Category: Statistics

Sci Rep. 2025 Dec 23. doi: 10.1038/s41598-025-32485-x. Online ahead of print.

ABSTRACT

Heavy-metal (HM) contamination undermines soil functions and food safety, while risk appraisals often rely on chemical indices that can be unstable in the presence of extremes and only indirectly reflect biological integrity. We present an integrative framework that couples standardized contamination metrics with soil microbiome profiling to deliver stable, interpretable classifications and actionable bioindicators. Twelve peri-urban soils from Southern Italy were analysed for potentially toxic elements, including Arsenic (As), Cadmium (Cd), Chromium (Cr), Copper (Cu), Nickel (Ni), Lead (Pb), and Zinc (Zn) and profiled by shotgun metagenomics. We introduce a Standardized Ecological Risk index (SPERI) that preserves the ranking conveyed by conventional composites yet reduces outlier leverage. SPERI strongly agreed with Improved Potential Ecological Risk Index (IPERI) while stabilizing variance (R² = 0.896) and improved between-site comparability. Along the contamination gradient, community structure shifted consistently: families such as Pseudomonadaceae, Xanthomonadaceae and Rhodospirillaceae increased with risk, whereas Geodermatophilaceae and Nocardiaceae declined. Simple decision-tree models trained on family-level relative abundances reliably separated SPERI classes and repeatedly selected Zn- and Cd-enriched sites as primary split drivers, aligning microbial signals with chemical risk. By combining open, reproducible analytics with jointly chemical- and microbiome-informed endpoints, this workflow improves the interpretability and transferability of ecological risk assessment and supports targeted remediation and monitoring in contaminated agro-ecosystems.

PMID:41430427 | DOI:10.1038/s41598-025-32485-x

BMC Psychol. 2025 Dec 22. doi: 10.1186/s40359-025-03867-7. Online ahead of print.

ABSTRACT

BACKGROUND: Against the backdrop of building an education powerhouse, this study aims to explore the relationship between moral education and anomie behaviors in university physical education classes, and to examine the serial mediating role of attitudes toward sports norms and self-efficacy in this relationship.

METHODS: A questionnaire survey was conducted among 2,340 undergraduate students from 20 universities across the country. The collected data were organized and analyzed using SPSS Statistics 27.0.

RESULTS: Moral education exerted a significant negative predictive effect on anomie behaviors in physical education classes. This influence was primarily mediated through the serial mediation pathway of attitudes toward sports norms and self-efficacy. The effect sizes for these three pathways were -0.051, -0.018, and -0.013, accounting for 45.54%, 16.07%, and 11.61% of the total effect, respectively.

CONCLUSION: Moral education directly influences anomie behaviors in university physical education classes. Attitudes toward sports norms and self-efficacy for sports-related norms play a serial mediating role in the relationship between moral education and anomie behaviors in physical education classes.

PMID:41430349 | DOI:10.1186/s40359-025-03867-7

Sci Rep. 2025 Dec 22. doi: 10.1038/s41598-025-32529-2. Online ahead of print.

ABSTRACT

The number of human infections with Plasmodium knowlesi, a malaria parasite typically found in long-tailed and pig-tailed macaques, have increased and P. knowlesi has become the sole cause of indigenous cases of malaria in Malaysia since 2018. The reasons for the increase are multifactorial and could include human-to-human transmission through mosquito bites. Such transmission would require viable gametocytes circulating in the blood of infected individuals as this is the only parasite blood stage transmissible to mosquitoes. The objectives of this study were to determine the proportion of P. knowlesi malaria patients with viable gametocytes and to determine the association between gametocyte load and duration of illness prior to hospital admission, and with total parasitaemia. The mRNA transcripts of pks25, a gene expressed in mature female P. knowlesi gametocytes, were measured by a real-time PCR assay in blood samples from 295 patients at Kapit Hospital, Sarawak, Malaysian Borneo with PCR-confirmed single infections of P. knowlesi. Viable gametocytes were present in 67.5% (199/295) of patients. A positive correlation was seen between gametocyte load and total parasitaemia (ρ = 0.32, p = 0.01), whereas there was no statistically significant association between gametocyte carriage and duration of illness prior to hospitalisation (ρ = 0.28, p = 0.7). Forty (20%) of 199 gametocyte-positive samples had fewer than 500 pks25 transcript copies/µL, but 25 (12.5%) of 199 gametocyte-positive patients had elevated levels of gametocytes; 13 (10.8%) had between 10,001 and 100,000 and 12 (6%) had > 100,000 pks25 transcript copies/µL. Our findings demonstrate the presence of viable gametocytes in a substantial proportion of patients, including some with relatively high densities. This observation, taken together with other findings, underscores the potential of humans to serve as infectious hosts of P. knowlesi, but they do not constitute direct evidence of human-to-human transmission. Significant gaps still remain in our understanding of P. knowlesi gametocyte biology and infectivity. Addressing these gaps is essential to ascertain whether human-to-human transmission of P. knowlesi, which was experimentally demonstrated in the 1960s, occurs in natural settings. Continued surveillance of human P. knowlesi infections together with studies on gametocyte biology, vector bionomics, and monitoring of macaque host populations in relation to environmental alterations are vital to understand changes in the dynamics of P. knowlesi malaria transmission, and to inform strategies for its control and prevention.

PMID:41430347 | DOI:10.1038/s41598-025-32529-2

Diagn Pathol. 2025 Dec 22. doi: 10.1186/s13000-025-01744-w. Online ahead of print.

ABSTRACT

BACKGROUND: Recent studies have shown that tumor cell membranes exhibit lower polarity than normal cell membranes, a characteristic that can be harnessed for cancer diagnosis. TPAS (viscosity-responsive plasma membrane probe), a recently developed staining method using cell membrane polarity probes, may selectively visualize cervical cancer cells by targeting membrane polarity differences, offering a potential new approach for cervical cancer screening.To investigate the diagnostic value of TPAS staining combined with liquid-based thin-layer cytological testing (TCT) and human papillomavirus (HPV) testing in detecting cervical cancer.

METHODS: A total of 100 patients with suspected cervical precancerous lesions from the People’s Hospital of Shaanxi Province between May 2024 and May 2025 were studied. All patients underwent TPAS testing, HPV testing and TCT. Biopsy results were the gold standard for evaluating positivity rates and diagnostic values of the tests, both individually and in combination.

RESULTS: Among the 100 participants, the positive rates of the tests were as follows: TPAS detection rate was 86.7%, HPV detection rate was 80%, TCT rate 66.7%, and TCT + HPV rate was 35.00%. The combined TPAS + HPV testing showed higher accuracy (72.00%) and sensitivity(70.6%) than TCT + HPV (58.0%)and (54.1%), and the differences were statistically significant ((χ2 = 14.00,P = 0.0002).

CONCLUSION: TPAS combined with HPV testing has high specificity, sensitivity and accuracy, making it a promising approach for cervical cancer diagnosis.

PMID:41430333 | DOI:10.1186/s13000-025-01744-w

J Occup Med Toxicol. 2025 Dec 22. doi: 10.1186/s12995-025-00493-2. Online ahead of print.

ABSTRACT

BACKGROUND: Pneumoconiosis is among the most frequently diagnosed occupational diseases in Turkey, with the ceramic industry accounting for a considerable proportion. This study aimed to assess the frequency of pneumoconiosis among ceramic industry workers referred to an occupational medicine clinic with suspected pneumoconiosis, to identify high-risk departments, and to evaluate the referral process and workplace case management practices.

METHODS: In this cross-sectional study, 295 ceramic industry workers aged 18-64 years who were referred to an occupational medicine clinic for suspected pneumoconiosis by three medium-sized companies between 2013 and 2018 were analyzed. Data were obtained from referral forms and clinic records. Pneumoconiosis diagnosis was established by occupational medicine specialists based on chest radiographs, high-resolution computed tomography, and occupational history. The Kolmogorov-Smirnov test was used to assess the normality of the distribution. Pearson’s chi-square and Mann-Whitney U tests were used for statistical analysis.

RESULTS: Of the 295 workers, 56.3% were current smokers, and 32.5% were diagnosed with pneumoconiosis. The frequency of pneumoconiosis was lower among never-smokers compared with the current and ex-smokers (p < 0.01). The highest diagnosis rates were observed in shaping (41.9%), glazing (38.6%), and raw material processing (36.6%) departments. Referral documents often lacked essential information, with workplace duties missing in 89.5%, workplace exposures in 84.1%, and hygiene assessments in 100% of cases. Among the workers diagnosed with pneumoconiosis who attended at least one follow-up visit, 49.2% were reassigned to different duties. Of the smokers within this follow-up group, 79.0% continued smoking.

CONCLUSIONS: Pneumoconiosis is a significant occupational disease among ceramic workers in Turkey, requiring coordinated preventive action at both workplace and national levels. The critical lack of adequate exposure data in referral documents and the absence of structured post-diagnosis follow-up reveal weaknesses in current occupational hygiene and workplace health surveillance practices. Strengthening accurate assessment and documentation of exposure, standardizing referral protocols, ensuring effective periodic screenings, and promoting structured post-diagnosis follow-up, including smoking cessation interventions, are fundamental to improve disease management. To ensure effective control of pneumoconiosis in the ceramic industry in Turkey, existing legislation and occupational safety and health principles must be translated into well-monitored preventive actions at the workplace.

PMID:41430293 | DOI:10.1186/s12995-025-00493-2

J Cardiothorac Surg. 2025 Dec 22. doi: 10.1186/s13019-025-03752-9. Online ahead of print.

ABSTRACT

BACKGROUND: Stage III non-small cell lung cancer (NSCLC) is a complex and challengingdisease due to its variability and the absence of standardized treatment protocols. Thisstudy aimed to investigate the role of surgical resection as part of a multimodal treatmentapproach to improve overall survival (OS) and disease-free survival (DFS) in resource-limited settings.

METHODS: The medical records of 309 patients who underwent surgery for confirmed primary lung cancer at the King Hussein Cancer Center (KHCC) in Amman, Jordan, between 2016 and 2022 were reviewed. 59 of them diagnosed with Stage III NSCLC underwent curative surgeries. Patients were grouped into three categories: surgery alone, neoadjuvant therapy followed by surgery, and surgery combined with adjuvant therapy. Demographic, clinical, and survival data were statistically analyzed to compare the outcomes across these groups.

RESULTS: The study cohort consisted predominantly of males (86.4%), withadenocarcinoma being the most common histological subtype (54.2%). Patients whounderwent surgery alone had the lowest recurrence rate and highest three-year OS andDFS rates (66.7%). Improved OS and DFS were observed in patients with pN0 status andno evidence of lymphovascular invasion (LVI). Minimally invasive surgical approaches suchas VATS were associated with better perioperative outcomes than open surgery.

CONCLUSION: Surgical resection, particularly when achieving negative margins (R0) inpatients with N0 disease, is critical for improving survival in patients with Stage IIINSCLC. Multimodal strategies can enhance these benefits further. However, challengesrelated to healthcare access in resource-limited settings highlight the need for customizedtreatment protocols and broader access to advanced medical therapies.

PMID:41430277 | DOI:10.1186/s13019-025-03752-9

Harm Reduct J. 2025 Dec 22;22(1):200. doi: 10.1186/s12954-025-01346-1.

ABSTRACT

BACKGROUND: Substance use disorder is a persistent public-health challenge in Iran, where multiple treatment settings operate in parallel. This study assessed within-modality changes over 12 months among clients in Methadone Maintenance Treatment (MMT), Drop-in Centers (DICs), Therapeutic Communities (TCs), compulsory (Article 16) treatment.

METHODS: A prospective, naturalistic cohort was conducted across 15 routine-care centers in Kerman Province (May 2023-May 2024). Of 493 enrolled, 470 completed follow-up (MMT/DIC at 12 months; TC/compulsory at end-of-treatment [EOT]). MMT/DIC were assessed at baseline, 2 months, and 12 months; TC/Article 16 at baseline and EOT. Outcomes were assessed using the Maudsley Addiction Profile (MAP). Within-modality changes from baseline were estimated with mixed-effects models in Stata 15, using two-sided tests (α = 0.05).

RESULTS: MMT was associated with reductions in alcohol, opium, and heroin use, lower odds of interpersonal conflicts, fewer physical/psychological problems, and fewer days of illness-related unemployment. DIC showed decreases in physical/psychological problems, drug-related harms (e.g., dealing), and fighting; changes in spouse/relative/friend-conflict indicators were not statistically significant. TC showed short-term reductions in several substances; employment decreased during the residential phase (a programmatic constraint rather than a change in employability). Article 16 showed declines in selected substances and health problems during observation; durability post-discharge remains uncertain.

CONCLUSIONS: Findings indicate domain-specific, within-modality changes rather than comparative effectiveness between settings. In TCs, short-term within-modality declines were observed in alcohol and selected illicit opioids at EOT alongside limited employment opportunities during residence due to programmatic restrictions. Within MMT, improvements were observed in selected psychosocial indicators at follow-up, consistent with stabilization during ongoing care. Within DICs, reductions were observed in health problems and certain risk behaviors, aligning with their harm-reduction and linkage role. Within Article 16, short-term declines were observed in selected substances and health problems during observation; durability after discharge is uncertain without structured aftercare. Overall, no single modality appears universally superior; matching clients to treatment according to target outcomes, and implementing stepped-care or blended pathways with robust post-treatment supports-particularly following compulsory programs-may optimize long-term impact.

PMID:41430274 | DOI:10.1186/s12954-025-01346-1

Int J Equity Health. 2025 Dec 22;24(1):346. doi: 10.1186/s12939-025-02590-4.

ABSTRACT

BACKGROUND: Burkina Faso has been dealing with a worsening security situation since 2015, resulting in more than two million people being forced to leave their homes. Gender-based violence (GBV) has escalated and is a major issue in situations involving conflict and forced displacement. This research examines the views and opinions of internally displaced individuals on VBG in Burkina Faso, specifically emphasizing how ingrained social structures contribute to this problem.

METHODS: This study employed a qualitative, descriptive, and exploratory research design. The research was conducted in Kaya city, a region heavily impacted by displacement. Data were collected through 58 focus group discussions, which included 352 participants. The data were thematically analyzed using NVivo 12 and the approach developed by Braun and Clarke, enabling a thorough identification of key patterns and themes.

RESULTS: Findings enabled the identification of several critical dimensions of GBV, its root causes, and risk factors. GBV was highlighted as deeply rooted in cultural and structural determinants, with gender inequality, power imbalances, and entrenched social constructs forming its primary foundations. Economic hardship, ignorance, behavioral issues like alcohol misuse, and institutional shortcomings were seen as contributors exacerbating GBV but not necessarily its root causes. Participants emphasized heightened GBV risks during humanitarian crises, manifesting in physical, sexual, and psychological violence linked to harmful traditional practices like female genital mutilation (FGM), forced marriages, and the sexual division of labor. Though harmful practices persist, divergent views on GBV trends emerged, with some reporting reductions due to shifting behaviors or constraints. Preventive efforts, such as awareness campaigns and local interventions, were noted but insufficient against sociocultural barriers to survivor support, including stigmatization and victim-blaming.

CONCLUSIONS: This research elucidates the deep-rooted sociocultural and structural determinants of GBV, reflecting persisting gender inequities and systemic oppression. The findings underscore the pressing requirement for thorough communication plans that increase understanding of accessible services and foster participation despite the widespread stigma, shame, and fear that prevent individuals from seeking help.

PMID:41430229 | DOI:10.1186/s12939-025-02590-4

BMC Med Ethics. 2025 Dec 22. doi: 10.1186/s12910-025-01355-6. Online ahead of print.

ABSTRACT

BACKGROUND: Consumer and community involvement (CCI) is widely recognised as an ethical imperative in health and biomedical research. However, there is a lack of evidence and guidance regarding ethical approaches. The aim of this research was to test and refine an existing ethical framework for consumer partnerships in research to enhance understanding of ethical issues and approaches to CCI in research.

METHODS: A sub-analysis of a co-produced ethnographic study which explored the processes and outcomes of consumer engagement over three and a half years in a PhD research partnership, was conducted against an existing ethical framework for CCI. The framework included organisational ethics, research integrity, relational ethics, and research ethics. Participants included four consumers, two academics, and a PhD candidate in an Australian capital city. Two consumer co-researchers collaborated in this study across the research cycle. Data were obtained over three and a half years from six interviews, six focus groups, monthly online logs, field notes, and a reflexive diary. Descriptive statistics and qualitative content analysis were used to analyse 2035 units of data.

FINDINGS: A total of 1911 (93.9%) units of data aligned to an ethical category. Hence, the research team were constantly encountering ethical decision-making. A combination of organisational ethics and relational ethics was most frequently coded (30.1%, n = 576), followed by relational ethics alone (24.3%, n = 465), and research integrity and relational ethics (n = 229, 12.0%). Qualitative analysis identified some ethical tensions and many more practical and planned ethical approaches to support meaningful research partnership and positive research processes and outcomes. Examples and quotes are provided against each of the four ethical categories to illustrate and expand on the framework. An update to the framework is provided.

CONCLUSIONS: The updated framework highlighted the complexities of CCI and focused beyond traditional research ethics to include relationships, organisational factors, and research integrity. The narrative of ethical issues being a challenge to overcome in CCI, needs to change. An emphasis on adopting a proactive approach to promote ethical and authentic team power sharing, reflection, and active communication is needed.

PMID:41430221 | DOI:10.1186/s12910-025-01355-6

BMC Oral Health. 2025 Dec 22;25(1):1923. doi: 10.1186/s12903-025-07113-9.

ABSTRACT

BACKGROUND: To determine the most appropriate fiducial markers distribution strategy in navigation surgery for three different tilted implant scenarios by comparing the target registration error (TRE) of tilted implants in fully edentulous maxillae.

METHODS: The cone beam computed tomography scanned a maxillary edentulous model with 16 bone-anchored mini-screws (8 for registration and 8 for target registration error measurement), which was further imported into the navigation system for registration and target registration measurement. Each of the 5 strategies was performed six times, and the measurements were repeated twice around 4 target points each time. A mixed linear model was utilized for data analysis.

RESULTS: Registration distribution, measurement site, and their interaction had a statistically significant influence on TREs (P = 0.010, 0.000, and 0.001, respectively). Two markers on the anterior alveolar crest, 2 in the buccal of the anterior alveolar ridge, and 2 on both sides of the maxillary tuberosity can realize the minimal TREs for tuberosity-pterygoid-palatine implant (TPP) at both coronal and apical points. No significant TRE differences were found for apical points of mesial tilted implant in ‘all on four’ and zygomatic implants among the 5 registration strategies.

CONCLUSIONS: For TPPs, incorporating fiducial markers on maxillary tuberosity for registration can help reduce the TRE in dynamic navigation.

TRIAL REGISTRATION: Not applicable.

PMID:41430215 | DOI:10.1186/s12903-025-07113-9