Category: Statistics

Diabetes Ther. 2026 Feb 16. doi: 10.1007/s13300-026-01843-x. Online ahead of print.

ABSTRACT

INTRODUCTION: GLP-1 receptor agonists (GLP-1 RAs) are hypothesized to reduce peripheral arterial disease (PAD) complications through mechanisms, including enhanced cardiac function, improved cardiovascular risk factors and inflammation, and local vascular effects such as angiogenesis. We assessed the effectiveness of GLP-1 RAs in lowering the risk of major adverse limb events (MALE) among individuals with diabetes and diagnosed PAD.

METHODS: This was a meta-analysis of a structured search of MEDLINE, PubMed, and SCOPUS databases until 16 June 2025. Eligibility criteria were randomized controlled trials of GLP-1 RAs reporting major adverse limb events from PAD. We identified five articles published up to June 2025 that met the inclusion and exclusion criteria. Study selection, data extraction, and quality assessment were carried out by two reviewers working independently and in duplicate, to assess eligibility and risk of bias, and extract data from eligible studies. Random-effects models were used to pool estimates across the included studies. Meta-analyses were performed using Cochrane-RevMan.

RESULTS: Five studies were included in the meta-analysis, comprising 25,067 patients in total. There were 433 revascularization events. Compared with the control group, the overall log odds ratio for revascularization with GLP-1 RA treatment was 0.87 (95% confidence interval [CI]: 0.73, 1.05; p = 0.13). Two of the studies reported amputation rates (comprising 224 events), with an overall log odds ratio of 0.82 (95% CI: 0.53, 1.27; p = 0.37) for GLP-1 RA treatment.

CONCLUSIONS: In this meta-analysis of randomized trials, GLP-1 RAs were not associated with statistically significant differences in revascularization or amputation outcomes in individuals with diabetes and PAD.

PMID:41697522 | DOI:10.1007/s13300-026-01843-x

Insights Imaging. 2026 Feb 16;17(1):44. doi: 10.1186/s13244-025-02198-w.

ABSTRACT

OBJECTIVES: To evaluate the publication outcomes of oral presentations delivered at the European Congress of Radiology (ECR) 2019 and examine factors influencing conversion to full-text articles; findings were also compared with ECR 2010.

MATERIALS AND METHODS: A total of 1817 oral presentations from ECR 2019 were analyzed. Publication status was determined by searching PubMed/MEDLINE up to December 2023. For each matched article, Journal Impact Factor (JIF) and Google Scholar citations/year were recorded. Additional variables included country of origin, collaboration type, imaging modality, and study design. Statistical analyses used chi-square and Kruskal-Wallis, with p < 0.05 considered significant.

RESULTS: Of 1817 oral presentations, 844 (46.5%) were published, with no significant difference from ECR 2010 (43%, p = 0.091). Abstracts originated from 71 countries, with Italy (16.5%) and China (15.5%) contributing the most. Publications appeared in 254 journals. Publication rates varied significantly by country (p < 0.001), with Switzerland (74.4%) and the Netherlands (68.8%) achieving the highest rates. When analyzed by continent, abstracts from Asia showed a significantly higher publication rate than those from Europe (52.3% vs. 43.6%, p = 0.001). Publication outcomes also varied significantly by imaging modality (p = 0.002) and subspecialty (p < 0.001). Breast imaging achieved the highest median JIF (4.9), whereas Artificial Intelligence/Machine Learning (AI/ML) demonstrated the highest median annual citation count (10.5).

CONCLUSIONS: Nearly half of the ECR 2019 oral presentations achieved peer-reviewed publication, maintaining rates from 2010. The congress’s contributor landscape has become more global, with greater participation from Asia. While traditional radiological fields remain prevalent, AI/ML abstracts demonstrated high citation rates. These findings reflect contemporary trends in radiological research.

CRITICAL RELEVANCE STATEMENT: By analyzing the publication outcomes of ECR 2019, with comparisons to 2010 data, this study examines evolving global patterns in publication outcomes, offering insights to enhance the dissemination of radiological research.

KEY POINTS: Converting oral presentations to publications remains challenging in radiological research. Nearly half of the ECR 2019 oral presentations were published, showing a modest, non-significant increase from ECR 2010. The congress has become increasingly global, with notable growth in participation from Asia. This study reveals radiology’s evolving scientific landscape and current research priorities.

PMID:41697518 | DOI:10.1186/s13244-025-02198-w

Adv Ther. 2026 Feb 16. doi: 10.1007/s12325-025-03481-4. Online ahead of print.

ABSTRACT

INTRODUCTION: Acid sphingomyelinase deficiency (ASMD) is a rare lysosomal storage disorder with heterogenous clinical manifestations, including interstitial lung disease (ILD). Respiratory manifestations are the leading causes of mortality in patients with ASMD type B and type A/B. In ILD, the percent predicted diffusing capacity of the lungs for carbon monoxide (DL_CO) is a common clinical endpoint; however, its clinical relevance in patients with ASMD remains unclear.

METHODS: This post hoc analysis explored the relationship between DL_CO and mortality risk in patients with ASMD type B and type A/B. Data from a prospective natural history study (NCT02004704) and a retrospective cohort study conducted in the United States were pooled based on the eligibility criteria. Percent predicted DL_CO was imputed for 10 records (9/68 patients), assuming an annual 1% linear decrease in DL_CO. A Cox proportional hazards model was fitted using percent predicted DL_CO as a time-varying predictor at < 60% and ≥ 60%.

RESULTS: A total of 68 patients (prospective study, n = 40; retrospective study, n = 28) diagnosed with ASMD type B or type A/B during childhood (aged 1-12 years) with ≥ 1 DL_CO measurement were included in the analysis. A total of 12 deaths were recorded. The estimated hazard ratio (95% confidence interval) was 0.77 (0.22-2.67), indicating a potential trend toward an association of lower mortality risk with higher percent predicted DL_CO (≥ 60%). However, the result was not statistically significant (p = 0.69) because of the limited sample size, thus warranting further prospective validation.

CONCLUSIONS: To our knowledge, this is the first analysis to explore the relationship between DL_CO and mortality risk in patients with ASMD type B and type A/B. Overall, these findings underscore how DL_CO affects the mortality risk in patients with ASMD.

PMID:41697516 | DOI:10.1007/s12325-025-03481-4

Dig Dis Sci. 2026 Feb 16. doi: 10.1007/s10620-026-09766-0. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the impact of perianal Crohn’s disease (PCD) activity on quality of life (QoL), fecal continence, and sexual function in patients with Crohn’s disease (CD), and to identify factors associated with impaired patient-reported outcomes.

METHODS: A cross-sectional analytical study was conducted, from an existing database of patients with CD at Shaare Zedek Medical Center who diagnosed with and without perianal disease and were seen in IBD clinic between June 2023 and August 2024. The patients agreed to participate and answered validated questionnaires that assessed QoL (SIBDQ), fecal incontinence (WEXNER), and sexual function (IIEF for men, FSFI for women).

RESULTS: A total of 150 patients with CD were recruited, including 47 with PCD (active and non-active) and 103 without PCD. Patients with active PCD had significantly lower QoL compared to those with non-active PCD and without PCD (p = 0.001). Two major risk factors for decreased QoL were identified: age over 40 (p = 0.024) and only conservative treatment (without chronic medication) (p = 0.031). Although no significant difference was found in fecal incontinence between groups, 64.2% of patients with CD reported some degree of incontinence. Sexual function scores were lower in patients with CD, particularly women, though the difference was not statistically significant.

CONCLUSION: Active PCD significantly reduces QoL in patients with CD, with older age and absence of chronic treatment contributing to poorer outcomes. These findings highlight the need for optimized treatment strategies to improve patient well-being. Further research should explore additional clinical and psychological aspects affecting patients with CD with perianal involvement.

KEY MESSAGES: What is already known? Perianal Crohn’s disease is a severe phenotype linked to high morbidity and healthcare use. Its impact on quality of life is known, but the roles of disease activity, incontinence, and sexual function remain unclear. What is new here? Active perianal disease significantly worsens quality of life, unlike inactive disease. Older age and lack of maintenance therapy further reduce patient-reported outcomes. How can this study help patient care? Distinguishing active from inactive disease is crucial. Early detection, ongoing therapy, and structured assessment of continence and sexual health can improve quality of life.

PMID:41697513 | DOI:10.1007/s10620-026-09766-0

Ann Surg Oncol. 2026 Feb 16. doi: 10.1245/s10434-026-19224-w. Online ahead of print.

ABSTRACT

BACKGROUND: Ureteroileal anastomotic strictures (UASs) occurring after radical cystectomy (RC) with ileal conduit (IC) diversion that are not amenable to endoscopic management often necessitate surgical repair. This study aimed to describe the authors’ stepwise approach to robotic surgical repair of UAS and to assess the feasibility, safety, and long-term efficacy of robotic reimplantation for UAS after RC.

METHODS: A retrospective cohort study analyzed 103 patients who underwent radical cystectomy and subsequently experienced UAS between January 2015 and September 2022, all of whom received a robot-assisted laparoscopic ureteroileal bypass repair technique. The primary endpoints were the collection of perioperative variables and the evaluation of postoperative outcomes such as complications, functional outcomes, and the need for further interventions. Data were analyzed using descriptive statistics to summarize patient characteristics and outcomes.

RESULTS: The study identified 103 patients and 112 renal units, of which 31 had right-sided, 61 had left-sided, and 9 had bilateral strictures. The mean time from cystectomy to stricture diagnosis was 11.5 ± 3.5 months, and the average time from diagnosis to robotic revision was 10.4 ± 2.4 months. Malignancy was excluded in all strictures. The mean stricture length was 2.2 ± 1.2 cm. The mean operative time was 130.4 ± 28.6 min, with a mean estimated blood loss of 67.5 ± 15.3 ml and a mean hospital stay of 5.0 ± 1.5 days. The 30-day complication rates was 15.6 %, and the 30- to 90-day complication rate was 0, with all complications classified as Clavien grade 1 or 2. During a median follow-up period of 24.3 months, the stricture recurrence rate was 5.8 % and the median time to stricture recurrence was 245 days (interquartile range [IQR], 136-584 days).

CONCLUSIONS: Robotic reimplantation with a bypass technique after radical cystectomy is a safe and feasible approach for treating ureteroileal stricture. This method demonstrated promising outcomes and warrants further validation through larger prospective studies.

PMID:41697474 | DOI:10.1245/s10434-026-19224-w

Ann Surg Oncol. 2026 Feb 16. doi: 10.1245/s10434-026-19181-4. Online ahead of print.

ABSTRACT

BACKGROUND: The prognostic significance of perineural invasion (PNI) and lymphovascular invasion (LVI) in early-stage oral squamous cell carcinoma (OSCC) remains uncertain. The role of postoperative radiotherapy (PORT) in this subgroup is debated. This study aimed to clarify the clinical impact of PNI/LVI and determine the effect of PORT across risk-stratified subsets of early-stage OSCC.

METHODS: We retrospectively analyzed 6,121 patients with pT1-2N0M0 OSCC from the Taiwan Cancer Registry (2018-2022). Patients were categorized into Group A (PNI-/LVI-) and Group B (PNI+ and/or LVI+). Clinicopathological characteristics, survival outcomes, and the effect of PORT were assessed using multivariable analysis and propensity score matching (PSM).

RESULTS: The PNI/LVI positivity occurred in 13.5% of patients and was independently associated with poorer differentiation, greater depth of invasion (> 5 mm), T2 classification, tongue subsite, lower BMI, and female sex. Group B patients exhibited significantly lower overall survival (HR 1.45, p = 0.001) and disease-free survival (HR 1.44, p < 0.001), with inferior locoregional control versus Group A. PORT significantly improved locoregional control in Group B (p = 0.005), but no overall or disease-free survival benefit was observed, likely due to effective salvage surgery. In contrast, in Group A, PORT offered no benefit and was associated with worse outcomes.

CONCLUSIONS: Perineural invasion and/or LVI represent key adverse prognosticators in early-stage OSCC. Postoperative radiotherapy selectively enhances locoregional control in intermediate-risk patients, but survival outcomes remain unaffected. A risk-adapted therapeutic approach is warranted, tailoring PORT to patients with adverse features and avoiding overtreatment in low-risk cases.

PMID:41697470 | DOI:10.1245/s10434-026-19181-4

Insights Imaging. 2026 Feb 16;17(1):48. doi: 10.1186/s13244-026-02206-7.

ABSTRACT

INTRODUCTION: Intra-pancreatic fat deposition (IPFD) is associated with pancreatic diseases, but its systemic implications remain unclear.

MATERIALS AND METHODS: We analyzed 25,547 UK Biobank participants (median follow-up 6.27 years) with MRI-derived pancreatic proton density fat fraction. Multi-variable Cox models, causal mediation, restricted cubic splines, and subgroup analyses assessed IPFD-disease associations. Significant associations were examined through bidirectional Mendelian randomization (MR) using the UK Biobank and FinnGen data. Receiver operating characteristic curves and the Youden index were used to identify a clinically relevant and statistically optimal IPFD threshold.

RESULTS: Higher IPFD independently increased the risk of 12 multi-systemic diseases: non-insulin-dependent diabetes, primary hypertension, heart failure, cerebral infarction, cholelithiasis, gastritis and duodenitis, diaphragmatic hernia, chronic renal failure, gonarthrosis, disorders of refraction and accommodation, senile cataract, and sleep disorders. Causal mediation by non-insulin-dependent diabetes was negligible. Nonlinear dose-response patterns and effect modifications by sex, race, smoking, and obesity emerged. MR analysis supported the potential causal effects of IPFD on refractive/accommodation disorders and gonarthrosis. An IPFD cutoff of 7.35% (95% CI: 5.68-9.23%) optimally stratified the risk.

CONCLUSION: IPFD is an independent risk factor for diverse conditions, including metabolic, cardiovascular, digestive, musculoskeletal, ophthalmologic, urinary, and mental/behavioral disorders. A pancreatic fat threshold of 7.35% may guide clinical screening and preventive strategies.

CRITICAL RELEVANCE STATEMENT: This study critically establishes intra-pancreatic fat as a novel, causal multi-system disease risk factor and provides a 7.35% quantitative threshold to advance radiological screening and prevention protocols.

KEY POINTS: Limited research exists on the systemic effects of IPFD. Pancreatic fat deposition independently raises risk for 12 multi-system diseases. A 7.35% pancreatic fat threshold can guide clinical screening and prevention.

PMID:41697450 | DOI:10.1186/s13244-026-02206-7

Eur J Pediatr. 2026 Feb 16;185(3):132. doi: 10.1007/s00431-026-06789-7.

ABSTRACT

Following the SARS-CoV-2 pandemic, a significant percentage of people are now experiencing long-term symptoms, despite a continuing lack of concrete documentation of physiological and risk profiles that hinders diagnosis and treatment, particularly in pediatric contexts. This review aims to highlight the existing evidence for measurable physiological markers for post-acute sequelae of SARS-CoV-2 infection (long COVID) in children, adolescents, and young adults. Titles providing data related to measurable biomarkers distinguishing young long COVID patients from controls were compiled and analyzed. Results were displayed in table and diagram form for optimal qualitative evaluation of the relationship between markers and symptomatology within the context of each organ system. Only human studies published in English, Italian, Portuguese, German, and Spanish between the 5th of February 2025 and the 31st of December 2025 were considered, and no other time constraints were applied. Following search and criteria evaluation, nine studies were included, totaling 41 occurrences identified in diseased patients with statistically significant variation from healthy controls. Markers suggest the presence of organic manifestations based on published literature, although more data and future studies will be necessary to establish clear connections.

CONCLUSION: The data compiled for this review adds to the body of evidence indicating a physiological manifestation of long COVID and its consequences. Further investigation into potential risk factors, pre- and post-pubescent manifestations, and specific inflammatory and immune pathways will be necessary for a more concrete understanding of long COVID and its effects on children, adolescents, and young adults.

WHAT IS KNOWN: • Long COVID is estimated to affect a significant population of patients, despite the lack of concrete physiological diagnostic and prognostic measures. • Pediatric incidence of the disease is still largely debated, and published data are scarce.

WHAT IS NEW: • A total of 41 biomarker occurrences were identified by selected studies, which were consistent with expected physiology behind reported symptoms. • The body of data discussed suggests the presence of physiological phenomena behind the long-term symptoms experienced by pediatric long- COVID patients.

PMID:41697443 | DOI:10.1007/s00431-026-06789-7

Int Ophthalmol. 2026 Feb 16;46(1):117. doi: 10.1007/s10792-026-03981-4.

ABSTRACT

PURPOSE: Dry eye disease (DED) is a common ocular condition that, if left untreated, can lead to visual impairment. The present study was conducted to investigate the prevalence of DED among ophthalmologists, optometrists, and nurses.

METHODS: This cross-sectional study included ophthalmologists, optometrists, and nurses who attended the Emirates Society of Ophthalmology (ESO) conference in 2024 in the United Arab Emirates. Eligible participants were asked to complete the Dry Eye Questionnaire (DEQ-5), based on which the presence and severity of DED were assessed.

RESULTS: The study included 203 participants (53.2% males), with the majority being ophthalmologists (47.8%), followed by nurses (17.2%), optometrists (13.8%), and others (21.2%). The overall prevalence of DED was 82.8%. DED prevalence was significantly higher among females than males (88.4% vs 77.8%, p = 0.046), and female optometrists had a 4.36-fold higher risk of DED than male optometrists (p = 0.013). Regarding DED severity, 27.6% of the participants had mild DED, 35.5% had moderate DED, and 19.7% had severe DED. Females who worked as ophthalmologists (RR = 1.72, p = 0.045) and those engaged in other professions (RR = 3.31, p = 0.002) had a significantly higher risk of severe DED.

CONCLUSION: This study highlights alarmingly high rates of DED among ocular care professionals. Female optometrists had a significantly higher risk of DED than male optometrists.

PMID:41697442 | DOI:10.1007/s10792-026-03981-4

Environ Monit Assess. 2026 Feb 16;198(3):225. doi: 10.1007/s10661-026-15073-y.

ABSTRACT

The irrigation of crops with wastewater can lead to the accumulation of heavy metals (HMs), posing environmental and health risks. This study analyzed HMs in industrial wastewater, soils, and food crops around Hattar Industrial Estate (HIE), Pakistan. Wastewater and soil samples were assessed for physicochemical properties, and all samples were digested and analyzed for HMs using inductively coupled plasma optical emission spectroscopy (ICP-OES). HMs levels varied consistently across water, soils, and crops at six sites, with accumulation in crops following the order: Ca > Cu > Mn > Zn > Cr > Ni > As > Al > Cd > Co > Pb > Se. Leafy crops showed higher bioaccumulation than fruit and root/tuber crops, with Zn exhibiting the highest Bioaccumulation Factor (BF). Pearson’s correlation and principal component analyses revealed positive correlations among metals and identified potential sources of crop contamination. In vitro gastrointestinal assays indicated HMs bioaccessibility ranging from 0-94%. While most HMs posed no noncarcinogenic risk, Ni and Cr present significant carcinogenic risks. Regular monitoring and preventative measures are recommended to ensure food safety, human health, and environmental protection.

PMID:41697411 | DOI:10.1007/s10661-026-15073-y