Category: Statistics

Clin Rheumatol. 2026 Feb 17. doi: 10.1007/s10067-026-07966-7. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate serum tartrate-resistant acid phosphatase 5b (TRACP5b) levels in patients with ankylosing spondylitis (AS) and primary osteoporosis (OP), and to assess its diagnostic value, correlations with bone mineral density (BMD) and disease activity, and its potential as a marker of secondary osteoporosis in AS.

METHODS: In this cross-sectional comparative study, 23 patients with AS, 24 patients with primary OP, and 20 healthy controls were recruited from Assiut University Hospitals. Demographic, clinical, laboratory, and dual-energy X-ray absorptiometry (DXA) data were collected. AS disease activity was assessed using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Serum TRACP5b was measured by ELIZA. Group differences, correlations, and ROC curve analysis were performed.

RESULTS: AS patients were predominantly male and younger than OP patients. Primary OP patients had significantly lower DXA T-scores than AS patients (mean difference = 2.36, p < 0.001). TRACP5b levels were higher in AS patients than controls but not significantly different (p = 0.111). In AS, TRACP5b correlated with age (r = 0.534, p = 0.009) and disease activity (r = 0.427, p = 0.042) but not with BMD. ROC analysis showed moderate diagnostic performance for detecting secondary osteoporosis in AS (AUC = 0.653). No significant differences in TRACP5b or BMD were found across AS treatment groups.

CONCLUSION: Serum TRACP5b may serve as a supplementary marker of osteoclast activity in AS and shows moderate diagnostic value for secondary osteoporosis, with levels more related to age and disease activity than BMD. Larger studies are needed to confirm its clinical utility. Key Points • Serum TRACP5b levels were higher in patients with AS than in healthy controls, though without consistent statistical significance, reflecting biological variability. • TRACP5b correlated positively with age and disease activity (BASDAI) in AS but not with BMD, disease duration, or ESR, highlighting its link to inflammatory bone resorption. • ROC analysis showed TRACP5b had moderate diagnostic performance for secondary osteoporosis in AS, but limited value in primary osteoporosis. • Our findings suggest that TRACP5b may serve as supplementary marker of bone turnover in AS, warranting further validation in larger, longitudinal studies.

PMID:41699179 | DOI:10.1007/s10067-026-07966-7

J Contam Hydrol. 2026 Feb 10;278:104885. doi: 10.1016/j.jconhyd.2026.104885. Online ahead of print.

ABSTRACT

Eutrophication of the northern Gulf of America (NGOA) (also known as northern Gulf of Mexico) due to excess nutrients has resulted in harmful algal blooms, the development of hypoxic zones, and negative impacts on seafood production, recreational activities, and marine transportation. With a growing recognition of afforestation to maximize timber production and improve water quality, there is a critical need to investigate impacts of afforestation on nitrogen (N) loads to the NGOA. Using the Pearl River Basin (PRB) located in Mississippi and Louisiana along with the HAWQS (Hydrologic and Water Quality System) model and the Kolmogorov-Smirnov (KS) test, we assessed the impacts of afforestation (by converting all corn and soybean lands in the PRB to mixed-forest lands) on total nitrogen (TN) and nitrate-N loads to the NGOA over a 31-year period from 1990 to 2020. Simulations showed that average annual TN and nitrate-N loads were, respectively, 26% and 28% higher in the base scenario than in the afforestation scenario, with statistically significant differences based on the KS test. The result indicates that afforestation contributed to a very significant reduction in annual N loading from the PRB to the NGOA, which could occur from enhancing N adsorption and immobilization within forest soils, reducing application of synthetic N fertilizers, and decreasing surface runoff after afforestation. Notably, the magnitude of N load reduction was not directly proportional to the area of cropland conversion, suggesting that other factors, including the specific location of afforestation (e.g., riparian zones), land slope, and the types of tree species planted, may also significantly influence N load. Two distinct daily TN loading phases were observed: 1) a slow-loading phase at daily streamflow ≤1200 m³ s^-1, and 2) a fast-loading phase at daily streamflow >1200 m³ s^-1. These findings have not been reported in the literature and underscore the value of strategically designed afforestation for optimizing N load reduction in the Gulf region. Additionally, very few studies have investigated the impacts of afforestation on daily N load to the NGOA, and this study would help fill the research gap.

PMID:41698280 | DOI:10.1016/j.jconhyd.2026.104885

Eur J Oncol Nurs. 2026 Feb 11;81:103147. doi: 10.1016/j.ejon.2026.103147. Online ahead of print.

ABSTRACT

PURPOSE: Health literacy influences surgical outcomes by affecting patients’ ability to understand information, manage their health and navigate the healthcare system. Yet, little is known about health literacy in patients with colorectal liver metastases. This study assessed health literacy across different domains and explored associations with sociodemographic and clinical factors aiming to identify knowledge gaps within this population.

DESIGN: Cross-sectional.

METHODS: A total of 122 patients with colorectal liver metastases were recruited between December 2021 and December 2024. Health literacy was assessed using the Health Literacy Questionnaire. Descriptive statistics were used to characterize the sample and to present the overall health literacy profiles. Associations between health literacy and selected sociodemographic and clinical variables were examined using, both univariate and multivariate linear regression analyses.

RESULTS: Participants reported the greatest challenges in the Health Literacy Questionnaire domains “ability to find good health information” (mean score 3.98 ± 0.56, range 1-5) and “appraisal of health information” (mean score 2.63 ± 0.55, range 1-4). Lower health literacy scores were significantly associated with male gender, lower educational attainment, living alone, and the presence of comorbidity.

CONCLUSION: This study provides novel insights into the health literacy of patients with colorectal liver metastases and highlights the importance of identifying and addressing health literacy challenges in clinical care. Tailored communication and support may enhance treatment outcomes, particularly to vulnerable patient groups. Further research is needed to explore how health literacy impacts decision-making and treatment adherence in complex cancer care.

PMID:41698272 | DOI:10.1016/j.ejon.2026.103147

Eur J Oncol Nurs. 2026 Feb 13;81:103151. doi: 10.1016/j.ejon.2026.103151. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to investigate how illness acceptance, body compassion, and post-traumatic growth interact to influence hope in cancer patients, by identifying the sequential mediating pathways among these psychosocial variables.

METHODS: This cross-sectional study recruited 226 cancer patients from three hospitals in Turkey between April and July 2025. The data were obtained through the administration of the Acceptance of Illness Scale, the Body Compassion Scale, the Posttraumatic Growth Scale-Short Form, and the Herth Hope Scale. Descriptive statistics, reliability analyses, and mediation analyses based on the bootstrap method (5000 samples, 95% confidence interval) were conducted, and results with p < 0.05 were considered statistically significant.

RESULTS: All study variables were positively correlated (p < 0.05). Illness acceptance was significantly associated with body compassion (β = 0.382, p = 0.003) but not with posttraumatic growth (β = -0.010, p = 0.922), whereas body compassion was positively associated with posttraumatic growth (β = 0.128, p = 0.018). When hope was the outcome, illness acceptance (β = 0.397, p = 0.004), body compassion (β = 0.311, p < 0.001), and posttraumatic growth (β = 0.528, p < 0.001) showed significant positive effects. Mediation analyses revealed significant indirect effects of illness acceptance on hope via body compassion and via body compassion and posttraumatic growth in sequence, but not via posttraumatic growth alone.

CONCLUSIONS: Illness acceptance enhances hope in cancer patients directly and indirectly through body compassion and a sequential pathway involving post-traumatic growth, supporting acceptance- and body-focused interventions in oncology nursing care.

PMID:41698271 | DOI:10.1016/j.ejon.2026.103151

Biomed Phys Eng Express. 2026 Feb 16. doi: 10.1088/2057-1976/ae462e. Online ahead of print.

ABSTRACT

activity, known as fetal phonocardiogram (fPCG), provides valuable information for the early identification of fetal cardiac anomalies. However, dynamic artifacts, background noise, and powerline disturbances usually degrade signal quality, challenging analysis. The article proposes a multiscale frequency-time analysis denoising architecture. Robust peak detection is possible using a statistical envelope based on the Hilbert transform, following moving-average smoothing. Applying predefined rate intervals, physiological gating differentiates maternal and fetal heart rate (HR) streams. Fetal and maternal peaks can be accurately distinguished using only their physiological rate ranges, as this involves gating. Metrics such as the correlation coefficient, Root Mean Square Error(RMSE), and Signal-to-Noise Ratio (SNR) were used to evaluate system performance. The proposed method works well, especially in medical signal augmentation situations, where fine-grained oscillatory features are difficult to handle with conventional methods.

PMID:41698241 | DOI:10.1088/2057-1976/ae462e

Anesth Analg. 2026 Feb 16. doi: 10.1213/ANE.0000000000007930. Online ahead of print.

ABSTRACT

Delirium is a serious acute neurocognitive condition that is common and debilitating in older people who undergo major surgery or are acutely ill. The nature of delirium, baseline comorbidity of older adults and related contextual factors present unique ethical challenges in delirium prevention and treatment trials; yet there is limited literature on how these challenges should be best addressed. The objective of this rapid review was to examine the reporting of key ethical processes for older adults (approval, recruitment, consent, retention) in delirium intervention trials. A rapid search in December 2023 with restricted key terms (“Delirium,” “Randomized Controlled Trial”), databases (PubMed, CINAHL), older adult participants and English language, and a final publication date range of 2020 to 2023, resulted in 411 articles screened, 153 full-text reviews, and 51 randomized controlled trial (RCTs) reports (with 11 published protocols) included. Data extraction and synthesis aligned with general guidance for ethical approval, processes and reporting of clinical studies, including for people with key vulnerabilities for research participation. Trials were categorized by degree of ethical reporting and statistical tests explored associated trial characteristics. The 51 RCTs were conducted in diverse countries, with the most sizeable proportion in China (51%). Most trials evaluated a delirium prevention (96%) and/or pharmacological intervention (69%) and were individually randomized (88%), phase 3 (84%), and perioperative (75%). No trial fully reported all ethical processes. Most of the 51 trials fully reported who provided consent (88%), the consent approach (88%), and ethical approval details (63%); around half fully reported safety assessments (59%) and how, where and when participants were recruited (49%). However, few trials fully reported who recruited participants (31%), who obtained consent (22%); how trial information was provided (27%), whether capacity was assessed prior to consent (10%), how participants were supported though the trial design or processes (18%) or in-trial communications (8%). Compared to the 19 trials (37%) with little to no reporting of ethical processes, the 16 (31%) trials with fuller reporting more often had a separately published protocol (56% vs 0%, P < .001), were conducted outside of China (87.5% vs 11%, P < .001) and had lower median consent (56% vs 96%, P < .01) and retention rates (89% vs 96%, P < .05). These results will help inform future efforts focused on improving the conduct and reporting of ethical processes in delirium trials.

PMID:41698182 | DOI:10.1213/ANE.0000000000007930

Anesth Analg. 2026 Feb 12. doi: 10.1213/ANE.0000000000007967. Online ahead of print.

ABSTRACT

BACKGROUND: The use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) is increasing with the expansion of their indications. Their effect on pain and opioid use after surgery is unknown. We hypothesized that GLP-1RA use would be associated with reduced perioperative opioid consumption and pain scores.

METHODS: This is a retrospective cohort study conducted at an academic center. Adult patients undergoing oncological surgery were included in the study. Patients were excluded if they had urgent surgery, were pregnant at the time of surgery, had nonoperating room procedures, or had biopsies or procedures not requiring general anesthesia. Patients who filled GLP-1RA prescriptions within 90 days of surgery were considered GLP-1RA users; those who did not fill prescriptions in the previous 12 months were controls. The association between the use of GLP-1RAs and perioperative opioid consumption and pain intensity after cancer surgery was investigated.

RESULTS: 17,027 patients were included in the study. Of them, 486 patients who used GLP-1RA were matched with 486 non-GLP-1RA users. Intraoperative oral morphine equivalents (OME) were similar for patients on GLP-1RA (74.7 ± 125.51 mg) and non-GLP-1RA users (69.68 ± 123.5 mg; P =.55). In PACU (-0.94; 95% confidence interval [CI], -2.49 to 0.61; P =.23), postoperative day (POD)0 (-0.29; 95% CI, -1.21 to 0.62; P =.52) and POD1 (-1.18; 95% CI, -3.36 to 1.01; P =.29), the difference also did not reach statistical significance. However, we observed a statistically significant reduction in OME in POD2 (-1.98; 95% CI, -3.82 to -0.13, P =.04), and POD3 (-1.94; 95% CI, -3.57 to -0.31, P =.02) in patients taking GLP-1RAs. Our analysis showed no statistically significant differences in pain scores between groups. A linear mixed-effects model demonstrated that the interaction between the treatment cohort and postoperative time was not statistically significant for OME (P =.1) and pain scores (P =.86).

CONCLUSION: GLP-1RA use was not associated with clinically meaningful reductions in perioperative opioid use or pain scores. Further studies should assess if GLP-1RAs are associated with analgesic effects during the perioperative period in other patient populations.

PMID:41698178 | DOI:10.1213/ANE.0000000000007967

J Pharm Pract. 2026 Feb 16:8971900261427076. doi: 10.1177/08971900261427076. Online ahead of print.

ABSTRACT

Bacteremia is a potentially life-threatening infection, especially if sepsis or septic shock develops. The 2021 Surviving Sepsis Campaign recommends initiating antibiotics within the first hour for septic shock to improve patient outcomes. The objective of this study is to assess the clinical impact of real-time pharmacist review of blood culture polymerase chain reaction (PCR) results. This single-center, retrospective cohort study included patients admitted with a positive blood culture PCR result that was not covered with the appropriate antimicrobials at the time of the result. The cultures without a pharmacist’s review were from calendar year 2021, while the post-intervention group’s cultures were obtained throughout 2024. The primary endpoint was the time to appropriate antimicrobial coverage. A total of 303 patients were included, with 151 in the pre-intervention group and 152 in the post-intervention group. The post-intervention group notably had a higher number of resistant gram-negative isolates compared to the pre-intervention group (65 isolates [74.7%], (vs) 35 isolates [55.6%], P = .02). The median time to appropriate antimicrobial coverage improved from 10.6 hours in the pre-intervention group to 3.8 hours in the post-intervention group (P < .001). All-cause mortality decreased numerically (34 patients [22.5%] in the pre-group vs 27 patients [17.8%] in the post-group, P = .32). The time to appropriate antimicrobial coverage improved after the implementation of real-time pharmacist review of blood cultures. Although the decrease in mortality was not statistically significant, most patients who expired grew resistant organisms, which were more prevalent in the post-intervention group.

PMID:41698168 | DOI:10.1177/08971900261427076

Salud Publica Mex. 2025 Nov 22;67(6 (nov-dic)):738-746. doi: 10.21149/16916.

ABSTRACT

OBJETIVO: Analizar los patrones de intermitencia en el suministro de agua entre 2022 y 2024 a manera de identificar desigualdades regionales y socioeconómicas, y su relación con la disponibilidad de agua renovable y el estrés hídrico. Material y métodos. Se usaron datos de la Encuesta Nacional de Salud y Nutrición Continua 2022, 2023 y 2024. Se estimó la proporción de hogares con acceso continuo (24/7) al agua potable por región, nivel socioeconómico (NSE) y estrato urbano-rural. Además, se compararon niveles de intermitencia según la disponibilidad regional de agua renovable per cápita y niveles de sequía.

RESULTADOS: Sólo 36.5% de los hogares tienen suministro continuo. La intermitencia es más alta en hogares rurales del sur y entre los hogares con menor NSE. De forma paradójica, las regiones con mayor sequía presentan mejor abasto.

CONCLUSIONES: La intermitencia en México parece responder más a desigualdades en infraestructura y factores socioeconómicos que a condiciones ambientales de escasez hídrica.

PMID:41698149 | DOI:10.21149/16916

Salud Publica Mex. 2025 Nov 22;67(6 (nov-dic)):575-586. doi: 10.21149/16997.

ABSTRACT

OBJETIVO: Describir el consumo de grupos de alimentos recomendables y no recomendables para consumo cotidiano y su asociación con características sociodemográficas en población mexicana. Material y métodos. Información proveniente de las Encuestas Nacionales de Salud y Nutrición continuas 2020-2024, utilizando un cuestionario de frecuencia de consumo de alimentos de 7 días. Se estimaron terciles de consumo en gramos de ocho grupos de alimentos por grupo poblacional y se analizó su asociación con características sociodemográficas mediante modelos de regresión logística ordinal.

RESULTADOS: El consumo de frutas, verduras y leguminosas fue muy bajo en todas las edades. Vivir en regiones sur y centro se asoció con mayor posibilidad de estar en los terciles más altos de consumo de frutas y verduras y menor posibilidad de consumo de leguminosas y carnes procesadas y en localidades urbanas mayor posibilidad de consumir carnes procesadas. Conclusión. La población de región sur y centro tuvieron mayor consumo de alimentos recomendables.

PMID:41698147 | DOI:10.21149/16997