Category: Statistics

Lung Cancer. 2026 Mar 24;215:109384. doi: 10.1016/j.lungcan.2026.109384. Online ahead of print.

ABSTRACT

OBJECTIVES: The improvements from minimally invasive surgery and Enhanced Recovery After Surgery (ERAS) protocols have enabled more octogenarians to be considered for curative treatment of early-stage lung cancer. However, evidence on short-term outcomes after ERAS-guided Video-Assisted Thoracoscopic Surgery (VATS) lobectomy in this age group remains limited. The aim was to evaluate perioperative outcomes and assess specific challenges in octogenarians undergoing VATS lobectomy following a well-established ERAS-protocol.

METHODS: We conducted a retrospective observational study of consecutive adults undergoing VATS lobectomy within an ERAS program from 2009 to 2024. All patients followed standardized care and followed an ERAS protocol. Patients aged ≥80 years underwent an additional preoperative risk assessment.

RESULTS: Among 4,602 patients, 335 (7.3%) were octogenarians (median age 82 years, IQR 81-83). Median length of stay was one day longer among octogenarians (4 (IQR: 2-7) vs 3 days (IQR: 2-6), p = 0.004). Overall complication rates were comparable between octogenarians and younger patients, except for postoperative atrial fibrillation (octogenarians 12% vs 7.6%, p = 0.012). Within 30 days, 40 octogenarians (11.9%) were readmitted, most commonly for pneumonia (30%), pneumothorax (25%), and pleural effusion (20%). 30-day mortality was not statistically different between octogenarians and younger patients (octogenarians 1.8% vs 1.2%, p = 0.29). The number of octogenarians undergoing VATS lobectomy has increased from 2.5% of all patients in 2009 to 11.7% in 2024.

CONCLUSION: VATS lobectomy within an ERAS framework appears safe and feasible in carefully selected octogenarians, yielding acceptable short-term outcomes. Chronological age alone should not preclude surgical treatment.

PMID:41904848 | DOI:10.1016/j.lungcan.2026.109384

Mult Scler Relat Disord. 2026 Mar 22;109:107155. doi: 10.1016/j.msard.2026.107155. Online ahead of print.

ABSTRACT

BACKGROUND: Facial emotion recognition (FER) is affected in multiple sclerosis (MS), impacting interpersonal functioning. Standard FER tests utilize static/posed stimuli, lacking in ecological validity. In this pilot study, we used the Emotion Authenticity Recognition (EAR) test, featuring both genuine/posed dynamic expressions, to assess FER in an MS sample, also investigating behavioral/neuroimaging correlates.

METHODS: A group of 54 MS patients (36 F; age = 41.4 ± 11.0, education = 14.7 ± 2.8) and a matched age/sex/education sample of 54 healthy controls (HCs) completed the EAR test, which provides two indices: Emotion Recognition (ER) and Emotion Authenticity (EA). Associations were explored with clinical/neuropsychological/self-report/MRI data. Structural 3T-MRI was analyzed using Voxel-Based Morphometry (VBM) for regional gray matter volumes.

RESULTS: No significant differences were found with standard t-tests for ER and EA between MS and HCs. Bayesian independent t-tests revealed moderate evidence for no group difference in ER (BF10 = 0.210, % error = 0.029) and anecdotal evidence in favor of the null hypothesis for EA (BF10 = 0.658, % error = 0.017). In MS, ER correlated with age (r = -0.50, p < 0.001), disease duration (R = -0.30, p = 0.030), education (R = 0.34, p = 0.012), and with domain-specific/global cognitive functioning (all r indexes among 0.3 – 0.5). EA was lower in patients with severe cognitive impairment (r = 0.47, p < 0.001) and associated with empathy (R = 0.29, p = 0.037). ER was associated with bilateral widespread cortical regions and cerebellum, while EA with fronto-temporal cortices and amygdala.

CONCLUSIONS: Despite no statistically significant differences observed compared to HCs, EAR in MS reflected age, cognition, and brain damage: this test captures subtle alterations, underscoring the value of dynamic and genuineness-based measures in MS assessment. These preliminary findings warrant further investigation into emotion-cognition interactions in MS.

PMID:41904839 | DOI:10.1016/j.msard.2026.107155

J Environ Radioact. 2026 Mar 27;295:107969. doi: 10.1016/j.jenvrad.2026.107969. Online ahead of print.

ABSTRACT

This study assessed indoor ²²²Rn concentrations, health risk, and key determinants in residential dwellings across Al Khums and Al Sahel, Libya. Al Khums showed an Arithmetic Mean (AM) of 54 Bq/m³ (Exceedance Rate 4.3%), while Al Sahel registered an AM of 102 Bq/m³. Crucially, the high AM in Al Sahel was statistically divergent from its low Geometric Mean (GM) (38 Bq/m³), which was even lower than the GM in Al Khums (45 Bq/m³). This divergence, coupled with a 17.9% exceedance rate in Al Sahel, confirmed that the high risk is heavily skewed and driven by a small number of critically high-concentration dwellings, not a geographical factor. Multiple Linear Regression analysis which explained 46.7% of the variance (Adjusted R²) confirmed that concentrations are primarily governed by non-linear structural and behavioral factors. Significant negative correlations were found for the Reciprocal of Modified Ventilation Rate (1/(V+2)), and the Reciprocal of Modified Storey Level (1/(S+2)), confirming ventilation duration and distance from the soil as dominant mitigation factors. The Quality of Window Opening Method also provided significant negative correlation, highlighting the power of occupant behavior. Conversely, Natural Gas Use for Cooking showed a significant positive correlation; identified as both a direct source of ²²²Rn and a catalyst for the “stack effect,” where combustion-induced depressurization enhances the infiltration of radon-rich soil gas. Based on a realistic occupancy factor of 7000 h/year, the resulting Excess Relative Risks (ERR) for lung cancer in Al Khums and Al Sahel were estimated at 0.859 and 1.633, respectively, underscoring the necessity of integrating these non-linear predictive factors into regional building codes and public health mandates.

PMID:41904837 | DOI:10.1016/j.jenvrad.2026.107969

J Health Psychol. 2026 Mar 29:13591053261429220. doi: 10.1177/13591053261429220. Online ahead of print.

ABSTRACT

Rural green spaces (RGS) are associated with enhanced psychological wellbeing (PWB), yet South Asian Muslim women face disparities in access, engagement, and health outcomes. This study investigates the relationships between perceived access to RGS, rate of engagement, and PWB among 600 self-identified South Asian Muslim women in England. Using structural equation modelling, we examine the moderating roles of identity visibility and active engagement. Findings indicate that perceived access is positively associated with PWB and is especially important for individuals with higher identity visibility and lower levels of active engagement. While perceived access is significantly associated with engagement with RGS, rate of engagement does not statistically predict PWB. These results offer a nuanced perspective on the intersection of identity, environment, and mental health, and have important implications for inclusive policy and nature interventions. This research contributes to and extends existing frameworks on access and wellbeing by foregrounding the experiences of a marginalised population.

PMID:41904809 | DOI:10.1177/13591053261429220

J Epidemiol Glob Health. 2026 Mar 29. doi: 10.1007/s44197-026-00545-8. Online ahead of print.

ABSTRACT

BACKGROUND: Non-unions (NU) after fractures, especially in cases with the need of surgical intervention, represent one of the most severe complications in traumatology. As previous studies estimate post-fracture NU risk between 2% and 10% data inconsistencies persist. In particular, the data on the influence of different anatomical regions, age and sex on fracture associated NU is scarce. Therefore, this study aims to provide a comprehensive descriptively assessment of the ratio of surgically treated tibia and femur NU to tibia and femur fractures based on a nationwide dataset, with a specific focus on differences across anatomical regions.

METHODS: This retrospective, population-based, cross-sectional analysis of the German InEK database (2019-2023) was conducted, including 888,442 fractures and 3,017 NU cases. The study focused on ICD- (International Statistical Classification of Diseases and Related Health Problems-) coded diagnoses of femur and tibia NU and their associated fractures. To enhance precision, fracture and NU sites were grouped according to different anatomical regions assessed by documented OPS- (Operation and Procedure Classification System) codes. Subgroup analyses were performed for age and sex.

RESULTS: Surgically treated femoral shaft NU had the highest incidence (0.18 cases per 100,000 residents and year), followed closely by tibial shaft NU (0.16). The highest NU/100-fractures ratio was observed in tibial shaft (1.277), followed by distal tibia (1.095) and distal femur (0.996). Across all localisations, men had clearly higher NU/100-fractures ratios than women. NU/100-fractures ratios also varied with age, with highest ratio in the economically active population, followed by a generally decline in older patients.

CONCLUSION: This nationwide database study indicates that surgically treated NU/fracture ratios of femur and tibia are generally low. The proportion of NU to fracture differ between different anatomical regions. In general, proximal localisations showed lower NU/100-fractures ratios than distal localisations within the femur and in comparison of femur and tibia. Independently of the anatomical localisation men had a higher NU/100-fractures ratio than women. As highest NU/100-fractures ratios were detected in the economically active population, this highlights the substantial socioeconomic burden associated with this condition.

PMID:41904778 | DOI:10.1007/s44197-026-00545-8

Clin Rheumatol. 2026 Mar 29. doi: 10.1007/s10067-026-08052-8. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this single-blind randomized clinical trial was to compare the effectiveness of extracorporeal shock wave therapy (ESWT) and high-intensity laser therapy (HILT) on clinical parameters in knee osteoarthritis.

PATIENTS AND METHODS: A total of 60 patients aged between 40 and 75 years, diagnosed with primary knee osteoarthritis and admitted to the Department of Physical Medicine and Rehabilitation, Gaziantep University, were included in the study. Sixty patients were randomized into two groups using the envelope method. Group 1 received ESWT (3 sessions/week, total of 6 sessions), and Group 2 received HILT (5 sessions/week, total of 10 sessions) for a duration of 2 weeks. A standardized home exercise program was applied to all patients. Patients were evaluated before treatment, after treatment, and at the 6th week post-treatment using the Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Lequesne algofunctional knee index. Statistical analyses were performed using SPSS 22.0 (IBM Corp., Armonk, NY, USA), including t-test, chi-square, ANOVA, and Pearson correlation; significance was set at p < 0.05.

RESULTS: In both groups, compared to pre-treatment values, significant improvements were observed in VAS (p < 0.001), WOMAC pain, stiffness, and physical function (p < 0.001), as well as Lequesne index scores (p < 0.001) after treatment and at the 6th week post-treatment. No significant differences were found between the groups in intergroup comparisons.

CONCLUSION: Both ESWT and HILT are effective and safe treatment methods for reducing pain, disease severity, and improving physical function in knee osteoarthritis. Our findings support broader clinical use of both treatments, though further comprehensive studies are required. Key Points • In both the ESWT and laser groups, significant improvements were observed in VAS, WOMAC pain, stiffness, and physical function and Lequesne index scores at 6 weeks post-treatment compared to pre-treatment values. • In patients with knee osteoarthritis receiving ESWT and HILT treatment, improvement was achieved in terms of pain and functionality, but our study showed that neither agent was superior to the other.

PMID:41904772 | DOI:10.1007/s10067-026-08052-8

Bull Environ Contam Toxicol. 2026 Mar 29;116(4):84. doi: 10.1007/s00128-026-04214-1.

ABSTRACT

Air pollution presents a significant threat to both human health and plant life. While air pollution in Dhaka has been widely studied for its effects on humans, its impact on plants remains underexplored. This investigation aimed to assess the effects of air pollution on selected plant species in Dhaka, Bangladesh, by evaluating Air Pollution Tolerance Index (APTI) and Anticipated Performance Index (API). Five tree species-Mangifera indica, S. mahagoni, Polyalthia longifolia, Ficus religiosa, and Artocarpus heterophyllus-were examined to evaluate their tolerance and suitability for pollution-affected environments by determining APTI and API across traffic, industrial, and control locations. The results showed strong species differences: M. indica was considerably tolerant, A. heterophyllus and S. mahagoni showed moderate tolerance, and P. longifolia and F. religiosa had low performance, making them unsuitable for highly polluted areas. M. indica showed the highest total chlorophyll content (TCC) values in industrial and the highest relative water content (RWC) indicating its superior resilience to pollution. This research demonstrates that selected roadside trees can serve as effective bioindicators and help guide plant choice for greenbelt development and urban environmental management.

PMID:41904767 | DOI:10.1007/s00128-026-04214-1

Genetics. 2026 Mar 27:iyag074. doi: 10.1093/genetics/iyag074. Online ahead of print.

ABSTRACT

Ancestral recombination graphs (ARGs) are an attractive means for quantitative genetic analysis of complex traits because they encode the realized genetic relatedness between a sample of individuals in the presence of genetic drift, recombination, and mutation. Data structures for efficiently storing ARGs can also be used to rapidly process millions of genomes and are thus promising for fitting linear mixed models to large phenotype and genome datasets. Here, we study the problems of variance component estimation and prediction of genetic values with ARGs, by describing a generative model of complex traits with additive effects on an ARG and then developing algorithms that use the ARG to solve these problems efficiently on biobank-scale datasets. We observe nearly linear scaling of runtime with sample size, which is achieved by using the succinct tree sequence representation of the ARG for implicit matrix-vector products, along with modern randomized linear algebra algorithms. We estimate variance components using restricted maximum likelihood, which we find performs substantially better than the Haseman–Elston method. In simulation tests, both variance component estimation and prediction of genetic values (using the best linear unbiased predictor) perform nearly as well with inferred ARGs as with true ARGs. We also discuss interpretations of the variance component estimates as mutational variance and additive genetic variance. We provide an implementation of the algorithms as a Python package tslmm, which leverages the tree sequence library tskit.

PMID:41904656 | DOI:10.1093/genetics/iyag074

Int J Pharm Pract. 2026 Mar 29:riag037. doi: 10.1093/ijpp/riag037. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to explore pharmacists’ attitudes, beliefs, and perceptions regarding the supply of Mifepristone and Misoprostol (MS-2 Step), in order to identify potential barriers and enablers to providing this service.

METHODS: A cross-sectional study was conducted between 29th of August 2024 to the 10th of February 2025. Registered community pharmacists were recruited through convenience sampling via direct email to pharmacies and professional social media platforms to complete a 19-item online survey. Data were analysed in SPSS to using descriptive statistics, non-parametric tests, and logistic regression to examine factors associated with willingness to dispense MS-2 Step.

KEY FINDINGS: Two hundred thirty-four registered community pharmacists were recruited from all states/territories in Australia with the majority working full-time (47.9%) and practicing for 1-5 years (30.8%). The main perceived benefit to the service was increased accessibility to medical abortion for women (69.5%), while a key barrier to the provision of the service was the lack of sufficient training/education for pharmacists (29.5%). Participants also expressed wanting to expand their scope of practice but being restricted by work constraints/pressures. Cultural and religious beliefs were also identified as a barrier to providing the service (26.1%).

CONCLUSIONS: This study revealed that most pharmacists are willing to provide medical abortion to reduce burden on the healthcare system and increase accessibility. However, they are restricted by lack of training, and conscientious objection as well as religious or moral beliefs.

PMID:41904653 | DOI:10.1093/ijpp/riag037

Postgrad Med J. 2026 Mar 29:qgag033. doi: 10.1093/postmj/qgag033. Online ahead of print.

NO ABSTRACT

PMID:41904652 | DOI:10.1093/postmj/qgag033