Tag: statistics

Int J Gynaecol Obstet. 2026 Feb 21. doi: 10.1002/ijgo.70886. Online ahead of print.

ABSTRACT

OBJECTIVE: The accurate diagnosis of multicompartment pelvic organ prolapse (POP) is fundamental to surgical success. This study aims to compare the diagnostic performance of transperineal ultrasound against clinical examination (pelvic organ prolapse quantification, POP-Q) for the detection of compartmental defects in patients with multicompartment POP, using assessment under spinal anesthesia as the reference standard.

METHOD: A prospective randomized diagnostic accuracy study was designed, including 129 patients scheduled for multicompartment POP surgery. Patients were randomly assigned to undergo either a preoperative POP-Q two-dimensional transperineal ultrasound assessment. The reference standard for all patients was the intraoperative POP-Q assessment, conducted under spinal anesthesia immediately before surgery. Sensitivity, specificity, and likelihood ratios (LR) were calculated for each method and compartment.

RESULTS: Both techniques demonstrated high sensitivity for the diagnosis of cystocele (100% vs 98.3%). However, their performance varied across the other compartments. Ultrasound showed superior specificity for uterine prolapse (73.4% vs 45.4%) and rectocele (86.3% vs 66.0%) and was particularly robust in confirming enterocele (LR+ of 10.5). In turn, clinical examination had a higher sensitivity for detecting rectocele (61.5% vs 21.4%) and was highly reliable for ruling out cystocele and uterine prolapse (LR- of 0).

CONCLUSION: Clinical examination and ultrasound are complementary in the diagnosis of prolapse. Their combined use is key to accurate surgical planning.

PMID:41721567 | DOI:10.1002/ijgo.70886

J Dent Educ. 2026 Feb 21. doi: 10.1002/jdd.70181. Online ahead of print.

ABSTRACT

OBJECTIVES: This study provides a descriptive, multi-institutional comparison of dental students’ recognition accuracy and management decisions of oral soft tissue pathological entities across four US dental schools. While prior single-institution studies have evaluated diagnostic ability, this work provides a multi-institutional comparison to identify recognition and decision-making variability as well as potential educational implications.

MATERIALS AND METHODS: A voluntary, anonymous online survey with twenty image-based multiple-choice questions was administered to 160 students. Each question included an image, patient demographics, and key case details. Management questions were provided with reference diagnoses to prevent conflation of diagnostic and management errors. Descriptive statistics, t-tests, logistic regression, chi-square tests, and multi-rater kappa statistics were used to analyze performance, with effect sizes, reference groups, and 95% confidence intervals reported. Model fit for logistic models was assessed using likelihood ratio tests.

RESULTS: Students demonstrated a high level of recognition for conditions like candida (84%) and tobacco keratosis (95%). Subtle or clinically variable lesions were more challenging, such as erosive lichen planus (50%) and idiopathic leukoplakia (58%). Management accuracy frequently lagged behind recognition accuracy. Significant inter-school differences were observed for both recognition (χ² = 27.66, p < 0.0001) and management (χ² = 30.80, p < 0.0001), with students from School #4 outperforming peers. Kappa values remained low (< 0.2 for most items), indicating wide variability and limited internal agreement.

CONCLUSION: Students demonstrated strong theoretical knowledge of common oral pathological entities but variability in identifying and managing rare or diagnostically nuanced conditions. Because this survey evaluates recognition rather than competence, findings highlight the need for case-based, competency-aligned teaching approaches to strengthen diagnostic reasoning and management decision-making.

PMID:41721556 | DOI:10.1002/jdd.70181

Mol Genet Genomic Med. 2026 Mar;14(3):e70188. doi: 10.1002/mgg3.70188.

ABSTRACT

BACKGROUND AND AIM: Hereditary spherocytosis (HS) is a common disease in hereditary hemolytic anemia. Advancements in sequencing technology have enabled the identification of a growing number of mutation sites associated with HS. This study analyzed the clinical characteristics and gene mutations of HS in our center.

METHODS: Retrospective collection of data on 59 Chinese pediatric patients with HS admitted to the Hematology Department of Chongqing Medical University Affiliated Children’s Hospital from 2013 to 2022. Second-generation gene sequencing was performed on participants, with verification of detected variants using Sanger sequencing. Data analysis was conducted using various databases, and statistical methods were used for differential analysis.

RESULT: We collected clinical data of 59 Chinese children with HS phenotype, including 27 males (45.8%) and 32 females (54.2%), all unrelated. The age of onset ranged from 0 to 180 months, with a median age of 60 months. Our study found that ANK1 and SPTB gene mutations were the primary causes of HS, with missense and frameshift mutations being the most common. De novo mutations were present in 37 (62.7%) patients, while the remaining mutations were inherited. We noted a higher proportion of females (p = 0.032) and lower total bilirubin levels (p = 0.014) in patients with multiple gene mutations. Patients with ANK1 gene mutations experienced more severe anemia compared to those with SPTB gene mutations (p = 0.041). Additionally, there were significant differences in mean corpuscular hemoglobin concentration (MCHC) between different mutation types (p = 0.036), indicating lower MCHC levels in the missense mutation group. No differences in clinical phenotypes were observed among different structural domains of ANK1 and SPTB mutations. Splenectomy significantly alleviated the symptoms in HS patients.

CONCLUSION: We identified unique genetic and clinical characteristics mutations of HS in Chongqing, China. These findings expand the mutation spectrum of HS and have implications for early diagnosis and treatment of the disease.

PMID:41721551 | DOI:10.1002/mgg3.70188

J Prim Care Community Health. 2026 Jan-Dec;17:21501319261421476. doi: 10.1177/21501319261421476. Epub 2026 Feb 21.

ABSTRACT

BACKGROUND: Persistent high healthcare utilization has rarely been analyzed in adolescent populations although there are specific chronic health issues also among adolescents, like mental health challenges and some somatic illnesses, which need long-term treatments. Therefore, it remains unclear whether such high utilization is persistent among adolescents. Recognizing patterns of high service utilization and its’ persistence are essential for preventing avoidable healthcare use.

MATERIALS AND METHODS: This population-based study focused on all adolescents born in 2004 (n = 1483) from North Karelia, Finland. Healthcare service use data (2018-2021) was extracted from the electronic patient register. A high utilizer of healthcare (HU: the abbreviation also refers to high utilization) was defined as a person having been in contact with healthcare services during at least 12 days a year (attendance days). A persistent HU (pHU) was a person identified as being HU during 3 or 4 of all 4 follow-up years. The prevalence of diagnoses set to young people was compared in accordance with ICD-10 diagnostic categories between pHU and non-pHU groups.

RESULTS: pHUs accounted for 18.5% (n = 275) of all adolescents born in 2004. A total of 53.5% (n = 793) of adolescents met the criteria of single-year HU during the follow-up period, and of these, 34.7% were also identified as pHU. The pHU group was particularly emphasized in mental and behavioral disorders (RR = 4.5, CI: 3.6-5.5, P < .001), as well as the diseases of the nervous system (RR = 3.4, CI: 2.2-5.1, P < .001) and musculoskeletal system/connective tissue (RR = 3.2, CI: 2.4-4.3, P < .001).

CONCLUSIONS: The continuation from single-year to multi-year HU was relatively high. Thus, single-year high utilization is a strong indicator of future persistence in healthcare service utilization. Further research is needed to identify differences in clinical and psychosocial characteristics between single-year high utilizers and those whose high-utilization continues for years.

PMID:41721530 | DOI:10.1177/21501319261421476

Hand (N Y). 2026 Feb 21:15589447261416974. doi: 10.1177/15589447261416974. Online ahead of print.

ABSTRACT

BACKGROUND: Dupuytren’s disease causes progressive flexion contractures and impaired hand function. While percutaneous needle aponeurotomy (PNA) provides rapid correction with low morbidity, the effect on grip strength remains unclear. Grip strength is a key surrogate of hand function and overall health, yet it has been inconsistently evaluated as an outcome in Dupuytren’s disease.

METHODS: A prospective study was conducted at a tertiary referral center including 53 patients (80 digits) treated with PNA between February 2024 and March 2025. Standardized assessments included grip strength (Jamar dynamometer, American Society of Hand Therapists protocol), joint extension deficits, patient-reported outcomes (Southampton, Unité Rhumatologique des Affections de la Main [URAM]), and return-to-work data. Grip strength was reassessed at 2 months postprocedure to capture early functional recovery. Statistical analysis used paired t tests and Wilcoxon signed-rank tests, with significance set at P < .05.

RESULTS: Mean grip strength improved from 24.9 to 28.7 kg (mean change + 3.8 kg, P < .001). Extension deficits decreased significantly at all levels, with mean correction of 25.5° at the metacarpophalangeal joint (MCPJ) and 29.3° at the proximal interphalangeal joint (PIPJ) (P < .001). At 2 months, the median URAM score was 4 out of 45, and the Southampton score was 3 out of 20, reflecting excellent functional recovery. Forty-four employed patients returned to work within 1 week. Complications were minor (skin tears n = 9, transient hypersensitivity n = 1) with no major adverse events.

CONCLUSIONS: Percutaneous needle aponeurotomy (PNA) not only corrects digital contracture but also yields clinically significant improvements in grip strength, reinforcing its value as a functional outcome measure. These findings support PNA as a safe, effective first-line treatment for selected patients with Dupuytren’s disease.

PMID:41721527 | DOI:10.1177/15589447261416974

Phys Sportsmed. 2026 Feb 20. doi: 10.1080/00913847.2026.2636506. Online ahead of print.

ABSTRACT

BACKGROUND: Horse riding is a common sport, but no study specifically addresses joint dislocations. The purpose of this study is to describe joint dislocations due to equines using a national emergency department (ED) database. Such data can be helpful in injury prevention strategies.

METHODS: The National Electronic Injury Surveillance System (NEISS) database for the years 2000-2023 was used. The NEISS database is a statistically representative sample of injuries seen in EDs across the US giving national estimates. Mechanism of injury was tabulated into groups: 1) did the patient fall from the horse 2) was the patient bucked, thrown, or kicked off of the horse, 3) was there equipment (tack) malfunction, 4) was the patient stepped on by the horse, 5) was the patient struck by/against an object, 6) was the patient kicked by the, 7) and others.

RESULTS: There were 625 dislocations which involved the shoulder (289, 46.2%), elbow (95, 15.2%), finger (85, 13.6%), acromioclavicular joint (48, 7.7%), patellofemoral joint (39, 4.8%), hip (22, 3.5%), pubic symphysis (16, 2.6%), and ankle (7, 1.1%). The average age was 41 years; 49.7% were male and 50.3% female. Mechanisms of injury were falling from the horse (54.1%), bucked/thrown off (27.7%), equipment malfunction (7.3%), stepped on by the horse (2.1%), struck by/against an object (1.9%), kicked (0.6%), and others (4.0%). Those with elbow dislocations were the youngest (average 32 years) and pubic symphysis the oldest (average 52 years) (p < 10^-4). Females had the highest percentage of patellofemoral dislocations (70.2%) and males the highest percentage of pubic symphysis dislocations (92.9%) (p = 0.0018).

CONCLUSION: Although joint dislocations due to equestrian activity are uncommon, the majority occurred in the upper extremity. Male/female involvement is equal, different than the typical female predominance in equestrian activity and overall equestrian related injuries.

PMID:41721521 | DOI:10.1080/00913847.2026.2636506

Biophys J. 2026 Feb 19:S0006-3495(26)00137-2. doi: 10.1016/j.bpj.2026.02.017. Online ahead of print.

ABSTRACT

Natural fluctuations in gene expression (“noise”) impact many cell processes such as differentiation, proliferation, and apoptosis. Negative feedback gene circuits, a gene self-repressing its own transcription e.g. through protein binding, are often used to reduce the single-gene expression noise and control its impact on investigated phenomena. However, the detailed, quantitative understanding of how temporal and population-level noise is affected by natural mammalian gene expression processes and how this dependence is modified by transcriptional negative feedback is lacking. Here, we present a comprehensive framework combining Live-cell Imaging of Single-Cell Arrays (LISCA) with likelihood-free inference methods to characterize stochastic gene expression in the time domain and at single-cell resolution. We investigate the temporal and population-level variability in protein levels driven by a negative feedback circuit and compare the results with constitutive expression where the feedback mechanism is broken. We use inferred kinetic rate parameters to validate several hybrid stochastic/deterministic models at their predictive capacity regarding Coefficient of Variation (CV) versus mean protein level relation. Our analysis shows significant differences between temporal and population-level noise profiles. We show how feedback strength and cooperativity quantitatively control not only mean protein levels per cell but also their variation range within cell population (CV_p) and across time in individual cells (CV_t).

PMID:41721509 | DOI:10.1016/j.bpj.2026.02.017

Foot Ankle Int. 2026 Feb 20:10711007251413197. doi: 10.1177/10711007251413197. Online ahead of print.

ABSTRACT

BACKGROUND: Total ankle arthroplasty (TAA) is increasingly used as a motion-preserving alternative to ankle arthrodesis for end-stage ankle disease. The Salto Talaris fixed-bearing prosthesis was designed to enhance joint kinematics while minimizing bone resection and reducing complications seen in earlier implant generations. This study reports midterm clinical outcomes, including survivorship, complications, reoperation and failure rates in a large, single-surgeon cohort.

METHODS: A retrospective review was conducted of 1121 primary TAAs performed in 1023 patients (98 bilateral) between May 2008 and December 2022. Patients with a minimum of 2-year clinical follow-up were included and any patients who failed or passed away before then were accounted for. Data included demographics, comorbidities, preoperative ankle diagnosis, ancillary procedures, intra- and postoperative complications, and patient-reported outcomes measures (PROMs). Complications were identified and then classified by the Glazebrook system (low-, medium-, high-grade). Reoperations and revisions were coded according to the Canadian Orthopaedic Foot and Ankle Society reoperations coding system.

RESULTS: The mean age at the index TAA surgery was 65.5 (range, 28.7-94.4) years, with osteoarthritis being the most common diagnosis. The average follow-up was 5.5 (range, 2-17.2) years. Key PROMs showed statistically significant improvements from preoperative to latest follow‑up (Veterans RAND 12-Item Health Survey physical component summary, +10.1 [95% CI 8.83-10.77]; Ankle Osteoarthritis Scale [AOS] pain, -29.2 [95% CI 25.43-29.72]; AOS disability, -32.8 [95% CI 29.32-33.80]; visual analog scale for pain, -36.8 [95% CI 32.6-40.7]; all P < .001). Implant survivorship was 94.6% at the time of this report. A total of 240 ankles (21.4%) experienced at least 1 complication. Secondary reoperations occurred in 134 ankles (12.0%), with 61 ankles failing (5.4%) and leading to a revision TAA, conversion to arthrodesis, or an explant to antibiotic spacer. Most failures were due to high-grade complications including aseptic loosening (22/61) and deep infection (19/61). Among the failed ankles, 2 patients ultimately underwent a below-the-knee amputation.

CONCLUSION: In this large cohort, the Salto Talaris TAA was associated with improvements in patient-reported quality of life, activity, and pain, and showed high survivorship with relatively low failure (5.4%) and reoperation (12.0%) rates at an average of 5.5 years after index surgery.

PMID:41721500 | DOI:10.1177/10711007251413197

J Intellect Disabil Res. 2026 Feb 20. doi: 10.1111/jir.70093. Online ahead of print.

ABSTRACT

BACKGROUND: Children and adolescents with intellectual disabilities often do not meet the recommended guidelines for physical activity (PA) and sedentary behaviour (SB). Evidence-based recommendations for effective interventions are lacking. This study aimed to review existing interventions and identify effective components for this population.

METHODS: A systematic search of Web of Science, Medline, ERIC, Ovid and SPORTDiscus was conducted from their inception to February 2023, to identify eligible articles according to a series of inclusion and exclusion criteria. The Revised Tool to Assess Risk of Bias in Randomized Trials (RoB 2.0) was used to assess risk of bias in the included studies. The random-effects model was used to pool the weighted results and the I² statistic was applied to assess heterogeneity of the included studies.

RESULTS: Five randomized controlled trials were included in this review. Regarding intervention components, four trials exclusively used exercise, whilst the other one combined exercise with health education and diet. The meta-analysis demonstrated that interventions were effective at increasing PA (3.73 min, Z = 4.44, 95% CI [2.09, 5.38], p < 0.00001) and decreasing SB (-15.31 min, Z = 2.59, 95% CI [-26.90, -3.72], p = 0.01), compared with control groups.

CONCLUSIONS: Exercise was an effective intervention component in promoting PA and reducing SB in children and adolescents with intellectual disabilities. The findings of this study provided preliminary evidence for decision-making in PA promotion and SB reduction in the target population.

PMID:41721474 | DOI:10.1111/jir.70093

J Chem Inf Model. 2026 Feb 20. doi: 10.1021/acs.jcim.6c00299. Online ahead of print.

ABSTRACT

Drug-like molecules often interact with multiple biological targets. Assessing this polypharmacology is essential for drug development. Here, we trained deep neural networks to associate bioactive molecules up to 80 non-hydrogen atoms reported in ChEMBL 34, represented as binary substructure fingerprints, with lists of targets on which the molecules are ≥50% active at ≤10 μM. We included 2,496,555 interactions between 1,187,089 molecules and 7546 targets having at least five reported active molecules, including single proteins, protein complexes, protein families, cell lines, organisms, and further target types. This represents a much larger data set than in previously reported models, which were mostly limited to protein targets. Our models achieve good performances in terms of recall and precision per molecule and per target, as illustrated by overall statistics and by a case study in comparison with other online prediction tools. PPB3 predictions can be performed online at https://ppb3.gdb.tools/.

PMID:41721463 | DOI:10.1021/acs.jcim.6c00299