Category: Statistics

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

Clin Lab. 2026 Apr 1;72(4). doi: 10.7754/Clin.Lab.2025.250922.

ABSTRACT

BACKGROUND: Carbapenem-resistant Pseudomonas aeruginosa (CRPA) infection is becoming increasingly severe in clinical practice, yet its host metabolic characteristics remain unclear. Based on metabolomics, this study compares the metabolic profiles of patients infected with CRPA versus susceptible strains, aiming to identify potential diagnostic biomarkers and therapeutic targets.

METHOD: This single-center case-control study enrolled 20 inpatients diagnosed with Pseudomonas aeruginosa infection at the Second People’s Hospital between May 2023 and May 2024. Based on antimicrobial susceptibility testing, patients were divided into a CRPA group (n = 10) and a carbapenem-susceptible (CSPA) group (n = 10). Plasma samples from all patients underwent untargeted metabolomic analysis using ultrahigh-performance liquid chromatography-mass spectrometry. Differential metabolites were screened by applying principal component analysis, orthogonal partial least squares-discriminant analysis multivariate statistical analysis, and univariate analysis. These metabolites were subsequently annotated and subjected to pathway enrichment analysis using the Kyoto Encyclopedia of Genes and Genomes (KEGG), Human Metabolome Database, and ChemSpider databases.

RESULTS: Metabolomic analysis identified 19 differentially abundant metabolites, more than half of which were involved in lipid metabolism. This was primarily characterized by the upregulation of glycerophospholipids (such as phosphatidylserine and phosphatidylinositol) and the downregulation of glycerophosphocholine, phosphatidylethanolamine, and certain sphingolipids. Beyond lipids, compounds such as cholic acids, p-cresol sulfate, and hippuric acid were also significantly upregulated. KEGG enrichment analysis revealed that the differential metabolites were predominantly enriched in pathways related to glycerophospholipid metabolism, sphingolipid metabolism, and ether lipid metabolism, indicating that disrupted lipid metabolism is a core metabolic feature of CRPA infection.

CONCLUSIONS: This study demonstrates that the metabolic differences in CRPA-infected patients are concentrated in lipid metabolism, suggesting a close association between drug-resistant infections and host-pathogen lipid metabolic remodeling. Changes in relevant lipids hold value as potential diagnostic and prognostic biomarkers, while lipid metabolic pathways may also represent novel targets for future therapeutic interventions.

PMID:41979631 | DOI:10.7754/Clin.Lab.2025.250922

J Prosthodont. 2026 Apr 14. doi: 10.1111/jopr.70141. Online ahead of print.

ABSTRACT

PURPOSE: To compare the long-term survival of nonsurgical endodontic re-treatment versus single-tooth implants and to identify independent demographic, systemic, and lifestyle predictors of failure using a statistical model that accounts for patient-level clustering.

MATERIALS AND METHODS: A retrospective cohort study was conducted using electronic health records from a university setting between 2010 and 2016. Two cohorts were defined by Current Dental Terminology (CDT) codes: endodontic re-treatment (n = 1001) and single-tooth implants (n = 1822). The primary outcome was treatment failure (extraction or removal). To address the nonindependence of multiple procedures within the same patient, a shared frailty Cox proportional hazards model was employed to calculate hazard ratios (HRs) adjusted for clustering.

RESULTS: The analysis included 2823 procedures. The shared frailty model revealed that single-tooth implants had a significantly lower risk of failure compared to endodontic re-treatment (HR = 0.21; 95% confidence interval [CI]: 0.14-0.33; p < 0.001). Stratified frailty models revealed that tobacco use (HR = 2.76; p < 0.001) and diabetes (HR = 2.37; p = 0.007) were strong predictors of failure, specifically for endodontic re-treatments, alongside thyroid problems and osteoporosis. In the implant cohort, high blood pressure emerged as a significant predictor (HR = 3.96; p = 0.048). Unlike in standard survival models, patient age was not a significant predictor of failure (p = 0.335) after adjusting for patient frailty.

CONCLUSIONS: When rigorously accounting for intra-patient correlation, single-tooth implants demonstrated a superior survival advantage over endodontic re-treatment in this population. However, the long-term success of both modalities is significantly associated with the patient’s systemic health, with specific risk factors varying by modality.

PMID:41979007 | DOI:10.1111/jopr.70141

Alzheimers Dement. 2026 Apr;22(4):e71365. doi: 10.1002/alz.71365.

ABSTRACT

INTRODUCTION: Digital speech biomarkers (DSBs) support the detection and monitoring of Alzheimer’s disease (AD) in Latinos. However, they have not been benchmarked against standard cognitive and neuroimaging measures, missing a critical validation milestone.

METHODS: Thirty-three AD patients and 33 healthy controls completed verbal fluency tasks, episodic memory and executive tests, and magnetic resonance imaging (MRI) (volume) and functional MRI (fMRI) (connectivity) scans. Between-group machine learning classification was compared among fluency-derived DSBs, episodic and executive test scores, MRI, and fMRI measures.

RESULTS: The fluency classifier’s performance (area under the curve [AUC] = 0.84) was comparable (p > 0.14) to the episodic (AUC = 0.90), executive (AUC = 0.79), and structural (AUC = 0.90) classifiers and superior to the functional classifier (AUC = 0.65, p = 0.002). Top discriminating features were word length and frequency, both associated with right (pre)frontal volume upon adjusting for sociodemographic factors.

DISCUSSION: DSBs appear non-inferior to standard cognitive and imaging measures, supporting scalable AD assessments in Latinos.

HIGHLIGHTS: We examined digital speech biomarkers (DSBs) for detecting AD in Latinos. DSBs were benchmarked against cognitive and neuroimaging features. DSB-based classifiers matched or outperformed cognitive and brain classifiers. Top DSBs included word length, phonological neighborhood, and frequency. Word length and frequency correlated with right (pre)frontal brain volume.

PMID:41979006 | DOI:10.1002/alz.71365

J Prosthodont. 2026 Apr 14. doi: 10.1111/jopr.70142. Online ahead of print.

ABSTRACT

PURPOSE: This 5-year cross-sectional study aimed to determine whether immediate and delayed impression workflows result in differences in crestal bone levels (CBLs), peri-implant indices, mucosal margin position, and pink esthetic score (PES).

MATERIALS AND METHODS: Patients who had received a single posterior implant crown in the premolar and molar regions for ≥5 years were identified. Outcome measurements for peri-implant indices, including modified plaque index (mPI), modified sulcus bleeding index (mSBI), presence or absence of bleeding on probing (BoP), and probing pocket depths (PPDs), were measured at six sites per implant. The peri-implant mucosal margin position was measured relative to an adjacent or contralateral tooth. CBLs were assessed radiographically using standardized vertical bitewing radiographs with the paralleling technique. PES was calculated with a total possible score of 14. The Shapiro-Wilk test was employed to assess the normality of the data distribution. For variables following a normal distribution, a two-sample t-test was used to compare the mean values between the two groups. Conversely, for non-normally distributed data, the Mann-Whitney U test was utilized to determine whether significant differences existed between the group distributions. The significance level was set at 0.05.

RESULTS: Mean mesial CBL for the immediately- and delayed-impressed groups were -0.30 ± 1.01 mm and 0.07 ± 1.18 mm, respectively. Mean distal CBL for the same groups were -0.14 ± 0.56 mm and -0.30 ± 0.79 mm, respectively. Mean mesio-buccal, mid-buccal, and disto-buccal PPDs were 3.18 ± 1.08 mm, 1.36 ± 0.76 mm, and 2.73 ± 1.10 mm for the immediate impression group and 3.14 ± 1.35 mm, 1.93 ± 1.14 mm, and 3.07 ± 1.07 mm for the delayed impression group. Mean mesio-lingual, mid-lingual, and disto-lingual PPDs were 2.55 ± 0.69 mm, 1.45 ± 0.69 mm, and 3.09 ± 0.94 mm for the immediate impression group and 3.29 ± 0.83 mm, 2 ± 1.24 mm, and 3.50 ± 1.45 mm for the delayed impression group. Mean PES was 12.64 ± 1.03 and 12 ± 2 for the immediately- and delayed-impressed groups. There were no statistically significant differences between immediate and delayed impression groups for PES, peri-implant indices, mucosal marginal position, or CBLs.

CONCLUSION: At 5 years, there was no significant difference in PES, CBL, peri-implant indices, or mucosal margin position between implants restored with immediate impressions and those restored with delayed impressions made after osseointegration and soft tissue healing.

PMID:41978996 | DOI:10.1111/jopr.70142

Geospat Health. 2026 Feb 2;21(1). doi: 10.4081/gh.2026.1453. Epub 2026 Apr 14.

ABSTRACT

This study investigates spatial disparities in cancer and lung-cancer mortality across Europe through an integrative geospatial epidemiological framework. Using age-standardised Eurostat mortality data for 2022 at the NUTS-2 level, we combine Getis-Ord Gi* and Anselin Local Moran’s I to detect statistically significant hot/cold spots, while multivariate regressions incorporate environmental and topographic predictors. Results reveal pronounced east-west and urban-rural gradients: persistent high-mortality clusters span Central and Eastern Europe, where historical industrialisation, elevated smoking prevalence, and structural healthcare gaps converge. By contrast, Southern European regions – Portugal, western Spain, and southern Greece – are associated with lower observed mortality levels, plausibly reflecting favourable behavioural profiles, environmental conditions, and healthcare accessibility. Spatial outliers identify territories where localised factors, such as air-pollution peaks or differential diagnostic capacity, modify broader regional patterns. Overall, the findings highlight geography as a structuring context for exposure, vulnerability, and access to care, rather than as a direct causal driver of cancer risk, and demonstrate the value of spatial epidemiology for territorial health governance, environmental monitoring, and urban planning. Policy relevance is twofold. First, the evidence supports region-specific interventions aligned with the Sustainable Development Goals (SDG) – especially SDG 3 (health), SDG 10 (reduced inequalities), and SDG 11 (sustainable cities). Second, the spatial outputs provide a robust empirical basis for informing the health-equity ambitions of Europe’s Beating Cancer Plan and the environmental-justice agenda of the European Green Deal. By bridging granular geospatial evidence with EU-wide priorities, the study underscores the need for place-based, equity-oriented frameworks in cancer prevention and control across heterogeneous European landscapes.

PMID:41978989 | DOI:10.4081/gh.2026.1453

Proc Inst Mech Eng H. 2026 Apr 14:9544119261441368. doi: 10.1177/09544119261441368. Online ahead of print.

ABSTRACT

Electrospun nanofiber scaffolds are important in biomedicine, especially skin tissue engineering, in which scaffold porosity and fiber orientation significantly affect cell penetration, nutrition diffusion, and biomechanical integration. Despite progress on image-based, non-destructive methods for SEM analysis, integrating quantitative metrics from multiple morphological descriptors into a unified and automated workflow remains challenging. In this paper, we present a software tool developed using MATLAB App Designer, which facilitates SEM image analysis for non-destructive characterization of electrospun nanofiber scaffolds. This application provides capability to determine porosity, pore size, fiber diameter and fractal dimension as well as estimation of BET surface area and Barrett-Joyner-Halenda (BJH) volume based on geometric models. Eight independently electrospun nanofiber scaffolds, fabricated at identical electrospinning parameters, were analyzed using a combination of automated thresholding, morphological processing, and skeletonization. For each sample, five SEM images were analyzed (total = 40 images). Estimated BET and BJH data were extrapolated from image-based parameters, considering cylindrical-like scaffold geometry to assess internal consistency. High correlations were observed between porosity and surface area, and pore size with BJH volume highlight that the model is appropriate for relative scaffold screening. Statistical comparison detected various methods (Otsu and morphological thresholding) were significantly different from each other (p < 0.05), indicating importance of method choices on results. A user-friendly GUI allows users to access techniques and view metric outputs easily. Although strong R values were observed, they reflect internal coherence, not external validation. The tool offers a replicable platform for early-stage scaffold assessment in tissue engineering and nanomaterial research.

PMID:41978985 | DOI:10.1177/09544119261441368