Category: Statistics

BMC Oral Health. 2025 May 31;25(1):869. doi: 10.1186/s12903-025-06238-1.

ABSTRACT

BACKGROUND: Tooth loss is often followed by potential complications, including restricted mouth opening, edema, regional pain, and alveolar osteitis (AO), all of which can impair socket healing and quality of life, compromising the ability to socialize and speak post-extraction. One of the approaches currently used to minimize adverse effects is to use platelet-rich fibrin (PRF) immediately following tooth extraction to reduce these complications. This study aims to evaluate the effectiveness of platelet-rich fibrin in promoting soft and hard tissue healing, and its effects on post-extraction complications.

METHOD: A systematic review and meta-analysis were conducted, following an electronic and manual search of PubMed, EMBASE, Web of Science, and Scopus databases. A total of 455 articles were screened, of which 41 articles underwent systematic review, and 21 studies (701 patients) were included for meta-analysis. Statistical analyses were performed using Comprehensive Meta-Analysis software. The risk of bias was evaluated by three assessors based on five domains. To evaluate PRF effectiveness, the focus was on split-mouth designs to minimize inter-patient variability.

RESULT: PRF significantly improved soft tissue healing (eight studies, p < 0.05), reduced AO incidence (four studies, p < 0.05), and lowered post-operative pain (eleven studies, p < 0.05). However, PRF did not demonstrate statistically significant improvement in bone healing (three studies, p > 0.05).

CONCLUSION: The analysis showed that PRF significantly improved soft tissue healing and reduced the incidence of AO. While PRF helped reduce pain, the results were inconsistent and influenced by the timing of post-operative assessments. The impact on hard tissue healing was controversial, and future research should explore alternative methods to evaluate PRF’s effects on bone regeneration.

PMID:40450285 | DOI:10.1186/s12903-025-06238-1

BMC Oral Health. 2025 May 31;25(1):857. doi: 10.1186/s12903-025-06203-y.

ABSTRACT

BACKGROUND: Achieving optimal dentofacial aesthetics requires an understanding of tooth morphology and its impact on dental harmony. Variations in tooth size can significantly influence the occurrence of different malocclusions, affecting aesthetics and functional occlusion. This systematic review aims to analyse and summarise the existing literature on tooth size variations in different malocclusion categories, focusing on the morphological dimensions of permanent dentition.

METHODS: Systematic literature search was conducted in six electronic databases (PubMed/Medline, Cochrane, Web of science, Scopus, LILAC, OVID) until February 2025 for original articles assessing the morphological dimension of the permanent dentition in various malocclusions. The risk of bias and quality assessment was done using the modified Downs and Black quality index for retrospective and cross sectional study. The review was registered on Prospero (CRD42024526671).

RESULTS: Nine studies (4 retrospective, 5 cross sectional) met the eligibility criteria. A total of 2044 pre-treatment dental casts of patients with various malocclusions were included. In mandibular first molars, the mean difference (MD) of the mesiodistal width was higher in Class III malocclusion than Class II div 1 malocclusion (3 studies; MD [95%CI]: 0.45[, -0.66, -0.24]), Class II division 2 malocclusion (3 studies; MD [95%CI]: 0.29[, -0.55, -0.24]) and Class I malocclusion (7 studies; MD [95%CI]: 0.20[ -0.35 to -0.05]). These findings were statistically significant. For mandibular canines, MD of the mesiodistal width was higher in Class III malocclusion than in Class II division 1 malocclusion (3 studies; MD [95%CI]:0.28 [ -0.45 to -0.10]), which was statistically significant. With the maxillary canines, the MD of the mesiodistal width was higher in Class II division 1 malocclusion (3 studies; MD [95%CI]: 0.30[0.12, 0.47]), which was statistically significant.

CONCLUSION: In Class III malocclusion, the mandibular dentition was found to be significantly larger compared to other malocclusions. The Maxillary dentition was significantly larger in Class II malocclusion compared to other malocclusions. Within the limitations of the study, Class III and Class II malocclusions were found to have larger mesio-distal width as compared to Class I malocclusion. These findings may aid clinicians in treatment planning, particularly in space analysis, arch coordination, and appliance selection during orthodontic interventions.

PMID:40450279 | DOI:10.1186/s12903-025-06203-y

BMC Complement Med Ther. 2025 May 31;25(1):195. doi: 10.1186/s12906-025-04938-3.

ABSTRACT

BACKGROUND: Herbal products have been used for gas pains in children for many years. However, the quality of herbal products used in children and the presence of contamination in the products are controversial. This study was conducted to evaluate the frequency of use of herbal products for gas pain in pediatric patients, the attitudes of parents towards the use of herbal products, and the pyrrolizidine alkaloid content of herbal products used for gas pain.

METHODS: The survey part of the study was conducted between 15.06.2020-15.09.2020 at Gazi University Hospital Pediatrics Clinics. The surveys were conducted face to face with the parents. The Statistical Package for Social Sciences (SPSS) 23 program was used in the analysis of the data. In the other part of the study, 28 herbal products frequently used in gas pain were purchased from spice shops, markets and internet sites and their pyrrolizidine alkaloid content was evaluated by LC-QTOF-MS analysis.

RESULTS: 31.5% of the participants had their children use herbal products for gas pains. When the plants used for gas pains in children were examined, fennel came first with a usage rate of 51.3%. The plants used in gas pains were purchased from spice shops by most of the participants (59%). The presence of pyrrolizidine alkaloids above 10 µg/kg concentration was detected in 75% of herbal products used in gas pains.

CONCLUSION: In all segments of society, children are given herbal products for gas pains. Parents mostly buy herbal products from spice shops. Products sold for gas pains may cause hepatotoxic effects in children when consumed for a long time and in high doses due to the pyrrolizidine alkaloids they contain. Herbal products to be used in gas pain should be used under the consultancy of a physician/pharmacist and should be obtained from pharmacies.

PMID:40450273 | DOI:10.1186/s12906-025-04938-3

BMC Oral Health. 2025 May 31;25(1):858. doi: 10.1186/s12903-025-06285-8.

ABSTRACT

OBJECTIVES: The objectives were to assess the knowledge, attitudes, and barriers to referrals for oral lesions from the perspectives of antenatal care providers and dentists, as well as the frequency of referrals to dental clinics at the same facility.

METHODS: A mixed-method study was conducted in the Gynaecology, Obstetrics, and Dental Departments of one public-sector and one private hospital from October 2024 to January 2025.The study included antenatal care and dental care providers and utilized purposive sampling. Two structured questionnaires, validated through a pilot study, were administered via Google Forms. Ethical approval was obtained, and confidentiality was maintained. The data were analyzed using SPSS version 27, and incomplete responses were excluded. Descriptive statistics were performed for numerical data, while thematic analysis was conducted for open-ended responses.

RESULTS: A total of 30 participants took part in the study, including 5 from a private hospital and 25 from a public-sector hospital, further divided into 17 dentists and 13 antenatal care providers. The majority (69.2%) of ANC workers had knowledge of oral lesions during pregnancy, yet only 53.8% provided awareness to pregnant women. The most common oral lesion was gum bleeding (20.5%), whereas the key challenge in treatment included a lack of guidelines (34.5%). A total of 61.5% of the participants incorporated oral health checkups into their medical history, and 84.6% collaborated with other health professionals. Additionally, recurrence, time constraints, and superstitious beliefs pose challenges for healthcare providers.

CONCLUSION: Despite awareness, gaps exist in knowledge, patient education, and systemic support. Integrating oral health screening into maternal care and improving collaboration may enhance patient outcomes. Poor periodontal health has been linked to low birth weight, preterm delivery, and preeclampsia.

PMID:40450271 | DOI:10.1186/s12903-025-06285-8

BMC Nurs. 2025 May 31;24(1):622. doi: 10.1186/s12912-025-03300-9.

ABSTRACT

OBJECTIVE: The purpose of the study was to evaluate the efficacy of employing high-fidelity simulation (HFS) in enhancing mental health nursing students’ practice, satisfaction, and self-confidence in contrast to a group of students undergoing traditional nursing education methods.

METHODS: A quasi-experimental pre and post-test, two groups study was conducted from March to June 2024. The study conducted with 75 nursing students from Arab American University Palestine and An-Najah National University. The Educational Practices Questionnaire-Curriculum and Learner Satisfaction and Self-Confidence in learning method were used to assess nursing students’ practice, satisfaction, and self-confidence. Normality of data was confirmed using Shapiro-Wilk test. Statistical t-tests were used to compare between the two groups.

RESULT: The results revealed significant differences in the educational practice, satisfaction, and self-confidence scores between the experimental and control groups (p < 0.05). Specifically, the educational practice scores in the experimental group (M = 73.3 ± SD 5.62) was higher than that in the control group (M = 61.4 ± SD 6.82). Also, the mean of the student’s satisfaction scores in the experimental group (M = 21.8 ± SD 2.35) was higher than that in the control group (M = 18.1 ± SD 4.84). Furthermore, the mean of the student self-confidence scores in the experimental group (M = 35.9 ± SD 3.47) was higher than that in the control group (M = 29.1 ± SD 6.69).

CONCLUSION: The study supports using high-fidelity simulation alongside clinical site experiences to link nursing knowledge and practice. Consequently, mental health nursing students’ benefit from advanced training that maintains their competency, theoretical knowledge, clinical judgment, collaborative functioning, leadership, and communication skills. While high-fidelity simulation enhances learning in mental health nursing education, it should be viewed as a complementary approach rather than a replacement for actual clinical placements.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40450268 | DOI:10.1186/s12912-025-03300-9

BMC Public Health. 2025 May 31;25(1):2014. doi: 10.1186/s12889-025-23253-7.

ABSTRACT

BACKGROUND: Water, Sanitation, and Hygiene (WASH) are essential for preventing infectious diseases and promoting public health, particularly among school-aged children. This study assessed the knowledge and practices of WASH among secondary school students in Ikeduru Local Government Area, Imo State, Nigeria, comparing public and private school students.

METHODS: A descriptive cross-sectional study design was employed, and data were collected using a structured questionnaire and an observational checklist. A multi-stage sampling technique was used to select 20 secondary schools, with a total of 400 students participating in the study. Data were analyzed using the Statistical Package for Social Sciences (SPSS), with descriptive and inferential statistics applied to determine associations between variables at a 5% level of significance.

RESULTS: Findings revealed that while public school students exhibited higher WASH knowledge (87.1%) compared to private school students (54.3%), private school students demonstrated better WASH practices, with 65.5% maintaining good hygiene compared to 55.7% of public-school students (p = 0.043). Significant disparities were observed in handwashing behaviors, toilet use, and drinking water sources. Public school students faced greater challenges due to inadequate sanitation facilities, leading to a higher prevalence of open defecation (55.7%) compared to private school students (6.9%). Despite high awareness of WASH-related diseases, practice gaps remained, particularly in public schools, where limited access to hygiene facilities hindered adherence to proper sanitation practices.

CONCLUSIONS: The study highlights the need for targeted interventions to improve WASH infrastructure, particularly in public schools. Policies should prioritize the provision of adequate toilets, functional handwashing stations, and safe drinking water to bridge the gap between knowledge and practice. Strengthening hygiene education and implementing behavior change strategies will enhance WASH compliance and reduce the burden of preventable diseases among students.

PMID:40450261 | DOI:10.1186/s12889-025-23253-7

BMC Musculoskelet Disord. 2025 May 31;26(1):535. doi: 10.1186/s12891-025-08756-z.

ABSTRACT

OBJECTIVE: To explore the biomechanical properties of a four-dimensional structure locking osteosynthesis plate that can alter its structure and functionality over time.

METHODS: According to the AO classification (AO-A2) standard, 18 artificial femoral shaft oblique fracture models with the same position and shape were generated and subsequently randomly divided into 2 groups (n = 9). In the experimental group, the four-dimensional locking plate was fixed, and in the control group, the locking plate was fixed. In vitro loading experiments were carried out under three conditions: 1400 N axial compression, 500 N internal and external four-point bending, and 15 N·m torsion. The average compression stiffness, average bending stiffness, average torsional stiffness, and displacement were compared between the two groups.

RESULTS: Under vertical loading, the average compression stiffness of the experimental group (558.7 ± 39.1) N/mm was greater than that of the control group (548.8 ± 24.5) N/mm, (P = 0.73); and the average displacement of the fracture end of the experimental group (3.3 ± 0.2) mm was lower than that of the control group (3.4 ± 0.3) mm, (P = 0.47). The differences were not statistically significant. Under four-point bending loading, the average bending stiffness of the experimental group (466.6 ± 85.8) N/mm was lower than that of the control group (542.5 ± 43.2) N/mm, and the difference was not statistically significant (P = 0.24). The average displacement of the fracture ends in the experimental group (1.6 ± 0.2)mm was greater than that in the control group (1.2 ± 0.1)mm, and the difference was statistically significant (P = 0.02). Under torsional loading, the average torsional stiffness of the experimental group (1.0 ± 0.1) N·m/deg was lower than that of the control group (1.1 ± 0.1) N·m/deg, (P = 0.27); and the average angular displacement of the fracture end of the experimental group (15.9 ± 1.3) deg was greater than that of the control group (14.6 ± 1.3) deg, (P = 0.26). There was no significant difference between the two groups.

CONCLUSION: The anti-compression, anti-bending and anti-torsion properties of four-dimensional locking plates are similar to those of conventional locking plates and can meet the mechanical requirements of internal fracture fixation.

PMID:40450259 | DOI:10.1186/s12891-025-08756-z

BMC Nurs. 2025 May 31;24(1):621. doi: 10.1186/s12912-025-03292-6.

ABSTRACT

BACKGROUND: Nurses play a vital role in patient care, and their perceptions of their work environment are crucial for healthcare quality. A supportive and well-resourced work environment enhances the quality of care and increases employee commitment. The physical environment directly influences nurses’ well-being and efficiency, while a culture that fosters collaboration and communication is essential for improving patient outcomes and ensuring high-quality care. This study aimed to analyse nurses’ assessments of the work environment, organisational culture and work organisation over three decades (1999, 2009 and 2021) to understand their connection to changes in nursing activities over time. Data were collected via a structured questionnaire.

METHODS: A cross-sectional survey methodology was adopted. Descriptive statistical analysis, correlation analysis and logistic regression analysis were conducted via IBM SPSS. These analyses sought to track temporal changes, explore relationships between workforce resources and nursing activities, and investigate the determinants of the perceived nurse-to-patient ratio.

RESULTS: In the work environment domain, the perceived quality of the physical work environment remained stable, although the nurse-to-patient ratio increased insufficiently. Changes in organisational culture yielded improvements in communication and the psychosocial work environment but reductions in the quality of collaboration. With respect to work organisation, a greater standardisation of nursing work emerged over time. The logistic regression analysis indicated that nurses working in regional hospitals and departments with more beds more frequently considered the nurse-to-patient ratio to be insufficient.

CONCLUSIONS: The nurses’ views showed that despite the increased health care workforce, the nurse-to-patient ratio was often seen as insufficient. Although the quality of the physical environment either remained stable or improved, organisational culture shifts indicated less group work and greater multiprofessional cooperation. This study underscores the necessity of a comprehensive approach for evaluating the nurse-to-patient ratio, integrating both quantitative and qualitative measures to effectively gauge and improve the nursing work environment.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40450258 | DOI:10.1186/s12912-025-03292-6

BMC Public Health. 2025 May 31;25(1):2019. doi: 10.1186/s12889-025-23288-w.

ABSTRACT

OBJECTIVES: Rifampicin-resistant tuberculosis (RR-TB) remains a critical health challenge in southwest China. This study investigates healthcare-seeking delays and patient pathways among RR-TB patients in Yunnan province, employing diagram visualization. Aim to explore the accessibility and challenges of medical services for RR-TB.

METHODS: A retrospective cohort study was conducted among RR-TB patients who were enrolled in the Tuberculosis Management Information System (TBMIS) from 2020 to 2022. Data was collected via a face-to-face questionnaire survey to measure the patient pathways and delays of RR-TB patients at different health facility levels. SPSS statistical software was used for descriptive statistics, nonparametric tests, and patient pathway analysis. Sankey diagram, box plot and a heat map were used for data visualization.

RESULTS: Sankey diagrams revealed 7 distinct diagnostic pathways, with 49.4% diagnosed after one health facility visit. Over 50% of patients were diagnosed at county level facilities (Level 2), prolonging delays. As the level of health facility increases, the flow of RR-TB patients gradually decreased. Treatment pathways were simple with 4 routes. 92.4% of RR-TB patients enrolled treatment after visiting only one health facility, reflecting shorter treatment delays (median: 5 days). The median total delay was 66 days (Interquartile range: 28 to 155) of RR-TB patients. The diagnostic delay and total delay in lower health facilities was significantly higher than that in higher-levels (P < 0.05).

CONCLUSIONS: This study visualizes RR-TB healthcare-seeking flows in economically underdeveloped areas of China. Though healthcare access is decent, diagnostic delays are notable, especially at under-resourced facilities. We should pay more attention to and enhance the RR-TB diagnostic capabilities of primary health facilities. While treatment pathways are simple, financial burdens might be a key issue. Reducing these burdens through multi-channel funding and policy support is essential.

PMID:40450248 | DOI:10.1186/s12889-025-23288-w

BMC Public Health. 2025 May 31;25(1):2027. doi: 10.1186/s12889-025-23275-1.

ABSTRACT

BACKGROUND: The effect of HIV infection on the nutritional status of patients has been widely known for several years, as well as the synergy between the infection and the conditions of poverty in developing countries. However, particular communities like pastoralists in underdeveloped countries live in a unique crossroad where challenges related to HIV prevention and control, and vulnerability to the disease exacerbate each other. Thus information from such range of contexts is valuable in addressing the complicated medical condition resulting from the combination of HIV infection and malnutrition. This study therefore aimed to assess the nutritional status and its associated factors among HIV infected children from pastoral zones of south Ethiopia.

METHODS: Multicenter cross-sectional study was conducted among 399 HIV-positive ≤ 15 year children. Data were collected systematically from selected participants by using interviewer administered structured and pre-tested questionnaires. We used Epi-data version 4.1 for data entry and SPSS Version 25for data analysis. A p-value of < 0.05 was considered to declare statistical significance with the corresponding 95% confidence interval. The goodness of fit (GOF) of the model was checked using Hosmer-Lemeshow test. The p-value of the Hosmer-Lemeshow test of this model is p-value greater than 0.05 which confirms that the model is correctly specified.

RESULTS: The magnitude of underweight (weight-for-age z-score ≤ -2) was found to be 50.1%, 95% CI (0.45-0.55).In the multi-variable analysis, the mothers ‘age of15 to 18 years(AOR = 2.02; 95% CI = 1.10-3.71), mother’s exposure to mass media(AOR = 1.58; 95% CI = 1.05-2.39), household food insecurity(AOR = 1.92; 95% CI = 1.18-3.13) and having history of Oropharyngeal disease(AOR = 1.56; 95% CI = 1.01-2.39) were significantly associated with being underweight.

CONCLUSION: The prevalence found in this study was high when compared with the local studies. Policies and intervention strategies aimed at improving childhood nutrition and health should address the identified determinant factors.

PMID:40450246 | DOI:10.1186/s12889-025-23275-1