Category: Statistics

Int J Urol. 2026 May;33(5):e70473. doi: 10.1111/iju.70473.

ABSTRACT

OBJECTIVE: Pelvic organ prolapse (POP) is a common pelvic floor disorder in postmenopausal women, yet no biomarkers currently exist to predict its development. This study aimed to investigate the relationship between sex hormone levels, particularly androgens, and the severity of POP in postmenopausal women.

METHODS: We conducted a prospective observational study including 109 postmenopausal women with POP and 66 age-matched women without POP (control group) at Saga University Hospital. POP severity was classified using the Pelvic Organ Prolapse Quantification (POP-Q) system. Salivary free testosterone and 17β-estradiol were measured, along with serum dehydroepiandrosterone sulfate (DHEA-S), using enzyme-linked immunosorbent assays. Clinical characteristics and lower urinary tract symptoms were also assessed. Statistical comparisons were performed using t-tests, Chi-square tests, and Pearson correlation analysis.

RESULTS: The POP group had significantly higher BMI and parity and reported more severe lower urinary tract symptoms than the control group. Salivary free testosterone levels were significantly decreased, and serum DHEA-S levels were significantly increased in the POP group (p = 0.0157 and p = 0.0082, respectively), while estradiol levels showed no significant difference. Advanced POP (stages III-IV) was associated with further reductions in free testosterone. DHEA-S levels were unexpectedly higher in POP stages II and III compared to controls.

CONCLUSION: Reduced levels of circulating androgens, particularly Salivary free testosterone, may be associated with POP development and severity. Salivary free testosterone could serve as a non-invasive biomarker for POP risk stratification. Further longitudinal and multi-institutional studies are needed to clarify the role of androgens in POP pathophysiology.

PMID:42138067 | DOI:10.1111/iju.70473

J Dent Educ. 2026 May 15. doi: 10.1002/jdd.70238. Online ahead of print.

ABSTRACT

PURPOSE: This study evaluated the effectiveness of combining a digital real-time evaluation system and virtual simulation system in enhancing tooth preparation skills for preclinical training.

METHODS: A total of 32 students from the Class of 2020 were trained using the traditional phantom head simulator. In contrast, 28 students from the Class of 2021 and 32 students from the Class of 2022 completed the training and the first ceramic crown preparation test and were assigned to Groups A or B, receiving training either with the digital real-time evaluation system or with the virtual simulation system, respectively. After completing the second incisor crown preparation test, training tasks were exchanged for a month, concluding with a final incisor crown preparation test and questionnaire. Students from the Class of 2022 completed a multidomain well-being survey to evaluate their perceived stress levels and overall well-being.

RESULTS: The 2021 and 2022 cohorts scored significantly higher than the 2020 cohort in the final test. Groups A and B (the 2021 and 2022 cohorts) showed statistically significant sequential improvement across the three tests. However, no significant difference was observed between the performance of Group A and Group B in any individual test (p > 0.05). Students expressed stronger support for the implementation of the digital real-time evaluation system relative to the virtual simulation system.

CONCLUSIONS: The combination of the digital real-time evaluation system with virtual simulation system enhances the manual dexterity of dental students in ceramic crown preparation. The sequence in which these two digital methods are implemented does not influence the effectiveness of preclinical tooth preparation training, suggesting that this combined approach may serve as a flexible and effective strategy for preclinical education. A positive association was observed between students’ final test scores in tooth preparation and their emotional well-being.

PMID:42138060 | DOI:10.1002/jdd.70238

Psychol Med. 2026 May 15;56:e154. doi: 10.1017/S0033291726103663.

ABSTRACT

The nosological status and psychopathology of delusional disorder have been a subject of debate since Kraepelin distinguished it from schizophrenia and affective psychoses. Contemporary diagnostic manuals define delusional disorder primarily by the presence of delusions, offering limited guidance for its differentiation from schizophrenia. Notably, DSM-5 introduced a major, seemingly unexplained change by allowing bizarre delusions in delusional disorder, contrary to ICD-11, prior DSM editions, and classical descriptions. This narrative review revisits the seminal works of six classical authors (Kraepelin, Jaspers, Kretschmer, Sérieux and Capgras, and De Clérambault), who shaped the concept of delusional disorder (paranoia), and their detailed clinical cases of the disorder. All considered delusional disorder to be an independent psychotic disorder, characterized by chronic, systematized, nonbizarre delusions, preservation of personality, and minimal hallucinations, with a largely intact experiential framework outside of the delusional theme. Additional features such as delusional misinterpretations, illusions, and false memories were also emphasized in the classical literature. We examined these authors’ clinical cases of delusional disorder for the presence of delusional features characteristic of schizophrenia (delusional mood, first-rank symptoms, autistic-solipsistic delusions, and double bookkeeping), which index alterations in the structure of experience rather than mere delusional content. Such delusions were rarely found in the classical clinical cases of delusional disorder. Our findings highlight psychopathological distinctions between delusional disorder and schizophrenia, suggesting that schizophrenia involves a qualitative alteration of the experiential framework that is absent in delusional disorder. These findings raise concerns about the validity of the DSM-5 change, allowing bizarre delusions in delusional disorder.

PMID:42138058 | DOI:10.1017/S0033291726103663

Otolaryngol Pol. 2025 Nov 25;79(6):9-14. doi: 10.5604/01.3001.0055.3301.

ABSTRACT

<b>Introduction:</b> Postural stability depends on the integration of various neural circuits, including somatosensory, motor, visual, vestibular, and cognitive systems, which enable flexible posture and gait control. However, the understanding of vestibular otolith function and its brain connections remains limited.<b>Aim:</b> To elucidate the anomalies of cervical vestibular-evoked myogenic potentials (cVEMPs) and their clinical correlation with symptoms associated with brainstem involvement in individuals with Parkinson’s disease (PD).<b>Methods:</b> This prospective, observational, case-control study consisted of 62 subjects: 31 idiopathic PD patients (cases) and 31 healthy volunteers (controls). Each participant underwent an otological examination, hearing evaluation, cVEMP test, and pull test. We also recorded the affected side, previous frequent falls, and illnesses duration.<b>Results:</b> The mean Revised Movement Disorder Society Unified Parkinson’s Disease Rating Scale Section III score was 14.10 8.42, and the mean scale of Hoehn and Yahr was 1.77 0.62. A statistically significant difference (P < 0.001) was found between the two groups in cVEMP identification, with presence of response in almost two thirds of Parkinson’s disease patients. In the case group, there was a considerable delay in the mean P13 and N23 latencies (P < 0.001) and a significant reduction in the mean P13-N23 amplitude (P = 0.001).<b>Conclusions:</b> cVEMP is a quick, easy, and noninvasive method to investigate brainstem dysfunction and the pathophysiological dynamics of the saccular section of the otolith and its central connection in patients with PD.

PMID:42138044 | DOI:10.5604/01.3001.0055.3301

J Eval Clin Pract. 2026 Jun;32(4):e70444. doi: 10.1111/jep.70444.

ABSTRACT

RATIONALE: Acutely hospitalised patients may be medically ready for discharge but face psychosocial and other non-medical barriers to returning home. This increases their length of stay and may lead to exposure to hospital associated risks such as hospital-acquired infections. To address these non-medical delays, a transdisciplinary allied health service (the Flying Squad, n = 1.9 Full Time Equivalent professionals) was established at The Royal Melbourne Hospital.

AIMS AND OBJECTIVES: To evaluate the feasibility (demand, implementation, practicality, acceptability and limited efficacy) of this service.

METHOD: A single-site observational study was conducted to determine the demand (number of referrals and patient characteristics including indicators of complexity via the Blaylock Risk Assessment Screening Score; BRASS), implementation (timing of referrals and home visits completed), practicality (case examples, adverse events), acceptability (compliments and complaints) and limited efficacy (estimated number of hospital days saved through the Flying Squad intervention [anticipated minus actual length of stay], discharge destination, hospital length of stay and 28-day readmissions).

RESULTS: Over 12 months, 147 participants were seen by the Flying Squad professionals (median age 64 years [Interquartile Range 51-78 years], 61% male, on day 14 [Interquartile age 7-24] of their hospital admission). Median BRASS scores were 14 (Interquartile Range 9-19] indicating “at risk of requiring extended discharge planning”. Fifty-four home visits were completed for 34 (23%) participants, and one adverse event was reported (fall with no injuries during a home visit). The service won two hospital Awards for Excellence. The median length of hospital stay was 26 [13-45] days; 80 (54%) participants were discharged directly home, and 13 (9%) were readmitted after 28 days. It was estimated that the Flying Squad saved 756 hospital days over 12 months.

CONCLUSION: The Flying Squad was a feasible service that may assist with addressing non-medical barriers to discharge.

PMID:42138035 | DOI:10.1111/jep.70444

Psychol Med. 2026 May 15;56:e155. doi: 10.1017/S0033291726103857.

ABSTRACT

BACKGROUND: Emotion dysregulation is a transdiagnostic construct associated with multiple mental health conditions and shown to be an amenable target for treatment. The original Emotion Dysregulation Inventory (EDI) was created as a proxy-report measure validated in autistic and nonautistic youth. The goal of the current study was to develop a self-report version, the EDI-Self-Report (EDI-SR), that captures a first-person perspective and creates the option of multi-reporter measurement from adolescence through adulthood.

METHODS: Using methods developed by the Patient-Reported Outcomes Measurement Information System (PROMIS), potential items and response options were written and tested in cognitive interviews. Two samples (996 participants who are autistic or have other intellectual and developmental disabilities and 1,000 participants selected to be representative of the US census as a nonclinical comparison group) completed the initial item pool. Items were assessed using exploratory and confirmatory factor analyses, item response theory analyses, concurrent calibrations, convergent correlations with comparable legacy measures, internal consistency reliability, and test-retest reliability.

RESULTS: Exploratory factor analyses suggested splitting Reactivity and Dysphoria items for confirmatory factor analyses and subsequent analyses. Following analyses, a 25-item Reactivity scale, a 7-item Dysphoria scale, and a 6-item Reactivity short-form scale were finalized. EDI-SR subscales showed convergent validity and superior total information when compared with similar measures, strong internal consistency reliability, and good test-retest reliability.

CONCLUSIONS: The EDI-SR provides an efficient, precise measure of ED in autistic individuals, individuals with other intellectual and developmental disabilities, and a US census-matched representative sample, and allows for multi-reporter assessment in clinical and research contexts.

PMID:42138030 | DOI:10.1017/S0033291726103857

Nurs Open. 2026 May;13(5):e70558. doi: 10.1002/nop2.70558.

ABSTRACT

AIM: To explore longitudinal trajectories of health literacy and identify the associated factors throughout nursing education.

DESIGN: A prospective longitudinal design with a four-year follow-up.

METHODS: The present study was performed at a state university’s nursing department in the capital city of Türkiye. The population consisted of 240 nursing students who studied in the selected faculty between 2015 and 2019. Overall, 191 nursing students were included in the final analysis (n = 191). The data were collected via a questionnaire and the Adult Health Literacy Scale. The first follow-up was performed between September and December 2015. The other three follow-ups were applied 12 months after each participant’s enrollment date, every year from September to December. The data were analysed via the IBM SPSS 25.0 program. Descriptive statistics, Repeated Measures ANOVA, and Linear Mixed Model were used to present the data.

RESULTS: The mean age was 18.49 ± 0.99, and 86.4% were women. Of the students, 50.8% lived in an urban area, 97.9% were internet users, 38.7% had visual impairment, and 38.2% had glasses. A statistically significant difference existed between the health literacy mean scores over time. Nursing students’ health literacy levels decreased among rural area residents and increased among students who had no vision problems and were internet users.

CONCLUSIONS: This study suggests that the health literacy levels of nursing students increased during the education period. Internet use, place of residence, and having a visual problem affected the alterations in health literacy levels over time.

RELEVANCE TO CLINICAL PRACTICE: Findings can be a valuable resource for nurse educators and faculty managers to produce effective strategies to increase the health literacy level of prospective nurses.

PATIENT AND PUBLIC CONTRIBUTIONS: It was not appropriate or possible to involve patients or the public in the design, conduct, reporting, or dissemination plans of our research.

PMID:42138014 | DOI:10.1002/nop2.70558

Clin Physiol Funct Imaging. 2026 May;46(3):e70067. doi: 10.1111/cpf.70067.

ABSTRACT

BACKGROUND: Peak expiratory flow (PEF) obtained from dedicated PEF meters and various types of spirometers is often used interchangeably in research, despite differences in both devices and expiratory maneuver technique. The aim of this study was to assess the effects of expiratory maneuver type and measurement device on PEF.

METHODS: We recruited 20 healthy adults experienced in performing spirometry. Each subject performed three measurements using two expiratory maneuvers (a short, explosive maneuver and a long, spirometry-style maneuver) with four devices: the handheld microspirometers Medikro Duo and MIR Spirobank, the laboratory spirometer Vyntus Pneumo, and the Mini-Wright PEF meter.

RESULTS: PEF differed significantly between devices (F(3,133) = 171.8, p < 0.001), but not between short and long expiratory maneuver techniques (F(1,133) = 2.24, p = 0.137). There was no significant interaction between device and technique (F(3,133) = 0.72, p = 0.543). Compared with the Mini-Wright, Spirobank yielded PEF values that were on average 87.1 L/min higher (74.6-99.7, p < 0.001), and Vyntus Pneumo 26.5 L/min higher (14.0-39.1, p < 0.001), whereas Medikro did not differ significantly from the Mini-Wright (mean difference -9.5 L/min, -22.1-3.1, p = 0.269). The pairwise differences between the three spirometers were all statistically significant (all p < 0.001).

CONCLUSIONS: Because short and long expiratory maneuver techniques yield similar results on PEF, future studies of home spirometry may compare the diagnostic performance of PEF and forced expiratory volume in 1 s (FEV₁) using the same long, spirometry-style expiratory maneuvers. However, comparison of absolute PEF values between devices must be done cautiously.

PMID:42138012 | DOI:10.1111/cpf.70067

Ginekol Pol. 2026;97(4):272-278. doi: 10.5603/gpl.108254.

ABSTRACT

OBJECTIVES: To assess long-term efficacy and safety of uterine artery embolization for symptomatic uterine fibroids.

MATERIAL AND METHODS: This retrospective cohort study included women undergoing uterine artery embolization for symptomatic fibroids from 2012 to 2023. A validated questionnaire assessed symptoms (e.g., heavy menstrual bleeding, pelvic pain) pre- and post- uterine artery embolization. Data on fibroid characteristics, follow-up duration, menopause status, and complications were collected. Patients were stratified into follow-up terciles. Statistical analyses included Wilcoxon signed-rank tests, linear regression with menopause adjustment, and Spearman correlations tests (p < 0.05).

RESULTS: Uterine artery embolization significantly reduced symptoms, particularly bleeding-related complaints, with sustained efficacy across short-, mid-, and long-term follow-up, even after menopause adjustment. Menopause enhanced symptom relief. No correlations were found between symptom reduction and age, fibroid size, or prior treatment. Complications, mostly minor, occurred in a notable proportion, with rare major events. A small subset achieved successful pregnancies post-embolization.

CONCLUSIONS: Uterine artery embolization is an effective, minimally invasive treatment for fibroid-related symptoms, with sustained benefits over time; menopause significantly predicts greater symptom improvement.

PMID:42138001 | DOI:10.5603/gpl.108254

J Genet Couns. 2026 Jun;35(3):e70220. doi: 10.1002/jgc4.70220.

ABSTRACT

Genetic counseling assistants (GCAs) support genetic counselors (GCs) and genetics clinic workflows, but their potential roles in pretest genetic counseling for rare diseases have not been explored. A pilot within the Mayo Clinic Center for Individualized Medicine’s Genetic Testing and Counseling Clinic (GTAC), which offers predefined tests for patients with rare disease, explored the impact of GCA pretest education on appointment time and patient questions. After training, GCAs met GTAC patients prior to the GC to provide scripted information on genetics concepts, the visit purpose, and the test including result types and disclosure plans. Data from the pilot and a control group were collected and analyzed using descriptive statistics and two-sided t-tests. Patient cohort characteristics did not differ between the two models. When a GCA provided pretest education, the GC spent an average of 11.2 minutes less with the patient during their session compared to visits completed solely by the GC (p < 0.0001). Total appointment time was not impacted by GCA education. Questions asked to GCAs were often not within GCA scope to answer (72.7%), and some patients asked repetitive questions to both the GC and GCA (63.2%). Reduction in GC time per patient could lead to increased accessibility by allowing additional patients to be seen in a day. Similar models may support GCA professional development while allowing GCs to remove repetitive education from their genetic counseling sessions, leading to less burnout and/or increased job satisfaction. Impact on administrative workflows, access, revenue, patient satisfaction and outcomes and GC/GCA satisfaction and benefits can continue to be explored when trialing models incorporating GCAs in pretest education roles.

PMID:42137995 | DOI:10.1002/jgc4.70220