Tag: statistics

Orthop Surg. 2026 Aug 7. doi: 10.1111/os.70403. Online ahead of print.

ABSTRACT

OBJECTIVE: We previously developed a novel internal tension-relieving augmentation suture, the Chinese knotting technique (CKT), which demonstrated better knee kinematic recovery and clinical outcomes when assisting posterior cruciate ligament (PCL) reconstruction. This study evaluated the biomechanical effect of the CKT in cadaveric PCL reconstruction and provided experimental evidence for its clinical application.

METHODS: Ten fresh-frozen adult knee joint specimens were randomly divided into the conventional reconstruction (CR; n = 5) and CKT (n = 5) groups. First, all native PCLs underwent cyclic fatigue testing with a standardized fixation method, and the relaxation length was recorded. The native PCL was then transected and reconstructed. After reconstruction, the same fixation method was applied for biomechanical testing to measure stiffness, elastic modulus, maximum load, and relaxation length.

RESULTS: No statistically significant differences were observed between the two groups in donor age (54.40 ± 5.94 years vs 56.60 ± 5.98 years), gender distribution (male: 80.00% vs. 60.00%), or specimen side (left: 60.00% vs. 40.00%) (p > 0.05). All specimens underwent successful reconstruction and testing with no instances of tissue damage or fixation abnormalities. The biomechanical testing revealed no statistically significant differences in stiffness (68.60 ± 8.62 N/mm vs. 65.40 ± 12.14 N/mm) or elastic modulus (147.60 ± 5.68 MPa vs. 142.60 ± 1.52 MPa) between the two groups (p > 0.05). However, the CKT group demonstrated a significantly higher maximum load (603.20 ± 77.44 N) compared with the CR group (442.20 ± 20.52 N) and a significantly lower relaxation length (1.50 ± 0.09 mm vs. 2.46 ± 0.02 mm) (p < 0.05).

CONCLUSION: The CKT preserved the basic mechanical properties of the graft in PCL reconstruction. This technique significantly increased the maximum load and reduced residual deformation after cyclic loading, thereby providing enhanced biomechanical protection for the graft. This approach may offer technical support for early postoperative rehabilitation and a reduced risk of graft failure.

PMID:42568106 | DOI:10.1111/os.70403

J Am Heart Assoc. 2026 Aug 7:e048794. doi: 10.1161/JAHA.126.048794. Online ahead of print.

ABSTRACT

BACKGROUND: Tracking mortality is essential to advance understanding of population health. Further evaluation of long-term stroke mortality trends and subtypes in the United States is needed to guide preventive public health and clinical interventions.

METHODS: This study used the National Vital Statistics System CDC Wide-ranging Online Data for Epidemiologic Research (WONDER) data for adults aged 25 years and older in the United States from 1970 to 2023. Outcomes included absolute number and age-adjusted mortality of total stroke, and its subtypes acute ischemic stroke and intracerebral hemorrhage. Data were analyzed overall and by sex and race.

RESULTS: From 1970 to 2023, overall age-adjusted stroke mortality decreased by 82% from 177 to 32 per 100 000. The age-adjusted mortality of acute ischemic stroke decreased by 81% from 135 to 26 per 100 000, and the age-adjusted mortality of intracerebral hemorrhage declined by 86% from 42 to 6 per 100 000. Sex and race trends were similar, though notably age-adjusted mortality of acute ischemic stroke and intracerebral hemorrhage among those identifying as Black remained highest throughout the time period. Joinpoint regression models identified the 1970s and early 2000s as significant periods of mortality decline.

CONCLUSIONS: Stroke mortality has significantly declined over the last half century, with decreases in both acute ischemic stroke and intracerebral hemorrhage corresponding to public health and clinical advancements, though disparities remain. Continued efforts in prevention and treatment strategies should be made to further this decline, with particular attention to those identifying as non-White race.

PMID:42568098 | DOI:10.1161/JAHA.126.048794

Crit Care. 2026 Aug 7;30(1):405. doi: 10.1186/s13054-026-06234-z.

ABSTRACT

BACKGROUND: ICU patients commonly require invasive mechanical ventilation. Although weaning from ventilation is crucial for patient outcomes, it is commonly not performed according to guideline recommendations. We investigated if a complex telemedicine intervention improves the weaning process and outcomes.

METHODS: This is a secondary analysis of the stepped-wedge cluster-randomized controlled Enhanced Recovery after Intensive Care (ERIC) trial, which was conducted among ten clusters of ICUs in the metropolitan area of Berlin, Germany. ERIC examined the impact of a complex telemedicine intervention, which included daily telemedicine rounding by an intensivist and ICU nurse, on the adherence to eight quality indicators of ICU care. We analyzed patients who received invasive mechanical ventilation for at least two consecutive days and at least one spontaneous breathing trial (SBT). We investigated the impact of the intervention on the weaning process and weaning outcomes using descriptive statistics and mixed-effects regressions.

RESULTS: Of 1,463 patients enrolled in the trial, 308 patients were analyzed (control condition: 55; intervention condition: 253). Patients in the intervention group received significantly more SBTs than patients in the control group (51% vs 27% of the patient days; p < 0.001). There was no difference between the groups with respect to the weaning classification (p = 0.21), weaning success rate (28% vs 36%; p = 0.32), and time from the first SBT to successful weaning (2 [IQR 1, 5] vs 4 [IQR 1, 13] days; p = 0.12). The median time of invasive mechanical ventilation of successfully weaned patients was significantly shorter in the intervention than in the control group (7 [IQR 4, 10] vs 9 [IQR 6, 20] days; p = 0.031). In our multivariable regressions, the intervention was not associated with weaning success (OR for weaning failure: 1.45 [95%-CI 0.71-2.95]; p = 0.302), but with a shorter time between the first SBT and successful weaning (β = 0.56 [0.32-0.98]; p = 0.042).

CONCLUSIONS: Although ICU telemedicine did not improve the weaning success rate, our findings indicate that it facilitates the exploitation of existing weaning potential by ensuring more frequent SBTs and thereby shortening ventilation duration of successfully weaned patients. The study is the first to highlight the potential of telemedicine to enhance ICU weaning practices.

REGISTRATION: www.

CLINICALTRIALS: gov (Identifier: NCT03671447; first submitted on August 22, 2018).

PMID:42568095 | DOI:10.1186/s13054-026-06234-z

Malar J. 2026 Jul 25;25(1):288. doi: 10.1186/s12936-026-06066-w.

ABSTRACT

BACKGROUND: Experimental huts are the gold standard for the semi-field evaluation of insecticide-treated nets (ITNs) but the design of the huts used varies markedly between sites. Structural differences may influence mosquito behaviour – and, consequently, the measured efficacy of ITNs. This raises concerns about the comparability, validity, and policy relevance of trial outcomes. We assessed the influence of four commonly used hut designs on entomological endpoints central to ITN evaluations.

METHODS: A 126-night comparative trial was conducted in Tanzania, using 18 experimental huts in two contiguous 9 × 9 Latin squares. Four hut types-East African, West African, Ifakara, and Rapley-were tested with PRONet Duo, Interceptor^® G2, MAGNet^®, and untreated nets. Sleepers and treatments were rotated throughout the trial. The primary outcome was 72-h mortality (M72); secondary outcomes were mosquito density, blood-feeding success, and exiting. Endpoint estimates for each hut type were compared using East African huts as the reference. Non-inferiority analysis of PRONet Duo in each hut type were compared with findings from a sister trial conducted exclusively in West African huts in West Africa.

RESULTS: A total of 22611 Anopheles gambiae s.l. (99.9% An. arabiensis) were collected. Rapley and Ifakara huts captured over six times more mosquitoes than East African huts (rate ratio [RR] = 6.50 and 6.22, respectively; both p < 0.0001), whereas West African huts caught 88% fewer mosquitoes (RR = 0.12, p < 0.0001). West African huts recorded the highest mortality (70%) and blood feeding (15%) whilst the other hut types recorded 40-46% mortality and 3-8% blood feeding. All hut designs and the West African sister trial detected the same direction of effect between PRONet Duo and Interceptor^® G2 and predicted non-inferiority of PRONet Duo, although smaller sample sizes limited statistical certainty in East African and West African huts in Tanzania.

CONCLUSIONS: Experimental hut design substantially affected key entomological outcomes, influencing both the magnitude of measured efficacy of ITNs and the statistical power of trials. Whilst relative product performance was broadly consistent across designs, absolute values varied widely, underscoring the need for greater standardisation of hut architecture in ITN evaluations. Harmonising experimental hut designs and reporting standards would strengthen cross-site comparability, improving the reliability of vector control product assessments, and enhancing the evidence base for global malaria control policy.

PMID:42568085 | DOI:10.1186/s12936-026-06066-w

BMC Oral Health. 2026 Aug 8;26(1):1384. doi: 10.1186/s12903-026-09486-x.

ABSTRACT

OBJECTIVES: Reliable sex estimation using dental metrics has important implications for clinical assessment and forensic identification, particularly in adolescents where skeletal indicators may be limited. This study aimed to validate the accuracy and clinical applicability of a digital odontometric model for sex estimation in an Egyptian adolescent population.

METHODS: A total of 150 dental casts from individuals aged 12-19 years were digitized using a high-resolution three-dimensional scanner. Mesiodistal and buccolingual dimensions of the permanent first molars, mesiodistal widths of the maxillary canines, and intercanine, interpremolar, and intermolar arch widths were obtained using Facad Ortho tracing software. Statistical comparisons between sexes were performed, and discriminant function analysis was applied to construct and validate a predictive model for sex estimation.

RESULTS: All measured parameters demonstrated significantly higher mean values in males compared with females (p < 0.05). The buccolingual and mesiodistal dimensions of the maxillary first molar exhibited the greatest sexual dimorphism (26.95% and 25.98%, respectively). The developed discriminant function model achieved a prediction accuracy of 97.8% for males and 100% for females.

CONCLUSIONS: Digital odontometric analysis provides a promising approach for assessing sexual dimorphism in adolescents, pending external validation. This promising model may serve as a reliable adjunct for clinical evaluation and forensic identification within population-specific contexts pending further multicenter validation.

CLINICAL RELEVANCE: Digital measurement of tooth and arch dimensions enables objective, standardized assessment of sex-related differences, supporting its integration into orthodontic diagnostics, treatment planning, and forensic casework where conventional skeletal indicators may be unavailable or inconclusive.

PMID:42568081 | DOI:10.1186/s12903-026-09486-x

BMC Oral Health. 2026 Aug 8;26(1):1383. doi: 10.1186/s12903-026-09411-2.

ABSTRACT

BACKGROUND: Conventional removable partial dentures (RPDs) involve a process that is often susceptible to errors and demands a significant investment of time. The introduction of computer-aided design and computer-aided manufacturing (CAD/CAM) technology and materials witnessed significant advancements in recent years to produce accurate removable partial dentures. This study evaluated the retention and wear of PolyEtherKetoneKetone (PEKK) compared to Cobalt-Chromium (CoCr) in digitally fabricated double crown removable partial dentures for lower Kennedy Class I cases.

METHODS: The study was performed on 3D digital models of mandibular Kennedy Class I with prepared premolars bilaterally. The double crown RPDs were designed and fabricated digitally to get 14 copies of RPDs. Two groups were defined (n = 7); the first group were milled from Co-Cr discs, and the other’s from PEKK blanks. Initial retention was measured using a universal testing machine. RPDs were then subjected to dynamic loading in a chewing simulator over 100,000 cycles followed by 540 manual insertion and removal cycles and were remounted on the testing machine to measure final retention simulating six months. Wear was assessed using Geomagic Control X software, where negative deviations highlighted areas of degradation. Data was collected and analyzed for statistical analysis. Two Sample t-test was used to compare between the two groups and Paired t test to study the changes within each group. The significance level was set at P ≤ 0.05.

RESULTS: PEKK group showed a statistically significantly higher final retentive values after 6 months (11.6 N) than Co-Cr (2 N). Moreover, results showed higher retention loss in Co-Cr group (16.9 N) compared to PEKK (3.7 N). Additionally, wear assessment of primary copings indicated a higher deviation in the Co-Cr group (-0.25 mm) compared to PEKK (-0.096 mm), with a notable correlation (0.651, P-value = 0.011) between retention loss and wear.

CONCLUSIONS: Within the limitation of this study, it could be concluded that PEKK provided digitally fabricated double crown RPDs with higher retention values and less wear than Co-Cr after simulation of 6 months of RPD use.

PMID:42568076 | DOI:10.1186/s12903-026-09411-2

BMC Psychiatry. 2026 Jul 24;26(1):610. doi: 10.1186/s12888-026-08412-3.

ABSTRACT

INTRODUCTION: Sexual dysfunction and distress are common among depressed patients and significantly affect their quality of life. This study aims to determine the prevalence of sexual dysfunction and distress and identify potential associated factors.

METHOD: This cross-sectional study was conducted at a tertiary care hospital in Riyadh, Saudi Arabia, with data collection from April to June, 2025. The study involved 258 participants with depression aged 18-65, recruited using a convenience sampling technique. The study tool consisted of a questionnaire we developed to assess sociodemographic and other factors and the validated Arabic versions of the Female Sexual Distress Scale-Revised (FSDS-R) to measure sexual distress and the Arizona Sexual Experiences Scale (ASEX) to evaluate sexual functioning.

RESULTS: The ASEX mean total score was 18.04 ± 6.4, with 45.74% of participants exhibiting sexual dysfunction. A statistically significant relation was found between sexual dysfunction and female sex (p < 0.001), lower monthly income (p = 0.004), history of chronic diseases (p = 0.022), taking medications for them (p = 0.016), and experiencing physical symptoms (p = 0.001). The FSDS-R mean total score was 20.62 ± 14.4, and 72.09% were deemed to be experiencing sexual distress. A statistically significant relation was found between experiencing sexual distress and marital status (p = 0.008), having other psychiatric disorders (p = 0.048), positive history of smoking cigarettes (p = 0.010) and its duration (p = 0.024), and positive history of chronic diseases (p = 0.018).

CONCLUSION: The study highlights the concerning figures of sexual dysfunction and distress among patients with depression and that numerous factors could be associated with them. These findings underscore the need for a multidisciplinary approach involving teams from psychiatry, gynecology, and urology. The findings also reflect the need to screen for high-risk groups, such as those with other psychiatric and chronic medical illnesses. Moreover, the findings highlight the need for prevention, early detection, and effective intervention for sexual dysfunction and distress to mitigate their negative consequences.

PMID:42568075 | DOI:10.1186/s12888-026-08412-3

Orphanet J Rare Dis. 2026 Aug 7;21(1):268. doi: 10.1186/s13023-026-04529-6.

NO ABSTRACT

PMID:42568074 | DOI:10.1186/s13023-026-04529-6

Am J Health Promot. 2026 Aug 7:8901171261468183. doi: 10.1177/08901171261468183. Online ahead of print.

ABSTRACT

PurposeTo determine whether the specificity of mandates in Wisconsin’s state comprehensive planning statute is associated with the inclusion and actionability of healthy eating and active living items in local comprehensive plans.DesignRetrospective, cross-sectional, multilevel policy content analysis.SettingWisconsin.Sample93 local comprehensive plans, stratified by urbanicity and regional planning commission area.MeasuresLocal comprehensive plans were scored using the Healthy Living and Active Design Scorecard for Comprehensive Plans. Wisconsin’s state comprehensive planning statute was evaluated for general or specific mandates for each item in the Scorecard.AnalysisDifference in weighted percentage of municipalities scoring for items not mandated, mandated with general language, and mandated with specific language; one-sided Welch difference of means tests.ResultsMandating an item with general language is associated with a 33.6 percentage point higher inclusion rate in local plans and mandating an item with specific language is associated with a 50.2 percentage point higher inclusion rate in local plans. All differences are statistically significant at the 0.05 confidence level.ConclusionHealthy eating and active living items that are mandated by state statute are more likely to be included in local comprehensive plans than items that are not mandated. Mandated items are also more likely to be included in local comprehensive plans in an actionable manner, which may make them more likely to be implemented.

PMID:42568066 | DOI:10.1177/08901171261468183

Scand J Prim Health Care. 2026 Dec;44(1):2712981. doi: 10.1080/02813432.2026.2712981. Epub 2026 Aug 7.

ABSTRACT

INTRODUCTION: The relationship between alcohol consumption and the incidence of myocardial infarction (MI), stroke and all-cause mortality exhibits significant regional variation.

OBJECTIVE: This prospective study aimed to investigate this association analyzing data from a cohort of Swedish men aged 45-50 years at baseline, evaluating subgroups over various time intervals, and compiling data on cardiovascular endpoints.

METHODS: The Coeur study, conducted between 1993 and 1995, included 973 middle-aged male employees out of a randomly selected sample of 1144 individuals from a Swedish automotive company. Participants were followed for 30 years using national health registers. The accumulated incidence of first-time stroke, first-time MI and all-cause mortality was calculated and adjusted for cardiovascular risk factors. Data analysis employed time-to-event methods (Kaplan-Meier’s estimates and hazard ratios) and measures of association (odds ratios and correlation analysis).

RESULTS: No statistically significant association was observed between alcohol consumption and stroke (p > 0.05). However, alcohol consumption was associated with lower odds of MI (OR = 0.57, 95% CI: 0.41-0.79) and a slight increase in survival time (HR = 0.997, 95% CI: 0.995-1.000). Alcohol consumers had a median survival advantage of 1.3 years compared to non-consumers. All beverage types showed a negative association with all-cause mortality (total alcohol: OR = 0.57; beer: OR = 0.68, 95% CI: 0.50-0.92; wine: OR = 0.55, 95% CI: 0.41-0.75). Conversely, beer consumption was linked to higher odds of MI (OR = 1.70, 95% CI: 1.05-2.75).

CONCLUSIONS: While alcohol consumption in middle-aged men after 30 years follow-up is associated with increased survival time, beer correlates with a higher likelihood of MI.

PMID:42568036 | DOI:10.1080/02813432.2026.2712981