Tag: statistics

Int J Radiat Biol. 2026 Mar 18:1-11. doi: 10.1080/09553002.2026.2636303. Online ahead of print.

ABSTRACT

PURPOSE: This article analyzes intracellular processes of adaptation to the nutrient medium and radiation exposure.

METHODS: The analysis uses experimental data on the effects of nutrient medium on yeast cells and published research of cellular responses to radiation exposure.

RESULTS: Adaptation of cells to both the nutrient medium and external radiation exposure revealed the consistent formation of pseudo-wild cell centers (PWCs) dependent on the environment and genotype. These quasi-equilibrium foci change as PWCs undergo modification, death, and proliferation. The cellular adaptation system demonstrates an interaction between the environment, genes, and proteins. Adaptation depends on external active energy, and is associated with variability in the secondary structure of genes and the tertiary structure of proteins.

CONCLUSIONS: Adaptation creates an energy-dependent sequence of quasi-equilibrium states of PWC foci by optimizing the conformational structures of genes and proteins. From a physical perspective, the active energy of a changing environment disrupts but immediately optimizes genetic structures according to the principle of free energy minimization; quasi-equilibrium foci of PWCs are continuously formed, ensuring diversity, stability, and reproduction under suitable conditions.

PMID:41848575 | DOI:10.1080/09553002.2026.2636303

J Homosex. 2026 Mar 18:1-25. doi: 10.1080/00918369.2026.2642717. Online ahead of print.

ABSTRACT

Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) clients often receive suboptimal mental health care. LGBTQ+ clinical competence self-report measures have been developed to assess therapists’ knowledge and attitudes and subjective self-perceived skills and performance. However, therapist self-perceived assessments of their skills and performance have been found to be biased. Observational measures of LGBTQ+ competence are needed to more objectively evaluate therapists’ skills and performance. The objective of this exploratory pilot study was to develop and assess the coding reliability of observational measures of therapists’ competence with LGBTQ+ clients. The observational measure developed and tested in this study consisted of 29 items that corresponded to 29 expected competencies applicable to LGBTQ+ competent and ethical therapy. On-line initial consultations between 43 therapists and a simulated client were video recorded. Two trained self-identifying LGBTQ+ coders observed the video-recordings and used the 29 items to rate the LGBTQ+ competencies of these 43 therapists. We generated item proportions and kappa statistics. This preliminary study suggests that 13 measures of LGBTQ+ clinical competence were operationally defined to be observable, measurable, and reliably coded. Future research is warranted to both confirm and expand on this conclusion to advance evidence-based approaches to improve the mental health care for LGBTQ+ clients.

PMID:41848553 | DOI:10.1080/00918369.2026.2642717

Can Urol Assoc J. 2026 Mar 16. doi: 10.5489/cuaj.9407. Online ahead of print.

ABSTRACT

INTRODUCTION: Even small quantities of prescribed opioids for acute postoperative pain can lead to addiction, hinder recovery, and be unnecessary. This study evaluated whether an opioid-free postoperative pathway following reconstructive urologic surgery increased pain-related patient communication.

METHODS: An opioid-free postoperative protocol was implemented at our institution in 2019. We conducted a case-cohort study of patients undergoing artificial urinary sphincter (AUS) placement, urethroplasty, or buried penis repair (BPR) between 2015 and 2023. Patients with concurrent surgeries or preoperative opioid use were excluded. Retrospective chart review captured demographics, surgical data, and pain-related communications within 60 days postoperatively. Statistical analysis included unpaired t-tests and chi-squared tests.

RESULTS: The study included 360 patients: 181 opioid recipients and 179 opioid-free (BPR: 84; urethroplasty: 140; AUS: 132). No significant demographic differences were observed. Pain-related communication did not significantly differ between groups. In the non-opioid cohort, only 3.9% received an opioid within 60 days postoperatively. Pain-related communication occurred in 21% of opioid-treated patients and 16% of non-opioid patients. Among those who contacted providers for pain, 25.8% in the opioid group received refills, while 30.5% of opioid-naive patients were newly prescribed opioids (p=0.26). Most opioid-treated patients (74.2%) were managed with non-narcotic methods after initial contact.

CONCLUSIONS: An opioid-free postoperative regimen for reconstructive urologic procedures, such as urethroplasty, BPR, and AUS placement, is feasible, well-tolerated, and does not increase pain-related patient communication, supporting broader adoption of opioid-sparing approaches in surgical care.

PMID:41848541 | DOI:10.5489/cuaj.9407

Food Funct. 2026 Mar 18. doi: 10.1039/d5fo04235f. Online ahead of print.

ABSTRACT

Background: Olive leaves, a by-product of olive oil production, are rich in oleuropein, a phenolic compound with antioxidant and anti-inflammatory properties. This systematic review and meta-analysis evaluated the effects of olive leaf extract (OLE) and oleuropein on glucose metabolism, lipid profile, and inflammatory markers in randomized clinical trials (RCTs). Methods: The review was registered in PROSPERO (CRD42022375615) and followed PRISMA guidelines. PubMed, Scopus, and Web of Science were searched up to January 2026 without restrictions. Eligible studies were RCTs in adults comparing OLE or oleuropein with placebo or control. Study selection, data extraction, and risk of bias (RoB 2) assessment were performed independently by two reviewers; certainty of evidence was assessed with GRADE. Meta-analyses were conducted when at least two trials reported suitable data. Results: Eleven RCTs were included (4 short-term and 7 continuous-intake trials). Short-term crossover studies showed heterogeneous effects on postprandial glycemia and insulin responses, precluding meta-analysis. In continuous-intake, parallel-design RCTs, pooled analyses demonstrated no statistically or clinically significant effects on glycemic or lipid outcomes. Evidence regarding inflammatory markers was scarce and of low certainty. Conclusion: The current evidence does not support clinical recommendations for OLE supplementation aimed at health benefits. Data from methodologically consistent and robust trials indicate no statistically significant metabolic or inflammatory effects under usual human consumption patterns, whereas evidence from other study designs remains inconclusive. Further high-quality RCTs are required to clarify potential metabolic benefits.

PMID:41848522 | DOI:10.1039/d5fo04235f

Int Angiol. 2026 Mar 18. doi: 10.23736/S0392-9590.26.05521-5. Online ahead of print.

ABSTRACT

BACKGROUND: Evaluate mid-term outcomes, including amputations and mortality, in patients with critical limb-threatening ischemia (CLTI) deemed unsuitable for vein bypass surgery undergoing endovascular treatment in the femoropopliteal segment.

METHODS: A retrospective analysis was conducted including all patients undergoing endovascular treatment for CLTI at a university hospital between 2013-2017. Kaplan-Meier (KM) analyses estimated survival probabilities, and major amputation rates were compared between genders and diabetic versus non-diabetic patients.

RESULTS: One hundred thirty-four patients and 142 limbs were included. 49% of lesions classified as TASC-II D. Technical success was achieved in 95% of limbs. Median follow-up was 24 months (IQR: 13-36 months). 31% had died by study conclusion. KM-estimated freedom from all-cause mortality was 67% (95% CI: 59-77%) at 48 months. The major amputation rate was 25% (N.=35 limbs). KM-estimated freedom from major amputation was 64% (95% CI: 48-85%) at 46 months. There was no significant difference in major amputation-free survival between genders: females 76% (95% CI 63-91%) vs males 70% (95% CI 60-82%) at 36 months. The rate of major amputations was higher in patients with diabetes (19/55, 35% vs. 16/87, 18%, P=0.048), however, KM-estimates showed no statistically significant difference over time, P=0.570.

CONCLUSIONS: In this CLTI cohort unsuitable for vein bypass surgery, 25% underwent major amputation and 31% died following endovascular treatment during a median follow-up of 24 months. Larger comparative studies, including conservative treatment, are needed to define optimal management for complex femoropopliteal lesions.

PMID:41848486 | DOI:10.23736/S0392-9590.26.05521-5

J Nutr Educ Behav. 2026 Mar 17:S1499-4046(26)00040-0. doi: 10.1016/j.jneb.2026.02.004. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the relationship between adult intuitive eating and perceived food security during childhood.

METHODS: A survey was conducted consisting of the Intuitive Eating Scale-2 and the 6-item short form of the US Household Food Security Module modified to assess perceived food security status in participants aged 0-17 years. Student, faculty, and staff participants (n = 331) were primarily White, women, and aged 18-24 years. Analyses included descriptive statistics, Mann-Whitney U tests, and Kendall’s Tau-b correlations.

RESULTS: Overall, perceived childhood food insecurity was negatively correlated with adult intuitive eating (T_b = -0.1, P = 0.03) and body-food choice congruence (T_b = -0.1, P = 0.03). When stratified by gender, among women, perceived childhood food insecurity was negatively correlated with adult intuitive eating (T_b = -0.1, P = 0.04).

CONCLUSIONS AND IMPLICATIONS: Perceived childhood food insecurity and adult intuitive eating warrant further exploration to identify those who may benefit from intuitive eating education.

PMID:41848476 | DOI:10.1016/j.jneb.2026.02.004

J Foot Ankle Surg. 2026 Mar 17:S1067-2516(26)00045-1. doi: 10.1053/j.jfas.2026.02.009. Online ahead of print.

ABSTRACT

BACKGROUND: Comparative trials evaluating surgical outcomes are critical in guiding treatment for hallux valgus. However, the statistical stability of these outcomes is not well documented. Purpose The purpose of this study was to evaluate the statistical fragility of comparative studies analyzing minimally invasive surgery (MIS) versus open techniques for hallux valgus correction.

STUDY: Design A systematic review identified comparative studies assessing MIS versus open hallux valgus correction.

METHODS: Outcome data were extracted with Fragility Index (FI) and Continuous Fragility Index (CFI) calculated for significant outcomes, and reverse FI (rFI) and reverse CFI (rCFI) for nonsignificant outcomes. Fragility Quotient (FQ) was calculated for each and compared to the number of patients lost to follow-up (LTFU).

RESULTS: Of 628 studies screened, 18 met inclusion criteria, totaling 1,369 patients. Among 88 dichotomous outcomes, the median FI was 2, FQ was 0.021, rFI was 4, and rFQ was 0.072. For 236 continuous outcomes, the median CFI was 8, CFQ was 0.116, rCFI was 19, and rCFQ was 0.280.

CONCLUSION: This is the first study to evaluate fragility in comparative trials on MIS versus open hallux valgus correction and among the first to assess reverse fragility in continuous outcomes. Significant results were more fragile than nonsignificant data and dichotomous outcomes were more fragile than continuous ones with nearly a quarter having an FI lower than the number of patients LTFU. Both outcome types demonstrated considerable statistical fragility supporting the cautious interpretation of MIS vs open hallux valgus findings and the reporting of statistical fragility data alongside P-values to better contextualize the robustness of clinical research.

PMID:41848475 | DOI:10.1053/j.jfas.2026.02.009

J Am Coll Cardiol. 2026 Mar 10:S0735-1097(26)00328-1. doi: 10.1016/j.jacc.2026.01.076. Online ahead of print.

ABSTRACT

BACKGROUND: Coronary artery disease (CAD) polygenic risk score (PRS), low-density-lipoprotein cholesterol (LDL-C), lipoprotein(a) (Lp(a)), and high-sensitivity C-reactive protein (hsCRP) are biomarkers that predict CAD. It is unclear whether integrating genomics with lipid and inflammatory biomarkers could complement traditional risk scores in identifying people at risk of CAD.

OBJECTIVES: This study assesses the predictive value of CAD PRS, LDL-C, Lp(a), and hsCRP for incident CAD across different age and sex groups.

METHODS: Participants (n = 215,695) from the UK Biobank aged 40 to 69 years with baseline CAD PRS, LDL-C, Lp(a), and hsCRP values were followed for 12 years to assess the incidence of CAD. We evaluated a multivariable-adjusted Cox model that included all 4 biomarkers, net reclassification index, C-statistics, and population attributable risk across different age and sex groups.

RESULTS: Over a 12-year follow-up, 4,721 men and 2,425 women developed CAD. The HRs for incident CAD associated with each biomarker elevation were 1.79 (95% CI: 1.70-1.89) for CAD PRS, 1.60 (95% CI: 1.48-1.66) for LDL-C, 1.20 (95% CI: 1.12-1.29) for Lp(a), and 1.64 (95% CI: 1.57-1.72) for hsCRP. CAD PRS demonstrated a stronger association in men (HR per SD: 1.49; 95% CI: 1.45-1.54) than women (HR per SD: 1.37; 95% CI: 1.31-1.44; P-interaction ≤ 0.001). All biomarkers conferred greater HRs at younger ages (P < 0.0001). Individuals with all biomarkers elevated had a 4.65-fold increased risk of CAD compared with those with no elevated biomarkers. A combined 4-biomarker model had a higher C-statistic of 0.753 compared with the pooled cohort equations (C-statistic of 0.740). The C-statistic of the combined 4-biomarker model was also higher in younger individuals in both sexes and yielded a 32.0% continuous net reclassification index when compared with the pooled cohort equations.

CONCLUSIONS: CAD PRS, LDL-C, hsCRP, and Lp(a) show independent age- and sex-specific associations with CAD. Measuring all 4 biomarkers may improve midlife CAD risk prediction for both male and female patients.

PMID:41848465 | DOI:10.1016/j.jacc.2026.01.076

Stat Med. 2026 Mar;45(6-7):e70465. doi: 10.1002/sim.70465.

ABSTRACT

Publication bias (PB) poses a significant threat to meta-analysis of diagnostic studies, as studies yielding significant results are more likely to be published in scientific journals, leading to the synthesized diagnostic capacity possibly being overestimated. Sensitivity analysis provides a flexible method to address PB by assuming different proportions of unpublished studies. Most existing methods addressing PB in meta-analysis of diagnostic studies are based on the bivariate normal model using normal approximations. However, they are unsuitable for meta-analysis with sparse data, which is common in diagnostic studies with high sensitivities or specificities. Alternatively, the bivariate binomial model relies on the exact within-study model and has better finite sample properties. To address PB in the bivariate binomial model, we model the selective publication process of diagnostic studies by extending the Copas t-statistic model and propose the likelihood conditional on published and estimation strategies. Our proposal provides an interpretable way to address PB on the summary receiver operating characteristic curve, an essential tool for synthesizing diagnostic accuracy. We show the practicability of the proposed method on several real-world meta-analyses of diagnostic studies and evaluate the performance by simulation studies.

PMID:41847888 | DOI:10.1002/sim.70465

Emerg Med Australas. 2026 Apr;38(2):e70245. doi: 10.1111/1742-6723.70245.

ABSTRACT

OBJECTIVE: The National Blood Authority (NBA) provides a Major Haemorrhage Protocol (MHP) template for Australian hospitals to develop and modify an MHP algorithm for their needs. However, it is unclear whether the evidence-based guidance from NBA is utilised by individual facilities. The aims of this study were to: (1) establish the baseline composition of MHP from public hospitals across Queensland and (2) compare content using the NBA algorithm and evidence-based recommendations.

METHODS: An explanatory qualitative design was used. Individual health service MHP were assessed against the NBA algorithm by a minimum of two members of the research team.

RESULTS: Seventy-eight MHP algorithms were retrieved from 113 hospitals and health facilities within Queensland. 99% (n = 77) of algorithms provided recommendations for red blood cell delivery and fibrinogen replacement. Variations existed on the availability of fresh blood products between hospitals and geographical locations. 90% of algorithms (n = 70) contained activation criteria; 21% (n = 14) incorporated additional non-NBA specific criteria. Less than half of MHP algorithms (n = 30, 40%) contained information regarding the management of critically bleeding paediatric patients.

CONCLUSION: There is significant variability in the content of MHP algorithms across Queensland, Australia, despite the availability of evidence-based guidelines for patients who are severely bleeding. Whilst individual health facilities are encouraged to modify MHPs to suit local contexts, the evidence on how to safely accomplish this remains limited and could account for the variations identified in this study. Further guidance is required for hospitals with restricted access to blood products, limited pathology testing capabilities, and who manage critically bleeding paediatric patients.

PMID:41847872 | DOI:10.1111/1742-6723.70245