Category: Statistics

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

J Rural Health. 2026 Jan;42(1):e70112. doi: 10.1111/jrh.70112.

ABSTRACT

PURPOSE: Rural hospitals face persistent financial challenges that often threaten their survival. To address this, the 2023 “Rural Emergency Hospital” (REH) designation offers Critical Access Hospitals and hospitals with fewer than 50 beds enhanced Medicare reimbursement and annual facility payments if they discontinue inpatient services while maintaining outpatient care and a 24-hour emergency department. This study evaluates the characteristics of hospitals that choose REH conversion and examines the perceived community impact of the change.

METHODS: We analyze Centers for Medicare & Medicaid Services cost report data to compare converting hospitals to eligible nonconverting hospitals. We also conduct a content analysis of 33 news articles and phone interviews with local rural residents to assess how REH conversions are presented in the media and perceived in communities.

FINDINGS: Hospitals that converted to REH status had low inpatient volumes, occupancy rates, and revenues, suggesting they were positioned to benefit financially from eliminating inpatient services. Content analysis revealed that news articles were primarily neutral in tone (54.5%), with most (90%) describing the financial benefits of conversion. Interviews with rural residents highlighted negative perceptions of local health care and revealed that many preferred not to use their local REH even when available.

CONCLUSIONS: REH designation may provide financial lifelines to rural hospitals with declining inpatient demand, but community skepticism and limited willingness to use REHs may constrain their role in sustaining health care access. The long-term effectiveness of this policy may depend on addressing both financial viability and community trust in rural health care delivery.

PMID:41546444 | DOI:10.1111/jrh.70112

Am J Sports Med. 2026 Jan 16:3635465251399208. doi: 10.1177/03635465251399208. Online ahead of print.

ABSTRACT

BACKGROUND: There is no consensus regarding the appropriate indications for the addition of lateral extra-articular tenodesis (LET) to anterior cruciate ligament (ACL) reconstruction (ACLR).

PURPOSE: To determine if incomplete correction of the pivot shift during ACLR is an appropriate intraoperative indication to add the LET, in terms of clinical outcome.

STUDY DESIGN: Cohort study; Level of evidence, 3.

METHODS: From January 2018, incomplete correction of the pivot shift relative to the contralateral knee was used as the indication to add LET to ACLR. Patients presenting before this date comprised group A and those after group B. Study criteria included first-ever ACL rupture, participating in pivoting sports, no other significant ligament injury, and surgery within 3 months of injury. Outcomes of interest were recurrent instability, meniscal tears, and patient-reported outcome measures (PROMs): Tegner activity score (TAS), Knee injury and Osteoarthritis Outcome Score subscales for sport and recreation (sport/rec) and knee-related quality of life, subjective International Knee Documentation Committee score, and Lysholm knee score. Statistical analysis was performed.

RESULTS: Group A (2258 patients; 51% male) and group B (2497 patients; 58% male) were similar regarding age, body mass index, knee dominance, time to surgery, graft diameter, and preinjury TAS (P > .05). Group A had a lower male-to-female ratio (P < .05) and lower posterior tibial slope (P = .01). After 2 years, group A had a higher incidence of ACL rerupture than group B (101/2258 [4.5%] vs 75/2497 [3%]; P = .01), with a significant sex and group interaction (P = .04). Males in group A (4.4%) had a higher rate of recurrence than males in group B (2.4%) at 2 years (P = .03), while in females the rate of recurrence was similar (4.5% vs 3.8%; P = .42). Group A had a higher incidence of experiencing a subsequent ipsilateral meniscal tear (58/2258 [2.6%] vs 35/2497 [1.4%]; P = .02). All PROMs were similar (P > .05). Pivot-shift grade before surgery did not correlate with risk of recurrence (P = .991). Uncorrected residual pivot shift was associated with a higher ACL graft rupture rate (P < .001).

CONCLUSION: Using incomplete correction of the pivot shift during ACL surgery as the primary indication to perform LET is associated with lower rates of recurrent ACL rupture, and ipsilateral meniscal tears. Pivot-shift grade before surgery was not associated with risk of recurrence, while residual pivot shift after surgery was.

PMID:41546441 | DOI:10.1177/03635465251399208

Psychophysiology. 2026 Jan;63(1):e70235. doi: 10.1111/psyp.70235.

ABSTRACT

Sighing generates a reliable sympathetic cardiovascular response that, like exercise, could be leveraged in a graded “stress test” to reveal preclinical changes in cardiovascular health and stress reactivity. This study presents the fixed-interval volitional sighing (FIVS) protocol, which rhythmically paces sighs at different frequencies to systematically load the cardiovascular system. Cardiovascular and autonomic responses during the FIVS protocol were statistically dissected to independently characterize physiological responses. Sex differences were explored as a preliminary step toward characterizing factors that affect sigh reactivity. Healthy college students (n = 250, 65% female) completed a baseline task and two sighing tasks: a longer inter-sigh interval task (1 sigh per 30 s, long interval), followed by a shorter inter-sigh interval task (1 sigh per 15 s, short interval). Heart rate (HR), blood pressure, and respiration were continuously measured. Mixed models with a priori cardiorespiratory assumptions isolated HR, low-frequency heart rate variability (LF-HRV), high-frequency HRV (HF-HRV), pulse transit time variability (PTTv), mean arterial pressure (MAP), low-frequency blood pressure variability (LF-BPV), and high-frequency BPV (HF-BPV) responses to the sighing tasks. HR, LF-HRV, PTTv, MAP, and LF-BPV increased significantly from baseline to both sighing tasks, with greater changes observed during short-interval sighing. HF-BPV increased similarly from baseline to both sighing tasks. HF-HRV decreased only during the short-interval sighing task. Males exhibited greater increases than females in HR, LF-HRV, LF-BPV, HF-BPV, and PTTv but smaller decreases in HF-HRV in response to sighing. Volitional sighing elicits cardiac, vascular, and autonomic responses consistent with sympathetic activation. As time under load and loading intensity increased, greater responses were observed in several vascular and sympathetic indices. Sex differences suggest that the FIVS protocol can detect person-specific differences in cardiovascular responding. Sighing is physically accessible for most people, and the FIVS protocol may be useful as a stress test to detect early-stage cardiovascular or autonomic dysfunction.

PMID:41546440 | DOI:10.1111/psyp.70235