Category: Statistics

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

Sci Rep. 2026 Apr 11. doi: 10.1038/s41598-026-47567-7. Online ahead of print.

ABSTRACT

Plastic pollution, resulting from the persistence of conventional polymers, remains a critical environmental challenge that necessitates the development of biodegradable alternatives. Polyhydroxyalkanoates (PHAs) represent an attractive solution, being naturally synthesized by microorganisms under nutrient-limited conditions. This study investigates the production of PHAs using lignocellulosic wood waste, specifically sal and teak residues, as an economical carbon source. Fermentable sugars were obtained via dilute sulfuric acid hydrolysis (10% w/v biomass with 4% v/v H₂SO₄), incubated at 120 °C for 1 h, and filtered to yield a hydrolysate containing approximately ~ 36 mg/mL total reducing sugars (DNS assay). The hydrolysate served as the carbon source in bioprocess optimization (optimal carbon concentration: 2.50%, equivalent to 25 g/L). Potential PHA-producing isolates were screened using Nile Blue and Sudan Black staining. The most efficient producer, Klebsiella pneumoniae strain DSM 30,104 (MK2023), confirmed through 16 S rRNA sequencing, demonstrated notable PHA accumulation. Process parameters-including carbon and nitrogen concentrations and Temperature-were optimized through Plackett-Burman Design (PBD) followed by Response Surface Methodology (RSM) using a face-centered central composite design. Optimal production was achieved at 2.50% carbon, 0.105% nitrogen, and 34 °C, yielding 5.7 mg/mL PHA after 72 h with 10% (v/v) inoculum. UV-Vis and FTIR analyses confirmed the polymer’s identity as polyhydroxybutyrate (PHB). The study highlights wood waste as a viable, low-cost substrate for PHA synthesis, promoting sustainable biopolymer production while advancing circular bioeconomy practices.

PMID:41965809 | DOI:10.1038/s41598-026-47567-7

Malar J. 2026 Apr 11. doi: 10.1186/s12936-026-05884-2. Online ahead of print.

ABSTRACT

BACKGROUND: In the Greater Mekong Subregion, militaries constitute a critical but often underserved malaria transmission reservoir, given their high mobility, deployment to endemic areas, and frequent exposure to vectors. In Thailand, the Royal Thai Army (RTA) is a key risk population, yet their malaria practices, perceptions, and the scale and scope of coordination with the Ministry of Public Health (MoPH) are not well understood. A joint military-civilian research team conducted a rapid formative assessment in Sisaket Province, a persistent transmission hotspot, to characterize the unique RTA risk profile and identify opportunities to strengthen RTA-MoPH coordination on malaria elimination efforts.

METHODS: Using a mixed-methods design, the research team conducted a five-year (2016-2020) retrospective analysis of Sisaket’s malaria case and program response data, alongside 16 focus group discussions (FGDs) and 17 key informant interviews (KIIs) with RTA and MoPH respondents across all military ranks and health system levels in the province’s three highest-burden districts (Kantharalak, Khun Han, Phu Sing). Qualitative data were collected between December 2021-January 2022 and thematically analyzed using an inductive content analysis approach. Quantitative data were descriptively analyzed using statistical methods to characterize the RTA malaria risk profile and identify and compare recent trends in program response between military and non-military populations in Sisaket Province.

RESULTS: 432 military malaria cases were reported in Sisaket between 2016 and 2020, accounting for 18% of the province’s total 2425 cases (with the proportion ranging from 14 to 30% annually). All military malaria cases were male, with a median age of 28 years. 96% of military cases were diagnosed and treated at MoPH facilities, with 41% of cases classified as indigenous and 40% as imported from abroad. Qualitative data were collected from a total of 116 respondents (72 RTA, 44 MoPH) through 16 FGDs and 17 KIIs. Malaria prevention and treatment practices and perceptions among soldiers were largely consistent across the three study districts. RTA-MoPH coordination occurred at all levels through both formal and informal channels and was reported to be improving and expanding by some respondents. Though several areas could benefit from increased collaboration: patient follow-up, border control efforts, vector control, and further capacitation of military medics. The RTA and MoPH both expressed strong interest in strengthening military-civilian coordination; though to better enable this, several identified challenges may need to be addressed, including restricted MoPH access to military sites, lack of continuity in relationships due to frequent RTA rotations, communication constraints, and broader differences in military versus civilian operating procedures.

CONCLUSION: Strengthening RTA-MoPH coordination towards successfully interrupting malaria transmission in Thailand may require formalizing and standardizing some joint operating procedures, increasing communication and military-civilian touchpoints, and further capacitating the RTA to carry out malaria prevention, diagnosis and treatment, and patient follow-up activities. For Thailand to achieve its goal of nationwide malaria elimination, it is crucial that the RTA as a high-risk population be fully engaged in the country’s malaria control and response efforts.

PMID:41965802 | DOI:10.1186/s12936-026-05884-2

Trials. 2026 Apr 11. doi: 10.1186/s13063-026-09706-3. Online ahead of print.

ABSTRACT

BACKGROUND: Randomised implementation trials evaluate the effects of implementation strategies on implementation outcomes and may also monitor clinical effectiveness. Routine healthcare data are used in implementation trials for participant identification, intervention delivery, and/or outcome ascertainment. Trial efficiency (scientific, operational, statistical, and economic) is operationalised across trial design, processes, superstructure, infrastructure, and stakeholder engagement (the Trial Efficiency Pentagon). Despite frequent usage, the contribution of routine data to implementation trial efficiency remains underexplored. We aimed to investigate how the use of routine healthcare data affects trial efficiency in two implementation trials.

METHODS: We conducted a qualitative comparative case study of two implementation trials, one UK-based and one US-based. Participants were purposively sampled from trial teams involved in the use and management of routine healthcare data. Data were collected through semi-structured interviews, document analysis, and feedback workshops. Framework analysis guided by the Trial Efficiency Pentagon was used to analyse the data, and data flow diagrams were developed to visualise routine data pathways within each trial.

RESULTS: The two trials (DIGITS and IMP²ART) used routine data to characterise the practice population of eligible patients, support clinical and economic outcome evaluation, facilitate audit and feedback, and assist in intervention delivery. Common facilitators that supported the use of routine data included sufficient IT and hardware capacity, relatively low cost, centralised regulatory approval for multi-site studies, and strong collaboration and partnerships. Common barriers included administrative complexity, redundant bureaucratic processes, and challenges with data sharing requirements. Key differences included the DIGITS trial’s in-house data warehouses within an integrated healthcare system ensured high data quality and enabled preliminary analyses. In contrast, the IMP²ART trial, managing a larger national sample, employed an external research database to integrate data from various EHR systems but faced challenges such as legacy systems, diverse coding practices and site-specific approvals. Data quality can act as either a facilitator or a barrier.

CONCLUSIONS: Routine data has an impact on implementation trial efficiency across trial design, processes, superstructure, infrastructure, and stakeholder engagement. To improve trial efficiency in public healthcare systems, researchers must address technological and regulatory barriers to accessing data. In private healthcare systems, data use and access hinges on investing in robust IT infrastructure and ensuring comprehensive organisational commitment.

TRIAL REGISTRATION: IMP²ART trial registration: ISRCTN15448074; DIGITS trial Clinicaltrials.gov Identifier: NCT05160233.

PMID:41965800 | DOI:10.1186/s13063-026-09706-3

Spinal Cord. 2026 Apr 11. doi: 10.1038/s41393-026-01196-z. Online ahead of print.

ABSTRACT

STUDY DESIGN: Single-center observational study.

OBJECTIVES: To perform the translation, cross-cultural adaptation, and analysis of the measurement properties of the Spanish version of the Spinal Cord Injury Pain Instrument (SCIPI) for the screening of neuropathic pain (NP) in spinal cord injury (SCI).

SETTING: Hospital, Spain.

METHODS: Participants with SCI and pain were included for the pre-final version (n = 10) and the final version (n = 136). Translation and cross-cultural adaptation of the SCIPI were performed by native speakers in both languages. The statistical analysis included internal consistency, validity, test-retest reliability, and diagnostic accuracy.

RESULTS: All the items of the pre-final version of the SCIPI were understood. Moderate test-retest reliability (intraclass correlation coefficient (ICC) = 0.78, 95% confidence interval (CI), 0.69 to 0.84, p < 0.001) and CR coefficient of internal consistency of 0.484 were found. Strong correlations between the SCIPI and the Douleur Neuropathique 4 (DN4) were revealed (rho = 0.619, p < 0.001). The best cutoff value was 2 points, with an outstanding discriminant ability according to the area under the curve (AUC) value (AUC = 0.937) associated with high sensitivity (91.13%) and specificity (91.67%).

CONCLUSIONS: The Spanish version of the SCIPI may be a reliable and valid tool, with an excellent discriminant ability, for the screening of NP in people with SCI.

PMID:41965781 | DOI:10.1038/s41393-026-01196-z

Sci Rep. 2026 Apr 11. doi: 10.1038/s41598-026-44827-4. Online ahead of print.

ABSTRACT

Glyphosate is the most extensively applied systemic herbicide worldwide, yet its safety remains under scrutiny, with ongoing investigations into potential carcinogenicity. Epidemiological studies associate chronic glyphosate exposure with elevated risks of non-Hodgkin lymphoma and possible endocrine disruption, emphasizing the need for sensitive detection methods. Here, we report a handheld enzymatic biosensor, GlyphoSense Chip, for direct, rapid detection of underivatized glyphosate in drinking water. The device integrates a photodiode-based CMOS chip with an engineered glyphosate N-acetyltransferase and a colorimetric reaction, achieving a sensitivity of 38 µV·mL µg^-1·s^-1 and quantification within one minute. Biosensor response was linear over 0.016-12.5 µg mL^-1 (R² = 0.993) with a detection limit of 0.028 µg mL^-1. Recovery analysis in fortified tap water yielded relative standard errors of 1.2-5.8%, and results were statistically indistinguishable from quantitative mass spectrometry (p > 0.05). This work establishes a robust, field-deployable platform for glyphosate monitoring in water resource safety applications.

PMID:41965777 | DOI:10.1038/s41598-026-44827-4