Category: Statistics

Commun Dis Intell (2018). 2026 Mar 24;50. doi: 10.33321/cdi.2026.50.015.

ABSTRACT

During winter months of temperate regions, concurrent epidemics of multiple respiratory pathogens can occur, causing periods of increased clinical burden. Case time series, which are predominantly used to monitor infection levels, can exhibit substantial noise and day-of-the-week effects, limiting the visual interpretation of trends in raw data. However, statistical methods can infer smoothed trends within case time series by quantifying and accounting for different sources of noise. Here we apply statistical models to estimate the epidemic dynamics of SARS-CoV-2, respiratory syncytial virus (RSV), and influenza subtypes (influenza A H3N2, influenza A H1N1, and influenza B) in Victoria, Australia, over the 2024 winter season. We model trends in daily reported cases and the daily growth rate over time for all pathogens/subtypes. We present: (1) retrospective analyses using the final dataset up to 10 September 2024 and (2) weekly real-time analyses from 19 March 2024 to 10 September 2024 using data up to each timepoint, including a retrospective performance evaluation. We estimated similar peak timing of SARS-CoV-2 and RSV epidemics in late May, followed by a H3N2-dominant influenza epidemic, which peaked in early July. Transient increases in SARS-CoV-2 activity coincided with the emergence of new variants and transient decreases in influenza activity corresponded to the timing of school holidays. Real-time estimates demonstrated good agreement with those produced at the end of the season, with significant overlap of the 95% credible intervals. Our findings demonstrate how statistical methods can be implemented in real time to synthesise noisy case time-series data into interpretable trends (including uncertainty), enabling quantification of the strength of evidence for whether epidemic activity is increasing, stable or declining. Our real-time outputs were reported weekly to the Department of Health, Victoria during June-September 2024, complementing other routine surveillance indicators.

PMID:41871329 | DOI:10.33321/cdi.2026.50.015

Commun Dis Intell (2018). 2026 Mar 24;50. doi: 10.33321/cdi.2026.50.016.

ABSTRACT

BACKGROUND: Endemic measles was verified as eliminated in Australia in 2014. We describe Australian measles epidemiology, 2014-2024.

METHODS: National measles notification data were analysed by age; sex; state/territory of residence; genotype; place of acquisition (overseas/Australia); vaccination status (number of doses); and outbreak reference ID (for clusters).

RESULTS: Between 2014 and 2024, there were 1,095 measles notifications (average annual notification rate 0.4 per 100,000 population per year). The highest annual notification rates were recorded in 2014 (1.4 per 100,000 per year) and 2019 (1.1 per 100,000 per year), when rates in the Northern Territory were 21.4 and 12.6 per 100,000 population per year, respectively. Although notification rates were highest among infants < 1 year of age (average 3.8 notifications per 100,000 population per year), people aged 20-49 accounted for 57.2% of total notifications (n = 626). Of cases with a known immunisation status (n = 766), there were 513 cases (66.9%) who reported being unvaccinated; 20.1% (n = 154) reported having received one dose of MMR vaccine prior to infection; and 12.1% (n = 93) reported two or more doses. For notifications where country of acquisition was available (n =1,077), just over half of cases (55.1%) were acquired in Australia. Where measles was acquired overseas (n = 493), the most common countries of acquisition were Indonesia (n = 99; 20.1%), the Philippines (n = 82; 16.6%) and India (n = 52; 10.5%). There were 47 clusters during the reporting period, of which the largest involved 74 linked cases in 2019. Of recorded clusters, 44 (93.6%) had a source country outside of Australia. Notifications tended to peak each year in the months coinciding with the end of Australian school holiday periods.

CONCLUSION: Australia has sustained measles elimination since 2014; this review of measles epidemiology, demonstrating a predominance of unvaccinated returning international travellers 20-49 years of age, provides strong motivation for maintaining high routine two-dose coverage and promoting measles vaccination to adults travelling internationally.

PMID:41871328 | DOI:10.33321/cdi.2026.50.016

J Geriatr Psychiatry Neurol. 2026 Mar 23:8919887261436696. doi: 10.1177/08919887261436696. Online ahead of print.

ABSTRACT

ObjectiveThis systematic review aims to evaluate recent evidence on interventions for sleep disturbances in dementia, a major clinical concern, with limited pharmacological and non-pharmacological strategies examined in controlled trials.MethodsWe included eight RCTs (N = 666 participants; 2020 – January 2025) in people with dementia and sleep disturbances. Records were identified via MEDLINE, screened using PRISMA-guidelines, and non-randomized or non-intervention studies were excluded. Risk-of-bias was assessed with Cochrane RoB2, and effect sizes (Cohen’s d) were calculated in R.ResultsZ-drugs indicated small-large benefits, with eszopiclone significantly improving sleep efficiency and latency. Orexin receptor antagonists indicated mixed evidence, with low-dose lemborexant (2.5 mg) most favorable, meeting benchmarks for nocturnal awakenings. Circadian modulation light therapy was associated with reduced nocturnal awakenings in small trials, while relaxation-based music therapy indicated little to no effect. Social stimulation with PARO indicated increased sleep time and large positive effects on sleep efficiency, despite missing clinical benchmarks.ConclusionsEvidence is limited by sparse reporting and few trials per intervention. Z-drug eszopiclone, low-dose ORA lemborexant, and social stimulation PARO show the most favorable profile across outcomes and benchmarks, but pharmacological options require careful risk-benefit consideration. Non-pharmacological approaches appear safer but under-researched. Future trials should standardize outcomes and tailor strategies to patient needs. No external funding. The review was registered in INPLASY: https://doi.org/10.37766/inplasy2025.1.0097.

PMID:41871321 | DOI:10.1177/08919887261436696

J Craniofac Surg. 2026 Mar 23. doi: 10.1097/SCS.0000000000012548. Online ahead of print.

ABSTRACT

PURPOSE: To microscopically examine the central thickness of the superior tarsal plate and determine whether it exhibits uneven thickness or contour.

METHODS: Central sagittal sections of 22 upper eyelids (12 right and 10 left) from 15 East Asian cadavers (8 male and 7 female), aged 38 to 88 years old (mean age: 70.5 y), were histologically analyzed. Specimens were fixed in 10% formalin and stained with Masson’s trichrome. The thickest and thinnest regions of each tarsal plate were measured, and statistical analysis was performed to compare these measurements.

RESULTS: A statistically significant difference was found between the thickest and thinnest regions of the tarsal plate (P<0.001). The thickest areas were located around the superior one-third of the tarsal height, while the thinnest areas were found near the inferior one-fourth, close to the marginal artery or slightly below the insertion of the levator aponeurosis. No statistically significant differences were observed based on age (thickest: P=0.632 and thinnest: P=0.785), sex (thickest: P=0.844 and thinnest: P=0.237), or laterality (thickest: P=1.000 and thinnest: P=0.404).

CONCLUSION: The superior tarsal plate demonstrates an uneven crescent-shaped central contour, with a prominent thickening in the superior region. The thickest portion is located around the superior one-third of the tarsal height, while the thinnest portion lies near the inferior one-fourth, adjacent to the marginal artery or slightly below the levator aponeurosis insertion. No significant differences were found based on age, sex, or laterality.

PMID:41871289 | DOI:10.1097/SCS.0000000000012548

Clin Exp Dent Res. 2026 Apr;12(2):e70315. doi: 10.1002/cre2.70315.

ABSTRACT

OBJECTIVES: The main aim of this systematic review and meta-analysis was to report the prevalences of orofacial and dental injuries among rugby players and to discuss the prevention of these injuries through mouthguard use.

METHODS: A literature search of the PubMed, Scopus, EMBASE, Cochrane Library and Dentistry & Oral Science Sources (DOSS) databases was performed to identify eligible studies from 1998 to 31^st March 2025. This review was conducted on studies reporting the prevalence or incidence of orofacial or dental injuries among rugby players.

RESULTS: In total, 268 records were screened for eligibility, and 16 studies met the inclusion criteria. The overall prevalence of orofacial injuries was 40.4% (95% CI: 38.5-42.2) with the higher prevalence (70.2%) in a study of 2010 among male rugby players of 17-18 years. The most common orofacial injuries involve the soft tissues. The overall prevalence of dental injuries was 19.6% (95% CI: 18.1-21.3). A fractured tooth was the most common dental injury. Mouthguards were mainly worn during competition, less during training. The certainty in cumulative evidence was considered to be very low.

CONCLUSION: This review highlights a high rate of orofacial and dental injuries in rugby. It is necessary to increase awareness and the use of protective mouthguards to enhance prevention.

PMID:41871283 | DOI:10.1002/cre2.70315

Proc Natl Acad Sci U S A. 2026 Mar 31;123(13):e2527755123. doi: 10.1073/pnas.2527755123. Epub 2026 Mar 23.

ABSTRACT

In early 2025, the NIH unexpectedly terminated 2,291 active research grants, withdrawing $2.45 billion and disrupting thousands of projects. While the economic magnitude of these cuts is known, less is understood about how they differed across researchers’ demographic groups. Using an original dataset of publicly available records, we documented how cancelations varied by gender and career stage. Although cuts occurred across all regions and institution types, statistical patterns show that early-career investigators-assistant professors, postdoctoral scholars, trainees, and graduate students-were disproportionately affected, as were women. Women’s projects were smaller on average, had a larger share of unspent funds at cancelation, and were more concentrated in training and transition awards. Although available data cannot determine downstream causal effects, NIH economic multipliers suggest a potentially large unrealized loss to the US research enterprise. These patterns highlight the vulnerability of early-career researchers and women to abrupt funding instability and underscore the need for sustained investment to protect the future scientific workforce.

PMID:41871241 | DOI:10.1073/pnas.2527755123

Proc Natl Acad Sci U S A. 2026 Mar 31;123(13):e2523152123. doi: 10.1073/pnas.2523152123. Epub 2026 Mar 23.

ABSTRACT

Why do girls outperform boys in education? One contributing factor might be that girls read more than boys, which fosters competencies relevant in education. Moreover, boys might rely more heavily on schools to support and encourage reading, meaning that unplanned and planned school closures disproportionally affect boys. We map the gender gap in reading in the period 2020 to 2022 using two large-scale datasets from Denmark, one measuring students’ weekly reading in school via a popular reading app and the other measuring students’ borrowing of library books. Our data document a clear gender gap in reading that increased during unplanned school closures due to the COVID-19 pandemic and planned closures due to vacations. Our findings underscore the role of schools in mitigating gender differences in reading.

PMID:41871238 | DOI:10.1073/pnas.2523152123

J Clin Psychiatry. 2026 Mar 18;87(2):26f16375. doi: 10.4088/JCP.26f16375.

ABSTRACT

Persons with mental health disorders are at increased risk of dental disease, including lost teeth. Dental implants are the preferred option for most persons who have lost teeth. Recent studies suggest that antidepressant drugs, especially the selective serotonin reuptake inhibitors, are associated with an increased risk of dental implant failure. This article provides a background about the epidemiology of loss of teeth, the causes of tooth loss, the need to replace lost teeth, and the use of dental implants to replace lost teeth. Two meta-analyses of retrospective cohort studies of the association between antidepressant use and implant failure are examined in detail. One meta-analysis included 6 studies and the other, 10 studies. An additional retrospective cohort study, published after the meta-analyses, is also examined. In summary, there is consistent evidence for a higher risk of implant failure in patients taking antidepressants, and for a higher number of implants failing in patients taking antidepressants, relative to patients not taking antidepressants. Broad findings were that, at the patient level, implant failure occurred in 6%-23% of antidepressant users vs 2%-8% of nonusers, and at the implant level, implant failure occurred in 6%-22% of antidepressant users vs 2%-9% of nonusers. Because unadjusted risks were more than doubled in antidepressant users, it implies that, in the real world, antidepressant use is a clinically important marker for risk of implant failure; it is hard to draw cause and effect inferences from the studies reviewed because of inadequacies in study designs and statistical methods. Action points are that antidepressant users should be educated about the risk of implant failure, and vigorous efforts should be made to identify and negate, to the extent possible, other risk factors for implant failure in these patients. Suggestions are offered for future research in the field.

PMID:41871232 | DOI:10.4088/JCP.26f16375

Urol Int. 2026 Mar 23:1-13. doi: 10.1159/000551610. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the performance of five advanced reasoning models on urology-related clinical multiple-choice questions from the MedQA dataset, and to benchmark AI performance against medical students and experienced urologists in terms of accuracy, response efficiency, and agreement patterns.

METHODS: We extracted 434 urology-relevant items and evaluated five models-DeepSeek-R1, ChatGPT O4-mini, Gemini 2.5 Pro, Claude 3.7 Sonnet, and Grok 3-using a standardized prompt. Accuracy was computed against reference answers; API response times and connection failures were recorded. In addition, 20 senior medical students and 20 experienced urologists answered subsets of the same item bank using a balanced block design; group-level majority-vote answers were used as human baselines. Statistical analyses included Cochran’s Q and McNemar tests (AI-only accuracy), a logistic generalized linear mixed-effects model (GLMM) with urologists as the reference (model-adjusted accuracy), Fleiss’ κ and Cohen’s κ (agreement), and Friedman and Wilcoxon signed-rank tests (response time).

RESULTS: Across the AI-only comparison, all models achieved high accuracy (86.9-93.3%), with DeepSeek-R1, ChatGPT O4-mini, and Gemini 2.5 Pro outperforming Claude 3.7 Sonnet and Grok 3. In the model-adjusted analysis, all five AI models showed significantly higher odds of correct answers than experienced urologists (all p < 0.001, Dunnett-adjusted), while medical students did not differ significantly from urologists. ChatGPT O4-mini had the shortest median API response time (5.03 s), whereas group-level median task completion times were 15.87 s for students and 17.57 s for urologists; Grok 3 was slowest among AI models (27.62 s). Connection failure rates were 0% for ChatGPT O4-mini, Gemini 2.5 Pro, and Claude 3.7 Sonnet; 1.6% for DeepSeek-R1; and 2.8% for Grok 3. Agreement across the five AI models and the two human majority-vote baselines was moderate-to-substantial (Fleiss’ κ = 0.685, p < 0.001).

CONCLUSION: Modern reasoning models achieve strong accuracy and efficiency on urology-focused benchmark questions, supporting their potential role as useful clinical assistants when implemented with appropriate human oversight. ChatGPT O4-mini’s rapid latency further underscores its suitability for time-sensitive workflows, while model-adjusted analyses indicate its consistently superior accuracy relative to experienced urologists within this standardized assessment format.

PMID:41871224 | DOI:10.1159/000551610

Postgrad Med J. 2026 Mar 23:qgag030. doi: 10.1093/postmj/qgag030. Online ahead of print.

ABSTRACT

Physicians rely on clinical judgment and patients look for it. However, clinical judgment is infrequently discussed in the literature, and is often perceived as an intuitive art, that is likely to be replaced by technology and artificial intelligence. This review offers a reconceptualization of the role of clinical judgment in current medical practice and research, informed by the extensive knowledge that has accumulated in psychosomatic medicine. Clinical judgment consists of three phases: collecting clinical information; interpretation and clinical reasoning; decision making. Interviewing is the primary method for gathering data. Clinical reasoning involves bringing together relevant information and formulating hypotheses, which result in decisions and therapeutic acts. Clinimetrics, the science of clinical measurements, facilitates physician’s reasoning and organization of data. Improving the features of clinical judgment is likely to yield a highly effective precision medicine.

PMID:41871207 | DOI:10.1093/postmj/qgag030