Category: Statistics

Dermatol Surg. 2026 Aug 17. doi: 10.1097/DSS.0000000000005323. Online ahead of print.

ABSTRACT

BACKGROUND: Dermatology residency requires completion of a preliminary internship year in internal medicine (IM), general surgery (GS), or a transitional year (TY). Whether internship background differs between residents who pursue Mohs micrographic surgery fellowship and those who do not is unknown.

OBJECTIVE: To compare preliminary year training backgrounds of Mohs surgery fellows and general dermatology residents.

METHODS: The authors performed a cross-sectional analysis of publicly available internship data for Mohs surgery fellows (2023-2025) and a random sample of US dermatology residents (2024-2025). Internship training was categorized as IM, GS, or TY. The prevalence of GS training was compared using chi-square analysis.

RESULTS: The final cohorts included 231 Mohs fellows and 266 dermatology residents. Mohs fellows were significantly more likely to have completed GS internship or other prior surgical residency training compared with dermatology residents (6.1% vs 1.9%, p = .014). Distributions of IM and TY training were similar between groups.

CONCLUSION: A small but statistically significant increase in surgical preliminary training was observed among Mohs fellows compared with dermatology residents. Internal medicine and TY internships remain the predominant pathways for Mohs fellowship preparation.

PMID:42599274 | DOI:10.1097/DSS.0000000000005323

J Emerg Nurs. 2026 Aug 14:S0099-1767(26)00238-2. doi: 10.1016/j.jen.2026.06.025. Online ahead of print.

ABSTRACT

INTRODUCTION: Virtual reality and related immersive technologies have been increasingly explored as patient education tools, but evidence supporting their role in emergency department–based patient education remains limited.

METHODS: This prospective, single-center randomized study included emergency department patients with traumatic wounds requiring suturing and/or their primary wound caregivers. Participants were assigned to mixed reality-based wound care education using Meta Quest 3 or conventional nurse practitioner-delivered education. Pretest and posttest knowledge scores and participant-reported outcomes were compared using nonparametric tests.

RESULTS: A total of 293 participants were analyzed, including 147 in the control group and 146 in the Meta Quest group. Baseline characteristics did not differ significantly between the groups. Knowledge scores improved significantly from pretest to posttest in both groups (both P < .001). The median score change was 1 in both groups, and the between-group difference did not reach statistical significance (P = .06). Participant-reported comprehension, satisfaction, and confidence were comparable between the groups (all P > .05).

DISCUSSION: Mixed reality-based wound-care education was associated with significant short-term improvement in knowledge scores; however, the magnitude of improvement and participant-reported outcomes were comparable to those observed with conventional health care professional-delivered education. These findings support the potential feasibility of mixed reality as an adjunctive modality for standardized wound-care education in the emergency department, although superiority over conventional education was not demonstrated.

PMID:42599253 | DOI:10.1016/j.jen.2026.06.025

J Emerg Nurs. 2026 Aug 14:S0099-1767(26)00243-6. doi: 10.1016/j.jen.2026.07.005. Online ahead of print.

ABSTRACT

INTRODUCTION: Emergency department overcrowding contributes to prolonged wait times, increased mortality, and staff burnout. The vertical flow model was developed to improve patient flow and has demonstrated reductions in length of stay, door-to-provider time, and rates of patients who leave without being seen. Although it is adaptable to different emergency department settings, implementation has primarily occurred in large, urban hospitals. This project aimed to develop a staff-led policy for a modified vertical flow model tailored to a small, rural emergency department.

METHODS: An anonymous survey was distributed to emergency department staff to assess perceptions of the current patient flow and perceived areas for improvement. Survey data were analyzed using descriptive statistics and used to guide the development of a modified vertical flow model policy. The proposed policy was submitted to emergency department leadership for review and was revised based on feedback.

RESULTS: Nearly 75% of participants rated the current patient flow as 3 or lower on a 5-point Likert scale. Participants identified reducing door-to-provider time as a key factor in improving patient flow. Major barriers included the increasing patient volume and delays in orders and discharge processes. When comparing emergency department performance metrics 6 months before and 6 months postimplementation, a decrease was found in length of stay and rates of patients who left without being seen.

DISCUSSION: A modified vertical flow model policy was developed using the waiting room as the vertical flow area and was revised due to limited provider availability to include protocol orders in triage. The revised policy was accepted by emergency department leadership, demonstrating that the model can be adapted successfully in small, rural emergency departments.

PMID:42599252 | DOI:10.1016/j.jen.2026.07.005

J Perianesth Nurs. 2026 Aug 13:S1089-9472(26)00385-0. doi: 10.1016/j.jopan.2026.06.017. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to (1) identify modifiable preoperative risk factors for postoperative delirium (POD) in elderly patients undergoing hip surgery under general anesthesia, and (2) evaluate the feasibility and potential effectiveness of a nurse-led, home-based physical and cognitive intervention to prevent POD.

DESIGN: A two-phase mixed-method study was conducted, consisting of a retrospective cohort analysis (Phase 1) and a prospective non-randomized interventional study with historical controls (Phase 2). Phase 1 analyzed 42 patients aged ≥70 years to identify preoperative risk factors. Phase 2 evaluated a 14-day home-based exercise and cognitive training program (59 intervention; 79 controls).

FINDINGS: Phase 1 identified preoperative bed rest (OR = 6.66, P =.03) and inadequate comprehension of orientation materials (OR = 18.17, P =.02) as significant POD risk factors. In Phase 2, POD occurred in 5.1% of the intervention group versus 12.7% of controls (P =.153). Adherence was high: 69.5% completed exercise training, 76.3% completed cognitive training, and 64.4% achieved full completion of both intervention components. No adverse events were reported. Although statistical significance was not reached, a trend toward reduced POD incidence was observed.

CONCLUSIONS: A nurse-led, dual-component preoperative intervention combining physical and cognitive training demonstrated high feasibility, strong adherence, and potential clinical applicability in elderly hip surgery patients. These findings support further investigation of scalable non-pharmacological perioperative strategies for POD prevention.

PMID:42599249 | DOI:10.1016/j.jopan.2026.06.017

Traffic Inj Prev. 2026 Aug 14:1-8. doi: 10.1080/15389588.2026.2710811. Online ahead of print.

ABSTRACT

OBJECTIVE: Overtaking maneuvers between motor vehicles and bicycles (OVB) represent a critical hazard for cyclists due to required lateral clearances and vehicle speeds. This study aims to evaluate the OVB process in urban environments, focusing on the main geometric and operational attributes that influence cyclists’ objective road safety indicators.

METHODS: A quasi-naturalistic observational study was conducted on urban roads in Fortaleza, Brazil, using an instrumented bicycle. Data on vehicle speed, lateral passing distance, lane configuration, vehicle type, and the presence of adjacent traffic were collected across 1,075 overtaking maneuvers. Statistical analyses were performed to assess the impact of these attributes on safety indicators.

RESULTS: Analysis revealed that 76% of observed passing maneuvers violated the Brazilian national recommendation of maintaining a minimum lateral distance of 1.50 m. The presence of cycling infrastructure and the absence of traffic in adjacent lanes were significantly associated with greater passing distances. Furthermore, a behavioral compensatory threshold was identified at a 0.85-meter lateral distance: drivers modulated speed as a risk-mitigation mechanism only during critical clearances, whereas no speed adjustments were observed at the 1.50-meter legal threshold.

CONCLUSIONS: A vast majority of drivers fail to comply with recommended passing distances, highlighting the need for targeted infrastructure and operational interventions. The existence of dedicated cycling facilities effectively improves lateral separation. Moreover, drivers adapt speed only under extreme proximity (under 0.85 m), demonstrating that legal limits alone do not induce safer driver behavior without structural or physical support.

PMID:42599244 | DOI:10.1080/15389588.2026.2710811

Acta Crystallogr B Struct Sci Cryst Eng Mater. 2026 Aug 1;82(Pt 4):367-368. doi: 10.1107/S205252062600795X. Epub 2026 Aug 1.

ABSTRACT

Computational crystal engineering approaches to design multicomponent solid forms are a popular means to target experiments that are likely to result in successful outcomes. By utilizing statistics of intermolecular interactions across a large database of experimental crystal structures, Stevens et al. [Acta Cryst. (2026), B82, 391-398] provide a rapid means of identifying key synthons for rational cocrystal design.

PMID:42599227 | DOI:10.1107/S205252062600795X

Vector Borne Zoonotic Dis. 2026 Aug 14:15303667261479462. doi: 10.1177/15303667261479462. Online ahead of print.

ABSTRACT

BACKGROUND: Global dengue cases have surged in recent years. In Ecuador, reported cases increased from 27,906 in 2023 to 57,712 in 2024. Despite the availability of multiple vaccines in other countries, factors such as socioeconomic disparities, climate change, and vaccine hesitancy continue to hinder prevention efforts. This study aims to analyze the perceptions of the Ecuadorian population and explore possible reasons for hesitancy toward the dengue vaccine.

METHODS: This cross-sectional observational study was conducted in accordance with the STROBE guidelines. Online surveys, adapted from Kricorian et al., were distributed via the Qualtrics app between June 1st, 2024, and June 25, 2025. Eligible participants were Ecuadorian, at least 18 years old, and had a minimal education level of bachelor. Statistical analysis included descriptive percentages and chi-square tests, with significance set at p < 0.05.

RESULTS: A total of 735 participants were included. Most perceived a dengue vaccine as safe (87.2%, n = 641), while 12.8% (n = 94) considered it unsafe. Overall, 75.9% expressed willingness to be vaccinated. Perceived vaccine safety was significantly associated with vaccination willingness, region of residence, and willingness to vaccinate offspring (all p < 0.001), but not with education level, dengue understanding (p = 0.747), or prior dengue experience (p = 0.111).

CONCLUSION: Most Ecuadorians perceive dengue vaccines as safe, yet hesitancy persists. Targeted educational efforts are essential to improve acceptance and coverage.

PMID:42599207 | DOI:10.1177/15303667261479462

Oncologist. 2026 Aug 14:oyag325. doi: 10.1093/oncolo/oyag325. Online ahead of print.

ABSTRACT

BACKGROUND: Triple-negative breast cancer (TNBC) is an aggressive breast cancer subtype for which neoadjuvant chemotherapy (NACT) is used for locally advanced (LA) disease. Patients with TNBC who experienced a pathologic complete response (pCR) following NACT have been found to have extended overall survival (OS) compared to patients with residual disease. Sparse data exists on the frequency and impact of pCR following NACT for TNBC in East Africa.

METHODS: We retrospectively reviewed patients diagnosed with LA TNBC who received NACT between 2018 and 2022 at Moi Teaching and Referral Hospital in Eldoret, Kenya. After NACT, patients underwent mastectomy in which specimens were reviewed histologically as either pCR or residual disease in the breast and/or axilla. Clinical data were analyzed using descriptive statistics and Kaplan-Meier methods.

RESULTS: Sixty-nine women with LA TNBC were included. Patient characteristics at diagnosis: Median age = 51 years (IQR 44-60); T4 disease = 34 (49%); and nodal involvement = 62(91%). Forty-six patients (67%) received anthracycline/taxane-based chemotherapy with a median of 8 cycles (IQR 6-8), and 47 (68%) underwent mastectomy, with only 7% achieving pCR. Assuming all lost-to-follow-ups died, the worst-case OS was 83% and 56% at 1 and 2 years, respectively.

CONCLUSIONS: In this LMIC setting, patients who presented with LA TNBC had lower pCR rates following NACT than observed in high-income countries. Our findings highlight the critical need for innovative, cost-effective programs focused on early detection of breast cancer, linkage of care, and delivery of more effective therapies to improve outcomes in the region.

PMID:42599194 | DOI:10.1093/oncolo/oyag325

Can Rev Sociol. 2026 Nov;63(4):e70048. doi: 10.1111/cars.70048.

ABSTRACT

Suicide rates among Indigenous Peoples in Canada remain significantly higher than those in non-Indigenous populations, yet explanations have mostly focused on individual and clinical factors. This study offers a sociological perspective by framing suicidality as an anomic response to structural frustration and strain caused by settler colonialism. In this view, patterns of suicidality, like patterns of drug use, are seen not as symptoms of personal pathology but as effects of structural harm experienced by Indigenous communities. Using data from the 2017 Aboriginal Peoples Survey, the analysis explores how structural conditions, together with constellations, relate to differences in suicidal thoughts. The results reveal that functional disability and unmet medical needs are strongly linked to both past and recent suicidal ideation, while residential instability correlates with past suicidal ideation. Marital ties are associated with lower levels of past suicidality. Variations across Indigenous identities remain, with Inuit respondents showing higher levels of suicidal thoughts. Mental health and a constellation of coping mechanisms also relate to suicidality. These findings emphasize the need to view suicidality within the context of broader structural inequalities and contribute to a sociological understanding that is informed by Indigenous and decolonial scholarship.

PMID:42599191 | DOI:10.1111/cars.70048

Neuropsychopharmacol Rep. 2026 Sep;46(3):e70161. doi: 10.1002/npr2.70161.

ABSTRACT

Behavioral tests in mice and other animals are widely used to study anxiety and to evaluate the efficacy of anxiolytic compounds. However, the validity of behavioral tests used to assess anxiety-like behavior has been questioned because their results are often inconsistent and not readily replicated across studies. We developed a simple falling-trap test to examine whether the number of falls could serve as an index of anxiety-like behavior. The test is designed to produce falls from an elevated path, based on the hypothesis that less-anxious mice would be more prone to fall. Male C57BL/6N mice were given vehicle or chlordiazepoxide (CDP), and their behavior was evaluated using both the novel test and the elevated plus maze (EPM). The outcomes were the number of falls in the falling-trap test and open-arm time in the EPM. In the falling-trap test, CDP-treated mice did not show a statistically significant increase in the number of falls compared with control mice. In contrast, CDP significantly increased open-arm time in the EPM. Thus, under the present experimental conditions, these findings did not support the hypothesis that the number of falls in the falling-trap test could serve as a measure of anxiety-like behavior. Further studies are needed to determine the conditions under which this assay could be useful and to establish its reliability and validity.

PMID:42599184 | DOI:10.1002/npr2.70161