Category: Statistics

Biodegradation. 2026 Feb 21;37(2):39. doi: 10.1007/s10532-026-10267-0.

ABSTRACT

This study investigated the biotransformation of three different plastic surfaces, polypropylene (PP), polyvinyl chloride (PVC) and polyethylene (PE), by anaerobic digestion (AD) system microorganisms under mesophilic conditions. For that, a laboratory-scale AD system was established and plastics were immersed in the sludge for a 50-day incubation period, measured for any significant mass loss. Statistical analysis showed a significant mass loss (p < 0.05) in PVC pieces with a 1.1 ± 0.16 mg average reduction, while PP and PE didn’t show any significant mass loss. Raman spectroscopy analysis revealed temporally increasing novel peaks in PVC at 1729 cm^-1 corresponding to C = O stretching vibrations. This was considered significant and compared against an unchanged marker of PVC, revealing a newly identified peak that has not been documented in prior studies of this material. PP also indicated a temporal increase of novel peaks in the spectral range of C = C stretching vibrations in the region of 1512 cm^-1. Atomic force microscopy (AFM) analysis of PVC showed a reduction in average roughness amplitude from 100 to 90 nm in 30 days and 65 nm to 50 days revealing surface biotransformation. Phase-contrast microscopy further confirmed surface embrittlement across all plastics. Several bacterial species that were associated with plastic biotransformation were isolated and characterized using 16 s rRNA molecular marker gene-based identifications. In conclusion, this study suggests that, the changes to overall surface of the plastics and newly observed surface transformation of PVC leading to biodeterioration, by AD system microorganisms.

PMID:41721890 | DOI:10.1007/s10532-026-10267-0

Abdom Radiol (NY). 2026 Feb 21. doi: 10.1007/s00261-026-05406-3. Online ahead of print.

ABSTRACT

OBJECTIVE: Traditional MRI often requires breath-holding, which is challenging for some patients. This study investigates the Liver Acceleration Volume Acquisition-Flexible (LAVA-Flex) sequence using Cartesian sampling. We aim to assess how various combinations of compressed sensing (CS) and number of excitations (NEX) parameters affect image quality and scanning time for liver MRI under free-breathing conditions. Our goal is to identify the optimal parameter combination and offer a liver imaging protocol that is easily applicable for patients who cannot hold their breath.

METHOD: In this preliminary study, six CS-NEX parameter combinations were tested on healthy volunteers using a 3.0 T MRI: Group A (CS1.2/NEX2), Group B (CS2/NEX5), Group C (CS2/NEX6), Group D (CS2/NEX7), Group E (CS2.5/NEX5), and Group F (CS2.5/NEX6). Objective evaluation indicators included the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Subjective assessment employed a 5-point scoring system to evaluate liver margin sharpness, vascular clarity, respiratory motion artifacts, and overall diagnostic value. Statistical analysis was performed using one-way analysis of variance (ANOVA), the Kruskal-Wallis test, and the weighted kappa test, with P < 0.05 considered statistically significant.

RESULT: We included a total of 30 volunteers in the study. The scanning times varied significantly across the six groups. Objective assessment indicated that the SNR increased progressively with the optimization of the CS-NEX combination, whereas the CNR did not differ significantly between groups. Subjectively, Group A scored the lowest for image quality, while Groups D to F scored the highest. Group E, with the shortest scanning time, achieved the best balance of image quality and efficiency.

CONCLUSION: The combined effect of CS and NEX successfully addressed the challenge of liver imaging during free breathing using traditional MRI equipment. The optimal parameter combination, Group E, achieved the best balance between image quality and time efficiency in 98 s, offering a viable solution for breath-hold-impaired patients.

PMID:41721868 | DOI:10.1007/s00261-026-05406-3

Eur Radiol. 2026 Feb 21. doi: 10.1007/s00330-026-12385-y. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the performance of a commercial artificial intelligence (AI) software in detecting intracranial hemorrhage (ICH) in emergency settings, compared to on-call radiology residents.

MATERIALS AND METHODS: All consecutive unenhanced cerebral CT-scans performed in a single center over a 3-month period in the emergency department in patients with suspected ICH, initially interpreted by radiology residents on-call and subsequently verified and approved by a board-certified radiologist, were concomitantly analyzed by an AI software for the presence of ICH. Results from the AI software were stored in a separate PACS partition and were unavailable to the radiologists for the case reading. We assessed the diagnostic performance of the AI software and of the radiology residents in detecting ICH. The reference standard was the final report of the board-certified radiologist.

RESULTS: Radiology reports of 2153 CT-scans were analyzed, and ICH prevalence was 15.4% (331/2153). The AI software achieved an overall sensitivity of 84% and a specificity of 94.4%, and radiology residents achieved a sensitivity of 96.4% and a specificity of 99.6%, respectively (p-values < 0.001). The sensitivity was 97.7% for AI and 98.5% for residents when CT examinations displayed an association of multiple hemorrhagic types (p = 1). The sensitivity was 95.2% for AI and 98.4% for radiology residents in the presence of multiple ICH sites (p = 0.11).

CONCLUSION: Radiology residents demonstrated a significantly higher performance in detecting ICH compared to the AI software. AI exhibited very good diagnostic performance only in the presence of multiple hemorrhagic sites or multiple hemorrhage types.

KEY POINTS: QuestionHow does the performance of the AI software compare to that of radiology residents in detecting ICH on unenhanced CT in real-life emergency workflow conditions? FindingsIn the emergency setting, the AI software demonstrated lower overall sensitivity and specificity than radiology residents for detecting ICH. Clinical relevanceIn real-life emergency conditions at a university hospital, the AI software did not offer a superior performance compared to radiology residents in detecting ICH. The integration of AI in this specific setting remains to be defined.

PMID:41721849 | DOI:10.1007/s00330-026-12385-y

Endocrinol Diabetes Metab. 2026 Mar;9(2):e70180. doi: 10.1002/edm2.70180.

ABSTRACT

INTRODUCTION: Concerns about diabetic ketoacidosis (DKA) and euglycemic ketoacidosis (eKA) are balanced against possible organ-protective benefits in the debated perioperative management of sodium-glucose cotransporter-2 (SGLT2) inhibitors. This meta-analysis compared the perioperative clinical and laboratory outcomes associated with perioperative exposure to SGLT2i.

METHODS: Through July 31, 2025, we searched PubMed, Web of Science, Scopus, and CENTRAL for observational studies and randomised controlled trials comparing the outcomes of preoperative use of SGLT2 inhibitors with non-use in patients undergoing cardiac or non-cardiac surgery. We pooled data using a random-effects model and investigated heterogeneity using leave-one-out sensitivity analyses.

PROSPERO-ID: CRD420251155809.

RESULTS: There were 10 studies comprising 246,242 patients. Due to considerable heterogeneity, the primary pooled analysis revealed no significant association between SGLT2 inhibitor use and either eKA (OR 4.86; p = 0.11) or DKA (OR 2.21; p = 0.11). However, a significant increase in the risk of eKA (OR 1.11; p < 0.001) and DKA (OR 5.33; p < 0.001) was observed using leave-one-out sensitivity analysis to identify outliers. On the other hand, the usage of SGLT2 inhibitors was associated with a statistically significant decrease in both mortality (OR 0.73; p = 0.006) and acute renal injury (OR 0.68; p < 0.0001). The SGLT2 inhibitor group had significantly lower perioperative pH, base excess, and blood glucose levels.

CONCLUSION: The use of perioperative SGLT2 inhibitors poses a clinical paradox between significant renoprotection and survival advantages and a latent risk of ketoacidosis concealed by considerable heterogeneity. While metabolic monitoring is essential, current surgeries requiring more prolonged withholding may need to weigh metabolic risk against the drug’s significant benefit in reducing acute kidney injury and mortality.

PMID:41721639 | DOI:10.1002/edm2.70180

Nurs Open. 2026 Feb;13(2):e70407. doi: 10.1002/nop2.70407.

ABSTRACT

AIM: To provide a comprehensive understanding of how nurse managers’ leadership styles affect staff engagement and to identify key themes that influence engagement from both statistical and experiential perspectives within a multicultural healthcare context.

DESIGN: Explanatory sequential mixed-methods design, with integration occurring across the design, methods and reporting stages using the Pillar Integration Process.

METHODS: The study was conducted in four public hospitals in western Saudi Arabia. Quantitative data were collected from 278 registered nurses using the validated Multifactor Leadership Questionnaire (MLQ-5X) and Utrecht Work Engagement Scale (UWES-9). Thirteen nurses participated in follow-up semi-structured interviews. The study adhered to the Good Reporting of a Mixed Methods Study (GRAMMS) guidelines.

RESULTS: Four integrated themes emerged: relational leadership, recognition and reward, impact of neglectful leadership and cultural competence in leadership. Saudi and non-Saudi nurses perceived leadership differently, influenced by cultural norms.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

PMID:41721584 | DOI:10.1002/nop2.70407

Int J Gynaecol Obstet. 2026 Feb 21. doi: 10.1002/ijgo.70869. Online ahead of print.

ABSTRACT

OBJECTIVE: Novel human papillomavirus (HPV) tests must undergo thorough validation before implementation in the cervical cancer screening population. The MyGene HPV sexually transmitted infection (STI) assay (MHSA), an emerging test based on emerging next-generation sequencing, presents as a promising tool for enhancing detection capabilities in screening settings. This study aims to conduct a comparative analysis of the clinical performance of two assays (Cobas 4800 vs. MHSA) in detecting 14 high-risk (GR)-HPV genotypes for the identification of high-grade cervical intraepithelial neoplasia (CIN2+/CIN3+) in longitudinal cervical cancer screening among Chinese women.

METHODS: A total of 2985 consecutive specimens from a cervical screening program in Erdos City were examined using both MHSA and Cobas 4800 assays. Follow-up study was also conducted for 3 years.

RESULTS: The overall percent agreement (OPA), percentage of negative agreement (PNA), and Kappa statistics for 14 HR-HPV positivity, type-specific HPV16, HPV18, and 12 other HR-HPV demonstrated strong concordance between the two assays. The clinical performance of MHSA was comparable to the Cobas 4800 assay at both baseline and over the 3-year cumulative follow-up. Moreover, MHSA effectively reduced unnecessary colposcopy referrals and showed better triage efficiency both at baseline and at the 3-year follow-up. When combined with HPV typing and cytology results, MHSA outperforms the Cobas 4800 in terms of clinical performance and triage efficiency.

CONCLUSION: Our study indicated that MHSA could be considered a valuable option for cervical cancer screening in China.

PMID:41721577 | DOI:10.1002/ijgo.70869

J Med Virol. 2026 Feb;98(2):e70848. doi: 10.1002/jmv.70848.

ABSTRACT

Since the initial recommendations for universal infant hepatitis B vaccination in the United States, vaccination coverage has increased significantly. However, a trend of declining antibody levels has been observed among early vaccinees. This study aims to investigate hepatitis B vaccination coverage and vaccine-associated immunity among US-born children and adolescents. We used data from the 2017-2020 National Health and Nutrition Examination Survey to include US-born participants aged 2 to 18 years who had complete hepatitis B serological data and vaccination history. We determined the prevalence of completing the hepatitis B vaccination series and the prevalence of vaccine-associated immunity. A total of 2,852 US-born children and adolescents were included in the study, achieving a complete hepatitis B vaccination coverage rate of 83.9% (95% CI: 81.5%-86.3%). Among the 2,317 individuals who had complete hepatitis B vaccination series, the vaccine-related immunity rate was 35.2% (95% CI: 32.5%-37.8%). Multivariable logistic regression analysis identified age group, race/ethnicity, family income to poverty ratio, and hepatitis A antibody as significant factors associated with complete vaccination coverage (p < 0.05). Additionally, the hepatitis B surface antibody levels decreased with age (p < 0.05). Hepatitis B vaccination coverage among US-born children and adolescents declined during the 2017-2020 period. Targeted vaccination efforts in underserved populations may help improve vaccination coverage. Future continuous monitoring of trends in both vaccination and seropositivity rates is needed.

PMID:41721575 | DOI:10.1002/jmv.70848

Int J Gynaecol Obstet. 2026 Feb 21. doi: 10.1002/ijgo.70886. Online ahead of print.

ABSTRACT

OBJECTIVE: The accurate diagnosis of multicompartment pelvic organ prolapse (POP) is fundamental to surgical success. This study aims to compare the diagnostic performance of transperineal ultrasound against clinical examination (pelvic organ prolapse quantification, POP-Q) for the detection of compartmental defects in patients with multicompartment POP, using assessment under spinal anesthesia as the reference standard.

METHOD: A prospective randomized diagnostic accuracy study was designed, including 129 patients scheduled for multicompartment POP surgery. Patients were randomly assigned to undergo either a preoperative POP-Q two-dimensional transperineal ultrasound assessment. The reference standard for all patients was the intraoperative POP-Q assessment, conducted under spinal anesthesia immediately before surgery. Sensitivity, specificity, and likelihood ratios (LR) were calculated for each method and compartment.

RESULTS: Both techniques demonstrated high sensitivity for the diagnosis of cystocele (100% vs 98.3%). However, their performance varied across the other compartments. Ultrasound showed superior specificity for uterine prolapse (73.4% vs 45.4%) and rectocele (86.3% vs 66.0%) and was particularly robust in confirming enterocele (LR+ of 10.5). In turn, clinical examination had a higher sensitivity for detecting rectocele (61.5% vs 21.4%) and was highly reliable for ruling out cystocele and uterine prolapse (LR- of 0).

CONCLUSION: Clinical examination and ultrasound are complementary in the diagnosis of prolapse. Their combined use is key to accurate surgical planning.

PMID:41721567 | DOI:10.1002/ijgo.70886

J Dent Educ. 2026 Feb 21. doi: 10.1002/jdd.70181. Online ahead of print.

ABSTRACT

OBJECTIVES: This study provides a descriptive, multi-institutional comparison of dental students’ recognition accuracy and management decisions of oral soft tissue pathological entities across four US dental schools. While prior single-institution studies have evaluated diagnostic ability, this work provides a multi-institutional comparison to identify recognition and decision-making variability as well as potential educational implications.

MATERIALS AND METHODS: A voluntary, anonymous online survey with twenty image-based multiple-choice questions was administered to 160 students. Each question included an image, patient demographics, and key case details. Management questions were provided with reference diagnoses to prevent conflation of diagnostic and management errors. Descriptive statistics, t-tests, logistic regression, chi-square tests, and multi-rater kappa statistics were used to analyze performance, with effect sizes, reference groups, and 95% confidence intervals reported. Model fit for logistic models was assessed using likelihood ratio tests.

RESULTS: Students demonstrated a high level of recognition for conditions like candida (84%) and tobacco keratosis (95%). Subtle or clinically variable lesions were more challenging, such as erosive lichen planus (50%) and idiopathic leukoplakia (58%). Management accuracy frequently lagged behind recognition accuracy. Significant inter-school differences were observed for both recognition (χ² = 27.66, p < 0.0001) and management (χ² = 30.80, p < 0.0001), with students from School #4 outperforming peers. Kappa values remained low (< 0.2 for most items), indicating wide variability and limited internal agreement.

CONCLUSION: Students demonstrated strong theoretical knowledge of common oral pathological entities but variability in identifying and managing rare or diagnostically nuanced conditions. Because this survey evaluates recognition rather than competence, findings highlight the need for case-based, competency-aligned teaching approaches to strengthen diagnostic reasoning and management decision-making.

PMID:41721556 | DOI:10.1002/jdd.70181

Mol Genet Genomic Med. 2026 Mar;14(3):e70188. doi: 10.1002/mgg3.70188.

ABSTRACT

BACKGROUND AND AIM: Hereditary spherocytosis (HS) is a common disease in hereditary hemolytic anemia. Advancements in sequencing technology have enabled the identification of a growing number of mutation sites associated with HS. This study analyzed the clinical characteristics and gene mutations of HS in our center.

METHODS: Retrospective collection of data on 59 Chinese pediatric patients with HS admitted to the Hematology Department of Chongqing Medical University Affiliated Children’s Hospital from 2013 to 2022. Second-generation gene sequencing was performed on participants, with verification of detected variants using Sanger sequencing. Data analysis was conducted using various databases, and statistical methods were used for differential analysis.

RESULT: We collected clinical data of 59 Chinese children with HS phenotype, including 27 males (45.8%) and 32 females (54.2%), all unrelated. The age of onset ranged from 0 to 180 months, with a median age of 60 months. Our study found that ANK1 and SPTB gene mutations were the primary causes of HS, with missense and frameshift mutations being the most common. De novo mutations were present in 37 (62.7%) patients, while the remaining mutations were inherited. We noted a higher proportion of females (p = 0.032) and lower total bilirubin levels (p = 0.014) in patients with multiple gene mutations. Patients with ANK1 gene mutations experienced more severe anemia compared to those with SPTB gene mutations (p = 0.041). Additionally, there were significant differences in mean corpuscular hemoglobin concentration (MCHC) between different mutation types (p = 0.036), indicating lower MCHC levels in the missense mutation group. No differences in clinical phenotypes were observed among different structural domains of ANK1 and SPTB mutations. Splenectomy significantly alleviated the symptoms in HS patients.

CONCLUSION: We identified unique genetic and clinical characteristics mutations of HS in Chongqing, China. These findings expand the mutation spectrum of HS and have implications for early diagnosis and treatment of the disease.

PMID:41721551 | DOI:10.1002/mgg3.70188