Category: Statistics

Front Med (Lausanne). 2025 Mar 10;12:1502456. doi: 10.3389/fmed.2025.1502456. eCollection 2025.

ABSTRACT

BACKGROUND: Safe perioperative nursing care is crucial to improving outcomes of surgical care. This is a report on the pilot implementation of a nursing training programme aimed at strengthening safe perioperative nursing care in Nigeria, aligning with the nation’s strategic framework for surgical, obstetric, anaesthesia, and nursing plan. The aim of this report is to highlight the need to incorporate perioperative nursing training into efforts to scale up access to surgical care in low resource settings.

METHODS: The Nursing Care Saves Lives (NCSL) training programme which was designed for training in perioperative nursing of cleft lip and palate patients, was adapted for perioperative nursing training. A 5-day intensive training was deployed, involving lectures, hands-on activities, simulations, and group problem-solving exercises. Pre- and post-training surveys were administered, and participant feedback and 3-months follow-up assessments obtained. The data has been analysed using descriptive statistics.

RESULTS: Twenty-six participants who were nurses involved in perioperative care, from both public and private hospitals, completed the training. Pre-training evaluation scores ranged from 23 to 72% (median 68%), increasing significantly to 61-98% (median 76%) post-training (p = 0.0001). Participants rated all training contents as useful, with high satisfaction in neonatal resuscitation and basic life support skills. Infection prevention and control, helping babies breathe, and effective communication were identified as key learnings. Recommendations for future training included facilitation skills, nutrition, and research. Although 10 (40%) participants organised step down trainings, limited funding and training materials were key barriers to step down.

CONCLUSION: The NCSL training programme has the potential for promoting and strengthening safe perioperative nursing care. Strategic efforts are needed to scale up and expand access to this training within the wider perioperative nursing community, to enhance patient safety and surgical outcomes in the setting.

PMID:40130251 | PMC:PMC11931009 | DOI:10.3389/fmed.2025.1502456

J Rural Health. 2025 Mar;41(2):e70018. doi: 10.1111/jrh.70018.

ABSTRACT

PURPOSE: Drug overdoses are now a leading cause of pregnancy-related deaths in the United States. Despite evidence of rural-urban disparities in substance use, there has not yet been a nationally representative examination of rural-urban differences in perinatal substance use. This study provides a comprehensive examination of rural-urban disparities in perinatal substance use.

METHODS: This study uses cross-sectional data to examine 3499 pregnant women from the 2015-2019 National Survey on Drug Use and Health (NSDUH). Rural (nonmetro)-urban (metro) differences in past-month tobacco use, alcohol use, binge drinking, illicit drug use, and marijuana use were examined using Rao-Scott chi-square tests and multivariable logistic regression using complex survey weights.

FINDINGS: In 2015-2019, past-month tobacco use varied geographically, as rural pregnant participants were more likely to have used tobacco than those in small and large urban areas (24.7% vs. 15.2% and 8.2%, respectively, p < 0.0001). After controlling for sociodemographic and health care needs, rural pregnant women were more likely to report tobacco use (adjusted odds ratio [aOR]: 2.32, 95% confidence interval [CI]: 1.66, 3.25) but were less likely to report alcohol use (aOR: 0.58, 95% CI: 0.34, 0.98) than their large urban counterparts. There were no rural-urban differences in the odds of binge drinking, illicit drug use, or marijuana-only use in the past month.

CONCLUSIONS: Geographic variations in perinatal substance use highlight the need for tailored interventions targeting substance use prevention during pregnancy, prioritizing tobacco in rural areas and alcohol in urban areas.

PMID:40128129 | DOI:10.1111/jrh.70018

Anal Chem. 2025 Mar 24. doi: 10.1021/acs.analchem.4c05962. Online ahead of print.

ABSTRACT

This work presents the first indirect immunoassay performed on a paper-based microfluidic platform for the diagnosis of canine visceral leishmaniasis (CVL). The IgG antibody biomarker, which signifies the presence of this infectious disease, was captured with a recombinant K39 antigen and detected with secondary antibodies that were conjugated with cleavable ionic probes. The use of ionic probes enabled direct analysis of the assay results through an on-chip paper spray mass spectrometry (MS) technology. This MS-based immunoassay was developed to allow for early detection of CVL in asymptomatic dogs. The sensitivity required for such a diagnostic method was demonstrated through internal standard calibration in which sample dilution as low as 1/4000 was achieved. Aside from high sensitivity, the ionic probes are stable, which allowed the paper device to be stored at room temperature and under ambient conditions for 30 days without affecting the diagnostic outcome. Our method was used to analyze 20 clinical canine serum samples, where we detected a 2 orders of magnitude higher signal for CVL-positive samples compared to negative samples. MS signal derived from the 10 CVL-positive serum clinical samples showed a strong correlation with antibody titers determined by immunofluorescence assay. This correlation was confirmed through Pearson’s statistical analysis. Overall, the high sensitivity and positive results from stability tests observed for our platform are expected to enable large-scale CVL screening in asymptomatic dogs in remote areas, especially when combined with portable mass spectrometers.

PMID:40128119 | DOI:10.1021/acs.analchem.4c05962

Medicine (Baltimore). 2025 Mar 21;104(12):e41851. doi: 10.1097/MD.0000000000041851.

ABSTRACT

The COVID-19 pandemic has brought a significant increase in the incidence of acute respiratory distress syndrome (ARDS). This retrospective study aims to compare the differences in demographic, clinical, and biochemical variables and predictive factors in 2 situations of ARDS cause (COVID-19 vs NON-COVID-19) in patients admitted to the intensive care unit. The Mann-Whitney rank-sum test was performed for quantitative variables, and Fisher exact test for qualitative variables. 115 patients with ARDS were enrolled (53 patients with COVID-19 ARDS and 62 NON-COVID-19 ARDS). The COVID-19 ARDS group consisted of 33 male patients (66.2%), whereas the NON-COVID-19 ARDS group had 25 male patients (40.3%) (P = .0248). The median and interquartile age difference of the COVID-19 ARDS group was 64.0 [52.0-69.5], and non-COVID-19 ARDS was 49.0 [34.0-63.0] (P = .0011). Body mass index, simplified acute physiology score, sequential organ failure assessment, and intensive care unit length of stay, with P-values of .0061, .0002, .0003, and <.0001, respectively (COVID-19 vs NON-COVID-19 ARDS). Diabetes, arterial hypertension, venous thrombosis, and chronic obstructive pulmonary disease had values of <.0001, .0234, .0358, and .0001, respectively. On the other hand, the NON-COVID-19 ARDS group had a greater need for dialysis (P = .0109). The stepwise logistic regression showed that relevant clinical, and demographic characteristics associated with ARDS due to COVID-19, such as male gender, diabetes, chronic obstructive pulmonary disease, and body mass index, were independent prognostic factors of severity in patients with COVID-19 ARDS, compared to NON-COVID-19 ARDS. The overall mortality rate was 62.9% for COVID-19 ARDS and 77.4% for the non-COVID-19 ARDS group (P = .2950). Ventilatory parameters of COVID-19 ARDS and NON-COVID-19 ARDS were similar.

PMID:40128087 | DOI:10.1097/MD.0000000000041851

Medicine (Baltimore). 2025 Mar 21;104(12):e41937. doi: 10.1097/MD.0000000000041937.

ABSTRACT

Fanconi anemia (FA) is an inherited disorder characterized by congenital malformations, bone marrow failure, and malignancies. Hematopoietic cell transplant (HCT) is the only proven cure for the hematological complications. FA patients have increased chromosomal instability and aberrant deoxyribonucleic acid repair and thus can only tolerate low doses of chemotherapy or radiation as part of conditioning prior to HCT. Yet, they are still prone to severe regimen related toxicities including hemorrhagic cystitis (HC) from cyclophosphamide (CY). As CYP2B6 is a primary enzyme responsible for the catalyzation of the prodrug form of CY, understanding the association between CYP2B6 genetic variants and HC in FA patients may predict which patients will be more susceptible to developing HC. A descriptive genetic association study was performed to identify genetic variants associated with HC in patients with FA who underwent HCT between 1999 and 2017. All patients received a CY-based preparative regimen and had pretransplant recipient deoxyribonucleic acid available for genomic analysis. Forty FA pediatric patients were eligible for this analysis. They had received HCT from matched sibling donors (n = 6) or alternative donors (n = 34) for marrow failure (n = 38) or myelodysplastic syndrome (n = 2). The incidence of HC was 32.5% which occurred at a median of 32 days (range 20-180) after HCT. 9 patients had a concomitant viral infection (BK virus, n = 8 both adenovirus and BK virus, n = 1). No genetic variants were significantly associated with HC. The top variants were rs2279343 (g.23060A > G), and rs2279344 (g.23280G > A) in the CYP2B6 gene. The incidence of HC among FA patients with the rs2279343 variant was 42% (CI 22%-62%) compared to 20% (CI 0%-40%) among those without the variant (P = .19). The incidence of HC among patients with the variant in rs2279344 was 40% (CI 22%-58%) compared to 10% (CI 0%-28%) among those without (P = .11). No variants in our analysis were statistically associated with HC. The data suggest that CYP2B6 variants may increase the risk for HC in FA patients who received a CY based preparative therapy but these risk variants must be further evaluated in a larger population.

PMID:40128086 | DOI:10.1097/MD.0000000000041937

Medicine (Baltimore). 2025 Mar 21;104(12):e41891. doi: 10.1097/MD.0000000000041891.

ABSTRACT

Febrile seizures (FS) are among the most common neurological disorders in childhood, and their pathogenesis may be influenced by multiple factors. As scientific research progresses, the significant role of B vitamins in the nervous system has become progressively clearer. In this study, children clinically diagnosed with FS were selected as the experimental group, and febrile children without a history of convulsions or a family history of seizures were selected as the control group to investigate the potential correlation between FS and whole-blood B vitamin levels. The concentrations of B vitamins in whole blood were measured using liquid chromatography-mass spectrometry, and statistical analyses were conducted using SPSS 25.0, followed by significance testing. The levels of vitamins B1, B2, B5, B6, B7, and B12 in the experimental group were significantly higher than those in the control group, particularly vitamins B5 and B7 (P < .05). Additionally, statistically significant differences were observed between sodium and calcium ion levels. These results suggest that febrile convulsions are the complex outcome of multiple factors, including known ion channel defects. Vitamin B may play a role in febrile convulsions and warrants further investigation.

PMID:40128085 | DOI:10.1097/MD.0000000000041891

Medicine (Baltimore). 2025 Mar 21;104(12):e41914. doi: 10.1097/MD.0000000000041914.

ABSTRACT

Indoor air pollution (IAP) is a risk factor leading to cataracts. The disease burden of cataracts due to IAP is currently greater in low- and middle-income countries, an in-depth analysis is necessary to track the current time trend of cataracts caused by IAP in low- and middle-income countries. Our data from the global burden of disease 2021 study. In our study, disability-adjusted life years (DALYs) and DALYs rate were used to assess the disease burden of cataracts due to IAP across 17 low- and middle-income countries. The contribution of IAP exposure to the associated burden of cataracts was quantified by using population attribution fractions. Additionally, the estimated annual percentage change was calculated to quantify the long-term trend in the burden of cataracts due to IAP from 1990 to 2021. An age-period-cohort model was used to estimate the effects of age, period, and cohort on time trend of disease burden. In 2021, age-standardized DALY rates (ASDR) values varied widely across the 17 countries. Pakistan had the highest ASDR 122.5 (-35.3 to 247.4). ASDR declined in all 17 countries. For all countries, the age effect increases rapidly after about age 55. South Africa, Brazil, and Mexico have made great progress in the period and cohort effects. The situation of burden for IAP-related cataracts varies across countries, and it is necessary to set targeted public health strategies and interventions.

PMID:40128084 | DOI:10.1097/MD.0000000000041914

Medicine (Baltimore). 2025 Mar 21;104(12):e41881. doi: 10.1097/MD.0000000000041881.

ABSTRACT

Androgenetic alopecia (AGA) is a condition with a rapidly evolving research landscape. The expanding volume of AGA research necessitates synthesis to identify trends and gaps. Bibliometric analysis can be used to quantify the characteristics of a body of literature, and this technique has not been previously applied to AGA. We aimed to evaluate the bibliometric characteristics of the top 100 most cited AGA articles over the past 50 years. This includes the analysis of contributing authorship, institutional affiliation, journal representation, publication years, citation counts, country productivity, and funding sources, among other characteristics. We used the Web of Science to identify and characterize the 100 most cited AGA publications between 1975 and 2024. A secondary analysis was performed to identify and characterize the top 20 most cited AGA articles from 2020 to 2024. The top 100 articles amassed 24,289 citations. Authors from the United States contributed the most articles (n = 56). The University of Pennsylvania contributed the most articles (n = 11). Dr Elise A Olsen and Dr George Cotsarelis were the most frequent contributors. The Journal of the American Academy of Dermatology published the most number of articles. From 1975 to 2024, most studies primarily discussed pathophysiology (45%) and treatment (35%). However, from 2020 to 2024, 75% of the top articles focused on the treatment options. This bibliometric analysis provides an overview of influential AGA research over the last 50 years, highlighting shifting trends toward treatment optimization and emerging therapies.

PMID:40128083 | DOI:10.1097/MD.0000000000041881

Medicine (Baltimore). 2025 Mar 21;104(12):e41735. doi: 10.1097/MD.0000000000041735.

ABSTRACT

This study aimed to assess the effects of failure mode and effect analysis (FMEA)-based nursing intervention combined with early rehabilitation training on the outcomes of mechanically ventilated patients in the cardiac intensive care unit (CICU). A retrospective cohort design included 100 patients who underwent tracheal intubation and mechanical ventilation in the CICU from January 2023 to June 2024. The observation group (n = 50) received FMEA-based nursing intervention alongside early rehabilitation training, while the control group (n = 50) received standard nursing care with early rehabilitation training. Results demonstrated that the observation group had significantly better muscle strength levels, lower incidence of ICU-acquired weakness, fewer tracheal intubation-related complications, shorter durations of mechanical ventilation, and reduced hospital stays compared to the control group (P < .05). Additionally, nursing satisfaction was significantly higher in the observation group (P = .027). In conclusion, the combination of FMEA-based nursing intervention and early rehabilitation training notably improves the prognosis of mechanically ventilated patients in the CICU, minimizes complications, and enhances patient satisfaction with nursing care.

PMID:40128075 | DOI:10.1097/MD.0000000000041735

Medicine (Baltimore). 2025 Mar 21;104(12):e41759. doi: 10.1097/MD.0000000000041759.

ABSTRACT

Lower extremity deep venous thrombosis (LEDVT) is a common complication in patients with acute hemorrhagic stroke, leading to increased risk of pulmonary embolism, disability, and mortality. Despite its importance, LEDVT often goes undetected in clinical practice, and early preventive strategies remain insufficient. This study aimed to explore the incidence of LEDVT in acute hemorrhagic stroke patients, identify key risk factors, and discuss potential preventive measures to reduce its occurrence and improve patient outcomes. A retrospective analysis was conducted on 431 acute hemorrhagic stroke patients admitted to The First Affiliated Hospital of Chengdu Medical College between January 2022 and December 2023. Relevant clinical data, including patient demographics, comorbidities, NIHSS score, and treatment history, were collected. LEDVT was diagnosed using standardized ultrasound criteria. Statistical analyses, including univariate and multivariate logistic regression, were performed using SPSS 17.0 to identify independent risk factors associated with LEDVT. The incidence of LEDVT among the 431 acute hemorrhagic stroke patients was 12.1%, with 52 cases identified. Significant risk factors for LEDVT included advanced age, diabetes, infection, prolonged bed rest, high-dose diuretic use, NIHSS score ≥16, and hyperlipidemia (P < .05). Gender, smoking history, and alcohol consumption were not found to be statistically significant. Multivariate logistic regression revealed that advanced age, diabetes, infection, prolonged bed rest, high-dose diuretic use, NIHSS score ≥16, and hyperlipidemia were independent risk factors for LEDVT. LEDVT in acute hemorrhagic stroke patients is influenced by multiple factors, including comorbidities, severity of neurological impairment, and treatment regimens. Dehydration therapy used for managing brain edema and intracranial pressure was also found to be an independent risk factor. Given the significant impact of LEDVT on patient prognosis, early identification of at-risk patients and the implementation of proactive preventive measures-such as pharmacological treatments and physical interventions-are critical in reducing the occurrence of LEDVT, alleviating patient suffering, and improving long-term outcomes. Future studies should focus on refining preventive strategies and exploring more individualized interventions to further reduce the incidence of LEDVT in these patients.

PMID:40128074 | DOI:10.1097/MD.0000000000041759