Tag: statistics

Acta Neurol Belg. 2026 Jul 30. doi: 10.1007/s13760-026-03113-w. Online ahead of print.

ABSTRACT

BACKGROUND: Neuromodulation therapies, including vagus nerve stimulation (VNS), anterior nucleus of the thalamus deep brain stimulation (ANT-DBS), and responsive neurostimulation (RNS), have become established treatments for drug-resistant epilepsy. While seizure outcomes have been well-characterized, the long-term neuropsychiatric consequences of these interventions remain incompletely understood. This review aimed to compile available evidence on depression, anxiety, cognitive function, and quality of life following chronic neuromodulation therapy in adults and children with epilepsy.

METHODS: We conducted a systematic search of PubMed, EMBASE, the Cochrane Library, and PsycINFO from inception through September 2025. Studies reporting neuropsychiatric outcomes after at least six months of VNS, ANT-DBS, or RNS therapy in patients with epilepsy were eligible. Random-effects meta-analysis was performed using standardized mean differences (SMDs). Heterogeneity was assessed via Cochran Q and I-squared statistics. Publication bias was evaluated with funnel plots and Egger regression.

RESULTS: From 2,847 records screened, 35 studies met inclusion criteria and 24 contributed to quantitative synthesis, encompassing 2,418 patients. The pooled effect on depression was a small but statistically significant improvement (SMD = -0.25; 95% CI: -0.43 to -0.07; p = 0.007). Subgroup analysis showed VNS had the largest antidepressant effect (SMD = -0.40; 95% CI: -0.69 to -0.10), while ANT-DBS (SMD = -0.18; 95% CI: -0.50 to 0.15) and RNS (SMD = -0.14; 95% CI: -0.47 to 0.19) showed non-significant trends toward improvement. Cognitive outcomes remained largely stable across all modalities, with no significant decline in overall cognitive performance (VNS: SMD = 0.07; DBS: SMD = 0.05; RNS: SMD = 0.02). Quality of life improved progressively, with clinically meaningful gains observed by the second year of treatment across modalities. Neuropsychiatric adverse events were most frequent in the ANT-DBS group, where 14.8% reported depressive symptoms during the blinded phase of the SANTE trial, though these diminished substantially over long-term follow-up.

CONCLUSIONS: Neuromodulation for drug-resistant epilepsy is associated with modest improvements in depression and quality of life without meaningful cognitive deterioration over follow-up durations of 6 months to 14 years. VNS demonstrated the most robust antidepressant signal, likely reflecting its established effects on monoaminergic brainstem circuits. Clinicians should monitor neuropsychiatric status, particularly during the early postimplantation period for ANT-DBS. Earlier intervention may optimize mood and quality of life benefits.

PMID:42530840 | DOI:10.1007/s13760-026-03113-w

Community Ment Health J. 2026 Jul 30. doi: 10.1007/s10597-026-01664-z. Online ahead of print.

ABSTRACT

Faith and spirituality have long been recognized as important components of recovery from mental illness, yet little is known about how these experiences evolve over time or the extent to which individuals feel supported by mental health professionals in pursuing them. This study explored how peer support workers’ experiences with spirituality and faith change over time, how they perceive the role of spirituality in their recovery, and how supported they feel by mental health professionals from whom they are receiving care in this aspect of their well-being. The study involved a cross-sectional online survey of 266 peer support workers in the United States, examining their experiences with faith and spirituality. Data were analyzed using paired-sample t-tests and descriptive statistics. Participants reported significantly more positive faith and spiritual experiences in the present compared to the past. Current experiences were largely positive (83%), with 92% reporting that faith/spirituality played a very positive or positive role in their recovery. Nonetheless, challenges persisted, including disagreement with family or friends about religious issues (62%) and feeling lonely or different from others because of religious or spiritual beliefs (40%). While most participants (63%) felt encouraged by healthcare providers to pursue spirituality, fewer than half (45%) reported receiving active support. Findings suggest faith and spirituality are a significant part of recovery for many peer support workers. However, inconsistent provider support underscores the need for more integrated, holistic models of mental health services that acknowledge spirituality as a dynamic, evolving dimension of recovery.

PMID:42530835 | DOI:10.1007/s10597-026-01664-z

Environ Sci Pollut Res Int. 2026 Jul 30. doi: 10.1007/s11356-026-38087-y. Online ahead of print.

ABSTRACT

Advancing air pollution forecasting: a review of physical, statistical, and machine learning methods provides a timely and comprehensive overview of deterministic, statistical, machine learning (ML), and hybrid approaches in air quality modeling. The review effectively summarizes recent developments and highlights emerging trends, such as physics-informed machine learning and integrated forecasting systems. However, several critical operational challenges require further discussion. These include model transferability across data-sparse regions, uncertainty quantification, the interpretability of deep learning architectures, operational robustness, and data quality constraints. Recent advancements in adaptive mesh refinement, AI-assisted chemical transport models, and hybrid deep learning frameworks further underscore the need for explainable, multi-scale, and impact-oriented systems. We argue that future air quality forecasting must move beyond predictive accuracy alone to increasingly integrate atmospheric chemistry, high-resolution observations, rigorous uncertainty analysis, and public health frameworks. Hybrid systems that couple physical interpretability with artificial intelligence represent the most promising frontier for next-generation operational workflows.

PMID:42530833 | DOI:10.1007/s11356-026-38087-y

Environ Sci Pollut Res Int. 2026 Jul 30. doi: 10.1007/s11356-026-38094-z. Online ahead of print.

ABSTRACT

Chronic scarcity of continuous in situ sampling severely hampers trophic monitoring in tropical reservoirs, restricting the application of data-intensive models in regulatory environments. Therefore, the aim of this study was to develop a cross-validation framework integrating a Mamdani Fuzzy Inference System (FIS) with Sentinel-2 Normalized Difference Chlorophyll Index (NDCI) retrievals via Google Earth Engine (GEE) to overcome these limitations. The methods involved parameterizing the FIS with subtropical thresholds using a 16-year limnological dataset from the Billings Reservoir (Brazil). This system was then cross-validated against satellite-derived NDCI distributions using non-parametric statistical tests. Subsequently, it was applied to the Funil Reservoir to evaluate spatial transferability based exclusively on NDCI mapping, without concurrent in situ validation. The results demonstrated a statistically significant validation at the Billings Reservoir (Kruskal-Wallis, p < 0.05 ), confirming that NDCI medians vary systematically across fuzzy-classified trophic states. Additionally, Levene’s test revealed homogeneous variance for total phosphorus (TP) ( W = 3.09 , p = 0.051 ) contrasting with heteroscedastic chlorophyll-a (Chl-a) ( p < 0.05 ), characterizing the distinct dispersion regimes of eutrophication drivers and biological responses. Furthermore, the NDCI-based application to the Funil Reservoir yielded synoptic maps that indicated potential algal bloom expansion at resolutions unattainable by conventional monitoring. In conclusion, this approach establishes remote sensing-based surveillance via NDCI, initially calibrated by fuzzy logic, as a valuable screening tool for eutrophication monitoring in data-scarce aquatic systems.

PMID:42530831 | DOI:10.1007/s11356-026-38094-z

Adv Ther. 2026 Jul 30. doi: 10.1007/s12325-026-03734-w. Online ahead of print.

ABSTRACT

INTRODUCTION: To evaluate postpartum depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS) and identify demographic, obstetric, and neonatal factors associated with EPDS positivity in women without prior psychiatric history.

METHODS: This retrospective, archive-based multicentre study enrolled 763 women aged 20-35 years who delivered at two public hospitals in Turkey (June 2022-June 2025). Variables included educational attainment, employment, pregnancy planning, mode of delivery, abortion/stillbirth history, preeclampsia, birth weight, and neonatal intensive care unit (NICU) admission. Participants were classified as EPDS < 13 or ≥ 13 at the fourth postpartum week; comparisons used univariable and multivariable logistic regression with Bonferroni adjustment.

RESULTS: Of 763 women, 198 (26.0%) scored ≥ 13. After adjustment and Bonferroni correction, history of abortion and preeclampsia remained statistically significant. Working status and history of stillbirth showed nominal associations before correction but did not remain significant after Bonferroni correction. NICU admission was significant in unadjusted analysis but did not remain significant after adjustment (aOR 1.44, 95% CI 0.80-2.60, p = 0.226).

CONCLUSION: Postpartum depressive symptoms affected one in four women. After adjustment and Bonferroni correction, preeclampsia and history of abortion remained associated with EPDS positivity. Targeted psychological screening may be considered for women with high-risk pregnancy or neonatal complications.

PMID:42530824 | DOI:10.1007/s12325-026-03734-w

Int J Cardiovasc Imaging. 2026 Jul 30. doi: 10.1007/s10554-026-03785-8. Online ahead of print.

ABSTRACT

The Coronary Artery Disease Reporting and Data System (CAD-RADS) standardizes coronary CT angiography (CCTA) reporting, but not all reports contain CAD-RADS classifications. We benchmarked 54 large language model (LLM) configurations across 50 distinct models, including recent proprietary and open-weight reasoning models, for zero-shot CAD-RADS classification. We retrospectively analyzed 500 anonymized CCTA reports from four hospitals across three U.S. regions. Expert cardiovascular radiologists provided the reference standard (human inter-rater [Formula: see text]). Fifty-four model configurations (50 distinct LLMs; four configurable models tested in both thinking and non-thinking modes) spanning Llama 2 7B through recent thinking models (DeepCogito v2, Gemini 3 Pro) processed reports using identical zero-shot prompts. Performance was measured with unweighted Cohen’s κ. Two LLMs met both pre-specified non-inferiority criteria ([Formula: see text] margin and entire 95% CI within the human inter-rater agreement band, [Formula: see text]-0.956): Claude 4.6 Opus ([Formula: see text], 95% CI 0.817-0.889) and the open-weight Gemma 4 31B ([Formula: see text], 95% CI 0.810-0.882), which ranked second overall. Both met the criteria at the pre-specified [Formula: see text] margin; at [Formula: see text] no model qualified. On the reports originally dictated without a CAD-RADS statement (n=343), the top models reached [Formula: see text]. Performance declined with longer thinking chains (proxy for case complexity), but thinking-mode outperformed non-thinking mode on matched difficult reports. Gemma 4 31B remained non-inferior at 3-bit quantization and fits on a 24 GB consumer GPU. Current LLMs extract the CAD-RADS stenosis severity category from unstructured CCTA reports with agreement approaching the human inter-rater band, without task-specific training. Our data shows the remarkable rise of open models. A 31B open-weight model matched top proprietary systems and runs on consumer GPUs, enabling privacy-preserving local deployment for clinical data mining.

PMID:42530821 | DOI:10.1007/s10554-026-03785-8

Updates Surg. 2026 Jul 30. doi: 10.1007/s13304-026-02787-4. Online ahead of print.

NO ABSTRACT

PMID:42530818 | DOI:10.1007/s13304-026-02787-4

J Racial Ethn Health Disparities. 2026 Jul 30. doi: 10.1007/s40615-026-03120-w. Online ahead of print.

ABSTRACT

Racial inequities related to COVID-19 exposure, morbidity, mortality, and access to care in the United States (U.S.) are notable, and COVID-19 vaccine uptake is lower among Black Americans than White Americans. Yet, mechanisms linking healthcare experiences to COVID-19 vaccination behavior among young adults are not well characterized. We analyzed cross-sectional data collected between March and June 2023 from 360 Black young adults (ages 18-29) enrolled in a digital health trial in Georgia, Alabama, and North Carolina (NCT05490329). Discrimination in medical settings and group-based medical mistrust were assessed. COVID-19 vaccination was measured as ever receiving at least one dose. Correlations and a mediation model (PROCESS Model 4; 5,000 bootstrap resamples) tested whether medical mistrust statistically mediated the association between discrimination in medical settings and COVID-19 vaccination, adjusting for age, sex at birth, state, insurance, education, and perceived COVID-19 risk. In mediation analyses, discrimination in medical settings had a significant total effect on COVID-19 vaccination (B=-0.44, SE=0.13, p<.001) and was associated with higher mistrust (B=0.42, SE=0.04, p<.001); higher medical mistrust was associated with lower likelihood of COVID-19 vaccination (B=-0.65, SE=0.24, p=.006). The indirect effect was significant (B=-0.28, SE=0.12, 95% CI [-0.557, – 0.081]). Findings suggest that discriminatory healthcare encounters may reduce COVID-19 vaccination uptake partly through elevated medical mistrust, highlighting the need for trust-building, non-stigmatizing strategies to improve vaccination among Black young adults in the U.S. South.

PMID:42530812 | DOI:10.1007/s40615-026-03120-w

Geroscience. 2026 Jul 30. doi: 10.1007/s11357-026-02399-1. Online ahead of print.

ABSTRACT

Declines in nicotinamide adenine dinucleotide (NAD+) are linked to metabolic stress accompanying aging and disease. While precursor-based approaches elevate systemic NAD, their clinical translation can be constrained by biosynthetic bottlenecks and first-pass metabolism. RENEWAL-NAD+ (ClinicalTrials.gov NCT07336836; retrospectively registered 01/04/2026) was a double-blind, randomized, placebo-controlled Phase 0/1b trial in healthy adults aged 45-75 years (60 randomized; primary analysis n = 50) evaluating 5 days of oral LathMized® NAD+ (LNAD+), a physicochemically modulated formulation that alters the supramolecular organization and solution behavior of NAD+ while preserving its native molecular structure. The primary endpoints were change in intracellular NAD (icNAD), measured in whole blood, and circulating NAD (cirNAD), measured in separated plasma, relative to baseline. LNAD+ produced a rapid and pronounced increase in icNAD, with a 53% elevation versus placebo at Day 6 (p = 5.48e^-14; Hedges’ g = 3.66), while cirNAD was unchanged (p = 0.60), demonstrating compartment-selective augmentation. Plasma NAD catabolites increased substantially (1-methyl-nicotinamide, MeNAM p = 5.39e^-13; N1-methyl-2-pyridone-5-carboxamide, 2PY p = 2.95e^-16), consistent with downstream engagement of NAD metabolic flux. Exploratory analyses identified non-overlapping correlates for the two compartments (cirNAD tracking inflammatory and metabolic markers, icNAD tracking red blood cell indices and NAM). Treatment was very well tolerated: symptom incidence was comparable between groups (p = 0.68), only one mild adverse event (nausea, Grade 1) occurred in the LNAD+ arm, and no secondary clinical, vital-sign, wellbeing, or wearable-derived endpoint survived multiplicity correction. These data demonstrate rapid intracellular NAD augmentation after oral LNAD+ dosing with pharmacodynamic evidence of downstream metabolism, compartment-specific physiological signatures, and a favorable short-term safety profile, with exploratory multi-omic analyses ongoing.

PMID:42530810 | DOI:10.1007/s11357-026-02399-1

Eur Arch Paediatr Dent. 2026 Jul 30. doi: 10.1007/s40368-026-01254-3. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate and compare the 12-month clinical and radiographic success of partial pulpotomy in primary molars using three bioactive materials-MTA, Biodentine, and TheraCal PT-and to assess the influence of final restoration type on treatment outcomes.

METHODS: This randomised controlled trial was conducted in a university postgraduate dental clinic setting and included 120 children aged 4-7 years with cariously exposed, restorable primary molars diagnosed with reversible pulpitis. Teeth were randomised to one of three pulp-capping materials (MTA, Biodentine, or TheraCal PT) and restored with either a preformed metal crown (PMC) or glass ionomer cement (GIC), forming six subgroups. Clinical and radiographic outcomes were assessed at regular intervals using modified Zurn and Seale criteria. Outcome assessment was performed by two blinded evaluators. Cox regression analysis and Kaplan-Meier survival curve were used.

RESULTS: A total of 120 participants (20 per subgroup) were included in the intention-to-treat analysis. No statistically significant differences were observed amongst the groups (p > 0.05). Overall success rates across the six subgroups ranged from 65 to 90% at 12 months. Cox regression showed no significant effect of capping material (Biodentine: HR = 1.06; TheraCal PT: HR = 1.75; overall p > 0.05) or restoration type (GI vs PMC: HR = 1.79; 95% CI 0.82-3.92; p = 0.145) on treatment survival. No material-related adverse events were reported.

CONCLUSIONS: Partial pulpotomy using MTA, Biodentine, or TheraCal PT demonstrated comparable clinical and radiographic outcomes at 12 months. No statistically significant differences were observed between the evaluated materials or final restoration types.

CLINICAL REGISTRY: ClinicalTrials.gov, NCT06227390, submission date: 22 December 2023.

PMID:42530796 | DOI:10.1007/s40368-026-01254-3