Category: Statistics

J Neonatal Perinatal Med. 2026 Aug 14:19345798261475686. doi: 10.1177/19345798261475686. Online ahead of print.

ABSTRACT

ObjectiveNeonatal hyperbilirubinemia (NHB) is a common clinical condition that may lead to long-term neurodevelopmental impairment due to bilirubin-induced neurotoxicity. The development of reliable methods for neurological monitoring in affected newborns remains a major challenge in neonatal care. This study aimed to evaluate the association between treatment and EEG changes on cerebral activity in infants with hyperbilirubinemia using conventional EEG.Methods & MaterialsThis prospective before-and-after study was conducted on neonates aged over 35 weeks of gestation who were diagnosed with hyperbilirubinemia. Demographic and clinical data, including neonatal age, sex, birth weight, presence of ABO incompatibility, and treatment modalities, were collected. Maternal data, including parity, mode of delivery, and maternal and neonatal blood groups, were also recorded.Conventional EEG was performed for all neonates during the first eight hours of hospitalization and repeated after therapeutic interventions, including phototherapy and, when indicated, exchange transfusion.ResultsA total of 26 neonates with hyperbilirubinemia were included in this study. The mean total serum bilirubin level before treatment was 23.01 ± 2.99 mg/dL.A statistically significant change in the EEG spectral power was observed before and after treatment in the frontal regions Fp1, Fp2, and Fz, particularly within the delta and beta frequency bands.Furthermore, the findings demonstrated that delta activity was significantly dominant in the Fp1, Fp2, and Fz regions both before and after treatment. In contrast, no dominant frequency bands were observed in the C3, O1, T3, C4, T4, Cz, and O2 regions either before or after treatment.ConclusionHyperbilirubinemia in neonates may be associated with alterations in cortical electrical activity as assessed by conventional EEG. In our study, delta band activity was significantly predominant in the frontal regions (Fp1, Fp2, and Fz) both before and after treatment. Moreover, delta band activity remained the predominant frequency in the frontal regions (Fp1, Fp2, and Fz) before and after treatment, suggesting persistent frontal cortical involvement despite treatment.Further studies with larger samples are recommended to clarify whether these EEG changes reflect a transient bilirubin effect or age-related maturation patterns.

PMID:42596718 | DOI:10.1177/19345798261475686

J Periodontal Implant Sci. 2026 Jul 30. doi: 10.5051/jpis.2500240012. Online ahead of print.

ABSTRACT

PURPOSE: This pilot study investigated the effects of different extraction-socket bone-resorption patterns on alveolar ridge preservation (ARP) performed with an open-wound healing technique.

METHODS: Sites were divided into two groups according to cone-beam computed tomography (CBCT) findings obtained immediately after ARP surgery (T1): group 1 included sockets with vertical bone resorption >1/3 of the buccal/labial or lingual/palatal bone wall, and group 2 included sockets with vertical bone resorption ≤1/3 of the buccal/labial and lingual/palatal bone walls. Follow-up CBCT was performed approximately 5 months after surgery (T3). Hard-tissue changes were measured by superimposing CBCT images obtained at T0 (before tooth extraction), T1, and T3. Soft-tissue healing was evaluated at suture removal (T2), and biopsy specimens were collected before implant placement.

RESULTS: Sixteen participants with 19 sites completed this pilot study. All included patients underwent ARP with an intentionally exposed xenogeneic collagen matrix seal; however, one patient did not undergo implant-placement surgery at our hospital. Overall, CBCT measurements of ridge alterations showed excellent intra-rater reliability and minimal systematic bias. Bone resorption occurred in both groups (P<0.05), reflecting the natural bone-remodeling process. However, no intergroup differences were observed in horizontal or vertical dimensional changes. In addition, locally estimated scatterplot smoothing analysis identified bootstrap median inflection points below the 1/3 threshold, suggesting a possible nonlinear relationship between the vertical resorption proportion and three-dimensional changes. No statistically significant differences were observed in soft-tissue healing or implant-related outcomes. Histomorphometric evaluation of biopsy specimens showed new bone formation without signs of inflammation or fibrous encapsulation.

CONCLUSIONS: Within the limitations of this study, intentionally exposing the xenogeneic collagen matrix seal yielded comparable outcomes in non-contained and contained sockets. This finding may reflect the material’s ability to reduce the adverse effects of socket-wall resorption; however, larger multicenter studies are warranted.

TRIAL REGISTRATION: Chinese Clinical Trial Registry Identifier: ChiCTR2300078331.

PMID:42596716 | DOI:10.5051/jpis.2500240012

J Periodontal Implant Sci. 2026 Jun 15. doi: 10.5051/jpis.2601920096. Online ahead of print.

ABSTRACT

PURPOSE: This study evaluated the regenerative potential of a novel polyethylene glycol (PEG)-chitosan hydrogel as an alternative to a conventional collagen membrane for guided tissue regeneration (GTR) of class II furcation defects in a canine model.

METHODS: Standardized class II furcation defects were created in the maxillary third and fourth premolars of 6 beagle dogs. Sites were randomly allocated to 4 groups: 1) sham control, 2) particulate biphasic calcium phosphate (BCP) with a cross-linked collagen membrane (O3CM), 3) collagenated BCP with a collagen membrane (O3ColCM), and 4) particulate BCP with PEG-chitosan hydrogel (O3TG). After 8 weeks, specimens were processed for histological and histomorphometric analyses. The primary outcome was hard tissue area (HTA) within a predefined 3-mm region of interest.

RESULTS: Histologically, O3TG showed consolidated graft particles in close contact with the surrounding tissues and new bone formation extending coronally from the defect base, with no notable inflammatory response. Histomorphometric analysis revealed no statistically significant differences among the groups. Median HTA values ranged from 1.55 mm² in O3TG to 1.92 mm² in the control group (P=0.997). The non-filled area tended to be smaller in O3CM (0.68 mm²) and O3TG (0.66 mm²) than in the control group (1.14 mm²) and O3ColCM (1.58 mm²), although the difference was not statistically significant (P=0.258).

CONCLUSIONS: Within the limitations of this study, PEG-chitosan hydrogel achieved regenerative outcomes comparable to those of collagen membrane-based GTR while stabilizing BCP particles without adverse inflammation. Given its ease of handling and biocompatibility, PEG-chitosan hydrogel may represent a clinician-friendly alternative to collagen membranes for periodontal regeneration in class II furcation defects.

PMID:42596715 | DOI:10.5051/jpis.2601920096

J Periodontal Implant Sci. 2026 May 26. doi: 10.5051/jpis.2600560028. Online ahead of print.

ABSTRACT

PURPOSE: To retrospectively evaluate the effects of vestibuloplasty using a xenogeneic collagen matrix (XCM) at implant sites with insufficient peri-implant keratinized tissue (PIKT) and a shallow peri-implant vestibule (PIV).

METHODS: Patients who underwent vestibuloplasty with an XCM between July 2021 and August 2023 at Kyung Hee University Dental Hospital were included. Inclusion criteria were PIKT <2 mm, PIV <4 mm at baseline, and a follow-up duration of >6 months. Clinical parameters, including PIKT and PIV, were measured at baseline and at 1 month, 6 months, and the final visit. Marginal bone level (MBL), probing depth (PD), bleeding on probing (BOP), and the modified plaque index (mPI) were recorded at the final visit. Descriptive statistical analyses were performed.

RESULTS: Thirteen patients with 22 implant sites were included, with a mean follow-up of 1.19±0.27 years. Baseline PIKT and PIV were 0.59±0.57 mm and 2.66±0.81 mm, respectively. At the final visit, the mean gains in PIKT and PIV were 1.52±1.16 mm and 2.73±1.99 mm, resulting in final values of 2.11±1.01 mm and 5.39±1.85 mm, respectively. Clinical and radiographic peri-implant parameters indicated favorable conditions (PD: 2.30±0.61 mm; BOP: 0.15±0.26; mPI: 0.27; MBL: 1.23±0.97 mm).

CONCLUSIONS: Vestibuloplasty using an XCM was associated with achieving clinically accepted threshold values for PIKT and PIV while maintaining favorable peri-implant conditions. Long-term follow-up is warranted.

PMID:42596711 | DOI:10.5051/jpis.2600560028

J Periodontal Implant Sci. 2026 May 6. doi: 10.5051/jpis.2504740237. Online ahead of print.

ABSTRACT

PURPOSE: This study evaluated phase-specific peri-implant marginal bone level (MBL) changes associated with abutment disconnection and reconnection during prosthetic procedures by comparing implant-level (IL) and abutment-level (AL) restorative protocols over a 1-year period.

METHODS: This two-arm randomized controlled clinical trial included patients receiving posterior mandibular fixed partial dentures following soft tissue augmentation. Implants were randomly assigned (1:1) to IL or AL protocols. In the IL group, repeated abutment disconnection and reconnection were performed during prosthetic procedures, whereas in the AL group, a definitive abutment was connected and maintained without disconnection. Standardized periapical radiographs were obtained at implant placement (T0), 2 weeks after second-stage surgery (T1), at definitive prosthesis delivery (T2), and 1 year after loading (T3). MBL changes were analyzed by phase: suprastructure connection (T1-T0), prosthetic (T2-T1), maintenance (T3-T2), and cumulative (T3-T0). Statistical significance was set at P<0.05.

RESULTS: Implant success was 100% at 1 year in both groups. In the IL group, MBL changes were Δ(T1-T0)=-0.41±0.43 mm, Δ(T2-T1)=-0.34±0.38 mm, and Δ(T3-T2)=-0.31±0.43 mm, with a cumulative change of Δ(T3-T0)=-1.06±0.49 mm. In the AL group, the corresponding values were -0.81±0.44 mm, -0.14±0.24 mm, -0.12±0.30 mm, and -1.08±0.39 mm, respectively. Phase-specific remodeling differed between protocols, whereas the cumulative 1-year change was comparable.

CONCLUSIONS: Under conditions of vertical soft tissue augmentation, abutment disconnection and reconnection were associated with phase-specific MBL remodeling; however, cumulative 1-year MBL changes were similar between IL and AL protocols.

PMID:42596708 | DOI:10.5051/jpis.2504740237

Nucl Med Commun. 2026 Aug 14. doi: 10.1097/MNM.0000000000002230. Online ahead of print.

ABSTRACT

OBJECTIVE: Nuclear medicine is a well-established modality for assessing infection or loosening of prosthetic joint replacements. However, previous research suggests that loosening and low-grade periprosthetic infection can appear similar. Patients with vitamin D deficiency have been noted to have poorer outcomes postsurgery for both infection and loosening. Patients with low-grade uptake and low vitamin D levels may be mismanaged if imaging is inaccurate. This study evaluated the association between nuclear medicine imaging accuracy and vitamin D levels in patients with prosthetic joint replacements.

METHODS: A retrospective single-center cohort study was carried out. Data were collected anonymously with 298 cases including knee and hip prostheses. Clinical findings were split into two categories: matched, whereby scan reports agreed with clinical findings, and unmatched, whereby they did not match and therefore imaging was inaccurate. Chi-squared and Fisher’s exact tests were performed to assess statistical significance.

RESULTS: Analysis shows a statistically significant association between imaging accuracy of prosthetic joint replacements and vitamin D level (P < 0.001). There was no significant difference between prosthesis types. Patients with low vitamin D were 2.61 times more likely to have inaccurate results.

CONCLUSION: There was an association between vitamin D levels and nuclear medicine imaging accuracy, and imaging results in cases with low vitamin D levels were two times more likely to be inaccurate. Prospective research would be appropriate to further confirm this. Vitamin D levels could be used as an indicator for the accuracy of imaging results, or low vitamin D levels could be managed before imaging.

PMID:42596699 | DOI:10.1097/MNM.0000000000002230

J Nurs Manag. 2026;2026(1):e2066972. doi: 10.1155/jonm/2066972.

ABSTRACT

OBJECTIVES: To evaluate the impact of implementing an evidence-based intrapartum care quality improvement program on childbirth outcomes for laboring women.

METHODS: A quasiexperimental interrupted time series (ITS) study using routinely collected hospital data was conducted at the Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China. The study period spanned from November 1, 2021, to December 31, 2022, with a 4-month preparation phase (April 1, 2022, to July 31, 2022) excluded from analysis. A total of 422 women were included (211 preintervention and 211 postintervention), aggregated into 20 biweekly time points (10 preintervention and 10 postintervention). Key measures included intrapartum cesarean section (ICS) rates, oxytocin use, duration of labor, and childbirth experience scores. Sociodemographic and clinical data were extracted from routine records, and childbirth experience was assessed using the Childbirth Experience Questionnaire (CEQ 2.0).

RESULTS: Prior to the intervention, the ICS rate increased by 2.057% per biweekly time point (p = 0.015). After implementation, the ICS rate showed a decreasing trend, with a slope reduction of 2.782% compared with the preintervention trend (p = 0.018), resulting in an overall postintervention slope of -0.725% per biweekly time point. The estimated contribution of the intervention to ICS reduction was -22.69%. Compared with the preintervention group, women in the intervention phase had lower oxytocin use (71.09% vs. 80.09%, p < 0.05), shorter total labor duration (median 456.5 min [265.0-602.5] vs. 472.5 min [280.0, 670.0], p < 0.05), and higher childbirth experience scores (72.23 ± 9.76 vs. 69.27 ± 8.84, p < 0.05).

CONCLUSION AND IMPLICATIONS FOR NURSING MANAGEMENT: This quality improvement program effectively optimized intrapartum care through reduced medical interventions and enhanced childbirth experiences. Successful scaling up requires institutional commitment to midwifery continuity models, context-adaptive implementation strategies, and sustained investment in midwifery training and outcome monitoring systems to ensure equitable and woman-centered care delivery.

PMID:42596690 | DOI:10.1155/jonm/2066972

Proteins. 2026 Aug 13. doi: 10.1002/prot.70166. Online ahead of print.

ABSTRACT

An advanced theory based on statistical physics was applied to microscopically investigate androstenone adsorption and its relationship with olfactory perception in chimpanzees and gorillas. For this purpose, dose-response curves of androstenone on olfactory receptors of chimpanzee OR7D4 and gorilla OR7D4 were analyzed by statistical physics. The two-energy adsorption model fits the chimpanzee data well, and the gorilla data are best fit by the one-energy adsorption model. The stereographic parameter analysis indicated that the studied pheromones were docked in a nonparallel manner in both species via a multimolecular mechanism. The analysis showed that the molecules interacted with different amino acid residues, resulting in distinct olfactory responses. The positive values of the molar adsorption energies indicate that an exothermic and physisorption process occurred in both olfactory systems. The docking analysis revealed that androstenone binds to the olfactory receptors of chimpanzees and gorillas through specific interactions with amino acid residues in the binding pockets. The docking results indicated distinct binding modes in each species, involving van der Waals, alkyl, and C-H interactions, which corroborated the energy trends predicted by the statistical physics model. These findings provided insights into the molecular mechanisms underlying the differential olfactory responses in chimpanzees and gorillas. Statistical physics was an excellent tool for evaluating and interpreting the interactions between androstenone and olfactory receptors.

PMID:42595735 | DOI:10.1002/prot.70166

J Public Health Dent. 2026 Aug 13. doi: 10.1111/jphd.70073. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to develop a framework to guide the provision of basic denture services within public oral health facilities in selected districts of KwaZulu-Natal, South Africa. The study addressed gaps in oral rehabilitation services, particularly the dominance of tooth extractions, limited prosthodontic capacity, and the lack of systematic, evidence-based planning for denture service delivery in underserved communities.

METHODS: A multi-stage qualitative synthesis integrating four data sources was undertaken: a 5-year review of district-level oral health service statistics, semi-structured interviews with provincial executives, oral health managers, clinicians, and private providers, and a patient survey on tooth loss and oral health-related quality of life. Findings were triangulated and interpreted using Health Needs Assessment Theory, Public-Private Partnership Theory, the Universal Health Coverage framework, and principles of social justice and quality of life.

RESULTS: Analysis revealed persistently high extraction rates, minimal denture provision, rural-urban disparities, and inadequate laboratory and human resources. Stakeholders reported limited financial capacity, infrastructure constraints, and inconsistent understanding of National Health Insurance requirements. Patient responses demonstrated substantial functional and psychosocial impacts of missing teeth and highlighted unmet rehabilitative needs. These insights informed the development of a three-stage framework comprising evidence production, stakeholder engagement, and enactment of program changes.

CONCLUSIONS: The resulting framework offers a context-responsive, evidence-informed approach to improving denture services at district level. By integrating needs-based planning, collaborative implementation, and continuous monitoring, the framework supports equitable access to oral rehabilitation and aligns with national priorities for universal health coverage and improved oral health-related quality of life.

PMID:42595710 | DOI:10.1111/jphd.70073

Restor Dent Endod. 2026 Aug 12. doi: 10.5395/rde.2026.51.e34. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to evaluate the shear bond strength (SBS) of different resin cements to three-dimensional (3D)-printed restorative resins and to investigate the effects of silane treatment and substrate type on bonding performance.

METHODS: Four resin cements-three self-adhesive and one adhesive-were applied to two types of 3D-printed resins: ODS Permanent Resin (OPR) and Graphy Permanent Resin (GPR). Each substrate was tested with and without silane treatment. SBS was measured, and the failure modes were classified. Scanning electron microscopy (SEM) was used to analyze surface morphology of the 3D-printed substrates. Statistical analyses were performed to determine the effects of cement type, silane application, and substrate type on SBS.

RESULTS: Resin cement type significantly influenced SBS, with Clearfil SA (Kuraray) exhibiting the lowest values, while the other cements demonstrated comparable performance. Silane treatment and substrate type did not show statistically significant effects on SBS. SEM analysis revealed smoother surfaces in OPR compared to GPR. Failure mode analysis showed predominantly cohesive failures for OPR, whereas GPR exhibited more adhesive and mixed failures.

CONCLUSIONS: Resin cement selection plays a crucial role in achieving optimal bond strength to 3D-printed restorative resins. Silane application provided limited benefits for filler-deficient substrates, indicating that alternative surface treatments may be necessary.

PMID:42595706 | DOI:10.5395/rde.2026.51.e34