Tag: statistics

Fam Med. 2026 Jan;58(1):20-26. doi: 10.22454/FamMed.2026.956887.

ABSTRACT

BACKGROUND AND OBJECTIVES: Family medicine residency faculty occupy multiple roles with residents, including teacher, adviser, evaluator, and supervisor. Faculty also might fill noncurricular roles in social settings and in providing health care services to residents. These overlapping responsibilities create potential for dual relationships that may blur boundaries and cause ethical concerns. While national guidelines prohibit overtly inappropriate relationships, little guidance exists for common noncurricular interactions. This study examined the prevalence, types, and consequences of faculty-resident dual relationships and assessed faculty awareness of related policies.

METHODS: We conducted a convergent mixed-methods survey of US family medicine faculty that included demographic items, questions about specific dual relationships and policy awareness, and an open-ended prompt concerning boundary crossings. Quantitative data were analyzed using descriptive statistics and χ2 tests; qualitative responses underwent thematic analysis.

RESULTS: We received 213 responses. Frequently reported dual relationships included social comingling (68%), provision of minor medical or behavioral services (54%), and personal relationships (36%); financial or contractual ties were rare (≤3%). We observed significant differences by faculty type: Behavioral health faculty were more likely to provide minor services (P = 0.004), while physician faculty more often provided intensive services (P = 0.011). Awareness of residency policies was low. Qualitative responses highlighted boundary crossings with negative impacts on residents, faculty, and programs.

CONCLUSIONS: Dual relationships are common in family medicine residencies, yet policy guidance is limited. Stronger institutional and professional guidelines would support resident wellness, faculty objectivity, and professional boundaries.

PMID:41854849 | DOI:10.22454/FamMed.2026.956887

Fam Med. 2026 Jan;58(1):12-19. doi: 10.22454/FamMed.2026.646169.

ABSTRACT

BACKGROUND AND OBJECTIVES: Maternal care in the United States is in crisis due to obstetrics workforce shortages. Family physicians, with whole-person training and geographical practice distribution, are well-positioned to address this crisis. Family physicians completing a family medicine obstetrics (FMOB) fellowship are trained in surgical skills and high-risk pregnancy management, and often practice in health care shortage areas. This study aimed to update and expand knowledge on FMOB fellowships, focusing on program characteristics and financial sustainability.

METHODS: We sent an email-based survey examining fellowship structure and financial information to 44 FMOB fellowships. Representatives of 22 fellowships (50%) anonymously completed the online survey. Authors used descriptive statistics, including frequency, mean, and standard deviation, to summarize the data.

RESULTS: Half the fellowships were housed in family medicine residency programs. Fellowships, mostly 1 year long, admitted on average 2.2 fellows annually. Financially, nearly half (45%) the fellowships operated at a budget deficit, with clinical revenue and federal funding being major funding sources. More than 50% of programs reported that fellows spent less than 20% of their time as an independent billing physician.

CONCLUSIONS: FMOB fellows are surgically trained and uniquely positioned to help address the current crisis, including filling obstetric care gaps in underserved and rural areas. Given funding challenges FMOB fellowships face, developing strategies for financial viability of FMOB fellowships going forward is crucial. Opportunities include increasing clinical revenue generation and attaining secure funding via pursuit of accreditation status for FMOB fellowship programs from the Accreditation Council for Graduate Medical Education.

PMID:41854848 | DOI:10.22454/FamMed.2026.646169

Biochem Genet. 2026 Mar 19. doi: 10.1007/s10528-026-11351-z. Online ahead of print.

ABSTRACT

This study aimed to investigate the effects of Lavandula angustifolia oil and medical ozone on the gene expressions of CYP1A1, CYP1A2, CYP2B1, and CYP3A1, as well as on the levels of Malondialdehyde (MDA), and the activities of Superoxide Dismutase (SOD) and Catalase (CAT) enzymes on acute liver toxicity. Experimental groups were established by separating 10-week-old 28 Wistar male rats, each weighing between 350 and 450 g, into four groups of seven rats each. Gene expression levels were determined using RT-qPCR. MDA measured in the tissue samples by the thiobarbituric acid method. SOD and CAT enzyme activities measured spectrophotometrically. CYP1A1 fold regulation significantly decreased in the Lavandula (p = 0.012), and medical ozone (p = 0.044) groups compared to the control group. However, changes in the combination group were not statistically significant compared to the control group (p = 0.133). There were no significant differences in the fold regulations of CYP1A2, CYP2B1, and CYP3A1 among any groups (p > 0.05). MDA levels were significantly lower in the Lavandula, and medical ozone groups compared to the control group (p = 0.001). CAT enzyme activity did not show significant differences in the Lavandula (p = 0.096) and medical ozone groups (p = 0.103) but decreased significantly in the combination group (p = 0.031). SOD enzyme activity did not show significant differences among the groups (p = 0.112). Lavandula and medical ozone treatments significantly reduced CYP1A1 gene expression and MDA levels, which may indicate their potential in reducing oxidative stress. These findings highlight the complexity of combined therapies and suggest possible interactions or suppressive effects between the agents, which have not been previously reported.

PMID:41854830 | DOI:10.1007/s10528-026-11351-z

Discov Oncol. 2026 Mar 19. doi: 10.1007/s12672-026-04841-4. Online ahead of print.

ABSTRACT

INTRODUCTION: The role of peripheral blood basophil (PBB) and their telomere length (TL) in the pathogenesis and prognosis of hepatocellular carcinoma (HCC) patients has not been fully studied. The correlation between PBB and TL is the risk of HCC.

METHODS: 30 healthy participants and 80 HCC patients from our hospital were included in this study, and their clinical baseline data and clinical characteristics were statistically analyzed. TL and telomerase in PBB were analyzed using quantitative real-time PCR. Univariate and multivariate Cox regression, Kaplan-Meier survival analysis, and natural splines were used.

RESULTS: Healthy participants 66.23 ± 11.20 years and 62.71 ± 13.27 HCC patients showed no significant difference in their gender, age, highest education level, and the distribution of PBB counts. There was a significant difference in their TL. A significant correlation between PBB count and recurrence in HCC patients was observed. Significant spline terms (PBB count: p < 0.01; BAS TL: p < 0.001) confirmed nonlinear associations, justifying avoiding dichotomy. Patients with higher PBB counts (>0.125⋅10⁹) having a higher risk of recurrence (HR reaching 182.49 [5.00-6664.20], p<0.01). HCC patients with PBB-TL levels greater than 1.5 have a higher risk of recurrence (HR peaking at 66.62 [8.27-536.51], p<0.001). Sensitivity analysis adjusted spline degrees of freedom (df) to 2, 3, 4. AIC values varied minimally (PBB count: 87.2-89.3; BAS TL: 106.1-110.1), indicating model robustness to df changes.

CONCLUSION: The preliminary results of this study support the use of PBB counting and TL for predicting HCC recurrence, supporting reliable nonlinear modeling.

PMID:41854795 | DOI:10.1007/s12672-026-04841-4

Breast Cancer Res Treat. 2026 Mar 19;216(3):31. doi: 10.1007/s10549-026-07917-5.

ABSTRACT

PURPOSE: To investigate long-term outcomes for triple‑negative breast cancer (TNBC) patients enrolled in JBCRG-22.

METHODS: TNBC (cT1c-T3, cN0-1, M0) patients were stratified by homologous recombination deficiency (HRD) and germline BRCA mutation (gBRCAm) status. Group A patients (aged < 65 years with HRD-positive tumors, or those with gBRCAm, if available) were randomized to receive 4 cycles of weekly paclitaxel (group A1) or eribulin (group A2), both with carboplatin, followed by 4 cycles of anthracycline. Group B patients (aged < 65 years with HRD-negative tumors or aged ≥ 65 years) were randomized to receive 6 cycles of eribulin plus cyclophosphamide (group B1) or eribulin plus capecitabine (group B2). Five-year invasive disease-free survival (IDFS), distant disease-free survival (DDFS), and overall survival (OS) were assessed. Additionally, data were analyzed by biomarker levels including lymphocyte count (LC) and neutrophil-to-lymphocyte ratio (NLR).

RESULTS: Ninety-nine patients were followed for a median of 5.6 years. In patients who received eribulin-based therapy (groups A2 + B1 + B2), 5-year IDFS and OS rates, respectively, were 95% and 100% in patients who achieved pCR after neoadjuvant therapy (n = 20) and 71.4% and 80.2% in those who did not (n = 56), showing significantly better prognosis in the pCR cohort (p < 0.05). OS tended to be better in patients with baseline LC ≥ 1500/mm³ and NLR < 3, particularly in eribulin-treated patients, although differences were non-significant.

CONCLUSIONS: These findings will help guide the development of eribulin-based neoadjuvant chemotherapy for selected TNBC patients. Our exploratory analysis of LC and NLR results may help inform clinical prediction models for eribulin-treated patients.

TRIAL REGISTRATION: The study has been registered with the University Hospital Medical Information Network Clinical Trials Registry ( https://www.umin.ac.jp/ctr/index-j.htm ) with unique trial number UMIN000023162. The Japan Breast Cancer Research Group trial number is JBCRG-22.

PMID:41854792 | DOI:10.1007/s10549-026-07917-5

Head Neck Pathol. 2026 Mar 19;20(1):34. doi: 10.1007/s12105-026-01908-0.

ABSTRACT

AIM: To characterize the expression of CD8 + T cells, CD68 + macrophages, and PDL1 in HPV-related multiphenotypic sinonasal carcinoma (HMSC) and evaluate their correlations with clinical outcomes.

MATERIALS AND METHODS: This retrospective cross-sectional study analyzed 27 HMSC cases. Clinical and histopathological data were obtained from medical records. Immunohistochemical expression of CD8 and CD68 was assessed quantitatively and qualitatively in stromal and intratumoral compartments. PDL1 expression was evaluated using the Combined Positive Score (CPS). HPV genotyping was performed using the Anyplex II HPV28 assay. Statistical analyses included descriptive statistics, Fisher’s exact test, Chi-square test, Spearman’s correlation, Student’s t-test, Mann-Whitney U test, Kaplan-Meier survival analysis with log-rank test, and Cox proportional hazards models.

RESULTS: The cohort included 15 (55.6%) males and 12 (44.4%) females, with a mean age of 59.5 years. Most patients presented without recurrence (n = 17, 63.0%), lymph node metastasis (n = 22, 81.5%), or distant metastasis (n = 23, 85.2%). HPV-33 was the predominant genotype, detected in 17 cases (63.0%). PDL1 positivity was observed in 12 tumors (44.4%) and correlated with increased CD8 + infiltration (ρ = 0.602, p < 0.01). Higher densities of CD8 + T cells and CD68 + macrophages were associated with reduced recurrence risk. Older age correlated with higher Ki67 index (ρ = 0.452, p < 0.05), lower PDL1 expression (ρ=-0.436, p < 0.05), and increased recurrence. Lymph node and distant metastases were associated with poorer disease-specific survival (p = 0.020 and p = 0.010, respectively).

CONCLUSIONS: The immune microenvironment, characterized by CD8 + and CD68 + cell density and PDL1 expression, together with patient age, appears to influence clinical outcomes in HMSC. These findings suggest that a subset of HMSC patients, particularly those with an inflamed tumor microenvironment, may be candidates for PDL1-targeted immunotherapy.

PMID:41854784 | DOI:10.1007/s12105-026-01908-0

J Egypt Public Health Assoc. 2026 Mar 19;101(1):7. doi: 10.1186/s42506-026-00211-8.

ABSTRACT

BACKGROUND: Microbial communities in aquatic ecosystems are integral to water quality and public health, yet their structure and underlying ecological processes in regions like Egypt remain underexplored. To address this gap, this research explores the structure and dynamics of prokaryotic communities in tap water and groundwater in Cairo, Egypt.

METHODS: Using environmental DNA metabarcoding, bioinformatics, and statistical modeling, we investigated microbial composition, pathogen identification, environmental factors, and ecological assembly processes.

RESULTS: The sequence analysis revealed the presence of 6,868 amplicon sequence variants (ASVs), with distinct community structures between groundwater and tap water. Proteobacteria dominated both habitats, with significant habitat-specific variations in Firmicutes, Actinobacteria, Verrucomicrobia, and Bacteroidota. Key genera included Methylobacterium in tap water, and Thauera and Legionella in groundwater, reflecting habitat-specific adaptations. The potential presence of Legionella-detected through 16 S rRNA gene signatures-may indicate conditions that could support organisms associated with diseases such as Legionnaires’ disease; however, 16 S-based detection does not confirm viability or infectivity. Similarly, the surrogate presence of taxa such as Streptococcus salivarius, Stenotrophomonas maltophilia, and Acinetobacter baumannii in tap-water samples suggests possible post-treatment contamination or biofilm-associated persistence, warranting further targeted monitoring using methods capable of confirming viability. Ecological assessments indicated that stochastic mechanisms, particularly ecological drift, were the dominant forces shaping microbial community assembly in both water sources, whereas homogeneous selection exerted a moderate influence specifically within groundwater environments. Environmental parameters such as DO%, NO₂-N, and NO₃-N were critical in shaping tap water communities, while NH₄-N and TDS influenced groundwater communities.

CONCLUSION: This study highlights the distinct microbial dynamics of groundwater and tap water, emphasizing the importance of integrated water quality management strategies to mitigate nutrient pollution, monitor potential pathogen signatures, and protect public health.

PMID:41854783 | DOI:10.1186/s42506-026-00211-8

Cancer Causes Control. 2026 Mar 19;37(4):62. doi: 10.1007/s10552-026-02152-1.

ABSTRACT

PURPOSE: Synthetic census tracts can allow for release of small area cancer data without compromising patient confidentiality. We used synthetic and actual census tract data for California and actual data for New York State (NYS) to examine associations of small area socioeconomic factors with breast cancer prognosis and outcomes and to evaluate results obtained from synthetic versus actual data.

METHODS: We retrieved data on invasive, first primary breast cancers diagnosed between 2006 and 2017 in females ages ≥ 18 in California (n = 237,156) or NYS (n = 149,789). We categorized into quintiles census tract-level exposures and used multivariable-adjusted multilevel logistic and Cox proportional hazards regression analyses to examine associations with stage, grade, subtype, and overall and cancer-specific survival. We conducted separate analyses for California and NYS and compared results from the two states and from synthetic and actual data for California.

RESULTS: Except for income inequality, greater disadvantage for each socioeconomic variable was statistically significantly associated with more advanced stage, higher grade, higher-risk subtypes, and poorer survival in both states. Synthetic and actual results for California were consistent in direction and statistical significance, but the synthetic data tended to overestimate associations with stage and underestimate associations with grade, subtype, and survival.

CONCLUSION: Our results indicate that residence in more disadvantaged census tracts is associated with poorer breast cancer prognosis and outcomes. Associations were similar across two large, diverse states, and synthetic results approximated actual results for California. Additional work is needed to improve early diagnosis, care, and outcomes for individuals with breast cancer in disadvantaged areas.

PMID:41854767 | DOI:10.1007/s10552-026-02152-1

J Egypt Public Health Assoc. 2026 Mar 19;101(1):8. doi: 10.1186/s42506-026-00214-5.

ABSTRACT

BACKGROUND: The Palestinian healthcare system has historically relied on referrals of patients to health facilities across Palestine’s borders. Patients referred typically suffered from chronic conditions or congenital anomalies for which the governmental health facilities in Palestine lacked treatment or diagnostic options. The ongoing Israeli genocide on the Palestinian population has destroyed much of the health system and facilities in Gaza and caused tens of thousands of traumatic injuries that need referral abroad, on top of the cohort of patients with chronic conditions and congenital anomalies.

FINDINGS: Statistics published by the WHO-oPt show that 7,841 patients have been allowed medical evacuation and referral from Gaza between the start of the war in October 2023 and 29 September 2025. About two-thirds of all patients (n = 5,000. 63.8%) were medically evacuated before the Israeli military forces occupied the Rafah border crossing with Egypt on 7 May 2024, and 1,702 (21.7%) patients were evacuated between 19 January 2025 and 17 March 2025 as part of the ceasefire agreement. Egypt has received the majority of patients (n = 3,995, 51%) who have been medically evacuated. Excluding the two periods mentioned, a clear Israeli policy emerged since occupying the Rafah border crossing, which weaponized healthcare by preventing patients from Gaza from being medically evacuated to travel abroad to receive life-saving healthcare.

CONCLUSIONS: The Israeli policy of weaponizing the referrals and medical evacuations has resulted in excess mortality that merits further research and quantification, as patients succumbed to their medical conditions or injuries while waiting to exit Gaza. Action needs to be taken by host countries to step up their efforts to receive more patients from Gaza and put more pressure on Israel to facilitate the safe evacuation process of these patients.

PMID:41854766 | DOI:10.1186/s42506-026-00214-5

Int Ophthalmol. 2026 Mar 19;46(1):166. doi: 10.1007/s10792-026-04037-3.

ABSTRACT

PURPOSE: To leverage a novel Data Integration Centre (DIC) infrastructure and real-world data to analyze pandemic-driven changes in the incidence, demographics, and management of corneal ulceration (H16.0) in a tertiary care setting.

METHODS: We conducted a retrospective single-center analysis of 3029 cases (2016-2024), stratified into pre-pandemic, pandemic, and post-pandemic periods. Data were sourced via the institutional DIC. We employed descriptive statistics and regression models to evaluate temporal trends, age/sex distributions, length of stay (LOS), and surgical interventions.

RESULTS: A significant structural shift from inpatient to outpatient care was observed, with outpatient cases rising by 70% during the pandemic while inpatient numbers declined. A notable demographic shift occurred, with a higher proportion of younger male patients (aged 30-40) affected during and after the pandemic. Mean LOS decreased progressively from 6.27 (pre-pandemic) to 4.13 days (post-pandemic). Despite an overall decline in surgical procedures, the rate of keratoplasties per 1000 patients increased significantly in the post-pandemic phase.

CONCLUSION: The COVID-19 pandemic precipitated a marked restructuring of care for corneal ulcers towards outpatient management and was associated with a distinct demographic shift. The increase in keratoplasty rates for the diagnosis of corneal ulcer after the pandemic could be due to a significantly changed local care structure during the pandemic and the prioritization of follow-up treatment for more difficult cases. This study demonstrates the practical utility of DIC-derived real-world data for health services research, providing robust evidence on evolving care patterns and disease burden.

CLINICAL TRIAL REGISTRATION NUMBER: The study was approved by the Ethics Committee of the Saxony Medical Association under reference number EK-BR-102/23-1 in accordance with the ICH-GCP-Guidelines.

PMID:41854745 | DOI:10.1007/s10792-026-04037-3