Category: Statistics

J Interv Card Electrophysiol. 2026 Jun 18. doi: 10.1007/s10840-026-02361-3. Online ahead of print.

ABSTRACT

BACKGROUND: Esophageal injury following radiofrequency ablation for atrial fibrillation is closely associated with esophageal temperature. Studies suggest that discontinuous ablation may prevent excessive esophageal temperature rise; however, the temperature characteristics of discontinuous ablation strategy during ultra-high-power short-duration ablation remain unexplored.

METHODS: Fresh porcine cardiac tissue was used. A 15-mm deep vertical hole was drilled from the endocardial surface, and a temperature probe was inserted. The QDOT catheter (Biosense Webster) was positioned at the endocardial site of probe insertion, and the lesion was created using a 90 W, 4-s ablation strategy. After a predefined interval, a second lesion was created.Based on the inter-lesion time interval, samples were divided into four groups: 10 s (group 1), 20 s (group 2), 40 s (group 3), and 60 s (group 4). Temperature was recorded every 10 s.

RESULTS: Temperature curves in groups 1 and 2 exhibited a unimodal pattern, whereas groups 3 and 4 showed a bimodal pattern. Mean peak temperatures differed among groups: group 1, 39.1 °C (38.6-39.5 °C); group 2, 38.4 °C (38.0-38.7 °C); group 3, peak 38.0 °C (37.5-38.2 °C) with a sub-peak of 37.3 °C (37.1-37.5 °C); group 4, peak 37.8 °C (37.5-38.0 °C) with a sub-peak of 37.3 °C (36.9-37.6 °C). Peak temperatures differed significantly among groups (P < 0.0001). Analysis of repeated temperature measurements revealed a statistically significant between-groups effect (F = 7.2, P < 0.002). Using < 38.5 °C as a safety threshold for peak temperature, 8 cases (73.3%) in group 1 exceeded the threshold, 4 cases (27%) in group 2 reached the threshold, whereas neither group 3 nor group 4 exceeded it.

CONCLUSION: Tissue temperature demonstrates significant delayed and cumulative effects during ultra-high-power short-duration ablation. In our ex vivo model, longer inter-lesion intervals were associated with a more gradual temperature rise.

PMID:42313340 | DOI:10.1007/s10840-026-02361-3

J Appl Genet. 2026 Jun 18. doi: 10.1007/s13353-026-01079-2. Online ahead of print.

ABSTRACT

The mrk operon gene clusters encode type 3 fimbriae, involving in biofilm formation. Hence, we aimed to find out the distribution of mrk genes among uropathogenic Klebsiella pneumoniae (UPKP) strains. Moreover, mrk genes, hypermucoviscosity (HMV) characteristic and antimicrobial resistance (AMR) patterns and profiles were successfully, provided. From August 2023 to January 2024, 104 positive urine samples were collected. Standard microbiological and biochemical tests were employed to confirm the UPKP strains. Kirby-Bauer disc diffusion method was recruited to conduct antimicrobial susceptibility test (AST). The HMV characteristic in UPKP isolates was assessed using the string test. Finally, multiplex polymerase chain reaction (mPCR) was used to identify mrk genes distribution. Chi-square (χ²) and Fisher’s exact tests were utilized for statistical analysis. The mrk gene distribution varied among the UPKP isolates comprising mrkA (1.92%), mrkB (0.00%), mrkC (5.77%), mrkD (23.08%), mrkE (37.50%), and mrkF (83.65%). No mrk genes were detected among 13.46% (14/104) of UPKP isolates. The most common mrk gene patterns involved mrkF (32.70%), mrkE-mrkF (25.00%), and mrkD-mrkF (11.54%). In addition, the isolates exhibited diverse AMR profiles and phenotypes including: 65 multi-drug resistant (MDR) strains (nine groups, 42 patterns), 13 extensively drug-resistant (XDR) strains (nine patterns), nine pan drug-resistant (PDR) strains, 23 ESBL producers, and nine HMV isolates. None of the HMV strains displayed XDR, PDR, or ESBL phenotypes, suggesting limited horizontal gene transfer (HGT). Detailed analysis of mrk genes and AMR characteristics in UPKP, provides essential information for selecting effective prevention protocols and treatments for urinary tract infections (UTIs) and combating AMR.

PMID:42313334 | DOI:10.1007/s13353-026-01079-2

Wien Med Wochenschr. 2026 Jun 18. doi: 10.1007/s10354-026-01165-4. Online ahead of print.

ABSTRACT

BACKGROUND: Chikungunya virus (CHIKV) is an arthropod-borne virus belonging to the genus Alphavirus; it has been increasingly linked to neurological complications. This study aimed to highlight the neurological manifestations of chikungunya virus infection.

METHODS: This retrospective case series was conducted at the Aga Khan University Hospital, Karachi, Pakistan. Adult patients (aged 18 years and above) with typical arboviral prodrome (fever, arthralgias, myalgias) who tested positive for chikungunya IgM antibodies in serum and demonstrated new-onset neurological symptoms were included in the study. The sample size consisted of 18 patients. Descriptive statistics were used to demonstrate demographics and the clinical, radiological, and electrodiagnostic details of participants. Patients with neuro-chikungunya were trichotomized based on the extent of neuroaxis involvement into those with central nervous system (CNS) involvement, those with CNS and peripheral nervous system (PNS) involvement, and those with isolated PNS involvement.

RESULTS: This study found heterogenous nervous system involvement in chikungunya virus infection, including the brain, spinal cord, nerve roots, and peripheral nerves in variable combinations. The majority of patients in this cohort had CNS involvement (55%). Patients with widespread neuroaxis involvement tended to have a complicated hospital course leading to intensive care unit admission and even mortality.

CONCLUSION: The widespread neurological involvement seen in this study potentially points towards the possibility that chikungunya virus may affect the entire neuroaxis. Studies focusing on long-term sequelae are needed to ascertain the prognosis of neuro-chikungunya.

PMID:42313329 | DOI:10.1007/s10354-026-01165-4

Arch Osteoporos. 2026 Jun 18;21(1):93. doi: 10.1007/s11657-026-01684-y.

ABSTRACT

Fragility fractures are frequently under-recognized in emergency departments. A survey of 34 professionals revealed inconsistent assessment of key risk factors. Relevant gaps emerged between awareness and routine practice across professional roles. These findings highlight opportunities to improve recognition, documentation, and secondary prevention in ED settings.

PURPOSE: Fragility fractures are often under-recognized in the emergency setting, where the absence of standardized procedures leads to missed opportunities for diagnosis and secondary prevention. This project aimed to explore current emergency department (ED) practices regarding the identification and management of fragility fractures.

METHODS: A qualitative, cross-sectional survey was conducted among 34 healthcare professionals (10 emergency physicians, 11 radiologists, and 13 emergency nurses) from various Italian regions. The questionnaire, developed by a multidisciplinary expert panel, investigated propensities and self-reported practices related to fracture assessment, risk factor identification, and diagnosis of fragility fracture. All responses were grouped by role and represented graphically. Findings were then discussed during an expert meeting with the same panel.

RESULTS: Survey data revealed a generally high level of self-reported awareness of fragility risk factors among ED professionals but inconsistent implementation of the necessary diagnostic workup in daily practice. Important indicators, such as prior fractures, history of falls, family history of hip fracture, and use of risky medications, were often under-assessed. The term “fragility fracture” at discharge from the ED was rarely used, and role-based discrepancies emerged in risk assessment practices.

CONCLUSION: This survey highlights relevant gaps between awareness and clinical practice in the identification of fragility fractures in the emergency setting. Improving consistency in risk assessment and documentation may represent a key step toward optimizing secondary prevention and standardizing fragility fracture management in EDs.

PMID:42313315 | DOI:10.1007/s11657-026-01684-y

Health Justice. 2026 Jun 18. doi: 10.1186/s40352-026-00425-0. Online ahead of print.

ABSTRACT

BACKGROUND: Individuals released from jail die by self‑harm at nearly nine times the rate of the general U.S.

POPULATION: Most jails rely on traditional screening methods, such as brief self-report questionnaires, which are often inconsistently administered and have limited sensitivity and predictive accuracy. This highlights the urgent need for alternative self-harm risk identification methods during and after incarceration.

OBJECTIVE: To evaluate the feasibility of applying an existing self-harm risk prediction model to jail populations.

METHODS: We analyzed data from 4,154 individuals incarcerated in Michigan jails who were enrolled in Medicaid. We applied a prediction model, originally developed by the Mental Health Research Network (MHRN), to identify individuals at elevated risk for self-harm. Predictors included demographics, mental health and substance use diagnoses, medical comorbidities, prior history of self-harm, mental health-related hospitalizations, and dispensing of psychotropic medications.

RESULTS: The study cohort was predominantly male (70%) and racially diverse (50% Black, 43% White), with a median jail stay of just one day. Overall, the model demonstrated good discrimination, achieving a C-statistic of 0.77, with 68% sensitivity and 77% specificity, and a 99% negative predictive value. Notably, among individuals with shorter jail stays, predictive performance was better, with the C-statistic increasing to 0.80.

CONCLUSIONS: Health records-based models demonstrated good predictive performance and may offer a scalable, data-driven alternative to traditional screening tools in jails. Integrating health records-based risk prediction tools in jails could improve early detection of self-harm risk and support more targeted prevention efforts.

PMID:42313308 | DOI:10.1186/s40352-026-00425-0

Bull Math Biol. 2026 Jun 18;88(7):120. doi: 10.1007/s11538-026-01681-9.

ABSTRACT

The transmission of numerous zoonotic diseases hinges on the tripartite interactions among humans, animals and the environment. The One Health paradigm underscores the inextricable interconnection between human health, animal health and ecosystem health. This study innovatively develops a multi-host zoonotic disease transmission model incorporating both pathogen compartment and temperature effects. Through rigorous mathematical analysis, we prove the non-negativity and boundedness of solutions and systematically investigate the existence conditions and global asymptotic stability characteristics of equilibrium points. For intervention strategies, we establish an optimal control framework, demonstrating not only the existence of optimal solutions but also deriving explicit analytical expressions. Numerical simulations validate the model’s dynamic characteristics and enable quantitative evaluation of different interventions. Empirical analysis using China’s brucellosis surveillance data reveal: there is a potential correlation between temperature changes and the cases number and the model achieves a goodness-of-fit of 0.98 for cumulative cases, strongly validating its reliability; temperature influence quantification showed each ${10}^{\circ }$ C increase in mean annual temperature reduced peak incidence by 3888 cases (17.91%) and 20-year cumulative cases by 49556 (20.37%). Multi-strategy comparative studies identified pharmaceutical intervention with 40% enhanced treatment efficacy as the optimal strategy, providing scientific evidence for zoonotic disease control.

PMID:42313298 | DOI:10.1007/s11538-026-01681-9

Environ Monit Assess. 2026 Jun 18;198(7):738. doi: 10.1007/s10661-026-15588-4.

ABSTRACT

Understanding the distribution and controlling factors of trace elements in topsoils is essential for evaluating soil quality and potential environmental risks. This study investigated the concentrations, spatial distribution, enrichment characteristics, and environmental controls of trace elements (Co, Cu, Mo, Ni, and Zn) in surface soils of Cao Bang Province, northern Vietnam. Trace element concentrations were determined using inductively coupled plasma mass spectrometry (ICP-MS) following acid digestion of soil samples. The concentrations ranged from below detection limit (BDL) to 278.11 mg kg^-1 for Co, 0.26-269.32 mg kg^-1 for Cu, BDL-15.12 mg kg^-1 for Mo, BDL-482.58 mg kg^-1 for Ni, and 0.02-947.05 mg kg^-1 for Zn. Spatial interpolation revealed considerable variability across the study area, although most soils exhibited low to moderate concentrations. Enrichment factor (EF) values were generally below 3, indicating minimal to moderate enrichment and suggesting that these elements mainly originate from natural lithogenic sources. Principal component analysis showed strong associations among Co, Cu, Ni, and Zn, whereas Mo displayed a distinct behavior due to its sensitivity to oxidation reduction conditions and soil pH, which differs from the other transition metals. Statistical analyses indicated that topography and parent materials had no significant influence (p > 0.05) on trace element concentrations, while elevation showed a weak but significant effect on Ni (p = 0.049). Overall, the distribution of trace elements in Cao Bang topsoils is largely controlled by natural geochemical processes and long-term weathering, with limited evidence of significant anthropogenic contamination. These results provide important baseline information for topsoil environmental assessment and future monitoring in northern Vietnam.

PMID:42313280 | DOI:10.1007/s10661-026-15588-4

Geospat Health. 2026 Feb 2;21(1). doi: 10.4081/gh.2026.1443. Epub 2026 Jun 18.

ABSTRACT

Dengue Haemorrhagic Fever (DHF) remains a public health burden in Indonesia with substantial provincial variation. We modelled province-level DHF counts in 2023 using Bayesian spatial conditional autoregressive Poisson models with population offsets. Predictors were average annual temperature (per 1°C) and the number of public health workers (province-level count). Spatial dependence was supported by Moran’s I=0.4689 (p=0.021). We fitted models using Besag-York-Mollié (BYM) and Leroux priors via Markov chain Monte Carlo and compared fit using the Deviance Information Criterion (DIC) and the Watanabe-Akaike Information Criterion (WAIC). In the BYM model, temperature was associated with lower risk (RR=0.90; 95% CrI: 0.76 to 1.07), with uncertainty including unity, whereas workforce density was associated with higher reported risk (RR=1.05; 95% CrI: 1.03 to 1.07). Estimates were similar under the Leroux prior (temperature RR=0.89; 95% CrI: 0.74 to 1.07; workforce RR=1.04; 95% CrI: 1.02 to 1.07), and BYM showed marginally better fit. Risk mapping indicated elevated burden in parts of Kalimantan and eastern Indonesia. Findings may inform geographically targeted surveillance and vector control; the workforce association should be interpreted cautiously because it may reflect reporting capacity or reactive deployment.

PMID:42312467 | DOI:10.4081/gh.2026.1443

J Prosthodont. 2026 Jun 18. doi: 10.1111/jopr.70180. Online ahead of print.

ABSTRACT

PURPOSE: To investigate, based exclusively on randomized controlled trials (RCTs), the current evidence on the influence of different prosthetic abutment designs on peri-implant clinical outcomes and esthetic parameters.

METHODS: This systematic review and meta-analysis of RCTs was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A comprehensive and systematic search was conducted across multiple databases and gray literature, including MEDLINE/PubMed, Scopus, Web of Science, Embase, ReBEC, Trials, Virtual Health Library, and ProQuest, to identify RCTs comparing different abutment designs. Abutments were categorized into narrowed (concave, curved), straight (linear, convex, cylindrical), and widened (wide) profiles. The primary outcomes were marginal bone loss (MBL), probing depth (PD), and Pink Esthetic Score (PES), all assessed through meta-analyses. Secondary outcomes included abutment survival, biological and technical complications, as well as additional aesthetic parameters, including mid-facial mucosal zenith (MMZ), keratinized mucosa width (KMW), mucosal thickness (MT), mucosa position (MP), and soft tissue profile (SP). Risk of bias was assessed using the Cochrane RoB 2.0 tool, and the certainty of evidence was evaluated according to the GRADE approach.

RESULTS: The search resulted in 10,566 studies; after removal of duplicates, 5270 studies remained. Of those, 5252 were excluded based on title and abstract screening. Ultimately, 10 RCTs with follow-ups ranging from 3 to 60 months were included for quantitative and qualitative assessments. Of these, six provided data that could be pooled and were included in the quantitative analysis. Risk of bias varied among studies, with high risk observed in 2 RCTs, some concerns in 5 studies, and low risk in 3 studies, primarily related to outcome measurement and blinding, as assessed using the RoB 2.0 tool. Overall certainty of evidence was rated moderate. The meta-analyses showed no statistically significant difference in MBL, PD or PES between narrowed and straight profiles (MBL: SMD = 0.08, p = 0.66); PD: SMD = -0.05, p = 0.80; PES: SMD = -0.12, p = 0.51). Additionally, no differences were found in biological or esthetic outcomes between abutment types, with stable peri-implant parameters and high patient satisfaction. Technical complications were rare, involving early failures and occasional fractures, especially in concave abutments.

CONCLUSION: Based on the current evidence and within the limitations of the included studies, abutment shape does not appear to significantly influence peri-implant tissue response or esthetic outcomes. Further well-designed RCTs with standardized protocols, adequate sample sizes, and longer follow-up are required to increase the certainty of the evidence and improve the external validity of the findings.

PMID:42312454 | DOI:10.1111/jopr.70180

Eur J Paediatr Dent. 2026 Jun 1;27(2):154-163. doi: 10.23804/ejpd.2026.2783.

ABSTRACT

AIM: To identify and analyse the 100 most-cited articles published in paediatric dentistry journals, providing an updated bibliometric overview of the field and comparing findings with previous analysis.

METHODS: The Web of Science database was searched up to January 2026 to identify the most-cited papers published in paediatric dentistry journals. The top 100 articles were selected and analysed for citation count, publication year, source journal, geographic distribution, authorship, study design, and thematic area. Co-occurrence network analysis was performed using VOSviewer.

CONCLUSION: Compared with the 2019 analysis, citation thresholds have risen substantially, systematic reviews have replaced cross-sectional studies as the dominant design, MIH has emerged as a leading research theme, and geographic disparities in citation accumulation persist and warrant attention.

PMID:42312443 | DOI:10.23804/ejpd.2026.2783