Category: Statistics

J Environ Sci (China). 2026 May;163:348-375. doi: 10.1016/j.jes.2025.08.053. Epub 2025 Aug 27.

ABSTRACT

Neonicotinoid insecticides (NEOs) are a group of widely used insecticides in agriculture, livestock, and pest control for pets. However, increasing reports on their adverse effects on non-target organisms have aroused growing public concerns. Therefore, it is necessary to evaluate NEO exposure and the related human health. This review summarized the human biomonitoring studies on NEOs, and the epidemiological, in vitro, and in vivo toxicological investigations on the health effects of NEOs. Human biomonitoring studies revealed significant changes in NEO detection frequencies, concentrations, and profiles across different human populations, suggesting potential variances in exposure patterns or metabolic processes. Certain metabolites may be more sensitive biomarkers than their parent molecules, as evidenced by higher levels of some NEO metabolites than those of their parent compounds. Although human epidemiological data has revealed associations between NEO exposure and diverse detrimental health outcomes including reproductive and developmental abnormalities, oxidative damage, etc., the cross-sectional design of most studies cannot elucidate causality, necessitating further prospective research. In vitro and in vivo studies have shown various toxic effects of NEOs, including neurotoxicity, hepatotoxicity, reproductive toxicity, genotoxicity, etc. Further research on the molecular mechanisms beyond oxidative stress is worthwhile. Given metabolic activation, additional metabolites of both conventional and new generation NEOs as well as NEO-like compounds need to be determined, and their toxicities should be evaluated. This review can be contributed to the comprehensive understanding of the threat from extensive exposure to NEOs and proposed future research directions can aid to improve studies on health effects of NEOs.

PMID:41887854 | DOI:10.1016/j.jes.2025.08.053

J Environ Sci (China). 2026 May;163:197-208. doi: 10.1016/j.jes.2025.12.062. Epub 2025 Dec 25.

ABSTRACT

As urban renewal accelerates, heavy metals (HMs) pollution resulting from industrial activities in urban areas must be considered. This study examines 36 representative redevelopment industrial sites in the Jinshan District of Shanghai, where the concentrations of eight HMs in the soil were assessed. Based on this data, the characteristics of heavy metal concentrations and their sources in the region were investigated, followed by a risk assessment of HMs pollution. The results indicate that the soil in the study area exhibits low levels of pollution, with moderate ecological risks. Using Pearson correlation analysis and the Absolute Principal Component Score-Multiple Linear Regression (APCS-MLR) source apportionment model, the HMs were categorized into several sources: An industrial source dominated by Cu (74.84 %), a traffic source dominated by Zn (67.51 %), a natural source dominated by Cr and As (66.50 % and 64.98 %, respectively), and a mixed source. A probabilistic risk assessment was conducted using Monte Carlo simulation, which incorporates the probability distributions of various assessment parameters, thereby reducing uncertainty in the results. The findings show that the non-carcinogenic risk for all populations in the study area (children, adult females, and adult males) remains within acceptable limits. However, the carcinogenic risk proportional probabilities for these populations were found to be 48.13 %, 32.49 %, and 11.41 %, respectively, indicating a notable risk level. Uncertainty analysis results suggest that the heavy metals Cd and As exhibit high sensitivity in the model. This study provides theoretical support for the prevention and control of soil pollution during urban renewal.

PMID:41887839 | DOI:10.1016/j.jes.2025.12.062

J Environ Sci (China). 2026 May;163:154-162. doi: 10.1016/j.jes.2025.07.002. Epub 2025 Jul 2.

ABSTRACT

Ammonia and nitrous oxide emissions impacts are beginning to get more attention, due to their potential to adversely effect on air pollution, climate and human health. Vehicle emission and laboratory simulation testing were employed to analyze the ammonia (NH₃) and nitrous oxide (N₂O) emission characteristics from a light-duty gasoline vehicle equipped with a monolithic three-way catalyst. It was found that NH₃ emission factors were much higher than N₂O emission factors, reaching 27.8 mg/km for an engine-aged catalyst. Catalyst aging and degradation resulted in the loss of three-way catalytic activity and reducibility, which led to a significant increase in the emissions of NH₃ and N₂O by-products. An engine aged catalyst showed higher N₂O and NH₃ emission than thermally aged catalyst for the real vehicle tests. Raman and electron probe results indicated that the agglomeration of active metals affects the dissociation process of NO on the metal surface, thereby affected the selectivity of the catalyst for N₂O and NH₃.

PMID:41887835 | DOI:10.1016/j.jes.2025.07.002

Lancet Public Health. 2026 Apr;11(4):e253-e263. doi: 10.1016/S2468-2667(26)00030-7.

ABSTRACT

BACKGROUND: Gender-based violence (GBV) is an important public health issue in Europe, yet standardised cross-national data remain scarce. Emergency departments (EDs) are often the first point of contact for an individual who has been assaulted. This study aimed to analyse GBV-related ED presentations using data from the European Injury Database (IDB).

METHODS: This cross-sectional study analysed IDB data from 16 European countries (Jan 1, 2008, to Dec 14, 2023), defining GBV as intentional injuries inflicted by male perpetrators, involving female individuals aged ≥15 years. Descriptive analyses compared GBV with other female injuries (female victims in whom the perpetrator was recorded as female or was not specified). Multivariable logistic regression assessed GBV-associated injury severity compared with other violence against girls and women, adjusting for age, period, and country.

FINDINGS: Of 5 643 295 injury-related ED attendances, 1 960 096 were other female injuries and 21 048 were violence cases, of which 10 315 were GBV. Mean age was 38·2 years (SD 15·7) for individuals subjected to GBV and 55·3 years (41·5) for those with other female injuries. There were higher rates of head and face injuries, contusions, and asphyxiation-related injuries in cases of GBV than other female injuries, but there were lower rates of fractures. Most GBV events occurred in domestic settings (5802 [56·3%] of 10 315 GBV cases) and during night-time hours (3931 [41·9%]), involving physical force (7340 [73·1%]); perpetrators were most commonly intimate partners (4906 [47·6%]) or strangers (1546 [15·0%]). Hospital admission was more frequent in GBV than in other female injuries (2210 [21·4%] of 10 315 vs 366 765 [18·7%] of 1 960 096; p<0·0001). GBV was associated with higher injury severity compared with other female injuries after adjustment (odds ratio 1·22, 95% CI 1·12-1·34; p<0·0001).

INTERPRETATION: GBV-related ED cases show distinct features that characterise the visible spectrum of violence against girls and women in emergency settings. These patterns highlight the need for improved documentation and greater awareness of less visible presentations. Cross-national variability underscores the need for harmonised surveillance protocols to capture the true burden of GBV in Europe.

FUNDING: None.

PMID:41887827 | DOI:10.1016/S2468-2667(26)00030-7

Lancet Public Health. 2026 Apr;11(4):e212-e220. doi: 10.1016/S2468-2667(26)00043-5.

ABSTRACT

BACKGROUND: Fiscal food policies can improve diets and reduce the burden of diet-related diseases. We aimed to model the effects of various health-promoting food taxes and subsidies in Australia on health, economics, and equity.

METHODS: In this modelling study, the modelled scenarios included a 20% tax on unhealthy foods (ie, sugar-sweetened beverages, confectionery, snack foods, biscuits, pastries, ice cream, and processed meat), a 20% subsidy for fruits and vegetables, and a 20% tax on unhealthy foods earmarked to subsidise fruits and vegetables. We used a food demand system and nationally representative dietary intake data from the National Nutrition and Physical Activity Survey to estimate changes in energy, sodium, fruit, and vegetable intake for each policy across 5-year age-sex-socioeconomic status groups. These changes were input into a multiple-cohort proportional multistate lifetable model to estimate premature deaths averted, gains in health-adjusted life-years (HALYs), and health-care cost savings over the lifetime of the 2019 Australian adult population. Analyses were stratified by food category and socioeconomic quintile.

FINDINGS: We estimated that a 20% tax on unhealthy foods could avert 212 000 (95% uncertainty interval 196 000-229 000) premature deaths, generate 1370 000 (1270 000-1480 000) HALYs, lower health-care costs by AU$14·9 billion (4·6-27·5), and promote health equity. The estimated HALYs gained could be approximately 7 times greater than by taxing sugar-sweetened beverages alone. Conversely, a 20% subsidy for fruits and vegetables could avert 44 000 (36 000-52 000) premature deaths and generate 203 000 (155 000-249 000) HALYs, but might not lead to meaningful changes in health-care costs. Furthermore, earmarking the 20% tax to fund subsidies for fruits and vegetables could offset some of the financial burden of the tax.

INTERPRETATION: Fiscal food policies could be powerful levers to promote health and equity in Australia and should be considered by policy makers.

FUNDING: Australian Research Training Program.

PMID:41887824 | DOI:10.1016/S2468-2667(26)00043-5

Am J Orthod Dentofacial Orthop. 2026 Apr;169(4):532-540. doi: 10.1016/j.ajodo.2025.11.022.

ABSTRACT

INTRODUCTION: This study aimed to evaluate the physical properties of directly 3-dimensional-printed clear aligners (DPA), fabricated from TA-28 resin (Graphy Inc, Seoul, Republic of Korea), subjected to thermal cycling, focusing on color stability and surface wettability as indicators of clinical performance and material durability.

METHODS: Ninety disc-shaped specimens (15.0 × 2.0 mm) were fabricated using the manufacturer-recommended TA-28 resin (Graphy Inc). For color stability assessment, samples (n = 60) were immersed in distilled water, black tea, coffee, or red wine and evaluated at 1, 3, 7, and 14 days using a spectrophotometer based on the International Commission on Illumination L∗a∗b∗ and International Commission on Illumination color difference 2000 (ΔE00) systems. For surface wettability, specimens (n = 30) were subjected to thermal cycling at 5°C-55°C for 7 and 14 days, and the water contact angle was measured using the sessile drop method. Statistical analyses were conducted using the Kruskal-Wallis test for overall comparisons of nonparametric data, with post-hoc pairwise tests performed using the Mann-Whitney U test. For normally distributed variables, paired-samples t tests were applied. A significance level of P <0.05 was considered statistically meaningful.

RESULTS: Colorization tests revealed clinically unacceptable discoloration (ΔE₀₀ >2.25) in specimens immersed in tea, coffee, and red wine, with red wine producing the most severe changes (ΔE00 >30 at 14 days). A time-dependent increase in discoloration was observed across all staining solutions. Water contact angle values were consistently <90°, confirming a hydrophilic surface profile. Although values decreased after 7- and 14-day thermal cycling, the differences were not statistically significant (P = 0.143 and P = 0.599), indicating stable surface wettability over the aging period.

CONCLUSIONS: DPAs fabricated from TA-28 resin demonstrate hydrophilic surface characteristics and are highly susceptible to discoloration when exposed to pigmented beverages. These findings represent preliminary laboratory observations rather than clinical performance outcomes. Further studies simulating intraoral conditions, including mechanical wear and daily cleaning, are required to confirm the long-term esthetic stability of DPAs.

PMID:41887815 | DOI:10.1016/j.ajodo.2025.11.022

Chem Res Toxicol. 2026 Mar 26. doi: 10.1021/acs.chemrestox.6c00143. Online ahead of print.

ABSTRACT

Computational models are crucial for rapid hazard screening of novel chemicals when time and resources are not available for laboratory assessment. The rise of machine learning (ML) methods powering quantitative structure-activity relationship (QSAR) models has enabled data-driven development of predictive models for health effects screening. However, these models are typically single-task, meaning that they are trained on a single toxicological endpoint and lack transferability to similar tasks, i.e., the ability to predict chemicals’ effects on related endpoints. Thus, when predictions are needed for another endpoint, a new model must be trained from scratch. Further, single-task ML models are typically trained on very large, homogeneous data sets, which are not available for most adverse outcome endpoints. Effective hazard screening would benefit from approaches that can handle multiple small, noisy data sets recording complex chemical and biological mechanisms. To that end, we trained an ML model simultaneously on multiple tasks curated from moderate-sized (∼1000 observations) ToxCast data sets. To predict novel tasks from small (∼100 observations) ToxCast data sets, we combined our pretrained multitask model with a task-specific predictor, either a random forest or a neural network. These two components comprise a novel ML pipeline that generates and uses molecular representations from our multitask model. Compared to a common ML approach using standard chemical representations, our pipeline performed statistically better on a majority of tasks, regardless of the choice of downstream predictor. The advantage of the molecular representations from our multitask model, over those from a single-task model, is that they combine information on multiple effects to provide a model of chemical space that captures generalizable information. This work contributes to efforts to improve the utility of ML QSAR methods for predicting chemicals’ bioactivity on low-data toxicological endpoints.

PMID:41887802 | DOI:10.1021/acs.chemrestox.6c00143

Perfusion. 2026 Mar 26:2676591261439568. doi: 10.1177/02676591261439568. Online ahead of print.

ABSTRACT

ObjectiveMyocardial protection research in adult cardiac surgery has increasingly examined single dose del Nido cardioplegia alongside conventional multidose blood cardioplegia. Using a scientometric modeling approach, this study aims to quantitatively evaluate whether the thematic emphasis of this literature has expanded over time from pure protection efficacy toward workflow-related procedural parameters.MethodsA total of 269 focal publications published between 2000 and 2025, representing a 25-years analytical period, comparing myocardial protection strategies were analyzed using the Web of Science (WoS) Core Collection database. Author keywords were stratified by two independent reviewers into two predefined conceptual domains: the Efficacy Domain, including terms related to physiological myocardial protection (e.g., troponin, ischemia-reperfusion), and the Efficiency Domain, including workflow-related procedural parameters (e.g., cross-clamp time, minimally invasive surgery, single dose cardioplegia), with strong inter-rater agreement (Cohen’s κ = 0.92). Temporal trends were quantified using weighted linear regression models to evaluate the association between publication year and the relative prominence of efficiency-domain terminology.ResultsAnalysis of publication volume reveals a marked increase in literature, particularly from 2018 onwards. Keyword network analysis identified three distinct clusters: (1) traditional blood cardioplegia, (2) modern adult surgery/minimally invasive applications, and (3) evidence synthesis. Trend analysis demonstrated a statistically significant increase in the prominence of efficiency-related terms over the study period (β = 0.027 per year, 95% CI 0.014-0.040; p for trend <0.01).ConclusionThis scientometric analysis indicates an increasing emphasis in the literature on workflow-related procedural parameters in the evaluation of cardioplegia strategies in adult cardiac surgery. Contemporary studies increasingly report workflow-related procedural parameters such as uninterrupted surgical flow, cross-clamp time, and compatibility with minimally invasive or robotic techniques in the evaluation of cardioplegia strategies. These findings indicate an expanding investigational emphasis within the literature toward workflow-related procedural parameters alongside traditional efficacy and safety-oriented outcomes.

PMID:41886766 | DOI:10.1177/02676591261439568

Obstet Gynecol. 2026 Mar 26. doi: 10.1097/AOG.0000000000006271. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate postpartum type 2 diabetes testing and classification using the revised 2022 American Diabetes Association (ADA) diagnostic criteria, in comparison with the American College of Obstetricians & Gynecologists’ (ACOG) criteria, in women with gestational diabetes mellitus (GDM) across inpatient and outpatient testing settings. Secondarily, we aimed to evaluate whether the timing of administration of the screening test was associated with differences in results.

METHODS: This was a retrospective cohort study of patients with GDM who delivered at a single institution between 2023 and 2025. The traditional cohort (January-December 2023) was recommended an outpatient 75-g, 2-hour oral glucose tolerance test (OGTT). The hybrid cohort (June 2024-June 2025) was given the option of inpatient screening during the delivery hospitalization or outpatient testing. The primary outcome was OGTT completion. Secondary outcomes were diagnoses of glucose intolerance or diabetes. In January 2022, the ADA revised postpartum diagnostic criteria so that a diabetes diagnosis would require two abnormal values instead of a single abnormal OGTT value. The ACOG and 2022 ADA criteria were applied to OGTT results retrospectively to estimate their effect on postpartum diabetes classification. In a subgroup analysis, we examined whether the timing of postpartum OGTTs influenced the results.

RESULTS: In the traditional cohort, 6,689 deliveries occurred; of these, 309 patients (4.6%) had GDM and met inclusion criteria. In the hybrid cohort, 6,312 deliveries occurred; of these, 276 (4.4%) patients met inclusion criteria. Rates of OGTT completion were higher in the hybrid cohort than in the traditional cohort (73.9% vs 31.7%, P<.001). Inpatient testing yielded higher rates of glucose intolerance (48.0%) and diabetes (15.4%) than outpatient testing in either cohort (traditional: 19.4% glucose intolerance and 4.1% diabetes; hybrid: 20.7% glucose intolerance and 3.4% diabetes). Application of the 2022 ADA criteria resulted in the reclassification of most ACOG-defined diabetes results as glucose intolerant (Bowker χ2=24, P<.001). In an adjusted multinomial regression that used ACOG criteria, inpatient testing was associated with glucose intolerance (adjusted odds ratio [aOR] 3.06; 95% CI, 1.57-5.97) and overt diabetes (aOR 4.65; 95% CI, 1.14-18.9) when compared with outpatient testing. Testing on postpartum day 1 relative to outpatient testing was associated with glucose intolerance (aOR 2.20; 95% CI, 1.36-3.57) and overt diabetes (aOR 3.92; 95% CI, 1.69-9.06), whereas testing on or after postpartum day 2 did not show a statistically significant association.

CONCLUSION: Inpatient screening improves the rate of postpartum testing, but diagnostic classification varies widely by the criteria used (ACOG vs ADA) and test timing (postpartum day 1 vs 2), which underscores the need for national guidance on optimal timing and interpretation of postpartum OGTTs.

PMID:41886750 | DOI:10.1097/AOG.0000000000006271

JMIR Cancer. 2026 Mar 26;12:e87347. doi: 10.2196/87347.

ABSTRACT

BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory syndrome that requires rapid diagnosis and intervention. However, identifying these patients is difficult because the HLH-2004 diagnostic criteria are complex and not always captured systematically in electronic health records (EHRs). Furthermore, it is unclear how clinicians use these criteria to diagnose HLH and make treatment decisions. There is a critical need for validated computable phenotypes to accurately identify patients and study treatment-related outcomes in HLH.

OBJECTIVE: The aim of this study is to compare different approaches to using the EHR to build computable phenotypes of patients with HLH and to evaluate characteristics and outcomes of patients meeting the HLH-2004 diagnostic criteria who received HLH-directed therapies compared to those who did not.

METHODS: Three approaches to computable phenotype development in the EHR were taken by identifying patients (1) with an HLH-specific International Statistical Classification of Diseases, Tenth Revision (ICD-10) code, (2) with an HLH-specific treatment plan, and (3) meeting the HLH-2004 clinical criteria for diagnosis of HLH. Among patients who met the HLH-2004 criteria, we evaluated the characteristics and outcomes of patients who received HLH-directed therapies compared to those who did not. HLH treatment was defined as either any chemotherapy or HLH-specific therapy (dexamethasone, methylprednisolone, anakinra, ruxolitinib, cyclosporine, etoposide, or emapalumab).

RESULTS: We identified 388 patients with possible HLH across the three cohorts. An HLH ICD-10 diagnosis (n=220) and meeting 5 or more clinical criteria (n=245) were much more common than a HLH treatment plan (n=42). Among the patients meeting HLH-2004 clinical criteria, 193 (79%) received HLH-directed therapy. There was no difference in any specific HLH criteria between those who did and did not receive HLH-directed therapy. In-hospital mortality was very high among both groups and was 15% among those who received HLH-directed therapy and 13.5% among those who did not receive HLH-directed therapy. Among 1325 patients with an elevated ferritin and fever, only 252 (19%) met >5 clinical criteria.

CONCLUSIONS: Constructing HLH cohorts from EHR data is challenging, with diagnosis codes, treatment plans, and clinical criteria each capturing distinct but overlapping populations.

PMID:41886745 | DOI:10.2196/87347