Category: Statistics

Int J Equity Health. 2026 Jul 11. doi: 10.1186/s12939-026-02873-4. Online ahead of print.

ABSTRACT

BACKGROUND: Anxiety disorders, depressive disorders, migraine, and rheumatoid arthritis are common chronic conditions that contribute substantially to disability, recurrent care needs, and productivity losses, yet remain comparatively under-prioritised in health policy. In Mexico, these conditions disproportionately affect women, but their economic burden has not been comprehensively quantified from a gender perspective.

OBJECTIVE: To estimate the direct and indirect economic burden of anxiety disorders, depressive disorders, migraine, and rheumatoid arthritis in Mexico among adults aged 20 years and older between 2005 and 2021, from a societal perspective and by gender.

METHODS: We conducted a cost-of-illness analysis from a societal perspective. Direct costs were estimated by combining condition-specific prevalence from the Global Burden of Disease Study 2021 (GBD 2021) with normative per-case treatment costs derived from national clinical guidelines and official cost sources. Indirect costs were valued using three complementary approaches: the Human Capital Approach (HCA), based on predicted annual labour income from nationally representative employment surveys; a GDP-per-capita benchmark (1 DALY = 1 GDP per capita); and a willingness-to-pay approach using the value of a statistical life year (VSLY) transferred to Mexico following OECD methods. All costs were expressed in 2021 international dollars (Int$).

RESULTS: Between 2005 and 2021, the four disorders accounted for 28.8 million DALYs lost. Migraine was the most prevalent condition, but depressive disorders generated the highest direct costs (Int$310.5 billion) and the largest share of indirect costs (41.1%). Indirect costs totalled Int$106.8 billion under the HCA, Int$582.2 billion under the GDP-per-capita valuation, and Int$2.9 trillion under the willingness-to-pay approach. Under the GDP-per-capita benchmark, the combined economic burden of the four disorders reached approximately Int$1.2 trillion over the study period. Women consistently bore a greater burden than men across all four conditions and under all valuation methods; total indirect costs borne by women were 2.0 times higher for anxiety disorders, 2.1 times higher for depressive disorders, 2.2 times higher for migraine, and 3.8 times higher for rheumatoid arthritis.

CONCLUSIONS: Anxiety disorders, depressive disorders, migraine, and rheumatoid arthritis impose a substantial and unequally distributed economic burden in Mexico. The persistent excess burden among women indicates that these high-disability chronic disorders should be understood not only as a public health problem, but also as a health equity concern. More gender-responsive priority setting, stronger continuity of care, and better financial protection may help reduce both disability and its downstream economic consequences in Mexico and other LMICs with segmented health systems.

PMID:42436481 | DOI:10.1186/s12939-026-02873-4

BMC Oral Health. 2026 Jul 11. doi: 10.1186/s12903-026-09186-6. Online ahead of print.

ABSTRACT

BACKGROUND: Despite the increasing use of bleach-shade composite resins in recent years, studies examining the optical properties of these materials remain limited. Furthermore, there are insufficient data on the effectiveness of surface treatments for removing stains from these materials. This study evaluated the effects of different surface treatment protocols on the color stability, whiteness index, and surface roughness of bleach-shade composite resins after coffee immersion.

METHODS: A total of 300 specimens were prepared from four bleach-shade composite resins (Estelite Asteria BL, Brilliant EverGlow BL Translucent, G-aenial A’chord BW, and Opallis E-Bleach L) and one multi-shade (Filtek Z250 A2) composite resin (n = 60 per material). The specimens were randomly allocated to six groups (n = 10): Group 1 (one-step polishing, OptraGloss), Group 2 (two-step polishing, Nova Twist), Group 3 (bleaching, Whiteness HP), Group 4 (bleaching + one-step polishing), Group 5 (bleaching + two-step polishing), and Group 6 (control). All specimens were immersed in a coffee solution for 12 days. Measurements (color and roughness [Ra]) were performed at baseline (t₀), after staining (t₁), and after the surface treatments (t₂). Color differences were calculated using the CIEDE2000 formula (∆E₀₀), and whiteness index (WI_D) values were determined using the CIELAB-based WI_D formula. Statistical analyses were performed using the Kruskal-Wallis, Dunn, and robust ANOVA tests (p < 0.05).

RESULTS: At the t₁ time point, all specimens exhibited clinically unacceptable ΔE₀₀ values and decreased WI_D values. The Asteria group exhibited the highest color stability at t₁, while the Brilliant and A’chord groups exhibited the highest WI_D values (p < 0.05). At the t₂ time point, while Ra increased in the bleaching groups, the lowest Ra values were found in the one-step polishing group (p < 0.05).

CONCLUSIONS: Coffee exposure adversely affected the optical and surface properties of bleach-shade composite resins. Bleaching alone showed limited effectiveness, whereas polishing improved the esthetic outcomes and maintained clinically acceptable surface characteristics. Material-dependent differences were observed among the tested composites.

PMID:42436480 | DOI:10.1186/s12903-026-09186-6

J AOAC Int. 2026 Jul 10:qsag062. doi: 10.1093/jaoacint/qsag062. Online ahead of print.

ABSTRACT

BACKGROUND: Rapid laboratory detection methods need to be tested against reference methods to confirm their efficiency and suitability.

OBJECTIVE: In an unpaired study, the IEH Salmonella-Cronobacter spp. and Cronobacter sakazakii-Salmonella Multiplex PCR Assays’ performance was compared with the FDA-BAM reference methods Chapter 5 for Salmonella and Chapter 29 for Cronobacter sakazakii detection on stainless-steel (SS) and sealed concrete (SC) surfaces.

METHODS: Seeking a shorter enrichment time for the candidate method, the Salmonella-Cronobacter broth enrichments for 18, 20, 22, and 24 h at 35 °C were analyzed with the IEH Multiplex PCR Assays. Two pathogen cocktails were prepared: one including S. Typhimurium ATCC 19585, S. Senftenberg 775W, and S. Enteritidis PT30, and a second one including C. sakazakii MEI 27583, C. sakazakii ATCC 29544, and C. sakazakii ATCC 29004. The Salmonella and C. sakazakii cocktails were independently inoculated onto separate SS and SC following the AOAC guidelines. Additionally, a competing microorganism was added at a concentration 10-100-times higher than that of the pathogens.

RESULTS: The candidate method yielded zero false negatives and zero false positives, with 100% sensitivity and 100% specificity for both SS and SC surfaces, regardless of the inoculation level (high, low, and uninoculated) and the enrichment time (i.e. 18, 20, 22, and 24 h for Salmonella, and 20, 22, and 24 h for C. sakazakii). The candidate method successfully detected both target microorganisms on both surface types with a minimum enrichment of 20 h. Statistical analysis using the probability of detection (POD) confirmed the equivalency between the candidate method and the reference methods at either inoculation level or enrichment time (P > 0.05).

CONCLUSION: The IEH Salmonella-Cronobacter spp. and Cronobacter sakazakii-Salmonella Multiplex PCR Assays demonstrated performance comparable to the FDA-BAM reference methods for the detection of Salmonella and C. sakazakii on SS and SC, with a significantly shorter turnaround time.

PMID:42434802 | DOI:10.1093/jaoacint/qsag062

3 Biotech. 2026 Aug;16(8):320. doi: 10.1007/s13205-026-04953-2. Epub 2026 Jul 9.

ABSTRACT

The complex and refractory structure of printed circuit boards (PCBs) limits the efficiency of conventional metal recovery processes. This led to the hypothesis that indigenous bacterial strains isolated from e-waste-contaminated sites may possess metabolic adaptations that facilitate metal mobilization. This study aims to isolate heavy-metal tolerant bacterial strains from e-waste contaminated soil, these isolates were evaluated for bioleaching efficiencies against PCBs at various pulp densities of 5 g/L, 10 g/L and 15 g/L, from which, Bacillus sp. SSNBT005 (Accession no: – PV453749), was found to be the most potent isolate. To ensure analytical rigor, experiments were performed in triplicate (n = 3) and were compared against abiotic controls to quantify the microbe mediated leaching. Statistical analysis (ANOVA, p < 0.05), confirmed that SSNBT005 significantly enhanced metal recovery, specifically, the strain achieved metal recovery efficiencies of about 94.24 ± 1.00, for silver (Ag) and upto 90.78 ± 0.37 for chromium (Cr), reaching raw recovery concentrations of 0.0186 g/L and 0.544 g/L respectively. FESEM analysis supports these quantitative findings, revealing some localized pitting and surface degradation of the PCB matrix as the result of microbial activity. FTIR analysis indicated changes in absorption bands associated with surface functional groups after bioleaching. These results support the hypothesis that SNBT005 actively facilitates metal recovery.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13205-026-04953-2.

PMID:42434791 | PMC:PMC13350597 | DOI:10.1007/s13205-026-04953-2

Ann Transl Med. 2026 Jun 30;14(3):32. doi: 10.21037/atm-2026-0131. Epub 2026 Jun 29.

ABSTRACT

BACKGROUND: Patients with coexisting type 2 diabetes mellitus (T2DM) and inflammatory bowel disease (IBD) represent a high-risk population with competing comorbidities, complex medication regimens, and overlapping inflammatory pathways. Although the role of sodium-glucose co-transporter-2 (SGLT2) inhibitors in managing type 2 diabetes is well-established, their impact on outcomes in diabetic patients with coexisting IBD remains unclear. This study aimed to investigate the association between SGLT2i use and hospitalization, intensive care unit (ICU) admission, mortality, IBD-related complications, and surgical procedures in diabetic patients with IBD.

METHODS: We conducted a retrospective cohort study using the TriNetX Global Collaborative Network. Cohort 1 comprised diabetic patients with IBD who received SGLT2 inhibitors with at least three dispensations within one year of IBD diagnosis, and Cohort 2 comprised diabetic patients with IBD never prescribed SGLT2i, matched on baseline characteristics, comorbidities, IBD-specific medications, and laboratory values, yielding 3,950 patients per cohort. Clinical outcomes were evaluated at 1 and 5 years following the index event.

RESULTS: At 1 year, hospitalization, ICU admission, and mortality were significantly lower in Cohort 1 [risk ratio (RR): 0.886, P<0.001; RR: 0.851, P=0.03; and RR: 0.525, P<0.001, respectively]. Kaplan-Meier analysis demonstrated improved survival in Cohort 1 [94.27% vs. 88.76%, P<0.001; hazard ratio (HR): 0.490]. IBD-related complications and surgical procedures were also significantly reduced (RR: 0.879, P=0.004 and RR: 0.548, P=0.02, respectively). At 5 years, hospitalization, ICU admission, and mortality remained significantly lower in Cohort 1 (RR: 0.932, P=0.002; RR: 0.848, P=0.003; and RR: 0.545, P<0.001, respectively). Kaplan-Meier analysis continued to demonstrate improved survival in Cohort 1 (85.01% vs. 74.95%, P<0.001; HR: 0.532), whereas IBD-related complications and surgical procedures were numerically lower but no longer statistically significant (RR: 0.954, P=0.18 and RR: 0.741, P=0.15, respectively).

CONCLUSIONS: SGLT2i therapy in diabetic patients with IBD was associated with reduced hospitalization, ICU admission, and mortality, with persistent benefits observed at both 1 and 5 years of follow-up. Reductions in IBD-related complications and surgical procedures were observed, particularly at 1 year. These findings suggest a potential disease-modifying role warranting further prospective investigation.

PMID:42434776 | PMC:PMC13349731 | DOI:10.21037/atm-2026-0131

Front Oncol. 2026 Jun 26;16:1780642. doi: 10.3389/fonc.2026.1780642. eCollection 2026.

ABSTRACT

BACKGROUND: Bone cancer is a rare malignancy worldwide, with incidence patterns that vary by age, sex, and geographic region. In Saudi Arabia, however, comprehensive population-based evidence describing the national epidemiology of bone cancer remains limited. This study aimed to describe bone cancer incidence in Saudi Arabia according to age group, sex, calendar year, and administrative region, with particular emphasis on age-standardized incidence rates (ASIRs).

METHODS: A retrospective population-based descriptive study was conducted using data from the Saudi Cancer Registry. All primary bone cancer cases diagnosed between 2004 and 2020 were included. Incidence patterns were summarized using frequencies, age-specific incidence rates, crude incidence rates (CIRs), and ASIRs, stratified by sex, age group, year of diagnosis, and region. Statistical analyses were performed using SPSS software version 30.

RESULTS: Between 2004 and 2020, a total of 2,275 primary bone cancer cases were recorded in Saudi Arabia, including 1,318 males (57.9%) and 957 females (42.1%). Bone cancer accounted for approximately 2.0% of all cancers among males and 0.9% among females. Mean ASIRs were higher in males (≈1.0 per 100,000) than females (≈0.7 per 100,000), while CIRs remained below 2.0 per 100,000 throughout the study period. Age-specific incidence showed a clear adolescent peak, most prominent in the 15-19-year age group, followed by the 10-14-year group. Regional variation in ASIRs was observed, with higher rates in Al-Jouf and Najran and persistently lower rates in Jazan.

CONCLUSION: Bone cancer in Saudi Arabia is rare but demonstrates distinct variation by sex, age, and region. The observed male predominance and adolescent peak are consistent with international epidemiological patterns. Continued enhancement of population-based cancer surveillance is essential to support accurate epidemiological assessment and informed public health planning.

PMID:42434761 | PMC:PMC13349887 | DOI:10.3389/fonc.2026.1780642

Front Oncol. 2026 Jun 26;16:1764691. doi: 10.3389/fonc.2026.1764691. eCollection 2026.

ABSTRACT

PURPOSE: To assess the cross-software reproducibility of Computed Tomography (CT) radiomic features extracted using three widely adopted platforms (Siemens syngo.via Frontier, 3D Slicer/PyRadiomics, and mint Lesion) and to identify a subset of highly robust features suitable for multi-platform and multi-center radiomics applications.

METHODS: A retrospective cohort of 97 lesions (primary colorectal cancer, colorectal liver metastases, and hepatocellular carcinoma) who underwent contrast-enhanced Computed Tomography (CT) in the portal venous phase was analyzed. Semi-automatic 3D lesion segmentations were exported for radiomic extraction across the three platforms. Shared radiomic features among tools were harmonized and z-score normalized. Cross-platform similarity was assessed using distribution distance metrics, hierarchical clustering, and the Adjusted Rand Index (ARI). A novel Composite Robustness Index (CI) integrating Pearson correlation, Kolmogorov-Smirnov statistics, and mean fold-difference was developed to quantify feature-level reproducibility.

RESULTS: First-order intensity features and key GLCM descriptors (e.g., Correlation, Joint Average, Sum Entropy) demonstrated the highest cross-software stability, with nearly superimposable distributions and strong concordance in clustering structure. Siemens syngo.via Frontier and 3D Slicer/PyRadiomics showed the highest agreement (mean ARI >0.85), while mint Lesion™-which lacks higher-order texture families-showed moderate deviations (mean ARI ≈ 0.70-0.75). High-order features, particularly GLDM and GLRLM metrics, exhibited substantial variability across platforms. The CI ranking enabled identification of a reproducible set of “highly reproducible features, “ including glcm_Correlation, firstorder_Mean, firstorder_RMS, firstorder_90Percentile, and shape axis-length descriptors.

CONCLUSION: Despite intrinsic software differences, a consistent subset of radiomic features remains reproducible across heterogeneous extraction tools. The combined use of distribution analysis, hierarchical clustering, and the Composite Robustness Index offers a rigorous framework for evaluating cross-platform reliability. These findings support the feasibility of multi-tool radiomics and provide a validated feature set for harmonized quantitative imaging pipelines.

PMID:42434756 | PMC:PMC13349753 | DOI:10.3389/fonc.2026.1764691

Front Oncol. 2026 Jun 26;16:1852397. doi: 10.3389/fonc.2026.1852397. eCollection 2026.

ABSTRACT

OBJECTIVE: Walking is a simple and accessible form of aerobic exercise that may improve cardiorespiratory fitness (CRF) in cancer patients; however, its independent effects remain unclear. This systematic review and meta-analysis aimed to evaluate the effects of walking training on CRF, fatigue, dyspnea, safety, and adherence in adult cancer patients.

METHODS: A systematic search was conducted in 4 databases-Web of Science, Embase, PubMed, and Cochrane Library Database-covering the period from the inception of each database through November 28, 2025. The inclusion criteria were randomized controlled trials (RCTs) evaluating walking interventions for cancer patients. Priority was given to meta-analyses of outcome measures using a random-effects model. If the statistical heterogeneity is less than 40%, a fixed-effects model is used.

RESULTS: 11 randomized controlled trials involving 649 participants were included. Compared with standard care or no intervention, walking training was associated with statistically significant improvements in the two outcomes: peak oxygen uptake (VO₂ peak) (SMD = 0.56; 95% CI: [0.06, 1.06]; I² = 75%; τ²=0.28; P = 0.03) and fatigue (SMD = -0.45; 95% CI: [-0.71, -0.18]; I² = 32%; τ²=0; P = 0.001). In contrast, no statistically significant effects were observed for maximal oxygen uptake (VO₂ max) (SMD = 0.20;95% CI: [-0.15, 0.54]; I² = 0%; P = 0.26), 6-Minute Walk Distance (6MWD) (MD = 53.97;95% CI: [-23.00, 130.93]; I² = 80%; τ²=2538;P = 0.17), and dyspnea (SMD = -0.18, 95% CI: [-0.47, 0.11]; I² = 0%; P = 0.23). No serious intervention-related adverse events were reported, and adherence rates ranged from 67% to 94%.

CONCLUSION: Current evidence suggests that walking training may improve VO₂ peak and reduce fatigue in cancer patients, while demonstrating acceptable short-term safety and adherence. However, these findings should be interpreted cautiously because the certainty of evidence remains low. Larger, high-quality randomized controlled trials with standardized intervention protocols and longer follow-up periods are needed to confirm these findings.This study conducted a systematic literature search in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Prior to the search, the study protocol was prospectively registered on the international systematic review registry platform (PROSPERO, registration number: CRD420251140743) to ensure the scientific rigor and methodological soundness of this study.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier CRD420251140743.

PMID:42434753 | PMC:PMC13349785 | DOI:10.3389/fonc.2026.1852397

Front Oncol. 2026 Jun 26;16:1866001. doi: 10.3389/fonc.2026.1866001. eCollection 2026.

ABSTRACT

INTRODUCTION: Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal malignancy with a rising global incidence. Differentiating PDAC from non-malignant pancreatic conditions, particularly chronic pancreatitis (CP), remains challenging due to overlapping clinical and radiological features, highlighting the need for new biomarkers. The best-validated serum biomarker, carbohydrate antigen 19-9 (CA19-9), has limited clinical utility due to its suboptimal sensitivity and specificity. This study aimed to evaluate the diagnostic performance of serum macrophage inhibitory cytokine 1 (GDF15), syncollin (SYCN), and thrombospondin-2 (TSP-2), both alone and in multi-marker panels, for differentiating PDAC from CP and healthy controls (HCs). The selection of these markers was based on prior evidence linking GDF15 to PDAC diagnosis and prognosis, SYCN to pancreatic tissue damage, and TSP-2 to tumor microenvironment remodeling.

METHODS: This study included 188 individuals: 78 diagnosed with PDAC, 79 with CP and 31 HCs. PDAC and CP were diagnosed based on clinical, imaging, histopathological, and laboratory findings, and classified according to the 8th TNM classification and the updated Cambridge system, respectively. Serum GDF15, SYCN, and TSP-2 levels were quantified using ELISA. Statistical analyses included group comparisons, correlation testing, and receiver operating characteristic (ROC) curve analysis with assessment of the area under the curve (AUC).

RESULTS: GDF15 and SYCN were significantly elevated in PDAC compared with both CP and HCs, whereas TSP-2 did not differ significantly between those groups. For PDAC vs HCs, GDF15 provided the strongest overall discrimination (AUC = 0.86; sensitivity 97%, specificity 71%), while SYCN showed a lower AUC (0.77) but very high specificity (94%). The combined GDF15 + SYCN panel increased AUC to 0.89. For PDAC vs CP, GDF15 achieved moderate diagnostic performance (AUC = 0.73), SYCN performed less well (AUC = 0.65), and TSP-2 performed near chance (AUC = 0.52). Incorporating age and bilirubin in the model improved discrimination between PDAC and CP, yielding a maximum AUC of 0.88. Additionally, positive correlations were observed between SYCN and diabetes, as well as between GDF15 and hyperbilirubinemia, in patients with PDAC.

CONCLUSIONS: These results suggest that GDF15 and SYCN are promising serum biomarkers for PDAC, whereas TSP-2 appears to have limited diagnostic utility.

PMID:42434748 | PMC:PMC13349920 | DOI:10.3389/fonc.2026.1866001

Front Oncol. 2026 Jun 26;16:1842330. doi: 10.3389/fonc.2026.1842330. eCollection 2026.

ABSTRACT

BACKGROUND: Primary small-bowel tumors are uncommon and frequently present with non-specific symptoms. Timely and accurate diagnosis relies on a range of radiologic and endoscopy-based modalities, yet their comparative diagnostic performance remains uncertain.

METHODS: We performed a systematic review and diagnostic test accuracy meta-analysis. PubMed, Embase, CNKI, and Wanfang databases were searched from inception to August 31, 2025, and the reference lists of included studies and relevant reviews were hand-searched. Two reviewers independently screened studies, extracted data, and assessed the risk of bias using the QUADAS-2 tool. To avoid unit-of-analysis errors, the primary analysis used a de-duplicated dataset with one representative arm per study cohort according to a prespecified hierarchy: the primary or original/consensus reading reported by the source article, then the arm with the largest analyzable 2×2 denominator, and finally the estimate closest to the within-study median diagnostic odds ratio if ties remained. Pooled sensitivity and specificity were estimated using hierarchical bivariate random-effects models, while alternative arms were retained for sensitivity analyses.

RESULTS: Twenty-one studies met the eligibility criteria and were included in the quantitative synthesis. The overall pooled sensitivity was 0.91 (95% CI: 0.87-0.93) and specificity was 0.88 (95% CI: 0.78-0.94), with an area under the summary receiver operating characteristic curve of 0.95 (95% CI: 0.93-0.97). Between-study heterogeneity was substantial. In modality-stratified analyses, dedicated enterography techniques (magnetic resonance enterography and computed tomography enterography) demonstrated the highest comprehensive diagnostic accuracy, outperforming conventional contrast-enhanced CT and functional imaging.

CONCLUSIONS: Contemporary imaging modalities exhibit high overall diagnostic performance for primary small-bowel tumors. Enterography-based cross-sectional imaging yielded the most favorable point estimates, although confidence intervals overlapped with those of conventional CT. These findings support CTE and MRE as strong diagnostic options within a multimodality pathway rather than proving clear statistical superiority.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251144585.

PMID:42434747 | PMC:PMC13349763 | DOI:10.3389/fonc.2026.1842330