Category: Statistics

JAMA Netw Open. 2026 Jul 1;9(7):e2625117. doi: 10.1001/jamanetworkopen.2026.25117.

ABSTRACT

IMPORTANCE: Respiratory syncytial virus (RSV) infection is the leading cause of infant hospitalizations in the US. Two immunization options are available to protect infants against hospitalization-maternal vaccination during pregnancy or RSV antibody shot administration for infants after birth. Gaps in immunization coverage suggest missed opportunities to protect infants against RSV-associated hospitalization.

OBJECTIVE: To describe RSV immunization intentions, behaviors, and preferences among pregnant women and parents of young children (ages 0-5 years).

DESIGN, SETTING, AND PARTICIPANTS: For this survey study, 2 concurrent national cross-sectional surveys were implemented in April 2024. Participants were recruited from a representative online survey panel of US adults. Participants were 18 years or older and either pregnant or the parent of a young child. Data were analyzed from May to November 2025.

MAIN OUTCOMES AND MEASURES: The outcomes of interest were prevalence of positive intention to receive RSV antibody shot for child among pregnant women and parents and prevalence of positive intention to receive RSV maternal vaccine among pregnant women.

RESULTS: Of 1765 parents and 174 pregnant women, most were aged 30 years or older (parent: 78.1% [95% CI, 76.2%-80.0%]; pregnant women: 64.0% [95% CI, 56.8%-71.1%]). Among pregnant women eligible for vaccination, 55.5% (95% CI, 47.7%-63.3%) reported a positive intention toward maternal RSV vaccination. Among pregnant women with negative or unsure intention, 35.8% (95% CI, 24.3%-47.3%) would probably or definitely accept RSV vaccination following a strong health care practitioner recommendation. Among parents, 59.8% (95% CI, 57.5%-62.1%) reported a positive intention toward RSV antibody shot administration for their child. Among parents with negative or unsure intention, 27.0% (95% CI, 23.7%-30.2%) would probably or definitely accept the RSV antibody shot for their child following a strong health care practitioner recommendation. More participants preferred maternal vaccination (parents: 48.3% [95% CI, 46.0%-50.6%]; pregnant women: 58.2% (95% CI, 50.9%-65.6%]) over infant RSV antibody shot administration (parents: 9.4% (95% CI, 8.1%-10.8%]; pregnant women: 6.2% (95% CI, 2.6%-9.8%). Top reasons for negative or unsure intentions in both groups included lack of information and safety concerns.

CONCLUSIONS AND RELEVANCE: In this survey study, pregnant women and parents of young children preferred maternal RSV vaccination for protecting infants against RSV infection. For some participants with negative or unsure intentions about RSV immunization, a strong health care practitioner recommendation shifted intention toward accepting immunization. Future research efforts should design and evaluate novel communication strategies for providing information about RSV immunization options to eligible families, in addition to strengthening health care practitioner recommendation in favor of immunization.

PMID:42496974 | DOI:10.1001/jamanetworkopen.2026.25117

J Cancer Educ. 2026 Jul 24. doi: 10.1007/s13187-026-02951-9. Online ahead of print.

ABSTRACT

Children and adolescents with a history of childhood cancer may experience psychosocial, cognitive, and school-related difficulties, yet survivorship education and follow-up need to reflect heterogeneous needs rather than assume uniform impairment. This cross-sectional case-comparison study compared shared psychosocial and metacognitive outcomes in 61 participants with a history of childhood cancer and 57 age-aligned typically developing peers aged 8-17 years, and examined trauma-related symptoms and school-related burden within the cancer-history group. Shared Strengths and Difficulties Questionnaire outcomes and harmonized Metacognitions Questionnaire-derived outcomes were analyzed using Welch tests, Hedges’ g, and false-discovery-rate correction. Within the cancer-history group, correlations and theory-driven regression models examined metacognitive correlates of psychosocial, trauma-related, and school-impact outcomes. The analyses provided no evidence of statistically reliable between-group differences after correction, although the modest sample means that small group differences cannot be excluded. Within the cancer-history group, low cognitive confidence in memory was strongly associated with hyperactivity/inattention and total difficulties, and negative beliefs about worry were the clearest unique statistical correlate of trauma-related symptoms. School-related burden was common, with 60.7% endorsing at least one school-impact item, but this prevalence should be interpreted cautiously because comparable school-impact data were not collected from peers. The findings inform cancer education by identifying targets for survivorship psychoeducation, family-school-health-care communication, and school reintegration support: perceived cognitive competence, worry-related beliefs, and school participation.

PMID:42496966 | DOI:10.1007/s13187-026-02951-9

Biochem Genet. 2026 Jul 24. doi: 10.1007/s10528-026-11428-9. Online ahead of print.

ABSTRACT

Shilajit, a natural product with a documented history of use in traditional medicine for millennia, poses considerable challenges in elucidating its biological origin and pharmacological properties. In this study, a multidisciplinary approach integrating DNA metabarcoding and biochemical profiling was employed to investigate processed shilajit samples from the Pamir-Alai Mountains. Environmental DNA analysis identified 50 plant taxa across taxonomic levels ranging from order to species, indicating substantial botanical contributions to shilajit’s composition. Among the identified taxa, Apiaceae and Asteraceae were the most represented families, while Vincetoxicum rossicum, Populus alba, and Quercus suber were the dominant species detected through metabarcoding analysis. Complementary biochemical analyses demonstrated notable antioxidant capacity and the presence of diverse bioactive compounds. Furthermore, oxidative stress-related biomarkers (NO, MDA, and GSH) were evaluated in the brain tissue of healthy rats following shilajit administration. No statistically significant differences were observed between the control and shilajit treated groups, suggesting that shilajit maintains physiological oxidative balance in healthy brain tissue. These findings provide important baseline biochemical data and support future investigations of shilajit’s biological effects in validated oxidative stress and neurological disease models.

PMID:42496934 | DOI:10.1007/s10528-026-11428-9

Biochem Genet. 2026 Jul 24. doi: 10.1007/s10528-026-11434-x. Online ahead of print.

ABSTRACT

Integrating high-throughput sequencing with phylogenetic analysis now spans everything from single genes to long-read pangenomes and metagenomes, yet practitioners still face fragmented, tool-centric guidance. This review revisits algorithms, tools, and workflows for sequence and phylogenetic analysis in the NGS-based omics era, with a focus on comparative performance and scenario-driven decision-making. We first organise classical approaches to tree reconstruction – distance methods, maximum parsimony, maximum likelihood, and Bayesian inference – around core criteria of consistency, efficiency, robustness, and computational cost. We then examine multiple sequence alignment strategies, contrasting progressive, consistency-based, and structure-aware algorithms (such as MAFFT variants and T-Coffee family tools) with segment-based and incremental approaches (for example DIALIGN, anchored domains, and local updates) and alignment-free representations based on k-mers, absent words, and related statistics. For inference, we compare heuristic engines optimised for ultra-large alignments (FastTree, VeryFastTree, online tree optimisation) with full ML frameworks (IQ-TREE, RAxML-NG) and Bayesian platforms for time-scaled phylogenies and phylodynamics (MrBayes, BEAST family). We explicitly discuss trade-offs in accuracy, memory, scalability, and uncertainty support, and show how GPU-enabled implementations change the feasible design space. Beyond these core components, we address current trends that strongly influence method choice: long-read assemblies and pangenomes; data quality issues, contamination, recombination, and horizontal gene transfer; phylogenetic placement and alignment-free screening in metagenomics; and real-time pathogen surveillance using Nextstrain-style workflows. A dedicated section covers workflow management and containerisation (Snakemake, Nextflow, Docker/Singularity) together with benchmarking datasets and FAIR reporting, positioning reproducible pipelines as a first-class requirement rather than an afterthought. To make the review directly actionable, we provide a methodological checklist, a decision framework figure mapping input data to recommended strategies, and a large comparative table summarising algorithmic principles, best use cases, strengths, limitations, scalability, uncertainty support, and reproducibility notes for widely used tools. Applications in infectious disease genomics, oncology, and microbiome research illustrate how these choices translate into biological and clinical insight in practice.

PMID:42496932 | DOI:10.1007/s10528-026-11434-x

J Neurooncol. 2026 Jul 24;179(1):14. doi: 10.1007/s11060-026-05711-3.

ABSTRACT

BACKGROUND: Brain metastases (BrM) are a major cause of morbidity among patients with breast cancer (BC), particularly those with HER2+ or triple-negative disease. The relationship between neoadjuvant chemotherapy (NAC) and subsequent risk of BrM in patients with early-stage BC remains poorly defined.

METHODS: We conducted a single-centre retrospective cohort study of 457 consecutive patients who were treated with NAC for early-stage BC at Sunnybrook Odette Cancer Centre between 2008 to 2019, among whom 25 developed BrM (cohort 1). To evaluate factors associated with shorter time to BrM development, an additional 129 patients with BC who received NAC and were subsequently diagnosed with BrM were identified (cohort 2). Descriptive statistics were used to summarize patient and treatment characteristics. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and identify factors associated with the development of BrM. Univariable analyses (UVA) were performed for all covariates. Bayesian Information Criteria determined best models from subsets of covariates when performing multivariable analyses (MVA).

RESULTS: Among 586 patients, the median age at BC diagnosis was 49.0 (IQR: 42-58) years. The most common BC subtype was HER2+ (n = 225, 38.4%), followed by hormone receptor (HR)+/HER2- (n = 213, 36.3%) and triple negative BC (n = 132, 22.5%). Following NAC, 134 patients (22.9%) had a pathologic complete response (pCR) and 409 (69.8%) had residual disease. In the overall cohort, the median time from BC diagnosis to BrM development was 38.0 (IQR 19.1-70.9) months. In cohort 1, 25 patients (5.5%) developed BrM with a median follow-up of 43.1 months. Median time to BrM was shortest for patients with triple-negative BC (18.0 months), followed by those with HER2+ (32.0 months), and HR+/HER2- disease (49.1 months). In the pooled cohort (n=586), multivariable analysis identified residual nodal involvement (HR 4.46 [95% CI 2.67-7.45], p<0.0001), inflammatory BC (HR 3.11 [95% CI 1.95-4.96], p<0.0001), and HER2+ or triple-negative subtype (HR 2.87 [95% CI 1.80-4.58], p<0.0001) as independently associated with shorter time to BrM development.

CONCLUSIONS: Among patients treated with NAC for early-stage BC, residual nodal disease, inflammatory BC, and HER2+ or triple-negative subtype are associated with a higher risk of BrM development. Whether BrM screening is warranted among patients with these high-risk features warrants evaluation.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:42496928 | DOI:10.1007/s11060-026-05711-3

J Egypt Public Health Assoc. 2026 Jul 24;101(1):26. doi: 10.1186/s42506-026-00224-3.

ABSTRACT

BACKGROUND: International medical students face elevated risks of depression, anxiety, post-traumatic stress disorder (PTSD; characterized by re-experiencing, avoidance, and a sense of threat per ICD-11), and complex PTSD (C-PTSD; encompassing core PTSD symptoms alongside disturbances in self-organization, including emotion dysregulation, negative self-concept, and relationship difficulties). This study aims to determine the prevalence of these conditions among students at Ain Shams University (n = 310) and to compare those from conflict-affected regions with those from non-conflict regions.

METHODS: This analytical cross-sectional survey (October 2024-January 2025) employed the Depression, Anxiety, and Stress 21 Scale (DASS-21) and the International Trauma Questionnaire (ITQ). Statistical significance was set at p < 0.05.

RESULTS: Students experienced a high symptom burden: 36.5% had extremely severe depression, 42.3% had extremely severe anxiety, and 18.4% had extremely severe stress. PTSD was identified in 18.4% of students, while C-PTSD was identified in 21.5%. Students from conflict-affected regions exhibited significantly higher rates across all outcomes compared with non-conflict peers (depression, anxiety, stress, PTSD, and C-PTSD: all p < 0.05).

CONCLUSION: International medical students, particularly from conflict-affected areas, exhibit substantial mental health problems. The prevalence of C-PTSD (21.5%) exceeded that of PTSD (18.4%), underscoring chronic trauma impact. Targeted interventions-trauma-informed counseling, peer support, and resilience training-are urgently needed. Findings provide baseline data for the development of culturally sensitive mental health programs at Ain Shams University and similar institutions.

PMID:42496924 | DOI:10.1186/s42506-026-00224-3

Int J Health Econ Manag. 2026 Jul 24;26(3):16. doi: 10.1007/s10754-026-09420-2.

ABSTRACT

This article analyzes the economic responses of household heads confronted with SARS-CoV-2 symptoms during the partial lockdown period imposed in Cameroon in 2020. By isolating the specific effect of the individual symptomatic shock from that of general health restrictions, it fills a gap that the literature on the economic effects of COVID-19 has not yet directly addressed. The data come from a household survey conducted in Cameroon, and five economic responses are analyzed, namely over-indebtedness, active occupational mobility, and reductions in health, education, and sanitary protection expenditures. To address endogeneity, two complementary strategies are employed, namely the kinky least squares (KLS) method, which corrects endogeneity bias without resorting to an external instrument, and the recursive bivariate probit with instrumental variable, which jointly models binary treatment and outcome while accounting for the correlation between their unobserved error terms. Kinky least squares estimates establish a positive and statistically significant relationship between SARS-CoV-2 symptomatic manifestations and all of the selected economic responses. The recursive bivariate probit confirms these results, with the exception of active occupational mobility, whose coefficient remains positive but loses its statistical significance once non-linearity and the correlation of unobserved disturbances are fully accounted for. The decomposition of average treatment effects indicates that SARS-CoV-2 symptomatic manifestations increase the probability of reducing sanitary protection expenditures by 37.3% across the entire population (ATE) and by 38.1% among household heads who were actually affected (ATET). For education expenditures, these effects are 28.6% and 25.6%, respectively. For health expenditure reductions, these effects are 23.2% and 18.6%, respectively. These findings argue in favor of the free distribution of sanitary protection devices, the subsidization of medical consultations and community drug stockpiles, the maintenance of school transfer payments, and zero-interest emergency credit lines for informal workers experiencing temporary work incapacity. These measures will nonetheless remain insufficient as long as the health coverage system remains critically underdeveloped.

PMID:42496914 | DOI:10.1007/s10754-026-09420-2

Exp Brain Res. 2026 Jul 24;244(8):163. doi: 10.1007/s00221-026-07366-y.

ABSTRACT

Whether the cognitive benefits of athletic training transfer to specific academic domains, such as arithmetic, remains poorly understood. This study investigated the behavioral and electrophysiological (ERP) correlates of multiplication verification in 19 high school cycling athletes and 19 matched controls. Behaviorally, athletes exhibited significantly lower baseline mathematical proficiency (SATM scores), lower accuracy, slower reaction times and poorer processing efficiency. Electrophysiologically, athletes initially demonstrated significantly larger posterior P300 amplitudes than controls. Crucially, these group differences were substantially attenuated after statistically controlling for baseline mathematical proficiency using analysis of covariance (ANCOVA). The findings suggest that arithmetic-related neural processing differences in athletes may be associated with variability in mathematical proficiency rather than reflecting a generalized neurocognitive disadvantage. More broadly, the results support the view that cognitive adaptations associated with athletic expertise may be relatively domain-specific and may not automatically generalize to highly practiced academic skills such as arithmetic verification.

PMID:42496911 | DOI:10.1007/s00221-026-07366-y

Fish Physiol Biochem. 2026 Jul 24;52(4):126. doi: 10.1007/s10695-026-01753-6.

ABSTRACT

Aquaculture intensification is increasingly recognized as a strategic pathway to fight food insecurity. It is also harnessed to meet the rising global demand for high-quality animal protein. This has led to a growing need for fish seed and a heightened concerned for broodstock nutrition, reproductive efficiency, and quality of seeds. In the present study, reproductive responses of African catfish Heterobranchus bidorsalis broodstock were evaluated at graded levels of ethanolic Moringa oleifera leaf extract (EMOLE) as a phytogenic feed additive. A total of 84 broodstock (800.00 ± 150.00 g) were randomly assigned to 4 isonitrogenous (40% crude protein) diets containing 0.0% (control), 1.0%, 2.0% and 3.0% EMOLE in a completely randomized design with three replications. Fish were fed at 5% body weight, twice daily for 16 weeks. Reproductive indices assessed included milt motility, sperm morphology, milt volume and concentration, gonadosomatic index, egg diameter, fecundity, fertilization rate, hatching rate, and hatchling survival. Data were analyzed using descriptive statistics, one-way analysis of variance at α 0.05, using SPSS 20 software. Results showed that dietary EMOLE significantly improved reproductive performance. Fish fed 3.0% EMOLE exhibited the highest sperm motility (92.00 ± 2.31%), sperm concentration (225.33 ± 0.02 × 10⁶ ml⁻¹), fecundity (6118.00 ± 200.70), fertilization rate (78.63 ± 0.51%), hatchability (78.20 ± 0.67%), and larval survival (78.07 ± 1.27%). Sperm abnormalities were significantly reduced in supplemented groups. These findings indicate that 3.0% EMOLE can serve as a natural phytogenic feed additive for improving gonadal development and reproductive performance in Heterobranchus bidorsalis broodstock. This further places Moringa as a natural, cost-effective phytogenic additive for enhancing broodstock performance and sustainable seed production.

PMID:42496907 | DOI:10.1007/s10695-026-01753-6

Eur J Trauma Emerg Surg. 2026 Jul 24;52(1):229. doi: 10.1007/s00068-026-03277-3.

ABSTRACT

PURPOSE: Computed Tomography (CT) with intravenous (IV) contrast is critical to the evaluation of the trauma patient. A pandemic-related lockdown occurred in Spring 2022 in the city where iohexol iodinated contrast media) is manufactured, resulting in a global shortage. We explored the potential impact of this shortage on contrast utilization and patient outcomes.

METHODS: A retrospective study was performed of all trauma patients who underwent CT between January and December 2022 at a level I trauma center. Pre-contrast conservation (PRE) period was defined as January to April 2022, and post-conservation (POST) as May to December 2022. Demographics, utilization rates (bolus/patient) and outcomes were evaluated. Chi-square tests were performed for categorical variables and Mann-Whitney U tests for continuous variables. Statistical significance was set at p < 0.05.

RESULTS: 1,097 patients were included; 509 in the pre-shortage period, 588 post-shortage. 857 CTs with contrast (1.68 contrast bolus/patient) were performed pre-conservation and 979 post-conservation (1.66 contrast bolus/patient) (p = 0.04). Maximum Abbreviated Injury Scale (AIS) head, head/neck, and extremity were higher post-shortage (p < 0.05); however, mortality was higher in the pre-conservation group (p < 0.0012). There were 9 cases of Acute Kidney Injury (AKI, 8 PRE, 1 POST), 22 delayed diagnoses (14 PRE, 8 POST) and 2 missed injuries (PRE 2, POST 0).

CONCLUSIONS: Despite a nationwide IV contrast shortage and volume of contrast utilization per patient, we did not observe an increase in delayed diagnoses, missed injuries or AKI although these events remain small with no clear adverse signal. This may reflect the proactive institutional measures deployed to decrease nonurgent contrast use in the inpatient and outpatient settings in order to conserve contrast for more emergent settings. Based on the limited data set and truncated pre-shortage periods we were not able to reach any meaningful conclusions regarding quality of care and impact on outcomes. Next steps may include multi-center analysis to determine the larger clinical impact of this shortage.

PMID:42496906 | DOI:10.1007/s00068-026-03277-3