Tag: statistics

Lancet Reg Health West Pac. 2026 Feb 11;67:101804. doi: 10.1016/j.lanwpc.2026.101804. eCollection 2026 Feb.

ABSTRACT

BACKGROUND: The estimated effectiveness of SMS (short message service) reminders for improving childhood vaccine coverage and timeliness has varied in previous studies. The observed heterogeneity in effectiveness may be explained in part by variation in reminder content or timing of the reminder relative to the vaccine schedule date. We sought to evaluate the effectiveness of a range of SMS reminders of varied content and timing for improving on-time childhood vaccination.

METHODS: AuTOMATIC was a multi-centre Bayesian adaptive factorial randomised trial comparing four alternative SMS message framings at three alternative message timings versus a no reminder control strategy. Participants were parents of children registered with one of 20 primary care clinics Australia-wide and randomly assigned to one of 12 SMS reminder arms or to control. Reminders varied by framing of content (neutral, positive, risk-based or social benefit) and timing (14 days prior to the due date, on the due date, or 7 days afterwards). The primary endpoint was on-time vaccination, i.e. within 28 days of its scheduled date. Allocation probabilities were updated and stopping rules implemented over the trial according to pre-specified rules based on the posterior probability of effectiveness of each arm evaluated at interim analyses. Trial procedures were largely digitally automated. This trial was registered on Australian New Zealand Clinical Trials Registry (ACTRN12618000789268).

FINDINGS: Between January 14, 2021 and February 26, 2024, 9993 parents were randomised and all were included in the primary analysis; between 380 and 1110 were assigned to each of the 12 SMS reminder arms and 637 to control. The adjusted odds ratio (aOR) of on-time vaccination for each of the 12 SMS arms compared to control ranged from 1.02 [95% CrI 0.76-1.34] to 1.53 [1.22, 1.92] with a pooled effect aOR of 1.29 [1.06, 1.55]. This pooled effect corresponded to a standardised difference of 6% [2%, 11%] in the proportion of on-time vaccinations.

INTERPRETATION: On average, SMS reminders were associated with a modest increase in on-time vaccination compared to no reminder. There was evidence that neutral SMS reminders were less effective than persuasive reminders, but we were unable to identify a single best combination of reminder content framing and timing.

FUNDING: Ramaciotti Foundations, Royal Australasian College of Physicians, and the Western Australia Department of Health.

PMID:41789401 | PMC:PMC12958076 | DOI:10.1016/j.lanwpc.2026.101804

ScientificWorldJournal. 2026 Mar 3;2026:5479774. doi: 10.1155/tswj/5479774. eCollection 2026.

ABSTRACT

OBJECTIVE: This study is aimed at evaluating and comparing the scientific reliability of three large language models (LLMs), Perplexity, iASK, and ChatGPT 4o mini, based on their responses to orthodontic-related queries.

MATERIALS AND METHODS: The three LLMs were prompted with 10 clinical orthodontic questions, and their responses were assessed independently by two evaluators using a structured scoring system (0-10). Statistical analyses, including Pearson and Spearman correlations, Cronbach’s alpha, and Wilcoxon signed-rank test, were performed to determine interevaluator reliability and model performance differences.

RESULTS: Perplexity achieved the highest mean score (7.2), followed by iASK (5.4) and ChatGPT 4o mini (5.2). High consistency between evaluators was observed (Cronbach^‘s alpha = 0.947). A significant difference was noted between Perplexity and both ChatGPT 4o mini and iASK (p = 0.002). Pearson and Spearman correlations indicated strong agreement between evaluators (r = 0.982, ρ = 1.000).

CONCLUSION: Perplexity demonstrated superior performance in orthodontic-related queries compared to ChatGPT 4o mini and iASK. The findings highlight the importance of evaluating AI models for clinical applicability and reliability.

PMID:41789391 | PMC:PMC12957766 | DOI:10.1155/tswj/5479774

ScientificWorldJournal. 2026 Mar 3;2026:9813151. doi: 10.1155/tswj/9813151. eCollection 2026.

ABSTRACT

Mallotus paniculatus (Lam.), a member of the Euphorbiaceae Juss family, is a little tree or shrub that has long been used in folk medicine to cure ailments like fever, wound healing, and postpartum recuperation. In this study, Swiss albino mice were used to evaluate the analgesic, antipyretic, and antidiarrheal properties of the acetone extract of M. paniculatus (AMP). Standard screening techniques were used to identify the phytochemical ingredients. Three models were used to evaluate analgesic activity: the tail immersion test, formalin-induced paw licking, and acetic acid-induced writhing. Antipyretic activity was assessed using a fever model induced by brewer’s yeast. At the same time, antidiarrheal effects were evaluated by castor oil-induced diarrhea, and gastrointestinal motility was studied using a charcoal meal marker. Furthermore, in silico analyses-such as molecular docking, ADME profiling, toxicity prediction, and PASS analysis-were conducted using online tools. The results indicated that AMP at a lower dose (200 mg/kg) produced significant analgesic effects across all pain models compared with the control group. In the antipyretic evaluation, AMP administered at 400 mg/kg illustrated the most pronounced reduction in body temperature after 4 h, which was statistically significant (p < 0.01). The same higher dose (400 mg/kg) also significantly reduced diarrheal episodes and slowed gastrointestinal motility in both the castor oil-induced diarrhea and charcoal meal transit tests. Molecular docking analysis further corroborated these pharmacological effects, revealing that AMP compounds exhibited strong binding affinity toward key target receptors associated with pain, inflammation, and gastrointestinal activity. Collectively, these results indicate that AMP has promising potential as a natural multitarget therapeutic agent for the treatment of pain, fever, and diarrhea.

PMID:41789388 | PMC:PMC12957538 | DOI:10.1155/tswj/9813151

BMJ Public Health. 2026 Mar 3;4(1):e003365. doi: 10.1136/bmjph-2025-003365. eCollection 2026.

ABSTRACT

INTRODUCTION: Food insecurity (FI) is inadequate access to food needed for normal growth, development and maintenance of an active and healthy lifestyle, due to economic barriers. FI is associated with poor physical and mental health, including worse outcomes in chronic health conditions. Existing research presents conflicting evidence regarding the relationship between FI and healthcare utilisation.

OBJECTIVE: This systematic review and meta-analysis explores the association between FI and acute care utilisation status.

DESIGN: Systematic review and meta-analysis.

DATA SOURCES: A systematic search was conducted in December 2024 in the electronic databases MEDLINE, EMBASE, APA PsycINFO, CINAHL and SocINDEX.

ELIGIBILITY CRITERIA: Study inclusion criteria included: (1) reported associations between food insecurity and at least one acute care utilisation outcome of interest (hospitalisations, emergency department (ED) visit, readmission, hospital length of stay); (2) adult populations; and (3) original research.

DATA EXTRACTION AND SYNTHESIS: Two reviewers extracted data and assessed study quality using the Newcastle-Ottawa Scale. A meta-analysis was conducted for hospitalisations and ED outcomes.

RESULTS: The search strategy identified 4410 studies; of these, 52 studies (with a total sample size of n=1 653 065) met criteria for inclusion into the systematic review. Most studies reported a significant association between FI and increased rates of acute care utilisation. Food insecurity was associated with both increased hospitalisations (pooled OR 1.44 (95% CI 1.26 to 1.66), n=19) and ED visits (pooled OR 1.61 (95% CI 1.39 to 1.87), n=13) in meta-analysis; however, statistical heterogeneity was high (I²=62.4% and 60.2%, respectively). Review limitations include a predominance of observational, often cross-sectional studies, substantial heterogeneity and mainly high-income countries included in the sample.

CONCLUSIONS: FI is associated with higher rates of acute care utilisation-in particular, hospitalisations and ED visits. Identifying food-insecure individuals and deploying strategies to address their economic and food-related needs is a health system priority.

PMID:41789371 | PMC:PMC12959075 | DOI:10.1136/bmjph-2025-003365

BMJ Public Health. 2026 Mar 3;4(1):e003101. doi: 10.1136/bmjph-2025-003101. eCollection 2026.

ABSTRACT

INTRODUCTION: Despite significant progress achieved in the past decade, the European Union (EU) tobacco epidemic remains one of the world’s most important. As the decline in smoking prevalence stagnated in the past years and little legislative progress has been made in tobacco control policies, we provide updated estimates of the healthcare costs of smoking in the EU.

METHODS: The study uses 2019 data from the European Health Interview Survey, covering all EU Member States except for France, Germany, Ireland and Sweden, which are excluded because of data access and data quality reasons. We apply econometric methods to examine the differential use of inpatient and daycare hospitalisation services among smokers and never smokers. Based on the model estimates, we compute the smoking-attributable costs for these hospital services across Member States.

RESULTS: We find that smoking is positively associated with inpatient and daycare hospitalisation. Across countries, smoking-related costs range from EUR 5 billion (Spain) to EUR 28 million (Latvia) for inpatient hospitalisation, and from EUR 550 million (Netherlands) to EUR 3 million (Malta and Slovenia) for daycare services.

CONCLUSIONS: The results of this paper show that smoking imposes significant healthcare costs across the EU. Importantly, the total healthcare costs of smoking are likely to be significantly higher than reported in this study, which only focuses on two types of healthcare services. These updated estimates underscore the need to reinvigorate tobacco control policies at national and EU level to reduce the health and economic burden of smoking and protect the health systems resources.

PMID:41789370 | PMC:PMC12959015 | DOI:10.1136/bmjph-2025-003101

BMJ Public Health. 2026 Feb 25;4(1):e003858. doi: 10.1136/bmjph-2025-003858. eCollection 2026.

ABSTRACT

INTRODUCTION: Low back pain (LBP) is a serious health issue that may impact a person at some point in their life, which negatively impacts the health-related quality of life (HRQOL) of those affected people. This study aimed to investigate the HRQOL of patients with LBP in Bangladesh.

METHODS: A multicentre cross-sectional study was conducted between August 2024 and February 2025, including 369 patients with LBP. This study recruited both male and female individuals aged 18 to 60 years with a structured questionnaire. Descriptive statistics, as well as bivariate and multivariate analyses, were conducted to analysed the data. The significance level was set at <0.05.

RESULTS: Widowed/divorced LBP survivors encounter significantly greater challenges in mobility (adjusted OR (aOR) 29.37, 95% CI 4.75 to 181.87) and self-care (aOR 8.30, 95% CI 1.51 to 45.83) relative to single/married survivors. Individuals with a previous history of spinal surgery experienced significant challenges in self-care (aOR 4.78, 95% CI 1.01 to 22.64) and usual activity (aOR 4.78, 95% CI 1.01 to 22.64), in comparison to those without such surgical history. LBP survivors experiencing severe pain exhibited a 13-fold increase in mobility (aOR 12.91, 95% CI 1.26 to 132.48), nearly a 7-fold increase in self-care (aOR 6.78, 95% CI 1.85 to 23.56), approximately a 15-fold increase in usual activity (aOR 14.56, 95% CI 2.45 to 46.12) and nearly 13-fold increases in anxiety/depression (aOR 12.67, 95% CI 1.78 to 32.07) when compared with patients with mild pain.

CONCLUSION: This study indicated that patients with LBP reported having problems in multiple dimensions of quality of life. Several factors drive LBP, which is associated with significant disability and overall HRQOL. Multidisciplinary management strategies, especially those targeted toward improving pain control and physical and psychological well-being, could reduce disability and improve quality of life.

PMID:41789369 | PMC:PMC12959047 | DOI:10.1136/bmjph-2025-003858

BMJ Public Health. 2026 Feb 27;4(1):e003531. doi: 10.1136/bmjph-2025-003531. eCollection 2026.

ABSTRACT

OBJECTIVES: Inadequate housing and living conditions underpin significant health and wellbeing inequality in Australia, particularly for Indigenous people. This review aimed to define infectious disease (ID) outcomes used to measure the health impact of inadequate housing in Australia within a research context.

DESIGN: A systematic review of published studies following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines.

DATA SOURCES: Four online databases were searched in May 2024 with no date restrictions using terms relating to housing, ID and Australia. Results were screened in Covidence.

ELIGIBILITY CRITERIA: Studies were included if they measured both housing exposures and ID outcome variables among any population group in Australia. Both quantitative and qualitative designs were considered.

DATA EXTRACTION AND SYNTHESIS: Data were extracted from 81 studies. Exposures and outcomes were classified according to the Healthy Living Practices (HLPs) and the International Classification of Primary Care (ICPC-2) body system classes, respectively. Acute infections and chronic post-infectious sequelae were considered ID outcomes. Descriptive statistics were calculated and ID-HLP associations were synthesised and narratively described. Methodological quality was assessed from both biomedical and Indigenous perspectives using relevant appraisal tools.

RESULTS: Most studies (79%) were published within the past 25 years and more than half (60%) involved remote-living Indigenous children and families. A total of 176 measured ID outcomes and 571 ID-HLP associations were tested. Exposures were frequently related to the negative effects of crowding (HLP5), unsafe wastewater treatment/drinking water (HLP3) and reduced capacity for washing people (HLP1). Skin, respiratory and digestive system infections were the most common ID outcomes, followed by eye and ear infections and post-infectious cardiovascular sequelae. Studies relied on intensive data collection methods and bespoke definitions.

CONCLUSIONS: Substantial research has described ID outcomes associated with inadequate housing in Australia. However, high-quality evidence is lacking, and methodological heterogeneity between studies limits the synthesis and actionability of this work. We recommend prospective classification of housing exposures according to the HLPs and encourage the exploration of routinely collected primary care data. Agreed measurement approaches and data collection tools that are consistent with Indigenous Data Sovereignty principles would add value.

PROSPERO REGISTRATION NUMBER: CRD42024541393.

PMID:41789367 | PMC:PMC12959062 | DOI:10.1136/bmjph-2025-003531

Chem Sci. 2026 Feb 26. doi: 10.1039/d6sc00250a. Online ahead of print.

ABSTRACT

Nonribosomal peptide synthetases (NRPSs) assemble bioactive peptides from various building blocks. The binding pocket residues governing building block specificity have allowed prediction of NRPS products but not design of specificity. A reason for this failure has been ignorance of NRPS multispecificity. Here, we employ a hydroxamate assay (HAMA) to determine multispecificity for mutant libraries of the adenylation (A-)domain in module SrfAC of surfactin synthetase. A multispecific version of SrfAC is developed and its functional flexibility probed by fully randomizing 15 residues around the active site. We identify mutations with profound impact on specificity revealing remarkable evolvability and explain the effect of a selected mutant by computational modelling. Statistical analysis of the specificity divergence caused by 285 point mutations has revealed an outstanding influence of three sequence positions on specificity, which provides a roadmap for NRPS engineering. Our results suggest that promiscuity drives neofunctionalization of A-domains and mimicking this process will help to design valuable peptides in the lab.

PMID:41789360 | PMC:PMC12959268 | DOI:10.1039/d6sc00250a

Am J Dent. 2025 Feb;39(1):47-52.

ABSTRACT

PURPOSE: To evaluate the effect of different infection control barriers used with light curing units (LCU) on the shear bond strength (SBS) of glass ceramics with various translucencies and thicknesses during adhesive cementation.

METHODS: 60 extracted molar teeth cut in halves mesio-distally to obtain 120 enamel surfaces. Lithium disilicate blocks (GC, Initial Lisi Blocks); 30 High Translucency (HT) 0.5 mm, 30 Low Translucency (LT) 0.5 mm, 30 HT 1.0 mm, 30 LT 1.0 mm discs with 3 mm diameter were produced (n=120). Samples were categorized into three groups according to the infection control barriers (n=40): 1-LCU without barrier, 2-Disposable barrier on LCU (Pinnacle Cure Sleeve), 3-LCU wrapped with stretch film. The SBS test was performed after thermocycling. Failure modes were determined at x20 and classified and statistically analyzed (P< 0.05).

RESULTS: Differences between all the groups were significant (P< 0.001). The highest SBS values were obtained as HT LCU 0.5 mm, LT LCU 0.5 mm, HT Sleeve 0.5 mm and LT Sleeve 0.5 mm, respectively. Highest SBS values were seen in HT LCU 0.5 mm (16.51± 0.68), while LT 1.0 mm stretch (10.76± 1.37) showed the lowest values. Mostly mixed failures occurred in the 0.5 mm sample groups showing higher SBS values.

CLINICAL SIGNIFICANCE: While the application of a sleeve on a LCU may slightly reduce the shear bond strength values of glass ceramics, it can still be beneficial for the cementation of these materials as it helps prevent cross-infection.

PMID:41785028

Am J Dent. 2026 Feb;39(1):31-36.

ABSTRACT

PURPOSE: To assess the influence of the resin-based substrate shade and the single-shade resin composite thickness on color matching ability.

METHODS: Discs (Ø6 x 2 mm) made from a conventional resin composite (Z350 XT) simulated high- (B1B), medium- (A3B), and low-luminosity (C3B) substrates. Each disc (n=10) received sequential increments of the following single-shade resin composites: Palfique Omnichroma (PO) or Vittra APS Unique (VU), at thicknesses of 0.5, 1 and 2 mm. Color parameters [CIEL*a*b*, Vita Scale (SGU), ΔEab, and ΔE₀₀] were determined for conventional resin composite and post-application measurement of single-shade resin composite thicknesses. Statistical analyses included the Mann-Whitney, Kruskal-Wallis, Dunn, Friedman, or Nemenyi tests (α= 0.05).

RESULTS: The ΔEab and ΔE₀₀ values were significantly lower for PO than for VU (P< 0.05). At 1 mm, a decrease in L* values were observed for both resin composites and substrates (P< 0.05). The lowest ΔSGU values were recorded on the high-luminosity substrate (B1B), regardless of the applied thickness (P< 0.05).

CLINICAL SIGNIFICANCE: Single-shade resin composites did not completely match the resin substrate. Palfique Omnichroma outperformed Vittra APS Unique in all aspects, particularly in showing less overall color change, and especially when applied over high-luminosity resin substrates.

PMID:41785026