Tag: statistics

BMC Health Serv Res. 2026 Feb 5. doi: 10.1186/s12913-026-14093-1. Online ahead of print.

ABSTRACT

BACKGROUND: This study explores the “wave-off” mechanism in healthcare, in which physicians implicitly discourage patient revisits to manage high workloads. Understanding this mechanism is critical for balancing workload management and patient-centered care, as it highlights how physician discretion shapes patient behavior and operational efficiency.

METHODS: We analyze 200,426 outpatient records from a cardiology department to investigate the relationship between physician workload and the likelihood of patient revisits. We introduce a novel metric, Sample Entropy, to quantify patient “stickiness,” or the propensity to revisit. We examine physician behaviors-such as referrals for diagnostic examinations and medication prescribing-to identify strategies used to modulate patient flow. Statistical analyses assess the impact of workload on revisit patterns and the mechanisms driving the wave-off effect.

RESULTS: Higher physician workloads are significantly associated with reduced short-term patient revisits. Physicians manage workload by prescribing more medications and referring fewer diagnostic examinations, laboratory tests, particularly for patients with higher stickiness as measured by Sample Entropy. These behaviors alleviate short-term workload pressure but risk long-term inefficiencies, potentially reflecting bounded rationality in clinical decision-making.

CONCLUSIONS: The wave-off mechanism illustrates a trade-off between immediate workload relief and long-term operational performance. While it helps physicians address short-term capacity constraints, it may undermine optimal long-term patient care and system efficiency. This study highlights the operational and behavioral implications of physician-driven demand modulation, including the subtle yet consequential phenomenon of physician-reduced demand, in which patients are implicitly discouraged from revisiting due to workload-driven adjustments in care delivery.

PMID:41645147 | DOI:10.1186/s12913-026-14093-1

BMC Oral Health. 2026 Feb 5. doi: 10.1186/s12903-026-07846-1. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this study is to evaluate the flexural strength and surface hardness of denture base resins that have been milled using computer-aided design and computer-aided manufacturing milling (CAD/CAM) and conventional heat-polymerized denture base resins (HP).

METHODS: Eighty samples were made using CAD/CAM resin material (Polident CAD/CAM and Interdent CC discs) and conventional heat-polymerised acrylic resin (HP) (IvoBase CAD and PMMA). Based on the denture base material, the samples were categorised into eight groups: each group (n = 10), flexural strength (n = 40), surface hardness (n = 40). Both the surface hardness and flexural strength were evaluated using the Vickers hardness test and the three-point flexure test, respectively. A statistical analysis with a significance level of α = 0.05 was used to analyze the data.

RESULTS: Compared with HP resins, milled CAD/CAM resins demonstrated significantly higher flexural strength and surface hardness (p < 0.001). The flexural strength of MHC 72.72 ± 5.95 is significantly lower than that of IHC 78.96 ± 3.36, PCC 108.59 ± 6.51, and VCC 99.88 ± 6.05 MPa. Surface hardness is significantly lower in MHC (18.40 ± 2.28 VHN) than in the other groups: IHC (21.30 ± 2.40 VHN), PCC (31.07 ± 2.07 VHN), and VCC (27.09 ± 1.55 VHN).

CONCLUSION: Compared with heat-polymerized acrylic resin, milled CAD/CAM resins performed exceptionally well in terms of flexural and surface mechanical properties.

PMID:41645141 | DOI:10.1186/s12903-026-07846-1

BMC Nurs. 2026 Feb 5. doi: 10.1186/s12912-026-04371-y. Online ahead of print.

NO ABSTRACT

PMID:41645139 | DOI:10.1186/s12912-026-04371-y

BMC Surg. 2026 Feb 5. doi: 10.1186/s12893-026-03562-3. Online ahead of print.

ABSTRACT

BACKGROUND: Wrist ganglion cysts (GCs) are the most common soft-tissue masses of the hand and wrist. Although surgical excision is considered the most effective treatment, recurrence remains a clinical concern. Anatomical and demographic predictors of postoperative recurrence are not well established.

METHODS: We included 347 patients who underwent surgical excision of wrist GCs between 2015 and 2023, with a minimum follow-up of 24 months. Clinical data (age, sex, side, hand dominance) and magnetic resonance imaging (MRI)-based topographic features (volume, surface area, wall thickness, location, longest and shortest diameters, aspect ratio, and distance to the adjacent joint) were recorded retrospectively. The primary outcome was cyst recurrence at a minimum follow-up of 24 months, defined as clinically or radiologically confirmed return of the cyst. Statistical analyses included chi-square tests, t-tests or Mann-Whitney U tests, and univariable and multivariable logistic regression analyses. All analyses were performed in the Python (Google Colab) environment using the pandas, NumPy, SciPy, and statsmodels libraries.

RESULTS: The overall recurrence rate at a minimum follow-up of 24 months was 8.6% (30 of 347). Dominant-hand involvement was significantly associated with recurrence (χ² p = 0.006). In age-adjusted logistic regression, dominant-hand involvement increased the risk (OR = 6.51; 95% CI, 1.87-22.63; p = 0.003). Cyst distance to the adjacent joint was significantly shorter in recurrent cases (mean 7.6 mm vs. 8.1 mm; t-test p = 0.001, Mann-Whitney U p = 0.021). Based on age-adjusted logistic regression, each additional millimeter of cyst-to-joint distance conferred a 41% relative reduction in recurrence risk (OR = 0.59; 95% CI, 0.39-0.90; p = 0.013).

CONCLUSIONS: MRI-based evaluation of cyst-to-joint distance and consideration of dominant-hand involvement may help identify patients at increased risk of recurrence after surgical excision of wrist GCs. Incorporating these factors into preoperative planning may optimize surgical strategy, guide follow-up, and improve patient counseling.

PMID:41645133 | DOI:10.1186/s12893-026-03562-3

BMC Infect Dis. 2026 Feb 5. doi: 10.1186/s12879-026-12784-y. Online ahead of print.

ABSTRACT

BACKGROUND: Hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infections remain an important public health challenge among people living with HIV (PLHIV), with their heaviest toll borne in sub-Saharan Africa. These infections accelerate liver disease progression, complicate antiretroviral therapy (ART) management, and contribute to morbidity and mortality. This study assessed the seroprevalence of HBV and HCV and liver injury among PLHIV on ART in the Upper East Region of Ghana.

METHODS: In a cross-sectional survey, a total of 294 PLHIV receiving ART at three treatment sites were recruited between June and August, 2024. Sociodemographic and clinical data were obtained using a structured questionnaire after informed consent. Participants were screened for HBV serological markers and anti-HCV using a lateral flow rapid immunochromatographic test, and liver injury was evaluated biochemically by measuring serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. Descriptive statistics were used to summarise participant characteristics and logistics regression to assess factors associated with HBV and HCV coinfections and liver injury.

RESULTS: The overall seroprevalence of viral hepatitis was 13.3% (95% CI: 9.6-17.7), with HBV (9.2%; 95% CI: 6.1-13.1) more common than HCV (4.1%; 95% CI: 2.1-7.0). HBV infection was significantly higher in males than females (17.5% vs. 7.4%; p = 0.025) and more common among participants with tertiary education (21.4%; 95% CI: 4.7-50.8) relative to those without formal education (4.5%; 95% CI: 1.7-9.6; p = 0.022). Urban residents showed higher but not statistically significant HBV seroprevalence than rural participants (14.9% vs. 7.3%; p = 0.050). HCV seroprevalence showed no significant sociodemographic associations. The seroprevalence of liver injury was 17.7% (95% CI: 13.5-22.5). Being a male was independently associated with liver injury (adjusted odds ratio [aOR]: 4.35; 95% CI: 1.81-10.47; p = 0.001). Older age was also a predictor: compared to participants aged 20-30 years, those aged 31-40 (aOR: 13.31; 95% CI: 1.37-129.76; p = 0.026), 41-50 (aOR: 20.01; 95% CI: 1.90-210.33; p = 0.013), and > 50 years (aOR: 15.62; 95% CI: 1.41-172.51; p = 0.025) had markedly increased odds. Longer ART duration was protective: individuals on ART for > 10 years had reduced odds of liver injury compared to those on ART for 1-5 years (aOR: 0.39; 95% CI: 0.16-0.97; p = 0.042).

CONCLUSION: The findings show that HBV and HCV are prevalent among PLHIV on ART in the Upper East Region of Ghana. Liver injury affects nearly one in five PLHIV in this setting. These findings highlight the need for targeted viral hepatitis B and C and liver enzymes monitoring and integration of hepatitis management into HIV care, particularly among older men and patients in the early years of ART in this population.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:41645131 | DOI:10.1186/s12879-026-12784-y

BMC Pediatr. 2026 Feb 5. doi: 10.1186/s12887-026-06579-y. Online ahead of print.

ABSTRACT

BACKGROUND: Burn injuries among children under five remain a significant public health concern globally, particularly in low- and middle-income countries like Tanzania. Despite various national efforts, the burden and associated factors of burns, particularly in relation to rural-urban differences, have not been well-documented in the Dodoma Region. The study aimed to compare the prevalence of burn wounds and associated factors among children under five years old between rural and urban areas in Dodoma Region.

METHODS: An analytical cross-sectional study was conducted from May to June 2025, involving 299 children under five years from both rural and urban areas in the Dodoma Region. Data were collected through structured questionnaires and analyzed using SPSS version 27 with descriptive and inferential statistics.

RESULTS: Overall, the prevalence of burn wounds for children under five was 78 (26%) for both urban and rural areas. By categorizing, 31 (39.7%) of burn wound cases were from urban areas, and 47 (60.3%) cases were from rural areas. In rural areas, good caregiver supervision was associated with the majority of children under five ending up with no burn wound (χ² = 4.16, P = 0.04). The household hazards in urban areas were associated with burn wounds among children under-five (χ² = 17.69, P < 0.001). In rural areas, the under-five children without risk behaviours were associated with most of under five children ending up with no burn wound (χ² = 4.31, P = 0.038). Moreover, several participants’ sociodemographic characteristics were associated with the prevalence of burn wounds.

CONCLUSION: This study found that burn injuries among under-five children in the Dodoma region are more prevalent in rural areas than in urban areas. In comparing predictors of burn wounds in rural and urban areas, a major contributing factor to burn wounds in rural areas is poor caregiver supervision, while the predictor of burn wounds in urban areas is household hazards.

PMID:41645110 | DOI:10.1186/s12887-026-06579-y

BMC Geriatr. 2026 Feb 5. doi: 10.1186/s12877-025-06945-y. Online ahead of print.

ABSTRACT

BACKGROUND: Individuals at risk of frequent hospitalisation often experience complex health and social challenges. Peer health navigation programmes have emerged as a promising strategy to support these patients, improve continuity of care, and reduce hospital use. The strategy has strong alignment with the transition of care management model.

OBJECTIVE: To describe the baseline demographic characteristics, self-reported health status, and frailty of patients enrolled in the Northern Patient Watch (NPW) program. NPW employs peer health navigators, under the supervision of health professionals, to support individuals at high risk of recurrent hospital admissions.

METHODS: This observational study examined all patients who enrolled in the NPW programme between November 2021 and October 2024. Baseline data were collected on demographics, health-related quality of life (EQ-5D-5 L), and frailty (Rockwood Clinical Frailty Scale). Descriptive statistics were used to summarise the findings.

RESULTS: A total of 650 patients were enrolled. The mean age was 70 years, and 56% were female. One-third lived alone, and 29% spoke a language other than English at home. The mean EQ-5D-5 L index score was 0.72, with a mean EQ-VAS of 58.9, indicating moderate health-related quality of life. Moderate issues were frequently reported across all EQ-5D-5 L dimensions, particularly in mobility, pain, and mental health. Two-thirds of participants were classified as vulnerable or frail.

CONCLUSION: Patients who enrol in peer health navigation programmes such as NPW are typically older adults with moderate but not severe health challenges. These individuals may be particularly well positioned to benefit from early, tailored support that can prevent further deterioration. Findings highlight the potential value of peer navigation programmes in engaging at-risk populations before health crises occur.

PMID:41645076 | DOI:10.1186/s12877-025-06945-y

Cancer. 2026 Feb 15;132(4):e70285. doi: 10.1002/cncr.70285.

ABSTRACT

BACKGROUND: Hematopoietic stem cell transplantation (HCT) is an intensive and invasive procedure used in cancer treatment that depends heavily on the involvement of caregivers and places them at high risk for posttraumatic stress disorder (PTSD) symptoms. These symptoms are frequently overlooked in oncology and general health care settings. The suitability and utility of the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) within cancer caregivers remains uncertain. This study sought to evaluate its performance as a brief (five-item) case finding screening alternative to the longer (20-item) PTSD Checklist for DSM-5 (PCL-5) in caregivers of survivors who received an HCT 1-5 years ago.

METHOD: A total of 106 caregivers completed the PC-PTSD-5 and PCL-5 during recruitment for a randomized clinical trial. Optimal cut scores for identifying probable PTSD and item performance were determined using indices correcting for chance and item response theory analyses.

RESULTS: Of the caregivers evaluated, 33% screened as positive for probable DSM-5 PTSD using the PCL-5. The PC-PTSD-5 exhibited acceptable internal consistency and significant associations with PCL-5 scores (total, r = 0.79; items r [range] [0.60-0.69]). A cutoff score of 3 provided optimal sensitivity for screening (κ[Se] = 1). Item response theory analyses indicated the need for the complete PC-PTSD-5 items to provide the greatest information across varying levels of PTSD.

CONCLUSION: Although not an instrument validation study, these findings provide preliminary support for using the PC-PTSD-5 as a succinct, effective screening tool among cancer caregivers in a clinical context.

PMID:41645050 | DOI:10.1002/cncr.70285

Int J Numer Method Biomed Eng. 2026 Feb;42(2):e70138. doi: 10.1002/cnm.70138.

ABSTRACT

Existing lumped arterial stenosis models struggle to accurately capture the pressure and flow relationship of complex lesion morphologies, thereby limiting their ability to accurately evaluate lesions. To overcome these limitations, we introduce a geometry-informed, data-driven lumped stenosis model that incorporates realistic lesion shapes using statistical shape modeling (SSM). By generating a large dataset of synthetic coronary stenoses, hence focusing on epicardial lesions, and evaluating them through high-fidelity 3D computational fluid dynamics (CFD), we derived reference pressure drops across a diverse range of lesion geometries and flow regimes. These CFD-derived pressures and flows, along with their corresponding shape coefficients, were used to train a lumped parameter model capable of rapidly estimating trans-lesional pressure drops. Remarkably, only five shape modes were necessary to effectively describe the geometric variability, underscoring the efficiency of the approach. Compared to a conventional lumped model, our approach significantly improved pressure drop prediction accuracy, especially in the case of irregular stenosis morphologies. Integration of the new data-driven lumped stenosis model within a 1D pulse wave propagation framework was also successful, aligning simulated pressure and flow waveforms much closer with high-fidelity CFD-coupled results. In turn, the estimation of the fractional flow reserve, a clinically validated index of lesion-specific ischemia, also improved by 18% compared to a conventional lumped model. Although only validated using synthetic lesion data, the model’s architecture allows easy integration of additional shape features and lesion-specific parameters, paving the way for future validation on patient-derived geometries.

PMID:41645049 | DOI:10.1002/cnm.70138

J Prosthodont. 2026 Feb 5. doi: 10.1111/jopr.70100. Online ahead of print.

ABSTRACT

PURPOSE: This in vitro study aimed to investigate the effect of different grit sizes of dental burs on the marginal adaptation of lithium-reinforced glass-ceramic restorations. The objective was to determine if finishing with fine-grit burs after initial preparation with coarser-grit burs enhances the marginal adaptation of restorations produced using computer-aided design and computer-aided manufacturing (CAD-CAM) technology.

MATERIALS AND METHODS: Fifty impacted human molar teeth with intact enamel were extracted and divided into five groups (n = 10 per group). For group 1, a neutral band chamfer bur (107 µm) was used, while for group 2, a black band bur (181 µm) was used. A green band bur (151 µm) was used for group 3. For group 4, preparation was done using a black band bur and finished with the red band bur (46 µm), while for group 5, a green band bur was used for preparation and finished with the red band bur. Three-dimensional (3D) scans of the prepared teeth were obtained using an intraoral scanner (Virtuo Vivo, Dental Wings), and CAD software was used to design the crowns. The restorations were milled from lithium disilicate blocks (IPS e.max CAD, Ivoclar Vivadent) on a chairside milling machine (M10, Camcube). Marginal gap assessment on the buccal, mesial, palatal/lingual, and distal surfaces by a stereomicroscope at 20× magnification and with 840 LP/mm resolution was performed. The measurements were performed for 32 equidistant points per sample, totaling 1600 points. ImageJ software was used for the analysis. Additionally, scanning electron microscopy (SEM) was used on 10 samples for validation. Statistical analysis was conducted using the Kruskal-Wallis and Mann-Whitney U tests at the 0.05 significance level.

RESULTS: There was a statistically significant difference in marginal adaptation between the different groups, with groups 4 (Black-Red) and 5 (Green-Red) showing a better marginal fit (p < 0.05). Within each group, no significant difference was observed between the buccal, mesial, distal, and palatal sides.

CONCLUSION: Finishing tooth preparation with a fine-grit red diamond bur after using coarser-grit burs significantly enhances the marginal adaptation of glass-ceramic restorations produced by CAD-CAM technology. This technique could lead to better clinical outcomes in patients treated with such restorations.

PMID:41645020 | DOI:10.1111/jopr.70100