Category: Statistics

Brief Bioinform. 2026 May 4;27(3):bbag249. doi: 10.1093/bib/bbag249.

ABSTRACT

The Coronavirus Disease 2019 (COVID-19) pandemic has highlighted the significance of reliable molecular biomarkers in clinical use. Despite the popularity of traditional statistical approaches, the high dimensionality of transcriptomic data presents challenges for these conventional methods. While artificial intelligence (AI) algorithms have emerged as highly advantageous for handling these complex datasets, there is a lack of evaluation of these approaches in COVID-19 transcriptomic studies. This review aims to provide an evaluation of these studies employed for transcriptomic biomarker discovery in COVID-19 using AI, assessing their study designs, methodologies, and outcomes. Based on a comprehensive search for literature across five databases including Web of Science Core Collection, Scopus, PubMed/MEDLINE, IEEE Xplore Digital Library, and LitCovid from December 2019 to March 2025, this review selected 63 studies for a narrative synthesis of four key sections: (i) The Landscape of AI-Driven COVID-19 Transcriptomics, (ii) Limitations of Studies, (iii) A Proposed AI-Driven Transcriptomics Framework, and (iv) Clinical Translation Challenges, Opportunities, and Future Directions. Our analysis revealed limitations in data quality, sample size, and heterogeneity, as well as methodologies regarding validation and interpretability. Thus, we proposed an evidence-informed workflow that addresses these current limitations in study design, while acknowledging real-world constraints. We further discuss the emerging potential of agentic AI systems as a promising solution to current limitations. By bridging methodological gaps with translation considerations, this review can enhance pandemic response strategies for future emerging infectious diseases. Key Points Applications observed in reviewed studies mainly included applications in diagnosis and severity stratification of COVID-19 patients. The limitations of current studies included small sample sizes, the reliance on public datasets lacking detailed metadata, batch effects and data heterogeneity reducing model robustness, the lack of external validation, risks of data leakage and circular validation leading to inflated performance metrics, and challenges in model interpretability. An evidence-informed AI-driven framework is proposed, acknowledging real-world constraints including small pandemic cohort sizes, domain shift from viral evolution, and resource-limited settings, with emerging agentic AI systems offering potential solutions.

PMID:42184107 | DOI:10.1093/bib/bbag249

Crit Care Explor. 2026 May 25;8(6):e1418. doi: 10.1097/CCE.0000000000001418. eCollection 2026 Jun 1.

ABSTRACT

IMPORTANCE: Pediatric cerebral venous sinus thrombosis (CVST) is being increasingly recognized and can pose substantial risks of morbidity and mortality. Data on the epidemiology, management, and outcomes of CVST in the PICU remain limited.

OBJECTIVES: To describe the clinical characteristics, management, and outcomes of critically ill children with CVST during their admission to the PICU.

DESIGN, SETTING, AND PARTICIPANTS: We conducted a retrospective observational cohort study in a quaternary PICU in Toronto, Canada, between 2018 and 2023. Patients 18 years old and younger with acute primary CVST (CVST being the primary indication for ICU admission) and secondary CVST (diagnosis during an admission for an alternative diagnosis) were included in this study.

MAIN OUTCOMES AND MEASURES: The primary outcome was in-hospital mortality. Descriptive statistics were used to describe characteristics and outcomes.

RESULTS: Thirty patients were admitted with a diagnosis of CVST: 19 (63%) primary, 11 (37%) secondary. Fourteen (47%) had an associated cerebral infarct, and nine (30%) had an associated intracranial hemorrhage. The most common condition associated with secondary CVST was a brain disease requiring neurosurgical intervention (5/11). Five (17%) children with CVST died in this study, of which four had a primary CVST. Children residing in neighborhoods with increased marginalization were disproportionally represented in this cohort.

CONCLUSIONS AND RELEVANCE: Primary CVST is more common than secondary and is associated with significant mortality. The disproportionate impact on marginalized children emphasizes the need for heightened awareness and determination of factors associated with this finding.

PMID:42184099 | DOI:10.1097/CCE.0000000000001418

J Gastrointest Cancer. 2026 May 25;57(1):124. doi: 10.1007/s12029-026-01492-0.

ABSTRACT

PURPOSE: Adjuvant radiation (AR) remains a controversial treatment modality for pancreatic ductal adenocarcinoma (PDAC). This study aimed to evaluate the findings of the RTOG 0848 trial assessing the benefits of adjuvant radiation in node-negative disease utilizing a national database.

METHODS: Utilizing the National Cancer Database, all patients diagnosed with non-metastatic PDAC, who underwent pancreatectomy, were included (2004-2019). The trend of adjuvant radiation utilization was evaluated. Overall survival in a cohort of patients mimicking the RTOG 0848 protocol was examined as were clinicodemographic and pathologic predictors of adjuvant radiation.

RESULTS: Overall rates of adjuvant radiation decreased from 45 to 12%, while neoadjuvant radiation rates simultaneously increased from 4 to 12%. Positive margins and nodal disease were the strongest predictors of adjuvant radiation receipt (OR 1.7[ 95% CI: 1.6-1.7] p < 0.001 and OR: 1.1 [95% CI: 1.1-1.2] p < 0.001; respectively). Both high-risk pathologic groups experienced a decline in the use of adjuvant radiation over time, even after exclusion of patients who received neoadjuvant radiation. After application of the RTOG 0848 criteria, improved overall survival was observed in patients with node-negative and positive margins (adjuvant radiation: 28.6 [95% CI: 25.4-31.8] vs 23.0 [95% CI: 19.4-26.7] months; p = 0.005). In the margin positive cohort, adjuvant radiation was significantly associated with reduced mortality (HR: 0.791 [95% CI: 0.7-0.9]; p < 0.001).

CONCLUSION: Evaluation of RTOG 0848 in the setting of real-world data indicates a role for adjuvant radiation for patients with margin-positive, node-negative pancreatic cancer. This highlights the essential role of multidisciplinary discussions regarding patients with PDAC care.

PMID:42184090 | DOI:10.1007/s12029-026-01492-0

Nano Converg. 2026 May 25;13(1):21. doi: 10.1186/s40580-026-00551-3.

ABSTRACT

Synthetic graphites have been widely used in industrial applications, including as anodes in lithium-ion batteries. Because they are produced at temperatures above 3000 °C, which generate highly ordered graphitic domains, there is typically no discernible evidence of their precursor materials. In this study, three types of graphite, coal tar based anisotropic graphite, petroleum fluid oil based anisotropic graphite, and coal tar based isotropic graphite, were prepared. Conventional characterization techniques such as X-ray diffraction, Raman spectroscopy, transmission electron microscopy, and even electrochemical performance were unable to distinguish their precursors. Therefore, we introduced laser desorption/ionization time-of-flight mass spectrometry (LDI-MS) combined with multivariate statistical analysis to characterize three graphites prepared from different synthetic precursors as well as two commercial graphites. The resulting LDI-MS spectra were analyzed using principal component, hierarchical cluster, and heatmap analyses, which are widely used in clinical mass spectrometric diagnostics. Notably, LDI-MS coupled with multivariate statistics successfully classified the graphites depending on their precursor materials and processing parameters, such as heat-treatment temperature, whereas conventional analytical tools failed to reveal these differences. These results clearly demonstrate the strong potential of LDI-MS and statistical analysis for the precise characterization of carbon materials and for distinguishing their origins and processing routes.

PMID:42184059 | DOI:10.1186/s40580-026-00551-3

Acta Parasitol. 2026 May 25;71(3):122. doi: 10.1007/s11686-026-01312-2.

ABSTRACT

BACKGROUND: Cutaneous leishmaniasis (CL) remains a neglected tropical disease that disproportionately affects indigenous populations, where transmission is shaped by complex socioenvironmental conditions. Our objective is to describe and analyze the sociodemographic, environmental, clinical, and therapeutic characteristics of CL cases in the Xakriabá indigenous population, and to explore associations between these characteristics and clinical outcomes.

METHODS: An observational analytical study based on a case series was conducted using secondary data from the Brazilian Notifiable Diseases Information System (SINAN), covering the period from 2013 to 2024. Analyses were restricted to internal associations among reported cases, without inference of population-level risk. Sociodemographic, environmental, clinical, and therapeutic variables were analyzed using descriptive statistics and logistic regression models.

RESULTS: A total of 259 CL cases were identified. Most cases occurred in males (63%) and individuals aged 20-39 years (38%), with nearly all cases residing in rural areas (99%). Associations were observed between clinical outcomes and variables such as occupational exposure (OR = 2.45; 95% CI 1.38-4.33) and proximity to vegetation (OR = 2.71; 95% CI 1.49-4.92). These findings represent associations within the case population and should not be interpreted as causal effects or population risk estimates. A high proportion of missing laboratory data was identified. Spatial distribution was described without inferential analysis.

CONCLUSION: CL in the Xakriabá population is characterized by heterogeneous distribution and associations with socioenvironmental factors within reported cases. Given the study design, results should be interpreted cautiously, without causal inference. Strengthening diagnostic capacity, improving data quality, and implementing territorially adapted public health strategies are essential to improve disease management in indigenous contexts.

PMID:42184053 | DOI:10.1007/s11686-026-01312-2

Discov Ment Health. 2026 May 25. doi: 10.1007/s44192-026-00366-y. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Pregnancy is accompanied by numerous physical and psychological changes that can affect sexual quality of life and increase sexual distress in women. Identifying effective interventions to address these issues is essential. This study aimed to evaluate the effect of mindfulness-based cognitive-behavioral therapy on sexual distress and sexual quality of life in pregnant women.

METHODS: In this single-blind randomized clinical trial, 84 pregnant women (20-35 weeks of gestation) were randomly assigned to an intervention group (n = 40) or a control group (n = 41) using a block design. The intervention group participated in seven weekly sessions of mindfulness-based cognitive therapy. Data were collected using a demographic questionnaire, the Sexual Quality of Life-Female (SQOL-F) questionnaire, and the Female Sexual Distress Scale (FSDS).

RESULT: At baseline, there were no statistically significant differences between the two groups in demographic characteristics, sexual distress, or sexual quality of life. Repeated measures analysis showed significant improvements in the intervention group compared with the control group in overall sexual quality of life and its dimensions (psychosexual feelings, sexual and relationship satisfaction, self-worthlessness, and sexual repression). Sexual distress scores were also significantly reduced in the intervention group after the intervention and at follow-up.

DISCUSSION: Mindfulness-based cognitive-behavioral therapy appears to be an effective approach for enhancing sexual quality of life and reducing sexual distress in pregnant women. Integrating this intervention into prenatal care services may help promote the overall well-being of expectant mothers.

TRIAL REGISTRATION: This study was approved by the Ethics Committee of Ahvaz Jundishapur University of Medical Sciences (IR.AJUMS.REC.1399.135) and registered in the Iranian Registry of Clinical Trials (IRCT20200901048581N1) on September 21, 2020.

PMID:42184044 | DOI:10.1007/s44192-026-00366-y

Hernia. 2026 May 25;30(1):228. doi: 10.1007/s10029-026-03690-y.

ABSTRACT

PURPOSE: Retromuscular mesh placement is recommended for incisional hernia repair, but the current certainty of evidence remains low. This study aimed to compare the risk of reoperation for recurrence among adults undergoing incisional hernia repair with onlay, retromuscular, preperitoneal, and intraperitoneal onlay mesh (IPOM).

METHODS: This study used prospectively collected data from the Danish Ventral Hernia Database that were linked to the Danish National Patient Register and the Danish Civil Registration System. We included patients undergoing elective incisional hernia repair with defect widths ≤ 10 cm operated between 2007 and 2025. The primary outcome was reoperation for recurrence, analyzed using Cox regression, and included subgroup analyses of defect width, surgical approach, and type of previous incision.

RESULTS: In total, 5,375 patients were included, of whom 14% received a preperitoneal mesh placement, 22% retromuscular placement, 30% IPOM with defect closure, and 34% onlay placement. Compared with preperitoneal placement, onlay was associated with a higher risk of reoperation (HR 2.62, 95% CI 1.73-3.95; p < 0.001). Onlay was associated with a higher risk than all other placements. However, this association was not observed in subgroup analyses for defect widths ≤ 2 cm (p = 0.058), in which retromuscular placement was associated with a significantly increased risk of reoperation.

CONCLUSION: Onlay mesh placement for defect widths > 2 cm and retromuscular mesh placement for defect widths ≤ 2 cm were associated with higher risk of reoperation for recurrence.

PMID:42184040 | DOI:10.1007/s10029-026-03690-y

Support Care Cancer. 2026 May 25;34(6):578. doi: 10.1007/s00520-026-10829-1.

ABSTRACT

PURPOSE: The relationship between financial hardship and pain in cancer survivors remains poorly understood, with limited evidence linking financial hardship to pain outcomes.

METHODS: This nationwide web-based cross-sectional study examined the relationship between pain and financial hardship in French cancer survivors. Data were collected between January 27 and March 20, 2023, through 12 cancer associations and 12 Facebook groups. Primary outcomes were financial hardship (QLQ-C30) and pain status (BPI-SF). Secondary measures included pain characteristics, socio-professional categories and clinical factors, specific items of social precariousness, anxiety, depression, and health-related quality of life.

RESULTS: The sample included 1,012 survivors (82.6% female; mean age 55.2 ± 11.1 years), with breast cancer the most frequent (61.6%), and 50.4% undergoing anticancer treatment. Financial hardship was more prevalent among those with pain (OR: 2.7, 95% CI [2.1-3.6]), and financial hardship scores correlated with pain scores (Spearman’s rho: 0.28, p < 0.001). Multivariate analysis confirmed associations between financial hardship and pain severity (mild pain: OR: 1.57, 95% CI [1.08-2.29]; moderate pain: OR: 2.12, 95% CI [1.43-3.13]; severe pain: OR: 2.87, 95% CI [1.59-5.16]), particularly among individuals who had completed anticancer treatment, as well as with younger age, living alone, anxiety, depression, and socio-professional categories such as entrepreneurs, employees, and unemployed individuals.

CONCLUSIONS: Financial hardship is associated with pain severity. Younger survivors, those living alone, those with psychological distress, and those post-treatment seem more vulnerable. These findings emphasize the need for targeted interventions and research to reduce financial and psychosocial disparities in cancer survivorship.

PMID:42184033 | DOI:10.1007/s00520-026-10829-1

Histochem Cell Biol. 2026 May 25;164(1):40. doi: 10.1007/s00418-026-02494-6.

ABSTRACT

Mesenchymal stem cells (MSCs) are widely utilized in regenerative medicine owing to their differentiation potential and paracrine effects. Although numerous tissues have been identified as sources of MSCs, the search for novel, noninvasive sources continues. To date, the stem cell content of colostrum has not been investigated. To address this gap, this study aimed to comparatively evaluate the biological properties, proliferative dynamics, and functional potential of cell populations derived from colostrum and mature milk. Cells isolated from both sources (n = 3) were morphologically assessed under in vitro culture conditions and were induced to undergo multilineage differentiation. Phenotypic characterization was performed by flow cytometric analysis. Proliferation capacity was assessed by determining population doubling time (PDT) and performing colony formation assays, while cell viability was evaluated using the methyl thiazolyl tetrazolium (MTT) assay. Cells initially exhibited an epithelial-like morphology and adopted a fibroblast-like phenotype after passaging. Colostrum-derived and mature milk-derived cells displayed multilineage differentiation potential, and flow cytometric profiling confirmed the presence of cells positive for CD73, CD90, and CD105 in both sources. Colostrum-derived cells exhibited higher cell densities; however, population doubling times showed no statistically significant difference between the groups. MTT analysis demonstrated a progressive increase in metabolic activity in both groups, with colostrum-derived cells exhibiting significantly higher optical density values from day 2 onward. No statistically significant difference in colony-forming efficiency was observed between the groups. Consequently, these preliminary findings suggest that colostrum may harbor cell populations exhibiting MSC-like properties and could represent a potential area of interest for MSC research.

PMID:42184018 | DOI:10.1007/s00418-026-02494-6

Neuroradiol J. 2026 Jun;39(3):280-289. doi: 10.1177/19714009251387296. Epub 2025 Oct 14.

ABSTRACT

IntroductionPreoperative embolization reduces intraoperative blood loss (IBL) in meningioma treatment, but the optimal embolic material remains uncertain. This systematic review and meta-analysis compares the effectiveness and safety of particle versus liquid embolic agents in the preoperative embolization of meningiomas.MethodsPubMed, Cochrane, Embase, and Scopus were searched for studies comparing particles and liquid embolic agents in patients undergoing preoperative embolization of meningiomas. Primary outcomes included the degree of devascularization, IBL, ischemic events, and overall complications. The risk of bias was assessed using the ROBINS-I. Statistical analyses were conducted using R.ResultsThe analysis included four studies, covering a total of 1827 patients. Particles were associated with a significantly lower incidence of operative complications (OR = 0.35; 95% CI 0.20-0.62; p < 0.001; I² = 0.0%). The other outcomes did not differ between groups. Regarding IBL, no significant difference was observed between particulate and liquid embolic agents (MD = -65.01 mL; 95% CI -237.01-107.00; p = 0.46; I² = 77.8%).ConclusionOur systematic review and meta-analysis indicate no significant differences between particulate and embolic agents; however, particulate agents were associated with a lower incidence of overall complications, suggesting a potential advantage in perioperative safety.

PMID:42184015 | DOI:10.1177/19714009251387296