Category: Statistics

J Orthop Surg Res. 2025 Dec 2. doi: 10.1186/s13018-025-06547-9. Online ahead of print.

ABSTRACT

BACKGROUND: Humeral lateral condyle fractures are common pediatric elbow injuries, with Jakob type III representing the most severe form. While open reduction and internal fixation is the standard treatment, consensus is lacking on the optimal fixation method. Inadequate fixation can lead to serious complications. The efficacy of absorbable internal fixation materials remains debated. This study aimed to evaluate the outcomes of different internal fixation materials for treating these fractures in children.

METHODS: A retrospective review was conducted on 51 children (39 male, 12 female; mean age 4.8 years) with Jakob type III fractures treated surgically between January 2020 and December 2023. Patients were divided into three groups based on fixation: Kirschner wires (Group A), metal hollow screws (Group B), and absorbable hollow screws (Group C). Statistical significance was set at P < 0.05.

RESULTS: The average hospitalization was 3.8 ± 0.2 days, median operation time was 60 min, and mean follow-up was 25.2 ± 12.1 months. No significant differences were found among groups regarding gender, age, postoperative plaster fixation time, final carrying angle, elbow varus deformity, lateral condyle protrusion, Mayo elbow score, or satisfaction. However, significant differences existed in hospital stay, operation time, time to implant removal, total hospitalization costs, and material costs. Group B had a significantly longer hospital stay (mean 4.9 days) compared to Groups A and C (3.5 and 3.4 days). Operative time was longest in Group A (mean 60 min vs. 45 and 47 min). Implant removal time was significantly longer in Group B (median 93 days vs. 34 days in Group A). Group B had the highest total hospitalization costs (mean $2623.0), while Group C had the highest material costs (mean $996.5). Group A had the lowest costs in both categories.

CONCLUSION: Different internal fixation materials achieved comparable therapeutic effects for pediatric Jakob type III lateral condylar fractures. Absorbable screws provided the advantage of eliminating the need for a second surgery for removal.

PMID:41327221 | DOI:10.1186/s13018-025-06547-9

Malar J. 2025 Dec 1. doi: 10.1186/s12936-025-05699-7. Online ahead of print.

ABSTRACT

BACKGROUND: Recent epidemiological data indicate that 30-50% of all malaria infections are asymptomatic, with parasite densities below the limit of detection of standard diagnostic tests. A highly sensitive rapid diagnostic test (hsRDT) was developed to detect these low-density Plasmodium falciparum infections. This study evaluated the diagnostic performance of both hsRDTs and conventional RDTs (cRDT) in reactive case detection (RACD) activities among individuals (contacts) living and/or working in proximity to an “index case” in Ann Township in Rakhine State, Myanmar.

METHODS: This prospective community-based RACD study was conducted in 2017-2018 among residents aged at least five years old in 50 villages of Ann Township. We assessed the sensitivity, specificity, and positive and negative predictive values of both a hsRDT (NxTek™ Eliminate Malaria Ag P.f) and a cRDT (SD Malaria Ag P.f/P.v) using an ultra-sensitive polymerase chain reaction (usPCR) diagnostic assay as the gold standard.

RESULTS: A total of 1,990 participants, all contacts of 51 index P. falciparum cases, were recruited. Among them, 28 (1.4%) tested positive by cRDT, 78 (3.9%) by hsRDT, and 171 (8.6%) by usPCR for P. falciparum mono-infection. The sensitivity and specificity of the hsRDT were 27.9% (95% CI 18.2-39.6%) and 98.8% (95% CI 98.2-99.4%), respectively, while the sensitivity and specificity of the cRDT were 13.7% (95% CI 7.6-20.7%) and 100% (95% CI 100-100%), respectively. The differences in sensitivity and specificity between hsRDT and cRDT were statistically significant (p < 0.01 for both).

CONCLUSIONS: Although hsRDTs identified more infected contacts than cRDTs during reactive case detection, they have low overall sensitivity compared to usPCR. In resource-limited settings, such as Myanmar, the use of hsRDTs in RACD should be guided by careful consideration of their field feasibility and cost-effectiveness to support malaria elimination efforts. (285 words).

PMID:41327219 | DOI:10.1186/s12936-025-05699-7

BMC Public Health. 2025 Dec 1. doi: 10.1186/s12889-025-25783-6. Online ahead of print.

NO ABSTRACT

PMID:41327211 | DOI:10.1186/s12889-025-25783-6

BMC Pulm Med. 2025 Dec 1;25(1):550. doi: 10.1186/s12890-025-04030-z.

ABSTRACT

BACKGROUND: Computed tomography (CT)-based quantification of coronavirus disease 2019 (COVID-19) pneumonia is widely performed, and total pneumonia volume, ground-glass opacity (GGO), and consolidation affect disease severity. However, there is insufficient information on how consolidation to GGO (C/G) ratio correlates with clinical characteristics including disease severity and complications in COVID-19 patients.

METHODS: This retrospective cohort study included 1,194 hospitalized patients with COVID-19 from four member hospitals of the Japan COVID-19 Task Force. Critical outcomes were defined as conditions requiring high-flow oxygen or invasive mechanical ventilation, or death. Patients were divided into two groups based on %pneumonia (percentage of pneumonia volume divided by total lung volume) using receiver operating characteristic curve, and those with high %pneumonia were further divided into two groups based on C/G ratio. Critical outcomes and complications were then compared between high and low C/G ratio groups.

RESULTS: The optimal cutoff value of %pneumonia to predict critical outcomes was 17.1%, classifying the included patients into low (Group 1, n = 900) and high (n = 294) %pneumonia groups. The optimal cutoff value of C/G ratio was 0.202, classifying patients in the high %pneumonia group into two groups: low (Group 2, n = 192) and high C/G (Group 3, n = 102) ratio groups. The incidence of critical outcomes was stair-step high in all three groups (2.1%, 21.4%, and 37.3%, respectively). Multivariable analysis revealed an independent relationship between C/G ratio and critical outcomes from other known risk factors (adjusted odds ratio: 1.92, 95% confidential interval: 1.03-3.59, P = 0.040). Group 3 also showed significantly higher serum C-reactive protein (Group 1: 2.96 mg/dL, Group 2: 8.90 mg/dL, Group 3: 11.4 mg/dL) and procalcitonin (Group 1: 0.16 ng/mL, Group 2: 0.25 ng/mL, Group 3: 1.19 ng/mL) levels and incidence of bacterial infection (Group 1: 5.6%, Group 2: 10.4%, Group 3: 20.3%), compared with other groups.

CONCLUSIONS: CT-density analysis of COVID-19 pneumonia in a large patient population showed that C/G ratio was a significant predictor of critical outcomes and useful for prognosis evaluation.

PMID:41327196 | DOI:10.1186/s12890-025-04030-z

BMC Med Educ. 2025 Dec 1;25(1):1666. doi: 10.1186/s12909-025-08167-7.

ABSTRACT

BACKGROUND: The COVID-19 pandemic significantly impacted all aspects of human life, including education. Medical universities faced various challenges, including the need for virtual education and changes in educational systems, and were forced to adapt their teaching methods. The goal of this study is to explore the lessons learned from the COVID-19 pandemic in educating medical students and to design a virtual education framework at Tehran University of Medical Sciences.

METHODS: This is a sequential exploratory mixed-method study, consisting of qualitative and quantitative phases. In the qualitative phase, in-depth semi-structured interviews were conducted with 25 faculty members from Tehran University of Medical Sciences. In the so-called “quantitative” phase, a literature review and expert panel were employed; these methods are not inherently quantitative (i.e., they do not involve statistical analysis of numerical data). It is recommended to replace the term “quantitative” with a more accurate descriptor, such as “literature synthesis and expert consensus,” or describe this phase differently. The findings from both phases were subsequently used to design the virtual education framework.

RESULTS: The study revealed that using modern technologies for virtual education in medical universities is crucial and requires strengthening infrastructure. Furthermore, clinical education in a virtual format presents significant challenges and the need for developing blended learning methods. Ultimately, the virtual education framework at Tehran University of Medical Sciences was designed and developed. The virtual education system formulated here focuses on three pillars: infrastructure development, faculty empowerment, and establishing blended learning practices. A short description of the pillars here provides readers with a clearer sense of the framework’s structure and priorities.

CONCLUSION: The COVID-19 pandemic provided an opportunity to assess and improve virtual education at medical universities. Given the successes achieved, it is essential to develop the infrastructure for virtual education and establish clear standards for it so that blended and electronic education can be implemented more effectively alongside in-person education in the future. To address the challenges in clinical education highlighted by the study, implementing blended learning approaches emerges as a key strategy for improving virtual and in-person medical education.

PMID:41327193 | DOI:10.1186/s12909-025-08167-7

BMC Psychiatry. 2025 Dec 1. doi: 10.1186/s12888-025-07675-6. Online ahead of print.

ABSTRACT

BACKGROUND: Attention deficit hyperactivity disorder is a neurodevelopmental disorder marked by a persistent pattern of symptoms, including inattention, hyperactivity, and impulsivity. Children and adolescents with attention deficit hyperactivity disorder may struggle with low self-esteem, troubled relationships, and poor performance in school. Adolescents with attention deficit hyperactivity disorder further have a higher risk of anxiety and depression and increasing risky behaviors, such as substance use. Attention deficit hyperactivity disorder is one of the most common neurodevelopmental disorders in children, affecting approximately 5-8%, primarily boys, and often persisting into adulthood.

OBJECTIVE: The study aimed to assess the prevalence of attention deficit hyperactivity disorder and associated factors among children and adolescents in Borama town, Somaliland, in 2024.

METHODS: A community-based cross-sectional study design was employed involving 422 children and adolescents. The data was collected through face-to-face interviews using a structured questionnaire between April and June 2024. A multistage sampling approach was applied to recruit the study participants. The data was entered into Epi Data 4.6, then exported to SPSS 26.0 for analysis. Binary logistic regression analysis was performed to identify predictors, with statistical significance declared at p-value < 0.05. The presence of attention deficit hyperactivity disorder in children and adolescents was evaluated using the Vanderbilt Attention Deficit Hyperactivity Disorder Diagnostic Parent Rating Scale.

RESULT: The prevalence of attention deficit hyperactivity disorder among children and adolescents in Borama town, Somaliland, was found to be 13.7%. The findings indicated that younger children, aged 6 to 11 years [AOR = 2.2, 95% CI (1.2; 4.15)], single-parent family structures [AOR = 2.4, 95% CI (1.3; 4.6)], maternal health status during pregnancy [AOR = 3.3, 95% CI (1.4; 8.19)], and a family history of mental illness [AOR = 4.1, 95% CI (1.7; 9.6)] were significantly associated with attention deficit hyperactivity disorder.

CONCLUSION: The study revealed a relatively high prevalence of attention deficit hyperactivity disorder among children and adolescents in Borama town. Being young (aged 6 to 11 years), single-parent family structure, maternal health problems during pregnancy, and familial history of mental illness were identified as significant risk factors. Strengthening community support systems, improving maternal healthcare services, and providing mental health support may help reduce the risk factors associated with ADHD in the society.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:41327178 | DOI:10.1186/s12888-025-07675-6

BMC Public Health. 2025 Dec 1. doi: 10.1186/s12889-025-25539-2. Online ahead of print.

ABSTRACT

BACKGROUND: Disability-adjusted life years (DALYs) are widely used to prioritize public funding for science, technology and innovation (ST&I) in health. In universal systems such as Brazil’s Unified Health System (SUS), however, allocation decisions may also incorporate broader political and social considerations.

OBJECTIVE: To assess whether Brazilian public ST&I funding for neglected tropical diseases (NTDs) and Zika (2006-2019) aligned with disease burden measured by DALYs, and to examine how observed funding patterns reflect political commitments to health equity and innovation in the Global South.

METHODS: Cross-sectional analysis of national research calls (2006-2019). Actual disbursements were compared with expected values proportional to the DALY distribution for each disease. Associations between DALYs and funding were evaluated using Spearman correlation.

RESULTS: High-burden diseases-including tuberculosis, Chagas disease and schistosomiasis-received less funding than expected, while Zika and leprosy obtained disproportionately higher investments. Overall, the correlation between DALYs and funding was weak and not statistically significant; a significant negative trend emerged within a subgroup of major NTDs.

CONCLUSIONS: DALYs did not operate as the sole criterion guiding Brazil’s ST&I funding. Political urgency, social mobilization and SUS operational priorities influenced allocation, indicating that ST&I functions not only as a technical instrument but also as a political strategy to reduce health inequities and foster context‑appropriate innovation for vulnerable populations in the Global South.

PMID:41327158 | DOI:10.1186/s12889-025-25539-2

BMC Psychiatry. 2025 Dec 1. doi: 10.1186/s12888-025-07654-x. Online ahead of print.

ABSTRACT

BACKGROUND: Although the associations between intimate partner violence and women’s adverse mental health are widely recognized, inconsistencies persist concerning specific risk factors, forms of IPV, and related mental disorders. Women often hesitate to disclose their experience without proactive and sensitive questioning from healthcare professionals. The aim of this review is to summarize existing evidence on the effects of IPV experience on mental disorders and associated factors among women through a synthesis of systematic reviews and meta-analyses of quantitative studies.

METHODS: The review adhered to a standardized protocol based on the Preferred Reporting Items for Overview of Systematic Reviews and Meta-Analyses (PRIOSMA) guidelines. We searched databases, including Medline/PubMed, the Cochrane Library, and HINARY, from inception to April 15, 2025. Only English-language articles were included. The updated A MeaSurement Tool to Assess the Methodological Quality of Systematic Reviews (AMSTAR 2) was employed. Two independent reviewers assessed the methodological quality of the studies.

RESULTS: Seventeen reviews were included from the initial identification of 1,167 articles. The qualitative synthesis revealed a significant association between intimate partner violence and common mental disorders, including depressive disorder, anxiety disorder, panic disorder, posttraumatic stress disorder (PTSD), and perinatal disorders. The methodological quality of the included reviews ranged from low to critically low.

CONCLUSION: Qualitative synthesis revealed a significant association between IPV and adverse mental health outcomes in women. However, given that the methodological quality of the included reviews ranged from low to critically low, these findings must be interpreted with caution.

PROTOCOL REGISTRATION: The protocol was registered on PROSPERO under registration number CRD42025643126.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:41327156 | DOI:10.1186/s12888-025-07654-x

BMC Oral Health. 2025 Dec 1;25(1):1861. doi: 10.1186/s12903-025-07213-6.

ABSTRACT

BACKGROUND: Hypohyperdontia, a rare numeric dental anomaly combining tooth agenesis and supernumerary teeth (ST), impacts aesthetics and function. Limited epidemiological data exist in Chinese populations. This study investigates its prevalence and distribution.

METHODS: This retrospective study analyzed 10,112 panoramic radiographs(PRs)(August 2021 ~ December 2023) to assess hypohyperdontia prevalence, distribution and associated characteristics, including patient demographics, dentition type, ST (number, morphology, location, orientation), and tooth agenesis patterns (number, location). The hypohyperdontia patients were stratified into pre- and post-eruption groups based on permanent anterior/supernumerary tooth eruption status. All data were presented as counts(n) and percentage (%), and statistically analysed using logistic regression and Chi-square test.

RESULTS: Prevalence was 0.66% (67/10112; M: F 42:25) without gender difference (OR = 1.28, 95% CI: 0.78-2.11, p = 0.329). Most cases were diagnosed in the mixed dentition (mean age: 6.97 years), with 85.07% (57/67) affecting both jaws. The anteroposterior type (58.21%, 39/67) predominated over anterior type (41.79%, 28/67). Eruption-wise, 10 and 57 cases were pre- and post-eruption, respectively. ST were predominantly single (73.13%, 49/67), conical (56/85), and vertically/inverted-oriented (38/85 and 34/85, respectively), with premaxillary predilection (p = 0.001). Single-tooth agenesis was most common (38/67 cases; total missing teeth = 115). Mandibular agenesis was more frequent (p = 0.001), primarily affecting second premolars (64/115), followed by lateral incisors (26/115), without side preference (p = 0.641).

CONCLUSIONS: Hypohyperdontia prevalence is 0.66%, within the global range (0.002% to 3.1%) with no gender bias. Typically diagnosed in mixed dentition, most cases are bimaxillary involvement. Isolated posterior involvement is rare. ST and agenesis patterns mirror isolated anomalies. Early panoramic screening in suspected cases facilitates timely multidisciplinary management to prevent functional and aesthetic complications.

PMID:41327153 | DOI:10.1186/s12903-025-07213-6

BMC Pediatr. 2025 Dec 1;25(1):975. doi: 10.1186/s12887-025-06050-4.

ABSTRACT

BACKGROUND: Children born to HIV-positive mothers are at increased risk for a range of neonatal complications that may negatively impact auditory development. In low- and middle-income countries (LMICs) like South Africa, where both HIV exposure and adverse neonatal outcomes are prevalent, understanding the relationship between early clinical risk factors and hearing loss is critical for informing early hearing detection and intervention (EHDI) strategies.

METHODS: This study aimed to examine the association between neonatal complications-such as prematurity, low birth weight, hyperbilirubinemia, neonatal intensive care unit (NICU) admission, and ototoxic drug exposure-and hearing outcomes in children born to HIV-positive mothers in a South African tertiary care setting. A retrospective secondary data analysis was conducted on medical records of 85 children aged 0-5 years who were born to HIV-positive mothers and assessed at an Academic Hospital in Johannesburg, South Africa. Demographic, clinical, and audiological data were extracted and analysed using descriptive statistics, chi-square tests, and logistic regression to identify significant associations and predictors of hearing loss.

RESULTS: The cohort demonstrated a balanced gender distribution, with most children between 2 and 5 years old. Low birth weight (58.8%), prematurity (44.7%), and NICU admission (49.4%) were the most prevalent neonatal risk factors. Hearing loss was identified in 17.6% of the sample, with sensorineural hearing loss (SNHL) accounting for the majority of cases (11.8%). Significant associations were found between hearing loss and prematurity (p = 0.042), low birth weight (p = 0.031), hyperbilirubinemia (p = 0.016), NICU admission (p = 0.028), and ototoxic drug exposure (p = 0.012). Logistic regression analysis revealed that hyperbilirubinemia (OR = 4.12, p = 0.005) and ototoxic drug exposure (OR = 5.19, p = 0.002) were the strongest independent predictors of hearing loss.

CONCLUSIONS: Neonatal complications are key contributors to hearing loss among HIV-exposed children in South Africa. These findings, particularly the identification of hyperbilirubinemia and ototoxic exposure as the strongest predictors, highlight the urgent need for risk-based EHDI approaches, routine audiological follow-up for at-risk neonates, and integration of hearing health services into existing maternal and child health frameworks. Strengthening early identification efforts in LMICs is essential to reducing preventable hearing loss and promoting equitable developmental outcomes.

PMID:41327152 | DOI:10.1186/s12887-025-06050-4