Tag: statistics

J Am Heart Assoc. 2026 Jan 22:e042619. doi: 10.1161/JAHA.125.042619. Online ahead of print.

ABSTRACT

BACKGROUND: Black and female patients with atrial fibrillation have more strokes. Certain left atrial appendage (LAA) morphologies impose a higher stroke risk. Whether anatomic differences in LAA morphology are associated with race or sex remains unexplored.

METHODS: We identified consecutive patients with computed tomography for LAA morphology and categorized each patient by self-reported race (Black versus non-Black) and sex. Each LAA morphology was assigned a score based on published relative LAA thrombus risk (lowest to highest: “chicken wing,” “windsock” and “cactus,” “cauliflower”). Scores and prevalence were compared across races and sexes using a Wilcoxon rank-sum test and Fisher’s exact test, respectively. Logistic regression was performed to find the association of race (adjusting for sex) and sex with higher risk LAA morphologies.

RESULTS: Among 211 patients (27% Black, n=58; 47% female, n=100), there was no difference in the projected hypothetical stroke risk across race or sex (median for Black versus non-Black patients: 1 [interquartile range, 1-4] versus 1 [interquartile range, 1-1], P=0.11; median for women versus men: 1 [interquartile range, 1-4] versus 1 [interquartile range, 1-4], P=0.62). The highest risk LAA morphology, cauliflower, had greater odds of being present in Black versus non-Black patients (unadjusted odds ratio [OR], 6.0 [1.4-25.1], P=0.049; adjusted OR, 4.8 [1.1-20.9], P=0.035). Although cauliflower LAA morphology was more prevalent in women (n=7 [9%] versus n=2 [2%] in men; P=0.063), this difference nor odds of cauliflower LAA morphology being present in women were statistically significant.

CONCLUSIONS: The highest risk LAA morphology, cauliflower, demonstrated greater odds of being present in Black patients versus non-Black patients. The difference in women versus men did not reach statistical significance. Although the study was underpowered to make the findings declarative, these results are provocative regarding the differential stroke risk across races and sexes.

PMID:41568568 | DOI:10.1161/JAHA.125.042619

Eur J Psychotraumatol. 2026 Dec;17(1):2605803. doi: 10.1080/20008066.2025.2605803. Epub 2026 Jan 22.

ABSTRACT

Background: Physical activity is increasingly incorporated in trauma-focused treatments as an augmentation strategy to improve treatment outcome. In a novel VR exposure treatment known as 3MDR (Multi-modal Motion-assisted Memory Desensitization and Reconsolidation), patients engage in low-intensity physical activity by walking on a treadmill throughout the therapy session, approaching trauma-related pictures that progressively enlarge until fully displayed in a VR environment. Physical activity is considered a key augmentation strategy in this treatment, with the proposed mechanism that walking toward a trauma-related picture facilitates the reduction of trauma-related avoidance, thereby improving treatment outcome. However, neither the specific effect of walking during this treatment nor the proposed working mechanism have been scientifically examined yet.Objective: In this paper we describe the rationale and study design of a randomised controlled trial (RCT) to examine the specific effect of walking toward trauma-related stimuli during VR exposure on treatment outcome. In addition, we will test whether walking toward trauma-related pictures facilitates a greater reduction in trauma-related avoidance.Method: Patients with PTSD (N = 158) are randomised to two treatment conditions: walking (VR exposure while walking) or stationary (VR exposure without walking), while keeping all other treatment aspects constant. Participants in both conditions receive two preparatory treatment sessions, 6 or 12 VR exposure sessions, and one closure session. The primary outcome is clinician-rated PTSD symptom severity. Secondary outcomes are both clinician-rated- and self-reported trauma-related avoidance symptom severity, as well as self-reported PTSD symptom severity. Assessments take place pre- and after 6 and 12 VR exposure sessions (posttreatment), and at 3-, 6-, 12- and 18- months follow-up.Conclusion: This RCT aims to examine whether incorporating walking during trauma-focused treatment in a VR exposure environment augments the treatment of patients with PTSD.

PMID:41568558 | DOI:10.1080/20008066.2025.2605803

Int J Gynaecol Obstet. 2026 Jan 22. doi: 10.1002/ijgo.70831. Online ahead of print.

ABSTRACT

OBJECTIVE: Cervical cancer remains a major public health concern globally. It is the fourth leading cause of cancer deaths among women worldwide. In 2020, the global incidence of cervical cancer was estimated to be 604 000 with a standardized mortality rate of 341 000. In Tanzania, cervical cancer is the most common female cancer and a leading cause of cancer-related deaths. The majority of data demonstrating the survival rate of cervical cancer originates from high- and middle-income countries with contributions from low-income countries such as Tanzania being relatively scarce. Determining the factors associated with survival is critical in an attempt to inform strategies to improve outcome of women with cervical cancer. The aim of the present study was to determine the 3-year overall survival rate and associated factors among women with invasive cervical cancer attended at Ocean Road Cancer Institute (ORCI) from 2018 to 2020.

METHODS: A retrospective cohort study was conducted at ORCI by using their cancer registry database. The study included 256 women diagnosed with cervical cancer from 2018 to 2020. Survival analysis was estimated by using Kaplan-Meir analysis, Cox regression hazard proportion and log-rank test and a P value of less than 0.05 was considered statistically significant. Stata version 17 was used for analysis.

RESULTS: Among 256 women with cervical cancer, the survival rate across one-, two- and 3-years, respectively were 83.6%, 77.0%, and 72.7%. Survival rate was significantly associated with both FIGO stage during diagnosis and hemoglobin level. Those who received concurrent chemoradiotherapy had a higher survival rate compared to those who received radiotherapy or chemotherapy only, and it was statistically significant with P < 0.001.

CONCLUSION: The study found an overall survival rate of 72.7% over 3 years. Factors associated with survival rate were early FIGO stage at diagnosis, normal hemoglobin level at diagnosis, and the use of concurrent chemoradiotherapy. Proper staging, good patient preparation and good choice of treatment improves survival. With availability of advance treatment options in the country the survival rate of women is promising.

PMID:41568557 | DOI:10.1002/ijgo.70831

J Am Heart Assoc. 2026 Jan 22:e044241. doi: 10.1161/JAHA.125.044241. Online ahead of print.

ABSTRACT

BACKGROUND: The role of colchicine, an anti-inflammatory agent, in improving cardiovascular outcomes in patients with recent myocardial infarction remains unclear. We sought to evaluate the efficacy and safety of colchicine compared with placebo in patients with recent myocardial infarction (within 1 month of symptom onset) at a follow-up of at least 1 year.

METHODS: We systematically searched MEDLINE, Embase, and the Cochrane Library until January 2025 for randomized controlled trials comparing colchicine to placebo in recent myocardial infarction. The primary outcome was major adverse cardiovascular events (MACE; as defined by the included studies) at maximum follow-up. Secondary outcomes included individual MACE components and safety (serious adverse events [AEs], any AEs, and gastrointestinal AEs). Count data were pooled using random-effects models with inverse variance weighting to estimate risk ratios (RRs) and 95% CIs.

RESULTS: A total of 5 randomized controlled trials were included with 6620 patients randomized to colchicine and 6625 to placebo. Most participants (79%) were male, with mean ages ranging from 59 to 61 years. Follow-up durations ranged from 1 to 3 years. At maximum follow-up, there was no statistically significant difference in MACE between colchicine and placebo (8.2% versus 9.3%; RR, 0.83 [95% CI, 0.66-1.04]). Analyses of individual MACE components were also inconclusive. Randomization to colchicine did not increase the overall incidence of AEs or serious AEs compared with placebo.

CONCLUSIONS: In patients with recent myocardial infarction, the available evidence assessing the effect of colchicine, in addition to standard therapy, on MACE remains inconclusive over a median follow-up duration of 1 year.

PMID:41568554 | DOI:10.1161/JAHA.125.044241

J Am Geriatr Soc. 2026 Jan 22. doi: 10.1111/jgs.70301. Online ahead of print.

ABSTRACT

BACKGROUND: In 2015, the Netherlands implemented long-term care (LTC) reforms to promote aging-in-place, potentially impacting nursing home (NH) access for older individuals with dementia. This study examines how the reform affected NH admission rates and waiting list prevalence for this population.

METHODS: We performed interrupted time series analyses to evaluate trends in NH admissions (2011-2019, Statistics Netherlands) and waiting list prevalence (2013-2018, National Healthcare Institute) before and after the 2015 LTC reform. Incidence rate ratios (IRR) were calculated for monthly NH admission rates and waiting list prevalence.

RESULTS: Among 270,706 older people with dementia, the reform was negatively associated with NH admission rates (IRR 0.610 [0.547-0.681]), halting the pre-reform decline and stabilizing the post-reform trend (IRR 1.001 [0.999-1.002]). The reform was positively associated with NH waiting list prevalence (IRR 1.159 [1.048-1.282]).

CONCLUSION: Among older Dutch people with dementia, the 2015 Dutch LTC reform was associated with fewer NH admissions and longer waiting lists. While stabilization of the NH admissions may reflect prioritization of persons with dementia within stricter eligibility criteria, the concurrent rise in waiting list prevalence suggests that institutional capacity did not keep pace with persistent need. As a result, many older people with dementia remain longer in the community, raising concerns regarding their health and safety as well as the burden on their informal caregivers.

PMID:41568552 | DOI:10.1111/jgs.70301

Gynecol Endocrinol. 2026 Dec 31;42(1):2618881. doi: 10.1080/09513590.2026.2618881. Epub 2026 Jan 22.

ABSTRACT

BACKGROUND: Astrocytes, once regarded as passive support cells, are recognized as active regulators of synaptic organization and neuronal integration. Through extension or retraction of their processes, astrocytes influence synapse formation and elimination. Astrocytes express estrogen receptors, and animal studies have shown that estradiol modifies astrocytic morphology in relation to synaptic density.

OBJECTIVE: To examine the effects of estradiol and two clinically available selective estrogen receptor modulators (SERMs), tamoxifen, and raloxifene on astrocyte processes in human brain tissue.

METHODS: Human temporal lobe cortical slices were incubated for 60 min with estradiol (10 nM), tamoxifen (1.0 µM), or raloxifene (1.0 µM), and the results were compared with untreated control slices. Astrocytes were visualized by immunostaining for the glial cytoskeletal marker glial fibrillary acidic protein (GFAP). Light microscopy image analysis was used to quantify astrocytic process thickness and branching, using Neurolucida® software.

RESULTS: Control slices exhibited astrocytic branch extension and thinning during the incubation period. Similar morphological changes were observed in the tamoxifen-treated slices. In contrast, raloxifene treatment was associated with a significant reduction in astrocyte branching and thinning compared with controls (p = 0.01 for primary processes). Estradiol treatment resulted in intermediate reductions in astroglial process measures that did not reach statistical significance.

CONCLUSIONS: Estradiol, tamoxifen, and raloxifene – widely used hormonal agents – were associated with distinct effects on astrocyte morphology in human cortical tissue. These findings support a role for estrogen receptor modulation in astroglial structural regulation and suggest a potential cellular mechanism contributing to central nervous system symptoms reported in clinical settings.

PMID:41568550 | DOI:10.1080/09513590.2026.2618881

Haematologica. 2026 Jan 22. doi: 10.3324/haematol.2025.288956. Online ahead of print.

ABSTRACT

Red blood cell (RBC) transfusions for anemia associated with lower-risk myelodysplastic syndromes/neoplasms (LR-MDS) often contribute to reduced quality of life (QOL). Thus, reduction in RBC transfusion dependency (TD) is a primary therapeutic goal. Imetelstat is a firstin-class, competitive telomerase inhibitor approved to treat certain adult patients with LR-MDS with RBC-TD anemia who have not responded to, have lost response to, or are ineligible for erythropoiesis-stimulating agents. In the phase III IMerge study (NCT02598661), treatment with imetelstat resulted in clinically meaningful, statistically significant increases in the primary endpoint of ≥8-week RBC transfusion independence (TI) versus placebo. Because patients with LR-MDS experience detrimental effects on numerous facets of QOL (physical, emotional, social, and functional), these exploratory analyses assessed patient-reported outcomes using the Functional Assessment of Chronic Illness Therapy-Fatigue, Quality of Life in Myelodysplasia Scale, and Functional Assessment of Cancer Therapy-Anemia questionnaires as part of the phase III IMerge study. Nominal P values were reported. Fewer imetelstat-treated patients experienced deterioration in fatigue and more imetelstat-treated patients experienced sustained improvement in fatigue and QOL versus placebo. In the imetelstat group, 8-week, 24-week, and 1-year RBC-TI responders had sustained improvements in predefined significance thresholds versus nonresponders for fatigue (70%, 73%, and 88%, respectively, vs. 37%, 41%, and 44%, respectively; P.

PMID:41568521 | DOI:10.3324/haematol.2025.288956

Curr Drug Targets. 2026 Jan 9. doi: 10.2174/0113894501406097251015114440. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aimed to investigate the expression of the epidermal growth factor receptor (EGFR) in non-small cell lung cancer (NSCLC) tissues and its association with the frequency of legume food intake.

METHODS: Clinical data from 93 NSCLC patients at Jiujiang University-affiliated Hospital (2018-2023) were collected. Postoperative recurrence status and legume intake were obtained via telephone follow-up. Fourteen patients with recurrence or metastasis were assigned to the first progression (FP) group. Propensity score matching (1:3) was used to select 42 non-progression (NP) matched patients, totaling 56 for analysis. Patients were divided into low- and high-legume intake groups. EGFR expression was assessed by immunohistochemistry and statistical analysis.

RESULTS: EGFR positivity was higher in the FP group (78.6%, 11/14) than in the NP group (47.6%, 20/42) (P < 0.05). The NP group had a greater proportion of patients with high-frequency legume consumption compared to the FP group (71.4% vs. 35.7%, P < 0.05). Furthermore, patients with high-frequency legume intake (42.9%, 15/35) showed significantly lower EGFR positivity than those in the low-frequency intake group (76.2%, 16/21) (P < 0.05). These results indicate that higher legume intake correlates with both reduced EGFR expression and a decreased postoperative recurrence risk.

DISCUSSION: These findings suggest that higher legume intake is associated with reduced EGFR expression and better postoperative outcomes in NSCLC patients. Legume consumption may modulate disease progression through EGFR regulation.

CONCLUSION: High legume intake correlates with improved prognosis and lower EGFR expression in NSCLC. Further large-scale prospective studies are needed to validate these associations and explore their clinical implications.

PMID:41568509 | DOI:10.2174/0113894501406097251015114440

Curr Top Med Chem. 2026 Jan 9. doi: 10.2174/0115680266377273251010093254. Online ahead of print.

ABSTRACT

INTRODUCTION: The objective of this study was to synthesize and characterize the Formononetin- Celecoxib Conjugate, evaluate its efficacy both in vitro and in vivo, and ascertain its potential as a medicinal agent for osteoarthritis (OA).

METHODS: Phytoconstituents from Glycine max and FDA-approved drugs were meticulously curated and subjected to computational analyses for target identification and molecular docking. The Formononetin-Celecoxib Conjugate was subsequently synthesized and characterized using spectroscopic techniques. In vitro assessments included MTT viability assays and ELISA analyses. In vivo efficacy was evaluated using an MIA-induced OA mouse model.

RESULTS: Molecular Formononetin-Celecoxib Conjugate has high binding affinity towards MMP-9. In vitro, the conjugate was non-toxic and significantly reduced MMP-9 expression. In vivo, it attenuated paw volume (p < 0.05) and prevented body weight loss in OA-induced mice, especially at 200 mg/kg. Statistical analysis (Mean ± SD; two-way ANOVA with Tukey’s test) confirmed significant therapeutic benefits.

DISCUSSION: The study validates the conjugate’s anti-inflammatory and disease-modifying potential through both computational and experimental approaches. Its effects on MMP-9 inhibition suggest translational relevance for human OA. However, small sample size and lack of blinding remain limitations requiring further investigation.

CONCLUSION: Our study demonstrates the promising potential of the Formononetin-Celecoxib Conjugate as a novel therapeutic intervention for OA. By integrating computational predictions with experimental validations, this approach represents a step toward precision medicine in managing OA.

PMID:41568487 | DOI:10.2174/0115680266377273251010093254

Arterioscler Thromb Vasc Biol. 2026 Jan 22. doi: 10.1161/ATVBAHA.125.324017. Online ahead of print.

ABSTRACT

BACKGROUND: Obesity predisposes individuals to multiple pathologies, including metabolic dysfunction-associated steatotic liver disease and diabetes. Although it is known that accumulation of proinflammatory macrophages within adipose tissues drives adiposity and provokes obesity-linked sequelae, the molecular mechanisms that provoke macrophage dysfunction in obesity remain elusive. Macrophages express high levels of uPA (urokinase plasminogen activator), and uPA has been implicated in leukocyte migration.

METHODS: Human adipose tissues from patients receiving bariatric surgery were collected and analyzed for uPA protein levels. To determine the impact of uPA in adipose tissue and subsequent high-fat diet (HFD)-induced weight gain and metabolic diseases, a novel mouse model with a conditional knockout of uPA (Plau^fl/fl) was generated. Plau^WT/WT, Plau^KO/KO (global uPA deficiency), and Plau^fl/fl/LysM Cre+ (conditional uPA deficiency in macrophages) mice were fed low-fat diet or HFD for up to 20 weeks.

RESULTS: Protein levels of visceral adipose tissue uPA positively correlated with body mass index in patients with obesity, and uPA levels decreased in adipose tissue 2 years after bariatric surgery. The expression and activity of uPA also increased in the adipose tissue of HFD-fed control mice. Plau^KO/KO mice displayed reduced weight gain and metabolic sequelae through 14 weeks on a HFD compared with Plau^WT/WT mice, but not with prolonged HFD feeding. Interestingly, Plau^fl/fl/LysM Cre+ mice developed HFD-induced metabolic pathologies equivalently to Plau^WT/WT mice.

CONCLUSIONS: Our findings suggest that global uPA deletion, but not selective deletion of uPA in LysM+ myeloid cells, attenuates the development of early-stage HFD-driven obesity and pathologies consistent with metabolic syndrome.

PMID:41568458 | DOI:10.1161/ATVBAHA.125.324017