Tag: statistics

Vaccine. 2026 Jul 10;88:128916. doi: 10.1016/j.vaccine.2026.128916. Online ahead of print.

ABSTRACT

This study aimed to compare the immunogenicity of three meningococcal vaccines used as booster doses in children primed with MPCV-AC in China. A total of 250 eligible children were enrolled to receive MPSV-AC, MPCV-ACYW₁₃₅, or MPCV-AC as a booster dose. Participants were subdivided into day 7 and day 28 subgroups based on the timing of sample collection. Blood samples were collected at baseline, day 7, and day 28 to measure IgG antibodies against serogroups A and C by ELISA. Baseline GMCs of IgG were 4.34 μg/mL (seropositivity: 79.2%) for serogroup A and 4.36 μg/mL (seropositivity: 82.0%) for serogroup C, both negatively correlated with age and time interval (p < 0.05). All vaccines significantly increased IgG levels at days 7 and 28 post-booster compared with baseline (p < 0.01). In the day 7 group, MPSV-AC yielded a lower GMC (19.14 μg/mL) and seroconversion rate (43.8%) for serogroup A compared with MPCV-ACYW₁₃₅ (44.69 μg/mL, 78.9%) and MPCV-AC (43.06 μg/mL, 78.1%). In the day 28 group, MPSV-AC showed a comparable GMC for serogroup A (44.42 μg/mL vs. 60.39 μg/mL and 44.66 μg/mL) and a higher GMC for serogroup C (113.40 μg/mL) than MPCV-ACYW₁₃₅ (59.62 μg/mL) and MPCV-AC (72.75 μg/mL). Only two mild adverse events were reported during the study period. These findings suggest that boosting with MPSV-AC, MPCV-ACYW₁₃₅, or MPCV-AC is safe and immunogenic; however, further studies are warranted to assess the long-term persistence of immunity conferred by these booster vaccines.

PMID:42430875 | DOI:10.1016/j.vaccine.2026.128916

Vaccine. 2026 Jul 10;88:128910. doi: 10.1016/j.vaccine.2026.128910. Online ahead of print.

ABSTRACT

BACKGROUND: Vaccine-preventable diseases continue to burden U.S. population health. Despite the Affordable Care Act (ACA) eliminating cost-sharing for recommended vaccines in 2010, adult vaccination rates persistently fall below Healthy People 2030 targets, signaling that access alone is insufficient.

OBJECTIVES: To synthesize peer-reviewed literature (2010-2025) on interventions designed to increase vaccine intention or uptake among U.S. adults; characterize strategies, populations, settings, and study quality; and identify predictors of vaccine uptake rate.

METHODS: Following PRISMA 2020 guidelines, a multi-database search was conducted across PubMed, Web of Science, Ovid/MEDLINE, and EBSCOhost, with a final updated search in December 2025. Dual independent reviewers screened studies in two stages. Quality was assessed using the EPHPP tool and certainty evaluated using GRADE. Strategies were categorized per the WHO Behavioral and Social Drivers of Vaccination (BeSD) Model. A meta-regression was conducted on 79 studies, with narrative synthesis across all 92 included studies.

RESULTS: Of 11,219 records, 92 studies were included. Study designs were predominantly RCTs; Influenza and COVID-19 vaccines were most commonly studied. In the meta-regression (adjusted R² = 0.229), prioritizing a specific population (b=0.121, p=.027), using service quality improvement strategies (b=0.226, p=.040), and recruiting through community-based partner organizations (b=0.585, p=.005) or healthcare organizations (b=0.230, p=.040) were associated with significantly higher vaccine uptake rates. Onsite vaccination was associated with lower uptake rates (b=-0.185, p=.033), an effect confirmed as specific to the COVID-19 pandemic emergency-response context rather than a generalizable effect of the strategy in sensitivity analysis. Narrative synthesis identified message framing and educational campaigns as the most frequently deployed strategies, with multi-component designs and community partnerships showing the most favorable outcomes.

CONCLUSIONS: Effective adult vaccination strategies were multifactorial. Service quality improvement, priority population focus, and community-based recruitment were the strongest predictors of higher uptake. Findings support the WHO BeSD model’s Practical Issues domain: reducing friction outperformed persuasion alone. GRADE certainty remained LOW to MODERATE, emphasizing the need for higher-quality, equity-focused research.

REGISTRATION: This systematic review was registered at Open Science Framework: 10.17605/OSF.IO/SM7YD.

PMID:42430872 | DOI:10.1016/j.vaccine.2026.128910

Am J Emerg Med. 2026 Jun 29;109:133-140. doi: 10.1016/j.ajem.2026.06.041. Online ahead of print.

ABSTRACT

OBJECTIVE: This study focuses on characterizing the voices that are amplified through peer reviewed publication and how they relate to one another. This study aims to 1) identify patterns of author collaboration and representation, 2) assess how this varies among different journals, 3) examine the relationship between author collaboration and quantitative publication.

METHODS: This is a bibliometric analysis using descriptive statistics and network analysis, examining all publications in four influential emergency medicine journals from January 2015 through December 2024. Authors and journals were assessed on quantity of publications, patterns of co-authorship, and network characteristics of individual and aggregate journals.

RESULTS: There is a sharp right-skew of authorship – most authors have only a single article published in ten years. The most prolific authors in emergency medicine demonstrate significantly more publications than their peers. Journals show a propensity to publish multiple articles from a small number of authors, but there is variation among journals as to how many unique authors appeared during the timeframe studied. There was a gender disparity identified among the top authors, most of whom were men.

CONCLUSION: Bibliometric analysis is able to demonstrate academic influence while also casting light on the role of journals in peer-reviewed publication patterns. Publication is a vital component of academic success and tangible evidence of professional influence. How authors collaborate and journals select manuscripts is impactful, and unfortunately this study demonstrates inequity among the most visible authors in the most impactful journals.

PMID:42430864 | DOI:10.1016/j.ajem.2026.06.041

Ultrasonics. 2026 Jun 9;168:108192. doi: 10.1016/j.ultras.2026.108192. Online ahead of print.

ABSTRACT

The strengthening of steel structures with carbon fiber reinforced polymer (CFRP) composites has gained wide acceptance in civil engineering, yet interfacial bonding defects such as inclusion, delamination, and porosity can severely degrade structural performance. Conventional ultrasonic testing often suffers from noise contamination and limited feature extraction, restricting the reliability of defect identification. To address this issue, this study integrates phased array ultrasonic testing (PAUT) with encoder-assisted acquisition and advanced signal processing. Wavelet packet transform (WPT) was applied to denoise and decompose A-scan signals, from which eight statistical energy-based features were extracted to construct discriminative feature vectors. These vectors were then used to train and compare three backpropagation artificial neural network (BP-ANN) variants. The BP-ANN trained with the conjugate gradient algorithm achieved the highest overall accuracy of 95.83% among the three investigated optimization strategies. The results indicate that WPT-based feature engineering improves the discriminative capability of ultrasonic features under controlled laboratory conditions, while encoder-assisted acquisition improves the consistency of PAUT signal collection. The proposed framework provides a feasible approach for intelligent classification of interfacial defects in CFRP-steel hybrid structures and may serve as a reference for future studies involving real manufacturing defects and practical engineering scenarios.

PMID:42430857 | DOI:10.1016/j.ultras.2026.108192

Mar Environ Res. 2026 Jul 10;221:108248. doi: 10.1016/j.marenvres.2026.108248. Online ahead of print.

ABSTRACT

The Indo-Pacific finless porpoise (Neophocaena phocaenoides), a coastal cetacean species widely distributed from the Taiwan Strait to the Persian Gulf, is an iconic species that may represent an overall status indicator of marine ecosystems. However, growing anthropogenic pressures have led to declines in the population of this species in many regions such as Hong Kong waters, highlighting the need for complementary monitoring approaches. In this study, we applied two environmental DNA (eDNA) analysis methods, species-specific quantitative PCR (qPCR) and cetacean-targeting metabarcoding using μCeta primers, to detect Indo-Pacific finless porpoise eDNA around the Soko Islands, Hong Kong. First, we empirically validated the performance of the qPCR primers previously designed in another study. Then, in March 2025, water samples were collected from surface and bottom water layers at 20 locations in the Soko Islands area, a known habitat of Indo-Pacific finless porpoises in Hong Kong. The qPCR analysis detected finless porpoise eDNA in eight out of 40 samples, but all eDNA concentrations were below the limit of quantification. μCeta metabarcoding detected finless porpoise eDNA in seven out of 40 samples. The qPCR and μCeta metabarcoding approaches showed comparable detection rates for Indo-Pacific finless porpoises. Interestingly, the μCeta metabarcoding method detected a transient cetacean species, the false killer whale (Pseudorca crassidens), at a single location. Both methods showed consistent detection rates between surface and bottom water layers, with no statistically significant difference. Overall, the two eDNA analysis methods successfully detected finless porpoise eDNA around the Soko Islands, demonstrating the potential of these approaches for monitoring Indo-Pacific finless porpoises and other cetaceans in this region. Taken together, our findings provide a basis for an eDNA-based cetacean monitoring framework in Hong Kong waters.

PMID:42430845 | DOI:10.1016/j.marenvres.2026.108248

Psychiatry Res. 2026 Jul 4;364:117312. doi: 10.1016/j.psychres.2026.117312. Online ahead of print.

ABSTRACT

BACKGROUND: Schizophrenia is a disabling mental disorder. Quality of life (QoL) reflects patients’ social-psychological prognosis in mental health services. Sleep and physical activity relate to symptoms and prognosis closely, but their interplay and link to QoL are unclear. This study aimed to explore their impact on schizophrenia patients’ QoL.

METHODS: The samples for this study were derived from Shanghai Community-based Severe Mental Disorders cohort. QoL was assessed using the World Health Organization Quality of Life Assessment Scale Short Form (WHOQOL-BREF); sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI); physical activity was assessed using the International Physical Activity Questionnaire Short Form. The statistical analysis was conducted using SPSS 24 and R 4.4.1. We used linear regressions to assess the impact of sleep quality, analysis of variance for PA, and analysis of variance and post-hoc tests for the interaction effect.

RESULTS: The final sample consisted of 5210 cases, with an average age of 59.0 years. Among them, 2,778 were female (53.3%). The patient scored the lowest on the dimension of social relationships (M = 12.864, SD = 2.254) regarding their QoL. Improvement in sleep and an increase in physical activity (all p < 0.001) both contribute to QoL of patients. For the environmental health (F = 5.013, p = 0.007, η_p² = 0.002) dimension, the two have a mutual compensatory effect.

CONCLUSIONS: This study emphasizes the significance of sleep and physical activity for the recovery of patients with schizophrenia, particularly highlighting the crucial role of improving sleep.

PMID:42430832 | DOI:10.1016/j.psychres.2026.117312

J Surg Res. 2026 Jul 10;326:212-218. doi: 10.1016/j.jss.2026.06.029. Online ahead of print.

ABSTRACT

INTRODUCTION: The incidence and pattern of blunt traumatic injury are believed to correlate with what bioengineers termed imparted energy (IE), which combines the change in velocity (Δv) and the principal direction of force. In this study, our objective was to evaluate the incidence and pattern of cervical spine injury (CSI) following falls, stratified by fall height. We hypothesized that the incidence of CSI would not correlate with fall height, as the vertical IE vector of a fall does not translate into the horizontal IE relevant to cervical spine motion.

METHODS: We queried the trauma registry at our level I trauma center for all patients admitted with fall-related injury between 2013 and 2018. CSI was identified using International Classification of Diseases, Ninth Revision, codes 805, 806, 839, or 952. For eligible patients, we extracted clinical and radiographic data from registry and inpatient chart review. A single author (N.K) reviewed computed tomography scans of patients with CSI to confirm the diagnosis. We classified patients into 3 fall-height groups: ground-level fall (GLF); low fall (LF), <20 feet; and high fall (HF), ≥20 feet. We also classified CSI anatomically into an upper (C1-C3) and lower (C4-C7) injuries. Descriptive summary statistics were performed, and a regression model was used to identify independent risk factors for CSI. A P value < 0.05 was considered statistically significant.

RESULTS: During the study period, 4759 patients suffered from a fall. This included 1571 GLF patients, 2518 LF patients, and 670 HF patients. The overall incidence of CSI was 4.9%, 8.9% among GLF patients, 2.5% among LF patients, and 4.3% among HF patients. Fall height was not a significant risk factor for CSI (odd ratio [OR], 0.59; 95% confidence interval [CI], 0.47-0.75. However, age (OR, 1.03; CI, 1.02-1.04) and male gender (OR, 1.7; CI, 1.3-2.3) were significant risk factors. Additionally, older patients more frequently sustained upper (C1-C3) CSI, whereas younger patients more commonly sustained lower (C4-C7) CSI.

CONCLUSIONS: The overall incidence of CSI after a fall was 4.9%. There was no correlation between fall height and the incidence of CSI. This finding may be explained by the mismatch between the vertical vector of fall-related IE and the horizontal direction of cervical spine motion. Future studies will continue to explore the incidence and injury pattern of CSI across other trauma mechanisms.

PMID:42430831 | DOI:10.1016/j.jss.2026.06.029

J Neurosurg. 2026 Jul 10:1-10. doi: 10.3171/2026.1.JNS251897. Online ahead of print.

ABSTRACT

OBJECTIVE: Maximal safe resection of intra-axial brain tumors near the motor cortex is aided by intraoperative motor mapping. Here, the authors compared outcomes in patients undergoing either low-frequency bipolar stimulation (LFBS) or high-frequency monopolar stimulation (HFMS) for cortical and/or subcortical motor mapping during brain tumor resection.

METHODS: A retrospective analysis of patients undergoing an asleep craniotomy with motor mapping or an awake craniotomy with motor and speech mapping with a single surgeon was performed. Three cohorts were compared: 1) asleep LFBS (AsLFBS), 2) awake LFBS (AwLFBS; motor + speech mapping), and 3) asleep HFMS. HFMS mapping was not used for awake craniotomies.

RESULTS: A total of 284 patients who underwent 300 craniotomies with motor mapping were identified. No significant differences in permanent neurological deficits (p = 0.377) or extent of resection (EOR) of nonenhancing tumors (p = 0.453) were identified between LFBS or HFMS motor mapping cases. Both EOR (92.7% vs 83.5%, p = 0.035) and permanent neurological deficits (7.6% vs 3.3%) occurred more frequently in enhancing tumors with LFBS, although the latter was not statistically significant. HFMS was associated with higher rates of subcortical motor pathway identification (p = 0.001) and fewer total intraoperative seizures (p = 0.003) compared with LFBS. Previous resection (HR 0.46, p = 0.003) and a higher cortical threshold (HR 0.95, p = 0.023) were significantly associated with longer survival, while preoperative aphasia (HR 2.24, p = 0.022), hospital length of stay (HR 1.1, p = 0.005), an insular-based tumor (HR 3.5, p = 0.021), and a histological diagnosis of glioblastoma (HR 2.9, p = 0.001) were negative predictors. Interestingly, overall FLAIR EOR was significantly associated with a marginally decreased overall survival (HR 1.01, p = 0.011).

CONCLUSIONS: No significant differences in postoperative neurological deficits were found between LFBS and HFMS paradigms. HFMS may identify subcortical motor fibers more reliably while resulting in significantly fewer intraoperative seizures. Although LFBS was associated with greater EOR of contrast-enhancing tumors, it may also be associated with higher rates of postoperative deficits, perhaps reflecting less reliable identification of subcortical motor fibers.

PMID:42430806 | DOI:10.3171/2026.1.JNS251897

J Neurosurg Spine. 2026 Jul 10:1-15. doi: 10.3171/2026.2.SPINE251657. Online ahead of print.

ABSTRACT

OBJECTIVE: Preoperative risk-stratification tools, including frailty, nutritional, and surgical risk metrics, are used to predict complications after spine surgery. The relative performance of these tools across complication types and surgical subgroups is not well characterized. This study aimed to compare the predictive performance of 5 risk metrics, American College of Surgeons Surgical Risk Calculator (ACS SRC), serum albumin, Risk Analysis Index (RAI), modified 5-item frailty index (mFI-5), and Geriatric Nutritional Risk Index (GNRI), for perioperative complications.

METHODS: The authors analyzed 362,145 adult spine surgery patients from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) from 2017 to 2022. Adjusted odds ratios were estimated via multivariable logistic regression, controlling for age, sex, urgency, and procedure type (defined by Current Procedural Terminology [CPT] codes). Subgroup analyses were stratified by ICD-10 diagnosis category, including degenerative disease, tumor, trauma, infection, and spinal deformity. Discrimination for predicting complications was assessed using C-statistics and DeLong’s test.

RESULTS: Across all endpoints, ACS SRC had the best predictive accuracy: mortality C-statistic (95% CI) 0.908 (0.900-0.916), Clavien-Dindo grade IV (CD-IV) 0.823 (0.816-0.830), and major complications 0.749 (0.745-0.752). Serum albumin, despite being a single laboratory value, ranked second with mortality C-statistic (95% CI) 0.820 (0.807-0.833), CD-IV 0.734, and major complications 0.682 and showed strong discrimination for infectious complications (e.g., sepsis, septic shock, surgical site infection, and urinary tract infection), as well as for hospital length of stay and nonhome discharge. Compared to frailty-based metrics, albumin showed significantly better predictive value (p < 0.001 for pairwise comparisons) and maintained its advantages across all subgroups, including high-risk groups such as infection, trauma, and tumor cases. RAI provided moderate mortality prediction (C-statistic 0.807) and was most effective for predicting cardiovascular events, while both GNRI (0.753) and mFI-5 (0.647) were less consistent and demonstrated weaker associations with adverse outcomes. Multivariable regression confirmed that lower preoperative albumin and higher ACS SRC predictions were robust, independent predictors of increased risk for major complications, CD-IV events, and mortality. These performance patterns remained stable across surgical indications and in subgroup analyses.

CONCLUSIONS: ACS SRC remains among the comprehensive tools for risk stratification in spine surgery. Serum albumin offers strong, consistent predictive value, especially for infectious, respiratory, and life-threatening complications, and may be a valuable alternative when calculator inputs are incomplete.

PMID:42430800 | DOI:10.3171/2026.2.SPINE251657

Syst Biol. 2026 Jul 10:syag048. doi: 10.1093/sysbio/syag048. Online ahead of print.

ABSTRACT

Phylogenetic modeling of morphological shape in two or three dimensions is one of the most challenging statistical problems in evolutionary biology. As shape data are inherently correlated and non-linear, most naïve methods for phylogenetic analysis of morphological shape fail to capture the biological realities of evolving shapes. In this study we propose a novel framework for evolutionary analysis of morphological shape which facilitates stochastic character mapping on landmark shapes. Our framework is based on recent advances in mathematical shape analysis and models the evolution of shape as a diffusion process that accounts for the evolutionary correlation between nearby landmarks. The diffusion process we consider is parametrized in terms of meaningful parameters describing the evolutionary rate and the degree of spatial autocorrelation among landmarks. The framework we propose assumes that the phylogenetic tree is fixed and uses a Metropolis-Hastings Markov Chain Monte Carlo sampling scheme for inferring ancestral shapes and parameters of the model. We evaluate the new inference algorithm using simulations and show that the method leads to improved estimates of the shape at the root and well-calibrated credible sets of shapes at internal nodes. In addition, we also compare the diffusion parameter describing the degree of spatial autocorrelation to an existing metric of integration and find that they quantify integration in a shape in a similar way. To illustrate the method, we also apply it to a previously published data set of butterfly wing images.

PMID:42430784 | DOI:10.1093/sysbio/syag048