Category: Statistics

Med Image Comput Comput Assist Interv. 2026;15963:661-671. doi: 10.1007/978-3-032-04965-0_62. Epub 2025 Sep 19.

ABSTRACT

Optical coherence tomography (OCT) images are often acquired as highly anisotropic volumes, where the scanning step is dense along the fast axis but sparse along the slow axis. This affects image analysis, such as image registration for longitudinal alignment. To create more isotropic volumes, bicubic interpolation can be used along the slow axis, but it generally produces blurry features. Registration-based interpolation can reduce blurriness, but often fails to generate realistic OCT images. Deep generative models can sample realistic images, but lack the structural consistency constraints required for interpolation. In this paper, we propose an unsupervised image interpolation method that combines registration-based interpolation with a deep generative model to overcome their individual limitations and improve the structural accuracy and realism of interpolated OCT images. We compare the proposed method with both bicubic and registration-based interpolation on real OCT datasets, and show that it achieves the best interpolation performance.

PMID:42434689 | PMC:PMC13352931 | DOI:10.1007/978-3-032-04965-0_62

Front Behav Neurosci. 2026 Jun 19;20:1861841. doi: 10.3389/fnbeh.2026.1861841. eCollection 2026.

ABSTRACT

BACKGROUND: Aging is associated with progressive alterations in behavioral function, yet majority of the studies interpret behavioral outcomes on an assay-by-assay basis, limiting understanding of how behavioral domains are organized. Our previously published study used a mouse cohort to report assay-specific behavioral effects. In this study, we examined whether aging-related behavioral signals remain localized to individual assays or can be summarized as coordinated domain-level patterns.

METHODS: A structured rule-based workflow was implemented for feature engineering, direction harmonization, z-score standardization, and domain-level composite construction across locomotion/exploration, anxiety/avoidance, depression/passive coping, cognition/learning, memory, and sociability domains. Outcomes were analyzed using parametric or non-parametric models following assumption screening, with effect sizes reported.

RESULTS: Domain-level composite scores did not show significant age- or sex-related effects, indicating limited broad behavioral separation. In contrast, refined feature-level analysis identified modest locomotor differences (core locomotion distance; Kruskal-Wallis p = 0.048) and the clearest age-related signal in Barnes Maze performance, particularly the Barnes Maze efficiency index (F = 10.815, p < 0.001), with reduced performance in older animals. Repeated-measures analyses further confirmed training-related improvements in latency across days. Several additional measures showed a trend but did not reach statistical significance and hence are reported descriptively only.

CONCLUSION: Aging-related behavioral changes in this dataset were concentrated in specific assay-level measures rather than broadly distributed across domains. Domain-level aggregation reduced separation of effects, indicating that the present composites should be interpreted as heuristic summaries rather than validated behavioral dimensions. The main added value of this reanalysis is therefore interpretive, showing that the strongest signals remain most evident in selected measures, particularly Barnes Maze outcomes.

PMID:42434686 | PMC:PMC13351101 | DOI:10.3389/fnbeh.2026.1861841

Cureus. 2026 Jun 9;18(6):e110557. doi: 10.7759/cureus.110557. eCollection 2026 Jun.

ABSTRACT

BACKGROUND AND OBJECTIVE: The rising prevalence of opioid use during pregnancy has contributed to increasing rates of neonatal opioid withdrawal syndrome (NOWS). Traditional management using the Finnegan Neonatal Abstinence Scoring System (FNASS) is associated with prolonged hospitalization, increased neonatal intensive care unit (NICU) utilization, and reduced maternal‑infant bonding. Function‑based models such as Eat, Sleep, Console (ESC) emphasize non‑pharmacologic care and may improve outcomes. This project aimed to transition from FNASS to ESC within a small safety‑net hospital and evaluate associated clinical outcomes.

METHODS: We conducted a single‑center quality improvement initiative using a phased implementation strategy over 2.5 years. Eligible neonates were >36 weeks gestation or >2000 grams with prenatal opioid exposure. Clinical outcomes were compared between infants managed with FNASS (n=24) and ESC (n=12). Due to the small sample size and skewed distributions, continuous variables were analyzed using Mann-Whitney U tests and reported as medians with interquartile ranges.

RESULTS: ESC implementation was associated with shorter median length of stay (3.5 vs. 16.5 days; p<0.001), fewer days on pharmacologic treatment (0 vs. 11.5 days; p=0.008), and fewer days in the NICU (0 vs. 13.5 days; p<0.001). Infants in the ESC group spent a higher percentage of hospitalization bonding with their mothers (100% vs. 14.6%; p=0.002), although the total number of bonding days did not differ significantly (p=0.199). Pharmacologic treatment use was lower in the ESC group (0% vs. 54.2%; p=0.002).

CONCLUSIONS: Transitioning to ESC was associated with reduced pharmacologic treatment, shorter hospitalization, decreased NICU utilization, and improved maternal‑infant bonding. These findings support the feasibility of ESC implementation in resource‑limited safety‑net settings and highlight a scalable framework for equitable NOWS care.

PMID:42434680 | PMC:PMC13349960 | DOI:10.7759/cureus.110557

Cureus. 2026 Jun 10;18(6):e110582. doi: 10.7759/cureus.110582. eCollection 2026 Jun.

ABSTRACT

Introduction Menstrual cups are a safe, cost-effective, and sustainable menstrual hygiene product; however, their awareness and acceptability among adolescents remain low due to socio-cultural barriers and misconceptions. The study aimed to assess the knowledge, awareness, myths, and acceptability of menstrual cups among adolescent girls and to evaluate factors influencing their willingness to use them. Materials and methods A community-based cross-sectional study was conducted among 812 adolescent girls aged 13-19 years in Nagamangala taluk, Karnataka, from February to April 2026. Data were collected using a pre-tested semi-structured questionnaire. Knowledge was categorized as adequate when >50% responses were correct. Associations were analyzed using the chi-squared test, with p < 0.05 considered statistically significant. Results Awareness of menstrual cups was observed in 308 (37.9%) participants. Adequate knowledge was present in 342 (42.1%), while myths and misconceptions were reported by 498 (61.3%). The most common misconception was fear of pain during insertion 362 (44.6%). Overall, 548 (67.5%) participants expressed willingness to use menstrual cups. Awareness increased significantly with age (χ² = 9.82, p = 0.002). Willingness was significantly higher among those aware, 220 (71.4%), compared to those not aware, 328 (65.1%) (χ² = 4.21, p = 0.040). Adequate knowledge was associated with higher acceptability (χ² = 14.7, p < 0.001), while the presence of myths was associated with lower willingness (χ² = 41.6, p < 0.001). Conclusion Despite low awareness and prevalent misconceptions, the acceptability of menstrual cups was relatively high, particularly after exposure to appropriate information. Strengthening menstrual health education and addressing myths may improve the adoption of menstrual cups among adolescents.

PMID:42434676 | PMC:PMC13352334 | DOI:10.7759/cureus.110582

Cureus. 2026 Jun 10;18(6):e110620. doi: 10.7759/cureus.110620. eCollection 2026 Jun.

ABSTRACT

Deglutition disorders and cognitive impairment co-occur frequently in older adults and in patients with neurodegenerative or cerebrovascular disease, yet the intellectual structure and collaborative patterns at this clinical interface have not been mapped. We performed a bibliometric analysis, with scoping-review-style charting, of publications indexed in the Scopus database through the search date of 10 October 2025; we retrieved 1,190 records and retained the 100 most-cited articles for in-depth analysis. Because the most recent publications (2023-2025) have not yet accrued sufficient citations, the resulting top-100 corpus spans 2009-2022. Articles were stratified into three citation tiers: Hyperclassics (≥500 citations, n = 11), Top-Class (250-499 citations, n = 20), and Classics (100-249 citations, n = 69). Performance analysis and science mapping were conducted in R version 4.4.2 (R Foundation for Statistical Computing, Vienna, Austria) using the bibliometrix and biblioshiny packages (open-source; https://www.bibliometrix.org/). Continuous variables were compared using the Kruskal-Wallis test followed by post hoc Mann-Whitney U tests; categorical variables with the chi-squared test and Cramér’s V; and correlations among journal indicators with Spearman’s rho and 95% confidence intervals derived via Fisher’s z-transformation. The corpus accumulated 30,872 total citations (range 112-4,312). Stroke was the leading venue (6 articles; 7,909 citations; 25.6% of the corpus), and the United States contributed 32 articles representing 47% of all citations, followed by the United Kingdom, Italy, Canada, and Germany. Hyperclassics significantly out-cited Classics in both total citations and citations per year (both p<0.0001) but not in author count or active years. Inter-metric correlations among Journal Impact Factor (JIF), CiteScore, SCImago Journal Rank (SJR), and Source Normalized Impact per Paper (SNIP) were uniformly strong (ρ>+0.84; all p<0.001), whereas correlations between these journal-level indicators and article-level citations were weak (ρ +0.22 to +0.29; all p<0.05). Keyword co-occurrence resolved three thematic clusters-stroke, dementia, and dysphagia (clinical burden and nutrition); Parkinson’s disease and movement disorders; and neurological symptoms, cognition, and diagnostic imaging-while a complementary thematic-evolution analysis traced eight finer research streams. The field is dominated by stroke-related research and Anglo-American academic medicine, with a small set of influential guidelines driving disproportionate citation weight. Within this most-cited corpus, articles centred explicitly on the dysphagia-cognition interface were comparatively few (14% of the corpus), whereas disease-context and guideline records predominated; sensitivity analyses excluding peripheral records preserved the thematic and geographic structure. Estimating under-representation relative to clinical burden would require a field-normalised denominator and is proposed as future work. Future work should prioritize mechanistic neuroimaging in cognitively impaired patients, validated screening instruments adapted for dementia and parkinsonism, and comparative-effectiveness trials of dysphagia interventions across diagnostic categories.

PMID:42434674 | PMC:PMC13354282 | DOI:10.7759/cureus.110620

Cureus. 2026 Jun 9;18(6):e110560. doi: 10.7759/cureus.110560. eCollection 2026 Jun.

ABSTRACT

Introduction Effective labor analgesia plays a crucial role in improving maternal comfort and the overall childbirth experience. The aim of the present study was to compare maternal satisfaction and breakthrough pain between programmed intermittent epidural bolus (PIEB) and continuous epidural infusion (CEI) techniques for labor analgesia. Materials and methods This cross-sectional study was conducted in the Department of Anesthesiology among 192 term pregnant women who received epidural labor analgesia. The participants were equally divided into PIEB (n = 96) and CEI (n = 96) groups according to the maintenance epidural regimen received during labor. Maternal satisfaction was assessed using a 0-10 numeric rating scale. Secondary outcomes included breakthrough pain, physician-administered rescue boluses, patient-controlled epidural analgesia (PCEA) utilization, analgesic consumption, adverse events, and willingness to repeat the same analgesic technique. Statistical analysis was performed with p < 0.05 considered statistically significant. Results Maternal satisfaction scores were significantly higher in the PIEB group than in the CEI group (8.6 ± 0.9 vs. 7.9 ± 1.2; p = 0.001). High satisfaction (score ≥8) was observed in 72 (75.0%) participants in the PIEB group compared with 56 (58.3%) in the CEI group. Breakthrough pain occurred less frequently in the PIEB group than in the CEI group (p = 0.011). The number of physician-administered top-up boluses and PCEA activation was significantly lower in the PIEB group. Total local anesthetic volume and fentanyl consumption were also significantly reduced in the PIEB group (p < 0.05). Adverse maternal events were low and comparable between the groups. Conclusions PIEB provided superior maternal satisfaction and improved analgesic efficacy with lower anesthetic consumption than CEI while maintaining a comparable safety profile. These findings support the use of PIEB as an effective maintenance strategy for epidural analgesia during labor.

PMID:42434670 | PMC:PMC13350300 | DOI:10.7759/cureus.110560

Cureus. 2026 Jun 9;18(6):e110554. doi: 10.7759/cureus.110554. eCollection 2026 Jun.

ABSTRACT

Lumbar radiculopathy is a prevalent and debilitating spinal condition that causes severe pain, functional impairment, and diminished quality of life. Although conservative treatments are widely recommended as first-line management, establishing their comparative effectiveness remains challenging due to substantial heterogeneity in the literature. This systematic review synthesized and critically appraised the evidence evaluating non-surgical, conservative interventions for lumbar radiculopathy. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, this review was prospectively registered with PROSPERO (CRD420261407070). Comprehensive electronic searches were conducted across PubMed, Scopus, Web of Science, Embase, and the Cochrane Library up to 2026. Randomized controlled trials (RCTs) involving participants with clinically or radiologically confirmed lumbar radiculopathy were eligible for inclusion. Methodological quality was evaluated using the Cochrane Risk of Bias 2 (RoB 2) tool. Due to marked clinical and methodological heterogeneity, a quantitative meta-analysis was precluded, and a structured narrative synthesis was performed instead. Nineteen RCTs published between 2016 and 2026 met the inclusion criteria. The investigated therapies included manual therapy, neural mobilization, exercise rehabilitation, physical modalities, and multimodal regimens. Rather than purely qualitative benefits, individual trials demonstrated quantifiable short-term improvements. Manual therapy combined with exercise or neurodynamics yielded significant advantages over conventional care; for instance, adding spinal mobilization with leg movement (SMWLM) achieved a mean difference (MD) in leg pain reduction of 2.0 (95% CI: 1.4 to 2.6) at two weeks and 2.6 (95% CI: 1.9 to 3.2) at six months. Similarly, targeted neural mobilization outperformed traditional therapy at eight weeks (pain MD: -2.4, 95% CI: -3.1 to -1.7; disability MD: -12.8%, 95% CI: -16.1% to -9.5%). Traditional Persian manual therapy combined with exercise reduced low back pain by 4.28 units (95% CI: 3.36 to 5.19). However, clinical superiority was inconsistent across all outcome domains, long-term follow-ups were rare, and conservative treatment non-response or failure remained a distinct clinical possibility. Methodological limitations, including a high risk of bias regarding incomplete blinding of participants/therapists and selective outcome reporting, were frequently observed across multiple trials. Conservative interventions yield measurable, statistically significant short-term improvements in pain and function for lumbar radiculopathy. However, the overall certainty of the evidence is limited by high clinical heterogeneity and trial-level methodological constraints, which precluded data pooling. Findings should be interpreted cautiously, and further high-quality trials with standardized outcomes and adverse event reporting are required.

PMID:42434659 | PMC:PMC13349735 | DOI:10.7759/cureus.110554

Vaccine. 2026 Jul 10;88:128916. doi: 10.1016/j.vaccine.2026.128916. Online ahead of print.

ABSTRACT

This study aimed to compare the immunogenicity of three meningococcal vaccines used as booster doses in children primed with MPCV-AC in China. A total of 250 eligible children were enrolled to receive MPSV-AC, MPCV-ACYW₁₃₅, or MPCV-AC as a booster dose. Participants were subdivided into day 7 and day 28 subgroups based on the timing of sample collection. Blood samples were collected at baseline, day 7, and day 28 to measure IgG antibodies against serogroups A and C by ELISA. Baseline GMCs of IgG were 4.34 μg/mL (seropositivity: 79.2%) for serogroup A and 4.36 μg/mL (seropositivity: 82.0%) for serogroup C, both negatively correlated with age and time interval (p < 0.05). All vaccines significantly increased IgG levels at days 7 and 28 post-booster compared with baseline (p < 0.01). In the day 7 group, MPSV-AC yielded a lower GMC (19.14 μg/mL) and seroconversion rate (43.8%) for serogroup A compared with MPCV-ACYW₁₃₅ (44.69 μg/mL, 78.9%) and MPCV-AC (43.06 μg/mL, 78.1%). In the day 28 group, MPSV-AC showed a comparable GMC for serogroup A (44.42 μg/mL vs. 60.39 μg/mL and 44.66 μg/mL) and a higher GMC for serogroup C (113.40 μg/mL) than MPCV-ACYW₁₃₅ (59.62 μg/mL) and MPCV-AC (72.75 μg/mL). Only two mild adverse events were reported during the study period. These findings suggest that boosting with MPSV-AC, MPCV-ACYW₁₃₅, or MPCV-AC is safe and immunogenic; however, further studies are warranted to assess the long-term persistence of immunity conferred by these booster vaccines.

PMID:42430875 | DOI:10.1016/j.vaccine.2026.128916

Vaccine. 2026 Jul 10;88:128910. doi: 10.1016/j.vaccine.2026.128910. Online ahead of print.

ABSTRACT

BACKGROUND: Vaccine-preventable diseases continue to burden U.S. population health. Despite the Affordable Care Act (ACA) eliminating cost-sharing for recommended vaccines in 2010, adult vaccination rates persistently fall below Healthy People 2030 targets, signaling that access alone is insufficient.

OBJECTIVES: To synthesize peer-reviewed literature (2010-2025) on interventions designed to increase vaccine intention or uptake among U.S. adults; characterize strategies, populations, settings, and study quality; and identify predictors of vaccine uptake rate.

METHODS: Following PRISMA 2020 guidelines, a multi-database search was conducted across PubMed, Web of Science, Ovid/MEDLINE, and EBSCOhost, with a final updated search in December 2025. Dual independent reviewers screened studies in two stages. Quality was assessed using the EPHPP tool and certainty evaluated using GRADE. Strategies were categorized per the WHO Behavioral and Social Drivers of Vaccination (BeSD) Model. A meta-regression was conducted on 79 studies, with narrative synthesis across all 92 included studies.

RESULTS: Of 11,219 records, 92 studies were included. Study designs were predominantly RCTs; Influenza and COVID-19 vaccines were most commonly studied. In the meta-regression (adjusted R² = 0.229), prioritizing a specific population (b=0.121, p=.027), using service quality improvement strategies (b=0.226, p=.040), and recruiting through community-based partner organizations (b=0.585, p=.005) or healthcare organizations (b=0.230, p=.040) were associated with significantly higher vaccine uptake rates. Onsite vaccination was associated with lower uptake rates (b=-0.185, p=.033), an effect confirmed as specific to the COVID-19 pandemic emergency-response context rather than a generalizable effect of the strategy in sensitivity analysis. Narrative synthesis identified message framing and educational campaigns as the most frequently deployed strategies, with multi-component designs and community partnerships showing the most favorable outcomes.

CONCLUSIONS: Effective adult vaccination strategies were multifactorial. Service quality improvement, priority population focus, and community-based recruitment were the strongest predictors of higher uptake. Findings support the WHO BeSD model’s Practical Issues domain: reducing friction outperformed persuasion alone. GRADE certainty remained LOW to MODERATE, emphasizing the need for higher-quality, equity-focused research.

REGISTRATION: This systematic review was registered at Open Science Framework: 10.17605/OSF.IO/SM7YD.

PMID:42430872 | DOI:10.1016/j.vaccine.2026.128910

Am J Emerg Med. 2026 Jun 29;109:133-140. doi: 10.1016/j.ajem.2026.06.041. Online ahead of print.

ABSTRACT

OBJECTIVE: This study focuses on characterizing the voices that are amplified through peer reviewed publication and how they relate to one another. This study aims to 1) identify patterns of author collaboration and representation, 2) assess how this varies among different journals, 3) examine the relationship between author collaboration and quantitative publication.

METHODS: This is a bibliometric analysis using descriptive statistics and network analysis, examining all publications in four influential emergency medicine journals from January 2015 through December 2024. Authors and journals were assessed on quantity of publications, patterns of co-authorship, and network characteristics of individual and aggregate journals.

RESULTS: There is a sharp right-skew of authorship – most authors have only a single article published in ten years. The most prolific authors in emergency medicine demonstrate significantly more publications than their peers. Journals show a propensity to publish multiple articles from a small number of authors, but there is variation among journals as to how many unique authors appeared during the timeframe studied. There was a gender disparity identified among the top authors, most of whom were men.

CONCLUSION: Bibliometric analysis is able to demonstrate academic influence while also casting light on the role of journals in peer-reviewed publication patterns. Publication is a vital component of academic success and tangible evidence of professional influence. How authors collaborate and journals select manuscripts is impactful, and unfortunately this study demonstrates inequity among the most visible authors in the most impactful journals.

PMID:42430864 | DOI:10.1016/j.ajem.2026.06.041