Category: Statistics

Minerva Urol Nephrol. 2026 Jan 27. doi: 10.23736/S2724-6051.25.06301-3. Online ahead of print.

ABSTRACT

BACKGROUND: The role of surgical exploration and frozen sections (FSs) in monorchid patients with testicular nodules is still not well defined. We tested the role of surgical exploration and FSs in monorchid patients and the impact on the chance of testis sparing surgery (TSS).

METHODS: We identified 81 consecutive monorchid patients with testicular nodules between 2008 and 2024 candidates to surgical exploration and FSs. The statistical significance of differences in medians and proportions was tested with the Wilcoxon rank sum and chi-square tests. Multivariable logistic regression models (MLRMs) were used.

RESULTS: Testicular lesions number was available in 61 patients and was one in 35 (57.4%) of those, two in 15 (24.6%), three in 7 (11.5%) and more than three in 4 (6.5%). Median larger lesion size was 12 mm (IQR 9-20 mm). FSs were performed in 59 (73%) patients and showed germ-cell tumor (GCT) in 53 (65.4%). Orchidectomy was performed in 68 patients (84%). In 55 of 56 patients (98.3%) definitive histology confirmed FSs. Thirteen (16%) had TSS including 7 patients with seminomatous GCT, of those none had disease relapse at follow-up. At MLRMs older age was associated with lower probability of GCT (Odds Ratio 0.91, Confidence Interval 0.84-0.99, P value 0.03).

CONCLUSIONS: FSs are feasible and reliable in monorchid patients following a history of GCT. Nonetheless, TSS is rarely performed, as most of these patients actually have GCT. The few ones who had TSS had excellent oncological results.

PMID:41591767 | DOI:10.23736/S2724-6051.25.06301-3

J Gen Intern Med. 2026 Jan 27. doi: 10.1007/s11606-025-10114-7. Online ahead of print.

ABSTRACT

IMPORTANCE: Alcohol use disorder (AUD) has been associated with reduced adherence to and discontinuation of HIV preexposure prophylaxis (PrEP), potentially compromising its effectiveness.

OBJECTIVE: This study examines the relationship between AUD and PrEP adherence and continuation.

DESIGN: Retrospective cohort study using MarketScan Commercial Claims data.

PARTICIPANTS: We included individuals aged 16-64 who initiated PrEP between January 1, 2014, and December 31, 2021, and had continuous insurance coverage.

MAIN MEASURES: AUD diagnosis was identified within six months before PrEP initiation. Adherence was measured using the proportion of days covered (PDC) over 180 days and categorized by clinically relevant thresholds (≥ 85%, ≥ 80%, ≥ 57%). Continuation was assessed based on uninterrupted PrEP supply without a ≥ 30-day gap. Statistical analyses included propensity-score matching and regression modeling.

KEY RESULTS: Among 43,913 eligible individuals, 1,245 (2.84%) had an AUD diagnosis prior to PrEP initiation. In a matched sample of 1,153 individuals, those with AUD had lower mean PDC (59.54% [34.14] vs. 65.85% [33.18]; p < 0.001) and fewer mean days of continuous PrEP use (107 [67.20] days vs. 119.90 [65.21] days; p < 0.001) compared to the Without AUD group. Regression analyses showed individuals with AUD had 6.31% lower mean PDC (95% CI: -9.05% to -3.57%; p < 0.001) and 12.93 fewer days of PrEP continuity (95% CI: -18.34 to -7.52 days; p < 0.001) compared to the Without AUD group. Findings may not be generalizable beyond commercially insured individuals, and we may have not captured all factors that influence PrEP adherence.

CONCLUSION: Individuals with AUD before PrEP initiation exhibited lower adherence and continuation compared to those without AUD. Targeted interventions may be required to enhance PrEP adherence and continuity in this population.

PMID:41591743 | DOI:10.1007/s11606-025-10114-7

Saudi Dent J. 2026 Jan 27;38(2):12. doi: 10.1007/s44445-025-00116-w.

ABSTRACT

Canine teeth are essential to dentofacial aesthetics and functional harmony. When impacted they impair both form and function leading to psychological distress and poor health-related quality of life. This study investigates the approaches to managing impacted canines in the southern region of Najran, Kingdom of Saudi Arabia. This was a retrospective study with data collection from Najran Specialty Regional Dental Center in Najran, Kingdom of Saudi Arabia from 2020 to 2024. Clinical record data extracted include age, sex, radiographs, position of impacted canine, location of impacted canine and management protocol. The data were analyzed using IBM SPSS Statistics for IOS Version 25 (Armonk, NY: IBM Corp). P-value ≤ 0.05 was considered statistically significant. A total of 98 patients comprising 44 males (44.9%) and 54 females (55.1%) with impacted canines were managed during the study period. Age ranged from 13 to 30 years with mean ± SD age of 19.3 ± 3.3 years. Age group 16-20 years were in the majority (56 (57.1%)) while age group 26-30 were the least (3 (3.1%)). The majority of the impacted canines were located in the maxilla (85 (86.7%). Considering, management protocol, the majority (57 (58.2%)) of the patients with impacted canine were treated by non-surgical canine exposure. Most of our patients are young adults with the majority having maxillary canine impaction in the palatal location. Our favorite option is non-surgical canine exposure. Treatment durations ranges from two to four years with the majority in the 2.5 to 3 years.

PMID:41591704 | DOI:10.1007/s44445-025-00116-w

Int J Clin Oncol. 2026 Jan 27. doi: 10.1007/s10147-026-02974-8. Online ahead of print.

ABSTRACT

BACKGROUND: Sarcopenia is a critical comorbidity in esophageal cancer patients undergoing neoadjuvant therapy (NAT), linked to poor surgical outcomes and survival. However, its reported prevalence varies widely, and a comprehensive synthesis of evidence is lacking.

OBJECTIVE: To systematically evaluate and quantify the prevalence of the sarcopenia disease in in patients known to be diagnosed with esophageal cancer and receiving preoperative neoadjuvant therapy and examine its association with clinical outcomes.

METHODS: Following PRISMA guidelines 2020, This systematic review and meta-analysis that was registered on PROSPERO (CRD420251109294), provides a comprehensive search through PubMed, SCOPUS, Web of Science, and the Cochrane Library to identify research papers reporting sarcopenia prevalence in esophageal cancer patients undergoing neoadjuvant chemotherapy or chemoradiotherapy. Pooled prevalence estimates and outcome associations were calculated using random-effects models. Subgroup and sensitivity analyses were performed to explore heterogeneity, and study quality was assessed using the Newcastle-Ottawa Scale.

RESULTS: Twenty-six research studies comprising 3298 patients were included. The pooled prevalence of sarcopenia following neoadjuvant therapy was 48% (95% CI 38-58%), with considerable heterogeneity (I² = 95.7%). Sarcopenia was significantly associated with worse overall survival (HR: 2.10; 95% CI 1.72-2.57) but showed no statistically significant association with recurrence-free survival or postoperative complications. Most studies were of moderate to high quality, though differences in diagnostic criteria and assessment timing contributed to heterogeneity.

CONCLUSIONS: Sarcopenia is highly prevalent among patients with esophageal cancer undergoing neoadjuvant therapy. Although sarcopenia was consistently associated with poorer overall survival, these findings are derived from heterogeneous definitions, variable assessment timing, and unadjusted outcome analyses, and should therefore be interpreted as associative rather than causal. Standardized diagnostic criteria, incorporation of muscle strength assessment, and prospective studies are required in future research.

PMID:41591683 | DOI:10.1007/s10147-026-02974-8

Discov Oncol. 2026 Jan 27. doi: 10.1007/s12672-025-03876-3. Online ahead of print.

ABSTRACT

Aging-related diseases, particularly cancer, remain major health challenges that demand new therapeutic strategies. Chimeric antigen receptor (CAR) T cell therapy has emerged as a powerful modality in immuno-oncology, enabling patient-derived T cells to be engineered ex vivo to recognize and eliminate tumor antigens. Here, we identify FAM168B (family with sequence similarity 168 member B, also known as myelin-associated neurite-outgrowth inhibitor, MANI) and its homolog FAM168A (tongue cancer resistance-associated protein 1, TCRP1) as candidate membrane-associated proteins expressed on cancer cell surfaces. The unique characteristics of FAM168B suggest its potential as a tumor-specific target for CAR T cell development. This approach could expand the therapeutic repertoire of CAR T cell therapy and support the design of more precise and versatile treatment strategies for diverse cancer types.

PMID:41591662 | DOI:10.1007/s12672-025-03876-3

Adv Ther. 2026 Jan 27. doi: 10.1007/s12325-025-03473-4. Online ahead of print.

ABSTRACT

INTRODUCTION: Sickle cell pain crises (SCPCs) are debilitating pain events that significantly impact quality of life in patients with sickle cell disease (SCD), but no fit-for-purpose tool exists to capture patients’ experiences of them. We developed a patient-reported outcome (PRO) tool to capture patients’ SCPC experiences and ensured its content validity through cognitive debriefing (CD) interviews with adolescents and adults with SCD.

METHODS: In this non-interventional, qualitative research study, a targeted literature review (TLR) was conducted to create preliminary items and a preliminary conceptual model (CM) of SCPCs in patients with SCD. Next, an item-generation session was held with clinical experts, followed by hybrid concept elicitation (CE) and CD interviews with patients over three waves; the preliminary items and CM were refined iteratively after each wave. SCPC and impact disturbance ratings were summarised using descriptive statistics. CD responses were analysed on the basis of a semi-structured discussion guide.

RESULTS: The TLR identified 12 articles describing 47 concepts related to pain, anatomical sites, duration, frequency, and impacts of SCPCs. In CE interviews, patients described various aspects of their SCPC experience, including anatomical sites affected, pain characteristics, and duration. CD interviews confirmed the content validity of the eDiary, with patients finding most questions and response options clear and useful. The diary was modified on the basis of patient feedback per wave.

CONCLUSION: The SCPC eDiary is a novel PRO instrument that captures the frequency, severity, and impact of home-managed pain crises. Future studies should assess its real-world use and performance in clinical settings.

PMID:41591645 | DOI:10.1007/s12325-025-03473-4

Clin Pharmacokinet. 2026 Jan 27. doi: 10.1007/s40262-025-01617-x. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Accurate assessment of the glomerular filtration rate (GFR) is crucial in critically ill children, yet standard estimation formulas (eGFR) perform poorly, especially in the youngest. Iohexol plasma clearance is the reference standard for measured GFR; however, its routine use is limited by logistical constraints. This study aims to develop and internally validate a population pharmacokinetic model of iohexol in critically ill children, to derive a practical model-based GFR estimation formula (eGFR_iohexol), and to compare its predictive performance against established eGFR formulas (eGFR_Schwartz, eGFR_{Smeets/Pierce}).

METHODS: After administration of iohexol, up to six blood samples were drawn from 107 patients over a 6-hour interval. Data from 93 patients were used for model building, and from 31 patients for internal validation. Reference clearances were obtained using the post hoc Bayesian clearance estimates. Predictive performances of eGFR_iohexol, eGFR_Schwartz, and eGFR_{Smeets/Pierce} were compared with reference clearances using bias, imprecision, Total Deviation Index, concordance correlation coefficient, and the percentage of predictions within 10 and 30% error (P10, P30) around reference clearances.

RESULTS: The final model identified body surface area, serum creatinine, cystatin C, postoperative status, and clonidine treatment as significant predictors of iohexol clearance. eGFR_iohexol demonstrated minimal bias (-0.8%) and imprecision (21%) and high accuracy (P30 = 87%), particularly in patients under 2 years of age (P30 = 90 vs 40% for eGFR_Schwartz). Furthermore, eGFR_iohexol also demonstrated superiority over eGFR_{Smeets/Pierce}, which exhibited moderate bias (-5.4%) and reduced accuracy (P30 = 68%).

CONCLUSIONS: A model-derived GFR estimation formula based on iohexol population pharmacokinetic modeling might allow for an accurate bedside assessment of kidney function in critically ill children, outperforming the Schwartz and Smeets/Pierce formulas, particularly in infants. External validation in larger pediatric intensive care unit populations, across the full age and GFR range, is warranted to confirm the generalizability of this equation and its potential for broader clinical application.

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT05179564, registered retrospectively on 5 January, 2022.

PMID:41591642 | DOI:10.1007/s40262-025-01617-x

Mol Cell Biochem. 2026 Jan 27. doi: 10.1007/s11010-026-05482-5. Online ahead of print.

ABSTRACT

Despite observed epidemiological associations, the direct causality between chronic kidney disease (CKD) and senile cataract remains unclear. This bidirectional Mendelian randomization (MR) study assessed the causal associations between CKD-including glomerular filtration rate (eGFR), urinary albumin-to-creatinine ratio (UACR), dialysis, and rapid eGFR decline-and senile cataract. Summary statistics from genome-wide association studies (GWAS) of European ancestry were analyzed. Data for senile cataract comprised 404,086 individuals, while data for CKD and related kidney function traits were sourced from large-scale meta-analyses (sample size up to 1,004,040). Instrumental variables with F-statistics greater than 10 were utilized to estimate causality via inverse-variance weighted (IVW) regression, complemented by weighted median, weighted mode, and MR-Egger methods. Sensitivity analyses included MR-PRESSO for pleiotropy adjustment and Cochran’s Q for heterogeneity assessment. Additionally, a multivariable MR (MVMR) analysis was conducted to adjust for type 2 diabetes (T2D). Univariable MR analyses did not support causal relationships between general CKD, eGFR, UACR, or dialysis and senile cataract. However, in the MVMR analysis adjusting for T2D, a genetically predicted rapid eGFR decline (Rapid3) was significantly associated with an increased risk of senile cataract (OR = 1.089, P = 0.014). Reverse MR analyses indicated no causal effect of senile cataract on CKD or kidney function traits. This study found no evidence for a direct causal link between general CKD and senile cataract. However, the findings suggest that rapid deterioration of kidney function may be a causal risk factor for cataract, independent of shared genetic pathways with T2D. These results underscore the clinical importance of monitoring ocular health in patients experiencing accelerated kidney function loss.

PMID:41591627 | DOI:10.1007/s11010-026-05482-5

Discov Nano. 2026 Jan 27;21(1):17. doi: 10.1186/s11671-026-04447-3.

ABSTRACT

Ultra-wideband (UWB) technology has garnered significant interest from researchers worldwide. Reducing antenna size, guaranteeing radiation stability, attaining impedance matching, and keeping costs down are recent challenges.The adaptability, compactness, and wideband performance of log-periodic sawtooth planar antennas for UWB applications show great potential. There is much potential for improvement, especially in high-gain and multi-band settings, as indicated by the current research and advancements in resonator structures, reconfigurability, and meta surface designs. These advancements guarantee that log-periodic architectures will remain relevant and it targets wideband sub-GHz applications that complement 5G networks, including control, broadcast, and backward-compatibility services. A toothed log-periodic antenna based on graphene is proposed in this study to operate in the 0.1-1.3 GHz frequency range. In proposed method by varying the DC voltage applied to the graphene, the antenna’s bandwidth, radiation pattern, and operating frequency range is dynamically adjusted. The graphene’s chemical potential, surface conductivity, and surface impedance, this voltage control makes it possible to create a reconfigurable antenna design is adjusted. A log-periodic graphene lattice coupled to a 50-ohm feed line makes up the antenna’s radiating element. Simulation and implementation results demonstrate that the antenna generates stable, directional radiation patterns over a wide frequency range from 0.1 to 1.3 GHz when the chemical potential of graphene is set to 1 eV.

PMID:41591626 | DOI:10.1186/s11671-026-04447-3

Clin Rheumatol. 2026 Jan 27. doi: 10.1007/s10067-026-07962-x. Online ahead of print.

ABSTRACT

OBJECTIVE: The study aimed to evaluate Antinuclear antibody detection by indirect immunofluorescence and line immunoassay in patients with suspected autoimmune diseases and to correlate immunofluorescence patterns and autoantibody profiles with their clinical features to improve diagnostic interpretation.

METHODS: A retrospective cross-sectional study was conducted on 1,342 patients clinically suspected of autoimmune diseases over nine months at a tertiary care hospital in North India. All samples were tested using indirect immunofluorescence on HEp-2 cells. Line immunoassay was performed on samples showing nuclear immunofluorescence patterns. Associations between serological findings, demographic variables, clinical features, and final diagnoses were statistically analysed.

RESULTS: Of the 1,342 patients clinically suspected of autoimmune diseases, antinuclear antibodies by indirect immunofluorescence assay were detected in 308 patients (22.95%). Among these positive samples, nuclear patterns were observed in 206 (66.88%) cases and cytoplasmic patterns in 102 (33.11%). The speckled nuclear pattern was the most frequent (151/206; 73.30%), followed by homogeneous (9.22%), nucleolar (8.74%), and centromere (4.85%) patterns. Line immunoassay performed on nuclear pattern-positive samples identified antigen-specific autoantibodies in 67 cases (32.52%), while no autoantibodies were identified in 139 cases (67.48%). The most commonly detected autoantibodies were anti-Ro52, anti-Ro60, and anti-dsDNA. A statistically significant association was observed between indirect immunofluorescence assay patterns and autoantibody profiles (χ2 = 597.587, p < 0.001). Antinuclear antibody positivity showed significant correlation with joint-related symptoms (p < 0.001) and swollen glands (p = 0.004). Distinct immunofluorescence patterns and autoantibody profiles demonstrated disease-specific associations, including centromere pattern with systemic sclerosis and homogeneous and speckled patterns with systemic lupus erythematosus and Sjögren’s disease.

CONCLUSION: A combined diagnostic approach using indirect immunofluorescence for screening and line immunoassay for antigen-specific profiling improves diagnostic accuracy. This strategy is particularly valuable in resource-limited settings, enabling targeted diagnosis and clinical decision-making. Key Points • A dual methodology combining indirect immunofluorescence with Line immunoassay enhances diagnostic specificity in the identification of autoimmune diseases. • Significant associations were identified among Antinuclear antibody patterns, autoantibody profiles, and specific autoimmune diseases. • The study reinforces the utility of integrating indirect immunofluorescence and Line immunoassay in routine autoimmune diagnostics, especially in resource-limited healthcare settings.

PMID:41591621 | DOI:10.1007/s10067-026-07962-x