Category: Statistics

Support Care Cancer. 2026 Feb 16;34(3):206. doi: 10.1007/s00520-026-10434-2.

ABSTRACT

PURPOSE: Allogenic hematopoietic stem cell transplantation (allo-HSCT) is a curative treatment for hematological disorders but often results in micronutrients deficiency and complications. Vitamin C, a potent antioxidant, may improve endothelial function, tissue protection, and immune recovery. This study evaluated the effects of early high-dose vitamin C supplementation on plasma vitamin C levels and post-HSCT complications.

METHODS: In this pilot, triple-blind, placebo-controlled trial, 31 adult allo-HSCT patients were randomized to receive intravenous vitamin C (50 mg/kg/day) or placebo from day + 1 to + 14, followed by oral vitamin C (500 mg/day) or placebo until day + 100. Plasma vitamin C levels were measured at days 0, + 7, + 15, and discharge. Patients were monitored for post-HSCT complications until day + 100.

RESULTS: Plasma vitamin C levels were significantly higher in the vitamin C group at all time points (P < 0.001). Trends toward reduced acute graft-versus-host disease (33% vs. 44%), lower oral mucositis severity (46.6% vs. 62.5%), and shorter duration (7.5 ± 3.6 vs. 9.1 ± 3.7 days) were observed, though not statistically significant. No significant adverse events were reported.

CONCLUSION: High-dose vitamin C effectively corrected plasma levels, and while trends toward reduced complications were observed in allo-HSCT patients, larger trials are needed to confirm these findings.

PMID:41692856 | DOI:10.1007/s00520-026-10434-2

Diabetologia. 2026 Feb 16. doi: 10.1007/s00125-026-06675-9. Online ahead of print.

ABSTRACT

AIMS/HYPOTHESIS: Type 1 diabetes develops gradually, and previous exposures may influence incidence. We aimed to assess the geographical variation in type 1 diabetes incidence in Sweden by considering all residential locations from birth to diagnosis in individuals aged 0-30 years, diagnosed between 2005 and 2022. Significant high- and low-risk clusters were identified for different life stage exposure windows.

METHODS: In 21,774 individuals with type 1 diabetes, all residential geographical locations from birth to diagnosis were geocoded. Geostatistical analysis of the incidence of type 1 diabetes was conducted at the municipality level using the most common residential location during four life stage-specific exposure windows (at diagnosis, the first 5 years after birth, 5 years prior to diagnosis, and from birth to diagnosis). Spatial scan statistics were used to identify statistically significant high- and low-risk clusters for each window. Land use and land cover within these clusters were also characterised.

RESULTS: Significant geographical variation in the incidence of type 1 diabetes was observed. The incidence was consistently higher in rural, low-population-density areas, particularly in central Sweden, and lower in major urban areas. The largest number of spatial clusters of both high risk (RR 1.29-16.0) and low risk (RR 0.32-0.73) was identified when using the most common residential location during the first 5 years after birth. High-risk clusters for this exposure window were characterised by forested and agricultural land, while low-risk clusters were characterised by urban land and open land other than agricultural land.

CONCLUSIONS/INTERPRETATION: Our findings suggest that the development of type 1 diabetes in Sweden varies geographically and is associated with specific features of the local surroundings in early childhood. This is important knowledge as a basis for identifying possible environmental risk factors and the relationship with risk of type 1 diabetes in future studies.

PMID:41692841 | DOI:10.1007/s00125-026-06675-9

Sci Rep. 2026 Feb 15. doi: 10.1038/s41598-026-40365-1. Online ahead of print.

ABSTRACT

Fathers’ involvement in child feeding positively influences feeding practices and child nutrition. Inadequate feeding practices are a major contributor to preventable childhood illnesses and mortality. Although fathers’ participation is important, evidence on the level and factors associated with their involvement in the study area is limited. This study aimed to assess the magnitude of fathers’ involvement in child feeding and associated factors among fathers of children aged 6-24 months in Chena district, Kaffa zone, Southwest Ethiopia, 2025. A community-based cross-sectional study was conducted from February 1 to June 20, 2025, among 622 fathers of children aged 6-24 months, selected using systematic random sampling. Data were collected via structured, pretested questionnaires, coded, entered into EpiData v4.6, and analyzed using SPSS v27. Variables with p < 0.25 in bivariable analysis were included in multivariable logistic regression. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were calculated, and p < 0.05 was considered statistically significant. Of the 622 fathers, 259 (41.6%) were involved in child feeding. Factors positively associated with involvement included college education or above (AOR = 4.41, 95% CI: 1.67-11.66), good knowledge of child feeding (AOR = 2.84, 95% CI: 1.78-4.51), positive attitude (AOR = 2.10, 95% CI: 1.34-3.28), and good cultural beliefs regarding child feeding (AOR = 2.22, 95% CI: 1.40-3.51). Fathers whose workplaces were far from home and who were mostly absent at night were less likely to be involved (AOR = 0.44, 95% CI: 0.22-0.90). Fathers’ involvement in child feeding in Chena district is low. Educational status, workplace proximity, knowledge, attitude, and cultural beliefs significantly influence fathers’ engagement. Interventions promoting father participation should address these factors to improve child feeding practices.

PMID:41692827 | DOI:10.1038/s41598-026-40365-1

Sci Rep. 2026 Feb 15. doi: 10.1038/s41598-026-40155-9. Online ahead of print.

ABSTRACT

This paper presents a study of pitch (F0) and duration related features of transition and non-transition regions of speech, carried out to better understand and characterize speech recorded from stroke patients. A speech corpus consisting of read speech as well as five sustained vowels, recorded from 50 stroke patients and 50 healthy speakers in a clinical environment, was developed for this purpose. A gender specific statistical analysis of F0 contour showed that median F0 of an utterance shows consistent trend in distinguishing utterances from the stroke patients and healthy control speakers across all vowel categories. The utterances from female speakers of the stroke study group tended to have a lower F0 median in comparison with that of the healthy control group. In contrast, male speakers in the stroke study group exhibited a higher F0 median compared to the control group. The durations of the transition and non-transition (steady state) regions in the utterances were estimated by an analysis of the gradient of cepstral coefficient vector as a function of frame index. The male and female speakers of the stroke study group showed shorter transition regions with higher relative transition areas as compared to those of the healthy control group. In contrast, the non-transition (steady state) regions tend to show longer duration in the stroke study group. The observed statistical trends in the F0 and duration analysis were validated using one-way ANOVA tests.

PMID:41692813 | DOI:10.1038/s41598-026-40155-9

Ann Gen Psychiatry. 2026 Feb 15. doi: 10.1186/s12991-026-00640-x. Online ahead of print.

ABSTRACT

BACKGROUND: Treatment discontinuation remains a major challenge for patients with schizophrenia, often resulting in relapse and subsequent rehospitalization. While treatment persistence is a practical marker of real-world effectiveness, findings related to lurasidone continuation in clinical settings in Japan are limited.

METHODS: For this retrospective observational study, the records of 62 patients with schizophrenia who had lurasidone treatment initiated at Aichi Medical University Hospital between June 2020 and December 2024 were analyzed. Treatment persistence was defined as continuation of lurasidone for ≥ 180 days. Associations of baseline characteristics, including illness duration, prior antipsychotic class (serotonin-dopamine antagonist, SDA; dopamine partial agonist, DPA; multi-acting receptor-targeted antipsychotic, MARTA), and other clinical variables, with six-month persistence were analyzed using Kaplan-Meier survival analysis and log-rank testing.

RESULTS: The six-month treatment persistence rate was 54.8%. Patients with illness duration < 5 years showed a significantly greater rate of persistence (71.4%) as compared to those with a longer duration (46.3%) (P = 0.046). Persistence also varied based on prior antipsychotic class, with the rate 76.5% for SDA, 50.0% for DPA, and 35.0% for MARTA (P = 0.045). No statistically significant differences in six-month persistence were observed across sex, treatment setting, or lurasidone dose range.

CONCLUSIONS: This is the first known study to evaluate real-world lurasidone persistence in patients in Japan. The findings indicate that both pharmacodynamic compatibility and early-phase treatment can enhance persistence. The insights obtained underscore the importance of individualized treatment planning, though require further validation by use of prospective, multi-center studies.

PMID:41692791 | DOI:10.1186/s12991-026-00640-x

Eur J Med Res. 2026 Feb 15. doi: 10.1186/s40001-026-04014-7. Online ahead of print.

ABSTRACT

BACKGROUND: The American Heart Association (AHA) recently proposed the cardiovascular-kidney-metabolic (CKM) syndrome to unify cardiovascular, renal, and metabolic dysfunctions into a single framework. However, the relationship between the Dietary Inflammatory Index (DII) and CKM progression remains unclear. Leveraging data from the National Health and Nutrition Examination Survey (NHANES), this study investigated the dose-response relationship and potential heterogeneity between DII and CKM stages.

METHODS: A total of 15,335 participants from the 2005-2018 NHANES cycles were included. CKM stages (0-4) were categorized following the AHA 2023 framework. DII scores were computed, and their associations with CKM stages were assessed using multivariable logistic regression, considering both continuous and quartile-based (Q1-Q4) DII measures. Restricted cubic spline (RCS) analysis was applied to explore nonlinear relationships, and subgroup analyses were conducted for sensitivity.

RESULTS: In multivariable logistic regression analyses, higher DII was robustly associated with CKM progression in a dose-response manner. For each one-unit increase in the continuous DII, the odds of being in Stage 4 were 31% higher (OR = 1.31; 95% CI 1.04-1.65). In quartile analysis, the highest DII quartile (Q4) was associated with a 4.18-fold higher odds of Stage 4 compared to Q1 (OR = 4.18; 95% CI 1.65-10.6). RCS analysis showed a linear association between DII and CKM Stages 1, 2, and 4, whereas Stage 3 exhibited slightly reduced odds when DII > 1.5. Subgroup analyses indicated that higher DII was consistently linked with more severe CKM stages across most demographic and lifestyle factors.

CONCLUSIONS: Elevated DII scores substantially increase the risk of advanced CKM stages, with potential threshold effects. Behavioral factors (e.g., smoking and alcohol intake) and socioeconomic status may modify the DII-CKM relationship.

PMID:41692773 | DOI:10.1186/s40001-026-04014-7

Eur J Radiol. 2026 Feb 11;197:112698. doi: 10.1016/j.ejrad.2026.112698. Online ahead of print.

ABSTRACT

OBJECTIVES: Adenomyomatosis (ADM) is generally considered a benign condition. However, it can be associated with chronic cholecystitis – a known risk factor for gallbladder cancer. Therefore, studies have proposed follow-up with ultrasound for asymptomatic patients with focal ADM. Currently, there are no formal recommendations regarding the frequency and length of follow-up. The aims of this study were to assess the growth of ADM lesions during follow-up and to examine the differences between larger and smaller ADM lesions.

METHODS: 144 patients who underwent MRI-MRCP at our institution between the years 2014-2024 were identified through radiological reports as having a diagnosis of ADM. 43 patients had more than one examination. Demographic, clinical and radiological data were collected retrospectively. We divided the cohort into two groups based on the primary lesion size (axial diameter below or above 1.5 cm) and compared between them.

RESULTS: The group of small lesions included 98 patients and the larger lesions group included 46 patients. We did not find a statistically significant correlation between the size of. ADM and the demographic or clinical characteristics examined. Only 9 ADM lesions grew during follow-up – 6 from the smaller lesions group and 3 from the large lesions group (p > 0.05). The median follow-up period was 35 months. None of our patients developed gallbladder carcinoma.

CONCLUSIONS: Our results confirm the common hypothesis that ADM are benign lesions. Therefore, we believe that follow-up is not needed for lesions with a clear diagnosis of focal ADM.

PMID:41691732 | DOI:10.1016/j.ejrad.2026.112698

Eur J Obstet Gynecol Reprod Biol. 2026 Feb 12;320:115006. doi: 10.1016/j.ejogrb.2026.115006. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aimed to evaluate the expression of selected immunohistochemical (IHC) markers and serum squamous cell carcinoma antigen (SCC-Ag) in vulvar squamous cell carcinoma (VSCC), and to investigate associations with recurrence and death using molecular clustering and diagnostic performance analyses.

STUDY DESIGN: This single-centre prospective study included 27 patients with histologically confirmed VSCC. Tumour specimens were assessed for expression of p16, p53, programmed death-ligand 1 (PD-L1), CD44 and epidermal growth factor receptor (EGFR). Serum SCC-Ag was measured and correlated with clinical outcomes. Statistical analyses comprised Pearson’s correlation, logistic regression, receiver operating characteristic curve analysis, diagnostic performance metrics, and unsupervised hierarchical clustering integrating IHC and SCC-Ag data.

RESULTS: No significant associations were observed between individual IHC markers and clinical outcomes. Serum SCC-Ag showed a positive trend towards association with recurrence (r = 0.462; p = 0.071), with an increased odds ratio (OR) (OR = 2.7). When analysed as a binary variable, SCC-Ag demonstrated sensitivity of 50%, specificity of 76%, and overall accuracy of 70%. As a continuous variable, SCC-Ag achieved an area under the curve value of 0.83. The combination of SCC-Ag and p53 improved sensitivity to 83% and negative predictive value to 89%. Unsupervised hierarchical clustering identified three biological subgroups, with the cluster characterized by high SCC-Ag and EGFR expression and low p16 expression associated with recurrence more frequently.

CONCLUSION: Serum SCC-Ag showed superior prognostic performance compared with individual IHC markers, and may be useful for postoperative risk stratification in VSCC. Combined biomarker panels, including p53, PD-L1, EGFR and p16, yielded promising sensitivity, supporting future strategies.

PMID:41691727 | DOI:10.1016/j.ejogrb.2026.115006

Eur J Obstet Gynecol Reprod Biol. 2026 Feb 5;320:114990. doi: 10.1016/j.ejogrb.2026.114990. Online ahead of print.

ABSTRACT

OBJECTIVE: Urinary incontinence is a common issue yet frequently overlooked in patients with endometrial cancer, especially post-treatment. Both advanced age and obesity as shared risk factors for endometrial cancer and urinary incontinence compound this burden. We hypothesized that there is insufficient awareness and suboptimal integration of urinary incontinence management into endometrial cancer care.

METHODS: The European Network of Young Gynaecologic Oncologists (ENYGO) team conducted a cross-sectional online survey from February to November 2024 using SurveyMonkey, targeting healthcare professionals involved in gynecologic oncology care. The 31-item questionnaire covered demographics, diagnostics, treatment protocols, and urinary incontinence-related practices. Statistical analysis was performed using SPSS V28.0, including descriptive statistics, normality testing, and appropriate reporting of mean ± SD or median with interquartile ranges.

RESULTS: Our final analysis included 85 complete responses. Respondents were from 31 countries, with a median age of 38 years, and 55.3% of them were female. Although 65.9% of institutions had urogynecologists, only 3.5% of respondents had formal urogynecology training. Urinary incontinence was most frequently discussed before surgery (27.1%) and least before targeted therapy (9.4%). Radiation therapy was identified by 75.4% as the main contributor to urinary incontinence. While 96.5% asked about urinary incontinence during follow-up, only 14.1% managed it post-treatment. Major barriers included lack of training (54.1%) and resources (31.8%). Notably, 58.8% expressed interest in further training.

CONCLUSION: Despite high reported awareness of urinary incontinence, proactive assessment and management remain inconsistent in endometrial cancer care. Structured education, interdisciplinary collaboration, and guideline development are needed to optimize quality of life outcomes.

PMID:41691725 | DOI:10.1016/j.ejogrb.2026.114990

J Surg Educ. 2026 Feb 14;83(5):103885. doi: 10.1016/j.jsurg.2026.103885. Online ahead of print.

ABSTRACT

OBJECTIVE: Entrustable professional activities (EPAs) have been embraced by the medical education community as a framework to guide competency-based education systems. The Vascular Surgery Board and Association for Program Directors in Vascular Surgery collaborated on the development of 15 vascular surgery EPAs, covering the core clinical activities of a vascular surgeon. We sought to explore engagement and perceptions of feasibility and utility of EPA assessment implementation for participants in a national, multi-institutional pilot.

DESIGN: Faculty assessment and trainee self-assessment of 15 vascular surgery EPAs were rated on a 4-point entrustment scale: 1 = limited participation, 2 = direct supervision, 3 = indirect supervision, and 4 = practice-ready, with accompanying behavioral anchors describing the actions expected of a learner at each level. Following an introductory webinar, the American Board of Surgery EPA Application assessment tool (delivered via SIMPL) was provided to all participating programs. Surveys evaluating the perceived feasibility and utility of the EPAs were developed. The surveys were distributed to pilot participants via email in June 2024 and responses were collected using Qualtrics. For Likert-scale items, descriptive statistics were calculated. For open-ended responses, thematic analysis was conducted to explore perceptions of respondents. This retrospective cohort study received an exemption determination from the University of Utah Institutional Review Board prior to the initiation of study procedures.

SETTING: This was a national, multi-institutional study. Participating programs included both academic, community, and hybrid programs.

PARTICIPANTS: Thirty institutions (22 fellowship, 27 residency programs) participated in the pilot. Post-pilot surveys were completed by 89 participants, including 22 program directors (Response rate 73%), 13 program managers (Response rate 43%), 26 trainees, and 28 faculty.

RESULTS: A total of 2746 EPA assessments were completed by faculty and trainees during the pilot. Regarding ease of integration of EPA assessments into perioperative workflow, 92% of trainees and 96% of faculty had neutral or positive responses. Eight four percent of trainees agreed that they were comfortable initiating EPA assessments. Seventy seven percent of trainees felt that EPA data would help them to set learning goals and 77% felt that EPA assessments helped them identify areas for improvement. For faculty, 74% felt the EPA assessments helped them identify topics on which to provide feedback.

CONCLUSIONS: This study demonstrates the feasibility and utility of EPA workplace-based assessment implementation at a diverse subset of vascular surgery training programs. Integration into usual clinical workflow was viewed as easy by both faculty and trainees. Furthermore, trainees felt the assessments were helpful to their learning, and faculty felt the assessment anchors helped them give meaningful feedback to trainees. These findings support an overall positive reception to EPA assessments in vascular surgery.

PMID:41691722 | DOI:10.1016/j.jsurg.2026.103885