Category: Statistics

J Epidemiol. 2026 Mar 7. doi: 10.2188/jea.JE20250668. Online ahead of print.

ABSTRACT

Age-standardization is a key statistical method used in health statistics to adjust rates such as mortality or incidence, enabling comparisons across populations or time points with different age structures. This review traces its historical development, global and country-specific practices, and future directions. The method dates back to the 19th century, with major adoption in the 20th century through the Segi and Doll’s World Standard Population. While the World Health Organization (WHO) introduced an updated standard in 2000, the International Agency for Research on Cancer (IARC) continues to use the Segi and Doll’s standard in the Cancer Incidence in Five Continents series, prioritizing consistency and comparability in long-term cancer surveillance. Case studies from the IARC, the United States (U.S.), Japan, and the Republic of Korea (Korea) illustrate different responses to changing demographics. The U.S. adopted the 2000 standard with expanded age detail for the elderly population. Japan introduced the 2015 Japan Standard Population to account for its rapidly aging society, though regional data limitations presented challenges. Korea, experiencing one of the fastest aging transitions globally, updated to a 2020 standard for more accurate national and sub-national reporting. The review also emphasizes that age-standardization can obscure important age-specific trends. Methods like Joinpoint clustering help detect divergent trends by age groups. Looking forward, age-standardization remains essential amid global demographic shifts. However, updates of standard populations must balance improved relevance with the need for continuity and robust data. International coordination and digital tools will support more flexible and transparent health statistics in the future.

PMID:41795926 | DOI:10.2188/jea.JE20250668

Eur J Heart Fail. 2026 Mar 6:xuag066. doi: 10.1093/ejhf/xuag066. Online ahead of print.

NO ABSTRACT

PMID:41795868 | DOI:10.1093/ejhf/xuag066

Respir Med. 2026 Mar 5:108753. doi: 10.1016/j.rmed.2026.108753. Online ahead of print.

ABSTRACT

BACKGROUND: Allergic rhinitis (AR) and asthma due to house dust mite (HDM) are increasing in children worldwide, including Indonesia, where the tropical environment favors HDM proliferation. Although Subcutaneous immunotherapy (SCIT) is widely used, local pediatric evidence remains limited.

OBJECTIVE: To evaluate the effect of HDM SCIT on clinical and immunological outcomes in children with AR and AR plus asthma.

METHODS: A double-blind randomized controlled trial was conducted in 41 children, divided into AR (n=20) and AR+asthma (n=21) groups. Participants received weekly HDM SCIT for 14 weeks. Total IgE, specific IgE, IL-10, TGF-β1, Combined Symptom Medication Score (CSMS), and Visual Analogue Scale (VAS) were measured before and after treatment. Statistical analyses included paired t-test, Wilcoxon, independent t-test, and Mann-Whitney, with significance at p<0.05.

RESULTS: HDM SCIT significantly reduced total IgE, TGF-β1, CSMS, and VAS (p<0.05). Specific IgE showed a downward trend without statistical significance. IL-10 levels slightly increased but were not significant (p=0.683). No significant differences in treatment effect were observed between AR and AR+asthma groups (p>0.05).

CONCLUSION: HDM SCIT improved clinical outcomes and reduced key immunological markers in children with AR and AR plus asthma, though no intergroup differences were found. These findings provide preliminary evidence supporting HDM SCIT as a safe and beneficial adjunct therapy in Indonesian pediatric populations.

PMID:41795860 | DOI:10.1016/j.rmed.2026.108753

Dermatology. 2026 Mar 8:1-13. doi: 10.1159/000551368. Online ahead of print.

ABSTRACT

Introduction Seborrheic keratoses (SK) are common benign epidermal tumors. Their pathogenesis is unknown, and no pathological significance is ascribed to them, although they could be part of paraneoplastic syndromes, in addition to presenting a variety of somatic mutations. SKs are associated with increased age, family history and sun-exposure. Methods This study aimed to analyze if SK was related to DNA repair genes polymorphisms and analyze if any epidemiological, clinical or environmental characteristics could modify their prevalence. It was conducted an epidemiological, analytical, observational, cross-sectional, retrospective case-control study. Both univariate and multivariate logistic regression models were used to evaluate which characteristics were associated with having >50 SKs versus <10. Results A total of 294 patients with melanoma were studied, 270 (91.8%) having had less than 10 SKs, while 24 (8.2%) >50. Of all the polymorphisms studied, only rs25487 in XRCC1 reached statistical significance (OR=3.56; 95% CI 1.36-9.33; p=0.01). In addition, an increasing age (OR=1.07; 95% CI 1.03-1.11; p=0.001) and the phototype (III-V vs. I-II) (OR=0.28; 95% CI 0.12-0.68; P=0.005) were related to the presence of >50 SKs. Conclusion We identified that increasing age, having a phototype I-II and the existence of the rs25487 polymorphism could be associated with the occurrence of KS.

PMID:41795822 | DOI:10.1159/000551368

Neurol Res. 2026 Mar 8:1-10. doi: 10.1080/01616412.2026.2641139. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to evaluate the effect of serum cholinesterase (CHE) levels on early neurological deterioration (END) in patients with mild anterior circulation stroke.

METHODS: We conducted a retrospective case-control study in the Neurology Department of Jiangsu Taizhou People’s Hospital from July 2018 to June 2023. A total of 334 patients with mild anterior circulation ischemic stroke (National Institutes of Health Stroke Scale [NIHSS] ≤5 points) admitted within 24 h were included. Patients were classified into an END group and a non-END group according to the occurrence of END, and binary logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) across serum CHE quintiles.

RESULTS: A statistically significant difference and a clear linear trend (p < 0.05) were identified after adjusting for multiple confounding factors, indicating a protective effect of elevated CHE levels against END. Age stratified analysis was limited by reduced sample sizes and insufficient statistical power to detect potential subgroup differences.

CONCLUSION: In this retrospective case-control study, the END group had a significantly higher incidence of atrial fibrillation (AF) and lower CHE levels than the non-END group. The findings indicate an inverse association between CHE levels and the risk of END.

PMID:41795817 | DOI:10.1080/01616412.2026.2641139

J Dual Diagn. 2026 Mar 8:1-10. doi: 10.1080/15504263.2026.2638190. Online ahead of print.

ABSTRACT

BACKGROUND: The COVID-19 pandemic prompted a rapid expansion of telehealth services in patients with substance use disorders (SUD) and comorbid mental health conditions (dual diagnosis). However, evidence on the effectiveness and utilization of hybrid care (combining in-person and telehealth modalities) in this population remains limited.

OBJECTIVE: This study aims to analyze the use of a hybrid treatment (telehealth and in-person treatment) among patients with dual pathology across three distinct periods-before, during, and after COVID-19-related public health measures-and to assess the impact of hybrid care on treatment dropout rates.

METHODS: A retrospective observational study was conducted using electronic health records (EHR) from 6,365 outpatients diagnosed with SUD and comorbid mental disorders, between March 2018 and September 2023. Patients were classified by treatment modality (in-person vs. hybrid) and period of care. Bivariate statistics and Cox regression analyses were performed to identify predictors of treatment dropout, accounting for demographic and clinical variables.

RESULTS: Hybrid care utilization increased significantly during the pandemic and remained elevated post-pandemic. Women and patients with opioid use disorder were more likely to receive hybrid care. Patients receiving hybrid therapy had significantly lower dropout rates and longer treatment durations. Also, patients in coordinated care (addiction and mental health centers) show lower rates of dropout. Cox regression confirmed that hybrid care was the strongest predictor of reduced treatment dropout across all periods.

CONCLUSIONS: Hybrid care models enhance treatment retention among dual diagnosis patients, underscoring the need to maintain and optimize telehealth options for this high-risk group even beyond pandemic-related restrictions.

PMID:41795803 | DOI:10.1080/15504263.2026.2638190

Int J Clin Oncol. 2026 Mar 8. doi: 10.1007/s10147-026-03005-2. Online ahead of print.

ABSTRACT

BACKGROUND: Metastatic bladder urothelial carcinoma has poor survival, and large comparative genomic studies using uniform targeted sequencing of paired primary and metastatic lesions remain limited. We compared gene- and pathway-level alterations between primary and metastatic tumors METHODS: We analyzed 2,880 bladder urothelial carcinoma samples (2,305 primary; 575 metastatic) from 2,343 patients profiled with MSK-IMPACT. Somatic mutations and copy number alterations were integrated per gene and compared between primary and metastatic samples in the full cohort and in a paired subset using standard statistical tests.

RESULTS: Primary and metastatic samples showed broadly similar driver landscapes. In the full cohort, KDM6A, FGFR3, STAG2, and ERCC2 were more frequently altered in primary tumors, whereas no individual genes were enriched in metastases; these differences were not significant in paired analyses. At the pathway level, TP53 pathway alterations were relatively more frequent in metastases, while DNA damage response alterations were enriched in primary tumors; other pathways showed comparable alteration rates. Apoptosis-focused analyses identified no significant gene-level differences, but suggested a trend toward higher alteration rates in the TP53 pathway and apoptosis regulators in metastases.

CONCLUSION: Primary and metastatic lesions of bladder urothelial carcinoma show broadly similar gene- and pathway-level alteration profiles on targeted DNA sequencing. TP53 pathway and apoptosis-related alterations are modestly more frequent in metastases, consistent with impaired stress responses and apoptosis evasion.

PMID:41795757 | DOI:10.1007/s10147-026-03005-2

Int J Clin Oncol. 2026 Mar 8. doi: 10.1007/s10147-026-02980-w. Online ahead of print.

ABSTRACT

BACKGROUND: The 9th edition of the UICC TNM classification redefined N categories and clinical stages for salivary gland cancer (SGC). We validated the prognostic utility of this redefinition and evaluated the impact of anatomical nodal spread.

METHODS: We retrospectively analyzed 166 patients with SGC and 93 parotid gland cancer (PGC) patients treated with curative surgery. Cases were restaged according to the TNM classification of the UICC 9th edition. Kaplan-Meier survival curves, Cox models, and statistical indices (AIC, likelihood ratio χ², C-index) were used to compare the findings based on the 8th and 9th editions. Nodal metastases were classified as “Intraparotid lymph nodes (LNs) only”, “Limited to levels I-III LNs”, and “Beyond levels I-III LNs”.

RESULTS: Kaplan-Meier curves showed clearer separation by N category and clinical stage for the 9th edition, although its prognostic performance by statistical indices was similar to that of the 8th edition. In the PGC surgery subset, LN metastasis, particularly N2 in the 9th edition, was the strongest adverse prognostic factor, and the new 9th edition pathological N categories were also useful. Additionally, prognosis worsened with increasing nodal extent. Twelve patients with metastases beyond levels I-III developed distant metastases despite standard treatment, and 10 with salivary duct carcinoma, indicating potential benefit from adjuvant systemic therapy.

CONCLUSIONS: Kaplan-Meier analyses suggested that the 9th edition provided better intercategory discrimination than the 8th edition, despite no statistical superiority being demonstrated. Nodal metastasis extending beyond levels I-III may be a useful biomarker for selecting patients for adjuvant systemic therapy.

PMID:41795756 | DOI:10.1007/s10147-026-02980-w

Aging Clin Exp Res. 2026 Mar 8. doi: 10.1007/s40520-026-03349-9. Online ahead of print.

NO ABSTRACT

PMID:41795734 | DOI:10.1007/s40520-026-03349-9

Oecologia. 2026 Mar 8;208(3):40. doi: 10.1007/s00442-026-05876-8.

ABSTRACT

Climate change is rapidly altering high-latitude coastal wetlands through increasing temperatures, more frequent flooding, and changing herbivore abundance and distribution. Examining plant functional trait responses to these drivers provides insight into how plant communities are shaped by climate change. We used a one-year full-factorial mesocosm experiment in coastal Alaska to assess immediate responses of two size-related traits (vegetative height and leaf area) and two leaf economics traits (specific leaf area [SLA] and leaf dry matter content [LDMC]) to warming, flooding, and goose herbivory in three dominant species across two wetland communities (Lowland and Upland) differing in landscape position. We sampled different sedges (Carex rariflora and Carex lyngbyei) and the same deciduous dwarf-shrub (Salix fuscescens) in the two wetlands. Warming increased plant size for the sedge (leaf area: + 15%) and the shrub (height: + 15%; leaf area: + 19%) in the Lowland wetland only. Flooding promoted acquisitive trait values for the Lowland sedge (SLA: + 8%; LDMC: – 6%) and conservative values for the Upland shrub (SLA: – 9%; LDMC: + 11%). The shrub thus showed clear wetland-specific responses to warming and flooding. Herbivory triggered coordinated responses across all three species, consistently decreasing size-related trait values (height: – 17-35%; leaf area: – 33-50%) and promoting acquisitive trait values (SLA: + 14-40%; LDMC: – 12-23%). Despite the absence of interactions, each driver contributed significantly to trait variation, underscoring the value of multifactorial approaches. The combination of consistent (herbivory) and context-dependent (flooding and warming) responses highlights the complexity of trait responses and improves predictions of rapid phenotypic adjustments in coastal high-latitude wetlands.

PMID:41795722 | DOI:10.1007/s00442-026-05876-8