Category: Statistics

Cureus. 2026 Jul 8;18(7):e112307. doi: 10.7759/cureus.112307. eCollection 2026 Jul.

ABSTRACT

INTRODUCTION: Short dental implants have been proposed as a minimally invasive alternative to standard implants for rehabilitation of posterior edentulous regions with limited bone availability. However, concerns remain regarding their long-term survival and risk of failure compared to standard-length implants. This study aimed to compare the survival and failure rates of short (<10 mm) and standard (≥10 mm) dental implants placed in the posterior maxilla and mandible.

MATERIALS AND METHODS: This retrospective cohort study included 207 patients who received 363 dental implants in the posterior jaw. The implants were categorized as short implants (<10 mm; n = 141) and standard implants (≥10 mm; n = 222). Demographic characteristics, implant-related variables, and clinical outcomes were retrieved from the patient records. Implant failure, survival rates, and the influence of jaw location on implant outcomes were assessed. Statistical analyses included chi-square test or Fisher’s exact test, independent-samples t-tests, and odds ratio calculations. Statistical significance was set at p < 0.05.

RESULTS: The mean age of the study population was 52.1 ± 10.5 years, with 142 (68.6%) males and 65 (31.4%) females. Overall, implant failure was significantly higher among short implants than among standard implants (p < 0.001). Standard implants demonstrated significantly lower odds of failure than short implants (OR = 0.29; 95% CI: 0.15-0.57). In the maxilla, the failure rates were 18 (28.6%) for short implants and 8 (8.5%) for standard implants (p = 0.002), whereas in the mandible, the corresponding rates were 10 (12.8%) and 7 (5.5%), respectively (p = 0.110). The cumulative survival rates were lower for short implants as compared to standard implants.

CONCLUSION: Standard dental implants demonstrated significantly higher survival rates and lower failure rates than short implants in posterior jaw rehabilitation. Although short implants remain a useful treatment option in anatomically restricted sites, careful case selection is necessary, particularly in the posterior maxilla, where the risk of failure appears to be greater.

PMID:42571603 | PMC:PMC13452643 | DOI:10.7759/cureus.112307

PeerJ. 2026 Aug 5;14:e21593. doi: 10.7717/peerj.21593. eCollection 2026.

ABSTRACT

BACKGROUND: Traumatic brain injury (TBI) frequently results in persistent emotional and cognitive dysfunction, yet the neural mechanisms underlying these deficits remain incompletely understood. This study examined the impact of non-severe TBI (nTBI) on emotional processing, with a focus on brain activation, functional connectivity, effective connectivity, and their relationship to cognitive performance.

METHODS: Twenty right-handed male nTBI participants (mean age: 30.70 ± 11.78 years) and 20 age-matched healthy male controls (mean age: 27.85 ± 7.73 years) underwent functional magnetic resonance imaging (fMRI) while viewing emotional images from the International Affective Picture System (IAPS). Brain activation was analyzed using Statistical Parametric Mapping (SPM12). Functional connectivity was assessed with seed-based analysis (medial visual network, mVN) using the CONN toolbox. Effective connectivity was evaluated using dynamic causal modeling (DCM) and parametric empirical Bayes (PEB). Neuropsychological assessments covering memory, intelligence, and executive function were included to characterize general cognitive function within the cohort, with exploratory analyses examining relationships with connectivity measures.

RESULTS: Compared to controls, the nTBI group exhibited reduced activation in the calcarine cortex and lingual gyrus during emotional processing. Functional connectivity analysis showed decreased mVN connectivity with the frontal pole and dorsal anterior cingulate cortex (dACC), with increased mVN-ACC and mVN-supramarginal gyrus connectivity specifically during negative emotion processing. Effective connectivity analysis revealed altered directional influences within visual-limbic-cognitive control networks, including altered mVN-to-dACC and right amygdala-to-dACC connectivity patterns, as well as valence-specific modulation of self-inhibition. Exploratory analyses suggested potential correlations between connectivity alterations and cognitive performance, though these relationships varied across domains and should be interpreted cautiously.

CONCLUSIONS: Non-severe TBI disrupts emotional network function by altering both functional and effective connectivity, particularly in visual, limbic, and cognitive control regions. These alterations may contribute to emotional dysregulation following injury. Findings support the relevance of brain connectivity-based markers in understanding post-TBI emotional processing and highlight potential targets for intervention. Interpretations should be made cautiously, given the study limitations, including the use of static visual stimuli and a homogenous male sample.

PMID:42571587 | PMC:PMC13452427 | DOI:10.7717/peerj.21593

Cureus. 2026 Jul 9;18(7):e112345. doi: 10.7759/cureus.112345. eCollection 2026 Jul.

ABSTRACT

Background Epilepsy, chronic monotherapy of antiseizure medications (ASMs), as well as the secondary disturbance of the thyroid axis, which includes both subclinical and clinical hypo- and hyperthyroidism, are crucial endocrine challenges during children’s development. In this study, the levels of thyroid hormones in children with epilepsy who underwent chronic monotherapy were compared with those of healthy children with no history of seizures and no experience with anticonvulsants. Moreover, in this study, the goal was to identify the actual rates, dynamics, and dose-dependence of thyroid dysfunction in the aforementioned study population. Methodology A prospective, observational, case-control study was conducted involving 150 patients with epilepsy on ASM treatment (cases) and 150 healthy control subjects who were matched for age and sex from a pediatric outpatient/inpatient department. The history, classification of seizures, and ASMs were documented. Serum thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4) were measured using the electro-chemiluminescent immunoassay test. Statistical analysis was performed using SPSS version 28 through one-way analysis of variance and paired Student’s t-test. Results Patients exhibited a significantly higher mean TSH level (3.82 ± 2.21 vs. 2.89 ± 1.12 mIU/L; p < 0.001) and a significantly lower mean fT4 level (1.28 ± 0.29 vs. 1.35 ± 0.31 ng/dL; p = 0.012), while fT3 characteristics did not change (p = 0.45). Analyses of subgroups revealed that atypical febrile seizures (4.56 ± 2.67 mIU/L) and generalized tonic-clonic seizures (4.12 ± 2.45 mIU/L) exhibited the most significant predisposition to extreme elevations in TSH levels (p = 0.004). Regarding treatment options, patients undergoing sodium valproate monotherapy presented the highest mean TSH levels (4.02 ± 2.11 mIU/L; p = 0.001), but levetiracetam appeared to be an effective thyroid-preserving choice and provided a more favorable fT4 profile (1.35 ± 0.33 ng/dL; p = 0.020). Regarding timing, the TSH peak occurred significantly between six and nine months of the drug administration period (4.35 ± 2.41 mIU/L; p = 0.024). In addition, a clear dose-dependent pattern was detected, with mean TSH levels rising progressively to a maximum of 5.20 ± 3.12 mIU/L within the highest 25-30 mg/kg dosing range (p = 0.008), representing a notable 31% endocrine elevation. Conclusions Children with epilepsy receiving maintenance therapies with sodium valproate or phenytoin have a considerable chance of suffering from subclinical hypothyroidism, which increases sharply between six and nine months of treatment at high doses. Thyroid function monitoring is strongly advised within the first year of treatment, along with dose adjustment and evaluation of thyroid-sparing drugs, such as levetiracetam.

PMID:42571574 | PMC:PMC13452441 | DOI:10.7759/cureus.112345

Cureus. 2026 Jul 9;18(7):e112357. doi: 10.7759/cureus.112357. eCollection 2026 Jul.

ABSTRACT

Left atrial appendage closure (LAAC) has emerged as a non-pharmacological alternative to oral anticoagulation for stroke prevention in atrial fibrillation (AF). While early randomized trials established non-inferiority of LAAC versus warfarin, the comparative effectiveness of LAAC against contemporary direct oral anticoagulants (DOACs) remains less well characterized. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing percutaneous LAAC with oral anticoagulation-either warfarin or DOACs-in adults with non-valvular AF. PubMed/MEDLINE, Embase, and CENTRAL were searched from inception through May 2026. The primary outcome was a composite of stroke, systemic embolism (SE), and cardiovascular death. The key secondary outcome was major bleeding. Five RCTs comprising 6,116 patients were included. Pooled analysis demonstrated no significant difference between LAAC and oral anticoagulation for the composite primary outcome (RR 0.90; 95% CI 0.71-1.14; I²=34%). LAAC was associated with a statistically significant 24% reduction in major bleeding events compared with anticoagulation (RR 0.76; 95% CI 0.61-0.94; I²=0%). Individual secondary outcomes, including cardiovascular death, stroke, and SE, were not significantly different between groups. Subgroup analysis by anticoagulant class suggested a larger composite efficacy benefit of LAAC over warfarin (RR 0.69) than over DOACs (RR 0.98), consistent with the established intracranial hemorrhage reduction conferred by DOACs relative to warfarin. In conclusion, LAAC achieves comparable thromboembolic protection to oral anticoagulation while significantly reducing major bleeding, supporting its role as a viable alternative in appropriately selected patients with AF, particularly those at elevated bleeding risk.

PMID:42571570 | PMC:PMC13452731 | DOI:10.7759/cureus.112357

Cureus. 2026 Jul 9;18(7):e112351. doi: 10.7759/cureus.112351. eCollection 2026 Jul.

ABSTRACT

INTRODUCTION: Necrotizing fasciitis (NF) is a rapidly progressive, life-threatening soft tissue infection characterized by necrosis of the fascia and subcutaneous tissues, with high rates of amputation and mortality. Early diagnosis and aggressive surgical intervention are critical determinants of outcome, yet data from eastern India remain scarce. This study aimed to describe the clinicopathological profile of NF and evaluate factors associated with poor outcomes in patients admitted to a tertiary care center in Jharkhand.

METHODS: This hospital-based observational study was conducted in the Department of General Surgery, Tata Main Hospital, Jamshedpur, from November 2020 to March 2022. One hundred consecutive patients diagnosed with NF were enrolled. Demographic data, clinical features, microbiological findings, and surgical management were recorded using a predesigned proforma. In-hospital mortality was used as the surrogate for poor outcomes. The chi-square test was used to assess associations between clinical variables and mortality, with p<0.05 considered statistically significant.

RESULTS: The mean age of participants was in the 41-60-year group, with a male preponderance (76%). Diabetes mellitus was the most common comorbidity (66%). The lower extremity was the most frequently affected site (75%). Staphylococcus species (29%) and Escherichia coli (25%) were the predominant isolates. Debridement was performed in 97% of patients, and amputation was required in 18%. In-hospital mortality was 14%. On statistical analysis, diabetes mellitus (p=0.022), delayed or absent debridement (p=0.008), requirement of multiple surgeries (p=0.002), and amputation (p=0.009) were significantly associated with poor outcome.

CONCLUSION: Diabetes mellitus, delayed or absent debridement, requirement of multiple operative sittings, and amputation were significantly associated with in-hospital mortality in NF. Early clinical recognition and prompt aggressive surgical intervention, with meticulous management of diabetes, are essential to improve outcomes in this life-threatening condition.

PMID:42571558 | PMC:PMC13452577 | DOI:10.7759/cureus.112351

Clin Park Relat Disord. 2026 Jul 26;15:100488. doi: 10.1016/j.prdoa.2026.100488. eCollection 2026.

ABSTRACT

Introduction: Clinical trials and observational studies have demonstrated that carbidopa/levodopa enteral suspension (CLES) significantly improves advanced Parkinson’s disease (aPD) symptoms. This study examined the real-world, long-term impact of CLES on patient-reported outcomes (PROs) in people with aPD. Methods: Pursuing Real-World Outcomes via Duopa Ecosystem (PROviDE) was a 36-month prospective, observational study evaluating the effectiveness of CLES in patients with aPD in the US. PROs were collected at baseline, 3 months, and every 6 months after CLES initiation and included OFF-time, Treatment Satisfaction Questionnaire for Medication-9 (TSQM-9), and Parkinson’s Disease Questionnaire-8 (PDQ-8) assessing PD-related quality of life (QoL). Longitudinal treatment effects were evaluated using mixed-effect models. Results: Of 104 patients, 47 (45.2%) provided 36 months of data and were evaluated in the final mixed-model analysis. Patients mean standard deviation (SD) age was 67.0 (8.7) years with a mean (SD) PD diagnosis of 11.0 (6.2) years. Compared with baseline, CLES resulted in statistically significant and clinically meaningful improvements in hours of OFF-time as early as month 3 (mean: -2.7 h/day, p < .0001) and sustained at month 36 (-1.7 h/day, p = .004). Improvements were also observed in treatment effectiveness (≥19 points, all p < .0001), global satisfaction with treatment and convenience of therapy (≥10 points each; all p < .001) over 36 months. A statistically significant improvement in PDQ-8 was observed as early as month 3 (-4.1, p = .001) with no worsening over time. Conclusion: Long-term treatment with CLES provides significant and clinically meaningful reduction in OFF-time, patient’s treatment satisfaction, and maintained QoL in the real-world setting.

PMID:42571531 | PMC:PMC13452392 | DOI:10.1016/j.prdoa.2026.100488

MethodsX. 2026 Jul 28;17:104077. doi: 10.1016/j.mex.2026.104077. eCollection 2026 Dec.

ABSTRACT

Wearable EEG-based Lie and Truth detection requires structured descriptor engineering to achieve reproducible results and ensure method transparency. The existing approaches use loosely integrated features alongside hidden modeling methods, which create challenges for understanding their results and verifying research progress across different studies. The existing research gap requires the development of a deterministic descriptor framework to document wearable EEG systems. The research presents the Structured Multi-Domain EEG Descriptor with Phase-Based Connectivity as a reproducible framework that uses five-channel wearable EEG signals to classify binary Lie-Truth. The method emphasizes coordinated descriptor organization and controlled evaluation, summarized as follows:•The structured integration of temporal statistics, fractal complexity, spectral power distributions, and phase-based connectivity within a unified descriptor representation augmented by meta-correlation modelling.•The processing framework provides detailed specifications for preprocessing, window-level segmentation, descriptor extraction, fold-wise normalization, classifier evaluation, and computational profiling.•A controlled evaluation strategy for examining statistical consistency, descriptor separability, domain-level feature contribution, and workstation-based computational feasibility.Validation on the publicly available LieWaves dataset demonstrates stable fold-wise behaviour and consistent classifier responses under controlled conditions.

PMID:42571525 | PMC:PMC13452325 | DOI:10.1016/j.mex.2026.104077

Health Care Transit. 2026 Jul 31;4:100151. doi: 10.1016/j.hctj.2026.100151. eCollection 2026.

ABSTRACT

INTRODUCTION: Each year in the United States, an estimated 1.2 million youth with chronic conditions or functional limitations reach adulthood and must transition from pediatric to adult health care, a process often fragmented by service loss, limited adult providers, and complex waiver and financial systems. The University of Alabama at Birmingham developed the Staging Transition for Every Patient (STEP) Program which includes an annual Healthcare Transition Conference. Here we describe the conference and analyze two years of attendee feedback.

METHODS: Conference planning followed an iterative, participatory co-design framework in which a steering committee of providers, community partners, caregivers, and individuals with lived experience shaped programming, and attendee feedback from each year informed the next. We evaluated the conference using post-conference surveys from the 2024 (n = 34) and 2025 (n = 43) events, summarized with descriptive statistics and thematic analysis; feedback from 2024 was used to tailor the 2025 program.

RESULTS: Across both years, attendees valued content on medical transition, Medicaid and community waivers, financial and legal planning, and lived experience. In 2025, 88% reported being “very likely” to attend again. In response to 2024 feedback, the 2025 program added sessions on financial planning, guardianship, day-program sessions and an expanded self-advocate panel. Despite these changes, the 2025 cohort continued to prioritize psychosocial topics including caregiver support and respite (55.8%), social support and relationships (53.5%), and aging with a disability (51.2%).

DISCUSSION/CONCLUSION: A community-engaged, iterative conference was highly valued but revealed a persistent gap between delivered logistical content and unmet psychosocial support needs. The STEP conference offers a transferable model for community-based transition education and a method for identifying and responding to evolving family needs.

PMID:42571513 | PMC:PMC13452330 | DOI:10.1016/j.hctj.2026.100151

PeerJ. 2026 Aug 5;14:e21614. doi: 10.7717/peerj.21614. eCollection 2026.

ABSTRACT

OBJECTIVE: This study aimed to investigate the acute effects of dynamic stretching (DS) combined with different blood flow restriction (BFR) pressures on explosive performance in healthy young males, and to examine whether these effects differed across estimated arterial occlusion pressure (AOP) levels and performance tasks.

METHODS: In a randomized crossover design, 20 participants completed four warm-up protocols: DS alone, and DS combined with BFR at 30%, 50%, or 70% of estimated AOP applied to the proximal thighs. Explosive performance was assessed before and after each warm-up protocol using countermovement jump (CMJ), standing long jump (SLJ), 10-m sprint (10mSS), and 505 change-of-direction (505COD) tests.

RESULTS: CMJ showed a significant time × condition interaction. All DS+BFR protocols produced greater CMJ change scores than DS alone (all p < 0.01), with mean changes of 5.80 ± 1.99 cm, 5.95 ± 2.33 cm, and 5.15 ± 1.90 cm for the 30%, 50%, and 70% estimated AOP conditions, respectively, compared with 3.50 ± 2.21 cm in the DS condition. No significant differences were observed among the three BFR pressures. In contrast, SLJ, 10-m sprint, and 505COD showed no significant time × condition interactions, indicating that adding BFR did not provide statistically greater acute benefits than the DS condition for these tasks.

CONCLUSION: Adding BFR to dynamic stretching produced an additional acute benefit for CMJ, but this effect was not pressure-dependent across the estimated AOP levels tested. The additional benefit of BFR was not observed for SLJ, 10-m sprint, or 505COD, suggesting that the acute effects of DS+BFR may be task-specific.

PMID:42571496 | PMC:PMC13452422 | DOI:10.7717/peerj.21614

J Shoulder Elb Arthroplast. 2026 Jun 25;10(4):100057. doi: 10.1016/j.jsea.2026.100057. eCollection 2026 Dec.

ABSTRACT

BACKGROUND: Minimal clinically important differences (MCIDs) following primary total elbow arthroplasty (TEA) remain undefined, limiting interpretation of clinical benefit. This study aimed to determine TEA-specific distribution-based MCIDs from baseline variability in primary elective TEA cohorts and identify previously published MCIDs across elbow conditions.

METHODS: A systematic search identified primary elective TEA studies reporting baseline variability statistics. Pooled standard deviations (SD) estimated MCIDs via the half-SD method (all measures) and the one standard error of measurement method (multi-item scales). A scoping review identified published anchor- or distribution-based MCIDs. Outcomes assessed: pain visual analog scale, Mayo Elbow Performance Score (MEPS), Disabilities of Arm, Shoulder and Hand, Quick Disabilities of Arm, Shoulder and Hand, Oxford Elbow Score, and elbow range of motion.

RESULTS: Fifty-six studies contributed to baseline data. Half-SD-derived MCIDs were 1.0 point for pain visual analog scale, 11 points for MEPS, 15° for flexion-extension arc, and 20° for pronation-supination arc; the one-standard error of measurement-derived MCID for MEPS was 16 points. The scoping review identified no TEA-specific MCID studies and 9 across other elbow conditions, with wide variability.

CONCLUSION: These TEA-specific, distribution-based MCID estimates for pain, function, and range of motion offer a pragmatic framework for outcome interpretation, shared decision-making, and future research.

PMID:42571476 | PMC:PMC13452322 | DOI:10.1016/j.jsea.2026.100057