Category: Statistics

J Magn Reson Imaging. 2026 Aug 12. doi: 10.1002/jmri.70485. Online ahead of print.

ABSTRACT

BACKGROUND: Osteoporotic vertebral compression fractures (OVCFs) are prevalent but frequently remain unrecognized. While bone mineral density (BMD) is the primary assessment tool, MRI-based parameters associated with bone and muscle quality may offer additional value, yet sex-specific analyses are limited, despite sex differences in incidence and hormones.

PURPOSE: To explore the associations between MRI-based vertebral bone quality (VBQ) score, psoas muscle index (PMI), and paravertebral muscle fat infiltration (FI) fraction with OVCFs, and to assess the potential diagnostic performance of MRI parameters across sexes.

STUDY TYPE: Retrospective.

POPULATION: 260 subjects (≥ 50 years); 130 OVCF patients (73.0 years (67.0-80.0), 89 females) and 130 non-fracture (NF) patients (64.5 years (58.0-73.0), 76 females).

FIELD STRENGTH AND SEQUENCES: 3 T and 1.5 T. T1-weighted TSE and T2-weighted TSE (Siemens) and T1-weighted FSE and T2-weighted FSE (United Imaging).

ASSESSMENT: VBQ was calculated on sagittal T1-weighted MRI; PMI and FI were quantified on axial T2-weighted MRI at the L3 endplate by ImageJ. BMD was derived from CT using QCT PRO software. Two trained observers, blinded to clinical data, performed all MRI measurements.

STATISTICAL TESTS: Significance level was set at p < 0.05. t-test/Mann-Whitney U test, chi-squared test (χ²), Spearman’s rank correlation coefficient, multivariate logistic regression, receiver operating characteristic (ROC) curve analysis with area under the curve (AUC). Bootstrap resampling (1000 iterations) for internal validation.

RESULTS: The OVCF group exhibited significantly elevated VBQ (3.71 ± 0.55 vs. 3.25 ± 0.58) and FI (24.11% (21.66-28.92) vs. 20.31% (18.90-22.14)), while PMI (3.42 ± 1.02 vs. 4.08 ± 1.14) and BMD (55.82 mg/cm³ (38.75-70.90) vs. 89.24 mg/cm³ (67.80-110.00)) were reduced. FI was independently associated with OVCFs exclusively in females (OR = 1.566). The combined MRI model (VBQ + FI + PMI) yielded a significantly higher AUC in females (AUC = 0.896) than in males (AUC = 0.720).

DATA CONCLUSION: VBQ, PMI, and FI reveal significant sex-specific correlations with OVCFs. The multi-parametric MRI model shows considerable potential as a diagnostic aid for OVCFs in individuals aged over 50, particularly in females.

TECHNICAL EFFICACY STAGE: 2 (Diagnostic Accuracy).

PMID:42581773 | DOI:10.1002/jmri.70485

Brain Behav. 2026 Aug;16(8):e71669. doi: 10.1002/brb3.71669.

ABSTRACT

OBJECTIVE: Early language development forms the foundation for cognitive, social, and academic skills. This study aimed to compare the language, speech, and communication skills of twins and singleton children aged 24-36 months and to explore associations with sociodemographic, biological, and environmental factors in the Turkish population METHOD: The study was conducted with 100 children, comprising 30 twin pairs (60 children, 30 male, 30 female) and 40 singletons (23 male, 17 female), with a mean age of 33.4 ± 5.26 months. Receptive and expressive language skills were evaluated using the Test of Early Language Development-Third Edition, Turkish Version (TEDIL), parent-reported language skills were assessed with the Adapting the Language Development Survey to Turkish (DILTAR), communication skills were evaluated with the Children’s Communication Checklist-2 (CCC-2), and speech development was assessed with the Ankara Articulation Test (AAT). Sociodemographic (maternal age, education), biological (birth weight, gestational age), and environmental (television viewing time) factors were analyzed through correlational analyses.

RESULTS: Twins exhibited significantly lower birth weights and earlier gestational age at birth compared to singletons. Twins demonstrated lower performance in TEDIL receptive language scores and AAT scores compared to singletons (p < 0.05). In the CCC-2 subscales of speech, syntax, semantics, use of context, and social relationships, twins scored significantly lower than singletons. A negative correlation was found between TEDIL receptive language scores and television viewing time across all children (r = -0.603). In twins, statistically significant correlations were observed between language-related scores and maternal age, maternal gestational age, birth weight, and maternal education (p < 0.05).

CONCLUSION: This study provided culturally grounded evidence from Turkish children and demonstrated that 24-36-month-old twins are at increased risk for delays in language, speech, and communication skills compared to singleton peers. The findings suggest that the twinness effect in early toddlerhood reflects the combined influence of biological maturity at birth (e.g., lower birth weight and earlier gestational age), sociodemographic characteristics (e.g., maternal education and age), and environmental factors (e.g., television viewing time). Rather than being attributable to a single determinant, early language and communication outcomes in twins appear to emerge from dynamic interactions between biological and environmental conditions. These results underscore the importance of early, multidimensional screening and comprehensive assessment of twins’ communication development to facilitate the timely identification of potential delays. Early intervention approaches that combine speech-language therapy with enriched environmental support strategies may help mitigate developmental risk and promote optimal communication outcomes.

PMID:42581767 | DOI:10.1002/brb3.71669

Surg Innov. 2026 Aug 12:15533506261477024. doi: 10.1177/15533506261477024. Online ahead of print.

ABSTRACT

PurposeLiver transection techniques in robotic liver resection (RLR) have not yet been standardized. We introduced robotic ultrasonic shears (longitudinal clustered shears [LCS]); however, the lack of an articulating joint limits operative angles. To overcome this, we implemented strategic surgical maneuvers. This study aimed to evaluate the liver transection efficiency of the robotic ultrasonic shears in RLR.MethodsFifty-three patients who underwent RLR concurrently between 2023 and 2025 were retrospectively analyzed (LCS group, n = 23; conventional [CONV] group using Maryland bipolar forceps, n = 30). We compared liver transection speed, total ischemia time, and short-term outcomes.ResultsDespite a lower proportion of low-difficulty cases in the LCS group, it demonstrated significantly higher transection speed (median: 0.71 vs 0.38 cm²/min, P < .001) and shorter total ischemia time (63 vs 78 min, P = .011). Postoperative albumin levels on days 3 and 5 were significantly higher (P = .004), and the complication rate (Clavien-Dindo grade ≥ II) was significantly lower (8.7% vs 30.0%, P = .049) in the LCS group. Multivariate analysis identified the use of LCS (P = .003) as an independent predictor of higher transection speed. Exploratory subgroup analyses confirmed that the LCS group had significantly higher transection speed in non-anatomical resections (P < .001) and significantly shorter ischemia time in anatomical resections (P = .021), although the higher transection speed in anatomical resections did not reach statistical significance.ConclusionsRobotic ultrasonic shears with optimized maneuvers significantly improve transection speed and reduce ischemia time, enhancing the efficiency of RLR.

PMID:42581764 | DOI:10.1177/15533506261477024

J Magn Reson Imaging. 2026 Aug 12. doi: 10.1002/jmri.70500. Online ahead of print.

ABSTRACT

BACKGROUND: Placental MRI has shown T2* decreases during contractions and increases during maternal hyperoxia. However, how contraction-induced placental oxygenation and deformation relate to uterine deformation and differ from hyperoxia-induced responses remains unknown.

PURPOSE: To quantify placental T2* and deformation changes during spontaneous non-labor uterine contractions and maternal hyperoxia, testing the hypothesis that contractions produce mechanically mediated placental responses distinct from hyperoxia.

STUDY TYPE: Retrospective.

POPULATION: Forty-nine MRI datasets from 46 pregnant participants with singleton pregnancies (24-39 weeks gestation).

FIELD STRENGTH/SEQUENCE: 3 T; dynamic multi-echo gradient-echo echo-planar imaging.

ASSESSMENT: Non-labor uterine contractions were defined as events lasting ≥ 0.5 min with peak uterine volume reduction > 2.5%. Placental T2* and deformation of the uterus, myometrium, placenta, fetus and amniotic fluid were quantified during normoxia (normal air, 21% O₂, 5 min) with and without contractions, and maternal hyperoxia (100% FiO₂, 4 min). Regional analyses were performed within and outside imaging-defined placental cotyledons.

STATISTICAL TESTS: Linear regression, linear mixed-effects models, Pearson correlation and paired t-tests (p < 0.05).

RESULTS: Complete contractions during normoxia were identified in 22 datasets, reducing placental T2* by 4.64 ± 0.75 ms. Maternal hyperoxia increased placental T2* by 11.36 ± 0.62 ms relative to normoxia. Significant gestational age-by-duration interactions were observed for contraction-associated placental deformation (β = 2.47 ± 1.04% points/min/week) and T2* reduction (β = 1.50 ± 0.44 ms/min/week). At baseline, cotyledons exhibited higher T2* than surrounding placental tissue (β = -11.56 ± 0.95 ms). Contractions significantly reduced the inside-outside cotyledon T2* difference (β = 3.14 ± 1.34 ms), whereas hyperoxia preserved regional heterogeneity (p = 0.48).

DATA CONCLUSION: Spontaneous non-labor uterine contractions induced coordinated decreases in placental volume and oxygenation that intensified with gestational age and contraction duration. In contrast, maternal hyperoxia produced larger, more uniform increases in oxygenation.

EVIDENCE LEVEL: 3.

TECHNICAL EFFICACY: Stage 3.

PMID:42581746 | DOI:10.1002/jmri.70500

Obstet Gynecol Sci. 2026 Aug 12. doi: 10.5468/ogs.26014. Online ahead of print.

ABSTRACT

OBJECTIVE: Hysterectomy is one of the most commonly performed gynecological surgeries worldwide. This study aimed to evaluate the clinical indications, surgical routes, and intraoperative and postoperative outcomes of hysterectomies performed at a tertiary care center over an 8-year period.

METHODS: This ambispective observational study was conducted from February 2016 to May 2024. It included 1,083 women who underwent hysterectomy for benign, malignant, or obstetric indications via abdominal, laparoscopic, vaginal, or robotic approaches. Data were collected retrospectively (2016-2022) and prospectively (2022-2024). Parameters analyzed included patient demographics, indications, surgical approach, anesthesia, blood loss, complications, and transfusion requirements. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 25 (COMPANY, CITY, STATE, COUNTRY).

RESULTS: Of 1,083 cases, 84.21% were performed for benign and 15.78% for malignant conditions. Abdominal hysterectomy was most common (44.41%), followed by robotic (39.51%), vaginal (12.00%), and laparoscopic (4.06%). Robotic hysterectomy had the lowest blood loss (median 52.5 mL) and transfusion rates (intraoperative, 0.47%; postoperative, 1.40%), compared with abdominal (median 300 mL; intraoperative, 18.71%, postoperative, 13.30%). Vaginal hysterectomy had the shortest operative time but slightly higher blood loss than minimally invasive approaches. Major complications such as bladder, bowel, and ureteric injuries were more frequent in abdominal cases.

CONCLUSION: Minimally invasive techniques, especially robotic surgery, are associated with reduced blood loss and complication rates. This audit highlights the need to encourage minimally invasive hysterectomy where feasible and underscores the importance of systematic documentation to inform practice and policy improvements.

PMID:42581742 | DOI:10.5468/ogs.26014

J Korean Biol Nurs Sci. 2026 May;28(2):353-364. doi: 10.7586/jkbns.26.011. Epub 2026 May 26.

ABSTRACT

PURPOSE: This study aimed to identify factors associated with hospitalization among older adults with mild traumatic injuries who presented to a regional emergency medical center or regional trauma center.

METHODS: This retrospective secondary data analysis used medical records from trauma patients aged ≥ 65 years who were triaged as Korean Triage and Acuity Scale levels 4 or 5 and visited a regional emergency medical center or regional trauma center in Korea between January 1 and December 31, 2022. Of 38,371 visits during the study period, 442 older adults with mild traumatic injuries were included. Data on general characteristics, disease-related characteristics, medical treatments, and nursing interventions were analyzed using descriptive statistics, t-tests, χ² tests, and multivariate logistic regression analysis.

RESULTS: The 442 participants comprised 228 men (51.6%) and 214 women (48.4%); 225 participants (50.9%) were aged 65-74 years. In the multivariate analysis, longer emergency department stays were associated with a higher likelihood of hospitalization (odds ratio [OR] = 1.01; 95% confidence interval [CI], 1.00-1.01). Patients with fractures were more likely to be hospitalized (OR = 11.25; 95% CI, 1.12-111.78), whereas those who received counseling and education were less likely to be hospitalized (OR = 0.01; 95% CI, 0.00-0.04).

CONCLUSION: These findings highlight the important role of emergency nursing care in the hospital admission process and support the need to incorporate nursing-related factors into future emergency department research and intervention strategies.

PMID:42581732 | DOI:10.7586/jkbns.26.011

J Korean Biol Nurs Sci. 2026 May;28(2):330-340. doi: 10.7586/jkbns.26.002. Epub 2026 May 27.

ABSTRACT

PURPOSE: This study examined the effects of emotional experiences and interactions with healthcare providers on self-management behaviors and glycemic control, as measured by hemoglobin A1c (HbA1c), in patients with type 2 diabetes mellitus.

METHODS: This cross-sectional study included 120 patients recruited from six local clinics between April 12 and July 15, 2021. Data were collected using the Scale of Positive and Negative Experience, the Client Satisfaction Tool, the Summary of Diabetes Self-Care Activities Questionnaire, and HbA1c measurements. Descriptive statistics, t-tests, analysis of variance, Pearson correlation coefficients, and hierarchical regression analyses were performed using SPSS version 31.0.

RESULTS: The mean age of the participants was 60.06 years, and the mean duration of diabetes was 7.79 years. Hierarchical regression analysis showed that interactions with healthcare providers and smoking status explained 11.0% of the variance in self-management behaviors. Negative emotion, sex, presence of diabetic complications, and smoking status explained 27.0% of the variance in HbA1c levels.

CONCLUSION: Negative emotions and the quality of interactions with healthcare providers were significant factors associated with self-management behaviors and glycemic control in patients with type 2 diabetes mellitus. These findings highlight the need for early identification of high-risk patients and for comprehensive management strategies that incorporate psychological support and smoking cessation interventions. In addition, regular, individualized education and feedback, together with empathetic communication that acknowledges patients’ emotional experiences, may be important components of effective diabetes care.

PMID:42581730 | DOI:10.7586/jkbns.26.002

J Korean Biol Nurs Sci. 2026 May;28(2):300-316. doi: 10.7586/jkbns.26.016. Epub 2026 May 26.

ABSTRACT

PURPOSE: This descriptive correlational study aimed to identify personal, organizational, and environmental factors influencing the performance of standard precautions (SPs) among intensive care unit (ICU) nurses.

METHODS: A structured questionnaire survey was conducted among 166 ICU nurses at two tertiary hospitals in South Korea. Data were analyzed using IBM SPSS Statistics version 25.0, including independent t-tests, analysis of variance, Pearson correlation analysis, and hierarchical regression analysis.

RESULTS: Hierarchical regression analysis identified organizational culture for infection control (β = .41, p < .001), awareness of SPs (β = .37, p < .001), and clinical experience (β = .18, p = .007) as significant predictors of SP performance. In contrast, the infection prevention environment was not a statistically significant predictor. The final model explained 54.0% of the variance in SP performance (F = 23.39, p < .001), with an adjusted R2 of 52.0%.

CONCLUSION: To enhance SP performance among ICU nurses, multidimensional, career-tailored interventions are needed to move beyond traditional knowledge-based education and facilitate the transition from awareness to practice. In addition, establishing supportive and constructive communication systems within a nonpunitive environment for reporting infection control errors or noncompliance, together with supportive leadership, may help create a sustainable organizational foundation for infection prevention. Ultimately, shifting the focus from physical facilities to organizational culture is essential for preventing pathogen transmission and ensuring physiological safety.

PMID:42581728 | DOI:10.7586/jkbns.26.016

J Korean Biol Nurs Sci. 2026 May;28(2):217-230. doi: 10.7586/jkbns.26.013. Epub 2026 May 27.

ABSTRACT

PURPOSE: This study provides an updated analysis of research trends in the Journal of Korean Biological Nursing Science (JKBNS) by examining changes in publication volume, methodological approaches, and thematic evolution among articles published between 2011 and 2025.

METHODS: Retrospective descriptive and bibliometric analyses were conducted on 537 articles published in JKBNS. Publication characteristics and statistical methods were summarized, and annual trends were examined. Keyword co-occurrence networks were generated using VOSviewer, and changes in research topics over time were explored using burst keyword analysis based on abstract-derived keywords.

RESULTS: Annual publication volume fluctuated but increased markedly in recent years, rising from 35 articles in 2024 to 58 articles in 2025. A language crossover occurred in 2024, when English-language articles (n = 19, 54.3%) exceeded Korean-language articles (n = 16, 45.7%); this predominance of English-language articles became more evident in 2025 (n = 36, 62.1%). Adult patients were the most common study population (n = 127, 23.7%). Analysis of variance was the most frequently used statistical method (n = 236, 43.9%), followed by linear regression (n = 84, 15.6%) and logistic regression (n = 59, 11.0%). Burst keyword analysis highlighted recent increases in aging- and health behavior-related terms. Co-occurrence mapping identified interconnected thematic areas spanning health behavior and risk, nursing knowledge and practice, and biologically oriented research.

CONCLUSION: Between 2011 and 2025, JKBNS demonstrated growth in publication volume, a shift toward English-language articles, and evolving research topics, while maintaining thematic continuity with its biological orientation.

PMID:42581722 | DOI:10.7586/jkbns.26.013

Ann Occup Environ Med. 2026 Aug;38:e23. doi: 10.35371/aoem.2026.38.e23. Epub 2026 Jul 1.

ABSTRACT

BACKGROUND: Occupational and environmental medicine (OEM) specialists are key personnel within the occupational health system. Recent developments, such as the introduction of the Serious Accidents Punishment Act and the expansion of occupational health policies targeting vulnerable workers, have highlighted the need to broaden the role of OEM specialists. This study analyzed the current workload of OEM specialists and projected their medium- to long-term demand.

METHODS: The demand for OEM specialists was defined as the actual observed service utilization volume under the current legal, institutional, and policy environment. Key work areas were categorized as special health examinations and outsourced occupational health management services. Data sources included administrative records from the Korea Occupational Safety and Health Agency (KOSHA) and the Ministry of Employment and Labor (MoEL), statistics on worker health examination results, and evaluation data from specialized agencies for occupational health management. Demand through 2035 was projected by applying the observed historical growth trend in service utilization. The required number of specialists was calculated by applying the average workload per specialist in the base year.

RESULTS: As of 2025, 577 OEM specialists were working at 255 special health examination institutions. Among the 153 occupational health management agencies, 265 physicians were employed, including 133 OEM specialists. The number of workers requiring services from OEM specialists is predicted to continue growing. Applying the current average workload per physician, an additional 132 special health examination physicians and 92 occupational health management agency physicians will be needed by 2035.

CONCLUSIONS: Actual workforce demand may differ from the projections presented in this study depending on changes in policies, industrial structure, service delivery models, and work efficiency. Future studies should incorporate need-based estimates that reflect the diverse roles of OEM specialists and use integrated workforce data to provide more refined projections.

PMID:42581702 | DOI:10.35371/aoem.2026.38.e23