Category: Statistics

BMC Nurs. 2025 Jul 7;24(1):863. doi: 10.1186/s12912-025-03533-8.

ABSTRACT

BACKGROUND: Nurses are the core workforce responsible for coordinating and delivering patient care, playing a critical role in ensuring patient safety and enhancing healthcare quality. However, when confronted with multiple patient demands, scarce medical resources, and heavy workloads, nurses’ subjective perceptions of workload may trigger specific psychological response mechanisms, which in turn negatively affect their work status and nursing behavior.

AIM: This study aimed to explore the impact of nurses’ perceived workload on missed nursing care and presenteeism, and to examine the mediating roles of occupational stress and emotional intelligence in these relationships.

METHODS: A cross-sectional study design was employed. Between May and October 2024, 730 questionnaires were distributed, with 706 valid responses collected, resulting in an effective response rate of 96.7%. Descriptive statistics and Pearson correlation analyses were conducted using SPSS 27.0. Structural equation modeling was performed using AMOS 25.0, and mediation effects were tested via the bootstrap method.

RESULTS: The results showed that nurses’ perceived workload was not directly associated with missed nursing care(β = 0.04, P>0.05) or presenteeismββ = 0.13, P>0.05). However, occupational stress played a significant mediating role in the relationship between perceived workload and missed nursing care (PW → OS, β = 0.96, P < 0.001; OS → MNC, β = 0.59, P < 0.001), as well as in the relationship between perceived workload and presenteeism (PW → OS, β = 0.96, P < 0.001; OS → PRE, β = 0.55, P < 0.001). Similarly, emotional intelligence served as a significant mediator in the relationship between perceived workload and missed nursing care (PW → EI, β = -0.56, P < 0.001; EI → MNC, β = -0.25, P < 0.001), and also in the relationship between perceived workload and presenteeism (PW → EI, β = -0.56, P < 0.001; EI → PRE, β = -0.13, P < 0.001).

CONCLUSIONS: Nurses’ perceived workload does not directly lead to missed nursing care or presenteeism; rather, it mainly influences their work status and nursing behavior indirectly through either occupational stress or emotional intelligence.

IMPLICATIONS FOR NURSING MANAGEMENT: When optimizing the work environment and human resource allocation, nursing managers should not only focus on the distribution of objective workload but also pay close attention to nurses’ perceived workload and the development of their psychological coping mechanisms.

PMID:40624705 | DOI:10.1186/s12912-025-03533-8

BMC Nutr. 2025 Jul 7;11(1):136. doi: 10.1186/s40795-025-01108-z.

ABSTRACT

INTRODUCTION: With the substantial growth rate of the Black immigrant population in the US, the impact of colonization on the diets of Black Americans and disproportionately high rates of chronic diseases among individuals with African descent, studies should place more emphasis on ethnicity when investigating nutrition-related risk factors. This study examined the relationship between variations in citizenship level and diet quality among adult subjects with African descent.

METHODS: We analyzed data from 1,198 adults with African descent in NHANES 2015-2016. A ‘citizenship level’ scale was developed using principal component analysis, incorporating years lived in the US, country of birth, and citizenship status. Diet quality was assessed using HEI scores. Associations between citizenship level, sex, age, income, and diet quality (poor, moderate, or good) were examined using a Monte Carlo simulation of Fisher’s exact tests. Linear regression models were employed to examine the relationship between citizenship level and continuous HEI scores, adjusting for sex, age, and income, with stratified analyses conducted for each demographic subgroup.

RESULTS: Fisher’s exact tests revealed that the level of US citizenship, sex, age, and income level were all significantly associated with the categorical level of diet quality (HEI). Linear regression analysis demonstrated that a lower level of US citizenship was significantly associated with higher HEI scores, indicative of better diet quality (p < 0.001), even after adjusting for sex, age, and income. This relationship persisted across most demographic subgroups but appeared stronger among males and those in the lowest income bracket. The relationship was also significant for younger adults but not for adults aged 65 and older.

CONCLUSIONS: Studies suggest a need for more inclusive and culturally tailored nutrition interventions. To minimize the negative impact of colonization and US assimilation on diet quality, future studies should consider stratifying groups based on the heterogeneity of this population and interventions that utilize traditional dietary patterns of the African diaspora as tools to improve the quality of life among people of African descent.

PMID:40624702 | DOI:10.1186/s40795-025-01108-z

Clin Epigenetics. 2025 Jul 7;17(1):118. doi: 10.1186/s13148-025-01893-1.

ABSTRACT

BACKGROUND: Alcohol consumption can have harmful effects on health, depending on the quantity and frequency. Understanding the underlying molecular mechanisms is essential to grasp its health consequences. The study aimed to assess the association between alcohol consumption and blood DNA methylation, an epigenetic mechanism that controls gene expression.

METHODS: The epigenome-wide association study (EWAS) included 1,538 women from a case-cohort study within the French E3N cohort. Weighted linear mixed-effects models were used to assess the associations between self-reported alcohol consumption (in g/day in 1993) and DNA methylation at 715,986 CpGs measured with the HumanMethylationEPIC Beadchip. Women were cancer-free at blood collection in 1995-1999.

RESULTS: Of the 715,986 sites analyzed, 19,255 were associated with alcohol consumption (FDR < 0.05). Over-representation analysis highlighted enrichment of genes involved in cancer, the nervous system and aging. Of these 19,255 sites, 1,528 were replicated in an independent case-control study, with 85 also identified in other EWAS. Notably, at least six studies reported sites in SLC7A11, ANP32B, MCM2, HNRNPA1, SNORD30, and TRA2B genes.

CONCLUSIONS: Several potential methylation markers for alcohol consumption, documented prior to blood sampling, have been identified. The link between these sites and chronic diseases should be investigated to understand the molecular mechanisms underlying the harmful effects of alcohol consumption on health.

PMID:40624694 | DOI:10.1186/s13148-025-01893-1

Lipids Health Dis. 2025 Jul 7;24(1):231. doi: 10.1186/s12944-025-02603-9.

ABSTRACT

BACKGROUND: Evidence has noted associations of osteoarthritis (OA) with obesity and C-reactive protein (CRP). However, little is clarified about the link between cardiometabolic index (CMI) and OA and the mediating role of CRP.

METHODS: Participants from NHANES 2001-2010 were enrolled. CMI was computed based on anthropometric and biochemical indexes, covering height, waist circumference, triglyceride, and high-density lipoprotein cholesterol. OA diagnosis data were derived from the Medical Conditions questionnaires. Multivariate logistic regressions, restricted cubic spline (RCS) analysis, subgroup analyses, and interaction tests were implemented to investigate the association. A mediation analysis was employed to verify the mediating role of CRP.

RESULTS: After controlling for all covariates, CMI was significantly linked with OA (OR: 1.07, 95% CI (1.01, 1.13), P = 0.038). RCS analyses elicited a non-linear link between CMI and OA (P – non – linear = 0.0012). The inflection point was 0.54. Threshold effect analysis was conducted through two-segment linear regression, including the left side ( < = 0.54) (OR: 2.06, 95% CI: 1.03, 6.58) and the right side of the inflection point (> 0.54) (OR: 0.40, 95% CI: 0.15, 1.03). CRP partially mediated the link between CMI and OA, around 7.59% of the total effect.

CONCLUSION: CMI is positively linked with OA, with CRP mediating the link. This paper unveils novel perspectives on the mechanism that links CMI to OA. Managing CMI and monitoring CRP levels may alleviate OA.

PMID:40624686 | DOI:10.1186/s12944-025-02603-9

BMC Urol. 2025 Jul 7;25(1):161. doi: 10.1186/s12894-025-01852-1.

ABSTRACT

PURPOSE: The purpose of this study was to compare the efficacy and safety of holmium laser resection versus conventional surgical excision for the treatment of urethral caruncle. The study aimed to evaluate the potential advantages of holmium laser, such as its precision and minimal invasiveness, over traditional surgical methods.

METHODS: A retrospective cohort study included 116 patients (50 laser vs. 66 conventional) from June 2020 to August 2023. Outcomes included operative time, complications, and recurrence.

RESULTS: The laser cohort demonstrated statistically significant reductions in operation duration (6.4 ± 1.2 vs. 28 ± 4.3 min, p < 0.001), catheterization time (2.1 ± 0.8 vs. 6.3 ± 1.5 days, p < 0.001), and length of hospitalization (3.2 ± 0.8 vs. 4.3 ± 1.1 days, p < 0.001) compared to the conventional surgical group. The holmium laser group had lower postoperative bleeding rates (0% vs. 6.0%, p = 0.08). One recurrence occurred in the conventional surgical group. No patient in either group developed urethral stricture during the follow-up period.

CONCLUSION: Holmium laser resection is a safe and efficient alternative for urethral caruncle, associated with reduced operative time and morbidity.

PMID:40624683 | DOI:10.1186/s12894-025-01852-1

BMC Nurs. 2025 Jul 7;24(1):871. doi: 10.1186/s12912-025-03429-7.

ABSTRACT

BACKGROUND: The aim of this study was to determine the impact on the quality of life of patients on maintenance hemodialysis following nursing interventions grounded in the health ecology model.

METHODS: A simple sampling method was used to select 188 maintenance hemodialysis patients who attended our dialysis center between January and February 2024. The patients were divided into an intervention group and a control group using a random number table method. The control group received conventional nursing measures, while the intervention group received nursing interventions based on the health ecology model. The patients were assessed at the time of enrollment and after six months of follow-up, using the Health Promotion Lifestyle Scale, Social Support Rating Scale, Electronic Health Literacy Scale, and SF-36 Quality of Life Scale. The compliance rates for blood calcium, phosphorus, and potassium concentrations were recorded.

RESULTS: At six months post-intervention, patients in the intervention group had significantly higher scores than those in the control group for health-promoting lifestyles, social support ratings, e-health literacy scores, and quality of life ability scores (p < 0.05). The intervention group also had superior compliance rates for standardized blood calcium, phosphorus, and potassium concentrations compared to those measured in the control group. This difference was statistically significant (p < 0.05).

CONCLUSION: Nursing interventions based on the health ecology model effectively enhance the quality of life and promote health in maintenance hemodialysis patients.

TRIAL REGISTRATION: The research was conducted as a prospective, randomized, controlled trial and was retrospectively registered with the China Clinical Trial Registry under the identifier ChiCTR2400088458, with the registration date of August 20, 2024.

PMID:40624662 | DOI:10.1186/s12912-025-03429-7

Adv Rheumatol. 2025 Jul 7;65(1):31. doi: 10.1186/s42358-025-00464-5.

ABSTRACT

OBJECTIVE: To determine the prevalence of metabolic syndrome (MetS) in patients with childhood onset Systemic Lupus Erithematosus (cSLE) and controls from Northeastern Brazil and to verify its association with specific SLE parameters and cardiovascular risk factors.

METHODS: The prevalence of MetS was assessed cross-sectionally in 58 patients with cSLE and 33 age -matched controls. Information was collected by clinical examination and standardized questionnaires, investigating personal and family history of cardiovascular disease and obesity and socioeconomic and demographic characteristics.

RESULTS: The prevalence of MetS was higher in cSLE patients than in controls according to both ABRAN criteria (8.6% vs. 0%; p = 0.083) and IDF criteria (10,3% vs. 3.0%; p = 0.208), but without statistical significance. Importantly, 91.4% of patients were from a low-income household. Patients with MetS according to ABRAN also had lower ESR levels (p = 0.039), higher total cholesterol (p = 0.013), HDL-c (p = 0.007) and triglycerides (p = 0.001) and a lower albumin level (p = 0.016). Patients with MetS according to IDF had higher SDI scores (p = 0.039) and higher C3 and C4 levels (p < 0.001 and p < 0.001, respectively). The multivariate logistic regression identified higher levels C4 (OR = 32.6; 95% CI = 1.0-544.0; p = 0.015) and increase in the number of leukocytes (OR = 1.9, 95%CI = 1.1-3.2; p = 0.022) as independent risk factors for MetS in patients with cSLE.

CONCLUSION: The prevalence of Mets in the patients with cSLE seems to be low in this population. There was association of MetS with higher cumulative damage indices and levels of complement. We did not observe any association with clinical manifestations, autoantibody profile and dose of corticosteroids.

PMID:40624660 | DOI:10.1186/s42358-025-00464-5

BMC Med Educ. 2025 Jul 7;25(1):1020. doi: 10.1186/s12909-025-07622-9.

ABSTRACT

BACKGROUND: Manual dexterity is a critical component of dental education, especially during the early stages of preclinical training. Recent advancements in simulation technology, such as virtual reality (VR) haptic simulators and layered tooth models such as Caviprep (hereafter referred to as the layered model), offer promising tools to enhance psychomotor skills. This study aimed to explore their combined and individual effects on manual skills development in novice dental students. We hypothesized that combined training with VR and layered models would result in greater improvements in manual skills than either modality alone or conventional methods.

METHODS: Forty-eight second-semester dental students were randomly assigned to four groups: Group 1 (the layered model + VR), Group 2 (the layered model only), Group 3 (VR only), and Group 4 (Control; extracted teeth only). All students received identical theoretical instruction and standardized demonstrations for occlusal amalgam cavity preparation. Manual dexterity was assessed using a standardized evaluation form completed by three blinded evaluators. Statistical analyses were conducted using SPSS 23.0, with significance set at p < 0.05.

RESULTS: A significant difference was observed among groups in terms of cavity depth accuracy (p = 0.001), with the control group (Group 4) performing significantly worse. There were no statistically significant differences in other evaluated parameters including cavity outline, floor smoothness, internal line angles, marginal ridge integrity, retention form, or cavity width (p > 0.05).

CONCLUSIONS: The integration of VR simulators and layered models enhances depth control during cavity preparation exercises in early dental training. These tools may provide valuable benefits in developing the manual skills essential for clinical competence.

TRIAL REGISTRATION: Not applicable.

PMID:40624647 | DOI:10.1186/s12909-025-07622-9

BMC Nurs. 2025 Jul 7;24(1):874. doi: 10.1186/s12912-025-03488-w.

ABSTRACT

BACKGROUND: Education has continuously evolved to keep pace with advancements in information technology. Virtual reality (VR) has emerged as an innovative and effective learning approach that enhances student engagement, particularly in developing problem-solving and critical thinking skills. Since its introduction in the early 1980s, VR has gained increasing attention in nursing education due to its potential to improve learning outcomes and skill acquisition. However, there is a need for further research to explore its impact on critical thinking disposition among nursing students.

METHODS: This quasi-experimental pretest-posttest study was conducted with a convenience sample of 190 nursing students from Damietta University’s Faculty of Nursing. Participants were assessed on their critical thinking disposition and VR-related knowledge at three time points: before the intervention, immediately after, and two months post-intervention.

AIM: The VR-based educational program aimed to improve students’ critical thinking disposition and assess their knowledge of virtual reality before, during, and after the program.

RESULTS: A statistically significant improvement in students’ mean scores for critical thinking disposition was observed across all evaluations (p < 0.001). The effect size (η²p ≥ 0.14) indicated a substantial impact, reinforcing the effectiveness of the VR-based educational program in fostering higher-order cognitive skills. Additionally, students demonstrated increased retention of VR-related knowledge when assessed immediately after the program and again after two months.

CONCLUSIONS: This study highlights the transformative potential of VR as an educational tool in nursing. VR-based learning promotes active engagement, knowledge retention, and skill development in a safe and controlled environment. By integrating VR programs into nursing education, institutions can enhance students’ critical thinking, collaboration, and communication skills, ultimately preparing them for real-world clinical practice. Given these findings, educational institutions should consider incorporating VR technology to support the continuous development of essential nursing competencies.

TRIAL REGISTRATION: This study is formally registered on ClinicalTrials.gov (Identifier Code: NCT06622811; Registration Date: 01/10/2024).

PMID:40624646 | DOI:10.1186/s12912-025-03488-w

BMC Nurs. 2025 Jul 7;24(1):860. doi: 10.1186/s12912-025-03506-x.

ABSTRACT

BACKGROUND: Peritoneal dialysis (PD) is a widely used form of home dialysis. However, the efficacy of telehealth care in long-term management for PD patients remains unclear.

OBJECTIVE: The objective of this study is to assess the effectiveness of a smart management system in improving adherence, quality of life, and clinical outcomes in PD patients.

METHODS: The study was a retrospective cohort analysis on PD patients who underwent new catheter placement between January 2022 and June 2023. The smart PD management system, an artificial intelligence (AI)-driven, nurse-led, patient-centered management system, was used to remotely monitor patients’ health at home and assist healthcare team in patient management, serving as a complement to conventional clinic visits. Patient data, including dialysis diary, symptoms, laboratory test results, and medication records, were collected through a smartphone app and uploaded to a cloud server. An AI system conducted real-time data analysis and promptly notified the healthcare team upon detecting any abnormalities. Online health coaches and nurses provided personalized guidance and interventions to patients, addressing issues in real-time. The primary endpoints of the study were changes and achievement rates in blood pressure and laboratory test results associated with complications. Secondary endpoints included changes in adherence and quality of life at recruitment and end of follow-up.

RESULTS: A total of 127 patients participated in the smart management system from January 2022 to June 2023 were included in the analysis. Most of them (94.5%) were receiving continuous ambulatory PD (CAPD). Over an average follow-up period of 11.0 (IQR 5.0-16.0) months, the average systolic blood pressure of the patients decreased from a baseline of 132.1 (SD 13.2) mmHg to 122.6 (SD 14.1) mmHg (P < 0.001). The overall blood pressure achievement rate (< 140/90 mmHg) increased from 61.4% at baseline to 79.5% (P = 0.001) at the end of the follow-up period. Regarding anemia, the average hemoglobin and the achievement rate increased from 98.8 (SD 19.8) g/L at baseline to 114.4 (SD 18.4) g/L (P < 0.001), and from 50.0 to 78.4% (P < 0.001), respectively. Improvements of varying degrees were observed in mineral and bone disorder, electrolyte balance, and nutritional status, even though they did not reach statistical significance. The patients’ adherence to uploading dialysis diaries significantly increased from 78 to 95.7% (P < 0.001) during the last week of follow-up period compared to the first week after enrollment. Furthermore, there were observed improvements in the quality of life, including diet, sleep, and daily activities.

CONCLUSIONS: The utilization of the smart PD management system was associated with enhanced patient adherence, improved quality of life, and superior clinical outcomes in PD patients.

PMID:40624644 | DOI:10.1186/s12912-025-03506-x