Category: Statistics

Turk Arch Pediatr. 2026 May 21;61(6):495-501. doi: 10.65717/TurkArchPediatr.2026.25440.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the indications and clinical and microbiological outcomes of tigecycline use in pediatric patients and to analyze the factors associated with treatment success and mortality.

METHODS: The patients receiving tigecycline antibiotic therapy at a tertiary university hospital over a 12-year period were evaluated.

RESULTS: During the study period, tigecycline was used in 66 patients. The median age of the patients was 11 years (range: 2 months to 18 years), and 40 (60.6%) were male. While 53% of the patients received empirical treatment, 46.9% received targeted therapy. The majority of patients (81.8%) received tigecycline for “off-label” indications, with bacteremia being the most common “off-label” indication. Microbiological and clinical success rates were 77.1% and 66.7%, respectively. While clinical success did not differ significantly between empiric and targeted therapy groups (P=.22), microbiological success was significantly higher in the targeted therapy group (P=.02). No statistically significant differences were observed between indication types. However, mortality was higher in patients with bacteremia who were treated with tigecycline compared with the non-bacteremic group (P=.007). Tigecycline was combined with other antibiotics in all patients. No serious adverse events requiring discontinuation of tigecycline treatment or dose revision were observed during follow-up.

CONCLUSIONS: This study suggests that tigecycline, due to its broad spectrum of antibacterial activity, may be an important option in children in combination with other antibiotics in the absence of alternative options or in the absence of response to treatment.

PMID:42228818 | DOI:10.65717/TurkArchPediatr.2026.25440

Transplantation. 2026 Jun 2. doi: 10.1097/TP.0000000000005770. Online ahead of print.

NO ABSTRACT

PMID:42228811 | DOI:10.1097/TP.0000000000005770

PLoS One. 2026 Jun 2;21(6):e0348881. doi: 10.1371/journal.pone.0348881. eCollection 2026.

ABSTRACT

This study investigates the structural, optical, morphological, magnetic, and photocatalytic properties of Fe3O4/TiO2 nanocomposites (FeT NCs), synthesized through a modified sol-gel method for the photodegradation of Reactive Yellow 145 (RY145). Characterization of FeT NCs (PL, XRD, FTIR, VSM, DRUV-Vis, DLS, Zeta potential, XPS, BET, SEM, TEM, TGA) revealed that Fe3O4 incorporation into TiO2 enhances charge separation, suppresses electron-hole recombination through Ti-O-Fe linkages, and improves photocatalytic efficiency. The calcined 0.025FeT3 exhibited high crystallinity with dominant anatase TiO2 and no rutile transition. SEM and TEM revealed a core-shell morphology with Fe3O4 cores encapsulated by TiO2, while aggregation was minimized by synthesis conditions. Optimal photocatalytic performance (84.51% % RY145 removal at neutral pH) was achieved using 1 mg mL-1 0.025FeT3 following pseudo-first-order kinetics. The Langmuir-Hinshelwood model yielded rate and equilibrium constants of 2.80 mg.L-1 min-1 and 2.42 L mg-1, respectively. Mechanistic and scavenging experiments indicated that photogenerated holes and •OH radicals dominated the degradation process. The FeT catalyst maintained high stability over six cycles. Magnetic measurements showed soft magnetic behavior with low coercivity and remanence, favoring easy recovery. The reduced bandgap (2.62 eV) facilitated visible-light activation, while BET analysis confirmed a mesoporous structure with high surface area. XPS verified the oxidation states of Fe and Ti, and HPLC confirmed RY145 decomposition via azo bond cleavage and oxidation to carboxylic acids, demonstrating efficient and sustainable photocatalytic activity. 0.025FeT3 demonstrated efficient, stable, and magnetically retrievable photocatalytic activity under visible light, highlighting its potential for sustainable treatment of textile wastewater. To optimize the batch experimental data, a novel ML-driven predictive framework was tested to model and map the relationships between the selected optimization parameters (FeT contents, FeT dose, reaction time), to predict RY145 photodegradation efficiency, and to identify the optimal operating window for improved photocatalytic performance (using three regression measures R2, MAE, and RMSE). The CNN models outperformed with a predicted accuracy and R2 value of 0.91. Based on the results, ML-based evaluation outperformed manual optimization and traditional statistical methods, delivering a more efficient and reliable way for process optimization.

PMID:42228765 | DOI:10.1371/journal.pone.0348881

Acta Otolaryngol. 2026 Jun 2:1-7. doi: 10.1080/00016489.2026.2677603. Online ahead of print.

ABSTRACT

BACKGROUND: Polycystic ovary syndrome (PCOS) is a common endocrine disorder that may affect multiple organ systems. While cochlear and otolith involvement has been investigated, the impact on semicircular canal-mediated vestibulo-ocular reflex (VOR) function remains unclear.

AIMS/OBJECTIVES: To evaluate canal-specific, high-frequency VOR function in women with PCOS using the video head impulse test (vHIT) and compare findings with healthy controls.

MATERIAL AND METHODS: This single-center case-control study included 42 women with PCOS (Rotterdam criteria) and 35 age-matched controls. vHIT was performed using the Interacoustics EyeSeeCam system. Canal-specific VOR gains, asymmetry indices (LARP, RALP, lateral), and corrective saccade frequencies were analyzed.

RESULTS: After correction for multiple comparisons (Benjamini-Hochberg method), LARP asymmetry was the only parameter that remained statistically significant in PCOS (p = 0.002; p = 0.019). Unadjusted differences in left lateral and right posterior canal gains did not survive correction. Corrective saccade frequency did not differ between groups.

CONCLUSIONS AND SIGNIFICANCE: Women with PCOS exhibited subtle, canal-specific differences in high-frequency VOR function. However, these findings should be interpreted cautiously, and their clinical significance remains uncertain.

PMID:42228394 | DOI:10.1080/00016489.2026.2677603

Work. 2026 Jun 2:10519815261454977. doi: 10.1177/10519815261454977. Online ahead of print.

ABSTRACT

BackgroundA growing body of evidence suggests that a combination of physical, psychological, and environmental factors increases the likelihood of experiencing complaints related to the arm, neck, and/or shoulder (CANS), although the precise nature of these relationships and their potential long-term effects remain uncertain.ObjectiveTo synthesize evidence from prospective cohort studies investigating the risk factors associated with the development of CANS among workers who use computers.MethodsA systematic search was conducted in PubMed, ProQuest, Scopus, Cochrane Library, and Google Scholar to identify prospective cohort studies published between January 2010 and 2025. Eligible studies investigated risk factors of CANS among workers using computers, with a follow-up period of at least one year. Two reviewers independently screened studies, extracted data, and assessed methodological quality using the Newcastle-Ottawa Scale. Relative risks (RR) and 95% confidence intervals (CI) were pooled using a random-effects meta-analysis. Heterogeneity among studies was assessed using Cochran’s Q test and the I² statistic.ResultsTwo studies indicated a low risk of bias, while the remaining studies were assessed as having a moderate risk. For overall exposures, the correlation with the prevalence of CANS was the duration of using computers or mouse >4 h/day and BMI, with RR = 1.25 (95% CI: 1.08-1.44) and 1.05 (95% CI: 1.02-1.08), respectively.ConclusionProlonged computer use and higher body mass index were significant predictors of CANS, and the findings highlight the importance of ergonomic interventions and health promotion strategies to reduce work-related musculoskeletal complaints in sedentary occupational environments.

PMID:42228393 | DOI:10.1177/10519815261454977

NeuroRehabilitation. 2026 Jun 2:10538135261455053. doi: 10.1177/10538135261455053. Online ahead of print.

ABSTRACT

ObjectiveEvidence for structured group telerehabilitation in stroke is limited. We evaluated therapist-led group telerehabilitation effects on physical function, psychological well-being, and health-related quality of life (HRQoL) in patients with chronic stroke, and identified functional predictors of improvement.MethodsThirty-five patients with chronic stroke were randomized into the telerehabilitation exercise group, referred to as TEG, with eighteen participants, or the self-exercise rehabilitation group, referred to as SRG, with seventeen participants. Outcomes were assessed at baseline and post-intervention. Interaction effects between group and time were evaluated. Significance was set at p < .025 for primary outcomes, Berg Balance Scale (BBS) and Timed Up and Go Test (TUG). Functional predictors were examined via baseline-adjusted regression.ResultsBoth groups showed significant within-group improvements (p < .001). Interaction effects revealed statistically significant, though modest, gains in BBS and TUG in the TEG versus SRG. Lower-limb strength, fall efficacy, and depressive symptoms improved over time without significant between-group differences. HRQoL gains were meaningful, especially in the TEG. Regression confirmed group allocation independently predicted balance and mobility improvements (R² = 0.152 and 0.153), with no group effects for other measures.ConclusionReal-time, group-based telerehabilitation led by physical therapists serves as a clinically viable alternative that supports functional balance, mobility, and HRQoL in patients with chronic stroke. These findings demonstrate statistically significant improvements in functional outcomes compared with unsupervised exercise, suggesting that this structured remote approach, by providing superior functional benefits over unsupervised exercise, serves as a practical and accessible alternative to traditional facility-based rehabilitation is unavailable.

PMID:42228382 | DOI:10.1177/10538135261455053

JAMA Netw Open. 2026 Jun 1;9(6):e2616141. doi: 10.1001/jamanetworkopen.2026.16141.

ABSTRACT

IMPORTANCE: Ontario’s public drug program (Ontario Drug Benefit [ODB]) announced coverage for flash glucose monitoring (FGM) systems effective September 16, 2019, for eligible patients with insulin-requiring diabetes. However, even within the context of a publicly funded program, access to benefits is complex and can be inequitable.

OBJECTIVE: To evaluate the association between immigration status and time to accessing the FGM system through the ODB program.

DESIGN, SETTING, AND PARTICIPANTS: This population-based cohort study used retrospective data on Ontario residents 66 years or older who were ODB eligible and insulin requiring as of September 15, 2019, and followed up with individuals until March 31, 2023. Statistical analysis was performed from August 2025 to April 2026.

EXPOSURE: Immigrants were propensity score matched with long-term residents on age (within 2 years) and sex.

MAIN OUTCOME AND MEASURE: Marginal Cox proportional hazards regression models were used to examine the association between immigration status and the main outcome, time to receipt of first FGM sensor. Secondary analyses stratified the exposure according to timing of immigration (recent immigrants arriving to Canada within 10 years vs long-term immigrants).

RESULTS: A total of 109 079 individuals (median age, 73 years [IQR, 70-79 years]; 59 649 male [54.7%]) met the inclusion criteria, most of whom were long-term residents (95 677 [87.7%]). Within this cohort, 13 257 of 13 402 immigrants (98.9%) were matched with an equal number of long-term residents. In the primary analysis, immigrants had a significantly lower hazard of initiating FGM compared with long-term residents (36.7 per 100 person-years vs 38.8 per 100 person-years; hazard ratio [HR], 0.95 [95% CI, 0.93-0.98]). In secondary analyses stratified by timing of immigration, recent immigration status was associated with a significantly longer time to FGM initiation compared with long-term residents (HR, 0.87 [95% CI, 0.80-0.94]); long-term immigrants also had a significantly lower hazard of initiating FGM compared with long-term residents (HR, 0.94 [95% CI, 0.91-0.98]).

CONCLUSIONS AND RELEVANCE: In this population-based cohort study of older adults with insulin-requiring diabetes, immigrants faced a longer time to access to FGM systems compared with long-term residents, with the greatest disparity observed among people who immigrated to Canada in the past decade. Efforts are needed to address barriers that may hinder timely access to novel medications or devices, which may include health care system navigation, patient-clinician communication, and cultural or knowledge barriers.

PMID:42228372 | DOI:10.1001/jamanetworkopen.2026.16141

JAMA Netw Open. 2026 Jun 1;9(6):e2616362. doi: 10.1001/jamanetworkopen.2026.16362.

ABSTRACT

IMPORTANCE: Lower neighborhood socioeconomic status (nSES) is associated with worse stroke recovery. It remains unclear what factors could be targeted therapeutically to mitigate nSES-associated poststroke recovery differences.

OBJECTIVE: To identify the extent with which receipt of hyperacute treatment, neighborhood density of home health services, density of rehabilitation clinics, density of recreation centers, transportation access, and walkability mediate the association between nSES and stroke recovery.

DESIGN, SETTING, AND PARTICIPANTS: The population-based stroke cohort Brain Attack Surveillance in Corpus Christi (BASIC) enrolled individuals between 2009 and 2022 in Nueces County, Texas. Candidate mediators were derived from BASIC, Redfin, or the National Neighborhood Data Archive. Causal mediation analyses were performed. Participants were followed from time of stroke to 90 days after stroke. Participants’ census tracts at time of stroke were used to define neighborhoods. Individuals aged 45 years or older with completed baseline and community-dwelling 90-day assessments were included. Data analysis was performed from January 2024 to April 2026.

EXPOSURE: nSES, a validated index of neighborhood deprivation.

MAIN OUTCOMES AND MEASURES: The primary outcomes were 90-day functional status (activities of daily living [ADL] and instrumental ADL [IADL] questionnaire score), depressive symptom burden (Patient Health Questionnaire [PHQ]-8 Score), and quality of life (Stroke-Specific Quality-of-life questionnaire [SS-QoL] score). Associations between nSES and the outcomes were assessed using generalized estimating equations.

RESULTS: Among the 2203 individuals with 90-day outcomes from 77 census tracts, 1044 (47.4%) were female, the median (IQR) acute National Institute of Health Stroke Scale score was 3 (1 to 6), and the median (IQR) age was 66 (57 to 75) years. Higher nSES was associated with better outcomes across all measures (PHQ-8 score, β = -1.21 [95% CI, -1.86 to -0.56]; ADL-IADL score, β = -0.20 [95% CI, -0.27 to -0.13]; SS-QoL score, β = 0.20 [95% CI, 0.11 to 0.29]). Shifting all mediator distributions from low-nSES to high-nSES neighborhoods modestly attenuated the association of nSES with PHQ-8 score by 14.1% (95% CI, -36.3% to 64.5%) and accounted for 15.1% (95% CI, -11.0% to 41.2%) of the association of nSES with ADL-IADL score and 5.6% (95% CI, -25.4% to 36.6%) of the association of nSES with SS-QoL score. However, no evaluated factors were statistically significant mediators.

CONCLUSIONS AND RELEVANCE: In this cohort study of a biethnic urban population with predominantly mild strokes, higher nSES was associated with better outcomes. These differences were not significantly mediated by hyperacute treatment, postacute care resource density, transportation access, or walkability. Future studies should evaluate to what extent time to hyperacute treatment, postdischarge disposition, poststroke therapy intensity, and other factors may underlie differences in stroke recovery by nSES.

PMID:42228368 | DOI:10.1001/jamanetworkopen.2026.16362

JAMA Netw Open. 2026 Jun 1;9(6):e2616370. doi: 10.1001/jamanetworkopen.2026.16370.

ABSTRACT

IMPORTANCE: Due to legal restrictions, many patients pay out of pocket for later abortion care in the US. Knowledge of facility availability, self-pay prices, and state Medicaid acceptance may enable timely access to care.

OBJECTIVE: To estimate quoted self-pay prices and assess state Medicaid acceptance for later abortion care from 23 to 33 weeks of pregnancy duration.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used a mystery caller design from November 2024 through April 2025. Contacted US health care facilities (clinics and hospitals) advertised offering abortion care at or after 23 weeks in August 2024.

EXPOSURE: Mystery calls at 2-week pregnancy duration periods advertised for providing care (23, 25, 27, 29, 31, and 33 weeks) to request self-pay prices. Facilities in states permitting Medicaid coverage received additional calls regarding acceptance.

MAIN OUTCOMES AND MEASURES: Facility availability by pregnancy duration, quoted self-pay prices, and reported state Medicaid acceptance.

RESULTS: A total of 130 facilities in 20 states and the District of Columbia advertised providing abortion care at or after 23 weeks of pregnancy (52 clinics, 78 hospitals). The overall response rate for obtaining at least 1 usable quoted self-pay price or range was 60.2% (112 of 186 facilities). Median self-pay prices increased from $3000 at 23 weeks to $17 250 at 33 weeks, with a statistically significant increase of $2541 from 23 to 25 weeks. The number of facilities providing care declined from 130 at 23 weeks to 31 at 25 weeks and 3 at 33 weeks. Among facilities in states with Medicaid coverage, 73 of 105 (69.5%) consistently reported accepting Medicaid; acceptance declined at later pregnancy durations and varied by state.

CONCLUSIONS AND RELEVANCE: In this cross-sectional mystery call study of 130 facilities advertising later abortion care in August 2024, self-pay prices increased with pregnancy duration, while service availability and Medicaid acceptance declined. Improving self-pay price transparency and expanding the availability of later abortion care, especially in states with Medicaid coverage, may facilitate more timely access to care.

PMID:42228367 | DOI:10.1001/jamanetworkopen.2026.16370

JAMA Netw Open. 2026 Jun 1;9(6):e2616375. doi: 10.1001/jamanetworkopen.2026.16375.

ABSTRACT

IMPORTANCE: Statin use has been associated with improved survival in patients with breast cancer, but there are no data on the association between statin use and survival in different intrinsic breast cancer subtypes.

OBJECTIVE: To assess the associations between statin use and survival in patients with early breast cancer of different intrinsic subtypes.

DESIGN, SETTING, AND PARTICIPANTS: A retrospective population-based cohort study of female patients with invasive breast cancer diagnosed in Finland between 1995 and 2013. The cohort was limited to early breast cancer cases with sufficient data for surrogate intrinsic subtyping. All data originated from Finnish national registries. Statistical analyses were performed from September to November 2023.

EXPOSURE: Statin use, statin dose, and blood cholesterol levels before and after diagnosis.

MAIN OUTCOMES AND MEASURES: All-cause and breast cancer-specific mortality during follow-up.

RESULTS: A total of 7389 female patients with early breast cancer were included (median [range] age at diagnosis, 60 [21-102] years). Prediagnostic statin use was not associated with breast cancer-specific or all-cause mortality. Postdiagnostic statin use was associated with lower age-adjusted breast cancer-specific (hazard ratio [HR], 0.68; 95% CI, 0.57-0.82) and all-cause (HR, 0.83; 95% CI, 0.75-0.92) mortality. In a multivariable-adjusted model, statin use was associated with higher breast cancer-specific survival in all hormone receptor-positive subtypes (luminal A-like, luminal B-like [HER2-negative], and luminal B-like [HER2-positive]). All-cause mortality was lower among statin users in patients with hormone positive and triple-negative subtypes. One-year lag-time analysis or adjustment for blood-cholesterol levels after breast cancer diagnosis did not affect the results substantially. While the benefit of statin use was noticed in all statin users regardless of dose intensity, a trend of dose-dependent risk reduction was observed regarding breast cancer-specific mortality.

CONCLUSIONS AND RELEVANCE: In this cohort study of patients with early breast cancer, prediagnostic statin use was not associated with higher survival; however, postdiagnostic statin use was associated with lower all-cause and breast cancer-specific mortality among patients with hormone receptor-positive intrinsic subtypes. These findings suggest that statin therapy may improve survival of patients with early hormone receptor-positive subtypes.

PMID:42228366 | DOI:10.1001/jamanetworkopen.2026.16375