Category: Statistics

Adv Sci (Weinh). 2026 Mar 15:e21637. doi: 10.1002/advs.202521637. Online ahead of print.

ABSTRACT

Conventional methods to control electromagnetic (EM) fields via digital coding metasurfaces are basically focused on generating deterministic EM responses, such as beam forming, holographic imaging, and harmonic modulation, by employing specific coding patterns or sequences. In contrast, controlling random EM fields aims to produce EM fields with target temporal statistical properties, such as spatial mean and variance distributions. Here, we propose a framework to control the spatial distribution of temporal statistical properties of EM fields via random time-space coding metasurfaces (RTCM). We establish a statistical model of RTCM in probability space and reveal that the spatial mean and variance distributions of EM fields are determined by the marginal and pairwise joint distributions of the random codes. Time-varying random EM fields with desired mean and variance distributions are generated by the sampling codes constrained by these distributions. We further show that simultaneously direct transmission and jamming can be achieved via the spatial mean and variance peaks, respectively. This work extends the metasurface paradigm into the probability domain, marking a shift from deterministic response design to probabilistic structuring, and paving the way for new approaches in communication, information security, and EM countermeasures.

PMID:41833001 | DOI:10.1002/advs.202521637

QJM. 2026 Mar 14:hcag077. doi: 10.1093/qjmed/hcag077. Online ahead of print.

ABSTRACT

BACKGROUND: Healthcare professionals working in hospitals during armed conflict are exposed to extreme psychological stress while maintaining clinical duties. Although psychological distress is well documented, the biological mechanisms linking wartime stress to functional outcomes such as workability remain insufficiently characterized.

OBJECTIVES: To investigate associations between psychological distress, perceived stress, workability, and inflammatory biomarkers among healthy hospital healthcare professionals working under acute wartime conditions.

METHODS: A prospective observational study was conducted among 90 healthy healthcare professionals employed at a hospital in central Israel during the October 2023 missile attacks. Participants completed validated questionnaires assessing psychological distress, perceived stress, and workability. Blood samples were collected to measure inflammatory biomarkers. Associations between psychological measures, workability indices, and biomarker levels were analyzed using multivariable statistical models.

RESULTS: Higher levels of psychological distress and perceived stress were significantly associated with reduced workability scores. Elevated stress measures correlated with increased levels of pro-inflammatory biomarkers, suggesting activation of inflammatory pathways. These biological changes partially mediated the relationship between psychological distress and impaired workability.

CONCLUSIONS: Acute wartime stress among hospital healthcare professionals is associated with both psychological impairment and measurable inflammatory responses, which may contribute to reduced functional capacity. These findings provide insight into the biological embedding of extreme occupational stress and underscore the need for targeted psychosocial and organizational interventions to protect healthcare workers operating under conflict conditions.

PMID:41832997 | DOI:10.1093/qjmed/hcag077

Oncologist. 2026 Mar 14:oyag081. doi: 10.1093/oncolo/oyag081. Online ahead of print.

ABSTRACT

BACKGROUND: Given the superior relapse-free survival (RFS) and different safety profiles of 1 year of adjuvant S-1 or uracil/tegafur (UFT) for stage II/III rectal cancer, the benefit-risk of these two regimens was formally assessed using the Net Treatment Benefit (NTB).

PATIENTS AND METHODS: Individual patient data from the JFMC 35-C1 trial were used. S-1 and UFT were compared regarding RFS, incidence of grade ≥3 symptoms, and incidence of grade ≥3 laboratory abnormalities reported as adverse events (AEs). Laboratory abnormalities and symptoms were analyzed as binary variables and as counts. Univariate and multivariate NTBs were computed for various ways of prioritizing the outcomes.

RESULTS: The univariate NTB for RFS was 9.2% (95% confidence interval [CI], 3.4% to 15.2%, P = 0.005) in favor of S-1. The univariate NTB was not statistically significant for any symptom. For grade ≥3 laboratory AEs, only thrombocytopenia was statistically significant in favor of UFT (NTB=-0.8%; 95% CI, -1.6% to -0.02%; P = 0.044). In the multivariate analysis considering RFS as the outcome of first priority, the incidence of grade ≥3 symptoms as second, and the incidence of grade ≥3 laboratory abnormalities as third, the multivariate NTB was 8.8% (95% CI, 2.7% to 14.9%, P = 0.014) in favor of S-1. In sensitivity analyses according to age group, the NTB was generally positive for patients <70 years but non-significant for those ≥70 years old.

CONCLUSION: The reanalysis of the JFMC 35-C1 trial suggests that S-1 has a superior benefit-risk to UFT when RFS is considered as the outcome of first priority, followed by the incidence of grade ≥3 symptoms and of grade ≥3 laboratory abnormalities.

PMID:41832993 | DOI:10.1093/oncolo/oyag081

Endocr Metab Immune Disord Drug Targets. 2026 Mar 9. doi: 10.2174/0118715303462423260125161230. Online ahead of print.

ABSTRACT

INTRODUCTION: Osteoporosis (OP) is a major public health burden; however, the role of SERPIN family proteins remains incompletely understood. This study aimed to investigate genetically inferred associations between SERPINs and OP and to explore potential regulatory relationships.

METHODS: Genome-wide association study (GWAS) summary statistics were used to perform two sample Mendelian randomization (MR) and summary-data-based Mendelian randomization (SMR) analyses. Primary MR estimates were derived using inverse-variance-weighted (IVW), MR-Egger, weighted median, simple mode, and weighted mode methods. Cancellous bone tissue from the greater trochanter of the femur was collected from three patients with OP and three non-osteoporotic controls. qPCR and WB were used to analyze the whole bone homogenate, IHC was used to detect decalcified bone sections, and mediation analysis was used to explore potential regulatory associations.

RESULTS: Among the proteins of the SERPIN family, only SERPING1 had an obvious positive correlation with the risk of osteoporosis (OR = 1.06, P = 0.0012). qPCR, WB, and IHC analyses demonstrated increased SERPING1 mRNA and protein expression in bone tissue from OP patients. Mediation analyses suggested that cg15918732 DNA methylation may serve as an upstream regulatory factor for SERPING1 expression. In addition, the downstream associations also consist of the alteration of immune cell conditions, like the decrease in the quantity of natural killer cells and T cells, and the rise in the level of mononuclear cells, and so forth.

DISCUSSION: These findings provide genetic evidence for the possible role of SERPING1 in OP, which may be achieved through epigenetic regulation and immune pathways. Due to the corresponding characteristics of genetic inference and the small sample size, these results are hypothetical and generative.

CONCLUSION: This study shows that DNA methylation of cg15918732 may be associated with SERPING1 expression in osteoporosis and immune-related traits. These findings provide new insights into potential epigenetic and immunological pathways in osteoporosis, which may contribute to future mechanistic and translational research.

PMID:41832983 | DOI:10.2174/0118715303462423260125161230

Int J Qual Health Care. 2026 Mar 14:mzag038. doi: 10.1093/intqhc/mzag038. Online ahead of print.

ABSTRACT

INTRODUCTION: Diagnostic errors in laboratory processes can compromise the accuracy of final diagnoses. Such errors represent a significant patient safety concern and are linked to adverse clinical outcomes. This study aimed to determine the frequency, types, and impacts of laboratory-related diagnostic errors on the final clinical diagnosis, patient harm, and organizational reputation in a large private hospital network in Thailand.

METHODS: A retrospective study analyzed diagnostic errors in clinical laboratory testing processes at Bangkok Hospital Headquarters (BHQ), Thailand, over a three-year period (January 1, 2021-December 31, 2023). Data were retrieved from a voluntary incident reporting system covering domains such as clinical hematology, clinical chemistry, metabolic diagnostics, genetics, microbiology, hormonology, serology, and coagulation. Descriptive statistics were employed to classify errors by laboratory process, sub-process, and subtype, identify causal factors, and evaluated the clinical impacts.

RESULTS: Out of 5,951,783 samples processed, 34,395 incidents were reported, of which 1,031 (2.9%) related to diagnostic errors. Errors predominantly occurred in the pre-analytical process (89.2%), followed by post-analytical (10.7%) and analytical process (0.1%). The most common error subtypes were incorrect test ordering (48.2%) and specimen collection (34.6%). Human factors accounted for 91.1% of errors, with technical and organizational factors contributing minimally. 90.6% of errors had no impact on final clinical diagnosis; 7.8% resulted in delayed diagnosis, 0.9% in missed diagnosis, and 0.7% in wrong diagnoses. Most errors (98%) caused no patient harm, 1.9% led to temporary harm, and one error affected organizational reputation. No sentinel events were reported.

DISCUSSION AND CONCLUSION: To strengthen diagnostic safety across healthcare systems, organizations should adopt comprehensive, system-level strategies that effectively address human-factor vulnerabilities and streamline laboratory workflows. Implementing evidence-based strategies could contribute to achieving higher diagnostic accuracy and advancing patient safety within clinical laboratory processes.

PMID:41832967 | DOI:10.1093/intqhc/mzag038

JNCI Cancer Spectr. 2026 Mar 14:pkag024. doi: 10.1093/jncics/pkag024. Online ahead of print.

ABSTRACT

BACKGROUND: S0221 investigated weekly vs (vs) every 2 weeks (Q2W) dosing of doxorubicin(A)/cyclophosphamide (C) followed by paclitaxel (P) in patients with high-risk early breast cancer. After an interim analysis, randomization to the two AC arms was stopped for futility and the trial was modified to study only the P schedules.

PATIENTS AND METHODS: Between December 2003 and November 2010, 2716 patients were randomized in a 2 x 2 factorial design to: 15 weeks of weekly A and daily C vs 6 cycles of Q2W AC; and weekly P for 12 weeks vs 6 cycles of Q2W P. Between January 2011 and January 2012, an additional 578 patients were assigned to 4 cycles of Q2W AC x 4 and randomized to weekly vs Q2W P. Updated survival was assessed using log-rank tests and Cox regression models. We compared outcomes by breast cancer subtype as well.

RESULTS: At a median follow-up of 12.1 years, there were no significant differences among the four treatment arms in disease free survival [DFS] (p = 0.91) or overall survival [OS] (p = 0.34) in the original protocol. Among the 578 patients assigned AC for 4 cycles and randomized to P weekly vs Q2W P, there were no overall differences in DFS (p = 0.32) or OS (p = 0.42).

CONCLUSION: As there were no significant outcome differences in DFS or OS between the studied schedules of AC and P with extended follow-up in the original or revised protocol, either paclitaxel schedule may be recommended, with selection based on toxicity, cost, or patient preference.

PMID:41832961 | DOI:10.1093/jncics/pkag024

Trends Psychiatry Psychother. 2026 Mar 15. doi: 10.47626/2237-6089-2025-1095. Online ahead of print.

ABSTRACT

OBJECTIVE: Major Depressive Disorder (MDD) is a multifactorial psychiatric disease influenced by a combination of genetic and environmental factors. Among the genes linked to MDD, the Melanocortin 1 Receptor (MC1R), Catechol-O-Methyltransferase (COMT), Brain-Derived Neurotrophic Factor (BDNF), and the serotonin transporter (5-HTT) are of particular interest due to their critical roles in stress regulation and neural function. Despite their biological significance, the contribution of specific polymorphisms within these genes to MDD risk remains understudied.

METHODS: This retrospective observational case-control study included 87 Colombian patients diagnosed with MDD according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The control group comprised Latino/admixed individuals without, sourced from the gnomAD v2.1.1 database. The complete coding region of the MC1R gene and three polymorphisms: 5-HTTLPR Insertion/Deletion 44 bp, BDNF-c.196G>A, and COMT-c.472G>A were genotyped using PCR and Sanger sequencing.

RESULTS: The polymorphisms rs885479 and rs4680 were identified as protective factors against MDD, while the polymorphisms rs796296176, rs779504604, rs1805005 were associated with an increased risk of developing MDD (OR:22.87, OR:51.26, OR: 1.97, respectively).

CONCLUSION: Several of the analyzed polymorphisms (rs796296176, rs779504604, rs1805005) increase the risk for MDD. Notably, we provide novel evidence of these polymorphisms in MC1R as a risk to MDD.

PMID:41832959 | DOI:10.47626/2237-6089-2025-1095

Occup Ther Health Care. 2026 Mar 15:1-17. doi: 10.1080/07380577.2026.2640978. Online ahead of print.

ABSTRACT

This study examined the effectiveness of multidisciplinary dialectical behavior therapy and acceptance and commitment therapy informed training for caregivers of youth in a day program setting. A one-group pretest-posttest design was used to assess the impact of multidisciplinary caregiver psychoeducation on caregiver stress and family function. Data was collected from 22 caregivers, revealing statistically significant improvements in caregiver stress and family functioning, suggesting that the caregiver education delivered within a day program setting is an effective intervention among families with children experiencing mental health challenges.

PMID:41832939 | DOI:10.1080/07380577.2026.2640978

Eur Radiol. 2026 Mar 15. doi: 10.1007/s00330-026-12392-z. Online ahead of print.

ABSTRACT

OBJECTIVES: To establish a semi-quantitative hepatic subcapsular flow (HSF) score using color Doppler ultrasonography (CDUS) and evaluate the performance of both the HSF score and hepatic capsular retraction (HCR) sign for identifying biliary atresia (BA), while simultaneously correlating with liver fibrosis.

MATERIALS AND METHODS: This study prospectively recruited 170 infants (35 BA and 135 non-BA; 124 males and 46 females) with a median age of 50 days (interquartile range 35-71). Multimodal ultrasound (grayscale ultrasound, CDUS, elastography) was utilized to evaluate the HSF score, HCR sign, and established markers (triangular cord [TC] sign, gallbladder, porta hepatis lymph nodes [PHLNs]). Diagnostic performance of individual and combined indicators was evaluated using the receiver operating characteristic curve (ROC). Additionally, correlations were analyzed between HSF score, HCR sign, and serum and histopathological liver fibrosis indicators.

RESULTS: The HSF score (cutoff ≥2) demonstrated an area under the ROC curve (AUC) of 0.950, superior to the cutoff ≥1 (p = 0.036) and higher (though not significantly) than established markers (all p > 0.05). The HCR sign had a lower AUC than other markers (all p < 0.05) but had high specificity within the studied cohort. It was also associated with higher liver stiffness measurement and fibrosis stage (p < 0.001, p = 0.001).

CONCLUSION: The liver capsule in BA infants undergoes significant morphological changes, which can be assessed using the HSF score and HCR sign. The HSF score provides reliable diagnostic performance for BA. The HCR sign, as a supplementary diagnostic marker, shows high specificity and correlates with the severity of liver fibrosis. These two indicators may support the diagnosis of BA and fibrosis assessment.

KEY POINTS: Question Can novel ultrasonographic signs-HSF score and HCR sign-improve the non-invasive diagnosis of BA and fibrosis assessment in cholestatic infants? Findings The HSF score demonstrated excellent diagnostic performance, while the HCR sign offered high specificity and was associated with liver fibrosis. Clinical relevance The HSF score is reliable for diagnosing BA, and the HCR sign serves as a high-specificity marker correlated with the severity of liver fibrosis, thus aiding in early diagnosis and fibrosis assessment.

PMID:41832932 | DOI:10.1007/s00330-026-12392-z

Eur Radiol. 2026 Mar 15. doi: 10.1007/s00330-026-12466-y. Online ahead of print.

ABSTRACT

OBJECTIVES: To determine if the apparent diffusion coefficient (ADC) can distinguish acellular mucin from cellular mucin in the treated tumor bed of patients with mucinous rectal adenocarcinoma after neoadjuvant therapy.

MATERIALS AND METHODS: This retrospective study included patients with mucinous rectal adenocarcinoma treated with neoadjuvant therapy, followed by restaging MRI and surgical resection or biopsy. Three radiologists blinded to histopathology results independently segmented volumes of interest on diffusion-weighted imaging and ADC maps. A medical physicist performed histogram analysis of ADC map segmentations, calculating various ADC metrics: mean, standard deviation, median, 1st quartile, 2nd quartile, 3rd quartile, and 4th quartile. The Wilcoxon rank sum test with false discovery rate correction for multiple testing was used to examine associations between ADC metrics and tumor mucin cellularity at histopathology for each reader. Multivariable logistic regression was used to adjust for acquisition parameters and institutions.

RESULTS: Of 150 patients (mean age, 58 ± 14 years; 48/150 (32% female), 25 patients (17%) had acellular mucin and 125 (83%) had cellular mucin at histopathology. At univariable analysis, there was no significant association between any ADC metric and tumor mucin cellularity (q-value = 0.14-0.58). At multivariable analysis, most ADC metrics were significantly associated with tumor mucin cellularity for all readers (q-values = 0.016-0.025) with odds ratios between 0.09 (95% CI: 0.02, 0.42) and 0.49 (95% CI: 0.22, 0.96).

CONCLUSIONS: ADC may be a potential tool for assessing pathologic complete response in mucinous rectal adenocarcinoma after neoadjuvant treatment, after adjusting for acquisition parameters and institutions.

KEY POINTS: QuestionCan the apparent diffusion coefficient (ADC) distinguish between cellular and acellular mucin (i.e., pathologic complete response) in mucinous rectal adenocarcinoma after neoadjuvant therapy? FindingsAfter controlling for acquisition parameters, ADC metrics were significantly associated with tumor mucin cellularity. Clinical relevanceAcellular mucin is equivalent to clinical complete response and can undergo watch-and-wait management, whereas cellular mucin is incomplete response, and its safety for watch-and-wait management is not validated. ADC may be a potential tool to make the distinction to assist treatment decision-making.

PMID:41832931 | DOI:10.1007/s00330-026-12466-y