Category: Statistics

Otolaryngol Pol. 2026 Mar 5;80(1):1-8. doi: 10.5604/01.3001.0055.5832.

ABSTRACT

<b>Introduction:</b> Subglottic stenosis (SGS) is a rare, recurring fibroinflammatory disease that causes upper airway narrowing and severe dyspnea. Patients often require multiple surgeries due to chronic restenosis. The unpredictable nature of SGS may significantly affect psychological well-being. <br><br><b>Aim:</b> The aim of this study is to determine the prevalence of depression and anxiety in SGS patients and identify associated risk factors. <br><br><b>Materials and methods:</b> A retrospective chart review was conducted of patients diagnosed with SGS at a tertiary care center from 2012 to 2022. Data collected included demographics, SGS etiology, number/type of surgeries, tracheostomy history, pulmonary function tests, medications, and psychiatric history. Statistical analyses included t-tests, chi-square, and ANOVA with Bonferroni correction. <br><br><b>Results:</b> Of 246 patients (mean age 54, body mass index [BMI] 32 8.7), 16% had a clinical diagnosis of depression, and 49% reported a history of anxiety or depression. Patients with psychiatric comorbidities were older (57.7 vs 52.1 years, p<0.05). Intubation was the leading cause of SGS (41.9%) and significantly associated with depression (p = 0.03). Patients with depression had higher rates of hospital admission within a year (p = 0.00). Interestingly, those with mental health hospitalizations were significantly younger (p = 0.01). <br><br><b>Discussion:</b> Depression and anxiety are more prevalent in SGS patients than in the general population. Contributing factors include age, etiology (particularly intubationrelated SGS), and surgical burden. <br><br><b>Conclusions:</b> Mental health should be an integral part of SGS management. Future prospective studies using standardized symptom surveys may better capture the psychological impact of SGS and inform holistic patient care.

PMID:41789544 | DOI:10.5604/01.3001.0055.5832

Hemodial Int. 2026 Mar 6. doi: 10.1111/hdi.70064. Online ahead of print.

ABSTRACT

INTRODUCTION: The relationship between serum calcium levels at the initiation of hemodialysis and coronary artery calcium score (CACS) remains unclear. This study examined whether albumin-corrected calcium (correctedCa; Payne’s formula) and ionized calcium (ionizedCa) measured at dialysis initiation are associated with CACS assessed by screening coronary computed tomography.

METHODS: This single-center cross-sectional study included 176 adults who initiated hemodialysis between 2015 and 2023 and underwent coronary computed tomography with CACS measurement within ±30 days. Restricted cubic spline (RCS) logistic regression was used to evaluate the associations of correctedCa and ionizedCa with CACS ≥ 400, adjusting for clinical covariates. Subgroup analyses were performed according to the median serum albumin level. For models in which nonlinearity was not significant, logistic models treating the variable as a linear term were fitted to calculate odds ratios (OR) per 1-standard deviation (SD) increase.

FINDINGS: The mean age was 70.9 years, 32.9% were women, 54.3% had diabetes, and the mean eGFR was 5.45 mL/min/1.73 m². Higher calcium levels were associated with higher CACS. ionizedCa showed a linear association with CACS ≥ 400 (OR per 1-SD, 1.51; 95% CI, 1.08-2.11). correctedCa also showed a statistically linear association (OR per 1-SD, 1.53; 95% CI, 1.09-2.13), although the RCS curve visually plateaued at higher correctedCa levels. Subgroup analyses revealed that this convex pattern was driven by the low-albumin group.

DISCUSSION: Higher calcium at hemodialysis initiation was associated with increased coronary calcification. ionizedCa tended to show a more stable linear relationship with CACS than correctedCa, as correctedCa may overestimate ionizedCa in patients with low albumin. Measurement of ionizedCa at dialysis initiation may help refine vascular calcification risk stratification as patients enter the dialysis period.

PMID:41789532 | DOI:10.1111/hdi.70064

J Atten Disord. 2026 Mar 6:10870547261419589. doi: 10.1177/10870547261419589. Online ahead of print.

ABSTRACT

OBJECTIVE: ADHD and internalising symptoms such as anxiety and depression are known to be associated in adolescence and understanding the mechanisms linking them is important for improving mental health outcomes for adolescents with ADHD symptoms. Our objective was to examine these mechanisms.

METHOD: In this study, we leverage a high-quality longitudinal dataset, the Millennium Cohort Study (n = 2,607 male, n = 2,791 female) to simultaneously evaluate a range of hypothesised mediating mechanisms. These include indirect effects via peer problems, conduct problems, self-esteem, injuries and accidents, relationships with parents, academic performance, risky decision-making, parental mental health, educational motivation, and general health. We used exploratory longitudinal mediation analysis with regularised structural equation modelling (regSEM) to examine 14 candidate mediators of the ADHD-internalising association across ages 11, 14 and 17.

RESULTS: Regularisation with lasso did not result in the de-selection of any of these mediators; however, only two were statistically significant.

CONCLUSION: Results suggest there may be many mediators of small effect involved in the relation between ADHD symptoms and later internalising problems but point to self-esteem and parental mental health as priority mechanisms for further study in future causal and interventional research.

PMID:41789525 | DOI:10.1177/10870547261419589

J Glob Health. 2026 Mar 6;16:04079. doi: 10.7189/jogh.16.04079.

ABSTRACT

BACKGROUND: Tuberculosis (TB) remains a major public health challenge in China and worldwide, with smoking being a key modifiable risk factor. Given China’s large population and rising smoking rates, this paper aims to examine the link between smoking and TB incidence.

METHODS: We systematically searched six databases from inception for studies reporting smoking exposure, TB outcomes, and smoker-non-smoker comparisons. Two reviewers independently screened records, extracted data, and assessed bias. We analysed smoking-TB associations using random-effects meta-analysis of odds ratios (ORs) and hazard ratios (HRs).

RESULTS: We included 17 studies reporting ORs and 7 studies reporting HRs in the quantitative synthesis. The pooled OR for TB incidence among smokers compared with non-smokers was 1.77 (95% confidence interval (CI) = 1.29-2.43), indicating a statistically significant increase in risk of TB. For studies reporting hazard ratios, the pooled estimate was 2.39 (95% CI = 1.28-4.45), showing a significant association between smoking and increased TB incidence.

CONCLUSIONS: Both active and passive smoking significantly elevate the risk of TB and worsen its outcomes in China. Our result indicate that COVID-19 pandemic may have indirectly exacerbated smoking-related risks through disruptions to TB services, heightened psychosocial stress, and shifts in smoking behaviours, with potential implications for TB risk and outcomes. Thus, integrating smoking cessation strategies into TB programmes, focusing on heavy smokers in especially high-prevalence areas, and raising public awareness could enhance efforts to prevent and control TB worldwide.

REGISTRATION: PROSPERO: CRD420251070123.

PMID:41789521 | DOI:10.7189/jogh.16.04079

J Glob Health. 2026 Mar 6;16:04078. doi: 10.7189/jogh.16.04078.

ABSTRACT

BACKGROUND: The high incidence and economic burden of coronary heart disease (CHD) represent a major public health challenge in Xinjiang, a region in northwest China. We aimed to assess the effects of a diagnosis-related group (DRG) policy on treatment costs and treatment efficiency in Bortala Mongol Autonomous Prefecture, Kashgar, and Kizilsu Kirghiz Autonomous Prefecture of Xinjiang, China.

METHODS: We retrieved data on CHD inpatients from three prefectures in the Xinjiang medical insurance database. Then, we used interrupted time series analyses to evaluate the effect of the DRG policy on these inpatients. The analysis spanned the period from 1 January 2022 to 31 December 2024, with the policy intervention point for each prefecture defined by its respective DRG implementation date. We divided patients into pre-DRG and post-DRG groups based on the timing of the DRG policy’s implementation. The outcome variables for treatment costs were total cost, drug cost, medical supplies cost, and out-of-pocket (OOP) payments; the outcome variable for treatment efficiency was length of stay (LOS).

RESULTS: Compared to the pre-DRG period, the total cost, drug cost, OOP, and LOS for CHD inpatients in three prefectures all decreased, with a growth rate (GR)<0. In contrast, the medical supplies cost in the Bortala Mongol Autonomous Prefecture and the Kizilsu Kirghiz Autonomous Prefecture increased (GR>0). Following the implementation of the DRG in Xinjiang, CHD inpatients in the Bortala Mongol Autonomous Prefecture saw a significant downward trend in drug cost (β₃ = -26.898; 95% confidence interval (CI) = -45.303, -8.493; P = 0.004), and their LOS decreased significantly in both level (P = 0.001) and trend (P = 0.034). The total cost for CHD inpatients in Kashgar showed a significant downward trend, and drug cost decreased significantly in both level (P = 0.003) and trend (P < 0.001). However, we observed no statistically significant differences in the remaining indicators of the two regions, or for all changes for CHD inpatients in the Kizilsu Kirghiz Autonomous Prefecture (all P > 0.05).

CONCLUSIONS: The DRG policy in Xinjiang has successfully controlled certain treatment costs and improved treatment efficiency for inpatients with CHD in the Bortala Mongol Autonomous Prefecture and in Kashgar. However, the implementation of DRG in the Kizilsu Kirghiz Autonomous Prefecture has not yet shown significant results and thus warrants monitoring and research.

PMID:41789517 | DOI:10.7189/jogh.16.04078

Res Synth Methods. 2026 Mar 6:1-14. doi: 10.1017/rsm.2026.10074. Online ahead of print.

ABSTRACT

Network meta-analysis (NMA) is a vital methodology for synthesizing evidence across multiple treatments and informing medical decision-making. However, effective visualization and interpretation of results from large networks of interventions remain challenging, particularly for non-specialists. NMAstudio 2.0 is an innovative, interactive web application designed to address these difficulties by streamlining NMA workflows and enhancing result visualization. Developed using Python and R, NMAstudio 2.0 seamlessly integrates with established NMA frameworks. Our exemplar application of NMAstudio 2.0 using a Cochrane Review comparing several treatments for chronic plaque psoriasis demonstrates its capacity to facilitate all crucial steps of an NMA. The application features an intuitive interface for uploading data, automating analyses, generating interactive visualizations such as network diagrams, forest plots, ranking plots, and producing unique outputs like boxplots for transitivity checks and bidimensional forest plots. Most outputs are dynamically linked with the network diagram, enabling users to interactively explore evidence networks, apply advanced filtering, and highlight specific features by selecting nodes or edges within the diagram. While NMAstudio 2.0 aims to simplify NMAs, it also incorporates steps during the data upload process to mitigate the risk of producing poorly reported NMAs. NMAstudio 2.0 represents a significant step forward in improving the usability and accessibility of NMA, offering researchers a robust, versatile platform for evidence synthesis. Its integration of advanced features with an emphasis on user experience positions it as a valuable resource for enhancing decision-making and promoting evidence-based practice across diverse contexts.

PMID:41789459 | DOI:10.1017/rsm.2026.10074

Hypertension. 2026 Mar 6. doi: 10.1161/HYPERTENSIONAHA.125.26397. Online ahead of print.

ABSTRACT

BACKGROUND: Contemporary hypertension guidelines emphasize individualized blood pressure (BP) management, often incorporating age; yet chronological age alone may be insufficient to guide optimal treatment. The frailty index offers a multidimensional measure of biological aging and may better guide BP management.

METHODS: We pooled participant-level data from SPRINT (Systolic Blood Pressure Intervention Trial) and ACCORD (Action to Control Cardiovascular Risk in Diabetes). The frailty index was calculated using a 31-item Rockwood cumulative-deficit model, with frailty defined as a frailty index >0.21. Participants were also categorized by age (<65 versus ≥65 years). Systolic BP (SBP) time in target range (TTR) was calculated using linear interpolation across 10 mm Hg intervals. Restricted cubic splines and stratified Cox models were used to assess the association between TTR within predefined SBP targets and major adverse cardiovascular events.

RESULTS: A total of 19 230 participants were included in the analysis (mean age, 65.2 years; 49.0% women; 68.2% classified as frail). Restricted cubic spline analyses showed a J-shaped relationship between average SBP and major adverse cardiovascular events, with clearer separation by frailty than by age. Among frail individuals, greater time spent within SBP intervals between 110 and 140 mm Hg was associated with lower major adverse cardiovascular event risk (hazard ratios per 10% increase in TTR, 0.92-0.94), whereas among nonfrail individuals, greater time spent below 130 mm Hg was associated with lower risk (hazard ratios per 10% increase in TTR, 0.89-0.98). Age demonstrated limited discrimination. Findings were consistent in separate analyses of SPRINT and ACCORD.

CONCLUSIONS: The frailty index, rather than chronological age, more accurately discriminates optimal SBP targets in hypertensive patients, whereas chronological age may remain a more practical tool in resource-limited settings.

PMID:41789453 | DOI:10.1161/HYPERTENSIONAHA.125.26397

F1000Res. 2026 Feb 3;15:176. doi: 10.12688/f1000research.177011.1. eCollection 2026.

ABSTRACT

OBJECTIVE: To evaluate the association between Fusobacterium nucleatum and c-Myc expression in Oral Potentially Malignant Disorders (OPMDs) and Oral Squamous Cell Carcinoma (OSCC) and to explore its potential role in oral carcinogenesis.

MATERIALS AND METHODS: A total of 32 histopathologically confirmed cases (18 OPMDs and 14 OSCC) were analyzed. Anaerobic cultures and polymerase chain reaction (PCR) were used to detect F. nucleatum. Immunohistochemistry (IHC) was performed to assess c-Myc expression. Statistical analysis was conducted using Mann-Whitney and Chi-square tests, with p < 0.05 considered significant.

RESULTS: F. nucleatum was detected in eight OSCC and two OPMD cases, with higher colony counts in OSCC. All samples were positive for c-Myc, but their expression levels varied. In OPMDs, positivity was mainly observed in the basal and suprabasal epithelial layers, whereas OSCC showed both peripheral and central tumor cell localization. F. nucleatum-positive OSCC cases demonstrated strong nuclear c-Myc staining (50-75% positive cells). Tobacco habits, particularly combined smoking and smokeless use, were more common in F. nucleatum-positive OSCC cases.

CONCLUSION: F. nucleatum colonization correlates with increased c-Myc expression in OPMDs and OSCC, supporting its possible role in microbially driven oral carcinogenesis. These findings suggest its potential as a prognostic biomarker and a therapeutic target.

PMID:41789431 | PMC:PMC12959620 | DOI:10.12688/f1000research.177011.1

Transp Policy (Oxf). 2026 Feb;176:103920. doi: 10.1016/j.tranpol.2025.103920. Epub 2025 Nov 24.

ABSTRACT

This study explores the complex relationships among metropolitan- and neighborhood-level racial segregation, transportation, and tract-level employment outcomes using data from over 28,000 census tracts in 95 Metropolitan Statistical Areas (MSAs) in the United States. Results from a series of multilevel models indicate that the availability of private (but not public) transportation is positively related to employment rate at the census-tract level. We also find census tracts with higher shares of Hispanics and African Americans have higher unemployment rates, but MSA-level dissimilarity is not significantly related to tract-level unemployment. We also determine that there is no moderating effect of MSA-level racial segregation on the relationship between transportation and employment outcomes. Findings reveal the critical role of automobiles in connecting employees to jobs. They further highlight that a reduction in racial segregation at the neighborhood level might benefit employment outcomes at the census tract level.

PMID:41789421 | PMC:PMC12959454 | DOI:10.1016/j.tranpol.2025.103920

Stat Probab Lett. 2026 Jun;233:110662. doi: 10.1016/j.spl.2026.110662. Epub 2026 Feb 2.

ABSTRACT

Directional replicability addresses the question of whether an effect studied across $n$ independent studies is present with the same direction in at least $r$ of them, for $r\ge 2$ . When the expected direction of the effect is not specified in advance, the state of the art recommends assessing replicability separately by combining one-sided $p$ -values for both directions (left and right), and then doubling the smaller of the two resulting combined $p$ -values to account for multiple testing. In this work, we show that this multiplicative correction is not always necessary, and give a sufficient and necessary condition under which it can be safely omitted.

PMID:41789419 | PMC:PMC12959485 | DOI:10.1016/j.spl.2026.110662