Category: Statistics

Front Vet Sci. 2026 May 20;13:1793754. doi: 10.3389/fvets.2026.1793754. eCollection 2026.

ABSTRACT

INTRODUCTION: Raw meat-based diets (RMBD) are increasingly popular among dog guardians, yet the role of personal nutrition habits and pet-guardian relationships in their adoption remains unclear. This study examines how these factors, alongside previously identified drivers of pet food selection, specifically relate to the decision to feed RMBD.

METHODS: Data from 433 dog guardians were collected via an e-survey, from which 46 questions were selected for analysis in this study. Participants were placed into raw or cooked groups based on their dogs’ primary diet. Responses were assessed using descriptive statistics and univariate logistic regression.

RESULTS: A cooked diet was the primary feeding method for 291 participants, while 142 reported providing a diet that included at least one raw element. Households with an income exceeding CA $100,000 were predictive of raw feeding, while possession of graduate education was protective against it. Intact dogs of medium size were also associated with raw feeding practices. Compared to supermarkets and veterinary clinics, pet specialty stores were significantly more likely to be used by raw feeders for pet food purchases. Additionally, the provision of supplements to ensure dietary balance was linked to raw feeders, with the inclusion of fish oil increasing the odds of feeding RMBD. Raw feeding was also associated with greater perceived knowledge of canine nutrition and a preference for minimally processed pet foods, whereas emphasis on the convenience or cost of feeding reduced the likelihood of adopting RMBD. Survey questions evaluating guardians’ nutrition habits and perceived relationships with their pets did not predict diet group membership.

CONCLUSION: Differences between raw feeders and guardians feeding cooked diets were observed in demographics (e.g., income and education), dog characteristics (e.g., breed size and sexual status), supplement use, pet food opinions and purchasing locations, and perceived dog nutrition knowledge. However, no differences were found in personal nutrition habits or the perceived human-animal bond.

PMID:42245978 | PMC:PMC13231891 | DOI:10.3389/fvets.2026.1793754

Front Vet Sci. 2026 May 20;13:1817578. doi: 10.3389/fvets.2026.1817578. eCollection 2026.

ABSTRACT

The clinical significance and ultrasonographic features of intermediate patellar ligament (IPL) desmopathy in horses are still debated and considered nonspecific. Elastosonography allows assessment of tissue elasticity in response to an external stimulus. The aim of the study was to describe the elastosonographic characteristics of the equine IPL, evaluate the feasibility of both strain (SE) and two-dimensional shear wave elastography (2D-SWE), and assess the consistency of the data obtained from these techniques. 20 adult horses of mixed breed, sex and athletic use were selected and allocated to a Sound Group (GS, n.15) or a Lame Group (GL, n.5) based on orthopedic examination findings, according to the presence a stifle-originating lameness and/or with ultrasonographic evidence of IPL lesion. SE and 2D-SWE of both IPLs were performed in longitudinal and transverse scans. Using the same Region of Interest (ROI), SE evaluated the Elasticity Index of the IPL (EI_IPL) and the Strain Ratio (SR) between the IPL and infrapatellar fat pad, while 2D-SWE measured Shear Wave Velocity (m/s) and Young’s modulus (kPa). Feasibility of both techniques was good, with acceptable to good Intraclass Correlation Coefficient (0.7 < ICC < 0.9) (p < 0.05). No significant differences were found between left and right limb, or between intraoperator measurements (Wilcoxon test). No correlation was observed between SE variables (EI and SR) or SWE variables (m/s and kPa) and IPL diameter/thickness ratio (Pearson correlation). SE was able to differentiate between GS and GL, with an EI of the IPL that was statistically higher in GS in transverse scan (respectively, 1.9 and 1.7; p = 0.001). Equine IPL can be efficiently investigated using SE and 2D-SWE. It exhibits elastosonographic characteristic of a hard, non-deformable structure, with increased stiffness in cases of chronic injuries.

PMID:42245976 | PMC:PMC13229688 | DOI:10.3389/fvets.2026.1817578

Front Vet Sci. 2026 May 20;13:1812140. doi: 10.3389/fvets.2026.1812140. eCollection 2026.

ABSTRACT

BACKGROUND: The equine temporomandibular joint (TMJ) is divided into two non-communicating joint (discotemporal DTJ and discomandibular DMJ) compartments. Ultrasound has been extensively used as a diagnostic tool in the horse, but previous work has reported that ultrasound-guidance did not improve the success rate of TMJ arthrocentesis. However, this research focused only on the larger, easily accessed, DTJ compartment. However, most of the osseous pathology of the equine TMJ has been reported to be in the smaller DMJ.

OBJECTIVE: To determine whether using ultrasound-guidance would reduce the number of attempts to successfully perform arthrocentesis of the equine TMJ, specifically the DMJ.

STUDY DESIGN: Experimental study using cadaver animals.

METHODS: The TMJ regions of seven thawed cadaver heads were clipped and cleansed. Arthrocentesis of the left DTJ and DMJ was attempted before repeating the attempts using ultrasound guidance. The number of attempts required to perform successful arthrocentesis of each joint compartment was documented before the second operator performed the same task. The same procedures were then performed on the opposite side of the head.

RESULTS: As operators gained experience, their success rate climbed. Statistically, none of the other documented outcome variables significantly affected the number of attempts to obtain successful arthrocentesis. Despite that, ultrasound-guidance allowed immediate unequivocal evidence of successful arthrocentesis into the targeted joint compartment.

MAIN LIMITATIONS: Low number of normal cadaver horse heads and a lack of randomization of attempt techniques.

CONCLUSIONS: This study shows that ultrasound-guidance did not reduce the number of attempts required for successful DTJ, or DMJ arthrocentesis. However, it did allow for the immediate unequivocal evidence of successful arthrocentesis into the targeted joint compartment.

PMID:42245975 | PMC:PMC13229617 | DOI:10.3389/fvets.2026.1812140

Front Med (Lausanne). 2026 May 20;13:1719823. doi: 10.3389/fmed.2026.1719823. eCollection 2026.

ABSTRACT

OBJECTIVE: Dysmenorrhea is a prevalent gynecological disorder impairing quality of life for women of reproductive age. Although traditional herbal decoctions (THDs) are widely used for dysmenorrhea in Korea, robust real-world evidence regarding their clinical outcomes and safety is limited. This descriptive, hypothesis-generating registry study aimed to examine individualized THDs for dysmenorrhea using registry data from a multicenter observational study.

METHODS: This multicenter, prospective observational registry study enrolled women aged 19-65 years with dysmenorrhea from 33 traditional Korean medicine (TKM) clinics and one TKM hospital in Korea (July 2022-June 2023). Participants were categorized into a THD group (received THDs for ≥10 days) and a non-THD group. Primary outcomes were changes in pain intensity (Numeric Rating Scale, NRS), duration of menstrual pain, and analgesic consumption (defined as the number of analgesic tablets taken per menstrual cycle), assessed at each visit. To address confounding and selection bias, a difference-in-differences analysis using inverse probability of treatment weighting (IPTW) based on propensity scores was performed. Missing data were handled using complete-case analysis, supported by Little’s MCAR test (p = 0.39). Safety was assessed by monitoring and categorizing adverse events.

RESULTS: A total of 119 participants in the THD group and 16 in the non-THD group completed the study. Both groups demonstrated significant within-group reductions in menstrual pain intensity over time. Regarding between-group differences, the THD group showed a significantly greater observed reduction in menstrual pain intensity at visit 2 compared to the non-THD group (Estimate = -1.41, p = 0.029); no significant between-group difference was observed at other time points. Analgesic use also showed a statistically significant observed decrease in the THD group at visit 2 (Estimate = -1.63, p = 0.001). No statistically significant between-group difference was identified for pain duration at any time point. Mild adverse events were reported by 9 participants (7.6%) in the THD group; all resolved spontaneously. No adverse events occurred in the non-THD group.

CONCLUSION: These preliminary findings suggest that individualized THDs may be associated with reduced menstrual pain intensity and analgesic consumption in women with dysmenorrhea in real-world settings; however, significant between-group differences were observed at a single time point only, pain duration did not differ significantly between groups, and comparative safety conclusions remain constrained by the small control group. Larger, adequately powered studies are needed to confirm these exploratory findings.

PMID:42245970 | PMC:PMC13230185 | DOI:10.3389/fmed.2026.1719823

Front Med (Lausanne). 2026 May 20;13:1845722. doi: 10.3389/fmed.2026.1845722. eCollection 2026.

ABSTRACT

PURPOSE: The aim of this study was to compare the effectiveness of amniotic membrane plugging (AMP) versus acellular porcine corneal stroma (APCS) partially penetrating deep anterior lamellar keratoplasty (PP-DALK) in the treatment of small corneal perforation.

METHODS: A total of 44 patients (44 eyes) with small corneal perforation (<3 mm in diameter) were retrospectively included. Among them, 24 eyes were treated with AMP (AMP group), and 20 eyes were treated with APCS-PP-DALK (APCS-PP-DALK group). The best-corrected visual acuity (BCVA), corneal transparency, ocular irritation symptoms, corneal thickness, primary disease control, postoperative complications, and survival rate were assessed.

RESULTS: Both groups showed significant postoperative improvement in BCVA versus baseline (both p < 0.001), with no difference in overall visual outcome between APCS-PP-DALK and AMP groups (p = 0.607). Corneal transparency was better in the APCS-PP-DALK group at 1, 3, and 6 months compared with the AMP group (all p < 0.05), though this difference resolved by 12 months. Corneal thickness increased significantly in both groups after surgery, with the APCS-PP-DALK group exhibiting greater thickness than the AMP group at 6 months (p < 0.001). The primary disease control rate was 85% in the APCS-PP-DALK group and 87.5% in the AMP group, yielding no statistically significant difference between the groups (p = 0.810). Furthermore, the incidence of postoperative complications was comparable between the two groups (p = 0.844).

CONCLUSION: Both AMP and APCS-PP-DALK are effective and safe treatments for small corneal perforation.

PMID:42245966 | PMC:PMC13229708 | DOI:10.3389/fmed.2026.1845722

Front Med (Lausanne). 2026 May 20;13:1822534. doi: 10.3389/fmed.2026.1822534. eCollection 2026.

ABSTRACT

BACKGROUND: Appropriate analgesia and sedation are essential in intensive care units (ICU). Daily sedation interruption (DSI) minimizes sedation and maximizes patient care by interrupting or reducing sedative infusion.

OBJECTIVE: This study aimed to assess the knowledge, attitudes, and practices of intensive care unit nurses regarding daily sedation interruption and to identify factors associated with its implementation in clinical practice.

METHODS: A cross-sectional survey was conducted among ICU nurses from five general hospitals in Sichuan Province, China, from July 29, 2024, to August 20, 2024, using convenience sampling. The nurses completed a self-designed online questionnaire on the DSI that included three dimensions: knowledge, attitude, and practical behavior. This study followed the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines for reporting cross-sectional studies.

RESULTS: In total, 343 valid questionnaires were collected, with a recovery rate of 95.3%. The DSI knowledge score of ICU nurses was 4 (2-4) points, with a scoring rate of 40%. The DSI attitude score of ICU nurses was 37 (31-40) points, with a scoring rate of 92.5%. Forty-two percent (144) of nurses had received DSI training, and 2.6% (9) of nurses had never implemented DSI. The most commonly used sedation assessment tool was the Richmond Agitation Sedation Scale (RASS) (80.8%). The most common impediment to DSI implementation was increased incidence of self-removal of tracheal tubes and other catheters (71.4%). There were significant differences in DSI knowledge among nurses by age, gender, professional title, education level, and years working in the ICU (p < 0.05). There were statistically significant differences in the attitudes of ICU nurses toward DSI by age, professional title, educational level, and years of work in the ICU (p < 0.05).

CONCLUSION: DSI knowledge among ICU nurses is insufficient, recognition is high, and practice behaviors need to be strengthened. ICU nurses need more training and guidance in the knowledge and practice of DSI.

PMID:42245965 | PMC:PMC13230142 | DOI:10.3389/fmed.2026.1822534

Front Med (Lausanne). 2026 May 20;13:1816591. doi: 10.3389/fmed.2026.1816591. eCollection 2026.

ABSTRACT

BACKGROUND AND PURPOSE: Rectal neuroendocrine tumor (NET) is relatively common together with pancreatic NET in the context of a rare disease. Endoscopic resection is a commonly used treatment method. The aim of this prospective study is to analyze the safety and efficacy of endoscopic full-thickness resection (EFTR) in the treatment of rectal NET.

PATIENTS AND METHODS: Patients who met the inclusion and exclusion criteria were randomly assigned to the endoscopic submucosal dissection (ESD) group and the EFTR group. Compare whether there are statistically significant differences between the two groups in terms of postoperative complications, hospital stay, and the rate of positive surgical margins.

RESULTS: This study included 58 patients, 43 patients were in the ESD group and 15 patients were in the EFTR group. There were no significant statistical differences between the two groups in terms of gender (P = 0.975), age (P = 0.477), and length of hospital stay (P = 0.207). Neither of the two groups of patients experienced delayed perforation after the operation (P = 1.000). In the ESD group, there was one patient who experienced delayed bleeding, while in the EFTR group, there were no patients with delayed bleeding (P = 0.746). In the ESD group, 4 patients had positive margins, while in the EFTR group, no patients had positive margins (P = 0.291). In the ESD group, 17 patients had tumor margins less than 500 micrometers from the bottom, while in the EFTR group, no patient had such a condition (P = 0.002).

CONCLUSION: Endoscopic full-thickness resection combined with endoscopic purse-string suture is a safe method for treating rectal NETs, and it has a higher complete resection rate compared to ESD.

PMID:42245963 | PMC:PMC13229794 | DOI:10.3389/fmed.2026.1816591

J Cardiothorac Surg. 2026 Jun 4. doi: 10.1186/s13019-026-04323-2. Online ahead of print.

ABSTRACT

BACKGROUND: Tetralogy of Fallot (ToF) is the most common cause of cyanotic congenital heart disease and pulmonary regurgitation (PR) remains its most frequent postoperative complication. The preoperative z score of the pulmonary valve annulus (PVA) has been associated with an increased risk of PR after ToF repair; however, the optimal cut-off value varies among studies and has not been investigated in the Indonesian population. This study aimed to determine the predictive value of the preoperative MSCT-derived PVA diameter z score for early PR after ToF repair.

METHODS: This retrospective cohort study was conducted using secondary data from pediatric patients who underwent ToF repair at the National Cardiac Center Harapan Kita between January 2023 and December 2024. The preoperative PVA diameter was measured using cardiac multislice computed tomography (MSCT). Early PR was assessed via echocardiography within 45 days post-operatively. Multivariable logistic regression was performed and receiver operating characteristic (ROC) curve analyses were performed.

RESULTS: A total of 101 subjects were analysed. Both maximal and minimal diameters of the PVA z scores were associated with moderate or greater PR in the univariate analysis (p = 0.001 and p < 0.001, respectively). However, in multivariate analysis, only transannular patch (TAP) remained an independent predictor (p < 0.001), while PVA z scores were no longer statistically significant. ROC analysis revealed that the minimal diameter of the PVA z score (area under the curve [AUC] 0.701; cut-off – 2.5) demonstrated moderate discriminatory ability, with high specificity (90.6%) but limited sensitivity (42%).

CONCLUSION: Preoperative PVA z score is associated with early PR but does not independently predict the outcome after adjustment, as its effect is largely mediated by surgical strategy, particularly the use of TAP. While the proposed cut-off of – 2.5 demonstrates high specificity, its low sensitivity limits its utility as a screening tool. PVA z score should therefore be interpreted alongside intraoperative factors rather than used as a standalone predictor of postoperative PR, as it reflects a preoperative anatomical parameter that influences surgical decision-making.

PMID:42243828 | DOI:10.1186/s13019-026-04323-2

BMC Surg. 2026 Jun 4. doi: 10.1186/s12893-026-03853-9. Online ahead of print.

ABSTRACT

BACKGROUND: Posterior cruciate ligament (PCL) avulsion fractures at the tibial insertion can cause posterior knee instability and accelerate osteoarthritis. Meyers-McKeever type II/III fractures require surgery. Traditional open approaches are traumatic, while arthroscopic techniques are limited by equipment, learning curves, and fixation efficacy.

OBJECTIVE: To evaluate the short-term clinical outcomes and feasibility of a combined vertical medial posterior incision approach using a small T-plate and high-strength suture fixation for isolated PCL avulsion fractures.

METHODS: We retrospectively reviewed 21 patients with isolated Meyers-McKeever type II/III PCL tibial avulsion fractures treated with posteromedial longitudinal mini-incision fixation using a mini T-plate combined with high-strength suture. Operative parameters, fracture healing, knee ROM, Tegner-Lysholm score, IKDC score, posterior drawer test, and complications were assessed.

RESULTS: The mean surgery duration was 81.5 ± 20.9 min, with an average intraoperative blood loss of 33 ± 11 ml. All fractures achieved anatomical reduction, with an average healing time of 10.9 ± 1.6 weeks. At the final follow-up (mean 10.6 ± 5.2 months), knee ROM improved significantly from 76.5°±12.1° preoperatively to 132.2°±4.2° (P < 0.05). Both Tegner-Lysholm scores (from 45.5 ± 9.3 to 95.5 ± 2.8) and IKDC scores (from 35.9 ± 8.9 to 96.8 ± 1.5) showed statistically significant improvements (P < 0.05). The posterior drawer test was negative in all patients, and no infection, implant failure, or gastrocnemius weakness was observed.

CONCLUSION: Posteromedial longitudinal mini-incision fixation with a mini T-plate combined with high-strength suture achieved satisfactory clinical outcomes for PCL tibial avulsion fractures. The proposed 5T concept summarizes the main practical advantages of this technique. In this descriptive case series (Level IV evidence), the technique achieved satisfactory short-term clinical outcomes for PCL tibial avulsion fractures, particularly in patients with small or comminuted fragments. Further prospective comparative studies are needed to validate its long-term clinical value.

PMID:42243827 | DOI:10.1186/s12893-026-03853-9

BMC Pediatr. 2026 Jun 4. doi: 10.1186/s12887-026-07036-6. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the clinical efficacy and safety of single-port transscrotal laparoscopic orchiopexy combined with a hernia needle (SPLT-Orchiopexy) in children with palpable middle- and low-position undescended testes.

METHODS: A retrospective analysis was conducted on 200 children with palpable middle- and low-position undescended testes who underwent surgical treatment at our hospital between March 2021 and April 2023. Patients were categorized into two groups according to the surgical technique used: the conventional laparoscopic surgery (CLS, n = 120) group and the SP-Orchiopexy group (n = 80). Perioperative indicators, postoperative pain assessed using the Face, Legs, Activity, Cry, and Consolability (FLACC) scale. Scar outcomes at 6 months postoperatively were evaluated using the Observer Scar Assessment Scale (OSAS) and the Patient Scar Assessment Scale (PSAS), which were compared between two groups. The incidence of postoperative complications was also compared between groups. Logistic regression analysis was performed to identify factors associated with postoperative complications.

RESULTS: The SPLT-Orchiopexy group showed significantly shorter operative time, less intraoperative blood loss, earlier ambulation, and shorter length of hospital stay (t = 11.15-16.91, all P < 0.001). FLACC scores at 6, 12, and 24 h postoperatively were significantly lower in the SPLT-Orchiopexy group (Z = 4.67-6.91, all P < 0.001). At 6-month follow-up, both OSAS and PSAS scores were lower in the SPLT-Orchiopexy group (Z/t = 7.31-7.65, all P < 0.001). The overall incidence of postoperative complications was lower in the SPLT-Orchiopexy group (χ² = 4.68, P = 0.031). The surgical approach did not reach statistical significance as an independent predictor of postoperative complications, but it demonstrated a trend toward reduced complication risk (Wald = 1.49, P = 0.222).

CONCLUSION: SPLT-Orchiopexy may provide advantages in terms of minimal invasiveness, postoperative recovery, pain relief, cosmetic outcomes, and postoperative complications in children with palpable middle- and low-position undescended testes. Further prospective studies are warranted to validate these findings.

PMID:42243819 | DOI:10.1186/s12887-026-07036-6