Category: Statistics

Curr Med Sci. 2026 Jan 8. doi: 10.1007/s11596-025-00160-x. Online ahead of print.

ABSTRACT

OBJECTIVE: The benefits of caffeine to human health have been widely reported, but the association between caffeine intake and mortality among patients with chronic kidney disease (CKD) has been rarely reported in large epidemiologic studies. This study aimed to investigate the association between caffeine intake and mortality among CKD patients.

METHODS: Our study was conducted among non-dialysis CKD patients in the 2003-2016 National Health and Nutrition Examination Survey (NHANES). Weighted COX regression analysis was used to explore the linear relationship between caffeine intake and mortality among CKD patients (including all-cause mortality, as well as mortality due to cardiovascular disease, cancer, cerebrovascular disease, nephropathy, and influenza or pneumonia). Restricted cubic spline analysis was performed to explore the nonlinear relationship. Finally, threshold effects were analyzed through fitting a two-piecewise linear regression model.

RESULTS: In a fully adjusted model, no significant linear association was found between caffeine intake and mortality. However, there was a U-shaped association between caffeine intake and all-cause mortality (inflection point: 277 mg). Moreover, there was a J-shaped association between caffeine intake and cardiovascular mortality (inflection point: 252 mg) and cancer mortality (inflection point: 79 mg).

CONCLUSION: All-cause mortality was reduced in CKD patients when caffeine intake was less than 277 mg (about 1.85 cups of Americano). However, excessive caffeine intake was associated with increased all-cause mortality, cardiovascular mortality and cancer mortality in this population.

PMID:41505074 | DOI:10.1007/s11596-025-00160-x

Radiol Med. 2026 Jan 8. doi: 10.1007/s11547-025-02170-0. Online ahead of print.

ABSTRACT

PURPOSE: This meta-analysis evaluates the diagnostic performance of computed tomography (CT)-based artificial intelligence (AI) models versus radiologists for preoperative microvascular invasion (MVI) detection in hepatocellular carcinoma (HCC).

METHODS: A systematic literature search was conducted in PubMed, Embase, and Web of Science to identify studies published up to February 2025 focusing on the diagnostic accuracy of CT-based AI models for the preoperative detection of MVI in HCC, compared with the diagnostic performance of radiologists. A bivariate random-effects model was employed to calculate the pooled sensitivity, specificity, and area under the curve (AUC), all presented with 95% confidence intervals (CIs). Heterogeneity among studies was assessed using the I² statistic. The methodological quality of included studies was evaluated using a modified version of the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool.

RESULTS: Of 918 identified studies, 32 studies with 3,709 cases were included. For the internal validation set, the pooled sensitivity, specificity, and AUC for detecting MVI in HCC were 0.83 (95% CI 0.79-0.87), 0.81 (95% CI 0.76-0.86), and 0.89 (95% CI 0.86-0.92), respectively. Radiologists achieved a sensitivity of 0.82 (95% CI 0.63-0.93), specificity of 0.65 (95% CI 0.45-0.81), and AUC of 0.80 (95% CI 0.77-0.84).

CONCLUSIONS: CT-based AI may have the potential to outperform radiologists in predicting MVI in HCC. However, existing evidence is limited by study heterogeneity and limited number of the direct comparison between AI and radiologists. Prospective multicenter studies are needed to validate its clinical utility.

PMID:41505041 | DOI:10.1007/s11547-025-02170-0

Eur Phys J E Soft Matter. 2026 Jan 8;49(1-2):1. doi: 10.1140/epje/s10189-025-00544-w.

ABSTRACT

This work investigates chiral particles, which break mirror symmetry, in turbulent Taylor-Couette flow. These particles generally display a translation-rotation coupling moving through a quiescent fluid. Here, we performed experiments using large chiral particles (typical size 5mm) in turbulent Taylor-Couette flow, for Reynolds numbers $9·{10}^3\le \text{Re}\le 1.5·{10}^5$ . The density-matched chiral particles are studied in a dilute regime $(\varphi =1.7·{10}^{–4})$ , where their location and orientation are tracked over time to investigate the particle-fluid coupling. We investigate whether the translation-rotation coupling observed at low Reynolds numbers is still observable over the measured high Reynolds numbers, using the tracked location and orientation. Similarly, we verify whether the chiral particles display a preferred location or orientation, and whether the left-handed and right-handed particles show different rotation statistics. The location data show that the chiral particles closely follow the structure of Taylor vortices. Hence, the orientation data and rotation data of the chiral particles are split between the Taylor vortices and particle chiralities. The results show no difference in rotation and orientation dynamics between chiralities. Rather, the particle dynamics are flow-dominated, where the flow vorticity determines the specific particle dynamics.

PMID:41505007 | DOI:10.1140/epje/s10189-025-00544-w

Arch Osteoporos. 2026 Jan 8;21(1):20. doi: 10.1007/s11657-025-01635-z.

ABSTRACT

In the U.S’s largest integrated health system, during a 24-year period (1999-2022), bisphosphonate treatment initiation for fracture prevention in men shifted towards higher-risk populations, including older men and those with prior fracture and frailty.

PURPOSE: To evaluate 24-year trends in bisphosphonate (BP) initiation among older U.S. male Veterans and shifts in demographic and clinical characteristics of BP-treated men over time.

METHODS: U.S. national Veterans Health Administration (VHA) data (1999-2022) were queried to identify men aged ≥ 50 years with a first prescription for an FDA-approved BP for fracture prevention. Age, race, ethnicity, BP drug and route, prior fracture, and, in those aged ≥ 65 years, Veterans Affairs Frailty Index (VA-FI), were examined across five time periods. Temporal trends were analyzed using chi-square and nonparametric trend tests.

RESULTS: A total of 298,340 men initiated a BP during 1999-2022, of whom 233,857 (78.4%) were aged ≥ 65 years. BP initiation rose sharply after FDA approval of BPs for men in 2000, peaked in 2004-2005, then declined by about 50% between 2006 and 2012, and then plateaued. Over time, the proportion of BP initiators aged < 65 years declined from a peak of 28.2% during the middle time period (2008-2012) to a nadir of 13.3% during the final years (2018-2022, p < 0.001 for trend). Among the subset of men age 65 and older who initiated BP, the proportion with prior fracture increased from 8.3% in 1999-2002 to 24.5% in 2018-2022 (p < 0.001). Notably, over half of the men who initiated BP during 1999-2002 were classified as non-frail, whereas in the most recent time period (2018-2022), over half of BP initiators were frail (mildly, moderately, or severely) and only 14.8% of them were non-frail (p < 0.001).

CONCLUSION: In the VHA, BP initiating patterns shifted over time towards treating older men, with much larger proportions of men who had a prior fracture and were classified as frail.

PMID:41504976 | DOI:10.1007/s11657-025-01635-z

Arch Womens Ment Health. 2026 Jan 8;29(1):14. doi: 10.1007/s00737-025-01658-y.

ABSTRACT

PURPOSE: Maternal depression is a significant public health concern that can adversely affect both mothers and their children. Although various psychotherapeutic interventions have been proposed, their relative comparative efficacy remains unclear. This network meta-analysis (NMA) aimed to evaluate and compare the efficacy of different psychotherapeutic interventions in reducing maternal depressive symptoms.

METHODS: A systematic search was conducted in the Web of Science Core Collection (Science Citation Index Expanded and Social Sciences Citation Index) to identify randomized controlled trials (RCTs) published between 1 February 2021 and 1 February 2025. Eligible studies included mothers aged ≥ 18 years who were assessed for maternal depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS) and received any form of psychotherapy. Data were extracted using a predefined format (PROSPERO ID: CRD420251010916). Random-effects models were used to perform the NMA in R, reporting mean differences (MD) with 95% confidence intervals (CIs) and P-scores.

RESULTS: A total of 8 RCTs involving 2,919 participants were included. Cognitive behavioral therapy (CBT) was the only intervention that showed a statistically significant reduction in depressive symptoms compared to treatment as usual (TAU) (MD = -3.22, 95%CI: -5.91 to -0.54; p = 0.019; P-score = 0.92). Other interventions showed trends toward improvement, but these were not statistically significant (p > 0.05).

CONCLUSION: CBT emerged as the most efficacious psychotherapeutic approach in both direct and indirect comparisons, supported by statistical evidence from the NMA.

PMID:41504974 | DOI:10.1007/s00737-025-01658-y

J Gastrointest Cancer. 2026 Jan 8;57(1):5. doi: 10.1007/s12029-025-01391-w.

ABSTRACT

PURPOSE: Secondary malignant neoplasms of the liver are more common than primary liver cancers but remain understudied. This study provides the first nationwide analysis of liver metastases-related mortality trends and disparities in the US.

METHODS: This study analyzed CDC WONDER mortality data (1999-2023) and US Cancer Statistics incidence data for adults ≥ 45 years. Liver metastases-related (ICD-10: C78.7) mortality was stratified by demographics, geographic regions, and primary site of malignancy. Age-adjusted mortality and incidence rates (AAMRs, AAIRs) and crude mortality rates (CMRs) were reported per 100,000 population. Temporal trends were analyzed using Joinpoint regression to calculate annual and average annual percentage changes (APC, AAPC).

RESULTS: Liver metastases-related AAMR rose from 23.8 (1999) to 25.1 (2023) (AAPC = 0.22%*, 95% CI: 0.14-0.29). Males accounted for 51.3% of the 597,332 deaths and had higher AAMRs than females throughout. Lung (25.6%) and colon (24.6%) cancers were the leading primary sites causing deaths related to liver metastases. AAIRs and AAMRs (irrespective of metastasis) declined for most primary cancers. CMRs had an increasing trend, with nearly a 10-fold difference between ages 45-54 and 85+. Non-Hispanic (NH) Blacks had the highest AAMR with a declining trend (AAPC=-0.66%*), while NH Whites saw a significant increase (AAPC = 0.49%*). The West showed the biggest regional increase (AAPC = 1.24%*). AAMR rose the most in Vermont (AAPC = 5.30%*). Rural areas consistently had higher AAMRs (1999-2020).

CONCLUSION: Mortality from liver metastases has risen among older US adults, with notable demographic and geographic disparities. Improved survival among patients with primary cancers means more individuals are living long enough to experience recurrence and develop late liver metastases, underscoring the need for enhanced detection, surveillance, and management.

PMID:41504955 | DOI:10.1007/s12029-025-01391-w

Oecologia. 2026 Jan 8;208(2):21. doi: 10.1007/s00442-025-05855-5.

ABSTRACT

Apex carnivores are known to regulate ecosystem structure and function, including via interactions with syntopic, competitively inferior carnivores. These effects may be dependent on relative carnivore density and resource availability or productivity. We investigated the functional effect of African lions as an apex carnivore on the presence of co-occurring large carnivore species across two adjoining National Parks that contrast in relative densities of carnivores and prey. We employed two-species occupancy models from track data to test statistical interactions between lions and the other syntopic large carnivore species, while accounting for each species’ habitat selection. We further investigated the influence of anthropogenic and natural variables on these co-occurrence dynamics. Our models revealed that the occurrence of each carnivore species was best predicted by access to their own key resources. We also found significant statistical interactions between lions and cheetahs, lions and leopards, and lions and spotted hyenas in resource-rich landscapes. Finally, we found limited support for the competition exclusion hypothesis between most species, with the exception of lion-African wild dog co-occurrence patterns. Species’ co-occurrence dynamics were all influenced by resource availability, with lion-leopard and lion-cheetah co-occurrence decreasing strongly with increasing resource availability. Most species co-occurrence declined with increasing occurrence of lions. The patterns revealed by this study improves predictions of how changes in resource availability and carnivore occurrence could impact carnivore community dynamics and the functional role of apex carnivores.

PMID:41504937 | DOI:10.1007/s00442-025-05855-5

Pediatr Nephrol. 2026 Jan 8. doi: 10.1007/s00467-025-07076-7. Online ahead of print.

ABSTRACT

BACKGROUND: Early detection of ophthalmological and kidney complications of hypertension in children and adolescents may play a significant role in prophylaxis and prevent irreversible organ damage. This study aimed to assess standard kidney injury markers (creatinine, urea, uric acid, cystatin C, 24-h microalbuminuria), as well as potential ophthalmological changes using optical coherence tomography (OCT) and optical coherence tomography angiography (OCT-A) in the early course of newly diagnosed hypertension in children and adolescents.

METHODS: The study group consisted of 56 children and adolescents with newly diagnosed hypertension who had not received antihypertensive treatment prior to the study. Fifteen individuals served as controls. The ECHO, abdominal ultrasound, ophthalmological examination, urine and blood tests were performed.

RESULTS: The concentration of cystatin C was increased in patients with hypertension. Children and adolescents with hypertension had decreased values of GFR (90.31 ± 13.00 ml/min/1.73 m²), estimated by the Filler equation, compared to subjects with optimal values of blood pressure (99.00 ± 9.27 ml/min/1.73 m²). The data revealed statistically significant differences in the retinal vessel density analyzed by OCT-A, which was decreased in the control group compared with the study group.

CONCLUSIONS: Pediatric patients with newly diagnosed hypertension have increased concentrations of cystatin C and hypofiltration estimated by the Filler equation. OCT-A might be considered a diagnostic tool for better understanding the early process of microvascular changes and the influence of concomitant comorbidities in newly diagnosed systemic hypertension.

PMID:41504898 | DOI:10.1007/s00467-025-07076-7

Pain Manag. 2026 Jan 7:1-15. doi: 10.1080/17581869.2025.2608572. Online ahead of print.

ABSTRACT

INTRODUCTION: Effects of Spinal Cord Stimulation (SCS) on physical activity and self-efficacy remain unexplored.

PURPOSE: To evaluate effects of SCS on pain intensity, physical activity, health-related quality of life (HRQL), and self-efficacy among chronic neuropathic pain patients.

METHODS: Randomized controlled trial, the first phase of a 3-part intervention study. Patients >18 years of age underwent SCS implantation after a test trial and were randomized 1:1 to active SCS or conventional medical management (CMM) with the SCS switched off. Data were collected at baseline and 3 months after implantation regarding pain (Numeric Rating Scale; NRS), physical activity (accelerometer), HRQL, and self-efficacy.

RESULTS: Participants implanted with SCS (n=42) were randomized to active SCS (n=21) or CMM (n=21). Nineteen participants crossed over from CMM to active SCS due to lack of pain relief. Neuropathic pain intensity decreased significantly from baseline to 3 months (NRS 6.7 to 4.5; p <0.001) in patients with active SCS. Moderate-to-vigorous physical activity increased by 26 minutes/week (87%), although not statistically significant. Patients reported significant improvements in HRQL and self-efficacy.

CONCLUSION: SCS seems to reduce neuropathic pain intensity which might contribute to improvements in HRQL and self-efficacy. Low physical activity levels in this population should prompt targeted rehabilitation interventions.

CLINICAL TRIAL REGISTRATION: The https://clinicaltrials.gov/ identifier is NCT03740763 and the Västra Götaland Region (VGR) registry (https://www.researchweb.org/is/vgr/) identifier is 216271.

PMID:41503863 | DOI:10.1080/17581869.2025.2608572

Nutr Hosp. 2025 Dec 17. doi: 10.20960/nh.06054. Online ahead of print.

ABSTRACT

INTRODUCTION: pressure injuries (PIs) are chronic wounds of the skin and subcutaneous tissue with multifactorial etiology. They are preventable in 95 % of cases; however, their prevalence reaches up to 33 % among institutionalized individuals. This study comprehensively identified environmental, clinical, nutritional, and functional factors associated with the presence of pressure injuries in institutionalized older adults.

METHODS: observational, cross-sectional, and analytical study conducted in 55 institutionalized older adults selected by non-probabilistic quota sampling. Nutritional status (MNA), body composition (bioimpedance), functional status (Barthel Index), frailty (FRAIL scale), and presence of PIs (NPUAP) were assessed. The analysis included descriptive statistics, bivariate tests (chi-square, Fisher’s exact, Student’s t-test), and multivariate logistic regression with stepwise selection, reporting odds ratios and 95 % confidence intervals.

RESULTS: the majority were women (74.5 %), with a mean age of 86.7 years (SD, 9.8) and a mean institutionalization time of 7.3 years. The prevalence of PIs was 43.6 %. Statistically significant associations were found between PIs and nutritional status (p = 0.027), phase angle (p = 0.007), functional status (p = 0.011), and diaper use (p = 0.001). In multivariate logistic regression analysis, diaper use showed an OR of 24 (IC 95 %, 2.57-223.7, p < 0.005).

CONCLUSION: diaper use is an independent risk indicator for PIs in multivariate analysis. Additionally, systematic use of bioimpedance in institutionalized patients contributes to a comprehensive assessment of older adults, strengthening the management of pressure injuries and their clinical context.

PMID:41503844 | DOI:10.20960/nh.06054