Tag: statistics

Drugs Real World Outcomes. 2026 Jun 10. doi: 10.1007/s40801-026-00560-y. Online ahead of print.

ABSTRACT

BACKGROUND: Antidepressants are widely prescribed, with increasing use among older adults. However, evidence on their association with dementia remains inconsistent.

OBJECTIVE: This study examines the association between long-term antidepressant use and dementia risk in older adults using a propensity score-matched design, with a separate analysis of long-term tricyclic antidepressant (TCAs) use, given their anticholinergic properties.

METHODS: A retrospective cohort study was conducted using Swiss healthcare claims data (2013-2023) from older adults aged 65 years and above. Long-term antidepressant users (> 2 years) and long-term TCAs users were separately matched to nonusers using variable ratio propensity score matching. The primary outcome was incident dementia, defined by a recorded dementia diagnosis or antidementia drug prescription. Covariates were derived from inpatient and/or outpatient records, depending on the respective variable.

RESULTS: A final sample of 19,155 long-term antidepressant users were compared with 20,648 propensity score matched nonusers. After adjusting for covariates, long-term antidepressant use was significantly associated with dementia (odds ratio [OR] 1.92, 95% confidence interval [CI] 1.72-2.15, p < 0.001). Long-term TCAs users also had higher odds of developing dementia compared with nonusers (OR 1.73, 95% CI 1.33-2.25, p < 0.001). Sensitivity analyses largely confirmed these results: long-term antidepressant users had higher odds of developing dementia compared with short-term users (OR 1.23, 95% CI 1.11-1.35, p < 0.001), but for TCA, the difference between long-term and short-term users was not statistically significant (OR 1.25, 95% CI 0.99-1.57, p = 0.059).

CONCLUSIONS: These findings suggest that long-term antidepressant and long-term TCAs use is associated with an increased risk of dementia in older adults, even after accounting for various comorbidities. This study adds to the ongoing debate on the link between antidepressants and dementia. Future research is needed to further clarify underlying mechanisms and guide clinical practice.

PMID:42268515 | DOI:10.1007/s40801-026-00560-y

Ann Biomed Eng. 2026 Jun 10. doi: 10.1007/s10439-026-04213-7. Online ahead of print.

ABSTRACT

PURPOSE: This study investigates the dynamic regulation of cerebral oxygenation in individuals with mild cognitive impairment (MCI) compared to healthy controls, using a novel pseudorandom binary sequence (PRBS) gas challenge. Traditional assessments often overlook frequency-dependent features of cerebrovascular control; this work aims to uncover latent deficits through broadband perturbations and nonparametric dynamic modeling.

METHODS: Seventeen ApoE4-negative participants (9 controls, 8 MCI) underwent a three-session supine protocol involving PRBS-modulated inhalation of hypoxic and hypercapnic gas mixtures. Physiological signals-including near-infrared spectroscopy (TOI), arterial pressure (ABP), and end-tidal CO₂ (PETCO₂)-were recorded. Laguerre-based Volterra modeling and Principal Dynamic Mode (PDM) decomposition were used to analyze the dynamic response of cerebral oxygenation to ABP and CO₂ stimuli. Group differences were statistically assessed using Welch’s t-tests and repeated measures ANOVA.

RESULTS: Controls showed significant increases in ventilation and TOI from baseline to stimulation ( $p<0.01$ ), while MCI did not. Gain of the first CO₂ PDM increased in controls during PRBS (p = 0.016) but decreased in MCI. A low-frequency ABP-derived PDM ( $\sim$ 0.014 Hz), consistent with endothelial-dependent vasodilation, was elevated only in controls during stimulation. Persistent differences in spectral recovery, kernel profiles, and PDM Gains suggested impaired baroreflex and chemoreflex regulation, and possible disruption of cholinergic-linked neurovascular coupling in MCI.

CONCLUSION: PRBS gas modulation combined with dynamic modeling revealed subtle but significant cerebrovascular control impairments in MCI. This methodology enables mechanistic insights into early pathophysiology and may aid future physiomarker development.

PMID:42268486 | DOI:10.1007/s10439-026-04213-7

Metab Brain Dis. 2026 Jun 10;41(1):132. doi: 10.1007/s11011-026-01895-9.

ABSTRACT

Alzheimer’s disease (AD) is characterized by progressive cognitive decline accompanied by profound disturbances in cerebral energy metabolism. Mitochondrial dysfunction has long been implicated in AD pathophysiology; however, the specific contribution of mitochondrial enzymes in human disease remains fragmented across heterogeneous studies. Enzymes regulating carbon entry into the tricarboxylic acid cycle, oxidative phosphorylation, and redox balance represent key metabolic control points whose dysfunction may contribute to neuronal vulnerability. To systematically synthesize human evidence on mitochondrial enzyme alterations in Alzheimer’s disease and to evaluate the feasibility of quantitative meta-analysis based on current reporting practices. A systematic literature search was conducted in PubMed, Scopus, and Web of Science from database inception through January 2026 in accordance with PRISMA 2020 guidelines. Studies were included if they investigated mitochondrial enzymes in human postmortem brain tissue, human-derived cellular models, or peripheral biospecimens. Risk of bias was assessed using the ROBINS-I tool. The feasibility of meta-analysis was evaluated based on the availability and comparability of group-level summary statistics. Fifteen studies met the eligibility criteria and were included in the final synthesis. Mitochondrial enzymes involved in carbon entry into the tricarboxylic acid cycle, oxidative phosphorylation, redox regulation, and neurotransmitter-linked mitochondrial metabolism were the most frequently investigated targets. Direct enzyme-activity evidence most consistently implicated selected metabolic control points, particularly PDHC and αKGDHC, whereas additional studies supported mitochondrial impairment through protein or post-translational modification changes, respiratory dysfunction, redox alterations, or RNA-regulatory mechanisms. Quantitative meta-analysis was not feasible due to heterogeneous assay methodologies, variable normalization strategies, and inconsistent reporting of group-level summary statistics. Human evidence consistently implicates mitochondrial enzyme dysfunction as a central metabolic feature of Alzheimer’s disease. However, progress toward cumulative quantitative synthesis remains limited by methodological heterogeneity and incomplete reporting of enzyme activity outcomes. Standardized measurement and reporting of mitochondrial enzyme alterations will be essential to advance mechanistic understanding and enable future meta-analytic integration.

PMID:42268484 | DOI:10.1007/s11011-026-01895-9

Daru. 2026 Jun 10;34(2):33. doi: 10.1007/s40199-026-00609-x.

ABSTRACT

BACKGROUND: Growing evidence supports the therapeutic role of nutraceuticals as complementary and alternative therapies in patients with type 2 diabetes mellitus (T2DM). Resveratrol, a natural polyphenol compound has been shown to modulate metabolically disturbances include insulin resistance and lipid profile disturbances.

OBJECTIVES: This umbrella review and meta-analysis study conducted to assess the effect of resveratrol on glycemic indices and lipid profile in T2DM.

METHODS: The study was performed by using the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines (PRISMA) checklist. The PubMed, Web of Sciences, and Google Scholar databases were used to search the published papers up to 2025. The AMSTAR questionnaire was used for assessing the quality of eligible studies. Additionally, The Cochran Q test and I² statistics were used for examining heterogeneity.

RESULTS: Of 10 meta-analyses evaluating the resveratrol effects on glycemic indices and lipid profile showed no significant effects on fasting blood sugar, glycosylated hemoglobin A1c (HbA1c), insulin, homeostatic model assessment for insulin resistance (HOMA-IR), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), triglyceride (TG), total cholesterol (TC), despite significant heterogeneity. Nevertheless, based on SMD analyses, resveratrol supplementation showed only significant effects on LDL-C reduction. Also, significant decline in serum insulin level was observed for sample size ≥ 500 and study number ≥ 10.

CONCLUSION: Given the high heterogeneity and limitations attributed to the study, resveratrol supplementation was not considered as a beneficial agent in declining glycemic indices and lipid profile in patients with T2DM.

PMID:42268476 | DOI:10.1007/s40199-026-00609-x

Saudi Dent J. 2026 Jun 10;38(6):84. doi: 10.1007/s44445-026-00177-5.

ABSTRACT

To evaluate the stain resistance of repressed IPS Emax and Celtra Press after thermo-mechanical fatigue. Two pressable glass ceramics, IPS e.max press (Ivoclar, Vivadent) and Celtra press (Dentsply, Sirona), were used in this study. Thirty discs (2 × 10 mm) were fabricated: (n = 15) e.max press (Group E) and Celtra press (Group C). The discs were fabricated using a repressing technique where remnant buttons from the initial press were reshaped as new ingots by removing all sprues. Each group was subdivided into three equal subgroups after thermo-mechanical fatigue according to the immersion solution: subgroup (AS): Artificial saliva (control immersion medium), subgroup(T): Tea solution and subgroup (C): Cola solution, (n = 5). Color and translucency measurements were recorded for all specimens. Data was collected and statistically analyzed using a two-way ANOVA test to study the interaction of study variables. Statistical analysis revealed that IPS e.max Press displayed significantly greater color deviation (ΔE) compared to Celtra Press in artificial saliva and tea groups, whereas no significant difference was observed between groups immersed in cola (p = 0.064).TP increased after staining, particularly in cola subgroups, with Celtra Press/cola showing the highest values. Two-way ANOVA revealed significant effects of material, staining medium, and their interaction on both ΔE and TP (p < 0.001). Both repressed IPS e.max Press and Celtra Press ceramics are susceptible to changes in color stability and translucency following exposure to common staining agents and thermomechanical aging.

PMID:42268468 | DOI:10.1007/s44445-026-00177-5

Environ Geochem Health. 2026 Jun 10;48(9):396. doi: 10.1007/s10653-026-03284-8.

ABSTRACT

This study investigates the impact of the September 2024 flood on the trace elements concentration in the floodplain sediments at the mouth of the Nysa Kłodzka River into the Odra Valley. The research integrated geological mapping, sediment sampling (112 samples from 56 locations), laboratory analyses of trace element concentrations (44 representative samples from 22 locations), statistical evaluation (Mann-Whitney U test), and calculation of the geochemical and ecotoxicological indices (Enrichment Factor, Geoaccumulation Index, Contamination Factor, Degree of Contamination, Single Index of Ecological Risk Factor, Potential Ecological Risk Index). The results indicate that the 2024 flood event caused an increase in the concentrations of trace elements in surface sediments compared to subsurface, pre-flood layers (significant increase of Pb and Cd). The applied geochemical and ecotoxicological indices confirmed that the 2024 flood event enhanced both contamination levels and ecological risk in floodplain sediments. Overall, the findings emphase the important role of flood events in the mobilization, transport, and redistribution of contaminants within river floodplains.

PMID:42268447 | DOI:10.1007/s10653-026-03284-8

Environ Monit Assess. 2026 Jun 10;198(7):703. doi: 10.1007/s10661-026-15541-5.

ABSTRACT

Air pollution and fine particulate matter (PM2.5) pose significant environmental and public health challenges, particularly in rapidly urbanizing regions. Long-term assessment of spatiotemporal patterns of PM2.5 is essential for effective air quality management and pollution mitigation. This study examines the long-term spatiotemporal distribution of PM2.5 concentrations across multiple decades using advanced geostatistical and hybrid modeling approaches. Pakistan, ranked as one of the most polluted countries worldwide according to recent global air quality assessments, is selected as the study region to investigate persistent patterns of particulate pollution. A hybrid spatial interpolation (HSI) framework integrating machine learning algorithms with regression kriging is employed to improve prediction accuracy and capture complex spatial trends. A decade-by-decade analysis was carried out to capture changes in PM2.5 patterns over successive decades. The results indicate that PM2.5 concentrations remained consistently elevated across most regions of Pakistan, frequently exceeding the WHO annual guideline of $5\mu {\text{g,m}}^{–3}$ and, in recent assessments, reaching levels multiple times higher than this threshold, with evidence of increasing extremes and spatial expansion rather than a uniform rise in average levels. Spatial analysis revealed a persistent southwest to northeast orientation along the Indus corridor, covering Karachi, Hyderabad, and Sukkur, and extending toward the central plains of Multan, Lahore, Faisalabad, and Gujranwala. The proposed HSI framework achieved improved interpolation performance and provided a more refined representation of spatial PM2.5 patterns. Overall, the findings highlight the persistence and spatial expansion of PM2.5 concentrations and provide a quantitative basis for improved air quality management and policy formulation.

PMID:42268431 | DOI:10.1007/s10661-026-15541-5

Naunyn Schmiedebergs Arch Pharmacol. 2026 Jun 10. doi: 10.1007/s00210-026-05538-9. Online ahead of print.

ABSTRACT

Delirium in older adults is often due to an acute infectious insult or metabolic dysfunction. Traditionally, muscarinic antagonists have been implicated in delirium, but the association remains inconsistent. The delirium-producing effects of medications require a multifaceted understanding that goes beyond their anticholinergic actions and simultaneously considers other medical etiologies. The current study is a subgroup analysis of an 18-month prospective study on dyselectrolytemia conducted in the Department of Geriatric Medicine in a tertiary North Indian hospital. Findings are compared with those of a decade-old study from a non-geriatric service at the same hospital. Among 411 admissions, delirium occurred in 26.5% and was multifactorial in 64.2%. Infections and acute kidney injury were the leading causes. Medications were involved in 23.9%. Medication-induced delirium cases were related to severe hyponatremia or hypernatremia and direct neurological effects, in addition to usual antimuscarinic actions. However, at the study population level, while 3.3-fold higher odds of delirium were observed in patients aged 80 and above, no association was observed with the number of medications or with medications with strong anticholinergic potential. Increasing age was the strongest independent risk factor for delirium. A higher rate of medication-related causes was identified compared to past data from the same center, but different setups preclude any definite conclusions. Medication-induced delirium had a favorable outcome and was reversible in the majority. The study reinforces the role of meticulous medication review in therapeutic decision-making for older persons. The absence of an association with anticholinergic medications may be due to differences in population characteristics, limited statistical power of the study design, and evolving prescribing trends. The delirium-producing risk of individual medication classes warrants further larger studies.

PMID:42268391 | DOI:10.1007/s00210-026-05538-9

Dig Dis Sci. 2026 Jun 10. doi: 10.1007/s10620-026-10054-0. Online ahead of print.

ABSTRACT

BACKGROUND: Nowadays, Endoscopic Muscularis Dissection (EMD) and Endoscopic Cap External Snare Resection (ECESR) are utilized as effective techniques for removing small submucosal tumors. Herein, We aimed to clarify the efficacy and outcomes of ECESR vs EMD to determine the optimal minimally invasive approaches for managing small (≤ 12 mm) Gastric Submucosal Tumors (sGSMT) arising from the muscularis propria (MP) layer.

METHODS: This study retrospectively included data from patients who underwent ECESR or EMD to excise sGSMT of 12 mm or less. The propensity score matching (PSM) algorithm mitigated selection bias using age, gender, tumor size, location, and growth patterns for one-to-one matching. Finally, 96 patients were divided into ECESR (48) and EMD (48) groups. Clinicopathologic characteristics, procedural outcomes (procedure time, tumor resection time, and R0 resection), adverse events, length of hospital stay, and costs were compared between the two groups.

RESULTS: After PSM, the ECESR group experienced significantly shorter procedure time and tumor resection time (23 [21, 22] vs 47 [40-56] min; 5 [5, 6] vs 27 [26-30] min, P < 0.001). The ECESR group exhibited significantly shorter hospital stays (P < 0.001) and lower operation costs (P < 0.001) compared to the EMD group. Both groups achieved high rates of complete (R0) resection, with no statistically significant difference observed. Importantly, no recurrence or metastasis was observed in either group during follow-up. The incidence of adverse events, including perforation and postoperative complications, was comparable between groups, and no statistically significant differences were identified..

CONCLUSIONS: For sGSMT (≤ 12 mm), ECESR exhibits shorter procedure and tumor resection times, speedier recovery, lower operating costs, and shorter hospital stays compared to EMD.

PMID:42268359 | DOI:10.1007/s10620-026-10054-0

Appl Psychophysiol Biofeedback. 2026 Jun 10. doi: 10.1007/s10484-026-09792-8. Online ahead of print.

ABSTRACT

An investigation the effect of an Electromyography Respiratory Biofeedback (ERB) method on the anxiety level of male patients with incomplete cervuaical spinal cord injury (CSCI). 40 patients (men) were included in the study considering the inclusion criteria and randomly divided into two groups of 20 patients. The control group received 15 sessions of common respiratory physiotherapy (CRPT). In addition to 15 sessions of CRPT, the intervention group also received 15 sessions of ERB. Anxiety level was measured by the Zung questionnaire for both groups at three levels, before the beginning of the treatment, after the completion of the treatment and one month after the completion of the treatment sessions. The results were evaluated by SPSS software. The results of the repeated measure test showed that both CRPT and the addition of ERB can have statistically significant effects on the anxiety level of patients over time (p-value < 0.001). The emotional and physical subscales of the Zung questionnaire were also statistically significantly affected by the passage of time in both groups. The values related to the total score of the Zung questionnaire and its emotional and physical subscales, in the control group, increased again one month after the treatment sessions, while in the control group, these values continued to decrease. CRPT aimed at improving diaphragmatic breathing can reduce the anxiety level of patients with CSCI in the short term, and these positive effects may diminish over time. However, the addition of ERB appears to support the short-term maintenance of these therapeutic effects during the one-month follow-up.

PMID:42268352 | DOI:10.1007/s10484-026-09792-8