Category: Statistics

JMIR Res Protoc. 2026 Feb 12;15:e71620. doi: 10.2196/71620.

ABSTRACT

BACKGROUND: Pediatric patients with end-stage kidney disease require kidney transplants (KTs) throughout their lifetime. Long-term graft survival is dependent on multiple factors, which are broadly categorized as donor- and recipient-related factors. Advances in transplant care and changes in donor population demographics necessitate an updated analysis on donor risk factors to guide clinical decision-making.

OBJECTIVE: In this systematic review and meta-analysis, we will focus on the impact of donor factors on graft survival in pediatric KT, excluding transplants from donation after circulatory death as the latter are less common in children.

METHODS: This review encompasses studies reporting donor-related risk factors for graft survival in pediatric KT, including age, size, comorbidities, and ethnicity for living and deceased donors, as well as the cause of death and length of hospitalization for deceased donors. The literature search will use the following databases: PubMed, Scopus, Web of Science, Embase, and Cochrane. Two independent reviewers will select studies and assess their quality. Pooled estimates of relevant factors will be computed via a random-effects model using the Stata/BE (version 19) software. Depending on data availability, subgroup analyses will be conducted based on donor type (living vs deceased). The reporting of findings will adhere to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.

RESULTS: The search and screening for the systematic literature review are anticipated to be finished in June 2026. Data extraction, quality appraisal, and subsequent data synthesis will begin in July 2026. The review is expected to be completed by October 2026, and the study results will be published in 2027.

CONCLUSIONS: Our review will provide a comprehensive synthesis of the available evidence on kidney donor risk factors impacting graft survival in pediatric KT. The results of this review could provide valuable insights for clinical decisions, policy development, and ongoing efforts to improve outcomes for children with end-stage kidney disease requiring KT.

PMID:41678799 | DOI:10.2196/71620

JMIR Cancer. 2026 Feb 12;12:e84788. doi: 10.2196/84788.

ABSTRACT

Our study describes the characteristics of remote patient monitoring use among commercially insured patients with cancer from 2019 to 2023.

PMID:41678798 | DOI:10.2196/84788

JMIR Pediatr Parent. 2026 Feb 12;9:e71367. doi: 10.2196/71367.

ABSTRACT

BACKGROUND: The population of young individuals not in employment, education, or training (NEET) is highly diverse, but a common problem appears to be their mental health. NEETs due to illness or disability are of particular concern for social exclusion, but little is known of how young individuals who are NEET with and without disability make use of, and gain from, employment interventions. There is also a scarcity of research on psychological interventions and mental health outcomes among young NEETs. Acceptance and commitment therapy (ACT) has shown promising results in psychological outcomes in young adults.

OBJECTIVE: This study aimed to expand the knowledge on the effects of an app-based intervention built on ACT on NEETs with and without disabilities.

METHODS: A 2-arm randomized controlled trial was conducted in 2021, including 151 young NEETs aged 16-24 years. Participants were recruited mainly via social media platforms and through organizations working with young NEETs. The intervention group (n=77) used an app for psychological well-being with the possibility for digital group meetings for 6 weeks, and the control group (n=74) received film clips once a week. Outcomes were self-assessed through questionnaires. Statistical analyses were made using chi-square, Mann-Whitney U test, general linear model, and logistic regression.

RESULTS: No differences in effects on mental health were seen between the intervention and control group, neither overall nor between young NEETs with or without disability. Usage data show that 68.8% (53/77) of the participants in the intervention group downloaded the app, and 24.7% (19/77) completed all 6 modules. Effects on employment and education levels were only seen within the intervention group, where those who had completed one or more modules had a higher likelihood of being active in terms of employment and education compared to those who did not complete modules. No significant effects were seen in employment and education levels in relation to disability status. A high proportion of the participants had a disability, few were in contact with a youth employment center, and there was an overrepresentation of young women in general. Participants with disabilities had lower self-esteem, had less frequently completed high school, had less work experience, and a larger proportion had been in the NEET situation for over a year. A higher dropout were seen among participants in the intervention group and among young men.

CONCLUSIONS: No effects of the app-based intervention were seen for psychological well-being between young NEETs with disabilities and those without, but the results showed potential effects on employment and education levels related to engagement in the intervention. NEETs with disabilities are of particular concern and might need additional efforts or other types of interventions than the one investigated in this study. Findings can be considered weak due to the low adherence and high attrition.

TRIAL REGISTRATION: ISRCTN Registry ISRCTN46697028; https://www.isrctn.com/ISRCTN46697028.

PMID:41678795 | DOI:10.2196/71367

J Med Internet Res. 2026 Feb 12;28:e82322. doi: 10.2196/82322.

ABSTRACT

BACKGROUND: Although cancer screening is essential for early detection and an improved prognosis, screening beyond the recommended guidelines may increase the risk of false-positive results. Consequently, educating individuals about the potential harm of non-guideline-based cancer screening is essential; however, effective communication methods remain unclear.

OBJECTIVE: This study aimed to evaluate the effectiveness of different types of educational videos in encouraging preferences for guideline-based cancer screening.

METHODS: This 3-arm pseudorandomized controlled trial was conducted in June 2025 using a Japanese online survey platform. Eligible respondents were working adults aged 30 to 60 years with no history of major cancer. Respondents were assigned to 1 of the following 3 video conditions: video A, which provided a logical explanation of false-positive risks; video B, which presented the narrative of a woman who received a false-positive result from breast cancer screening; and video C, which depicted a man who underwent unnecessary follow-up testing after tumor marker screening. The primary outcome was the preference for guideline-based cancer screening after watching the videos. The secondary outcomes included 7 self-reported video evaluation items, such as perceived relevance and clarity, assessed using a 5-point Likert scale. Differences in the primary outcome between video groups were analyzed using multivariable logistic regression with adjustment for covariates. Means and 95% CIs were calculated for each secondary outcome according to sex and video group. In addition, before-and-after changes in screening preferences were assessed using McNemar test, with a significance level of .05.

RESULTS: In total, 1200 respondents (400 per group) completed the survey. No statistically significant differences in the primary outcome were observed among the video groups. With reference to video A, the adjusted odds ratios for preferring guideline-based screening were 0.89 (95% CI 0.59-1.32) for video B and 0.98 (95% CI 0.65-1.46) for video C. Regarding secondary outcomes, male respondents rated video B less favorably than female respondents in terms of relevance and willingness to undergo guideline-based screening. The before-and-after comparison showed a significant change in preference for guideline-based screening (P=.04). These videos appeared to be more effective for individuals with an annual history of colorectal cancer screening than for those without such a history.

CONCLUSIONS: Educational videos have the potential to influence cancer screening preferences; however, no single video format has demonstrated clear superiority. These findings underscore the importance of tailoring educational materials to the target audience characteristics. Further research is required to develop effective strategies for encouraging guideline-based cancer screening.

TRIAL REGISTRATION: University Hospital Medical Information Network Clinical Trials Registry UMIN000060549; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000066119.

PMID:41678792 | DOI:10.2196/82322

J Am Acad Orthop Surg Glob Res Rev. 2026 Feb 11;10(2). doi: 10.5435/JAAOSGlobal-D-25-00178. eCollection 2026 Feb 1.

ABSTRACT

PURPOSE: The purpose of this study was to analyze national trends in knee and shoulder arthroscopy to identify seasonal and annual variability using the Healthcare Cost and Utilization Project-Nationwide Ambulatory Surgery Sample (HCUP-NASS) dataset.

METHODS: Estimated national rates of ambulatory knee and shoulder arthroscopy were analyzed using HCUP-NASS data from 2016 to 2021. Time trend plots were generated to identify potential seasonal trends in these procedures.

RESULTS: There was a decreasing trend in the number of procedures (shoulder arthroscopy, rotator cuff repair [RCR], knee arthroscopy, meniscal repair [MR]/meniscectomy, and anterior cruciate ligament reconstruction [ACLR]) done from 2016 to 2021. There were an estimated 264,987 (95% confidence interval [CI] = 251,205 to 276,770) patients who underwent shoulder arthroscopy and 381,125 (95% CI = 362,555 to 399,696) patients who underwent knee arthroscopy in 2021, as compared with 345,892 (95% CI = 326,224 to 365,559) patients who underwent shoulder arthroscopy and 521,912 (95% CI = 496,905 to 546,919) patients who underwent knee arthroscopy in 2016. Male patients showed markedly higher rates of shoulder arthroscopy, RCR, knee arthroscopy, MR, and ACLR procedures as compared with female patients, whereas female patients showed markedly higher rates of knee arthroscopy done without MR and ACLR. Shoulder and knee arthroscopy rates peaked in the 55 to 75-year-old age group. In addition, both procedures were most frequently done in December and had the lowest utilization in the month of July.

CONCLUSION: There was a nonlinear decrease in the estimates of shoulder arthroscopy, RCR, MR/meniscectomy, knee arthroscopy, and anterior cruciate ligament reconstruction procedures from 2016 to 2021, with peaks in 2016 and 2019, and a low point in 2020. There are notable variations in rates of knee and shoulder arthroscopy procedures by age and sex.

CLINICAL RELEVANCE: Recent data on commonly done ambulatory orthopaedic arthroscopies are important for policy makers and for understanding utilization trends.

PMID:41678780 | DOI:10.5435/JAAOSGlobal-D-25-00178

N Z Med J. 2026 Feb 13;139(1629):49-58. doi: 10.26635/6965.7173.

ABSTRACT

BACKGROUND: Burnout is a chronic syndrome that compromises physician wellbeing and patient care. This study aimed to quantify burnout among New Zealand ophthalmologists and identify key demographic and practice-related factors associated with increased risk, as well as to assess lifetime burnout experiences, time off taken and barriers to seeking help.

METHODS: A cross-sectional study of 171 New Zealand ophthalmologists used a modified Mini Z 2.0 Burnout Survey to assess workplace satisfaction, stress and burnout, while additional questions gathered demographic and practice characteristics, as well as retrospective data on burnout frequency, time off taken, help sought and perceived barriers.

RESULTS: Out of 161 delivered surveys, 84 responses were received (52% response rate). Overall burnout was 20%, with a significantly higher rate in the public sector (p<0.05). Burnt-out respondents reported notably lower job satisfaction, team effectiveness and workload control. No significant associations were found with other demographic or practice factors. Sixty-three percent had experienced burnout at least once, and 40% reported multiple episodes, yet only 15.5% took time off. Among those who sought help (51%), family members were the most common source of support, while 43% did not seek help, primarily due to time constraints.

CONCLUSION: This study shows that burnout affects one in five New Zealand ophthalmologists. Findings underscore the importance of reducing stigma and cultivating supportive environments that encourage help-seeking without fear of repercussions. Reducing administrative tasks and expanding mental health resources, especially in the public sector, may mitigate burnout and strengthen workforce recruitment and retention.

PMID:41678759 | DOI:10.26635/6965.7173

Toxicol Sci. 2026 Feb 12:kfag011. doi: 10.1093/toxsci/kfag011. Online ahead of print.

ABSTRACT

Parental exposure to toxicants can affect progeny health. However, laboratory studies often employ exposures that result in loading of pollutants to gametes, or toxic effects to parents which could indirectly affect germ cell or gamete health. Here, we took advantage of the biology of Caenorhabditis elegans to carry out a study in which we minimized the potential for maternal loading of toxicants, and used an exposure paradigm that either did (high concentration) or did not (low concentration) significantly impact the health of the P0 generation. We hypothesized that parental exposure to mitochondrial toxicants during germ cell and gamete development, at levels not causing P0 toxicity, would result in altered mitochondria and organismal health in offspring. In the P0 generation, a high rotenone concentration altered growth, mitochondrial respiration, gene expression, induction of the mitochondrial unfolded protein response, and susceptibility to dopaminergic neurodegeneration induced by a chemical rechallenge later in life. However, we observed minor or no effects in P0 at a low concentration. In high-exposure F1 offspring, we observed altered embryo size, larval developmental stage distribution, spare respiratory capacity, heat shock protein expression, and dopaminergic neurodegeneration after a secondary rotenone challenge. The only effects observed in the F1 offspring of the low exposure were a 1.7% decrease in egg size (size later in development was normal), and moderate evidence of a slightly increased sensitivity to heat shock protein expression and dopaminergic neurodegeneration caused by a secondary later-in-life rotenone exposure. We recommend parental toxicity be carefully assessed to contextualize offspring outcomes.

PMID:41678270 | DOI:10.1093/toxsci/kfag011

Exp Clin Psychopharmacol. 2026 Feb 12. doi: 10.1037/pha0000832. Online ahead of print.

ABSTRACT

Cannabidiol (CBD), a nonintoxicating molecule derived from the cannabis plant, is garnering attention as a novel sleep aid despite a dearth of empirical literature supporting its efficacy for sleep-related indications. The present study aimed to address this gap. Participants were 63 individuals (M_age = 29.27; SD_age = 9.58) reporting elevated trait worry who were randomly assigned to take 300 mg CBD, 50 mg CBD, or placebo daily for 2 weeks. Results suggested 300 mg CBD decreased sleep disturbances and sleep quality significantly more than 50 mg CBD (B = -0.39, t = -2.59, p < .05, d = 0.08), but not placebo (B = -0.32, t = -2.09, p = .10, d = 0.07) with no effects on sedation or cognitive impairment. These data suggest 300 mg CBD showed significantly greater improvement than 50 mg CBD but did not show statistically significant improvement compared to placebo. More work is needed to assert strong conclusions regarding CBD’s effects on sleep-related indicators. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PMID:41678223 | DOI:10.1037/pha0000832

Psychol Assess. 2026 Mar;38(3):253-265. doi: 10.1037/pas0001451.

ABSTRACT

We thank Stein et al. (2026) and Jenkins (2026) for their commentaries on our critical review of the Social Cognition and Object Relations Scale-Global system as applied to the Thematic Apperception Test (Sinclair et al., 2023) and appreciate the opportunity to respond in kind. Although we acknowledge the considerable effort put into these response articles (analytically and conceptually), both fall short in addressing the myriad serious methodological and procedural concerns we raised in 2023 and do little to move the needle in support of this assessment technique. This article will review the many ways these responses misinterpret and misrepresent our original review and the voluminous methodological problems with the “meta-analyses” that are presented by Stein et al.-and the various ways they are statistically confounded, confusing, and scientifically unsound. Further, this article will highlight the considerable number of logical inconsistencies that are inherent within Stein et al.’s core arguments, as well as the numerous contradictions between Stein et al. and Jenkins-all of which seriously undermine the methodology itself. Given the many ethical ambiguities that arise as a result, we conclude with a repeat calling for a moratorium on this methodology until these issues are sufficiently resolved. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PMID:41678221 | DOI:10.1037/pas0001451

Clin Exp Rheumatol. 2026 Feb 6. doi: 10.55563/clinexprheumatol/itysdz. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to develop and validate a risk stratification scale for unfavourable outcomes in adult patients with IgA vasculitis nephritis (IgAVN).

METHODS: The derivation cohort in this study was constructed using the existing prognosis data from adult IgAVN cohorts. We extracted the risk factors and their hazard ratios. Only statistically significant risk factors were included in our final risk stratification scale. Then this study validated the risk stratification scale in an external cohort of Chinese patients. The performance of the risk stratification scale was evaluated by the receiver operating characteristic (ROC), calibration, decision, and Kaplan-Meier curves.

RESULTS: Ten cohorts involving 1,814 adult patients with IgAVN were included in this meta-analysis. Serum albumin (ALB), estimated glomerular filtration rate (eGFR), endocapillary hypercellularity (E1), and tubular atrophy/interstitial fibrosis (T1/2) were included in the risk stratification and scored according to their weightings (maximum score: 6.5). An external cohort comprising 133 patients was used to validate the risk stratification scale. The area under the curve (AUC) value of the scoring scale was 0.88 (95%CI: 0.78-0.99), with a sensitivity of 0.79 (95%CI: 0.49-0.95) and specificity of 0.89 (95%CI: 0.82-0.94), at a cut-off value of 3. The calibration, decision, and Kaplan-Meier curves further confirmed the robust performance of the risk stratification scale.

CONCLUSIONS: In this study, we established a simple and practical tool to identify adult IgAVN patients at high risk of unfavourable outcomes. Reasonable use of the risk stratification scale can help make early clinical decisions and facilitate the development of precision medicine.

PMID:41678202 | DOI:10.55563/clinexprheumatol/itysdz