Category: Statistics

Front Public Health. 2026 Feb 4;14:1742648. doi: 10.3389/fpubh.2026.1742648. eCollection 2026.

ABSTRACT

BACKGROUND: College students are considered a high-risk group for post-traumatic stress disorder (PTSD). Existing non-pharmacological interventions, although effective and accessible, still have notable limitations. Regular aerobic exercise, as a potential mental health promotion strategy, requires empirical validation in real campus environments to determine its specific effects on reducing anxiety, depression, and PTSD symptoms, as well as its role in enhancing psychological resilience.

METHOD: This study employed a single-group pre-test/post-test design and was conducted in August 2025 at a comprehensive university in Sichuan, China. Using convenience sampling, 47 participants with elevated PTSD symptoms were recruited for the “School-Based Regular Aerobic Exercise” intervention trial (operationalized as a 21-Day Exercise Check-In Activity). All participants engaged in 30 min of aerobic exercise daily for 3 weeks. Before and after the intervention, participants completed the PTSD Checklist for DSM-5 (PCL-5), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Connor-Davidson Resilience Scale (CD-RISC).

RESULT: All 47 participants completed the 21-day intervention. Significant pre- to post-intervention improvements were observed in PTSD symptoms, anxiety, depression, and psychological resilience. Clinical significance analysis showed that 57.45% of participants fell below the PTSD clinical cutoff after the intervention, and 87.23% demonstrated reliable change. Exploratory change-score analyses indicated that improvements in resilience were significantly associated with reductions in anxiety and PTSD symptoms, but not depression.

CONCLUSION: In a real-world campus setting, this 21-day school-based regular aerobic exercise intervention appears feasible and is associated with improvements in PTSD-related symptoms and psychological resilience. However, because the study lacked randomization and a control group, causal inferences regarding effectiveness and underlying mechanisms cannot be made. Randomized controlled trials with longer follow-up periods and objective activity measures are warranted.

PMID:41717623 | PMC:PMC12913432 | DOI:10.3389/fpubh.2026.1742648

Front Public Health. 2026 Feb 4;14:1704501. doi: 10.3389/fpubh.2026.1704501. eCollection 2026.

ABSTRACT

INTRODUCTION: In the context of heightened economic uncertainty and frequent extreme events, enhancing the resilience of pharmaceutical supply chains, safeguarding their security and stability, and promoting high-quality development in China’s pharmaceutical industry have become pressing issues requiring in-depth research.

METHODS: This study takes China’s pharmaceutical industry from January 1, 2012, to March 31, 2023, as the research subject. The TENET method is employed to construct a tail risk network for the pharmaceutical supply chain. We examine its structural characteristics and dynamic temporal patterns, while analyzing variations in risk spillover effects across different tail risk events. Results: At the overall supply chain level, tail risks exhibit notable time-varying characteristics, with total connectedness rising significantly during risk events. At the module level, the production module serves as the primary source of both risk input and output. Cross-module analysis reveals clustering characteristics in risk spillovers between the production and distribution modules. Additionally, bidirectional spillovers are observed between the service and distribution modules, as well as between these modules and the production module. At the institutional level, the in-degree and out-degree of pharmaceutical institutions are not correlated with market capitalization. Hengrui Pharmaceuticals, Aier Eye Hospital, and Fosun Pharma are identified as systemically important institutions in the supply chain. Furthermore, the characteristics of the risk network vary under different tail risk events: financial crises elevate the overall risk level of the supply chain, whereas public health events do not significantly impact the overall risk level. Nonetheless, tail events universally increase the frequency of risk propagation within the supply chain.

DISCUSSION: While the TENET model employed in this study serves as a powerful tool for analyzing tail risk networks, it possesses inherent limitations. Future research could integrate structured econometric models, such as the introduction of exogenous instrumental variables, or adopt high-frequency data causal discovery techniques. These approaches would help disentangle intrinsic causal pathways and further reveal the “topology of risk transmission.

PMID:41717622 | PMC:PMC12913452 | DOI:10.3389/fpubh.2026.1704501

Front Public Health. 2026 Feb 4;14:1715356. doi: 10.3389/fpubh.2026.1715356. eCollection 2026.

ABSTRACT

BACKGROUND: In December 2023, the local HIV confirmatory laboratory in a Southwestern city of China conducted molecular network analysis on newly reported cases of young students and nonstudent men who have sex with men (MSM) from 2018 to 2023 and identified a key molecular cluster. The aim of the study is to analyze the transmission network characteristics and elucidate the potential transmission dynamics within this cluster, and prevent further spread of the disease.

METHODS: A cluster was designated as a key molecular cluster based on node characteristics, internal network density, and whether young students were involved. For the key cluster, a face-to-face epidemiological investigation was conducted, and detailed information on sociodemographic characteristics, histories of high-risk sexual behavior and sexual partners was collected. For those individuals identified through sexual partner tracing, HIV nucleic acid extraction, HIV-1 pol gene amplification, and sequencing were performed. Molecular network and ML phylogenetic tree analyses were conducted to verify whether they belong to the same molecular cluster.

RESULTS: All 20 individuals in the key molecular cluster were male, with 9 being young students and 11 being nonstudent MSM The investigations revealed that three young students (A, B, C) provided the geosocial networking app (Blued) account information of the same high-risk sexual partner (H, was not included in the aforementioned molecular cluster), who actively solicited unprotected anal sex with these three individuals. H was contacted through Blued by local MSM organizations, and tested HIV-positive. After sexual partner tracing of H, he provided information on one high-risk sexual partner (D). Cross-referencing H’s Blued data with local AIDS sexual partner tracing databases linked him to two young students diagnosed with HIV (E, F). Laboratory molecular network analysis confirmed that H belonged to the same molecular cluster as the aforementioned six people living with HIV (PLWH).

CONCLUSION: By combining molecular transmission network analysis with epidemiological investigations, one individual with multiple high-risk sexual links who was initially not included in the molecular cluster was promptly detected, potentially preventing further transmission by creating awareness of HIV status and provision of HIV treatment services. It is necessary to improve the molecular network monitoring and conduct high-quality epidemiological investigation on the identified key molecular clusters as soon as possible to find persons who would benefit from HIV treatment and prevention services.

PMID:41717618 | PMC:PMC12913388 | DOI:10.3389/fpubh.2026.1715356

Front Public Health. 2026 Feb 4;14:1706377. doi: 10.3389/fpubh.2026.1706377. eCollection 2026.

ABSTRACT

PURPOSE: This study aims to explore the correlation between Fundamental Movement Skills (FMS) and Aquatic Competence (AC) acquisition in preschool children aged 4-6 years.

METHODS: A total of 120 preschool children aged 4-6 years with no swimming learning experience (60 boys and 60 girls) were recruited in Beijing. All subjects were stratified and randomly divided into an experimental group and a control group (30 boys and 30 girls). Before and after a 6-week (twice a week, total of 12 sessions) aquatic movement skills course in the experimental group, all children underwent FMS and AC testing. Descriptive statistics were performed on the results of the two tests, and the Mann-Whitney U test was used to compare the ΔAC of the two groups of subjects. Analysis of covariance (ANCOVA) and rank-transformed ANCOVA were used for inter-group difference analysis. Spearman rank correlation analysis was used to explore the correlation between FMS and AC acquisition.

RESULTS: The locomotor skills, object control, and FMS scores of the experimental group and the control group in the post-test were all higher than those in the pre-test, and the AC post-test score of the experimental group was higher than the pre-test. The improvement levels of locomotor skills (F = 18.98, p < 0.01, η² = 0.14), object control (F = 32.19, p < 0.01, η² = 0.22), FMS (F = 45.85, p < 0.01, η² = 0.28), and AC (F = 1663.96, p < 0.01, η² = 0.93) in the experimental group were significantly better than those in the control group. At the same time, the improvement level of Aquatic Competence (ΔAC) in the experimental group was significantly higher than that of the control group (Z = -9.48, p < 0.01). Correlation analysis indicates that the acquisition of AC in boys is significantly positively correlated with object control skills (r = 0.419, p = 0.021) and FMS (r = 0.388, p = 0.034).

CONCLUSION: Learning aquatic movement skills can significantly enhance the fundamental movement skills and aquatic competence of preschool children aged 4-6 years. The control skills of boys are related to their aquatic competence acquisition. Therefore, during the preschool stage, focusing on and cultivating children’s fundamental movement skills, especially object control abilities, is of great significance for their effective development of future aquatic competence.

PMID:41717617 | PMC:PMC12913400 | DOI:10.3389/fpubh.2026.1706377

Ann Clin Transl Neurol. 2026 Feb 19. doi: 10.1002/acn3.70342. Online ahead of print.

ABSTRACT

BACKGROUND: Emerging evidence suggests that low-frequency neural oscillations are dynamically regulated by consciousness levels, with the recovery of low cortical activity potentially serving as a neurophysiological substrate for conscious emergence. Targeted enhancement of these low-frequency rhythms in patients with disorders of consciousness (DoC) may constitute a promising neuromodulation strategy to facilitate consciousness recovery in severe brain injury.

OBJECTIVE: This study systematically examined the neurophysiological effects of intermittent theta-burst stimulation (iTBS), specifically its potential to enhance low-frequency cortical activity and promote consciousness recovery in patients with DoC. Through multimodal neural assessments, we aimed to elucidate the mechanistic relationship between iTBS-induced neural oscillation modulation and behavioral manifestations of consciousness improvement.

RESULTS: This prospective cohort study enrolled 30 patients with DoC, of whom 18 completed the full intervention protocol. Two-way repeated-measures analysis of variance revealed significant group × time interaction effects on the Coma Recovery Scale-Revised (CRS-R) scores, F(1, 16) = 6.543, p = 0.021. Post hoc simple effects analysis demonstrated significant temporal improvement in the active transcranial magnetic stimulation (TMS) group, F(1, 16) = 36.463, p < 0.001, with mean CRS-R scores increased from 9.300 ± 1.320 at baseline to 11.700 ± 1.409 post-intervention (p < 0.001). Conversely, sham stimulation revealed statistically nonsignificant changes (9.845 ± 1.476 versus 10.750 ± 1.575, p = 0.067). Neurophysiological assessments revealed emerging neurophysiological changes in the iTBS group, including enhanced resting-state low-frequency oscillations (delta: 21.642% increase, p = 0.449; theta: 6.800% increase, p = 0.789) and augmented auditory-evoked responses (phrase-level 22.917% increase, p = 0.280; syllable-level: 22.963% increase, p = 0.504), suggesting potential neural plasticity mechanisms that require further validation.

CONCLUSION: Collectively, this study established iTBS targeting the left dorsolateral prefrontal cortex as a clinically effective and well-tolerated neuromodulation approach for consciousness rehabilitation in patients with DoC, with therapeutic effects mediated by iTBS-induced enhancement of thalamocortical low-frequency oscillations.

TRIAL REGISTRATION: https://www.

CLINICALTRIALS: gov. Unique identifier: NCT03385278. Registered on October 24, 2017.

PMID:41714857 | DOI:10.1002/acn3.70342

Clin Exp Med. 2026 Feb 20. doi: 10.1007/s10238-026-02058-x. Online ahead of print.

NO ABSTRACT

PMID:41714836 | DOI:10.1007/s10238-026-02058-x

Int J Gynaecol Obstet. 2026 Feb 19. doi: 10.1002/ijgo.70903. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the effects of the levonorgestrel-releasing intrauterine system (LNG-IUS) and dienogest (DNG) on systemic inflammatory markers and anemia parameters in patients with adenomyosis after 6 months of treatment.

METHODS: This retrospective longitudinal observational cohort study included 162 women diagnosed with adenomyosis at İzmir Buca Seyfi Demirsoy Training and Research Hospital between 2020 and 2025. A total of 89 patients received LNG-IUS (Mirena), and 73 were treated with DNG 2 mg/day. Hemoglobin (Hb), neutrophil, lymphocyte, and platelet counts were obtained before treatment (baseline) and at 6 months to calculate the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII). Statistical analyses were performed using SPSS 27.0, with P < 0.05 considered significant.

RESULTS: Baseline demographic and obstetric characteristics were similar between the groups (P > 0.05). At 6 months, hemoglobin levels increased significantly more in the LNG-IUS group compared with the DNG group (2.29 ± 3.61 vs. 0.84 ± 4.82; P = 0.035). No significant differences were observed between groups in neutrophil, lymphocyte, platelet counts, or inflammatory indices (NLR, PLR, SII) before and after treatment (P > 0.05).

CONCLUSION: Both LNG-IUS and DNG are safe and effective medical options for adenomyosis management. LNG-IUS provided superior improvement in hemoglobin levels and bleeding control, while neither treatment significantly altered systemic inflammatory indices. These findings suggest that inflammation in adenomyosis is largely confined to the local uterine environment and that hematologic markers such as NLR, PLR, and SII may have limited sensitivity in reflecting short-term therapeutic response.

PMID:41714827 | DOI:10.1002/ijgo.70903

NPJ Digit Med. 2026 Feb 19. doi: 10.1038/s41746-026-02431-w. Online ahead of print.

ABSTRACT

Systematic reviews provide the highest level of evidence but remain resource-intensive. We evaluated the performance of a large language model (LLM; ChatGPT, OpenAI) in a PRISMA-guided review of randomized controlled trials on vaginal vault prolapse surgery. Prompts were carefully designed to minimize errors, and outputs were verified. Each task was completed within minutes. For title/abstract screening, recall was 69.8% and precision 85.7% (κ = 0.77); full-text agreement 94.1-100% (κ = 0.82-1); data extraction accuracy 87.5-99.7%. From 18 RCTs (1668 women), sacrocolpopexy (SC) showed higher anatomic success than sacrospinous fixation (SSF) (OR 1.42, 95% CI 0.71-2.84). Transvaginal mesh improved 3-year objective success compared with SSF (OR 1.84, 95% CI 1.13-2.99) but had higher reoperation rates (5-16% vs 2-4%) than SC. We did not find conclusive evidence that any single technique is superior; most comparisons were underpowered, with wide confidence intervals and substantial heterogeneity. All LLM-derived statistical results were identical to those from conventional R analyses, confirming robustness. Validated LLM workflows can enable more efficient and scalable evidence synthesis.

PMID:41714807 | DOI:10.1038/s41746-026-02431-w

Br J Math Stat Psychol. 2026 Feb 19. doi: 10.1111/bmsp.70037. Online ahead of print.

ABSTRACT

The detection of the number of modes in distributions of ordinal data is relevant for applied researchers across disciplines, from uncovering polarization to detecting incidence groups in clinical symptom scales. Yet, established modality detection methods are either purely descriptive or not developed for ordinal data. In the present paper, we attempt to fill this gap by proposing a recursive modality detection method (ReMoDe) which detects modes in univariate distributions through recursive significance testing. We provide a comprehensive review of existing modality detection methods and outline their potential pitfalls when applied to ordinal scales. Based on a benchmark of 172 simulated ordinal samples of different sample sizes, we demonstrate that ReMoDe outperforms other established modality detection methods. We furthermore present a stability test for our method as well as p-values and approximated Bayes factors for each detected mode. To make our method easily applicable for researchers, we introduce open-source R and Python packages.

PMID:41714803 | DOI:10.1111/bmsp.70037

Commun Med (Lond). 2026 Feb 19. doi: 10.1038/s43856-026-01419-7. Online ahead of print.

ABSTRACT

BACKGROUND: Frailty is an important factor in human aging associated with a broad range of adverse outcomes. Frailty metrics are time intensive to collect making them difficult for larger scale application.

METHODS: We apply machine learning to predict these frailty metrics, associated risk factors, and adverse outcomes from activity data. We use activity data collected using Actigraphy wearable accelerometer sensors, which are devices that measure acceleration along three axes of movement. Models were evaluated using Area Under the receiver operator Curve (AUC), Area Under Precision Recall Curve (AUPRC), Spearman rank test, Mann-Whitney U test, or Kruskal-Wallis test on repeated subsampling of train and test sets. All statistical tests are reported using -log₁₀(P-value).

RESULTS: Machine learning models show strong predictive performance even with small amounts of accelerometry data available. They are also able to better determine adverse outcomes such as hospitalization and mortality than frailty metrics themselves in our geriatric population.

CONCLUSIONS: This approach of wearable activity data-based prediction of frailty offers a surrogate (proxy or estimate) for determining frailty metrics in a scalable manner. It can also be used to determine adverse outcomes such as hospitalizations and mortality, allowing frailty to be used as a metric in other studies or medical practices.

PMID:41714788 | DOI:10.1038/s43856-026-01419-7