Category: Statistics

Indian J Pediatr. 2026 Jan 28. doi: 10.1007/s12098-026-05992-6. Online ahead of print.

ABSTRACT

OBJECTIVES: To determine the accuracy of Face2Gene (F2G) app in the diagnosis of a genetic syndrome as a first correct response, after uploading the image of the patient in the app (top 1 accuracy), first 3 responses (top 3 accuracy), and first 10 responses (top 10 accuracy) out of 30 differential diagnoses given by the app. Also, to determine the accuracy of the app for rare and ultra-rare diagnoses given by the app.

METHODS: Frontal facial images of individuals with the diagnosis of a genetic syndrome (established clinically or molecularly) were analysed with and without additional clinical features.

RESULTS: In this study, a total of 118 children were recruited. Overall, the molecularly confirmed eventual diagnosis appeared in the “top 10” suggested syndromes by Face2Gene in 75/118 cases, providing a diagnostic yield of 63.6%. In this study, the top 1 accuracy for correct first diagnosis by the app and clinician’s first diagnosis was 45.8% (n = 54). The Mcnemar test was examined for the clinician’s accurate diagnosis as compared to top 1, top 3, and top 10 accuracy by the app and the p-value was statistically significant for top 10 accuracy (0.0005) and not for the top 1 and 3 diagnoses. The top 10 accuracy for the app in the rare cases was 21/30 cases (70%), and for ultra-rare cases was 28/64 (43.8%).

CONCLUSIONS: The Face2Gene app is useful as an assistant to clinicians in the diagnosis of rare and ultra-rare diseases. The top 10 accuracy is better than clinical diagnosis, and the yield is better for the ultra-rare cases and the single gene disease category, too.

PMID:41593402 | DOI:10.1007/s12098-026-05992-6

Pharmacoecon Open. 2026 Jan 27. doi: 10.1007/s41669-025-00632-9. Online ahead of print.

ABSTRACT

BACKGROUND/OBJECTIVE: Hospital-level care at home is gaining traction, but evidence on health economic implications remains limited. The aim of this study was to estimate expected costs of continuous remote monitoring of vital signs in the post-discharge setting, to assess the burden of readmissions among relevant patient groups, and to compare monitoring costs with the potential savings from reduced readmissions. The study was conducted from a restricted societal perspective within the Danish healthcare system.

METHODS: The costs of 3-day post-discharge home monitoring were estimated using a micro-costing approach based on the WARD-Home project. The analysis excluded healthcare costs incurred outside the hospital sector or beyond the 3-day period. Readmission rates, length of stay, and associated costs were analyzed using Danish registry data on patients potentially suitable for post-discharge monitoring but currently not receiving it.

RESULTS: Estimated per-patient costs of 3-day monitoring were EUR 159. Registry data showed an overall 3-day readmission rate of 1.7%, with average length of stay of 4.4 days, and costs of EUR 4674. Comparing average costs of readmissions within 3 days-corresponding to monitoring duration-with the monitoring costs indicated that if post-discharge monitoring reduces readmissions, cost-neutrality could be achieved if it prevents one readmission in every 29 patients monitored.

CONCLUSIONS: Continuous remote monitoring offers a solution to post-discharge patients at risk of short-term deterioration and readmission. If one readmission is prevented per every 29 patients monitored, the approach has the potential to achieve cost-neutrality. Future studies are needed to validate these estimates and determine whether reductions in readmissions and actual cost savings can be achieved in practice.

PMID:41593391 | DOI:10.1007/s41669-025-00632-9

Appl Psychophysiol Biofeedback. 2026 Jan 27. doi: 10.1007/s10484-026-09766-w. Online ahead of print.

ABSTRACT

This study examined heart rate variability (HRV) in children with attention deficit hyperactivity disorder (ADHD) using a case-control design. A total of 52 children aged 6-12 years participated. ADHD diagnosis was confirmed by a child psychiatrist according to DSM-5 criteria, and comorbidities (e.g., anxiety, ODD) were excluded. Participants were then stratified into ADHD (n = 33; 17 boys, 16 girls) and control groups (n = 19; 12 boys, 7 girls), with MOXO d-CPT used to characterize performance profiles. Resting-state HRV was recorded for 5 min using the validated Polar H10 device. Time-domain (SDNN, RMSSD), frequency-domain (VLF, LF, HF), and non-linear indices were analyzed. The Good performance group demonstrated significantly lower VLF power compared to the Weak group (η² = 0.176, p < 0.05), and the SNS Index was significantly higher in the Weak hyperactivity group (d = 0.49, p = 0.048), indicating increased sympathetic activation associated with poorer performance. Non-significant trends were observed for SDNN (η² = 0.08) and RMSSD (η² = 0.07), suggesting modest parasympathetic differences, though these did not reach statistical significance. These findings highlight VLF and the SNS Index as the most robust HRV metrics associated with impulsivity and hyperactivity performance on the MOXO d-CPT, while other HRV domains showed only preliminary or non-significant effects. Future longitudinal studies are needed to evaluate HRV’s potential for monitoring treatment response and its specificity to cognitive subdomains in ADHD.

PMID:41593388 | DOI:10.1007/s10484-026-09766-w

Eur Radiol. 2026 Jan 27. doi: 10.1007/s00330-026-12319-8. Online ahead of print.

ABSTRACT

Mismatch imaging has become a key concept in neuroradiology, offering valuable insights into the pathophysiology of cerebrovascular and oncological conditions. By highlighting discrepancies between neuroimaging parameters, mismatch-based algorithms have revolutionized diagnosis, treatment planning, and patient prognosis. In stroke-related clinical scenarios, the mismatch concept is now essential in identifying candidates for thrombolysis or estimating the stroke onset time. However, the increasing use of mismatched terminology can lead to confusion, particularly when the exact mismatch target or required imaging modalities are unclear. Concerning stroke evaluation, there is a wide range of computed tomography perfusion (CT) maps and MRI sequences that are currently used for describing and determining mismatch concepts. Apart from the well-known penumbra-core mismatch related to CTP, the combination of features of different MRI sequences has provided a wide range of mismatch scenarios, such as perfusion-weighted imaging (PWI)/diffusion-weighted imaging (DWI) mismatch, magnetic resonance angiography (MRA)/DWI mismatch, susceptibility-weighted imaging (SWI)/DWI mismatch, or the DWI/FLAIR mismatch. Each one of these mismatches has its own clinical and physiopathological meaning, ranging from time-to-onset stroke estimation to selection of endovascular procedures. This article explores the different mismatch concepts used for stroke evaluation, including other related, less-used ones, focusing on their underlying physiopathology, clinical relevance, and supporting scientific evidence, all from a practical and educational perspective. KEY POINTS: Question Mismatch imaging offers transformative diagnostic insights in stroke, yet consistent definitions and standardized methodologies are essential to fully realize its clinical potential. Findings Our study reviews mismatch paradigms, outlines their pathophysiological basis, and compares clinical implications, highlighting critical limitations and the need for standardized imaging methodologies. Clinical relevance Standardizing mismatch imaging enhances diagnostic accuracy, optimizes patient selection for therapies, and improves prognostic assessment, ultimately enabling more consistent and reliable clinical decision-making in stroke.

PMID:41593382 | DOI:10.1007/s00330-026-12319-8

Naunyn Schmiedebergs Arch Pharmacol. 2026 Jan 28. doi: 10.1007/s00210-025-04964-5. Online ahead of print.

ABSTRACT

PURPOSE: This Phase 1 study evaluated the pharmacokinetics (PK), pharmacodynamics (PD), immunogenicity, and safety of INTP23.1, a proposed denosumab biosimilar, compared with US- and EU-licensed reference denosumab (Xgeva®) in healthy male volunteers.

METHODS: This randomized, double-blind, three-arm, 36 week, parallel-group trial (CTRI/2020/09/027619), assessed a single 35 mg subcutaneous dose of INTP23.1, Xgeva (US), or Xgeva (EU), administered in the upper arm. PK endpoints were statistically compared using geometric least-squares means (LSM) and 90% confidence intervals (CIs). PD markers were evaluated, immunogenicity and safety were assessed through validated assays, and adverse events (AEs) were monitored.

RESULTS: A total of 234 healthy male volunteers were enrolled. Baseline demographics were similar across the three treatment sequence groups. PK equivalence was demonstrated, with all geometric LSM ratios and 90% CIs for maximum serum concentration, area under the concentration-time curve (AUC) from time zero to the last measurable concentration, and AUC from time zero to infinity falling within the predefined bioequivalence range of 80.00% to 125.00%. PD responses showed comparable suppression of C-terminal telopeptide (CTX) and procollagen type 1 N-terminal propeptide (P1NP) across treatment groups. Immunogenicity profiles were similar, with low anti-drug antibody incidence and no neutralizing antibodies detected. AEs were generally mild or moderate in intensity, and no unexpected safety signals were observed.

CONCLUSIONS: INTP23.1 demonstrated comparable PK, PD, immunogenicity, and safety to US- and EU-licensed denosumab reference products in healthy male volunteers. These findings support further clinical development of INTP23.1 as a denosumab biosimilar for approved indications.

TRIAL REGISTRATION NUMBER: CTRI/2020/09/027619; Registered 07/09/2020.

PMID:41593375 | DOI:10.1007/s00210-025-04964-5

Eur J Nucl Med Mol Imaging. 2026 Jan 28. doi: 10.1007/s00259-026-07763-z. Online ahead of print.

ABSTRACT

PURPOSE: To compare the performance of a multidisciplinary team (MDT) with the proposed standardized PROMISE classification system for indeterminate bone uptake on staging PSMA PET.

METHODS: 744 staging PSMA PET/CT scans (140 ¹⁸F-PSMA-1007 and 604 ⁶⁸Ga-PSMA-11 PET/CT) were retrospectively reviewed for the presence of indeterminate bone metastatic staging. 95 scans which were discussed at an MDT meeting were further analysed for the comparison with the PROMISE classification system. MDT interpretation of the bone staging was recorded as positive or negative, based on risk stratification, imaging review, and clinically suitable management options. Additional resources were occasionally used, such as bone biopsy, musculoskeletal MRI, or re-evaluation after initial androgen deprivation therapy. MDT and PROMISE classification were compared for agreement. Statistical assessment was made on any differences in age, PSA, T-stage, Gleason score, risk, SUVmax and tracer used between negative and positive patients in both methods. Discordant cases were correlated with follow up data.

RESULTS: The overall incidence of indeterminate bone uptake in staging PSMA PET scans was 16.9%, reaching 40% for ¹⁸F-PSMA-1007. There was substantial agreement between MDT and PROMISE interpretation (87.3%). The MDT was more likely to interpret an indeterminate bone uptake as negative in patients with lower Gleason score and in scans where ¹⁸F-PSMA-1007 was used. The data from long-term follow up favoured the MDT interpretation in all the cases of disagreement. Examples of pitfalls in rib or thoracic spine foci of uptake are presented and recommendations for PET reporters and MDTs have been generated based on the results.

CONCLUSION: PROMISE may interpret indeterminate bone PSMA uptake with high accuracy. Therefore, PET reporters are recommended to use the PROMISE algorithm, while being mindful of common pitfalls related to the Gleason score, tracer used and anatomical localisation of indeterminate bone findings. Additional discussion in an MDT meeting is recommended with a view to resolve all equivocal findings.

PMID:41593361 | DOI:10.1007/s00259-026-07763-z

Support Care Cancer. 2026 Jan 27;34(2):134. doi: 10.1007/s00520-026-10382-x.

ABSTRACT

Psychiatric symptoms are frequently found in patients with cancer and often require specific pharmacological treatment. Depression seems to be the most common psychiatric disorder followed by adjustment disorders, anxiety, and delirium. Psychiatric comorbidities are responsible for worse quality of life and low adherence to anticancer treatment. Many different psychiatric drugs are beneficial, but there are increasing risks of drug-drug interactions (DDIs) with anticancer drugs. We conducted a PRISMA-compliant systematic review (PROSPERO registered) on drug-drug interactions between psychiatric and anticancer medications, using predefined search terms in electronic databases and specialized interaction software. Only six studies met the predefined inclusion criteria, confirming a significant lack of evidence on this topic. The available studies were often limited by small sample sizes, inadequate controls, or insufficient assessment of drug interactions. Our expanded search in drug interaction software allowed us to cross-reference results and identify clinically relevant interactions. The aim of this paper is to collect and summarize in a user-friendly format the most significant DDIs and to show unfavorable and potentially dangerous combination of drugs.

PMID:41593353 | DOI:10.1007/s00520-026-10382-x

Acta Psychol (Amst). 2026 Jan 26;263:106307. doi: 10.1016/j.actpsy.2026.106307. Online ahead of print.

ABSTRACT

In modern multilingual and multicultural societies, effective second or foreign language learning requires not only linguistic skills but also strong social competencies. This study examines the effect of collaborative writing instruction on the social skills of Grade 10 students in Ethiopia. A quasi-experimental design was used, and 86 students, 43 in each of the experimental and control groups, participated. The study used a lottery method to assign participants to an experimental and a control group. The experimental group was involved in collaborative writing tasks, whereas the control group received the conventional instruction. The data were collected using questionnaires and interviews. Subsequently, the quantitative data were analyzed using descriptive statistics, ANCOVA, independent-samples t-tests, and paired-sample t-tests, while the qualitative data were analyzed thematically. The results showed that students in the experimental group demonstrated a statistically significant improvement in social skills compared to those in the control group. Qualitative data also highlighted the attitudes of participants toward collaborative writing as transformative, which boosted their social interactions, teamwork, and confidence. This study not only underscores the pedagogical value of collaborative writing but also offers evidence to implement these practices, enhancing necessary social skills across different learning settings. By linking language learning with social skills enhancement, this research contributes to the literature on language education and proposes instructional frameworks relevant to diverse globalized classrooms.

PMID:41592369 | DOI:10.1016/j.actpsy.2026.106307

Am J Phys Med Rehabil. 2025 Dec 9. doi: 10.1097/PHM.0000000000002916. Online ahead of print.

ABSTRACT

Magnetic resonance imaging is the current “gold standard” for measuring cervical muscle volume, but the associated time and cost may be prohibitive in numerous environments. This study sought to develop a novel and accessible model for estimating cervical muscle volume in adolescent athletes. It was hypothesized that cervical muscle volume could be accurately predicted using a combination of clinically-accessible variables. This secondary analysis of clinical trial data utilized 78 sets of biomechanics lab measurements and neck magnetic resonance imaging scans collected in a total of 42 adolescent athletes to develop a multiple linear regression model for predicting total cervical muscle volume. The final regression model was significant (R2 = 0.7644, F = 78.94, p < 0.001) and successfully predicted total cervical muscle volume using body weight, sex, and neck circumference as model inputs. These variables can be easily obtained using simple measurement tools that are available across most clinical and research environments. This model may be used by medical professionals and researchers to estimate total cervical muscle volume when magnetic resonance imaging measurements are unavailable.

PMID:41592341 | DOI:10.1097/PHM.0000000000002916

Am J Phys Med Rehabil. 2025 Nov 28. doi: 10.1097/PHM.0000000000002908. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare adipose-derived cell therapies (ADCTs) versus non-active controls in treating knee osteoarthritis.

DESIGN: This systematic review and meta-analysis included randomized controlled trials (RCTs) comparing ADCTs with placebo or no treatment in patients with knee osteoarthritis. Two reviewers extracted study, patient, and intervention data, as well as patient-reported outcomes. Random-effects meta-analyses were performed for outcomes reported in at least three studies. The primary outcome was pain improvement at six months, with secondary outcomes including function, quality of life, and adverse events.

RESULTS: Eight RCTs (585 patients) were included. ADCTs showed superior pain improvement versus controls at six months, with WOMAC Pain (MD -1.75, 95% CI -2.62 to -0.88) and KOOS Pain (MD 7.95, 95% CI 0.98 to 14.93) achieving statistical significance. Functional outcomes also improved significantly, while quality of life favored ADCT but did not reach significance. No serious adverse events occurred, although two patients reported severe events after ADCT.

CONCLUSIONS: At six months, ADCTs provided greater pain relief and functional improvement than non-active controls, though no benefit was observed for quality-of-life. Severe adverse events were uncommon, but additional studies are needed for long-term efficacy and safety.

PMID:41592340 | DOI:10.1097/PHM.0000000000002908