Category: Statistics

Popul Health Metr. 2026 Feb 3. doi: 10.1186/s12963-026-00456-7. Online ahead of print.

ABSTRACT

PURPOSE: Public health surveillance systems require high-quality data to represent the population. In the absence of comprehensive or random testing throughout the COVID-19 pandemic, we have developed a proxy method for synthetic random sampling to estimate the actual community-level viral incidence, based on viral testing of patients who are asymptomatic and present for elective procedures within a hospital system.

METHODS: The approach collects routine testing data on SARS-CoV-2 exposure among outpatients and performs statistical adjustments of sample representation using multilevel regression and poststratification (MRP), a procedure that adjusts for nonrepresentativeness of the sample and yields stable small group estimates. We extend MRP to accommodate time-varying data and granular geography.

RESULTS: We have developed an open-source, user-friendly MRP interface for public implementation of the Bayesian analysis workflow. We illustrate the MRP interface with an application to track community-level COVID-19 viral transmission in Michigan. We present the estimated infection rate over time for the targeted population and across demographic and geographic subpopulations.

CONCLUSION: The interface provides timely, substantive insights into population health trends and serves as a valuable surveillance tool for future epidemic preparedness. Beyond monitoring COVID-19, the MRP interface can analyze a wide range of health and social science data, making it broadly applicable to diverse research areas with reproducibility and scientific rigor.

PMID:41634841 | DOI:10.1186/s12963-026-00456-7

Parasit Vectors. 2026 Feb 3. doi: 10.1186/s13071-025-07232-w. Online ahead of print.

ABSTRACT

BACKGROUND: Broad-spectrum combination products with efficacy against endo- and ectoparasites offer the potential to optimize owner adherence to expert recommendations for canine antiparasitic treatments. In the development program for a chewable tablet containing fluralaner, moxidectin, and pyrantel, a non-terminal study design was implemented to determine anthelminthic efficacy. Four laboratory studies assessed the efficacy of this investigational veterinary product (IVP) against adult hookworms and adult Toxascaris leonina.

METHODS: In four single-site, non-terminal dose confirmation studies, dogs were inoculated with third-stage larvae of Uncinaria stenocephala (Studies 1 and 2), Ancylostoma caninum (Study 3), or larvated eggs of T. leonina (Study 4). Using fecal egg counts (FECs) from those infections, dogs were ranked and randomized to groups (Studies 1, 3, and 4, 10 per group; Study 2, 8 per group and treated once orally, on day 0, with the minimum recommended IVP dose (fluralaner 10 mg/kg, moxidectin 0.025 mg/kg, pyrantel 5 mg/kg) (BRAVECTO^® TriUNO, MSD), or left untreated. Approximately 2 weeks later, both groups in all studies were treated orally with a diagnostic dewormer (DDW) containing emodepside-praziquantel (Profender^® modified-release Tablets for Dogs, Vetoquinol). The primary efficacy objective was determined by counts of expelled worms recovered after DDW treatment. Copro-antigen enzyme-linked immunosorbent assay (ELISA), polymerase chain reaction (PCR), and FECs were completed at key time points.

RESULTS: Adequacy of infection was shown in all studies. Relative to the control groups, statistically significant reductions in mean worm counts were found in IVP-treated groups in Studies 1, 2, 3, and 4 (99.8%, P < 0.0001; 100%, P = 0.0002; 100%, P < 0.0001; and 99.4%, P < 0.0001, respectively). All control dogs had positive FECs until the DDW treatment, while no eggs were detected after day 0 in 36 of the 38 IVP-treated dogs. Findings from copro-PCR and antigen-ELISA were consistent with and confirmatory of the conclusions from worm counts and FECs.

CONCLUSIONS: A single, orally administered dose of this chewable tablet formulation is effective in treating canine infections with adult hookworms (U. stenocephala, A. caninum) and T. leonina. Non-terminal studies present a valid means of determining the efficacy of anthelmintic treatments for these canine intestinal parasites.

PMID:41634831 | DOI:10.1186/s13071-025-07232-w

J Orthop Surg Res. 2026 Feb 3. doi: 10.1186/s13018-026-06690-x. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to evaluate the effectiveness of skin staplers for wound closure following extended L-shaped incisions in the treatment of calcaneal fractures.

METHODS: A randomized controlled trial was performed on 82 calcaneal fracture cases (Sanders types III-IV) that underwent extended L-shaped incisions at the Second Hospital of Shanxi Medical University from June 2022 to March 2025. Out of these, 60 cases met the inclusion and exclusion criteria. A non-blinded, open, randomized controlled trial was conducted, assigning patients to either the stapler group (n = 28) or the Allgower-Donati group (n = 32). The key parameters assessed included wound closure time, the area of postoperative inflammatory reaction, changes in skin temperature at the incision corners, and wound healing grades. These parameters were then compared between the two groups.

RESULTS: At the 2-week postoperative follow-up, when sutures were removed, no significant differences were found in terms of inflammatory reaction area, skin temperature changes, or wound healing grades between the two groups. However, the stapler group demonstrated a notably shorter wound closure time (10.89 ± 2.87 min) compared to the Allgower-Donati group (20.44 ± 2.01 min).

CONCLUSION: The use of skin staplers for wound closure resulted in healing outcomes that showed no statistically significant differences from those achieved with the Allgower-Donati suturing technique in extended L-shaped incisions for calcaneal fractures. Importantly, the skin stapler method significantly reduces wound closure time (P < 0.05), which can lead to shorter overall surgical durations and a decreased risk of wound infections.

PMID:41634804 | DOI:10.1186/s13018-026-06690-x

Breast Cancer Res. 2026 Feb 3. doi: 10.1186/s13058-026-02222-x. Online ahead of print.

ABSTRACT

BACKGROUND: Reproductive factors are key breast cancer risk factors, yet contemporary generational patterns remain unclear. We aimed to evaluate trends in reproductive factors among US women born between 1910 and 2000.

METHODS: We conducted a serial, cross-sectional analysis of reproductive factors using data from the US National Health and Nutrition Examination Survey (NHANES) collected between 1999 and 2020. Female participants were grouped by birth cohorts (1910-1930, then by 10-year to 2000). Self-reported data were used to derive age at menarche, prevalence of age at menarche < 12 years, age at natural menopausal, prevalence of first live birth after age 30, and lifetime number of live births.

RESULTS: Data on 28,481 US women were analyzed. From birth cohort 1910-1930 to 1990-2000, the mean age at menarche declined from 13.0 (95%CI 12.9 to 13.1) to 12.4 (95%CI 12.3 to 12.5) years (difference = – 0.6, 95%CI – 0.7 to – 0.5, p for trend < 0.001). This decline was observed in both US (12.9 [95%CI 12.9 to 13.0] to 12.4 [95%CI 12.3 to 12.5]) and non-US born (13.3 [95%CI 13.1 to 13.6] to 12.3 [95%CI 12.1 to 12.5]) women. From birth cohort 1910-1930 to 1990-2000, the prevalence of age at menarche < 12 years increased from 14.2% (95%CI 12.4 to 16.1) to 26.5% (95%CI 24.3 to 28.9%). The prevalence of first live birth after age 30 increased from 4.7% (95%CI 3.1 to 6.9%) to 10.6% (95%CI 7.3 to 15.0%) from birth cohort 1910-1930 to 1980-1990. Among women who attained menopause (up to birth cohort 1950-1960), no significant changes were observed for age at natural menopausal. However, the average lifetime number of live births declined from 3.5 to 2.4 with a significant decline in the proportion of grand multiparous women.

CONCLUSIONS: Over the past century, women in the US are attaining menarche earlier, more likely to have their first birth after age 30 and having fewer births. Parsing the extent to which changes in reproductive factors are contributing to the rising incidence of estrogen receptor positive breast cancer, especially in premenopausal women, is necessary to devise long-lasting and sustainable preventive strategies.

PMID:41634775 | DOI:10.1186/s13058-026-02222-x

BioData Min. 2026 Feb 4. doi: 10.1186/s13040-025-00508-y. Online ahead of print.

NO ABSTRACT

PMID:41634772 | DOI:10.1186/s13040-025-00508-y

Patient Saf Surg. 2026 Feb 3;20(1):7. doi: 10.1186/s13037-025-00467-7.

NO ABSTRACT

PMID:41634770 | DOI:10.1186/s13037-025-00467-7

Cardiovasc Diabetol. 2026 Feb 3. doi: 10.1186/s12933-025-03071-2. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: Current clinical risk tools in type 1 diabetes do not include left ventricular dysfunction or inflammation, potentially limiting early risk detection. We aimed to evaluate the associations and predictive value of combining echocardiography with inflammatory biomarkers for mortality and major adverse cardiovascular events (MACE).

METHODS: In a prospective cohort of individuals with type 1 diabetes without known cardiovascular disease, we evaluated whether subclinical left ventricular dysfunction, defined by an elevated ratio of early mitral inflow velocity to early diastolic mitral annular velocity (E/e’) or impaired global longitudinal strain (GLS), combined with elevated levels of an inflammatory biomarker (interleukin-6 [IL-6], soluble urokinase-plasminogen-activator-receptor [suPAR], or high-sensitivity C-reactive-protein [hsCRP]), was associated with all-cause mortality and MACE. Cox models were adjusted for all 10 variables included in the Steno T1 Risk Engine variables: age, sex, systolic blood pressure, duration of diabetes, HbA1c, low-density lipoprotein, estimated glomerular filtration rate, albuminuria status, smoking, and physical activity. C-statistics and net reclassification improvement were assessed.

RESULTS: Among 876 participants (51% male, median age 50 years), 114 deaths occurred over 14.5 years of follow-up. Elevated E/e’ combined with IL-6 or suPAR, but not hsCRP, was independently associated with mortality. Compared with individuals with E/e’ <8 and non-elevated IL-6, the hazard ratio (HR) for E/e’ 8-13 with elevated IL-6 was 2.5 (95% CI 1.4 to 4.6, P < 0.01), and for E/e’ ≥13 with elevated IL-6 was 3.4 (1.5-7.6; P < 0.01). Corresponding HRs for suPAR were 2.4 (1.2 to 4.7, P < 0.01) and 3.9 (1.8 to 8.5, P < 0.01). Adding E/e’ and an inflammatory biomarker increased the C-statistic from 0.839 (Steno T1 Risk Engine alone) to 0.887 (E/e’ and IL6) and 0.868 (E/e’ and suPAR). Findings were similar for GLS and with MACE as the outcome.

CONCLUSIONS: Echocardiography combined with inflammatory biomarkers synergistically identifies individuals with type 1 diabetes, without known cardiovascular disease, who are at high risk of mortality and MACE.

PMID:41634769 | DOI:10.1186/s12933-025-03071-2

Allergy Asthma Clin Immunol. 2026 Feb 3. doi: 10.1186/s13223-026-01013-5. Online ahead of print.

ABSTRACT

BACKGROUND: Antibiotic use in infants is hypothesized to alter the gut microbiota, influencing immune system dysregulation and increasing allergy risk. We aim to assess the prevalence of allergic diseases in children treated with different classes of antibiotics in early life.

METHODS: A retrospective cohort study was conducted from April 2024 to January 2025 in three main hospitals in the West Bank in Palestine. Records of pediatric admissions of children who received antibiotic treatment within their first six months of life were reviewed, followed by parents’ interview regarding the development of allergies.

RESULTS: A total of 423 medical records were included. The average age of children was 7.33 ± 1.38 years (mean ± SD), and 62.41% of them were males. The total prevalence of allergic diseases was 29.55%. Common manifestations of allergies were skin reactions (70.4%), wheezing (16.8%), and respiratory symptoms (10.4%). Among the most common reported triggers were food (10.17%) and dust (7.33%). The most commonly prescribed antibiotics were Beta-lactams; cefotaxime (78.49%), and ampicillin (63.59%). No statistically significant association was found between the number of antibiotics used and the development of allergies (p = 0.45). Similarly, different classes of antibiotics did not show an impact on developing allergies except for Trimethoprim/Sulfamethoxazole (p = 0.05). A significant decrease in allergy was observed with increasing age (p = 0.011).

CONCLUSION: Allergic conditions affect about one third of children treated with antibiotics in early life. While allergic conditions tended to decrease with age, no association was observed between antibiotic number/class and later allergy, except for a hypothesis-generating signal toward lower odds with TMP-SMX.

PMID:41634755 | DOI:10.1186/s13223-026-01013-5

BMC Womens Health. 2026 Feb 3. doi: 10.1186/s12905-026-04310-8. Online ahead of print.

ABSTRACT

BACKGROUND: Incarcerated women face significantly elevated cervical cancer risks compared to the general population due to higher human papillomavirus (HPV) prevalence, limited healthcare access, and socio-demographic vulnerabilities. Despite elevated risk, female inmates are substantially less likely to receive cervical screening. No studies examining cervical screening among incarcerated populations in Nordic countries have been identified.

OBJECTIVE: To examine risk factors for cervical abnormalities, screening experiences, HPV vaccination status, barriers to screening participation, and symptoms among incarcerated women in Norway before and after a cervical screening campaign.

METHODS: A repeated cross-sectional study was conducted in all three Norwegian prisons with women’s wards using a researcher-developed questionnaire. Data were collected at baseline (January/February 2025, n = 77) and post-campaign (May/June 2025, n = 97). The campaign included informational materials, prison visits, and educational sessions. The questionnaire assessed demographics, risk factors, screening history, vaccination status, participation barriers, and symptoms. Data were analyzed using descriptive statistics and chi-square tests.

RESULTS: Most respondents were aged 25-44 years, serving sentences under six months. High prevalence of risk factors was observed: tobacco/snus use (61.0%/53.9% at baseline) and multiple sexual partners (38.2% reported ≥ 5 partners). While 68.8% had prior cervical screening, only 19.6% received screening during incarceration. HPV vaccination rates were low (16.9%). Primary barriers included insufficient information (22.7% baseline, 33.8% post-campaign), fear of pain, previous trauma, and healthcare mistrust. Approximately one-third reported symptoms potentially indicating cervical abnormalities, most commonly persistent lower back pain (52% baseline, 65.6% post-campaign) and pelvic pain (36% baseline, 40.6% post-campaign). No statistically significant differences were observed between baseline and post-campaign responses.

CONCLUSIONS: Incarcerated Norwegian women exhibit multiple cervical cancer risk factors yet face substantial screening barriers during imprisonment. The campaign demonstrated limited impact on screening uptake, suggesting comprehensive sustained interventions are needed. Future strategies should address structural barriers, ensure adequate follow-up care, and explore self-sampling approaches to reduce health disparities in this vulnerable population.

PMID:41634726 | DOI:10.1186/s12905-026-04310-8

Virol J. 2026 Feb 3. doi: 10.1186/s12985-026-03088-3. Online ahead of print.

ABSTRACT

BACKGROUND: West Nile virus (WNV) is primarily transmitted by the bite of Culex mosquitoes, but other mechanisms, such as blood transfusion, have also been described. Since its identification in the Americas in 1999, WNV has circulated consistently in the United States of America (USA); however, although WNV has been detected in humans in South America, no major outbreaks have occurred in more than 20 years. One of the hypotheses to explain this difference is the underdiagnosis of the infection. In Mexico, nine isolated cases have been officially reported since 2003 despite its proximity to the USA. In this study, we aim to demonstrate the circulation of WNV in blood donors from a northern border city of Mexico.

METHODS: Between August and September of 2023, 86 serum samples from volunteer blood donors were collected to determine anti-WNV Immunoglobulin (Ig) G using a commercial enzyme-linked immunosorbent assay (ELISA) kit. In a subgroup of 44 samples, anti-WNV IgM was determined. To corroborate the IgM results, nucleic acid amplification tests (NAAT) were performed to determine RNA of WNV, Dengue and Zika. The participants were questioned about the history of travel to the USA; all of them were residents of the city of Nogales, Sonora, located on the border with the state of Arizona. For the comparison of seronegative and seropositive donor groups, the Chi-square test and Mann-Whitney U test were used for qualitative and quantitative variables, respectively. Additionally, a spatial analysis of seropositive cases was conducted.

RESULTS: One sample was reactive to anti-WNV IgM and IgG; however, all NAAT results were negative. In addition, 19 samples were reactive for IgG, and no statistically significant differences were found between the groups. Seropositive cases showed a geographic pattern of clustering on the outskirts of the city, in areas with low population density.

CONCLUSIONS: Our results strongly suggest recent WNV circulation among residents from the northern border of Mexico. The lack of differences regarding the history and frequency of travel to the USA suggests that contact with the virus occurs in Mexico and that the low reported circulation in the region represents an underdiagnosis of the disease.

PMID:41634716 | DOI:10.1186/s12985-026-03088-3