Category: Statistics

Health Educ Behav. 2026 Jun 2:10901981261453327. doi: 10.1177/10901981261453327. Online ahead of print.

ABSTRACT

Southeast Asian cancer screening rates are alarmingly the lowest across all racial and ethnic groups in the United States. This paper examines barriers to breast cancer screening among Southeast Asian women, an understudied and underserved subgroup within the broader Asian American population, participating in a culturally tailored navigation intervention. A total of 194 women were randomly assigned to either the intervention-Tailored Messaging System^© group (n = 103) or the information-reminder only group (n = 91). The intervention group received tailored messages addressing barriers, beliefs, perceived risks, and self-efficacy, along with guidance to complete mammograms, delivered by trained community health advisors over 10 weeks. The information group received screening information by mail. Barriers were evaluated via a questionnaire at baseline in both groups. Results showed statistically significant differences in mammography screening by ethnicity, but not by intervention group. The Lao constituted the largest group, with 20 (37.7%) screened, followed by Cambodians at 7 (26.1%), whereas only 5 (8.5%) of the Vietnamese and none (0.0%) of the Filipina women completed mammograms. Findings indicate that some Southeast Asian women are less likely to get screened for breast cancer due to modifiable factors such as health insurance, doctors’ recommendations, fears, and perceptions. Disaggregating data for Southeast Asian women subgroups is an essential step for uncovering barriers in cancer screening uptake. Public health interventions and campaigns should consider these barriers and the importance of using disaggregated data.

PMID:42227134 | DOI:10.1177/10901981261453327

Mol Biol (Mosk). 2026 Mar-Apr;60(2):266-275. doi: 10.7868/S3034555326020056.

ABSTRACT

Nowadays, against the backdrop of a global increase in cancer incidence, the search for prognostic markers to assess individual risks is particularly relevant. Early identification of altered DNA methylation patterns may serve as a reliable indicator of malignant transformation and be used for diagnostic purposes. The objective of this study was to assess the methylation level of CpG dinucleotides in the promoter regions of DNA repair genes (AKT1, DDB2, GADD45A, XPC and XRCC3) in the blood of chronically exposed individuals who subsequently developed cancers. The study was conducted in individuals who were affected by chronic low dose-rate exposure in 1950-1960s in the Southern Urals. The main group included exposed individuals in the latent period of cancer development-104 people, the comparison group consisted of exposed individuals without cancers-188 people. The methylation level was assessed in bisulfite-converted DNA samples using methylation-specific high-resolution melting. It was established that in exposed individuals from the main group, there was a statistically significant decrease in the methylation level in the AKT1 and GADD45A gene promoter, relative to the comparison group (4.37 versus 7.23%, p < 0.001 and 10.73 versus 19.58%, p < 0.001, respectively). As for the XRCC3 gene, there was an increase in the methylation level of CpG dinucleotides in the promoter in individuals from the main group relative to the comparison group (5.38 versus 6.18%, p < 0.001). When the prognostic potential of methylation parameters of the AKT1, GADD45A, XRCC3 gene promoters was assessed for the purposes of early diagnosis of cancer development risk, it was found that when these loci were analyzed together, the AUC was 0.89 (95% CI: 0.85-0.93) at p < 0.001.

PMID:42227125 | DOI:10.7868/S3034555326020056

Clin Trials. 2026 Jun 2:17407745261449668. doi: 10.1177/17407745261449668. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: The Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results trial randomized patients with diabetes to liraglutide or placebo. The per-protocol analysis conditioned on post-baseline adherence and therefore lacked a well-defined estimand. This study sought to evaluate a subset of Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results to estimate the effect of sustained liraglutide exposure corresponding to a well-defined per-protocol analysis.

METHOD: We used the roadmap of targeting learning to define the estimand for the sustained treatment analysis and estimated it with longitudinal targeted minimum loss-based estimation, accounting for protocol deviations and censoring using post-baseline confounders. The results were compared to the intention-to-treat analysis. We report 3.5-year risks of the primary composite outcome (myocardial infarction, stroke, or cardiovascular mortality) and secondary outcomes (each of the primary outcome’s components, revascularization, unstable angina pectoris, heart failure, and all-cause mortality).

RESULTS: The intention-to-treat analysis estimated 3.5-year risks for the primary composite outcome of 11.8% (95% confidence interval: 10.8 to 12.8) in the liraglutide arm and 13.3% (95% confidence interval: 12.3 to 14.3) in the placebo arm, with a risk difference of 1.5% (95% confidence interval: 0.1 to 2.9). Accounting for post-baseline confounders, the sustained treatment analysis estimated 3.5-year risks of 11.4% (95% confidence interval: 10.4 to 12.5) for sustained exposure to liraglutide versus 12.6% (95% confidence interval: 11.5 to 13.7) for sustained exposure to placebo, yielding a risk difference of 1.1% (95% confidence interval: -0.4 to 2.6). Sustained exposure to liraglutide showed no statistically significant difference compared with sustained exposure to placebo for any secondary outcomes at 3.5 years.

CONCLUSION: We used contemporary methods for causal inference to define and estimate the sustained treatment effects of the Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results study by accounting for both baseline and time-varying confounders. The results were consistent with the findings of the original Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results trial.

PMID:42227113 | DOI:10.1177/17407745261449668

Probl Endokrinol (Mosk). 2026 May 20;72(2):86-97. doi: 10.14341/probl13704.

ABSTRACT

BACKGROUND: Hypoparathyroidism (HypoPT) and pseudohypoparathyroidism (PHP) are rare, predominantly genetically determined diseases in children with similar complications, characterized by hypocalcemia and hyperphosphatemia. PHP and HypoPT have similar complications: brain and lens calcification. In HypoPT, there is also an increased risk of developing nephrocalcinosis. Data on the frequency and structure of complications in affected children in Russia are limited, and comparative studies are lacking.

AIM: To compare the prevalence of chronic complications and to identify factors associated with their development in children with PHP and congenital forms of HypoPT.

MATERIALS AND METHODS: A retrospective study with a prospective component included 135 children with PHP and congenital forms of HypoPT. The results of laboratory and instrumental studies were evaluated.

RESULTS: At least one complication associated with HypoPT/PHP was identified in 82% of children. Nephrocalcinosis was most frequently detected in patients with autoimmune polyendocrine syndrome type 1 (APS-1) (67%) and autosomal dominant hypocalcemia type 1 (ADH1), and much less often in patients with PHP (22%) and unspecified forms of HypoPT (18%). Disease duration, as well as the duration of therapy with active vitamin D analogs and calcium supplements, was significantly longer in patients with nephrocalcinosis (p &lt; 0.001). An association between nephrocalcinosis and cataracts was established (p=0.005). Hypercalciuria persisted in 60% of patients despite medical compensation, was most prevalent in APS-1 and ADH1, and was not observed in PHP (p &lt; 0.001). No statistically significant relationship was identified between hypercalciuria and the development of nephrocalcinosis (p=0.567). A decrease in eGFR corresponding to CKD stage 2 was observed in 48.9% of patients. Fahr’s syndrome was detected in 76% of cases, predominantly involving the basal ganglia, and the presence of mineral deposits was associated with hyperphosphatemia (p=0.010). Cataract and micronephrolithiasis were less frequent (18.6% and 3.9%, respectively), with no significant differences between nosological groups. The most common lens opacities observed were cortical (68%) and posterior subcapsular (41%). The duration of the disease was longer in patients with cataracts (p = 0.018).

CONCLUSION: Among the complications observed in children, nephrocalcinosis, hypercalciuria, and Fahr’s syndrome were the most frequent. Renal complications predominated in patients with APS-1 and ADH1. Hypercalciuria persisted despite optimal serum calcium levels in most patients.

PMID:42227095 | DOI:10.14341/probl13704

Probl Endokrinol (Mosk). 2026 May 20;72(2):78-85. doi: 10.14341/probl13645.

ABSTRACT

BACKGROUND: Type 1 diabetes mellitus (T1DM) is a chronic progressive autoimmune disease characterized by destruction of pancreatic betta cells leading to insulin deficiency, measured by C-peptide testing. C-peptide secretion has been studied in diagnostic, prognostic and therapeutic aspects in patients with already manifested T1DM. Insulin secretion assessed by the level of C-peptide at the preclinical stage remains under-studied.

AIM: The aim of the study was to assess the possibility of predicting the development of T1DM in healthy siblings based on dynamic measurements of C-peptide concentration.

MATERIALS AND METHODS: A multicenter prospective longitudinal study involving 532 individuals was conducted. Median follow-up duration was 5.6 years. Group 1 (n=325) included children aged 0-18 years with newly diagnosed T1DM; group 2 (n=201) consisted of healthy brothers and sisters (siblings) who did not develop T1DM until the end of the study; group 3 (n=6) comprised healthy siblings who developed T1DM before the study completion. All participants underwent dynamic testing of blood analysis for C-peptide using solid-phase chemiluminescent immunoassay. RESULTS: In groups 1 and 3, the actual median concentration of baseline C-peptide was below reference values: 0.31 ng/mL [95% CI 0.10-1.39] and 0.56 ng/mL [95% CI 0.32-0.85], respectively. In group 2, it corresponded to the lower limit of reference values: 0.88 ng/mL [95% CI 0.28-2.69]. The observed differences were statistically significant between groups 1 and 2 (χ2 =168.29, df=1, p &lt; 0.001) and between groups 2 and 3 (χ2 =4.2292, df=1, p=0.040). Regression modeling revealed a nonlinear positive relationship between C-peptide concentration and age. At any age category, the median initial C-peptide concentration in groups 1 and 3 was lower than that in group 2 above the average level (“intercept”) characteristic for the cohort of specific age. The association between C-peptide concentration and time since observation onset was statistically significant (p &lt; 0.05) and bidirectional: over time, concentrations decreased in groups 1 and 3 and increased in group 2.

CONCLUSION: Measurement of baseline C-peptide levels followed by dynamic monitoring may serve as an additional screening tool for predicting the risk of T1DM development in healthy siblings.

PMID:42227094 | DOI:10.14341/probl13645

Phlebology. 2026 Jun 2:2683555261458164. doi: 10.1177/02683555261458164. Online ahead of print.

ABSTRACT

ObjectivePhlebolymphedema is a progressive condition caused by combined venous and lymphatic dysfunction. Although complete decongestive therapy (CDT) is widely used in clinical practice, objective evidence regarding its effectiveness across different disease stages is limited. This study aimed to evaluate the short-term effectiveness of CDT in patients with lower extremity phlebolymphedema and to examine the influence of disease stage and body mass index (BMI) on treatment response.MethodsThis retrospective study included patients with phlebolymphedema treated at a tertiary lymphedema clinic between 2020 and 2024. Chronic venous insufficiency was diagnosed by lower-extremity venous duplex Doppler ultrasonography, and lymphatic dysfunction was confirmed by lymphoscintigraphy. All patients completed a standardized intensive CDT program consisting of manual lymphatic drainage, multilayer compression bandaging, and therapeutic exercises for 10 sessions over 2 weeks. Extremity volume was measured using circumferential measurements and calculated with the truncated cone formula. Pre- and post-treatment volumes were compared, and associations with disease stage and BMI were analyzed.Results62 patients (72.2% female), corresponding to 108 affected lower extremities, were analyzed. The mean BMI was 36.5 ± 6.3 kg/m². CDT resulted in a statistically significant reduction in extremity volume (median reduction: 0.55 L; p < .001). Treatment response differed across disease stages, with greater absolute volume reduction observed in Stage 3 disease (p = .007). A positive correlation was identified between BMI and volume reduction (ρ = 0.322, p = .0007). Age, sex, and history of venous surgery were not associated with treatment response.ConclusionCDT is an effective treatment modality for achieving a significant short-term reduction in extremity volume in patients with phlebolymphedema. Clinically meaningful volume reduction can be achieved across all disease stages, including patients with advanced-stage disease and elevated BMI. These findings support the role of CDT as a primary conservative treatment option in routine phlebolymphedema management.

PMID:42227080 | DOI:10.1177/02683555261458164

J Sex Marital Ther. 2026 Jun 2:1-22. doi: 10.1080/0092623X.2026.2680162. Online ahead of print.

ABSTRACT

Infidelity is one of the most devastating events in a relationship, yet many couples choose to reconcile and stay together in its aftermath. There is scarce research on how likely such an outcome is amongst individuals motivated to achieve it as well as on pathways to and predictors of relationship preservation, defined as remaining in the original relationship. This study administered the Pathways Through Infidelity Survey to individuals who have had an affair (“commitment-breaking partners”) and whose partner has had an affair (“betrayal-experiencing partners”) recruited through the social media profiles of three mental health professionals enabling post-infidelity recovery and reconciliation. Analysis was performed using descriptive statistics and Classification and Regression Trees (CART). Analyzable responses were obtained from 1151 commitment-breaking and 2278 betrayal-experiencing partners. The strongest predictors of relationship preservation were love for commitment-breaking partners and formalization of the relationship (marriage, engagement, long-term relationship) for betrayal-experiencing partners. Relationship preservation after infidelity was found to follow neither a linear, nor uniform, nor a necessarily complex trajectory. A variety of pathways to it were identified, some brief and direct and others long and convoluted. Amongst individuals accessing social media contents about recovery and reconciliation after infidelity, relationship preservation is likely and predictable.

PMID:42227060 | DOI:10.1080/0092623X.2026.2680162

Acta Med Acad. 2026 May 26. doi: 10.5644/ama2006-124.509. Online ahead of print.

ABSTRACT

OBJECTIVE: This retrospective study aimed to record, analyze, and evaluate data concerning patients who underwent total thyroidectomy, focusing on the main indications that led to surgical therapy, as well as postoperative complications and oncological outcomes.

MATERIALS AND METHODS: A retrospective study was conducted on 312 patients who underwent total thyroidectomy or lobectomy at the First Department of Surgery of Sismanogleio General Hospital in Athens between 2019 and 2024. Demographic data, indications, intraoperative parameters, complications, and histological findings were recorded. Statistical analyses were performed using SPSS v29.0.

RESULTS: Among the 312 patients, 222 (71.2%) were female, and 90 (28.8%) were male, with a mean age of 54.3±13.3 years. Total thyroidectomy was performed in 96.5% of the cases. The main indications were nodular hyperplasia (31.4%), autoimmune thyroiditis (18.9%), multinodular goiter (12.8%), and papillary carcinoma (17.3%). The overall complication rate was 31.7%, with transient postoperative hypocalcemia being the most common complication (25.3%). Permanent hypocalcemia occurred in 1.9% of patients, hemorrhage in 3.5%, and recurrent laryngeal nerve palsy in 1.3% of patients. Papillary carcinoma was the most frequent malignancy, followed by follicular, medullary, and anaplastic carcinomas. Approximately 20% of patients were diagnosed with incidental carcinoma-mostly papillary microcarcinoma-emphasizing the importance of total thyroidectomy, even for benign thyroid diseases.

CONCLUSIONS: Total thyroidectomy is a safe and effective therapeutic option with low rates of permanent complications. The systematic identification and preservation of the parathyroid glands, intraoperative nerve monitoring, and meticulous hemostasis are key factors for minimizing inadvertent complications and optimizing outcomes.

PMID:42227046 | DOI:10.5644/ama2006-124.509

Cardiol Young. 2026 Jun 2:1-6. doi: 10.1017/S1047951126113456. Online ahead of print.

ABSTRACT

BACKGROUND: Echocardiography has become a crucial diagnostic tool for assessing heart diseases in children within low- and middle-income countries, where the burden of heart diseases remains substantial.

OBJECTIVES: This study aimed to audit echocardiography (echo) reports by reviewing the trends in echocardiography, indications for echocardiography, and the frequency and pattern of paediatric heart diseases seen at the Paediatric Cardiology Unit of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, over a five-year period.

METHODS: A total of 1,155 echocardiography reports were reviewed using a structured proforma to extract relevant data. Statistical analyses were conducted using IBM SPSS version 25.

RESULTS: Male participants constituted 52.1% of the study population. Ages ranged from 9 hours to 18 years, with a mean ± SD of 3.24 ± 4.46 years. The most frequent indication for echocardiography was fast breathing (38.27%). Approximately 31.86% of the echocardiograms were normal. CHD accounted for 63.55% of diagnoses, with 67.17% classified as acyanotic CHD and 32.83% as cyanotic CHD. Ventricular septal defect (VSD, 15.26%) and tetralogy of Fallot (TOF, 14.99%) were the most common CHDs. Acquired heart diseases were found in 4.59% of cases, with rheumatic heart disease being the most prevalent within this group (35.85%).

CONCLUSION: CHDs remain the predominant paediatric heart diseases, occurring nearly 14 times more frequently than acquired heart diseases. Ventricular septal defect and tetralogy of Fallot were the most common acyanotic and cyanotic CHDs, respectively. Among the acquired heart diseases, rheumatic heart disease was the leading diagnosis.

PMID:42227033 | DOI:10.1017/S1047951126113456

Development. 2026 Jun 2:dev.205559. doi: 10.1242/dev.205559. Online ahead of print.

ABSTRACT

KAT6A (MOZ) and KAT6B (QKF/MORF) are related histone lysine acetyltransferases (KATs) that have a high degree of functional redundancy during development. In the absence of KAT6A embryos undergo an anterior homeotic transformation of the axial skeleton, develop an interrupted aortic arch, have ventricular septal defects and fail to form definitive hematopoietic stem cells. KAT6B has roles in brain, skeletal and hematopoietic system development. Since loss of KAT6A leads to highly penetrant phenotypes this allows us to determine if the acetylation function is essential for all activities. We show that loss of acetyltransferase activity did not phenocopy the loss of the KAT6A protein. While the mutation the KAT domains of both KAT6A and KAT6B together increased the severity of phenotypes observed, these were milder than complete KAT6A loss of function. KAT domain mutants displayed ventricular septal defects and reduced (but not eliminated) hematopoietic stem cell activity. However, they did not display homeotic transformations or aortic arch defects, suggesting that while acetylation is important some functions, others can proceed without this activity. Accordingly, KAT6 proteins appear to have functions beyond acetylation.

PMID:42227022 | DOI:10.1242/dev.205559