Tag: statistics

Br J Math Stat Psychol. 2026 Mar 20. doi: 10.1111/bmsp.70044. Online ahead of print.

ABSTRACT

Cognitive Diagnosis Models (CDMs) are widely used in latent-variable modeling for classification tasks that diagnose abilities or skills. Originally developed for dichotomous indicators, CDMs have been extended to polytomous and continuous responses, including bounded continuous variables (e.g. proportions or index scores on a 0-1 or 0-100 scale). We introduce a Bounded DINA (B-DINA) model, an extension of DINA for handling bounded continuous responses, using a Beta distribution with an appropriate mean-precision parameterization. We present a Bayesian estimation framework, define interpretable item parameters and compute posterior probabilities of membership in each latent-attribute profile. We explicitly address label-switching nonidentifiability and assess absolute model fit via posterior predictive $p$ -values (PPP). Also, we have conducted a simulation study to evaluate parameter recovery for our proposed method and its performance. Further, we illustrate the model mainly with municipal data from Southeastern Brazil, where bounded indices summarize economy, education and health. Our proposed B-DINA effectively classifies municipalities and reveals relationships between observed indicators and latent attributes. As bounded continuous variables are common across the social sciences and policy analysis, our proposed B-DINA could offer a broadly applicable classification tool in the practice.

PMID:41862425 | DOI:10.1111/bmsp.70044

Prenat Diagn. 2026 Mar 20. doi: 10.1002/pd.70129. Online ahead of print.

ABSTRACT

OBJECTIVE: Advances in prenatal genetic screening have improved the detection of fetal genetic conditions; however, disparities in utilization persist. Our objective was to determine whether implementation and timing of prenatal genetic testing, including partner testing, differs according to insurance payor status.

METHOD: We conducted a retrospective chart review of pregnant patients who initiated prenatal care and delivered at our academic center in 2024. Patients were stratified by site: a resident clinic serving publicly insured, racially diverse patients and faculty practices serving predominantly privately insured, homogenous patients. Data were extracted from the electronic medical record, and statistical comparison was performed.

RESULTS: We reviewed 201 charts (101 resident clinic, 100 faculty practice). Compared with faculty practice patients, resident clinic patients were younger and more likely to be non-White, Hispanic, or non-English speaking. Among publicly insured patients, gestational age (GA) at initial visit was later, as was GA at genetic testing collection. Preconception screening was more common among privately insured patients. Concurrent testing and completion of screening was lower in publicly insured patients, and there were longer delays to partner testing.

CONCLUSIONS: Publicly insured patients had delayed prenatal genetic testing, reduced partner testing, and lower screening completion. Strategies are needed to provide equitable access to timely prenatal genetic testing.

PMID:41862421 | DOI:10.1002/pd.70129

Urol Oncol. 2026 Mar 19:111063. doi: 10.1016/j.urolonc.2026.111063. Online ahead of print.

ABSTRACT

INTRODUCTION: To examine the association of presurgical physical activity with urinary and sexual function following radical prostatectomy for clinically localized prostate cancer.

METHODS: Participants were recruited from 2011 to 2014 at 2 US institutions and provided self-reported urinary and sexual functions using the modified Expanded Prostate Cancer Index Composite (EPIC, scale from 0 to 100) at baseline (presurgery) and 5-week, 6-month, and 12-month after surgery. Moderate-to-vigorous intensity physical activity (MVPA) was assessed using the Community Healthy Activities Model Program for Seniors and classified into 3 categories. We evaluated changes in function pre- and postsurgery by linear generalized estimating equation (GEE) models and recovery in function after surgery by logistic GEE models.

RESULTS: Among 401 eligible participants, 38.4%, 35.2% and 26.4% engaged in low, medium, and high MVPA before surgery. Urinary function did not vary by MVPA at baseline or during recovery. For sexual function, patients with high MVPA had better sexual function (p = 0.008) at baseline than those with low or medium levels of MVPA. During the recovery phase, this difference disappeared at 5-week postsurgery but returned by 6-month (p = 0.035) and persisted up to 12-month postsurgery (p = 0.004). A suggestive higher likelihood of sexual function recovery was observed by 12-month postsurgery among participants with high versus low MVPA (OR: 2.42; 95% CI: 0.96-6.08; p = 0.060).

CONCLUSION: Physically active prostate cancer patients had better sexual function before and after surgery, with a suggestive though statistically non-significant clinical recovery after surgery. These findings support the potential for exercise prehabilitation to improve side effects associated with radical prostatectomy.

PMID:41862406 | DOI:10.1016/j.urolonc.2026.111063

Dis Mon. 2026 Mar 19:102099. doi: 10.1016/j.disamonth.2026.102099. Online ahead of print.

ABSTRACT

BACKGROUND: Obesity-related heart failure with preserved ejection fraction (HFpEF) is associated with high morbidity and limited therapeutic options. Tirzepatide, a dual agonist of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors, has demonstrated reductions in cardiovascular mortality and worsening heart failure events in a recent randomized controlled trial. However, pooled evidence for tirzepatide’s cardiovascular and clinical effects in HFpEF remains limited. Moreover, head-to-head comparisons of tirzepatide with semaglutide, another incretin-mimetic therapy shown to be beneficial in HFpEF, are sparse. This meta-analysis aims to systematically analyze the efficacy and safety of tirzepatide in patients with HFpEF.

METHODS: We conducted a systematic review by searching multiple databases up to December 5, 2025 evaluating tirzepatide versus standard therapy and semaglutide for cardiovascular outcomes in patients with obesity-related HFpEF. Statistical analysis was performed using RevMan 5.4, with an inverse variance random effects model to calculate hazard ratios (HR) and odds ratios (OR). Heterogeneity was assessed using the Higgins I² test. The study protocol is registered in PROSPERO (CRD420251170117).

RESULTS: Our final analysis included five studies, including RCTs and observational studies with a total of 47,710 patients with HFpEF and BMI ≥ 30 kg/m², a mean age of 64.7 years, and follow-up ranging from 52 to 146 weeks. Tirzepatide was associated with a significant reduction in the composite outcome of cardiovascular mortality and worsening heart failure events compared with standard therapy (HR 0.50; 95% CI: 0.42-0.60; p < 0.001). A significant reduction in heart failure exacerbation events alone was also observed with tirzepatide versus standard therapy (HR 0.75; p = 0.04), whereas no significant difference was seen when compared with semaglutide (HR 0.95; p = 0.31). Heart failure hospitalization and all-cause mortality did not differ significantly between tirzepatide and either standard therapy or semaglutide. No statistically significant difference in adverse drug reactions was observed.

CONCLUSION: In this meta-analysis, tirzepatide was associated with a significant reduction in the composite outcome of cardiovascular mortality and worsening heart failure events in patients with HFpEF and obesity. When compared to semaglutide, there were no significant differences in heart failure hospitalization or all-cause mortality.

PMID:41862384 | DOI:10.1016/j.disamonth.2026.102099

Clin Ther. 2026 Mar 19:S0149-2918(26)00047-0. doi: 10.1016/j.clinthera.2026.02.013. Online ahead of print.

ABSTRACT

PURPOSE: Medical cannabis (MC) patients frequently rely on budtenders, dispensary staff without formal medical training, for therapeutic guidance. This study examined whether budtender guidance aligns with that of MC clinicians and identified factors influencing alignment.

METHODS: A national sample of budtenders (n = 87) from multiple US states completed a survey in March to April 2025, which included 3 patient vignettes (chronic pain, pregnancy with insomnia, and posttraumatic stress disorder) and the Cannabis Knowledge Assessment Tool. Their responses were compared with consensus guidance from 7 MC clinicians. Alignment was rated on a 5-point scale, and statistical analyses included a 1-sample t test and multiple linear regression.

FINDINGS: Budtender guidance significantly diverged from clinician consensus (M = 2.75 vs 5.0; P < 0.001). Clinicians recommended MC for chronic pain, advised against use during pregnancy, and recommended cautious low-Δ-9-tetrahydrocannabinol regimens for posttraumatic stress disorder. In contrast, many budtenders suggested higher Δ-9-tetrahydrocannabinol dosages or endorsed MC use in pregnancy. Regression analysis revealed that higher Cannabis Knowledge Assessment Tool scores (P = 0.005) and absence of illicit market experience (P = 0.029) predicted closer alignment with clinician guidance, whereas dispensary type and cannabis-related degrees were not significant predictors.

IMPLICATIONS: These findings highlight variability in the quality of budtender guidance and the potential risks of relying on nonclinician sources for MC advice. Enhancing evidence-based cannabis education and establishing clearer policy frameworks may help ensure dispensary staff provide safer, clinically informed guidance to patients seeking cannabinoid therapy.

PMID:41862355 | DOI:10.1016/j.clinthera.2026.02.013

Neurosci Lett. 2026 Mar 19:138578. doi: 10.1016/j.neulet.2026.138578. Online ahead of print.

NO ABSTRACT

PMID:41862329 | DOI:10.1016/j.neulet.2026.138578

J Orthop Sci. 2026 Mar 19:S0949-2658(26)00082-5. doi: 10.1016/j.jos.2026.02.015. Online ahead of print.

ABSTRACT

BACKGROUND: Real-time ultrasound monitoring of muscle architecture changes during dynamic contractions is gaining traction as a practical tool for neuromuscular functional assessment.

PURPOSE: This study aimed to assess the muscle thickness (MT) and deformation velocity of rectus femoris (RF) for predicting muscle strength capacity, evaluating their predictive validity and clinical feasibility.

METHODS: Twenty-three elderly individuals with knee osteoarthritis (KOA) were examined. The thickness of the muscle at rest (MT_rest) and at maximal voluntary isometric contraction (MT_contraction), the velocity from rest state to maximum contraction (Velocity_activation) and the velocity from maximal contraction to rest state (Velocity_relaxation) were obtained by M-mode ultrasound. Maximum flexor and extensor strength were measured using an isokinetic dynamometer, the gold-standard assessment tool.

RESULTS: MT_rest and MT_contraction were significantly correlated with extension strength, also showed correlations with flexion strength. Velocity_activation correlated significantly with both strength (extension: r = 0.742; flexion: r = 0.707). Velocity_activation, but not MT, remained a statistically significant predictor of both extension and flexion strength in multivariate regression models (extension: adjusted R² = 0.381; flexion: adjusted R² = 0.314).

CONCLUSIONS: The deformation of RF, as measured by M-mode ultrasound, provides a visualization method for assessing extension and flexion strength. Velocity_activation showed a significant correlation with both extension and flexion strength. Furthermore, it improved the prediction of thigh muscle strength beyond muscle thickness (MT) alone. Assessing the deformation of RF by M-mode ultrasound may be valuable for detecting alterations in muscle strength and function throughout the disease process in individuals with knee osteoarthritis (KOA).

PMID:41862305 | DOI:10.1016/j.jos.2026.02.015

Nutr Metab Cardiovasc Dis. 2026 Feb 10:104624. doi: 10.1016/j.numecd.2026.104624. Online ahead of print.

ABSTRACT

BACKGROUND AND AIM: This study investigates genetic evidence for a causal association between alcohol intake and 1174 diseases, and various biomarkers.

METHODS AND RESULTS: A phenome-wide Mendelian randomization (MR) study was conducted using data from 337,463 UK Biobank participants. Five MR methods and sensitivity analyses tested linear associations, while non-linear MR assessed intake-dependent effects. Alcohol consumption was associated with 22 distinct diseases across ten categories. Beyond the strong association between genetically indexed alcohol intake with ‘alcohol-related disorders’ (OR per log-unit/week: 7.02, 95% CI: 5.26-9.37), MR analyses suggested robust evidence for increased risks of ‘cerebrovascular diseases’ (1.63, 1.20-2.21), ‘essential hypertension’ (1.34, 1.07-1.67), ‘electrolyte imbalance’ (1.82, 1.34-2.48), ‘magnesium metabolism disorder’ (4.39, 2.06-9.39), ‘open wounds of head, neck, and trunk’ (2.15, 1.39-3.33), and ‘symptoms involving nervous and musculoskeletal systems’ (2.16, 1.60-2.91). Suggestive evidence indicated higher risks for 12 diseases, mostly mental and digestive disorders, and lower risks for ‘benign neoplasms of connective and other soft tissue’, ‘urinary calculus’, and migraines. Seven diseases exhibited non-linear yet monotonic trends (all P_{non-linearity} ≤ 0.05). Alcohol intake was robustly associated with biomarkers including bilirubin, urine sodium, urea, and blood pressure.

CONCLUSION: This comprehensive analysis supports alcohol’s causal role in multiple diseases and biomarkers, highlighting significant risks with minimal benefits.

PMID:41862300 | DOI:10.1016/j.numecd.2026.104624

J Cyst Fibros. 2026 Mar 20:S1569-1993(26)00044-5. doi: 10.1016/j.jcf.2026.02.015. Online ahead of print.

ABSTRACT

Elexacaftor-Tezacaftor-Ivacaftor (ETI) has substantially improved lung function and life expectancy for people with cystic fibrosis (pwCF). Emerging evidence suggests that overweight, obesity and dyslipidaemia are now developing in pwCF prescribed ETI. This scoping review, conducted adhering to PRISMA guidelines, aimed to provide an overview of the research currently available that investigated body mass index (BMI), body composition and serum lipid profiles in adults with CF treated with ETI. Peer-reviewed articles and conference abstracts were identified through database searches and conference proceedings. Studies reporting BMI, body composition (fat mass, fat-free mass) and serum lipid profiles in adults with CF following ETI initiation were included. Data were extracted and synthesised descriptively. Of 126 studies (60 peer-reviewed, 66 conference abstracts), 90% reported increased BMI after ETI initiation, with 61% indicating this was statistically significant. Fat and fat-free mass rose significantly in 5 of 8 and 4 of 7 studies, respectively. In the 18 studies (11 peer-reviewed publications, 7 conference abstracts) reporting serum lipids, significant increases were observed; for total cholesterol (72% of studies), LDL-C (80%), and HDL-C (56%), with increased triglycerides (31%), non-HDL cholesterol and HDL: Total Cholesterol ratio (22% for both) less frequently seen. Current evidence suggests that BMI, weight, and serum lipids increase in adults with CF following ETI initiation, with some studies also reporting increased fat- and fat-free mass. The majority of measurements remain within the recommended range. These findings highlight the importance of ongoing monitoring of nutritional status and cardiometabolic health in this population. Prospective research to better characterise long-term cardiometabolic health in pwCF is required.

PMID:41862297 | DOI:10.1016/j.jcf.2026.02.015

J Voice. 2026 Mar 19:S0892-1997(26)00096-2. doi: 10.1016/j.jvoice.2026.02.031. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to analyze the voice quality of patients with vocal fold polyps and laryngopharyngeal reflux (LPR) and to explore the effect of LPR on voice quality in these patients.

METHODS: A total of 89 adult patients with vocal fold polyps were retrospectively selected between 1 August 2020 and 30 April 2025 using convenience sampling. The reflux finding score (RFS) and the reflux symptom index (RSI) were assessed after vocal fold polypectomy. Patients with an RFS > 7 and an RSI > 13 or with a previous diagnosis of LPR comprised the reflux group, whereas patients with vocal fold polyps but without evidence of LPR comprised the control group. Both groups underwent voice assessment using the Voice Handicap Index-10 (VHI-10) and fiber optic nasopharyngoscopy to evaluate vocal fold morphology. The Voice-Related Quality of Life (V-RQOL) questionnaire and the grade-roughness-breathiness-asthenia-strain (GRBAS grade) scale were also used. Differences in the above indicators between the two groups were compared.

RESULTS: The mean VHI-10 score (18.59 ± 8.956 vs 13.51 ± 7.354, P = 0.012) and the GRBAS grade (2.28 ± 0.615 vs 1.91 ± 0.626, P = 0.032) in the reflux group were higher than those in the control group, whereas the V-RQOL score (57.98 ± 20.13 vs 74.12 ± 18.69, P = 0.019) in the reflux group was lower than that in the control group; the differences were statistically significant. The incidence of broad-based vocal fold polyps (72.9% vs 20.8%, P = 0.032) and bilateral vocal fold polyps (78.4% vs 45.8%, P = 0.017) in the reflux group was higher than that in the control group, and these differences were statistically significant.

CONCLUSION: Laryngopharyngeal reflux may cause patients with vocal cord polyps to be more prone to sessile vocal cord polyps and bilateral vocal cord polyps, which in turn aggravates the hoarseness of the patient ‘s voice; laryngopharyngeal reflux may also affect the physiological, psychological and quality of life of patients with vocal cord polyps. Anti-reflux therapy is recommended for patients with vocal cord polyps with LPR after surgery.

PMID:41862294 | DOI:10.1016/j.jvoice.2026.02.031