Category: Statistics

Pediatr Allergy Immunol. 2025 Aug;36(8):e70166. doi: 10.1111/pai.70166.

ABSTRACT

BACKGROUND: Discrepancies between parent reports and electronic health records (EHRs) challenge the accurate estimation of childhood allergic disease prevalence. This study aimed to: (1) compare parent reports of asthma, eczema, and allergic rhinitis with GP-recorded diagnoses; (2) identify factors associated with reporting differences; and (3) assess the predictive validity of parent reports for future diagnoses.

METHODS: Data were analyzed from 2594 children (aged 4-5 years) in the UK Born in Bradford (BiB) cohort. Parent-reported symptoms and diagnoses from questionnaires were compared against diagnoses in primary care EHRs. Agreement was assessed using prevalence estimates and agreement metrics. Logistic and Poisson regression models were used to identify factors influencing reporting and to evaluate predictive validity.

RESULTS: Agreement varied by condition. For parent-reported “ever-diagnosed” asthma, agreement with GP records was good (Kappa = 0.68), while for recent eczema symptoms, it was poor (Kappa = 0.07), though this improved after adjusting for prevalence (PABAK = 0.66). Parent reports were highly reliable for ruling out diagnoses. Factors including ethnicity and GP visit frequency were associated with reporting discrepancies. Parent reports at age 4-5 strongly predicted a future GP diagnosis, increasing the risk fivefold for asthma and threefold for allergic rhinitis.

CONCLUSION: Neither parent reports nor EHRs alone capture the full picture of childhood allergic disease. Parent reports offer crucial insights into symptom burden and future risk, while EHRs provide objective diagnostic data. An integrating approach, combining both sources, is essential for comprehensive epidemiological research and a more complete understanding of disease burden.

PMID:40772360 | DOI:10.1111/pai.70166

Nord J Psychiatry. 2025 Aug 7:1-9. doi: 10.1080/08039488.2025.2539782. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of the study was to investigate the empirical validity of the Chinese Brief Cognitive Test (C-BCT) and examine the correlation between cognitive symptoms and functional outcomes in people with schizophrenia.

METHODS: Patients with schizophrenia (n = 145) together with 723 healthy controls underwent testing with C-BCT and MATRICS Consensus Cognitive Battery (MCCB). Clinical staff measured Positive and Negative Syndrome Scale (PANSS) and Personal and Social Performance (PSP) Scale for patients. One-way analysis of covariance was conducted to compare cognitive performance across groups. The correlation between C-BCT performance and PANSS and PSP was examined using the Pearson product moment correlation. The Global Deficit Score (GDS) was used to identify the severity of cognitive impairment. The generalized linear model was used to analyze the effects of age, sex and education.

RESULTS: The four scales of C-BCT alongside composite scaled score (Css) demonstrated statistical differences between groups with partial eta squared scores between 0.049 and 0.171. Composite scaled score was weakly correlated with each scale of the PANSS (r-value ranged from -0.242 to -0.190), and weakly correlated with PSP. In addition to Digit Span Task, scales of C-BCT had different correlations with PANSS and PSP. There were differences in GDS among patients with different employment status (p < .05). 55.9% of the patient sample had been identified as cognitive impaired using C-BCT.

CONCLUSIONS: The C-BCT exhibits good empirical validity in Chinese patients with schizophrenia. Information processing speed, executive function, attention/vigilance, and overall cognitive performance were differently related to clinical symptoms and social function.

HIGHLIGHTS: Cognitive impairment is one of the core symptoms and dimensions of schizophrenia.The Chinese Brief Cognitive Test (C-BCT) is a simplified cognitive assessment tool based on the Chinese cultural environment.The C-BCT has good empirical validity in Chinese patients with schizophrenia, and can evaluate neurocognition in Chinese patients with schizophrenia in a shorter time.The C-BCT may be helpful for clinicians and researcher because of its convenience and efficiency.

PMID:40772332 | DOI:10.1080/08039488.2025.2539782

Ren Fail. 2025 Dec;47(1):2539933. doi: 10.1080/0886022X.2025.2539933. Epub 2025 Aug 7.

ABSTRACT

BACKGROUND: Acute kidney injury (AKI) in critically ill patients often requires continuous renal replacement therapy (CRRT), yet predictors of successful transition off CRRT remain unclear. This study aimed to identify clinical factors associated with successful and sustained CRRT discontinuation.

METHODS: We retrospectively analyzed 924 adult ICU patients who received CRRT between January 2010 and December 2024. The primary outcome was successful CRRT transition, defined as discontinuation without CRRT re-initiation within 7 days or transition to intermittent hemodialysis. Multivariable logistic regression was used to evaluate associations with clinical, hemodynamic, and biochemical parameters.

RESULTS: Of 924 patients (mean age 60 ± 14 years; 66% male), 823 (89%) successfully transitioned off CRRT. Vasopressor use (adjusted odds ratio [aOR] 0.68, p = 0.0001) and mechanical ventilation (aOR 0.56, p = 0.02) were associated with lower odds of success. On transition day, higher urine output (per 1 L, aOR 1.39, p = 0.003), serum bicarbonate (aOR 1.10, p = 0.032), and mean arterial pressure (aOR 1.02, p = 0.031) were positive predictors, while elevated blood urea nitrogen (aOR 0.98, p = 0.05) and higher obligate fluid intake (per 1 L, aOR 0.84, p = 0.032) were negative predictors. At day 7, sustained success was positively associated with urine output (aOR 1.35, p = 0.008) and serum pH (aOR 1.58, p = 0.049), and negatively associated with vasopressor use (aOR 0.69, p = 0.0001) and obligate intake (aOR 0.68, p < 0.0001).

CONCLUSION: Higher urine output, better acid-base status, and stable hemodynamics predict successful and sustained CRRT discontinuation. Ongoing vasopressor use and high fluid burden reduce the likelihood of success.

PMID:40772290 | DOI:10.1080/0886022X.2025.2539933

Front Genet. 2025 Jul 23;16:1635734. doi: 10.3389/fgene.2025.1635734. eCollection 2025.

ABSTRACT

Forensic genetic genealogy (FGG) is a force-multiplier for human identification, leveraging dense single nucleotide polymorphism (SNP) data to infer relationships through identity by descent (IBD) segment analysis. Although powerful for investigative lead generation, broad adoption of SNP-based identification methods by the forensic community, especially medical examiners and crime laboratories, necessitates likelihood ratio (LR)-based relationship testing, to align with traditional kinship testing standards. To address this gap, a novel method was developed that incorporates LR calculations into FGG and SNP testing workflows. This approach is unique in that it dynamically selects unlinked, highly informative SNPs based on configurable thresholds for minor allele frequency (MAF) and minimum genetic distance for a robust and reliable analysis. Employing a curated panel of 222,366 SNPs from gnomAD v4 and data from the 1,000 genomes project, high accuracy in resolving relationships up to second-degree relatives can be achieved. For example, a subset of 126 SNPs (MAF > 0.4, minimum genetic distance of 30 cM) yielded 96.8% accuracy and a weighted F1 score of 0.975 across 2,244 tested pairs. This LR-based methodology enables forensic laboratories to select informative SNPs and integrate modern genomic data with existing accredited relationship testing frameworks, providing critical statistical support for close-relationship comparisons and enhances the rigor of FGG- and SNP-based human identification applications.

PMID:40772272 | PMC:PMC12325062 | DOI:10.3389/fgene.2025.1635734

Front Genet. 2025 Jul 23;16:1599724. doi: 10.3389/fgene.2025.1599724. eCollection 2025.

ABSTRACT

BACKGROUND: Estrogen receptor-positive (ER+) breast cancer, a prevalent subtype of breast malignancy, demonstrates complex etiological associations with multiple risk factors. Micronutrients, as essential nutritional components for human physiology, may potentially influence the pathogenesis and progression of breast carcinoma. This investigation employs Mendelian randomization (MR) methodology to assess causal relationships between 15 micronutrients and ER+ breast cancer.

METHODS: In this study, instrumental variables (IVs) for 15 micronutrients were extracted from the genome-wide association studies (GWAS) database, including copper, calcium, carotene, folate, iron, magnesium, potassium, selenium, vitamin A, vitamin B12, vitamin B6, vitamin C, vitamin D, vitamin E, and zinc. Concurrently, summary data related to ER+ breast cancer were obtained from the FinnGen database. Following the selection of appropriate IVs, we conducted a two-sample MR analysis. This analytical framework incorporated comprehensive sensitivity analyses to evaluate potential heterogeneity and horizontal pleiotropy, with the inverse variance weighted (IVW) method established as the principal analytical approach.

RESULTS: The findings of our study revealed a significant causal relationship between vitamin B6 and ER+ breast cancer. Notably, genetically predicted elevated vitamin B6 levels were significantly associated with an increased risk of ER+ breast cancer [Odds Ratio (OR): 1.275; 95%Confidence Interval (CI): (1.017-1.600); P = 0.035]. In contrast, no statistically significant associations were observed between the other 14 micronutrients and ER+ breast cancer risk (P > 0.05 for all).

CONCLUSION: Our results indicated that higher concentrations of vitamin B6 may be positively associated with ER+ breast cancer risk, and further research is needed to elucidate the underlying biological mechanisms of this association. This study provides new insights into understanding the role of micronutrients in breast cancer.

PMID:40772270 | PMC:PMC12325068 | DOI:10.3389/fgene.2025.1599724

J Arrhythm. 2025 Aug 6;41(4):e70156. doi: 10.1002/joa3.70156. eCollection 2025 Aug.

ABSTRACT

BACKGROUND: Ventricular arrhythmias are prevalent among heart failure with reduced ejection fraction (HFrEF) patients. Rapid rate non-sustained ventricular tachycardia (RR-NSVT) and sustained ventricular tachycardia (VT) can be detected on implantable cardioverter-defibrillator (ICD) interrogation due to discrimination algorithms that differentiate supra-ventricular from ventricular tachycardia. This study aims to assess the incidence of RR-NSVT and sustained VT on ICD interrogation and their correlation with HFrEF guideline-directed medical therapy (GDMT) compliance.

METHODS: DesignCross-sectional, analytical study. SettingHeart rhythm device clinic, Electrophysiology department, National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan. ParticipantsPatients implanted with dual chamber ICD or cardiac resynchronization therapy defibrillator (CRT-D), aged 18 years or above with HFrEF. Outcome MeasureCovariates included demographics, comorbidities, medications, GDMT compliance, and cardiac rhythm device parameters. Incidence of RR-NSVT, sustained VT, and their correlation with HFrEF GDMT compliance was assessed using multivariate logistic regression.

RESULTS: Study evaluated 139 patients. Men 77.7%. The mean age was 56.4 ± 13.9 years. The mean LV ejection fraction was 26.4% ± 5.5%. 109 (78.4%) were GDMT compliant (94.3% on beta-blockers, 93.5% on renin-angiotensin inhibitors, 71.9% on aldosterone antagonists, and 15.8% on SGLT-2 inhibitors). RR-NSVT episodes were observed in 54 (38.8%) patients, out of whom 37 had RR-NSVT despite GDMT compliance, although this correlation was not statistically significant. Twelve (8.6%) patients had sustained VT, which was significantly less common with GDMT compliance.

CONCLUSION: More than one-third of participants had RR-NSVT episodes despite HFrEF GDMT compliance. These patients also had associated sustained VT episodes, the occurrence of which was significantly less with GDMT compliance.

PMID:40772237 | PMC:PMC12326080 | DOI:10.1002/joa3.70156

Neurobiol Lang (Camb). 2025 Jul 22;6:nol.a.8. doi: 10.1162/nol.a.8. eCollection 2025.

ABSTRACT

Prediction has become a key concept for understanding language comprehension, language production, and more recently reading. Recent studies suggest that predictive mechanisms in reading may be related to domain-general statistical learning (SL) abilities that support the extraction of regularities from sequential input. Both mechanisms have been discussed in relation to developmental dyslexia. Some suggest that SL is impaired in dyslexia with negative effects on the ability to make linguistic predictions. Others suggest that dyslexic readers rely to a greater extent on semantic and syntactic predictions to compensate for lower-level deficits. Here, we followed these two research questions in a single study. We therefore assessed the effects of semantic and syntactic prediction in reading and SL abilities in a population of university students with dyslexia and a group of typical readers using fMRI. The SL task was a serial reaction time (SRT) task that was performed inside and outside the scanner. The predictive reading task was performed in the scanner and used predictive versus nonpredictive semantic and syntactic contexts. Our results revealed distinct neural networks underlying semantic and syntactic predictions in reading, group differences in predictive processing in the left precentral gyrus and right anterior insula, and an association between predictive reading and SL, particularly in dyslexic readers. These findings contribute to our understanding of the interplay between SL, predictive processing, and compensation in dyslexia, providing new insights into the neural mechanisms that support reading.

PMID:40772236 | PMC:PMC12328026 | DOI:10.1162/nol.a.8

Front Cell Dev Biol. 2025 Jul 23;13:1642539. doi: 10.3389/fcell.2025.1642539. eCollection 2025.

ABSTRACT

Although large language models (LLMs) show significant potential in clinical practice, accurate diagnosis and treatment planning in ophthalmology require multimodal integration of imaging, clinical history, and guideline-based knowledge. Current LLMs predominantly focus on unimodal language tasks and face limitations in specialized ophthalmic diagnosis due to domain knowledge gaps, hallucination risks, and inadequate alignment with clinical workflows. This study introduces a structured reasoning agent (ReasonAgent) that integrates a multimodal visual analysis module, a knowledge retrieval module, and a diagnostic reasoning module to address the limitations of current AI systems in ophthalmic decision-making. Validated on 30 real-world ophthalmic cases (27 common and 3 rare diseases), ReasonAgent demonstrated diagnostic accuracy comparable to ophthalmology residents (β = -0.07, p = 0.65). However, in treatment planning, it significantly outperformed both GPT-4o (β = 0.49, p = 0.01) and residents (β = 1.71, p < 0.001), particularly excelling in rare disease scenarios (all p < 0.05). While GPT-4o showed vulnerabilities in rare cases (90.48% low diagnostic scores), ReasonAgent’s hybrid design mitigated errors through structured reasoning. Statistical analysis identified significant case-level heterogeneity (diagnosis ICC = 0.28), highlighting the need for domain-specific AI solutions in complex clinical contexts. This framework establishes a novel paradigm for domain-specific AI in real-world clinical practice, demonstrating the potential of modularized architectures to advance decision fidelity through human-aligned reasoning pathways.

PMID:40772224 | PMC:PMC12325206 | DOI:10.3389/fcell.2025.1642539

Cureus. 2025 Jul 5;17(7):e87360. doi: 10.7759/cureus.87360. eCollection 2025 Jul.

ABSTRACT

Objectives This study set out to compare the mechanical behavior of graphene and zirconia in the context of their potential use in fixed dental prostheses. Specifically, we evaluated three critical properties: Rockwell hardness, to understand surface durability; compressive strength, to assess resistance to biting forces; and flexural strength, to examine performance under bending stress. To approximate real-world conditions, all samples were subjected to thermocycling, simulating the thermal changes typical of the oral cavity. The goal was to explore whether graphene could serve as a viable alternative to zirconia in restorative applications. Methods A systematic in vitro protocol was followed. Standardized specimens of graphene and zirconia were fabricated and subjected to 30,000 thermocycles between 5°C and 55°C. Mechanical tests were conducted using a universal testing machine. Rockwell hardness was measured using a standard durometer, while compressive and flexural strengths were evaluated through load-to-failure testing. Data were statistically analyzed using independent-sample t-tests, with significance defined at p<0.05. Results Zirconia showed markedly higher compressive strength compared to graphene, making it better suited for high-load areas of the mouth. Interestingly, the two materials performed similarly in Rockwell hardness, suggesting comparable surface durability. Flexural strength results were also close, with no significant difference, indicating that graphene may perform well under bending or tensile forces. These outcomes reaffirm zirconia’s status as a robust material for prosthodontics while also opening the door for graphene as a lightweight, structurally capable alternative. Conclusion While zirconia continues to outperform in terms of compressive strength, graphene demonstrates meaningful potential due to its comparable flexural strength and hardness, along with the added advantage of being significantly lighter. These findings support further investigation into graphene’s role in restorative dentistry, especially in cases where weight, design complexity, or aesthetics demand alternative materials. Future research should explore its biocompatibility, long-term performance, and integration with current dental systems.

PMID:40772214 | PMC:PMC12325734 | DOI:10.7759/cureus.87360

Cureus. 2025 Jul 6;17(7):e87389. doi: 10.7759/cureus.87389. eCollection 2025 Jul.

ABSTRACT

Background Pancreatic ductal adenocarcinoma (PDAC) remains a highly lethal malignancy with limited effective systemic therapies. Modified FOLFIRINOX (mFOLFIRINOX) and gemcitabine plus nab-paclitaxel (GN) are commonly used first-line regimens. The purpose of this study is to evaluate real-world efficacy (response rates, progression-free survival (PFS) and overall survival (OS)) and toxicity (grade 3/4 hematologic and non-hematologic toxicities) of first-line mFOLFIRINOX and gemcitabine plus nab-paclitaxel in patients with advanced pancreatic ductal adenocarcinoma. Methods We conducted a retrospective analysis of 64 patients with advanced PDAC treated between May 2023 and May 2025. Thirty patients received GN, and 34 received mFOLFIRINOX. Efficacy outcomes included overall response rate (ORR), clinical benefit rate (CBR), PFS, and OS. Toxicities were graded using Common Terminology Criteria for Adverse Events (CTCAE) v4.0. Statistical analyses included Kaplan-Meier survival estimates and Cox regression modeling. Results The median age was 59 years (range: 32-75), with a predominance of male patients (68.2%). Most had Eastern Cooperative Oncology Group Performance Status (ECOG PS) 0-1 (89.1%). Patients receiving mFOLFIRINOX were younger and more likely to have tumors in the pancreatic head, whereas elevated CA19-9 levels were more common in the GN group. ORR was 57% in the GN arm and 52.9% with mFOLFIRINOX (P=0.179), while CBR was comparable (77% vs. 76.5%, P=0.985). The median progression-free survival of patients receiving GN was 6.97 months and 8.5 months with FOLFIRINOX (HR: 1.14; 95% CI: 0.58 – 2.22; P=0.713). mFOLFIRINOX had a median overall survival benefit (HR: 1.352; 95% CI 0.63 – 2.90; P=0.428), but this did not reach statistical significance. One-year OS was higher with mFOLFIRINOX (91.6% vs. 82.4%), as was 1.5-year OS (76.3% vs. 55.0%). Paradoxically, one-year PFS favored GN (32.5% vs. 20.3%). Grade 3/4 hematologic toxicities were more frequent with mFOLFIRINOX (e.g., neutropenia: 20% vs. 8.8%, anemia: 20% vs. 5.9%). GN was associated with more grade 3/4 vomiting (38.2% vs. 10%, P=0.009), diarrhea (26.5% vs. 3.3%, P=0.011), and neuropathy (29.4% vs. 6.7%, P=0.02). Dose modifications and treatment delays were similar, though delays were more frequent in the mFOLFIRINOX arm. Conclusions Both mFOLFIRINOX and GN demonstrated comparable efficacy in real-world treatment of advanced PDAC. mFOLFIRINOX offered better long-term OS but carried a higher risk of hematologic toxicity, while GN was associated with greater gastrointestinal and neurological adverse effects. Treatment selection should be guided by patient-specific factors such as comorbidities and tolerance to toxicity. Sequential treatment planning, including access to second-line therapy, significantly impacts survival and should be integral to care strategies.

PMID:40772207 | PMC:PMC12324980 | DOI:10.7759/cureus.87389