Category: Statistics

Sci Rep. 2026 Jan 4. doi: 10.1038/s41598-025-34521-2. Online ahead of print.

ABSTRACT

This retrospective observational study compared the effects of traditional Anterior Repositioning Splint (ARS) and digital ARS on the upper airway of patients with skeletal Class II malocclusion and temporomandibular joint degenerative joint disease. A total of 110 patients were included and divided into two groups: the traditional ARS group (55 cases) and the digital ARS group (55 cases). Dolphin Image 11.95 software was used to measure the CBCT of the temporomandibular joint before and after treatment, and upper airway-related indicators were analyzed. Additionally, patient satisfaction and chairside adjustment time were assessed. The results showed that in the traditional group, the oropharyngeal volume and the total oronasopharyngeal volume significantly increased after treatment (P < 0.05), while there was no statistical difference in the nasopharyngeal volume and the minimum oropharyngeal cross-sectional area. In the digital group, the nasopharyngeal volume significantly increased after treatment (P < 0.05), and the other three indicators increased more significantly (P < 0.01). Intergroup comparisons of changes in upper airway indicators, only the minimum cross-sectional area, the digital group showed a significantly greater improvement than the traditional group (95%CI: 2.15-62.59; P = 0.023). There was no difference in the base tooth discomfort score between the two groups, but there were statistical differences in the degree of speech impact, foreign body sensation, appearance impact, opposing tooth discomfort, total satisfaction score, and chairside adjustment time (P < 0.05). The conclusion is that the digital anterior repositioning anatomical splint is superior to the traditional splint in terms of improvement effects on the upper airway, efficiency of clinical operations and patient satisfaction. Clinical trial number: KS20241029001.

PMID:41486329 | DOI:10.1038/s41598-025-34521-2

Sci Rep. 2026 Jan 4. doi: 10.1038/s41598-025-33787-w. Online ahead of print.

ABSTRACT

Biofilm formation and bacterial colonization on titanium implants pose significant challenges in healthcare, often leading to implant failure. Surface modifications using nanotechnology offer a promising approach to improve antibacterial properties while maintaining biocompatibility. To evaluate the surface characteristics, cytocompatibility, and antibacterial efficacy of titanium discs coated with polydopamine (PDA) alone versus PDA combined with poly (MBAAm-co-SBMA) zwitterionic nanoparticles. This in vitro comparative study involved the coating of titanium discs into two groups: Group 1 (PDA-coated) and Group 2 (PDA + poly (MBAAm-co-SBMA) zwitterionic nanoparticle-coated). poly (MBAAm-co-SBMA) zwitterionic nanoparticles were synthesized using the distillation-precipitation polymerization method. Surface morphology and Surface Roughness was analyzed using field emission scanning electron microscopy (FESEM) and Atomic force Microscopy (AFM), and elemental composition was determined via energy-dispersive spectroscopy (EDS). Cell viability was assessed using BCA protein assay in, while antibacterial activity against Streptococcus mutans was evaluated using the disk diffusion method. Statistical analysis was conducted using one-way ANOVA with a post-hoc Tukey test (p < 0.05), and results were reported as mean ± standard deviation . FESEM revealed uniform nanoparticle deposition with globular morphology PDA + poly (MBAAm-co-SBMA) zwitter ion nanoparticles. EDS confirmed increased carbon presence in the zwitterion-coated group. Cell viability was comparable between PDA (49.1%) and PDA + poly (MBAAm-co-SBMA) zwitterion (52.5%) groups. PDA + poly (MBAAm-co-SBMA) zwitterion group showed a significantly reduced S. mutans colony count (1.25 × 10⁴ CFU/mL) versus Group 1 (1.4 × 10⁵ CFU/mL). Conclusion Even though Polydopamine has significant antibacterial activity as evidenced in literature, it was observed in this study that, PDA-poly (MBAAm-co-SBMA) zwitterionic nanoparticle coatings demonstrated superior antibacterial activity and favourable surface morphology than PDA, without compromising cytocompatibility, making them suitable for reducing biofilm-associated infections on titanium implants.

PMID:41486295 | DOI:10.1038/s41598-025-33787-w

Int J Eat Disord. 2026 Jan 4. doi: 10.1002/eat.70020. Online ahead of print.

ABSTRACT

OBJECTIVE: To review the history of the term atypical anorexia nervosa and the challenges surrounding its current description and to propose a new name and diagnostic criteria.

METHOD: We review the use of the term “atypical” in the literature on eating disorders and in the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM) and note several terms in the current description that are in need of clarification. We also describe how the ICD-11 has grappled with atypical anorexia nervosa.

RESULTS: The first use of atypical anorexia nervosa was by Hilde Brȕch to describe individuals who had lost substantial weight but who lacked the characteristic psychological features of anorexia nervosa. In the section on Eating Disorders Not Otherwise Specified, the DSM-IV included a description of a disorder very similar to the description of atypical anorexia nervosa; the DSM-5 slightly changed the wording and applied the term atypical anorexia nervosa. Features in the description in need of definition include “significant weight loss” and “normal or above normal weight,” and the current name is problematic.

DISCUSSION: We discuss these issues and several potential options for defining features in the current description and for a new name. Following other examples in the DSM-5-TR, we propose the disorder be named “anorexia nervosa-like eating disorder (weight in normal or above normal range)” (acronym: ANLED) and suggest diagnostic criteria which could be included in the DSM-5-TR section on Conditions for Further Study.

PMID:41486258 | DOI:10.1002/eat.70020

Childs Nerv Syst. 2026 Jan 5;42(1):5. doi: 10.1007/s00381-025-07044-4.

ABSTRACT

PURPOSE: Chiari I malformation (CM1) is often incidentally detected on neuroimaging, with a minority of cases requiring intervention. There remain variability in the available guidelines for predicting surgery in pediatric CM1 patients. The study sought to design a preoperative scoring system using key radiological factors to anticipate likelihood of surgery in pediatric CM1 patients.

METHODS: A retrospective single-center study examining 122 CM1 patients identified between January 2007 to February 2020 was carried out. Radiological parameters associated with surgery as an outcome vs no surgery were collected and analyzed to develop a preoperative scoring system.

RESULTS: The statistically significant radiological parameters associated with surgical intervention include herniated tonsil ≥ 1 cm (85.2%), obex below McRae’s line (70.4%), dilated central canal and syrinx (63.0%) and medullary kinking (51.9%). These variables were scrutinized for predictiveness in developing a 10-point preoperative scoring system.

CONCLUSION: This study highlights the association of herniated tonsil, syrinx and medullary kinking with surgery as outcome. The proposed scoring system combining these imaging features shows increasing surgery probability with higher scores, reaching 100% at score of 10 and 50% at score of 4. This system may aid in triage, screening and prioritizing the patients for urgent neurosurgical referral or for conservative management.

PMID:41486256 | DOI:10.1007/s00381-025-07044-4

Magn Reson Med. 2026 Jan 4. doi: 10.1002/mrm.70246. Online ahead of print.

ABSTRACT

PURPOSE: To present a method for quantifying dissolved ¹²⁹Xe spectroscopy using singular value decomposition (SVD) and a dynamic red blood cell (RBC)/membrane ratio as a biomarker of disease.

METHODS: A spectroscopic sequence was performed in 45 subjects (27 healthy, 12 dyspnea of unknown origin [DUO], and 6 pulmonary hypertension [PH]) consisting of 499 pulse/acquire experiments. SVD was used to construct a low-noise approximation of FID data, and time-domain curve-fitting was performed on all free induction decays allowing calculation of RBC (218 ppm) and membrane (197 ppm) signal amplitudes and the RBC/membrane ratio. RBC/membrane oscillation amplitudes were assessed using independent t-tests. An Analysis of Covariance (ANCOVA) test was performed to control for age and sex, followed by post hoc Tukey tests for pairwise comparisons.

RESULTS: Independent t-tests demonstrated statistically significant differences in RBC oscillation amplitudes and RBC/membrane oscillation amplitudes among healthy subjects and DUO patients (p-value = 0.003 and p-value = 0.0008, respectively). An ANCOVA test was performed to control for age and sex and resulted in statistically significant differences among diseases (p = 3.12 × 10^-6). A post hoc pairwise Tukey test demonstrated statistical significance among healthy subjects and DUO patients (p = 3.12 × 10^-5) and among healthy and PH patients (p = 2.56 × 10^-5).

CONCLUSION: Dynamic RBC-to-membrane ratio measurements may yield useful physiological information related to overall lung health.

PMID:41486254 | DOI:10.1002/mrm.70246

Int J Cardiovasc Imaging. 2026 Jan 5. doi: 10.1007/s10554-025-03594-5. Online ahead of print.

ABSTRACT

Reference values for myocardial strain as measured by feature-tracking (FT) MRI cine images are known. As these values may be impacted by source image resolution, we aimed at assessing strain parameters across low-resolution single-shot and high-resolution segmented cine images using different FT software. Thirty-seven patients (median age 40 years [IQR: 26-52]; 13 female) with same-session segmented high-resolution (SEG) and compressed sensing-accelerated single-shot (CS) cines from a 1.5T system (Magnetom Sola, Siemens Healthineers) were retrospectively included. Commercial (CVI42, Circle) and prototype software (TrufiStrain, Siemens Healthineers), FT and DRA, respectively, were used for analysis. Peak circumferential and radial strain were calculated globally and segmentally using individual segment peaks (peak-segment) or segment strain at the global peak frame (peak-frame). Equivalence was tested with the two one-sided test (TOST) for equivalence (90% CI), and Spearman correlation (ρ) with left ventricular ejection fraction (LVEF) was calculated. A significance level of α = 0.05 was used. Strain values differed significantly between SEG and CS images for most combinations, except peak-segment global circumferential strain (GCS) using DRA (SEG: -16.0% [- 17.5, – 14.4] vs. CS: -16.8% [- 17.8, – 14.9]; p = 0.072), which met equivalence criteria (mean difference – 0.38%, CI90: -0.72% to – 0.05%). Using CS images, DRA-derived GCS correlated more strongly with LVEF (ρ = -0.780) than did FT-derived GCS (ρ = -0.514). In most cases, myocardial strain was not equivalent across accelerated low-resolution and high-resolution segmented images. Only one of eight tested combinations (strain parameter, software, peak definition) met statistical equivalence, showcasing the need for novel processing methods to mitigate variability.

PMID:41486248 | DOI:10.1007/s10554-025-03594-5

Ann Surg Oncol. 2026 Jan 5. doi: 10.1245/s10434-025-18941-y. Online ahead of print.

ABSTRACT

BACKGROUND: Cachexia is associated with worse postoperative outcomes, but the added role of neoadjuvant therapy (NAT) is unclear. This study evaluated whether preoperative cachexia and NAT act as a “double jeopardy” after pancreatoduodenectomy.

PATIENTS AND METHODS: A nationwide observational cohort study was conducted using the Norwegian NORGAST registry (2016-2023). Adults undergoing pancreatoduodenectomy for malignancy were included. Cachexia was defined by consensus weight-loss criteria. Modified Poisson and Cox models (with a cachexia and NAT interaction term) estimated adjusted risk ratios (aRR) for textbook outcome (TO), prolonged length-of-stay (LOS), and adjusted hazard ratios (aHR) for overall survival.

RESULTS: Of 1424 patients undergoing pancreatoduodenectomy, cachexia was present in 588 (41.3%). Having cachexia was associated with higher TO (aRR 1.28, 95% CI 1.13-1.46) with effect modification by body mass index (BMI) (interaction P = 0.047). Patients with cachexia had a lower risk of prolonged LOS (aRR 0.64, 95% CI 0.51-0.80). Cachexia was not independently associated with overall survival (aHR 1.15, 95% CI 0.97-1.36). NAT was associated with a higher hazard of death (aHR 1.44, 95% CI 1.09-1.92), likely reflecting confounding by indication. No statistically significant interaction between cachexia and NAT was observed for TO (P = 0.277) or for survival (P = 0.863).

CONCLUSIONS: Preoperative cachexia was associated with higher rates of TO. Higher TO was attributed to patients with overweight or obesity, to a shorter index stay, and more frequent transfers to a secondary facility, but not fewer complications. Cachexia was not associated with worse long-term survival, and a “double jeopardy” between cachexia and receiving NAT was not found.

PMID:41486235 | DOI:10.1245/s10434-025-18941-y

Sci Rep. 2026 Jan 4. doi: 10.1038/s41598-025-34849-9. Online ahead of print.

ABSTRACT

The rapid evolution of urban demographics necessitates advanced predictive modeling to optimize rail transit capacity and reliability. This study presents a novel age-sensitive demand forecasting and anomaly detection framework for Istanbul’s urban rail network, utilizing a comprehensive dataset of 721,328 passenger-trip records collected between 2021 and 2023. By engineering eleven spatiotemporal and transactional features, passengers are classified into four distinct age cohorts (< 20, 20-30, 30-60, 60+) to capture diverse mobility behaviors. The methodological approach benchmarks four classical linear classifiers, three gradient-boosting decision trees, and a tabular deep learning model (SAINT) against a proposed two-stage hybrid ensemble. This hybrid architecture integrates the deep representational capability of the SAINT Transformer with the categorical robustness of CatBoost, employing a stacking strategy enriched with calibrated uncertainty meta-features (entropy and maximum confidence). Rigorous evaluation using a chronological hold-out protocol demonstrates that the proposed ensemble establishes a new state-of-the-art performance, achieving a peak accuracy of 91.94% and a ROC-AUC of 0.9910, significantly surpassing the standalone SAINT (90.12%) and CatBoost (74.78%) baselines. The statistical significance of this enhancement is confirmed via McNemar’s test (p < 0.001), while five-fold time-series cross-validation verifies generalization stability. Furthermore, an unsupervised anomaly detection mechanism is introduced, achieving a ROC-AUC of 0.77 in distinguishing irregular latent patterns through synthetic perturbation validation. Post-hoc SHAP analysis elucidates the model’s decision-making dynamics, revealing that cumulative usage frequency primarily drives predictions for the working-age population, whereas consistent solo travel behavior characterizes the senior demographic. Consequently, this work delivers a robust, highly calibrated, and interpretable solution for intelligent transportation planning, offering actionable insights for real-time capacity management and operational resilience.

PMID:41486208 | DOI:10.1038/s41598-025-34849-9

J Orthop Surg Res. 2026 Jan 4. doi: 10.1186/s13018-025-06622-1. Online ahead of print.

ABSTRACT

INTRODUCTION: The purpose of the study is to evaluate the effect of medical ozone therapy on fracture healing in rats.

MATERIALS AND METHODS: 20 male Wistar-Albino rats were randomly divided into two groups as Control Group (n = 10) and Ozone Group (n = 10). The fracture model was created by bilateral femur transverse osteotomy and fixation with an intramedullary Kirschner wire. No medical treatment was applied to the control group, whereas Ozone gas at a dose of 1 cc/kg at a concentration of 20 µg/ml was administered intraperitoneally to the ozone group for 8 weeks. All groups were sacrificed at the end of the 8th week. Radiological examination was performed by direct radiography of all femurs. The left femurs of both groups were examined histopathologically (Hematoxylin-Eosin), immunohistochemically (BMP-7, Osteocalcin, Osteopontin, TRAP) and histochemically (Masson Trichrome). Biomechanical (3-point bending test) analysis was performed on the right femurs. The liver and kidneys were also examined histopathologically.

RESULTS: Radiographic (p = 0.008) and histopathological (p = 0.001) examinations revealed that fracture healing scores of the Ozone Group were significantly inferior compared to the Control Group. In the immunohistochemical examination, the positivity scores of BMP-7 (p = 0.009), Osteocalcin (p = 0.001) and Osteopontin (p = 0.023) were statistically significantly lower in the Ozone group compared to the control group, while the TRAP (p = 0.016) positivity score was significantly higher. In histochemical examination, Masson Trichrome positivity was found to be significantly lower in the Ozone group compared to the control group (p < 0.001). Biomechanical analysis revealed that fracture healing was lower in the Ozone group compared to the Control group in parameters Yield Force (p = 0.012), Yield at Elongation (p = 0.030), Maximum Force (p = 0.009), Maximum Elongation (p = 0.023), Maximum Stress (p = 0.045). As a result of the examination of possible side effects on liver (p = 1.000) and kidney (p = 0.181), no statistically significant difference was found between the groups.

CONCLUSION: Medical ozone therapy demonstrated a detrimental effect on fracture union, as evidenced by inferior radiological, histopathological, immunohistochemical, histochemical, and biomechanical outcomes. These findings indicate that systemic ozone treatment may adversely influence bone healing processes.

PMID:41486165 | DOI:10.1186/s13018-025-06622-1

BMC Geriatr. 2026 Jan 5. doi: 10.1186/s12877-025-06793-w. Online ahead of print.

ABSTRACT

BACKGROUND: Health inequality is a global issue, with a particularly significant impact on older adults. In China, differences in the urban administrative hierarchy may lead to uneven allocation of public resources, resulting in the concentration of public resources in cities with higher administrative hierarchies and, consequently, health inequality among older adults. Therefore, this study aims to explore the relationship between urban administrative hierarchies and older adults’ subjective physical and mental health, while also analyzing the role of resource allocation mechanisms in shaping this dynamic.

METHODS: This study utilizes data from the China Family Panel Studies, the China City Statistical Yearbook, and the China Urban Construction Statistical Yearbook, employing a multi-dimensional fixed effects model, incorporating province, individual, and time variables, to evaluate the impact of the urban administrative hierarchy on the subjective physical and mental health inequality of older adults. The study considers medical and environmental resources as potential mediating variables and explores the moderating role of marketization.

RESULTS: The findings reveal a positive correlation between the urban administrative hierarchy and older adults’ subjective physical and mental health, with those in cities with higher administrative hierarchies enjoying higher quality of life and subjective health levels. This is primarily due to cities with higher administrative hierarchies owning medical and environmental resources. Furthermore, the level of marketization has a positive moderating effect on the positive relationship between urban administrative hierarchy and older adults’ mental health, but has no significant impact on physical health. Heterogeneity analysis by region and age indicates that the impact of the urban administrative hierarchy on the physical and mental health of older adults is more pronounced in economically less developed regions and among younger elderly individuals.

CONCLUSION: The study highlights the inequalities in the subjective physical and mental health of older adults across cities with different administrative hierarchies in China. By providing more resources, cities with higher administrative hierarchies can significantly improve older adults’ life quality and subjective health. Meanwhile, marketization further strengthens the positive impact of urban administrative hierarchy on mental health. By introducing the urban administrative hierarchy as a macro-level political system into the study of individual health disparities, this research not only expands the analytical perspective on health inequalities among older adults, but also provides empirical support for understanding the current trends in elderly migration for retirement. Moreover, it offers valuable insights for global aging governance and promoting health equity.

PMID:41486144 | DOI:10.1186/s12877-025-06793-w