Category: Statistics

Arch Orthop Trauma Surg. 2026 Mar 3;146(1):92. doi: 10.1007/s00402-026-06255-x.

ABSTRACT

OBJECTIVE: The pararectus approach (PRA) offers good visualization of the entry point for posterior column screw insertion with an adequate screw length. However, conventional practice typically employs the lateral window (LW) of the pelvic approach. This study aimed to compare the radiographic trajectory of posterior column screws inserted via the PRA with that of screws inserted via the LW approach.

METHODS: We retrospectively analyzed 68 cases of posterior column screw placement during acetabular fracture surgery, beginning in March 2020, when metal-reformatted images could be generated from postoperative pelvic computed tomography (CT) scans. Group 1, consisting of 32 cases where screws were inserted through the second window of the PRA, was compared with Group 2, which included 36 cases using the LW in combination with various pelvic approaches. Demographic data (including body mass index [BMI] and presence of sacral dysplasia), the coronal angle of the posterior column screw in three-dimensional (3D) images, Sagittal Angle to Linea Terminalis (SALT), Sagittal Angle to Ischial Line (SAIL), and screw length (measured from 3D-CT metal-reformatted images) were analyzed.

RESULTS: Demographic data, including BMI and the presence of sacral dysplasia, were not significantly different between the two groups. The average coronal angle of the posterior column screw was 4.6° in Group 1 and 12.2° in Group 2, indicating a significant difference between both groups. For sagittal angles, SALT was 75.8° in Group 1 and 34.6° in Group 2, while SAIL was – 24.5° and – 4.1° in Groups 1 and 2, respectively, with both differences being statistically significant. The average screw length, measured by 3D-CT, was 73.2 mm and 93.7 mm in Groups 1 and 2, respectively, also demonstrating a significant difference between both groups.

CONCLUSION: Although the PRA allows good visualization of the posterior column screw entry point, it presents limitations in achieving optimal sagittal and coronal insertion angles due to the anatomical constraints of the abdomen and surrounding structures. In contrast, the LW approach demonstrated a screw trajectory that more closely aligns with the ideal anatomical corridor.

PMID:41774246 | DOI:10.1007/s00402-026-06255-x

J Mol Model. 2026 Mar 3;32(4):86. doi: 10.1007/s00894-026-06674-y.

ABSTRACT

CONTEXT: Coal slime water treatment and resource recovery are vital for the sustainable development of coal industry sustainability. Kaolinite, over 60% of clay minerals in coal slime water, is key for high-value flotation utilization. Phosphonic-acid collectors adsorb effectively on kaolinite via -PO(OH)₂ groups, but their structural diversity (phenyl/benzylphosphonic acids and esters) blurs structure-adsorption relationships. Existing studies focus on single collectors for specific minerals, lack a systematic screening/prediction database, and rarely combine first-principle calculations with three-dimensional quantitative structure-activity relationship (3D-QSAR) to explore multi-type collector mechanisms on kaolinite. This study combined density functional theory (DFT) with 3D-QSAR to study phosphonic-acid collector adsorption on kaolinite (001). Comparative molecular field analysis (CoMFA) and comparative molecular similarity indices analysis (CoMSIA) models were validated, with CoMSIA performing optimally (q² = 0.843, r² = 0.984). Diethyl (2-chlorobenzyl)phosphonate and (2-hydroxyphenyl)phosphonic acid in the test set showed prediction errors < 1%, confirming reliability. Two novel collectors (4-propylphenylphosphonic acid, 3-methyl-4-nitrophenylphosphonic acid) were designed, outperforming all database collectors, corroborating model validity and supporting high-efficiency collector development for kaolinite recovery.

METHODS: First-principle calculations via Cambridge Serial Total Energy Package (CASTEP) yielded the adsorption energies of 35 phenyl/benzylphosphonic acids/esters on kaolinite (001) to build a molecular structure-adsorption database. The dataset was split into 80% training and 20% test sets post molecular energy minimization. CoMFA/CoMSIA models were built via partial least squares (PLS) regression, evaluated by q², r², F-statistic and standard error of estimate (SEE); contour maps analyzed molecular field effects. New collectors were designed via CoMSIA and DFT-verified.

PMID:41774237 | DOI:10.1007/s00894-026-06674-y

Support Care Cancer. 2026 Mar 3;34(3):267. doi: 10.1007/s00520-026-10502-7.

ABSTRACT

PURPOSE: The aim of this scoping review was to explore the current knowledge on multimodal prehabilitation in digestive oncology, identifying the evidence, challenges, and future perspectives for research in this field.

METHODS: Research was realized by two independent reviewers in four databases following PRISMA-ScR guidelines. Data of included articles were extracted, and risk of bias analyzed.

RESULTS: Finally, 51 articles were included. Despite the heterogeneity of interventions, the totality of studies combined physical activity interventions with nutritional support following for five of them the European Society of Parenteral and Enteral Nutrition recommendations, with intervention lasting at least 4 weeks before surgery. Psychological support was inconsistently incorporated. Evidence suggests that prehabilitation improves functional capacities, with an average increase in 6-min walk test distance ranging from + 35 to + 70 m across randomized controlled trials, and concurrent improvements in body composition. However, the impact on perioperative outcomes and length of hospital stay was unclear.

CONCLUSIONS: Implementing structured prehabilitation programs could be a key strategy to improve surgical outcomes in gastrointestinal cancers.

PMID:41774232 | DOI:10.1007/s00520-026-10502-7

Fish Physiol Biochem. 2026 Mar 3;52(2):38. doi: 10.1007/s10695-026-01664-6.

ABSTRACT

Microplastics (MPs) are one of the fastest-growing sources of pollution and have become a substantial risk to both the environment and human health. Hence, the present investigation was conducted to assess the potential toxic effects of Polyvinyl chloride (PVC) MPs (Treatment I- 3 µg/L and Treatment II- 30 µg/L) on D. rerio for 20 days. The PVC-MPs were characterised by SEM, XRD, DLS and FTIR analyses, and their presence was confirmed in the gastrointestinal tract of the fish. When compare to the control group, the studied locomotive, behavioural, blood (haematology) and tissue (gill, gut and brain) biomarkers (SOD, GST, GPx, LPO, AChE, histopathology) were altered significantly (P < 0.05) in the PVC-MPs treatment groups. Locomotive and behavioural responses declined. Among the blood biomarkers, RBC counts were increased significantly in the PVC-MPs treatments. Whereas, WBC counts were decreased. Tissue (gill, gut and brain) SOD and GPx activity was accelerated in the PVC-MPs treated fish. In contrast, the GST activity in the gill, gut, and brain tissues were declined. LPO levels in the gill of the PVC-MPs fish were increased. PVC-MPs inhibited AChE activity in the brain tissue of fish. No visible histological changes were noticed in the control group. Whereas, a series of histological anomalies were visualized in the gill, gut and brain tissues of the PVC-MPs. These biomarker-responses of fish reveals that PVC-MPs is potentially a toxic substance to non-target organisms. The studied locomotory, behavioural, haematological, antioxidants, AChE and histopathology are useful biomarkers to asses potential toxicity of plastic related materials on aquatic organisms.

PMID:41774229 | DOI:10.1007/s10695-026-01664-6

Cancer Causes Control. 2026 Mar 3;37(4):55. doi: 10.1007/s10552-026-02129-0.

ABSTRACT

PURPOSE: Anxiety before a first-time screening colonoscopy is a commonly reported patient-level barrier to completing colorectal cancer (CRC) screening. This pilot study evaluated the feasibility, acceptability, and preliminary efficacy of “For peace of mind. Get Screened,” a brief online mindfulness-based intervention (MBI) to reduce anxiety before a first-time screening colonoscopy.

METHODS: Participants (n = 100) were randomized (October 2023-July 2024) to usual care or the MBI (daily CRC screening infographics guided by the Protection Motivation Theory, mindfulness infographics, and brief mindfulness meditations based on Monitor and Acceptance Theory) starting five days before their scheduled colonoscopy. Anxiety was assessed using the State-Trait Anxiety Inventory-State Subscale (STAI-S) in the endoscopy suite’s waiting room.

RESULTS: Participant retention was 83% due to patient and health system issues. Participant satisfaction with the MBI was high (mean: 6.40 out of 7). The MBI group had an average STAI-S score 2.54 points lower than the usual care group, though this difference was not statistically significant (32.24 vs. 34.78; p = 0.21). However, among participants not lost to follow up (n = 83), the MBI group had significantly lower waiting room STAI-S scores compared to the usual care group (31.52 vs. 35.21; p = 0.02). Clinical outcomes did not differ between groups.

CONCLUSION: Feasibility of the MBI was partially limited due to logistical issues. Findings support MBI acceptability and suggest that a brief MBI has the potential to decrease anxiety prior to a first-time colonoscopy. A larger randomized controlled trial is needed to further examine the efficacy of this intervention.

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT06233253.

PMID:41774215 | DOI:10.1007/s10552-026-02129-0

Eur Eat Disord Rev. 2026 Mar 3. doi: 10.1002/erv.70095. Online ahead of print.

ABSTRACT

OBJECTIVE: We examined the clinical validity of DSM-5 severity specifiers for bulimia nervosa (BN) and binge eating disorder (BED) in Korean outpatients.

METHOD: Seven hundred ninety-nine outpatients with BN (n = 668; mean age = 23.7 years; 95% female; mean BMI = 20.54 kg/m²) or BED (n = 131; mean age = 26.1 years; 89% female; mean BMI = 25.07 kg/m²) were recruited from an eating disorders clinic. For BN, we assessed the validity of severity specifiers based on purging-type behaviours and overall compensatory behaviours. For BED, we examined the validity of the current severity specifier and an alternative specifier with an adjusted threshold based on the frequency distribution.

RESULTS: For BN, severity based on purging-type behaviours differentiated BMI and self-injury, whereas severity based on overall compensatory behaviours differentiated the level of weight suppression as well as eating-related and general psychopathology. In both classifications, increasing severity was linked to a greater likelihood of self-injury. For BED, 90% of patients were classified as mild-to-moderate using the current specifier. The adjusted index correlated more strongly with EDE-Q shape concerns and global scores than the current index.

CONCLUSIONS: The BN specifier differentiated clinical variables across severity groups. The adjusted BED specifier may better differentiate severity in the Korean population than the DSM-5 specifier, suggesting the potential benefit of cultural adjustments.

PMID:41773480 | DOI:10.1002/erv.70095

Health Technol Assess. 2026 Feb 25:1-34. doi: 10.3310/GJMR0715. Online ahead of print.

ABSTRACT

BACKGROUND: The bacterium Staphylococcus aureus is a leading cause of hospital-acquired infections. These infections are difficult to treat when there is increasing resistance to penicillin, known as methicillin-resistant Staphylococcus aureus. Patients who carry Staphylococcus aureus in the nose and skin are prone to developing infections and many patients admitted to hospital are routinely ‘decolonised’ to reduce this risk. The current standard treatment for nasal decolonisation is the antibiotic nasal mupirocin. There are concerns about over-reliance on a single treatment and the risk of mupirocin-resistant methicillin-resistant Staphylococcus aureus. Robust evidence for alternatives to mupirocin is required.

OBJECTIVE: To investigate whether there are clinically and cost-effective alternatives to mupirocin for early nasal decolonisation of methicillin-resistant Staphylococcus aureus among adult hospital inpatients.

DESIGN AND METHODS: We designed a multicentre, three-arm parallel-group, non-inferiority, randomised controlled trial with economic and qualitative evaluations, to recruit 3000 participants.

SETTING AND PARTICIPANTS: Adult hospital inpatients identified as being colonised with methicillin-resistant Staphylococcus aureus on routine hospital admission screening were eligible for inclusion.

INTERVENTIONS: Participants were randomised (ratio 1 : 1 : 1) to receive one of the following decolonisation treatments: mupirocin (2%) nasal ointment (3 g), polyhexanide (0.1%) nasal gel (30 ml) or chlorhexidine (0.1%) with neomycin (0.5%) nasal cream (15 g). Neither participants nor the investigators were blind to treatment allocation.

MAIN OUTCOME MEASURES: The primary outcome was successful early nasal decolonisation, defined as a negative trial specific nasal methicillin-resistant Staphylococcus aureus swab taken 48 hours following treatment completion. Secondary outcomes included successful early nasal decolonisation of methicillin-resistant Staphylococcus aureus not fully susceptible to mupirocin, successful late nasal decolonisation, acceptability of treatment to patients, methicillin-resistant Staphylococcus aureus infections, length of hospital inpatient stays and re-admissions, adverse events and mortality. Outcomes were collected up to 4 weeks following treatment completion.

RESULTS: Recruitment and retention of participants were much lower than expected. In total, 297 patients were assessed for eligibility and 32 patients randomised. All participants received treatment as allocated. Seven participants withdrew from the study. The mean age was 73.8 years (standard deviation 16.6 years), with 62.5% (n = 20) of participants being male. Semistructured interviews were undertaken with patients (N = 5), clinical teams (N = 19) and clinical trials unit staff (N = 5) to explore barriers and facilitators to recruitment and consent processes. Data from the qualitative evaluation contributed to progress discussions at trial management meetings and resulting remedial activities undertaken.

LIMITATIONS: The trial closed early after reaching < 2% of the recruitment target. The planned statistical and health economic analyses could not be conducted due to the limited data. The study objectives were not addressed due to poor recruitment.

CONCLUSIONS: It was not feasible to recruit to this trial in the current context, due to a reduced level of methicillin-resistant Staphylococcus aureus testing being undertaken in hospitals within the National Health Service.

FUTURE WORK: To facilitate future research, further understanding of the routine decolonisation pathways in line with the revision to national guidance issued in 2021 is required. Validation of methicillin-resistant Staphylococcus aureus viability to increase processing time for nasal swabs could be undertaken and further exploration of the use of self-swabbing at home.

FUNDING: This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number NIHR132718.

PMID:41773476 | DOI:10.3310/GJMR0715

Biomol Biomed. 2026 Mar 3. doi: 10.17305/bb.2026.13556. Online ahead of print.

ABSTRACT

Early diagnosis of Alzheimer’s disease (AD) presents significant challenges. This study assessed the diagnostic utility of seven plasma biomarkers and PET-CT imaging in cognitively healthy individuals (HC), those with mild cognitive impairment (MCI), and AD patients. Seventy participants (20 with MCI, 35 with AD, and 15 HC) underwent plasma testing for amyloid-beta 40 (Aβ40), amyloid-beta 42 (Aβ42), the Aβ42/Aβ40 ratio, phosphorylated tau 181 (p-tau181), p-tau217, glial fibrillary acidic protein (GFAP), and neurofilament light chain (NfL), along with cognitive assessments using the Mini-Mental State Examination (MMSE). Statistical comparisons among groups were performed, and receiver operating characteristic (ROC) curves were utilized to evaluate diagnostic accuracy. Spearman’s correlation coefficient was applied to examine the relationships between biomarkers and MMSE scores. Additionally, 18 patients, including 14 with AD and 4 with MCI, underwent 18F-Florbetapir (18F-AV45) PET-CT amyloid imaging. The consistency between plasma biomarkers and PET-CT in detecting amyloid pathology was evaluated using Cohen’s Kappa. Plasma Aβ42 levels and the Aβ42/Aβ40 ratio were significantly lower in AD patients compared to those with MCI and HC (p<0.05), while levels of p-tau181, p-tau217, NfL, and GFAP were significantly elevated (p<0.05). Aβ42 and the Aβ42/Aβ40 ratio exhibited positive correlations with MMSE scores (p<0.01), whereas p-tau181, p-tau217, GFAP, and NfL demonstrated negative correlations (p<0.001). The plasma Aβ42/Aβ40 ratio, p-tau181, and p-tau217 levels showed significant concordance with 18F-AV45 PET-CT results for detecting amyloid deposition (p<0.05). A reduced plasma Aβ42/Aβ40 ratio, along with increased p-tau181 and p-tau217 levels, is significantly associated with a clinical diagnosis of AD, cognitive decline (as indicated by lower MMSE scores), and positive amyloid deposition on PET-CT. These three core biomarkers, when combined with GFAP and NfL, may enhance diagnostic accuracy for AD in cross-sectional assessments, particularly when integrated with imaging and cognitive evaluations.

PMID:41773433 | DOI:10.17305/bb.2026.13556

S Afr Fam Pract (2004). 2026 Feb 19;68(1):e1-e9. doi: 10.4102/safp.v68i1.6226.

ABSTRACT

BACKGROUND: District hospitals (DHs) are essential providers of surgical care in low- and middle-income countries. Despite recommendations to strengthen DH surgical services, data on South African DH surgical capacity remain limited. This study describes the volume, scope and workforce of surgical services at a rural Eastern Cape DH over 7 years.

METHODS: A retrospective audit of all surgical procedures (January 2016-December 2022) was conducted using theatre register data. Patient demographics, procedure type and surgical provider were extracted to analyse trends in surgical volume, scope and workforce.

RESULTS: A total of 2616 operations were performed, predominantly in females (97%), with a median age of 25 years. Statistical process control analysis showed a significant upward shift in the mean monthly surgical volume from 27 to 41 procedures. The surgical scope expanded from 14 different types of procedures in 2016 to 25 in 2022, covering obstetrics, gynaecology, general surgery, orthopaedics and urology. Caesarean sections accounted for 82% of procedures. Family medicine registrars and specialists performed the highest number of procedures per person.

CONCLUSION: Surgical services expanded in both volume and scope, demonstrating the capacity of district-level facilities to meet essential surgical needs.Contribution: This study provides rare longitudinal data on rural South African DH surgical services, highlighting the critical role of decentralised family medicine training and senior staffing in supporting surgical expansion and strengthening district-level care.

PMID:41773406 | DOI:10.4102/safp.v68i1.6226

S Afr Fam Pract (2004). 2026 Feb 12;68(1):e1-e9. doi: 10.4102/safp.v68i1.6218.

ABSTRACT

BACKGROUND: Chronic pain is a major global health challenge that impairs quality of life through physical disability, psychological distress, and socioeconomic burden. Despite its prevalence, limited research examines its multidimensional impact in South African primary healthcare. This study evaluated the quality of life and factors influencing chronic pain in patients attending a primary healthcare clinic in Gqeberha, South Africa.

METHODS: A cross-sectional study was conducted among 208 adults with chronic pain attending Walmer 14th Avenue Clinic. Data were collected using the Brief Pain Inventory, capturing demographics, pain severity, interference, relief, and management. Descriptive statistics, bivariate analysis, and multivariable logistic regression were performed using SPSS v29.

RESULTS: Participants had a mean age of 50.2 years; most were female (71.6%). Back pain was most common (43.8%), while pelvic/groin pain was most severe. Pain relief was inadequate in 74% of participants, with 15.9% reporting none. Sleep was the most affected quality-of-life domain (72% interference). Predictors of higher pain interference included pain severity (p 0.001), pain relief (p = 0.003), marital status (p = 0.004), and employment status (p = 0.005). Disease-specific treatments and adjuvant therapies provided better relief than paracetamol, nonsteroidal anti-inflammatory drugs, or opioids.

CONCLUSION: Severe pain and inadequate relief are prevalent in primary healthcare. Improving access to adjuvant and disease-specific therapies, as well as addressing socioeconomic factors, is thus essential for enhanced patient outcomes.Contribution: This study highlights the interplay between chronic pain, sociodemographic factors, and quality of life in South African primary care and underscores the need for tailored, multimodal, resource-sensitive pain management strategies to inform policy.

PMID:41773405 | DOI:10.4102/safp.v68i1.6218