Category: Statistics

Facial Plast Surg Aesthet Med. 2026 Feb 26:26893614261422044. doi: 10.1177/26893614261422044. Online ahead of print.

ABSTRACT

BACKGROUND: Literature regarding the longevity of deep plane facelifts is limited.

OBJECTIVE: To measure the time duration between initial deep plane facelifts and revision facelifts among patients treated in a single-surgeons practice over a 30-year period.

METHODS: Chart review from a surgeon’s 30-year experience performing revision facelifts. Patient demographics and motivation, timing for primary/revision facelifts, and adjunctive procedures were collected. Patients were stratified into groups ≤53 and >53 based on statistical assessment. t-Tests were used.

RESULTS: A total of 93 revision facelifts on patients who underwent deep plane lifts were included. Seventy-seven patients had a second facelift, 14 had a third, and 2 had a fourth. Sex (female 73/77, 94.8%; male 4/77, 5.2%), age at time of first facelift (mean = 53.5 ± 6.85), second facelift (mean = 64.5 ± 6.5). Adjunctive procedures: Upper/lower blepharoplasty (18.18%, 7.8%), brow lift (15.5%), and rhinoplasty (7.8%) (Table 1). The mean interval between the primary deep plane facelift and the secondary lift was 10.9 years ± 5.1 Patients who underwent primary facelift surgery at ≤53 years of age returned for revision facelift after 12.4 years ± 5.6; patients >53 returned 9.3 years later ± 3.9 (p = 0.004).

CONCLUSION: Patients returning for revision surgery following deep plane facelifts do so after an average of 10.9 years. Patients who are younger at the time of their initial facelift may have greater longevity.

PMID:41749415 | DOI:10.1177/26893614261422044

J Biomed Mater Res B Appl Biomater. 2026 Mar;114(3):e70047. doi: 10.1002/jbm.b.70047.

ABSTRACT

Placental-derived biomaterials are rising in popularity for use in treating severe skin injuries due to their abundant pro-healing factors which result in improved healing outcomes. Clinical use of human-derived placental products, however, is limited by high costs, donor availability, and high variability (due to age, health, and genetic factors). Porcine-derived placental biomaterials have structure and pro-healing factors similar to human placental materials, and can be mass produced on a larger scale, with reduced variability and cost. In this study, porcine-derived placental biomaterials were compared to human-derived placental biomaterials in a full-thickness skin defect rat model. Porcine-derived placental powder (PP), porcine-derived placental membrane (PM), and human-derived amniotic membrane (HM) were tested and compared to no treatment in 36 rats. At 3, 7, and 14 days, rats were euthanized, and defects were excised for H&E and picrosirius red staining. Analyses included wound area measurement, gross inflammation and histological inflammation scoring, qualitative assessments via H&E staining, and quantification of collagen in defects via picrosirius staining over the 14-day healing process. No statistical differences were found between treatment groups at each timepoint for percent difference to adjacent control defect measurements including wound area, histological inflammation scoring, and collagen quantification analyses. PP treated defects had lower gross inflammation scores compared to HM at Day 3 (p = 0.048). Trends observed in wound area measurements, gross and histological inflammation scores, and collagen quantification suggested that PP treated defects induced greater healing efficacy at earlier timepoints. Additionally, PP defects had more rapid and robust crust formation which may have contributed to improved healing outcomes based on reduced inflammation, improved hair follicle growth, re-epithelialization, collagen formation, and protection during wound dressing changes.

PMID:41749412 | DOI:10.1002/jbm.b.70047

Cancer Imaging. 2026 Feb 26. doi: 10.1186/s40644-026-01012-0. Online ahead of print.

ABSTRACT

PURPOSE: Response assessment in the treatment of metastatic sarcoma primarily depends on imaging, as no established clinical or serological biomarkers reliably predict survival outcomes. This study evaluates the utility of Response Evaluation Criteria in Solid Tumors (RECIST v1.1) in predicting overall survival (OS) in sarcoma patients with pulmonary metastases.

METHODS: We selected consecutive study subjects from a prospective registry based on the following criteria: (1) available CT imaging at first diagnosis of pulmonary metastases from sarcoma, (2) available follow-up CT imaging within 16 weeks of systemic therapy initiation, (3) documentation of OS. Volumetric segmentation of up to 5 lung metastases was performed over time. Progressive disease (PD) was defined as increase of the unidimensional sum of lesions ≥ 20% or appearance of new metastases according to RECIST v1.1. Kaplan-Meier survival analyses were performed. P values < 0.05 were considered statistically significant.

RESULTS: Ninety-two patients were included (median age: 58 years; 50% female). Average time of follow-up CT was 67 days after baseline imaging. Patients with PD on first follow-up imaging (n = 24; 26%) showed significantly shorter OS (13.9 months vs. 29.3 months; p = 0.014). The unidimensional growth threshold of 20% proposed by RECIST did not stratify OS (14.6 months vs. 26.8 months, p = 0.221). The appearance of new metastases (n = 16; 17%) indicated significantly shorter OS (7.8 months vs. 27.0 months; p < 0.001) and was frequently observed even in patients with decreasing size of existing metastases (n = 7; 8%).

CONCLUSION: Imaging progression patterns of pulmonary metastatic sarcoma demonstrate distinct associations with OS, highlighting the need for sarcoma-specific adaptations to established response criteria.

PMID:41749400 | DOI:10.1186/s40644-026-01012-0

Eur J Med Res. 2026 Feb 26. doi: 10.1186/s40001-026-04081-w. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore the relationships between inflammatory markers obtained from complete blood count (CBC) and the prevalence of myocardial infarction (MI).

METHODS: A cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) spanning 1999 to 2020. A total of 46,697 US adults were enrolled, including 1824 with self-reported physician-diagnosed MI history. Systemic inflammatory response index (SIRI) and five other CBC-derived inflammatory indices were included. Logistic regression models, restricted cubic spline analysis, and subgroup analysis were applied to examine the association between these indices and MI prevalence with adjustments for potential confounding variables. Interaction analysis was used to verify the sex-specific effect modification and mediation analysis was performed to explore the mediating role of metabolic diseases including hypertension, diabetes and dyslipidemia.

RESULTS: After full adjustment for confounding factors, elevated SIRI, NLR, MLR, and NMLR were significantly positively associated with MI prevalence (all P < 0.001). Restricted cubic spline analysis revealed nonlinear dose-response relationships between SIRI, MLR, SII, and MI prevalence (all P for non-linearity < 0.05). Significant sex-specific heterogeneity was observed. SIRI, NLR, NMLR, and SII had markedly stronger positive correlations with MI in females than males (all P for interaction < 0.05). Mediation analysis indicated metabolic diseases mediated approximately one-quarter to one-third of the SIRI-MI history association.

CONCLUSION: This study revealed a significant link between CBC-derived inflammation markers and MI prevalence, with sex acting as a key modifier. Further longitudinal research is crucial to assess the utility of these accessible, low-cost indicators in routine cardiovascular risk assessment and to clarify causal pathways.

PMID:41749357 | DOI:10.1186/s40001-026-04081-w

Syst Rev. 2026 Feb 26. doi: 10.1186/s13643-026-03123-y. Online ahead of print.

ABSTRACT

BACKGROUND: Preventive care – asking, advising or referring patients for help with smoking, nutrition, alcohol, physical activity, and weight (SNAP-W) – is not consistently provided in routine outpatient care due to barriers such as time, other priorities, and forgetfulness. Digital health interventions (DHIs) integrated into routine care offer a promising solution and are acceptable to clinicians and patients. A systematic review is needed to synthesise existing evidence on the effectiveness of DHIs that engage patients, alongside routine care, to provide preventive care targeting SNAP-W in outpatient settings.

METHODS: We will include randomised and non-randomised studies that compare a DHI supporting the provision of preventive care for SNAP-W health behaviours with usual care. The DHI must integrate with routine clinician-provided care. Participants will be adult patients/clients of any outpatient healthcare service. The primary outcomes will be provision/receipt of preventive care elements addressing the SNAP-W health behaviours. Secondary outcomes will include SNAP-W behaviour change outcomes. Eligible studies will be identified via MEDLINE, EMBASE, PsycINFO, Scopus, and CINAHL. Two reviewers will independently conduct study selection, data extraction, and risk of bias assessment, with a third resolving disagreements. Risk of bias will be assessed using Cochrane RoB-2 for randomised and ROBINS-I for non-randomised trials. If feasible, a meta-analysis will be conducted to estimate the pooled effect of DHIs by health behaviour. Exploratory sub-group (e.g., type of clinical setting, preventive care element) analyses will be conducted to determine possible causes of statistical heterogeneity. If a meta-analysis is not feasible, results will be summarised using direction of effect per the Synthesis Without Meta-analysis guidelines.

DISCUSSION: This review will identify whether DHIs that engage patients as part of outpatient health care are effective at improving delivery of SNAP-W preventive care for adults attending these services. These findings will be of interest to service providers, policy makers and implementation researchers seeking to improve health outcomes through routine preventive care provision.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD420251067831.

PMID:41749355 | DOI:10.1186/s13643-026-03123-y

J Transl Med. 2026 Feb 26. doi: 10.1186/s12967-026-07921-9. Online ahead of print.

ABSTRACT

BACKGROUND: Programmed cell death (PCD) plays an important role in diabetic retinopathy (DR); however, the underlying genetic mechanisms remain unclear. We used Mendelian randomization (MR) to investigate the causal relationships between PCD-related genes and DR. This study aimed to investigate the effects of PCD on the risk of DR by conducting MR analysis.

METHODS: Summary statistics from gene expression quantitative trait loci (eQTL) studies (31,684 Europeans) were analyzed. Genetic instrumental variables were selected using cis-eQTL single-nucleotide polymorphisms (SNPs; P < 5 × 10^{– 8}). Summary data-based MR (SMR) was employed to assess causal associations between PCD-related genes and DR, with three additional MR methods used for sensitivity testing. Bayesian colocalization was used to examine the shared regulatory mechanisms between PCD QTLs and DR risk loci.

RESULTS: Sensitivity and colocalization analyses revealed six genes that affected DR: cathepsin H (CTSH), NAD(P)H: quinone oxidoreductase 1 (NQO1), tribbles pseudokinase 3 (TRIB3), and phosphoglycerate mutase 5 (PGAM5), which increased DR risk, and iron-responsive element binding protein 2 (IREB2) and tumor necrosis factor (TNF), which exhibited protective effects. Multivariate MR confirmed significant causal effects for CTSH, IREB2, and PGAM5 (p < 0.050). Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis (including 10 STRING-derived genes) revealed that 13 genes were enriched in necroptosis, apoptosis, mitophagy, and TNF signaling pathways in DR.

CONCLUSIONS: This MR study supports the causal involvement of PCD in DR and identifies candidate genes (CTSH, IREB2, PGAM5, NQO1, TRIB3, and TNF) for therapeutic targeting or biomarker development in DR prevention or diagnosis.

PMID:41749353 | DOI:10.1186/s12967-026-07921-9

Eur J Med Res. 2026 Feb 26. doi: 10.1186/s40001-026-04029-0. Online ahead of print.

ABSTRACT

OBJECTIVES: The incidence of bladder cancer after kidney transplantation is high, but there is a lack of ideal treatment options.This study is an exploratory case series aiming to preliminarily observe the clinical manifestations and safety profile of Olaparib combined with intravesical perfusion in treating secondary bladder cancer post-kidney transplantation, so as to generate scientific hypotheses for subsequent research.

METHODS: This is a single-center preliminary study that analyzed the clinical data of 7 patients with secondary bladder cancer after kidney transplantation who received Olaparib combined with intravesical perfusion therapy. Seven patients with secondary bladder cancer after kidney transplantation were enrolled. Pathologically, 6 cases were high-grade non-muscle-invasive bladder cancer, and 1 case was small cell carcinoma complicated with high-grade non-invasive bladder cancer. Genetic testing showed 4 patients carried Homologous Recombination Repair (HRR) gene mutations, while 3 were negative. All received Olaparib combined with intravesical chemotherapy. Only descriptive follow-up was performed to monitor treatment responses, progression-free survival (PFS), and adverse events (AEs).

RESULTS: The median PFS of all patients was 15.8 months, with 15.7 months in HRR-mutated patients and 16 months in non-mutated ones. Tumor recurrence occurred in Patient 1 (20 months post-treatment) and Patient 7 (14 months post-treatment). Patient 4 discontinued Olaparib at 18 months without metastasis or recurrence during follow-up. All patients had varying drug-related AEs, but no Grade 4/5 severe events were reported, and renal allograft function remained normal throughout the study.

CONCLUSIONS: Olaparib combined with intravesical perfusion showed certain disease control effects in these 7 patients. However, limitations including small sample size, lack of a control group, and no predefined endpoints resulted in insufficient statistical power, so the findings are preliminary and hypothesis-generating.

PMID:41749345 | DOI:10.1186/s40001-026-04029-0

Liver Int. 2026 Apr;46(4):e70559. doi: 10.1111/liv.70559.

ABSTRACT

BACKGROUND: Chronic hepatitis D (CHD) causes severe chronic hepatitis. Knowledge is limited about factors correlating with ALT in treatment-naïve patients with CHD. This study analysed the pattern and determinants of ALT elevation in a large cohort of patients with CHD, including young adults, compared to propensity score-matched (PSM) patients with chronic hepatitis B (CHB).

METHODS: We identified 2382 treatment-naïve HBsAg+ adults with CHD (HDV RNA positive) and 1553 with CHB attending a liver center in Mongolia during 2015-2023. The correlation between ALT levels, virological, biochemical, and fibrosis parameters was assessed using Spearman coefficient (rho). Logistic regression analysis was used to identify determinants of elevated ALT in 1371 PSM pairs with CHD and CHB matched on age, sex, metabolic factors, and date of initial test.

RESULTS: In CHD, 78.5% of patients had ALT elevation, with the highest prevalence in the 18-20 years group (n = 219, 84.5%). This age group displayed 8.2-adjusted odds ratio (aOR) for elevated ALT, 2.7-aOR for elevated GGT, and 4.5-aOR of cirrhosis than matched CHB group (all p < 0.05). In CHD, ALT correlated weakly with HDV RNA (rho = 0.23) and liver stiffness (rho = 0.37), moderately with GGT (rho = 0.48), while showed no correlation with HBV DNA or HBsAg. Independent factors for elevated ALT were age < 30 years, elevated GGT and HDV RNA levels.

CONCLUSIONS: In this large cohort of Asian patients, an earlier and more severe inflammatory process could be demonstrated in CHD compared to CHB regardless of liver cirrhosis. Longitudinal studies are warranted to risk-stratify and prioritise patients for therapies.

PMID:41749331 | DOI:10.1111/liv.70559

Knee Surg Relat Res. 2026 Feb 26;38(1):9. doi: 10.1186/s43019-026-00308-6.

ABSTRACT

PURPOSE: Patellofemoral (PF) complications are a common cause of dissatisfaction and revision following total knee arthroplasty (TKA), often linked to altered kinematics and implant design. “Patella-friendly” femoral components with a wider, funnel-shaped trochlear groove may better restore native patellar motion. This study evaluated PF kinematics both before and after TKA performed using kinematic alignment, investigating the role of implant design and quadriceps loading.

METHODS: In total, 12 paired fresh-frozen cadaveric lower limbs were tested before and after TKA. Within each pair, one limb received a traditional medial pivot femoral component, while the contralateral limb received a “patella-friendly” medial pivot femoral component. Native and implanted knees were tested by flexing the knee under the action of an external load applied through the quadriceps tendon, varying its magnitudes (20, 160, 280N) and directions in the frontal (neutral,±6°, ±12°) and sagittal plane (neutral, +5° anterior). Motion was captured using an eight-camera optoelectronic system.

RESULTS: In the reference condition (20N, neutral direction), neither design showed statistical differences versus native (p > 0.05). However, the patella excursion in varus-valgus rotation was much higher in the specimens implanted with the traditional femoral component design (35.1° versus 14.6° native) than with the patella-friendly (20.5°). Differences between the designs emerged mainly with quadriceps load variations, especially frontal direction changes, which significantly affected patellar motion in both native and implanted knees (p < 0.05). Overall, the patella-friendly design better reproduced native kinematics under most conditions. However, with extreme medial loading (12°), three out of six specimens implanted with the patella-friendly femoral component were untestable owing to instability, and others exhibited high lateral displacement and trochlear dysplasia. In contrast, all traditional design implants remained stable, though with greater deviation from native kinematics.

CONCLUSIONS: This study provides foundational insights into PF biomechanics before and after TKA with kinematic alignment. By analyzing the interplay between implant geometry and quadriceps loading direction, it emphasizes the importance of selecting femoral components on the basis of individual patient anatomy. Our findings suggest that patella-friendly femoral components-although capable of better reproducing native motion in some cases-may not be suitable for patients with medially directed quadriceps forces or severely varus morphotypes.

PMID:41749321 | DOI:10.1186/s43019-026-00308-6

Diabetes Obes Metab. 2026 Feb 26. doi: 10.1111/dom.70576. Online ahead of print.

ABSTRACT

BACKGROUND: We examined the association between visit-to-visit HbA1c variability and risk of mortality, acute myocardial infarction (AMI), stroke, lower extremity amputation (LEA), neuropathy, and nephropathy.

METHODS: We conducted a retrospective cohort study of adults with type 2 diabetes managed at specialist outpatient clinics between 2009 and 2017. HbA1c variability was assessed using intra-individual visit-to-visit coefficient of variation (COV), variation independent of mean (VIM), and HbA1c Variability Score (HVS). Diabetes-related outcomes were identified using diagnosis and service codes. Cox proportional hazards and weighted Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

RESULTS: The cohort comprised 18 293 patients (mean age: 63.8 ± 13.1 years; 55.1% male). Compared to those in the lowest quartiles of HbA1c variability, patients in the highest quartile had higher HRs for mortality (COV: HR = 2.03, 95% CI: 1.43-2.88; VIM: HR = 2.70, 95% CI: 1.61-4.53; HVS: HR = 2.32, 95% CI: 1.49-3.62), and nephropathy (COV: HR = 1.34, 95% CI: 1.14-1.56; VIM: HR = 1.31, 95% CI: 1.14-1.52; HVS: HR = 1.20, 95% CI: 1.04-1.39), with statistically significant tests for linear trend. No significant associations were observed between HbA1c variability and AMI (HR = 0.88, 95% CI: 0.51-1.52), stroke (HR = 1.19, 95% CI: 0.92-1.56), neuropathy (HR = 1.01, 95% CI: 0.80-1.28), or LEA (HR = 1.00, 95% CI: 0.65-1.55).

CONCLUSION: Higher HbA1c variability was associated with significantly increased risk of mortality and nephropathy, but not significantly associated with the risk of AMI, stroke, neuropathy, or LEA.

PMID:41749305 | DOI:10.1111/dom.70576