Category: Statistics

Laryngoscope. 2026 Feb 4. doi: 10.1002/lary.70405. Online ahead of print.

ABSTRACT

OBJECTIVE: There is no consensus on blood thinner management in the perioperative period for head and neck free flap reconstructions. This study evaluated head and neck free flap outcomes in patients on baseline blood thinners, aspirin flap prophylaxis, and deep venous thrombosis (DVT) prophylaxis regimens.

METHODS: Patients undergoing head and neck free flap reconstruction at a single tertiary, academic institution were included. Patients were grouped according to baseline blood thinners, aspirin flap prophylaxis, and DVT prophylaxis regimens. The primary outcome was overall complication rate, while secondary outcomes included flap compromise, flap failure, bleeding, venous thrombotic events, and arterial thrombotic events. Statistical analysis was performed with Fisher’s exact test and risk ratio (RR) regression analysis, using propensity score-adjusted models.

RESULTS: Of 470 patients, 16.6% experienced postoperative complications. Longer preoperative holds (odds ratio [OR] = 1.81, p = 0.04) and delayed resumption of baseline blood thinners (OR = 1.56, p = 0.04) were associated with increased complication risk, particularly flap compromise. Unfractionated heparin was associated with higher complication rates compared to sequential compression devices (RR = 3.10, p = 0.018) and low molecular weight heparin (RR = 2.79, p < 0.001) for DVT prophylaxis. No other perioperative blood thinner regimens were significantly associated with postoperative complications.

CONCLUSIONS: Most regimens, including baseline blood thinners, aspirin flap prophylaxis, and DVT prophylaxis, can be managed safely in the perioperative period. However, unfractionated heparin was associated with higher complication rates than other DVT prophylaxis regimens. While baseline blood thinners did not increase most complications, prolonged preoperative holding and delayed resumption may jeopardize flap viability-highlighting a modifiable point of intervention.

PMID:41636139 | DOI:10.1002/lary.70405

Lakartidningen. 2026 Feb 4;123:25052.

ABSTRACT

A high coverage rate of cervical cancer screening is necessary to prevent cervical cancer. Women who have not been tested in the last 10 years are considered as long-term non-attenders from the screening program. A recent report from the Regional Cancer Centers in Sweden addressed geographic disparities in the 10-year coverage rate among 33-62-year-old women residing in Sweden in 2023, and compared the results with those in a previous report from 2020. The analytic method employed is referred to as geomapping, based on geo-coded data to 5984 neighborhoods (Statistics Sweden’s Demographic Statistics Areas [DeSO]). Individual data on HPV/Pap testing in the previous 10-year period, age, and residential address (used for the geo-coding) were retrieved from the National Cervical Screening Registry. Neighborhood-level data on economic standard, proportion of non-Western immigrants, and geographic location (urban/semi-urban/rural) were assessed, based on data from Statistics Sweden, for estimation of neighborhood-level associations. The overall 10-year coverage rate decreased from 91.9% in 2020 to 91.1% in 2023. We identified 147 out of the 5984 neighborhoods as showing statistical evidence for a pronouncedly lower 10-year coverage rate than the overall average of 91.1 %. Furthermore, we found a decreasing 10-year coverage rate with lower economic standard, as well as with increasing proportion of non-Western immigrants. After adjustments for these two neighborhood-level covariates, we found that rural geographical location was associated with lower 10-year coverage rate. The results demonstrate that geomapping can provide a rational basis for targeting population-level interventions to improve screening. Specifically, it is rational to allocate extra resources, if available, towards the 147 identified neighborhoods with a pronouncedly lower 10-year coverage rate.

PMID:41636138

Hum Vaccin Immunother. 2026 Dec;22(1):2609345. doi: 10.1080/21645515.2025.2609345. Epub 2026 Feb 4.

ABSTRACT

Human papillomavirus (HPV) is a major global health concern due to its link to cervical and other cancers. Although HPV vaccination is highly effective, acceptance and willingness to pay (WTP) differ widely across populations. This review summarizes global evidence from 2015-2025. A systematic search of PubMed, Scopus, CENTRAL, Web of Science, and Google Scholar was conducted in 2025 following PRISMA guidelines. Studies reporting data on knowledge, acceptance, attitudes, and WTP across any population were included. Quality assessment used ISPOR checklists, and data were synthesized in Excel 2019. Thirty-five studies met inclusion criteria, with China and Nigeria contributing most. WTP ranged from 52.68% in lower-middle-income countries to 65.38% in low-income countries. Mean WTP was highest in upper-middle-income settings. Knowledge, positive attitudes, socioeconomic status, and trust increased WTP, while cost remained the primary barrier. Improving affordability, awareness, and policy support is essential to enhance global HPV.

PMID:41636135 | DOI:10.1080/21645515.2025.2609345

JBI Evid Synth. 2026 Feb 4. doi: 10.11124/JBIES-25-00177. Online ahead of print.

ABSTRACT

OBJECTIVE: This systematic review will examine the association between pesticide use and cancer incidence among farm workers.

INTRODUCTION: Farmers are the most essential part of many countries’ agriculture-based economies. Several studies have identified acute and chronic hazards associated with pesticide use, including lymphoma, leukemia, brain tumors and other cancers. However, no systematic reviews have comprehensively assessed the association between pesticide use and cancer incidence among farmers.

ELIGIBILITY CRITERIA: Primary observational studies (case-control, cohort, and cross-sectional) that include participants who are farm workers (farmers, their spouses, and seasonal workers) in any geographic location and that document exposure to pesticides associated with cancer incidence will be eligible for inclusion.

METHODS: Academic databases (PubMed, Web of Science Core Collection, Ovid Embase, Cochrane CENTRAL, and ProQuest Health and Medical Collection), non-academic databases (Google Scholar up to 20 pages), and other gray literature (OAIster, Shodhganga, and medRxiv) will be searched. Two reviewers will independently screen titles/abstracts and full texts, with adjudication by a third reviewer. Critical appraisal of the included studies will be performed using JBI checklists. Quantitative outcomes on the association of pesticide exposure and cancer incidence will be pooled in statistical meta-analysis, where possible. Heterogeneity between studies will be assessed statistically using standard χ2 and I2 tests. Where statistical pooling is not possible, the findings will be presented narratively. Certainty of the evidence regarding the carcinogenicity of pesticides will be assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.

REVIEW REGISTRATION: PROSPERO CRD420251019979.

PMID:41636132 | DOI:10.11124/JBIES-25-00177

J Basic Microbiol. 2026 Feb;66(2):e70148. doi: 10.1002/jobm.70148.

ABSTRACT

Cordycepin, a nucleoside analog derived from Cordyceps militaris, is a bioactive compound with potent pharmacological properties and growing relevance in functional food and pharmaceutical industries. However, its production is highly variable depending on cultivation conditions, making real-time and scalable prediction essential for efficient process control. This study aimed to develop a machine learning-based predictive model to estimate cordycepin content based on measurable cultivation parameters. Three machine learning algorithms-XGBoost, Random Forest, and Support Vector Machine-were trained using experimental data encompassing environmental and nutritional factors. Model validation was conducted using Tropsha’s statistical criteria, and model explainability was achieved through SHAP analysis. A user-friendly GUI was also developed for real-time prediction and application. Among the models, XGBoost demonstrated the highest performance with a cross-validated Q² of 0.9087 and an R² of 0.9544, satisfying all statistical requirements for reliability. SHAP analysis identified light wavelength and carbon/nitrogen ratio as the most influential factors in cordycepin biosynthesis. The developed GUI enables end-users to input cultivation conditions and receive immediate predictions, facilitating data-driven decision-making. This approach offers a scalable and interpretable framework for optimizing bioactive compound production in edible fungi, with potential application in smart bioprocessing and precision fermentation.

PMID:41636097 | DOI:10.1002/jobm.70148

Diagn Interv Radiol. 2026 Feb 4. doi: 10.4274/dir.2026.263679. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the feasibility and early postprocedural hemorrhage outcomes of absorbable gelatin sponge (AGS) torpedo tract closure and to briefly describe the tract-closure method used following portal vein recanalization in pediatric native-liver extrahepatic portal vein obstruction.

METHODS: We retrospectively reviewed the cases of 18 consecutive children [11 boys, 7 girls; median age, 7 years (range, 5-12)] treated between 2020 and 2025 who underwent transsplenic and/or trans-hepatic portal vein recanalization with planned tract embolization using AGS torpedoes. The access sheath sizes were 5F and 6F, and unfractionated heparin was administered intraprocedurally in all cases. Procedures with inadvertent sheath dislodgment before embolization or intraprocedural wire perforation were excluded. The primary outcome was clinically significant access-tract hemorrhage within 24 hours, defined as a hemoglobin decrease > 2 g/dL together with an interval increase in intraperitoneal free fluid on ultrasound. Descriptive statistics were used; technical outcomes were summarized per tract and safety outcomes per patient.

RESULTS: Eighteen patients underwent embolization of 28 access tracts (13 transsplenic and 15 trans-hepatic). The median number of torpedoes used per tract was three (range, 2-4). All access tracts were successfully embolized with AGS torpedoes (28/28, 100%). No clinically significant access-tract hemorrhage occurred at either the patient (0/18) or tract level (0/28) within 24 hours after AGS embolization. Small perisplenic or perihepatic fluid collections were observed in 16 (88.9%) patients immediately after the procedure without an interval increase on follow-up ultrasound within 24 hours following the intervention.

CONCLUSION: AGS torpedo tract closure appears feasible and effective in preventing clinically significant access- tract hemorrhage after pediatric portal vein recanalization, including cases requiring dual access with introducer sheaths of up to 6F and intraprocedural anticoagulation. Prospective, large, multicenter studies using standardized hemostasis endpoints are needed to validate these preliminary findings.

CLINICAL SIGNIFICANCE: A readily available, absorbable material deployed as torpedoes can achieve controlled, layered parenchymal sealing in pediatric portal venous interventions.

PMID:41636081 | DOI:10.4274/dir.2026.263679

Hip Int. 2026 Feb 4:11207000251405200. doi: 10.1177/11207000251405200. Online ahead of print.

ABSTRACT

AIMS: This retrospective multicentre study, involving 38 UK hospital trusts, aimed to characterise the demographic features, inpatient management, and referral patterns of patients with prosthetic hip dislocations. The primary focus was to identify factors influencing a definitive management plan following acute total hip arthroplasty (THA) dislocation, and to assess differences in the management of primary versus revision THA dislocations.

METHODS: Data from 645 patients who sustained acute prosthetic hip dislocations between 01 January 2019 and 31 July 2019, were collected from electronic medical records. Patients were divided into Primary and Revision THA groups. Statistical analyses were used to explore demographic patterns, comparative analyses, and factors influencing referral decisions, with significance set at p < 0.05.

RESULTS: The mean age of patients was 76.2 years, with a predominance of females (65.7%) and posterior dislocations (72.7%). Of the patients, 37.8% underwent reduction in the Emergency Department (ED), with a success rate of 69.7%, while 72.9% required reduction in theatre, achieving a success rate of 90.6%. Inpatient mortality was 1.2%. Only 32.5% of patients had a definitive management plan following their dislocation. Primary THA patients (n = 504) were predominantly female (69.6%) compared to Revision THA patients (n = 141, 48.9%, p < 0.001). Anterior dislocations were more common in the Revision THA group (26.2% vs. 17.3%, p = 0.017). The primary THA group had a higher success rate in closed reduction (92.9% vs. 82.9%, p = 0.002). Revision THA patients were more likely to have a definitive management plan (52.9% vs. 26.9%, p < 0.001).

CONCLUSIONS: This study highlights significant variability in the management of THA dislocations, particularly in the lack of standardised protocols for inpatient management and onward referral to revision arthroplasty surgeons. Standardisation of care pathways is needed to optimise outcomes for patients with prosthetic hip dislocations.

PMID:41636051 | DOI:10.1177/11207000251405200

Hip Int. 2026 Feb 4:11207000251409092. doi: 10.1177/11207000251409092. Online ahead of print.

ABSTRACT

BACKGROUND: The optimal threshold to blood transfusion in patients after hip fracture surgery is unclear. This study leveraged regression discontinuity to quantify blood transfusion practices across haemoglobin thresholds of 7.0, 8.0, and 10.0 g/dL.

METHODS: This study used the enhanced claims-based Premier Inc. database and included inpatients, aged 50+, with an ICD-10 code for hip fracture and hip surgery, and at least one haemoglobin following surgery. For each patient-day following surgery, we determined the lowest haemoglobin level and whether blood transfusion was administered. Regression discontinuity (RD) models with local linear regression were used to calculate risk differences, mean differences, and 95% confidence intervals (CIs) for blood transfusion use.

RESULTS: There were 320,194 patient-days (among 93,111 patients) included in analyses. Transfusion occurred on 29,425 patient-days (9.2%). The median haemoglobin on patient-days with a transfusion was 7.0 (interquartile range [IQR] 6.7-7.6) g/dL and the median haemoglobin on patient-days without a transfusion was 9.3 (IQR 8.4-10.4) g/dL. There was a statistically significant increase in transfusion use crossing a haemoglobin threshold of 7.0 g/dL (19.0; 95% CI, 13.5-22.5 absolute percentage points) and a small, statistically significant increase in transfusion use crossing an 8.0 g/dL haemoglobin threshold. (3.2; 95% CI, 0.9-6.2 absolute percentage points). There was no discontinuity in transfusion use across a haemoglobin concentration threshold of 10.0 g/dL (-0.2; 95% CI -0.7-0.3 absolute percentage points).

CONCLUSIONS: After hip fracture surgery, transfusion based on a haemoglobin threshold of 7.0 g/dL was more common than at guideline recommended 8.0 g/dL or at the liberal threshold of 10 g/dL.

PMID:41636050 | DOI:10.1177/11207000251409092

Hip Int. 2026 Feb 4:11207000251415004. doi: 10.1177/11207000251415004. Online ahead of print.

ABSTRACT

INTRODUCTION: The functionality of the hip joint is primarily determined by the anatomical relationship between acetabulum and femur. Impairment of this relationship can lead to diseases such as femoroacetabular impingement and hip osteoarthritis. In patients undergoing total hip arthroplasty, accurate placement of the acetabular and femoral components in accordance with native 3-dimensional anatomy (3D) is crucial for obtaining prosthesis stability and survival, also for preventing postoperative complications such as wear, dislocation and osteolysis. Therefore, 3D determination of native anatomical features of the hip joint is highly important.

METHODS: A total of 100 adults were randomly selected. Right femur and acetabulum were segmented using MIMICS program. 2D and 3D measurements of femoral anteversion according to posterior condylar and transepicondylar axis, acetabular anteversion, acetabular inclination and combined anteversion were determined. The differences between gender groups and the correlations of two- and three-dimensional measurement results were evaluated.

RESULTS: According to 2D and 3D measurements, statistically significant differences were observed between gender groups in all parameters except for 2D acetabular inclination. A very strong correlation was observed between 3D femoral anteversion measurements performed using the posterior condylar axis and transepicondylar axis. Our findings revealed statistically significant differences between 2D and 3D measurements in most parameters, which have clinical relevance.

CONCLUSIONS: A very strong correlation between femoral anteversion measurements obtained using the transepicondylar and posterior condylar axes supports the intraoperative use of the transepicondylar axis reliably. We believe the data obtained from our study will contribute to understand the 3-dimensional native anatomy of the hip joint.

PMID:41636049 | DOI:10.1177/11207000251415004

Nanoscale. 2026 Feb 4. doi: 10.1039/d5nr05100b. Online ahead of print.

ABSTRACT

DNA damage repair is essential for maintaining genomic integrity, thereby preventing diseases like cancer. Traditionally, radioresistance has been linked to the ability of cells to repair DNA double-strand breaks (DSBs) accurately. Recent research emphasizes the critical role of spatial chromatin organization and its dynamic reorganization in regulating repair and gene expression. In this study, we have employed single-molecule localization microscopy (SMLM) and Python-based mathematical methods of statistics and topology to locally analyze the spatial organization of γH2AX and 53BP1 foci in ¹⁵N-ion irradiated normal human dermal fibroblasts (NHDF) and highly radioresistant U87 glioblastoma cells over extended post-irradiation (PI) periods with nanoscale resolution. Our findings reveal that U87 cancer cells fail to regulate chromatin changes at DSB sites during and after repair. Specifically, Ripley’s statistics and cluster analysis showed that both NHDF and U87 cells exhibit smaller, denser, and better separated γH2AX nano-foci surrounded by 53BP1 nano-foci. Mathematical topology approaches, including persistent homology, revealed that γH2AX nano-foci (clusters) have lower topological similarity compared to the more conserved 53BP1 nano-foci during the 24-hour repair period. These findings support the non-random, functional spatial organization of DSB repair (nano)foci and demonstrate its preservation in cancer cells. However, principal component analysis of persistent images showed that γH2AX- and 53BP1 nano-foci in normal fibroblasts exhibit stable, closed cycles, while U87 cells display chaotic, open shifts in topology in the 2D latent space. Combined with DSB repair kinetics measurements, this observation indicates that although U87 cells rejoin DSBs similar to normal cells, they experience more pronounced, dysregulated chromatin alterations during repair, ultimately failing to restore it to its pre-irradiation state. These alterations correlate with topologically more variable DSB sites, slower (more challenging) repair focus formation but faster repair once foci are established, compared to NHDF cells. More disorganized repair and persistent topological alterations likely contribute to genetic instability of cancer cells after irradiation and the development of radioresistant clones, posing challenges for effective radiotherapy.

PMID:41636021 | DOI:10.1039/d5nr05100b