Tag: statistics

IEEE Trans Neural Syst Rehabil Eng. 2026 Jun 5;PP. doi: 10.1109/TNSRE.2026.3700284. Online ahead of print.

ABSTRACT

Cochlear implants (CIs) restore hearing in individuals with severe sensorineural hearing loss. In recent years, electrically evoked auditory steady-state responses (EASSRs) to amplitude modulated (AM) signals have been studied as an objective measure. EASSRs can be objectively detected in electroencephalography (EEG) recordings at the modulation frequency using statistical tests. However, the presence of electrical stimulation artifacts from the CI itself hinders the EASSR detection. Whereas previous research has focused on an experimental characterization of these artifacts, this study presents a theoretical analysis of the stimulation signal together with an experimental analysis of the resulting artifacts to characterize their properties, origins and the effects of system nonlinearities.

METHODS: A stimulation signal model is presented and analyzed. The effects of pulse asymmetry and nonlinearity are examined. The theoretical statements are experimentally validated using an experimental setup containing a head phantom.

RESULTS: The analysis shows that the stimulation artifact at the modulation frequency is inherent to the stimulation signal, even in the absence of system nonlinearities. Moreover, when the pulse asymmetry is taken into account, second and higher order polynomial nonlinearities are found to contribute negligibly to the spectral component at the modulation frequency.

SIGNIFICANCE: The experimental analyses indicate the proposed signal model is a more accurate model for the stimulation signal and the resulting stimulation artifact at the modulation frequency. The model may form an important step in determining artifact contamination in EEG recordings of EASSRs and other envelope-following responses in CI recipients, enabling improved response detection.

PMID:42247548 | DOI:10.1109/TNSRE.2026.3700284

IEEE Trans Biomed Eng. 2026 Jun 5;PP. doi: 10.1109/TBME.2026.3700464. Online ahead of print.

ABSTRACT

OBJECTIVE: Patient-specific instrumentation (PSI) and robotic systems are being developed to improve Total Knee Arthroplasty outcomes in severe knee osteoarthritis. In image-based solutions, preoperative CT scans provide accurate bone geometry for planning, but not cartilage, which can affect intraoperative registration, thus surgical accuracy, if not addressed properly. Solutions exist, such as bone probing through cartilage, but they require additional surgical steps. As an alternative, Statistical Shape Models (SSMs) can automatically predict cartilage from bone shape. The present study evaluates whether SSMs can capture pathological variability, which features complex patterns of cartilage loss and bone deformation.

METHODS: Segmentations from the OAI-ZIB database were classified into healthy and pathological groups based on joint space narrowing. Coupled bone-cartilage SSMs were trained separately on these groups, for femur and tibia. The performance of the SSM was assessed by comparing bone fitting and cartilage prediction accuracy.

RESULTS: Bone fitting errors (median 0.27-0.32 mm) and cartilage prediction errors (median 0.41-0.49 mm, RMSE 0.66-0.79 mm) were comparable to the literature, with cartilage errors close to the inter-observer MRI manual segmentation variability reported for similar datasets. Predictive performance was similar for healthy and pathological cases, suggesting that SSMs can capture pathological variability. However, osteophytes were not fully captured, locally affecting prediction accuracy.

CONCLUSION: The four coupled SSMs accurately reconstructed bone and predicted cartilage in both healthy and arthritic knees, suggesting robustness to pathological variability and suitability for clinical integration.

SIGNIFICANCE: The proposed method could be integrated into CT-based PSI or robotic workflows without requiring MRI or additional steps.

PMID:42247542 | DOI:10.1109/TBME.2026.3700464

PLoS One. 2026 Jun 5;21(6):e0333572. doi: 10.1371/journal.pone.0333572. eCollection 2026.

ABSTRACT

Microplastics (MPs) in soils are becoming increasingly recognised as important terrestrial contaminants, yet their vertical distribution below the plough layer remains poorly understood. Here, we examined 76 genetic soil horizons from 27 profiles along four transects spanning managed and unmanaged land uses in Fars Province, southwest Iran, to depths of up to 140 cm. A total of 392 MPs were recovered from 71 of 76 samples, comprising 342 fibres (87.2%), 48 fragments or films and two spherules, with concentrations reaching about 320 particles kg-1 of dry soil. Raman analysis of 98 representative particles showed a dominance of polyamides, polyesters and polyolefins. MP abundance, size and polymer type were heterogeneous among sites and horizons, and only a few statistically significant relationships with soil properties were observed (notably inverse relationships with sand at Darab and silt at Sarvestan). MPs occurred throughout the profiles, including the deepest horizons, with no consistent size- or polymer-related fractionation with depth. These observations indicate sustained MP accumulation in soils and suggest that downward transport can occur under arid to semi-humid conditions through percolation, drying-cracking of the substrate and bioturbation. Because strong local point sources were not evident at most sites and fibres dominated the assemblage, atmospheric deposition is considered a major contributor at the soil surface, although additional source-specific data are needed to confirm this inference. The persistence and vertical mobility of MPs in Fars soils indicate potential risks to subterranean ecosystems and groundwater quality.

PMID:42247464 | DOI:10.1371/journal.pone.0333572

PLoS One. 2026 Jun 5;21(6):e0342982. doi: 10.1371/journal.pone.0342982. eCollection 2026.

ABSTRACT

BACKGROUND: During emergencies and crises, comprehending the influence of various factors on the health-related quality of life (HRQoL) of older adults is crucial for enhancing it. This study aimed to investigate the mediating role of resilience in the relationship between social support and health related quality of life.

METHODS: In this descriptive-analytical cross-sectional study, 341 older adults over 60 years participated, in 2023. Vaux’s social support questionnaire, SF-36 health-related quality of life questionnaire, and Conner and Davidson’s resilience questionnaire were used. Structural equation modeling (SEM) was used to determine the role of resilience as a mediator between social support and HRQoL. Statistical analysis of data was performed using STATA 14.2 software.

RESULTS: Based on the results, a one-unit increase in social support is associated with a 0.44-unit increase in resilience (β = 0.44) and a 0.24- unit increase in HRQoL (β = 0.24) on average. Furthermore, considering the mediating role of resilience, a one-unit increase in social support contributes 0.097- units directly (β = 0.097) and 0.12- units indirectly (β = 0.12) to HRQoL on average. The total effect of social support on HRQoL was also significant (β = 0.22).

CONCLUSION: Considering the mediating role of resilience in the relationship between social support and HRQoL among older people during the Covid-19 pandemic and the possibility of emergencies and pandemics in the future, it is necessary to carry out interventions focusing on improving resilience skills to make social support more effective in the elderly and to improve the quality of life related to health.

PMID:42247444 | DOI:10.1371/journal.pone.0342982

PLoS One. 2026 Jun 5;21(6):e0340749. doi: 10.1371/journal.pone.0340749. eCollection 2026.

ABSTRACT

BACKGROUND: Cutaneous melanoma incidence is rising globally, yet clinicopathological data from the high ultraviolet (UV) environment in the United Arab Emirates (UAE), with its diverse expatriate population, remain scarce. This study aims to characterize the histopathological features of cutaneous melanoma in a large, multi-ethnic cohort in the UAE.

METHODS: This retrospective cross-sectional study analyzed histopathologically confirmed cases of cutaneous melanoma diagnosed at a specialized dermatopathology laboratory in the UAE from 01/01/2017-01/01/2025. Patient demographics, tumor location, histologic subtype, Clark level, Breslow thickness, mitosis, lymphovascular, and perineural invasion were extracted and analyzed. Descriptive statistics, group comparisons, and multivariable logistic regression were performed using IBM SPSS version 29.0 to identify predictors of thick melanoma (Breslow thickness >1.0 mm).

RESULTS: A total of 597 patients met the inclusion criteria (50.8% male; mean age 47.4 ± 12.3 years). Individuals of European ancestry constituted 73.4% of cases. Superficial spreading melanoma was the predominant subtype (58.5%), and 46.9% of melanomas were thin (≤1.0 mm). Males presented with significantly thicker tumors than females (Breslow thickness of 0.72 ± 1.32 vs. 0.50 ± 0.58 mm; p < 0.01) and exhibited distinct anatomical distributions predominant to the trunk as compared to females with leg predominance. Multivariable analysis confirmed nodular melanoma (OR 18.40; 95% CI [7.08, 47.86]; p < 0.001) as the single strongest independent predictor of thick melanoma.

CONCLUSION: Melanoma in the UAE disproportionately affects fair-skinned expatriates and frequently presents with sex-specific clinical patterns. These findings highlight the need for targeted public awareness initiatives to reduce melanoma morbidity and mortality in the region.

PMID:42247436 | DOI:10.1371/journal.pone.0340749

PLOS Glob Public Health. 2026 Jun 5;6(6):e0006553. doi: 10.1371/journal.pgph.0006553. eCollection 2026.

ABSTRACT

Postpartum depression (PPD) harms maternal and child health. Evidence showed elevated PPD during the COVID-19 pandemic, but post-pandemic data from low-resource urban settings are limited. We measured PPD prevalence and its correlates among mothers attending postnatal clinics in Bole sub-city, Addis Ababa, Ethiopia, during the post-COVID-19 period (data collection: 1 March-30 April 2024). An institution-based cross-sectional study enrolled 410 mothers who delivered 2 weeks-1 year prior, attending five primary health centres. Participants were selected using systematic random sampling, with proportional allocation based on client flow across five primary health centers. Depressive symptoms were screened with the Edinburgh Postnatal Depression Scale (EPDS); a cutoff ≥11 defined probable PPD. Data were entered in EpiData and analysed in SPSS. Bivariate analyses (p < 0.25) identified candidates for multivariable logistic regression; adjusted odds ratios (AOR) with 95% confidence intervals (CI) and p < 0.05 indicated statistical significance. A total of 410 mothers participated (mean age 28.8 ± 4.7 years). The prevalence of postpartum depression (PPD) was 20.0% (82/410; 95% CI: 16.4-24.1%). In multivariable logistic regression analysis, primiparity (AOR = 7.83; 95% CI: 1.29-47.71), unplanned pregnancy (AOR = 2.49; 95% CI: 1.25-4.95), poor partner support (AOR = 13.23; 95% CI: 3.08-56.94), low social support (AOR = 3.31; 95% CI: 1.13-9.74), and induction of labor (AOR = 2.73; 95% CI: 1.13-6.60) were independently associated with higher odds of postpartum depression. One in five mothers screened positive for PPD in this post-COVID-19 urban primary-care sample. First-time mothers and those with limited partner or social support, unplanned pregnancies, or induction of labour are at elevated risk. Integrating routine PPD screening into postnatal care, strengthening partner- and community-based support, and expanding family-planning and counselling services are priority measures to reduce PPD burden in Addis Ababa and similar settings.

PMID:42247429 | DOI:10.1371/journal.pgph.0006553

PLoS One. 2026 Jun 5;21(6):e0351214. doi: 10.1371/journal.pone.0351214. eCollection 2026.

ABSTRACT

Airway foreign-body aspiration in adults is uncommon but can be life-threatening.Flexible bronchoscopy is the standard first-line therapy,but critically ill patients may need extracorporeal life support.This study aims to characterize the diagnosis,management,and outcomes of adult airway foreign-body cases treated at a single center over nearly 12 years to inform a standardized clinical pathway.A single-center retrospective observational study of consecutive patients aged ≥14 years with confirmed airway foreign body who were treated at a tertiary hospital in China were conducted.Medical records of consecutive adolescent and adult patients diagnosed with airway foreign-body aspiration and admitted to the hospital from 01/01/ 2014-30/11/2025 were reviewed.Data included demographics,imaging,extraction method, respiratory support and so on.Descriptive statistics were reported as medians with interquartile ranges or counts and percentages.A total of 41 patients were included,with a median age of 59.5 years(interquartile ranges 51-72) and 65.85% male.Flexible bronchoscopy was attempted as the primary intervention in 38 patients(92.68%) and succeeded in 81.58%(31/38) to remove airway foreign body.Most patients(78.05%) required only nasal cannula oxygen,while nine patients(21.95%) needed advanced support including mechanical ventilation (14.63%),high-flow oxygen(4.88%),and extracorporeal life support (2.44%).At discharge,most survivors had a good neurological outcome,with 36 patients(87.80%) having a Cerebral Performance Categories score of 1.The 28-day survival rate was 92.68%.These findings show that flexible bronchoscopy is an effective first-line therapy,and rigid bronchoscopy or surgery is useful when flexible bronchoscopy fails.In unstable cases,timely extracorporeal life support can bridge to definitive removal.These results support a tiered,multidisciplinary approach incorporating early chest computed tomography,flexible bronchoscopy,and escalation to advanced airway or extracorporeal support.

PMID:42247425 | DOI:10.1371/journal.pone.0351214

Am J Speech Lang Pathol. 2026 Jun 5:1-12. doi: 10.1044/2026_AJSLP-25-00622. Online ahead of print.

ABSTRACT

PURPOSE: Nasopharyngoscopy is an imaging method used to visualize the velopharyngeal mechanism. To quantify the movement of the mechanism during speech, an international working group recommended standardized rating guidelines. While these guidelines are widely cited in research, the extent to which cleft teams apply them in a clinical setting is unclear.

METHOD: This cross-sectional study examined clinical nasopharyngoscopy reports from 11 cleft teams in North America. Descriptive statistics were used to summarize the proportion of reports that included ratings for the extent of velar movement, left and right lateral pharyngeal wall movement, gap size, and a surgical recommendation. Fisher’s exact and chi-square tests were used to assess differences in reporting by cleft team and whether the inclusion of quantitative ratings was associated with a surgical recommendation being included.

RESULTS: A total of 188 nasopharyngoscopy reports were included. The extent of velar movement was reported in 68% (n = 127) of reports, the left and right lateral pharyngeal wall movement was reported in 38% (n = 71), and the size of the gap was reported in 70% (n = 132). Only 34% (n = 63) of reports included all three quantitative ratings. Inclusion of all three quantitative ratings varied significantly (p < .001) across teams. Teams either never included all the ratings (n = 4/11) or inconsistently included all ratings (n = 7/11).

CONCLUSIONS: Findings suggest that what is documented clinically in nasopharyngoscopy reports varies both within and across teams. To achieve more consistent reporting within individual teams, providers may consider implementing standardized clinical templates. To achieve consistency across teams, these findings suggest a need for renewed efforts at developing consensus on the nasopharyngoscopy elements important to clinicians.

PMID:42247245 | DOI:10.1044/2026_AJSLP-25-00622

Anal Chem. 2026 Jun 5. doi: 10.1021/acs.analchem.6c01767. Online ahead of print.

ABSTRACT

Ulcerative colitis is a chronic inflammatory condition of the gastrointestinal tract with a rising global prevalence that underscores the urgent need for noninvasive approaches to monitor disease progression and treatment response. Recent evidence links metabolic alterations in colitis to disease severity, suggesting that metabolic profiling is a promising biomarker strategy. Here, we employed Raman spectroscopy (RS) as a sensitive, label-free approach to profiling serum and tissue metabolomes in murine and canine models of colitis. We identified 16 statistically significant metabolites in the murine sera that distinguished healthy from colitis mice with an area under the curve receiver operating characteristic (AUC-ROC) value of 0.98. Both serum and tissue metabolites showed moderate to strong correlations with proinflammatory cytokines, disease activity index, bodyweight, and histology scores of colon. This approach was extended to canine sera, differentiating colitic dogs treated with a synbiotic-IgY supplement from placebo controls with an AUC of 0.81, highlighting Raman features broadly associated with sugars and amino acids as key discriminative metabolites. Our analysis revealed that metabolic changes in placebo-treated dogs were diet-driven, whereas synbiotic supplementation modulated lipid and fatty acid profiles associated with the gut microbiota activity. Proteomic analysis validated RS findings and showed significant alterations in pathways associated with lipid transport and also demonstrated that synbiotic supplementation reduced inflammatory pathways while promoting extracellular matrix remodeling and gut healing. Collectively, these results indicate that metabolic profiling offers an impactful strategy for the diagnosis of UC and prediction of therapeutic response, laying the groundwork for personalized medicine in inflammatory diseases.

PMID:42247239 | DOI:10.1021/acs.analchem.6c01767

JAMA Health Forum. 2026 Jun 1;7(6):e261295. doi: 10.1001/jamahealthforum.2026.1295.

ABSTRACT

IMPORTANCE: Current pregnancy surveillance efforts in the US face substantial challenges in providing timely and accurate data on prenatal care use. Electronic health record (EHR) networks have the potential to enhance existing surveillance systems by providing near real-time, clinically documented data.

OBJECTIVE: To assess whether EHR network data could be used to define valid and reliable surveillance metrics of prenatal care use.

DESIGN, SETTING, AND PARTICIPANTS: This longitudinal cohort study included US adults (age ≥18 years) who received prenatal care and delivered a live birth from January 1, 2023, to December 31, 2024, at a facility that used the Epic Cosmos EHR network.

EXPOSURE: Live birth at a facility that used the selected EHR network.

MAIN OUTCOMES AND MEASURES: Prenatal care use was calculated as the proportions of patients who initiated care by the 13th week of pregnancy (early care) and who received adequate or better prenatal care (adequate care). Raking weights were applied to adjust the EHR sample to match the marginal distributions for US residents with live births by age, race and ethnicity, insurance, pregnancy risk factors, and geographic region. Electronic health records-based metrics were externally validated against published natality data estimates from National Center for Health Statistics (NCHS) using the two 1-sided test of equivalence. Patterns by demographics, state, and year were examined.

RESULTS: In total, 1 963 496 patients (mean [SD] age, 29.5 [5.7] years; 100% women) had a live birth and evidence of prenatal care at a facility using the selected EHR network during the study period. Compared with all US birthing people (n = 7 224 951), patients who gave birth at a facility using the selected EHR network had lower Medicaid coverage (40.5% vs 21.1%) and a higher prevalence of pregnancy risk factors (eg, prior preterm birth: 4.0% vs 8.8%). After weighting to the national population, EHR-based estimates of early care were consistently lower than those from NCHS data (68.0% [95% CI, 67.9%-68.2%] vs 76.1% [95% CI, 76.1%-76.1%]). However, adequacy estimates were equivalent to NCHS-based estimates (76.0% [95% CI, 75.9%-76.2%] vs 75.2% [95% CI, 75.1%-75.2%]; P < .001 at 0.01 equivalence bound), aligned with expected demographic patterns, and were stable across place and time.

CONCLUSIONS AND RELEVANCE: In this cohort study, EHR network data reliably informed surveillance of prenatal care adequacy after adjusting for nonrepresentativeness of the patient population. These findings suggest that near real-time availability of EHR data has the potential to improve the timeliness of population-level pregnancy surveillance to better inform policy, public health, and clinical efforts aimed at enhancing prenatal care access and use among individuals receiving inadequate care.

PMID:42247225 | DOI:10.1001/jamahealthforum.2026.1295