Tag: statistics

Climacteric. 2026 Jan 30:1-6. doi: 10.1080/13697137.2026.2615391. Online ahead of print.

ABSTRACT

OBJECTIVE: Adhesive capsulitis (AC) is considered idiopathic, yet typically affects women aged 40-60 years. The purpose of this study was to determine whether hormone therapy is protective against AC in menopausal women. The study hypothesized that patients prescribed hormone therapy would have lower odds of AC than those not using hormone therapy.

METHOD: Medical record extraction for a single health maintenance organization was used to identify postmenopausal women aged 40- 60 years and assess the utilization of hormone therapy and diagnosis of AC. The distribution of AC and endocrine disorders was compared between treatment groups using chi-squared tests and the odds ratio (OR) was reported.

RESULTS: The cohort included 1952 patients (152 hormone therapy, 1800 without hormone therapy). No statistically significant differences were found between treatment groups for endocrine disorders. A higher percentage of AC was noted in patients without hormone therapy compared to patients with hormone therapy (7.65% vs. 3.95%), although the association was not statistically significant (OR 1.99; 95% confidence interval 0.86-4.58; p = 0.10).

CONCLUSION: This pilot study did not demonstrate a statistically significant difference in odds of AC in menopausal women with and without hormone therapy. Larger prospective studies are needed to further explore potential protective effects of hormone therapy against AC.

PMID:41614260 | DOI:10.1080/13697137.2026.2615391

ANZ J Surg. 2026 Jan 30. doi: 10.1111/ans.70513. Online ahead of print.

ABSTRACT

BACKGROUND: Cosmetic tourism has become increasingly popular, with patients seeking lower cost cosmetic surgery overseas. However, complications often necessitate management in local public hospitals upon their return, placing a burden on healthcare systems. This study examines the demographics, complications, interventions and resource utilisation of patients presenting to an Australian hospital with complications from overseas cosmetic surgery.

METHODS: This study retrospectively reviewed patients who presented to Westmead Hospital, NSW, during two time periods-01/07/2022 to 01/01/2023 and 01/05/2024 to 30/12/2024-with complications following cosmetic surgery performed overseas. Hospital records were analysed to extract data on patient demographics, comorbidities, presenting complications, interventions, diagnostic tests and resource utilisation. Descriptive statistics were used to summarise the findings, and patterns in clinical management were evaluated.

RESULTS: Twenty-four patients met the inclusion criteria, with a mean age of 38.4 ± 12.5 years; 87.5% were female. Comorbidities included smoking (50%), mental health conditions such as anxiety, depression, or self-harm (20.8%) and hypothyroidism (12.5%). Abdominoplasty (54.2%), breast augmentation (20.8%) and liposuction (25%) were the most frequently performed procedures. The mean Charlson Comorbidity Index was 0.2 ± 0.4, and the mean LACE Index was 5.9 ± 1.5. Complications included wound dehiscence (45.8%), infection (41.7%) and seroma (20.8%). The median time from surgery to presentation was 3.8 weeks, with a mean hospital stay of 3.3 ± 2.9 days. Interventions included oral antibiotics (83.3%), IV antibiotics (58.3%), drainage or aspiration (33.3%) and surgery (54.2%).

CONCLUSION: Overseas cosmetic surgery is associated with high complication rates and significant utilisation of public hospital resources. These findings highlight the impact of cosmetic tourism on the Australian healthcare system.

PMID:41614248 | DOI:10.1111/ans.70513

APMIS. 2026 Feb;134(2):e70144. doi: 10.1111/apm.70144.

ABSTRACT

The present investigation was designed to assess the prognostic value of microRNA-648 (miR-648) in osteosarcoma (OS) and elucidate its regulatory mechanisms. Quantitative real-time PCR was employed to measure miR-648 expression levels in 80 paired OS specimens and their matched adjacent non-tumor tissues. Statistical assessments of clinical parameters were conducted using Chi-squared tests, while patient survival data were evaluated through Kaplan-Meier estimation and Cox proportional hazards regression modeling. Functional assays were performed in OS cell lines. Bioinformatic prediction of target genes was followed by experimental validation using dual-luciferase reporter assays. MiR-648 exhibited significant downregulation in OS clinical specimens and cell lines (p < 0.001). Low miR-648 expression correlated with lung metastasis (p = 0.027), advanced Enneking stage (p = 0.031), and poorer progression-free survival (p < 0.001). MiR-648 was identified as a significant independent prognostic indicator (hazard ratio [HR] = 0.235, p < 0.001). Moreover, the overexpression of miR-648 significantly suppressed cellular proliferation, migration capacity, and invasion potential while enhancing apoptotic activity (p < 0.001). High mobility group box 1 (HMGB1) was confirmed as a direct target, with its role in reversing miR-648’s tumor-suppressive effects. MiR-648 exerts tumor-suppressive effects in OS by modulating HMGB1, suggesting its clinical utility as both a prognostic biomarker and a therapeutic intervention point.

PMID:41614245 | DOI:10.1111/apm.70144

Cancer Med. 2026 Feb;15(2):e71549. doi: 10.1002/cam4.71549.

ABSTRACT

PURPOSE: To determine whether adolescent and young adults (AYA) with Hodgkin lymphoma (HL) who are treated by oncologists with “AYA expertise” improve outcomes.

METHODS: All AYA aged 15-21 years diagnosed with HL in Ontario, Canada between 1992 and 2012 were identified, and clinical data abstracted as part of the IMPACT cohort. Linked administrative data were used to identify primary oncologists, defined as “AYA experts” if at diagnosis, ≥ 15% of the oncologist’s previous 2 years of chemotherapy billings were for patients aged 15-29 years. Associations between seeing an AYA expert and outcomes were analysed.

RESULTS: Among 863 AYA with HL, 225 unique primary oncologists were identified. A total of 112 (13.0%) AYA had a primary oncologist with AYA expertise. Older patients [adjusted OR (aOR): 0.8 per year, 95% CI: 0.7-1.0; p = 0.04] and those seen in adult community hospitals [vs. regional cancer centre, aOR: 0.1, 95% CI: 0.02-0.4; p = 0.001] were less likely to see an AYA expert. Only 56 (6.4%) AYA received a fertility consult within 30 days of HL diagnosis; most occurred in the later study period (2006-2012). Seeing an AYA expert was associated with increased odds of fertility consultation (aOR: 2.1, 95% CI: 1.0-4.3; p = 0.04). Among the full cohort, there was no association between AYA expert care and event-free survival (EFS), overall survival (OS), or subsequent live birth.

CONCLUSION: A volume-based definition of AYA expertise was associated with receipt of fertility consults, but not with EFS or OS for AYA with HL. If validated in other populations and settings, seeing a volume-defined AYA expert could serve as a quality metric in AYA cancer care.

PMID:41614232 | DOI:10.1002/cam4.71549

Cancer Med. 2026 Feb;15(2):e71595. doi: 10.1002/cam4.71595.

ABSTRACT

INTRODUCTION: Advances in mesothelioma management have translated into longer patient survival and different treatment-related side effects including nephrotoxicity. The risk of developing adverse renal outcomes in patients with mesothelioma and associated risk factors remains undefined.

METHODS: We analysed territory-wide data from electronic health records of patients with mesothelioma followed at public hospitals in Hong Kong between 1st January 2000 to 31st December 2022. Prevalence of acute kidney injury (AKI), renal progression (> 30 mL/min drop in eGFR), and upstaging of chronic kidney disease (CKD) and associated risk factors were evaluated.

RESULTS: 222 patients were included. 18 (5.1%) patients developed acute kidney injury (AKI), and risk factors included diabetes mellitus (DM), use of bevacizumab and the presence of third space fluid (pleural effusion, pericardial effusion, ascites). 47 (21.2%) patients had upstage of CKD, and 31 (14.0%) patients showed renal progression. 18, 9, and 4 patients developed renal progression within 12 months from diagnosis, 12-24 months from diagnosis, and more than 24 months from diagnosis. Risk factors for upstage of CKD included the presence of third space fluid, platinum-based chemotherapy, use of immune check-point inhibitors, AKI during follow-up, more lines of cytotoxic chemotherapy received, and cycles of pemetrexed used. Predictors for renal progression included the presence of ascites and use of bevacizumab.

CONCLUSION: Short- and long-term adverse kidney outcomes are prevalent in patients with mesothelioma and show strong associations with treatments received. Careful patient selection and close monitoring of renal function may help avoid untoward acute and chronic nephrotoxicity.

PMID:41614227 | DOI:10.1002/cam4.71595

Front Digit Health. 2026 Jan 14;7:1698551. doi: 10.3389/fdgth.2025.1698551. eCollection 2025.

ABSTRACT

INTRODUCTION: Dementia is a progressive condition that impacts cognitive and motor functions, with early symptoms often subtle and difficult to detect. Early detection is crucial for effective intervention and improved care. Recent advances in sensor technology enable continuous monitoring of human motion, providing valuable indicators of dementia and cognitive decline.

METHODS: This systematic review is the first to focus exclusively on motion-based dementia detection, excluding other neurological conditions. The study aimed to address gaps in the literature by analysing evidence for motion assessment as a tool for dementia detection and by identifying and comparing sensor types, sensor placements, motion assessment tasks, extracted motion features, and analytical methods. Electronic databases (PubMed, Web of Science, IEEE Xplore and Scopus) were searched for articles published between January 2015 to May 2025.

RESULTS: A total of 23 published articles were included. Sensors used across studies included inertial measurement units, pressure mats, cameras, and passive infrared sensors, with placements on body parts, wall-mounted, or floor-based. Motion assessment tasks were grouped into three categories: gait, activities of daily living, and standing postural control. Regarding analytical approaches, 11 studies employed machine learning techniques, while 12 studies utilised statistical analysis. The findings indicate that motion-based assessments demonstrate strong potential for dementia detection, as motion-related features extracted from specific tasks can serve as sensitive indicators of dementia-related cognitive decline.

DISCUSSION: Compared with traditional dementia diagnostic pathways that often involve lengthy assessment cycles, this review’s findings provide guidance on refining motion-based sensor selection, task design, and analytical methods to improve standardisation and reproducibility. Future research should prioritise: (1) large-scale, longitudinal data collection with confirmed dementia diagnoses to support machine learning model development; (2) standardisation of sensor types, placements, and motion metrics to enhance comparability; and (3) integration of multimodal data, including motion and brain signals, using explainable machine learning techniques to improve detection accuracy and clinical interpretability.

PMID:41614144 | PMC:PMC12850517 | DOI:10.3389/fdgth.2025.1698551

BMC Public Health. 2026 Jan 29. doi: 10.1186/s12889-026-26359-8. Online ahead of print.

ABSTRACT

BACKGROUND: Unsafe child feces disposal is a recognized public health concern linked to adverse child health outcomes. While previous studies have examined its impact, the spatial heterogeneity and determinants of unsafe child feces disposal in India remain underexplored. This study addresses this research gap by investigating the spatial distribution and key factors influencing unsafe disposal practices across Indian districts.

METHOD: This study utilized data from the National Family Health Survey-5 (2019-2021) to conduct a comprehensive spatial analysis. Univariate and Bivariate Local Indicators of Spatial Association (LISA) clustering were employed to identify spatial patterns of unsafe child feces disposal. To examine the determinants, a Spatial Error Model (SEM) was applied, while Fairlie decomposition was used to quantify the contribution of various factors to regional disparities.

RESULTS: The Univariate LISA analysis identified 170 hotspot districts characterized by high levels of unsafe child feces disposal, primarily located in Odisha, Jharkhand, Bihar, Assam, and Tamil Nadu. The SEM analysis revealed that maternal education, household wealth, sanitation access, and religious affiliation are significant determinants. Hotspot districts demonstrated a 22% higher likelihood of unsafe disposal compared to cold spots. Decomposition results indicated that household wealth accounted for 65.3% of the observed disparity, followed by sanitation (17.1%), religion (7.4%), media exposure (4.5%), and education (3.2%).

CONCLUSION: This study underscores the pronounced spatial disparities in unsafe child feces disposal across Indian districts. Addressing these disparities requires targeted interventions focusing on improving sanitation, enhancing maternal education, and leveraging media outreach to promote safe disposal practices.

PMID:41612356 | DOI:10.1186/s12889-026-26359-8

J Orthop Surg Res. 2026 Jan 30. doi: 10.1186/s13018-026-06671-0. Online ahead of print.

ABSTRACT

BACKGROUND: Achilles tendon rupture (ATR) often limits early rehabilitation following conventional repair. The ligament augmentation reconstruction system (LARS) offers immediate mechanical stability and enables early mobilization. However, few studies have directly compared LARS with conventional suture techniques in ATR.

PURPOSE: To compare the efficacy and safety of the LARS versus the conventional Kessler suture technique for managing acute closed ATR.

STUDY DESIGN: Retrospective Cohort Study.

METHODS: A retrospective analysis was conducted on 91 patients who underwent surgical repair for ATR. The cohort was divided into two groups: 59 patients were treated with the LARS and 32 with the conventional Kessler suture technique. Functional outcomes were assessed using the Achilles tendon Total Rupture Score (ATRS) and American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score at 3, 6, and 12 months postoperatively. Complications and re-rupture rates were systematically documented and compared between the groups.

RESULTS: At the 3-month follow-up, the LARS group demonstrated significantly superior functional outcomes, with markedly higher ATRS (78.00 ± 15.01 vs. 55.00 ± 16.30, P < 0.001) and AOFAS scores (87.03 ± 5.44 vs. 82.03 ± 3.92, P < 0.001) compared to the conventional repair group. This superiority was maintained at the 6-month assessment for both the ATRS (88.00 ± 12.18 vs. 76.00 ± 13.23; P < 0.001) and AOFAS scores (94.78 ± 4.90 vs. 89.06 ± 4.54; P < 0.001). However, by 12 months postoperatively, the differences in both ATRS and AOFAS scores between the two groups were no longer statistically significant (P > 0.05). The LARS group reported one case of gastrocnemius weakness, while the conventional group experienced two cases of delayed wound healing and one superficial infection.

CONCLUSION: LARS repair enables a faster functional recovery in the short term compared to conventional Kessler repair, without increasing complication rates. While both techniques yield comparable excellent results by one year, the accelerated recovery pathway provided by LARS establishes it as a safe and effective treatment option, especially valuable for patients requiring an early return to activity.

PMID:41612352 | DOI:10.1186/s13018-026-06671-0

BMC Health Serv Res. 2026 Jan 29. doi: 10.1186/s12913-025-13990-1. Online ahead of print.

ABSTRACT

BACKGROUND: The prevalence of obesity worldwide has reached pandemic levels and is anticipated to escalate swiftly in developing nations. Given the substantial surge in obesity rates observed over the last three decades, assessing obesity-related costs is imperative for informing policy decisions.

OBJECTIVES: This study aimed to estimate direct medical and non-medical costs, along with indirect costs associated with laparoscopic sleeve gastrectomy (LSG), laparoscopic Roux-en-Y bypass (LRYGB), and pharmacotherapy for obesity in adult populations in Iran.

METHODS: An economic analysis was conducted to evaluate the costs of pharmacological and surgical obesity treatments over a one-year period in 2023 from a societal perspective. This analysis incorporated direct medical costs (e.g., medications, counseling, hospitalization), direct non-medical costs (e.g., transportation), and indirect costs (e.g., lost productivity). Cost components and resource use were identified through literature reviews and expert validation. Medical tariffs and hospital bills informed medical cost estimations, while patient self-report questionnaires were utilized for non-medical and indirect cost calculations. The analysis followed established reporting guidelines and employed a micro-costing approach to ensure a comprehensive evaluation.

RESULTS: The total costs were highest for LSG (2,294.98 USD), followed by LRYGB (2,266.85 USD), and pharmacotherapy (402.67 USD). Direct medical costs represented the largest proportion of total costs for all interventions, followed by direct non-medical costs and then indirect costs. Direct non-medical costs were notably higher for LSG and LRYGB compared to pharmacotherapy, with no statistically significant difference observed between LSG and LRYGB. Indirect costs were significantly greater for surgical interventions compared to pharmacotherapy, while no significant difference was noted between LSG and LRYGB.

CONCLUSION: Surgical interventions incurred higher total costs than pharmacotherapy, primarily due to substantial direct medical costs associated with LSG. Pharmacotherapy exhibited relatively higher direct non-medical costs, and indirect costs were a notable contributor across all interventions. These findings shed light on the economic burden of obesity and advocate for further exploration of costs related to lifestyle modifications and long-term assessments. The data supports future cost-effectiveness studies, aiding decision-making in obesity management.

PMID:41612331 | DOI:10.1186/s12913-025-13990-1

BMC Oral Health. 2026 Jan 29. doi: 10.1186/s12903-026-07765-1. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the diagnostic performance of photon-counting detector computed tomography (PCD-CT) and cone-beam computed tomography (CBCT) at dose-matched radiation levels (high, standard, and low) for detecting and evaluating simulated endodontic conditions, treatments, and associated complications.

METHODS: Sixteen extracted third molars with eight endodontic tasks were imaged using PCD-CT and CBCT. Qualitative (image quality, artifact susceptibility, diagnostic interpretability) and quantitative (endodontic working length) parameters were assessed by two observers using a five-point Likert scale. Descriptive statistics and weighted kappa (κ) were used for data analysis.

RESULTS: High- and standard-dose PCD-CT demonstrated superior image quality and anatomical visualization compared to CBCT (median 5, IQR 5-5; κ = 1.0; all p < 0.001). Low-dose PCD-CT remained diagnostically robust, outperforming CBCT, except in root canal visualization, where both performed similarly. Diagnostic accuracy of pathologies and complications was slightly higher with PCD-CT (80-88%) than with CBCT (75-88%). Endodontic working length measurements were consistently accurate across all protocols, with near-perfect inter-observer agreement (κ = 0.84-0.86, all p < 0.001).

CONCLUSIONS: PCD-CT demonstrated superior diagnostic performance over CBCT across multiple endodontic tasks, particularly at high and standard doses. Even at low doses, PCD-CT maintained robust accuracy and image quality, outperforming dose-matched CBCT in most parameters. Endodontic working length assessment was equally reliable across both modalities. Overall, PCD-CT offers diagnostic advantages over CBCT, particularly in challenging cases involving complex anatomy or high-density materials. Its effective performance at lower radiation levels emphasizes its clinical potential and supports broader implementation in dentomaxillofacial diagnostics.

PMID:41612315 | DOI:10.1186/s12903-026-07765-1