androgen levels, also keeping bone well-being/homeostasis in mind.

PMID:40704316 | PMC:PMC12284499 | DOI:10.3389/fnut.2025.1477992