Category: Statistics

J Alzheimers Dis. 2026 Mar 10:13872877261424407. doi: 10.1177/13872877261424407. Online ahead of print.

ABSTRACT

BACKGROUND: Dementia rates have accelerated in recent decades, yet our ability to screen for and predict who is at risk remains limited. The Montreal Cognitive Assessment (MoCA) and the Alzheimer’s Disease Assessment Scale-Cog-13 item (ADAS-Cog-13) are common screeners that provide insight into early dementia progression. However, how these tools relate to biomarkers and psychological predictors before formal diagnosis is unclear.

OBJECTIVE: This study examines associations between biological and psychological factors with MoCA and ADAS-Cog-13 scores to guide clinicians in selecting the most informative screener for specific dementia risk profiles.

METHODS: Zero-order correlations and Classification and Regression Trees were conducted using data from the ADNI-DOD database, comprising high-risk veterans without baseline dementia.

RESULTS: MoCA scores were primarily associated with biomarker predictors and depression, whereas ADAS-Cog-13 scores were primarily associated with post-traumatic stress disorder diagnoses.

CONCLUSIONS: Cognitive screeners tailored to brief psychological and medical histories may improve early detection of cognitive decline and Alzheimer’s disease.

PMID:41804748 | DOI:10.1177/13872877261424407

Int J Surg Pathol. 2026 Mar 10:10668969251412915. doi: 10.1177/10668969251412915. Online ahead of print.

ABSTRACT

Testis torsion is a scrotal emergency in which parenchymal damage cannot be accurately predicted. This situation leads to atrophy in the follow-up of patients who underwent orchidopexy, and potentially reversible injury can be detected in the orchiectomy series. This study aimed to find answers to questions about the accurate detection of testes with potentially reversible injury. The testes of patients who underwent orchiectomy due to testis torsion under the age of 35 (n = 54) were re-examined. Considering the vascular anatomy of the testis, necrotic changes in the epididymal, anti-epididymal, and central regions were scored from grade 1 to 3. The necrosis score was obtained by multiplying the degree and percentage of necrotic areas. Potentially reversible injury (Grade 1) was detected in 10 (18%) testes, and 3 of them had partial necrotic changes. Grade 1 injury could be detected after a symptom duration of up to 168 h, while grade 3 could be observed after as short as 6 h. The median symptom duration of Grade 3 necrosis was higher than that of Grade 1 and Grade 2, but this difference was not statistically significant (P = .066). Testis pain, swelling, and abdominal pain were most commonly seen in high-grade injuries (P = .047). The highest necrosis scores were observed in the central region of the testes, followed by the epididymal and anti-epididymal side (P = .035). Clarification of the injury pattern of the twisted testes will allow a more accurate estimation of parenchymal damage and salvage ability.

PMID:41804737 | DOI:10.1177/10668969251412915

Am J Rhinol Allergy. 2026 Mar 10:19458924261428330. doi: 10.1177/19458924261428330. Online ahead of print.

ABSTRACT

BackgroundOlfactory dysfunction (OD) is a significant symptom in non-eosinophilic chronic rhinosinusitis with nasal polyps (neCRSwNP), but its non-type 2 inflammation-driven mechanisms remain unclear.ObjectiveTo investigate the roles of local nasal non-type 2 inflammatory cytokines and systemic immune indicators in neCRSwNP-associated OD.MethodsSeventy-nine neCRSwNP patients were enrolled and divided into neCRSwNP with OD (neCRSwNP-wOD, n = 49) and neCRSwNP without OD (neCRSwNP-woOD, n = 30) groups. Olfactory function was assessed using the T&T Olfactometer. Nasal mucus cytokines (IFN-γ, TNF-α, IL-1β, IL-17) were measured by ELISA. Peripheral blood inflammatory indicators including absolute neutrophil count (Neut), neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), were analyzed. Statistical methods included the Mann-Whitney U test, Spearman correlation analysis, multivariate logistic regression, and ROC curve analysis.ResultsNasal IFN-γ and IL-17 levels were significantly elevated in the OD group (both P < 0.05), while TNF-α and IL-1β showed no difference. Patients with OD also exhibited higher Neut, NLR, and SII (all P < 0.05). Olfactory scores strongly correlated with Neut (r = 0.639, P < 0.01) and moderately with IFN-γ (r = 0.533, P < 0.01). Multivariate regression identified IFN-γ, IL-17, and Neut as independent risk factors for OD. ROC analysis indicated that Neut had the highest predictive accuracy (AUC = 0.839), and a combined model of three indicators (Lund-Kennedy score, IL-17 and Neut) achieved excellent diagnostic performance (AUC = 0.964).ConclusionOlfactory dysfunction in neCRSwNP is associated with the combined involvement of local Th1/Th17 pathway activation (IFN-γ/IL-17) and neutrophil-mediated systemic inflammation. IFN-γ, IL-17, and peripheral blood neutrophils may be involved in the development of olfactory dysfunction in neCRSwNP.

PMID:41804729 | DOI:10.1177/19458924261428330

Iran J Immunol. 2026 Mar 10;23(1). doi: 10.22034/iji.2026.109210.3127.

ABSTRACT

BACKGROUND: Miscarriage occurs when a pregnancy ends spontaneously before the fetus is viable outside the uterus. Early miscarriage, sometimes referred to as first-trimester miscarriage, happens before 12 weeks. Vascular endothelial growth factor (VEGF), an angiogenic protein essential for blood vessel formation, and cluster of differentiation 68 (CD68), a marker of macrophages, are vital to the immune response.

OBJECTIVE: This research aimed to evaluate VEGF and CD68 expression patterns in placental tissues and decidua from first-trimester miscarriage, to ascertain their potential roles in immune response and angiogenesis in miscarriage.

METHODS: The study included 60 women who experienced spontaneous abortion during the first trimester, 30 with missed abortion, and 30 with incomplete abortion. Using immunohistochemical staining, the expression of CD68 and VEGF in decidua and placental tissues was investigated. Expression levels were scored semi-quantitatively by averaging data from five fields per slide and subjected to statistical analysis.

RESULTS: Building on these methods, immunohistochemical staining confirmed significantly elevated CD68 expression in both placental and decidua tissues from missed and incomplete abortions, indicating enhanced macrophage infiltration. Widespread staining (>50%) was seen in 50% of incomplete abortion decidua and 30% of missed abortion tissues. In contrast, VEGF expression was predominantly negative across all samples, with no case showing positive staining, indicating impaired angiogenesis.

CONCLUSION: The findings highlight a dual pathological mechanism in early miscarriage characterized by enhanced inflammatory macrophage infiltration and deficient angiogenic support. This imbalance may contribute to placental dysfunction and pregnancy failure. These results underscore the potential diagnostic and therapeutic relevance of immune-angiogenic pathways in early miscarriage.

PMID:41804715 | DOI:10.22034/iji.2026.109210.3127

J Pediatr Orthop. 2026 Mar 10. doi: 10.1097/BPO.0000000000003250. Online ahead of print.

ABSTRACT

INTRODUCTION: Pediatric buckle fractures are common. These are often referred to as orthopaedic surgery offices, despite evidence that specialty evaluation is unnecessary. Here, we sought to determine if the provision of an educational video instead of an in-person visit with an orthopaedic provider would be non-inferior for patient-reported outcomes and demonstrate improvement in other outcomes, such as patient, caregiver, and provider time spent on caring for this injury.

METHODS: This was a single-center, prospective, randomized controlled, non-inferiority trial of 41 patients with distal radius buckle fractures. The video group was emailed a 1.5-minute educational video and did not have any in-person visits with an orthopaedic provider. The in-person group had a standard in-person visit. Patients were followed over 6 weeks. A non-inferiority analysis was performed using the Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Short Form v2.0-Upper Extremity 8a. Other outcome measures were collected for satisfaction, time spent on healthcare activities, missed time from work/school, and provider time spent delivering care.

RESULTS: Compared with the in-person group, the video group demonstrated a non-inferior PROMIS score improvement from baseline to 6 weeks post-injury. Both groups were overall satisfied with their care, with no statistically significant difference. Patients and caregivers in the video group spent significantly less mean±SD time on healthcare activities aside from learning (video: 59.8±54.1 min vs. in-person: 144.1±95.2 min; P=0.002), had less time missed from work (video: 8.5±27.4 min vs. in-person: 137.1±246.1 min; P=0.006), and less time missed from school (video: 95.1±209.3 min vs. in-person 191.4±259.2 min; P=0.037). In addition, the provider spent significantly less time delivering care for patients in the video group (video: 0.0±0.0 min vs. in-person: 33.7±17.9 min).

CONCLUSIONS: For patients with distal radius buckle fractures, video-based education should be considered as an alternative to an in-person orthopaedic visit.

LEVEL OF EVIDENCE: Therapeutic Level I.

PMID:41804710 | DOI:10.1097/BPO.0000000000003250

J Magn Reson Imaging. 2026 Mar 10. doi: 10.1002/jmri.70289. Online ahead of print.

ABSTRACT

BACKGROUND: Major adverse cardiovascular events (MACE) are a leading cause of morbidity and mortality in patients with end-stage renal disease (ESRD). However, risk stratification and prognostic prediction remain limited.

PURPOSE: To assess the incremental prognostic value of combined left atrial (LA) and left ventricular (LV) strain in predicting MACE among ESRD patients receiving renal replacement therapy.

STUDY TYPE: Prospective.

POPULATION: Three hundred thirteen ESRD patients (mean age: 53.8 ± 14.0 years; 202 males) undergoing maintenance dialysis.

FIELD STRENGTH/SEQUENCE: Balanced steady-state free precession (bSSFP) cine sequence at 3.0 T.

ASSESSMENT: Myocardial strain was analyzed from bSSFP cine images using feature-tracking software (CVI42). LA strain components were reservoir (LARS), conduit (LAScd), and contractile (LASct) strain, and LV strain included global longitudinal (GLS), radial (GRS), and circumferential (GCS) strain. Patients were followed up via clinical records and MACE were documented. Prognostic models were constructed using multivariable Cox proportional hazards regression. The baseline prediction model of conventional cardiovascular risk factors was then compared with models incorporating LARS and GLS to assess incremental prognostic value.

STATISTICAL TESTS: Cox proportional hazards regression identified predictors of MACE, and model performance was evaluated using C-index, Akaike and Bayesian information criteria (AIC/BIC), and Kaplan-Meier analysis. p < 0.05 was considered significant.

RESULTS: During a median follow-up of 16.93 months, 61 patients developed MACE. LARS (hazard ratio (HR) 0.90, 95% confidence interval (CI) 0.87-0.94) and LV GLS (HR 1.21, 95% CI 1.08-1.36) were independent predictors. The Cox model incorporating both LARS and LV GLS showed improved discrimination compared with the clinical risk factor model (C-index 0.79 vs. 0.70). Stratification by both LA and LV strain markers significantly improved MACE prediction (log-rank: p < 0.001).

DATA CONCLUSION: The integration of LA and LV strain offered superior prognostic value for MACE prediction in ESRD patients, enabling refined risk stratification beyond traditional measures.

EVIDENCE LEVEL: 2.

TECHNICAL EFFICACY: Stage 3.

PMID:41804678 | DOI:10.1002/jmri.70289

Environ Microbiol. 2026 Mar;28(3):e70278. doi: 10.1111/1462-2920.70278.

ABSTRACT

Microplastic (MP) biodegradation is critical for mitigating plastic pollution, yet the ecological mechanisms linking polymer properties to plastisphere microbiome assembly and catalytic function remain unclear. Using thermophilic composting as an accelerated model, we reveal a fundamental dichotomy in which biodegradable MPs (BMPs: polylactic acid [PLA] > polybutylene succinate [PBS] > poly (butylene adipate-co-terephthalate) [PBAT]) undergo rapid thermophilic degradation shaped by stronger environmental filtering of diverse degraders, whereas conventional MPs (CMPs: low-density polyethylene [LDPE]) exhibit delayed degradation with greater stochastic influence. Metagenomics uncovered 489 degradative genes predominantly distributed across uncultured taxa, enabling reconstruction of polymer-specific multi-enzyme pathways, supported by isolating 32 potential degraders (31 candidate novel). PLA/PBS degradation primarily relied on thermophilic-phase PLA depolymerase and cutinase, PBAT on late-stage polyesterase and PETase, and LDPE on alkane monooxygenase and laccase. Statistical modelling showed BMP degradation strongly associated with plastisphere-physicochemical interactions (> 90% variance), whereas CMP appeared primarily constrained by material properties (e.g., degrader succession in PLA, enrichment in PBS/PBAT, and high molecular weight in LDPE). Functionally dominant degraders (1.9% of total microbes) were estimated to contribute 52.4%-80.6% of biodegradation efficiency. This work elucidates the core polymer-plastisphere-functional nexus underlying MP biodegradation during composting, providing a predictive framework and microbial resource for targeted remediation.

PMID:41804664 | DOI:10.1111/1462-2920.70278

N C Med J. 2025 Dec 23;86(4). doi: 10.18043/001c.154041.

ABSTRACT

Medicaid expansion in North Carolina has notably improved payer mix, lowered rates of uninsured and charity care, and boosted billable revenue for safety-net organizations such as Federally Qualified Health Centers. At the same time, expansion has added administrative complexities and enrollment difficulties, which produced uneven benefits across the state’s FQHC programs.

PMID:41804618 | DOI:10.18043/001c.154041

Expert Rev Anticancer Ther. 2026 Mar 10. doi: 10.1080/14737140.2026.2644385. Online ahead of print.

ABSTRACT

BACKGROUND: Cutaneous malignant melanoma (CMM) is a highly malignant tumor that necessitates early diagnosis and precise survival prediction. The development of accurate prognostic models is essential for improving patient survival.

RESEARCH DESIGN AND METHODS: This retrospective study analyzed data from 5979 CMM patients in the SEER database (2004-2015), with external validation using the TCGA dataset. Patients were randomly allocated to training and testing sets in a 7:3 ratio. The SMOTE+DeepSurv (DeepSmote) model was compared against seven models, including DeepSurv, XGBoost, Logistic Regression (LR), Support Vector Machine (SVM), Random Forest (RF), K-Nearest Neighbors (KNN), and Decision Tree (DT). Model performance was evaluated using Area Under the Curve (AUC), accuracy, precision, recall, and F1-score.

RESULTS: The DeepSmote model demonstrated superior prognostic performance across both SEER and TCGA datasets. On the SEER test set, it achieved an AUC of 0.96, accuracy of 0.95, and F1-score of 0.95 for 1-year prediction. This strong performance was maintained in the external TCGA cohort (AUC: 0.91, accuracy: 0.88, F1-score: 0.87), and consistent superiority was observed for 3- and 5-year predictions, confirming its robustness and generalizability.

CONCLUSION: DeepSmote provides an accurate, generalizable prognostic tool for CMM survival prediction, outperforming other models across multiple datasets and evaluation metrics.

PMID:41804614 | DOI:10.1080/14737140.2026.2644385

Pulmonology. 2026 Dec;32(1):2640669. doi: 10.1080/25310429.2026.2640669. Epub 2026 Mar 10.

ABSTRACT

BACKGROUND: Exposure to cigarette smoke is a risk factor for endothelial dysfunction, leading to alterations in pulmonary vascular architecture and contributing to the development of pulmonary hypertension. Despite this evidence, the impact of smoking on pulmonary arterial hypertension (PAH) has only recently gained recognition.

RESEARCH QUESTION: The primary objective of this study was to further investigate the influence of cigarette smoking on the diagnosis and progression of patients with PAH and chronic thromboembolic pulmonary hypertension (CTEPH).

STUDY DESIGN AND METHODS: We assessed the prevalence of cigarette smoking and analysed the demographics and clinical outcomes of ever-smokers versus never-smokers included in the Spanish Registry of Pulmonary Arterial Hypertension (REHAP).

RESULTS: A total of 1763 patients from the REHAP registry were included in the study, of whom 1293 had PAH and 450 had CTEPH. Among these, 771 patients (43.7%) were classified as ever-smokers, comprising 44% (n = 570) of those diagnosed with PAH and 42.7% (n = 201) of those with CTEPH. In PAH patients, ever-smokers were significantly older at diagnosis and study enrolment compared to never-smokers. Notably, a poorer clinical course was observed in male PAH patients who were ever-smokers, with a statistically significant association. In contrast, no significant differences in survival rates were detected between ever-smokers and never-smokers with CTEPH.

CONCLUSION: Cigarette smoking is associated with delayed diagnosis and worse survival outcomes in PAH but not in CTEPH. Male ever-smokers patients with PAH has worse prognosis than female ever-smokers. Further research is warranted to elucidate the underlying mechanisms contributing to the negative correlation between smoking and PAH.

PMID:41804599 | DOI:10.1080/25310429.2026.2640669