Category: Statistics

J Environ Manage. 2025 May 3:125549. doi: 10.1016/j.jenvman.2025.125549. Online ahead of print.

ABSTRACT

In the new era of high-quality economic development, the digital economy presents new opportunities for China to achieve low-carbon transformation and enhance environmental protection. This paper analyzes daily data from January 3, 2019, to March 25, 2025, employing the variational mode decomposition (VMD) algorithm to separate China’s digital economy, environmental protection, and carbon neutrality markets into long-term, short-term, and disturbance-term components. Furthermore, this study utilizes a model-free connectedness approach to investigate spillover effects and portfolio strategies among these three markets. The results reveal strong spillovers between the digital economy, environmental protection, and carbon neutrality markets, with the long-term spillover from carbon neutrality to the digital economy being the most pronounced. The spillover network indicates that carbon neutrality is the source, environmental protection is the recipient, and the digital economy is the intermediary. These spillovers are time-varying; short-term and disturbance-term effects significantly intensified with the emergence of ChatGPT and generative AI technologies. Additionally, the portfolio strategies demonstrate that the digital economy offers lower hedging costs and high efficiency in addressing short-term and disturbance-term effects. Conversely, carbon neutrality proves to be a more effective long-term hedging tool. Moreover, this study suggests that long-term strategies are a better benchmark during rising returns. In contrast, a disturbance-term hedging strategy is recommended for managing non-systemic risks during declining portfolio return phases. The findings provide practical guidance for asset allocation and risk management in the digital, environmental, and carbon sectors.

PMID:41176431 | DOI:10.1016/j.jenvman.2025.125549

J Rheumatol. 2025 Nov 1:jrheum.2025-0475. doi: 10.3899/jrheum.2025-0475. Online ahead of print.

ABSTRACT

OBJECTIVE: We aimed to investigate the prevalence and incidence of atlantoaxial subluxation (AAS) in psoriatic arthritis (PsA), identify associated risk factors, and describe the clinical and radiographic characteristics of affected patients.

METHODS: We included individuals from our observational cohort of PsA, excluding those with a history of trauma or cervical spine surgery. We calculated prevalence and incidence of AAS, and we used descriptive statistics to summarize and compare baseline demographic and disease-related characteristics between patients with and without AAS. Additionally, we used Cox regression with time-varying covariates to identify factors linked to AAS development and performed multivariable GEE analysis to assess associations with AAS.

RESULTS: Among 1,535 PsA patients, 34 (2.21%) were identified with AAS, including 20 at baseline and 14 during follow-up, with an incidence of 1.16 per 1000 person-years. Patients with AAS had higher rates of radiographic sacroiliitis (71.0%) and greater peripheral joint damage. Elevated ESR was observed in 86.7% of cases. Cox regression identified radiographic sacroiliitis (HR 6.61, 95% CI 1.64-26.67) as the strongest predictor of AAS, while male sex was associated with a lower hazard (HR 0.42, 95% CI 0.07-0.89). In GEE analysis, radiographic sacroiliitis (OR 3.64, 95% CI 1.6-8.24) and higher modified Steinbrocker scores were associated with AAS, whereas older age (OR 0.95, 95% CI 0.93-0.98) and male sex (OR 0.40, 95% CI 0.17-0.92) were associated with lower ORs.

CONCLUSION: AAS is an uncommon complication in PsA strongly associated with radiographic sacroiliitis and radiographic damage in peripheral joints.

PMID:41176349 | DOI:10.3899/jrheum.2025-0475

Vector Borne Zoonotic Dis. 2025 Oct 30. doi: 10.1177/15303667251392007. Online ahead of print.

ABSTRACT

Background: Brucellosis is a zoonotic bacterial disease that can affect humans and animals. It is often transmitted to humans through the consumption of contaminated animal products or by direct contact with infected animals. In Kenya, data on human and animal brucellosis are limited. Methods: To investigate the seroprevalence and molecular prevalence of human brucellosis in Kenya, we randomly selected from the healthy participants with possible exposure to animals and animal products and randomly selected 348 out of 2,779 human blood samples, that were obtained from a larger longitudinal cohort study that investigated of dengue, chikungunya and Rift Valley Disease exposure in western (Kisumu) and coastal (Ukunda) Kenya. Results: Our study included 126 males (36%), 222 females (64%) in different age categories, and 61 children aged 16 years and younger (18%), with an overall median age of 29.5 years (2- to 75-year age range). Samples were tested by Abnova Brucella IgG enzyme-linked immunosorbent assay (ELISA) Kit (KA0954). Of the tested individuals, anti-Brucella IgG antibodies were detected in 96 (28%) of 348 randomly selected participants. All samples yielded negative results in quantitative polymerase chain reaction (qPCR) analysis. There was no statistically significant correlation between Brucella exposure and study site, gender, age, socioeconomic status, ownership of particular livestock (sheep, goats, and cattle), or consumption of raw animal products. However, highly educated individuals were more likely to have Brucella exposure (odds ratio = 2.02, 1.20-3.41, p = 0.01). Conclusion: In comparison to previous seroprevalence-based studies conducted in nonpastoral Kenyan communities, our study revealed relatively higher seropositivity. This article emphasizes the importance of conducting surveillance for brucellosis in urban areas. Urban brucellosis surveillance within the framework of One Health could serve as a baseline to guide future research on brucellosis in humans.

PMID:41176335 | DOI:10.1177/15303667251392007

J Immunother Cancer. 2025 Oct 31;13(10):e012432. doi: 10.1136/jitc-2025-012432.

ABSTRACT

PURPOSE: A recently published phase 2 neoadjuvant trial in patients with early-stage non-small cell lung cancer (NSCLC) (NCT02818920) evaluated the potential efficacy of pembrolizumab administration in the absence of chemotherapy. This communication reports on conventional and distribution-based immune profiling efforts in efforts to identify novel biomarkers predictive of benefit.

METHODS: Patients with stage 1B-3A NSCLC received two cycles of pembrolizumab (P), followed by surgical resection of the remaining tumors (NCT02818920). Banked peripheral blood mononuclear cells (PBMCs) were analyzed at baseline and following the second dose of P. Resected tumors were disaggregated, and cells were viably cryopreserved. Based on pathologic examination of the tumors, patients were categorized as major pathologic responders (MPR; ≤10% viable tumor present), or non-MPR (>10% viable tumor present). High-parameter immune phenotyping by flow cytometry was performed on all available tumor and PBMC specimens, and results were expressed using both conventional phenotypic frequency analyses as well as a novel distribution-based biomarker identification strategy aimed at discovery of patterns associated with MPR.

RESULTS: Conventional, frequency-based flow cytometric immune phenotyping of participant tumor microenvironments and PBMC revealed several MPR-associated trends, only a few of which reached statistical significance. The distribution-based biomarker identification strategy greatly enhanced the discovery of statistically significant cell types and patterns of change associated with MPR.

CONCLUSIONS: This novel, distribution-based analytic framework identified MPR-associated immune cell subsets in baseline PBMC that were not evident using conventional frequency-based immune profiling. Profiling the microenvironment of MPR-associated tumors revealed statistically significant distributional differences among highly expressed cellular markers on CD8⁺ cells.

PMID:41176317 | DOI:10.1136/jitc-2025-012432

Int J Psychophysiol. 2025 Oct 30:113283. doi: 10.1016/j.ijpsycho.2025.113283. Online ahead of print.

ABSTRACT

Proactive control is defined as the capacity of an individual to selectively allocate attentional resources to task-relevant cues during the preparatory phase of a task, actively encode and sustain this information within working memory, and subsequently establish appropriate response readiness. Research demonstrates that proactive control has neuroplasticity. The dorsolateral prefrontal cortex (DLPFC) is critically implicated in the modulation of proactive control. Theta oscillations, functioning as a neural gating mechanism, facilitate the preferential allocation of attentional resources toward the processing of memory-relevant information, thereby enhancing the maintenance of such information and playing a pivotal role in memory encoding and cognitive resource distribution. The present study employed theta-frequency transcranial alternating current stimulation (tACS) targeting the DLPFC to further elucidate the neuroplasticity of proactive control. Concurrently, to investigate the relationship between fluid intelligence and proactive control, participants’ fluid intelligence was assessed pre- and post-stimulation. A cohort of 58 participants was randomly assigned to receive either left DLPFC stimulation (n = 29) or right DLPFC stimulation (n = 29). The results revealed that stimulation of the left DLPFC significantly enhanced participants’ proactive control capabilities. In ERP indicators, the CNV, following active stimulation, the CNV in the BX condition was significantly greater than that in the pre and sham stimulation (p ≤ 0.006). In behavioral outcomes, the accuracy rate for the BX condition was significantly higher after active stimulation compared to that in pre-stimulation and sham stimulation (p ≤ 0.017). In the lDLPFC group, fluid intelligence performance was significantly enhanced, and fluid intelligence scores after active stimulation were significantly higher compared to those during pre and sham stimulation (p ≤ 0.032). A statistically significant correlation was observed between participants’ proactive control capabilities and fluid intelligence. In the rDLPFC group, no significant changes in any of the indicators were observed. These findings underscore the efficacy of neuromodulatory interventions targeting the left DLPFC in augmenting proactive control and suggest a dynamic interplay between proactive control and fluid intelligence.

PMID:41176257 | DOI:10.1016/j.ijpsycho.2025.113283

J Pediatr Surg. 2025 Oct 30:162758. doi: 10.1016/j.jpedsurg.2025.162758. Online ahead of print.

ABSTRACT

BACKGROUND: Post-obstructive diuresis (POD) is a potentially serious complication following surgical correction of ureteropelvic junction obstruction (UPJO) in pediatric patients. Characterized by excessive urine output after decompression of a chronically obstructed renal system, POD may result in significant fluid and electrolyte imbalance. While physiologic POD is transient, pathologic forms require careful management. This study aimed to determine clinical and demographic risk factors associated with POD following UPJO surgery in a pediatric population.

METHODS: We conducted a retrospective cross-sectional study of pediatric patients undergoing UPJO correction at two tertiary centers in Mashhad, Iran, from July 1, 2020, to July 1, 2021. Data were extracted from hospital records, including age, sex, hydronephrosis grade, presence of renal tubular acidosis (RTA), serum creatinine, and anemia status. POD was defined as urine output >4 mL/kg/h for three consecutive hours postoperatively. Statistical analyses included Chi-square tests and independent t-tests; p < 0.05 was considered significant.

RESULTS: A total of 360 patients were included (65% male; mean age: 62.2 ± 18.3 months). POD occurred in 22 patients (6.1%). Patients with POD were significantly younger (mean age: 50.3 ± 10.7 months vs. 63.2 ± 18.6 months; p < 0.001) and more frequently presented with Grade 4 hydronephrosis (81.8% vs. 45.6%; p = 0.001). No significant associations were found between POD and sex (p = 0.435), RTA (p = 0.683), serum creatinine levels (p = 0.509), or anemia (p = 0.347).

CONCLUSION: Younger age and severe hydronephrosis were significantly associated with increased risk of POD after surgical correction of UPJO. These findings underscore the importance of close postoperative monitoring in high-risk pediatric populations. Prospective studies with standardized POD criteria are needed to validate these predictors and optimize perioperative care.

PMID:41176216 | DOI:10.1016/j.jpedsurg.2025.162758

Complement Ther Med. 2025 Oct 30:103280. doi: 10.1016/j.ctim.2025.103280. Online ahead of print.

ABSTRACT

OBJECTIVE: Heart failure (HF) remains a significant health burden around the world, and Baduanjin is an effective intervention for patients with HF. This study aimed to objectively evaluate the effects of Baduanjin on exercise tolerance, cardiac function, and quality of life in patients with HF.

METHOD: From the time the database was constructed to May 8, 2025, we searched eight databases and two registry systems. Clinical randomized controlled trials (RCTs) of Baduanjin in treating HF were retrieved. The primary outcomes were the 6-minute walk test (6MWT) and left ventricular ejection fraction (LVEF). Secondary outcomes were left ventricular end-diastolic dimension (LVDD), left ventricular end-systolic dimension (LVSD), N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP), BNP levels, Minnesota Living with Heart Failure Questionnaire (MLHFQ), Anaerobic threshold (AT), Metabolic equivalent of task (MET), peak oxygen consumption (VO₂ peak), and Maximal oxygen consumption (VO₂ max). Two researchers performed rigorous data extraction and quality assessment. The quality of the included RCTs was evaluated using the Cochrane Risk of Bias assessment tool, version 2.0 (RoB 2), and statistical analyses were performed using RevMan 5.4 and Stata 17.0 software.

RESULT: A total of 46 RCTs involving 3597 people were included in this study. Meta-analysis showed that Baduanjin could improve the 6MWT [ MD=50.71, 95% CI (37.48, 63.94), P<0.01], LVEF [ MD=3.57, 95% CI (2.70, 4.45), P<0.01], LVDD [ MD = -2.33, 95% CI (-2.82, -1.84), P<0.01], LVSD [ MD = -1.83, 95% CI (-2.31, -1.36), P < 0.01], NT-proBNP levels [ MD = -139.49, 95% CI (-204.08, -74.89), P < 0.01], BNP levels [ MD = -77.68, 95% CI (-110.80, -44.56), P < 0.01], MLHFQ [ MD = -8.15, 95% CI (-12.31, -3.99), P < 0.01], MLHFQ-E [ MD = -3.23, 95% CI (-3.71, -2.74), P < 0.01], MLHFQ-P [ MD = -3.23, 95% CI (-4.17, -3.29), P < 0.01], MLHFQ-G [ MD = -3.56, 95% CI (-4.76, -2.35), P < 0.01], AT [ MD= 1.65, 95% CI (1.22, 2.09), P <0.01], MET [ MD=0.65, 95% CI (0.12, 1.19), P ＜0.05], VO₂ peak [ MD= 1.36, 95% CI (0.40, 2.31), P ＜0.01], and VO₂ max [ MD= 2.21, 95% CI (1.05, 3.37), P < 0.01] when compared to control groups, and the subgroup analyses showed that the efficacy of 3 months of continuous intervention with Baduanjin was the best.

CONCLUSION: Our study is the first comprehensive meta-analysis to evaluate the treatment of HF with Baduanjin. The results suggest that Baduanjin improves exercise tolerance, cardiac function, and quality of life in patients with HF.

PMID:41176179 | DOI:10.1016/j.ctim.2025.103280

J ISAKOS. 2025 Oct 30:101027. doi: 10.1016/j.jisako.2025.101027. Online ahead of print.

ABSTRACT

INTRODUCTION/OBJECTIVES: This study aimed to investigate variables associated with increased odds of anterior cruciate ligament (ACL) re-tear and re-operation after ACL reconstruction (ACLR) using hamstring autograft. We hypothesised that a proximal and/or distal graft diameter smaller than 8.5 mm would be associated with higher odds of re-tear.

MATERIALS AND METHODS: Patients who underwent primary ACLR between 2019 and 2022 were prospectively followed and retrospectively analyzed. Patients were excluded in cases of multi-ligament knee injury, bilateral ACLR, or age under 18 years old. ACL re-tear was assessed at a minimum follow-up of 24 months (mean 42 months, range 24 to 60 months). Baseline characteristics, as well as intraoperative and postoperative data, were collected. Clinical outcomes and knee laxity were assessed 12 months postoperatively. Univariate logistic regression was performed to identify associations with re-tear and re-operation. P values <0.05 were considered statistically significant.

RESULTS: Overall, 255 patients were included, with a mean age of 30.3 ± 10.6 years. A hamstring graft was used in all cases. Intraoperative meniscal treatment was performed in 47.1% of cases (121 knees), and lateral extra-articular tenodesis in 15% (37 of 255 knees). The re-tear rate was 7.1% (18 knees). A proximal graft size <8.5 mm was statistically significantly associated with ACL re-tear (odds ratio [OR] 3.1, p=0.023). Male gender and graft size showed a statistically significant interaction effect with ACL re-tear (p=0.016). In total, 30 patients (12%) underwent re-operation at a mean follow-up of 42 months (range 24 to 60 months). A medial meniscal (MM) tear was associated with increased odds of re-operation (OR 2.8, p=0.010). The re-operation rate was higher in cases of MM repair (27%) compared with MM debridement (5%, p=0.040). Lateral meniscal tears were not associated with an increased re-operation rate (p=0.496).

CONCLUSIONS: A proximal graft diameter <8.5 mm in hamstring autograft ACLR is associated with increased odds of re-tear, particularly in young, active male patients. Meniscal tears are associated with higher odds of subsequent surgery on the same knee, especially following medial meniscal repair.

LEVEL OF EVIDENCE: IV.

PMID:41176162 | DOI:10.1016/j.jisako.2025.101027

Int J Infect Dis. 2025 Oct 30:108167. doi: 10.1016/j.ijid.2025.108167. Online ahead of print.

ABSTRACT

BACKGROUND: Congenital cytomegalovirus (CMV) infection can cause sensorineural impairment in children. Our primary objective is to estimate the proportion of women in France who received counselling from health-care providers about preventing CMV transmission during pregnancy, and our secondary objective to identify factors associated with their receiving this counselling.

METHODS: Using data collected at childbirth in France from women included in the 2021 national perinatal survey (ENP), we first estimated the proportion of women who received counselling about preventing CMV infection during pregnancy and then used univariate and multivariate analyses to compare maternal characteristics between women who reported such counselling and those reporting not being counselled or not remembering.

FINDINGS: Among the 10 866 women interviewed, 1737 (16·0%) reported being counselled about CMV during pregnancy. Those less likely to have been counselled were born in North African or Sub-Saharan countries (respectively, adjusted odds ratio 0·49, 95%CI 0·34-0·71 and 0·58, 95%CI 0·37-0.89) compared to women born in France, and those with a low educational level (0·56, 95%CI, 0·48-0·66 for women with high-school level, compared to women with 3 years or more postsecondary schooling). Primiparous, compared with multiparous, women were less likely to have been counselled (ORa 0·61, 95%CI 0·53-0·69).

INTERPRETATION: Too few women receive counselling about CMV prevention during pregnancy. The women least informed were less educated and more socially vulnerable. They are probably also the women who have the least access to preventive health information.

FUNDING: The French ENP were supported by the Ministry of Health and Santé Publique France.

PMID:41176151 | DOI:10.1016/j.ijid.2025.108167

Respir Med. 2025 Oct 30:108460. doi: 10.1016/j.rmed.2025.108460. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the clinical effectiveness and feasibility of the structured ST-OSA-PS-OMT model for adults with Obstructive Sleep Apnea and Primary Snoring, focusing on changes in excessive daytime sleepiness and patient-reported effectiveness within an AI-enhanced telemedicine framework.

MATERIALS AND METHODS: Retrospective observational cohort study from November 2021 to November 2022 with 87 adults with OSA and PS. They received OMT through the Smart Therapy for Obstructive Sleep Apnea and Primary Snoring with Orofacial Myofunctional Therapy (ST-OSA-PS-OMT) program. Demographic variables, clinical data, orofacial myofunctional examination, and satisfaction were evaluated using the Perception Scale of Effectiveness of Orofacial Myofunctional Therapy in Sleep-Disordered Breathing -Patient Reported Outcome Measures (EPE-TMO-TRS-PROMs), type 1 (83%)/type 3 (17%) polysomnography, and the Epworth Sleepiness Scale (ESS).

RESULTS: 87 patients with Sleep-Disordered Breathing (SDB) (mean age 49.71 ± 13,28 years, 60.9% female) received OMT. Improvement was observed in ESS (9.41 ± 5.65 to 7.26 ± 5.43). Snoring (28.7%), endocrine-metabolic comorbidities (50.6%), and cardiovascular comorbidities (36.8%) were prevalent. Erythematous palatine pillars (93.1%) and descended soft palate (90.8%) were found, with the latter showing a significant relationship (X²=37.3373p=1.5^-7). The majority rated OMT as effective. Descriptive analysis revealed that patients with psychiatric comorbidities tended to perceive treatment as more effective, while those with Class III malocclusion showed a tendency toward lower treatment favorability.

CONCLUSION: The ST-OSA-PS-OMT model represents a viable and effective therapeutic approach for OSA/PS, as evidenced by significant ESS improvement and positive patient-reported outcomes. The AI-enhanced telemedicine framework establishes a foundation for therapeutic personalisation. Key anatomical findings, particularly the association between a descended velum and erythematous pillars, justify refined pre-treatment assessment protocols. Future research should focus on longitudinal studies and developing targeted intervention strategies for subgroups with less favourable responses, including those with Angle Class III malocclusion.

PMID:41176093 | DOI:10.1016/j.rmed.2025.108460