Tag: statistics

J Coll Physicians Surg Pak. 2026 Feb;36(2):253-257. doi: 10.29271/jcpsp.2026.02.253.

ABSTRACT

OBJECTIVE: To evaluate the effectiveness and safety of duodenum suspension in the laparoscopic treatment of congenital duodenal obstruction (CDO).

STUDY DESIGN: A descriptive study. Place and Duration of the Study: Department of Paediatric Surgery, Ganzhou Maternal and Child Healthcare Hospital, Ganzhou, China, from January 2015 to December 2024.

METHODOLOGY: Patients who underwent surgery for duodenal obstruction were categorised into three groups: open repair (OP), laparoscopic repair (LA), and laparoscopy with duodenal suspension (Sus-LA). Patients with severe malformations or age >1 month were excluded. Demographics, comorbidities, intraoperative and postoperative data, and outcome parameters were evaluated. Descriptive statistics were employed to summarise the distribution of continuous variables, with normally distributed data presented as mean ± standard deviation and skewed data as median (interquartile range). ANOVA, Welch’s t-test, Bonferroni post hoc comparison, and Fisher’s exact test were used for pairwise comparisons.

RESULTS: Thirty-eight patients were included, with no significant differences in gender, age, weight, gestational weeks, obstruction aetiologies, and comorbidities among the groups (p >0.05). Operating time was shorter in the Sus-LA group [120.0, (48) minutes] compared to the LA group [(176.5, (75) minutes, p = 0.001)], but did not differ from the OP group [85.0, (31) minutes; p = 0.055]. Time to feed initiation was shorter in the Sus-LA group [4.0, (3) days] than the OP group [7.5, (4) days; p = 0.033], with no difference between the OP and LA groups [p >0.99]. The length of hospital stay differed significantly among the groups [23.0 (8), 24.0 (15), and 18.0 (8) days, respectively, (p = 0.036)]. Complications occurred in 13 (34.2%) patients, with lower frequencies in the Sus-LA group (7.7%) than the OP group (55.6%; p = 0.024).

CONCLUSION: Duodenal suspension in the laparoscopic treatment of neonatal duodenal obstruction is a manoeuvre that facilitates the surgical procedure and is associated with reduced surgical difficulty, shorter operative time, and decreased postoperative complications.

KEY WORDS: Neonate, Duodenal obstruction, Duodenum suspension, Laparoscopy, Complications.

PMID:41689328 | DOI:10.29271/jcpsp.2026.02.253

J Coll Physicians Surg Pak. 2026 Feb;36(2):248-252. doi: 10.29271/jcpsp.2026.02.248.

ABSTRACT

OBJECTIVE: To compare the effects of intermittent classical blood cardioplegia and single-dose modified Del Nido cardioplegia on postoperative serum lactate levels and extubation time in patients undergoing coronary artery bypass grafts (CABG).

STUDY DESIGN: An observational study. Place and Duration of the Study: Department of Cardiovascular Surgery, Faculty of Medicine, Kastamonu University, Kastamonu, Turkiye, from 2020 to September 2023.

METHODOLOGY: Forty patients who underwent CABG between 2020 and 2023 were randomly divided into two groups. Group 1 formed 20 patients who received intermittent classical blood cardioplegia, and Group 2 formed 20 patients who received single-dose modified Del Nido cardioplegia. Demographic data, bypassed vessels, cardiopulmonary bypass (CPB) time, aortic cross clamp (ACC) time, postoperative drainage, inotrope required and extubation time, glomerular filtration rate (GFR), and serum lactate levels were recorded 2 hours after surgery. The Shapiro-Wilk test was utilised to evaluate the normality of data distribution. The Mann-Whitney U test was employed for variables that did not follow a normal distribution, whereas normally distributed variables were analysed using the independent samples t-test. Additionally, the chi-square test was applied to compare categorical variables across groups.

RESULTS: No statistically significant differences were detected between the groups with respect to demographic data, ACC time, CPB time, bypassed vessels, postoperative drainage, inotrope requirement, or GFR. Postoperatively, lactate levels were statistically lower in Group 2 than in Group 1, and extubation time was statistically shorter in Group 2 than in Group 1 (p <0.001).

CONCLUSION: Modified Del Nido cardioplegia reduces postoperative lactate levels and extubation time. Therefore, modified Del Nido cardioplegia provides better patient stability and myocardial protection than the classical blood cardioplegia after CABG.

KEY WORDS: Atherosclerosis, Coronary artery bypass grafting, Mortality.

PMID:41689327 | DOI:10.29271/jcpsp.2026.02.248

J Coll Physicians Surg Pak. 2026 Feb;36(2):240-247. doi: 10.29271/jcpsp.2026.02.240.

ABSTRACT

OBJECTIVE: To identify the motivational factors and barriers influencing undergraduate (UG) research in a dental college in Pakistan from students’ perspectives using semi-structured interviews.

STUDY DESIGN: A qualitative phenomenological study. Place and Duration of the Study: Nishtar Institute of Dentistry, Multan, Pakistan, from October 2022 to October 2023.

METHODOLOGY: A validated, modified, and pilot-tested Vodopivec questionnaire was distributed among 67 consenting final-year BDS students as a pre-test to assess their knowledge of research. The pre-test results were calculated manually. Based on these results, a study sample of 20 students was selected: 10 students with the top scores and 10 students with the bottom scores. Semi-structured interviews were conducted with these students until data saturation was achieved. Thematic analysis was performed using NVivo software.

RESULTS: Twelve themes were identified by students, including both research barriers and promoting factors. Each theme comprised several subthemes. The major themes included the poor status of UG research, lack of institutional vision, and insufficient funding. Subthemes included no research-related coursework, favouritism by teachers, and inadequate laboratory infrastructure with untrained research faculty. The incorporation of research projects into the community dentistry subject was suggested in the final year BDS programme.

CONCLUSION: There is a suboptimal status of UG research in public-sector dental colleges in Pakistan, with few motivational factors and numerous barriers.

KEY WORDS: Undergraduate research, Motivational factors, Barriers, Curriculum, Dentistry.

PMID:41689326 | DOI:10.29271/jcpsp.2026.02.240

J Coll Physicians Surg Pak. 2026 Feb;36(2):233-239. doi: 10.29271/jcpsp.2026.02.233.

ABSTRACT

This meta-analysis aimed to compare the efficacy and safety of Diode laser haemorrhoidoplasty (DLH) with conventional haemorrhoidectomy (CH) techniques, namely Milligan-Morgan haemorrhoidectomy (MMH) and Ferguson haemorrhoidectomy (FH), for the treatment of symptomatic haemorrhoids. A search of PubMed, Embase, Cochrane, Web of Science, and Scopus identified 13 eligible studies. Primary outcomes included intraoperative blood loss, postoperative bleeding, pain (measured by VAS), complications (e.g., urinary retention and anal stenosis), recovery time, and recurrence rate. Statistical analysis used both random-effects and fixed-effects models, with results reported as 95% confidence intervals (CIs), and heterogeneity was assessed using the I2 statistic. The results showed that DLH offered significant benefits over MMH and FH, including reduced intraoperative blood loss (MD = -20.19 mL, 95% CI: -28.32 -12.07; p <0.001), lower postoperative bleeding (OR = 0.32, 95% CI: 0.11 – 0.93; p = 0.04), and less postoperative pain, both immediately and one week later. Key Words: Diode laser haemorrhoidoplasty, Milligan-Morgan haemorrhoidectomy, Ferguson haemorrhoidectomy, Haemorrhoids, Meta-analysis.

PMID:41689325 | DOI:10.29271/jcpsp.2026.02.233

J Coll Physicians Surg Pak. 2026 Feb;36(2):217-222. doi: 10.29271/jcpsp.2026.02.217.

ABSTRACT

OBJECTIVE: To compare serum homocysteine, zinc, and copper levels between chronic obstructive pulmonary disease (COPD) patients and healthy controls, and to assess their associations with systemic inflammation.

STUDY DESIGN: A comparative cross-sectional study. Place and Duration of the Study: Department of Pulmonary Diseases, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkiye, from February to April 2025.

METHODOLOGY: This study evaluated homocysteine, folic acid, vitamin B12, zinc, and copper levels in 30 COPD patients and 30 healthy controls (HCs). Pearson’s chi-square test was used to compare categorical variables between groups. The Student’s t-test was employed for comparisons between two groups. Pearson’s correlation analysis was conducted to assess the relationship between continuous variables.

RESULTS: Statistically significant differences were found in leucocyte, platelet, red cell distribution width (RDW), immature granulocyte, and immature granulocyte percentage levels in COPD patients (p <0.001, p = 0.024, p = 0.002, p = 0.035, and p = 0.022, respectively). CRP levels were significantly elevated in the COPD group (p = 0.006). No statistically significant differences were found in homocysteine, folic acid, vitamin B12, zinc, and copper levels between the COPD and Control groups (p >0.05). All measured values in both groups were within the normal reference ranges. However, zinc levels positively correlated with RDW (r = 0.417; p = 0.030), and a negative correlation was observed between copper levels and RDW (r = -0.543; p = 0.009) in the COPD group.

CONCLUSION: Homocysteine, zinc, copper, vitamin B12, and folic acid levels did not differ between COPD patients and HCs, all within normal ranges. Secondary analyses showed significant haematogram and CRP alterations, indicating systemic inflammation. These markers cannot be used as inflammatory parameters in COPD.

KEY WORDS: COPD, Homocysteine, Zinc, Copper, Vitamin B12, Folic acid.

PMID:41689323 | DOI:10.29271/jcpsp.2026.02.217

Forensic Sci Int Genet. 2026 Feb 3;83:103444. doi: 10.1016/j.fsigen.2026.103444. Online ahead of print.

ABSTRACT

Mitochondrial DNA (mtDNA) analysis is a frequently used tool for determining the potential origin of biological traces found at crime scenes. The method typically involves comparing the genetic profile of the trace with that of a suspect. While a mismatch between the two profiles usually leads to the exclusion of the suspect, the evidential value of a match is sometimes difficult to grasp. This is particularly true in cases that are more complex than a simple trace-suspect comparison. We considered two such scenarios and developed means for appropriate statistical interpretation of the respective mtDNA results. One scenario requires the evaluation of a composite hypothesis about trace donorship in multiple cases involving an mtDNA profile match with one and the same suspect. The other scenario calls for the consideration of a second mtDNA profile found at the crime scene that matches a matrilineally unrelated contact person of the suspect. For both scenarios, we propose formally linked mathematical methods for interpreting the mtDNA data which, under certain assumptions, allow valid quantification of the evidential value of the latter for or against the suspect. Furthermore, we illustrate the application of both methods with example calculations under realistic assumptions about the required parameters.

PMID:41687183 | DOI:10.1016/j.fsigen.2026.103444

ESMO Open. 2026 Feb 12;11(3):106043. doi: 10.1016/j.esmoop.2025.106043. Online ahead of print.

ABSTRACT

BACKGROUND: The phase III NAPOLI 3 trial established liposomal irinotecan in combination with 5-fluorouracil/leucovorin plus oxaliplatin (NALIRIFOX) as a superior first-line (1L) treatment option compared with gemcitabine plus nab-paclitaxel (Gem + NabP) in patients with previously untreated metastatic pancreatic ductal adenocarcinoma (mPDAC), without imposing an upper age limit on enrollment. The current analysis of the NAPOLI 3 data investigated the potential impact of older age on the efficacy and safety of NALIRIFOX.

PATIENTS AND METHODS: Adults with previously untreated mPDAC were randomly assigned in a 1 : 1 ratio to receive NALIRIFOX or Gem + NabP. This post hoc analysis compared outcomes for patients aged ≥70 years versus <70 years. Endpoints included overall survival (OS), progression-free survival (PFS), and safety. No statistical comparison was carried out.

RESULTS: Of the 770 patients in the NAPOLI 3 population, 553 were aged <70 years and 217 were aged ≥70 years. Median OS and median PFS with NALIRIFOX were 11.7 months and 7.4 months, respectively, in the <70 years subgroup (n = 275) and 10.0 months and 7.3 months, respectively, in the ≥70 years subgroup (n = 108). The benefit of NALIRIFOX versus Gem + NabP was preserved in the older versus younger subgroup. There was no evidence of increased treatment-related toxicity in the older (versus younger) subgroup.

CONCLUSIONS: NALIRIFOX improved mPDAC survival versus Gem + NabP irrespective of patient age, with no signals for reduced tolerability in the older (versus younger) patients. The results provide reassurance that triplet therapy with NALIRIFOX is an efficacious and tolerable regimen in older treatment-naive patients with mPDAC who were fit enough for inclusion in NAPOLI 3, supporting consideration of its use as 1L therapy in this population.

PMID:41687160 | DOI:10.1016/j.esmoop.2025.106043

Sci Total Environ. 2026 Feb 12;1019:181520. doi: 10.1016/j.scitotenv.2026.181520. Online ahead of print.

ABSTRACT

Previously reported rooftop ambient aerosol measurements in Raleigh, NC, USA, detected episodic events where sub-10 nm particle number concentrations (PNC) exceeded 3.73 × 10⁵ cm^-3. Their small size and temporally stable modal diameter (sometimes persisting for days) indicated origins from nearby primary emission sources rather than mesoscale new particle formation (NPF) events. To investigate potential sources, simulations were conducted using the U.S. Environmental Protection Agency’s Gaussian plume-based model, AERMOD. Campus surveys and Google Earth analyses identified three candidate sources near the measurement site, including two combined heat and power (CHP) facilities with high-efficiency natural gas turbines and heat recovery steam generators that provide energy to NC State’s campus. Distinct point sources were modeled for each facility using an emission factor of 5 × 10^-4 g s^-1. The study explored source contributions under varying micrometeorological conditions (e.g., wind speed, wind direction, solar radiation, and planetary boundary layer height). Wind pattern analysis revealed distinct plumes from individual power plants reaching the receptor site. Statistical analyses confirmed wind direction and speed as the strongest predictors of modeled mass concentrations, and that observed PNC profiles during NPF and particle burst events are fundamentally distinct. Exceptionally high sub-10 nm particle growth rates were observed during plume transport, averaging 104-120 nm hr^-1. These findings reveal that expanding deployment of CHPs for distributed power generation may pose unrecognized health risks through sub-10 nm particle emissions with demonstrated respiratory and neurological impacts. New emission standards may be needed to address ultrafine particle production from natural gas combustion technologies.

PMID:41687154 | DOI:10.1016/j.scitotenv.2026.181520

Int J Drug Policy. 2026 Feb 12;150:105183. doi: 10.1016/j.drugpo.2026.105183. Online ahead of print.

ABSTRACT

Systemic violence is a structural feature of drug economies and a key spillover of prohibitionist drug policies. Despite its centrality, the concept is often applied in ways that obscure its distinct purposes, market levels, and organizational contexts. To address this gap, the study examines violence at the intersection of mafia activity and drug markets, focusing on its distribution across market levels (retail, national wholesale, transnational), organizational functions (governance and trade), and rivalry configurations (inter-, intra-, and extra-clan). It draws on a press-based dataset of mafia-related homicides in Italy (2014-2024) to code and analyze these dynamics. Results show that more than half of all mafia homicides are drug-related, mainly tied to governance activities and concentrated at the retail level of the market. This pattern marks a qualitative shift in mafia violence: increasingly selective, embedded in market dynamics, confined to criminal circuits. Statistical analyses reveal significant associations between activity type, market level, and rivalry configuration, indicating that coercion concentrates where regulatory control and market participation intersect. This pattern underscores the multifunctional nature of Italian mafias, which govern markets from within while actively engaging in trade. By grounding this overlap empirically, the study advances theoretical debates on organized crime’s role in shaping illicit economies. It also offers a replicable framework for analyzing drug-related violence in the absence of official statistics.

PMID:41687149 | DOI:10.1016/j.drugpo.2026.105183

J Surg Res. 2026 Feb 12;319:141-151. doi: 10.1016/j.jss.2026.01.012. Online ahead of print.

ABSTRACT

INTRODUCTION: Preoperative abnormal sodium level is suggested to increase mortality risk in surgeries, including colectomy for colorectal cancer. However, it remains unclear which age groups are most affected by this electrolyte derangement. To bridge this gap and to better risk stratify patients preoperatively, we assessed the association of age on patients with abnormal sodium level undergoing colectomy for colorectal cancer.

MATERIALS AND METHODS: We reviewed the American College of Surgeons National Safety Quality Improvement Program Procedure-Targeted Colectomy database from 2015-2020, identifying patients over the age of 18 who underwent colectomy for primary colon cancer. We dichotomized the group by age, either younger than or 65 y and older. We collected demographics, comorbidities, laboratory values, and operative variables. We performed descriptive statistics, univariate analysis, and multivariable logistic regression with interaction term analysis. Our primary outcome was the relationship between age and 30-d mortality among patients with abnormal sodium levels. We defined statistical significance using two-sided tests as P < 0.05.

RESULTS: We identified 89,745 patients who underwent colectomy for primary colon cancer, 50,528 of those were aged 65 y and older. On multivariate analysis, we found that age ≥65 y is associated with an increased risk of mortality (odds ratio [OR], 2.574, P < 0.01). We found sodium level to have a U-shaped relationship with increased risk of mortality for both hyponatremia and hypernatremia (hyponatremia OR, 1.38, P < 0.01, hypernatremia OR, 1.878, P < 0.01), controlling for demographics and comorbidities. On multivariate interaction analysis, sodium level did not pose a clinically significant higher mortality risk to patients’ age (OR, 1.002, P < 0.01).

CONCLUSIONS: Advanced age and abnormal sodium level are independently associated with 30-d mortality following colectomy for colon cancer. Furthermore, the association between abnormal sodium levels and mortality does not differ in a clinically meaningful way between younger and older patients. This finding reinforces that abnormal sodium level is associated with an increased mortality risk after colectomy for colon cancer and provides a potential target for further study.

PMID:41687140 | DOI:10.1016/j.jss.2026.01.012