Category: Statistics

Prim Health Care Res Dev. 2026 Aug 12;27:e92. doi: 10.1017/S1463423626101637.

ABSTRACT

AIM: This study aims to evaluate the feasibility and educational impact of utilizing SHCs as primary care training sites in undergraduate medical education, with the goal of enhancing clinical competencies in young adult healthcare.

BACKGROUND: Family Medicine (FM) is essential for integrating community-based health services into medical education. In Turkey, final-year medical students complete a one-month rotation at Family Health Centers (FHCs). However, young adults often utilize Student Health Centers (SHCs) on university campuses, resulting in a gap in students’ experience with this age group. Addressing this, our programme initiated the inclusion of SHCs in the FM internship rotation for the 2024-2025 academic year.

METHODS: A mixed-methodology study was conducted in two phases. A retrospective analysis was performed on medical records of patients aged 18-25 who attended the SHC over a one-month period. A prospective 9-item online survey assessed the educational impact on final-year medical students following their FM internship, which included the SHC rotation. Descriptive and qualitative statistical analyses were performed to summarize the survey and clinical data.

FINDINGS: A total of 1228 patients were seen at the SHC, mirroring FHC trends. All 87 interns surveyed rated the FM programme initiative positively, with 94.1% highly satisfied and 85.9% reporting improved primary care skills. Qualitative feedback highlighted the value of practical experience and called for longer rotations.

CONCLUSION: Integrating SHC rotations into undergraduate medical education is both feasible and beneficial, providing relevant primary care experience for medical students and enhancing training in the care of young adult populations.

PMID:42581653 | DOI:10.1017/S1463423626101637

Biostatistics. 2026 Jan 20;27(1):kxag031. doi: 10.1093/biostatistics/kxag031.

ABSTRACT

Egocentric-network randomized trials (ENRTs) are increasingly used to estimate causal effects under interference when measuring complete sociocentric network data is infeasible. ENRTs rely on egocentric network sampling, where a set of egos is first sampled, and each ego recruits a subset of its neighbors as alters. Treatments are then randomized across egos. While the observed ego-networks are disjoint by design, the underlying population network may contain edges connecting them, leading to contamination. Under a design-based framework, we show that the Horvitz-Thompson estimators of direct and indirect effects are biased whenever contamination is present. To address this, we derive bias-corrected estimators and propose a novel sensitivity analysis framework based on sensitivity parameters representing the probability or expected number of missing edges. This framework is implemented via both grid sensitivity analysis and probabilistic bias analysis, providing researchers with a flexible tool to assess the robustness of the causal estimators to contamination. We apply our methodology to the HIV Prevention Trials Network 037 study, finding that ignoring contamination may lead to underestimation of indirect effects and overestimation of direct effects.

PMID:42581609 | DOI:10.1093/biostatistics/kxag031

J Health Psychol. 2026 Aug 11:13591053261472711. doi: 10.1177/13591053261472711. Online ahead of print.

ABSTRACT

The present study aimed to provide an initial validation of a scale designed to measure pregnancy-specific partner violence, focusing on abuse dynamics uniquely shaped by the gestational period. A total of 250 pregnant women were included for the purpose of exploratory factor analysis, while 302 pregnant women were included for confirmatory factor analysis. In addition to descriptive statistics, the Mann-Whitney U test, Kruskal-Wallis test, and Spearman correlation test were used for data analysis. The Cronbach’s Alpha value for the scale, comprising a single factor structure and a total of 20 items, was found to be 0.986, while the McDonald’s Omega coefficient was 0.988. A negative and statistically significant correlation was observed between the levels of partner violence and the levels of marital satisfaction reported by pregnant women (p < 0.05). It is suggested that the Pregnancy Partner Violence Scale provides promising preliminary evidence for assessing such violence, though further validation in diverse settings is warranted.

PMID:42581567 | DOI:10.1177/13591053261472711

Stomatologiia (Mosk). 2026;105(4):19-24. doi: 10.17116/stomat202610504119.

ABSTRACT

OBJECTIVE: Analysis of the implementation and use of telemedicine technologies in the field of maxillofacial surgery at the Federal Center of the National Medical Research Center “Central Research Institute of Maxillofacial Surgery” of the Ministry of Health of the Russian Federation in 2022-2024.

MATERIAL AND METHODS: The data of 3229 telemedicine consultations (TMC) in 88 constituent entities of the Russian Federation for the period 2022-2024 were ranked. The share of cases requiring patient routing to the federal center and additional examination was determined. The analysis of the availability and staffing of maxillofacial surgeons was carried out. The increase/decrease of indicators was calculated using the standard formula for relative change as a percentage. The relationship between indicators (population size, staffing, availability, number of CFLs and number of TMCs) was estimated using the Pearson correlation coefficient (r).

RESULTS: The total number of TMCs increased from 833 in 2022 to 1296 in 2024, an increase of 55.6%. The leader in absolute number of TMCs is the Volga Federal District. At the same time, a decrease in the number of consultations was noted in the North-Western District. The share of TMCs that required patient routing to the federal center was 26.6% in 2024. There was a steady increase in the share of cases that required additional examination: from 65% in 2022, 73.7% in 2023, and 69.5% in 2024. A moderate negative correlation was found between the number of doctors and the number of TMK (r≈-0.61…-0.64), and a weak positive correlation was found between the number of doctors and the volume of consultations (r≈0.37-0.38). Despite fluctuations in the number of doctors in 2023 and subsequent growth in 2024, the overall staffing increased by 5.8% over the three-year period.

CONCLUSION: The data obtained indicate that telemedicine technologies in maxillofacial surgery are an effective tool for increasing the availability of specialized and high-tech medical care, especially in regions with a severe shortage of personnel and a large territorial distance. TMC contributes to early diagnosis, clarification of treatment tactics, optimization of patient routing to federal centers, and strengthening the professional competencies of regional specialists.

PMID:42581521 | DOI:10.17116/stomat202610504119

Stomatologiia (Mosk). 2026;105(4):5-10. doi: 10.17116/stomat20261050415.

ABSTRACT

OBJECTIVE: Comparative assessment of water absorption and solubility of polymer materials for temporary restorations, differing in composition and technology of application (CAD/CAM, 3D printing, traditional analog method).

MATERIALS AND METHODS: Four materials were studied: Huge PMMA (CAD/CAM), Dental Sand Pro (3D printing), Sinma-M (hot polymerization) and Tempokor Automix (chemical curing). Samples in the form of discs (n= 4-8 per group) were made according to the requirements of GOST R 71412-2024. Water absorption (p_w) and solubility (p_s) tests were carried out in distilled water at a temperature of 37 ± 1 °C for 7 days. The statistical analysis was performed using the Student’s t-test.

RESULTS: Statistically significant intergroup differences were found (p<0.05). The highest water absorption was observed in the Dental Sand Pro 3D printing material (40.04±1.59 micrograms/mm³), which corresponds to the upper limit of the standard value. The values of p_w for Huge PMMA (26.76±1.70 micrograms/mm³) and Sigma-M (24.05±2.65 micrograms/mm³) are below the established limit. The solubility of Sinma-M (11.21±3.17 micrograms/mm³) exceeded the standard value (7.5 micrograms/mm³) and was significantly higher than that of Huge PMMA (0.78±0.16 micrograms/mm³) and Dental Sand Pro (4.32±1.44 micrograms/mm³). The Tempocor material showed satisfactory results in both parameters.

CONCLUSION: The water absorption and solubility of polymer materials for temporary restorations significantly depend on both the chemical composition and the manufacturing technology. Milled PMMA (CAD/CAM) demonstrated the greatest stability, while traditional materials showed high variability in properties. The results obtained should be taken into account in the clinical selection of the material to ensure the long-term success of orthopedic treatment.

PMID:42581519 | DOI:10.17116/stomat20261050415

Subst Use Misuse. 2026 Aug 11:1-8. doi: 10.1080/10826084.2026.2711947. Online ahead of print.

ABSTRACT

Background: Social anxiety is associated with worse cannabis-related outcomes, but the mechanisms underlying this relation have been understudied. The present study tested whether psychological inflexibility indirectly accounts for the association between social anxiety and multiple cannabis-related outcomes (i.e., cannabis-related problems, perceived barriers for cannabis reduction or cessation, and coping-motivated cannabis use). Methods: Using a cross-sectional design, data were collected via an online survey from 143 undergraduates (77.6% female, M_age = 19.85, SD_age=2.29) who reported cannabis use within the past three months. Results: Results indicated that social anxiety was positively associated with cannabis-related problems, perceived barriers to cannabis reduction or cessation, and coping-motivated cannabis use. These associations occurred indirectly via psychological inflexibility. In contrast, neither social anxiety nor psychological inflexibility was statistically significantly associated with cannabis use frequency. Conclusions: These findings suggest that psychological inflexibility may represent an important underlying process between social anxiety and maladaptive cannabis-related outcomes, particularly those reflecting problematic use patterns and coping-motivated use. Targeting psychological inflexibility may therefore be a promising intervention focus for individuals with elevated social anxiety who use cannabis.

PMID:42581016 | DOI:10.1080/10826084.2026.2711947

J Oral Rehabil. 2026 Aug 11. doi: 10.1111/joor.70287. Online ahead of print.

ABSTRACT

BACKGROUND: Temporomandibular disorders (TMD) have the potential to progress to a chronic form associated with various comorbidities. Prolonged symptoms may lead to central sensitization (CS), resulting in decreased treatment response and highlighting the need for personalized treatment strategies.

OBJECTIVE: This study evaluated psychological conditions and comorbidities in TMD patients based on CS-related symptom levels measured by the Central Sensitization Inventory (CSI) and investigated the association between these levels and long-term treatment outcomes.

MATERIALS AND METHODS: CS-related symptom levels were assessed using the CSI in 112 TMD patients (score ≥ 40 indicating significant levels of CS symptoms). Psychological, sleep, autonomic and pain-related comorbidities were evaluated by validated questionnaires. Participants received standardized conservative treatment, including behavioural, physical, stabilization splint and pharmacological therapies. After 6 months, patients were re-evaluated for clinical signs. Data were statistically compared between the high (n = 40) and low (n = 72) CSI groups and associations between clinical characteristics and CSI levels were analyzed. Longitudinal changes were analyzed using Generalized Estimating Equations.

RESULTS: High CSI (35.7%) was associated with higher McGill Pain Questionnaire (MPQ) scores, widespread pain and higher levels of anxiety, depression, somatization and autonomic symptoms (all p_adj < 0.05 after Bonferroni correction). At 6-month follow-up, the high CSI group showed a trend toward a smaller reduction in pain (group × time interaction, χ² = 5.587, p = 0.018), suggesting a potentially less favourable treatment response to conservative therapy.

CONCLUSION: TMD patients with higher CSI scores exhibit more multidimensional comorbidities and diminished response to conservative therapy. Early identification of CS-related symptoms may be beneficial for establishing personalized treatment strategies.

PMID:42581010 | DOI:10.1111/joor.70287

Cancer Rep (Hoboken). 2026 Aug;9(8):e70651. doi: 10.1002/cnr2.70651.

ABSTRACT

BACKGROUND AND AIM: Lung cancer remains one of the leading causes of cancer-related mortality worldwide. Type 2 diabetes mellitus (T2DM), the most prevalent endocrine disorder, is commonly managed with Metformin, an antidiabetic medication that has demonstrated potential anticancer properties. This meta-analysis aimed to discover the association between Metformin use and the risk of lung cancer in patients with T2DM.

METHODS: A comprehensive search of online databases was conducted up to January 1, 2026, to identify relevant observational studies. After screening, appropriate data were extracted. Meta-analyses utilized the most fully adjusted hazard ratio (HR) with corresponding 95% confidence intervals (CI) as the effect measures. All statistical analyses were performed using R Statistical Software.

RESULTS: The pooled analysis of 29 observational studies showed a significant reduction in lung cancer risk among Metformin users compared with nonusers (HR: 0.85, 95% CI: [0.77-0.94], p = 0.002). Subgroup analyses revealed significant associations in cohort studies (HR: 0.79, 95% CI: [0.70-0.89], p < 0.01) and in studies conducted in Asia (HR: 0.82, 95% CI: [0.68-0.99], p = 0.04). Extended Metformin use (> 3 years) was associated with a significant reduction in lung cancer risk (HR: 0.87, 95% CI: [0.79-0.95]; p < 0.01), whereas no significant effect was observed for shorter durations.

CONCLUSION: This meta-analysis indicated a potential protective effect of Metformin use in individuals with T2DM against lung cancer, with a significant risk reduction observed, particularly among long-term users and in Asian populations. The significant associations identified in cohort studies and in extended-duration use underscore metformin’s promise in lung cancer prevention.

PMID:42581008 | DOI:10.1002/cnr2.70651

J Pediatr Urol. 2026 Jul 30:106190. doi: 10.1016/j.jpurol.2026.106190. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate outcomes of conservative versus endoscopic initial management in pediatric ureterocele through a systematic review and exploratory meta-analysis, with emphasis on secondary surgical intervention and clinically relevant postoperative outcomes.

METHODS: A systematic review was conducted according to PRISMA 2020 guidelines. PubMed/MEDLINE, Embase, Scopus, and reference lists were searched for studies published from 1990 onward evaluating pediatric ureterocele managed initially with conservative observation and/or endoscopic puncture or incision. Comparative studies, retrospective cohorts, and case series with extractable data were eligible. Studies including single-system, duplex-system, intravesical, and ectopic ureteroceles were included. The primary outcome was secondary surgical intervention after initial management. Secondary outcomes included de novo vesicoureteral reflux (VUR), febrile urinary tract infection (UTI), and treatment success. Risk of bias was assessed using established tools for observational studies.

RESULTS: Twenty-five studies met inclusion criteria. Most were retrospective cohorts or case series with heterogeneous anatomical subtypes, patient populations, and outcome definitions. Sample sizes ranged from 9 to 287 patients. Four studies provided direct comparative data suitable for quantitative synthesis of the primary outcome. In a random-effects exploratory meta-analysis, no statistically significant difference was identified between initial observation and endoscopic treatment regarding the risk of secondary intervention (RR 0.40, 95% CI 0.13-1.24; I² = 36.5%). Across observational cohorts, selected low-risk patients managed conservatively frequently avoided surgical intervention during follow-up, whereas endoscopic decompression remained effective in symptomatic or higher-risk patients, although repeat procedures or delayed reconstruction were required in a subset. Secondary outcomes, including de novo VUR and febrile UTI, could not be quantitatively synthesized because of inconsistent definitions and reporting across studies.

CONCLUSIONS: Current evidence remains limited by retrospective study design, substantial anatomical heterogeneity, and confounding by indication. Although definitive comparative conclusions cannot be drawn, available data suggest that individualized management strategies may be appropriate in selected patients. Management decisions should be individualized according to anatomy, clinical presentation, obstruction, infection risk, and renal functional characteristics. Further prospective multicenter studies are needed to better define optimal patient selection criteria.

PMID:42580998 | DOI:10.1016/j.jpurol.2026.106190

Jt Comm J Qual Patient Saf. 2026 Jul 14:S1553-7250(26)00168-6. doi: 10.1016/j.jcjq.2026.07.004. Online ahead of print.

ABSTRACT

BACKGROUND: Accreditation is widely used to improve healthcare quality and patient safety; however, staff experiences during accreditation preparation and survey activities remain inadequately understood, particularly in Middle Eastern healthcare settings. The objective of this study was to examine healthcare staff experiences during Joint Commission International (JCI) accreditation and identify organizational factors associated with positive accreditation experiences and perceived outcomes.

METHODS: A cross-sectional survey was conducted among clinical and nonclinical staff at a tertiary academic medical center in Dubai, United Arab Emirates, following a JCI accreditation survey. Descriptive statistics, bivariate analyses, and multivariable logistic regression were used to evaluate associations between organizational factors and staff-reported experiences.

RESULTS: A total of 304 staff responses were analyzed. Overall perceptions of accreditation were highly favorable, with more than 90% of respondents reporting positive perceptions of patient safety, quality of care, teamwork, and leadership engagement. Leadership engagement (adjusted odds ratio [AOR] 2.45), perceived improvements in patient safety (AOR 2.89), and quality of care (AOR 2.63) were independently associated with positive accreditation experiences. Workload manageability (AOR 0.61) and psychological safety (AOR 0.68) were negatively associated with positive experience. Nurses and allied health professionals reported more favorable perceptions than physicians, although differences were small. Qualitative findings highlighted the need for continuous readiness, protected time for accreditation activities, improved coordination, and ongoing training.

CONCLUSION: Healthcare staff generally perceived JCI accreditation positively and associated it with improvements in patient safety and quality of care. Leadership engagement emerged as a key facilitator of positive accreditation experiences, whereas workload burden and psychological safety represented important challenges. Organizations implementing accreditation programs should prioritize continuous readiness, workforce support, psychological safety, and targeted physician engagement strategies to sustain accreditation benefits.

PMID:42580990 | DOI:10.1016/j.jcjq.2026.07.004