Category: Statistics

Sci Rep. 2025 May 19;15(1):17266. doi: 10.1038/s41598-025-02137-1.

ABSTRACT

The primary treatment for breast cancer patients is surgery which often impacts physical activity (PA). This study aimed to investigate factors associated with the PA level of Thai women with breast cancer after surgical mastectomy at Siriraj Hospital, Thailand. Ninety-three participants completed the questionnaires which included personal information, the Global Physical Activity Questionnaire, perceived benefits, perceived barriers, perceived self-efficacy, interpersonal influence and situational influence, the Thai Body Image Index score, and the Thai Hospital Anxiety and Depression Scale. Data was analysed using descriptive statistics, Chi-square statistics (Odds-Ratio and 95% Confidence Interval) and multiple logistic regression analysis. The study found that post-mastectomy Thai women participated in sufficient PA (2.8 metabolic equivalent of tasks (METs)). It was also found that PA at work was associated with occupation, higher incomes, moderate satisfaction as assessed by the Thai Body Image Index score, and higher levels of anxiety and depression. Participation in recreational activities was associated with older age, higher perceived self-efficacy, and greater interpersonal influence. However, statistically significant associations from the chi-square test did not remain significant after analysis with the multiple logistic regression. By exploring these associations, we can tailor supportive care strategies to address the PA needs of individuals affected by breast cancer which is essential for the development of comprehensive interventions that optimize patient health and well-being throughout the cancer journey.

PMID:40383805 | DOI:10.1038/s41598-025-02137-1

J Neuroeng Rehabil. 2025 May 18;22(1):111. doi: 10.1186/s12984-025-01619-7.

ABSTRACT

BACKGROUND: Children with cerebral palsy (CP) experience significant mobility and balance impairments. Non-invasive brain stimulation (NIBS), including transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS), has emerged as a potential therapeutic intervention. Nevertheless, the safety and effectiveness of NIBS in children with CP remain uncertain and require further investigation. This study aimed to evaluate the safety and effectiveness of NIBS in improving mobility and balance function in children with CP.

METHODS: Randomized controlled trials written in English were searched in five databases (PubMed, Embase, Scopus, Web of Science, and ProQuest), from the first available records in each database to April 2024. Statistical analysis focused on outcomes related to mobility and balance function immediately following intervention and one-month follow-up.

RESULTS: A total of 16 studies encompassing 346 children with CP, aged 3-14 years, were included. The meta-analysis indicated that NIBS is safe and well-tolerated [Risk Difference = 0.16, 95% CI – 0.01-0.33], with a low incidence of adverse events. Significant improvements were observed in mobility post-intervention and at one-month follow-up, particularly in Gross Motor Function Measure scores [standard mean difference (SMD) = 0.47 to 0.63, P < 0.05]. Gait parameters, including gait velocity (SMD = 1.28, P < 0.01) and stride length (SMD = 0.70, P = 0.01) showed immediate improvements. However, no significant improvements were found in balance post-tDCS or at follow-up.

CONCLUSIONS: Our findings support the use of NIBS as a safe and feasible tool for enhancing mobility in children with CP, demonstrating both immediate and sustained improvements in gait parameters such as velocity and stride length. However, the impact on balance remains inconclusive. Future research should focus on extending follow-up periods, increasing sample sizes, and exploring tailored stimulation protocols to better understand the long-term efficacy and optimal application of NIBS in pediatric populations.

PMID:40383797 | DOI:10.1186/s12984-025-01619-7

Eur J Med Res. 2025 May 19;30(1):392. doi: 10.1186/s40001-025-02655-8.

ABSTRACT

OBJECTIVE: The study analyzed the relationship between serum levels of HMGB1 and biochemical indices related to atherosclerosis, clarifying the diagnostic value of HMGB1 in cases of myeloproliferative neoplasm (MPN) accompanied by atherosclerosis (AS).

METHODS: The bone marrow samples and serum were obtained from patients with MPN. qPCR was used to detect the level of HMGN1 mRNA in bone marrow mononuclear cells, while ELISA was used to measure the level of HMGB1 in serum. Additionally, relevant biochemical indices of the patients were collected and the correlation between these indices and HMGB1 levels was assessed.

RESULTS: Compared with the control group, MPN patients exhibited significantly elevated levels of HMGB1 in both bone marrow mononuclear cells and serum. The Pearson correlation analysis revealed a negative correlation between serum HMGB1 levels and both HDL-C and ApoA1. The ROC curve analysis demonstrated that serum HMGB1 had an AUC of 0.929 (P < 0.001) for predicting the complication of AS in MPN patients, with a sensitivity of 100.00% and a specificity of 78.05%. Furthermore, logistic regression analysis showed that serum HMGB1 levels were statistically significant in determining the presence of AS in MPN patients (P < 0.05).

CONCLUSION: Elevated levels of HMGB1 in the bone marrow and serum of MPN patients demonstrate a correlation with biochemical indices related to AS. This finding may serve as a valuable reference for predicting AS complications in MPN patients.

PMID:40383792 | DOI:10.1186/s40001-025-02655-8

BMC Med Educ. 2025 May 18;25(1):723. doi: 10.1186/s12909-025-07281-w.

ABSTRACT

BACKGROUND: Chronotype, which denotes an individual’s preference for morning or evening activity patterns, has been linked to variations in cognitive performance, sleep behavior, and stress levels. This study investigates the association between chronotype, perceived stress, and academic performance among first-year medical students.

METHODS: A cross-sectional descriptive study was conducted among 148 medical students at a private university. Chronotype was assessed using the Munich Chronotype Questionnaire (MCTQ), and perceived stress was measured using the Perceived Stress Scale (PSS). Academic performance was categorized into “Excellent” (marks > 65%) and “Average” (marks < 55%). Statistical analyses included independent t-tests, chi-square tests to evaluate differences and associations.

RESULTS: Morning chronotypes demonstrated significantly higher academic performance, with 49.1% in the “Excellent” group compared to 29% of Evening chronotypes (p =.03). Perceived stress scores were significantly higher among Evening chronotypes (24.9 ± 12.1) than Morning chronotypes (20.7 ± 9.3, p =.028). Furthermore, Evening chronotypes exhibited longer sleep latency (41.17 ± 13.35 min vs. 14.49 ± 12.14 min, p <.001) and greater variability in weekend sleep schedules (p <.001). Gender differences in stress and academic performance were minimal and not statistically significant.

CONCLUSION: Chronotype significantly affects academic performance and stress levels among medical students, with Morning types performing better academically experiencing less stress. Tailored strategies like flexible scheduling and sleep hygiene promotion can help Evening chronotypes overcome challenges, improving academic outcomes and psychological well-being.

PMID:40383776 | DOI:10.1186/s12909-025-07281-w

Neurol Res Pract. 2025 May 19;7(1):33. doi: 10.1186/s42466-025-00387-y.

ABSTRACT

Magnetic resonance imaging (MRI) is a critical diagnostic tool and monitoring modality for multiple sclerosis (MS), frequently employing gadolinium-based contrast agents (Gd). However, concerns regarding the accumulation of Gd have prompted international guidelines (MAGNIMS-CMSC-NAIMS, 2021) to advocate for the limitation of Gd utilization. Consequently, we assessed of the impact of the 2021 guidelines on the use of Gd in MRI in MS patients in Germany by conducting a retrospective analysis of MRI data from 12,833 MS patients in the German MS Register (2019-2024). Generalized additive models were employed to analyze Gd use trends over time by MRI type (cranial, spinal, combined). From 2020 to 2024, a significant decline in Gd use was observed, with percentages dropping from 74.2 to 41.2% in cranial MRI, from 78.2 to 39.2% in spinal MRI and from 81.8 to 59.0% in combined MRI (p < 0.001). The most substantial decline occurred within the initial five years of MS. Gd use in MS MRI scans has significantly decreased in line with the updated guidelines. Nevertheless, its persistent utilization in over one-third of cases necessitates further examination.

PMID:40383774 | DOI:10.1186/s42466-025-00387-y

BMC Vet Res. 2025 May 19;21(1):356. doi: 10.1186/s12917-025-04826-5.

ABSTRACT

BACKGROUND: Antimicrobial use (AMU) by veterinarians is crucial for animal health management worldwide. Its extensive and improper use with insufficient monitoring has raised concerns about antimicrobial resistance (AMR). Veterinarians’ opinions on antimicrobial agents and AMR are crucial in shaping their prescription practices. Understanding these opinions and practices is essential for mitigating the impact of AMR. Therefore, a questionnaire-based cross-sectional study was conducted to investigate the antimicrobial prescription practices and antimicrobial knowledge of veterinarians in Palestine. Descriptive and statistical analyses were performed at a confidence interval of 95%.

RESULTS: A survey targeting 358 veterinarians in Palestine received 104 responses (29.1%). The majority of respondents were male (92.3%) and aged 31-40 (47.1%) or under 30 (42.3%). Most practiced in Hebron (31.7%), while others practiced in Jenin (14.4%), Tulkarm (11.5%), and Nablus (11.5%). The practices mainly included mixed practices (48.1%), farm animals (26.0%), and small animals (13.5%). Training on antimicrobial agents was primarily in English (93.3%), lasting five years (91.3%), with 40.4% having multiple course emphases in nonclinical years and 46.2% in clinical years. Only 57.7% had no additional degrees, but 54.8% attended training courses or conferences. Most veterinarians (64.4%) felt that they did not overprescribe antimicrobial agents, although 41.3% used them in 41-60% of cases. Clinical signs were relied upon for prescriptions by 85.6%, but only 39.4% had access to laboratory facilities for antimicrobial susceptibility testing. Most respondents (76.0%) acknowledged antimicrobial misuse, and 71.2% felt there was inadequate supervision of AMU. AMR was seen as a serious issue by 99.0%, with improper prescription habits cited as a major cause (81.7%). Recommendations to combat resistance included conducting sensitivity tests, enhancing veterinary oversight, promoting biosecurity, and enforcing stricter regulations on antimicrobial sales and use.

CONCLUSION: This study provides valuable insights into the knowledge, attitudes, and practices of veterinarians in Palestine regarding AMU and AMR. The study underscored gaps in oversight, with many respondents feeling that there was inadequate supervision of AMU in veterinary practice. The findings highlight the need for enhanced training, stricter regulations, and improved monitoring to mitigate the risks of AMR effectively. By implementing these recommendations, it is possible to promote responsible AMU, safeguard public health, and ensure the continued effectiveness of antimicrobial agents for future generations. Addressing these challenges will require a concerted effort from all stakeholders to create a robust framework for antimicrobial stewardship in veterinary practice.

PMID:40383773 | DOI:10.1186/s12917-025-04826-5

BMC Med Educ. 2025 May 18;25(1):722. doi: 10.1186/s12909-025-07304-6.

ABSTRACT

BACKGROUND: Organ shortages remain a primary factor limiting transplant number. Raising awareness about organ donation and its medical benefits is one approach that could help dispel misunderstandings, improve willingness to donate, and increase the number of donors. This study aimed to examine the attitudes and knowledge of undergraduate students in medicine, health sciences, and technical fields regarding organ donation and transplantation, as well as to explore potential differences in perspectives across these groups.

METHODS: An observational web-based questionnaire survey was created for Finnish undergraduate medical, health science, and technical students. The survey included both multiple-choice questions evaluated on a Likert scale from 1 to 5 and open-ended questions. Descriptive statistical analyses were used to evaluate the results.

RESULTS: A total of 559 students completed the questionnaire, comprising 210 (37.6%) medical, 146 (26.1%) health science, and 203 (36.3%) technical students. Willingness to donate was significantly higher among medical and health science students compared to technical students (97.6%, 94.5%, and 85.7%, respectively; p < 0.001). A total of 42 respondents indicated they would not donate their organs after death. The prevalence of non-donors was lower among medical and health science students combined compared to technical students (3.7% vs. 14.3%; 95% CI for the difference: 5.8-16.3%; p < 0.001). Among non-donors, 78.6% expressed willingness to receive an organ if needed. Non-donors were less likely to have shared their opinion on organ donation compared to donors (21.4% vs. 69.2%, p < 0.001). Only 8.8% of respondents felt there is sufficient public discussion about organ donation and transplantation, while 45% considered brain death a valid definition of death.

CONCLUSIONS: Overall, willingness to donate organs after death is high (92.5%), with the highest willingness observed among medical students. A majority of the respondents expressed their will to donate organs and tissues. Most non-donors cited lack of knowledge as the main reason for not donating, though two-thirds of them indicated willingness to receive an organ if needed. Increased awareness about organ donation is necessary.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40383765 | DOI:10.1186/s12909-025-07304-6

BMC Oral Health. 2025 May 19;25(1):737. doi: 10.1186/s12903-025-06067-2.

ABSTRACT

BACKGROUND: Oral health is a key indicator of overall well-being, and diabetes, a complex metabolic disorder, often leads to related oral health problems. Given the high prevalence of diabetes among Indian older adults and elderly persons, this study examines the diabetes associated risk of dental caries and periodontal disease among them.

METHODS: This cross-sectional study analysed data from 65,562 adults aged 45 and above, based on the 2017-18 Longitudinal Ageing Study in India (LASI) Wave-1 survey. We used bivariate cross-tabulation to estimate the prevalence, chi-square analysis to examine the prevalence differentials and multivariate logistic regression to estimate the adjusted odds ratio (AOR).

RESULTS: Bivariate analysis shows that diabetic older adults demonstrate a slightly higher prevalence of dental caries (20.43%) compared to those without diabetes (18.62%), but there is no significant difference in periodontal disease between the two groups. The regression analysis confirms that diabetes significantly increases the risk of both dental caries (AOR: 1.18, p < 0.001) and periodontal disease (AOR: 1.10, p = 0.008). Additionally, females and urban residents are at a higher risk of dental caries, while rural residents face a greater risk of periodontal disease. Socioeconomic factors, such as lower education and higher wealth, play a key role in caries and periodontal problems.

CONCLUSION: Effective management of diabetes-associated oral health problems in India requires a comprehensive, population-specific approach due to the country’s diverse demographic and socioeconomic landscape. Tailored interventions focusing on diabetes care, education, and access to oral health services are essential, particularly for high-risk groups like older adults, women, rural residents, and those with lower education or socioeconomic status.

PMID:40383764 | DOI:10.1186/s12903-025-06067-2

BMC Pediatr. 2025 May 19;25(1):399. doi: 10.1186/s12887-025-05735-0.

ABSTRACT

BACKGROUND: To improve the nutritional management of premature infants in neonatal intensive care units (NICUs), we developed and implemented a standardized parenteral nutrition (PN) protocol aimed at optimizing early macronutrient delivery. This study evaluated the impact of the new protocol on growth parameters and clinical outcomes in preterm neonates.

METHODS: This prospective, non-randomized interventional cohort study included two groups of preterm infants born before 32 weeks of gestation or with birth weights under 1250 g. The PRE group received individualized PN formulations based on clinician discretion, while the POST group received PN guided by a newly introduced, stepwise algorithmic protocol aiming to optimize early protein and energy intake. Anthropometric data, daily energy and macronutrient intakes during the first 14 days, and weight at day 28 were collected. Clinical outcomes-including the incidence of sepsis, necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH) retinopathy of prematurity (ROP) and hospitalization duration-were compared between groups.

RESULTS: A total of 139 infants were enrolled (69 PRE, 70 POST). While weight gain in the first 14 days was similar, the POST group showed significantly greater weight and weight velocity by day 28. These improvements paralleled higher mean daily energy and protein intakes during the early postnatal period. The incidence of bacterial sepsis was significantly reduced in the POST cohort, possibly reflecting better nutritional status and improved PN preparation practices. Although other complications did not differ significantly, fewer infants in the POST group required prolonged hospitalization (> 90 days).

CONCLUSION: Implementation of a standardized PN protocol improved early nutritional intake and was associated with better growth and reduced infection rates in premature infants. These findings support the use of structured PN strategies to enhance early neonatal outcomes in NICU settings.

TRIAL REGISTRATION: The Iranian Registry of Clinical Trials (http//www.irct.ir) with the identification No. IRCT20240519061838N2. Registered 24 November 2024.

PMID:40383757 | DOI:10.1186/s12887-025-05735-0

Malar J. 2025 May 18;24(1):157. doi: 10.1186/s12936-025-05353-2.

ABSTRACT

BACKGROUND: Spatial and temporal identification of malaria-endemic areas is a key component of vector-borne disease control. Strategies to target the most vulnerable populations, the periods of high transmission and the most affected geographical areas, should make vector-borne disease control and prevention programmes more cost-effective. The present study focuses on the spatial and temporal dynamics of malaria cases and the exogenous factors influencing the transmission in an area with pyrethroid-resistant mosquito vector populations.

METHODS: A prospective cohort study of 1806 children under 10 years of age was conducted over 20 months to assess the risk of malaria incidence in the Cove-Zagnanado-Ouinhi (CoZO) health zone located in southern Benin. Childhood malaria data were used to identify malaria hotspots according to months of follow-up using spatial scanning methods based on the Kulldoff algorithm. Stability scores were calculated by season to assess incidence heterogeneity. Incidence values by month were aggregated with meteorological data; and demographic data were merged to detect cross-correlation between incidence and meteorological variables. Generalized equation estimators were chosen for their ability to handle intra-group correlation, ensuring robust and interpretable results despite the complexity of the data to identify factors explaining the spatio-temporal heterogeneity of malaria incidence in the CoZO health zone.

RESULTS: Malaria incidence ranged from 1.41 (95% IC 0.96-2.08) to 13.91 (95% IC 12.22-15.84) cases per 100 child-months. Spatial heterogeneity in malaria transmission hotspots was observed over the study period, with relative risks ranging from 1.59 (p-value = 0.032) to 16.24 (p-value = 0.002). There was a significant negative association (correlation coefficient = – 0.56) between malaria incidence and temperature; and a slightly positive association (correlation coefficient = 0.58) between malaria incidence and rainfall. A significant association between malaria incidence with average house altitude (adjusted incidence rate ratio [aIRR] 1 (95% IC 0.99-1) P < 0.001), soil type aIRR 0.54 (0.39-0.75) p < 0.001 and temperature (incidence rate ratio [IRR] 0.69 (0.66-0.73) p < 0.001).

CONCLUSION: This study uses innovative technologies such as remote sensing and geographic information systems (GIS) to analyse the environmental, meteorological and geographical factors influencing malaria transmission, thereby identifying high-risk areas and associated factors. It demonstrates that these tools improve the accuracy of control strategies, while highlighting the crucial role of the environment and human behaviour, paving the way for more targeted interventions against malaria and other vector-borne diseases.

PMID:40383756 | DOI:10.1186/s12936-025-05353-2