Tag: statistics

J Palliat Med. 2026 Mar 1:10966218261425592. doi: 10.1177/10966218261425592. Online ahead of print.

ABSTRACT

OBJECTIVES: To determine the frequency with which emergency medical services (EMS) clinicians recognize patients enrolled in hospice and describe their prehospital management.

METHODS: Observational cohort study of patients enrolled in hospice who were transported by EMS within a health system between May 5, 2018, and June 4, 2023. Two physicians reviewed each encounter to determine whether interventions were comfort-focused (hospice philosophy) or life-sustaining care. Interrater reliability was 100% (k = 1.0). Descriptive statistics are provided.

RESULTS: EMS clinicians identified hospice enrollment in 51% (n = 46) of 88 encounters. Most patients (90%, n = 79) received comfort-focused care. Life-sustaining care was provided to four patients identified as hospice-enrolled and included cardiopulmonary resuscitation, an advanced airway, and vasopressors (n = 1, 25%); spinal immobilization (n = 2, 50%), and naloxone (n = 1, 25%).

CONCLUSION: Most patients received care consistent with the philosophy of hospice. However, EMS clinicians may have only identified half of patients enrolled in hospice. This demonstrates an opportunity to improve recognition of patients’ care preferences, starting in the out-of-hospital setting.

PMID:41766378 | DOI:10.1177/10966218261425592

Psychol Med. 2026 Mar 2;56:e59. doi: 10.1017/S0033291726103341.

ABSTRACT

BACKGROUND: Poverty is associated with the severity of common mental health disorders and increased physical comorbidities. However, its effects on severe mental illness (SMI), beyond increasing their incidence, are less understood, especially in low- and middle-income countries. We here examined the relationship between baseline household income and subsequent mental and physical health outcomes in a large cohort of individuals diagnosed with schizophrenia or bipolar disorder in Colombia.

METHODS: Retrospective cohort and case-control study using electronic health records from over 5 million Colombians. We identified individuals diagnosed with schizophrenia or bipolar disorder and their baseline household income. Mental health outcomes included third-line antipsychotic treatments (clozapine or antipsychotic polypharmacy) and psychiatric hospitalizations. Physical outcomes included diagnoses of hypertension, type 2 diabetes, and HbA1c levels, compared with rates in individuals without SMI.

RESULTS: We included 12,216 (6,485 women) participants newly diagnosed with bipolar disorder or schizophrenia between 2019 and 2023. Compared to middle-income participants (between $700-1,750USD/month), patients on a low income (less than $700USD/month) were more likely to require third-line antipsychotic treatment (OR 1.84 [1.64, 2.08]) and psychiatric hospitalization (incidence rate ratio 1.30 [1.21, 1.41]). Low-income participants with SMI had hypertension and diabetes rates like middle-income participants without SMI who were 20 years older. However, the combined effect of SMI and low income together posed a less-than-additive risk. Lower income was associated with higher HbA1c levels in diabetes, while a diagnosis of SMI was associated with lower levels.

CONCLUSIONS: Low income at SMI onset is associated with worse mental and physical health outcomes.

PMID:41766372 | DOI:10.1017/S0033291726103341

Mol Oncol. 2026 Mar 1. doi: 10.1002/1878-0261.70218. Online ahead of print.

ABSTRACT

Transcriptional heterogeneity in pancreatic ductal adenocarcinoma (PDAC) arises not only from changes in gene expression but also from dynamic rewiring of gene-gene coordination. Using a divergent-edge framework applied to 77 155 malignant cells from 42 tumors, we identified four reproducible adaptive modules-integrated growth-energy (IGE), stress-adaptive transcription (SAT), IL-2-linked immune evasion (IL2), and multi-pathway collective invasion (MPC)-that cut across canonical PDAC states and reflect distinct regulatory programs. Integrating these modules with CRISPR-Cas9 dependency profiles and PRISM drug-response data revealed that adaptive behaviors collapse into two higher-order axes: a biosynthetic-metabolic IGE axis enriched for translational and DNA-repair dependencies, and a broader SAT-IL2-MPC stress-immune-invasion axis characterized by proteostasis, cytokine-linked, and cytoskeletal vulnerabilities. This architecture emerges only when divergent-edge modules are mapped into functional genomics space. Module activity also carried clinical relevance in PDAC. SAT-high tumors showed poorer survival, while MPC-high tumors exhibited a similar adverse trend; together, these modules defined a stress-immune-invasion poor-prognosis axis. In contrast, IGE activity showed no overall risk association, although an optimal-cut point-defined IGE-high subgroup displayed modestly improved survival.

PMID:41766370 | DOI:10.1002/1878-0261.70218

BJPsych Bull. 2026 Mar 2:1-7. doi: 10.1192/bjb.2026.10223. Online ahead of print.

ABSTRACT

AIMS AND METHOD: Treatment non-adherence is a well-established predictor of relapse in schizophrenia, yet its broader clinical impact remains unclear. This study examines the association between clinician-recorded treatment non-adherence and clinical outcomes during the first year following a schizophrenia diagnosis. Using a bespoke natural language processing algorithm applied to anonymised electronic health records, we classified the recorded treatment adherence status of 2667 patients. Multivariable and Poisson regression analyses were conducted to assess associations of recorded treatment non-adherence with clinical outcomes.

RESULTS: Compared with the remainder, those classified as non-adherent had greater increases in recorded symptoms and higher frequency and duration of in-patient admissions and crisis care episodes. They were also prescribed a greater number of different antipsychotics and developed a greater number of recorded physical health comorbidities.

CLINICAL IMPLICATIONS: Treatment non-adherence is associated with markedly poorer clinical outcomes, emphasising the importance of early identification and targeted interventions to support adherence.

PMID:41766367 | DOI:10.1192/bjb.2026.10223

Asia Pac J Clin Oncol. 2026 Mar 1. doi: 10.1111/ajco.70093. Online ahead of print.

ABSTRACT

AIM: To explore the supportive care needs of people with cancer and their caregivers in South Australia and identify areas for service improvement.

METHODS: A cross-sectional survey study was conducted. Quantitative data assessed unmet needs across multiple supportive care domains, while qualitative responses provided contextual insights. Descriptive statistics and thematic content analysis were used to interpret findings.

RESULTS: Psychological and emotional needs emerged as key priorities and were frequently underpinned by unmet informational and practical needs. Emotional distress was prevalent across the sample, despite only a minority of respondents reporting that access to psychological services was an unmet need. Caregivers often reported that their emotional well-being was not prioritized, leading to stress and burnout. A significant unmet need for both groups was access to tailored, relevant information, especially regarding government entitlements and navigating the healthcare system. Practical and financial concerns, including fatigue, reduced functional ability, financial strain, and challenges accessing transport, were also common. These findings highlight that supportive care needs are interconnected, with gaps in one domain often exacerbating challenges in others.

CONCLUSION: Supportive care for people with cancer and their caregivers requires an integrated approach that embeds psychological support, delivers accessible and tailored information, and ensures equitable access to practical resources. Aligning services with the Australian Cancer Plan can help reduce disparities, improve engagement, and enhance overall well-being. Future longitudinal research should explore evolving needs, with a focus on underrepresented populations, including culturally and linguistically diverse groups, men, younger individuals, and people with rarer cancers.

PMID:41766360 | DOI:10.1111/ajco.70093

J Helminthol. 2026 Mar 2;100:e25. doi: 10.1017/S0022149X26101205.

ABSTRACT

Domestic cats are the only felines living exclusively with humans, making them ecologically invasive and widespread across terrestrial habitats. Their domestication stems from their rodent control abilities and companionship. However, they are susceptible to gastrointestinal parasites such as Ancylostoma spp., Toxocara cati, and Dipylidium caninum, causing issues like anaemia, vomiting, and sometimes death, especially in kittens. These parasites can also pose zoonotic risks, transmitting diseases like visceral and ocular larva migrants to humans. A total of 100 cats with no deworming history were examined over six months. The overall prevalence of intestinal helminths was 23.0%, with Ancylostoma spp. being the most common (11.0%), followed by Toxocara cati (7.0%), Taenia spp. (2.0%), and mixed infections (3.0%). The prevalence was higher in females (26.92%) than in males (18.75%). Age-wise, kittens under 6 months had the highest infection rate (36.17%), while cats aged 6-12 months showed the lowest (10.71%). Non-descriptive breeds exhibited a higher infection rate (34.88%) than descriptive breeds (14.03%). Most cats were kept in confined spaces (72.0%), with 57.0% being descriptive breeds. Cats were mostly fed a mix of cooked and commercial cat food (59.0%), while only 33.0% were vaccinated and 20.0% dewormed. Behavioural issues like licking (51.0%) and self-biting (13.0%) were noted. Only 41.0% of owners were aware of zoonotic disease risks from cats. Chi-square analysis revealed significant associations between infection rates and risk factors (variables) such as breed, age, diet, vaccination, and deworming status. Non-descriptive breeds, unvaccinated cats, and those fed vegetarian diets had significantly higher infection rates (p < 0.05). Unconfined housing also contributed to increased infection risk, though not statistically significant. The research was significant because it highlighted the public health risks, as many cat owners and pet lovers were unaware of the zoonotic potential of intestinal helminths in cats.

PMID:41766343 | DOI:10.1017/S0022149X26101205

Clin Chem Lab Med. 2026 Mar 2. doi: 10.1515/cclm-2026-0169. Online ahead of print.

NO ABSTRACT

PMID:41766327 | DOI:10.1515/cclm-2026-0169

Shanghai Kou Qiang Yi Xue. 2025 Dec;34(6):561-570.

ABSTRACT

PURPOSE: To investigate the effects of small extracellular vesicles (sEVs) derived from human umbilical cord mesenchymal stem cells(hUCMSCs) on the migration and osteogenic/odontogenic differentiation ability of human dental pulp stem cells(hDPSCs), the migration and tube formation ability of human umbilical vein endothelial cells (HUVECs) and their possible mechanisms.

METHODS: hUCMSCs, hDPSCs and HUVECs were cultured and identified, hUCMSC-sEVs and LPSpre-hUCMSC-sEVs were isolated and identified, HUVECs and hDPSCs were assigned to 4 kinds of treatments, including the negative control group(NC), the positive control group(PC), the hUCMSC-sEVs group and the LPSpre-hUCMSC-sEVs group. Cell migration ability was detected by Transwell and wound healing assays. Tube formation capacity of HUVECs was assessed by tube formation experiment. The osteogenic/odontogenic differentiation ability of hDPSCs was evaluated by alizarin red staining and RT-qPCR. High-throughput small RNA sequencing was used to define miRNA profiles in sEVs.

RESULTS: hUCMSCs, hDPSCs, HUVECs, hUCMSC-sEVs and LPSpre-hUCMSC-sEVs were successfully isolated and identified. Compared with NC group, both LPSpre-hUCMSC-sEVs group and hUCMSC-sEVs group promoted migration of hDPSCs, migration and tube formation of HUVECs. There was no significant difference between LPSpre-hUCMSC-sEVs group and hUCMSC-sEVs group in promoting migration of hDPSCs (P＞0.05). LPSpre-hUCMSC-sEVs group was stronger than hUCMSC-sEVs group in promoting migration and tube formation of HUVECs(P＜0.05). The calcium salt deposition in LPSpre-hUCMSC-sEVs group and hUCMSC-sEVs group was higher than that in PC group, and the calcium salt deposition in LPSpre-hUCMSC-sEVs group was higher than that in hUCMSC-sEVs group(P＜0.05). The mRNA expression levels of ALP, OSX, OCN and RUNX2 in PC group, hUCMSC-sEVs group and LPSpre-hUCMSC-sEVs group were higher than those in NC group(P＜0.05), and hUCMSC-sEVs group and LPSpre-hUCMSC-sEVs group were higher than PC group(P＜0.05). In addition, the expression levels of OCN and RUNX2 in LPSpre-hUCMSC-sEVs group were higher than those in hUCMSC-sEVs group(P＜0.05), while there was no significant difference in ALP and OSX between LPSpre-hUCMSC-sEVs group and hUCMSC-sEVs group(P＞0.05). The expression level of DSPP in PC group and hUCMSC-sEVs group was higher than that in NC group, but the difference was not statistically significant(P＞0.05). The expression level of DSPP in LPSpre-hUCMSC-sEVs group was higher than that in PC group (P＜0.05). The most highly expressed miRNAs including hsa-miR-21-5p, hsa-let-7a-5p, hsa-miR-100-5p, hsa-miR-26a-5p and hsa-miR-222-3p, and differentially expressed miRNAs including hsa-miR-199a-3p, hsa-miR-122-5p, hsa-miR-1246 and hsa-miR-615-3p were detected, which may be the key factors of LPSpre-hUCMSC-sEVs.

CONCLUSIONS: Small extracellular vesicles derived from human umbilical cord mesenchymal stem cells can promote migration and osteogenic/odontogenic differentiation of hDPSCs, as well as migration and angiogenesis of HUVECs, and LPS can enhance these effects, which may be related to miRNAs which are the most abundantly and diffferentially expressed in LPSpre-hUCMSC-sEVs.

PMID:41766305

Melanoma Res. 2026 Mar 2. doi: 10.1097/CMR.0000000000001092. Online ahead of print.

ABSTRACT

To compare ultrasonographic and histopathological measurements of tumor size in enucleated eyes with choroidal melanoma and to evaluate the prognostic significance of tumor dimensions and morphological characteristics in a Serbian cohort. This retrospective study included 59 consecutive patients with histopathologically confirmed choroidal melanoma who underwent enucleation at the University Eye Hospital, Clinical Centre of Serbia. All ultrasonographic examinations, surgical procedures, and histopathological assessments were performed by single dedicated subspecialists. Preoperative B-scan ultrasonography was used to measure tumor base diameter and thickness, which were compared with postoperative macroscopic histopathological dimensions using paired statistical tests, Bland-Altman analysis, and intraclass correlation coefficients (ICC). Survival outcomes were assessed using Pearson and Spearman correlations and Kaplan-Meier analysis. Patients were followed for a minimum of 1 year, with some monitored for up to 5 years. Data are presented as mean ± SD. The mean ultrasonographic base diameter and thickness were 14.63 ± 3.98 and 10.34 ± 3.54 mm, respectively, compared with 18.04 ± 6.54 and 10.55 ± 3.72 mm on pathology. Bland-Altman analysis demonstrated good agreement for tumor thickness (mean difference 0.2 mm; limits of agreement -5.5 to +5.5 mm) and acceptable agreement for base diameter (mean difference 3.4 mm; limits -8.2 to +15.1 mm). ICC indicated moderate agreement for base diameter (0.501) and excellent agreement for thickness (0.843). Pathological thickness correlated significantly with shorter metastasis-free survival (r = -0.293, P = 0.024). Kaplan-Meier analysis showed significantly poorer survival for patients with T3-T4 tumors. Ultrasonography provides a reliable preoperative estimation of choroidal melanoma size, particularly for tumor thickness, although histopathology remains essential for prognostication. Survival patterns in this cohort align with international data, highlighting the relevance of tumor thickness and morphology and emphasizing the value of data from an underrepresented region.

PMID:41766297 | DOI:10.1097/CMR.0000000000001092

J Pediatr Orthop B. 2026 Mar 2. doi: 10.1097/BPB.0000000000001342. Online ahead of print.

ABSTRACT

Hereditary multiple exostoses (HME) represent a rare skeletal disorder characterized by multiple osteochondromas, often leading to angular deformities in the lower limbs as well as leg length discrepancy (LLD), managed with tension band plates (TBP) for deformity correction. However, the utility of both angular deformity and LLD in HME has not been comprehensively evaluated. In this study, we retrospectively reviewed 25 pediatric patients with HME who visited our institution and reached skeletal maturity between 2012 and 2024, assessing a total of 50 limbs. Surgical indications included patients aged greater than 10 years with an open growth plate, predicted LLD of greater than or equal to 20 mm at the skeletal maturity, and a mechanical axis zone (MAZ) greater than or equal to Zone 2. We categorized the outcomes into four groups: excellent [LLD < 10 mm; mechanical axis percentage (%MA) ≤ ±25%], good (LLD < 15 mm; %MA ≤ ±50%), fair (LLD < 20 mm or at least one limb classified as %MA ≤ ±100%), and poor (worse than the previous categories). We used paired t-tests for statistical analyses. Among the 17 surgically treated patients, TBP was performed on 27 limbs and 60 physes. In most cases, multisite and staged surgeries were required. Angular deformities improved significantly, with the mean hip-knee-ankle angle reduced from 7.8 to 2.7° (lower extremity < 0.01), and 92% of limbs achieved MAZ Zone 1. LLD was corrected from 17.6 to 5.6 mm (P < 0.01) at an average correction rate of 0.47 mm/month. The final outcomes were excellent, good, and fair or poor in 12, 11, and 2 patients, respectively. Major complications were not observed. TBP treatment is effective in correcting both angular deformity and LLD in patients with HME, offering a minimally invasive strategy for comprehensive correction of this complex skeletal dysplasia. Careful surgical planning and timing are essential and staged multisite procedures are often required.

PMID:41766296 | DOI:10.1097/BPB.0000000000001342