Tag: statistics

Front Vet Sci. 2026 Jul 8;13:1863158. doi: 10.3389/fvets.2026.1863158. eCollection 2026.

ABSTRACT

BACKGROUND: Cephalopina titillator (C. titillator) is the causative agent of camel nasopharyngeal myiasis and is widespread in camel-rearing regions worldwide, causing impaired health, reduced productivity, and economic losses. However, despite the veterinary importance of C. titillator, global epidemiological evidence remains limited and fragmented, and no comprehensive synthesis of prevalence data across camel-rearing regions has previously been conducted. The objective of this review was to estimate the global pooled prevalence of C. titillator infestation in camels. In addition, subgroup analyses were made to assess the effect of camel species, geographic region, and study period on the pooled prevalence of C. titillator infestation.

METHODS: The review was conducted in accordance with PRISMA 2020 guidelines. The review protocol was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD420261344750. A literature search was conducted in multiple databases including PubMed/MEDLINE, Scopus, Web of Science (WoS), Google Scholar, and CAB Direct (Centre for Agriculture and Bioscience International database; CABI). Pooled prevalence was estimated by a random-effects meta-analysis using R software. Heterogeneity of the prevalence reports was assessed using Cochran’s Q and the I² statistic. Funnel plot and Egger’s test were used for assessing study bias.

RESULTS: Forty-one epidemiological studies involving 18,959 camels from 11 countries were included in this review. The pooled prevalence of C. titillator infestation was 67% (95% CI: 59-75%). Heterogeneity among studies was very high (I² = 99.1%, p < 0.001). Subgroup analyses revealed significant differences in pooled prevalence among study regions (p = 0.0016), whereas pooled prevalence was not significantly affected by study period or camel species (p > 0.05). Although the funnel plot showed slight asymmetry, Egger’s regression test did not indicate statistically significant small-study effects (p = 0.497).

CONCLUSION: This meta-analysis demonstrated a high pooled prevalence of C. titillator infestation (67%; 95% CI: 59-75%) and revealed important geographical variation across camel-rearing countries, highlighting the substantial epidemiological burden of infestation and the need for region-specific surveillance and control strategies.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO, Registration No. CRD420261344750. Publicly accessible at: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=1344750.

PMID:42488901 | PMC:PMC13388046 | DOI:10.3389/fvets.2026.1863158

JB JS Open Access. 2026 Jul 24;11(3):e26.00192. doi: 10.2106/JBJS.OA.26.00192. eCollection 2026 Jul-Sep.

ABSTRACT

BACKGROUND: Physical therapy (PT) is essential to recovery after orthopaedic surgery, yet predictors of postoperative PT utilization across procedure types remain poorly understood. This study aimed to identify demographic and clinical predictors of PT utilization after 8 common orthopaedic procedures using a diverse national cohort.

METHODS: Patients undergoing 8 orthopaedic procedures were identified from the National Institutes of Health All of Us Research Program. The primary outcome was PT utilization within 180 days of surgery. Sequential multivariable logistic regression evaluated predictors of PT utilization, adjusting for demographics, comorbidities, insurance, employment, preoperative PT, 0- to 14-day postoperative opioid prescriptions, and procedure type. Procedure-stratified analyses were performed. Statistical significance was set as p < 0.050.

RESULTS: Among 12,666 patients (59% female; mean age, 58 ± 13 years), including 1,531 (12%) Hispanic/Latino and 1,445 (11%) Black patients, overall postoperative PT utilization was 44%. Female sex was associated with lower odds of PT utilization compared with male sex (adjusted odds ratio [aOR], 0.85; 95% confidence interval [CI], 0.78 to 0.92; p < 0.001), an effect that persisted after full adjustment. Preoperative PT (aOR, 8.91; 95% CI, 7.75-10.23; p < 0.001) and 0- to 14-day postoperative opioid prescriptions (aOR, 1.66; 95% CI, 1.50-1.83; p < 0.001) were independently associated with higher PT utilization. The association between female sex and lower PT utilization reached statistical significance in the total knee arthroplasty subgroup only in procedure-stratified analyses (aOR, 0.78; 95% CI, 0.67-0.91; p = 0.001). PT utilization was associated with lower 90-day emergency department visits (aOR, 0.67; 95% CI, 0.59-0.76; p < 0.001).

CONCLUSIONS: Preoperative PT and early postoperative opioid prescriptions were the strongest predictors of postoperative PT utilization. Female sex was associated with lower PT utilization after comprehensive adjustment, although structural and unmeasured factors may partially account for this finding. These findings identify factors associated with rehabilitation access after orthopaedic surgery. Preoperative PT engagement, equitable opioid-prescribing practices, and strategies to address insurance-related barriers warrant further investigation as potential approaches to improve postoperative rehabilitation access.

LEVEL OF EVIDENCE: Level III, Prognostic. See Instructions for Authors for a complete description of levels of evidence.

PMID:42488892 | PMC:PMC13391136 | DOI:10.2106/JBJS.OA.26.00192

JB JS Open Access. 2026 Jul 24;11(3):e25.00300. doi: 10.2106/JBJS.OA.25.00300. eCollection 2026 Jul-Sep.

ABSTRACT

» Native femoral version (NFV) demonstrates inconsistent correlation with prosthetic femoral version (PFV) and should not be relied upon in isolation for femoral version planning in cementless total hip arthroplasty (THA). » Final stem version is strongly influenced by intramedullary canal morphology, fixation mechanics, and stem design philosophy. Straight, tapered wedge, and diaphyseal-engaging stems demonstrate greater variability in PFV, whereas anatomic and calcar-guided short stems may better preserve NFV. » Current planning methods inadequately characterise three-dimensional canal anatomy and fail to simulate canal-stem interaction, limiting accurate prediction of PFV. » Intraoperative estimation methods remain inconsistent and highly dependent on surgeon experience. Robotic-assisted THA enables real-time PFV measurements and supports femur-first strategies to optimise combined anteversion, although current systems still rely on computed tomography templating without true canal-stem interaction modelling. » Reliable PFV prediction will likely require next-generation planning platforms integrating internal canal anatomy, statistical shape modelling and artificial intelligence-driven modelling into planning workflows.

PMID:42488890 | PMC:PMC13391145 | DOI:10.2106/JBJS.OA.25.00300

Vet Med Int. 2026 Jul 22;2026:5535645. doi: 10.1155/vmi/5535645. eCollection 2026.

ABSTRACT

Endoparasites are a major health concern affecting equine productivity and welfare worldwide. Understanding farmers’ knowledge, attitudes, and practices (KAP) toward parasite control is critical for designing effective interventions. This study assessed KAP levels among farmers in South Gondar Zone, Northwest Ethiopia, and identified factors associated with good KAP. A community-based cross-sectional study was conducted among 150 farmers. KAP scores were initially categorized into three levels (low, moderate, and high) and analyzed using chi-square (χ ²) tests to explore bivariate associations. For logistic regression analyses, KAP outcomes were dichotomized into good and poor categories. Univariable and multivariable binary logistic regression models were used to identify independent predictors of good KAP, with p ≤ 0.05 considered statistically significant. The study employed representative sampling across districts, a pretested questionnaire, and comprehensive adjustment using multivariable logistic regression to enhance the reliability of the findings. Among 150 respondents, 120 (80%) were male and 30 (20%) female. The majority were adults (50.7%), followed by young (34.7%) and old (14.7%) age groups. Nearly half of the participants were with no formal education (49.3%), 44% had primary education, and 6.7% had secondary education. Farmers were evenly distributed across three districts (Dera, Fogera, and Libokemkem), and most (n = 123, 82%) lived within 1-10 km of a veterinary facility. Overall, 52.7% of farmers demonstrated good knowledge, 66.7% exhibited a positive attitude, and 91.3% reported good practices toward equine endoparasites. Multivariable binary logistic regression analysis using SPSS (v. 27) revealed that, for knowledge, adults (AOR = 0.12, 95% CI: 0.03-0.50) and older farmers (AOR = 0.10, 95% CI: 0.02-0.55) were less likely to have good knowledge compared to young farmers, whereas educated farmers were substantially more likely to have good knowledge (AOR = 15.8, 95% CI: 3.4-73.8). Regarding attitude, adults (AOR = 0.015, 95% CI: 0.002-0.12) and older farmers (AOR = 0.013, 95% CI: 0.001-0.12) were less likely to have a positive attitude, while education (AOR = 18.5, 95% CI: 5.0-68.0) and residence in Libokemkem district (AOR = 3.80, 95% CI: 1.36-10.57) were positively associated with good attitude. For practice, good practices were more likely among adult farmers (AOR = 54.5, 95% CI: 4.8-620), but less likely among females (AOR = 0.18, 95% CI: 0.04-0.78) and farmers living > 10 km from veterinary services (AOR = 0.06, 95% CI: 0.004-0.95). Age and education were key determinants of farmers’ KAP toward equine endoparasite control. Hence, targeted educational interventions focusing on different age and education groups could improve parasite management practices in this region.

PMID:42488887 | PMC:PMC13389813 | DOI:10.1155/vmi/5535645

Vet Med Int. 2026 Jul 22;2026:9933937. doi: 10.1155/vmi/9933937. eCollection 2026.

ABSTRACT

Newcastle disease (ND) is a notifiable and highly contagious disease causing a significant economic loss in village chicken production. So, a cross-sectional study was conducted in the East Gojjam zone of Ethiopia to determine the status of ND among unvaccinated village chickens. The study sites were selected randomly. However, the chicken owners included were households that had at least four chickens with no prior history of ND vaccination. A total of 314 serum and 76 pooled tracheal and cloacal swab samples were collected from apparently healthy birds. The hemagglutination inhibition (HI) test and reverse-transcription polymerase chain reaction (RT-PCR) were conducted for serological and virological tests, respectively. The data were analyzed using the SPSS version 20 software package. Descriptive statistics and generalized linear mixed models were used for data analysis. The overall seroprevalence rate at the individual chicken level was found to be 93% (292/314 chickens). At the household level, ND was identified in all sampled households, with a minimum of two seropositive chickens found in each household. However, these chickens tested negative for the ND virus by RT-PCR. The seroprevalence rates of the NDV at each study site were 95.0%, 96.0%, and 86.9% for Gozamin, Enemay, and Debre Elias woredas, respectively, with a statistically significant difference (p < 0.05) observed among the study sites through descriptive analysis. Chickens from households where ND had occurred showed a significant association with seropositivity (p = 0.023, COR = 2.72). Contact with other flocks was the primary risk factor identified, with chickens that had such contact showing significantly higher odds of ND seropositivity compared to those that did not (p < 0.001, AOR = 5.18). Furthermore, households with access to veterinary service demonstrated significantly higher odds of NDV seropositivity (p = 0.006, AOR = 5.07) in comparison to those without such access. This implies that professional services in the area are utilized reactively in response to disease occurrence rather than as a proactive preventive measure. The findings revealed that the ND virus antibodies in village chicken were very high, indicating that ND is the major disease in the area that can threaten village chicken production. Therefore, programmed immunization is vital in order to prevent the occurrence of the disease. Awareness creation among smallholder farmers on the prevention and control measures for ND is recommended. Additionally, further research focusing on the virus strain identification is required.

PMID:42488886 | PMC:PMC13389809 | DOI:10.1155/vmi/9933937

Niger Med J. 2026 Mar 26;66(6):2128-2144. eCollection 2025 Nov-Dec.

ABSTRACT

BACKGROUND: Laparoscopy is underutilized in underdeveloped countries. The residency program provides a good opportunity to introduce laparoscopy to gynecology trainees. This study aimed to evaluate residents’ exposure and education on laparoscopic training in gynecology across different centers in Southwest Nigeria.

METHODOLOGY: This study was carried out among 75 resident doctors in gynecology across four centers in Southwest Nigeria. Data was collected using a modified pretested semi-structured questionnaire. Continuous and categorical variables were summarized, and the Chi-square test was used to test for statistical associations at p<0.05.

RESULTS: The study found that two-thirds of the respondents had attended a local training program in laparoscopy, and 81.3% of the residents had an above-average level of knowledge. The level of knowledge of laparoscopy was significantly associated with the cadre of the residents, center, and the level of exposure of the residents to laparoscopy (χ2 = 7.040, p= 0.008; χ2 = 19.233, p= 0.001; χ2 = 28.440, p= 0.001). While laparoscopy facilities were available in almost all centers, the average monthly laparoscopy procedure was 2.40±1.25. Only about half of the doctors have assisted in laparoscopic procedures, and just 4.0% have performed a laparoscopic procedure under supervision. Exposure to laparoscopy was associated with the cadre, center, the average number of laparoscopies performed per month in the center, availability of training programs for laparoscopy and the availability of skills lab (χ2 = 10.215, p= 0.001; χ2 = 25.182, p= 0.001; χ2 = 15.444, p= 0.001; χ2 = 35.810, p= 0.001; χ2 = 8.214, p= 0.004). Factors limiting exposure and expertise included lack of funds, low surgeon motivation, lack of trained personnel, and institutional support.

CONCLUSION: The study indicates high knowledge and exposure to laparoscopy among Southwest Nigerian doctors, but low competence, emphasizing the need for further inclusion in Nigeria’s postgraduate training programs.

PMID:42488881 | PMC:PMC13391114

J Hazard Mater. 2026 Jul 16;515:143013. doi: 10.1016/j.jhazmat.2026.143013. Online ahead of print.

ABSTRACT

Although pesticide exposure occurs through multiple pathways and has been linked to diverse health outcomes, the overall evidence remains unclear. We systematically searched PubMed/MEDLINE, Embase, CINAHL, and Google Scholar up to November 20, 2025, for meta-analyses examining pesticide exposure and adverse health outcomes. We recalculated pooled estimates using random-effects models and converted all effect metrics to equivalent odds ratios with 95% confidence intervals. The quality of included reviews was assessed using AMSTAR 2, and the credibility of evidence was graded using predefined criteria (Class I to IV). A total of 53 meta-analyses covering 235 associations were included. Among the 77 main associations, 48.1% achieved statistical significance, of which 51.4% were supported by highly suggestive or suggestive evidence. Significant associations with pesticide exposure were observed across several health domains, particularly oncological, metabolic, neurological, and respiratory outcomes, with additional signals emerging in subgroup analyses. Particularly, exposures to organochlorine pesticides had increased odds of non-Hodgkin lymphoma. Exposure to dichlorodiphenyldichloroethylenes was associated with diabetes mellitus and non-Hodgkin lymphoma, while exposure to organochlorine insecticides was associated with hypothyroidism. Pesticide exposure was associated with childhood lower respiratory infections among respiratory outcomes. These findings identify priorities for prevention and highlight the need for better exposure assessment.

PMID:42485730 | DOI:10.1016/j.jhazmat.2026.143013

ESMO Open. 2026 Jul 22;11(8):108335. doi: 10.1016/j.esmoop.2026.108335. Online ahead of print.

ABSTRACT

BACKGROUND: Currently, three cyclin-dependent kinase 4 and 6 inhibitors (CDK4/6i) are approved in combination with endocrine therapy (ET) as first-line treatment of patients with hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (MBC). The impact of homologous recombination repair (HRR) pathogenic variants (PV) on outcomes with first-line CDK4/6i plus ET in HR-positive/HER2-negative MBC remains uncertain.

PATIENTS AND METHODS: We conducted a multicenter, real-world, case-control study including 233 patients with HR-positive/HER2-negative MBC treated with first-line CDK4/6i and ET. Among them, 116 presented HRR PVs and 117 were matched controls with negative germline testing. The primary objective was to compare progression-free survival (PFS) and overall survival among germline-BRCA2 PV carriers, other HRR PV carriers, and controls. To minimize baseline differences in prognostic factors between PV carriers and controls, inverse probability of treatment weighting was applied. Molecular analyses in pre-CDK4/6i samples among patients with BRCA2 PV were carried out, including RAD51-foci, PAM50 intrinsic subtype, and RB1 loss of heterozygosity (LOH).

RESULTS: Among the included 233 patients, median age at diagnosis was 45 years (interquartile range 39-56) and 33% had de novo metastatic disease. Primary resistance to adjuvant ET was present in 10% and secondary resistance in 27%. After a median follow-up of 44 months, patients with germline-BRCA2 PVs (n = 67) had significantly shorter PFS [11 versus 27 months; adjusted hazard ratio (aHR) 2.73, 95% confidence interval (CI) 1.65-4.51, P < 0.001] compared with controls. Among patients with endocrine-sensitive disease, germline BRCA2 PV carriers had markedly shorter PFS (median PFS 12 versus 39 months; aHR 4.04; 95% CI 1.82-8.98, P < 0.001). Exploratory analyses revealed RB1 LOH before CDK4/6i-treatment in most evaluable BRCA2 tumors.

CONCLUSIONS: BRCA2 PVs were independently associated with poorer outcomes to first-line CDK4/6i plus ET in HR-positive/HER2-negative MBC compared with controls, especially relevant among patients with endocrine-sensitive disease. These findings suggest that patients with a germline PV in BRCA2 may require alternative first-line strategies.

PMID:42485699 | DOI:10.1016/j.esmoop.2026.108335

Cancer Treat Res Commun. 2026 Jul 22;48:101326. doi: 10.1016/j.ctarc.2026.101326. Online ahead of print.

ABSTRACT

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal malignancy with limited durable treatment options despite evolving multimodal and systemic strategies. Systemic inflammation has emerged as a clinically relevant determinant of outcomes in several cancers. The systemic immune-inflammation index (SII; platelet count x neutrophil count / lymphocyte count) integrates key circulating immune cell populations and may serve as an accessible prognostic biomarker in PDAC.

METHODS: A systematic search of PubMed was performed for studies published up to 11 April 2025. Eligible full-text English studies reported hazard ratios (HRs) with 95% confidence intervals (CIs) for overall survival (OS) according to SII (typically high versus low SII, defined by a study-specific cutoff). Pooled HRs were calculated using an inverse-variance random-effects model. Heterogeneity was assessed using Cochran’s Q and the I² statistic. Small-study effects were evaluated by funnel plot inspection and Egger’s regression test.

RESULTS: Seventeen studies (18 datasets) comprising 4218 patients were included. Elevated SII was associated with worse OS (pooled HR 1.58, 95% CI 1.19 – 2.08; p < 0.01). Between-study heterogeneity was substantial (I² = 89.9%). Funnel plot inspection did not suggest major asymmetry, and Egger’s test did not provide statistical evidence of small-study effects (p = 0.072).

CONCLUSIONS: Elevated SII is associated with poorer overall survival and represents a practical prognostic biomarker derived from routine laboratory testing. Considerable heterogeneity across studies-likely driven by differences in case mix, treatment context, and SII cutoff definitions-underscores the need for standardized thresholds and prospective, harmonized validation studies.

PMID:42485687 | DOI:10.1016/j.ctarc.2026.101326

BJS Open. 2026 Jul 3;10(4):zrag095. doi: 10.1093/bjsopen/zrag095.

ABSTRACT

BACKGROUND: Postoperative hypoparathyroidism is the most common complication after total thyroidectomy, and is associated with impaired quality of life and increased long-term healthcare use. Indocyanine green fluorescence imaging enables real-time intraoperative assessment of parathyroid perfusion, potentially improving gland preservation. However, its cost-effectiveness in routine surgical practice has not been formally evaluated.

METHODS: A model-based cost-effectiveness analysis was conducted comparing angiography-guided thyroidectomy with conventional thyroidectomy from the perspective of the Spanish National Health System. A state-transition Markov model simulated long-term outcomes for adults undergoing thyroidectomy, incorporating the incidence of transient and permanent hypoparathyroidism, health-related quality-adjusted life-years, and direct medical costs. The model used contemporary surgical data, included a 35-year time horizon, and discounted costs and effects at 3.5% annually. Probabilistic and deterministic sensitivity analyses were used to assess parameter and structural uncertainty. Cost-effectiveness was judged at a willingness-to-pay threshold of €30 000 per quality-adjusted life-year.

RESULTS: Angiography-guided thyroidectomy was associated with lower lifetime healthcare costs (€563.7 million versus €613.2 million) and greater health benefits (310 997 versus 299 107 quality-adjusted life-years), yielding a gain of 11 889 quality-adjusted life-years and €49.5 million in cost savings. Angiography-guided thyroidectomy dominated conventional thyroidectomy in all sensitivity analyses, with an incremental net monetary benefit of €406.2 million (95% uncertainty interval €381.7 million to €431.5 million). Scenario and joint probabilistic analyses confirmed robustness under alternative utility values and surgical outcomes.

CONCLUSION: Angiography-guided thyroidectomy may be a cost-saving innovation within publicly funded healthcare systems by reducing the incidence and chronic burden of postoperative hypoparathyroidism. These findings support broader adoption of fluorescence-guided surgery and underscore the need for real-world implementation studies to validate cost-effectiveness, and inform training and procurement strategies.

PMID:42485666 | DOI:10.1093/bjsopen/zrag095