Tag: statistics

JMIR AI. 2026 Apr 17;5:e80173. doi: 10.2196/80173.

ABSTRACT

BACKGROUND: Artificial intelligence (AI) can enhance diagnostic accuracy, efficiency, and decision-making in health care, but real-world impact depends on practitioners’ acceptance and readiness to use AI in clinical workflows. The United Arab Emirates offers a policy-driven context to study these factors, given active national AI strategies and rapid health system digitization.

OBJECTIVE: This study aimed to develop and validate a model explaining how trust, perceptions, perceived risk, and perceived benefit shape practitioners’ acceptance of AI and, in turn, their readiness to implement AI in clinical practice. The model integrates the Technology Acceptance Model, the Unified Theory of Acceptance and Use of Technology, and the Theory of Trust and Acceptance of Artificial Intelligence Technology.

METHODS: We conducted a cross-sectional online survey of 182 United Arab Emirates-based health care practitioners (physicians, nurses, dentists, and allied health staff). Constructs included trust, perception, perceived risk, perceived benefit, acceptance, and readiness. Knowledge of AI was also assessed using true or false statements. We performed confirmatory factor analysis and structural equation modeling, reporting standard fit indices. The survey adhered to the Checklist for Reporting Results of Internet E-Surveys guidelines, and ethics approval and electronic consent were obtained.

RESULTS: Trust was positively associated with perception (β=.704; P<.001) and perceived benefit (β=.191; P=.02) and negatively associated with perceived risk (β=-.301; P<.001). Acceptance was positively associated with trust (β=.452; P<.001), perception (β=.459; P<.001), and perceived benefit (β=.168; P=.002), and negatively associated with perceived risk (β=-.140; P=.009). Acceptance strongly predicted readiness (β=.874; P<.001). The model fit indices are standardized root-mean-square residual of 0.068, root-mean-square error of approximation of 0.0913, goodness-of-fit index of 0.802, adjusted goodness-of-fit index of 0.763, and comparative fit index of 0.906. Our knowledge assessment found notable gaps among participants, underscoring a need for education and training. Our study sample was predominantly drawn from Dubai-based health care settings (103/182, 57%) and nursing roles (71/182, 39%); therefore, these findings primarily reflect the Dubai health regulatory environment and nursing workflows and may not generalize to the broader federal health care system across all Emirates.

CONCLUSIONS: Trust is a central lever for advancing AI acceptance and implementation readiness among the study cohort of United Arab Emirates-based health care practitioners. Implementation programs should prioritize building institutional and technical trust (transparency, safety, and governance), reducing perceived risk (privacy, security, and reliability), and amplifying perceived benefits through hands-on demonstrations and workflow-aligned use cases. Targeted training to close knowledge gaps should accompany policy and organizational measures aligned with national AI strategies to accelerate responsible, clinician-in-the-loop adoption.

PMID:42012070 | DOI:10.2196/80173

Math Med Biol. 2026 Apr 21:dqag004. doi: 10.1093/imammb/dqag004. Online ahead of print.

ABSTRACT

An impulsive differential equation model of cancer treatment by radiation therapy (RT) is studied. Analytical results for the model’s persistence and eradication of cancer cell volumes are obtained to illuminate the dynamics between tumor growth and RT. It is also shown that, although periodic solutions may exist, they are necessarily unstable. A modified model is then proposed, assuming that RT is more effective than the first model assumes. In addition to similar results as for the original model, conditions are obtained under which periodic solution exists and is globally stable, showing the possibility that regression can occur in periodicity. Numerical simulations are provided to confirm the results.

PMID:42012065 | DOI:10.1093/imammb/dqag004

Acta Orthop Belg. 2026 Apr 20;92(1). doi: 10.52628/92.1.15163.

ABSTRACT

The use of surgical navigation using holograms provided by mixed reality glasses is already a reality in other fields of orthopaedics as the shoulder or knee. Due to this, this study aimed to develop and evaluate a mixed reality-based system for navigation in derotational radius osteotomies, focusing on its accuracy and reproducibility. To this end, a holographic computing software based on C++ language and code integrable in MRTK 2 (Microsoft, Redmond, USA) was generated to be implemented in Microsoft Hololens 2. Using the 3D Builder software, positioners and trackers, recognisable by mixed reality glasses, were designed and patented, allowing us to know the changes in spatial relationship between two trackers. A total of 41 radius biomodels were used. A hand surgery consultant and an orthopaedics resident each performed ten rotational osteotomies using freehand technique and ten with the navigation system. Afterwards, a CT scan was performed, measuring the variation achieved. The error was defined as the difference between the planned and obtained orientation in both techniques and analyzed statistically. Under these conditions, the median error of the navigated system was 1º [0-2.25°], compared to 11º [7-19.5°] with the freehand technique (p<0.05). Error did not significantly increase with greater osteotomy magnitudes. The navigated system demonstrated higher accuracy and reproducibility. No significant inter-surgeon differences were observed in either technique. In conclusion, surgical navigation based on holographic computerization improves the accuracy of radius rotational osteotomies. Due to its reproducibility and simplicity, it represents a potential technique for future surgical navigation.

PMID:42012047 | DOI:10.52628/92.1.15163

Acta Orthop Belg. 2026 Apr 20;92(1). doi: 10.52628/92.1.14713.

ABSTRACT

This meta-analysis study was conducted to evaluate the effect of education-based interventions on the development of deep vein thrombosis (DVT) in patients undergoing orthopedic surgery. In this study, the terms “deep vein thrombosis,” “orthopedic surgery,” and “patient education” were searched in Turkish and English in the relevant literature published in the last 20 years in the Web of Science, PubMed, ScienceDirect, Scopus, and Google Scholar databases. A total of 8021 studies were found as a result of the search. Six studies that met the inclusion criteria were reviewed. In the meta-analysis, the Odds Ratio (OR) was calculated as the effect size, and Cochran’s Q test and I² statistic were used for heterogeneity analysis. Publication bias was assessed using funnel plots and Egger regression tests. The meta-analysis found that the risk of developing DVT was significantly lower in groups that received educational interventions compared to control groups (OR ≈ 0.50, 95% CI: 0.37-0.69, p <0.001). Educational interventions have been effective through mechanisms such as encouraging early mobilization, increasing compliance with anticoagulant medication use, and raising awareness about DVT symptoms (p <0.05). In orthopedic surgery patients, education-based interventions applied in conjunction with pharmacological and mechanical methods are effective in preventing DVT. Systematic integration of patient education programs into clinical practice will contribute significantly to improving patient safety and reducing postoperative complications. Future studies should focus on the integration of digital health technologies and the evaluation of long-term effects. The study has been registered with PROSPERO (CRD420251047966).

PMID:42012043 | DOI:10.52628/92.1.14713

Acta Orthop Belg. 2026 Apr 20;92(1). doi: 10.52628/92.1.15273.

ABSTRACT

PURPOSE: This study aimed to validate potential clinical and radiological features for distinguishing enchondromas from atypical cartilaginous tumours (ACT) and to analyse the association between maximum tumour diameter and local recurrence of enchondromas. It is important to note that this research serves as a validation cohort rather than proposing a new diagnostic framework.

MATERIALS AND METHODS: This retrospective study reviewed the clinical data of 50 patients pathologically diagnosed with enchondroma or ACT and treated in our center between 1 January 2015 and 1 June 2024. Imaging characteristics, recurrence outcomes and other variables were compared among patients, and chi-square tests were used to assess the influence of maximum tumour diameter and other relevant factors on the recurrence rate. This study has been approved by the ethics committee of our institution.

RESULTS: Patients with a maximum tumor diameter ≥ 5 cm exhibited a higher recurrence risk (recurrence 8 % vs. non-recurrence 0 %, P = 0.01, P < 0.05). This difference is statistically significant and may aid in distinguishing enchondroma from ACT. Moreover, all recurrent cases exhibited cortical bone destruction, which further validates the importance of this imaging feature as a key differentiating point. The primary treatment consisted of curettage combined with bone grafting, yielding an overall favorable prognosis.

DISCUSSION: A maximum tumor diameter of ≥5 cm and cortical bone destruction can be considered important predictive factors for local recurrence, and they may also assist in differentiating between atypical cartilaginous tumors (ACTs) and enchondromas. Based on our findings, we are more inclined to consider lesions ≥5 cm as ACTs, particularly when accompanied by cortical destruction, as these features suggest a more aggressive biological behavior. Therefore, we recommend performing extended curettage combined with intraoperative electrocautery or other effective local adjuvant techniques in such cases to achieve adequate tumor control and reduce the risk of recurrence.

PMID:42012039 | DOI:10.52628/92.1.15273

Acta Orthop Belg. 2026 Apr 20;92(1). doi: 10.52628/92.1.15247.

ABSTRACT

This study aimed to evaluate the feasibility of proximal femoral nailing (PFN) in the lateral decubitus position using a standardized, limb-based approach without a traction table and to report early postoperative (24-72 hours) radiographic and technical outcomes, focusing on lag screw position and tip- apex distance (TAD). This single-center retrospective study included 52 adult patients (>18 years) who underwent PFN in the lateral decubitus position according to a standardized algorithm between January 2021 and December 2024. Demographic characteristics, fracture classification, operative parameters, early postoperative (24-72 hours) radiographic measurements (TAD and Cleveland-Bosworth quadrant position), and postoperative complications recorded during available follow-up were collected. Evans and Boyd-Griffin classifications were used for fracture typing. Statistical analyses evaluated the association between fracture stability and operative duration; analyses involving cut-out were interpreted descriptively due to the low event count. The mean age was 70.5 ± 13.4 years, and 59.6% of patients were male. According to the Evans classification, 69.2% of fractures were stable, 23.1% were unstable, and 7.7% were reverse oblique. The mean operative preparation time was 10.4 ± 1.8 minutes, and the mean operative duration was 43.6 ± 7.9 minutes; operative duration was longer in unstable fractures (p < 0.001). According to the Cleveland-Bosworth system, 73.1% of lag screws were positioned central- central, and no screws were placed in the superior-posterior quadrant. The mean TAD was 17.7 mm, and 96.2% of patients had TAD < 25 mm. Cut-out occurred in two patients (3.8%) and was observed among patients with higher TAD values; this observation was considered exploratory. We present a novel standardized, limb-based lateral decubitus PFN algorithm without a traction table. The approach yielded reproducible early postoperative radiographic parameters (24-72 hours), including acceptable TAD values and favorable Cleveland-Bosworth screw placement.

PMID:42012036 | DOI:10.52628/92.1.15247

Acta Orthop Belg. 2026 Apr 20;92(1). doi: 10.52628/92.1.15100.

ABSTRACT

While the relationship between radial head fractures (RHF) and coronoid process fractures (CPF) is biomechanically established, the exact frequency of CPF in RHF patients without focus on elbow dislocations is underexplored. To better estimate the likelihood of CPF, the analysis of typical fracture constellations is useful. The aim of this study was therefore to analyze the correlation between RHF severity and the presence and type of CPF. This retrospective study analyzed 356 RHF patients, evaluating the prevalence and correlation of CPF using CT and intraoperative data. Only cases with confirmed presence or absence of CPF based on CT imaging or surgical reports were included. CPF were classified according to O’Driscoll (OD) and correlated with the severity of the RHF according to Mason (MA). Descriptive statistics and correlation using Spearman correlation were performed. CPF was observed in 42.1 % of RHF patients. 51.3 % of CPF were OD Type 1, 26% Type 2 and 10.7% Type 3. The correlation between RHF severity and CPF presence was statistically significant but weak (Spearman r = 0.19). In this study cohort, a high proportion of additional CPF were found in the presence of RHF. Although the correlation was weak, increasing RHF severity was associated with a higher likelihood of CPF. These findings emphasize that in cases of RHF, the CP should be critically examined and CT imaging should be considered in unclear cases.

PMID:42012035 | DOI:10.52628/92.1.15100

Acta Orthop Belg. 2026 Apr 20;92(1). doi: 10.52628/92.1.15335.

ABSTRACT

We have not identified any research in the literature that explores the severity of knee osteoarthritis in relation to the type of hip fracture. In our study, we examined the severity of knee osteoarthritis in patients with hip fractures affecting the intertrochanteric (Group 1) and femoral neck region (Group 2). In our study, patients over 50 years of age were analyzed and Kellgren-Lawrence classification was applied to bilateral knee radiographs. The correlation between the severity of knee osteoarthritis and the classification of hip fractures was analyzed, and subgroups were compared. The stages of knee osteoarthritis in Group 1 and Group 2; the stage of knee osteoarthritis on the hip fracture side and the healthy side were compared both between groups and within groups. 109 patients were evaluated in Group 1 and 74 patients in Group 2. The knee osteoarthritis grade of Group 1 patients was significantly more severe on both the fractured side (3.44 ± 0.81) and the healthy side (3.17 ± 0.91) in comparison to the fractured side (2.89 ± 1.00) (p<0.01) and the healthy side (2.88 ± 0.82) (p=0.032) of Group 2 patients. In Group 1, the severity of knee osteoarthritis on the fractured side was statistically substantially greater than on the healthy side (p<0.01). In Group 2, the comparison of knee osteoarthritis severity between the fractured and healthy sides revealed no statistically significant difference (p=0.849). Severe knee osteoarthritis was associated with a higher proportion of intertrochanteric hip fractures. Also, the hip on the same side as the knee with more advanced osteoarthritis is more likely to fracture.

PMID:42012032 | DOI:10.52628/92.1.15335

Acta Orthop Belg. 2026 Apr 9;92(1). doi: 10.52628/92.1.12938.

ABSTRACT

Although there have been improvements in surgical fixation techniques, the process of fracture healing continues to pose challenges, especially for patients with additional health issues. Low-intensity pulsed ultrasound (LIPUS) has been proposed as a non-invasive method to facilitate faster bone recovery; however, its effectiveness in clinical settings remains unclear. This study aimed to assess the impact of LIPUS on the healing of lower limb fractures. A double-blinded, prospective, randomised controlled trial was conducted in two hospitals in Gauteng, South Africa. The study was approved by the University of the Witwatersrand (M150236). Ninety-four individuals aged 18 years and older with lower limb fractures were consecutively recruited and randomly assigned to either the LIPUS or control group. The intervention group underwent 20-minute LIPUS sessions every alternate day for a duration of 20 days during their hospitalisation, followed by follow-up after discharge. Callus formation, cortical bridging, fracture gap, and overall radiographic healing were evaluated at 6, 12, and 18 weeks. An intention-to- treat analysis was performed to accommodate missing radiographs and loss to follow-up. No statistically significant differences were found between the intervention and control groups concerning callus formation, cortical bridging, fracture gap, or overall healing at any assessment time. A high rate of loss to follow-up and unavailability of radiographs diminished the analysis’s power. LIPUS did not show a notable improvement in fracture healing when compared to standard care. Its clinical use may need to be reevaluated, especially in low- and middle-income countries, where cost-effectiveness is a crucial factor.

PMID:42012031 | DOI:10.52628/92.1.12938

Chem Biodivers. 2026 Apr;23(4):e03832. doi: 10.1002/cbdv.202503832.

ABSTRACT

This study investigates the chemical composition and bioactivity of essential oils (EOs) extracted from leaves and cones of Cupressus sempervirens L., collected from six different geographic zones in Algeria. Antioxidant potential was assessed via DPPH and β-carotene bleaching (BCB) assays, while antifungal activity was tested against Fusarium culmorum (BTCR) and Fusarium oxysporum f. sp. albedinis (Foa). Steppe-derived EOs showed superior bioactivity than Saharan derived EOs. The leaves EOs from Ain Maabed (Djelfa) exhibited the highest antioxidant capacity (2.322 ± 0.21 mg VE/g EO), and the leaves EOs from Gtaya demonstrated the strongest antifungal effect (1.274 ± 0.03 g H/mL EO). Statistical analysis identified limonene and umbellulone as key contributors to these effects. Findings highlight the potent antifungal properties of C. sempervirens leaf EOs, supporting their potential as eco-friendly alternatives to synthetic fungicides in plant disease management.

PMID:42012026 | DOI:10.1002/cbdv.202503832