Category: Statistics

J Cardiovasc Imaging. 2026 Jan 22;34(1):2. doi: 10.1186/s44348-025-00063-4.

ABSTRACT

BACKGROUND: Transthoracic echocardiography derived left ventricular ejection fraction (LVEF) is a cornerstone in heart failure risk prevention. However, the lower limits of normal LVEF remains imprecisely defined. We aimed to define normal LVEF ranges by sex, age group, and self-reported race/ethnicity using data from population-based echocardiographic studies.

METHODS: We systematically searched MEDLINE for studies published between January 1, 2000, and January 3, 2025, that reported the mean and standard deviation of LVEF measured by 2D or 3D echocardiography in healthy, community-based adult populations.

RESULTS: In 10 studies (n = 10,427; female sex, 48%), the pooled mean LVEF was 62.8% (95% confidence interval, 61.0%-64.7%), with estimated lower and upper normal limits of 51.8% and 73.2%, respectively. Women had higher mean LVEF (63.7%) than men (61.9%), with corresponding lower normal limits of 52.7% and 51.7%, respectively. LVEF was similar across age groups. Individuals of Asian origin had 2 to 3 percentage points higher LVEF than Black or White individuals, with lower normal limits of 54% for women and 53% for men. Fewer than 1% of women and approximately 1% of men would be expected to have an LVEF below 50%. Across all demographic subgroups, the probability that an LVEF < 50% is within the normal range was < 5%. There was significant heterogeneity of the included studies (e.g., τ² = 8.82, I² = 99.7% for overall analysis) that appeared unexplained by sex, age, or echocardiography modality (2D vs. 3D).

CONCLUSIONS: In healthy adults, the lower limit of normal LVEF is approximately 53% for women and 52% for men, with slightly higher thresholds among individuals of Asian origin. An LVEF < 50% is highly unlikely to reflect normal function, regardless of sex, age, or self-reported race/ethnicity. Given the high statistical heterogeneity, the results should be interpreted with caution.

PMID:41572417 | DOI:10.1186/s44348-025-00063-4

Br J Haematol. 2026 Jan 22. doi: 10.1111/bjh.70342. Online ahead of print.

ABSTRACT

Waldenström’s macroglobulinaemia (WM) is a rare B-cell lymphoproliferative disorder with multiple effective front-line treatment options. However, real-world comparative data on commonly used regimens are limited. We conducted a retrospective cohort study of 348 consecutive, newly diagnosed WM patients treated between 2002 and 2024. Patients received first-line therapy with either bortezomib-dexamethasone-rituximab (BDR, n = 35), Bruton’s tyrosine kinase inhibitors (BTKis, n = 57) or dexamethasone-rituximab-cyclophosphamide (DRC, n = 256). BTKi demonstrated the highest MRR (major response rate, ≥PR) (80.7%), followed by DRC (68.4%) and BDR (40.0%) (p < 0.001). The median PFS and OS did not differ significantly among regimens. TTNT seemed to be longer in the BTKi group (log-rank p = 0.025), with a 74% reduced risk of salvage therapy compared to DRC (aHR = 0.26, p = 0.016). Cumulative WM-related mortality at 5 years was lowest in BTKi-treated patients (4.1% vs. 13.0% DRC vs. 17.1% BDR), though differences were not statistically significant. In this single-centre analysis, both BTKi and DRC led to prolonged disease control in the upfront treatment of patients with WM. Extended follow-up and prospective validation are needed to reveal potential long-term survival differences.

PMID:41572416 | DOI:10.1111/bjh.70342

BMC Psychol. 2026 Jan 22. doi: 10.1186/s40359-026-03992-x. Online ahead of print.

ABSTRACT

BACKGROUND: Improved internet access has exposed rural adolescents in China to a greater risk of internet addiction. However, existing studies seldom examine the relationship between dynamic changes in internet addiction and psychosocial maladjustment. This study aims to explore the transition patterns of internet addiction and its associations with emotional and interpersonal problems over time.

METHODS: A one-year longitudinal survey was conducted among 782 middle school students in rural China. Latent Profile Analysis (LPA) was conducted to identify internet addiction profiles at two time points. Latent Profile Transition Analysis (LPTA) was then used to examine the transition patterns between profiles over time. Subsequently, statistical analyses were conducted to explore how these transitions were associated with emotional and interpersonal problems.

RESULTS: Three profiles of internet addiction were identified: minimal-internet addiction, low-internet addiction, and high-internet addiction. Based on LPTA, most adolescents with higher internet addiction at T1 shifted to lower-severity profiles over time (high → minimal: 35.3%; low → minimal: 39.8%; high → low: 33.3%), while some with initially lower levels transitioned to more severe profiles (minimal → high: 6.9%; low → high: 12.2%; minimal → low: 25.7%). Transition into higher addiction profiles predicted increased depression, anxiety, and poorer relationships with parents, peers, and teachers. Conversely, reductions in addiction were linked to improved depressive symptoms.

CONCLUSIONS: Changes in internet addiction have an impact on adolescent psychosocial maladjustment. Early detection and flexible interventions are essential in rural settings.

PMID:41572413 | DOI:10.1186/s40359-026-03992-x

BMC Psychol. 2026 Jan 22. doi: 10.1186/s40359-026-03994-9. Online ahead of print.

ABSTRACT

BACKGROUND: In Turkey, smartphone use exceeds both European and global averages, posing potential risks to individuals’ physical, social, and psychological well-being. The present research aimed to examine the relationships among smartphone addiction, significance quest, and passion, as well as to identify the mediating role of passion in the relationship between significance quest and smartphone addiction. In this regard, since there was no instrument available to assess passion within the Turkish cultural context, Study 1 adapted the Passion Scale for use in Turkish culture. Study 2 then investigated the associations among smartphone addiction, significance quest, and passion.

METHODS: During the adaptation process of the Passion Scale, SPSS 25.0 was used for the exploratory factor analysis (EFA), and Mplus 7 was employed for the confirmatory factor analysis (CFA). In Study 1, the measurement invariance of the Turkish version of the scale was also examined across groups formed according to gender, age and types of activities performed with passion. The sample sizes for EFA and CFA are 270 and 289, respectively. Majority of participants in both groups are aged between 19 and 25 (EFA: 71.2%; CFA: 66.1%). In Study 2, after testing multivariate statistical assumptions, the SEM-based mediation model was tested using Mplus 7. The study group of Study 2 consisted of 674 individuals from different ages (22.6% of participants were adolescents aged 15-18; 57.1% of participanst aged 19-25; 20.3% of participants aged 26-35).

RESULTS: The findings of Study 1 demonstrated that the two-factor structure of the Passion Scale was confirmed within the Turkish cultural context and that the scale exhibited high reliability. In Study 2, positive and significant relationships were identified between significance quest and smartphone addiction, between significance quest and obsessive passion, and between obsessive passion and smartphone addiction. Moreover, obsessive passion was found to mediate the relationship between significance quest and smartphone addiction. In contrast, no significant associations were observed between significance quest and harmonic passion, nor between harmonic passion and smartphone addiction.

CONCLUSIONS: The results of the study suggest that obsessive passion is one of the factors that strengthens the relationship between the significance quest and smartphone addiction. When an individual with obsessive passion experiences a loss of significance, their usage process may progress toward smartphone addiction, even if they are not yet addicted.

PMID:41572409 | DOI:10.1186/s40359-026-03994-9

Cardiooncology. 2026 Jan 22;12(1):9. doi: 10.1186/s40959-025-00417-3.

ABSTRACT

BACKGROUND: HIV, cancer, and their respective treatments are independently associated with cardiovascular risk, but limited data exist on the intersection of these conditions. The purpose of this study was to gain insights into the cardiovascular risk factor burden and cardiac function in people with HIV (PWH) treated for breast cancer.

METHODS: In a cohort of PWH and breast cancer treated with anthracyclines and/or trastuzumab (2017-2022) in Botswana, we assessed pre-treatment (baseline) left ventricular ejection fraction (LVEF), and prospectively obtained an echocardiogram at least one year after cancer treatment initiation. Wilcoxon signed rank sum test was used to test the differences between baseline and follow-up LVEF.

RESULTS: Thirty-three women were enrolled at a median of 2.1 years (Quartile (Q)1-Q3 1.8-3.1) from their cancer treatment initiation. The median age was 48.0 years (Q1-Q3 44.0-54.0). All but one patient was on antiretroviral therapy (ART); the median ART duration was 11.6 years (Q1-Q3 6.3-15 years) with a median viral load of 30 (Q1-Q3 0-30) and CD4 count of 874 (Q1-Q3 361-1131). At baseline, 70% were obese or overweight, and 24.2% reported hypertension; this increased to 30.3% at follow-up. The median LVEF at baseline was 65% (Q1-Q3 60-68%), and decreased to 62% (Q1-Q3 59-65%) at follow-up; an absolute difference of 2.9%, 95%CI: -5.3 to -0.2% (p = 0.038). There was no report of clinical heart failure.

CONCLUSIONS: Obesity and hypertension are highly prevalent amongst PWH and breast cancer. We also noted a statistically significant, but modest decline in LVEF after cancer therapy initiation. Further studies are needed to prospectively characterize the cardiovascular risk factor burden and changes in cardiac structure and function following cardiotoxic cancer treatment in this population.

PMID:41572399 | DOI:10.1186/s40959-025-00417-3

BMC Nutr. 2026 Jan 22. doi: 10.1186/s40795-026-01258-8. Online ahead of print.

NO ABSTRACT

PMID:41572393 | DOI:10.1186/s40795-026-01258-8

Biomark Res. 2026 Jan 22;14(1):17. doi: 10.1186/s40364-026-00897-0.

NO ABSTRACT

PMID:41572346 | DOI:10.1186/s40364-026-00897-0

Diabetol Metab Syndr. 2026 Jan 22. doi: 10.1186/s13098-025-02039-2. Online ahead of print.

ABSTRACT

BACKGROUND: The impact of discordance between remnant cholesterol (RC) and low-density lipoprotein cholesterol (LDL-c) on diabetes, diabetic kidney disease (DKD), diabetic retinopathy (DR) and cardiovascular disease (CVD) remains unclear. This study aims to explore the association between the discordance and these outcomes, using data from the National Health and Nutrition Examination Survey (NHANES) 1999.1-2020.3 and Clinical Medical College & Affiliated Hospital of Chengdu University.

METHODS: We prespecified a ± 15 percentile-point cutoff for discordance between RC and LDL-c, defined as RC percentile minus LDL-c percentile. Using this rule, 11,826 NHANES participants (cohort 1) and 306 participants from the Clinical Medical College & Affiliated Hospital of Chengdu University (cohort 2) were categorized as low discordance ( ≤ – 15), concordant (- 15 to + 15), or high discordance ( ≥ + 15). Key variables were screened by the Boruta algorithm. Logistic regression analysis models, restricted cubic spline (RCS), and subgroup analyses were used to assess the associations of discordance with outcomes. Receiver operating characteristic (ROC) and three machine learning models were used to assess the predictive value of the discordance for outcomes.

RESULTS: High discordance was significantly associated with increased risks of diabetes (OR -cohort 1: 2.371, 95% CI: 1.848-3.055; OR -cohort 2: 4.064, 95% CI: 1.750-10.020), DKD (OR: 2.593, 95% CI: 1.930-3.521), DR (OR: 2.205, 95% CI: 1.404-3.556), and CVD (OR -cohort 1: 2.299, 95% CI: 1.900-2.791; OR -cohort 2: 3.220, 95% CI: 1.266-8.175). In cohort 1, the RCS analysis showed linear relationships for these outcomes. Hypertension, HOMA-IR ≥ 3.1 and HOMA-β < 100 were identified as significant modifiers in subgroup analyses. In cohort 2, the RCS analysis showed linear relationships for diabetes and non-linear for CVD. All machine learning models demonstrated great predictive value of the discordance for diabetes and CVD.

CONCLUSION: The discordance is a significant predictor of diabetes, diabetic microvascular diseases, and cardiovascular disease.

KEY MESSAGE: (1)The discordance between RC and LDL-c is significantly associated with diabetes, diabetic microvascular diseases, and cardiovascular disease.(2) In NHANES, the RCS analysis showed linear relationships for diabetes, DKD, DR and CVD. In clinical cohort, the RCS analysis showed linear relationships for diabetes and non-linear for CVD.(3)The association of discordance with diabetes, DKD and CVD was more prevalent in individuals with hypertension and HOMA-IR ≥3.1, while individuals with hypertension were more sensitive to DR and individuals with HOMA-β <100 were more sensitive to diabetes.(4)The discordance showed the certain predictive ability for all outcomes.

PMID:41572345 | DOI:10.1186/s13098-025-02039-2

Child Adolesc Psychiatry Ment Health. 2026 Jan 22. doi: 10.1186/s13034-026-01026-3. Online ahead of print.

ABSTRACT

BACKGROUND: Adolescent loneliness and mental health have become escalating public health concerns. However, despite previous findings, research on how the school environment influences the relationship between loneliness and mental health remains scarce.

OBJECTIVES: Therefore, the objectives of this study are to identify key socio-ecological factors associated with adolescent mental health, examine the gender differences in socio-ecological factors and investigate whether the association between loneliness and mental health varies across individual schools.

METHODS: Data were drawn from the 2021/22 Czech dataset of the HBSC study, comprising 14,588 Czech adolescents aged 11-15 years old. Descriptive statistics and gender comparisons were conducted, followed by multilevel linear regression analyses accounting for the hierarchical structure of the data (students nested within schools). The nested models examined associations between mental health and key predictors using random intercepts and random slopes.

RESULTS: Boys reported better mental health, higher life satisfaction, stronger self-rated health and lower loneliness than girls. Boys also experienced better family support, communication and more frequent family meals. Girls reported more peer support, stronger preferences for online communication and greater academic pressure. Mental health was positively associated with family and health-related variables, and negatively with loneliness, bullying and academic stress. The relationship between loneliness and mental health was consistent across schools, with minimal variation attributable to school-level factors.

CONCLUSIONS: While gender-based differences were observed, loneliness consistently showed a strong negative association with mental health for boys and girls. These findings emphasise the central role of individual and family-related factors in adolescent mental health. They also suggest that in more structurally and culturally homogeneous educational systems, school-level differences in mental health may be limited, with wider socioeconomic and cultural influences operating relatively uniformly across schools. This underscores the importance of system-wide and family-focused approaches as well as national school-based programmes.

PMID:41572343 | DOI:10.1186/s13034-026-01026-3

Syst Rev. 2026 Jan 22. doi: 10.1186/s13643-026-03073-5. Online ahead of print.

ABSTRACT

BACKGROUND: Mental disorders, particularly anxiety and mood disorders, significantly impair individuals’ ability to perform daily activities, potentially leading to sedentary behavior and increasing the risk of non-communicable diseases such as diabetes, cancer, and obesity. Physical activity plays a crucial role in supporting mental health, and team sports represent a promising intervention strategy. Therefore, the aim of this systematic review is to evaluate the impact of team sports practice on anxiety and mood disorders. Furthermore, it will analyze how different modalities of team sports contribute to mental health improvements and identify gaps in the current literature to guide future research directions.

METHODS: This systematic review will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines and is registered in PROSPERO (CRD420251121611). A comprehensive search will be carried out across four electronic databases (PubMed, Embase, Web of Science, and Scopus) with no restrictions on language or publication date. Two independent reviewers will screen titles and abstracts using predefined eligibility criteria and extract data with standardized tables. A third independent reviewer will resolve any disagreements. Extracted data will include publication title, authors, year, assessment tools for anxiety and mood disorders, type of intervention, and primary outcomes related to the effects of team sports on these disorders. Risk of bias will be assessed using the Cochrane Risk of Bias tool (RoB 2.0). Data will be synthesized using a random-effects meta-analysis (DerSimonian-Laird) when at least two sufficiently homogeneous studies report the same outcome. Continuous outcomes will be pooled as mean differences (same scale) or standardized mean differences (different instruments). Statistical heterogeneity will be assessed using Cochran’s Q and the I² statistic. If heterogeneity is high (I² > 75%) or if pooling is not feasible, findings will be summarized narratively, with planned subgroup and sensitivity analyses. The certainty of evidence will be assessed using GRADE.

DISCUSSION: This systematic review is expected to provide comprehensive evidence on the potential effects of team sports participation on anxiety and mood disorders. By synthesizing findings from randomized controlled trial, the review aims to clarify the extent to which engaging in team sports may contribute to mental health promotion and symptom reduction. The results may inform clinical practice, guide the design of community-based interventions, and support policymakers in developing evidence-based strategies that use team sports as a non-pharmacological approach to improve psychological well-being.

TRIAL REGISTRATIONS: Systematic review registration: PROSPERO CRD420251121611.

PMID:41572328 | DOI:10.1186/s13643-026-03073-5