Category: Statistics

Eur J Clin Pharmacol. 2026 Jan 17;82(2):34. doi: 10.1007/s00228-025-03958-9.

ABSTRACT

BACKGROUND: Levosimendan and Milrinone are commonly used inotropic agents in patients undergoing cardiac surgery; there is a lack of evidence regarding the comparative safety and efficacy of both drugs. We aim to compare the clinical efficacy and safety of levosimendan versus Milrinone in these patients.

METHODS: We conducted a systematic review and meta-analysis following PRISMA guidelines. PubMed, Scopus, Web of Science, and Cochrane Central were searched up to November 30, 2024, for studies comparing levosimendan and Milrinone in adult and pediatric cardiac surgery patients. We used R statistical software to pool dichotomous data using odds ratio (OR) and continuous data using mean difference (MD) with a 95% confidence interval (CI).

RESULTS: Seventeen studies (15 RCTs and 2 observational) involving 890 patients were included. Across all efficacy outcomes, including cardiac index (MD 0.02, 95% CI -0.15-0.19), mean arterial pressure (MAP) (MD -0.09, 95% CI -1.97-1.79), and mPAP (mean pulmonary artery pressure) (MD -0.88, 95% CI -2.66, 0.89), no significant differences were found between the two drugs (P > 0.05). Safety outcomes, including all-cause mortality (OR 0.97, 95% CI 0.48-1.93), acute kidney injury (OR 0.89, 95% CI 0.55-1.44), and arrhythmias (OR 0.87, 95% CI 0.41-1.88), showed no statistically significant differences (P > 0.05).

CONCLUSION: Levosimendan and Milrinone showed no significant differences in efficacy or safety in cardiac surgery patients. However, wide confidence intervals indicate potential clinically relevant effects. Current evidence does not favor any single agent universally, supporting individualized use based on patient phenotype and institutional practice. Further high-quality trials are needed to confirm.

PMID:41546720 | DOI:10.1007/s00228-025-03958-9

Bioprocess Biosyst Eng. 2026 Jan 17. doi: 10.1007/s00449-025-03277-4. Online ahead of print.

ABSTRACT

Global economic burden due to plastic pollution is estimated to be over $3 trillion annually. Bioplastics derived from bacteria-synthesized biopolymers like polyhydroxyalkanoates (PHAs), are a remarkably versatile sustainable alternative. Research on optimal growth-conditions for microbial PHA-synthesis fed-on sustainable substrates, particularly by phototrophic-mixed-cultures (PMC) enriched with purple non-sulphur bacteria (PNSB) is essential. This study intends to understand the effect of nitrogen and phosphorus concentrations on PHA-production by PMC grown using fuel synthesis wastewater (FSW) (organic by-product of Fischer-Tropsch process) as substrate. Stoichiometric quantification and 16 S metagenomic sequencing followed by statistical and bioinformatic analysis were done. High PHA-production (65-82% of biomass) is observed to be induced by Low-Nitrogen conditions enriching Rhodopseudomonas, Paludibacter and Pleomorphomonas and a Low-Phosphorus condition enriching Rhodopseudomonas, Rhodoplanes and Lentimicrobium. Analysis of metabolic-potential revealed 16 enzymes (of 8 different PHA-synthesis-pathways) inherent within the genomes of bacteria enriched by these culture conditions. This study identifies optimal nitrogen and phosphorus concentrations and the corresponding microbial-composition of FSW substrate-grown PMC-system to maximize PHA-production in a laboratory-scale bioprocess.

PMID:41546704 | DOI:10.1007/s00449-025-03277-4

Graefes Arch Clin Exp Ophthalmol. 2026 Jan 17. doi: 10.1007/s00417-025-07110-2. Online ahead of print.

ABSTRACT

BACKGROUND: Lyme disease ophthalmic manifestations are underestimated due to a wide variety of clinical presentations and a lack of robust evidence. We performed a systematic review and meta-analysis to analyze the prevalence of ocular findings in patients diagnosed with Lyme Disease.

METHODS: This systematic review and meta-analysis was conducted following PRISMA guidelines. We systematically searched PubMed, Embase, Lilacs, and the Cochrane Central Register of Controlled Trials databases for studies enrolling patients diagnosed with Lyme disease who exhibited ocular manifestations until April 2024. The latest version of the Newcastle-Ottawa Scale (NOS) was utilized to evaluate the risk of bias. All statistical analyses were performed using RStudio statistical software version 4.3.2. Heterogeneity was assessed using I² statistics.

RESULTS: A total of 21 studies were included, comprising 859 patients. The population was mostly male (52%), with a mean follow-up of 4.6 ± 3.14 years. Diplopia and strabismus were assessed in only five studies, yet they were the most reported ocular manifestations, with a prevalence of 50.74% (CI: 36.73-65.61; I² = 10%). Anterior segment findings, including conjunctivitis, keratitis, and cataracts, had a pooled incidence of 23.76% (CI: 13.83-37.71; I² = 76%). Ten studies analyzed posterior segment findings, which included retinitis, chorioretinitis, neuroretinitis, posterior uveitis, intermediate uveitis, and retinal vasculitis, resulting in an overall prevalence of 19.66% (CI: 7.87-41.23; I² = 74%). Third cranial nerve palsy was found in 18.65% of the cases (CI: 8.91-34.95; I² = 62%), while optic nerve findings were present in 10.76% of the cases (CI: 5.43-20.22; I² = 24%).

CONCLUSION: The results of this systematic review and meta-analysis including over 859 patients suggest that ocular findings in Lyme disease such as conjunctivitis, anterior uveitis, strabismus and diplopia) are common and should raise the suspicion of infection even before serological diagnosis.

PMID:41546697 | DOI:10.1007/s00417-025-07110-2

Eur J Clin Pharmacol. 2026 Jan 17;82(2):28. doi: 10.1007/s00228-025-03935-2.

ABSTRACT

BACKGROUND: Hemodynamic instability during colonoscopy sedation remains a significant clinical concern. Esketamine’s sympathomimetic properties may protect against these risks while reducing sedative requirements. Hence, we aim to evaluate the efficacy and safety of esketamine in improving intraprocedural sedation during colonoscopy.

METHODS: We systematically searched PubMed, Scopus, CENTRAL, and Web of Science until June 2025 for randomized controlled trials. The primary outcome was the incidence of intraprocedural hypotension; secondary outcomes included bradycardia, hypoxemia, and recovery parameters. Dichotomous outcomes were pooled using risk ratios (RR) and continuous outcomes using standardized mean differences (SMD), with heterogeneity assessed via I² statistics.

PROSPERO ID: CRD420251105691.

RESULTS: Five randomized controlled trials comprising 858 patients were included in our analysis. Esketamine significantly reduced the risk of intraprocedural hypotension (RR: 0.34, 95% CI 0.22-0.53; I²=58%) and the incidence of hypoxemia (RR: 0.38, 95% CI 0.19-0.73; I²=0%). A reduction in injection pain was also observed (RR: 0.42, 95% CI 0.19-0.97; I²=80.5%), though this finding showed sensitivity in leave-one-out analysis. No significant differences were found between groups in bradycardia risk (RR: 0.51, 95% CI 0.23-1.14), total propofol requirement (SMD: -0.23, 95% CI -0.50 to 0.04), induction time, or procedure duration. The reduction in hypotension remained robust in sensitivity analyses.

CONCLUSION: Esketamine significantly enhanced hemodynamic stability and reduced sedative demand during colonoscopy without delaying recovery, supporting its use in high-risk patients.

PMID:41546692 | DOI:10.1007/s00228-025-03935-2

Clin Infect Dis. 2026 Jan 17:ciag027. doi: 10.1093/cid/ciag027. Online ahead of print.

ABSTRACT

BACKGROUND: Conventional hospital antibiograms summarize aggregated resistance rates, limiting their utility for individualized antimicrobial selection. Existing statistical and machine learning models predict each phenotype separately, ignoring correlations among resistance profiles. We developed novel multi-task extreme gradient boosting (XGBoost) models utilizing structured data in electronic health records (EHRs) to predict resistance to eight antimicrobial classes simultaneously and evaluated their performance within the Veterans Health Administration (VHA).

METHODS: We conducted a retrospective multicenter study of Escherichia coli and Klebsiella spp. isolates collected at 127 hospitals and >1,400 clinics from January 2017 to September 2024. Data from January 2017 to September 2023 were used for model development, while data from October 2023 to September 2024 were used for simulated prospective testing. Model performances were compared to hospital antibiograms and single-target XGBoost models.

RESULTS: The training cohort included 536,252 E. coli and 246,898 Klebsiella spp. isolates; the test cohort included 75,138 and 38,015 isolates, respectively. On the test data, the multi-task model achieved overall areas under the receiver operating characteristic curve (AUROCs) of 0.779 (E. coli) and 0.810 (Klebsiella spp.), with good to excellent per-class performance (AUROCs range: 0.743-0.847). A multi-task approach improved calibration and decreased false negative rates for carbapenem resistance, while predicting individualized resistance probabilities for all target antimicrobials simultaneously (“personalized antibiograms”).

CONCLUSIONS: A multi-task XGBoost framework can accurately predict individualized resistance profiles for common Gram-negative pathogens, outperforming conventional antibiograms and single-target models. Personalized antibiograms may enhance the selection of empiric therapy, including the detection of carbapenem resistance in low-endemicity settings.

PMID:41546531 | DOI:10.1093/cid/ciag027

Cell Transplant. 2026 Jan-Dec;35:9636897251410650. doi: 10.1177/09636897251410650. Epub 2026 Jan 17.

ABSTRACT

Recent years have witnessed rapid advancements in 3D bioprinting and the widespread application of mesenchymal stem cells (MSCs) across various medical disciplines. The synergistic integration of 3D bioprinting and MSCs has opened innovative avenues for tissue engineering and regenerative medicine, particularly in bone tissue repair and regeneration. However, the progress of 3D bioprinting in the field of MSCs research still requires further exploration, and there remains a scarcity of related bibliometric analyses in this domain. With the aim of addressing this existing gap, this research systematically searched the Web of Science Core Collection for publications spanning from January 2003 to October 2025. It employed CiteSpace for cluster and evolution analysis, VOSviewer for collaboration network and keyword co-occurrence analysis, and the R package “bibliometrix” for statistical evaluation of bibliometric indicators. This bibliometric analysis focused on tissue engineering research integrating 3D bioprinting with MSCs, encompassing 1,846 original articles. These articles were authored by 10,276 researchers from 2,024 institutions across 69 countries and published in 342 academic journals. From 2014 to 2023, the number of annual publications exhibited a fluctuating yet rapid upward trend. China and the United States emerged as the most influential countries, with China experiencing a particularly substantial increase in research output-though international collaborations among institutions and authors remained limited. Wu C.T. and Bose S. stood out as key contributors to this field, while journals such as Biomaterials and Biofabrication have significantly advanced the discipline. High-frequency keywords including “3D printing” and “tissue engineering” reflected the core research directions, whereas emerging terms such as “MSC-EVs” and “nanocomposites” indicated current frontiers; in addition, “bioink,” “3D scaffold,” “osteogenesis,” and “angiogenesis” represented areas gaining growing research attention. Overall, this bibliometric study provides a thorough overview of the research tendencies and developments related to 3D bioprinting in the MSC field.

PMID:41546527 | DOI:10.1177/09636897251410650

Public Health Rep. 2026 Jan 17:333549251406108. doi: 10.1177/00333549251406108. Online ahead of print.

ABSTRACT

OBJECTIVES: Nonprobability sampling, commonly used in disaster research, can lead to incorrect estimates or limit the generalizability of results. We collected data through the Texas Flood Registry (TFR) and used raking and propensity score weighting to provide insight into the effect of Hurricane Harvey (hereinafter, Harvey) on Harris County, Texas.

METHODS: From April 2018 through October 2020, residents of areas affected by Harvey enrolled in the TFR completed a survey on their storm-related experiences (n = 20 653). Using logistic regression, we assessed the relationship between Harvey-related exposures and distress among Harris County residents (n = 12 279). We used raking to adjust the sample distribution to reflect demographic characteristics of Harris County and propensity scores to address confounding.

RESULTS: Of respondents, 56% and 43% reported home damage and income loss due to Harvey, respectively. From April 2018 through April 2020, respondents completed the Impact of Event Scale questionnaire (n = 10 631), with 23% reporting symptoms consistent with severe distress related to Harvey. The raking-adjusted odds ratio of greater Harvey-related distress was 6.21 (95% CI, 5.44-7.09) times higher among residents who had home damage than among those who did not and 2.92 (95% CI, 2.59-3.30) times higher among those who had economic loss than among those who did not.

CONCLUSIONS: We found consistent associations between adverse storm experiences and Harvey-related distress across unweighted and weighted approaches. We recommend using raking to adjust a nonprobability sample to better reflect population demographic characteristics and obtain general trends of postdisaster exposures and outcomes. We recommend using propensity scores when outcomes may be related to unmeasured confounding.

PMID:41546479 | DOI:10.1177/00333549251406108

J Pers. 2026 Jan 17. doi: 10.1111/jopy.70047. Online ahead of print.

ABSTRACT

INTRODUCTION: Network analysis is a statistical tool for understanding interrelations between symptoms and the relative importance of symptoms in a disorder. This is especially appealing to psychopathy researchers, as network analysis may provide some insights that bring the field closer to resolving debates about psychopathy-relevant features.

METHODS: In the present study (N = 612), we first conducted network analysis on the Triarchic Psychopathy Measure (TriPM) and subsequently conducted a scale-level analysis of psychopathic traits from seven psychopathy inventories.

RESULTS: In the TriPM network, we found that items from Meanness and Disinhibition were among the most central. Meanness items assessing deficits in empathy were highly influential nodes in the network, but also demonstrated significant topological overlap. Boldness items were less central but still important to the TriPM network. Scales indexing impulse control problems, affective deficits, and interpersonal dominance were among the most influential in the domain-level network. This included measures of callousness, impulsiveness, and need for stimulation, and grandiosity and manipulativeness.

CONCLUSION: Despite concerns about the application of network analysis to cross-sectional data, our results support the relevance of boldness, meanness, and disinhibition to the conceptualization and measurement of psychopathy.

PMID:41546477 | DOI:10.1111/jopy.70047

Orthod Craniofac Res. 2026 Jan 17. doi: 10.1111/ocr.70099. Online ahead of print.

ABSTRACT

To summarise the scientific evidence from systematic reviews on the differences between fixed functional appliances (FFA) with and without skeletal anchorage for the treatment of Class II malocclusion in growing patients. A systematic search on six major databases was performed. Primary outcomes were changes in Co-Gn, SNB angle and the lower incisor inclination. ROBIS tool to assess risk of bias and GRADE instrument to assess evidence quality were used. Mean differences (MD) or risk ratios (RR) with their 95% confidence intervals were calculated from random-effects meta-analyses. A total of 10 systematic reviews were identified, six at high risk of bias, three at unclear risk of bias and one at low risk of bias. The meta-analysis with only RCTs studies indicated that FFA with skeletal anchorage did not produce a statistically significant increase in Co-Gn (pooled MD = +1.37 mm, 95% CI from -0.88 to 3.62; p = 0.23, I² = 96%, three studies, GRADE low). No statistically significant differences were identified for SNB angle between FFA with and without skeletal anchorage (pooled MD = +0.31 degrees, 95% CI from -0.03 to 0.66; p = 0.08, I² = 51%, three studies, GRADE low). FFA with skeletal anchorage showed a statistically greater decrease for lower incisor inclination (pooled MD = -5.03, 95% CI from -8.49 to -1.58; p = 0.004, I² = 89%, four studies, GRADE low). Low evidence of findings from exclusively RCTs studies suggested that FFA with skeletal anchorage could reduce the lower incisor inclination with a greater percentage of complications. However, no significant differences were found for mandibular dimensions and mandibular protrusion between FFA with and without skeletal anchorage.

PMID:41546469 | DOI:10.1111/ocr.70099

Pediatr Blood Cancer. 2026 Jan 16:e70124. doi: 10.1002/1545-5017.70124. Online ahead of print.

ABSTRACT

BACKGROUND: We describe clinical and biologic characteristics of neuroblastoma in older children, adolescents, and young adults (OCAYA); describe survival outcomes in the post-immunotherapy era; and identify if there is an age cut-off that best discriminates outcomes.

METHODS: Patients diagnosed with neuroblastoma at ≥547 days between 2003 and 2022 from the International Neuroblastoma Risk Group Data Commons were compared by age subgroups. Recursive partitioning, dividing younger versus older at all monthly cut-points between 18 months and 15 years, was undertaken using Cox regression models of event-free survival (EFS), overall survival (OS), and OS post-relapse (OSPR). Kaplan-Meier curves of clinical/biologic subgroups were compared with log-rank tests.

RESULTS: 7,835 patients met inclusion criteria: 18 months to <5 years (n = 5841), 5 to <10 years (n = 1488), 10 to <15 years (n = 357), and ≥15 years (n = 149) at diagnosis. Younger patients were more likely to have MYCN amplification (18 months to 5 years: 31%; 5-10 years: 15%) than older (10-15 years: 8%; ≥15 years: 7%) (p < 0.0001), metastatic disease (p < 0.0001), and high mitosis-karyorrhexis index (MKI) (p < 0.0001) and less likely to have diploid tumors (p < 0.001). Repeatedly dichotomizing the cohort, younger patients had superior EFS and OS (p < 0.05) for all cut-offs ≤40 months (hazard ratios: 1.1-1.3). Among high-risk OCAYA (International Neuroblastoma Staging System [INSS] Stage 4; n = 5005 [64% of cohort]), those diagnosed 2010-2022 had superior EFS/OS versus 2003-2009 in each age group (p < 0.0001). OSPR remained poor for all OCAYA (5-year OSPR 14% ± 0.7%).

CONCLUSIONS: For patients ≥547 days old, any age cut-off ≤40 months discriminated younger (superior EFS/OS) versus older patients; no cut-off was optimal. OCAYA diagnosed 2010-2022 (post-immunotherapy era) had superior outcomes versus 2003-2009. Stratification by comprehensive molecular biomarkers will likely best inform novel therapeutic strategies for OCAYA.

PMID:41546455 | DOI:10.1002/1545-5017.70124