Tag: statistics

Stat Med. 2026 Mar;45(6-7):e70497. doi: 10.1002/sim.70497.

ABSTRACT

High-dimensional omics data often exhibit complex yet organized dependencies, characterized by intelligent network properties like high modularity, small-worldness characteristics, and scale-free topology. However, integrating these structured interdependencies between omics variables into multivariate regression models presents challenges. The primary difficulty lies in accurately specifying and estimating dependency parameters that capture these network patterns within regression frameworks. Common covariance estimation methods may not preserve these network properties and can also be computationally intensive. To address these challenges, we propose a novel multivariate regression model that incorporates an interconnected community structure, reflecting the organized relationships among omics outcome variables. Our approach includes efficient estimation algorithms, featuring closed-form regression estimators and likelihood-based dependence estimators. We also establish the asymptotic properties of estimators to ensure theoretical robustness and hypothesis testing. Extensive simulations demonstrate the enhanced accuracy and sensitivity of our method, as evidenced through benchmarking against existing regression models. We applied our approach to a dataset to assess the associations between 249 metabolomic biomarkers, measured using nuclear magnetic resonance spectroscopy, and alcohol intake among 3984 participants. Results indicate that light alcohol consumption is positively associated with high-density lipoprotein cholesterol (HDL, i.e., the good cholesterol), high-density lipoprotein particles, and Apolipoproteins A1, indicators linked to cardiovascular health.

PMID:41853895 | DOI:10.1002/sim.70497

Pediatr Pulmonol. 2026 Mar;61(3):e71568. doi: 10.1002/ppul.71568.

ABSTRACT

INTRODUCTION: Pulmonary hemorrhage (PHem) is a severe and often fatal condition in neonates, particularly affecting preterm and very low birth weight infants. It is associated with significant morbidity and mortality, yet distinctions between early- and late-onset PHem and their respective risk factors remain unclear. This study aimed to evaluate clinical characteristics, risk factors, management strategies, and outcomes of neonates with PHem, with a focus on early versus late onset.

MATERIALS AND METHODS: In this retrospective cross-sectional study, medical records of neonates diagnosed with PHem in a tertiary NICU between January 2014 and December 2020 were analyzed. Early PHem was defined as onset within the first 7 days of life, and late PHem as onset thereafter. Collected data included antenatal, perinatal, and postnatal variables, surfactant and PDA management, and clinical outcomes. Statistical analyses included univariate and multivariate logistic regression to identify risk factors for early PHem and mortality.

RESULTS: A total of 80 neonates with PHem were included (mean gestational age 27.7 ± 3.6 weeks; mean birth weight 1092 ± 587 g). Early PHem accounted for 83.7% (n = 67) and late PHem for 16.3% (n = 13) of cases. Infants with early PHem had significantly higher mean airway pressure (MAP) at 12 h (p = 0.044) and a greater need for post-PHem surfactant therapy (p = 0.044). Conversely, late PHem was associated with higher rates of sepsis (p = 0.009), coagulopathy (p = 0.019), and hemodynamically significant PDA (92.3% vs. 47.8%, p = 0.008). Duration of mechanical ventilation (p < 0.001) and oxygen therapy (p = 0.002) were longer in the late PHem group. Overall mortality was 82.5%, with no statistically significant difference between early and late PHem (80.6% vs. 92.3%, p = 0.446).

CONCLUSION: PHem remains a significant cause of neonatal morbidity and mortality. Early and late PHem represent distinct clinical entities with different risk profiles, their management and long-term outcomes are similar. Despite these differences, mortality remains high in both groups. Identification of key risk factors, especially delivery room resuscitation, may guide preventive strategies and optimize neonatal care.

PMID:41853879 | DOI:10.1002/ppul.71568

J Cosmet Dermatol. 2026 Mar;25(3):e70792. doi: 10.1111/jocd.70792.

ABSTRACT

BACKGROUND: Acne vulgaris is one of the most prevalent disorders affecting 9%-10% of the global population, representing as papules, pustules, and comedones, with a pathogenesis involving increased sebum production, C. acnes colonization, and inflammation. Conventional treatments like retinoids and antibiotics often cause side effects, thus diverting attention toward probiotics as an alternative therapy. Lactobacillus probiotics, having their immunomodulatory, anti-inflammatory, and antimicrobial properties, are useful in managing acne by reducing inflammation and oxidative stress with proved safety profile and the potential to reduce antibiotic reliance. This systematic review and meta-analysis evaluate the efficacy of Lactobacillus-based probiotics compared to placebo and benzoyl peroxide in reducing inflammatory lesions, non-inflammatory lesions, and total acne lesion counts. The findings aim to clarify their therapeutic role and provide evidence on their effectiveness and safety.

OBJECTIVES: This systematic review and meta-analysis investigated the effectiveness of oral and topical Lactobacillus-based probiotics or postbiotics, compared with placebo or benzoyl peroxide, in patients with acne vulgaris.

METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted, including studies evaluating oral or topical Lactobacillus-based probiotic or postbiotic interventions in patients with acne vulgaris. Primary outcomes were changes in inflammatory lesion counts, while secondary outcomes included non-inflammatory and total lesion counts, skin hydration, and sebum concentration. All analyses were performed using random-effects models with 95% confidence intervals (CI), and heterogeneity was quantified using the I² statistic.

RESULTS: A total of five RCTs involving 332 participants were included. The pooled mean difference for non-inflammatory lesions was -1.39 (95% CI -5.10 to 2.32, p = 0.46), for inflammatory lesions was -0.08 (95% CI -1.28 to 1.11, p = 0.89), and for total lesion counts was -9.07 (95% CI -20.71 to 2.57, p = 0.13). These results concluded that there was no significant reduction in lesion counts with Lactobacillus-based probiotics as compared to placebo or benzoyl peroxide. Heterogeneity was moderate to low across studies.

CONCLUSION: This meta-analysis indicates that Lactobacillus-based probiotics do not provide significant clinical benefits in reducing inflammatory lesions, non-inflammatory lesions, and total acne lesion counts in Acne vulgaris patients compared to placebo or benzoyl peroxide.

PMID:41853869 | DOI:10.1111/jocd.70792

Vet Radiol Ultrasound. 2026 Mar;67(2):e70156. doi: 10.1111/vru.70156.

ABSTRACT

Elastography is a promising technique for assessing tissue stiffness in the adrenal glands of dogs with hypercortisolism (HC). This study compared 30 dogs, 15 of which were healthy (control group) and 15 diagnosed with HC, confirmed by low-dose dexamethasone suppression test (n = 11) or ACTH stimulation test (n = 4) without prior treatment. Ultrasound measurements revealed a significant increase in the dimensions of the adrenal glands, especially in the left adrenal gland, with more frequent changes in the cranial pole (86.7%, p = 0.00003) and caudal pole (80%, p = 0.00005). Qualitative elastography indicated varied tissue stiffness patterns in sick dogs, with a predominance of mixed patterns (46.7%), whereas dogs in the control group showed uniform moderate stiffness. Semiquantitative analysis showed that the adrenal glands of sick dogs were significantly stiffer compared to the adjacent mesentery, with variations ranging from 33% to 80% stiffer. The Mann-Whitney test revealed statistically significant differences in adrenal stiffness between the groups (U = 4.500; Z = -4.621; p < 0.001). These findings suggest that elastography, combined with conventional ultrasonography, may be an effective complementary diagnostic tool in detecting adrenal changes in dogs with HC.

PMID:41853861 | DOI:10.1111/vru.70156

Circulation. 2026 Mar 19. doi: 10.1161/CIRCULATIONAHA.125.079023. Online ahead of print.

ABSTRACT

BACKGROUND: Premature atrial contractions (PACs) are independently associated with atrial fibrillation, stroke, and heart failure, yet no pharmacological therapy is approved for PAC suppression. Experimental studies have identified a functional cardiac glutamatergic system in which N-methyl-D-aspartate receptors regulate atrial electrophysiology. Preclinical studies show that pharmacological antagonism of N-methyl-D-aspartate receptors with memantine suppresses atrial arrhythmias.

METHODS: We conducted an investigator-initiated, phase 2, multicenter, randomized, double-blind, placebo-controlled trial. Symptomatic adults with frequent PACs (≥1000/24 h) were randomly assigned to receive memantine or placebo for 6 weeks. The primary end point was the percentage change in mean 24-hour PAC count from baseline to the end of treatment. The primary analysis was performed in the intention-to-treat population. Prespecified secondary end points included the responder rate (≥50% PAC reduction), percentage change in nonsustained atrial tachycardia burden, and cumulative incidence of new-onset atrial fibrillation.

RESULTS: Among 241 patients included in the efficacy analysis, memantine resulted in a greater reduction in PAC count than placebo (between-group difference, 47.1 percentage points; P=0.0045). The responder rate was higher with memantine than with placebo (52.4% versus 23.1%; P<0.0001). Memantine also reduced nonsustained atrial tachycardia burden (between-group difference, 30.98 percentage points; P=0.0043) and was associated with a lower cumulative incidence of new-onset atrial fibrillation (4.8% versus 23.9%; P<0.0001). No clinically meaningful differences were observed in electrocardiographic intervals or left ventricular function, and no drug-related serious adverse events occurred.

CONCLUSIONS: In patients with frequent symptomatic PACs, memantine reduced atrial ectopy and atrial tachyarrhythmia burden and demonstrated a favorable safety profile. These findings provide proof of concept for a novel, non-ion channel-based therapeutic strategy targeting the cardiac glutamatergic system.

REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT06501638.

PMID:41853846 | DOI:10.1161/CIRCULATIONAHA.125.079023

Front Psychol. 2026 Mar 3;17:1773282. doi: 10.3389/fpsyg.2026.1773282. eCollection 2026.

ABSTRACT

BACKGROUND: There is no recommended measure of parent-infant interaction that is psychometrically robust, feasible (i.e., brief and simple to use) and validated for use from birth to 12 months for routine use in Perinatal Mental Health Services (PMHS). This study tested the cross-sectional construct validity of the global sensitivity scale and a sensitivity composite from the NICHD Parent-Infant Interaction scales in a clinical sample of parents and babies, and the inter-rater reliability of all the NICHD scales in a sub-sample of dyads with infants under 3 months of age.

METHODS: Secondary analysis using parent-infant interaction videos from a Randomized Controlled Trial in specialist PMHS in England were used. Participants were 275 dyads who completed baseline self-reports (parental mental health symptoms, parent-reported bonding) and parent-infant observation tasks where sensitivity was measured (free play, book sharing, clothing change). Parents with infants over 2 months of age (N = 180), also completed measures of child development. Non-parametric correlations and linear regression were conducted to assess construct validity and intra-class correlations were conducted to evaluate inter-rater reliability.

RESULTS: Amongst dyads with infants 0-3 months, inter-rater reliability was good for the global and composite sensitivity scale, but poor-to-moderate for the scales of parental intrusiveness, dyadic mutuality and the infant scales. In the full sample of dyads, there was a small but significant negative association between the global and composite sensitivity scales and parental mental health symptom severity, but this association was not statistically significant when sensitivity was observed in the free play alone. In terms of child development, greater sensitivity was only associated with fewer socio-emotional problems when it was observed during the clothing change task. There was a statistically significant negative association between observed sensitivity and bonding difficulties, and the strength of this association was greater for younger infants than older infants.

CONCLUSION: These findings contribute to the evidence base of the NICHD scales in a PMHS setting and suggest ways that the clinical utility of the NICHD scales could be improved for routine practice.

PMID:41853827 | PMC:PMC12992259 | DOI:10.3389/fpsyg.2026.1773282

Front Psychol. 2026 Mar 3;17:1722181. doi: 10.3389/fpsyg.2026.1722181. eCollection 2026.

ABSTRACT

INTRODUCTION: When performing in public, musicians experience varying levels of music performance anxiety (MPA). The degree of MPA is influenced by various internal and external factors and differs between performances. Previous studies have mainly focused on the general disposition of MPA, but comparatively limited attention has been given to the experience of MPA in particular performance situations. In this study, the Performance-related Questionnaire for Musicians (PQM) is introduced and validated. The questionnaire was developed to assess situational MPA, thus filling a gap in standardized questionnaires relating to individual performances.

METHODS: The fourth revised German version of the PQM was tested regarding the reliability of the factor structure and the validity on a sample of 605 musicians. The PQM questionnaire focuses on aspects of situational MPA referring to a just-finished performance. It needs to be completed directly after a performance and considers retrospectively the times before and during the performance, as well as the moment when filling in the questionnaire after the performance. For the analysis, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed. Furthermore, the questionnaire was implemented in a mobile application for the individual acquisition of PQM results across various performances. In a case study, data were analysed from 31 performances of one musician.

RESULTS: A three-dimensional factor structure at the time points before, during, and after the performance showed reliable consistencies in the EFA, and the CFA confirmed the structure with adequate model fit statistics. The three dimensions represent, first, the degree of MPA symptoms (the higher the scale, the more severe the MPA); second, coping with MPA (the higher the scale, the more positive the coping); and third, self-efficacy (the higher the scale, the more positive the self-efficacy). The results of the case study with the mobile application showed individual differences and consistencies in situational MPA between performances.

DISCUSSION: The results show that the PQM is a valid tool for assessing situational MPA. The implementation as a mobile application is described as very practical and supports the use of the PQM for individual self-assessment and feedback.

PMID:41853819 | PMC:PMC12992244 | DOI:10.3389/fpsyg.2026.1722181

Front Psychol. 2026 Mar 3;17:1741344. doi: 10.3389/fpsyg.2026.1741344. eCollection 2026.

ABSTRACT

BACKGROUND: Fear of progression (FoP) is a prevalent psychological issue among stroke patients. Previous studies failing to distinguish characteristics of patient groups with varying FoP levels. Latent profile analysis (LPA) classifies individuals into distinct subgroups via continuous FoP indicators, boosting classification accuracy by accounting for variable uncertainty. Given FoP’s heterogeneity, investigating FoP profiles and their influencing factors in stroke patients is clinically significant for personalized psychological care and improved patient quality of life.

METHODS: A total of 366 stroke patients were selected as study subjects through convenience sampling, and a cross-sectional survey was conducted. FoP was assessed using the Fear of Progression Questionnaire-Short Form (FoP-Q-SF, 2 dimensions, 12 items). Independent variables included demographic characteristics, clinical indicators, the Recurrence Risk Perception Scale for Stroke patients (RRPSS), and the Medical Coping Modes Questionnaire (MCMQ). LPA was performed on the FoP-Q-SF items to identify subgroups. The R3STEP method was used to analyze influencing factors of subgroup membership, and the BCH method was applied to compare differences in distal outcomes across subgroups. Statistical significance was set at p < 0.05.

RESULTS: The study sample had a mean age of 63.93 ± 10.58 years, with 70.5% males and 65.0% first-ever stroke patients. Two latent profiles were identified: Low-FoP Adaptive Type (C1, 48.6%) and High-FoP Sustained Type (C2, 51.4%). The R3STEP showed that age 18-59 years (OR = 0.476, 95%CI = 0.245-0.924, p = 0.028), hypertension comorbidity (OR = 0.402, 95%CI = 0.237-0.683, p = 0.001), higher RRPSS score (OR = 0.971, 95%CI = 0.946-0.995, p = 0.022), MCMQ-confrontation (OR = 0.920, 95%CI = 0.863-0.982, p = 0.011), and MCMQ-avoidance (OR = 0.796, 95%CI = 0.723-0.876, p < 0.001) were significant influencing factors (all p < 0.05). BCH analysis indicated that C2 patients had higher RRPSS score (p < 0.001), higher NIHSS score (p = 0.002) and lower adaptive coping ability than C1.

CONCLUSION: This study revealed significant heterogeneity in FoP among stroke patients. Age, hypertension comorbidity, excessive recurrence risk perception, MCMQ-confrontation, and MCMQ-avoidance were associated with high FoP. Healthcare providers should prioritize identifying high-risk individuals and develop tailored interventions to reduce FoP and improve rehabilitation outcomes.

PMID:41853816 | PMC:PMC12992214 | DOI:10.3389/fpsyg.2026.1741344

Infect Dis Model. 2026 Mar 2;11(3):969-1008. doi: 10.1016/j.idm.2026.01.005. eCollection 2026 Sep.

ABSTRACT

BACKGROUND: Forecasting influenza outbreaks remains a significant challenge due to the complexity of disease transmission and the influence of environmental and behavioral factors. Traditional models based solely on the basic reproduction number $\left(R_0\right)$ often fall short in capturing the full scope of outbreak dynamics.

METHODS: In this study, we employ a seasonally adjusted SEIRT model incorporating stochastic differential equations (SDEs), including Brownian motion and Lévy jump processes, to simulate random and abrupt fluctuations in transmission. A branching process approximation is used to evaluate the probability of an epidemic under the influence of seasonal variability and stochastic perturbations. The model is calibrated using weekly influenza case data from Mexico, with noise components estimated from publicly available CDC [1] and WHO [2] surveillance data.

RESULTS: Simulation results show that the inclusion of stochastic effects and periodic transmission rates significantly enhances the model’s accuracy in reflecting real-world epidemic dynamics. Numerical comparisons between deterministic, Brownian-based, and Lévy-based scenarios reveal that both the initial state of the exposed or infectious subpopulation and the seasonal transmission patterns are critical to determining outbreak probabilities. Results indicate that seasonal transmission rates and stochastic effects significantly alter epidemic probabilities, with Lévy processes capturing abrupt outbreak dynamics more accurately than deterministic models.

CONCLUSIONS: The findings underscore that deterministic models may underestimate epidemic risk when they overlook random and sudden changes in contact rates or disease introduction. The proposed stochastic modeling framework yields a deeper understanding of influenza transmission dynamics by incorporating uncertainty and seasonal variability, thereby supporting more informed and effective public health decision-making.

PMID:41853796 | PMC:PMC12992947 | DOI:10.1016/j.idm.2026.01.005

Infect Dis Model. 2026 Mar 4;11(3):1009-1021. doi: 10.1016/j.idm.2026.03.002. eCollection 2026 Sep.

ABSTRACT

Mpox re-emerged globally in 2022, disproportionately affecting gay, bisexual, and other men who have sex with men (GBMSM). In 2024, Thailand became the first Asian country to detect Clade Ib Mpox, prompting urgent decisions on deploying a limited supply of 3000 vaccine doses. However, evidence on the comparative effectiveness of different vaccine allocation and behavioural strategies in this context remains scarce. We developed a deterministic compartmental model of Mpox transmission among high- and low-risk GBMSM, calibrated to Thailand’s national surveillance data (January 2023-May 2025). The model simulated a range of hypothetical scenarios under a constrained supply of 3000 vaccine doses, distributed either over a short 5-month period or extended across the 28-month epidemic horizon. We evaluated pre-exposure prophylaxis ( $PrEP$ ), post-exposure prophylaxis ( $PEP$ ), dose-sparing regimens, and mixed allocations of the two approaches. Each strategy was examined under alternative rollout timings (early vs. supply-delayed) and in combination with behaviour change, represented as reductions in sexual activity during symptomatic periods. The model reproduced Thailand’s epidemic trajectory. Our simulations suggested that early PrEP rollout would have yielded the greatest reduction in incidence, particularly among high-risk GBMSM. PEP strategies would have had a modest impact overall, though single-dose sparing with delayed rollout (months 5-9) would have been notably effective as the epidemic peak occurred during this period. Mixed PrEP and PEP approaches would have produced intermediate benefits, while behaviour change alone significantly would have lowered transmission. Combining PEP with even modest behavioural changes further enhanced prevention and helped reduce spillover into low-risk groups. Under constrained vaccine supply, dose-sparing and mixed vaccination strategies could improve overall coverage and impact, especially when paired with behavioural changes. Integrating flexible and context-specific vaccination approaches with realistic behavioural modifications offers the best potential for Mpox control in Thailand and similar settings.

PMID:41853794 | PMC:PMC12995482 | DOI:10.1016/j.idm.2026.03.002