Category: Statistics

Arch Osteoporos. 2026 Apr 14;21(1):67. doi: 10.1007/s11657-026-01699-5.

ABSTRACT

PURPOSE: This study aimed to reevaluate a simple radiographic measurement, the cortical thickness index (CTI), using standard plain radiographs to investigate its association with the presence of hip fracture in older persons.

METHODS: The study group (SG) consisted of 46 patients (35 females, 11 males) aged 65 years and older who presented to the emergency department with hip fractures. Two control groups were formed: One comprising 46 older persons aged 65 years and older (CG-G) and another of young adults aged 20-30 (CG-YA), both referred to the outpatient clinic and had available plain hip radiographs. CTI was measured for all participants by the first author. Additionally, two observers independently measured CTI to assess intraobserver and interobserver agreement.

RESULTS: Intraobserver and interobserver agreement was almost perfect based on Cohen’s kappa classification ( $\kappa$ > 0.8). The mean CTI for the SG was 0.389 ± 0.05, while the mean CTI for the CG-G was 0.571 ± 0.048, and for the CG-YA was 0.585 ± 0.048. A statistically significant difference was found between the SG and both CG-G and CG-YA groups (p < 0.001). No significant difference was observed between CG-G and CG-YA (p > 0.05). A CTI threshold of 0.485 demonstrated high discriminative ability for distinguishing older persons with hip fracture from those without fracture, yielding a sensitivity of 97.83% and a specificity of 95.65%.

CONCLUSION: CTI is significantly reduced in older persons with hip fracture. As a quick and accessible measurement on standard radiographs, CTI may assist clinicians in distinguishing individuals with hip fracture from those without fracture in outpatient settings.

PMID:41979765 | DOI:10.1007/s11657-026-01699-5

Appl Biochem Biotechnol. 2026 Apr 14. doi: 10.1007/s12010-026-05688-9. Online ahead of print.

ABSTRACT

Marine-derived endophytic fungi have long been recognised as valuable sources of therapeutic metabolites. In the present study, the endophyte Penicillium rubens strain PrubVJ was studied for optimised production of bioactive compounds using Response Surface Methodology (RSM). Experimental data predicted that incubation time was identified as the most influential variable, with maximum protein yield (190 mg/L) observed at day 20, antioxidant activity (74%) at 10-15 days and total phenolics (1,724 ± 19 µg GAE g⁻¹ DW) at day 25. The optimal fermentation conditions (25 °C, pH 3.6, 4 g/L salinity, 10 days incubation) with a desirability of 0.92, yielding 158 ± 1.325 mg/L protein, 1,798 ± 18 µg GAE g⁻¹ DW phenolics, and 84.9% antioxidant activity were predicted from the RSM model. Experimental validation under these conditions achieved protein yield of 190 mg/L, phenolics of 1,724 µg GAE g⁻¹ DW, and 74% antioxidant activity, confirming the reliability and robustness of the model. The developed quadratic models exhibited strong statistical reliability with stochastic parameters such as F-value and p-value, and coefficients of determination (R², adjusted R² and predicted R²) above 80% for all responses, validating model adequacy. Collectively, these findings establish P. rubens strain PrubVJ as a promising microbial platform, providing a reliable framework for optimising fungal fermentation. This study recommends the optimized strategy for large-scale pharmaceutical bioprocessing of fungal metabolites, to reduce production costs and accelerate the discovery of novel bioactive metabolites with pharmaceutical relevance, particularly for anticancer, antimicrobial, and antioxidant applications.

PMID:41979742 | DOI:10.1007/s12010-026-05688-9

J Gen Intern Med. 2026 Apr 14. doi: 10.1007/s11606-026-10392-9. Online ahead of print.

ABSTRACT

PURPOSE: International medical graduates (IMGs) and Puerto Rican medical graduates (PRMGs) are integral to the United States (U.S.) physician workforce yet face unique immigration-related and professional challenges. We conducted a study to investigate reasons for migration, perceived barriers, discrimination, satisfaction, and factors influencing IMGs’ and PRMGs’ decisions to remain in the U.S. versus return to their home countries.

METHODS: We conducted a cross-sectional, online survey of foreign-born physicians who obtained their medical degrees outside the continental United States and were currently training or practicing in the U.S. The survey captured demographic and professional characteristics, migration history, cultural adaptation, discrimination, and overall professional experiences. Descriptive statistics summarized responses. Among physicians who completed training and were practicing independently in the U.S., we compared overall experience ratings and discrimination-related distress between the training and independent practice phases using the Wilcoxon signed-rank test and McNemar’s test.

RESULTS: Of 352 respondents, most were IMGs (82.1%) and 16.8% were PRMGs. Nearly half reported racial and/or ethnic discrimination (49.6%) and language discrimination (37.8%) during training. In paired analyses among those currently in independent practice, overall experience ratings shifted from the training to independent practice phase, with “excellent” ratings more common during training than independent practice. Among participants who experienced language discrimination in both phases, distress levels decreased over time. Despite high rates of discrimination and pressure to assimilate, most participants reported excellent (63.6%) or good (52.9%) overall experiences during training and practice, respectively. Only 9.3% had returned to their home country, most of whom reported extreme happiness after returning.

CONCLUSION: High rates of racial, ethnic, gender, and language discrimination, along with pressures to assimilate, characterize IMGs’ and PRMGs’ journeys in the U.S. healthcare system. Nevertheless, most report high professional satisfaction. Interventions are needed to address discrimination, support cultural identity, and promote sustainable careers for this essential segment of the U.S. workforce.

PMID:41979730 | DOI:10.1007/s11606-026-10392-9

J Gen Intern Med. 2026 Apr 14. doi: 10.1007/s11606-026-10390-x. Online ahead of print.

ABSTRACT

BACKGROUND: Food insecurity (FI) is a driver of chronic disease. Produce prescription (PRx) interventions pair access to produce with education, but evidence among Medicaid-insured adults remains limited.

OBJECTIVE: Evaluate the impact of PRx on FI, fruit and vegetable (FV) intake, and psychosocial and clinical outcomes among adults with chronic conditions.

DESIGN: Prospective, non-randomized cohort study with a matched comparison group.

PARTICIPANTS: A total of 125 Medicaid-insured, food-insecure adults with chronic metabolic conditions were enrolled in the intervention cohort and 92 matched to the Supplemental Nutrition Assistance Program (SNAP)-only cohort.

INTERVENTION: Weekly home-delivered produce, registered dietitian-led coaching, and education over 12 months.

MAIN MEASURES: FI (USDA 10-item Food Security Survey Module), FV intake (National Cancer Institute screener), depression (PHQ-9), loneliness (UCLA 3-item), fatigue (FACIT-F), healthcare utilization and costs, and blood pressure (BP). For the comparison cohort, some measures were obtained for 6 months of follow-up.

KEY RESULTS: At 6 months, based on between-group differences, PRx was associated with greater improvements in FV intake (difference in change: + 0.3 vs. + 0.03 cups/day, p = 0.002) and greater reductions in loneliness (difference in change: -0.6 points, p = 0.022). Between-group differences for FI (-8.2 percentage points, p = 0.26) and moderate-to-severe depression (-10.8 percentage points, p = 0.07) favored PRx but were not statistically significant. At 12 months, no significant between-group differences in healthcare utilization and costs were observed. Among the 105 (84%) intervention participants who completed 12-month follow-up, between the pre- and post-intervention periods, FI declined by 17.1% (p = 0.003), FV intake increased by 0.4 cups/day (p < 0.001), fatigue improved by 3.1 points (p = 0.019), and among participants with elevated baseline BP (n = 73), systolic BP decreased by 8.6 mmHg (p = 0.003).

DISCUSSION: In this study, PRx was associated with improved diet quality and loneliness compared with a SNAP-only comparison. Within-group analyses demonstrated improvements across dietary, psychosocial, and BP outcomes, supporting further evaluation using randomized or comparative designs.

PMID:41979725 | DOI:10.1007/s11606-026-10390-x

Atten Percept Psychophys. 2026 Apr 14;88(4):106. doi: 10.3758/s13414-026-03249-0.

ABSTRACT

The relationship between time perception and brightness perception remains poorly understood. Here we present a computational account linking the two domains, grounded in established principles of neural information processing in visual cortex. A nonlinear transducer maps luminance to population spike rate, while correlated gain fluctuations impose an upper bound on achievable signal-to-noise ratios. Perceptual magnitudes in both domains are decoded from the same spike-count statistics, yielding a reciprocal trade-off in perceptual resolution: brighter stimuli improve temporal precision but impair brightness sensitivity, whereas longer stimuli enhance brightness sensitivity but degrade temporal resolution. We tested this conjectured trade-off in two psychophysical experiments manipulating stimulus duration and luminance. Model predictions closely matched the behavioral data, revealing a fundamental coding limit in vision: the time-intensity uncertainty principle. This limit provides a unified explanation for near-miss relations to Weber’s law for time perception and intensity perception, Bloch-like temporal summation effects governing brightness discrimination sensitivity, and luminance-dependent shifts in duration discrimination sensitivity.

PMID:41979719 | DOI:10.3758/s13414-026-03249-0

Ann Hematol. 2026 Apr 14;105(5):245. doi: 10.1007/s00277-026-06979-1.

NO ABSTRACT

PMID:41979693 | DOI:10.1007/s00277-026-06979-1

Arch Womens Ment Health. 2026 Apr 14;29(3):63. doi: 10.1007/s00737-026-01700-7.

ABSTRACT

PURPOSE: Prenatal stress affects up to 74% of expectant mothers and has been implicated in shaping early child development. This study aims to examine the associations between both subjective (self-reported) and objective prenatal stress and infant temperament at 12 months of age. Additionally, we investigate whether maternal postpartum depression (PPD) mediates these associations.

METHODS: We analyzed data from 1,510 mother-infant dyads in the French EDEN birth cohort. Prenatal stress was assessed using the State Anxiety Inventory (STAI), the Center for Epidemiological Studies Depression Scale (CES-D), and a measure of negative life events (NLEs). Infant temperament at 12 months was measured using the Emotionality Activity Sociability (EAS) questionnaire. Adjusted logistic regression models and mediation analyses were used to assess direct and indirect effects.

RESULTS: Prenatal anxiety was associated with greater infant sociability, while prenatal depression predicted increased emotionality and shyness. Objective stress was related to lower infant activity. Mediation analyses revealed that PPD partially mediated the effects of prenatal depression and anxiety on infant emotionality and shyness, accounting for approximately 32% of the association between prenatal depression and infant emotional temperament. No mediation effect was found for the activity domain, although a small inverse direct association was observed.

CONCLUSION: Our findings suggest that maternal prenatal stress influences infant temperament in a trait-specific manner and that PPD plays a mediating role in certain domains. These results highlight the importance of addressing both prenatal and postnatal maternal stress when considering early emotional and behavioral development in children.

CLINICAL TRIAL NUMBER: not applicable.

PMID:41979692 | DOI:10.1007/s00737-026-01700-7

Environ Monit Assess. 2026 Apr 14;198(5):454. doi: 10.1007/s10661-026-15201-8.

ABSTRACT

Effective air-quality management can benefit from grouping monitoring sites according to their joint behavior across pollutants, yet many existing studies either focus on single pollutants or compress information into composite indices. This study addresses that gap by clustering air-quality monitoring stations in Türkiye’s Marmara Region using a multi-layer Self-and Super-Organizing Maps (Supersom) framework that treats pollutants jointly. The dataset comprises daily PM₁₀, SO₂, NO₂, NO, and O₃ measurements from 13 stations between November 2018 and September 2022. To enhance comparability and robustness, daily series are aggregated to weekly values, missing data and outliers are corrected within a structured pre-processing scheme, kernel smoothing is applied, and seven normalization schemes are benchmarked. A five-layer Supersom model is then trained under 120 layer-order permutations, generating more than 10,000 candidate maps via online learning. Model selection proceeds in stages by discarding solutions with empty units, comparing quantization errors within each normalization type and assessing within-cluster variability to identify a reliable configuration. The best solution, obtained under logarithmic normalization, reveals four interpretable clusters: (1) metropolitan stations influenced by traffic and industry, with elevated PM₁₀, NO₂, and SO₂; (2) rural and peri-urban stations with higher O₃ and lower NO, NO₂, and SO₂; (3) heavy-industry and port-corridor stations with high NO₂ and NO and relatively lower O₃; and (4) rural and agricultural contexts with higher SO₂ and moderate PM₁₀. The results indicate that modeling multiple pollutants simultaneously and systematically examining layer-order effects can yield stable, policy-relevant groupings that support network rationalization and targeted control strategies.

PMID:41979677 | DOI:10.1007/s10661-026-15201-8

Int Orthop. 2026 Apr 14. doi: 10.1007/s00264-026-06805-3. Online ahead of print.

ABSTRACT

PURPOSE: Acute Achilles tendon rupture with delayed treatment more than four weeks is referred to as chronic, which can lead to severe functional impairment. The literature advocates surgical reconstruction to restore ankle joint push-off strength. This study aims to introduce the technique and clinical outcomes of endoscopic autologous tendon suspension fixation for chronic insertional Achilles tendon rupture.

METHODS: Twenty-two patients (16 males, 6 females) with a mean age (range) of 49.2 ± 10.3 (30-67) years underwent Achilles tendon reconstruction surgery using all-endoscopic autologous tendon suspension fixation. Patients were evaluated at the last follow-up, with assessment indicators including Visual analogue scale (VAS), American Orthopaedic Foot & Ankle Society Ankle Hindfoot Scale (AOFAS-AH), Achilles tendon total rupture score (ATRS), Foot and Ankle Ability Measure (FAAM), Range of motion (ROM) and maximum calf circumference.

RESULTS: All patients successfully completed the surgery, with an operation time of 62.91 ± 8.82 (45-80) min, intraoperative blood loss of 15 (5-35) mL, and all surgical approaches healed in one stage, with no damage to important structures such as blood vessels, nerves, and tendons during the operation. Twenty-two patients were followed up for 16.23 ± 2.94 (12-23) months. Two patients reported weakness in single-leg heel raises, which subsequently improved with heel raise exercises. At the last follow-up, the AOFAS-AH score improved from 60.64 ± 8.83 (45-77) preoperatively to 94.18 ± 3.91 (88-100), while the ATRS score increased from 45.59 ± 5.85 (35-57) preoperatively to 93.18 ± 4.68 (83-100), and the VAS score decreased from 6 (1) to 1 (0), with all differences being statistically significant. Similarly, the FAAM- Activity of Daily Living (FAAM-ADL) score increased from 44.73 ± 8.79 (30-59) to 90.95 ± 4.62 (83-99), and the FAAM- -Sports (FAAM-S) score increased from 43.55 ± 7.14 (31-55) to 88.27 ± 8.18 (74-99). All differences were statistically significant. (all P < 0.001). The dorsiflexion angle of the affected side ankle joint (13.2 ± 1.9°), plantar flexion angle of the ankle joint (44.3 ± 1.6°), and maximum calf circumference (35.6 ± 1.5 cm) were compared with the healthy side (13.3 ± 1.9°, 44.5 ± 1.7°, 35.6 ± 1.6 cm), and there was no statistically significant difference (all P > 0.05). According to the Arner-Lindholm scoring assessment: excellent in 19 cases, good in three cases, with an excellent and good rate of 100% (22/22).

CONCLUSION: This study demonstrates that all-endoscopic autologous suspension fixation achieves satisfactory outcomes in patients with chronic Achilles tendon ruptures. This technique effectively restores distal ruptures, making it a viable option for Achilles tendon reconstruction.

PMID:41979664 | DOI:10.1007/s00264-026-06805-3

Clin Lab. 2026 Apr 1;72(4). doi: 10.7754/Clin.Lab.2025.250616.

ABSTRACT

BACKGROUND: Intertrochanteric fracture (ITF) is a common but devastating condition with high mortality in the elderly population. Early identification of high-risk patients to prevent poor prognosis is essential as treatment of postoperative adverse outcomes is complex. C-reactive protein (CRP)/albumin (ALB) ratio (CAR) is a predictor of prognosis in many diseases, but its correlation with postoperative prognosis in patients with ITF remains unclear.

METHODS: One hundred and six elderly patients who underwent ITF surgery between May 2021 and May 2023 were retrospectively analyzed. Patients were evaluated based on postoperative Harris Score and SF-36 Score for good and poor recovery groups. CAR, ALB, and hemoglobin with statistically significant differences in univariate analysis were included in multifactorial logistic regression analysis to screen for independent influences. Predictive efficacy was analyzed using the ROC curve to obtain the area under the curve (AUC). Sample regression models were constructed to test whether there was a nonlinear relationship between ALB and CAR and the prognostic outcomes of patients with ITF. The correlation of ALB and CAR with Harris Score and SF-36 Score was analyzed by Pearson’s correlation analysis.

RESULTS: Elevated CAR (OR = 2.18, p = 0.00) was an independent risk factor for poor recovery in patients with ITF, while ALB (OR = 0.90, p = 0.03) was an independent protective factor against poor recovery. All CAR showed good predictive efficacy when the cutoff value took CAR > 1.79. In contrast, the predictive efficacy of ALB was low. Restricted cubic spline model and Pearson’s correlation analysis showed a linear relationship between CAR, poor recovery in ITF patients, and a negative correlation with Harris Score and SF-36 Score.

CONCLUSIONS: Serum CAR is significantly associated with poor postoperative prognosis in elderly patients with ITF and may be an independent risk factor for postoperative quality of life and hip recovery.

PMID:41979637 | DOI:10.7754/Clin.Lab.2025.250616