Tag: statistics

Clin Transl Oncol. 2026 Jun 3. doi: 10.1007/s12094-026-04412-7. Online ahead of print.

ABSTRACT

BACKGROUND: Breast and gynaecological cancers represent the leading oncological burden among women worldwide. We aimed to describe long-term mortality trends for these malignancies in Spain over a 26 year period, focusing on differences between early-onset (< 50 years) and late-onset (≥ 50 years) disease.

METHODS: Mortality data (1999-2024) were obtained from the Spanish National Institute of Statistics. Age-standardised mortality rates (ASMRs) were calculated per 100,000 women using the 2013 European Standard Population. Joinpoint regression estimated annual percentage changes (APC) and average annual percentage changes (AAPC) with 95% confidence intervals (CI).

RESULTS: Total annual deaths rose from 9531 to 11,641, despite declining ASMRs for most sites. Breast cancer mortality decreased consistently (AAPC – 1.4%; 95% CI – 1.5, – 1.3), with a more pronounced reduction in the < 50 group (AAPC – 2.5%). Significant ASMR declines were observed for uterus NOS (- 2.3%), ovary (- 0.7%), and cervix uteri (- 0.6%). In the < 50 cohort, ovarian cancer mortality fell sharply (AAPC – 2.1%). Conversely, corpus uteri cancer was the only site showing an increasing trend (AAPC + 0.4%; 95% CI 0.1, 0.8), with a steeper increase observed among women ≥ 50 years. Non-monotonic trends were identified for less common gynaecological cancers.

CONCLUSIONS: Mortality rates for breast and most gynaecological cancers in Spain have declined, although absolute deaths have increased. These trends are potentially consistent with advances in prevention and care alongside population ageing. The rise in corpus uteri cancer represents an emerging public health concern potentially associated with increasing metabolic risk factors, highlighting the need for targeted prevention strategies.

PMID:42234293 | DOI:10.1007/s12094-026-04412-7

Neurosurg Rev. 2026 Jun 3;49(1):430. doi: 10.1007/s10143-026-04347-1.

ABSTRACT

Anterior lumbar interbody fusion (ALIF) is widely used for degenerative lumbar disc disease, offering restoration of disc height and sagittal alignment. However, pseudarthrosis remains a relevant complication, and the benefit of supplemental posterior fixation over stand-alone constructs is still debated. To compare the incidence of pseudarthrosis following stand-alone ALIF versus ALIF combined with posterior pedicle screw fixation. A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD42024581358). PubMed/MEDLINE, Embase, Cochrane Library, and BVS were searched for studies published between 2013 and September 2024. Clinical studies including patients with degenerative lumbar disease undergoing ALIF with at least 12 months of follow-up were eligible. Study selection and data extraction were performed independently by two reviewers. Risk of bias was assessed using the Joanna Briggs Institute (JBI) tool for observational studies and Risk of Bias 2 (RoB 2) for randomized trials. Random-effects models were used to estimate pooled pseudarthrosis prevalence and clinical outcomes. Fourteen studies comprising 917 patients and over 1,000 operated levels were included. The pooled prevalence of pseudarthrosis was 8.17% (95% CI: 5.04-11.31), with substantial heterogeneity (I²=70.8%). Pseudarthrosis rates were numerically higher in stand-alone ALIF (8.95%; 95% CI: 4.54-13.37) compared with ALIF combined with posterior fixation (6.76%; 95% CI: 3.58-9.94), although the difference was not statistically significant (p = 0.429). Significant clinical improvement was observed, with a mean reduction of 4.16 points in VAS and a 24.46-point improvement in ODI. Meta-regression demonstrated no association between pseudarthrosis rates and clinical outcomes. Notably, stand-alone ALIF was associated with a significantly higher risk of reoperation for symptomatic pseudarthrosis (RR 6.8; 95% CI: 1.9-24.5; p < 0.01). ALIF provides substantial pain relief and functional improvement, with a relatively low overall rate of pseudarthrosis. Although stand-alone constructs showed a trend toward higher pseudarthrosis rates without statistical significance, they were associated with a markedly increased risk of reoperation. These findings suggest that, while fusion rates may appear comparable, supplemental posterior fixation may confer greater mechanical reliability and reduce clinically meaningful failure in selected patients.

PMID:42234274 | DOI:10.1007/s10143-026-04347-1

Int J Cardiovasc Imaging. 2026 Jun 3. doi: 10.1007/s10554-026-03744-3. Online ahead of print.

ABSTRACT

To compare different methods for myocardium quantification and exploratively evaluate the prognostic relationship between PET-measured viable myocardium and clinical outcomes in coronary artery disease (CAD) patients with ischemic cardiomyopathy (ICM). 183 CAD patients who underwent one-day ¹³NH₃ and ¹⁸F-FDG PET/CT myocardial viability assessment were retrospectively enrolled. Using Corridor4DM software, different types of myocardium (viable, normal, scar) were quantified via visual analysis, semi-quantitative scoring, and software automatic quantification. As an exploratory secondary analysis, patients were grouped and method-dependent grouping differences were analyzed. The correlation between viable myocardium, treatment decisions, and prognosis was retrospectively evaluated. Software identified the most normal myocardium and the least viable myocardium, while semi-quantitative scoring was the opposite. High inter-method consistency (all ICC>0.75) was observed, in which visual and software analyses showed optimal agreement, contrasting with scoring analysis. No significant differences were found among when viable myocardium<20%, but scoring analysis underestimated viable myocardium as its extent increased (P<0.001). Notably, all three methods exhibited concordant and comparable prognostic predictive value (AUC: 0.595-0.669 for OS and 0.529-0.533 for MACE). And exploratory prognostic analysis (n = 113) revealed no statistically significant interaction between treatment strategy and viability for either OS or MACE. However, a potential trend was observed where revascularization was associated with improved outcomes specifically in patients with a higher extent of viable myocardium (≥ 37%). Three analyses demonstrated high consistency in myocardium quantification, with visual and software analysis showing optimal agreement. Software analysis enhances clinical efficiency, offering improved sensitivity and objectivity. Furthermore, the three methods showed concordant prognostic predictive value; While exploratory analyses suggested potential prognostic trends, no statistically significant interaction was found between treatment strategy and viability. Accurately assessing viable myocardium via software automatic quantification offers an objective tool for assessment, though its role in guiding treatment decisions requires further validation.

PMID:42234272 | DOI:10.1007/s10554-026-03744-3

Amyloid. 2026 Jun 3:1-7. doi: 10.1080/13506129.2026.2678340. Online ahead of print.

ABSTRACT

BACKGROUND: Diflunisal has been shown to slow the progression of hereditary transthyretin (ATTRv) amyloidosis. We examined the efficacy of diflunisal using data from SveATTR, a longitudinal Swedish registry open for patients with ATTR amyloidosis.

METHODS: Data from diflunisal treated patients registered in SveATTR through Dec 2022 were included. Available data on Kumamoto score, PND score/FAP stage, mBMI, NYHA classification and Karnofsky performance status were analyzed using random coefficients mixed effects modeling, and the results were combined with those of the pivotal diflunisal trial.

RESULTS: In total, 118 registry subjects were included. Estimated mean time of diflunisal therapy was 3.4 (range 0.1 to 10.2) years. Random coefficients mixed effects modeling demonstrated gradual progression of disease over time by upward trend of Kumamoto score, PND score and FAP stage, and downward trend in Karnofsky score and mBMI while NYHA class score remained unchanged. A Bayesian augmentation analysis was undertaken using registry data and pivotal trial data. After 24 months, the probability of superiority for diflunisal over placebo was 99.6% and 97.2% for Kumamoto score and mBMI, respectively.

CONCLUSIONS: SveATTR registry data align with the results of the pivotal trial, providing long-term real-world evidence that confirm the efficacy of diflunisal for ATTRv amyloidosis.

PMID:42233236 | DOI:10.1080/13506129.2026.2678340

Gigascience. 2026 Jun 2:giag067. doi: 10.1093/gigascience/giag067. Online ahead of print.

ABSTRACT

Traditional Kaplan-Meier curves capture aggregate survival trends within broad patient subgroups but overlook the heterogeneity of individual patients. In contrast, single-patient survival risk models bridge this gap by incorporating each patient’s unique clinical, genomic, and demographic characteristics, generating personalized survival curves. These individualized visualizations enhance patient-clinician communication by translating complex statistics into intuitive, time-based visuals that are easier to interpret. However, the complexity, high dimensionality, and heterogeneity of multi-omics data present significant challenges for analysis, interpretation, and model development. To address these challenges, we introduce the Cancer Patient Survival Model (CPSM), an R package designed to deliver individualized survival and risk predictions through a fully integrated, reproducible computational pipeline. CPSM includes 10 core functions organized into four key steps: (1) Data Preprocessing and Normalization, (2) Feature Selection, (3) Survival Risk-Group Prediction Modeling, and (4) Visualization and Nomogram Construction. We demonstrate the utility of CPSM using publicly available TCGA datasets for four cancer types: glioblastoma multiforme (GBM), acute myeloid leukemia (LAML), pancreatic adenocarcinoma (PAAD) and breast invasive cancer (BRCA). CPSM efficiently handles high-dimensional datasets with over 60,000 RNA transcripts and diverse clinical variables, enabling robust and interpretable individualized survival predictions under varying data conditions. Model performance was evaluated using repeated cross-validation with uncertainty quantification, ensuring robust and reliable estimates in high-dimensional, small-sample settings. In summary, CPSM provides an efficient, user-friendly, end-to-end solution for integrating patient data and generating personalized survival and risk predictions. Its integrated visual tools enhance interpretability and support more informed clinical decision-making. The package is freely available on Bioconductor (https://bioconductor.org/packages/devel/bioc/html/CPSM.html) and GitHub (https://github.com/hks5august/CPSM).

PMID:42233233 | DOI:10.1093/gigascience/giag067

Acta Psychiatr Scand. 2026 Jun 3. doi: 10.1111/acps.70114. Online ahead of print.

ABSTRACT

INTRODUCTION: Individuals with mental illness have a markedly reduced life expectancy, partly due to a significantly increased risk of developing type 2 diabetes, driven by lifestyle factors and the adverse metabolic effects of psychotropic medications. This study examined whether abnormal laboratory values indicating incident diabetes, when ordered within psychiatric services, were followed by documented interventions.

METHODS: We used electronic health record data from the Psychiatric Services of the Central Denmark Region and drew a random sample of patients with incident diabetes detected between 2019 and 2024. Incident diabetes was defined by the first laboratory value ordered by the psychiatric services indicating diabetes: glycated haemoglobin ≥ 48 mmol/mol, fasting plasma glucose ≥ 7.0 mmol/L, plasma glucose ≥ 11.1 mmol/L during a 2-h oral glucose tolerance test or random plasma glucose. Patients with pre-existing diabetes, identified through ICD-10 codes or antidiabetic medication history, were excluded. Manual chart review assessed whether incident diabetes was followed, within 3 months, by documented clinical intervention (such as referral, repeat testing, or medication initiation), or was merely acknowledged without further action. Descriptive statistics and adjusted logistic regression analysis were used to characterise the cohort and examine characteristics associated with lack of intervention.

RESULTS: Among 416 patients with incident diabetes (57% male, median age 48 years [IQR: 35-59], 33% with schizophrenia or other psychotic disorders), only 37% received a clinical intervention. The most frequent intervention was referral to a general practitioner (27%), while antidiabetic medication was initiated in only 6% of those who received an intervention. The only characteristic associated with lack of clinical intervention was body mass index < 25 kg/m² (adjusted odds ratio 3.82, 95% CI: 1.92-8.20).

CONCLUSION: This study suggests that appropriate clinical intervention following detection of incident diabetes is lacking. This may inform future strategies to reduce metabolic and cardiovascular risks among individuals with mental illness.

PMID:42233222 | DOI:10.1111/acps.70114

Br J Nutr. 2026 Jun 3:1-34. doi: 10.1017/S0007114526107624. Online ahead of print.

ABSTRACT

Skinfold prediction equations (SF-PE) are used to estimate percent body fat (%BF), but it’s unclear which SF-PE are most accurate among different age/sex groups. The purpose was to assess accuracy of estimating %BF from SF-PE in young, middle-age, and older male and female adults, and compare %BF from SF-PE to Inbody770 (IB770), a selected bioelectrical-impedance criterion reference. Two hundred two healthy males (n=96) and females (n=106) had %BF assessed from 12 SF-PE for females, 13 SF-PE for males, and IB770. Repeated measures 1-way ANOVAs (p < 0.01) were employed for three age groups for both males and females, and Bland-Altman plots were employed to evaluate the agreement between IB770 and SF-PE. Based both on statistical assessment and the Bland-Altman plots, similarity, agreement, and accuracy observed in %BF between IB770 and SF-PE were determined. From these assessments and plots, the following SF-PE are recommended to estimate %BF in young males (YM), middle-age males (MM), older males (OM), young females (YF), middle-age females (MF), and older females (OF) (%BF between IB770 and SF-PE shown): 1) YM: IB770 = 16.2%; Durnin 1974 (DW) = 16.3%; Williams 1992 (W) = 16.2%; Lean 1996 (L) = 16.6% ; 2) MM: IB770 = 19.7%; W = 19.7%; DW = 22.3%; 3) OM: IB770 = 24.4%; DW = 25.3%; W = 22.4%; 4) YF: IB770 = 24.9%; Jackson 1985 (JP3b) = 23.8%; 5) MF: IB770 = 25.2%; Jackson 1980 = 25.0%; JP3b = 26.1%; and 6) OF: IB770 = 36.6%; Peterson 2003 = 36.2%. Given that SF-PE either underestimated, overestimated, or accurately estimated %BF compared to IB770, this emphasizes the importance of using SF-PE that are appropriate for different age/sex groups and provide as accurate as possible estimates of %BF. Assessing %BF accurately is important given excessive %BF increases cardiometabolic disease risk.

PMID:42233218 | DOI:10.1017/S0007114526107624

Am J Public Health. 2026 Jun 3:e1-e10. doi: 10.2105/AJPH.2026.308500. Online ahead of print.

ABSTRACT

Objectives. To identify nutritional characteristics associated with the perceived addictive potential of commonly consumed foods in the US food supply, the majority of which are ultraprocessed foods (UPFs). Methods. In a demographically diverse sample of US adults (n = 1664; 55.2% female), participants rated the perceived addictiveness of 297 commonly consumed foods (74.4% UPFs). Data were collected through Prolific in June 2024. Machine-learning models identified nutritional predictors of addictiveness using both the 15 variables required on US Nutrition Facts labels and an expanded set of 166 nutrient characteristics from the Nutrition Data System for Research. Results. Models performed comparably and revealed consistent nonlinear associations between nutrient content and perceived addictiveness. Foods higher in carbohydrates, glycemic load, energy density, and fat were rated as more addictive. These nutrient profiles were rare in minimally processed foods but common in UPFs, which frequently exceeded multiple addictive nutrient thresholds simultaneously. Conclusions. This study identifies a nutritional signature linked to perceived addictive potential. Findings provide a data-driven framework for identifying foods most likely to promote compulsive intake and inform policies aimed at creating a healthier, less addictive food environment. (Am J Public Health. Published online ahead of print June 3, 2026:e1-e10. https://doi.org/10.2105/AJPH.2026.308500).

PMID:42233199 | DOI:10.2105/AJPH.2026.308500

Ther Clin Risk Manag. 2026 May 27;22:597422. doi: 10.2147/TCRM.S597422. eCollection 2026.

ABSTRACT

PURPOSE: This retrospective multicenter cohort study evaluated the real-world effectiveness of propofol alone versus a propofol-plus-dexmedetomidine combination on clinical outcomes in mechanically ventilated ICU patients.

METHODS: Adult mechanically ventilated ICU patients receiving long-term continuous infusion sedation (≥48 h) with either propofol alone or propofol plus dexmedetomidine were identified from the MIMIC-IV and eICU databases. An external validation cohort from Nanjing Drum Tower Hospital (2013-2022) was assembled using the same eligibility criteria. Patients were categorized into a propofol monotherapy group (Pro) and a propofol plus dexmedetomidine group (Pro+Dex). Outcomes included 28-day all-cause mortality, incident delirium, ICU length of stay, duration of mechanical ventilation, and longitudinal changes in mean arterial pressure, heart rate, and oxygen saturation.

RESULTS: Among 5495 patients (Pro: n=4730; Pro+Dex: n=765), the Pro+Dex regimen was associated with lower 28-day mortality (adjusted HR: 0.45, 95% CI: 0.36-0.56; P < 0.001) and a markedly reduced incidence of delirium (adjusted OR: 0.28, 95% CI: 0.21-0.37; P < 0.001), but with a modestly longer ICU stay (13.07 vs 10.60 days; adjusted ratio: 1.23, 95% CI: 1.18-1.29). Mechanical ventilation duration did not differ significantly between groups (154.79 vs 157.64 hours; adjusted ratio: 0.98, 95% CI: 0.92-1.05). Longitudinal mixed-effects models suggested a more stable MAP trajectory and lower HR with Pro+Dex, while SpO₂ was slightly lower on average but remained stable over time. Subgroup analyses were broadly consistent with the overall cohort. In the external validation cohort, Pro+Dex was also associated with significantly lower 28-day mortality, whereas the reduction in delirium incidence did not reach statistical significance.

CONCLUSION: In this large real-world multicenter study, combination sedation with propofol and dexmedetomidine was associated with lower 28-day mortality and a lower risk of delirium, without a significant difference in mechanical ventilation duration, although ICU length of stay was modestly longer.

PMID:42233162 | PMC:PMC13222770 | DOI:10.2147/TCRM.S597422

Front Cell Infect Microbiol. 2026 May 18;16:1816857. doi: 10.3389/fcimb.2026.1816857. eCollection 2026.

ABSTRACT

OBJECTIVE: To establish a rapid multiplex PCR capillary electrophoresis (MPCE) method for the simultaneous detection of seven sexually transmitted infection pathogens, and to evaluate its clinical utility.

METHODS: We designed specific primers and optimized multiplex PCR conditions. Capillary electrophoresis enabled fragment analysis. We assessed diagnostic performance, including sensitivity, specificity, anti-interference capacity, and repeatability. Using commercially available reagents as references, we evaluated the agreement of MPCE with 205 clinical samples. Kappa consistency test and McNemar test were used to evaluate the consistency and difference between this method and the reference methods.

RESULTS: The detection system was successfully constructed, with a detection time of three hours. It enabled simultaneous detection of seven common genital tract pathogens, including Chlamydia trachomatis (CT), Ureaplasma urealyticum (UU), Mycoplasma genitalium (MG), Neisseria gonorrhoeae (NG), Mycoplasma hominis (MH), Herpes simplex virus type 2 (HSV-2), and Ureaplasma parvum (UP). The method demonstrated good specificity and anti-interference capacity, with a limit of detection (LOD) ranging from 325 to 900 copies/mL across all targets. Repeatability results showed minimal fragment length fluctuations (0.13-0.20 nt), and the coefficient of variation (CV) for log peak area ranged from 0.78% to 5.56%. Agreement between the developed method and commercial reference assays was good for all seven pathogens: CT, 94.93% (Kappa = 0.84); MG, 95.12% (Kappa = 0.88); NG, 96.59% (Kappa = 0.91); UP, 95.61% (Kappa = 0.88); MH, 97.07% (Kappa = 0.82); HSV-2, 100% (Kappa = 1.00); and UU, 91.71% (Kappa = 0.69). The positivity rates of MG and NG detected by this method were higher than those by the reference methods (P = 0.008 and P = 0.011, respectively), and there was no statistical difference for the other pathogens (P>0.05).

CONCLUSION: This study successfully established a MPCE-based assay for the simultaneous detection of seven common genital tract pathogens (CT, UU, MG, NG, MH, HSV-2, and UP) in a single reaction. The method demonstrated high sensitivity, excellent repeatability and strong agreement with commercial reference assays. With its high throughput and rapid turnaround time, this method is well-suited for clinical screening and large-scale epidemiological surveillance of genital tract infections.

PMID:42233157 | PMC:PMC13223153 | DOI:10.3389/fcimb.2026.1816857