Category: Statistics

Naunyn Schmiedebergs Arch Pharmacol. 2025 Aug 1. doi: 10.1007/s00210-025-04482-4. Online ahead of print.

ABSTRACT

Acute basilar artery occlusion (BAO) is a rare but devastating type of ischemic stroke that significantly impacts outcomes. This systematic review and meta-analysis aim to evaluate the efficacy and safety of combining IVT with EVT (EVT + IVT) versus EVT alone in treating acute BAO, focusing on functional independence, mortality, reperfusion success, and hemorrhagic and procedural complications. We conducted a comprehensive search up to May 2025. Effect sizes were expressed as odds ratios (ORs) with 95% confidence intervals (CIs), and statistical significance was determined using p-values. Risk of bias was assessed using the ROBINS-I tool, and certainty of evidence was rated via the GRADE framework. Eight observational studies comprising 5252 patients (1777 EVT + IVT and 3475 EVT alone) were included. The analysis revealed that EVT + IVT showed higher odds of functional independence (mRS 0-2) compared to EVT alone, with an odds ratio of 1.23 (95% CI 1.06-1.43, p = 0.0080). Additionally, EVT + IVT significantly reduced mortality, with an odds ratio of 0.81 (95% CI 0.68-0.96, p = 0.0141). No significant differences were observed in symptomatic intracerebral hemorrhage, subarachnoid hemorrhage, reperfusion success (mTICI 2b/3), or procedural complications. This meta-analysis demonstrates that EVT + IVT is associated with improved functional independence and reduced mortality in acute BAO compared to EVT alone, without increasing the risk of hemorrhagic or procedural complications. These results are, however, based on very low certainty evidence. While bridging therapy appears to provide clinical benefits, high-quality randomized trials are urgently needed to confirm these findings and refine treatment protocols for posterior circulation strokes.

PMID:40748475 | DOI:10.1007/s00210-025-04482-4

Int Orthop. 2025 Aug 1. doi: 10.1007/s00264-025-06623-z. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate and compare the effectiveness of an intelligent fracture reduction robotic system in assisting closed reduction and intramedullary nailing of femoral shaft fractures with that of conventional fluoroscopy-assisted manual reduction and fixation.

METHODS: In this prospective, non-randomized controlled study, 30 patients with newly diagnosed femoral shaft fractures were enrolled, with 15 cases in the experimental group (robot-assisted) and 15 cases in the control group (conventional). The experimental group utilized an orthopaedic surgical navigation system to assist in closed reduction and intramedullary nailing, while the control group underwent fluoroscopy-assisted manual reduction and fixation. The reduction time, total operation time, intraoperative fluoroscopy count, blood loss, and reduction error were compared between the two groups.

RESULTS: Baseline characteristics were similar across both groups. The experimental group required significantly fewer intraoperative fluoroscopies (36.67 ± 25.41 vs. 117.26 ± 61.28, P < 0.001). Postoperative femoral length discrepancy (1.74 ± 1.37 mm) and anteversion difference (3.66 ± 3.37°) were significantly smaller in the experimental group compared to the control group (4.16 ± 2.67 mm, P = 0.004; 13.81 ± 9.58°, P = 0.001). Intraoperative blood loss was comparable between groups (experimental group: 207.33 ± 119.91 mL vs. control group: 240.00 ± 139.13 mL, P = 0.497). Reduction time was not statistically significant (experimental group: 74.27 ± 27.38 min vs. control group: 69.73 ± 34.10 min, P = 0.691).

CONCLUSIONS: The robot-assisted approach provided more precise fracture reduction, required fewer intraoperative X-ray fluoroscopies, and offered significant advantages over the conventional method for the minimally invasive treatment of femoral fractures.

PMID:40748453 | DOI:10.1007/s00264-025-06623-z

Infection. 2025 Aug 1. doi: 10.1007/s15010-025-02586-w. Online ahead of print.

NO ABSTRACT

PMID:40748451 | DOI:10.1007/s15010-025-02586-w

Psychol Health Med. 2025 Aug 1:1-15. doi: 10.1080/13548506.2025.2539943. Online ahead of print.

ABSTRACT

This study is conducted to analyze the relationship between the transformative power of suffering among nurses and their compassion level of others’ lives after the earthquake. Nurses are under the risk of experiencing a second trauma since they give care for earthquake survivors while they are also survivors at the same time. This study is a descriptive cross-sectional study. This study was conducted among 238 nurses. Data of the study were collected with Socio-demographic Form, the Transformative Power of Suffering Scale (TPSS) and Compassion of Others’ Lives Scale (COOL). The study was reported following the STROBE. The TPSS mean score of nurses was found as 20.61 ± 7.62, their total mean score of COOL was found as 10.63 ± 2.09. Statistically significant differences were found between the age, gender, working period, position in the unit of nurses and mean scores of TPSS. In the correlation analysis, a weak positive correlation between TPSS and total COOL and its subscales was found. It was found that TPSS mean score of nurses was at medium-level, that COOL total mean score of nurses was at good level and as the transformative power of suffering increased, the compassion of others’ lives increased.

PMID:40747634 | DOI:10.1080/13548506.2025.2539943

Hum Vaccin Immunother. 2025 Dec;21(1):2541496. doi: 10.1080/21645515.2025.2541496. Epub 2025 Aug 1.

ABSTRACT

The COVID-19 epidemic has significantly disrupted routine childhood immunization programs. This study assesses the impact of different COVID-19 prevalence phases on immunization coverage and timeliness in Shanghai, China. We employed a retrospective cohort design, encompassing children born between September 1, 2018, and August 30, 2023. Children were categorized into three COVID-19 phases based on their expected vaccination dates: baseline period, epidemic period, and pre/post-epidemic period. Kaplan-Meier estimators were utilized to ascertain the cumulative vaccination probabilities, with differences tested using the log-rank method. A multivariate Cox proportional hazards model was conducted to assess the impact of COVID-19 phases on vaccination timeliness. Vaccination timeliness significantly declined when the vaccination window coincided with an epidemic period, particularly for older children and during heightened epidemic activity. The probability of timely vaccination at 2 months was 0.89 (95% CI: 0.86-0.92) in the baseline period and 0.53 (95% CI: 0.51-0.55) in the epidemic period, compared to the pre/post-epidemic period. At 3 months, the probability of timely vaccination decreased 12% (HR = 0.88, 95% CI 0.86-0.90) and 49% (HR = 0.51, 95% CI 0.49-0.53), respectively. Similarly, for vaccinations scheduled at 4 months, the probabilities of timely vaccination were 0.87 (95% CI 0.85-0.89) and 0.49 (95% CI 0.47-0.51) times. At 5 months, the probabilities declined 9% (HR = 0.91, 95% CI 0.87-0.94) and 57% (HR = 0.43, 95% CI 0.40-0.46), correspondingly. Our study assessed the notable decline of vaccination timeliness during epidemic periods, highlighting the need for targeted strategies to mitigate disruptions in routine childhood immunization services.

PMID:40747582 | DOI:10.1080/21645515.2025.2541496

Fam Pract. 2025 Jun 4;42(4):cmaf054. doi: 10.1093/fampra/cmaf054.

ABSTRACT

BACKGROUND: Appropriate medication behavior is important to ensure patients receive optimal health benefits from interacting with their healthcare providers. Communication between patients and providers is essential in ensuring patients take prescribed medication appropriately.

OBJECTIVE: To investigate the available evidence on the effectiveness of bi-directional communication interventions that focus on both patients and clinicians in outpatient settings aimed at changing how patients take their medications. The desired patient medication behavior changes included initiation, adherence, dose escalation, dose reduction, and discontinuation.

METHODS: We performed a systematic review of research studies assessing bi-directional patient-provider communication interventions targeting patient medication behavior change in the outpatient setting. We identified the types of interventions used in each study and the components of successful trials.

RESULTS: We included eight randomized controlled trials and two quasi-experimental trial with a total of 2,911 adult participants. Among the 10 studies, 9 reported statistically significant improvement in the desired direction of medication behavior change in the intervention group compared to control group.

CONCLUSION: This scoping review shows the promise of bi-directional patient-provider communication tools in impacting behavior related to how patients take their prescribed medications. More randomized controlled trials with standardized outcomes are needed to better assess the utility of patient-provider communication tools.

PRACTICE IMPLICATIONS: Including both patient and provider in an effort to improve desired patient medication behavior change should be considered when educational interventions are designed.

PMID:40747580 | DOI:10.1093/fampra/cmaf054

Health Promot Int. 2025 Jul 1;40(4):daaf132. doi: 10.1093/heapro/daaf132.

ABSTRACT

Health literacy (HL) is a critical determinant of health, as it affects health behavior and outcomes, in addition to equity in health. This study aimed to translate, culturally adapt, and validate the Swedish version of HLS19-Q12 (HLS19-Q12-SE). The HLS19-Q12 is a widely used instrument that consists of 12-items and is often used to assess HL in Europe. A convergent mixed-methods design was applied, including cognitive interviews (n = 8) and psychometric testing with a survey sample (n = 374) and test-retest group (n = 28). The instrument was forward and backwards translated and culturally adapted. Data was analyzed using confirmatory and exploratory factor analysis, correlation testing, and reliability assessments. Cognitive interviews explored the clarity, interpretation, and contextual relevance of the items. Participants found the HLS19-Q12-SE clear and easy to understand, though some reported difficulties with unfamiliar health situations and uncertainty of the term “health information.” Based on the interviews, the examples for one of the items were culturally adapted. Psychometric testing showed good feasibility, no floor or ceiling effects on scale level, and moderate positive correlations with other HL instruments, supporting internal and external validity. Structural validity was confirmed, and internal consistency and test-retest reliability were satisfactory. However, ceiling effects were observed at the dichotomous item level, and correlations with self-rated health and social status were low. The HLS19-Q12-SE is a reliable and valid instrument for assessing general HL in Sweden. While psychometric properties were strong overall, future research should address ceiling effects on item level and explore the instrument’s performance in more diverse populations.

PMID:40747568 | DOI:10.1093/heapro/daaf132

Jpn J Nurs Sci. 2025 Oct;22(4):e70013. doi: 10.1111/jjns.70013.

ABSTRACT

AIM: Currently, there is no Japanese tool to measure organizational context factors that influence nurses’ implementation of evidence-based practices. This study aimed to translate, culturally adapt, and psychometrically evaluate the Alberta Context Tool (ACT) for nurses in Japan.

METHODS: We completed forward translations with reconciliation, expert discussions, back translations with reconciliation, back translation review by tool developers, and semi-structured cognitive interviews with verbal probing. A convenience sample of nurses from five hospitals completed the translated tool. Item descriptives (including missing data), internal structure (confirmatory factor analyses [CFA]), criterion validity (correlations with Team Climate Inventory [TCI] items “support for innovative ideas”), internal consistency reliability (Cronbach’s alpha, item-concept correlations), and test-retest reliability (intraclass correlation) were examined.

RESULTS: Cognitive debriefing with nine nurses led to modifying 10 ACT items. A total of 508 nurses completed the survey. CFA showed an acceptable model fit for the seven scale-based concepts ( x 2 $$ {x}^2 $$ = 1037.28, root mean square error of approximation = 0.054, Comparative Fit Index = 0.913, Tucker-Lewis Index = 0.902, standardized root mean square residual = 0.053). Correlations between the 10 ACT concepts and TCI ranged from .08 to .43, with nine statistically significant (p < .05). Cronbach’s alpha ranged from .22 to .91 (exceeding 0.70 for 8/10 concepts), and item-concept correlations ranged from .15 to .96 (exceeding 0.70 for 26/56 items). Retest reliability (N = 65) ranged from 0.45 to 0.81.

CONCLUSIONS: The ACT Japanese version demonstrated initial evidence of acceptable validity and reliability for most concepts and items, supporting its use in assessing organizational context.

PMID:40747563 | DOI:10.1111/jjns.70013

Cancer Med. 2025 Aug;14(15):e71121. doi: 10.1002/cam4.71121.

ABSTRACT

BACKGROUND: The increasing number of cancer survivors (CSs) globally highlights the critical need for healthcare systems to address their unmet needs. These needs span physical, psychosocial, spiritual, informational, and practical dimensions and, if unaddressed, can impact quality of life and healthcare satisfaction.

AIMS: This study aimed to identify and understand the unmet needs of CSs in Italy to guide the development of patient-centered survivorship care services.

METHODS: A cross-sectional qualitative study was conducted between April 2023 and January 2024 at the Comprehensive Cancer Centre of Reggio Emilia, Italy. Data were collected through focus groups and individual interviews with 35 CSs and seven caregivers selected via convenience sampling. Eligibility criteria included non-cutaneous CSs with a 5-year survival rate of ≥ 65% who had completed active treatment and were in follow-up care. Data were analyzed using the Framework Method.

RESULTS: Four key themes emerged: (1) Dignity and Respect: Emphasis on the importance of treating CSs with dignity and respect within healthcare settings; (2) Desire for Normality: Highlighting CSs’ strong desire to regain a sense of normalcy post-treatment; (3) Pursuit of Control Over One’s Life: CSs’ need to maintain control, particularly regarding information needs and treatment management; (4) Existential Vulnerability: The vulnerability and fragility felt by CSs, underscoring their need for emotional support and reassurance.

CONCLUSIONS: Unmet needs remain a significant challenge for CSs, necessitating the implementation of tailored, patient-centered care interventions. Addressing these needs can enhance quality of life, satisfaction, and outcomes for CSs worldwide.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT06236373.

PMID:40747540 | DOI:10.1002/cam4.71121

Iran J Parasitol. 2025 Apr-Jun;20(2):213-226. doi: 10.18502/ijpa.v20i2.19027.

ABSTRACT

BACKGROUND: The use of nanocarriers in combination with other treatments shows significant promise in addressing drug-resistant diseases, particularly malaria. Given the high prevalence of drug-resistant malaria, research into innovative therapies is crucial. This study focuses on a nanoform of chitosan, a biodegradable polymer, combined with Crocus sativus (saffron) and chloroquine to enhance their antimalarial effects.

METHODS: Saffron extract and chloroquine were separately conjugated with chitosan, followed by confirmation tests to determine conjugation efficiency. Both chloroquine-resistant and sensitive strains of Plasmodium falciparum were cultured to calculate the IC50 values of various treatments in vitro. This study was conducted at the School of Public Health, Tehran University of Medical Sciences, Tehran, Iran in 2024.

RESULTS: Confirmation tests (FTIR, DLS, Zeta potential, TEM) verified proper drug conjugation to nanocomposites, with observed nanosize, the percentage of conjugation was 64.4% for chloroquine and 42.9% for saffron. Toxicity and hemolysis tests confirmed safe doses. The IC50s values for Chloroquine, Nanoparticle-Chloroquine, Saffron, and Nanoparticle-Saffron were 0.3, 0.8, 42.5, and 6.24 μg/ml, respectively, for the sensitive strain, and 5, 1, 12.5, and 3.12 μg/ml, respectively, for the resistant strain. Combination therapy with the fixed ratio method showed synergistic effects. Statistical analysis revealed synthesized nanocomposites’ superior inhibition of P. falciparum growth compared to non-nano. Significant differences were observed in some cases (P< 0.05).

CONCLUSION: Utilizing nanocarriers and combination therapy is an appropriate strategy for addressing drug resistance. Saffron’s anti-malarial effects on P. falciparum were notably increased when linked to chitosan nanocomposites. Furthermore, employing a fixed ratio technique enhanced the therapeutic effectiveness of saffron when combined with chloroquine and chloroquine-nanocomposites across all concentrations.

PMID:40747512 | PMC:PMC12307787 | DOI:10.18502/ijpa.v20i2.19027