Category: Statistics

BMC Gastroenterol. 2025 Mar 29;25(1):206. doi: 10.1186/s12876-025-03798-y.

ABSTRACT

BACKGROUND AND AIM: Nonalcoholic fatty liver disease (NAFLD) with liver fibrosis is associated with liver-related mortality and cardiovascular disease. Estimated glucose disposal rate (eGDR), which is an insulin resistance-related index, is related to the mortality caused by NAFLD. This study aimed to investigate the predictive value of eGDR for liver fibrosis in patients with NAFLD.

METHODS: The data from the National Health and Nutrition Examination Survey 2017-2020.03 were analyzed in the present study. NAFLD was diagnosed using the controlled attenuation parameter (CAP) tests using FibroScan^® model 502 V2 Touch.

RESULTS: The data from 1585 individuals were analyzed, including 224 with significant fibrosis and 1361 with nonsignificant fibrosis. Individuals with significant fibrosis were older and had higher CAP values and lower eGDRs (both P < 0.01). A negative correlation was found between eGDR and stiffness degrees (odds ratio: 0.643, 95% confidence interval: 0.643-0.726, P < 0.001); the correlation was also significant after adjusting for age, sex, and ethics (P < 0.001). For participants with obesity and overweight, eGDR was negatively correlated with age, CAP, body mass index (BMI), waist circumference, C-reactive protein level, and white blood cell (WBC) count (all P < 0.05). The multivariate analysis revealed that age, eGDR, BMI, aspartate aminotransferase (AST), and WBC and platelet (PLT) counts (all P < 0.05) were independent risk factors for significant fibrosis. A model incorporating eGDR, BMI, age, AST, WBC, and PLT had an AUROC of 0.822, and was superior to conventional noninvasive scoring systems, including the AST-to-PLT ratio index, fibrosis-4 level, and gamma-glutamyl transpeptidase to platelet ratio for individuals with obesity (all P < 0.01).

CONCLUSION: Low eGDR was negatively correlated with liver fibrosis in individuals with NAFLD and obesity, and a model incorporating eGDR, BMI, age, AST, WBC, and PLT demonstrated strong predictive value for fibrosis evaluation.

PMID:40158190 | DOI:10.1186/s12876-025-03798-y

BMC Med Educ. 2025 Mar 29;25(1):458. doi: 10.1186/s12909-025-06978-2.

ABSTRACT

BACKGROUND: The Progress Test Medizin (PTM) is a formative test for medical students issued twice a year by the Charité-Universitätsmedizin Berlin. The PTM provides a numerical feedback based on a global view of the strengths and weaknesses of students. This feedback can benefit from more fine-grained information, pinpointing the topics where students need to improve, as well as advice on what they should learn in light of their results. The scale of the PTM, taken by more than 10,000 participants every academic semester, makes it necessary to automate this task.

METHODS: We have developed a seven-step approach based on large language models and statistical analysis to fulfil the purpose of this study. Firstly, a large language model (ChatGPT 4.0) identified keywords in the form of MeSH terms from all 200 questions of one PTM run. These keywords were checked against the list of medical terms included in the Medical Subject Headings (MeSH) thesaurus published by the National Library of Medicine (NLM). Meanwhile, answer patterns of PTM questions were also analysed to find empirical relationships between questions. With this information, we obtained series of questions related to specific MeSH terms and used them to develop a framework that allowed us to assess the performance of PTM participants and compose personalized feedback structured around a curated list of medical topics.

RESULTS: We used data from a past PTM to simulate the generation of personalized feedback for 1,401 test participants, thereby producing specific information about their knowledge regarding a number of topics ranging from 34 to 243. Substantial knowledge gaps were found in 14.67% to 21.76% of rated learning topics, depending on the benchmarking set considered.

CONCLUSION: We designed and tested a method to generate student feedback covering up to 243 medical topics defined by MeSH terms. The feedback generated with data from students in later stages of their studies was more detailed, as they tend to face more questions matching their knowledge level.

PMID:40158187 | DOI:10.1186/s12909-025-06978-2

Popul Health Metr. 2025 Mar 29;23(1):11. doi: 10.1186/s12963-025-00374-0.

ABSTRACT

BACKGROUND: Evidence indicating persistent geographic inequalities in health outcomes signifies a need for routine subnational monitoring of health-related Sustainable Development Goal targets in sub-Saharan Africa. Health facilities may be an appropriate subnational unit for monitoring purposes, but a lack of suitable demographic data complicates the production of baseline facility-level population denominators against which progress can be reliably measured. This scoping review aimed to map the methods and data sources used to estimate health facility catchment areas and translate them to population denominators for child health indicators in the region.

METHODS: Peer-reviewed research publications and grey literature reports were identified by searching bibliographic databases and relevant organisational websites. The inclusion criteria required that studies were conducted in sub-Saharan Africa since January 2000, described quantitative method(s) for estimating health facility catchment areas and/or population denominators, and focussed on children as the population of interest. Following title/abstract then full text screening of search results, relevant data were extracted using a standard form. Thematic analysis was undertaken to extract themes and present a narrative synthesis.

RESULTS: Overall, 33 research publications and 3 grey literature reports were included. Of these, only 7 research studies and 1 technical guidance document outlined aims explicitly framed around methods development and/or evaluation. Studies increasingly estimated catchment areas using complex geostatistical or travel time-based modelling approaches rather than simpler proximity metrics, and produced denominators by intersecting catchment boundaries with gridded population surfaces rather than aggregating area-based administrative counts. Few studies used data produced by or describing health facilities to link estimation methods to service utilisation patterns, inter-facility competition or facility characteristics.

CONCLUSION: There is a need for catchment population estimation methods that can be scaled to national-level facility networks and replicated across the region. This could be achieved by leveraging routinely collected health data and other readily available and nationally consistent data sources. Future methodological development should emphasise modern geostatistical approaches drawing upon the relative strengths of multiple data sources and capturing the range of spatial, supply-side, individual-level and environmental factors with potential to influence catchments’ extent, shape and demographic composition.

PMID:40158185 | DOI:10.1186/s12963-025-00374-0

BMC Public Health. 2025 Mar 29;25(1):1198. doi: 10.1186/s12889-025-22397-w.

ABSTRACT

OBJECTIVE: This study aimed to explore the relationship between physical fitness and cognitive control in Chinese children, with a focus on gender differences and the moderating role of family support for physical activity (FSFPA).

METHOD: This study employed a cross-sectional design to assess 148 children aged 12-14 years from Guangzhou. Physical fitness was evaluated using the National Student Physical Fitness Standard, family support for physical activity (FSFPA) was measured with the validated Family Support for Physical Activity Scale, and cognitive control was assessed using the Stroop color-word task, Go/No-Go task, and task-cue paradigm. The statistical analyses included descriptive statistics, correlation analysis, and hierarchical regression analysis to examine the relationships between variables.

RESULTS: Gender differences were observed in physical fitness and cognitive control. Girls scored higher in physical fitness and showed better accuracy in interference suppression, with faster reaction times in impulse control. BMI and speed were positively correlated with cognitive flexibility in both genders. For boys, cardiopulmonary endurance positively affected interference suppression, and muscle strength influenced impulse control. BMI and speed were linked to cognitive flexibility. For girls, speed, cardiopulmonary endurance, and muscle strength improved interference suppression, while BMI influenced cognitive flexibility. FSFPA moderated the relationship between physical fitness and cognitive control for both genders. It positively impacted interference suppression and cognitive flexibility for both boys and girls.

CONCLUSION: Physical fitness in Chinese children is positively associated with cognitive control, with gender-specific differences in the fitness components influencing cognitive outcomes. FSFPA significantly moderates this relationship, enhancing the positive effects of physical fitness on cognitive control. These findings suggest that promoting physical fitness, particularly through family-based physical activity support, may improve children’s cognitive control abilities.

PMID:40158184 | DOI:10.1186/s12889-025-22397-w

BMC Cardiovasc Disord. 2025 Mar 29;25(1):235. doi: 10.1186/s12872-025-04690-z.

ABSTRACT

BACKGROUND: The risk of hypertension varies based on ethnicity, environmental factors, and genetic predispositions. Studies have reported a higher risk of cardiovascular diseases (CVD) and hypertension among the Newar ethnic groups in Nepal. However, the genetic analysis for Methylenetetrahydrofolate reductase (MTHFR C677T) gene mutations, serum homocysteine, and high-sensitivity C-reactive protein (hs-CRP) levels across different ethnicities remains unexplored.

METHODS: Sociodemographic information and baseline data of 489 participants were obtained from the first phase of the Dhulikhel Heart Study. Preserved blood samples were analyzed for MTHFR C677T polymorphism using real-time polymerase chain reaction (TaqMan assay), and serum homocysteine was measured through immunoassay techniques. Descriptive analysis, the Hardy-Weinberg equilibrium test, and multinomial regression were performed.

RESULTS: The prevalence of homozygous mutation (TT) was 19.8% in the Newar group and 12.5% in the Brahmin/Chhetri ethnicity. The highest mean value of homocysteine (19.4 µmol/L) was observed in homozygous participants, followed by the heterozygous mutant group (17.4 µmol/L). A statistically significant association (P = < 0.001) was found between homocysteine levels and blood pressure.

CONCLUSIONS: The Dhulikhel Heart Study reveals a significant prevalence of the MTHFR C677T gene mutation among the Newar ethnicity compared to other groups. Elevated levels of homocysteine and high-sensitivity C-reactive protein (hs-CRP) were associated with increased blood pressure.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40158176 | DOI:10.1186/s12872-025-04690-z

BMC Pregnancy Childbirth. 2025 Mar 29;25(1):373. doi: 10.1186/s12884-025-07330-8.

ABSTRACT

BACKGROUND: There are no specific guidelines regarding the definition, diagnostic workup and treatment of recurrent pregnancy loss (RPL) in China at present. Whether the diagnostic workup should occur after two or three or more pregnancy losses in the Chinese population is not clear.

METHODS: This cross-sectional study collected data from January 2017 to December 2022 from the RPL Clinic at Shengjing Hospital, affiliated with China Medical University. The results of diagnostic tests for evidence-based and possible risk factors of RPL,which is defined as two or more failed clinical pregnancies, were collected. The data collected include parental chromosomal karyotypes, immune factors (anticardiolipin antibody, anti-β2-glycoprotein I antibody, lupus anticoagulants, and antinuclear antibodies), endocrine factors (polycystic ovary syndrome, thyroid dysfunction, hyperprolactinemia, obesity, and glucose abnormalities), anatomical factors (uterine malformations, endometrial polyps, intrauterine adhesions, uterine fibroids or adenomyosis), coagulation factors (thrombelastogram, antithrombin III, and homocysteine levels) and other factors (vitamin D levels, MTHFR polymorphisms and ultrasound indices of endometrial receptivity). All these data were compared between patients with two or three or more pregnancy losses.

RESULTS: Among all 785 patients with RPL, the rates of abnormal anatomical factors (40.96% versus 32.94%, P = 0.021, OR 1.41, (95% Cl 1.05-1.89)), endometrial polyps (6.21% versus 3.06%, P = 0.034, OR 2.10, (95% Cl 1.04-4.23)) and obesity (13.76% versus 5.59%, P < 0.0001, OR 2.69, (95% Cl 1.62-4.49)) were significantly higher in people with three or more pregnancy losses than in people with two pregnancy losses. The rates of other diagnostic tests were not statistically significant between the two groups.

CONCLUSION: Based on the high rate of abnormal test results in the Chinese RPL population, our findings may provide evidence for patients in our area begin routine etiological screening after two pregnancy losses.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03561766, 18/5/2018.

PMID:40158174 | DOI:10.1186/s12884-025-07330-8

BMC Gastroenterol. 2025 Mar 29;25(1):207. doi: 10.1186/s12876-025-03808-z.

ABSTRACT

BACKGROUD: Gallstones are a common disease that imposes a significant burden on public health resources. Sarcopenia is an age-related condition characterized by a decline in muscle mass, strength, and function. However, its relationship with gallstones remains unclear.

METHODS: This cross-sectional study included 2,167 US adults from the National Health and Nutrition Examination Survey. We used the multivariable logistic regression models and restricted cubic spline regression to to assess the relationship between sarcopenia and gallstones. Additionally, subgroup analyses and propensity score matching (PSM) were conducted to account for potential confounding factors.

RESULTS: We found a significant negative association between the sarcopenia index and the prevalence of gallstones (OR: 0.253, 95% CI: 0.132-0.471, P < 0.001). In Model 4, which integrated all covariates, sarcopenia was associated with approximately a 100% increased prevalence of gallstones compared to non-sarcopenia patients (OR: 1.995, 95% CI: 1.340-2.948, P < 0.001). The results of PSM also confirmed the association between sarcopenia and gallstones (OR: 1.982, 95% CI: 1.217-3.285, P = 0.007). Notably, this association was more pronounced in subgroups including females, non-Hispanic whites, married individuals, and higher education level.

CONCLUSION: In summary, our findings suggest a positive association between sarcopenia and the prevalence of gallstones in US adults. This suggests that we should increase the emphasis on gallstone disease screening in sarcopenia patients. However, this finding needs to be validated through further large-scale prospective studies.

PMID:40158173 | DOI:10.1186/s12876-025-03808-z

BMC Nurs. 2025 Mar 29;24(1):338. doi: 10.1186/s12912-025-03028-6.

ABSTRACT

INTRODUCTION: Innovative approaches are essential in nursing education to ensure the continuity of skill acquisition, particularly in situations where traditional face-to-face teaching methods are not feasible.

OBJECTIVE: This study aimed to evaluate the effectiveness of remote learning in enabling student nurses to acquire psychomotor skills, with a focus on ‘blood pressure measurement’-a noninvasive procedure that can be practiced safely at home.

METHODS: Using an experimental design with group randomization and a mixed-method approach, 44 first-year nursing students participated, with 22 in the experimental group and 22 in the control group. After a theoretical course on blood pressure measurement, the control group followed a licensed video program, while the experimental group practiced with a simulated patient under an educator’s guidance in an remote environment. The research was conducted between March 2021 and October 2021, encompassing all phases of the study. These phases included preliminary information, remote training, and feedback sessions in March 2021, the first assessment in April 2021, and the second assessment in October 2021. The ‘Descriptive Characteristics Form,’ ‘Blood Pressure Measurement Skill Checklist,’ and ‘We Practice Remote Clinical Skills Together Online Comments Form’ were used for data collection. Descriptive statistics (means, standard deviations, frequencies, percentages) and the Mann-Whitney U test were applied for quantitative data analysis, while qualitative data were analyzed inductively based on student opinions from both groups.

RESULTS: The first performance assessment showed no significant difference between the control and experimental groups’ mean scores (p = 0.440). However, the second assessment revealed a significant difference favoring the experimental group (p = 0.001). The qualitative data were categorised into three main themes: emotions, learning and confidence, with a total of 34 codes. Emotions accounted for 50% of the codes, including happiness, stress, comfort and anxiety. Learning accounted for 41% and included awareness, interaction-communication, skill acquisition and information retention. Finally, self-confidence, represented by skill practice in the laboratory, accounted for 9% of the codes.

CONCLUSION: This study demonstrates that educator-guided remote skill training can positively impact students’ psychomotor skill acquisition. It highlights the potential for effectively teaching specific nursing skills in remote environments when guided by an educator.

PMID:40158171 | DOI:10.1186/s12912-025-03028-6

BMC Public Health. 2025 Mar 29;25(1):1199. doi: 10.1186/s12889-025-22385-0.

ABSTRACT

BACKGROUND: Intimate partner violence (IPV) is a prevalent public health problem and a significant contributor to morbidity and mortality among women and girls. IPV significantly interferes with individual’s quality of life (QoL). This study examined and compared the relationship between experience of IPV and QoL of young women in urban slums and non-slums communities of Ibadan, Nigeria.

METHODS: The study was conducted in the five Local Government Areas (LGAs) of Ibadan municipal, Oyo State, and employed a cross-sectional design. The study population were 1,050 young women aged between 18 and 24 years, who had ever been or currently was in a relationship. Data were collected using semi-structured and close-ended 97-items questionnaire, adapted from standardized instruments of the WHO VAW study (WHO, 2013) and WHOQOL BREF. Data were analysed using STATA 16. hierarchical multiple regression model was used to describe relationship between the outcome and independent variables.

RESULTS: The age (21.0 ± 2.1 years) of respondents was the same in both communities. Prevalence of physical (31.4%, 13.4%), psychological (58.6%, 31.5%) and sexual IPV (37.1%, 18.3%) were (p < 0.05) higher in the slums than non-slums, respectively. Overall QoL score was lower among IPV victims than non-victims in both non-slum (67.3 ± 23.4; 72.2 ± 19.8) and slum communities (67.3 ± 23.1 versus 72.4 ± 21.1). Physical and psychological QoL scores were lower (p < 0.05) among IPV victims in both settings. The predictors of overall QoL were experience of any IPV, perceived social support, partner’s age, while experience of sexual IPV and partner’s age were predictors of psychological QoL. Lastly, the predictors of physical QoL were experience at sexual debut and perceived social support.

CONCLUSION: Experience of IPV was common in both communities, with a consequential reduction in the QoL of young women. Measures to improve the QoL of young women need to target reduction of IPV and available social support in both settings.

PMID:40158170 | DOI:10.1186/s12889-025-22385-0

World J Surg Oncol. 2025 Mar 29;23(1):107. doi: 10.1186/s12957-025-03717-1.

ABSTRACT

BACKGROUND: Neuropilin and tolloid-like 2 (NETO2) facilitates the progression of various cancers, but its role in hepatocellular carcinoma (HCC) is not known. This study aimed to assess the potential of targeting NETO2 in HCC and its relationship with the STAT3/C-MYC pathway.

METHODS: HCC cells (Huh7 and MHCC-97 H) were cultured and transfected with control siRNA (siCtrl), NETO2 siRNA (siNETO2), control overexpression (oeCtrl), or NETO2 overexpression (oeNETO2), with non-transfected cells used as blank controls.

RESULTS: NETO2 mRNA and protein expressions were reduced in both Huh7 and MHCC-97 H cells. EdU and CCK-8 assays indicated that cell proliferation was decreased after siNETO2 transfection in Huh7 and MHCC-97 H cells. TUNEL assay found revealed that the cell apoptosis rate was greater after siNETO2 transfection in MHCC-97 H cells, and tended to be greater in Huh7 cells (but the difference was not statistically significant). Transwell invasion assay revealed that the number of invasive Huh7 and MHCC-97 H cells decreased after siNETO2 transfection. Cell scratch assay revealed that the cell migration rate was reduced after siNETO2 transfection in Huh7 cells but was not significantly different in MHCC-97 H cells. Western blotting revealed that p-STAT3 and C-MYC expressions were decreased after siNETO2 transfection in Huh7 and MHCC-97 H cells. Overexpression experiments revealed that cell proliferation and invasion were promoted but that the cell apoptosis rate was reduced after oeNETO2 transfection in Huh7 and MHCC-97 H cells.

CONCLUSION: NETO2 knockdown suppresses HCC cell proliferation, invasion, and migration and inactivates the STAT3/C-MYC pathway, suggesting that NETO2 is a potential target for HCC treatment.

PMID:40158169 | DOI:10.1186/s12957-025-03717-1