Tag: statistics

Orv Hetil. 2026 Aug 2;167(31):1238-1247. doi: 10.1556/650.2026.33612. Print 2026 Aug 2.

ABSTRACT

INTRODUCTION: According to epidemiological data from Hungary, cardiovascular diseases cause the greatest loss of health among the population and are responsible for a significant proportion of premature deaths. This reinforces the health policy position that cardiovascular prevention, including improving medication adherence, must be given top priority in patient care. Long-term survival in patients who have experienced acute coronary syndrome depends heavily on medication adherence, particularly regarding statins and anticoagulants; however, domestic surveys indicate deficiencies in the use of preventive medications.

OBJECTIVE: The aim of our study was to compare the attitudes and beliefs regarding antiplatelet agents and cholesterol-lowering drugs among patients in the secondary prevention group who underwent percutaneous coronary intervention and those in the primary prevention control group, using the Beliefs about Medicines Questionnaire (BMQ).

METHODS: A cross-sectional, questionnaire-based study included 162 secondary prevention patients and 136 primary prevention patients who had undergone percutaneous coronary intervention. Medication attitudes were measured using the specific and general dimensions of the BMQ, and SPSS 27.0 was used for statistical analysis.

RESULTS: Among patients in the secondary prevention group, both drug groups were characterized by lower levels of concern and more accepting attitudes, whereas in the primary prevention group, sceptical (p<0.05) and ambivalent attitudes were more common (p<0.001). Based on the analysis of respondents by attitude group and the examination of the BMQ’s general subscales, percutaneous coronary intervention significantly influenced beliefs regarding medications. This change was clinically significant in terms of treatment adherence (p<0.001) Discussion and conclusion: Patients who have undergone percutaneous coronary intervention have more favourable attitudes toward medication, which highlights the role of targeted education and psychoeducation in improving adherence in the non-intervention population. However, adherence in the secondary prevention group cannot be considered optimal either, therefore further targeted education is warranted in this patient group as well. Orv Hetil. 2026; 167(31): 1238-1247.

PMID:42543013 | DOI:10.1556/650.2026.33612

Pain Ther. 2026 Aug 2. doi: 10.1007/s40122-026-00876-1. Online ahead of print.

ABSTRACT

INTRODUCTION: Moderate-to-severe postoperative pain is common after cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). Evidence that liposomal bupivacaine provides clinically important advantages over conventional local anesthetics is inconsistent, and evidence in CRS + HIPEC remains limited. This trial evaluated the incremental efficacy and safety of liposomal bupivacaine incisional infiltration added to patient-controlled intravenous analgesia (PCIA) compared with saline infiltration plus PCIA.

METHODS: In this single-center, randomized, participant- and assessor-blinded, placebo-controlled trial, adults aged 18-65 years scheduled for elective CRS + HIPEC were assigned 1:1 to standardized PCIA plus liposomal bupivacaine incisional infiltration (PCIA-LB) or PCIA plus normal saline infiltration (PCIA-NS). The primary endpoint was the incidence of moderate-to-severe movement-evoked incisional pain (numeric rating scale > = 4) within 72 h. The prespecified primary efficacy analysis used the per-protocol set (PPS), with a conservative intention-to-treat (ITT) sensitivity analysis. PCIA followed an institutional standard operating procedure. Monitoring was continuous in the intensive care unit (ICU); after transfer to the ward, pulse oximetry was continued through postoperative day 3, with intermittent electrocardiography and noninvasive blood pressure monitoring.

RESULTS: The PPS included 94 patients (PCIA-NS, n = 48; PCIA-LB, n = 46). Moderate-to-severe movement-evoked pain within 72 h was less frequent with PCIA-LB than with PCIA-NS (19.6% versus 70.8%, P < 0.001). The conservative ITT sensitivity analysis supported the same conclusion (26.0% versus 68.0%, P < 0.001). PCIA-LB also produced a modest reduction in cumulative 72-h study-recorded oral morphine milligram equivalents (556.8 [473.4, 600.0] versus 600.0 [557.4, 630.0] mg, P = 0.002) and reduced rescue analgesia (30.4% versus 54.2%, P = 0.020). QoR-15 scores did not differ significantly. Overall analgesia-related adverse events occurred in 23.9% and 10.4% of the PCIA-LB and PCIA-NS groups, respectively (P = 0.143). No participant required naloxone, emergency airway intervention, or ventilatory support for a clinically recognized opioid-related respiratory event, and no local anesthetic systemic toxicity, incisional infection, or fat liquefaction was observed.

CONCLUSIONS: Compared with saline infiltration, liposomal bupivacaine incisional infiltration reduced early movement-evoked incisional pain and rescue analgesia and produced a statistically significant but quantitatively modest reduction in 72-h opioid consumption captured by the study records after CRS + HIPEC. It did not improve QoR-15. These findings do not establish superiority over plain bupivacaine, ropivacaine, or catheter-based regional techniques, and the study was not powered to establish safety.

TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR2500100826. Registered at 00:00 on 15 April 2025, before enrollment of the first participant later the same day.

PMID:42542999 | DOI:10.1007/s40122-026-00876-1

J Immigr Minor Health. 2026 Aug 2. doi: 10.1007/s10903-026-01976-y. Online ahead of print.

ABSTRACT

Acculturative stress, arising from cultural and psychological changes following intercultural contact, may increase vulnerability to maladaptive coping behaviors, including emotional eating. Evidence suggests that the association between acculturative stress and disordered eating differs by sex; however, Arab migrant populations remain underrepresented in this field. This study aimed to examine sex-stratified, migration-related predictors of emotional eating among Arab migrants living in Türkiye. This cross-sectional research was conducted between June 2022 and March 2024 and included 528 adults who migrated to Türkiye from Arab countries. Sociodemographic and migration-related characteristics were collected. Acculturative stress was assessed using the Acculturative Stress-Social, Attitudinal, Familial, and Environmental-Revised Short Form (SAFE-Short), and emotional eating was evaluated with Emotional Eating Scale (EES). Body mass index (BMI) was calculated from self-reported weight and height. Sex-stratified regression analyses were performed. BMI was positively associated with all EES subscales in both female and male participants. However, among male participants, the overall regression models for the Anger and Anxiety subdimensions were not statistically significant. Also, no sociodemographic or migration-related variables were associated with emotional eating among male participants. In females, higher age was associated with lower depression-related emotional eating, while single marital status was associated with higher anger-related emotional eating. Employment was associated with lower anger- and anxiety-related emotional eating. Migration due to personal safety concerns, living with individuals from different countries, and higher acculturative stress were associated with higher emotional eating scores in females. These findings may indicate that in social contexts where direct emotional expression is less acceptable for females, emotions are more likely to be regulated through eating-related behaviors.

PMID:42542994 | DOI:10.1007/s10903-026-01976-y

Int Orthop. 2026 Aug 2. doi: 10.1007/s00264-026-06975-0. Online ahead of print.

ABSTRACT

BACKGROUND: Robotic-assisted total knee arthroplasty (TKA) requires pin trackers fixed to the femur and tibia. The influence of femoral pin tracker placement (intra-incisional or extra-incisional) on fracture risk remains controversial, with limited clinical and biomechanical evidence.

METHODS: A retrospective cohort study included 688 patients who underwent robotic-assisted TKA (505 in intra-incisional group, 183 in extra-incisional group). The incidence of femoral periprosthetic fractures was compared between the two groups within three months postoperatively. Finite-element analysis (FEA) simulated femoral biomechanical behaviour under compression, torsion, and bending loads in three models: control, intra-incisional, and extra-incisional groups.

RESULTS: One fracture occurred in the extra-incisional group (1/183, 0.55%), whereas none occurred in the intra-incisional group (0/505), the difference was not statistically significant (Fisher’s exact test, P = 0.266). In the FEA, ultimate loads and fracture patterns were similar among the control, intra-incisional, and extra-incisional models under all three loading conditions, and no simulated fracture initiated at nail channels.

CONCLUSION: Perioperative femoral fracture involving tracker nail channels was rare in this cohort, and its incidence did not differ significantly between intra-incisional and extra-incisional placement. When a standardized pin-placement protocol is followed, either location appears to have a limited effect on short-term fracture risk.

PMID:42542985 | DOI:10.1007/s00264-026-06975-0

Nurs Inq. 2026 Oct;33(4):e70153. doi: 10.1111/nin.70153.

ABSTRACT

Workplace violence against nurses and midwives intensified during the COVID-19 pandemic, exposing and amplifying longstanding structural marginalization in health systems across Latin America. This study analyzes how different forms of violence were experienced and described by nursing professionals during this period. A secondary qualitative analysis was conducted using text-based responses from an international online survey developed by the Global Consortium, which included 3860 nurses and midwives from 18 Latin American and Caribbean countries. Data were examined through Descending Hierarchical Classification using IRaMuTeQ, followed by reflective thematic analysis for interpretive integration. The analysis identified five lexical classes, reorganized into three interconnected themes: direct violence related to care delivery and system collapse; stigma, fear, and disruption of social belonging; and ethical-political suffering associated with structural blame, moral suffering, and moral injury. Despite contextual differences across countries, narratives revealed recurring patterns of emotional overload, professional delegitimization, and exposure to multiple forms of violence. These findings position violence against nursing professionals during the pandemic as a structural and multifaceted phenomenon rooted in historical inequities and institutional fragility, underscoring the need for sustained policies that strengthen workforce protection, ethical accountability, and institutional support in both routine healthcare settings and future public health emergencies.

PMID:42542957 | DOI:10.1111/nin.70153

Nutr Cancer. 2026 Aug 2:1-13. doi: 10.1080/01635581.2026.2710446. Online ahead of print.

ABSTRACT

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative treatment for acute leukemia; however, the first year after transplantation is associated with an increased risk of morbidity and mortality. This study aimed to evaluate changes in nutritional intake and body composition during the first 100 days following allo-HSCT and to examine their associations with one-year all-cause mortality. In this single-center prospective study, 152 adults scheduled to undergo allo-HSCT were assessed at baseline and on days +30 and +100 after transplantation. Assessments included anthropometric and body-composition measurements, dietary intake evaluation, and nutritional risk screening using the Nutritional Risk Screening 2002 (NRS-2002) tool. The prevalence of nutritional risk increased from 8.6% at baseline to 69.1% on day +30. In the primary analysis, a greater decline in fat-free mass (FFM) was associated with an increased risk of death within one year after transplantation (adjusted HR = 1.04 per 1-kg loss). However, this association was no longer observed in the landmark sensitivity analysis. During the first 100 days following allo-HSCT, nutritional status and body composition deteriorated markedly. A greater decline in FFM was associated with higher one-year mortality in the primary analysis; however, this association was attenuated and was no longer statistically significant in the landmark sensitivity analysis.

PMID:42542947 | DOI:10.1080/01635581.2026.2710446

J Eval Clin Pract. 2026 Aug;32(5):e70540. doi: 10.1111/jep.70540.

ABSTRACT

BACKGROUND: With the continuous advancement of technology, it is predicted that artificial intelligence technologies will be utilised more by academicians and students in nursing education. There are no studies examining the awareness and concerns of artificial intelligence and robot nurses.

OBJECTIVE: This study was conducted to determine the effect of the training provided to increase nursing students’ awareness of artificial intelligence and robot nurses on the anxiety of students towards artificial intelligence.

DESIGN: It is a pre-test post-test quasi-experimental type study in line with STROBE instructions.

PARTICIPANTS: The study was conducted with 282 nursing students between 15 December 2022 and 15 October 2023.

METHODS: Introductory Information Form, ‘Artificial Intelligence Knowledge Test (AIK)’, and ‘Artificial Intelligence Anxiety Scale (AIAS)’ were employed to collect the data of the study. The data obtained in the study were analysed through SPSS (Statistical Package for Social Sciences) for Windows 25.0 software.

RESULTS: The nursing students were female (68.8%), and 83.7% of them had heard of concepts of artificial intelligence and robot nurses. The mean knowledge score of the students before the training on artificial intelligence and robot nurses was 63.08 ± 9.96, the mean knowledge score after the training was 66.70 ± 9.85 and a significant difference was detected between the mean knowledge scores (p < 0.05). The mean score of the AIAS scale was 4586 ± 11.18 before the training, 4810 ± 11.59 after the training and a significant difference was detected between the mean scores (p < 0.05).

CONCLUSION: This study revealed that, as a result of the training provided for artificial intelligence and robot nurses, students’ knowledge levels and their anxiety towards artificial intelligence increased. The results may guide the inclusion of artificial intelligence in the curriculum of nursing education for artificial intelligence and robot nurses.

PMID:42542946 | DOI:10.1111/jep.70540

Clin Exp Dent Res. 2026 Aug;12(4):e70398. doi: 10.1002/cre2.70398.

ABSTRACT

OBJECTIVE: This cross-sectional survey aimed to assess oral health in patients with inflammatory bowel diseases (IBD) living in Austria.

METHODS: Data collection was conducted with an online questionnaire, including when possible validated tools, covering general medical history, socioeconomic factors, IBD-related parameters, and various oral health parameters, that is, tooth loss rate, prevalence of severe periodontitis, oral health-related quality of life (OHRQoL), and presence of oral lesions. The questionnaire was disseminated to the members of the Austrian Crohn’s Disease/Ulcerative Colitis Association.

RESULTS: The analysis included the responses of 327 patients (68% female; average age 46 years), 134 with ulcerative colitis (UC) or IBD unclassified, and 193 with Crohn’s disease (CD). Based on self-reported data, about 85% of the patients reported intake of an IBD-related medication and about two thirds of the responders reported some IBD activity in the past 12 months. Approximately 24% of the patients had < 20 remaining teeth, 34% had severe periodontitis, and 7% reported poor OHRQoL. IBD diagnosis did not affect the odds for having < 20 teeth or self-reported severe periodontitis, but patients with CD presented more frequently with poor OHRQoL. In addition, patients with CD received more frequently information from their physician on the possibility of oral lesions due to IBD; however, > 50% of all patients indicated not having any problems with oral lesions.

CONCLUSIONS: Oral health remains inadequately addressed in patients with IBD despite the significant need for dental care. Hence, treating physicians should motivate patients with IBD to inform their dentist about their diagnosis and to maintain regular dental checkups.

PMID:42542944 | DOI:10.1002/cre2.70398

J Psychoactive Drugs. 2026 Aug 2:1-9. doi: 10.1080/02791072.2026.2712399. Online ahead of print.

ABSTRACT

This paper aims to evaluate the perceived value of the drug prevention activities in Malaysia’s high-risk areas. The drug prevention activities involved are counseling, outreach, workshop, and program. A quantitative method is employed in this study to investigate the participants’ perception on the programs. A cross-sectional survey of 332 participants across seven selected high-risk regions in Peninsular Malaysia were selected for their proximity to international borders and high drug-related crime statistics. The results revealed compelling insights, showing that emotional and social values were strongly correlated with program effectiveness, while functional value showed only marginal influence. These findings challenge conventional policy approaches by demonstrating that community-based interventions fostering emotional support networks and social cohesion yield substantially greater impact than traditional information-driven or enforcement-focused strategies. The study also has theoretical contributions by validating the applicability of perceived value theory in substance abuse prevention contexts, while offering practical recommendations for policymakers to redesign interventions with greater emphasis on psychosocial support mechanisms. Limitations include the cross-sectional design and regional focus, suggesting opportunities for future longitudinal studies across broader geographical areas to assess program sustainability and cultural adaptability.

PMID:42542935 | DOI:10.1080/02791072.2026.2712399

Jt Dis Relat Surg. 2026 Jul 24;37(3):873-881. doi: 10.52312/jdrs.2026.2959. Epub 2026 Jul 24.

ABSTRACT

OBJECTIVES: This study aims to evaluate the midterm clinical outcomes of patients with complex clubfoot treated using the Ponseti method and to assess the sustainability of deformity correction over time.

PATIENTS AND METHODS: Between January 2016 and January 2021, a total of 38 feet in 26 patients with complex clubfoot treated using the modified Ponseti method were retrospectively analyzed. The patients were divided into two groups: those treated entirely in our institution (study center group) and those referred from external centers after unsuccessful initial treatment (external center group). Clinical severity was assessed using the Pirani score, and ankle dorsiflexion (DF) was measured during follow-up. Functional outcomes were evaluated using the Pirani-Based Score (PBS) and the Oxford Ankle Foot Questionnaire (OxAFQ). Relapse rates, additional procedures, and treatment success were analyzed. Independent predictors of outcomes were identified.

RESULTS: Of a total of 26 patients included in the study, 2 were male and 24 were female with a mean age of 6.78 ± 1.29 (range, 5 to 8) years. Of these patients, 14 (53.8%) had unilateral involvement, while 12 (46.2%) had bilateral deformity. The external clinic group presented at a significantly later age than the study center group (p < 0.001), while baseline deformity severity was comparable. Pirani scores and DF measurements improved significantly in both groups, with no intergroup differences during follow-up (p > 0.05). Functional outcomes showed a significant difference in PBS scores, which were higher in the external clinic group (p = 0.045), indicating worse functional performance, while the OxAFQ scores were similar between groups (p = 0.911). Relapse rates were higher in the own clinic group but did not reach statistical significance (p = 0.254). Multivariate analysis revealed that age was the only independent predictor of treatment success (odds ratio [OR] = 2.067, p = 0.019), while referral status was not an independent determinant.

CONCLUSION: The modified Ponseti method provides effective midterm correction in complex clubfoot regardless of referral status. Although referred patients present later and may demonstrate worse functional outcomes, referral source does not independently influence treatment success. Early recognition and appropriate application of modified Ponseti principles remain critical for optimal outcomes.

PMID:42542930 | DOI:10.52312/jdrs.2026.2959