Category: Statistics

Int Urol Nephrol. 2026 May 13. doi: 10.1007/s11255-026-05196-z. Online ahead of print.

ABSTRACT

PURPOSE: Children with nephrotic syndrome (NS) receive long-term steroid therapy and hence there is an increased risk of bone mineral disease. The objective of the study was to compare the bone mineral density (BMD) in children with NS with that of healthy age-matched controls by using Dual-energy x-ray absorptiometry (DXA) and its correlation with metabolic parameters.

METHODS: A single-center cross-sectional study was conducted to assess the BMD using DXA scan in children aged 5-14 years with NS compared to age and gender-matched healthy children in a tertiary care center. Sixty-two children were included (31 with NS and 31 healthy children as controls), and BMD’s were assessed using a DXA scan. Z-scores were calculated and correlated with biochemical parameters such as serum alkaline phosphatase, calcium, phosphate, parathormone, and vitamin D.

RESULTS: Low BMD was observed in almost 64.5% of children with NS. The mean BMD and height adjusted Z score were lower in children with NS than healthy children. The mean BMD/Z-score in NS and controls were-left femur neck (- 2.18 ± 1.49 vs – 0.461 ± 0.94), right femur neck (- 2.47 ± 1.54 vs – 0.50 ± 0.88), spine (- 1.72 ± 1.16 vs – 0.603 ± 0.80), respectively and these differences were statistically significant (p < 0.05). The correlation between cumulative steroid dose and BMD/Z-score was not statistically significant.

CONCLUSION: Children with NS had lower BMD and serum vitamin D levels than healthy children despite calcium and vitamin D supplementation, and they need periodic evaluation.

PMID:42126769 | DOI:10.1007/s11255-026-05196-z

Int Urol Nephrol. 2026 May 13. doi: 10.1007/s11255-026-05187-0. Online ahead of print.

ABSTRACT

BACKGROUND: Robot-assisted radical prostatectomy (RARP) is a widely adopted and effective treatment for localized prostate cancer. The Retzius-sparing approach (RS-RARP) has been shown to significantly improve early urinary continence recovery while maintaining comparable long-term oncological outcomes relative to the anterior approach. However, the impact of body mass index (BMI) on RS-RARP outcomes remains insufficiently investigated. The present study aimed to address this gap.

METHODS: A retrospective analysis was conducted on 596 patients who underwent RS-RARP between April 2016 and December 2023, including 197 normal-weight, 287 overweight, and 112 obese individuals. Perioperative, oncological, and functional outcomes were assessed.

RESULTS: Estimated blood loss was significantly higher in obese patients. No statistically significant differences in urinary continence rates were observed at any time point. Immediate continence rates were 77%, 72%, and 79%, while one-year continence rates were 97%, 96%, and 98% in the normal-weight, overweight, and obese groups, respectively. Oncological outcomes were comparable across groups, although a non-significant trend toward a higher rate of pN1 disease was observed in obese patients (12% vs. 10% vs. 8%, p = 0.1). RS-RARP was found to be feasible and safe across all BMI categories.

CONCLUSIONS: The current study suggests that RS-RARP portends optimal early and one-year urinary continence recovery rates, regardless of BMI. No statistically significant differences were noted regarding safety and oncological outcomes among the three BMI categories.

PMID:42126768 | DOI:10.1007/s11255-026-05187-0

Int J Implant Dent. 2026 May 13;12(1):21. doi: 10.1186/s40729-026-00690-6.

ABSTRACT

PURPOSE: This pilot randomized clinical trial compared peri-implant tissue health around milled cobalt-chromium (CoCr) versus polyether ether ketone (PEEK) secondary telescopic crowns in implant-retained mandibular overdentures over 12 months.

METHODS: Twelve completely edentulous patients received two implants each. After randomization, secondary crowns were fabricated from milled CoCr (n = 6 patients) or PEEK (n = 6 patients). Assessor-blinded outcome assessments such as marginal bone loss (MBL), probing depth (PD), and plaque index (PI) were performed at baseline, 6, 9, and 12 months post-loading. Statistical analysis used the patient as the unit of analysis.

RESULTS: No statistically significant inter-group differences were found at any time point. At 12 months, mean MBL was 0.48 ± 0.15 mm for CoCr and 0.45 ± 0.16 mm for PEEK (p = 0.735). PD increased over time within groups but remained comparable between groups (CoCr: 2.58 ± 0.58 mm, PEEK: 2.33 ± 0.41 mm at 12 months; p = 0.411). PI scores also showed no significant inter-group differences (p > 0.05).

CONCLUSIONS: Over 12 months, milled PEEK and CoCr secondary telescopic crowns demonstrated comparable peri-implant tissue health. PEEK presents a viable metal-free alternative for this application. These preliminary findings warrant confirmation in larger, long-term studies.

PMID:42126762 | DOI:10.1186/s40729-026-00690-6

Environ Monit Assess. 2026 May 13;198(6):585. doi: 10.1007/s10661-026-15389-9.

ABSTRACT

Land use transformation contributes to land surface temperature (LST) change, which has been considered as one of the most critical environmental challenges. This study aim to analyze the impacts of land use dynamics on normalized difference vegetation index (NDVI) and LST between 1984 and 2024 in selected districts of Jimma Zone, southwestern Ethiopia. Landsat 5 TM (1984), Landsat 5 TM + (1997), Landsat 7 ETM + (2010), and Landsat 8 OLI-TIRS (2024) with 30 m spatial resolution were acquired from the USGS website. All spatial data were georeferenced to the UTM projection (Zone 37), and the WGS 84 datum. In this study, geospatial data were layer stacked and mosaicked using the geospatial analyst tool. The classified land use class was validated using GPS field survey points and Google Earth imagery. To realize the significant effects between NDVI and LST, correlation analysis was conducted for each year. One-way ANOVA was performed to test differences between land use classes. Mean separation analysis was performed using LSD at p= 0.05, using R statistical software to determine land use practices that are most effective. Results showed that the dense forest declined by 12.92%, indicating large-scale deforestation likely driven by agricultural expansion. In contrast, agricultural land increased by 7.09%, while open forest decreased by 4.66%. More expansion was observed in settlements, increasing by + 11.27%, underscoring intense unscientific infrastructure development that consumes surrounding landscapes. Even water bodies were reduced by 0.80%, a critical indicator of stress from drought and irrigation demands. The consistent and substantial decline in the maximum NDVI value, which has been declined from 0.51 in 1984 to a much lower 0.41 in 2024.Dense forest experienced a significant warming of 8.2 °C, diminishing its natural cooling capacity. Agricultural land had its minimum temperature rise from (18.6 °C-25.3 °C) by 6.7 °C. Open forest showed a consistent warming trend. The relationship among NDVI and LST is negative; this means that for each single unit of increase in NDVI, the LST drops. The most extreme LSTs were consistently found in settlements. The statistical test of surface temperature among LULC classes shows that settlements and agricultural land are a high level of significant warmer at the range of p = from 1.09 × 10^ (-5) to 2.24 × 10^ (-2).

PMID:42126741 | DOI:10.1007/s10661-026-15389-9

Radiol Med. 2026 May 13. doi: 10.1007/s11547-026-02212-1. Online ahead of print.

ABSTRACT

PURPOSE: Accurate differentiation of human epidermal growth factor receptor 2 (HER2)-zero, HER2-low, and HER2-positive breast cancer (BC) is crucial for guiding therapeutic decisions, particularly with the development of novel HER2-targeted treatments. This study aimed to evaluate whether intravoxel incoherent motion (IVIM) imaging histogram parameters could provide additional diagnostic value in distinguishing among these HER2 expression subtypes beyond conventional BI-RADS assessments.

MATERIALS AND METHODS: This retrospective single-center study included 181 breast cancer patients (30 HER2-zero, 107 HER2-low, and 44 HER2-positive). All patients underwent preoperative breast MRI on a 3.0-T scanner, including conventional sequences (T1-weighted, T2-weighted, dynamic contrast-enhanced and diffusion-weighted imaging) and intravoxel incoherent motion (IVIM) imaging. Histogram features derived from IVIM parameters-true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f)-were extracted and compared across the HER2 subgroups. Two diagnostic models were constructed: a conventional model based on BI-RADS features and a combined model incorporating both BI-RADS and IVIM histogram features. Statistical analyses included univariate logistic regression, Akaike information criterion (AIC), area under the receiver operating characteristic curve (AUC), integrated discrimination improvement (IDI), net reclassification index (NRI), and DeLong test.

RESULTS: Conventional BI-RADS features alone could not distinguish between HER2-zero and HER2-low tumors. Although D_Entropy demonstrated modest discrimination (AUC = 0.569), this comparison was analyzed descriptively without constructing predictive models. Consequently, conventional and combined models were not constructed for this comparison. For HER2-low versus HER2-positive differentiation, the combined model (including D_Skewness and tumor size) achieved significantly higher performance (AUC = 0.727) than the conventional model (AUC = 0.587). Similarly, for HER2-zero versus HER2-positive, the combined model (D_Skewness, tumor size, and axillary lymph node [ALN] status) outperformed the conventional model (tumor size and ALN status), with AUCs of 0.730 versus 0.700. Improvements in diagnostic performance with the combined model were statistically confirmed by the DeLong test, NRI, and IDI metrics in the HER2-low versus HER2-positive and HER2-zero versus HER2-positive comparisons.

CONCLUSIONS: IVIM histogram parameters, particularly D_Skewness and D_Entropy, may enhance the ability to differentiate HER2 expression subtypes in breast cancer when integrated with conventional BI-RADS features. The combined model improves diagnostic performance, supporting its potential utility in refining HER2 status evaluation and optimizing personalized treatment strategies.

PMID:42126725 | DOI:10.1007/s11547-026-02212-1

Mar Biotechnol (NY). 2026 May 13;28(3):83. doi: 10.1007/s10126-026-10627-0.

ABSTRACT

Microbial platforms are now recognized as sustainable sources of long-chain polyunsaturated fatty acids (PUFAs). This study presents a novel bioprocessing approach that integrates abiotic stress with exogenous phytohormones, indole-3-acetic acid (IAA), salicylic acid (SA), and abscisic acid (ABA) to enhance the biosynthesis of PUFAs in marine Thraustochytrium sp. BM2. While individual stress strategies are known to either enhance lipid accumulation or modulate oxidative responses. The combined effect of phytohormones and multiple treatments of cold stress conditions (4 °C) enhanced the PUFAs fraction (including DHA, EPA, DPA, and ARA) and lowered the SFAs fraction. IAA combined with cold stress marginally enhanced lipid yield by 73.3% (up to 9.48 g L⁻¹), but the composition of fatty acids was significantly changed. These changes were aligned with significant increases in EPA (100%, 0.38 g L⁻¹), DPA (19%, 1.06 g L⁻¹), and DHA (19%, 1.94 g L⁻¹). SA in combination with cold stress achieved a 39.7% increase in lipid yield (7.63 g L⁻¹), with corresponding improvements in EPA (21%, 0.23 g L⁻¹), DHA (5.2%, 1.72 g L⁻¹), while ARA (300%, 0.12 g L⁻¹). The combined effect of ABA resulted in enhanced levels of EPA, DPA, DHA, and ARA by 21%, 39%, 16%, and 200%, respectively. These results were statistically validated by ANOVA, with all variations demonstrating significance at p < 0.05. This sustainable and eco-efficient strategy addresses the limitations of fish oil-based PUFA production, aligning with the United Nations Sustainable Development Goals (SDGs: 7, 12, and 13) and offering a scalable alternative for the nutraceutical and biofuel industries.

PMID:42126715 | DOI:10.1007/s10126-026-10627-0

Work. 2026 May 13:10519815261438027. doi: 10.1177/10519815261438027. Online ahead of print.

ABSTRACT

BackgroundStanding work is common across a wide range of industries and service sectors and has been associated with the development of low back pain.ObjectiveTo analyze changes in low back pain across eight experimental scenarios combining exposure to risk factors associated with standing work.MethodologyA controlled factorial experiment (2³) comprising eight experimental scenarios and 32 simulations. Thirty volunteers (16 men and 14 women) participated in the study. Each participant completed an experimental scenario involving light manual activity in a standing position for 120 min, varying posture (dynamic or static), surface (hard or soft), and the use of insoles (with or without inserts). Every 30 min, low back pain intensity was recorded using a Visual Analog Scale (0 mm = no pain; 100 mm = maximum pain). Results: Time had a significant effect on increases in low back pain relative to baseline (T0 = 1.71, SE = 0.34). The estimated increases in low back pain from baseline were 1.41 at (T1), 2.38 at (T2), 3.07 at (T3), and 3.66 at (T4), all of which were statistically significant (p < 0.001).ConclusionsLow back pain intensity increased significantly and similarly across all experimental scenarios, regardless of the combination of factors evaluated (posture, surface, or insole use). The results indicate that low back pain, as the starting point of clinical pain perception (≥ 9 mm VAS), manifests itself after 60 min of standing, regardless of the combined study factors.

PMID:42125858 | DOI:10.1177/10519815261438027

Water Environ Res. 2026 May;98(5):e70395. doi: 10.1002/wer.70395.

ABSTRACT

This study presents a systematic and reproducible methodology for developing synthetic wastewater that mimics the bulk physicochemical characteristics of palm oil mill final effluent (SWM-POME_FE) at laboratory scale. The framework was established through four sequential phases: (1) physicochemical characterization of real POME_FE (R-POME_FE), (2) dose-response analysis of selected media, (3) iterative formulation of SWM-POME_FE, and (4) stability and statistical validation. R-POME_FE was characterized across 10 sampling events to establish baseline conditions for key parameters. Dose-response analyses of glucose, lignin, surfactant, unrefined red palm oil, and NH₄Cl were conducted to reproduce COD, BOD₅, color, O&G, and NH₃-N contributions. Three progressively refined formulations were developed through iterative adjustments, demonstrating strong agreement between experimental results (Exp-R) and calibrated predictions (Cal-P), with deviations ranging from 0.3% to 6.3%. Statistical similarity analysis of the final SWM-POME_FE formulation showed that NH₃-N, O&G, color, and turbidity closely matched the distribution of the R-POME_FE dataset, with mean values falling within the 95% confidence interval, interquartile range, and ±10% tolerance band. These parameters also exhibited very small standardized deviations (|z| ≤ 0.2), indicating negligible differences relative to the natural variability of the field measurements. TSS met all criteria except the interquartile range (z = 0.76). In contrast, COD and BOD₅ fell outside the central distribution metrics but remained within the observed field range (z = 1.03 and 1.52, respectively). Although formal equivalence testing using the two one-sided tests procedure did not demonstrate strict equivalence, this was attributed to the large natural variability of the field measurements. Stability assessments further confirmed the robustness of the formulation, with < 5% variation during the 5-day short-term test and only minor reductions after 3-month storage, indicating that SWM-POME_FE provides a stable physicochemical surrogate for controlled laboratory studies.

PMID:42125849 | DOI:10.1002/wer.70395

J Back Musculoskelet Rehabil. 2026 May 13:10538127261448975. doi: 10.1177/10538127261448975. Online ahead of print.

ABSTRACT

ObjectiveQuantify the burden of occupational ergonomic-attributable low back pain (LBP) in men aged 20-54 from 1990-2021 at global, regional and national levels to inform targeted prevention.MethodsWe extracted Global Burden of Disease (GBD) 2021 estimates of disability-adjusted life-years (DALYs) for LBP (ICD-10 M54.3-M54.5) related to occupational ergonomic risks. Age-standardized DALY rates (ASDRs) and estimated annual percentage change (EAPC) were computed by Socio-demographic Index (SDI) quintile, 27 GBD regions, 204 countries and seven 5-year age bands. Predictive models linking burden with time, age, SDI and geography were trained and interpreted using SHAP to reveal each predictor’s direction and contribution. Reference-scenario forecasts of DALYs and ASDRs to 2050 were produced with 95% uncertainty intervals. All statistical analyses were performed using R software (version 4.3.1).ResultsFrom 1990 to 2021, total DALYs rose while ASDRs declined. The greatest ASDR decrease occurred in low-SDI settings; high-SDI settings showed the largest 2021 burden. Andean Latin America had the largest increase, South Asia the steepest decline, and Central Europe the highest 2021 rate. China, India and the United States had the largest national DALY totals; the 45-49 age group carried the heaviest burden. Forecasts indicate continued growth in absolute DALYs alongside declining age-standardized rates through 2050.ConclusionAbsolute occupational LBP burden among men aged 20-54 increased despite falling ASDRs. SHAP-guided forecasts support prioritizing ergonomic interventions in high-burden settings and the 45-49 age cohort.

PMID:42125822 | DOI:10.1177/10538127261448975

Anat Sci Educ. 2026 May 13. doi: 10.1002/ase.70229. Online ahead of print.

ABSTRACT

Pathologists’ assistants (PAs) are pivotal in healthcare, conducting autopsies and examining tissues under a pathologist’s guidance. Embryology knowledge is crucial for PAs to accurately assess anomalies and identify pathologies. Yet, it is often overlooked in academic PA training programs. Given the cognitive demands on students and limited curricular time, integrating embryology requires the identification of vocationally relevant topics. This study sought to determine essential embryology learning objectives (LOs) for PAs by consulting practicing PAs and pathologists. Beginning with an initial list of 85 LOs across 16 embryology content themes, practicing PAs and pathologists rated how essential each LO is to professional practice via an online survey. The Lawshe content validity method quantified consensus, with results stratified by stakeholder group characteristics. The survey, distributed via various networks, had 115 respondents (PAs = 102) from across Canada (61% from Ontario), with diverse academic backgrounds. Fifteen LOs were identified as statistically essential, covering numerous embryology content themes including terminology, neurulation, placenta/fetal membranes, and cardiovascular, gastrointestinal, and urinary systems. PAs expected more of themselves compared to pathologists (LOs = 14 vs LOs = 6), with additional discrepancies among PA service cohorts and those with differing years of experience and types of training. This research has, for the first time, identified the essential embryology learning objectives specific to the PA profession, revealing differences in knowledge expectations among relevant professional stakeholders. The final list of 15 essential learning objectives can be immediately leveraged to design streamlined embryology curricula that meet vocational relevance across PA training programs.

PMID:42125813 | DOI:10.1002/ase.70229