Category: Statistics

Pituitary. 2026 Jul 8;29(4):120. doi: 10.1007/s11102-026-01711-8.

NO ABSTRACT

PMID:42418114 | DOI:10.1007/s11102-026-01711-8

Clin Rheumatol. 2026 Jul 8. doi: 10.1007/s10067-026-08284-8. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to investigate the frequency and associated factors of impaired adrenal response on Synacthen test in patients with rheumatic diseases undergoing low-dose maintenance GC therapy.

METHODS: This single-center, retrospective, observational study included 48 patients with autoimmune rheumatic diseases on maintenance GC therapy (prednisolone ≤ 5 mg/day) who had previously received ≥ 5 mg/day for ≥ 3 months and underwent adrenal function testing between January 2021 and May 2023. Impaired adrenal response was defined by both low baseline cortisol and inadequate response to the standard-dose (250 μg) Synacthen test in this study. Daily dose, treatment duration, cumulative dose, and history of methylprednisolone pulse therapy were evaluated. Statistical comparisons were performed using Mann-Whitney U, Fisher’s exact, and receiver operating characteristic (ROC) analyses.

RESULTS: Impaired adrenal response on Synacthen test meeting the study-defined criteria was identified in 30 of 48 patients (62.5%). Compared with the normal adrenal response group, affected patients had significantly higher cumulative GC doses, lower baseline cortisol levels, and more frequent histories of methylprednisolone pulse therapy. Exploratory ROC analysis identified an optimal cumulative glucocorticoid dose cutoff of 10,371.5 mg associated with impaired adrenal response on Synacthen test (prednisolone equivalent).

CONCLUSIONS: Impaired adrenal response on Synacthen test was frequently observed among patients selected for adrenal function testing during maintenance GC therapy at ≤ 5 mg/day. Higher cumulative GC exposure and prior pulse therapy were associated with impaired adrenal response on Synacthen test, suggesting that a targeted, risk-based approach to adrenal evaluation may be useful even during low-dose treatment. Key Points • Impaired adrenal response on Synacthen test was detected in 62.5% of patients selected for adrenal function testing during maintenance glucocorticoid therapy at ≤ 5 mg/day. • A cumulative glucocorticoid dose ≥ 10,371.5 mg was associated with impaired adrenal response on Synacthen test. • Exploratory ROC analysis identified basal cortisol ≤ 6.1 μg/dL and daily glucocorticoid dose ≥ 3.5 mg as potential thresholds associated with impaired adrenal response on Synacthen test. • Adrenal suppression may occur even in clinically stable patients receiving low-dose therapy.

PMID:42418112 | DOI:10.1007/s10067-026-08284-8

Neurotox Res. 2026 Jul 8;44(4):32. doi: 10.1007/s12640-026-00810-5.

ABSTRACT

Background the deployment of fifth-generation (5G) wireless telecommunications infrastructure, incorporating millimeter-wave (mmWave, 24-100 GHz) and sub-6 GHz frequencies, has renewed scientific and public health interest in the potential neurobiological effects of radiofrequency electromagnetic fields (RF-EMF). While extensive research has examined lower-frequency RF-EMF from 2G/3G/4G technologies, the specific effects of mmWave frequencies on CNS cellular biology-including microglial polarization and intracellular calcium signaling-remain less characterized. This systematic review evaluates experimental evidence from in vitro and in vivo studies on the effects of high-frequency EMF (300 MHz-300 GHz) on neuroimmune responses, microglial function, CNS calcium homeostasis, and related outcomes. Methods PubMed, EMBASE, Web of Science, and the EMF-Portal were searched from inception to January 2026 following PRISMA 2020 guidelines. Experimental (in vitro and animal) studies reporting CNS-relevant outcomes after high-frequency RF-EMF exposure were eligible. Exposure must have been within the 300 MHz to 300 GHz range. Quality assessment used adapted OHAT risk-of-bias criteria. A narrative synthesis was conducted; quantitative pooling was performed where three or more studies reported the same outcome. Results forty-one studies met inclusion criteria (see PRISMA Flow Diagram, Fig. 1): 7 in vitro (cell culture), 29 in vivo (rodent model), and 5 reviews/meta-analyses. The detailed characteristics of all included studies are summarized in Table 1. At specific absorption rate (SAR) levels at or below the International Commission on Non-Ionizing Radiation Protection (ICNIRP) general public exposure guidelines (2 W/kg averaged over 10 g), the majority of studies (27/41, 66%) found no statistically significant effects on neuroinflammatory markers, microglial morphology, or calcium signaling. Eleven studies (27%) reported transient, low-magnitude increases in intracellular Ca²⁺ or pro-inflammatory cytokine expression at exposures near or exceeding guideline limits; these effects were not consistently reproducible across independent laboratories. Three studies (7%) reported effects below guideline thresholds that may warrant further investigation. No study identified neuropathological changes (neuronal death, axonal injury) attributable to RF-EMF at guideline-compliant exposures. Conclusions current experimental evidence does not establish that high-frequency RF-EMF at guideline-compliant exposure levels produces significant adverse effects on microglial polarization, CNS calcium homeostasis, or neuroinflammatory responses. Methodological heterogeneity, inadequate dosimetry, and limited independent replication constrain confidence in both positive and negative findings. Standardized, rigorously controlled experimental studies are needed, particularly for mmWave frequencies (> 6 GHz) where data are sparse. Our findings support the current scientific consensus that high-frequency RF-EMF below regulatory limits does not pose a clearly established neurobiological hazard.

PMID:42418111 | DOI:10.1007/s12640-026-00810-5

J Gastrointest Cancer. 2026 Jul 8;57(1):149. doi: 10.1007/s12029-026-01517-8.

ABSTRACT

PURPOSE: Neutrophils are at the forefront of innate immune response. The prognostic impact of tumour-associated neutrophils (TANs) remains unclear. This study aimed to evaluate the prognostic role of TANs in colorectal cancer (CRC).

METHODS: A systematic review and meta-analysis were conducted using PubMed, Embase, and Scopus to identify studies correlating TANs with time-to-event survival analysis in patients with stages I-IV CRC from the date of inception until April 2024. Articles were included if they involved the identification of TANs through hematoxylin-eosin (HE) or immunohistochemistry (IHC) and reported survival analysis. Data was collected from the tumour core (TC) and invasive margin (IM). The hazard ratios (HRs) were extracted from the study results. Heterogeneity was evaluated using Cochran’s Q and I². Primary and secondary endpoints were overall survival (OS) and disease-free survival (DFS).

RESULTS: Of 4,292 citations found, 18 studies fulfilled eligibility criteria, encompassing 7,406 patients. IHC was used to identify TANs in 12 trials, while six performed HE. Five studies included patients with disease stages I-III, and 13 had stages I-IV. High TANs at the IM were associated with improved OS (HR = 0.64, 95% Confidence Interval [CI] 0.50-0.81, I² = 48%) and DFS (HR = 0.47, 95% CI 0.25-0.88, I² = 32%). At the TC, high TANs showed a trend towards better OS (HR = 0.82, 95% CI 0.61-1.10, I² = 83%) and DFS (HR = 0.48, 95% CI 0.21-1.07, I² = 93%), although not statistically significant and with high heterogeneity.

CONCLUSION: In this systematic review and meta-analysis, high TANs at the invasive margin (IM), the tumour-host interface, was associated with improved prognosis in CRC. In contrast, no statistically significant association was observed for high TANs at the tumour core (TC).

PMID:42418102 | DOI:10.1007/s12029-026-01517-8

Metabolomics. 2026 Jul 8;22(4):120. doi: 10.1007/s11306-026-02505-6.

ABSTRACT

INTRODUCTION: Cultivation of medicinal plants provides an opportunity for economic gain and health care accessibility. Ensuring consistent quality plant material is important for plants such as Pelargonium sidoides DC used for production of phytomedicines that are available in local and international markets. There is limited research on how agronomic factors affects phytochemicals in P. sidoides roots.

OBJECTIVE: To evaluate the effect of different irrigation regimes and harvesting age on metabolite accumulation in dried roots of P. sidoides.

METHODOLOGY: Irrigation was applied at 75%, 50% and 25% plant available water (PAW) corresponding to well- watered, moderate water deficit and severe water deficit respectively. P. sidoides, which were harvested at 6, 12 and 18 months after imposing the different water deficit treatments, roots dried and subjected to ultra-performance liquid chromatography -quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS) coupled with multivariate statistical analysis.

RESULTS: Unsupervised multivariate analysis showed that irrigation did not affect the obtained metabolic features. Orthogonal partial least squares discriminant analysis (OPLS-DA) showed statistically significance difference between 6 versus 12- and 18- months harvest ages. Compounds such as umckalin, epigallocatechin dimer, and gallic acid were increased in 12 and 18 months compared to the 6 months harvest. Sucrose/trehalose was increased by 0.2431- and 0.560- fold in 6 months compared to 12- and 18-months harvest ages respectively. On quantification, umckalin increased from 260.40 mg/kg DW at 6 months to 431.61 mg/kg DW at 12 months, while epigallocatechin rose from 342.98 mg/kg DW to 505.58 mg/kg DW over the same period. Umckalin sulphate was highest at 6 months under 25% PAW (7110.32 mg/kg DW) and decreased at 12 months harvest under the same irrigation level (4522.05 mg/kg DW).

CONCLUSION: The results indicated that younger plants accumulated more primary metabolites and modified secondary metabolites, whereas older plants accumulate more secondary metabolites. Moreover, cultivation of P. sidoides in limited water is plausible.

PMID:42418094 | DOI:10.1007/s11306-026-02505-6

J Community Health. 2026 Jul 8. doi: 10.1007/s10900-026-01594-7. Online ahead of print.

ABSTRACT

Tackle football is the most participated youth sport in the U.S. with leagues beginning as early as age 5. Exposure to cumulative repetitive head impacts (RHI) over years of play is increasingly viewed as a major contributor to chronic traumatic encephalopathy (CTE), a progressive neurodegenerative disease documented in contact sport athletes. Amid growing awareness of CTE, parents may turn to online information to guide decisions about youth tackle football participation. This cross‑sectional study examined the readability of online CTE information. Using the search term, ‘CTE,’ 68 URLs providing non‑technical information were identified after applying exclusion criteria. Online software was used to generate metrics from six widely-used readability formulas. Grade-level readability scores were categorized as ≤ Grade 8, 9-12, and ≥ 13 and summarized using descriptive statistics; distributions were compared by URL designation using chi-square tests (P < 0.05). Web page publication/revision date and presence of references were recorded. Median readability scores ranged from high school to early college with few pages meeting the recommended ≤ Grade 8 reading level for the general population. Levels were similarly high across non-commercial (.org,.gov,.edu) and commercial (.com) domains. Nearly 40% lacked clear publication or revision dates; fewer than half (47.1%) included references. Commonly accessed online CTE resources exceed recommended reading levels. This digital barrier impairs parents’ functional health literacy and capacity for informed decision-making. As research on CTE and tackle football participation evolves, there is a need for plain‑language, clearly-sourced, updated online resources tailored to this decisional context.

PMID:42418055 | DOI:10.1007/s10900-026-01594-7

Eur J Pediatr. 2026 Jul 8;185(8):559. doi: 10.1007/s00431-026-07234-5.

ABSTRACT

Over the past decade, new evidence has emerged regarding postnatal corticosteroids use in extremely preterm infants, particularly early prophylactic hydrocortisone. In France, national recommendations published in 2010 address late postnatal corticosteroids use only and do not incorporate the most evidence-based data. We aimed to provide a national overview of prescribing practices in French neonatal intensive care units (NICUs), focusing on prophylactic hydrocortisone. A national survey was conducted between 1 June and 13 August 2024 among all 66 French level III NICUs using a structured online questionnaire. One response per center was gathered. Fifty-five of 66 (83%) NICUs responded. Prophylactic hydrocortisone was used in 33 (60%) centers: 16 (29%) systematically and 17 (31%) selectively. Among users, 21 (64%) targeted the same population as the PREMILOC study. Non-users cited concerns about benefit-risk balance, lack of evidence, and absence of national guidelines. Fear of neurodevelopmental risk was more frequent among non-users (9/22 (41%) vs 1/33 (3%), p < 0.001), while perceived spontaneous intestinal perforation risk did not differ.

CONCLUSION: Hydrocortisone use in French NICUs remain heterogeneous due to safety concerns and a possible uncertainty about the strength of evidence. These findings underscore the need for updated national guidelines to support harmonized, evidence-based care for ELGANs.

WHAT IS KNOWN: • Recent evidence supports prophylactic hydrocortisone to improve survival without bronchopulmonary dysplasia in extremely preterm infants. • French national recommendations (2010) address late corticosteroid use (beyond 3 weeks) and do not incorporate recent evidence-based data.

WHAT IS NEW: • This national survey provides the first overview of hydrocortisone use in French NICUs, highlighting heterogeneity in prescribing practices. • It identifies discrepancies between evidence and clinical practice, supporting the need for updated guidelines.

PMID:42418052 | DOI:10.1007/s00431-026-07234-5

Eurasian J Med. 2026 Jun 30;58(4):1-5. doi: 10.5152/eurasianjmed.2026.261486.

ABSTRACT

BACKGROUND: Sudden sensorineural hearing loss (SSNHL) is an otologic emergency with a highly variable clinical course. Hyperbaric oxygen therapy (HBOT) has been widely used as an adjunctive treatment; however, its efficacy and determinants of treatment response remain incompletely defined. The aim of this study was to evaluate hearing outcomes in patients receiving HBOT and to assess the association between treatmentrelated factors and audiometric recovery.

METHODS: This retrospective study included 65 patients with idiopathic SSNHL. Pure tone audiometry thresholds were evaluated at baseline, post-treatment, and long-term follow-up when available. Changes were analyzed with the Wilcoxon signed-rank and Friedman tests, and correlations with recovery were assessed using Spearman’s analysis.

RESULTS: Complete pre- and post-treatment data were available for 65 patients. A statistically significant improvement in hearing thresholds was observed, decreasing from 41.7 ± 21.9 dB at baseline to 31.9 ± 22.1 dB following HBOT (P < .001). Among 19 patients with long-term follow-up, hearing thresholds further improved to 25.9 ± 17.3 dB. A significant difference was observed between baseline and long-term measurements (P = 0.006), although the overall comparison did not reach statistical significance (P = .209). No significant correlations were identified between hearing improvement and the number of HBOT sessions (r = 0.11, P = .387) or treatment delay (r = -0.06, P = .658). Etiological factors observed in the study population included upper respiratory infection (n = 30), acoustic barotrauma (n = 2), trauma (n = 1), and cases with no identifiable cause (n = 32). When analyzed according to etiology, no statistically significant difference in hearing threshold improvement was observed between groups (Kruskal-Wallis test, P = .151).

CONCLUSION: HBOT demonstrated a positive effect on hearing thresholds in patients with SSNHL, with the observed audiological improvements appearing to be sustained at long-term follow-up Cite this article as: Kuduban O, Özkan R. Shortand long-term hearing outcomes after hyperbaric oxygen therapy in idiopathic sudden sensorineural hearing loss. 2026, 58(4), 1486, doi: 10.5152/ eurasianjmed.2026.261486.

PMID:42417092 | DOI:10.5152/eurasianjmed.2026.261486

Epilepsia. 2026 Jul 8. doi: 10.1002/epi.70378. Online ahead of print.

ABSTRACT

OBJECTIVE: Cerebral cavernous malformations (CCMs) are vascular anomalies frequently associated with drug-resistant epilepsy. Surgical resection is a well-established treatment; however, the optimal strategy to achieve long-term seizure freedom (SF) remains unclear. Intraoperative electrocorticography (ECoG) may enhance seizure outcome by guiding resection extent, yet comparative evidence is limited. To evaluate the efficacy of ECoG-guided resection in patients with CCMs, a single-center comparative retrospective cohort analysis and a meta-analysis were performed.

METHODS: We analyzed 67 adult patients with CCMs who underwent resective surgery with or without ECoG guidance at our institution. The primary outcome of interest was SF. Statistical analysis included univariate analysis, Kaplan-Meier and receiver operating characteristic curves, and uni- and multivariate logistic regression. Additionally, we searched databases to identify studies reporting SF outcomes in patients with CCM-related epilepsy who underwent ECoG-guided surgery. A random-effects model was used to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs).

RESULTS: Seventeen patients underwent ECoG-tailored resection, and 50 underwent standard microsurgical lesionectomy (non-ECoG). SF rates were higher in the ECoG group at 24-, 30-, and 36-month follow-up (p < .05), although the ECoG group also displayed greater resection volumes (p < .01). After excluding temporal lobectomies, improved seizure outcomes remained significant only in extratemporal ECoG-guided lesionectomies (p < .05). On univariate analysis, ECoG use and postsurgical antiseizure medication were significant predictors of SF. Meta-analysis of seven studies, including our cohort, comprised 241 patients (130 ECoG, and 111 non-ECoG) and demonstrated better seizure outcomes with ECoG-guided resection compared to lesionectomy alone (OR = 6.01, 95% CI = 3.03-11.92, p < .001).

SIGNIFICANCE: ECoG-guided resection is associated with better long-term SF in patients with CCM-related epilepsy. Our evidence shows that ECoG may be a useful adjunct in cases of CCM-related epilepsy surgery, particularly in extratemporal lesions.

PMID:42417083 | DOI:10.1002/epi.70378

J Am Heart Assoc. 2026 Jul 8:e047762. doi: 10.1161/JAHA.125.047762. Online ahead of print.

ABSTRACT

BACKGROUND: Breast cancer (BC) and atrial fibrillation (AF) represent increasing global health burdens with shared risk factors. However, their coincidence burden and global distribution among older women (≥55 years) remain unclear.

METHODS: This study integrated data from the Global Burden of Disease 2021 database spanning 204 countries and territories, covering incidence rates of BC and AF and exposure rates of 58 risk factors. Using a 4-quartile classification algorithm, we divided the globe into 3 regions (consistent, BC-dominant, and AF-dominant area). Risk factors were screened by using machine learning models (random forest, spatial statistics, and SHAP interpretability framework). Population-attributable fraction and a composite risk index model were generated to evaluate disease burdens and spatial risk localization of BC and AF.

RESULTS: The consistent area (80 countries, 39.60%) exhibited overlapping BC-AF incidence, while BC-dominant (65 countries, 32.18%) and AF-dominant (57 countries, 28.22%) regions highlighted geographic disparities. After screening of machine learning models, 2 shared factors (smoking and alcohol use) and 2 BC-specific factors (high body mass index and low physical activity) were included in the calculation of population-attributable fraction, potentially reducing global BC and AF incidence by 29.05% and 11.75% after shifting these factors to theoretical minimum exposure levels. For most factors, high-risk zones clustered in North and South America, Europe, and Oceania mainly correlate with dietary and lifestyle patterns.

CONCLUSIONS: The spatial coincidence of BC and AF present a significant global health challenge. Addressing both shared and region-specific risk factors can substantially reduce the dual burden of these diseases.

PMID:42417071 | DOI:10.1161/JAHA.125.047762