Category: Statistics

Proc Inst Mech Eng H. 2026 Jan 23:9544119251412486. doi: 10.1177/09544119251412486. Online ahead of print.

ABSTRACT

Talar replacement procedures offer good clinical outcomes for patients experiencing talar osteonecrosis with collapse. However, there is a potential for cartilage wear as the artificial talus prosthesis articulates against the native articular cartilage (AC) in the ankle joint. Therefore, this study investigated the wear of AC against candidate implant biomaterials with the aim of selecting an appropriate material for use in talar replacement procedures. Cobalt chrome alloy (Co-28Cr-6Mo), titanium alloy (Ti-6Al-4V), ultra-high molecular weight polyethylene (UHMWPE), industrial grade natural polyether ether ketone (PEEK), and polycarbonate-urethane (PCU) were tested against porcine AC submerged in bovine serum using an in vitro customized dual-motion wear testing setup. A total of 43,200 cycles at a frequency of 3 Hz were completed for each test. Both macroscopic and microscopic analyses were used to quantify cartilage wear using the Outerbridge and Osteoarthritis Research Society International (OARSI) clinical grading systems, respectively. In the macroscopic analysis, Ti-6Al-4V demonstrated the most AC wear, followed by Co-28Cr-6Mo, PEEK, UHMWPE, and PCU. In the microscopic analysis, PEEK demonstrated the most AC wear, followed by Ti-6Al-4V, Co-28Cr-6Mo, UHMWPE, and PCU. PCU demonstrated the least amount of AC wear compared to all other biomaterials and showed statistically insignificant differences with the control group (porcine cartilage-on-cartilage) in both macroscopic and microscopic inspections. These results suggest that PCU may be a suitable candidate material for coating talus implants as it demonstrated superior AC wear performance compared to the other biomaterials investigated in this study.

PMID:41574491 | DOI:10.1177/09544119251412486

Geriatr Gerontol Int. 2026 Jan;26(1):e70354. doi: 10.1111/ggi.70354.

ABSTRACT

AIM: Calf circumference (CC) is a simple surrogate marker of muscle mass. Body mass index (BMI) adjustment and age-specific cutoffs for low CC have been proposed to optimize its use in clinical practice. This study aimed to clarify the association of BMI-adjusted CC and age-specific cutoffs with in-hospital falls among older adults.

METHODS: This study was conducted using data from the Japan Hospital Acquired Complications (J-HAC) project, a multicenter cohort study. In this analysis, we included adults aged ≥ 65 years. CC was measured on admission, and the occurrence of falls was assessed and recorded by medical personnel throughout the hospitalization. BMI adjustment and age-specific cutoffs for low CC were applied based on previous studies. Multivariable logistic regression models were developed to examine the association between in-hospital falls and BMI-adjusted CC and age-specific low CC cutoffs, adjusting for age and comorbidities.

RESULTS: A total of 808 patients (mean age 83.7 ± 6.6 years, 57.2% females) were analyzed. In females, higher BMI-adjusted CC was significantly associated with a lower risk of in-hospital falls after adjusting for age and comorbidities (adjusted OR = 0.88, 95% CI: 0.77-0.998). Furthermore, low BMI-adjusted CC, as defined by age-specific cutoff values, was independently associated with an increased fall risk in the multivariable model (adjusted OR = 2.39, 95% CI: 1.03-5.54). In contrast, no significant associations were observed in males regardless of CC adjustment or cutoff criteria.

CONCLUSIONS: BMI-adjusted CC and age-specific cutoffs showed a stronger association with in-hospital falls among older females than unadjusted CC. Further validation in diverse populations and outcomes is required to confirm their usefulness.

PMID:41574473 | DOI:10.1111/ggi.70354

Aging Ment Health. 2026 Jan 23:1-13. doi: 10.1080/13607863.2026.2614952. Online ahead of print.

ABSTRACT

OBJECTIVES: Positive aspects of caregiving (PAC) are assumed to protect against caregiver suffering, but evidence is lacking. Two studies examined this assumption through testing the reciprocal causality between PAC and burden/depression, and exploring the mechanisms linking these constructs.

METHODS: MethodsIn Study One, 99 dementia caregivers were interviewed six months apart. In Study Two, 45 caregivers provided 620 diaries across eight weeks.

RESULTS: In Study One, baseline burden predicted increased depressive symptoms, whereas baseline depressive symptoms predicted less PAC. Although burden was unrelated to PAC concurrently, burden was found to strengthen PAC after depression was controlled for (statistical suppression). Contrary to prevailing assumption, PAC predicted neither burden nor depression. In Study Two, 213 of the 620 diaries contained narratives linking burden to PAC. Supporting the PAC-enhancing role of burden, four mechanisms were extracted using thematic analysis, describing unrelenting caregiving stress enriching the significance of their work and pressuring them to learn, to push beyond boundaries, and to transform thinking.

CONCLUSION: Chronic hardship may be a breeding ground for positive meanings, yet also increasing depression, undermining positivity. Consequently, burden has a direct positive effect, but an indirect negative effect via depression, on PAC. A conceptual model depicting such complex dynamics is proposed.

PMID:41574438 | DOI:10.1080/13607863.2026.2614952

Aging Ment Health. 2026 Jan 23:1-10. doi: 10.1080/13607863.2026.2612734. Online ahead of print.

ABSTRACT

OBJECTIVES: The COVID-19 pandemic has exacerbated loneliness among older adults. This study evaluates the relationship between loneliness, depression, and suicidal ideation in this population during the early pandemic by utilizing data from the All of Us (AoU) Research Program.

METHOD: We analyzed cross-sectional data from 17,084 individuals aged ≥65 enrolled in the AoU Research Program who completed a COVID-19 related survey in May 2020. Participants were categorized into loneliness quartiles based on their UCLA Loneliness Scale Short Form-8 scores. Descriptive statistics and chi-square tests assessed demographic differences. Poisson regression models with robust standard errors tested associations between loneliness quartiles and both depression and suicidal ideation, adjusting for age, gender, race, ethnicity, education, marital status, employment status, housing status, health insurance status, and social support.

RESULTS: Among 17,084 participants (mean age 72.0 years [SD 5.3], 55% female, 89% White), we found a clear stepwise pattern: as loneliness increased, so did the risk of depression and suicidal ideation. Compared to the lowest loneliness quartile, those in the highest loneliness quartile were approximately 25 times more likely to experience moderate-to-severe depression (adjusted relative risk [aRR] = 25.09, 95% CI: 16.63-37.84) and 44 times more likely to report suicidal ideation (aRR = 44.31, 95% CI: 19.69-99.71). Intermediate loneliness levels (quartiles 2-3) also showed elevated risks (depression aRRs: 2.45, 7.33; suicidal ideation aRRs: 4.03, 11.87).

CONCLUSION: Increasing levels of loneliness were associated with greater risk of depression and suicidal ideation among older adults during the early pandemic, underscoring the need for targeted loneliness interventions for this vulnerable population.

PMID:41574431 | DOI:10.1080/13607863.2026.2612734

J Food Sci. 2026 Jan;91(1):e70831. doi: 10.1111/1750-3841.70831.

ABSTRACT

Milk adulteration is a threat to food safety and public health. It is especially tricky in regions where getting quick, inexpensive tests is not always an option. To tackle this, we have come up with a simple, affordable approach. It uses easy image analysis combined with machine learning to detect common adulterants in milk. Instead of relying on laboratory equipment, all we need are straightforward optical images-just photos of milk samples. From there, we look for clues that indicate contamination, making the whole process more accessible and practical. We had taken digital photographs of milk samples mixed with water, detergent, starch, and synthetic milk. From these images, we found key statistics: the average brightness, how much it varies, and higher order features like skewness and kurtosis. These help us understand how the light scattering and turbidity change as adulterants are added. Using principal component analysis (PCA), we simplified the data, and then support vector machines (SVMs) helped classify that samples were adulterated versus pure. The results were not perfect, but they were promising. Our model hit about 85% accuracy in identifying adulteration across the different types and amounts of contaminants. In particular, adding water made the mean intensity increase, whereas detergent, starch, and synthetic milk each produced unique patterns in skewness and kurtosis due to their scattering effects. Compared to expensive spectroscopic solutions, this approach is faster, does not require chemicals, and is economical, making it ideal for quick checks, even right at the point of sale or in rural areas.

PMID:41574420 | DOI:10.1111/1750-3841.70831

Int J Gynaecol Obstet. 2026 Jan 23. doi: 10.1002/ijgo.70807. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the diagnostic utility of three non-invasive hepatic fibrosis indices-aminotransferase-to-platelet ratio index (APRI), Fibrosis-4 (FIB-4), and FIB-5-in pregnancies complicated by intrahepatic cholestasis of pregnancy (ICP), and exploratory analysis of neonatal outcomes.

METHODS: This retrospective case-control study included 217 pregnant women who delivered at Göztepe Prof. Dr. Süleyman Yalçın City Hospital, a tertiary care center affiliated with Istanbul Medeniyet University, between September 2018 and February 2024. The study population was divided into two groups: 105 women diagnosed with ICP and 112 pregnant women without ICP who served as controls. The diagnosis of ICP was based on clinical pruritus, elevated serum bile acid levels (>10 μmol/L), and abnormal liver function tests. Women with pre-eclampsia, HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome, coagulopathy, hepatitis, multiple pregnancies, or other hepatic conditions were excluded. Laboratory parameters including aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), albumin, and platelet counts were used to calculate APRI, FIB-4, and FIB-5 scores. Statistical analyses included Mann-Whitney U-tests for group comparisons and receiver operating characteristics (ROC) curve analyses to determine the diagnostic performance of each score.

RESULTS: APRI and FIB-5 scores were significantly higher in the ICP group compared with controls, whereas FIB-4 showed a smaller between-group difference (P < 0.001 for APRI and FIB-5; P = 0.022 for FIB-4). ROC analysis demonstrated good diagnostic performance for APRI (area nder the curve [AUC] = 0.902; cut-off = 0.39; sensitivity = 82%; specificity = 89%) and moderate performance for FIB-5 (AUC = 0.718; cut-off = -1.84; sensitivity = 67%; specificity = 70%). FIB-4 showed lower diagnostic value (AUC = 0.590). Elevated scores were also associated with adverse neonatal outcomes, increased rates of preterm birth, and greater need for neonatal intensive care.

CONCLUSION: APRI, FIB-4, and FIB-5 are elevated in pregnancies affected by ICP and may serve as supportive, non-invasive markers reflecting hepatocellular stress and hepatic involvement. Among these indices, APRI showed the best diagnostic performance, FIB-5 demonstrated moderate discriminative ability, and FIB-4 had limited diagnostic utility. These indices may provide clinicians with additional information when evaluating hepatic dysfunction and may be associated with neonatal outcomes, although they are not validated prognostic tools. Prospective studies are warranted to further validate their clinical utility.

PMID:41574414 | DOI:10.1002/ijgo.70807

J Clin Pharmacol. 2026 Jan;66(1):e70139. doi: 10.1002/jcph.70139.

ABSTRACT

Valproic acid (VPA) is highly protein-bound, thereby impacting its free fraction and clearance in hypoalbuminemia. There is limited data on VPA use in such patients. Thus, this study evaluates the impact of adjusted VPA concentration (aVPAc) in predicting effectiveness and adverse effects compared to total VPA (tVPA) levels in hypoalbuminemic patients. A retrospective cohort study involved adult patients with seizures or epilepsy between January 1, 2016, and December 31, 2022. The levels of tVPA and aVPA (adjusted for albumin) were compared using receiver operating characteristic curves, and AUC differences were assessed using the DeLong method. Safety endpoints included hepatotoxicity, hyperammonemia, hyponatremia, and thrombocytopenia, while effectiveness endpoints were seizure occurrence, status epilepticus, and the use of additional antiepileptic medications during hospitalization. Of the 1621 screened patients, 71 with hypoalbuminemia received VPA. An aVPAc threshold of 154.19 mg/dL demonstrated higher sensitivity (86%) but lower specificity (47%) for predicting hepatotoxicity compared to a tVPA threshold of 67.53 mg/dL (sensitivity: 71%, specificity: 72%). Although aVPAc yielded a comparable negative predictive value (96% vs 95%), tVPA showed superior positive predictive value (25% vs 18%) and a higher Youden index (0.43 vs 0.33), indicating better overall discriminatory performance; however, these findings did not achieve statistical significance. In contrast, an aVPAc threshold of 188 mg/dL showed a sensitivity of 100% and a specificity of 82% for predicting hyperammonemia, which is superior to the tVPA threshold of 74.32 mg/dL that has a sensitivity of 40% and a specificity of 88%. The aVPAc also achieved a higher Youden index of 0.82 compared to 0.28 for tVPA. Adjusted VPA concentrations showed greater sensitivity than tVPA in predicting hepatotoxicity and hyperammonemia, suggesting potential utility for ruling out these adverse effects in hypoalbuminemic patients. Further research with a larger sample size is needed to validate these findings.

PMID:41574403 | DOI:10.1002/jcph.70139

Front Med (Lausanne). 2026 Jan 7;12:1715028. doi: 10.3389/fmed.2025.1715028. eCollection 2025.

ABSTRACT

BACKGROUND: Medical emergencies (MEs) in dental practice, though rare, can occur posing significant risks to patients. Dental professionals should be well-prepared to manage such situations. This study aimed to assess the knowledge, self-perceived confidence and preparedness of dental students and interns regarding the management of MEs in dental settings.

METHODS: A questionnaire-based cross-sectional study was conducted among clinical dental students and interns at a dental college in Saudi Arabia. Data were collected using an anonymous, self-administered online questionnaire consisting of 20 multiple-choice questions assessing knowledge, preparedness and confidence in handling MEs. Statistical analysis was performed using SPSS and employing Pearson’s Chi-squared test and logistic regression analysis.

RESULTS: The study analyzed data from 145 out of 200 participants invited (response rate = 72.5%). Most participants were female (51.0%) and aged ≥ 24 years (62.8%). A high knowledge level was identified in 58.6% of participating students and interns. While females exhibited a slightly higher knowledge than males, higher confidence and preparedness levels were identified among males, though the difference was not statistically significant (p = 0.05). Older and more advanced students demonstrated significantly higher knowledge and confidence (p < 0.05). The most encountered emergency by participants during dental treatment was syncope (65.5%), and seizures (29.6%). Adrenaline was the most commonly cited emergency drug in terms of availability in dental practices (38.6%), followed by anti-histamines (23.4%), while atropine was the least available (13.8%). Notably, 58.6% of participants reported lack of these emergency drugs in their practice settings.

CONCLUSION: The study highlighted a gap in the preparedness of dental students and interns to manage MEs effectively. The findings emphasize the need for enhanced training and education, particularly in managing more severe medical emergencies, to improve the overall emergency response in dental practices. Further, efforts should focus on increasing access to emergency drugs and equipment, along with regular BLS training, to ensure optimal patient safety.

PMID:41574378 | PMC:PMC12819686 | DOI:10.3389/fmed.2025.1715028

Front Med (Lausanne). 2026 Jan 7;12:1661619. doi: 10.3389/fmed.2025.1661619. eCollection 2025.

ABSTRACT

OBJECTIVES: We utilized high-frequency ultrasound to characterize vulvar skin alterations in lichenoid vulvar dermatoses (LVD) and to determine whether the sonographic vascular index (VI) correlates with histopathological microvessel density (MVD) and microvessel area (MVA).

METHODS: This study included thirty-seven patients with pathologically confirmed LVD who attended Henan Provincial People’s Hospital between December 2021 and May 2024. A control group of thirty-five healthy women, matched for age and BMI was selected during the same period. High-frequency ultrasound parameters of the vulvar skin between the two groups were analyzed using statistical tests. Vulvar skin specimens from LVD patients were stained with CD34 to determine MVD and MVA, and the correlation with the VI from ultrasound parameters was assessed.

RESULTS: (i) Analysis of variance showed that epidermal thickness, subepidermal low echogenic band (SLEB) thickness, dermal thickness, and VI were significantly increased in the LVD group compared to the control group (all P < 0.05). (ii) Correlation analysis revealed a positive correlation between the VI and MVD, MVA (r = 0.438, r = 0.630, both P < 0.05).

CONCLUSION: The vulvar skin thickness and VI in patients with LVD are increased compared to the control group. The VI reflects the microvascular status in LVD, highlighting the significant value of high-frequency ultrasound in assessing LVD.

PMID:41574372 | PMC:PMC12819178 | DOI:10.3389/fmed.2025.1661619

Front Med (Lausanne). 2026 Jan 7;12:1678666. doi: 10.3389/fmed.2025.1678666. eCollection 2025.

ABSTRACT

BACKGROUND: Pharmacy education is undergoing global transformation to better align with evolving healthcare demands. However, in Romania, pharmacy curricula remain centrally regulated and standardized, with limited input from graduates or employers.

OBJECTIVE: This study investigates the perceptions of Romanian pharmacy graduates (2009-2023) regarding the relevance of their curriculum, competency development, and professional preparedness across various employment sectors.

METHODS: A mixed-methods, cross-sectional survey was conducted with 473 alumni from all accredited pharmacy faculties in Romania. Quantitative data were analyzed using descriptive statistics, ANOVA, and logistic regression, while qualitative responses underwent thematic content analysis.

RESULTS: Graduates reported moderate overall preparedness (Mean = 3.08/5), with significant variation by institution, age, and job sector. High self-assessed competencies were noted in Pharmacology and Communication, while Management, Regulatory Affairs, and Therapy management were identified as key gaps. Disciplines such as Pharmacology and Clinical Pharmacy were rated highly useful, whereas Physics and Inorganic Chemistry were frequently cited as disproportionately difficult and less applicable. Open-ended responses emphasized the need for greater curricular flexibility, experiential learning, and integration of soft skills and entrepreneurship.

CONCLUSION: The results highlight a misalignment between standardized pharmacy education and the diverse realities of professional practice. The study advocates for alumni-informed reforms, modular curricula, and the integration of transversal competencies to enhance workforce readiness and sector-specific applicability.

PMID:41574364 | PMC:PMC12819258 | DOI:10.3389/fmed.2025.1678666