Tag: statistics

Cureus. 2026 Jul 30;18(7):e113646. doi: 10.7759/cureus.113646. eCollection 2026 Jul.

ABSTRACT

Background Tongue thrusting is a common neuromuscular habit associated with abnormal tongue posture and dentoalveolar changes. Tongue crib and tongue tamers are commonly used habit-breaking appliances, but limited studies have compared their effectiveness using cone beam computed tomography (CBCT) analysis. Aim This study aims to compare the efficacy of tongue crib and tongue tamers in repositioning the tongue in patients with tongue thrust using CBCT analysis. Materials and methods Forty subjects aged 14-30 years with tongue thrusting habit were randomly divided into two groups: tongue crib (Group 1) and tongue tamers (Group 2). CBCT with barium sulphate coating was used to evaluate tongue posture. Parameters assessed included tongue tip position, U1-PP, L1-MP, interincisal angle, overjet, overbite, and lower lip retraction. Patient discomfort was evaluated using a visual analog scale (VAS). Statistical analysis was performed with significance set at p ≤ 0.05. Results Tongue tip position and dentoalveolar parameters significantly improved with both appliances. Compared to tongue tamers, tongue crib showed statistically significant improvement in tongue tip retraction and overbite improvement. On the other hand, tongue tamers demonstrated greater patient acceptability and comfort. Conclusion Both tongue crib and tongue tamers were effective in repositioning the tongue and improving associated dentoalveolar changes, but the tongue crib was more effective clinically, whereas tongue tamers provided better patient comfort.

PMID:42669026 | PMC:PMC13525915 | DOI:10.7759/cureus.113646

Cureus. 2026 Jul 30;18(7):e113679. doi: 10.7759/cureus.113679. eCollection 2026 Jul.

ABSTRACT

OBJECTIVES: The Hall technique (HT) manages dental caries in primary molars by sealing the lesion with a preformed metal crown, a minimally invasive strategy aimed at arresting the disease process. Although convincing evidence of efficacy is available, global acceptance varies. This study aimed to evaluate the knowledge, attitudes, and practices (KAP) of Jordanian pediatric dentists regarding the HT and its main features.

METHODS: A cross-sectional study was carried out using an online questionnaire distributed to Jordanian pediatric dentists from November 1 to 30, 2025. The questionnaire surveyed demographics, knowledge (rationale, indications), attitudes (efficiency, evidence-based), and practices (current use, challenges, concerns). Descriptive statistics, chi-square tests, and binomial logistic regression were used to identify predictors of HT implementation among 120 participants.

RESULTS: Most respondents were female (103/120, 85.8%) and board-certified (91/120, 75.8%). The rationale for caries arrest by sealing with the HT was understood by 118/120 (98.3%) of the respondents. The frequency of HT use was 104/120 (86.7%). Years of clinical practice were significantly associated with the perception that HT is best for uncooperative patients (p = 0.031), and belief in medical contraindications was associated with reduced HT use (p = 0.024). The main concerns were occlusion (65/120, 54.2%), sealing over caries (54/120, 45.0%), and parental acceptance (54/120, 45.0%). The majority perceived HT as a time-saving method (111/120, 92.5%), and the attitudes were generally positive. Logistic regression analysis revealed that the belief in time-saving (OR = 8.58, 95% CI: 2.09-35.21, p = 0.003) and evidence base (OR = 5.21, 95% CI: 1.37-19.81, p = 0.015) were significant positive predictors for HT use, whereas the concern of parental acceptance (OR = 0.24, 95% CI: 0.09-0.65, p = 0.005) and sealing over caries (OR = 0.34, 95% CI: 0.13-0.89, p = 0.027) were significant negative predictors. The model explained 28.4-45.2% of the variance in HT use and was a good fit (Hosmer-Lemeshow p = 0.342).

CONCLUSION: Pediatric dentists in Jordan had a high level of knowledge of and use of the HT, with adoption rates higher than in many other countries. A positive perception of time efficiency and evidence-based belief strongly favor clinical use, while concerns about parental acceptance and sealing over caries are the main barriers to consistent implementation.

PMID:42669021 | PMC:PMC13525859 | DOI:10.7759/cureus.113679

Psychol Res Behav Manag. 2026 Aug 25;19:625275. doi: 10.2147/PRBM.S625275. eCollection 2026.

ABSTRACT

BACKGROUND: Excessive time spent on social media and smartphones, as well as inappropriate use, has raised concerns about their potential impact on mental health. Many studies have shown that social media addiction and smartphone addiction are associated with poor sleep quality and increased risk of depression and anxiety. This study examined the mediating role of lifestyle on the relationship between social media and smartphone use addictions with poor sleep quality, anxiety, and depression.

METHODS: A cross-sectional study was conducted among 1324 undergraduate and graduate students aged 20-40 years. Participants completed validated self-report measures assessing social media addiction, smartphone addiction, sleep quality, anxiety symptoms, depressive symptoms, and lifestyle behaviors, including smoking, alcohol consumption, eating behaviors, and physical activity.

RESULTS: The mean scores for sleep quality, anxiety, and depressive symptoms were 6.9 ± 3.4, 6.7 ± 5.4, and 8.6 ± 5.8, respectively. In this cross-sectional study, mediation analysis indicated statistically significant indirect associations through lifestyle between social media addiction and poor sleep quality (the indirect effects: unstandardized coefficient [B] = 0.006, 95% confidence interval [CI] [0.002-0.014]), anxiety symptoms (B = 0.007, 95% CI [0.001-0.016]), and depressive symptoms (B = 0.013, 95% CI [0.006-0.025]). Similarly, lifestyle was observed to mediate the association between smartphone use addiction and poor sleep quality (the indirect effects: B = 0.005, 95% CI [0.002-0.010]), anxiety symptoms (B = 0.006, 95% CI [0.001-0.015]), and depressive symptoms (B = 0.012, 95% CI [0.005-0.020]). Although the indirect effects were statistically significant, their magnitude was small, indicating that lifestyle accounted for a limited proportion of the associations between technology-related addictions and sleep quality and mental health problems.

CONCLUSION: Lifestyle behaviors statistically mediated the associations of social media or smartphone use addiction with poor sleep quality, anxiety, and depression. Although causal inferences cannot be made, these findings suggest that lifestyle practices may be important in understanding and addressing the mental health challenges associated with excessive technology use.

PMID:42669002 | PMC:PMC13525800 | DOI:10.2147/PRBM.S625275

Cureus. 2026 Jul 30;18(7):e113673. doi: 10.7759/cureus.113673. eCollection 2026 Jul.

ABSTRACT

Background The format of the American Board of Dermatology (ABD) exams has now changed with a self-assessment Basic Exam in the first year of dermatology residency, followed by certification Core Exams during residency and the Applied Exam after completion of residency. Objective To determine if the Basic Exam scores correlate with performance on the new certification exams in dermatology. Methods Deidentified examination data from residents between 2018 and 2023 was obtained from the ABD. The basic exam scores between those who passed and failed the certification exams were analyzed. The optimal threshold for Basic Exam scores was then calculated using a receiver operating characteristic curve. Results For the 1585 residents included, there was a statistically significant difference in Basic Exam performance for those who passed and failed the certification exams (p < 0.001). The threshold cutoff varied by certification exam with a total Basic Exam score range of 75.55 to 79.55 and percentile rank range of 22%-38%. Limitations Demographic data was not available to include in the analysis. Conclusion The Basic Exam performance correlates with certification exam performance. The average threshold of total score of 78.5 and percentile rank of 31.4% would capture 77% of residents who failed the certification exams.

PMID:42669000 | PMC:PMC13525833 | DOI:10.7759/cureus.113673

Caspian J Intern Med. 2026 Mar 10;17(2):449-456. doi: 10.22088/cjim.17.2.449. eCollection 2026.

ABSTRACT

BACKGROUND: Pancreatic cancer is among the deadliest malignancies globally, marked by poor prognosis and limited survival. This research investigated the demographic and clinical determinants affecting overall survival in patients diagnosed with pancreatic cancer in Guilan Province, Iran.

METHODS: A total of 50 pathologically and radiologically confirmed cases of pancreatic cancer were analyzed. Demographic, anthropometric, and clinical data were extracted from medical records. Survival probabilities were estimated using the Kaplan–Meier method, and intergroup differences were tested using the log-rank test. Cox proportional hazards modeling identified predictors of mortality, with significance defined at p < 0.05. Statistical analyses were conducted in SPSS (v16) and GraphPad Prism (v8).

RESULTS: The majority of patients were male (60%) and over 60 years old (58%), while 46% had normal BMI and 40% had blood group O. Comorbidities were present in 42%, and 32% were diagnosed at stage IV. Mean and median survival were 39.6 and 9.0 months, respectively. One-, three-, and five-year survival rates were 45.2%, 31.3%, and 23.5%. Advanced tumor stage (III/IV) significantly predicted shorter survival (p < 0.001). Underweight individuals had higher mortality risk (HR = 2.79; 95% CI: 1.21–6.42; P = 0.016). In multivariate models, male gender, blood group O, and advanced disease remained independent negative prognostic indicators.

CONCLUSION: Male sex, advanced stage, low BMI, and blood group O were major determinants of poorer survival in pancreatic cancer. These results emphasize the need for individualized treatment and closer follow-up among high-risk groups.

PMID:42668993 | PMC:PMC13525829 | DOI:10.22088/cjim.17.2.449

Cancer Manag Res. 2026 Aug 25;18:636474. doi: 10.2147/CMAR.S636474. eCollection 2026.

ABSTRACT

BACKGROUND: Thyroid cancer incidence is rising globally; however, histopathological data from Somalia are scarce, and no comprehensive characterization of resected thyroid specimens has been reported.

METHODS: A retrospective review of 438 thyroidectomy specimens reported at a histopathology referral laboratory in Mogadishu, Somalia, between 2022 and 2025 was performed. Each specimen was classified as benign, borderline, or malignant according to the World Health Organization criteria. The associations between malignancy and age and sex were examined using chi-square or Fisher exact tests and unadjusted logistic regression.

RESULTS: The cohort was predominantly female (90%), with a median age of 37 years. Benign lesions accounted for 366 specimens, borderline lesions for 8, and malignant lesions for 64, giving an overall malignancy proportion of 14.6%. Nodular and colloid goiters dominated the benign diagnoses, and papillary thyroid carcinoma was the most frequent malignant subtype, accounting for 50 of 64 cases. Malignancy was highest in patients aged 30 years or younger (22.2%), and the variation across age groups was statistically significant. The incidence of malignancy did not differ significantly according to sex. Among malignant tumors, the median size was 3.0 cm, and most were in the early tumor category.

CONCLUSION: Benign goiter dominates thyroid surgical pathology in Mogadishu, while papillary carcinoma leads to a modest malignant burden that is proportionally greatest in younger patients. Strengthening pathology capacity, preoperative cytology, and cancer surveillance is therefore warranted.

PMID:42668992 | PMC:PMC13525814 | DOI:10.2147/CMAR.S636474

Caspian J Intern Med. 2026 Mar 10;17(2):403-411. doi: 10.22088/cjim.17.2.403. eCollection 2026.

ABSTRACT

BACKGROUND: Renal diseases strongly influence global health burden and healthcare costs, especially for countries with low and middle socio-demographic indices. This study aimed to provide data on kidney disorder patterns and compare results with our previous analysis of biopsy-proven renal diseases to determine how the pattern is changing in our region.

METHODS: This cross-sectional analysis of 2,392 native renal biopsies was performed from 2019 to 2024 at the Namazi Hospital, a tertiary referral healthcare center in Shiraz, Iran.

RESULTS: Of 2,392 native kidney biopsies, primary glomerulonephritis was the most common finding, with the leading diagnosis of membranous glomerulonephritis (MGN), followed by focal segmental glomerulosclerosis (FSGS), and mesangioproliferative GN (MesGN). For secondary GN, lupus nephritis (LN), diabetic nephropathy, and amyloidosis were prominent. Lupus nephritis was the only female-predominant subtype (p < 0.001). Significant male predominance was observed in MGN (p < 0.001), IgA nephropathy (p< 0.001), Amyloidosis (p< 0.05), and hypertensive nephropathy (p < 0.05), whereas most other renal biopsy subtypes showed no statistically significant gender differences (p > 0.05). Age-related analysis showed that LN was the predominant finding in patients <45 years, whereas MGN was the most common among older patients (P < 0.001).

CONCLUSION: Comparing the proportions of biopsy results with our previous analysis revealed that FSGS and LN decreased dramatically, while MGN, Diabetic nephropathy, IgA nephropathy, and tubulointerstitial diseases showed increasing trends. These data provided essential clues for further studies on organizing renal health goals.

PMID:42668987 | PMC:PMC13525818 | DOI:10.22088/cjim.17.2.403

PeerJ. 2026 Aug 24;14:e21631. doi: 10.7717/peerj.21631. eCollection 2026.

ABSTRACT

INTRODUCTION: Intensive Care Unit (ICU) patients are at high risk of acute clinical deterioration and in-hospital mortality. Accurate prediction of in-hospital mortality is essential for optimizing clinical decision-making and resource allocation. However, most existing models rely primarily on short-term physiological data from a single hospitalization and lack adequate external validation. This study develops a deep learning-based model that integrates long-term temporal clinical sequences derived from patients’ historical ICU records with diagnostic information from the current ICU admission to predict in-hospital all-cause mortality during the current hospitalization. The proposed framework is applicable to both patients with a single ICU admission and those with multiple ICU admissions.

METHODS: We used current and historical International Classification of Diseases (ICD) codes, temporal features, and basic demographics to construct the prediction models. Single-admission patients were represented as one-event sequences, while repeated-admission patients were represented as longitudinal diagnostic trajectories. Model training and internal validation were conducted based on the MIMIC-IV database, while the eICU and MIMIC-III databases were used for external independent testing. Five deep learning (DL) models, including Informer and Transformer, were constructed for comparative analysis. On this basis, a stacked model integrating these five base models was further developed. The Area Under the Receiver Operating Characteristic Curve (AUROC), calibration curves, and clinical epidemiological analyses involving meta-analyses across different datasets were used to comprehensively evaluate the model’s predictive performance, generalizability, and specific clinical application value.

RESULTS: A total of 22,176 patients from Medical Information Mart for Intensive Care IV (MIMIC-IV), MIMIC-III, and eICU were included, and five deep learning models as well as one stacked ensemble model were constructed. In the internal validation set, the AUROC of most deep learning models exceeded 0.89, with the exception of the RNN. Among them, the Informer model achieved the best internal performance, with an AUROC of 0.95 (95% CI [0.928-0.967]). In the dual external validation across different databases, model performance exhibited apparent heterogeneity across cohorts. Although no single model consistently outperformed others, the stacked ensemble model showed relatively competitive overall predictive accuracy and stable generalizability.

CONCLUSIONS: Compared with traditional models based on short-term biochemical indicators, the proposed deep learning models and the stacked ensemble model demonstrated competitive predictive performance for in-hospital mortality. This study demonstrates the potential of deep learning for ICU mortality prediction and proposes a novel framework for integrating longitudinal diagnostic trajectories into predictive modeling.

PMID:42668985 | PMC:PMC13525758 | DOI:10.7717/peerj.21631

PeerJ. 2026 Aug 24;14:e21549. doi: 10.7717/peerj.21549. eCollection 2026.

ABSTRACT

BACKGROUND: The purpose of this study was to compare the influence of three enamel finishing and polishing systems (Sof-Lex discs, lithium disilicate Eve burs and lithium disilicate polishing burs) on the shear bond strength and distribution of failure modes of nanohybrid composite resin bonded to enamel.

MATERIALS AND METHODS: A sample of 240 healthy human premolars were randomized into four treatment groups (n = 60 per group): (1) untreated control, (2) Sof-Lex disc polishing, (3) lithium disilicate EVE burs (Li-EVE) burs, and (4) lithium disilicate polishing burs (Li-Polish) burs. Specimens were prepared with standardized protocols and restored with a nanohybrid composite and universal adhesive system. The enamel surfaces were etched with 35% phosphoric acid. Shear bond strength (SBS) was measured using a universal testing machine and fracture modes were assessed with a dissecting microscope. Descriptive statistics, one-way analysis of variance (ANOVA), Games-Howell post hoc test, and chi-square analysis of the mode of failure were conducted at α = 0.05.

RESULTS: There were significant differences in SBS between the groups (F(3,236) = 10.54, p = 1.6 ± 10^-6). Both Sof-Lex (31.39 ± 7.81 MPa) and Li-Polish (30.94 ± 5.70 MPa) had significantly higher bond strength values than control (23.18 ± 14.04 MPa) and Li-EVE (26.00 ± 8.26 MPa) (p ≤ 0.024). There was no significant difference between Sof-Lex and Li-Polish (p = 0.82). The failure modes were predominantly cohesive in all the groups and the distribution of failure modes was not significantly different (χ ² (3) = 6.31, p = 0.098, Cramér’s V = 0.162).

CONCLUSION: The enamel polishing system significantly influenced composite bond strength. Multi-step polishing systems, e.g., Sof-Lex discs or Li-Polish burs, increased adhesive performance markedly over the control groups or one-step polished systems to untreated enamel. The failure mode was not significantly influenced by polishing systems. These findings demonstrated the importance of finishing systems for successful restorative performance.

PMID:42668980 | PMC:PMC13525744 | DOI:10.7717/peerj.21549

J Multidiscip Healthc. 2026 Aug 25;19:624664. doi: 10.2147/JMDH.S624664. eCollection 2026.

ABSTRACT

BACKGROUND: As newly employed nurses transition into clinical practice, understanding and implementing Entrustable Professional Activities (EPAs) is crucial for ensuring quality patient care and professional development. This study aims to assess the knowledge, attitudes, and practices (KAP) of newly employed nurses regarding EPAs.

METHODS: A cross-sectional, multicenter study was conducted between September 2024 and November 2024 in six general hospitals. The study included newly employed nurses who voluntarily consented to participate. A self-designed questionnaire was used to collect demographic characteristics and KAP scores.

RESULTS: A total of 240 valid questionnaires were collected. Among the participants, 193 (80.42%) were female, and 219 (91.25%) held an associate or bachelor’s degree. Additionally, 142 respondents (59.17%) reported working 40 to 49 hours per week, while 172 (71.67%) had received training related to EPAs. The median (interquartile range) scores for knowledge, attitude, and self-reported practice were 16 (13-18.5), 46 (40-50), and 40 (38-49), respectively. Exploratory path analysis showed that knowledge was negatively associated with self-reported practice after accounting for attitude (β = -0.121, P = 0.012), whereas attitude was positively associated with self-reported practice (β = 0.514, P = 0.012). The path from knowledge to attitude (β = 0.111, P = 0.115) and the indirect association between knowledge and self-reported practice through attitude (β = 0.057, P = 0.127) were not statistically significant.

CONCLUSION: Newly employed nurses demonstrated insufficient knowledge but positive attitudes and proactive self-reported practices regarding EPAs. Positive attitudes were associated with higher self-reported practice scores, whereas the association between knowledge and self-reported practice was more complex. Targeted education combining EPA-related knowledge, practical training, and mentorship may support self-reported practice, although its effects on actual clinical performance and patient outcomes require evaluation in future longitudinal or interventional studies.

PMID:42668973 | PMC:PMC13525766 | DOI:10.2147/JMDH.S624664