Tag: statistics

Psychooncology. 2026 Feb;35(2):e70389. doi: 10.1002/pon.70389.

ABSTRACT

OBJECTIVE: Rumination is a common cognitive response in cancer patients, influencing psychological adjustment. This study examined the associations between intrusive and deliberate rumination and self-compassion in individuals undergoing cancer treatment, using structural equation modeling (SEM).

METHODS: A cross-sectional correlational study was conducted with 202 adult cancer patients undergoing active treatment at a public hospital. Participants completed validated self-report instruments: the Event-Related Rumination Inventory and the Brief Self-Compassion Inventory. Data were analyzed using descriptive statistics, Pearson correlation, and SEM.

RESULTS: The SEM results indicated that intrusive rumination was significantly and negatively associated with self-compassion (β = -0.828, p < 0.001), whereas deliberate rumination showed a significant positive association with self-compassion (β = 0.753, p < 0.001). The model explained 60.3% of the variance in self-compassion. Subgroup analyses showed that self-compassion and deliberate rumination were higher among participants with higher education and those who were employed, while intrusive rumination was higher in patients with prior metastasis or relapse.

CONCLUSIONS: The findings underscore the need to distinguish between adaptive and maladaptive forms of rumination in cancer care. Targeting intrusive rumination and supporting deliberate reflection may represent important considerations for psychosocial care.

PMID:41653186 | DOI:10.1002/pon.70389

Psychooncology. 2026 Feb;35(2):e70395. doi: 10.1002/pon.70395.

ABSTRACT

BACKGROUND: Adult cancer survivors are likely to be hospitalised with chronic illnesses, although evidence for childhood and AYA survivors is limited.

AIM: This study quantified hospitalisations and the costs of health services used by survivors of childhood, adolescent, and young adult (AYA) cancers with and without chronic conditions.

METHODS: We assessed long-term survivors (≥ 5 years past diagnosis) of childhood and AYA cancers diagnosed at ages 0-39 years between 1997 and 2011 in Queensland, Australia. Utilising a linked administrative dataset, we determined the prevalence of chronic conditions from hospital records using classification codes (ICD-10-AM) and quantified hospitalisations and associated costs in 2024 Australian dollars (AU$). Generalised linear regression modelling was used to examine how chronic conditions affected healthcare costs, controlling for clinical and socio-demographic factors.

RESULTS: Of 14,422 participants, 16% (n = 2286) were hospitalised with at least one chronic disease, with hypertension (n = 675, 4.7%) and depression (n = 463, 3.2%) being the most common. Inpatient admissions were significantly higher for survivors with chronic conditions (mean 3, SD = 10) compared to those without chronic conditions (mean 1, SD = 4). The mean annual costs were highest for those with chronic kidney disease (AU$26,428, SD = AU$30,331), schizophrenia (AU$22,835, SD = AU$37,204), epilepsy (AU$22,361, SD = AU$37,224), paralysis (AU$22,051, SD = AU$32,165) and chronic heart failure (AU$21,912 SD = AU$38,763). Hypertension (AU$5.4 million) and depression (AU$4.3 million) incurred the highest total costs over the follow-up period.

CONCLUSION: Implementing targeted survivorship care and preventative measures for high-cost conditions such as schizophrenia and chronic kidney disease may optimise healthcare resource use and reduce the economic burden for this population.

PMID:41653182 | DOI:10.1002/pon.70395

J Adolesc Health. 2026 Feb 7:S1054-139X(25)00830-4. doi: 10.1016/j.jadohealth.2025.12.260. Online ahead of print.

ABSTRACT

PURPOSE: The adolescent mental health treatment gap is a significant public health challenge, especially in low-resource settings where services are often adult-oriented. The Safe Haven intervention, adapted from Zimbabwe’s Friendship Bench, addresses this gap by leveraging near-peer youth lay counselors trained in Problem-Solving Therapy. This study evaluates the feasibility and outcomes of Safe Haven across three sites in Botswana.

METHODS: Participants aged 12-25 years (N = 115) were recruited from clinical and community sites. Pre-intervention and post intervention assessments using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Shona Symptom Questionnaire measured depression, anxiety, and common mental disorder symptoms. Pre/post differences in scores were statistically tested using Wilcoxon signed-rank tests.

RESULTS: Significant reductions were observed in all mental health outcomes. Over four to six sessions (4-16 weeks), median Patient Health Questionnaire-9 scores decreased from 6 (interquartile range [IQR] 4-11) to 1 (IQR 0-3) (p < .001), with 78% showing improvement, and moderate depression symptoms reduced from 29% to 3%. Generalized Anxiety Disorder-7 scores decreased from 9 (IQR 7-12) to 2 (IQR 0-7), with 86% improving, and moderate or severe anxiety symptoms declined from 47% to 9%. Shona Symptom Questionnaire scores decreased from 10 (IQR 7-14) to 1 (IQR 0-4) (p < .001), with 93% improving.

DISCUSSION: Safe Haven demonstrates potential in addressing Botswana’s youth mental health needs, including underserved groups such as younger adolescents and those living with HIV. Although limitations include the prepost design and small sample size, findings support further scaling and controlled evaluations to optimize impact across diverse settings and populations.

PMID:41653177 | DOI:10.1016/j.jadohealth.2025.12.260

JACC Asia. 2026 Jan 28:S2772-3747(26)00027-X. doi: 10.1016/j.jacasi.2025.12.014. Online ahead of print.

ABSTRACT

BACKGROUND: Early-stage pulmonary arterial hypertension (PAH) with mild hemodynamic abnormalities is increasingly being concerned because of the revised PAH definition. However, there is a lack of randomized controlled trials evaluating the efficacy of currently available medications in this population.

OBJECTIVES: The ALEPH (Ambrisentan for Early Low-Risk Pulmonary Arterial Hypertension) trial is designed to investigate the efficacy and safety of ambrisentan in early-stage low-risk PAH patients.

METHODS: The ALEPH trial is a multicenter, randomized, double-blind, placebo-controlled clinical study. Eligible patients are diagnosed with PAH according to 2022 European Society of Cardiology and the European Respiratory Society guidelines, with mean pulmonary artery pressure >20 and <25 mm Hg, pulmonary vascular resistance >2 and ≤3 WUs, and PAWP ≤15 mm Hg by right heart catheterization, classified as low-risk, and have not previously received PAH-specific therapy. Participants are randomly assigned to receive either ambrisentan or placebo for 12 months. The primary endpoint is a composite of PAH progression. Secondary endpoints include changes in hemodynamic and echocardiographic parameters, N-terminal pro-B-type natriuretic peptide levels, World Health Organization functional class, 6-minute walk distance, and time to clinical events such as hospitalization or death. Primary analysis will be performed in the intention-to-treat population, with sensitivity analysis in the per-protocol population. Statistical analyses include Z-test for the primary endpoint, Cox proportional hazards models for time-to-event data, and analysis of covariance or Mann-Whitney U test for continuous variables.

CONCLUSIONS: The ALEPH trial aims to generate high-quality evidence regarding the efficacy and safety of ambrisentan monotherapy in early-stage, low-risk PAH. This study may provide valuable insight into early therapeutic intervention for patients with mild hemodynamic disorder. (Ambrisentan for Early Low-Risk Pulmonary Arterial Hypertension [ALEPH]; NCT06987097).

PMID:41653169 | DOI:10.1016/j.jacasi.2025.12.014

J Nutr Educ Behav. 2026 Feb 6:S1499-4046(25)00514-7. doi: 10.1016/j.jneb.2025.12.008. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate potential mediators of weight loss in the Strong Hearts, Health Communities-2.0 (SHHC-2.0) trial.

DESIGN: Community-randomized trial (intervention vs delayed intervention). Outcomes were evaluated at baseline and postintervention.

SETTING: Eleven rural, medically-underserved communities PARTICIPANTS: Women (n = 182), mean age 57.2 years, 97.6% White, non-Hispanic.

INTERVENTION: Classes delivered 2 times/wk for 24 weeks, targeting diet and physical activity behaviors.

MAIN OUTCOMES MEASURES: Dependent variable: weight; mediators: diet and physical activity behaviors, and related psychosocial factors.

ANALYSIS: Mixed linear regressions evaluated the effect of mediators on weight loss.

RESULTS: Significant mediators included dietary behaviors (Rapid Eating Assessment for Participants-Short; 31.8%; P = 0.03), healthy eating attitudes (23.0%; P = 0.03), and dietary cognitive restraint (29.8%; P = 0.01). Physical activity did not mediate weight loss; however, a worsening in attitudes toward exercise was a mediator of weight loss (22.6%; P = 0.01). Social support for diet and physical activity was unchanged in the intervention group and did not mediate weight loss effects.

CONCLUSIONS AND IMPLICATIONS: Healthy eating attitudes and dietary cognitive restraint represent important targets for future behavioral interventions for weight loss. Hypothesized mediators found to be nonsignificant (i.e., social support) represent opportunities for future intervention optimization.

PMID:41653167 | DOI:10.1016/j.jneb.2025.12.008

World J Surg. 2026 Feb 7. doi: 10.1002/wjs.70260. Online ahead of print.

ABSTRACT

PURPOSE: Glucagon-like peptide-1 (GLP-1) receptor agonist medications are revolutionizing approaches to weight loss, including in the neoadjuvant setting. Obesity poses a challenge to the hernia surgeon, as an independent modifiable risk factor for hernia occurrence which also connotates a higher risk of post-operative morbidity, complications, and recurrence. This is the first review to investigate the neoadjuvant potential of GLP-1 receptor agonists to result in weight loss prior to elective abdominal wall hernia surgery in obese patients.

METHODS: A computer-assisted search of Medline, PubMed, and EMBASE was conducted to identify studies reporting on the utility of GLP-1 receptor agonist medications in neoadjuvant weight loss prior to abdominal wall hernia surgery.

RESULTS: A total of three retrospective studies were included in this narrative study. In this study, GLP-1 receptor agonists have been found to contribute to either statistically significantly greater weight loss and BMI reductions, or at least equivalent outcomes, in the pre-operative setting prior to elective abdominal wall hernia repair, when compared to conventional lifestyle modifications alone. However, neoadjuvant GLP-1 receptor agonists have not been shown to be superior to pre-operative bariatric surgery in effecting weight loss and BMI reduction. GLP-1 receptor agonists have also been found to be associated with an earlier surgery date if weight loss is the barrier to surgery, when compared to both lifestyle modifications and bariatric surgery. Crucially, GLP-1 receptor agonists have not been shown to lead to more complications or hernia recurrences in terms of post-operative outcomes. These results are limited by the relative paucity of data, the heterogeneity of the included studies, and the absence of long-term outcomes.

CONCLUSION: There may be a promising role for GLP-1 receptor agonists in the neoadjuvant approach to abdominal wall hernia repair, by inducing and accelerating pre-operative weight loss without a negative impact on post-operative outcomes. Only limited conclusions can yet be drawn at this stage and large-scale prospective studies, ideally in a randomized controlled setting, are necessary to investigate this finding further.

PMID:41653161 | DOI:10.1002/wjs.70260

J Surg Oncol. 2026 Feb 7. doi: 10.1002/jso.70211. Online ahead of print.

ABSTRACT

Tranexamic acid (TXA) is widely used across surgical specialties to reduce perioperative blood loss, yet its specific role in hepatic resection remains unclear. This meta-analysis, performed according to PRISMA guidelines, evaluated the efficacy and safety of TXA in liver surgery. Outcomes of interest included mean intraoperative blood loss, the proportion of patients receiving transfusion, and mean units of red blood cells transfused intraoperatively and postoperatively. Secondary endpoints included postoperative mortality, thromboembolic events, and hospital length of stay. Of 36 articles assessed, nine studies met eligibility criteria for inclusion. TXA use was associated with a statistically significant reduction in intraoperative blood loss (SMD – 0.18; 95% CI, – 0.28 to – 0.09; p < 0.01), although transfusion requirements did not differ significantly between groups (RR 0.81; 95% CI, 0.47-1.38; p = 0.44). Interpretation of these findings is limited by substantial heterogeneity among included studies (I² = 82%). While TXA appears effective in reducing intraoperative bleeding, its use may confer a higher risk of postoperative thromboembolic complications, suggesting that TXA administration during hepatic resection should be selective and individualized rather than routine.

PMID:41653150 | DOI:10.1002/jso.70211

Global Spine J. 2026 Feb 7:21925682261424528. doi: 10.1177/21925682261424528. Online ahead of print.

ABSTRACT

Study DesignRetrospective study.ObjectiveThis study aimed to investigate the association between preoperative patient expectations and postoperative satisfaction in elderly patients with adult spinal deformity (ASD), with particular emphasis on identifying potential dose-response relationships.MethodsWe conducted a retrospective cohort study of elderly patients (aged ≥65 years) with ASD undergoing thoracolumbar fusion surgery at our institution. Participants were stratified into satisfied and dissatisfied cohorts based on postoperative the North American Spine Society (NASS) satisfaction scores assessed at follow-up. Comprehensive data collection included demographic characteristics, radiological parameters, surgical variables, and perioperative outcomes. Propensity score matching using the nearest-neighbor method was applied to both groups of patients. Conditional logistic regression models adjusted for confounders were employed to assess associations. Nonlinear relationships were investigated through smoothed curve fitting with covariate adjustment. Threshold effects were analyzed using piecewise regression models, with receiver operating characteristic (ROC) curve analysis validating optimal cutoff values.ResultsIn our study involving 234 elderly patients with ASD undergoing thoracolumbar fusion surgery between September 2019 and September 2022, we analyzed statistically significant differences between a case group (patient dissatisfied) and a control group (patient satisfied). We matched 82 patients in each group using nearest-neighbor matching. Despite this matching, there were still significant differences in key variables such as American Society of Anesthesiologists (ASA), Age-adjusted Charlson Comorbidity Index (ACCI), complications, previous spine surgery, perioperative outcomes, and preoperative expectation (P < .05). In our fully adjusted model, we found that higher expectation scores were associated with lower satisfaction levels. Our curve-fitting analysis revealed that the risk of decreased patient satisfaction increased notably when the expectation score exceeded 53 points. Two-piecewise regression confirmed this threshold (OR = 0.29, 95% CI 0.17 ∼ 0.38, P < .001), corroborated by Receiver operating characteristic (ROC) analysis (AUC = 0.808, sensitivity 83.6%, specificity 63.2%).ConclusionOur findings identify 53 points as the critical threshold on preoperative expectation scales where satisfaction risk markedly escalates in elderly spinal deformity patients undergoing thoracolumbar fusion. The demonstrated dose-response relationship underscores the clinical importance of preoperative expectation management in this population.

PMID:41653124 | DOI:10.1177/21925682261424528

Infancy. 2026 Jan;31(1):e70074. doi: 10.1111/infa.70074.

ABSTRACT

Digital media has become ubiquitous for families, yet little is known about how infants and toddlers are exposed to it across different contexts and demographics. Most existing research focuses narrowly on total screen time, often neglecting critical factors such as media type, user, timing, and background exposure. The current study sought to address this gap by asking 252 socioeconomically diverse caregivers of children 8-25 months about their child’s media exposure, including how much, what kinds, when, by whom, and in what form digital media is used in the home. Consistent with prior work, infants averaged over 2 hours/day of direct media use but were exposed to even higher rates of indirect background TV (over 4.6 hours/day). Such background exposure represents 66%-75% of children’s total TV and handheld device exposure and is significantly more common on weekends. However, there is substantial variability in children’s media environments, with older infants being exposed to greater amounts and more diverse forms of media. Notably, children from lower-SES households experience more background media and caregiver phone use, which may introduce both visual and auditory distractions during key developmental periods. This study highlights that the most prominent source of media exposure early in life is not through children’s personal use of devices, but rather indirect exposure through background media use, which varies widely across families. To truly capture the landscape of young children’s technology exposure and the impact on development, we must consider the broader media environment, not just the screen in front of the child.

PMID:41653108 | DOI:10.1111/infa.70074

Vet Med Sci. 2026 Mar;12(2):e70835. doi: 10.1002/vms3.70835.

ABSTRACT

INTRODUCTION: The public health and economic impact of brucellosis remain a significant concern in Ethiopia. The high seroprevalence rates observed in both camels and humans indicate the potential for cross-species transmission, highlighting the risk of brucellosis spreading. However, there is limited evidence concerning the relationship between brucellosis prevalence in humans and camels in the pastoralist regions of Ethiopia.

METHODS: A cross-sectional study was conducted among 390 camels and 390 camel farmers in the Dire district from November 2023 to March 2024, using multistage sampling. This study aimed to determine the seroprevalence of brucellosis in camel farmers and their camels. During screening and confirming the presence of brucellosis, a modified rose Bengal plate test (MRBPT) and an indirect enzyme-linked immunosorbent assay (I-ELISA) were used, respectively, as a test series.

RESULT: Among 390 camels, 7.17%, 95% CI (4.99-10.22) and 4.36%, 95% CI (2.72-6.91) were seropositive for Brucella using MRPT and I-ELISA, respectively. Among 390 camel farmers, Brucella seroprevalence was 7.69% (95% CI: 5.42-10.81) by MRBPT and 3.08% (95% CI: 1.75-5.35) by I-ELISA. In camels, adult (OR: 5.59, 95% CI: 1.67-44.48), female (OR: 2.83, 95% CI: 1.54-12.81) and large herds (OR: 5.10, 95% CI: 1.27-20.49) were statistically significant risk factors for the seroprevalence of camel brucellosis. In humans, the presence of a positive animal in the household (OR: 5.07, 95% CI: 1.10-23.34) and camel farmers who consume raw milk (OR: 2.75, 95% CI: 1.51-5.21) were also statistically significant risk factors for the seroprevalence of brucellosis.

CONCLUSION: The presence of a Brucella-positive camel in households and the consumption of raw milk highlight shared exposure at the human-animal interface. In marginal areas of Ethiopia, such as the Dire district, camel herders often face challenges accessing public services and information regarding zoonotic diseases. Consequently, promoting preventive strategies and raising awareness about the public health effects of camel brucellosis are encouraged to decrease the impact of this zoonotic disease in pastoral communities.

PMID:41653100 | DOI:10.1002/vms3.70835