Category: Statistics

Epilepsia. 2025 Dec 31. doi: 10.1002/epi.70084. Online ahead of print.

ABSTRACT

There is debate on the predictive value of multiday seizure cycles versus simple statistical baselines. Multidien seizure cyclicity is a prevalent, patient-specific phenomenon with promise for epilepsy management. We challenge the assertion that cycle tracking is no better than a moving average, which is an inherently retrospective model that lags changes in seizure likelihood. This commentary compared a causal cyclic forecast to a prospectively applied moving average across a large seizure diary cohort (n = 768) and two gold-standard chronic EEG cohorts (n = 24). For the EEG and diary cohorts, cycle tracking demonstrated significantly superior accuracy to the moving average for both hourly and daily forecasts (p < 0.0001), using multiple performance metrics. These results confirm that event-based cyclical models offer more accurate, simulated real-world forecasts. Robust forecasting tools must prioritize the detection and modeling of seizure cycles to move beyond simple baseline performance and provide actionable clinical utility.

PMID:41474376 | DOI:10.1002/epi.70084

FASEB J. 2026 Jan 15;40(1):e71400. doi: 10.1096/fj.202502393R.

ABSTRACT

Gastric cancer (GC) has a high incidence in China. There is a closed-loop structure in circRNAs, which is involved in various cellular biological processes such as tumor development. However, there is a lack of research on the function of circRNAs in GC. In this study, we aimed to explore the potential of circXPO1 as a diagnostic biomarker and the role of circXPO1 in the progression of GC. We screened out circXPO1 through circRNA sequencing. Using exonuclease digestion assay, agarose gel electrophoresis (AGE), Sanger sequencing, and gDNA experiment, we proved that circXPO1 contained a cyclic structure. Quantitative real-time fluorescent Polymerase Chain Reaction (qRT-PCR) was used to detect the expression of circXPO1 in plasma and GC tissues. The receiver operating characteristic curve (ROC curve) was established to evaluate the diagnostic efficacy of circXPO1. The role of circXPO1 was assessed in vitro. The binding sites between circXPO1 and miRNAs were predicted by CircBank, Circinteractome, CircAtlas and miRanda databases. CircXPO1 was up-regulated in 67 GC tissues compared with the adjacent normal tissues (p = 0.0002). It was stable and hard to be degraded, which made it an ideal tumor biomarker. Compared with the patients in the normal control group, the expression level of circXPO1 in plasma was higher in GC patients (p < 0.001) and those with benign lesions (p = 0.0031) with statistically significant differences. CircXPO1 was proved to have satisfactory diagnostic efficacy in distinguishing GC patients from healthy donors (AUC = 0.813, 95% CI: 0.749-0.877). Besides, the diagnostic efficacy, sensitivity, and specificity could achieve 0.853, 78% and 86%, respectively, when circXPO1, CEA and CA199 were used together in diagnosis. In addition, in vitro experiments indicated that circXPO1 knockdown significantly weakened the proliferation, invasion and migration of GC cells. It was also predicted that circXPO1 could serve as a sponge of miR-1248 to regulate the progression of GC.

PMID:41474375 | DOI:10.1096/fj.202502393R

Biomed Eng Online. 2025 Dec 30;24(1):153. doi: 10.1186/s12938-025-01450-0.

ABSTRACT

INTRODUCTION: Dental autotransplantation (DAT) is a surgical procedure used to replace hopeless or missing teeth. The technique entails the purposeful extraction of a desired sound tooth, which is then implanted into another alveolar site of the same oral cavity.

OBJECTIVES: To analyse the survival rates and success rates of DAT in relation to donor teeth with an incomplete root development (open apex) and complete root formation (closed apex). Additionally, it attempts to evaluate the prognostic components of DAT with infection-related (inflammatory) root resorption, ankylosis, and pulpal necrosis complications.

MATERIALS AND METHODS: An electronic search was conducted using EBSCO MEDLINE Web of Science, Scopus and Cochrane databases from January 2014 until November 2024. The selected articles were chosen within the parameters outlined in the Materials and Statistical Methodology section. The addressed PICO question “does the stage of the donor tooth’s root development affect the long-standing prognosis and clinical outcomes of dental autotransplantation?”.

RESULTS: The final 26 articles featured a total of 2837 transplanted teeth: 2192 donor teeth with an open apex and 645 donor teeth with a closed apex. The overall survival rate was 93.8% in the open apex group and 92.6% in the closed apex group. Success rate was 84.0% in the open apex group and 86.7% in the closed apex group. The rate of infection-related root resorption was 6.3% in the open apex group and 5.9% in the closed apex group. The rate of ankylosis was 4.4% in the open apex group and 6.7% in the closed apex group. The rate of pulp necrosis was 6.4% in the open apex group. No factors were identified as influencing the rate of pulp necrosis; however, the duration of follow-up was significantly associated with the rate (p = 0.057). None of the selected articles reported pulp necrosis rate in the closed apex; thus, no meta-analysis was possible.

CONCLUSION: DAT is a reliable treatment alternative for the replacement of lost teeth. The procedure yields low complication rates of infection-related root resorption, ankylosis, and pulp necrosis, while achieving high rates of survival and success. It can be accomplished with donor teeth that have an open or closed apex.

PMID:41469883 | DOI:10.1186/s12938-025-01450-0

Lipids Health Dis. 2025 Dec 30. doi: 10.1186/s12944-025-02840-y. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the associations between longitudinal body roundness index (BRI) trajectories and the risk of incident diabetes mellitus (DM) using data from the China Health and Retirement Longitudinal Study (CHARLS).

METHODS: Group-based trajectory modeling (GBTM) identified distinct BRI trajectories (Waves 1-3, 2011-2016). Their associations with DM incidence (Wave 4, 2017-2018) were assessed using multivariate Cox models. The predictive performance of a single baseline BRI was compared with body mass index (BMI) and waist circumference (WC) via receiver operating characteristic (ROC) analysis. Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) evaluated the incremental value of adding BRI trajectories to a conventional risk model. Subgroup and sensitivity analyses, including a landmark approach, assessed robustness.

RESULTS: Among 4,150 participants, 103 developed DM. Three stable BRI trajectories were identified: low-stable (49.0%), moderate-stable (41.3%), and high-stable (9.7%). Compared with the low-stable group, the high-stable group had a significantly increased DM risk with a fully-adjusted hazard ratio (HR) of 2.63 (95% confidence interval [CI]: 1.41-4.91). A single baseline BRI showed comparable discrimination to BMI and WC (AUC ≈ 0.63). Longitudinal trajectories of BRI, BMI, and WC all identified high-stable subgroups with elevated risk (HRs: BRI = 2.63, BMI = 2.16, WC = 2.31), with overlapping confidence intervals. However, adding BRI trajectories to a conventional model significantly improved risk reclassification (NRI = 10.76%, 95% CI: 2.40-19.47) and discrimination (IDI = 0.27%, 95% CI: 0.03-0.52). Results were consistent across subgroups and sensitivity analyses.

CONCLUSIONS: Sustained high BRI exposure, captured by longitudinal trajectory modeling, is independently associated with increased DM risk. While BRI trajectories were not statistically superior to BMI or WC trajectories, the longitudinal framework itself adds value over single-time-point assessments by more robustly identifying individuals with persistent high adiposity-related risk, highlighting the utility of monitoring long-term body shape stability for early risk stratification.

PMID:41469881 | DOI:10.1186/s12944-025-02840-y

BMC Med Educ. 2025 Dec 30. doi: 10.1186/s12909-025-08529-1. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to evaluate whether increases in heart rate-used as an objective surrogate marker of rescuer fatigue-could influence CPR performance during infant chest compressions.

METHODS: This study was a manikin-based simulation study that enrolled PALS-certified pediatric emergency nurses matched by clinical experience and randomly assigned to three groups. All participants performed three 2-min cycles of infant chest compressions on a manikin (Little Baby QCPR). Each group completed a 90-s exercise protocol at different time points to induce varying degrees of heart-rate elevation. The primary outcome was the difference in CPR quality across groups according to heart-rate variation (percentage increase from baseline).

RESULTS: Twenty-seven nurses were enrolled and evenly allocated to Groups A, B, and C (n = 9 each). Heart rate increased immediately after exercise in all groups and gradually declined during subsequent compression cycles, with no significant between-group differences at any time point (baseline 85-100 bpm/cycle, peak 130-150 bpm/cycle). Across all cycles, CPR performance metrics-including total compression count, hand-placement accuracy, mean compression velocity, compression depth, and chest recoil-showed no significant within-group changes for any group. Similarly, no significant between-group differences were observed for any CPR parameter during any cycle. In post-hoc analyses, stratification by the median percentage increase in heart rate (> 67.7% vs. < 67.7%) revealed no statistically significant differences in CPR quality between groups.

CONCLUSION: Within this short, three-cycle simulation, exercise-induced heart-rate elevation was not associated with measurable deterioration in infant CPR quality.

PMID:41469879 | DOI:10.1186/s12909-025-08529-1

BMC Infect Dis. 2025 Dec 30. doi: 10.1186/s12879-025-12489-8. Online ahead of print.

ABSTRACT

BACKGROUND: Mortality remains high among people living with HIV (PLHIV) undergoing maintenance hemodialysis (MHD). However, data on the survival of MHD patients in first-tier Chinese cities are limited. This study aimed to analyze the clinical characteristics and survival of PLHIV receiving MHD in Shanghai.

METHODS: We conducted a retrospective cohort study at the Blood Purification Center of Shanghai Public Health Clinical Center. Clinical data were collected for PLHIV and HIV-negative controls who initiated MHD between November 2011 and September 2023. Survival was compared using Kaplan-Meier curves, and risk factors were identified through Cox regression analyses.

RESULTS: The study included 45 PLHIV and 54 HIV-negative individuals who underwent MHD for over three months. PLHIV were significantly younger at MHD initiation and had a higher proportion of males compared to controls (54.4 ± 14.4 vs. 61.6 ± 16.5 years, p = 0.025; 88.9% vs. 64.8%, p = 0.005). At baseline, the mean CD4 count for PLHIV was 261.1 ± 155.2 cells/µL, and 66.7% (30/45) had undetectable viral loads. The maximum follow-up durations were 145 months for PLHIV and 107 months for controls, with median survival times of 45 months and 61 months, respectively. Survival rates at 12, 24, 36, and 60 months were lower in the HIV group than in the control group (74.8% vs. 88.7%, 71.4% vs. 80.2%, 67.2% vs. 67.7%, and 33.2% vs. 67.7%), with a statistically significant difference observed only at 60 months (p = 0.0343). The overall difference in cumulative survival probability between the two groups was not significant (Log-rank test, p = 0.15). After adjusting for covariates, age ≥ 60 years at MHD initiation was significantly associated with reduced survival in both PLHIV (hazard ratio [HR] 3.14, 95% confidence interval [CI]: 1.15-8.54, p = 0.025) and the entire patient cohort (HR 3.15, 95% CI: 1.31-7.58, p = 0.01).

CONCLUSION: PLHIV initiated MHD at a younger age but exhibited lower long-term survival rates, particularly at 60 months, compared to HIV-negative individuals. Age ≥ 60 years at dialysis initiation was an independent risk factor for mortality in PLHIV.

TRIAL REGISTRATION: Not applicable.

PMID:41469861 | DOI:10.1186/s12879-025-12489-8

Jpn J Clin Oncol. 2025 Dec 31:hyaf211. doi: 10.1093/jjco/hyaf211. Online ahead of print.

ABSTRACT

The ARASENS trial demonstrated a significant overall survival (OS) benefit for a triplet regimen in metastatic castration-sensitive prostate cancer (mCSPC). We aimed to determine whether this benefit is synergistic or additive. Using a mathematical model of independent drug action and published data from the ARASENS and ARANOTE, we compared the observed OS of the triplet regimen to a predicted OS curve. Reconstructed individual patient data were compared using a Cox model. The observed OS was statistically superior to the predicted OS (hazard ratio [HR] 0.82, 95% CI 0.68-0.99; P = .047), indicating a clinical benefit ~18% greater than the expected additive effect. To address confounding by subsequent therapies, we analyzed time to initial subsequent anticancer therapy, which showed an even more pronounced greater-than-additive benefit (HR 0.57, 95% CI 0.44-0.74; P < .001). These findings suggest the triplet regimen provides an early therapeutic advantage that exceeds additive expectations, supporting an upfront combination strategy in mCSPC.

PMID:41469858 | DOI:10.1093/jjco/hyaf211

Arch Gynecol Obstet. 2025 Dec 30;313(1):1. doi: 10.1007/s00404-025-08277-z.

ABSTRACT

OBJECTIVE: The purpose of this study was to compare oral estradiol valerate and estradiol transdermal gel for clinical pregnancy outcomes in patients undergoing frozen-thaw embryo transfer (FET).

METHODS: This was a prospective study performed between March 1, 2017 and October 30, 2019. Totally 244 HR FET cycles were included, with 123 cycles using oral estrogen tablets (oral group) and 121 applying estradiol transdermal gel (gel group). The primary aim of this study was to compare implantation (IR), clinical pregnancy (CPR), miscarriage (MR) and live birth (LBR) rates between the two groups. The secondary aim was to assess liver function, specifically measuring alanine transaminase (ALT) and aspartate transaminase (AST) levels at 12 weeks of gestation.

RESULTS: There were no significant differences in EPR, IR, and CPR between the two groups. Meanwhile, the gel group had a higher live birth rate (55.37% versus 51.20%, p = 0.302) and a lower miscarriage rate (5.79% versus 10.57%, p = 0.173) compared with the oral group, but statistical significance was not reached. The oral group had higher ALT (16.58 ± 6.13 versus 23.78 ± 7.17, p < 0.001) and AST (19.70 ± 3.58 versus 23.78 ± 7.17, p = 0.001) levels at 12 weeks of gestation.

CONCLUSION: Estradiol transdermal gel is a safe and feasible alternative for endometrial preparation in frozen embryo transfer cycles, yielding comparable ongoing pregnancy rates to the standard oral regimen.

PMID:41469840 | DOI:10.1007/s00404-025-08277-z

Sci Rep. 2025 Dec 30. doi: 10.1038/s41598-025-34198-7. Online ahead of print.

ABSTRACT

Recurrent implantation failure (RIF) occurs in 10-15% of IVF cycles with evidence from a few randomized control trials (RCTs) that local endometrial injury (LEI) leads to higher live birth rates whose exact mechanism is currently unknown. During the implantation period, modulation in immune milieu occur in tandem with profound morphologic and functional changes in the endometrium. The landscape of immune cells in the endometrium in pre- and post-LEI in RIF is currently unknown. Thirty-seven women with RIF (age 34.6 ± 3.3 years old) underwent LEI by two sequential mid-luteal phase endometrial biopsies prior to embryo transfer. To characterize the immunological landscape alterations in LEI, we performed immunophenotypic assessment with flow cytometry to provide insights into the basal (first biopsy) and altered (second biopsy) biology of dendritic cells (DC), macrophages, natural killer (NK), T and B cells in the RIF population before and after LEI. Clinical pregnancies occurred in seventeen women (46%). Among analysed immune cells, T (34.6%) and NK cells (26.2%) predominate in the mid-luteal endometrium. A consistent increase in lymphocytes and decrease in antigen presenting cells (APCs) were observed between the two biopsies although not statistically significant. Interrogation of the immune milieu in patients who either fell pregnant or not did not show any differences once cases with endometriosis were taken out of the analyses. There were no further difference in any of the other measured immune cell subsets between the first and second endometrial biopsy. We found limited changes in the immune cell compartments after LEI. Further research with higher resolution methods may provide more information on the effects of LEI.

PMID:41469836 | DOI:10.1038/s41598-025-34198-7

Sci Rep. 2025 Dec 30. doi: 10.1038/s41598-025-34050-y. Online ahead of print.

ABSTRACT

This study investigates the influence of Bacillus pumilus-induced calcium carbonate precipitation (MICP) on the flexural performance and durability of jute fibre-reinforced concrete (JFRC). A nominal 1:2:4 concrete mix with 1% jute fibre (treated and untreated) was prepared and dosed with three bacterial concentrations (B1.5, B12, and B24). Prismatic beams (150 × 150 × 500 mm) were cured and tested at 7, 14, 21, and 28 days under three-point bending, and a total of twelve beams per mix (n = 12), corresponding to three replicate specimens at each curing age, were evaluated. Fresh properties (slump and compaction factor), mass and dimensional loss, SEM microstructural observations, and statistical analysis (two-way ANOVA and Tukey HSD) were used to interpret results. Findings show that bacterial dosage strongly governs performance: low dosage (B1.5) produced minor early-age gains; moderate dosage (B12) yielded delayed but measurable improvements; and high dosage (B24) produced the greatest 28-day flexural enhancement, although with reduced workability. Durability tests indicated improved resistance to acid attack and lower mass and dimensional loss for bacterial mixes, with B1.5 and B24 dosages showing the most favourable performance depending on the metric assessed. SEM observations confirmed progressive CaCO₃ deposition with increasing bacterial concentration, enhancing fibre-matrix bonding and reducing microcrack connectivity. Overall, the study demonstrates a measurable synergy between jute fibres and microbially induced calcite precipitation, indicating that appropriately dosed B. pumilus can significantly enhance the flexural behaviour and durability of JFRC. These findings provide insight into the development of low-cost, bio-enhanced natural-fibre composites for sustainable construction applications.

PMID:41469828 | DOI:10.1038/s41598-025-34050-y