Tag: statistics

Arthroplast Today. 2026 Jun 18;40:102068. doi: 10.1016/j.artd.2026.102068. eCollection 2026 Aug.

ABSTRACT

BACKGROUND: Preoperative anemia is a risk factor for adverse outcomes following total hip arthroplasty (THA), disproportionately affecting females and contributing to morbidity. While both anemia and sex are independently linked to postoperative complications, few studies have examined outcomes within anemic patients stratified by sex. This study compared 90-day postoperative complication rates between anemic male and anemic female patients undergoing primary THA.

METHODS: A retrospective cohort analysis was performed with a final matched analytic cohort of 45,788 anemic adults undergoing primary THA. Anemia was defined by the World Health Organization sex-based hemoglobin thresholds. Anemic male and anemic female patients were matched 1:1 using propensity scores based on demographics, comorbidities, and risk factors. Ninety-day postoperative complications were assessed using International Classification of Diseases, Tenth Revision and Current Procedural Terminology codes. Statistical comparisons included odds ratios, Kaplan-Meier survival analysis, and Cox proportional hazards models.

RESULTS: The matched sex-based comparison revealed distinct complication profiles. Anemic females experienced higher rates of readmission, wound dehiscence, urinary tract infections, and transfusions. Anemic males had higher incidences of deep vein thrombosis and acute kidney injury. Complications such as sepsis, pneumonia, prosthetic joint infection, and mortality did not differ significantly by sex, contrasting with literature on unstratified populations.

CONCLUSIONS: Within anemic THA patients, postoperative complication patterns differed meaningfully by sex, supporting the need for sex-informed perioperative risk assessment. Current hemoglobin thresholds and perioperative risk models may insufficiently account for physiological and clinical sex differences. Further study is needed to determine whether sex-specific preoperative optimization strategies can improve outcomes.

PMID:42376632 | PMC:PMC13311186 | DOI:10.1016/j.artd.2026.102068

Arthroplast Today. 2026 Jun 19;40:102064. doi: 10.1016/j.artd.2026.102064. eCollection 2026 Aug.

ABSTRACT

BACKGROUND: Technology-assisted total knee arthroplasty (TA-TKA), including computer navigation and robotic assistance, has been developed to improve implant alignment and soft tissue balance. While utilization has increased, evidence regarding clinical benefit remains mixed. This study evaluated national and regional utilization trends of TA-TKA and compared postoperative complication rates with manual TKA (M-TKA).

METHODS: Patients undergoing primary TKA between January 1, 2020, and December 31, 2024, were identified in the TriNetX United States Collaborative Network. Patient demographics, hospital characteristics, and postoperative complications were obtained. Cohorts were 1:1 propensity score matched for sex, body mass index, and comorbidities. Surgical complications were compared at 0-30 days, 31-90 days, and 91 days-3 years between M-TKA and TA-TKA cohorts. In addition, subanalysis was conducted comparing 3-year surgical complication rates between TA-TKA and M-TKA, stratified by region.

RESULTS: Of 198,263 TKA patients, 147,156 underwent M-TKA and 39,624 underwent TA-TKA. TA-TKA utilization increased by 375%, from 11.9% in 2020 to 27.0% in 2024 (P < .0001). After matching, TA-TKA was associated with lower risks of periprosthetic fracture, deep infection, revision surgery, and aseptic loosening (all P ≤ .031). Across all regions, statistically significant findings demonstrated decreased risk of surgical complications at 3 years associated with TA-TKA when compared to M-TKA (P < .001).

CONCLUSIONS: TA-TKA utilization has more than doubled in recent years, though adoption remains variable across regions and institutions. Compared with M-TKA, TA-TKA was associated with significantly lower surgical complication rates through 3 years of follow-up. These findings support continued adoption of TA-TKA and highlight the need for further research on long-term outcomes and cost-effectiveness.

PMID:42376631 | PMC:PMC13312537 | DOI:10.1016/j.artd.2026.102064

Open Res Afr. 2026 May 29;9:30. doi: 10.12688/openresafrica.16627.1. eCollection 2026.

ABSTRACT

INTRODUCTION: Malaria remains a major public health issue in sub-Saharan Africa, especially in Mali. Despite the promising prospects of genetically modified mosquitoes (GMMs), their use raises several concerns. Community engagement is essential to the success of this tool. We assessed the Malian population’s knowledge and perception of the risks associated with this technology.

METHODS: The study was conducted in rural areas in the Koulikoro region and Bamako (urban). The survey included 874 heads of household. The statistical analysis was done on R 4.3.0. Univariable and multivariable logistic regression were performed to identify key factors associated with the risk perceptions of GMMs. The study was approved by the ethics committee of the University of Sciences, Techniques, and Technologies of Bamako. Written informed consent was obtained from each participant.

RESULTS: The median age was 42 years (IQR: 33, 54), and 20.0% had no formal education. Only 18.2% (159/874) had previously heard information about GMMs, mainly by health workers (61.6%) and radio broadcasts (20.8%). The overall rate of risk perception regarding GMMs was 47.7% (417/874), with the most cited concern being the transmission of unknown diseases (95.9%). A high level of education was positively associated with higher risk perception. As well as being unaware of GMMs, doubts about the efficacy and safety of GMMs. The acceptability rate of GMMs was 77%, conditional on assurances that technology would not cause harmful effects and would first be tested in a controlled, restricted environment before being deployed on a large scale.

CONCLUSION: Robust community engagement is essential for both research and real-world implementation of GMMs. A Thorough understanding of the conditions related to acceptance of this technology offers a strategic pathway for researchers and policymakers to design GMM that is socially responsive and contextually appropriate.

PMID:42376620 | PMC:PMC13310356 | DOI:10.12688/openresafrica.16627.1

Vet Anim Sci. 2026 Jun 9;34:100732. doi: 10.1016/j.vas.2026.100732. eCollection 2026 Dec.

ABSTRACT

Phytogenics are emerging as an alternative approach to maintain animal health and productivity without using antibiotics in the livestock industry. This study investigated the function and mechanism of a phytogenic formulation composed of Bidens pilosa extract and bentonite (BPB) on diarrhea, gut microbiota and growth performance in calves. Twenty-six 15-day-old Holstein Friesian calves were fed control or 0.5% BPB diets for 4 weeks. Their diarrhea, gut microbiota, fecal IgA, and bacterial growth were analyzed using culture-based methods, 16S rRNA sequencing, and statistical analyses. BPB (0.5%) significantly reduced diarrhea, fecal scores, and fecal IgA levels, but increased body weight in calves. Furthermore, metagenomic analysis and selective agar assays indicated that 0.5% BPB decreased three bacterial genera, Campylobacter, Clostridium_sensu_stricto_1, and Escherichia/Shigella, but increased seven other bacterial genera, including Lactobacillus, Ruminococcus, and Bacteroides, in the feces of calves. Mechanistic studies suggested that BPB augmented the proliferation of bacteria associated with beneficial effects, subsequently inhibiting the growth of bacteria associated with harmful effects in the intestines of calves. In conclusion, BPB mitigated diarrhea and gut inflammation and increased body weight gain in calves by modulating the gut microbiota. This modulation involved the upregulation of bacteria with beneficial potential that antagonize the growth of bacteria with pathogenic potential.

PMID:42376617 | PMC:PMC13311206 | DOI:10.1016/j.vas.2026.100732

Proc Mach Learn Res. 2025 Jul;267:72505-72534.

ABSTRACT

Collecting gold-standard phenotype data via manual extraction is typically labor-intensive and slow, whereas automated computational phenotypes (ACPs) offer a systematic and much faster alternative. However, simply replacing the gold-standard with ACPs, without acknowledging their differences, could lead to biased results and misleading conclusions. Motivated by the complexity of incorporating ACPs while maintaining the validity of downstream analyses, in this paper, we consider a semi-supervised learning setting that consists of both labeled data (with gold-standard) and unlabeled data (without gold-standard), under the covariate shift framework. We develop doubly robust and semiparametrically efficient estimators that leverage ACPs for general target parameters in the unlabeled and combined populations. In addition, we carefully analyze the efficiency gains achieved by incorporating ACPs, comparing scenarios with and without their inclusion. Notably, we identify that ACPs for the unlabeled data, instead of for the labeled data, drive the enhanced efficiency gains. To validate our theoretical findings, we conduct comprehensive synthetic experiments and apply our method to multiple real-world datasets, confirming the practical advantages of our approach.

PMID:42376611 | PMC:PMC13310800

Tech Innov Patient Support Radiat Oncol. 2026 Jun 4;39:100417. doi: 10.1016/j.tipsro.2026.100417. eCollection 2026 Sep.

ABSTRACT

PURPOSE: To determine if version upgrades to treatment planning system software have an impact on the clinical application of a knowledge-based planning model built in a previous version.

METHODS: Twenty patients’ data sets treated for prostate cancer were retrospectively selected for planning on three different versions of Eclipse (Varian Medical Systems) treatment planning system, (Vn13.6, Vn15.6, Vn16.1) using a multi-centre RapidPlan model that was built in Vn13.6. Each plan was created using identical beam arrangement, and optimisation objectives and calculation settings. The RapidPlan model was also re-trained in Vn15.6 and Vn16.1 and the datasets were replanned using these models with the same method.

RESULTS: Seven plan comparisons were performed, evaluating four target metrics and eight organ at risk (OAR) metrics. Statistically significant differences to median values for target dose metrics were observed in 10 out of 28 plan comparisons and for OARs in 23 out of 56 plan comparisons. Re‑extracted and re‑trained models in Vn15.6 and Vn16.1 improved target coverage and several OAR dose metrics. Small increases were observed in some OAR metrics for a subset of plans using the Vn15.6 model; however, the largest variations were minor (≤1.4%), including Bladder_65Gy (<1.3%), Bladder_70Gy (<0.7%), Rectum_65Gy (<0.9%), and Rectum_70Gy (<1.4%).

CONCLUSION: Eclipse version upgrades will have varying effects on the resultant plans optimised using a RapidPlan models developed and trained in earlier versions. This study confirms the recommendation from the vendor that it is important to re-extract and re-train RapidPlan models when an Eclipse version upgrade is undertaken to ensure optimal dosimetry is achieved.

PMID:42376610 | PMC:PMC13311788 | DOI:10.1016/j.tipsro.2026.100417

Cancer Manag Res. 2026 Jun 23;18:604901. doi: 10.2147/CMAR.S604901. eCollection 2026.

ABSTRACT

PURPOSE: Prostate-specific antigen (PSA), a common screening tool for prostate cancer (PCa), has a high false-positive rate and is largely suboptimal. PSA is also weakly validated in men of African ancestry (moAA), who disproportionately bear the disease burden, necessitating investigation into its widespread use. Previously, we found that plasmacytoma variant translocation 1 (PVT1) exons 4A, 4B, and 9 are overexpressed in PCa tissues. Here, we report on the first serum-based evaluation of these exons to determine their utility in improving detection and risk stratification of PCa.

PATIENTS AND METHODS: Total RNA was extracted from serum samples obtained retrospectively from 144 multiracial men with elevated PSA who underwent prostate biopsy. Likelihood ratio test was used to evaluate the potential benefit of utilizing these alone or in combination with PSA. Regression analysis was used to evaluate the association of individual biomarkers with the odds of PCa and for evaluating endpoint predictions. Model generalizability was assessed using cross-validation and area under the receiver operating characteristic curve (ROC-AUC). All statistical tests were performed at a 5% level of significance using the Sklearn library in Python.

RESULTS: Our results indicate that combining PSA with PVT1 exon 4A or 9 improves PCa risk stratification in the general population, increasing AUC from 0.72 to 0.75 as well as PCa detection, increasing specificity from 0.41 to 0.59. Within moAA, combining PSA with PVT1 exon 4A improves PCa detection substantially, increasing AUC from 0.44 to 0.67. Remarkably, PVT1 exon 4A alone achieves an AUC of 0.79.

CONCLUSION: Our study provides preliminary exploratory evidence to support PVT1 exon 4A and PVT1 exon 9 as promising PCa risk biomarkers that can reduce disparity in PCa detection and management. Further validation in larger patient cohorts will be necessary to establish the clinical utility of these novel biomarkers.

PMID:42376599 | PMC:PMC13310659 | DOI:10.2147/CMAR.S604901

Cancer Manag Res. 2026 Jun 25;18:603191. doi: 10.2147/CMAR.S603191. eCollection 2026.

ABSTRACT

PURPOSE: To investigate the effects of Jianpi Rougan method on lenvatinib (LEN) relative dose intensity (RDI), toxicity-related treatment discontinuation, and treatment tolerability in intermediate-to-advanced hepatocellular carcinoma (HCC).

METHODS: A real-world, retrospective study was conducted on 152 intermediate-to-advanced HCC patients receiving LEN. Patients were grouped based on concurrent use of Jianpi Rougan decoction (combined, n = 73) or not (monotherapy, n = 79). Primary endpoints were RDI at weeks 8, 12, and overall, and the proportion of RDI ≥ 80%. Secondary endpoints included toxicity-related discontinuation, adverse events, and short-term efficacy (objective response rate, ORR; disease control rate, DCR). Propensity score matching (PSM, 1:1) was employed to balance baseline confounders.

RESULTS: After PSM (65 pairs, n = 130), baseline characteristics were balanced. The combined group showed significantly higher RDI at week 12 (P = 0.001) and overall (P = 0.003), increased proportion of RDI ≥ 80% (P = 0.029), fewer dose reductions (P = 0.022) and interruptions (P = 0.045), reduced toxicity-related permanent discontinuation (P = 0.021), decreased overall discontinuation (P = 0.034), and longer treatment duration (P = 0.042). Decreased appetite was less frequent in the combined group (P = 0.036), with trends towards less diarrhea and transaminase elevation. ORR and DCR were higher in the combined group, but the differences were not statistically significant (P > 0.05).

CONCLUSION: Jianpi Rougan method combined with LEN was associated with improved RDI, lower rates of toxicity-related treatment discontinuation, and enhanced treatment persistence in real-world practice, supporting its role as a feasible integrative strategy to maintain targeted therapy intensity.

PMID:42376598 | PMC:PMC13313011 | DOI:10.2147/CMAR.S603191

OTO Open. 2026 Jun 29;10(3):e70275. doi: 10.1002/oto2.70275. eCollection 2026 Jul-Sep.

ABSTRACT

OBJECTIVE: To systematically review the literature for medical therapies that promote facial nerve regeneration and recovery.

DATA SOURCES: PubMed/Medline, Embase, and SCOPUS databases were searched for English-language studies published from inception through May 2025.

REVIEW METHODS: Human studies evaluating the efficacy of medical therapy on facial nerve regeneration using validated facial nerve grading scales were included.

RESULTS: Nine studies were included in qualitative analysis, and 6 were included in a meta-analysis. Treatments included nimodipine (n = 6), pentoxifylline (n = 1), co-enzyme Q10 (n = 1), and extracellular vesicles (n = 1). All studies used HB score, and recovery was defined as HB score ≤3. Recovery was observed in 94% (95% CI:[90%, 97%]) of patients treated with nimodipine and 84% (95% CI: [70%, 97%]) of control patients; this was not statistically significant (OR 2.26, 95% CI: [0.97, 5.26]). Nimodipine significantly decreased HB score by 1.66 (95% CI: [0.81, 2.52]) before and after treatment. Pentoxifylline and extracellular vesicles demonstrated some efficacy, while co-enzyme Q10 was not efficacious.

CONCLUSION: Nimodipine improved HB score but was not significantly associated with recovery to HB score ≤3 compared to controls. Pentoxifylline and extracellular vesicles may have some efficacy, but co-enzyme Q10 is not effective. Further research is required to uncover additional treatments.

PMID:42376590 | PMC:PMC13312993 | DOI:10.1002/oto2.70275

Front Microbiol. 2026 Jun 15;17:1746922. doi: 10.3389/fmicb.2026.1746922. eCollection 2026.

ABSTRACT

Insect gut microbiomes are recognized as potential reservoirs of enzymatic activities relevant to plastic metabolism. Here, we investigated the taxonomic and functional dynamics of the Tenebrio molitor gut microbiota under dietary exposure to low-density polyethylene (LDPE) and polyethylene terephthalate (PET) using 16S rRNA sequencing and shotgun metagenomics. Significant compositional shifts were detected at the ASV level, with plastic-fed cohorts showing enrichment of taxa implicated in xenobiotic metabolism. Predicted functional changes suggested altered abundance of pathways related to aromatic compound processing and redox homeostasis. Metagenomic assembly and functional annotation, performed through a reproducible open-source workflow, revealed several putative proteins with distant homology to enzymes such as phthalate dioxygenases, urethanases, and polyhydroxyalkanoate depolymerases. A metagenome-assembled genome (MAG) assigned to Enterococcus accounted for most recovered protein-coding sequences. Although gene-level comparisons did not show statistically significant differences, Gene Set Enrichment Analysis (GSEA) highlighted ABC transporter signatures and stress-response ATPases under plastic-exposed conditions. Overall, this exploratory study reveals microbial shifts and putative genetic indicators of metabolic potential within the T. molitor gut, providing a reproducible analytical framework for future investigations into the microbial role in plastic bioconversion.

PMID:42376574 | PMC:PMC13311072 | DOI:10.3389/fmicb.2026.1746922