Category: Statistics

PLoS One. 2026 Aug 11;21(8):e0356066. doi: 10.1371/journal.pone.0356066. eCollection 2026.

ABSTRACT

BACKGROUND: Whether screening for Adverse Childhood Experiences (ACEs) can improve health outcomes may depend in part on screening being acceptable and accurate. Screening modality and context may be important determinants of these characteristics.

OBJECTIVE: We compared telephone ACE screenings by 211LA (a health and human services information and referral center) to self-completed screenings during well-child visits and identified family factors associated with differences in ACEs reporting.

PARTICIPANTS AND SETTING: This is a secondary analysis of data from the intervention arm (n = 51) of a pilot randomized trial of telephone ACE care coordination via 211LA versus usual care at three Federally Qualified Health Centers. Children who had ≥ 1 ACE on the Pediatric ACEs and Related Life-events Screener (PEARLS) administered during a well-child visit and were randomized to the intervention were connected to 211LA 1-2 weeks after their clinic visit. 211LA then administered a subsequent telephone PEARLS screening.

METHODS: A within-subjects design examined whether scores differed between clinic and 211LA screening. Linear regressions tested whether trust in healthcare providers, parent stress, financial security, education, income, child age/sex, Latine ethnicity, and English proficiency predicted higher 211LA than clinic scores.

RESULTS: In paired t-tests, mean ACE scores were higher (2.08 vs. 1.35, p = 0.002) through 211LA than through clinics. In linear regressions, greater trust in healthcare providers (β = 0.64, p = 0.049), more parental stress (β = 0.06, p = 0.028), and speaking English “Well” versus “Very well” (β = 1.85, p = 0.043) were associated with a greater difference in 211LA versus clinic scores.

CONCLUSIONS: Telephone-based screening may be effective for sensitive questions. Specific family factors may affect which screening approaches are preferable.

PMID:42579699 | DOI:10.1371/journal.pone.0356066

PLoS One. 2026 Aug 11;21(8):e0354367. doi: 10.1371/journal.pone.0354367. eCollection 2026.

ABSTRACT

The non-medical use of sedatives and prescription opioids is a growing public health concern, particularly among Latino populations. This study aim was to identify individual and social determinants associated with non-medical use of sedatives and prescription opioids among Latinos in the United States. A cross-sectional analysis was conducted using the National Institute of Health All of Us Dataset. The sample included 22,457 Hispanic/Latino adults with complete data. The main outcomes were lifetime street opioids use, and past 3-month non-medical use of sedatives and prescription opioids. Independent variables included depression, discrimination, education, income, nativity, and language spoken at home. The non-medical use of sedatives and opioids in the past 3 months was low (0.4% sedatives, 0.2% opioids). Older age, being male, and reporting depression, discrimination, and neighborhood disorder were associated with increased odds of opioids use. Higher education, income, foreign-born status, and non-English language spoken at home were protective factors. Findings highlight the need for culturally tailored interventions targeting high-risk adult Latino subgroups to address opioid and non-medical use of sedatives disparities.

PMID:42579686 | DOI:10.1371/journal.pone.0354367

J Vet Med Educ. 2026 Aug 11:e20260040. doi: 10.3138/jvme-2026-0040. Online ahead of print.

ABSTRACT

The study objective was to evaluate changes in senior veterinary students’ perceptions of companion animal primary care and career preferences following a primary care clinical rotation. A multi-institutional survey was administered to veterinary students at 10 US colleges of veterinary medicine before and after a companion animal primary care rotation between January 2024 and July 2025. Survey items were organized into six conceptually defined perception groupings. Changes in perception scores and agreement with a career goal were analyzed using linear mixed-effects models with random intercepts for student and school. Career preferences were assessed using ordinal rankings of eight career paths, and free-text responses were analyzed using structured, AI-assisted inductive thematic analysis. A total of 442 students completed the pre-rotation survey, and 83 had a paired post-rotation survey. Post-rotation, modest but statistically significant increases were observed in perceptions of clinical complexity and intellectual engagement (β = 0.13, 95% CI 0.01-0.26) and scope and holistic practice (β = 0.09, 95% CI 0.00-0.18). Agreement that companion animal primary care was a career goal also increased (β = 0.21, 95% CI 0.07-0.36). School-level clustering accounted for little variance, while student-level clustering was substantial. Companion animal practice was the only career path for which the median rank improved. Free-text responses reflected greater appreciation of the breadth, complexity, and intellectual demands of primary care following the rotation. Overall, primary care rotations were associated with small but consistent shifts toward more informed and favorable perceptions of companion animal primary care.

PMID:42579334 | DOI:10.3138/jvme-2026-0040

J Hum Nutr Diet. 2026 Aug;39(4):e70330. doi: 10.1111/jhn.70330.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the validity and reliability of the Turkish version of the Short Questionnaire for the Evaluation of Adherence to the Mediterranean Diet and Nutritional Sustainability (MedQ-Sus), which excludes alcohol consumption and simultaneously assesses adherence to the Mediterranean diet and a sustainable diet, in adults.

METHODS: The study included 138 adults, of whom 39.9% were male and 60.1% were female, with a mean age of 34.3 ± 12.7 years. The MedQ-Sus is a brief questionnaire that generates a Mediterranean Diet score and a Sustainable Diet score from the same eight food-group consumption data using different scoring criteria. Dietary intake was assessed using 3-day food records. Validity was evaluated by comparing the MedQ-Sus scores with corresponding food-group and nutrient intakes derived from the food records and by examining construct validity using a modified alternate Mediterranean Diet score (aMED) and the Planetary Health Diet Index (PHDI). Associations and agreement were assessed using Spearman correlation coefficients, Bland-Altman analysis, and intraclass correlation coefficients (ICCs) based on absolute agreement, as appropriate. Test-retest reliability was evaluated in 71 randomly selected participants 4 weeks after the initial administration.

RESULTS: Statistically significant and positive correlations were found between the consumption levels of all food groups associated with the Mediterranean Diet score components. The Sustainable Diet score showed positive correlations with all food groups except legumes and fresh fruits (p < 0.05). The strongest relationship for both the Mediterranean Diet score (r = 0.490) and the Sustainable Diet score (r = 0.488) was observed in the consumption of fish and fish products (p < 0.001). Bland-Altman analysis indicated an acceptable level of agreement between the MedQ-Sus scores and the corresponding estimates derived from the food records. As adherence levels measured by the MedQ-Sus increased, intakes of fish, olive oil, dietary fibre, magnesium, zinc, monounsaturated fatty acids, and omega-3 fatty acids increased, whereas polyunsaturated fatty acid intake decreased. In the test-retest analysis, strong positive correlations were observed for the Mediterranean Diet score (r = 0.782) and the Sustainable Diet score (r = 0.813) (both p < 0.001).

CONCLUSION: The MedQ-Sus demonstrated good validity and reliability as a practical screening tool for simultaneously assessing adherence to the Mediterranean diet and adherence to a sustainable diet among the adults included in this study, while its exclusion of alcohol consumption may support its use across different adult population groups.

PMID:42579329 | DOI:10.1111/jhn.70330

Eur J Prev Cardiol. 2026 Aug 11:zwag412. doi: 10.1093/eurjpc/zwag412. Online ahead of print.

ABSTRACT

AIMS: To investigate the effect of long-term beta-blocker therapy on physical activity (PA) level after myocardial infarction (MI) in patients without heart failure.

METHOD: The BETAMI trial, randomised patients hospitalised with a MI without heart failure (LVEF ≥40%) to beta-blocker or no beta-blocker. In this pre-planned sub-study PA level was assessed by guideline-recommended PA level (≥30 minutes moderate activity ≥5 days/week) or not and self-reported hours/week with light to moderate and vigorous PA. Between-group differences in PA from baseline before randomisation to 18-months were estimated by linear mixed models. Exploratory analysis assessed treatment effects on a composite of all-cause mortality and major adverse cardiovascular events using Cox proportional hazards model.

RESULTS: Of the 2867 randomised patients, 2185 (76%) responded to the PA questions and were included in this analysis. Mean age was 62.5 (SD 10.1) years, 20.6% were women. No differences in guideline-recommended PA level or mean hours of light to moderate and vigorous PA were reported between the beta-blocker and non-beta-blocker group at baseline or during 18-months follow-up. At 12-month follow-up, 37.0% in the beta-blocker group and 36.7% in the no beta-blocker group reported guideline-recommended PA level (OR 0.97, 95% CI 0.69-1.37). Exploratory, hypothesis-generating analyses did not demonstrate a statistically significant interaction (p for interaction = 0.06) between treatment assignment and baseline PA level for recurrent clinical events.

CONCLUSIONS: Beta-blocker therapy did not result in a change in PA level in post-MI patients without heart failure during the 18 months follow-up.

PMID:42579327 | DOI:10.1093/eurjpc/zwag412

Cranio. 2026 Aug 11:1-11. doi: 10.1080/08869634.2026.2715421. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate short-term clinical and ultrasonographic changes in the masseter muscle following botulinum toxin type A (BoNT-A) injection in participants clinically assessed as having bruxism.

METHODS: Seventeen participants received standardized bilateral BoNT-A injections. Masseter muscle thickness was measured by ultrasonography at baseline, 14 days, and 90 days. Pain intensity (VAS), histogram parameters, and fractal dimension were also assessed. Bilateral measurements were averaged for statistical analysis.

RESULTS: VAS scores and masseter muscle thickness decreased significantly at days 14 and 90 compared with baseline, with no significant difference between follow-up visits. Histogram and fractal dimension analyses showed no significant changes over time.

CONCLUSION: BoNT-A significantly reduced pain and masseter muscle thickness, whereas ultrasonographic texture parameters remained unchanged during the 90-day follow-up.Clinical trials number: NCT07545200.

PMID:42579291 | DOI:10.1080/08869634.2026.2715421

JASA Express Lett. 2026 Aug 1;6(8):081201. doi: 10.1121/10.0044581.

ABSTRACT

Monitoring the abundance and distribution of marine mammals is essential for evaluating human and environmental effects. Passive acoustic monitoring offers a non-visual alternative, but estimating animal numbers remains difficult. We introduce Spatial Counting of Animal Numbers (SCAN), a method that counts unique bearings of detected calls to estimate a conservative minimum number of animals present. SCAN is a complementary metric to traditional presence/absence results and calibrated density estimates. The method is demonstrated using sei whale calls recorded by a four-element array on an autonomous glider. SCAN increases the information on marine mammal populations derived from passive acoustic recordings.

PMID:42579286 | DOI:10.1121/10.0044581

JAMA Netw Open. 2026 Aug 3;9(8):e2627878. doi: 10.1001/jamanetworkopen.2026.27878.

ABSTRACT

IMPORTANCE: American Indian and Alaska Native individuals report higher rates of substance use disorders and psychological distress compared with individuals from other racial and ethnic groups. However, few evidence-based, culturally grounded programs address substance use and mental health for urban American Indian and Alaska Native emerging adults.

OBJECTIVE: To test 2 culturally grounded virtual interventions for substance use among urban American Indian and Alaska Native emerging adults.

DESIGN, SETTING, AND PARTICIPANTS: In this randomized clinical trial, participants were recruited across the US from December 1, 2020, to October 27, 2023. Participants completed an online screening questionnaire. Eligibility criteria included (1) age 18 to 25 years; (2) living in an urban area in the US (not a rancheria or a reservation); (3) self-identification as American Indian or Alaska Native; (4) no opioid use disorder; and (5) English speaking. The participants completed baseline surveys, were randomized to 1 of 2 culturally grounded virtual interventions, and completed 3-, 6-, and 12-month surveys. Follow-up was completed January 28, 2025. Analysis was based on intention to treat.

INTERVENTIONS: Participants received either 3 Traditions and Connections for Urban Native Americans (TACUNA) workshops and a wellness circle, or an opioid education health and wellness cultural (HWC) workshop (usual care).

MAIN OUTCOMES AND MEASURES: Surveys focused on opioid, alcohol, and cannabis use (primary outcome) and consequences of alcohol and other drug use, mental health, cultural connection, and peer influence (secondary outcomes).

RESULTS: Among the 541 randomized participants (451 [83.2%] female; mean [SD] age, 22.1 [2.2] years), the TACUNA and HWC groups both reported decreased frequency of cannabis use (B [SE], -0.44 [0.20] and -0.54 [0.21], respectively) and decreased rates of positive screens for alcohol (B [SE], -0.03 [0.01] and -0.02 [0.01], respectively) and cannabis (B [SE], -0.02 [0.01] and -0.03 [0.01], respectively) use disorders. Rates of time spent with peers who use alcohol and prescription opioids, clinical depression and anxiety, alcohol and cannabis consequences, and peer norms around alcohol, cannabis, prescription opioids, and heroin use improved in both groups. Only TACUNA participants reported decreases in frequency (B [SE], -0.51 [0.20]) and quantity (B [SE], -0.25 [0.09]) of alcohol use and quantity of cannabis use (B [SE], -0.07 [0.03]). In addition, TACUNA participants reported greater decreases in time spent around peers using cannabis and heroin and greater decreases of anxiety compared with HWC participants.

CONCLUSIONS AND RELEVANCE: In this randomized clinical trial of 2 virtual culturally grounded interventions for substance use, virtual recruitment and intervention successfully reached urban American Indian or Alaska Native emerging adults with decreased access to resources. Both groups reduced consequences and cannabis use; however, only TACUNA participants reported decreases in quantity of alcohol and cannabis use and time spent around peers using cannabis and heroin and greater decreases in anxiety. These findings emphasize the role of bringing American Indian and Alaska Native emerging adults together to discuss ways to reduce alcohol and other drug use and socially connect with their tribal communities in the urban environment in a virtual setting.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04617938.

PMID:42579280 | DOI:10.1001/jamanetworkopen.2026.27878

JAMA Netw Open. 2026 Aug 3;9(8):e2627917. doi: 10.1001/jamanetworkopen.2026.27917.

ABSTRACT

IMPORTANCE: More than 70% of people experiencing homelessness report current smoking. Contingency management (CM) interventions that provide financial incentives for smoking cessation have shown short-term promise, but extended CM interventions have not been well studied in this population.

OBJECTIVE: To assess the feasibility and preliminary efficacy of an extended 6-month CM intervention for smoking cessation among adults experiencing homelessness.

DESIGN, SETTING, AND PARTICIPANTS: This pilot parallel 2-group randomized clinical trial was conducted in 3 safety-net clinics in San Francisco, California. Adults experiencing homelessness who smoked cigarettes and intended to quit within 6 months were enrolled from November 8, 2021, to June 27, 2023. Participants were followed up for 6 months, completed 24-week follow-up on January 9, 2024, and completed exploratory 52-week follow-up on May 21, 2024. Data were analyzed between June 1, 2024, and December 31, 2025.

INTERVENTIONS: Participants were randomized to extended CM or a control condition. The CM group received escalating gift card incentives for carbon monoxide (CO)-verified abstinence, starting at $13 and increasing by $0.50 for each negative test result for 6 months. Control participants received $5 per visit regardless of abstinence.

MAIN OUTCOMES AND MEASURES: The preliminary efficacy outcome was 7-day point prevalence abstinence (PPA; CO-verified self-report of abstinence). The secondary outcome was repeated 7-day PPA.

RESULTS: Of 83 participants, 42 were randomized to CM and 41 to a control. The mean (SD) age was 47.0 (10.8) years, and 53 participants (63.9%) were men. At 6 months, 7-day PPA was 31.0% in the CM group and 12.2% in the control group. After adjustment for covariates and with missing data treated as smoking, participants in the CM group had higher odds of achieving 7-day PPA at 6 months than those in the control group (adjusted odds ratio, 3.24 [95% CI, 1.03-10.19]; P = .04).

CONCLUSIONS AND RELEVANCE: In this pilot randomized clinical trial of adults experiencing homelessness, an extended CM intervention was feasible to implement and was associated with higher odds of 7-day PPA than the control condition. These findings suggest that extended CM may be a promising strategy for supporting smoking cessation in this population, but larger trials are needed to confirm efficacy.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04982952.

PMID:42579279 | DOI:10.1001/jamanetworkopen.2026.27917

JAMA Netw Open. 2026 Aug 3;9(8):e2628389. doi: 10.1001/jamanetworkopen.2026.28389.

ABSTRACT

IMPORTANCE: Maternal influenza vaccination effectively reduces risk of influenza among infants younger than 6 months, who are too young to receive influenza vaccination, in temperate countries with well-demarcated influenza seasons. However, evidence is limited supporting the clinical effectiveness of seasonal maternal influenza vaccination in tropical regions with year-round influenza transmission.

OBJECTIVE: To identify the clinical effectiveness of maternal influenza vaccination in reducing the risk of infant influenza hospitalization in a tropical setting.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study was conducted in Singapore, a tropical country with year-round influenza transmission. Participants included all infants (citizens or permanent residents of Singapore) born between May 1, 2017, and December 1, 2023, who had complete sociodemographic information for both children and their mothers derived from national administrative databases and survived at least 2 weeks after birth. Statistical analysis was performed from May 1, 2017, to April 30, 2024.

EXPOSURE: Receipt of influenza vaccination during pregnancy. Maternal vaccination status was classified using the National Immunization Registry and was linked to infant outcomes via the national birth registry.

MAIN OUTCOME AND MEASURES: The main outcome was infant influenza hospitalization from birth until 6 months of age, recorded in the national health care claims database. Hazard ratio (HR) of infant influenza hospitalizations was contrasted among infants with vaccinated mothers (received influenza vaccination during pregnancy) vs unvaccinated mothers (did not receive influenza vaccination during pregnancy), using overlap-weighted Cox proportional hazards regression model. Vaccine effectiveness (VE) was calculated as 1 – HR.

RESULTS: A total of 221 185 infants (113 625 males [51.4%]) were included. Overall, 25.9% of infants were born to vaccinated mothers. Infants were followed up from birth until an influenza hospitalization, 6 months of age, or death, whichever occurred first. The mean (SD) follow-up time was 181.9 (5.6) days for infants born to vaccinated mothers and 182.3 (5.0) days for infants born to unvaccinated mothers. Risk of influenza hospitalization was significantly lower in infants born to vaccinated mothers (adjusted HR [AHR], 0.59; 95% CI, 0.45-0.77). Maternal influenza vaccination was associated with significant VE estimates among infants (VE against hospitalization, 41%; 95% CI, 23%-55%). The VE estimate was statistically significant regardless of trimester timing (VE against hospitalization, first trimester: 52% [95% CI, 20%-71%]; second trimester: 37% [95% CI, 12%-56%]; third trimester: 41% [95% CI, 8%-64%). Maternal influenza vaccination remained protective regardless of season timing (VE against hospitalization, current season: 41% [95% CI, 12%-61%]; prior season: 41% [95% CI, 19%-58%]).

CONCLUSIONS AND RELEVANCE: In this retrospective cohort study in a tropical region with year-round influenza transmission, a strategy of immunizing mothers at any point during their pregnancy was associated with reduced risk of infant influenza hospitalization.

PMID:42579278 | DOI:10.1001/jamanetworkopen.2026.28389