Front Digit Health. 2026 Jun 10;8:1811259. doi: 10.3389/fdgth.2026.1811259. eCollection 2026.
NO ABSTRACT
PMID:42359447 | PMC:PMC13291121 | DOI:10.3389/fdgth.2026.1811259
Category: Statistics
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Cureus. 2026 Jun 24;18(6):e111438. doi: 10.7759/cureus.111438. eCollection 2026 Jun.
ABSTRACT
Extramedullary disease (EMD) in multiple myeloma refers to soft-tissue plasmacytomas that spread hematogenously and grow independently of bone, an aggressive phenotype that has been associated with poorer responses and shorter survival across successive treatment eras. Bispecific antibodies are highly active in relapsed or refractory multiple myeloma (RRMM), but their efficacy in patients with baseline EMD has not been quantitatively synthesized. We performed a systematic review and meta-analysis, reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidance, of prospective trials of B-cell maturation antigen (BCMA)- or G protein-coupled receptor class C group 5 member D (GPRC5D)-directed CD3 bispecific antibodies in RRMM that reported the objective response rate (ORR) in patients with baseline EMD. One estimate per trial was included; proportions were pooled using a random-effects model on the logit scale with restricted maximum-likelihood estimation of between-study variance, and heterogeneity was assessed with the Cochran Q test and the I-squared statistic; fixed-effect and leave-one-out sensitivity analyses were performed, and risk of bias was appraised for each EMD subgroup. Four prospective studies comprising 144 patients with baseline EMD were included. Study-level ORRs were 58.3% for teclistamab, 38.5% for elranatamab, 52.6% for linvoseltamab, and 44.6% for talquetamab when recommended phase 2 dose cohorts were combined. The random-effects pooled ORR was 45.2% (95% CI, 37.2-53.4), with no observed between-study heterogeneity (I-squared = 0%); estimates were identical under a fixed-effect model, and leave-one-out pooled ORRs ranged narrowly from 44.0% to 47.6%. BCMA- and GPRC5D-directed bispecific antibodies produce objective responses in approximately half of patients with RRMM and baseline EMD, with broadly similar activity across agents despite high-risk biology, although the small number of trials and their differing, sometimes paramedullary-inclusive, definitions of EMD warrant caution in interpreting this estimate. These pooled estimates provide a benchmark for patient counseling and trial design and support combination strategies to improve outcomes in this population.
PMID:42359424 | PMC:PMC13293460 | DOI:10.7759/cureus.111438
Front Plant Sci. 2026 Jun 10;17:1810933. doi: 10.3389/fpls.2026.1810933. eCollection 2026.
ABSTRACT
INTRODUCTION: Restored estuarine floodplains with an artificially controlled reduced tide (CRT) are dynamic areas created for flood protection whilst also providing habitats for estuarine wildlife. However, the reintroduction of the tide poses stressors, including salinity and waterlogged soils because of periodic flooding, on established vegetation such as English oak (Quercus robur). Therefore, newly opened CRT areas give the opportunity of studying the effects of flooding, salinity, and drainage, on hydrogen peroxide (H2O2) concentrations in plants, as a proxy for stress.
METHODS: This was done on English oak samples retrieved from both field and mesocosm settings using commercially available peroxide assay kits.
RESULTS: Our results indicated that H2O2 concentrations measured in the field were affected by the time of sampling, while concentrations in the mesocosm were influenced by soil type. Flooding and salinity did not show detectable effects on H₂O₂ concentrations, either individually or in combination with soil type, within the scope of our experimental design, which had constrained statistical power to detect subtle effects. Additionally, our results did not correspond with the deterioration and mortality of English oak observed in the field and mesocosm experiments, indicating limited suitability of H₂O₂ as a standalone indicator of physiological stress under these conditions.
DISCUSSION: Overall, we recommend that future studies include a broader range of indicators to assess the tree stress responses in dynamic CRT environments.
PMID:42359418 | PMC:PMC13290460 | DOI:10.3389/fpls.2026.1810933
PCN Rep. 2026 Jun 24;5(2):e70367. doi: 10.1002/pcn5.70367. eCollection 2026 Jun.
ABSTRACT
AIM: Some features of neurodevelopmental disorders (NDDs) have been discussed as potential factors related to criminal behavior, and addressing their characteristics may help prevent recidivism among forensic patients. However, evidence from Japan remains limited. This study examined the association between NDDs and recidivism among forensic outpatients receiving treatment under Japan’s Medical Treatment and Supervision Act (MTSA).
METHODS: This retrospective cohort study used the national database of Japanese forensic outpatients who received treatment under the MTSA between 2005 and 2017. Generalized linear models analyzed the association between NDDs, including intellectual disability (ID), autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD), and recidivism during outpatient treatment.
RESULTS: A total of 2135 patients were included in the analysis, of whom 221 (10.4%) exhibited recidivism. ID, ASD, and ADHD were observed in 10.0%, 3.9%, and 0.3% of patients, respectively. Both ID (adjusted odds ratio [aOR] = 1.92, 95% confidence interval [CI]: 1.29-2.87) and ASD (aOR = 2.94, 95% CI: 1.64-5.27) were associated with an increased risk of recidivism. ID was associated with a higher risk of physical violence (aOR = 2.01, 95% CI: 1.28-3.14) and arson (aOR = 3.43, 95% CI: 1.01-11.71), whereas ASD was associated with physical violence (aOR = 2.87, 95% CI: 1.51-5.46).
CONCLUSION: Among Japanese forensic outpatients, ASD and ID were associated with an increased risk of recidivism during outpatient treatment. These findings highlight the importance of developing tailored support and multidisciplinary interventions that address the specific needs of individuals with NDDs.
PMID:42359389 | PMC:PMC13292018 | DOI:10.1002/pcn5.70367
Int J Nurs Stud Adv. 2026 Jun 9;11:100596. doi: 10.1016/j.ijnsa.2026.100596. eCollection 2026 Dec.
ABSTRACT
BACKGROUND: Spiritual care is a core element of holistic nursing, especially in demanding settings such as emergency and intensive care units where patients often face life-threatening conditions and end-of-life challenges. Despite its importance, little is known about nurses’ competence in providing spiritual care and the factors that shape it.
OBJECTIVE: This study aimed to explore spiritual care competence and its predictors among nurses working in critical and emergency settings.
DESIGN: A cross-sectional study.
SETTINGS: The study was conducted in the emergency and intensive care units of two central hospitals in Qazvin, Iran.
PARTICIPANTS: A total of 180 nurses working in critical care and emergency units participated in the study.
METHODS: Data were collected using the Spiritual Care Competence Scale, the Spiritual Intelligence Self-Report Inventory, and the Death Attitude Profile-Revised. Descriptive statistics and logistic regression analyses were performed using SPSS version 23.
RESULTS: Nurses demonstrated moderate levels of spiritual care competence (86.79 ± 4.25) and spiritual intelligence (57.15 ± 6.13). Among death attitude dimensions, neutral acceptance scored highest, while approach acceptance scored lowest. Logistic regression revealed that age, work experience, spiritual intelligence, and a positive attitude toward death were significant predictors of spiritual care competence (p < 0.05).
CONCLUSION: Spiritual care competence among nurses is associated with personal maturity, professional experience, spiritual intelligence, and positive attitudes toward death. Integrating spiritual care education and fostering positive perspectives on death may enhance nurses’ preparedness to deliver comprehensive, patient-centered care.
PMID:42359385 | PMC:PMC13292470 | DOI:10.1016/j.ijnsa.2026.100596
Dent Res J (Isfahan). 2026 May 14;23:15. doi: 10.4103/drj.drj_411_24. eCollection 2026.
ABSTRACT
BACKGROUND: Oral lichen planus (OLP) is a chronic mucocutaneous inflammatory disease that is somewhat frequently manifested in various clinical forms: reticular OLP (ROLP) and erosive OLP (EOLP), and some cases are associated with dysplasia. Higher risk of malignant transformation has been linked to dysplastic alterations in OLP. Glucose transporter protein (GLUT1) is a transmembrane glycoprotein associated with increased glucose metabolism and proliferation of cells. This study’s objective was to analyze and compare the expression patterns of GLUT1 in EOLP, ROLP, and lichen planus-related dysplasia in an attempt to acquire improved knowledge of the molecular pathways that underlie the etiology and advancement of OLP.
MATERIALS AND METHODS: In this retrospective study, analysis of GLUT1 expression was done in 32 samples of OLP (16 for ROLP, 10 for EOLP, and 6 for OLP with dysplasia) with immunohistochemistry. Statistical analysis was performed using Pearson’s Chi-square and F-tests, with significance set at P < 0.05. The immune GLUT-1 expression was evaluated semi-quantitatively and qualitatively at ×100 magnification.
RESULTS: The mean percentage of GLUT1-positive cells in ROLP (16.53 ± 11.72) was lower than that in EOLP and OLP with dysplasia. Among the three groups, there was a significant difference in terms of staining intensity, intracellular location, and extent of GLUT1 immunoexpression within the epithelium layers (0.000, 0.034, and 0.006, respectively).
CONCLUSION: GLUT1 overexpression reflects increased glycolytic activity of proliferating cells in response to hypoxia and high energy requirements in EOLP and OLP-related dysplasia. GLUT1 expression may predict the malignant potential of OLP toward oral squamous cell carcinoma.
PMID:42359380 | PMC:PMC13293537 | DOI:10.4103/drj.drj_411_24
BMC Chem. 2026 Jun 25. doi: 10.1186/s13065-026-01853-7. Online ahead of print.
ABSTRACT
The development of environmentally sustainable analytical methodologies capable of resolving highly overlapped multicomponent systems remains an important challenge in modern analytical chemistry. UV spectrophotometry offers several practical advantages, including minimal solvent-consumption, rapid analysis, low operational cost, and instrumental simplicity; however, its quantitative application is often constrained by severe spectral-overlap among analytes. In the present study, a dual-matrix chemometric framework was developed for the simultaneous determination of five spectrally overlapping analytes-hydrochlorothiazide (HCD), losartan potassium (LOS), ramipril (RAP), N-nitrosodiethylamine (NDA), and toluene (TLN)-in pharmaceutical formulations and fortified human plasma samples. The proposed methodology integrates a five-factor, five-level multilevel experimental design for calibration, Sobol quasi-random sampling for external validation, and Firefly Algorithm-optimized Partial Least Squares (FA-PLS) modeling for adaptive wavelength selection and multivariate calibration. The developed models demonstrated excellent analytical performance. For pharmaceutical formulations, mean recoveries ranged from 99.68 to 100.57%, with RMSEP values between 0.037 and 0.094 µg/mL. For fortified human plasma samples, mean recoveries ranged from 98.18 to 98.97%, with RMSEP values between 0.059 and 0.146 µg/mL, demonstrating the feasibility of the proposed approach under biologically relevant matrix conditions. The environmental profile of the proposed methodology was comprehensively evaluated using multiple complementary tools, including NEMI, ComplexGAPI, AGREE, the Multicolor Assessment Tool, carbon footprint estimation, and the Need-Quality-Sustainability index. Collectively, these assessments confirmed the favorable greenness and overall sustainability characteristics of the developed spectrophotometric approach. To the best of our knowledge, no previous UV spectrophotometric chemometric method has been reported for the simultaneous determination of LOS, RAP, and HCD in the presence of both NDA and TLN within a single analytical workflow without a prior separation step. The proposed dual-matrix FA-PLS framework demonstrates that UV spectrophotometry, when coupled with advanced chemometric optimization and statistically designed calibration strategies, can provide an accurate, sensitive, and environmentally sustainable platform for multicomponent pharmaceutical analysis and proof-of-concept application to biological matrices.
PMID:42351205 | DOI:10.1186/s13065-026-01853-7
AIDS Res Ther. 2026 Jun 26. doi: 10.1186/s12981-026-00912-2. Online ahead of print.
ABSTRACT
BACKGROUND: Anemia is a significant concern for people with HIV worldwide, as it is associated with reduced life expectancy, fatigue, weakness, reduced physical functioning, psychological distress such as depression and anxiety, and poorer quality of life. This study aimed to assess the prevalence of anemia and identify factors associated with anemia among people with HIV receiving antiretroviral therapy at public health institutions in Jigjiga, Ethiopia.
METHODS AND MATERIALS: An institution-based cross-sectional study was conducted from July 11 to August 12, 2023, involving 392 people with HIV receiving antiretroviral therapy in Jigjiga, Ethiopia. Data were collected using a structured questionnaire and hemoglobin measurements, then coded and entered in EpiData version 3.1. Statistical analysis was performed using SPSS version 20, with multivariate logistic regression used to identify factors associated with anemia. Statistical significance was set at p < 0.05.
RESULTS: The overall prevalence of anemia in the study population was 39% (95% CI: 34.3-44.2). Among those with anemia, 0.6% had severe anemia, 33.5% had moderate anemia, and 4.9% had mild anemia. Female sex, presence of opportunistic infections, and low dietary diversity scores were significantly linked to anemia in multivariate analysis (p < 0.05).
CONCLUSION: Anemia was identified as a moderate public health problem among people with HIV receiving ART at the study sites. The findings highlight the importance of providing targeted support to women and ensuring timely diagnosis and treatment of opportunistic infections to reduce the severity and impact of anemia. Furthermore, patients with poor dietary diversity should be offered nutritional counselling to enhance their health outcomes.
SIGNIFICANCE FOR PUBLIC HEALTH: Anemia continues to pose a substantial public health burden among people living with HIV/AIDS, particularly in low-resource settings. This study provides context-specific evidence from Jigjiga, a region with limited existing data, helping to fill a critical knowledge gap. The results offer valuable insights for healthcare providers and policymakers to design targeted interventions, improve anemia screening and management, and enhance the quality of life for People with HIV on ART.
PMID:42351202 | DOI:10.1186/s12981-026-00912-2
BioData Min. 2026 Jun 25. doi: 10.1186/s13040-026-00579-5. Online ahead of print.
ABSTRACT
BACKGROUND: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease with median survival of 3-5 years. Patient responses to treatments vary widely, highlighting the need for personalized care. Clustering patients based on disease progression could improve prognosis, guide clinical decision-making, and optimize clinical trial design. This study aimed to identify robust ALS patient clusters using ALS Functional Rating Scale-Revised (ALSFRS-R) scores and to determine diagnostic parameters predictive of cluster membership, enabling earlier stratification and targeted management.
METHODS: Data from the Tours ALS center registry (April 1997-October 2023) were analyzed; after preprocessing, 353 patients monitored every three months between January 2004 and July 2023 with ALSFRS-R, clinical, biological, and demographic data were retained. After preprocessing to handle missing or aberrant data, a weakly supervised approach labeled patient pairs based on their ALSFRS-R sequences. These labels were used to train a classifier to learn a distance for off-the-shelf clustering algorithms. Multiple configurations were tested, varying clustering algorithms, dimensionality reduction method, and number of clusters. Random Forest (RF) model predicted cluster membership from diagnostic parameters. Optimal clustering was selected using silhouette score, validated with Kaplan-Meier survival analysis. Stability and robustness were assessed with the Adjusted Rand Index (ARI) and silhouette score respectively. Predictive performance was evaluated using specificity, sensitivity, positive predictive value (PPV), and negative predictive value (NPV). Diagnostic parameters associated with clusters were identified using Kruskal-Wallis and chi-squared tests for continuous and categorical variables.
RESULTS: Three clusters (n = 139, 121, 93) were identified, demonstrating strong separation (silhouette ≈ 0.6) and high stability of results (ARI ≈ 0.7). Survival differed significantly among clusters: over 50% of patients in the third cluster survived beyond 50 months, compared to less than 25% in the other clusters. Thirteen diagnostic parameters-including ALSFRS-R subscores, IgG levels, albumin quotient, and time to diagnosis-were key predictors of cluster membership. Cluster prediction achieved specificity and NPV ≈ 0.75, with close sensitivity and PPV compared to state-of-the-art methods.
CONCLUSION: This framework successfully stratifies ALS patients into clinically meaningful clusters, revealing underlying disease heterogeneity and providing strong prognostic insight. Such classification can facilitate personalized care, guide therapeutic decisions, and inform the design of targeted interventions to improve outcomes.
CLINICAL TRIAL NUMBER: Not applicable.
PMID:42351201 | DOI:10.1186/s13040-026-00579-5
J Cardiothorac Surg. 2026 Jun 25. doi: 10.1186/s13019-026-04482-2. Online ahead of print.
ABSTRACT
OBJECTIVES: This study compared clinical outcomes of cardiac surgeries performed by a single surgeon (operating alone [OA]) versus those performed by multiple surgeons (operating together [OT]) to evaluate the feasibility and safety of different surgical staffing models.
METHODS: We retrospectively reviewed adult patients who underwent cardiac surgery at Chung-Ang University Hospital from September 2016 to August 2021. Between September 2016 and August 2018, two or three surgeons assisted each other (OT), while from September 2018 to August 2021, a single surgeon operated alone (OA). After propensity score matching, 79 patients were selected in each group for analysis.
RESULTS: Major postoperative adverse events, including mortality, stroke, new-onset atrial fibrillation, and low cardiac output, did not statistically significant differ between groups. Other postoperative outcomes such as, acute kidney injury, ICU stay length, hospital days, CPB time, ACC time was not statistically different, whereas operation time was shorter in the OT group than in the OA group (median 300 vs. 379 min, P < 0.001).
CONCLUSIONS: Except for differences in operation time, there were not significantly different short-term postoperative outcomes in OT and OA groups. Given the various limitations of the present study, the result should be interpreted cautiously.
PMID:42351185 | DOI:10.1186/s13019-026-04482-2