Tag: statistics

Psychopharmacology (Berl). 2025 May 17. doi: 10.1007/s00213-025-06809-8. Online ahead of print.

ABSTRACT

RATIONALE: Adverse childhood experiences (ACEs) have been identified as a major risk factor for psychiatric disorders from childhood to adult life along with the dysregulation of neuroendocrinological processes mediating stress and inflammation. The endocannabinoid system (ECS) has been found to play a putative role in the release of inflammatory cytokines.

OBJECTIVE: We investigated the role of the ECS in the interplay between ACEs and interleukin 6 (IL-6) as an inflammatory marker.

METHODS: We analysed ACEs (CTQ, Bernstein et al. 2003), plasma IL-6 and endocannabinoid concentrations (anandamide (AEA) and 2-arachidonoylglycerol (2-AG) in a cohort comprising 48 female individuals diagnosed with borderline personality disorder (BPD) and 31 matched healthy controls (HCs).

RESULTS: We found higher IL-6 levels in individuals with BPD compared to HCs and, across all study participants, observed significant positive correlations between AEA, 2-AG and IL-6 levels. CTQ sum scores correlated positively with IL-6 concentrations at a trend level (statistically significant for sexual abuse). Correlations between CTQ sum scores and IL-6 levels were particularly strong in participants with low endocannabinoid levels (lowest three quartiles; n = 57) while in the quartile with the highest endocannabinoid levels (n = 19), no correlations were evident. Furthermore, an exploratory analysis applying a median split for IL-6 levels revealed that the number of individuals with recent suicide attempts (< 1 month ago) was significantly higher in the high IL-6 levels group (OR = 0.22; 95%CI = 0.06-0.86).

CONCLUSION: Our findings support the bidirectional link between ACEs and immune system alterations and suggest that endocannabinoids may counteract the stress-inflammatory response.

PMID:40381004 | DOI:10.1007/s00213-025-06809-8

Psychopharmacology (Berl). 2025 May 17. doi: 10.1007/s00213-025-06795-x. Online ahead of print.

ABSTRACT

RATIONALE: The head twitch response (HTR) is a spontaneously occurring behavior in mice that is increased in frequency by serotonergic psychedelics. The mouse HTR is often used as a proxy for psychedelic-like drug effects, but limited information is available about sex differences in HTRs evoked by various classes of psychedelics (i.e., phenethylamines, lysergamides, tryptamines).

OBJECTIVE AND METHODS: To examine potential sex differences in responsiveness to structurally-distinct psychedelics, acute effects of subcutaneous 2,5-dimethoxy-4-iodo-amphetamine (DOI, 0.03-10 mg/kg), lysergic acid diethylamide (LSD, 0.003-1 mg/kg), and 4-phosphoryloxy-N,N-dimethyltryptamine (psilocybin, 0.03-10 mg/kg) on HTRs were compared in male and female C57BL/6J mice. For comparison, effects of the drugs on locomotor activity and body temperature were also determined.

RESULTS: Drug potencies for inducing HTRs were similar in males and females for all drugs, with only LSD exhibiting detectable differences due to increased maximal counts in females. Importantly, the maximum number of HTRs observed for all drugs was higher in females, with significant differences between sexes for DOI and LSD. Dose x sex interactions for the dose-response data were statistically significant for psilocybin and LSD, with females displaying more HTRs after the highest or peak doses of all drugs. The acute effects of drugs on locomotion and temperature varied by drug, but were similar in both sexes.

CONCLUSIONS: The present results overall show no substantial sex differences in the potencies to induce HTRs for DOI, LSD, and psilocybin in C57BL/6J mice. However, females uniformly displayed more HTRs at high doses administered across chemotypes. The results further suggest that commonly used doses of psychedelics induce comparable psychedelic-like effects in male and female C57BL/6J mice, but modest differences may emerge at high doses.

PMID:40381003 | DOI:10.1007/s00213-025-06795-x

Int J Soc Psychiatry. 2025 May 17:207640251340820. doi: 10.1177/00207640251340820. Online ahead of print.

ABSTRACT

BackgroundAssets, income, socioeconomic status, and other measures of financial position are consistent predictors of depression. Although financial stress has been proposed as a mediator of this relationship, no study has explored this hypothesis using a rigorous longitudinal design or outside of high-income countries.AimsWe address this gap using longitudinal cohort data across four timepoints.MethodThe sample comprised 831 women (M = 35.9 years old) living in Nawalpur, a rural district in the Gandaki province of Nepal; the majority were married (88%) and of Janajati caste/ethnicity (61%). The direct effect of financial position on depressive symptoms and its indirect effect through financial stress were estimated using a cross-lagged panel mediation model (CLPM); we also conducted cross-sectional mediation models – of the sort typically employed in mediation analyses – for comparison and bias estimation.ResultsIn the CLPM, financial stress significantly mediated the financial position-depressive symptom relationship between timepoints one and three, but not between timepoints two and four (likely due to loss of power). After accounting for financial stress as a mediator, the direct effects of financial position on depressive symptoms were not statistically significant. The cross-sectional models overestimated the relationship between financial stress and depressive symptoms; otherwise, results between the CLPM and cross-sectional models were comparable.ConclusionsOur findings suggest that interventions addressing financial stress may improve depressive symptoms. Methodologically, we argue that more researchers should employ longitudinal designs when investigating mediation processes.

PMID:40380863 | DOI:10.1177/00207640251340820

Br J Surg. 2025 Apr 30;112(5):znaf082. doi: 10.1093/bjs/znaf082.

ABSTRACT

BACKGROUND: Implant-based breast reconstruction is the most common technique after mastectomy. Breast implants are categorized by surface type as smooth, textured, or polyurethane-covered, each with specific attributed advantages and complication profiles. High-quality comparative studies are, however, limited. This study compared revision incidence and indications for revision among these implant types.

METHODS: A prospective, nationwide cohort from the Dutch Breast Implant Registry was analysed. Permanent implants used between 2017 and 2022 for direct-to-implant or two-stage reconstruction were included. Surface-related revision was the primary outcome. Cumulative incidences were estimated using a competing risk model. Cause-specific hazard ratios (HRcs) were calculated using univariable and multivariable models, accounting for implant clustering and confounders. Subgroup analyses examined revisions for specific complications.

RESULTS: Of 3996 implants, 76.9% were textured, 12.4% smooth, and 10.8% polyurethane-covered. At 4 years, the cumulative incidence of revision surgeries did not differ between textured (11.1%; 95% c.i. = 9.9 to 12.5), smooth (13.0%; 95% c.i. = 8.5 to 18.4), and polyurethane-covered (16.1%; 95% c.i. = 12.4 to 20.2) implants. Multivariable analysis found no association between surface type and surface-related revision. Subgroup analysis however revealed that polyurethane-covered implants had increased hazards of revision for capsular contracture (HRcs = 2.49; 95% c.i. = 1.24 to 5.01) and asymmetry (HRcs = 2.31; 95% c.i. = 1.33 to 4.02).

CONCLUSION: After adjusting for confounders and clustering, surface-related revision in a reconstructive setting did not significantly different among breast implant surface types overall. Polyurethane-covered implants may, however, require more revisions due to capsular contracture and asymmetry.

PMID:40380859 | DOI:10.1093/bjs/znaf082

J Gerontol B Psychol Sci Soc Sci. 2025 May 17:gbaf089. doi: 10.1093/geronb/gbaf089. Online ahead of print.

ABSTRACT

OBJECTIVES: Mortality prediction and the identification of mortality risks are central to social and biological sciences. Traditional models often assess linear associations between single risk factors and mortality. Transformer models, capable of capturing long-term dependencies across multiple variables, offer a novel approach to mortality prediction. This study introduces a transformer-based model applied to data from the Health and Retirement Study (HRS).

METHODS: We analyzed data provided by 38,193 adults aged ≥50 years participating in the HRS, a longitudinal US study surveyed biennially since 1992. Linked mortality data were obtained from the National Death Index and postmortem interviews. Using the transformer architecture, we modeled changes in 126 risk factors spanning financial, physical, and mental health domains manifesting over 29 years. Prediction performance was assessed across multiple settings, with traditional statistical and machine learning models serving as benchmarks.

RESULTS: Over a median follow-up of 9 years, 17,448 deaths occurred (crude rate: 39.6 per 1,000 person-years). The transformer model consistently outperformed traditional and machine learning methods, achieving a twofold improvement in average precision scores (APS) for next-wave mortality prediction relative to the best benchmark model.

DISCUSSION: Transformer-based models, such as BEHRT, significantly enhance mortality prediction compared with traditional approaches. These findings highlight the potential of transformer neural network models in social science-focused population health research on aging.

PMID:40380823 | DOI:10.1093/geronb/gbaf089

BJS Open. 2025 May 7;9(3):zraf030. doi: 10.1093/bjsopen/zraf030.

ABSTRACT

BACKGROUND: Operating rooms generate substantial waste and budget expenditure due to extensive material usage. Reusable instruments are often packaged in trays, which accumulate instruments over time. This review quantifies the advantages of tray optimization (removing redundant instruments), including reduced environmental impact, costs, operating room and processing time.

METHODS: Following PRISMA guidelines, searches were conducted in PubMed, Embase, Web of Science and The Cochrane Library in August 2024 for studies on optimizing surgical trays in human surgeries. Studies were included if they reported on optimization approaches and outcomes related to environmental, economic or efficiency improvements. Exclusions included studies on disposable instruments, animal or veterinary research and patient-specific trays. Risk of bias was assessed using the ROBINS-I (Risk Of Bias In Non-randomised Studies – of Interventions) tool.

RESULTS: The search identified 4511 studies, with 45 meeting the inclusion criteria. Half of the studies showed a serious risk of bias, while the rest had a moderate risk. Three main optimization strategies were identified, with expert analysis being the most common (n = 29), followed by mathematical modelling. Environmental benefits were reported in all three included studies, although limited in number. Studies reported that 19 to 89% of instruments could be removed from trays, with 31 studies unanimously reporting cost reductions. Additionally, 17 studies demonstrated improved operational efficiency.

CONCLUSION: Tray optimization strategies effectively reduce resource use, resulting in environmental and economic benefits. Although no standard method exists, effective strategies such as procedure observation and clinician feedback may eliminate over half of the instruments, offering a significant opportunity to minimize resource consumption in the operating room.

PMID:40380812 | DOI:10.1093/bjsopen/zraf030

Global Spine J. 2025 May 16:21925682251343525. doi: 10.1177/21925682251343525. Online ahead of print.

ABSTRACT

Study DesignA systematic review and meta-analysis.ObjectivesThis systematic review and meta-analysis aim to evaluate the diagnostic accuracy of CT in detecting PLC injuries in traumatic thoracolumbar fractures.MethodsA comprehensive search of PubMed/MEDLINE, Embase, and Web of Science was conducted up to January 2025. Studies were included if they examined the diagnostic validity of CT for PLC injuries compared with MRI with predefined outcomes (true/false positives/negatives). Quality assessment was performed using the QUADAS-2 tool, and statistical analysis involved bivariate binomial regression to generate summary receiver operating characteristic (SROC) curves and pooled estimates of sensitivity and specificity.ResultsEight studies involving 1440 patients were included. The pooled sensitivity and specificity of CT for PLC injury detection were 75% (95% CI: 68 to 80, P = 0.00) and 87% (95% CI: 71 to 95, P = 0.00), respectively. The area under the curve (AUC) from the SROC analysis was 0.81 (95% CI: 0.78 to 0.84), indicating fair diagnostic accuracy. Meta-regression analysis revealed that sensitivity and specificity remained consistent across advanced CT techniques, multiplanar reconstruction, and full MRI protocol, but extensive trauma, CT 16-64 or ≥128 slices, and 3.0 T MRI scanner influenced it. No significant publication bias was detected.ConclusionThis meta-analysis demonstrates that CT has fair diagnostic accuracy for detecting PLC injuries in traumatic thoracolumbar fractures, supporting its clinical utility. Future research should explore integrating advanced imaging technologies to enhance CT’s diagnostic precision.

PMID:40380790 | DOI:10.1177/21925682251343525

Stud Health Technol Inform. 2025 May 15;327:1471-1472. doi: 10.3233/SHTI250655.

ABSTRACT

This study aimed to explore nursing care for patients underwent coronary artery bypass graft (CABG) surgery using standardized nursing records. A total of 184,029 nursing statements from 122 patients were analyzed, with 437 unique statements accounting for the majority of data. These statements were semantically mapped to SNOMED CT concepts related to clinical findings, situations, and procedures. The most prominent categories included pain management, postoperative lung care, and mental status assessments. The findings highlight the potential of standardized nursing records in identifying key nursing practices and improving outcomes for CABG surgery patients.

PMID:40380758 | DOI:10.3233/SHTI250655

Stud Health Technol Inform. 2025 May 15;327:1457-1458. doi: 10.3233/SHTI250648.

ABSTRACT

This research explores factors influencing the use of wearable technology by people with Multiple Sclerosis (PwMS) to assist in symptom self-management. Using Q-methodology, 19 PwMS in Saudi Arabia (SA) participated. The PwMS study revealed three perspectives: supporters of wearable technology, pragmatic optimists, and cautious sceptics. The preliminary findings highlight the importance of addressing both practical and psychological barriers to facilitate wearables integration in the management of MS.

PMID:40380751 | DOI:10.3233/SHTI250648

Stud Health Technol Inform. 2025 May 15;327:1451-1452. doi: 10.3233/SHTI250645.

ABSTRACT

This research evaluates ICD-11 using the cancer Biomedical Informatics Grid (caBIG®) Terminology Review Criteria Matrix version 3.3 and the National Committee on Vital and Health Statistics (NCVHS) criteria for adoption and implementation and guidelines for curation and dissemination of health terminology and vocabulary standards. The aim is to determine if ICD-11 meets acceptable terminology practices and to identify its strengths and weaknesses.

PMID:40380748 | DOI:10.3233/SHTI250645