Tag: statistics

Front Public Health. 2026 Mar 31;14:1798507. doi: 10.3389/fpubh.2026.1798507. eCollection 2026.

ABSTRACT

BACKGROUND: Thyroid disorders are common and often under-recognized. Evidence on public thyroid health literacy in Palestine is limited. This study assessed public knowledge of thyroid disorders among adults in the West Bank, Palestine.

METHODS: A cross-sectional online survey was conducted from May 1 to August 1, 2025, among adults (≥18 years) residing in the West Bank. Participants with current or prior health-professional training or employment in healthcare were excluded. Non-probability convenience sampling was used through social media distribution (Facebook, WhatsApp, Telegram). Knowledge was assessed using a 17-item multiple-choice instrument covering risk factors (7 items), clinical manifestations (7 items), and preventive behaviors (3 items). Correct responses were scored as 1 and incorrect/”I don’t know” as 0; knowledge levels were categorized as low (<50%), moderate (50-75%), and high (>75%). Data were analyzed using descriptive statistics, chi-square tests, and ordinal logistic regression.

RESULTS: A total of 1,119 participants were included (71.3% women, 75.0% university-educated). Mean knowledge score was 8.60/17 (50.6%); 56.7% had low knowledge, 26.3% moderate, and 17.1% high. Risk-factor knowledge was lowest (mean 2.97/7; 42.4%), while prevention-related knowledge was comparatively higher (mean 2.03/3; 67.7%). Notable gaps were observed for medication-related risks (amiodarone 9.7%; lithium 11.0%) and pregnancy/postpartum risk (41.7%). In adjusted analyses, higher knowledge was associated with age >50 years (aOR 1.71), while lower knowledge was associated with male sex (aOR 0.70) and no formal education versus university education (aOR 0.26).

CONCLUSION: Public knowledge of thyroid disorders in the West Bank was generally low, with the most pronounced deficits related to pregnancy and the postpartum period and to medication associated thyroid dysfunction. These findings support targeted, low cost health education integrated into routine primary care, maternal and reproductive health services, and community pharmacy counseling, with future studies needed to evaluate effects on timely care seeking and safer medication practices.

PMID:41988568 | PMC:PMC13076517 | DOI:10.3389/fpubh.2026.1798507

Front Physiol. 2026 Mar 31;17:1754825. doi: 10.3389/fphys.2026.1754825. eCollection 2026.

ABSTRACT

BACKGROUND: With the continuous advancement of sports training methodologies, high-intensity interval training (HIIT) and small-sided games (SSG) have emerged as crucial strategies for enhancing players’ physical fitness. However, the comparative effects of these training modalities on various fitness components and their underlying physiological adaptation mechanisms remain insufficiently explored.

OBJECTIVES: This systematic review and meta-analysis aim to compare the overall impact of HIIT and SSG on players’ physical fitness and examine the moderating effects of different training parameters, including training frequency, intervention duration, players’ training experience, age, and gender. The findings seek to provide theoretical insights for optimising training protocols.

METHODS: A systematic search was conducted in databases including PubMed, Web of Science, Scopus, and EBSCOhost to identify relevant English-language randomised controlled trials that met predefined eligibility criteria. Hedges’ g was used as the effect size metric, and a random-effects model was applied for meta-analyses of power, speed, endurance, and agility. Subgroup analyses were performed to assess the influence of potential moderators.

RESULTS: The meta-analysis revealed that, compared to SSG, HIIT produced a small but statistically significant improvement in speed (ES = 0.564) and a moderate and statistically significant improvement in endurance (ES = 0.706). In contrast, gains in power (ES = -0.144) and agility (ES = -0.159) were trivial in magnitude and not statistically significant. Subgroup analyses indicated that lower training frequency (<3 sessions per week) and shorter intervention duration (<6 weeks) yielded significant improvements. Furthermore, players across different age groups benefited from HIIT, while sex did not exhibit a significant moderating effect.

CONCLUSION: This systematic review and meta-analysis confirm that both HIIT and SSG effectively enhance players’ physical fitness, with HIIT demonstrating a distinct advantage in improving speed and endurance. Although HIIT showed relatively limited improvements in power and agility compared to SSG, both training modalities exert their effects through distinct physiological adaptation mechanisms. Subgroup analysis findings suggest that appropriately balancing training frequency and intervention duration is crucial for achieving optimal training outcomes. Future research should further investigate the long-term effects of these interventions to provide a more robust theoretical foundation for personalised training program design.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier CRD42024555633.

PMID:41988503 | PMC:PMC13076140 | DOI:10.3389/fphys.2026.1754825

ACS ES T Water. 2026 Mar 12;6(4):2458-2467. doi: 10.1021/acsestwater.5c01470. eCollection 2026 Apr 10.

ABSTRACT

Evaluating drinking water treatment (DWT) performance requires understanding how dissolved organic matter (DOM) is transformed during treatment and how these transformations drive the formation of disinfection byproducts (DBPs), which remain major concerns in drinking water safety. While current regulations target a limited number of DBP classes, including trihalomethanes (THMs) and haloacetic acids (HAAs), chlorination of DOM produces a much broader pool of largely unregulated DBPs with poorly understood toxicological relevance. In this study, a full-scale conventional drinking water treatment plant was evaluated using an integrated analytical framework combining molecular-level DOM fingerprinting by high-resolution mass spectrometry, targeted DBP quantification by gas chromatography-mass spectrometry, and adsorbable organic halide measurements. This integrated approach enables the assessment of DOM transformation and DBP formation under realistic treatment conditions. Although approximately 60% of dissolved organic carbon (DOC) was removed, molecular fingerprinting revealed a highly selective DOM removal pattern. Aromatic and condensed aromatic compounds were preferentially eliminated, whereas aliphatic and unsaturated fractions persisted and showed a positive statistical association with DBP formation. These results indicate that bulk DOC removal alone is insufficient to mitigate DBP formation and highlight the need for treatment strategies targeting specific reactive DOM fractions to enhance drinking water safety.

PMID:41988169 | PMC:PMC13078287 | DOI:10.1021/acsestwater.5c01470

Ann Ital Chir. 2026 Apr 10;97(4):694-700. doi: 10.62713/aic.4469.

ABSTRACT

AIM: The optimal uterine suturing technique for repeat caesarean section in women with a scarred uterus remains controversial, and evidence comparing novel techniques, such as the breakwater suture, with conventional methods in terms of comprehensive recovery is limited. The objective of this study is to investigate the combined effects of single-layer suturing, double-layer suturing, and breakwater suture techniques on postoperative recovery in patients with scarred uteri undergoing repeat caesarean section.

METHODS: In this retrospective cohort study, 300 pregnant women with scarred uteri undergoing repeat caesarean section at The Maternal and Child Health Care Hospital of Tong Xiang between January 2022 and December 2024 were included. The sample was divided into three groups based on the type of suture used: single-layer suture group (n = 108), double-layer suture group (n = 103), and breakwater suture group (n = 89). Primary outcomes comprised postoperative recovery time, complications, uterine healing status, psychological state, and sleep quality.

RESULTS: There were no significant differences in baseline characteristics among the three groups (p > 0.05). Regarding postoperative recovery, the breakwater suture group demonstrated significantly shorter time to anal flatus, time to first ambulation, and postoperative hospital stay compared with both the single-layer and the double-layer suture groups (p < 0.05). Postoperative ultrasound revealed significantly greater uterine segment myometrial thickness in the breakwater suture group compared to the other two groups (p < 0.001). At six months postoperatively, the incidence of uterine diverticulum in the breakwater suture group (4.5%) was significantly lower than that in the single-layer suture group (15.7%); the overall difference among the three groups was statistically significant (p = 0.041). Furthermore, patients in the breakwater suture group demonstrated significantly better postoperative outcomes on the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Edinburgh Postnatal Depression Scale (EPDS), and Pittsburgh Sleep Quality Index (PSQI) compared with the other groups (p < 0.001).

CONCLUSIONS: In repeat caesarean sections in women with scarred uteri, the breakwater suture technique comprehensively promotes postoperative recovery and may be recommended as a suturing method.

PMID:41987623 | DOI:10.62713/aic.4469

Zhongguo Zhen Jiu. 2026 Apr 12;46(4):547-552. doi: 10.13703/j.0255-2930.20250221-k0003. Epub 2026 Feb 4.

ABSTRACT

OBJECTIVE: To observe the effect of electroacupuncture (EA) on intestinal function after laparoscopic colorectal cancer surgery.

METHODS: A total of 72 patients with malignant tumors of the sigmoid colon or rectum scheduled for laparoscopic surgery were randomly divided into an observation group (36 cases) and a control group (36 cases, 1 case discontinued). The observation group received EA starting from the first postoperative day. Acupoints used included Zhongwan (CV12), Qihai (CV6), and bilateral Quchi (LI11), Tianshu (ST25), Zusanli (ST36), Shangjuxu (ST37), and Xiajuxu (ST39). EA apparatus was connected between bilateral Tianshu (ST25), as well as ipsilateral Zusanli (ST36) and Shangjuxu (ST37), using continuous wave at a frequency of 2 Hz, current intensity of 2 to 3 mA, adjusted to patient tolerance. The control group received sham EA using the same acupoints. For sham EA, the needle tips were inserted into adhesive pads without touching the skin surface, and the EA apparatus was specially modified to be non-conductive, thus preventing any effective current circuit. Both groups were treated once daily for 30 min each time, for five consecutive days. The time to first anal exhaust, time to first defecation, number of postoperative administrations of the analgesic flurbiprofen axetil, and postoperative hospital stay were recorded in the two groups. Numerical rating scale (NRS) score was assessed from postoperative day 1 to 5, and the incidence of postoperative intestinal obstruction within 14 days was also recorded in the two groups.

RESULTS: The time to first defecation in the observation group was shorter than that in the control group (P<0.01). Among patients aged ≥65 years, the time to first anal exhaust and the time to first defecation in the observation group were earlier than those in the control group (P<0.05, P<0.01). A positive correlation was found between age and time to first exhaust and defecation (r=0.472, r=0.604, P<0.01). The NRS scores on postoperative day 4 and 5 in the observation group were lower than those in the control group (P<0.01, P<0.05). There were no statistically significant differences between the two groups in terms of the number of flurbiprofen axetil administrations or length of hospital stay (P>0.05). No cases of intestinal obstruction occurred in either group within 14 days postoperatively.

CONCLUSION: EA can accelerate the recovery of bowel function after laparoscopic colorectal cancer surgery, which might have greater clinical value for patients aged 65 years or older.

PMID:41987441 | DOI:10.13703/j.0255-2930.20250221-k0003

J Nurs Manag. 2026;2026(1):e9157658. doi: 10.1155/jonm/9157658.

ABSTRACT

BACKGROUND: Burnout among emergency healthcare providers, including physicians, nurses, and paramedics, is a growing global concern, particularly in developing countries where prevalence rates can reach 70%-80%. Burnout negatively impacts healthcare systems and patient outcomes. However, limited studies compare burnout rates across these professions or focus on the Middle Eastern context, including Jordan. This study aims to assess burnout prevalence among emergency physicians, nurses, and paramedics in Jordan and identify associated demographic and work-related factors.

METHODS: A cross-sectional descriptive study was conducted using a paper-based, self-administered questionnaire incorporating the Copenhagen Burnout Inventory (CBI). Participants were drawn from emergency departments in 15 hospitals and 13 ambulance stations. Data were analyzed using SPSS Version 25, employing descriptive statistics, ANOVA, and logistic regression to identify burnout predictors.

RESULTS: A total of 560 participants completed the survey (response rate: 70%). The prevalence rates for personal, work-related, and patient-related burnout were 83.7%, 79.2%, and 64.0%, respectively, with overall high burnout rates (75.6%). Sleep deprivation (p ≤ 0.002), poor supervisor relationships (p ≤ 0.01), and attempts to change workplaces (p ≤ 0.03) were associated with all burnout dimensions. Female participants and those with one to three children showed higher burnout odds (p = 0.004, p = 0.045, respectively). No significant differences in burnout rates were observed among professions.

CONCLUSIONS: This study highlights alarmingly high burnout prevalence rates among emergency healthcare providers in Jordan, stressing the need for tailored strategies to mitigate burnout and improve the resilience of the healthcare system. Future research should explore the long-term impacts of systemic factors and post-COVID-19 dynamics.

PMID:41986944 | DOI:10.1155/jonm/9157658

J Anat. 2026 Apr 15. doi: 10.1111/joa.70153. Online ahead of print.

ABSTRACT

The domestic dog (Canis lupus familiaris), a species characterized by remarkable phenotypic diversity resulting from selective breeding, is among the several mammals that may exhibit an anatomical perforation of the humeral condyle, designated as the supratrochlear foramen (STF). The prevalence of the STF varies considerably across mammalian species and has been proposed to reflect functional adaptations linked to evolutionary and biomechanical factors, particularly in the human humerus. To the best of our knowledge, comprehensive studies on STF variation within present-day canine populations remain scarce. This study aimed to determine the prevalence and morphology of the STF in extant dogs, and to compare these findings with those from Roman Imperial Period dogs, and Iberian wolves (Canis lupus signatus), a subspecies considered representative of the dog’s wild ancestor, in order to explore evolutionary changes within Canis lupus subspecies. We analyzed 269 humeri (123 extant dogs, 76 ancient dogs, 70 Iberian wolves) using osteometric measurements and statistical analysis. Our results demonstrate that the STF was observed in 73.17% of extant dogs, compared to 82.89% in ancient dogs and 98.57% in Iberian wolves, suggesting a reduction in its prevalence over time in domestic lineages that may be linked to human-driven selection processes. In all studied groups, the STF was consistently located closer to the lateral humeral epicondyle, and its predominantly transversely elongated shape reveals a common morphological pattern across Canis lupus subspecies. Despite differences in humeral size among groups, STF dimensions showed a positive correlation with overall humeral measurements, with larger humeri exhibiting proportionally larger and more frequent STFs. Extant dogs displayed the smallest STF dimensions, followed by ancient dogs, with Iberian wolves having the largest. Considering the potential impact of the STF on the biomechanical properties of the distal humerus, this study provides new insights into its anatomical variability in dogs, emphasizing its clinical relevance for orthopedic diagnostic accuracy and surgical treatments in veterinary medicine.

PMID:41986904 | DOI:10.1111/joa.70153

Neurocrit Care. 2026 Apr 15. doi: 10.1007/s12028-026-02519-x. Online ahead of print.

ABSTRACT

BACKGROUND: A subset of patients with anterior circulation large-vessel occlusion (LVO) stroke progressed to malignant middle cerebral artery infarction (mMCAi) despite successful recanalization following endovascular treatment. This study investigated whether full medical support (FMS) could improve functional outcomes beyond reducing mortality in this population.

METHODS: In this retrospective cohort study, consecutive patients from hospital-based stroke registry (May 2015 to August 2021) with anterior LVO stroke who developed mMCAi despite successful recanalization were included. Patients were stratified into two groups on the basis of the intensity of postprocedural care: the FMS group (aggressive neurocritical care) and the non-FMS group (limited medical support or comfort care). The primary outcome was survival without severe disability, defined as a modified Rankin Scale (mRS) score of 0-4 at 90 days. Secondary outcomes included ordinal shift analysis of the mRS, rates of functional independence (mRS 0-2 and 0-3), and 90-day mortality.

RESULTS: Among 114 eligible patients, 65 were assigned to the FMS group and 49 to the non-FMS group. The FMS group demonstrated a significantly higher rate of the primary outcome (46.2% vs. 6.1%; P < 0.001) along with a markedly lower 90-day mortality (23.1% vs. 81.6%; P < 0.001) compared with the non-FMS group. After adjustment for age, gender, and confounders, FMS remained independently associated with increased odds of achieving mRS 0-4 [adjusted odds ratio (aOR), 5.88; 95% confidence interval (CI) 1.31-26.40; P = 0.021) and with reduced mortality (aOR, 0.14; 95% CI 0.05-0.42; P < 0.001), while no statistically significant difference was observed in the proportion of patients achieving an mRS of 0-2 or in those achieving an mRS of 0-3.

CONCLUSIONS: In patients who developed mMCAi after successful recanalization, FMS is associated with a greater likelihood of survival without severe disability (mRS 0-4). These findings suggest that withdrawal of aggressive medical care in this population should be approached with caution.

PMID:41986794 | DOI:10.1007/s12028-026-02519-x

Sci Rep. 2026 Apr 15. doi: 10.1038/s41598-026-48407-4. Online ahead of print.

ABSTRACT

Systemic sclerosis (SSc) is an autoimmune disorder marked by fibrosis of the skin and internal organs, with B cells increasingly recognized as key players in its pathogenesis. However, the characteristics of the B cell receptor (BCR) repertoire in SSc remain insufficiently defined. In this study, we performed high-throughput sequencing of immunoglobulin heavy chain genes in 15 female anti-centromere antibody (ACA)-positive SSc patients and five age-matched healthy female controls to explore disease-specific repertoire biases. A total of 2,597,460 in-frame sequence reads and 384,111 unique reads were obtained. While diversity metrics, including the Shannon, Simpson, and Pielou indices, tended to be higher in the SSc group, the differences were not statistically significant. Notably, the average complementarity-determining region 3 (CDR3) length was significantly shorter in SSc patients compared to controls (16.91 ± 3.727 vs. 17.44 ± 3.836, p < 0.0001). Gene usage analysis revealed no significant differences in IGHJ or IGHC segments; however, several IGHV and IGHD segments displayed statistically significant differences. IGHD5-5 (1.636% vs. 0.547%, p = 0.0001) and IGHD5-18 (1.607% vs. 0.547%, p = 0.0001) were significantly overrepresented in the SSc group, whereas IGHV1/OR15-2 was significantly underrepresented (0.062% vs. 0.130%, p = 0.0080). Further analysis demonstrated that IGHD5-5 clones with a 15-nucleotide CDR3 length were more conserved and exhibited distinctive sequence patterns compared to other lengths or genes. Specific nucleotide lengths, including 15, 23, and 24 for IGHD5-5, and 18 for IGHV1/OR15-2, showed significant frequency differences between groups (p < 0.05). Sequence logo plots confirmed reduced variability in these conserved clones, suggesting antigen-driven clonal selection. These findings identify unique BCR repertoire features in ACA-positive SSc patients and suggest their potential utility as disease biomarkers or therapeutic targets.

PMID:41986546 | DOI:10.1038/s41598-026-48407-4

J Voice. 2026 Apr 14:S0892-1997(26)00131-1. doi: 10.1016/j.jvoice.2026.03.019. Online ahead of print.

ABSTRACT

OBJECTIVE: Dysphonia in patients with Parkinson’s Disease (PD) negatively impacts quality of life. Treatment options are evolving and include both invasive and non-invasive interventions. The present study aims to assess current therapies and their effectiveness through a scoping review of the literature.

DATA SOURCES: PubMed, Ovid, and Embase.

REVIEW METHODS: Three databases were searched for articles through 2023 pertaining to treatment of PD-related dysphonia in accordance with PRISMA guidelines. Included studies were reviewed to extract demographic information, treatment techniques, and outcomes. Of 277 studies reviewed, 49 publications met inclusion criteria with a total of 1388 patients.

RESULTS: Treatments were categorized into groups: voice therapy, pharmacologic intervention, deep brain stimulation (DBS), vocal fold augmentation, neurosurgical intervention, and dietary modification. Measures reported to assess outcomes were heterogenous across studies. Voice therapy had the highest number of studies with statistically significant results, totaling 18 studies. Other treatments, including DBS, demonstrated improvement in systemic symptoms with worsening of voice symptoms.

CONCLUSION: The literature of current therapeutic options for PD patients with dysphonia is heterogenous; however, voice therapy remains standard of care. Further studies should emphasize standardization of voice metrics to permit head-to-head comparisons across treatment modalities. There is also an opportunity to leverage combining therapies for PD patients, but optimization of such regimens requires further investigation.

PMID:41986189 | DOI:10.1016/j.jvoice.2026.03.019