Tag: pubmed

Ann Clin Transl Neurol. 2026 Feb 19. doi: 10.1002/acn3.70342. Online ahead of print.

ABSTRACT

BACKGROUND: Emerging evidence suggests that low-frequency neural oscillations are dynamically regulated by consciousness levels, with the recovery of low cortical activity potentially serving as a neurophysiological substrate for conscious emergence. Targeted enhancement of these low-frequency rhythms in patients with disorders of consciousness (DoC) may constitute a promising neuromodulation strategy to facilitate consciousness recovery in severe brain injury.

OBJECTIVE: This study systematically examined the neurophysiological effects of intermittent theta-burst stimulation (iTBS), specifically its potential to enhance low-frequency cortical activity and promote consciousness recovery in patients with DoC. Through multimodal neural assessments, we aimed to elucidate the mechanistic relationship between iTBS-induced neural oscillation modulation and behavioral manifestations of consciousness improvement.

RESULTS: This prospective cohort study enrolled 30 patients with DoC, of whom 18 completed the full intervention protocol. Two-way repeated-measures analysis of variance revealed significant group × time interaction effects on the Coma Recovery Scale-Revised (CRS-R) scores, F(1, 16) = 6.543, p = 0.021. Post hoc simple effects analysis demonstrated significant temporal improvement in the active transcranial magnetic stimulation (TMS) group, F(1, 16) = 36.463, p < 0.001, with mean CRS-R scores increased from 9.300 ± 1.320 at baseline to 11.700 ± 1.409 post-intervention (p < 0.001). Conversely, sham stimulation revealed statistically nonsignificant changes (9.845 ± 1.476 versus 10.750 ± 1.575, p = 0.067). Neurophysiological assessments revealed emerging neurophysiological changes in the iTBS group, including enhanced resting-state low-frequency oscillations (delta: 21.642% increase, p = 0.449; theta: 6.800% increase, p = 0.789) and augmented auditory-evoked responses (phrase-level 22.917% increase, p = 0.280; syllable-level: 22.963% increase, p = 0.504), suggesting potential neural plasticity mechanisms that require further validation.

CONCLUSION: Collectively, this study established iTBS targeting the left dorsolateral prefrontal cortex as a clinically effective and well-tolerated neuromodulation approach for consciousness rehabilitation in patients with DoC, with therapeutic effects mediated by iTBS-induced enhancement of thalamocortical low-frequency oscillations.

TRIAL REGISTRATION: https://www.

CLINICALTRIALS: gov. Unique identifier: NCT03385278. Registered on October 24, 2017.

PMID:41714857 | DOI:10.1002/acn3.70342

Clin Exp Med. 2026 Feb 20. doi: 10.1007/s10238-026-02058-x. Online ahead of print.

NO ABSTRACT

PMID:41714836 | DOI:10.1007/s10238-026-02058-x

Int J Gynaecol Obstet. 2026 Feb 19. doi: 10.1002/ijgo.70903. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the effects of the levonorgestrel-releasing intrauterine system (LNG-IUS) and dienogest (DNG) on systemic inflammatory markers and anemia parameters in patients with adenomyosis after 6 months of treatment.

METHODS: This retrospective longitudinal observational cohort study included 162 women diagnosed with adenomyosis at İzmir Buca Seyfi Demirsoy Training and Research Hospital between 2020 and 2025. A total of 89 patients received LNG-IUS (Mirena), and 73 were treated with DNG 2 mg/day. Hemoglobin (Hb), neutrophil, lymphocyte, and platelet counts were obtained before treatment (baseline) and at 6 months to calculate the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII). Statistical analyses were performed using SPSS 27.0, with P < 0.05 considered significant.

RESULTS: Baseline demographic and obstetric characteristics were similar between the groups (P > 0.05). At 6 months, hemoglobin levels increased significantly more in the LNG-IUS group compared with the DNG group (2.29 ± 3.61 vs. 0.84 ± 4.82; P = 0.035). No significant differences were observed between groups in neutrophil, lymphocyte, platelet counts, or inflammatory indices (NLR, PLR, SII) before and after treatment (P > 0.05).

CONCLUSION: Both LNG-IUS and DNG are safe and effective medical options for adenomyosis management. LNG-IUS provided superior improvement in hemoglobin levels and bleeding control, while neither treatment significantly altered systemic inflammatory indices. These findings suggest that inflammation in adenomyosis is largely confined to the local uterine environment and that hematologic markers such as NLR, PLR, and SII may have limited sensitivity in reflecting short-term therapeutic response.

PMID:41714827 | DOI:10.1002/ijgo.70903

NPJ Digit Med. 2026 Feb 19. doi: 10.1038/s41746-026-02431-w. Online ahead of print.

ABSTRACT

Systematic reviews provide the highest level of evidence but remain resource-intensive. We evaluated the performance of a large language model (LLM; ChatGPT, OpenAI) in a PRISMA-guided review of randomized controlled trials on vaginal vault prolapse surgery. Prompts were carefully designed to minimize errors, and outputs were verified. Each task was completed within minutes. For title/abstract screening, recall was 69.8% and precision 85.7% (κ = 0.77); full-text agreement 94.1-100% (κ = 0.82-1); data extraction accuracy 87.5-99.7%. From 18 RCTs (1668 women), sacrocolpopexy (SC) showed higher anatomic success than sacrospinous fixation (SSF) (OR 1.42, 95% CI 0.71-2.84). Transvaginal mesh improved 3-year objective success compared with SSF (OR 1.84, 95% CI 1.13-2.99) but had higher reoperation rates (5-16% vs 2-4%) than SC. We did not find conclusive evidence that any single technique is superior; most comparisons were underpowered, with wide confidence intervals and substantial heterogeneity. All LLM-derived statistical results were identical to those from conventional R analyses, confirming robustness. Validated LLM workflows can enable more efficient and scalable evidence synthesis.

PMID:41714807 | DOI:10.1038/s41746-026-02431-w

Br J Math Stat Psychol. 2026 Feb 19. doi: 10.1111/bmsp.70037. Online ahead of print.

ABSTRACT

The detection of the number of modes in distributions of ordinal data is relevant for applied researchers across disciplines, from uncovering polarization to detecting incidence groups in clinical symptom scales. Yet, established modality detection methods are either purely descriptive or not developed for ordinal data. In the present paper, we attempt to fill this gap by proposing a recursive modality detection method (ReMoDe) which detects modes in univariate distributions through recursive significance testing. We provide a comprehensive review of existing modality detection methods and outline their potential pitfalls when applied to ordinal scales. Based on a benchmark of 172 simulated ordinal samples of different sample sizes, we demonstrate that ReMoDe outperforms other established modality detection methods. We furthermore present a stability test for our method as well as p-values and approximated Bayes factors for each detected mode. To make our method easily applicable for researchers, we introduce open-source R and Python packages.

PMID:41714803 | DOI:10.1111/bmsp.70037

Commun Med (Lond). 2026 Feb 19. doi: 10.1038/s43856-026-01419-7. Online ahead of print.

ABSTRACT

BACKGROUND: Frailty is an important factor in human aging associated with a broad range of adverse outcomes. Frailty metrics are time intensive to collect making them difficult for larger scale application.

METHODS: We apply machine learning to predict these frailty metrics, associated risk factors, and adverse outcomes from activity data. We use activity data collected using Actigraphy wearable accelerometer sensors, which are devices that measure acceleration along three axes of movement. Models were evaluated using Area Under the receiver operator Curve (AUC), Area Under Precision Recall Curve (AUPRC), Spearman rank test, Mann-Whitney U test, or Kruskal-Wallis test on repeated subsampling of train and test sets. All statistical tests are reported using -log₁₀(P-value).

RESULTS: Machine learning models show strong predictive performance even with small amounts of accelerometry data available. They are also able to better determine adverse outcomes such as hospitalization and mortality than frailty metrics themselves in our geriatric population.

CONCLUSIONS: This approach of wearable activity data-based prediction of frailty offers a surrogate (proxy or estimate) for determining frailty metrics in a scalable manner. It can also be used to determine adverse outcomes such as hospitalizations and mortality, allowing frailty to be used as a metric in other studies or medical practices.

PMID:41714788 | DOI:10.1038/s43856-026-01419-7

Sci Rep. 2026 Feb 19. doi: 10.1038/s41598-026-40725-x. Online ahead of print.

NO ABSTRACT

PMID:41714774 | DOI:10.1038/s41598-026-40725-x

Sci Rep. 2026 Feb 19. doi: 10.1038/s41598-026-39761-4. Online ahead of print.

NO ABSTRACT

PMID:41714752 | DOI:10.1038/s41598-026-39761-4

Nature. 2026 Feb 19. doi: 10.1038/s41586-026-10274-4. Online ahead of print.

ABSTRACT

Epstein-Barr virus (EBV) infects ≈90-95% of the global population^1,2 and persists in B cells as a life-long infection³. Prior EBV-infection is associated with autoimmune and neoplastic disease⁴. Still, the biological basis of host control during EBV persistence remains unclear. Here, we report the identification of non-genetic and genetic factors that are associated with EBV control during persistent infection. Using blood-based genome sequence (GS) data from 486,315 UK Biobank and 336,123 All of Us participants, we identified short read-pairs mapping to the EBV genome in 16.2% and 21.8% of individuals, respectively. EBV-read detection (EBVread+) reflects increased viral load in blood cells, as shown by orthogonal measurements, and was associated with HIV infection, immunosuppressive drug intake, and current smoking. Genome-wide analyses of EBVread+ identified strong associations at the Major Histocompatibility Complex (MHC), including 54 independent HLA-alleles of MHC class I and II, and at 27 genomic regions outside MHC. Epistasis with distinct HLA-alleles of MHC class I was observed at the ERAP2 locus. Analysis of individuals with EBV-associated diseases⁴ revealed a higher polygenic burden of EBVread+ for HLA-alleles at MHC class I in multiple sclerosis (driven by HLA-A*02:01), and at MHC class II in rheumatoid arthritis. Phenome-wide analyses identified a polygenic overlap of EBVread+ with inflammatory bowel disease, hypothyroidism, and type 1 diabetes. Our study establishes by-products of human GS as a surrogate marker of EBV viral load. This will facilitate investigation and treatment for EBV and other persistent viral infections.

PMID:41714741 | DOI:10.1038/s41586-026-10274-4

Skeletal Radiol. 2026 Feb 20. doi: 10.1007/s00256-026-05169-4. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate MRI abnormalities of the pulvinar and ligamentum teres (LT) in patients with atraumatic hip pain, as well as to describe a grading system for pulvinar signal abnormalities and test its reproducibility.

MATERIALS AND METHODS: This retrospective study included 128 patients with atraumatic hip pain and no reported structural abnormalities other than those of the pulvinar and LT on hip MRI, along with 64 asymptomatic controls. MR images were evaluated by two readers and included grading of pulvinar signal abnormalities (normal, grade 1: < 50% fat replacement, grade 2: > 50% fat replacement), LT signal abnormality, LT thickening, and LT tear. Ordinal variables were dichotomized for further analysis. Group differences were analyzed using logistic regression models. Inter-reader agreement was assessed using kappa statistics.

RESULTS: Pulvinar signal abnormalities were significantly associated with a higher odds ratio (OR) of hip pain (OR, 4.28; 95% CI, 1.81-11.49; p = 0.002). No significant group differences were found for LT signal increase, LT thickening, or LT tear (p-value range = 0.43-0.71). Inter-reader and intra-reader agreement for pulvinar signal abnormalities grading were almost perfect (κ = 0.85 [95% CI, 0.76-0.93] and κ = 0.92 [95% CI, 0.64-1.00]).

CONCLUSION: Patients with atraumatic hip pain undergoing MRI demonstrated a significantly higher prevalence of pulvinar signal abnormalities in the absence of other relevant structural pathology. These results underscore the importance of systematically evaluating the pulvinar during hip MRI interpretation. Furthermore, a grading system for pulvinar signal abnormalities was introduced.

PMID:41714735 | DOI:10.1007/s00256-026-05169-4