Tag: pubmed

Behav Res Methods. 2026 Aug 7;58(9):260. doi: 10.3758/s13428-026-03137-3.

ABSTRACT

Interoception, the capacity to sense, perceive, and metacognitively appraise viscerosensory and homeostatic signals, is a growing focus in psychology and psychiatry. Adaptive psychophysical tasks now allow quantification of perceptual sensitivity, bias, and precision in cardiac and respiratory domains. However, accurately estimating these parameters often requires large numbers of trials or participants, posing practical challenges, especially in clinical research where participant availability and tolerance are limited. One approach to reduce participant burden while maintaining statistical rigor is to optimize data analysis. Here, we present hierarchical Bayesian models tailored for cardiac and respiratory interoceptive psychophysics that efficiently estimate sensitivity, bias, and precision at both individual and group levels. Using simulations and empirical data, we validate these models and demonstrate that they allow enhanced inference relative to conventional approaches. To support adoption, we provide openly accessible resources, including a tutorial on implementing and fitting these models in R (written with researchers without modeling expertise in mind) and an app for sample-size justification. These tools facilitate robust, efficient, and generalizable modeling of interoceptive performance, enabling rigorous studies even with limited trials or participant availability.

PMID:42567971 | DOI:10.3758/s13428-026-03137-3

Nat Biomed Eng. 2026 Aug 7. doi: 10.1038/s41551-026-01742-3. Online ahead of print.

ABSTRACT

Healthcare artificial intelligence systems often degrade in performance when deployed across institutions, with documented performance drops and perpetuation of discriminatory patterns embedded in data. This brittleness comes, in part, from learning statistical associations rather than causal mechanisms. Causal graph neural networks address this by combining graph-based representations of biomedical data with causal inference to learn invariant mechanisms instead of just spurious correlations. This Perspective reviews the methodology of structural causal models, disentangled causal representation learning, and techniques for interventional prediction and counterfactual reasoning on graphs. We discuss applications across psychiatric diagnosis and brain network analysis, cancer subtyping with multi-omics causal integration, continuous physiological monitoring and drug recommendations. These methods provide building blocks for patient-specific causal digital twins that could support in silico clinical experimentation. Remaining challenges include computational costs that preclude real-time deployment, validation challenges that go beyond standard cross-validation, and the risk of causal-washing where methods adopt causal terminology without rigorous evidentiary support. We propose a tiered framework distinguishing causally inspired architectures from causally validated discoveries and outline future directions, including scalable causal discovery, multimodal data integration and regulatory pathways for these methods. Making practical causal digital twins possible will require an honest assessment of what current methods deliver, sustained collaboration across disciplines and validation standards that match the strength of the causal claims being made.

PMID:42567948 | DOI:10.1038/s41551-026-01742-3

Clin Oral Investig. 2026 Aug 8;30(9):380. doi: 10.1007/s00784-026-07070-9.

ABSTRACT

OBJECTIVE: To evaluate patient-reported changes in orofacial and masticatory symptoms after BoNT-A application in individuals presenting bruxism-related complaints.

MATERIALS AND METHODS: A retrospective cross-sectional observacional study was conducted with 61 adult participants (47 women, 14 men) who underwent BoNT-A treatment for bruxism. An online questionnaire, assessed masticatory and orofacial symptoms before and after treatment, using a five-point frequency scale. Data were analyzed with descriptive statistics, paired t-tests, and Spearman’s correlation (p < 0.05). This observational study was reported in accordance with the STROBE guidelines.

RESULTS: A statistically significant reduction in total symptom scores was observed after treatment (p < 0.05), with a mean decrease from 32.4 ± 11.5 (before) to 15.6 ± 6.59 (after), representing an overall reduction of approximately 52%. No significant differences in symptom improvement were observed between sexes or in relation to age. Although an overall difference among professional categories was identified, post hoc analysis did not show significant pairwise differences between groups.

CONCLUSION: Individuals with bruxism-related complaints reported improvement in pain-related and masticatory symptoms after BoNT-A application. BoNT-A may represent a supportive approach for managing orofacial and muscle-related complaints; however, further studies with standardized diagnostic criteria and objective outcome measures are needed to clarify its long-term clinical effects.

CLINICAL RELEVANCE: BoNT-A application may contribute to the management of pain-related and masticatory complaints reported by individuals with bruxism-related symptoms, supporting its potential use as an adjunctive approach in selected clinical situations.

PMID:42567938 | DOI:10.1007/s00784-026-07070-9

Commun Biol. 2026 Aug 7;9(1):1059. doi: 10.1038/s42003-026-10751-6.

ABSTRACT

Fast, highly constrained sensorimotor acts require rapid coordination of distributed cortical systems on subsecond timescales. Here, we used source-resolved magnetoencephalography to characterise time-locked cortical connectivity during voluntary swallowing in 74 healthy adults. Cluster-based network statistics revealed focal swallowing-related connectivity changes confined to anatomically selective subnetworks. Undirected phase-lagged connectivity identified theta- and low-gamma weighted phase lag index (wPLI) effects involving somatosensory, motor, supramarginal, and insular regions. Directed connectivity revealed sparse high-gamma phase slope index (PSI) subnetworks centred on the primary somatosensory cortex and anterior insula. Time-window analyses demonstrated temporally evolving low-gamma interactions between posterior parietal and insular regions, while laterality analyses showed rightward theta-band directed asymmetries during later swallowing phases. In contrast, global graph-theoretical metrics and node-level hub measures remained largely stable after correction for multiple comparisons. These findings indicate that voluntary swallowing is supported by focal, frequency-specific, and temporally structured cortical interactions rather than broad global network reconfiguration.

PMID:42567925 | DOI:10.1038/s42003-026-10751-6

Sci Rep. 2026 Aug 7;16(1):24453. doi: 10.1038/s41598-026-64336-8.

ABSTRACT

Two simple, sensitive, and eco-friendly spectroscopic methods were developed for the determination of ensartinib through ion-pair complexation with eosin Y. Method A represents the first reported spectrofluorometric assay for the studied drug and it is based on fluorescence quenching of eosin Y at pH 3.3, showing linearity over 100-1000 ng mL⁻¹ with LOD and LOQ values of 21.2 and 64.1 ng mL⁻¹, respectively. Method B is a spectrophotometric method based on measuring the absorbance of the formed ion-pair complex at 550 nm, obeying Beer’s law over 1.0-10.0 µg mL⁻¹, with LOD and LOQ values of 132 and 400 ng mL⁻¹, respectively. Both methods were validated according to ICH guidelines and exhibited excellent accuracy (98.51-101.68%) and precision (RSD < 2%). The proposed procedures were successfully applied to capsules, providing mean recoveries of 99.29 ± 1.11% and 100.39 ± 0.98% for Methods A and B, respectively. Statistical comparison with a reported chromatographic method showed no significant difference at the 95% confidence level. The environmental impact of the developed methods was assessed using AGREE and GAPI tools, confirming their compliance with green analytical chemistry principles.

PMID:42567906 | DOI:10.1038/s41598-026-64336-8

Hear Res. 2026 Jul 29;480:109764. doi: 10.1016/j.heares.2026.109764. Online ahead of print.

ABSTRACT

OBJECTIVE: This study examined if the amplitude growth function (AGF) of the electrically evoked compound action potential (ECAP) can objectively predict the perceptual loudness growth function (LGF) in cochlear implant (CI) users.

METHODS: ECAP AGFs were measured in 16 CI users across all active electrodes using the MED-EL AutoART fine-grain procedure. Perceptual LGFs were obtained with psychophysical loudness scaling at stimulation rates between 150 and 1200 pulses per second (pps). A third experiment collected ECAP and LGF data simultaneously at 80 pps. Both physiological and perceptual functions were normalized to their dynamic ranges, and a power-law transformation was fitted to model the transformation between ECAP amplitude and perceived loudness. The effects of stimulation rate and electrode position on the model parameters were examined statistically, and the model’s predictive accuracy was assessed using a goodness-of-fit (R²) analysis.

RESULTS: Loudness growth functions showed a systematic rate dependency: shifting from compressive at 80 pps to expansive at 1200 pps. Electrode-specific effects were less pronounced. The power-law exponent increased significantly with stimulation rate (p < 10⁻¹⁵), indicating steeper loudness growth at higher rates. The transformation model was remarkably accurate predicting perceptual loudness: 66% of fits yielded R²>0.8 and 45% >0.9, demonstrating strong correspondence between physiological and perceptual growth functions.

CONCLUSIONS: A strong, systematic relationship exists between ECAP AGFs and perceptual loudness growth across stimulation rates in CI users. Modeling loudness growth from ECAP data provides a viable path toward objective, physiology-based individualization of compression functions in future CI fittings.

PMID:42566843 | DOI:10.1016/j.heares.2026.109764

Breast. 2026 Jul 22;89:104886. doi: 10.1016/j.breast.2026.104886. Online ahead of print.

ABSTRACT

INTRODUCTION: Axillary surgery for early breast cancer has become less aggressive. However, the optimal approach after neoadjuvant systemic therapy (NST) remains uncertain and depends on axillary response. Especially the significance of nodal micrometastases (ypN1mi) after NST regarding oncological outcome remains controversial. Our study retrospectively analyzed ypN1mi occurrence in five neoadjuvant GBG/AGO-B trials from 2012 to 2019.

METHODS: We analyzed 3211 high-risk early breast cancer patients from five neoadjuvant chemotherapy studies (GeparSepto, GeparOcto, GeparNuevo, GeparX, GeparOla). Patients who underwent breast surgery were analyzed based on type of axillary surgery, ypN1mi incidence, and its correlation with outcome.

RESULTS: 98.5% (3163/3211) of patients had breast surgery and axillary information data available. Before NST, 44.1% (1395/3163) had sentinel lymph node biopsy (SLNB), 0.7% (22/3163) underwent axillary lymph node dissection (ALND), and 55.2% (1746/3163) had no axillary surgery. After NST, 65.3% (2057/3150) underwent axillary surgery: SLNB only in 19.4% (612/3150), targeted lymph node biopsy (TLNB) only in 0.2% (5/3150), targeted axillary dissection (TAD) in 0.9% (27/3150), ALND only in 40.9% (1288/3150), and completion ALND following SLNB, TLNB, or TAD in 4.0% (125/3150). Disease-free survival (DFS) was significantly reduced with hazard ratios (HR) of 2.53 (CI 1.63-3.92; p < 0.001) for ypN1mi and 2.43 (CI 1.98-3.00; p < 0.001) for ypN1 compared to ypN0. Likewise, HRs for overall survival (OS) were 3.17 (CI 1.77-5.68) for ypN1mi and 3.03 (CI 2.28-4.03) for ypN1.

CONCLUSION: Our data suggest that minimal axillary residuals after NST may affect DFS, DDFS and OS; however, further analysis is needed to assess other variables.

PMID:42566837 | DOI:10.1016/j.breast.2026.104886

J Prev Alzheimers Dis. 2026 Aug 7;13(9):100647. doi: 10.1016/j.tjpad.2026.100647. Online ahead of print.

ABSTRACT

INTRODUCTION: We aimed to estimate the cost-effectiveness of the patient-centered special care unit for behavioral and psychological symptoms of dementia (SCU-B) in the Respectful Caring for the Agitated Elderly (RECage) study.

METHODS: A health-economic evaluation was performed alongside a controlled European multicenter three-year longitudinal cohort study enrolling 508 participants in a non-SCU-B cohort and SCU-B cohort. Health service resource use, costs, quality-adjusted life years (QALYs), and incremental cost per QALY gained were assessed.

RESULTS: Total QALYs were lower (-0.13; bootstrap-interval -0.23 to -0.02) and total costs were higher (€24,960; bootstrap-interval 14,870 to 35,090) in the SCU-B cohort. Base case and sensitivity analyses indicated the SCU-B was likely not cost-effective.

DISCUSSION: Widespread implementation as well as disinvestment of SCU-B cannot be recommended, given the uncertainty of the study results. We recommend a randomized study stratified by (local/county) region for conclusive evidence.

PMID:42566821 | DOI:10.1016/j.tjpad.2026.100647

Int J Orthop Trauma Nurs. 2026 Aug 6;62:101311. doi: 10.1016/j.ijotn.2026.101311. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze discharge planning for older adults hospitalized due to fractures resulting from same-level falls, combining the investigation of associations between sociodemographic and clinical variables with a qualitative exploration of the processes and perceptions involved.

METHOD: A mixed-methods study conducted in a public hospital in the interior of Bahia and in home settings. A total of 142 medical records of older adults hospitalized for fractures (September 2022 to August 2023) were analyzed, and interviews were conducted with 16 participants after discharge. Quantitative data were analyzed using descriptive statistics and Pearson’s chi-square test (p < 0.05), while qualitative data were analyzed through content analysis.

RESULTS: Only 17 medical records included discharge instructions, which were generic and restricted to clinical aspects. Interviews revealed a predominance of lack of guidance on fall prevention and reports of ptophobia after discharge, leading to activity restriction and social isolation. An association was found between lower limb fractures and female sex, as well as the presence of two to three comorbidities; individuals aged 60 to 79 years showed a higher occurrence of upper limb fractures.

CONCLUSION: The findings point to the urgent need for structured, individualized, and multidisciplinary long-term planning. Nurse-led protocols that include guidance on fall prevention and psychosocial support are essential to prevent ptophobia and activity restriction, ensuring safe hospital-to-home transitions for older adults who have sustained fractures resulting from same-level falls.

PMID:42566810 | DOI:10.1016/j.ijotn.2026.101311

Radiography (Lond). 2026 Aug 7;32(6):103530. doi: 10.1016/j.radi.2026.103530. Online ahead of print.

ABSTRACT

INTRODUCTION: People in prison experience significant health disparities and rely on acute hospitals for secondary care, including diagnostic imaging. Despite this, little is known about how diagnostic radiographers experience imaging people from prison in acute hospital settings. This study aimed to examine these experiences in the UK.

METHODS: This paper reports the Phase One survey dataset from the EXPOSE study, a wider doctoral programme. A cross-sectional survey was conducted as Phase One of a sequential explanatory mixed-methods study. Registered diagnostic radiographers in the UK with experience in imaging people from prison were recruited using convenience and snowball sampling. Data were collected via an online survey and analysed using descriptive statistics to identify patterns and variation in reported experiences. Phase Two qualitative findings will be reported separately.

RESULTS: Fifty-five diagnostic radiographers participated. Most reported high confidence and perceived ability to deliver comparable care. However, 40% indicated that knowledge of offence history influenced their professional approach to some extent. Physical restraints were commonly encountered, with inconsistent documentation of clinical risk. Workflow, radiation protection, MRI safety, and patient positioning were frequently affected. Communication practices were altered for many participants. Despite minimal reported impact on image quality, variability in practice was evident. Most participants reported no formal training and limited awareness of the equivalence of care principle, relying primarily on informal coping strategies.

CONCLUSION: Diagnostic radiographers reported sustaining imaging delivery despite security-related, operational and ethical challenges. The variability in restraint-related processes, information-sharing and local protocols identifies conditions that may threaten consistent, person-centred care.

IMPLICATIONS FOR PRACTICE: Imaging departments should develop local pathways covering clinical-prison role boundaries, physical restraint decisions, proportionate information-sharing, modality-specific guidance, escalation and access to organisational support.

PMID:42566808 | DOI:10.1016/j.radi.2026.103530