Category: Statistics

Cureus. 2025 Mar 31;17(3):e81532. doi: 10.7759/cureus.81532. eCollection 2025 Mar.

ABSTRACT

Background Obstetrical emergencies are multifaceted and complex, and their urgency demands a combination of clinical skills. As a result, it is generally observed that minimum teaching takes place during these emergencies. This study aimed to formulate a simulation learning module centered on chosen obstetrical emergencies and evaluate its efficacy in measuring the competency of undergraduate midwifery students. Design and participants The study utilized a non-randomized time series interventional research design among 188 midwifery students (control group 90, intervention group 98). A hybrid simulation was administered to the intervention group. The research employed several tools: a proforma for background variables, a structured questionnaire, and the Objective Structured Clinical Examination (OSCE) of selected obstetrical emergencies. Results In the present study, 98% of participants in the control group demonstrated inadequate competency in the pretest, post-test I, and post-test II. In contrast, all participants (100%) in the intervention group had adequate competency followed by moderately adequate competency in the post-test I and post-test II. The study reported that there was a significant difference between the assessments (pretest, post-test-I, post-test-II) in the knowledge and skills of the interventional group with the effect size (eta squared=0.70, 0.99), respectively. The results showed a statistically significant difference (P<0.001) in overall competency scores between the control and intervention groups at pretest, with a moderate effect size (Cohen’s d=0.68). The intervention group demonstrated substantial improvements at post-test I (Cohen’s d=23.61) and post-test II (Cohen’s d=15.83). Conclusion Hybrid simulation is an appropriate method for equipping healthcare providers to gain and maintain competence in managing obstetric emergencies. Therefore, simulation must be incorporated into the curriculum to allow students to immerse themselves in their clinical learning, which enhances their communication, confidence, and satisfaction.

PMID:40314050 | PMC:PMC12043380 | DOI:10.7759/cureus.81532

Cureus. 2025 Mar 31;17(3):e81533. doi: 10.7759/cureus.81533. eCollection 2025 Mar.

ABSTRACT

Introduction Cementless Oxford unicompartmental knee arthroplasty (OUKA) has been shown to have less frequent radiolucent lines and equivalent or even better results than those of cemented OUKA. However, tibial fractures are more frequent in cementless OUKA than in cemented OUKA, especially in Asian countries. A hybrid option, with a cementless femur and cemented tibia, may, therefore, be a good compromise. This study compares the clinical results of hybrid OUKA with those of fully cemented OUKA. Materials and methods This retrospective study included 108 consecutive unicompartmental knee arthroplasties implanted between September 2016 and September 2018 in our hospital. Cases were divided into two groups: those using cemented fixation and those using hybrid fixation OUKAs. Pre- and postoperative knee range of motion (ROM), operation time, pre-and postoperative Oxford knee score (OKS), and complications were compared between the groups two years after OUKA was performed. Results There was no significant difference in pre- and postoperative ROM, operation time, and OKS performed unilateral OUKA, but mean OKS was higher in the hybrid group than in the cemented group performed bilateral OUKA (p<0.01). Both groups included one revision to total knee arthroplasty each. There was no statistically significant difference in the rate of revision (p=0.723). Conclusions Better clinical outcomes were achieved in the hybrid fixation group than in the cemented fixation group, with an equivalent rate of complication. Longer follow-up periods are needed to confirm the benefits of hybrid fixation in OUKA over time.

PMID:40314040 | PMC:PMC12043381 | DOI:10.7759/cureus.81533

JGH Open. 2025 Apr 29;9(5):e70171. doi: 10.1002/jgh3.70171. eCollection 2025 May.

ABSTRACT

AIMS: This study aimed to determine the seroprevalence of hepatitis B virus (HBV) among newly diagnosed cancer patients in Khartoum State, Sudan, prior to chemotherapy initiation and to identify associated risk factors.

METHODS AND RESULTS: A cross-sectional study was conducted from October 2022 to April 2023 at various oncology centers in Khartoum State. A total of 300 newly diagnosed cancer patients, aged 18 years and older, were included. Blood samples were screened for Hepatitis B surface antigen (HBsAg) using a rapid immunochromatographic test (ICT) and confirmed by enzyme-linked immunosorbent assay (ELISA). The study found that 31 patients (10.3%) were HBsAg positive. A significant association was observed between HBV positivity and patients’ history of blood transfusions (41.9% of positive cases), as well as geographic origin, with higher rates among those from Western Sudan (44.7%) and Central Sudan (40.6%). Patients diagnosed with hematological malignancies exhibited the highest HBV prevalence. Statistical analysis revealed significant correlations between HBV positivity and factors such as age, gender, residence, and transfusion history, indicating these as key risk factors.

CONCLUSION: The study reveals a notable HBV seroprevalence among cancer patients in Khartoum, particularly linked to blood transfusion history and specific regions. These findings emphasize the need for routine HBV screening in oncology patients before chemotherapy to prevent reactivation and improve clinical outcomes.

PMID:40314027 | PMC:PMC12041132 | DOI:10.1002/jgh3.70171

JGH Open. 2025 Apr 30;9(5):e70153. doi: 10.1002/jgh3.70153. eCollection 2025 May.

ABSTRACT

BACKGROUND AND AIM: Crohn’s Colitis Care, a structured, disease-specific electronic medical record, is proven to promote more complete data capture in adult Inflammatory Bowel Disease care. This study aimed to determine whether similar effectiveness was seen in pediatrics.

METHODS: Matched patient records from a hospital’s standard electronic medical record (pre-Crohn’s Colitis Care) and those in Crohn’s Colitis Care were retrospectively reviewed (12 months each). The presence of disease-specific data items per platform were compared (21 core, 5 age-specific). Data are presented as percentage recorded (recorded items/total eligible for age). Descriptive and statistical analytics were used.

RESULTS: Paired records were reviewed for 114 children, of whom 78 (68%) had Crohn’s disease and 69 (61%) were male. Median age at diagnosis was 13.5 years (IQR12.0-15.5), with mean disease duration 3.6 years (±2.4). Crohn’s Colitis Care was more likely to capture 9 items: general wellbeing, stool urgency and frequency, disease duration, comorbidities, pubertal stage, sexual activity, alcohol and drug usage (each p < 0.05). The standard platform was more likely to capture 4 items: liquid stools, phenotype, disease indices, and vaccinations (each p < 0.05). Crohn’s Colitis Care achieved more eligible data items recorded per patient (75.3% ±11.5 vs. 67.7% ± 8.9; p < 0.001). Item completion rate in both platforms inversely correlated with patient age (p < 0.05).

CONCLUSIONS: Consistent with findings in adult care, Crohn’s Colitis Care achieved more complete disease-data capture in pediatrics compared to a standard platform. Given that not all items were better recorded in the structured platform, work to understand and address barriers is needed to optimize complete data capture for care and research.

PMID:40314025 | PMC:PMC12041941 | DOI:10.1002/jgh3.70153

ACS Appl Energy Mater. 2025 Apr 7;8(8):5455-5467. doi: 10.1021/acsaem.5c00483. eCollection 2025 Apr 28.

ABSTRACT

Layered double hydroxides (LDH) have exhibited promising applications as electrocatalysts in oxygen evolution reactions (OER). In this work, trimetallic LDHs (CoNiFe-LDH) were designed and grown on graphene (G) through a one-step hydrothermal approach to obtain a structure that promotes efficient charge transfer. A 2-level full-factorial design was utilized to evaluate the effects of varying the concentrations of Co (1.5, 3, and 4.5 mmol) and graphene (10, 30, and 50 mg) on the OER activity. The potential needed to deliver 10 mA cm^-2 was chosen as the response parameter. The independent and dependent parameters were fitted to a linear model equation through ANOVA analysis. The computed p-values were below 0.05 signifying the statistical significance of the concentrations of cobalt and graphene and their interaction, suggesting a correlation with the OER activity. The OER experiments were conducted in triplicate using the Co_[3]Ni_[3]Fe_[3]-LDH/G_[30] (central point) to estimate variability (0.58%). Comparative analysis showed that Co_[1.5]Ni_[3]Fe_[3]-LDH/G_[10] achieved the lowest onset potential (1.54 V), potential at 10 mA cm^-2 (1.58 V), and Tafel slope (58.4 mV dec^-1), indicating that a low concentration of cobalt and graphene make an efficient electrocatalyst for OER. Furthermore, the optimized composite demonstrated favorable electronic properties, with a charge transfer resistance (R_CT) of 188.1 Ω, and exhibited good stability, maintaining its catalytic activity with no significant loss over a 24-h period.

PMID:40314022 | PMC:PMC12042162 | DOI:10.1021/acsaem.5c00483

Curr Urol. 2025 Mar;19(2):110-116. doi: 10.1097/CU9.0000000000000266. Epub 2025 Jan 21.

ABSTRACT

OBJECTIVES: The aim of this study was to observe the clinical effectiveness of simultaneous electroacupuncture stimulation on the tibial nerve (TN) and ilioinguinal-iliohypogastric nerve (IIN/IHN) in the treatment of refractory overactive bladder (OAB) in women.

MATERIALS AND METHODS: A prospective study was conducted involving 94 female patients with a diagnosis of OAB in the Urology Department of our hospital from September 2022 to October 2023. The patients were randomly divided into a TN-IIN/IHN group and a control group, each comprising 47 cases. All patients in both groups had received anticholinergic muscarinic receptor antagonists (tolterodine/solifenacin), β3 receptor agonists, flupentixol/melitracen, and other basic treatment regimens with poor results. The TN-IIN/IHN group received simultaneous electroacupuncture on the TN and IIN/IHN, whereas the control group received pelvic floor muscle biofeedback electrical stimulation. Both groups underwent treatment 3 times a week for a total of 4 weeks. Bladder symptoms (24-hour voiding diary), OAB Symptom Score, OAB-Quality of Life Questionnaire, and anxiety and depression scores were compared and analyzed before treatment, after treatment, and at a 3-month follow-up. Clinical efficacy was also assessed.

RESULTS: Both groups showed significant improvement in voiding frequency, nocturia, urgency, OAB Symptom Score, and average voiding volume after treatment and at follow-up (p < 0.01). The TN-IIN/IHN group showed significantly superior results compared with the control group (p < 0.01). Quality of life scores and anxiety and depression scores significantly decreased (p < 0.01), with the TN-IIN/IHN group scores significantly lower than those of the control group (p < 0.01). The treatment success rate in the TN-IIN/IHN group was 84.78%, whereas that in the control group was 28.89%, showing a statistically significant difference (p < 0.01). No significant adverse reactions occurred in either group during the treatment period.

CONCLUSIONS: Simultaneous electroacupuncture on the TN and IIN/IHN is effective in treating refractory OAB in women and has good long-term efficacy. This therapy is safe, convenient, and free of significant adverse reactions, providing a new approach for the clinical treatment of refractory OAB in these patients. It significantly improves bladder symptoms and alleviates anxiety and depression, thereby markedly enhancing the patients’ quality of life.

PMID:40314016 | PMC:PMC12042199 | DOI:10.1097/CU9.0000000000000266

Curr Urol. 2025 Mar;19(2):125-132. doi: 10.1097/CU9.0000000000000268. Epub 2025 Jan 27.

ABSTRACT

OBJECTIVES: The aim of this study was to evaluate the effects of the combination of bacteriophage therapy with antibiotics and bacteriophage treatment alone on relieving clinical symptoms of chronic recurrent cystitis caused by multidrug-resistant bacteria.

MATERIALS AND METHODS: This clinical trial compared the treatment methods of 217 female patients with chronic recurrent cystitis caused by multidrug-resistant bacteria, who were investigated from June 2020 to May 2023. Patients were allocated into 4 groups: group I: received bacteriophage (Sextaphage) therapy alone; group II: received a combination of bacteriophages (Sextaphage) and furazidin; group III: received a combination of bacteriophage (Sextaphage) and furazidin with cefixime; and group IV: received furazidin and cefixime (without bacteriophage). The primary outcome included changes in the acute cystitis symptom scale and the pain visual analog scale, which were completed on days 7 and 14 following treatment. Secondary outcome measures included bladder diary records of urinary symptoms, median voided volumes, level of bacteriuria, and degree of leukocyturia.

RESULTS: Initially, 217 female patients were presented during baseline visits. Those who did not meet the criteria inclusions were excluded, and 178 female patients were included in the final analysis. Statistically significant improvements from baseline in acute cystitis symptom scale scores for differential, typical symptoms, and quality of life domains were observed after 14 days of treatment in groups II, III, and IV. The pain level measured on the 14th day with the visual analog scale significantly decreased in groups II, III, and IV compared with group I. The patients of group I had a reduction of mean level bacteriuria of Escherichia coli from 10⁶ to 10² CFU/mL at 14 days of therapy. Significant improvement of voided volume from baseline was observed in groups II, III, and IV. Episodes of urinary frequency, both daytime and night-time, reduced significantly from baseline in all 4 groups only at 14 days of treatment.

CONCLUSIONS: Bacteriophage cocktail alone or with antibiotics may improve clinical symptoms in women with chronic recurrent cystitis caused by multidrug-resistant bacterial pathogens. In addition to improving clinical symptoms, the therapy with a phage cocktail may restore antibiotic sensitivity and increase the efficacy of antimicrobial agents.

PMID:40314011 | PMC:PMC12042198 | DOI:10.1097/CU9.0000000000000268

J Immunol Res. 2025 Apr 24;2025:5539590. doi: 10.1155/jimr/5539590. eCollection 2025.

ABSTRACT

Objective: This study aimed to analyze the relevant risk factors for nosocomial infection (NI) in patients who were admitted to an emergency department, explore the correlation between each influencing factor and the risk of NI, and evaluate the application value of immunological indicators on the patient prognosis, all of which can provide reference for clinical guidance. Methods: We prospectively enrolled 128 patients meeting the inclusion criteria who visited the emergency department of Dongzhimen Hospital, Beijing University of Chinese Medicine, from January 1 to December 31, 2019. Basic information and serum samples were collected from the patients, and flow cytometry was used. T lymphocyte subgroups, CD3⁺CD4⁺and CD3⁺CD8⁺, and natural killer (NK) cells were measured. Patients were divided into infection group and control group according to whether nosocomial infection occurred within 48 h of admission. Age, gender, type of disease, APACHE II score, Charlton score, T lymphocyte subtypes, and NK cell values were compared, and a logistic multivariate regression analysis was conducted. A multifactor regression analysis was performed on various risk factors. The nomogram website was used to draw a nomogram model of meaningful indicators, and the receiver-operating characteristic (ROC) curve was based on experimental results. Results: Logistics multivariate regression analysis showed the Charlton score and NK cell count were independent risk factors for nosocomial infection. Cell counts for subsets CD3⁺CD4⁺ and CD3⁺CD8⁺ were protective factors, and the OR value and 95% CI were 5.199 (1.933-13.983), 1.248 (1.055-1.475), 0.851 (0.790-0.916), and 0.832 (0.711-0.973), p < 0.05. respectively. Statistical significance was set at p < 0.05.The nomogram model suggested that the area under the curve for predicting the risk of nosocomial infection was 0.920 (0.872-0.967), p < 0.001. Conclusion: Patients with low CD3⁺CD4⁺ and CD3⁺CD8⁺ T lymphocyte or high NK cell count as well as high Charlton score are more likely to have nosocomial infection. Then, we speculate that the risk of nosocomial infection within 48 h is also high for patients with underlying diseases and immune function that is affected and suppressed on admission, regardless of whether infection occurs during hospitalization.

PMID:40313971 | PMC:PMC12045693 | DOI:10.1155/jimr/5539590

Front Immunol. 2025 Apr 17;16:1576849. doi: 10.3389/fimmu.2025.1576849. eCollection 2025.

ABSTRACT

BACKGROUND: C-X-C motif chemokine ligand 9 (CXCL9) is induced by the interferon-γ response, and its receptor, C-X-C motif chemokine receptor 3, is a well-established marker of T-helper 1 (Th1) cells, which play an essential role in type 1 immune responses. CXCL9 expression is upregulated in patients with interstitial lung disease (ILD), COVID-19, and asthma. Although type 1 inflammation and CD8⁺ T cell activation are considered central to the inflammatory pathophysiology of chronic obstructive pulmonary disease (COPD), the relationship between blood levels of Th1 chemokines and this pathophysiology remains unclear. This study aimed to investigate the relationship between CXCL9 and chronic respiratory diseases.

METHODS: We conducted a retrospective cohort study. The serum levels of CXCL9, surfactant protein A (SP-A), Krebs von den Lungen-6 (KL-6), and C-reactive protein (CRP) were analyzed in 165 patients with ILD and COPD. COPD was diagnosed using pulmonary function tests according to the Global Initiative for Chronic Obstructive Lung Disease criteria. Statistical analyses included Fisher’s exact test, Steel-Dwass test, Mann-Whitney U, and Wilcoxon test. An unsupervised hierarchical cluster analysis using complete linkage and Euclidean distance was performed for data clustering.

RESULTS: CXCL9 levels were significantly higher in patients with COPD and interstitial ILD than in healthy smokers and non-smokers. The median serum CXCL9 levels in patients with ILD, COPD, healthy smokers, and healthy nonsmokers were 61.6, 69.3, 37.0, and 32.5pg/mL, respectively. CXCL9 levels in patients with COPD significantly correlated with KL-6, SP-A, blood eosinophil ratio, lactate dehydrogenase (LDH), and CRP levels, with correlation coefficients of 0.243, 0.381, 0.225, 0.369, and 0.293, respectively. Additionally, CXCL9 levels were negatively correlated with FEV₁%. Levels of LDH and KL-6 and the neutrophil ratio were significantly elevated in non-eosinophilic COPD patients with high CXCL9 levels.

CONCLUSIONS: Our results highlight the potential role of CXCL9 in the inflammatory pathophysiology of COPD.

PMID:40313944 | PMC:PMC12043484 | DOI:10.3389/fimmu.2025.1576849

Front Immunol. 2025 Apr 17;16:1542780. doi: 10.3389/fimmu.2025.1542780. eCollection 2025.

ABSTRACT

BACKGROUND: Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy with a poor prognosis, and its clinical management remains a significant challenge due to the high recurrence rates and limited treatment options. Despite advances in understanding the molecular mechanisms underlying ACC, no reliable biomarkers have been validated for routine clinical use.

METHODS: We analyzed RNA sequencing data from The Cancer Genome Atlas (TCGA) database (n=79) and Genotype Tissue Expression (GTEx) database (n=128) to investigate the expression of VGF in ACC and normal adrenal tissues. Gene expression levels of VGF were quantified and correlated with clinicopathological features and survival outcomes. Statistical methods included Cox proportional hazards models and Kaplan-Meier analysis, while Gene Set Enrichment Analysis (GSEA) was utilized to identify relevant biological pathways associated with VGF expression. Clinical data from 7 ACC patients from YANTAI YUHUANGDING Hospital were also analyzed. The expression of VGF in ACC and normal adrenal gland tissue was further validated through IHC experiments.

RESULTS: Our results demonstrate that VGF expression is elevated in ACC tissues compared to normal adrenal tissues and is significantly associated with advanced disease stages, lymph node involvement, metastasis and poor overall survival. VGF levels also correlate with immune cell infiltration, including Th2 cells, T helper cells, and Neutrophils. Importantly, our study establishes VGF as a potential prognostic biomarker for ACC and highlights its role in tumor progression and immune modulation. Additionally, GSEA analysis suggests that VGF is involved in cytokine receptor interaction and the P13K-Akt signaling pathway, possibly relating to tumor immunity.

CONCLUSIONS: VGF could serve as a valuable marker for patient stratification, monitoring disease progression, and predicting responses to immunotherapies. Future studies should focus on investigating circulating VGF levels as a non-invasive biomarker for ACC to improve clinical management and treatment outcomes.

PMID:40313932 | PMC:PMC12043488 | DOI:10.3389/fimmu.2025.1542780