Tag: statistics

Vasc Endovascular Surg. 2026 Apr 28:15385744261447457. doi: 10.1177/15385744261447457. Online ahead of print.

ABSTRACT

ObjectiveContrast-induced nephropathy remains a significant concern in patients undergoing endovascular aneurysm repair (EVAR), particularly those with pre-existing renal impairment. This study aimed to evaluate the feasibility and safety of using a one-quarter diluted contrast agent during EVAR to reduce contrast volume without compromising imaging quality or clinical outcomes.MethodsWe retrospectively reviewed EVAR procedures performed between July 2022 and September 2024. A total of 96 patients were included, with 50 receiving undiluted contrast and 46 receiving a one-quarter diluted solution. All procedures were conducted using the same angiographic system and protocol. Pixel values and signal-to-noise ratios (SNRs) were measured from digital subtraction angiography (DSA) images. Subjective image quality was independently evaluated by three vascular surgeons using a standardized 5-point scale. Postoperative type I/III endoleaks were identified on contrast-enhanced CT or ultrasound within 30 days. Statistical comparisons were performed using Welch’s t-test, Mann-Whitney U test, chi-square test, or Fisher’s exact test, as appropriate.ResultsProcedural success was achieved in all cases. The diluted group achieved a 70% reduction in contrast volume (19.8 ± 11.5 mL vs 67.7 ± 30.5 mL; P < .001). Pixel values (2.87 ± 8.75 vs 2.99 ± 5.59; P = .936), SNRs, and surgeon-rated image quality were comparable between groups. The incidence of type I/III endoleaks (2.0% vs 4.3%; P = .606) and radiation parameters did not differ significantly.ConclusionsUse of a one-quarter diluted contrast agent during EVAR provided image quality and safety comparable to undiluted contrast while significantly reducing contrast volume. This technique may represent a practical strategy to mitigate renal risk in patients with impaired kidney function.

PMID:42050389 | DOI:10.1177/15385744261447457

J Am Coll Health. 2026 Apr 28:1-12. doi: 10.1080/07448481.2026.2663303. Online ahead of print.

ABSTRACT

OBJECTIVE: This study estimated the prevalence of psychological disabilities among university students, characterized associations between symptom severity and functional limitations, explored self-identification and service registration across mental health diagnoses, and examined mental health stigma’s effect on service access.

PARTICIPANTS: 104,729 post-secondary students from the 2023-2024 Healthy Minds Study.

METHODS: Descriptive statistics addressed the first three aims; multivariable logistic regression addressed the fourth.

RESULTS: Self-reported psychological disabilities comprised 13.1% of all disabilities. Self-reported functional limitations increased sigmoidally with PHQ-9 and GAD-7 scores. Students with anxiety and depression were least likely to self-identify as having a psychological disability despite reporting functional limitations. Personal and perceived stigma were not associated with DSO registration, but were negatively associated with mental health treatment access; help-seeking stigma was negatively associated with both.

DISCUSSION: Novel self-identification, self-disclosure and stigma data are provided to support improved reporting and service access for students with psychological disabilities.

PMID:42050382 | DOI:10.1080/07448481.2026.2663303

Eur J Sport Sci. 2026 May;26(5):e70181. doi: 10.1002/ejsc.70181.

ABSTRACT

This randomized controlled trial examined the effects of a 10-week high-intensity interval training (HIIT) program on physiological and hematological outcomes in 28 adolescent girls with overweight or obesity. Participants were randomly assigned to a HIIT group or a control group. The HIIT protocol comprised 4 sets of 6 × 15-s bouts at 90%-105% of maximal aerobic speed (MAS), interspersed with 15-s active recovery at 50% MAS, performed three times per week. Significant group×time interactions were observed for body composition, aerobic capacity, maximal heart rate (HRmax), erythrocytes, hemoglobin, hematocrit, creatine kinase (CK), and lactate dehydrogenase (LDH). Between-group comparisons showed greater improvements in body mass, body fat, waist circumference, MAS, estimated VO₂max, and plasma volume in the HIIT group compared with controls, though not all differences reached statistical significance. Within-group analysis in the HIIT group revealed reductions in body mass (p < 0.001, d = 0.37), body fat (p = 0.001, d = 0.78), waist circumference (p < 0.001, d = 0.54), HRmax (p = 0.020, d = 0.88), erythrocytes (p = 0.007, d = 0.46), hemoglobin (p = 0.019, d = 0.84), hematocrit (p = 0.004, d = 0.34), CK (p = 0.049, d = 0.29), and LDH (p = 0.032, d = 0.41), alongside increases in MAS (p = 0.007, d = 0.64) and estimated VO₂max (p = 0.007, d = 0.64). Plasma volume variation was also higher in the HIIT group. Overall, a 10-week HIIT intervention enhanced body composition, plasma volume, and cardiorespiratory fitness, while reducing markers of muscular and metabolic stress. These results indicate that HIIT is a feasible and effective approach for improving physiological and metabolic health in adolescent girls with overweight or obesity, supporting its potential as a targeted exercise strategy in this population.

PMID:42050353 | DOI:10.1002/ejsc.70181

Sci Rep. 2026 Apr 28. doi: 10.1038/s41598-026-50614-y. Online ahead of print.

ABSTRACT

Africa bears the highest global burden of HIV/AIDS, with young people disproportionately affected. University students are at increased risk of HIV infection due to campus-related lifestyle factors. HIV self-testing (HIV-ST) represents a promising strategy to enhance HIV diagnosis rates and support progress toward the UNAIDS 95-95-95 targets. This study evaluated the proportion of undergraduate students in Imo State, Nigeria, who underwent HIV counseling and testing (HCT) in the past year. A secondary objective was to assess the effect of health education on HIV-ST uptake among participants. The study employed a cross-sectional design with embedded intervention and included all government-owned universities and polytechnics in Imo State: Federal University of Technology Owerri (FUTO), Imo State University (IMSU), Federal Polytechnic Nekede (FEP), and University of Agriculture and Environmental Sciences (UAES). Simple random sampling and systematic random sampling were used to select the participants. A total of 317, 316, 421 and 359 were sampled from FEP, IMSU, FUTO and UAES respectively. A health education intervention was administered to increase HIV testing uptake; particularly HIV-ST. Data were collected from participants aged 16-25 years between October and December 2025 using an adapted structured questionnaire. Statistical analysis, using the chi-square test, was used to examine associations between participants’ socio-demographic characteristics and HIV testing uptake. Results indicated that HIV testing uptake among participants in the past year was 178 (42.3%) at FUTO, 174 (48.5%) at UAES, 77 (24.4%) at IMSU, and 95 (30%) at FEP. Prior to the health education intervention, none of the students had previously used HIV-ST. Following the health education intervention, HIV-ST uptake increased to 53 (29.8%), 48 (27.6%), 30 (38.9%), and 34 (35.8%) at FUTO, UAES, IMSU, and FEP, respectively. The overall HIV testing uptake and HIV-ST of the participants was 37.1%, and 11.7% respectively. Statistical analysis revealed that marital status and gender influenced HIV testing uptake, with married participants and females more likely to be tested. HIV testing uptake among undergraduates in Imo State remains low, with all institutions reporting rates below 50%, which is significantly lower than the UNAIDS 95% target. This raises concerns about Nigeria’s ability to achieve the UNAIDS 2030 target. Health education was shown to be an effective strategy for increasing HIV-ST among the participants. It is recommended that health education be integrated into national strategies to enhance HIV testing uptake, with particular attention to young adults, especially males, in the design and implementation of voluntary counseling and testing services.

PMID:42050333 | DOI:10.1038/s41598-026-50614-y

J Clin Sleep Med. 2025 Jun;21(6):1007-1021. doi: 10.5664/jcsm.11610. Epub 2025 Jun 1.

ABSTRACT

STUDY OBJECTIVES: We aimed to describe the feasibility, acceptability, and preliminary efficacy of a pilot randomized controlled trial of a sleep health intervention (SLEEPSMART) for children with juvenile idiopathic arthritis and their parents.

METHODS: Fifty children, 8-13 years of age, with juvenile idiopathic arthritis and sleep deficiency and their parents participated in the study. Participants were randomized to either the SLEEPSMART intervention or the control group (usual care). The SLEEPSMART intervention lasted 7 weeks and included weekly educational modules, quizzes, assignments, goal setting, and an online sleep coach. Children wore actigraphy and completed sleep diaries and surveys at baseline, immediately postintervention, and 1 month postintervention. Feasibility was measured by the percentage of eligible, enrolled, and retained child-parent dyads; engagement was measured when dyads completed the modules; and usefulness and acceptability were measured with the Treatment Evaluation Inventory and qualitative exit interviews.

RESULTS: Of the 50 child-parent dyads enrolled, 88% completed the baseline assessment. Seventy-five percent of children and 89% of parents reported high acceptance; 89% of parents and 80% of children recommend SLEEPSMART. Compared to children in the control group, those who received the SLEEPSMART intervention had significant improvements in actigraphy total sleep time and sleep efficiency and Patient-Reported Outcomes Measurement Information System sleep disturbance scores immediately postintervention and at 1-month follow-up and in their dysfunctional beliefs and attitudes about sleep and sleep efficacy scores 1 month postintervention. Parents in the SLEEPSMART group had significant improvements in the Patient-Reported Outcomes Measurement Information System sleep-related impairment and dysfunctional beliefs and attitudes about sleep scores immediately postintervention and at 1-month follow-up and in their self-efficacy scores 1 month postintervention in comparison to parents in the control group.

CONCLUSIONS: SLEEPSMART was feasible, acceptable, and improved objective and self-report sleep and self-efficacy outcomes in children with juvenile idiopathic arthritis and their parents.

CLINICAL TRIAL REGISTRATION: Registry: ClinicalTrials.gov; Name: Sleep Shared-Management Intervention for Children with Juvenile Idiopathic Arthritis; URL: https://clinicaltrials.gov/study/NCT04066205 ; Identifier: NCT04066205 CITATION: Zhai S, Palermo TM, Shenoi S, et al. A shared-management web-based intervention for sleep deficiency in school-age children with juvenile idiopathic arthritis and their parents: feasibility and acceptability study. J Clin Sleep Med. 2025;21(6):1007-1021.

PMID:42050319 | DOI:10.5664/jcsm.11610

Intern Emerg Med. 2026 Apr 28. doi: 10.1007/s11739-026-04360-8. Online ahead of print.

ABSTRACT

Patients with celiac disease have lower bone mineral density (BMD) and higher incidence of fractures compared to age- and sex-matched controls. There are no studies of denosumab, an antiresorptive drug, which is a fully human monoclonal antibody that binds the receptor activator of NFκB ligand (RANKL) in celiac patients with osteoporosis. The aim is to study the long-term effect of denosumab on BMD in celiac patients with osteoporosis on a gluten-free diet (GFD), compared to non-celiac osteoporotic patients. Fifteen celiac patients with osteoporosis and control subjects of the same age, sex, BMI, and fragility fractures were enrolled. At baseline, each patient underwent biochemical tests, spine X-ray, and DXA measurements, and the Charlson Comorbidity Index (CCI) was computed. At each visit (every 2 years ± 6 months), with a follow-up of 4 years, any adverse events or new clinical fractures, DXA measurements, and CCI were recorded. In celiac patients, a statistically significant median delta increase in total hip T-score of 0.11 compared to baseline was observed (ANOVA p< 0.05), while in the control group, it was 0.07 (ANOVA p < 0.05), with no difference between groups. New fractures occurred in the celiac group in five patients during the follow-up, and in two patients in the control group (p = 0.38). No adverse events occurred during follow-up. In celiac patients with osteoporosis on GFD, denosumab, with up to 4 years of follow-up, increased hip BMD without adverse events.

PMID:42050298 | DOI:10.1007/s11739-026-04360-8

Eur Radiol. 2026 Apr 28. doi: 10.1007/s00330-026-12591-8. Online ahead of print.

NO ABSTRACT

PMID:42050295 | DOI:10.1007/s00330-026-12591-8

Eur Radiol. 2026 Apr 28. doi: 10.1007/s00330-026-12559-8. Online ahead of print.

ABSTRACT

OBJECTIVES: CT-derived assessment of regional ventilation is possible with paired inspiration and expiration scans. Normative reference values for CT-derived ventilation remain undefined. The aim of this study is to establish reference values for pulmonary ventilation using CT, with pulmonary function tests (PFTs) as the clinical standard.

MATERIALS AND METHODS: In this prospective, single-center study (December 2022-April 2024), 103 healthy adults underwent spirometry-guided inspiratory and expiratory CT. Lobes were segmented automatically using TotalSegmentator. Voxel-wise ventilation was quantified as the relative air volume change between inspiration and expiration via nonlinear registration, normalized to inspiratory lung volume. CT-derived lung volumes were compared with PFT-derived total lung capacity (TLC), residual volume (RV), and vital capacity (VC). Reference intervals were reported as mean ± standard deviation and 5th-95th percentiles. Multivariable analyses assessed the effects of sex, age, height, lung region, and gravitational orientation.

RESULTS: Ninety-one participants (mean age, 53 ± 12 years; 49 men) were included. Mean ventilation was 59.5% ± 8.5% (5th-95th percentile, 42.1-72.5%). CT-derived volumes were systematically lower than PFT values but strongly correlated: CT-TLC (-13.8%, r = 0.89), CT-RV (-2.5%, r = 0.80), and CT-VC (-20.8%, r = 0.82). Ventilation decreased with age (p < 0.001) and increased with height (p < 0.05). Regionally, ventilation was higher in the lower lobes (p < 0.003) and posterior regions (p < 0.001).

CONCLUSION: CT-derived ventilation correlates strongly with PFT-indices but yields lower absolute values. Demographic and anatomical factors significantly influence ventilation distribution. These normative data provide a reference framework for clinical functional lung assessment.

KEY POINTS: Question Can normative reference values for CT-derived regional lung ventilation be established, and how do these metrics relate to pulmonary function tests and anatomical/demographic factors? Findings Mean CT-derived ventilation was 59.5% ± 8.5% with strong pulmonary function test correlations. Ventilation exhibited significant regional heterogeneity and systemic variations by anatomical location, age, and sex. Clinical relevance Normative reference values enable objective classification of CT-derived ventilation, standardizing interpretation and reducing subjectivity. They facilitate earlier detection of regional dysfunction, quantitative phenotyping, risk stratification, longitudinal monitoring, and comparability with pulmonary function testing and other imaging.

PMID:42050294 | DOI:10.1007/s00330-026-12559-8

Eur Radiol. 2026 Apr 28. doi: 10.1007/s00330-026-12553-0. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess whether multi-echo T2* MRI can differentiate neonatal hemochromatosis (NH) from other causes of neonatal liver failure (NLF) by evaluating siderosis in the liver and extrahepatic organs.

MATERIALS AND METHODS: This retrospective study evaluated 26 infants ≤ 20 weeks of age, who underwent MRI with Gradient-Recalled (GRE) multi-echo T2* sequence for liver failure. Two radiologists noted the degree of siderosis in the liver, pancreas, thyroid, spleen and renal cortex using a semiquantitative scale. Kendall’s tau was used to assess the correlation between siderosis grades and final diagnosis. Consensus review by hepatologist, neonatologist, and pathologist using integrated clinical, biochemical, imaging and histopathologic data served as the reference standard for the final diagnosis.

RESULTS: Of 26 patients, 7 had NH and 19 had other causes of NLF. Interobserver agreement was highest for liver (κ = 0.97), followed by kidney (κ = 0.87), spleen (κ = 0.84), thyroid (κ = 0.80), and pancreas (κ = 0.73). Significant positive correlations between siderosis grades and NH diagnosis were found for thyroid (Kendall’s tau = 0.70, p < 0.01), pancreas (Kendall’s tau = 0.67, p < 0.01), and liver (Kendall’s tau = 0.42, p = 0.03), while spleen showed a significant negative correlation (Kendall’s tau = -0.51, p < 0.01). MRI demonstrated 100% sensitivity, 89.5% specificity, 77.8% positive predictive value, 100% negative predictive value, and 92.3% overall accuracy for NH diagnosis. There were significant differences among groups in R2* values for the pancreas, thyroid and spleen, with no differences in the liver.

CONCLUSION: Multi-echo T2* MRI reliably distinguishes NH from other causes of NLF by revealing significant siderosis in the thyroid and pancreas, with relative sparing of the spleen.

KEY POINTS: Question Neonatal hemochromatosis (NH) is a rare but often fatal condition causing neonatal liver failure (NLF), and differentiating it from other causes of NLF is challenging. Finding Pancreatic and thyroid iron deposition, as seen on MRI, strongly correlated with NH, and splenic iron deposition correlated inversely with NH. Clinical relevance Multi-echo T2* MRI is a highly accurate, non-invasive technique for early differentiation of neonatal hemochromatosis from other liver failure causes, potentially enabling earlier diagnosis of NH and guiding crucial management decisions in affected neonates.

PMID:42050293 | DOI:10.1007/s00330-026-12553-0

Obes Surg. 2026 Apr 28. doi: 10.1007/s11695-026-08701-6. Online ahead of print.

ABSTRACT

BACKGROUND: Endoscopic sleeve gastroplasty (ESG) is an established endoscopic bariatric therapy. Two main platforms are currently used in clinical practice: the OverStitch Endoscopic Suturing System (OESS) and the triangulation Endomina System (ES). Comparative data regarding their technical performance and suture durability remain limited. This experimental study aimed to compare both systems in terms of usability, safety, and durability of full-thickness sutures.

METHODS: In this prospective comparative animal study, six adult minipigs were randomized to ESG using either OESS or ES (three animals per group; five sutures per animal). Primary outcomes included ease of use, tissue apposition (TA) tightness assessed at index procedure, day 15 endoscopy, and day 30 necropsy, as well as histological evaluation of serosal fusion and bite size.

RESULTS: All procedures were successfully completed without intra-procedural adverse events. Overall ease-of-use scores were higher with ES compared to OESS (median 6 vs 5; p=0.047). Immediate post-procedural TA scores were similar between groups (both tight; p=1). However, at day 15, ES demonstrated significantly higher TA scores than OESS (OR=29.1; 95% CI 4.3-200.3; p=0.026). At day 30 necropsy, TA remained significantly tighter with ES (OR=199.9; 95% CI 2.5-16245; p=0.029). No leaks or abscesses were observed. Histologically, serosal fusion was observed only in the ES group, although differences did not reach statistical significance.

CONCLUSION: Both ESG platforms were safe and feasible in this animal model. While immediate suture performance was comparable, the Endomina System demonstrated superior mid-term durability and tighter tissue apposition compared with OverStitch. The clinical relevance of these findings warrants further investigation.

PMID:42050283 | DOI:10.1007/s11695-026-08701-6