Category: Statistics

Eur J Psychotraumatol. 2026 Dec;17(1):2611511. doi: 10.1080/20008066.2025.2611511. Epub 2026 Jan 29.

ABSTRACT

Background and Objective: Previous studies have shown that experience of racial discrimination is associated with increased mental health problems, especially stress. Using a cluster analytical procedure, the current study aimed to examine stress characteristics related to racial discrimination in individuals from diverse racial identities.Method: In total, 4220 participants completed the questionnaires assessing stress, resilience, everyday racial discrimination, and experience of major racial discrimination. K-means cluster analysis was performed to cluster participants’ features regarding stress, resilience, everyday racial discrimination, and major racial discrimination. To determine the optimal number of clusters, the gap statistic was employed. Extracted clusters were then compared across racial groups using chi-square tests.Results: Cluster analysis revealed a three-cluster solution, including ‘low stress’, ‘stress cluster with high racial discrimination’, and ‘stress cluster with low racial discrimination’ clusters. Concerning the race-differences, Black (32.57%) and Indigenous (33.63%) participants had higher membership in the stress cluster with high racial discrimination compared to other racialized groups. Regarding the stress cluster with low racial discrimination, a higher membership was observed among Arab participants (30.82%) and those with other racial identities (30.40%) compared to other racialized groups.Conclusions: The findings demonstrate a type of stress characterized by high levels of racial discrimination and accompanying psychosocial burdens. Implications for intervention, prevention, and future research are discussed in the paper.

PMID:41608817 | DOI:10.1080/20008066.2025.2611511

Glob Chang Biol. 2026 Feb;32(2):e70728. doi: 10.1111/gcb.70728.

ABSTRACT

Tropospheric ozone (O₃) is a pervasive stressor that impairs forest biomass and alters carbon allocation strategies. This study assessed biomass responses across 17 woody taxa under free-air controlled exposure (FACE), integrating a decade of experiments conducted with an analogous exposure regime applied to deciduous and evergreen species. The analysis provided a comparative evaluation of existing flux-based metrics. Statistical analyses revealed consistent reductions in relative total (RTB), aboveground (RTAB), and belowground (RTBB) biomass with increasing O₃ uptake in terms of phytotoxic ozone dose (POD₁ mmol m^-2). Deciduous species reached the 4% biomass reduction threshold (CL₄) at lower POD₁ levels for RTBB (10.21), RTAB (13.16), and RTB (10.77) and displayed relatively small ${△}_{{\mathrm{POD}}_1}$ values for RTBB (2.75), RTAB (5.70), and RTB (3.31), where ${△}_{{\mathrm{POD}}_1}$ represents the increment in O₃ uptake required to reach the CL₄ threshold. In contrast, evergreen species showed higher CL₄ for RTBB (11.48), RTAB (15.40), and RTB (13.86) and larger ${△}_{{\mathrm{POD}}_1}$ values for RTBB (8.40), RTAB (12.32), and RTB (10.78), reflecting a slower biomass decline. Contrasting relationships suggest that leaf habit-specific patterns are associated with divergent carbon allocation strategies under O₃ stress. In deciduous species, POD₁ and Leaf Index Flux (LIF) were negatively correlated with shoot-to-root ratio (S/R), whereas in evergreen species, both indices were positively correlated with leaf area ratio (LAR) and S/R. In conclusion, flux-based metrics provided a biologically robust framework for quantifying O₃-induced biomass losses, revealing higher sensitivity in deciduous species than in evergreens and highlighting the root as the most vulnerable compartment under O₃ exposure. The findings should be interpreted considering the spatial and temporal constraints of a single-site FACE experiment and the focus on O₃ as a stand-alone stressor without interaction effects. Future research should combine O₃ uptake with multi-stressor frameworks to better predict biomass and carbon responses in complex field conditions.

PMID:41608815 | DOI:10.1111/gcb.70728

Circ Cardiovasc Interv. 2026 Jan 29:e016191. doi: 10.1161/CIRCINTERVENTIONS.125.016191. Online ahead of print.

ABSTRACT

BACKGROUND: The DynamX bioadaptor, a novel coronary implant, is designed to restore vessel function when the thin polymer coating covering the helical strands resorbs 6 months post-percutaneous coronary intervention. We aimed to evaluate vessel conformability 1 year after percutaneous coronary intervention with the bioadaptor, compared with conventional drug-eluting stents (DESs).

METHODS: Vessel segments were 1:1 randomized to a novolimus-eluting bioadaptor or a durable polymer novolimus-eluting second-generation DES. Coronary computed tomography angiography was performed at 1 and 12 months post-implantation, and the 3-dimensional geometry of the treated segments in coronary computed tomography angiography was analyzed. The primary outcome was the change in dynamic vessel geometry, including curvature flexibility (bending motion), torsion flexibility (twisting motion), and path flexibility (3-dimensional motion) of the treated segment during the cardiac cycle.

RESULTS: A total of 48 vessel segments in 48 patients were randomized, with 24 receiving bioadaptor and 24 receiving DES. In within-group paired analyses, the bioadaptor group showed a significant improvement in torsion flexibility from 1 to 12 months, whereas no significant change was observed in the DES group. Although curvature and path flexibility increased numerically in the bioadaptor group, these within-group differences were not statistically significant. However, when comparing the magnitude of change between groups, the increase in path flexibility was significantly greater with the bioadaptor than with DES, indicating a superior restoration of 3-dimensional vessel motion.

CONCLUSIONS: The novel bioadaptor technology demonstrated favorable restoration of 3-dimensional dynamic geometry of the treated vessel segment 12 months after implantation, in comparison with traditional DES. These initial mechanistic findings suggest a potential explanation for the favorable clinical outcomes observed in prior trials, and our analytical approach may offer new insights to guide future vascular implant designs and evaluations.

REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04936191.

PMID:41608781 | DOI:10.1161/CIRCINTERVENTIONS.125.016191

Am J Sports Med. 2026 Jan 29:3635465251400357. doi: 10.1177/03635465251400357. Online ahead of print.

ABSTRACT

BACKGROUND: Total knee arthroplasty (TKA) provides pain relief and functional improvement for end-stage knee osteoarthritis patients. As TKA use increases in younger patients, return to sports (RTS) has become a key outcome measure. While RTS rates after TKA are generally high, they vary significantly across studies due to differences in study design, patient populations, and RTS definitions.

PURPOSE: To determine RTS rates, evaluate return to preoperative sport levels, quantify time to RTS, and identify factors affecting RTS after TKA.

STUDY DESIGN: Cohort study; Level of evidence, 2.

METHODS: We analyzed 21,466 primary TKAs performed between 2016 and 2022. Of these, 1782 patients (8.3%) were athletes at baseline, with 1464 (82.2%) completing 1-year follow-up. We recorded demographic characteristics, comorbidities, baseline and 1-year RTS status, time to RTS, athlete type, and patient-reported outcomes. Analysis included descriptive statistics, Cox regression for time to RTS, and logistic regression for RTS-associated factors.

RESULTS: Of 1464 patients, 782 (53.4%) achieved RTS, while 676 (46.6%) did not; both contact and noncontact sports were included. Among those who returned, 62% resumed their previous sport at the same level, 34.5% at a reduced intensity, and 3.4% switched to a different sport. The median RTS time was 12 weeks, with 90% returning within 27 weeks. Medicaid patients had a delayed RTS compared with those with commercial insurance (hazard ratio [HR], 0.51). Overweight patients returned sooner than normal-weight patients (HR, 1.41). Female patients (odds ratio [OR], 0.76) and Black patients (OR, 2.34) had lower RTS odds, while recreational (OR, 0.06) and competitive athletes (OR, 0.10) had higher RTS odds versus those not participating in athletic activities.

CONCLUSION: Over half of athletes returned to sports within 1 year of TKA, most within 27 weeks. RTS rates varied by preoperative competitive level, sex, race, body mass index, and comorbidity burden. These findings can guide patient expectations and shared decision-making regarding post-TKA sports participation. Future research should focus on improving RTS rates in high-risk groups, standardizing RTS criteria, and stratifying outcomes by sport type and impact level to enable more individualized patient recommendations.

PMID:41608778 | DOI:10.1177/03635465251400357

Stroke Vasc Interv Neurol. 2025 Nov 14;5(6):e001702. doi: 10.1161/SVIN.124.001702. eCollection 2025 Nov.

ABSTRACT

BACKGROUND: Mechanical thrombectomy is a critical intervention for patients with acute ischemic stroke with large vessel occlusion. However, significant barriers remain in its widespread implementation, particularly in low- to middle-income countries, including a shortage of trained physicians and limited access to advanced medical technologies. This systematic review and meta-analysis aimed to comprehensively evaluate current mechanical thrombectomy training methodologies and assess their effectiveness in improving procedural skills among neurointerventional teams.

METHODS: We conducted a systematic review following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, searching PubMed, Scopus, and Web of Science. Eight studies were included, with 3 studies eligible for meta-analysis. We assessed training approaches, participant demographics, and procedural outcomes using the Risk of Bias in Non-randomized Studies of Interventions tool and performed statistical analysis using OpenMetaAnalyst software.

RESULTS: Various training modalities, including virtual reality simulations and hands-on workshops, consistently demonstrated positive effects on procedural skills and professional confidence, demonstrating significant improvements across multiple metrics. Our systematic review and meta-analysis revealed statistically significant reductions in total procedure time (average decrease of 17.84 minutes, 95% CI: [-22.19 to -13.48]), number of handling errors (decreased by 6.34 errors, 95% CI: [-13.16 to 0.48]), contrast volume (decreased by 27.35 mL, 95% CI: [-45.11 to -9.60]), and fluoroscopy time (reduced by 8.07 minutes, 95% CI: [-10.71 to -5.44]). Participants showed increased procedural steps completed, with an average increase of 6.52 steps (95% CI: [3.99-9.05]).

CONCLUSION: Structured, simulation-based mechanical thrombectomy training programs can significantly enhance procedural skills, clinical decision-making, and professional confidence among neurointerventional teams, potentially improving stroke care.

PMID:41608732 | PMC:PMC12697599 | DOI:10.1161/SVIN.124.001702

Stroke Vasc Interv Neurol. 2025 Sep 16;5(6):e001933. doi: 10.1161/SVIN.125.001933. eCollection 2025 Nov.

ABSTRACT

BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are commonly prescribed for the management of type 2 diabetes, and recent studies have highlighted their neuroprotective and anti-inflammatory properties. However, their influence on clinical outcomes in patients undergoing endovascular treatment for unruptured intracranial aneurysms remains largely unexplored.

METHODS: This retrospective cohort study utilized the TriNetX database to identify patients with type 2 diabetes (International Classification of Diseases, Tenth Revision [ICD-10]: E11) and unruptured intracranial aneurysms (ICD-10: I67.1). Patients were categorized based on the use of GLP-1RAs. The outcomes included overall survival, poor functional outcome, new subarachnoid hemorrhage, and hydrocephalus. The propensity score matching method was applied.

RESULTS: A total of 6824 patients met the inclusion criteria, with 447 patients in each group following propensity score matching. No statistically significant differences were observed in short- and mid-term mortality between GLP-1RAs users and non-users. However, long-term mortality was significantly lower in the GLP-1 group (odds ratio 0.58, 95% CI 0.36-0.94). Furthermore, GLP-1RAs users demonstrated significantly reduced risks of poor functional outcomes (odds ratio 0.37, 95% CI 0.21-0.66), new subarachnoid hemorrhage (odds ratio 0.39, 95% CI 0.27-0.56), and hydrocephalus (odds ratio 0.57, 95% CI 0.33-0.97) at 3 months, with similar trends persisting in mid- and long-term follow-up.

CONCLUSION: Use of GLP-1RAs in patients with unruptured intracranial aneurysms treated via endovascular intervention is associated with improved long-term survival and reduced risks of subarachnoid hemorrhage, hydrocephalus, and poor functional outcomes. These findings suggest a potential therapeutic benefit beyond glycemic control. Prospective studies are needed to validate these results and explore their implications for clinical decision-making in aneurysm treatment.

PMID:41608727 | PMC:PMC12697656 | DOI:10.1161/SVIN.125.001933

Stroke Vasc Interv Neurol. 2025 Sep 24;5(6):e001818. doi: 10.1161/SVIN.125.001818. eCollection 2025 Nov.

ABSTRACT

BACKGROUND: The Alberta Stroke Program Early Computed Tomography Score and core volume on preoperative imaging are key predictors of clinical outcomes following endovascular therapy in patients with a large ischemic core. Although the corticospinal tract is essential for motor function, its prognostic impact in patients with a large ischemic core remains unclear.

METHODS: This multicenter retrospective study analyzed preoperative imaging data from patients with Alberta Stroke Program Early Computed Tomography Score ≤5 who underwent endovascular therapy. The presence of lesions in the posterior corona radiata and lesions in the primary motor cortex was assessed. A good outcome was defined as a modified Rankin Scale score ≤3 at 90 days. The association between lesions in the posterior corona radiata, lesions in the primary motor cortex, and good outcome was analyzed using univariable and stepwise multivariable logistic regression, with variable selection based on Akaike information criterion corrected for small sample size.

RESULTS: Among 107 patients, 37 (34.6%) achieved a good outcome. In univariable analysis, neither lesions in the posterior corona radiata nor core volume was significantly associated with a good outcome. In stepwise multivariable logistic regression, modified Rankin Scale score before onset (odds ratio, 0.30 [95% CI, 0.10-0.73]), cardioembolism (odds ratio, 0.25 [95% CI, 0.08-0.76]), absence of lesions in the primary motor cortex involvement (odds ratio, 13.49 [95% CI, 3.75-63.45]), and shorter onset-to-reperfusion time (odds ratio, 0.996 [95% CI, 0.992-0.998]) were independent predictors. Alberta Stroke Program Early Computed Tomography Score and the absence of multiple artery occlusion were retained in the final model but were not statistically significant.

CONCLUSION: Absence of lesions in the primary motor cortex involvement was independently associated with good outcome after endovascular therapy in patients with large ischemic core, suggesting its potential utility as a complementary imaging marker in this population.

PMID:41608725 | PMC:PMC12697621 | DOI:10.1161/SVIN.125.001818

Stroke Vasc Interv Neurol. 2025 Oct 23;5(6):e001789. doi: 10.1161/SVIN.125.001789. eCollection 2025 Nov.

ABSTRACT

BACKGROUND: There is limited information on systemic blood pressure goals and variability before and during mechanical thrombectomy and how it affects outcomes in large vessel ischemic stroke.

METHODS: A longitudinal cohort study of patients with acute ischemic stroke and large vessel occlusion who underwent thrombectomy at a comprehensive stroke center in southwestern Colombia (January 2017-January 2023). Two groups were defined: group H (hypotension before thrombectomy, defined as >30 mmHg systolic blood pressure drop between arrival and anesthesia induction) and no hypotension (NH) group. Primary outcomes included functional status (modified Rankin Scale score, 0-2 favorable; 3-6 unfavorable) and mortality (modified Rankin scale score = 6) at discharge and 90-day follow-up. Inverse probability weighting was used to reduce confounding.

RESULTS: A total of 167 patients (44.3% female), median age 66 (interquartile range, 53-76), underwent thrombectomy. Admission National Institutes of Health Stroke Scale score and Alberta Stroke Program Early Computed Tomography Score were similar (16.5 versus 16; Alberta Stroke Program Early Computed Tomography Score 9 in both). Thrombolysis was used in 45.4% (H: 23.3% versus NH: 22.1%). Door-to-needle time: 56 minutes versus 47 minutes; door-to-groin: 138 minutes versus 129.5 minutes. Procedure duration was longer in H (100 minutes versus 85 minutes). Successful reperfusion was not significantly different (modified Thrombolysis in Cerebral Infarction≥2b) 73.05% (H: 76.6%, NH: 70%, P = 0.29). Unfavorable modified Rankin scale score at discharge: H: 70.1%, NH: 68.9% (P = 0.86). Mortality at discharge: H: 32.5%, NH: 16.7% (P = 0.2); at 90 days: H: 37.7%, NH: 18.9% (P = 0.02) with inverse probability weighting analysis showing higher mortality in H both at discharge (odds ratio [OR] = 2.16, 95% CI: 0.93-5.04, P = 0.07) and 90 days (OR = 2.93, 95% CI: 1.25-6.86, P = 0.01) only the latter with statistical significance.

CONCLUSION: Hypotension before thrombectomy in large vessel occlusion stroke was associated with increased 90-day mortality. Worse functional outcomes were also observed, though not statistically significant. Early blood pressure control during anesthetic induction may improve prognosis.

PMID:41608719 | PMC:PMC12697584 | DOI:10.1161/SVIN.125.001789

Front Microbiol. 2026 Jan 13;16:1735665. doi: 10.3389/fmicb.2025.1735665. eCollection 2025.

ABSTRACT

INTRODUCTION: Understanding the dynamics of soil organic carbon (SOC) in sloping farmlands is critical, as they play a vital role in the global carbon cycle and soil health. Although prior research has focused on physical carbon loss due to erosion, the biological mechanisms by which slope gradients affect microbial carbon cycling remain poorly understood.

METHODS: Soil samples were collected from maize fields with three slope gradients (30°, 45°, and 60°) across different growth stages. Key indicators were determined as follows: SOC by potassium dichromate oxidation (external heating method); DOC by ultrapure water extraction (1:5 ratio) and organic carbon analyzer; POC by sodium hexametaphosphate dispersion, 53-μm sieving, and chromic acid oxidation; soil Ca²⁺, Mg²⁺, and Cl^– by EDTA complexometric titration and silver nitrate titration, respectively; invertase (SUC) by 3,5-dinitrosalicylic acid colorimetry; polyphenol oxidase (SPPO) and peroxidase (SPOD) by commercial kits with L-dopa as substrate. Statistical analyses were performed using IBM SPSS 26 (One-way ANOVA with LSD post-hoc test, Pearson correlation analysis) and Origin 2024 (Principal Component Analysis, PCA). Normality of data was verified prior to analysis, and significance was set at P < 0.05.

RESULTS: Results showed that SOC levels decreased with increasing slope steepness, while DOC peaked at 45°. SPPO and SPOD activities (involved in recalcitrant carbon decomposition) were significantly elevated at 60°. SUC activity was positively correlated with DOC, while oxidase activities were positively associated with POC and negatively with Mg²⁺.

DISCUSSION: This study identifies a critical slope threshold (30°-45°) for DOC loss: DOC availability on steeper slopes stimulates microbial synthesis of SPPO and SPOD, enhancing recalcitrant carbon degradation and potentially intensifying long-term SOC depletion. The identification of this threshold provides insights for designing microbiome-informed strategies to mitigate soil degradation and safeguard ecological security.

PMID:41608696 | PMC:PMC12835812 | DOI:10.3389/fmicb.2025.1735665

Mediterr J Rheumatol. 2026 Jan 8;37(Suppl 1):92-99. doi: 10.31138/mjr.030125.epr. eCollection 2026 Mar.

ABSTRACT

OBJECTIVES: The onset, progression and recurrence of psoriasis is believed to be related to mood and psychological disorders, such as depression. Psoriasis affects the personal, social and sexual life of patients resulting in psychological stress.

AIM: The purpose of the research is the psychometric evaluation of patients with psoriasis.

METHODS: Seventy one patients with psoriasis were enrolled in the study. The measurement of the severity of psoriasis in the patients was implemented through specific indicators, the Psoriasis Area and Severity Index (PASI). Beck’s Depression Inventory (BDI) was used to measure the intensity of depressive symptoms. In addition, the Eysenck Personality Questionnaire (EPQ), the self-completed scale Brief Symptom Inventory SCL – 90, and the HDHQ questionnaire (Psychometric Hostility and Direction of Hostility Questionnaire) were given. The validity and reliability of questionnaires rely on input from experts and potential responders who may suggest pertinent revisions to prepare forms with attractive designs, easily understandable questions, and correctly ordered points that appeal to target respondents.

RESULTS: Females with psoriasis have on average significantly higher scores in the BDI depression scale (13.5±10.0 vs. 7.9±8.3, p=0.009) compared to men, as well as in the SCL90 depression scale (13.64±10.18 vs. 7.00±5.45, p=0.003). The extroversion scale of the EPQ is statistically significantly related with the patients’ psychiatric history and stable income. Patients receiving medication for psoriasis are 2 times more likely to answer the lie questions positively than patients not receiving medication (OR=2.01, p=0.028).

CONCLUSION: Psoriasis exerts a direct influence on the social daily life of the individual, at a functional and behavioural level. It is essential to emphasise the importance of addressing the psychological effects of psoriasis along with its physical aspects for better outcomes.

PMID:41608670 | PMC:PMC12835929 | DOI:10.31138/mjr.030125.epr