Category: Statistics

Sci Rep. 2025 Jul 30;15(1):27870. doi: 10.1038/s41598-025-12572-9.

ABSTRACT

Mistreatment can adversely affect students’ academic performance and mental health. This study investigated the prevalence of mistreatment and its association with academic motivation among Thai clinical-year medical students. A cross-sectional study was conducted among medical students throughout Thailand using the Composite Questionnaire of Mistreatment and Academic Motivation Scale (AMS). Descriptive statistics, chi-square tests, correlations, and regression analyses were conducted. A p value < 0.05 was considered statistically significant. The sample included 399 students, with a median age of 23 years (interquartile range [IQR]: 22-24), and 61.5% were female. A total of 81% of participants experienced mistreatment. Twenty-nine percent of students thought that mistreatment occurred because the maltreaters did not consider mistreatment as inappropriate or serious. Students who experienced mistreatment exhibited lower AMS (B = – 9.16, 95% CI – 15.37 to – 2.95, p value = 0.004) than those who did not. Moreover, students who experienced academic mistreatment exhibited a higher amotivation score (B = 1.50, 95% CI 0.16 to 2.85, p value = 0.029) than those who did not. The prevalence of mistreatment was unexpectedly high, and it was associated with students’ motivation to study. Educational institutions should prioritize addressing this issue and developing strategies to provide assistance, including enhancing reporting systems.

PMID:40739292 | DOI:10.1038/s41598-025-12572-9

Sci Rep. 2025 Jul 30;15(1):27771. doi: 10.1038/s41598-025-13738-1.

ABSTRACT

This study investigated the relationship between protein and energy intake during the early (days 1-2) and late (days 3-7) acute phase and prognosis in septic patients with nutritional risk screening 2002 ≥ 3. Cox regression analysis was performed to identify factors associated with 28-day mortality. Among 293 shock patients, higher energy intake in days 3-7 was signifcantly associated with lower 28-day mortality (hazard ratio, 0.969; 95% confidence interval, 0.942-0.997; P = 0.033). Kaplan-Meier analysis showed achieving 75% of energy target in days 3-7 correlated with decreased 28-day mortality (P = 0.040). In 309 non-shock patients, no significant relationships between nutritional therapy during acute phase and 28-day mortality were observed. Enhanced energy intake in days 3-7 showed no correlation with improvements in length of intensive care unit/hospital stay, ventilator-free days, non-ICU survival days or hospitalization costs for septic patients. In shock patients, energy intake in days 3-7 demonstrated no relationship with secondary infections; however, among non-shock patients, achieving 50% of energy intake in days 3-7 was linked to lower incidence of fungus infections (P = 0.006) and intra-abdominal infections(P = 0.003). Our findings demonstrate statistical associations between augmenting energy intake during the late acute phase and potential benefits in sepsis.

PMID:40739291 | DOI:10.1038/s41598-025-13738-1

Sci Rep. 2025 Jul 30;15(1):27758. doi: 10.1038/s41598-025-13245-3.

ABSTRACT

Intussusception is a significant cause of child mortality in sub-Saharan Africa, yet its exact causes remain unclear. Two main theories suggest it may be linked to dietary factors or infections, highlighting the need for research to identify specific risk factors. Accordingly, this study aimed to investigate the factors associated with intussusception in children under five years of age. A hospital-based unmatched case-control study design was employed, using an interviewer-administered structured questionnaire and a review of medical records for data collection. Data were analysed using SPSS version 25, and both bivariate and multivariable logistic regression models were applied. Variables with a p-value < 0.25 in the bivariate analysis were included in the multivariable logistic regression model. Statistical significance was declared at a p-value of less than 0.05. The study included 52 cases and 156 controls. The average age of the cases was 11.5 months (SD ± 8.60), and that of the controls was 18.9 months (SD ± 15.4). Among the participants, males accounted for 65.4% of the cases and 53.8% of the controls, while females comprised 34.6% of the cases and 46.2% of the controls. Variables significantly associated with intussusception included age between 6 and 12 months [AOR = 3.13; 95% CI: 1.04-9.41], history of gastrointestinal infections [AOR = 5.07; 95% CI: 2.14-11.9], mixed feeding with breast milk and formula [AOR = 17.12; 95% CI: 5.42-54], and feeding with breast milk and homemade foods [AOR = 9.28; 95% CI: 2.52-34.2]. This study demonstrates that children aged 6 to 12 months, a history of gastrointestinal infections, previous medication use, and mixed feeding practices (breast milk combined with formula or homemade foods) are associated with an increased risk of intussusception. Educating mothers and caregivers on proper hygiene practices to reduce infections, and promoting awareness of the benefits of exclusive breastfeeding, are essential preventive strategies.

PMID:40739284 | DOI:10.1038/s41598-025-13245-3

Stem Cell Res Ther. 2025 Jul 30;16(1):413. doi: 10.1186/s13287-025-04537-6.

ABSTRACT

BACKGROUND: Induced pluripotent stem cell-derived fibroblasts (iFBs) hold promise for autologous disease modelling, but their ability to replicate tissue-specific fibroblast characteristics remains unclear. Fibroblasts exhibit significant heterogeneity, with distinct subtypes playing critical roles in organ function and integrity. This study investigates whether iFBs can acquire tissue-specific transcriptional profiles through co-culture with cells from different germ layers, including skin (keratinocytes), heart (cardiomyocytes), gut (intestinal cells), and lung (bronchial epithelial cells).

METHODS: iFBs were co-cultured directly or indirectly with organ-specific cell types, followed by bulk RNA sequencing and pathway analysis. Transcriptional profiles were compared to primary fibroblasts using principal component analysis (PCA), large single-cell databases of over 20,000 cells for single-cell deconvolution and targeted qPCR validation. Statistical significance was assessed via one-way ANOVA.

RESULTS: Transcriptomic analysis revealed that iFBs exhibit transcriptional plasticity, adopting molecular phenotypes aligned with their co-culture environment across all germ layers. Paracrine signalling induced transient tissue-specific changes in indirectly co-cultured iFBs, but sustained interactions were required for stable adaptations. Pathway analysis highlighted functional shifts, such as TGF-β activation in cardiac iFBs and ECM remodelling in dermal iFBs. However, single-cell deconvolution showed incomplete tissue specification, with iFBs retaining mixed fibroblast subpopulations.

CONCLUSIONS: These findings demonstrate that iFBs can adopt tissue-specific transcriptional profiles, supporting their potential for modelling fibrotic microenvironments in 3D in vitro systems. However, the partial and transient nature of these adaptations underscores the need to validate whether transcriptional changes translate to functional fibroblast behaviours, such as ECM dysregulation or aberrant TGF-β signalling, in complex tissue models. Optimising co-culture conditions to stabilise these phenotypes will be critical for leveraging iFBs in fibrosis research, drug screening, and personalised disease modelling.

PMID:40739279 | DOI:10.1186/s13287-025-04537-6

BMC Chem. 2025 Jul 30;19(1):227. doi: 10.1186/s13065-025-01570-7.

ABSTRACT

Today’s crystal engineering in coordination chemistry community offers diverse applications and innovative bonding concepts in crystal assembly. The current research delves into synthesizing one novel Cu(II) complex, [(NO₃)Cu(H₂O)(L^2,2-Me2)(μ-H₂O)Cu(L^2,2-Me2)](H₂O)ClO₄ (L^2,2-Me2 = Schiff base) with NaClO₄. A combination of standard spectroscopic methods, including SEM-EDX, XPS, and SCXRD (single-crystal X-ray diffraction) study, was used to characterize the complex. The X-ray structure reveals that the di-nuclear Cu(II) complex crystallizes in the triclinic space group P-1, and the crystal assembly is stabilized predominantly by C-H···π interactions, as well as hydrogen bonding interactions such as N-H⋯O and O-H⋯O. A comprehensive DFT analysis, a hallmark of our research, explored the complex semiconductors and sensing capabilities for cations (Co²⁺/Ni²⁺/Cd²⁺) and anions (Br^–/I^–), providing valuable insights into the ECT (Electronic Charge Transfer) processes within the complex. MEP surface and FMO energy gap support the complex sensing and semiconductor behaviour. Antimicrobial screening reveals comparable activity for the Schiff base and its Cu(II) complex against both Gram +ve/-ve bacterial and fungal strains based on zone of inhibition (ZOI) and minimum inhibitory concentration (MIC). Meanwhile, the in vitro anticancer activity of the Cu(II) complex was assessed using the Trypan blue exclusion and MTT methods on the HepG2 and H9c2 cancer cell lines. The IC₅₀ value indicates that the Cu(II) complex exhibits significant anticancer activity. The structure-activity relationship (SAR) through the chelation/Tweedie’s polarization theory, complex geometry, hydrogen bond-type supramolecular interactions, the redox role of Cu(II) metal ions, and the generation of reactive oxygen species (ROS) by Cu(II) metal ions, which adequately explain the biological activity of the complex. Subsequently, the complex was utilized for potential applications in sensors or therapeutics, and combined DFT and biological findings underscore the novel research on the Cu(II) complex.

PMID:40739274 | DOI:10.1186/s13065-025-01570-7

Cost Eff Resour Alloc. 2025 Jul 30;23(1):38. doi: 10.1186/s12962-025-00645-5.

ABSTRACT

INTRODUCTION: Hospitals provide essential health services, focusing on quality, safety, and patient-centered care. The rising prevalence of communicable and non-communicable diseases in Indonesia has led to increased National Health Insurance (NHI) costs, with communicable diseases representing a significant burden despite global progress in disease control. Tuberculosis remains a major global health concern, causing 1.25 million deaths in 2023, while Indonesia ranks second globally for tuberculosis burden, accounting for 10% of global TB cases with an estimated 969,000 cases annually. Despite efforts to improve quality, Haji and Labuang Baji Hospitals face challenges, including financial losses and suboptimal patient outcomes. This study aims to assess the impact of an Integrated Clinical Pathway (ICP)-based Professional Nursing Practice Model on clinical outcomes, hospital costs, and patient satisfaction at these hospitals.

METHODS: This study employed action research methodology by developing, implementing, and evaluating the clinical guidelines and ICP for 10 diseases that were categorized as high volume, high risk, and high cost based on secondary data analysis using the NHI databases. Data was collected through observation of the ICP implementation on 40 patients and interviews of Professional Care Providers (PCPs) and was analyzed using IBM SPSS Statistics version 28.

RESULTS: A total of 40 patients from Haji Hospital (n = 20) and from Labuang Baji Hospital (n = 20) with diagnoses of pulmonary tuberculosis, pneumonia, dyspepsia, typhoid fever, normal delivery, and COPD were included and analyzed. Compliance with ICPs in both hospitals was quite low: 50.02% in Haji Hospital and 44.46% in Labuang Baji Hospital. However, the length of patients’ stays (LOS) generally complied with ICP standards, although some cases exceeded the benchmarks. Hospital costs varied across different disease diagnoses, impacting overall financial outcomes. Patient satisfaction improved across all diagnostic categories.

CONCLUSION: The implementation of ICP at both hospitals showed that all indicators of patient clinical outcomes improved according to the time specified in ICP, resulting in patients’ LOS being shorter than stipulated in ICP and an increase in patient satisfaction. ICP implementation has also led to hospitals earning different profits in almost all diagnoses.

PMID:40739272 | DOI:10.1186/s12962-025-00645-5

J Health Popul Nutr. 2025 Jul 30;44(1):269. doi: 10.1186/s41043-025-01013-y.

ABSTRACT

INTRODUCTION: Observational studies have indicated that individuals with hypertension (HTN) and diabetes mellitus (DM) tend to exhibit elevated plasma atherogenic index of plasma (AIP), defined as log (triglyceride [TG]/high-density lipoprotein cholesterol (HDL-C)). However, the precise relationship between these factors remains unclear. This study aimed to examine the correlations among HTN, DM, and AIP.

METHODS: Data from the National Health and Nutrition Examination Survey (NHANES; 2011-2016), a nationally representative sample, were analyzed to assess the relationship between AIP and the coexistence of HTN and DM in United States (US) adults. AIP served as the exposure variable, adjusted for 28 covariates. Baseline characteristics, correlation analysis, stratified analysis, and non-linear modeling were employed to elucidate these associations. The Extreme Gradient Boosting (XGBoost) machine learning algorithm was utilized to evaluate the predictive value of various variables for the presence of HTN and DM. Receiver operating characteristic (ROC) curve analysis was performed to assess AIP’s diagnostic accuracy for detecting HTN and DM.

RESULTS: Baseline characteristics revealed that individuals with HTN and DM had higher mean AIP values (0.39). Participants with alcohol use, obesity, or metabolic syndrome were more likely to present with both conditions. A significant positive correlation between AIP and the coexistence of HTN and DM was found (model 1: odds ratio [OR] = 5.93, 95% confidence interval [CI] = 3.84-9.16, P < 0.001; model 2: OR = 6.78, 95% CI = 4.14-11.1, P < 0.001; model 3: OR = 3.95, 95% CI = 1.66-9.39, P = 0.005), as confirmed by stratified analysis and smoothing curve analysis. The XGBoost algorithm identified AIP as an important predictor of HTN and DM. ROC curve analysis demonstrated AIP’s relatively high accuracy in predicting these conditions. Smoothing curve analysis further supported the positive associations among AIP, HTN, and DM.

CONCLUSION: This cross-sectional study highlights AIP was significantly associated with HTN combined with DM, underscoring its potential as a diagnostic tool. These findings provide valuable insights for future preventive and therapeutic approaches.

PMID:40739270 | DOI:10.1186/s41043-025-01013-y

Trials. 2025 Jul 30;26(1):263. doi: 10.1186/s13063-025-08910-x.

ABSTRACT

BACKGROUND: The United Kingdom Medical Research Council (MRC) guidance for complex interventions recommends the nesting of process evaluations in randomised controlled trials (RCTs) of complex interventions. To date, there has been limited review of how the MRC guidance has been operationalised in RCTs of complex interventions.

OBJECTIVES: This scoping review aimed to identify how process evaluations nested in RCTs on complex interventions have been conducted and reported since the 2015 publication of MRC guidance.

METHODS: We identified articles in PubMed and Scopus that cited the 2015 main journal article on the MRC guidance and applied an RCT filter to these articles. Studies reporting on RCT nested process evaluations in any field of health or social care were included. Data was extracted about study details, process evaluation study design, including methods used for data collection, data analyses, integration with RCT data and use of theory in process evaluation design.

RESULTS: We identified 160 RCTs and 53 pilot/feasibility RCTs. Most process evaluations included a combination of qualitative and quantitative data collection methods, either triangulated (mixed method studies) or not (multi-method studies). Most studies did not report the use of theory in shaping how the process evaluation was designed. Common methods for data analysis included descriptive statistics and thematic analysis for quantitative and qualitative studies respectively. There was limited triangulation of process evaluation data with RCT outcomes.

CONCLUSIONS: Whilst process evaluations can be helpful in explaining outcomes of RCT interventions and subsequent implementation of these intentions, information gathered from process evaluations is often not fully reported in papers. There are currently no suitable reporting guidelines for process evaluations linked to RCTs; work to develop such guidelines, potentially as a StaRI checklist extension, would be valuable.

PMID:40739244 | DOI:10.1186/s13063-025-08910-x

Diabetol Metab Syndr. 2025 Jul 30;17(1):302. doi: 10.1186/s13098-025-01864-9.

ABSTRACT

BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease, seriously threatening the public health. However, the specific role of metabolic score of visceral fat (METS-VF) as a prognostic marker in the MASLD population remains unclear. In this study, we explored the association and nonlinear relationship between METS-VF and all-cause mortality among MASLD population.

METHODS: This study included American adults aged over 20 years with MASLD who participated in the Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994) in the United States. Kaplan-Meier curve was used to explore the relationship between different METS-VF levels and all-cause mortality. Multivariable Cox regression analysis was used to explore the independent linear relationship between METS-VF and all-cause mortality. In addition, Cox regression with restricted cubic spline functions and smooth curve fitting were used to evaluate potential nonlinear associations. An inflection point of METS-VF was determined using a two-piece Cox regression model.

RESULTS: During an average follow-up period of 23.15 years, there were 1,413 all-cause deaths and the cumulative all-cause mortality proportion was 46.6%. Kaplan-Meier curve revealed that high METS-VF significantly increased the mortality risk in the MASLD population. Multivariate Cox regression analysis revealed that METS-VF was independently associated with all-cause mortality (hazard ratio [HR]: 1.121; 95% confidence interval [CI]: 1.103-1.139; P < 0.001). Cox regression with restricted cubic spline functions and smooth curve fitting showed a J-shaped relationship between METS-VF and all-cause mortality, with an inflection point of 6.394. The HR was 1.068 (95% CI: 1.038-1.099, P < 0.001) before the inflection point and 1.143 (95% CI: 1.122-1.166, P < 0.001) after it.

CONCLUSION: This study reveals that higher METS-VF levels are significantly associated with an increased risk of all-cause mortality in individuals with MASLD, characterized by a J-shaped non-linear relationship. This finding provides a new indicator for prognosis assessment in the MASLD population.

PMID:40739243 | DOI:10.1186/s13098-025-01864-9

BMC Cancer. 2025 Jul 30;25(1):1246. doi: 10.1186/s12885-025-14583-1.

ABSTRACT

BACKGROUND: Brain metastasis is a common and serious complication in patients with non-small cell lung cancer (NSCLC), often associated with poor prognosis. While traditional diagnostic approaches such as magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) cytology are commonly used for detection, these methods have notable limitations. Circulating tumor DNA (ctDNA) in CSF has been reported as a superior alternative. This study evaluates the diagnostic test accuracy of CSF ctDNA for CNS metastases detection in patients with NSCLC, in comparison to CSF cytology, while also examining its potential prognostic value.

METHODS: A systematic search was conducted to identify studies that reported CSF ctDNA detection in NSCLC patients with brain or leptomeningeal metastases. Pooled detection rates, sensitivity, specificity, and diagnostic odds ratios were meta-analyzed. Heterogeneity and publication bias were assessed using standard statistical methods. Subgroup and sensitivity analysis were applied to identify and address source of high heterogeneity.

RESULTS: Twenty-six studies were included. The pooled detection rate of CSF ctDNA (86%, 95% CI: 0.79-0.91) was significantly higher than CSF cytology (60%, 95% CI: 36% % 81%). Diagnostic test accuracy analysis for CSF ctDNA showed high pooled sensitivity (91.8%, 95% CI: 74.2%-97.8%), specificity (93.5%, 95% CI: 76.7% – 98.5%) and diagnostic odds ratio (DOR) (93.51%, 95% CI: 13.85-631.44). Additionally, CSF ctDNA detected clinically relevant mutations that correlated with poorer overall survival, highlighting its prognostic potential.

CONCLUSION: CSF ctDNA demonstrates superior diagnostic accuracy for detecting CNS metastases in NSCLC compared to CSF cytology. Its molecular insights may support earlier detection and inform personalized treatment strategies. However, further validation in clinical settings is required.

PMID:40739228 | DOI:10.1186/s12885-025-14583-1