Category: Statistics

Arthritis Care Res (Hoboken). 2026 Jul 22. doi: 10.1002/acr.80121. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate whether extending the American College of Rheumatology (ACR)-recommended monitoring interval for complete blood count and liver function tests in patients receiving methotrexate (MTX) affects timely detection of medication-related toxicity.

METHODS: We conducted an observational cohort analysis of 14,199 laboratory encounters from 2,439 patients receiving MTX with at least two measurements of alanine aminotransferase (ALT), aspartate aminotransferase (AST), white blood cell (WBC) count, hematocrit (HCT), mean corpuscular volume (MCV), and/or platelet (PLT) count. Fibrosis-4 (FIB-4) scores were calculated when possible. Changes between consecutive measurements were plotted against time between encounters. Monitoring intervals of 3 months (45-135 days) and 6 months (135-225 days) were compared. After propensity score matching, we assessed incident clinically relevant abnormalities.

RESULTS: Testing frequency showed no meaningful correlation with changes in ALT, AST, WBC, HCT, MCV, PLT, or FIB-4 (all R² < 0.01). Mean laboratory changes did not differ meaningfully between monitoring intervals. Patients monitored every 135-225 days were equally or less likely to develop incident abnormal results than those monitored every 45-135 days; most odds ratios were not statistically significant (p > 0.05). Patients in the 6-month group were less likely to develop ALT >1×ULN (OR 0.72 [0.52-0.99]) or MCV >100 fL (OR 0.67 [0.46-0.96]).

CONCLUSION: Extending routine MTX monitoring from every 3 months to every 6 months was not associated with more severe abnormalities or delayed detection of toxicity, suggesting quarterly testing may be more frequent than necessary and could be reconsidered to reduce cost and patient burden.

PMID:42485655 | DOI:10.1002/acr.80121

J Vet Intern Med. 2026 Jul 1;40(4):aalag139. doi: 10.1093/jvimsj/aalag139.

ABSTRACT

BACKGROUND: Middle ear abnormalities are frequently observed in brachycephalic dogs due to their anatomical variation, and the prevalence of these abnormalities may be influenced by modern breed popularity.

HYPOTHESIS/OBJECTIVES: We hypothesized that 10% of dogs with signs of neurologic disease will have incidental otitis media (OM) and that brachycephalic breeds will have a higher occurrence of OM.

ANIMALS: Three hundred eighty client-owned dogs that underwent magnetic resonance imaging (MRI) of the head for any signs of neurologic disease.

METHODS: Retrospective, single-institution study. Prevalence of any kind of otitis and association with dog clinical signs were analyzed using standard multinomial formulas and Fisher’s exact test. Signalment variables with P-values less than .1 but with no zero counts on bivariable analysis were included in a multivariable logistic regression model. Statistical significance was set to P < .05.

RESULTS: Of the dogs in this study, 60 (15.7%) had otitis of any kind. Among these, 15 (3.9%) were diagnosed with otitis of any kind as the primary cause of their clinical signs, all of which were affected by OM and all but one had otitis interna (OI). Forty-five (45/380, 11.8%) were classified with incidental otitis of any kind. The most common form of otitis was OM in 54 dogs (54/380, 14.2%). French Bulldogs were the most common breed reported (32/380, 8.4%) and 18 (56%) had evidence of 1 or more types of otitis: 5 causative and 13 incidental.

CONCLUSION AND CLINICAL IMPORTANCE: Otitis media is commonly an incidental finding in dogs undergoing MRI of the head, especially in brachycephalic breeds. French Bulldogs are more frequently affected. These findings can help guide diagnostic and treatment approaches for dogs with neurologic disease.

PMID:42485624 | DOI:10.1093/jvimsj/aalag139

Hum Vaccin Immunother. 2026 Dec;22(1):2701546. doi: 10.1080/21645515.2026.2701546. Epub 2026 Jul 22.

ABSTRACT

A systematic literature review was conducted to build a comprehensive evidence base of qualitative/quantitative studies to identify barriers and enablers influencing maternal immunization (MI). Searches of seven databases on 20/10/2023 and 26/10/2023 yielded 87,367 records. Two reviewers performed full-text screening of 484 records. English-language articles from countries that had national recommendations for pertussis-containing maternal vaccines and reported on maternal vaccine acceptance, trust, and hesitancy were eligible. Overall, 184 studies were included. Barriers involving individual and group influences like lack of knowledge and reduced awareness of MI, pre-existing anti-vaccination beliefs and attitudes, and perceived concerns about vaccine safety and efficacy were the most prominent. Proactive communication and recommendations from healthcare professionals and public health authorities were major enablers, alongside trusting the information provided by healthcare professionals. Our results show that vaccine hesitancy is a complex phenomenon. Addressing both practical and perceptual barriers to MI might increase vaccination coverage among pregnant individuals.

PMID:42485609 | DOI:10.1080/21645515.2026.2701546

JCO Glob Oncol. 2026 Jul;12(7):e2500254. doi: 10.1200/GO-25-00254. Epub 2026 Jul 22.

ABSTRACT

PURPOSE: To assess willingness of patients with cancer to participate in observational studies (OBS) and clinical trials (CT) and to examine the factors influencing their decision to join CT.

METHODS: A cross-sectional study using a systematic sampling strategy was conducted from December 2023 to June 2024. Data were collected directly from patients and their medical charts. Logistic regression was performed to identify significant predictors of patients’ willingness to participate in CT.

RESULTS: A total of 367 patients participated, 58.9% were females, and 59.8% had stage IV disease. Most participants (81%) had a performance status (PS) of 0-1, with only 1.9% having prior experience with a CT and 9% with OBS. Willingness to join OBS was higher than willingness to join CT (64% v 31.6%, P < .001). Key barriers included fear of side effects (61.6%), lack of information (46.3%), and concerns about the investigational product (41.6%). Motivators were having their treating physician as the principal investigator (42.5%) and prior human testing of the product (40.6%). Patients who underwent surgery or believed that their physical or psychological condition is unsuitable for trials were less likely to participate (P < .05, odds ratio [OR], 0.30, 0.38, 0.37, respectively). Patients with a friend or relative who had joined a trial were more willing to participate (P < .05, OR, 3.48).

CONCLUSION: The results highlight a low level of willingness to participate in CT. Some barriers could be avoided during the study design phase. Discrepancies between patients’ self-assessed PS and physicians’ evaluations may lower the enrollment rates. Encouraging patients who have participated in CTs to share their experiences with the family and friends could significantly improve the community’s willingness to join CT.

PMID:42485596 | DOI:10.1200/GO-25-00254

JCO Glob Oncol. 2026 Jul;12(7):e2600203. doi: 10.1200/GO-26-00203. Epub 2026 Jul 22.

ABSTRACT

PURPOSE: Lung cancer remains the leading cause of cancer-related mortality worldwide. Immune checkpoint inhibitors (ICIs) have become the standard of care for stage IV non-small cell lung cancer (NSCLC). In 2021, Lebanon experienced a severe economic collapse that resulted in major shortages of immunotherapy and treatment interruptions. The aim of this study was to explore the potential impact of immunotherapy shortage on progression-free survival (PFS).

METHODS: This retrospective multicenter study included patients with newly diagnosed stage IV NSCLC treated between January 2019 and December 2020 (control group) and between October 2021 and December 2022 (crisis group). The primary end point was PFS, defined from treatment initiation to progression according to RECIST 1.1 criteria or death. Kaplan-Meier survival curves were generated, and differences were assessed using log-rank test.

RESULTS: A total of 500 medical records were reviewed; 158 eligible patients were included (73 control, 85 crisis). The total cohort included 60.8% men with a mean age of 69.7 years. Among immunotherapy recipients, 44.0% received full-dose therapy (dose density ratio = 1.0), 41.4% received 50%-99% of standard dose (dose density ratio = 0.50-0.99), and 14.7% received <50% (dose density ratio = <0.50). The median PFS was 6.33, 12.86, and 10.23 months, respectively; no statistically significant difference was observed (P = .132).

CONCLUSION: Despite a statistically significant reduction in immunotherapy dose density during the economic crisis, no statistically significant difference in PFS was detected between the precrisis and crisis groups. These findings suggest that reduced immunotherapy dosing may not be associated with inferior short-term survival outcomes in stage IV NSCLC, although the study was not designed or powered to establish equivalence.

PMID:42485593 | DOI:10.1200/GO-26-00203

JCO Oncol Pract. 2026 Jul 22:OP2501431. doi: 10.1200/OP-25-01431. Online ahead of print.

ABSTRACT

PURPOSE: Adherence to operative standards and thorough documentation of surgical technique are critical, particularly in multidisciplinary clinical trials. We sought to evaluate variability in the performance and documentation of oncologically relevant aspects of technical surgery among patients enrolled in Alliance A021501, a phase 2 National Clinical Trials Network randomized clinical trial of neoadjuvant therapy for borderline resectable pancreatic adenocarcinoma.

METHODS: We reviewed the primary operative and pathology reports of all enrolled patients who underwent complete pancreatic resection. Operative techniques and pathologic end points with potential to influence recurrence and survival were evaluated.

RESULTS: Fifty-one of 126 study participants (40.5%) underwent complete pancreatectomy. The extent of lymphadenectomy was documented in 36 (70.6%) operative reports, and 5 (9.8%) reports outlined the specific lymph node stations removed. Periadventitial dissection of the superior mesenteric artery was described in 25 of 50 (50.0%) operative reports. Immediate histopathologic analysis of the hepatic duct and pancreatic parenchyma margins was documented in 29 of 50 (58.0%) and 32 of 49 (65.3%) reports, respectively, and presence or absence of residual disease following resection was documented in 9 of 51 (17.6%) reports. Specimen orientation was documented in 19 of 51 (37.3%) pathology reports, and 30 of 49 (61.2%) pathology reports stated the distance between the tumor and final SMA margin.

CONCLUSION: Even in this rigorously controlled, multicenter, randomized pancreatic cancer clinical trial, performance of key elements of technical surgery was inconsistent, and documentation was incomplete. Standardization of technique and documentation in clinical trials and within clinical practice should be addressed to improve quality assurance and trial interpretability.

PMID:42485590 | DOI:10.1200/OP-25-01431

Arch Endocrinol Metab. 2026 Jul 22;70(5):e260078. doi: 10.20945/2359-4292-2026-0078.

ABSTRACT

OBJECTIVE: To evaluate the effect of taurine supplementation on the lipid profile of male hypothyroid Wistar rats.

MATERIALS AND METHODS: Adult male Wistar rats were induced to hypothyroidism by treatment with 0.03% methimazole in drinking water. After 21 days, half of the hypothyroid animals received daily taurine supplementation by gavage (520 mg/kg b.w.), while the other half received water. Control animals received taurine at the same dose or water by gavage for an additional 21 days, totaling 42 days of treatment. The groups were: Control (C), Taurine (T), Hypothyroid (H), and Hypothyroid + Taurine (H+T) (n = 5-20/group). Data were expressed as mean ± SEM, and statistical analysis was performed using two-way ANOVA followed by Tukey’s post-test.

RESULTS: Hypothyroidism increased serum total cholesterol (TC) and LDL levels, which were reduced by taurine supplementation. Hepatic diacylglycerol concentration increased with taurine supplementation, but this effect was not observed in hypothyroid animals. Taurine increased AMPK and ACC phosphorylation in the liver independently of thyroid hormone levels.

CONCLUSION: Hypothyroidism induces changes in the lipid profile, particularly increasing TC and LDL cholesterol levels. Taurine supplementation in hypothyroid rats partially reversed lipid alterations and increased AMPK and ACC phosphorylation in the liver, suggesting metabolic benefits.

PMID:42485573 | DOI:10.20945/2359-4292-2026-0078

Neurourol Urodyn. 2026 Jul 22. doi: 10.1002/nau.70390. Online ahead of print.

ABSTRACT

BACKGROUND: Urinary incontinence (UI) is a common and debilitating complication in patients with dementia, significantly impacting quality of life, increasing caregiver burden, and accelerating institutionalization.

OBJECTIVE: Despite numerous studies, reported prevalence estimates vary widely, and a precise global pooled prevalence has not been established.

METHODS: This systematic review and meta-analysis followed PRISMA guidelines. A comprehensive search of PubMed/MEDLINE, Scopus, and Web of Science was conducted from November to December 2025, without publication year restrictions. Observational studies reporting the point prevalence of UI in dementia patients were included. Two independent reviewers screened studies, extracted data, and assessed methodological quality using the Newcastle-Ottawa Scale. A random-effects meta-analysis (restricted maximum likelihood method) was used to pool prevalence estimates. Heterogeneity was assessed using the I² statistic. Subgroup analyses were performed by setting and UI assessment method, and meta-regression examined associations with Human Development Index (HDI) and temporal trends.

RESULTS: Ten studies comprising 286,544 participants were included. The pooled global prevalence of UI in dementia patients was 39.7% (95% CI: 23.9%-58.1%), with substantial heterogeneity (I² > 95%). Prevalence ranged from 4% in Taiwan to 88% in Japan. Subgroup analyses revealed significantly higher prevalence in clinic/hospital settings compared to community settings (47.5% vs. 28.7%, p = 0.023), and in studies using single-question interviews versus medical record extraction (59.2% vs. 23.2%, p = 0.016). Meta-regression showed a significant positive association with HDI (coefficient: 5.69, p < 0.001). Sensitivity analysis confirmed the robustness of the pooled estimate.

CONCLUSION: Approximately 40% of dementia patients experience UI, with substantial variation by setting and assessment method. Standardized assessment protocols are needed to inform targeted interventions and reduce disease burden.

PMID:42485548 | DOI:10.1002/nau.70390

Appl Spectrosc. 2026 Jul 22:37028261474584. doi: 10.1177/00037028261474584. Online ahead of print.

ABSTRACT

The combination of laser-induced breakdown spectroscopy (LIBS) and machine learning provides a rapid approach for coal ash quantification. However, in practical coal preparation plants, calibration samples are often limited, and ash contents are usually confined to a narrow range, making reliable quantitative modeling difficult. To address this issue, we propose a structured spectral in-context learning framework for small-sample coal ash quantification. Unlike conventional methods that rely on task-specific iterative parameter optimization, the proposed framework performs downstream inference by conditioning on a limited set of calibration samples using a pre-trained tabular foundation model. To adapt continuous high-dimensional LIBS spectra to this framework, segmented statistical descriptors and multi-scale Haar-like features were constructed to capture subtle local spectral variations associated with narrow ash-content changes. The experimental results show that the proposed SS-ICL framework achieves robust predictive performance under restricted conditions, with an R² of 0.8880 and an RMSE of 0.1953 in a narrow-range washed-coal scenario. These results demonstrate that the proposed framework provides a practical and robust strategy for on-site LIBS-based coal quality analysis in restricted industrial environments.

PMID:42485543 | DOI:10.1177/00037028261474584

J Spinal Cord Med. 2026 Jul 22:1-10. doi: 10.1080/10790268.2026.2657701. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effectiveness of synchronous telerehabilitation-based resistance exercises on upper limb function in people with paraplegia.

SETTING: Rehabilitation interventions were conducted either synchronously via telerehabilitation or through unsupervised home-based programs in participants’ residential environments.

PARTICIPANTS: Twenty-one people with paraplegia, aged 18-60, who were partially or fully wheelchair-dependent and had sufficient upper limb function and access to online communication tools.

INTERVENTIONS: Both groups followed the same resistance exercise program (3 times/week for 6 weeks). The telerehabilitation group performed exercises under real-time remote supervision of a physiotherapist, while the control group completed an unsupervised home-based exercise program.

OUTCOME MEASURES: Primary outcomes included upper limb muscle strength assessed via handheld dynamometry, physical performance measured by the 20-Meter Wheelchair Push Test, and physical activity levels evaluated using the Physical Activity Scale for Individuals with Physical Disabilities.

RESULTS: Significant within-group improvements were observed in the Study Group for shoulder and wrist strength, mobility performance, and physical activity levels (P < 0.01). However, no statistically significant between-group differences were observed post-intervention (P > 0.05).

CONCLUSION: Synchronous telerehabilitation-based resistance exercises significantly enhanced upper limb strength, mobility, and activity levels in people with paraplegia. Comparable post-treatment outcomes between groups suggest that structured home-based exercise programs may also be effective when appropriately designed and supported.Trial registration: ClinicalTrials.gov identifier: NCT07115693.

PMID:42485535 | DOI:10.1080/10790268.2026.2657701