Category: Statistics

JACC Clin Electrophysiol. 2026 Feb 24:S2405-500X(26)00126-X. doi: 10.1016/j.jacep.2026.01.051. Online ahead of print.

ABSTRACT

BACKGROUND: Accurate selection of patients who will benefit from a primary-prevention implantable cardioverter-defibrillator (ICD) remains a challenge. Cardiac magnetic resonance imaging (CMR) of myocardial tissue heterogeneity and EntropyX_QT, a nonlinear electrocardiographic (ECG) measure of cardiac repolarization dynamics, predict ventricular tachyarrhythmias (VTs) and sudden cardiac arrest.

OBJECTIVES: Because CMR and EntropyX_QT are fundamentally distinct structural and electrical measures, we hypothesized that they add major independent prognostic value to conventional clinical predictors of sudden cardiac arrest.

METHODS: In 230 consecutive patients with a left ventricular ejection fraction ≤35% in sinus rhythm, baseline exposures before primary prevention ICD implantation included demographics, history, medications, laboratory results, conventional ECG indices of heart rate and QT variability, CMR myocardial tissue characterization, and EntropyX_QT. The primary endpoint was ICD shock for VT, and secondary endpoints included all-cause events, including mortality.

RESULTS: Over 6.1 ± 3.3 years of follow-up, 62 patients (27%) received appropriate ICD shocks. In multivariable analyses, EntropyX_QT and CMR gray zone mass yielded adjusted hazard ratios (per SD change) of 1.8 (95% CI: 1.4-2.3) and 1.5 (95% CI: 1.2-1.8), respectively, and improved Harrell’s C-statistic from 0.59 to 0.73 in a model composed of conventional clinical predictors, left ventricular end-systolic volume (LVESV) and prescribed diuretics. EntropyX_QT was the strongest predictor in years 1-3, whereas CMR and LVESV were stronger in years >3. Moreover, EntropyX_QT independently predicted the secondary endpoints.

CONCLUSIONS: EntropyX_QT and CMR gray zone mass complement each other and conventional risk factors, improving risk stratification for appropriate ICD shock and mortality, and together may enhance the selection of primary prevention ICD recipients. (Prospective Observational Study of the ICD in Sudden Cardiac Death Prevention (PROSe-ICD; NCT00733590).

PMID:41823943 | DOI:10.1016/j.jacep.2026.01.051

J Nutr Educ Behav. 2026 Mar 12:S1499-4046(26)00035-7. doi: 10.1016/j.jneb.2026.01.020. Online ahead of print.

ABSTRACT

OBJECTIVE: Valid, reliable, and comprehensive instruments enable early care and education (ECE) sites to self-assess nutrition and physical activity practices and policies, but availability is limited. Therefore, we developed and assessed the test-retest reliability and convergent validity of the Site-Level Assessment Questionnaire (SLAQ).

DESIGN: Reliability testing compared questionnaires completed by ECE personnel at 2 time points (reliability pairs). Convergent validity testing compared questionnaires completed by ECE personnel with questionnaires completed by researchers (validity pairs). Semistructured interviews with personnel who completed the SLAQ informed revisions.

SETTING: California Supplemental Nutrition Assistance Program Education-eligible ECE sites.

PARTICIPANTS: Convenience sample of 32 ECE sites (18 school districts; 14 Head Starts).

VARIABLES MEASURED: Seventy-six items assessing wellness policies, federal food program participation, meals, snacks, beverages, food environment, feeding practices, nutrition education, gardens, physical activity, screen time, family involvement, and breastfeeding support.

ANALYSIS: Weighted κ test statistics and percent agreement were calculated for each item to assess agreement between reliability pairs and validity pairs.

RESULTS: Eighty-eight percent of items showed moderate or higher reliability; 52% had moderate or higher validity. On the basis of these results and interview findings, the SLAQ was revised to address issues identified.

CONCLUSIONS AND IMPLICATIONS: Findings suggest acceptable validity and reliability of the SLAQ for assessing policies and practices at SNAP-Ed-eligible ECE sites in California. Further testing with larger, randomly selected, and geographically and socioeconomically diverse populations could broaden its application. As is, the comprehensive assessment data the SLAQ provides can be used to identify opportunities for improving ECE practices and policies that support children’s health.

PMID:41823935 | DOI:10.1016/j.jneb.2026.01.020

J Adolesc Health. 2026 Mar 13:S1054-139X(26)00004-2. doi: 10.1016/j.jadohealth.2026.01.002. Online ahead of print.

ABSTRACT

PURPOSE: Suicide continues to be a leading cause of death among young adults aged 18-25. Young adults are increasingly turning to crisis text services (CTSs) for support with suicidal ideation (SI). This study identified characteristics associated with young adults’ CTS use and outlined suggested improvements from users (“texters”).

METHODS: Young adults with a history of SI (n = 118) were recruited online and completed a cross-sectional survey. The quantitative data were analyzed using descriptive statistics and chi-square tests, and the qualitative data were analyzed using content analysis.

RESULTS: CTS use was associated with female sex, minoritized sexual orientation, having a mental health provider, and prior hospitalization for SI or a suicide attempt. Texters were more likely than nontexters to use other support sources. The most common barriers to CTS use were thinking it would not help (46%), embarrassment (41%), and wanting to solve the problem independently (35%). Texters recommended enhancing CTS by fostering warmer, more validating, and personalized interactions; improving availability and response times; and counselor training to tailor support to individual needs.

DISCUSSION: While young adults often use CTSs alongside other supports for SI, this study identifies opportunities to strengthen their usefulness and impact. Enhancing accessibility, personalization, and cultural responsiveness may help CTS better meet the needs of diverse young adults.

PMID:41823922 | DOI:10.1016/j.jadohealth.2026.01.002

J Hand Surg Am. 2026 Mar 13:S0363-5023(26)00131-0. doi: 10.1016/j.jhsa.2026.01.025. Online ahead of print.

ABSTRACT

PURPOSE: To assess scapholunate bridge augmentation with all-suture, knotless anchors in cadaveric wrists through evaluation of radiographic parameters, by comparing the bridged wrist to the wrist with an intact scapholunate interosseous ligament (SLIL) and sectioned SLIL.

METHODS: Nine cadaveric specimens were tested in 6 positions: wrist flexion, extension, ulnar deviation (UD), radial deviation (RD), clenched fist, and neutral. Radiographic parameters including scapholunate interval (SLI), scapholunate angle (SLA), and dorsal scaphoid translation (DST) were measured for each position. The SLIL was then sectioned, and parameters were measured in all 6 positions. The SLIL was repaired using one knotless anchor in the scaphoid and one in the lunate, with the repair suture from each anchor shuttled into the opposing anchor and tensioned to bridge the interval. Parameters were again measured in the 6 positions. Scapholunate interval was evaluated using repeated measures analysis of variance at α = 0.05; descriptive statistics were performed for SLA and DST.

RESULTS: Scapholunate interval was different between testing states in flexion (P < .001), UD (P < .001), RD (P = .01), clenched fist (P < .001), and neutral (P = .02). Post hoc testing revealed SLI was wider in the sectioned state than the intact state and bridged states in flexion, UD, and clenched fist. Scapholunate interval in these 3 states was similar between intact and bridged states. In neutral, SLI was narrower in the bridged state compared with intact and sectioned states. In RD, SLI was narrower in the bridged state compared with the sectioned state. Abnormal SLA (>60°) was only seen in flexion, across all 3 states. Mean DST increased after sectioning, then decreased after bridging, in extension, UD, RD, clenched fist, and neutral, although statistical conclusions cannot be drawn.

CONCLUSIONS: Scapholunate bridge augmentation restored radiographic parameters of carpal alignment.

CLINICAL RELEVANCE: With further cadaveric testing followed by clinical study, this technique may prove to be a useful treatment for SLIL injury.

PMID:41823917 | DOI:10.1016/j.jhsa.2026.01.025

Biology (Basel). 2026 Mar 7;15(5):439. doi: 10.3390/biology15050439.

ABSTRACT

Climate change, together with intensifying human activities, is reshaping global plant invasion dynamics and increasingly threatening ecosystem stability and biodiversity. Cockleburs are highly invasive weeds with strong ecological plasticity and dispersal capacity, causing widespread impacts on agricultural systems and native ecosystems. Here, we used the maximum entropy (MaxEnt) model to assess the current (2001-2020) and future (2021-2040, 2041-2060, and 2061-2080) potential distributions, key driving factors, and centroid shifts of four invasive cocklebur species-Cyclachaena xanthiifolia (=Iva xanthiifolia), Xanthium chinense, Xanthium italicum, and Xanthium spinosum-at the global scale under current climate conditions and three Shared Socioeconomic Pathway scenarios (SSP126, SSP245, and SSP585). Species occurrence records were integrated with climatic, topographic, and anthropogenic variables to project habitat suitability. Model performance was robust, with mean training and testing area under the receiver operating characteristic curve (AUC) values > 0.8 for all species and mean true skill statistic (TSS) values > 0.8 for three species (0.660 for Xanthium spinosum). Suitable habitats were jointly shaped by climatic and anthropogenic factors, although the dominant drivers differed among species. Cyclachaena xanthiifolia and Xanthium spinosum were primarily constrained by temperature and precipitation, whereas Xanthium italicum and Xanthium chinense were more strongly associated with human activity. At present, suitable habitat areas for Cyclachaena xanthiifolia, Xanthium chinense, Xanthium italicum, and Xanthium spinosum were 1196.92 × 10⁴, 358.76 × 10⁴, 888.34 × 10⁴, and 1985.14 × 10⁴ km², respectively. Future projections indicated overall contractions in suitable habitat, with pronounced interspecific variation. Xanthium chinense showed the largest mean decline (-161.23 × 10⁴ km² relative to the present), whereas Cyclachaena xanthiifolia experienced the smallest reduction (-53.15 × 10⁴ km² on average). Centroid analyses further suggested overall shifts toward higher latitudes and elevations under warming scenarios. Despite uncertainties related to climate scenario variability and assumptions inherent in species distribution modelling, these findings provide quantitative evidence to support global invasion risk assessment and climate-adaptive management of invasive cockleburs.

PMID:41823866 | DOI:10.3390/biology15050439

Biology (Basel). 2026 Feb 28;15(5):407. doi: 10.3390/biology15050407.

ABSTRACT

Autoimmune diseases arise from complex interactions between genetic susceptibility, immune regulation, and tissue-specific inflammatory processes, yet most risk variants identified by genome-wide association studies occur in non-coding regions with poorly defined biological functions. This review addresses the challenge of interpreting non-coding regulatory variants in autoimmunity by synthesizing emerging analytical frameworks that integrate functional genomics, single-cell profiling, spatial transcriptomics, and multi-omics data. We describe stepwise strategies that refine statistical associations through regulatory annotation, immune cell-state resolution, and perturbational evidence, highlighting complementary approaches such as massively parallel reporter assays, transcriptome-wide association studies, and single-cell expression quantitative trait locus mapping. These methods demonstrate that many autoimmune risk variants exert context-dependent effects that emerge only in specific immune cell states, activation trajectories, or tissue microenvironments. Advances in spatial and chromatin-informed technologies further clarify how regulatory variation shapes immune circuits in diseases such as systemic lupus erythematosus and rheumatoid arthritis. Finally, we discuss how machine learning-enabled multi-omics integration supports molecular endotyping and therapeutic inference while emphasizing interpretability and reproducibility. Collectively, this review highlights a shift from static variant annotation toward dynamic, context-aware analytical frameworks that enable mechanism-informed interpretation of genetic risk in autoimmune disease.

PMID:41823835 | DOI:10.3390/biology15050407

Biology (Basel). 2026 Feb 28;15(5):398. doi: 10.3390/biology15050398.

ABSTRACT

Martagon Lily, Lilium martagon, belongs to geophytes inhabiting mainly forest communities in temperate regions of Europe and Asia and it is considered as a rare and endangered species in many regions. The presented investigations were conducted in three populations, occurring in forest habitats in Southern Poland: Wolski Forest (population 1), Mount Chełm (population 2), and Hrabeński Forest (population 3). At each site, 10 phytosociological relevés covering an area of 100 m² were taken. For each phytosociological relevé, the Shannon-Wiener, Pielou, and Simpson indices, as well as the number of species, were calculated. The detailed field studies were conducted in permanent study patches measuring 20 m × 20 m. The measurements of habitat conditions (e.g., number of species, soil moisture, light intensity at ground level, height of plant cover) were carried out in 2018. The observations of the abundance and developmental structure of stems, as well as selected traits (e.g., height, number and dimensions of leaves, number of flowers) were conducted in 2018-2023. The analysis of phytosociological relevés showed that the study sites in Wolski Forest and Mount Chełm were located in the Tilio cordatae-Carpinetum betuli oak-hornbeam forest association, while the study site in Hrabeński Forest was situated in the Dentario glandulosae-Fagetum mountain beech forest association. The statistical analysis confirmed that the greatest Shannon and Simpson index values, number of species, soil humidity, light intensity at ground level, and height of plant cover were recorded in Hrabeński forest. The greatest number of Lilium martagon stems and a lack of juvenile stems was found in population 3, while in less abundant populations-1 and 2-juvenile, immature, virginile, and generative stems were found. The statistical analysis showed that the highest immature and virginile stems with the greatest number of whorl leaves, as well as the substantial height of generative stems and number of whorl leaves observed in population 3, might be the result of growing in conditions of lateral shading provided by adjacent plants. The lowest height of immature and virginile stems recorded in population 1 and generative stems noticed in population 2 might be caused by them being overshaded by the canopy of surrounding trees. Moreover, the obtained results suggest the favourable impact of weather conditions during the meteorological spring and summer of 2019 on the growth of Lilium martagon stems. Nevertheless, the lack of a unified trend in the studied populations indicates the occurrence of site-specific temporal variability of individual traits. Considering the obtained results, it can be concluded that population 3 presents a much better state and prospects for persistence in the occupied site than populations 1 and 2. At the same time, it should be pointed out that further long-term observations of populations of Lilium martagon located in different habitat conditions are still strongly desired.

PMID:41823826 | DOI:10.3390/biology15050398

Prehosp Emerg Care. 2026 Mar 13:1-18. doi: 10.1080/10903127.2026.2639473. Online ahead of print.

ABSTRACT

OBJECTIVES: Research in the prehospital setting is frequently conducted with federal Exception from Informed Consent (EFIC). An EFIC requires community consultation (CC) and public disclosure (PD) to inform community members about research plans and create opportunities for community feedback and study modification prior to approval. There is limited research on the relative effectiveness of varying CC and PD strategies, particularly with increasing utilization of social media. We sought to characterize the frequency of use and reach of specific CC/PD strategies in the Pediatric Dose Optimization for Seizure in EMS (PediDOSE) trial, assess their relative effectiveness, and offer guidance to future EFIC studies on optimal strategies and potential pitfalls in conducting CC/PD.

METHODS: We completed a retrospective review of the CC/PD plans and summary reports from all 20 sites in the PediDOSE trial. We used descriptive statistics to determine the frequency and reported reach of specific CC/PD strategies. We also described sites’ modifications of their initial CC/PD plans.

RESULTS: All sites completed the required CC/PD activities, which began in October 2021. Sites conducted 52 CC meetings; meeting with community groups had the lowest attendance (median 9, IQR 2-11) and were the most frequently cancelled. Most sites (16/20) utilized social media for CC/PD; however, only 4 sites use paid social media advertisements. Paid advertising had greater reach on Facebook than posts to existing institutional followers (median reach 13992 paid vs 2504 free) at reasonable cost. All sites created PD materials and conducted CC surveys in Spanish; a majority of sites (11/20) reported actively recruiting minoritized populations for inclusion in CC/PD activities with variable success.

CONCLUSIONS: Based on our experience we recommend the following: EFIC studies should utilized paid social media for PD. Studies should establish standardized metrics for success of social media campaigns before beginning CC/PD activities. community meetings for CC should be conducted with inclusion of all relevant stakeholder groups, and sites should consider using social media to augment CC activities. Investigators of EFIC studies involving children should develop explicit plans to engage children and minoritized populations in CC/PD.

PMID:41823798 | DOI:10.1080/10903127.2026.2639473

Nanomaterials (Basel). 2026 Mar 3;16(5):319. doi: 10.3390/nano16050319.

ABSTRACT

Despite their excellent mechanical properties, metallic glasses (MGs) are significantly hindered by poor plasticity and toughness, which are essential for structural applications. The brittleness arises from the rapid propagation of shear bands (SBs), leading to strain softening and catastrophic failure. Recent advancements in microstructural engineering, particularly boundary engineering, such as nano-glass, focus on the utilization of heterogeneous structures to promote the proliferation and delocalization of SBs. Various attempts have been made experimentally to address these issues, but with very limited improvement in tensile strength and toughness. Under tensile loading, micro- or nano-pillar samples exhibit strain softening and continue to undergo plastic deformation after reaching yield or peak stress, especially the nano-glass micro-pillar. Reports on tensile strain-hardening in MG micro-pillars are rare. In this finite element simulation study, we optimize appropriate statistical and spatial distributions of free volume within the microsamples. Both the post-yield strength and the mean tangent modulus increase with progressive gradient structural modifications, thereby inducing a transition from strain-softening to strain-hardening behavior, as well as a concurrent transition from plastic fracture to brittle fracture. We systematically investigate the deformation mechanisms and transition mechanisms of fracture modes, which are closely associated with heterogeneous microstructures and their evolution in MGs. These insights into the transition mechanism could significantly facilitate the design and optimization of MGs to achieve enhanced toughness and strain hardening.

PMID:41823771 | DOI:10.3390/nano16050319

Mod Rheumatol. 2026 Mar 13:roag028. doi: 10.1093/mr/roag028. Online ahead of print.

ABSTRACT

OBJECTIVES: Low-dose aspirin (LDA) is widely recommended to prevent hypertensive disorders of pregnancy (HDP). However, the evidence of its effectiveness in pregnancies with systemic lupus erythematosus (SLE) remains limited. This study evaluated the efficacy of LDA in preventing HDP in women with SLE.

METHODS: We conducted a retrospective cohort study of 124 pregnancies with SLE managed at our hospital. Pregnancy outcomes were compared between women treated with LDA and those not treated, using propensity score and inverse probability weighting analyses to adjust for confounders.

RESULTS: LDA was used in 65 pregnancies and not used in 59. HDP occurred in 7/65 (10.8%) and 8/59 (13.6%), respectively. After adjusting for potential confounders, including antiphospholipid antibodies, lupus nephritis, chronic hypertension, chronic kidney disease, history of HDP, and hydroxychloroquine use, the risk ratio for HDP with LDA was 0.76 (95% confidence interval: 0.25-2.33; p=0.64). Sensitivity analysis was consistent.

CONCLUSIONS: LDA did not significantly reduce the incidence of HDP in women with SLE. This lack of effect may reflect the low event rate in a well-controlled cohort. These findings underscore the need for individualized risk assessment and careful monitoring, beyond reliance on LDA alone, in the management of pregnancies with SLE.

PMID:41823715 | DOI:10.1093/mr/roag028