Category: Statistics

Lifetime Data Anal. 2026 Jun 5;32(3):38. doi: 10.1007/s10985-026-09696-z.

ABSTRACT

Assessing causal treatment effect on a time-to-event outcome and identifying important risk factors that contribute to the outcome of interest are crucial in many scientific studies. Although existing instrumental variable (IV) methods can address the endogenous treatment selection and yield an unbiased causal treatment effect estimate in the presence of censoring, the corresponding variable selection technique has not been investigated. In this paper, we propose a variable selection method for a wide class of causal semiparametric transformation models with all-or-nothing treatment compliance and right-censored data. Specifically, the minimum information criterion is embedded in the optimization step of the proposed expectation-maximization algorithm, rendering sparse estimators of the complier causal treatment effect and other regression parameters. The asymptotic properties of our method are established, including consistency and oracle property. Extensive simulation studies are conducted to evaluate the finite sample performance of the proposed method. An application to a colorectal cancer screening dataset is provided.

PMID:42247097 | DOI:10.1007/s10985-026-09696-z

Ir J Med Sci. 2026 Jun 5. doi: 10.1007/s11845-026-04449-1. Online ahead of print.

ABSTRACT

BACKGROUND: Glioblastoma is the most common malignant brain tumour in adults and carries a poor prognosis despite advances in molecular characterisation and therapy. The 2021 World Health Organisation classification redefined glioblastoma as an IDH-wildtype diffuse astrocytic tumour with aggressive histological or molecular features. Standard of care therapy has changed little over the last two decades, and outcomes remain suboptimal, with considerable heterogeneity in survival influenced by clinical, molecular, and treatment-related factors.

AIMS: This study evaluates the clinical and molecular characteristics, treatment strategies, and survival outcomes for glioblastoma patients at Cork University Hospital from 2006-2023 to assess changes in management and outcomes.

METHODS: 494 patients were diagnosed with glioblastoma between 1st of January 2006 and 31st of December 2023. IDH mutant cases were excluded. Data was extracted from medical records, with survival analyses using the Kaplan-Meier method and COX proportional hazards model.

RESULTS: The median age was 63 years (range: 17-86). Increased availability of molecular markers was observed between the time periods. Median overall survival remained stable over time (2006-2010: 9.9 months; 2011-2014: 11.9 months; 2015-2019: 10.9 months; 2020-2023: 11.1 months), with no statistical significance between periods. On multivariate analysis, key prognostic factors included age at diagnosis, ECOG performance status, glucocorticoid use at baseline, MGMT methylation status, and completion of the adjuvant chemo-radiation.

CONCLUSIONS: Despite advances in our understanding of the pathogenesis of glioblastoma, the mOS median overall survival in our real-world patient cohort did not improve over time. The findings emphasise the need for ongoing research efforts to improve outcomes in this lethal disease.

PMID:42247092 | DOI:10.1007/s11845-026-04449-1

Intern Emerg Med. 2026 Jun 5. doi: 10.1007/s11739-026-04419-6. Online ahead of print.

ABSTRACT

Gallstones are a common digestive disorder whose development is influenced by abnormal liver function, metabolic disorders, and inflammatory states. The albumin-bilirubin (ALBI) score is a comprehensive indicator for assessing liver function and has been widely applied in liver cancer and chronic liver diseases; however, its association with gallstones remains unclear. This study analyzed NHANES data from 2017 to 2020, including 6332 adult participants. Survey-weighted multivariable logistic regression was performed to assess the association between ALBI and gallstone prevalence. Furthermore, the dose-response relationship was examined using restricted cubic spline (RCS) modeling. Subgroup analyses were conducted to assess the robustness of this association across different demographic and clinical strata. In addition, an exploratory mediation analysis was performed to examine whether body mass index (BMI) statistically accounted for part of the observed association between ALBI and gallstone prevalence. Multivariable logistic regression indicated that higher ALBI was associated with higher odds of gallstone prevalence (OR = 2.670, 95% CI: 1.778 – 4.008, P = 0.001). RCS analysis indicated that the relationship between ALBI and gallstones is approximately linear (P-overall < 0.0001, P-nonlinearity = 0.7779). The results of the subgroup analyses were consistent and robust. Exploratory mediation analysis suggested that BMI statistically accounted for 23.95% of the observed association between ALBI and gallstone prevalence in the mediation model. Higher ALBI levels were associated with a higher prevalence of gallstones, showing an approximately linear dose-response pattern. BMI statistically accounted for part of this association in exploratory mediation models, but this finding should not be interpreted as evidence of causal mediation given the cross-sectional design. Because gallstone status was self-reported, these findings should be interpreted with caution. Prospective studies are warranted to clarify temporal relationships, validate these associations, and determine whether ALBI provides clinically meaningful information beyond established gallstone risk factors.

PMID:42247086 | DOI:10.1007/s11739-026-04419-6

Jpn J Radiol. 2026 Jun 5. doi: 10.1007/s11604-026-02024-3. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to investigate alterations in white matter microstructure in children with Tourette syndrome (TS) and to explore its potential role in pathophysiology.

METHODS: Diffusion tensor imaging data were collected from 53 children with TS and 91 typically developing controls. White matter integrity was assessed and analyzed using fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD). Correlations with tic severity and quality of life (QOL) were examined, followed by mediation analysis to assess whether motor tic severity mediated the relationship between FA values in the right anterior corona radiata (ACR_R) and QOL.

RESULTS: Children with TS exhibited widespread white matter alterations, lower FA in ACR_R and left anterior limb of the internal capsule, lower MD in the inferior fronto-occipital fasciculus, and lower AD in ACR_R, alongside higher MD in the genu of the corpus callosum, higher AD in the inferior fronto-occipital fasciculus, and higher RD in ACR_R. The FA values in ACR_R showed a significant negative correlation with motor tic severity (r = – 0.302, P = 0.031) and a significant negative correlation with physical/activities of daily living (ADL) subscale of QOL (r = – 0.468, P < 0.001). Motor tic severity was positively correlated with physical/ADL subscale of QOL (r = 0.430, P = 0.008). Motor tic severity partially mediated the relationship between FA values in ACR_R and physical/ADL scores (β = – 0.091, 95% CI [- 0.208, – 0.016]).

CONCLUSIONS: These findings suggest that impaired white matter microstructure may be associated with the pathophysiology of TS, and that future interventions may benefit from simultaneously addressing neural circuit integrity and symptom management.

PMID:42247083 | DOI:10.1007/s11604-026-02024-3

Jpn J Radiol. 2026 Jun 5. doi: 10.1007/s11604-026-02021-6. Online ahead of print.

ABSTRACT

PURPOSE: Large language models (LLMs) are increasingly integrated into radiology workflows, but their demographic biases have not been evaluated in diagnostic radiology. This study aimed to investigate racial and sex biases in the diagnostic performance of LLMs (text-only and vision models) in radiology and to evaluate whether prompting strategies mitigate these biases.

MATERIALS AND METHODS: This retrospective study included consecutive Diagnosis Please cases published in Radiology from April 1998 to October 2024, excluding cases with sex-specific diseases. For each case, eight race-sex scenarios were generated by altering four race/ethnicity categories (Asian, Black, Hispanic, White) and two sex categories (male, female). Three LLMs (GPT-5, Claude Sonnet 4.5, Gemini 2.5 Flash) were evaluated as text-only models (medical history and imaging findings) and vision models (medical history and images) using three prompting strategies (basic, self-consistency, chain-of-thought prompting). Generalized estimating equations were used to compare diagnostic accuracy across race/ethnicity, sex, and prompting strategies.

RESULTS: A total of 286 cases were included. Across models and conditions, ten significant race-related and four significant sex-related differences in diagnostic accuracy were observed. Among the four race/ethnicity groups, Black patients were most likely to have significantly lower accuracy (four of the ten statistically significant race-related comparisons [40%]) and least likely to have significantly higher accuracy (1/10 [10%]). Vision models with female patients under basic prompting showed a higher number of significant race-related differences (6/10 [60%]) than vision models with male patients and all text-only models. Text-only and vision models showed no statistically significant differences in diagnostic accuracy across prompting strategies (p = 0.78 and 0.95, respectively); basic and self-consistency prompting produced ten and four significant race- or sex-related differences, respectively, whereas no significant differences were observed with chain-of-thought prompting.

CONCLUSION: Large language models exhibited racial and sex biases in diagnostic radiology, and chain-of-thought prompting may help mitigate these biases.

PMID:42247082 | DOI:10.1007/s11604-026-02021-6

AIDS Behav. 2026 Jun 5. doi: 10.1007/s10461-026-05149-8. Online ahead of print.

ABSTRACT

Thoughts of death or self-injury and the clinical implications of such thoughts remain largely underassessed among people with HIV (PWH) in Africa. As strong predictors of suicidal ideation and death by suicide, it is paramount to understand these risk indicators, particularly in populations with heightened susceptibility to poor mental health. We aimed to characterize thoughts of death or self-injury (i.e., self-injurious thoughts) and their relationship with non-same-day (i.e., delayed) anti-retroviral treatment (ART) initiation and longitudinal disengagement from clinic in a cohort of PWH newly entering HIV care in Cameroon. We conducted structured interviews with PWH aged 21 + initiating clinical care between June 2019 and March 2020. Clinical records were used to ascertain ART initiation date and disengagement from the clinic across two years following care initiation. Log binomial regression was used to estimate the association between self-injurious thoughts at care initiation and delayed ART initiation. A Fine and Gray sub-distribution proportional hazards model was used to quantify the cumulative incidence of disengagement from the clinic (i.e., a gap in clinic visits > 183 days) and differences in these estimates across groups. Of 426 enrolled individuals, seventy-one (16.7%) endorsed self-injurious thoughts at entry into care, 24 (33.8%) of whom had active thoughts of self-injury. Self-injurious thoughts at entry into care were positively associated with delayed ART initiation (adjusted prevalence ratio = 1.8; 95% CI: 1.2, 2.9) and cumulative incidence of disengagement from clinic, though differences in disengagement were statistically non-significant. Interventions are urgently needed to support the mental health and well-being of PWH entering care and improve down-stream HIV treatment outcomes.

PMID:42247071 | DOI:10.1007/s10461-026-05149-8

Mol Biol Rep. 2026 Jun 5;53(1):893. doi: 10.1007/s11033-026-12056-7.

ABSTRACT

BACKGROUND: Lipopolysaccharide (LPS)-induced sepsis is one of the leading causes of acute kidney injury (AKI). Gallic acid (GAL), a natural polyphenolic compound, exhibits potent antioxidant, anti-inflammatory, and cytoprotective properties. This study aimed to investigate the renoprotective effects of GAL.

METHODS: Thirty-two adult male Wistar rats were randomly divided into four groups (n = 8): Control, LPS (5 mg/kg, i.p.), LPS + GAL (100 mg/kg i.p. administered immediately before LPS), representing a preventive treatment design and GAL-alone. Renal tissues were examined histologically using hematoxylin-eosin staining and toll-like receptor 4(TLR4), nuclear factor kappa B(NF-κB), and interleukin-1 beta (IL-1β) immunoexpression by immunohistochemical staining. mRNA expression levels of sirtuin 1(SIRT1), adenosine monophosphate-activated protein kinase(AMPK), forkhead box O3(FOXO3), phosphoinositide 3-kinase (PI3K), protein kinase B(AKT1), glutathione peroxidase 4(GPX4), aquaporin 4 (AQP4), glycogen synthase kinase-3 beta(GSK3β) were assessed. Serum creatinine (CRE) and urea levels were analyzed to determine renal functional status.

RESULTS: LPS administration caused marked renal injury, characterized by severe hyperemia, hemorrhage, tubular necrosis, and increased TLR4, NF-κB, and IL-1β expression. GAL treatment attenuated these changes, with a significant reduction only in hyperemia scores, while decreases in hemorrhage, neutrophil infiltration, and necrosis remained nonsignificant. GAL administration was associated with reversal of the LPS-related decrease in PI3K, AKT1, AMPK, FOXO3, SIRT1, GPX4 and AQP4 mRNA expression, along with reduced GSK3β mRNA expression. Serum CRE levels improved with GAL, whereas the urea reduction was not statistically significant.

CONCLUSION: GAL showed a renoprotective effect in this preventive model of LPS-induced AKI and was associated with reduced inflammatory marker expression together with favorable changes in PI3K/AKT1/FOXO3/SIRT1-related mRNA profiles. These findings suggest that GAL may have prophylactic against early endotoxin-associated renal injury.

PMID:42247065 | DOI:10.1007/s11033-026-12056-7

J Phys Condens Matter. 2026 Jun 4. doi: 10.1088/1361-648X/ae7886. Online ahead of print.

ABSTRACT

We present a combined light-scattering methodology for the ensemble-averaged characterization of bacterial morphology and size distributions directly in aqueous suspension. The approach integrates heterodyne near-field scattering with three-dimensional cross-correlation dynamic light scattering, providing continuous access to the scattered intensity over an extended range of scattering vectors. This configuration enables simultaneous probing of length scales associated with both the axial and radial dimensions of bacterial cells. The measured intensity profiles exhibit form-factor features characteristic of spherocylindrical particles, including oscillatory behavior arising from finite particle geometry. To interpret the experimental data, the bacterial population is modeled as a polydisperse ensemble of randomly oriented spherocylinders. Orientational averaging and population heterogeneity are explicitly incorporated into the scattering model, allowing quantitative extraction of distributions of cell length and radius for multiple bacterial strains. The calculated form factors show good agreement with experimental measurements across the full scattering range, demonstrating sensitivity to both axial and transverse polydispersity. These results establish the combined scattering framework as a statistically robust method for characterizing bacterial morphology in suspension. The approach complements microscopy-based measurements and provides a quantitative experimental basis for physical modeling of bacterial systems relevant to biomedical, environmental, and industrial contexts.

PMID:42246133 | DOI:10.1088/1361-648X/ae7886

Psychogeriatrics. 2026 Jul;26(4):e70187. doi: 10.1111/psyg.70187.

ABSTRACT

BACKGROUND: Population ageing is accompanied by increasing exposure to psychosocial challenges, including age-related stereotypes and stigma. Internalized age-related stigma has emerged as an important psychosocial factor associated with mental health and well-being among older adults. However, empirical evidence examining its associations with well-being, quality of life, depressive symptoms and perceived social support remains limited, particularly in non-Western cultural contexts.

METHODS: This cross-sectional quantitative study included 139 adults aged 65 years and older attending an internal medicine outpatient clinic. Cognitive eligibility was assessed using the revised Turkish version of the Mini-Mental State Examination. Data were collected through face-to-face interviews. Measures included the Internalized Stigma of Ageing Scale (ISAS), WHO-5 Well-Being Index, Geriatric Depression Scale (GDS-15), WHO Quality of Life-AGE (WHOQOL-AGE), Multidimensional Scale of Perceived Social Support (MSPSS), and the Attitudes Towards Ageing Questionnaire. Statistical analyses comprised t-tests, one-way analysis of variance, Pearson correlation and hierarchical multiple linear regression.

RESULTS: Participants demonstrated moderate levels of internalized age-related stigma. Internalized stigma was significantly higher among participants who were unemployed and those living alone or with adult children. Internalized stigma was negatively associated with well-being, quality of life and perceived social support, and positively associated with depressive symptoms. Regression analyses indicated that lower well-being, poorer quality of life, higher depressive symptoms and lower perceived social support were significantly associated with higher internalized stigma.

CONCLUSIONS: Internalized age-related stigma is a significant psychosocial correlate of mental well-being and quality of life in later life. Interventions targeting psychological well-being and social support may play a role in mitigating stigma-related vulnerability in later life.

PMID:42246113 | DOI:10.1111/psyg.70187

J Health Polit Policy Law. 2026 Jun 5:12650571. doi: 10.1215/03616878-12650571. Online ahead of print.

ABSTRACT

CONTEXT: Arguably, the most pressing issues in Medicare financing today center on Medicare Advantage (MA). Rising MA enrollment may lower TM spending via a spillover effect wherein cost-efficient practices in MA are applied to TM enrollees. At the same time, growing MA enrollment results in a shrinking share of TM enrollees, raising concerns about how MA plans are reimbursed, since MA payments and rebates depend, in part, on average TM spending.

METHODS: This study estimates the effect of MA enrollment shares on per-enrollee TM spending using county-level CMS data. TM spending is the product of three factors: a local price index for TM services, average price- and risk-adjusted spending per enrollee (“quantity” of services used), and average TM risk scores. We estimate the effect of MA enrollment shares on each factor.

FINDINGS: Increased MA enrollment is associated with a statistically significant reduction in TM price- and risk-adjusted spending. MA enrollment is linked to reduced outpatient service use and reduced use of procedures, tests, imaging, durable medical equipment, and ambulance services among TM enrollees.

CONCLUSIONS: Reduced spending in TM from rising MA enrollment is a form of Medicare savings that offsets, to a small degree, the substantial estimated overpayments made to MA plans.

PMID:42246093 | DOI:10.1215/03616878-12650571