Category: Statistics

Clin Transl Sci. 2026 Apr;19(4):e70533. doi: 10.1111/cts.70533.

ABSTRACT

Renin-angiotensin-aldosterone system inhibitors are widely prescribed for chronic kidney disease, but their causal effect on kidney function remains uncertain. This study investigated the impact of starting renin-angiotensin blockade on renal function in adults with kidney disease. A retrospective cohort study was conducted in Korea using a quasi-experimental staggered difference-in-differences design with propensity score matching to estimate time-varying treatment effects. Overall, 1,204 adults (375 treated and 829 contemporaneous not-yet-treated controls) were followed for 3 years. Initiation of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers was recorded, and treatment exposure was categorized monthly. The primary outcome was a change in estimated glomerular filtration rate after initiation, evaluated over sequential intervals up to 12 months. The overall average treatment effect of two-way fixed effects model was not statistically significant (-1.47 mL/min/1.73 m²; p = 0.33). However, initiation was associated with an immediate and significant decline in eGFR at event time 0 (estimate: -3.87 mL/min/1.73 m², p < 0.05) and at event time 1 and 3 (p < 0.05). Beyond these early intervals, there was no evidence of progressive deterioration in kidney function during the 1-year follow-up. Declines following initiation of renin-angiotensin blockade are early, transient, and primarily hemodynamic in nature rather than reflective of structural kidney injury. Importantly, this quasi-experimental analysis of real-world data reproduced the findings of randomized trials, reinforcing current guideline recommendations to continue therapy in chronic kidney disease provided that reduction in filtration rate remains below the accepted threshold of 30%.

PMID:41876398 | DOI:10.1111/cts.70533

Alzheimers Dement. 2026 Mar;22(3):e71297. doi: 10.1002/alz.71297.

ABSTRACT

INTRODUCTION: Amyloid-targeting therapies for Alzheimer’s disease require regular MRI monitoring for amyloid-related imaging abnormalities (ARIA). 3D scans are more sensitive but time intensive; ultra-fast implementations could improve access and reduce burden.

METHODS: Eighty scans from 20 participants were acquired with standard 2D fluid-attenuated inversion recovery (FLAIR) and T2*-gradient recalled echo (T2*-GRE), or accelerated Wave-controlled aliasing in parallel imaging (Wave-CAIPI) 3D FLAIR and susceptibility-weighted imaging (SWI) at 3 T. Two neuroradiologists graded ARIA-E (edema/effusion) and ARIA-H (hemosiderin deposits). Bayesian models estimated sensitivity, specificity, severity agreement, and interchangeability between acquisitions.

RESULTS: Accelerated sequences reduced acquisition time by up to 56%. Four participants had ARIA-E and microbleeds; five had microbleeds alone. Sensitivity and specificity for ARIA-E were identical (1.00; 0.94-0.95); severity was comparable. Replacing standard with accelerated FLAIR did not decrease severity agreement (interchangeability 1.4; 95% highest-density interval [HDI] -3.6% to 5.4%). Fast SWI showed higher microbleed severity gradings.

DISCUSSION: Wave-CAIPI offers fast high-resolution FLAIR acquisitions with comparable performance for ARIA-E monitoring. Wave-CAIPI SWI provides high-quality scans that may aid ARIA-H interpretation.

PMID:41876395 | DOI:10.1002/alz.71297

Cancer Med. 2026 Mar;15(3):e71703. doi: 10.1002/cam4.71703.

ABSTRACT

BACKGROUND: Paranasal sinus tumors are rare malignancies that are known to be aggressive with poor outcomes. Data are limited regarding factors associated with survival and prognosis. In this study, we investigated factors associated with survival for both patients with squamous cell carcinoma (SCC) and adenocarcinoma (AC).

METHODS: The Surveillance, Epidemiology and End Results (SEER) data was utilized from the years 2000 to 2019. Kaplan-Meier survival analysis and Cox regression modeling were employed to evaluate the relationship between several co-variates and overall survival (OS) and disease-specific survival (DSS) among patients with SCC and AC.

RESULTS: A total of 5276 patients with SCC and 5222 patients with AC were included. Compared to SCC patients, those with AC were younger and presented with less differentiated and more advanced tumors (p < 0.0001). The median OS for SCC was 203 months compared to the 56 months in patients with AC (p < 0.0001). Primary site, race, stage, grade, and treatment modalities utilized were significantly predictive of OS and DSS in SCC patients in univariate analysis. Among AC patients, we found stage, grade, and treatment modalities to be significantly predictive of OS and DSS in univariate analysis. For SCC, stage (p < 0.001), primary site (p < 0.001), and treatment (p < 0.001) were significant predictors of survival on multivariate analysis. Specifically, nasal SCC was found to have improved survival compared to other sites. For AC, stage (p < 0.001) and treatment (p < 0.001) were significant predictors of survival on multivariate analysis. For both SCC and AC, treatment with both radiation and surgery had improved survival compared to radiation alone (p < 0.0001).

CONCLUSION: SCC and AC of the paranasal sinus and nasal cavity portend an overall poor prognosis with limited survival. Our study effectively elucidates factors associated with survival which may be useful in treatment and counseling patients with paranasal sinus AC and SCC.

PMID:41876393 | DOI:10.1002/cam4.71703

Am J Hum Biol. 2026 Mar;38(3):e70247. doi: 10.1002/ajhb.70247.

ABSTRACT

OBJECTIVES: Duration and quality of sleep are influenced by many factors, including hormonal changes. The aim of this study was to investigate the differences between the phases of the menstrual cycle in total sleep duration and sleep stage distribution, specifically the duration of rapid eye movement (REM) phase, light, and deep sleep states and compare sleep parameters between ovulatory and anovulatory cycles.

METHODS: The study involved 130 women aged 20-35 (mean = 26.2 years; SD = 4.14). Ovulation was detected using luteinizing hormone (LH) urine tests. Sleep data were collected using the Fitbit Alta HR trackers, which measured total sleep time and the duration of sleep stages. Sleep parameters were analyzed separately for each of the five phases: menstrual bleeding, follicular, periovulatory, luteal, and premenstrual using repeated measures ANOVA. Differences between ovulatory and anovulatory cycles were assessed using Student’s t-test.

RESULTS: Women with the ovulatory cycle slept longer and had longer REM phases compared to women without ovulation. No statistically significant differences were observed in total sleep duration or sleep stage distribution across five phases of the menstrual cycle among women with detected ovulation.

CONCLUSION: The findings suggest that ovulatory status might be associated with differences in total sleep time and REM sleep duration, whereas sleep duration and sleep stage distribution across menstrual cycle phases remain relatively constant. These results suggest that the presence of ovulation, rather than phase-specific changes during the cycle, may play a more important role in shaping sleep characteristics.

PMID:41876389 | DOI:10.1002/ajhb.70247

Cancer Med. 2026 Mar;15(3):e71748. doi: 10.1002/cam4.71748.

ABSTRACT

BACKGROUND: Although the impact of increased time to treatment initiation (TTI) on outcomes for patients with oropharyngeal squamous cell carcinoma (OPSCC) has been well-studied, a deeper understanding of the mechanisms underlying delay in patients with human papillomavirus (HPV)-negative OPSCC is lacking in the current literature.

OBJECTIVE: To assess differences in sociodemographic factors and treatment timelines between patients with HPV-negative OPSCC with shorter versus. longer TTI.

METHODS: Patients treated for HPV-negative OPSCC at a single academic institution between 2013 and 2023 were retrospectively identified via chart review and dichotomized by the cohort median TTI (53.5 days; defined as the time from biopsy to first treatment initiation). Clinical timelines between delayed and nondelayed patients were compared using descriptive statistics and Mann-Whitney U testing. Independent predictors of delayed TTI (> 53.5 days) were evaluated using multivariate logistic regression modeling, with adjusted odds ratios (aORs) and 95% confidence intervals reported.

RESULTS: Seventy-six patients were identified. On multivariable analysis, male sex (aOR 3.28; 95% CI 1.02-10.49), unmarried status (aOR 5.96; 95% CI 1.36-26.07), primary chemoradiation versus surgery (aOR 0.25; 95% CI 0.07-0.85), and biopsy available before arrival (aOR 4.08; 95% CI 1.32-17.36) were independently and significantly (p< 0.05) associated with delayed treatment initiation. Treatment timeline analysis revealed that both the interval from biopsy to referral and the interval from PET scan to treatment initiation differed significantly between delayed and nondelayed patients (p< 0.05).

CONCLUSION: Primary nonsurgical treatment and lack of social support were found to be independently associated with treatment delay in patients with HPV-negative OPSCC. These findings highlight opportunities for improving the care of HPV-negative OPSCC at the specialty level.

PMID:41876381 | DOI:10.1002/cam4.71748

Hematology. 2026 Dec 31;31(1):2648344. doi: 10.1080/16078454.2026.2648344. Epub 2026 Mar 24.

ABSTRACT

INTRODUCTION: Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare type of cutaneous lymphoma lacking standardized treatments. Consequently, patient outcomes vary significantly.

METHODS: This study explored the clinical characteristics and prognostic factors of 205 SPTCL patients from 2000 to 2021 in the Surveillance, Epidemiology, and End Results (SEER) database.

RESULTS: Overall survival (OS) at 1, 3, and 5 years were 78.3%, 75.7%, and 66.4%, respectively. Patients diagnosed after 2008 (possibly excluding the γ-δ subtype) (HR = 0.197, 95% CI = 0.106-0.364, p = 0.000) and Asian or Pacific Islanders (HR = 0.210, 95% CI = 0.049-0.902, p = 0.036) were independent predictors of favorable survival, whereas age 50-60 years (HR = 3.213, 95% CI = 1.357-7.607, p = 0.008) and age > 60 years (HR = 5.039, 95% CI = 2.327-10.911, p = 0.000) were independently associated with poor survival. Patients who received radiotherapy alone exhibited a significantly lower hazard risk compared to those receiving no chemotherapy or radiation (HR = 0.216, 95% CI = 0.048-0.983, p = 0.048). No statistically significant differences in prognosis were observed between patients who received no chemotherapy or radiation and those who received either chemotherapy alone (HR = 1.276, 95% CI = 0.644-2.529, p = 0.485) or radiochemotherapy (HR = 1.283, 95% CI = 0.463-3.558, p = 0.632). These associations persisted after IPTW adjustment, with age, race, year of diagnosis, and treatment remaining independent predictors of OS in SPTCL.

CONCLUSIONS: The Ann Arbor staging was not suitable for SPTCL. Radiotherapy represents an appropriate therapeutic option for patients with single or localized skin lesions. No statistically significant differences in prognosis were observed between patients who received no chemotherapy or radiation and those who received either chemotherapy alone or radiochemotherapy. This finding suggests that immunomodulatory agents may be preferable to cytotoxic therapy as initial treatment for SPTCL, an inflammatory lymphoma.

PMID:41876379 | DOI:10.1080/16078454.2026.2648344

Aging Male. 2026 Dec 31;29(1):2647019. doi: 10.1080/13685538.2026.2647019. Epub 2026 Mar 24.

ABSTRACT

OBJECTIVE: To compare the real-world safety profiles of α1-adrenoceptor antagonists (α1-blockers), 5α-reductase inhibitors (5ARIs), and phosphodiesterase type 5 inhibitor (PDE5I) used in the treatment of benign prostatic hyperplasia (BPH).

METHODS: This retrospective pharmacovigilance study analyzed FDA Adverse Event Reporting System (FAERS) from Q1 of 2004 to Q2 of 2025. Reports of adverse events (AEs) in male BPH patients receiving AUA guideline-recommended drugs including α-1 blockers (tamsulosin, silodosin, doxazosin, and alfuzosin), 5ARIs (finasteride and dutasteride), and tadalafil were extracted. Disproportionality analysis was performed to detect significant safety signals. AEs were classified using MedDRA terms.

RESULTS: Among 9,540 unique reports and 25,796 AEs entries, patients aged 65-80 years accounted for the majority of the reports. Most AEs occurred within 30 days of treatment initiation. Hospitalization was the most common serious outcome. Sixteen significant AEs were detected, including pollakiuria, gynecomastia, breast pain and so on, with distinct reporting patterns across drug classes.

CONCLUSIONS: This large-scale pharmacovigilance analysis identified distinct post-marketing safety signals among guideline-recommended pharmacotherapies for BPH, confirming known risks and suggesting potential novel adverse-event signals warranting further investigation.

PMID:41876378 | DOI:10.1080/13685538.2026.2647019

Eur J Intern Med. 2026 Mar 23:106813. doi: 10.1016/j.ejim.2026.106813. Online ahead of print.

ABSTRACT

BACKGROUND: Antibiotic treatment for asymptomatic bacteriuria (AB) is not recommended in the general population, and its significance in oncohematological patients remains unclear.

OBJECTIVES: This study aimed to determine the prevalence of AB in hematologic patients and assess the frequency of bacteremia caused by the same microorganism isolated in untreated baseline asymptomatic bacteriuria (Baseline-AB) during myelosuppression.

METHODS: A prospective, observational study was conducted from 2012-2017 in adult patients admitted for chemotherapy. Urine cultures (UCs) were performed, and no prophylactic antibiotics were administered. Blood and UC samples were collected during episodes of febrile neutropenia (FN) before antibiotic administration and compared with baseline UC results.

RESULTS: Among 121 patients, 167 FN episodes were recorded, with 19 (11.3%) having Baseline-AB. A urinary focus was found in 1/19 (5.2%) of the Baseline-AB episodes, compared to 9/148 (6%) of the non baseline-AB (No-Baseline-AB) episodes (OR: 0.86; 95% CI:0.10-7.17;p = 0.88). Bacteremia occurred in 4/19 (21%) of the Baseline-AB episodes and in 38/148 (25.6%) of the No-Baseline-AB episodes. Only 1/19 patients in the Baseline-AB group (5.2%) had bacteremia caused by the same microorganism identified in the baseline UC.

OUTCOME: FN resolved in all Baseline-ABs and in 96.6% of No-Baseline-ABs. Overall mortality occurred in 9/121 (7.4%) patients.

CONCLUSION: Baseline-ABs were present in more than 10% of episodes, but no correlation was found between Baseline-ABs and bacteremia during FN. Only one case showed the same pathogen in both the baseline UC and the blood culture, suggesting that routine antibiotic treatment for Baseline-AB may not be necessary in this population.

PMID:41876326 | DOI:10.1016/j.ejim.2026.106813

Cardiovasc Revasc Med. 2026 Mar 19:S1553-8389(26)00103-X. doi: 10.1016/j.carrev.2026.03.012. Online ahead of print.

ABSTRACT

BACKGROUND: Coronary vulnerable plaque (VP) identification is crucial for preventing acute events. Intravascular ultrasound with near-infrared spectroscopy (IVUS-NIRS) is a reference technique to assess plaque vulnerability by quantifying lipid core burden index (LCBI) and plaque burden (PB). Murray’s flow ratio (μFR) and maximal radial wall strain (RWS_max) are new angiography-derived parameters that may stratify plaque risk profile. We aim to evaluate their ability to identify VP as defined by IVUS-NIRS.

METHODS: This retrospective study included 89 lesions who underwent IVUS-NIRS. VP was defined as maxLCBI_4mm ≥325 and PB ≥70%. μFR and RWS_max were calculated offline. Pearson/Spearman correlations assessed relationships with IVUS-NIRS parameters. Receiver operating characteristic (ROC) curve evaluated diagnostic performance for VP. Potential confounders were included in a multivariable model.

RESULTS: μFR was inversely correlated with maxLCBI_4mm (r = -0.452, p < 0.001) and PB (r = -0.276, p = 0.009). RWS_max was positively correlated with maxLCBI_4mm (r = 0.597, p < 0.001) and PB (r = 0.294, p < 0.001). ROC analysis revealed good accuracy for identifying VP for both μFR (AUC = 0.71) and RWS_max (AUC = 0.80). In multivariable analysis, RWS_max remained independently associated with VP, whereas μFR lost statistical significance.

CONCLUSIONS: μFR and RWS_max were correlated with PB and maxLCBI_4mm. RWS_max demonstrated independent predictive ability to identify VP.

PMID:41876322 | DOI:10.1016/j.carrev.2026.03.012

J Cardiothorac Vasc Anesth. 2026 Mar 3:S1053-0770(26)00202-8. doi: 10.1053/j.jvca.2026.03.004. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate paraspinal injectate spread following intertransverse process (ITP) block using 10 mL versus 20 mL in cadaveric models.

DESIGN: Prospective.

SETTING: An anatomy laboratory at an academic medical institution.

PARTICIPANTS: Adult cadavers (6 traditionally embalmed, 2 GreenMBalmed).

INTERVENTIONS: Under ultrasound guidance, 0.1% methylene blue dye was injected into the T3-4 or T7-8 ITP space using the mid-transverse process technique. A total of 12 injections were performed, with 6 injections per volume.

MEASUREMENTS AND MAIN RESULTS: In 8 adult cadavers, retropleural dissection and multilevel vertebral corpectomy assessed dye spread to the intercostal nerves, paravertebral space, and anterior/posterior epidural spaces. Paravertebral spread occurred in 11 of 12 injections. With 10 mL, the median spread was 2 levels in the paravertebral space and 1.5 levels in the intercostal space. With 20 mL, the median spread was 2 levels in both spaces. Epidural spread (anterior and/or posterior) occurred in 5 of 6 injections in each volume group. However, multilevel epidural spread (≥3 levels) occurred in 3 of 6 injections with 20 mL and 0 of 6 with 10 mL. With 20 mL, anterior epidural spread ranged 0 to 5 levels and posterior epidural spread ranged 0 to 7 levels, reflecting greater variability and occasional extensive spread. No statistically significant between-volume differences in median spread were detected.

CONCLUSION: These findings support anatomical continuity between the ITP and epidural spaces. Compared with 10 mL, 20 mL ITP injections showed greater variability and occasional extensive epidural spread, which may increase the risk of sympathectomy-related effects such as hypotension.

PMID:41876319 | DOI:10.1053/j.jvca.2026.03.004