Category: Statistics

J Family Med Prim Care. 2026 Feb;15(2):659-667. doi: 10.4103/jfmpc.jfmpc_1330_25. Epub 2026 Mar 20.

ABSTRACT

BACKGROUND: Electronic cigarettes (e-cigarettes) have become a popular alternative to traditional smoking, especially among youth. However, their impact on respiratory health is underexplored in the Saudi university context. The aim is to assess the prevalence of e-cigarette use and its association with adverse respiratory symptoms among students at Imam Mohammad Ibn Saud Islamic University (IMSIU) in Riyadh, Saudi Arabia.

METHODS: A cross-sectional online survey was conducted from August to October 2024 among 404 undergraduate students at IMSIU. A validated, bilingual questionnaire (in Arabic and English) was distributed via social media. Descriptive statistics and Pearson’s Chi-square or exact tests were used to assess associations between e-cigarette use and respiratory symptoms.

RESULTS: Among 404 respondents, 27.2% were current e-cigarette users, and 76.5% of them had used e-cigarettes in the past five days. E-cigarette use was significantly associated with adverse respiratory symptoms. Bronchitis was reported in 41.7% of nonusers who had abstained in the past 30 days, compared to 16.3% and 12.5% among users who vaped for one to five days and six to 30 days, respectively (P = .048). Chronic cough, chest congestion, wheezing, and breathlessness were significantly more prevalent among current and former users than never users (P < .05 across multiple symptoms).

CONCLUSION: E-cigarette use is prevalent among Saudi university students and is linked to increased respiratory symptoms, including bronchitis, wheezing, and fatigue. These findings highlight the urgent need for public health strategies, educational programs, and regulatory actions to address the health risks of vaping in young populations.

PMID:42023384 | PMC:PMC13098866 | DOI:10.4103/jfmpc.jfmpc_1330_25

J Family Med Prim Care. 2026 Feb;15(2):817-823. doi: 10.4103/jfmpc.jfmpc_1899_25. Epub 2026 Mar 20.

ABSTRACT

CONTEXT: Diabetes is a chronic disease leading to multiple complications. Diabetes foot led to significant morbidity and mortality. Therefore, it is recommended to do screening foot exam in patients with diabetes on annual basis.

AIM: Investigate diabetic foot screening practice and risk factors associated with foot complications.

SETTINGS AND DESIGN: This is a cross-sectional study was conducted at the Adult Endocrinology Outpatient Clinics, King Abdulaziz Medical City, Riyadh, Saudi Arabia. Methods and Material: Demographic data, clinical and laboratory variables, documentation of foot exam, and foot complications were collected from the medical records of a sample of patients with diabetes attending endocrinology/diabetes clinics from January 2020 to December 2024. Statistical Analysis: Descriptive statistics summarized participant characteristics. Associations between variables were assessed using Chi-square or Fisher’s Exact test as appropriate.

RESULTS: The study included 202 patients, 56% female. Foot exam was done in 41% of the study sample and 12% had foot complications. Around 33% of those who did not have foot complaints were examined. Males were more likely to have foot complications than females (18% vs. 7%, P = 0.017). Education about foot care provided more frequently in patients, who had foot examination (61% vs. 10%, P < 0.001). Foot complications were present in 18% of patients with other diabetes-related complications, compared with 3% of those without diabetes-related complications (P = 0.001).

CONCLUSION: Foot examination was performed in less than half of the patients. Foot complications were more in men, and those with other diabetes complications.

PMID:42023382 | PMC:PMC13098882 | DOI:10.4103/jfmpc.jfmpc_1899_25

J Family Med Prim Care. 2026 Feb;15(2):961-967. doi: 10.4103/jfmpc.jfmpc_868_25. Epub 2026 Mar 20.

ABSTRACT

BACKGROUND: Youth in India face increasing vulnerability to hypertension, obesity, anxiety, and depression, necessitating urgent, and integrated health interventions.

METHODS: This cross-sectional survey sampled 4,852 youth aged 15-30 using stratified cluster sampling with probability proportionate to size (PPS). Data on depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), non-suicidal self-injury (NSSI), suicidal ideation, hypertension, obesity, and sleep issues were collected through standardized tools via a smartphone application. Data analysis was conducted using IBM SPSS Statistics Version 30.0.1.1, with weighted estimates accounting for sampling probabilities.

RESULTS: Findings revealed 11.5% of youth screened positive for depression, 10.9% for anxiety, and 9.5% for hypertension. Obesity was more prevalent among females (24.4%), while underweight was common in males (31.2%). Poor sleep quality affected 26.9%, with higher rates observed in urban areas. Additionally, 2.4% reported NSSI. The study highlights alarming health concerns among youth, with 1 in 10 experiencing depression, anxiety, and cell phone addiction. Elevated risks of suicidal behaviour, sleep issues, and non-communicable diseases were evident. Targeted interventions, psychosocial support, and stronger health system responses are essential to mitigate these risks.

CONCLUSION: Youth face overlapping health challenges, including mental disorders, obesity, hypertension, and injuries. Prioritizing youth-focused interventions and stronger collaboration between healthcare and education systems is crucial to address these issues.

PMID:42023380 | PMC:PMC13098857 | DOI:10.4103/jfmpc.jfmpc_868_25

J Family Med Prim Care. 2026 Feb;15(2):530-539. doi: 10.4103/jfmpc.jfmpc_1142_25. Epub 2026 Mar 20.

ABSTRACT

Patients diagnosed with cancer remain at risk of developing subsequent primary malignancies due to genetic predisposition, environmental factors, and improved survival associated with advances in diagnosis and treatment. Understanding the pattern of dual primary malignancies is essential, yet evidence from low-resource regions such as Kashmir is scarce. This retrospective study analyses the frequency, clinical patterns, and histopathological profiles of second primary malignancies (SPMs) among patients treated at a tertiary cancer centre in northern India. Medical records of 5,731 patients seen at the Department of Radiation Oncology, Government Medical College, Srinagar, between January 2020 and December 2024 were reviewed using Warren and Gates criteria. Thirty-five patients were identified with SPMs, yielding an incidence of 0.611%. Of these, 60% were synchronous and 40% metachronous, occurring 10 months to 19 years after the first tumour. The median age at initial diagnosis was 58 years, with peak incidence in the sixth and seventh decades. Males predominated overall, although females were more likely to present with synchronous cancers, while males formed the majority of metachronous cases. Gastrointestinal cancers were the most common primary tumours, followed by breast and genitourinary malignancies, and this distribution was largely mirrored in secondary cancers. Notably, over 80% of patients had at least one gastrointestinal tumour, and more than half of breast cancer patients developed thyroid cancer as the second primary. Most patients received curative treatment for both malignancies. The findings highlight the need for sustained clinical vigilance and long-term follow-up to enable early detection and optimal management of SPMs.

PMID:42023376 | PMC:PMC13098840 | DOI:10.4103/jfmpc.jfmpc_1142_25

J Family Med Prim Care. 2026 Feb;15(2):793-800. doi: 10.4103/jfmpc.jfmpc_1800_25. Epub 2026 Mar 20.

ABSTRACT

INTRODUCTION: Standard evaluation protocols for mild traumatic brain injury (mTBI), the same as concussion, support cost-effective care and successful outcomes. While clinical guidelines endorse these in young populations (ages <65), evidence is limited for older adults (ages ≥65), particularly regarding self-reported measures and provocation testing. This study aims to assess mTBI-specific protocols, including provocation tests, in older adults with and without mTBI.

METHODS: This pilot study was conducted in an academic research laboratory, in which 13 community members aged ≥65 with or without a history of mTBI were enrolled. Participants completed: 1) a participant-reported Health History Form, a Patient-Specific Functional Scale (PSFS), and a Post Concussion Symptom Scale (PCSS); and 2) physical provocation testing using the Motion Sensitivity Quotient (MSQ) and a modified submaximal protocol of the Buffalo Concussion Bike Test (BCBT-M). Descriptive and Mann-Whitney U tests were used for statistical analysis.

RESULTS: This study was safely completed by all participants (n = 13) in one session. Findings (95%CI, P < 0.05) included no differences between the group (non-mTBI = 9, mTBI = 4) median (Mdn) in age (Mdn = 73; U = 17; P = 0.940), and BCBT-M level of completion (Mdn = 7; 5.3-8.5; U = 13.5; P = 0.472). The PSFS (Mdn = 6.3; 5.8-7.1; U = 4.0; P = 0.034), the PCSS (Mdn = 42.5; U = 0.00; P = 0.003), and the MSQ (Mdn = 16.0; U = 3.0; P = 0.020) had significant differences between mTBI and non-mTBI groups.

CONCLUSIONS: This pilot study demonstrated that older adults with and without mTBI fully engaged in standard guidelines of self-reported and physical provocation measures, with differences between the mTBI and non-mTBI groups. These early findings may inform baseline status among older adults with mTBI.

PMID:42023375 | PMC:PMC13098812 | DOI:10.4103/jfmpc.jfmpc_1800_25

J Family Med Prim Care. 2026 Feb;15(2):586-591. doi: 10.4103/jfmpc.jfmpc_1139_25. Epub 2026 Mar 20.

ABSTRACT

CONTEXT: Health literacy is considered as a tool in public health to reduce health disparities. This is considered an important issue among adolescents since investing during these formative years will result in informed decision making and healthier lifestyle choices in adulthood.

AIMS: To assess the health literacy level and associated factors among rural adolescents in Pondicherry.

SETTINGS AND DESIGN: A community-based cross-sectional study was conducted in the rural field practice area of a private medical college.

METHODS AND MATERIAL: A cross-sectional study was conducted among 250 rural adolescents residing in the rural field practice area of a private medical college using simple random sampling. Modified HLS-EU-Q16 (Short version of the European Health literacy survey) questionnaire was used to assess health literacy.

STATISTICAL ANALYSIS USED: Chi-square test and logistic regression.

RESULTS: The mean age of the study participants was 14.33 ± 2.81. The prevalence of inadequate health literacy was 82%. There was significant association between the health literacy scores and socioeconomic status (P = 0.004), father’s occupation (P < 0.001), education of the parents (P < 0.001), and school class of the children (P < 0.001). There was a significant increase in health literacy scores with an increase in age.

CONCLUSIONS: This study has revealed that the majority of adolescents in rural areas of Pondicherry have inadequate health literacy. Therefore, targeted interventions are required to empower adolescents to make informed decisions regarding their health for them to lead healthier lives.

PMID:42023371 | PMC:PMC13098801 | DOI:10.4103/jfmpc.jfmpc_1139_25

Optom Vis Sci. 2026 Mar;103(3):e70039. doi: 10.1002/ovs2.70039.

ABSTRACT

PURPOSE: Currently, there are neither guidelines for school-based vision program operations nor a registry of programs that exist in the United States. We aim to describe the characteristics of school-based vision programs across the United States through a survey.

METHODS: We identified 10 organizations that operated one or more school-based vision programs during the 2022-2023 school year. We developed and distributed an online survey form to collect information on program demographics, program components, and protocols for vision screenings and eye exams, as well as procedures for obtaining consent, dispensing glasses, and funding resources. Organizations were asked to complete a survey for each school district in which they operated, which we defined as an individual program. Programs that did not complete the survey were excluded. We used descriptive statistics to describe program characteristics. We compared grade levels that received vision screening by school-based vision programs and their respective screening mandate in the state where the programs operated.

RESULTS: Seven organizations participated and provided data about 184 unique school-based vision programs. These programs operated in 19 states and the District of Columbia. All 184 programs provided vision screenings, eye exams, and eyeglasses. 94.6% of programs included instrument-based screening, with 46.7% using it exclusively. School-based vision programs most frequently screened elementary school grades. For eye exams, 81% of programs utilized opt-out consent; 21.7% of programs included dilation. Vision screenings were mostly conducted by program staff (164/184, 89.1%), and eye exams were performed by optometrists (183/184, 99.5%). Nine programs (5.0%) reported providing additional care beyond eyeglasses provision, while 135 (73.4%) reported having an established relationship with community eye care providers for students referred for additional evaluation and care.

CONCLUSIONS: Many school-based vision programs operate in the United States. These programs focus on vision screening, eye exams, and eyeglasses provision. Establishing a registry of programs would help to disseminate lessons learned and track outcomes data. Future programs will benefit from guidelines to ensure they are operating according to best practices.

PMID:42020923 | DOI:10.1002/ovs2.70039

Geroscience. 2026 Apr 22. doi: 10.1007/s11357-026-02212-z. Online ahead of print.

ABSTRACT

Age is a well-known risk factor to develop severe viral respiratory infections, including severe COVID-19. This study aimed to identify the biological alterations linked to severe disease in elderly patients with COVID-19. For this purpose, we employed a derivation cohort with 450 SARS-CoV-2 infected and unvaccinated patients admitted to hospital wards and a validation cohort with 244 SARS-CoV-2 infected and unvaccinated patients admitted to hospital Intensive Care Unit (ICU). Twenty-one biomarkers were measured in plasma samples from patients upon admission, including SARS-CoV-2 RNA, IgG antibodies, and protein biomarkers. Patient cohorts were divided into two groups based on age: adult (≤ 70 years old) and elderly (> 70 years old) patients. In the derivation cohort, 90-day mortality rate observed in the adult group was 6.0% whereas in the elderly group it rises to 31.6%, same trend was noticed regarding the validation cohort, with 11.2% versus 40.3% 90-day mortality rates for adult and elderly groups, respectively. The machine-learning framework XGBoost-SHAP, fed with the plasma biomarkers information, was used to profile an age-related host response to SARS-CoV-2 infection. Based on SHAP plot, elderly patients had a strong thrombo-inflammatory response profile (significantly elevated plasma levels of: lipocalin-2, endothelin-1, D-dimer) combined with deficient adaptive and cytotoxic antiviral responses. Model performance evaluated with the validation cohort confirmed the robustness and generalizability of the model developed (AUC = 0.710). In conclusion, the machine learning approach we built allowed us to identify the presence of a deranged host response in elderly patients with COVID-19 linked to poor viral control and increased mortality.

PMID:42020919 | DOI:10.1007/s11357-026-02212-z

Nat Biotechnol. 2026 Apr 22. doi: 10.1038/s41587-026-03084-6. Online ahead of print.

ABSTRACT

Single-cell RNA sequencing (scRNA-seq) analyses typically focus on alignment and differential gene expression, being blind to other transcriptome variation. Here we present sc-SPLASH for statistics-first, reference-free discovery on barcoded scRNA-seq and spatial transcriptomics; its independent BKC submodule optimizes barcoded data preprocessing and is approximately 50-fold faster than UMI-tools. sc-SPLASH discovers secreted repeat proteins in immune-like cells of sponge (Spongilla; missing from the reference) and tunicate (Ciona).

PMID:42020848 | DOI:10.1038/s41587-026-03084-6

Support Care Cancer. 2026 Apr 23;34(5):458. doi: 10.1007/s00520-026-10645-7.

ABSTRACT

PURPOSE: Cancer diagnosed during pregnancy presents unique challenges, requiring women to navigate treatment alongside pregnancy and early parenthood. While clinical aspects are well studied, the psychosocial impact on survivorship remains underexplored. This study examined the lived experiences of women diagnosed during pregnancy, focusing on emotional, psychological and practical challenges from diagnosis through survivorship.

METHODS: A qualitative study was conducted using interview data from 20 women in the UK diagnosed with cancer during pregnancy. Participants were recruited via Mummy’s Star, a charity supporting individuals affected by cancer in pregnancy. Interviews were thematically analysed using template analysis, focusing on decision-making, psychosocial burden and support needs.

RESULTS: Six inter-related themes were identified: (1) managing cancer with uncertainty, women reported distress due to delayed investigations and treatment adjustments during pregnancy; (2) ethical decision-making, emotionally charged choices around treatment, birth and feeding were made with limited or conflicting information; (3) balancing cancer and its treatment with pregnancy and family life, early parenting was disrupted; (4) work disruption and financial strain, treatment-related costs and lost income caused hardship; (5) emotional impact of diagnosis and treatment, including lasting psychological effects; and (6) Coping and support, guilt, fear of recurrence and unmet support needs persisted post-treatment.

CONCLUSIONS: Women diagnosed with cancer in pregnancy face profound, long-term emotional and financial challenges. Fragmented care and inadequate support exacerbate these difficulties. Integrated multidisciplinary care is essential to improving survivorship.

PMID:42020845 | DOI:10.1007/s00520-026-10645-7