Tag: statistics

Korean J Radiol. 2025 Jul;26(7):650-659. doi: 10.3348/kjr.2025.0049.

ABSTRACT

OBJECTIVE: To compare the efficacy of microwave ablation (MWA) and surgical resection (SR) for small (≤3 cm) hepatocellular carcinoma (HCC) in older patients.

MATERIALS AND METHODS: This retrospective study initially enrolled 319 patients who were aged ≥65 years, had a single HCC ≤3 cm, and had Child-Pugh class A or B. Of these, 108 received MWA and 211 received SR. Overall survival (OS), disease-free survival (DFS), local tumor progression (LTP), complications, and postoperative hospital stay were compared between the groups. Hazard ratios (HRs) were estimated using the SR group as reference. Propensity score matching (PSM) was used to minimize confounding biases.

RESULTS: After PSM, 80 patients each were included in the MWA and SR groups. There were no statistically significant differences in the 1-, 3-, and 5-year OS rates (MWA: 96.2%, 80.3%, and 55.4%, respectively; SR: 91.3%, 81.4%, and 64.8%, respectively; HR = 1.06; 95% confidence interval [CI], 0.61-1.85; P = 0.839) and DFS rates (MWA: 72.4%, 43.2%, and 26.4%, respectively; SR: 78.8%, 51.2%, and 38.0%, respectively; HR = 1.27; 95% CI, 0.84-1.90; P = 0.247) between the MWA and SR groups. MWA was associated with a higher LTP rate (HR = 2.96; 95% CI, 1.21-7.28; P = 0.028). Additionally, older patients in the MWA group had fewer complications (52.5% vs. 97.5%, P < 0.001) and shorter postoperative hospital stay (3 days vs. 6 days, P < 0.001) than those in the SR group.

CONCLUSION: In older patients with a single HCC ≤3 cm, MWA was superior to SR in terms of complications and postoperative hospital stay, and there was no significant difference in the 5-year OS and DFS outcomes. Therefore, MWA may be an alternative curative treatment for such patients.

PMID:40590077 | DOI:10.3348/kjr.2025.0049

Korean J Radiol. 2025 Jul;26(7):626-637. doi: 10.3348/kjr.2024.1261.

ABSTRACT

OBJECTIVE: This study aimed to evaluate changes in left ventricular and left atrial mechanics in relation to the severity of aortic stenosis (AS) by comparing computed tomography (CT)-derived strain values in patients with mild-to-severe AS.

MATERIALS AND METHODS: This single-center retrospective study included 120 patients (median age, 76 years; 45.0% male), comprising 30, 30, and 60 patients with mild, moderate, and severe AS, respectively, all of whom underwent multiphase cardiac CT between 2015 and 2021. Patients were selected from 177 individuals who met the initial eligibility criteria, with matching for age, sex, and hypertension in a 1:1:2 ratio across the mild, moderate, and severe AS groups. Electrocardiography-gated cardiac CT images were analyzed to obtain various quantitative left ventricle (LV) and left atrium (LA) strain parameters. Statistical differences in cardiac CT-derived LV and LA strain parameters among mild, moderate, and severe AS were evaluated using the Kruskal-Wallis test, followed by post-hoc tests.

RESULTS: The median LV global longitudinal strain differed significantly across AS severity (GLS: -19.4%, -18.2%, and -16.2% for mild, moderate, and severe AS, respectively; P < 0.001), with the absolute value decreasing as AS severity increased. Additionally, the median values of LV global circumferential strain (GCS: -29.8%, -30.8%, and -27.4%, respectively; P = 0.045), LV global radial strain (GRS: 50.1%, 50.3%, and 39.3%, respectively; P = 0.004), and LA conduit strain (11.5%, 11.2%, and 9.0%, respectively; P = 0.031) differed significantly according to AS severity, with lower absolute values observed in patients with severe AS.

CONCLUSION: In patients with AS, CT-derived LV and LA strains revealed changes in myocardial deformation according to AS severity. Specifically, there was a gradual decrease in the absolute value of LV GLS with increasing AS severity and initial preservation until moderate AS, followed by an eventual decrease in the absolute values of LV GCS, LV GRS, and LA conduit strain in severe AS.

PMID:40590075 | DOI:10.3348/kjr.2024.1261

Intern Med J. 2025 Jul 1. doi: 10.1111/imj.70138. Online ahead of print.

ABSTRACT

BACKGROUND: Lung cancer remains a significant public health problem and a leading cause of cancer-related mortality worldwide. The delays in the diagnosis of lung cancer are more pronounced for rural and regional Australians compared to their urban counterparts. Implementing an online HealthPathway is one way to reduce delays in the diagnosis of lung cancer.

AIM: The Townsville Lung Cancer Referral Pathway (TLCRP) was implemented to guide local general practitioners (GPs) in the referral process of people with suspected lung cancer. The aim of the study was to compare the time interval from initial GP consultation of the person with suspected lung cancer to the first specialist referral and from the first specialist referral to the initial specialist appointment, before and after implementation of TLCRP. Other lung cancer service outcomes were also compared between the pre- and post-implementation groups.

METHODS: A retrospective cohort study of 316 participants was conducted, and descriptive statistical analysis of the data was used to discern any difference in timelines and other clinical outcomes in the pre-pathway implementation group compared to the post-pathway implementation group.

RESULTS: The time interval from initial GP presentation to initial referral to specialist appointment was significantly reduced in the post-pathway group (15 days) compared to the pre-pathway group (8 days, P = 0.03). However, the time interval from GP referral to initial appointment with a specialist increased in the post-pathway group (15 and 20 days, P = 0.03). Many of the Cancer Australia lung cancer optimal care pathway referral guidelines were not met. Only 40% of the pre-pathway group and 34% of the post-pathway group were seen in the specialist clinic within 2 weeks of GP referral. Significant proportions of patients in both groups did not have chest x-rays ordered by the GP, and the proportion of participants who were appropriately referred to the respiratory clinic did not improve after implementation of TLCRP (76% and 72%). Nearly 30% of participants in both groups were diagnosed after emergency presentation.

CONCLUSIONS: TLCRP improved the time interval from initial GP consultation to specialist referral, thus meeting its primary objective. However, better strategies are required to improve other timelines and meet Cancer Australia’s lung cancer optimal care pathway guidelines.

PMID:40590064 | DOI:10.1111/imj.70138

Cleft Palate Craniofac J. 2025 Jul 1:10556656251355791. doi: 10.1177/10556656251355791. Online ahead of print.

ABSTRACT

ObjectiveAugmented reality (AR) has recently emerged as a potential alternative to 3D-printed technology in craniomaxillofacial surgery. The purpose of this study was to evaluate the feasibility and accuracy of AR craniotomy guides for fronto-orbital advancement (FOA) compared to conventional 3D-printed guides.DesignRetrospective comparative study.SettingCleft and craniofacial center at a tertiary children’s hospital.Patients3D-printed skull models from 9 patients with metopic or coronal craniosynostosis who underwent FOA between January 2022 and November 2023.InterventionsA novel application was developed to project AR craniotomy guides onto 3D-printed skull models. AR guides were compared to conventional 3D-printed guides by utilizing both guidance modalities. The discrepancy at 8 pre-determined reference points was measured, including bilateral nasofrontal (NF), zygomaticofrontal (ZF), barrel stave (BS), and tenon extension (TE).Main Outcomes MeasureMeasured discrepancy in millimeters between AR guides and 3D-printed guides at the pre-determined reference points.ResultsThe anterior reference points (NF, ZF) had mean discrepancies ranging from 0.31 to 0.61 mm. The posterior points had mean discrepancies ranging from 1.39 to 3.28 mm (BS, TE). There was no statistically significant difference found between the two modalities at any reference point.ConclusionsAR craniotomy guides had a high level of accuracy, particularly at the anterior reference points. AR guides demonstrated feasibility as an alternative to 3D-printed craniotomy guides, in-vitro. Further research is required to translate this novel application to cadaver models and improve precision at posterior landmarks.

PMID:40590062 | DOI:10.1177/10556656251355791

Public Health Rev. 2025 Jun 16;46:1607355. doi: 10.3389/phrs.2025.1607355. eCollection 2025.

ABSTRACT

OBJECTIVES: As the aging population grows, Alzheimer’s disease and related dementias (ADRD) present a major public health challenge. Environmental noise, linked to stress and sleep disruption, may increase ADRD risk. We aimed to summarize the research literature on long-term noise exposure and ADRD.

METHODS: We conducted a systematic review and meta-analysis of studies investigating the association of long-term (≥1 year) noise exposure and ADRD assessed with standardized diagnostic criteria. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Eligible studies reported hazard ratios (HR) or similar effect estimates with confidence intervals.

RESULTS: A multilevel random-effects meta-analysis of six longitudinal studies using 13 effect sizes found a significant association between long-term noise exposure and incident ADRD (HR: 1.15, 95% CI: 1.03-1.28). Interaction effects between noise source and dementia subtype were not statistically significant.

CONCLUSION: Long-term noise exposure may contribute to ADRD risk. Heterogeneity between studies highlights the need for standardized exposure assessment and consideration of other environmental factors. Future research should include the exposome approach for identifying environmental drivers of dementia.

PMID:40590049 | PMC:PMC12206670 | DOI:10.3389/phrs.2025.1607355

Front Hum Neurosci. 2025 Jun 16;19:1592640. doi: 10.3389/fnhum.2025.1592640. eCollection 2025.

ABSTRACT

INTRODUCTION: Therapeutic strategies for patients with severe acquired motor disability are relatively limited and show variable efficacy. Innovative technologies such as brain-computer interfaces (BCIs) have been developed recently that might benefit certain types of patients.

METHODS: Here, we tested a previously described auditory BCI, the Encephalophone, which may offer new options to improve quality of life and function. Eleven subjects with acquired moderate to severe motor disability, who had lost their ability to express themselves musically, were enrolled and 10 completed a clinical pilot study of the hands-free Encephalophone brain-computer interface (BCI). Subjects were briefly instructed on the use of the Encephalophone BCI, which uses EEG measured motor imagery to allow users to generate musical notes in real time without requiring movement. Subjects then underwent a pitch-matching task, a measure of accuracy, to attempt to match a given target pitch 3 times within 10 s. They were allowed free play, where they could improvise music over a backing track. After 2-3 songs – approximately 10 min – of freely improvised playing, subjects repeated the pitch-matching task. There were 3 sessions of testing and free play per subject, within 2 weeks, with at least 1 day separating sessions.

RESULTS: All subjects, on average, improved their pitch-matching accuracy by 15.6 percentage points and increased their number of hits by 58.7% over the 3 sessions, with all subjects scoring accuracy percentages significantly above random probability (19.05%). A subjective self-reporting survey of ratings of such factors as a feeling of expressing oneself, enjoyment, discomfort, and feeling of control showed a generally favorable response.

DISCUSSION: We suggest that this training approach using an auditory BCI may provide an innovative solution to challenges in recovery from motor disability.

CLINICAL TRIAL REGISTRATION: https://research.providence.org/clinical-research, Swedish Health Services #: STUDY2017000301.

PMID:40590025 | PMC:PMC12206841 | DOI:10.3389/fnhum.2025.1592640

Front Pediatr. 2025 Jun 16;13:1553317. doi: 10.3389/fped.2025.1553317. eCollection 2025.

ABSTRACT

BACKGROUND: The appropriate length of resection for the dilated segment in Hirschsprung’s disease (HSCR) remains a subject of debate, and the correlation between postoperative clinical outcomes has yet to be elucidated. This study aimed to explore the relationship between the dilated segment resection length (DSRL) and the short-term clinical outcome of HSCR, as well as to determine the optimal DSRL value.

METHODS: The clinical data of all children with HSCR who underwent a pull-through surgery at Shanxi Children’s Hospital from May 2016 to September 2023 were analyzed retrospectively, the baseline characteristics such as sex, gestational age, family history, and complications such as soiling, perianal erosion, constipation were collected. The groups were stratified in recto-sigmoid aganglionosis (short-segment) and extended colonic (long-segment), and DSRL was divided into three groups: DSRL < 10 cm, 10 ≤ DSRL < 20 cm, and DSRL ≥ 20 cm. The Wingspread score system was used to evaluate anal function and analyze the short-term clinical outcome.

RESULTS: A total of 223 children were included in the study, among which 104 cases had short-segment HSCR and 119 cases had long-segment HSCR. The median age at which pull-through surgery was performed was 4 months. In cases of short-segment HSCR, aside from preoperative anemia, baseline characteristics showed no statistically significant differences among the three groups. No statistically significant association was observed between DSRL, the total length of intestinal resection, the length of aganglionosis,and postoperative clinical outcomes.For short-segment HSCR, the best postoperative bowel function was observed when DSRL < 10 cm, with the optimal value being 7.25 cm. In cases of long-segment HSCR, no statistically significant differences in baseline characteristics were observed among the three groups. DSRL, the total length of intestinal resection and the length of aganglionosis all showed statistically significant differences in relation to soiling and perianal erosion. For long-segment HSCR, the best postoperative bowel function was observed when 10 ≤ DSRL < 20 cm, with the optimal value being 13.00 cm.

CONCLUSIONS: Not only the dilated segment resection length matters for the outcome but also the length of aganglionosis. For short-segment HSCR, DSRL, the total length of intestinal resection and the length of aganglionosis showed no significant impact on short-term clinical outcomes. In contrast, these parameters in long-segment HSCR were significantly associated with soiling and perianal erosion, although overall patient quality of life remained satisfactory. Data from a single clinical center suggest that optimal clinical outcomes for children are achieved when the DSRL measurements are 7.25 cm for short-segment HSCR and 13.00 cm for long-segment HSCR.

PMID:40590015 | PMC:PMC12206712 | DOI:10.3389/fped.2025.1553317

J Mech Behav Biomed Mater. 2025 Jun 27;170:107115. doi: 10.1016/j.jmbbm.2025.107115. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the mechanical and adhesive properties of additively manufactured (AM) materials with variable sustainability and recyclability as alternatives to traditional light-cured acrylic resin for dental custom trays.

MATERIALS AND METHOD: Four different AM materials; a photopolymer resin tray material printed with DLP and three FDM printed polylactic acid (PLA), recycled PLA and Polyethylene Terephthalate Glycol (PETG) and a conventional light-cure acrylic resin (LC PMMA) as a control were used to construct dumbbell (tensile testing), rectangular (flexural testing) to verify suitability for custom trays (n=10/group). To evaluate bond strength, specimens were manufactured at 0, 45 and 90° printing orientation (n=10/group). Surface roughness was evaluated with confocal scanning microscopy. The three mechanical tests were completed in a universal testing machine (Instron) according to ISO 527-2 and ISO 20795-1. Results were statistically analysed with PRISM (Version 10) Software using one-way ANOVA and Kruskal-Wallis tests, with statistical significance set at p < 0.05. Confocal analysis and SEM analysis were conducted for quantitative and qualitative surface analysis.

RESULTS: For tensile and flexural strength, PLA (Recycled) and PETG showed no statistically significant difference (p > 0.05) from LC PMMA. AM materials yielded a higher bond strength than the LC PMMA material. Print orientation was found to affect the bond strength of some materials with varying surface roughness as contributing factors.

CONCLUSION: LC PMMA, PLA (Recycled), and PETG have the greatest flexural and tensile strengths. PLA (Recycled) and PETG were the highest performing AM options with regard to flexural and tensile strength for custom trays. All AM materials showed a significantly higher bond strength compared to LC PMMA. To maximise the bond strength, PLA (Recycled) should be printed at an angle of 0°, and PETG at 0 or 90°. Dental practitioners should consider the varying degrees of recyclability of materials, in addition to their mechanical properties.

PMID:40587918 | DOI:10.1016/j.jmbbm.2025.107115

Eur J Surg Oncol. 2025 Jun 24;51(8):110281. doi: 10.1016/j.ejso.2025.110281. Online ahead of print.

ABSTRACT

INTRODUCTION: Retroperitoneal lymph node dissection (RPLND) is an integral part of the multidisciplinary treatment of Testis cancer (TC). Up to now, only few studies compared traditional open RPLND (O-RPLND) with minimally invasive approach. We investigated surgical outcomes and complication rates of patient with TC treated with O-RPLND or robot assisted (RA-RPLND).

MATERIALS AND METHODS: We performed a retrospective analysis of all consecutive patients who underwent RPLND for TC, between 2001 and 2023. We recorded Patient demographics, perioperative and post-operative data. Descriptive statistics depicted differences between O-RPLND and RA-RPLND. Multivariable Poisson regression models (MPRMs) tested for predictors of surgical drain permanence, NSAIDs use (days), LOS, EBL and OT. Multivariable logistic regression models (MLRM) tested for of post operative complications.

RESULTS: Of 144 patients who underwent RPLND, 53 (36.4 %) were treated with RA-RPLND and 91 (63.6 %) with O-RPLND. RA-RPLND group had significantly lower median EBL (50 ml vs 150 ml in O- RPLND; p < 0.01), median LOS (4 days vs 5.5 days in O-RPLND; p < 0.01), median drain indwelling days (4 vs 5 in O-RPLND; p = 0.03), Hb drop (1.5 g/dl vs 1.9 g/dl; p = 0.02) and median NSAIDs use (1 day vs 3 days in O-RPLND; p < 0.01). No difference in intra- and postoperative complication rates was recorded. In MPRM, RA-RPLND was associated with shorter LOS (RR:0.28; p < 0.01), drain permanence time (RR: 0.83; p = 0.01), NSAIDs use (RR:0.63; p < 0.01), and OT (RR 0.85; p < 0.01).

CONCLUSION: RA-RPLND appears to lead to shorter LOS and permanence of surgical drain, lower need for painkillers, lower blood loss and lower OT to O-RPLND, but does not seem associated with lower complication rates compared to O-RPLND. Our findings require prospective validation in future randomized trials.

PMID:40587911 | DOI:10.1016/j.ejso.2025.110281

Biochem Biophys Res Commun. 2025 Jun 27;777:152258. doi: 10.1016/j.bbrc.2025.152258. Online ahead of print.

ABSTRACT

OBJECTIVE: To minimize local recurrence of tongue cancer, it is necessary to tackle the issues of radiotherapy resistance and sensitivity in tongue squamous cell carcinoma (TSCCa). This study focuses on understanding how HOX transcript antisense intergenic RNA (HOTAIR) influences resistance to radiotherapy in TSCCa by modulating the Notch signaling pathway.

METHODS: The TSCCa cells SCC9 and SCC25 were divided into six experimental groups: (1) 8 Gy irradiation group, (2) 8 Gy with negative control, (3) 8 Gy with silent HOTAIR, (4) 8 Gy with null control, (5) 8 Gy with overexpressing HOTAIR, and (6) 8 Gy with silent HOTAIR and Jagged1. After assessing changes in apoptosis, proliferation, and invasion abilities of cells in each group using CCK-8, flow cytometry, and Transwell assays, we also utilized qRT-PCR and WesternBlot to evaluate changes in genes and proteins associated with the Notch pathway. These alterations induced by HOTAIR were validated in vivo using nude mouse tumor-bearing model.

RESULTS: In the silenced HOTAIR group, both ex vivo and in vivo studies revealed decreased cell survival and invasiveness, increased apoptosis, and significantly reduced expression of Notch1, Jagged1, and HES-1 at gene and protein levels (all P < 0.05). In contrast, adding an agonist of the Notch signaling pathway produced opposite results (all P < 0.05).

CONCLUSION: The regulation of the Notch signaling pathway by HOTAIR is associated with resistance to radiotherapy in squamous cell carcinoma of the tongue.

PMID:40587909 | DOI:10.1016/j.bbrc.2025.152258