Category: Statistics

Mol Cell Biochem. 2026 Jun 2. doi: 10.1007/s11010-026-05588-w. Online ahead of print.

ABSTRACT

Spatial organisation of immune cells reflects a balance between tissue anchoring and migratory compatibility, yet how this balance is structured within inflammatory skin disease remains poorly understood. Spatial transcriptomic analyses defined transit-retention immune organisation across lesional and non-lesional skin in atopic dermatitis (AD) and psoriasis (PsO). A unified transit-retention axis captured contextual immune organisation within leukocyte-rich tissue microenvironments. Non-lesional skin in both diseases exhibited retention-dominant organisation. In contrast, psoriatic lesions showed disruption of retention dominance, accompanied by coordinated alignment of antigen presentation, T cell activation, Th17, and B cell programmes with transit-compatible organisation, a pattern not observed in AD. An independent spatial transcriptomic dataset of psoriatic skin enabled assessment of compartmental specificity and clinical relevance. These analyses identified the epidermis as the primary site of transit-skewed reorganisation, with epidermal transit alignment scaling with disease severity. Extension of the same transcriptional framework to circulating adaptive immune cells using CITE-seq revealed lineage-specific transit-associated features in psoriatic disease. Circulating CD4 T cells and B cells showed stronger transcriptional and protein-level alignment with transit-associated states in PsO and psoriatic arthritis. Together, these analyses reveal transit-skewed adaptive immune organisation as a unifying feature of psoriatic disease.

PMID:42228270 | DOI:10.1007/s11010-026-05588-w

Eur J Epidemiol. 2026 Jun 2. doi: 10.1007/s10654-026-01417-y. Online ahead of print.

ABSTRACT

Type 1 Diabetes (T1D) is a common chronic autoimmune disorder in children and adolescents worldwide. We described the development of T1D incidence from 2012 to 2021 and compared the incidence of the pre-pandemic period (2012-2019) with the pandemic period (2020-2021) in Bavaria, Germany. Routinely collected health claims from the Bavarian Association of Statutory Health Insurance Physicians (KVB), covering a population of 2 million children and adolescents (aged ≤ 19 years), were used. All cases of newly diagnosed T1D (ICD-10-GM E10) were included. Sex-specific annual and quarterly crude incidence rates (CIR) and age-standardized incidence rates (ASIR) were calculated. Sex-specific CIRs were calculated by 5-year age groups. Interrupted time series analysis was used to analyze trend changes in the pandemic versus the pre-pandemic period. From 2012 to 2021, 5,762 incident cases were identified in Bavaria. Overall, an increasing incidence was observed with an average annual increase of 3.7% in females (from 23.5 in 2012 to 32.5 per 100,000 person-years (py) in 2021) and 5.0% in males (from 25.2 to 38.9 per 100,000 py). The increase was highest in age groups 0-4 (12.4%) in males and 15-19 (8.5%) in females. Regression analysis showed no clear level or slope change in T1D incidence for both sexes during the pandemic period. When accounting for non-linear trends, a statistically significant level change was observed for females during the pandemic period (ß=7.66, 95% CI 0.23, 15.09), suggesting a potential association for females. The increasing T1D incidence in Bavarian youth from 2012 to 2021 highlights the importance of incidence surveillance.

PMID:42228226 | DOI:10.1007/s10654-026-01417-y

Plant Foods Hum Nutr. 2026 Jun 2;81(2):72. doi: 10.1007/s11130-026-01515-y.

ABSTRACT

Nonalcoholic fatty liver disease is a prevalent metabolic disorder linked to lifestyle factors. This study aimed to evaluate the effects of Pilates exercise and broccoli sprout supplementation, individually and combined, on liver enzyme levels in women with nonalcoholic fatty liver disease. In this double-blind, randomized controlled trial, 32 women aged 30-45 years from Mashhad were allocated into four groups: Pilates plus broccoli sprout supplement(SP), Pilates plus placebo(PP), supplement only(S), and placebo control(P). The Pilates training was performed three times per week for 8weeks at intensities progressing from 54 to 75% of maximum heart rate. Participants in supplementation groups received two 500 mg tablets daily (total 1,000 mg/day) of standardized broccoli sprout extract produced under good manufacturing practice guidelines. Serum liver enzyme levels, including aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase, were measured before and after the intervention. Data normality was assessed using the Kolmogorov-Smirnov test. Paired t-tests were applied for between-group comparisons, while one-way analysis of variance and analysis of covariance adjusted for baseline values were used for between-group comparisons. Tukey’s post-hoc test was employed for pairwise analyses with p < 0.05 considered statistically significant. After 8 weeks, no statistically significant differences were observed in enzyme levels among the groups. Pilates exercise and broccoli sprout supplementation, alone or in combination, did not significantly alter hepatic enzyme levels in this population The modest exercise intensity and supplement dosage may have been insufficient to elicit measurable hepatic effects. Future studies should consider higher exercise intensities, longer intervention periods, and more diverse participant characteristics to better clarify potential synergistic effects in nonalcoholic fatty liver disease management.

PMID:42228225 | DOI:10.1007/s11130-026-01515-y

Eur J Health Econ. 2026 Jun 2. doi: 10.1007/s10198-026-01931-6. Online ahead of print.

ABSTRACT

OBJECTIVES: The EQ Health and Wellbeing Short Version (EQ-HWB-9) is a 9-item instrument capturing multidimensional health or well-being. This study aimed to evaluate its psychometric properties in Chinese college students-a high-risk group for mental health problems.

METHODS: A nationwide online cross-sectional survey was conducted across eastern, central, and western China between January and February 2025. Ceiling and floor effects of the EQ-HWB-9 were evaluated based on the response distributions of its items. Convergent validity of EQ-HWB-9 items, as well as its level sum score (LSS) and utility score was assessed according to their correlations with EQ-VAS score using Spearman correlations. Known-group validity of LSS and utility score was evaluated by comparing the mean difference and effect sizes of six pairs of college students with different status. Sensitivity of the two scores was further tested by comparing its efficiency to detect the differences with EQ-VAS score using relative efficiency (RE).

RESULTS: A total of 3,589 college students participated in the survey, with females being 53.4% and mean age of 20.7 years. Two EQ-HWB-9 items-daily activities (75.8%) and mobility exhibited (74.6%) ceiling effects. All EQ-HWB-9 items demonstrated statistically significant correlations with the EQ-VAS score ranging from – 0.421 to -0.312, and both the EQ-HWB-9 LSS and utility score showed moderate correlations (LSS: -0.522; Utility: 0.522). Differences in mean values of LSS and utility score were statistically significant in five out of six known-groups (except for gender). The two scores generally demonstrated larger RE values compared to EQ-VAS score (LSS range: 1.049-51.590; Utility range: 0.715-61.143).

CONCLUSIONS: Despite the high ceiling effect in physical-related dimensions, it appears that the EQ-HWB-9 is a valid instrument in assessing health and well-being among Chinese college student.

PMID:42228220 | DOI:10.1007/s10198-026-01931-6

Eur J Health Econ. 2026 Jun 2. doi: 10.1007/s10198-026-01943-2. Online ahead of print.

ABSTRACT

Longevity and death rates are closely linked to socioeconomic conditions. However, the relationship between income and specific causes of death (CoD) remains insufficiently explored. This study examines socioeconomic inequalities in cause-specific mortality in Spain, simultaneously accounting for CoD, age, sex, and income. To the best of our knowledge, no previous study has jointly combined all these variables. Using data for the entire population residing in Spain from 2010 to 2019, we compute death rates by CoD, age, sex, and income decile by linking individual demographic records with census tract-level disposable income. The analysis covers 4 million deaths and over 466 million person-years at risk. Robust income-based relative risks and gradients by CoD are calculated for five-year age groups, stratified by sex, while Relative Index of Inequality (RII) values are derived for single years of age. Results show strong and consistent income-related inequalities in mortality across age, CoD, and sex, especially among younger and middle-aged groups. Particularly steep and significant gradients are found for circulatory, respiratory, digestive, infectious, endocrine, and genitourinary diseases, as well as for symptoms and abnormal findings, and other conditions, with lower-income individuals facing markedly higher risks. For neoplasms, nervous, mental and behavioural disorders, and external causes, patterns are more heterogeneous and gender-specific. Notably, neoplasms exhibit RIIs < 1 among women aged 55 and older. Overall, the results highlight widespread income-related inequalities in mortality in Spain and underscore the need to prioritise lower-income groups in public health efforts, particularly regarding chronic and behavioural health conditions.

PMID:42228219 | DOI:10.1007/s10198-026-01943-2

Hernia. 2026 Jun 2;30(1):237. doi: 10.1007/s10029-026-03736-1.

ABSTRACT

PURPOSE: Ventral hernias are common abdominal wall defects associated with substantial healthcare burden and impaired quality of life. Minimally invasive extraperitoneal techniques have evolved to optimize midline reconstruction while avoiding intraperitoneal mesh placement, especially in the setting of diastasis recti. Preperitoneal Extended Totally Extraperitoneal (PeTEP) repair is a recently introduced approach, but evidence regarding its safety and effectiveness remains limited. Therefore, we performed a systematic review and meta-analysis to synthesize the available evidence.

METHODS: A systematic search of PubMed, Embase, and the Cochrane Library was conducted to identify studies evaluating PeTEP repair for ventral hernia with or without rectus diastasis. Meta-analytical pooling of outcomes was performed using a random-effects model. All statistical analyses were conducted using R software (version 4.4.1).

RESULTS: Four studies were included, comprising 99 patients, with a mean age of 51.53 years and a mean body mass index of 29.55 kg/m². The pooled mean operative time was 129.48 min (95% CI 74.96 to 184.00). Hematoma occurred in 10.61% of patients (95% CI 5.14 to 20.62), and overall postoperative complications in 21.21% (95% CI 12.98 to 32.69), with no intervention required in either case. Bulging was observed in 4.88% of cases (95% CI 1.22 to 17.52). No recurrences were reported across studies, with follow-up ranging from 1 to 12 months.

CONCLUSION: Current evidence suggests that PeTEP may be a feasible minimally invasive extraperitoneal approach for ventral hernia repair. However, further comparative studies with longer follow-up are needed.

PMID:42228218 | DOI:10.1007/s10029-026-03736-1

Nurs Crit Care. 2026 Jul;31(4):e70528. doi: 10.1111/nicc.70528.

ABSTRACT

BACKGROUND: Intensive care nurses are frequently exposed to emotionally demanding and ethically challenging situations, which may affect their emotional awareness and moral functioning. Alexithymia, characterised by difficulties in identifying and expressing emotions, may be an important factor contributing to moral distress in intensive care settings.

AIM: This study aimed to examine the relationship between alexithymia and moral distress among intensive care nurses and to compare their levels according to sociodemographic and professional characteristics.

STUDY DESIGN: A descriptive and correlational design was employed. Data were collected from intensive care nurses in Sivas, Türkiye, using the Personal Information Form, the Toronto Alexithymia Scale-20 (TAS-20) and the Moral Distress Scale-Revised (MDS-R). Data were analysed using Pearson’s correlation analysis, independent samples t-test, one-way ANOVA and Welch’s ANOVA (p < 0.05).

RESULTS: Among the 146 intensive care nurses included in the study, 34 (23.3%) were classified as alexithymic, 37 (25.3%) as possibly alexithymic, and 75 (51.4%) as non-alexithymic. A moderate, positive and statistically significant correlation was found between total alexithymia and moral distress scores (r = 0.623, p < 0.001). Moral distress was positively associated with all alexithymia subdimensions, including difficulty identifying feelings, difficulty describing feelings and externally oriented thinking (p < 0.001). Higher levels of alexithymia and moral distress were observed among female nurses, single nurses, those with postgraduate education, longer intensive care experience and nurses with prior or current intentions to leave the profession (p < 0.05).

CONCLUSION: Alexithymia was significantly associated with higher levels of moral distress among intensive care nurses. Interventions aimed at enhancing emotional awareness and adaptive coping may help mitigate moral distress in intensive care settings.

RELEVANCE TO CLINICAL PRACTICE: Integrating emotion-focused support strategies into intensive care practice may strengthen nurses’ psychological resilience and contribute to workforce sustainability.

PMID:42227230 | DOI:10.1111/nicc.70528

Int J Biostat. 2026 Jun 1. doi: 10.1515/ijb-2025-0066. Online ahead of print.

ABSTRACT

In right-skewed count data, the mean is disproportionately affected by a long upper tail, whereas the median remains a more representative measure of central tendency. Discrete Weibull (DW) regression links covariates to a shifted median, which in turn induces the exact integer median; however, a single DW component can fit poorly when the observed count distribution has a markedly heavier upper tail than a single-component model can accommodate. We propose a contaminated DW (cDW) regression that augments the baseline DW distribution with a more dispersed secondary component within a finite mixture while retaining a single shifted-median link. This mixture accommodates extreme counts more effectively, thereby stabilizing the median-based regression coefficients. The model accommodates general lower truncation at an arbitrary threshold c, including c = 1 for strictly positive outcomes and c = 0 for nonnegative counts, and is estimated using a straightforward Bayesian Markov chain Monte Carlo algorithm implemented in JAGS; R code accompanies the paper. Applied to hospital length-of-stay data, the cDW regression reduces the influence of outliers and achieves superior predictive performance relative to a single-component DW model, as demonstrated by leave-one-out cross-validation and a Kullback-Leibler influence diagnostic. Simulation experiments show that, under strongly heavy-tailed mixture settings, the cTDW model accurately recovers the regression coefficients and improves on the single-component TDW model. Because the added tail component can increase probability mass at both extremes, we further recommend embedding the cDW in a hurdle framework when structural zeros are present: the zero probability is modeled separately, and the heavy-tail mixture is applied only to positive counts. The cDW regression model provides a robust, median-centered alternative for analyzing skewed, possibly truncated count outcomes.

PMID:42227217 | DOI:10.1515/ijb-2025-0066

J Palliat Med. 2026 Jun 2:10966218261448973. doi: 10.1177/10966218261448973. Online ahead of print.

ABSTRACT

BACKGROUND: Population-level data on palliative care need remain limited in many regions. Cancer mortality is commonly used as a proxy indicator of population-level palliative care demand. Gulf Cooperation Council (GCC) countries have undergone rapid demographic and epidemiological transition, highlighting the need for evidence-informed planning.

OBJECTIVES: To examine long-term trends in cancer mortality across six GCC countries (Saudi Arabia, United Arab Emirates, Kuwait, Qatar, Bahrain, and Oman) and assess implications for palliative care planning.

DESIGN: Ecological time-trend analysis.

SETTING/SUBJECTS: National mortality data from six GCC countries (2000-2022).

MEASUREMENTS: Age-standardized cancer mortality rates (ICD-10 C00-C97) were obtained from the World Health Organization Global Health Observatory. Trends were evaluated using annual percentage change estimates, segmented (joinpoint) regression, and models accounting for between-country variability.

RESULTS: Data availability varied substantially across countries. Bahrain, Kuwait, and Qatar had sufficient longitudinal data and demonstrated statistically significant declines in age-standardized cancer mortality (p < 0.001), with the largest reduction observed in Bahrain. Nonlinear, phase-dependent trends were identified. Countries with limited data were analyzed descriptively.

CONCLUSIONS: Cancer mortality trends in GCC countries vary according to data completeness. Declining mortality does not necessarily indicate reduced palliative care need. Cancer mortality remains a pragmatic population-level indicator for planning in settings with limited direct measures of need. Strengthening mortality surveillance and integrating palliative care into national cancer control strategies are essential.

PMID:42227184 | DOI:10.1177/10966218261448973

Health Educ Behav. 2026 Jun 2:10901981261453327. doi: 10.1177/10901981261453327. Online ahead of print.

ABSTRACT

Southeast Asian cancer screening rates are alarmingly the lowest across all racial and ethnic groups in the United States. This paper examines barriers to breast cancer screening among Southeast Asian women, an understudied and underserved subgroup within the broader Asian American population, participating in a culturally tailored navigation intervention. A total of 194 women were randomly assigned to either the intervention-Tailored Messaging System^© group (n = 103) or the information-reminder only group (n = 91). The intervention group received tailored messages addressing barriers, beliefs, perceived risks, and self-efficacy, along with guidance to complete mammograms, delivered by trained community health advisors over 10 weeks. The information group received screening information by mail. Barriers were evaluated via a questionnaire at baseline in both groups. Results showed statistically significant differences in mammography screening by ethnicity, but not by intervention group. The Lao constituted the largest group, with 20 (37.7%) screened, followed by Cambodians at 7 (26.1%), whereas only 5 (8.5%) of the Vietnamese and none (0.0%) of the Filipina women completed mammograms. Findings indicate that some Southeast Asian women are less likely to get screened for breast cancer due to modifiable factors such as health insurance, doctors’ recommendations, fears, and perceptions. Disaggregating data for Southeast Asian women subgroups is an essential step for uncovering barriers in cancer screening uptake. Public health interventions and campaigns should consider these barriers and the importance of using disaggregated data.

PMID:42227134 | DOI:10.1177/10901981261453327