Category: Statistics

Colorectal Dis. 2026 Feb;28(2):e70390. doi: 10.1111/codi.70390.

ABSTRACT

BACKGROUND: Colorectal mucinous adenocarcinoma (MAC) is challenging due to its unique pathophysiology and increasing incidence in younger populations. Treatment guidelines for early-onset MAC remain unclear, with clinical decisions often based on extrapolated data from classical adenocarcinoma. We aimed to assess the association between the extent of surgical resection and systemic therapy in patients with early-onset colonic MAC and survival.

METHODS: Retrospective cohort analysis of patients aged 20-50 with stage II-III colonic MAC using the SEER database (2000-2020). We evaluated overall survival (OS) and cancer-specific survival (CSS) based on surgical resection (segmental vs. extended) and systemic therapy, using Kaplan-Meier and Cox regression analyses.

RESULTS: The cohort included 2553 patients (58.5% male; mean age 42.7 years). Segmental resection was performed in 27.6%. Extended resection was more commonly performed in right-sided and stage III disease. Systemic therapy was administered to 62.1%, predominantly for stage III disease with unfavourable tumour features. Systemic therapy was associated with improved restricted mean 5-year CSS (51.7 vs. 47.8 months, p = 0.041) and OS (51.1 vs. 45.9 months, p = 0.008) in stage III, but not stage II, disease. Extended resection was associated with a modest survival benefit for CSS (56.5 vs. 54.3 months, p = 0.027) and OS (56.0 vs. 53.3 months, p = 0.007) in stage II, but not stage III, disease.

CONCLUSION: Systemic therapy was associated with a significant survival benefit in patients with stage III early-onset MAC, supporting its role as a cornerstone of treatment despite the histology’s presumed chemoresistance.

PMID:41689391 | DOI:10.1111/codi.70390

Colorectal Dis. 2026 Feb;28(2):e70401. doi: 10.1111/codi.70401.

ABSTRACT

BACKGROUND: The incidence of surgical site infections (SSIs) has been reported to be significantly higher in colorectal surgeries compared to other surgical procedures. Wound protectors have been developed to help reduce the incidence of SSIs by creating a barrier between the incisional wound and the contaminated surgical field, but their efficacy remains uncertain.

OBJECTIVE: To assess whether the use of wound protectors reduces the incidence of SSIs in patients undergoing open colorectal surgery.

DATA SOURCES: A comprehensive literature review was conducted using PubMed, Embase, Web of Science and Cochrane databases from inception to January 2025.

STUDY SELECTION: Randomised controlled trials (RCTs) assessing the efficacy of wound protectors for reducing the incidence of SSIs in patients undergoing open colorectal surgery.

INTERVENTIONS: The intervention consisted of wound protectors (e.g., Alexis O-ring wound retractors, plastic ring drape).

MAIN OUTCOMES MEASURES: The main outcome was SSI. We pooled risk ratios (RRs) with a 95% confidence interval (CI) using a random effects model. Statistical analysis was performed using R software (version 4.4.2).

RESULTS: We included 6 RCTs comprising 666 patients, of whom 327 (49 %) were randomised to the wound protectors’ group. The mean follow-up duration was 30 days post-operatively. The incidence of SSIs was significantly lower in the intervention group (RR 0.44; 95% CI 0.22-0.88; p = 0.021). Subgroup analysis of four RCTs evaluating Alexis-O ring wound retractors showed a significantly lower incidence of SSIs in the experimental group (RR 0.21; 95% CI 0.09-0.48; p < 0.001).

CONCLUSION: Wound protectors were associated with a significantly lower incidence of SSIs in patients undergoing open colorectal surgery.

PMID:41689388 | DOI:10.1111/codi.70401

Neurol Res. 2026 Feb 14:1-16. doi: 10.1080/01616412.2026.2628609. Online ahead of print.

ABSTRACT

OBJECTIVES: To compare clinical sensitization phenotype (CSP) and neuropathic-like pain features (NLPF) in patients with cervicogenic headache (CGH) and asymptomatic controls, and, within CGH group, to examine their associations with psychological distress, sleep quality, and health-related quality of life (HRQoL).

METHODS: In this case-control study, 39 patients with CGH and 36 age- and sex-matched healthy controls were evaluated between July and October 2025. CSP and NLPF were assessed using Central Sensitization Inventory (CSI) and pain-DETECT questionnaire. Headache impact, neck disability, psychological distress, sleep quality, and HRQoL were evaluated using Headache Impact Test (HIT-6), Neck Disability Index (NDI), Hospital Anxiety and Depression Scale (HADS), Jenkins Sleep Scale (JSS), and SF-36.

RESULTS: CGH patients showed significantly higher CSI, HIT-6, NDI, HADS, and JSS scores than controls (all p < 0.001), indicating a pronounced CSP, greater disability, and increased psychosocial burden. Although pain-DETECT scores were higher in CGH group, between-group difference did not reach statistical significance (p = 0.074); however, a moderate effect size suggested potential clinical relevance. Within CGH group, CSI scores correlated strongly with HADS (r = 0.68), NDI (r = 0.64), and JSS (r = 0.59). Regression analyses showed that CSI scores were independently associated with pain-DETECT scores (B = 0.275, p = 0.008), while pain-DETECT (B = 0.986, p = 0.008) and JSS scores (B = 0.910, p = 0.037) were independently associated with CSI levels.

DISCUSSION: CSP and NLPF represent interrelated clinical pain phenotypes in CGH and are associated with greater disability, psychological distress, and sleep disturbance.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT07292181, Registration date: 3 July 2025.

PMID:41689387 | DOI:10.1080/01616412.2026.2628609

Cutan Ocul Toxicol. 2026 Feb 14:1-7. doi: 10.1080/15569527.2026.2630770. Online ahead of print.

ABSTRACT

INTRODUCTION: Human beta-defensin 2 (hBD-2) is an antimicrobial peptide upregulated by IL-17A and TNF-α, important in skin immunity and inflammation. While hBD-2 is elevated in psoriatic skin, its systemic expression and clinical significance remain unclear, particularly in psoriatic arthritis (PsA).

OBJECTIVES: To compare serum hBD-2 levels among patients with psoriasis vulgaris, PsA, and healthy controls, and to evaluate its correlation with disease severity and inflammatory markers.

METHODS: This case-control study included 66 patients with psoriasis, 30 with PsA, and 67 healthy controls. Serum hBD-2, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were measured. Psoriasis severity was assessed using the Psoriasis Area and Severity Index (PASI). A p value < 0.05 was considered statistically significant.

RESULTS: Median serum hBD-2 levels were significantly higher in psoriasis and PsA groups compared to controls (p < 0.001), but no significant difference was found between the two patient groups (p: 0.223). In the psoriasis group, hBD-2 showed no significant correlation with PASI (r: 0.218, p: 0.095), CRP (r: 0.158, p: 0.277), or ESR (r: 0.129, p: 0.369). CRP and ESR were significantly higher in the PsA group than in other groups (p < 0.001 and p: 0.002, respectively).

CONCLUSIONS: Although serum hBD-2 is elevated in psoriasis and PsA, it does not correlate with clinical or laboratory disease activity in psoriasis. These findings suggest that hBD-2 may reflect local cutaneous immune activation rather than systemic inflammation.

PMID:41689371 | DOI:10.1080/15569527.2026.2630770

J Anim Breed Genet. 2026 Feb 14. doi: 10.1111/jbg.70041. Online ahead of print.

ABSTRACT

The primary objective of this study was to estimate the variance and covariance components, genetic parameters, and genetic trends for key reproductive traits in Murciano-Granadina (MG) dairy goats reared under Iranian breeding conditions. Data were collected over 6 years (2016-2021) from a commercial dairy goat farm located in the Chahshahi region of Kerman Province, southern Iran. The analysed reproductive traits included age at first service (AFS), age at first kidding (AFK), kidding interval (KI), gestation length (GL), service period (SP) and dry period (DP). The dataset comprised 7573 animals with detailed pedigree information involving 337 sires and 3772 dams. The flock was reared under standardised nutritional and management conditions within an intensive breeding system, ensuring optimal conditions for reliable genetic parameter estimation. Variance component and genetic parameters were estimated by Bayesian inference fitting a univariate animal model using the GIBBS1F90 program. Direct heritability estimates ( $h_a^2$ ) ranged from low to moderate, with GL showing the highest $h_a^2$ (0.23 ± 0.03), followed by DP (0.12 ± 0.05), AFK and AFS (both 0.12 ± 0.03). KI had a low $h_a^2$ of 0.10 ± 0.02, while SP showed the lowest estimate (0.007 ± 0.001), suggesting stronger environmental and management influences on this trait. Repeatability was moderate for GL (0.45 ± 0.06) and DP (0.19 ± 0.04), but low for SP (0.04 ± 0.01), reflecting variable trait consistency across parities. Genetic and phenotypic trend analyses revealed minimal, statistically non-significant (p > 0.05) fluctuations in all reproductive traits. The study demonstrates that reproductive traits in Murciano-Granadina goats under Iranian breeding conditions exhibit low to moderate $h_a^2$ , yet maintain sufficient additive genetic variance to allow for potential genetic improvement through selection.

PMID:41689355 | DOI:10.1111/jbg.70041

Acta Paediatr. 2026 Feb 13. doi: 10.1111/apa.70456. Online ahead of print.

ABSTRACT

AIM: Tuberculosis (TB) among refugee minors in low-incidence countries remains underexplored. We estimated the incidence of TB disease among refugee minors compared to Danish-born minors.

METHODS: This nationwide prospective historical cohort study included 31 172 refugee minors (< 18 years) granted residency in Denmark from 1993 to 2015. Each was matched 1:6 with a Danish-born control on age and sex. Follow-up extended from the date of residency until the earliest of: TB diagnosis, the age of 21 years, or study-end (31.12.2015). Data were obtained from Statistics Denmark and the International Reference Laboratory of Mycobacteriology. We conducted descriptive analyses and estimated incidence rates (IRs) using Poisson regression.

RESULTS: Refugee minors had a 48 times higher TB IR compared to their Danish-born peers. Notably, refugee minors from sub-Saharan Africa had an IR of 203 per 100 000 person-years. For both refugee minors and their Danish-born peers, pulmonary TB was the most common form, but still more than a third had extrapulmonary manifestations. Among refugee minors, most TB cases were diagnosed more than 2 years after arrival.

CONCLUSION: Our findings underscore the need for national policies and clinical guidelines for TB screening of all refugee minors upon arrival to reduce morbidity and advance TB elimination efforts.

PMID:41689350 | DOI:10.1111/apa.70456

Nurs Health Sci. 2026 Mar;28(1):e70310. doi: 10.1111/nhs.70310.

ABSTRACT

Clinical education plays a crucial role in nursing students’ learning process, where they apply theoretical knowledge and develop their professional identities. However, experiences of incivility encountered during this process can negatively impact students’ psychological well-being, academic performance, and professional motivation. This study explored incivility among Turkish nursing students and examined the potential consequences. A descriptive qualitative study design was used. This descriptive qualitative study was conducted between 11.03.2025 and 30.03.2025, involving 19 nursing students from the nursing program at a state university in Turkey. Data were collected through face-to-face interviews, and thematic analysis was employed to analyze the data. The data analysis yielded four primary themes and five subthemes: (I) Types of Incivility, (II) Effects of Incivility, (III) Coping Strategies, and (IV) Solutions and Suggestions. The experience of uncivil behavior during clinical practice significantly affected students’ academic performance and professional career development. Beyond documenting experiences of incivility, the findings demonstrate how repeated low-intensity uncivil behaviors cumulatively undermine nursing students’ professional identity development, learning engagement, and willingness to provide holistic patient care.

PMID:41689345 | DOI:10.1111/nhs.70310

J Clin Ultrasound. 2026 Feb 13. doi: 10.1002/jcu.70198. Online ahead of print.

ABSTRACT

BACKGROUND: Hepatocellular carcinoma (HCC) at the early stage frequently evades detection. Aberrant expression of miR-1233 has been reported in various malignancies, yet its level and potential clinical value in HCC remain unknown.

OBJECTIVE: This study evaluated miR-1233 expression and potential diagnostic performance in HCC patients.

MATERIALS AND METHODS: This prospective study enrolled 100 individuals with benign hepatic tumors and 120 cases with HCC. They all underwent dual-source CT imaging and were confirmed pathologically. The miR-1233 level was quantified by qRT-PCR. The multivariate logistic regression analysis was employed to identify the underlying risk factors of HCC. Pearson correlation analysis was carried out to assess the association of miR-1233 with alpha fetoprotein (AFP) or des-gamma-carboxy prothrombin (DCP). After statistical analysis in SPSS, ROC curves were generated for significantly different miR-1233, dual-CT parameters, and the combination to compare their diagnostic performance in distinguishing HCC patients.

RESULTS: Serum miR-1233 was up-regulated in HCC patients. The expression pattern of miR-1233 showed positive correlation to AFP and DCP indicators. In ROC curve of miR-1233, AUC reached 0.821, with a sensitivity of 73.33% and specificity of 76.67%. Combined with the differential dual-CT parameters, the AUC reached 0.944, with both sensitivity and specificity exceeding 90%.

CONCLUSION: Serum miR-1233 was significantly up-regulated in HCC patients. The diagnostic efficacy of miR-1233 combined with dual-source CT was superior to that of the single one in recognizing HCC individuals.

PMID:41689344 | DOI:10.1002/jcu.70198

J Coll Physicians Surg Pak. 2026 Feb;36(2):277-279. doi: 10.29271/jcpsp.2026.02.277.

ABSTRACT

Suicide among medical students is a serious issue. To understand the pattern and risk factors associated with medical students’ deaths by suicide, a Google search was conducted for news reports in the last 10 years (2013-2023) using the keywords: medical students, suicide, death by suicide, medical student suicide, and Pakistan. Over this decade, 12 medical student suicides were reported, of which two were excluded. Among the remaining 10 suicide cases, eight were males, and two were females (male-to-female ratio was 4:1). Most of the victims (n = 7, 70%) were in their clinical years of study. The most frequently used method of suicide was hanging (n = 3, 30%), followed by firearms (n = 2, 20%), jumping in front of trains (n = 2, 20%), and drug overdose (n = 1,10%). Academic failure was reported as the most common precipitating factor. Suicide among medical students is an urgent issue that requires a multi-layered preventive strategy, including improved mental health support to medical students. Key Words: Medical students, Pakistan, Suicide, Mental health.

PMID:41689334 | DOI:10.29271/jcpsp.2026.02.277

J Coll Physicians Surg Pak. 2026 Feb;36(2):271-273. doi: 10.29271/jcpsp.2026.02.271.

ABSTRACT

This study aimed to investigate the potential educational applications of teacher-made mind maps for students. This quasi-experimental study employed a single-group pre-test, post-test design and was conducted from September 2022 to April 2024. Fifty-five medical students studying symptomatology, who were willing to participate, were recruited. The effectiveness of teacher-made mind maps was assessed based on changes in two test scores, and students’ perceptions were evaluated using questionnaires. The difference between pre-test and post-test scores in two tests was statistically significant (p <0.001), and the majority of students provided favourable feedback. Teacher-made mind maps were effective in improving students’ academic performance, were well received by students, and are recommended for use in student teaching. Key Words: Mind map, Perception, Motivation, Academic performance, Medical education.

PMID:41689332 | DOI:10.29271/jcpsp.2026.02.271