Tag: statistics

Hip Int. 2026 Aug 14:11207000261469470. doi: 10.1177/11207000261469470. Online ahead of print.

ABSTRACT

BACKGROUND/OBJECTIVES: The acetabular labrum plays a key role in hip biomechanics, reducing contact pressure and peak stress on articular cartilage. In femoroacetabular impingement (FAI), injuries often require surgical intervention. While anatomical repair restores function, irreparable cases necessitate labral reconstruction with grafts. Despite advancements, detailed morphometric studies remain limited. This study analyses labral morphometry, focusing on regional and sex-based differences to optimise graft selection.

MATERIALS AND METHODS: 18 adult hip specimens were included after screening for normal hip morphometry on fluoroscopy (Wiberg 25-40°, alpha angle <55°, preserved joint space; Tönnis <2) and verification of intact labral and chondral structures after dissection. Morphometric measurements included labrum height (anterior,superior,posterior), acetabular diameter, anterior superior iliac spine (ASIS) distance, and transverse ligament (TAL) width. Specimens were analysed regionally and stratified by sex. Statistical comparisons identified morphometric differences.

RESULTS: Labrum height was greatest in the posterior (7.49 ± 0.95 mm), followed by the superior (6.78 ± 0.91 mm) and anterior (5.60 ± 0.71 mm) regions. Statistically significant (p < 0.05) sex-based differences were observed in all measurements. Males exhibited greater labral height in the superior (7.19 ± 1.02 mm vs. 6.29 ± 0.91 mm), posterior (7.38 ± 0.66 mm vs. 6.93 ± 0.70 mm), and anterior (5.49 ± 1.03 mm vs. 5.03 ± 0.71 mm) regions. Additionally, males had larger transverse ligament width (7.04 ± 0.68 mm vs. 6.66 ± 0.63 mm), ASIS distance (285.73 ± 7.12 mm vs. 275.88 ± 9.24 mm), and acetabular diameter(54.35 ± 2.76 mm vs. 50.29 ± 4.97 mm).

CONCLUSIONS: The acetabular labrum shows progressive height variation – posterior > superior > anterior – with males exhibiting approximately 1 mm greater dimensions across all regions. These anatomical differences should guide graft selection and surgical planning to optimise patient-specific hip preservation and outcomes.

PMID:42596771 | DOI:10.1177/11207000261469470

Hip Int. 2026 Aug 14:11207000261466581. doi: 10.1177/11207000261466581. Online ahead of print.

ABSTRACT

PURPOSE: To assess the impact of the intramedullary canal occupying ratio (ICOR) on bone union and the stability of fixation in intertrochanteric fracture treatment using proximal femoral nail anti-rotation (PFNA) surgery.

METHODS: A retrospective analysis included 151 patients aged 60 years and above who underwent PFNA for unilateral intertrochanteric fractures between June 2020 and 2022. Patients were categorised into 3 groups based on ICOR percentiles (0.48-0.93). Bone healing was assessed using the Radiographic Union Score for Hip (RUSH) at 2, 6, and 12 weeks postoperatively. Fixation stability was assessed by comparing immediate and 3-month postoperative radiographs. Multivariate regression was used to assess the relationship between ICOR, RUSH scores, and fixation stability.

RESULTS: No significant differences in RUSH scores or stability measurements were found among the 3 ICOR-based groups. Multivariate regression showed no clear correlation between ICOR and RUSH scores, except for a statistically significant but not clinically relevant association with changes in neck-shaft angle. In contrast, RUSH scores were significantly associated with fracture severity according to the OTA/AO Classification.

CONCLUSION: ICOR was not a significant predictor of fracture healing or fixation stability. In uncertain cases regarding nail size, using a smaller nail was not linked to inferior radiographic or fixation-related outcomes.

PMID:42596769 | DOI:10.1177/11207000261466581

Arch Suicide Res. 2026 Aug 14:1-11. doi: 10.1080/13811118.2026.2715598. Online ahead of print.

ABSTRACT

OBJECTIVE: Most self-report measures of suicidal ideation (SI) index thoughts or behaviors but broadly fail to contextualize the degree to which SI is perceived to impair quality of life. Theories of suicide propose that psychological inflexibility (i.e., metacognitive distress) about SI may compound suicidal cognitions and impact suicide risk. This study tested whether suicidal cognitions and psychological inflexibility about SI interact to amplify SI severity.

METHODS: Self-report measures of suicidal cognitions, psychological inflexibility, and SI severity were collected from U.S. military veterans (N = 87) with current SI at a health care system in the Southeast United States. The sample primarily identified as male (70%) and White/Caucasian (45.6%). A moderation model tested main and interactive effects of suicidal cognitions and psychological inflexibility about SI on SI severity.

RESULTS: There was a significant interaction between suicidal cognitions and psychological inflexibility about SI, such that the statistically significant relationship between suicidal cognitions and SI severity increased at each level (-1 SD, mean, and +1 SD) of psychological inflexibility about SI.

CONCLUSIONS: Psychological inflexibility about SI may amplify SI severity, which has theoretical implications for ideation-to-action frameworks of suicide. In addition to treating underlying suicidal cognitions, patients may benefit from addressing concerns about the meaning and impact of SI itself.

PMID:42596761 | DOI:10.1080/13811118.2026.2715598

J Intellect Disabil Res. 2026 Aug 14. doi: 10.1111/jir.70160. Online ahead of print.

ABSTRACT

BACKGROUND: Identifying flexible and rigorous methods to administer assessments in Down syndrome research is critical for limiting participation burden. Tablet assessments have the potential to be presented remotely, but consistency between researcher and caregiver administrations is unknown.

METHOD: Participants were 24 children with Down syndrome aged 10-17 years and their caregivers. Children completed two sessions: one administered by their caregiver and one administered by research staff. Tablet measures were selected from the NIH Toolbox and the Cambridge Neuropsychological Test Automated Battery (CANTAB).

RESULTS: There were no significant differences between child performance on researcher-administered compared to caregiver-administered NIH Toolbox Flanker, CANTAB RTI and CANTAB PAL measures. Floor effects impacted additional measures with high agreement (NIH Toolbox Pattern Comparison).

CONCLUSIONS: Task completion did not differ across administrators, demonstrating evidence for parents’ ability to facilitate assessments. Inconsistent agreement statistics warrant future work in larger samples and additional understanding of child tablet assessment performance.

PMID:42596758 | DOI:10.1111/jir.70160

Expert Rev Vaccines. 2026 Dec;25(1):2715854. doi: 10.1080/14760584.2026.2715854. Epub 2026 Aug 14.

ABSTRACT

BACKGROUND: Medicaid beneficiaries typically have low vaccination rates, in part due to limited access. Pharmacies provide easy-to-access locations for vaccination.

RESEARCH DESIGN AND METHODS: This was a retrospective analysis of trends in pharmacy-based vaccination by age and race or ethnicity among Medicaid recipients aged ≥9 from 1 January 2018 (before the COVID-19 pandemic) to 31 December 2023. The percentage of all vaccinations administered at pharmacies and the overall percentage change in vaccination rates were determined.

RESULTS: With some exceptions, overall routine and seasonal vaccination rates remained lower in 2023 than in 2018-2019. This was observed for human papillomavirus (HPV), influenza, and tetanus-containing (Tdap/Td) vaccines in adolescents and for hepatitis A, influenza, meningococcal, pneumococcal, and Tdap/Td vaccines in various adult age groups. The percentage of routine and seasonal vaccinations administered at pharmacies increased over the study period among adults, with increases of 5.2-17.5 percentage points for hepatitis A, hepatitis B, HPV, meningococcal, pneumococcal, and tetanus-containing vaccines among those aged 19-49. Across age groups, pharmacy-based vaccination was most frequent in White enrollees, followed by Black and then Hispanic enrollees, with smaller differentials in adults aged ≥65.

CONCLUSIONS: Generally overall vaccine administration rates declined in Medicaid beneficiaries; however, the proportion administered at pharmacies increased.

PMID:42596755 | DOI:10.1080/14760584.2026.2715854

J Glob Health. 2026 Aug 14;16:04274. doi: 10.7189/jogh.16.04274.

ABSTRACT

BACKGROUND: Bronchiolitis remains the commonest acute lower respiratory tract infection in younger children globally. Bronchiolitis is often misdiagnosed as World Health Organization (WHO)-classified pneumonia due to closely related clinical manifestations. Our primary objective was to assess the prevalence of viral bronchiolitis among WHO-classified pneumonia, and the secondary objective was to evaluate their management.

METHODS: This was a prospective observational study. Infants (aged <2 years) suffering from WHO-classified pneumonia attending the country’s largest academic paediatric hospital ‘Bangladesh Shishu Hospital and Institute’, Dhaka, during July 2020 through June 2021 were enrolled (n = 60) following systematic sampling (every second child). We revalidated all infants meeting the inclusion criteria (cough, fast breathing and/or chest in-drawing) for bronchiolitis assessment using clinical, radiological, haematological, biochemical, and microbiological analyses. Nasopharyngeal aspirate (NPA) was subjected to polymerase chain reaction (PCR) assay for respiratory syncytial virus (RSV), influenza A, and influenza B viruses. Clinical features, treatment modalities, mode of discharge, and length of hospital stay (LOS) were subjected to differentiate bronchiolitis from WHO-classified pneumonia.

RESULTS: PCR of NPA of 60 WHO-classified pneumonia cases yielded RSV in 41 (68%) who had pertinent clinical symptoms and signs suggestive of bronchiolitis, attested by benign chest radiography (85%). Further, their mean (x̄) and standard deviation (SD) complete blood count (x̄ = 15,488; SD = 1874/cm) with x̄ = 36% (SD = 11) neutrophil) and C-reactive protein (x̄ = 4.49 (5.88) mg/L cut off reference value >5 mg/L) were indicative more as non-bacterial infections favouring RSV bronchiolitis. In contrast, all 19 non-RSV cases did not differ in clinical findings, as attested by haematological, microbiological and radiographical features, suggesting bronchiolitis-like illness, further supported by disease outcome, discharge pattern and LOS (x̄ = 4.7; SD = 2.29) days). Nevertheless, antibiotics were given in 95% of all 60 cases.

CONCLUSIONS: There was a high proportion of bronchiolitis among WHO-classified pneumonia, and antimicrobials were prescribed to treat those cases. The findings need the attention of policymakers to address the overlap between WHO-classified pneumonia and bronchiolitis and minimise the potential overuse of antibiotics.

PMID:42596748 | DOI:10.7189/jogh.16.04274

J Glob Health. 2026 Aug 14;16:04276. doi: 10.7189/jogh.16.04276.

ABSTRACT

BACKGROUND: Arthritis, characterised by inflammation, pain, and joint stiffness, is emerging as a significant health concern in ageing populations worldwide. While many studies have examined the effects of outdoor environmental risk factors on arthritis, fewer have investigated the effects of residential ecological factors.

METHODS: We included 2,511 participants in the cohort study and 13,886 participants in the cross-sectional study from the Chinese Longitudinal Healthy Longevity Survey. We employed multivariate Cox proportional hazards and logistic regression to analyse the cohort and cross-sectional data. For each residential environment factor, we developed three models, with model three adjusted for all potential confounders collected in our study, which we considered our primary model.

RESULTS: We identified a significant association between the use of non-clean fuel and a higher risk of arthritis (hazard ratio (HR) = 1.42; 95% confidence interval (CI) = 1.05-1.93) through cohort analysis. Conversely, residing in high-rise buildings with elevators was associated with a reduced risk of arthritis (HR = 0.12; 95% CI = 0.02-0.86). Our cross-sectional study reflects a reduced risk of arthritis associated with summer window ventilation for one to five times/week (odds ratio (OR) = 0.70; 95% CI = 0.50-0.97) and more than five times/week (OR = 0.66; 95% CI = 0.48-0.90). Additionally, distance of >300 m was also associated with a lower risk of arthritis (OR = 0.79; 95% CI = 0.69-0.89).

CONCLUSION: These findings underscore the crucial role of residential environmental factors in the risk of arthritis development. These results have important implications for public health policies aimed at reducing the prevalence of arthritis.

PMID:42596747 | DOI:10.7189/jogh.16.04276

Subst Use Addctn J. 2026 Aug 14:29767342261465527. doi: 10.1177/29767342261465527. Online ahead of print.

ABSTRACT

BACKGROUND: Harmful substance use affects millions of people, producing health and social consequences that require both professional support and effective self-management. This study piloted a self-management program targeting the consequences of substance addiction in adults enrolled in medication-based program.

METHODS: A parallel-group pilot trial compared the Self-Management Substance Addiction Consequences Program (ADS Program) with treatment as usual (TAU) to assess the program’s effectiveness and identify the need for adjustments to the intervention or the trial design. Seventy-two randomly selected adults enrolled for at least 5 weeks in medication-based program for alcohol or other drugs participated. Data were collected at baseline and after 8 to 21 weeks to assess effects on substance addiction consequences (SAC) and positive mental health (PMH).

RESULTS: Of the 236 patients screened, 72 were randomized: 38 to the ADS Program and 34 to TAU. Twenty-five participants completed the ADS Program (34.2% attrition), and 16 completed TAU (52% attrition). ADS participants attended more sessions (6 vs 2), although still fewer than planned. Participants in the ADS Program demonstrated significant reduction in SAC (paired t(24) = -5.718, P < .001, d = -1.169). Similar improvements were observed in the TAU group (paired t(15) = -6.357, P < .001, d = -1.580), with no significant differences between groups (P > .05). PMH also improved in both groups. The ADS group showed a statistically significant increase (paired t(20) = -3.945, P < .001, d = -0.861), whereas the TAU group demonstrated marginally non-significant improvement (paired t(11) = -2.170, P = .053, d = -0.626). No significant between-group differences were identified (P > .05).

CONCLUSIONS: This pilot trial indicates that the ADS Program is feasible, safe, and potentially effective in supporting self-management of SAC. Findings suggest an adjusted duration of 6 to 18 weeks may be beneficial. Given the substantial dropout rate, further research with larger samples is needed to confirm effectiveness and improve retention.

PMID:42596740 | DOI:10.1177/29767342261465527

Child Care Health Dev. 2026 Sep;52(5):e70330. doi: 10.1111/cch.70330.

ABSTRACT

BACKGROUND: Childcare centres for toddlers and preschool-aged children serve as a setting crucial to mental development, as stable relationships with caregivers and peers outside the family form. Children with early mental health disorders, especially externalising behaviours, are at increased risk of being excluded from access to these institutional services.

METHODS: The retrospective study investigates partial or full exclusion from childcare centre attendance among toddlers and preschoolers (N = 177) who received psychiatric day clinic treatment within two periods (2018/2019 and 2023/2024). We compared excluded and non-excluded children regarding clinical parameters in a binary logistic regression. Furthermore, treatment trajectories were examined to assess reintegration into childcare settings as a potential therapeutic outcome.

RESULTS: Among the patients in the psychiatric day clinic for toddlers and preschoolers, the rate of exclusion from childcare centre attendance was 25.5% (2023/2024) and 8.0% (2018/2019), respectively. Boys were predominantly excluded from childcare centre attendance with 66.7% (2018/2019) and 92.3% (2023/2024). Overall for both cohorts, while male sex (p = 0.028) and cohort membership in the 2023/24 cohort (p = 0.009) predicted exclusion, other investigated variables (i.e., socioeconomic status, migration status, parental psychiatric condition) did not show an effect. In 78.1% of the excluded patients in the combined samples, (partial) reintegration or improvement of social integration was recorded or initiated during treatment.

CONCLUSIONS: In our study, exclusion from childcare attendance differed between 2018/2019 and 2023/2024 in toddler and preschool children, especially affecting boys. In line with the UN Convention on the Rights of the Child, 1989, ensuring inclusive access to early education regardless of physical or mental impairments should be an important therapeutic goal. Mental health professionals should pay special attention to and actively support prevention and reintegration regarding early life exclusion experiences from childcare centres.

PMID:42596739 | DOI:10.1111/cch.70330

Subst Use Addctn J. 2026 Aug 14:29767342261467585. doi: 10.1177/29767342261467585. Online ahead of print.

ABSTRACT

BACKGROUND: Treatment for alcohol and opioid withdrawal when managed independently is well-established; however, specific guidance on their concurrent management is lacking. This review evaluated the relationship between buprenorphine initiation and time to initiation on key substance use disorder outcomes for inpatients at risk for both alcohol and opioid withdrawal.

METHODS: This single-center retrospective cohort study included patients admitted to the acute psychiatry unit from January 1, 2019 through September 30, 2023 and at risk for concurrent opioid and alcohol withdrawal. Patients were divided into 4 cohorts depending on time to buprenorphine initiation from admission: 0 to 24 hours (n = 85), 24 to 72 hours (n = 44), >72 hours (n = 16), and those who did not receive buprenorphine (n = 187). The primary outcome compared the patient-directed discharge (PDD) rate among the 4 cohorts. Secondary outcomes compared the overall length of stay, inpatient readmission rates at 30 and 90 days, and buprenorphine medication retention at 90 days. Descriptive statistics were used for analysis.

RESULTS: Of all psychiatric admissions meeting inclusion criteria (N = 332), 43.7% (n = 145) received buprenorphine. PDD rates were higher in those who did not receive buprenorphine compared to those who did (15.5% [n = 29] vs 6.9% [n = 10]) and in those who initiated buprenorphine between 24 and 72 hours versus 0 to 24 hours of admission (11.4% [n = 5] vs 5.9% [n = 5]). Absence of buprenorphine initiation also resulted in higher inpatient readmission rates at both 30 (25.1% [n = 47] vs 11.0% [n = 16]) and 90 days (46% [n = 86] vs 24.1% [n = 35]).

CONCLUSIONS: Patients who did not receive buprenorphine had the highest rate of PDD and readmission. Buprenorphine initiation within 24 hours of admission was associated with a lower rate of PDD. Results highlight the importance of the timely initiation of evidence-based medications for opioid use disorder in patients with concurrent alcohol withdrawal, leading to more favorable outcomes for patients and the facility.

PMID:42596730 | DOI:10.1177/29767342261467585