Tag: statistics

Psychiatr Hung. 2026;41(1):44-52.

ABSTRACT

Between 1985 and 2024, Hungary’s annual suicide rate gradually decreased from approximately 46 per 100000 people to approximately 17 per 100 000 people (i.e., by approximately 63 percent), while the number of patients receiving medication for depression increased twelvefold. Studies confirm that more widespread and effective treatment of depression has played a key role in this significant decline in suicides. There have been two periods of stagnation in the decline in suicide rates over the last 40 years: the first was between 2007 and 2011, while the second has been ongoing since 2019. These two periods were characterized by suboptimal functioning of psychiatric care and reduced access to care. Keywords: Hungary; suicide rate; suicide; antidepressants.

PMID:42502910

Psychiatr Hung. 2026;41(1):25-43.

ABSTRACT

INTRODUCTION: Test anxiety impacts approximately 25-50% of university students’ psychological wellbeing and academic achievement, yet support options remain limited. Despite rising demand for mental health services, many students face barriers in accessing help. Digital mental health interventions (DMHIs) could provide accessible support; however, their effectiveness in alleviating test anxiety has not been systematically evaluated. This review aimed to assess how effectively DMHIs reduce test anxiety in students and to identify key features of these interventions.

METHOD: The protocol was preregistered on OSF (July 21, 2025) and adhered to PRISMA 2020 guidelines. Searches were conducted in PubMed, PsycINFO, Scopus, Web of Science, ERIC, and ClinicalTrials.gov in August 2025. Eligible studies involved higher education students, utilized a DMHI, reported validated test anxiety outcomes, and employed experi mental designs. Risk of bias was assessed using RoB 2 and ROBINS-I tools.

RESULTS: Eight studies with a total of 813 students met inclusion criteria, including six randomized controlled trials. Inter ventions utilized multicomponent, mindfulness-based, or serious game formats delivered through web or app platforms. All studies reported reductions in test anxiety post-intervention; however, only three found statistically significant improvements over controls. Multicomponent programs showed the most consistent benefits. Most studies assessed test anxiety with a bidimensional measure, though emerging models highlight the importance of a multidimensional perspec tive to distinguish components.

CONCLUSION: DMHIs hold promise for reducing test anxiety, especially when integrating cognitive or dialectical behavioral therapy with study skills or mindfulness. Further research, including follow-ups and multidimensional assessments, is essential to establish their full efficacy.

PMID:42502909

Vet Clin Pathol. 2026 Jul 26. doi: 10.1111/vcp.70116. Online ahead of print.

ABSTRACT

BACKGROUND: The edible insect industry, driven by the nutritional and environmental benefits of mealworms, faces increasing challenges from pathogens affecting Tenebrio molitor farming systems. Hemocyte-based health assessments could provide valuable diagnostic insights, yet standardized hemolymph processing protocols and hematological reference intervals (RIs) are currently lacking for this species.

OBJECTIVES: This study aimed to develop practical protocols for hemolymph sampling, refine hemocyte classification, and establish hematological RIs for both larval and adult stages of T. molitor.

METHODS: An optimized tearing method, involving capillary collection of hemolymph from a proleg transected at the femoral-tibial joint, was used to sample healthy individuals. Total and differential hemocyte counts were determined using a hemocytometer and Wright-Giemsa-stained smears, respectively, and from distinct insect populations (n = 41-43 samples per group). Hemolymph was analyzed in pools due to the small size of T. molitor. Transmission electron microscopy was conducted on a multinucleated giant hemocyte (MGH) isolated from a histologic slide. RIs were calculated following American Society for Veterinary Clinical Pathology (ASVCP) guidelines, and life-stage differences were statistically assessed.

RESULTS: Granular cells and plasmatocytes predominated, whereas prohemocytes and oenocytoids were rare. MGHs, newly identified in T. molitor, were characterized as a fifth hemocyte population. Significant life-stage differences were observed, warranting separate RIs for larvae and adults. The established RIs were relatively wide, reflecting natural fluctuations in invertebrate hemolymph volume and the unsexed, age-diverse reference population.

CONCLUSIONS: This report of hematological RIs for T. molitor lays the groundwork for implementing hemocyte-based health surveillance in yellow mealworm beetle farming.

PMID:42502903 | DOI:10.1111/vcp.70116

J Res Adolesc. 2026 Sep;36(3):e70237. doi: 10.1111/jora.70237.

ABSTRACT

Sexually and racially diverse (SD) adolescents experience elevated proximal and distal minority stressors that vary across school, community, and policy contexts. Limited research has examined how access to and use of LGBTQIA+ supportive structures, such as Gender and Sexualities Alliances (GSAs), LGBTQIA+ community centers, and affirming school staff, shape distal minority stress for racially and sexually diverse youth across geographic settings. Using cross-sectional national sample data of SD adolescents from the Adolescent Stress Experiences Over Time Study (ASETS; N = 1076), this study applied binary logistic regression and linear regression to assess how racial identity, urbanicity, and structural access to and use of LGBTQ community centers and school affirmative SD groups are associated with distal sexual minority stress domains (homonegative climate, social marginalization, and intersectional stress), friend social support, and coping skills. Results indicated that GSA presence, regardless of individual participation, was associated with reduced odds of minority stress across all domains, while attending a GSA was further associated with increased use of engagement-oriented coping strategies. Conversely, community center attendance was associated with higher odds of social marginalization, suggesting contextual variability in the protective impacts of community-based supports. Geographic differences in distal minority stress were evident in only one domain, homonegative climate, and rurality was not significantly associated with differences in peer social support or coping. Findings underscore the importance of school-embedded, structurally inclusive supports for reducing minority stress and bolstering resilience among sexually and racially diverse adolescents, and highlight ongoing gaps in support for youth outside urban areas or in restrictive community climates. Future research should examine culturally grounded mechanisms that enhance the effectiveness of supportive structures and ensure inclusivity across racial and geographic contexts.

PMID:42502898 | DOI:10.1111/jora.70237

Int J Urol. 2026 Jul;33(7):e70582. doi: 10.1111/iju.70582.

ABSTRACT

OBJECTIVES: Talazoparib plus enzalutamide improved overall survival (OS) in the biomarker-unselected TALAPRO-2 population, but OS benefit was not statistically significant in the homologous recombination repair (HRR) non-deficient or unknown subgroup, whereas radiographic progression-free survival (rPFS) was prolonged. We explored time-dependent patterns in estimated treatment effects in this subgroup.

METHODS: Approximate individual-level data for 636 patients were reconstructed from published Kaplan-Meier curves; original trial-level patient data were unavailable. The proportional hazards assumption was assessed using Schoenfeld residuals and log-log plots. Interval-specific hazard ratios (HRs) were estimated using piecewise Cox models. A treatment-by-log(time + 1) interaction was evaluated formally. Sensitivity analyses included alternative interval schemes, landmark analyses, restricted mean survival time (RMST), and descriptive application of the same piecewise framework to the HRR-deficient subgroup.

RESULTS: The proportional hazards assumption was not rejected for OS (p = 0.63) or rPFS (p = 0.37). For OS, the 36-48-month interval showed a nominally lower hazard with talazoparib (HR 0.59; 95% confidence interval [CI] 0.36-0.97; nominal p = 0.039). For rPFS, the lowest HR occurred at 0-6 months (HR 0.56; 95% CI 0.37-0.86; p = 0.008). Treatment-by-log(time + 1) interactions were not statistically significant for OS (p = 0.44) or rPFS (p = 0.12).

CONCLUSIONS: This reconstructed-data post hoc analysis suggested exploratory time-dependent patterns in effect estimates without formal evidence of a time-varying treatment effect. Findings are descriptive, hypothesis-generating, and should not be extrapolated to molecularly confirmed HRR-proficient disease.

TRIAL REGISTRATION: ClinicalTrials.gov: NCT03395197.

PMID:42502892 | DOI:10.1111/iju.70582

PeerJ. 2026 Jul 22;14:e21473. doi: 10.7717/peerj.21473. eCollection 2026.

ABSTRACT

BACKGROUND: Neonatal mortality remains one of the most pressing global health challenges, disproportionately affecting low- and middle-income countries. In Ethiopia, complex interrelated factors contribute to high neonatal mortality rates, creating a multifaceted public health concern that demands comprehensive investigation. Despite the magnitude of this challenge, there exists a notable lack of longitudinal studies that examine the temporal patterns of neonatal deaths, survival, and associated risk factors throughout the complete neonatal period. This study addresses this gap by evaluating survival outcomes and identifying determinants of mortality among neonates admitted to the neonatal intensive care unit at Zewditu Memorial Hospital, a referral facility serving a high-burden urban population in Addis Ababa, Ethiopia.

METHODS: A retrospective cohort study of 1,014 neonates admitted to the neonatal intensive care unit from September 11, 2020 to September 10, 2023 was conducted. Systematic random sampling was used to select patients. An electronic data collection method was used, and the data were exported to STATA version 17.0 for cleaning and analysis. Bi-variable and multivariable Cox proportional hazard regression models were employed to identify mortality risk predictors. Kaplan-Meier survival estimates and log-rank tests were used to compare survival probabilities. Model adequacy was assessed using the Cox-Snell residual test.

RESULTS: Over 7,945 neonate-days, the mortality incidence rate was 13.72 deaths per 1,000 neonate-days (95% confidence interval (CI) [11.37-16.55]), with most deaths occurring within the first week. Significant predictors of mortality risk were extremely low birth-weight (<1,000 g; Adjusted Hazard Ratio (AHR) = 18.94, 95% CI [7.89-45.23]), very low birth weight (1,000-1,499 g; AHR = 5.09, 95% CI [2.75-9.43]), perinatal asphyxia (AHR = 3.52, 95% CI [2.25-5.49]), neonatal sepsis (AHR = 2.47, 95% CI [1.28-4.77]), respiratory distress syndrome (AHR = 1.65, 95% CI [1.01-2.68]), and meconium aspiration syndrome (AHR = 2.35, 95% CI [1.20-4.57]).

CONCLUSION: This study found associations between elevated neonatal mortality rates and birth weight and specific perinatal complications as key factors linked to survival. The predominance of deaths within the first week, particularly among neonates with low birth weight, perinatal asphyxia, sepsis, respiratory distress syndrome, and meconium aspiration syndrome, necessitates the implementation of risk-stratified care and intensive early monitoring. These findings provide evidence for targeted interventions that could substantially reduce neonatal mortality in resource-constrained healthcare settings.

PMID:42502858 | PMC:PMC13401358 | DOI:10.7717/peerj.21473

Psychol Res Behav Manag. 2026 Jul 21;19:620815. doi: 10.2147/PRBM.S620815. eCollection 2026.

ABSTRACT

BACKGROUND: Continuous ambulatory peritoneal dialysis (CAPD) requires patients to perform complex self-management tasks at home. Fear of progression and coping styles may influence self-management, but their dimension-level relationships remain poorly understood.

OBJECTIVE: To investigate the network structure linking fear of progression, coping styles, and self-management among CAPD patients and identify central and bridging dimensions that may be relevant for nursing assessment and intervention planning.

METHODS: A cross-sectional study was conducted among 328 CAPD patients in a tertiary hospital in Sichuan, China. Fear of progression, coping styles, and CAPD self-management were assessed using validated questionnaires. A psychometric network was estimated at the dimension level, and centrality, bridge centrality, and network stability were evaluated.

RESULTS: The strongest edge was observed between physical health-related and social/family-related fear of progression (edge weight = 0.663). Confrontation coping exhibited the highest strength and expected influence and showed the strongest cross-community connectivity, with bridge strength and bridge expected influence z-scores of 2.57 and 2.60, respectively. The strongest cross-community edge was identified between confrontation coping and diet management (edge weight = 0.264). Centrality and bridge centrality analyses demonstrated acceptable-to-good stability.

CONCLUSION: Confrontation coping emerged as a central and bridging dimension linking psychological responses and self-management behaviours in CAPD patients. These findings reflect statistical connectivity rather than causal relationships and may help identify priorities for nursing assessment and future intervention research.

PMID:42502848 | PMC:PMC13401381 | DOI:10.2147/PRBM.S620815

Mater Today Bio. 2026 Jul 15;39:103465. doi: 10.1016/j.mtbio.2026.103465. eCollection 2026 Aug.

ABSTRACT

The key for nanozymes to achieving sequential infection-inflammation-repair in wound infection therapy and healing lies in how to resolve the contradiction of reactive oxygen species (ROS) regulation between antibacterial therapy and anti-inflammation. Herein, a freestanding pristine CuGeO₃ (CGO) nanozyme film (NF) composed of nanowires is first designed and simply synthesized. Such a NF with flexibility, wet tissue adhesion properties, alongside water/blood absorbing capability could serve as a wound dressing and present superb antibacterial/antibiofilm efficacy for photothermal/chemodynamic synergistic therapy of wound infection owing to its extraordinarily outstanding photothermal performance, and glutathione depletion-enhanced peroxidase-like activity to generate ROS in acidic infection microenvironments (IMEs). Attractively, it is disclosed that after completing infection therapy, the enzyme activity of this CGO NF automatically and continuously switches into catalase-like activity to eliminate ROS as IMEs switches into neutral microenvironments. This promotes the M2 phenotype polarization of macrophages to relieve inflammation and accelerate wound repair. Furthermore, the longer and entangled nanowire structure of the CGO NF prone to retention in the wound site minimizes its toxicity to healthy tissues. Overall, it is the first paradigm to leverage a photothermal NF consisting of inorganic nanomaterials only as a wound dressing. Based on such a safe, effective, activity-switchable NF dressing, adaptive infection-inflammation-repair cascade in wound infection therapy and healing has been realized, achieving 98.7% wound closure within 10 days. We believe this work will foster the therapeutic application of activity-switchable nanozymes, and provide meaningful insights into nanozymes-based wound infection therapy and healing.

PMID:42502815 | PMC:PMC13400452 | DOI:10.1016/j.mtbio.2026.103465

Food Sci Nutr. 2026 Jul 24;14(7):e72171. doi: 10.1002/fsn3.72171. eCollection 2026 Jul.

ABSTRACT

Preventing sarcopenia is a major goal for older adults. High protein breakfast, while maintaining overall daily intake, has been proposed as a promising approach to support muscle health. However, the optimal timing of protein consumption remains uncertain. Therefore, the specific effects of breakfast protein intake are therefore important for refining nutritional recommendations. The methodology of this review is as follows: which included randomized controlled trials (RCTs) comparing morning protein intake with no intake in healthy and frail adults aged ≥ 60 years. A trained librarian developed comprehensive search strategies for MEDLINE, CENTRAL, EMBASE, and ClinicalTrials.gov. Two reviewers independently screened the studies, extracted data, and assessed the risk of bias using Cochrane’s RoB tool 1.0. Standardized mean differences (SMD) were calculated using Review Manager. Seven RCTs involving 305 participants were included. Five studies (n = 181) reported lean mass with an SMD of -0.11 (95% CI, -0.41 to 0.18). Six studies (n = 274) measured grip strength (SMD -0.01; 95% CI, -0.25 to 0.23). Three studies (n = 157) evaluated lower limb strength (SMD -0.11; 95% CI, -0.41 to 0.18), showing similar results. Morning protein intake had a marginal reduction in total daily energy intake (SMD -0.35; 95% CI, -0.70 to 0.00), and had a significant reduction in trials without exercise (SMD, -0.47; 95% CI, -0.82 to -0.11). As a conclusion, morning protein intake may not improve muscle mass, strength, or physical performance among older adults and may reduce little food intake without exercise. But the evidence is very uncertain. Further high-quality RCTs are needed for the effects of morning protein intake on muscle health in older adults.

PMID:42502805 | PMC:PMC13400828 | DOI:10.1002/fsn3.72171

JID Innov. 2026 Jun 4;6(5):100498. doi: 10.1016/j.xjidi.2026.100498. eCollection 2026 Sep.

ABSTRACT

Skin cancer is a growing public health concern, yet patterns in younger adults remain inadequately described. We quantified the global incidence, mortality, disability-adjusted life years, and age-standardized rates of melanoma and nonmelanoma skin cancer in adults aged 20-44 years using Global Burden of Disease 2021 estimates and assessed United States melanoma mortality in those aged 25-44 years from 1999 to 2023 using national vital statistics. From 1990 to 2021, age-standardized melanoma incidence declined, whereas nonmelanoma skin cancer cases rose from 142,018 to 292,052, with an increasing age-standardized incidence of basal cell carcinoma. The burden was greatest in countries with higher sociodemographic development and peaked at ages 40-44 years; women experienced a higher incidence, but men had higher mortality. In the United States, melanoma mortality decreased from 0.99 to 0.47 deaths per 100,000 between 1999 and 2023, representing an average annual reduction of 3.56%. Projections suggest continued declines in melanoma but sustained increases in nonmelanoma skin cancer. These findings indicate a growing and uneven skin cancer burden in young adults, supporting targeted prevention and earlier detection.

PMID:42502795 | PMC:PMC13400237 | DOI:10.1016/j.xjidi.2026.100498