Category: Statistics

GE Port J Gastroenterol. 2026 Jan 8. doi: 10.1159/000549922. Online ahead of print.

ABSTRACT

INTRODUCTION: Inflammatory bowel disease (IBD) care demands a multidisciplinary approach and adherence to quality indicators to optimize patient outcomes. This study aimed to evaluate the structure and quality of IBD care in Portugal, exploring the perceptions of gastroenterologists and identifying areas for improvement.

METHODS: A cross-sectional online survey was conducted among Portuguese gastroenterologists between January and February 2024. The questionnaire assessed IBD care organization, processes and perceptions regarding quality indicators. Responses from 57 participants were analyzed using descriptive and inferential statistics.

RESULTS: Most participants (74%) work in public hospitals, with 89.5% providing specialized IBD consultations. Multidisciplinary teams are present in 58% of the participants’ centers. In addition to gastroenterologists, IBD multidisciplinary teams include mostly surgeons (88%) and radiologists (62%). Waiting times for nonurgent IBD-specific consultations varied, with 61% of the respondents reporting delays exceeding 1 month. More than two-thirds reported waiting times for nonurgent endoscopic and cross-sectional exams longer than 3 months. Psychological and nutritional assessments were underprioritized, with only 6% and 37% of centers routinely performing these evaluations, respectively. Only 42% of participants answered that their centers keep updated patient registries and 16% used quality indicators known to all team members. Most responders (76%) reported research activity in their units, mainly through national multicenter (88.1%) and observational studies (71%). Units with multidisciplinary teams were significantly more likely to follow structured protocols, provide timely care, and adopt advanced diagnostic tools. Most participants acknowledge the importance of quality indicators, classifying them as mandatory or relevant, with 96% supporting the auditing of IBD centers.

CONCLUSIONS: This study highlights strengths in the Portuguese IBD care, including multidisciplinary collaboration, research engagement, and widespread awareness of quality indicators. However, challenges remain, such as delays in specialized IBD consultations, endoscopic and cross-sectional exams, and inadequate scheduling for other consultations. Moreover, gaps persist in integrating psychological and nutritional care and maintaining updated patient registries. Expanding multidisciplinary teams and strengthening quality monitoring are critical for improving care outcomes for Portuguese IBD patients.

PMID:41669687 | PMC:PMC12885556 | DOI:10.1159/000549922

BMC Med Educ. 2026 Feb 10. doi: 10.1186/s12909-026-08786-8. Online ahead of print.

ABSTRACT

BACKGROUND: Burnout among medical students is a widespread problem that threatens academic performance, well-being, and professional identity. The educational environment is crucial for shaping students’ psychological resilience regarding burnout. The current study investigates how perceptions of the educational environment and reflective self-perceptions are associated with burnout symptoms among students enrolled in three different language medical programs.

METHODS: A cross-sectional, self-report study was conducted among 731 medical students across three language programs at a Hungarian university. Participants completed the Maslach Burnout Inventory-Student Survey (MBI-SS) and the Dundee Ready Education Environment Measure (DREEM). Language program, age, sex and study semester were also included as variables into the model and statistical analyses to check for potential meaningful differences.

RESULTS: Significant differences in burnout dimensions were observed across language groups, with international students reporting higher emotional exhaustion and lower academic efficacy. All five DREEM subscales showed moderate correlations with burnout dimensions. Regression analyses identified social self-perception as a consistent negative predictor of exhaustion and cynicism, and academic self-perception as a significant positive predictor of academic efficacy. Reflective self-perception mechanisms were found to function as protective factors across all models.

CONCLUSIONS: Medical students’ burnout is significantly linked to their perceptions of both academic and social aspects of their competences related to their educational environment. Enhancing self-reflective capacities and fostering a socially supportive learning climate may help reduce burnout risk, particularly among international and female students.

PMID:41668171 | DOI:10.1186/s12909-026-08786-8

BMC Med Educ. 2026 Feb 10. doi: 10.1186/s12909-026-08770-2. Online ahead of print.

ABSTRACT

BACKGROUND: Academic stress is a dynamic cognitive appraisal process in which students perceive educational demands as exceeding their coping resources This perception is associated with emotional and behavioral responses that relate to well-being and perceived academic stress.

OBJECTIVE: This study aimed to identify the main academic stressors in medical students and to examine their relationship with sleep quality, physical activity, and gender, specifically focusing on perceived stress rather than academic grades.

METHODS: An analytical cross-sectional study was conducted including sociodemographic questions and validated instruments: the Pittsburgh Sleep Quality Index (PSQI), the Academic Stress Questionnaire (E-CEA), and the short form of the International Physical Activity Questionnaire (IPAQ). Logistic regression analyses were performed.

RESULTS: Significant gender-related differences were found in stress responses and coping strategies. Female students reported higher levels of academic overload (p = 0.004), emotional demands, and exam-related anxiety (p = 0.005), as well as differences in exam preparation strategies (p = 0.037). Regarding lifestyle factors, poor sleep quality was identified as a significant factor associated with higher stress levels (OR = 1.12; 95% CI: 1.03-1.22).

CONCLUSION: Academic overload and exam anxiety were identified as significant factors associated with medical students´ well-being. Female students showed a higher probability of reporting stress (OR = 5.56). These findings highlight the need for gender-sensitive psychoeducational interventions that promote healthy sleep habits and stress management alongside physical activity recommendations.

PMID:41668169 | DOI:10.1186/s12909-026-08770-2

Crit Care. 2026 Feb 10. doi: 10.1186/s13054-026-05882-5. Online ahead of print.

NO ABSTRACT

PMID:41668159 | DOI:10.1186/s13054-026-05882-5

Ann N Y Acad Sci. 2026 Feb;1556(1):e70211. doi: 10.1111/nyas.70211.

ABSTRACT

Panic-buying incidents triggered by public emergencies are often accompanied by panic emotions, which are prone to spread in both time and space, causing serious negative impacts on social stability and economic development. Therefore, we took stimuli-organism-response (SOR) as our framework to comprehensively consider the effects of internal and external factors and to clarify the chain evolution process of stimulus panic-buying behavior. Second, based on an improved infectious disease model using the Markov chain and combined with cellular automata methods, we studied the spatiotemporal evolution of group panic-buying behavior. Specifically, we focused on the evolutionary process of panic-buying across temporal sequences and within macroscopic geographical spaces such as urban communities. Our simulations yielded compelling insights: (1) the intensity of panic-buying information has a significant stimulating effect on panic-buying behavior. Interestingly, previous encounters with such buying experiences can act as a soothing balm, alleviating panic emotions. (2) The groups that participate in and stop buying both exhibit a clustered distribution in space, forming several clustered buying areas in space. Individuals at the center of the buying area often participate in the buying first, while those at the edge are more likely to stop buying. (3) Partition control implemented in the buying area can help mitigate the cascading effects of fear-driven purchasing behavior and increase its rate of decline. In addition, we also verified the effectiveness of the model using a case study in China, and discuss the model’s theoretical and practical significance, limitations, and future research directions.

PMID:41668143 | DOI:10.1111/nyas.70211

Cancer Med. 2026 Feb;15(2):e71602. doi: 10.1002/cam4.71602.

ABSTRACT

INTRODUCTION: We evaluated the incidence of anxiety, depression, and suicidality amongst TC survivors and the impact of chemotherapy on these outcomes.

METHODS: We conducted a retrospective cohort study of men diagnosed with TC in the United States Veterans Affairs Health System from 1990 to 2016. De novo anxiety or depression was a composite endpoint comprised of diagnosis codes for anxiety, depression, or medications used to treat these diagnoses. Incident suicidality was defined as a diagnosis code for suicidal ideation. 2022 TC patients were compared in a 1:3 ratio to 6375 controls. Cox proportional hazards models were employed for statistical analysis.

RESULTS: Mean age at diagnosis was 42.6 years. 5-year cumulative incidence of anxiety or depression was 53.4% in TC patients and 35% for controls (p < 0.001). TC patients were more likely to develop anxiety or depression (HR 1.66, 95% CI 1.56-1.78, p < 0.001) and suicidality (HR 22.99, 95% CI 17.52-30.17, p < 0.001). In the TC cohort, factors associated with a higher risk of anxiety or depression were divorce (HR 1.15, 95% CI 1.00-1.32, p = 0.044), unemployment (HR 1.68, 95% CI 1.47-1.9, p < 0.001), and receipt of chemotherapy (HR 1.20, 95% CI 1.06-1.35, p < 0.001).

CONCLUSIONS: Psychological morbidity due to depression, anxiety, and suicidality is high among TC survivors. In our analysis chemotherapy increases the rates of psychosocial morbidity. Clinicians should be proactive in screening and intervening for these diagnoses in TC survivors to provide early intervention and improve health comes.

PMID:41668134 | DOI:10.1002/cam4.71602

BMC Med Educ. 2026 Feb 10. doi: 10.1186/s12909-026-08741-7. Online ahead of print.

ABSTRACT

BACKGROUND: Accurately predicting academic performance among medical postgraduate students is crucial for understanding educational outcomes and providing effective early academic guidance. Traditional statistical approaches often struggle to balance predictive performance with interpretability, particularly when handling complex relationships among academic and psychosocial factors.

METHODS: A semi-structured survey was administered to medical postgraduate students at a Chinese medical university, yielding a final sample of 1,091 participants. GPA was dichotomized into two categories: outstanding academic performance (GPA ≥ 80) and non-outstanding academic performance (GPA < 80). Feature selection was performed using the Boruta algorithm. Logistic regression and XGBoost models were developed and evaluated on a held-out test set. Model performance was assessed using the area under the receiver operating characteristic curve, accuracy, and complementary validation metrics. Shapley Additive Explanations (SHAP) analysis was applied to interpret the contributions of key predictors.

RESULTS: Both models demonstrated acceptable predictive performance. Undergraduate academic achievement emerged as the most influential predictor of GPA classification, followed by selected psychosocial characteristics and foundational academic skills. Shapley Additive Explanations (SHAP) interpretation provided transparent insights into the relative importance and directionality of these predictors.

CONCLUSION: This study presents an interpretable machine learning framework for predicting academic performance in medical postgraduate education. By combining predictive modeling with explainable techniques, the proposed approach supports reliable performance assessment while maintaining transparency, offering a methodological foundation for future research and cautious application in educational analytics.

PMID:41668132 | DOI:10.1186/s12909-026-08741-7

BMC Nutr. 2026 Feb 10. doi: 10.1186/s40795-026-01268-6. Online ahead of print.

ABSTRACT

BACKGROUND: Endometriosis is a chronic, inflammatory condition affecting women, characterized by the presence of endometrial tissue outside the uterus. This study aimed to explore the relationship between dominant food patterns and the incidence of endometriosis in women aged 15-45 years.

METHODS: This case-control study involved 180 women, with 60 participants in the case group (with endometriosis) and 120 in the control group. Participants, aged 15-45, were recruited from the Kosar Educational and Therapeutic Center. Endometriosis diagnosis was confirmed via ultrasound or laparoscopy by a gynecologist. Dietary intake was assessed using a 146-item food frequency questionnaire. Factor analysis was used to identify dominant dietary patterns, and statistical tests (Chi-squared, Mann-Whitney U, T-tests) alongside logistic regression were used to assess the relationship between dietary patterns and endometriosis, adjusting for confounding factors (e.g., BMI, menstrual cycle characteristics, physical activity, education level).

RESULTS: Three dominant dietary patterns were identified. Pattern one was high in red meat, solid oils, high-fat snacks, and processed foods. Pattern two featured vegetables, grains, and coffee, while pattern three included sugar, cereals, and jam. Significant associations were found between food pattern one (OR = 25.54, 95% CI: 111.72-5.84, P < 0.001) and food pattern three (OR = 1.86, 95% CI: 1.14-3.04, P = 0.01) with increased risk of endometriosis. Higher energy, lipid, and carbohydrate intake were significantly associated with endometriosis (P < 0.001).

CONCLUSIONS: Food patterns high in processed meats, oils, and sugars may increase the risk of endometriosis in women.

TRIAL REGISTRATION: The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Ethics Committee of Urmia University of Medical Sciences, Urmia, Iran (Ethics Code IR.UMSU.REC.1400.396).

PMID:41668123 | DOI:10.1186/s40795-026-01268-6

Parasit Vectors. 2026 Feb 10. doi: 10.1186/s13071-026-07271-x. Online ahead of print.

ABSTRACT

BACKGROUND: Hard tick infestation occurs naturally in humans, domestic animals, and livestock species. Upon feeding, ticks transmit a wide variety of pathogens that may result in serious diseases with severe public health and economic impacts. While tick-borne diseases significantly impact human and animal health and agricultural production worldwide, as ectoparasites, ticks can also cause serious tissue injury, tick paralysis, or exsanguination from mass infestation. Experimental tick feeding is necessary to study tick-borne diseases and effectively test novel vaccines and therapeutics. Such studies raise concerns about on-host tick containment. Classically, tick containment cells for feeding on animals are rigid, lidded containers that are adhered to the host’s skin with adhesive or tape. They are bulky and easily damaged.

METHODS: Here, we describe the use of mesh packets, termed ‘teabags,’ containing 20 male and 5 female ticks each of both Amblyomma americanum and Dermacentor variabilis applied with surgical tape beneath harnesses on five dogs to allow tick feeding. Canine hematological and blood chemistry parameters were recorded before, during, and after tick feeding.

RESULTS: Successful feeding for 7 days was observed for both tick species (21-24/25 A. americanum and 3-14/25 D. variabilis per dog). Statistically significant shifts were detected in canine host hematological and blood chemistry parameters during tick feeding, indicating that infestation with even small numbers of ticks affects the systemic hematological and blood chemistry parameters.

CONCLUSIONS: This new method is safe, humane, and effective and will improve the experimental design, containment, and safety of tick-feeding research across many host, parasite, and pathogen species.

PMID:41668111 | DOI:10.1186/s13071-026-07271-x

BMC Med Educ. 2026 Feb 11. doi: 10.1186/s12909-026-08746-2. Online ahead of print.

ABSTRACT

INTRODUCTION: In recent decades, numerous studies have explored Problem-based Learning (PBL) or Case-based Learning (CBL) alone, but few have investigated their combination. Fundamental nursing is a core course for nursing undergraduates, and anaphylactic shock (a life-threatening clinical emergency) is a key teaching content. Traditional lecture-based learning (LBL) lacks interaction and fails to enhance critical thinking, highlighting the need for teaching methods.

METHODS: Nursing undergraduates from a medical college were randomly divided into two groups (n=50 each): the traditional group (LBL) and the PBL-CBL group (combined method). The intervention focused on anaphylactic shock in fundamental nursing (September 2022-June 2024). Data were collected via post-class tests (theoretical, practical, case analysis) and anonymous questionnaires (California Critical Thinking Disposition Inventory, satisfaction, time consumption). Statistical analysis used SPSS 18.0.

RESULTS: The PBL-CBL group had significantly higher total test scores (87.33±4.21 vs. 73.32±3.66, P<0.001) and better performance in all test sections. Questionnaire results showed higher critical thinking scores (truth-seeking, analytical skills, etc.), course satisfaction, and teacher-student interaction in the PBL-CBL group, though it consumed more learning time (P<0.05).

DISCUSSION: The combined PBL-CBL method outperforms traditional LBL in deepening knowledge, enhancing clinical analysis ability, and improving critical thinking. It is a promising approach for fundamental nursing teaching, though it requires more student preparation time.

PMID:41668093 | DOI:10.1186/s12909-026-08746-2