PLoS One. 2026 Jun 22;21(6):e0351890. doi: 10.1371/journal.pone.0351890. eCollection 2026.
NO ABSTRACT
PMID:42330424 | DOI:10.1371/journal.pone.0351890
Tag: statistics
Rheumatology (Oxford). 2026 Jun 22:keag321. doi: 10.1093/rheumatology/keag321. Online ahead of print.
ABSTRACT
OBJECTIVES: Lymphoid interstitial pneumonia (LIP) is a rare form of Interstitial Lung Disease (ILD), often associated with Sjögren Disease (SjD). However, the clinical-serologic characteristics of SjD-LIP remain poorly characterized. Our objective was to describe the clinical course and outcome of SjD-associated LIP and to compare this subgroup with other SjD-ILD patterns.
METHODS: SjD patients with HRCT-confirmed ILD followed in Pisa Rheumatology Unit (January 2019-November 2024) were retrospectively enrolled. ILD patterns were classified through multidisciplinary discussion. Clinical and laboratory data were collected according to ESSDAI definitions, along with pulmonary symptoms and function tests (PFTs).
RESULTS: Fifty-five SjD-ILD patients were included (M: F = 9:46), of whom 11 were diagnosed with LIP (F: M = 11:0). LIP patients showed thin-walled parenchymal cysts as the predominant HRCT finding, and largely preserved pulmonary function (median FVC 101% [IQR 98-105]; DLCO 76% [IQR 75-81]). After a median 5-years follow-up (IQR 2-7) all LIP patients were alive with stable PFTs. Compared with the remaining 44 non-LIP, LIP patients were younger at SjD diagnosis (p<0.001) and more frequently presented purpura (p=0.012), constitutional symptoms (p=0.001), lymphadenopathy (p=0.023), hypergammaglobulinemia (p<0.001), triple anti-Ro60/52/La positivity (p=0.035) and C3 hypocomplementemia (p=0.009).ILD preceded SjD diagnosis in 30/44 non-LIP vs 1/11 LIP patients (p<0.001), with lower FVC% (p=0.049) and DLCO% (p=0.036) in non-LIP.
CONCLUSION: LIP defines a distinct, immunologically active phenotype within the spectrum of SjD-ILD, characterized by greater extrapulmonary systemic involvement and serologic markers of B cell hyperactivity, but limited pulmonary functional impact. These findings support long-term lymphoma surveillance and a potential role for B cell targeted therapies in selected patients.
PMID:42330423 | DOI:10.1093/rheumatology/keag321
Medicina (B Aires). 2026;86(3):575-584.
ABSTRACT
INTRODUCTION: Massive bone defects remain a significant challenge in limb reconstruction and salvage procedures. The aim of this study was to analyze the clinical outcomes and implant survival in a series of patients undergoing extensive femoral resections reconstructed with modular megaprosthesis.
MATERIALS AND METHODS: A retrospective case analysis was conducted including patients who underwent massive femoral bone resections, with a median age of 59 years (IQR 57-70) and a mean follow-up of 6.7 years (SD 4.9). Twenty-nine endoprostheses were used for oncologic resections and eleven for non-oncologic massive bone defects. Reconstructions included 21 proximal femurs, 17 distal femurs, one intercalary prosthesis, and one total femur replacement. Implant survival, complication rates and their management were analyzed. Functional outcomes were assessed using the Musculoskeletal Tumor Society (MSTS) scoring system.
RESULTS: Nineteen patients (47.5%) experienced complications: 9 in proximal femoral reconstructions and 7 in distal femoral cases. The most frequent complication was periprosthetic joint infection 20% (8), followed by prosthetic dislocation 15% (6), and aseptic loosening 10% (4). The MSTS improved from (11.8 ± 6.2) preoperatively to (17.3 ± 7.9) (p< 0.001). The incidence of death was higher in patients with an oncologic diagnosis compared to non-oncologic diagnosis. without reaching statistical significance.
CONCLUSION: Modular resection endoprostheses offer a versatile option for segmental bone reconstruction, providing acceptable mid-term functional outcomes. However, prosthetic instability, particularly in proximal femoral replacements and periprosthetic joint infection remains a frequent relevant complication.
PMID:42330373
Bioinformatics. 2026 Jun 22:btag432. doi: 10.1093/bioinformatics/btag432. Online ahead of print.
ABSTRACT
SUMMARY: We developed DirectASRM, a comprehensive database for the systematic identification, integration, and annotation of allele-specific RNA modifications (ASRMs) from direct RNA sequencing data. DirectASRM enables single-base, transcript-level detection of ASRMs across multiple RNA modification types, diverse organisms and condition-specific contexts. The database further evaluates the confidence of each ASRM-SNP pair association within isoform context by jointly considering statistical evidence of allelic modification imbalance and independent support from external next-generation sequencing (NGS) – based RNA modification resources. DirectASRM also provides extensive functional annotations for ASRMs and their associated variants, including intra-sample transcript-level allele-specific expression (ASE) and allele-specific splicing, as well as additional post-transcriptional regulatory features such as miRNA binding, circRNA, RNA-protein interactions, and disease relevance. Overall, DirectASRM serves as a comprehensive resource that supports systematic investigation of the potential functional impact of genetic variants in epitranscriptomic regulation.
AVAILABILITY AND IMPLEMENTATION: DirectASRM database is freely accessible at http://modinfor.com/DirectASRM/. DirectASRM pipeline is available at GitHub (https://github.com/jiayin1101/DirectASRM_pipeline) and Zenodo (DOI: https://doi.org/10.5281/zenodo.19876077).
SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.
PMID:42330361 | DOI:10.1093/bioinformatics/btag432
Adv Sci (Weinh). 2026 Jun 22:e76249. doi: 10.1002/advs.76249. Online ahead of print.
ABSTRACT
Phenolic photodissociation at the air-water interface proceeds orders of magnitude faster than in bulk water, yet the structural origins of this acceleration remain insufficiently understood. Here, we present a descriptor-level analysis supporting a dual-control picture, in which phase-dependent photodissociation reflects both πσ*-related dark-state accessibility and the local solvent’s capacity to accommodate transferred electron density. We construct a structure-resolved, statistics-driven framework that bypasses snapshot-level multireference conical-intersection searches by identifying solvent-side dark-state acceptor orbitals {σp*}, constructing their energy distribution ε(σp*), and linking it to local microenvironment descriptors that quantify coordination saturation and directional constraint. Truncated cluster models prove unreliable because boundary microstates dominate acceptor selection and mask the intrinsic interface-bulk contrast. Periodic slab models remove this bias: the interfacial ε(σp*) distribution is shifted lower by approximately 0.7 eV and substantially broadened relative to bulk, predominantly through within-motif energy-window shifts rather than differences in hydrogen-bond topology. Low-coordination, weakly constrained microenvironments correlate systematically with lower ε(σp*), and small-system SA-CASSCF diagnostics support the same trend direction. Together, these descriptor-level signatures indicate that the air-water interface favors both dark-state access and transferred-electron stabilization, providing transferable inputs for multiphase photochemical modeling and strategies for tuning interfacial reactivity through control of defect-rich microstate supply.
PMID:42330358 | DOI:10.1002/advs.76249
Br J Radiol. 2026 Jun 22:tqag153. doi: 10.1093/bjr/tqag153. Online ahead of print.
ABSTRACT
OBJECTIVES: To compare the diagnostic performance of Dual-Energy CT (DECT), Diffusion-Weighted MRI (DWI), and Chemical Shift MRI (CSI) in differentiating metastatic from non-metastatic cervical lymph nodes in patients with head and neck cancer, using histopathology as the reference standard.
METHODS: In this prospective cross-sectional study, 38 patients with suspected head and neck malignancy underwent DECT, DWI, and CSI prior to histopathological evaluation. A total of 194 lymph nodes were analysed. Quantitative parameters including DWI- apparent diffusion coefficient (ADC), DECT- normalised iodine concentration (NIC), spectral HU, electron density, effective atomic number and CSI in-out phase ratio were assessed. Diagnostic performance was evaluated using receiver operating characteristic (ROC) analysis, and comparison between modalities was performed using the DeLong test.
RESULTS: Of 194 lymph nodes, 71 were metastatic and 122 were non-metastatic. ADC values were significantly lower in metastatic nodes (p < 0.0001). Dual-energy CT parameters and chemical shift MRI did not show statistically significant differences. ROC analysis demonstrated superior diagnostic performance of ADC compared to other parameters.
CONCLUSION: DWI demonstrates superior diagnostic performance in differentiating metastatic cervical lymph nodes, while DECT and CSI show limited utility. Multiparametric MRI, particularly DWI, should be preferred for nodal characterization in head and neck cancer.
ADVANCES IN KNOWLEDGE: This study provides direct comparative evidence showing that ADC-based DWI is significantly superior to DECT quantitative parameters and CSI for nodal metastasis detection, supporting its role as the primary functional imaging tool.
PMID:42330356 | DOI:10.1093/bjr/tqag153
Rev Esc Enferm USP. 2026 Jun 22;60:e20250573. doi: 10.1590/1980-220X-REEUSP-2025-0573en. eCollection 2026.
ABSTRACT
OBJECTIVE: To assess the knowledge, attitudes, and practices of self-medication and factors associated with this behavior among students in the health field.
METHOD: A cross-sectional study conducted at a public university in Minas Gerais with 237 students. Data collection was carried out using a structured form to obtain sociodemographic variables and information on knowledge, attitudes, and practices regarding self-medication. Descriptive analysis and regression modeling were performed.
RESULTS: The majority (84.8%) reported practicing self-medication and demonstrated a high level of favorability for the behavior; 57.7% demonstrated adequate knowledge. Students in the early grades were more likely to have inadequate knowledge. Favorable attitudes were significantly associated with the 18-20 age group and low income. The highest rates of self-medication were statistically linked to young people and those who self-identified as Black.
CONCLUSION: The high incidence of self-medication and the false perception of technical autonomy highlight the medicalization of life as a response to academic pressures. The results demonstrated vulnerabilities associated with structural inequalities and reinforce the need for institutional interventions focused on medication safety.
PMID:42330354 | DOI:10.1590/1980-220X-REEUSP-2025-0573en
Eur Stroke J. 2026 Jun 2;11(6):aakag066. doi: 10.1093/esj/aakag066.
ABSTRACT
INTRODUCTION: Adverse non-motor outcomes dominate the lived reality of post-stroke recovery, yet remain poorly understood after intravenous thrombolysis (IVT), endovascular thrombectomy (EVT) or both. We characterised the prevalence of outcomes in 13 non-motor domains, stratified by mRS scores, and identified baseline factors associated with adverse outcomes at 6 months follow-up.
METHODS: We conducted a prospective observational sub-study within the Stroke Investigation Group in North and Central London (SIGNAL) registry to characterise non-motor outcomes after IVT, EVT or both. At 6 months, we assessed mRS alongside 13 patient-reported non-motor domains, including neuropsychiatric, fatigue, sleep, social participation, sensory, autonomic and cognitive outcomes. We used unadjusted analysis to estimate prevalence and adjusted multivariate logistic regression to investigate associated baseline factors.
RESULTS: We included 642/646 (99.3%) eligible surviving patients (median age 73 years; 43.5% female; median NIHSS = 5; mRS = 1) treated with IVT, EVT or both. At 6 months, the prevalence of adverse non-motor outcomes across 13 domains ranged from 18% to 56% across all treatment groups. Among patients with a favourable functional outcome (mRS 0-2, n = 409), fatigue (51.3%), sleep disturbance (47.6%) and mood problems (39.6%) were most prevalent. In those with an unfavourable outcome (mRS 3-5, n = 233), dependency in activities of daily living (51.0%), reduced social participation (44.3%) and bladder dysfunction (41.0%) were common. Stroke recurrence, female sex and baseline NIHSS > 5 were significantly associated with multiple adverse non-motor outcomes at 6 months.
CONCLUSION: Despite favourable mRS, a high proportion of patients treated with IVT and/or EVT report adverse non-motor outcomes. Systematic non-motor assessments alongside mRS are needed to accurately capture post-stroke symptom burden and guide person-centred life after stroke care.
PMID:42330319 | DOI:10.1093/esj/aakag066
JMIR Nurs. 2026 Jun 22;9:e82101. doi: 10.2196/82101.
ABSTRACT
BACKGROUND: The rapid advancement of digital technologies, combined with the evolving complexity of health care environments, has introduced a new paradigm in nursing practice. Clinical nurses are now required not only to deliver safe and effective patient care but also to demonstrate competencies in digital literacy and innovation. Among these emerging competencies, digital leadership has become a critical attribute-enabling nurses to lead digital transformation, ensure patient safety, enhance care quality, and support system-level change within health care organizations. Despite its increasing relevance, there is a notable absence of validated measurement tools tailored to assess digital leadership in clinical practice.
OBJECTIVE: This study aimed to develop and psychometrically validate a Digital Leadership Scale for Clinical Nurses (DLS-CN) to systematically evaluate the digital leadership capabilities of nurses working in clinical settings.
METHODS: The scale development process followed a rigorous multistep procedure. Initial items were derived from previous qualitative research involving a literature review and in-depth interviews, complemented by an additional literature review conducted in this study. The content validity of 38 preliminary items was evaluated by 9 experts over 2 rounds. A pilot test was conducted with 30 nurses, followed by cognitive interviews with 5 nurses to refine item clarity and relevance. The final set of items was administered to 446 clinical nurses across various health care institutions. Data were randomly split for exploratory factor analysis and confirmatory factor analysis. Additional analyses were conducted to evaluate item discrimination, convergent validity, and internal consistency using IBM SPSS 25.0 and AMOS 23.0.
RESULTS: The finalized DLS-CN consists of 29 items grouped under four domains: (1) ability to use digital technology, (2) digital safety management, (3) digital collaboration mindset, and (4) organizational influence. These 4 factors explained 56.9% of the total variance. The scale showed strong internal consistency (Cronbach α=0.95). Convergent validity was demonstrated through strong positive correlations with the Nursing Informatics Competency Scale (Pearson correlation coefficient r=0.82; P<.001) and the Self-Leadership Scale (Pearson correlation coefficient r=0.83; P<.001).
CONCLUSIONS: The DLS-CN is a valid and reliable instrument for measuring digital leadership among clinical nurses. It offers a practical tool for educators, administrators, and researchers to assess and enhance digital leadership capabilities-ultimately supporting the digital transformation of health care systems.
PMID:42330315 | DOI:10.2196/82101
Dis Esophagus. 2026 May 12;39(3):doag061. doi: 10.1093/dote/doag061.
ABSTRACT
Anastomotic leak is a serious complication following esophagectomy, contributing to substantial morbidity and mortality. Omental reinforcement of the esophagogastric anastomosis has been proposed as an adjunct to reduce the risk of leakage. This systematic review and meta-analysis evaluated the impact of omental reinforcement following esophagectomy. A PRISMA-guided search of PubMed, Embase, and Web of Science till December 2025 identified comparative studies evaluating esophagectomy with versus without omental reinforcement in adults. The primary outcome was anastomotic leak; secondary outcomes included severe leaks, stricture, and postoperative mortality. Random-effects meta-analysis was performed, with prespecified subgroup and sensitivity analyses. Certainty of evidence was assessed using GRADE. Nine comparative studies involving 2227 patients were included (1170 with reinforcement; 1057 controls), comprising four randomized trials and five observational cohorts. Omental reinforcement significantly reduced anastomotic leak (risk ratio [RR] 0.32, 95% CI 0.23-0.44; I2 = 0%), corresponding to Absolute Risk Reduction (ARR) 7.9% (95% CI 7.1-9.7%) and Number Needed to Treat (NNT) 13 (95% CI 11-15). The effect remained robust across randomized trials, cervical and intrathoracic anastomoses, and both open and minimally invasive/robotic approaches. Severe leaks requiring reoperation were also reduced (RR ≈ 0.22). Stricture formation (RR 0.78) and mortality (RR 0.71) favored reinforcement but were not statistically significant. Certainty of evidence for the primary outcome was moderate. Omental reinforcement substantially reduces the incidence and severity of anastomotic leak following esophagectomy, with consistent benefit across surgical approaches and anastomotic locations. Given its biological rationale, low cost, and favorable safety profile, omental reinforcement (omentoplasty) represents a valuable adjunct in esophagogastric reconstruction.
PMID:42330313 | DOI:10.1093/dote/doag061