Tag: statistics

Circ Popul Health Outcomes. 2026 Feb 24:e012643. doi: 10.1161/CIRCOUTCOMES.125.012643. Online ahead of print.

ABSTRACT

BACKGROUND: Inconsistent selection of reference groups may contribute to inconclusive blood pressure control targets for patients with hypertension. This study aims to identify optimal systolic blood pressure (SBP) targets for individuals with and without cardiovascular disease (CVD) by employing a novel metric combining blood pressure magnitude and duration.

METHODS: We conducted a secondary analysis of individual-level data from 4 clinical trials (ACCORD, ALLHAT, SHEP, and SPRINT). Participants aged >80 years, with prevalent heart failure, or with missing follow-up SBP measurements or CVD history were excluded. The proportion of time-in-target range (TTR) was estimated using linear interpolation to quantify longitudinal SBP changes across predefined SBP ranges. Associations between TTR and major adverse cardiovascular events were assessed using stratified Cox proportional hazards models, analyzed separately by CVD history, and stratified by study trials, with hazard ratios (HRs) estimated per 10% increase in TTR. Lower TTR within the same target served as the implicit reference.

RESULTS: Among 59 727 participants included in the analysis, the mean age was 65.8 (SD, 6.9) years, 52.3% were men, and 24 524 (41.1%) had a history of CVD. Higher TTR within SBP ranges of 110 to 140 mm Hg was consistently associated with a lower risk of major adverse cardiovascular events in participants with and without CVD. For SBP of 110 to 120 mm Hg, HRs were 0.89 (95% CI, 0.86-0.92) in participants without CVD and 0.93 (95% CI, 0.90-0.95) among those with CVD; corresponding HRs were 0.86 (95% CI, 0.83-0.88) and 0.90 (95% CI, 0.88-0.92) for 120 to 130 mm Hg, and 0.94 (95% CI, 0.92-0.96) and 0.93 (95% CI, 0.91-0.95) for 130 to 140 mm Hg. SBP ≥150 mm Hg was associated with increased major adverse cardiovascular event risk in both groups, whereas SBP <110 mm Hg was associated with reduced risk only in participants without CVD (HR, 0.91 [95% CI, 0.86-0.97]) and not among those with CVD (HR, 1.02 [95% CI, 0.98-1.06]).

CONCLUSIONS: Restricted cubic spline analyses demonstrated a J-shaped association between achieved SBP and major adverse cardiovascular event irrespective of CVD history. Maintaining SBP within 110 to 140 mm Hg was similarly associated with lower cardiovascular risk in patients with and without CVD. Risk appeared lowest when SBP was between 120 and 130 mm Hg, while an SBP target <110 mm Hg may offer additional benefit among patients without CVD.

PMID:41732877 | DOI:10.1161/CIRCOUTCOMES.125.012643

Cardiol Young. 2026 Feb 24:1-6. doi: 10.1017/S1047951126111299. Online ahead of print.

ABSTRACT

OBJECTIVES: To compare the clinical efficacy and prognosis of Ozaki procedure and Ross procedure in the treatment of paediatric aortic valve disease.

METHODS: According to the predetermined inclusion and exclusion criteria, relevant clinical studies were comprehensively searched in three databases, and relevant data were extracted for analysis and comparison.

RESULTS: This meta-analysis included four retrospective cohort studies with a total of 243 patients (117 undergoing Ozaki procedure and 126 undergoing Ross procedure). There were no significant difference in the in-hospital all-cause mortality [odds ratio = 1.38; 95% confidence interval: 0.38, 5.07, p = 0.63] and all-cause mortality during the follow-up period [odds ratio = 1.85; 95% confidence interval: 0.54, 6.32, p = 0.32] between Ozaki procedure and Ross procedure. The reoperation on the aortic valve [odds ratio = 10.48; 95% confidence interval: 2.22, 49.40, p = 0.003] was higher in the Ozaki procedure than in the Ross procedure. There were no patients who underwent pulmonary valve reoperation after Ozaki procedure [odds ratio = 0.21; 95% confidence interval: 0.03, 1.23, p = 0.08]. The cumulative reoperation rate after Ozaki procedure [odds ratio = 2.29; 95% confidence interval: 0.93, 5.66, p = 0.07] was higher than that of Ross procedure, but the difference was not statistically significant. The cardiopulmonary bypass time after Ozaki procedure [odds ratio = -32.09; 95% confidence interval:-45.05, -19.14, p < 0.00001] was shorter than that of Ross procedure. The incidence of postoperative complications [odds ratio = 0.24; 95% confidence interval: 0.04, 1.62, p = 0.14], aortic cross-clamping time [odds ratio = -20.39; 95% confidence interval: -43.68, 2.90, p = 0.09], ventilator assistance time [odds ratio = 1.71; 95% confidence interval: -42.70, 46.13, p = 0.94], and ICU time [odds ratio = -0.38; 95% confidence interval: -0.93, 0.16, p = 0.17] in Ozaki procedure was not statistically significant compared to Ross procedure.

CONCLUSIONS: In the treatment of children with aortic valve disease, there is no statistically significant difference between the Ozaki procedure and the Ross procedure in terms of freedom from reoperation and all-cause mortality.

PMID:41732876 | DOI:10.1017/S1047951126111299

Clin Child Psychol Psychiatry. 2026 Feb 24:13591045261417801. doi: 10.1177/13591045261417801. Online ahead of print.

ABSTRACT

PurposeGiven adolescents’ extensive social media use and its mixed impacts, this study explores: (1) adolescent and young adult (AYA) social media habits, (2) familial factors associated with parental controls, and (3) social media use among AYA with disordered eating.MethodsAYA aged 11-20 visiting an urban academic medical center and fluent in English or Spanish were surveyed on social media use and mental health. Caregivers of minors provided consent and data on demographics and parental controls. The survey included multiple choice, yes/no, and free-text questions. Analyses included descriptive statistics, correlations, and qualitative coding.ResultsParticipants averaged 15.3 years; 46% spent 4+ hours on social media daily. Younger adolescents (11-14) were more likely to report high use (p = 0.002) and have parental controls (p = 0.006). Most AYA (76%) felt better after using social media. Over half of parents (54.4%) used controls. Qualitative themes included: social media’s unrecognized benefits, its dual role in time use, and its value for health information.ConclusionAYA generally viewed social media positively, though many wished to reduce usage. Parental controls focused more on content than time. Social media supported some with eating disorders, though 30% encountered harmful content.

PMID:41732862 | DOI:10.1177/13591045261417801

Cardiol Young. 2026 Feb 24:1-7. doi: 10.1017/S1047951126111305. Online ahead of print.

ABSTRACT

BACKGROUND: Early post-operative arrhythmia is a frequent complication after paediatric cardiac surgery. Although usually transient, it contributes to considerable morbidity and may increase mortality. This study aimed to determine the incidence, predictors, and outcomes of early post-operative arrhythmia following paediatric open-heart surgery.

METHODOLOGY: A single-centre retrospective cohort study was conducted on paediatric patients who underwent open-heart surgery for congenital or acquired heart diseases between January 2022 and December 2024. Pre-operative, intraoperative, and post-operative parameters were analysed to identify independent predictors using multivariate logistic regression.

RESULTS: Of 2,096 patients analysed, 220 (10.5%) developed early post-operative arrhythmias, mainly tachyarrhythmias. The most common were complete heart block (3.2%), accelerated junctional rhythm (2.8%), and junctional ectopic tachycardia (1.9%). Tetralogy of Fallot repair had the highest incidence (20.2%). Independent predictors included prolonged cardiopulmonary bypass (OR 1.005, 95% CI 1.002-1.009, p = 0.002), extended aortic cross-clamp time (OR 1.006, 95% CI 1.001-1.011, p = 0.011), and prolonged inotropic support (OR 1.035, 95% CI 1.009-1.063, p = 0.009). Serum magnesium ≥ 1.0 mmol/L was identified as a protective factor. Arrhythmia was associated with longer mechanical ventilation (median 4 vs. 2 days), ICU stay (8 vs. 4 days), and hospitalisation (20 vs. 12 days; all p < 0.001). Mortality was higher but not statistically significant (5.9% vs. 3.6%, p = 0.087).

CONCLUSION: Post-operative arrhythmia occurred in 10.5% of paediatric cardiac surgeries, most frequently after Tetralogy of Fallot repair. Prolonged bypass, aortic cross-clamp times, hypomagnesemia, and high inotropic support were independent risk factors associated with increased morbidity.

PMID:41732850 | DOI:10.1017/S1047951126111305

J Orthop. 2026 Feb 11;75:136-142. doi: 10.1016/j.jor.2026.02.045. eCollection 2026 May.

ABSTRACT

BACKGROUND: Comparison of the clinical efficacy of full-endoscopic large-channel interbody decompression and fusion combined with unilateral versus bilateral pedicle-screw fixation in the treatment of single-level lumbar degenerative disease.

METHODS: We conducted a retrospective analysis of the clinical data of 56 patients with single-level lumbar degenerative disease who underwent full-endoscopic large-channel interbody decompression, fusion, and internal fixation surgery at our hospital. Among them, 26 patients underwent unilateral pedicle screw fixation (UPSF), and 30 patients underwent bilateral pedicle screw fixation (BPSF).The comparison included the following parameters: surgical time, intraoperative fluoroscopy frequency, hospitalization costs, length of hospital stay, changes in hemoglobin levels before and after surgery, and complication rates. Preoperative and postoperative pain were assessed using the Visual Analog Scale (VAS) at 3 days, 3 months, and 1 year. Functional disability was evaluated using the Oswestry Disability Index (ODI) at preoperative, 3-month, and 1-year follow-ups. One year post-surgery, interbody fusion was evaluated by CT, and clinical outcomes were assessed using the modified MacNab criteria.

RESULTS: The surgical time, intraoperative fluoroscopy frequency, hospitalization costs, and length of hospital stay were significantly higher in the BPSF group compared to the UPSF group (P < 0.05). There was no statistical difference in the changes in hemoglobin levels between the two groups postoperatively (P > 0.05). The VAS scores at 3 days, 3 months, and 1 year, as well as the ODI scores at 3 months and 1 year, were significantly lower than preoperative values in both groups (P < 0.05). However, there were no significant differences in the VAS and ODI scores at the same time points between the two groups (P > 0.05). The complication rates, fusion rates at 1 year, and the excellent rate according to the modified MacNab criteria were not significantly different between the two groups (P > 0.05).

CONCLUSIONS: The treatment of single-segment lumbar degenerative disease using a large-channel full-endoscopic intervertebral decompression and fusion combined with UPSF is safe and effective. Compared with BPSF group, UPSF group has advantages in terms of fewer fluoroscopy times, shorter surgical duration, lower hospitalization costs, and shorter hospital stays.

PMID:41732788 | PMC:PMC12924900 | DOI:10.1016/j.jor.2026.02.045

J Orthop. 2026 Feb 4;75:163-167. doi: 10.1016/j.jor.2026.02.021. eCollection 2026 May.

ABSTRACT

BACKGROUND: While two-stage revision is considered the gold standard, single-stage revision continues to gain popularity for the treatment of chronic periprosthetic joint infections. In this single-provider, single-protocol study, the outcomes between the two approaches were compared.

METHODS: This was a retrospective study that included 63 consecutive adult patients who underwent single-stage or two-stage total hip revision arthroplasty for chronic periprosthetic joint infection between 2009 and 2020. Only the two-stage approach was performed between 2009 and 2014, while only single stage was performed between 2015 and 2020. Infections were classified using the Delphi-based consensus criteria. Three major outcomes were compared between the revision approaches: the rates of postoperative complications, reinfections, and reoperations.

RESULTS: There were 43 (68.3%) single-stage and 20 (31.8%) two-stage revisions. The mean age was 59.5 ± 13 years with 35 (55.6%) women. The mean body mass index was 35.8 ± 9.1 kg/m². At the mean follow-up rate of 6.9 years (range, 2.1-10.8 years), the rate of no recurrence of infection was 81.4% in the single-stage cohort compared to 80.0% in the two-stage cohort (p = 1.000). Reoperation rate for single-stage revision due to a non-infectious reason was higher than two-stage (20.9% versus 15.0%; p = 0.7367). No statistically significant differences were noted for other postoperative complications.

CONCLUSION: Single-stage revision is as effective as two-stage revision for the treatment of chronic periprosthetic hip joint infections in patients with limited exclusion criteria.

PMID:41732787 | PMC:PMC12925240 | DOI:10.1016/j.jor.2026.02.021

Indian J Psychol Med. 2026 Feb 21:02537176261421806. doi: 10.1177/02537176261421806. Online ahead of print.

ABSTRACT

BACKGROUND: We aimed to study the prevalence of behavioral problems among school-going children, the factors affecting them, and to establish normative scores for the Strengths and Difficulties Questionnaire (SDQ) parent form.

METHODS: A cross-sectional questionnaire-based study was conducted among schoolchildren aged 6-11 years from two primary schools in South India. Parents of children included in the study were asked to fill out the Kannada/English version of the SDQ Parent Form.

RESULTS: The SDQ parent report forms were filled by parents of 671 children, of which 49.8% (n = 334) were boys with a M: F ratio of 1:1.01. There was an equal distribution across different age groups. The comparison of scores between boys and girls showed no statistically significant difference in all scales except for the hyperactivity subscale, where the boys had a higher score with a median (IQR) of 4 (2,5) compared to the girls’ score of 3 (1,4) (p = .001). Regarding age, although the total difficulties score, conduct problems score, hyperactivity score, and internalizing score were higher in the 9-11-year-old group than in the 6-8-year-old group, the p value was not significant. Children of fathers with higher educational status scored better in the peer problems and prosocial scores. The newer cut-off scores have been generated and are divided into four bands, similar to the 4-band categorization on the SDQ scoring site.

CONCLUSIONS: Boys had higher scores on the hyperactivity subscale than girls. Normative data for Indian children aged 6-11 years have been generated and are similar to UK data.

PMID:41732772 | PMC:PMC12924766 | DOI:10.1177/02537176261421806

Innov Aging. 2026 Jan 16;10(3):igaf149. doi: 10.1093/geroni/igaf149. eCollection 2026.

ABSTRACT

BACKGROUND AND OBJECTIVES: To better inform service provision and social services, Australia has long needed a comprehensive national ageing study that is comparable with international ageing studies and eligible to join the register of harmonized cross-national studies of ageing. We conducted a pilot study to fill this gap in Australia’s social and health data collection on ageing.

RESEARCH DESIGN AND METHODS: We utilized online computer-assisted web interviewing (CAWI) and a follow-up Telephone Interview for Cognitive Status (TICS) screening. Participants were drawn from a Roy Morgan Consumer Panel using random probability sampling. Data collected were compared with the national Census data.

RESULTS: Among 1172 online CAWI survey participants (mean age: 65.8 years; 51.0% female), 46.8% had a chronic health condition or disability, 26.1% were full-time employed, and 46.8% were fully or partially retired. Compared with 2021 Australian Census data, the sample was broadly representative by age, sex, geographic region, and health, but respondents tended to have higher education levels (66% reported completing secondary schooling vs 42% in the Census) and underrepresented culturally and linguistically diverse backgrounds (21% born overseas vs 39%; 4% speak a language other than English at home vs 23%); 804 respondents completed TICS (mean[SD] = 33.6[2.8]; range: 22-41), with 71.4% classified as cognitively normal, 27.7% ambiguous, and 1.1% cognitively impaired.

DISCUSSION AND IMPLICATIONS: This pilot demonstrated the feasibility of online and telephone-based data collection with cognitive screening to capture demographic and health profiles of older Australians, providing a strong foundation for future large-scale national ageing studies.

PMID:41732765 | PMC:PMC12924878 | DOI:10.1093/geroni/igaf149

Kidney Int Rep. 2026 Jan 21;11(4):103789. doi: 10.1016/j.ekir.2026.103789. eCollection 2026 Apr.

ABSTRACT

INTRODUCTION: In the AWARD-7 clinical trial participants with type 2 diabetes mellitus (T2D) and moderate-to-severe chronic kidney disease (CKD), a once-weekly treatment with dulaglutide slowed kidney function decline compared with insulin glargine. This post hoc study evaluated dulaglutide’s effect on 6-month changes in plasma concentrations of 21 Joslin Kidney Panel (JKP) proteins, which were previously associated with end-stage kidney disease (ESKD) risk.

METHODS: Plasma concentrations of JKP proteins in participants treated with dulaglutide (n = 124) and insulin glargine (n = 125) were measured using a customized Joslin OLINK proteomic platform. Changes in circulating JKP protein concentrations from baseline to 6 months were determined.

RESULTS: Baseline JKP protein concentrations were similar between groups. After 6 months, 14 JKP proteins increased in the insulin glargine group and decreased in the dulaglutide group with statistically significant between-group differences. The most significant differences were observed for 8 tumor necrosis factor (TNF)-receptors (TNF-R1, -R2, -R3, -R4, -R6B, -R7, -R19L, and -R27), key mediators of inflammatory and apoptotic pathways. In addition, CD160, WFDC2, DLL1, LAYN, SYND1, and EPHA2 were significantly different between treatments, although to a lesser degree, and 7 other proteins remained unaffected. Kidney injury molecule 1 (KIM1), a marker of proximal tubule stress, declined in both groups without significant differences. Treatment effects were more pronounced in participants with lower baseline estimated glomerular filtration rate or higher baseline urinary albumin-to-creatinine ratio, hemoglobin A1c, or body mass index.

CONCLUSION: Six months of dulaglutide treatment significantly lowered concentrations of 14 JKP proteins, particularly those involved in inflammatory and fibrotic pathways. These findings provide insight into biological mechanisms that may underlie the reno-protective effects of dulaglutide.

PMID:41732754 | PMC:PMC12925400 | DOI:10.1016/j.ekir.2026.103789

Int J Cardiol Heart Vasc. 2026 Feb 14;63:101886. doi: 10.1016/j.ijcha.2026.101886. eCollection 2026 Apr.

ABSTRACT

Background: With the growing popularity of amateur endurance sports, including marathon running, it is crucial to recognize transient myocardial changes induced by prolonged physical exertion and to evaluate potential predictors of cardiac fatigue. Methods: A total of 105 runners participating in the 2023 Silesia Marathon (half-marathon, marathon, and ultramarathon) were studied. Transthoracic echocardiography was performed at baseline (1-4 days pre-race), immediately after the race, and 14 days later. Parameters of left and right ventricular function were assessed, including left ventricular ejection fraction (LVEF), left ventricular global longitudinal strain (LV GLS), right ventricular global longitudinal strain (RV GLS), right ventricular free wall strain (RV FWS), tricuspid annular plane systolic excursion (TAPSE), as well as left and right atrial strain. Regression analyses were conducted to explore demographic- and training-related predictors of exercise-induced functional changes. Results: Immediately post-race, LVEF decreased slightly but remained within the normal range, while LV GLS was significantly reduced in marathon and ultramarathon runners compared with baseline (p = 0.008). RV GLS and RV FWS showed smaller, non-significant declines, and TAPSE demonstrated a non-significant reduction. Atrial strain parameters were transiently decreased but normalized at follow-up. All ventricular and atrial parameters returned to baseline within two weeks, confirming the reversibility of the observed changes. Between-group comparisons revealed no significant differences in cardiac response according to race distance. Regression analyses did not identify consistent predictors of functional decline. Trends suggested that higher weekly training volume may attenuate reductions in LVEF and TAPSE, whereas older age may predispose individuals to a greater decline in TAPSE; however, these associations did not reach statistical significance. Conclusion: Long-distance running induces mild, transient, and reversible changes in ventricular and atrial function in amateur runners. These alterations appear largely independent of race distance and cannot be reliably predicted by simple demographic or training-related indices.

PMID:41732747 | PMC:PMC12924757 | DOI:10.1016/j.ijcha.2026.101886