Category: Statistics

Cancer Med. 2026 Mar;15(3):e71635. doi: 10.1002/cam4.71635.

ABSTRACT

BACKGROUND: In China, the incidence and burden of pediatric neoplasms have been increasing, contributing to escalating healthcare expenditures and productivity losses, with hospitalization costs constituting a major component of the economic burden. However, evidence on the full spectrum of neoplasm-related hospitalization costs for pediatric patients remains limited, particularly from real-world longitudinal studies.

METHODS: This retrospective multicenter cohort study (2017-2023) analyzed pediatric hospitalization data in Shanghai by integrating data from two administrative databases. The study included all children aged ≤ 18 years hospitalized with ICD-10-coded benign and malignant neoplasms and related complications. Hospitalization costs were discounted to 2023 values, converted to US dollars, and analyzed using descriptive statistics and generalized linear models (GLMs) to identify influencing factors, including socioeconomic, clinical, and hospital-related variables.

RESULTS: Among 688,131 pediatric hospitalizations, 13,057 (1.91%) were for neoplasms. Neoplasm patients had significantly higher care intensity and hospitalization costs than nonneoplasm patients, with malignant neoplasms incurring the highest median costs. From 2017 to 2023, total costs for neoplasm patients declined by 26.88%, driven by a 52.87% reduction in drug costs, contrasting with rising costs for nonneoplasm patients. Leukemia was the most prevalent condition, while some rare but high-cost entities, such as secondary malignant neoplasms of the respiratory and digestive organs, were among the most expensive. GLM analysis identified sex, insurance type, pathology, surgical interventions, length of stay, and hospital characteristics as significant cost drivers.

CONCLUSION: This study provides comprehensive evidence on hospitalization cost patterns, trends, and influencing factors for pediatric neoplasms. It highlights the need for enhanced insurance coverage, early diagnosis and treatment, and equitable resource allocation to reduce disparities.

PMID:41872103 | DOI:10.1002/cam4.71635

Clin Pediatr (Phila). 2026 Mar 23:99228261431967. doi: 10.1177/00099228261431967. Online ahead of print.

ABSTRACT

The aim of this study was to examine the effect of inspiratory muscle training (IMT) on respiratory functions, balance, and functional capacity in trainable children with intellectual disabilities. Thirty children aged between 8 and 17 years, diagnosed with trainable intellectual disabilities, were randomly assigned to either an experimental group (IMT) or control (conventional physiotherapy) group (5 days/week/8 weeks). Spirometry, 6-minute walk test (6MWT), and the Berg Balance Scale (BBS) were used for assessment. There were significant main effects of time and time × group interaction on 6MWT, predicted 6MWT, BBS, forced expiratory volume in 1 second (FEV₁), forced expiratory volume in 1 second (percentage of predicted) (FEV₁%), forced vital capacity (FVC), forced vital capacity (percentage of predicted), and maximal expiratory pressure (percentage of predicted (MEP%) in the experimental and control groups (P < .05). There was a statistically significant main effect of time on FEV₁/FVC, maximal inspiratory pressure, maximal inspiratory pressure (percentage of predicted), and MEP values (P < .05), with no significant group or interaction effects. Inspiratory muscle training is a feasible and effective intervention for individuals with intellectual disabilities, aiming to improve their respiratory function, functional capacity, and balance.

PMID:41872065 | DOI:10.1177/00099228261431967

Musculoskeletal Care. 2026 Mar;24(1):e70209. doi: 10.1002/msc.70209.

ABSTRACT

OBJECTIVE: To explore associations between the presence and severity of diastasis of the rectus abdominis muscles (DRAM) and common postpartum musculoskeletal complaints in the first 2 years postpartum.

STUDY DESIGN: Cross-sectional survey among women within 2 years of childbirth.

BACKGROUND: DRAM commonly affects women during pregnancy and postpartum, but its relationship with musculoskeletal complaints remains unclear. This study investigates the association between DRAM and postpartum musculoskeletal complaints, including low back pain, pelvic girdle pain, abdominal pain, and pelvic floor dysfunction.

METHODS AND MEASURES: Participants were identified from medical records of women who had delivered a baby in the previous 2 years at Southwest Healthcare, Warrnambool, Victoria, Australia. An electronic questionnaire collected data on DRAM presence and severity (self-reported based on self-assessment or prior healthcare professional screening), musculoskeletal complaints, and pelvic floor dysfunction both currently (within the past week) and early postpartum (within the first 3 months). Statistical univariate and multivariate regression analyses explored associations between DRAM presence or severity and reported symptoms adjusted for age, parity, delivery method and time since last delivery.

RESULTS: Of 177 respondents (from 785 survey invitations), 38% (n = 70) reported DRAM. In multivariate analysis, DRAM presence was significantly associated with current (p = 0.034) and early postpartum (p = 0.037) abdominal discomfort, and urinary urgency symptoms early postpartum (p = 0.033). No significant associations were found between DRAM and low back pain, pelvic girdle pain, or stress urinary incontinence.

CONCLUSION: DRAM was weakly associated with abdominal discomfort and urinary urgency symptoms but not with other musculoskeletal complaints. These findings align with limited previous research on this topic. More data are needed to explore the association between DRAM severity and musculoskeletal disorders.

PMID:41872055 | DOI:10.1002/msc.70209

J Pediatr Gastroenterol Nutr. 2026 Mar 23. doi: 10.1002/jpn3.70402. Online ahead of print.

ABSTRACT

OBJECTIVES: Dysbiosis due to early-life antibiotics may contribute to the development of functional gastrointestinal disorders (FGIDs). This follow-up study of a birth cohort primarily investigates the association between antibiotic treatment in the first week of life and the presence of FGIDs at 9-12 years. Secondarily, it examines whether a history of infantile colic or current food allergy is associated with FGIDs.

METHODS: A prospective observational birth cohort of 436 term-born infants was followed up at the age of 9-12 years; 151 received intravenous antibiotics in the first week of life due to suspected early onset sepsis (AB+) and 285 did not (AB-). Participants filled out questionnaires on the presence of FGIDs (Rome IV questionnaire) and food allergies, and FGID diagnoses were reported by general practitioners. Statistical analyses included chi-squared tests and multivariable logistic regression.

RESULTS: 306 of 388 eligible participants (79.5%) participated in the follow-up study: 109 (35.6%) AB+ and 197 (64.4%) AB-. FGID prevalence at 9-12 years was similar in AB+ and AB- (any FGID: odds ratio [OR] 1.083, 95% confidence interval [CI] 0.608-1.932). Infantile colic was not significantly associated with FAPDs after adjusting for confounders (adjusted OR 2.007, 95% CI 0.978-4.003, p = 0.051). Children with a food allergy were more likely to have a functional abdominal pain disorder (FAPD) (adjusted OR 4.028, 95% CI 1.532-10.286).

CONCLUSIONS: No statistically significant association was observed between first-week antibiotics or infantile colic and FGIDs at 9-12 years of age, but FAPDs were significantly more prevalent in children with food allergies.

PMID:41872049 | DOI:10.1002/jpn3.70402

Ann Pharmacother. 2026 Mar 23:10600280261429453. doi: 10.1177/10600280261429453. Online ahead of print.

ABSTRACT

BACKGROUND: Antifungal resistance among Candida species has become increasingly prevalent in recent years.

OBJECTIVES: This study aims to identify independent predictors for poor outcomes associated with serious clinical infections caused by fluconazole non-susceptible Candida sp. across the Veterans Health Administration.

METHODS: This retrospective, observational, nationwide analysis included adults admitted to any Veterans Affairs Medical Center (VAMC) between January 1, 2009, and September 30, 2024, with positive cultures (or rapid diagnostic test) for Candida sp. from otherwise-sterile sites. Multivariate logistic regression assessed associations with the 30-day mortality in patients with these Candida sp. infections, regardless of fluconazole susceptibility.

RESULTS: Eligible cases were found from 1613 patients with 1651 culture episodes from otherwise-sterile sites detecting Candida sp. with available fluconazole susceptibility data. Non-susceptible Candida sp. was discovered in 261 of these episodes. Independent variables associated with 30-day mortality in fluconazole non-susceptible infection included reduced serum bicarbonate, thrombocytopenia, recent exposure to the macrolide/tetracycline/clindamycin antibiotics, elevated blood urea nitrogen, and lack of recent outpatient surgery. In the propensity-matched comparison, 30-day mortality between the 2 groups was not statistically significant: 26.6% for episodes with susceptible fluconazole isolates vs 24.9% for non-susceptible episodes (139/522 vs 65/251; P = 0.60).

CONCLUSION AND RELEVANCE: Several host-derived physiological markers and recent exposure to protein synthesis inhibitor antibiotics were independent variables associated with 30-day mortality in patients with non-susceptible serious Candida sp.

INFECTIONS: This information may guide clinicians toward strategies to improve the clinical outcomes of these patients.

PMID:41872045 | DOI:10.1177/10600280261429453

Addiction. 2026 Mar 23. doi: 10.1111/add.70397. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Gambling disorder (GD) has been linked to suicidal ideation and suicide deaths; however, evidence on all-cause and cause-specific mortality-particularly in Asian populations-remains limited. Using a retrospective cohort study based on nationwide matched and sibling cohort, we investigated all-cause and cause-specific mortality risk in patients with GD.

DESIGN, SETTING AND PARTICIPANTS: A retrospective cohort study was conducted using 2000-2022 data from Taiwan’s National Health Insurance Research Database. A cohort of 961 individuals diagnosed with GD was identified. An age- and sex-matched control cohort (n = 3,844) and an unaffected sibling cohort (n = 675) were constructed. Cumulative survival was illustrated using Kaplan-Meier curves.

MEASUREMENTS: Cox regression models estimated crude and adjusted hazard ratios (AHR) for all-cause, natural-cause and unnatural-cause (accidents and suicides) mortality risks. Covariates for adjustment included sociodemographic factors, physical and psychiatric comorbidities and familial confounding.

FINDINGS: Over a mean follow-up of 8 years, GD was associated with elevated all-cause mortality risk [AHR 1.20, 95% confidence interval (CI) = 0.90-1.61] driven by statistically significantly elevated risk of unnatural mortality (AHR 6.15, 95% CI = 3.44-10.98) and especially suicide mortality (AHR 10.03, 95% CI = 4.71-21.33). Risk of natural mortality was statistically significantly lower in GD patients (AHR 0.66, 95% CI = 0.45-0.96). Sibling cohort analysis revealed a similar trend (all-cause mortality: AHR 1.70, 95% CI = 0.67-4.28; unnatural cause mortality: AHR 8.65, 95% CI = 1.62-46.22; suicide mortality: AHR 7.24, 95% CI = 0.74-70.59; natural cause mortality: AHR 0.48, 95% CI = 0.13-1.73). Results remained consistent after adjustment for individual psychiatric comorbidities.

CONCLUSIONS: Gambling disorder patients in Taiwan appear to have a statistically significantly increased risk of unnatural-cause mortality and especially suicide mortality compared with matched controls. Policies and clinical interventions for treating GD patients should focus on suicide prevention to reduce mortality in this population.

PMID:41872026 | DOI:10.1111/add.70397

ACS Appl Mater Interfaces. 2026 Mar 23. doi: 10.1021/acsami.6c02193. Online ahead of print.

ABSTRACT

We report the use of lipid membrane-coated quartz nanopipettes to enhance exosome detection via resistive pulse sensing. By exploiting the self-assembly and compositional versatility of lipid molecules, nanopipettes were functionalized with lipid membranes comprising neutral and cationic lipids, with or without cholesterol, to modulate surface charge and membrane viscosity. Using bovine milk-derived exosomes as a model system, we demonstrate a marked improvement in capture rate and a reduction in nonspecific adsorption. This improvement further enabled statistical analysis of translocation times and signal amplitudes, providing significant insights into the interactions between exosomes and lipid membranes during nanopore passage under an applied electric field.

PMID:41872023 | DOI:10.1021/acsami.6c02193

Rheumatology (Oxford). 2026 Mar 24:keag127. doi: 10.1093/rheumatology/keag127. Online ahead of print.

ABSTRACT

OBJECTIVES: To systematically review the spectrum of urological manifestations and fertility outcomes reported in FMF patients, excluding renal amyloidosis-related involvement.

METHODS: A systematic search was conducted according to PRISMA 2020 Guidelines in PubMed, Web of Science, Google Scholar, and Cochrane Library, up to 4 July 2025. Studies include FMF patients with a confirmed urological pathology were eligible. Data was extracted and presented through descriptive statistics.

RESULTS: A total of 110 records were published between 1973 and 2025. Of which 38 met the inclusion criteria (14 case reports, 10 case series, 10 cross-sectional, and four cohort studies) and covered a total of 2,040 patients (mean age 23.35±16 years; 43.2% female). Results included acute scrotum (n = 64) with 75% of recurrence, testicular amyloidosis (n = 40) confirmed with biopsy, epididymo-orchitis (n = 25) with fever present in 84%, testicular torsion (n = 4), hydrocele (n = 4), and bladder amyloidosis (n = 2). Among 189 semen analyses reported, azoospermia and oligospermia were in 26.9% and 14.8% of cases. Infertility was reported in patients with testicular amyloidosis.

CONCLUSION: Our study results show that acute scrotum and epididymo-orchitis were the most frequent urological manifestations in FMF, and testicular amyloidosis and fertility impairment were also notable. These findings highlight the importance of considering urological involvement as part of the FMF spectrum in clinical practice.

PMID:41872020 | DOI:10.1093/rheumatology/keag127

Bioinformatics. 2026 Mar 23:btag140. doi: 10.1093/bioinformatics/btag140. Online ahead of print.

ABSTRACT

MOTIVATION: Despite the widely recognized importance of replicability in biological research, computational methods to quantify irreplicability and identify irreplicable instances remain underdeveloped. This paper presents an efficient and robust computational framework to address this gap.

RESULTS: To tackle the challenge of defining an acceptable level of intrinsic heterogeneity among replicable studies, we introduce a distinguishability criterion, ensuring that replicable effects, while potentially heterogeneous, can be distinguished from zero effects and maintain consistent directions with high probability. We implement a Bayesian model criticism approach, reporting a Bayesian p-value to identify potential irreplicable instances. Through numerical experiments, we demonstrate the efficacy of the proposed methods in detecting batch effects in high-throughput experiments and identifying instances of the publication bias. Finally, we apply the framework to multi-tissue eQTL data from the GTEx consortium, uncovering tissue-specific eQTLs that represent biological heterogeneity across tissues.

AVAILABILITY: An R package DiscRep implementing our method is available on GitHub (https://github.com/PengWang96/DiscRep).

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

PMID:41872019 | DOI:10.1093/bioinformatics/btag140

J Gynecol Oncol. 2026 Mar;37(2):e58. doi: 10.3802/jgo.2026.37.e58.

ABSTRACT

OBJECTIVE: The aim of this study was to examine the impact of hospital surgical volume and hospital region on overall survival (OS) in patients with ovarian cancer.

METHODS: This retrospective cohort study utilized nationwide claims data from Korea (2012-2020) to analyze ovarian cancer patients who underwent surgery. Hospitals were classified as high-volume (≥20) or low-volume (<20) based on the annual volume of upfront ovarian cancer surgeries. Propensity score matching (PSM) (1:1) addressed confounder imbalances between the groups. OS was assessed via Kaplan-Meier analysis, log-rank tests, and Cox regression, with subgroup analyses by cancer stage.

RESULTS: A total of 11,510 patients were included in the cohort (high-volume: 8,241; low-volume: 3,269), with 3,236 matched pairs identified through PSM. Compared with low-volume hospitals, treatment at high-volume hospitals was associated with a 21% reduction in mortality risk (adjusted hazard ratio [aHR]=0.79; 95% confidence interval [CI]=0.70-0.89). This survival advantage persisted across localized/regional (aHR=0.77; 95% CI=0.63-0.95) and distant-stage disease (aHR=0.81; 95% CI=0.71-0.92). In contrast, hospital location (capital vs. noncapital) was not significantly associated with OS in the entire cohort (aHR=1.09; 95% CI=0.97-1.21) or in stage-specific analyses.

CONCLUSION: These findings highlight that instead of simply distributing hospitals geographically, establishing high-volume surgical centers is crucial to improving survival outcomes for patients with ovarian cancer.

PMID:41871963 | DOI:10.3802/jgo.2026.37.e58