Heart Vessels. 2026 Apr 29. doi: 10.1007/s00380-026-02700-4. Online ahead of print.
NO ABSTRACT
PMID:42050278 | DOI:10.1007/s00380-026-02700-4
Tag: statistics
Environ Monit Assess. 2026 Apr 28;198(5):516. doi: 10.1007/s10661-026-15378-y.
ABSTRACT
Can Gio District in southern Vietnam, including the Can Gio Biosphere Reserve and the urbanized beaches of Can Thanh Town, is a rapidly developing coastal area facing increasing pressures from marine plastic pollution. This study compared beach litter monitoring using 1 m × 1 m quadrats with in situ collection against smartphone imagery captured via the Mergin Maps app and later annotated in DotDotGoose. Mergin Maps was selected because it provides an open‑source, smartphone‑based GIS platform for rapid, low‑cost capture of georeferenced quadrat images, which is more feasible for routine monitoring in resource‑limited coastal settings than drone surveys or fully manual transect methods. Across four sandy beaches, at Bui Lam Beach field surveys recorded 399 items, while image-based analysis detected 410 items; at Bui Lam-Tac Xuat Beach, field surveys recorded 212 items, compared with 236 from image-based analysis, indicating strong tidal influence and clam farming activities at these sites. At Can Thanh Park, 189 items were counted in the field compared with 149 items in images, whereas at Tac Xuat, a tourist beach with regular cleanups, 82 and 71 items were recorded by field and image-based methods, respectively. Overall litter densities exceeded 10 items m⁻2 for both methods, and plastics accounted for more than 96% of all items, with foam and fragmented single-use products dominating. Although a relatively high error percentage was observed between the two monitoring methods (mean 43.15% ± 32.81%, ranging from 0 to 116.67% across quadrats), this was mainly due to under-detection of items that were partially buried, obscured by vegetation, or mixed with organic matter during image-based classification. Despite this limitation, statistical analysis revealed no significant difference between image-based classification and field data regarding litter count (p > 0.05). Mergin Maps provides a rapid assessment tool for monitoring marine litter, with statistically equivalent results to field sampling and approximately 2.5-3 times faster field data collection than conventional quadrat sampling.
PMID:42050267 | DOI:10.1007/s10661-026-15378-y
Rheumatol Ther. 2026 Apr 28. doi: 10.1007/s40744-026-00857-y. Online ahead of print.
ABSTRACT
INTRODUCTION: Despite the European Alliance of Associations for Rheumatology (EULAR) recommendation to minimize glucocorticoid (GC) use in systemic lupus erythematosus (SLE), prospective data quantifying toxicity across low-dose ranges are lacking. This study aimed to assess toxicity using the GC toxicity index (GTI) in SLE patients and compare toxicity profiles among dose-defined subgroups.
METHODS: Patients from the STAR cohort (May 2023-May 2024) were prospectively followed up for 1 year. Stratified by average daily prednisone (PDN) dose, toxicity was assessed using GTI comprising the aggregate improvement score (AIS) and the cumulative worsening score (CWS) at baseline and 1 year. Three pre-planned stepwise comparisons used dose thresholds of 7.5 mg, 5 mg, and 2.5 mg, with a Bonferroni-corrected significance level of P < 0.0167 (α = 0.05/3). Quantile regression evaluated the association between average daily PDN dose and CWS/AIS.
RESULTS: Of 302 patients, the PDN ≤ 7.5 mg/day group (n = 223) showed statistically lower median CWS [0 (IQR 0-19) vs. 48 (IQR 19-84), P < 0.001] and AIS [0 (IQR – 19-10) vs. 40 (IQR 9-74), P < 0.001] compared to the PDN > 7.5 mg/day group (n = 79). Within the low-dose group, patients with 5 < PDN ≤ 7.5 mg/day (n = 52) exhibited higher median CWS [10.5 (IQR 0-29) vs. 0 (IQR 0-19), P = 0.002] and wider AIS interquartile range [0 (IQR – 18.75-29) vs. 0 (IQR – 20-0), P = 0.010] than the PDN ≤ 5 mg/day subgroup (n = 171). No significant differences in CWS or AIS were observed between the PDN ≤ 2.5 mg/day (n = 90) and 2.5 < PDN ≤ 5 mg/day (n = 81) subgroups. Quantile regression indicated that each 1 mg/day increase in PDN dose raised median CWS by 3.33 points and median AIS by 3.42 points.
CONCLUSIONS: To our knowledge, this study provided the first prospective and quantitative evidence using the GTI to demonstrate that PDN dose reduction to ≤ 5 mg/day was linked to reduced toxicity. Moreover, we found that no dose was entirely safe, which strongly supported the EULAR strategy of rigorous GC minimization.
PMID:42050254 | DOI:10.1007/s40744-026-00857-y
Arch Gynecol Obstet. 2026 Apr 28;313(1):180. doi: 10.1007/s00404-026-08407-1.
ABSTRACT
OBJECTIVE: To examine walking behavior during pregnancy and its association with obstetric and neonatal outcomes.
METHODS: This retrospective cohort study included pregnant patients who delivered between 2020 and 2024 at a tertiary medical center. Daily step counts were recorded via the Health Auto Expert mobile application from three months before conception until admission to the labor ward. Pregnancy and delivery data were obtained from medical records. The primary outcome was a composite of delivery complications by step-count category: Above-Average and Below-Average, based on the cohort mean. Secondary outcomes included postpartum complications, mode of delivery, and neonatal outcomes.
RESULTS: The mean daily step count during pregnancy was 2539, declining progressively with gestation. Of 176 patients, 71 (40%) were Above-Average and 105 (60%) Below-Average. The Above-Average group had higher pre-pregnancy activity (4541.7 vs 2330.3 steps/day, p < 0.001) and higher maternal age. No significant differences were found in composite delivery or postpartum complications. Vacuum extraction was more frequent in the Above-Average group (15.5% vs 3.8%, p = 0.014), though not significant after adjustment. Median neonatal birth-weight percentile was 54.5, lower in the Above-Average group (44.0 [25.0-71.0] vs 60.0 [38.0-78.0], p = 0.024), without significance in multivariable analysis.
CONCLUSIONS: Walking patterns declined across pregnancy. Step count was not associated with delivery complications or adverse maternal or neonatal outcomes. Walking during pregnancy appears safe and was not associated with adverse maternal or neonatal outcomes in this predominantly sedentary cohort of low-risk pregnancies.
PMID:42050160 | DOI:10.1007/s00404-026-08407-1
Eur Arch Otorhinolaryngol. 2026 Apr 29. doi: 10.1007/s00405-026-10205-z. Online ahead of print.
ABSTRACT
PURPOSE: The maturation of auditory pathways in newborns, particularly in pre-terms, is a crucial process influencing the accuracy and timeliness of early audiological diagnosis. The aim of this study was to investigate the effect of postnatal auditory pathway maturation on hearing loss diagnosis by comparing early and later ABR assessments in pre-term and full-term newborns.
METHODS: Seventy-eight newborns (156 ears) were enrolled and divided by gestational age. All underwent initial screening, clinical Auditory Brainstem Response (ABR), tympanometry, and evaluation of diagnostic timing. Statistical analyses were performed with Jamovi (v.2.3.28).
RESULTS: In full-term newborns, the initial screening significantly predicted ABR outcomes, whereas no such correlation emerged in pre-terms. However, pre-terms showed a significant improvement in ABR thresholds over time, consistent with postnatal maturational effects on auditory pathway function. Additionally, pathological tympanograms (type B) were associated with a delayed diagnosis.
CONCLUSIONS: These findings stress the need for tailored protocols and extended follow-up in pre-term newborns, as well as early detection of middle ear conditions to minimize both under- and over-diagnosis.
PMID:42050140 | DOI:10.1007/s00405-026-10205-z
Arch Gynecol Obstet. 2026 Apr 28;313(1):177. doi: 10.1007/s00404-026-08361-y.
ABSTRACT
PURPOSE: Adenomyosis is a chronic uterine disorder characterised by ectopic endometrial tissue within the myometrium, frequently associated with dysmenorrhea, abnormal uterine bleeding (AUB), chronic pelvic pain (CPP), and dyspareunia. No standardised guidelines are currently available for its management, and therapeutic options remain limited for women seeking fertility preservation. This study aimed to evaluate the efficacy of intravaginal progesterone in alleviating adenomyosis-related symptoms in patients seeking fertility preservation.
METHODS: In this prospective monocentric observational study, 85 patients aged 22-50 years with ultrasound-confirmed symptomatic adenomyosis were enrolled between April 2020 and April 2024. Inclusion criteria were age 18-55 years, BMI 18-35, and a Visual Analogue Scale (VAS) score ≥ 7 for dysmenorrhea, AUB, CPP, or dyspareunia. All patients received 200 mg/day of intravaginal progesterone for 10 days per cycle. Symptom severity was assessed using VAS scores at baseline and at 6 months. Data were analysed using non-parametric statistical tests.
RESULTS: Sixty-five patients completed the 6-month follow-up. Four patients conceived during treatment and were excluded from the final analysis. Statistically significant improvements were observed for all assessed symptoms (all p < 0.05). Median VAS scores decreased for dysmenorrhea (9 to 6, p < 0.001), AUB (8 to 6, p < 0.001), chronic pelvic pain (5.5 to 3.5, p < 0.001), and dyspareunia (2 to 0, p = 0.020). The overall treatment satisfaction was high, with a mean Likert score of 7.5 out of 10.
CONCLUSION: Intravaginal progesterone appears to be an effective fertility-sparing treatment for symptomatic adenomyosis, providing significant relief across all primary symptoms, with high patient satisfaction. Larger controlled studies are warranted to confirm these preliminary findings and further define its role in clinical practice.
PMID:42050103 | DOI:10.1007/s00404-026-08361-y
Nat Genet. 2026 Apr 28. doi: 10.1038/s41588-026-02609-8. Online ahead of print.
NO ABSTRACT
PMID:42050059 | DOI:10.1038/s41588-026-02609-8
Mycopathologia. 2026 Apr 29;191(3):49. doi: 10.1007/s11046-026-01073-6.
ABSTRACT
Mucormycosis ranks third among invasive mycoses after Candidiasis and Aspergillosis and is associated with high mortality. Its incidence has increased with the rising number of immunosuppressed patients. In developing countries, the most common predisposing factor is uncontrolled diabetes mellitus (DM), whereas in developed countries it is immunosuppressive conditions. To examine local epidemiological data, predisposing factors, diagnostic and therapeutic options and survival in our center eighty-six adult mucormycosis patients between 2000 and 2020 were retrospectively analyzed. Thirty-nine (45.35%) were male, 47 (54.65%) were female, and the median age was 52 years (IQR, 42.5-62). The most frequent clinical presentation was sinus involvement, observed in 77 cases (89.53%). Of these, 38 (44.18%) were sinonasal, 5 (5.81%) sinoorbital, 9 (10.47%) rhinocerebral, and 25 (29.07%) rhino-orbito-cerebral mucormycosis. The remaining 9 cases (10.47%) had pulmonary mucormycosis. Predisposing factors included hematologic diseases in 51 patients (59.30%), DM in 33 (38.37%), solid organ transplantation (SOT) in 7 (8.14%), and solid organ malignancy in 7 (8.14%). The most common symptoms were fever (70.93%), swelling around the eyes and face (51.16%), pain (40.7%), erythema (34.88%), nasal discharge (30.23%), and headache (25.58%). Most frequent physical examination findings were necrotic lesions in the oral cavity and sinuses (87.21%), ophthalmoplegia (29.07%), ptosis (26.74%), vision loss (25.58%), and proptosis (22.09%). In all cases, amphotericin B formulations were preferred as initial therapy. Patients who received combination therapy (n = 14), 13 used posaconazole (POS) + liposomal amphotericin B (L-AmB) and one patient used itraconazole (ITC) + L-AmB. POS was administered to 14 patients receiving sequential oral therapy. The median duration of amphotericin B therapy was 46.5 days (IQR, 14.7-84.5), and the median total duration of antifungal therapy was 46.5 days (IQR, 14.7-90.3). The most common adverse effect of amphotericin B formulations was hypokalemia [L-AmB 68.75%, amphotericin B deoxycholate (AmB-D) 54.84%, amphotericin B lipid complex (ABLC) 50%]. At least one surgical intervention was performed in 74.42% of cases. The 12-week mortality rate was 48.84%, overall mortality rate was 61.63%. In analysis advanced age [12-week: OR: 1.04 (95% CI: 1.01-1.07), p = 0.011; overall: OR: 1.04 (95% CI: 1.01-1.07), p = 0.026 respectively], coexistence of both hematologic disease and DM [12-week OR: 5.73 (95% CI: 1.16-28.33), p = 0.032] associated with mortality. No significant difference was observed in 12-week mortality between surgical and non-surgical patients (p = 0.107). In contrast, overall mortality was significantly higher in the non-surgical group (81.8% vs. 54.7%, p = 0.024). In univariable logistic regression analysis, surgical intervention was associated with a 73.2% reduction in the odds of overall mortality (OR: 0.268, 95% CI: 0.082-0.882, p = 0.030). In the multivariable logistic regression analysis, age was the only variable significantly associated with 12-week and overall mortality (respectively, p = 0.004 and p = 0.026). Each one-year increase in age was associated with an OR of 1.05 (95% CI: 1.02-1.09) for 12-week mortality and 1.04 (95% CI: 1.01-1.07) for overall mortality. In conclusion; our study showed that despite advanced diagnostic methods and antifungals, mortality remained high, sinus involvement was the most frequent involvement, surgical debridement increased survival, but increasing age was associated with poor prognosis.
PMID:42050055 | DOI:10.1007/s11046-026-01073-6
Nat Comput Sci. 2026 Apr;6(4):417-429. doi: 10.1038/s43588-026-00974-2. Epub 2026 Apr 28.
ABSTRACT
The finite element method (FEM) is a well-established numerical method for solving partial differential equations (PDEs). However, its mesh-based nature gives rise to substantial computational costs, especially for complex multiscale simulations. Emerging machine learning-based methods provide data-driven solutions to PDEs, yet they present challenges, including high training cost and low model reusability. Here we propose the neural-operator element method (NOEM) by synergistically combining FEM with operator learning to address these challenges. NOEM leverages neural operators to simulate subdomains that require fine meshes in FEM. In each subdomain, a neural operator is used to build a single element, namely, a neural-operator element (NOE). NOEs are then integrated with standard finite elements to represent the entire solution through the variational framework. Thereby, NOEM does not necessitate dense meshing and offers efficient simulations. We demonstrate the accuracy, efficiency and scalability of NOEM by performing systematic theoretical analysis and numerical experiments, such as nonlinear PDEs, multiscale problems, PDEs on complex geometries and discontinuous coefficient fields.
PMID:42050047 | DOI:10.1038/s43588-026-00974-2
Arch Gynecol Obstet. 2026 Apr 28;313(1):178. doi: 10.1007/s00404-026-08368-5.
ABSTRACT
BACKGROUND: In this systematic review and meta-analysis, we aimed to explore the availability of alternatives to oxytocin for preventing postpartum haemorrhage (PPH) during vaginal births (VB) and caesarean births (CB).
METHODS: We followed the Cochrane guidelines for the review, and reported the results using the PRISMA guidelines. Using a thorough search strategy, we retrieved original articles from SCOPUS, PubMed, Web of Science, and the Cochrane Library from January 2015 to February 2025. We analyzed the RCTs to compare Tranexamic Acid (TXA), carbetocin, and misoprostol with oxytocin for preventing PPH in both vaginal and caesarean births. The review’s protocol has been officially registered with PROSPERO under the identifier CRD420251002602.
RESULTS: A meta-analysis of 20 trials showed no statistically significant difference in reducing blood loss during vaginal births (SMD = – 0.21; 95% CI – 0.62 to 0.19; I2 = 96%). However, contrasting results were observed in cesarean births (SMD = – 0.82; 95% CI – 1.49 to – 0.16; p = 0.02). Correspondingly, no statistically significant difference was found in the occurrence of PPH in vaginal births (OR = 0.80; 95% CI 0.53 to 1.21; I2 = 98%), while significant variances were detected in cesarean births (OR = 0.58; 95% CI 0.43 to 0.80; I2 = 21%). Hemoglobin variation was notably lower in both vaginal and cesarean births (SMD = – 0.32; 95% CI – 0.49 to – 0.16; I2 = 93%) and (SMD = – 0.90; 95% CI – 1.52 to – 0.27; I2 = 96%), respectively.
CONCLUSION: Considering the substantial heterogeneity and mostly non-significant pooled results, the current findings should be viewed as indicative rather than conclusive. Further rigorous, well-designed randomized controlled trials are necessary to better define their effectiveness, optimize dosing, and identify patient groups most likely to benefit.
PMID:42050041 | DOI:10.1007/s00404-026-08368-5