Category: Statistics

J Nurs Manag. 2026;2026(1):e2913316. doi: 10.1155/jonm/2913316.

ABSTRACT

BACKGROUND: Nurses are increasingly required to adapt to organizational changes related to healthcare reform. Organizational members’ readiness for implementing change is a key determinant of effective change. However, a reliable tool for assessing organizational readiness for implementing change among Chinese nurses is currently lacking.

AIMS: To cross-culturally adapt the Organizational Readiness for Implementing Change (ORIC) scale and validate its psychometric properties in the context of Chinese healthcare institutions.

METHODS: In this cross-sectional study, Samples A and B were collected using convenience and stratified convenience sampling from four tertiary Grade A hospitals from July to December 2025. Data were collected using the General Information Questionnaire and the adapted Chinese ORIC scale. Sample A was used for item analysis and exploratory factor analysis, while Sample B was used for multilevel confirmatory factor analysis and multilevel reliability to examine the psychometric properties of the ORIC scale.

RESULTS: The valid response rates were 100% for Sample A and 93.33% for Sample B. Item analysis supported the retention of all 10 items (r > 0.300, p < 0.050). Exploratory factor analysis extracted two factors, accounting for 79.81% of the total variance. Multilevel confirmatory factor analysis demonstrated a good fit of the two-factor structure at the organizational level (χ²/df = 1.211, RMSEA = 0.014, CFI = 0.978, TLI = 0.988, SRMR-Within = 0.024, SRMR-Between = 0.017). Reliability analyses indicated good multilevel internal consistency (Cronbach’s ɑ = 0.771-0.988) and satisfactory test-retest reliability (p < 0.001).

CONCLUSIONS: The Chinese ORIC scale comprises two dimensions with 10 items. Following rigorous cross-cultural adaptation and validation, it demonstrates good psychometric properties and can be used to assess nurses’ organizational readiness for implementing change in Chinese healthcare institutions.

IMPLICATIONS FOR NURSING MANAGEMENT: The validated Chinese ORIC scale provides nursing managers with an evidence-based tool to assess organizational readiness for implementing change from the perspective of nurses as organizational members. By capturing shared perceptions of change commitment and change efficacy at the organizational level, it can inform targeted implementation strategies, strengthen organizational support, and facilitate successful healthcare change initiatives.

PMID:42590921 | DOI:10.1155/jonm/2913316

Small. 2026 Aug 12:e75018. doi: 10.1002/smll.75018. Online ahead of print.

ABSTRACT

Solving the morphological complexity of nanomaterials such as silver nanoparticles, at the one-atom level, is a prerequisite to reach a rational design of their properties. To date, structural measurements in ultra-high vacuum of silver nanoparticles remain uninterpreted. The narrow competition between octahedra and decahedra evolves in morphological statistics in the range 309-923 atoms, whereas the most stable icosahedra appear as a minority. To solve this debate, an extensive ab initio investigation of silver nanoparticles is presented in the range 18-1654 atoms (500 nanoparticles). Originally, we interpret measurements, thanks to the inclusion of defects. A very narrow competition is highlighted between defective truncated octahedra and Marks-decahedra, both dominating defective icosahedra in number but not in stability, and the experimental assumption suggesting that the presence of all symmetries is due to kinetic trapping is supported. Highly accurate computational conditions are mandatory to predict crossing sizes between structures, within one-atom precision. This exigence results from the usual stability descriptor. Imagine solving the morphological debate of silver nanoparticles without an accuracy of 10 – 5 eV. at – 1 in cohesion energy is illusory. The provided ab initio database opens promising perspectives to train machine-learning approaches aiming to examine morphological battles at larger size.

PMID:42590916 | DOI:10.1002/smll.75018

J Magn Reson Imaging. 2026 Aug 12. doi: 10.1002/jmri.70496. Online ahead of print.

ABSTRACT

BACKGROUND: Ectopic fat deposition in the liver and pancreas is closely linked to metabolic dysfunction, a key driver of the global burden of chronic disease. However, studies on intra-organ distribution of ectopic fat in the pediatric obese population remain limited.

PURPOSE: To assess MRI-based spatial distribution patterns of hepatic and pancreatic fat using a fully automated nnU-Net model and evaluate their association with biochemical risk markers.

STUDY TYPE: Prospective.

SUBJECT: Eighty-one pediatric patients (age: 12 [11, 13] years, 57 males) with overweight or obesity based on body mass index z-score.

FIELD STRENGTH/SEQUENCE: 1.5 T, gradient-echo modified-DIXON T₁W.

ASSESSMENT: The spatial distribution of fat in liver and pancreas, the correlations between hepatic and pancreatic fat fraction (FF), and the association between the fat measures and biochemical risk markers were evaluated.

STATISTICAL TESTS: Paired Wilcoxon test or t-test, repeated measure ANOVA or Friedman’s test, Kruskal-Wallis test, Spearman correlation analysis. Significance was set at p < 0.05.

RESULTS: Hepatic FF was significantly higher in the right lobe (median, 16.22%) than in the left lobe (median, 10.43%), and increased with distance from the portal vein. The degree of hepatic fat heterogeneity increased with the amount of fat deposition (whole variance: Level 0: 4.10; Level 1: 11.53; Level 2: 28.94; Level 3: 31.21). Then, the FF and its variance in the pancreatic body and tail were significantly higher than those in the head. A weak but statistically significant correlation (r range, 0.29-0.38) was observed between hepatic and pancreatic FF. Hepatic FF correlated with triglyceride and apolipoprotein B, but pancreatic fat showed no association (p range, 0.096-0.994) with lipid profiles, HOMA-IR, or HOMA-β.

DATA CONCLUSION: Intra-hepatic and intra-pancreatic fat were heterogeneously distributed in pediatric obese population. Although fat accumulation in the liver and pancreas was weakly correlated, hepatic and pancreatic fat may arise from distinct metabolic disorders.

EVIDENCE LEVEL: 2.

TECHNICAL EFFICACY: Stage 1.

PMID:42590912 | DOI:10.1002/jmri.70496

Pharmacoepidemiol Drug Saf. 2026 Sep;35(9):e70446. doi: 10.1002/pds.70446.

ABSTRACT

PURPOSE: Although antidepressant use during pregnancy has been linked to adverse birth outcomes such as stillbirth and preterm delivery, existing evidence is conflicting and rarely presents absolute risk estimates. We aimed to assess the association between antidepressant use during pregnancy and birth outcomes, alongside estimates of absolute risk to aid clinical interpretation.

METHODS: We conducted a multi-country cohort study using data from the UK Clinical Practice Research Datalink (1996-2018), Norwegian Medical Birth Registry (2009-2020), and Swedish Medical Birth Register (2006-2020). Discordant sibling analyses and paternal negative controls were used to investigate associations with stillbirth, neonatal death, gestational age, size for gestational age, and Apgar score < 7 at 5-min among pregnancies delivered at ≥ 22 weeks’ gestation.

RESULTS: Among 120 209 (4.8%) pregnancies exposed to antidepressants, maternal use was associated with stillbirth (adjusted pooled odds ratio [aOR] 1.16, 95% CI 1.05-1.28), preterm delivery (aOR 1.26, 95% CI 1.23-1.30), and low Apgar score (aOR 1.83, 95% CI 1.75-1.91). Associations persisted in sibling analyses with greater uncertainty. The predicted absolute risk of stillbirth was 0.34% among unexposed pregnancies and 0.40% among exposed. When restricting to mothers with depression or anxiety, the association with stillbirth attenuated (aOR 1.07, 95% CI 0.94-1.21). Paternal antidepressant use was modestly associated with preterm delivery and low Apgar score.

CONCLUSIONS: Maternal antidepressant use during pregnancy may be associated with increased risks of preterm delivery and low Apgar score, though absolute risks remain low. Residual confounding related to parental mental health is likely to explain part of these associations.

PMID:42590906 | DOI:10.1002/pds.70446

United European Gastroenterol J. 2026 Sep;14(7):e70271. doi: 10.1002/ueg2.70271.

ABSTRACT

BACKGROUND: Endoscopy with histopathological assessment of esophageal biopsies is the cornerstone for the diagnosis and phenotypic characterization of eosinophilic esophagitis (EoE).

OBJECTIVE: To evaluate temporal trends in endoscopic assessment and biopsy sampling practices for EoE in a large European cohort and their association with temporal trends in diagnostic delay (DD).

METHODS: A cross-sectional analysis was conducted using multicenter data from the EoE CONNECT registry. Endoscopic findings and biopsy data at diagnosis were analyzed. Temporal trends in biopsy strategies, EREFS implementation, and DD were assessed. Diagnostic sensitivity of individual esophageal segments and their combinations was evaluated in patients undergoing multi-segment sampling. Associations between guideline publication and biopsy practices were analyzed using logistic regression models.

RESULTS: A total of 3298 patients were included. Biopsies were obtained from one esophageal segment in 12.6% of patients, two segments in 63.6%, and three segments in 23.8%. Adherence to guideline-recommended biopsy strategies improved over time, with reduced single-segment sampling and increased use of ≥ 2 segments. Distal esophageal biopsies provided the highest diagnostic sensitivity, and sampling that included the distal segment achieved sensitivity above 97%, particularly when combined with middle esophageal biopsies. EREFS reporting increased from 88-90% to over 98% in recent years. DD decreased significantly over time (approximately 0.7 years per calendar year), accompanied by a shift from mixed/stricturing to inflammatory phenotypes.

CONCLUSION: Increased alignment with international guidelines, reflected by standardized endoscopic reporting and multi-segment biopsy protocols, was associated with improved diagnostic sensitivity, reduced DD, and fewer fibrostricturing presentations.

PMID:42590904 | DOI:10.1002/ueg2.70271

Paediatr Anaesth. 2026 Aug 12. doi: 10.1002/pan.70279. Online ahead of print.

ABSTRACT

BACKGROUND: In pediatric anesthesia, minimum alveolar concentration (MAC) guides inhalational agent dosing but may not accurately reflect anesthetic depth. EEG-guided anesthesia has shown benefits in adults but remains underused in children.

AIMS: This study aims to evaluate the effect of EEG-guided anesthesia with SedLine on emergence delirium (ED) and sevoflurane dose in behaviorally noncompliant children undergoing dental procedures under general anesthesia.

METHODS: In this prospective, randomized controlled trial, 100 children aged 4-10 years were randomized to standard anesthesia guided by MAC and conventional clinical signs (standard group) or EEG-guided anesthesia titrated to SedLine parameters (primary target: PSI 25-50; secondary parameter: SEF 10-15 Hz) (EEG-S group). Primary outcome was ED incidence assessed by the Pediatric Anesthesia Emergence Delirium Scale (PAEDS). Secondary outcomes included mean EtSevo values, postoperative pain, rescue analgesia, nausea/vomiting, recovery time.

RESULTS: Median PAEDS scores during the first 120 min postoperatively were significantly lower in the EEG-S group compared with the Standard group (e.g., upon arrival to PACU: 4 [IQR 4] vs. 8 [IQR 4.5]). In addition, the incidence of ED upon arrival in the recovery room was significantly lower in the EEG-S group (17% vs. 43%) and at 10 min postoperatively (17% vs. 37%). The mean end-tidal sevoflurane concentration was statistically lower in the EEG-S group (maintenance EtSevo 1.88 ± 0.25 vs. 1.98 ± 0.20; mean difference = 0.10, 95% confidence interval: 0.006-0.190; p = 0.036). Postoperative FLACC pain scores were also lower in the EEG-S group, representing a potential confounding factor for ED outcomes.

CONCLUSION: EEG-guided anesthesia was associated with lower PAEDS scores and reduced sevoflurane consumption compared with standard management. However, given small EEG-derived differences and potential confounding by postoperative pain, these findings should be interpreted cautiously. Within the applied target ranges, EEG-derived parameters were not independently associated with ED, and specific EEG targets predictive of ED could not be identified.

TRIAL REGISTRATION: This study was registered (Protocol Registration Receipt NCT06400706/OKocaturk/May 02 2024) at http://www.

CLINICALTRIAL: gov.

PMID:42590887 | DOI:10.1002/pan.70279

J Nurs Manag. 2026;2026(1):e9937065. doi: 10.1155/jonm/9937065.

ABSTRACT

AIM: To assess levels of quantum leadership, organizational transparency, and organizational readiness for change among staff nurses and to examine whether organizational transparency statistically mediates the association between quantum leadership and organizational readiness for change.

DESIGN: A cross-sectional descriptive study was reported in accordance with STROBE guidelines.

METHODS: A census sampling approach was used to recruit 350 staff nurses from Shoubrakhit General Hospital. Data were collected using the Quantum Leadership Survey, the Organizational Transparency Instrument, and the Organizational Readiness for Implementing Change Scale.

RESULTS: Most nurses reported high levels of quantum leadership (77.1%), organizational transparency (66.3%), and readiness for change (85.4%). Correlation analysis showed positive associations among the three main variables. The statistical mediation model indicated that quantum leadership was directly associated with organizational readiness for change and showed a small positive indirect association through organizational transparency. The model demonstrated acceptable overall fit.

CONCLUSION: Quantum leadership was positively associated with organizational readiness for change, with organizational transparency showing a small statistical mediating role. Given the cross-sectional, self-report, single-hospital design, the findings should be interpreted cautiously as associations rather than evidence of causal processes.

IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers and nursing leaders should strengthen transparent communication channels, involve nurses meaningfully in committees and change-related discussions, support accountable decision-making, and assess staff readiness before major organizational initiatives.

PMID:42590874 | DOI:10.1155/jonm/9937065

J Psychiatr Ment Health Nurs. 2026 Aug 12. doi: 10.1111/jpm.70187. Online ahead of print.

ABSTRACT

INTRODUCTION: Workplace stress is prevalent in psychiatric nursing, with compassion fatigue significantly challenging nurses’ well-being and care quality. Effective prevention requires identifying at-risk nurses using validated assessment frameworks. The contemporary approach to workforce mental health emphasises proactive, targeted interventions tailored to individual risk profiles. Nurses play a central role in sustaining therapeutic environments, and their psychological resources are critical to this process. However, the heterogeneity of compassion fatigue among psychiatric nurses remains underexplored.

AIM: To empirically identify distinct subtypes of compassion fatigue among psychiatric nurses and examine their key predictors: METHODS: Using convenience sampling, 297 psychiatric nurses were selected from five Chinese hospitals to participate in a cross-sectional online survey. Measures of sociodemographic traits, occupational stress, social support, psychological resilience, coping methods, and compassion fatigue (as measured by the Professional Quality of Life Scale) were all filled out by the participants. Standardised scores for burnout, secondary traumatic stress, and compassion satisfaction were used as indicators in latent profile analysis. To find the ideal number of profiles, model fit indices such as the Lo-Mendell-Rubin likelihood ratio test, entropy, Bayesian information criterion, and Akaike information criterion were compared. Subsequent multivariate logistic regression examined predictors of profile membership. Data analysis was conducted using statistical methods, and the STROBE guideline was followed in reporting.

RESULTS: Three distinct compassion fatigue profiles were identified among psychiatric nurses: Mild Fatigue-Traumatic Stress (18.5%, n = 55), Moderate Fatigue-Low Burnout (64.0%, n = 190), and Severe Fatigue (17.5%, n = 52). Multivariate logistic regression revealed that older age, higher work stress, and greater use of negative coping were significant risk factors for more severe profiles, whereas not working night shifts, higher social support, greater positive coping, and higher psychological resilience were associated with reduced risk. The Severe Fatigue group exhibited the most adverse profile-highest work stress, lowest resilience and support, and greatest reliance on negative coping. Conversely, the group with the highest levels of resilience and social support was Mild Fatigue-Traumatic Stress.

CONCLUSION: There are different subgroups of psychiatric nurses who feel compassion fatigue, each with unique risk and protective characteristics. These results highlight the necessity of profile-specific, focused treatments that address organisational and personal issues. Early career nurses and those working night shifts may benefit from priority support to mitigate occupational psychological burden and enhance workforce well-being.

PMID:42590873 | DOI:10.1111/jpm.70187

J Hum Lact. 2026 Aug 12:8903344261470652. doi: 10.1177/08903344261470652. Online ahead of print.

ABSTRACT

BACKGROUND: Breastfeeding remains the recommended feeding method during public health emergencies; however, pandemic-related restrictions created new challenges for mothers and their healthcare teams, including lactation professionals (LPs). The COVID-19 pandemic may have heightened LPs’ occupational stress and limited their ability to provide lactation support.

RESEARCH AIMS: This study examined occupational stress among LPs, identified stressors and coping strategies, and explored how pandemic-related workplace policies influenced lactation services.

METHODS: A mixed-methods design was employed. A cross-sectional online survey assessed the experiences of hospital- and clinic-based LPs during the COVID-19 pandemic. Key informant interviews were conducted to identify stressors, coping strategies, and service delivery impacts. Descriptive and inferential statistics were conducted, and qualitative data were analyzed using reflexive thematic analysis.

RESULTS: The sample included 1,373 healthcare professionals. Most LPs (91.8%) reported moderate to high perceived stress consistent with other studies. Key stressor themes included new policy implementation, evolving personal protective equipment requirements, employment changes, the transition to telehealth, and fear of infection. Participants reported using problem management, emotional regulation, and meaning-based coping strategies. Themes describing impacts on lactation service provision included reduced or delayed support, protected breastfeeding practices, hindered interpersonal connectedness, and telehealth limitations. Clinical policy changes were perceived to both hinder and improve lactation services.

CONCLUSIONS: During public health emergencies, LPs-especially those with dual role responsibilities-require additional support. Interventions should build upon coping strategies identified in this study. Future research should examine how stressors influence service provision, the effectiveness of coping strategies, and the potential role of geographic context in policy implementation.

PMID:42590868 | DOI:10.1177/08903344261470652

J Hum Lact. 2026 Aug 12:8903344261470803. doi: 10.1177/08903344261470803. Online ahead of print.

ABSTRACT

BACKGROUND: Mothers of late preterm infants need support with breastfeeding.

AIM: The aim of this study was to examine the effect of Telephone Breastfeeding Support (delivered via telephone calls and WhatsApp messages) given to mothers of late preterm infants discharged from the neonatal intensive care unit (NICU) on breastfeeding outcomes.

METHODS: The study was a single-blind, pretest-posttest, randomized, parallel two-group, controlled experimental study. The study involved 62 mothers in a NICU from August 2021 to August 2022. After all late preterm infants participating in the study completed their routine discharge procedures, pre-intervention data were collected from their mothers, and a breastfeeding guide was sent to their phones. The intervention group (n = 31) received breastfeeding support through WhatsApp and phone calls for 16 weeks. Posttests were taken when the infant was 6 months old. Data were collected using the mother-infant information form, the Breastfeeding Self-Efficacy Scale Short Form (BSES-SF), the Iowa Infant Feeding Attitude Scale (IIFAS), and the breastfeeding duration assessment form.

RESULTS: When the infant reached 6 months, no statistically significant differences were found in inter- or intra-group BSES-SF scores, nor in inter-group IIFAS scores (p > 0.05). In the intragroup analysis, the intervention group showed a statistically significant improvement in pre- and post-intervention IIFAS scores (p < 0.05), while a significant difference was also observed between groups in breastfeeding cessation rates (p < 0.05).

CONCLUSION: Telephone breastfeeding support has been shown to improve infant feeding attitudes and increase breastfeeding maintenance. Telephone breastfeeding support can be safely implemented for mothers of late preterm infants.

PMID:42590865 | DOI:10.1177/08903344261470803