Tag: statistics

Endocr Metab Immune Disord Drug Targets. 2026 Jan 27. doi: 10.2174/0118715303389695251030101747. Online ahead of print.

ABSTRACT

INTRODUCTION: Urethral stricture is a common urological disease characterized by a narrowing of the urethra leading to functional changes that reduce or completely block urine flow from the kidney to the bladder. This condition significantly affects the patient’s quality of life and can lead to serious complications, such as urethral dilatation and hydronephrosis, which may result in irreversible kidney failure if left untreated.

METHODS: This was an observational cross-sectional study conducted on 35 patients, treated for urethral stricture at the Department of Uro-nephrology Surgery, Ninh Thuan Province General Hospital, from January to October 2023.

RESULTS: All enrolled patients underwent urethral stricture endoscopic incision using holmium laser, and were followed up at 1 and 3 months postoperatively. The difference in the degree of hydronephrosis on CT scans before and after surgery at 3 months was statistically significant (p < 0.01).

DISCUSSION: To report the safety and efficacy outcomes of holmium laser urethrotomy for the treatment of urethral stricture, patients underwent internal urethrotomy with holmium laser energy, with an average age of 47.7 ± 15.8 years (range: 15-72 years). Thirty patients (85.7%) underwent urological surgery, 3 (8.6%) underwent obstetric and gynecological surgery, and 2 (5.7%) had unknown etiologic causes.

CONCLUSION: The use of the holmium laser for the management of urethral strictures has been found to be safe and effective, ensuring shorter operating times, a lower recurrence rate, and fewer serious postoperative complications.

PMID:41603220 | DOI:10.2174/0118715303389695251030101747

Endocr Metab Immune Disord Drug Targets. 2026 Jan 27. doi: 10.2174/0118715303418611251125045911. Online ahead of print.

ABSTRACT

INTRODUCTION: Diabetic microvascular disease (DMiVD) involves dysregulated immune cell function, but the precise pathogenic mechanisms remain unclear.

MATERIALS AND METHODS: We conducted a two-sample Mendelian randomization (MR) study using comprehensive GWAS and FinnGen summary statistics, encompassing 731 immune cell phenotypes, 473 gut microbial taxa, 91 inflammatory proteins, 179 lipid types, 1,400 plasma metabolites, 20 micronutrients, and DMiVD cases. The analysis aimed to evaluate causal associations between these variables and DMiVD. We further explored potential mediating roles of gut microbiota, plasma lipidome, and metabolites using mediation analysis, with multiple sensitivity tests confirming the robustness of our findings.

RESULTS: We identified 20 immune cell phenotypes, 33 gut microbial taxa, 31 lipid types, and 83 plasma metabolites with significant causal associations with DMiVD. Mediation analysis revealed that the risk effect of CD3+ resting Tregs on diabetic nephropathy was partly mediated by phosphatidylcholine (16:0_18:2) (10.7%). Additionally, the protective effect of CX3CR1 on monocytes against DMiVD was partly mediated by Unclassified Bacilli A (35%), Species CAG-177 sp003538135 (22.6%), and triacylglycerol (52:6) (25.5%).

DISCUSSION: These findings advance understanding of DMiVD pathogenesis, highlighting that modulation of key metabolic pathways and immune regulatory nodes may represent promising therapeutic strategies. Further experimental studies are needed to validate these potential causal relationships.

CONCLUSION: Using causal inference approaches, this study identifies immune cell-mediated mechanisms underlying DMiVD, involving gut microbiota, plasma lipids, and metabolites. The results suggest potential intervention targets for mechanistic studies and therapeutic development.

PMID:41603219 | DOI:10.2174/0118715303418611251125045911

Curr Med Imaging. 2026 Jan 27. doi: 10.2174/0115734056419448251211063018. Online ahead of print.

ABSTRACT

INTRODUCTION: Small gastrointestinal stromal tumors (SGISTs, maximum diameter≤2 cm) still carry a risk of malignancy, and their preoperative evaluation remains a significant challenge. Radiomics, an emerging technique for analyzing image data, has yet to be employed to assess the risk stratification of SGISTs. To develop and validate a CT radiomics model for the preoperative prediction of risk stratification in patients with SGISTs.

METHOD: This study enrolled 133 patients with SGISTs, including 97 in the low-grade group and 36 in the high-grade group. Patients were randomly assigned to a training set (n = 93) and a testing set (n = 40) at a ratio of 7:3. Radiomics features were extracted from preoperative CT images, and dimensionality reduction was performed using the LR-LASSO to identify the most predictive features for constructing the radiomics model. Clinical features were evaluated using univariate and multivariate logistic regression analyses to develop a clinical model. Subsequently, the optimal radiomics and clinical features were integrated to establish a combined model. Model performance was evaluated using ROC curve analysis, and a corresponding nomogram was generated to facilitate clinical application. The Delong test was used to compare the ROC curves, with a p-value < 0.05 considered statistically significant.

RESULTS: Univariable clinical analysis identified maximal tumour diameter as the only significant predictor, with the clinical model achieving an AUC of 0.641 (95% CI: 0.533-0.748). Among the radiomics signatures derived from multiphase CT (non-contrast to delayed phases), the model based on portal venous phase images demonstrated the highest discriminative ability, yielding the best AUC values in both the training set (AUC = 0.848, 95% CI: 0.764-0.931) and the testing set (AUC = 0.824, 95% CI: 0.696-0.953). The combined model, which integrated radiomics features with maximum tumour diameter, demonstrated improved performance, attaining an AUC of 0.862 (95% CI: 0.743-0.975) in the training set and 0.859 (95% CI: 0.743-0.975) in the testing set. Notably, the predictive performance of both the radiomics and combined models was significantly greater than that of the clinical model (DeLong test, P < 0.05). However, no statistically significant differences were observed between the AUC values of the radiomics and combined models. Calibration curves indicated a good fit, and the DCA demonstrated that both the radiomics model and the combined model provided greater clinical benefits.

DISCUSSION: The radiomics model demonstrated superior performance to the clinical model for the preoperative prediction of risk stratification in SGISTs. As a visualization tool, the nomogram of the combined model plays a critical role in optimizing early surgical resection decisions.

CONCLUSION: The radiomics model could serve as an effective tool for non-invasive risk stratification of SGISTs, offering clear advantages over risk stratification models based solely on conventional clinical parameters. This approach could support improved preoperative clinical decisionmaking.

PMID:41603218 | DOI:10.2174/0115734056419448251211063018

Neurourol Urodyn. 2026 Jan 28. doi: 10.1002/nau.70221. Online ahead of print.

ABSTRACT

PURPOSE: Hemorrhagic radiation cystitis (HRC), a complication of pelvic radiation therapy, results from hypoxic and ischemic injury and causes urinary symptoms like hematuria, dysuria, frequency, urgency, and retention. Hyperbaric Oxygen Therapy (HBOT), where patients breathe 100% oxygen at increased atmospheric pressure, enhances tissue oxygenation, promoting neovascularization and reducing inflammation. The optimal pressure remains unclear, though pressures above 1.41 ATA are efficacious, with higher pressures increasing side effect risks. This study compares the efficacy and side effects of 2.0 versus 2.5 ATA therapy at two sites.

MATERIALS AND METHODS: A retrospective chart review of 93 patients treated for HRC at two sites was conducted. Data on demographics, efficacy (symptom reduction), and side effects were analyzed using GraphPad Prism. Chi-squared and Mann-Whitney tests were used for statistical analysis. Mixed effects logistic regression models were used.

RESULTS AND CONCLUSIONS: Fewer patients treated at 2.5 ATA experienced gross hematuria within 1-year post-therapy compared to those treated at 2.0 ATA (p < 0.05). However, time to hematuria recurrence showed no difference between the groups (10.2 vs. 9.6 months). No difference was observed in other urinary symptoms. Adverse events were increased at 2.5 ATA when analyzed with a mixed effects logistic regression model. Other treatment parameters, including treatment number and duration, were similar across groups. These findings suggest an association between 2.5 ATA treatment and lower rates of hematuria recurrence, but further randomized studies are necessary to determine causality. Future studies should also assess quality of life and explore variations in treatment protocol for efficacy and safety.

CLINICAL TRIAL REGISTRATION: As this is a retrospective study, no clinical trial registration is necessary.

PMID:41603214 | DOI:10.1002/nau.70221

Neurourol Urodyn. 2026 Jan 28. doi: 10.1002/nau.70218. Online ahead of print.

ABSTRACT

BACKGROUND: Bladder filling rate has the potential to significantly impact the results of a urodynamics study (UDS). The International Continence Society (ICS) recommends two methods to determine the filling rate: Body weight divided by 4 (BW/4) and 10% of maximum voided volume (MVV) (10%MVV) from a bladder diary. However, there is no evidence if one method is superior to the other.

MATERIALS AND METHODS: This prospective study included patients undergoing UDS for non-neurological diseases, and the filling rate was calculated using both formulas. The study cohort consisted predominantly of patients with voiding lower urinary tract symptoms (LUTS). All the patients underwent UDS twice-once with the filling rate calculated by BW/4 method and once with the 10% MVV method. All UDS parameters, including the maximum cystometric capacity (MCC) were recorded and compared between the two methods used to calculate the fill rates. The MCC recorded during the UDS, with both methods, was further compared with the patient’s MVV documented on the bladder diary to assess its accuracy.

RESULTS: The study included 31 patients, and the calculated fill rate by the BW/4 method was 16 mL/min, and that with 10%MVV was 33 mL/min. The MCC on the UDS was 323 mL (IQR: 238-422) for the BW/4 method and 348 mL (IQR: 236-430) for the 10% MVV method, with no statistically significant difference from the MVV as recorded on the bladder diary (p = 0.961 and p= 0.549, respectively). Other urodynamic parameters, including first sensation, first desire to void, strong desire, bladder compliance, and detrusor overactivity, also showed no significant variation between the two methods to calculate the filling rate.

CONCLUSION: Both the BW/4 and 10% MVV formulas provide reliable estimates of MCC and do not significantly alter the urodynamic parameters. While the BW/4 method better aligns with the physiological filling rates, the 10% MVV method can result in faster filling and shorter duration of the urodynamic study, without adversely affecting its quality. These findings, however, may not apply to patients with storage LUTS, and studies in more diverse populations are warranted.

PMID:41603208 | DOI:10.1002/nau.70218

Epilepsia. 2026 Jan 28. doi: 10.1002/epi.70076. Online ahead of print.

ABSTRACT

OBJECTIVE: Forecasting epileptic seizures is a difficult task. Studies of seizure prediction have investigated many different EEG features, but none of them have been useful enough to be applied in clinical practice beyond trials. Moreover, most of these features have been applied to short-term intracranial EEG (iEEG) recordings, limiting the possibility of reliable statistical evaluation. This paper proposes a machine learning algorithm to forecast an epileptic seizure 2-4 mins before seizure. This allows patients to seek help, or stimulation devices to work.

METHODS: This paper investigates a large subset of features from the past and present to unravel which features and feature analysis methods will yield the best performance on long-term iEEG recordings (from 14 patients with focal epilepsy) and thus provide the most reliable step toward clinical utility. Specifically, this study implements a multiple long-time scale cycle feature analysis framework for seizure forecasting that considers the state-of-the-art time series features of critical slowing down (autocorrelation and variance) as well as interictal epileptiform discharge (IED) / spike rate, High Frequency Activity (HFA), seven different univariate features, and three Neural Mass Model (NMM) features based on brain dynamics.

RESULTS: Seizure phase histograms of all the features are then analyzed to investigate each feature’s potential for seizure forecasting by evaluating corresponding synchronization indices (SI) on fast (40 minutes to 2 days) and slow (2+ days) wideband time scales. Out of all combinations considered, the overall performance comparison across patients highlights that ‘autocorrelation + variance + NMM + spike rate’ features achieve the highest average AUC of 0.83, showcasing its performance in forecasting seizures.

SIGNIFICANCE: A model is proposed that has a similar performance compared to the state-of-the-art method, without the need of selecting the best channel prior to model building. Light is also shed on the comparative performance on long-term recordings of many of the seizure forecasting features considered in the past.

PMID:41603191 | DOI:10.1002/epi.70076

Endocr Metab Immune Disord Drug Targets. 2026 Jan 26. doi: 10.2174/0118715303412026251125095355. Online ahead of print.

ABSTRACT

INTRODUCTION: Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system, influenced by both genetic and environmental factors. Among the environmental factors, early childhood self-medication may be relevant in MS development. This study aimed to evaluate the association between MS risk and self-medication practices before the age of 15.

METHODS: Under a case-control approach, 260 demographically matched healthy controls from the Azeri community and 469 MS patients completed a comprehensive questionnaire on childhood self-medication history. Regarding the kind and frequency of drug usage, statistical comparisons were made among the groups using the chi-square test.

RESULTS: Self-medication was common in both cohorts; however, individuals with multiple sclerosis exhibited a markedly greater use of corticosteroids, analgesics, and hypnotics (p < 0.05). Conversely, healthy controls reported more frequent use of iron and calcium supplements, antihistamines, acetaminophen, antibiotics, and adult cold medications (p < 0.05). No significant differences were observed for multivitamins, vitamin D, or non-steroidal anti-inflammatory drugs (p > 0.05).

DISCUSSION: This study suggests that unsupervised use of certain medications, such as corticosteroids and hypnotics, before age 15 may increase the risk of developing multiple sclerosis, while common supplements and over-the-counter drugs may have a protective effect. Responsible drug use in childhood should be emphasized through education and regulation.

CONCLUSION: Early-life use of certain medications, especially corticosteroids and hypnotics, may be linked to increased MS risk, while the use of supplements and common over-the-counter drugs might have protective associations. Educational and regulatory efforts are needed to prevent unsupervised medication use in children.

PMID:41603186 | DOI:10.2174/0118715303412026251125095355

Ginekol Pol. 2026 Jan 28. doi: 10.5603/gpl.105643. Online ahead of print.

ABSTRACT

OBJECTIVES: Vaginal flatus is a common postpartum issue that can impact women’s quality of life. This study investigates the effectiveness of Kegel exercises in reducing vaginal flatus among postpartum women.

MATERIAL AND METHODS: In this study, forty postpartum women were enrolled between July 2022 and December 2022 at the Gynecology and Obstetrics Clinic of Istanbul Camlıca Medipol Hospital. The required sample size was calculated based on a power analysis assuming a medium effect size (Cohen’s d = 0.5), a power of 80%, and a significance level of 5%, resulting in a minimum of 17 participants per group. To account for potential dropouts, 20 participants were included in each group. Women in this study were randomly assigned to either an experimental or a control group. The experimental group performed Kegel exercises, whereas the control group received no intervention. Participants in the experimental group completed Kegel exercises three times daily in three different positions for three weeks. Additionally, a six-week home exercise program was implemented, including fast and slow contractions targeting both type I and type II muscle fibers. The assessment included vaginal flatus frequency and bother scores measured through a validated questionnaire, as well as sexual quality of life evaluated using the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PSQ-12).

RESULTS: A significant reduction in vaginal flatus frequency and bother scores was observed in the experimental group following the intervention (p < 0.01). The mean vaginal flatus frequency score decreased from 2.95 to 2.0 in the experimental group. Comparisons of pre- and post-intervention vaginal flatus frequency/bother scores and PSQ-12 values revealed a statistically significant difference only in the experimental group (p < 0.05).

CONCLUSIONS: The findings indicate that Kegel exercises effectively reduce the frequency and bother associated with vaginal flatus in postpartum women. Incorporating pelvic floor exercise into postpartum care programs may improve overall well-being and sexual health outcomes.

PMID:41603160 | DOI:10.5603/gpl.105643

Epilepsia. 2026 Jan 28. doi: 10.1002/epi.70096. Online ahead of print.

ABSTRACT

OBJECTIVE: Pathogenic variants in γ-aminobutyric acid type A (GABA_A) receptor genes have been associated with a wide spectrum of neurological disorders. We aimed to delineate the clinical trajectories associated with gain-of-function (GoF) and loss-of-function (LoF) variants in GABRB2 and GABRB3, and to develop a risk-prediction model for gross motor dysfunction based on age at seizure onset.

METHODS: Clinical data, including seizure onset, epilepsy syndromes, cognitive outcomes, and gross motor function classification system (GMFCS), were collected through direct interviews, physician reports, and literature review. Kruskal-Wallis, Mantel-Cox and non-parametric analysis of variance (ANOVA) with Dunn’s corrected post hoc tests were used for statistical comparisons. A logistic ordinal regression model was developed to predict GMFCS outcomes based on age at seizure onset.

RESULTS: We analyzed a cohort of 117 individuals with pathogenic GABRB2 (n = 49) and GABRB3 (n = 68) variants. Fifty-three individuals carried GoF variants and 64 carried LoF variants. The GoF group was associated with earlier seizure onset, higher seizure frequency, and lower rates of seizure freedom. Gross motor dysfunction was markedly worse in the GoF group, with 64% classified as GMFCS IV or V (non-ambulation), compared to 7.5% in the LoF group. An inverse correlation was found between age at seizure onset and GMFCS severity in the GoF, but not the LOF group. The risk model predicted a >90% likelihood of non-ambulation for individuals with GoF variants and seizure onset before 1 month of age, decreasing to ~35% with seizure onset after 20 months.

SIGNIFICANCE: We found a clear genotype-phenotype correlation in GABRB2- and GABRB3-related disorders, demonstrating that GoF variants are associated with a more severe neurodevelopmental trajectory. The age at seizure onset serves as a biomarker for predicting motor outcomes in individuals with GoF variants. These findings provide guidance regarding prognosis, need for early intervention, and data for comparison of efficacy in targeted therapeutic interventions for GABA_A receptor-related disorders.

PMID:41603155 | DOI:10.1002/epi.70096

Transfusion. 2026 Jan 28. doi: 10.1111/trf.70097. Online ahead of print.

ABSTRACT

BACKGROUND: Blood collection agencies are shifting to gender-neutral risk assessment for donor eligibility. Pre-implementation data on donor eligibility and acceptance rates are essential to understand the likely impact of these changes locally.

STUDY DESIGN AND METHODS: A cross-sectional online survey was emailed to current Australian blood donors (donated in the last 12 months). Consistent with the recommendations of the United Kingdom’s For the Assessment of Individualised Risk (FAIR) project and the United States of America (USA) Food and Drug Administration (FDA) gender-neutral screening criteria, participants were asked about sexual behaviors in the last 3 months (multiple partners, new partners, anal sex) and whether being asked about these would deter them from donating. Demographic characteristics and behavioral responses were analyzed using descriptive statistics and chi-square tests.

RESULTS: Of 7938 respondents (11.3% response rate), only 0.6% (95% CI 0.4-0.8) would be ineligible under gender-neutral criteria (0.7%, 95% CI 0.2-1.8 of those who donated in the last 3 months). Those potentially ineligible were younger and less likely to identify as heterosexual. While tolerance for screening questions was generally high (≥70.0% indicated questions would not stop them donating), 12.7% (95% CI 12.0-13.4) indicated that one or more of the questions asked of all would stop or be quite likely to stop them attempting to donate. Some variation in tolerance was observed by demographic categories.

DISCUSSION: Implementation of gender-neutral screening criteria in Australia would result in minimal donor loss due to ineligibility. While questions would be generally tolerated, careful implementation considering demographic variations is warranted.

PMID:41603152 | DOI:10.1111/trf.70097