Category: Statistics

Sci Rep. 2026 Mar 29. doi: 10.1038/s41598-026-46269-4. Online ahead of print.

NO ABSTRACT

PMID:41905973 | DOI:10.1038/s41598-026-46269-4

Br J Nutr. 2026 Mar 30:1-27. doi: 10.1017/S0007114526106965. Online ahead of print.

ABSTRACT

This study aimed to evaluate adherence to the Mediterranean diet, a recognized healthy eating pattern, and the tendency toward orthorexia nervosa in professional athletes, and to examine their relationship with physical activity levels. The study was conducted with athletes (n=134) at the Turkish Olympic Preparation Center (TOHM). Data were collected using a questionnaire covering: socio-demographic information, dietary habits, anthropometric measurements, the Mediterranean Diet Quality Index (KIDMED), the International Physical Activity Questionnaire-Short Form (IPAQ-SF), and the ORTO-11 scale assessing orthorexic tendencies. Of the participants, 17.2% had poor dietary quality, 60.4% moderate, and 22.4% good dietary quality. According to the ORTO-11 (cutoff ≤25 points), 30.6% of athletes exhibited orthorexic tendencies. Athletes adhering to a diet had significantly higher orthorexia tendencies compared to non-dieters (p<0.05). A significant association was found between athletic experience and orthorexic tendencies, particularly among those with 4-8 years and ≥8 years of experience (p<0.05). Moreover, athletes consuming three main meals had significantly higher KIDMED and ORTO-11 scores than those consuming two meals (p<0.05). No statistically significant correlation was found between the KIDMED score, ORTO-11 score, and physical activity level (p>0.05). Professional athletes showed moderate adherence to the Mediterranean diet, while certain groups displayed higher orthorexia tendencies. Diet quality and orthorexic tendencies differed significantly with eating habits such as athletic experience and meal patterns, whereas physical activity level had no effect. These findings highlight the importance of multidisciplinary nutrition strategies focusing on both performance and sustainable healthy eating behaviors.

PMID:41905962 | DOI:10.1017/S0007114526106965

J Clin Periodontol. 2026 Mar 29. doi: 10.1111/jcpe.70120. Online ahead of print.

ABSTRACT

AIM: To compare the impact of intraoral scanning (IOS) and cone-beam computed tomography (CBCT) registration on implant positional accuracy in robotic computer-assisted implant surgery (r-CAIS).

MATERIALS AND METHODS: Patients requiring implant placement in the anterior or premolar regions were enrolled and randomly allocated to either a CBCT group or an IOS group at a 1:1 ratio. Implant positional accuracy was assessed by comparing planned versus actual implant positions using global platform deviation, global apex deviation and angular deviation. Subgroup analyses were performed based on jaw position and span length. The implant survival rate and patient satisfaction were recorded at prosthesis delivery. Statistical analysis was performed using linear mixed-effects modelling.

RESULTS: Thirty-two patients were included (16 patients with 25 implants in each group). In the IOS group, the global platform deviation, global apex deviation and angular deviation were reported as mean ± standard deviation (SD): 0.89 (0.65) mm, 0.95 (0.77) mm and 1.91 (1.98)°, respectively. In the CBCT group, the corresponding values were 0.88 (0.42) mm, 0.98 (0.46) mm and 1.84 (1.46)°. No statistically significant differences were found between IOS and CBCT groups (p > 0.05) regardless of jaw position or edentulous span. The implant survival rate and patient satisfaction were 100% in both groups.

CONCLUSIONS: Preoperative registration using IOS is non-inferior to CBCT-based registration in implant accuracy for r-CAIS, supporting its application as a radiation-free alternative for registration in partially edentulous patients with sufficient number of stable residual teeth.

TRIAL REGISTRATION: ChiCTR2400093045.

PMID:41905961 | DOI:10.1111/jcpe.70120

J Matern Fetal Neonatal Med. 2026 Dec;39(1):2650951. doi: 10.1080/14767058.2026.2650951. Epub 2026 Mar 29.

ABSTRACT

BACKGROUND: Infants born before 32 weeks of gestation are at high risk of developing intraventricular hemorrhage (IVH), which is associated with significant mortality and morbidity as well as long-term neurodevelopmental impairment. There is currently a lack of consensus regarding the impact of delivery mode on these infants. Therefore, the aim of this study was to determine the association between mode of delivery and the incidence of severe intraventricular hemorrhage (sIVH) in very to extremely preterm infants born before 32 weeks of gestation.

METHODS: This retrospective cohort study was conducted at the University Hospital Zurich, Switzerland, using integrated obstetric and neonatal databases. Live births born between 23 + 0 and 31 + 6 weeks from 2015 to 2023 were included. Confounders were selected a priori based on a direct acyclic graph, and severe IVH incidence was compared between vaginal and cesarean delivery using univariable and multivariable logistic regression models.

RESULTS: A total of 683 infants were eligible for analysis. The proportion of children born by cesarean section was 77.5%. The incidence of sIVH in preterm infants delivered by cesarean section was 4.7% compared to 3.9% in vaginal deliveries. The univariable logistic regression analysis demonstrated no significant association between cesarean section and sIVH (OR 1.32, 95% CI 0.53-3.28, p = 0.529).

CONCLUSION: In this cohort of very and extremely preterm infants, there was no significant association between the incidence of severe IVH and mode of delivery. These findings do not support cesarean sections as a preventive measure for sIVH and highlight the importance of optimizing pre-, peri-, and postnatal factors that impact haemodynamic stability.

PMID:41905948 | DOI:10.1080/14767058.2026.2650951

Environ Health Prev Med. 2026;31:24. doi: 10.1265/ehpm.25-00416.

ABSTRACT

BACKGROUND: New tobacco products, including heated tobacco products and electronic cigarettes, are rapidly increasing in popularity among younger populations worldwide, particularly in Japan. Thus, clarifying the effects of both active and passive smoking of new tobacco products during pregnancy is an urgent public health concern. We focused on nausea and vomiting in pregnancy (NVP) which is traditionally and epidemiologically considered an indicator of healthy pregnancy progression. In this study, we classified maternal and paternal smoking status focussing on new tobacco product use and investigated its association with the absence of NVP.

METHODS: This cross-sectional study used control data from a case-control study designed to explore modifiable factors for anorectal malformations. The questionnaire survey was conducted within seven Japanese regions between December 2019 and March 2023, enrolling a total of 1,522 postpartum women. The study included 1,450 postpartum women who delivered singleton babies and provided complete information. The main outcome was the absence of NVP. The exposure was the smoking status of mothers and their partners, classified into four categories: dual users (combustible cigarettes and new tobacco products), new tobacco product-only users, combustible cigarette-only users, and non-smokers (reference). Logistic regression analysis was performed to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the absence of NVP.

RESULTS: Based on maternal smoking status, the absence of NVP was reported in 27.1% of dual users, 25.0% of new tobacco product-only users, 18.0% of combustible cigarette-only users, and 15.2% of non-smokers. Maternal dual use was associated with an increased OR of the absence of NVP (adjusted OR = 2.07, 95% CI: 1.02-4.22). After restricting to non-smoking mothers, the adjusted OR for paternal combustible cigarette smoking was 2.62 (95% CI: 1.25-5.50).

CONCLUSION: Our main finding was the positive association between maternal dual use of new tobacco products and combustible cigarettes during pregnancy and the absence of NVP. This suggests that smoking cessation guidance during pregnancy, including new tobacco products, is particularly warranted.

TRIAL REGISTRATION: Not applicable.

PMID:41905935 | DOI:10.1265/ehpm.25-00416

J Matern Fetal Neonatal Med. 2026 Dec;39(1):2648184. doi: 10.1080/14767058.2026.2648184. Epub 2026 Mar 29.

ABSTRACT

BACKGROUND: Low birth weight (LBW) is one of the major causes of neonatal mortality and an important factor influencing the growth and development of newborns. This study aimed to investigate the prevalence of LBW and its related maternal and neonatal factors.

METHODS: This was a retrospective cross-sectional study. The research subjects were 89,214 pregnant women who gave birth at Maternity & Child Healthcare Hospital of Longgang District, Shenzhen City from 2015 to 2021. Factors associated with LBW encompassed demographic characteristics, antenatal and obstetric factors, and neonatal states. R software was used for statistical analyses, and multivariable logistic regression was performed to identify the significantly related factors of LBW.

RESULTS: The prevalence of LBW in this study was 3.88%. Education level (Junior college and below vs. College and above, OR: 1.18, 95%CI 1.09-1.29), parity (Nulliparous vs. Parous, OR: 1.37, 95%CI 1.20-1.56), pre-pregnancy BMI (Underweight vs. Normal, OR: 1.62, 95%CI 1.47-1.78), mode of delivery (Cesarean section vs. Vaginal delivery, OR: 1.70, 95%CI 1.56-1.86), congenital malformation (Yes vs. No, OR: 2.79, 95%CI 2.40-3.25), sex of neonate (Female vs. Male, OR: 1.70, 95%CI 1.56-1.85), Apgar 1 min score (<7 vs. ≥7, OR: 4.57, 95%CI 2.73-7.58), number of antenatal care visits (<8 vs. ≥8, OR: 1.97, 95%CI 1.80-2.15), gestational age (<37 weeks vs. ≥37 weeks, OR: 48.80, 95%CI 44.65-53.36), pregnancy complications (Yes vs. No, OR: 1.69, 95%CI 1.52-1.88) were identified as risk factors for LBW. Number of pregnancies (2 vs. 1, OR: 0.82, 95%CI 0.72-0.94; ≥3 vs. 1, OR: 0.75, 95%CI 0.64-0.87) was considered as a protective factor. Premature birth, pregnancy complications, and insufficient antenatal care visits had synergistic effects on LBW.

CONCLUSIONS: LBW was correlated with specific maternal and neonatal factors, and there were interactions between the influencing factors. Compared with a single intervention, comprehensively assessing pregnancy risks to develop personalized antenatal care may be more effective.

PMID:41905931 | DOI:10.1080/14767058.2026.2648184

Nihon Ronen Igakkai Zasshi. 2026;63(1):48-59. doi: 10.3143/geriatrics.63.48.

ABSTRACT

AIM: To develop a dementia and delirium nursing education program for nurses in acute care hospitals with the aim of enhancing their practical competencies. The program, based on person-centered care, included a 60-minute workshop and regular case conferences held two to three times per week. This study aimed to evaluate the effects of the program by examining changes in nurses’ knowledge and self-efficacy regarding dementia and delirium nursing, as well as patient outcomes, including falls, self-removal of tubes or catheters, and the use of physical restraints.

METHODS: The program was conducted over a three-month period from November 2023 to January 2024 in a gastrointestinal surgical ward of an acute care hospital with a 7:1 nurse-to-patient ratio. Twenty-five nurses participated in this study. Questionnaires assessing knowledge and self-efficacy were administered before and after intervention. Patient outcome data, including falls, self-removal of tubes or catheters, and use of physical restraints, were collected from the medical records and compared before and after the intervention.

RESULTS: Nurses’ knowledge and self-efficacy significantly improved after the intervention. Although the total number of patients with dementia and delirium increased significantly, the incidents of self-removal of tubes or catheters and the use of physical restraints significantly decreased. Falls decreased from two to zero, although this difference was not statistically significant.

CONCLUSIONS: The program was effective in improving nurses’ knowledge and self-efficacy in dementia and delirium care and in reducing self-removal of tubes or catheters, as well as reducing the use of physical restraints.

PMID:41905923 | DOI:10.3143/geriatrics.63.48

Adv Clin Exp Med. 2026 Mar 30. doi: 10.17219/acem/216746. Online ahead of print.

ABSTRACT

BACKGROUND: Crohn’s disease (CD) is a non-specific inflammatory bowel disorder for which no definitive cure is available. The primary management strategy is pharmacological treatment aimed at alleviating symptoms. However, many patients ultimately require surgical intervention to manage complications arising from the disease.

OBJECTIVES: The aim of this study was to investigate disease-related factors that may increase the risk of early postoperative complications in patients with CD.

MATERIAL AND METHODS: A meta-analysis was conducted based on studies examining early surgical and medical complications following abdominal surgery for CD. The analyzed risk factors included disease duration prior to surgery, history of previous surgeries, presence of concurrent perianal disease, intra-abdominal abscess during surgery, and Montreal classification subtypes A1-3, L1-4, and B1-3. A systematic review was performed using 4 major databases: PubMed, Cochrane Library, Academic Search Ultimate (EBSCO), and Google Scholar. Outcomes were assessed using the odds ratio (OR) and response ratio (R), together with 95% confidence intervals (95% CIs). Egger’s test was used to evaluate publication bias. Heterogeneity was assessed using the I2 statistic, with I2 > 50% indicating significant variability.

RESULTS: A total of 51 articles met the inclusion criteria. The analysis identified several significant risk-increasing factors: history of previous surgeries (OR = 1.39; 95% CI: 1.23-1.57), Montreal classification group B3 (OR = 1.26; 95% CI: 1.11-1.42), disease duration before surgery (R = 1.10; 95% CI: 1.02-1.18), and group L2 (OR = 1.38; 95% CI: 1.11-1.72). Conversely, factors associated with a reduced risk of postoperative complications included group L1 (OR = 0.81; 95% CI: 0.71-0.92) and group B2 (OR = 0.81; 95% CI: 0.71-0.91).

CONCLUSION: This meta-analysis aggregated data from a broad spectrum of patients and treatment settings across multiple institutions worldwide. Although some risk of bias and heterogeneity was observed, the findings nevertheless highlight the importance of considering disease subtype and progression when assessing the likelihood of postoperative complications in patients with CD. This knowledge may be valuable for optimizing treatment strategies.

PMID:41904989 | DOI:10.17219/acem/216746

Otolaryngol Head Neck Surg. 2026 Mar 29. doi: 10.1002/ohn.70218. Online ahead of print.

ABSTRACT

OBJECTIVE: There is increasing use of intraoperative parathyroid hormone (ioPTH) in minimally invasive parathyroidectomy (MIP). While ioPTH has improved cure rate, there is little evidence to suggest effectiveness in primary hyperparathyroidism (PHP) with concordant preoperative localisation. This study aims to determine if ioPTH improves cure rates in such cases.

DATA SOURCES: A search of PubMed, Embase, and Cochrane databases identified studies that compared MIP with and without ioPTH, in patients with concordant preoperative imaging of ultrasonography and technetium-99m sestamibi (MIBI) scans. Inclusion criteria were comparative studies between years 2000 and 2023.

REVIEW METHODS: Analysis was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. Primary outcome was the overall cure rate. Secondary outcomes analyzed include operative duration, and conversion to neck exploration.

RESULTS: Six studies involving 884 patients were eligible for inclusion. The overall cure rate was 97.3%, higher in those that had ioPTH than without, but this was not statistically significant (98.3% vs 96.0%, P = .18). Operative duration was reported in 2 studies, showing significantly longer duration in the ioPTH group. Overall conversion rate to bilateral neck exploration was 6.64% in the ioPTH group, with a success rate of 4.80%.

CONCLUSION: Use of ioPTH in MIP with concordant localization did not result in statistically significant higher cure rates. Operative time is potentially longer with use of ioPTH. It is difficult to justify the routine use of ioPTH for such cases based on cure rates alone; considerations should also be given to center-specific case volume, surgical experience, and overall cost outcomes.

PMID:41904980 | DOI:10.1002/ohn.70218

J Int Med Res. 2026 Mar;54(3):3000605261433691. doi: 10.1177/03000605261433691. Epub 2026 Mar 29.

ABSTRACT

BackgroundIntracerebral hemorrhage is associated with high mortality in intensive care settings. Current prognostic models have limitations, including poor interpretability and insufficient validation in critically ill populations. In this study, we developed an interpretable machine learning model to predict survival in intensive care unit patients with intracerebral hemorrhage.MethodsThis retrospective study used data from patients with intracerebral hemorrhage in the eICU Collaborative Research Database for model development and the Medical Information Mart for Intensive Care IV database for external validation. Clinical, laboratory, and physiological parameters within 24 h of intensive care unit admission were extracted. Six machine learning survival algorithms, including the Random Survival Forest, were implemented. Model performance was assessed using the time-dependent area under the curve, concordance index, and Brier score. Model interpretability was achieved through the SHapley Additive exPlanations framework.ResultsThe cohort comprised 5797 patients from eICU and 1423 patients from Medical Information Mart for Intensive Care IV. Random Survival Forest demonstrated superior performance, with a time-dependent area under the curve of 0.88 in internal validation and 0.82 on day 1 of external validation. SHapley Additive exPlanations analysis identified Glasgow Coma Scale score, Acute Physiology Score, age, creatinine, temperature, and systolic blood pressure as key predictors. Critical risk thresholds were Glasgow Coma Scale score <9.8, Acute Physiology Score >52.7, and age >62.9 years.ConclusionWe developed a machine learning survival prediction model that demonstrated robust performance and clinical utility. The web-based tool may enhance intensive care unit risk stratification and clinical decision-making.

PMID:41904977 | DOI:10.1177/03000605261433691