Category: Statistics

Vaccine. 2026 Apr 10;81:128565. doi: 10.1016/j.vaccine.2026.128565. Online ahead of print.

ABSTRACT

INTRODUCTION: There is evidence that pre-booked appointments (PBA) for vaccination can enhance uptake, but might also result in reactance. We assessed the effect of PBA versus self-scheduling on uptake of COVID-19 vaccination during the 2023 autumn campaign in the Netherlands.

METHODS: Persons aged ≥60 years were personally invited by mail. Those born between 01-01-1934 and 01-05-1952 (i.e., age 71.7-90.0 on 31-12-2023) received a letter with a PBA, while the others received a letter inviting them to self-schedule an appointment. National registries of sociodemographic determinants and COVID-19 vaccination were linked by a unique personal identifier. A regression discontinuity design was applied to estimate the local average treatment effect at 71.7 and 90.0 years of age among non-institutionalised adults with ≥1 prior COVID-19 vaccination. Stratified analyses were done for sociodemographic subgroups.

RESULTS: The autumn 2023 vaccination coverage among non-institutionalised persons aged ≥60 years with ≥1 prior registered COVID-19 vaccination (N = 4.0 million) was 55.0%. PBA resulted in a 3.3 (95% CI 2.6-4.1) and 4.7 (95% CI 3.7-5.7) percentage point higher uptake at 71.7 and 90.0 years, respectively. Subgroup analyses showed predominantly positive results. However, statistically significant interactions between several determinants of vaccination and the PBA effect indicate that the effect size differed between subgroups.

DISCUSSION: This nationwide quasi-experimental study shows that PBA is effective in increasing uptake. However, differences of the PBA effect between subgroups should be taken into account to increase equity of the vaccination programme.

PMID:41965975 | DOI:10.1016/j.vaccine.2026.128565

Eur J Obstet Gynecol Reprod Biol. 2026 Apr 6;322:115100. doi: 10.1016/j.ejogrb.2026.115100. Online ahead of print.

ABSTRACT

OBJECTIVE: To study the effect of intrauterine instillation of Hyaluronan enriched media on reproductive outcomes of intrauterine insemination treatment.

DESIGN AND PARTICIPANTS: 100 couples with unexplained infertility were approached and were randomly allocated to the intervention and control arm with 1:1 allocation over 2 years of duration.

INTERVENTION AND OUTCOME MEASURES: The study participants received controlled ovarian stimulation and intrauterine insemination. Additionally, the intervention group, received intrauterine administration of Hyaluronan enriched media. The intervention group and control group was compared for clinical pregnancy, live birth and miscarriages using the SPSS statistical package (version 23.0).

RESULTS: The study observed a trend of improved cumulative biochemical pregnancy rates (33.3% Vs 15.5%, RR 2.14, 95% CI 0.96-4.75, p = 0.061) and clinical pregnancy rates (31.1% Vs 15.5%, RR 2.00, 95% CI 0.89-4.48, p = 0.093) in the intervention group, which however did not reach statistical significance. The cumulative live birth occurrence was statistically significantly better in the intervention arm (28.9% vs 11.1%). RR 2.60, 95% CI 1.01-6.89, p = 0.047) of the trial. Similar miscarriage rates were observed in both arms of the trial (4.4% Vs 4.4%, RR 1.0, 95% CI 0.15-6.79, p = 1.00). The intrauterine insemination instillation of hyaluronan enriched media was well tolerated by participants in the intervention arm.

CONCLUSIONS: The study suggests a potential benefit of use of hyaluronan enriched media as a novel minimally invasive add-on intervention to facilitate the enhancement of success rates of IUI treatment.

PMID:41965969 | DOI:10.1016/j.ejogrb.2026.115100

Eur J Sport Sci. 2026 May;26(5):e70174. doi: 10.1002/ejsc.70174.

ABSTRACT

This study aimed to analyze potential menstrual cycle-related changes in physical parameters associated with performance and injury risk, focusing on neuromuscular control and motor performance in physically active young females. Twenty-two healthy participants with regular menstrual cycles (24-34 days) were examined sequentially during the follicular phase (day 3), ovulatory phase (within 48 h after a positive urine LH test), and luteal phase (7 days post-ovulation). Ovulation was indicated by a positive urinary LH surge test. The assessments included countermovement jump (CMJ), squat jump (SJ), postural control, ankle dorsiflexion range of motion (ROM), and isokinetic concentric maximal strength. Statistical analyses involved one-way repeated-measures ANOVA or the Friedman test for non-normally distributed data. Significant effects across the menstrual cycle were found for maximum concentric flexion strength (p = 0.003; ${\eta }_G^2$ = 0.037) and ankle ROM (p = 0.043; ${\eta }_G^2$ = 0.010). Post hoc analysis revealed a significant increase in concentric flexion strength from the follicular to the luteal phase (p = 0.004), whereas no significant pairwise differences were observed for ankle ROM. Concentric flexion strength increased significantly from the follicular to the luteal phase (+7.4%), and ankle ROM showed a trend toward improvement, with the highest values observed in the luteal phase (+3.8%). In contrast, CMJ, SJ, and postural control remained constant across all phases. Overall, neuromuscular and motor performance parameters appear largely consistent throughout the menstrual cycle, with only small fluctuations in strength and flexibility. These findings suggest that menstrual cycle-related changes have limited functional relevance but may still warrant consideration in future studies investigating individual responses and injury risk.

PMID:41965941 | DOI:10.1002/ejsc.70174

Vet Med Sci. 2026 May;12(3):e70925. doi: 10.1002/vms3.70925.

ABSTRACT

OBJECTIVE: The study aimed to evaluate the effect of a one-shot oral administration of pentoxifylline on semen parameters in normospermic and oligospermic dogs.

METHODS: Twenty-nine dogs were categorized as normospermic or oligospermic based on baseline sperm concentration. After 10 days from the first semen evaluation, each dog received 10 mg/kg of pentoxifylline orally, given 40 min prior to ejaculation. Semen was evaluated using a Computer-Assisted Sperm Analysis (CASA) system and Eosin-Nigrosin staining for vitality.

RESULTS: Compared with baseline, pentoxifylline treatment resulted in a statistically significant increase in sperm concentration and progressive motility (p < 0.01), most notably in oligospermic dogs.

CONCLUSION AND CLINICAL SIGNIFICANCE: These findings highlight the beneficial effects of pentoxifylline and confirm its potential as an adjunct therapy for improving semen quality in subfertile male dogs.

PMID:41965913 | DOI:10.1002/vms3.70925

Sci Rep. 2026 Apr 11. doi: 10.1038/s41598-026-47461-2. Online ahead of print.

ABSTRACT

The correlations between the serum 25(OH)D level with white matter hyperintensities (WMH) and gait disorders were determined in patients with cerebral small vessel disease. Patients with WMH (n = 217) were enrolled, while 52 healthy individuals were designated as the control group. The 217 patients populated the vitamin D deficiency, insufficiency, and sufficiency groups. The 217 patients with WMH were also divided into periventricular white matter hyperintensities (PWMH) and deep white matter hyperintensities (DWMH) groups. The serum 25(OH)D level was negatively correlated with the severity of WMH, especially PWMH (P < 0.05). A significant difference in gait existed among the groups with different 25(OH)D levels and the control group (all P < 0.001). All indicators had statistical significance between the 25(OH)D insufficiency and deficiency groups, between the 25(OH)D sufficiency and deficiency groups, and the control and 25(OH)D deficiency groups. The serum 25(OH)D level was positively correlated with the total SPPB score, the total Tinetti balance and gait analysis (TBGA) score (P < 0.05), but negatively correlated with TUG time (P < 0.05). The combination of WMH severity and the serum 25(OH)D level more effectively indicated the falling risk than a single indicator, with an AUC value of 0.806. Logistic regression analysis showed that 25(OH)D, age, whether a cerebral infarction had occurred, hypertension, and smoking were the significant influencing factors for WMH (P < 0.05); and gender, age, presence of coronary heart disease, total score of WMH, and 25(OH)D had significant impacts on falls (P < 0.05). The serum 25(OH)D level had a negative correlation with WMH, especially PWMH. The serum 25(OH)D level was negatively correlated with gait disorders. The combination of WMH severity and serum 25(OH)D level was more discriminative at identifying low-risk versus high-risk falling groups than relying on a single indicator. 25(OH)D and age were significant influencing factors for WMH, as well as for the falls.

PMID:41965910 | DOI:10.1038/s41598-026-47461-2

Nat Commun. 2026 Apr 11. doi: 10.1038/s41467-026-71725-0. Online ahead of print.

ABSTRACT

Brain functions involve processing in local networks as well as modulation from brainwide signals, such as arousal. Dissecting the contributions of populations of neurons to these functions requires knowledge of interactions between brain areas. We investigated these interactions using dual hemisphere recordings of prefrontal cortex in monkeys performing a spatial memory task. To tease apart global processing from local interactions, we applied a novel statistical approach called pCCA-FA (a combination of probabilistic canonical correlation analysis and factor analysis) to analyze trial-to-trial variability in neuronal activity. We found substantial shared variability among neurons within each population, much of which was actually shared across populations and linked to an arousal process. Our work presents a path by which we can leverage multi-area recordings to reveal aspects of brain functions that are hidden in single-area recordings.

PMID:41965893 | DOI:10.1038/s41467-026-71725-0

Sci Rep. 2026 Apr 11;16(1):12065. doi: 10.1038/s41598-026-44875-w.

ABSTRACT

Neurologists, as specialists in a high-stress field, which hold lots of mental and emotional stressors. The complexity of neurological conditions, the extended working hours, and the emotional burden of managing chronic or terminal patients contributes to a stressful work environment. Globally, studies have shown that healthcare professionals, particularly those in specialties of high demand like neurology, are at risk of depression and burnout. This study aims to assess the prevalence of depressive symptoms among neurologists in Egypt. Help identify the risk factors that contribute to these depressive symptoms. A cross-sectional survey was conducted among Egyptian neurologists working in both public and private healthcare institutions. Participants in the study completed the Patient Health Questionnaire-9 (PHQ-9) to assess the severity of depressive symptoms. Data on demographics, job satisfaction, shift duration, workload and overall job satisfaction were also collected and analyzed using descriptive and inferential statistics. Out of 138 neurologists surveyed, nearly half (43.5%) reported moderate to severe depressive symptoms. Those with a prior diagnosis of depression were especially affected-more than 8 in 10 (82.4%, 95% CI 66.2%-91.7%) reported significant symptoms, compared to just over a third (37.5%, 95% CI 28.8%-47.1%) of those without a known history (p < 0.001). Higher depression scores were also linked to early career stage and longer working hours. Over half of the neurologists with less than three years of experience (53.1%) and those working more than 80 h per week (56.3%) screened positive for moderate to severe depression. These findings highlight a high burden of depressive symptoms among Egyptian neurologists, particularly those early in their careers or with a prior history of depression, emphasizing the urgent need for targeted mental health interventions and systemic workplace reforms.

PMID:41965879 | DOI:10.1038/s41598-026-44875-w

Orphanet J Rare Dis. 2026 Apr 11. doi: 10.1186/s13023-026-04345-y. Online ahead of print.

ABSTRACT

OBJECTIVES: Research focused on clinical differences and long-term prognosis in anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis (anti-MDA5+ DM) patients across age groups remains limited. This study aimed to explore the differences in the clinical manifestations and long-term mortality of anti-MDA5+ DM patients across age groups.

METHODS: We included 318 newly diagnosed anti-MDA5+ DM patients, recruited from June 2018 to January 2024. The median follow-up time was 22.5 months (4.5-36 months). The Cochran-Armitage test for trend (CATT) was employed to assess the statistical significance of changes in the proportion of clinical characteristics across different age groups. Cox regression analysis and a nomogram model were developed to stratify the risk associated with mortality.

RESULTS: In the cohort of 318 patients, 123 (38.7%) were aged < 50 years, 124 (39.0%) were aged 50-59 years, and 71 (22.3%) were aged ≥ 60 years. Clinical manifestations and comorbidities such as cough, Pneumocystis jirovecii pneumonia (PJP), dyspnea, and rapidly progressive interstitial lung disease (RP-ILD) increased with age, while rash and arthralgia decreased. PJP was a major factor in poor prognosis, especially among older patients who were more susceptible to infection. The nomogram, the first prognostic model incorporating both age and PJP infection in anti-MDA5+ DM, demonstrated its independent and combined effects on mortality and enabled early risk stratification, providing a valuable tool for clinical decision-making.

CONCLUSIONS: Clinical manifestations and laboratory parameters varied in anti-MDA5+ DM patients across different age groups. Advanced age and PJP are major factors associated with poor prognosis, with patients aged ≥ 60 years showing the highest mortality and being predominat in the high-risk group.

PMID:41965859 | DOI:10.1186/s13023-026-04345-y

Parasit Vectors. 2026 Apr 11. doi: 10.1186/s13071-026-07356-7. Online ahead of print.

ABSTRACT

BACKGROUND: Toxoplasma gondii, an obligate intracellular parasite with felids as its definitive hosts, undergoes sexual reproduction and oocyst shedding in the feline small intestine, a critical stage for its transmission. Small non-coding RNAs, particularly microRNAs (miRNAs), are crucial post-transcriptional regulators in host-pathogen interactions, but their role in the definitive host’s intestine during T. gondii infection remains unexplored.

METHODS: Fifteen cats were divided into control, primary infection (6, 10, 14 days post-infection, DPI), and secondary infection (SI) groups. Infection was confirmed via B1 gene polymerase chain reaction (PCR). Small RNA sequencing was performed on the ileal epithelium. Bioinformatics analyses identified known and novel miRNAs, differential expression, target genes, and enriched pathways. Key miRNA-messenger RNA (mRNA) interactions were validated by dual-luciferase assay, and sequencing results were confirmed by quantitative PCR (qPCR).

RESULTS: Successful infection was molecularly confirmed. Sequencing identified 2666 miRNAs (2575 known, 91 novel). A dynamic pattern of differentially expressed (DE) miRNAs was observed, with peaks at 6 DPI (126), 10 DPI (122), 14DPI (36) and SI DPI (237), coinciding with active oocyst shedding. Key miRNAs like hsa-miR-199b-5p and ssc-miR-199b-5p were persistently downregulated. Target prediction and network analysis revealed complex interactions, including miR-199b-5p targeting CYTH1 and COQ7. Functional enrichment highlighted significant involvement of target genes in the Rap1 and AMPK signaling pathways, as well as processes related to development and cellular organization. The novel_538-CNN2 interaction was experimentally validated.

CONCLUSIONS: This study provides the first comprehensive profile of miRNA expression in the feline small intestine during T. gondii infection. The temporal dynamics and specific dysregulation of miRNAs, coupled with enrichment in key pathways controlling cell adhesion and metabolism, suggest that T. gondii could orchestrate a sophisticated post-transcriptional program in its definitive host to potentially modify the intestinal environment for successful oocyst production and shedding. These findings lay the groundwork for future functional studies regarding the interplay between T. gondii and its definitive hosts.

PMID:41965856 | DOI:10.1186/s13071-026-07356-7

Transl Psychiatry. 2026 Apr 11. doi: 10.1038/s41398-026-04029-y. Online ahead of print.

ABSTRACT

Breast cancer (BC) is a leading cause of mortality among women. Comorbidity with mood disorders is a condition either disregarded or underdiagnosed in BC patients, but that might ultimately jeopardize health trajectories. This is supported by evidence indicating that the same biological pathways relevant for mood disorders may also underlie tumorigenesis. In this study, we aimed at deriving a reliable biosignature of mental health vulnerability in BC patients. We conducted a cross-sectional study in a population of 44 women diagnosed with BC who underwent surgery before receiving adjuvant chemotherapy. All subjects were scored for symptoms of depression, anxiety and stress; blood samples were used to measure relevant biomarkers of inflammation, energy homeostasis and brain plasticity, while circadian cortisol rhythm was assessed in the saliva. Based on a rigorous statistical approach, we identified a specific immune- metabolic biosignature of depression relying upon each subject’s BMI, IL-5 and leptin. Following the validation of the model, we defined a cut-off value to identify those subjects who are at elevated risk of poor prognosis based on our biosignature. This signature holds potential for the timely identification of those individuals for whom depressive symptoms are sustained by a deranged immune-metabolic milieu and might therefore be at higher risk of poorer health outcomes. Our results strengthen the importance of accounting for brain-body communication in cancer and suggest that routine screening for mental health in BC patients should be prioritized in order to put in place tailored intervention strategies to improve health outcomes.

PMID:41965831 | DOI:10.1038/s41398-026-04029-y