Category: Statistics

J Nurs Manag. 2026;2026(1):e5594415. doi: 10.1155/jonm/5594415.

ABSTRACT

BACKGROUND: Empowerment in nurses is a multidimensional construct that has favorable results for both the patient and the employee and is emphasized in order to provide high-quality healthcare. For this concept to be translated into practice, measurement tools developed in this field are of critical importance. Although several validated instruments assess structural, psychological, or behavioral empowerment separately, each having been validated independently, using distinct samples, scoring frameworks, and item structures, no instrument evaluating all three dimensions simultaneously within a single scale has been identified. This gap limits nurse managers in comprehensively diagnosing empowerment and in evaluating the effectiveness of empowerment interventions.

OBJECTIVE: The study was conducted to develop a valid and reliable measurement tool aiming to determine the empowerment levels of nurses in a multidimensional manner in terms of structural, psychological, and behavioral dimensions.

METHODS: In this methodological study, the standard scale development and validation procedures required for instruments to be psychometrically sound were employed. An initial 256-item pool was generated based on a comprehensive literature review and an autoethnographic approach involving 36 nurses. Subsequently, face and content validity (Lawshe’s technique) were evaluated. Data were collected between May and September 2017 from nurses (N = 1992) working across 10 hospitals affiliated with a regional health group in Istanbul; the study was completed with a final sample of 743 nurses (37.3%). Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to determine the construct validity of the scale. Cronbach’s alpha, item analyses, and test-retest analyses were employed to assess reliability.

RESULTS: The draft nursing empowerment scale (NES), developed as a result of the face and content validity studies, consisted of 136 items and was administered to the sample group. The EFA conducted resulted in a NES consisting of 103 items and three factors (structural, psychological, and behavioral), explaining 49.95% of the total variance (KMO = 0.97; Bartlett χ² = 58,144.65, p < 0.001). The scale factor structure was supported by supplementary CFA. The goodness-of-fit indicators (χ²/df = 3.75; RMSEA = 0.06; CFI = 0.92; NFI = 0.90; GFI = 0.90; AGFI = 0.88) were favorable. Internal consistency was observed (Cronbach’s α = 0.98 overall; subscale α = 0.91-0.98) and 15-day test-retest correlation was r = 0.86 (subscale r = 0.73-0.83).

CONCLUSIONS: The NES demonstrates good psychometric properties as a comprehensive, multidimensional research instrument. Future research should test the scale on independent and diverse samples. Its considerable length (103 items) is acknowledged as a practical limitation, and the development of a shorter, practice-oriented form is planned.

IMPLICATIONS FOR NURSING MANAGEMENT: The NES enables the simultaneous, multidimensional measurement of structural, psychological, and behavioral empowerment within a single instrument. It could be useful in determining empowerment levels and evaluating the effectiveness of targeted empowerment strategies.

PMID:42669038 | DOI:10.1155/jonm/5594415

Anticancer Drugs. 2026 Aug 24. doi: 10.1097/CAD.0000000000001842. Online ahead of print.

ABSTRACT

Oxaliplatin-induced peripheral vascular pain (OIVP) often requires central venous port placement. Conventional preventive strategies have limited efficacy, and the use of some effective analgesics is restricted. This single-center retrospective study evaluated the efficacy and safety of prophylactic tramadol. Electronic medical records of patients who received oxaliplatin-based chemotherapy via a peripheral intravenous line and experienced vascular pain [numerical rating scale (NRS) score ≥ 4] were reviewed. Patients who received prophylactic tramadol in a subsequent cycle were included (n = 23). The primary endpoint was the response rate (≥30% reduction in the NRS score from baseline). The secondary endpoint was the change in NRS score compared with the baseline score in the previous cycle. The response rate was 73.9% [95% confidence interval (CI): 51.6-89.8%]. The median NRS score for OIVP decreased significantly from 7.0 at baseline to 3.0 following tramadol administration (P < 0.0001). Administration greater than or equal to 60 min before infusion was associated with a higher response rate (88.9%; 95% CI: 51.8-99.7%) than administration at 30 min (64.3%; 95% CI: 35.1-87.2%), although this difference was not statistically significant (P = 0.208). Adverse events were mild, with grade 2 nausea reported in two (8.7%; 95% CI: 1.1-28.0%) patients. This exploratory study suggested that prophylactic tramadol was associated with a reduction in pain severity in OIVP, with a favorable safety profile. Thus, tramadol may be a promising and accessible prophylactic option, particularly when access to controlled analgesics is limited.

PMID:42669037 | DOI:10.1097/CAD.0000000000001842

J Nurs Manag. 2026;2026(1):e7889163. doi: 10.1155/jonm/7889163.

ABSTRACT

AIMS: To identify the latent profiles of Chinese Generation Z new nurses’ job crafting, explore their demographic characteristics, and examine the predictive role of innovative behaviors in distinct job crafting profiles.

BACKGROUND: New nurses experience high levels of stress and turnover intention during early career transition, highlighting the importance of proactive work behaviors. Although job crafting and innovative behavior are both considered important for professional development and workforce sustainability, evidence on their association and heterogeneity among new nurses remains limited.

METHODS: This cross-sectional study was conducted using convenience sampling among new nurses from three tertiary hospitals in Midwestern China between March and May 2023. Participants completed the Innovative Behavior Scale, the Job Crafting Scale, and a demographic questionnaire. Latent profile analysis (LPA) was applied to identify potential subgroups of job crafting among new nurses. LPA was conducted using Mplus 8.3, while descriptive statistics, chi-square tests, analysis of variance, and multinomial logistic regression were performed using SPSS 27.0.

RESULTS: Three job crafting profiles were identified: “low job crafting profile” (43.3%), “moderate job crafting profile” (47.5%), and “high job crafting profile” (9.2%). Significant differences were observed in age, marital status, educational attainment, and innovative behavior (P< 0.05). Multinomial logistic regression further indicated that innovative behavior was a significant predictor of profile membership (P< 0.05).

CONCLUSION: Heterogeneity in job crafting among Chinese Generation Z new nurses and the key role of innovative behavior in shaping job crafting patterns are evident, with implications for targeted managerial strategies to support professional development.

IMPLICATIONS FOR NURSING MANAGEMENT: Practical implications include tailoring management strategies to each profile: supporting foundational skills and psychological safety for nurses in the low job crafting profile, promoting gradual task enhancement and professional confidence-building for nurses in the Moderate job crafting profile, and sustaining empowerment and leadership development among nurses in the high job crafting profile.

PMID:42669036 | DOI:10.1155/jonm/7889163

J Magn Reson Imaging. 2026 Aug 30. doi: 10.1002/jmri.70520. Online ahead of print.

ABSTRACT

BACKGROUND: Cerebrovascular aging is characterized by progressive reductions in cerebral blood flow and vascular compliance. Although long-term endurance exercise has been associated with improved brain health, its relationship with cerebrovascular aging remains incompletely understood.

PURPOSE: To assess associations between long-term endurance exercise and intracranial arterial structural and hemodynamic characteristics, and to determine whether these associations differ with age.

STUDY TYPE: Prospective cross-sectional study.

POPULATION: Fifty-one endurance runners (≥ 5 h/week endurance exercise for ≥ 3 years) and 51 matched sedentary controls.

FIELD STRENGTH/SEQUENCE: Intracranial four-dimensional velocity-encoded gradient echo sequence (4D Flow MRI) at 3.0 T.

ASSESSMENT: Luminal cross-sectional area, blood flow, pulsatility index (PI), and resistive index (RI) were quantified in the bilateral internal carotid arteries and basilar artery. Total cerebral blood flow (TCBF) was calculated from these vessels.

STATISTICAL TESTS: Univariable analysis was used to compare groups. Multivariable linear regression and linear mixed-effects models were used to assess associations of age and long-term endurance exercise with cerebrovascular structural and hemodynamic parameters, with additional testing for age-by-exercise interactions. A p value < 0.05 was considered significant.

RESULTS: Endurance runners had significantly higher TCBF than sedentary controls (586.2 ± 85.7 vs. 540.7 ± 85.6 mL/min). Older age was independently associated with lower cerebral blood flow (β = -2.636 mL/min per year) and higher PI (β = 0.003 per year), whereas long-term endurance exercise was independently associated with larger luminal cross-sectional area (β = 1.119 mm²) and higher TCBF (β = 52.929 mL/min) and higher vessel-level blood flow (β = 19.313 mL/min). In addition, endurance exercise was associated with higher RI (β = 0.054) but not PI (β = 0.026). No significant age-by-exercise interactions were observed.

DATA CONCLUSION: Long-term endurance exercise was associated with larger intracranial arterial luminal dimensions and higher cerebral blood flow, without significant differences in age-related hemodynamic changes between groups.

STAGE OF TECHNICAL EFFICACY: 2.

PMID:42669028 | DOI:10.1002/jmri.70520

Cureus. 2026 Jul 30;18(7):e113646. doi: 10.7759/cureus.113646. eCollection 2026 Jul.

ABSTRACT

Background Tongue thrusting is a common neuromuscular habit associated with abnormal tongue posture and dentoalveolar changes. Tongue crib and tongue tamers are commonly used habit-breaking appliances, but limited studies have compared their effectiveness using cone beam computed tomography (CBCT) analysis. Aim This study aims to compare the efficacy of tongue crib and tongue tamers in repositioning the tongue in patients with tongue thrust using CBCT analysis. Materials and methods Forty subjects aged 14-30 years with tongue thrusting habit were randomly divided into two groups: tongue crib (Group 1) and tongue tamers (Group 2). CBCT with barium sulphate coating was used to evaluate tongue posture. Parameters assessed included tongue tip position, U1-PP, L1-MP, interincisal angle, overjet, overbite, and lower lip retraction. Patient discomfort was evaluated using a visual analog scale (VAS). Statistical analysis was performed with significance set at p ≤ 0.05. Results Tongue tip position and dentoalveolar parameters significantly improved with both appliances. Compared to tongue tamers, tongue crib showed statistically significant improvement in tongue tip retraction and overbite improvement. On the other hand, tongue tamers demonstrated greater patient acceptability and comfort. Conclusion Both tongue crib and tongue tamers were effective in repositioning the tongue and improving associated dentoalveolar changes, but the tongue crib was more effective clinically, whereas tongue tamers provided better patient comfort.

PMID:42669026 | PMC:PMC13525915 | DOI:10.7759/cureus.113646

Cureus. 2026 Jul 30;18(7):e113679. doi: 10.7759/cureus.113679. eCollection 2026 Jul.

ABSTRACT

OBJECTIVES: The Hall technique (HT) manages dental caries in primary molars by sealing the lesion with a preformed metal crown, a minimally invasive strategy aimed at arresting the disease process. Although convincing evidence of efficacy is available, global acceptance varies. This study aimed to evaluate the knowledge, attitudes, and practices (KAP) of Jordanian pediatric dentists regarding the HT and its main features.

METHODS: A cross-sectional study was carried out using an online questionnaire distributed to Jordanian pediatric dentists from November 1 to 30, 2025. The questionnaire surveyed demographics, knowledge (rationale, indications), attitudes (efficiency, evidence-based), and practices (current use, challenges, concerns). Descriptive statistics, chi-square tests, and binomial logistic regression were used to identify predictors of HT implementation among 120 participants.

RESULTS: Most respondents were female (103/120, 85.8%) and board-certified (91/120, 75.8%). The rationale for caries arrest by sealing with the HT was understood by 118/120 (98.3%) of the respondents. The frequency of HT use was 104/120 (86.7%). Years of clinical practice were significantly associated with the perception that HT is best for uncooperative patients (p = 0.031), and belief in medical contraindications was associated with reduced HT use (p = 0.024). The main concerns were occlusion (65/120, 54.2%), sealing over caries (54/120, 45.0%), and parental acceptance (54/120, 45.0%). The majority perceived HT as a time-saving method (111/120, 92.5%), and the attitudes were generally positive. Logistic regression analysis revealed that the belief in time-saving (OR = 8.58, 95% CI: 2.09-35.21, p = 0.003) and evidence base (OR = 5.21, 95% CI: 1.37-19.81, p = 0.015) were significant positive predictors for HT use, whereas the concern of parental acceptance (OR = 0.24, 95% CI: 0.09-0.65, p = 0.005) and sealing over caries (OR = 0.34, 95% CI: 0.13-0.89, p = 0.027) were significant negative predictors. The model explained 28.4-45.2% of the variance in HT use and was a good fit (Hosmer-Lemeshow p = 0.342).

CONCLUSION: Pediatric dentists in Jordan had a high level of knowledge of and use of the HT, with adoption rates higher than in many other countries. A positive perception of time efficiency and evidence-based belief strongly favor clinical use, while concerns about parental acceptance and sealing over caries are the main barriers to consistent implementation.

PMID:42669021 | PMC:PMC13525859 | DOI:10.7759/cureus.113679

Psychol Res Behav Manag. 2026 Aug 25;19:625275. doi: 10.2147/PRBM.S625275. eCollection 2026.

ABSTRACT

BACKGROUND: Excessive time spent on social media and smartphones, as well as inappropriate use, has raised concerns about their potential impact on mental health. Many studies have shown that social media addiction and smartphone addiction are associated with poor sleep quality and increased risk of depression and anxiety. This study examined the mediating role of lifestyle on the relationship between social media and smartphone use addictions with poor sleep quality, anxiety, and depression.

METHODS: A cross-sectional study was conducted among 1324 undergraduate and graduate students aged 20-40 years. Participants completed validated self-report measures assessing social media addiction, smartphone addiction, sleep quality, anxiety symptoms, depressive symptoms, and lifestyle behaviors, including smoking, alcohol consumption, eating behaviors, and physical activity.

RESULTS: The mean scores for sleep quality, anxiety, and depressive symptoms were 6.9 ± 3.4, 6.7 ± 5.4, and 8.6 ± 5.8, respectively. In this cross-sectional study, mediation analysis indicated statistically significant indirect associations through lifestyle between social media addiction and poor sleep quality (the indirect effects: unstandardized coefficient [B] = 0.006, 95% confidence interval [CI] [0.002-0.014]), anxiety symptoms (B = 0.007, 95% CI [0.001-0.016]), and depressive symptoms (B = 0.013, 95% CI [0.006-0.025]). Similarly, lifestyle was observed to mediate the association between smartphone use addiction and poor sleep quality (the indirect effects: B = 0.005, 95% CI [0.002-0.010]), anxiety symptoms (B = 0.006, 95% CI [0.001-0.015]), and depressive symptoms (B = 0.012, 95% CI [0.005-0.020]). Although the indirect effects were statistically significant, their magnitude was small, indicating that lifestyle accounted for a limited proportion of the associations between technology-related addictions and sleep quality and mental health problems.

CONCLUSION: Lifestyle behaviors statistically mediated the associations of social media or smartphone use addiction with poor sleep quality, anxiety, and depression. Although causal inferences cannot be made, these findings suggest that lifestyle practices may be important in understanding and addressing the mental health challenges associated with excessive technology use.

PMID:42669002 | PMC:PMC13525800 | DOI:10.2147/PRBM.S625275

Cureus. 2026 Jul 30;18(7):e113673. doi: 10.7759/cureus.113673. eCollection 2026 Jul.

ABSTRACT

Background The format of the American Board of Dermatology (ABD) exams has now changed with a self-assessment Basic Exam in the first year of dermatology residency, followed by certification Core Exams during residency and the Applied Exam after completion of residency. Objective To determine if the Basic Exam scores correlate with performance on the new certification exams in dermatology. Methods Deidentified examination data from residents between 2018 and 2023 was obtained from the ABD. The basic exam scores between those who passed and failed the certification exams were analyzed. The optimal threshold for Basic Exam scores was then calculated using a receiver operating characteristic curve. Results For the 1585 residents included, there was a statistically significant difference in Basic Exam performance for those who passed and failed the certification exams (p < 0.001). The threshold cutoff varied by certification exam with a total Basic Exam score range of 75.55 to 79.55 and percentile rank range of 22%-38%. Limitations Demographic data was not available to include in the analysis. Conclusion The Basic Exam performance correlates with certification exam performance. The average threshold of total score of 78.5 and percentile rank of 31.4% would capture 77% of residents who failed the certification exams.

PMID:42669000 | PMC:PMC13525833 | DOI:10.7759/cureus.113673

Caspian J Intern Med. 2026 Mar 10;17(2):449-456. doi: 10.22088/cjim.17.2.449. eCollection 2026.

ABSTRACT

BACKGROUND: Pancreatic cancer is among the deadliest malignancies globally, marked by poor prognosis and limited survival. This research investigated the demographic and clinical determinants affecting overall survival in patients diagnosed with pancreatic cancer in Guilan Province, Iran.

METHODS: A total of 50 pathologically and radiologically confirmed cases of pancreatic cancer were analyzed. Demographic, anthropometric, and clinical data were extracted from medical records. Survival probabilities were estimated using the Kaplan–Meier method, and intergroup differences were tested using the log-rank test. Cox proportional hazards modeling identified predictors of mortality, with significance defined at p < 0.05. Statistical analyses were conducted in SPSS (v16) and GraphPad Prism (v8).

RESULTS: The majority of patients were male (60%) and over 60 years old (58%), while 46% had normal BMI and 40% had blood group O. Comorbidities were present in 42%, and 32% were diagnosed at stage IV. Mean and median survival were 39.6 and 9.0 months, respectively. One-, three-, and five-year survival rates were 45.2%, 31.3%, and 23.5%. Advanced tumor stage (III/IV) significantly predicted shorter survival (p < 0.001). Underweight individuals had higher mortality risk (HR = 2.79; 95% CI: 1.21–6.42; P = 0.016). In multivariate models, male gender, blood group O, and advanced disease remained independent negative prognostic indicators.

CONCLUSION: Male sex, advanced stage, low BMI, and blood group O were major determinants of poorer survival in pancreatic cancer. These results emphasize the need for individualized treatment and closer follow-up among high-risk groups.

PMID:42668993 | PMC:PMC13525829 | DOI:10.22088/cjim.17.2.449

Cancer Manag Res. 2026 Aug 25;18:636474. doi: 10.2147/CMAR.S636474. eCollection 2026.

ABSTRACT

BACKGROUND: Thyroid cancer incidence is rising globally; however, histopathological data from Somalia are scarce, and no comprehensive characterization of resected thyroid specimens has been reported.

METHODS: A retrospective review of 438 thyroidectomy specimens reported at a histopathology referral laboratory in Mogadishu, Somalia, between 2022 and 2025 was performed. Each specimen was classified as benign, borderline, or malignant according to the World Health Organization criteria. The associations between malignancy and age and sex were examined using chi-square or Fisher exact tests and unadjusted logistic regression.

RESULTS: The cohort was predominantly female (90%), with a median age of 37 years. Benign lesions accounted for 366 specimens, borderline lesions for 8, and malignant lesions for 64, giving an overall malignancy proportion of 14.6%. Nodular and colloid goiters dominated the benign diagnoses, and papillary thyroid carcinoma was the most frequent malignant subtype, accounting for 50 of 64 cases. Malignancy was highest in patients aged 30 years or younger (22.2%), and the variation across age groups was statistically significant. The incidence of malignancy did not differ significantly according to sex. Among malignant tumors, the median size was 3.0 cm, and most were in the early tumor category.

CONCLUSION: Benign goiter dominates thyroid surgical pathology in Mogadishu, while papillary carcinoma leads to a modest malignant burden that is proportionally greatest in younger patients. Strengthening pathology capacity, preoperative cytology, and cancer surveillance is therefore warranted.

PMID:42668992 | PMC:PMC13525814 | DOI:10.2147/CMAR.S636474