Category: Statistics

Pain Rep. 2026 Jan 16;11(1):e1401. doi: 10.1097/PR9.0000000000001401. eCollection 2026 Feb.

ABSTRACT

INTRODUCTION: A history of childhood maltreatment (CM) and trauma-related symptoms has been associated with the development of pain conditions. Individuals raised in Residential Youth Care (RYC) often report significant exposure to CM, high rates of posttraumatic stress disorder (PTSD), and an increased risk for various adverse health outcomes, making them a high-risk group for pain symptoms. Objectives: This study examines the role of CM, trauma, and symptoms of PTSD and dissociation for pain indicators.

METHODS: As part of the 10-year follow-up project, N = 157 individuals (68.15% women) with a history of RYC were recruited. Pain symptoms were assessed using standardized questions from a large-scale population-based study in Norway, recording headache, pain lasting at least 3 months, pain intensity, as well as continuous muscle and joint pain. Childhood maltreatment was measured using the Maltreatment and Abuse Chronology of Exposure scale, and dissociative symptoms through self-report online survey. Trauma load and symptoms of PTSD were evaluated using clinician-administered interviews based on the PTSD Checklist, aligned with Diagnostic and Statistical Manual of Mental Disorders-5 criteria.

RESULTS: We confirmed associations between CM, trauma load and pain intensity, and body pain distribution in a high-risk group, while we did not find associations for headache. Symptoms of PTSD and dissociation predominantly mediated the relationship between CM/trauma load and pain symptoms.

CONCLUSION: A history of CM and trauma-related symptoms are crucial for understanding pain symptoms in individuals transitioning to adulthood after RYC. Posttraumatic stress disorder and dissociation symptoms may contribute to development and exacerbation of pain symptoms and may be a target for intervention.

PMID:41562117 | PMC:PMC12815552 | DOI:10.1097/PR9.0000000000001401

JSES Int. 2025 Dec 2;10(2):101420. doi: 10.1016/j.jseint.2025.101420. eCollection 2026 Mar.

ABSTRACT

BACKGROUND: The supraspinatus plays a critical role in stabilizing the glenohumeral joint and facilitating arm elevation. The biomechanical disruption caused by supraspinatus tears changes the normal force couple balance between the deltoid and rotator cuff muscles, often resulting in superior migration of the humeral head and altered scapulohumeral rhythm (SHR). This study aims to prospectively compare the shoulder kinematics of patients preoperatively and after arthroscopic rotator cuff repair using magnetic inertial measurement units with a motion analysis system.

METHODS: A prospective study was conducted with data collection on 21 patients who underwent shoulder arthroscopy for rotator cuff tear repair. Preoperatively and at a minimum 12-month follow-up, each patient was evaluated using the range of motion (ROM) assessment and the Constant-Murley Score (CMS). Patients were examined using the ShowMotion 3D kinematic tracking system (NCS Lab, Modena, Italy), which uses wireless wearable noninvasive magnetic and inertial measurement units sensors to assess the three-dimensional kinematics of the shoulder. For each plane of elevation (ie, flexion and abduction), the SHR was described by 3 scapulothoracic rotations (ie, protraction-retraction, mediolateral rotation, and posterior-anterior tilting) as a function of humeral anteflexion or humeral abduction.

RESULTS: Active flexion and external rotation ROM showed statistically significant improvement (P = .039 and P = .006, respectively). CMS pain, strength, and total showed statistically significant improvement (P = .039 and P = .006, respectively). All the patients showed a nonstatistically significant difference of the SHR along the entire ROM between pre- and postoperative evaluation. The P value in flexion and abduction was >.05; the only statistically significant value was on tilt at 60° in flexion (P = .044).

CONCLUSION: A persistent scapular dyskinesis was observed after arthroscopic rotator cuff repair. Despite a statistically significant improvement reported for active flexion, active external rotation, and for the total CMS, scapular dyskinesis is not resolved with surgery and may contribute to worse long-term outcomes. Further biomechanical and clinical research studies are needed to define specific rehabilitation programs, to maximize outcomes, and to prevent possible cause of reinjury of the rotator cuff repaired.

PMID:41562109 | PMC:PMC12814056 | DOI:10.1016/j.jseint.2025.101420

JSES Int. 2025 Dec 2;10(2):101415. doi: 10.1016/j.jseint.2025.101415. eCollection 2026 Mar.

ABSTRACT

BACKGROUND: As surgical technologies, such as three-dimensional preoperative planning, computer navigation, and augmented reality, become increasingly utilized in shoulder arthroplasty, questions remain about their value from the patient’s perspective. While education and patient interest have driven demand and technology adoption in hip and knee arthroplasty, their role in shoulder procedures remains unclear. This study aimed to evaluate patient perceptions of innovative technologies in shoulder arthroplasty and assess whether preoperative education influences confidence, satisfaction, and expectations.

METHODS: In this prospective observational study, 87 patients scheduled to undergo shoulder arthroplasty at a single institution completed a preoperative survey assessing demographics, baseline familiarity with surgical technologies, and perceptions of surgeon use of innovative tools prior to seeing their provider. Following this, patients then viewed a standardized educational video on the role of technology in shoulder arthroplasty. Postvideo responses measured changes in confidence, satisfaction, and outcome expectations. Statistical analysis included paired t-tests and analysis of variance to evaluate prepost changes and demographic associations.

RESULTS: Over half of patients (56.3%) were unfamiliar with innovative technologies at baseline, yet 60.9% reported increased confidence in surgeons using it. Most patients (66.7%) preferred the use of advanced planning technologies, though only 41.5% would choose a low-volume surgeon using these tools over a high-volume surgeon using conventional techniques. Improvements in confidence were significantly correlated with higher education and income levels (r = 0.31, P = .003). After viewing an educational video, patient confidence in their surgeon increased (P = .03), and expectations for improved outcomes (P < .001), fewer complications (P < .001), less pain (P < .001), and faster recovery (P < .001) significantly rose. Despite favorable perceptions, 62.1% of patients were unwilling to pay more, travel further, or wait longer to receive care involving innovative technologies.

CONCLUSION: Targeted preoperative education on surgical technology may improve patient confidence, strengthen perceptions of surgeon competency, and elevate expectations of care. While enthusiasm for advanced tools was observed following education, broader adoption may still be influenced by cost and accessibility. These findings support the role of brief, technology-focused education in enhancing the overall patient experience in shoulder arthroplasty.

PMID:41562108 | PMC:PMC12814059 | DOI:10.1016/j.jseint.2025.101415

JSES Int. 2025 Dec 1;10(2):101411. doi: 10.1016/j.jseint.2025.101411. eCollection 2026 Mar.

ABSTRACT

BACKGROUND: A common concern of patients after rotator cuff repair is when they can drive. The purpose of this study is to evaluate the activation of the rotator cuff while driving to help guide surgeon recommendations.

METHODS: A computerized driving simulator was used by 16 volunteers who performed a series of turns with their hands in different positions on the steering wheel. Muscle activity of the supraspinatus, infraspinatus, and biceps was recorded using electromyography. Muscle activity was also recorded while closing the door, fastening the seat belt, and turning a key in the ignition and quantified by a board-certified electromyographer.

RESULTS: For the right supraspinatus, infraspinatus, and biceps muscles, there was statistically significant higher level of activation when the right hand was in the 12 o’clock position and the 3 o’clock position as compared with the 6 o’clock positions. This was the same for the left side with the left hand in the 12 o’clock and 9 o’clock positions compared to the 6 o’clock positions (P < .003). Activity of all muscles was minimal when the car door was closed with the opposite hand. Fastening the seat belt and turning the key in the ignition also demonstrated rotator cuff activation.

CONCLUSION: Rotator cuff activity during driving can be minimized by closing the door using the nonoperative arm and driving with the nonoperative arm in the 12 o’clock position with the operative arm at the side and holding the wheel at the 6 o’clock position.

PMID:41562106 | PMC:PMC12814054 | DOI:10.1016/j.jseint.2025.101411

Front Immunol. 2026 Jan 5;16:1717935. doi: 10.3389/fimmu.2025.1717935. eCollection 2025.

ABSTRACT

INTRODUCTION: The manipulation of the gut microbiota of disease vectors has emerged as a new approach to use in the integrated control of vector-borne diseases. For this purpose, a deep knowledge of their gut microbial communities is essential. To our knowledge, to date, no study has documented the gut microbiome dynamics of Phlebotomus duboscqi sand flies over the entire time-period required for the maturation of a Leishmania infection. Here, we address this limitation.

METHODS: P. duboscqi midguts were dissected both before and at different days after L. major infection and subjected to genomic DNA extraction followed by amplification of the V3-V4 hypervariable regions of the 16S rRNA, sequencing, and metagenomics analysis.

RESULTS: We observed a decrease in the number of Amplicon Sequence Variants (ASVs) early after infection, at D2, and late after infection, at D12. More so Sphingomonas, Ochrobactrum, and Serratia emerged as the most prevalent genera in relative terms, before, early after, and late after infection, respectively. These results translated into a separation between the 3 groups in the context of a beta diversity analysis, with statistical relevance. Importantly, we were able to establish Corynebacterium spp. and Enterococcus spp. as potential markers of non-infected and infected sand flies, respectively, as well as Streptococcus spp., Sphingomonas spp., Ralstonia spp., and Abiotrophia spp. as potential specific markers of late infections (ANCOM-BC analysis).

DISCUSSION: Overall, we show that the composition of the gut microbiota of P. duboscqi sand flies changes significantly over the course of an infection with L. major parasites.

PMID:41562094 | PMC:PMC12812887 | DOI:10.3389/fimmu.2025.1717935

Front Immunol. 2026 Jan 5;16:1698271. doi: 10.3389/fimmu.2025.1698271. eCollection 2025.

ABSTRACT

INTRODUCTION: Long COVID (LC) is an infection-associated chronic condition and illness (IACCI) with no currently approved treatments. In order to address SARS-CoV-2 persistence and herpesvirus reactivation, which have been implicated as drivers of LC, sustained use of antiviral combinations may be useful in treating patients with the illness.

METHODS: A convenience sample of patients undergoing an extended course of antiviral therapy was studied. Patients received either 120 days of IMC-2 only (IO) or 120 days of IMC-2 with the addition of 15 days of Paxlovid (IP), prescribed off-label at an outpatient clinic for people with LC. The Patient Global Impression of Change (PGIC) was used to measure therapy response over time, with primary focus on fatigue and secondary focus on brain fog and dysautonomia. Visual analog scales (VAS) were also used to track perceived symptom improvements.

RESULTS: A total of 27 people with LC were approached for treatment, of whom 24 completed one or both protocols. Twelve received the IO protocol, and 12 received the continuous IP combination. Both groups reported reductions in fatigue on the PGIC, but participants receiving IP experienced a statistically significant improvement compared with those receiving IO (p < 0.0001). Similarly, using a VAS, patients in the IP group reported an average 55.3% (p < 0.0001) greater reduction in fatigue than the IO group. Participants who completed the IP intervention demonstrated durable clinical benefit, with symptom improvements remaining consistent at 120-, 305-, and 731-day follow-ups.

DISCUSSION: This small, open-label case series provides pilot evidence supporting the need for a larger trial of combination antivirals for people living with LC. Based on these results, a larger, controlled trial of IMC-2 paired with Paxlovid is recommended.

PMID:41562079 | PMC:PMC12812670 | DOI:10.3389/fimmu.2025.1698271

Front Immunol. 2026 Jan 5;16:1641260. doi: 10.3389/fimmu.2025.1641260. eCollection 2025.

ABSTRACT

AIM: This study aimed to evaluate serum visfatin levels in treated patients with Relapsing-Remitting Multiple Sclerosis (RRMS) (PwMS) receiving disease-modifying therapy (DMT) and in naive MS patients (nMS), and to investigate their association with clinical characteristics, treatment status, and disease activity, including NEDA-3 status.

METHODS: A total of 45 PwMS under treatment at least 1 year, 20 nMS patients, and 44 age- and sex-matched healthy controls (HC) were included. Clinical and demographic data were recorded. Serum visfatin, lipid profiles, inflammatory markers, and vitamin levels were measured. Visfatin levels were compared not only between treated and naive MS patients but also within the treated group according to NEDA-3 status and treatment type (first-line vs. second-line disease-modifying therapy). Statistical analyses were performed to assess group differences and correlations.

RESULTS: Visfatin levels differed significantly across the three groups (Kruskal-Wallis H = 19.701, p < 0.001). Pairwise comparisons revealed significant differences between all groups: the control group had higher visfatin levels than both the nMS (p < 0.001) and PwMS (p = 0.006). The treated group also showed higher visfatin levels compared to the naive MS group (p = 0.014). Among PwMS visfatin levels were lower than in healthy controls (p = 0.006). Among PwMS patients, those meeting the NEDA-3 criteria had lower visfatin levels and EDSS scores compared with non-NEDA patients (p = 0.008 and p = 0.006, respectively). No significant correlation was found between visfatin and relapse count or EDSS. LDL and total cholesterol levels were significantly higher in patients receiving fingolimod.

CONCLUSION: Across the three groups, visfatin levels differed significantly, with healthy controls showing the highest levels, followed by PwwMS, and the lowest levels observed in nMS patients. Lower serum visfatin levels in stable treated MS patients may reflect reduced inflammatory burden and effective immunomodulation. These findings suggest that visfatin could serve as a potential biomarker for treatment response in MS. Nevertheless, longitudinal studies including larger cohorts of naive patients are needed to clarify visfatin’s regulatory role in MS pathophysiology and its interaction with disease-modifying therapies.

PMID:41562070 | PMC:PMC12812522 | DOI:10.3389/fimmu.2025.1641260

Ann Appl Stat. 2025 Dec;19(4):3372-3393. doi: 10.1214/25-aoas2112. Epub 2025 Dec 5.

ABSTRACT

Major depressive disorder (MDD), a leading cause of disability and mortality, is associated with reward-processing abnormalities and concentration issues. Motivated by the probabilistic reward task from the Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) study, we propose a novel framework that integrates the reinforcement learning (RL) model and drift-diffusion model (DDM) to jointly analyze reward-based decision-making with response times. To account for emerging evidence suggesting that decision-making may alternate between multiple interleaved strategies, we model latent state switching using a hidden Markov model (HMM). In the engaged state, decisions follow an RL-DDM, simultaneously capturing reward processing, decision dynamics, and temporal structure. In contrast, in the lapsed state, decision-making is modeled using a simplified DDM, where specific parameters are fixed to approximate random guessing with equal probability. The proposed method is implemented using a computationally efficient generalized expectation-maximization (EM) algorithm with forward-backward procedures. Through extensive numerical studies, we demonstrate that our proposed method outperforms competing approaches across various reward-generating distributions, under both strategy-switching and non-switching scenarios, as well as in the presence of input perturbations. When applied to the EMBARC study, our framework reveals that MDD patients exhibit lower overall engagement than healthy controls and experience longer responses when they do engage. Additionally, we show that neuroimaging measures of brain activities are associated with decision-making characteristics in the engaged state but not in the lapsed state, providing evidence of brain-behavior association specific to the engaged state.

PMID:41562021 | PMC:PMC12814034 | DOI:10.1214/25-aoas2112

Res Vet Sci. 2026 Jan 13;202:106064. doi: 10.1016/j.rvsc.2026.106064. Online ahead of print.

ABSTRACT

Eucoleus aerophilus is a ubiquitous zoonotic nematode found in the tracheobronchial mucosa of the definitive hosts, described in wild and domestic canids, including the red fox (Vulpes vulpes). To assess E. aerophilus occurrence and intensity in red foxes, the respiratory system of 126 foxes from Region of Murcia (SE, Spain) were examined. Statistical analyses were performed to investigate the influence of biotic and abiotic factors on the parasite’s occurrence. The occurrence of E. aerophilus was 28.6% (95% CI: 20.6-36.4), with a mean intensity of 3.1 nematodes per parasitised fox. The infection rate and parasite intensity were higher in forested areas, suggesting that earthworm abundance and a longer survival of infective E. aerophilus eggs increase the risk of transmission and maintenance in the environment. Moreover, an inverse relationship between E. aerophilus occurrence and temperature (p < 0.05) was observed. Results demonstrated that foxes participate in maintaining the cycle of E. aerophilus in semi-arid Mediterranean environments. This should be taken into account at the wild-domestic-human interface. The development of a predictive model of E. aerophilus infection risk in red foxes will allow the design of future strategies for the prevention of capillariosis, especially in areas where contact between foxes, domestic carnivores, and humans exists.

PMID:41558101 | DOI:10.1016/j.rvsc.2026.106064

J Neurol Sci. 2026 Jan 17;481:125762. doi: 10.1016/j.jns.2026.125762. Online ahead of print.

ABSTRACT

Identifying accessible and reliable biomarkers for Alzheimer’s disease (AD) remains a major challenge, particularly in low- and middle-income countries. Phosphorylated tau at threonine 181 (p-tau181) measured in plasma has shown strong diagnostic performance, but its potential in saliva, a truly noninvasive biofluid, remains uncertain. This study compared plasma and salivary p-tau181 levels, assessed their agreement, and evaluated their diagnostic accuracy in a Latin American cohort. Eighty participants were clinically classified as cognitively unimpaired (CU, n = 25), mild cognitive impairment (MCI, n = 22), or Alzheimer’s dementia (AD, n = 33). Plasma and salivary p-tau181 concentrations were quantified using Single Molecule Array (Simoa) assays. Salivary p-tau181 levels were markedly higher than plasma levels (900.26 vs. 26.67 pg/mL; p < 0.001) but showed no correlation. Bland-Altman analysis revealed a mean bias of -1.56 with significant proportional bias (β = 0.73; p < 0.001), and Passing-Bablok regression confirmed the absence of a linear relationship between matrices. Plasma p-tau181 showed a numerical increase across the cognitive continuum, reaching statistically significant differences only when AD was compared with CU and MCI (AUC = 0.82; 95% CI 0.73-0.92), whereas salivary p-tau181 failed to discriminate clinical groups (AUC = 0.55, ns). These results demonstrate that plasma and salivary p-tau181 are not interchangeable and that current saliva-based quantification methods lack clinical reliability. This study provides the first evidence from Latin America supporting the diagnostic validity of plasma, but not salivary, p-tau181, and highlights the need for further investigation into pre-analytical and biological determinants of salivary biomarker variability.

PMID:41558095 | DOI:10.1016/j.jns.2026.125762