Credible Interval Research Articles

Comparative effectiveness of various exercise interventions on cardiorespiratory fitness in adults living with overweight or obesity: A systematic review and Bayesian network meta-analysis.

This study evaluated how different exercise interventions affect maximal oxygen uptake (VO2max) in adults with overweight or obesity. We systematically searched five databases from inception to February 2025 to identify relevant randomized controlled trials (RCTs). We used the Cochrane risk of bias tool. A Bayesian network meta-analysis with a random-effects model was conducted. A total of 93 RCTs involving 4,446 participants were included. The network meta-analysis showed high-intensity interval training (HIIT) ranked highest (Surface Under the Cumulative Ranking Curve [SUCRA]: 82.5%; Standardized Mean Difference [SMD]: 4.85; 95%Credible Interval [CrI]: 3.90, 5.80), followed by high-intensity aerobic training (HAT) (SUCRA: 76.7%; SMD: 4.72; 95%CrI: 3.78, 5.68), and combined aerobic and resistance training (CT) (SUCRA: 69.1%; SMD: 4.52; 95%CrI: 3.48, 5.60), with resistance training (RT) least effective (SUCRA: 18.3%; SMD: 2.57; 95%CrI: 1.32, 3.86). All six interventions effectively improved VO2max in overweight or obese adults. Among them, HIIT was most beneficial. Coaches and fitness professionals should consider these findings to help adults with overweight or obesity achieve optimal outcomes.

Household Income, Maternal Allostatic Load During Pregnancy, and Offspring With Autism Spectrum Disorders.

Relative maternal poverty is a suggested social determinant of autism spectrum disorders (ASDs) in offspring; however, this association may be confounded by the maternal broader autism phenotype (BAP). The biological mechanisms underlying this association are largely understudied. We examined the association between household income during pregnancy and ASDs in offspring, adjusting for confounders including maternal BAP, and explored whether maternal chronic stress, measured by allostatic load (AL) during pregnancy, mediates this association. Data on 59,998 mother-child dyads were obtained from the Japan Environment and Children's Study, a nationwide birth cohort. Household income was categorized into tertiles (< 4 million, 4-6 million, > 6 million JPY) and offspring ASD diagnosis by age four was assessed via guardian's report. Bayesian logistic regression models indicated that mothers from low- and middle-income households had a 58% (95% credible interval [CI]: 28%-98%) and a 37% (95% CI: 12%-70%) higher risk of offspring ASDs, respectively, compared to those from high-income households. AL, defined as three or more out of 10 biomarkers in the highest risk quartile, did not mediate these associations. Low and middle household income during pregnancy was associated with a higher risk of ASD diagnosis, and high AL did not mediate this association.

Relationship between masticatory function and sarcopenic obesity in community-dwelling older adults aged 75 or older: a cross-sectional study

ObjectiveThe relationship between sarcopenic obesity and masticatory function is poorly understood. This study aims to explore this association in community-dwelling individuals aged 75 years or older.MethodsThis study analyzed data from 236 community-dwelling adults aged 75 years or older. Masticatory function was assessed using spectrophotometric measurement of gum color differences before and after chewing color-changeable gum (ΔE*ab). Participants were categorized into tertiles of masticatory function based on their ΔE*ab values. The tertiles were defined as low, intermediate, and high. Sarcopenic obesity was assessed using the Consensus statement of the Japanese Working Group on Sarcopenic Obesity. Bayesian multinomial logistic regression was employed to examine the relationship between masticatory function and sarcopenic obesity.ResultsThe prevalence rates for obesity, sarcopenia, and sarcopenic obesity were 15.3%, 24.2%, and 9.7%, respectively. After adjusting for covariates, participants with high masticatory function had a significantly lower posterior estimate of sarcopenic obesity (posterior estimate: −1.83 [95% credible interval: −3.66, −0.22]) and sarcopenia (posterior estimate: −1.97 [95% credible interval: −3.37, −0.72]) compared with participants with low masticatory function. However, no significant associations were observed between masticatory function and obesity.ConclusionsThese findings suggest that high masticatory function is associated with a significantly lower prevalence of sarcopenic obesity in older adults.

Knee flexion range of motion does not influence muscle hypertrophy of the quadriceps femoris during leg press training in resistance-trained individuals

ABSTRACT This study investigated the effect of knee flexion range of motion (ROM) during the leg press exercise on quadriceps femoris muscle hypertrophy in resistance-trained individuals. Twenty-three participants (training age: 7.2 ± 3.5 years) completed a within-participant design, performing four sets of unilateral leg presses to momentary failure twice weekly for 8 weeks. In one leg, the knee flexion range of motion (ROM) was fixed at approximately 5–100°, while for the other leg, participants used their maximum individualized ROM (5–154 ± 7.8°). Quadriceps muscle thickness was assessed via B-mode ultrasonography in the proximal, central, and distal regions of the mid- and lateral thighs. Bayesian analyses were conducted to quantify treatment effects and provide inferential estimates using credible intervals and Bayes Factors (BF). Univariate and multivariate analyses indicated ‘moderate’ (BF = 0.14 to 0.22) and ‘extreme’ (BF < 0.01) evidence in support of the null hypothesis, respectively. Within-condition analyses revealed small-to-medium hypertrophic adaptation in both conditions, with absolute increases ranging from 1.08 mm to 1.91 mm. These findings suggest that both knee flexion ROMs are similarly effective for promoting quadriceps femoris muscle hypertrophy over a relatively short training-period in resistance-trained individuals.

Phylogeographic History of Tomato Chlorosis Virus

Tomato chlorosis virus (ToCV), first reported in Florida, USA, in 1998, has since emerged in multiple regions worldwide, posing a significant threat to global tomato production. However, its origin, migration patterns, and evolutionary history remain poorly understood. In this study, we used Bayesian phylogeographic analysis of coat protein gene sequences from 155 ToCV isolates to reconstruct its phylogeographic history. Our results show that ToCV evolves at a rate of 6.24 × 10−4 subs/site/year (95% credibility interval: 4.35 × 10−4–8.28 × 10−4), with the most recent common ancestor dating back to 1882. The maximum clade credibility (MCC) tree revealed three major clades, with Clade 1—whose most recent common ancestor dates to approximately 1975—comprising over 90% of the isolates. Although the exact origin of ToCV remains uncertain, we identified five distinct migration pathways: one from Europe to the Americas, one from Europe to South Asia, one from the Middle East to East Asia, one from East Asia to mainland China, and one from mainland China to Europe. These findings underscore the complex global spread of ToCV and suggest that multiple geographic areas have contributed to its ongoing evolution and dissemination.

Misclassification of yellow fever vaccination status revealed through hierarchical Bayesian modeling.

Vaccination coverage estimates are crucial inputs to decisions about investments in vaccination, yet they can be prone to inaccuracies. At the individual level, inaccuracies can be described in terms of the sensitivity and specificity of vaccination status. We estimated these quantities using a hierarchical Bayesian analysis of data from a test-negative study design with reported yellow fever vaccination status as the exposure. Our analysis accounted for the possibility of misclassification of both the exposure and the test at the country level. Across all countries, our median estimates of the sensitivity and specificity of vaccination status were 0.69 (95% credible interval [CrI]: 0.21-0.98) and 0.70 (95% CrI: 0.21-0.98), respectively. Median estimates at the country level ranged from 0.06 (95% CrI: 0.04-0.09) to 0.96 (95% CrI: 0.94-0.98) for sensitivity, and from 0.15 (95% CrI: 0.09-0.23) to 0.98 (95% CrI: 0.90-1.00) for specificity. This suggests that there is substantial misclassification of yellow fever vaccination status in general and extensive variation in misclassification across countries. Taking into account misclassification in vaccination status, we made adjustments to reported vaccination coverage and showed that reported coverage may be significantly underestimated in 10 out of 20 countries and significantly overestimated in 5 out of 20.

National serosurvey and risk mapping reveal widespread distribution of Coxiella burnetii in Kenya

Coxiella burnetii, the causative agent of Q fever, is an emerging pathogen that has the potential to cause severe chronic infections in animals and humans worldwide. The detrimental impact on public health is projected to be higher in the low- and middle-income countries given their lower capacity to sustain effective surveillance and response measures. We implemented a national serosurvey of cattle in Kenya to map the spatial distribution of the pathogen. The study used serum samples that were collected from randomly selected cattle in different ago-ecological zones across the country. These samples were screened for the pathogen using PrioCHECK Ruminant Q Fever AB Plate ELISA kit. The laboratory findings were analyzed using INLA package to identify risk factors for C. burnetii exposure from herd- and animal-level factors, area, and bioclimatic datasets accessed from online databases. A total of 6,593 cattle were recruited for the study; of these, 7.9% (95% CI; 7.2–8.5) were seropositive. Outputs from the multivariable analysis revealed that the animal age and some of the geographical variables including wind speed, area under shrubs and “petric calcisols” type of soil were significantly associated with C. burnetii seropositivity. Being a calf, weaner or subadult was associated with lower odds of exposure compared to being an adult by 0.24 (credibility interval: 2.5% and 97.5%), 0.41 (0.30–0.55) and 0.51 (0.38–0.69), respectively. In addition, a unit increase in the wind speed increased the odds of C. burnetii seropositivity by 1.27 (1.05–1.52) while an increase on the land area under shrubs was associated with lower odds of exposure (0.67 [0.47–0.69]). The effect of petric calcisols was non-linear; an increase of the land area with this soil type was associated with an exponential increase in C. burnetii seropositivity. This study provides new data on C. burnetii seroprevalence, information of its risk factors and a prevalence map that can be used for C. burnetii risk surveillance and control. The identification of environmental risk factors for C. burnetii exposure, and the increasing awareness of the zoonotic potential of the pathogen, calls for the need to enhance the existing collaborations for the surveillance and control of C. burnetii in line with the One Health framework. The evidence generated on the potential role of environmental factors can also be used to design nature-based interventions, such as replacement of vegetation in denuded areas, to reduce potential for the aerosolization of the pathogen. Livestock vaccination in the hotspots would also reduce animal infections and hence the contamination of the environment.

Immediate Death: Not So Bad If You Discount the Future but Still Worse than It Should Be.

ObjectivesDiscrete choice experiments (DCEs) as a valuation method require preferences to be anchored on the quality-adjusted life-year scale, usually through tasks involving choices between immediate death and various impaired health states or between health states with varying durations of life. We sought to determine which anchoring approach aligns best with the composite time tradeoff (cTTO) method, with a view to informing a valuation protocol that uses DCEs in place of the cTTO.MethodsA total of 970 respondents from Trinidad and Tobago completed a DCE with duration survey. Tasks involved choosing between 2 lives with identical durations, followed by a third option, representing either full health for a number of years or immediate death. Data were analyzed using mixed logit models, both with and without exponential discounting for time preferences.ResultsAssuming linear time preferences, the estimated utility of immediate death was -2.1 (95% credible interval [CrI] -3.2 to -1.2) versus -0.28 (95% CrI -0.47, -0.10) when allowing for nonlinear time preferences. Under linear time preferences, the predicted health-state values anchored on duration had range (-1.03, 1) versus (0.34, 1) when anchored on immediate death. The ranges under nonlinear time preferences were (-0.54, 1) versus (-0.22, 1). The estimated discount parameter was 23% (95% CrI 22% to 25%).ConclusionsThe nonzero discount parameter indicates that time preferences were nonlinear. Nonlinear time preferences anchored on duration provided the closest match to the benchmark EQ-VT cTTO values in Trinidad and Tobago, whose range was (-0.6, 1). Thus, DCE with duration can provide similar values to cTTO provided that nonlinear time preferences are accounted for and anchoring is based on duration.HighlightsTime preferences for health states in Trinidad and Tobago were nonlinear.In discrete choice tasks, we show that immediate death has a utility less than zero.DCE utilities under nonlinear time preferences with anchoring on duration agreed well with cTTO utilities.

The Spector Job Satisfaction Survey: Associations of Satisfaction with Leaving EMS

The Spector Job Satisfaction Survey: Associations of Satisfaction with Leaving EMS

Decadal stability in stream fish communities and contemporary ecological drivers of species occupancy in two Appalachian U.S. National Parks

ABSTRACT Objective Although conserving fish biodiversity in lotic systems is challenging, protected areas can provide refuge from certain environmental stressors. In the Appalachian region, USA, the National Park Service manages the Delaware Water Gap National Recreation Area and New River Gorge National Park &amp; Preserve, which contain abundant and diverse freshwater resources. To assess the effectiveness of these protected areas in conserving stream fishes, we evaluated decadal changes and ecological drivers of species occupancy and detection. Methods Using fish assemblage data from backpack electrofishing surveys conducted in both parks during 2013–2014 and 2022–2023, we quantified temporal differences in species occupancy and detection probabilities using a Bayesian hierarchical multispecies occupancy modeling approach. For the 2022–2023 survey, we included habitat variables as predictors of occupancy and detection. Results Community composition and occupancy probabilities for species in both parks remained similar through time, with the most recent occupancy estimates ranging from 0.07 (90% CI = 0.02, 0.14) for Variegate Darter Etheostoma variatum and Rainbow Darter E. ­caeruleum to 0.73 (90% credible interval = 0.59, 0.85) for Blacknose Dace Rhinichthys atratulus. Changes in occupancy were more prominent at Delaware Water Gap National Recreation Area than New River Gorge National Park &amp; Preserve, with Yellow Perch Perca flavescens having a posterior mean difference of −0.17 [90% credible interval = −0.35, −0.01] and American Eel Anguilla rostrata having a high posterior probability (&amp;gt;80%) of occupancy increasing by at least 1%. Habitat variables were related to community structure, but effects varied in significance, magnitude, and direction among species and parks. Conversely, species-specific detection probabilities were comparatively less affected by environmental and sampling effort predictors. Conclusions Between 2013 and 2023, occupancy estimates for 44 fish species across two protected, ecologically diverse landscapes remained relatively stable. Furthermore, we highlight the efficacy of national parks in maintaining freshwater fish biodiversity amidst rapid global change.

Treatment for Dyskinesia in Parkinson's Disease: A Network Meta-analysis of Randomized Controlled Trials.

Dyskinesia is a motor complication of Parkinson's disease (PD) posing therapeutic challenges. The optimal therapy for dyskinesia in PD has not been identified due to the lack of comprehensive evaluation of treatments. The aim was to compare the efficacy and safety of interventions for alleviating levodopa-induced dyskinesia in PD. We conducted a Bayesian network meta-analysis (NMA) by systematically searching PubMed, Web of Science, Embase, Cochrane Library, ClinicalTrials.gov, and EudraCT databases up to April 1, 2024. The primary efficacy outcome was the change in scores on dyskinesia rating scales from baseline. The study included 85 randomized controlled trials (RCT) involving 13,826 PD patients, comprising 39 interventions. Nine treatments were significantly more effective in reducing scores on dyskinesia rating scales than control (placebo, sham surgery, sham repetitive transcranial magnetic stimulation, or best medical treatment). Globus pallidus interna deep brain stimulation (GPi-DBS) had the highest probability to be the most effective (standardized mean difference, 95% credible interval: -1.27, -1.65 to -0.88; surface under the cumulative ranking curve [SUCRA]: 97.4%), followed by levodopa-carbidopa intestinal gel infusion (SUCRA = 89.7%), subthalamic nucleus (STN)-DBS (SUCRA = 89%), immediate-release (IR) amantadine (SUCRA = 86.5%), pallidotomy (SUCRA = 84.9%), ADS-5102 (SUCRA = 82.9%), clozapine (SUCRA = 77.2%), OS320 (SUCRA = 64.8%), and AFQ056 (SUCRA = 54.5%). GPi-DBS was superior to STN-DBS, and pallidotomy ranked higher than subthalamotomy. ADS-5102 and OS320 had higher adverse event (AE) rates compared to control, whereas AFQ056 and ADS-5102 were linked to more serious AEs. This RCT-based NMA identifies and ranks nine efficacious interventions for dyskinesia in PD. GPi-DBS may be the most effective therapy for treating dyskinesia, with IR amantadine ranking highest among oral medications. Novel anti-dyskinetic medications are associated with less-favorable tolerance profiles. © 2025 International Parkinson and Movement Disorder Society.

Analysis of stress–strength reliability from a generalized exponential distribution under maximum ranked set sampling with unequal samples

Ranked set sampling (RSS) acts as an efficient and flexible way of collecting population information. In this paper, estimation of stress–strength reliability (SSR) is considered under maximum ranked set sampling with unequal samples (MRSSU) framework. When the lifetimes of strength and stress variables are characterized by the generalized exponentiated distributions, point and interval estimators of SSR are obtained under classical likelihood and Bayesian approaches, respectively. Maximum likelihood estimators of SSR are explored under different strength and stress parameter cases and approximate confidence intervals are constructed by using asymptotic theory. Bayesian estimators and the highest posterior density credible intervals are also established, and the associated Monte Carlo sampling approach is proposed for complex posterior computation. To compare the performance of the different proposed methods, extensive simulation studies are conducted under various designed experimental settings, and the results indicate that both classical and Bayesian approaches work satisfactorily and the latter one appears more appealing under MRSSU scenario. Finally, two real-life examples are investigated to demonstrate the applications of our methods.

Traditional practices versus modern healthcare: Determinants of traditional medicine use after potential dog bites among dog-owning households in Nigeria.

Canine rabies is endemic in Nigeria, with a low dog vaccination rate. Often, dog bite victims resort to traditional remedies, which can lead to fatalities. Our study investigated factors influencing decisions to seek traditional remedies in Nigeria. We conducted a cross-sectional study in 2022 involving 4,162 dog-owning households. A joint random effect Bayesian regression model was developed to examine the role of sociodemographic, socioeconomic, and infrastructural covariates. This model included a latent variable measuring a respondent's understanding of rabies risk based on literacy levels and responses to questions about rabies epidemiology. Our results indicated that 27% (95% Confidence Interval [Cl); 26-27) of respondents would preferably seek traditional remedies following a dog bite. Male respondents were 24% more likely than female respondents to seek traditional remedies (odds ratio [OR]: 1.24; 95%, Credible Interval CrI): 1.07-1.31). Similarly, individuals residing in rural areas reported 55% higher likelihood of using traditional remedies than those in urban areas (OR: 1.55; 95% CrI: 1.43-1.67). Respondents residing in areas with no veterinary services reported 35% higher likelihood of using traditional remedies than those near such facilities (OR: 1.35; 95% CrI: 1.15-1.42). Children under 16 years reported 27% lower likelihood of using traditional remedies than adults (OR: 0.73; 95% CrI: 0.49-0.84). Private or unemployed individuals were more likely to seek traditional remedies than civil servants (OR: 1.99; 95% Crl: 1.53-2.37). Respondents with tertiary education reported 42% lower likelihood of using traditional remedies than those without formal education (OR: 0.58; 95% CrI: 0.49-0.62). Our latent variable representing understanding of rabies risk was negatively associated with the probability of seeking traditional remedies (OR: 0.67; 95% CrI: 0.54-0.73). Lastly, poverty was negatively associated with the likelihood of seeking traditional remedies (OR: 0.78; 95% CrI: 0.66-0.82). Our findings provide important insights into healthcare behaviour decisions and their possible associations with rabies outcomes in Nigeria. These results highlight the need to improve public education, enhance access to medical care, and involve traditional healers in rabies prevention and control programs.

Inference on multicomponent stress-strength model using progressively censored data from exponentiated Pareto distribution

ABSTRACT This article deals with the Bayesian and classical estimation approaches for the reliability of stress-strength of a multicomponent system assuming both the stress and strength variables follow exponentiated Pareto distribution independently based on the progressively censored data. In the classical estimation, the maximum likelihood estimate, asymptotic confidence and two bootstrap confidence intervals boot-t \\amp boot-p are constructed for multicomponent stress-strength (MSS) reliability. In the Bayesian estimation, the Bayes estimates under the squared error loss function using Markov chain Monte Carlo (MCMC) techniques are obtained. The highest posterior density credible interval based on the MCMC method of the MSS reliability are constructed. The different estimates obtained are compared using a Monte Carlo simulation study which is carried out for various sample sizes and different censoring schemes. Two different real data sets are studied to illustrate the real-life applications of the study. Finally, the conclusions based on the study with the future scope of the work are provided.

Indirect treatment comparison of oral sebetralstat and intravenous recombinant human C1 esterase inhibitor for on-demand treatment of hereditary angioedema attacks

BackgroundThe goal of on-demand treatment for hereditary angioedema attacks is to halt attack progression to minimize morbidity and mortality. Four on-demand treatments have been approved thus far (ecallantide, icatibant, recombinant human C1 esterase inhibitor [rhC1INH], and plasma-derived C1INH). Results from the sebetralstat phase 3 KONFIDENT trial (NCT05259917) have been reported. To put these results into context without head-to-head trials, an indirect treatment comparison (ITC) was conducted to facilitate comparisons of efficacy and safety across treatment options.MethodsBased on a systematic literature review and feasibility assessment, only the pivotal trial for intravenous rhC1INH (NCT01188564) reported necessary data for a comparable primary efficacy endpoint (time to beginning of symptom relief) to enable an ITC with oral sebetralstat. Bayesian fixed-effects network meta-analyses models were conducted to indirectly compare the efficacy and safety outcomes of sebetralstat and rhC1INH (NCT01188564, NCT00225147, NCT00262301). A matching-adjusted indirect comparison (MAIC) of efficacy was performed, adjusting for baseline attack severity and demographic characteristics.ResultsThe fixed-effects model found no significant differences in time to beginning of symptom relief between sebetralstat 300 mg and rhC1INH 50 IU/kg (hazard ratio [95% credible interval], 0.96 [0.42–2.15] to 1.19 [0.58–2.45]). After adjusting for baseline attack severity, the MAIC showed numerically favorable results with sebetralstat compared with rhC1INH, regardless of whether baseline demographics were matched. The fixed-effects model found no significant differences in treatment-related treatment-emergent adverse events. All sensitivity analyses returned consistent results.ConclusionsThis ITC found no significant differences in time to beginning of symptom relief and overall treatment-related treatment-emergent adverse events between sebetralstat and rhC1INH.

Treatment of Noncompressible Torso Hemorrhage With Thermoreversible Intra-abdominal Foam: A Dose-response Study in a Porcine Model.

Noncompressible torso hemorrhage (NCTH) leads to significant mortality in civilian settings where transport to a trauma center may be delayed and is also the leading cause of exsanguination on the battlefield. Fast Onset Abdominal Management (F.O.A.M.) is a medical device under development that deploys a rapidly expanding thermoreversible foaming agent from a prefilled pressurized canister via an autostopping needle inserted into the peritoneal cavity. Previous pilot and safety studies in porcine models of NCTH have shown that F.O.A.M. increased survival and reached desired intra-abdominal pressure endpoints without significant adverse effects. However, the optimal intra-abdominal deployment pressure for the foaming agent is yet to be determined. In this prospective study, NCTH was modeled using a modified Ross-Burns swine model wherein a grade IV-V liver laceration was made in 40 animals. Each F.O.A.M. device was set to deliver agent to a preset intra-abdominal goal pressure. The pressure for the initial cohort was 60mmHg and the experimental pressure for each subsequent cohort of animals was selected to be the pressure with the highest posterior probability of being the minimum effective pressure based on an ordinal Bayesian continual reassessment method. After the allocation of animals to various pressures delivered by the F.O.A.M. device ranging between 50 and 80mmHg, 33/40 swine had interpretable outcomes (e.g., technically successful device deployments). Based on a priori exclusion criteria, 7 animals were excluded from the analysis, four based on prototype device failure, and three based on off-target needle administration. At the final analysis, two pressures (70mmHg and 80mmHg) remained in the 95% credible interval. Pressure is the gold standard for effective tamponade of bleeding. In this dose-finding study of the F.O.A.M. device for intra-abdominal tamponade of NCTH in a porcine model, we found a 95% posterior probability that either 70mmHg or 80mmHg is the minimum effective pressure as defined in our model. Future studies will be needed to assess long-term survival and adverse events at this pressure.

Motor cortex repetitive transcranial magnetic stimulation in fibromyalgia: a multicentre randomised controlled trial.

Despite affecting 2-4% of the population worldwide, fibromyalgia often remains refractory to treatment. Here we report the first international randomised double-blind, sham-controlled trial developed to assess the efficacy of repetitive transcranial magnetic stimulation (rTMS) as an add-on therapy for fibromyalgia. Women aged ≥18 yr with fibromyalgia refractory to best available treatment were enrolled in Brazil, France, and Japan, and randomised to 10 Hz motor cortex (M1) rTMS, 3000 pulses day-1, or sham stimulation. This included 10 induction sessions over 2 weeks, followed by weekly maintenance (6 weeks), and fortnightly extended maintenance (8 weeks). Primary outcome was ≥50% pain reduction at week 8 compared with baseline. Secondary outcomes included pain interference, mood, global impression of change, and Fibromyalgia Impact Questionnaire (FIQ) scores at weeks 8 and 16. We randomised 101 women (mean age 48 [range 25-83] yr) into active (n=52) or sham (n=49) arms. Bayesian analysis revealed a 99.4% probability of ≥50% pain reduction at week 8 in the active group vs sham (odds ratio [OR] 3.04; 95% credible interval [95% CrI] 1.26-8.06), with a number needed to treat of 4.54. Frequentist analysis confirmed that relative pain reduction was higher in the active than in the sham group (40.4% vs 18.4%, P=0.028). At week 16, this probability reduced to 34.2% (OR 0.815; 95% CrI 0.313-2.1), but the likelihood of FIQ score reduction was 79.1%. The intervention appeared safe. Add-on M1-repetitive transcranial magnetic stimulation reduced pain intensity up to 8 weeks in women with fibromyalgia. Although analgesic effects waned, functional improvements remained during extended maintenance at week 16.

Constraint on Lorentz invariance violation for spectral lag transition in GRB 160625B using profile likelihood

We reanalyze the spectral lag data for GRB 160625B using frequentist inference in order to constrain the energy scale (EQG) of Lorentz Invariance Violation (LIV). For this purpose, we use profile likelihood to deal with the astrophysical nuisance parameters. This is in contrast to Bayesian inference implemented in previous works, where marginalization was carried out over the nuisance parameters. We show that with profile likelihood, we do not find a global minimum for χ2 as a function of EQG below the Planck scale for both linear and quadratic models of LIV, whereas bounded credible intervals were previously obtained using Bayesian inference. Therefore, we can set one-sided lower limits in a straightforward manner. We find that EQG≥2.55×1016 GeV and EQG≥1.85×107 GeV at 95% c.l., for linear and quadratic LIV, respectively. Therefore, this is the first proof-of-principles application of profile likelihood method to the analysis of GRB spectral lag data to constrain LIV.

Identification of distinct clinical profiles of sepsis risk in paediatric emergency department patients using Bayesian profile regression

BackgroundSepsis affects 25 million children and neonates annually, causing significant mortality and morbidity. Early identification and treatment are crucial for improving outcomes. Identifying children at risk is challenging due to...

Association between HIV-1 Nef-mediated MHC-I downregulation and the maintenance of the replication-competent latent viral reservoir in individuals with virally suppressed HIV-1 in Uganda: an exploratory cohort study.

Association between HIV-1 Nef-mediated MHC-I downregulation and the maintenance of the replication-competent latent viral reservoir in individuals with virally suppressed HIV-1 in Uganda: an exploratory cohort study.