Category: Statistics

JAMA Health Forum. 2026 Jan 2;7(1):e256294. doi: 10.1001/jamahealthforum.2025.6294.

ABSTRACT

IMPORTANCE: In 2023, the Centers for Medicare & Medicaid Services terminated dual-eligible special needs plan look-alikes-Medicare Advantage plans with beneficiary panels composed of more than 80% dual-eligible individuals but lacking Medicaid integration. Understanding whether this policy promoted dual-eligible enrollment in integrated care plans, particularly those attaining high-level integration, is critical.

OBJECTIVE: To describe dual-eligible enrollment transitions after the look-alike plan termination and evaluate whether the policy was associated with increased enrollment in highly integrated plans.

DESIGN, SETTING, AND PARTICIPANTS: This repeated cross-sectional study analyzed US Medicare administrative data from January 2017 to January 2023. Samples were limited to full-benefit dual-eligible beneficiaries.

MAIN OUTCOMES AND MEASURES: First, a beneficiary-level analysis was conducted on 2023 enrollment patterns among full-benefit dual-eligible individuals whose 2022 plans were terminated, including factors associated with enrollment in highly integrated plans in 2023. Next, a county-year-level difference-in-differences design was used to compare changes in full-benefit dual-eligible enrollment before (2017-2022) and after (2023) the termination policy between counties with vs without terminated look-alike plans. A difference-in-differences design was used to evaluate whether the look-alike termination policy was associated with the proportion of full-benefit dual-eligible individuals enrolled in highly integrated care plans.

RESULTS: Between 2017 and 2022, 482 of 2576 counties had full-benefit dual-eligible individuals enrolled in look-alike plans for at least 1 year. Of the 170 399 full-benefit dual-eligible individuals enrolled in look-alike plans in 2022 (58.9% female; 20.6% Asian, 44.8% Hispanic, 11.3% non-Hispanic Black, 21.4% non-Hispanic White, and 2% other) and remained dual-eligible in 2023, only 5.4% transitioned to highly integrated plans, while 55.6% moved to nonintegrated plans. Dual-eligible individuals transitioning to highly integrated plans were more likely to be older (65-74 years: adjusted difference, 3.4 percentage points [pp]; 95% CI, 2.8-4.1 pp; 75-84 years: adjusted difference, 4.1 pp; 95% CI, 3.3-4.8 pp; ≥85 years: adjusted difference, 5.0 pp; 95% CI, 4.0-5.9 pp), female (adjusted difference: 0.6 pp; 95% CI, 0.2-0.9 pp), without disabilities (adjusted difference, -0.7 pp; 95% CI, -1.2 to -0.2 pp), and less likely to be Asian (adjusted difference, -5.0 pp; 95% CI, -5.6 to -4.4 pp) or Black (adjusted difference, -0.9 pp; 95% CI, -1.6 to -0.2 pp). The termination policy was not associated with a significant differential increase in enrollment into highly integrated plans in counties with look-alike plans compared with those without (0.6 pp; 95% CI, -0.4 to 1.6 pp). However, there was a 2.6-pp differential increase (95% CI, 0.01-5.1 pp) in enrollment into plans offering some integration, primarily driven by enrollment growth in plans with lower levels of integration. Enrollment also increased in conventional Medicare Advantage plans with fewer than 80% of dual-eligible enrollees (2.6 pp; 95% CI, 0.7-4.5 pp) after the termination policy.

CONCLUSIONS AND RELEVANCE: In this study, the termination of look-alike plans was insufficient to significantly shift dual-eligible individuals toward highly integrated plans. Complementary strategies are necessary to ensure that dual-eligible individuals enroll into highly integrated care models that may improve outcomes.

PMID:41543835 | DOI:10.1001/jamahealthforum.2025.6294

Arch Sex Behav. 2026 Jan 16. doi: 10.1007/s10508-025-03282-4. Online ahead of print.

ABSTRACT

Understanding trends in age of first sex and first marriage is vital for interventions addressing sexually transmitted infections (STIs/HIV) and youth sexual behavior. Shifts in these milestones affect fertility, contraceptive use, and STI/HIV dynamics. Traditional descriptive statistics often overlook younger populations, leading to inaccurate trend assessments. This study analyzed trends in median age at first sex and first marriage using survival analysis. Data from eight surveys within Magu Health and Demographic Surveillance System (1994-2016) were analyzed, focusing on individuals aged 15-24 years. The accelerated failure time (AFT) model with log-logistic distribution estimated these medians. Results showed an increase in median age at first sex by one year for both sexes and in first marriage by one year for females and two years for males. The AFT model captured gradual increases from 2003-2004 to 2015-2016 for females and 2003-2004 to 2010 for males, while standard descriptive statistics showed no changes in specific periods: age at first sex, 1996-1997 to 2012-2013 (females) and 2003-2004 to 2012-2013 (males); first marriage, 1994-1995 to 2015-2016 (females) and 2003-2004 to 2010 (males). Individuals with no education had lower median age at first sex (males: 17.1 vs. 18.3 years; females: 16.2 vs. 18.2) and first marriage (females: 18.0 vs. 21.3) than those with secondary or higher education. HIV-positive individuals experienced slightly earlier age at first sex and first marriage than negative individuals. Education plays a pivotal role in delaying these events. The AFT model enriches trend assessment.

PMID:41543812 | DOI:10.1007/s10508-025-03282-4

J Gastrointest Cancer. 2026 Jan 16;57(1):19. doi: 10.1007/s12029-025-01373-y.

ABSTRACT

PURPOSE: Earlier detection of colorectal cancer (CRC) can improve survival rates. A simple, effective blood test may help improve screening participation. The multi-target blood protein (MTBP; ColoSTAT^®) test and algorithm uses concentrations of five protein biomarkers of CRC and patient’s sex and age to generate a CRC likelihood score. We compared the performance of the MTBP test in detecting CRC to colonoscopy, the ‘gold standard’.

METHODS: This cross-sectional, multicenter study enrolled participants into two cohorts: participants recently colonoscopically diagnosed with CRC and progressing to surgery or neoadjuvant treatment (Cohort 1), and participants with no CRC history who were scheduled for colonoscopy (Cohort 2). Due to COVID-19 pandemic-related recruitment delays, Cohort 1 was supplemented with bio-banked blood samples (BBS) from patients with clinically confirmed CRC. Performance goals for sensitivity and specificity of the MTBP test compared to colonoscopy were ≥ 73% (lower 95% confidence limit [LCL] > 60%) and ≥ 90% (LCL > 80%), respectively.

RESULTS: Cohort 1 included 29 patients, Cohort 2 enrolled 768 patients and 192 BBS were included. Median age when providing samples was 64 years (range, 40-85 years); 53.4% were female. Definitive MTBP test results were obtained from 657 samples. 112 and 389 samples met the criteria for inclusion in the primary sensitivity and specificity analyses, respectively. The sensitivity of ColoSTAT^® for detection of all-stage CRC compared to colonoscopy was 81.3% (95%CL 73.0%-87.4%) and the specificity, 91.0% (95%CL 87.7%-93.5%).

CONCLUSIONS: The MTBP test met pre-specified primary performance endpoints and warrants further evaluation in clinical populations at elevated risk of CRC.

PMID:41543810 | DOI:10.1007/s12029-025-01373-y

Support Care Cancer. 2026 Jan 16;34(2):100. doi: 10.1007/s00520-025-10277-3.

ABSTRACT

PURPOSE: To summarize the impact of exercise interventions on cardiorespiratory fitness (CRF) in childhood cancer survivors (CCS) and determine optimal FITT (Frequency, Intensity, Type, Time) parameters to improve CRF in CCS.

METHODS: Electronic databases Medline, Embase, Web of Science, Scopus, Central, CINAHL, SPORTDiscus and clinicaltrials.gov were systematically searched from inception to 09/04/2025. Reference lists of relevant articles and review papers were manually screened. Studies included CCS < 19 years at diagnosis, undergoing any type of exercise intervention with peak oxygen consumption (VO₂peak) and/or 6-min walk test (6MWT) distance as outcomes for CRF.

RESULTS: Ten studies involving 309 participants (55.7% male, 6-23 years) were included. Exercise interventions significantly improved VO₂peak (n = 6 studies; MD = 4.40 ml/kg/min; p < 0.01; 95% CI, [1.86; 6.94]) and 6MWT (n = 5 studies; MD = 53.59 m; p = 0.01; 95% CI, [16.31; 90.88]) compared to usual care in CCS. Meta-regression revealed no significant associations between frequency, intensity, type, time, and VO₂peak (n = 6) or 6MWT (n = 3).

CONCLUSION: Exercise interventions significantly improved CRF in CCS. Due to the limited amount and heterogeneity of included studies, optimal FITT parameters to increase CRF in CCS could not be identified. More randomized controlled trials with large sample sizes are needed to complement existing evidence and increase the robustness of the findings.

PMID:41543801 | DOI:10.1007/s00520-025-10277-3

Intern Emerg Med. 2026 Jan 16. doi: 10.1007/s11739-025-04258-x. Online ahead of print.

ABSTRACT

This retrospective cohort study, conducted between December 2022 and December 2023, aims to observe the efficacy of bedside ultrasound-informed cardiopulmonary resuscitation (CPR) in determining the possible etiology of cardiac arrest, increase the success rate of CPR, shorten the recovery of spontaneous circulation (ROSC) time, and improve the prognosis. The patients were placed into two groups: ultrasound and conventional, to find the causes of cardiac arrest and promptly address them. The differences in the discovery rate of the possible causes of cardiac arrest, CPR success rate, and ROSC time between the two groups of patients were statistically significant (P < 0.05). The effect of the right-sided peak systolic velocity (PSV) of the common carotid artery (CCA) (CCA-PSV) on the success rate of CPR was statistically significant (P < 0.05). The difference between the mean hospital stay and 28-day survival rate of the two groups was not statistically significant (P > 0.05). The use of bedside ultrasound-informed CPR can help in determining the possible causes of cardiac arrest in some patients and can improve the success rate of CPR and shorten the time of ROSC. However, there was no significant difference in shortening the mean hospital stay and increasing the 28-day survival rate. A correlation was noted between the right-sided CCA-PSV and the CPR success rate and ROSC time in patients in the ultrasound group.

PMID:41543793 | DOI:10.1007/s11739-025-04258-x

J Racial Ethn Health Disparities. 2026 Jan 16. doi: 10.1007/s40615-025-02828-5. Online ahead of print.

ABSTRACT

Non-Hispanic (NH) Black birthing persons show the highest prevalence of low-risk cesareans (30.8%), compared to NH White birthing persons (25.3%). Individual, as well as place-based and ecological factors, may contribute to this racial disparity. We examine individual- and county-level characteristics that contribute to the racial disparity, as well as the extent to which the disparity can be attributed to differences in measured characteristics of racial groups. We retrieved data on all live births in the US, between 1998 to 2018, from natality files assembled by the National Center of Health Statistics Division of Vital Statistics. We conduct an Oaxaca-Blinder decomposition of all low-risk births (> 11 million) from all counties in the US. We find that differences in measured characteristics comprise 47.5% of the racial disparity. Older maternal age, higher birthweight percentile, and unmarried status contribute the greatest towards widening the disparity, whereas contextual factors, such as county-level poverty and education, play a more complex and nuanced role. Given that over half of the disparity remains unexplained, it indicates that unmeasured differences – either due to treatment of racial groups, patient preferences, or other healthcare supply-side factors – could play a significant role. Future research should investigate additional antecedents of low-risk cesareans among NH Black birthing persons.

PMID:41543787 | DOI:10.1007/s40615-025-02828-5

Arch Gynecol Obstet. 2026 Jan 16;313(1):45. doi: 10.1007/s00404-025-08292-0.

ABSTRACT

PURPOSE: Primary: To evaluate whether robotic-assisted laparoscopic surgery using the Senhance® Surgical System has the potential to reduce muscular demands compared to conventional laparoscopy. Secondary: To verify that the novel eye-tracking feature for zoom and the selection of functions in the Senhance® System menu is not associated with increased eyestrain or neck strain.

METHODS: In a within-subject design, 2 experienced surgeons performed 11 robot-assisted and 12 conventional laparoscopic procedures. Muscular demands were monitored throughout surgical procedures by assessing the muscle activity via bipolar surface electromyography of seven muscles of the lower back, shoulder-neck, and forearms. Surgeons’ head, arm, and torso posture was assessed by gravimetrical position sensors. Furthermore, musculoskeletal discomfort, mental and physical workload, task difficulty and working precision were rated by the surgeons. In addition, a ten-item eyestrain questionnaire was administered after each surgical procedure.

RESULTS: Four out of seven muscles were relieved when working with Senhance®. Only in the left shoulder-neck area there was a statistically significant increase in muscle activation associated with robotic-assisted surgery. Changes in surgeons’ posture related to the surgical technique corresponded to the changes in muscle activation. Furthermore, surgeons reported no musculoskeletal discomfort under both conditions and similar levels of workload (mental and physical), and task difficulty. Working precision was subjectively rated to be better during standard laparoscopy. No eyestrain occurred during any of the procedures.

CONCLUSION: This exploratory study identified the potential of the Senhance® Surgical System for ergonomic improvements and indicated no impairments by the novel eye-tracking feature on muscle demands and eyestrain. Follow-up studies with larger and more diverse indications are needed that also consider clinical outcomes, which were not part of the present study.

PMID:41543778 | DOI:10.1007/s00404-025-08292-0

J Cross Cult Gerontol. 2026 Jan 16;41(1):1. doi: 10.1007/s10823-025-09556-7.

ABSTRACT

Of the almost two million older persons in Ghana, fewer than 300,000 receive pensions from the Social Security and National Insurance Trust (SSNIT), having contributed to the pension scheme during their working years. Since ageing is associated with several social, economic, and health adversities, it is important to ascertain the quality of life of this population to identify areas of their lives that may need improvement. Consequently, this study examined the quality of life of 437 pensioners benefiting from the SSNIT pension scheme in the Greater Accra Region of Ghana. The study employed mixed-methods and utilized the WHOQOL-BREF to measure the quality of life under the physical, psychological, social, and environmental domains. The findings suggested that the pensioners had at best a moderate social, physical, psychological, and environmental quality of life. Based on the findings, the study recommends policy actions aimed at enhancing pension adequacy, strengthening social support and community engagement opportunities, and improving access to health and welfare services for pensioners.

PMID:41543769 | DOI:10.1007/s10823-025-09556-7

J Neural Transm (Vienna). 2026 Jan 16. doi: 10.1007/s00702-025-03093-w. Online ahead of print.

ABSTRACT

The global prevalence of Autism Spectrum Condition (ASC) is increasing, yet effective supportive interventions remain largely unidentified, highlighting the urgent need to clarify the underlying neuropathophysiology. Neuroimaging offers a pathway toward this understanding; however, most studies rely on indirect measures of neurophysiology, whereas direct approaches such as [¹⁸F]Fluorodeoxyglucose positron emission tomography (FDG-PET) remain underutilized and lack systematic synthesis in the literature. This review and meta-analysis evaluated FDG-PET research in ASC. A systematic search identified 2,725 records, of which 21 studies compared FDG-PET findings between autistic and neurotypical individuals. Nine met the inclusion criteria for the review, and eight were included in the meta-analysis. The review revealed inconsistent findings, reporting both increased and decreased glucose metabolism in ASC, likely reflecting methodological heterogeneity. The meta-analysis found no statistically significant differences, but indicated a weak non-significant trend toward elevated glucose metabolism in the striatum in autistic compared to neurotypicals individuals (standardized mean difference [SMD] = 0.416; 95% CI – 0.200 to 1.032; p = 0.186). Despite 40 years of FDG-PET research in ASC, the number of studies remains limited, and several exhibit methodological shortcomings. Evidence from FDG-PET studies in other psychiatric and neurological disorders underscores the technique’s potential value in ASC research. The findings of this study further emphasize the urgent need for rigorously designed investigations to clarify the relationship between cerebral glucose metabolism and autism, with the ultimate goal of advancing our understanding of the autistic brain.

PMID:41543762 | DOI:10.1007/s00702-025-03093-w

Eur J Nutr. 2026 Jan 16;65(1):28. doi: 10.1007/s00394-025-03879-4.

ABSTRACT

PURPOSE: To develop and evaluate an anti-inflammatory dietary index based on the specific dietary culture and preference among Chinese adults.

METHODS: A total of 6322 participants were included and were further separated into a training (n = 4514) and a validation set (n = 1808). In the training set, we utilized reduced rank regression to derive a dietary index based on the intake of 33 food groups and five pre-identified anti-inflammatory nutrients. In the validation set, interleukin (IL)-1β, IL-4, IL-6, and high-sensitivity C-reactive protein (hs-CRP) were measured, and a total inflammation score (TIS) was constructed. Pearson partial correlation analysis and multivariate generalized linear regression were applied to explore the relationship between dietary indices and inflammatory biomarkers.

RESULTS: The derived dietary index, termed Nutrient-derived Anti-inflammatory Dietary Index (NADI), mainly characterized by a higher intake of fresh vegetables and fruits, mushrooms and fungi, soybeans, fresh eggs, and tea, alongside a lower intake of red meat, alcohol, and refined grains. NADI significantly correlated with several well-established dietary indices. Participants in the highest quintile of NADI had lower plasma levels of IL-1β (relative concentration [RC]: 0.67, 95% CI 0.58 ~ 0.77), hs-CRP (RC: 0.68, 95% CI 0.58 ~ 0.80), and TIS (RC: 0.43, 95% CI 0.31 ~ 0.59) compared with the lowest quintile in the fully adjusted model. Results were similar in subgroups and sensitivity analyses.

CONCLUSIONS: NADI effectively captures inflammation-related dietary quality and could serve as a valuable instrument for evaluating the impact of dietary inflammatory potential on health outcomes in Chinese adults.

PMID:41543748 | DOI:10.1007/s00394-025-03879-4