Category: Statistics

J Assoc Res Otolaryngol. 2026 May 26. doi: 10.1007/s10162-026-01054-y. Online ahead of print.

ABSTRACT

PURPOSE: Investigate the genetic components of sensorineural hearing loss (SNHL) by performing genome-wide meta-analyses using the data from FinnGen and Estonian Biobank.

METHODS: We studied genome-wide associations of SNHL in FinnGen and the Estonian Biobank in the general population and in sex- and age-of-onset stratified subgroups. The study-specific GWASs were combined through inverse variance-weighted genome-wide meta-analyses, encompassing a total of 531,059 individuals (Ncases = 35,960). Age-stratified meta-analyses included 28,198 individuals diagnosed at the age of 55 years or after and 7762 individuals diagnosed before the age of 55 years, with 495,099 controls. Sex-stratified meta-analyses included 313,501 females (Ncases = 17,761) and 217,558 males (Ncases = 18,199).

RESULTS: In the meta-analysis focusing on the general population, 22 SNHL-associated loci (±1 Mb window) were observed, three of which were previously unreported. In the sex-stratified analysis, two previously unreported SNHL loci were observed in the female subgroup and one locus in the male subgroup. Additionally, in the age-stratified analysis, two previously unreported SNHL loci were observed in the subgroup of those that were diagnosed at the age of 55 years or after. In those diagnosed before the age of 55 years, one previously unreported locus was observed. Overall, 32 loci were associated with SNHL at p < 5 × 10^-8 in at least one of the study groups. Of these, nine have not been previously reported in association with SNHL. We also estimated if there were significant differences in the effect sizes of the lead variants at each locus between the analytical subgroups and observed differences for 14 variants.

CONCLUSIONS: Previously unreported SNHL risk loci and differences in effect sizes found in this study provide additional insight into the genetic underpinnings of SNHL. Our results validate the role of mechano-transduction and genetic components affecting the structure of the inner ear in the background of SNHL. Our study contributes to our understanding of the genetic causes of SNHL and may open the door for further translational research.

PMID:42192083 | DOI:10.1007/s10162-026-01054-y

J Racial Ethn Health Disparities. 2026 May 26. doi: 10.1007/s40615-026-03024-9. Online ahead of print.

ABSTRACT

Acculturation has been shown to be relevant to health outcomes. However, methodological limitations remain in the existing literature, particularly the lack of psychometric validation of acculturation measures for Asian American population. As a result, little is known about distinct acculturation profiles within this population and how these profiles relate to perceived stress and health. This study employs latent profile analysis (LPA) to identify distinct acculturation profiles among 337 Asian Americans and to examine their associations with perceived health and perceived stress. LPA were used based on acculturated-related variables, including perceived acculturation, immigration generation, associated ethnic group, heritage language competency pressure, English competency pressure, pressure to acculturation, pressure against acculturation. We detected a 3-class solution: acculturated, bicultural, and enculturated. Compared to bicultural group, the acculturated group has statistically significant lower perceived stress (p < .001), higher perceived mental health (p < .001) and physical health (p < .001); the enculturated group reported significantly lower perceived mental health than the bicultural group (p <.001). These findings highlight nuanced differences in health perceptions across acculturation profiles. Notably, the enculturated group may be at elevated risk for poorer mental health outcomes, underscoring the need for culturally tailored mental health interventions. By elucidating how acculturation experiences impact perceived health and stress, this study offers practical insights for mental health professionals and healthcare providers, encouraging the development of tailored, culturally sensitive interventions for Asian American subgroups based on their acculturation experiences.

PMID:42192078 | DOI:10.1007/s40615-026-03024-9

Reprod Sci. 2026 May 26. doi: 10.1007/s43032-026-02125-4. Online ahead of print.

ABSTRACT

This study aims to further clarify the correlation between the quantity of natural killer (NK) cells in the endometrium and the successful implantation of embryos during the specific implantation window. Patients were stratified into four distinct groups according to the quantity of natural killer (NK) cells detected during the implantation window. The groups were defined as follows: Group A (NK cell percentage ≥ 10%, n = 62), Group B (NK cell percentage: 5%-9.99%, n = 128), Group C (NK cell percentage: 1%-4.99%, n = 106), and Group D (NK cell percentage ≤ 0.5%, n = 30). Among Group A, 32 patients received intrauterine infusion of dexamethasone (designated as Subgroup A1), while the remaining 30 patients did not undergo this treatment (designated as Subgroup A2). For Groups B and D, immunohistochemistry was performed to detect the expression of IGFBP1 (an endometrial decidualization marker) and HBP1 (a decidualization-related transcription factor). The live birth rate in Group D was statistically significantly lower than that in the other three study groups. For Group A, after dexamethasone administration, a notable reduction in NK cell quantity was observed in Subgroup A1 (patients who received intrauterine dexamethasone infusion) during the implantation window; however, the pregnancy rates of Subgroup A1 and Subgroup A2 (patients without dexamethasone treatment) were comparable. Furthermore, in Group D patients, the expression levels of the decidualization markers IGFBP1 and HBP1 were significantly lower than those in the reference group (Group B, as specified in Methods). Insufficient natural killer (NK) cells during the embryo implantation window significantly impede the embryo implantation process. This shortage of NK cells may be attributed to inadequate endometrial decidualization. Notably, although intrauterine infusion of dexamethasone effectively reduces NK cell counts, it does not exert a significant impact on clinical outcomes.

PMID:42192073 | DOI:10.1007/s43032-026-02125-4

Environ Monit Assess. 2026 May 27;198(6):657. doi: 10.1007/s10661-026-15505-9.

ABSTRACT

Continuous and uninterrupted air quality monitoring is essential for environmental management and public policy formulation, which requires the absence of missing data and good quality measurements. However, due to a variety of factors (local power outages, data transmission, instrument calibration, preventive maintenance, weather conditions, etc.), measurement gaps with different time windows frequently occur in historical air quality data. This work addresses the problem of missing data in air quality monitoring time series, which compromises the quality of information and hinders decision-making related to air pollution. Carbon monoxide (CO) data were imputed in artificially generated gaps (from 24 to 72 h) for a monitoring station located in Salvador, Bahia (Brazil). Three dynamic modeling strategies with different architectures and learning algorithms were applied: XGboost and two recurrent neural networks (LSTM and RNN). The results showed that, although XGboost presented the lowest medians associated with RMSE and MAE distributions (0.1028 and 0.1266 ppm, respectively), the difference compared to the neural networks was not statistically significant. The statistical analysis of the predictions showed that the mean of the residuals does not differ significantly from zero, indicating an absence of systematic bias and suggesting that the imputed values preserve the dominant dynamics and seasonal patterns of the original series. The percentages of gaps consistently described by the models were 82.0% (XGboost) and 91.3% (LSTM and RNN recurrent neural networks). The results demonstrate that the adopted model structures (decision tree and recurrent neural networks), along with a systematic approach involving the analysis and preparation of the training sample (identification of input variables, mapping of existing gaps in the historical data of the measurement station, and generation of artificial gaps, among others), enabled the imputation of dynamic CO data, preserving the dominant behavior of the time series and ensuring the validity of environmental monitoring.

PMID:42192051 | DOI:10.1007/s10661-026-15505-9

Support Care Cancer. 2026 May 27;34(6):582. doi: 10.1007/s00520-026-10816-6.

ABSTRACT

PURPOSE: As the number of cancer survivors increases, psychological distress has become an important issue. Using nationally representative data, we evaluated mental health outcomes among Korean cancer survivors compared with cancer-free controls and developed models to identify individuals at risk of psychological distress.

METHODS: We analyzed data from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2021. Psychological outcomes were assessed using standardized questionnaires, and a composite distress outcome was constructed. Risk stratification models were developed among cancer survivors using logistic regression and machine learning algorithms, including random forest, XGBoost, LightGBM, support vector machines, k-nearest neighbors, and naïve Bayes.

RESULTS: A total of 88,061 participants were included, comprising 3733 cancer survivors and 84,328 cancer-free controls. Compared with cancer-free controls, cancer survivors had higher odds of depressed mood (OR 1.33; 95% CI 1.18-1.51), suicidal ideation (OR 1.14; 95% CI 1.00-1.31), suicide planning (OR 1.91; 95% CI 1.37-2.65), and mental health counseling (OR 1.36; 95% CI 1.08-1.71). Among cancer survivors, multiple models were evaluated, with logistic regression showing the highest performance (AUROC 0.689), followed by XGBoost (0.686). In logistic regression, longer working hours, depression history, activity limitation, female sex, smoking, employment, low income, and distorted body image were independently associated with distress. SHAP analysis identified activity limitation, sex, and depression history as key factors.

CONCLUSIONS: Cancer survivors experience increased psychological distress across multiple outcomes. Machine learning-based models may help identify individuals at higher risk of psychological distress, supporting risk-based assessment in survivorship care.

PMID:42192026 | DOI:10.1007/s00520-026-10816-6

Eur J Nutr. 2026 May 26;65(4):140. doi: 10.1007/s00394-026-04002-x.

ABSTRACT

PURPOSE: To examine the associations of planetary health diet (PHD) with all-cause and cause specific mortality, alongside heart age based on the Guangzhou Biobank Cohort Study (GBCS) and conduct mediation analysis.

METHODS: Participants were recruited from the GBCS and were aged ≥ 50 years. Dietary information was collected using a validated Food Frequency Questionnaire. Participants were assigned PHD scores between 0 (no adherence to PHD) and 140 (complete adherence to PHD). Primary outcomes were all-cause, cardiovascular disease (CVD) and cancer mortality. Causes of death were identified through death registry. Secondary outcome, heart age, was calculated using sex-specific 10-year CVD risk prediction models previously developed and validated in the GBCS. Cox proportional hazards regression and linear regression were used to analyze the associations of PHD scores with mortality and heart age. Mediation analyses were conducted using the difference method implemented by the “mediate” SAS macro.

RESULTS: Of 25,550 participants aged 50+ years, during 417,590 person-years of follow-up, higher PHD scores was linearly associated with lower all-cause and CVD but not cancer mortality (hazard ratio (HR) (95% confidence interval (CI)) per 10-point increment: 0.94 (0.92-0.97), 0.92 (0.89-0.95) and 0.97 (0.93-1.01)). The association with all-cause mortality was mediated by white blood cell count (WBC), waist-to-hip ratio and waist-to-hip-to-height ratio (mediation proportion (95% CI): 6.2% (3.2-11.7%), 2.6% (0.9-7.2%) and 5.4% (2.8-9.9%)), whereas the association with CVD mortality was mediated by WBC and waist-to-hip-to-height ratio (7.9% (4.1-14.9%) and 7.4% (3.0-17.0%)). A negative association between PHD scores and heart age was observed in women but not in men (β (95% CI) per 10-point increment: – 0.13 (- 0.24, -0.01) and 0.05 (- 0.15, 0.25) years, P_interaction < 0.001).

CONCLUSION: Higher adherence to PHD was linearly associated with lower all-cause and CVD but not cancer mortality in Chinese aged 50+ years, and with lower heart age in women only. Our findings advocate for PHD in middle-aged to older Chinese, particularly women to improve cardiovascular health.

PMID:42192022 | DOI:10.1007/s00394-026-04002-x

Transpl Infect Dis. 2026 May 26:e70245. doi: 10.1111/tid.70245. Online ahead of print.

ABSTRACT

BACKGROUND: Despite increasing interest in sex and gender in transplant medicine, the impact of recipient-donor sex combinations (RDSCs) on posttransplant infections, graft survival, and rejection remains unclear. To assess if RDSC is independently associated with infectious events in solid organ transplantion (SOT) recipients.

METHODS: This retrospective cohort study assessed a national prospectively maintained registry including six transplant centers. All adult patients, undergoing primary transplant of either heart, kidney, liver, or lung, between May 1, 2008, and December 31, 2021, were included. Endpoints were clinically significant infectious events (primary endpoint), graft survival, rejection, and overall survival within the first year. Patients were grouped as per RDSC. The primary statistical outcome of the organ-specific, a priori known risk factor-adjusted analyses are reported as incidence rate ratios (IRRs).

RESULTS: The cohort included 5033 recipients: 2886 (57.3%) kidney, 1224 (24.3%) liver, 515 (10.2%) lung, and 408 (8.1%) heart transplants, documenting 6067 infections. Recipient-donor sex mismatch was not associated with weighted posttransplant infection risk in heart (IRR: 1.06; 95% CI: 0.75, 1.48; p = 0.75), kidney (IRR: 1.03; 95% CI: 0.90, 1.17; p = 0.69), liver (IRR: 1.10; 95% CI: 0.81, 1.50; p = 0.52), or lung (IRR: 1.02; 95% CI: 0.82, 1.26; p = 0.89) recipients. Female kidney recipients had significantly higher infection rates than males (IRR: 1.50; 95% CI: 1.32, 1.71; p < 0.001), largely explained by urinary tract infections. One-year graft survival, rejection, and overall survival were unaffected by RDSC across all organs.

CONCLUSION: RDSC does not influence 1-year SOT infectious outcome, as well as rejection or graft survival as exploratory outcomes.

PMID:42189585 | DOI:10.1111/tid.70245

Arch Argent Pediatr. 2026 May 28:e202510997. doi: 10.5546/aap.2025-10997.eng. Online ahead of print.

ABSTRACT

Introduction. Multiple pregnancies are more frequently associated with adverse maternal and neonatal outcomes. The incidence of multiple pregnancies has increased with the use of assisted reproductive technologies (ART): they account for between 15% and 25% of twin births. ART has also been associated with adverse outcomes in both singleton and multiple pregnancies, although the available evidence is limited and heterogeneous. Objective. To evaluate maternal and perinatal outcomes in spontaneously conceived twin pregnancies and compare them with those conceived through ART. Population and methods. Patients aged 18 years or older with twin pregnancies who reached a gestational age of 24.0 weeks and who underwent first-trimester screening, follow-up, and delivery at the Hospital Italiano de Buenos Aires between January 2014 and December 2022. A composite outcome of maternal and neonatal adverse events was analyzed. Neurological development was monitored until age 2. Results. A total of 243 twin pregnancies were included (148 ART; 95 spontaneous). The ART group had a higher prevalence of advanced maternal age, nulliparity, obesity, and chronic diseases, with statistically significant differences (p <0.001). There were no significant differences in primary maternal outcomes (29% vs. 23%; p = 0.347) or neonatal outcomes (16% vs. 19%; p = 0.371). We found an increased frequency of autism spectrum disorders in pregnancies conceived through ART. Conclusion. Twin pregnancies resulting from ART showed similar maternal and neonatal outcomes to those resulting from spontaneous conception, despite significant differences in baseline maternal characteristics. Long-term follow-up studies are needed.

PMID:42189568 | DOI:10.5546/aap.2025-10997.eng

JAMA Neurol. 2026 May 26. doi: 10.1001/jamaneurol.2026.1443. Online ahead of print.

ABSTRACT

IMPORTANCE: Postherpetic neuralgia (PHN) is a refractory neuropathic pain condition with limited therapeutic options. Although electroacupuncture has demonstrated potential analgesic effects, high-quality evidence from rigorous randomized clinical trials remains limited.

OBJECTIVE: To determine whether electroacupuncture reduces pain severity compared with sham electroacupuncture and evaluate its safety in patients with PHN.

DESIGN, SETTING, AND PARTICIPANTS: This multicenter, randomized, sham-controlled clinical trial took place at 7 tertiary hospitals in China and enrolled participants from October 2020 to July 2022, with the last follow-up in September 2022. Data analyses were performed from August to December 2025. Participants with PHN aged 45 to 75 years and moderate to severe pain (11-point Numeric Rating Scale [NRS-11] score ≥4) were recruited. Of 1072 patients screened, 624 were excluded. The remaining 448 participants were randomized to electroacupuncture (n = 225) or sham electroacupuncture (n = 223); 383 participants (85.49%) completed the trial.

INTERVENTION: Twenty sessions of electroacupuncture or sham electroacupuncture over 4 weeks, followed by a 4-week posttreatment follow-up.

MAIN OUTCOMES AND MEASURES: The primary outcome was the change in the NRS-11 scores from baseline to week 4, with responders defined as participants achieving a 30% or more reduction in NRS-11 scores.

RESULTS: Of 448 participants, the mean (SD) age was 63.19 (9.26) years, 233 (52.01%) were male, and 215 were female (47.99%). At week 4, the electroacupuncture group had a greater decrease in the NRS-11 scores (-1.52) than the sham electroacupuncture group (-0.99) with an adjusted mean difference of -0.53 (95% CI, -0.61 to -0.43; P < .001), and the responder rate was significantly higher in the electroacupuncture group (46.68%) than in the sham electroacupuncture group (24.28%) (adjusted risk difference, 22.40%; 95% CI, 13.02%-31.79%; P < .001). These treatment benefits persisted through a 1-month follow-up; no clinically significant adverse events were observed.

CONCLUSIONS AND RELEVANCE: Among patients with PHN in this study, electroacupuncture provided a statistically significant reduction in pain severity, increased responder rates, and improved pain-related functional outcomes. These benefits suggest that electroacupuncture may be a useful nonpharmacological option for integrated management of PHN.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04560361.

PMID:42189557 | DOI:10.1001/jamaneurol.2026.1443

JAMA Netw Open. 2026 May 1;9(5):e2615000. doi: 10.1001/jamanetworkopen.2026.15000.

ABSTRACT

IMPORTANCE: The abrupt withdrawal of humanitarian aid in early 2025 has destabilized health systems across sub-Saharan Africa, yet little is known about the frontline realities of these cuts in refugee-hosting settings.

OBJECTIVE: To explore health care practitioners’ perspectives and experiences of how reductions in global health funding have affected services and refugee health and to identify practitioner recommendations for sustaining care.

DESIGN, SETTING, AND PARTICIPANTS: This qualitative study used semistructured, in-depth interviews conducted in July 2025 at 6 health facilities within Nakivale Refugee Settlement, Uganda. Participants were health care practitioners representing diverse cadres and facility sizes.

EXPOSURE: Reduction of humanitarian aid.

MAIN OUTCOMES AND MEASURES: The primary outcomes were health care practitioners’ perspectives on the impacts of funding reductions, including changes in service delivery, supply availability, staff conditions, and anticipated future health trends, as well as their recommendations to mitigate harms. Rapid qualitative techniques and thematic analysis were used to analyze responses to obtain actionable implications systematically and efficiently.

RESULTS: The 26 participants (mean [SD] age, 30.92 [3.52] years; 16 men [61.5%]) had a mean (SD) duration in practice of 6.80 (2.65) years, with a mean (SD) of 3.09 (1.92) years in Nakivale. Interviews yielded 4 overarching themes and 18 subthemes: (1) reductions in health care services (HIV and tuberculosis services, nutritional support, maternal health, immunization adherence, inpatient and outpatient care, and perceptions of service availability), (2) supply shortages (medical supplies, transportation fuel, and household support), (3) deteriorating staff conditions (staff reduction, workload and burnout, and resilience), and (4) future predictions and recommendations (disease patterns, migration patterns, bridging the funding gap, and general settlement conditions).

CONCLUSIONS AND RELEVANCE: This qualitative study examined the cascading outcomes of humanitarian aid withdrawal on refugee health care through the voices of frontline practitioners. Their testimonies underscored urgent priorities for restoring and retargeting aid-investing in high-impact levers, strengthening local leadership, and advancing policy reforms-to safeguard refugee health and system resilience, while reminding us of the shared human stakes of humanitarian policy and the global responsibility to act.

PMID:42189537 | DOI:10.1001/jamanetworkopen.2026.15000