Category: Statistics

Eur J Public Health. 2026 Mar 14;36(2):ckag050. doi: 10.1093/eurpub/ckag050.

ABSTRACT

Socioeconomic disadvantage is associated with severe maternal morbidity (SMM), across high-income countries. However, neighbourhood-level measures of disadvantage, often used in population-based studies, may underestimate the effect of individual socioeconomic disadvantage. This study aimed to compare the strength of the associations between individual- and neighbourhood-level measures of socioeconomic disadvantage and SMM risk in a high-income country. We conducted a nationwide, population-based cohort study using the Dutch Data InfrAstructure for ParEnts and childRen (DIAPER). The cohort consisted of 832 866 women who gave birth in the Netherlands between 1 January 2012, and 31 December 2021. Multilevel multivariable Poisson regression was used to calculate adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) for individual and neighbourhood-level measures of socioeconomic disadvantage. The role of pre-existing physical and mental health conditions in this association was examined using causal mediation analysis. Individual-level measures of socioeconomic disadvantage showed the strongest association with SMM, with the largest risk ratio of SMM between women with individual low educational attainment compared to those with high educational attainment (aRR 1.41, 95% CI 1.33-1.50), whereas the aRR for low compared to high neighbourhood education was 1.21 (95% CI 1.14-1.28). Physical health conditions mediated between 11% and 29% of the association with SMM across the different measures of disadvantage. Individual measures of socioeconomic position are more strongly associated with SMM than neighbourhood-level measures and pre-existing physical health conditions are important factors in this association. Future research should recognize the potential underestimation of risk when using neighbourhood-level disadvantage as a proxy for individual disadvantage.

PMID:41954921 | DOI:10.1093/eurpub/ckag050

Eur J Public Health. 2026 Mar 14;36(2):ckag057. doi: 10.1093/eurpub/ckag057.

ABSTRACT

The spouses of women with gestational diabetes mellitus (GDM) seem to be at risk of developing type 2 diabetes and cardiovascular diseases (CVDs). We comparatively analysed the risk factors, lifestyle, socioeconomic factors, and health of the spouses of women with (cases, n = 599) and without (controls, n = 586) GDM. This cross-sectional study utilized data from the Finnish Gestational Diabetes study. Data of the spouses were collected using a structured questionnaire: socioeconomic factors, smoking, alcohol consumption, health, own perinatal health, and family history of diabetes and CVDs. Age-adjusted odds ratios (aORs) were analysed using multivariate logistic regression. The mean ages of the cases and the controls were 33.5 years and 31.2 years, respectively [mean difference: 2.4 years, 95% confidence interval (CI): 1.68-3.02]. The mean body mass index of the cases (26.9 kg/m2) was 0.78 kg/m2 (95% CI: 0.34-1.21) higher than that of the controls. Fewer cases attained the highest educational level (13.5% vs. 16.9%, aOR 0.64, 95% CI: 0.46-0.90). The cases reported more often alcohol consumption (85.4% vs. 78.7%, aOR 1.59, 95% CI: 1.16-2.17); chronic disease, impairment, or disability (17.4% vs. 12.6%, aOR 1.43, 95% CI: 1.03-2.00); or mental disorder (8.0% vs. 5.1%, aOR 1.63, 95% CI: 1.01-2.64). The cases reported more risk factors for adverse health outcomes, more chronic diseases and mental disorders than the controls. Therefore, lifestyle counselling should also be provided to the spouses of women with GDM.

PMID:41954919 | DOI:10.1093/eurpub/ckag057

JAMA Otolaryngol Head Neck Surg. 2026 Apr 9. doi: 10.1001/jamaoto.2026.0284. Online ahead of print.

ABSTRACT

IMPORTANCE: Morbidity after traditional extracapsular tonsillectomy (ECTE) is high in adolescents and adults. Alternatively, intracapsular tonsillectomy (ICTE) may have a similar efficacy and reduce postoperative morbidity.

OBJECTIVE: To investigate the recovery time and morbidity after ICTE compared to ECTE in 16- to 65-year-olds with recurrent or chronic tonsillitis.

DESIGN, SETTING, AND PARTICIPANTS: The FINITE randomized, patient-blinded, 3-arm clinical trial compared ECTE, intracapsular coblation tonsillectomy (ICTEc), and intracapsular microdebrider tonsillectomy (ICTEm) in the treatment of patients aged 16 to 65 years with recurrent and chronic tonsillitis. The trial was conducted from September 2019 to January 2023 with a 1-month follow-up. The study was conducted at 1 secondary and 1 tertiary hospital in Finland. The data were analyzed between January 2023 and January 2025.

INTERVENTIONS: The ECTE vs ICTEc vs ICTEm ratio was 1:1:1.

MAIN OUTCOMES AND MEASURES: The main outcome was postoperative recovery time. The clinically significant difference between groups in recovery time was predefined to be 3 days favoring the ICTE groups.

RESULTS: A total of 366 patients, aged 16 to 65 years who were diagnosed with recurrent or chronic tonsillitis and scheduled for tonsillectomy, were eligible for inclusion in the FINITE study. After exclusions, 179 patients were randomized (mean [SD] age, 26.7 [8.8] years; 39 [22%] male and 138 [78%] female), and 161 patients (94%) completed the 1-month follow-up. The mean (SD) postoperative recovery time was similar in the 3 groups: 12.1 (4.7) days in the ECTE group, 11.1 (4.6) days in the ICTEc group, and 10.3 (4.6) days in the ICTEm group. In the secondary outcome analysis, swallowing pain intensity was lower in the ICTEc and ICTEm group compared to the ECTE group during postoperative days 1 to 10 and 12, and days 2 to 12, respectively. Daily activity impairment due to pain interference resolved faster in the ICTE groups.

CONCLUSIONS AND RELEVANCE: In patients aged 16 to 65 years with recurrent or chronic tonsillitis who participated in this randomized clinical trial, recovery times of ICTE and ECTE did not differ to statistical significance. ICTE resulted in a lower pain intensity and faster resolution of pain interference compared to ECTE.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03654742.

PMID:41954901 | DOI:10.1001/jamaoto.2026.0284

Spine (Phila Pa 1976). 2026 Apr 9. doi: 10.1097/BRS.0000000000005688. Online ahead of print.

ABSTRACT

STUDY DESIGN: Prospective observational multicenter cohort study.

OBJECTIVE: To evaluate and compare functional outcomes, as measured by AO Spine Patient Reported Outcome Spine Trauma (PROST), in neurologically intact patients with thoracolumbar (TL) burst fractures treated operatively or nonoperatively.

SUMMARY OF BACKGROUND DATA: The optimal management of these patients remains debated.

METHODS: This investigation was part of a prospective observational international multicenter cohort study. Neurologically intact adults (18-65 y) with acute (≤10 d) TL burst fractures were included from various sites across the world. Provided treatment was determined by the local standard of care. PROST was administered at multiple prospective timepoints from baseline up to 2-years post-injury. Descriptive statistics were used to analyze patient and clinical characteristics. Multivariable mixed models for repeated measures were used to assess differences in treatment groups and between the fracture types.

RESULTS: A total of 93 patients were included (mean age 41 y, 57% male). Most sustained high-energy trauma (73.1%) and had type A3 fractures (63.4%), with 61.3% treated nonoperatively. Both nonsurgical (34.2 to 86.0) and surgical (39.9 to 85.6), as well as fracture types (A4: 38.4 to 85.6; A3: 36.4 to 87.3) demonstrated significant improvements in PROST scores over time (P<0.001). No statistically significant differences in PROST scores were found between treatment groups or fracture types. Although, surgically treated patients showed higher PROST scores within the first 3 months, and nonsurgical patients had marginally higher scores hereafter, these differences were not statistically significant and converged by 2 years.

CONCLUSION: Both surgical and nonsurgical treatment of neurologically intact TL burst fracture patients resulted in comparable long-term functional outcomes as measured by AO Spine PROST. A descriptive trend was observed with surgically treated patients showing higher mean PROST scores up to 3 months post-treatment, however, between-group differences were not statistically significant and equalized by two years.

PMID:41954890 | DOI:10.1097/BRS.0000000000005688

Genes Genomics. 2026 Apr 9. doi: 10.1007/s13258-026-01749-9. Online ahead of print.

NO ABSTRACT

PMID:41954879 | DOI:10.1007/s13258-026-01749-9

Odontology. 2026 Apr 9. doi: 10.1007/s10266-026-01366-8. Online ahead of print.

ABSTRACT

Remineralization of early carious lesions can prevent their progression to cavitated stages. While cow milk and artificial saliva have demonstrated good remineralization potentials, the effects of goat milk remain unexplored. This study aimed to compare the remineralization capabilities of goat milk, cow milk, and artificial saliva on demineralized enamel surfaces. The tooth specimens were demineralized using citric acid, then split into three groups, each subjected to either artificial saliva, cow milk, or goat milk for remineralization. Surface roughness was measured using a Mitutoyo Surftest (SJ-210 Series), while microhardness was measured by the standard Vickers hardness method using a Wilson hardness tester, before any intervention, after demineralization, and after remineralization. Additionally, scanning electron microscopic (SEM) examination was performed at baseline, following demineralization, and remineralization. The groups did not significantly differ from one another in roughness and microhardness at baseline and following demineralization. However, following remineralization, there was a statistically significant difference between goat milk and both artificial saliva and cow milk groups, where goat milk revealed the least roughness and the highest microhardness. No significant distinctions were found between the artificial saliva and cow milk groups. A strong negative correlation between roughness and microhardness was established across all three groups. SEM confirmed goat milk to have a comparable surface morphology with the other two groups, showing a homogenous surface with few irregularities. In conclusion, goat milk demonstrated a promising remineralization potential compared to artificial saliva and cow milk. This study emphasizes the value of goat milk as a natural alternative to remineralizing agents, offering a simple yet effective strategy to prevent early carious lesions and combat demineralization.

PMID:41954844 | DOI:10.1007/s10266-026-01366-8

Environ Monit Assess. 2026 Apr 9;198(5):426. doi: 10.1007/s10661-026-15220-5.

ABSTRACT

Methane (CH₄), a Kyoto Protocol-regulated greenhouse gas produced by multiple pathways, remains challenging to characterize regionally due to spatiotemporal limitations of current measurements. In this study, we present a regional-scale CH₄ modeling framework using the GEOS-Chem atmospheric chemistry-transport model over South Korea and evaluate the model performance with ground and aircraft observations. Model performance was evaluated using monthly mean CH₄ concentrations observed at three ground-based monitoring sites (Anmyeondo, Gosan, and Ulleungdo) by the Korea Meteorological Administration (KMA) from 2017 to 2022. The nested regional-scale modeling was conducted at a horizontal resolution of 0.25°×0.3125° using boundary conditions from coarser 2°×2.5° global simulations driven by Modern-Era Retrospective analysis for Research and Applications, Version 2 (MERRA-2) meteorological fields. The model showed good agreement with surface observations, with a root mean square error (RMSE) of 19.63 ppb (0.99% of the mean CH₄) and a correlation coefficient (r) of 0.84. Validation against vertical profiles showed a systematic underestimation when evaluated across all observation-model pairs. The RMSE was 32.55 ppb (1.65% of the mean CH₄), with a r of 0.77, with the level of agreement relatively declining at higher altitudes. In addition, we used the KMA aircraft observations to identify regional-scale characteristics in CH₄ concentrations over South Korea often influenced by dominant emissions. The findings are expected to provide a scientific basis for future investigations of the spatiotemporal variability of CH₄ and its key drivers over South Korea.

PMID:41954842 | DOI:10.1007/s10661-026-15220-5

Int Ophthalmol. 2026 Apr 9;46(1):199. doi: 10.1007/s10792-026-04060-4.

ABSTRACT

PURPOSE: To evaluate the triglyceride-glucose index (TyG), novel systemic inflammatory biomarkers, and lipid profile in patients with neovascular age-related macular degeneration (nAMD), and to investigate their potential relationship with disease presence.

METHODS: This retrospective case-control study included 59 patients diagnosed with nAMD and 67 age- and sex-matched healthy controls. Demographic characteristics, fasting biochemical tests, lipid profile, complete blood count, and serum inflammatory indices were recorded. Triglyceride-glucose index, systemic inflammatory indices derived from various hematological parameters and lipid levels were calculated. Laboratory parameters and calculated indexes were compared between the two groups using Statistical Package for the Social Sciences (SPSS).

RESULTS: Triglyceride-glucose index was significantly higher in the nAMD group than in controls (4.84 ± 0.27 vs. 4.69 ± 0.17, p = 0.0001). Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) levels were also elevated in the nAMD group (p = 0.0001 for both). Among hematological markers, white blood count (WBC), neutrophil, and monocyte counts were significantly increased in nAMD patients (p = 0.012, p = 0.001, p = 0.015, respectively). Inflammatory indices including neutrophil/lymphocyte ratio (NLR) (p = 0.015), monocyte/HDL-C ratio (MHR) (p = 0.003), systemic inflammation aggregate index (AISI) (p = 0.025), and C reactive protein/albumine ratio (CAR) (p = 0.006) were significantly higher in the nAMD group, whereas the systemic immune inflammation index (SII), platelet/lymphocyte ratio (PLR) and monocyte/lymphocyte ratio (MLR) showed no significant differences (p > 0.05). Serum lipid levels and atherogenic lipid ratios did not differ between the groups.

DISCUSSION: Patients with nAMD exhibit increased systemic inflammatory activity and metabolic stress, reflected by elevated NLR, MHR, AISI, and CAR levels. In addition, TyG, a novel indicator of systemic insulin resistance, was found to be elevated in nAMD patients. These findings suggest that metabolic dysregulation and chronic low-grade systemic inflammation may contribute to nAMD pathogenesis independently of serum lipid levels. The TyG and inflammation-derived biomarkers may serve as potential systemic indicators for nAMD risk or disease activity.

PMID:41954837 | DOI:10.1007/s10792-026-04060-4

Geroscience. 2026 Apr 9. doi: 10.1007/s11357-026-02224-9. Online ahead of print.

ABSTRACT

Normal aging is accompanied by declines in executive function, and regular physical exercise has been proposed as a protective factor. However, the neural correlates linking long-term habitual exercise to executive efficiency in older adults remain unclear. This study combined resting-state functional magnetic resonance imaging (rs-fMRI) with behavioral assessments to examine whether long-term habitual exercise is associated with executive performance and resting-state neural organization in older adults. A total of 105 older adults (52 long-term habitual exercisers and 53 non-habitual exercisers) completed task-switching, Stroop and N-back paradigms and underwent rs-fMRI scanning. Behavioral outcomes included accuracy, reaction time, task cost and executive efficiency index. Neural measures included amplitude of low-frequency fluctuations (ALFF), regional homogeneity (ReHo) and degree centrality (DC). Older adults with long-term habitual exercise showed higher accuracy and faster responses across tasks, with no group differences in task cost but higher executive efficiency, compared with non-habitual exercisers. They also exhibited higher ALFF, ReHo and DC in frontoparietal, motor and striatal regions, alongside lower resting-state metrics in occipito-cerebellar networks. Mediation models indicated that ALFF in the pallidum, DC in prefrontal and cingulate cortices, and ReHo in frontoparietal regions statistically accounted for the association between exercise status and executive efficiency. Long-term habitual exercise was associated with better executive performance and distinct resting-state functional organization in older adults. Frontoparietal and striatal systems emerged as candidate intrinsic correlates of executive efficiency in physically active older adults.

PMID:41954831 | DOI:10.1007/s11357-026-02224-9

Int Ophthalmol. 2026 Apr 9;46(1):200. doi: 10.1007/s10792-026-04075-x.

ABSTRACT

PURPOSE: To evaluate the effect of parenteral iron treatment on the choroidal thickness, retinal nerve fiber layer (RNFL) thickness and retrobulbar blood flow in females with iron deficiency anemia (IDA) and to explore the mediation role of the changes in Doppler flow parameters in this relationship.

METHODS: A total of 55 eyes of 55 females in the reproductive period with a diagnosis of IDA were included in this prospective observational study. The hematologic values and the choroidal thickness at the subfoveal area and 500, 1000, 1500 µm nasal and temporal to the fovea, RNFL thickness, and central retinal artery (CRA) and ophthalmic artery (OA) parameters one day before and 8-12 weeks after parenteral iron treatment were evaluated in the patients.

RESULTS: The choroidal thickness at all measurement points and the RNFL thickness in all quadrants were significantly higher than the pre-treatment values following treatment (p < 0.05). The CRA peak systolic velocity (PSV) and end-diastolic velocity (EDV) values and the OA PSV values were statistically significantly lower after treatment compared to the pre-treatment values (p < 0.001, p < 0.01, p = 0.05, respectively). According to the mediation analysis, changes in hemoglobin (Hb), hematocrit (Hct), and mean corpuscular volume indirectly affected the superior RNFL thickness via the changes observed in OA EDV and the pulsatile index.

CONCLUSIONS: Parenteral iron treatment leads to significant improvement in both the hematological parameters and the retinal and choroidal circulation. This improvement was found to occur in a balanced manner through the changes in the retrobulbar blood flow parameters.

PMID:41954824 | DOI:10.1007/s10792-026-04075-x