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Nevin Manimala Statistics

What Nourishes Us: Psychometric Validation of Culturally Grounded Measures of Indigenous Nourishment in a Cross-Sectional Study of 2 Urban Native Communities

Public Health Nutr. 2026 Mar 25:1-28. doi: 10.1017/S1368980026102262. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine the Indigenous Nourishment Scales (INS), a set of community-developed strengths-based measures of nourishment, for psychometric validity and reliability through community-based research with two urban American Indian/Alaska Native (AI/AN) communities.

DESIGN: Cross-sectional survey of health measures and INS. Descriptive statistics, exploratory factor analysis (EFA), correlation analysis, and regression were used to determine the psychometric properties of the INS and their relationship with Physical (Fruit and Vegetable Intake), Spiritual (Spiritual Wellbeing), Emotional (Emotional Wellbeing), and Relational (Social Wellbeing) health outcomes.

SETTING: Two urban cities in the U.S.

PARTICIPANTS: 249 urban AI/AN adults.

RESULTS: EFA revealed two unidimensional scales (Connectedness to Food; Indigenous Food Identity), and one two-factor scale (Access to and Participation in Indigenous Foodways). The INS demonstrated strong internal consistency reliability and convergent construct validity as evidenced by their association with fruit and vegetable intake and other related concepts. Regression models showed that Access to Indigenous Foodways and Participation in Indigenous Foodways were significantly and positively associated with all four domains of wellbeing. Food Connectedness was positively and significantly associated with spiritual, emotional, and relational wellbeing, while Indigenous Food Identity was positively and significantly associated with spiritual and emotional wellbeing.

CONCLUSIONS: Positive associations between scale scores and multiple domains of wellbeing indicate the potential relevance of Indigenous nourishment as a meaningful determinant of health. By establishing the psychometric validity of community-developed measures, this study offers a pathway for Indigenizing assessments of nutrition and wellbeing among AI/AN peoples.

PMID:41878784 | DOI:10.1017/S1368980026102262

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Nevin Manimala Statistics

Integrated analysis of MALDI-TOF MS and whole-genome sequencing for subtyping Salmonella

Front Microbiol. 2026 Mar 9;17:1782552. doi: 10.3389/fmicb.2026.1782552. eCollection 2026.

ABSTRACT

Current subtyping methods are often restricted by labor intensity and high costs. To address this, this study integrated matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) with whole-genome sequencing (WGS) to characterize Salmonella isolates and investigate the correlation between spectral features and genomic data. Between 2023 and 2024, 96 Salmonella isolates from Yixing, Jiangsu Province, China, underwent serotyping, WGS, and MALDI-TOF MS profiling. Serotyping and Multilocus Sequence Typing (MLST) analysis resolved 25 serovars and 21 sequence types. Machine learning models based on spectral features achieved area under the curve (AUC) values exceeding 0.90 for Salmonella typhimurium, ST11, ST155, ST19, and ST34. Specific discriminatory mass peaks were identified, and their correlations with genomic annotations were investigated through peak-gene co-occurrence analysis. The findings indicate that discriminatory MALDI-TOF MS peaks can serve as statistical indicators for specific genomic features, reflecting underlying genomic differences. This study proposes a machine learning-based classification strategy that enables rapid analysis of MALDI-TOF MS spectra in routine diagnostics, thereby extending the application of mass spectrometry in Salmonella subtyping. This strategy functions as a high-throughput pre-filter to concentrate WGS efforts on high-risk clones for accelerated outbreak investigation.

PMID:41878745 | PMC:PMC13006217 | DOI:10.3389/fmicb.2026.1782552

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Nevin Manimala Statistics

Dual-graph knowledge distillation for few-shot class-incremental microorganism recognition

Front Microbiol. 2026 Mar 9;17:1791871. doi: 10.3389/fmicb.2026.1791871. eCollection 2026.

ABSTRACT

Environmental microorganism recognition from microscopic images is crucial for environmental monitoring and ecological analysis. In practical scenarios, microorganism categories often evolve over time, and newly emerging classes usually have only a few labeled samples due to high annotation costs. This combination naturally gives rise to the few-shot class-incremental learning (FSCIL) problem. FSCIL requires models to incrementally learn new classes under severe data scarcity while effectively retaining knowledge of previously learned ones. In this work, we propose a unified FSCIL framework for environmental microorganism recognition. The proposed method is composed of three complementary components. First, a contrastive-inspired fine-grained representation learning strategy is introduced in the base session. This strategy enhances intra-class compactness by mining prediction-consistent augmented samples, without introducing explicit contrastive losses. Second, a prototype rectification mechanism is designed to stabilize the representations of incremental classes by leveraging semantic structures learned from base classes. Third, a dual-graph knowledge distillation framework is proposed to preserve both instance-level and class-level relational knowledge during incremental learning. This process is guided by a teacher model updated via exponential moving average. Experiments conducted on the EMDS-7 dataset demonstrate the effectiveness of the proposed approach. Compared with state-of-the-art FSCIL methods, our method achieves the highest average accuracy of 78.19% and maintains the best final-session accuracy of 65.36%. Meanwhile, strong base-session performance is consistently preserved. These results indicate that the proposed framework effectively mitigates catastrophic forgetting and enables robust adaptation to new microorganism categories in real-world incremental recognition scenarios.

PMID:41878735 | PMC:PMC13006286 | DOI:10.3389/fmicb.2026.1791871

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Nevin Manimala Statistics

Systematic review and meta-analysis of antioxidant treatment in patients with acute mountain sickness induced by high altitude exposure

Front Physiol. 2026 Mar 9;17:1779008. doi: 10.3389/fphys.2026.1779008. eCollection 2026.

ABSTRACT

Acute Mountain Sickness (AMS) is a frequent condition triggered by exposure to hypobaric hypoxia at high altitude. Its pathophysiology involves endothelial dysfunction and oxidative stress, with elevated oxidative molecules identified as key contributors to its development. Antioxidant therapies such as vitamins C/E, α-lipoic acid, and Ginkgo biloba have been proposed, though results across studies remain inconsistent.

OBJECTIVE: This study aims to evaluate the effects of antioxidant treatments in subjects with AMS induced by high-altitude exposure, examining their impact on clinical outcomes and oxidative stress markers.

METHODS: A systematic review and meta-analysis were performed according to PRISMA2020 guidelines. Searches were conducted in PubMed, Scopus, and Web of Science through November 2025, supplemented by snowball methods, focusing on studies investigating antioxidant treatments in humans exposed to hypobaric or high-altitude hypoxia. Inclusion criteria were original research in English with full-text availability, human exposure to hypobaric hypoxia, AMS assessment using the Lake Louise Score (LLS), and explicit antioxidant interventions compared with placebo or control. A random-effects meta-analysis using the REML estimator was applied to calculate relative risk (RR), including continuity corrections for zero-event studies. Data extraction was performed in duplicate, and risk of bias was evaluated using the Cochrane tool.

RESULTS: The search yielded 727 records; nineteen studies were included in the qualitative synthesis, and four trials provided comparable dichotomous data for quantitative analysis. Pooled estimates showed a non-significant trend toward reduced AMS incidence with antioxidant treatment (RR ≈ 0.73; 95% CI: 0.47-1.11; p = 0.14). Moderate heterogeneity was detected (I2 = 52%, Q p = 0.048). Although not statistically significant, all studies showed a direction of effect favoring antioxidants. Nevertheless, interpretation is limited using pre-2018 LLS diagnostic criteria, absence of studies under chronic intermittent hypobaric hypoxia, and methodological variability.

CONCLUSION: Current evidence does not demonstrate a statistically significant protective effect of antioxidant therapy against AMS; however, findings remain inconclusive due to few available trials, small sample sizes, pharmacokinetics and pharmacodynamics analysis, and methodological heterogeneity. Larger, well-designed trials with standardized ascent profiles and redox biomarkers are required to determine clinical efficacy.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261331390, identifier CRD420261331390.

PMID:41878732 | PMC:PMC13006292 | DOI:10.3389/fphys.2026.1779008

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Nevin Manimala Statistics

A general framework for investigating neurodevelopment of brain functional networks using multisite and longitudinal neuroimaging

Ann Appl Stat. 2026 Mar;20(1):604-622. doi: 10.1214/25-aoas2133. Epub 2026 Mar 20.

ABSTRACT

In recent years longitudinal, multi-site imaging studies have emerged as key tools for investigating brain function. These studies follow a large number of participants for an extended period, offering exciting opportunities to uncover brain functional network changes over time as a function of clinical and demographic covariates. However, these studies also introduce many statistical challenges such as site-effects and accounting for the heterogeneous nature of network differences between subjects. Robust statistical methods are highly needed to address these issues, but to date there has been little methods development addressing these problems in the context of data-driven brain network estimation. This work addresses this gap in the literature, introducing a general Bayesian framework, REMBRAiNDT, incorporating site- and subject-effects into the network decomposition, while also enabling covariate effect estimation and efficient information pooling across brain locations. We use our procedure to conduct a novel analysis of neurodevelopment among adolescents in the longitudinal, multi-site ABCD study. We find extensive evidence of increasing functional integration with age in networks associated with higher order cognitive processes. Our study is one of the first to examine neurodevelopment using blind source separation in the longitudinal ABCD study data, and the findings enrich earlier cross-sectional results on neurodevelopment.

PMID:41878728 | PMC:PMC13008291 | DOI:10.1214/25-aoas2133

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Nevin Manimala Statistics

Thread-Embedding versus Manual Acupuncture for Overactive Bladder in Postmenopausal Women: Randomized Controlled Trial

Int J Womens Health. 2026 Mar 19;18:582171. doi: 10.2147/IJWH.S582171. eCollection 2026.

ABSTRACT

OBJECTIVE: Overactive bladder (OAB) is a common condition in older women, characterized by urinary urgency, frequency, and nocturia. This study compared the efficacy and safety of thread-embedding acupuncture (TEA) and sham TEA in postmenopausal women with OAB.

METHODS: In this multicenter, randomized, controlled trial, 68 postmenopausal women with OAB were allocated in a 1:1 ratio to receive TEA or sham TEA (manual acupuncture without thread embedding) once weekly for 8 weeks, followed by an 8-week follow up. The primary outcome was the mean daily voiding frequency over 3 days. Secondary outcomes included other bladder diary parameters, the Overactive Bladder Symptom Score (OABSS), and the King’s Health Questionnaire score.

RESULTS: At week 8, both groups showed reductions in 24-hour micturition frequency; however, after adjustment for baseline values using ANCOVA, no significant between-group difference was observed in the primary outcome. Repeated measures analysis demonstrated no significant group-by-time interactions for secondary outcomes, although significant improvements over time were observed in both groups. At follow-up, nighttime voiding remained significantly reduced from baseline in the TEA group, whereas this reduction was not statistically significant in the sham group; however, the between-group difference did not reach statistical significance. No serious adverse events were reported.

CONCLUSION: TEA and manual acupuncture were effective and safe in reducing OAB symptoms in postmenopausal women, with no significant differences between interventions. Larger, long-term studies are needed to clarify specific benefits of TEA.

PMID:41878717 | PMC:PMC13007670 | DOI:10.2147/IJWH.S582171

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Nevin Manimala Statistics

Prevalence and Determinants of Facility Delivery Among Women in Somalia: Insights from the 2020 Somali Demographic and Health Survey (SDHS)

Int J Womens Health. 2026 Jan 27;18:560668. doi: 10.2147/IJWH.S560668. eCollection 2026.

ABSTRACT

BACKGROUND: High maternal mortality in sub-Saharan Africa has been linked to inadequate medical care for pregnant women due to limited health facility delivery utilization. In Somalia, many births still take place at home, most often without a skilled birth attendant. This study aimed to identify the prevalence and determinants of facility delivery among pregnant women in Somalia using data from the 2020 Somalia Demographic and Health Survey (SDHS).

METHODS: This cross-sectional study analyzed SDHS 2020 data for 18,561 women aged 15-49 years. Descriptive statistics summarized participant characteristics and delivery location. Binary logistic regression was used to identify determinants of facility delivery. Variables with p < 0.05 were considered statistically significant, and adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported.

RESULTS: The prevalence of facility delivery was 20.8%, indicating high utilization of home delivery. Several factors were significantly associated with increased odds of facility delivery. Women in the highest wealth had over five times higher odds of delivering at a health facility (AOR = 5.63; 95% CI: 4.56-6.97). Women who attended ANC had four times higher odds of facility delivery (AOR = 4.42; 95% CI: 3.99-4.89). Women who perceived the distance between their home and the nearest health facility as a barrier had 75% lower odds of facility delivery (AOR = 0.25; 95% CI: 0.23-0.27). Additionally, nomadic residence, high parity (≥5 children), and early marriage were significantly associated with lower likelihood of facility-based delivery.

CONCLUSION: Facility delivery remains low in Somalia. Wealth status, ANC attendance, and perceived distance to health facilities were key determinants of facility delivery, alongside residence type, parity, and early marriage. Improving ANC coverage, enhancing birth preparedness education, and increasing access to skilled birth attendants are vital steps to reduce home delivery.

PMID:41878707 | PMC:PMC13006375 | DOI:10.2147/IJWH.S560668

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Nevin Manimala Statistics

Training with ultrasound-guided puncture simulator of arteriovenous fistula for hemodialysis: experience from a center of excellence in Pará, Brazil

J Vasc Bras. 2026 Mar 16;24:e20240184. doi: 10.1590/1677-5449.202401842. eCollection 2025.

ABSTRACT

BACKGROUND: Arteriovenous fistulas (AVF) and arteriovenous grafts are important arteriovenous accesses (AVA) for patients who need hemodialysis. However, in approximately 20 to 40% of AVFs, professionals fail to successfully cannulate a new AVA for consistent use. Therefore, the ability to perform ultrasound-guided puncture is a necessary skill, particularly for accesses classified as ‘difficult’. However, only a minority of nursing professionals consider themselves capable of handling ultrasound. Therefore, simulated practice environments can enable trainees to develop the skills and dexterity needed to simultaneously handle the ultrasound probe and insert the needle.

OBJECTIVES: The object of this study was to analyze the effects of training with an ultrasound-guided arteriovenous fistula access simulator at a center of excellence in Belém, PA, Brazil.

METHODS: This analytical intervention study assessed a nursing team (17 nurses) before and after training in ultrasound-guided puncture using a simulator model comprising a chicken breast and a latex balloon, chosen because of its low cost and high fidelity. Training was carried out on January 26th and 27th, 2024, at the Fundação Hospital de Clínicas Gaspar Vianna.

RESULTS: After training with a simulator, participants’ performance improved in all analyzed variables, with statistical significance differences. Furthermore, they rated the model as a good simulation of reality and as important for professional training and reported feeling more confident after training.

CONCLUSIONS: Training with the ultrasound-guided puncture simulator positively influenced the performance of hemodialysis professionals.

PMID:41878694 | PMC:PMC13007339 | DOI:10.1590/1677-5449.202401842

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Nevin Manimala Statistics

Exploring the role of trained surgical care nurses in cricothyrotomy and other emergency procedures: a systematic review and meta-analysis

Front Surg. 2026 Mar 9;12:1562039. doi: 10.3389/fsurg.2025.1562039. eCollection 2025.

ABSTRACT

BACKGROUND: There is a severe shortage of healthcare professionals, emphasized in a stark manner by the recent COVID-19 pandemic, where the mortality rate was primarily a consequence of medical professionals lacking the technical know-how for conducting specialized procedures. Therefore, this systematic review and meta-analysis aimed to evaluate the success rates of nurse-performed emergency surgeries, focusing on trauma care (e.g., cricothyrotomy), rural obstetric emergencies (e.g., caesarean section, hysterectomy), and general procedures (e.g., laparotomy, appendectomy).

METHODS: A systematic search was conducted across eight major databases (PubMed, Embase, CINAHL, Scopus, Web of Science, PsycINFO, Cochrane Library, ProQuest) following PRISMA guidelines. Four eligible studies were identified, and data were pooled using a fixed-effects model.

RESULTS: The synthesis of data across the four selected studies revealed a pooled relative risk (RR) of 0.88 (95% CI: 0.78, 1.00) and odds ratio (OR) of 0.80 (95% CI: 0.65, 0.99) about the efficacy in emergency surgeries conducted by nurses. These four studies were the only ones meeting our strict inclusion criteria of reporting outcome data on nurse-performed emergency procedures. An analysis of heterogeneity demonstrated minimal variability among the studies, with a Chi2 value of 1.54, df = 3, P = 0.67, and I2 = 0%. The test for overall effect yielded a statistically significant Z statistic of 2.03 (P = 0.04), indicating a meaningful finding. The observed inferences also showed that the surgical procedures exhibited minimal complications.

CONCLUSION: This study suggests that trained nurses can safely and effectively perform selected emergency surgical procedures. While encouraging, the limited number of studies highlights the need for further research to confirm these findings and guide clinical practice.

PMID:41878671 | PMC:PMC13006495 | DOI:10.3389/fsurg.2025.1562039

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Nevin Manimala Statistics

Enrolment, attendance, and education resourcing and support among 5-12 year old autistic students in Aotearoa New Zealand: a nationwide cross-sectional study

Int J Popul Data Sci. 2026 Mar 19;10(2):3362. doi: 10.23889/ijpds.v10i2.3362. eCollection 2026.

ABSTRACT

INTRODUCTION: Participation in education underpins positive lifelong outcomes, yet Autistic children often encounter barriers to enrolment, attendance, and access to support. Evidence indicates that systemic challenges such as inadequate support, limited autism-specific teacher training, and restricted access to resources contribute to disparities in educational outcomes. While small sample studies highlight these inequities, population-level evidence is limited.

OBJECTIVES: To quantify nationwide differences in school enrolment, attendance, and access to educational resourcing and support services between Autistic and non-Autistic children aged 5-12 years in Aotearoa New Zealand (NZ), and to examine variation by co-occurring intellectual disability (ID).

METHODS: Cross-sectional analysis using NZ’s Integrated Data Infrastructure, including all children aged 5-12 in 2019. Autism and ID were identified from hospital, mental health, and disability service use datasets. Outcomes included enrolment, attendance, and access to supports. Propensity score matching (1:10) compared Autistic and non-Autistic students across outcomes, including stratification by ID status.

RESULTS: Among 517,872 students aged 5-12 years, 8,169 (1.6%) were Autistic and of those 28.8% had co-occurring ID. Compared to matched peers, Autistic children were less likely to be enrolled in school (94.9% vs. 97.4%; Prevalence ratio [PR]=0.97, 95% confidence interval [CI]=0.97-0.98) but more likely to be enrolled in specialist schools (14.4% vs. 0.2%; PR=70.15, 95% CI=65.73-74.88), Te Kura (2.1% vs. 0.2%; PR=9.65, 95% CI=8.22-11.34), or home-schooling (2.2% vs. 0.9%; PR=2.45, 95% CI=2.11-2.84). Regular attendance was lower (49.3% vs. 61.2; PR=0.80, 95% CI=0.79-0.82), with higher rates of chronic absence (7.7% vs. 3.2%; PR=2.45, 95% CI=2.27-2.64). Access to supports was significantly higher for Autistic students across a range of services. Disparities were often more pronounced among Autistic children with ID.

CONCLUSION: This study demonstrates significant differences in enrolment, attendance, and access to educational supports between Autistic and non-Autistic students in NZ, underscoring the urgent need for targeted and sufficiently resourced supports to ensure equitable participation.

PMID:41878670 | PMC:PMC13007848 | DOI:10.23889/ijpds.v10i2.3362