Category: Statistics

Diabetes Technol Ther. 2026 Jan 23:15209156251414976. doi: 10.1177/15209156251414976. Online ahead of print.

ABSTRACT

BACKGROUND: Automated insulin delivery (AID) systems integrate continuous glucose monitoring (CGM) and insulin pumps with algorithms that adjust insulin delivery. While randomized controlled trials (RCTs) demonstrate improvements in glycemic outcomes with AID, large-scale real-world data (RWD) analyses are needed to evaluate performance in routine care.

METHODS: This retrospective, registry-based cohort study included adults (≥18 years) with type 1 diabetes (T1D) in the Swedish National Diabetes Register (NDR) from 2014 to 2024. Hemoglobin (Hb)A1c values were averaged per person-year and aggregated by clinic. Insulin delivery/glucose monitoring combinations included multiple daily injections (MDIs) with blood glucose meter (MDI-BG), MDI with CGM (MDI-CGM, reference), conventional continuous subcutaneous insulin infusion with blood glucose meter (CSII-BG), CSII with CGM (CSII-CGM), and AID systems (Tandem Control-IQ technology, Medtronic 670G, and Medtronic 780G). Mixed-model regression assessed HbA1c outcomes, with treatment, year, age, diabetes duration, gender, body mass index, physical activity level, smoking habits, and clinic size as fixed effects; with random effects for clinics; and weighting by clinic sample size.

RESULTS: After adjusting for the covariates, AID systems were associated with significantly lower HbA1c compared with MDI-CGM: β = -4.0 mmol/mol (95% confidence interval [CI] -4.3 to -3.7, P < 0.001), with individual system effects, Tandem Control-IQ technology β = -4.8 mmol/mol (95% CI -5.2 to -4.5, P < 0.001), Medtronic 780G β = -3.1 (-3.5 to -2.7, P < 0.001), and Medtronic 670G β = -2.9 (95% CI -3.5 to -2.4, P < 0.001). CSII-CGM also outperformed MDI-CGM: β = -1.7 mmol/mol (95% CI -1.9 to -1.4, P < 0.001). Differences between the Tandem and Medtronic AID systems were significant (P < 0.001).

CONCLUSIONS: In a nationwide RWD analysis, AID use was consistently associated with clinically and statistically significant HbA1c reductions in adults with T1D, with the greatest effect for Tandem Control-IQ technology. These findings align with RCTs and international RWD, supporting AID as a preferred technology in routine diabetes care for T1D.

PMID:41574582 | DOI:10.1177/15209156251414976

Eval Rev. 2026 Jan 23:193841X261416558. doi: 10.1177/0193841X261416558. Online ahead of print.

ABSTRACT

Many evaluations of human services programs rely heavily on survey follow-up to collect outcome data from randomized controlled trials. Evidence clearinghouses will give their highest grade of evidence quality to such evaluations if attrition is low. Declining survey response rates, particularly in the control group, are making it more difficult for evaluators to meet this clearinghouse standard. Hendra and Hill (2019) suggested that it might be better to settle for substantially lower response rates, finding that the pursuit of high target response rates adds time and money while reducing nonresponse bias little if at all. This paper reports on a new approach to boosting response rates that allows reluctant respondents to complete a shortened version of the data collection instrument. Although the method is effective at increasing the response rate and costs less than traditional approaches for boosting response rates, this paper suggests that the data collected from reluctant respondents with the new method probably did not substantially reduce nonresponse bias on impacts, a finding broadly consistent with that of Hendra and Hill. On the other hand, the method did find some important differences in the means of some outcomes within the study arms, a finding that is could be important for descriptive surveys.

PMID:41574576 | DOI:10.1177/0193841X261416558

Cyberpsychol Behav Soc Netw. 2026 Jan 23:21522715261416232. doi: 10.1177/21522715261416232. Online ahead of print.

ABSTRACT

Neuromuscular diseases (NMDs) cause the loss of motor, communicative, and swallowing skills resulting in a decreased quality of life. Among these, rehabilitation plays a crucial role, and virtual reality (VR), with its potential for immersive digital experiences, could significantly contribute to enhancing rehabilitation outcomes. The aim of this observational study was to assess changes in the emotional-affective states of hospitalized patients with NMDs who participated in an immersive VR recreational experience. Patients ≥ 16 years with an NMD clinical and/or genetic diagnosis, underwent a recreational VR experience and completed a set of pre and post questionnaires assessing mood, positive (PA) and negative affects (NA), state anxiety, emotional state, and emotional response. Thirty-eight patients were enrolled. PANAS reported significant changes between pre and post VR: an improvement in PA (Δ: 6.79 ± 6.30, Cohen’s d: 1.20, p < 0.0001) and a decrease in NA (Δ: -7.11 ± 6.29, Cohen’s d: 1.38, p < 0.0001). No statistically significant difference emerged comparing changes over-time by stratifying for age, gender, education, anxiety and depression levels. Moreover, state anxiety significantly decreased (Δ: -3.95 ± 6.15, Cohen’s d: 0.57, p < 0.0001) and emotional state significantly improved after exposure to VR (Δ: 0.63 ± 2.14, Cohen’s d: 0.29, p = 0.0004). Finally, Self-Assessment Manikin showed that VR elicited low levels of arousal (3.87 ± 3.46) and high levels of pleasure (8.37 ± 1.81) and dominance (8.37 ± 1.88). This study highlights the potential of VR technology as a valuable tool during the hospitalization of NMD patients.

PMID:41574556 | DOI:10.1177/21522715261416232

CNS Neurol Disord Drug Targets. 2026 Jan 14. doi: 10.2174/0118715273423680251125073602. Online ahead of print.

ABSTRACT

INTRODUCTION: Sodium-glucose transport protein 2 (SGLT-2) inhibition regulates neuronal excitability by shifting glucose metabolism toward ketone utilization and by reducing oxidative stress and inflammation. Based on these mechanisms, this study investigated the anticonvulsant and anti-inflammatory effects of empagliflozin, a SGLT-2 inhibitor with neuroprotective properties, in a penicillin-induced epilepsy model.

METHODS: Thirty-five adult male Wistar rats were randomly divided into five groups (n = 7/group): sham, control (penicillin only), empagliflozin (10 mg/kg), diazepam (5 mg/kg), and empagliflozin + diazepam. Penicillin (500 IU) was administered intracortically to induce focal epileptiform activity. Electrocorticography (ECoG) recordings were obtained for 180 minutes to assess seizure latency, spike-wave frequency (SWF), and amplitude. Serum and cortical tissue levels of TNF-α, IL-6, and HMGB-1 were quantified using enzyme-linked immunosorbent assay (ELISA).

RESULTS: All treatment groups exhibited a statistically significant increase in latency to the first epileptiform activity compared to the control group. The empagliflozin group showed a marked reduction in SWF between 30 and 180 minutes, particularly during the 121-180-minute period. Tissue TNF-α levels were significantly lower in the empagliflozin + diazepam group compared to the control. Tissue IL-6 levels were lowest in the empagliflozin-only group, whereas serum IL-6 levels were significantly reduced in the combined treatment group. No significant differences in HMGB-1 levels were observed across groups.

DISCUSSION: Empagliflozin demonstrated anticonvulsant and anti-inflammatory effects by delaying seizure onset, reducing SWF, and modulating pro-inflammatory cytokine levels.

CONCLUSION: Empagliflozin demonstrated anticonvulsant and anti-inflammatory effects by delaying seizure onset, reducing SWF, and modulating pro-inflammatory cytokine levels. These findings suggest that empagliflozin may have therapeutic potential in epilepsy through SGLT-2 inhibition.

PMID:41574536 | DOI:10.2174/0118715273423680251125073602

Emergencias. 2025 Dec;37(6):427-432. doi: 10.55633/s3me/094.2025.

ABSTRACT

OBJECTIVE: In 2022, a retrospective analysis was conducted in public hospitals in the Community of Madrid (Spain) without transplant programs. The aim was to evaluate the loss of potential donors with catastrophic brain injury.

METHODS: We used clinical and administrative databases (CMBD, CORE-ONT, and HORUS). Deceased patients with compatible diagnoses according to ICD-10 were included, excluding those with active tumor disease. Relevant clinical variables were analyzed, and patients were categorized into 3 groups: evaluated as donors, ineligible as donors, and potential donors not evaluated. Statistical analysis included univariate techniques and a multivariate analysis using categorical principal components analysis (CATPCA).

RESULTS: Out of 1,429 deceased patients, 12 evaluated donors, 39 ineligible donors due to medical criteria, and 33 potential donors who were not evaluated were identified. This last group represents a significant loss in donation potential. Most effective donors were patients younger than 70 years admitted to hospitals with neurosurgery, in intensive care units, with prolonged mechanical ventilation, and without severe organ failure. In contrast, non-donors presented higher rates of comorbidities such as septic shock or renal failure. Multivariate analysis via CATPCA identified a total of 3 patient patterns and highlighted a significant group of missed potential donors.

CONCLUSIONS: These findings reinforce the need to implement strategies to improve early donor detection, such as emergency department staff training, inter-hospital collaboration, and use of technological tools. The study concludes that a structured intervention could significantly reduce donor loss in non-transplant centers.

PMID:41574511 | DOI:10.55633/s3me/094.2025

Proc Inst Mech Eng H. 2026 Jan 23:9544119251412486. doi: 10.1177/09544119251412486. Online ahead of print.

ABSTRACT

Talar replacement procedures offer good clinical outcomes for patients experiencing talar osteonecrosis with collapse. However, there is a potential for cartilage wear as the artificial talus prosthesis articulates against the native articular cartilage (AC) in the ankle joint. Therefore, this study investigated the wear of AC against candidate implant biomaterials with the aim of selecting an appropriate material for use in talar replacement procedures. Cobalt chrome alloy (Co-28Cr-6Mo), titanium alloy (Ti-6Al-4V), ultra-high molecular weight polyethylene (UHMWPE), industrial grade natural polyether ether ketone (PEEK), and polycarbonate-urethane (PCU) were tested against porcine AC submerged in bovine serum using an in vitro customized dual-motion wear testing setup. A total of 43,200 cycles at a frequency of 3 Hz were completed for each test. Both macroscopic and microscopic analyses were used to quantify cartilage wear using the Outerbridge and Osteoarthritis Research Society International (OARSI) clinical grading systems, respectively. In the macroscopic analysis, Ti-6Al-4V demonstrated the most AC wear, followed by Co-28Cr-6Mo, PEEK, UHMWPE, and PCU. In the microscopic analysis, PEEK demonstrated the most AC wear, followed by Ti-6Al-4V, Co-28Cr-6Mo, UHMWPE, and PCU. PCU demonstrated the least amount of AC wear compared to all other biomaterials and showed statistically insignificant differences with the control group (porcine cartilage-on-cartilage) in both macroscopic and microscopic inspections. These results suggest that PCU may be a suitable candidate material for coating talus implants as it demonstrated superior AC wear performance compared to the other biomaterials investigated in this study.

PMID:41574491 | DOI:10.1177/09544119251412486

Geriatr Gerontol Int. 2026 Jan;26(1):e70354. doi: 10.1111/ggi.70354.

ABSTRACT

AIM: Calf circumference (CC) is a simple surrogate marker of muscle mass. Body mass index (BMI) adjustment and age-specific cutoffs for low CC have been proposed to optimize its use in clinical practice. This study aimed to clarify the association of BMI-adjusted CC and age-specific cutoffs with in-hospital falls among older adults.

METHODS: This study was conducted using data from the Japan Hospital Acquired Complications (J-HAC) project, a multicenter cohort study. In this analysis, we included adults aged ≥ 65 years. CC was measured on admission, and the occurrence of falls was assessed and recorded by medical personnel throughout the hospitalization. BMI adjustment and age-specific cutoffs for low CC were applied based on previous studies. Multivariable logistic regression models were developed to examine the association between in-hospital falls and BMI-adjusted CC and age-specific low CC cutoffs, adjusting for age and comorbidities.

RESULTS: A total of 808 patients (mean age 83.7 ± 6.6 years, 57.2% females) were analyzed. In females, higher BMI-adjusted CC was significantly associated with a lower risk of in-hospital falls after adjusting for age and comorbidities (adjusted OR = 0.88, 95% CI: 0.77-0.998). Furthermore, low BMI-adjusted CC, as defined by age-specific cutoff values, was independently associated with an increased fall risk in the multivariable model (adjusted OR = 2.39, 95% CI: 1.03-5.54). In contrast, no significant associations were observed in males regardless of CC adjustment or cutoff criteria.

CONCLUSIONS: BMI-adjusted CC and age-specific cutoffs showed a stronger association with in-hospital falls among older females than unadjusted CC. Further validation in diverse populations and outcomes is required to confirm their usefulness.

PMID:41574473 | DOI:10.1111/ggi.70354

Aging Ment Health. 2026 Jan 23:1-13. doi: 10.1080/13607863.2026.2614952. Online ahead of print.

ABSTRACT

OBJECTIVES: Positive aspects of caregiving (PAC) are assumed to protect against caregiver suffering, but evidence is lacking. Two studies examined this assumption through testing the reciprocal causality between PAC and burden/depression, and exploring the mechanisms linking these constructs.

METHODS: MethodsIn Study One, 99 dementia caregivers were interviewed six months apart. In Study Two, 45 caregivers provided 620 diaries across eight weeks.

RESULTS: In Study One, baseline burden predicted increased depressive symptoms, whereas baseline depressive symptoms predicted less PAC. Although burden was unrelated to PAC concurrently, burden was found to strengthen PAC after depression was controlled for (statistical suppression). Contrary to prevailing assumption, PAC predicted neither burden nor depression. In Study Two, 213 of the 620 diaries contained narratives linking burden to PAC. Supporting the PAC-enhancing role of burden, four mechanisms were extracted using thematic analysis, describing unrelenting caregiving stress enriching the significance of their work and pressuring them to learn, to push beyond boundaries, and to transform thinking.

CONCLUSION: Chronic hardship may be a breeding ground for positive meanings, yet also increasing depression, undermining positivity. Consequently, burden has a direct positive effect, but an indirect negative effect via depression, on PAC. A conceptual model depicting such complex dynamics is proposed.

PMID:41574438 | DOI:10.1080/13607863.2026.2614952

Aging Ment Health. 2026 Jan 23:1-10. doi: 10.1080/13607863.2026.2612734. Online ahead of print.

ABSTRACT

OBJECTIVES: The COVID-19 pandemic has exacerbated loneliness among older adults. This study evaluates the relationship between loneliness, depression, and suicidal ideation in this population during the early pandemic by utilizing data from the All of Us (AoU) Research Program.

METHOD: We analyzed cross-sectional data from 17,084 individuals aged ≥65 enrolled in the AoU Research Program who completed a COVID-19 related survey in May 2020. Participants were categorized into loneliness quartiles based on their UCLA Loneliness Scale Short Form-8 scores. Descriptive statistics and chi-square tests assessed demographic differences. Poisson regression models with robust standard errors tested associations between loneliness quartiles and both depression and suicidal ideation, adjusting for age, gender, race, ethnicity, education, marital status, employment status, housing status, health insurance status, and social support.

RESULTS: Among 17,084 participants (mean age 72.0 years [SD 5.3], 55% female, 89% White), we found a clear stepwise pattern: as loneliness increased, so did the risk of depression and suicidal ideation. Compared to the lowest loneliness quartile, those in the highest loneliness quartile were approximately 25 times more likely to experience moderate-to-severe depression (adjusted relative risk [aRR] = 25.09, 95% CI: 16.63-37.84) and 44 times more likely to report suicidal ideation (aRR = 44.31, 95% CI: 19.69-99.71). Intermediate loneliness levels (quartiles 2-3) also showed elevated risks (depression aRRs: 2.45, 7.33; suicidal ideation aRRs: 4.03, 11.87).

CONCLUSION: Increasing levels of loneliness were associated with greater risk of depression and suicidal ideation among older adults during the early pandemic, underscoring the need for targeted loneliness interventions for this vulnerable population.

PMID:41574431 | DOI:10.1080/13607863.2026.2612734

J Food Sci. 2026 Jan;91(1):e70831. doi: 10.1111/1750-3841.70831.

ABSTRACT

Milk adulteration is a threat to food safety and public health. It is especially tricky in regions where getting quick, inexpensive tests is not always an option. To tackle this, we have come up with a simple, affordable approach. It uses easy image analysis combined with machine learning to detect common adulterants in milk. Instead of relying on laboratory equipment, all we need are straightforward optical images-just photos of milk samples. From there, we look for clues that indicate contamination, making the whole process more accessible and practical. We had taken digital photographs of milk samples mixed with water, detergent, starch, and synthetic milk. From these images, we found key statistics: the average brightness, how much it varies, and higher order features like skewness and kurtosis. These help us understand how the light scattering and turbidity change as adulterants are added. Using principal component analysis (PCA), we simplified the data, and then support vector machines (SVMs) helped classify that samples were adulterated versus pure. The results were not perfect, but they were promising. Our model hit about 85% accuracy in identifying adulteration across the different types and amounts of contaminants. In particular, adding water made the mean intensity increase, whereas detergent, starch, and synthetic milk each produced unique patterns in skewness and kurtosis due to their scattering effects. Compared to expensive spectroscopic solutions, this approach is faster, does not require chemicals, and is economical, making it ideal for quick checks, even right at the point of sale or in rural areas.

PMID:41574420 | DOI:10.1111/1750-3841.70831