Category: Statistics

Korean J Med Educ. 2026 Sep;38(3):248-255. doi: 10.3946/kjme.2026.210. Epub 2026 Aug 31.

ABSTRACT

PURPOSE: This study examined whether perceived medical need for disclosure (PMND) predicts prosocial intention to disclose patient information (PI) among health professional students, and whether personal norms (PN) moderate this relationship. A particular focus was PN’s dual statistical role-its direct association with PI and its moderation of the PMND-PI association.

METHODS: A cross-sectional survey was administered to 210 undergraduate students at a single Korean university (116 medical, 42 nursing, 52 emergency medical services). Participants were randomly assigned to one of four scenarios (2×2: disease severity × information security environment). Four-step hierarchical regression and simple slope analyses tested the main and moderating effects.

RESULTS: PMND positively predicted PI (β=0.347, p<0.001). PN exerted a significant negative direct effect on PI (β=-0.148, p<0.05) yet significantly amplified the PMND-PI relationship via a positive interaction (β=0.165, p<0.05). Simple slope analyses confirmed that the effect of PMND on PI strengthened progressively from low PN (estimate= 0.194, p=0.069) through average PN (estimate=0.380, p<0.001) to high PN (estimate= 0.567, p<0.001).

CONCLUSION: PN showed a double-edged statistical role: a negative direct association with disclosure intention alongside a positive moderating association that amplified the link between perceived medical need and prosocial disclosure intention. These findings suggest that health professional education may need to go beyond merely reinforcing PN and offer training differentiated by students’ levels of PN, helping them channel moral obligation through lawful procedures in clinically charged situations.

PMID:42669606 | DOI:10.3946/kjme.2026.210

Autism Res. 2026 Aug 30:e70356. doi: 10.1002/aur.70356. Online ahead of print.

ABSTRACT

Reduced social attention (SA) is a hallmark feature of autism that is foundational to social communication and interaction. However, emerging evidence suggests that reduced SA may not be uniformly expressed across the autism spectrum. Sex and cognitive ability (IQ) have been identified as relevant stratification variables, potentially moderating SA in autistic children. We examined differential patterns of SA stratified by sex and cognitive ability in a large, longitudinal sample of autistic and neurotypical (NT) children (ages 6-11 years) from the Autism Biomarkers Consortium for Clinical Trials (ABC-CT), examining SA across four measurement timepoints (Baseline, 6 weeks, 6 months, and 4 years). SA was measured using the oculomotor index of gaze to human faces (OMI) derived from standardized eye-tracking (ET) assays, with children stratified by sex (male, female) and IQ (IQ ≥ 85, IQ < 85). Linear mixed-effects models were used to evaluate the effects of sex, IQ, and timepoint on SA, with additional analyses assessing the stability and clinical associations of OMI. Autistic females did not exhibit lower OMI scores compared to autistic males; however, relative to sex-matched NT children, autistic females showed approximately twice the reduction in OMI observed in autistic males. Likewise, the reduction in OMI associated with autism (i.e., ASD < NT) was larger in autistic children with below-average IQ than in those with average or above-average IQ. These differences were relatively stable across measurement timepoints, and OMI was more strongly associated with clinical features like face memory and adaptive behavior in autistic males and the average or above-average IQ autism subgroup. While reduced SA is a general feature of autism, its expression is stratified by sex and cognitive ability. These findings highlight the importance of subgroup stratification to better understand heterogeneity in autism and improve the utility of SA as a therapeutic biomarker.

PMID:42669601 | DOI:10.1002/aur.70356

ANZ J Surg. 2026 Aug 30. doi: 10.1111/ans.70935. Online ahead of print.

ABSTRACT

BACKGROUND: Outcomes in aesthetic breast surgery are dependent on accurate pre-operative breast measurements. The accuracy of large scale 3-dimentional scanners has been reported, the use of handheld scanners has not been described.

OBJECTIVES: The authors aimed to determine the trueness of anthropometric measurements of breasts obtained from a handheld 3D scan compared to direct measurements.

METHODS: Three raters measured the breasts of 19 women using three anthropometric measurements (direct) measurements: sternal notch to nipple (Sn-N), nipple to inframammary fold (N-IMF), base width (BW). The measurements were taken directly by two raters using a measuring tape, and digitally by one rater using the software on 3D scans acquired with the Artec Leo handheld 3D scanner. Statistical analysis was completed with Bland-Altman plots as well as scatter plots to identify bias between the two methods.

RESULTS: The study found that the 3D scanner showed varying levels of bias when compared to direct breast measurements. Sn-N measurement showed smaller differences, while the N-IMF and BW measurements exhibited larger discrepancies. The 3D scanning process was significantly faster, taking only 30 s per scan, compared to roughly 5 min for direct measurements, with an additional 10 min for image processing and digital measurements.

CONCLUSION: Three-dimensional scanning is most accurate for Sn-N and is more variable when measuring BW and N-IMF due to obscured landmarks on frontal imaging. The BW and N-IMF measurements also showed the most inter-rater variability. Consistent with previous research 3D scanning has limited trueness when measuring N-IMF as it is a dynamic measurement.

PMID:42669600 | DOI:10.1111/ans.70935

Pharmacoepidemiol Drug Saf. 2026 Sep;35(9):e70470. doi: 10.1002/pds.70470.

ABSTRACT

INTRODUCTION: Postpartum psychotropic medication use is heterogeneous, comprising continuation of prenatal treatment, initiation, transient use and complex polypharmacy. Prior studies have reported the prevalence of potential infant exposure to psychotropics via breast milk, but characterisations better capturing the heterogeneity of this exposure are lacking. We aimed to identify distinct postpartum psychotropic treatment patterns using hierarchical clustering accounting for medication type, timing and polypharmacy, and to describe breastfeeding characteristics across these patterns.

METHODS: Population-based cohort study of mothers using psychotropics during the first postpartum year using linked Danish national registers 2012-2023. From a source population of 659 866 mother-child pairs with live-born singleton births, 38 528 mothers redeemed at least one psychotropic prescription during the first postpartum year and comprised the study cohort. Weekly psychotropic use was defined by redeemed prescriptions using prescribed daily dose assumptions. Hierarchical agglomerative clustering (tame R package) identified distinct treatment patterns based on medication type, timing and polypharmacy. The number of patterns was determined from interpretability, size and examination of the hierarchical dendrogram. Exclusive breastfeeding prevalence and duration were described across patterns among pairs with recorded breastfeeding habits (64%).

RESULTS: Eight distinct treatment patterns were identified, differing in psychotropic type, timing and polypharmacy. Three SSRI-dominated patterns (24 225 pairs, 63%) ranged from increasing SSRI use (Pattern I; n = 11 731), through continued SSRI use with high persistence (Pattern II; n = 7167), to mixed use involving SSRIs and other psychotropics (Pattern III; n = 5327; 48% using three or more medications). The remaining five patterns (14 303 pairs, 37%) were dominated by benzodiazepine-related drugs, other antidepressants, centrally acting sympathomimetics, antipsychotics or complex mixed use, ranging from late-initiated benzodiazepine-related use (Pattern IV; median initiation Week 27; persistence 13%) to early-initiated, highly persistent mixed use (Pattern VIII; median initiation Week 4; persistence 94%). Exclusive breastfeeding duration varied across patterns, with long-duration exclusive breastfeeding (181 days or more) highest in the SSRI-continued pattern (Pattern II, 10.6%) and lowest in the mixed-use-increasing and antipsychotics-sporadic patterns (Patterns III and VII, 5.1% and 5.2%).

CONCLUSION: Postpartum psychotropic treatment patterns are clinically heterogeneous and exclusive breastfeeding practices differ across treatment patterns.

PMID:42669595 | DOI:10.1002/pds.70470

Dig Liver Dis. 2026 Aug 30:S1590-8658(26)00880-7. doi: 10.1016/j.dld.2026.07.082. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Selection criteria for liver transplant allocation are crucial for benefit-risk assessment of every patient evaluated for liver transplantation (LTx). Currently, Milan criteria are the key decision tool in several countries to assess whether a patient with hepatocellular carcinoma (HCC) is eligible for LTx. In this post-hoc analysis of the SiLVER Study, we analysed the performance of Milan criteria compared to the broader criteria UCSF, Up-to-7 and MT 2.0 to assess whether there is need to reform the selection process of HCC patients evaluated for LTx.

METHODS: Outcomes of 485 patients of the multicentre and randomized SiLVER Study were analysed determined by recurrence-free survival (RFS), overall survival (OS) and freedom of tumor (FoT).

RESULTS: Discrimination was modest for all four criteria and showed no statistically significant differences across OS (C-index 0.55-0.57), RFS (0.57-0.59) or FoT (0.62-0.64), with Metroticket 2.0 numerically highest. In the competing-risks analysis, being outside any criterion was associated with an increased subdistribution hazard of recurrence (sHR 2.7-3.6, all p < 0.001). The broader criteria classified substantially more patients as eligible (Up-to-7 83.9% vs Milan 65.6%).

CONCLUSIONS: Our data based on explant histopathology suggest that Milan criteria exclude patients with HCC evaluated for LTx without demonstrable benefit, questioning Milan criteria as sole selection tool in many regions doing liver transplants.

PMID:42669573 | DOI:10.1016/j.dld.2026.07.082

Postgrad Med. 2026 Aug 30:1-10. doi: 10.1080/00325481.2026.2727239. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with psoriatic disease present a distinctive metabolic phenotype, yet the optimal anthropometric marker to capture cardiometabolic risk remains unclear. We evaluated whether waist circumference provides superior cardiometabolic discrimination and reclassification compared with BMI in psoriatic disease.

METHODS: In this cross-sectional study, we assessed consecutive patients with psoriasis and/or psoriatic arthritis (n = 572). The primary outcome was clustered cardiometabolic burden (≥2 predefined cardiometabolic abnormalities). Waist circumference and BMI were compared using principal component analysis (PCA), ROC curves, Youden-derived sex-specific thresholds, and both categorical and continuous reclassification metrics (NRI and IDI), overall and stratified by sex. Additional sensitivity analyses used standard metabolic cutoffs (ATP III/IDF).

RESULTS: Waist circumference and BMI showed the highest loadings on the first principal component representing the cardiometabolic axis, with a slightly higher contribution from waist circumference (loading 0.864 vs 0.826). Waist circumference showed modest but statistically significant improvement in discrimination compared with BMI for clustered cardiometabolic abnormalities (AUC 0.78 vs 0.73 for ≥2 factors, DeLong p = 0.003; AUC 0.78 vs 0.71 for ≥3 factors, DeLong p < 0.001). Waist circumference-derived thresholds provided incremental risk stratification beyond BMI, with consistent improvements in reclassification metrics across cardiometabolic burden definitions. Youden-derived thresholds (100 cm in men and 99 cm in women) showed better balance between sensitivity and specificity than ATP III and IDF criteria, while maintaining clinically relevant likelihood ratios. Sensitivity analyses incorporating waist-to-height ratio showed similar findings without additional benefit over waist circumference alone.

CONCLUSION: Waist circumference provided consistently better overall cardiometabolic discrimination than BMI and may represent a more informative anthropometric marker for cardiometabolic risk assessment in psoriatic disease.

PMID:42669569 | DOI:10.1080/00325481.2026.2727239

J Nutr Sci Vitaminol (Tokyo). 2026;72(4):299-306. doi: 10.3177/jnsv.72.299.

ABSTRACT

This study investigated the relationship between masticatory behaviors, masticatory ability, and body mass index (BMI) in healthy adult males and females using a newly developed wearable mastication counter. A total of 106 healthy dentulous participants were included. Assessments during rice ball consumption evaluated mastication frequency, meal duration, mastication speed, masticatory ability, and the presence of fast-eating habits. Statistical analyses compared factors by sex and fast-eating habits and examined the relationships between BMI and these factors, with a 5% significance level. The results showed that BMI was significantly associated with sex, fast-eating habits, and mastication frequency. Females had higher mastication frequency and longer meal durations but mastication speed and lower masticatory ability compared with males. Additionally, participants in the fast-eating group exhibited higher BMI, lower mastication frequency, and shorter meal durations than those in the non-fast-eating group. In conclusion, BMI was associated with sex, fast-eating habit, and mastication frequency in this cross-sectional sample. Further longitudinal or interventional studies are needed to clarify causality.

PMID:42669529 | DOI:10.3177/jnsv.72.299

Circ J. 2026 Aug 28. doi: 10.1253/circj.CJ-26-0093. Online ahead of print.

ABSTRACT

BACKGROUND: Small dense low-density lipoprotein cholesterol (sdLDL-C) is an established atherogenic marker; however, the association between estimated sdLDL-C (EsdLDL-C) and arterial stiffness remains unclear.

METHODS AND RESULTS: We analyzed 23,623 participants (13,518 men, 10,105 women). EsdLDL-C was calculated using the Sampson equation, and arterial stiffness was defined as a brachial-ankle pulse wave velocity (baPWV) ≥1,400 cm/s. After adjustment for cardiovascular risk factors, higher EsdLDL-C levels were significantly associated with arterial stiffness in the overall population and in men, whereas the association in women did not reach statistical significance in the continuous analysis. Nevertheless, the risk of arterial stiffness increased in a stepwise manner across EsdLDL-C quartiles; the highest EsdLDL-C quartile had a significantly higher risk than the lowest in both men (odds ratio [OR] 1.91; 95% confidence interval [CI] 1.59-2.29) and women (OR 1.54; 95% CI 1.22-1.95). In a 4-group analysis, high EsdLDL-C significantly increased risk, regardless of whether estimated low-density lipoprotein cholesterol levels were below or above the median. Stratified analysis by systolic blood pressure (SBP; <120, 120-129, 130-139, and ≥140 mmHg) revealed that the association was significant across all categories in men, but was less consistent in women and was significant only in the strict normotensive group (SBP <120 mmHg).

CONCLUSIONS: EsdLDL-C calculated from standard lipid parameters is significantly associated with arterial stiffness. This association is robust in men and evident in normotensive women, suggesting that EsdLDL-C is a useful indicator for arteriosclerotic risk assessment.

PMID:42669485 | DOI:10.1253/circj.CJ-26-0093

Kurume Med J. 2026 Aug 31. doi: 10.2739/kurumemedj.MS7312006. Online ahead of print.

ABSTRACT

INTRODUCTION: Lower gastrointestinal tract stenoses are commonly treated with surgery or endoscopic balloon dilation. We conducted a clinical trial to investigate a novel endoscopic treatment called radial incision and cutting (RIC). Although RIC has demonstrated a high technical success rate and has been shown to improve subjective symptoms, the relatively high rate of delayed bleeding in cases of ileocolonic anastomotic strictures due to Crohn’s disease (CD) can be problematic. Herein, we report the design of a prospective, single-center, single-arm, exploratory pilot study to evaluate safety and feasibility of self-expandable metallic stent (SEMS) placement as an alternative dilation strategy for ileocolonic anastomotic strictures in CD, particularly in patients in whom delayed bleeding after RIC has been a clinical concern.

METHODS: The major inclusion criteria include age 18-80 years, ileocolonic anastomotic strictures after surgery for CD, and a history of endoscopic balloon dilation or RIC for such strictures. We will employ a SEMS designed for malignant biliary stenosis and conduct SEMS placement in five participants. The primary outcome is the safety of SEMS placement, assessed by determining the frequency of adverse events of special interest, including delayed bleeding and perforation. The secondary outcomes include the technical success rate of SEMS placement, procedure duration, improvement in subjective symptoms, SEMS migration rate, success rate of SEMS removal 1 week after placement, and duration of hospitalization. Subjective symptom improvement is evaluated using the visual analog scale, and long-term results are analyzed using descriptive statistics, Student’s t-test, and Kaplan-Meier curves.

CONCLUSION: This exploratory study provides useful information regarding the safety of SEMS placement for ileocolonic anastomotic strictures due to CD, which may contribute to further investigation.

PMID:42669468 | DOI:10.2739/kurumemedj.MS7312006

J Craniofac Surg. 2026 Aug 28. doi: 10.1097/SCS.0000000000012850. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to report 2 cases of dedifferentiated liposarcoma (DDLPS) in the peripharyngeal space and review the relevant literature to summarize its clinical and histopathologic features and therapeutic approaches, especially operative selection and prognosis.

METHODS: A comprehensive review of the literature was performed in January 2025 to identify relevant articles using the PubMed database. Sixty patients were included in this study: 2 new cases from Beijing Tongren Hospital in 2018 and 2023, and 58 previously reported cases that occurred between 1979 and 2024 from a systematic review of the literature. We analyzed and summarized the patients’ epidemiological data, clinical features, and treatment regimens. The main outcomes were overall survival (OS) and recurrence-free survival (RFS).

RESULTS: DDLPS was approximately twice as common in men as in women, with a median age of 61 years (range: 20-86 y). MDM2 amplification was positive in 13 patients (13/14, 92.9%). Nearly all the patients underwent surgical excision (35/36, 97.2%). Almost half of the patients (17/36, 47.2%) underwent surgery with postoperative radiotherapy (RT). The 1-year, 3-year, and 5-year OS rates were 91.3%, 81.2%, and 81.2%, respectively. The 1-year, 3-year, and 5-year RFS rates were 91.3%, 74.9%, and 64.2%, respectively. Local radical excision is the preferred treatment modality for DDLPS. Adjuvant chemoradiotherapy after radical surgery resection had no statistically significant impact on OS or RFS (P˃0.05).

CONCLUSIONS: Detection of MDM2 during initial biopsy can prevent delays in diagnosis and treatment. Local radical excision is the preferred treatment modality for DDLPS.

PMID:42669453 | DOI:10.1097/SCS.0000000000012850