Category: Statistics

Ther Adv Gastroenterol. 2026 May 15;19:17562848261446862. doi: 10.1177/17562848261446862. eCollection 2026.

ABSTRACT

BACKGROUND: ARID1A mutations are frequent in gastric cancer (GC) and may indicate an immune-active tumor microenvironment.

OBJECTIVES: This study aimed to assess the efficacy of the immune checkpoint inhibitor (ICI) plus chemotherapy as first-line therapy in advanced GC and explore its association with key molecular features according to the status of ARID1A-mutation.

DESIGN: This was a retrospective, single-center cohort study.

METHODS: We analyzed 258 patients with advanced HER2-negative GC who received ICI plus chemotherapy between 2022 and 2024. ARID1A mutation status and other molecular features were assessed using next-generation sequencing. Also, the status for Epstein-Barr virus (EBV), programmed death-ligand 1 (PD-L1), and claudin 18.2 was done. Treatment outcomes were evaluated between ARID1A-mutant and wild-type groups.

RESULTS: Among 258 patients, 67 (26.0%) harbored at least one ARID1A mutation. ARID1A mutant tumors (MT) showed significantly higher tumor mutational burden (median 18.0 vs 6.7 mut/Mb), EBV positivity (11.8% vs 0.6%), MSI-H status (10.6% vs 6.3%), and PD-L1 CPS ⩾50 (14.9% vs 1.0%) compared to wild-type (WT). The median progression-free survival (PFS) was numerically longer in the ARID1A MT group (9.7 vs 8.5 months; HR 0.75; 95% CI, 0.53-1.10), though not statistically significant. There was no significant difference for the ORR (55.2% vs 64.4%, p = 0.19), and the overall survival (27.4 vs 31.1 months; HR 0.83; 95% CI, 0.58-1.20) between the two groups.

CONCLUSION: ARID1A mutations were associated with immune-active molecular features and a trend toward improved PFS to ICI plus chemotherapy. Further research for ARID1A as a potential biomarker for ICI is warranted in advanced GC.

PMID:42153215 | PMC:PMC13180195 | DOI:10.1177/17562848261446862

J Public Health Res. 2026 May 16;15(2):22799036261452463. doi: 10.1177/22799036261452463. eCollection 2026 Apr.

ABSTRACT

BACKGROUND: Air pollution is a leading global public health challenge, with PM2.5 exposure strongly associated with respiratory and cardiovascular morbidity. In developing countries like Pakistan, urban air pollution levels are particularly severe. In 2021, Peshawar was ranked 9th globally for pollution, with PM2.5 levels 12 to 16 times higher than WHO limits. This study investigates chronic exposure to heavy traffic emissions and its long-term effects on lung function in Peshawar’s roadside vendors, a highly exposed occupational group from an under-reported location.

DESIGN AND METHODS: A cross-sectional study was conducted on 218 non-smoker male roadside vendors in Peshawar. Spirometry assessed FEV1, FVC, PEF, and FEV1/FVC ratio against GLI-predicted values adjusted for age and BMI. Duration of work and daily exposure hours were documented. Ground-based PM2.5 data (2019-March 2025) were recorded separately. Analysis was performed in SPSS using multivariate linear regression models.

RESULTS: PM2.5 remained consistently high (mean range: 139-166 μg/m³) from 2019-2025, with notable occasional spikes observed. All spirometric indices declined with increasing exposure duration. Regression showed each additional year reduced GLI-predicted %FEV1 by 0.3 % (p=0.042) and %PEF by % 0.47 (p=0.018). Descriptive statistics showed the >20-year exposure group had the lowest GLI-predicted % means for FEV1, FVC, FEV1/FVC and PEF values. Normal spirometry predominated, but restrictive and obstructive patterns were also observed in earlier exposure groups.

CONCLUSION: Prolonged roadside air pollution exposure progressively impairs lung function, underscoring the urgent need for occupational and environmental public health interventions to safeguard high-risk informal workers.

PMID:42153209 | PMC:PMC13180141 | DOI:10.1177/22799036261452463

J Public Health Res. 2026 May 14;15(2):22799036261451538. doi: 10.1177/22799036261451538. eCollection 2026 Apr.

ABSTRACT

INTRODUCTION: Domestic violence remains a major global health and human rights issue, with pregnant women being among the most affected groups. In Ethiopia, evidence from individual studies on violence during pregnancy has been inconsistent. Therefore, this review aimed to estimate the combined prevalence of domestic violence among pregnant women in Ethiopia and to identify determinants contributing to its occurrence.

METHODS: A comprehensive literature search was performed across multiple databases, including PubMed, HINARI, Scopus, EMBASE, Web of Science, Global Health, African Journals Online (AJOL), and Google Scholar. Study quality was evaluated using the Joanna Briggs Institute (JBI) checklist for analytical cross-sectional studies. Heterogeneity among studies was assessed using the Cochrane Q and I² statistics, and a random-effects model was applied to compute the pooled prevalence.

RESULTS: The overall pooled prevalence of domestic violence during pregnancy in Ethiopia was found to be 44% (95% CI: 29.86-58.15). The likelihood of experiencing violence was significantly higher among women with partners who consumed alcohol frequently (POR = 1.63; 95% CI: 1.43-1.85), those with low educational attainment (AOR = 6.3; 95% CI: 2.78-14.44), and women with unintended pregnancies (POR = 4.99; 95% CI: 2.96-8.43).

CONCLUSION: Nearly half of pregnant women in Ethiopia face domestic violence; influenced primarily by low educational status, partner alcohol use, and unintended pregnancy. Addressing this public health challenge requires integrated interventions focusing on women’s empowerment, male partner behavior, reproductive health services, and routine screening in antenatal care.

PMID:42153207 | PMC:PMC13180146 | DOI:10.1177/22799036261451538

Iran J Pharm Res. 2026 Feb 9;25(1):e162445. doi: 10.5812/ijpr-162445. eCollection 2026 Jan-Dec.

ABSTRACT

BACKGROUND: Dietary patterns are effective in obesity treatment. This has led to more investigations on its mechanisms in combating obesity.

OBJECTIVES: This study investigated the effects of ginseng and green tea extracts (GTE) on selected markers of lipid metabolism and the expression of some related genes in adipocytes.

METHODS: After a one-month period of consuming a high fatty content diet, a total of 42 male Wistar rats were assigned to seven groups randomly. The rats were then subjected to an eight-week treatment where they were administered different dosages of GTE and ginseng extract (GE) through oral administration. Then, some serologic parameters pertaining to lipid metabolism were analyzed in the treated rats. Furthermore, alterations in the expression levels of select genes, bone morphogenetic protein 7 (BMP7), hormone-sensitive lipase (HSL), and leptin, implicated in lipid metabolism, were quantified within the adipose tissue of the rats utilizing the reverse transcription-quantitative polymerase chain reaction (RT-qPCR) methodology. Ultimately, the chemical composition of the extracts was analyzed by high performance liquid chromatography (HPLC).

RESULTS: The findings indicated that the utilization of the extracts had a notable impact on the reduction of body weight. There was a noteworthy enhancement of high-density lipoprotein levels across all study groups, as indicated by a statistically significant increase at a confidence level of 95%. The efficacy of the administered extracts was observed in a significant upregulation in BMP7 and HSL gene expression. Conversely, there was a notable reduction in leptin expression, which reached statistical significance at a confidence level of 95%. HPLC results detected 9 ginsenosides in the GE, among which Rb1 (100 mAU) was present in the largest amount, and 9 alkaloids in the GTE, among which epicatechin (EC) (380 mAU) and caffeine (320 mAU) were present in the largest amount.

CONCLUSIONS: The present study holds the potential to offer novel insights regarding the mechanism through which GE and GTE exert their anti-obesity effects.

PMID:42153195 | PMC:PMC13180287 | DOI:10.5812/ijpr-162445

Iran J Pharm Res. 2026 Apr 27;25(1):e166629. doi: 10.5812/ijpr-166629. eCollection 2026 Jan-Dec.

ABSTRACT

BACKGROUND AND OBJECTIVE: The present study investigated the effect of folic acid in a rat model of sciatic nerve injury (SNI)-induced cognitive dysfunction.

METHODS: In this study, six groups with six male Wistar rats in each group were used. The simple randomization method was adopted for unbiased assignment of animals based on age, sex, and weight variations. Folic acid (10 and 20 mg/kg) and donepezil (1 mg/kg) were administered by the oral (p.o.) route for 10 days. The rats’ cognition was assessed by the Morris water maze (MWM) test. The assessment of the learning trial (acquisition) was the escape latency time (ELT), while the assessment of memory retention (retrieval) was the time spent in the target quadrant (TSTQ), which was measured in the MWM test. The brain samples of rats were used to assess biomarkers such as total protein, reduced glutathione (GSH), thiobarbituric acid reactive substances (TBARS), and acetylcholinesterase (AChE) activity. The behavioral data were statistically analyzed by a two-way analysis of variance (ANOVA) test, and biomarkers were analyzed by one-way ANOVA. The 95% confidence level (P < 0.05) was fixed for confirmation of statistical significance.

RESULTS: The administration of folic acid statistically (P < 0.05) reduced the SNI-induced elevated ELT and TSTQ levels compared to the sham control group. However, folic acid also prevented the rise in TBARS and AChE activity and the drop in GSH after SNI. The comparable outcomes were statistically (P < 0.05) similar to those of the donepezil-administered group.

CONCLUSIONS: Folic acid has great potential to be used in treating peripheral nerve injury-associated cognitive dysfunction.

PMID:42153193 | PMC:PMC13180334 | DOI:10.5812/ijpr-166629

Orbit. 2026 May 18:1-5. doi: 10.1080/01676830.2026.2673568. Online ahead of print.

ABSTRACT

PURPOSE: To determine whether prophylactic antibiotic administration following the development of an orbital floor fracture or after orbital floor fracture repair is associated with a reduced risk of orbital or periorbital cellulitis.

METHODS: A multicenter retrospective cohort study was designed using data obtained from the TriNetX United States Collaborative Network. Patients with orbital floor fractures were categorized by antibiotic exposure within 14 days of diagnosis. Similarly, patients who underwent orbital floor fracture repair were queried to determine whether or not they received antibiotics either at the time of surgery or in the immediate postoperative period. The primary outcome was orbital or periorbital cellulitis within 180 days, assessed after 1:1 propensity-score matching for demographic and clinical variables. Statistical analyses were then performed to determine differences in the two groups.

RESULTS: Among 3,169 matched pairs, antibiotic use was associated with higher cellulitis incidence after incident orbital floor fracture (1.93% vs 0.57%, respectively; RR = 3.40, p < 0.0001). In 1,116 matched pairs who underwent orbital floor fracture repair, patients who received antibiotics were more likely to develop orbital cellulitis than those that did not (2.69% vs. 1.08%, respectively; RR = 2.50, 95% CI [1.29-4.86], p = 0.005).

CONCLUSION: Prophylactic antibiotics did not reduce infection risk after incident orbital floor fracture or after floor fracture repair and were associated with higher cellulitis rates. While clinical decision making may depend on a variety of factors, routine use of antibiotics in these settings may not be appropriate.

PMID:42151747 | DOI:10.1080/01676830.2026.2673568

Muscle Nerve. 2026 May 18. doi: 10.1002/mus.70286. Online ahead of print.

ABSTRACT

INTRODUCTION/AIMS: Given limited research on patient perspectives of speech-language pathology (SLP) services in ALS care, this study aimed to assess the satisfaction with, and understanding of, SLP services by people with ALS (pwALS) and to examine the alignment between services received and patient-reported impairments.

METHODS: A cross-sectional survey assessing pwALS’ perceptions of SLPs was distributed from October 2024 to January 2025 through electronic mailing lists of relevant professional organizations. A questionnaire examined pwALS’ understanding of the SLP role, satisfaction levels, alignment between patient-reported impairments and SLP interventions, and perceived gaps in care. Responses were analyzed using descriptive statistics, with open-ended items analyzed using qualitative analysis.

RESULTS: The 81 survey respondents consisted of pwALS (81.5%), caregivers (11.1%), family members (4.9%), and others (2.5%). Overall satisfaction with SLP care was high, though open-ended responses revealed gaps in understanding. Many were unaware of the full scope of SLP services; only 17.3% recognized cognitive evaluation and 8.6% cognitive therapy, compared with speech (77.8%) and swallowing (81.5%) evaluations. Reported services often did not align with communication and swallowing needs, but patients educated about a service were significantly more likely to use it.

DISCUSSION: Overall satisfaction with SLP care was high; however, open-ended responses revealed gaps in understanding, unmet needs, and limited awareness of the full scope of SLP services. This misalignment highlights the need for improved patient and caregiver education regarding the role and timing of SLP involvement to enhance engagement, appropriate service use, and outcomes in ALS care.

PMID:42151746 | DOI:10.1002/mus.70286

JMIR Form Res. 2026 May 13. doi: 10.2196/78701. Online ahead of print.

ABSTRACT

BACKGROUND: Emergency trauma care (ETC) in the “golden hour” can reduce the fatality rates by 20% – 50%. Imparting ETC training in undergraduate Indian medical graduate (IMG) curriculum can prepare them for both pre-hospital and hospital set-up management as a first responder, thus saving lives. However, teaching these lifesaving skills for managing acute trauma patient like spinal injury in competency based medical education (CBME) curriculum, is challenging. These skills can be taught on standardized patient, allowing the learner, to safely learn the skills on a living responding human being, thus achieving a higher level of clinical competency and better communication skills. However, their availability is limited. In such a scenario, video demonstration of such skills is an easy and reliable teaching learning method.

OBJECTIVE: The study aims to evaluate the effectiveness of using standardized patient versus video demonstration for teaching psycho-motor skills in the management of spinal injury to under graduate students.

METHODS: A prospective interventional comparative study was carried out in the Orthopaedics department of a teaching hospital from September 2024 to February 2025, with Institutional Ethics Committee approval. Thirty undergraduate students posted in Orthopaedics, were divided into two groups (15 each) based on their even and odd roll numbers (systematic sampling). One group was shown video demonstration (VD) of skills like application of an improvised cervical collar and log rolling maneuver in the management of spinal injury patient in primary setting and other group was taught on a standardized patient (SP). The students were assessed by objective structured clinical examination (OSCE) and maneuvers were performed by them on mannequins. Pre-test and Post Test evaluation with peer validated questionnaire along with student’s feedback was taken. The data was analyzed by unpaired t test for OSCE scores and paired t test for pre and post test scores with statistical significance set at p < 0.05 (Confidence interval 95%). Student feedback questionnaire based on 5-point Likert scale was evaluated.

RESULTS: There was significant difference in the mean OSCE scores obtained by VD group 15.47 and by SP group is 18.27 (p value 0.004). However, in comparing the OSCE scores obtained in individual skill demonstration stations for log rolling maneuver and cervical spine immobilization (a pure psycho-motor skill), the mean scores of VD group were 2.27 and 3.20 and SP group was 2.33 and 3.27 respectively. This difference was not significant (p value 0.74 and 0.79 respectively). The student feedback showed teaching with standardized patient, was marginally more interesting and effective method, giving them more confidence to apply these skills in primary setting if needed.

CONCLUSIONS: The study shows both methods are equally effective for teaching lifesaving psycho-motor skills in the management of spinal injury. However, SP group students had better student engagement . Hence a blended approach , where a video demonstration is used to teach large groups or can be given to students prior to the sessions, followed by teaching or assessing on standardized patient for application of these skills will lead to optimum results and save time.

PMID:42151725 | DOI:10.2196/78701

Neurocrit Care. 2026 May 18. doi: 10.1007/s12028-026-02533-z. Online ahead of print.

ABSTRACT

BACKGROUND: Dexmedetomidine (DEX), a selective alpha-2 adrenergic receptor agonist, is widely used in various surgical settings, including cardiac and general surgeries, for its sedative, analgesic, and neuroprotective properties. Patients undergoing brain surgery are particularly susceptible to postoperative delirium (POD). Given the established benefits of dexmedetomidine in other surgical fields, its potential to mitigate delirium in neurosurgery warrants investigation.

METHODS: A systematic search of PubMed, Embase, Scopus, and Cochrane databases was conducted from inception to January 2025 and updated in April 2025, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Risk of bias was assessed, and a meta-analysis was performed using Review Manager 5.4.1. Five randomized controlled trials were included, evaluating the efficacy of DEX in preventing POD in adult patients undergoing brain surgery.

RESULTS: A total of 646 patients were enrolled, with DEX administered with a loading dose ranging from 0.5 to 1 μg/kg over 10 min, followed by a maintenance infusion rate of 0.1 to 0.5 μg/kg/h during the surgical procedure. The pooled risk ratio (RR) for POD with DEX was 0.47 (95% confidence interval (CI): 0.35-0.63; p < 0.00001); reflecting a 53% reduction in the risk of postoperative delirium, with no statistical heterogeneity detected (χ² = 2.09, degrees of freedom (df) = 4, p = 0.72; I² = 0%). Subgroup analyses showed similar effect estimates across brain tumor and other cranial procedures. Adverse events were comparable between groups and generally mild.

CONCLUSIONS: This meta-analysis found that perioperative dexmedetomidine was associated with a significant reduction in postoperative delirium risk in neurosurgical patients. Further multicenter trials are needed to confirm these findings and to refine optimal administration strategies.

PMID:42151722 | DOI:10.1007/s12028-026-02533-z

Stat Med. 2026 May;45(10-12):e70591. doi: 10.1002/sim.70591.

ABSTRACT

In progressive diseases such as Alzheimer’s, treatments that slow progression should start early to preserve higher levels of functioning for a longer period. In corresponding clinical trials, treatment effects are usually expressed as mean differences on a clinical scale at fixed time points. Early in the disease course, however, these mean differences may appear small but may nonetheless correspond to an important slowing of disease progression. This complicates the appreciation of the relevance of observed treatment effects. We introduce a class of target parameters that quantify treatment effects on the time scale in longitudinal studies; for instance, in terms of time saved or percentage slowing of progression. We focus on data from randomized trials where the target parameters are identified under regularity assumptions. These target parameters remain well defined if treatment was not randomized, but additional untestable assumptions are required for identification. We propose general two-step estimators. In the first step, the data can be analyzed with standard methods for longitudinal data and standard software can thus be used. In the second step, summary statistics from the first step are used for inferences about the target parameters. The second step has been implemented in the TCT R package. We study the asymptotic properties and efficiency of these two-step estimators, and evaluate them in an extensive simulation study. These estimators are used in a phase 2/3 clinical trial for Alzheimer’s disease, leading to important additional insights into the treatment effect.

PMID:42151713 | DOI:10.1002/sim.70591