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Nevin Manimala Statistics

Working memory, updating and vocabulary development in Albanian-speaking children aged 8 and 10: the primacy of socioeconomic status

Child Neuropsychol. 2026 Aug 26:1-24. doi: 10.1080/09297049.2026.2720194. Online ahead of print.

ABSTRACT

This study examined the relationship between receptive vocabulary, working memory processes, non-verbal intelligence, and socioeconomic status (SES) in Albanian-speaking children during middle childhood. The research was motivated by the linguistic characteristics of Albanian, a morphologically rich and orthographically transparent language that provides an informative context for examining how cognitive resources and environmental factors contribute to vocabulary acquisition. A sample of 168 children aged 8-10 years completed measures of receptive vocabulary (British Picture Vocabulary Scale), verbal working memory (Listening Recall), updating ability (N-back task), and non-verbal intelligence (Raven’s Progressive Matrices). Descriptive statistics, correlational analyses, multiple regression, and moderation analyses were conducted to examine the associations among these variables. Results indicated that receptive vocabulary was positively correlated with age, SES, intelligence, and verbal working memory. Multiple regression analysis revealed that parental SES was the only significant predictor of receptive vocabulary performance, accounting for the largest unique proportion of variance. Working memory showed a modest association with receptive vocabulary, whereas updating ability was not a significant predictor. Moderation analyses further demonstrated that SES significantly moderated the relationship between working memory and receptive vocabulary, such that the association was stronger among children from higher SES backgrounds.

PMID:42655971 | DOI:10.1080/09297049.2026.2720194

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Effect of protective ventilation throughout the intubation period on perioperative oxygenation in patients undergoing MIDCABG: a randomised controlled trial

Ann Med. 2026 Dec;58(1):2720367. doi: 10.1080/07853890.2026.2720367. Epub 2026 Aug 26.

ABSTRACT

INTRODUCTION: Minimally invasive direct coronary artery bypass grafting (MIDCABG) requires prolonged one-lung ventilation (OLV), increasing postoperative pulmonary complications (PPCs) risk. We investigated whether protective lung ventilation (PLV) throughout intubation benefits MIDCABG patients.

METHODS: In this single-center randomized study, MIDCABG patients received PLV (low tidal volume of 6-8 mL·kg-1, PEEP of 6 cm H2O, alveolar recruitment maneuvers) or conventional mechanical ventilation (CMV, tidal volume of 8-10 mL·kg-1, without PEEP or maneuvers) from tracheal intubation to extubation. The primary outcome was perioperative oxygenation, assessed by the PaO2/FiO2 ratio.

RESULTS: Sixty patients (n = 30 per group) were enrolled. Compared with CMV, PLV improved PaO2/FiO2 ratios (mean difference at OLV60: 34.56 mmHg; 95% CI: 11.78-57.33; p < 0.01), shortened median durations of postoperative mechanical ventilation (median difference: -4.5 h, 95% CI: -8.5 to -0.5; p = 0.013) and hospital stay (median difference: -3.0 days, 95% CI: -5.0 to -1.0; p = 0.019). PLV also reduced driving pressure, airway pressure and intrapulmonary shunt during OLV (all p < 0.05). Desaturation occurred in 23.3% of CMV patients and 13.3% of PLV patients (p = 0.506). Hemodynamic parameters were generally comparable between groups, except for lower MPAP and PVRI in the PLV group during OLV and after ICU admission (p < 0.05). The incidence of PPCs did not differ between groups.

CONCLUSIONS: In patients undergoing MIDCABG, PLV applied throughout intubation improved perioperative oxygenation and shortened the duration of postoperative mechanical ventilation and hospital stay, but did not reduce PPCs.

CLINICAL TRIAL REGISTRATION: ChiCTR1900022005.

PMID:42655964 | DOI:10.1080/07853890.2026.2720367

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Applications of Artificial Intelligence Technologies in Nursing for Noncommunicable Chronic Diseases: A Scoping Review

J Nurs Manag. 2026;2026(1):e5288231. doi: 10.1155/jonm/5288231.

ABSTRACT

BACKGROUND: Noncommunicable chronic diseases (NCDs) account for approximately 41 million deaths each year and 74% of global deaths. Artificial intelligence (AI) is increasingly used for risk prediction, monitoring, and decision support in chronic disease care, but its nursing-specific applications, implementation maturity, and ethical reporting remain incompletely mapped.

AIM: To map evidence on AI applications in nursing care for NCDs, with attention to application contexts, nursing roles, technical characteristics, care phases, outcomes, and ethical governance.

METHODS: A scoping review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). MEDLINE, CINAHL, Web of Science, PsycINFO, IEEE Xplore, ACM Digital Library, and CNKI were searched from 1 January 1985 to 25 June 2025. Grey literature sources and reference lists were also searched. Data were charted using a structured extraction form and synthesised with descriptive statistics and content analysis.

RESULTS: Forty-three studies published between 2005 and 2025 were included. Research increased after 2020 (n = 34, 79.07%), and China and the United States each contributed 11 studies (25.58%). Oncology nursing was the most common disease area (n = 17, 39.53%). The most frequently reported AI technologies were natural language processing (n = 14, 32.56%) and risk prediction models (n = 12, 27.91%). AI was mainly used for clinical decision support (n = 17, 39.53%) and risk assessment (n = 14, 32.56%), whereas applications supporting nursing intervention design and outcome evaluation were limited. Ten studies (23.26%) did not report ethics approval.

CONCLUSIONS: AI applications in nursing care for NCDs are expanding, but current evidence remains concentrated in assessment-oriented and decision-support functions. Gaps persist in intervention implementation, outcome validation, data representativeness, and ethical oversight.

IMPLICATIONS FOR NURSING MANAGEMENT: With AI currently concentrated in hospital-based settings and assessment-oriented functions, and with 32.56% of included studies not reporting nursing or patient outcome validation, nursing leaders should prioritise extending AI implementation and governance to underserved care settings through targeted workforce training, ethical oversight, and systematic evaluation using nursing-sensitive outcomes.

PMID:42655959 | DOI:10.1155/jonm/5288231

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Noninvasive Profiling of the Glioma Vascular Microenvironment via 7T MRI: Decoding Angiogenic Signatures for Isocitrate Dehydrogenase and World Health Organization Grade Differentiation

J Magn Reson Imaging. 2026 Aug 26. doi: 10.1002/jmri.70523. Online ahead of print.

ABSTRACT

BACKGROUND: Accurate preoperative glioma grading and molecular subtyping are important for treatment. The vascular microenvironment promotes tumor progression. A noninvasive screening tool capable of mapping tumor vascularity may assist in preoperative grading and subtyping of gliomas.

PURPOSE: To evaluate 7T susceptibility-weighted imaging (SWI) for differentiating glioma isocitrate dehydrogenase (IDH) status and World Health Organization (WHO) grade based on vascular microenvironment features.

STUDY TYPE: Retrospective.

POPULATION: Among 218 patients with histologically confirmed gliomas, 152 (70%) were assigned to training and 66 (30%) to validation by stratified random sampling. The training/validation sets included 61/26 IDH-mutant, 91/40 IDH-wildtype, 57/25 Grade 1-2, and 95/41 Grade 3-4 gliomas.

FIELD STRENGTH/SEQUENCE: 7T; T1-weighted Magnetization prepared 2 rapid acquisition gradient echo (MP2RAGE) and SWI.

ASSESSMENT: Two independent neuroradiologists delineated tumors on 7T SWI. Vascular topology, density, and intensity were extracted following Frangi filtering and 3D skeletonization. Following feature selection, logistic regression (LR), support vector machine (SVM), naive Bayes (NB), and random forest (RF) were developed to differentiate IDH mutant from IDH wildtype, and WHO Grade 1-2 from WHO Grade 3-4.

STATISTICAL TESTS: Continuous and categorical variables were compared using Student’s t-test/Mann-Whitney U test and chi-square test, respectively. Cohen’s kappa statistic and intraclass correlation coefficient (ICC) were used to assess the interobserver agreement. Features were selected by t-test (or Mann-Whitney U test) and Spearman’s rank correlation. Sensitivity, specificity, accuracy, F1-score, and area under the curve (AUC) were used to evaluate model performance. A p value < 0.05 was considered significant.

RESULTS: Nine robust vascular features were retained. Imaging models achieved AUCs of 0.816-0.843 for IDH status and 0.834-0.874 for WHO grade in the internal validation set. Integrating clinical factors improved performance, with optimal AUCs of 0.888 and 0.889, respectively.

DATA CONCLUSION: Integrating 7T SWI vascular features with machine learning may aid noninvasive differentiation of glioma molecular status and grade.

EVIDENCE LEVEL: 4.

TECHNICAL EFFICACY: Stage 2.

PMID:42649122 | DOI:10.1002/jmri.70523

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Prevalence of Healthy Eating Initiatives in Australian Primary Schools: A Cross-Sectional Survey

Health Promot J Austr. 2026 Oct;37(4):e70232. doi: 10.1002/hpja.70232.

ABSTRACT

ISSUE ADDRESSED: Schools are recommended settings for promoting healthy eating, but to achieve population-level impact, initiatives must be widely implemented. Limited data are available to assess the implementation of Australian school-based healthy eating initiatives. This study examined the implementation of healthy eating initiatives in Australian primary schools and whether implementation is associated with school characteristics (school size, remoteness, socio-economic status).

METHODS: A cross-sectional study surveyed a nationally representative sample of Australian primary school principals (August 2022-October 2023) regarding 32 healthy eating initiatives across five opportunities for healthy eating: healthy food in the classroom, at school, brought to school, outside of school and other. Initiatives were identified from recent systematic reviews aligned with Australian and global guidelines. Prevalence estimates were weighted to the national school population, and logistic regression models examined associations with school characteristics.

RESULTS: Of the 669 participating schools, 569 completed the healthy eating survey, with implementation rates ranging from 7% to 97%. The most frequently implemented initiatives were: in the classroom, ‘Permission or breaks to drink water in class time in ≥ 80% of classes daily’ (97%); at school, ‘Install water stations for free access to cooled plain or optionally carbonated water’ (64%); brought to school, ‘Information on healthy eating sent home to parents’ (88%); and outside of school, ‘Healthy eating programs delivered in partnership with community organisations or services’ (31%). Ten initiatives were associated with school size (n = 5), remoteness (n = 7), or socio-economic status (n = 3).

CONCLUSIONS: Implementation rates of the 32 healthy eating initiatives varied substantially, and most initiatives had similar rates across school characteristics (school size, remoteness, socio-economic status). SO WHAT?: This first national study provides crucial information on the implementation of individual healthy eating initiatives in Australian primary schools, highlighting which initiatives and school subgroups require policy and practice investment to support implementation.

PMID:42649102 | DOI:10.1002/hpja.70232

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Impact of Adjusted Creatinine Clearance on Carboplatin Dosing in Endometrial Cancer: A Retrospective Study

Biol Pharm Bull. 2026;49(8):1285-1290. doi: 10.1248/bpb.b26-00201.

ABSTRACT

Carboplatin (CBDCA) dosing is commonly determined using the Calvert formula, with creatinine clearance (Ccr) estimated by the Cockcroft-Gault formula. In Japan, where serum creatinine (sCr) is usually measured enzymatically, unadjusted Ccr may overestimate glomerular filtration rate and lead to CBDCA overdosing. We retrospectively compared treatment exposure, hematologic toxicity, and exploratory oncologic outcomes in patients with endometrial cancer who received postoperative paclitaxel plus CBDCA therapy. Patients were grouped according to whether CBDCA dosing was based on the conventional Cockcroft-Gault formula (CG group) or on adjusted Ccr calculated by adding 0.2 mg/dL to sCr (adjusted group). The incidence of Grade ≥3 neutropenia was significantly lower in the adjusted group than in the CG group. The 5-year progression-free survival (PFS) rate was numerically lower in the adjusted group than in the CG group, although no statistically significant difference was observed between the groups. Because the number of PFS events was limited, the effect of adjusted Ccr-based dosing on oncologic outcomes remains uncertain. These findings suggest that adjusted Ccr-based dosing may reduce hematologic toxicity in routine clinical practice. However, given the limited number of PFS events and the wide uncertainty in survival estimates, further studies are needed to clarify its impact on oncologic outcomes.

PMID:42649080 | DOI:10.1248/bpb.b26-00201

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Construction and Validation of Plasma Protein-Based Musculoskeletal Biological Age and Genetic and Environmental Risk Profiles

Aging Cell. 2026 Aug;25(8):e70636. doi: 10.1111/acel.70636.

ABSTRACT

The musculoskeletal system is key to aging. Nonetheless, existing protein-based musculoskeletal aging clocks have limited predictive performance and fail to characterize genetic or environmental determinants. We first constructed a musculoskeletal protein pool by integrating transcriptomic enrichment, protein functional annotation, and literature expertise. Two musculoskeletal aging clocks-MSKAge and MSKAgeMort-were then developed using proteomic data of 21,070 UK Biobank participants. Acceleration metric (MSKAgeAccel/MSKAgeMortAccel) quantified deviations of biological age from chronological age, with positive values indicating accelerated musculoskeletal aging. Associations of MSKAgeAccel/MSKAgeMortAccel with mortality, musculoskeletal disorders, and age-related diseases were assessed using Cox proportional hazards models. Environmental and genetic determinants were evaluated by linear regression and genome-wide association analyses, respectively. Drug repurposing was used to identify potential targets of musculoskeletal diseases. A total of 39 musculoskeletal-related proteins constituted the pool. Leveraging these proteins, MSKAge (rfemale = 0.62; rmale = 0.56) and MSKAgeMort (rfemale = 0.93; rmale = 0.88) were constructed. Both MSKAgeAccel and (in particular) MSKAgeMortAccel predicted mortality, musculoskeletal diseases, and age-related diseases effectively. MSKAgeMortAccel showed significant associations with musculoskeletal disorders, including osteoarthritis, rheumatoid arthritis, gout, and low back pain. MSKAgeMortAccel was influenced by environmental pollutants, psychological factors, and unhealthy lifestyles. Genetic analyses revealed 13 variants and 71 genes enriched in epigenetic regulation and extracellular environment-receptor interaction. Zinc was identified as a candidate musculoskeletal drug. We established a reliable musculoskeletal aging clock and elucidated genetic and environmental determinants. This framework enables stratification of individuals at risk of accelerated musculoskeletal aging, paving the way for anti-aging interventions.

PMID:42649044 | DOI:10.1111/acel.70636

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Cognitive function predicts all-cause mortality independent of social engagement among community-dwelling elderly Japanese men: a 15-year prospective cohort study

Environ Health Prev Med. 2026;31:56. doi: 10.1265/ehpm.26-00105.

ABSTRACT

BACKGROUND: As the global population ages, cognitive impairment has become a growing public health concern. Although epidemiological studies have examined its association with mortality, sex-stratified analyses and community-based investigations in elderly Asian men remain scarce. Furthermore, social engagement may confound the association between cognitive impairment and mortality; yet few studies among community-dwelling elderly Asian men have simultaneously examined cognitive impairment and social engagement in relation to all-cause mortality in a prospective cohort design. This study therefore aimed to examine whether cognitive impairment is associated with an increased risk of all-cause mortality independent of social engagement among community-dwelling elderly Japanese men over a 15-year follow-up period.

METHODS: This prospective cohort study enrolled 2,174 men aged ≥65 years. Follow-up assessments were conducted at five, ten, and fifteen years, with all-cause mortality as the primary outcome. Cognitive function was assessed using the Mini-Mental State Examination. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazards models to examine the association between cognitive function and all-cause mortality. Confounder-adjusted Kaplan-Meier survival curves were generated using inverse probability of treatment weighting.

RESULTS: The final analytic sample comprised 1,741 men. High social engagement was associated with a lower risk of all-cause mortality. Compared with participants with normal cognitive function, the hazard ratios (HRs) for all-cause mortality were 1.29 (95% CI: 1.06-1.56) for mild cognitive impairment and 1.59 (95% CI: 1.10-2.29) for severe cognitive impairment, after adjusting for potential confounding factors including social engagement.

CONCLUSIONS: Cognitive impairment independently predicts an increased risk of all-cause mortality in community-dwelling elderly Japanese men.

PMID:42649026 | DOI:10.1265/ehpm.26-00105

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Intraoperative Thromboelastography-activated Clotting Time After Weaning From Cardiopulmonary Bypass Correlates With Fibrinogen Concentration, and Its Prolongation May Predict Hypofibrinogenemia

J Cardiothorac Vasc Anesth. 2026 Aug 9:S1053-0770(26)00790-1. doi: 10.1053/j.jvca.2026.08.124. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate the clinical significance of thromboelastography-activated clotting time (T-ACT) measured after weaning from cardiopulmonary bypass (CPB), particularly its potential to predict the need for blood transfusion and guide transfusion strategies in pediatric cardiac surgery.

DESIGN: Retrospective observational study.

SETTING: A single tertiary university hospital operating room.

PARTICIPANTS: 218 pediatric patients aged <7 years scheduled for elective cardiac surgery using CPB.

MEASUREMENTS AND MAIN RESULTS: After weaning from CPB and protamine administration, thromboelastography analysis and laboratory tests (including coagulation and blood count tests) were performed. Univariate analysis using the Spearman rank correlation coefficient was employed to evaluate associations between T-ACT and intraoperative patient and surgical variables measured after weaning from CPB. T-ACT showed negative correlations with platelet count, fibrinogen levels, prothrombin time, citrated rapid thromboelastography maximum amplitude, and citrated functional fibrinogen maximum amplitude. Multivariate regression using the forced-entry method included variables with p < 0.10 in the univariate analyses. The fibrinogen level, prothrombin time, and citrated functional fibrinogen maximum amplitude were statistically significant (p < 0.05). Hypofibrinogenemia detection was identified as particularly important for predicting coagulation disorders after weaning from CPB. Receiver operating characteristic analysis of T-ACT for discriminating intraoperative fibrinogen ≤150 mg/dL yielded a cutoff value of 158.1 seconds (area under the curve: 0.84; p < 0.0001).

CONCLUSIONS: In pediatric patients undergoing cardiac surgery with CPB, intraoperative T-ACT measured after weaning from CPB correlated with fibrinogen concentration, and T-ACT prolongation may discriminate hypofibrinogenemia.

PMID:42649009 | DOI:10.1053/j.jvca.2026.08.124

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The 24-mo Outcomes from the Noninferiority Randomised Controlled Trial of Surgery for Men with Urodynamic Stress Incontinence After Prostate Surgery (MASTER)

Eur Urol Focus. 2026 Aug 26:S2405-4569(26)00163-X. doi: 10.1016/j.euf.2026.07.012. Online ahead of print.

ABSTRACT

BACKGROUND: The artificial urinary sphincter (AUS) is the most common surgical procedure for persistent stress urinary incontinence (SUI) after prostate surgery, whereas the male sling is a newer alternative.

OBJECTIVE: To compare the 24-mo outcomes of the sling versus the AUS.

DESIGN, SETTINGS, AND PARTICIPANTS: This was an unblinded, noninferiority randomised controlled trial including men from 27 UK urological centres with bothersome urodynamic SUI after prostate surgery.

INTERVENTION: Men were randomised to receive a transobturator sling (n = 190) or an AUS (n = 190). Randomisation was minimised by type of surgery (radical prostatectomy/transurethral resection of the prostate), previous radiotherapy for prostate cancer (yes/no), and centre.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary outcome was self-reported continence (a composite outcome derived from two items in the validated International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form [ICIQ-UI SF]) at 12 mo after randomisation, with a noninferiority margin of 15%, via postal questionnaire. The secondary outcomes were self-reported continence, further treatments, patient-reported measures and serious adverse events up to 24 mo.

RESULTS AND LIMITATIONS: A total of 380 participants were included. In terms of continence, the sling was noninferior to the AUS at 24 mo (estimated absolute risk difference in the intention-to-treat analysis, -0.006; 95% confidence interval [CI], -0.092 to 0.080; noninferiority p = 0.001), indicating lower success in the sling group, but with a CI excluding the noninferiority margin. Incontinence symptom scores (ICIQ-UI SF) decreased from 16.1 and 16.4 at baseline to 7.9 and 7.1 in the sling and AUS groups, respectively. The mean difference was 1.4 (95% CI, 0.2-2.6; p = 0.024). Secondary outcomes favoured the AUS over the sling. By 24 mo, more men underwent further surgery after receiving a sling (n = 20, 11%) than after receiving an AUS (n = 4, 2%).

CONCLUSIONS: The 24-mo results confirm that the sling is noninferior to the AUS. Symptoms and quality of life significantly improved in both groups. Overall, secondary and post hoc analyses favour the AUS.

PATIENT SUMMARY: Continence levels and symptoms improve with both surgeries. Most men are satisfied with their surgery, despite not being completely dry. Almost all other results show that men who have an artificial urinary sphincter have better outcomes than those who have a sling. Trial registration International Randomised Controlled Trial Registry, ISRCTN49212975. This trial was registered on July 22, 2013, and participants were randomised between January 29, 2014, and December 28, 2017.

PMID:42648940 | DOI:10.1016/j.euf.2026.07.012