Category: Statistics

J Clin Psychol Med Settings. 2026 Feb 2. doi: 10.1007/s10880-026-10129-0. Online ahead of print.

ABSTRACT

Chronic pain (CP) and hazardous/harmful drinking (HD) commonly co-occur. HD contributes to the onset and severity of CP, while CP severity predicts alcohol use disorder relapse. Integrated treatments for CP and HD are needed in rural areas, where CP and alcohol-related consequences occur at higher rates and treatment accessibility is lower. This study assessed the acceptability and feasibility of an app-based cognitive-behavioral intervention for CP and HD. Participants (n = 32) were rural residents reporting CP and HD (mean age = 49.81, SD = 8.79). Participants were randomized to intervention or assessment-only control. Self-report questionnaires at baseline and 12-week follow-up assessed program acceptability, pain, alcohol involvement, and functioning. Timely recruitment and low attrition (3.2%) supported procedure feasibility, while app engagement suggested intervention feasibility and acceptability. Descriptive statistics suggest reductions in pain (37% reduction in median pain in intervention group vs. 10% in control group). Changes in alcohol-related behavior were not consistent across outcomes and warrant further study (e.g., no change in median heavy drinking episodes in intervention, with 77% reduction in control; 60% reduction in alcohol consequences in intervention vs. 27% in control). This mobile intervention is feasible and acceptable for rural residents and may help address CP and functioning among those who engage in HD.

PMID:41622395 | DOI:10.1007/s10880-026-10129-0

J Bone Miner Metab. 2026 Feb 1. doi: 10.1007/s00774-025-01682-z. Online ahead of print.

ABSTRACT

INTRODUCTION: Though low serum magnesium (Mg) levels are associated with adverse outcomes in patients on haemodialysis, the interaction with calcimimetics remains uncertain. We hypothesized a potential interaction between serum Mg levels and calcimimetic use in cardiovascular events (CVEs), all-cause mortality, and new fractures during follow-up in patients on haemodialysis.

MATERIALS AND METHODS: This single-centre retrospective cohort included 399 Japanese adults on maintenance haemodialysis, followed for ≤ 5 years. Cox models with time-dependent serum Mg levels and calcimimetic usage interaction adjusted for clinicodemographic and biochemical covariates.

RESULTS: At baseline, 205 patients (51.4%) were prescribed calcimimetics (median serum Mg, 2.5 mg/dL). The mean observational period was 40.6 months, and 122 CVEs, 159 all-cause mortality, and 69 new fractures occurred (incidence rates: 0.09, 0.10-, and 0.05 per patient-year), respectively. The time-dependent model showed serum Mg < 2.4 mg/dL was associated with a markedly higher risk for new fractures in calcimimetic-naïve patients. Serum Mg levels were not significantly associated with CVEs and all-cause mortality, regardless of calcimimetic usage. The restricted cubic spline curve demonstrated linear inverse trends of serum Mg levels with all-cause mortality and new fractures in calcimimetic-naïve patients. However, no significant interaction between Mg and calcimimetic use was observed for any outcome.

CONCLUSION: We did not detect a statistically significant interaction between serum Mg levels and calcimimetic use. Nonetheless, low serum Mg (< 2.4 mg/dL) was associated with a higher risk of fractures, particularly among calcimimetic-naïve patients. Thus, low serum Mg is a potentially modifiable risk marker associated with fracture risk, particularly in calcimimetic-naïve patients.

PMID:41622380 | DOI:10.1007/s00774-025-01682-z

Arch Womens Ment Health. 2026 Feb 2;29(1):30. doi: 10.1007/s00737-025-01666-y.

ABSTRACT

PURPOSE: This study investigates how different forms and intensities of intimate partner violence (IPV)-particularly emotional abuse and coercive control control-are associated with symptoms of depression and anxiety among women in Nepal.

METHODS: We analyzed the 2022 Nepal Demographic and Health Survey, focusing on 4377 ever-partnered women aged 15-49 years. IPV was categorised into four domains: physical, sexual, emotional, and coercive control. Depression and anxiety were assessed using Nepali versions of the PHQ-9 and GAD-7. Multivariable logistic regression and marginal effects models were applied to estimate associations and explore dose-response patterns.

RESULTS: Emotional IPV (aOR = 3.8) and coercive control (aOR = 1.8) were independently associated with moderate-to-severe depressive symptoms. Similar associations were observed for anxiety (emotional IPV aOR = 2.9; coercive control aOR = 1.6). Male partner alcohol use independently increased the risk of both IPV and common mental disorders (CMDs). Predicted probabilities of CMD symptoms were 5.45% with neither IPV nor alcohol use, 7.82% with alcohol use only, 11.64% with IPV only, and 17.95% with both exposures. Marginal effects analysis showed a clear dose-response pattern: each additional act of emotional, physical, or sexual IPV significantly increased CMD risk.

CONCLUSION: Psychological IPV-including emotional abuse and coercive control-has a strong, cumulative effect on women’s mental health and remains underrecognized in clinical protocol and public health policies. Male partner alcohol use further amplifies this risk. Integrated IPV-mental health-alcohol interventions, grounded in syndemic and trauma-informed frameworks, are urgently needed in Nepal’s primary health care systems.

PMID:41622374 | DOI:10.1007/s00737-025-01666-y

Psychopharmacology (Berl). 2026 Feb 2. doi: 10.1007/s00213-026-07016-9. Online ahead of print.

ABSTRACT

RATIONALE/OBJECTIVES: Major Depressive Disorder is a common and disabling psychiatric illness whose pharmacological treatment options have historically been characterized by relatively low response rates. “Treatment-resistant depression” has emerged to describe patients whose depressive symptoms fail to respond to multiple courses of oral antidepressant medications. In 2019, the FDA approved intranasal esketamine as augmentation to an oral antidepressant in patients with treatment-resistant depression (TRD). While intranasal esketamine’s efficacy was demonstrated in Janssen pharmaceutical’s drug development program, publications on its real-world use have shown varying degrees of effectiveness. We aim to assess intranasal esketamine’s effectiveness in a real-world clinical setting in Hartford, Connecticut, and are among the first to do so in an American sample using the Montgomery-Asberg Depression Rating Scale (MADRS), the same outcome measure used in the clinical trials where efficacy was established.

METHODS: In this analysis, a sample of 50 patients were enrolled in an intranasal esketamine treatment program at the Institute of Living (IOL) in Hartford, Connecticut. Information for these patients was obtained through retrospective analysis of the electronic health record. Descriptive statistics were used to analyze symptom severity and outcomes, using the Montgomery-Asberg Depression Rating Scale (MADRS) score at baseline and over 16 weeks of treatment.

RESULTS: Assessment showed that moderate to severe baseline symptoms of depression were reduced to the mild range after 4 weeks and this effect was sustained over 16 weeks of treatment. Adverse effects were transient and generally mild (dissociation and sedation being the most common), with no safety events, and very few discontinuations related to tolerability.

CONCLUSION: Results of this analysis demonstrate real-world effectiveness of intranasal esketamine as augmentation therapy in treatment resistant depression. The medication was well tolerated, with no safety events, misuse or dependence. While results demonstrating the efficacy of intranasal esketamine in patients with TRD were observed in the clinical trial studies, this analysis shows intranasal esketamine treatment to be safe and effective in a real-world clinical setting.

PMID:41622351 | DOI:10.1007/s00213-026-07016-9

Neurol Sci. 2026 Feb 2;47(2):216. doi: 10.1007/s10072-026-08826-7.

ABSTRACT

BACKGROUND: Manganese (Mn) is an essential but neurotoxic trace element implicated in neurodegenerative disorders. Its association with amyotrophic lateral sclerosis (ALS) remains uncertain. We conducted a systematic review and meta-analysis to evaluate whether Mn concentrations differ between ALS patients and healthy controls.

METHODS: We systematically searched PubMed, EMBASE, Web of Science, and Scopus for observational studies comparing Mn concentrations between ALS patients and healthy controls. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Heterogeneity was assessed with the I² statistic, and publication bias was evaluated by Egger’s test.

RESULTS: Twelve studies (446 ALS cases, 652 controls) measuring Mn in blood, serum, cerebrospinal fluid (CSF), hair, urine, toenail, plasma, or tissue were included. The pooled SMD was 0.05 (95% CI: – 0.20 to 0.30; p = 0.68; I² = 71.7%), indicating no significant difference in Mn concentrations. Subgroup analyses by biological matrix and analytical method showed no consistent pattern; meta-regression identified analytical method as a significant source of heterogeneity.

CONCLUSION: No publication bias was detected (Egger’s p = 0.53). Peripheral Mn concentrations do not differ significantly between ALS patients and controls. Future research should employ longitudinal and CNS-targeted approaches, incorporating occupational exposure assessment and standardized analytical protocols.

PMID:41622338 | DOI:10.1007/s10072-026-08826-7

Osteoporos Int. 2026 Feb 2. doi: 10.1007/s00198-025-07834-1. Online ahead of print.

ABSTRACT

We compared two methods to describe adherence to osteoporotic drugs after fragility fractures. While both similarly predicted refracture risk, a novel approach using sequence analysis provided a clearer picture of patient behavior, helping clinicians better understand and address adherence issues in osteoporosis care.

BACKGROUND: Fragility fractures are common among individuals with osteoporosis, causing significant morbidity, mortality, and healthcare costs. Although effective pharmacological treatments exist, underdiagnosis and poor treatment adherence remain pervasive in clinical practice.

METHODS: In order to select an effective methodology to describe and visually represent treatment adherence and correctly stratify patients with fragility fractures according to their adherence patterns, a conventional method using average PDC was compared to an alternative method, given by the state sequence analysis (SSA) and clustering procedure. Data on patients aged 50 or older who experienced fragility fractures between 2012 and 2017 were retrieved from healthcare utilization databases in Lombardy, Italy. Fine and Gray’s model was employed to analyze the association between adherence (calculated by conventional and alternative methods) and refracture risk. Finally, the discriminatory power to predict outcomes was calculated for each approach.

RESULTS: Out of the 8976 patients included in this observational study, four different adherence groups were considered using the conventional method (very poor, poor, intermediate, and optimal), while three clusters (non-adherence, short-term adherence, and long-term adherence) were obtained from the SSA. Compared with non-adherent patients, those with long-term adherence were found to have a significantly reduced risk of combined death and refracture with both methods. Regarding discriminatory performance, the two approaches showed similar AUC, 0.646 and 0.644 for conventional and alternative methods, respectively.

CONCLUSIONS: Based on the SSA and cluster analysis, the alternative method does not significantly modify the prediction of the refracture risk but enhances the description and visualization of the adherence patterns.

PMID:41622332 | DOI:10.1007/s00198-025-07834-1

Sci Rep. 2026 Feb 1. doi: 10.1038/s41598-025-31832-2. Online ahead of print.

ABSTRACT

Heat warning systems represent a critical health adaptation strategy under global boiling. This study evaluates the appropriateness of the existing criteria of heat warning categories, which were established based on climatology. The objectives were (1) to evaluate the association of the daily maximum temperature (Tmax) and multiple health outcomes (including emergency visits, hospitalization cases, and mortality of heat-related illness (HRI), cardiovascular, respiratory, diabetes, and renal diseases) considering both the lag and cumulative effects, and (2) to identify vulnerable groups (considering their demographic, occupation, geographic, and health status) and areas of heat-health impacts. Weather and health records in Taiwan from May to October from 2000 to 2019 were analyzed using generalized additive models. The results show that HRI was the most sensitive health outcome, and the relative risk (RR) was 1.81 (confidence interval (CI): 1.51 – 2.18) and 2.99 (CI: 1.99 – 4.49) for emergency visits and hospitalizations, respectively, when Tmax was ≥ 34 °C. The corresponding RRs were 2.00 (CI: 1.67 – 2.39) and 2.39 (CI: 1.44 – 3.95) when Tmax was ≥ 32 and ≥ 31 °C for three consecutive days, respectively. The morbidity risks of cardiovascular, respiratory, diabetes, and renal diseases all increased at different temperature thresholds. Significant associations between Tmax and health outcomes occurred at thresholds lower than the current warning thresholds, indicating the need for revision. Both lag and cumulative effects need to be considered in heat-health warning systems. People with hypertension, hyperglycemia, or hyperlipidemia were found to be more vulnerable, as they had higher RRs for pneumonia, COPD, and stroke than the general population. Among different occupations, farmers were found to be most vulnerable. This study demonstrates a methodology considering both lag and cumulative effects that can be applied in other countries to assist in the establishment of evidence-based heat-health warning systems.

PMID:41622278 | DOI:10.1038/s41598-025-31832-2

Eur Arch Otorhinolaryngol. 2026 Feb 1. doi: 10.1007/s00405-025-09958-w. Online ahead of print.

ABSTRACT

BACKGROUND: Cerebrospinal fluid (CSF) rhinorrhea is a clinically significant condition resulting from abnormal communication between the subarachnoid space and the nasal cavity. Although multiple surgical techniques have been developed, their long-term outcomes remain inadequately defined. Our systematic review and meta-analysis aimed to assess the long-term efficacy and safety of surgical interventions used to manage CSF rhinorrhea.

METHODS: A comprehensive search of PubMed, Scopus, Web of Science, and the Cochrane Library was conducted from database inception to March 2025. Studies evaluating any surgical interventions for managing CSF rhinorrhea and following the patients for at least one year were included. Our study outcomes were success, recurrence, and complication rates. All statistical analyses were performed using STATA 18 BE.

RESULTS: Our review encompassed 114 studies involving 4187 patients with CSF rhinorrhea. The endoscopic repair demonstrated a high primary success rate, estimated at 93% (1-2 years), 92% (2-5 years), and 91% (more than 5 years). Recurrence after endoscopic repair remained low, varying from 7% to 11%. Complications were uncommon, with meningitis reported in 1-2% of cases, sinusitis estimated at 1%, and headache from 1 to 3%. The craniotomy approach achieved a high primary success rate, reaching 95% at 1-2 years, then dropping to 75% at 2-5 years, and increasing again to 98% at > 5 years. Additionally, the risk of recurrence (5-22%) and complications were generally higher after craniotomy (3-6%).

CONCLUSION: Endoscopic repair demonstrated excellent long-term outcomes with minimal morbidity, supporting its role as the standard approach for most CSF rhinorrhea cases. Although craniotomy carries a higher risk of recurrence and complications, it remains appropriate for complex or frontal defects. Surgical management should be individualized according to defect site, CSF flow, and patient-specific factors to optimize outcomes. Nevertheless, we have some limitations as most included studies were observational and retrospective, and there was heterogeneity in study design and outcome reporting.

PMID:41622274 | DOI:10.1007/s00405-025-09958-w

Eur Arch Otorhinolaryngol. 2026 Feb 1. doi: 10.1007/s00405-026-10011-7. Online ahead of print.

ABSTRACT

OBJECTIVE: Ménière’s disease (MD) is characterized by episodic vertigo, fluctuating hearing loss, tinnitus, and aural fullness. As vertigo is a cardinal symptom, evaluating vestibular function is essential for disease assessment. However, the relationship between vestibular function and the degree or location of endolymphatic hydrops (EH), as well as the stages of Ménière’s disease (MD), remains unclear.

METHODS: Patients diagnosed with definite Unilateral Ménière’s disease (UMD) underwent a comprehensive vestibular function evaluation, including cervical and ocular vestibular evoked myogenic potentials (cVEMP, oVEMP), video head impulse test (vHIT), caloric test, and sensory organization test (SOT). Inner ear gadolinium-enhanced MRI (Gd-MRI) was performed to the assessment of endolymphatic hydrops(EH).Vestibular function parameters were compared across MD stages and EH categories. Fisher’s exact test was used for statistical analysis.

RESULTS: cVEMP and oVEMP non-response rates increased significantly with advancing MD stage and were significantly higher in Stages III-IV compared to Stages I-II. vHIT abnormalities were predominantly observed in Stage IV. Caloric test abnormalities were significantly lower in Stage I but showed no significant differences among later stages(II, III, IV). No significant differences were found in SOT-derived balance function (BF) or vestibular function (VF) across MD stages. Furthermore, there was no linear correlation between vestibular test results and overall endolymphatic hydrops level(EHL). Similarly, vestibular dysfunction rates did not differ significantly among patients with isolated cochlear, isolated vestibular, or both cochlear and vestibular EH.

CONCLUSION: Vestibular function changes in UMD are stage-dependent, with early involvement of otolithic and low-frequency semicircular canal function, while high-frequency canal dysfunction appears later. However, these changes do not consistently correlate with EH severity or anatomical distribution. Central compensation and functional-structural mismatch may underlie these discrepancies. Multimodal and longitudinal approaches are needed to better understand vestibular pathophysiology in MD.

PMID:41622266 | DOI:10.1007/s00405-026-10011-7

BMC Sports Sci Med Rehabil. 2026 Feb 2. doi: 10.1186/s13102-026-01560-9. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of this randomized controlled trial was to determine the effects of a four-week running-based high-intensity interval training (HIIT) intervention on the reactive strength index (RSI) and motor abilities in youth football players. In this context, the contributions of the running-based HIIT protocol HIIT protocol, implemented in addition to regular football training, were evaluated on performance indicators such as speed, back strength, change of direction (COD), and countermovement jump (CMJ). This study aims to contribute to the development of scientifically grounded training programs to support performance improvement in youth football players.

METHODS: A quantitative research design was employed in this study, specifically a randomized pretest-posttest controlled experimental design. Twenty male youth football players, aged 11-13 years, who voluntarily participated in the study were randomly allocated to either the experimental group (EG; n = 10) or the control group (CON; n = 10). The EG participated in a running-based HIIT program three times per week for four weeks by replacing a low-to-moderate-intensity technical-tactical segment of their regular football training, whereas the CON continued with only regular football training during this period without any additional training volume. The players underwent RSI, 10 m, 20 m, and 30 m sprint tests, back strength tests, the Illinois Agility Test, and CMJ tests both before the training sessions and at the end of the four-week intervention.

RESULTS: According to the repeated-measures ANOVA results, pretest values did not differ significantly between the groups (p > .05). Over the 4-week period, significant improvements with large effect sizes were observed in RSI, sprint performance (10, 20, 30 m), back strength, COD, and CMJ tests (p < .05; ηp² = 0.29-0.55). Significant group × time interactions were also detected for all variables, again with large effect sizes (p < .05; ηp² = 0.20-0.30), indicating greater improvements in the EG compared to the CON. However, despite these favourable within-group changes, between-group post-test comparisons did not reach statistical significance.

CONCLUSIONS: This study revealed that a 4-week HIIT intervention applied to youth male football players had positive effects on the RSI and motor abilities, as evidenced by large within-group improvements and significant group × time interactions, despite the absence of statistically significant between-group post-test differences. These findings suggest that HIIT protocols should be integrated into training programs as an effective strategy to improve explosive strength, COD, and overall functional performance in young athletes.

TRIAL REGISTRATION: This randomized controlled trial was retrospectively registered with ISRCTN (ISRCTN45188963) on 16 July 2025 due to administrative delays during ethics approval and registry processing.

PMID:41622262 | DOI:10.1186/s13102-026-01560-9