Tag: statistics

Fundam Clin Pharmacol. 2026 May;40(3):e70092. doi: 10.1111/fcp.70092.

ABSTRACT

Psychotropic medicines are known to impair cognitive function acutely, but the specific effects of individual substances remain underexplored. This study investigates the effects of dexamphetamine and zolpidem on cognitive performance to quantify the potential risk of intake and their pharmacokinetic and pharmacodynamic relationship. This randomized, double-blind, placebo-controlled trial (EudraCT 2021-005381 – 17) included 60 healthy men aged 26 ± 5 (mean ± SD) years. Participants received a single oral dose of 30-mg dexamphetamine, 5-mg zolpidem, or placebo (n = 20 per group). Cognitive performance was assessed at baseline and 3 and 8 h after dosing using the computerized Psytest system. Dexamphetamine and zolpidem improved sustained attention, with significant reduction of omissions at 8 h. Reaction time improved in both groups, but zolpidem impaired phasic alertness. Working memory remained unchanged. Plasma concentration of dexamphetamine and zolpidem was 70.8 ± 10.4 ng/mL and 39.0 ± 20.7 ng/mL at 3 h and 45.9 ± 7.9 ng/mL and 8.7 ± 6.6 ng/mL at 8 h, respectively. No correlation between drug plasma concentration and cognitive performance measures was demonstrable. Dexamphetamine caused the strongest subjective effects and highest liking ratings, whereas zolpidem elicited greater subjective dislike. Tolerability was best with placebo, followed by zolpidem and dexamphetamine. Single therapeutic doses of dexamphetamine and zolpidem modestly affected cognitive function 3 h after intake, with no relationship between cognitive performance and the study medicines’ plasma concentration. Both medicines improve cognition after 8 h but differed in subjective emotional effects. Nevertheless, generalizability is limited by the inclusion of healthy men only. Trial Registration: EudraCT: Nr: 2021-005381-17.

PMID:42087266 | DOI:10.1111/fcp.70092

Implement Sci Commun. 2026 May 5. doi: 10.1186/s43058-026-00955-6. Online ahead of print.

ABSTRACT

BACKGROUND: Syringe services programs (SSPs) are an evidence-based intervention for preventing infectious diseases and reducing the risk of overdose. Florida passed legislation that authorizes the implementation of SSPs (via the Infectious Disease Elimination Act; IDEA) in 2019. However, little is known about how organizational contexts and interorganizational networks shape adoption, implementation, and sustainment of this intervention.

METHODS: We conducted a cross-sectional, statewide survey of organizations engaged in implementing SSPs and related services between March and May 2025, using a community-based participatory research approach with the Florida Harm Reduction Collective. The survey assessed SSP implementation, barriers and facilitators, implementation climate, organizational sustainability, and interorganizational networks. Data were analyzed using descriptive statistics, t-tests for group comparisons, and social network analysis to examine relational structures and organizational centrality.

RESULTS: A total of 29 organizations representing 18 counties responded to the survey. Eight counties reported operating a sanctioned SSP, while none of the remaining counties had ordinances or champions supporting SSP adoption. Stigma and political resistance, lack of funding, and restrictive laws and policies were cited as major barriers to SSP implementation. There was an overall weak implementation climate for SSPs (mean = 1.4 on a 0-4 scale), though it was significantly stronger in counties with operational SSPs (1.8 vs. 1.1, p = 0.01). Organizations reported relatively strong organizational sustainability (mean = 5.6 on a 1-7 scale), with high ratings for program adaptation and lower scores for funding stability. Social network analysis revealed that the Florida Harm Reduction Collective served as the most central and influential node connecting diverse organizations statewide.

CONCLUSIONS: Our findings highlight both structural barriers (e.g., funding, stigma, restrictive policies) and organizational strengths (e.g., adaptability, network connectivity) in Florida’s harm reduction landscape. Addressing policy barriers, expanding and stabilizing funding availability, and leveraging statewide networks will be critical for strengthening implementation of SSPs in Florida and expanding equitable access to harm reduction services for people who use drugs.

PMID:42087235 | DOI:10.1186/s43058-026-00955-6

J Cardiothorac Surg. 2026 May 5. doi: 10.1186/s13019-026-04246-y. Online ahead of print.

ABSTRACT

OBJECTIVES: Current evidence does not support superiority of one cardioplegia type over another, but stems from low-risk populations. Therefore, we compared outcomes of multimorbid, high-risk infective endocarditis (IE) patients receiving Custodiol^®crystalloid or Calafiore blood cardioplegia during cardiac surgery.

METHODS: We retrospectively analyzed 553 patients (mean EuroScore II 22.7 ± 21.1) who underwent surgery for IE between 2009 and 2023 and received either cold crystalloid (Custodiol^®, n = 335) or warm blood (Calafiore, n = 218) cardioplegia. The primary endpoint was 1-year mortality. Secondary endpoints included 30-day mortality, postoperative stroke, and new-onset dialysis. Propensity score matching (1:1, 14 covariates) resulted in 175 matched pairs. Statistical analysis included nonparametric and exact tests.

RESULTS: In the overall cohort, patients receiving Custodiol^® were higher risk and had higher mortality and morbidity. After matching, there was no significant difference in 1-year mortality between patients receiving Custodiol^® and Calafiore (37.1% vs. 28.6%, p = 0.09). 30-day mortality trended to be lower in the Calafiore group without reaching statistical significance (22.9% vs. 14.9%, p = 0.057). However, stroke was less frequent (4.6% vs. 10.9%, p = 0.029), ICU stay was shorter (3[1-8] vs. 6[3-12.5] days, p < 0.001) and postoperative dialysis was numerically less common (13.7 vs. 20.6%, p = 0.091). These differences were most evident in procedures with shorter cross-clamp times, such as isolated mitral or aortic valve surgery, where mortality and recovery parameters consistently favored Calafiore.

CONCLUSIONS: In high-risk endocarditis patients warm blood cardioplegia may be superior to cold crystalloid, although differences did not reach statistical significance. However, propensity matching may not have accounted for all differences, which warrants further discussion and investigation.

PMID:42087214 | DOI:10.1186/s13019-026-04246-y

BMC Nutr. 2026 May 5. doi: 10.1186/s40795-026-01342-z. Online ahead of print.

ABSTRACT

BACKGROUND: Severe acute pancreatitis (SAP) is a life-threatening condition marked by systemic inflammation, organ failure, and high morbidity. Nutritional support plays a critical role in SAP management, with total enteral nutrition (TEN) and total parenteral nutrition (TPN) being the primary approaches. While TEN maintains gut integrity and may reduce complications, TPN bypasses the gastrointestinal tract and may worsen systemic inflammation. This study aimed to perform an updated systematic review and meta-analysis comparing the efficacy and safety of TEN versus TPN in SAP patients.

METHODS: Following PRISMA guidelines, we searched PubMed, Scopus, and Web of Science for randomized controlled trials and cohort studies comparing TEN and TPN in SAP. Outcomes included infection rate, organ failure, mortality, necrosis, surgical intervention, hospital stay, and serum markers (amylase, lipase, albumin, IL-6). Quality assessment was done using ROB2 and NOS tools. GRADE methodology was applied to assess evidence certainty.

RESULTS: A total of 23 studies involving 7,674 patients (2,750 TEN and 4,924 TPN) were analyzed. TEN was significantly associated with lower odds of infection (OR = 0.35; 95% CI: 0.18-0.70; p = 0.003), multiple organ failure (OR = 0.41; 95% CI: 0.21-0.78; p = 0.007), and mortality (OR = 0.50; 95% CI: 0.33-0.76; p = 0.001), compared to TPN. The requirement for surgical intervention was also reduced with TEN (OR = 0.26; 95% CI: 0.07-1.00; p = 0.05), although with high heterogeneity and low certainty. No significant differences were observed in pancreatic necrosis (OR = 0.88; p = 0.62) or hospital stay (MD = 1.9 days; p = 0.11). Biochemical markers including serum amylase, lipase, albumin, and IL-6 showed no statistically significant differences between the two groups. GRADE analysis rated the certainty of evidence as moderate for infection and hospital stay, low for organ failure and mortality, and very low for surgical intervention.

CONCLUSION: Our updated meta-analysis demonstrates that total enteral nutrition is associated with significantly better clinical outcomes than total parenteral nutrition in patients with severe acute pancreatitis, particularly in reducing infection, organ failure, and mortality. Although differences in secondary outcomes were not statistically significant, the overall evidence supports TEN as the preferred nutritional approach in SAP management.

PMID:42087204 | DOI:10.1186/s40795-026-01342-z

Crit Care. 2026 May 5. doi: 10.1186/s13054-026-06035-4. Online ahead of print.

ABSTRACT

BACKGROUND: In severe acute kidney injury (AKI), delayed renal replacement therapy (RRT) strategies allow many KDIGO stage-3 patients to avoid dialysis, but excessive postponement in those who ultimately require RRT may worsen outcomes. Early physiologically grounded markers to identify patients likely to need RRT are lacking. We evaluated whether combining early glomerular filtration kinetics and timed urinary urea excretion could improve discrimination of subsequent RRT initiation under a delayed strategy.

METHODS: TUBSAKI is a prospective bicentric ICU cohort including adults with KDIGO stage-3 AKI managed with a protocolized delayed RRT strategy. Blood and 24-hour urine samples were collected at diagnosis (D0) and day 1 (D1). Glomerular filtration dynamics were assessed using kinetic GFR (kGFR), and timed urinary urea excretion was assessed using UUEI. Discrimination for subsequent RRT was assessed using ROC curves and AUC. A combined logistic model (kGFR D0-D1 + UUEI D1) was internally validated by bootstrap, with sensitivity analyses adjusted for SOFA and KDIGO stage-3 oliguria.

RESULTS: Among 110 patients, 31 (28%) required RRT. kGFR D0-D1 showed good discrimination (AUC 0.81 [0.72-0.89]), and UUEI D1 moderate discrimination (AUC 0.74 [0.63-0.82]). The combined model showed an AUC of 0.85 ([0.76-0.91]), optimism-corrected AUC 0.83, and acceptable calibration. Discrimination remained stable after adjustment for SOFA and oliguria. Incremental gain over kGFR alone was modest and not statistically significant.

CONCLUSIONS: Early glomerular filtration kinetics and urinary urea excretion were associated with subsequent RRT initiation under a delayed strategy. The incremental clinical value of UUEI remained limited in this cohort, and external validation is required before clinical use.

PMID:42087193 | DOI:10.1186/s13054-026-06035-4

BMC Med Inform Decis Mak. 2026 May 6;26(1):160. doi: 10.1186/s12911-026-03350-2.

NO ABSTRACT

PMID:42087181 | DOI:10.1186/s12911-026-03350-2

BMC Sports Sci Med Rehabil. 2026 May 6. doi: 10.1186/s13102-026-01711-y. Online ahead of print.

ABSTRACT

BACKGROUND: Team-level defensive efficiency is a central determinant of success in professional football, yet defenders’ physical and motor profiles are rarely examined in relation to ecological defensive outcomes, particularly in under-researched professional leagues. This study investigated anthropometric and motor-fitness signatures of defensive efficiency among professional football defenders in the Nigeria Premier Football League (NPFL) using multivariate profiling methods.

METHODS: An observational ecological study was conducted among 36 professional defenders from Enugu Rangers International FC across three competitive seasons (2021/22-2023/24). Standardised anthropometric and motor-fitness assessments (agility, vertical-jump power, reaction time, balance, and coordination) were obtained during pre-season testing. Team-level defensive efficiency was derived from predefined ecological defensive indicators obtained from official league statistics, including goals conceded per match, defensive success index, points per goal conceded, and goal-prevention rate. Analyses included Spearman correlations, Kruskal-Wallis tests with eta-squared effect sizes (η²_H), principal component analysis (PCA), and k-means clustering; no individual-level regression was undertaken.

RESULTS: GA/PLD was relatively stable between full seasons (0.79 in 2021/22; 0.87 in 2023/24), whereas DSI and PPGC improved (0.68→0.74; 1.87→2.06), with GPR and GD/PLD also increasing (0.27→0.38; 0.29→0.53), indicating that comparable goals conceded yielded more favourable results. Defenders showed substantial muscularity (mean BMI 25.7 kg/m²; muscle mass 41.2 kg) and good motor fitness (agility 11.0 s). Anthropometric variables were strongly coupled, and BMI and jump classifications showed large effects on muscle mass, body fat, and jump power. PCA yielded three components explaining 72.5% of variance (body size/composition; agility-balance-coordination; power vs. adiposity), and k-means clustering identified three defender archetypes that differed most clearly in agility, separating heavier, slower stoppers from leaner, faster coverage profiles and balanced hybrids.

CONCLUSION: This ecological profiling study shows that, within a single NPFL club, professional defenders cluster into distinct anthropometric and motor-fitness archetypes-ranging from heavier high-mass stoppers to leaner, more agile mobile coverage defenders-while team-level indicators suggest increasingly efficient conversion of broadly stable goals conceded into better results and goal difference. These patterns do not establish individual causal effects but illustrate how multivariate profiling can support role allocation, interpretation of body-size and power metrics, and context-sensitive conditioning in data-limited professional environments. Inferences remain exploratory and are constrained by single-club sampling, lack of player-level event data, and unquantified cluster stability.

PMID:42087177 | DOI:10.1186/s13102-026-01711-y

Genome Biol. 2026 May 5. doi: 10.1186/s13059-026-04086-y. Online ahead of print.

ABSTRACT

RNA velocity has recently emerged as a key tool in the analysis of single-cell transcriptomic data, yet connecting RNA velocity analyses to underlying regulatory processes has proved challenging. Here, we propose CRAK-Velo, a semi-mechanistic model that integrates chromatin accessibility data in the estimation of RNA velocities. CRAK-Velo provides biologically consistent estimates of developmental flows and enables accurate cell-type deconvolution, while additionally shining light on regulatory processes at the level of interactions between genes and chromatin regions.

PMID:42087173 | DOI:10.1186/s13059-026-04086-y

Confl Health. 2026 May 5. doi: 10.1186/s13031-026-00795-0. Online ahead of print.

ABSTRACT

BACKGROUND: Timely prehospital care is essential in preventing trauma‑related deaths in conflict settings, yet civilian systems often lack the capacity for rapid stabilization and evacuation. Trauma Stabilization Points (TSPs), adapted from military models, have been introduced in Gaza to provide forward‑deployed triage and stabilization. This study describes patient characteristics, clinical presentations, interventions, and outcomes at a TSP operating in Khan Younis, Gaza, in 2024 during the ongoing war.

METHODS: We conducted a retrospective cross‑sectional analysis of routinely collected patient‑level data from a TSP operated by the Palestinian Red Crescent Society with support from the WHO and an international emergency medical team. All patients presenting between 12 February and 28 April 2024 were included. Descriptive statistics and logistic regression assessed associations between patient characteristics, injury severity, interventions, and referral outcomes.

RESULTS: 1,928 patients were entered into the dataset. Non‑traumatic conditions accounted for 53% of attendances, while 47% were trauma‑related. Most patients (94.8%) were stable, as defined by the Interagency Integrated Triage Tool (IITT) on arrival. A total of 3482 interventions were recorded, dominated by basic care (86%). Overall, 80.6% of patients were discharged, 19.3% referred to still-functioning hospitals, and 0.1% died at the TSP. Clinical instability, fractures, and penetrating injuries were significantly associated with referral, while basic interventions (e.g., wound suturing, antipyretics) predicted discharge.

CONCLUSIONS: Despite operating in a high‑intensity conflict, the TSP primarily functioned as a triage and primary‑care access point rather than a trauma‑focused facility. The dominance of on-site treatment and same-day discharge suggest the TSP offloaded some non-urgent patients from overwhelmed hospitals and likely contributed to reducing consumption of limited ambulance resources.

PMID:42087157 | DOI:10.1186/s13031-026-00795-0

BMC Surg. 2026 May 6. doi: 10.1186/s12893-026-03813-3. Online ahead of print.

ABSTRACT

BACKGROUND: Perforated peptic ulcer is a critical emergency disease requiring surgery, and postoperative intra-abdominal abscess (IAA), an organ/space surgical site infection (SSI), is a common complication. Intraoperative irrigation is a common IAA prevention approach; however, scientific evidence supporting its effectiveness is lacking. We aimed to investigate the association between intraoperative irrigation volume and IAA using multicentre data.

METHODS: This multicentre retrospective cohort study was conducted between January 2011 and December 2023. The study included patients aged ≥ 18 years who underwent laparotomy or laparoscopy for perforated peptic ulcer, defined as perforation of a gastric or duodenal ulcer. The primary and secondary outcomes were IAA incidence and superficial incisional SSI, respectively, and their association with the intraoperative irrigation volume was determined through multivariable logistic regression analyses.

RESULTS: The study included 478 patients with a median age of 66 years (interquartile range [IQR]: 54-75 years), 344 (72.0%) of whom were males. The median irrigation volume was 7.0 (IQR: 5-10) L. Among the 478 patients, IAA and superficial incisional SSI occurred in 52 (10.9%) and 71 (14.9%), respectively. The irrigation volume and the outcomes exhibited no significant association (for IAA: adjusted odds ratio [AOR] = 1.04, 95% confidence interval [CI] = 0.97-1.11, p = 0.25; for superficial incisional SSI: AOR = 1.07, 95% CI = 1.00-1.14, p = 0.053).

CONCLUSIONS: There was no statistically significant association between increased intraoperative irrigation volume and a decreased incidence of postoperative IAA formation. These findings suggest that alternative strategies, rather than uncontrolled high-volume irrigation, are required for IAA prevention.

PMID:42087153 | DOI:10.1186/s12893-026-03813-3