Category: Statistics

Sci Rep. 2026 Apr 28. doi: 10.1038/s41598-026-50614-y. Online ahead of print.

ABSTRACT

Africa bears the highest global burden of HIV/AIDS, with young people disproportionately affected. University students are at increased risk of HIV infection due to campus-related lifestyle factors. HIV self-testing (HIV-ST) represents a promising strategy to enhance HIV diagnosis rates and support progress toward the UNAIDS 95-95-95 targets. This study evaluated the proportion of undergraduate students in Imo State, Nigeria, who underwent HIV counseling and testing (HCT) in the past year. A secondary objective was to assess the effect of health education on HIV-ST uptake among participants. The study employed a cross-sectional design with embedded intervention and included all government-owned universities and polytechnics in Imo State: Federal University of Technology Owerri (FUTO), Imo State University (IMSU), Federal Polytechnic Nekede (FEP), and University of Agriculture and Environmental Sciences (UAES). Simple random sampling and systematic random sampling were used to select the participants. A total of 317, 316, 421 and 359 were sampled from FEP, IMSU, FUTO and UAES respectively. A health education intervention was administered to increase HIV testing uptake; particularly HIV-ST. Data were collected from participants aged 16-25 years between October and December 2025 using an adapted structured questionnaire. Statistical analysis, using the chi-square test, was used to examine associations between participants’ socio-demographic characteristics and HIV testing uptake. Results indicated that HIV testing uptake among participants in the past year was 178 (42.3%) at FUTO, 174 (48.5%) at UAES, 77 (24.4%) at IMSU, and 95 (30%) at FEP. Prior to the health education intervention, none of the students had previously used HIV-ST. Following the health education intervention, HIV-ST uptake increased to 53 (29.8%), 48 (27.6%), 30 (38.9%), and 34 (35.8%) at FUTO, UAES, IMSU, and FEP, respectively. The overall HIV testing uptake and HIV-ST of the participants was 37.1%, and 11.7% respectively. Statistical analysis revealed that marital status and gender influenced HIV testing uptake, with married participants and females more likely to be tested. HIV testing uptake among undergraduates in Imo State remains low, with all institutions reporting rates below 50%, which is significantly lower than the UNAIDS 95% target. This raises concerns about Nigeria’s ability to achieve the UNAIDS 2030 target. Health education was shown to be an effective strategy for increasing HIV-ST among the participants. It is recommended that health education be integrated into national strategies to enhance HIV testing uptake, with particular attention to young adults, especially males, in the design and implementation of voluntary counseling and testing services.

PMID:42050333 | DOI:10.1038/s41598-026-50614-y

J Clin Sleep Med. 2025 Jun;21(6):1007-1021. doi: 10.5664/jcsm.11610. Epub 2025 Jun 1.

ABSTRACT

STUDY OBJECTIVES: We aimed to describe the feasibility, acceptability, and preliminary efficacy of a pilot randomized controlled trial of a sleep health intervention (SLEEPSMART) for children with juvenile idiopathic arthritis and their parents.

METHODS: Fifty children, 8-13 years of age, with juvenile idiopathic arthritis and sleep deficiency and their parents participated in the study. Participants were randomized to either the SLEEPSMART intervention or the control group (usual care). The SLEEPSMART intervention lasted 7 weeks and included weekly educational modules, quizzes, assignments, goal setting, and an online sleep coach. Children wore actigraphy and completed sleep diaries and surveys at baseline, immediately postintervention, and 1 month postintervention. Feasibility was measured by the percentage of eligible, enrolled, and retained child-parent dyads; engagement was measured when dyads completed the modules; and usefulness and acceptability were measured with the Treatment Evaluation Inventory and qualitative exit interviews.

RESULTS: Of the 50 child-parent dyads enrolled, 88% completed the baseline assessment. Seventy-five percent of children and 89% of parents reported high acceptance; 89% of parents and 80% of children recommend SLEEPSMART. Compared to children in the control group, those who received the SLEEPSMART intervention had significant improvements in actigraphy total sleep time and sleep efficiency and Patient-Reported Outcomes Measurement Information System sleep disturbance scores immediately postintervention and at 1-month follow-up and in their dysfunctional beliefs and attitudes about sleep and sleep efficacy scores 1 month postintervention. Parents in the SLEEPSMART group had significant improvements in the Patient-Reported Outcomes Measurement Information System sleep-related impairment and dysfunctional beliefs and attitudes about sleep scores immediately postintervention and at 1-month follow-up and in their self-efficacy scores 1 month postintervention in comparison to parents in the control group.

CONCLUSIONS: SLEEPSMART was feasible, acceptable, and improved objective and self-report sleep and self-efficacy outcomes in children with juvenile idiopathic arthritis and their parents.

CLINICAL TRIAL REGISTRATION: Registry: ClinicalTrials.gov; Name: Sleep Shared-Management Intervention for Children with Juvenile Idiopathic Arthritis; URL: https://clinicaltrials.gov/study/NCT04066205 ; Identifier: NCT04066205 CITATION: Zhai S, Palermo TM, Shenoi S, et al. A shared-management web-based intervention for sleep deficiency in school-age children with juvenile idiopathic arthritis and their parents: feasibility and acceptability study. J Clin Sleep Med. 2025;21(6):1007-1021.

PMID:42050319 | DOI:10.5664/jcsm.11610

Intern Emerg Med. 2026 Apr 28. doi: 10.1007/s11739-026-04360-8. Online ahead of print.

ABSTRACT

Patients with celiac disease have lower bone mineral density (BMD) and higher incidence of fractures compared to age- and sex-matched controls. There are no studies of denosumab, an antiresorptive drug, which is a fully human monoclonal antibody that binds the receptor activator of NFκB ligand (RANKL) in celiac patients with osteoporosis. The aim is to study the long-term effect of denosumab on BMD in celiac patients with osteoporosis on a gluten-free diet (GFD), compared to non-celiac osteoporotic patients. Fifteen celiac patients with osteoporosis and control subjects of the same age, sex, BMI, and fragility fractures were enrolled. At baseline, each patient underwent biochemical tests, spine X-ray, and DXA measurements, and the Charlson Comorbidity Index (CCI) was computed. At each visit (every 2 years ± 6 months), with a follow-up of 4 years, any adverse events or new clinical fractures, DXA measurements, and CCI were recorded. In celiac patients, a statistically significant median delta increase in total hip T-score of 0.11 compared to baseline was observed (ANOVA p< 0.05), while in the control group, it was 0.07 (ANOVA p < 0.05), with no difference between groups. New fractures occurred in the celiac group in five patients during the follow-up, and in two patients in the control group (p = 0.38). No adverse events occurred during follow-up. In celiac patients with osteoporosis on GFD, denosumab, with up to 4 years of follow-up, increased hip BMD without adverse events.

PMID:42050298 | DOI:10.1007/s11739-026-04360-8

Eur Radiol. 2026 Apr 28. doi: 10.1007/s00330-026-12591-8. Online ahead of print.

NO ABSTRACT

PMID:42050295 | DOI:10.1007/s00330-026-12591-8

Eur Radiol. 2026 Apr 28. doi: 10.1007/s00330-026-12559-8. Online ahead of print.

ABSTRACT

OBJECTIVES: CT-derived assessment of regional ventilation is possible with paired inspiration and expiration scans. Normative reference values for CT-derived ventilation remain undefined. The aim of this study is to establish reference values for pulmonary ventilation using CT, with pulmonary function tests (PFTs) as the clinical standard.

MATERIALS AND METHODS: In this prospective, single-center study (December 2022-April 2024), 103 healthy adults underwent spirometry-guided inspiratory and expiratory CT. Lobes were segmented automatically using TotalSegmentator. Voxel-wise ventilation was quantified as the relative air volume change between inspiration and expiration via nonlinear registration, normalized to inspiratory lung volume. CT-derived lung volumes were compared with PFT-derived total lung capacity (TLC), residual volume (RV), and vital capacity (VC). Reference intervals were reported as mean ± standard deviation and 5th-95th percentiles. Multivariable analyses assessed the effects of sex, age, height, lung region, and gravitational orientation.

RESULTS: Ninety-one participants (mean age, 53 ± 12 years; 49 men) were included. Mean ventilation was 59.5% ± 8.5% (5th-95th percentile, 42.1-72.5%). CT-derived volumes were systematically lower than PFT values but strongly correlated: CT-TLC (-13.8%, r = 0.89), CT-RV (-2.5%, r = 0.80), and CT-VC (-20.8%, r = 0.82). Ventilation decreased with age (p < 0.001) and increased with height (p < 0.05). Regionally, ventilation was higher in the lower lobes (p < 0.003) and posterior regions (p < 0.001).

CONCLUSION: CT-derived ventilation correlates strongly with PFT-indices but yields lower absolute values. Demographic and anatomical factors significantly influence ventilation distribution. These normative data provide a reference framework for clinical functional lung assessment.

KEY POINTS: Question Can normative reference values for CT-derived regional lung ventilation be established, and how do these metrics relate to pulmonary function tests and anatomical/demographic factors? Findings Mean CT-derived ventilation was 59.5% ± 8.5% with strong pulmonary function test correlations. Ventilation exhibited significant regional heterogeneity and systemic variations by anatomical location, age, and sex. Clinical relevance Normative reference values enable objective classification of CT-derived ventilation, standardizing interpretation and reducing subjectivity. They facilitate earlier detection of regional dysfunction, quantitative phenotyping, risk stratification, longitudinal monitoring, and comparability with pulmonary function testing and other imaging.

PMID:42050294 | DOI:10.1007/s00330-026-12559-8

Eur Radiol. 2026 Apr 28. doi: 10.1007/s00330-026-12553-0. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess whether multi-echo T2* MRI can differentiate neonatal hemochromatosis (NH) from other causes of neonatal liver failure (NLF) by evaluating siderosis in the liver and extrahepatic organs.

MATERIALS AND METHODS: This retrospective study evaluated 26 infants ≤ 20 weeks of age, who underwent MRI with Gradient-Recalled (GRE) multi-echo T2* sequence for liver failure. Two radiologists noted the degree of siderosis in the liver, pancreas, thyroid, spleen and renal cortex using a semiquantitative scale. Kendall’s tau was used to assess the correlation between siderosis grades and final diagnosis. Consensus review by hepatologist, neonatologist, and pathologist using integrated clinical, biochemical, imaging and histopathologic data served as the reference standard for the final diagnosis.

RESULTS: Of 26 patients, 7 had NH and 19 had other causes of NLF. Interobserver agreement was highest for liver (κ = 0.97), followed by kidney (κ = 0.87), spleen (κ = 0.84), thyroid (κ = 0.80), and pancreas (κ = 0.73). Significant positive correlations between siderosis grades and NH diagnosis were found for thyroid (Kendall’s tau = 0.70, p < 0.01), pancreas (Kendall’s tau = 0.67, p < 0.01), and liver (Kendall’s tau = 0.42, p = 0.03), while spleen showed a significant negative correlation (Kendall’s tau = -0.51, p < 0.01). MRI demonstrated 100% sensitivity, 89.5% specificity, 77.8% positive predictive value, 100% negative predictive value, and 92.3% overall accuracy for NH diagnosis. There were significant differences among groups in R2* values for the pancreas, thyroid and spleen, with no differences in the liver.

CONCLUSION: Multi-echo T2* MRI reliably distinguishes NH from other causes of NLF by revealing significant siderosis in the thyroid and pancreas, with relative sparing of the spleen.

KEY POINTS: Question Neonatal hemochromatosis (NH) is a rare but often fatal condition causing neonatal liver failure (NLF), and differentiating it from other causes of NLF is challenging. Finding Pancreatic and thyroid iron deposition, as seen on MRI, strongly correlated with NH, and splenic iron deposition correlated inversely with NH. Clinical relevance Multi-echo T2* MRI is a highly accurate, non-invasive technique for early differentiation of neonatal hemochromatosis from other liver failure causes, potentially enabling earlier diagnosis of NH and guiding crucial management decisions in affected neonates.

PMID:42050293 | DOI:10.1007/s00330-026-12553-0

Obes Surg. 2026 Apr 28. doi: 10.1007/s11695-026-08701-6. Online ahead of print.

ABSTRACT

BACKGROUND: Endoscopic sleeve gastroplasty (ESG) is an established endoscopic bariatric therapy. Two main platforms are currently used in clinical practice: the OverStitch Endoscopic Suturing System (OESS) and the triangulation Endomina System (ES). Comparative data regarding their technical performance and suture durability remain limited. This experimental study aimed to compare both systems in terms of usability, safety, and durability of full-thickness sutures.

METHODS: In this prospective comparative animal study, six adult minipigs were randomized to ESG using either OESS or ES (three animals per group; five sutures per animal). Primary outcomes included ease of use, tissue apposition (TA) tightness assessed at index procedure, day 15 endoscopy, and day 30 necropsy, as well as histological evaluation of serosal fusion and bite size.

RESULTS: All procedures were successfully completed without intra-procedural adverse events. Overall ease-of-use scores were higher with ES compared to OESS (median 6 vs 5; p=0.047). Immediate post-procedural TA scores were similar between groups (both tight; p=1). However, at day 15, ES demonstrated significantly higher TA scores than OESS (OR=29.1; 95% CI 4.3-200.3; p=0.026). At day 30 necropsy, TA remained significantly tighter with ES (OR=199.9; 95% CI 2.5-16245; p=0.029). No leaks or abscesses were observed. Histologically, serosal fusion was observed only in the ES group, although differences did not reach statistical significance.

CONCLUSION: Both ESG platforms were safe and feasible in this animal model. While immediate suture performance was comparable, the Endomina System demonstrated superior mid-term durability and tighter tissue apposition compared with OverStitch. The clinical relevance of these findings warrants further investigation.

PMID:42050283 | DOI:10.1007/s11695-026-08701-6

Heart Vessels. 2026 Apr 29. doi: 10.1007/s00380-026-02700-4. Online ahead of print.

NO ABSTRACT

PMID:42050278 | DOI:10.1007/s00380-026-02700-4

Environ Monit Assess. 2026 Apr 28;198(5):516. doi: 10.1007/s10661-026-15378-y.

ABSTRACT

Can Gio District in southern Vietnam, including the Can Gio Biosphere Reserve and the urbanized beaches of Can Thanh Town, is a rapidly developing coastal area facing increasing pressures from marine plastic pollution. This study compared beach litter monitoring using 1 m × 1 m quadrats with in situ collection against smartphone imagery captured via the Mergin Maps app and later annotated in DotDotGoose. Mergin Maps was selected because it provides an open‑source, smartphone‑based GIS platform for rapid, low‑cost capture of georeferenced quadrat images, which is more feasible for routine monitoring in resource‑limited coastal settings than drone surveys or fully manual transect methods. Across four sandy beaches, at Bui Lam Beach field surveys recorded 399 items, while image-based analysis detected 410 items; at Bui Lam-Tac Xuat Beach, field surveys recorded 212 items, compared with 236 from image-based analysis, indicating strong tidal influence and clam farming activities at these sites. At Can Thanh Park, 189 items were counted in the field compared with 149 items in images, whereas at Tac Xuat, a tourist beach with regular cleanups, 82 and 71 items were recorded by field and image-based methods, respectively. Overall litter densities exceeded 10 items m⁻2 for both methods, and plastics accounted for more than 96% of all items, with foam and fragmented single-use products dominating. Although a relatively high error percentage was observed between the two monitoring methods (mean 43.15% ± 32.81%, ranging from 0 to 116.67% across quadrats), this was mainly due to under-detection of items that were partially buried, obscured by vegetation, or mixed with organic matter during image-based classification. Despite this limitation, statistical analysis revealed no significant difference between image-based classification and field data regarding litter count (p > 0.05). Mergin Maps provides a rapid assessment tool for monitoring marine litter, with statistically equivalent results to field sampling and approximately 2.5-3 times faster field data collection than conventional quadrat sampling.

PMID:42050267 | DOI:10.1007/s10661-026-15378-y

Rheumatol Ther. 2026 Apr 28. doi: 10.1007/s40744-026-00857-y. Online ahead of print.

ABSTRACT

INTRODUCTION: Despite the European Alliance of Associations for Rheumatology (EULAR) recommendation to minimize glucocorticoid (GC) use in systemic lupus erythematosus (SLE), prospective data quantifying toxicity across low-dose ranges are lacking. This study aimed to assess toxicity using the GC toxicity index (GTI) in SLE patients and compare toxicity profiles among dose-defined subgroups.

METHODS: Patients from the STAR cohort (May 2023-May 2024) were prospectively followed up for 1 year. Stratified by average daily prednisone (PDN) dose, toxicity was assessed using GTI comprising the aggregate improvement score (AIS) and the cumulative worsening score (CWS) at baseline and 1 year. Three pre-planned stepwise comparisons used dose thresholds of 7.5 mg, 5 mg, and 2.5 mg, with a Bonferroni-corrected significance level of P < 0.0167 (α = 0.05/3). Quantile regression evaluated the association between average daily PDN dose and CWS/AIS.

RESULTS: Of 302 patients, the PDN ≤ 7.5 mg/day group (n = 223) showed statistically lower median CWS [0 (IQR 0-19) vs. 48 (IQR 19-84), P < 0.001] and AIS [0 (IQR – 19-10) vs. 40 (IQR 9-74), P < 0.001] compared to the PDN > 7.5 mg/day group (n = 79). Within the low-dose group, patients with 5 < PDN ≤ 7.5 mg/day (n = 52) exhibited higher median CWS [10.5 (IQR 0-29) vs. 0 (IQR 0-19), P = 0.002] and wider AIS interquartile range [0 (IQR – 18.75-29) vs. 0 (IQR – 20-0), P = 0.010] than the PDN ≤ 5 mg/day subgroup (n = 171). No significant differences in CWS or AIS were observed between the PDN ≤ 2.5 mg/day (n = 90) and 2.5 < PDN ≤ 5 mg/day (n = 81) subgroups. Quantile regression indicated that each 1 mg/day increase in PDN dose raised median CWS by 3.33 points and median AIS by 3.42 points.

CONCLUSIONS: To our knowledge, this study provided the first prospective and quantitative evidence using the GTI to demonstrate that PDN dose reduction to ≤ 5 mg/day was linked to reduced toxicity. Moreover, we found that no dose was entirely safe, which strongly supported the EULAR strategy of rigorous GC minimization.

PMID:42050254 | DOI:10.1007/s40744-026-00857-y