Tag: statistics

J Robot Surg. 2026 Aug 6;20(1):803. doi: 10.1007/s11701-026-03785-9.

ABSTRACT

Hilar lymph nodes with dense adhesion to the bronchus and pulmonary artery (“doornail” nodes) can be encountered unexpectedly during robot-assisted pulmonary resection. We report our experience managing these nodes and associated factors. This retrospective single-center cohort study included 1,185 patients undergoing robot-assisted pulmonary resection (March 2021-September 2024). Preoperative factors were analyzed using Firth penalized logistic regression in a clinically selected model (age, maximal voluntary ventilation [MVV], and tumor diameter). Operative time and blood loss were compared using robust regression models. Perioperative outcomes were compared descriptively between attempted separate dissection and en bloc stapling. Doornail hilar lymph nodes occurred in 48 of 1,185 patients (4.05%; 95% CI, 3.07-5.33%). Older age remained associated with this finding after adjusting for MVV and tumor diameter (adjusted OR per 10 years, 2.316; 95% CI, 1.533-3.596; P<0.001). Operative time was longer unadjusted (105 vs 92 min; P=0.027) but not after adjustment. Among these 48 patients, 45 (93.8%) received en bloc stapling with no blood loss exceeding 200 mL, transfusion, or prespecified in-hospital complication, whereas all 3 (6.3%) who underwent attempted separate dissection had substantial bleeding (700-2,400 mL), and 2 required transfusion. No conversion to thoracotomy occurred. Doornail hilar lymph nodes occurred in about 4% of patients; older age remained associated with this finding after adjusting for MVV and tumor diameter. Because strategy selection was non-random and groups differed in resection extent, comparative safety cannot be established; en bloc stapling after tissue thinning may be feasible when a node cannot be safely separated.

PMID:42560620 | DOI:10.1007/s11701-026-03785-9

Photochem Photobiol Sci. 2026 Aug 6. doi: 10.1007/s43630-026-00962-5. Online ahead of print.

ABSTRACT

BACKGROUND: The Neodymium-doped Yttrium Aluminum Garnet (Nd: YAG) laser is proposed as an adjunct to scaling and root planing (SRP) to enhance bacterial reduction and healing in periodontitis. This study aims to evaluate the efficacy of Nd: YAG laser therapy (1064 nm) compared with SRP alone in improving clinical periodontal outcomes.

METHODS: This systematic review adhered to PRISMA 2020 guidelines and was prospectively registered with PROSPERO. We included only randomized controlled trials (RCTs) comparing SRP with adjunctive Nd: YAG laser therapy to SRP alone in patients with periodontitis. The primary outcomes were pocket depth (PD), plaque index (PI), bleeding on probing (BOP), and clinical attachment loss (CAL) assessments at baseline and after three months. Secondary outcomes included gingival cervical fluid (GCF) at baseline and after three months. Risk-of-bias assessment (using ROB-2) was performed independently by multiple reviewers. All statistical analyses were performed using R (version 4.4.3). The certainty of evidence for all outcomes was evaluated using the GRADE approach.

RESULTS: The systematic review and meta-analysis included 22 randomized controlled trials published between 2010 and 2025, totaling 776 patients. Meta-analysis demonstrated that adjunctive ND: YAG laser with SRP significantly improved PD reduction compared with SRP alone (MD = – 0.46 mm; 95% CI -0.82 to – 0.10; p = 0.0117), Subgroup analysis showed that split-mouth RCTs had a larger effect (MD = – 0.66 mm) than parallel-group RCTs (MD = – 0.20 mm), but the difference between subgroups was not significant. No statistically significant benefits were observed for PI (MD = – 0.03; 95% CI -0.19 to 0.13; p = 0.63), CAL (MD = – 0.04; 95% CI -0.21 to 0.13; p = 0.61), GCF volume (MD = – 0.20; 95% CI -0.45 to 0.06; p = 0.097), or BOP (MD = – 7.88; 95% CI -19.23 to 3.46; p = 0.17).

CONCLUSION: Adjunctive Nd: YAG laser therapy provides a modest, statistically significant benefit in reducing periodontal pocket depth beyond conventional therapy alone. However, it does not demonstrate superior efficacy in improving clinical attachment levels or plaque control. Consequently, while beneficial for pocket reduction, current evidence does not support its routine universal use as a substitute for standard mechanical debridement.

PMID:42560618 | DOI:10.1007/s43630-026-00962-5

Neurosurg Rev. 2026 Aug 6;49(1):517. doi: 10.1007/s10143-026-04439-y.

ABSTRACT

Although enhanced recovery after surgery (ERAS) has demonstrated benefits in various surgical specialties, evidence supporting its application in elective glioma craniotomies remains limited. This study compared the institutional ERAS pathway with conventional perioperative care in adults undergoing elective craniotomy for a single cerebral glioma. This retrospective cohort study (2019-2024) at a Thai university hospital enrolled patients aged ≥ 15 years with histologically confirmed gliomas. Propensity score matching (PSM; 1:1) addressed measured baseline confounding, and inverse probability of treatment weighting (IPTW) served as a sensitivity analysis. The primary outcomes were total hospital length of stay (LOS), intensive care unit (ICU) LOS, and postoperative LOS. Of 153 eligible patients (ERAS, n = 58; conventional, n = 95), PSM yielded 53 matched pairs. The ERAS group had shorter median total (9 vs. 12 days; p = 0.004) and postoperative (7 vs. 9 days; p = 0.037) LOS, with equivalent ICU LOS, hospitalization costs, and complication rates. The results of the IPTW analysis were directionally consistent. In multivariable logistic regression analyses, 2-hour preoperative carbohydrate loading (adjusted odds ratio [95% confidence interval] 5.98 [1.08-33.02], p = 0.040) and early oral fluid intake within postoperative 8 h (5.74 [1.22-26.96], p = 0.027) independently predicted a short postoperative LOS (< 7 days). Thus, ERAS was associated with shorter hospital stay without increased complications. Preoperative carbohydrate loading and early oral fluid intake were independently associated with a short postoperative LOS, identifying them as high-priority targets for a pragmatic, stepwise implementation strategy for ERAS in elective glioma craniotomies. Prospective multicenter studies are required to further optimize this pathway.

PMID:42560602 | DOI:10.1007/s10143-026-04439-y

Matern Child Health J. 2026 Aug 6. doi: 10.1007/s10995-026-04310-y. Online ahead of print.

ABSTRACT

BACKGROUND: Autism spectrum disorder (ASD) is a complex neurodevelopmental condition. Diagnosis is based on developmental history and behavioral observation. Parental age has been identified as a potential risk factor for ASD.

OBJECTIVES: This study aimed to assess the association between maternal age, paternal age, parental education level, smoking history, and ASD risk.

METHODS: This case-control study included 154 individuals with ASD and 335 controls. Demographic, clinical, and familial data were collected through structured questionnaires and interviews. Statistical analysis included descriptive statistics and chi-square tests for categorical variables.

RESULTS AND DISCUSSION: A total of 489 participants were included (154 ASD cases and 335 controls). The ASD group was predominantly male (77%), compared with the control group (68%). Mothers in both groups most commonly held a bachelor’s degree (40%), while fathers showed more variable educational backgrounds. A family history of ASD was significantly more frequent in the ASD group (23%) compared with controls (5.4%), whereas a family history of psychiatric disorders showed no significant difference (15% vs. 11%). NICU admission (11% vs. 2.4%) and preterm delivery (7.3% vs. 1.8%) were more common in the ASD group. In multivariable analysis, paternal age (adjusted OR = 1.08, 95% CI: 1.03-1.14), maternal age (adjusted OR = 1.09, 95% CI: 1.03-1.15), male sex (adjusted OR = 4.13, 95% CI: 2.38-7.16), and family history of ASD (adjusted OR = 2.40, 95% CI: 1.09-5.30) were independently associated with ASD.

CONCLUSIONS: ASD risk was independently associated with parental age, male sex, and family history of ASD, highlighting the role of genetic and demographic factors. Prospective longitudinal studies are needed to further clarify ASD risk trajectories.

PMID:42560598 | DOI:10.1007/s10995-026-04310-y

Environ Monit Assess. 2026 Aug 6;198(9):920. doi: 10.1007/s10661-026-15752-w.

ABSTRACT

This study integrates longitudinal groundwater monitoring, spatiotemporal plume modeling, and deterministic health risk assessments to evaluate petroleum-derived contamination at an urban fuel station on the European side of Istanbul, Turkey. Over a 20-month monitoring period encompassing ten sampling events, the spatiotemporal distribution of benzene, toluene, ethylbenzene, xylenes (BTEX), methyl tert-butyl ether (MTBE), and total petroleum hydrocarbons (TPH) was analyzed using the Groundwater Spatiotemporal Data Analysis Tool (GWSDAT). Results revealed significant subsurface migration governed by the local hydraulic gradient, with maximum concentrations peaking at 79,000 µg/L for MTBE at the facility boundary and 5100 µg/L for benzene. MTBE acted as a high-mobility tracer, forming the leading edge of the dissolved-phase plume and demonstrating active off-site migration vectors into the adjacent unconfined aquifer. To quantify the resulting environmental liabilities, Tier 3 human health risk modeling was conducted using the Risk-Integrated Software for Cleanups (version 5.0) framework for adult and child receptors across ingestion, dermal, and inhalation pathways. The assessment indicated a severe, unacceptable non-carcinogenic threat to pediatric populations, with a cumulative hazard index (HI) reaching 13, driven primarily by the inhalation of indoor vapors volatilizing from the subsurface plume. For adults, the cumulative HI was 3.9, while the excess lifetime cancer risk (ELCR) exceeded the standard regulatory safety threshold of 1 × 10^-6 due to persistent benzene mass flux. Probabilistic sensitivity analysis identified exposure duration and the soil-to-indoor air attenuation factor as the most critical parameter uncertainties. These concrete toxicological metrics demonstrate that natural attenuation alone is insufficient. Consequently, an adaptive remediation framework, utilizing in situ chemical oxidation (ISCO) for the mobile MTBE leading edge and soil vapor extraction (SVE) for the volatile BTEX source, is required, providing quantitative justification for municipal authorities to enforce strict land-use setbacks and mandatory indoor vapor screening.

PMID:42560596 | DOI:10.1007/s10661-026-15752-w

J Neurooncol. 2026 Aug 6;179(1):31. doi: 10.1007/s11060-026-05741-x.

ABSTRACT

PURPOSE: This study aimed to determine where along the surgical care pathway race- and ethnicity-associated differences emerge after primary transsphenoidal surgery (TSS) for Cushing’s disease (CD).

METHODS: Single-center retrospective cohort of 104 adults undergoing primary TSS for pathologically confirmed CD (2013-2024): 44 White non-Hispanic (WnH), 44 Hispanic, and 16 Black. Preoperative phenotype, perioperative complications, biochemical remission, radiographic persistence, and reintervention were compared across groups using unweighted statistics (Kruskal-Wallis, chi-square or Fisher’s exact tests). Sensitivity analysis used inverse probability of treatment weighting (IPTW) with a multinomial propensity model; Black subgroup comparisons were considered exploratory.

RESULTS: Hispanic patients lived closer to the center (p = 0.003) and presented with milder disease. Black patients were younger (p = 0.003), with higher BMI (p = 0.033) and near-uniformly solid tumors (94%; p = 0.040). Postoperative arginine vasopressin deficiency was less frequent in Hispanic than WnH patients (25% vs. 55%; p = 0.005). Durable remission rates were comparable (WnH 79%, Hispanic 81%, Black 88%), though Black patients had higher day-1 cortisol and delayed remission on IPTW sensitivity, higher radiographic persistence (38% vs. 21%), and higher crude reintervention (25% vs. 4.5%; p = 0.036). On exploratory IPTW analysis, Hispanic patients also showed shorter reintervention-free survival despite favorable baseline features (IPTW HR 4.20; p = 0.036), a signal not apparent in unadjusted analysis.

CONCLUSION: Race- and ethnicity-associated differences emerged mainly at baseline presentation and in postoperative trajectory, whereas durable biochemical remission converged across groups; Black subgroup analyses were limited by small sample size and residual imbalance after weighting. These hypothesis-generating findings support postoperative surveillance tailored to where differences emerge rather than to ultimate remission and require validation in larger multicenter cohorts.

PMID:42560567 | DOI:10.1007/s11060-026-05741-x

Environ Monit Assess. 2026 Aug 6;198(9):918. doi: 10.1007/s10661-026-15761-9.

ABSTRACT

Reservoir water quality is critical for drinking water security and sustainable watershed management. Land use and landscape patterns can either enhance or attenuate pollutant transport by altering hydrological connectivity, runoff pathways, and retention capacity. However, these effects remain relatively underexplored across seasons and spatial scales in reservoir watersheds. This study used remote sensing data from 2005, 2010, 2015, and 2020 to assess changes in land use composition, land use intensity, and landscape patterns in the Qiaodian Reservoir watershed, Jinan, China. Furthermore, RDA and PLSR were applied to identify the associations between water quality indicators and variations in land use and landscape patterns based on experimental data. The results showed that from 2005 to 2020, land use change was dominated by grassland loss and landscape pine forest expansion, primarily driven by the conversion of grassland to cultivated land (4.79 km²) and cultivated land to landscape pine forest (3.04 km²). The sub-basin and 100 m buffer scales were identified as key spatial scales affecting water quality. On the sub-basin scale, land use demonstrated its strongest capacity to explain water quality in November. Total Edge (TE), Total Area (TA), Landscape Division Index (DIVISION), and Contagion Index (CONTAG) were identified as important landscape metrics associated with reservoir water-quality variation. These findings provide a scientific basis for targeted land management and reservoir water resource protection.

PMID:42560561 | DOI:10.1007/s10661-026-15761-9

Arch Gynecol Obstet. 2026 Aug 6;313(1):245. doi: 10.1007/s00404-026-08548-3.

NO ABSTRACT

PMID:42560555 | DOI:10.1007/s00404-026-08548-3

J Neurooncol. 2026 Aug 6;179(1):32. doi: 10.1007/s11060-026-05748-4.

ABSTRACT

PURPOSE: Central nervous system solitary fibrous tumors (CNS SFTs) are rare mesenchymal neoplasms. The 2021 World Health Organization (WHO) classification recognizes a single SFT entity characterized by NAB2::STAT6-associated biology. This study evaluated clinicopathologic and immunohistochemical features, with particular emphasis on STAT6, CD34, and p16 expression.

METHODS: We retrospectively reviewed 25 CNS SFTs identified between 2004 and 2024. Clinical, radiologic, histologic, immunohistochemical, treatment, and outcome data were collected. Histologic slides were reviewed by two neuropathologists. Immunohistochemistry for STAT6, CD34, and p16 was performed; molecular testing was unavailable.

RESULTS: The cohort included 13 men and 12 women, with a mean age of 51 years. Among tumors with available site data, most were intracranial. WHO grades were grade 1 in 40%, grade 2 in 24%, and grade 3 in 36%. Nuclear STAT6 expression was present in all cases. CD34 expression was greatest in grade 1 tumors, whereas p16 expression was numerically highest in grade 3 tumors; neither marker showed a statistically significant association with recurrence. Tumor size increased across WHO grades. Outcome analyses were limited by few events and heterogeneous follow-up.

CONCLUSION: CNS SFTs are clinicopathologically heterogeneous. STAT6 was a consistent diagnostic marker in this cohort. CD34 and p16 showed grade-related numerical patterns, but their prognostic value was not established. Larger, molecularly confirmed cohorts with standardized long-term follow-up are required.

PMID:42560553 | DOI:10.1007/s11060-026-05748-4

Environ Monit Assess. 2026 Aug 6;198(9):922. doi: 10.1007/s10661-026-15770-8.

ABSTRACT

Missing values are common in air-quality monitoring records and can distort downstream analyses when reconstruction methods do not match the temporal structure of the data. This study examines whether a lightweight seasonal refinement can improve shape-preserving Stineman interpolation for hourly air-quality series and when that refinement is reliable in practice. To address this question, we propose similarity-weighted seasonal anchor Stineman interpolation (SW-SAST), which preserves a local Stineman anchor while selectively borrowing cross-day information when nearby daily analogues are compatible with the local estimate. The method was evaluated on the UCI Air Quality and Beijing PM 2.5 datasets under MCAR, MAR, and MNAR mechanisms, with missing rates from 10% to 50% across 30 repeated runs per condition. The evaluation includes a univariate LSTM reference baseline, RMSE, MAPE, Pearson’s R, confidence intervals, and contiguous gap-length experiments. SW-SAST slightly improved performance on the UCI dataset, especially under MCAR and MAR, but it did not outperform the original Stineman interpolator on the Beijing dataset. The contribution is therefore not a universal replacement for local interpolation, but a clearer account of when similarity-weighted seasonal borrowing can strengthen or weaken imputation in air-quality monitoring records.

PMID:42560544 | DOI:10.1007/s10661-026-15770-8