Category: Statistics

Emerg Med Australas. 2025 Jun;37(3):e70060. doi: 10.1111/1742-6723.70060.

ABSTRACT

OBJECTIVES: To explore and describe patients’ expectations, perceptions and experiences of having a pelvic examination (PV) in the emergency department (ED) and to describe ED clinicians’ attitudes and perceptions regarding PVs.

METHODS: A mixed methods study using questionnaires and semi-structured interviews with patients and clinicians at two EDs in the same health service (tertiary ED and urban district ED) between May 2023 and February 2024. Quantitative data are reported descriptively using means and proportions. A qualitative descriptive approach and thematic analysis were used to develop themes from interviews and gather granular insights from participants’ first-hand experiences.

RESULTS: Clinicians completed 84 questionnaires and nine interviews. Patients completed 63 questionnaires and eight interviews. Quantitative and qualitative data were merged to form four themes: (1) the variable clinical utility of the PV in ED, (2) lack of ED clinician confidence and training, (3) bedside manner as primary influence on patient experience, and (4) the inadequate ED setting for performing intimate exams.

CONCLUSIONS: The utility of PVs in ED remains ambiguous and it is vital to avoid unnecessary invasive exams. However, urgent PVs will sometimes be needed and participants have made actionable suggestions to improve the clinical care delivered when performing PVs in ED. The four themes can inform future strategies to advance clinicians’ training, confidence and skill level when performing PVs. This will lead to overall enhanced patient experience and satisfaction and reduce downstream negative consequences of having an inadequate PV experience in ED.

PMID:40384467 | DOI:10.1111/1742-6723.70060

Ying Yong Sheng Tai Xue Bao. 2024 Dec 18;35(12):3497-3506. doi: 10.13287/j.1001-9332.202411.032.

ABSTRACT

Soil biological health assessment is an integral component of soil health evaluation, providing crucial insights into soil processes from a biological perspective. However, current soil health assessments primarily rely on soil physical and chemical indicators, lacking standardized methods and framework for incorporating soil biological indicators. We reviewed the development of soil health assessment and proposed a method, which incorporates the ‘dimension reduction’ of soil health index evaluation system using exploratory factor analysis and the ‘scoring’ based on cumulative normal distribution function into the soil biological health assessment. We further used this method to analyze soil biological health status of upland in black soil region at field and regional scales. The results showed that the use of exploratory factors could reflect soil biological health status in multiple dimensions, which was more conducive to formulating soil health conservation policies or measures according to local conditions. Our results highlighted the critical role of soil biota and their interaction networks in soil health assessment, which would provide necessary technical support for soil health assessment using soil biological indicators.

PMID:40383902 | DOI:10.13287/j.1001-9332.202411.032

Cancer Causes Control. 2025 May 19. doi: 10.1007/s10552-025-02010-6. Online ahead of print.

ABSTRACT

PURPOSE: Accumulating evidence suggested long-term exposure to air pollution as a risk factor of lung cancer. Recent efforts confirmed the association based on extended population and individual exposure by leveraging administrative databases and complete address information. However, few studies achieved simultaneous improvements. Using the 2 million cohort along with their individual residential exposures, this study aimed to investigate the association of four criteria pollutants and incident lung cancer in the Seoul Metropolitan Area, South Korea.

METHODS: Our study population included 2,035,278 people aged ≥ 30 years and without cancer for 2002-2006 from the National Health Insurance System database. We identified lung cancer incidence for 2007-2016 and assessed individual long-term exposure to particulate matter ≤ 10 µm and 2.5 µm in diameter (PM₁₀ and PM_2.5), nitrogen dioxide (NO₂), and ozone at participants’ home addresses by using previously validated exposure prediction models. Using time-varying Cox proportional hazard models, we estimated hazard ratios (HRs) per interquartile range increase in each pollutant concentration adjusting for individual and area-level characteristics.

RESULTS: There were 18,229 lung cancer new cases over 10 years. We did not find the association for all four pollutants (PM₁₀: HR = 0.99 [95% Confidence Interval = 0.93-1.04]; PM_2.5: 0.97 [0.92-1.02]; NO₂: 1.00 [0.96-1.05]; and ozone: 1.01 [0.98-1.04]). The extended stratified and sensitivity analyses mostly showed null associations.

CONCLUSION: Our findings of no association contradictory to existing evidence, despite the considerable improvement in exposure assessment and population size, suggest further examination by integrating histological variation and indoor and/or personal exposure.

PMID:40383829 | DOI:10.1007/s10552-025-02010-6

Sci Rep. 2025 May 18;15(1):17256. doi: 10.1038/s41598-025-99848-2.

ABSTRACT

Systemic volume changes during acute lung injury (ALI) are closely related to lung injury severity, disease progression, and treatment methods. Twenty-one goats were divided into control, mild injury, and severe injury groups via oleic acid injection. Carotid ultrasound measured carotid diameter and corrected flow time (FTc), while cardiac ultrasound assessed aortic and pulmonary artery velocity-time integral (VTI). Post-euthanasia at 6 h, lung wet-to-dry (W/D) ratio and pathological scores were analyzed. Statistical trends, correlations between ultrasound parameters and lung injury markers, and diagnostic performance via ROC analysis were evaluated. The severe injury group had significantly higher lung W/D ratios and pathological scores than the mild injury group. Carotid ultrasound showed a progressive decrease in carotid diameter and FTc post-injury, with FTc significantly lower in the severe injury group at 6-h. FTc was negatively correlated with lung W/D ratio and pathological scores. Cardiac ultrasound indicated a decreasing trend in aortic and pulmonary artery VTI post-injury, with pulmonary artery VTI significantly lower in the severe injury group at all times and negatively correlated with lung W/D ratio and pathological scores. ROC analysis showed that pulmonary artery VTI had the highest area under the curve (AUC), with values greater than 0.8 at all time points. The combined use of pulmonary artery VTI and carotid FTc had AUC values greater than 0.85 at all time points, peaking at 6-h (AUC = 0.951). In conclusion, pulmonary artery VTI is an excellent indicator for evaluating ALI severity post-injury, and the combination of pulmonary artery VTI and carotid FTc shows strong diagnostic performance for assessing ALI severity.

PMID:40383807 | DOI:10.1038/s41598-025-99848-2

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