Tag: statistics

NCHS Data Brief. 2024 Oct;(36).

ABSTRACT

OBJECTIVES: This report describes changes in total, early, and late fetal mortality between 2022 and 2023 (provisional), as well as fetal mortality by maternal race and Hispanic origin and state of residence. Comparisons are made with findings from 2021 to 2022.

METHODS: Data are based on reports of fetal death filed in the 50 states and the District of Columbia and collected via the National Vital Statistics System. In this report, only fetal deaths reported at 20 weeks of gestation or more are included. Data for 2021 and 2022 are final and data for 2023 are provisional.

RESULTS: In 2023, the overall fetal mortality rate was 5.52 fetal deaths per 1,000 live births and fetal deaths, which was not significantly different from the 2022 rate (5.48). From 2022 to 2023, the early fetal mortality rate (20-27 weeks of gestation) significantly increased by 4% to 2.89 per 1,000, while the late fetal mortality rate (28 weeks of gestation or more) was essentially unchanged at 2.64. Among the race and Hispanic-origin groups, the fetal mortality rate increased for Asian non-Hispanic women and was not significantly different for other groups. Fetal mortality rates increased in 4 states, declined in 1 state, and were not significantly different for 45 states and the District of Columbia from 2022 to 2023. In comparison, from 2021 to 2022, the fetal mortality rate declined for total, early, and late fetal deaths, as well as for White non-Hispanic women and in five states.

PMID:39817856

Biometrics. 2025 Jan 7;81(1):ujae169. doi: 10.1093/biomtc/ujae169.

ABSTRACT

Pharmacogenomics stands as a pivotal driver toward personalized medicine, aiming to optimize drug efficacy while minimizing adverse effects by uncovering the impact of genetic variations on inter-individual outcome variability. Despite its promise, the intricate landscape of drug metabolism introduces complexity, where the correlation between drug response and genes can be shaped by numerous nongenetic factors, often exhibiting heterogeneity across diverse subpopulations. This challenge is particularly pronounced in datasets such as the International Warfarin Pharmacogenetic Consortium (IWPC), which encompasses diverse patient information from multiple nations. To capture the between-patient heterogeneity in dosing requirement, we formulate a novel change surface model as a model-based approach for multiple subgroup identification in complex datasets. A key feature of our approach is its ability to accommodate nonlinear subgroup divisions, providing a clearer understanding of dynamic drug-gene associations. Furthermore, our model effectively handles high-dimensional data through a doubly penalized approach, ensuring both interpretability and adaptability. We propose an iterative 2-stage method that combines a change point detection technique in the first stage with a smoothed local adaptive majorize-minimization algorithm for surface regression in the second stage. Performance of the proposed methods is evaluated through extensive numerical studies. Application of our method to the IWPC dataset leads to significant new findings, where 3 subgroups subject to different pharmacogenomic relationships are identified, contributing valuable insights into the complex dynamics of drug-gene associations in patients.

PMID:39817854 | DOI:10.1093/biomtc/ujae169

J Trauma Stress. 2025 Jan 16. doi: 10.1002/jts.23128. Online ahead of print.

ABSTRACT

Although empirical support for the International Statistical Classification of Diseases and Related Health Problems (11th ed.; ICD-11) distinction between posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) is growing, research into the ICD-11 CPTSD model in prison staff is lacking. This study used latent profile analysis (LPA) to (a) determine if there are distinct groups of trauma-exposed prison governors (i.e., “wardens” in the United States and Canada) who have symptom profiles consistent with the distinction between PTSD and CPTSD and (b) identify predictors and posttraumatic maladaptive beliefs associated with the latent profiles. Trauma-exposed prison governors (N = 385) completed the International Trauma Questionnaire (ITQ) and a measure of traumatic life events. LPA was used to extract profiles using the six ITQ symptom clusters and revealed four profiles: CPTSD (8.4%), PTSD (14.4%), disturbances in self-organization (DSO; 11.0%), and low symptoms (66.3%). Membership in the CPTSD and DSO profiles was associated with cumulative traumatization, odds ratios (OR) = 1.42 and OR = 1.26, respectively, and poorer health, OR = 2.84 and OR = 1.64, respectively, relative to the low symptom profile, and membership in the PTSD profile was associated with younger age, OR = 0.91, relative to the low symptom profile. The CPTSD profile showed the highest level of posttraumatic maladaptive beliefs. This study yields empirical support for the ICD-11 CPTSD model in prison staff. The results provide additional support for the validity of ITQ measurement of PTSD and CPTSD.

PMID:39817824 | DOI:10.1002/jts.23128

Postgrad Med. 2025 Jan 16. doi: 10.1080/00325481.2025.2454218. Online ahead of print.

ABSTRACT

AIM: This study aims to clarify hematological parameters, transfusion requirements, and adverse events of preoperative intravenous (IVIS) versus oral iron supplementation (OIS) in elective surgery patients.

METHODS: We conducted a comprehensive literature search across multiple databases up to 10 December 2023. Twelve RCTs involving 930 participants met our eligibility criteria. Our analysis focused on post-treatment hemoglobin levels, changes in hemoglobin from baseline, ferritin levels, hemoglobin attainment rates, transfusion requirements, and adverse events. We employed the random-effects model for data synthesis, calculating pooled standard mean differences (SMD) or mean differences (MD) or risk ratios (RR) with 95% confidence intervals (CI). Methodological quality was assessed using the Cochrane ROB 2 tool and Jadad score. The GRADE approach evaluated the confidence in effect estimates.

FINDINGS: IVIS significantly improved post-treatment hemoglobin levels (MD = 0.77 g/dL, 95% CI [0.30 to 1.23]), hemoglobin increments (MD = 0.69 g/dL, 95% CI [0.01 to 1.37]), and ferritin levels (MD = 260.03 ng/mL, 95% CI [119.65 to 400.42]) compared to OIS. IVIS also led to a higher hemoglobin attainment rate (RR = 1.88, 95% CI [1.24 to 2.86]). No significant differences were noted in transfusion rates or volumes. IVIS was associated with fewer digestive (RR = 0.10, 95% CI [0.05 to 0.22]; I2 = 0%) but more pain-related adverse events (RR = 7.79, 95% CI [1.78 to 34.07]; I2 = 0%). Hospital stay durations and mortality rates were similar between the two groups.

INTERPRETATION: IVIS offers a superior improvement in hematological parameters for elective surgery patients but not reducing transfusion needs compared to OIS. While IVIS has fewer digestive adverse events, it increases pain-related complications. These findings highlight the importance of personalized approaches in selecting iron supplementation methods, carefully balancing time, efficacy, and adverse event profiles.

REGISTRATION: PROSPERO CRD42023483284.

PMID:39817823 | DOI:10.1080/00325481.2025.2454218

Chaos. 2025 Jan 1;35(1):013140. doi: 10.1063/5.0238864.

ABSTRACT

Adolescent idiopathic scoliosis (AIS), which typically occurs in patients between the ages of 10 and 18, can be caused by a variety of reasons, and no definitive cause has been found. Early diagnosis of AIS or timely recognition of progression is crucial for the prevention of spinal deformity and the reduction of the risk of surgery or postponement. However, it remains a significant challenge. The purpose of this study is to develop an easy-to-use, non-invasive, and portable method for early diagnosis of AIS. A new framework of moving entropy-based computer vision method is presented, which can determine the severity of AIS by analyzing patients’ walking videos. First, Alphapose system and direct linear transformation method are employed to estimate 3D keypoint coordinates. Then, the joint angle-based and joint distance-based dynamic network are constructed. Based on these works, the new measures called moving angle entropy and moving edge-weighted graph entropy are proposed and fused using canonical correlation analysis. Finally, the power spectral exponents of entropy sequences are calculated and used in recognizing the severity of AIS. A comparison with healthy subjects and statistical analysis for entropy values can provide effective information for quantifying AIS. The recognized results of our proposed method were also comparable with the clinical diagnosis of Cobb angle from imaging by a certified clinician.

PMID:39817783 | DOI:10.1063/5.0238864

Folia Parasitol (Praha). 2025 Jan 9;72:2025.002. doi: 10.14411/fp.2025.002.

ABSTRACT

Markers of chronic infection Toxoplasma gondii (Nicolle et Manceaux, 1908) have been associated with suicidal self-directed violence (SSDV). We present the results of the first study relating T. gondii IgG serology with suicide attempts and suicidal ideation in United States Veterans, known to have higher suicide rates than members of the general population. We also related T. gondii serology to SSDV risk factors, including valid and reliable measures of trait impulsivity, aggression, self-reported depression, and sleep disturbance. We recruited 407 Veterans enrolled at three Veterans Affairs Medical Centers with mean (S.D.) age = 45.6 (11.6) years; 304 men (74.7%); 203 with a history of SSDV and 204 with no history of any self-directed violence (SDV). Seropositivity and serointensity, categorised as high (top quartile) or low (lower three quartiles), were analysed in relationship to SSDV, suicidal ideation and clinical risk factors using age and gender-adjusted linear and logistic methods, after transformations and nonparametric tests when appropriate. Associations between seropositivity and SSDV and its risk factors were not significant in all groups. High serointensity, while not associated with SSDV or repeat suicide attempts, was positively associated with suicidal ideation, depression, impulsivity, and daytime dysfunction due to sleepiness (p < 0.05), but only in Veterans with a history of SSDV. In Veterans without a history of SDV, no associations were significant. These associations remained significant after adjustment for certain socioeconomic factors (i.e., income, homelessness, military rank). Including education in the model downgraded the statistical significance of suicidal ideation and depression to statistical trends, but the significance of associations with impulsivity and daytime dysfunction due to sleepiness remained. Major limitations include the cross-sectional design, overall low seropositivity within the sample, and potentially spurious results due to multiple comparisons. Thus, the results of this report need to be replicated in larger samples, ideally longitudinally.

PMID:39817778 | DOI:10.14411/fp.2025.002

J Virol. 2025 Jan 16:e0173024. doi: 10.1128/jvi.01730-24. Online ahead of print.

ABSTRACT

The Antibody Mediated Prevention (AMP) trials showed that passively infused VRC01, a broadly neutralizing antibody (bNAb) targeting the CD4 binding site (CD4bs) on the HIV-1 envelope protein (Env), protected against neutralization-sensitive viruses. We identified six individuals from the VRC01 treatment arm with multi-lineage breakthrough HIV-1 infections from HVTN703, where one variant was sensitive to VRC01 (IC₅₀ < 25 ug/mL) but another was resistant. By comparing Env sequences of resistant and sensitive clones from each participant, we identified sites predicted to affect VRC01 neutralization and assessed the effect of their reversion in the VRC01-resistant clone on neutralization sensitivity. In four pairs, a single mutation restored partial or full sensitivity to VRC01, whereas in the fifth participant, transfer of the entire [Formula: see text]23-V5 loop was required. No VRC01 resistance mutations could be identified in the sixth participant, with the discordant clones differing by >100 amino acids. Mutations responsible for the differential neutralization phenotypes occurred at distinct sites across Env, including residues in loop D, the CD4-binding loop, and between the [Formula: see text]23 and V5 loops. Analysis of deep sequencing env data showed that VRC01 resistance was likely the property of the acquired virus, rather than occurring through post-acquisition evolution. Although VRC01-resistant parental clones generally retained sensitivity to other CD4-binding site bNAbs, they were less potently neutralized than the VRC01-sensitive clones. In conclusion, VRC01 resistance mutations occurred through multiple mutational pathways, but sensitivity to second-generation CD4bs bNAbs was retained even in VRC01-resistant transmitted viruses, confirming the potential of these bNAbs for HIV-1 prevention studies.IMPORTANCEThe Antibody Mediated Prevention (AMP) trials provided proof of principle that VRC01, a CD4-binding site (CD4bs) HIV-1 broadly neutralizing antibody (bNAb), prevented the acquisition of antibody-sensitive viruses. However, understanding common mutations that confer resistance to different bNAbs provides important insights into the genetic barrier to resistance. Here we studied six AMP trial participants with breakthrough infections mediated by multiple viral lineages with discordant VRC01 sensitivity. We identified different mutations across the CD4-binding site that conferred resistance to VRC01 and showed that these mutations were a property of the acquired virus, rather than a result of post-acquisition evolution. We found that although VRC01 resistance was associated with reduced neutralization potency of second-generation CD4-binding site bNAbs, overall neutralization sensitivity was generally retained, which is promising for future use of such bNAbs in clinical trials.

PMID:39817771 | DOI:10.1128/jvi.01730-24

Hum Vaccin Immunother. 2025 Dec;21(1):2452026. doi: 10.1080/21645515.2025.2452026. Epub 2025 Jan 16.

ABSTRACT

Hepatitis B (Hep B) remains a critical public health issue globally, particularly in Tibet, where vaccination rates and influencing factors among college students are yet understudied. This study applies a cross-sectional design to investigate the Hep B vaccination rate among 1,126 college students in Tibet and utilizes the expanded theory of planned behavior (ETPB) to identify vaccination behavior intention (BI) and vaccination behavior (VB). Stratified cluster sampling across three universities was used to assess behavioral attitudes (BA), subjective norms (SN), perceived behavioral control (PBC), past vaccination history (PVH) and vaccination knowledge (VK), and used structural equation modeling (SEM) for model validation and multi-group comparison. Results indicated that 16.3% of students had received the Hep B vaccine. VK notably improved BA toward vaccination (β = 0.518, p < .001). BA (β = 0.232, p < .001), PBC (β = 0.239, p < .001), SN (β = 0.385, p < .001) positively influenced BI. However, PVH failed to predict BI. BI (β = 0.448, p < .001) and PVH (β = 0.127, p < .001) were significant predictors of VB. Significant ethnic variations were noted. The positive effect of PVH on VB (β = 0.151, p < .001) and the mediating role of PBC in VB (β = 0.076, p < .05) were significant among Tibetan students. The effect of VK on BA was stronger among Tibetans (β = 0.503, p < .05),while the impact of attitude on BI was more pronounced among Han students (β = 0.366, p < .05). The vaccination rate for Hep B among college students in Tibet is relatively low, and the ETPB model effectively explains their vaccination intentions and behaviors. Tailored intervention strategies for Tibetan and Han students are recommended to boost vaccination rates effectively.

PMID:39817760 | DOI:10.1080/21645515.2025.2452026

Womens Health (Lond). 2025 Jan-Dec;21:17455057241307089. doi: 10.1177/17455057241307089.

ABSTRACT

In 2023, a breast cancer risk assessment and a subsequent positive test for the BRCA-2 genetic mutation brought me to the uncomfortable intersection of a longstanding career as an advocate for high-quality medical evidence to support shared patient-provider decision making and a new role as a high-risk patient. My search for studies of available risk-management options revealed that the most commonly recommended approach for women with a ⩾20% lifetime breast cancer risk, intensive screening including annual mammography and/or magnetic resonance imaging beginning at age 25-40 years, was supported only by cancer-detection statistics, with almost no evidence on patient-centered outcomes-mortality, physical and psychological morbidity, or quality of life-compared with standard screening or a surgical alternative, bilateral risk-reducing mastectomy. In this commentary, I explore parallels between the use of the intensive screening protocol and another longstanding women’s health recommendation based on limited evidence, the use of hormone therapy (HT) for postmenopausal chronic disease prevention, which was sharply curtailed after the publication of the groundbreaking Women’s Health Initiative trial in 2002. These declines in HT utilization were followed by marked decreases in breast cancer incidence, providing a compelling lesson on the critical importance of a solid evidentiary basis for women’s health decisions. Known harms accompanying the benefits of breast screening-overdiagnosis, psychological effects, and mammography-associated radiation-exposure risks-make empirical measurement of patient-centered outcomes essential. Yet, published research on intensive screening of women at high breast cancer risk has largely ignored these outcomes, leaving patients, providers, and guideline developers lacking the evidence needed for best practice. Outcomes research is both feasible and urgently needed to inform care decisions and health policy for this patient population.

PMID:39817753 | DOI:10.1177/17455057241307089

J Hum Nutr Diet. 2025 Feb;38(1):e70011. doi: 10.1111/jhn.70011.

ABSTRACT

BACKGROUND: Meeting protein intake recommendations is relevant for maintaining muscle mass. This study aimed to describe protein intake and its association with meal patterns and dietary patterns.

METHODS: An in-house designed, web-based 4-day record was used in the national dietary survey (in 2010/2011). Participants 60 years and older were included in the analysis (n = 533). Protein intake was described by hour of consumption, self-indicated meals and food source. Eating and drinking occasion (EDO) and food groups were defined, from which meal patterns and three a posteriori dietary patterns (using principal component analysis) were assessed.

RESULTS: We observed a mean protein intake of just over 1 g/kg body weight (bw) in both men and women. Over 50% of the protein intake was sourced from the food groups meat, fish and milk/yoghurt. A bolus intake of 30 g protein per meal was observed in a small proportion of participants at breakfast and lunch, but was most common at dinner (41% women and 56% men). No strong correlations were observed between protein intake and neither dietary patterns nor the number of EDOs. A 5 g higher protein intake at any meal, but not higher EDO frequency, was associated with higher odds of meeting a protein intake over 1.1 g/kg bw.

CONCLUSIONS: Protein intake over 1.1 g/kg bw was met by 44% of the participants. Lunch and dinner were the highest contributors to protein intake. Dietary and meal patterns were weakly associated with protein intake. Only total daily protein intake was associated with reaching > 1.1 g/kg bw.

PMID:39817718 | DOI:10.1111/jhn.70011