Category: Statistics

Eur J Med Res. 2026 Feb 20. doi: 10.1186/s40001-026-04017-4. Online ahead of print.

ABSTRACT

BACKGROUND: Dual targeting with onabotulinumtoxinA and anti-CGRP monoclonal antibodies has emerged as a potential option for patients with chronic migraine who respond incompletely to single-agent preventive therapy. Evidence from individual observational reports suggests benefit, but the magnitude, consistency, and methodological quality of available studies remain unclear.

METHODS: A systematic search identified observational studies evaluating combination therapy with onabotulinumtoxinA plus an anti-CGRP monoclonal antibody. Ten studies met inclusion criteria, of which six provided extractable quantitative data for meta-analysis. Outcomes included monthly headache days (MHD), ≥ 50% and ≥ 75% responder rates, headache-related disability (MIDAS, HIT-6), and acute medication use. Random-effects models were applied, and heterogeneity, subgroup patterns, and publication bias were assessed. Of the ten eligible studies, only six provided extractable quantitative data for combination therapy and were included in pooled analyses.

RESULTS: Across six studies, combination therapy reduced MHD by a pooled – 7.9 days (95% CI – 10.2 to – 5.7). The pooled ≥ 50% responder rate was 0.51 (95% CI 0.37-0.66), and the ≥ 75% responder rate was 0.19 (95% CI 0.10-0.34). Disability measures improved, with MIDAS decreasing by – 47.4 points (95% CI – 65.7 to – 29.1) and HIT-6 by – 8.2 points (95% CI – 10.9 to – 5.5). Acute medication use declined by – 4.3 days per month (95% CI – 6.1 to – 2.5). Heterogeneity across outcomes was moderate to high. Subgroup analyses by age and sex showed generally consistent directionality, though several strata were represented by only one or two studies. Funnel plot inspection and Egger testing did not indicate marked publication bias.

CONCLUSIONS: Combination therapy with onabotulinumtoxinA and an anti-CGRP monoclonal antibody demonstrates clinically meaningful reductions in headache frequency, disability, and medication use across observational cohorts. Interpretation should remain cautious given high heterogeneity, the absence of controlled comparative designs, and limited subgroup data. Because dispersion measures were imputed in several studies, statistical precision may be overestimated, and effect sizes should be interpreted as approximate rather than definitive. Larger prospective studies are needed to clarify patient selection, durability of benefit, cost-effectiveness, and equity of access.

PMID:41721358 | DOI:10.1186/s40001-026-04017-4

BMC Public Health. 2026 Feb 20. doi: 10.1186/s12889-026-26601-3. Online ahead of print.

ABSTRACT

BACKGROUND: Men who have sex with men (MSM) face distinct external and internal stressors that substantially affect their mental health, leading to higher rates of depression and engagement in risky behaviors. Geosocial networking apps provide new perspectives to assess and promote the mental health of MSM. This study aims to examine the emotions and sentiments of MSM in Shenzhen, China, using data from a Chinese MSM geosocial networking app, and to explore the characteristics, temporal trends, and associated factors of emotions and sentiments.

METHODS: This cross-sectional study collected data from the geosocial networking app Blued using a web crawler, focusing on users in Shenzhen who posted more than 15 updates between September and October 2020. Natural language processing techniques, including word segmentation and sentiment analysis, were applied to assess emotional and sentiment patterns. Univariate and multivariate logistic regression analyses were used to identify associated factors with these patterns.

RESULTS: The study included 7,537 users with a mean age of 28.7. We found significant emotional fluctuations, particularly negative emotions, during early morning hours. Factors such as body mass index, social media engagement, and the frequency of health-related words were significantly associated with emotional and sentiment trends. Users who posted more frequently and had fewer blacklist entries exhibited more positive emotions.

CONCLUSIONS: Social media provides valuable insights into the mental health patterns of MSM. This study highlights the potential for real-time monitoring and targeted interventions tailored to the unique needs of sexual minorities. The findings underscore the importance of culturally relevant and LGBT-affirmative online mental health services.

PMID:41721351 | DOI:10.1186/s12889-026-26601-3

BMC Med. 2026 Feb 20. doi: 10.1186/s12916-026-04714-1. Online ahead of print.

ABSTRACT

BACKGROUND: Adherence to antihypertensive medication, alongside lifestyle modifications, is fundamental to managing hypertension and reducing the risk of cardiovascular disease. Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder associated with a range of cardiovascular diseases, including hypertension. ADHD medication has also been associated with hypertension. However, the influence of ADHD and ADHD medication on discontinuation and adherence to antihypertensive treatments is unknown.

METHODS: We conducted a multinational cohort study using electronic health databases from seven countries, which included adults who initiated antihypertensive medication between 2010 and 2020. ADHD was identified by a diagnosis of ADHD or dispensation of ADHD medications. The outcomes were (1) time to the first discontinuation of antihypertensive medication and (2) poor adherence, defined as the proportion of days covered (PDC) below 80% during 1-, 2-, and 5-year follow-up periods. We used Cox proportional hazards models and logistic regression to estimate associations, adjusting for age, sex, and calendar year of antihypertensive medication initiation. We pooled results from different countries via random-effects meta-analysis.

RESULTS: We identified 12,174,321 adults who initiated antihypertensive medication during the study period, including 320,691 (2.6%) with ADHD. In the pooled analysis across all countries, ADHD was associated with an increased rate of discontinuation in 5-year follow-up of antihypertensive medication (hazard ratio [HR] 1.14; 95% CI, 1.02-1.27). In age-stratified analyses, ADHD was associated with a higher rate of antihypertensive medication discontinuation in middle-aged (HR, 1.11; 95% CI, 1.01-1.23) and older adults (HR, 1.14; 95% CI, 1.01-1.29), but not in young adults. Individuals with ADHD also had higher odds of poor adherence across 1 year after treatment initiation (odds ratio [OR] 1.45, 95% CI 1.26-1.67) to 5 years (OR 1.64, 95% CI 1.34-2.00). Among those with ADHD, use of ADHD medications was associated with lower odds of poor adherence (1 year OR 0.66, 95% CI 0.60-0.73; 5 years OR 0.58, 95% CI 0.46-0.72).

CONCLUSIONS: Adults with ADHD are more likely to discontinue antihypertensive treatment and exhibit poor medication adherence. However, ADHD medication use appears to be associated with better adherence among individuals with ADHD.

PMID:41721349 | DOI:10.1186/s12916-026-04714-1

BMC Public Health. 2026 Feb 20. doi: 10.1186/s12889-026-26547-6. Online ahead of print.

NO ABSTRACT

PMID:41721335 | DOI:10.1186/s12889-026-26547-6

BMC Pediatr. 2026 Feb 20. doi: 10.1186/s12887-026-06633-9. Online ahead of print.

ABSTRACT

BACKGROUND: Pain is a common health problem and a leading reason for hospital admissions in children. Rational drug use is crucial in pediatric pain management, especially for young children who rely on their parents.

PURPOSE: This study aimed to determine the attitudes of mothers of children aged 0-6 years toward rational drug use in pain management.

METHODS: This descriptive, cross-sectional, and correlational study involved 403 mothers attending pediatric outpatient clinics at a university hospital. Data collection took place between April and June 2024 using a personal information form and the Parental Attitude Scale Towards Rational Drug Use (PASRDU). Data analysis included the Mann-Whitney U test for pairwise comparisons, the Kruskal-Wallis H test for groups larger than two, and Spearman Correlation analysis for variable relationships.

RESULTS: The mean age of the mothers was 31.60 (± 5.328) years; 45.4% had one child, and 50.9% held a university degree or higher. The mean PASRDU score was 174.01 ± 17.225. A statistically significant positive attitude towards rational drug use was linked to younger mothers, those with fewer children, and those with higher education and socioeconomic status (p < .005). PASRDU scores were also higher among mothers who reported greater self-efficacy in relieving their child’s pain and those who did not administer non-prescribed analgesics (p < .005).

CONCLUSIONS: Mothers generally exhibited high attitudes toward rational drug use in pain management. Attitudes varied by age, education, number of children, socioeconomic status, self-perceived competence in pain management, and use of non-prescribed medications. Nurse-led assessment and tailored education may support rational drug use in pediatric pain management.

TRIAL REGISTRATION: Not applicable.

PMID:41721334 | DOI:10.1186/s12887-026-06633-9

BMC Public Health. 2026 Feb 20. doi: 10.1186/s12889-026-26496-0. Online ahead of print.

NO ABSTRACT

PMID:41721333 | DOI:10.1186/s12889-026-26496-0

BMC Public Health. 2026 Feb 21. doi: 10.1186/s12889-026-26346-z. Online ahead of print.

ABSTRACT

BACKGROUND: Childhood obesity is a rising worldwide health issue with significant physical, psychological, and social implications. Beyond physical health, obesity has profound psychological effects, particularly on body image perception and self-esteem, which can be exacerbated by bullying and social stigmatization.

AIM: To assess body image perception among bullied obese children in Egypt and to examine the relationship between obesity, bullying experiences, and body image dissatisfaction.

METHODS: This case-control study was conducted on 86 Egyptian children aged 5 to 10 years who attended the outpatient nutrition and immunity clinic at the Medical Research Centre of Excellence (MRCE). A comprehensive, structured questionnaire and clinical examination were used and analyzed to assess participants.

RESULTS: The study included 86 children; 40 males and 46 females. Out of 86 children, 44 children were obese with mean of age (8.16 ± 1.78 y) and 42 were healthy children as controls with mean of age (7.69 ± 1.8. 55 y). A total of 27 children (34.6%) in the study population displayed acanthosis nigricans. Students in the obesity group reported higher rates of school bullying (36.4%) as compared to controls (11.9%). The family bullying was significantly higher in the obesity group at 40.9% compared to the control group at 7.1% (p = 0.001). A significant difference (p = 0.000) in sadness feeling was reported in obese children (56.8%) as compared with controls (11.9%). Children with family refusal showed statistically significant higher occurrences of expressing low self-esteem by refusing to be photographed (50%) and showing sadness (75%), especially in females.

CONCLUSION: This study highlights the obesity and its association with obesity-related health risks and emotional distress. School refusal was strongly linked to bullying and academic pressure. Negative school interactions affected family relationships, while family denial increased bullying and emotional distress. Females showed greater vulnerability to sadness than males.

PMID:41721328 | DOI:10.1186/s12889-026-26346-z

BMC Med Inform Decis Mak. 2026 Feb 20. doi: 10.1186/s12911-026-03379-3. Online ahead of print.

NO ABSTRACT

PMID:41721324 | DOI:10.1186/s12911-026-03379-3

BMC Proc. 2026 Feb 20;20(Suppl 10):9. doi: 10.1186/s12919-026-00365-5.

ABSTRACT

Cell migration is a fundamental phenomenon in biology that underlies normal development as well as cancer. Recently, a data-driven approach was introduced that uses deep reinforcement learning(DRL) and 3-D live images to study cell migration. This approach formulates the cell migration process as a sequential Markov decision process (MDP), so that hypotheses of the underlying mechanism of the observed migration can easily be incorporated as high-level regulatory rules and constraints for DRL. The application of the approach successfully uncovered a novel mechanism of cell migration in C. elegans embryogenesis that involves a modular organization of cells by using ubiquitous labels of cell nuclei and simple rules based on empirical statistics of the images. This success demonstrates new opportunities to use DRL to infer the biology of cell migration without prior knowledge. This paper presents an open framework, CellMigrationGym, to standardize the DRL approach to study cell migration. Built upon common packages (OpenAI Gym, PyBullet, and DRL libraries), CellMigrationGym provides powerful and flexible functions to investigate cell migration behavior. Through a case study, we demonstrate the critical functions of CellMigrationGym with technical details, such as 1) preparation and standardization of multiple observational data, 2) reward formulation and DRL model configuration appertaining to the hypotheses of migration mechanism (such as gradient-driven and collective cell behavior-driven mechanisms), 3) exploration of migration scenarios under hypothesized mechanisms, and 4) evaluation of neighboring cell’s influence on the cell migration.

PMID:41721321 | DOI:10.1186/s12919-026-00365-5

BMC Pediatr. 2026 Feb 21. doi: 10.1186/s12887-026-06550-x. Online ahead of print.

ABSTRACT

BACKGROUND: The prevalence of childhood asthma is increasing in developing countries, accompanied by numerous risk factors. This leads to substantial asthma related morbidity, mortality and economic consequences. The systematic review and meta-analysis aimed to determine prevalence and risk factors associated with asthma in East Africa, thereby elucidating the asthma burden among children and adolescents in the region.

METHODS: Relevant articles were identified through searches of five databases ( PubMed, Embase (Ovid), CINAHL (EBSCO), Scopus, and Web of Science), with the PRISMA guideline used for data extraction. Random effects meta-analyses were performed to calculate pooled estimates and associated 95% confidence intervals [CIs]. Heterogeneity between the studies was assessed using Cochrane Q-test and the I² statistic.

RESULTS: This meta-analysis encompassed 11 studies involving 20,258 children with asthma across six East African countries. The pooled prevalence of asthma was 15.2% (95% CI: 11.9%,18.5%), with notable variation across countries, ranging from 5.2% (95% CI: 3.3%, 7.1%) in Tanzania to 20.8% (95% CI: 17.6%, 24.0%) in Uganda. Risk factors for asthma included family history of asthma (pooled odds ratio [POR] = 3.1, 95% CI: 1.7, 4.5), environmental exposure(POR = 10.1, 95% CI: 1.3, 19.8), allergy exposure (POR = 3.1, 95% CI: 2.3, 4.0), and exposure to smoking (POR = 2.9, 95% CI: 1.4, 4.3).

CONCLUSION: The prevalence of asthma among children in East Africa was high, and multiple risk factors were associated with it.It appears that strategies and targeted interventions to address specific modifiable factors (e.g., environmental exposure, allergy exposure, and exposure to smoking) should be emphasized.

CLINICAL TRAIL NUMBER: CRD42024545007.

PMID:41721311 | DOI:10.1186/s12887-026-06550-x