Category: Statistics

J Pediatr Nurs. 2025 Jun 25;84:319-327. doi: 10.1016/j.pedn.2025.06.042. Online ahead of print.

ABSTRACT

PURPOSE: To identify the physical activity levels and influencing factors of children with epilepsy in China.

METHODS: This study was designed as a sequential explanatory mixed-method study. The quantitative phase included a sample of 195 children with epilepsy and their caregivers from November 2023 to April 2024. Data were analyzed using descriptive statistics, the independent t-tests, and one-way analysis of variance. The qualitative data were collected through semi-structured interviews, and a total of 8 children and 15 caregivers were interviewed from May 2024 to June 2024. The content analysis was conducted using the MaxQda software. Interpretative thematic analysis was used to explore the multidimensions of physical activity. The following joint display analysis was used to integrate quantitative and qualitative data.

RESULTS: Children with epilepsy tend to have limited physical activity and engage in a limited variety of activities, influenced by the multidimensional factors. Through joint display, five meta-themes and thirteen meta-subthemes were identified, including limited physical activity (insufficient physical activity and preference for simple activity types), misconceptions (excessive limitations, few concerns, and fear of seizure-related injury), personal factors (disease burden, personal characteristic, and the stigma), family and school factors (influenced by caregivers knowledge, parental and family support, and school support), and healthcare factors (the advice and attitudes of healthcare staff).

CONCLUSION: The research highlights the importance of supporting the physical activity of children with epilepsy. Epilepsy nurses should incorporate physical activity education and counseling into their routine clinical care, and develop targeted interventions to encourage regular physical activity.

IMPLICATIONS FOR PRACTICE: Epilepsy nurses should prioritize correcting misconceptions about physical activity in children with epilepsy. During clinical consultations, epilepsy nurses should implement tailored activity programs and provide individualized education and counseling.

PMID:40570474 | DOI:10.1016/j.pedn.2025.06.042

Prev Vet Med. 2025 Jun 24;243:106607. doi: 10.1016/j.prevetmed.2025.106607. Online ahead of print.

ABSTRACT

Smallholder dairy farming plays a crucial role in Kenya’s economy, with many farmers relying on dairy cattle for their livelihoods. However, milk production is affected by factors such as breed selection, nutrition, and endemic diseases. This cross-sectional study determined factors associated with daily milk yield in lactating smallholder dairy cows in Kabete Sub-County, Kiambu County, Kenya. We hypothesized that milk production is significantly associated with nutrition, management practices, and cow-level factors. On-farm questionnaires were administered to farmers in 62 randomly selected farms to collect animal- and farm-level information. A total of 196 lactating cows (1-6 per farm, averaging 3) were assessed, with measurements taken on daily milk yield, California Mastitis Test score, egg/oocyst count, days in milk, and body condition score (BCS). Descriptive statistics and multilevel mixed-effects linear regression were used for analysis, with daily milk yield as the outcome variable. The mean daily milk yield per cow was 10.8 ± 4.8 liters (range 1-24 liters). Feeding practices were significantly associated with daily milk yield. Cows supplemented with yeast products were associated with a 7.56 L/day higher milk yield compared to those without (β=7.56, 95 % CI 3.66-11.45). Feeding napier grass, hay, and dairy meal was associated with increased milk yield by 3.68 L/day (β=3.68, 95 % CI 0.89-6.46), 2.73 L/day (β=2.73, 95 % CI 1.32-4.12), and 2.16 L/day (β=2.16, 95 % CI 0.88-3.44), respectively. The association between BCS and daily milk yield depended on wheat bran supplementation; when fed, higher BCS (≥3) was associated to significantly increased yield. Each additional cow in the herd was associated with a 0.25 L/day increase in milk yield. Negative associations with daily milk yield included breed (β=-2.66, 95 % CI -4.59 to -0.08) and days in milk (β=-0.01, 95 % CI -0.008 to -0.004). Ayrshires produced 2.66 L/day less milk than Friesians. Mastitis also had a significant association, with daily milk yield decreasing by 2.52 L/day, 2.58 L/day, and 3.85 L/day when two, three, and four quarters were infected, respectively. In conclusion, feeding practices, particularly supplementation with yeast and specific forages, along with cow-level factors such as breed, days in milk, BCS, and mastitis status, significantly influenced milk yield in smallholder dairy farms.

PMID:40570469 | DOI:10.1016/j.prevetmed.2025.106607

J Emerg Med. 2025 Mar 19;75:14-23. doi: 10.1016/j.jemermed.2025.03.009. Online ahead of print.

ABSTRACT

BACKGROUND: Fever avoidance after cardiac arrest is recommended but cooling devices may not be used even if targeting normothermia.

OBJECTIVES: We sought to establish the incidence of postarrest fever and association with clinical outcomes depending on whether a cooling device was used.

METHODS: We conducted a retrospective study of adult cardiac arrest survivors admitted to intensive care units (ICUs) in our health system in 2021. Our primary outcome was discharged alive. Univariate and multivariable statistics were computed, and additional outcomes included cooling device use, Tmax of ≥38°C within 48 h of admission, and Glasgow Coma Scale (GCS) ≥8 at discharge.

RESULTS: 364 patients were screened and 194 ultimately analyzed. Seventy-eight (40.2%) were female, median (IQR) age was 63 (54.0-72.8) years old, 96 (49.7%) were provided a cooling device, and 49 (25.3%) reached a temperature ≥38°C within 48 h of admission. Patients without a cooling device more often reached Tmax ≥38°C (37.1% vs. 13.5%, p < 0.001). Greater GCS on day 3 was a consistent independent predictor of being discharged alive and of GCS ≥8 at discharge while failure to use a cooling device was the strongest independent predictor of postarrest fever.

CONCLUSIONS: Cooling devices were associated with fever prevention but used in patients who ultimately did poorly. Moreso than use of a cooling device, achieving fever avoidance may be more important for prognosis.

PMID:40570447 | DOI:10.1016/j.jemermed.2025.03.009

Talanta. 2025 Jun 25;296:128451. doi: 10.1016/j.talanta.2025.128451. Online ahead of print.

ABSTRACT

According to statistical data from the World Health Organization, in 2040, there will be an estimated 28.4 million new cancer cases. Gastric cancer (GC) is one of the most significantly deadly neoplasms: one out of every thirteen deaths worldwide. This situation happens due to two main factors: the clinical manifestations of the disease and the low efficacy of current detection techniques. The biosensors have gained attention as promising tools for early diagnosis, considering their easy integration into point-of-care technology. These devices enable the development of minimally invasive, highly sensitive, cost-effective, and user-friendly tests suitable for accurately screening large population groups. This review will explore applying nanomaterial-based electrochemical biosensor technology for screening, early detection, and prognostic assessment of stomach cancer. It comprehensively explains biosensor development engineering factors such as shelf life, scalability, reproducibility, and assay time. It compares Electroanalytical Techniques and biorecognition probes for successful biosensor manufacturing, instilling confidence in the review’s findings. The role of GC biomarkers and their diagnostic value and biological functions will be covered, highlighting emerging blood biomarkers. It emphasises electrochemical detection in clinical samples and the role of nanomaterials in these outcomes. Finally, translating nanobiosensors into mHealth applications by integration with Internet of Medical Things frameworks is critically reviewed, filling a critical knowledge gap. Therefore, the proposal aims to guide researchers in this interdisciplinary field of Biosensor PoC technologies development for the critical selection of biosensor components from a manufacturing and materials engineering point of view that guarantees a suitable integration and translation to the healthcare system.

PMID:40570441 | DOI:10.1016/j.talanta.2025.128451

JACC Adv. 2025 May 30;4(6 Pt 1):101827. doi: 10.1016/j.jacadv.2025.101827. Online ahead of print.

ABSTRACT

BACKGROUND: Implantable cardioverter-defibrillators (ICDs) are recommended in various forms of heart failure, but little is known about outcomes in peripartum cardiomyopathy (PPCM).

OBJECTIVES: The authors compared long-term ICD-related outcomes in patients with PPCM vs non-PPCM nonischemic cardiomyopathy (NICM).

METHODS: Patients with PPCM and a control group of ethnicity-matched non-PPCM patients, with ICD implantation between 1996 and 2016 were identified. Device interrogation records were reviewed through 2018. Device therapy (shocks, antitachycardia pacing), device-related complications, and outcomes were analyzed.

RESULTS: Of 150 patients with PPCM, 20% (N = 30) underwent ICD implantation at median time from diagnosis of 7 months (IQR: 15 months) and left ventricular ejection fraction of 18% (IQR: 18%). Over 8 ± 6 years of ICD use (mean), 43% received appropriate device therapy (shock and/or antitachycardia pacing), similar to the NICM control group. Inappropriate device therapy occurred in 30% of patients with PPCM, most commonly due to supraventricular tachycardia. One-third of patients required at least one subsequent invasive ICD-related procedure other than generator replacement. After ICD implantation, 9 patients with PPCM (30%) had subsequent improvement of left ventricular ejection fraction to >50% and 4 of them had received appropriate ICD therapy. In comparison to the control group, there were no statistically significant differences in device therapy, despite longer ICD follow-up in the NICM control group (median 12 months vs 5 months, respectively, P < 0.05).

CONCLUSIONS: In this cohort of patients with PPCM and ICD, rates of appropriate device therapy were high. Over long-term follow-up, rates of inappropriate shocks and device complications were also substantial in both PPCM and NICM cohorts.

PMID:40570406 | DOI:10.1016/j.jacadv.2025.101827

Mult Scler Relat Disord. 2025 Jun 20;101:106594. doi: 10.1016/j.msard.2025.106594. Online ahead of print.

ABSTRACT

There is a long-held hypothesis that multiple sclerosis (MS) affects the central nervous system in a length dependent way reflecting the propensity of longer central axonal projections to accumulate damage, but evidence for this is lacking. To determine the prevalence of body part involvement in MS and relate this to the putative axonal length innervating each body part, we asked people with MS to indicate affected body parts on a somatic diagram. Axonal length for each body part was calculated from neuroanatomical literature. The survey was part of the TONiC-MS study. Records from 5925 respondents were analysed for involvement of eleven distinct body parts (either hand/ upper limb /lower limb, urinary bladder, neck, speech, vision, swallowing), and also balance. Participants had a wide range of age, disease duration, disease subtypes and disability levels. Body part involvement in the whole sample was highly correlated with axonal length (rho 0.933). At an individual level, a logistic regression including covariates of age, disease type and disability level demonstrated that the probability of body part involvement was substantially dependent on axonal length across all disease types. Our study supports the hypothesis that MS disability reflects a length-dependent central axonopathy.

PMID:40570401 | DOI:10.1016/j.msard.2025.106594

J Contam Hydrol. 2025 Jun 19;274:104656. doi: 10.1016/j.jconhyd.2025.104656. Online ahead of print.

ABSTRACT

This study examines the origins, distribution, and health impact of potentially toxic elements (PTEs) found in the surface sediments of Vembanad Wetland, a Ramsar site on India’s southwest coast. Sediment from 14 sampling locations was seasonally analysed for Fe, Mn, Cu, Ni, Co, Zn, Cr, Pb and Cd. The average concentration of PTEs (mg/kg) follows the order: Fe (35,668.07 ± 20,082.98) > Mn (307.5 ± 36.71) > Zn (155.96 ± 99.45) > Cr (119.94 ± 79) > Ni (92.66 ± 32.69) > Cu (42.29 ± 17.26) > Pb (21.67 ± 11.65) > Co (20.64 ± 14.32) > Cd (2.21 ± 0.78). Higher average contamination factor (CF), enrichment factor (EF) and geoaccumulation index were observed for Cd (CF = 4.17, EF = 7.73, Igeo = 2.18) and Zn (CF = 4.85, EF = 2.44, Igeo = 0.38), indicating substantial anthropogenic enrichment. The average values of pollution indices such as PLI (1.49), TRI (11.69), mCd (15.1), and RI (251.69) indicate moderate to significant pollution. Average modified hazard quotient (mHQ) values revealed that Ni (3.19), Cr (2.76), Cd (1.99), and Zn (1.64) posed notable ecological risks. A potential health concern from prolonged exposure was indicated by the increased average total carcinogenic risk (TCR) values for Ni (9.24E-2), Cr (6.57E-2), and Cd (3.62E-2) in children. Multivariate analyses (PCA, PCC, HCA) suggested common contamination sources, with PCA-MLR confirming industrial discharge and agricultural runoff as dominant contributors. This study uniquely integrates seasonal variability, advanced pollution indices, and health risk evaluation, highlighting the urgent need for targeted management strategies in these sensitive aquatic systems.

PMID:40570382 | DOI:10.1016/j.jconhyd.2025.104656

Obstet Gynecol. 2025 Jun 26. doi: 10.1097/AOG.0000000000005986. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effectiveness of influenza vaccination during pregnancy against influenza in infants during their first 6 months of life.

METHODS: We conducted a cohort study among pregnant individuals enrolled in Kaiser Permanente Northern California (KPNC) and their infants. We followed all infants from birth until the first occurrence of a polymerase chain reaction test result positive for influenza, the infant reached age 6 months, death, disenrollment from KPNC, or the end of the study on December 31, 2022. We used Cox regression to compare the hazard of influenza in infants whose mothers were vaccinated against influenza during pregnancy with those whose mothers were unvaccinated. Hazard ratios (HRs) were adjusted for calendar time, maternal sociodemographic and comorbidities. Vaccine effectiveness was calculated as 100% (1-adjusted HR). We evaluated the association between vaccination and infant influenza outcomes any time during pregnancy and by trimester of vaccination.

RESULTS: Of the 245,498 infants included in the study, 46.0% were born to vaccinated mothers. The incidence of influenza was lower among infants of vaccinated mothers than unvaccinated mothers (0.12% vs 0.30%). After adjusting for covariates, vaccination during pregnancy was associated with a reduction in infant influenza in any clinical setting by 44.4% (95% CI, 31.4-54.9%). Vaccination during the first trimester was associated with a reduction in infant influenza by 11.3%, a reduction of 51.5% during the second trimester, and a reduction of 59.3% during the third trimester. The differences in vaccine effectiveness estimates that compared the first and second trimesters (P=.02) and compared the first and third trimesters (P<.001 were statistically significant.

CONCLUSION: Influenza vaccination during pregnancy was associated with a reduction in infant influenza infection by 44.4%. The reduction in infant influenza infection was greater when vaccination occurred in the second or third trimester, compared with the first trimester.

PMID:40570349 | DOI:10.1097/AOG.0000000000005986

N Z Med J. 2025 Jun 27;138(1617):100-112. doi: 10.26635/6965.6909.

ABSTRACT

AIM: To characterise the appropriateness of community referrer-rated urgency among dermatology referrals.

METHOD: Using e-referral data from a month representative of volume and service provision in a tertiary dermatology service, referrer-rated urgency and triage priority assigned by two specialist dermatologists were compared to determine appropriateness. Descriptive analysis was conducted to quantify the proportion of appropriately and inappropriately assigned urgency in priority populations of women, Māori and Pacific peoples and paediatric patients.

RESULTS: One-third of general dermatology referrals, and nearly one in six referrals of suspected skin cancers, had an inappropriately assigned urgency. A quarter of general dermatology and most melanoma referrals had urgency lower than triage priority. Māori and Pacific patients were under-represented in the proportion of referrals received by ethnicity when comparing to national and provincial population estimates. However, no significant disparities in appropriateness of urgency across ethnicity were observed, and the same was seen for female and paediatric patients.

CONCLUSION: Our study adds to the limited research on the appropriateness of referrer-rated urgency. We have pointed out that artificial intelligence (AI) has significant potential to improve the prioritisation of referrals by identifying melanoma and severe skin diseases.

PMID:40570338 | DOI:10.26635/6965.6909

N Z Med J. 2025 Jun 27;138(1617):85-99. doi: 10.26635/6965.6905.

ABSTRACT

AIM: Community-acquired pneumonia (CAP) is inequitably experienced in populations globally, with multiple social and environmental factors contributing to the risk of CAP; thus, predicting communities at increased risk is difficult. The aims of this study were to determine the geographical distribution of adults with CAP requiring hospitalisation in Christchurch, and to examine the associations between CAP and socio-economic and area deprivation.

METHODS: A retrospective clinical records review was conducted of all adult patients hospitalised with CAP at Christchurch Hospital over a 12-month period. Geocoding residential addresses allowed for geospatial hotspot analysis using the Getis-Ord Gi* method. Comparison of the relative rates of CAP in different socio-economic deprivation deciles was assessed using New Zealand census data and the Index of Multiple Deprivation (IMD).

RESULTS: The dataset comprised 924 hospitalisations. CAP hotspots were located in the northeast and southwest of the city. CAP was not equally distributed across the deprivation quantiles (p <0.001); compared with the least deprived quintile, quintiles four and five had rate ratios (95% confidence interval [CI]) of 1.5 (1.3 to 1.8) and 1.6 (1.3 to 2.0), respectively. Patients with CAP who identified as Māori or Pacific peoples were significantly younger, and a higher proportion were resident in areas of highest socio-economic deprivation relative to patients who identified as NZ European.

CONCLUSION: This study identified hotspots within Christchurch with higher rates of CAP requiring hospitalisation and has contributed further New Zealand-based evidence on the influence of socio-economic disparities on health inequity.

PMID:40570337 | DOI:10.26635/6965.6905