Category: Statistics

J Am Acad Orthop Surg Glob Res Rev. 2025 Dec 9;9(12). doi: 10.5435/JAAOSGlobal-D-25-00096. eCollection 2025 Dec 1.

ABSTRACT

INTRODUCTION: This retrospective and systematic review examines wound closure rates across the fasciotomy approach and wound management technique for lower leg compartment syndrome.

METHODS: A retrospective review was done for adult patients treated with lower leg fasciotomy at one level 1 center from 2012 to 2022 by the CPT code. Patient data were collected, including time to fasciotomy closure and techniques used. P < 0.05 was considered significant. A systematic review was done for studies reporting time to wound closure or rates of skin grafting in the setting of fasciotomy by the surgical approach for lower leg acute compartment syndrome in accordance with the PRISMA guidelines.

RESULTS: Of 101 patients, mean time to closure was 9.83 ± 10.16 days. Time to closure was shorter for single-incision (7.00 ± 6.45 days) versus dual-incision fasciotomy (10.31 ± 10.60 days), although insignificantly. Wound management at the time of fasciotomy included VAC (n = 34, time to closure 9.29 ± 10.34 days), shoelace technique (n = 12, 7.36 ± 3.75 days), and packing (n = 37, 10.94 ± 10.56 days). 38.2% treated with VAC, 16.7% shoelace technique, and 67.6% packing required skin grafting (P = 0.043). No specific patient factors were associated with time to closure, or with early versus late closure, defined by median time to closure (6 days). Median was reported here, given the skew of our data, and is therefore more reflective of the central trend of our data. Skin grafting (30.2% versus 69.8%, P = 0.026), increasing LOS (9.25 ± 4.66 days versus 13.64 ± 8.68 days, P = 0.003), and ISS (7.20 ± 4.84 versus 10.79 ± 9.76, P = 0.028) were associated with delayed closure. ISS was the only factor significantly associated with delayed closure on multivariate analysis (P = 0.05). Table 5 outlines the 25 articles included for the systematic review.

CONCLUSION: Our analysis revealed trends toward increasing time to closure in dual-incision versus single-incision fasciotomy for lower leg compartment syndrome. Wound management markedly favored the wound vac or shoelace technique, corroborated by the results of our systematic review.

PMID:41364383 | DOI:10.5435/JAAOSGlobal-D-25-00096

J Robot Surg. 2025 Dec 9;20(1):70. doi: 10.1007/s11701-025-03024-7.

ABSTRACT

In this study, we examined the global distribution and regional dynamics of telesurgery research across 94 countries. Data retrieved from Scopus (October 2025) included both articles and reviews. Forty-six countries produced more than five publications, while 48 contributed fewer (1-5 papers), revealing broad but uneven global participation. The United States (n = 620) and China (n = 399) were the most productive nations, together exceeding one thousand publications. Other major contributors included the United Kingdom (148), Italy (146), Japan (128), Germany (115), Canada (112), and France (110), reflecting dominance by technologically advanced countries. Mid-range outputs came from Spain (57), Australia (51), Brazil (37), Netherlands (36), and Iran (35), whereas smaller nations such as Chile, Croatia, Denmark, Ireland, Norway, and South Africa each published six papers. At the regional level, Europe (n = 681) and Asia (n = 567) accounted for over two-thirds of total output. Europe showed early and steady growth from the 1980s, while Asia expanded sharply after 2015, driven by China, Japan, and South Korea. Other regions-Middle East (n = 91), Australia & Oceania (n = 51), Latin America (n = 42), and Africa (n = 23)-showed modest but increasing engagement after 2020, reflecting disparities in technological and funding capacity. The United States maintained long-term leadership through three phases-initiation, consolidation, and expansion-whereas China experienced rapid growth after 2015. Overall, these findings highlight both the global rise and persistent regional inequality in telesurgery research, underscoring the dominance of high-income nations and the growing participation of emerging economies.

PMID:41364376 | DOI:10.1007/s11701-025-03024-7

J Math Biol. 2025 Dec 9;92(1):11. doi: 10.1007/s00285-025-02309-7.

ABSTRACT

We consider a generalized version of the birth-death (BD) and death-birth (DB) processes introduced by Kaveh et al. (R Soc Open Sci 2(4):140465. https://doi.org/10.1098/rsos.140465 ), in which two constant fitnesses, one for birth and the other for death, describe the selection mechanism of the population. Rather than constant fitnesses, in this paper we consider more general frequency-dependent fitness functions (allowing any smooth functions) under the weak-selection regime. A particular case arises in evolutionary games on graphs, where the fitness functions are linear combinations of the frequencies of types. For a large population structured as a star graph, we provide approximations for the fixation probability which are solutions of certain ODEs (or systems of ODEs). For the DB case, we prove that our approximation has an error of order 1/N, where N is the size of the population. The general BD and DB processes contain, as special cases, the BD-* and DB-* (where * can be either B or D) processes described in Hadjichrysanthou et al. (Dyn Games Appl 1(3):386. https://doi.org/10.1007/s13235-011-0022-7 )-this class includes many examples of update rules used in the literature. Our analysis shows how the star graph may act as an amplifier, suppressor, or remains isothermal depending on the scaling of the initial mutant placement. We identify an analytical threshold for this transition and illustrate it through applications to evolutionary games, which further highlight asymmetric structural effects across different game types. Numerical examples show that our fixation probability approximations remain accurate even for moderate population sizes and across a wide range of frequency-dependent fitness functions, extending well beyond previously studied linear cases derived from evolutionary games, or constant fitness scenarios.

PMID:41364371 | DOI:10.1007/s00285-025-02309-7

Environ Monit Assess. 2025 Dec 9;198(1):26. doi: 10.1007/s10661-025-14826-5.

ABSTRACT

CDOM, an important ocean colour product, accounts for 90% of non-water UV absorption in the upper ocean. CDOM absorption triggers photochemical reactions resulting in the release of greenhouse gases and alters microbial bioavailability of organic matter. The three different approaches for retrieving a_dg(λ) from satellite data were validated using a_CDOM(λ) generated from OC-CCI-derived remote sensing reflectance (R_rs) and in situ measured a_CDOM(λ). The multiple linear regression (MLR) model performed better than the two exponential decay models in quantifying CDOM in the UV region. The better performance of R_rs-based algorithms indicated that absorption-based algorithms need considerable improvement when compared to algorithms based on the combined absorption by detrital matter and CDOM (a_dg(λ)). As a result, the absorption-based algorithm was modified as the ASCDOM algorithm, which demonstrated improved retrieval at 275, 355, 38 and 412 nm for a_CDOM(λ). The ASCDOM algorithm’s strong statistical performance highlights its accuracy in retrieving satellite products for water quality evaluations and ocean colour monitoring.

PMID:41364351 | DOI:10.1007/s10661-025-14826-5

JMIR Form Res. 2025 Dec 8. doi: 10.2196/82889. Online ahead of print.

ABSTRACT

BACKGROUND: Digital vaccination campaigns are increasingly used to address declining vaccine confidence, yet evidence from large-scale, real-world interventions in middle-income countries is limited. Meta’s Brand Lift Studies (BLS), which use randomized test-control exposure, provide Bayesian esti-mates of attitudinal shifts resulting from digital content. Mexico, with over 88.6 million active internet users, provides a setting to evaluate the impact of targeted campaigns on vaccine atti-tudes.

OBJECTIVE: This study evaluated the impact of five digital vaccination campaigns implemented by the Aso-ciación Mexicana de Vacunología (@Vacunologia) on Facebook and Instagram in Mexico be-tween 2021 and 2022 on key attitudinal constructs related to COVID-19 vaccine confidence.

METHODS: This study used a retrospective ecological design, we analyzed aggregated BLS results for five campaigns targeting different audiences and vaccination themes. Measured outcomes included standard ad recall, perceived importance, perceived safety, perceived efficacy, and concerns about side effects. Statistical significance within the BLS framework was defined as an incre-mental lift of ≥2 percentage points with ≥90% posterior probability of replication-a threshold consistent with Meta’s operational Bayesian approach. Exploratory comparisons across cam-paigns were conducted using one-way analysis of variance (ANOVA), unpaired t-tests, and Fish-er’s Exact Tests.

RESULTS: Campaigns reached 84.9 million accounts and generated 179.4 million impressions with a total investment of USD 215,600. All campaigns produced statistically significant improvements in at least one attitudinal outcome (Bayesian threshold ≥90%). Standard ad recall increased in four campaigns (ANOVA, P < .001), and concerns about side effects decreased in two campaigns (t-test, P = .049; P = .006). Perceived safety, importance, and efficacy improved in selected audi-ences, with stronger effects observed among younger users and women (ANOVA, P = .005). No direct behavioral outcomes (eg, vaccination uptake) were measured; therefore, the findings reflect attitudinal rather than behavioral change. However, these constructs are recognized as proximal predictors of vaccine decision-making and constitute health-related outcomes.

CONCLUSIONS: Large-scale digital vaccination campaigns can meaningfully strengthen attitudinal determinants of vaccine confidence in a middle-income context. This social media advertising campaigns effec-tively increased standard ad recall and improved perceptions of vaccine importance and safety, particularly among younger audiences and women in urban areas. However, changes in efficacy perceptions and concerns about side effects were limited. The innovation and implications of this study lie in evaluating large-scale, real-world digital vaccine campaigns in Latin America using experimental BLS data. Findings highlight that audience segmentation yield stronger perceptual shifts, suggesting that tailored digital strategies can complement traditional public health com-munication. While BLS does not measure behavioral endpoints, the observed attitudinal im-provements represent foundational steps toward influencing vaccine-related behaviors. Future work should link digital attitudinal metrics with vaccination and epidemiological data to assess real-world health impact.

PMID:41364336 | DOI:10.2196/82889

CVIR Endovasc. 2025 Dec 9;8(1):107. doi: 10.1186/s42155-025-00623-1.

ABSTRACT

PURPOSE: To evaluate the safety and effectiveness of microfibrillar collagen paste (MCP), coils, and coils combined with gelatin sponge for transhepatic access tract embolization following portal vein islet cell transplant.

METHODS: A retrospective review was conducted at a single institution between January 2008 and October 2024, including 20, 28, and 21 consecutive islet cell transplant procedures requiring transhepatic access embolization with MCP, coils, and coil plus gelatin sponge, respectively. All procedures were performed via a right portal vein branch. MCP was performed using Avitene (BD). The average number of coils required in the coil plus gelatin sponge and coil-only groups were 1.8 and 1.6 coils per procedure, respectively. All patients were placed on therapeutic anticoagulation during the procedure and for at least two weeks post-transplant. Medical records were reviewed to compare laboratory results, portal venous pressures, post-procedure liver ultrasounds, and 30-day hemorrhagic events across the three groups.

RESULTS: All procedures were technically successful. However, one instance of coil migration into a portal vein branch occurred in the coil plus gelatin sponge group (1/28, 3.5%). Baseline hemoglobin, platelet counts, and partial thromboplastin time did not differ significantly between groups (p > 0.05). A statistically significant lower international normalized ratio (INR) was observed in the MCP group compared to the gelatin sponge and coil-only groups (1.0 vs. 1.1 vs. 1.1, p = 0.0036 and 0.004). No statistically significant differences were found in hemoglobin changes, post-transplant portal venous pressures, or post-embolization hemorrhagic events (p > 0.05). One patient in the coil plus gelatin sponge group developed a large subcapsular hematoma (1/27, 3.7%), while another in the MCP group experienced a large right hemothorax (1/20, 5.0%).

CONCLUSION: MCP, coils, and coil plus gelatin sponge are similarly effective for transhepatic access closure following islet cell transplant in anticoagulated patients. However, coil embolization may require multiple coils and carries a risk of migration.

PMID:41364309 | DOI:10.1186/s42155-025-00623-1

J Thromb Thrombolysis. 2025 Dec 9. doi: 10.1007/s11239-025-03211-1. Online ahead of print.

ABSTRACT

Clinical practice guidelines on the optimal thromboprophylaxis duration following total hip and knee arthroplasty (THA and TKA) and hip fracture surgery are inconsistent. The aim of this meta-analysis is to investigate the effect of pharmacological prophylaxis duration on postoperative venous thromboembolism (VTE) in these patients. The primary outcome was the incidence of symptomatic and confirmed VTE at three months following surgery. A systematic search was performed in MEDLINE Complete (EBSCO), Embase, CINAHL complete (EBSCO), Web of Science and in CENTRAL databases, for randomised controlled trials comparing extended (minimum 28 days for THA and 10 days for TKA) vs. shorter duration thromboprophylaxis or placebo following these operations. Fifteen trials with a total of 26,580 participants were identified. Compared to shorter prophylaxis, extended thromboprophylaxis reduced 90-day symptomatic and confirmed VTE (OR: 0.43; 95% CI: 0.26-0.72; P = 0.001, I² = 0%; P = 0.75, respectively), significant only in the THA subgroup (P = 0.002). Beneficial effects were also observed with 30-day deep venous thrombosis (DVT) (OR: 0.32; 95% CI: 0.20-0.50; P < 0.001) and proximal DVT incidence (OR: 0.22; 95% CI: 0.12-0.41; P < 0.001) following THA. There were insufficient data to support extended prophylaxis for hip fracture surgery or TKA. Extending thromboprophylaxis up to 25-35 days appeared to reduce the incidence of 90-day symptomatic and confirmed VTE, particularly after THA. However, contemporary perioperative protocols, including early mobilisation and risk stratification, must be considered in determining optimal prophylaxis duration.

PMID:41364287 | DOI:10.1007/s11239-025-03211-1

Eur J Popul. 2025 Dec 9. doi: 10.1007/s10680-025-09761-7. Online ahead of print.

ABSTRACT

Despite ongoing efforts to reduce health disparities, substantial mortality differences persist across and within European countries. Avoidable mortality, i.e. deaths preventable through timely medical care or effective public health measures, provides a useful framework for assessing these inequalities. While previous studies largely focus on national differences, this study examines spatial differences and trends in avoidable mortality at the district level. We analysed official cause-of-death statistics for 581 districts across 10 European countries from 2002 to 2019, using age-standardised death rates (SDR) as the primary outcome. Spatiotemporal clusters were identified using emerging hotspot analysis. Our results show that SDRs for avoidable mortality declined across most districts for both sexes, yet marked disparities persist between men and women and between amenable and preventable mortality. Districts in Central and Eastern Europe consistently exhibited higher SDRs than those in Western and Southern Europe, while Germany occupies an intermediate position with particularly high rates for amenable mortality. Spatiotemporal hotspot analysis confirmed these patterns and showed that persistent high-mortality (hotspots) and low-mortality (coldspots) clusters persist, reflecting both substantial within-country inequalities and cohesive cross-border mortality patterns. These findings suggest that national boundaries are not always the most meaningful lines for explaining health outcomes. Instead, local socioeconomic and structural determinants of health play a central role. Persistent hotspots highlight areas where targeted interventions are urgently needed, while coldspots may offer lessons for best practices. Addressing these inequalities requires targeted, place-based, and transnational strategies to effectively reduce health inequalities in Europe.

PMID:41364281 | DOI:10.1007/s10680-025-09761-7

J Robot Surg. 2025 Dec 9;20(1):65. doi: 10.1007/s11701-025-03031-8.

ABSTRACT

Robotic surgery enables automated capture of objective performance indicators (OPIs), which reflect gestures at the surgeon consoles as well as activity at the patient cart. This systematic review evaluated associations between OPIs and clinical outcomes from robotic surgery. Across nine studies, OPIs were associated with various intra-operative and post-operative outcomes, including estimated blood loss, operative time, hospital stay, continence recovery, quality of life, and positive surgical margins. Studies involving predictive models demonstrated improved outcome prediction when combining OPIs with patient and disease characteristics compared to using clinical variables alone. These findings suggest that OPIs provide meaningful data in regard to surgical quality and patient outcomes. Further multicenter research across surgical specialties and robotic platforms is needed to validate the potential utility of OPIs in surgical training, benchmarking, and quality assessment.

PMID:41364267 | DOI:10.1007/s11701-025-03031-8

Discov Oncol. 2025 Dec 9. doi: 10.1007/s12672-025-04121-7. Online ahead of print.

ABSTRACT

BACKGROUND: Glioma is the most common primary brain tumor in adults, malignant progression and recurrence are inevitable. Although mechanisms of glioma development and progression have been demonstrated, the underlying driver pathway activation and the related therapeutic targets of recurrent gliomas, notably recurrent isocitrate dehydrogenase (IDH) wild-type gliomas, are rudimentary.

METHODS: We analyzed the differential expression genes (DEGs) between two subgroups of 80 IDH wild-type recurrent gliomas from the Chinese Glioma Genome Atlas (CGGA). We then constructed and validated an 11-gene signature based on cell cycle-related DEGs. SPSS and R languages ​​were used for statistical analysis and graphical work.

RESULTS: We proposed a molecular classification based on gene expression profiles and divided them into two subtypes that differed in their biological features and prognoses. We then constructed and validated an 11-gene signature based on cell cycle-related DEGs to better explore the association between cell cycle and tumor malignant progression. Additionally, the risk score could predict the sensitivity of patients to radiotherapy or chemotherapy. Functional analysis demonstrated that genes associated with the high-risk group were involved in various aspects of glioma cell cycle regulation. Moreover, the knockdown of SYCE2 blocked cell proliferation and improved cell sensitivity to temozolomide (TMZ).

CONCLUSION: This study developed a cell cycle-related signature for predicting the prognosis of recurrent IDH wild-type glioma, and identified a novel biomarker SYCE2, which could be used to assess the response of patients to TMZ.

PMID:41364265 | DOI:10.1007/s12672-025-04121-7