Category: Statistics

Stat Med. 2026 Apr;45(8-9):e70433. doi: 10.1002/sim.70433.

ABSTRACT

Screening and surveillance programs for cancer, such as colorectal cancer (CRC), often yield electronic health records (EHR) of screening time, test results, and covariates. We consider EHR from CRC surveillance of individuals who have a high cancer risk due to their family history. These individuals, therefore, receive regular colonoscopies with the goal of finding and removing adenomas, precursor lesions to CRC. Our objective is to estimate time to adenoma incidence and explore associations with covariates. However, in doing so, several challenges of the CRC surveillance EHR have to be addressed. Importantly, the adenoma events are interval-censored, meaning the exact event times are unknown and only fall within intervals defined by colonoscopy visits. Furthermore, colonoscopies can miss adenomas due to human or technical error, leading to misclassification of individuals with adenomas as adenoma-free. Finally, the EHR data include individuals with adenomas at baseline, termed prevalent cases. This prevalence status may be unobserved if the baseline colonoscopy is missing or fails to detect existing adenomas. To address these challenges in the CRC EHR, and screening data in general, we develop a new prevalence-incidence mixture model (PIM) with a Bayesian estimation back-end through data augmentation and regularization priors. We show how to fit the model, estimate cumulative incidence functions, and evaluate model fit using information criteria as well as a non-parametric estimator. In extensive simulations, we show good performance of the model when informative priors on the test sensitivity are provided, which is usually possible. An implementation in the R package BayesPIM is provided.

PMID:41943977 | DOI:10.1002/sim.70433

Zh Nevrol Psikhiatr Im S S Korsakova. 2026;126(3. Vyp. 2):40-45. doi: 10.17116/jnevro202612603240.

ABSTRACT

OBJECTIVE: To comprehensively evaluate the neuroprotective potential of Mexidol following systemic administration in various dosage forms in a model of hemorrhagic stroke.

MATERIAL AND METHODS: The study was performed on 130 outbred male rats, weighing 180-200 g and aged 7-8 weeks. All animals were divided into 3 series: Series 1 – intravenous administration of Mexidol at doses of 50 and 100 mg/kg; Series 2 – intramuscular administration at doses of 50 and 100 mg/kg; Series 3 – intragastric administration at doses of 50, 100, and 200 mg/kg. Acute hemorrhagic stroke was modeled by administering autologous blood at a volume of 0.05 ml/kg body weight into the region of the internal capsule of the right hemisphere. Mexidol administration was initiated 30 minutes after modeling acute focal stroke. Twenty-four hours after the surgery, the severity of neurological deficit was assessed using the McGraw Stroke-Index Scale modified by I.V. Gannushkina. Subsequently, the animals were euthanized, the brain was isolated, fixed in formalin, and tomography was performed.

RESULTS: Intravenous administration of Mexidol at a dose of 100 mg/kg led to a statistically significant reduction in the severity of clinical symptoms 24 hours after surgery compared to control animals. Intramuscular administration produced a similar effect at doses of 50 and 100 mg/kg, while intragastric administration did so at doses of 100 mg/kg and 200 mg/kg. Intravenous and intramuscular administration of Mexidol at doses of 50 and 100 mg/kg did not affect the size of the brain lesion in rats, whereas intragastric administration of Mexidol at a dose of 200 mg/kg led to its reduction.

CONCLUSION: The obtained results indicate that, in cases of small intracranial hematomas (e.g., those remaining after surgical removal of the initial hematoma), Mexidol exerts a pronounced neuroprotective effect.

PMID:41943960 | DOI:10.17116/jnevro202612603240

Zh Nevrol Psikhiatr Im S S Korsakova. 2026;126(3. Vyp. 2):12-20. doi: 10.17116/jnevro202612603212.

ABSTRACT

OBJECTIVE: To study the features of left ventricle (LV) structural adjustment and comorbidity in patients with chronic cerebral ischemia (CCI) based on gender.

MATERIAL AND METHODS: The study included 316 patients diagnosed with chronic cerebral ischemia with a mean age of 61.9 years (range 36 to 86 years). All patients underwent a general clinical examination, assessment of echocardiography parameters, and measurement of the thickness of the common carotid artery (CCA) intima-media complex (IMC). The patients were divided into two groups based on gender: Group I included males (n=170), and Group II included females (n=146).

RESULTS: In males with CCI, the CCA IMC thickness (1.23±0.14 mm vs 1.16±0.11 mm, p<0.05) and the prevalence of atherosclerotic changes (57.6% vs 34.9%, p<0.05) were significantly higher than in females. Normal LV geometry was reported in 59.4% of males and only in 37.0% of females (p<0.05). The frequency of concentric LV remodeling was 8.8% in males and 6.2% in females. LV hypertrophy (LVH) was detected in 31.8% of males and 56.8% of females (p<0.05). The concentric type of LVH was more common in males (68.5%), whereas the eccentric type prevailed in females (74.7%). A statistically significant correlation of CCA IMC thickness with age (r=0.234), systolic (r=0.209) and diastolic blood pressure (r=0.151), hemoglobin concentration (r=-0.245), end-systolic LV size (r=0.125), end-systolic (r=0.151) and end-diastolic (r=0.135) LV volumes, as well as LV myocardial mass index (r=0.132) in the total sample was found. In the male group, CCA IMC thickness correlated with body mass index (r=0.291) and diastolic blood pressure (r=0.210). In the female group, strong correlations were found with hemoglobin concentration (r=-0.732) and end-systolic LV volume (r=0.176).

CONCLUSION: In patients with CCI, the most common morphofunctional LV changes were concentric LVH in males and eccentric LVH in females.

PMID:41943956 | DOI:10.17116/jnevro202612603212

Epidemiol Psychiatr Sci. 2026 Apr 7;35:e23. doi: 10.1017/S2045796026100638.

ABSTRACT

AIMS: Significant sex disparities in mental health have been observed amongst resettled refugees, yet how these disparities and their determinants evolve over time remains unclear. This study sought to quantitatively unravel determinants and changes in mental health disparities by sex.

METHODS: Data were drawn from Waves 1 (2013-2014), 5 (2017-2018) and 6 (2023) of the 10-year Building a New Life in Australia (BNLA) cohort. Post-traumatic stress disorder (PTSD) and high risk of severe mental illness (HR-SMI) were measured using the PTSD-8 and Kessler-6 scales. Fairlie method was used to quantify the disparity (total predicted probability difference by sex) and the contribution proportion of individual determinants (explained difference/total predicted probability difference × 100%).

RESULTS: A total of 2261 refugees were included at Wave 1, with 1833 (81.1%) and 905 (40.0%) followed up at Waves 5 and 6. Female refugees consistently experienced poor mental health, with the total predicted probability difference decreasing from the initial (Wave 1, 8.3%) to middle stage (Wave 5, 4.6%), then increasing in the long term (Wave 6, 6.3%). Determinants of disparities varied across waves, but poor status of physical health was a persistent contributor of disparities in PTSD (contribution proportion: 57.2%, 71.5% and 63.0% at each wave). Family conflict contributed at the initial (HR-SMI: 4.5%) and long-term stages (PTSD: 8.7%), while financial hardships (PTSD: 13.2%; HR-SMI: 23.2%), marital status (HR-SMI: 24.8%) and family concerns (PTSD: 8.0%) were key determinants at the middle stage. Unmet support or help during COVID-19 was a major contributor at Wave 6 (PTSD: 22.7%; HR-SMI: 8.0%).

CONCLUSIONS: Sex disparities exist in refugees’ mental health and require sustained attention and tailored strategies. To promote mental health equity, there is a long-term need to provide essential physical healthcare and financial assistance and address family-related stressors. Additionally, it is important to identify and address the specific psychosocial needs of women in times of crisis such as the COVID-19 pandemic.

PMID:41943952 | DOI:10.1017/S2045796026100638

Phys Occup Ther Pediatr. 2026 Apr 7:1-17. doi: 10.1080/01942638.2026.2652045. Online ahead of print.

ABSTRACT

AIMS: This project aimed to (1) Describe feeding self-help skills in autistic children with feeding challenges and (2) Identify the relationships among feeding self-help skills, feeding challenge severity, family mealtime factors, and adaptive behavior.

METHODS: This study used data from a cross-sectional national survey of 358 caregivers of autistic children (ages 2-12 years) with feeding challenges, recruited through a national research registry. Data were captured using validated caregiver-report measures. Descriptive statistics were completed to characterize feeding self-help skills and additional variables within the sample. Pearson’s R correlations were run to investigate relationships among variables.

RESULTS: Feeding self-help skills, feeding challenge severity, and adaptive behavior scores were widely heterogeneous. Overall, children in the study required higher levels of support from caregivers to participate in feeding and had lower adaptive behavior than expected for their age. Significant Pearson r correlations ranging from 0.11 to 0.60 were observed between feeding self-help skills, feeding challenge severity, family mealtime factors, and adaptive behavior.

CONCLUSIONS: Feeding self-help skills and adaptive behavior are essential to evaluate in autistic children with feeding challenges. Future research should explore component skills, (e.g. use of utensils) in addition to behavior and sensory components of feeding to inform child-centered evaluation and intervention.

PMID:41943951 | DOI:10.1080/01942638.2026.2652045

Psychol Med. 2026 Apr 7;56:e92. doi: 10.1017/S0033291726104012.

ABSTRACT

BACKGROUND: The individual effects of genetic factors and adverse childhood experiences (ACEs) on risk of psychosis, including schizophrenia (SCZ) and bipolar disorder (BIP), have been widely acknowledged, but their interaction effects on individual psychopathological symptoms remain unclear.

METHODS: Based on data from 163,704 individuals in the UK Biobank, we investigated the joint effects of polygenic risk scores (PRSs) of SCZ and BIP and ACEs on psychopathology. ACEs status and 55 psychopathological symptoms from seven domains were measured retrospectively using an online mental health questionnaire in 2016. Recent genome-wide association studies for SCZ and BIP were combined with genotype data to generate PRSs. Logistic regression analyses were then conducted to explore univariate and joint main effects of PRSs and ACEs on psychopathological symptoms, as well as their additive and multiplicative interaction effects.

RESULTS: The interaction mechanisms for PRSs and ACEs varied across symptom domains: additive interactions were observed on the depression (RERI_BIP-ACEs = 0.20-0.25), anxiety (RERI_SCZ-ACEs = 0.20; RERI_BIP-ACEs = 0.22-0.26), help-seeking (RERI_SCZ-ACEs = 0.24; RERI_BIP-ACEs = 0.23), and cognition domains (RERI_SCZ-ACEs = -0.23 to -0.17), whereas multiplicative interactions were only detected on the psychotic (beta_SCZ-ACEs = -0.543; beta_BIP-ACEs = -0.181), mania (beta_BIP-ACEs = -0.195), self-harm or suicide (beta_SCZ-ACEs = -0.118), and cognitive domains (beta_SCZ-ACEs = -0.204 to -0.157).

CONCLUSIONS: The interplay mechanisms for genetic liability to SCZ and BIP and ACEs vary across symptom domains. This study reveals heterogeneity in gene-ACEs interaction mechanisms underlying psychosis and may provide personalized guidance for psychological care after ACEs.

PMID:41943949 | DOI:10.1017/S0033291726104012

Epidemiol Psychiatr Sci. 2026 Apr 7;35:e22. doi: 10.1017/S2045796026100614.

ABSTRACT

AIM: Social functioning is a crucial aspect of psychosocial adaptation following forced displacement. Yet, it has received far less attention than understanding and addressing mental health problems among refugees and asylum-seekers. This study aimed to extend the ecological model of refugee distress – one of the most widely used frameworks in refugee mental health – to social functioning, and to identify direct and indirect pathways from established conflict- and displacement-related factors to social functioning alongside mental health problems.

METHOD: An online study with 1,235 refugees in Indonesia was conducted over a 2-year period. Conflict-related traumatic experiences before arrival in Indonesia, post-displacement stressors in the past 12 months, were measured at the onset of the study, while social functioning and mental health outcomes (symptoms of posttraumatic stress disorder, depression, and anger) were assessed 1 year later.

RESULTS: Longitudinal Structural Equation Modelling analysis revealed that diversity of conflict-related trauma predicted more post-displacement stress (β = 0.45, SE = 0.03, p < 0.001), higher mental health problems (β = 0.13, SE = 0.05, p = 0.004), but increased social functioning 1 year later (β = 0.10, SE = 0.04, p = 0.011), while post-displacement stressors predicted poorer mental health (β = 0.46, SE = 0.05, p < 0.011) and reduced social functioning (β = –0.09, SE = 0.04, p = 0.041). The indirect pathway from traumatic experiences via post-displacement stressors was positive for mental health (β = 0.21, 95% CI = 0.162-0.257) and negative for social functioning (β = –0.04, 95% CI = -0.082 to -0.003).

CONCLUSIONS: This study conceptually and empirically extended the ecological model of refugee distress to social functioning by highlighting the dual influences of conflict-related traumatic experiences. The findings provide a springboard for advancing research and practice in the mental health and psychosocial field.

PMID:41943947 | DOI:10.1017/S2045796026100614

Water Environ Res. 2026 Apr;98(4):e70343. doi: 10.1002/wer.70343.

ABSTRACT

This study investigated the effect of localized mechanical stirring on the performance and organic matter conversion pathways in two bench-scale horizontal flow anaerobic biodigesters treating swine wastewater (SW). Two reactors (total volume of 10.6L; working volume of 7.95 L) were operated in parallel for 150 days under identical conditions (hydraulic retention time [HRT] = 25 days; volumetric organic loading rate [VOLR] = 0.3-0.5 g V L^-1 day^-1 of TVS): one equipped with mechanical mixing (HF_w) and the other operated without mixing (HF_w/o). After system stabilization, no statistically significant differences were observed between the reactors with respect to hydrolysis and methanogenesis (%) or biogas production and composition. Mass balance analysis demonstrated that HF_w accumulated fewer solids within the reactor (5.5% of the applied chemical oxygen demand [COD]) compared with HF_w/o (13.6%). These findings indicate that mechanical stirring effectively mitigates sludge accumulation without compromising overall treatment performance or biogas generation.

PMID:41943942 | DOI:10.1002/wer.70343

Osong Public Health Res Perspect. 2026 Apr 7. doi: 10.24171/j.phrp.2025.0481. Online ahead of print.

ABSTRACT

OBJECTIVES: This study investigated a cluster of secondary human-to-human transmission of severe fever with thrombocytopenia syndrome (SFTS) in a hospital setting, focusing on infection risk factors and the role of personal protective equipment (PPE).

METHODS: A descriptive epidemiological investigation was conducted following the death of an index patient with laboratory-confirmed SFTS. A total of 27 close contacts, including healthcare workers and a funeral director, were monitored for symptoms. Suspected cases underwent real-time reverse transcription polymerase chain reaction testing. Clinical features, PPE use, and exposure histories were analyzed. The Fisher exact test was used to assess associations between PPE use and infection. Viral genotyping and sequence analyses were performed to evaluate transmission routes.

RESULTS: The index patient deteriorated rapidly and died after repeated cardiopulmonary resuscitation (CPR), during which 8 secondary cases occurred. Most infections were identified among individuals involved in CPR or postmortem care without adequate PPE. Although not statistically significant, infection rates were higher among those who did not wear masks or who used low-filtration masks. Proper use of gloves, gowns, and goggles was associated with lower infection rates. Cycle threshold values in secondary cases (range, 34-39) were higher than in the index case (14.07), suggesting lower viral loads. Sequence analysis demonstrated 99.6%-100% homology between the index and secondary cases; all isolates were genotype B, indicating direct transmission.

CONCLUSION: This study provides molecular and epidemiological evidence of nosocomial SFTS transmission. Inadequate PPE use during aerosol-generating procedures likely facilitated infection, underscoring the importance of strict adherence to PPE protocols and reinforced infection control practices.

PMID:41943912 | DOI:10.24171/j.phrp.2025.0481

Osong Public Health Res Perspect. 2026 Apr 7. doi: 10.24171/j.phrp.2025.0516. Online ahead of print.

ABSTRACT

OBJECTIVES: In alignment with the World Health Organization’s goal of eliminating hepatitis C, this study assessed the current treatment status and reasons for non-treatment among patients with hepatitis C in Jeonbuk State, Republic of Korea, to inform strategies for improving care engagement.

METHODS: Among 311 individuals diagnosed with hepatitis C and reported through the National Notifiable Infectious Disease Surveillance system between January 2023 and June 2024, 208 patients were surveyed after excluding those who had died or could not be contacted. Statistical analyses included the chi-square test, the Cochran-Armitage test for trend, and logistic regression.

RESULTS: Overall, 116 participants (55.8%) reported having received antiviral therapy. Among the 92 untreated individuals, the most common reason for non-treatment was the absence of symptoms (n=23; 25.0%), followed by the burden of drug costs (n=21; 22.8%).

CONCLUSION: These findings highlight suboptimal treatment uptake and key barriers that may hinder progress toward hepatitis C elimination. Expanding screening and strengthening linkage-to-care strategies, while addressing financial barriers, will be essential to achieving national elimination targets.

PMID:41943911 | DOI:10.24171/j.phrp.2025.0516