Category: Statistics

Vaccine. 2026 Feb 4;75:128302. doi: 10.1016/j.vaccine.2026.128302. Online ahead of print.

NO ABSTRACT

PMID:41643234 | DOI:10.1016/j.vaccine.2026.128302

Vaccine. 2026 Feb 4;75:128225. doi: 10.1016/j.vaccine.2026.128225. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate febrile seizure risk following monovalent COVID-19 mRNA vaccination among children aged 2-5 years.

METHODS: The primary analysis evaluated children who had a febrile seizure outcome in the 0-1 days following COVID-19 vaccination. A self-controlled case series analysis was performed in three commercial insurance databases to compare the risk of seizure in the risk interval (0-1 days) to a control interval (8-63 days). The exposure of interest was receipt of dose 1 and/or dose 2 of monovalent COVID-19 mRNA vaccinations. The primary outcome was febrile seizure (0-1 day risk interval). A conditional Poisson regression model was used to compare outcome rates in risk and control intervals and estimate incidence rate ratios (IRR) and 95% confidence intervals (CIs). Meta-analyses were used to pool results across databases.

RESULTS: The primary meta-analysis found a statistically significant increased incidence of febrile seizure, in the 0-1 days following mRNA-1273 vaccination compared to the control interval (IRR: 2.52, 95% CI: 1.35 to 4.69, risk difference (RD)/100,000 doses = 3.22 (95% CI -0.31 to 6.75)). For the BNT162b2 vaccination, the IRR was elevated but not statistically significant (IRR: 1.41, 95% CI: 0.48 to 4.11, RD/100,000 doses = -0.25 (95% CI -2.75 to 2.24).

CONCLUSIONS: Among children aged 2-5 years, the analysis showed a small elevated incidence rate ratio of febrile seizures in the 0-1 days following the mRNA-1273 vaccination.

PMID:41643233 | DOI:10.1016/j.vaccine.2026.128225

Sleep Med. 2026 Jan 30;141:108818. doi: 10.1016/j.sleep.2026.108818. Online ahead of print.

ABSTRACT

INTRODUCTION: Melatonin plays a key role in sleep regulation. Combining melatonin with its precursors, L-tryptophan (LT) and 5-Hydroxytryptophan (5HTP), may influence sleep-related outcomes, but evidence in children with neurodevelopmental disorders (NDDs) is limited. This exploratory study compares the effects of melatonin combined with 5HTP (M-5HTP) and melatonin combined with LT (M-LT) on sleep disorders in children with NDDs.

METHODS: This single-center, randomized pilot comparative trial involved children under five years of age with NDDs free of sleep-inducing drugs. Baseline evaluations and actigraphy monitoring were performed. Children were randomly assigned to either M-5HTP (1 mg Melatonin +10 mg 5HTP) or M-LT (1 mg Melatonin +20 mg LT) treatment at 8 p.m. for at least four weeks. Post-treatment actigraphy monitoring assessed sleep parameters.

RESULTS: Of 51 screened children, 26 were enrolled and 13 completed the study (M-5HTP: 9, M-LT: 4). No statistically significant between-group differences in change scores were observed. Within-group analyses showed a significant reduction in the Sleep Movement Index (SMI) from baseline to follow-up in the M-5HTP group (T0: 6.55; T1: 1.25; p=0.006), whereas no significant changes were observed in the M-LT group.

DISCUSSION: In this exploratory pilot study, a within-group reduction in nocturnal motor activity was observed among M-5HTP completers. Given the small sample size, high attrition rate, and limited statistical power, these findings should be interpreted cautiously and considered hypothesis-generating.

PMID:41643230 | DOI:10.1016/j.sleep.2026.108818

Am J Clin Pathol. 2026 Jan 5;165(2):aqaf148. doi: 10.1093/ajcp/aqaf148.

ABSTRACT

OBJECTIVE: The prevalence of mistreatment in the laboratory workforce is concerning. This study aimed to develop an antibullying course for laboratories and to pilot-test its effectiveness in improving knowledge, readiness for organizational change, and coping self-efficacy. In addition, it used geographic information system mapping to explore the geospatial distribution of bullying and course participation and to describe the program for potential implementation by other institutions.

METHODS: An 8-module online course was developed for laboratory management and nonsupervisory staff, focusing on best practices to address incivility at the organizational and individual levels. Participants completed a pre-course assessment, including the Short Negative Acts Questionnaire and a pretest, before taking the course. The program’s effectiveness was evaluated by comparing pre-course and post-course scores using paired sample t tests and geospatial analysis.

RESULTS: Of 127 laboratory professionals who completed the pre-course survey, 92 (72.4%) completed the bullying prevention course and post-course evaluation. More than half (55.1%) were classified as victims of workplace bullying, with regional analysis showing the highest bullying intensity in the West and Midwest regions that also showed contrasting course completion rates (85%-87% in the West vs <70% in the Midwest). Post-course assessment revealed statistically significant improvements in participants’ knowledge (mean increase from 2.57 to 3.08, P < .001) and coping strategies (2.60-2.94, P < .001), supporting the course’s efficacy. Most participants (77.2%) rated the course positively.

CONCLUSIONS: The issue is persistent and will require deliberate interventions. The piloted bullying prevention educational platform presented is promising and can be a foundation for future targeted educational interventions for pathology laboratories.

PMID:41643208 | DOI:10.1093/ajcp/aqaf148

JMIR Mhealth Uhealth. 2026 Feb 5;14:e67514. doi: 10.2196/67514.

ABSTRACT

BACKGROUND: Integrating electronic patient-reported outcomes (ePROs) into electronic health records (EHRs) can enhance the quality of patient care. However, collecting longitudinal ePRO data throughout treatment and posttreatment surveillance remains challenging in patients with breast cancer. To address this, we implemented an automated system that enables ePRO acquisition and seamless integration into the EHR. The system delivers questionnaire weblinks via a mobile messaging app, allowing patients to complete ePROs before clinic visits, with responses automatically transferred to the EHR.

OBJECTIVE: This study aimed to assess patient response rates to the ePRO system and identify key factors influencing the response rate among patients with breast cancer who received radiotherapy and postradiotherapy follow-up.

METHODS: We conducted a retrospective analysis of prospectively collected ePRO data by using the BREAST-Q questionnaire, a validated patient-reported outcome measure for breast surgery, from patients who received adjuvant radiotherapy at our institution between May 2023 and April 2024. At a preradiotherapy or postradiotherapy visit, each patient was asked to complete the questionnaire via a weblink sent to their mobile messaging app, KakaoTalk. The questionnaire was dispatched from minutes to several days before each visit. The response rate was calculated as the percentage of patients whose responses were successfully recorded in the EHR among those who were requested to respond. A complete response (CR) was defined as completion of all required questionnaire items. CR rates were analyzed according to clinical factors using univariate and multivariate logistic regression.

RESULTS: Data from 1488 patients were analyzed, encompassing 2431 encounters (median 1, IQR 1-2 per patient). The median age of the patients was 51 (range 23-83) years, with 65.1% (n=968) patients aged 40 to 59 years. Comorbidities were present in 15% (223/1488) of the patients. The CR rate for the first, second, and third ePRO encounters was 89.9% (1338/1488), 98.3% (735/748), and 97.3% (180/185), respectively. Among first-time respondents, younger patients had a significantly higher CR rate (patients aged <60 years: 100/1104, 90.9%; patients aged ≥60 years: 334/384, 87%; P=.03). The timing of the questionnaire dispatch also affected the CR rate (P<.001). The CR rate was the highest when questionnaires were sent more than 1 hour before the visit (547/583, 93.3%) or in the afternoon of the previous day (505/545, 92.7%) and the lowest when sent 2 or more days before (100/130, 76.9%) or within 1 hour before the appointment (92/112, 81.7%). Both age (P=.006) and timing (P<.001) remained significant in the multivariate analysis.

CONCLUSIONS: This study demonstrates the feasibility of integrating ePRO into EHR through a mobile messaging app-based system, with high patient adherence. Response rates were significantly influenced by patient age and the timing of questionnaire dispatch. These findings provide practical insight for optimizing ePRO implementation in routine oncology care.

PMID:41643191 | DOI:10.2196/67514

J Clin Exp Neuropsychol. 2026 Feb 5:1-8. doi: 10.1080/13803395.2026.2627996. Online ahead of print.

ABSTRACT

INTRODUCTION: PTSD is among the most commonly diagnosed mental health conditions in the military and veteran populations. Shura et al. (2023) and Schroeder and Bieu (2024) developed three symptom validity indices for the PTSD Checklist for the DSM-5 (PCL-5) examining overreported PTSD symptomatology in veteran populations. The current study aimed to cross-validate these SVTs in an active-duty United States military sample.

METHODS: The sample consisted of multiple criterion groups comprised active-duty service members (N = 165). Criterion for valid or invalid responses were based on Personality Assessment Inventory symptom validity scales. The three PCL-5 symptom validity indices included PCL-5 Symptom Severity (PSS), PCL-5 Extreme Symptom (PES), and PCL-5 Rare Items (PRI).

RESULTS: Areas under the curve ranged from .73 to .76 for valid full sample group versus invalid group, which met classification accuracy goals. Optimal cutoff scores were identified for each scale (PES ≥ 16, PSS ≥ 59, PRI ≥ 3) with corresponding sensitivities of PSS = 0.50, PES = 0.40, and PRI = 0.20 with specificity ≥0.90.

CONCLUSION: These findings provide support for the cross-validation of all three embedded symptom validity indices at the identified cutoff scores as PCL-5 over-report measures within an active-duty sample. The PSS and PES demonstrated superior classification statistics, as the PRI was hampered by lower sensitivity.

PMID:41643189 | DOI:10.1080/13803395.2026.2627996

JMIR Med Educ. 2026 Feb 5;12:e75534. doi: 10.2196/75534.

ABSTRACT

BACKGROUND: Artificial intelligence (AI) shows promise in clinical diagnosis, treatment support, and health care efficiency. However, its adoption in real-world practice remains limited due to insufficient clinical validation and an unclear impact on practitioners’ competence. Addressing these gaps is essential for effective, confident, and ethical integration of AI into modern health care settings.

OBJECTIVE: This study aimed to evaluate the effectiveness of informed AI use, following a tailored AI training course, on the performance of general practitioners (GPs) and internists in test-based clinical competence assessments and their attitudes toward clinical AI applications.

METHODS: A pre-post intervention study was conducted with 326 physicians from 39 countries. Participants completed a baseline test of clinical decision-making skills, covering diagnosis, treatment planning, and patient counseling; attended a 1.5-hour online training on effective AI use; and then took a similar postcourse test with AI assistance permitted (GPT-4.0). Test performance and time per question were compared before and after the training. Participants also rated AI accuracy, efficiency, perceived need for structured AI training, and their willingness to use AI in clinical practice before and after the course.

RESULTS: The average test scores improved from 56.9% (SD 15.7%) to 77.6% (SD 12.7%; P<.001), and the pass rate increased from 6.4% (21/326) to 58.6% (191/326), with larger gains observed among GPs and younger physicians. All skill domains (diagnosis, treatment planning, and patient counseling) improved significantly (all P<.001), while time taken to complete the test increased slightly from before to after the course (mean 40.25, SD 16.14 min vs 42.29, SD 14.02 min; P=.03). By the end of the intervention, physicians viewed AI more favorably, reporting increased confidence in its accuracy and time efficiency, greater appreciation for the need for structured AI training, and increased confidence and willingness to integrate AI into patient care.

CONCLUSIONS: Informed use of AI, based on tailored training, was associated with higher performance in test-based clinical decision-making assessments and greater confidence in using AI among GPs and internists. Building on previous research that often lacked structured training, focused primarily on model performance, or was limited in clinical scope, this study provides empirical evidence of both competence and perceptual improvement following informed AI use in a large, multinational cohort, enhancing the generalizability. These findings support the integration of structured AI training into medical education and continuing professional development to improve clinical performance and promote competent use of AI in clinical practice.

PMID:41643188 | DOI:10.2196/75534

AIDS. 2025 Dec 2. doi: 10.1097/QAD.0000000000004421. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare dementia incidence and prevalence by HIV status, race/ethnicity, and sex.

DESIGN: Retrospective cohort, 2000-2023.

METHODS: Adults with HIV aged ≥50 years and 1:20 matched individuals without HIV from Kaiser Permanente, a U.S. healthcare system, were included. Dementia diagnoses were identified via electronic health records. We estimated rates of incident dementia diagnoses and prevalence, overall and by time period (2000-2004, 2005-2009…2020-2023) using Poisson regression, and assessed trends using Joinpoint regression. Covariate-adjusted rate ratios compared dementia by HIV status, with sub-analyses stratified by race/ethnicity and sex.

RESULTS: Among 24,762 people with HIV and 494,963 people without HIV (86.9% men, 45.5% White, 23.1% Black, 20.3% Hispanic), incident dementia diagnoses declined from 2000-2023 in both people with and without HIV (-7.68% and -2.70% per period, respectively). Overall, the incidence of dementia diagnosis was higher in people with HIV (adjusted incidence rate ratio [aIRR]=1.72, 95% CI=1.59-1.85). In the most recent period (2020-2023), this difference was not statistically significant (aIRR=1.16, 95% CI=0.99-1.35), partly due to increases in diagnoses among people without HIV during this period. Dementia prevalence remained higher in people with HIV, overall (adjusted prevalence ratio [aPR]=1.71, 95% CI=1.61-1.82) and in 2020-2023 (aPR=1.59, 95% CI=1.46-1.73), with similar patterns by race/ethnicity and sex.

CONCLUSIONS: Incident dementia diagnoses have declined in people with HIV and are approaching those of people without HIV, with consistent trends across demographic subgroups. However, prevalence remains elevated, likely reflecting excess risk from earlier years. These findings highlight the need for sustained attention to cognitive health and the integration of dementia-related services in HIV care.

PMID:41643176 | DOI:10.1097/QAD.0000000000004421

Chem Biodivers. 2026 Feb;23(2):e02986. doi: 10.1002/cbdv.202502986.

ABSTRACT

This study investigated the chemical profile and allelopathic potential of Ambrosia artemisiifolia root exudates. Metabolomic profiling was performed on hydroponic culture exudates using XAD-4 resin and UHPLC-QTOF/MS. The analysis identified a total of 1408 metabolites, with stearidonic acid (SA) being the most abundant, accounting for 28.02% of the total root exudate constituents. The allelopathic bioassays conducted on dicot and monocot weed species revealed no statistically significant increase in growth at concentrations of 10-50 µg/mL, whereas inhibition occurred at 250 µg/mL or higher. Monocots exhibited greater sensitivity to the allelopathic effects. At a concentration 500 µg/mL, the application of exudates resulted in a reduction of root and shoot lengths in Setaria viridis by 24.18% and 51.85%, respectively, and in Poa annua by 28.34% and 27.89%, respectively. SA exhibited a stronger inhibitory effect, suppressing root elongation by 43.37% and 71.66% and shoot growth by 33.51% and 64.42% in S. viridis and P. annua, respectively. Moreover, both SA and root exudates modulated superoxide dismutase (SOD) and peroxidase (POD) activities in Amaranthus retroflexus and S. viridis. At higher concentrations, growth was inhibited despite the upregulation of these antioxidant enzymes, suggesting that the accumulation of reactive oxygen species (ROS) exceeded the plants’ antioxidant capacity. Results demonstrate root exudates drive invasion by disrupting antioxidant defenses, offering potential for concentration-dependent bioherbicides in sustainable weed management.

PMID:41643171 | DOI:10.1002/cbdv.202502986

JMIR Mhealth Uhealth. 2026 Feb 5;14:e76862. doi: 10.2196/76862.

ABSTRACT

BACKGROUND: The use of mobile health (mHealth) apps can assist with the management of gestational diabetes (GDM). Although a number of studies have demonstrated their efficacy in improving maternal-fetal outcomes, opinions differ regarding their usability and overall quality. Poorly designed apps, with ill-conceived features or inappropriate content, may pose a threat to patient safety. Nevertheless, very few studies provide in-depth evaluations of app design quality, and the diversity of features and techniques used remains insufficiently explored.

OBJECTIVE: We aimed to evaluate the quality and multifunctionality of commercially available mHealth apps for GDM.

METHODS: This is a systematic app review guided by the TECH (target user, evaluation focus, connectedness, and health domain) framework and the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 checklist. Searches were conducted on the Apple App Store and Google Play. Apps were screened by name, description, and full navigation to identify inclusions. The quality of the apps was evaluated using the Mobile App Rating Scale and IMS Institute for Healthcare Informatics Functionality Score. Multifunctionality of the apps was evaluated using the GDM-adapted features and techniques list developed from the App Behavior Change Scale, NICE (National Institute for Health and Care Excellence) 2015 guidelines, and previous studies. The general features list, which contains instruction, data security, customization, and technical issues, was derived from previous studies.

RESULTS: The search (June 2024) identified 23 commercially available apps from UK app stores. The overall app quality was evaluated to be satisfactory (Mobile App Rating Scale: mean 4.0, SD 0.36; IMS Institute for Healthcare Informatics Functionality Score: mean 5.83, SD 3.03). The multifunctionality evaluation found that the apps had a mean of 17.95 and SD of 7.31 across all 45 items. Overall, our findings suggested that mHealth apps for GDM achieved a certain level of multifunctionality. However, their feature types and supporting digital techniques are relatively basic. The apps focused on education and managing blood glucose control rather than integrating other self-monitoring data and pregnancy-relevant management into their design. The digital techniques used to achieve these features included text and manual operation, rather than other automated features.

CONCLUSIONS: This is the first app review to consider the relationship between app features and usability for women with GDM. Future app development should integrate a wide range of pregnancy-relevant information and more automated features and use advanced digital techniques to enable a holistic digital solution for women with GDM.

PMID:41643159 | DOI:10.2196/76862