Category: Statistics

Cancer Epidemiol. 2026 Feb 9;101:103014. doi: 10.1016/j.canep.2026.103014. Online ahead of print.

ABSTRACT

BACKGROUND: Causes of childhood cancer remain poorly understood. Using data from the case-control studies of the Childhood Cancer and Leukemia International Consortium (CLIC), we explored how maternal education as a key socioeconomic status (SES) indicator, varies across studies/countries and contributes to understanding of potential environmental and lifestyle risk factors.

METHODS: Control group data from cancer-free children matched by diagnosis date of cases from 16 studies were included, using both interview-based and health registry sources. Maternal education, the primary SES measure used in previous analyses with pooled CLIC data, was categorized as low, medium, or high according to the International Standard Classification of Education. Multinomial logistic regression assessed associations between maternal education and perinatal/lifestyle factors, calculating crude and adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) for high vs. low education.

RESULTS: Maternal education levels varied across studies and over time, with the highest proportions of highly educated mothers in the U.S. and lowest in Costa Rica, Italy, and Egypt. Higher maternal education was generally positively associated with higher birthweight, breastfeeding, daycare attendance, and maternal prenatal alcohol consumption. Higher maternal education was generally inversely associated with lower birthweight, younger maternal age, paternal occupational pesticide exposure, maternal prenatal smoking, and having more siblings. The direction of associations for older maternal age and for caesarean delivery differed substantially across regions. Exclusion of mothers < 21 years at birth of the index child had little effect on the results.

CONCLUSION: This multi-country analysis supports the use of maternal education for adjustment as a proxy for SES, showing largely consistent associations with various behaviors and exposures. While the direction of associations was generally consistent, the strengths varied sometimes considerably by geographical region. These findings support the inclusion of maternal education as a covariate in analyses of childhood cancer risk when pooling CLIC studies.

PMID:41666504 | DOI:10.1016/j.canep.2026.103014

Animal. 2026 Jan 20;20(3):101763. doi: 10.1016/j.animal.2026.101763. Online ahead of print.

ABSTRACT

Optimisation of slaughter weight is crucial for efficient farm management in all-in-all-out systems, but growth variability within pig batches complicates uniform marketing. This study aimed to reduce heterogeneity by developing a decision support system (DSS) for precision feeding, improving BW performance, thereby reducing batch variability. A 103-day commercial trial involving 365 pigs compared conventional 3-phase feeding with individual precision feeding (IPF). Two control groups, Control A and Control B (n = 81 each, six pens/group), received diets with stepwise standardised ileal digestible lysine (SID Lys) concentrations (8.80, 9.80, 10.60 g/kg and 9.00, 10.00, 10.80 g/kg, respectively) from traditional feeders, with feed intake recorded manually. In contrast, the IPF group (n = 203, nine pens) utilised robotic feeders to provide individually tailored diets. These were formulated in real-time by blending high (11.83 g/kg) and low (6.59 g/kg) SID Lys feeds. A DSS, integrating a nutritional model, stakeholder directives (minimum and limited daily decreases in the SID Lys concentration), and a qualitative model, calculated each pig’s requirements based on automatically collected real-time BW and feed intake data. Performance metrics were similar across all groups. However, the IPF group (18.55 g/kg) was more efficient in utilising SID Lys, requiring less per kg of live weight gain than Control A (19.67 g/kg) and Control B (19.71 g/kg). When pigs were classified by initial BW – heavy (HBW, IPF: 26; Control A: 23; Control B: 20 animals), moderate (MBW, IPF: 98; Control A: 39; Control B: 41 animals) and light-body-weight (LBW, IPF: 79; Control A: 19; Control B: 20 animals) – the IPF group showed an improvement of 4.2-6.8 kg in growth performance for HBW, and 2.6-4.3 kg in LBW, compared to controls, although not statistically significant. While overall batch variability remained similar (CV: 11.6% IPF, 11.9% Control A, 12.2% Control B), the IPF group was more homogeneous among LBW pigs (9.5%) compared to controls (11.5% and 13.8%). Greater HBW variation in IPF group balanced overall variability. Although direct feed cost savings and nitrogen excretion reductions were not achieved – attributed to technical feed distribution issues in the final phase and higher CP baselines in the experimental diets – an economic estimation revealed that the system’s profitability was driven by output maximisation. In conclusion, the DSS proved feasible for real-time commercial application, successfully enhancing nutrient utilisation efficiency and optimising the growth of animals at the extremes of the population distribution.

PMID:41666499 | DOI:10.1016/j.animal.2026.101763

Neural Netw. 2026 Feb 2;199:108676. doi: 10.1016/j.neunet.2026.108676. Online ahead of print.

ABSTRACT

Emotion recognition brain-computer interface (BCI) using electroencephalography (EEG) is crucial for human-computer interaction, medicine, and neuroscience. However, the scarcity of labeled EEG data limits progress in this field. To address this, self-supervised learning has gained attention as a promising approach. Despite its potential, self-supervised methods face two key challenges: (1) ensuring emotion-related information is effectively preserved, as its loss can degrade emotion recognition performance, and (2) overcoming inter-subject variability in EEG signals, which hinders generalization across subjects. To tackle these issues, we propose a novel knowledge-driven self-supervised learning framework for EEG emotion recognition. Our method incorporates domain knowledge to approximate the extraction of statistical feature differential entropy (DE), aiming to preserve emotion-related and generalizable information. The framework consists of two cascaded components as hard and soft alignments: a multi-branch convolutional differential entropy learning (MCDEL) module that simulates the DE extraction process, and a contrastive entropy alignment (CEA) module that exposes complex emotional semantics in high-dimensional space. Experiment results show that our method exhibits superior performance over existing self-supervised methods. The subject-independent mean accuracy and standard deviation of our method reached 84.48% ± 5.79 on SEED and 67.64% ± 6.35 and 68.63% ± 7.77 on the Arousal and Valence dimensions of DREAMER, respectively. We conduct an ablation study to demonstrate the contribution of each proposed component. Moreover, the t-SNE visualization intuitively presents the effect of our method on reducing inter-subject variability and discriminating emotional states.

PMID:41666485 | DOI:10.1016/j.neunet.2026.108676

Am J Trop Med Hyg. 2025 Dec 16:tpmd250128. doi: 10.4269/ajtmh.25-0128. Online ahead of print.

ABSTRACT

The epidemiological profile of hepatitis B (HBV) and hepatitis C (HCV) infections has not yet been sufficiently documented in the Democratic Republic of the Congo (DRC). The aim for the present study was to provide a descriptive analysis of HBV and HCV seroprevalence and assess trends, as well as any possible cohort effects in Bukavu, situated in the eastern DRC. Using laboratory data from the Provincial General Reference Hospital of Bukavu, the results of all HBV (hepatitis B surface antigen) and HCV (anti-HCV antibodies) serological tests performed between January 2019 and December 2023 were analyzed. Patients were grouped by possible complications and divided into age groups to assess trends and the cohort age effect. Of the 38,033 specimens tested, 807/19,333 (4.2%) and 321/18,700 (1.7%) tested positive for hepatitis B surface antigen and anti-HCV antibodies, respectively. Both infections were more prevalent in male participants than in female participants. The average age of patients was higher for those with HCV than for those with HBV (P = 0.0001). For HCV in particular, prevalence comparison between patients born before and after 1960 revealed a statistically significant difference: 10.5% versus 0.8% (P <0.0001). The profile analysis of the viral HBV and HCV epidemiology in Bukavu revealed significant changes over the years related to the degree of exposure to risk factors. These changes could explain the observed sex-related disparities regarding prevalence, as well as the cohort age effect clearly observed for HCV infections.

PMID:41666461 | DOI:10.4269/ajtmh.25-0128

Am J Trop Med Hyg. 2026 Feb 10:tpmd250329. doi: 10.4269/ajtmh.25-0329. Online ahead of print.

ABSTRACT

The Mandoto District in the central highlands of Madagascar experiences year-round transmission of Plasmodium vivax (P. vivax) and Plasmodium falciparum (P. falciparum). Monthly malaria case data from 27 health centers across Mandoto between 2019 and 2024 were analyzed alongside meteorological data to understand transmission dynamics and forecast potential influences of climate change using descriptive, cross-correlation, and seasonal autoregressive integrated moving average forecast models. Over a period of 6 years, 276,318 rapid diagnostic tests (RDTs) were performed, yielding a 39.6% positivity rate, totaling 109,428 malaria cases. After 2021, when multispecies RDTs became available, 71.5% of cases were attributed to P. falciparum, and 28.5% were attributed to P. vivax. Both species were co-endemic across all health centers, with the western region experiencing a higher transmission risk. Malaria cases peaked in January, with a second peak from April to June after the rainy season, and declined between July and September. Precipitation and temperature effectively revealed the seasonality of malaria dynamics, thereby improving model accuracy. Plasmodium falciparum exhibited stronger associations with precipitation and temperature variability. The present study highlights that combining time-series modeling with precipitation and temperature data can help predict malaria cases and support timely planning and resource allocation.

PMID:41666420 | DOI:10.4269/ajtmh.25-0329

Am J Trop Med Hyg. 2026 Jan 15:tpmd250372. doi: 10.4269/ajtmh.25-0372. Online ahead of print.

ABSTRACT

Soil-transmitted helminths (STHs) predominantly affect resource-poor communities with poor access to water, sanitation, and hygiene (WASH) infrastructure. Understanding the risk factors for STH infections can help inform public health control strategies, including WASH interventions and preventive chemotherapy. In this school-based cross-sectional study, mixed-effects logistic regression was used to examine the associations between WASH and socioeconomic factors and STH infections in Timor-Leste. Two statistical analyses were conducted: the first included individual-level sanitation and hygiene factors, whereas the second also included household-level WASH and socioeconomic factors. In the sanitation and hygiene analysis, “always use household latrine” was associated with lower odds of undifferentiated STH infection (adjusted odds ratio [aOR]: 0.59; 95% CI: 0.37-0.96). “Always wash hands before eating” was associated with lower odds of Trichuris trichiura (T. trichiura) infection (aOR: 0.35; 95% CI: 0.13-0.97), whereas “always have soap to wash hands at home” was associated with higher odds of T. trichiura infection (aOR: 4.22; 95% CI: 1.56-11.43). In the WASH and socioeconomic factors analysis, “usually defecate at household/neighbor’s latrine” was associated with lower odds of undifferentiated STH (aOR: 0.13; 95% CI: 0.04-0.43) and Ascaris lumbricoides infections (aOR: 0.19; 95% CI: 0.06-0.64). Additionally, the availability of school handwashing stations was associated with lower odds of T. trichiura infection (aOR: 0.21; 95% CI: 0.05-0.86). The present study indicates that sanitation and hygiene are important risk factors for STH infections, and therefore, efforts to reduce STH infections should also promote sanitation and hygiene infrastructure and practices.

PMID:41666419 | DOI:10.4269/ajtmh.25-0372

Brief Bioinform. 2026 Jan 7;27(1):bbag053. doi: 10.1093/bib/bbag053.

ABSTRACT

To understand how the tumor immune microenvironment (TIME) impacts clinical outcomes and treatment response, researchers have been leveraging single-cell protein multiplex imaging techniques. These technologies measure multiple protein markers simultaneously within a tissue sample, providing a more complete assessment of the TIME. However, statistical challenges arise from the over-dispersed and zero-inflated nature of the data and from relationships among different immune cell populations. To address these challenges, we developed a Bayesian hierarchical method using a beta-binomial (BB) distribution to model the abundance of multiple immune cell types simultaneously while incorporating relationships and immune cell differentiation paths. We applied the model to data from three large studies of high-grade serous ovarian tumors (Nurses’ Health Study I/II: N = 321, African American Cancer Epidemiology Study: N = 92, University of Colorado Ovarian Cancer Study: N = 103). We examined associations between cancer stage, age at diagnosis, and debulking status and the abundance of immune cell populations. We compared the multi-cell type model to individual cell type analyses using a Bayesian BB model. The multi-cell type model detected more associations, when present, with narrower credible intervals. To support broader application, we developed an R package, BTIME, with a detailed tutorial. In conclusion, the Bayesian multi-cell type model is flexible in how relationships between cell types are incorporated and can be used for cancer studies that interrogate the TIME.

PMID:41666406 | DOI:10.1093/bib/bbag053

Anesth Analg. 2026 Feb 10. doi: 10.1213/ANE.0000000000007982. Online ahead of print.

ABSTRACT

BACKGROUND: Post-dural-puncture headache (PDPH) is a common complication of neuraxial procedures used during labor and delivery, affecting about 1% of patients. Epidural blood patch (EBP) is the most effective treatment for PDPH, but few studies assess the success of an EBP based on the volume of injected blood, especially >20 mL. Our practice is injection until the patient feels persistent back pressure. We aimed to determine whether the volume of injected blood was associated with an improved outcome after an EBP in the obstetric population.

METHODS: We reviewed records for patients receiving EBP after an obstetric epidural procedure over a 10-year period (May 2014-February 2024) at a single tertiary academic medical center. The primary outcome was failure of the first EBP, defined by the patient receiving a second EBP for treatment. Secondary outcome included the complete resolution of symptoms after the primary EBP. We used a binomial generalized model to identify factors associated with the success of the primary EBP. A value of P ≤.05 was considered statistically significant.

RESULTS: Records from 317 patients were available, and we excluded 32 patients who received only single-shot spinal anesthesia from the primary analysis. Repeat EBP was performed in 65 (22.8%, 95% confidence interval [CI], 18.1%-28.1%) patients. In univariable analyses, the injected volume during EBP (median 28.0 mL, interquartile range [IQR] (22.0-32.0)), days from procedure to PDPH diagnosis, and from PDPH to EBP were associated with a successful EBP. In multivariable analyses, injected volume (odds ratio [OR] 0.96 per 1 mL, P =.028, 95% CI, 0.92-0.999) and days from PDPH diagnosis to EBP (OR 0.61 per day, P =.002, 95% CI, 0.43-0.81) were significantly associated with successful EBP. An analysis of the relationship between injected volume and repeated EBP suggested a dose-response relationship (P =.030). Complete symptomatic follow-up data documented for at least 3 days were available for 226 patients, and headache was completely resolved in 118 (52.2%, 95% CI, 45.5%-58.9%). In a multivariable analysis, a dichotomous division of the population revealed a significant association with headache resolution in the group receiving an injected volume of ≥30 mL compared with patients receiving <30 mL (OR 1.85, P =.049, 95% CI, 1.01-3.47).

CONCLUSION: We found that a larger injected volume of blood during an EBP was associated with a reduced likelihood of receiving a second EBP. Injection of 30 mL or more was significantly associated with complete resolution of headache symptoms after the first EBP. A prospective trial to determine the etiology of this relationship is warranted.

PMID:41666403 | DOI:10.1213/ANE.0000000000007982

J Trauma Nurs. 2026 Jan 30. doi: 10.1097/JTN.0000000000000913. Online ahead of print.

ABSTRACT

BACKGROUND: Imaging interpretations for pediatric trauma patients transferred from general emergency departments to pediatric hospitals differ in up to 40% of cases, with more than half affecting patient care. Delays in radiology image interpretation lead to extended emergency department stays, unnecessary reimaging, and delayed injury recognition. Currently, no streamlined imaging protocol exists to ensure timely image interpretation for severely injured pediatric patients.

OBJECTIVE: To assess improvements in timeliness and consistency of imaging interpretation before and after implementation of a streamlined protocol for severely injured pediatric trauma patients.

METHODS: A quality improvement pre- and post-intervention study was conducted at Level I and Level II Pediatric Trauma Centers located in the western United States from April 2023 to December 2024. Pediatric patients aged 18 and younger who met the institutional trauma activation criteria and came from a referring facility with images were included in the study. Outcomes included image interpretation timeliness and consistency (measured by variability in interpretation times and sustained process change via statistical process control charts).

RESULTS: There were 86 patients meeting criteria during the study. After implementation, the median time to image interpretation decreased from 145 to 51 min, and variability in interpretation times decreased (standard deviation decreased from 680 to 170 min). No missed injuries that changed patient care were observed before or after the intervention.

CONCLUSION: Implementation of a streamlined imaging protocol for pediatric trauma patients led to faster and more consistent image interpretation without compromising care quality.

PMID:41666384 | DOI:10.1097/JTN.0000000000000913

Retina. 2026 Jan 30. doi: 10.1097/IAE.0000000000004799. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the long-term functional and anatomical outcomes of pars plana vitrectomy (PPV) combined with subretinal recombinant tissue plasminogen activator (tPA) injection and gas tamponade in patients with subretinal hemorrhage secondary to retinal arterial macroaneurysm (RAM) rupture.

METHODS: This retrospective multicenter study included 18 eyes of 18 patients who underwent PPV with subretinal tPA injection and gas tamponade for subfoveal hemorrhage due to RAM rupture. Baseline demographic and clinical features, pre- and postoperative best-corrected visual acuity (BCVA), central macular thickness (CMT), postoperative complications, and the relationship between symptom-to-surgery interval and visual outcomes were evaluated over a minimum follow-up period of 12 months.

RESULTS: The mean preoperative BCVA was approximately 20/3300 (2.22 ± 0.73 logMAR), improving to about 20/140 (0.85 ± 0.57 logMAR) at the 12-month visit (p < 0.001). Earlier surgical intervention (≤14 days) was associated with greater improvement in BCVA. Subfoveal retinal pigment epithelium (RPE) atrophy developed in 38.9% of patients and was significantly associated with worse visual outcomes compared to extrafoveal atrophy (p = 0.02). ILM peeling was performed in 44.4% of cases; although those patients tended to have greater BCVA gains, the difference was not statistically significant. RPE atrophy was observed in 77.8% of patients postoperatively, with varying progression patterns.

CONCLUSIONS: PPV with subretinal tPA injection and gas tamponade appears to be an effective treatment for RAM-related subretinal hemorrhage, with significant improvements in visual acuity, particularly when performed within two weeks of symptom onset. The location of postoperative RPE atrophy is a critical prognostic factor for visual outcomes.

PMID:41666381 | DOI:10.1097/IAE.0000000000004799