Category: Statistics

Sports Med Open. 2026 Jun 7;12(1):64. doi: 10.1186/s40798-026-01014-z.

ABSTRACT

BACKGROUND: To our knowledge, no previous systematic review and meta-analysis of doping prevalence in sport from indirect estimation models (IEM) exists.

OBJECTIVE: To conduct a systematic review and meta-analysis of empirical IEM-based studies of admitted doping prevalence in sport.

METHODS: We conducted electronic database and ad hoc searches up to March 2025, and estimated lifetime and past year prevalence rates through a cross-classified model including prevalence (lifetime vs. past year), sample (competitive vs. recreational) and sports (multi-sport vs. single-sport) types.

RESULTS: Forty-six records (K) were included in the review (k [subset records included in the meta-analysis] = 30, n [independent studies from the records] = 34). The World Anti-Doping Agency’s definition of doping use was applied for data collection in most studies (k = 18), and doping prevalence was mostly assessed as past year/season (k = 20). Studies included in the meta-analysis were mostly conducted in Europe (k = 22) and applied the Unrelated Question (k = 8) and Forced Response with Cheater Detection (k = 6) models. Study participants were mostly multi-sport (k = 20) and competed at diverse levels, and most data (k = 28) was collected outside sport events. The corpus included articles that re-analysed existing data (k = 4). Lifetime prevalence was highest for multi-sport competitive athletes (22.6%) and lowest for single-sport competitive athletes (12.7%), whereas past year prevalence was highest for single-sport recreational sportspersons (15.5%) and lowest for multi-sport recreational sportspersons (8.7%).

CONCLUSIONS: Under IEM, about one of five multi-sport competitive athletes admitted to ever doping whereas about one of six of single-sport recreational sportspersons admitted to doping in the past year. Furthermore, multi-sport (vs. single-sport) competitive athletes show relatively higher doping prevalences, whereas single-sport (vs. multi-sport) recreational sportspersons report relatively higher doping prevalences. Secondary (re-)analysis presents a novel methodological challenge for meta-analyses. Registration PROSPERO: CRD42022373691.

PMID:42251609 | DOI:10.1186/s40798-026-01014-z

Am J Hosp Palliat Care. 2026 Jun 7:10499091261457550. doi: 10.1177/10499091261457550. Online ahead of print.

ABSTRACT

BackgroundMany studies exist outlining poor outcomes related to cardiopulmonary resuscitation (CPR) administered to patients who are elderly and/or have comorbid medical conditions with sudden cardiac arrest. Patients with asystole or pulseless electrical activity have worse outcomes. Studies show only 10% of patients with out-of-hospital cardiac arrest and initial asystole survive until they reach the hospital. Less than 5% survive until hospital discharge with good neurologic function.Research QuestionGiven these poor outcomes, the question arises: what are the impacts on the healthcare personnel providing this type of aggressive intervention?Study Design and MethodsThe study design was a cross-sectional, mixed-methods anonymous online survey of hospital personnel in one large academic setting. The survey included demographic questions and 6 questions regarding feelings around the use of CPR. Descriptive statistics were used to report on respondents and their responses. Thematic qualitative analysis of free-text responses was completed.ResultsOne-hundred fifty-four people of 780 (20%) responded to an anonymous survey sent to hospital personnel. Ninety-four percent of respondents were involved in a hospital code experience; 87% surveyed had performed CPR on an individual knowing there was a low likelihood of survival. Eight themes with subthemes were identified in the data. Participants primarily had challenging emotions associated with taking part in CPR including sadness and frustration.ConclusionsA large majority of healthcare workers surveyed in a single hospital system reported performing CPR on patients knowing there was a low likelihood of survival. Many respondents reported emotional effects.

PMID:42251604 | DOI:10.1177/10499091261457550

Phys Rev Lett. 2026 May 22;136(20):200401. doi: 10.1103/36fj-lsw7.

ABSTRACT

We theoretically investigate the role of spatial dimension and driving frequency in a nonequilibrium phase transition of a driven-dissipative interacting bosonic system. In this setting, spatial dimension is dictated by the shape of the external driving field. We consider both homogeneous driving configurations, which correspond to standard integer-dimensional systems, and fractal driving patterns, which give rise to a noninteger Hausdorff dimension for the spatial density. The onset of criticality is characterized by critical slowing down in the excited density dynamics as the system asymptotically approaches the steady state. By analyzing the system-size dependence of the asymptotic decay rate using numerical simulations of the full multimode dynamics, complemented by an analytical statistical mean-field treatment, we determine the lower critical dimension of the nonequilibrium phase transition. We show that this dimension can be noninteger and fractal in nature, and that it can be tuned continuously via the frequency detuning of the driving field.

PMID:42251579 | DOI:10.1103/36fj-lsw7

Phys Rev Lett. 2026 May 22;136(20):206101. doi: 10.1103/6n5m-rxc1.

ABSTRACT

Plastic deformation in amorphous solids is carried by localized shear transformations that self-organize into avalanches. In amorphous carbon modeled with a machine-learned interatomic potential, we find that the energetics and organization of these avalanches can be resolved by systematically following the underlying energy landscape. With a pseudoarclength numerical continuation framework, we decompose avalanches into constituent shear transformations and determine their strain-dependent energetics. Our analysis shows that, prior to onset, avalanches have a latent structure that consists of well-separated local minima. We further demonstrate that arclength continuation yields an event driven framework for following avalanche dynamics, eliminating time-step effects on statistical avalanche properties such as distributions of stress drops.

PMID:42251541 | DOI:10.1103/6n5m-rxc1

Urol J. 2026 May 24. doi: 10.22037/uj.v23i00.8445. Online ahead of print.

ABSTRACT

PURPOSE: To study the effect of Body mass index (BMI) on 24-h urine quantitative analysis in pediatric urolithiasis, and to explore whether obesity and overweight promote the formation of urinary calculi in children.

MATERIALS AND METHODS: A comprehensive search of EMBASE, Pubmed and the Cochrane Library, Web of Science, and Scopus were conducted in March 2024 and updated in October 2025 to find all related studies. BMI was used to specify the body size. And then, a predetermined inclusion and exclusion criteria was used to screen each article. Data from appropriate studies was extracted, a meta-analysis was performed using Stata14.0 software.

RESULTS: Eight studies, including 1033 children with urolithiasis who underwent 24-hour urine collection for chemical analysis, were included in this meta-analysis. The BMI ≥85th percentile group exhibited significantly higher uric acid excretion (SMD = 0.756, 95% CI = 0.092-1.420, P = .026). No statistically significant differences were found in calcium (SMD = -0.320, 95% CI = -0.600 to -0.050, P = .519), 24-h urine volume (SMD = -0.310, 95% CI = -0.790 to 0.160, P = .555), magnesium (SMD = -0.470, 95% CI = -0.820 to -0.120, P = .471), phosphate (SMD = -0.360, 95% CI = -0.610 to -0.110, P = .805), oxalate (SMD = -0.110, 95% CI = -0.390 to 0.170, P = .315), citrate (SMD = -0.190, 95% CI = -0.680 to 0.290, P = .057), or sodium (SMD = 0.200, 95% CI = -0.390 to 0.800, P = .050) excretion between the two groups. Sensitivity analyses confirmed the robustness of these findings.

CONCLUSION: While overweight/obese children with urolithiasis demonstrate higher urinary uric acid excretion, the absence of significant differences in other key urinary risk factors suggests that BMI alone should not be considered a separate and definitive risk factor for pediatric urolithiasis.

PMID:42251510 | DOI:10.22037/uj.v23i00.8445

Urol J. 2026 May 24. doi: 10.22037/uj.v23i00.8514. Online ahead of print.

ABSTRACT

BACKGROUND: Acute kidney injury is a common disease in hospitalized patients, which can have a significant impact on outcomes, including an increase in overall complications and mortality rates, criteria such as serum creatinine level, urinary output, And scoring systems such as KDIGO in acute conditions do not have acceptable specificity and sensitivity to evaluate the kidney function of people; Therefore, this study was conducted with the aim of determining the relationship between plasma uric acid level and mortality rate in patients with sepsis and acute kidney failure.

METHODS: In this descriptive-analytical (cross-sectional) study included 52 children , with the age range of one month to 15 years with sepsis (based on qSOFA criteria) and acute kidney failure (based on serum creatinine level) PICU of Ali Bin Abi Taleb Hospital from October 1401 to October 1402 were admitted and hospitalized, they were studied by census method. Within 48 hours after the admission of patients to the ICU, blood samples should be collected to check serum uric acid levels, electrolytes, albumin, complete blood count (CBC), kidney function tests, arterial blood gases, and chest x-rays. All patients were followed up until discharge or death due to progression of kidney failure. Finally, the findings of the research were analyzed using SPSS version 26 statistical software.

RESULTS: The mean age of patients was 3.66±4.92.The expired number in the hyperuricemia group was significantly higher than in the normal uric acid group (p-value = 0.03), an odds ratio of 3.45 indicates that a high level of uric acid is a risk factor for death. In this study, the duration of hospitalization was longer in those who survived (p-value = 0.02). A particularly strong predictor in our analysis was the QSOFA score (p < 0.001), highlighting its critical role in outcome alive or dead. Serum uric acid level and QSOFA scale showed no significant difference, in totally (p-value = 0.76), subgroup analysis from alive and death patients between uric acid and the QSOFA scale presented the same result (p-value = 0.203, p-value = 0.29, respectively) Conclusion: Finally, it can be stated that the level of uric acid can be considered as a laboratory variable to predict the prognosis of patients.

PMID:42251509 | DOI:10.22037/uj.v23i00.8514

J Int Med Res. 2026 Jun;54(6):3000605261452559. doi: 10.1177/03000605261452559. Epub 2026 Jun 6.

ABSTRACT

ObjectiveThis study aimed to systematically investigate the independent predictive value of the platelet-to-neutrophil ratio and platelet-to-lymphocyte ratio for 28-day all-cause mortality in patients with sepsis and to further evaluate their incremental discriminatory capacity when added to conventional prognostic scoring models.MethodsThis single-center retrospective cohort study involved 287 adult patients diagnosed with sepsis according to the Sepsis-3 criteria. Patients were stratified into high- and low-level groups based on the median values of platelet-to-neutrophil ratio and platelet-to-lymphocyte ratio, and baseline characteristics, and clinical outcomes were compared between groups. Univariate and multivariate Cox proportional hazards regression models were used to assess the independent associations of platelet-to-neutrophil ratio and platelet-to-lymphocyte ratio with 28-day mortality risk. To evaluate predictive performance, multiple models were constructed and compared, including Sequential Organ Failure Assessment score alone, Acute Physiology and Chronic Health Evaluation II score alone, each combined separately with platelet-to-neutrophil ratio or platelet-to-lymphocyte ratio, and a composite model integrating Acute Physiology and Chronic Health Evaluation II, day-3 lactate level, platelet-to-neutrophil ratio, and platelet-to-lymphocyte ratio. Model performance was rigorously assessed using receiver operating characteristic curves, calibration plots, decision curve analysis, integrated discrimination improvement, and net reclassification improvement, enabling a comprehensive evaluation of discrimination, calibration, clinical utility, and the incremental value of novel biomarkers.ResultsMultivariate Cox regression analysis revealed that lower platelet-to-neutrophil ratio (hazard ratio = 0.97, 95% confidence interval: 0.95-0.99, p = 0.012) and higher platelet-to-lymphocyte ratio (hazard ratio = 1.01, 95% confidence interval: 1.01-1.01, p = 0.043) were independently associated with increased 28-day all-cause mortality. Kaplan-Meier survival analysis confirmed significantly higher cumulative mortality in the low-platelet-to-neutrophil ratio and high-platelet-to-lymphocyte ratio groups (log-rank p < 0.05). The composite model incorporating Acute Physiology and Chronic Health Evaluation II, day-3 lactate level, platelet-to-neutrophil ratio, and platelet-to-lymphocyte ratio demonstrated superior predictive accuracy, with an area under the receiver operating characteristic curve (area under the curve) of 0.824 (95% confidence interval: 0.778-0.871), significantly outperforming both the Acute Physiology and Chronic Health Evaluation II only model (area under the curve: 0.746, p < 0.001) and the Sequential Organ Failure Assessment only model (area under the curve: 0.667, p < 0.001). Decision curve analysis showed that this model provided greater clinical net benefit across a broad range of threshold probabilities. Furthermore, both integrated discrimination improvement and net reclassification improvement analyses confirmed statistically significant improvements in discrimination and reclassification accuracy after the inclusion of platelet-to-neutrophil ratio and platelet-to-lymphocyte ratio (both p < 0.001).ConclusionPlatelet-to-neutrophil ratio and platelet-to-lymphocyte ratio are independent predictors of 28-day mortality in patients with sepsis. Incorporating these readily available and cost-effective inflammatory markers into traditional prognostic systems-such as Acute Physiology and Chronic Health Evaluation II-and combining them with dynamic lactate monitoring substantially enhances the discrimination, calibration, and clinical utility of risk prediction models. These findings provide robust evidence supporting the use of platelet-to-neutrophil ratio and platelet-to-lymphocyte ratio for early risk stratification and individualized prognostic assessment in clinical practice.

PMID:42251504 | DOI:10.1177/03000605261452559

Proc Inst Mech Eng H. 2026 Jun 6:9544119261456916. doi: 10.1177/09544119261456916. Online ahead of print.

ABSTRACT

Smash landings in badminton carry high injury risk, worsened by fatigue. Assess how fatigue and task predictability shape lower-limb biomechanics in elite male players and identify fatigue markers via explainable ML. Fourteen elites performed anticipated and unanticipated smash-landings before and after fatigue. Synchronous 3-D kinematics/kinetics were analyzed with a 2 × 2 repeated-measures ANOVA. XGBoost models based on anticipated-task trials were used to classify fatigue status; SHAP ranked feature importance. Fatigue and unpredictability independently affected peak coronal-plane knee moment (fatigue p = 0.033; task p = 0.016). Significant ankle-moment effects were also observed in the transverse plane. Statistical parametric mapping highlighted time-specific effects of fatigue and task on knee/ankle sagittal moments, with an interaction for knee sagittal ROM (p = 0.0395). XGBoost showed high accuracy, identifying peak ankle plantar-flexion moment as the foremost fatigue discriminator. Fatigue and unanticipated tasks were associated with reduced lower-limb control during smash landings. Knee moment and vertical ground-reaction force may serve as biomechanical indicators of fatigue-related movement alterations. Training strategies that combine fatigue exposure with decision-making demands may help improve motor control under high-demand task conditions.

PMID:42251489 | DOI:10.1177/09544119261456916

Trop Med Health. 2026 Jun 6. doi: 10.1186/s41182-026-00994-8. Online ahead of print.

ABSTRACT

BACKGROUND: The potential re-emergence of Mpox poses an increasing public health concern in the Horn of Africa, particularly in Ethiopia. This study examined perceptions of preparedness among surveyed surveillance professionals in Ethiopia regarding the disease surveillance system’s ability to detect and respond to a potential Mpox outbreak.

METHODS: A descriptive cross-sectional survey design was employed, utilizing a structured 58-item questionnaire that assessed preparedness across five domains: general awareness and understanding, surveillance infrastructure and resources, coordination and communication, preparedness and response, and policy, training, and equity. The survey was distributed to disease surveillance professionals at both federal and regional levels through purposive sampling. The data were analyzed using descriptive statistics, Mann-Whitney U tests, Cramér’s V, and content analysis.

RESULTS: Among the 42 surveyed surveillance professionals, 45.3% believed that the surveillance system could effectively respond to an Mpox outbreak, while 54.7% disagreed, reflecting divided perceptions within the sample. Respondents identified several perceived gaps, including limited awareness of Mpox-specific protocols, insufficient training, inadequate diagnostic capacity, and fragmented coordination across sectors. A substantial proportion of respondents reported system-related challenges, with 83.3% perceiving laboratory facilities as inadequate and 78.6% noting the absence of contingency plans. In addition, 57.1% indicated that their organizations lacked staff trained on Mpox, and 59.5% reported no stockpiles of personal protective equipment. Overall, the surveyed professionals expressed mixed perceptions of preparedness, with notable concerns regarding resource allocation, infrastructure, and policy implementation.

CONCLUSIONS: The study identifies perceived gaps among the 42 surveyed surveillance professionals regarding Mpox preparedness in Ethiopia, highlighting the need for enhanced training, strengthened infrastructure, improved coordination, and more equitable resource distribution. Addressing these gaps through targeted interventions may help strengthen disease surveillance capacity and improve the ability to detect, respond to, and manage emerging health threats such as Mpox.

PMID:42251460 | DOI:10.1186/s41182-026-00994-8

J Pharm Health Care Sci. 2026 Jun 6. doi: 10.1186/s40780-026-00592-0. Online ahead of print.

ABSTRACT

BACKGROUND: Antibiotic resistance has emerged largely due to the improper use of antibiotics in clinical practice, although most acute diarrheal diseases resolve without antibiotic treatment and should be reserved for cases of invasive bacterial or dysenteric diarrhea. This study aimed to assess the patterns of antibiotic use for acute diarrheal diseases at Nigist Elleni Mohammed Memorial Teaching Hospital (NEMMTH) in Central Ethiopia.

METHODS: A retrospective cross-sectional study was conducted to assess patients treated for diarrhea between January 1 and June 30, 2023. The appropriateness of antibiotic prescriptions for diarrhea was evaluated according to the Ethiopian Standard Treatment Guidelines. Data were collected using a structured abstraction form, and patient charts were selected through systematic random sampling. The analysis was performed using the Statistical Package for Social Sciences version 25.

RESULTS: Among 302 patients evaluated, 53.3% were female and 46.4% were children under five years old. Of the 302 patients, 57.6% had watery diarrhea. A total of 74.5% of patients received at least one antibiotic, of whom 73.5% received a single antibiotic during the treatment of acute diarrheal cases. The most commonly prescribed antibiotics were metronidazole (18.2%), cotrimoxazole (17.5%), and ciprofloxacin (11.6%). The proportion of inappropriate antibiotic prescribing was 77.1%.

CONCLUSIONS: This study found a high level of inappropriate antibiotic use for acute diarrheal disease at NEMMTH. Metronidazole and cotrimoxazole are the most commonly prescribed antibiotics. Ensuring proper management by adhering to the standard treatment guidelines is crucial.

PMID:42251448 | DOI:10.1186/s40780-026-00592-0