Category: Statistics

Pediatr Res. 2026 May 13. doi: 10.1038/s41390-026-04952-2. Online ahead of print.

ABSTRACT

BACKGROUND: There is a well-established link between growth and future health, but it is uncertain whether early life growth and well-being in adolescence are associated. We hypothesized that individuals with slower growth during infancy or childhood had a lower degree of well-being at age 18 years.

METHODS: This population-based study examined early life growth in relation to adolescent well-being in the GrowUp_1974&1990Gothenburg cohorts (n = 4319). Individual growth trajectories were modeled using the Quadratic-Exponential-Pubertal-Stop (QEPS) model, based on longitudinal height data. Well-being was assessed using the Gothenburg Well-being in Adolescence scale.

RESULTS: Associations between early life growth (birth size, height at ages 2, 4, and 7 years, and growth change) and adolescent well-being were uniformly small (β ranging from -0.2 to 0.2), with narrow confidence intervals and low explained variance (R² ≤ 1%). However, in the 1974 cohort, males born large for gestational age reported higher total well-being than peers born appropriate or small for gestational age, while females born large for gestational age by weight reported lower mood and self-esteem.

CONCLUSION: Differences in self-reported well-being at age 18 years associated with early-life growth were small and probably of minimal clinical importance, providing relevant information for healthcare professionals and parents.

IMPACT: This population-based study, with longitudinal growth data from over 4,000 Swedish adolescents, born in 1974 and 1990, showed that early life growth is of limited importance for self-reported well-being at age 18. There is a well-established link between growth and future health, but our results suggest that early deviations in physical growth are unlikely to have substantial implications for adolescent well-being in relatively healthy populations. The study’s findings may offer reassurance to clinicians and parents concerned about the long-term psychological consequences of early growth variations.

PMID:42129372 | DOI:10.1038/s41390-026-04952-2

Sci Rep. 2026 May 13;16(1):15046. doi: 10.1038/s41598-026-51334-z.

ABSTRACT

Studies have shown how air pollution and temperature affect blood pressure. We investigated the combined effect of air pollution and temperature on blood pressure in a cohort of older German women. We conducted a cross-sectional analysis of systolic (SBP) and diastolic blood pressure (DBP) data from follow-up 3 (2012-2013) of the Study on the influence of Air pollution on lung function inflammation and ageing (SALIA) cohort. Short-term data on daily air pollutants and temperature were obtained from the German Weather Bureau and the German Environment Agency. A generalized additive model was used to capture their combined effect. Stratified analyses were performed to quantify the variation in the estimated effects. The core model was adjusted for potential covariates. We observed a combined association of temperature and air pollution with blood pressure. We found that lower temperatures and higher levels of air pollutants such as PM_2.5 and NO₂ were associated with higher SBP and DBP. However, higher O₃ exposure was generally associated with lower SBP and DBP. Stratified analyses showed that the associations between temperature, air pollution, and blood pressure were stronger among women living in urban areas and those with lower socio-economic status. The combined effect of low ambient temperature and high air pollution substantially increased BP among older German women.

PMID:42129347 | DOI:10.1038/s41598-026-51334-z

Sci Rep. 2026 May 13. doi: 10.1038/s41598-026-51718-1. Online ahead of print.

ABSTRACT

Investigation of in utero, tissue-specific molecular pathways contributing to prenatal programming of childhood-onset asthma is needed to develop effective, targeted prevention strategies. We aimed to examine the relationship between predicted gene expression in placenta and childhood-onset asthma and to compare relationships between childhood- and adult-onset asthma. Asthma genome-wide association study published summary statistics were obtained from the UK Biobank and published placental gene expression quantitative trait loci were obtained from the Rhode Island Child Health Study. We used S-PrediXcan to evaluate and compare associations between placental predicted gene expression and childhood- and adult-onset asthma and to determine whether signals were placenta-specific. Among 8,038 tested placental predicted expression-asthma associations, we identified 56 (0.7%) genes only significantly associated with childhood-onset asthma, 12 (0.1%) genes only significantly associated with adult-onset asthma, and 18 (0.2%) shared genes. Predicted expression of several genes (ACTL9, AMN, C9orf38, C11orf30, CTSE, EFCAB13, EIF4E1B, FN1, GLS2, IL6, IVL, LZIC, MAN2A2, MEGT1, RACGAP1, SMAD6, SPATA5, TMEM25, VTI1B, WDR19) was not significantly associated with childhood- or adult-onset asthma in any non-placental tissue, suggesting that the associations may be placenta-specific. This study identified alterations in predicted expression of placental genes associated with transcriptional pathways critical to the development of asthma. We identified unique and shared pathways, particularly related to immune regulation, associated with childhood- and adult-onset. This expands our understanding of the fetal origins of asthma, highlights the placenta as an informative tissue in understanding asthma pathogenesis, and identifies target genes to prioritize for future functional studies.

PMID:42129325 | DOI:10.1038/s41598-026-51718-1

Sci Rep. 2026 May 13. doi: 10.1038/s41598-026-52632-2. Online ahead of print.

ABSTRACT

This study focuses on the vessel normalization window of anlotinib to preliminarily explore the optimal intervention timing for combining anlotinib with whole brain radiotherapy (WBRT) in treating brain metastases from non-small cell lung cancer (NSCLC). We aimed to explore the feasibility of combining anlotinib with WBRT based on the hypothesized vascular normalization window, and to investigate potential associations with intracranial tumor control, iPFS, and quality of life in patients with NSCLC brain metastases. This study was designed as a prospective, non-randomized, single-center cohort study. From Feb 8, 2024, to Sep 30, 2025, a total of 38 patients with NSCLC brain metastases diagnosed by the Department of Oncology, the Fifth Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, were prospectively recruited. Anlotinib was used as the intervention measure in this study. According to whether the patients received anlotinib or not, they were divided into the experimental group (anlotinib combined with WBRT) and the control group (sole WBRT), with 19 patients in each group. In the experimental group, the vascular normalization time window of anlotinib, which is 5 to 7 days, was precisely utilized. The specific medication regimen was to start taking 8 mg of anlotinib 5 days before the initiation of WBRT and continue the medication until the end of WBRT. In contrast, the control group received only WBRT. The primary and secondary endpoint indicators of the patients in both groups were followed up regularly. The primary endpoint indicators included the intracranial objective response rate (iORR) and iPFS, while the secondary endpoint indicators included the intracranial disease control rate (iDCR), quality of life, and adverse reactions. The Kaplan-Meier method was used to draw the survival curve.Meanwhile, the clinical characteristics of the patients in both groups, such as gender, age, primary tumor site, T stage, N stage, and the number of brain metastases, were collected. Univariate analysis was used to screen out the prognostic factors that might affect iPFS. Then, the factors with statistical differences (P < 0.10) in the univariate analysis were taken as independent variables, and further Cox multivariate regression analysis was carried out to explore the independent prognostic factors affecting iPFS. The test standard P value was < 0.05. From Feb 8, 2024, to Sep 30, 2025, a total of 38 patients diagnosed with brain metastases from NSCLC by the Oncology Department of the Fifth Affiliated Hospital of Chengdu University of Traditional Chinese Medicine were prospectively recruited and included in the statistical analysis. The median follow-up time was 15.2 months (95% CI: 9.02-21.37). The results showed that the experimental group had better iORR (57.90% vs. 15.79%, P = 0.017) and iDCR (100% vs. 73.68%, P = 0.046) compared to the control group, with statistically differences. Compared with the control group, the experimental group showed a advantage in iPFS (6.7 months vs. 4.27 months, P = 0.038), and the median iPFS was extended by an additional 2.43 months. The results of subgroup analysis showed that the iPFS of patients with ≥ 3 brain metastases and patients with < 3 brain metastases were 6.3 months and 6.7 months, respectively, and there was no significant difference between the two groups (P = 0.723). The iPFS was longer in patients with less than 3 metastases than those with more than 3 metastases (11.73 months vs. 3.17 months, P = 0.035). After WBRT, the iPFS of NSCLC patients with brain metastases who received anti-tumor therapy was improved compared with those who did not receive anti-tumor therapy (8.67 months vs. 3.80 months, P = 0.040). In terms of quality of life, the experimental group showed better outcomes in functional status, symptom domains, and overall health compared to the control group over time. Regarding adverse reactions, the main ones included decreased appetite, fatigue, nausea and vomiting, hypertension, Myelosuppression, dizziness, headache, and abnormal liver function indicators. Grade ≥ 3 adverse reactions primarily included anemia, agranulocytosis, leukopenia, thrombocytopenia, cognitive impairment and abnormal liver function indicators, most of which were tolerable after symptomatic treatment. Univariate regression analysis of the overall population indicated that antitumor therapy after WBRT (P = 0.078) and the number of organ metastases (P = 0.038) were clinically relevant factors affecting iPFS. Further multivariate Cox regression analysis revealed that antitumor therapy after WBRT (P = 0.047) and the number of organ metastases (P = 0.028) were independent prognostic factors influencing iPFS. In this exploratory cohort, low-dose (8 mg) anlotinib administered 5-7 days prior to WBRT was associated with higher iORR, iDCR, and longer iPFS relative to WBRT alone in patients with NSCLC brain metastases. This combination regimen showed a manageable safety profile and trends toward improved quality of life. Subgroup analyses suggested that patients with < 3 organ metastases or those receiving post-WBRT antitumor therapy tended to have prolonged iPFS. Multivariate Cox regression identified post-WBRT antitumor therapy and number of organ metastases as potential independent prognostic factors for iPFS in this cohort. These findings are hypothesis-generating and require validation in larger randomized controlled trials.

PMID:42129320 | DOI:10.1038/s41598-026-52632-2

Sci Rep. 2026 May 13. doi: 10.1038/s41598-026-52297-x. Online ahead of print.

ABSTRACT

Nigeria faces a significant energy deficit (61.2% electricity access), hindering progress toward SDG 7 (Affordable and Clean Energy) and SDG 13 (Climate Action). Despite geothermal potential, comprehensive assessments of low-enthalpy resources (that is, subsurface temperatures below 100 ℃) in transitional geological environments (TGEs) – basement-sedimentary contact zones with mixed conductive-advective heat transfer – remain underexplored. This study uses high-resolution aeromagnetic data interpretation with statistical modeling to delineate geothermal potential within the Egbako-Share axis of North-Central, Nigeria. Spectral analysis adopting centroid depth technique from 40 overlapping blocks was employed to estimate Curie Point Depths (CPD), geothermal gradients (GTG), and heat flow (HF). Statistical modeling – including correlation analysis, multiple regression, PCA, and spatial autocorrelation (Moran’s I, Getis-Ord Gi*) – provided a robust framework for resource assessment and risk evaluation. The analysis revealed significant geothermal resources with CPD ranging from 26 to 46 km (mean: 38 ± 6 km), GTG of 13-23 °C/km (mean: 16 ± 2 °C/km), and HF values of 31-57 mW/m² (mean: 39 ± 6 mW/m²). Strong negative correlations between CPD and both GTG (r = -0.892, p < 0.001) and HF (r = -0.891, p < 0.001) were established, with the regression model explaining 79.5% of HF variance. PCA identified 12 high-potential geothermal zones for low-enthalpy development. Under a conceptual scenario assuming full development of all 12 zones, modelled capacity could range from approximately 15 to 25 MW, with scenario-based annual CO₂ emission reductions of 85,000-140,000 t/year (subject to confirmatory drilling and feasibility studies), supporting Nigeria’s SDG 7, SDG 13, and related development targets.

PMID:42129299 | DOI:10.1038/s41598-026-52297-x

Comp Immunol Microbiol Infect Dis. 2026 May 12;128:102479. doi: 10.1016/j.cimid.2026.102479. Online ahead of print.

ABSTRACT

Domestic dogs are frequently exposed to tick-borne pathogens such as Babesia vogeli, Hepatozoon canis, Anaplasma platys and Ehrlichia canis, which can cause a wide range of clinical manifestations, although little is known about the epidemiological and clinicopathological profiles of mono- and co-infections. This study aimed to characterize infection patterns and identify clinical and epidemiological factors associated with mono-infections, and co-infections with two or more pathogens in naturally infected dogs. We analyzed 181 dogs from a hospital population with suspected hemoparasitic infections, assessed hematocrit and platelet counts, and used statistical models (Chi-square, Fisher’s exact test, odds ratios, and multinomial logistic regression) to evaluate associations between infection types and clinical or epidemiological variables. This is the first comprehensive Brazilian study correlating infection type with clinical and epidemiological factors. Dogs with a history of tick infestation were 3.41 times more likely to be co-infected with two pathogens, and infections involving two (84.6%) or three or more pathogens (90.9%) were more frequent in dogs without the use of tick control medications. Male dogs and those presenting epistaxis, hyporexia or anorexia, dehydration, onychogryphosis, and ectoparasites were more likely to be co-infected with three or more pathogens. Thrombocytopenia was common in all groups, with dogs co-infected with three or more pathogens showing 16.3 times higher odds and dogs co-infected with two pathogens had increased odds of anemia (OR = 2.11). These results underscore the importance of tick control and comprehensive pathogen screening in endemic regions, especially in Brazil’s semi-arid northeast, to enhance diagnosis, management, and prevention strategies.

PMID:42127483 | DOI:10.1016/j.cimid.2026.102479

Semergen. 2026 May 13;52(5):102770. doi: 10.1016/j.semerg.2026.102770. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze the association between healthcare resources and premature mortality from ischemic heart disease in the Spanish autonomous communities between 2018 and 2023.

METHODS: An observational ecological study was conducted using aggregated data by autonomous community and year. The dependent variable was premature mortality from ischemic heart disease (< 75 years, adjusted for age). Independent variables included primary care physician density and per capita healthcare expenditure. Descriptive statistics, Pearson correlations, and multiple lineal regression were applied.

RESULTS: The average premature mortality rate was 20.53/100,000 inhabitants (SD=4.59), being higher in men (34.21 vs. 7.66 in women) and in the Canary Islands, Asturias, and Andalusia. The rate remained stable over time (19.91-21.04/100,000). No significant associations were found between mortality and healthcare resources. However, healthcare expenditure correlated positively with the density of primary care physicians (r=0.307; P=.001).

CONCLUSIONS: Although the availability of healthcare resources did not explain the differences in premature mortality, this study highlights the persistent territorial and sex-based heterogeneity in Spain and the need for comprehensive strategies that combine investment, prevention, and the reduction of inequalities. The findings provide useful evidence for planning cardiovascular health policies at the regional level.

PMID:42127482 | DOI:10.1016/j.semerg.2026.102770

Breast. 2026 May 12;88:104797. doi: 10.1016/j.breast.2026.104797. Online ahead of print.

ABSTRACT

BACKGROUND: Women living with HIV (WLHIV) may present with distinct clinical and laboratory characteristics at the time of breast cancer diagnosis. While previous studies, including multi-country cohorts such as the ABC-DO study, have described baseline patient and tumor features, data on pre-treatment laboratory parameters in routine clinical settings remain limited. This study aimed to characterize baseline clinical and laboratory factors at diagnosis and assess differences by HIV status.

METHODS: We analyzed data from women newly diagnosed with breast cancer at three tertiary hospitals in Tanzania. HIV status was obtained from medical records or provider-initiated testing. Baseline clinical and laboratory variables measured before systemic cancer therapy were evaluated. Multivariable logistic regression was used to identify factors independently associated with HIV status.

RESULTS: Among 425 women with newly diagnosed breast cancer, 47 (11%) were living with HIV. Advanced disease at presentation was common across the cohort. Neutropenia (absolute neutrophil count <1.5 × 10⁹/L) was more frequent among WLHIV than among women without HIV (15% vs 3%) and remained independently associated with HIV status (adjusted odds ratio [aOR] 3.52, 95% confidence interval [CI] 1.26-9.79).

CONCLUSIONS: WLHIV more frequently presented with neutropenia and advanced disease at diagnosis. By identifying clinically relevant differences in hematologic status are detectable at presentation using routinely collected data, this study addresses a key gap in real-world evidence from sub-Saharan Africa. These findings provide clinically actionable insight into baseline patient status at entry into cancer care and may inform early clinical assessment and supportive care planning in resource-constrained settings.

PMID:42127480 | DOI:10.1016/j.breast.2026.104797

Clin Neurol Neurosurg. 2026 May 8;268:109465. doi: 10.1016/j.clineuro.2026.109465. Online ahead of print.

ABSTRACT

OBJECTIVE: Efgartigimod, a neonatal Fc receptor (FcRn) antagonist, has been shown to reduce pathogenic immunoglobulin G (IgG) autoantibodies, notably anti-acetylcholine receptor (AChR) antibodies, in myasthenia gravis (MG). While clinical trials have established its safety and efficacy, real-world evidence regarding its therapeutic effectiveness and steroid-sparing potential remains limited. This study aimed to evaluate the real-world efficacy and steroid-sparing benefits of efgartigimod in the clinical management of MG.

METHODS: Forty-one patients with generalized myasthenia gravis (gMG) were enrolled in this prospective study. Participants received efgartigimod treatment and were followed for 26 weeks. Clinical outcomes, primarily Myasthenia Gravis Activities of Daily Living (MG-ADL) scores and corticosteroid dosages, were systematically evaluated. Statistical analyses were performed using R version 4.5.0.

RESULTS: Patients were stratified into two cohorts based on treatment cycles: 22 received two cycles of efgartigimod, while 19 received a single cycle. Bulbar and respiratory symptoms improved within two weeks, whereas ocular and limb weakness required a more prolonged treatment duration to achieve clinical benefit. Myasthenia Gravis Activities of Daily Living (MG-ADL) scores demonstrated a significant decline, with a more rapid response observed in severe cases. By Week 26, the proportion of patients requiring more than 16 mg/d of methylprednisolone decreased from 63.4% at baseline to 14.6%. The two-cycle cohort exhibited a lower mean cumulative methylprednisolone dose (4861.50 mg vs. 5469.24 mg). No treatment-related adverse effects were observed.

CONCLUSION: Efgartigimod demonstrated variable clinical responses across different muscle groups, with early improvements in bulbar and respiratory function alongside significant steroid-sparing advantages. Given that baseline MG-ADL scores serve as a reliable predictor of the time to achieve minimal symptom expression (MSE), and considering that repeated treatment cycles further augment therapeutic efficacy, efgartigimod represents a promising steroid-sparing immunomodulatory strategy for the management of MG.

PMID:42127467 | DOI:10.1016/j.clineuro.2026.109465

J Plast Reconstr Aesthet Surg. 2026 Apr 18;117:226-234. doi: 10.1016/j.bjps.2026.04.011. Online ahead of print.

ABSTRACT

BACKGROUND: The deep inferior epigastric perforator (DIEP) flap is a reliable salvage option following complications of implant-based breast reconstruction (IBR). However, comparative data on indications and outcomes between radiated and non-radiated breasts remain limited.

METHODS: A ten-year retrospective cohort study was performed by including patients who underwent DIEP flap reconstruction following complicated IBR. Data were compared between radiated and non-radiated breasts using the Mann-Whitney U, Chi-square, and Fisher’s exact tests.

RESULTS: Among the 1684 patients who underwent IBR, 620 (36.8%) required implant removal or exchange, and 63 (3.7%) ultimately underwent DIEP flap reconstruction. In total, 89 breasts underwent DIEP reconstruction after complications of implant, among which 33 (37%) had received post-mastectomy radiation to the ipsilateral implant or tissue expander. Radiated breasts had higher rates of infection (25% vs. 7%, p = 0.02) and implant removal (34.4% vs. 7%, p = 0.002) rates prior to DIEP conversion. The median interval between mastectomy and DIEP reconstruction tended to be shorter in radiated breasts (28 vs. 39 months, p = 0.09). Capsular contracture was the most common indication for conversion (46.9% radiated vs. 29.8% non-radiated, p = 0.1). Flap survival was 100% in radiated breasts and 96.5% in non-radiated breasts (p = 0.53).

CONCLUSIONS: Permanent implant-to-DIEP conversion occurred in 3.7% of patients. Radiated breasts were more likely to experience infection and implant removal before conversion. Although the time to DIEP tended to be shorter in radiated patients, this was not statistically significant. DIEP flap reconstruction provides high survival in both groups, confirming its reliability as a salvage option.

PMID:42127452 | DOI:10.1016/j.bjps.2026.04.011