Tag: statistics

Knowledge, attitudes, and practices in pediatric hypoglycemia in Italy (KAPPHy study)

Post author By Nevin Manimala
Post date July 22, 2026

J Endocrinol Invest. 2026 Jul 22. doi: 10.1007/s40618-026-02992-3. Online ahead of print.

ABSTRACT

PURPOSE: Childhood hypoglycemia is associated with relevant morbidity and likely long-term neurological sequelae. Diagnostic thresholds and management strategies remain quite heterogeneous, particularly beyond the neonatal period. We aimed to evaluate current diagnostic and therapeutic practices for pediatric hypoglycemia management in Italy among members of the Italian Society of Pediatric Endocrinology and Diabetology (SIEDP) and the Italian Society of Metabolic Diseases and Newborn Screening (SIMMESN).

METHODS: An anonymous electronic survey including 43 questions about management of pediatric hypoglycemia was sent to SIEDP and SIMMESN members. Descriptive statistics and comparative statistical analysis between respondents of the two societies were run.

RESULTS: A total of 118 respondents participated. Most of them reported direct clinical experience in pediatric hypoglycemia and routinely used critical sampling during hypoglycemic episodes. Diagnostic thresholds were heterogeneous: 34.7% reported 50 mg/dL, 33.1% 60 mg/dL, and 22.0% 70 mg/dL. Comparative analysis between societies showed no differences in most diagnostic procedures, but significant differences emerged in diagnostic thresholds (p = 0.005), with SIMMESN members selected 60 mg/dL more frequently (adjusted p = 0.020), and SIEDP members more frequently 70 mg/dL (adjusted p = 0.013). SIMMESN members reported more frequent use of genetic testing for etiological diagnosis. SIEDP respondents showed a frequent used of continuous glucose monitoring in the follow-up.

CONCLUSION: Management of pediatric hypoglycemia in Italy is largely aligned with international recommendations. Clinically relevant variability persists, particularly in diagnostic thresholds, adoption of molecular analysis, and technologies, likely reflecting different clinical focus and patient populations. Our findings highlight the need for harmonized national recommendations and shared diagnostic definitions across scientific societies.

PMID:42484965 | DOI:10.1007/s40618-026-02992-3

Tags nevin manimala, pubmed, statistics

Nevin Manimala Statistics

Knowledge, attitude and practice of paediatric dentists towards silver diammine fluoride in Egypt: a national survey

Post author By Nevin Manimala
Post date July 22, 2026

Eur Arch Paediatr Dent. 2026 Jul 22. doi: 10.1007/s40368-026-01247-2. Online ahead of print.

ABSTRACT

OBJECTIVE: The primary aim was to assess the educational experience, knowledge, attitude, behaviour, and perceived barriers regarding silver diammine fluoride (SDF) use by Egyptian paediatric dentists. A secondary aim was to analyse how these domains are related.

METHOD: This cross-sectional survey used a pre-validated questionnaire, distributed electronically to all registered Egyptian paediatric dentists (n = 745) between March and May 2025. Data were analysed using SPSS version 23.0, with statistical significance set at p < 0.05.

RESULTS: A total of 546 paediatric dentists completed the survey (73% response rate). Most respondents (96.7%) were familiar with SDF, mainly through dental school (53.8%), and reported greater exposure during postgraduate training. Overall, 84.1% demonstrated moderate-good knowledge and positive attitudes towards SDF use, particularly for non-aesthetic primary teeth (88.7%) and patients with behavioural (85.6%) or medical (85%) challenges. However, clinical application remained limited, mainly for arresting caries lesions in primary teeth (32.4%), with patient or caregiver non-acceptance (89.1%) being the main barrier. Knowledge, attitude, and practice were positively correlated, and higher academic qualifications were significantly associated with greater knowledge and more frequent SDF use.

CONCLUSION: Although Egyptian paediatric dentists showed good awareness and positive attitudes towards SDF, its clinical use remained limited by parental reluctance and aesthetic concerns. Broader adoption may be supported by integrating SDF into undergraduate curricula, enhancing postgraduate training, and promoting targeted education campaigns.

CLINICAL RELEVANCE: Improved education and training on SDF can enhance its clinical use for managing caries in uncooperative or high caries-risk children. Addressing aesthetic concerns and caregiver acceptance may further support its wider adoption in paediatric practice. Individualised caries-risk assessment, integrated within a holistic caries-management plan, is essential for achieving successful SDF outcomes.

PMID:42484964 | DOI:10.1007/s40368-026-01247-2

Tags nevin manimala, pubmed, statistics

Nevin Manimala Statistics

Laparoscopic versus open repair for umbilical hernia: outcomes and complications

Post author By Nevin Manimala
Post date July 22, 2026

Hernia. 2026 Jul 22;30(1):297. doi: 10.1007/s10029-026-03792-7.

ABSTRACT

PURPOSE: This study aimed to evaluate which surgical approach is more beneficial for patients with umbilical hernia, and compare the clinical outcomes between the laparoscopic group and the open group.

MATERIALS AND METHODS: The databases of PubMed, EMBASE, and the Cochrane Library were used to search for eligible studies from their inception to December 31, 2025. Mean difference (MD), Odds ratios (OR), and 95% confidence intervals (CI) were pooled to analyze. The Newcastle-Ottawa Scale (NOS) scores were used to evaluate the quality of the included studies. This study was performed with Stata (V.18.0) software.

RESULTS: A total of thirteen studies involving 62,588 patients were included in this study. By comparing the postoperative outcomes, we found that the laparoscopic group had longer operative time (MD = 1.50, I²=97.28%, 95%CI = 0.54 to 2.47, P < 0.1), shorter postoperative hospital stay (MD=-0.57, I²=96.14%, 95%CI=-1.1 to -0.01, P < 0.1), fewer overall complications (OR = 0.65, I²=0.00%, 95%CI = 0.49 to 0.85, P < 0.1), fewer wound infection (OR = 0.55, I²=13.20%, 95%CI = 0.40 to 0.76, P < 0.1), fewer wound healing disorder (OR = 0.54, I²=0.00%, 95%CI = 0.30 to 1.00, P < 0.1), more respiratory complications (OR = 3.16, I²=0.00%, 95%CI = 1.88 to 5.32, P < 0.1), more heart related complications (OR = 3.75, I²=0.00%, 95%CI = 1.84 to 7.66, P < 0.1), more ileus (OR = 8.43, I²=0.00%, 95%CI = 2.98 to 23.84, P < 0.1), less bleeding (OR = 0.36, I²=0.00%, 95%CI = 0.14 to 0.91, P < 0.1) and shorter follow-up time (MD=-0.24, I²=0.00%, 95%CI=-0.41 to -0.08 P < 0.1).

CONCLUSION: Compared with open umbilical hernia surgery, laparoscopic surgery has more advantages in reducing postoperative hospital stay, wound infection, and overall complications.

PMID:42484912 | DOI:10.1007/s10029-026-03792-7

Tags nevin manimala, pubmed, statistics

Nevin Manimala Statistics

Genetically predicted vitamin D levels and risk of head and neck cancer: a mendelian randomization study

Post author By Nevin Manimala
Post date July 22, 2026

Cancer Causes Control. 2026 Jul 22;37(8):131. doi: 10.1007/s10552-026-02219-z.

ABSTRACT

OBJECTIVES: Observational studies examining the association between vitamin D and head and neck cancer (HNC) have reported conflicting results. We conducted a two-sample MR study to investigate the causal association between genetically predicted serum 25-hydroxyvitamin D (25(OH)D) levels and the risk of HNC and its major subtypes: oral cavity, laryngeal, hypopharyngeal, and HPV-negative oropharyngeal cancers.

DESIGN: Genetic instruments were selected from GWAS of 441,291 individuals (UK Biobank). Cancer outcomes were obtained from the HEADSpAcE consortium. Multiple sclerosis (MS) was analyzed as a positive control. We identified 115 independent genetic instruments for serum 25(OH)D. Causal estimates were primarily derived using inverse variance weighted (IVW) MR, supported by MR-Egger, weighted median, and mode-based methods. Extensive sensitivity analyses assessed heterogeneity, pleiotropy, and directionality.

RESULTS: We identified 115 independent genetic instruments for serum 25(OH)D levels, which explained 5.12% of the total phenotypic variance. The mean F-statistic was 198.3 and satisfied MR assumptions. Only 17 of 682 (2.5%) SNP-confounder associations reached nominal significance (p < 5 × 10⁻⁸), and none remained significant after Bonferroni correction, indicating no systematic confounding. Higher 25(OH)D levels were associated with a reduced risk of MS (IVW OR = 0.84, 95% CI 0.71-0.99, p = 0.038; weighted median OR = 0.82, 95% CI 0.70-0.96, p = 0.015), while no evidence of a causal association was observed between 25(OH)D and risk of HNC or any subtype (all IVW p > 0.05; ORs ranging from 0.95 to 1.25). Sensitivity analyses revealed no evidence of horizontal pleiotropy, influential outliers, or reverse causation for any cancer outcome.

CONCLUSIONS: This study provides robust genetic evidence that circulating 25(OH)D levels are not a major causal determinant of HNC risk and that our instruments are not confounded by major lifestyle or UV-related factors.

PMID:42484911 | DOI:10.1007/s10552-026-02219-z

Tags nevin manimala, pubmed, statistics

Nevin Manimala Statistics

Evaluation of ocular surface retention of artificial tears by scintigraphy

Post author By Nevin Manimala
Post date July 22, 2026

Int Ophthalmol. 2026 Jul 22;46(1):307. doi: 10.1007/s10792-026-04183-8.

ABSTRACT

PURPOSE: To compare the early phase ocular surface retention of five artificial tear formulations using lacrimal scintigraphy.

MATERIALS AND METHODS: Sixteen participants (25-42 years) without ocular or systemic disease were enrolled between January 2023 and January 2025, and both eyes were included. Each subject attended three alternate-day sessions and received one Tc-99 m-labeled drop (150 µCi) per eye per session according to predefined formulation pairs: HP guar + sodium hyaluronate (SH) versus saline; trehalose + SH versus dexpanthenol + SH; and SH alone versus polyvinyl alcohol + povidone. Ten-minute dynamic lacrimal scintigraphy was performed following each instillation to evaluate early-phase pre-corneal retention dynamics. Regions of interest were automatically tracked and manually corrected when required. Absolute scintigraphic counts and baseline-normalized 5/0-min and 10/0-min ratios were calculated. A total of 48 dynamic scans were analyzed using linear mixed-effects models with Dunn-Bonferroni post-hoc testing.

RESULTS: Scintigraphic counts decreased significantly over time (p < 0.001), with a significant overall difference among formulations (p = 0.006) and no group × time interaction (p = 0.279). Baseline-normalized ratios similarly demonstrated significant group and time effects (each p < 0.001). HP guar + SH showed greater normalized retention than saline (p = 0.031), and trehalose + SH likewise exceeded saline (p = 0.003). HP guar + SH demonstrated the highest overall retention across formulations and showed a numerical advantage over dexpanthenol + SH (MD = 0.117), though not statistically significant (p = 0.155).

CONCLUSIONS: Polymer-hyaluronate combinations, particularly HP guar + SH and trehalose + SH, demonstrated greater early-phase ocular surface retention dynamics compared with saline and several other tested formulations within the observed imaging period. HP guar + SH showed the highest overall retention profile among the evaluated preparations.

PMID:42484903 | DOI:10.1007/s10792-026-04183-8