Category: Statistics

J Gastroenterol Hepatol. 2026 Jan 23. doi: 10.1111/jgh.70249. Online ahead of print.

ABSTRACT

BACKGROUND AND AIM: The effectiveness of standard endoscopic treatment (SET) for non-variceal upper gastrointestinal bleeding (NVUGIB) may vary, particularly depending on the bleeding site, lesion size, and etiology. Recent studies suggest that hemostatic powder (HP) may effectively control bleeding secondary to malignant upper gastrointestinal lesions, but its efficacy in benign etiology for NVUGIB remains uncertain. This systematic review and meta-analysis aimed to compare the effectiveness of HP versus SET as first-line therapy for patients with non-malignant causes of NVUGIB.

METHODS: We systematically searched PubMed, Embase, and Cochrane Library databases for randomized controlled trials (RCTs) from inception to January 2025. We used risk ratios (RR) for binary outcomes and mean differences (MD) for continuous outcomes with their corresponding 95% confidence intervals (CIs).

RESULTS: We included 5 RCTs (708 patients). Compared to SET, HP was associated with marginally lower risk of further bleeding during esophagogastroduodenoscopy (EGD) (RR 1.04; 95% CI [1.001, 1.084]; p = 0.04) and similar rebleeding rate within 1, 3, 7, 15, and 30 days. The need for a second endoscopic treatment and the mean procedure time were similar between the groups. Subgroup analyses showed that HP has a lower risk of further bleeding during EGD only when analyzing Forrest IIa lesions, but not in active bleeding.

CONCLUSIONS: In patients with non-malignant NVUGIB, HP demonstrated lower risk of further bleeding during EGD in cases with non-bleeding visible vessels. There was no statistically significant difference in further bleeding during EGD for active bleeding, nor in rebleeding risk at 1, 3, 7, 15, or 30 days.

PMID:41575324 | DOI:10.1111/jgh.70249

J Int Med Res. 2026 Jan;54(1):3000605251411752. doi: 10.1177/03000605251411752. Epub 2026 Jan 23.

ABSTRACT

ObjectiveEsophageal cancer is among the most rapidly spreading malignancies worldwide. Early detection of esophageal cancer is critical for disease prevention and for improving overall population health. Most studies have used statistical methodologies to assess the esophageal cancer risk, and only a few studies have used prediction models.MethodsThe esophageal cancer dataset, comprising 3985 patient records with 85 demographic, pathological, and follow-up features, was obtained from Kaggle. A comprehensive data-engineering pipeline was implemented, including the removal of null and low-variance features, elimination of identifier variables to prevent data leakage, mode-based imputation, label encoding, and data standardization. Feature relevance was assessed using Mutual Information, and the top 31 clinically meaningful features were retained for model development. Six machine learning classifiers-Support Vector Machine, Gaussian Naïve Bayes, k-nearest neighbors, AdaBoost, Multilayer Perceptron, and LightGBM (Gradient Boosting Machine)-were trained and evaluated. A stratified 10-fold cross-validation was applied to maintain class balance, and GridSearchCV was used for hyperparameter optimization. Model interpretability was assessed using Shapley Additive Explanations (SHAP) for global and local feature attribution and Local Interpretable Model-Agnostic Explanations (LIME) for instance-level explanations. Furthermore, the top features identified by SHAP and LIME were used to retrain the LightGBM model to evaluate performance under reduced dimensionality.ResultsAmong all evaluated classifiers, LightGBM exhibited the highest and most stable performance, achieving an accuracy of 99.87% prior to hyperparameter tuning and 99.74% following stratified cross-validated tuning, with near-perfect precision, recall, F1-score, and area under the curve values. Explainability analyses indicated that clinically relevant variables, including tumor staging, smoking-related factors, and follow-up indicators, played a significant role in model predictions. The SHAP-selected top-20 feature model maintained high predictive performance (99.76%), demonstrating that the classifier remained robust despite dimensionality reduction.ConclusionsThe proposed LightGBM-based model demonstrates exceptional predictive accuracy and strong interpretability, suggesting its potential utility for the early detection of esophageal cancer using machine learning approaches.

PMID:41575322 | DOI:10.1177/03000605251411752

J Acoust Soc Am. 2026 Jan 1;159(1):685-701. doi: 10.1121/10.0042253.

ABSTRACT

Reliable acoustic path (RAP) channels support stable long-range propagation, but deep-sea communication over RAP is constrained by strong multipath. South China Sea measurements reveal stable arrival structures across multiple source depths, with distinct arrival branches and reverberation tails from scattering at interface inhomogeneities. A RAP-adaptive time-reversal equalizer suppresses multipath by reconstructing the channel impulse response via physics-guided statistical fitting, modeling it as a superposition of discrete multipaths and reverberation. Performance is evaluated using frequency-hopping spread spectrum M-ary frequency-shift keying and direct-sequence spread spectrum M-ary phase-shift keying and quantified with a network-level throughput analysis. Experiments demonstrate reduced inter-symbol interference and improved link reliability, indicating RAP-adaptive time-reversal equalizer as a practical physical-layer method for deep-sea acoustic networks.

PMID:41575259 | DOI:10.1121/10.0042253

Acta Anaesthesiol Scand. 2026 Mar;70(3):e70190. doi: 10.1111/aas.70190.

ABSTRACT

Ultrasound is increasingly used in anesthesia and intensive care medicine for procedural guidance and patient assessment. However, training and formal skills assessment vary, and there is limited knowledge about current ultrasound practices in the Nordic countries. This study aims to survey the availability, daily clinical use, and current state of ultrasound training and skills assessment among anesthesiologists across the Nordic countries. An online cross-sectional survey, designed according to the Consensus-Based Checklist for Reporting of Survey Studies (CROSS) guidelines was distributed as a convenience sample across anesthesiology departments in Denmark, Finland, Iceland, Norway, and Sweden, covering a range of hospital types, including regional and university hospitals. The survey consisted of three sections: demographics, ultrasound availability, and procedural use, including skills development and assessment. Key measures included the frequency of ultrasound use, types of procedures where ultrasound was employed, training methods, self-assessed proficiency, and the frequency of formal skills assessments. An overall response rate of 38% (n = 412) was obtained. Ultrasound was used daily or weekly by 96% of respondents, and procedures where ultrasound was most frequently used were vascular access (97%) and peripheral nerve blocks (83%). Practical training was primarily acquired through clinical use under supervision from colleagues, with limited use of simulation-based training. Few respondents (27% across procedures) reported formal skills assessments, and self-assessed proficiency varied, with intermediate and beginner levels being the most common. Retention of skills was rarely assessed, with an average of 8% across procedures. Ultrasound is used almost daily by most anesthesiologists in the Nordic region, with equipment readily available in the departments. Despite its frequent use, training and skills assessments vary with limited focus on ensuring skills retention. EDITORIAL COMMENT: This article presents the results of a survey on ultrasound availability, usage and training for anesthesiologists working in the Nordic countries. Keeping in mind responder bias, the availability and usage is high, but there is a low level of reported formal training and skills assessment. This highlights a need for structured training and competency assessment for ultrasound, that could be offered via nordic collaboration.

PMID:41575005 | DOI:10.1111/aas.70190

Surg Laparosc Endosc Percutan Tech. 2026 Jan 23. doi: 10.1097/SLE.0000000000001440. Online ahead of print.

ABSTRACT

BACKGROUND: A retrospective analysis was conducted on consecutive patients who underwent endoscopic retrograde cholangiopancreatography (ERCP). This study aimed to evaluate the efficacy and safety of different techniques in difficult biliary cannulation cases after unintentional pancreatic duct access.

METHODS: The patients were divided into 4 groups according to the cannulation method: the double guidewire (DGW) group, the transpancreatic sphincterotomy (TPS) group, the transpancreatic sphincterotomy combined with a pancreatic duct stent (TPS-PDS) group, and the precut over a pancreatic duct stent (PPDS) group. The baseline characteristics, biliary cannulation success rate, and postendoscopic retrograde cholangiopancreatography pancreatitis (PEP) incidence were compared and analyzed among these groups.

RESULTS: A total of 228 cases were enrolled, and there were no significant statistical differences among the groups in terms of the type of baseline characteristic. The final success rates for biliary cannulation ranged from 88.60% to 97.10%, and the incidence of PEP ranged from 0% to 27.50% among the 4 groups (P=0.147 and 0.005, respectively). The incidence of severe PEP was significantly higher in the TPS group compared with the other groups (P<0.001). Among the 156 cases that received pancreatic duct stent placement, the stents spontaneously migrated in 109 cases within 3 months. Furthermore, stents with trimmed wings had significantly higher migration rates when compared with stents without trimmed wings (88.50% vs. 22.70%, P<0.001).

CONCLUSIONS: For cases with difficult biliary cannulation after unintentional pancreatic duct access, TPS-PDS and PPDS are superior to DGW and TPS. Pancreatic duct stents with a trimmed front side wing would spontaneously migrate at a significantly higher rate.

PMID:41574963 | DOI:10.1097/SLE.0000000000001440

Acta Cardiol. 2026 Jan 23:1-14. doi: 10.1080/00015385.2026.2617492. Online ahead of print.

ABSTRACT

BACKGROUND: Ischaemic cerebrovascular events (CVEs) are a major complication of transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis.

PURPOSE: We aimed to determine the incidence and risk factors for CVE at 30 days and 1 year after TAVI in a large, real-world patient cohort and evaluate the association of these events with all-cause mortality at 1 year.

METHODS: All consecutive patients undergoing TAVI at a single centre between April 2008 and February 2024 were included in the analysis. CVE were defined as a composite of stroke and transient ischaemic attack.

RESULTS: One thousand and three patients (mean age 81.8 ± 7.0 years, 52.6% male, median EuroSCORE II 6% [Q1 = 3.51%; Q3 = 10.9%]) underwent TAVI with a self-expandable valve (SEV) (n = 275; 27.4%) or balloon-expandable valve (BEV) (n = 728; 72.6%). The cumulative incidence of CVE was 3.6% (95% confidence interval (95% CI) = [2.6%; 4.9%], n = 36) at 30 days (77.8% within 48 h) and 6.2% (95% CI = [4.8%; 7.8%], n = 62) at 1 year. Risk factors associated with a lower risk of CVE at 30 days included BEV vs. SEV (OR 0.32 [0.16-0.63], p = 0.0009) and larger baseline aortic valve area (AVA) (OR_{Unit = 0.1 cm2} 0.74 [0.61-0.91], p = 0.0035), while the risk was higher in the case of new-onset atrial fibrillation (AF) (OR 3.19 [1.18-8.59], p = 0.0218), diabetes (OR 2.00 [1.01-3.97], p = 0.0484), and conversion to sternotomy (OR 16.57 [4.62-59.48], p < 0.0001). Analysis at 1-year follow-up identified the same associations. Finally, the occurrence of CVE significantly increased 1-year all-cause mortality (OR 2.44 [1.32-4.50], p = 0.0045).

CONCLUSIONS: CVE after TAVI were associated with double the odds of 1-year all-cause mortality. Risk factors associated with CVE include the use of a SEV, new-onset AF, diabetes, conversion to sternotomy, and a smaller AVA.

PMID:41574953 | DOI:10.1080/00015385.2026.2617492

Stat Methods Med Res. 2026 Jan 23:9622802251412844. doi: 10.1177/09622802251412844. Online ahead of print.

ABSTRACT

Increasing epidemiologic evidence suggests that the diversity and composition of the gut microbiome can predict infection risk in cancer patients. Infections remain a major cause of morbidity and mortality during chemotherapy. Analyzing microbiome data to identify associations with infection pathogenesis for proactive treatment has become a critical research focus. However, the high-dimensional nature of the data necessitates the use of dimension-reduction methods to facilitate inference and interpretation. Traditional dimension reduction methods, which assume Gaussianity, perform poorly with skewed and zero-inflated microbiome data. To address these challenges, we propose a semiparametric principal component analysis method based on a truncated latent Gaussian copula model that accommodates both skewness and zero inflation. Simulation studies demonstrate that the proposed method outperforms existing approaches by providing more accurate estimates of scores and loadings across various copula transformation settings. We apply our method, along with competing approaches, to gut microbiome data from pediatric patients with acute lymphoblastic leukemia. The principal scores derived from the proposed method reveal the strongest associations between pre-chemotherapy microbiome composition and adverse events during subsequent chemotherapy, offering valuable insights for improving patient outcomes.

PMID:41574888 | DOI:10.1177/09622802251412844

Rev Esp Salud Publica. 2026 Jan 23;100:e202601003.

ABSTRACT

OBJECTIVE: The study analyzed how job precariousness affects the mental health of workers and the role of age in this relationship. Despite extensive research on job precariousness and mental health, few studies have addressed the multidimensionality of job precariousness or its differential impact by age.

METHODS: The research was carried out in the Valencian Community with a hundred participants. An online questionnaire with the EPRES scale was used to measure job precariousness and the GHQ-12 to assess mental health. Correlation and linear regression analyses were performed.

RESULTS: Significant statistical correlations were found between mental health and various dimensions of job precariousness: wages (r=0.444), vulnerability (r=0.530), rights (r=0.307) and capacity to exercise rights (r=0.340). Global precariousness correlated with mental health problems (r=0.429). Age showed a negative correlation with global precariousness (r=-0.389) but not with mental health. Only wages (f=4.810) and vulnerability (f=20.425) showed explanatory ability. The interaction between wages and age was significant (f=3.997). The impact of wage precariousness on mental health was greater in the young and almost nonexistent in the elderly.

CONCLUSIONS: Job precariousness negatively affects the mental health of workers. Specific dimensions such as wages and vulnerability have a significant impact. Wage precariousness affects young people more, suggesting that age moderates this impact, with mental health of young people being more vulnerable to wage precariousness.

PMID:41574850

Rev Esp Salud Publica. 2026 Jan 21;100:e202601002.

ABSTRACT

OBJECTIVE: Tobacco and alcohol are risk factors for preventable chronic diseases. Analyzing their environmental presence enables the development of measures that promote healthy environments. The aim of this paper was to describe and analyze differences in the density of alcohol and tobacco retail outlets (number of outlets/km²) by locality, census tract, and income level in the municipality of Siero (Asturias).

METHODS: A cross-sectional descriptive study was conducted between October 2023 and June 2024. The units of analysis were all streets within sixteen census tracts of Lugones (n=5), La Fresneda (n=3), and Pola de Siero (n=8), located in one of the municipalities with the highest prevalence of chronic diseases in Asturias. Data collection on tobacco and alcohol retail outlets was carried out through direct observation. Statistical data analysis was performed, including descriptive analyses (median and IQR), ANOVA to compare densities, and Spearman correlation, using IBM SPSS v27, with spatial analyses conducted in QGIS v3.34.

RESULTS: No significant statistical differences were observed in the densities of alcohol and tobacco outlets between census tracts within each town. However, differences were found between the three localities, with higher densities in Lugones (tobacco p=0.008; alcohol p=0.01). A strong correlation was found between the density of tobacco and alcohol outlets (r=0.997; p<0.001), but no significant correlation was found between outlet density and income for tobacco (p=0.082) or alcohol (p=0.076).

CONCLUSIONS: In small towns such as those included in this study, when developing public health policies on tobacco and alcohol, it may be more appropriate to consider the locality as a whole rather than individual census tracts, unlike recommendations for larger populations.

PMID:41574839

J Chem Phys. 2026 Jan 28;164(4):044903. doi: 10.1063/5.0303764.

ABSTRACT

We formulate gauge invariance for the equilibrium statistical mechanics of classical multi-component systems. Species-resolved phase space shifting constitutes a gauge transformation, which we analyze using Noether’s theorem and shifting differential operators that encapsulate the gauge invariance. The approach yields exact equilibrium sum rules for general mixtures. Species-resolved gauge correlation functions for the force-force and force-gradient pair correlation structure emerge on the two-body level. Exact 3g-sum rules relate these correlation functions to the spatial Hessian of the partial pair distribution functions. General observables are associated with hyperforce densities that measure the covariance of the given observable with the interparticle, external, and diffusive partial force density observables. Exact hyperforce and Lie algebra sum rules interrelate these correlation functions with each other. The practical accessibility of the framework is demonstrated for binary Lennard-Jones mixtures using both adaptive Brownian dynamics and grand canonical Monte Carlo simulations. In particular, we investigate the force-force pair correlation structure of the Kob-Andersen bulk liquid and we show results for representative hyperforce correlation functions in the symmetrical mixture of Wilding et al. confined between two asymmetric planar parallel walls.

PMID:41574804 | DOI:10.1063/5.0303764