J Neurodev Disord. 2026 Apr 23. doi: 10.1186/s11689-026-09695-z. Online ahead of print.
NO ABSTRACT
PMID:42026485 | DOI:10.1186/s11689-026-09695-z
Category: Statistics
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Radiography (Lond). 2026 Apr 22;32(4):103416. doi: 10.1016/j.radi.2026.103416. Online ahead of print.
ABSTRACT
INTRODUCTION: Missed fractures in the Emergency Department (ED) can lead to delayed treatment and patient harm. Radiographer preliminary clinical evaluation (PCE) aims to support referrers when interpreting radiographs in the absence of a definitive clinical report. This pre-implementation study evaluated radiographer participation and diagnostic accuracy in a department without an existing radiographer abnormality detection system.
METHODS: A prospective service evaluation study was conducted in a general hospital. Radiographers were asked to provide PCE for consecutive ED musculoskeletal trauma radiographs. Participation was recorded. PCEs were compared with the clinical report, and sensitivity, specificity and accuracy were calculated with 95% confidence intervals. Accuracy was evaluated against a fixed performance standard using a non-inferiority test. Differences in proportions between the first and second halves of the study period, in participation and accuracy, were assessed using z-tests.
RESULTS: Of 937 eligible examinations, 412 contained a PCE comment (44.0% participation), increasing significantly from 39.3% (182/463) in the first half of the study period to 48.5% (230/474) in the second half (p = 0.0045). After exclusions, 369 PCEs were analysed. Sensitivity, specificity and accuracy were 80.2%, 94.2% and 89.3%, respectively. The lower bound of the accuracy confidence interval (85.7%) exceeded the non-inferiority margin (82% accuracy), confirming PCE accuracy was statistically non-inferior to the 92% benchmark. Median time from examination attendance to PCE entry was 12 min.
CONCLUSION: Radiographers provided timely, accurate PCEs, achieving performance comparable with published standards, demonstrating the feasibility of implementing a PCE service.
IMPLICATIONS FOR PRACTICE: This study contributes to the evidence supporting PCE in departments without a 24-h hot-reporting service. Even without a dedicated training package, radiographers performed well, but this study emphasises that sensitivity remains a key area for further improvement.
PMID:42026441 | DOI:10.1016/j.radi.2026.103416
Nurse Educ Today. 2026 Apr 17;163:107122. doi: 10.1016/j.nedt.2026.107122. Online ahead of print.
ABSTRACT
BACKGROUND: Digital readiness has become a critical competency for future nurses in the evolving landscape of healthcare. Two essential components of this readiness-eHealth literacy and attitudes toward artificial intelligence (AI)-have gained prominence in nursing education. However, limited evidence exists regarding their interrelationship and associated demographic and behavioral factors, particularly in middle-income countries.
AIM: This study aimed to assess eHealth literacy and attitudes toward AI among undergraduate nursing students, identify associated demographic and behavioral factors, and examine the relationship between these two constructs as key dimensions of digital readiness.
METHODS: A descriptive and cross-sectional analytic study was conducted with 286 undergraduate nursing students at a public university in Türkiye during the 2024-2025 academic year. Participants were recruited using a voluntary, open invitation approach. Data were collected through an online survey, including a sociodemographic questionnaire, the eHealth Literacy Scale (eHEALS), and the General Attitudes Toward Artificial Intelligence Scale. Non-parametric tests and Spearman’s rho correlation were used for group comparisons and bivariate associations. Hierarchical multiple regression analysis was performed to evaluate the independent contribution of eHealth literacy to AI attitudes while controlling for potential confounding demographic and behavioral variables.
RESULTS: Of the 286 participants, the majority were female (75.9%) with a mean age of 20.7 years (SD = 2.78), predominantly in the 19-22 age range. Participants reported moderate-to-high eHealth literacy (M = 28.3, SD = 4.92) and favorable attitudes toward AI (M = 65.9, SD = 8.37). Significant differences were observed across gender, academic year, grade point average (GPA), and frequency of AI tool use. Students using generative AI tools such as ChatGPT scored significantly higher on both scales. A positive correlation was found between eHealth literacy and AI attitudes (r = 0.214, p < 0.001). In hierarchical regression analysis, demographic variables accounted for a small proportion of variance in AI attitudes, while behavioral factors (e.g., GPA and AI tool use) significantly improved the model. However, eHealth literacy did not make a statistically significant independent contribution to AI attitudes after controlling for these variables.
CONCLUSION: Undergraduate nursing students demonstrated promising levels of digital readiness. However, the relationship between eHealth literacy and AI attitudes appears to be context-dependent rather than independently predictive. Behavioral engagement with digital technologies plays a more prominent role in shaping AI attitudes. These findings underscore the need for nursing curricula to move beyond foundational digital literacy and incorporate experiential, practice-oriented AI learning opportunities to support comprehensive digital readiness.
PMID:42026438 | DOI:10.1016/j.nedt.2026.107122
Behav Res Methods. 2026 Apr 23;58(5):137. doi: 10.3758/s13428-026-02999-x.
ABSTRACT
In nonexperimental studies, obtaining an unbiased estimate of the average treatment effect (ATE) typically requires two key assumptions: that all relevant covariates are measured (i.e., no unmeasured confounding) and that the statistical model used for covariate adjustment is correctly specified. Two common approaches for adjustment are specifying an outcome model and propensity score weighting. To mitigate bias from model misspecification, doubly robust methods combine both approaches, ensuring unbiased ATE estimates if either the outcome model or the propensity score model is correctly specified. In this study, we review four doubly robust methods that have received considerable attention in the methodological literature but remain underutilized in psychological research: augmented inverse probability weighting, regression weighted by the inverse propensity score, regression incorporating the inverse propensity score as a covariate, and calibrated propensity score weighting. Using two simulation studies, we compare these methods with regression estimation and inverse probability weighting estimators. Our results suggest that doubly robust methods-particularly regression weighted by the inverse propensity score-offer greater protection against bias from model misspecification across various data-generating scenarios. We also discuss practical considerations for implementing doubly robust methods, including weight normalization, propensity score truncation, and potential efficiency losses due to overfitting. The different methods for estimating the ATE are illustrated in a data example.
PMID:42026423 | DOI:10.3758/s13428-026-02999-x
Musculoskeletal Care. 2026 Jun;24(2):e70224. doi: 10.1002/msc.70224.
ABSTRACT
INTRODUCTION: In recent years, the Ankylosing Spondylitis Performance Index (ASPI) has emerged as a new objective measure of physical function in patients with axial spondyloarthritis (axSpA). So far, only the relative interrater reliability of the ASPI test has been reported, but the absolute interrater reliability remains to be investigated.
OBJECTIVE: This study investigated the interrater absolute and relative reliability of the ASPI test in patients with axSpA from a [Nordic] country.
METHODS: Patients with axSpA were recruited from [a Danish] rheumatology outpatient clinic between October and November 2023. The participants performed the ASPI twice with two different raters, with a 15-min pause between tests. Absolute and relative reliability were assessed.
RESULTS: Fifty-two participants were included. The standard error measurement for the overall ASPI test was 3.4%, and the minimal detectable difference was 9.5%. The participants performed the ASPI test faster with the second rater (mean 38.15 s (standard deviation, SD 12.16 s) compared to the first rater (40.92 s (SD 12.07 s)) with a statistically significant reduction in time of -2.77 s (SD 4.53 s) (p < 0.001). The intraclass correlation coefficient of the ASPI test was 0.91 (95% CI 0.76-0.96).
CONCLUSION: The study showed high absolute interrater reliability with low interrater measurement error for single individuals and groups in patients with axSpA. The relative reliability was also high. However, ASPI demonstrated a learning effect at group level. This study offers clinically relevant guidance for interpreting differences in the ASPI scores when tests are repeated by different raters, relevant for real-world clinical practice.
PMID:42026410 | DOI:10.1002/msc.70224
Arch Orthop Trauma Surg. 2026 Apr 23;146(1):158. doi: 10.1007/s00402-026-06319-y.
ABSTRACT
BACKGROUND: Upper extremity amputations are associated with developing psychiatric conditions. The aim of this study is to identify differences in mental health outcomes for patients undergoing major versus minor upper extremity amputations.
METHODS: Data were obtained from the PearlDiver database between 2010 and 2022 using Current Procedural Terminology and International Classification of Diseases codes. Patients aged 10 and above without prior mental health diagnoses or antidepressant prescription records who underwent upper extremity amputations were stratified by major (shoulder disarticulation, arm, forearm, wrist, transmetacarpal) versus minor (single metacarpal, digit, phalanx) amputations. Demographic characteristics and rates of mental health diagnoses, antidepressant prescriptions, and psychotherapy care were assessed for 90 days and one year postoperatively, using Welch’s T-tests and Pearson’s chi-squared tests.
RESULTS: Patients with major amputations had increased risk of mental health diagnoses at 90 days (OR: 3.29, p < 0.001) and at one year (OR: 2.01, p < 0.001). Both groups had higher rates of mental health diagnoses than the general population. Patients undergoing major amputations had higher odds of starting antidepressants at 90 days (OR 3.82, p < 0.001) and at one year (OR 2.38, p < 0.001). Psychotherapy care was significantly increased after major amputations at 90 days (OR 5.47, p < 0.001) and at one year (OR 4.18, p < 0.001).
CONCLUSIONS: Mental health disorders, antidepressant use, and psychotherapy care are significantly higher for major upper extremity amputations compared to minor amputations. Surgical teams should provide mental health resources to mitigate negative effects from mental health needs after upper extremity amputation.
LEVEL OF EVIDENCE: III.
PMID:42026387 | DOI:10.1007/s00402-026-06319-y
World J Microbiol Biotechnol. 2026 Apr 24;42(5):230. doi: 10.1007/s11274-026-04971-5.
NO ABSTRACT
PMID:42026382 | DOI:10.1007/s11274-026-04971-5
J Math Biol. 2026 Apr 23;92(5):75. doi: 10.1007/s00285-026-02390-6.
ABSTRACT
Neurodegenerative diseases (NDs), such as Alzheimer’s, Parkinson’s, and prion diseases, are characterized by the dynamical spread of toxic proteins through the brain. In prion diseases, cellular prion protein ( ), produced by neurons, misfolds into a toxic form, known as scrapie prion protein ( ). induces neuronal stress which ultimately leads to cell death. In this paper, we develop mathematical models for the progression of prion diseases, incorporating a cellular defense mechanism that introduces a delay term affecting protein translation and a volatility term accounting for unaccounted biological factors influencing the system. We also extend the model to capture the spatial spread of toxic proteins over the brain connectome. Our first objective is to establish the existence and uniqueness of a global positive solution to the prion disease models. Afterwards, we analyze the asymptotic behavior of the models by identifying regimes of persistence and extinction of toxic proteins. For the deterministic delayed systems, we perform a stability analysis for the persistence and demonstrate that the system undergoes a Hopf bifurcation. We also study the intensity of fluctuations of the equilibrium state of the stochastic model. Additionally, we present numerical simulations to illustrate the model dynamics using biologically relevant parameters.
PMID:42026378 | DOI:10.1007/s00285-026-02390-6
Childs Nerv Syst. 2026 Apr 23;42(1):177. doi: 10.1007/s00381-026-07270-4.
ABSTRACT
OBJECTIVE: Moyamoya disease (MMD) is a progressive cerebrovascular disorder and an important cause of childhood stroke. Surgical revascularization is the established treatment for symptomatic disease. However, comparative data examining perioperative safety and long-term outcomes between pediatric and adult patients remain limited. This study hence aimed to evaluate whether age influences postoperative complications, early neurological outcomes, and long-term stroke risk following direct and/or indirect bypass surgery.
METHODS: We conducted a retrospective multicenter cohort study of patients with MMD who underwent surgical revascularization at 13 academic centers across North America between 2008 and 2022. The primary outcomes were overall postoperative complications and long-term stroke occurrence. Comparisons between pediatric (≤ 18 years) and adult (> 18 years) hemispheres were performed using overlap propensity score weighting (PSW) to adjust for differences in baseline characteristics. Sensitivity analyses were conducted in patients with ≥ 2 years of follow-up.
RESULTS: A total of 567 hemispheres (523 adult, 44 pediatric) were included. Adults had higher rates of vascular comorbidities, whereas pediatric patients more frequently presented with congenital conditions and earlier Suzuki grades. Pre- and post-PSW analyses demonstrated no significant age-related differences in outcomes (p ≥ 0.05). On weighted regression, age was not associated with postoperative complications (OR 0.92; 95% CI 0.41-2.05), discharge neurological status (mRS: OR 1.08; 95% CI 0.52-2.21; and NIHSS: OR 0.97; 95% CI 0.45-2.10), or long-term cerebrovascular events (OR 0.88; 95% CI 0.28-2.74). On sensitivity analysis of patients with > 2 years of follow-up, no pediatric hemispheres experienced stroke compared with 12% of adult hemispheres, though this difference was not statistically significant (p = 0.14).
CONCLUSIONS: Despite marked differences in baseline comorbidities and angiographic severity, pediatric and adult patients experienced similar perioperative outcomes and long-term stroke risk after bypass surgery. These findings support the durability and safety of both direct and indirect revascularization across age groups.
PMID:42026373 | DOI:10.1007/s00381-026-07270-4
Musculoskeletal Care. 2026 Jun;24(2):e70198. doi: 10.1002/msc.70198.
ABSTRACT
INTRODUCTION: Developmental dysplasia of the hip (DDH) is a common condition that can be effectively treated if detected early. DDH screening remains institution-based with no clear guidelines at the national level in many countries, including Jordan and most of the MENA region. The aim of the study was to assess Jordanian pediatricians’ DDH screening knowledge and skills, identify associated factors, and explore readiness for a national screening approach.
METHODS: A nationwide, cross-sectional, STROBE-compliant survey was administered (Aug-Sep 2025) to 255 Pediatricians. A 19-item questionnaire assessed aspects such as risk factors, age of screening, incidence in Jordan, physical signs, confidence in performing the Barlow and Ortolani manoeuvres, and management approaches, along with their ‘composite knowledge score’ score. CKS was graded using Bloom’s cut-offs (high ≥ 80%, moderate 60%-79%, low < 60%). Factors associated with higher CKS were examined with the Welch two-sample t-test, ANOVA and Tukey post hoc tests.
RESULTS: Only 9% achieved high CKS scores, 49.4% moderate, and 41.6% low. DDH screening was routinely performed by 69.4% of participants, and 70.6% had access to hip ultrasound at their workplace. The mean overall CKS was 61.6 ± 14.6 and the mean CKS scores were 63.3 ± 14.25 for specialists and 57.7 ± 14.78 for residents; Participants with more experience, higher infant exposure, and greater confidence in performing the Barlow and Ortolani manoeuvres achieved higher scores.
CONCLUSION: Our study revealed that pediatricians in Jordan generally lack adequate knowledge and skills in DDH screening, a gap consistent across location, sector, and experience level. Higher level of experience, greater exposure to infants and higher confidence in performing Barlow and Ortolani manoeuvres were associated with better proficiency. A national training programme coupled with national guidelines is needed to promote early detection and reduce late-presenting cases.
PMID:42026371 | DOI:10.1002/msc.70198