Category: Statistics

Vet Anaesth Analg. 2026 Feb 28;53(3):101217. doi: 10.1016/j.vaa.2026.101217. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the isoflurane-sparing effect and the intra- and postoperative analgesic efficacy of an ultrasound-guided transversus abdominis plane (TAP) block in pigs undergoing elective laparoscopic ovariectomy.

STUDY DESIGN: Prospective, randomised, blinded clinical study ANIMALS: A total of 35 female pigs.

METHODS: Pigs were randomly allocated to TAP or control groups. Premedication consisted of azaperone 1 mg kg^-1, xylazine 1.5 mg kg^-1, butorphanol 0.2 mg kg^-1, and ketamine 5 mg kg^-1 intramuscularly. Anaesthesia was induced with ketamine ± thiopental intravenously and maintained with isoflurane. A three-injection-point per hemiabdomen ultrasound-guided TAP block was performed with 1% lidocaine, 0.1 mL kg^-1 per point. No sham injection was performed in controls. Baseline heart rate (HR) and mean arterial pressure (MAP) were recorded before surgery at 1.0% end-tidal isoflurane (FE´Iso). Anaesthetic requirements were adjusted by a blinded investigator if HR and MAP deviated 20% from baseline. Ketamine 1 mg kg^-1 was administered for ventilator asynchrony. Postoperative pain was assessed using the UNESP-Botucatu pig composite acute pain scale. Pigs scoring ≥ 6/18 were given oral paracetamol 30 mg kg^-1. Statistical significance was set at p < 0.05.

RESULTS: After excluding nine pigs,12 were analysed in the TAP group and 14 in the control group. No statistically significant difference was found comparing overall isoflurane requirements (mean ± standard deviation FE´Iso area-under-the-curve: 7.12 ± 0.89 versus 7.19 ± 1.04 in TAP and control groups, respectively p = 0.775). Median postoperative pain scores (interquartile range) were 1 (1-4) in the TAP group and 1 (0-2) in controls. No significant differences were found in rescue analgesia requirements intra- (p = 0.759) or postoperatively (p = 0.867).

CONCLUSIONS AND CLINICAL RELEVANCE: Ultrasound-guided TAP block is a feasible technique in pigs. With the methodology used, no isoflurane-sparing effect of the TAP block was detected.

PMID:41966612 | DOI:10.1016/j.vaa.2026.101217

Vet Anaesth Analg. 2026 Mar 20;53(3):101226. doi: 10.1016/j.vaa.2026.101226. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the sedative effect of three doses of intranasal midazolam in the tropical screech owl (Megascops choliba).

STUDY DESIGN: Prospective, randomized experimental study.

ANIMALS: A group of 30 clinically healthy adult Megascops choliba.

METHODS: Owls were randomly assigned to one of three groups (n = 10). Each group was administered intranasal midazolam at doses of 2 mg kg^-1, 4 mg kg^-1, or 6 mg kg^-1. Sedation was assessed using a composite numerical rating scale (0-12). Righting reflex and recovery times were recorded. Statistical analyses were performed using analysis of variance (ANOVA) and multiple comparisons tests to compare sedation onset, depth, and duration among doses. Data are reported as median (interquartile range). A p value < 0.05 was considered statistically significant.

RESULTS: Onset time in seconds was significantly faster with 4 mg kg^-1 [32.5 (16.2-42.5) seconds] and 6 mg kg^-1 [29.5 (21.8-40.2) seconds] compared with 2 mg kg^-1 [77.0 (51.0-104.5) seconds; p = 0.010]. Median sedation scores over the observation period were lower in the 2 mg kg^-1 group [5.5 (3.7-5.8)] than in the 4 and 6 mg kg^-1 groups [7.2 (6.9-7.4) and 8.1 (7.7-8.4), respectively; p < 0.001]. No adverse effects were observed.

CONCLUSIONS AND CLINICAL RELEVANCE: Intranasal midazolam at 4-6 mg kg^-1 produced rapid, effective, and well-tolerated sedation in Megascops choliba, with no observable adverse effects. These findings contribute to optimizing sedative protocols for Strigiformes and support its practical value as a simple and efficient option for use in clinical and field settings.

PMID:41966611 | DOI:10.1016/j.vaa.2026.101226

J Prev Alzheimers Dis. 2026 Apr 10;13(6):100564. doi: 10.1016/j.tjpad.2026.100564. Online ahead of print.

ABSTRACT

BACKGROUND: Given the growing global public health burden of Alzheimer’s disease, this study used the Bayesian network meta-analysis to assess the effects of pharmacological and non-pharmacological interventions on cognitive function in the population with Alzheimer’s disease.

METHODS: Two investigators screened the literature from English databases (PubMed, MEDLINE, Embase, Cochrane CENTRAL, and Web of Science) and three major Chinese bibliographical databases (China National Knowledge Infrastructure Database, Wanfang Database, and VIP Database). We assessed the risk of bias and publication bias of the selected literature. Subsequently, a Bayesian network meta-analysis and meta-regression were conducted to further investigate the comparative efficacy of different interventions on cognitive outcomes.

RESULTS: A total of 4788 cases were initially identified. Photobiomodulation [SMD=0.66, 95%CrI (0.29, 1.02)], enriching environment [SMD=0.69, 95%CrI (0.08, 1.31)], pharmacological therapy [SMD=0.36, 95%CrI (0.17, 0.55)], cognitive stimulation therapy [SMD=0.32, 95%CrI (0.11, 0.55)] and exercise therapy [SMD=0.28, 95%CrI (0.06, 0.51)] showed considerable enhancements in cognitive function among individuals with Alzheimer’s disease. Photobiomodulation and enriching environment stood out, with their effects more potent than those of other therapies, as indicated by the surface under the cumulative ranking curve – photobiomodulation clocked in at 87.3%, while enriching environment scored 83.8%, versus pharmacological therapy’s 54.7%.

CONCLUSIONS: Among the interventions evaluated, photobiomodulation and enriching environment were associated with better improvements in cognitive function than pharmacological therapy. Exercise therapy and cognitive stimulation therapy also demonstrated beneficial effects. Music therapy showed no statistical difference from the control group. In addition, the research developed an innovative approach to contrast pharmacological and non-pharmacological treatments for Alzheimer’s disease.

REGISTRATION: PROSPERO 2025 CRD420251075628. Available from https://www.crd.york.ac.uk/PROSPERO/view/CRD420251075628.

PMID:41966601 | DOI:10.1016/j.tjpad.2026.100564

Clinics (Sao Paulo). 2026 Apr 10;81:100922. doi: 10.1016/j.clinsp.2026.100922. Online ahead of print.

ABSTRACT

INTRODUCTION: Hospitalization can generate stress and anxiety and lead to depression. Music therapy has been used in hospital environments to promote patient well-being. However, scarce research has examined heterogeneous groups using the single-session format. This controlled clinical trial aimed to compare the effects of three methods of single-session music therapy on reducing anxiety and depression in hospitalized adult patients with diverse endocrine disorders.

METHOD: Participants (n = 222) were non-randomly distributed into three experimental music therapy groups (compositional, songwriting, and receptive) and a control group. The instruments used were the Hospital Anxiety and Depression Scale (HADS; pre-and post-test).

RESULTS: The experimental groups presented a statistically significant decrease in the HADS scores (p < 0.05) compared with the control group. Participants in the experimental groups reported an enhancement in well-being.

DISCUSSION: Single-session music therapy interventions, mainly the receptive method, had a positive impact on reducing anxiety and depression in a heterogeneous group of hospitalized adult patients with endocrinopathies.

PMID:41966590 | DOI:10.1016/j.clinsp.2026.100922

J Craniomaxillofac Surg. 2026 Apr 10;54(7):104560. doi: 10.1016/j.jcms.2026.104560. Online ahead of print.

ABSTRACT

Mandibular condylar head fractures remain controversial with respect to optimal management. This systematic review and meta-analysis compared closed treatment and open reduction and internal fixation for intracapsular condylar head fractures. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was prospectively registered in the International Prospective Register of Systematic Reviews (CRD420261292186). Electronic databases were searched up to 31 December 2025. Randomized and non-randomized comparative studies with a minimum follow-up of three months were included. Risk of bias was assessed using the ROBINS-I and RoB 2 tool, and certainty of evidence was evaluated using the GRADE framework. Random-effects meta-analyses were performed where appropriate. Nine studies, including 547 patients, of which two were randomized trials, met the inclusion criteria. In the ORIF group, pre- and postoperative maximum mouth opening improved by a pooled mean difference of 19.70 mm (95% CI 3.22-36.18 mm), with substantial heterogeneity (I² = 97.9%). In the closed treatment group, the pooled mean improvement was 14.91 mm (95% CI -2.58 to 32.41 mm), with similarly high heterogeneity (I² = 98.3%). Direct comparison of postoperative maximum mouth opening demonstrated a small statistical difference favoring ORIF (mean difference 2.72 mm; 95% CI 0.28-5.17 mm; I² = 32.9%). Open reduction and internal fixation was associated with lower odds of postoperative occlusal discrepancy (odds ratio 0.14; 95% CI 0.03-0.79; I² = 68.1%). The pooled proportion of TMJ-related morbidity after closed treatment was 11% (95% CI 4-25%; I² = 75.7%); a pooled estimate for ORIF was not feasible. The pooled incidence of facial nerve weakness was 3% (95% CI 1-8%; I² = 0%) for standard preauricular approaches and 23% (95% CI 14-35%; I² = 62.0%) for modified preauricular approaches. Implant removal occurred in 4% of cases (95% CI 1-14%; I² = 24.0%). Radiological outcomes were heterogeneous and synthesized descriptively. The certainty of evidence ranged from low to very low. The differences observed were modest and should be interpreted cautiously. Both treatment strategies remain acceptable options pending higher-quality comparative evidence.

PMID:41966579 | DOI:10.1016/j.jcms.2026.104560

J Hazard Mater. 2026 Apr 7;509:142004. doi: 10.1016/j.jhazmat.2026.142004. Online ahead of print.

ABSTRACT

Polycyclic aromatic nitrogen heterocycles (PANHs), also known as azaarenes, are common co-contaminants at sites contaminated with polycyclic aromatic hydrocarbons (PAHs). Recent non-target analysis of PAH-contaminated soil samples has revealed an unexpected abundance and diversity of PANHs, with acridine standing out as a predominant compound within this group. Despite its known toxicity and prevalence in contaminated soils, the microbial communities and biochemical mechanisms responsible for acridine degradation remain poorly understood. We conducted DNA-stable isotope probing (DNA-SIP) using newly synthesized uniformly labeled ¹³C-acridine to comprehensively assess the bacterial taxa and functional genes involved in acridine biodegradation in a creosote-contaminated soil. Metagenomic analysis of ¹³C-enriched DNA from soil incubations identified a member of the genus Sphingobium as the primary acridine degrader. Transcriptomic analysis based on its 16S rRNA gene expression demonstrated a strong correlation with acridine removal from the soil. Shotgun metagenomic sequencing enabled the reconstruction of one metagenome-assembled genome (MAG). Functional annotation of this MAG revealed five gene clusters potentially involved in acridine biodegradation, and their actual contribution was assessed by gene expression analysis in soil incubations. Based on these findings, we reconstructed the metabolic pathway for putative acridine degradation in PAH-contaminated soil.

PMID:41966559 | DOI:10.1016/j.jhazmat.2026.142004

Oral Oncol. 2026 Apr 10;177:107969. doi: 10.1016/j.oraloncology.2026.107969. Online ahead of print.

ABSTRACT

OBJECTIVES: We assessed the expected losses of life expectancy (LE), quality of life (QoL), lifetime employment duration (LED), and lifetime productivity (LP) among workers with oral cancer (OC) in Taiwan.

MATERIALS AND METHODS: We linked five nationwide administrative databases in Taiwan and collected data on 22,908 pathologically verified OC workers from 2010 to 2019. Using a rolling algorithm, we estimated lifetime survival functions to obtain LEs. We abstracted each OC patient’s employment status and insured salaries to estimate LEDs and LP. Using the EQ-5D-3L QoL questionnaire repeatedly measured in 383 workers with OC at a single medical center, we multiplied the mean utility by survival rates to calculate quality-adjusted life expectancy (QALE). Finally, these estimates were compared with age-, sex-, and calendar-year-matched referents from vital statistics to estimate expected losses of LE, QALE, LED, and LP among workers with OC.

RESULTS: The earlier the stage, the lower the losses of QALEs and LP, with losses of 12.2 ± 4.3, 13.7 ± 2.5, 17.7 ± 2.3, and 21.4 ± 0.6 QALYs, respectively, for stages I-IV. The LED for stages I-IV were 8.4 ± 0.4, 6.9 ± 0.2, 5.6 ± 0.3, and 3.6 ± 0.2 years, respectively, corresponding with loss-of-LED -0.2 ± 0.4, 1.1 ± 0.2, 2.8 ± 0.3, and 4.4 ± 0.2 years, respectively. The LP for stages I-IV were US$122,929 ± 6440, 98,521 ± 2206, 77,636 ± 4625, and 48,887 ± 2170, respectively, which were equivalent to LP losses of 15.8 ± 4.7%, 31.0 ± 1.5%, 48.6 ± 2.8%, and 65.8 ± 1.6%, respectively.

CONCLUSION: The earlier the stage of OC diagnosis and treatment, the lower the losses of QALE, lifetime employment years, and LP. The above evidence would be useful for improving the incentive to screen among the target population.

PMID:41966555 | DOI:10.1016/j.oraloncology.2026.107969

Rev Esp Patol. 2026 Apr 10;59(3):100872. doi: 10.1016/j.patol.2026.100872. Online ahead of print.

ABSTRACT

INTRODUCTION: High-grade serous carcinoma (HGSC) is the most common and aggressive subtype of ovarian cancer. Although tumour stage and complete cytoreduction are key prognostic factors, the tumour immune microenvironment also influences prognosis, with CD8+ T lymphocytes representing the main effector component.

OBJECTIVE: To evaluate the clinical relevance of quantifying intraepithelial (ieTILs) and stromal (sTILs) CD8+ tumour-infiltrating lymphocytes using digital image analysis.

MATERIAL AND METHODS: A retrospective study was conducted on 74 patients with stage III-IV HGSC treated with cytoreductive surgery and chemotherapy. Tissue microarrays (TMAs) were constructed, and dual immunostaining for cytokeratin and CD8 was performed. Sections were analysed using supervised machine-learning algorithms to quantify ieTILs and sTILs. These parameters correlated with age, cytoreduction status, platinum-free interval (PFI), overall survival (OS), neoadjuvant therapy, and BRCA mutation status.

RESULTS: Patients with higher intraepithelial CD8+ T-cell infiltration showed longer overall survival and a trend toward a longer platinum-free interval, whereas stromal density was not associated with prognosis. In multivariate analyses, ieTILs remained as an independent prognostic factor for both OS and PFI.

CONCLUSIONS: Digital quantification of intraepithelial CD8+ TILs using dual immunostaining and machine-learning analysis provides an accurate assessment of the lymphocytic infiltrate and represents an independent prognostic factor in HGSC. The lack of prognostic value of stromal CD8+ density highlights the importance of assessing the spatial localisation of effector cells in tumour-immune interactions.

PMID:41966548 | DOI:10.1016/j.patol.2026.100872

Am J Emerg Med. 2026 Apr 5;105:56-62. doi: 10.1016/j.ajem.2026.04.002. Online ahead of print.

ABSTRACT

BACKGROUND: Pediatric orthopedic injuries represent a significant proportion of emergency department (ED) visits and are closely tied to physical activity, particularly organized sports. The COVID-19 pandemic imposed substantial disruptions on children’s routines and healthcare utilization, offering a unique opportunity to examine changes in orthopedic injury patterns across different pandemic phases. The objective of the current study was to evaluate temporal shifts in pediatric orthopedic injury characteristics and ED management before, during, and after the COVID-19 pandemic.

METHODS: This retrospective observational study included ED visits from two freestanding pediatric hospitals between January 2019 and December 2023. Patients aged 0-18 years with chief complaints related to upper or lower extremity injuries were analyzed. Demographic, clinical, and ED resource utilization variables were compared across pre-pandemic (2019), pandemic (2020-2021), and post-pandemic (2022-2023) periods using non-parametric statistical tests and trend analyses.

RESULTS: Among 29,777 encounters, orthopedic ED visits declined sharply in 2020, with relative increases in upper extremity and decreases in lower extremity injuries. ED length of stay peaked post-pandemic, and procedural sedation use increased during COVID but became more efficient over time. Imaging use dropped among low-acuity patients in 2020 and rebounded afterward. Public insurance coverage rose, while uninsured rates declined. Racial/ethnic representation also fluctuated during the pandemic.

CONCLUSIONS: The COVID-19 pandemic significantly influenced pediatric orthopedic ED presentations and management. While some trends have normalized, others – such as improved procedural efficiency – suggest enduring shifts in clinical practice. These insights can guide future preparedness and resource planning in pediatric emergency care.

PMID:41966546 | DOI:10.1016/j.ajem.2026.04.002

Infect Dis Health. 2026 Apr 10;31(3):100424. doi: 10.1016/j.idh.2026.100424. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to assess the current IPC practices at private-sector drug retail outlets in Southern Punjab, Pakistan, and to explore the facilitators and barriers to effective IPC implementation in these settings.

METHODS: A cross-sectional survey was conducted from July to October 2025, where data were collected from the pharmacists and pharmacy assistants working at private-sector drug retail outlets located in Southern Punjab, Pakistan. A structured questionnaire was designed following IPC guidelines from the World Health Organization, Centers for Disease Control and Prevention, and United States and National Institutes of Health, Pakistan. Multiple linear regression analysis was used to find the independent factors associated with IPC practices. p-value of <0.05 was considered statistically significant.

RESULTS: Out of total 187 drug retail outlets, 134 (71.7%) participated in the study. The majority of outlets exhibited suboptimal IPC practices (n = 112; 83.6%) and insufficient essential IPC resources (n = 71; 53.0%). Primary barriers associated with suboptimal IPC measures included staff non-compliance (n = 120; 89.6%), lack of formal monitoring mechanisms (n = 119; 88.8%), absence of IPC training opportunities (n = 118; 88.1%) and insufficient supervision (n = 117; 87.3%). Multiple linear regression analysis identified male gender (beta = -0.249, p = 0.005) and availability of IPC resources (beta = 0.217, p = 0.004) as significant factors associated with IPC practices.

CONCLUSION: Suboptimal IPC practices were observed at drug retail outlets due to staff commitment and regulatory deficits. Context-specific IPC policies were needed to explicitly address these gaps.

PMID:41966540 | DOI:10.1016/j.idh.2026.100424