Tag: pubmed

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

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

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

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

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

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

Clin Transl Sci. 2026 Apr;19(4):e70533. doi: 10.1111/cts.70533.

ABSTRACT

Renin-angiotensin-aldosterone system inhibitors are widely prescribed for chronic kidney disease, but their causal effect on kidney function remains uncertain. This study investigated the impact of starting renin-angiotensin blockade on renal function in adults with kidney disease. A retrospective cohort study was conducted in Korea using a quasi-experimental staggered difference-in-differences design with propensity score matching to estimate time-varying treatment effects. Overall, 1,204 adults (375 treated and 829 contemporaneous not-yet-treated controls) were followed for 3 years. Initiation of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers was recorded, and treatment exposure was categorized monthly. The primary outcome was a change in estimated glomerular filtration rate after initiation, evaluated over sequential intervals up to 12 months. The overall average treatment effect of two-way fixed effects model was not statistically significant (-1.47 mL/min/1.73 m²; p = 0.33). However, initiation was associated with an immediate and significant decline in eGFR at event time 0 (estimate: -3.87 mL/min/1.73 m², p < 0.05) and at event time 1 and 3 (p < 0.05). Beyond these early intervals, there was no evidence of progressive deterioration in kidney function during the 1-year follow-up. Declines following initiation of renin-angiotensin blockade are early, transient, and primarily hemodynamic in nature rather than reflective of structural kidney injury. Importantly, this quasi-experimental analysis of real-world data reproduced the findings of randomized trials, reinforcing current guideline recommendations to continue therapy in chronic kidney disease provided that reduction in filtration rate remains below the accepted threshold of 30%.

PMID:41876398 | DOI:10.1111/cts.70533

Alzheimers Dement. 2026 Mar;22(3):e71297. doi: 10.1002/alz.71297.

ABSTRACT

INTRODUCTION: Amyloid-targeting therapies for Alzheimer’s disease require regular MRI monitoring for amyloid-related imaging abnormalities (ARIA). 3D scans are more sensitive but time intensive; ultra-fast implementations could improve access and reduce burden.

METHODS: Eighty scans from 20 participants were acquired with standard 2D fluid-attenuated inversion recovery (FLAIR) and T2*-gradient recalled echo (T2*-GRE), or accelerated Wave-controlled aliasing in parallel imaging (Wave-CAIPI) 3D FLAIR and susceptibility-weighted imaging (SWI) at 3 T. Two neuroradiologists graded ARIA-E (edema/effusion) and ARIA-H (hemosiderin deposits). Bayesian models estimated sensitivity, specificity, severity agreement, and interchangeability between acquisitions.

RESULTS: Accelerated sequences reduced acquisition time by up to 56%. Four participants had ARIA-E and microbleeds; five had microbleeds alone. Sensitivity and specificity for ARIA-E were identical (1.00; 0.94-0.95); severity was comparable. Replacing standard with accelerated FLAIR did not decrease severity agreement (interchangeability 1.4; 95% highest-density interval [HDI] -3.6% to 5.4%). Fast SWI showed higher microbleed severity gradings.

DISCUSSION: Wave-CAIPI offers fast high-resolution FLAIR acquisitions with comparable performance for ARIA-E monitoring. Wave-CAIPI SWI provides high-quality scans that may aid ARIA-H interpretation.

PMID:41876395 | DOI:10.1002/alz.71297

Cancer Med. 2026 Mar;15(3):e71703. doi: 10.1002/cam4.71703.

ABSTRACT

BACKGROUND: Paranasal sinus tumors are rare malignancies that are known to be aggressive with poor outcomes. Data are limited regarding factors associated with survival and prognosis. In this study, we investigated factors associated with survival for both patients with squamous cell carcinoma (SCC) and adenocarcinoma (AC).

METHODS: The Surveillance, Epidemiology and End Results (SEER) data was utilized from the years 2000 to 2019. Kaplan-Meier survival analysis and Cox regression modeling were employed to evaluate the relationship between several co-variates and overall survival (OS) and disease-specific survival (DSS) among patients with SCC and AC.

RESULTS: A total of 5276 patients with SCC and 5222 patients with AC were included. Compared to SCC patients, those with AC were younger and presented with less differentiated and more advanced tumors (p < 0.0001). The median OS for SCC was 203 months compared to the 56 months in patients with AC (p < 0.0001). Primary site, race, stage, grade, and treatment modalities utilized were significantly predictive of OS and DSS in SCC patients in univariate analysis. Among AC patients, we found stage, grade, and treatment modalities to be significantly predictive of OS and DSS in univariate analysis. For SCC, stage (p < 0.001), primary site (p < 0.001), and treatment (p < 0.001) were significant predictors of survival on multivariate analysis. Specifically, nasal SCC was found to have improved survival compared to other sites. For AC, stage (p < 0.001) and treatment (p < 0.001) were significant predictors of survival on multivariate analysis. For both SCC and AC, treatment with both radiation and surgery had improved survival compared to radiation alone (p < 0.0001).

CONCLUSION: SCC and AC of the paranasal sinus and nasal cavity portend an overall poor prognosis with limited survival. Our study effectively elucidates factors associated with survival which may be useful in treatment and counseling patients with paranasal sinus AC and SCC.

PMID:41876393 | DOI:10.1002/cam4.71703

Am J Hum Biol. 2026 Mar;38(3):e70247. doi: 10.1002/ajhb.70247.

ABSTRACT

OBJECTIVES: Duration and quality of sleep are influenced by many factors, including hormonal changes. The aim of this study was to investigate the differences between the phases of the menstrual cycle in total sleep duration and sleep stage distribution, specifically the duration of rapid eye movement (REM) phase, light, and deep sleep states and compare sleep parameters between ovulatory and anovulatory cycles.

METHODS: The study involved 130 women aged 20-35 (mean = 26.2 years; SD = 4.14). Ovulation was detected using luteinizing hormone (LH) urine tests. Sleep data were collected using the Fitbit Alta HR trackers, which measured total sleep time and the duration of sleep stages. Sleep parameters were analyzed separately for each of the five phases: menstrual bleeding, follicular, periovulatory, luteal, and premenstrual using repeated measures ANOVA. Differences between ovulatory and anovulatory cycles were assessed using Student’s t-test.

RESULTS: Women with the ovulatory cycle slept longer and had longer REM phases compared to women without ovulation. No statistically significant differences were observed in total sleep duration or sleep stage distribution across five phases of the menstrual cycle among women with detected ovulation.

CONCLUSION: The findings suggest that ovulatory status might be associated with differences in total sleep time and REM sleep duration, whereas sleep duration and sleep stage distribution across menstrual cycle phases remain relatively constant. These results suggest that the presence of ovulation, rather than phase-specific changes during the cycle, may play a more important role in shaping sleep characteristics.

PMID:41876389 | DOI:10.1002/ajhb.70247