Category: Statistics

Int J Lab Hematol. 2026 May 11. doi: 10.1111/ijlh.70139. Online ahead of print.

ABSTRACT

OBJECTIVES: Criteria for visual examination of stained peripheral blood smear (PBS) differ among institutions in the United States and internationally. In an effort to standardize review criteria, the International Consensus Group for Hematology Review (ICGHR) proposed in 2005 a consensus list of rules for CBC findings that should trigger a review of automated cell counter results and potentially lead to further testing or blood smear review. The primary aim of this paper is to report on the published literature in the past 20 years regarding PBS review criteria and their ability to identify relevant peripheral blood abnormalities.

METHODS: We performed a systematic review of the published literature from 2005 to 2025 to investigate and summarize PBS review criteria and performance in the context of automated hematology analyzers in clinical laboratories.

RESULTS: Of 5351 citations, 68 studies met our search criteria. These studies included 22 countries and all major hematology analyzer manufacturers. Marked variability was observed in study populations, analyzer flagging criteria, details of PBS visual review, definitions of a “positive” smear, and approaches to statistical data analysis. Across studies, the blast flag sensitivity ranged from 18% to 100% while the blast flag specificity ranged from 17% to 100%. Wide ranges in sensitivity/specificity were also seen for atypical and/or abnormal lymphocyte flags across studies. For studies analyzing the same patient population, less striking variation was seen across instruments.

CONCLUSIONS: This systematic review provides a 20-year overview of the literature, highlighting significant variability in PBS review criteria, dependence on study design and hematology analyzer, and the importance of developing harmonized evidence-based guidelines.

PMID:42115681 | DOI:10.1111/ijlh.70139

NPJ Breast Cancer. 2026 May 11;12(1):69. doi: 10.1038/s41523-026-00940-1.

NO ABSTRACT

PMID:42115634 | DOI:10.1038/s41523-026-00940-1

Sci Rep. 2026 May 11. doi: 10.1038/s41598-026-44533-1. Online ahead of print.

ABSTRACT

Springs represent critical lifelines for mountain water security; however, discharge reductions and seasonal drying increasingly threaten 1.3 billion people dependent on Himalayan water systems amid accelerating climate change. This study presents a systematic application of classical hydrological methods across eight representative springs in the Tawi catchment, J&K UT, India, providing a comprehensive and unprecedented hydrometric assessment framework for data-scarce regions of Indian Himalayas. Three complimentary hydrological approaches were adopted: (1) flow regime analysis using hydrograph assessment and base flow separation, (2) statistical assessment using correlation and persistence functions, and (3) flow reliability evaluation using duration curves and variability indices. Results revealed distinct hydrological signatures: three springs exhibited perennial behavior with high base flow indices (0.67-0.88), strong groundwater contribution (> 800,000 L total volume), and low variability (CV < 0.3), while five springs demonstrated seasonal-flashy responses with discharge variability ratios exceeding 2.5. Cross-correlation analysis identified response lag times ranging from immediate (1 day) for shallow systems to 49 days for deeper groundwater-fed springs. Auto-correlation functions revealed memory of 14-49 days, indicating varying aquifer storage capacities. The evidence-based classification supports development of targeted community interventions: stable springs require recharge zone protection and forest conservation, whereas vulnerable springs necessitate artificial recharge structures, check dams, and community-based storage systems. This framework directly supports UN Sustainable Development Goal 6 (Clean Water and Sanitation) and Goal 13 (Climate Action), demonstrating that systematic, scientifically robust classical methods offer cost-effective alternatives for springshed management, thereby supporting mountain water security globally.

PMID:42115633 | DOI:10.1038/s41598-026-44533-1

Nat Commun. 2026 May 7. doi: 10.1038/s41467-026-72835-5. Online ahead of print.

ABSTRACT

Anopheles stephensi is a major malaria vector mainly present in southern Asia and the Arabian Peninsula. Since 2012 it has invaded several countries of eastern Africa, stimulating urgent efforts to develop more efficient strategies for vector control such as CRISPR/Cas9-based homing gene drives. Target site resistance due to end-joining repair is a significant challenge to the deployment of these systems. The use of multiple sgRNAs has the potential to solve this issue. Here we perform experimental crosses to assess the homing and cutting efficiency of both classical (e.g. four adjacent sgRNAs all in one construct) and additive (e.g. separate constructs each expressing a single sgRNA) multiplexing strategies targeting the cardinal locus, in the presence and absence of a resistance allele. We find resistance alleles at one sgRNA target site can be mitigated by the presence of the additional sgRNAs with either strategy, and do not significantly reduce the homing efficiency for either strategy, validating their effectiveness. Further modelling using parameters derived from the strains generated indicates that while both strategies can overcome resistance allele formation, the fitness of the drive-carrying alleles is a critical factor in determining the overall performance and persistence of a split drive.

PMID:42115602 | DOI:10.1038/s41467-026-72835-5

J Robot Surg. 2026 May 12;20(1):484. doi: 10.1007/s11701-026-03423-4.

ABSTRACT

Aims to clarify the role of robotic-assisted system in hysterectomies for benign and malignant conditions and offer strong evidence for choosing the best surgical approach. A retrospective study enrolled 4821 hysterectomy and radical hysterectomy cases post-robotic surgery introduction. Cases were categorized by disease status (benign or malignant) and surgical approach. Time-series analysis assessed annual trends in surgical approaches, and propensity score matching compared surgical outcomes to minimize bias. Over the past decade at our center, the use of robotic surgery for all benign and malignant hysterectomies increased from 6.1% to 38.2%. Among patients with cervical cancer, the robotic surgery utilization rate increased from 12.5% to 55.9% by 2024, and establishing this technique as a leading approach for cervical cancer alongside open surgery. While both robotic and laparoscopic approaches yield similar operative and complication outcomes, robotic surgery incurs an additional cost of 2.79 (thousand USD) for benign hysterectomies. However, for endometrial carcinoma with pelvic lymph node dissection, robotic surgery reduced operative time by 48.5 min (P < 0.05). In radical hysterectomy for cervical cancer, the robotic approach not only reduced operative time by 30 min (P < 0.05), but also significantly decreased intraoperative transfusions (2.5% vs 14.3%, P < 0.0001), unplanned reoperations (0.7% vs 3.9%, P = 0.021), surgical complications (25% vs. 40%, P = 0.0002), and major complications (3.6% vs 12.5%, P = 0.0001) compared to open surgery. Robotic-assisted systems are frequently used for hysterectomies, offering no benefit over laparoscopy for benign cases and being more costly. However, they shorten operative time in procedures involving pelvic lymph node dissection. Furthermore, in complex radical hysterectomies, they not only decrease operative time but also improve surgical outcomes, such as reducing blood transfusions, reoperations, and complications.

PMID:42115535 | DOI:10.1007/s11701-026-03423-4

J Gambl Stud. 2026 May 11. doi: 10.1007/s10899-026-10510-6. Online ahead of print.

ABSTRACT

This paper examines the impact of legalizing full-scale casino gaming on drug-related offenses in Hot Springs, Arkansas. While the state’s other casino-hosting cities-Pine Bluff and West Memphis-and the state of Arkansas as a whole have experienced a recent decline in drug-related offenses, Hot Springs has seen a notable increase. This research utilizes the synthetic control method to analyze city-level data from 2011 to 2024, comparing Hot Springs to a counterfactual “synthetic” city. This counterpart is constructed from a weighted combination of non-casino Arkansas cities, matched on pre-existing crime trajectories and socioeconomic predictors. Our findings indicate that Hot Springs experienced a statistically significant increase in drug arrests following the transition to full casino gaming in April 2019. By 2023 and 2024, the drug arrest rate in Hot Springs was approximately double that of its synthetic counterpart. We conclude that the social costs of gaming expansion are context-dependent. In Hot Springs, the increase may be driven by its status as a growing resort destination, where a high volume of transient visitors creates an anonymous environment conducive to illicit transactions.

PMID:42115532 | DOI:10.1007/s10899-026-10510-6

Hear Res. 2026 May 8;477:109654. doi: 10.1016/j.heares.2026.109654. Online ahead of print.

ABSTRACT

BACKGROUND: While Auditory Brainstem Response (ABR) provides a non-invasive window into auditory brainstem function, prior studies of ASD have primarily focused on localized waveform features (e.g., waves I, III, and V), potentially overlooking subtle but informative patterns in the full-band signal. This study introduces a deep learning framework to comprehensively characterize time-frequency signatures of auditory brainstem activity in ASD, with the goal of identifying neurophysiologically meaningful ABR features associated with ASD.

METHODS: We analyzed a clinical dataset of 1209 ABR recordings (ASD: 961; Typically Developing Controls: 248). A dual-branch Time-Frequency Fusion and Transformer-Based Network (TF-TBN) was developed. The temporal branch utilizes a Transformer-enhanced 1D-CNN to analyze raw ABR waveforms, while the frequency branch employs a Vision Transformer to analyze spectrograms generated via Continuous Wavelet Transform. A fusion module integrates these features for final classification. Model interpretability was analyzed to identify critical ABR features.

RESULTS: The TF-TBN model achieved a classification accuracy of 96.62%, significantly outperforming conventional deep learning baselines. Interpretability analysis revealed that the model’s decision was heavily influenced by prolonged absolute latencies of waves III and V, and interpeak latencies of I-III and I-V, which were confirmed as statistically significant in the ASD cohort. This suggests that the model successfully learned biologically plausible biomarkers of auditory pathway dysfunction.

CONCLUSIONS: This study provides the first comprehensive characterization of full-band ABR abnormalities in ASD using a deep learning framework. The TF-TBN model identifies prolonged wave III- and wave V-related timing features as prominent contributors to ASD-TD discrimination, with wave III-related delay emerging as an important component of the observed ABR abnormality. By linking AI-driven feature discovery to interpretable neurophysiological biomarkers, our work advances the analytical framework for ABR and contributes to understanding the neural basis of auditory processing deficits in ASD.

PMID:42114179 | DOI:10.1016/j.heares.2026.109654

J Pediatr Urol. 2026 Apr 27;22(4):105979. doi: 10.1016/j.jpurol.2026.105979. Online ahead of print.

ABSTRACT

INTRODUCTION: Hypospadias is a common congenital malformation with a complex etiology involving genetic susceptibility and environmental factors. MicroRNAs (miRNAs), as epigenetic modulators, are hypothesized to bridge these factors by regulating genes essential for urogenital development. The aim of this study was to investigate the expression profiles of specific miRNAs associated with AR, ESR1, and FGFR2 genes in both tissue and systemic circulation (blood) of children with hypospadias compared to healthy controls, to evaluate their potential as epigenetic footprints.

METHODS: The study included 20 boys undergoing surgical repair for isolated hypospadias and 20 age-matched healthy boys undergoing routine circumcision. Preoperative venous blood and intraoperative foreskin tissue samples were collected from all participants. The expression levels of miR-203a-3p, miR-210, miR-218-5p, miR-22-3p, miR-302c-3p, miR-355-5p, and miR-488-5p were analyzed using quantitative Real-Time PCR (qRT-PCR).

RESULTS: In tissue samples, no statistically significant differences were observed in miRNA expression between the hypospadias and control groups. However, significant dysregulation was detected in blood samples. miR-203a-3p was significantly upregulated, while miR-210, miR-218-5p, miR-22-3p, miR-302c-3p, miR-355-5p, and miR-488-5p were significantly downregulated in the hypospadias group compared to controls. Furthermore, a significant source-dependent difference (tissue vs. blood) was observed exclusively within the patient group, whereas tissue and blood levels were similar in healthy controls.

DISCUSSION: The discrepancy between tissue and blood results suggests that while local tissue expression may normalize postnatally, the systemic circulation retains a distinct profile of these epigenetic modulators. These findings demonstrate that circulating miRNAs are significantly dysregulated in hypospadias patients, suggesting a potential association with systemic responses to developmental disruptions, rather than establishing a direct etiology.

CLINICAL/TRANSLATIONAL APPLICABILITY: This study demonstrates that specific circulating miRNA profiles are altered in hypospadias, suggesting a potential association with systemic epigenetic modulations rather than localized defects. These preliminary data provide a foundation for future comprehensive studies to explore their roles in developmental anomalies.

PMID:42114169 | DOI:10.1016/j.jpurol.2026.105979

Prosthet Orthot Int. 2026 May 6. doi: 10.1097/PXR.0000000000000518. Online ahead of print.

ABSTRACT

BACKGROUND: A better understanding of the abilities and difficulties of children with unilateral congenital below-elbow deficiency, and the functional abilities they would like to improve by using a bionic prosthesis would inform the development and prescription of bionic prostheses.

OBJECTIVES: This study aimed to describe the functional abilities and desires for bionic prosthetic assistance of children with unilateral congenital below-elbow deficiency.

STUDY DESIGN: Preliminary, retrospective, cross-sectional, observational single-centre study.

METHODS: Eight children with unilateral congenital below-elbow deficiency were included (7 girls and 1 boy), with a median (Q1-Q3) age of 10.6 (10.1-11.4) years. We used the Disabilities of the Arm Shoulder and Hand Questionnaire to assess difficulties with activities of daily living and the Canadian Occupational Performance Measure to determine the child’s needs and desires in terms of a bionic prosthesis. Descriptive statistics were conducted.

RESULTS: The children were able to perform most activities of daily living but had difficulty with bimanual tasks. Most limitations related to schoolwork. The children described 35 significant activities that they desired a bionic prosthesis to facilitate: 15 related to leisure/sports, 5 to productivity and 15 to self-care activities.

CONCLUSIONS: Children with unilateral congenital below-elbow deficiency can perform many activities of daily living and sports and leisure activities without a prosthesis; however, they desire to improve their performance of these activities. Activities that are of particular importance to them include personal care and sports and leisure activities.

PMID:42114153 | DOI:10.1097/PXR.0000000000000518

JMIR Cancer. 2026 May 11;12:e89954. doi: 10.2196/89954.

ABSTRACT

BACKGROUND: About 4 in 10 people in Sweden get cancer during their lifetime, and approximately half of them will be diagnosed during their working life. As cancer survival rates improve, a growing number of individuals face challenges in returning to work following treatment. This increases the demand for effective return-to-work (RTW) strategies. Despite existing rehabilitation frameworks, cancer survivors often encounter barriers to sustainable work reintegration.

OBJECTIVE: This study aimed to investigate stakeholders’ perceptions of facilitators and barriers to RTW among cancer survivors, including factors promoting work-related well-being during the RTW process.

METHODS: During the development phase of a work-oriented rehabilitation intervention, semistructured interviews were conducted, with 25 stakeholders involved in the RTW process: health care professionals (n=12), social insurance officers (n=7), employers (n=5), and an employment service agency officer (n=1). Data were analyzed using qualitative content analysis.

RESULTS: Five overarching themes were identified that influenced RTW: collaboration and clear division of responsibilities, balancing individual adaptations, reducing structural barriers through support, views and expectations of the individual regarding RTW, and the emotional significance of work. Key facilitators included flexible work arrangements, individualized adaptations, a strong desire to work, and the emotional value of work. Barriers comprised lack of collaboration among stakeholders, particularly the absence of a clear division of responsibilities, as well as structural barriers, such as sick leave bureaucracy and financial obstacles. The role of rehabilitation coordinators was highlighted as pivotal in bridging gaps between stakeholders and ensuring continuity in care.

CONCLUSIONS: RTW for cancer survivors is a complex, multifactorial process requiring coordinated efforts across health care, insurance, and employment sectors. Enhancing collaboration, clarifying stakeholder responsibilities, and implementing flexible, individualized support structures are essential to facilitating cancer survivors’ RTW. Additionally, including a designated coordinator in the process is proposed. More support during the early phase of RTW is necessary to reduce the risk of long-term labor market exclusion. To help cancer survivors’ RTW, clear role definitions and shared responsibilities among stakeholders are essential. Flexibility in the RTW process helps individuals reintegrate at their own pace, reduces isolation, and promotes social connection. These are key considerations for future policies and support measures.

PMID:42114136 | DOI:10.2196/89954