Category: Statistics

J Build Phys. 2025 Oct 17;49(6):829-851. doi: 10.1177/17442591251367436. eCollection 2026 May.

ABSTRACT

Low-cost indoor air quality (IAQ) sensors offer new opportunities for real-time monitoring in the built environment by occupants and researchers. However, their performance can vary substantially depending on the environmental conditions. This study presents a comprehensive evaluation of carbon dioxide (CO₂) and fine particulate matter (PM_2.5) measurements from two consumer-grade low-cost sensors (the Airthings View Plus for CO₂ only and Air Gradient Pro for CO₂ and PM_2.5) through co-location tests with two reference instruments, Graywolf DSII-8 for CO₂ and Lighthouse Handheld 3016 for PM_2.5. Using time-series analysis, linear regression, Pearson correlation, Root-Mean Squared Error (RMSE), Bland-Altman test, and paired t-tests, we assess the precision and accuracy of these sensors. At a 5-minute sampling interval, the Air Gradient sensor had a higher coefficient of determination (R ²), stronger Pearson correlation, and narrower range of limits of agreement (LoAs), but higher bias (i.e. the mean difference) and RMSE, suggesting higher precision but lower accuracy when compared to Airthings. As a result, it can perform well for tracking the relative changes in CO₂, though less ideal for absolute concentrations without calibration. For PM_2.5, the Air Gradient also had relatively high R ² (0.79), moderately strong Pearson correlation (ρ = 0.69, p < 0.05), and a narrow range of LOAs (30.1 μg/m³) and low RMSE (5.8 μg/m³). Averaging the 5-minute measurements over 30-minute intervals generally improved the accuracy and precision of both sensors. However, statistically significant differences from the reference instruments remained for both sensors. Overall, this study offers a multi-metric assessment of consumer-grade sensors and highlights the need for in-situ calibration prior to long-term deployment.

PMID:42095132 | PMC:PMC13143174 | DOI:10.1177/17442591251367436

JB JS Open Access. 2026 May 6;11(2):e25.00315. doi: 10.2106/JBJS.OA.25.00315. eCollection 2026 Apr-Jun.

ABSTRACT

BACKGROUND: Surgical skill assessment in orthopaedic trauma surgery still relies on subjective expert ratings, which limits consistency and scalability. While digitalization offers a path toward objective and scalable assessment, the highly manual and haptic nature of surgery makes tool use difficult to capture digitally, keeping such approaches underdeveloped. This study introduces a digital assessment framework for orthopaedic trauma training that derives digital behavioral metrics (DBM) from tracked surgical tool motion. Specifically, it investigates (1) which DBM indicate technical proficiency and (2) to what extent these DBM are capable of predicting expert-rated surgical performance.

METHODS: Twenty-eight participants performed 3 standardized fracture fixations on synthetic bone models of the radius, ulna, and fibula. Tool motion was captured and transformed into a digital twin from which metrics such as path length, smoothness, and task duration were derived. These metrics were statistically compared with the average Global Rating Scale (GRS) obtained from 4 experts who rated each surgical performance. (1) Correlation analysis identified skill-relevant metrics and (2) a predictive model was trained to estimate performance from DBM evaluating its accuracy against the individual expert ratings.

RESULTS: (1) Several DBM were found to be indicative of surgical performance. Measures based on tool path length and time per activity showed strong correlations with expert ratings, reaching coefficients of up to 0.6. Correlation strength varied across tools and procedures. (2) The predictive model achieved a mean absolute difference of 3.8 points from the average GRS score (scale range: 28-70), outperforming the mean interexpert difference of 4.6 points.

CONCLUSION: DBM were identified as valid indicators of surgical skill. The study further demonstrated their predictive value, showing closer alignment with experts’ average GRS score than individual expert ratings. These findings highlight the feasibility of objective, expert-independent performance assessment in orthopaedic trauma surgery training.

PMID:42095124 | PMC:PMC13138458 | DOI:10.2106/JBJS.OA.25.00315

JB JS Open Access. 2026 May 6;11(2):e25.00303. doi: 10.2106/JBJS.OA.25.00303. eCollection 2026 Apr-Jun.

ABSTRACT

BACKGROUND: Total knee arthroplasty (TKA) is the treatment of choice for end-stage knee osteoarthritis in many patients. In younger patients with predominantly medial compartment disease, high tibial osteotomy (HTO) is performed as a joint-preserving treatment. However, concerns remain regarding potentially compromised outcomes of TKA after previous HTO given the axial deviation, osteotomy site, secondary surgery, previous hardware, and instrumentation. Therefore, this study compared long-term implant survival, revision, and infection rates, and patient-reported outcomes between patients undergoing TKA after HTO and matched TKA-only controls.

METHODS: Postoperative complications and revision surgeries were prospectively recorded in patients who underwent TKA from 2000 to 2023 at a single academic center. Patients with previous ipsilateral HTO formed the study group and were propensity matched 1:2 to TKA-only patients without a previous osteotomy based on age, sex, and body mass index. Knee Society Scores (KSS) were collected prospectively. Implant survivorship was analyzed using Kaplan-Meier survival curves and Cox proportional hazards models.

RESULTS: The study included 134 HTO-TKA and 268 matched TKA-only patients, with a mean follow-up of 10.5 ± 6.4 years (range: 0-24 years) after TKA. Both groups showed significant postoperative improvements in KSS (p < 0.02) with comparable clinical outcomes (HTO-TKA: 79.0 (6.0), TKA-only: 79.0 (11.8)). Revision arthroplasty rates were 5.2% for HTO-TKA and 4.5% for TKA-only (p = 0.69); the mean time to revision was 8.1 ± 8.7 years vs. 4.4 ± 3.5 years, respectively (p = 0.30). Infection rates were 2.2% and 1.1%, respectively (p = 0.74).

CONCLUSIONS: Revision and infection rates were comparable between HTO-TKA and matched TKA-only patients, with no statistically significant differences. Our findings demonstrate comparable patient-reported outcomes in both groups. These findings indicate that a previous HTO does not adversely affect TKA implant longevity or clinical outcomes when compared with matched primary TKA patients within the US population.

LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

PMID:42095123 | PMC:PMC13138463 | DOI:10.2106/JBJS.OA.25.00303

RSC Adv. 2026 May 5;16(25):23177-23189. doi: 10.1039/d6ra03291e. eCollection 2026 Apr 29.

ABSTRACT

Severe, gap-type peripheral nerve injuries often require surgical intervention in the form of a nerve autograft or synthetic nerve guidance scaffold to promote axonal regeneration and functional recovery. In this study, nerve guidance conduits (NGCs) were fabricated from aligned polycaprolactone (PCL) nanofibres with or without encapsulated glial cell line-derived neurotrophic factor (GDNF), and a fibrin sealant-based hydrogel. These constructs were evaluated in a murine sciatic nerve transection model using Thy1-YFP-H mice, allowing regenerating axons to be visualised in transverse sections throughout the constructs. Both PCL + GDNF and PCL-only conduits facilitated Schwann cell migration and successful axonal regeneration across the site of injury. Nerve autografts, the positive control, demonstrated the highest regenerating axon count in the distal stump, although statistical significance was not observed between groups. These results demonstrate that NGCs fabricated using aligned PCL nanofibres reliably facilitate nerve regeneration across nerve gaps to a degree, but require further investigation for application in peripheral nerve repair. Future studies that optimise growth factor delivery and conduit design would be beneficial to improve regenerative outcomes.

PMID:42095107 | PMC:PMC13141687 | DOI:10.1039/d6ra03291e

Rural Remote Health. 2026 May;26(2):9803. doi: 10.22605/RRH9803. Epub 2026 May 7.

ABSTRACT

INTRODUCTION: Child malnutrition remains a critical public health challenge in low- and middle-income countries, significantly contributing to morbidity and mortality among children less than age 5 years. In Northern Nigeria, persistent nutritional deficiencies, compounded by socioeconomic disparities and regional variations, demand urgent attention. This study examines trends and determinants of stunting, wasting, and underweight from 2013 to 2018.

METHODS: A cross-sectional research design was used for this study. Household and anthropometric secondary data were extracted from the 2013 and 2018 Nigeria Demographic and Health Surveys, focusing on 39,720 mother-child pairs in Northern Nigeria. Anthropometric measurements were converted into Z-scores, with stunting, wasting, and underweight defined as scores less than &minus;2 standard deviations. Chi-squared analyses were used to assess associations between malnutrition and various factors. Analyses were performed using IBM Statistical Package for the Social Sciences (v28.0), with statistical significance set at p<0.05.

RESULTS: Findings reveal that stunting increased from 39.4% to 44.7% (p<0.001) over the study period, whereas wasting declined markedly from 17.0% to 8.1% (p<0.001) and underweight decreased from 30.0% to 27.5% (p<0.001). Significant disparities emerged across regions, with the North-West exhibiting the highest malnutrition rates, and rural areas showing greater vulnerability than urban settings. Rural children had higher malnutrition rates than urban children. Higher maternal education and greater household wealth were strongly associated with a reduced risk of malnutrition.

CONCLUSION: This study contributes to the literature by showing that regional disparities and conflict-related instability exacerbate child malnutrition in Northern Nigeria. The findings revealed subnational variations that mirrored patterns in other crisis-affected regions, yet with distinct local drivers. The divergent trends in wasting (improved) and stunting (worsened) challenge the assumption that short-term interventions alone can address malnutrition in fragile settings. For practitioners in rural and remote health, these results emphasize the need for localized, multisectoral approaches. Such strategies must combine immediate nutritional support with long-term investments in maternal education, economic empowerment, and health systems adapted to the unique challenges of rural contexts, such as limited infrastructure and access to care.

PMID:42092302 | DOI:10.22605/RRH9803

Am J Surg. 2026 Apr 28;258:117013. doi: 10.1016/j.amjsurg.2026.117013. Online ahead of print.

ABSTRACT

BACKGROUND: Postoperative abdominal and shoulder pain, nausea, and vomiting are among the most common complications following laparoscopic surgery, often necessitating increased use of analgesics and antiemetics. This study aimed to compare the effects of nitrous oxide (N₂O) and positional maneuvers on pain intensity, incidence of nausea and vomiting, and analgesic requirements after laparoscopic surgery.

MATERIALS AND METHODS: This double-blind randomized clinical trial was conducted on 126 elective patients scheduled for laparoscopic cholecystectomy. The patients were randomly assigned into three groups of 42 individuals each: one group received N₂O, another received a combination of positional maneuver and pulmonary recruitment, and the third served as the control group. Pain intensity, nausea, vomiting, and time to first analgesic request were assessed at 6, 12, and 24 h postoperatively. Data were analyzed using ANOVA, Chi-square, and Fisher’s exact tests. A p-value of less than 0.05 was considered statistically significant. All analyses were performed using SPSS software, version 24.

RESULTS: The results showed that the N₂O group experienced the lowest intensity of abdominal and shoulder pain at all time points, and the time to first analgesic request was significantly longer in this group than the others (p < 0.05). Additionally, the incidence of nausea and vomiting was lower in the intervention groups than in the control group, and this difference was statistically significant (p < 0.05). Among the demographic variables, gender was the only factor associated with the occurrence of complications; females experienced vomiting more frequently than males.

CONCLUSION: Both nitrous oxide and positional maneuvers effectively reduced postoperative pain and gastrointestinal complications, with N₂O showing greater efficacy in minimizing symptoms and delaying analgesic need.

PMID:42092289 | DOI:10.1016/j.amjsurg.2026.117013

Int J Nurs Knowl. 2026 May 6:20473087261443267. doi: 10.1177/20473087261443267. Online ahead of print.

ABSTRACT

IntroductionFrailty among older adults is a critical issue in Japan’s super-aged society. Although potentially reversible, frailty may progress to disability if left unaddressed. Home-visit nursing plays a key role, yet outcome evaluation remains limited. This study examined the effectiveness of care for older adults with frailty using a six-step nursing process based on standardized nursing terminologies NANDA-I, NOC, and NIC.MethodsNine older adults diagnosed with Elder frailty syndrome received individualized home-visit nursing a six-step NNN process over three months. NOC indicators were defined as each participant’s “best possible state” and were evaluated monthly. Data were recorded in Excel and analyzed using EZR. Ethical approval was obtained, and informed consent was independently managed.ResultsAll nine participants completed the study. Most showed improvement in NOC indicators, and some demonstrated resolution of frailty-related symptoms. One participant showed improvement in the initially selected NOC indicators, but new nursing diagnoses emerged and other frailty-related indicators worsened, resulting in no overall improvement in frailty status. Six NOC outcomes showed statistically significant improvement (p < .05), with several demonstrating large effect sizes (Cohen’s d > 0.8). Nurses reported that using NNN helped clarify care focus and promoted team collaboration. In some cases, reassessment shifted the diagnostic framework from Elder frailty syndrome to Readiness for Enhanced Healthy Aging.ConclusionThe NNN-based six-step nursing process may support frailty improvement by visualizing individualized outcomes and guiding targeted care. It may also support collaboration and structured evaluation in home-visit nursing.Practical ImplicationsAlthough preliminary, NNN-based care shows potential for addressing frailty through individualized assessment. Defining NOC outcomes as the “best possible state” may reflect diverse aging trajectories. Visualizing care transitions may promote team knowledge sharing. Future implementation requires standardized documentation and practitioner training.

PMID:42092257 | DOI:10.1177/20473087261443267

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2026 Apr 20;44(4):304-308. doi: 10.3760/cma.j.cn121094-20250828-00342.

ABSTRACT

Objective: To compare and analyze the occupational exposure limits (OELs) specified in China’s “Occupational Exposure Limits for Hazardous Agents in the Workplace-Part 1: Chemical Hazardous Agents” (GBZ 2.1-2019) with the recommended exposure limits (RELs) issued by the National Institute for Occupational Safety and Health (NIOSH) in the United States, aiming to identify chemical hazardous factors requiring optimization of OELs. Methods: In March 2025, using the Chemical Abstracts Service registration number (CAS RN) as the core matching identifier, OELs from GBZ 2.1-2019 and NIOSH RELs in the United States were entered into Excel 2019 to construct a database. The OELs were matched one-to-one according to their classification types. Descriptive statistical methods were employed to analyze the ratio of exposure limits, and content comparisons were conducted to evaluate differences in classification types, legal status, and labeling applications. Results: The types and connotations of limits in China and the United States were basically the same. Among the 272 shared limits, 38.2% (104 items) were consistent, 23.9% (65 items) were basically consistent, and 37.9% (103 items) showed significant differences. There were 51 China standards that were significantly stricter than NIOSH standards in the United States, and 17 China standards that were significantly more lenient than NIOSH standards in the United States. Differences existed between China and the United States limits in terms of legal status and the application of certain labels. Conclusion: Domestic interim standards should be formulated as needed for internationally recognized but unestablished OELs, and OELs that are excessively strict, overly broad or inconsistent with type values should be adjusted. It is recommended to shorten or establish a dynamic OELs update mechanism.

PMID:42092253 | DOI:10.3760/cma.j.cn121094-20250828-00342

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2026 Apr 20;44(4):293-298. doi: 10.3760/cma.j.cn121094-20240722-00332.

ABSTRACT

Objective: To explore the mediating role of anxiety and social support between occupational stress and job burnout among locomotive drivers, and the regulatory role of self-requirement. Methods: A total of 1993 front-line drivers from 5 rail transit enterprises were selected as subjects by cluster random sampling method from March to June 2022. The job burnout, occupational stress, anxiety, social support and self-requirement were investigated by using the Marquis Work Burnout Inventory (General Version), Job Stress Survey, Generalized Anxiety Scale, Self-Reported Health Rating Scale and Self-Examination Questionnaire. Bootstrap method was used to examine the mediating effect of anxiety and social support between occupational stress and job burnout, and the regulatory effect of self-requirement. Results: The comprehensive score of job burnout for locomotive drivers was 2.60 (1.95, 3.24) points. There were statistically significant differences in the job burnout scores among drivers with different total working years, current job years, monthly working hours, and smoking status (H=12.12, 22.76, 41.36, 18.20, P<0.05). The mediating effect analysis showed that the partial mediating effect composed of occupational stress-anxiety-job burnout accounted for 30.8% of the total effect (β=0.008, 95%CI: 0.007-0.009), and the partial mediating effect composed of occupational stress-social support-job burnout accounted for 11.5% of the total effect (β=0.003, 95%CI: 0.003-0.004). The analysis of moderated mediating effect showed that the increase of self-requirement could amplify the proportion of the partial mediating effect of anxiety in the total effect (from 21.4% to 44.0%), and reduce the direct effect of work stress on job burnout and the partial mediating effect of social support. Conclusion: The occupational stress of locomotive drivers can indirectly affect job burnout through anxiety and social support. It is suggested to identify the self-requirement level of locomotive drivers and carry out targeted intervention on anxiety and social support to slow down the formation of job burnout.

PMID:42092251 | DOI:10.3760/cma.j.cn121094-20240722-00332

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2026 Apr 20;44(4):288-292. doi: 10.3760/cma.j.cn121094-20241213-00564.

ABSTRACT

Objective: To understand the radiation dose levels and distribution characteristics received by adult examinees during computed tomography (CT) examinations in Tianjin City, so as to provide scientific references for further optimizing CT examination protocols and reducing unnecessary radiation exposure. Methods: From October 2022 to September 2023, a stratified quota sampling method was used to select 15 medical institutions. One CT device was chosen from each institution, and a total of 1803 adult examinees undergoing CT examinations were investigated. Information including scanning region, tube voltage, tube current-time product, scanning length, volume computed tomography dose index (CTDI(vol)), and dose-length product (DLP) were collected and analyzed. The Kruskal-Wallis H test was applied to compare dose parameters among different grades of medical institutions and different scanning regions, with the Bonferroni method used to adjust the significance level for pairwise post hoc comparisons. The Cochran-Armitage trend test was used to analyze the dose trend across different numbers of detector rows. Results: In this survey, the median ages (M) of examinees undergoing cranial, chest, abdominal, and lumbar spine CT examinations were 42, 40, 41, and 43 years old, respectively. The median tube voltages were all 120 kV. The median tube current-time products were 268, 140, 196, and 242 mAs. The 75(th) percentiles (Q(3)) of CTDI(vol) were 60, 14, 20, and 23 mGy, and the Q(3) values of DLP were 844, 480, 758, and 612 mGy·cm. With the exception of abdominal CTDI(vol), CTDI(v)ol and DLP showed a decreasing trend with an increase in the number of CT detector rows, and the differences were statistically significant (P<0.05) . Conclusion: The Q(3) values of CTDI(vol) and DLP for adult CT examinations in Tianjin City were comparable to the national diagnostic reference levels. The Q(3) value of CTDI(vol) ranked at a moderate level among provinces and municipalities, while the Q(3) value of DLP remained at a relatively high level. Therefore, in clinical practice, it is advisable to minimize the scanning field of examinees to reduce radiation dose exposure and safeguard their health and safety.

PMID:42092250 | DOI:10.3760/cma.j.cn121094-20241213-00564