Nevin ManimalaBrief Bioinform. 2026 May 4;27(3):bbag240. doi: 10.1093/bib/bbag240.
ABSTRACT
We discuss the drawbacks of using homogeneity and completeness, statistics defined for the evaluation of clustering accuracy, for evaluating plasmid binning tools accuracy, motivated by the recently published paper “Circling in on plasmids: benchmarking plasmid detection and reconstruction tools for short-read data from diverse species,” by Teixeira et al.
PMID:42153317 | DOI:10.1093/bib/bbag240
Stat Med. 2026 May;45(10-12):e70575. doi: 10.1002/sim.70575.
ABSTRACT
Bang and Zhao address an important methodological gap by proposing meta-analytic methods for cost-effectiveness analysis (CEA) based on separate pooling of incremental costs (ΔC) and incremental effectiveness (ΔE), with summaries displayed on the cost-effectiveness plane. We share the aim of expanding the toolkit for CEA synthesis; however, we believe that several issues need clarification before the proposal can serve as a general blueprint. First, the two motivating examples appear not to satisfy the key combinability criteria described by Shields and Elvidge. Second, the proposal does not incorporate the data harmonization steps recommended for the meta-analysis of economic evaluations by Bagepally et al. Third, separate univariate pooling does not retain the within-study association between ΔC and ΔE, which complicates the joint interpretation of the pooled ICER and its uncertainty. As a possible way forward, we propose a two-stage framework in which a structured combinability assessment and data harmonization precede any quantitative synthesis, and discuss why joint modeling of (ΔC, ΔE) is preferable to separate univariate pooling. In our view, such a framework provides a more defensible route to pooled ICERs, joint uncertainty summaries, and decision-relevant quantities such as cost-effectiveness acceptability curves (CEACs).
PMID:42153314 | DOI:10.1002/sim.70575
Int J Med Robot. 2026 Jun;22(3):e70174. doi: 10.1002/rcs.70174.
ABSTRACT
INTRODUCTION: Endoscopic retrograde cholangiopancreatography (ERCP) is technically challenging, with high operator radiation exposure, physical strain, and a steep learning curve, necessitating a robotic solution. This study evaluated robotic-assisted ERCP feasibility and efficacy in an animal model.
METHODS: In this randomised controlled crossover study, three experienced endoscopists performed 24 ERCP procedures (12 robotic-assisted vs. 12 manual) on four beagles using the YunSRobot system. Primary outcomes included papilla positioning maintenance, cannulation time, and success rate.
RESULTS: Robotic-assisted ERCP demonstrated superior papilla positioning (95.74% vs. 77.25%, p < 0.01), indicating more endoscopic stability during cannulation. The successful cannulation rate was identical in both groups (83.3%). The robotic group required fewer attempts (2.0 vs. 3.5) and experienced no scope dislocations (0 vs. 5). No severe adverse events occurred in either group.
CONCLUSIONS: Robotic-assisted ERCP is feasible, safe, and effective, offering significantly improved endoscopic stability with comparable cannulation success to manual techniques.
PMID:42153283 | DOI:10.1002/rcs.70174
Med Teach. 2026 May 1:1-10. doi: 10.1080/0142159X.2026.2663870. Online ahead of print.
ABSTRACT
INTRODUCTION: Although peer support is known to foster well-being among students in health professions education, the mechanisms driving informal help-seeking behavior remain insufficiently understood. Ongoing psychological distress and persistent barriers to faculty-based support increase the need for accessible resources for these future health care professionals. This study explored whether students reach out when experiencing performance pressure and which opportunities they identify to strengthen their peer support network.
METHODS: This sequential, mixed-methods study was conducted at the Radboud University Medical Center, the Netherlands and spanned a six-year period through two distinct phases of data collection (2018-2024). In Part 1, 26 students in Medicine and Biomedical Sciences completed one-on-one interviews. Qualitative analysis identified six key barriers to informal help-seeking; ‘Stigma’ (S), ‘Harm’ (H), ‘Inutility’ (I), ‘Ego’ (E), ‘Load’ (L), and ‘Disapproval’ (D), together forming the SHIELD-framework. In Part 2, 946 students completed a survey developed from Part 1 findings. A mixed-format question design and advanced statistical analyses were used to examine latent patterns in their informal help-seeking behavior.
RESULTS: Across both study parts, most students concealed their internal struggles, creating a gap between experience and expression. Their motivations were consistently reflected in the SHIELD-framework across gender, program and year of study. ‘Stigma’ and ‘Disapproval’ captured fear of judgment. ‘Harm’ and ‘Load’ reflected concerns about burdening others or worsening personal distress. ‘Inutility’ referred to doubts about the usefulness of disclosure, while ‘Ego’ related to students’ self-image. Many students described suppressing difficult thoughts and emotions, keeping stress confined to their inner world.
DISCUSSION: Students’ tendency to shield their stress reflected a complex interplay of personal and contextual barriers. Our SHIELD-framework offers a practical and conceptual handhold for students and educators to better understand these dynamics. Supporting a shift from shielded stress to shared support requires intentional efforts that normalize vulnerability and foster meaningful peer connection.
PMID:42153275 | DOI:10.1080/0142159X.2026.2663870
Histol Histopathol. 2026 May 19:25092. doi: 10.14670/HH-25-092. Online ahead of print.
ABSTRACT
According to recent studies, periostin expression is significantly higher in cardiac disease and tumor tissues in the majority of cancers compared with normal tissues. Periostin was reported to be expressed in the stroma of Warthin’s tumors. In the present study, we focused on the periostin expression in Warthin’s tumor and malignant lymphomas, which require differentiation from these tumors. This study included 26 patients (28 specimens; 14 men and 12 women) with a mean age of 68.4 (range 51-85) years who underwent parotid tumor resection at the Division of Otorhinolaryngology, Tohoku Medical and Pharmaceutical University, between May 2016 and March 2022, and were clinically and pathologically diagnosed as Warthin’s tumors and malignant lymphomas. Formalin-fixed, paraffin-embedded sections from the surgical specimens were immunostained with anti-periostin antibodies to evaluate the expression and distribution of periostin. Histologically, the tumors were diagnosed as Warthin’s tumors in 13 cases (15 specimens) and malignant lymphomas in 13 cases (13 specimens). An increased expression of periostin was found in 24 (12 Warthin’s tumors and 12 malignant lymphomas) of the 28 samples (85.7%) in the stroma of both Warthin’s tumors and malignant lymphomas. Three distinct patterns of periostin expression were observed: negative, superficial, and infiltrative. Statistically significant differences were found between periostin expression patterns and the histological classification of the tumors. Our results suggest that periostin may be involved in the pathogenesis of Warthin’s tumors and malignant lymphomas, potentially serving as a novel biomarker for these conditions.
PMID:42153264 | DOI:10.14670/HH-25-092
Eur J Psychotraumatol. 2026 Dec;17(1):2660607. doi: 10.1080/20008066.2026.2660607. Epub 2026 May 19.
ABSTRACT
Background: Despite the increased attention paid to the separate effects of cumulative adversities and protection on mental health, the extent to which distinct clusters of risk and protective factors exist and have special effects on depression and anxiety symptom trajectories remains under-explored.Objective: To explore the effects of clusters of childhood adverse experiences and positive experiences on depression and anxiety symptom trajectories.Methods: A longitudinal study was conducted at two colleges in Anhui province, China, between October 2022 and November 2023. Questionnaires were administered to 4,764 first-year students anonymously, requesting information regarding their adverse childhood experiences (ACEs), positive childhood experiences (PCEs), depression and anxiety symptoms. Latent class analysis was utilized to identify classes based on ACEs and PCEs. Latent class growth analysis was used to recognize trajectories of depression and anxiety symptoms. Two models were conducted using regression analysis. The correlation between a single type of ACEs and PCEs and clusters and depression and anxiety symptom trajectories was explored.Results: Three classes of ACEs and PCEs clusters were identified, comprising between 17.8% and 61.% of the sample each. Three distinct classes were identified for trajectories of depression and anxiety symptoms. Those who were referred to trajectory 1 (‘low depression symptoms reducing’) were found to be at an increased risk of developing ‘high depression symptoms increasing’ and ‘moderate depression symptoms stabilized’, when compared with those in class 3 (‘low risk and high protection’). This was also the case for anxiety symptom trajectories.Conclusion: It is not only the case that distinct categories of ACEs and PCEs exist; furthermore, these groups exhibit varying probabilities of future depression and anxiety symptom trajectories. It is evident that a child’s preventative measures of ACEs are likely to be of greater consequence than positive protection.
PMID:42153254 | DOI:10.1080/20008066.2026.2660607
J Korean Med Sci. 2026 May 18;41(19):e139. doi: 10.3346/jkms.2026.41.e139.
ABSTRACT
BACKGROUND: This study aimed to compare the symptom structures of hikikomori in Korea and Japan through a network analysis approach, addressing the scarcity of comparative research and elucidating potential cross-cultural differences in its manifestation.
METHODS: Data were derived from the Research on Asian Psychotropic Prescription Patterns, Phase 3 (REAP-AD3) study, involving psychiatric patients in Korea and Japan. Social withdrawal symptoms were assessed using the one-month version of the 25-item Hikikomori Questionnaire (HQ-25M). Network analyses were performed to characterize symptom interconnections and centrality in both cohorts. Differences in network structure, edge strength, and global strength were evaluated using the network comparison test (NCT).
RESULTS: The NCT indicated no statistically significant differences in network structure invariance between Korean and Japanese patients. Notably, the most frequently endorsed symptom among Korean psychiatric patients was “no one to discuss important matters with,” whereas for Japanese psychiatric patients it was “difficulty enjoying social situations.”
CONCLUSION: Although overall network structures were largely comparable, the findings suggest subtle distinctions in the organization of social withdrawal symptoms between Korean and Japanese psychiatric patients. These differences underscore the importance of developing culturally tailored preventive and therapeutic strategies for hikikomori in these populations.
PMID:42153230 | DOI:10.3346/jkms.2026.41.e139
J Korean Med Sci. 2026 May 18;41(19):e138. doi: 10.3346/jkms.2026.41.e138.
ABSTRACT
BACKGROUND: A recently developed claims-based algorithm, originally designed using data from pregnancies with systemic lupus erythematosus, may enhance the identification of pregnancy episodes in Korean observational research. However, its applicability for estimating gestational age (GA) has not yet been validated in the general pregnant population. This study aimed to evaluate and refine the algorithm’s performance.
METHODS: We utilized nationwide claims data from the Korean National Health Insurance Service between February 27, 2021, and December 31, 2022, to identify pregnancy episodes, including deliveries, stillbirths (SBs), and abortive outcomes (ABs). GA for each episode was estimated using both the original and modified algorithms, which prioritized second-to-third trimester target scan (TS) codes and first-trimester TS codes, respectively. Identified episodes with GA outside clinically plausible ranges for each pregnancy outcome were either reclassified into different outcomes or excluded. Algorithm performance was evaluated based on the following three criteria: first, the agreement between the estimated GA and the specified GA range in delivery episodes with a preterm birth (PB) code; second, comparison of estimated preterm birth (ePB) rates with national statistics reported by the Korean Statistical Information Service (KOSIS); third, sensitivity analysis of ultrasound code prioritization on the ePB rate.
RESULTS: Among 581,740 pregnancy episodes, 456,157 were deliveries, 3,050 were SB, and 122,533 were AB. Deliveries with a GA of less than 37 weeks were classified as ePB, with rates of 39.7% in the original algorithm and 11.9% in the modified algorithm. In delivery episodes with PB codes that included specified GA ranges, the modified algorithm demonstrated higher agreement with the specified GA compared to the original algorithm (96.4% vs. 75.2%). The ePB rate estimated by the modified algorithm was also more consistent with the 9.4% reported by KOSIS, compared to the original algorithm (12.0% vs. 39.8%).
CONCLUSION: The modified algorithm, which prioritized first-trimester TS codes, improved the accuracy of GA estimation and reduced the underestimation observed in the original algorithm.
PMID:42153229 | DOI:10.3346/jkms.2026.41.e138
Cancer Med. 2026 May;15(5):e71956. doi: 10.1002/cam4.71956.
ABSTRACT
PURPOSE: Tobacco smoking adversely affects cancer outcomes; yet tobacco treatment for patients with non-tobacco-related cancers (non-TRCs) remains understudied. This study evaluated smoking behaviors, harm perceptions, and cessation support in this population.
METHODS: We conducted a cross-sectional survey of 124 adults who reported smoking within the past 30 days and were diagnosed with non-TRCs at two medical centers between 2018 and 2022. Data collected included demographics, smoking behaviors, harm perceptions, quit attempts, and receipt of cessation support from oncology providers.
RESULTS: Most participants (88%) recognized that continued smoking may shorten life expectancy; however, fewer recognized its impact on cancer recurrence (44%), treatment efficacy (46%), and treatment-related side effects (46%). Although 81% reported prior quit attempts, only 33% received prescription medication and 22% received counseling. Follow-up support from oncology teams was reported by 42% of participants.
CONCLUSION: Patients with non-TRCs demonstrate substantial gaps in awareness of the cancer-specific harms of continued smoking and report inconsistent receipt of evidence-based cessation support. Targeted education and systematic integration of tobacco treatment into oncology care are needed to improve outcomes in this population.
PMID:42153226 | DOI:10.1002/cam4.71956
Ther Clin Risk Manag. 2026 May 12;22:581371. doi: 10.2147/TCRM.S581371. eCollection 2026.
ABSTRACT
BACKGROUND: Caudal block in clinical practice relies on empirical drug administration without reliable prediction of anesthetic level, thereby limiting its application. This study aimed to develop a predictive model for sensory block level based on sacral canal anatomical factors and patient characteristics.
METHODS: A total of 132 patients undergoing elective anal surgery with caudal block were included. Ultrasound measured anatomical parameters (the width of the base of the sacrum (BSW), the anterior-posterior diameter of the sacral hiatus at its apex (SHAP), the anterior-posterior diameter of the sacral hiatus at the first segment inferior to the apex (SHFSIA-AP), the length of the sacral hiatus in the sagittal plane (SHLS) and demographic data (age, gender, height, weight) were collected. Sensory block level was categorized into five ordinal grades. Multivariable ordinal logistic regression identified independent predictors, with variance inflation factor (VIF) assessing multicollinearity and Brant test verifying proportional odds assumption. Model performance was evaluated via concordance index (C-index) and Lipsitz test, with internal validation performed using bootstrapping with 1000 resamples, and a nomogram was constructed.
RESULTS: Univariable analysis showed SHAP, SHLS, SHFSIA-AP, height, age, gender, and weight correlated with sensory block level (P<0.05). Final independent predictors were SHAP, SHLS, and height. No multicollinearity (VIF<5) and valid proportional odds assumption (Brant test P=0.36) were confirmed. The model had good predictive performance (C-index=0.881, 95% CI [0.809-0.953]) and fit (Lipsitz test P=0.49), with the nomogram visualizing probabilities of each block level category.
CONCLUSION: This study identified SHAP, SHLS, and height as predictors for caudal block sensory level. The nomogram enables individualized, precise drug administration, shifting the technique from experience-based to precision prediction.
PMID:42153217 | PMC:PMC13180391 | DOI:10.2147/TCRM.S581371