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Theophylline population pharmacokinetics from routine monitoring data in very premature infants with apnoea.

1. Theophylline is commonly used in neonatology for the treatment and prophylaxis of apnoea of prematurity, and during ventilator weaning. 2. NONMEM was used to study the population pharmacokinetics of intravenous and oral theophylline from retrospective drug monitoring data in 82 premature neonates, weighing < 1500 g at birth, and < or = 32 weeks gestational age. 3. Clearance (CL), volume of distribution (V), and oral bioavailability (F1) from liquid preparations were modelled alone, and under the influence of demographic and clinical covariates, assuming a 1-compartment model with first-order elimination. 4. The final population models with influential co-variates were as follows: CL (1h-1) = 0.0000123 *body weight (g) + 0.000377 *postnatal age (days); V (1) = 0.000937 *body weight (g); F = 0.918. 5. The CL was lower and V was higher than previously reported for less premature neonates, term babies, and older children. 6. Predictive performance of the population models was evaluated by Bayesian forecasting in a similar, but independent cohort of 30 infants. There was statistically insignificant bias and imprecision between measured and predicted serum theophylline concentrations. 7. Based on the validated population models, recommended maintenance theophylline dosages are provided for infants aged between 2 and 50 days, and weighing 700 to 2000 g.

Apnea

A statistical model of transmission of Hib bacteria in a family.

The simultaneous estimation of family and community transmission rates as well as cure rates from panel data in a recurrent Hib (Haemophilus influenzae type b bacteria) infection is considered. An individual-based stationary Markov process model with constant hazards in two age groups is applied to describe recurrent asymptomatic Hib infection in a family with small children. The problem of estimation is solved in terms of the Bayesian posterior of the model parameters. The model is used to predict prevalence and incidence of Hib carriage in families as a function of the family size and age structure.

Adult

Insights Into the Structural Features, Codon Usage Patterns, and Phylogenetic Analysis in Neoniphon argenteus (Teleostei: Holocentriformes) Based on Complete Mitochondrial Genome.

Neoniphon argenteus, a widely distributed nocturnal coral reef fish in the family Holocentridae, plays an important role in maintaining coral reef ecosystem health, yet its phylogenetic position remains poorly resolved. To bridge this gap, we sequenced and analyzed the complete mitochondrial genome of a specimen from the South China Sea to characterize its structural features, codon usage patterns, and phylogenetic relationships. The 16,569&#x2009;bp mitogenome (GenBank: PP190474.1) encodes 13 protein-coding genes (PCGs), 22 tRNAs, two rRNAs, and two non-coding regions, exhibiting a distinct A&#x2009;+&#x2009;T bias. All tRNAs fold into typical cloverleaf secondary structures except tRNA-Ser (AGN), which lacks the dihydrouridine (DHU) arm. The control region contains palindromic motifs (TACAT/ATGTA) capable of forming hairpin structures and five conserved sequence blocks, whereas the OL region harbors a conserved 5'-GCCGG-3' motif. RSCU analysis revealed 31 frequently used codons (RSCU >&#x2009;1) with a pronounced preference for A/C-ending codons. The &#x394;RSCU method identified 10 candidate optimal codons (GCA, CAA, GAA, GGA, AUU, CUA, CCA, CGA, ACA, and GUC). Selection pressure analysis using EasyCodeML and site-specific models indicated that all PCGs are predominantly under purifying selection, with no significant evidence of pervasive positive selection. ND6 exhibited elevated pairwise Ka/Ks ratios (mean&#x2009;=&#x2009;1.209&#x2009;&#xb1;&#x2009;0.047), consistent with reduced selective constraint rather than adaptive evolution. Phylogenetic analysis of 19 Holocentriformes species using maximum likelihood and Bayesian inference with partitioned models based on 13 PCGs and two rRNA genes (12S and 16S) assigned all taxa to two well-supported subfamilies (Holocentrinae and Myripristinae). Within Holocentrinae, Neoniphon species form a monophyletic clade nested within a paraphyletic Sargocentron, suggesting that the genus Sargocentron as currently defined is not monophyletic. This study provides useful baseline molecular data for further exploration of the evolutionary history of N. argenteus and other members of Holocentriformes.

Holocentridae

Efficacy and safety of cannabinoid-based interventions for behavioral and cognitive symptoms in dementia: systematic review and meta-analysis.

BACKGROUND: Behavioral and cognitive symptoms are frequent in Alzheimer's disease and dementia, and available pharmacological options offer limited benefit. Cannabinoid-based therapies have been proposed as alternatives, but evidence remains inconclusive. METHODS: We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library through November 2025 for randomized controlled trials evaluating cannabinoids in Alzheimer's disease or dementia. Primary outcomes were agitation measured by the Cohen-Mansfield Agitation Inventory (CMAI) and neuropsychiatric symptoms assessed by the Neuropsychiatric Inventory-Nursing Home version (NPI-NH). Secondary outcomes included cognition using the Mini-Mental State Examination (MMSE) and adverse events. Standardized Mean Differences (SMDs) and Risk Ratios (RRs) were synthesized using random-effects (REML) and Bayesian random-effects models. Risk of bias was evaluated with RoB 2, and certainty of evidence with GRADE. RESULTS: Nine trials (334 participants) met inclusion criteria. Cannabinoids did not improve CMAI (SMD -0.58, 95% CI -1.71 to 0.55; I2&#x2009;=&#x2009;84%), NPI-NH total (SMD -0.02, 95% CI -1.00 to 0.96; I2&#x2009;=&#x2009;67%), NPI-NH agitation (SMD -0.44, 95% CI -1.45 to 0.57; I2&#x2009;=&#x2009;48%), or MMSE (SMD 0.86, 95% CI -16.33 to 18.06; I2&#x2009;=&#x2009;96%). Bayesian posterior estimates were close to zero, supporting the absence of effect. Leave-one-out analyses reduced heterogeneity only after excluding influential trials but did not alter results. Certainty of evidence was moderate for behavioral outcomes and low for cognition. Overall adverse events were similar to placebo, while somnolence was more frequent with cannabinoids (RR 2.03, 95% CI 1.29-3.20). CONCLUSIONS: Cannabinoid-based therapies do not improve agitation, neuropsychiatric symptoms, or cognition in Alzheimer's disease and increase somnolence.

Humans

Individualising gentamicin dosage regimens. A comparative review of selected models, data fitting methods and monitoring strategies.

The various components required for individualising clinical drug dosage regimens are reviewed, including a study of 3 types of fitting procedures, 2 types of gentamicin pharmacokinetic model and the utility of D-optimal times for obtaining serum gentamicin concentrations. The combination of the current Bayesian fitting procedure, the kslope pharmacokinetic model [in which the elimination rate constant (kel) can change from dose to dose with changing creatinine clearance] and the explicit measurement of the assay error pattern yielded predictions of future serum gentamicin concentrations which were (a) slightly better than those found using weighted nonlinear least squares; (b) somewhat better than those found with Bayesian fitting and a fixed-kel model; (c) better than those found using the traditional linear regression fitting procedure and a fixed kel model. D-Optimally timed pairs of concentrations also predicted future concentrations at least as well, and more cost effectively.

Data Interpretation, Statistical

Open-loop-feedback control of serum drug concentrations: pharmacokinetic approaches to drug therapy.

Recent developments to optimize open-loop-feedback control of drug dosage regimens, generally applicable to pharmacokinetically oriented therapy with many drugs, involve computation of patient-individualized strategies for obtaining desired serum drug concentrations. Analyses of past therapy are performed by least squares, extended least squares, and maximum a posteriori probability Bayesian methods of fitting pharmacokinetic models to serum level data. Future possibilities for truly optimal open-loop-feedback therapy with full Bayesian methods, and conceivably for optimal closed-loop therapy in such data-poor clinical situations, are also discussed. Implementation of these various therapeutic strategies, using automated, locally controlled infusion devices, has also been achieved in prototype form.

Aged

Exploring hormonal influences on nicotine craving and use across the perinatal period: A prospective longitudinal study.

INTRODUCTION: Perinatal nicotine use is common despite well-documented adverse consequences. We examined associations between reproductive-related hormones with nicotine craving and use during the perinatal period to identify potential novel intervention points. METHODS: All participants reported use of nicotine during the perinatal period. Participants were enrolled at gestational week &#x2265;&#x2009;36 and followed to postpartum week 12 via daily surveys (i.e., nicotine craving via 100-point scale, dichotomous use) and weekly hormone measurement in saliva (cortisol, oxytocin) or dried blood spots (progesterone, estradiol, testosterone, dehydroepiandrosterone sulfate). Bayesian mixed-effects models accounted for within-person correlation while estimating hormone effects. RESULTS: Participants (n&#x2009;=&#x2009;46) were 28.9&#x2009;&#xb1;&#x2009;4.9 years old. During follow-up, exclusive combustible cigarettes (n&#x2009;=&#x2009;20), electronic nicotine delivery systems (ENDS; n&#x2009;=&#x2009;13), or dual (n&#x2009;=&#x2009;2) use was observed, with variability in use and craving across participants and over time. During pregnancy, higher oxytocin was linked to greater craving (&#x3b2;=16.31, 95% CI: 3.71, 28.83). Greater peripartum declines in oxytocin were associated with more craving (&#x3b2;=8.71, 95% CI: 0.75, 16.93) and use (&#x3b2;=1.13, 95% CI: 0.05, 2.43). During postpartum, lower estradiol was linked to more craving (&#x3b2;=-1.17, 95% CI: -2.15, -0.18) and use (&#x3b2;=-0.40, 95% CI: -0.76, -0.03). In models simultaneously evaluating all postpartum hormones, the lone meaningful association was between estradiol and craving (&#x3b2;=-1.66, 95% CI: -2.84, -0.48). CONCLUSIONS: The results of this study suggest that oxytocin and estradiol may contribute to the risk of perinatal nicotine use. Additional research is needed to replicate our observations in more diverse study samples and explore implications for clinical intervention.

Bayesian

Evaluating the quality of a probabilistic diagnostic system using different inferencing strategies.

In this paper we describe the evaluation of a probabilistic diagnostic system for patients with renal mass. Three inference models: Multi-membership Bayesian (MB), Minimal Diagnosis (MD) and Bayesian Network (BN), and 72 patients are used to illustrate three interrelated measures of system performance: accuracy, reliability and discriminating power. The inferencing strategies we tested demonstrated the kind of trade-offs in the performance measures that can be expected from imperfect systems. Ultimately, the purpose and expected use of a system should dictate the relative importance ascribed to different aspects of system performance.

Adolescent

Coupling of spectroscopy and nitrogen-oxygen isotopes unveils the mechanisms of dissolved organic matter and nitrate pollution in lakes within the agro-pastoral transition zone.

Lakes in arid and semi-arid regions are subjected to severe ecological stress, such as organic pollution, eutrophication, and salinization, due to climate change and human activities. This study investigates Chagannur Lake, a typical arid-region lake that is representative and ecologically sensitive in Northern China's agro-pastoral ecotone, to uncover its pollution characteristics and mechanisms. We employed fluorescence spectroscopy and stable isotope analysis to trace dissolved organic matter (DOM) and nitrate sources. The DOM composition was dominated by microbial metabolic byproducts and protein-like substances, suggesting that microbial processes are key to organic matter transformation. Source apportionment revealed that pollutants primarily originated from livestock and poultry manure (37.6 %), agricultural fertilizers (35.6 %), and soil erosion (24.7 %), with agricultural fertilizers contributing most significantly in the Gogstai River (63.3 %). A structural equation model (SEM) coupling spectral and mass spectrometric data revealed that microbial transformation significantly impairs the lake's self-purification capacity, thereby promoting pollutant accumulation (path coefficient = 0.91,*p < 0.05). Moreover, microbial processes link endogenous and exogenous pollution, a mechanism effectively traced by isotopic and fluorescence indices (path coefficient = 0.55, &#x204e;&#x204e;p < 0.01). These findings enhance the understanding of pollution sources and transformation mechanisms in arid-region lakes and offer foundational theoretical support for policymakers engaged in pollution control strategies.

Lakes

Bayesian forecasting of serum vancomycin concentrations in neonates and infants.

A dynamic pharmacokinetic model for i.v. vancomycin administration was developed and tested in 47 neonates and infants. Twenty-nine patients (Group 1), having two or more concentrations, were used to estimate population parameters by nonlinear least-squares analysis. Multiple stepwise linear regression techniques showed that estimated creatinine clearance, Clcr, and postnatal age were significant demographic factors related to vancomycin clearance (CL). No strong associations were found for the apparent volume of distribution. A one-compartment model was constructed using the associations of CLcr and postnatal age with vancomycin CL. Eighteen patients (Group 2), receiving 35 courses of vancomycin therapy, with both initial and subsequent sets of peak and trough concentrations, were used to test the predictive performance of the model with and without the use of Bayesian forecasting. Using only population-based parameters, the respective mean error (ME) (bias) and mean absolute error (MAE) (precision) for predicting subsequent peak concentrations were -1.20 and 3.89 mg/L and for trough concentrations, 0.83 and 2.23 mg/L, respectively. For the Bayesian method, these values were, respectively, 0.45 and 4.13 mg/L for peak concentrations and 1.55 and 2.40 mg/L for trough concentrations. When predicted concentrations occurred within 30 days of feedback concentrations, the Bayesian method tended to be slightly less biased and more precise than the population-based parameters. The opposite was true > 30 days of the initial set of feedback concentrations. The use of population-specific pharmacokinetic parameters and Bayesian forecasting should allow accurate dosage regimen design as well as minimize the need for monitoring serum vancomycin concentrations in neonates and young infants.

Bayes Theorem

A technique for measuring epidemiologically useful features of birthweight distributions.

Birthweight distributions have been conceptualized as a predominant Gaussian distribution contaminated in the tails by an unspecified 'residual' distribution. Acknowledging this idea, we propose a technique for measuring certain features of birthweight distributions useful to epidemiologists: the mean and variance of the predominant distribution; the proportions of births in the low- and high-birthweight residual distributions, and the boundaries of support for these residual distributions. Our technique, based on an underlying multinomial sampling distribution, involves estimating parameters in a mixture model for the multinomial bin probabilities after having chosen the support of the residual distribution with a model selection criterion. A modest simulation study and experience with a few actual datasets indicate that use of a Bayesian information criterion (BIC) as model selection criterion is superior to use of Akaike's information criterion (AIC) in this application.

Analysis of Variance

Identifying the fertile phase of the human menstrual cycle.

The identification of the human fertile phase as the time during which a woman or a couple may conceive is elusive. The fertile time depends on many factors in each individual menstrual cycle and may be said to be more of a statistical than a physiological entity. This paper reviews the application of statistical methods to three areas related to conception and the fertile phase. The first is the prediction and detection of ovulation from serial measurements, such as hormones, basal body temperature and cervical mucus, throughout the menstrual cycle. Typically, such variables increase from some baseline level to a peak around ovulation (the most fertile time), then subside to low levels in the postovulatory phase. The statistical challenge is to detect the rise (signalling the onset of potential fertility) and subsequent fall. Analytic methods considered include thresholds, Bayesian change-point models and particularly the cumulative sum (cusum) technique which is both simple to apply and understand, and effective. The second area comprises appropriate methods of analysing and interpreting data from clinical studies of the fertile phase, especially in so-called natural family planning (NFP) where it is usual for women to observe several indices of potential fertility. Such studies usually try to establish the temporal relationships between markers of the fertile phase and examine the success of different combinations of markers in delineating the fertile time in comparison with a standard 'defined' phase, for example, the interval from three days before to two days after the peak of luteinizing hormone. The third area is the assessment of the probability of conception on certain days of the cycle, which is vital to the understanding of the fertile phase and its application to NFP. Direct estimation of such probabilities is impractical; instead, resort must be made to estimation by maximum likelihood of the parameters of specially constructed models. Suitable models are described. Finally, the need for a new prospective study of the probability of conception in relation to the markers of the fertile phase used in the symptothermal method of NFP is discussed.

Female

Pharmacokinetics and pharmacodynamics of 21-day continuous oral etoposide in pediatric patients with solid tumors.

PURPOSE: The objectives of this study were to determine etoposide pharmacokinetics during continuous low-dose oral administration to children with solid tumors and to evaluate the relationships between parameters of etoposide systemic exposure and toxicity. PATIENTS AND METHODS: In this phase I study, children were administered oral etoposide (25 to 75 mg/m2/day) for 21 days as a diluted solution of the intravenous preparation, divided into three equal daily doses. Plasma pharmacokinetics were studied on day 1 of therapy in 18 children and again on day 21 in 14 of these children. Etoposide plasma concentration-time data were fitted to a first-order absorption, two-compartment model with use of bayesian estimation. Pharmacokinetic parameter estimates from day 1 were used to estimate steady-state etoposide systemic exposure in all children. Stepwise multivariate regression was used in an exploratory manner to determine patient, laboratory, or pharmacokinetic predictors of toxicity. RESULTS: Although there was substantial intrapatient variability, there was no difference in the area under the concentration-time curve [AUC(0-8hr)] measured at day 21 compared with the steady-state AUC(0-8hr) estimated from day 1 pharmacokinetic parameters (p = 0.64). Degree of neutropenia was best predicted by the estimated duration that steady-state plasma etoposide concentrations were maintained above 1 microgram/ml (t > 1 microgram/ml) rather than peak plasma concentrations, AUC(0-8hr), dosage, or other patient characteristics. Assuming a bioavailability of the oral solution of approximately 50%, the median etoposide systemic clearance was 21.4 ml/min/m2, a value similar to clearance estimates after intravenous etoposide in pediatric populations. CONCLUSION: We conclude that a parameter reflective of etoposide systemic exposure (t > 1 microgram/ml) correlates more strongly with neutropenia than does dosage or other patient characteristics.

Administration, Oral

Modelling human tibia structural vibrations.

Mode shapes and natural frequencies of human long bones play an important role in the interpretation, prediction and control of their dynamic response to external mechanical loads. This paper describes an experimental and theoretical study of free vibrations in an excised human tibia. Experimentally, seven tibial natural frequencies in the range 0-3 kHz were identified through measured structural transfer functions. Theoretically, a beam type Finite Element model of a human tibia is suggested. Unknown parameters in this model are determined by a Bayesian parameter estimation approach, by which very fine model/observation-accordance was achieved with realistic parameter estimates. A sensitivity analysis of the model confirms that the human tibia in a vibrational sense is more uniform than its complicated geometry would immediately suggest. Accordingly, two simple tibia models are identified, based on uniform beam theory with inclusion of shear deformations.

Biomechanical Phenomena

Leveraging functional annotations to map rare variants associated with Alzheimer disease with gruyere.

Increased availability of whole-genome sequencing (WGS) has facilitated the study of rare variants (RVs) in complex diseases. Multiple RV association tests are available to study the relationship between genotype and phenotype, but most do not fully leverage the availability of variant-level functional annotations. We propose genome-wide rare variant enrichment evaluation (gruyere), an empirical Bayesian framework that complements existing methods by learning global, trait-specific weights for functional annotations to improve variant prioritization. We apply gruyere to WGS data from the Alzheimer's Disease Sequencing Project to identify Alzheimer disease (AD)-associated genes and annotations. Growing evidence suggests that the disruption of microglial regulation is a key contributor to AD risk, yet existing methods have not examined rare non-coding effects that incorporate such cell-type-specific information. To address this gap, we (1) define per-gene non-coding RV test sets using predicted enhancer and promoter regions in microglia and other brain cell types (oligodendrocytes, astrocytes, and neurons) and (2) include cell-type-specific variant effect predictions (VEPs) as functional annotations. gruyere identifies 13 significant genetic associations not detected by other RV methods, four of which remain significant in omnibus tests. We find that deep-learning-based VEPs for splicing, transcription factor binding, and chromatin state are highly predictive of functional non-coding RVs. Our study establishes a robust framework incorporating functional annotations, coding RVs, and cell-type-associated non-coding RVs to perform genome-wide association tests, uncovering AD-relevant genes and annotations.

Alzheimer Disease

Comparative effects of pharmacological interventions in the prophylactic treatment of tension-type headache: systematic review and network meta-analysis.

BACKGROUND: Tension-type headache (TTH) is the most common neurological disorder. The comparative effect of pharmacological interventions for TTH prophylaxis remains unclear. We aimed to assess the comparative effects of pharmacological interventions in the prophylactic treatment of TTH. METHODS: Ovid Medline, Embase, and Cochrane were searched from inception to 12 December, 2025. Randomized controlled trials (RCTs) of medications compared to placebo or another medication for preventing TTH were included. The primary outcome was headache days per month. A Bayesian random-effect model was employed as the primary analysis of chronic TTH. RESULTS: Thirty-five RCTs were included, 33 (88.6%) RCTs involved chronic TTH patients, and 24 RCTs provided available data for meta-analysis. Amitriptyline 100&#x2009;mg presented more reduction of monthly headache days than placebo at 4&#x2009;and 8&#x2009;weeks (4&#x2009;weeks: MD -6.59, 95% CrI -11.22 to -0.64; 8&#x2009;weeks: MD -6.14, 95% CrI -10.27 to -0.87). BTX-A 100&#x2009;U can reduce monthly headache days (MD -3.79, 95% CrI -7.16 to -0.33). Amitriptyline 100&#x2009;mg was the highest-ranked treatment for monthly headache days at 4 (SUCRA 0.85), 8 (SUCRA 0.85), and 24 (SUCRA 0.87) weeks; 12&#x2009;weeks was lidocaine 25&#x2009;ml (SUCRA 0.75). Amitriptyline 100&#x2009;mg and BTX-A 500&#x2009;U showed a higher adverse event rate than placebo. CONCLUSION: Amitriptyline 100&#x2009;mg and BTX-A 100&#x2009;U may be options to reduce monthly headache days in patients with chronic TTH. Given the low to very low certainty of evidence, high risk of bias, and high heterogeneity, more studies are needed. TRIAL REGISTRATION: PROSPERO (CRD42025639586).

Humans

Bayesian inference of lineage trees by joint analysis of single-cell multimodal lineage-tracing data with BiLinT.

The advent of single-cell lineage-tracing technologies has enabled the simultaneous profiling of gene expression and lineage barcodes. However, accurate, high-resolution reconstruction of cell lineage trees remains challenging because most existing approaches treat these modalities separately and therefore fail to fully exploit their complementary information. Here we present BiLinT, a Bayesian framework that jointly models multimodal single-cell lineage-tracing data for lineage tree reconstruction. BiLinT integrates barcode evolution (a continuous-time Markov chain) with gene expression dynamics (an Ornstein-Uhlenbeck process) within a unified probabilistic model. Across synthetic and real data sets, BiLinT provides accurate lineage-tree reconstruction and reveals differentiation-associated clonal structure and developmental fate biases.

Journal Article