Tag: statistics

Biomed Eng Online. 2025 Jun 21;24(1):75. doi: 10.1186/s12938-025-01410-8.

ABSTRACT

BACKGROUND: Plastic bronchitis (PB) is a rare but potentially life-threatening condition that requires particular attention in pediatric patients, specifically those presenting with severe Mycoplasma pneumoniae pneumonia (SMPP). This study aimed to identify risk factors associated with PB in children with SMPP and develop a comprehensive risk factor scoring system.

METHODS: A retrospective analysis was conducted on SMPP patients who underwent bronchoscopy between January 2018 and October 2023. Based on bronchoscopic and pathological examination results, patients were categorized into PB (n = 142) and non-PB (n = 274) groups. Clinical manifestations, laboratory data, and imaging findings were analyzed. Risk factors for PB in SMPP children were identified through univariate and multivariate logistic regression analyses. A nomogram model incorporating independent risk factors was developed, and a PB risk factor scoring system was established. Model validation was performed through a prospective validation study.

RESULTS: Among 416 SMPP children (197 males, 219 females), mean age at disease onset was 6.9 ± 2.9 years and 6.6 ± 2.8 years in the PB and Non-PB groups, respectively. Multivariate logistic regression analysis identified eight independent predictors of PB in SMPP children: dyspnea, decreased breath sounds, neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase (LDH), mean platelet volume to platelet ratio (MPV/PLT), pleural effusion, ≥ 2/3 lobe consolidation, and atelectasis. The nomogram prediction model demonstrated excellent discriminative ability (AUC = 0.92, 95% CI 0.892-0.948, P < 0.005) and strong calibration between predicted and observed outcomes. In the prospective validation cohort (n = 565), the scoring system effectively stratified patients into risk categories: high-risk (71.62% PB incidence), intermediate-risk (59.79%), and low-risk (5.33%), with statistically significant inter-group differences (P < 0.001). The PB group exhibited significantly longer hospitalization durations, extended glucocorticoid treatment periods, higher proportions of glucocorticoid therapy utilization, and a greater frequency of bronchoscopy interventions (≥ 2 sessions) compared to the Non-PB group (all P < 0.05).

CONCLUSIONS: In this study, we developed and validated a nomogram to PB in children with SMPP. This model serves as a clinically practical tool for early PB identification, enabling physicians to initiate timely interventions and optimize disease management strategies.

PMID:40544237 | DOI:10.1186/s12938-025-01410-8

Neuropsychopharmacology. 2025 Jun 21. doi: 10.1038/s41386-025-02147-7. Online ahead of print.

ABSTRACT

While numerous studies have examined the subjective response to alcohol as an intermediate phenotype to understand its variability, heritability, and predictive capacity for alcohol-related disorders, in-depth analyses linking alcohol reactivity indicators to genetic factors within a large cohort have been absent. Our study aimed to quantify the exact contribution of each genetic variant relevant to the alcohol metabolism to the variability in alcohol response. Specifically, we focused on two primary genes involved in alcohol metabolism (ALDH2 and ADH1B) and three additional loci (ALDH1B1, ALDH1A1, and GCKR) that have been shown to have significant associations with drinking behaviors in Japanese individuals. We conducted the first study to assess the relationship between subjective response to alcohol (SR), evaluated by various assessment subscales, and genetic factors using an intravenous clamp technique in 429 healthy Japanese young adults. By reducing the dimensionality of the data to assess similarity structures, we identified three distinct clusters of SRs and participants. Each participant cluster exhibited a distinct alcohol response profile shaped by specific genetic contributions. Participant cluster 1 demonstrated the strongest response, followed by participant cluster 2, and then participant cluster 3. Participant cluster 1 may also be the most strongly influenced by the allelic status of ALDH2 and ADH1B. SR patterns varied accordingly, and the enrichment of the ALDH2*2 and ADH1B*2, differed across both participant and subscale clusters. Notably, the three participant clusters closely aligned with the three subscale clusters, highlighting a consistent genotype-phenotype relationship. Furthermore, the proportion of variance explained by these genes also varied across subscale clusters. Contrary to known functions, ADH1B showed associations at later timings when ALDH2 associations attenuate. Our three-cluster classification may improve prevention by enabling early identification of individuals at health risk.

PMID:40544219 | DOI:10.1038/s41386-025-02147-7

Ann Surg Oncol. 2025 Jun 21. doi: 10.1245/s10434-025-17664-4. Online ahead of print.

ABSTRACT

BACKGROUND: Lynch syndrome (LS) is an inherited disorder associated with an increased risk of colorectal and extracolonic malignancies, including gastric cancer (GC). This study quantifies the association between specific risk factors and GC development in patients with LS.

PATIENTS AND METHODS: We searched the PubMed and Scopus databases for prospective and retrospective cohort studies that evaluated patients with genetically confirmed LS and reported associations between demographic, clinical, or genetic characteristics and GC. We conducted a meta-analysis to pool risk ratios (RR) for key risk factors, including sex, genetic mutations, family history of GC, and Helicobacter pylori (HP) infection. We assessed heterogeneity using Cochran’s Q test and the I² statistic.

RESULTS: A total of 14 studies comprising 29,170 patients with LS met the inclusion criteria, of which 13 were included in the meta-analysis. Male sex (RR 2.8; 95% CI 2.2, 3.6; p < 0.001; I² = 0%), MLH1 (RR 1.8; 95% CI 1.4, 2.3; p < 0.001; I² = 0%) and MSH2 variants (RR 2.5; 95% CI 2.0, 3.2; p < 0.001; I² = 0%), family history of GC (RR 3.5; 95% CI 2.0, 5.8; p < 0.001; I² = 0%), and HP infection (RR 2.8; 95% CI 1.2, 6.8; p = 0.023; I² = 12.8%) were associated with increased GC risk. In contrast, the MSH6 variant was associated with lower GC risk (RR 0.6; 95% CI 0.4, 0.8; p = 0.006; I² = 0%).

DISCUSSION: Our findings confirm that male sex, MLH1 and MSH2 variants, family history of GC, and HP infection are significant risk factors for GC in individuals with LS. These findings support the need for individualized surveillance strategies and targeted risk-reduction measures to improve early detection and patient outcomes.

PMID:40544206 | DOI:10.1245/s10434-025-17664-4

Commun Psychol. 2025 Jun 21;3(1):93. doi: 10.1038/s44271-025-00265-y.

ABSTRACT

Perception is biased by expectations and previous actions. Pre-stimulus brain oscillations are a potential candidate for implementing biases in the brain. In two EEG studies (43 and 39 participants) on somatosensory near-threshold detection, we investigated the pre-stimulus neural correlates of an (implicit) previous choice bias and an explicit bias. The explicit bias was introduced by informing participants about stimulus probability on a single-trial level (volatile context) or block-wise (stable context). Behavioural analysis confirmed adjustments in the decision criterion and confidence ratings according to the cued probabilities and previous choice-induced biases. Pre-stimulus beta power with distinct sources in sensory and higher-order cortical areas predicted explicit and implicit biases, respectively, on a single subject level and partially mediated the impact of previous choice and stimulus probability on the detection response. We suggest pre-stimulus beta oscillations in distinct brain areas as a neural correlate of explicit and implicit biases in somatosensory perception.

PMID:40544197 | DOI:10.1038/s44271-025-00265-y

Psychiatry Res. 2025 Jun 16;351:116595. doi: 10.1016/j.psychres.2025.116595. Online ahead of print.

ABSTRACT

Aggressive behaviours pose a significant threat to both individual and societal security. Increasing evidence suggests that individuals exhibiting such behaviours demonstrate altered neurochemical levels including metabolites, neurotransmitters and receptors. However, findings from previous studies have shown inconsistencies. This study aimed to elucidate these neurochemical alterations through a case-control meta-analysis. A comprehensive literature search was conducted using Web of Science, Medline, and PubMed databases, identifying forty eligible studies (registration number: CRD420251014162). The neurochemicals examined included indictors of serotonin (5-HT), dopamine, N-acetyl aspartate (NAA), glutamate, glutamine, choline, creatine, phosphocreatine, myo-inositol, gamma-aminobutyric acid, homovanillic acid, norepinephrine, 3-methoxy-4-hydroxy-phenylglycol, neuropeptide Y-like immunoreactivity, and substance P-like immunoreactivity. These studies investigated neurochemical changes in the cerebrospinal fluid (CSF) and various brain regions, including the prefrontal cortex, orbital frontal cortex, anterior cingulate cortex, middle temporal gyrus, medial temporal lobe, parietal cortex, striatum, thalamus, amygdala, hippocampus, midbrain, and brainstem. Our meta-analysis revealed a significant reduction in NAA levels in the prefrontal cortex of individuals exhibiting aggressive behaviours compared to controls. Furthermore, NAA levels demonstrated a negative correlation with the severity of aggressive behaviours. The findings for the other neurochemicals all did not reach statistical significance. These findings suggest that reduced prefrontal NAA levels may serve as a neurobiological correlate of aggressive behaviours, with implications for developing assessment tools and targeted interventions.

PMID:40543113 | DOI:10.1016/j.psychres.2025.116595

Auris Nasus Larynx. 2025 Jun 20;52(4):420-425. doi: 10.1016/j.anl.2025.06.001. Online ahead of print.

ABSTRACT

OBJECTIVE: Heightened listening effort in cochlear implant (CI) users may have a significant impact on their balance performance. This study aims to investigate the impact of listening effort on postural control in typical-hearing adults presented with CI-simulated speech in noise.

METHODS: The study participants were fifty-eight adults with typical hearing (aged 20-24 years). Turkish Hearing in Noise Test (HINT) sentences were used as the speech material. The Modified Clinical Test of Sensory Interaction in Balance (mCTSIB) was used to evaluate static balance and it was performed by using Computerized Static Posturography. In the experimental design of the study, healthy participants with typical hearing listened to non-simulated and CI-simulated sentences and repeated what they heard while the participants were performing the mCTSIB test on the force platform of static posturography.

RESULTS: In this study, the participants’ postural sway velocity rates were compared under three task conditions. The results demonstrated a statistically significant increase in participants’ sway velocity rates when listening to 12-channel filtered speech in noise material compared to those from the baseline mCTSIB assessment. There was no statistically significant differences in postural sway rate ratios when listening to unfiltered speech in noise material.

CONCLUSION: Increased listening effort for CI-simulated speech-in-noise resulted in poorer postural balance. A better understanding of such a difficulty may help us to evaluate postural balance from different perspectives and plan an appropriate vestibular rehabilitation program.

PMID:40543097 | DOI:10.1016/j.anl.2025.06.001

Intern Med J. 2025 Jun 21. doi: 10.1111/imj.70123. Online ahead of print.

ABSTRACT

AIM: To determine the status of the current rheumatology workforce and model projections for the future rheumatology workforce in Australia.

BACKGROUND: The rheumatology workforce in Australia is currently facing a significant shortage. Identification of the optimal number of rheumatologists for the Australian population is challenging, and requires assessment of the current workforce.

METHODS: A survey of Australian Rheumatology Association (ARA) full members was undertaken in 2021, collecting demographic data, information about type and location of rheumatology practice and other clinical and non-clinical work, work intentions and job satisfaction. Descriptive statistics and multivariable regression analyses were performed. The clinical full-time equivalent (cFTE) was estimated based on the reported number of half-days worked in clinical rheumatology practice. Using the age and gender distribution of rheumatology specialists from the Department of Health Workforce Data Tool, workforce projections were produced for the period from 2018 to 2038.

RESULTS: A total of 81% (323/404) of full members of the ARA completed the survey. The median (interquartile range (IQR)) rheumatology clinical half-days worked/week was 6 (4-8). Adjusted to survey response, the reported clinical workload equates to the cFTE of 231 adult and 13 paediatric rheumatologists. A current shortfall of 302 adult rheumatologists and 41 paediatric rheumatologists exists relative to optimal care estimates. Furthermore, 38% of rheumatologists are considering reducing clinical hours temporarily or permanently, predominantly within the next 2 years. Based on current supply models, the shortfall will improve but will not reach optimal levels by 2038.

CONCLUSION: Australia has an undersupply of both adult and paediatric rheumatologists compared to optimal care ideals. An ageing workforce, many part-time, and the significant number planning to reduce hours within 2 years will exacerbate this undersupply unless the supply of rheumatologists is substantially increased.

PMID:40543071 | DOI:10.1111/imj.70123

Intern Med J. 2025 Jun 21. doi: 10.1111/imj.70129. Online ahead of print.

ABSTRACT

BACKGROUND: This retrospective cohort study investigated the clinical characteristics, treatment regimens and prognostic factors of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis in a single-centre setting between January 2019 and December 2024.

AIMS: The study aimed to identify independent factors affecting prognosis and to provide guidance for clinical practice.

METHODS: The study included 72 patients diagnosed with anti-NMDAR encephalitis. Clinical data – including demographic information, clinical manifestations, laboratory findings and treatment outcomes – were systematically collected. Patients were categorised into good prognosis (mRS ≤ 2) and poor prognosis (mRS ≥ 3) groups based on their 6-month follow-up modified Rankin Scale scores. Statistical analyses comprised univariate analysis and multivariate logistic regression to identify prognostic factors.

RESULTS: Of the 72 patients, 67 (93.1%) had a good prognosis, and five (6.9%) had a poor prognosis. The mean age was 32.72 years, with an equal gender distribution. Significant differences between outcome groups were observed in tumour presence (P < 0.001), blood tumour necrosis factor (TNF) levels (P = 0.0303), cerebrospinal fluid (CSF), interleukin (IL)-8 levels (P = 0.0013) and serum immunoglobulin (Ig) G levels (P = 0.00047). Psychiatric abnormalities were reported in 76.4% of patients and cognitive impairment in 87.5%. Only 29.2% of patients received immunotherapy. The multivariate analysis revealed no significant independent predictors among gender, age, psychiatric abnormality and cognitive impairment, possibly due to the limited sample size in the poor prognosis group.

CONCLUSIONS: The study identified tumour coexistence, elevated inflammatory markers (serum TNF, CSF IL-8) and increased serum IgG levels as substantial factors associated with poor prognosis in anti-NMDAR encephalitis. These findings underscore the importance of early tumour screening and inflammatory marker monitoring in clinical management. However, larger multicentre studies are required to validate these results and provide more comprehensive guidance for clinical practice.

PMID:40543064 | DOI:10.1111/imj.70129

Ann N Y Acad Sci. 2025 Jun 21. doi: 10.1111/nyas.15387. Online ahead of print.

ABSTRACT

Music-based interventions (MBIs) offer promising strategies for addressing speech-language impairments in individuals with nonfluent aphasia. This systematic review summarizes the current literature of MBIs for nonfluent aphasia recovery by types of MBIs to determine the efficacy of MBIs and assesses the risk of bias to identify common methodological limitations. A systematic search was conducted of MEDLINE, PubMed, and APA PsycInfo for the 20 years preceding July 2024. Risk of bias assessment was performed using the revised Joanna Briggs Institute critical appraisal tool for randomized controlled trials (RCTs). Ten RCTs met the inclusion criteria, featuring MBIs such as Melodic Intonation Therapy, Modified Melodic Intonation Therapy, and singing-based approaches. The results highlighted the potential of MBIs in various domains, particularly in enhancing repetition and naming abilities, even when compared to speech therapy. The reviewed studies exhibited a moderate to high risk of bias. Outcome measures varied widely, and functional communication, a critical rehabilitation goal, was examined in just two RCTs. Furthermore, heterogeneous control conditions and statistical methods hindered meaningful comparisons across studies. Future research should prioritize functional communication outcomes and refine intervention protocols to strengthen the evidence base. Addressing these gaps is essential for advancing the potential benefits of these clinical tools for nonfluent aphasia recovery.

PMID:40543062 | DOI:10.1111/nyas.15387

Health Econ. 2025 Jun 21. doi: 10.1002/hec.70004. Online ahead of print.

ABSTRACT

People are sometimes forced to move, and it is plausible that such relocation involves significant psychological costs. The challenge in identifying the mental health consequences of moving is that most moves are (at least partly) voluntary so that the sample of movers is self-selected. We focus on a natural experiment, the government-mandated relocation of some households after all households experienced an exogenous shock. We use this experiment to identify the causal impact of moving on people’s mental health, distinguishing between less severe and more severe health conditions, and between individuals with pre-existing mental health conditions and those without. The event we focus on is the 2011 Christchurch (New Zealand) earthquake, and the consequent decision of the government to relocate about 8000 households from some of the earthquake-affected areas. We use a comprehensive administrative dataset that includes health records with information on hospital attendance, specialist services, and prescribed medications for (almost) every resident in the city and compare the relocated individuals to those who lived elsewhere in the earthquake-damaged city. We examine both the likelihood of receiving mental health treatment (the extensive margin), and the intensity of treatment, measured by the number of visits to a clinic or hospital (the intensive margin). We find a statistically significant increase in the likelihood and frequency of receiving treatment for moderate mental health problems among individuals compelled to relocate, when compared to other residents of the earthquake-affected city who were allowed to remain in situ. This increase persisted to December 2013 for everyone, and remained significant for the elderly to the end of 2018. We found no such increase in health care utilisation for more severe mental health symptoms that required more acute interventions (in clinics or hospitals).

PMID:40543058 | DOI:10.1002/hec.70004