Category: Statistics

J Magn Reson Imaging. 2026 Aug 26. doi: 10.1002/jmri.70523. Online ahead of print.

ABSTRACT

BACKGROUND: Accurate preoperative glioma grading and molecular subtyping are important for treatment. The vascular microenvironment promotes tumor progression. A noninvasive screening tool capable of mapping tumor vascularity may assist in preoperative grading and subtyping of gliomas.

PURPOSE: To evaluate 7T susceptibility-weighted imaging (SWI) for differentiating glioma isocitrate dehydrogenase (IDH) status and World Health Organization (WHO) grade based on vascular microenvironment features.

STUDY TYPE: Retrospective.

POPULATION: Among 218 patients with histologically confirmed gliomas, 152 (70%) were assigned to training and 66 (30%) to validation by stratified random sampling. The training/validation sets included 61/26 IDH-mutant, 91/40 IDH-wildtype, 57/25 Grade 1-2, and 95/41 Grade 3-4 gliomas.

FIELD STRENGTH/SEQUENCE: 7T; T1-weighted Magnetization prepared 2 rapid acquisition gradient echo (MP2RAGE) and SWI.

ASSESSMENT: Two independent neuroradiologists delineated tumors on 7T SWI. Vascular topology, density, and intensity were extracted following Frangi filtering and 3D skeletonization. Following feature selection, logistic regression (LR), support vector machine (SVM), naive Bayes (NB), and random forest (RF) were developed to differentiate IDH mutant from IDH wildtype, and WHO Grade 1-2 from WHO Grade 3-4.

STATISTICAL TESTS: Continuous and categorical variables were compared using Student’s t-test/Mann-Whitney U test and chi-square test, respectively. Cohen’s kappa statistic and intraclass correlation coefficient (ICC) were used to assess the interobserver agreement. Features were selected by t-test (or Mann-Whitney U test) and Spearman’s rank correlation. Sensitivity, specificity, accuracy, F1-score, and area under the curve (AUC) were used to evaluate model performance. A p value < 0.05 was considered significant.

RESULTS: Nine robust vascular features were retained. Imaging models achieved AUCs of 0.816-0.843 for IDH status and 0.834-0.874 for WHO grade in the internal validation set. Integrating clinical factors improved performance, with optimal AUCs of 0.888 and 0.889, respectively.

DATA CONCLUSION: Integrating 7T SWI vascular features with machine learning may aid noninvasive differentiation of glioma molecular status and grade.

EVIDENCE LEVEL: 4.

TECHNICAL EFFICACY: Stage 2.

PMID:42649122 | DOI:10.1002/jmri.70523

Health Promot J Austr. 2026 Oct;37(4):e70232. doi: 10.1002/hpja.70232.

ABSTRACT

ISSUE ADDRESSED: Schools are recommended settings for promoting healthy eating, but to achieve population-level impact, initiatives must be widely implemented. Limited data are available to assess the implementation of Australian school-based healthy eating initiatives. This study examined the implementation of healthy eating initiatives in Australian primary schools and whether implementation is associated with school characteristics (school size, remoteness, socio-economic status).

METHODS: A cross-sectional study surveyed a nationally representative sample of Australian primary school principals (August 2022-October 2023) regarding 32 healthy eating initiatives across five opportunities for healthy eating: healthy food in the classroom, at school, brought to school, outside of school and other. Initiatives were identified from recent systematic reviews aligned with Australian and global guidelines. Prevalence estimates were weighted to the national school population, and logistic regression models examined associations with school characteristics.

RESULTS: Of the 669 participating schools, 569 completed the healthy eating survey, with implementation rates ranging from 7% to 97%. The most frequently implemented initiatives were: in the classroom, ‘Permission or breaks to drink water in class time in ≥ 80% of classes daily’ (97%); at school, ‘Install water stations for free access to cooled plain or optionally carbonated water’ (64%); brought to school, ‘Information on healthy eating sent home to parents’ (88%); and outside of school, ‘Healthy eating programs delivered in partnership with community organisations or services’ (31%). Ten initiatives were associated with school size (n = 5), remoteness (n = 7), or socio-economic status (n = 3).

CONCLUSIONS: Implementation rates of the 32 healthy eating initiatives varied substantially, and most initiatives had similar rates across school characteristics (school size, remoteness, socio-economic status). SO WHAT?: This first national study provides crucial information on the implementation of individual healthy eating initiatives in Australian primary schools, highlighting which initiatives and school subgroups require policy and practice investment to support implementation.

PMID:42649102 | DOI:10.1002/hpja.70232

Biol Pharm Bull. 2026;49(8):1285-1290. doi: 10.1248/bpb.b26-00201.

ABSTRACT

Carboplatin (CBDCA) dosing is commonly determined using the Calvert formula, with creatinine clearance (Ccr) estimated by the Cockcroft-Gault formula. In Japan, where serum creatinine (sCr) is usually measured enzymatically, unadjusted Ccr may overestimate glomerular filtration rate and lead to CBDCA overdosing. We retrospectively compared treatment exposure, hematologic toxicity, and exploratory oncologic outcomes in patients with endometrial cancer who received postoperative paclitaxel plus CBDCA therapy. Patients were grouped according to whether CBDCA dosing was based on the conventional Cockcroft-Gault formula (CG group) or on adjusted Ccr calculated by adding 0.2 mg/dL to sCr (adjusted group). The incidence of Grade ≥3 neutropenia was significantly lower in the adjusted group than in the CG group. The 5-year progression-free survival (PFS) rate was numerically lower in the adjusted group than in the CG group, although no statistically significant difference was observed between the groups. Because the number of PFS events was limited, the effect of adjusted Ccr-based dosing on oncologic outcomes remains uncertain. These findings suggest that adjusted Ccr-based dosing may reduce hematologic toxicity in routine clinical practice. However, given the limited number of PFS events and the wide uncertainty in survival estimates, further studies are needed to clarify its impact on oncologic outcomes.

PMID:42649080 | DOI:10.1248/bpb.b26-00201

Aging Cell. 2026 Aug;25(8):e70636. doi: 10.1111/acel.70636.

ABSTRACT

The musculoskeletal system is key to aging. Nonetheless, existing protein-based musculoskeletal aging clocks have limited predictive performance and fail to characterize genetic or environmental determinants. We first constructed a musculoskeletal protein pool by integrating transcriptomic enrichment, protein functional annotation, and literature expertise. Two musculoskeletal aging clocks-MSKAge and MSKAgeMort-were then developed using proteomic data of 21,070 UK Biobank participants. Acceleration metric (MSKAgeAccel/MSKAgeMortAccel) quantified deviations of biological age from chronological age, with positive values indicating accelerated musculoskeletal aging. Associations of MSKAgeAccel/MSKAgeMortAccel with mortality, musculoskeletal disorders, and age-related diseases were assessed using Cox proportional hazards models. Environmental and genetic determinants were evaluated by linear regression and genome-wide association analyses, respectively. Drug repurposing was used to identify potential targets of musculoskeletal diseases. A total of 39 musculoskeletal-related proteins constituted the pool. Leveraging these proteins, MSKAge (r_female = 0.62; r_male = 0.56) and MSKAgeMort (r_female = 0.93; r_male = 0.88) were constructed. Both MSKAgeAccel and (in particular) MSKAgeMortAccel predicted mortality, musculoskeletal diseases, and age-related diseases effectively. MSKAgeMortAccel showed significant associations with musculoskeletal disorders, including osteoarthritis, rheumatoid arthritis, gout, and low back pain. MSKAgeMortAccel was influenced by environmental pollutants, psychological factors, and unhealthy lifestyles. Genetic analyses revealed 13 variants and 71 genes enriched in epigenetic regulation and extracellular environment-receptor interaction. Zinc was identified as a candidate musculoskeletal drug. We established a reliable musculoskeletal aging clock and elucidated genetic and environmental determinants. This framework enables stratification of individuals at risk of accelerated musculoskeletal aging, paving the way for anti-aging interventions.

PMID:42649044 | DOI:10.1111/acel.70636

Environ Health Prev Med. 2026;31:56. doi: 10.1265/ehpm.26-00105.

ABSTRACT

BACKGROUND: As the global population ages, cognitive impairment has become a growing public health concern. Although epidemiological studies have examined its association with mortality, sex-stratified analyses and community-based investigations in elderly Asian men remain scarce. Furthermore, social engagement may confound the association between cognitive impairment and mortality; yet few studies among community-dwelling elderly Asian men have simultaneously examined cognitive impairment and social engagement in relation to all-cause mortality in a prospective cohort design. This study therefore aimed to examine whether cognitive impairment is associated with an increased risk of all-cause mortality independent of social engagement among community-dwelling elderly Japanese men over a 15-year follow-up period.

METHODS: This prospective cohort study enrolled 2,174 men aged ≥65 years. Follow-up assessments were conducted at five, ten, and fifteen years, with all-cause mortality as the primary outcome. Cognitive function was assessed using the Mini-Mental State Examination. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazards models to examine the association between cognitive function and all-cause mortality. Confounder-adjusted Kaplan-Meier survival curves were generated using inverse probability of treatment weighting.

RESULTS: The final analytic sample comprised 1,741 men. High social engagement was associated with a lower risk of all-cause mortality. Compared with participants with normal cognitive function, the hazard ratios (HRs) for all-cause mortality were 1.29 (95% CI: 1.06-1.56) for mild cognitive impairment and 1.59 (95% CI: 1.10-2.29) for severe cognitive impairment, after adjusting for potential confounding factors including social engagement.

CONCLUSIONS: Cognitive impairment independently predicts an increased risk of all-cause mortality in community-dwelling elderly Japanese men.

PMID:42649026 | DOI:10.1265/ehpm.26-00105

J Cardiothorac Vasc Anesth. 2026 Aug 9:S1053-0770(26)00790-1. doi: 10.1053/j.jvca.2026.08.124. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate the clinical significance of thromboelastography-activated clotting time (T-ACT) measured after weaning from cardiopulmonary bypass (CPB), particularly its potential to predict the need for blood transfusion and guide transfusion strategies in pediatric cardiac surgery.

DESIGN: Retrospective observational study.

SETTING: A single tertiary university hospital operating room.

PARTICIPANTS: 218 pediatric patients aged <7 years scheduled for elective cardiac surgery using CPB.

MEASUREMENTS AND MAIN RESULTS: After weaning from CPB and protamine administration, thromboelastography analysis and laboratory tests (including coagulation and blood count tests) were performed. Univariate analysis using the Spearman rank correlation coefficient was employed to evaluate associations between T-ACT and intraoperative patient and surgical variables measured after weaning from CPB. T-ACT showed negative correlations with platelet count, fibrinogen levels, prothrombin time, citrated rapid thromboelastography maximum amplitude, and citrated functional fibrinogen maximum amplitude. Multivariate regression using the forced-entry method included variables with p < 0.10 in the univariate analyses. The fibrinogen level, prothrombin time, and citrated functional fibrinogen maximum amplitude were statistically significant (p < 0.05). Hypofibrinogenemia detection was identified as particularly important for predicting coagulation disorders after weaning from CPB. Receiver operating characteristic analysis of T-ACT for discriminating intraoperative fibrinogen ≤150 mg/dL yielded a cutoff value of 158.1 seconds (area under the curve: 0.84; p < 0.0001).

CONCLUSIONS: In pediatric patients undergoing cardiac surgery with CPB, intraoperative T-ACT measured after weaning from CPB correlated with fibrinogen concentration, and T-ACT prolongation may discriminate hypofibrinogenemia.

PMID:42649009 | DOI:10.1053/j.jvca.2026.08.124

Eur Urol Focus. 2026 Aug 26:S2405-4569(26)00163-X. doi: 10.1016/j.euf.2026.07.012. Online ahead of print.

ABSTRACT

BACKGROUND: The artificial urinary sphincter (AUS) is the most common surgical procedure for persistent stress urinary incontinence (SUI) after prostate surgery, whereas the male sling is a newer alternative.

OBJECTIVE: To compare the 24-mo outcomes of the sling versus the AUS.

DESIGN, SETTINGS, AND PARTICIPANTS: This was an unblinded, noninferiority randomised controlled trial including men from 27 UK urological centres with bothersome urodynamic SUI after prostate surgery.

INTERVENTION: Men were randomised to receive a transobturator sling (n = 190) or an AUS (n = 190). Randomisation was minimised by type of surgery (radical prostatectomy/transurethral resection of the prostate), previous radiotherapy for prostate cancer (yes/no), and centre.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary outcome was self-reported continence (a composite outcome derived from two items in the validated International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form [ICIQ-UI SF]) at 12 mo after randomisation, with a noninferiority margin of 15%, via postal questionnaire. The secondary outcomes were self-reported continence, further treatments, patient-reported measures and serious adverse events up to 24 mo.

RESULTS AND LIMITATIONS: A total of 380 participants were included. In terms of continence, the sling was noninferior to the AUS at 24 mo (estimated absolute risk difference in the intention-to-treat analysis, -0.006; 95% confidence interval [CI], -0.092 to 0.080; noninferiority p = 0.001), indicating lower success in the sling group, but with a CI excluding the noninferiority margin. Incontinence symptom scores (ICIQ-UI SF) decreased from 16.1 and 16.4 at baseline to 7.9 and 7.1 in the sling and AUS groups, respectively. The mean difference was 1.4 (95% CI, 0.2-2.6; p = 0.024). Secondary outcomes favoured the AUS over the sling. By 24 mo, more men underwent further surgery after receiving a sling (n = 20, 11%) than after receiving an AUS (n = 4, 2%).

CONCLUSIONS: The 24-mo results confirm that the sling is noninferior to the AUS. Symptoms and quality of life significantly improved in both groups. Overall, secondary and post hoc analyses favour the AUS.

PATIENT SUMMARY: Continence levels and symptoms improve with both surgeries. Most men are satisfied with their surgery, despite not being completely dry. Almost all other results show that men who have an artificial urinary sphincter have better outcomes than those who have a sling. Trial registration International Randomised Controlled Trial Registry, ISRCTN49212975. This trial was registered on July 22, 2013, and participants were randomised between January 29, 2014, and December 28, 2017.

PMID:42648940 | DOI:10.1016/j.euf.2026.07.012

Hand (N Y). 2026 Aug 26:15589447261476242. doi: 10.1177/15589447261476242. Online ahead of print.

ABSTRACT

BACKGROUND: Threaded intramedullary nails offer a fixation option for proximal phalanx fractures with the advantage of immediate mobilization, avoiding secondary hardware removal, and decreased complications associated with exposed pins. There are currently limited data comparing the strength of intramedullary devices across various configurations with the traditional fixation method of Kirschner wires (K-wires). This study compared the biomechanical strength of intramedullary nail fixation (INF) in an “I,” “Y,” or “X” configuration or 2 Kirschner wires in an “X” configuration for transverse proximal phalanx fractures.

METHODS: Forty cadaveric proximal phalanges with simulated transverse fractures were randomized to 1 of 4 fixation groups: INF in an “I,” “Y,” or “X” configuration or 2 K-wires in an “X” configuration. The specimens were subjected to apex dorsal 3-point bending to failure using servohydraulic testing. Peak load to failure and stiffness were recorded. Analysis of variance was used to compare means between groups.

RESULTS: No statistically significant differences in mean peak load to failure were detected between groups. Stiffness differed among groups, with the INF “X” configuration producing the stiffest construct (mean stiffness, 210 N/mm), significantly stiffer than all other groups. The second stiffest construct was the INF “Y” configuration (150.9 N/mm), which was significantly higher than both the INF “I” construct (107.7 N/mm) and the K-wire construct (91.8 N/mm). There was no significant difference between the INF “I” construct and the K-wire construct.

CONCLUSION: Threaded INF in “X” or “Y” configurations offers superior stiffness compared to K-wire and “I” INF for proximal phalanx fractures.

PMID:42648891 | DOI:10.1177/15589447261476242

Anal Chim Acta. 2026 Oct 22;1420:345982. doi: 10.1016/j.aca.2026.345982. Epub 2026 Jul 16.

ABSTRACT

BACKGROUND: Untargeted LC-MS metabolomics converts chromatographic ion signals into feature tables used for downstream comparison, annotation, and biomarker discovery. However, widely used preprocessing workflows often return discordant feature lists and missingness patterns from the same raw data, limiting reproducible quantitative interpretation. Continuous wavelet transform (CWT)-based peak detection is central to several workflows, yet its scale-normalization convention was inherited from energy-preserving signal analysis rather than area-oriented chromatographic integration. The problem addressed here is whether CWT normalization itself creates scale-selection and integration-boundary bias in LC-MS feature-table construction.

RESULTS: Under a Gaussian reference peak model with a Mexican-hat wavelet, amplitude-preserving 1/a normalization produced a defined optimum at a = √2σ and model-derived integration boundaries at ±3σ, supporting area-oriented peak integration. We implemented this correction in MetaboQuality with shape-driven grouping and anchor-guided recovery, then evaluated it using authentic standards, pooled-QC replicates, public QC data, component ablation, comparator sensitivity, decoy controls, non-Gaussian simulations, and chemical-reference validation. In the primary pooled-QC benchmark before post-detection filling, MetaboQuality produced 4029 complete groups with RSD <30%, compared with 2461 for XCMS and 1672 for MZmine 4. At the stricter RSD <10% threshold, MetaboQuality yielded 931 complete groups before filling versus 526 for the XCMS reference branch; after filling, MetaboQuality yielded 973 groups, compared with 678 for XCMS and 748 in the XCMS fitgauss sensitivity run.

SIGNIFICANCE AND NOVELTY: The novelty lies in defining CWT normalization as an LC-MS-specific peak-integration determinant rather than a generic signal-processing detail. MetaboQuality links amplitude-preserving integration, shape-driven grouping, and anchor-guided recovery into a coordinated workflow, providing a principled route to more complete and reproducible feature tables without relying on unconstrained statistical imputation. This clarifies where algorithmic design can improve measurement consistency.

PMID:42648851 | DOI:10.1016/j.aca.2026.345982

Anal Chim Acta. 2026 Oct 22;1420:345957. doi: 10.1016/j.aca.2026.345957. Epub 2026 Jul 13.

ABSTRACT

Currently, there is an increasingly urgent need of high-efficient chemosensors for detecting highly toxic chromium ions (Cr³⁺ and Cr₂O₇^2-). Herein we propose an innovative lanthanide-based fluorescence sensing material, i.e., terbium coordination hybrid nanoparticles (6-MP)_0.01CF_0.004/Tb₁ that are obtained based on the coordination self-assembly strategy. Its terbium luminescence is strongly associated with the ligand-assisted terbium sensibilization energy transfer approach that is sensitive to specific inorganic stimuli. It is further revealed that (6-MP)_0.01CF_0.004/Tb₁ can be served as a real-time, selective, competitive and quantitative fluorescence chemosensor to detect Cr³⁺, Cr₂O₇^2-, and NO₂^– in aqueous solutions based on the quenched fluorescence of hybrid. Using statistical analysis methods, the hybrid (6-MP)_0.01CF_0.004/Tb₁ even can discriminate several groups of cation or anion analogues, especially Cr³⁺ and Cr₂O₇^2- that are distinguished from each other by the pH regulation. Moreover, this hybrid enables operators to monitor different contents of Cr³⁺, Cr₂O₇^2-, and NO₂^– in real water samples. This study not only develops a novel luminescent lanthanide-based hybrid but also provides a promising fluorescence sensing platform for multianalyte detection of toxic Cr³⁺, Cr₂O₇^2-, and NO₂^– in potential fields.

PMID:42648834 | DOI:10.1016/j.aca.2026.345957