Category: Statistics

Cancer Res Commun. 2026 Jun 4. doi: 10.1158/2767-9764.CRC-25-0756. Online ahead of print.

ABSTRACT

Assessments of chimeric antigen receptor (CAR) T-cell pharmacokinetics by flow cytometry (FC) and a droplet digital PCR (ddPCR) assay were compared in adult patients with relapsed/refractory B-cell acute lymphoblastic leukemia following treatment with obecabtagene autoleucel (obe-cel) in the Phase Ib/II FELIX study (NCT04404660). CAR T-cell persistence and B-cell aplasia (BCA) were then correlated with event-free survival (EFS). Peripheral blood (PB) samples collected from 127 obe-cel-infused patients were tested by FC and ddPCR. The Spearman correlation coefficient was used to measure the correlation between the number of CAR T-positive cells by FC and ddPCR. The impact of CAR T-cell persistence and BCA (B-cells <20 cells/µL by FC in PB) on EFS was assessed using Cox proportional hazards regression. ddPCR was observed to statistically correlate with both the surface (0.60, P < 0.0001) and intracellular FC assays (0.74, P < 0.0001). A higher sensitivity for detecting CAR T-cell positive samples was observed with ddPCR, with 58.8% and 41.3% of samples negative by surface and intracellular FC, respectively, being positive by ddPCR. Loss of CAR T-cell persistence (HR: 2.7; 95% CI: 1.4-5.4), and to a lesser degree B-cell recovery (HR: 1.7; 95% CI: 0.7-3.8), as time-dependent variables and at Month 3, were associated with poorer EFS. ddPCR demonstrated enhanced sensitivity over FC methods for detection of obe-cel persistence. Additionally, ongoing persistence and BCA were associated with longer EFS and may be taken into consideration, together with clinical parameters, in informing decision making.

PMID:42241689 | DOI:10.1158/2767-9764.CRC-25-0756

JMIR Med Educ. 2026 Jun 4;12:e81052. doi: 10.2196/81052.

ABSTRACT

BACKGROUND: Applicants participating in the Residency Match generally submit a photograph through the Electronic Residency Application Service (ERAS). Studies demonstrate that subjectively more attractive applicants are more likely to succeed during job recruitment, including a paper related to the Residency Match.

OBJECTIVE: This study further investigates the relationship between an applicant’s attractiveness and the likelihood that they are invited to interview with a residency program to explore if more attractive applicants are more likely to be invited to interview when controlled for demographic and academic variables. If there are enough data suggesting that an ERAS photograph being visible prior to the interview gives an unfair advantage to more attractive applicants, this practice might be reconsidered by some residency programs or by ERAS itself.

METHODS: Residency directors were surveyed on application review practices. Programs that viewed ERAS photographs prior to deciding whether to invite an applicant to interview were asked to share ERAS files of all reviewed applicants of the 2022 Match. A machine learning model was used to determine attractiveness scores for ERAS photographs. The scores ranged from 1 to 10, where 1 represents the least attractive and 10 represents the most attractive. Multivariable logistic regression analysis was performed considering attractiveness scores, demographics, and professional characteristics. The primary outcome of interest was an invitation to an interview with a residency program.

RESULTS: The residency program response rate was 47.5% (29/61). Among 2681 unique applications to 10 specialties in a single academic health system, the median attractiveness score for all applicants was 6.02 (IQR 5.54-6.55). The univariable analysis indicated a 19% higher invitation likelihood with a 1-point increase in attractiveness. After adjusting for demographics and professional experiences, the association lost statistical significance. Additional adjustment for United States Medical Licensing Examination scores further attenuated the association.

CONCLUSIONS: While higher attractiveness scores correlated with an increased likelihood of securing an interview, this correlation was not statistically significant after adjusting for other variables.

PMID:42241682 | DOI:10.2196/81052

J Appl Physiol (1985). 2026 Jun 4. doi: 10.1152/japplphysiol.00192.2026. Online ahead of print.

ABSTRACT

While estrogen is known to confer cardioprotective benefits in cisgender women, transgender women on gender-affirming hormone therapy may experience unique cardiovascular risks. Emerging evidence suggests that feminizing hormone therapy may confer both beneficial and adverse effects on cardiovascular, renal, and hepatic systems. In this cross-sectional study, transgender women receiving gender-affirming hormone therapy with orchiectomy (n=15) or without orchiectomy (n=15) were compared with age-matched cisgender men (n=15) and cisgender women (n=15). Transgender women had received hormone therapy for 11±3 years. Serum estradiol concentrations were significantly lower in cisgender men (33±10 pg/mL) than in transgender women with orchiectomy (141±47 pg/mL), transgender women without orchiectomy (116±41 pg/mL), and cisgender women (131±38 pg/mL), whereas serum testosterone concentrations were significantly higher in cisgender men (22.0±6.1 nmol/l) compared with the other groups (1.2±1.1, 0.6±0.3, 1.0±0.3 nmol/l) (all p<0.001). No statistically significant group differences were observed in brachial-ankle pulse wave velocity, brachial artery flow-mediated dilation, post-occlusive skin reactive hyperemia, or blood nitric oxide concentrations (all p>0.05). Blood urea nitrogen, creatinine, and liver enzyme concentrations were significantly higher in cisgender men than in the other groups (all p<0.05). Collectively, these results indicate that no statistically significant differences were observed in macro- and microvascular function, as well as liver and renal function, between transgender women (with or without orchiectomy) and cisgender women.

PMID:42241669 | DOI:10.1152/japplphysiol.00192.2026

Plant Physiol. 2026 Jun 4:kiag342. doi: 10.1093/plphys/kiag342. Online ahead of print.

ABSTRACT

Understanding how leaf water relations integrate with carbon economy is central to plant physiological ecology and to predictions of vegetation responses to environmental change, yet the degree of their coordination remains debated. We investigated relationships between leaf pressure-volume (PV) traits (leaf-specific capacitance at full turgor per dry mass (C*ft,mass), osmotic potential at the turgor loss point (πtlp), and other PV traits) and leaf economics spectrum (LES) traits (leaf nitrogen content, specific leaf area, and photosynthetic capacity) across temperate, subtropical, and tropical forests. These two suites of traits exhibited statistically partial coordination: C*ft,mass was tightly coupled with LES traits, whereas πtlp was independent of the LES framework, and this partial coupling was primarily driven by leaf saturated water content. Notably, coordination was strongest at the subtropical site, where conservative strategies strengthened the integration between PV and LES traits, thereby improving resource-use efficiency. This partial coupling provides insights into the multidimensional nature of plant functional strategies and the mechanisms underpinning species coexistence across forest types.

PMID:42241664 | DOI:10.1093/plphys/kiag342

Am J Public Health. 2026 Jun 4:e1-e10. doi: 10.2105/AJPH.2026.308439. Online ahead of print.

ABSTRACT

Objectives. To estimate associations of fatherhood with cardiovascular health (CVH), incident cardiovascular disease (CVD), and all-cause mortality. Methods. The Coronary Artery Risk Development in Young Adults (CARDIA) study is a US-based cohort that enrolled Black and White individuals aged 18 to 30 years at baseline (1985-1986). CVH was defined by Life’s Essential 8 scores. Models included multivariable linear regression and Cox proportional hazards. Results. Among 1648 men with fatherhood data, there was a statistical interaction between age at fatherhood onset and race on CVH (P < .05) in adjusted models. Among Black men, fathers had lower death rates than nonfathers (hazard ratio [HR] = 0.5; 95% confidence interval [CI] = 0.3, 0.9). Black fathers who were younger than 25 years (HR = 4.2; 95% CI = 1.2, 14.6) and those aged 25 to 29 years (HR = 4.2; 95% CI = 1.2, 14.8) at fatherhood onset had higher death rates compared with Black fathers who were aged 30 years or older. White fathers who were younger than 25 years and those aged 25 to 29 years at fatherhood onset had worse total CVH compared with White fathers who were aged 30 years or older (69.2 and 69.9 vs 73.3 points; P < .05). Conclusions. Fatherhood may be a protective health factor for Black men and adverse influence for young fathers, offering insight for public health programming. (Am J Public Health. Published online ahead of print June 4, 2026:e1-e10. https://doi.org/10.2105/AJPH.2026.308439).

PMID:42241661 | DOI:10.2105/AJPH.2026.308439

Am J Public Health. 2026 Jun 4:e1-e12. doi: 10.2105/AJPH.2025.308416. Online ahead of print.

ABSTRACT

Objectives. To describe trends in US community health worker (CHW) place of employment and wages and the impact of state certification programs and Medicaid reimbursement. Methods. Using 2012 to 2023 Bureau of Labor Statistics data, we performed tests of proportions to describe CHWs’ changes in employment in different industries, linear regression to compare their wages between industries, and staggered difference-in-differences to evaluate the impact of certification and Medicaid reimbursement on the proportion of CHWs in each industry and wages. Results. CHW employment in health care and government has increased (P < .001), and CHWs are paid the least in social assistance agencies (P < .001). Certification was associated with a decreased proportion of government and public health CHWs (-9.4%; P = .003) but was not associated with wages. Medicaid reimbursement was not associated with place of employment or wages. Conclusions. Substantial wage differences exist across industries employing CHWs, and neither Medicaid reimbursement nor certification was associated with higher wages. Certification may influence workforce distribution, particularly in government settings. Public Health Implications. Improved Medicaid reimbursement rates and billing procedures and optimized payment models could grow and sustain the CHW workforce. Decreases in government employment after certification warrant further research. (Am J Public Health. Published online ahead of print June 4, 2026:e1-e12. https://doi.org/10.2105/AJPH.2025.308416).

PMID:42241658 | DOI:10.2105/AJPH.2025.308416

JCO Glob Oncol. 2026 Jun;12(6):e2600117. doi: 10.1200/GO-26-00117. Epub 2026 Jun 4.

ABSTRACT

PURPOSE: In Brazil, diagnosing and treating non-small cell lung cancer (NSCLC) with actionable molecular alterations pose substantial challenges because of health care disparities. Anaplastic lymphoma kinase (ALK) rearrangements represent a clinically relevant subset with highly effective targeted therapies. However, real-world access to ALK diagnostics and treatments across different Brazilian health care sectors remains inadequately characterized.

METHODS: We conducted a cross-sectional survey of Brazilian oncologists between October 2024 and March 2025 to assess the availability of ALK testing and targeted therapies, alongside perceived implementation barriers. Of 197 responses collected, 156 were included in the final analytic cohort. Data were analyzed using descriptive statistics, and categorical variables were reported as proportions with 95% CIs.

RESULTS: Within the final analytic cohort (N = 156), 93.9% of the respondents practicing in the private sector (n = 147) reported access to ALK testing, whereas only 43.9% of those practicing in the public health care system (n = 107) had access. Access to ALK-targeted therapies was limited for the public health care population: 7.1% received crizotinib and <2% received newer-generation ALK-targeted therapies available in the first-line setting. By contrast, in the private sector, 75.6% and 60.9% reported access to alectinib and lorlatinib, respectively. Chemotherapy remained predominant in the public health care system. Main barriers included lack of reimbursement (58.3%), insufficient tissue (40.4%), and urgency to initiate treatment (36.5%).

CONCLUSION: Despite robust evidence supporting ALK-targeted therapies, this study highlights substantial disparities in access to diagnostics and treatment for ALK-rearranged NSCLC in Brazil, particularly among patients reliant on the public health care system. Findings underscore the need for policies to strengthen testing infrastructure, ensure equitable access to guideline-recommended therapies, and enhance provider education. Addressing these gaps is essential for equitable precision oncology and improved outcomes.

PMID:42241650 | DOI:10.1200/GO-26-00117

Nurs Open. 2026 Jun;13(6):e70600. doi: 10.1002/nop2.70600.

ABSTRACT

AIMS: To explore the effectiveness of a systematic epidemic prevention programme on the coping response of nursing staff caring for high-risk COVID-19 patients.

DESIGN: A one-group pre-post-test pre-experimental design was used.

METHODS: Through purposive sampling, a total of 84 nursing staff were recruited from a teaching hospital who had experiences in caring for high-risk COVID-19 patients. The participants underwent a systematic epidemic prevention programme. Before the intervention and 1 month, 3 months, and 6 months after the intervention at four time points, the coping response of the nursing staff was measured through three scales-the Impact of Event Scale-Revised, the General Health Questionnaire (GHQ), and the Brief Coping Orientations to Problems Experienced (Brief-COPE). The data were analyzed using descriptive and inferential statistics including generalised estimating equations, Pearson’s correlation coefficient, independent samples t-test, and analysis of variance.

RESULTS: The systematic epidemic prevention programme significantly improved nursing staff’s coping responses. IES-R scores decreased over time but did not reach statistical significance. GHQ scores showed a significant time effect, with reductions observed at 1 and 3 months post-intervention, and the greatest improvement at 3 months. Emotional coping significantly increased at 3 months post-intervention. Overall, the findings demonstrate a sustained improvement in coping responses across time points following the intervention.

REPORTING METHOD: The study followed the TREND and TIDieR checklists.

PATIENT OR PUBLIC CONTRIBUTION: None.

PMID:42241051 | DOI:10.1002/nop2.70600

Cornea. 2026 Jun 3. doi: 10.1097/ICO.0000000000004101. Online ahead of print.

ABSTRACT

PURPOSE: To determine whether there is an altered risk of specific cancers among individuals with Fuchs Endothelial Corneal Dystrophy (FECD).

METHODS: Retrospective, case-control study using data from the Utah Population Database, Utah Cancer Registry, and associated records. Cases were defined as individuals ≥40 years with a diagnosis of FECD. Controls were matched approximately 3:1 with cases on birth year, sex, whether born in Utah, and duration of follow-up in Utah. Twenty-two types/locations of cancer that were diagnosed between 1996 and 2022 were recorded. Cancer risk models were calculated using mixed-effect logistic regression, with adjustments for obesity, diabetes, tobacco use, race, ethnicity, and sex (except for sex-specific cancers). The main outcome measure was the odds of specific cancer diagnoses among FECD cases compared with matched controls.

RESULTS: A total of 4129 FECD cases and 12,371 controls were studied in the final analysis. A total of 885 (21.4%) FECD cases and 2514 (20.3%) controls were diagnosed with any cancer (P = 0.126). After adjusting for covariates, FECD cases did not have an altered likelihood of having a diagnosis of cancer overall (OR: 1.06; 95% CI, 0.97-1.16; P = 0.174), or according to any of the specific cancer sites/subtypes. There was a slightly higher likelihood of thyroid cancer among FECD cases (OR: 1.55; 95% CI, 1.00-2.38; P = 0.048) and prostate cancer among male FECD cases (OR: 1.20; 95% CI, 1.01-1.43; P = 0.036) that was not statistically significant after accounting for multiple comparisons.

CONCLUSIONS: Individuals with FECD did not have a significantly altered risk of any of the studied cancers.

PMID:42241014 | DOI:10.1097/ICO.0000000000004101

Knee Surg Sports Traumatol Arthrosc. 2026 Jun 4. doi: 10.1002/ksa.70470. Online ahead of print.

ABSTRACT

PURPOSE: We aimed to evaluate the direct and indirect costs of anterior cruciate ligament (ACL) injuries and assess their effects on career trajectories, market value, and potential associations with the age of the head coach at the time of injury in European professional football.

METHODS: A retrospective Transfermarkt.com cohort study was conducted on 211 professional male footballers who underwent ACL reconstruction. Primary outcomes related to demographics, career outcomes, market value, and coaching profiles were analysed. Data were analysed using SPSS 30, employing analysis of variance, Mann-Whitney U tests, Wilcoxon signed-rank tests, and independent-samples t-tests. Post-hoc power analysis (G Power) confirmed statistical power > 0.99 for the primary outcome.

RESULTS: The mean recovery period was 256.6 days (standard deviation [SD]: 91.9; median: 241; interquartile range [IQR]: 102; range: 109-674). ACL injuries were associated with a mean market value depreciation of approximately 2.5% (Value Drop Ratio [VDR]: 1.0; SD: 0.1; 95% confidence interval [CI]: 1.0159-1.033). Age was significantly associated with financial loss (F = 6.2, p < 0.001; Cohen’s f = 0.332); players ≥ 30 years showed a 5.5% decline compared to 0.9% for those aged ≤ 22 years. Post-injury, 16.0% transitioned to a lower-tier league and 7.3% to a higher-tier league. Players who transitioned to lower tiers had shorter mean recovery durations (221.6 vs. 264.1 days; p = 0.011). In an exploratory analysis (n = 38 coaches), teams coached by managers < 40 years had lower ACL injury rates among newly transferred players (p = 0.004). After Bonferroni correction (p < 0.007), only Scottish and Dutch subgroup findings remained significant.

CONCLUSION: ACL injuries in professional male footballers impose a substantial economic burden on clubs through market value depreciation, prolonged recovery and continued salary obligations. Older player age is the strongest determinant of financial impact, while a meaningful proportion of injured players transition to lower-tier leagues, with shorter recovery paradoxically associated with downward career mobility. These findings suggest that ACL injury constitutes a multidimensional risk encompassing medical, financial and career consequences.

LEVEL OF EVIDENCE: Level III, retrospective cohort study.

PMID:42241013 | DOI:10.1002/ksa.70470