Tag: statistics

Pain Res Manag. 2026;2026(1):e1671698. doi: 10.1155/prm/1671698.

ABSTRACT

BACKGROUND: Intravenous lidocaine infusion is increasingly used in chronic pain services; however, real-world data regarding durability of analgesic benefit and safety in routine practice remain limited.

OBJECTIVE: To evaluate patient-reported analgesic outcomes, duration of benefit and safety profile of intravenous lidocaine infusion in a tertiary chronic pain service.

METHODS: A retrospective service evaluation was conducted at Leicester General Hospital, pain management department, including all adult patients who received intravenous lidocaine infusion between October 2024 and March 2025. Lidocaine was administered at 3 mg/kg over 1 h under monitored day-case conditions. Patients were contacted by structured telephone follow-up to assess Numerical Rating Scale (NRS) pain scores, duration of benefit, adverse effects and satisfaction. Descriptive statistics were used to summarise outcomes.

RESULTS: Of 136 treated patients, 112 completed follow-up (82.4%). Mean baseline NRS decreased from 8.0 to 4.5 during the early posttreatment period, representing an absolute reduction of 3.5 points. More than 60% of patients reported clinically meaningful improvement, while sustained pain relief beyond 3 months was reported by 29% of patients. Adverse effects occurred in 17% of cases and were mild and self-limiting, with no serious adverse events observed. Overall satisfaction with treatment was high, with 85% of patients indicating that they would recommend intravenous lidocaine infusion for chronic pain management. Among these, 47% were receiving the infusion for the first time.

CONCLUSION: In this real-world cohort, intravenous lidocaine infusion was associated with short- to medium-term patient-reported pain improvement and a favourable safety profile. While a subset experienced sustained benefit beyond 3 months, most patients reported shorter duration relief. Prospective controlled studies using validated outcome measures are required to define long-term efficacy and optimal patient selection.

PMID:42363661 | DOI:10.1155/prm/1671698

Vet Dermatol. 2026 Jun 26. doi: 10.1111/vde.70098. Online ahead of print.

ABSTRACT

BACKGROUND: Fluorescent light energy (FLE; Phovia, Vetoquinol) is a photobiomodulation therapy that promotes healing and reduces inflammation. Cutaneous epitheliotropic lymphoma (CTCL) is a neoplastic skin disease with limited treatment options. Although FLE is not considered genotoxic, its use in neoplastic conditions is off-label.

HYPOTHESIS: To assess the safety and clinical effect of FLE as an adjunctive treatment for canine CTCL.

ANIMALS: Eight client-owned dogs were diagnosed with CTCL via biopsy analysis and immunohistochemical analysis.

MATERIALS AND METHODS: Each dog had one CTCL lesion treated with FLE with a lesion serving as a vehicle-control. Treatments were administered weekly for 6 weeks, followed by 3 months follow-up. Focal nodular lesions were assessed weekly using Response Evaluation Criteria of Solid Tumours (RECIST), while diffuse lesions were evaluated using the Canine Epitheliotropic Lymphoma Extent and Severity Index (CELESI). Owner-perceived efficacy and quality of life were assessed using the Owner Global Assessment of Treatment Efficacy (OGATE) and a quality-of-life (QoL) survey.

RESULTS: No statistically significant differences in estimated marginal means were observed between sites at any time point (p > 0.05). Within-subject analyses suggested more favourable lesion progression at FLE-treated sites, and 75% of RECIST-evaluated FLE lesions maintained stable disease. Diffuse FLE-treated lesions demonstrated clinical severity reductions of ≤ 35.3%. Over 66% of owners rated treatment response as ‘fair’ to ‘excellent’ on the OGATE. One dog was withdrawn at Week 3 as a consequence of unrelated worsening.

CONCLUSIONS AND CLINICAL RELEVANCE: FLE appears to be a safe adjunctive therapy for canine CTCL, although statistically significant treatment effects were not demonstrated.

PMID:42363651 | DOI:10.1111/vde.70098

J Intern Med. 2026 Jun 26. doi: 10.1111/joim.70130. Online ahead of print.

ABSTRACT

BACKGROUND: Existing models for predicting postoperative acute kidney injury (AKI) after non-cardiac surgery are often complex and insufficiently validated for broad clinical use. We developed and externally validated a simple yet accurate model for predicting both overall and critical AKI that can be readily applied in routine practice.

METHODS: The severity index model for AKI (SIM-AKI) was developed using data from 191,938 patients undergoing non-cardiac surgery at a tertiary hospital and externally validated using three independent datasets from other tertiary hospitals (n = 118,047; 86,092; 3727). Variables were selected using least absolute shrinkage and selection operator regression with 10-fold cross-validation, and predictor stability was assessed using backward elimination across 100 bootstrap resamples before multinomial logistic regression modeling. Model performance was evaluated using the C-statistic for discrimination, calibration plots, Brier scores, and decision curve analysis (DCA) for clinical utility.

RESULTS: The SIM-AKI model incorporated age, sex, diabetes mellitus, American Society of Anesthesiologists classification, cancer surgery, emergency status, major abdominal surgery, anemia, hypoalbuminemia, estimated glomerular filtration rate, intraoperative transfusion, and operation time. For overall AKI, C-statistics were 0.801 (95% CI 0.796-0.806) in development and 0.754, 0.742, and 0.759 in validation cohorts. For critical AKI, C-statistics were 0.838 (95% CI 0.826-0.850) in development and 0.796, 0.805, and 0.767 in validation cohorts, demonstrating good calibration and clinical benefit in DCA. The SIM-AKI compared favorably with existing AKI prediction models in discrimination.

CONCLUSION: SIM-AKI may serve as a reliable perioperative tool for predicting the risk of both overall and critical postoperative AKI in patients undergoing non-cardiac surgery.

PMID:42363648 | DOI:10.1111/joim.70130

Histopathology. 2026 Jun 26. doi: 10.1111/his.70202. Online ahead of print.

ABSTRACT

This systematic review with meta-analysis aims to analyse the existing literature on clinicopathological features of sporadic gastric hyperplastic polyps (GHP), with special emphasis on risk factors associated with neoplastic transformation, as well as available immunohistochemical and molecular data relevant to GHP carcinogenesis. We searched two electronic databases and included studies reporting the presence of dysplasia and adenocarcinoma arising in GHP. Meta-analysis of odds ratios (ORs) was performed using random-effects models. We included 58 studies, 11 of which were included in quantitative synthesis. The overall rate of neoplastic transformation in GHP was 6.0% and progression to adenocarcinoma was observed in 1.5%. Statistically significant risk factors for neoplastic transformation were age ≥65 years (OR 2.60; 95% confidence interval [CI] [1.88-3.59]), size ≥20 mm (OR 4.63; 95% CI [1.82; 11.77]) with increasing size thresholds, as well as intestinal metaplasia (OR 3.65; 95% CI [1.68; 7.97]). Although the evidence is limited, the available data suggest that GHP located in the cardia or arising in a dysplastic background gastric mucosa may represent higher-risk subsets. Immunohistochemical subtyping of dysplasia showed a progressive shift from a predominantly gastric phenotype in non-neoplastic GHP to a hybrid (gastric-intestinal) phenotype in dysplasia and adenocarcinoma. TP53 alterations and chromosomal instability were the most frequently reported molecular events. GHP present a significant neoplastic potential, particularly in the presence of additional clinicopathological risk factors. Lesion size, patient age and – above all – the status of the surrounding gastric mucosa should guide endoscopic management, pathological interpretation and surveillance strategies.

PMID:42363644 | DOI:10.1111/his.70202

Psychol Health Med. 2026 Jun 26:1-13. doi: 10.1080/13548506.2026.2694730. Online ahead of print.

ABSTRACT

Sickle Cell Disorder (SCD) is a complex, multi-system blood condition affecting 7.78 million people, with 80% of global cases in sub-Saharan Africa, especially Nigeria. The condition is associated with physical health complications and increased risk of emotional difficulties, highlighting the need for scalable psychosocial interventions for adolescents with SCD in Nigeria. This pilot study assessed the effect of Bibliotherapy as a low-intensity, scalable intervention for adolescents with SCD. The non-randomised pilot-controlled trial involved 42 adolescents with SCD recruited from a Sickle Cell Centre and a Haematology Clinic. Participants were stratified by gender, age and baseline Rosenberg Self-Esteem (RSE) scores, and dyad-matched into Intervention and Control groups to reduce baseline differences. The treatment arm received weekly, virtual, group-based, manualised Bibliotherapy over five weeks, based on selected texts from a memoir by a Nigerian psychiatrist who lived with SCD. Pre-specified primary outcome was the RSE score; secondary outcomes were Hope, Depressive symptoms and Satisfaction with the intervention. The control group received no intervention beyond routine psychoeducation. Participants were aged 13-19 years (M = 16.1, SD = 1.96), with 59.5% females. Controlling for baseline scores, age and gender, the intervention showed a statistically significant effect on self-esteem scores with medium effect size {F (1,37) = 4.84, p = 0.03, Partial Eta Squared = 0.12}, but no significant effect on Hope {F (1,36) = 0.64, p = 0.20, Partial Eta Squared = 0.04} or depressive symptoms {F (1,36) = 0.95, p = 0.34, Partial Eta Squared = 0.03}. All participants in the intervention arm found the book interesting and indicated that it helped them believe they could succeed despite having SCD. They expressed satisfaction with the intervention. This pilot Bibliotherapy intervention was feasible, well received and showed promising efficacy on self-esteem. Larger controlled trials are recommended to establish the generalisability of these findings in the region.Pan African Clinical Trial Registry (Registration Number PACTR202110602061985).

PMID:42363631 | DOI:10.1080/13548506.2026.2694730

Personal Ment Health. 2026 Aug;20(3):e70091. doi: 10.1002/pmh.70091.

ABSTRACT

We critically appraise the study by de Bruin et al., which examined whether avoidant personality traits and avoidant coping predict differential outcomes of cognitive-behavioral therapy (CBT) versus short-term psychodynamic psychotherapy (STPP) in adult depression. Although the authors address an important clinical question regarding dimensional personality assessment in treatment selection, several methodological issues may limit the strength of their conclusions. First, avoidant personality traits were operationalized using a composite score derived from subtracting extraversion from neuroticism on the NEO-FFI. Although dimensional models are increasingly encouraged, this approach may not adequately capture the multifaceted construct of avoidant personality pathology, which includes features such as rejection sensitivity, shame, social inhibition, and feelings of inadequacy, and may instead reflect broader negative affectivity or introversion. Second, the study may have been underpowered to detect moderation effects, which typically require larger samples than main effect analyses. Attrition and participant exclusion may have further reduced statistical power, limiting the ability to identify meaningful treatment interactions. Therefore, the absence of significant moderation effects should be interpreted cautiously and not taken as definitive evidence of equivalent treatment efficacy across levels of avoidant pathology. Despite these limitations, the study contributes to growing research on dimensional personality approaches in depression treatment, and further well-powered studies using validated measures are warranted.

PMID:42363611 | DOI:10.1002/pmh.70091

Inhal Toxicol. 2026 Jun 26:1-15. doi: 10.1080/08958378.2026.2689661. Online ahead of print.

ABSTRACT

OBJECTIVE: Some of the varieties of talc were reported to contain a small fraction of elongate particles, including tremolite. The biological effects of tremolite were demonstrated in literature as dependent on the habit of particles (asbestiform vs. non-asbestiform). The objective of this paper is to utilize advanced methodologies of risk evaluation to determine if risk of mesothelioma could be elevated in persons utilizing talcum powder.

METHODS: Monte Carlo simulation was used to calculate potency factors, cumulative exposure, and mesothelioma risk for a hypothetical scenario.

RESULTS: Excess risk of mesothelioma for the person would be estimated as 0.22 cases per 1,000,000 per lifetime, with 5th percentile of 0.003 and 95th percentile of 0.873. Upper bound of excess mesothelioma risk is lower than the U.S. EPA benchmark for the general population and also comprises only about 1.4% of the mesothelioma baseline level in unexposed people. The morphological habit of tremolite particles reported in talc was typical for non-asbestiform variety.

CONCLUSIONS: Quantitative risk assessment can be used to evaluate possible health outcomes of airborne exposure to talcum powder.

PMID:42363609 | DOI:10.1080/08958378.2026.2689661

J Ultrasound Med. 2026 Jun 26. doi: 10.1002/jum.70344. Online ahead of print.

ABSTRACT

OBJECTIVES: To establish gestational age-specific reference ranges for the intraplacental vascular index measured using microvascularity-flow ultrasound software (VI^MV) and to evaluate its variation by placental location, parity, and pregnancy outcome.

METHODS: This prospective study enrolled 354 singleton pregnancies, of which 243 (68.64%) uncomplicated cases were used to construct reference ranges. A residual bootstrap method with 500 iterations was applied to square-root-transformed VI^MV values, followed by back-transformation to derive the 5th, 50th, and 95th percentiles with 95% confidence intervals. Group differences were assessed using quantile regression, and associations with Doppler parameters were examined.

RESULTS: VI^MV increased significantly with advancing gestational age (linear coefficient 1.88, p = .007), following a curvilinear pattern with mild late-gestation downturn (quadratic coefficient – 0.036, p = .011). Posterior placentas showed slightly higher early values, although this difference was not significant; from 31 weeks onward, anterior placentas demonstrated significantly higher VI^MV (mean difference + 15.4, p = .010 at 31-35 weeks; +11.6, p = .003 at 36-40 weeks). Multiparous women showed a modestly higher fitted trajectory and a similar non-significant trend toward higher birthweight, but parity was not independently associated with VI^MV. Pregnancies complicated by maternal disease, hypertensive disorders, or small-for-gestational-age neonates exhibited lower trajectories than uncomplicated pregnancies, although these differences were not statistically significant. VI^MV was inversely associated with uterine and umbilical artery pulsatility indices and positively associated with umbilical vein time-averaged mean velocity.

CONCLUSIONS: Gestational age-specific VI^MV reference ranges were established. VI^MV may provide an adjunctive quantitative marker for assessing placental vascular adaptation and identifying pregnancies with altered placental perfusion.

PMID:42363588 | DOI:10.1002/jum.70344

Med Sci Monit. 2026 Jun 27;32:e951747. doi: 10.12659/MSM.951747.

ABSTRACT

BACKGROUND Chat Generative Pre-Trained Transformer (ChatGPT) is an advanced artificial intelligence (AI) tool that has become increasingly integrated into daily life. In Saudi Arabia, government initiatives actively encourage the adoption of AI technologies, yet information on public perceptions of this technology remains insufficient. This study assessed public awareness, attitudes, beliefs, and perceptions about ChatGPT in Saudi Arabia. MATERIAL AND METHODS A cross-sectional survey was conducted among individuals living Saudi Arabia, from July to September 2025. Data were collected via an online questionnaire consisting of 25 items collecting information on demographic characteristics, their perceptions, awareness, and use of ChatGPT, and their attitudes and perceived obstacles regarding ChatGPT. Descriptive statistics were used for data analyzing using SPSS version 26. RESULTS Of participants 1069, 56.7% were female and 76.5% held a university degree. While 48.7% were somewhat familiar with ChatGPT, over half (54.6%) of them reported positive attitudes toward ChatGPT. Perceived benefits included productivity and educational enhancement, but concerns centered on overdependence (61.3%), incorrect information (55.7%), job loss (54.2%), and biased content (53.5%). Key obstacles were lack of credibility (76%) and confidentiality concerns (68.5%). The findings indicate that gender (P=0.001), age (P=0.001), and educational attainment (P=0.001) are important factors influencing familiarity and comfort with ChatGPT in daily life. CONCLUSIONS The Saudi public demonstrates a balanced perspective toward ChatGPT, recognizing its potential to enhance productivity and education while expressing valid concerns about trust and accuracy. Targeted awareness and policy measures are needed to build confidence and responsible adoption.

PMID:42363582 | DOI:10.12659/MSM.951747

Medicine (Baltimore). 2026 Jun 26;105(26):e49266. doi: 10.1097/MD.0000000000049266.

ABSTRACT

The triglyceride-glucose-Chinese visceral adiposity index (TyG_CVAI) has been validated as an effective predictor of early stroke. However, its predictive efficacy across different glycemic metabolic states remains unexplored. This study utilized data from the China Health and Retirement Longitudinal Study, including 7744 stroke-free participants. Participants were categorized into 3 glycemic groups: diabetes mellitus (DM), prediabetes mellitus (Pre-DM), and normal glucose regulation (NGR). K-means clustering further divided participants into 2 clusters based on TyG_CVAI fluctuations: Cluster 1 (lower TyG_CVAI) and Cluster 2 (higher TyG_CVAI). The primary outcome was the first stroke occurrence. Statistical analyses included Kaplan-Meier survival curves, Cox proportional hazards models, restricted cubic spline analysis, and receiver operating characteristic curve analysis to assess associations between baseline TyG_CVAI and stroke risk. Over 9 years (2011-2020), 540 participants (7.0%) experienced a first stroke. Participants in Cluster 2 (higher TyG_CVAI) exhibited a significantly elevated stroke risk compared to Cluster 1. Kaplan-Meier analysis revealed significant differences in stroke incidence between clusters among Pre-DM, NGR, and the overall population (P < .001), but not in the DM group (P = .071). Cox regression models, adjusted for confounders, confirmed a significant positive correlation between TyG_CVAI and stroke risk in the overall population, Pre-DM, and NGR groups. The hazard ratios and 95% confidence intervals for Cluster 2 versus Cluster 1 were 1.40 (1.15-1.71), 1.42 (1.07-1.88), and 1.68 (1.19-2.36), respectively. In contrast, no significant association was observed in the DM group (P > .1). Restricted cubic spline analysis further supported that higher TyG_CVAI levels correlated with increased stroke risk. Elevated baseline TyG_CVAI is significantly associated with stroke risk in middle-aged and older adults. However, its predictive capacity is attenuated in individuals with diabetes compared to those with normal glycemic metabolism. These findings underscore the importance of considering glycemic status when evaluating TyG_CVAI as a stroke predictor.

PMID:42363562 | DOI:10.1097/MD.0000000000049266