Category: Statistics

J Nurs Scholarsh. 2026 Jul;58(4):e70116. doi: 10.1111/jnu.70116.

ABSTRACT

INTRODUCTION: Menopause affects nearly one-third of women’s lives and is associated with a wide range of physical and psychological symptoms-including sleep disturbances, mood fluctuations, and reduced quality of life-that represent a significant public health concern. While pharmacological treatments carry well-documented risks, evidence-based non-pharmacological interventions such as Mindfulness-Based Stress Reduction (MBSR) remain understudied in this population, particularly with respect to multiple psychosocial outcomes.

PURPOSE: This study aimed to evaluate the effects of a Mindfulness-Based Stress Reduction (MBSR) program on quality of life, life satisfaction, sleep quality, and mental well-being among menopausal women.

DESIGN: A randomized controlled trial with a pretest-posttest control group design.

METHODS: The study was conducted between February 28 and December 22, 2025, at a primary healthcare center in Türkiye. A total of 84 menopausal women were included (intervention: n = 43; control: n = 41). Data were collected using the Utian Quality of Life Scale, Riverside Life Satisfaction Scale, Pittsburgh Sleep Quality Index, and Warwick-Edinburgh Mental Well-Being Scale. The intervention group participated in an 8-week MBSR program, while the control group received no intervention. Data were analyzed using IBM SPSS Statistics (version 26.0).

FINDINGS: Compared with the control group, participants in the MBSR group demonstrated significant improvements in quality of life, life satisfaction, and mental well-being, along with significant reductions in sleep disturbances (p < 0.001). Within-group analyses showed significant improvements across all outcomes in the intervention group (p < 0.001), whereas no significant changes were observed in the control group (p > 0.05).

CONCLUSIONS: The MBSR program was associated with improvements in psychosocial well-being and sleep quality among menopausal women. These findings suggest that MBSR may be a beneficial non-pharmacological approach for managing menopausal symptoms.

PMID:42503602 | DOI:10.1111/jnu.70116

J Obstet Gynaecol Res. 2026 Aug;52(8):e70423. doi: 10.1111/jog.70423.

ABSTRACT

BACKGROUND: To compare the transvaginal natural orifice transluminal endoscopic surgery (vNOTES) approach versus conventional laparoscopy in bilateral tubal ligation for interval sterilization regarding perioperative outcomes, postoperative pain, and sexual function.

METHODS: This retrospective cohort study at a tertiary center included 88 women who underwent elective tubal ligation between February 2024 and October 2025 (vNOTES: n = 39; laparoscopy: n = 49). Women aged 18-45 years seeking permanent contraception with American Society of Anesthesiologists (ASA) physical status classification ≤ 3 were included. Primary outcomes included operative time and estimated blood loss (assessed by hemoglobin/hematocrit changes). Secondary outcomes included length of hospital stay, postoperative pain assessed using a visual analog scale (VAS) at 6 and 24 h postoperatively, total amount of analgesic requirements and sexual function evaluated using the Female Sexual Function Index (FSFI) preoperatively and at 1 and 6 months postoperatively. Statistical analysis used t-test/Mann-Whitney U test and chi-square/Fisher’s exact test (α = 0.05).

RESULTS: Baseline characteristics were comparable between groups (vNOTES: n = 39; laparoscopy: n = 49). No significant differences were found in hemoglobin changes or operative time. vNOTES demonstrated significantly shorter hospital stay (14.90 ± 7.27 vs. 20.10 ± 3.96 h, p < 0.001), lower postoperative total amount of analgesic requirements (1.72 ± 0.76 vs. 4.88 ± 1.63 doses, p < 0.001), and reduced VAS pain scores at 6 and 24 h. No intraoperative conversions occurred. Complication rates were similar between groups (p > 0.999). FSFI scores showed no significant differences at baseline, 1, or 6 months postoperatively.

CONCLUSION: vNOTES for tubal ligation offers significant advantages in postoperative pain reduction, decreased analgesic requirements, and shorter hospital stay while maintaining comparable operative times, safety, and sexual function outcomes.

PMID:42503601 | DOI:10.1111/jog.70423

Anim Sci J. 2026 Jan-Dec;97(1):e70226. doi: 10.1111/asj.70226.

ABSTRACT

This study characterized the association between the ventral and dorsal ruminal pH in cows. The experiment was conducted with six nonlactating rumen-cannulated Holstein cows fed either a grain-rich diet (65% concentrate in dry matter) or a forage-only diet. The dorsal and ventral ruminal pHs were measured in each cow using two identical indwelling systems, which recorded pH every 5 min. Furthermore, the volatile fatty acid concentrations and osmolality were determined in free ruminal liquid (FRL) of the ventral rumen and dorsal mat particle-associated ruminal liquid (PARL) and in feces. Precision and accuracy properties of dorsal ruminal pH and ventral ruminal pH as a measure of reproducibility were statistically evaluated. Data showed that the concordance correlation coefficient, representing the strength of the relationship between the ventral and dorsal ruminal pHs, was high when feeding the grain-rich diet (0.857), but low when feeding the forage-based diet (0.467), with accuracy of 0.917 and 0.525, and precision 0.935 and 0.890 for grain-rich diet and forage-based diet, respectively. The study established a relationship between ventral and dorsal ruminal pHs showing that ventral pH can serve as a proxy for dorsal pH, though this relationship demonstrated higher reproducibility only when feeding grain-rich diets.

PMID:42503600 | DOI:10.1111/asj.70226

Sports Med. 2026 Jul 26. doi: 10.1007/s40279-026-02506-4. Online ahead of print.

ABSTRACT

BACKGROUND: The annual incidence of Achilles tendon ruptures has increased by almost 3%. Despite the large amount of data available on post-injury treatment, there is a lack of evidence-based criteria to guide return to running after surgery.

OBJECTIVE: The aim of this study was to reach a consensus among experts on the criteria for resuming running following surgery for Achilles tendon rupture.

METHODS: Thirty-five international Achilles tendon experts were invited to participate in this modified Delphi study. The study was conducted in three rounds, with a threshold of 75% agreement (or disagreement) required for an item to achieve consensus. Sixteen clinical criteria were submitted to the expert panel. A five-point Likert scale was used. The study was conducted between January and June 2025.

RESULTS: Eight criteria achieved consensus after three rounds: seven criteria reached consensus for inclusion, and one criterion reached consensus for exclusion (calf circumference symmetry). The seven criteria were (1) the absence of pain in daily life; (2) the absence of pain during and after rehabilitation sessions; (3) walking without limping; (4) the ability to walk on tiptoes; (5) the ability to perform ten single-leg heel rises; (6) good single-leg balance; and (7) the patient feeling psychologically ready to resume running.

CONCLUSION: An expert consensus on the criteria to return to running after surgery for Achilles tendon rupture has been developed. These criteria, agreed by experts, may inform clinical decision making regarding return to running, but they require prospective validation before they can be used as decision rules. Further studies are needed to refine these criteria and evaluate their impact on functional outcomes during the return-to-running phase.

PMID:42503592 | DOI:10.1007/s40279-026-02506-4

Clin Rheumatol. 2026 Jul 27. doi: 10.1007/s10067-026-08318-1. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate whether the first-year cumulative vascular damage index (VDI) could serve as an independent predictor of relapse in patients with granulomatosis with polyangiitis (GPA).

METHODS: We retrospectively analysed 39 patients with GPA enrolled in a single-centre cohort. The first-year cumulative VDI was calculated as the area under the curve (AUC) of VDI scores during the first year using the trapezoidal rule. The earliest VDI, defined as the first VDI recorded ≥ 3 months after AAV diagnosis or AAV symptom onset, was also assessed as a contextual reference. Relapse was defined as the recurrence or new onset of vasculitic manifestations after ≥ 3 months of remission. The predictive accuracy for relapse was assessed using receiver operating characteristic (ROC) curves. Multivariable Cox proportional hazard models were performed to assess whether the first-year cumulative VDI is independently associated with the risk of relapse.

RESULTS: During a median follow-up of 40.6 (13.9-64.7) months, relapse occurred in 18 (46.2%) patients. The first-year cumulative VDI (AUC = 0.817) showed a significant predictive value for relapse, with a numerically higher accuracy than the earliest VDI (AUC = 0.734), although the difference was not statistically significant (p = 0.272). In the multivariable Cox model, the first-year cumulative VDI was significantly associated with relapse risk (adjusted hazard ratio [HR] = 6.536, 95% confidence interval [CI] = 1.746-24.460, p = 0.005), whereas the earliest VDI was not (adjusted HR = 1.358, 95% CI = 0.976-1.889, p = 0.070).

CONCLUSION: The first-year cumulative VDI independently predicts relapse in GPA, and outperformed early single time-point damage assessment. Our findings suggest that early cumulative damage evaluation may improve relapse risk stratification. Key Points • We assessed whether VDI can predict relapse in patients with GPA. • The first-year cumulative VDI was found to independently predict relapse in GPA. • Early cumulative damage evaluation may improve relapse risk stratification.

PMID:42503589 | DOI:10.1007/s10067-026-08318-1

Alzheimers Dement. 2026 Jul;22(7):e71686. doi: 10.1002/alz.71686.

ABSTRACT

INTRODUCTION: Sleep disturbance is common in dementia, impacting daytime function and care. Compared with Alzheimer’s disease (AD), sleep in frontotemporal dementia (FTD) is poorly characterized.

METHODS: We assessed sleep using the Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index in 58 people with primary progressive aphasia (PPA) and right temporal variant FTD, 32 with AD, and 36 cognitively healthy older volunteers. All participants had cognitive and behavioral assessments. Groups were compared using non-parametric statistics and correlations assessed sleep versus other indices.

RESULTS: Subjective sleep duration was increased in all syndromic groups. AD and semantic PPA were associated with increased daytime somnolence. Reported sleep quality varied between syndromes. Across the disease cohort, somnolence correlated with behavioral and empathy deficits; in AD, poorer sleep quality correlated additionally with self-monitoring deficits.

DISCUSSION: FTD and AD syndromes have distinct sleep phenotypes, and sleep alterations are associated with behavior. Standard sleep scales require careful interpretation in dementia.

PMID:42503587 | DOI:10.1002/alz.71686

J Appl Clin Med Phys. 2026 Aug;27(8):e70714. doi: 10.1002/acm2.70714.

ABSTRACT

BACKGROUND: Radiotherapy for vulvar carcinoma often employs the “frog-leg” position to minimize skin toxicity, but this position is biomechanically unstable and prone to setup errors using conventional skin markings.

PURPOSE: To evaluate the clinical efficacy of Surface-Guided Radiotherapy (SGRT) for setup accuracy in vulvar cancer patients treated in the frog-leg position and to quantify the biomechanical correlation between Body Mass Index (BMI) and setup errors.

METHODS: A retrospective cohort study of 20 vulvar cancer patients treated in the frog-leg position was conducted. All patients were treated using a uRT-linac 506c accelerator with integrated helical Fan-Beam CT (FBCT). Daily image guidance was performed using a two-step registration protocol (bony anatomy followed by soft-tissue fine-tuning). Setup errors from 500 FBCT datasets were compared between the conventional laser group (n = 10) and SGRT group (n = 10). The correlation between BMI and setup errors was analyzed using Spearman’s rank correlation.

RESULTS: The SGRT group demonstrated significantly superior setup accuracy across multiple key dimensions (p < 0.001). Notably, the Pitch error was reduced from 1.21° ± 0.48° in the Conventional Group to 0.07° ± 0.32° in the SGRT Group (Cohen’s d = 2.79). Longitudinal (LNG) error decreased from 0.49 ± 0.26 cm to 0.04 ± 0.24 cm (d = 1.82), and vertical (VRT) errors were similarly reduced.

BMI CORRELATION: In the Conventional Group, BMI showed a strong significant correlation with Pitch and Yaw errors (ρ = -0.81, P = 0.005), indicating that obesity may exacerbate pelvic rotational instability. Conversely, in the SGRT Group, no statistically significant correlation was observed between BMI and setup errors in any dimension (p > 0.05), demonstrating the system’s robustness against body habitus variations.

CONCLUSION: The frog-leg position is characterized by significant biomechanical instability due to distinct anatomical factors. Traditional skin marking methods are susceptible to the “skin traction effect” and interference from BMI. SGRT, through real-time topographical matching, effectively corrects pelvic tilt and longitudinal sliding. Crucially, it eliminates the setup uncertainty associated with BMI, providing a solid evidence-based foundation for precision radiotherapy and individualized PTV margin reduction.

PMID:42503572 | DOI:10.1002/acm2.70714

J Nurs Scholarsh. 2026 Jul;58(4):e70118. doi: 10.1111/jnu.70118.

ABSTRACT

INTRODUCTION: Adults who grow up with a parent with severe mental illness are exposed to prolonged developmental adversity, yet little is known about how this experience shapes multidimensional outcomes in adulthood. In particular, the roles of personal adaptive resources, childhood trauma, parental bonding, and morbidity in influencing quality of life, social functioning, and healthcare utilization remain insufficiently understood. This study aimed to examine the relationships between personal adaptive resources (resilience and general self-efficacy), childhood experiences (trauma and parental bonding), and adult outcomes, including quality of life, social functioning, morbidity, and healthcare utilization, as well as to examine the moderating role of resilience.

DESIGN: A cross-sectional quantitative design was employed.

METHODS: A convenience sample of 300 adults who grew up with a parent with severe mental illness completed a self-report questionnaire which consisted of validated scales for study variables: Personal Wellbeing Index-Adult, Connor-Davidson Resilience Scale-10, New General Self-Efficacy Scale, Social Functioning Questionnaire, Parental Bonding Instrument, Childhood Trauma Questionnaire, and EUROHIS survey items for morbidity and healthcare utilization. Data were analyzed using Spearman correlations, hierarchical multiple linear regression, negative binomial regression, and moderation analysis using PROCESS.

RESULTS: Resilience and self-efficacy independently predicted higher quality of life. Childhood trauma and parental overprotection independently predicted poorer social functioning, while parental care did not contribute unique variance in multivariate models. Childhood trauma significantly predicted morbidity, and morbidity was associated with increased healthcare utilization. Resilience did not moderate the relationship between childhood trauma and either morbidity or social functioning, indicating independent rather than interactive effects.

CONCLUSION: Among adults who grew up with a parent with SMI, resilience and self-efficacy function as independent contributors to subjective wellbeing, while childhood adversity and morbidity shape long-term social and health outcomes. Resilience does not appear to buffer the long-term effects of trauma on health or functioning.

PMID:42503553 | DOI:10.1111/jnu.70118

Eur J Pediatr. 2026 Jul 27;185(8):612. doi: 10.1007/s00431-026-07273-y.

ABSTRACT

This study aimed to investigate the characteristics of febrile seizure (FS) associated with Kawasaki disease (KD) using nationwide population-based data. Children aged ≤ 5 years were analyzed using claims data from the Korean Health Insurance Review and Assessment Service between 2007 and 2022. FS and KD were identified using ICD-10 codes R56.0 and M30.3, respectively. Clinical characteristics were compared between FS associated with KD (KD-FS) and FS without KD (non-KD-FS). Of 1,230,434 children with FS, 1,683 (0.1%) had concomitant KD. Children with KD-FS were younger (1.66 vs. 1.81 years, p < 0.0001) and more likely to be male (58.8% vs. 55.9%, p = 0.0163) than those with non-KD-FS. During the coronavirus disease 2019 pandemic, the overall incidence of FS decreased markedly, whereas that of KD-FS increased. KD-FS occurred more frequently in winter and showed a distinct seasonal pattern, whereas the incidence of non-KD-FS peaked in summer. Children with KD-FS were more frequently treated in secondary or tertiary hospitals and had longer hospital stays. Chloral hydrate and acute/emergency anticonvulsants were more frequently administered in the KD-FS group; however, maintenance anticonvulsant use did not differ. Cerebrospinal fluid analysis and brain computed tomography were performed more frequently in the KD-FS group; brain magnetic resonance imaging and electroencephalography utilization and mortality rates were comparable.

CONCLUSION: KD-FS is rare and does not appear to be associated with a more severe neurological course than non-KD-FS.

WHAT IS KNOWN: • Kawasaki disease (KD) is a systemic vasculitis that can be accompanied by neurological manifestations, including febrile seizures (FS). • FS during acute KD is rare and remain insufficiently characterized in large population-based studies.

WHAT IS NEW: • In this nationwide study, FS associated with KD are rare but show distinct demographic and seasonal features, including younger age and winter predominance. • However, FS associated with KD are not associated with worse neurological outcomes or mortality compared with non-KD febrile seizures.

PMID:42503538 | DOI:10.1007/s00431-026-07273-y

J Robot Surg. 2026 Jul 27;20(1):759. doi: 10.1007/s11701-026-03697-8.

ABSTRACT

To systematically characterize global publication trends, collaboration patterns, intellectual foundations, research hotspots, and emerging frontiers in artificial intelligence (AI)-enhanced robotic and robot-assisted surgery in urology. Publications were retrieved from the Web of Science Core Collection (WoSCC) using a topic search strategy that included three keyword groups: robot-assisted surgery, urologic diseases or procedures, and AI-related technologies. English-language articles and reviews were included. Meeting abstracts, conference proceedings, editorials, letters, non-English publications, studies unrelated to urologic robotic surgery, and studies without substantive AI or intelligent algorithmic content were excluded. RStudio was used for descriptive statistics and annual publication trend visualization. VOSviewer was used for auxiliary bibliometric network construction and visualization. CiteSpace was used to construct collaboration networks, co-citation networks, keyword co-occurrence maps, cluster maps, timeline and time-zone maps, and citation burst maps. A total of 401 records were initially retrieved, and 253 publications were finally included after screening by document type, language, and topical relevance. These comprised 199 articles (78.66%) and 54 reviews (21.34%). Publications in this field began in 2004 and increased rapidly after 2018, reaching a peak of 53 publications in 2025. Because 2026 was an incomplete retrieval year, only 23 publications were recorded. Italy, the United States, the Netherlands, China, and Japan were the leading contributing countries. The University of Turin, Azienda Ospedaliero-Universitaria San Luigi Gonzaga, IRCCS Fondazione del Piemonte per l’Oncologia, the Netherlands Cancer Institute, and Leiden University Medical Center were the most productive institutions. Keyword clustering showed that the major research hotspots included renal cell carcinoma, augmented reality, image-guided surgery, indocyanine green, machine learning, registration, deep learning, and bladder cancer. AI-enhanced robotic surgery in urology has evolved from early research on registration, navigation, and image-guided surgery toward a surgical intelligence stage characterized by augmented reality, three-dimensional reconstruction, machine learning-based prediction, deep learning-based segmentation, surgical video understanding, and skill assessment. Future studies should prioritize multicenter standardized datasets, sharing of intraoperative video and robotic platform data, model interpretability, prospective validation, and integration into real-world clinical workflows.

PMID:42503526 | DOI:10.1007/s11701-026-03697-8