Tag: statistics

J Matern Fetal Neonatal Med. 2026 Dec;39(1):2663199. doi: 10.1080/14767058.2026.2663199. Epub 2026 May 10.

ABSTRACT

INTRODUCTION: The postpartum period carries substantial risk for preventable morbidity, particularly among individuals with high-risk pregnancies complicated by chronic or pregnancy-associated conditions. Despite recommendations for early and ongoing postpartum follow-up, patterns of postpartum and acute care utilization across high-risk conditions remain poorly characterized. We evaluated postpartum and acute care utilization among individuals with high-risk pregnancies versus low-risk pregnancies in an urban safety-net health system.

METHODS: We conducted a retrospective cohort study of individuals who delivered at two campuses of a tertiary academic medical center between 1 June 2018 and 31 May 2022. High-risk pregnancy status was defined using ICD-9/10 codes corresponding to chronic medical or pregnancy-associated conditions; low-risk was defined by the absence of these codes. The primary outcome was attendance of ≥1 postpartum visit (PPV) within 12 weeks of delivery. Secondary outcomes included emergency department (ED) visits and hospital readmissions within 12 weeks postpartum. Multivariable logistic regression was used to estimate adjusted odds ratios (aORs).

RESULTS: Of 13,874 included individuals, 9435 (68.0%) had ≥1 high-risk diagnosis, and nearly half had multiple coexisting conditions. High-risk individuals were more likely than low-risk individuals to attend any PPV (59.2% vs. 45.4%) and an early PPV within 21 days (40.5% vs. 24.2%, both p < 0.001). ED visits (16.9% vs. 13.9%) and readmissions (5.4% vs. 2.7%) were also more frequent among high-risk individuals (p < 0.001). In adjusted analyses, hypertensive disorders of pregnancy (aOR 1.67), mental health conditions (aOR 1.49), cesarean delivery, and greater prenatal care utilization were associated with higher odds of PPV attendance, while gestational diabetes was associated with lower odds (aOR 0.79). High-risk conditions, particularly hypertensive disorders and pregestational diabetes, were associated with increased acute care utilization.

CONCLUSIONS: Although high-risk individuals were more likely to attend PPVs, overall engagement remained suboptimal and acute care utilization was high. These findings highlight the need for risk-tailored postpartum care and improved care coordination to reduce preventable morbidity.

PMID:42108383 | DOI:10.1080/14767058.2026.2663199

Int J Dent Hyg. 2026 May 10. doi: 10.1111/idh.70089. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to assess the antigingivitis and antiplaque efficacy of a 2% chlorhexidine (CHX)-impregnated dental floss in adults with gingivitis.

METHODS: This randomised clinical study included 42 patients diagnosed with gingivitis. They were randomly allocated into three groups: no interdental cleaning (NIC) group, which did not use any interdental cleaning device; dental floss (DF) group, individuals who used unwaxed dental floss without impregnation; and dental floss+CHX (DF + CHX) group, those who used the same dental floss, but with 2% CHX digluconate impregnation. A manual toothbrush and fluoride dentifrice were provided for all groups. Gingival Bleeding Index (GBI) and Quigley-Hein modified by Turesky plaque index (PI) were assessed by the same trained and calibrated examiner. Individuals were evaluated after 4- and 6-week. Taste preference was also evaluated at 6-week of follow-up. Groups were compared with the Kruskal-Wallis test using α < 5%.

RESULTS: Thirty-eight patients completed the study. To both outcomes, no statistically significant differences among groups were observed regardless of the follow-up (p > 0.05). However, within groups showed that all groups presented a significantly reduction of GBI and PI (p < 0.05). Regarding taste preference, no significant differences among groups were detected (p > 0.05).

CONCLUSION: The use of dental floss impregnated with 2% chlorhexidine did not present additional antigingivitis and antiplaque efficacy over 6 weeks of follow-up.

PMID:42108370 | DOI:10.1111/idh.70089

Ann Surg Oncol. 2026 May 11. doi: 10.1245/s10434-026-19761-4. Online ahead of print.

ABSTRACT

BACKGROUND: Gender equity in surgery remains an ongoing focus of investigation and while there are more women entering the surgical oncology workforce, disparities persist. Professional surgical organizations, such as the Society of Surgical Oncology (SSO), are powerful engines for scientific advancement and career growth. The objective of this study was to evaluate contemporary trends in gender representation related to active participation and leadership within the SSO.

MATERIALS AND METHODS: Data were obtained from the SSO database and website that included all membership, committee membership, and leadership roles as well as annual meeting program information from 2010 to 2025. Gender of individuals was determined by self-report or from institutional websites. Data were analyzed using descriptive statistics including logistic regression and two-way analysis of variance (ANOVA).

RESULTS: From 2010 to 2024, there was a significant increase in female committee membership, with women comprising 49.3% of members in 2024, up from 25.5% in 2010 (p < 0.001). Female representation was noted in relation to committee leadership with an increase from 2010, where women comprised 20.3% of leadership roles, to an increase of 48.1% in 2024 (p < 0.01). From 2013 to 2025, there was an overall increase in female SSO meeting presenters from 38.8% in 2013 to 44.4% in 2025 (p = 0.018).

CONCLUSIONS: Representation of women within the SSO membership, committee leadership, and presenters at the annual meeting has increased from 2010 to 2025. This finding reflects both broader societal advances towards inclusivity as well as the SSO’s ongoing efforts in working toward promoting career development for all members.

PMID:42108363 | DOI:10.1245/s10434-026-19761-4

Sci Rep. 2026 May 10. doi: 10.1038/s41598-026-52703-4. Online ahead of print.

ABSTRACT

This study investigates variation in the phytochemical composition of Cedrus libani A. Rich. leaves across an altitudinal gradient, focusing on volatile and flavonoid profiles. Leaf samples were collected from three elevations (1300, 1500, and 1700 m) in the Yukarı Gökdere Forest region (Isparta, Turkey). Volatile compounds were analyzed using GC-MS, and flavonoid compounds were determined by RP-HPLC. A total of 45 volatile compounds were identified, predominantly consisting of monoterpenes and sesquiterpenes. Major components included limonene, β-myrcene, α-pinene, caryophyllene, and germacrene-D, with significant variation observed among elevation groups. One-way ANOVA indicated that several volatile compounds differed significantly across elevations (p < 0.05). Flavonoid analysis showed that rutin and kaempferol decreased with increasing elevation, whereas quercetin and catechin exhibited higher values at higher elevations. All analyzed flavonoid compounds showed statistically significant differences among elevation groups (p < 0.05). Principal component analysis (PCA) revealed separation patterns among samples based on their chemical composition. Overall, the results indicate that the phytochemical composition of C. libani leaves varies along the studied elevational gradient. These findings provide a preliminary and descriptive assessment of altitude-related chemical variation and highlight the need for further studies incorporating broader sampling designs and environmental measurements.

PMID:42108332 | DOI:10.1038/s41598-026-52703-4

Diabetologia. 2026 May 11. doi: 10.1007/s00125-026-06732-3. Online ahead of print.

ABSTRACT

AIMS/HYPOTHESIS: Chronic kidney disease (CKD) complicates insulin dosing and increases glycaemic instability in diabetes. We aimed to compare feasibility, safety and efficacy of automated insulin delivery (AID) with usual care in people with diabetes and advanced CKD.

METHODS: We conducted a prospective, open-label, randomised crossover trial at five tertiary hospitals in Australia and one tertiary centre in Denmark. Adults aged ≥18 years with type 1 diabetes or insulin-treated type 2 diabetes and advanced CKD (stage 3b or higher, including dialysis) were eligible. Participants were randomly assigned in a 1:1 sequence to receive either AID followed by usual care with real-time continuous glucose monitoring (CGM), or the reverse sequence, each for 8 weeks. Allocation was generated centrally using computerised randomisation. Due to the nature of the intervention, participants and clinicians were aware of treatment assignment. The primary outcome was percentage time in range (3.9-10.0 mmol/l) during the final 3 weeks of each treatment period.

RESULTS: Forty participants (24 type 1 diabetes, 16 type 2 diabetes; median [IQR] age 60 [55, 69] years; HbA_1c 64 [54, 73] mmol/mol [8.0% (7.1%, 8.8%)]; eGFR 30 [18, 37] ml/min per 1.73 m²) were enrolled: 33 not on dialysis, four on peritoneal dialysis and three on haemodialysis. AID significantly improved all hyperglycaemic CGM metrics compared with usual care. Time in range (3.9-10.0 mmol/l) improved from 60% (51%, 66%) at the end of usual care to 73% (65%, 78%) at the end of AID (p<0.001). Hypoglycaemia rates were unchanged. Participants were predominantly pre-frail at baseline and remained stable on-trial. No serious adverse events were attributed to the study devices. Nonetheless, 25% of participants experienced hospital admissions during the trial period for medical issues unrelated to device use.

CONCLUSIONS/INTERPRETATION: AID is feasible and safe and compared with usual care provides superior glucose management in predominantly pre-frail people with diabetes complicated by advanced CKD.

TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12622000889752; ClinicalTrials.gov NCT06330194 FUNDING: This trial was funded by the Australian Centre for Advancing Diabetes Innovations (ACADI), St Vincent’s Hospital Melbourne and Diabetes Australia.

PMID:42108331 | DOI:10.1007/s00125-026-06732-3

Eur J Orthop Surg Traumatol. 2026 May 11;36(1):189. doi: 10.1007/s00590-026-04774-2.

ABSTRACT

BACKGROUND: Testosterone replacement therapy (TRT) may cause side effects after orthopedic procedures. With total hip arthroplasty (THA) rates increasing, this study evaluates the relationship between TRT and postoperative complications in THA patients.

METHODS: A retrospective review in a large academic hospital was conducted of hypogonadal patients treated with TRT, who underwent primary, elective THA between 2012 and 2024. These were 1:2 propensity-matched based on age, body-mass index, and comorbidities to a “control” group that was not treated with TRT. Patient and TRT characteristics including serum testosterone levels, form of administration, 90-day emergency department visits (ED) and readmissions, reoperations and revisions were explored.

RESULTS: Among 152 patients aged 61.3 years who underwent THA with a 2.7-year follow-up, TRT was mainly administered intramuscularly (51.3%) or via transdermal gel (46.1%), followed by pellets (2.0%), and oral tablets (1.6%). Overall rates of 90-day ED visits and readmissions did not differ significantly between TRT and control patients (7.9% vs. 5.3%, P = 0.270 and 7.9% vs. 5.6%, P = 0.225, respectively). TRT patients had a significantly lower rate of 90-day ED visits due to surgery-related causes (0.7% vs. 2.3%, P = 0.048) but a significantly higher rate due to non-surgery-related causes (7.2% vs. 3.0%, P = 0.034). The incidence of PJI did not differ significantly between the groups (2.0% vs. 1.0%, P = 0.319). Reoperations and revisions were not different between the groups (P = 0.650 and P = 0.057, respectively). TRT administration form was not associated with 90-day ED visits (P = 0.380), readmissions (P = 0.563), reoperations (P = 0.441) or revisions (P = 0.669). Testosterone levels demonstrated a weak, negative, yet significant correlation with 90-day ED visits (r = -0.35, P = 0.040), but not with reoperations or revisions (P = 0.348 and P = 0.431, respectively).

CONCLUSIONS: TRT in THA patients was associated with a reduced rate of surgery-related 90-day ED visits but an increased rate of non-surgery-related 90-day ED visits. Incidence of PJI and overall 90-day ED visits and readmission rates did not significantly differ. Administration form had no significant impact, while higher testosterone levels were linked to fewer 90-day ED visits. Although limited by its retrospective design and patient exclusions, further investigation is warranted to guide perioperative management in these patients, particularly given the known immunomodulatory effects of exogenous TRT.

PMID:42108328 | DOI:10.1007/s00590-026-04774-2

Emerg Radiol. 2026 May 11. doi: 10.1007/s10140-026-02475-1. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the clinical associations of admission non-contrast CT morphology in acute pancreatitis within a real-world emergency workflow.

MATERIALS AND METHODS: This retrospective observational cohort study included 264 consecutive adult patients admitted with acute pancreatitis to two surgical centers between 2019 and 2024. Patients were categorized according to the first imaging modality obtained at admission into an ultrasound-first (US-first) or computed tomography-first (CT-first) pathway. Baseline characteristics and in-hospital outcomes were compared between pathways. In the CT-first subgroup, all examinations were performed without intravenous contrast, and morphologic severity was assessed using the Balthazar classification. Associations between CT morphology and clinical outcomes were evaluated using univariable analyses.

RESULTS: Of the 264 patients, 143 (54.2%) were managed within a US-first pathway and 121 (45.8%) underwent CT as the initial imaging modality. Baseline demographic and etiologic characteristics were comparable between pathways. Patients in the CT-first pathway demonstrated numerically higher rates of adverse clinical outcomes at admission, including a longer length of hospital stay (median 8 vs. 6 days; p = 0.01) and numerically higher rates of severe acute pancreatitis and in-hospital mortality. Within the CT-first cohort, non-contrast CT morphology demonstrated heterogeneous inflammatory severity. Higher Balthazar grades were associated with stepwise numerical increases in rates of severe disease, complications, and length of hospital stay. When dichotomized, advanced morphologic severity (Balthazar grades D-E) showed higher odds of adverse outcomes compared with grades A-C, although these associations did not reach statistical significance.

CONCLUSION: In routine emergency practice, selection of ultrasound-first or CT-first imaging pathways appears largely driven by triage and organizational factors rather than predefined imaging strategies. In patients undergoing non-contrast CT at admission, higher Balthazar grades demonstrated consistent numerical gradients toward more severe clinical courses; however, these associations did not reach statistical significance. Early non-contrast CT morphology should therefore be interpreted as contextual inflammatory assessment rather than a standalone prognostic tool.

PMID:42108327 | DOI:10.1007/s10140-026-02475-1

Brain Inform. 2026 May 11. doi: 10.1186/s40708-026-00302-4. Online ahead of print.

ABSTRACT

Accurate detection of Mild Cognitive Impairment (MCI) is critical for timely intervention and for slowing progression to Alzheimer’s disease. Electroencephalography (EEG) offers a non-invasive and cost-effective measure of brain activity; however, its complex, non-linear dynamics limit conventional analysis. We propose a CNN-Res-SE-BiLSTM-BiGRU framework for the automated detection of MCI directly from raw EEG. Convolutional and residual blocks capture local temporal structure, bidirectional recurrent layers model long-range dependencies, and Squeeze-and-Excitation (SE) modules provide channel-wise attention. Predicted probabilities are calibrated using temperature scaling, and operating thresholds are selected on the validation set using Youden’s J statistic. The model is evaluated using five-fold cross-validation under both subject-dependent and strict subject-independent protocols on a primary resting-state dataset, with additional subject-independent validation on an odor EEG dataset. Under subject-independent evaluation on the odor dataset, the proposed model achieved an accuracy of 0.956 ± 0.051, with ROC-AUC of 0.971 ± 0.051 and PR-AUC of 0.934 ± 0.132. UMAP-based visualization and explainable AI analyses (SHAP and LIME) provide interpretable insight into the learned spatiotemporal patterns and sample-specific decisions. These results demonstrate robust, interpretable EEG-based MCI detection with potential clinical utility.

PMID:42108320 | DOI:10.1186/s40708-026-00302-4

Eur J Orthop Surg Traumatol. 2026 May 11;36(1):190. doi: 10.1007/s00590-026-04773-3.

ABSTRACT

PURPOSE: Ankle fractures are among the most common orthopedic injuries requiring operative management. Postoperative care varies across healthcare systems due to cultural, regulatory, and practice-based differences. This study evaluated whether such variation influences ankle fracture healing.

METHODS: We conducted a retrospective cohort study at two Level 1 trauma centers, one in the United States and one in Chile, from 2015 to 2023. Patients included had sustained Weber B or C ankle fractures due to falls and were treated with ORIF, with available 3- and 6-month radiographs. Demographic, clinical, and operative variables were recorded. Genetic matching was used to balance key covariates between cohorts.

RESULTS: Of 250 patients, 110 remained after genetic matching (55 pairs) with well-balanced baseline characteristics (all standardized mean differences < 0.1). No significant differences in fracture union time were observed between cohorts in either unmatched or matched analyses. In the matched cohort, mean union time was 108.6 ± 60.6 days in the U.S. group and 124.8 ± 88.2 days in the Chilean group (p = 0.235). Sensitivity analyses demonstrated consistent findings. Complication rates were similar, with no differences in infection, delayed union, or nonunion; however, a higher proportion of Chilean patients had no complications (72.7 vs. 50.9%, p = 0.038).

CONCLUSION: In this matched binational cohort, patients with operatively treated ankle fractures demonstrated comparable healing outcomes despite differences in postoperative care strategies across healthcare systems. These findings highlight the reliability of fracture healing in this injury pattern with low rate of complications despite cultural and system-level variation, supporting opioid-sparing strategies in appropriately selected patients.

PMID:42108318 | DOI:10.1007/s00590-026-04773-3

J Chem Ecol. 2026 May 11;52(3):41. doi: 10.1007/s10886-026-01716-4.

ABSTRACT

Availability and quality of vegetation are critical factors influencing herbivore nutrition and population dynamics. Fourier-transform infrared spectroscopy (FTIR) offers a promising approach to analyze herbivore diets using spectral properties of phytochemicals to identify plant items. We evaluated the potential of FTIR to identify plant taxa and parts consumed by an herbivore species. Crop contents from 236 rock ptarmigan (Lagopus muta MONTIN) individuals from Iceland, collected over nine years, were separated into pure fractions of plant taxa and parts (e.g., berries, leaves) and analyzed using FTIR in the mid-IR region (4000 -400 cm⁻¹). We classified plant taxa and parts with PCA and Random Forests (RF) based on spectral signals. FTIR revealed distinct chemical fingerprints for plant taxa and parts, consistent with previously established variation in lipids, proteins, carbohydrates, and chemical defenses. RF yielded high classification accuracy for plant parts (96.7%) and moderate accuracy for taxa (85.5%), confirming the method’s reliability. FTIR overcomes limitations of traditional genetic analyses by identifying plant parts with varying nutritional quality within species. FTIR provided insights into biochemical properties of plant items but could not distinguish chemically similar items. Future research should expand spectral reference libraries combining FTIR with quantification of phytochemicals and DNA metabarcoding.

PMID:42108314 | DOI:10.1007/s10886-026-01716-4