Tag: statistics

Disabil Rehabil. 2026 Aug 5:1-11. doi: 10.1080/09638288.2026.2706363. Online ahead of print.

ABSTRACT

PURPOSE: To test psychometric properties to support the validity of the Arabic language version of the Modified Falls Efficacy Scale (A-MFES) for use with older adults in rehabilitation settings.

MATERIALS AND METHODS: A cross-sectional study included the response of A-MFES for 207 older adults (66.6 ± 5.8) from Saudi Arabia. Rasch analysis was used to investigate psychometric properties like unidimensionality with reliability, targeting, rating scale functioning and Differential Item Functioning (DIF).

RESULTS: The main dimension was explained by 78.8% of the variance, which confirmed the unidimensionality of the A-MFES. The reliability coefficient was 0.95, indicating high internal consistency. Targeting showed that item difficulty covered 96% of the participants’ ability. No statistically significant DIFs were observed between males and females or between age groups. Rating scale functioning of the original 11-category scale indicated overlap between the adjacent categories. Collapsing adjacent categories suggested a six-category scale, which indicated better functioning.

CONCLUSION: Five of six validity evidence supported the validity of the A-MFES for use in rehabilitation settings to evaluate fall-related self-efficacy among older adults. The A-MFES indicated promising use for identifying older adults at fall risk and planning interventions accordingly. However, revision of rating scale structure is recommended, and further investigation is needed.

PMID:42554356 | DOI:10.1080/09638288.2026.2706363

Curr Cancer Drug Targets. 2024;24(1):46-58. doi: 10.2174/1568009623666230503094327.

ABSTRACT

AIM: The study aimed to explore the effect of metabolism on lung cancer.

BACKGROUND: The tumor microenvironment is largely influenced by metabolism, tightly involved in tumor progression.

OBJECTIVE: We try to investigate the effect of tumor metabolism terms on non-small cell lung cancer (NSCLC) prognosis, drug and immunotherapy sensitivity, as well as its underlying mechanisms.

METHODS: All the data was obtained from The Cancer Genome Atlas and Gene Expression Omnibus databases. R software was used to perform all statistical analyses and plots.

RESULTS: This study conducted 21 metabolism statuses in NSCLC to identify their underlying roles. We found that alpha-linolenic acid metabolism, sphingolipid metabolism, glycerophospholipid metabolism, fatty acid degradation, linoleic acid metabolism, primary bile acid biosynthesis, and fatty acid metabolism were protective factors for NSCLC. Next, we constructed a prognosis model based on primary bile acid biosynthesis, glycerophospholipid, and sphingolipid metabolism. Results in the present study showed that our model could effectively predict patients’ prognosis in both training and validation cohorts. A clinical correlation revealed that patients at high-risk exhibited more progressive clinical characteristics. Biological enrichment indicated that MYC targets, E2F targets, mTORC1 signaling, G2/M checkpoint, and epithelial-mesenchymal transition were activated in the high-risk group. Immune relation analysis showed that risk score positively correlated with Th2 cells, yet a negative correlation with CD56 bright NK, Th17, mast and CD8⁺ T cells. Moreover, our model was related to NSCLC patients’ sensitivity to immunotherapy and chemotherapy. Ultimately, eight characteristic genes were identified to distinguish the patients’ risk group in the real application.

CONCLUSIONS: The model we developed is a useful tool to predict NSCLC patients’ prognosis and is associated with the sensitivity of immunotherapy and chemotherapy. Meanwhile, our results can guide the following metabolism-related studies in NSCLC.

PMID:42554341 | DOI:10.2174/1568009623666230503094327

Psychol Health Med. 2026 Aug 5:1-20. doi: 10.1080/13548506.2026.2714468. Online ahead of print.

ABSTRACT

The aim of this study is to determine the effect of Cognitive Behavioural Therapy (CBT)-Based Psychoeducation given to children diagnosed with ADHD on internalized stigma and hope. This is a randomized controlled experimental study. The study was conducted with children diagnosed with attention-deficit/hyperactivity disorder who were followed up in a Paediatric Psychiatry outpatient clinic between May 2020 and January 2022. The study was completed with 145 children (75 in the control group, 70 in the experimental group). Data were collected using the descriptive characteristics form, the internalized stigma scale for children and adolescents, and the children’s hope scale (CHS). The experimental group received an 8-session, nurse-administered CBT-Based Psychoeducation program delivered in a closed-group format twice a week for 4 weeks, focusing on ADHD awareness, impulsivity, attention, hyperactivity, stigma, and hopeful thinking. No intervention was made to the control group during the study period; however, to meet ethical standards, the same CBT-Based Psychoeducation program was administered to the control group after all post-test measurements were completed. In addition to descriptive statistics, chi-square, dependent samples t-test, and independent samples t-test were used in the analysis of data. As a result of the measurements made before and after the CBT-based psychoeducation applied to the experimental group, internalized stigma decreased in children with ADHD, while the level of hope increased statistically significantly (p < 0.05). This change in the experimental group also showed a significant change compared to the control group. It was concluded that the nurse-led CBT-Based Psychoeducation program reduced internalized stigma and increased hope in children with ADHD.

PMID:42554334 | DOI:10.1080/13548506.2026.2714468

Oncologist. 2026 Aug 5:oyag314. doi: 10.1093/oncolo/oyag314. Online ahead of print.

ABSTRACT

INTRODUCTION: The rising incidence of early-onset GI cancer has made the impact of treatment-related gonadal toxicity increasingly significant. While there is ample evidence on oncofertility outcomes in breast cancer and hematological malignancies, data in GI cancers remain limited. We sought to evaluate oncofertility perspectives from the viewpoint of young GI cancer survivors across Europe.

METHODS: A cross-sectional 60-item electronic survey regarding oncofertility practices was distributed via patient digital platforms. The target population was survivors treated for GI cancers before the age of 45 or 50 years (women/men). Statistical analysis was performed on country, gender, and tumor type.

RESULTS: One hundred and forty survivors from 19 countries completed the survey (78F/62M), median age at diagnosis was 36.9y/35.6y (F/M), the majority had colorectal cancer, treated with chemotherapy (88%/89%) and radiotherapy (34%/48%). Fertility impact was discussed in 66% of women and 71% of men, but fewer were referred for fertility preservation (43%/57%), and fewer underwent preservation (18%/61%), with variability between countries. The main reason for not preserving fertility was lack of desire of future offspring (women) or lack of referral (men). Sexual health counseling was conducted in less than 50% of patients. Among women, 46% reported persistent amenorrhea and 64% menopausal symptoms. Significant sexual dysfunction was indicated by 69% of women and 83% of men.

CONCLUSION: Anti-cancer treatment has substantial impact on fertility and sexual function in young GI cancer survivors. Counseling, referral, and uptake vary across countries. Gonadal-related issues remain an unmet need in GI oncology, requiring improved counseling and clinical practice.

PMID:42554320 | DOI:10.1093/oncolo/oyag314

Scand J Clin Lab Invest. 2026 Aug 5:1-7. doi: 10.1080/00365513.2026.2713141. Online ahead of print.

ABSTRACT

The blood urea nitrogen (BUN)-to-plasma creatinine ratio is a conventional method for diagnosing dehydration. We examined the relationship between this method and the more recently promoted urine biomarkers of dehydration. Blood and urine sampling was performed in 921 patients who were fasting before surgery. The blood was analyzed for the BUN-to-plasma creatinine ratio which was divided into three ranges: low (<50), normal (50-100), and high (>100 mmol/L). The fractions of the cohort that belonged to these ranges were 8.9%, 76.7%, and 14.4%, respectively. The urine was analyzed for color, specific gravity, osmolality, and creatinine, and the results summarized in the Fluid Retention Index, which is a robust measure of renal water conservation. The analysis shows that none of the four urine biomarkers differed statistically between these three groups. The Fluid Retention Index was 2.3, 2.0, and 1.7, respectively (p = 0.17), which means that the degree of urine concentration varied in the opposite direction to that expected. Moreover, no linear correlations were found when individual blood and urine measurements were compared. Patients who were classified as being dehydrated according to the Fluid Retention Index had a mean BUN to creatinine ratio of 77 while the others had 76 mmol/L (p = 0.94). In conclusion, the BUN-to-ratio did not correlate with urine biomarkers of dehydration in fasting pre-surgical patients. This result suggests that the BUN-to-creatinine ratio may not reliably reflect hydration status and motivates a repeat study where the body volume deficit is known or the water consumption is monitored over time.

PMID:42554314 | DOI:10.1080/00365513.2026.2713141

JMIR Res Protoc. 2026 Aug 4;15:e74202. doi: 10.2196/74202.

ABSTRACT

BACKGROUND: The current landscape of emergency care (EC) is marked by high demand, leading to issues such as emergency department boarding, overcrowding, and subsequent delays that impact the quality and safety of patient care. Integrating data science into EC can enhance decision-making with predictive, preventative, personalized, and participatory approaches. However, gaps in adherence to fairness, accountability, interpretability, and responsibility are evident, particularly due to barriers to data-sharing, which often result in a lack of transparency and robust oversight in these applications.

OBJECTIVE: The FAIR-EC (Fair, Accountable, Interpretable, and Responsible-Emergency Care) collaboration adapts the existing Fair, Accountable, Interpretable, and Responsible principles to address emerging challenges as data science integrates with EC. This initiative aims to transform EC by establishing ethical artificial intelligence standards specifically tailored for this integration. By bridging the gap between EC professionals, data scientists, and other stakeholders, the collaboration promotes international cooperation that leverages advanced data science techniques to enhance EC outcomes across different care settings.

METHODS: We propose a federated research design to analyze extensive datasets from various global institutions without compromising patient privacy. This approach transforms epidemiological research with advanced data science techniques, emphasizing the harmonization of data for comprehensive analyses across different health care systems.

RESULTS: The FAIR-EC initiative has facilitated the identification and harmonization of datasets from diverse geographical regions, enabling the examination of regional variations in EC practices. As of paper submission, participating sites have identified retrospective EC datasets totaling >2 million records (eg, Duke Health >400,000 and Singapore General Hospital >1.7 million records). Initial projects have demonstrated feasibility and operational readiness, including implementation of federated workflows and ongoing development of a federated scoring system, cross-site evaluation, and adaptation of association studies and predictive models across various regions. Cross-site harmonization and pilot analyses are underway (with local ethics approvals in progress), and first multisite results are expected to be submitted in mid-late 2026, with additional project-level publications anticipated in 2027. These efforts highlight the feasibility of leveraging advanced data science techniques to address the complexities of EC while preserving patient privacy without centralizing individual-level data. This project was funded from September 1, 2022, to August 31, 2023.

CONCLUSIONS: FAIR-EC integrates data science ethically and effectively into EC, addressing challenges such as fragmented data, real-time handoffs, and public health crises. Its federated design harmonizes diverse data streams while preserving privacy, and its emphasis on ethical artificial intelligence aligns with the dynamic nature of EC. Despite challenges in data variability and system complexity, FAIR-EC establishes a strong foundation for innovation in global EC.

PMID:42554297 | DOI:10.2196/74202

Multivariate Behav Res. 2026 Aug 5:1-16. doi: 10.1080/00273171.2026.2699709. Online ahead of print.

ABSTRACT

In this study we advance causal mediation analysis for nominal mediators within a potential outcome framework. Through Monte Carlo simulations, we compared three inference methods for testing total natural indirect effects (TNIE) and pure natural indirect effects (PNIE): non-parametric bootstrapping, parametric resampling, and Bayesian estimation. Results showed that nominal mediation models yielded accurate estimates across conditions, with both maximum likelihood and Bayesian approaches performing well. All three inference methods maintained acceptable Type I error control and achieved adequate statistical power in larger samples, with comparable performance across approaches. We provide an empirical illustration using survey data on healthcare payment types and mental health help-seeking behavior to illustrate the model’s utility. Findings suggest that researchers can reliably estimate and test nominal mediation effects using any of the three inference approaches, providing a robust methodological framework for investigating causal pathways involving categorical mediating variables in social, behavioral, and health sciences.

PMID:42554287 | DOI:10.1080/00273171.2026.2699709

Int J Neural Syst. 2026 Aug 5:2750007. doi: 10.1142/S0129065727500079. Online ahead of print.

ABSTRACT

This study proposes a novel enhancement to the Conformer architecture for epileptic seizure identification by replacing the standard Vision Transformer (ViT) with the Swin Transformer. The proposed Swin-Conformer model leverages the hierarchical patch merging and shifted-window self-attention mechanisms of the Swin Transformer to better capture both local electrophysiological patterns and long-range temporal dependencies in electroencephalogram (EEG) signals. To handle the significant class imbalance inherent in epileptic EEG data, a weighted focal loss function is employed during training. The model is evaluated on the CHB-MIT dataset through stratified 10-fold cross-validation and validated on the independent Bonn EEG dataset. Experimental results demonstrate that the proposed model achieves accuracy of 99.24%, specificity of 99.55%, and sensitivity of 98.47% on the segment-based evaluation, as well as an event-based sensitivity of 99.50%, outperforming the original Conformer and state-of-the-art baseline methods. Ablation studies confirm that the performance gains originate from the Swin Transformer’s hierarchical multi-scale feature representation and efficient local-global attention mechanism. Statistical analysis confirms that the improvements are statistically significant ([Formula: see text]).

PMID:42554275 | DOI:10.1142/S0129065727500079

J Hypertens. 2026 Jul 17. doi: 10.1097/HJH.0000000000004367. Online ahead of print.

ABSTRACT

BACKGROUND: Many primary aldosteronism (PA) patients harbor concomitant mild autonomous cortisol secretion (MACS), termed “Connshing syndrome.” The prevalence and cardiometabolic impact of this co-secretion have not been quantitatively synthesized.

OBJECTIVE: To determine the pooled prevalence of MACS in PA and evaluate its association with cardiovascular (CV) events, type 2 diabetes mellitus (T2DM), and obesity.

DATA SOURCES: PubMed, Embase, Cochrane, Web of Science, and Scopus through January 2026.

METHODS: Following PRISMA 2020 and MOOSE guidelines (PROSPERO: CRD420261334965), studies reporting MACS prevalence [post-1 mg dexamethasone suppression test (DST) cortisol ≥1.8 μg/dl] in PA were included. Prevalence was pooled using random-effects models. Odds ratios (ORs) were calculated for cardiometabolic outcomes. Certainty was evaluated using GRADE.

RESULTS: Fourteen studies (2356 patients) were included. Pooled MACS prevalence was 26.2% [95% confidence interval (CI): 24.1-28.4; I2 = 24.2%; prediction interval: 21.6-31.4%], consistent across European (27.0%) and East Asian (25.2%) cohorts (P = 0.62). MACS + PA patients had higher odds of CV events (OR 1.60; 95% CI: 1.07-2.38; P = 0.021) and T2DM (OR 1.37; 95% CI: 1.00-1.86; P = 0.048), but not obesity (OR 1.10; P = 0.411). Sensitivity analyses confirmed robustness. GRADE certainty was moderate for prevalence and low for CV events.

CONCLUSIONS: Approximately one in four PA patients has MACS, associated with a 60% higher CV event risk. These findings support routine DST screening in PA and have implications for perioperative management and cardiometabolic risk stratification.

PMID:42554261 | DOI:10.1097/HJH.0000000000004367

Cancer. 2026 Aug 15;132(16):e70560. doi: 10.1002/cncr.70560.

ABSTRACT

BACKGROUND: Sexual health, central to overall well-being, remains under assessed in childhood, adolescent and young adult (CAYA) cancer survivorship. This study examined sexual health outcomes among CAYA cancer survivors using repeated assessments collected as part of routine survivorship care and compared these outcomes with population-based controls.

METHODS: Survivors completed one to six assessments on sexual activity, concerns about sex life, and contraceptive and condom use. Controls included age-matched Canadian Community Health Survey respondents. Multilevel and Bayesian models quantified predictors of sexual health outcomes whereas latent class growth analysis tested for high-risk subgroups.

RESULTS: Among survivors (n = 305; median age, 21.9 years; 49.8% male), 47.5% were not sexually active, compared with 11.2% of controls (unweighted n = 108,252; χ² = 404.35; p < .001; odds ratio [OR], 7.18; 95% Confidence Interval [CI], 5.73-8.99). Being in a relationship predicted sexual activity (Bayesian OR, 1806.83; 95% Credible Interval [CrI], 255.08-20,535.08). Condom use was less frequent among survivors than controls (45.6% vs. 27.2%; χ² = 27.48; p < .001; OR, 1.68; 95% CI, 1.42-1.99) and negatively associated with age (OR, 0.44; 95% CI, 0.26-0.74) and relationship status (OR, 0.09; 95% CI, 0.03-0.24). Not using birth control was similar between survivors and controls (26.9% vs. 25.8%; χ² = 0.10; p = .758). Within survivors, older age (OR, 0.41; 95% CI, 0.20-0.85) and higher treatment intensity (OR, 0.02; 95% CI, 0.00-0.47) were negatively associated with birth control use.

CONCLUSIONS: CAYA cancer survivors demonstrate less sexual activity and condom use than controls. Higher treatment intensity is associated with less birth control use, suggesting potential misaligned fertility perceptions. Survivorship programs should integrate structured sexual health counselling.

PMID:42554247 | DOI:10.1002/cncr.70560