Category: Statistics

J Burn Care Res. 2025 Sep 19:iraf181. doi: 10.1093/jbcr/iraf181. Online ahead of print.

ABSTRACT

BACKGROUND: ReCell, an autologous cell harvesting technology also known as Autologous Skin Cell Suspension (ASCS), has shown promise in enhancing skin regeneration for burn patients. Despite its growing use in clinical practice, the current literature displays considerable variability in study design and quality, leading to ongoing uncertainty about its true clinical effectiveness. This systematic review and meta-analysis aim to comprehensively evaluate the clinical efficacy of ASCS in the treatment of burns.

METHODS: A systematic review was conducted in accordance with PRISMA guidelines, utilizing searches across PubMed, Web of Science, Embase, and Cochrane databases. The review protocol was prospectively registered on PROSPERO (CRD42024606554). The Cochrane Risk of Bias Tool and the ROBINS-I tool were applied to assess bias in randomized controlled trials and observational studies, respectively. The overall methodological quality of included studies was appraised using the GRADE framework.

RESULTS: Fourteen studies (n = 3362) fulfilled the inclusion criteria. The pooled mean patient age was 37.6 years, with a male predominance (65.9%). The average %TBSA affected was 14.6% (95% CI: 8.8-20.4), with substantial heterogeneity (I2 = 95.1%). Meta-analysis demonstrated a statistically significant reduction in complication rates with ASCS combined with split-thickness skin grafting (STSG) compared to STSG alone (RR = 0.64, 95% CI: 0.41-1.00, p = 0.048). However, rates of wound infection and graft failure did not differ significantly between groups.

CONCLUSIONS: ASCS demonstrates potential in reducing complications in burn care. Nevertheless, due to heterogeneous study designs, further high-quality, large-scale randomized trials are warranted to validate its long-term efficacy and broader clinical utility.

PMID:40973648 | DOI:10.1093/jbcr/iraf181

Genome Biol Evol. 2025 Sep 19:evaf177. doi: 10.1093/gbe/evaf177. Online ahead of print.

ABSTRACT

Deep learning (DL) has been widely used in various scientific fields, but its integration into phylogenetics has been slower, primarily due to the complex nature of phylogenetic data. The studies that apply DL to sequencing data often limit analyses to 4-taxon trees. Many of these studies serve as “proof of principle” and perform similarly to traditional phylogeny reconstruction methods. New ways of using training data, such as encoding with compact bijective ladderized vectors or transformers, enable the handling of much larger trees and genomic data sets. This short perspective focuses on the application of DL in phylogenetics, introducing prevalent DL architectures. We highlight potential problems in the field by discussing the risks of using simulation-based training data and emphasize the importance of reproducibility and robustness in computational estimates. Finally, we explore promising research areas, including the combination of phylogenetics and population genetics in DL, the analysis of neighbor dependencies, and the potential to significantly reduce computational cost compared to traditional methods. This perspective illustrates the potential of DL in complementing traditional phylogeny reconstruction methods and aiding the advancement of phylogenetic analysis, especially in performing computationally demanding tasks such as model selection or estimating branch support values.

PMID:40973626 | DOI:10.1093/gbe/evaf177

Trans R Soc Trop Med Hyg. 2025 Sep 19:traf104. doi: 10.1093/trstmh/traf104. Online ahead of print.

ABSTRACT

As part of a regional initiative to enhance epidemic preparedness, the Dominican Republic became one of 16 national hubs in the Artificial Intelligence for Pandemic and Epidemic Preparedness and Response Network. This article outlines the early steps taken to introduce responsible artificial intelligence into public health practice by developing local capacity, predictive surveillance tools and ethical governance strategies. Drawing on implementation experiences within the country’s health institutions and communities, this article highlights practical lessons and operational insights. These findings support broader discussions on equity-focused digital innovation and provide a replicable model for low- and middle-income countries seeking to strengthen their readiness for future health threats.

PMID:40973619 | DOI:10.1093/trstmh/traf104

Clin Lung Cancer. 2025 Aug 26:S1525-7304(25)00219-0. doi: 10.1016/j.cllc.2025.08.012. Online ahead of print.

ABSTRACT

BACKGROUND: In treatment-naïve advanced non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutations, approximately 10% to 15% correspond to uncommon mutations. For patients with EGFR uncommon mutations, monotherapy with either a second-generation EGFR tyrosine kinase inhibitor (TKI), afatinib, or a third-generation EGFR-TKI, osimertinib, is recommended as the initial therapy. However, needs remain unmet for patients with central nervous system (CNS) metastases and those who do not respond adequately to single-agent TKI therapy for EGFR uncommon mutations. The recently published FLAURA2 trial showed that osimertinib in combination with platinum-pemetrexed significantly prolonged progression-free survival (PFS) and provided high disease control compared with osimertinib monotherapy for common mutations. Therefore, we planned this phase II study to evaluate the efficacy and safety of osimertinib in combination with platinum-pemetrexed in treatment-naïve NSCLC patients with EGFR uncommon mutations.

PATIENTS AND METHODS: Forty patients will be enrolled in the study. The primary endpoint is the objective response rate, and the secondary endpoints include safety, PFS and overall survival in overall patients, patients with and without CNS lesions at baseline and according to mutation subtype.

CONCLUSIONS: In this study, we will explore the efficacy and safety of osimertinib in combination with platinum-pemetrexed in treatment-naïve NSCLC patients with EGFR uncommon mutations. Our findings may provide treatment options for patients with EGFR uncommon mutations, especially those with CNS metastases or those requiring more intensive treatment.

PMID:40973606 | DOI:10.1016/j.cllc.2025.08.012

Clin Ther. 2025 Sep 18:S0149-2918(25)00271-1. doi: 10.1016/j.clinthera.2025.08.001. Online ahead of print.

ABSTRACT

PURPOSE: Tumor lysis syndrome (TLS) is a life-threatening metabolic emergency caused by rapid tumor cell breakdown, either spontaneously or after therapy, leading to electrolyte imbalances that can result in acute kidney injury, arrhythmias, seizures, and multiorgan failure. Despite its clinical importance, the relationship between anticancer drugs and TLS, particularly newer targeted therapies, remains poorly understood.

METHODS: We analyzed the US Food and Drug Administration (FDA) Adverse Events Reporting System database, a repository of adverse events associated with medical products, to identify TLS cases reported from the first quarter of 2004 to the third quarter of 2024. For signal detection, we used disproportionality analysis with 4 algorithms-reported odds ratio, proportional reporting ratio, Bayesian confidence propagation neural network, and empirical Bayes geometric mean. These algorithms assessed statistical correlations between anticancer drugs and TLS, based on a 2 × 2 contingency table framework.

FINDINGS: From the first quarter of 2004 to the third quarter of 2024, a total of 7340 TLS cases were documented in the FDA Adverse Events Reporting System database. Clinical characteristics, including age, sex, and outcomes, were analyzed. Among all reported TLS cases, 53.0% were men, and the mean age across all individuals was 56.9 ± 21.5 years. The incidence of TLS peaked in 2022, with a 42% increase from 2016 to 2017. A total of 118 antineoplastic drugs were identified as highly associated with TLS, of which only 18 had FDA-labeled TLS-related adverse reactions. Chemotherapy drugs were the most frequently associated with TLS. Venetoclax emerged as the top drug associated with TLS, comprising 10.72% of all TLS reports.

IMPLICATIONS: Our findings highlight critical drug-induced TLS associations, particularly with emerging targeted therapies such as venetoclax. The study underscores the need for clinicians to monitor TLS closely in patients receiving certain anticancer treatments and to refine therapeutic strategies to mitigate TLS risk, ensuring safer cancer care outcomes. Further longitudinal studies are warranted to validate these findings and enhance pharmacovigilance efforts.

PMID:40973598 | DOI:10.1016/j.clinthera.2025.08.001

Patient Educ Couns. 2025 Sep 13;141:109350. doi: 10.1016/j.pec.2025.109350. Online ahead of print.

ABSTRACT

OBJECTIVES: National estimates of the quality of care received by Middle Eastern and North African (MENA) individuals are unknown. Perceptions of patient-centered care (PCC) are important indicators of quality of care that differ by racial/ethnic minority groups. Our study aimed to estimate differences in parents’ perceptions of patient- and family-centered care (PFCC), an indicator of quality of care perceived by parents, between foreign-born MENA and other racial and ethnic groups.

METHODS: Data from 2000 to 2017 National Health Interview Survey and 2001-2018 Medical Expenditure Panel Survey was combined and analyzed at a federal statistical research data center, using the Head and Bute’s extension of Street’s ecological model as theoretical lens. The sample included 33,677 parents of foreign-born MENA children who reported visiting a health care provider within the past 12 months. Dependent variables included parent reports of communication variables related to how often providers: listened; showed respect; spent enough time; and explained things well. Multivariable logistic regression was used to evaluate the odds of receiving PFCC using a composite measure of PFCC quality and separate domains.

RESULTS: Parents of foreign-born MENA children had higher odds of reporting all PFCC qualities compared to foreign-born White (OR=2.49; 95 %CI=1.04-5.97) and Asian (OR=2.54; 95 %CI=1.13-5.68) groups. When separated by PFCC quality, parents of foreign-born MENA children had 3.23 times higher odds (95 %CI= 1.18-8.81) of reporting that their provider spent enough time with them compared to foreign-born Hispanics.

CONCLUSIONS: This study provides the first estimates of PFCC among MENA adults. Future studies can be designed to test unique health interventions and make recommendations for providers to deliver more culturally responsive care.

PRACTICE IMPLICATIONS: Findings add to the timely dialog advocating for a separate racial/ethnic category for MENA populations recently proposed by the US government and acknowledged by scientists for more rigorous and accurate assessments of health equity for all US populations.

PMID:40972075 | DOI:10.1016/j.pec.2025.109350

J Psychiatr Res. 2025 Sep 17;191:47-53. doi: 10.1016/j.jpsychires.2025.09.023. Online ahead of print.

ABSTRACT

BACKGROUND: Aggressive behaviors associated with schizophrenia are important determinants of the functional outcomes of the illness. Investigational transcranial magnetic stimulation (TMS) measures provide direct assessments of motor cortical inhibition, excitability, and plasticity, and these measures are known to be altered in individuals with schizophrenia. This study aimed to examine the association between these TMS measures and aggressive behavior in individuals with schizophrenia.

METHODS: 79 minimally treated patients with a diagnosis of schizophrenia as per DSM-5 were recruited for the study from Central Institute of Psychiatry, India. Short Interval Cortical Inhibition (SICI), Long Interval Cortical Inhibition (LICI), Cortical Silent Period (CSP), a proxy measure of recruitment gain (SI1mV – RMT), and measures of cortical plasticity were recorded, along with basic clinical data. The Modified Overt Aggression Scale (MOAS) was used to quantify total aggression scores.

RESULTS: CSP (R = 0.322, p = 0.004), SICI (R = -0.33, p = 0.003) and SI1mV – RMT (R = 0.367, p = 0.0008) were significantly correlated with total MOAS scores. A multivariate linear regression model including CSP, SICI, and SI1mV – RMT explained 17 % of the variance in total MOAS scores (p = 0.0036, Cohen’s f² = 0.2), indicating moderate predictive utility for clinical risk assessment. A multivariate logistic regression model with the same predictors achieved an AUC of 0.704 (p = 0.005) in distinguishing high aggressors (total MOAS score ≥10) from low aggressors. Despite the overall model being significant, none of the individual predictors reached statistical significance, suggesting possible interaction effects that warrant further exploration. Including other TMS measures and various clinical and sociodemographic variables did not improve the model fit.

CONCLUSION: TMS measures of cortical inhibition (SICI, CSP) and excitability (SI1mV – RMT) provide neurophysiological biomarkers for predicting aggressive behaviour in schizophrenia. This can potentially enable clinicians to identify high-risk patients for targeted interventions. Cross sectional design and moderate sample size are important limitations of the study.

PMID:40972066 | DOI:10.1016/j.jpsychires.2025.09.023

J Psychiatr Res. 2025 Sep 15;191:39-46. doi: 10.1016/j.jpsychires.2025.09.020. Online ahead of print.

ABSTRACT

BACKGROUND: Family members of patients in the intensive care unit (ICU) are a population that is often overlooked. Studies have found that posttraumatic stress disorder (PTSD), anxiety, and depression are the most common psychological disturbances in family members. However, the interrelationship between the three common psychological disturbances and the core performance is still unclear.

METHODS: A cross-sectional study was conducted on 579 family members of ICU patients in Hunan Province, China, from February 2023 to October 2023. The self-reported questionnaires used to evaluate were the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), the General Anxiety Disorder Scale (GAD-7), and the 9-item Patient Health Questionnaire (PHQ-9). SPSS 26.0 and R 4.3.2 software were used for statistical analyses and network analyses, and the EBICglasso model was employed to estimate the network.

RESULTS: Four hundred and eighty-seven cases were included in the final analysis after screening. The incidence of PTSD, anxiety, and depression was 27.72 %, 43.73 %, and 50.51 %, respectively. Network analysis indicated that negative alterations in cognition and mood (NACM), alterations in arousal and reactivity (AAR), trouble relaxing, and restlessness were core symptoms. The PTSD, anxiety, and depression networks were connected by AAR, irritability, feeling afraid, and restlessness. Moreover, in the depression network, the main manifestations are motor tension and fatigue in males and sad mood and guilt in females.

CONCLUSION: PTSD is the most prominent psychological disturbance among the three studied disorders. NACM and AAR may need close attention to reduce or prevent psychological disturbances in family members.

PMID:40972065 | DOI:10.1016/j.jpsychires.2025.09.020

Res Vet Sci. 2025 Sep 16;196:105899. doi: 10.1016/j.rvsc.2025.105899. Online ahead of print.

ABSTRACT

Mastitis, a multifactorial production disease, poses a significant challenge to dairy farming, necessitating the adoption of integrated and precision-based diagnostic approaches. This study explores the potential of thermal imaging combined with deep learning to enhance mastitis detection in lactating dairy cows. In this study, thermal images of the udder region of Sahiwal cows were captured using a handheld thermal camera and analyzed to classify udder quarters as healthy, Sub-clinical Mastitis (SCM), and Clinical Mastitis (CM). The classification was based on California Mastitis Test (CMT) scores, Somatic Cell Count (SCC) values, and thermal image analysis. Further, Convolutional Neural Network (CNN) models were developed to distinguish between healthy udder quarters and those affected by CM or SCM. The CNN model differentiating healthy quarters from CM achieved training, validation, and testing accuracies of 99 %, with precision, recall, and F1-score all at 0.99. Similarly, the model distinguishing healthy quarters from SCM recorded training and validation accuracies of 89 % and 85 %, respectively, while testing results showed an accuracy of 84 %, a precision of 0.87, a recall of 0.79, and an F1-score of 0.83. These findings highlight the potential of CNN-based thermal imaging for accurate mastitis detection, contributing to advancements in precision dairy farming and livestock health management.

PMID:40972062 | DOI:10.1016/j.rvsc.2025.105899

Geriatr Nurs. 2025 Sep 18;66(Pt B):103636. doi: 10.1016/j.gerinurse.2025.103636. Online ahead of print.

ABSTRACT

A prospective cohort study was conducted to describe the current pressure injury (PI) prevention strategies in Sri Lankan nursing homes. A consecutive sample of 210 older residents (≥ 60 years) was recruited from nine nursing homes. Over twelve weeks, data on 19 PI prevention strategies were gathered using weekly semi-structured observations, self-report data, and chart audits. PI prevention strategies were summarised using descriptive statistics, and the Mann-Whitney test was used to compare two subsamples according to PI risk (at-risk vs not-at-risk) using the Braden scale. Of the 210 recruited participants, 62 (29.5 %) and 148 (70.5 %) were assessed as at-risk (Braden score 6-18) and not-at-risk (Braden score 19-23), respectively. Use of PI preventive strategies was not associated with the risk of PI (U = 5188.5, z = 1.49, p = 0.13). Most frequently used prevention strategies were skin care, continence management (for those who required it), and mobilisation. This study highlights a potential gap in targeted prevention efforts and underscores the need for improved risk-based clinical decision-making in PI prevention.

PMID:40972059 | DOI:10.1016/j.gerinurse.2025.103636