Tag: statistics

Diabetes Obes Metab. 2026 Aug 18. doi: 10.1111/dom.71255. Online ahead of print.

ABSTRACT

AIMS: To establish age- and sex-specific reference percentiles for body shape indices in Chinese adults and to develop a composite body shape index (CBSI) for age-related chronic diseases screening.

MATERIALS AND METHODS: From the China National Health Survey, we recruited adults across six provinces from 2023 to 2025. Sex- and age-specific percentile curves for body shape indicators were constructed using the Lambda-Mu-Sigma method. CBSI was derived by sex-stratified exploratory factor analysis with varimax rotation, integrating adiposity, muscle function, and body proportion. Associations with chronic diseases were assessed in a training population (n = 11 220) and validated in an independent population (n = 5745). Incremental value over BMI was evaluated by integrated discrimination improvement (IDI) and net reclassification improvement (NRI).

RESULTS: Body shape index trajectories differed substantially by sex. Compared with CBSI < -0.5, CBSI > 0.5 was associated with elevated odds of hypertension (OR 6.42, 95% CI 5.51-7.48), diabetes (2.76, 2.25-3.38), dyslipidemia (3.86, 3.37-4.41), hyperuricemia (5.44, 4.67-6.34), abnormal ECG (1.63, 1.24-2.13), coronary heart disease (2.31, 1.62-3.27), stroke (3.05, 1.95-4.78), chronic kidney disease (3.06, 1.79-5.23), and musculoskeletal disorders (1.67, 1.09-2.55). These associations persisted in the validation set and individuals aged > 60 years. Adding CBSI to BMI-based models improved disease identification, with positive IDI and category-free NRI.

CONCLUSIONS: Age- and sex-specific reference centiles for body shape indicators can reflect trajectories of body composition and muscle health across the lifespan, which facilitates sarcopenia screening. The CBSI serves as an integrated screening tool for high-risk populations.

PMID:42613313 | DOI:10.1111/dom.71255

Lancet Digit Health. 2027 Jun 22:101036. doi: 10.1016/j.landig.2026.101036. Online ahead of print.

ABSTRACT

BACKGROUND: Autogenous arteriovenous fistulas (AVFs) are considered the gold standard for haemodialysis access; however, successful fistula maturation is often not achieved. Females and patients with comorbidities such as diabetes and obesity suffer lower rates of fistula maturation, meaning many must rely on catheters or synthetic grafts for access. Therefore, we aimed to compare human acellular tissue engineered vessel (ATEV) with AVF for functional and secondary patency, as well as duration of use over 1 year in patients with end-stage kidney disease.

METHODS: In this multicentre, randomised, controlled, phase 3 trial, patients with end-stage kidney disease were recruited from 31 centres across the USA. Patients with end-stage kidney disease on haemodialysis using an indwelling catheter, who were candidates for placement of either an AVF or an arteriovenous graft, underwent screening for enrolment. Centres were selected for their ability to conduct a randomised controlled trial, and with investigators experienced in haemodialysis access procedures; site selection ensured broad generalisability across the US haemodialysis population. Patients were randomly assigned 1:1 to receive either an AVF or a ATEV for haemodialysis access via central software and database in the operating room, by study site personnel and before any initial skin incisions. The surgeon, patient, and site staff were unmasked to the allocation. The coprimary outcomes were functional patency at 6 months and secondary patency at 12 months, evaluated separately and analysed together to report global relative patency. Efficacy analyses included all randomly assigned participants and safety analyses included all participants who underwent study access creation; missing data were handled according to prespecified estimand-based methods detailed in the statistical analysis plan. This trial is registered with ClinicalTrials.gov (NCT03183245) and is now complete.

FINDINGS: From Sept 29, 2017, to April 22, 2023, we enrolled 242 patients. 70 (29%) patients were female, 172 (71%) were male. 119 (49%) patients were assigned to receive an autogenous AVF, and 123 (51%) patients were assigned to receive an ATEV. Superiority of the ATEV was achieved for the coprimary endpoints, with a global relative patency of 1·17 (95% CI 1·04-1·31, p=0·0090). Functional patency at 6 months was 81·3% for patients who received an ATEV and 66·4% for those who received an AVF. Secondary patency at 12 months was 67·5% for the ATEV group and 62·2% for the AVF group. Duration of usability at 1 year was 7·4 months for the ATEV group versus 6·0 months for the AVF group (95% CI for difference 0·16-2·43, p=0·025). Access infection rates between groups were similar; the ATEV group required more interventions overall compared with the AVF group. Greater benefits of ATEV were observed in female patients and in male patients who were both diabetic and obese. In this subgroup (ie, female patients and male patients with diabetes and obesity), the global relative patency was 1·66 (95% CI 1·34-2·04) in favour of ATEV.

INTERPRETATION: ATEV provides superior haemodialysis access outcomes at 1 year compared with AVF, with pronounced benefits observed in female patients and in male patients with obesity and diabetes.

FUNDING: Humacyte.

PMID:42613284 | DOI:10.1016/j.landig.2026.101036

Acad Radiol. 2026 Aug 18:S1076-6332(26)00571-4. doi: 10.1016/j.acra.2026.07.062. Online ahead of print.

ABSTRACT

RATIONALE AND OBJECTIVES: To develop and validate a radiomics-based clinical model for the preoperative prediction of pathological complete response (pCR) to neoadjuvant chemotherapy (NACT) in human epidermal growth factor receptor 2 (HER2) -positive breast cancer patients.

MATERIALS AND METHODS: This retrospective study included HER2 -positive breast cancer patients who underwent preoperative NACT. Patients were recruited from Center 1 during the period January 2015 to December 2023, and from Center 2 during January 2018 to December 2024. When assessing pCR, surgical specimens served as the gold standard. The radiomics signature (RS) was first refined through redundancy and dimensionality reduction to mitigate overfitting. The retained features were then used to build a Least Absolute Shrinkage and Selection Operator (LASSO) regression model for further feature selection and RS optimization. Subsequently, an integrated model incorporating independent clinical risk factors and the RS was developed. Model performance was compared using the DeLong test on area under the curve (AUC) values.

RESULTS: A total of 659 patients were included, consisting of a training cohort (n=283) and an internal validation cohort (IVC) (n=121) from Center 1, and an independent external validation cohort (EVC) (n=255) from Center 2. The clinical model and RS model showed acceptable performance in predicting pCR, with AUC values of 0.699 and 0.817 respectively observed in the training cohort (TC). The integrated model demonstrated significantly higher predictive accuracy (AUC = 0.861) compared to both the clinical and RS models across all cohorts. The statistical significance of this difference was confirmed using DeLong’s test.

CONCLUSION: The clinical-radiomics combined model demonstrates improved and stable predictive performance for early response to NACT compared with radiomics-only and clinical-only models in both internal and external validation cohorts.

PMID:42613278 | DOI:10.1016/j.acra.2026.07.062

J Prosthet Dent. 2026 Aug 18:S0022-3913(26)00524-X. doi: 10.1016/j.prosdent.2026.07.019. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Studies investigating the effect of the titanium dioxide (TiO₂) coating on the microhardness, surface roughness, Candida albicans (C albicans) adhesion, and color change of conventionally manufactured, milled, and printed denture bases are lacking.

PURPOSE: The purpose of this in vitro study was to evaluate the microhardness, surface roughness, C albicans adhesion, and color change of different TiO₂-coated and noncoated denture bases.

MATERIAL AND METHODS: Polymethyl methacrylate (PMMA) disks were fabricated using different fabrication methods: conventionally heat polymerized, milled, and 3 dimensionally (3D) printed (N=240). Half of the specimens’ surfaces were coated with TiO₂ by atomic layer deposition (ALD). The microhardness of specimens was measured, yielding Vickers hardness numbers. Surface roughness was measured using a profilometer. C albicans adhesion was quantified as colony-forming units per milliliter (CFU/mL). Color difference between coated and noncoated specimens was evaluated using the CIEDE2000 formula. Factorial and 2-way ANOVA and the Pearson correlation analyses were used for statistical analyses (α=.05).

RESULTS: The production method and the coating status of the specimens affected the microhardness, surface roughness, and C albicans adhesion (P<.001). Surface roughness and C albicans adhesion were positively correlated (P<.001, r=0.904). The color change between TiO₂-coated and noncoated specimens was affected by the color and production method (P<.001).

CONCLUSIONS: TiO₂-coated, milled specimens demonstrated the highest microhardness, lowest surface roughness, and reduced C albicans adhesion. The original pink-colored, milled specimens showed the least color change. Milled PMMAs are processed under high pressure and temperature, resulting in lower residual monomer levels, reduced porosity, and improved material properties.

PMID:42613267 | DOI:10.1016/j.prosdent.2026.07.019

Dig Liver Dis. 2026 Aug 18:S1590-8658(26)00879-0. doi: 10.1016/j.dld.2026.07.081. Online ahead of print.

ABSTRACT

BACKGROUND: Optimal timing of cholecystectomy after acute biliary pancreatitis (abP) remains debated. While early surgery is recommended for mild abP, guidance for more severe disease is less well defined, and outcome heterogeneity suggests clinically relevant modifiers.

AIMS: To assess the impact of surgical timing, disease severity, and sex on outcomes after cholecystectomy following abP.

METHODS: This single-center retrospective cohort study included 205 patients undergoing cholecystectomy after abP. Outcomes were compared between early one-stage (during index admission) and interval two-stage cholecystectomy, stratified by abP severity and sex.

RESULTS: Overall morbidity did not differ between one-stage and two-stage cholecystectomy. However, one-stage surgery was associated with higher postoperative inflammatory response, need for intensive care, and longer hospitalization. In mild abP, males underwent more complex cholecystectomies, with longer operative time, increased blood loss, higher conversion rates, and more frequent intensive care. In moderate/severe abP, outcomes were largely comparable between sexes, except for prolonged intensive care need and a trend toward longer hospitalization in women after one-stage cholecystectomy.

CONCLUSION: Post-cholecystectomy outcomes after abP depend on the interaction between disease severity, surgical timing, and sex. While early cholecystectomy appears safe in mild abP, sex-specific vulnerabilities and resource utilization should be considered supporting tailored timing strategies.

PMID:42613244 | DOI:10.1016/j.dld.2026.07.081

J Pediatr Urol. 2026 Jul 22:106169. doi: 10.1016/j.jpurol.2026.106169. Online ahead of print.

ABSTRACT

INTRODUCTION: The American Urological Association (AUA) Annual Meeting is consistently competitive, accepting approximately one-third of the scientific abstracts submitted. Following abstract presentation, manuscript publication offers the opportunity to more widely disseminate research findings and methodology. Several prior studies have evaluated the publication rate of urology abstracts presented at regional and/or national conferences. In this study, we aim to both identify factors of Pediatric Urology abstracts presented at the annual meeting that were associated with an increased likelihood of manuscript publication and evaluate trends over time.

METHODS: All Pediatric Urology abstracts presented at AUA annual meetings from 2013 to 2022 were reviewed. Data was collected on primary author degree type, presentation format (e.g. poster v. podium), and author geographic region. Manuscripts were searched for on PubMed and Google Scholar using the abstract titles and authors’ names. Journal name, year of publication, and journal impact factor were recorded for published manuscripts. Impact factors were based on 2024 published values. SPSS statistical software was then used to analyze descriptive statistics and perform chi square analysis for categorical variables. Descriptive statistics, chi-square tests with pairwise Bonferroni correction, Cochran-Armitage trend testing, multivariable logistic regression, and Kaplan-Meier time-to-event analyses were performed.

RESULTS: 604 Pediatric Urology abstracts were presented from 2013 to 2022. Of these, 456 (75.5%) were moderated posters, 112 (18.5%) were videos, and 36 (6.0%) were podium presentations. 240 (39.7%) of these resulted in published manuscripts. Median time to publication was 1 years (IQR 1-2). 88.8% of published manuscripts (n = 213) had a physician listed as first author. Though there was an upward trend in the number of abstracts presented at annual meetings from 2013 (n = 72) to 2022 (n = 94), the rate of manuscript publication did not differ significantly across years (p = 0.066). An ordinal trend test, however, indicated a modest decline in publication rate across the study period (Cochran-Armitage p = 0.030). Manuscripts were published in 55 different journals with a median impact factor of 2.3 (IQR 1.9-6.8). 217 manuscripts (90.4%) were published within two years of abstract presentation. In contrast to several prior studies which found that podium presentations were more likely to subsequently get published as manuscripts, moderated poster presentations demonstrated the highest publication rate (44.7%), followed by podium presentations (30.6%), and video presentations (22.3%). Pairwise comparison with Bonferroni correction showed this format effect was driven by the difference between moderated poster and video presentations (adjusted p < 0.001); podium presentation were not statistically separable from either group.AUA geographic region was not associated with likelihood of manuscript publication (p = 0.648).

CONCLUSIONS: The overall manuscript publication rate for Pediatric Urology abstracts at the AUA annual meeting over ten years was 39.7% (publication searches conducted through March 2026). Presentation format was significantly associated with publication likelihood; pairwise comparison showed this effect was driven by the difference between poster and video presentations, while podium presentations were not statistically separable form either group given the limited window in which podium was offered (2019 and 2022). With moderated poster presentations demonstrating the highest publication rate. Geographic region did not impact likelihood of publication. The annual conversion rate showed a modest decline across the study period (trend p = 0.030), which may partly reflect shorter publication follow-up for recent meeting years.

PMID:42613241 | DOI:10.1016/j.jpurol.2026.106169

Int J Gynecol Cancer. 2026 Jul 11:104869. doi: 10.1016/j.ijgc.2026.104869. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the association between exposure to pembrolizumab-based therapy in the post-platinum setting and survival outcomes in patients with metastatic or recurrent uterine carcinosarcoma.

METHODS: In this retrospective study, patients with metastatic or recurrent uterine carcinosarcoma treated at three tertiary centers between January 2008 and April 2025 were included. Patients received various treatment modalities after recurrence or progression in the post-platinum setting. Survival outcomes were analyzed according to whether patients were exposed to pembrolizumab-based therapy after recurrence or progression. Survival after recurrence and overall survival were evaluated using Kaplan-Meier analyses and Cox proportional hazards models. Additional analyses using inverse probability of treatment weighting, doubly robust methods, and time-dependent Cox models were performed.

RESULTS: A total of 147 patients were included, of whom 42 (28.6%) received pembrolizumab-based therapy in the post-platinum setting. In multi-variable analyses, pembrolizumab-based therapy exposure was independently associated with improved survival after recurrence (hazard ratio 0.44, 95% confidence interval 0.24 to 0.83, p = .01) and overall survival (hazard ratio 0.48; 95% confidence interval 0.26 to 0.89, p =.02). Positive peritoneal washing cytology was independently associated with poorer survival outcomes. In time-dependent Cox analyses using inverse probability of treatment weighting, pembrolizumab-based therapy exposure remained significantly associated with improved survival after recurrence (hazard ratio 0.56, 95% confidence interval 0.33 to 0.96, p =.035), whereas the association with overall survival was no longer statistically significant.

CONCLUSIONS: Exposure to pembrolizumab-based therapy in the post-platinum setting was associated with improved survival after recurrence in patients with metastatic or recurrent uterine carcinosarcoma. These findings support the potential clinical relevance of pembrolizumab-based therapy in the post-platinum setting and warrant further prospective validation.

PMID:42613237 | DOI:10.1016/j.ijgc.2026.104869

Vox Sang. 2026 Aug 18. doi: 10.1111/vox.70336. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Hepatitis E virus (HEV) is a recognized transfusion-transmissible pathogen with significant impact in immunocompromised recipients. Data from Southeast Asia are limited, and the epidemiology of HEV in Muslim-majority populations with low pork consumption remains poorly characterized. This study aimed to determine anti-HEV immunoglobulin G (IgG) and immunoglobulin M (IgM) seroprevalence and associated demographic, dietary, environmental, zoonotic and knowledge-related factors among Malaysian blood donors.

MATERIALS AND METHODS: A prospective cross-sectional study was conducted among 500 consecutive blood donors at the Universiti Malaya Medical Centre. Anti-HEV IgG and IgM were measured using enzyme-linked immunosorbent assay. A structured questionnaire assessed demographic, dietary, environmental and zoonotic exposures. Univariate and multivariable logistic regression identified predictors of anti-HEV IgG seropositivity.

RESULTS: Anti-HEV IgG seroprevalence was 2.8% (14/500), and IgM positivity was 0.6% (3/500). IgG seropositivity increased with age but showed no association with dietary exposures, including pork consumption. Knowledge of HEV was low, with a median score of 1 out of 12. Multivariable analysis identified freshwater recreational exposure (adjusted odds ratio [aOR] 20.04; p = 0.017) and direct rodent contact (aOR 13.36; p = 0.030) as factors associated with anti-HEV IgG seropositivity; however, these findings were based on small numbers of exposed individuals and should be interpreted cautiously.

CONCLUSION: HEV seroprevalence in Malaysian blood donors was low, indicating a limited burden of previous HEV infection. The observed epidemiological profile suggests that environmental and zoonotic exposures may be associated with HEV seropositivity, although these findings require cautious interpretation. These findings provide baseline data for continued surveillance and future evaluation of transfusion-transmitted HEV risk in Malaysia.

PMID:42613182 | DOI:10.1111/vox.70336

Inj Prev. 2026 Aug 18:ip-2025-046042. doi: 10.1136/ip-2025-046042. Online ahead of print.

ABSTRACT

BACKGROUND: The National Collegiate Athletic Association Injury Surveillance Program (NCAA ISP) is among the longest-standing sport injury surveillance systems in the world. The NCAA ISP relies on a convenience sample of reporting institutions to estimate population-level injury metrics by scaling reported counts by an inverse school-reporting fraction and a fixed under-reporting correction. We propose a new method for improving population estimates of injury incidence obtained in the NCAA ISP, through a quasi-bootstrapping algorithm that capitalises on the historically archived NCAA ISP data.

METHODS: We employed a phased approach including both a simulation study and a practical application, grounded in the operational methods of the NCAA ISP.

RESULTS: Across a range of simulated conditions, the proposed method approximated true population values with near-zero bias, produced more stable estimates than the current method and generated valid uncertainty intervals for both injuries and exposures. We also noted that when applied to real-world data, the proposed method produced plausible and credible estimates of injury and exposure counts.

DISCUSSION: By incorporating real-world variability from archived data, this approach improves point and interval estimation even under conditions of low or biased reporting.

CONCLUSIONS: The proposed method demonstrates strong potential as a scalable and statistically robust alternative to current population estimation practices in injury surveillance systems that rely on convenience samples.

PMID:42613173 | DOI:10.1136/ip-2025-046042

BMJ Support Palliat Care. 2026 Aug 18:spcare-2026-006190. doi: 10.1136/spcare-2026-006190. Online ahead of print.

ABSTRACT

OBJECTIVES: Death literacy is a key factor in death-related psychosocial processes among caregivers. This research was carried out to determine the death literacy levels, care burdens and psychological well-being of individuals caring for cancer patients and to examine the relationships between these variables.

METHODS: The research, planned in a descriptive and cross-sectional design, was carried out in the oncology clinics of a university hospital between 16 October 2024 and 1 January 2025. The sample of the study consisted of 170 caregivers using the convenience sampling method. Data were collected with the Descriptive characteristics form, Death Literacy Scale, Caregiving Burden Scale and Psychological Well-being Scale. Statistical analyses were performed with the SPSS V.25.0 program; non-parametric tests, correlation and multiple regression analyses were used.

RESULTS: Participants’ death literacy and care burden levels were found to be moderate and their psychological well-being levels were found to be high. A low level of significant positive correlation was found between death literacy and psychological well-being. In contrast, no significant relationship was observed between death literacy and care burden. Education level and active participation in the care process are important factors that positively affect both death literacy and psychological well-being. Care burden was found to be higher in individuals with low education levels and single individuals.

CONCLUSIONS: There is a need for education-based structured interventions to support the coping skills with death of caregiving individuals, to increase their psychological well-being and to reduce their care burdens.

PMID:42613168 | DOI:10.1136/spcare-2026-006190