Tag: statistics

Sci Rep. 2026 Mar 22. doi: 10.1038/s41598-026-44452-1. Online ahead of print.

ABSTRACT

This study examines how shared leadership (SL) is associated with civil servants’ voice behavior (VB), focusing on indirect pathways via psychological capital (PsyCap) and organizational identification (OI). In a single-wave cross-sectional survey of 440 Chinese civil servants, SL was positively associated with PsyCap and OI. In turn, both factors were associated with higher levels of both promotive voice behavior (PVB) and prohibitive voice behavior (PRVB). Furthermore, SL showed indirect associations with VB through these psychological factors, underscoring the relevance of employees’ psychological resources and OI in leadership-voice relationships. Importantly, these relationships reflect statistical associations rather than direct causal effects. By elucidating how SL relates to VB through these psychological pathways, this study contributes to a more integrated understanding of leadership and voice in organizational research. The findings also offer context-specific implications for leadership development and organizational management in public-sector settings.

PMID:41865174 | DOI:10.1038/s41598-026-44452-1

Sci Rep. 2026 Mar 21. doi: 10.1038/s41598-026-44604-3. Online ahead of print.

ABSTRACT

Comorbid diseases are complex diseases associated with tuberculosis that may affect tuberculosis treatment outcomes and mortality. The impact of comorbid diseases on tuberculosis treatment outcomes and mortality is not well known in Ethiopia. To assess the impact of comorbid diseases and associated factors on tuberculosis treatment outcomes among tuberculosis patients in Southwest Oromia, Ethiopia. A multicenter retrospective cohort study was performed. Information on sociodemographic, clinical conditions, drug-related factors, and treatment outcomes was extracted. The collected data were entered into Epi-Data version 4.6 for data entry and exported to SPSS version 25 (IBM Corp., Armonk, NY, USA) for statistical analysis. Independent t-tests were used for continuous variables and chi-square for categorical variables for comparison of the tuberculosis patients with and without comorbid disease groups. Univariate and multivariate logistic regression were used for outcomes analysis. Statistical significance was determined at a p-value < 0.05 in multivariate logistic regression. Among a total of 1183 tuberculosis patients, females were 825(69.8%), and the mean age of the patients was 40.17 with a standard deviation of ± 16.02. The prevalence of unsuccessful tuberculosis treatment outcomes was 14.29%. Treatment interruption, death, and treatment failure among tuberculosis patients were 1.35%, 7.10%, and 5.83%, respectively. Comorbid diseases were a significant risk factor for unsuccessful tuberculosis treatment outcome (adjusted relative risk (RR) = 3.198, 95% CI 1.755-4.901), P < 0.001). Additionally, age (RR = 1.057, 95% CI 1.036-1.078, p < 0.001), being male (RR = 2.026, 95% CI 1.361-3.016, p = 0.001), living in rural areas (RR = 3.092, 95% CI 2.038-4.691, p < 0.001), and Charlson comorbidity index scores (1, 2, and ≥ 3) were independent predictors of unsuccessful tuberculosis treatment outcome. This study revealed that the prevalence of unsuccessful tuberculosis treatment outcomes was high. Comorbid diseases, Charlson comorbidity index scores (1, 2, and ≥ 3), age, being male, and living in rural areas were predictors for unsuccessful tuberculosis treatment outcome. It is important to implement an integrated management strategy for both tuberculosis and comorbid diseases to reduce the rate of unsuccessful tuberculosis treatment outcomes.

PMID:41865168 | DOI:10.1038/s41598-026-44604-3

Arch Gynecol Obstet. 2026 Mar 21;313(1):139. doi: 10.1007/s00404-026-08359-6.

ABSTRACT

KEY MESSAGE: Compared with conventional locked double-layer closure, an unlocked double-layer, endometrium-sparing closure was associated with lower isthmocele prevalence, greater residual myometrial thickness, and fewer postcesarean symptoms. If these findings are confirmed in prospective studies, adopting this closure approach could help to reduce morbidity related to the niche in routine cesarean practice.

BACKGROUND: Isthmocele, a cesarean scar defect associated with abnormal bleeding, pelvic pain, and diminished fertility, is becoming more well known as a result of the increasing prevalence of cesarean sections. Although the optimal closure technique is still a topic of debate, it is regarded as the most modifiable factor in the prevention of isthmocele.

OBJECTIVE: To compare the effects of the traditional locked double-layer uterine closure technique with the new unlocked double-layer, endometrium-protective technique on isthmocele incidence, residual myometrial thickness (RMT), and post-CS symptoms.

METHODS: From March 2023 to January 2025, a total of 180 women (97 conventional and 83 novel) who underwent low-segment cesarean sections at a tertiary care center were included in a retrospective comparative cohort study. At 12-24 weeks postpartum, residual myometrial thickness (RMT) and isthmocele presence were evaluated using saline-infusion sonohysterography. Independent predictors of RMT and isthmocele were identified through binary logistic and multiple linear regression analyses.

RESULTS: The new method was linked to less need for additional hemostatic sutures (2.4% vs. 11.3%; OR = 5.18), as well as a shorter operating time (26 vs. 33 min, p = 0.001). Compared with the new lockless double-layer technique, traditional locked double-layer closure was associated with a significantly higher risk of isthmocele (39.2% vs. 7.2%; OR = 8.27, 95%CI 3.28-20.85; p = 0.001). Additionally, the mean RMT was greater (13.91 vs. 10.18 mm, p = 0.001). While linear regression connected the novel technique and higher parity to greater RMT and preoperative anemia to decreased healing, logistic regression found that suture technique was the only independent predictor of isthmocele. The novel group had significantly lower rates of postmenstrual spotting, dysmenorrhea, and chronic pelvic pain (p = 0.001 for all).

CONCLUSIONS: Compared to the traditional locking technique, the locking, double-layer, endometrium-sparing uterine closure method, in which the first layer of the uterine incision is continuously sutured without locking and the second layer is reinforced with a continuous ‘U’-shaped suture, results in a statistically significant reduction in isthmocele formation, increased residual myometrial thickness, shorter operative time, and fewer niche-related symptoms. This method appears to improve short-term uterine healing and niche-related symptoms; however, its impact on future reproductive and obstetric outcomes remains unknown and requires prospective validation. However, multicenter studies with extended follow-up periods are warranted to confirm these findings.

PMID:41865166 | DOI:10.1007/s00404-026-08359-6

Ann Biomed Eng. 2026 Mar 21. doi: 10.1007/s10439-026-04089-7. Online ahead of print.

ABSTRACT

PURPOSE: This study evaluated tibiofemoral loading and medial meniscal stress distribution in individuals with flexible flatfoot (FFF) during walking under different foot progression angle (FPA) conditions.

METHODS: This study analyzed the gait of 28 FFF patients (16 males, 12 females) under three FPA conditions (neutral, toe-in, toe-out). Kinematic (Vicon) and kinetic (Kistler) data were used to estimate tibiofemoral forces in OpenSim. Subsequently, joint angles and muscle forces at peak tibiofemoral forces were used to drive a finite element (FE) model of the knee, enabling the comparison of meniscal von Mises stress, maximum shear stress, and contact pressure across FPA conditions.

RESULTS: Tibiofemoral force increased during early stance (9-11%) in the toe-in condition with this increase reaching statistical significance in males (p = 0.008, mean partial ${\eta }^2=0.70$ within the SPM-identified cluster). FE analysis showed that peak stresses and contact pressure were primarily localized in the anterior region of the medial meniscus. A consistent directional response to FPA was observed with the lowest peak values occurring in the toe-in condition and the highest values in the toe-out condition.

CONCLUSION: Adjusting FPA modulates intra-articular knee loading via the kinetic chain. For FFF patients, neutral FPA provides stable loading. The toe-in condition presents a complex mechanism: despite increasing tibiofemoral force (notably in males), it reduces peak stress by altering contact mechanics and stress distribution. Therefore, FFF gait interventions must be individualized based on factors like foot morphology, sex, and functional goals.

PMID:41865148 | DOI:10.1007/s10439-026-04089-7

Patient. 2026 Mar 21. doi: 10.1007/s40271-026-00806-5. Online ahead of print.

ABSTRACT

BACKGROUND: Cystic fibrosis (CF) is a progressive and multi-organ genetic condition most renowned for reduced lung function. The recent introduction of elexacaftor/tezacaftor/ivacaftor (ETI) has transformed physical health and life expectancy for many people with CF.

OBJECTIVES: This mixed methods study aimed to compare levels of physical health and self-concept before and after ETI commencement and explore lived experiences of ETI impact on self-concept: an individual’s overarching sense of identity.

METHODS: This study applied a mixed methods approach, using qualitative data to enrich and augment the insights gained by the quantitative data. Longitudinal quantitative data were collected from 20 adults to compare mean lung function, frequency of pulmonary exacerbations, body mass index (BMI), and self-concept scores before and after ETI commencement. Qualitative data were collected from 13 of these adults through in-depth, unstructured interviews, which were thematically analysed to identify key insights.

RESULTS: Descriptive and comparison statistical analysis demonstrated a significant increase in mean lung function and a significant decrease in mean frequency of pulmonary exacerbations following ETI commencement. No significant difference in BMI was identified. While mean self-concept scores before and after ETI commencement were not significantly different, thematic analysis of interview data highlighted that many participants had experienced self-concept recalibration across physical, social, and psychological domains of life related to ETI. The overarching theme of Self-concept recalibration and six subsequent themes emerged: Physical self: A ‘new’ CF and Weight gain – friend or foe; Social self: The gift of time and Goals and possibilities; and Psychological self: from Surviving to thriving and Into the unknown.

CONCLUSIONS: Findings highlight significant physical health improvement for many people with CF, and the potential for ETI to positively impact self-concept. However, challenges and nuanced self-concept experiences were also identified.

PRACTICE IMPLICATIONS: Integration of a self-concept approach to CF care is recommended.

PMID:41865142 | DOI:10.1007/s40271-026-00806-5

Sci Rep. 2026 Mar 22. doi: 10.1038/s41598-026-45385-5. Online ahead of print.

NO ABSTRACT

PMID:41865131 | DOI:10.1038/s41598-026-45385-5

Skeletal Radiol. 2026 Mar 22. doi: 10.1007/s00256-026-05199-y. Online ahead of print.

ABSTRACT

OBJECTIVES: The purpose of this study was to evaluate the effectiveness of collagen-sensitive dual-energy computed tomography (DECT) as a quantitative imaging tool for the assessment and monitoring of load-induced tendinopathy in the Achilles and patellar tendons, comparing it to magnetic resonance imaging (MRI).

METHODS: In a prospective study, 15 consecutive patients clinically diagnosed with Achilles or patellar tendinopathy underwent bilateral DECT and MRI at baseline and 6 months. Quantitative measurements included collagen density assessed via DECT and signal intensity via MRI. Clinical symptoms were evaluated using numerical pain ratings and VISA-A/P scores. The diagnostic accuracy of both imaging modalities was assessed using ROC analysis, and correlations between DECT and MRI findings were investigated.

RESULTS: DECT revealed significantly lower collagen densities on corresponding maps in affected tendons (n = 18, 23.7 ± 20.2) compared to unaffected tendons (n = 12, 60.2 ± 29.6 HU, p < 0.001), whereas MRI demonstrated increased signal intensities in pathological regions. ROC analysis indicated comparable diagnostic performance for DECT (AUC = 0.84) and MRI (AUC = 0.80). A strong inverse correlation (r = -0.83) was observed between DECT-measured collagen densities and MRI signal intensities. Clinical improvements at follow-up were reflected by normalization trends in both imaging modalities, though not statistically significant.

CONCLUSIONS: Collagen-sensitive DECT provides a reliable quantitative approach for detecting and assessing tendon pathologies in load-induced tendinopathy, demonstrating diagnostic capabilities comparable to MRI while offering the possibility for collagen density quantification.

PMID:41865099 | DOI:10.1007/s00256-026-05199-y

Sci Rep. 2026 Mar 21. doi: 10.1038/s41598-026-44603-4. Online ahead of print.

ABSTRACT

With the increasing availability of multimodal remote sensing (RS) data, semantic segmentation that leverages complementary information from true orthophotos (TOP) and digital surface models (DSM) has become essential for urban analysis. Diffusion-based segmentation provides an effective iterative refinement mechanism for modeling complex multimodal distributions; however, conventional pixel-wise supervision emphasizes local accuracy while overlooking global distribution alignment, often leading to inconsistent predictions and blurred object boundaries. Although maximum mean discrepancy (MMD) measures global statistical differences between predicted and ground-truth distributions, its effectiveness in high-dimensional class-probability spaces is limited by directional cancellation effects that reduce sensitivity to complex distribution shifts. To address this issue, we propose a projection-kernel regularized diffusion-based multimodal RS segmentation framework that enforces global statistical alignment through distribution-level regularization rather than modifying the intrinsic diffusion process. The proposed regularization performs multi-directional projections of high-dimensional class-probability vectors onto one-dimensional subspaces and derives a closed-form kernel integration to avoid numerical sampling across projection directions, enabling efficient and stable global distribution matching. In addition, a Cross-Attention Dual-Encoder Fusion (CADEF) module is introduced to alleviate geometry-texture misalignment, and a Hierarchical EMA-Gated Recursive Denoising (HERD) mechanism is designed to stabilize multiscale feature refinement. Experiments on the ISPRS Vaihingen and Potsdam benchmarks demonstrate that the proposed regularization consistently improves segmentation accuracy over state-of-the-art CNN-, Transformer-, and diffusion-based baselines, yielding enhanced global consistency and sharper boundary delineation. Code is available at: https://github.com/tonyy127/PKDiff.

PMID:41865080 | DOI:10.1038/s41598-026-44603-4

Commun Chem. 2026 Mar 21. doi: 10.1038/s42004-026-01974-z. Online ahead of print.

ABSTRACT

Intrinsically disordered protein regions (IDRs) play a key role in the formation of biomolecular condensates, a ubiquitous mode of cellular compartmentalization, but the underlying microscopic details remain unclear. Here, microsecond-level molecular dynamics simulations and fractal formalism are employed to study at atomistic resolution a model dense phase composed of 24 copies of a C-terminal 73-residue arginine- and glycine-rich IDR (RGG3) of fused in sarcoma (FUS) protein in the absence of RNA. RGG3 displays a highly dynamic behavior in the dense phase with only a small configurational entropy loss and a minor slowdown in diffusion as compared to the dilute phase. Despite rapid mixing, short contact residence times and structurally heterogenous binding interfaces in the dense phase, RGG3 exhibits a distinct dynamic binding mode, with statistically defined interaction motifs and a robust multi-scale topology of self-associated protein clusters. An analysis of bound water suggests that solvent entropy may significantly contribute to the thermodynamics of condensate formation. Our results demonstrate how a well-defined organization of the disordered protein dense phase across scales emerges from highly heterogenous, transient interactions at the molecular level.

PMID:41865079 | DOI:10.1038/s42004-026-01974-z

Sci Rep. 2026 Mar 21. doi: 10.1038/s41598-026-44888-5. Online ahead of print.

ABSTRACT

This study investigates the nonlinear fractional-order Pochhammer-Chree equation, featuring a power-law nonlinearity of order τ, a model that describes how nonlinear longitudinal waves travel in elastic materials with memory of prior deformations. Understanding nonlinear wave propagation in elastic materials with memory effects is important for accurately modeling complex physical phenomena in nonlinear elasticity, geophysics, and material science. To incorporate these memory effects, conformable fractional derivative is utilized that allowing us to examine the fractional-order spatial and temporal changes. Kumar-Malik method is used to extract analytical solutions like bright soliton, dark soliton, kink soliton and solitary wave forms, that demonstrates the dynamics of the model. To better understand these solutions behaviours, visual analysis is considered. In this analysis mathematica 14.2 is used to construct the two-dimensional, three-dimensional, and contour plots, which illustrate the influence of the fractional parameter χ on the waveforms. The shape, width and amplitude of the solitons also vary with the change in the value of the parameter, χ. These diagrams are able to make it clear how the system would respond to various physical situations. These findings indicate the efficiency of the Kumar-Malik method which guarantees accurate solutions of the fractional Pochhammer-Chree equation having power laws nonlinearity. The work enhances the theoretical knowledge on the nonlinear waves of the fractional-order systems and brings forth new uses in the field of mathematical physics and nonlinear elasticity.

PMID:41865072 | DOI:10.1038/s41598-026-44888-5