Category: Statistics

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

Nutr Hosp. 2025 Dec 17. doi: 10.20960/nh.06008. Online ahead of print.

ABSTRACT

INTRODUCTION: metabolic syndrome (MS) affects approximately 27 % of the global population and represents a growing public health concern. Identifying factors associated with its presence is essential for prevention, early diagnosis, and clinical management.

OBJECTIVE: to evaluate the association between depressive symptomatology (DS) and three IL-18 gene variants-rs360719 (-1297 T>C), rs187238 (-137 G>C), and rs1834481 (+488 C>G)-in individuals with MS.

METHODS: a descriptive, cross-sectional study was conducted between May and June 2023 involving 180 adults (90 with MS and 90 controls), diagnosed according to ALAD criteria. The PHQ-9 questionnaire was used to assess DS. Plasma IL-18 levels were measured using ELISA, and the IL-18 gene variants were genotyped by real-time PCR. The study was approved by the Ethics and Biosafety Committees (CEI-01-2023-02, CBIO-01-2023-02), and informed consent was obtained from all participants.

RESULTS: significant differences in anthropometric, biochemical, and blood pressure parameters were found between groups, confirming a dyslipidemic and inflammatory profile in the MS group. Although no statistically significant association was observed between DS and MS, a higher proportion of moderate to severe DS was noted in the MS group. No significant differences were identified in genotype or allele distributions of the studied variants. However, nonsignificant protective trends were observed for the G allele of rs360719 and rs1834481. Plasma IL-18 levels were significantly higher in participants with MS.

CONCLUSIONS: MS was associated with characteristic clinical and inflammatory alterations. Although no significant association was found with DS, the observed trends suggest a potential proinflammatory role of IL-18 and a possible protective effect of specific gene variants.

PMID:41503842 | DOI:10.20960/nh.06008

J Invest Surg. 2026 Dec;39(1):2560332. doi: 10.1080/08941939.2025.2560332. Epub 2026 Jan 8.

ABSTRACT

BACKGROUND: Abdominal aortic aneurysm (AAA) is a progressive vascular disorder that enlarges irreversibly and may ultimately rupture. Mendelian randomization (MR) provides a powerful approach to uncover biomarkers. We aimed to identify plasma proteins linked to AAA and evaluate their diagnostic potential.

METHODS: We performed a proteome-wide MR analysis using genetic instruments for 2,940 plasma proteins from the UK Biobank Pharma Proteomics Project (UKB-PPP). Summary statistics for AAA were obtained from the Finnish R9 GWAS, comprising 4,083 cases and 420,324 controls.

RESULTS: Eleven proteins showed significant causal associations with AAA risk (FDR < 0.05): seven positively and four negatively associated, highlighting their potential as diagnostic markers.

CONCLUSION: This study provides the first proteome-wide MR evidence linking plasma proteins to AAA, offering candidate biomarkers for diagnosis. As a hypothesis-generating work, further experimental and clinical validation is warranted.

PMID:41503834 | DOI:10.1080/08941939.2025.2560332

Traffic Inj Prev. 2026 Jan 7:1-9. doi: 10.1080/15389588.2025.2592858. Online ahead of print.

ABSTRACT

OBJECTIVES: Motorcyclists, as a vulnerable group of road users, not only suffer from trauma caused by collisions with other vehicles but also from the consequences of their own risky behaviors. As the number of motorcycle crashes has continued to rise in recent years, it is essential to understand trends in motorcyclists’ risky behaviors to enhance their safety. This study investigates the co-occurrence of six risky riding behaviors-speeding, alcohol-impaired riding, helmet nonuse, distraction, fatigue, and anger-and identifies rider characteristics associated with distinct behavioral profiles.

METHODS: This study analyzes data from 4,390 motorcyclists who participated in three annual surveys conducted in Florida between 2021 and 2023. The survey collected information on demographics, riding habits, risky motorcycling behaviors, and the perception that other drivers fail to notice or attend to motorcycles. Descriptive statistics and latent class analysis (LCA) were conducted to identify subgroups of riders based on co-occurring behaviors. A bias-adjusted three-step approach was used to examine associations between class membership and rider characteristics.

RESULTS: Four latent behavioral classes were identified: Very High-risk Riders, Moderate-Risk Riders, Drinking Riders, and Low-risk Riders. Each group exhibited distinct constellations of risky behaviors and demographic or attitudinal profiles. High-risk riders were more likely to be younger, less trained, and not using any safety gear. Alcohol use was especially pronounced among recreational riders regardless of age or gender. Formal motorcycle training was consistently linked to lower-risk classes.

CONCLUSION: This study advances the understanding of motorcyclist safety by demonstrating how risky behaviors cluster and how specific demographic and perceptual factors distinguish rider subgroups. These findings support the development of comprehensive safety interventions that target subgroups of motorcyclists who share similar risky profiles, rather than treating isolated behaviors.

PMID:41503803 | DOI:10.1080/15389588.2025.2592858

Drug Chem Toxicol. 2026 Jan 8:1-12. doi: 10.1080/01480545.2025.2606907. Online ahead of print.

ABSTRACT

The bio-accumulative nature of polychlorinated naphthalenes (PCNs) due to their slow biodegradation raise concerns regarding adverse effects on aquatic organisms and potential human health risks through trophic transfer. The persistent and traditional toxicity assessment of PCNs in aquatic species is constrained by experimental complexity, resource demands, and ethical considerations. Consequently, in silico approaches, particularly QSAR modeling in accordance with OECD guidelines, have emerged as robust alternatives to address data gaps and support hazard evaluation. In the present investigation, a Monte Carlo-based QSAR methodology employing CORAL software was utilized to assess the toxicity of PCNs in aquatic environments. An integrated dataset comprising 225 compounds with toxicity endpoints for green algae, Daphnia magna, and fish was assembled. Molecular structures were encoded using the Simplified Molecular Input Line Entry System (SMILES). Statistical evaluation confirmed the predictive robustness of the models, with Split 4 yielding superior external validation performance (r² = 0.9490, Q² = 0.9453, IIC = 0.9157, CII = 0.9633, CCC = 0.9661, r²_m = 0.8549, MAE = 0.192, S = 0.224, F = 1023). These findings substantiate the reliability of the developed QSAR model, underscoring its applicability in environmental toxicology, potential to design safer drug candidate and early-stage hazard assessment.

PMID:41503800 | DOI:10.1080/01480545.2025.2606907