Category: Statistics

Vox Sang. 2026 Mar 17. doi: 10.1111/vox.70237. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Transfusion-associated circulatory overload (TACO) is the leading cause of transfusion-related morbidity and mortality. We evaluated the incidence of TACO and its association with new fever (HOT-TACO) at a comprehensive cancer centre.

MATERIALS AND METHODS: Retrospective review of haemovigilance data (July 2019-October 2020) identified 100 possible to definite TACO cases. TACO cases were classified as HOT-TACO or regular TACO, differentiated by an association with new-onset fever. Both groups were assessed by type, age of blood products involved, reaction severity, cancer diagnosis and white blood cells (WBC) counts.

RESULTS: Among 1382 transfusion reactions in a 15-month period, 111 cases of TACO (8%) were diagnosed. A total of 100 adult TACO cases were included in this study; 16% of them were HOT-TACO cases. The median WBC counts pre- and post-transfusion in the HOT-TACO versus regular-TACO group were not statistically different (pre- 5.400 vs. 2.050, p = 0.19; post 4.100 vs. 1.900, p = 0.45). However, the HOT-TACO group had a 2.7-fold higher pre-WBC and a 2.2-fold higher post-WBC when compared with the regular TACO group. There were no significant differences in age of the blood products involved, red blood cell (RBC) age (median 12 days, p = 0.34), platelet age (single donor platelet [SDP]/random donor platelet [RDP] unit) (median 5/5 days, p = 0.32/p = 0.72) or reaction severity between groups.

CONCLUSION: We found an association of TACO and new fever in 16% of cases compared with 32% reported in a non-exclusive oncological setting. Findings are likely related to impaired immune response present in cancer patients associated with immunosuppression. Our findings support that fever should not be used to distinguish transfusion-related acute lung injury (TRALI) from TACO.

PMID:41844335 | DOI:10.1111/vox.70237

Plast Reconstr Surg. 2026 Mar 17. doi: 10.1097/PRS.0000000000013045. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with cleft lip and/or palate have a significantly higher prevalence of sleep-disordered breathing (SDB) due to congenital anatomic differences and the sequelae of surgical management. Of note, the velopharyngeal and oropharyngeal airway size plays a significant role. This single-center retrospective study compares the effect of conventional Furlow palatoplasty and small-Z Furlow palatoplasty on airway morphology.

METHODS: Consecutive patients with cleft lip and alveolus (CL/A) and cleft lip and palate (CL/P) presenting for secondary alveolar bone grafting (ABG) between 2017-2019 were enrolled for this study. Exclusion criteria included syndromic patients, previous secondary velopharyngeal surgery, and previous sleep surgery. Patients were divided into the control group (CL/A only), those who received primary conventional Furlow palatoplasty, and those who received primary small-Z palatoplasty. Speech was assessed by 2 experienced speech pathologists and SDB via the OSA-18 questionnaire. Airway and velum morphology was assessed using cone beam CT.

RESULTS: Amongst the 95 included patients, 23 were in the control group, 32 had conventional Furlow palatoplasty, and 40 patients had small-Z Furlow palatoplasty. There was no statistically significant difference in speech outcomes or OSA-18 scores between the 3 groups. However, compared to the conventional group, the small-Z group demonstrated increased velopharyngeal airway volume, decreased velar length and increased minimum cross-section area of the velopharyngeal airway.

CONCLUSION: Conventional and small-Z Furlow palatoplasty provided patients with a similar speech and sleep quality outcome. The small-Z palatoplasty, however, demonstrated an increased velopharyngeal airway volume and minimum cross-section area, as well as decreased velar length.

PMID:41843915 | DOI:10.1097/PRS.0000000000013045

JMIR Bioinform Biotechnol. 2026 Mar 17;7:e81219. doi: 10.2196/81219.

ABSTRACT

BACKGROUND: Cattle are among the most important livestock resources in Ethiopia, contributing significantly to the agricultural economy and rural livelihoods. They provide meat, milk, hides, draft power for crop production, and serve as a major source of income for farmers. Despite their vital role, cattle productivity is often constrained by various diseases, particularly parasitic diseases. One of the most significant of these is bovine fasciolosis, a condition caused by ingestion of metacercariae of liver flukes belonging to the genus Fasciola.

OBJECTIVE: This study aimed to assess the prevalence and associated risk factors of bovine fasciolosis in Bahir Dar, Ethiopia.

METHODS: A cross-sectional study was conducted from November 2021 to April 2022. A total of 384 cattle were randomly selected from different locations within the study area. Animals of all age groups and both sexes were included. Fecal samples were collected directly from the rectum of each animal using clean, labeled containers. The samples were examined using standard coprological techniques, specifically the sedimentation method, to detect liver fluke eggs. All findings were recorded, and the data were analyzed using descriptive statistical methods.

RESULTS: The overall prevalence of fasciolosis was 49.21% (n=189). Based on origin, Sebatamit had the most incidence at 61.84% (n=47), followed by Kebele 11 at 59.37% (n=57), Tikurit at 50% (n=59), and Latammba at 27.65% (n=26). Statistical analysis revealed significant disparities in occurrence among areas. Cattle in poor condition had the largest prevalence (n=80, 64%), followed by medium condition (n=85, 50%) and fat cattle (n=24, 26.96%). This variation was statistically significant. Age-group analysis revealed comparable prevalence rates, with young cattle at 50.38% (n=65), adults at 47.33% (n=71), and elderly cattle at 50.47% (n=53), with no significant differences found. There were no significant sex-related variations in prevalence, with males exhibiting a prevalence of 49.73% (n=93) and females 48.73% (n=96). Local cattle had a slightly higher prevalence (n=111, 51.62%) than crossbreeds (n=78, 46.15%), although the difference was not statistically significant (P=.29).

CONCLUSIONS: These findings underscore the need for targeted, location-specific control strategies and highlight the importance of improved nutritional and health management practices to reduce the burden of fasciolosis in cattle populations.

PMID:41843901 | DOI:10.2196/81219

PLoS One. 2026 Mar 17;21(3):e0339060. doi: 10.1371/journal.pone.0339060. eCollection 2026.

ABSTRACT

We study the problem of community detection in a general version of the block spin Ising model featuring M groups, a model inspired by the Curie-Weiss model of ferromagnetism in statistical mechanics. We solve the general problem of identifying any number of groups with any possible coupling constants. Up to now, the problem was only solved for the specific situation with two groups of identical size and identical interactions, see [1, 2]. Our results can be applied to the most realistic situations, in which there are many groups of different sizes and different interactions. In addition, we give an explicit algorithm that permits the reconstruction of the structure of the model from a sample of observations based on the comparison of empirical correlations of the spin variables, thus unveiling easy applications of the model to real-world voting data and communities in biology.

PMID:41843892 | DOI:10.1371/journal.pone.0339060

PLoS One. 2026 Mar 17;21(3):e0343571. doi: 10.1371/journal.pone.0343571. eCollection 2026.

ABSTRACT

Electrocardiogram (ECG) analysis is crucial for diagnosing cardiovascular conditions. While traditional classification models require large volumes of labeled data across multiple disease categories, anomaly detection offers a flexible alternative by identifying deviations from normal patterns-an approach particularly valuable given the rarity and diversity of cardiac conditions. However, existing anomaly detection methods often rely on R-peak detection or heartbeat segmentation, which increases preprocessing complexity and reduces robustness to signal variability. To address these limitations, we propose MMAE-ECG, a multi-scale masked autoencoder designed to capture both global and local dependencies without such preprocessing steps. MMAE-ECG integrates a multi-scale masking strategy and a multi-scale attention mechanism with distinct positional embeddings, enabling a lightweight Transformer encoder to efficiently model ECG signals. Additionally, an aggregation strategy is introduced to improve anomaly score estimation. Experiments demonstrate that MMAE-ECG achieves state-of-the-art performance in both anomaly detection and localization while significantly reducing computational costs. Specifically, it requires only approximately 1/78 of the inference FLOPs and 1/18 of the trainable parameters compared to the previous leading method. Ablation studies further validate the contributions of each component, demonstrating the potential of multi-scale masked autoencoders as an effective and efficient approach for ECG anomaly detection.

PMID:41843891 | DOI:10.1371/journal.pone.0343571

JMIR Form Res. 2026 Mar 17;10:e79667. doi: 10.2196/79667.

ABSTRACT

BACKGROUND: E-cigarette use remains prevalent among US adolescents, with many reporting daily use and high nicotine dependence. Few evidence-based mobile health interventions focus specifically on adolescents.

OBJECTIVE: This study aimed to evaluate the feasibility, engagement, and preliminary efficacy of vaper-to-vaper (V2V)-a multicomponent, peer-driven texting intervention supporting adolescent e-cigarette cessation.

METHODS: A cluster randomized pilot study was conducted in 5 Massachusetts high schools, with schools randomized to either the V2V texting intervention (n=3) or a control group (n=2) that received a link to the National Cancer Institute’s Smokefree.gov Quit Vaping website. The V2V intervention included four components: (1) peer-written messages provided motivation, tips, and strategies to support adolescents in quitting vaping, sent daily in the first 30 days; (2) peer videos featuring adolescents sharing their experiences with e-cigarettes and motivations to quit, sent regularly as links aligned with related peer message topics; (3) peer coaches-university students aged younger than 22 years who had successfully quit vaping-trained to provide support, encouragement and answers to participants’ questions through the texting platform; and (4) a fictional, gamified mystery story integrated into the texting platform to promote engagement. Each gamified message included a short story segment and a question, with the next segment unlocked after a response or automatically after 3 days. The intervention was mainly delivered over 30 days, but adolescents could message the peer coach over the 3 months. Eligible participants (grades 9-12, current e-cigarette users) were followed for 3 months. We assessed the feasibility of recruitment and retention (target: 80 participants, ≥85% retention), engagement with intervention components, and participant satisfaction. The secondary outcomes included improvements from baseline in confidence to quit, self-efficacy to resist vaping in specific high-risk situations, and fewer days vaped. E-cigarette cessation was biochemically verified using the Abbott iScreen cotinine test.

RESULTS: Seventy-one adolescents enrolled (intervention: 39/71, 55% ; control: 32/71, 45%), with a 96% follow-up rate at 3 months. Among intervention participants who responded to engagement items (N=37), high engagement-defined as self-reported use always, usually, or about half the time-was highest for peer messaging (n=29, 78%), followed by gamification (n=18, 49%), peer coaching (n=18, 49%), and peer video (n=13, 35%). The intervention group showed nonsignificant improvements in confidence to quit (n=17, 46%, vs n=9, 24%, moved from not at all, somewhat, or moderately confident to very or extremely confident) and in the number of days vaped in the past 30 days (-3.6 vs -2.9), while self-efficacy scores (adapted smoking self-efficacy scale range 12-60) were slightly lower compared to the control group (mean -0.21, SD 1.14, vs mean 0.06, SD 1.39). Cotinine-validated 7-day point prevalence abstinence was similar between groups (intervention: 21.6% vs control: 22.6%).

CONCLUSIONS: The V2V intervention demonstrated feasibility and acceptability, with strong engagement and high satisfaction. Although differences between groups were not statistically significant, findings suggest that peer-driven mobile interventions are a promising approach to support adolescent e-cigarette cessation.

PMID:41843855 | DOI:10.2196/79667

JMIR Mhealth Uhealth. 2026 Mar 17;14:e66074. doi: 10.2196/66074.

ABSTRACT

BACKGROUND: Accessibility barriers contribute to low participation in center-based cardiac rehabilitation. We developed an innovative, comprehensive, dual-phase telerehabilitation program to address this gap (Smartphone Cardiac Rehabilitation, Assisted Self-Management; SCRAM).

OBJECTIVE: The study aimed to determine the effectiveness of SCRAM for increasing maximal aerobic exercise capacity (VO2max).

METHODS: A multicenter, parallel 2-arm randomized controlled trial recruited clinically stable adults (aged ≥18 y) with diagnosed coronary heart disease at 3 hospitals in Victoria, Australia (Melbourne, Geelong, and Bendigo) from 2018 to 2021. Participants were randomized (1:1), stratified by sex and study site, to receive SCRAM plus usual cardiovascular care (intervention) or usual cardiovascular care alone (control). SCRAM provided 24 weeks of remote exercise supervision, coaching, and behavior change support via smartphone. Usual cardiovascular care included standard medical care and advice to seek a referral to center-based cardiac rehabilitation, which was heavily impacted during the COVID-19 pandemic. Due to the nature of the treatments, participants were not blinded to allocation; primary outcome assessors and biostatisticians were blinded. The primary outcome was VO2max at 24 weeks, analyzed on the principle of intention-to-treat, using linear regression adjusted for baseline and stratification factors on multiple imputed data.

RESULTS: Recruitment and data collection were heavily impacted by COVID-19, although SCRAM delivery was sustained throughout. Of 220 required participants, only 123 (56%) were recruited and randomized (intervention n=63, control n=60); 45% (55/123) had missing VO2max at 24 weeks-largely due to enforced COVID-19 restrictions. Mean VO2max at 24 weeks favored SCRAM (26.10, SD 10.72 mL/kg/min) over control (24.65, SD 7.87 mL/kg/min), but the difference was not statistically significant (mean difference=1.61 mL/kg/min, 95% CI -1.38 to 4.61, P=.28). Among secondary outcomes, patients receiving SCRAM had lower diastolic blood pressure at 24 weeks (mean difference=-5.54 mm Hg, 95% CI -10.01 to -1.06). All reported adverse events (control n=6, intervention n=16) were deemed mild or moderate, with only one deemed as possibly related to treatment. There were no deaths or hospitalizations.

CONCLUSIONS: This was an underpowered trial, but SCRAM did not lead to a clinically important difference in VO2max compared to usual cardiac care. SCRAM was resilient to COVID-19-related disruptions that significantly impacted the delivery of cardiac rehabilitation and supervised exercise training in particular. Further research is needed to conclusively assess treatment effects and understand how virtual cardiac rehabilitation can be translated into routine practice to augment center-based delivery and enhance equity of access.

PMID:41843837 | DOI:10.2196/66074

JCO Glob Oncol. 2026 Mar;12(3):e2500373. doi: 10.1200/GO-25-00373. Epub 2026 Mar 17.

ABSTRACT

PURPOSE: Leadership is essential for addressing global challenges in cancer care. Equipped with leadership skills, health care providers can respond effectively to complex oncology issues in diverse settings, including resource-constrained environments. The Princess Margaret Global Oncology Leadership Development (GOLD) program provides accessible, interdisciplinary leadership training to support this. Each year, roughly 165 clinical fellows train at the Princess Margaret Cancer Centre, most of whom are internationally trained. GOLD offers leadership training to any fellow interested in global oncology, supporting their ability to tackle complex challenges worldwide. This study describes the development, implementation, and outcomes of the first 5 years of the GOLD program.

METHODS: GOLD is a hybrid, multiformat leadership training program integrating experiential learning, mentorship, and systems-level thinking. It is offered free of charge and is open to all fellows in oncology to eliminate common barriers such as selection/promotion bias, travel, and cost. McNemar’s test and T-tests were used to compare rankings with pre- and postprogram survey and session evaluations. Inductive thematic analysis was conducted to analyze semistructured interviews.

RESULTS: Participants (53% female, 47 countries represented) showed statistically significant improvements in confidence across 24 leadership competencies. No associations were found between confidence gains and participants’ geographic or economic backgrounds. Thematic analysis identified four key themes: improved preparedness for leadership roles, sustained global networking and mentorship, enhanced understanding of leadership across diverse contexts, and growth in intrapersonal skills.

CONCLUSION: The GOLD program demonstrates the effectiveness of inclusive, experiential leadership training in oncology. By removing barriers to access and prioritizing diversity, it supports a new generation of global cancer leaders. Ongoing evaluation and adaptation will ensure that the program remains relevant across diverse sociocultural and economic contexts, contributing to more equitable and effective leadership in cancer care worldwide.

PMID:41843835 | DOI:10.1200/GO-25-00373

Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2026 Mar 17:1-14. doi: 10.1080/19440049.2026.2636065. Online ahead of print.

ABSTRACT

Commission Regulation 2021/808 sets performance criteria for methods for analysing pharmacologically active substances in food-producing animals. Due to the vast numbers of veterinary drugs and sample matrices, conventional re-validation of existing methods to this regulation is costly and disruptive to the delivery of routine analyses. This paper presents an alternative approach to method validation based on adding fortified samples to routine screening batches that is cost-effective and fits seamlessly within routine analytical workflows. The relationships between added concentration and each of three quantities: (1) mean measurement result, (2) the uncertainty of the mean result, and (3) the within laboratory reproducibility standard deviation are directly estimated by a maximum likelihood fit of a statistical model to measurement results. Hence, the model provides estimates of trueness, relative standard deviation and measurement uncertainty at concentrations of interest that are within the range of concentrations used in the model fit. The CCα (decision limit for confirmation) and CCβ (detection capability for screening) are calculated from estimates of measurement uncertainty. Because this approach uses data collected during routine analyses across a large number of analytical batches, rather than relying on specifically constructed validation studies, the resulting estimates of trueness and within-laboratory reproducibility better reflect real-world method performance. Estimates of performance do not rely on patterns of replication at specific concentrations or the availability of a particular number of results. Instead, the sufficiency of validation data is judged by the relative standard errors of estimates of within lab-reproducibility at concentrations of interest gained by a parametric bootstrap of the fitted statistical model. R script (a programming language used for statistical analysis) which demonstrates model fitting, performance parameter estimation and assessment of validation quality via a parametric bootstrap is provided here along with further scripts that demonstrate the method in two examples.

PMID:41843822 | DOI:10.1080/19440049.2026.2636065

J Chem Theory Comput. 2026 Mar 17. doi: 10.1021/acs.jctc.5c01970. Online ahead of print.

ABSTRACT

Stochastic formulations of electronic-structure theory often reduce computational cost by replacing exact contractions with statistical estimates obtained from random samples, a procedure that inherently introduces random fluctuations and systematic bias. The fluctuations decay as M^-1/2 with the number of samples M, whereas the bias generated in nonlinear or self-consistent settings decays as M^-1 and can remain significant for moderate M. To control this bias we employ the jackknife-2 estimator, which reduces its leading term to $O\left(M^{–2}\right)$ with only modest extra cost. We examine bias formation and removal in three settings: (i) stochastic treatments of the Markovian master equation using bundled dissipators, (ii) stochastic Kohn-Sham density functional theory for warm dense hydrogen, and (iii) stochastic evaluation of the Hubbard-model partition function. The first two settings have been presented in earlier works; accordingly, we review them only briefly and focus primarily on the issue of bias control. The Hubbard-model application is entirely new. For this case, we present two approaches: a direct estimator, which has large variance but no bias, and a “midway transition probability” (ΣMTP) estimator, which has smaller variance but introduces bias. Applying the jackknife-2 procedure to the ΣMTP estimator controls this bias and yields a substantially lower total error than the direct estimator. Across all cases, jackknife bias removal markedly improves the accuracy and reliability of stochastic electronic-structure calculations without increasing the computational cost.

PMID:41843818 | DOI:10.1021/acs.jctc.5c01970