Category: Statistics

Front Public Health. 2025 Oct 15;13:1602761. doi: 10.3389/fpubh.2025.1602761. eCollection 2025.

ABSTRACT

BACKGROUND: To analyze the results of seafarers’ health checkups, to understand the physical health status of seafarers and the high incidence of diseases, and to investigate the factors related to the abnormalities of electrocardiograms (ECG) of seafarers, so as to provide theoretical basis for improving the health level of seafarers and formulating the health intervention plan for seafarers.

METHODS: 10,174 seafarers who underwent health checkups at the Yangtze River Shipping General Hospital from January 2024 to December 2024 were selected as the survey subjects, and clinical data such as their general conditions, ECG and other functional examinations, and biochemical indicators were extracted. SPSS 26.0 software was used for statistical analysis to understand the disease composition of seafarers’ health checkups, and single-factor analysis and multifactor logistic regression analysis were used to explore the influencing factors of seafarers’ abnormal ECG results.

RESULTS: Abnormal body mass index (BMI), abdominal obesity, refractive error, liver function abnormality, ECG abnormality, high blood pressure, high fasting blood glucose and other abnormalities were more common in the health checkup of seafarers. Among them, abnormal ECG is mainly classified into myocardial ischemia/infarction and arrhythmia. Fatty liver and urinary stones were common in ultrasound examination of seafarers over 40 years old. High blood pressure, high fasting blood glucose and smoking were risk factors for abnormal ECG results.

CONCLUSION: Carrying out the health management of seafarers, strengthening the health education of seafarers with high prevalence of diseases, dynamically tracking the abnormal results of seafarers’ physical examination, and increasing the prevention and control of cardiovascular diseases in seafarers’ group can effectively improve the comprehensive health level of seafarers’ group.

PMID:41170486 | PMC:PMC12568659 | DOI:10.3389/fpubh.2025.1602761

Front Public Health. 2025 Oct 15;13:1677690. doi: 10.3389/fpubh.2025.1677690. eCollection 2025.

ABSTRACT

OBJECTIVES: This study aims to explore the causal relationship between nutritional status, life-space mobility (LSM), and cognitive function in community-dwelling older stroke patients, investigate the longitudinal mediating role of life-space mobility in the relationship between nutritional status and post-stroke cognitive function.

METHODS: A total of 284d ischemic stroke patients aged ≥60 years were recruited from the neurology inpatient department of a tertiary hospital, with follow-up assessments conducted at 3-, 6-, and 9- months post-stroke. Mini Nutrition Assessment-Short Form (MNA-SF) were used to assess nutritional status, the Life Space Assessment (LSA-C) was used to measure life-space mobility and the global cognitive function was assessed with the Mini Mental State Examination (MMSE). Linear mixed-effects model and cross-lag-panel model was applied to examine the longitudinal relations among the variables.

RESULTS: LMM analysis revealed a significant total effect of nutritional status on post-stroke cognitive function (Estimate = 0.026, 95%CI [0.022, 0.030], p < 0.001). A significant indirect effect through LSM was identified (Estimate = 0.006, 95% CI [0.004, 0.008], p < 0.001), accounting for 24.94% of the total effect. After controlling for the longitudinal influence of LSM, the direct effect remained significant (Estimate = 0.019, 95%CI [0.015, 0.023], p < 0.001), indicating a partial mediating role of LSM. In contrast, the CLPM revealed a complete mediation effect for the T2-T3 pathway, with a significant indirect effect (β = 0.029, 95%CI [0.004, 0.061], p < 0.05) and a non-significant direct effect, providing complementary evidence for the mediating role of life-space mobility through a different analytical approach.

CONCLUSION: In the chronic rehabilitation phase of older stroke patients, malnutrition can indirectly influence the development or exacerbation of post-stroke cognitive impairment via limited life-space mobility. This underscores the importance for early malnutrition identification and intervention and life-space mobility improvement to enhance long-term cognitive function in post-stroke care.

PMID:41170485 | PMC:PMC12568339 | DOI:10.3389/fpubh.2025.1677690

Front Public Health. 2025 Oct 15;13:1659996. doi: 10.3389/fpubh.2025.1659996. eCollection 2025.

ABSTRACT

This perspective article examines public health concerns related to herbicide exposure among children living in an agricultural and fishing village on the shores of Lake Chapala in Jalisco, Mexico. The discussion draws on published research comprising four pesticide exposure assessments conducted on children aged 0-14 years between 2016 and 2018. These assessments involved the collection of first-morning urine samples, which were analyzed using high-performance liquid chromatography coupled with tandem mass spectrometry (HPLC-MS/MS). The findings are as follows: November 2016 (n = 347; 24.2% positive; 7 herbicides detected), October 2017 (n = 187; 86.6% positive; 6 herbicides detected), May 2018 (n = 347; 52.2% positive; 4 herbicides detected), and October 2018 (n = 347; 12% positive; 4 herbicides detected). A total of three herbicides-glyphosate, 2,4-D (2,4-dichlorophenoxyacetic acid), and molinate-were detected in each of the four assessments. These results may represent the first evidence of persistent herbicide exposure in children in the Lake Chapala region. Further epidemiological studies are required to deepen the understanding of these findings.

PMID:41170484 | PMC:PMC12568689 | DOI:10.3389/fpubh.2025.1659996

Front Public Health. 2025 Oct 15;13:1667726. doi: 10.3389/fpubh.2025.1667726. eCollection 2025.

ABSTRACT

BACKGROUND: Mental health conditions are the second leading cause of disability in Indonesia, accounting for 13 percent of total years lived with disability. However, little is known about their broader economic impact. This study estimates the economic burden of anxiety and depression in adults, including healthcare costs and productivity losses, using a low-cost web panel approach that can be replicated in countries lacking data.

METHODS: A cross-sectional online survey was conducted with 5,828 Indonesian adults via a web panel. Participants completed the Patient Health Questionnaire-4 (PHQ-4) for themselves and household members, providing data on 16,096 individuals. Participants who screened positive for anxiety and/or depression symptoms based on the PHQ-4 (N = 438) were then asked about their healthcare utilization, days missed from work, and reduced productivity due to these symptoms. These responses were monetized and extrapolated based on the prevalence rate and population counts to generate per person and total annual costs.

RESULTS: Overall, 14.7 percent reported symptoms consistent with anxiety or depression, yet over 60 percent were never formally diagnosed, highlighting a large diagnosis gap. Direct healthcare costs averaged IDR 2,111,020 per person annually. Employees reported 34 missed workdays per year and were 51 percent less productive while working. Indirect costs via absenteeism and presenteeism averaged IDR 5,178,312 and IDR 11,021,700 per person. The total annual economic burden was IDR 463,811.33 billion (USD $29.22 billion), or 2.1 percent of Indonesia’s GDP, with labor market productivity losses accounting for 88.5 percent of the total.

CONCLUSION: Anxiety and depression impose substantial health and economic costs in Indonesia. Low-cost, evidence-based interventions-particularly workplace-focused programs-could generate significant health and economic benefits.

PMID:41170482 | PMC:PMC12570936 | DOI:10.3389/fpubh.2025.1667726

Child Health Nurs Res. 2025 Oct;31(4):248-256. doi: 10.4094/chnr.2025.028. Epub 2025 Oct 31.

ABSTRACT

PURPOSE: This study aimed to examine whether perceived parental alienation mediates the relationship between parental and adolescent depressive symptoms, and, if so, whether parents’ subjective health moderates this indirect effect.

METHODS: This cross-sectional study utilized secondary data from the 2021 wave of the Panel Study on Korean Children, enrolling 541 parent-child dyads. Parental depression was measured using the Kessler Psychological Distress Scale-6, a self-rated health item, the Korean version of the Center for Epidemiological Studies Depression Scale for Children, and a 6-item perceived alienation scale. Descriptive statistics, Pearson correlations, and variance inflation factor checks were conducted, followed by mediation and moderated mediation analyses using PROCESS Models 4 and 7 with 10,000 bootstraps in IBM SPSS ver. 27.0.

RESULTS: Parental depression did not directly predict adolescent depression (B=.02, t=.87) but was significantly related to perceived alienation (B=.16, p<.001), which in turn predicted higher adolescent depression (B=.20, p<.001). The indirect effect of alienation was also significant (B=.039; 95% confidence interval, 0.005-0.066). Subjective health moderated the depression-alienation link (interaction B=.19, p<.001), with stronger indirect effects observed among parents with better health.

CONCLUSION: Parental depression symptoms indirectly increase adolescent depression through perceived alienation, particularly when parents viewed their health positively. These results suggest that interventions targeting parental mental health and fostering open-family communication may help reduce adolescent depression.

PMID:41168116 | DOI:10.4094/chnr.2025.028

Child Health Nurs Res. 2025 Oct;31(4):237-247. doi: 10.4094/chnr.2025.024. Epub 2025 Oct 31.

ABSTRACT

PURPOSE: Because fever is a common symptom in children, parents must have accurate knowledge and management ability about it to be able to provide appropriate management. This study aimed to develop a fever management education program, incorporating case-based simulation practice for parents of hospitalized children, and examine its effects on knowledge of fever in children, anxiety related to fever, and self-efficacy in child fever management.

METHODS: A quasi-experimental, non-equivalent control group pretest-posttest design was employed. A total of 50 parents participated, with 24 and 26 in the experimental and control groups, respectively. The experimental group received both theoretical lectures and case-based simulation practice, whereas the control group received only theoretical lectures.

RESULTS: No statistically significant differences were observed between the groups regarding knowledge of fever or anxiety related to fever immediately after the intervention or at the 4-week follow-up. However, the experimental group showed a significant improvement in self-efficacy in fever management from pre- to post-intervention.

CONCLUSION: The findings suggest that fever management education incorporating case-based simulation practice, in addition to theoretical instruction, could potentially enhance parents’ confidence in managing childhood fever. Developing simulation-based educational interventions that enhance long-term effectiveness, can be feasibly integrated into hospital settings, and provide practical and accessible approaches is essential to support parents in effectively managing fever in real-life situations.

PMID:41168115 | DOI:10.4094/chnr.2025.024

Child Health Nurs Res. 2025 Oct;31(4):198-210. doi: 10.4094/chnr.2025.019. Epub 2025 Oct 31.

ABSTRACT

PURPOSE: This pilot study aimed to develop a virtual reality (VR) nursing simulation for pediatric pneumonia care tailored to the Korean clinical context and evaluate its educational effectiveness for nursing students.

METHODS: A single-group pretest-posttest design was employed with 20 senior nursing students from April to May 2025. The intervention was a 70-minute VR nursing simulation of pediatric pneumonia care, structured with pre-briefing, a main scenario, and debriefing. Data were collected on participants’ knowledge of pediatric pneumonia, clinical judgment (Nursing Clinical Judgment Scale), and simulation effectiveness (Simulation Effectiveness Tool-Modified) before and after the intervention. Usability (User Experience Questionnaire) and qualitative feedback were collected after the intervention. Pre-post comparisons were performed using paired t-tests.

RESULTS: The program did not yield a statistically significant change in knowledge scores (p=.893). However, there were significant improvements in the mean scores for clinical judgment (p<.001) and simulation effectiveness (p=.013). A qualitative analysis revealed that, while the participants found the experience immersive and realistic, they also reported operational difficulties, indicating the need for usability improvements.

CONCLUSION: The VR nursing simulation is a promising pedagogical tool for enhancing nursing students’ clinical judgment and perceived learning effectiveness in a Korean pediatric context. The findings suggest that, while the intervention was effective in improving practical reasoning, future iterations should focus on reinforcing knowledge acquisition and optimizing user experience to maximize the educational impact.

PMID:41168112 | DOI:10.4094/chnr.2025.019

Trop Med Int Health. 2025 Oct 30. doi: 10.1111/tmi.70049. Online ahead of print.

ABSTRACT

INTRODUCTION: Female genital schistosomiasis is a condition with a complex diagnosis and severe consequences such as infertility. In the absence of a reliable biomarker, in endemic settings the World Health Organization recommends colposcopy as a diagnostic tool for the detection of female genital schistosomiasis lesions. Nevertheless, it is seldom performed in low-resource contexts due to a lack of expertise or insufficient infrastructure. This study aims to assess Female Genital Schistosomiasis colposcopy at the primary level of care, evaluating its diagnostic accuracy in reference to gynaecologist diagnosis in a highly endemic context.

MATERIALS AND METHODS: This is a secondary analysis of a cross-sectional study conducted in the Boeny region of Madagascar, which collected colposcopy images and Female Genital Schistosomiasis decision at the primary health care level with re-evaluation by gynaecologists. Statistical analysis using R included descriptive statistics, measures of diagnostic accuracy with 95% confidence intervals and binary Poisson regression with robust standard errors, while reporting followed the STARD statement.

RESULTS: Among 495 included participants, a high sensitivity [96.4% (95% CI 93.7-98.0)] and relatively low specificity [28.7% (95% CI 21.8-36.5)], with a fair agreement [κ 0.30 (95% CI 0.22-0.39)], was observed for midwife-led colposcopy. Practice of midwives (3.5 months) was associated with reduced concordance [APR 0.88 (95% CI 0.79-0.98)] and specificity [APR 0.27 (95% CI 0.15-0.49)]. The environment of one health care centre negatively influenced concordance and specificity of midwife-led colposcopy.

CONCLUSION: Midwives can detect female genital schistosomiasis with high sensitivity but limited specificity when compared to expert gynaecologists, revealing variation in performance between environments as well as the influence of practice and workload. This study suggests that implementing midwife-led colposcopy at primary care level for female genital schistosomiasis screening is feasible but requires appropriate quality assurance measures.

PMID:41168099 | DOI:10.1111/tmi.70049

EBioMedicine. 2025 Oct 29:105967. doi: 10.1016/j.ebiom.2025.105967. Online ahead of print.

ABSTRACT

BACKGROUND: It is unclear whether pro-dopaminergic drugs reduce anhedonia in major depressive disorder (MDD) and further, if so, to what extent this is the case.

METHODS: With lived experienced experts we co-produced two living systematic reviews of randomised controlled trials (RCTs) investigating the relative efficacy of pro-dopaminergic interventions in reducing symptoms of anhedonia in people with MDD (versus placebo) and in relevant non-human animal models (versus vehicle control/no intervention). Multiple electronic databases were searched until June 9, 2024. The primary outcomes were subjective anhedonia symptoms in humans and sucrose preference test (a measure of reward sensitivity and proxy for anhedonia) in animals. We evaluated other important domains and clinical aspects closely related to anhedonia, such as reward/reinforcement tasks, anxiety symptoms, acceptability, tolerability, and adverse events. We performed pairwise meta-analyses separately for human and non-human studies. We also estimated the relative effects of pro-dopaminergic versus non-dopaminergic antidepressants in human studies on anhedonia and overall depressive symptoms using a series of random-effects network meta-analyses of both aggregate and patient-level data. A multidisciplinary panel of international experts (including people with lived experience) then interpreted the overall results and produced a list of recommendations via a triangulation process. This study is part of GALENOS (Global Alliance for Living Evidence in aNxiety, depressiOn, and pSychosis). PROSPERO registration: CRD42023451821.

FINDINGS: Pro-dopaminergic interventions were associated with a small reduction of anhedonia symptoms (6 RCTs, n = 2076; SMD -0.24, 95% CI -0.46 to -0.03) in people with MDD and increased sucrose preference in animal models (27 RCTs; SMD 1.34, 0.88 to 1.79). We did not find data about reward/reinforcement tasks in humans. Evidence was rated as low to moderate. In the network meta-analysis, some antidepressants with a non-dopaminergic mechanism of action showed reduction in anhedonia symptoms, which was larger than pro-dopaminergic drugs and probably independent of overall depression improvement.

INTERPRETATION: Our findings provide some support for the role of dopamine in anhedonia. However, the precise neurobiological mechanisms of anhedonia in major depression are still poorly understood and we posit that they may be possibly related to altogether different or more general effects of antidepressants on these symptoms. Therefore, data on reward, including reward-related learning and memory, are needed to properly examine the relationship between dopamine modulation and anhedonia.

FUNDING: Wellcome (GALENOS project).

PMID:41168072 | DOI:10.1016/j.ebiom.2025.105967

J Craniomaxillofac Surg. 2025 Oct 29:S1010-5182(25)00319-1. doi: 10.1016/j.jcms.2025.10.004. Online ahead of print.

ABSTRACT

Cleft lip and palate(CLP) is a deformity that affects the anatomical structure of the nose and the maxillary sinus(MS). In the management of MS pathologies, the prelacrimal recess approach(PLRA), a minimally invasive technique within endoscopic sinus surgery, holds significant importance. This study aims to evaluate the morphometric characteristics of the nasolacrimal duct(NLD) and the prelacrimal recess(PLR), as well as the feasibility of the prelacrimal recess approach(PLRA), in patients with unilateral cleft lip and palate(UCLP) using cone-beam computed tomography(CBCT). CBCT images of both the cleft and non-cleft sides of 60 patients with UCLP were retrospectively analyzed. Morphometric measurements related to the anatomy of the NLD and the PLR were performed and statistically compared.In these patients, the mediolateral diameter of the NLD was found to be significantly narrower on the cleft side(5.10 ± 1.29 mm) compared to the non-cleft side(5.74 ± 1.28 mm)(p = 0.03). The mediolateral thickness of the PLR was also significantly thinner on the cleft side(1.89 ± 1.46 mm) than on the non-cleft side(2.91 ± 1.95 mm)(p = 0.01). However, no significant difference was observed in the anteroposterior length of the PLR between the cleft side(5.08 ± 2.54 mm) and the non-cleft side(4.64 ± 2.67 mm)(p = 0.35).The prelacrimal recess and nasolacrimal canal on the cleft side may be affected in patients with UCLP. CBCT serves as a valuable tool in identifying these anatomical variations, which are frequently associated with congenital deformities such as UCLP and should be carefully considered during surgical planning.

PMID:41168059 | DOI:10.1016/j.jcms.2025.10.004