Category: Statistics

JCO Oncol Pract. 2026 May 31:101200OP2600433. doi: 10.1200/OP-26-00433. Online ahead of print.

ABSTRACT

PURPOSE: A prior national survey of U.S. hematology/oncology (H/O) fellowship curricula demonstrated substantial heterogeneity and limited protected didactic time. Since then, artificial intelligence (AI), including large language models (LLM) and ambient tools, has become increasingly integrated into trainee education and clinical practice. We conducted a multi-center survey to assess the use of AI among H/O fellows.

METHODS: H/O fellows were recruited via program leadership to complete an anonymous survey adapted from our prior study, with added questions on AI education, attitudes, and clinical use. Responses were collected via REDCap and summarized using descriptive statistics.

RESULTS: A total of 118 H/O fellows responded from 18 of 30 invited U.S. H/O fellowship programs (60%), primarily from academic centers (94%), with an even distribution across fellowship training years. Most fellows (74%) reported using AI tools. Other commonly used resources included NCCN guidelines (92%), UpToDate (86%). Only 8% reported receiving formal AI training. Most fellows viewed AI as useful for education (93%) and were confident using it for learning (74%); 92% anticipated increased use and 82% desired formal training. LLMs were most commonly used to clarify concepts (86%), summarize literature (83%), and explore emerging research (75%). AI-assisted documentation was the most frequent clinical application (51%). Reported barriers included (in order of highest concern) accuracy, lack of formal training, data privacy, and unclear ethical or institutional guidelines.

CONCLUSIONS: AI is widely used and valued by current H/O fellows, yet formal training during fellowship remains limited. These findings highlight the need for structured education on effective, safe, and ethical AI use to support clinical integration.

PMID:42218658 | DOI:10.1200/OP-26-00433

Health Informatics J. 2026 Apr-Jun;32(2):14604582261456889. doi: 10.1177/14604582261456889. Epub 2026 May 31.

ABSTRACT

We introduce a novel geostatistical framework to map and predict pedestrian fatalities in Cali, Colombia (2008-2010), addressing critical gaps in research on built environment risk factors particularly in low- and middle-income countries. We triple stack: (1) a grid-based global moving window reducing the modifiable areal unit problem, redistributing events and population; (2) a Poisson-based land use regression incorporating built environment data; and (3) Poisson kriging addressing small number issues. Nine built environment variables were significant predictors of pedestrian fatalities. Health centers had the highest risk increase (54%), while parks and population density were protective. The triple-stack model markedly improved risk prediction, sharpening hotspot delineation and reducing background noise; at high population densities, predictive errors were as low as 0.26 deaths. The framework is a transferable tool for other urban contexts; thus, we provide method decision-making support helping users select between a simplified, codeless, GUI based platform or an advanced, custom-coded approach. Our results demonstrate gains in model predictive accuracy may be primarily attributable to the first two layers, the grid and LUR. Although, Poisson kriging is traditionally used to address the “small number problem,” the first two layers may substantially stabilize rates, resulting in more realistic, interpretable risk maps.

PMID:42218637 | DOI:10.1177/14604582261456889

Asia Pac J Public Health. 2026 May 31:10105395261447325. doi: 10.1177/10105395261447325. Online ahead of print.

ABSTRACT

High-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) are widely used strategies for managing type 2 diabetes mellitus (T2DM), but evidence on their comparative effects and practical feasibility is limited. A systematic search of CNKI, Wanfang, PubMed, Web of Science, and EBSCO-SPORTDiscus was conducted up to January 31, 2026, to identify randomized controlled trials enrolling adults with T2DM. Twenty studies (n = 981; 49.6% male; mean age 58.04 ± 10.08 years; mean body mass index 28.03 ± 4.43 kg/m²) with interventions lasting ≥8 weeks reporting fasting blood glucose (FBG), fasting insulin (FINS), homeostatic model assessment of insulin resistance (HOMA-IR), glycated hemoglobin (HbA1c), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG), or total cholesterol (TC) were included. Data were extracted using standardized spreadsheets. Statistical analysis included standardized mean differences (SMDs) with 95% confidence intervals, heterogeneity assessment, and Egger’s test for publication bias. Compared with routine pharmacological treatment, HIIT significantly improved FBG (SMD = -1.24), HbA1c (-1.40), HOMA-IR (-1.03), FINS (-0.97), HDL (0.86), and TG (-0.55) (all P < .05), while no significant differences were observed for LDL, TC, or between HIIT and MICT. A 12-week, thrice-weekly HIIT protocol was most effective for glycemic control. High-intensity interval training’s time efficiency and motivational appeal may enhance adherence and support implementation in clinical practice and public health programs.

PMID:42218635 | DOI:10.1177/10105395261447325

Eur J Dent Educ. 2026 May 31. doi: 10.1111/eje.70203. Online ahead of print.

ABSTRACT

AIM: To assess the impact of a tailored ergonomic lecture on postural risk among second-year endodontic residents depending on the use of no magnification, ergonomic loupes, or an operating microscope.

METHODOLOGY: A within-subjects, repeated measures crossover study was conducted before and after a tailored ergonomic lecture. Ten postgraduate students from the Master’s in Endodontics at the European University of Madrid each treated three comparable molar cases under three randomised visual conditions: no magnification, 7.5× ergonomic loupes, and a dental microscope. Baseline and post-lecture procedures were video recorded from three angles, and the most representative still frame was scored using the Rapid Upper Limb Assessment (RULA). A 90-min tailored lecture on clinical ergonomics separated the two recording sessions. Musculoskeletal symptoms data were collected with the Nordic Questionnaire. Aligned-rank-transform ANOVA with Friedman and Conover post hoc tests was used for statistical analysis (α = 0.05).

RESULTS: All participants reported musculoskeletal pain during the preceding 12 months, most frequently in the neck (50%) and lower back (50%). At baseline, significant differences were found between magnification conditions (p = 0.00027). Students working without magnification had significantly higher RULA scores than those using loupes (p < 0.001) or a microscope (p < 0.001), with no significant difference between loupes and microscope (p = 0.96). Following the intervention, a marked reduction in RULA scores was observed in the no-magnification group; however, their scores remained significantly higher compared to the microscope group (p < 0.001) and the loupes group (p < 0.001).

CONCLUSIONS: A single, task-specific ergonomic session combined with magnification significantly reduced postural load in endodontic residents, although working with no magnification continued to pose moderate to severe risk.

PMID:42218628 | DOI:10.1111/eje.70203

Waste Manag Res. 2026 May 31:734242X261451606. doi: 10.1177/0734242X261451606. Online ahead of print.

ABSTRACT

Biogas desulfurization is essential to prevent equipment corrosion and ensure its suitability for energy applications. Although several technically established desulfurization technologies are commercially available, their implementation may still be constrained by acquisition costs, operational expenses, and environmental impacts associated with the use of conventional materials such as activated carbon. In this context, this study investigates the potential of two abundant agro-industrial residues – Luffa cylindrica and Carya illinoinensis – as low-cost and environmentally favorable filter media for biofilters applied to biogas desulfurization. A pilot-scale system operated for 62 days treating biogas with H₂S concentrations above 5000 ppm, and their performance was compared with that of a conventional activated carbon filter. Both biofilters demonstrated high initial removal efficiencies, reducing H₂S concentrations in the treated gas to below 20 ppm. Over time, the loofah-based filter showed a decline in performance due to sulfur accumulation, whereas the pecan shell medium exhibited greater operational stability and indications of self-regeneration, achieving performance statistically comparable to that of activated carbon. These results highlight the technical feasibility of using abundant agro-industrial biomass as alternative biofilter media, contributing to reduced operational costs and lower environmental impacts in biogas purification systems. The findings also reveal opportunities for integrating biomass waste valorization with biogas purification technologies, indicating promising pathways for more sustainable and economically accessible desulfurization strategies in decentralized and industrial biogas applications.

PMID:42218620 | DOI:10.1177/0734242X261451606

Mult Scler. 2026 May 31:13524585261449988. doi: 10.1177/13524585261449988. Online ahead of print.

ABSTRACT

BACKGROUND: There is growing support for high-efficacy disease-modifying therapy (DMT) in multiple sclerosis (MS), but escalation (ESC) approaches remain common.

OBJECTIVE: To describe decision-making in a pragmatic trial of early high-efficacy treatment (EHT) versus ESC.

METHODS: DELIVER-MS is a multi-center, pragmatic, randomized controlled trial (RCT) with a parallel observational study (OBS), which enrolled treatment-naïve people with RRMS in 31 UK/US sites. Primary outcome was as follows: 36-month brain volume loss according to initial treatment approach (EHT vs. ESC). Stepwise multivariable logistic regression was used to predict participation in RCT versus OBS and choice of EHT versus ESC within the OBS cohort.

RESULTS: In total, 816 people with MS were enrolled. Participants declined randomization due to preference for a particular DMT (85%), efficacy concerns (20%), and safety concerns (9%). RCT versus OBS participation was associated with lower relapse rate (p = 0.043) and greater brain parenchymal fraction (p = 0.002). Among 374 in the OBS cohort, 125 (33%) chose ESC and 249 (67%) chose EHT. People commencing EHT had higher education attainment (p < 0.001) and relapse rate (p = 0.025).

CONCLUSION: Baseline DELIVER-MS data demonstrate that participants with milder disease are more likely to participate in RCT. The choice of EHT versus ESC was associated with demographic factors and disease activity.

CLINICAL TRIAL REGISTRATION: NCT03535298.

PMID:42218617 | DOI:10.1177/13524585261449988

J Diabetes Sci Technol. 2026 May 30:19322968261450632. doi: 10.1177/19322968261450632. Online ahead of print.

ABSTRACT

INTRODUCTION: Driving requires complex cognitive, motor, and sensory coordination, all of which may be adversely affected by diabetes. For individuals treated with insulin, hypoglycemia represents the principal safety concern. Although many jurisdictions provide guidance for insulin-treated drivers, adherence to these recommendations remains unclear.

METHODS: An online survey was conducted among 500 licensed drivers with insulin-requiring type 2 diabetes (T2D) from the United States and the United Kingdom, not using continuous glucose monitoring (CGM). The survey included discrete and open-ended questions relating to diabetes management and driving behaviors. Descriptive and inferential statistical analyses were performed.

RESULTS: Participants were predominantly male (59%, n = 293) with a mean T2D duration of eight years. Insulin regimens included basal-only therapy (54%, n = 257), multiple daily injections (39%, n = 197), and continuous subcutaneous insulin infusion (9%, n = 46). Severe hypoglycemic event(s) in the preceding 12 months were reported by 34%, and 54% had evidence of impaired awareness of hypoglycemia (Clarke score >4). Furthermore, 37% (n = 185) limited their driving due to insulin-related concerns, and 72% (n = 359) worried particularly about hypoglycemia. Only 34% (n = 168) reported checking glucose levels before driving >75% of the time. If feeling hypo before driving, 59% (n = 295) would take a snack but drive immediately. If feeling hypoglycemic while driving, 10% (n = 48) would attempt to ‘get to their destination fast’. Only 27% (n = 138) carried fast-acting carbohydrates, and 42% (n = 210) felt safe to drive ‘as soon as I feel better’ while 32% (n = 163) would ‘wait 45 minutes and recheck their glucose levels’.

CONCLUSIONS: Potentially unsafe driving behaviors are common among adults with insulin-treated T2D. There appears to be a need to improve the understanding of safe driving guidance.

PMID:42218605 | DOI:10.1177/19322968261450632

Mil Med. 2026 May 31:usag253. doi: 10.1093/milmed/usag253. Online ahead of print.

ABSTRACT

INTRODUCTION: Military-civilian partnerships are increasingly recognized as necessary to sustain surgical readiness for expeditionary combat casualty care. Because military installations are geographically fixed and may have limited high-acuity case volume, medical readiness depends in part on access to civilian clinical environments. Under a training affiliate agreement, Keesler Medical Center (KMC) general surgeons were integrated into the trauma service at Memorial Hospital at Gulfport (MH), a civilian Level 2 trauma center.

MATERIALS AND METHODS: Non-elective general surgery cases at MH and KMC were compared during calendar year 2025. In addition, trauma activation data from MH were analyzed to characterize day-of-week patterns and the temporal distribution of high-acuity trauma, using blood product administration as a proxy for severity. Weekly clustering was evaluated using chi-square goodness-of-fit testing, and late-week comparisons were assessed using Fisher’s exact testing.

RESULTS: MH generated significantly greater non-elective surgical exposure per weekend call period than KMC (P < .001 using both parametric and non-parametric comparisons). Trauma activations were not evenly distributed across the week (P = .030), with higher volumes observed during mid- to late-week periods. High-acuity trauma demonstrated a similar directional late-week pattern but did not reach statistical significance.

CONCLUSIONS: Integration of military surgeons into a civilian trauma center substantially increased exposure to non-elective and high-acuity surgical care while simultaneously supporting community trauma coverage. These findings suggest that surgical readiness is influenced not only by site-level volume but by exposure density and temporal structure, supporting military-civilian partnership models that deliberately align personnel with high-yield clinical windows.

PMID:42218599 | DOI:10.1093/milmed/usag253

J Clin Exp Neuropsychol. 2026 May 30:1-24. doi: 10.1080/13803395.2026.2678869. Online ahead of print.

ABSTRACT

BACKGROUND: Reproductive factors have been associated with cognition in older women, yet findings have been inconsistent. Moreover, recent studies have also found similar associations in men.

OBJECTIVE: Examine the relationship between reproductive and cognitive factors in both sexes, controlling for multiple covariates.

METHODS: We analyzed data from 914 women with natural menopause (M^AGE = 72.65±5.57) and 811 men (M^AGE = 74.43±5.37) from the HELIAD study. Participants provided reproductive, medical, and social histories and had a comprehensive neuropsychological assessment, including Mild Cognitive Impairment and dementia diagnosis. Covariates included age, education, medical, genetic, lifestyle, and socioeconomic factors.

RESULTS: Controlling for age and education, in women, later menarche, earlier menopause, fewer menstrual years, shorter interpregnancy intervals, and menstrual regularity were associated with poorer cognitive outcomes. Earlier first childbirth (<25y), greater parity (especially, before 20y), and older age at fourth childbirth were linked to better cognition (ORs:.95-2.20). In men, older age at third and fourth child birth, having more children at ages 20-29 or 40+, the last child at >35y, and childlessness were associated with poorer cognition, while having the first child at >35y (language tasks) and having more children overall were associated with better cognition (ORs:1.37-2.20). After full-adjustment and Bonferroni correction, no associations remained.

CONCLUSIONS: Reproductive patterns may affect cognition differentially based on sex. Moderate reproductive activity may be protective, whereas extreme patterns (e.g. very early/late childbirth, childlessness) may be linked to cognitive decline. These associations attenuate after statistical adjustment and correction, necessitating further controlled and longitudinal studies to clarify these relationships.

PMID:42218593 | DOI:10.1080/13803395.2026.2678869

Disabil Rehabil. 2026 May 30:1-9. doi: 10.1080/09638288.2026.2669996. Online ahead of print.

ABSTRACT

BACKGROUND: People with multiple sclerosis (PwMS) experience impaired balance and elevated fall risk, yet research on reactive stepping responses to lateral perturbations remains limited. This study examined spatiotemporal characteristics and step choices following lateral perturbations in PwMS compared to healthy controls (HC).

METHODS: Seventeen individuals with relapsing-remitting MS and fourteen age- and gender-matched HCs completed lateral perturbation trials. Step latency, length, velocity, and step type were analyzed. A total of 60 valid perturbations in PwMS and 56 in HC were evaluated.

RESULTS: PwMS exhibited a higher frequency of steps or falls following perturbations compared to HC (38.2% vs. 12.5%, p = 0.0013). No statistically significant differences in step latency, length, or velocity were found between groups. However, step choice differed as PwMS more frequently employed crossover and medial steps, while HC primarily used lateral steps. PwMS also showed greater reliance on multiple steps for recovery.

CONCLUSIONS: While spatiotemporal stepping measures were similar between groups, PwMS demonstrated distinct compensatory stepping strategies compared to healthy controls. These findings highlight the need for targeted interventions aimed at improving lateral balance reactions and reducing fall risk in PwMS.

PMID:42218585 | DOI:10.1080/09638288.2026.2669996