Category: Statistics

PeerJ. 2026 Jul 30;14:e21550. doi: 10.7717/peerj.21550. eCollection 2026.

ABSTRACT

AIM: This study investigated the effects of different velocity loss (VL) thresholds during squat exercise at 80% of one-repetition maximum (1RM) on post-activation performance enhancement (PAPE) in basketball players.

METHODS: Nineteen male collegiate basketball players completed three familiarization sessions and four randomized crossover experimental sessions: control (passive rest), 5% VL, 10% VL, and 20% VL. Countermovement jump height (JH), peak power output (PPO), and reactive strength index modified (RSIm) were measured pre-test and at 3-min and 8-min post-squat. Linear mixed-effects models (LMMs) evaluated the effects of time, condition, and mean-centered relative strength on the outcome variables and repetition counts. To identify responders who exhibited meaningful improvements in jump height, the smallest worthwhile change (SWC) was calculated.

RESULTS: At the group level, no significant condition × time interactions or main effects of condition were observed for JH, PPO, or RSIm (p > 0.05), indicating no uniform PAPE effect across protocols. Furthermore, no statistically significant strength × time × condition interaction effects were observed. Repetition counts did not differ between the 5% and 10% VL conditions but were significantly lower in both conditions compared to the 20% VL condition (p < 0.01). Individual analysis showed the 20% VL condition yielded the highest number of responders (n = 11; 58%).

CONCLUSION: Squat protocols using 5-20% VL at 80% 1RM did not produce significant group-level CMJ performance improvements, suggesting that a comprehensive warm-up may create a performance ceiling. Furthermore, these responses were not moderated by relative strength. However, the high inter-individual variability and responder rates at higher VL thresholds highlight the importance of individualized PAPE programming.

PMID:42544330 | PMC:PMC13429104 | DOI:10.7717/peerj.21550

Dela J Public Health. 2026 Jul 31;12(3):110-113. doi: 10.32481/djph.2026.07.18. eCollection 2026 Jul.

ABSTRACT

INTRODUCTION: Prematurity remains a significant cause of infant and childhood morbidity and mortality. Infants who are exclusively breastfed during the first 6 months of life have improved outcomes. A majority of premature infants are discharged home on formula. Neonatal Intensive Care Unit (NICU) design may influence parental involvement and, in turn, affect breast milk utilization. This study assesses breast milk utilization at discharge, before, and after transitioning from a traditional open-bay NICU to a private, single-family room (SFR) NICU.

METHODS: This is a retrospective observational study of infants born at <32 weeks gestation admitted to a level III NICU before and after a transition from a traditional open-bay to a SFR NICU. Infants who received care in both NICU environments were excluded. The primary outcome was breast milk utilization at discharge. Standard descriptive statistics were used.

RESULTS: A total of 276 infants were included in the analysis. Demographic and clinical variables did not differ except for increased socioeconomic disadvantage and eligibility for donor breast milk. There was a significant increase in overall breast milk utilization (p=.04) but not maternal breast milk (p=0.61) in the SFR. Infants admitted to the traditional open-bay unit were younger at first oral feeding attempt (34.2 weeks (2.9)) compared to infants in the SFR room (35.2 weeks (2.4), p=0.007).

CONCLUSION: Transition from a traditional open-bay model to a single-family room (SFR) model affected the time of oral feeding initiation but did not significantly impact breast milk exposure, breastfeeding attempts, or parental involvement in feeding. Breastfeeding outcomes may be more strongly influenced by clinical practices and support systems rather than by the physical environment. Understanding the impact of the NICU environment on feeding practices can inform institutional policies aimed at optimizing breast milk utilization.

PMID:42544328 | PMC:PMC13429254 | DOI:10.32481/djph.2026.07.18

J Inflamm Res. 2026 Jul 29;19:613632. doi: 10.2147/JIR.S613632. eCollection 2026.

ABSTRACT

BACKGROUND: Heart failure (HF) and ischemic stroke (IS) frequently co-occur and worsen each other. Circulating immune cells may act as a cross-organ inflammatory bridge, but the key immune lineage, genetically supported mediators, and druggable targets remain unclear.

OBJECTIVE: To identify the immune-cell lineage, candidate gene, and tractable intervention target linking HF and IS.

METHODS: Bidirectional Mendelian randomization (MR) of genome-wide association study summary statistics was used to assess causal links between HF and IS. Mouse single-cell transcriptomic datasets from HF and IS models were integrated to define a shared immune/stromal atlas and characterize Ly6C⁺ monocyte expansion. Ly6C⁺ monocyte marker genes were mapped to human orthologs and evaluated using peripheral-blood expression quantitative trait locus data for gene-level MR, followed by expression validation, colocalization, summary-data-based MR, and spatial transcriptomics. In HF single-cell data, Ly6C⁺ monocytes were stratified by Nrip1 expression for cell-cell communication, pathway enrichment, and pseudotime analyses. Candidate-drug prediction, druggability evaluation, molecular docking, molecular dynamics simulation, and in vitro validation were then performed.

RESULTS: MR supported a bidirectional positive association between HF and IS. Both diseases showed expansion of inflammatory Ly6C⁺ monocytes at single-cell resolution. Among MR-implicated genes, NRIP1 was prioritized as a key gene associated with reduced IS risk, and genetic and spatial evidence supported its monocyte-mediated role in HF-IS coupling. Nrip1-stratified and pseudotime analyses suggested a homeostatic role through modulation of inflammatory thresholds and communication patterns. Drug prediction and in silico analyses indicated that retinoic acid-related small molecules may bind NRIP1 and exhibit preliminary druggability. In vitro, tretinoin alleviated ischemia-like HMC3 cell injury and inflammation by modulating monocyte NRIP1.

CONCLUSION: An NRIP1-centered monocyte network may represent a tractable immune bridge in HF-IS comorbidity, and tretinoin provides an entry point for NRIP1-targeted intervention.

PMID:42544320 | PMC:PMC13429124 | DOI:10.2147/JIR.S613632

Cureus. 2026 Jul 3;18(7):e111994. doi: 10.7759/cureus.111994. eCollection 2026 Jul.

ABSTRACT

Background Hypertension and obesity remain important public health concerns among Indigenous populations in Canada because of their association with cardiovascular disease and related chronic conditions. Limited recent national evidence has examined the relationship between body mass index and hypertension among Indigenous adults in Canada. Objective To examine the association between body mass index classification and hypertension among Indigenous adults in Canada using data from the 2022 Canadian Community Health Survey. Methods This cross-sectional study analyzed data from the 2022 Canadian Community Health Survey Public Use Microdata File. The study included 1,632 Indigenous adults aged 18 years and older, representing a weighted population of 607,892 individuals. Survey-weighted descriptive statistics and multivariable logistic regression analyses were performed while accounting for the complex survey design and bootstrap variance estimation. Hypertension was the outcome variable, while body mass index classification was the primary exposure variable. Results Among participants with hypertension, 92,384 (87.03%) were classified as overweight or obese, compared with 351,946 (70.14%) among those without hypertension. Adults aged 50-64 years had significantly higher odds of hypertension compared with adults aged 18-34 years (adjusted odds ratio (aOR)=9.54, 95% confidence interval (CI): 2.70-33.69, p<0.001). Participants aged 65 years or older also had higher odds of hypertension (aOR=13.59, 95% CI: 3.68-50.14, p<0.001). High cholesterol was significantly associated with hypertension (aOR=2.40, 95% CI: 1.23-4.70, p=0.011). Overweight or obese participants had higher odds of hypertension compared with underweight or normal weight participants; however, the association did not reach statistical significance after adjustment for demographic, behavioral, and clinical factors (aOR=2.15, 95% CI: 0.95-4.88, p=0.066). Conclusion This study highlights the burden of hypertension among Indigenous adults in Canada. Older age and high cholesterol were significantly associated with hypertension. Although overweight or obese participants demonstrated higher odds of hypertension, the association did not reach statistical significance after adjustment. Further longitudinal studies are needed to better understand the relationship between body mass index and hypertension among Indigenous populations in Canada.

PMID:42544307 | PMC:PMC13429213 | DOI:10.7759/cureus.111994

Clin Transl Sci. 2026 Aug;19(8):e70690. doi: 10.1111/cts.70690.

ABSTRACT

Identification of modifiable risk factors for prescription opioid use disorder (OUD)-related emergency department (ED) visits (ICD-10 F11.xx) is a clinical priority; however, most published models remain cross-sectional and lack pharmacogenomic (PGx) enrichment or dual-method feature confirmation. Using Virginia All-Payer Claims Database (APCD) data (2016-2019; 6,929,576 patients), we analyzed prescription OUD-related ED visits ( n = 1,505,138 cases; 5:1 matched controls) across seven age bands. CatBoost, XGBoost, and XGBoost-RF ensembles were trained within four utilization-density strata (25-split MCCV; 2016-2018 training; 2019 holdout) using PGx burden and pre-index temporal dynamics. Risk features were identified via a Consensus Filter (SHAP ∩ FFA) requiring SHAP values ≥ 75th percentile and FFA rule support ≥ 0.05. Dynamic Time Warping (DTW) characterized pre-index trajectories. On the 2019 low-density holdout, PR-AUC lift over prevalence ranged from 2.3× to 3.4×; the 25-44 band achieved an AUROC of 0.800 and 3.3× lift ( n = 4942 holdout cases). Top Consensus-Risk features included gabapentin, long-term opioid use (Z79.891), and pgx_num_drugs. DTW yielded three utilization archetypes in the 25-44 band ( n = 59,813), with a mean pre-index time-to-target of 6.8 months. While SHAP/FFA specify how to intervene (medication and care targets), DTW specifies when to act (surveillance window). These findings provide an observational risk-attribution framework for Consensus-Risk priority features and pre-index trajectory windows in claims-based prescription OUD-related ED care rather than identified causal treatment effects. We maintain the association-versus-causation distinction to support safer clinical use and preserve a path to prospective causal validation.

PMID:42543496 | DOI:10.1111/cts.70690

J Oral Rehabil. 2026 Aug 2. doi: 10.1111/joor.70256. Online ahead of print.

ABSTRACT

BACKGROUND: Bruxism and temporomandibular disorders (TMD) are multifactorial conditions in which cognitive and behavioural traits may play an underrecognised role. Hyperfocus, defined as intense and sustained attentional engagement, has been proposed as a potential driver of heightened sensorimotor activity and pain vulnerability, yet its relevance to bruxism and painful TMD remains poorly understood.

OBJECTIVES: To examine whether hyperfocus is associated with probable bruxism and painful TMD (pTMD), and to determine whether probable bruxism mediates the relationship between hyperfocus and pTMD.

METHODS: This cross-sectional observational study included eighty-five adults attending a university dental clinic who underwent standardised assessments for probable bruxism, pTMD, anxiety, depression, hyperactivity, and hyperfocus. Logistic regression models were used to identify factors associated with probable bruxism and pTMD. Mediation analyses tested whether probable bruxism explained the association between hyperfocus and pTMD.

RESULTS: Higher hyperfocus scores were significantly associated with both probable bruxism and pTMD. Each one-point increase in hyperfocus was linked to a 6.5% increase in the odds of PB and a 5.5% increase in the odds of pTMD. Hyperfocus was also associated with self-reported probable bruxism frequency in a dose-response pattern. Probable bruxism did not remain independently associated in the final multivariable model and therefore did not statistically explain the observed association between hyperfocus and pTMD, indicating that hyperfocus may act as an independent factor linked to both conditions.

CONCLUSION: Hyperfocus emerged as a trait associated with probable bruxism and painful TMD in this exploratory cross-sectional study. Longitudinal and mechanistic studies are needed to determine whether these associations reflect causal relationships.

PMID:42543493 | DOI:10.1111/joor.70256

Nurs Health Sci. 2026 Sep;28(3):e70406. doi: 10.1111/nhs.70406.

ABSTRACT

This study aims to examine the relationship between symptom clusters (depressive symptoms, sleep disturbances, and pain) and frailty in older adults, with a specific focus on mediation and moderation effects. Data from two cross-sectional studies in Changsha and Hong Kong were analyzed, including nursing home residents without cancer and older adults with cancer. Study-stratified analyses were conducted in SPSS 26.0 and PROCESS, with adjustment for available covariates. Mediation tested whether sleep disturbances were indirectly associated with depressive symptoms and frailty, and moderated mediation examined whether pain severity or interference conditioned the association between depressive symptoms and sleep disturbances. In both groups, frailty, depressive symptoms, sleep disturbances, and pain were significantly associated. Sleep disturbances showed a significant indirect association between depressive symptoms and frailty in both groups. Pain interference, but not pain severity, moderated the association between depressive symptoms and sleep disturbances only among older adults without cancer. The findings highlight the importance of assessing and managing depressive symptoms, sleep disturbances, and pain-related interference when addressing frailty in older adults, particularly among those without cancer.

PMID:42543491 | DOI:10.1111/nhs.70406

Adv Sci (Weinh). 2026 Aug 2:e76724. doi: 10.1002/advs.76724. Online ahead of print.

ABSTRACT

Objective measurement of tremors is important for assessing the severity and preventing misdiagnosis of Parkinson’s disease (PD). To address this demand, this study presents a multichannel, wireless, patch-type tremor monitoring system that integrates a high-repeatable fibrous crack-based strain (FCBS) sensor with a flexible wireless communication circuit. The FCBS sensor, incorporating crack structures, random fiber orientation, junction melting, and polymer penetration within a 3D conductive fiber network, achieves high sensitivity (gauge factor up to 476.89), a fast response time (≈ 6.64 ms), a wide working range (>200% strain), low Young’s modulus (≈45 kPa), and excellent repeatability (>100 000 cycles). In addition, this study demonstrates the first clinical application of a flexible strain sensor-based tremor monitoring system in patients with PD and ET for simultaneous multilocation tremor measurement. Through clinical trials, our system measured tremor indicators (peak amplitude and fundamental frequency), and tremor indicators obtained from multilocation showed improved correlation and statistical significance with tremor scoring in UPDRS III under specific conditions. These results demonstrate the applicability and potential of the flexible strain sensor-based system as a wearable platform for quantitative and objective tremor measurement.

PMID:42543484 | DOI:10.1002/advs.76724

Matern Health Neonatol Perinatol. 2026 Aug 3;12(1):31. doi: 10.1186/s40748-026-00280-9.

ABSTRACT

BACKGROUND: Accurate estimation of fetal weight is a crucial component of pregnancy management and plays a key role in reducing maternal and neonatal complications. Although ultrasonography is considered the gold standard, its limited availability and cost emphasize the need to assess alternative clinical methods.

METHODS: This cross-sectional study included 132 term pregnant women (37to 41 weeks) selected via non-probability sampling. Fetal weight was estimated prior to childbirth using three methods: ultrasonography (performed within the last two weeks of the third trimester to minimize the impact of rapid fetal weight gain closer to term), Johnson’s formula, and Insler’s formula and was compared with the actual birth weight immediately after childbirth. Data were analyzed using SPSS version 24, with descriptive statistics and regression.

RESULTS: The mean ± SD of estimated fetal weights (EFW) obtained via third-trimester ultrasonography and based on the Johnson and Insler formulas were 3164 ± 382.95 g, 3161.27 ± 302.90 g, and 3309.35 ± 374.05 g, respectively. Regarding diagnostic accuracy, the Johnson formula showed a precision of 69.70% for neonates < 3000 g and 71.21% for macrosomia (> 3500 g), the Insler formula showed a precision of 75.76% for neonates < 3000 g and 68.94% for macrosomia (> 3500 g). In the multivariate regression analysis of estimated fetal weight using the Johnson formula, only fundal height remained a significant independent predictor (β = 149.43, P < 0.001).

CONCLUSION: Although ultrasound is the most accurate method for estimating fetal weight, with the smallest mean difference from the actual weight, clinical methods, particularly the Insler method for normal weight pregnancies and the Johnson method for ruling out macrosomia, have acceptable accuracy.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:42543479 | DOI:10.1186/s40748-026-00280-9

Psychiatr Q. 2026 Aug 3. doi: 10.1007/s11126-026-10303-5. Online ahead of print.

ABSTRACT

This letter addresses significant methodological limitations in a recently published systematic review and meta-analysis evaluating the efficacy and safety of xanomeline-trospium (KarXT) in schizophrenia. A critical unit-of-analysis error is identified in the original review’s Table 1, wherein multiple secondary and post hoc publications from a single randomized controlled trial (EMERGENT-1) were extracted and treated as completely independent studies. This unit-of-analysis error violates statistical independence assumptions and likely contributed to an implausible pooled effect size; however, additional discrepancies in data extraction or effect-size calculation may also have influenced the pooled estimate (d = 0.08) that sharply contradicts individual trial data. Additionally, the review lacks registered protocol details, structured risk-of-bias reporting, and safety outcome pooling. Readers and clinicians are cautioned against interpreting the pooled conclusions in isolation.

PMID:42543467 | DOI:10.1007/s11126-026-10303-5