Category: Statistics

Neuroradiol J. 2026 May 11:19714009261450379. doi: 10.1177/19714009261450379. Online ahead of print.

ABSTRACT

BackgroundThis study aims to assess whether T2 relaxometry can distinguish tissue characteristics between high-grade gliomas and non-infiltrative lesions.MethodsWe report our initial experience using the Relaxo LNI software to analyze multi-echo T2 relaxometry magnetic resonance imaging in patients with high-grade gliomas. For comparison, peritumoral T2-hyperintense areas in meningiomas and metastases were used as reference regions for vasogenic edema, based on the established concept that these tumor types typically do not infiltrate adjacent tissue. In contrast, peritumoral hyperintensity observed in high-grade gliomas may represent either vasogenic edema or tumor infiltration.ResultsData from 30 patients were analyzed, including 20 with high-grade gliomas and 10 with metastasis or meningiomas. A statistically significant difference was observed in multi-echo T2 relaxation values between the glioma and non-glioma groups (p < 0.05). Mean T2 relaxation times were longer in the high-grade glioma group than in the non-glioma group (p < 0.05). Within the high-grade glioma group, central regions showed significantly longer mean relaxation times than peripheral regions (p < 0.05).ConclusionOur preliminary findings suggest that T2 relaxometry identifies differences in relaxation profiles between tumor tissue and control edema, indicating potential value in detecting variations in peritumoral tissue composition in high-grade gliomas. However, these results are exploratory and hypothesis-generating, lack histopathological validation, and require further investigation to clarify the role of T2 mapping in preoperative planning.

PMID:42109220 | DOI:10.1177/19714009261450379

Adv Sci (Weinh). 2026 May 11:e75533. doi: 10.1002/advs.75533. Online ahead of print.

ABSTRACT

Spatial multi-omics technologies enable in situ molecular profiling but face challenges in integrating multi-modal data for spatial domain identification and cell heterogeneity analysis. We propose SOTMGF, a self-supervised, goal-directed multi-view graph fusion framework for spatial multi-omics data. SOTMGF includes five modules: pre-clustering, sparse feature processing, multi-view feature extraction and fusion (integrating molecular expression, spatial location, disease microenvironment, and molecular associations), and multi-modality integration. The self-training process and graph embedding are optimized iteratively within a unified framework, enabling mutual benefits across several components. SOTMGF outperformed existing methods in spatial domain identification, data denoising, and detection of spatially variable molecular features. Innovatively, it jointly analyzes spatial transcriptomics (ST) and proteomics (SP) from the same tissue, computationally generates spatial ATAC-seq via Tangram, reconstructs spatial pseudo-expression to identify spatial dark genes/proteins (SDGs/SDPs), and iteratively optimizes self-training and graph embedding in a unified framework. SOTMGF outperforms existing methods in spatial domain detection and denoising, reveals mRNA-protein discordance, predicts key transcription factors, and aids biomarker and therapeutic target discovery, advancing spatial biology research, molecular regulatory mechanisms, and therapeutic discovery.

PMID:42109219 | DOI:10.1002/advs.75533

J Med Internet Res. 2026 May 11. doi: 10.2196/93349. Online ahead of print.

ABSTRACT

BACKGROUND: Artificial intelligence (AI)-themed delusions are increasingly observed in psychotic-spectrum disorders, reflecting the incorporation of contemporary sociotechnical elements into delusional systems. While prior research has examined the phenomenology of technology-related delusions, it remains unclear whether the structural role of AI within these belief systems (particularly when AI occupies a central, organizing function) is associated with increased violence risk or more restrictive forensic outcomes. Given the importance of dynamic clinical factors such as insight and treatment adherence in forensic risk assessment, clarifying the role of AI centrality has clinical and legal relevance.

OBJECTIVE: This study aimed to examine whether centrality of AI within psychotic delusional systems is associated with (1) violence toward others and (2) judicial findings of significant public safety risk in forensic psychiatric decisions.

METHODS: We conducted a retrospective observational study using jurisprudential data from the Société québécoise d’information juridique (SOQUIJ) database, including all publicly available Quebec tribunal and court decisions up to December 31, 2025. Eligible cases involved psychotic-spectrum disorders with explicit AI-related delusional content and judicial consideration of dangerousness or disposition. The unit of analysis was the judicial decision. A total of 29 judgments were included. AI centrality was coded as central (n=15) or non-central (n=14) using a structured, text-based framework. Primary outcome was documented violence toward others; secondary outcomes included direct AI-violence attribution and judicial findings of significant public safety risk. Covariates included lack of insight, treatment nonadherence, substance use disorder, and prior violence history. Data were extracted through full-text review using a standardized coding grid. Bivariate associations were analyzed using Fisher exact tests (α=.05), and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Exploratory logistic regression models were performed to assess adjusted associations.

RESULTS: Violence toward others was documented in 20/29 cases (69.0%; 95% CI 50.3-83.1). AI centrality was not significantly associated with violence (12/15 [80.0%; 95% CI 54.8-93.0] vs 8/14 [57.1%; 95% CI 32.6-78.6]; OR 2.91, 95% CI 0.63-13.45; P=.26). However, AI centrality was strongly associated with direct AI-violence attribution (9/15 [60.0%] vs 2/14 [14.3%]; OR 9.00, 95% CI 1.48-54.6; P=.014). Judicial findings of significant public safety risk were more frequent in AI-central cases (13/15 [86.7%] vs 9/14 [64.3%]; OR 3.60, 95% CI 0.63-20.5; P=.24), although not statistically significant. AI-central cases demonstrated higher prevalence of impaired insight (13/15 [86.7%] vs 8/14 [57.1%]; OR 4.89, 95% CI 0.79-30.1) and treatment nonadherence (9/15 [60.0%] vs 4/14 [28.6%]; OR 3.75, 95% CI 0.74-18.9).

CONCLUSIONS: AI centrality within delusional systems appears to be not independently associated with increased violence toward others but was strongly associated with AI-based attribution of behavior and markers of epistemic vulnerability, including impaired insight and treatment nonadherence. This study is innovative in operationalizing the structural role of AI within delusions using real-world forensic data, rather than focusing solely on thematic content. Unlike prior phenomenological or case-based research, it integrates jurisprudential analysis with quantitative risk modeling. These findings suggest that AI-themed delusions function as structural organizers of meaning and agency rather than novel criminogenic risk factors. Clinically and legally, this underscores the importance of prioritizing dynamic risk variables over thematic novelty, informing more proportionate forensic decision-making and risk assessment in an era of rapidly evolving digital environments.

PMID:42109215 | DOI:10.2196/93349

Eur J Pain. 2026 May;30(5):e70291. doi: 10.1002/ejp.70291.

ABSTRACT

BACKGROUND: Spinal disorders are associated with substantial healthcare costs, but prognostic factors associated with high spine-related healthcare expenditures remain insufficiently understood. Therefore, this study aimed to identify prognostic factors associated with spine-related healthcare costs among patients with spinal disorders.

METHODS: A prognostic factor study using data from the Norwegian Neck and Back Registry was conducted. Thirty-four potential prognostic factors were considered. Spine-related healthcare costs were analyzed as a continuous outcome. Continuous predictors were modelled using restricted cubic splines to account for potential non-linear associations. Univariable and multivariable adjusted models were fitted, with priori defined covariate adjustments.

RESULTS: The study included 7877 patients with spinal pain. In adjusted models, healthcare region (patients from the Mid-Norway, West and Southeast regions incurred 69.1%, 44.5% and 29.6% higher costs, respectively, compared with those in the North), disability (90th vs. 10th percentile: +29.2%; CI +11.9% to +49.2%), pain during activity (90th vs. 10th percentile: +23.4%; CI +7.6% to +41.6%), health-related quality of life (90th vs. 10th percentile: -21.3%; CI -31.1% to -10.0%), job satisfaction (90th vs. 10th percentile: +14.7%; CI +2.3% to +28.7%), and opioid use (+15.3%; CI +5.7% to +26.2%) were associated with healthcare costs.

CONCLUSIONS: This set of identified prognostic factors may be useful for characterizing patient subgroups, developing prognostic models to identify individuals at risk of high healthcare expenditures, and informing strategies to improve the efficiency and equity of healthcare resource allocation.

SIGNIFICANCE: This study identifies clinical and societal determinants of health associated with high spine-related healthcare costs, highlighting how these factors jointly drive resource use. These findings help clarify mechanisms underlying cost variation and support the future development of prognostic tools and targeted strategies to improve efficiency and equity in spine care.

PMID:42109197 | DOI:10.1002/ejp.70291

Phlebology. 2026 May 11:2683555261451555. doi: 10.1177/02683555261451555. Online ahead of print.

ABSTRACT

BackgroundLipedema is an adipose disorder associated with multiple impairments. Conservative treatments remain the mainstay of management, yet evidence regarding the effects of physical therapies on clinical, imaging, and body composition outcomes is limited. Radial extracorporeal shock wave therapy (rESWT) has been proposed as a non-invasive therapeutic option, although its impact is not fully established.MethodsThis was a prospective, longitudinal, within-patient study conducted in women with clinically diagnosed lipedema. One lower limb was treated with radial extracorporeal shock wave therapy (rESWT), whereas the contralateral limb served as an internal control. A total of 16 patients were initially assessed, of whom 12 completed the full follow-up and were included in the final analysis. rESWT was applied over six sessions (two sessions per week) using standardized parameters. Clinical outcomes (LEFS, EQ-5D, SF-36 Physical Function, and IPAQ) were assessed at baseline, 6 weeks, and 3 months. Ultrasound and elastography were used to evaluate subcutaneous tissue thickness and stiffness at predefined leg and thigh sites, while segmental bioimpedance analysis assessed body composition and fluid distribution. Longitudinal changes were analyzed using mixed-effects models.ResultsSignificant improvements were observed in functional capacity, quality of life, and physical activity levels at both 6 weeks and 3 months compared with baseline (p < .05). In contrast, no statistically significant changes were detected in ultrasound-derived tissue thickness, elastography measurements, or bioimpedance parameters over time, and no significant differences were detected between treated and control limbs within the constraints of the available sample size.ConclusionsrESWT was associated with meaningful clinical and functional improvements in patients with lipedema, despite the absence of detectable changes in tissue thickness, stiffness, or body composition. These findings suggest that the benefits of rESWT may be mediated through symptom modulation and functional adaptation rather than structural tissue modification, supporting its role as part of conservative, symptom-oriented treatment strategies in lipedema.

PMID:42109195 | DOI:10.1177/02683555261451555

Int J Health Plann Manage. 2026 May 11. doi: 10.1002/hpm.70084. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: The performance of healthcare organisations with their considerably complex structures is often on the agenda due to limited resources. Service quality, commonly assessed using the SERVQUAL scale, represents a key performance dimension in healthcare delivery. This paper aims to investigate the extent of meeting the expectations in health service provision in Turkiye and countries in Asia.

METHODS: We searched electronic databases, namely Web of Science, Google Scholar, PubMed, and Turkish Council of Higher Education National Thesis Centre, to find relevant and accessible English and Turkish studies published until 1 January 2023. Eligible studies were empirical research conducted in healthcare settings using the SERVQUAL scale and reporting expectation-perception gaps. Mean differences with 95% confidence intervals were calculated. Heterogeneity was assessed using the I² and τ² statistics, and publication bias was evaluated using funnel plots and Egger’s test.

RESULTS: A total of 47 studies (N = 13,581) were included. The highest quality gap occurred in the responsiveness (0.59) and reliability (0.54) dimensions. Patients had high levels of expectations from healthcare organisations in all five subdomains examined for both Turkiye and other Asian countries.

CONCLUSION: Highly significant quality gaps in the examined domains emphasise the need for improvements in appropriate and quality service delivery and the implementation of compassionate patient-centred approaches. We have concluded that healthcare managers and decision-makers should regularly monitor the quality level of provided healthcare services, find the gaps that need to be improved, and better understand how client expectations in healthcare might be shaped in different settings and countries. Limitations include the restriction to English and Turkish languages, the cross-sectional design of studies, and variability in hospital settings. No protocol was registered.

PMID:42109192 | DOI:10.1002/hpm.70084

Nucleic Acids Res. 2026 May 11:gkag454. doi: 10.1093/nar/gkag454. Online ahead of print.

ABSTRACT

Interpreting genome-wide epigenomic experiments, such as DNA methylation profiling and chromatin accessibility assays, requires tools that can identify which regulatory programs underlie coordinated changes across genomic regions. Without this regulatory context, lists of differential regions remain largely descriptive and difficult to interpret mechanistically. Existing approaches either apply hard significance cutoffs that discard moderate but biologically meaningful signals, or rely on gene-centric annotations that neglect enhancers and intergenic space, introducing bias into the interpretation. RegRegSEA addresses both shortcomings by adapting the Gene Set Enrichment Analysis framework directly to genomic coordinates. The server accepts a standard differential analysis table, ranks all tested intervals by a signed statistic, and computes enrichment scores against curated regulatory databases including transcription factor binding site collections. Results are returned as an interactive, publication-ready report featuring dynamic visualizations of enrichment profiles and regulatory annotations, along with downloadable leading-edge regions for downstream analyses. We demonstrate the utility of this approach through re-analysis of Down syndrome brain methylation data and chromatin accessibility in ageing mouse liver. The server is freely available at https://web.ccb.uni-saarland.de/regregsea/ and open to all users with no login required.

PMID:42109173 | DOI:10.1093/nar/gkag454

BJPsych Open. 2026 May 11;12(3):e133. doi: 10.1192/bjo.2026.11039.

ABSTRACT

BACKGROUND: Depression is common in end-stage kidney disease (ESKD) and is associated with poorer outcomes and higher mortality. However, treatment guidance is inconsistently applied.

AIMS: To investigate screening measures, somatic symptoms, comorbidities and psychosocial and cultural influences on depression diagnosis in ESKD patients.

METHOD: We recruited 300 people with ESKD receiving maintenance hospital haemodialysis in a deprived ethnically diverse area. We assessed depression using validated screening tools (Hamilton Depression Rating Scale and Patient Health Questionnaire 2) and a definitive ICD-10 diagnosis using a structured interview (Clinical Interview Schedule-Revised). We considered the role of adverse life events, co-occurring medical conditions, as well as age, sex and ethnicity, using descriptive statistics and multiple logistic regression.

RESULTS: An ICD-10 diagnosis of moderate or severe depression was made in 8% of the sample, taking care to exclude potentially confounding symptoms associated with chronic kidney disease and depression. Applying validated thresholds on commonly used screening tools yielded substantially higher prevalence estimates. An ICD-10 diagnosis of moderate and severe depression associated with loss events: death of a spouse, child or parent (odds ratio 3.62, 95% CI: 1.09-12, p = 0.04), financial strain (odds ratio 3.51, 95% CI: 1.04-11.87, p = 0.04), type 2 diabetes (odds ratio 5.32, 95% CI: 1.34-20.76, p = 0.02) and education, whereby university graduates were less likely to have depression than school-only attendees (odds ratio 0.18, 95% CI: 0.03-1.02, p = 0.05). Ethnicity and sex were not significantly associated with moderate or severe depression.

CONCLUSIONS: We found a lower prevalence of moderate to severe depression than commonly reported. Future research should consider careful diagnostic assessment, financial strain, loss events and physical co-occurring medical conditions such as diabetes.

PMID:42109130 | DOI:10.1192/bjo.2026.11039

J Atten Disord. 2026 May 11:10870547261448260. doi: 10.1177/10870547261448260. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine the effect of attention-deficit hyperactivity disorder (ADHD) on sex differences in the hazard risk of a physical disease (PD) in childhood and adolescence, per ICD-10 criteria.

METHOD: The Danish population born from 1984 to 1995, comprising over 800,000 individuals, was studied for the 13 different ICD-10 PD categories with ADHD as a time-dependent exposure in time-to-event settings. Time from birth to first episode PD, emigration, death, or 31st December 2017, whichever occurred first, was analyzed by use of piecewise Cox models.

RESULTS: Individuals with an ADHD diagnosis had higher or similar hazard risk than undiagnosed individuals throughout follow-up. Across all PD categories, baring malignant neoplasms, ADHD-diagnosed individuals had a higher hazard risk from teen age. In the general population, females had higher hazard risk of most PDs from teen age or early adolescence, while males had higher hazard risk in early childhood. Dispersed modification occurred in the hazard difference between sex post-ADHD diagnosis. For eye and adnexa diseases in childhood, males had about a 15% added hazard that of females in the general population, while females had twice the hazard of males among those diagnosed with ADHD. In the general population of young adulthood, females faced a hazard risk of endocrine, nutritional, and metabolic diseases nine times higher than that of males, with an ADHD diagnosis reducing this ratio by half.

CONCLUSION: The time-dependent ADHD diagnosis alters sex differences in the vulnerability to certain PD categories at various ages, while ADHD considerably increases vulnerability to all PDs except malignant neoplasms.

PMID:42109088 | DOI:10.1177/10870547261448260

ScientificWorldJournal. 2026;2026(1):e1551004. doi: 10.1155/tswj/1551004.

ABSTRACT

Chronic wounds, especially in diabetic patients, are difficult to manage because of delayed healing and high infection risk. Traditional polyherbal formulations, which are composed of multiple medicinal plants with synergistic effects, are widely used in wound care, but their clinical effectiveness has not been comprehensively synthesized. This study aimed to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing the effectiveness of traditional polyherbal formulations for wound healing. Databases were searched, and RCTs involving adults with wounds, where the intervention was traditional polyherbal formulation rather than a placebo, standard care, or other active treatments, were included. The meta-analysis was conducted via a random-effects model, and the certainty of evidence was evaluated via GRADE. Eight RCTs were included. The pooled mean difference for healing time favored polyherbal formulations (-3.28 days; 95%CI = -8.56 to 2.01) but was not statistically significant. Similarly, HbA1c reduction (-5.97%; 95%CI = -30.86 to 18.93) was not significantly different, with high heterogeneity (I² = 98%), and no publication bias was detected. Although several individual herbs within these formulations possess tissue-regenerative, angiogenic and anti-inflammatory properties, the pooled results indicate only a modest, nonsignificant trend toward faster healing. Variations in formulation composition, treatment duration, and methodological quality limit the certainty of evidence, which ranges from high (age) to very low (HbA1c) on the GRADE assessment. Overall, polyherbal formulations show therapeutic promise as adjuncts to standard wound, whereas larger, well-designed trials using standardized formulations and clinically relevant endpoints are needed to establish their efficacy and optimize their clinical application.

PMID:42109081 | DOI:10.1155/tswj/1551004