Category: Statistics

Arch Osteoporos. 2026 Feb 13;21(1):34. doi: 10.1007/s11657-026-01663-3.

ABSTRACT

In our real-world study of women with postmenopausal osteoporosis (PMO), general practitioners (GPs) adhered to French guidelines on stopping, changing, or continuing oral bisphosphonates in 60% of cases and adhered to guidelines on initiating oral BPs in only 39%. These findings highlight the need to educate GPs on PMO treatment recommendations.

PURPOSE: French guidelines for postmenopausal osteoporosis (PMO) recommend dual energy X-ray absorptiometry (DXA) assessment of bone mineral density (BMD) to guide treatment decisions. However, data reporting implementation of these guidelines in general practice is lacking. Our study assessed general practitioners’ (GPs’) use of DXA results to guide decisions regarding first-line oral bisphosphonate (oBP) treatment in women with PMO.

METHODS: In this multicenter cohort study, participating GPs enrolled women with PMO who had been receiving the first-line bisphosphonates for 2-5 years, had a reference (baseline) DXA in the 2 years pre-enrolment or ≤ 2 years prior to BP initiation, and agreed to a follow-up DXA. GPs prescribed a follow-up DXA to guide their decision to stop, continue, or change BPs. We checked the GPs’ decision for concordance with national treatment guidelines.

RESULTS: From January 2018 to November 2019, 23 GPs enrolled 99 women meeting the inclusion criteria. Based on follow-up DXA, the decision to stop, change, or continue oBPs aligned with guidelines in 60% of cases. Agreement was higher in women receiving oBPs for < 3 vs ≥ 3 years (70.2% vs 54.3%). Based on baseline DXA, the decision to initiate treatment was aligned in only 39% of cases, with the follow-up treatment decision aligned with guidelines in 72% of these cases. The consistency of treatment decision between GPs and the scientific committee was weak (kappa coefficient of 0.295).

CONCLUSION: Our study suggests insufficient awareness of national recommendations for PMO treatment in French general practice, highlighting the need for stronger GP education.

PMID:41686362 | DOI:10.1007/s11657-026-01663-3

Dermatol Ther (Heidelb). 2026 Feb 13. doi: 10.1007/s13555-026-01668-3. Online ahead of print.

ABSTRACT

INTRODUCTION: Topical corticosteroids are regarded as the first-line therapy for chronic hand eczema (CHE), despite a lack of substantial evidence from randomized controlled trials to confirm their efficacy. Topical benvitimod is a potential alternative for long-term maintenance.

METHODS: A prospective, single-center, open-label randomized trial was conducted, using a parallel-group design and enrolling 64 patients who had moderate-to-severe CHE. Patients were randomly divided into two treatment groups: 32 patients used 1% benvitimod cream twice a day for 8 weeks, whereas the other 32 patients received halometasone cream on the same application schedule and duration. The percentage of patients who achieved “treatment success” at week 12 was the primary endpoint. Secondary endpoints included changes in physician-assessed Hand Eczema Severity Index (HECSI), patient-reported subjective scores, the relapse rate, and adverse events. Patient-reported subjective scores included Patient Global Assessment (PaGA), Dermatology Life Quality Index (DLQI), and Quality of Life in Hand Eczema Questionnaire (QOLHEQ).

RESULTS: Fifty-nine patients completed the trial (30 in the benvitimod group and 29 in the halometasone group). The treatment success rate was 26.7% (8/30) in the benvitimod group and 24.1% (7/29) in the halometasone group (p = 0.824) at week 12. From baseline to week 12, the two groups demonstrated significant reductions in HECSI, PaGA, DLQI, and QOLHEQ scores (p < 0.05). However, no statistically significant differences were observed between the two groups. Among patients who achieved treatment success, 25.0% (2/8) patients in the benvitimod group and 57.1% (4/7) patients in the halometasone group relapsed at week 24 (p = 0.315). The main adverse events associated with benvitimod were skin pigmentation, pruritus, and skin dryness, none of which led to treatment discontinuation.

CONCLUSIONS: Benvitimod exhibits efficacy comparable to halometasone in managing moderate-to-severe CHE, along with a favorable safety and a low relapse rate.

TRIAL REGISTRATION NUMBER: ChiCTR2100051948.

PMID:41686361 | DOI:10.1007/s13555-026-01668-3

Int Ophthalmol. 2026 Feb 13;46(1):111. doi: 10.1007/s10792-026-03952-9.

ABSTRACT

PURPOSE: To compare safety, efficacy and patient experience when treated with intravitreal injections of a 30-gauge needle compared to a 34-gauge needle.

METHODS: A Prospective Randomized controlled study in a single tertiary medical center. Patients were randomly assigned to receive prescheduled intravitreal injection with either a 30 or a 34-gauge needle. Intravitreal injections were performed by a senior vitreoretinal surgeon or by a resident. After the intravitreal injection was performed, patients were asked to grade pain sensation on a Visual Analog Scale (VAS score). In addition, the presence or absence of subconjunctival hemorrhage (SCH) was recorded, as well as any post-injection complications in the following month.

RESULTS: Our cohort included 91 patients with a total of 114 injections. Mean age was 72.8 ± 12, with 51 females and 40 males. The mean pain score in the 30-gauge group was 3.17 ± 2.11 vs 3.05 ± 2.45 in the 34-gauge group. There was no statistically significant difference in the mean pain score among the two groups (p = 0.571) nor in gender (p = 0.563) overall. However, when the injections performed by a senior vitreoretinal surgeon, 34-gauge needles were statistically significantly less painful than 30-gauge needles (2.5 ± 2.0 vs. 3.4 ± 1.8; p = 0.04). Additionally, no difference was recorded in formation of SCH among the groups (p = 1).

CONCLUSION: The use of a 34-gauge needle was found to be less painful when used by a senior vitreoretinal surgeon and with similar safety profile as the 30 gauge needle. This may further improve patient satisfaction and increase treatment adherence.

PMID:41686360 | DOI:10.1007/s10792-026-03952-9

Clin Drug Investig. 2026 Feb 13. doi: 10.1007/s40261-026-01529-z. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: The intricate nature of pediatric patients’ physiology and the frequent administration of multiple medications in pediatric intensive care units expose hospitalized patients to potential drug-drug interactions. Therefore, this study aimed to examine and characterize clinically relevant drug-drug interactions in pediatric patients admitted to intensive care units, leveraging artificial intelligence to enhance their identification and management.

METHODS: Prescription data from pediatric intensive care unit admissions were analyzed using ContraIndicator, a natural language processing-based framework developed for the identification of potential drug-drug interactions. Medication information extracted from prescription records was evaluated against the DDInter database, and its clinical relevance was determined using the severity ratings of the database (major, moderate, and minor). Using univariate and multivariate logistic regression, the associations between severity and age, as well as between severity and the number of prescribed medications, were investigated.

RESULTS: The examination of 8010 prescriptions for 899 hospitalized patients identified 3884 potential drug-drug interactions. The most frequent interacting drug pairs were midazolam + fluconazole, fluconazole + fentanyl, fentanyl + dexamethasone, and vancomycin + piperacillin. Among the 49.6% (446) of pediatric patients who had at least one interaction (major, moderate, or minor), 38.8% (173) had a major potential drug-drug interaction. In this investigation, a higher number of prescribed drugs was significantly linked with a higher incidence of potential drug-drug interactions (odds ratio: 12.79; 95% confidence interval: 8.26-20.6; p < 0.001).

CONCLUSIONS: The study suggests that potential drug-drug interactions are frequent in pediatric intensive care units. The majority of these interactions were moderate, followed by major severity. There is a statistically significant association between the quantity of drugs provided and the prevalence of potential drug-drug interactions. The findings of this study could aid in planning and executing future studies, as well as in monitoring and preventing potential drug-drug interactions in patients receiving intensive care. This study introduces ContraIndicator, a graphical user interface that presents empirical findings and promotes awareness regarding potential drug-drug interactions.

PMID:41686358 | DOI:10.1007/s40261-026-01529-z

Support Care Cancer. 2026 Feb 13;34(3):195. doi: 10.1007/s00520-026-10458-8.

ABSTRACT

BACKGROUND & AIMS: Post-treatment anxiety and depression are prevalent but often underrecognized among bladder cancer patients. This systematic review and meta-analysis aimed to estimate the pooled prevalence of these symptoms and to evaluate the effectiveness of intensive nursing interventions.

METHODS: A comprehensive search of PubMed, EMBASE, the Cochrane Library, and Web of Science was conducted through October 18, 2025. Eligible studies included those reporting the prevalence or severity of anxiety and/or depression in bladder cancer patients, as well as studies comparing intensive nursing interventions with routine care. Data were synthesized using Stata/MP version 14.0. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. Heterogeneity was assessed using the I² statistic, and subgroup analyses were performed to explore potential sources of variability.

RESULTS: Sixteen studies involving 1,791 patients were included. The pooled prevalence of anxiety was 25.3% (95% CI: 22.2-28.6%) and that of depression was 29.4% (95% CI: 23.3-35.9%). Higher prevalence rates were observed in non-Western populations and among patients receiving multimodal treatment. Compared with routine care, intensive nursing interventions were associated with significant reductions in anxiety (SMD = -4.52; 95% CI: -6.07 to -2.96) and depression (SMD = -4.51; 95% CI: -5.96 to -3.07) (both P < 0.001). These findings remained robust in sensitivity analyses despite substantial heterogeneity.

CONCLUSION: Anxiety and depression are common among bladder cancer survivors. Intensive nursing interventions are associated with meaningful improvements in psychological outcomes and may be considered for integration into post-treatment supportive care.

TRIAL REGISTRATION: PROSPERO registration number: CRD42024590858.

PMID:41686342 | DOI:10.1007/s00520-026-10458-8

Discov Oncol. 2026 Feb 13. doi: 10.1007/s12672-026-04641-w. Online ahead of print.

ABSTRACT

Alterations in the vaginal microbiota contribute to the pathogenesis of cervical neoplasia. However, the distinctions in microbiota changes related to different human papillomavirus (HPV) subtypes, as well as the variation in gut microbiota, have not been fully explored. In this research, we endeavored to explore the shifts in the vaginal and intestinal microbiota in correlation with the advancement of cervical neoplasia and HPV infection. A total of 578 vaginal and intestinal cross-sectional specimens were collected from 348 subjects and subjected to 16 S rRNA sequencing. Statistical analyses were performed using R language, and Student’s t-test was employed to assess the significance of differences. Both within and between, sample diversity of the vaginal and intestinal microbiota exhibited substantial alterations across cervical intraepithelial neoplasia (CIN) stages and cervical carcinoma. The vaginal genera Lactobacillus, Enterococcus, Peptoniphilus, Atobium, Anerococcus, and Veillonella were associated with different CIN stages and cervical cancer type, whereas Allisonella, Lachnospiracae, Lactobacillus, Staphylococcus, and Sellimonas were associated with varying HPV types. A Random Forest-driven classifier highlighted the predictive potential of differential bacteria in cervical neoplasia and HPV infection, with intestinal bacteria showing higher predictive accuracy in certain instances. Specifically, the accuracy of differentiating CIN I from CIN III was superior for the intestinal bacterial model compared to the vaginal bacterial model (85.52% vs. 83.33%). The model also demonstrated high accuracy in predicting HPV infection, particularly in distinguishing HPV-16 from HPV-18 and HPV-58, with AUC values of 81.61% and 83.07%, respectively, compared to less than 70% for vaginal bacteria. Our findings reveal the intricate interplay among cervical neoplasia, HPV infection, and microbiota, with potential diagnostic and therapeutic implications.

PMID:41686340 | DOI:10.1007/s12672-026-04641-w

Environ Geochem Health. 2026 Feb 13;48(4):158. doi: 10.1007/s10653-026-03020-2.

ABSTRACT

The Daxing’anling region possesses China’s best-preserved cold-temperate primary forests, playing a vital role in the ecological security of Northeast China. This study investigates the hydrochemical characteristics, regulatory mechanisms, and potential health risks associated with nitrate in groundwater within the Songling area, aiming to provide scientific basis for sustainable water resource management in the region. By collecting 30 groundwater samples through systematic sampling, this study analyzed the groundwater chemistry characteristics and influencing factors in the study area using methods such as Piper’s three-line diagram, Gibbs diagram, factor analysis, ion ratio coefficients, and the APCS-MLR receptor model. Additionally, a health risk model was employed to assess health risks for different population groups. Results indicate: (1) The average pH value of groundwater in the study area is 7.14, exhibiting the smallest coefficient of variation (CV = 3.61). The average total hardness (TH) was 109.94 mg $·$ L^-1, with 73.33% of samples containing calcium carbonate concentrations below 300 mg $·$ L^-1. The average total dissolved solids (TDS) was 218.16 mg $·$ L^-1, all TDS values < 1 g $·$ L^-1. The average concentration of permanganate index (COD_Mn) was 1.05 mg $·$ L^-1. Iron (Fe) and manganese (Mn) exhibited the highest coefficients of variation ( $CV>370\%$ ), with average values of 1.43 mg $·$ L^-1 and 0.48 mg $·$ L^-1, respectively. The dominant anion and cation components were ${\text{Ca}}^{2+}$ (mean 34.23 mg $·$ L^-1) and ${\text{HCO}}_{\text{3}}^{–}$ (mean 103.52 mg $·$ L^-1), respectively. ${\text{NO}}_{\text{3}}^{–}$ was the primary exceedance factor in groundwater within the study area (exceedance rate 26.67%). (2) The most ion ratios relative to TDS fell within defined ranges, with sampling points highly concentrated in the low-value zone (ratio < 0.5), clearly approaching the rock weathering endpoint. 83.33% of water samples were above the 1:1 line ( ${\text{Na}}^{+}$ / ${\text{Cl}}^{–}$ > 1). The scatter plot fit slope between [(Ca²⁺ + Mg²⁺) – ( ${\text{SO}}_{\text{4}}^{2–}$ + ${\text{HCO}}_{\text{3}}^{–}$ )] and (Na⁺ + K⁺ – Cl^–) is -1.74 (R² = 0.74), approaching the theoretical exchange characteristic value of -1. (3) The KMO value in factor analysis was 0.603, and the Bartlett test showed a significance level of P < 0.001, indicating significant correlations among variables. Three principal factors with eigenvalues greater than 1 were extracted, collectively explaining 87.35% of the variance. APCS-MLR model analysis indicated groundwater chemical composition primarily originated from four principal contributors, including geological sources(F1, 37.24%), agricultural and lifestyle activities(F2, 12.70%), combined natural-human processes(F3, 14.00%), and other unknown sources(F4, 22.93%). (4) The average non-carcinogenic hazard index (HI) for groundwater nitrate exposure in children was 0.5973; The average HI for adult males was 0.3128; the average HI for adult females was 0.3963. The proportion of groundwater nitrate samples exceeding the non-carcinogenic risk (HI) threshold for children reached 23.33%, while the proportion for adults was only 10%. Among adult females, 16.67% of samples had HI values exceeding 0.8, indicating a potential for unacceptable risk. A comprehensive analysis leads to the following conclusions: (1) The groundwater in the study area is predominantly neutral to slightly alkaline, classified as low-hardness freshwater with extremely low levels of organic pollutants, indicating good water quality. Iron and manganese concentrations exhibit regionally inherent geochemical background characteristics. From an ionic composition perspective, groundwater is dominated by Ca²⁺ and ${\text{HCO}}_{\text{3}}^{–}$ , with its hydrochemical types primarily classified as HCO₃-Ca type (1-A type) and HCO₃-Ca $·$ Mg type (2-A type). (2) Groundwater chemical composition in the study area is primarily controlled by rock weathering, cation exchange, and human activities. Among these, the weathering and dissolution of carbonates, silicates, and gypsum jointly dominate the hydrogeochemical processes in this region. Additionally, human activities, particularly nitrate inputs from agricultural and domestic discharges, have become a significant factor altering the groundwater chemical environment. Specifically, ${\text{Ca}}^{2+}$ , ${\text{Mg}}^{2+}$ , and ${\text{HCO}}_{\text{3}}^{–}$ are mainly derived from the dissolution of carbonate and silicate minerals, whereas ${\text{Na}}^{+}$ originates from rock-salt and silicates. ${\text{SO}}_{\text{4}}^{2–}$ is significantly influenced by mining activities and evaporite dissolution, while ${\text{K}}^{+}$ , ${\text{Cl}}^{–}$ , and ${\text{NO}}_{\text{3}}^{–}$ are primarily attributed to domestic sewage and agricultural inputs. (3) Multivariate statistical analysis identified sources influencing groundwater chemistry as geological background sources, agriculture-lifestyle pollution sources, mixed natural-anthropogenic sources, and unknown. These sources exhibit an increasing trend from natural background to anthropogenic disturbance, indicating that geological background and water-rock interactions are the dominant forces shaping hydrochemical characteristics. However, various human activities also exert significant and widespread influence. (4) Nitrate Health Risk Assessment: Drinking water intake constitutes the primary pathway for nitrate-related health risks in humans. Among exposed populations, children face higher health risks than adults, with females exhibiting slightly higher risks than males. Overall, the health risks from nitrate contamination in the study area’s groundwater remain at a low level. Only a very small number of locations directly impacted by human and livestock activities show potential for exceeding concentration thresholds and elevated risks. The following four recommendations are proposed to strengthen water quality management in high-risk areas, promote scientific agricultural fertilization practices, improve wastewater treatment systems, and implement health monitoring and drinking water risk management for susceptible populations.

PMID:41686319 | DOI:10.1007/s10653-026-03020-2

Alzheimers Dement. 2026 Feb;22(2):e70992. doi: 10.1002/alz.70992.

ABSTRACT

INTRODUCTION: Vascular cognitive impairment (VCI), a major cause of cognitive impairment, remains underdiagnosed due to varying non-amnestic manifestations. It is important to detect VCI at the mild cognitive impairment (MCI) stage or earlier. We aimed to develop and validate ReCOGnAIze, a tablet-based, gamified, and interpretable app to detect VCI and MCI.

METHODS: A multi-phase, cross sectional study in an Asian community cohort with development phase (n = 200) and validation with 235 independent participants having comprehensive neuroimaging and neuropsychological data.

RESULTS: In differentiating VCI, ReCOGnAIze achieved strong performance (n = 154, AUC = 0.85), identifying digital features: processing speed and response time variability, consistent with known VCI impairments of executive functioning. Additionally, a generalizable ReCOGnAIze composite score distinguished MCI from cognitively healthy (CH) (n = 235, AUC = 0.90), outperforming the Montreal Cognitive Assessment (MoCA) (AUC = 0.70).

DISCUSSION: ReCOGnAIze is a scalable, explainable artificial intelligence (AI) tool that accurately detects VCI and MCI, with gamified, tablet-based, interpretable tasks.

HIGHLIGHTS: Non-significant differences on Montreal Cognitive Assessment (MoCA) for vascular cognitive impairment (VCI). ReCOGnAIze artificial intelligence (AI) models identify VCI with area under the curve (AUC) of 0.85. ReCOGnAIze games detect mild cognitive impairment (MCI) with AUC of 0.90, outperforming MoCA (AUC = 0.7). Processing speed and response time variability are key VCI markers.

PMID:41685533 | DOI:10.1002/alz.70992

J Med Virol. 2026 Feb;98(2):e70834. doi: 10.1002/jmv.70834.

ABSTRACT

BACKGROUND: Biliary atresia (BA) is a severe infantile hepatobiliary disorder of unknown etiology. Perinatal rotavirus (RV) infection has been implicated in animal models of BA; however, supporting human data remains limited. The study investigated the serological evidence of recent RV infection in infants with BA using RV-specific immunoglobulin (Ig)-A, a marker of primary infection unaffected by maternal antibodies.

METHODS: Serum samples from 17 infants with BA and 30 age-matched controls without gastrointestinal symptoms or prior RV vaccination were retrospectively analyzed. Anti-RV-IgA titers were measured by enzyme-linked immunosorbent assay using purified WA-strain virions. Cytomegalovirus (CMV)-IgM and Epstein-Barr virus (EBV)-viral capsid antigen (VCA)-IgM levels were assessed using commercial enzyme immunoassays.

RESULTS: RV-IgA was detected in 70.6% (12/17) of the patients with BA versus 3.4% (1/29) of the controls (p < 0.001). RV-IgA titers were significantly higher in the BA group (median: interquartile range 2^8.0:2^6.0-2^10.0) than in the control group (2^3.5:2^2.0-2^4.8) (p = 0.004). Among patients diagnosed with BA after 14 days of age, 84.6% (11/13) were RV-IgA-positive. CMV-IgM was detected in three patients in the BA group and one individual in the control group, while EBV-VCA-IgM was negative in BA patients and positive in two controls; neither difference was statistically significant.

CONCLUSIONS: The study findings support the potential association between RV infection and BA pathogenesis. However, the lack of an epidemiological reduction in BA following the introduction of the RV vaccine warrants caution in other studies. Further prospective multicenter studies are required to elucidate the causal role of RV infection in BA development.

PMID:41685501 | DOI:10.1002/jmv.70834

Stud Health Technol Inform. 2026 Feb 12;334:127-128. doi: 10.3233/SHTI260033.

ABSTRACT

Refugee populations in Canada experience disproportionately high rates of trauma-related mental health conditions. We conducted 15 semi-structured interviews across six stakeholder groups to explore mental healthcare gaps. Findings reveal three major barriers: fragmented regulatory frameworks; unsustainable funding models; and failure to integrate end-user needs.

PMID:41685489 | DOI:10.3233/SHTI260033