Category: Statistics

Malays J Pathol. 2026 Apr;48(1):115-123.

ABSTRACT

INTRODUCTION: Several MLLT10-associated single-nucleotide polymorphisms (SNPs) have been identified by genome-wide association studies (GWASs) as germline risk variants for meningioma in predominantly European cohorts, but their relevance in Koreans remains uncertain. We investigated these MLLT10 risk SNPs in Korean meningiomas, assessing differences across two time cohorts and comparing allele frequencies with those observed in other populations.

MATERIALS AND METHODS: Three MLLT10 SNPs (rs12770228, rs11012732, and rs1243180) were examined in 143 meningiomas from patients aged ≤50 years, comprising 62 fresh-frozen tissues collected during 1999-2003 (Period 1) and 81 formalin-fixed paraffin-embedded tissues from 2006-2023 (Period 2).

RESULTS: Three SNPs were detected in 9 of 143 meningiomas (6.3%). While the differences did not reach statistical significance (p > 0.05), minor allele frequencies of all three SNPs were reduced two- to four-fold in Period 2 compared with Period 1. The observed frequencies were similar to those reported in Japanese cohorts but substantially lower than the ≥30% reported in European populations.

CONCLUSION: Despite the limitation of using tumour-derived DNA to assess germline variants, our findings consistently showed that MLLT10 risk SNPs occur at very low frequencies in Koreans, similar to Japanese data and in contrast to Europeans. These results highlight the population-specific nature of MLLT10 variants and underscore the need for large-scale Asian studies for risk SNP analysis in meningiomas.

PMID:42059173

Malays J Pathol. 2026 Apr;48(1):53-61.

ABSTRACT

INTRODUCTION: The COVID-19 pandemic has caused a rise in secondary infections, including invasive fungal diseases (IFDs), which have greatly increased morbidity and mortality. This study aimed to explore the demographics, risk factors and outcomes of IFDs in COVID-19 patients admitted to our centre.

MATERIALS AND METHODS: We retrospectively reviewed data from PCR-confirmed category 4 or 5 COVID-19 patients between 2020 and 2023 who also had positive mycology cultures or serology. Patients with positive fungal tests more than 90 days after their initial COVID-19 diagnosis were excluded.

RESULTS: Among 5,075 PCR-positive COVID-19 patients, 23 (0.45%) met the criteria. Of these, 15 (65.2%) had candidiasis, seven (30.4%) aspergillosis, and one (4.3%) Exophiala fungaemia. No mucormycosis cases were identified. The male-to-female ratio of IFDs was 2.8:1, with ages ranging from 26 to 77 years (mean 59.6). The interval between COVID-19 diagnosis and positive fungal test ranged from 3 to 38 days, averaging 12.6 days for candidiasis and 16 days for aspergillosis (difference not statistically significant). Only acute kidney injury was significantly linked to candidiasis. Common factors across all cases included indwelling vascular catheters (95.7%), ICU admission (91.3%), mechanical ventilation (87%), lung diseases (65.2%), kidney impairment (60.9%), poorly controlled diabetes (34.8%), and liver impairment (26.1%). Overall mortality was 91.3% (100% for aspergillosis and Exophiala fungaemia, 86.7% for candidiasis).

CONCLUSION: Although IFD prevalence in COVID-19 patients is low, its high morbidity and mortality make it a critical concern. Early identification of risk factors may help reduce its occurrence and improve outcomes.

PMID:42059167

Liver Int. 2026 Jun;46(6):e70620. doi: 10.1111/liv.70620.

ABSTRACT

BACKGROUND: Previous exposure to hepatitis B virus (HBV) may influence the risk of developing hepatocellular carcinoma (HCC) and other liver-related events (LRE), in particular in patients after HCV cure. Previous studies were not conclusive and there are only few large studies on this topic from Europe.

METHODS: We analysed clinical endpoints (≥ 3-point increase in MELD score, oesophageal variceal bleeding, ascites, encephalopathy, liver transplantation, death, with/without HCC; HCC alone) in patients cured from HCV. Data were obtained from the German Hepatitis C Registry. Patients after organ transplantation, a history of HCC, HIV co-infection, or HBsAg positivity were excluded. A subanalysis was conducted in patients with cirrhosis. Statistical analyses included logistic regression to identify predictors of clinical endpoints and Kaplan-Meier curves to analyse the influence of HBV serological markers.

RESULTS: A cohort of 6198 patients fulfilled inclusion criteria, the median time of follow-up was 2.5 years (range 0.04-8.01). Serological evidence of previous HBV exposure was present in 1889 patients (anti-HBc positive). In patients with cirrhosis, univariate analyses identified anti-HBc positivity (odds ratio [OR], 1.48), cirrhosis (OR, 4.89), features of portal hypertension (ascites (OR, 5.66), oesophageal varices (OR, 4.88)), diabetes (OR, 3.23), and malignancies (OR, 10.34) as risk factors for composite LRE. In multivariable analysis, anti-HBc positivity (OR, 1.53) and cirrhosis (OR, 4.63) remained independent risk factors for the composite endpoints, whereas anti-HBc positivity was not associated with HCC or Kaplan-Meier survival analyses.

CONCLUSIONS: Resolved HBV infection was not associated with the development of HCC or survival in Caucasians after HCV cure. Although anti-HBc positivity was linked to composite outcomes, its clinical relevance appears limited.

TRIAL REGISTRATION: The registry was registered at the German Clinical Trials Register (DRKS; IDDRKS00009717).

PMID:42059159 | DOI:10.1111/liv.70620

J Esthet Restor Dent. 2026 Apr 30. doi: 10.1111/jerd.70175. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the effect of saliva contamination and a 10-MDP-containing cleaner (Katana Cleaner; Kuraray Noritake, Japan) on the shear bond strength (SBS) of an ultra-mild universal adhesive applied in self-etch mode to human dentin.

MATERIALS AND METHODS: Mid-coronal dentin of extracted molars was prepared with standardized smear layers and assigned to four groups: control (SU), saliva-contaminated (C + SU), cleaner-treated (K + SU), and saliva-contaminated plus cleaner-treated (C + K + SU). Each group was evaluated either after 24 h storage or after artificial aging by 20,000 thermal cycles (designated “+A”). SBS was measured using a universal testing machine, failure modes were classified, and dentin surfaces were examined by SEM. Data were analyzed with three-way and one-way ANOVA and Bonferroni post hoc tests (α = 0.05).

RESULTS: SBS ranged from 9.69 ± 6.03 MPa (C + SU + A) to 16.98 ± 6.53 MPa (SU + A). Saliva contamination significantly reduced SBS after aging (p = 0.002). The cleaner had no significant effect on immediate or long-term bond strength, and aging alone was not statistically significant. Failures were predominantly adhesive at dentin (63.3%). SEM analysis revealed partial collagen exposure with cleaner or adhesive use, but smear plugs remained intact.

CONCLUSIONS: Saliva contamination compromised the long-term performance of the universal adhesive. The 10-MDP-containing cleaner did not restore bond strength but also did not adversely affect bonding to dentin.

CLINICAL SIGNIFICANCE: Saliva contamination is a critical factor that compromises the durability of adhesive restorations and should be strictly avoided. When contamination occurs, decontamination agents that do not adversely affect tooth structure or interfere with adhesion may be useful. The 10-MDP-containing cleaner tested in this study was safe for dentin and showed a trend toward mitigating the effects of saliva contamination, although it did not fully restore bond strength.

PMID:42059156 | DOI:10.1111/jerd.70175

Emerg Med Australas. 2026 Jun;38(3):e70266. doi: 10.1111/1742-6723.70266.

ABSTRACT

OBJECTIVE: Australia’s ageing population resulted in increasing Emergency Department (ED) presentations among older adults, particularly frail and those at risk of adverse outcomes. Delirium contributes significantly to morbidity in this cohort. The 4AT screening tool is routinely employed to identify risk. This study examined the impact of the Geriatric Emergency Department Initiative (GEDI) on clinical outcomes for older community dwelling adults presenting to ED with a completed 4AT.

METHODS: A retrospective, single-centre observational cohort study was conducted at an urban district ED. Patients ≥ 75 years, and First Nations peoples ≥ 55 years, with a completed 4AT presenting between January 1 and June 30, 2023 were included. Data were extracted and analysed using descriptive and comparative statistics.

RESULTS: Of 1756 patients, 918 (52%) received GEDI input. Overall, 1135 (65%) had a 4AT score of 0 (no cognitive impairment), 410 (23%) with 4AT of 1-3 (mild cognitive impairment), and 211 (12%) with 4AT score of ≥ 4 (probable delirium). Among patients with a 4AT of 0, GEDI involvement was associated with shorter ED lengths of stay, lower admission rates, and higher discharges home (all p < 0.001). Patients with 4AT scores 1-3, GEDI involvement lowered admission rates, increased discharges home, with no difference in ED length of stay. No significant differences were observed with 4AT scores ≥ 4 when compared to standard care.

CONCLUSIONS: GEDI involvement reduced ED length of stay and admission rates among older adults without delirium or with mild cognitive impairment, but no significant impact was observed for patients with probable delirium.

PMID:42059151 | DOI:10.1111/1742-6723.70266

Inquiry. 2026 Jan-Dec;63:1. doi: 10.1177/00469580261448815. Epub 2026 Apr 30.

ABSTRACT

Current risk stratification for Post-cardiac Arrest Syndrome (PCAS) relies mainly on static admission variables and may fail to capture the dynamic systemic evolution. This study aimed to identify trajectory-defined thrombo-inflammatory phenotypes in PCAS using longitudinal trajectories of platelets, white blood cells (WBC), hemoglobin, and body temperature, and to evaluate their association with 30-day ICU mortality. We conducted a multicenter retrospective cohort study using the MIMIC-IV, MIMIC-III, and eICU-CRD databases, including adult patients with ICU stays of 2-90 days after cardiac arrest. A Multivariate Process Joint Latent Class Mixed Model (mJLCMM) identified latent classes from 30-day biomarker trajectories. The primary outcome was 30-day ICU mortality. Associations were evaluated using Inverse Probability Weighting (IPW) and Doubly Robust Estimation (DRE). Prognostic accuracy was compared against SOFA and OASIS scores using time-dependent Receiver Operating Characteristic (ROC) analysis. A total of 5,099 patients were included. Two phenotypes were identified: Class 1 (“Rapid Decline and Recovery”) and Class 2 (“Mild Decline and Recovery”). Class 1 was associated with higher 30-day ICU mortality (eICU: 46.7%; MIMIC: 24.6%). In doubly robust analyses, the class 2 remained associated with lower ICU mortality in both cohorts, with odds ratios (ORs) of 0.82 (95% CI, 0.72-0.96) in eICU and 0.74 (95% CI, 0.55-0.95) in MIMIC. By Day 30, the trajectory model outperformed SOFA and OASIS, with an AUC of 0.74 versus 0.54 and 0.59, respectively. This trajectory-based classification showed superior prognostic performance for 30-day ICU mortality and highlights the potential value of dynamic monitoring in post-cardiac arrest management.

PMID:42059137 | DOI:10.1177/00469580261448815

Reprod Domest Anim. 2026 May;61(5):e70212. doi: 10.1111/rda.70212.

ABSTRACT

The luteinizing hormone/choriogonadotropin receptor (LHCGR) gene is potentially a useful genetic marker for cattle reproductive status. This study aimed to investigate the impact of the LHCGR gene’s ss52050737 polymorphism on age at first calving (AFC), calving interval (CI), and ovarian status using the TaqMan PCR assay. AFC was categorized into 25-34 and 35-45 months, while CI was grouped into 330-410 and 411-800 days. Ovarian status was classified as active or inactive ovaries. Blood samples were collected from cows using EDTA-containing vacutainer tubes and stored at -20°C until DNA extraction and analysis. Three genotypes (GG, GT, and TT) were identified for the LHCGR gene SNP (ss52050737). The homozygous GG genotype was more frequent in cows with a CI of 330-410 days, and the genotype distribution showed a statistically significant association (p = 0.018) in cows with CI 330-410 and 411-800 days. On the other hand, the GG genotype was not significantly different in relation to AFC and ovarian status (active or inactive). These findings suggest that the ss52050737 polymorphism of the LHCGR gene has an impact on calving interval, and the G allele is associated with the CI of 330-410 days.

PMID:42059105 | DOI:10.1111/rda.70212

J Nurs Manag. 2026;2026(1):e3078316. doi: 10.1155/jonm/3078316.

ABSTRACT

AIM: To describe the prevalence of Missed Nursing Care and its predictors in Greek public hospitals.

BACKGROUND: Missed Nursing Care is defined as any aspect of required patient care that is omitted or delayed. Despite the available studies, little is still known in countries with significant nursing shortages, such as Greece, where 2.23 registered and assistant nurses per 1000 population have been reported, significantly below the EU-27 average.

METHODS: A national cross-sectional study was conducted in 28 of 124 public hospitals in Greece. Nurses and nursing assistants working in medical or surgical units, providing direct care to adult patients, and with at least 3 months of experience were eligible. The MISSCARE Survey Part A (5-point Likert scale; 1 = never, 5 = always missed), Part B (reasons, four-point Likert scale; 1 = not significant, 4 = significant reason) and the Practice Environment Scale of the Nurse Work Index (4-point Likert scale; 1 = totally agree, 4 = totally disagree) were used. Descriptive and inferential statistics were applied.

RESULTS: A total of 676 nurses participated. The Missed Nursing Care Part A total score was 2.06 (±0.65), with patients’ daily activities (mean = 2.32 ± 0.73) receiving higher scores than activities related to health status and treatments (mean = 1.80 ± 0.63). The overall score on the Practice Environment Scale of the Nurse Work Index was 2.53 (±0.49). Multiple linear regression analysis showed that issues in nursing care standards for quality of care, staffing adequacy and communication within the team were the most significant predictors of Missed Nursing Care.

CONCLUSION: Missed Nursing Care is a major problem in Greek hospitals. Inadequate staffing is a key factor in missed care according to nurses’ perceptions. Increasing nursing staff, along with implementing standards for nursing care and improving communication among team members, will enhance the quality of health services in Greece.

IMPLICATIONS FOR NURSING MANAGEMENT: Strengthening staffing levels and reinforcing nursing standards are essential strategies for reducing Missed Care in Greek public hospitals.

PMID:42059103 | DOI:10.1155/jonm/3078316

J Nurs Manag. 2026;2026(1):e8888440. doi: 10.1155/jonm/8888440.

ABSTRACT

BACKGROUND: Mushroom management, a leadership style characterized by withholding information, excluding employees from strategic processes, and maintaining top-down control, has been linked to adverse organizational outcomes. However, its impact on nurses and the psychological mechanisms through which this influence operates remain underexamined.

PURPOSE: This study examines the direct and indirect effects of mushroom management on nurses’ job satisfaction, with organizational identification (OI) as the mediating variable, guided by affective events theory and social identity theory.

METHODS: A cross-sectional survey was conducted with 317 nurses employed in private hospitals in Diyarbakır, Türkiye. Data were collected using validated Turkish versions of the Mushroom Management Scale (Birincioğlu and Tekin, 2018), Job Satisfaction Scale (Judge et al., 2008; Keser and Bilir, 2019), and Organizational Identification Scale (Mael, 1988; Tüzün and Özdoğan, 2006). All scales use a five-point Likert format (1 = strongly disagree to 5 = strongly agree). Confirmatory factor analysis confirmed good model fit (χ²/df = 2.21, CFI = 0.95, RMSEA = 0.062). Mediation was tested using Hayes’ PROCESS macro (Model 4) in SPSS 23.0 with 5000 bootstrap samples.

RESULTS: Mushroom management had significant negative effects on OI (standardized β = -0.46, p < 0.001) and job satisfaction (standardized β = -0.21, p = 0.001). OI positively predicted job satisfaction (standardized β = 0.48, p < 0.001). Mediation analysis confirmed a significant indirect effect (standardized β = -0.22, 95% CI [-0.31, -0.14]), with OI accounting for 51% of the total effect indicating partial mediation.

CONCLUSIONS: Mushroom management is associated with lower OI and job satisfaction among nurses, with OI serving as a key identity-based psychological mechanism. Healthcare leaders should prioritize transparent communication, participatory decision-making, and identity-affirming leadership practices to enhance nurse well-being and retention.

IMPLICATIONS FOR NURSING MANAGEMENT: Findings highlight the need for structured information-sharing protocols, mushroom-management-specific leadership training, and shared governance structures in private hospital settings. Periodic organizational climate monitoring using validated instruments is recommended.

PMID:42059094 | DOI:10.1155/jonm/8888440

Australas Psychiatry. 2026 Apr 30:10398562261444981. doi: 10.1177/10398562261444981. Online ahead of print.

ABSTRACT

ObjectivesThis survey evaluated psychiatry trainees’ attitudes toward conceptual and philosophical issues in psychiatry practice, research and training.MethodsA 20-item Likert questionnaire was administered to 156 psychiatry trainees (53 UK, 103 US) via Webropol (UK) and REDCap (US). The survey assessed demographics, familiarity with conceptual and philosophical issues, attitudes toward its importance, confidence in three domains of conceptual competence, and views on specific philosophical issues. Descriptive statistics and Mann-Whitney U tests were used to analyze UK and US responses. Free-text responses provided qualitative data.ResultsMost trainees (82% research, 92% practice) recognized the importance of conceptual and philosophical issues in psychiatry, with 96% supporting their inclusion in training, but only 28% felt their current training had adequately prepared them. Trainees were ‘somewhat confident’ in recognizing conceptual assumptions implicit in psychiatric work but felt less confident that they possessed the requisite philosophical vocabulary and ability to critically evaluate philosophical issues. Regarding specific philosophical positions, responses revealed a strong endorsement of explanatory pluralism and a rejection of naturalist definitions of mental disorder.ConclusionTrainees viewed conceptual skills as important but felt unprepared by current training programs. This article advocates for the integration of ‘conceptual competence’ in psychiatric education.

PMID:42059093 | DOI:10.1177/10398562261444981