Category: Statistics

JAMA Netw Open. 2026 Apr 1;9(4):e265061. doi: 10.1001/jamanetworkopen.2026.5061.

ABSTRACT

IMPORTANCE: Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer for which current guidelines recommend adjuvant chemotherapy. Data about the benefit of adjuvant chemotherapy in older women with TNBC are scarce.

OBJECTIVE: To assess the survival benefit of adjuvant chemotherapy in older women with nonmetastatic TNBC.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective population-based cohort study used the Surveillance, Epidemiology, and End Results database from January 1, 2010, to December 31, 2021. Participants included women 70 years or older with nonmetastatic TNBC who underwent surgical removal of breast tumor and were candidates for adjuvant chemotherapy. The median follow-up was 46 (IQR, 21-83) months. Statistical analysis was conducted on August 4, 2025.

EXPOSURE: Receipt or nonreceipt of adjuvant chemotherapy.

MAIN OUTCOMES AND MEASURES: The primary outcome was breast cancer-specific survival between patients who received chemotherapy and those who did not. Logistic regression models assessed variables associated with chemotherapy use. Machine learning with a generalized boosted model was used to estimate propensity scores. Inverse probability of treatment weighting and Cox proportional hazards regression methods were used to compare breast cancer-specific and overall survival.

RESULTS: A total of 5730 women (median age, 76 [IQR, 73-81] years) were included in the analysis; 2509 received chemotherapy and 3221 did not. Patients who received chemotherapy were younger (median age, 74 [IQR, 71-77] vs 79 [IQR, 74-84] years) and had more advanced disease (stage II-III, 1388 [54%.5] vs 1664 [51.7%]) than those who did not. Adjuvant chemotherapy was associated with improved breast cancer-specific survival (hazard ratio [HR], 0.69; 95% CI, 0.58-0.82) and overall survival (HR, 0.55; 95% CI, 0.49-0.62). Similar results were observed across subgroups. Increasing age (odds ratio [OR] for 80-89 years, 0.15 [95% CI, 0.13-0.17]; OR for ≥90 years, 0.02 [95% CI, 0.01-0.04]) was associated with lower odds of receiving adjuvant chemotherapy.

CONCLUSIONS AND RELEVANCE: In this cohort study of older women with TNBC, adjuvant chemotherapy was associated with improved survival outcomes. Underutilization of adjuvant chemotherapy in older women may contribute to worse outcomes. Geriatric assessment tools may help guide individualized treatment decisions and promote equitable care.

PMID:41941187 | DOI:10.1001/jamanetworkopen.2026.5061

Psychol Methods. 2026 Apr 6. doi: 10.1037/met0000829. Online ahead of print.

ABSTRACT

In recent years, there has been a growing call to advance psychological theorizing through formal modeling. We answer this by introducing a methodology for developing psychological theories using probabilistic network models (PNMs). Originating in statistical mechanics, PNMs describe networks of interacting elements and have already shaped prominent theories in attitude, emotion, and decision research. We present a systematic guide on how to develop, analyze, and validate PNMs. Central to our framework is a review of nine foundational models that researchers can start from, extend, and adapt to their specific contexts. For each of these models, we discuss existing applications and analyze them using two newly developed tools: a NetLogo model for simulations and an R package for visualizing mean-field dynamics. As a case study, we demonstrate the application of PNMs in theory development before discussing the assumptions and limitations of the framework. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PMID:41941158 | DOI:10.1037/met0000829

Psychol Methods. 2026 Apr 6. doi: 10.1037/met0000820. Online ahead of print.

ABSTRACT

Semantic richness refers to the number of distinct features people associate with a concept, a key indicator of how knowledge is represented and accessed in memory. It is typically measured through free-generation tasks-such as the property listing task-where participants list properties of everyday concepts (e.g., a BANANA might be described as “yellow,” “soft,” or something you “peel”). However, most studies simply count the observed features, ignoring sampling variability and leading to biased comparisons across groups. To address this limitation, we adapted the Chao2 estimator-originally developed in ecology-to infer the total number of features associated with a concept, including those not observed in a given sample. We validated this approach for psychological research through extensive Monte Carlo simulations based on empirical data from three languages. Results show that Chao2, and especially its bias-corrected version (Chao2BC), yield more accurate and interpretable estimates than simple counts. This framework reframes semantic richness as a problem of statistical inference, providing a principled basis for comparing conceptual data across languages, populations, and experimental contexts. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PMID:41941157 | DOI:10.1037/met0000820

Infect Dis (Lond). 2026 Apr 6:1-12. doi: 10.1080/23744235.2026.2651975. Online ahead of print.

ABSTRACT

OBJECTIVES: Research on Severe Fever with Thrombocytopenia Syndrome (SFTS) in Qingdao, an emerging public health threat, remains limited. This study aimed to systematically characterise its epidemiological features, identify spatiotemporal clustering patterns and develop a time-series prediction model to inform targeted prevention and control strategies.

METHODS: SFTS case data in Qingdao from 2014 to 2025 were acquired from the China Information System for Disease Control and Prevention. Spatial autocorrelation analysis, encompassing both global and local assessments, was performed using ArcGIS 10.8. The identification of spatiotemporal clusters was carried out with SatScan version 9.6. Furthermore, a Seasonal Autoregressive Integrated Moving Average (SARIMA) model was developed utilising R software (version 4.4.2) for time-series forecasting.

RESULTS: From 2014 to 2025, 711 SFTS cases were reported in Qingdao, corresponding to an average annual incidence of 0.61 per 100,000 population. There were 28 deaths, yielding a case fatality rate of 3.94%. Cases showed strong seasonality, with 99.16% occurring between April and October, predominantly among elderly farmers. Incidence exhibited positive spatial autocorrelation, with high-high clusters primarily concentrated in Huangdao District in the southern part of Qingdao. Spatiotemporal scan analysis identified three significant clusters located in the southern, northeastern and southwestern regions. The SARIMA model indicates that the number of cases is projected to exhibit an increasing trend beyond 2025.

CONCLUSION: SFTS in Qingdao exhibits obvious spatiotemporal clustering, and the number of cases continues to show an increasing trend.

PMID:41941155 | DOI:10.1080/23744235.2026.2651975

Psychol Trauma. 2026 Apr 6. doi: 10.1037/tra0002178. Online ahead of print.

ABSTRACT

OBJECTIVE: Posttraumatic growth refers to positive psychological changes following traumatic experiences. As research interest in posttraumatic growth increases, new tools for its measurement are being developed. However, concerns have been raised about the potential for illusory growth, which may inflate self-reported posttraumatic growth levels. To address this issue, the Stress-Related Growth Scale-Revised (SRGS-R) was created, using neutral item wording and a bipolar response scale to reduce response bias. This is the first time that the SRGS-R has been adapted and psychometrically validated outside its original English-language version.

METHOD: The adaptation procedure followed international recommendations and the methodology of the original SRGS-R study. Data were collected online from 636 Polish adults aged 18-72 who had experienced at least one Diagnostic and Statistical Manual of Mental Disorders, fifth edition-defined traumatic event, verified using the Life Events Checklist-5. Participants were randomly divided into two subsamples for exploratory (n = 309) and confirmatory (n = 327) factor analyses. In addition to the SRGS-R-PL, participants completed standardized Polish adaptations of instruments assessing posttraumatic stress disorder symptoms, coping strategies, depressive symptoms, and well-being.

RESULTS: Factor analysis confirmed a unidimensional structure explaining 53.97% of the variance, with good model fit. The SRGS-R-PL demonstrated high internal consistency (Cronbach’s α = .94) and theoretically consistent correlations with mental health measures and coping strategies.

CONCLUSIONS: The Polish version of the SRGS-R shows strong psychometric properties and validity, providing a reliable tool for assessing growth following stress or trauma. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PMID:41941139 | DOI:10.1037/tra0002178

Psychol Trauma. 2026 Apr 6. doi: 10.1037/tra0002159. Online ahead of print.

ABSTRACT

OBJECTIVE: Veterans with comorbid posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) often experience more severe symptoms, functional impairments, challenges in treatment engagement, and worse treatment outcomes than veterans with either disorder alone. Although topiramate is an effective pharmacotherapy for AUD and has shown promise in reducing PTSD symptoms, concerns about its potential cognitive side effects may deter prescribing providers and contribute to patient hesitancy. This study aimed to determine whether topiramate leads to adverse cognitive side effects that could impede its suitability to be used in tandem with prolonged exposure for PTSD and AUD.

METHOD: Data were analyzed from a double-blind, placebo-controlled trial in which 100 veterans with PTSD and AUD were randomized to receive prolonged exposure with either topiramate or placebo. Cognitive functioning was assessed at baseline and midtreatment, and PTSD symptoms were assessed at baseline and posttreatment.

RESULTS: Results showed no statistically significant differences between treatment groups in verbal learning and memory or processing speed performance at either time point, and all scores were within normal clinical ranges.

CONCLUSIONS: While minor declines in some cognitive domains were observed in both the topiramate and placebo groups, these changes were nonsignificant and not clinically meaningful (<1 standard deviation change). These findings suggest that topiramate does not produce clinically significant cognitive impairment when combined with prolonged exposure and may enhance treatment response. Future research should examine the long-term cognitive and therapeutic effects of topiramate to guide shared decision making and optimize integrated treatment for veterans with PTSD and AUD. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PMID:41941133 | DOI:10.1037/tra0002159

J Craniofac Surg. 2026 Apr 6. doi: 10.1097/SCS.0000000000012734. Online ahead of print.

ABSTRACT

Rhinoplasty is the fifth most commonly performed cosmetic surgery globally. While surgical techniques used for rhinoplasty have evolved significantly in the past century, the creation of precise osteotomies remains a cornerstone of the procedure. Recently, piezotomes have been associated with reduced postoperative pain, edema, ecchymosis, complications, and revision rates in rhinoplasty. Despite these clinically significant benefits, there remains a paucity of histologic analysis of osteotomies performed with piezotomes in a large translational preclinical model. In this study, n=12 adult sheep underwent lateral rhinoplasty of the posterior maxilla using each of the three surgical devices: piezotome, manual osteotome, and oscillatory saw. Subjects were randomized to heal for either 3 or 12 weeks postoperatively (n = 6 animals per cohort). En bloc samples were processed and analyzed histologically. A semiquantitative healing scale was used to quantify bony ingrowth into the osteotomy. Wilcoxon signed-rank tests were used to analyze the outcome variable. No statistically significant differences in semiquantitative grades were observed among groups (p > 0.05) at either time point. However, the piezotome was associated with more uniform, reproducible, and smoother osteotomy walls, and smaller bone chips at 3 weeks. At 12 weeks, all osteotomy techniques had complete or near-complete osteogenesis. Use of the piezotome did not completely prevent soft tissue injury. Some osteotomies demonstrated full-thickness penetration and injury to the underlying cartilage. All groups demonstrated comparable healing outcomes after 12 weeks. However, histologic results indicate that reliance solely on device technology may not be sufficient. Clinical judgement of these techniques and relevant case presentations is required to minimize unintended tissue injury.

PMID:41941121 | DOI:10.1097/SCS.0000000000012734

Alcohol Clin Exp Res (Hoboken). 2026 Apr;50(4):e70278. doi: 10.1111/acer.70278.

ABSTRACT

BACKGROUND: Alcohol use disorder (AUD) is associated with increased risks of some neuropsychiatric conditions and early-onset dementia. However, the association between Alzheimer disease (AD) and AUD is poorly characterized. To address this, we studied associations between AUD, cognition, and measures of AD neuropathology.

METHODS: We measured a lifetime history of AUD, cognitive decline, and blood biomarkers for AD in middle-aged and older participants (47-87 years) from the St. Louis site of the Collaborative Study on the Genetics of Alcoholism (COGA) (N = 392). Cognitive decline was measured using the Eight-item Informant Interview to Differentiate Aging and Dementia (AD8) (N = 366); 154 individuals had AD biomarkers derived from plasma measurements (Amyloid Probability Score 2, Aβ42/Aβ40, and %p-tau217). We used Poisson regression models to evaluate the relationship between AUD, age, and cognitive decline. AUD was categorized as no AUD, mild AUD, or moderate-to-severe AUD, and age was modeled as a piecewise linear variable segmented by decade. Linear regressions were used to assess the association between AD blood biomarkers and AUD.

RESULTS: Analyses revealed a significant association between moderate-to-severe AUD and increased cognitive decline in middle-aged and older adults (RR = 1.4, p < 0.001). While a greater proportion of participants with moderate-to-severe AUD met the Aβ42/Aβ40 threshold for predicting elevated brain amyloid compared to those with mild or no AUD, consistent with our hypothesis, this trend did not achieve statistical significance.

CONCLUSIONS: These results underscore the importance of addressing AUD as a potentially modifiable risk factor for cognitive decline in middle aged and older adults. Further study is needed to understand the link between AUD and AD biomarkers.

PMID:41941099 | DOI:10.1111/acer.70278

Clin Rheumatol. 2026 Apr 6. doi: 10.1007/s10067-026-08032-y. Online ahead of print.

ABSTRACT

INTRODUCTION/OBJECTIVES: To evaluate the impact of BA.5.2/BF.7 infections on the severity of systemic lupus erythematosus (SLE) and to identify associated risk factors.

METHODS: A cross-sectional study was conducted from January 6 to February 19, 2023. The study population included SLE patients and healthy controls infected with the BA.5.2/BF.7 variants. Odds ratios (ORs), risk differences (RDs), and their corresponding 95% confidence intervals (CIs) were calculated to assess the effects of infection on SLE severity and to explore related risk factors.

RESULTS: A total of 1,013 SLE patients and 2,125 healthy controls who were infected with BA.5.3/BF.7 were enrolled in the study. After adjusting for age, sex, comorbidities, and vaccination status, SLE was significantly associated with an increased risk of COVID-19 hospitalization (adjusted OR [aOR] 6.13, 95% confidence interval [CI] 3.06 to 12.27, p < 0.001). Among SLE patients, COVID-19 infection was associated with an increased risk of rash (risk difference [RD] 4.0%, 95% CI 1.5 to 6.6; p = 0.002), alopecia (RD 4.2%, 95% CI 0.9 to 7.6; p = 0.016), and mucosal ulcers (RD 3.3%, 95% CI 0.8 to 5.7; p = 0.012). Among SLE patients, the use of mycophenolate mofetil (MMF) was significantly associated with an increased risk of COVID-19 hospitalization (aOR 1.99, 95% CI 1.06 to 3.74; p = 0.033).

CONCLUSIONS: These findings highlight the importance of a nuanced approach in managing SLE patients with COVID-19. Key Points • The COVID-19 pandemic spread widely across China. However, the impact of systemic lupus erythematosus (SLE) medications on COVID-19-related hospitalization remains unclear. • Our study found that treatment with mycophenolate mofetil in SLE patients was associated with a higher risk of hospitalization for COVID-19. • These findings should alert policymakers and clinicians to the need for a more nuanced and cautious approach when managing SLE patients infected with the Omicron BA.5.2 or BF.7 subvariants.

PMID:41941087 | DOI:10.1007/s10067-026-08032-y

Saudi Dent J. 2026 Apr 6;38(4):44. doi: 10.1007/s44445-026-00155-x.

ABSTRACT

This randomized controlled trial aimed to compare the clinical and radiographic success rates of bacterial cellulose-reinforced MTA (BC-MTA) and conventional MTA in indirect pulp capping (IPT) treatment of primary teeth. A total of 40 primary molars diagnosed for IPT were randomly allocated into two groups: Group I (BC-MTA, n = 20) and Group II (Conventional MTA, n = 20). IPT procedures were carried out under aseptic conditions following local anesthesia, and teeth were restored with glass ionomer cement (GIC). Follow-up evaluations were performed clinically and radiographically at 3 and 9 months postoperatively. Data were analyzed using IBM SPSS Statistics 20, applying descriptive statistics, Chi-square, and independent t-tests (p < 0.05). At the end of 9 months, 75% of cases reported complete pain relief. Internal root resorption was observed in two teeth in Group I. Overall success rates at 9 months were 88.23% for BC-MTA and 100% for conventional MTA. Both BC-MTA and MTA showed favorable and comparable outcomes in IPT of primary teeth. While BC-MTA demonstrates potential due to its biocompatibility and improved handling characteristics, further studies are needed to validate its long-term clinical efficacy.Trial Registration: Ethical clearance was granted by SRM University IEC (SRMIEC-ST0323-442) and registered retrospectively in CTRI (CTRI/2024/12/077670).

PMID:41941071 | DOI:10.1007/s44445-026-00155-x