Category: Statistics

Ther Adv Psychopharmacol. 2025 Sep 9;15:20451253251367591. doi: 10.1177/20451253251367591. eCollection 2025.

ABSTRACT

BACKGROUND: Poor adherence to antipsychotic medications is the leading cause of relapses and hospitalizations in patients with schizophrenia, resulting in worse functional outcomes and quality of life. Long-acting injectable (LAI) antipsychotics are an effective therapeutic option to improve adherence, but they are often underutilized, particularly during inpatient care.

OBJECTIVE: To investigate the predictive factors for LAI utilization among inpatients with schizophrenia and to assess whether initiating a LAI antipsychotic treatment during hospitalization reduces the risk of readmission.

DESIGN: Observational prospective study.

METHODS: Patients were evaluated at admission, discharge, and after 3 months. Two comparisons were performed: patients who initiated a LAI during the hospitalization versus those who continued with oral antipsychotics, and readmitted versus not-readmitted patients within 3 months. Factors statistically associated with LAI initiation or readmission were entered as independent variables in two backward logistic regression models, having “LAI initiation” and “rehospitalization at three months” as outcomes.

RESULTS: One hundred two patients were included. Twelve were lost at follow-up. Forty-two (44%) initiated an LAI during the admission. Subjects who received LAI were significantly younger, more educated, and less adherent to treatment. Thirty (33%) patients were readmitted within 3 months after discharge. Re-hospitalized subjects had more psychiatric hospitalizations in the past and a lower rate of LAI antipsychotic treatment initiation during the studied hospitalization: 5/39 (13%) patients prescribed a LAI antipsychotic were readmitted within 3 months, compared with 25/51 (49%) prescribed an oral antipsychotic medication (OR = 0.19; p = 0.002).

CONCLUSION: Introducing LAI antipsychotic treatment during a psychiatric hospitalization may reduce the risk of early readmissions, thus facilitating the improvement of the course of the illness and the patient’s quality of life.

PMID:40937358 | PMC:PMC12420969 | DOI:10.1177/20451253251367591

Jamba. 2025 Aug 29;17(1):1898. doi: 10.4102/jamba.v17i1.1898. eCollection 2025.

ABSTRACT

Noncompliance with locational guidelines for petrol station facilities in South Africa’s urban areas is widespread, posing significant disaster risks. Petrol stations store and handle flammable substances such as liquefied petroleum gas, hydrogen and biodiesel, making adherence to environmental impact assessment (EIA) safety parameters critical. This study evaluates the spatial distribution and compliance of petrol stations in Johannesburg, Cape Town and Durban with the 2002 EIA guidelines. Using a mixed-methods approach, geospatial mapping via Google Earth and ArcGIS alongside secondary qualitative analysis, the study assessed petrol station distances from sensitive land uses (residential, public institutions and critical infrastructure) and the spacing between petrol stations. The results reveal a significant degree of noncompliance with the EIA’s 100-m setback from sensitive uses and the 3-km minimum distance between petrol stations. In all three cities, petrol stations are often clustered within high-density urban cores, overlapping safety buffer zones and situated near residential and institutional structures. These spatial patterns indicate a regulatory gap in land-use enforcement and raise serious concerns about disaster preparedness and risk exposure in urban areas. The findings emphasise the urgent need to integrate disaster risk reduction (DRR) into urban land-use planning. While the study acknowledges that existing noncompliant petrol stations cannot be retrofitted easily, it recommends embedding DRR into future siting policies and calls for emergency preparedness measures at high-risk sites.

CONTRIBUTION: The study’s spatially grounded analysis of EIA compliance across multiple cities in South Africa offers an evidence-based framework to guide future policy on hazardous facility siting in disaster-prone urban contexts.

PMID:40937353 | PMC:PMC12421480 | DOI:10.4102/jamba.v17i1.1898

China CDC Wkly. 2025 Sep 5;7(36):1168-1173. doi: 10.46234/ccdcw2025.196.

ABSTRACT

This study systematically evaluated the spatial distribution, health risks, and regulation of per- and polyfluoroalkyl substances (PFAS) in global drinking water using the PubMed and Web of Science databases (January 1, 2000 to February 25, 2025). Among the 122 studies reviewed, perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) received the greatest research attention (detected in 102 and 100 studies, respectively) and showed the highest detection rates (64.69% and 60.72%, respectively). Several other compounds, including perfluorooctane sulfonamide, perfluorobutanesulfonamide, and perfluoropropane sulfonate, also exhibited high detection rates but remain underregulated, underscoring the need for further research and regulatory oversight. The three countries with the highest concentrations of [Formula: see text] were the Republic of Korea, the United States, and China. Risk assessments indicated that perfluorohexanoic acid, perfluorobutanoic acid, and perfluorobutanesulfonic acid posed negligible health risks, while perfluorohexane sulfonic acid (PFHxS), PFOA, PFOS, and perfluorononanoic acid (PFNA) showed descending levels of health risk (PFHxS > PFOA > PFOS > PFNA). Regulatory approaches are shifting from compound-specific standards to integrated mixture-based frameworks, reinforced by progressively stringent limits.

PMID:40937346 | PMC:PMC12421654 | DOI:10.46234/ccdcw2025.196

J Multidiscip Healthc. 2025 Sep 5;18:5551-5561. doi: 10.2147/JMDH.S534760. eCollection 2025.

ABSTRACT

BACKGROUND: A multitude of congenital and acquired conditions can result in short stature, each with distinctive clinical presentations and treatment options. We aimed to develop and validate a prediction model to identify GHD among children with short stature using clinical and laboratory parameters.

METHODS: This retrospective observational study included 1120 children with short stature from a hospital in China. The data were randomly split into a derivation set and a validation set. Features were selected based on clinical relevance and statistical significance to construct a multivariate logistic regression model in the derivation set. Discrimination, calibration, and prediction accuracy were evaluated on both sets.

RESULTS: Of the 1120 children, 278 (25%) were diagnosed with GHD, 694 (62%) were male, and the mean age was 6.97 ± 2.97 years. The derivation set comprises 785 (70%) children. The model incorporates four predictors: age (OR=0.761; 95% CI 0.660, 0.873), delayed bone age (OR=1.841; 95% CI 1.365, 2.537), IGF-1 SDS (OR=0.148; 95% CI 0.095, 0.220), and IGF-1/IGFBP-3 ratio (OR=0.901; 95% CI 0.870, 0.930). The model exhibits good discriminative ability, with an AUC of 0.952 (0.937, 0.967) in the derivation set and 0.950 (0.927, 0.973) in the validation set. Furthermore, it shows high accuracy with sensitivity and specificity of 0.895 in the derivation set, which was 0.946 and 0.851 in the validation set. The model also demonstrates reliable calibration.

CONCLUSION: We have developed a prediction model for accurate screening of GHD in children with short stature.

PMID:40937344 | PMC:PMC12420774 | DOI:10.2147/JMDH.S534760

J Am Stat Assoc. 2025 Apr 4. doi: 10.1080/01621459.2025.2460231. Online ahead of print.

ABSTRACT

Epidemiological approaches for examining human health responses to environmental exposures in observational studies often control for confounding by implementing clever matching schemes and using statistical methods based on conditional likelihood. Nonparametric regression models have surged in popularity in recent years as a tool for estimating individual-level heterogeneous effects, which provide a more detailed picture of the exposure-response relationship but can also be aggregated to obtain improved marginal estimates at the population level. In this work we incorporate Bayesian additive regression trees (BART) into the conditional logistic regression model to identify heterogeneous exposure effects in a case-crossover design. Conditional logistic BART (CL-BART) utilizes reversible jump Markov chain Monte Carlo to bypass the conditional conjugacy requirement of the original BART algorithm. Our work is motivated by the growing interest in identifying subpopulations more vulnerable to environmental exposures. We apply CL-BART to a study of the impact of heat waves on people with Alzheimer’s disease in California and effect modification by other chronic conditions. Through this application, we also describe strategies to examine heterogeneous odds ratios through variable importance, partial dependence, and lower-dimensional summaries.

PMID:40937338 | PMC:PMC12422705 | DOI:10.1080/01621459.2025.2460231

Environ Epigenet. 2025 Sep 4;11(1):dvaf021. doi: 10.1093/eep/dvaf021. eCollection 2025.

ABSTRACT

The increasing incidence of opioid use during pregnancy has led to a rise in the number of infants exposed to opioids in utero. Prenatal opioid exposure may have consequences for health and (neuro)development, including neonatal opioid withdrawal syndrome (NOWS). It is unknown which infants are at greatest risk for NOWS. DNA methylation (DNAm) is an epigenetic mark reflecting both allelic variation and environmental exposures, which may provide biomarkers for prenatal opioid exposure and infant NOWS. The placenta is an accessible, biologically relevant tissue in which to directly investigate the epigenetic effects of prenatal opioid exposure. Therefore, the aims of this study were to examine whether prenatal opioid exposure is associated with differential DNAm, including epigenetic age acceleration (EAA) in the placenta. We performed an epigenome-wide association study based on co-methylated regions and single CpG sites in placental samples from in utero opioid-exposed (n = 19) and nonexposed infants (n = 143), correcting for potential confounders. We did not identify statistically significant differential DNAm profiles, but the strongest associations were found for cg06621211; cg18688392 (ZMIZ1, adjusted P = .068) and cg04460738 (KCNMA1, adjusted P = .068), although effect sizes were very small. One of these DNAm patterns (cg06621211) was in part under control of genetic variants through methylation quantitative trait loci. The involved single nucleotide polymorphism did not show significant associations in recent genome-wide association studies for phenotypes related to substance use, and the finding was not driven by potential co-occurring substance use based on sensitivity analyses. There was also no association between placental EAA and in utero opioid exposure. In conclusion, placental DNAm showed limited associations with in utero opioid exposure and NOWS diagnosis.

PMID:40937335 | PMC:PMC12422002 | DOI:10.1093/eep/dvaf021

Clin Kidney J. 2025 Aug 13;18(9):sfaf263. doi: 10.1093/ckj/sfaf263. eCollection 2025 Sep.

ABSTRACT

BACKGROUND: Short calciprotein crystallization time (low T50) is directly associated with an increased risk of cardiovascular events and mortality. Here, we investigated whether increases in dialysate bicarbonate concentrations increase T50 times in dialysis patients.

METHODS: In a prospective, single-center, single-arm, interventional trial in hemodialysis patients (N = 29), dialysate bicarbonate was decreased from baseline settings to 27 mmol/L (D-Bic 27) followed by an increase to 37 mmol/L (D-Bic 37), over the course of 6 weeks. The primary endpoint was the change in T50 time between the D-Bic 27 and D-Bic 37 phases. Measurements of endogenous calciprotein monomers (CPM), primary (CPP-1) and secondary (CPP-2) calciprotein particles were pre-specified secondary outcomes.

RESULTS: Twenty-four patients completed the study per protocol. T50 time increased significantly from 246 ± 77 to 282 ± 81 min from the D-Bic 27 to the D-Bic 37 phase (P < .0001). The hydrodynamic radius (size) of secondary calciprotein particles generated in the T50 test (CPP-2_Rh) did not differ significantly between study phases (251 ± 75 vs 240 ± 78 nm, P = .27). Comparing the D-Bic 27 with the D-Bic 37 phase, CPM (16.8 × 10³ vs 16.2 × 10³ AU/µL, P = .9) and CPP-1 (4.6 × 105 vs 4.5 × 10⁵ counts/mL, P = .7) did not change significantly, but there was a significant decrease in CPP-2 levels (5.9 × 10⁴ vs 3.2 × 10⁴ counts/mL, P < .0003). Intradialytically, T50 increased, CPM and CPP-1 decreased, while CPP-2 remained stable.

CONCLUSIONS: Raising dialysate bicarbonate resulted in a significant increase in T50 time and a reduction of CPP-2 levels.

PMID:40937333 | PMC:PMC12421725 | DOI:10.1093/ckj/sfaf263

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2025 Aug;33(4):1155-1160. doi: 10.19746/j.cnki.issn.1009-2137.2025.04.034.

ABSTRACT

OBJECTIVE: To analyze the positive rate and distribution of anti-M unexpected antibody in pediatric inpatients aged 0 to 14 years in central China.

METHODS: A total of 30 049 pediatric inpatients admitted to the Second Xiangya Hospital of Central South University, Wuhan Children’s Hospital and Children’s Hospital Affiliated of Zhengzhou University from May 2020 to August 2022 were enrolled in this study, and relevant clinical data were collected. Blood samples from the patients were tested for blood typing and screened for unexpected antibodies. For samples that screened positive for unexpected antibodies, identification was conducted using the identification panel to determine the specificity of the antibodies. The distribution and differences of anti-M antibodies in pediatric patients of different sexes, ages, blood groups, disease types, with or without a history of blood transfusion, and across different regions were analyzed.

RESULTS: Among 30 049 inpatients, the positive rate of unexpected antibodies was 0.91% (273/30 049), of which the positive rate of anti-M antibodies was 0.44% (131/30 049). The positive rate of anti-M antibodies in the neonates aged 0 to < 1 month was 0.10% (5/4 881), and all of them were IgG antibodies from their mothers; The positive rate of anti-M antibodies for the group aged from 1 month to < 1 year old was 0.23% (7/3 108), with no anti-M antibodies detected in patients aged 1-6 months; The positive rates of anti-M antibodies in the 1-4 years old group, 5-9 years old group, and 10-14 years old group were 0.87% (88/10 064), 0.38% (27/7 190), and 0.08% (4/4 806), respectively. The positive rate of anti-M antibodies in the 1-4 years old group was significantly higher than that of the other groups ( P <0.001), and there were also statistical differences in the positive rate between the 5-9 years old group and the 0-< 1 month and 10-14 years old groups ( P <0.001). The prevalences of anti-M antibodies in ABO blood group A, B, O and AB were 0.32% (30/9 482), 0.70% (58/8 293), 0.32% (31/9 595) and 0.45% (12/2 679), respectively. The prevalence of anti-M antibodies in patients with blood group B was significantly higher than that in patients with blood groups A and O ( P <0.05). The prevalences of anti-M antibodies in Hunan, Hubei and Henan was 0.18%, 0.32% and 0.71%, respectively. The prevalence of anti-M antibodies in Henan was significantly higher than that in Hunan and Hubei ( P <0.05), and the distribution showed obvious regional differences between the north and the south. There were no significant differences in the positive rate of anti-M antibodies between the children with different sexes, disease types, and with or without a history of blood transfusion (P >0.05).

CONCLUSION: This study reveals the distribution pattern of anti-M antibodies in pediatric inpatients aged 0-14 years in central China, which has reference value for the research on unexpected red blood cell antibodies in Chinese children.

PMID:40936145 | DOI:10.19746/j.cnki.issn.1009-2137.2025.04.034

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2025 Aug;33(4):1131-1137. doi: 10.19746/j.cnki.issn.1009-2137.2025.04.030.

ABSTRACT

OBJECTIVE: To investigate the expression of CSF-1 and CSF-1R in the peripheral blood of children with immune thrombocytopenia (ITP) and its clinical significance.

METHODS: Forty-four children with ITP treated in our hospital from February 2023 to January 2024 were selected as the observation group, and 40 healthy children were selected as the control group during the same period, and relevant clinical data were collected. Peripheral blood mononuclear cells (PBMC) of children with ITP and healthy children were separated, and the plasma levels of M1 macrophage-associated cytokines (TNF-α, IL-6), M2 macrophage-associated cytokines (IL-10, TGF-β), and CSF-1 were detected by ELISA in the children of both groups. The mRNA levels of M1 macrophage surface markers (CD86, iNOS), M2 macrophage surface markers (CD206, Arg-1) and CSF-1R were detected by RT-PCR in PBMC of children in both groups. Western blot was used to detect the expression of CSF-1R protein in PBMC of the two groups of children. The correlation between platelet count and CSF-1R mRNA expression in PBMC, TNF-α, IL-6, IL-10, TGF-β and CSF-1 in plasma was analyzed.

RESULTS: Compared with the control group, the levels of IL-10, TGF-β, CSF-1 and platelet count in plasma of children with ITP were significantly decreased (P < 0.01), and the levels of TNF-α and IL-6 were significantly increased (P < 0.01); the mRNA levels of the M1 macrophage surface markers (CD86, iNOS) in PBMC of children with ITP were significantly increased (P < 0.05), mRNA levels of M2 macrophage surface marker CD206 in PBMC of children with ITP were decreased compared with controls but the difference was not statistically significant ( P >0.05), mRNA levels of Arg-1 were decreased, the difference was statistically significant (P < 0.05). The mRNA and protein levels of CSF-1R in PBMC of ITP children were higher than that in controls. CSF-1R expression in PBMC of ITP was positively correlated with platelet count, IL-10, CSF-1 were positively correlated (r =0.822,0.481,0.405).

CONCLUSION: CSF-1 is significantly reduced in the plasma of ITP, and CSF-1R mRNA and protein expression is significantly elevated in PBMC of ITP, which are involved in the regulation of macrophage M1/M2 imbalance, and could serve as a potential therapeutic target for ITP.

PMID:40936141 | DOI:10.19746/j.cnki.issn.1009-2137.2025.04.030

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2025 Aug;33(4):1127-1130. doi: 10.19746/j.cnki.issn.1009-2137.2025.04.029.

ABSTRACT

OBJECTIVE: To investigate the efficacy and safety of stanozolol combined with avatrombopag in the treatment of chemotherapy-induced thrombocytopenia (CIT) in patients with relapsed/refractory tumors.

METHODS: Twenty-five patients with relapsed/refractory CIT admitted to the Hematology Department of Xiyuan Hospital, China Academy of Chinese Medical Sciences between March 2023 to December 2023 were enrolled. These patients received a combined therapy of stanozolol and avatrombopag. The clinical efficacy, onset time, changes in platelet levels and blood cell counts before and after treatment, and adverse reactions of patients were evaluated.

RESULTS: The combination therapy demonstrated remarkable efficacy with a total effective rate of 100%. Among the 25 patients, 19 achieved complete remission and 6 achieved partial remission. The median onset time was 42.5（range: 35-48）days. The average platelet count of the 25 patients increased from (25.73±17.75)×10⁹/L before treatment to (146.4±49.59)×10⁹/L after 3 months of treatment, with a statistically significant difference ( P < 0.05). 18 patients who previously required platelet transfusion were all weaned off platelet transfusion after 3 months of treatment, with a median time to be free from platelet transfusion was 26 (range: 18-51) days. During the treatment, both neutrophils and hemoglobin exhibited various degrees of elevation. Two patients experienced a slight increase in alanine aminotransferase(ALT) levels, which normalized after treatment with oral hepatoprotective drug. One patient had a PLT increase exceeding 350×10⁹/L, and the treatment with avatrombopag was suspended, and aspirin and other drugs were given to prevent thrombosis. No thrombose events or CIT-related bleeding events were observed in all patients.

CONCLUSION: The combination therapy of stanozolol and avatrombopag is significantly effective for treating relapsed/refractory CIT patients, with a high response rate and good safety, making it a suitable clinical treatment option.

PMID:40936140 | DOI:10.19746/j.cnki.issn.1009-2137.2025.04.029