Category: Statistics

BMC Musculoskelet Disord. 2025 Oct 1;26(1):904. doi: 10.1186/s12891-025-09129-2.

ABSTRACT

BACKGROUND: Exploring the effect of sarcopenia on the clinical outcome of delta large-channel endoscopic treatment of elderly patients with lumbar spinal stenosis.

METHODS: Data were collected from 87 patients who underwent delta large-channel endoscopy between January 2022 and June 2023 at the First Affiliated Hospital of Ningbo University. Skeletal muscle index at the L3 level SMI < 36 cm²/m² (males) and SMI < 29 cm²/m² (females) were used as diagnostic thresholds for sarcopenia. We divided patients who met the inclusion criteria into a sarcopenia group (41) and a non-sarcopenia group (46). Patients’ age, gender, BMI, responsible segment, procedure-related parameters (intraoperative bleeding, operative time, hospitalization time, and complication occurrence), and clinical outcomes (Visual Analog Scale for Pain (VAS) scores, JOA scores, Oswestry Dysfunction Index (ODI) scores, and MacNab scores at the time of final follow-up) were recorded and compared.

RESULTS: There were no significant differences in gender, age, BMI, intraoperative bleeding, operative time, hospitalization time, and complication occurrence between the two groups (P > 0.05). Surgery was successfully completed in both groups. Clinical outcomes, such as lumbar VAS scores was not significant different between the two groups (P > 0.05). While comparing the lumbar VAS scores between the two groups at 6 months and 12 months postoperatively, the scores of the non- sarcopenia group were lower than those of the sarcopenia group, and the difference was statistically significant (P < 0.05). In addition, in the postoperative follow-up at 3 months, 6 months and 12 months, the comparison of ODI scores and JOA scores between the sarcopenia group and the non-sarcopenia group was statistically significant (P < 0.05), in which the ODI scores of the non-sarcopenia group were significantly lower than those of the sarcopenia group, and the JOA scores of the non-sarcopenia group were significantly higher than those of the sarcopenia group.

CONCLUSION: Functional recovery after delta large-channel endoscopic decompression was better in non-sarcopenia patients than in the sarcopenia group, and sarcopenia had a greater impact on long-term postoperative outcomes in older patients. We need to emphasize the diagnosis and intervention of sarcopenia in patients to reduce the impact of sarcopenia on postoperative clinical outcomes. Whether sarcopenia affects the stability of lumbar spine in endoscopic patients requires a longer follow-up period and later studies.

PMID:41034829 | DOI:10.1186/s12891-025-09129-2

BMC Public Health. 2025 Oct 1;25(1):3278. doi: 10.1186/s12889-025-24539-6.

ABSTRACT

BACKGROUND: In recent years, with rapid societal changes and increasing educational pressures, the mental health of primary and secondary school students has garnered significant attention. Psychological resilience, as a core capacity for coping with adversity, and emotional competence, as a foundation for emotional regulation in social adaptation, are crucial for student development, with family functioning being a primary environmental factor closely associated with them. Research suggests that healthy family functioning may be associated with higher psychological resilience and emotional competence, while family dysfunction may be linked to increased psychological distress. However, the interconnected mechanisms among family functioning, psychological resilience, and emotional competence, as well as the roles of factors such as gender, urban-rural differences, and grade level, still require further exploration.

OBJECTIVES: To explore the associations between family functioning, psychological resilience, and emotional competence among primary and secondary school students in Chengdu, Sichuan Province, and their underlying mechanisms. The study aims to provide a scientific basis for educators and parents to develop targeted mental health interventions.

DESIGN: Multicenter cross-sectional study.

METHODS: A cluster sampling method was employed to survey 7,937 students from grades 1 to 9 across five schools in Chengdu. Data were collected using the Chinese Family Assessment Instrument (C-FAI, assessing family mutual support, communication, and conflict harmony), the Resilience Subscale and Emotional Competence Subscale of the Chinese Positive Youth Development Scale (CPYDS, measuring adaptation and recovery under stress, and the ability to perceive, understand, and manage emotions, respectively). Data were double-entered and verified using Epidata 3.1. SPSS 26.0 was used for descriptive statistics, correlation analysis, and difference tests (independent samples t-test, Welch t-test, one-way ANOVA, or Welch ANOVA based on data distribution, with Games-Howell post-hoc tests). Partial correlation analysis controlled for gender, urban/rural residence, and grade. Structural equation modeling was conducted using AMOS 26.0 to analyze the associations and mediating effects among family functioning, psychological resilience, and emotional competence, and to evaluate model fit. Harman’ s single-factor test was applied to detect common method bias. The significance level was set at α=0.05.

RESULTS: Family functioning showed significant differences across gender, urban/rural location, and grade level (P<0.05): male students (1.97±0.74), rural students (1.97±0.73), and students in grades 7-9 reported more severe family dysfunction. Psychological resilience was significantly positively correlated with emotional competence (r=0.646,P<0.001), and both were negatively correlated with family dysfunction (r=-0.394 and r=-0.376, respectively, P<0.001). The structural equation model demonstrated a good fit (CMIN/DF=6.988,RMSEA=0.027). Path analysis from the model indicated that psychological resilience may be indirectly associated with emotional competence through family functioning. The mediating effect of this path was 0.089, accounting for 9.2% of the total effect (95% CI: 0.667-0.726, P<0.001).

CONCLUSIONS: Family dysfunction is significantly negatively correlated with the psychological resilience and emotional competence of primary and secondary school students, with psychological resilience indirectly associated with emotional competence through family functioning. Boys, rural students, and those in grades 7-9 exhibit more severe family dysfunction, warranting focused attention. It is recommended to implement interventions such as “Parent-Child Co-Creation Day,” communication training, and “Father’ s Role Workshop” to optimize family functioning, thereby supporting the mental health of primary and secondary school students.

PMID:41034824 | DOI:10.1186/s12889-025-24539-6

BMC Med Res Methodol. 2025 Oct 1;25(1):225. doi: 10.1186/s12874-025-02667-2.

ABSTRACT

The ATR-FTIR spectral data represent a valuable source of information in a wide range of pathologies, including neurological disorders, and can be used for disease discrimination. To this end, the identification of the potential spectral biomarkers among all possible candidates is needed, but the amount of information characterizing the spectral dataset and the presence of redundancy among data could make the selection of the more informative features cumbersome. Here, a novel approach is proposed to perform feature selection based on redundant information among spectral data. In particular, we consider the Partition Around Medoids algorithm based on a dissimilarity matrix obtained from mutual information measure, in order to obtain groups of variables (wavenumbers) having similar patterns of pairwise dependence. Indeed, an advantage of this grouping algorithm with respect to other more widely used clustering methods, is to facilitate the interpretation of results, since the centre of each cluster, the so-called medoid, corresponds to an observed data point. As a consequence, the obtained medoid can be considered as representative of the whole wavenumbers belonging to the same cluster and retained in the subsequent statistical methods for disease prediction. An application on real data is finally reported to show the ability of the proposed approach in discriminating between patients affected by multiple sclerosis and healthy subjects.

PMID:41034819 | DOI:10.1186/s12874-025-02667-2

BMC Pregnancy Childbirth. 2025 Oct 1;25(1):1000. doi: 10.1186/s12884-025-08176-w.

ABSTRACT

BACKGROUND: Worldwide, preeclampsia continued to be one of a leading cause of maternal and perinatal morbidity and mortality. Indeed, developing countries like Ethiopia face significant public health challenges because of scarce data and limited applications of determinants of preeclampsia. Therefore, the aim of this research was to identify determinants of preeclampsia among pregnant and laboring mothers who came for antenatal care and labor and delivery services.

METHODS: We conducted an unmatched case-control study among women diagnosed with preeclampsia and admitted to Wolaita Sodo University Comprehensive Specialized Hospital. Two hundred seventy women with case to control ratio of 1:2 were participated. We computed descriptive statistics like frequencies, percentages, mean, and standard deviation. An independent sample t-test was computed to compare the difference in means of cases and controls. Chi-squared test was used to compare categorical variables between cases and controls. To assess the association between dependent and independent variables, we carried out bivariable and multivariable logistic regressions. Variables whose p-value < 0.05 were considered as having strong association and strength of association was measured using an odds ratio (OR) with its corresponding 95% confidence level (CI).

RESULTS: Pre-pregnancy overweight (OR = 6.7; 95%CI: 1.1-41.3 p = 0.0035), hypertension in the family member (OR = 3.1, 95%CI: 1.4-6.8, p = 004), multifetal gestation (OR = 5.4, 95% CI: 1.1-26, p = 003) and increased mid-gestation diastolic blood pressure of ≥ 80mmgh (OR = 7.6, 95%CI: 2.54-22.7, p = 0.002) were determinants of preeclampsia. Drinking coffee during pregnancy (OR = 0.27, 95%CI: 0.07, 0.94, p = 0.015) and iron and folic acid supplementation during pregnancy (OR = 0.48, 95%CI: 0.25-0.96, p = 0.041) were identified as protective factors.

CONCLUSION: Odds of preeclampsia was higher in women with pre-pregnancy overweight, family history of hypertension, multifetal gestation, and high mid-gestation diastolic blood pressure, whereas supplementation of iron and folic acid lowers the risk of preeclampsia. Therefore, health care providers should emphasis on preconception care and thorough clinical evaluation during pregnancy, which may provide opportunity to detect women likely to develop preeclampsia. Nutritional intervention and conducting further research on protective factors like coffee intake is recommended to clarify the inconsistent findings.

PMID:41034809 | DOI:10.1186/s12884-025-08176-w

BMC Cancer. 2025 Oct 1;25(1):1485. doi: 10.1186/s12885-025-14861-y.

ABSTRACT

OBJECTIVE: This study investigates the sensory and cognitive impact of cancer and its treatment, focusing on possible chemotherapy-induced hearing and olfactory impairment, and cognitive function. The primary aim is to evaluate the effectiveness and feasibility of an extended test battery for assessing sensory and cognitive function in cancer patients, providing foundational knowledge for a larger study. A secondary aim is to examine associations between chemotherapy types and sense-neurodegenerative function.

DESIGN: An observational cross-sectional, pilot study evaluated hearing, olfactory function, and cognitive function in first-line chemotherapy patients without prior brain injuries and ototoxic or otological histories. Self-reported outcomes on communication strategies, tinnitus and olfaction were collected. Data analysis applied descriptive statistics with t-tests, and Fisher´s exact tests to compare auditory, olfactory, and cognitive performance between treatment groups.

STUDY SAMPLE: Thirteen cancer survivors (n = 13), six (n = 6) females and seven (n = 7) males who received two different types of chemotherapy.

RESULTS: No significant differences were observed between the chemotherapy groups in audiological and olfactory tests, cognitive assessment, or self-reported outcomes. However, among those receiving platinum-based chemotherapy, participants reported greater use of communication strategies in specific areas.

CONCLUSION: No significant differences in hearing, olfactory, cognitive, and self-reported outcomes were found when examining cancer patients receiving two different chemotherapy types. The study highlights the need for advanced diagnostic tools to detect hearing, olfactory, and cognitive function in cancer survivors.

PMID:41034807 | DOI:10.1186/s12885-025-14861-y

BMC Cancer. 2025 Oct 1;25(1):1475. doi: 10.1186/s12885-025-14786-6.

ABSTRACT

BACKGROUND: There are limited real-world data on the prevalence of brain metastases (BM) in metastatic breast cancer (mBC) across the treatment pathway, especially when stratified by human epidermal growth factor receptor 2-positive (HER2+) or HER2-negative (HER2-) status. The goals of this study were to estimate the prevalence of BM at metastatic diagnosis and at the start of each line of systemic therapy (LOT), and to describe treatment patterns and overall survival (OS) in patients with and without BM.

METHODS: This retrospective cohort study included adult patients in the US with mBC diagnosed between January 2013 – May 2020, with known HER2 status from an electronic health record-derived, deidentified database. Patients were followed from mBC diagnosis to last activity date or death. Descriptive statistics were used for BM prevalence, patient characteristics, and treatment patterns. OS was estimated using the Kaplan-Meier method.

RESULTS: Of 12,644 patients with mBC in the database, 1923 (HER2+) and 9693 (HER2-) were included. The prevalence of BM at mBC diagnosis was 12.5% (HER2+) and 1.7% (HER2-). An NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®) recommended systemic treatment for BM was received by 25.0% of patients with BM (HER2+) versus 12.8% (HER2-) during first-line treatment. The prevalence of BM (documented before or within the same month of LOT start) was 11.2%, 22.8%, and 33.0% in those with HER2+ diseases who had at least one, two, and three prior LOTs, respectively. The prevalence of BM among patients with HER2- disease was 1.6%, 2.0%, and 2.8% in those who had at least one, two, and three prior LOTs, respectively. Median OS from mBC diagnosis among patients with versus without BM was 24 versus 37 months (HER2+) and 12 versus 27 months (HER2-).

CONCLUSIONS: In this real-world study of patients receiving care in US oncology clinics, the prevalence of BM in patients with mBC increased by LOT, and most were not receiving NCCN Guideline^®-recommended systemic therapies. OS was poorer in patients with BM versus without BM, especially in the HER2- population. These results highlight a need for more effective treatments for patients with mBC and BM.

PMID:41034805 | DOI:10.1186/s12885-025-14786-6

BMC Pregnancy Childbirth. 2025 Oct 1;25(1):999. doi: 10.1186/s12884-025-08091-0.

ABSTRACT

BACKGROUND: Recently, transvaginal ultrasound (TVS) has been proposed as an adjunct to transabdominal ultrasound (TAS) to help guide the management of PAS. However, the diagnostic accuracy of either technique, or both in combination, is dependent on the experience of the operator. This study aimed to evaluate the diagnostic accuracy of combined TAS and TVS techniques for PAS in differently-experienced operators.

METHODS: This study evaluated singleton pregnant women with placenta previa and suspected PAS from gestational age 28 weeks until delivery who had ultrasounds at a PAS tertiary referral center between January 2020 and November 2023. PAS was diagnosed following the International Federation of Gynecology and Obstetrics (FIGO) classification system and confirmed histopathologically. Retrospective evaluations were performed by two operators with different levels of experience, who were blinded to the clinical data and final diagnosis. Using stored images and video clips, they assessed the sonographic features selected from a Modified Delphi study of ultrasound signs associated with PAS. Inter-observer reliability was assessed using the kappa statistic. The predicted probability of PAS diagnosis was evaluated using a diagnostic accuracy test.

RESULTS: The images and related information of 70 pregnant women were used for the study. Fifty-five (78.57%) had PAS and 15 (21.43%) had placenta previa only. TAS with adjunctive TVS showed excellent interobserver agreement for all ultrasound features. Interobserver agreement in diagnosing PAS significantly improved with the adjunct method, achieving excellent agreement (0.92, p < 0.01). The diagnostic accuracy of the lower-experienced operator increased from 81.40% to 94.30% and the higher-experienced operator from 94.30% to 97.10%.

CONCLUSIONS: Prenatal diagnosis of PAS using TAS with adjunct TVS improved the PAS diagnostic accuracy, especially in the lower-experienced operator. These findings confirm the value of using TAS with TVS in the prenatal evaluation of high-risk pregnancies with suspected PAS.

PMID:41034796 | DOI:10.1186/s12884-025-08091-0

BMC Musculoskelet Disord. 2025 Oct 1;26(1):890. doi: 10.1186/s12891-025-09096-8.

ABSTRACT

PURPOSE: This study aims to develop a computational model to assess the cumulative probability of meniscal failure in the knee joint during running.

METHODS: The knee joint forces of twelve male participants were measured while running at speeds of 9 km/h, 12 km/h, and 15 km/h. These forces were used as boundary conditions in a finite element model. The proportion of high-stress elements in the meniscus during the support phase was calculated, and a Weibull distribution-based failure model was used to compute the cumulative injury probabilities of the meniscus over 360 days at the three running speeds.

RESULTS: Running speed had a significant main effect on this ratio(p = 0.041, F = 3.393, η_p² = 0.117), the ratio during the stance phase at 15 km/h was greater than at 9 km/h(p = 0.036, F = 5.402, Cohen’s d = 1.248), but this difference was not statistically significant when compared to 12 km/h(p = 0.513, F = 1.068, Cohen’s d = 0.224); similarly, there was no significant difference between 9 km/h and 12 km/h(p = 0.139, F = 1.335, Cohen’s d = 0.921).

CONCLUSIONS: Faster running speeds result in higher knee joint reaction forces, however, the probability of meniscal failure is lower. The risk of meniscal failure is more strongly associated with the frequency of stress applications than with the magnitude of the stress itself. Slower running speeds require more gait cycles to complete the same running distance, thereby prolonging loading duration and increasing the number of stress applications.

PMID:41034787 | DOI:10.1186/s12891-025-09096-8

BMC Anesthesiol. 2025 Oct 1;25(1):473. doi: 10.1186/s12871-025-03337-y.

ABSTRACT

INTRODUCTION: The study aimed to compare anesthesia maintenance using total intravenous anesthesia (TIVA) and inhalation anesthesia (IA) and investigating their effects on bleeding volume, intraoperative hemodynamic changes, and postoperative complications in women patients undergoing abdominal myomectomy.

METHODS: A double-blind randomized controlled trial was conducted on patients undergoing abdominal myomectomy at a large non-university hospital in northwest Iran in 2023. A total of 60 eligible patients were randomly assigned to two groups of TIVA (n = 30) and IA (n = 30) anesthesia methods. The study groups’ allocation was blinded to the anesthesiology provider and she was responsible for anesthesia and patient monitoring. The study outcomes were hemodynamic changes, bleeding during the surgery, anesthesia time, hospitalization, and postoperative complications between the study groups.

RESULTS: There were no significant differences in surgical indications, myoma size, hemoglobin levels, or clinical and obstetric characteristics before surgery between the two study groups (p > 0.05). The average blood loss (201.8 vs. 391.0 ml; P = 0.001), postoperative hemoglobin levels (11.6 vs. 10.5; P = 0.005), anesthesia times (100.6 vs. 114.3 min; P = 0.003), and hospitalization days (2.06 vs. 2.36; P = 0.005) showed statistically significant differences between the TIVA and IA groups, respectively. Mean arterial pressure (MAP) and heart rate values were significantly higher in the IA group compared to the TIVA group (P < 0.05). No muscle stiffness, dizziness, or respiratory depression were observed after surgery in either study group. The proportion of shivering in the TIVA and IA groups was 16.7% and 43.3%, respectively, indicating a significant statistical difference (P = 0.024). The proportion of optimal surgeon performance was reported to be higher in the TIVA group compared to the IA group (P = 0.014).

CONCLUSION: According to the findings of this study, the use of the TIVA method compared to IA during the maintenance of general anesthesia was linked to a reduction in intraoperative bleeding and transfusion requirements, as well as increased optimal surgeon performance in patients undergoing abdominal myomectomy. Furthermore, patients in the TIVA group experienced fewer complications during and after surgery, along with a shorter hospital stay.

TRIAL REGISTRATION: The study protocol was retrospectively registered and confirmed in the Iranian Registry of Clinical Trials under the number (IRCT20220930056059N1). Registration date: 2022-11-13. Expected recruitment start date: 2022-11-11.

PMID:41034776 | DOI:10.1186/s12871-025-03337-y

BMC Ophthalmol. 2025 Oct 1;25(1):527. doi: 10.1186/s12886-025-04358-4.

ABSTRACT

BACKGROUND: TransPRK, SMILE, and FS-LASIK are widely used surgical procedures for myopia correction, but differences in postoperative visual quality and optical zone design remain a subject of clinical interest. This study aimed to compare visual outcomes, higher-order aberrations (HOAs), contrast sensitivity, optical zone diameter, and corneal biomechanics among these three techniques.

METHODS: In this prospective cohort study, 82 patients (164 eyes) with myopia were randomly assigned to undergo TransPRK (n = 56 eyes), SMILE (n = 52 eyes), or FS-LASIK (n = 56 eyes). All procedures were performed at a single center, and patients were followed for six months postoperatively. Outcome measures included uncorrected visual acuity (UCVA), HOAs, contrast sensitivity under both bright and dark conditions, optical zone diameter, refractive error, corneal biomechanical parameters (corneal hysteresis and resistance factor), and subjective symptoms such as nighttime glare and halos. Statistical analysis involved ANOVA and chi-square tests.

RESULTS: At six months, all groups achieved comparable UCVA (≥ 96% achieving ≥ 1.0), but the TransPRK group demonstrated significantly lower total HOAs (0.25 ± 0.07 μm) and spherical aberrations (+ 0.05 ± 0.02 μm) than SMILE and FS-LASIK (P < 0.001). TransPRK also showed superior contrast sensitivity, particularly in low-light conditions (6 cpd: 1.05 ± 0.12 log units, P < 0.001). All techniques demonstrated comparable efficacy (indices > 1.0), with non-significant trends favoring SMILE for UCVA (98.08%) and TransPRK for refractive stability (-0.12 ± 0.25D; all P > 0.05). The SMILE group preserved the best corneal biomechanics (CH: 10.1 ± 1.1 mmHg; CRF: 10.5 ± 1.3 mmHg), while FS-LASIK had the highest incidence of nighttime glare (26.8%) and halos (23.2%) (P < 0.05).

CONCLUSIONS: TransPRK has good postoperative visual quality, but its advantages may be mediated by its larger optical zone design. In terms of night vision performance, SMILE surgery can effectively preserve the biomechanical properties of the cornea, while FS-LASIK achieved comparable 6-month acuity; we did not assess time-to-recovery. Selection of surgical modality should be individualized based on patient-specific anatomical and lifestyle factors.

PMID:41034774 | DOI:10.1186/s12886-025-04358-4