Tag: statistics

Clin Park Relat Disord. 2026 Jul 26;15:100488. doi: 10.1016/j.prdoa.2026.100488. eCollection 2026.

ABSTRACT

Introduction: Clinical trials and observational studies have demonstrated that carbidopa/levodopa enteral suspension (CLES) significantly improves advanced Parkinson’s disease (aPD) symptoms. This study examined the real-world, long-term impact of CLES on patient-reported outcomes (PROs) in people with aPD. Methods: Pursuing Real-World Outcomes via Duopa Ecosystem (PROviDE) was a 36-month prospective, observational study evaluating the effectiveness of CLES in patients with aPD in the US. PROs were collected at baseline, 3 months, and every 6 months after CLES initiation and included OFF-time, Treatment Satisfaction Questionnaire for Medication-9 (TSQM-9), and Parkinson’s Disease Questionnaire-8 (PDQ-8) assessing PD-related quality of life (QoL). Longitudinal treatment effects were evaluated using mixed-effect models. Results: Of 104 patients, 47 (45.2%) provided 36 months of data and were evaluated in the final mixed-model analysis. Patients mean standard deviation (SD) age was 67.0 (8.7) years with a mean (SD) PD diagnosis of 11.0 (6.2) years. Compared with baseline, CLES resulted in statistically significant and clinically meaningful improvements in hours of OFF-time as early as month 3 (mean: -2.7 h/day, p < .0001) and sustained at month 36 (-1.7 h/day, p = .004). Improvements were also observed in treatment effectiveness (≥19 points, all p < .0001), global satisfaction with treatment and convenience of therapy (≥10 points each; all p < .001) over 36 months. A statistically significant improvement in PDQ-8 was observed as early as month 3 (-4.1, p = .001) with no worsening over time. Conclusion: Long-term treatment with CLES provides significant and clinically meaningful reduction in OFF-time, patient’s treatment satisfaction, and maintained QoL in the real-world setting.

PMID:42571531 | PMC:PMC13452392 | DOI:10.1016/j.prdoa.2026.100488

MethodsX. 2026 Jul 28;17:104077. doi: 10.1016/j.mex.2026.104077. eCollection 2026 Dec.

ABSTRACT

Wearable EEG-based Lie and Truth detection requires structured descriptor engineering to achieve reproducible results and ensure method transparency. The existing approaches use loosely integrated features alongside hidden modeling methods, which create challenges for understanding their results and verifying research progress across different studies. The existing research gap requires the development of a deterministic descriptor framework to document wearable EEG systems. The research presents the Structured Multi-Domain EEG Descriptor with Phase-Based Connectivity as a reproducible framework that uses five-channel wearable EEG signals to classify binary Lie-Truth. The method emphasizes coordinated descriptor organization and controlled evaluation, summarized as follows:•The structured integration of temporal statistics, fractal complexity, spectral power distributions, and phase-based connectivity within a unified descriptor representation augmented by meta-correlation modelling.•The processing framework provides detailed specifications for preprocessing, window-level segmentation, descriptor extraction, fold-wise normalization, classifier evaluation, and computational profiling.•A controlled evaluation strategy for examining statistical consistency, descriptor separability, domain-level feature contribution, and workstation-based computational feasibility.Validation on the publicly available LieWaves dataset demonstrates stable fold-wise behaviour and consistent classifier responses under controlled conditions.

PMID:42571525 | PMC:PMC13452325 | DOI:10.1016/j.mex.2026.104077

Health Care Transit. 2026 Jul 31;4:100151. doi: 10.1016/j.hctj.2026.100151. eCollection 2026.

ABSTRACT

INTRODUCTION: Each year in the United States, an estimated 1.2 million youth with chronic conditions or functional limitations reach adulthood and must transition from pediatric to adult health care, a process often fragmented by service loss, limited adult providers, and complex waiver and financial systems. The University of Alabama at Birmingham developed the Staging Transition for Every Patient (STEP) Program which includes an annual Healthcare Transition Conference. Here we describe the conference and analyze two years of attendee feedback.

METHODS: Conference planning followed an iterative, participatory co-design framework in which a steering committee of providers, community partners, caregivers, and individuals with lived experience shaped programming, and attendee feedback from each year informed the next. We evaluated the conference using post-conference surveys from the 2024 (n = 34) and 2025 (n = 43) events, summarized with descriptive statistics and thematic analysis; feedback from 2024 was used to tailor the 2025 program.

RESULTS: Across both years, attendees valued content on medical transition, Medicaid and community waivers, financial and legal planning, and lived experience. In 2025, 88% reported being “very likely” to attend again. In response to 2024 feedback, the 2025 program added sessions on financial planning, guardianship, day-program sessions and an expanded self-advocate panel. Despite these changes, the 2025 cohort continued to prioritize psychosocial topics including caregiver support and respite (55.8%), social support and relationships (53.5%), and aging with a disability (51.2%).

DISCUSSION/CONCLUSION: A community-engaged, iterative conference was highly valued but revealed a persistent gap between delivered logistical content and unmet psychosocial support needs. The STEP conference offers a transferable model for community-based transition education and a method for identifying and responding to evolving family needs.

PMID:42571513 | PMC:PMC13452330 | DOI:10.1016/j.hctj.2026.100151

PeerJ. 2026 Aug 5;14:e21614. doi: 10.7717/peerj.21614. eCollection 2026.

ABSTRACT

OBJECTIVE: This study aimed to investigate the acute effects of dynamic stretching (DS) combined with different blood flow restriction (BFR) pressures on explosive performance in healthy young males, and to examine whether these effects differed across estimated arterial occlusion pressure (AOP) levels and performance tasks.

METHODS: In a randomized crossover design, 20 participants completed four warm-up protocols: DS alone, and DS combined with BFR at 30%, 50%, or 70% of estimated AOP applied to the proximal thighs. Explosive performance was assessed before and after each warm-up protocol using countermovement jump (CMJ), standing long jump (SLJ), 10-m sprint (10mSS), and 505 change-of-direction (505COD) tests.

RESULTS: CMJ showed a significant time × condition interaction. All DS+BFR protocols produced greater CMJ change scores than DS alone (all p < 0.01), with mean changes of 5.80 ± 1.99 cm, 5.95 ± 2.33 cm, and 5.15 ± 1.90 cm for the 30%, 50%, and 70% estimated AOP conditions, respectively, compared with 3.50 ± 2.21 cm in the DS condition. No significant differences were observed among the three BFR pressures. In contrast, SLJ, 10-m sprint, and 505COD showed no significant time × condition interactions, indicating that adding BFR did not provide statistically greater acute benefits than the DS condition for these tasks.

CONCLUSION: Adding BFR to dynamic stretching produced an additional acute benefit for CMJ, but this effect was not pressure-dependent across the estimated AOP levels tested. The additional benefit of BFR was not observed for SLJ, 10-m sprint, or 505COD, suggesting that the acute effects of DS+BFR may be task-specific.

PMID:42571496 | PMC:PMC13452422 | DOI:10.7717/peerj.21614

J Shoulder Elb Arthroplast. 2026 Jun 25;10(4):100057. doi: 10.1016/j.jsea.2026.100057. eCollection 2026 Dec.

ABSTRACT

BACKGROUND: Minimal clinically important differences (MCIDs) following primary total elbow arthroplasty (TEA) remain undefined, limiting interpretation of clinical benefit. This study aimed to determine TEA-specific distribution-based MCIDs from baseline variability in primary elective TEA cohorts and identify previously published MCIDs across elbow conditions.

METHODS: A systematic search identified primary elective TEA studies reporting baseline variability statistics. Pooled standard deviations (SD) estimated MCIDs via the half-SD method (all measures) and the one standard error of measurement method (multi-item scales). A scoping review identified published anchor- or distribution-based MCIDs. Outcomes assessed: pain visual analog scale, Mayo Elbow Performance Score (MEPS), Disabilities of Arm, Shoulder and Hand, Quick Disabilities of Arm, Shoulder and Hand, Oxford Elbow Score, and elbow range of motion.

RESULTS: Fifty-six studies contributed to baseline data. Half-SD-derived MCIDs were 1.0 point for pain visual analog scale, 11 points for MEPS, 15° for flexion-extension arc, and 20° for pronation-supination arc; the one-standard error of measurement-derived MCID for MEPS was 16 points. The scoping review identified no TEA-specific MCID studies and 9 across other elbow conditions, with wide variability.

CONCLUSION: These TEA-specific, distribution-based MCID estimates for pain, function, and range of motion offer a pragmatic framework for outcome interpretation, shared decision-making, and future research.

PMID:42571476 | PMC:PMC13452322 | DOI:10.1016/j.jsea.2026.100057

J Pediatr Soc North Am. 2026 Jul 8;17:100421. doi: 10.1016/j.jposna.2026.100421. eCollection 2026 Nov.

ABSTRACT

BACKGROUND: Posterior spinal fusion (PSF) is the standard surgical treatment for progressive adolescent idiopathic scoliosis (AIS). While return to sport after PSF has been described, return to school (RTS) remains poorly defined despite its educational and psychosocial importance. This study aimed to quantify RTS timelines, compare anticipated versus observed absences, and evaluate demographic, surgical, psychosocial, and socioeconomic predictors.

METHODS: Consecutively enrolled English-speaking AIS and juvenile idiopathic scoliosis (JIS) patients undergoing PSF at a single institution between 2022 and 2025 were prospectively studied. Preoperative surveys captured demographics, school type, anticipated RTS, and awareness of accommodations available through a patient’s school setting. Postoperative surveys documented actual RTS, attendance, and barriers. RTS was defined as the first day the patient resumed full-day, in-person school attendance. Partial day attendance, hybrid instruction, and virtual learning were not separately analyzed. The Pain Catastrophizing Scale assessed psychological status, and the Area Deprivation Index (ADI) measured socioeconomic context. Group comparisons used chi-square/Fisher’s exact tests and t-tests/Mann-Whitney U; regression identified predictors.

RESULTS: A total of 118 patients (84% female; mean age 14.5 ± 1.9 years) were included. Families anticipated 31.4 days of absence, while 71 postoperative respondents reported a mean absence of 46.8 ± 18.6 days (P = .022). Homeschool and private school students demonstrated numerically shorter RTS intervals than public school students (26.3, 32.8, and 43.1 days, respectively); however, these differences did not reach statistical significance (P = .160). Fusion length, sex, ADI, and race were not independent predictors of RTS.

CONCLUSIONS: AIS/JIS patients undergoing PSF returned to school at a mean of 6.7 weeks, approximately 2 weeks later than anticipated. Exploratory analyses suggested possible differences by school type and psychosocial factors, which should be investigated further in future, larger studies.

KEY CONCEPTS: (1)There may be an educational gap, as families tend to underestimate the time required for their child to return to school (RTS).(2)Surgical and demographic factors, including length of fusion, sex, Area Deprivation Index, and race, were not associated with time to RTS.

LEVEL OF EVIDENCE: II, Prospective cohort study.

PMID:42571470 | PMC:PMC13452329 | DOI:10.1016/j.jposna.2026.100421

JSAMS Plus. 2026 Jul 30;8:100153. doi: 10.1016/j.jsampl.2026.100153. eCollection 2026 Dec.

ABSTRACT

BACKGROUND: Heart failure (HF) significantly reduces functional capacity and quality of life in patients classified as New York Heart Association (NYHA) functional class II-III. While cardiopulmonary rehabilitation (CR) is beneficial, innovative strategies are required to improve accessibility and effectiveness for individuals unable to tolerate high hemodynamic loads.

AIMS: To compare the effects of conventional moderate-to-high intensity resistance training (CRT) versus low-load resistance training combined with blood flow restriction (BFRRT) on clinical, functional, and biochemical outcomes in HF patients.

METHODS AND ANALYSIS: This randomized, prospective, parallel-group clinical trial will include 52 patients (NYHA II-III) allocated into CRT (60-80% 1RM) or BFRRT (20-30% 1RM, calibrated at 50% arterial occlusion pressure) groups. The supervised intervention lasts 4 months, with an 8-month post-intervention follow-up. The primary outcome is the change in serum NT-proBNP levels. Secondary outcomes include quality of life, echocardiographic ventricular function, functional capacity, and clinical events. Advanced statistical models and exploratory machine learning analyses with k-fold cross-validation will be utilized for predictive modeling and exploring personalized medicine strategies.

IMPLICATIONS: The REHAB-WASHOUT HF trial aims to establish an effective, safe, and accessible therapeutic approach for HF rehabilitation, potentially enhancing clinical outcomes and guiding personalized prescriptive strategies in cardiovascular rehabilitation.

ETHICS AND REGISTRATION: Approved by the local institutional review board (No. 5.848.965; CAAE 64955022.9.1001.0029). Trial registration: RBR-5y8k7d7.

PMID:42571467 | PMC:PMC13452277 | DOI:10.1016/j.jsampl.2026.100153

Public Health Pract (Oxf). 2026 Jul 24;12:100832. doi: 10.1016/j.puhip.2026.100832. eCollection 2026 Dec.

ABSTRACT

OBJECTIVES: The COVID-19 pandemic was associated with increased maternal morbidity and mortality, with racially minoritized women having worse outcomes than other women in the United States. However, there is little understanding of pandemic-specific stressors that may contribute to disparate outcomes. Thus, this analysis provides descriptive statistics of COVID-19 pandemic related factors among a sample of women who recently gave birth in the United States that can inform future public health disaster preparedness.

STUDY DESIGN: Cross-sectional analysis of secondary data.

METHODS: Analysis of 2020-2021 Pregnancy Risk Assessment Monitoring System COVID-19 supplement data (weighted n = 453,231) identified five pandemic experience factors through factor analysis: family household stressors, housing instability, COVID prevention measures, COVID household exposure, and external exposure. Prevalence of each factor was estimated overall and by demographic factors.

RESULTS: Family household stressors affected 42.1% of women, including increased anxiety (48.5%) and job loss (29.9%). Housing instability impacted 11.3%, while 35.2% struggled accessing prevention supplies. Significant disparities emerged: Black and Hispanic women experienced highest family stress rates (48.5%, 48.0%); American Indian/Alaska Native women faced greatest housing instability (21.6%). Younger, unmarried women and those with lower education, Medicaid enrollment, or pre-existing vulnerabilities experienced disproportionate burdens.

CONCLUSIONS: Findings necessitate targeted emergency preparedness protocols prioritizing pregnant women’s social support infrastructure, including housing assistance programs, expanded childcare services, and guaranteed access to prevention resources. The pandemic exacerbated maternal health disparities, with marginalized communities bearing the greatest burden. Medicaid expansion and culturally-responsive interventions should be implemented to support vulnerable populations during public health crises.

PMID:42571459 | PMC:PMC13452337 | DOI:10.1016/j.puhip.2026.100832

Vet Anim Sci. 2026 Jul 29;34:100790. doi: 10.1016/j.vas.2026.100790. eCollection 2026 Dec.

ABSTRACT

Heat stress is an increasingly important constraint on cattle welfare, fertility, productivity, and developmental resilience. DNA methylation may mediate part of the molecular response to thermal exposure, but current studies differ widely in tissue type, exposure model, assay platform, and endpoint definition. This review systematically synthesizes evidence linking heat stress to DNA methylation changes in cattle and evaluates whether a quantitative meta-analysis of global methylation responses is currently feasible. A PRISMA-informed search was conducted for peer-reviewed bovine studies published between 2015 and early 2026. The PECO framework defined cattle or cattle-derived biological material as the population, heat stress or thermal challenge as the exposure, thermoneutral, cooled, or non-stressed conditions as comparators, and DNA methylation-related measures as outcomes. The predefined primary quantitative endpoint was global DNA methylation or hydroxymethylation reported as a continuous outcome. Locus-specific, promoter-level, DMC, DMR, and multi-omics studies were retained for structured qualitative synthesis. Global methylation studies often reported non-significant bulk changes, whereas sequencing-based and promoter-level studies revealed extensive tissue-specific and locus-specific methylation signatures involving oxidative stress, immune regulation, metabolism, endocrine signaling, and developmental programming. A formal pooled meta-analysis was not statistically defensible because fewer than three independent studies reported complete and comparable group-level data for the predefined global methylation endpoint. Heat stress in cattle appears to induce targeted, tissue-specific methylome remodeling rather than a consistent genome-wide shift in global methylation. Future studies should report extractable group-level methylation statistics, standardized heat-load metrics, tissue and cell-composition information, and phenotypic outcomes to enable robust meta-analysis. Beyond reporting standardization, future trial and cohort designs should prospectively incorporate paired global and locus-specific methylation endpoints to enable meta-analytic pooling within the next research cycle.

PMID:42571439 | PMC:PMC13452235 | DOI:10.1016/j.vas.2026.100790

EClinicalMedicine. 2026 Jul 31;98:104122. doi: 10.1016/j.eclinm.2026.104122. eCollection 2026 Aug.

ABSTRACT

Circulating tumor DNA (ctDNA) has emerged as a powerful prognostic biomarker in gastrointestinal (GI) oncology, with the strongest evidence in colorectal cancer. Postoperative ctDNA positivity identifies patients at high risk of recurrence, and serial clearance patterns further refine risk. However, prognostic validity has not consistently translated into treatment-selection utility. In stage II colon cancer, DYNAMIC supported chemotherapy de-escalation without compromising recurrence-free survival, whereas DYNAMIC-III showed that escalation in ctDNA-positive stage III disease did not improve outcomes. More recent randomized data from CIRCULATE suggest that ctDNA-positive patients with proficient mismatch repair and microsatellite-stable stage II colon cancer may benefit from adjuvant chemotherapy, although the intention-to-treat primary endpoint was not statistically significant. COBRA further highlights the vulnerability of low-risk populations to assay-dependent interpretation and unvalidated clearance endpoints. Outside colorectal cancer, ctDNA is strongly prognostic in gastro-esophageal, pancreatic, and biliary tract cancers, but evidence supporting ctDNA-directed treatment remains limited. Assay heterogeneity, variable tumor shedding, postoperative sampling timing, false-positive and false-negative results, and uncertain benefit from treating molecular recurrence before radiographic disease remain major barriers. Prospective trials must show that biomarker-guided interventions improve patient-important outcomes before ctDNA can serve as a stand-alone treatment mandate across GI cancers.

PMID:42571422 | PMC:PMC13452147 | DOI:10.1016/j.eclinm.2026.104122