Category: Statistics

Phys Life Rev. 2025 Nov 20;56:29-32. doi: 10.1016/j.plrev.2025.11.005. Online ahead of print.

NO ABSTRACT

PMID:41313835 | DOI:10.1016/j.plrev.2025.11.005

Midwifery. 2025 Nov 24;153:104683. doi: 10.1016/j.midw.2025.104683. Online ahead of print.

ABSTRACT

BACKGROUND: Primary postpartum hemorrhage (PPH) remains a major contributor to maternal morbidity and mortality globally. Despite improvements in maternal healthcare across the Middle East, the burden of PPH persists, and regional data on its predictors remain limited. This study aimed to examine the maternal and health service-related predictors of primary PPH among Middle Eastern women with vaginal delivery in Oman.

METHODS: A retrospective matched case-control study was conducted among 483 postpartum women who delivered vaginally at three hospitals in Oman between May 2022 and May 2024. Cases (women with PPH, ≥500 mL blood loss) were matched 1:2 with controls based on maternal age, parity, and pregnancy type. Demographic, maternal, and health service-related factors were obtained from medical records and standardized forms in collaboration with unit head nurses.” Data were analyzed using descriptive statistics, univariate analyses, and logistic regression (p < 0.05).

RESULTS: The prevalence of primary PPH was 10.4 %. No significant sociodemographic differences were observed between cases and controls. Logistic regression identified six significant predictors, including retained placenta (OR = 6.484), cervical tears (OR = 48.058), perineal tears (OR = 1.473), episiotomy (OR = 2.056), anticoagulant use (OR = 2.193), and mode of delivery (OR = 1.412). The highest PPH incidence occurred at the AXXX Hospital (28.58 %), which may reflect differences in service capacity and staffing.

CONCLUSION AND CLINICAL RELEVANCE: This multi-center case-control study strengthens evidence on PPH predictors in this under-researched region. Both maternal and health service-related factors were associated with increased risk of primary PPH. Emphasis on targeted postpartum assessments, preventive measures such as selective episiotomy and perineal support during delivery, and improved clinical documentation is warranted. Policy-level actions, including investments in workforce capacity and service delivery, may further reduce PPH and improve maternal outcomes in Oman and comparable contexts.

PMID:41313817 | DOI:10.1016/j.midw.2025.104683

J Med Internet Res. 2025 Nov 28;27:e77087. doi: 10.2196/77087.

ABSTRACT

BACKGROUND: Caring for children with rare genetic disorders is challenging due to complex medical needs and limited information. Often, information is scarce due to geographical dispersion and lack of access to expertise. Social media groups are increasingly used in parenting and in healthcare as tools for data sharing and acquisition, and online peer support. Online groups relating to specific rare diseases are increasingly used by parents navigating the difficulties of understanding their child’s diagnosis and providing them with support. Parents expect professionals to interact with them about information reported from online groups, but little is known regarding the content within these groups and the impact on families.

OBJECTIVE: We aimed to synthesize current knowledge of social media use among parents and caregivers of children with a rare genetic syndrome to inform how these data might be used in parent-doctor interactions and in the research setting.

METHODS: We completed a comprehensive literature review across Web of Science, PubMed, and PsycINFO using a search strategy with themes of caregivers, rare genetic disease, and social media. Studies published in English from 2005 onwards, with parents and caregivers as a cohort and a focus on rare genetic diseases, were included. In total, 159 articles were identified, which underwent a title sift followed by an abstract sift based on inclusion and exclusion criteria. Reference lists of included articles were also reviewed. A total of 12 studies were included, and a critical synthesis methodology was used to extract relevant points.

RESULTS: Most parents and caregivers use social media platforms, especially Facebook (Meta Platforms, Inc), particularly the group function. They are using social media groups as a tool for finding information related to their child’s rare genetic disease. A majority also engaged in online groups by sharing information and contributions of their own. This review highlights that caregivers are seeking three main types of support from social media: (1) medical information around diagnosis and treatments, (2) practical tips on care needs and equipment, and (3) social support, involving connection with other families who shared similar experiences. The use of social media improved accessibility to information regardless of time or geography and reduced feelings of isolation. Caregivers felt empowered in decision-making, and their interactions with health care professionals improved. Challenges include misinformation, concerns around privacy, emotional impacts of comparison, and a lack of online spaces for the rarest conditions.

CONCLUSIONS: Social media is a key tool for caregivers of children with rare genetic diseases. Addressing the associated challenges and harnessing the potential of these platforms can positively impact these families. Health care providers should consider discussing social media engagement in conversations with caregivers, and future research should focus on larger, longitudinal studies to explore the impacts of social media engagement.

PMID:41313807 | DOI:10.2196/77087

JMIR Form Res. 2025 Nov 28;9:e79534. doi: 10.2196/79534.

ABSTRACT

BACKGROUND: Generative artificial intelligence (GenAI), exemplified by ChatGPT and DeepSeek, is rapidly advancing and reshaping human-computer interaction with its growing reasoning capabilities and broad applications across fields such as medicine and education.

OBJECTIVE: This study aimed to evaluate the performance of 2 GenAI models (ie, GPT-4-turbo and DeepSeek-R1) on a standardized audiologist qualification examination in Chinese and to explore their potential applicability in audiology education and clinical training.

METHODS: The 2024 Taiwan Audiologist Qualification Examination, comprising 300 multiple-choice questions across 6 subject areas (ie, basic hearing science, behavioral audiology, electrophysiological audiology, principles and practice of hearing devices, health and rehabilitation of the auditory and balance systems, and hearing and speech communication disorders [including professional ethics]), was used to assess the performance of the 2 GenAI models. The complete answering process and reasoning paths of the models were recorded, and performance was analyzed by overall accuracy, subject-specific scores, and question-type scores. Statistical comparisons were performed at the item level using the McNemar test.

RESULTS: ChatGPT and DeepSeek achieved overall accuracies of 80.3% (241/300) and 79.3% (238/300), respectively, which are higher than the passing criterion of the Taiwan Audiologist Qualification Examination (ie, 60% correct answers). The accuracies for the 6 subject areas were 88% (44/50), 70% (35/50), 86% (43/50), 76% (38/50), 82% (41/50), and 80% (40/50) for ChatGPT and 82% (41/50), 72% (36/50), 78% (39/50), 80% (40/50), 80% (40/50), and 84% (41/50) for DeepSeek. No significant differences were found between the two models at the item level (overall P=.79), with a small effect size (accuracy difference=+1%, Cohen h=0.02, odds ratio 0.90, 95% CI 0.53-1.52) and substantial agreement (κ=0.71). ChatGPT scored highest in basic hearing science (88%), whereas DeepSeek performed the best in hearing and speech communication disorders (84%). Both models scored lowest in behavioral audiology (ChatGPT: 70% and DeepSeek: 72%). Question-type analysis revealed that both models performed well on reverse logic questions (ChatGPT: 79/95, 83%; DeepSeek: 80/95, 84%) but performed moderately on complex multiple-choice questions (ChatGPT: 9/17, 53%; DeepSeek: 11/17, 65%). However, both models performed poorly on graph-based questions (ChatGPT: 2/11, 18%; DeepSeek: 4/11, 36%).

CONCLUSIONS: Both GenAI models demonstrated strong professional knowledge and stable reasoning ability, meeting the basic requirements of clinical audiologists and suggesting their potential as supportive tools in audiology education. However, the presence of errors underscores the need for cautious use under educator supervision. Future research should explore their performance in open-ended, real-world clinical scenarios to assess practical applicability and limitations.

PMID:41313805 | DOI:10.2196/79534

JMIR Form Res. 2025 Nov 28;9:e63453. doi: 10.2196/63453.

ABSTRACT

BACKGROUND: The outbreak of the COVID-19 pandemic created significant challenges but also a unique opportunity, accelerating the evolution of higher education, including dental education. This encouraged dental education to adopt more flexible modes like blended learning.

OBJECTIVE: This study aimed to explore senior undergraduate dental students’ views on blended learning during and after the COVID-19 pandemic and to identify modifiable factors influencing their engagement.

METHODS: A survey was conducted among final-year undergraduate students at a top-ranking dental school in mainland China during the fall semesters of 2020-2021 and 2023-2024. The survey assessed satisfaction with blended learning, preferences for engagement, strengths compared to purely online or offline teaching, and factors influencing engagement during and after the pandemic.

RESULTS: Response rates were 75% (85/114) in 2020 and 73% (47/64) in 2023. Blended learning was used in 53% (26/49) of evaluated courses. High satisfaction was reported by 82% (93/114) in 2020 and 59% (38/64) in 2023, with significant differences between high- and low-satisfaction groups (P<.001). Satisfaction with specific course types and learning activities was analyzed. Factors associated with higher satisfaction were evaluated using Pearson correlation. Students acknowledged the strengths of blended learning over online- or offline-only formats. In total, 70% (80/114) in 2020 and 61% (39/64) in 2023 expressed a desire to participate in blended dental education. Factors decreasing engagement included unstable technical support (68/114, 60% in 2020 vs 26/64, 41% in 2023), poor online-offline integration (58/114, 51% vs 34/64, 53%), lack of motivation (51/114, 45% vs 24/64, 38%), and insufficient teacher-student interaction (44/114, 39% vs 20/64, 31%). Factors increasing engagement included high-quality learning materials (76/114, 67% vs 43/64, 67%) and improved technical environments (62/114, 54% vs 35/64, 55%).

CONCLUSIONS: Final-year dental students were generally satisfied with blended learning and recognized its strengths compared to purely online or offline formats, both during and after the pandemic. More efforts are required to enhance students’ potential engagement in blended learning for the future.

PMID:41313803 | DOI:10.2196/63453

Nurs Inq. 2026 Jan;33(1):e70071. doi: 10.1111/nin.70071.

ABSTRACT

Through an in-depth examination of how male nurses experience and overcome gender-based challenges in Turkey, where traditional gender norms and patriarchal values influence social perceptions and professional roles, this study aimed to advance larger conversations on workplace equality. In this respect, a qualitative descriptive design was used to conduct semi-structured interviews with 10 male nurses. The findings showed that most participants selected nursing for job security and financial stability over a career in caregiving. Some nurses advanced faster due to their perceived male authority, even though they often face social skepticism, gender-based discrimination, and isolation at work. The conflict between social acceptance and professional advancement is brought on by these dynamics. To eliminate preconceptions and attain gender equality in nursing, this study highlights the need for inclusive policies and cultural change by examining the experiences of male nurses in a conservative setting where women predominate.

PMID:41313800 | DOI:10.1111/nin.70071

J Eval Clin Pract. 2025 Dec;31(8):e70320. doi: 10.1111/jep.70320.

ABSTRACT

BACKGROUND AND OBJECTIVE: The Intolerance of Uncertainty Scale (IUS-12) is widely used in both clinical and community studies. Due to the length and inconsistent factor structure of the IUS-12, an abbreviated version consisting of five items (IUS-5) has been proposed. However, no study has examined its psychometric properties aside from the preliminary work by its developers. The current study investigated the factor structure of the IUS-5 as well as its reliability and validity.

METHOD: A sample of 315 nurses completed an online self-report questionnaire during the COVID-19 pandemic.

RESULTS: Confirmatory factor analysis of the IUS-5 suggested a deletion of one item. The final analysis supported a one-factor solution on the remaining four items (IUS-4) with a McDonald’s omega of 0.77. The validity of IUS-4 was assessed by testing its positive and negative correlations with existing related and contrary measures, respectively. Further, the validity of the IUS-4 was supported through known-group validation.

CONCLUSIONS: This is the first psychometric assessment of the IUS-5 measure of intolerance of uncertainty in a sample of nurses. Results from the current study supported a shorter measure of four items. However, more work needs to be conducted to examine the IUS-4 and IUS-5 in samples of healthcare providers with different cultural and linguistic backgrounds.

PMID:41313784 | DOI:10.1111/jep.70320

J Eval Clin Pract. 2025 Dec;31(8):e70319. doi: 10.1111/jep.70319.

ABSTRACT

INTRODUCTION: This study aimed to evaluate the effect of an interprofessional patient safety training programme on students’ attitudes and interprofessional collaboration.

METHODS: A quasi-experimental study with a nonequivalent control group was conducted at Shahid Rahnemoon Hospital, affiliated with Shahid Sadoughi University of Medical Sciences. Seventy students participated in the 2023-2024 internship courses, with 35 students in each group. Participants were assigned to two groups using cluster randomization based on their internal medicine rotation schedule. The intervention group received interprofessional education, while the control group received uniprofessional training. The intervention group engaged in case-based learning within mixed medical and nursing teams; the control group completed the same activities in separate uniprofessional groups. Two self-report questionnaires assessed attitudes towards patient safety and professionalism, as well as performance in interprofessional collaboration. Assessments occurred before the intervention, 1 month after, and 3 months after. Data analysis included descriptive and inferential statistics, specifically independent t tests, repeated measures ANOVA, and χ² tests, all conducted at a 95% confidence interval using SPSS version 26.

RESULTS: The study revealed a significant difference in both attitude (F = 19.4, p < 0.0001, η² = 0.28) and performance (F = 4.53, p = 0.013, η² = 0.060) across the three assessments.

CONCLUSION: The findings demonstrate that interprofessional training improved students’ attitudes and produced a moderate effect on performance. Sustained performance improvement may require longitudinal training. Future research should account for cultural factors and the structure of educational and healthcare systems.

PMID:41313752 | DOI:10.1111/jep.70319

BJS Open. 2025 Oct 30;9(6):zraf102. doi: 10.1093/bjsopen/zraf102.

ABSTRACT

BACKGROUND: Laparoscopic liver resection has been associated with less morbidity than, and similar global outcomes to, open liver resection. There is no robust evidence that these outcomes lead to similar clinical outcomes in patients aged over 80 years. The aim of this study was to analyse the short-term outcomes between open and laparoscopic liver resection in patients over 80 years old.

METHODS: A retrospective analysis was undertaken. The study population comprised patients aged ≥ 80 years who underwent laparoscopic or open liver resection between January 2014 and December 2019, and who presented with resectable malignant tumours. The primary outcome was postoperative morbidity, according to Dindo-Clavien grading. Cox regression models were used to compute hazard ratios and 95% confidence intervals. Propensity score matching (1 : 1) was performed to balance the two groups according to independent prognostic factors for morbidity.

RESULTS: A total of 988 patients were analysed from 34 centres (16 from Asia, 14 from Europe and 4 from America): 487 in the open group and 501 in the laparoscopic group. Independent risk factors associated with severe morbidity were the open approach (hazard ratio 1.59, 95% confidence interval 1.19 to 2.11; P < 0.001), Charlson Co-morbidity Index score > 7 (HR 1.69, 1.26 to 2.27; P < 0.001), more than one resected tumour (hazard ratio 1.55, 1.13 to 2.11; P = 0.006), major hepatectomy (hazard ratio 1.86, 1.22 to 2.83; P = 0.003), and Iwate score ≥ 7 (hazard ratio 1.43, 1.02 to 2.01; P = 0.03). Before propensity score matching, severe morbidity, length of intensive care unit stay, 90-day mortality, length of hospital stay, and readmission were better in the laparoscopic group (P < 0.050). These observations were confirmed after propensity score matching.

CONCLUSION: The laparoscopic approach is a safe procedure for elderly patients, with better morbidity and mortality outcomes than the open approach, and should be considered as a default option.

PMID:41313746 | DOI:10.1093/bjsopen/zraf102

J Foot Ankle Res. 2025 Dec;18(4):e70104. doi: 10.1002/jfa2.70104.

ABSTRACT

INTRODUCTION: Foot skin xerosis is common, particularly in older people and people with diabetes. Efficacy of emollient treatment of xerosis can be measured using skin hydration measurement devices. None of the devices currently available, however, have been explicitly assessed for their suitability for use on the skin of the foot. The plantar skin has a morphology and composition disparate from non-plantar skin sites, with a stratum corneum (SC) 16 times thicker than non-plantar skin SC. The shallow measurement depth of hydration measurement devices (0.015 mm for the Corneometer CM825) could be collecting data from incommensurate locations within plantar and non-plantar skin. The aim of this study is to examine how data collected using three hydration measurement devices with different measurement depths (Corneometer CM825, MoistureMeter D and MoistureMeter SC) correlate with tissue characteristics known to vary with skin hydration (hardness, elasticity, surface texture and patient perception) to inform their future use.

METHODS: Individuals aged 20-40 were recruited to attend the University of Salford Skin laboratory for data-collection. Following a 15-min acclimatisation period, measures were taken from four skin sites (plantar and non-plantar) using three hydration measurement devices, the SATRA STD 226 Durometer (SATRA Technology, Kettering, UK), Dermalab Elasticity probe (Cortex Technology, Hadsund, Denmark), Visioscan VC98 (Courage and Khazaka, Koln, Germany) and the Foot Skin health Questionnaire. Correlation analyses were conducted using SPSS (IBM SPSS Statistics Version 29.0.1.0).

RESULTS: Thirty-two participants were recruited (mean age ± (SD):27.9 ± 4.8; 53% female). The Corneometer CM825 (n = 20) and MoistureMeter SC (n = 32) demonstrate consistent weak-moderate strength correlations with skin elasticity, hardness and texture for both plantar and non-plantar skin. The MoistureMeter D (n = 32), however, correlated stronger with the physical characteristics of plantar skin than non-plantar skin. The only device that found a statistically significant difference between self-perceived ‘dry’ or ‘not dry’ skin was the Corneometer CM825 (Mann-Whitney U test p = 0.009).

CONCLUSION: The skin site being measured should guide the selection of a hydration measurement device. Future work should include a similar assessment using low-cost devices that are accessible to health care practitioners and expansion of the work to include xerotic skin.

PMID:41313744 | DOI:10.1002/jfa2.70104