Category: Statistics

BMC Geriatr. 2026 Feb 12. doi: 10.1186/s12877-026-07059-9. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Alzheimer’s disease and related dementias (ADRDs) are prevalent conditions that are stressful and elevate emotional distress in couples after diagnosis. Without treatment, emotional distress may become chronic and negatively affect couples’ quality of life. We report results from an NIH Stage 1A open pilot of Resilient Together for Dementia (RT-ADRD), a novel, dyadic, skills-based intervention aimed at preventing chronic emotional distress in couples early after diagnosis. We describe results from our mixed-methods single arm feasibility study, including preliminary feasibility and acceptability of the intervention, and qualitative feedback from exit interviews. We also present exploratory analyses for change in outcomes and mechanisms of action.

METHODS: Six couples (N = 12 individuals) were recruited within six months of ADRD diagnosis by their diagnosing providers. Participants completed baseline assessments, participated in weekly RT-ADRD sessions together, then completed post-intervention assessments and one 60-min exit interview together.

RESULTS: RT-ADRD exceeded all a-priori feasibility and acceptability benchmarks (> 70%). Feedback from exit interviews suggested that participants had favorable impressions of the program and found the skills useful and relevant. Participants also offered perspectives on barriers and facilitators of engagement and program enhancement. In exploratory analyses, persons living with dementia exhibited significant reductions in perceived stress at post-intervention (p < .05; Cohens d > 0.8). Both persons living with dementia and their care partners exhibited statistically significant improvements in positive dyadic interactions measured by the Dyadic Relationship Scale (ps < .05); Cohens ds > 0.8).

CONCLUSIONS: RT-ADRD shows promise as a feasible and acceptable dyadic intervention delivered early after diagnosis. Results support a future NIH Stage 1B trial of RT-ADRD to establish definitive feasibility markers of both intervention and control before formal efficacy testing.

TRIAL REGISTRATION: This open pilot was registered on ClinicalTrials.gov (NCT06421545) on 05/20/2024.

PMID:41652334 | DOI:10.1186/s12877-026-07059-9

BMC Microbiol. 2026 Feb 6. doi: 10.1186/s12866-026-04789-z. Online ahead of print.

ABSTRACT

BACKGROUND: Preterm birth is the leading cause of death in children under five years of age worldwide. The association between preterm birth and long-term outcomes is vaguely known. In very preterm infants, the gut microbiome is highly variable and impacted by the neonatal intensive care unit environment. Our objective was to better understand the crosstalk between the gut microbiome and the host at one month of age in very preterm infants and its impact on neurological outcomes at two years of age. We performed a multi-omics analysis of fecal samples collected in 2011 from 73 very preterm French infants at one month of age, grouped according to their neurodevelopment assessed at two years of age using the Ages & Stages questionnaire. Multi-omics profiling and integrative analyses were performed between 2022 and 2023, including fecal microbiome, metabolome, and host transcriptome characterization using 16 S rRNA gene sequencing, LC-MS, and mRNA sequencing, respectively.

RESULTS: The gut microbiome of very preterm infants at one month is mostly driven by either Escherichia or Staphylococcus, which are differentially associated with host immune markers (CAMP), metabolomic pathways, notably the energy pathway due to the presence of various nicotinamide adenine dinucleotides (NAD+) and two-year neurodevelopmental outcomes.

CONCLUSION: The gut microbiome at one month of age could be a noninvasive biomarker of gut immaturity and metabolic defects. Escherichia and Staphylococcus proportions were found to be the best indicators of physiological maturity and immaturity, respectively. Escherichia may help the process of intestinal maturation in preterm infants through specific metabolites production and is associated with a better neurodevelopment.

PMID:41652328 | DOI:10.1186/s12866-026-04789-z

Thyroid. 2026 Feb 6:10507256261423184. doi: 10.1177/10507256261423184. Online ahead of print.

ABSTRACT

BACKGROUND: Iodine deficiency disorders (IDDs) remain a public health concern, especially in pregnancy, despite universal salt iodization (USI) programs. Iran has sustained iodine sufficiency since the 1990s through national USI, but recent evidence suggests recurrent iodine insufficiency among pregnant women. This study reports findings from the sixth National Monitoring Survey (2022-2023) to reassess iodine status in schoolchildren and pregnant women in Iran.

METHODS: This cross-sectional survey included 11,221 schoolchildren aged 8-10 years and 2929 pregnant women from all 31 provinces. Multistage cluster sampling ensured national representativeness for children. At the same time, pregnant women were recruited from health centers by equal provincial quotas (60 per province, not population-weighted), and their individual intake of iodide along with folic acid supplements was documented. Urinary iodine concentration (UIC) was measured using the Sandell-Kolthoff method, and salt iodine content was assessed by iodometric titration at production and household levels. Data were analyzed with descriptive and nonparametric statistical methods.

RESULTS: The median UIC in schoolchildren was 133 µg/L (interquartile range [IQR]: 88-183), within the World Health Organization (WHO)-recommended range, with 67.7% having UIC ≥100 µg/L. However, 22.8% had a UIC of 50-100 µg/L and 9.5% <50 µg/L. In pregnant women, the median UIC was 128 µg/L (IQR: 84-187), below the WHO threshold of 150 µg/L, with 61.2% having UIC <150 µg/L and 34.4% <100 µg/L. 73.7% of pregnant women used iodide + folic acid supplement, with wide provincial variation of 38-84%. Household salt median iodine content was 32 ppm, but 30.6% of samples were <20 ppm, and only 54% were stored properly. Production-level salt had a median iodine content of 33.8 ppm.

CONCLUSIONS: Although Iran has maintained iodine sufficiency in the general population during the last three decades, mild iodine deficiency has reappeared among pregnant women due to incomplete usage of iodide folic acid supplementation. Strengthened monitoring, stricter quality assurance in salt production, improved adherence to iodine supplementation in pregnant women, and targeted provincial interventions are needed to sustain IDD elimination.

PMID:41652324 | DOI:10.1177/10507256261423184

Scand J Caring Sci. 2026 Mar;40(1):e70195. doi: 10.1111/scs.70195.

ABSTRACT

BACKGROUND: Unfinished nursing care refers to situations in which necessary nursing care is insufficient, incomplete, or not provided at all. Nursing students’ evaluations of unfinished nursing care based on their clinical observations are important indicators of their professional awareness and ethical development.

PURPOSE: This study aimed to examine the relationship between nursing students’ ethical values and their perceptions of unfinished nursing care.

METHODS: This descriptive and cross-sectional study was reported in accordance with the STROBE guidelines. The research was conducted between March 3 and May 30, 2025, with 615 students enrolled in the nursing department of a university located in western Türkiye. Data were collected using the ‘Descriptive Information Form’, the Unfinished Nursing Care Survey for Students, and the Ethical Values Scale for Students Studying in Health Sciences. Descriptive statistics and multiple linear regression analyses were performed to analyse the data.

RESULTS: The mean total score for interventions related to unfinished nursing care was 73.83 ± 12.08, and the mean score for reasons underlying unfinished care was 76.22 ± 13.35. The mean score for ethical values was 117.70 ± 15.08. According to the multiple regression analysis, significant predictors of unfinished nursing care included academic year level (β = 0.094, p = 0.031) and ethical values (β = 0.217, p < 0.001) (R² = 0.065, F = 7.998, p < 0.001). Among these predictors, ethical values were identified as the strongest predictor of unfinished nursing care levels.

CONCLUSION: Higher levels of ethical values among nursing students were associated with lower levels of unfinished nursing care. These findings suggest that nursing education programs should incorporate content aimed at strengthening students’ ethical values. These findings highlight the importance of integrating ethics education and reflective clinical supervision into nursing curricula to enhance students’ ethical competence and professional development.

PMID:41652306 | DOI:10.1111/scs.70195

Epileptic Disord. 2026 Feb 6. doi: 10.1002/epd2.70198. Online ahead of print.

ABSTRACT

OBJECTIVE: To quantitatively evaluate regional brain volume differences between pediatric patients with epilepsy and healthy controls using a fully automated volumetric magnetic resonance imaging (MRI) analysis performed with the Vol2Brain platform.

METHODS: This retrospective study included 150 children (75 with epilepsy and 75 healthy controls) who underwent 1.5 T cranial MRI examinations. High-resolution three-dimensional T1-weighted images were processed using Vol2Brain, a fully automated segmentation tool based on SPM12 and CAT12 frameworks. Absolute and relative volumes of 135 cortical and subcortical structures were computed. Statistical comparisons between groups were performed using the Shapiro-Wilk and Mann-Whitney U tests (p < .05).

RESULTS: Patients with epilepsy demonstrated significantly lower volumes in the hippocampus, frontal and temporal gray matter, thalamus, cerebellum, and total brain compared with controls, accompanied by a compensatory increase in cerebrospinal fluid volume. No significant volumetric differences were found in the remaining 128 brain structures, indicating a diffuse morphometric reorganization pattern extending beyond the epileptogenic focus.

SIGNIFICANCE: Fully automated volumetric MRI analysis using vol2Brain can reliably detect widespread structural brain alterations in pediatric epilepsy. These findings support the concept of epilepsy as a diffuse network disorder extending beyond focal lesions. Quantitative morphometry provides an objective approach to characterize subtle structural reorganization and may serve as a basis for future studies investigating clinical and neurocognitive correlations in pediatric epileptology.

PMID:41652297 | DOI:10.1002/epd2.70198

Breast. 2026 Jan 27;86:104703. doi: 10.1016/j.breast.2026.104703. Online ahead of print.

ABSTRACT

BACKGROUND: CDK4/6 inhibitors (CDK4/6i) in combination with endocrine therapy (ET) represent the standard of care for hormone receptor-positive, HER2-negative (HR+/HER2-) metastatic breast cancer (MBC) patients. However, no head-to-head randomized trials have directly compared palbociclib, ribociclib, and abemaciclib. Moreover, predictive biomarkers of resistance to CDK4/6i remain largely undefined. This study aimed to evaluate circulating tumor DNA (ctDNA)-based epigenetic and fragmentomic biomarkers as potential predictors of response and resistance in patients receiving CDK4/6i.

METHODS: We conducted a biomarker-driven analysis within the prospective, multicenter MAGNETIC.1 study, enrolling 149 patients with HR+/HER2- MBC treated with first-line endocrine therapy and a CDK4/6 inhibitor. Plasma samples were collected at baseline and during treatment (3 and 6 months). Droplet digital PCR was used to assess ESR1 promoter methylation and ACTB fragmentomic profiles. Progression-free survival (PFS) and overall survival (OS) were evaluated, and molecular dynamics were compared between treatment groups.

RESULTS: After a median follow-up of 34.8 months, no statistically significant differences in PFS or OS were observed between ribociclib and palbociclib treated patients, although ribociclib was associated with numerically longer PFS and higher survival rates. At the molecular level, palbociclib treatment was characterized by transient increases in ESR1 promoter methylation at the first evaluation and a rebound in ACTB_short fragment levels at six months relative to baseline. These dynamic patterns were not observed among patients receiving ribociclib.

CONCLUSIONS: ctDNA-based methylation and fragmentomic profiling revealed exploratory, treatment specific molecular dynamics, highlighting biological differences between CDK4/6 inhibitors. These findings support the feasibility of liquid biopsy-based biomarker studies in this setting, although their potential clinical relevance remains preliminary and requires validation in larger cohorts with earlier and more granular on-treatment timepoints.

PMID:41650543 | DOI:10.1016/j.breast.2026.104703

Res Dev Disabil. 2026 Feb 5;170:105241. doi: 10.1016/j.ridd.2026.105241. Online ahead of print.

ABSTRACT

Hyperfocus-an intense, uncontrollable state of attention-has gained attention for its dual adaptive and maladaptive outcomes and its potential role in gaming experience. Although distinguishing hyperfocus from flow during gameplay may be challenging, their predictive factors (e.g., escapism motivation) and consequences (e.g., burnout, self-efficacy) may differentiate the two constructs. However, the distinction between hyperfocus and flow in gaming contexts – particularly regarding their psychological outcomes and statistical predictors – remains insufficiently understood. The aims of this study were to a) establish possible differences in hyperfocus and flow as potential predictors of negative (cognitive, emotional burnout) and positive (self-efficacy) psychological outcomes among adult video gamers with ADHD traits, and b) compare these outcomes between individuals with a formal ADHD diagnosis and with an ADHD self-diagnosis. Data from 310 participants with ADHD traits were analyzed. First, an exploratory correlation analysis was conducted. Then, the relationships between hyperfocus, flow, escapism motivation, self-efficacy, and burnout were compared between persons with a formal ADHD diagnosis (N = 174) and self-diagnosis (N = 136) using the Mann-Whitney test, network analysis, and two PLS-SEM models. Flow and hyperfocus differed in both predictors and outcomes, with flow associated with greater self-efficacy and hyperfocus predicting higher burnout. Group comparisons indicated complex patterns: self-suppression escapism predicted flow only in the self-diagnosis group, while also predicting hyperfocus in both groups. Hyperfocus and flow emerge as qualitatively distinct states with different predictors and consequences. Furthermore, systematic differences between formally diagnosed and self-diagnosed individuals with ADHD traits underscore the necessity of distinguishing these subgroups in research on ADHD-related experiences.

PMID:41650538 | DOI:10.1016/j.ridd.2026.105241

Biomed Pharmacother. 2026 Feb 5;196:118881. doi: 10.1016/j.biopha.2025.118881. Online ahead of print.

ABSTRACT

INTRODUCTION: Neovascular age-related macular degeneration (nAMD) is a leading cause of irreversible vision loss in older adults. Intravitreal anti-vascular endothelial growth factor (VEGF) agents-including Aflibercept, Ranibizumab, Bevacizumab, Brolucizumab, and Faricimab-are the mainstay of therapy. However, their comparative efficacy and safety remain uncertain. This study aimed to compare the visual and systemic outcomes of these agents to inform clinical decision-making.

METHODS: A systematic search of PubMed, Embase, Scopus, and Web of Science from inception to September 2025 identified randomized controlled trials (RCTs) and observational studies comparing at least two anti-VEGF agents in nAMD. Eligible studies reported outcomes of best-corrected visual acuity (BCVA) change, visual gain ≥ 15 letters, mortality, or arteriothrombotic events. Risk of bias was assessed using Cochrane Risk of Bias 2 (RoB 2) and Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tools. A frequentist network meta-analysis estimated mean differences (MD) and odds ratios (OR) with 95 % confidence interval (CI). The protocol was registered in PROSPERO (CRD42025631298).

RESULTS: Sixteen studies involving 6758 participants (follow-up 3-24 months) met the inclusion criteria. For BCVA improvement, Aflibercept had the highest surface under the cumulative ranking curve (SUCRA) ranking (0.80), although all agents showed similar mean differences that were not statistically significant: aflibercept (MD 0.80; 95 % CI -1.20-2.80), Ranibizumab (0.64; -1.87-3.15), Bevacizumab (0.60; -2.02-3.22), Faricimab (2.20; -0.69-5.09), and Brolucizumab (4.20; -5.97-14.36). The larger point estimate for Brolucizumab reflects imprecision rather than superior visual efficacy. Mortality was lowest with Aflibercept (risk ratio (RR) 0.76; 95% CI 0.41-1.55). For arteriothrombotic events, no statistically significant differences were observed between anti-VEGF agents. Comparisons between Aflibercept and Bevacizumab (RR 1.11; 95% CI 0.60-2.07), aflibercept and Ranibizumab (RR 0.77; 95% CI 0.49-1.21), and Bevacizumab and Ranibizumab (RR 0.88; 95% CI 0.60-1.30) showed wide confidence intervals, reflecting substantial imprecision. Certainty of evidence (GRADE) ranged from moderate to low.

CONCLUSION: All anti-VEGF agents stabilize or improve vision in nAMD. Aflibercept may provide the most favorable efficacy-safety balance, Faricimab offers promising durability, and Brolucizumab demonstrates large visual gains with potential safety concerns. Further head-to-head and long-term real-world studies are needed to optimize individualized treatment strategies.

PMID:41650530 | DOI:10.1016/j.biopha.2025.118881

Addict Behav. 2026 Feb 3;176:108632. doi: 10.1016/j.addbeh.2026.108632. Online ahead of print.

ABSTRACT

INTRODUCTION: Motivation-phase smoking treatment can increase treatment reach and abstinence in persons unmotivated to quit smoking. However, Motivation-phase treatment is modestly and inconsistently effective. This research aims to identify factors that may influence the effectiveness of the two intervention components most commonly used in Motivation-phase treatment: nicotine replacement therapy (NRT) and reduction counseling.

METHODS: An exploratory, secondary analysis of a 4-factor, randomized trial enrolled 577 primary care patients who were willing to reduce, but not quit, smoking. Participants were randomized to the following interventions: smoking reduction counseling, nicotine mini-lozenge, behavioral activation counseling, and 5Rs-motivational counseling. Using a precision medicine approach, machine learning analyses determined whether demographic and smoking variables identified persons more likely to benefit from the interventions with regard to 24-hour quit attempts, entry into cessation treatment, and self-reported 7-day point prevalence abstinence at 1 year.

RESULTS: Quitting self-efficacy predicted the likelihood of making a quit attempt and entering cessation treatment. At high levels of self-efficacy (>3.5 out of 5), there were no significant effects of interventions. At low levels of self-efficacy (≤3.5 out of 5), receiving reduction counseling reduced the odds of making a quit attempt (OR = 0.51, p = 0.002), and receiving mini-lozenge reduced the odds of entering cessation treatment (OR = 0.55, p = 0.02). No significant effects were found for smoking abstinence.

CONCLUSIONS: Baseline quitting self-efficacy may identify persons who will not be aided by standard Motivation-phase treatment and thus require a different therapeutic approach. These results raise questions about whom to treat, and how to treat, individuals who decline cessation treatment.

PMID:41650518 | DOI:10.1016/j.addbeh.2026.108632

Nutrition. 2026 Jan 11;145:113110. doi: 10.1016/j.nut.2026.113110. Online ahead of print.

ABSTRACT

BACKGROUND: Poor dietary intake has been linked to depression during pregnancy, but little research has examined this in Hispanic populations.

OBJECTIVE: We examined third-trimester associations of study-derived dietary patterns with odds of prenatal depression and depressive symptoms in pregnant, low-income Hispanic women.

METHODS: Participants (N = 587) were drawn from the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) cohort in Los Angeles, CA. Diet was assessed using a 24-h recall tool. Women were assigned quartile rankings based on adherence to two previously derived dietary patterns: vegetables, oils, and fruit (VOF; healthier) and solid fats, refined grains, and cheese (SRC; less healthy). Depressive symptoms were defined using the Center for Epidemiological Studies-Depression Scale score, and a dichotomized depression outcome was defined as Center for Epidemiological Studies-Depression Scale scores ≥16.

RESULTS: Eighteen percent of participants were classified as depressed at the third-trimester visit. Women with the greatest adherence to the healthier dietary pattern (VOF) had 59% lower odds of depression (OR = 0.41, 95% CI: 0.19, 0.86) relative to women with the lowest adherence to this dietary pattern, after adjustment for covariates. Additionally, women with moderately high (third quartile) adherence to the VOF dietary pattern had 16.9% lower depressive symptoms (95% CI: -30.5%, -0.8%) compared with women with the lowest VOF adherence. Women with the highest VOF adherence had similar, non-statistically significant lower depressive symptoms (Beta = -10.4%, 95% CI: -25.7%, 8.1%).

CONCLUSION: Our results indicate that there are important relationships between a healthy diet and lower depression in late pregnancy, and suggest that nutritional counseling and improved neighborhood access to healthy food may be important for maternal mental health.

PMID:41650492 | DOI:10.1016/j.nut.2026.113110