Category: Statistics

NPJ Digit Med. 2026 Jun 2. doi: 10.1038/s41746-026-02837-6. Online ahead of print.

ABSTRACT

Large language models (LLMs) are being deployed in clinical settings despite an underdeveloped evidence base regarding their real-world effectiveness. This study employed systematic evidence mapping to characterize outcome measures used in published studies and registered clinical trials (Jan 2022-Jun 2025) evaluating LLM performance. Analysis of 55 included studies revealed a predominance of human-AI collaborative designs (65.5%) for decision support and symptom management. LLM-only interventions focused on functional performance and operational or process impact outcomes (e.g., accuracy and time saving), whereas LLM-assisted interventions showed positive clinical effects, particularly in psychological health endpoints. Critical evidence gaps persist: diagnostic accuracy in randomized trials was notably lower and more variable (range 0.65-0.88) compared to non-randomized studies (typically ≥ 0.80); clinical efficiency impacts were inconsistent, and reporting quality was suboptimal (78.8% mean CONSORT-AI adherence), with critical omissions in handling data quality and performance errors. These findings indicate a heterogeneous and insufficient evidence landscape, necessitating standardized core outcome sets, mandatory use of specialized reporting guidelines, and robust clinical trials to ensure the safe integration of LLMs.

PMID:42230743 | DOI:10.1038/s41746-026-02837-6

Sci Rep. 2026 Jun 3. doi: 10.1038/s41598-026-55791-4. Online ahead of print.

ABSTRACT

At the present stage, the development of renewable energy sources, particularly solar energy, is considered one of the key directions for ensuring energy security and sustainable development. In this context, training specialists with well-developed research and engineering thinking in the field of solar energy within the higher education system has become an urgent issue. The purpose of this study is to theoretically and empirically examine the effectiveness of developing students’ research and engineering activities through the implementation of a STEM Project-Based Learning (PjBL) approach in solar energy education. The study was conducted using a sequential explanatory design, consisting of two phases. In the first phase, a systematic literature review and meta-analysis were carried out based on studies published between 2015 and 2025 and selected from Web of Science, Scopus, and Google Scholar in accordance with the PRISMA methodology. The meta-analysis was performed using Comprehensive Meta-Analysis 4.0 software and included 15 empirical studies. In the second phase, a pedagogical experiment was conducted at Khoja Akhmet Yassawi International Kazakh-Turkish University involving 88 students divided into control and experimental groups. An independent samples t-test was applied to analyze the collected data. The meta-analysis results indicated a large overall effect size (d = 1.75; 95% CI [1.29, 2.22]; p < 0.001), suggesting the strong potential of STEM-PjBL in enhancing students’ research and engineering skills. The experimental results showed no statistically significant difference between the control and experimental groups at the pre-test stage (t = 0.1425; p = 0.887), while a significant difference was observed at the post-test stage (t = 5.8550; p < 0.001), with a large effect size (Cohen’s d = 1.27). The findings suggest that the implementation of STEM Project-Based Learning in solar energy education can effectively support the development of students’ research autonomy, engineering thinking, and their ability to connect theoretical knowledge with real-world applications.

PMID:42230742 | DOI:10.1038/s41598-026-55791-4

Sci Rep. 2026 Jun 2. doi: 10.1038/s41598-026-56353-4. Online ahead of print.

ABSTRACT

Psoriasis and inflammatory bowel disease (IBD) share genetic and immunological features, but the impact of concomitant psoriasis on the clinical course of IBD is not well defined. We investigated whether concomitant psoriasis is associated with increased treatment burden and worse outcomes in patients with IBD. This retrospective cohort study included 75 patients with IBD from two academic centers in South Korea (IBD with psoriasis [IBD-PS], n = 25; IBD-only, n = 50). The IBD-PS group included only patients in whom psoriasis was diagnosed prior to IBD. Demographic data and clinical outcomes were analyzed. The primary endpoints were biologic and immunomodulator (IMM) use, and secondary endpoints included IBD-related surgery and emergency room (ER) visits. Time-to-event outcomes were assessed using Kaplan-Meier methods. Biologic and IMM use were significantly higher in the IBD-PS group than in the IBD-only group (biologics: 40% vs. 16%; IMMs: 60% vs. 20%). Treatment escalation to biologics or IMMs occurred earlier in patients with concomitant psoriasis (log-rank P = 0.0021). ER visits were numerically more frequent among patients with severe psoriasis, and the time to first hard clinical event (IBD-related surgery or ER visit) tended to be shorter in the IBD-PS group, although this difference was not statistically significant. Overall, concomitant psoriasis may be associated with increased treatment intensity and a more aggressive IBD course. These findings support the need for coordinated multidisciplinary care and further validation in prospective multicenter studies.

PMID:42230724 | DOI:10.1038/s41598-026-56353-4

Comput Methods Programs Biomed. 2026 May 22;285:109458. doi: 10.1016/j.cmpb.2026.109458. Online ahead of print.

ABSTRACT

BACKGROUND: Ventricular late potentials (VLPs) are markers of arrhythmogenic substrate, but conventional assessment using signal-averaged ECG (SAECG) requires prolonged acquisition and operator-dependent artifact handling, limiting scalability and ambulatory use. Single-beat detection of VLP-like activity from standard surface ECG remains insufficiently validated.

OBJECTIVE: To evaluate the technical feasibility of interpretable single-beat detection of VLP-like perturbations from standard ECG leads without signal averaging.

METHODS: Using the MIMIC-IV-ECG database, we analyzed 120,000 beats from leads II, V2, and V6. Because large public datasets with beat-level clinically adjudicated VLP labels are not currently available, physiologically constrained synthetic VLP-like signals were injected into a subset of beats to create a controlled feasibility benchmark. For each beat, more than 200 features were extracted, including time-domain statistics, frequency-domain measures, wavelet coefficients, autocorrelation features, and localized windowed summaries. Ten classifiers were optimized using nested patient-wise cross-validation and evaluated in five settings: single-lead detection, cross-lead generalization, mixed-lead training, reduced training size, and class-imbalance robustness.

RESULTS: Gradient-boosted ensembles, particularly XGBoost and CatBoost, achieved strong discrimination on held-out single-beat data (AUC > 0.99; F1 > 0.93), while remaining stable with 10% of the training data and 5% positive-class prevalence. Performance was also robust in lead-transfer experiments. SHAP analysis identified localized entropy, dispersion, and related high-frequency descriptors in late post-R windows as the dominant predictors.

CONCLUSION: These findings support the methodological feasibility of interpretable single-beat detection of VLP-like signatures from routine surface ECG under controlled synthetic conditions. Validation on clinically adjudicated cohorts and external datasets is required before clinical translation.

PMID:42229036 | DOI:10.1016/j.cmpb.2026.109458

J Anxiety Disord. 2026 May 28;122:103188. doi: 10.1016/j.janxdis.2026.103188. Online ahead of print.

ABSTRACT

The 12-item Intolerance of Uncertainty Scale (IUS-12) is a widely used measure in anxiety disorders research and clinical practice, although recent research efforts have recommended the development of a briefer measure to reduce response burdens. The current study was designed to develop a short form of the IUS-12. We administered the IUS-12 to two samples (cross-sectional, n = 3952; longitudinal, n = 190) of Canadian Public Safety Personnel through an online self-report survey. Exploratory (EFA) and confirmatory (CFA) factor analyses assessed the factor structure of the IUS-12 and facilitated item reduction and optimization. Convergent and concurrent validity, as well as pre-post rank-order consistency were also assessed. The IUS-12 was reduced to a two-factor, six-item short form (i.e., IUS-6) that retains the factor structure of the IUS-12 with statistically comparable validity and consistency, which appears to retain the intended latent content for each subscale. Very strong statistically significant positive correlations were observed between IUS-6 and IUS-12 subscales (rs = .90-.94) and total scores (r = .95) for all samples, suggesting excellent construct validity. Moderate to strong statistically significant associations were also observed among the IUS-6 and IUS-12 total and subscales and measures of generalized anxiety, social anxiety, and anxiety sensitivity, suggesting good convergent validity (rs = .23-.64), with only small differences in correlation strengths (i.e., r < .14). The IUS-6 may be used as an ultra-short version of the IUS-12 for assessing self-reported intolerance of uncertainty in both cross-sectional and longitudinal research designs, potentiating reduced response burdens, which may be important in various research and clinical settings.

PMID:42229033 | DOI:10.1016/j.janxdis.2026.103188

Cogn Neurosci. 2026 Jun 2:1-2. doi: 10.1080/17588928.2026.2682170. Online ahead of print.

ABSTRACT

Slotnick (2026) provides a large number of simulations to demonstrate that statistical power in fMRI can be improved by including the sample size N when calculating an appropriate cluster extent threshold for thresholding statistical maps. I argue that the problems acknowledged by Slotnick can instead be solved using threshold free cluster enhancement (TFCE) and a permutation test, which together apply a large number of cluster forming thresholds and implicitly model the sample size as well as the spatial autocorrelation. Furthermore, I briefly mention some other approaches for increasing statistical power in fMRI.

PMID:42228992 | DOI:10.1080/17588928.2026.2682170

Neurodiagn J. 2026 Jun 2:1-13. doi: 10.1080/21646821.2026.2671520. Online ahead of print.

ABSTRACT

INTRODUCTION: Linked Quadripolar Stimulation (LQP) is a recent adaptation of transcranial electric motor evoked potential stimulation, with proposed advantages over traditional Bipolar (BP) stimulation. This study aims to comprehensively compare BP and LQP stimulation to validate the efficacy of LQP.

METHODS: BP and LQP stimulation were performed on 30 patients undergoing anterior cervical discectomy and fusion. A comprehensive assessment involved conducting four trials for each technique on each patient. An Accelerometer placed over the right masseter region recorded movement. A Mann-Whitney U test and Pearson Correlation Coefficient were used to quantitatively compare patient movement, compound muscle action potential (CMAP) response amplitude, and area under the curve (AUC) values.

RESULTS: TCMEP recordings were successfully obtained from the entire sample. No statistical significance was found between patient movement, amplitude, or area under the curve (AUC) between BP and LQP stimulation. A weak correlation was found between patient movement and stimulation intensity for both techniques. A strong correlation was found between amplitude and AUC values.

CONCLUSION: Patient movement and stimulation parameters showed similar outcomes between BP and LQP. LQP did not demonstrate reduced movement compared to BP stimulation. This study contributes valuable insights into the effectiveness of BP and LQP stimulation in anterior cervical discectomy and fusion surgery.

PMID:42228986 | DOI:10.1080/21646821.2026.2671520

Neurodiagn J. 2026 Jun 2:1-14. doi: 10.1080/21646821.2026.2659990. Online ahead of print.

ABSTRACT

The National Association of Epilepsy Centers mandates that epilepsy monitoring unit (EMU) patient observers must always be present to minimize risk of patient injury during admissions. To comply with this requirement, our staffing model and workflow were adjusted accordingly. Upon activation of the event button, rather than attending to EMU patients in person, the patient observer responded verbally through the room’s speaker system and subsequently contacted nursing staff via a Vocera™ device. This study evaluates the efficiency of this model by measuring the time between event button (PB) activation, observer response, and subsequent evaluation by either nursing staff or physicians. We retrospectively reviewed video EEG files for all available PBs on EMU patients admitted between January 1 and December 31, 2023, and calculated the intervals between PB activation, patient observer’s response, and in-person attendance by the health care provider. Patient demographics and event details were examined for statistical differences. Of 129 admissions (402 PBs), the median observer response time was 15 seconds, which increased with age (14 s, 16 s, and 20 s for <45, 45-64, and ≥65 yo, respectively; p = .027). The average time for a nurse or a physician to physically attend to the patient was 94 s (range, 4 to 1808 s). The average observer’s response to psychogenic non-epileptic seizures (PNES) was faster (10 s) than responses to epileptic seizures (14 s), accidents (15 s), and other events (17 s) (p < .001). There was no difference in response time between sexes (p = .870) or races (p = .197). Although patient observer response time was short, only 15% of PBs were seizure-related, while > 50% were accidental. These findings highlight the need to critically evaluate EMU staffing models to maintain compliance with the safety requirements, improve the accuracy of seizure detection, and to meet overall goals of EMU evaluation.

PMID:42228984 | DOI:10.1080/21646821.2026.2659990

Surg Laparosc Endosc Percutan Tech. 2026 Jun 1;36(3):e1448. doi: 10.1097/SLE.0000000000001448.

ABSTRACT

BACKGROUND AND AIMS: Esophageal foreign body (FB) impaction demands timely gastroscopic extraction, yet the need for preoperative radiographic imaging (PORI) varies by patient. To date, no validated risk-stratification tools exist to guide clinicians in determining the necessity of PORI before gastroscopic FB extraction. This study aims to fill this gap by developing a novel esophageal FB symptom score (EFBSS) to stratify patients at risk of severe complications, thereby providing a personalized approach to PORI decision-making.

METHODS: Patients with suspected FBs were retrospectively categorized into PORI or non-PORI groups. Gastroscopic success rate, complications, and survival prognosis were compared and analyzed between the 2 groups. Logistic regression was used to identify risk factors for FB-related perforation or surgical complications. A risk stratification system (low-risk: 0 to 3; moderate-risk: 4 to 6; high-risk: 7 to 9 points) was then built based on the likelihood of such complications to guide PORI decision-making.

RESULTS: There was no statistically significant difference between the PORI group (n=749) and the non-PORI group (n=1751) in the main outcome indicators, such as disease characteristics, FB types, incidence of complications, gastroscopic success rate, and survival prognosis (P>0.05). However, the PORI group had a longer duration of FB impaction and higher outpatient costs than the non-PORI group (P<0.05). The EFBSS includes swallowing FBs with pain, intentional ingestion of FBs, and cervical/chest/abdominal pain, with good discriminative power. The total score had an area under the receiver operating characteristic curve (AUC) of 0.822 (95% CI: 0.736-0.908), while the AUCs for the 3 components were 0.716, 0.699, and 0.894, respectively. The EFBSS system stratified the risk of FB-related perforation or surgical complications into 3 tiers: low (0.41%), moderate (2.95%), and high (39.29%). A significantly increasing risk trend was observed across tiers (P<0.001).

CONCLUSIONS: We developed a risk scoring system incorporating swallowing FBs with pain, intentional ingestion of FBs, and cervical/chest/abdominal pain. This system preoperatively stratifies patients by the risk of FB-related perforation or surgical complications to facilitate PORI decision-making and maximize benefits.

PMID:42228962 | DOI:10.1097/SLE.0000000000001448

Integr Comp Biol. 2026 Jun 2:icag061. doi: 10.1093/icb/icag061. Online ahead of print.

ABSTRACT

Geometric morphometrics is a common tool that quantifies shape variation and has been used to explore morphological changes over ontogeny and investigate evolutionary relationships. Lionfishes are suction feeders that have cycloid scales. Cycloid scales in bony fishes are smooth, overlapping structures that have been hypothesized to serve multiple functions such as protection and streamlining the fish for efficient locomotion. Lionfish undulate their soft dorsal, anal, and caudal fins to move slowly through the water column, near the substrate. In this study we examined invasive lionfish, Pterois volitans, collected from public fishing derbies on the eastern coast of Florida. We used 2D geometric morphometrics to investigate lionfish scale variation along the length of the body from three regions (anterior, middle, caudal), and between sexes. We placed eight landmarks using anatomical loci on sixty scales from twenty specimens similar in size (TL = 170mm- 230mm). We hypothesized to observe significant scale shape variation among body regions and we expected to see shape variation between sexes, as males exhibit more aggressive behavior during mating. Lionfish showed significant shape differences among all regions (anterior, middle, and caudal), with scales being more elongated near the caudal fin. We also observed statistically significant shape differences between male and female scales. Specifically, females have wider scales in the middle body region and males have wider scales near the caudal fin. Overall, this study reveals more information about the morphology and sexual dimorphic traits of lionfish using unconventional specimen collection methods (public lionfish derbies). When conducting research on invasive species we emphasize the importance of utilizing public events sponsored by state and local organizations, which are already engaging the public to significantly reduce population sizes.

PMID:42228949 | DOI:10.1093/icb/icag061