Category: Statistics

Vet Res. 2025 Oct 7;56(1):190. doi: 10.1186/s13567-025-01618-5.

ABSTRACT

Marek’s disease (MD), caused by Marek’s disease virus (MDV), poses a significant threat to the poultry industry worldwide by inducing neurological disorders and malignant lymphoma in infected chickens. The underlying mechanisms of the host response to MDV infection and tumorigenesis remain poorly understood. To gain insight into the host response, we analysed the transcriptomic and metabolomic profiles of the heart tissue of Wenchang chickens, an indigenous Chinese breed, using RNA sequencing and untargeted metabolomics. A total of 2470 and 2666 genes were significantly up- and down-regulated, respectively, between infected and uninfected chickens. KEGG pathway enrichment analysis revealed distinct transcriptional patterns in response to MDV infection: upregulated genes were enriched primarily in immunity-related pathways, whereas downregulated genes were associated with metabolic pathways. Among the 433 differentially expressed metabolites identified, only the caffeine metabolism pathway approached statistical significance (p = 0.067). Integrative mapping of genes and metabolites to the KEGG enzyme database highlighted L-tryptophan interactions, with KYNU, KMO, KYAT3, and AADAT as the most representative relationships. These results provide a quantitative overview of MDV-induced transcriptional and metabolic perturbations, suggesting that hosts may counteract viral infection and tumor progression by suppressing cellular metabolism to potentiate immune responses.

PMID:41057891 | DOI:10.1186/s13567-025-01618-5

BMC Nurs. 2025 Oct 7;24(1):1243. doi: 10.1186/s12912-025-03862-8.

ABSTRACT

BACKGROUND: Mentors play a crucial role in clinical nursing education, particularly in assessing student nurses. However, if students cannot perceive their mentors’ assessment-literate practices (referred to as mentors’ assessment-literate practices hereafter), students may not effectively utilize assessment information for learning. Despite its significance, mentors’ assessment-literate practices and the antecedent factors are not well studied. This study aims to explore the mediating role of nursing students’ self-efficacy in the relationship between their competence and their perception of mentors’ assessment-literate practices, while also examining potential gender bias in mentors’ assessment-literate practices.

METHODS: The study employed a cross-sectional quantitative design. Participants included 854 final-year nursing students (61 males, 793 females) from 10 colleges/universities in southern China. After eight months of clinical training, students reported on mentors’ assessment-literate practices, self-efficacy, internship grades, and gender. Path analysis was conducted using Mplus 8.10 to test the mediating model, and gender bias was assessed through differential item functioning analysis with Winsteps^® (Version 5.6.0.0).

RESULTS: The study found a full mediation effect of self-efficacy between competence and students’ perception of their mentors’ assessment-literate practices, with a statistically significant indirect association of 0.10. The path coefficient between competence and self-efficacy is 0.12, and between self-efficacy and perceived mentors’ assessment-literate practices is 0.86. Gender bias and gender difference were statistically not supported; however, three items showed large effect size regarding gender bias.

CONCLUSIONS: This study introduces assessment-literate practices as a key concept in nursing education, highlighting its antecedent factors and potential gender biases for better assessment practices. The findings suggest that self-efficacy plays a full mediating role; hence, stakeholders should prioritize developing students’ self-efficacy while improving their competence. Also, mentorship practices should be adjusted to ensure equal opportunities for both male and female students; specifically, they may need to be aware of potential gender bias, offering male students more practice opportunities and female students more chances to explain.

PMID:41057885 | DOI:10.1186/s12912-025-03862-8

BMC Med Educ. 2025 Oct 8;25(1):1371. doi: 10.1186/s12909-025-08038-1.

ABSTRACT

BACKGROUND: Peer education (PE) refers to the process of individuals being educated by their peers, that is, people with similar experiences or statuses. This study aimed to evaluate the effects of PE on the psychomotor skills and self-efficacy of nursing students.

METHODS: This single-blind randomized controlled trial was conducted with 63 undergraduate nursing students. Data were collected using the “Individual Descriptive Information Form”, “Intramuscular Injection Knowledge Level Assessment Form”, “Intramuscular Injection Psychomotor Skills Assessment Form”, and the “General Self-Efficacy Scale”. Descriptive statistics (numbers, percentages, means, standard deviations, and min-max values) were used. The independent samples t-test and Mann-Whitney U test were used to analyze differences between groups.

RESULTS: The mean age of the participants was 21.22 ± 0.85 years (range: 20 – 23), and 52.4% were female. No statistically significant differences were found between the groups in pretest, posttest, or self-efficacy scores (p > 0.05). However, the psychomotor skill levels differed significantly between the groups (p < 0.001), with the intervention group scoring higher than the control group.

CONCLUSIONS: Nursing students who received PE demonstrated significantly better psychomotor skills than those taught using traditional methods. It is recommended to integrate interactive learning strategies such as PE, where students can express themselves more freely and actively engage in the learning process, especially in nursing education areas requiring the development of psychomotor skills.

PMID:41057851 | DOI:10.1186/s12909-025-08038-1

Nutr J. 2025 Oct 7;24(1):152. doi: 10.1186/s12937-025-01169-7.

ABSTRACT

PURPOSE: This study aimed to translate and culturally adapt the Beverage Intake Questionnaire (BEVQ-15) to the Turkish population and to assess its validity and reproducibillity.

METHODS: This cross-sectional study included adults and older residing in Ankara, Turkey. The study process involved the translation of the BEVQ-15 from English into Turkish and its adaptation to the Turkish community. Adaptations to the original BEVQ-15 included separating the black tea and coffee category into distict categories, as well as herbal tea. Additionally, plain mineral water, flavored mineral water, kefir, and turnip juice were presented as individual categories. The adaptation of BEVQ-15 to Turkish preferences resulted in the BEVQ-21. Participants come to three visits, each two weeks apart. The BEVQ-21 was administered at visits 1 and 3, and a three day dietary record was returned during visit 2.. The BEVQ-21 was conducted at visit one (BEVQ-1) and visit three (BEVQ-2). Validity and reproducability statistical analyses were conducted using Wilcoxon signed-rank tests, Bland-Altman plots, and Spearman correlations.

RESULTS: Fifty-one participants completed all study visits. Minimal yet significant differences were identified between the two assessment tools (BEVQ-2 and DR) across various beverage categories, with mean differences ranging from 3 to 82 mL and 0 to 16 kcal. According to Bland-Altman plots between BEVQ-21 and dietary records, differences for water (mL), regular mineral water (mL), whole and flavored milk (mL and kcal), soft drinks (mL and kcal), black tea (mL), herbal teas (mL), and total beverage intake (mL) were found to be approximately consistent within the boundaries (p < 0.05). For reproducibility, sugary beverage and total beverage consumption were significantly associated between the first and second administration of the BEVQ-21 (r = 0.44-0.65, p ≤ 0.05).

CONCLUSIONS: The adapted BEVQ-21 for the Turkish population demonstrated validity and reproducibility for most types of beverage intake among adults in Turkey.

PMID:41057844 | DOI:10.1186/s12937-025-01169-7

BMC Palliat Care. 2025 Oct 7;24(1):245. doi: 10.1186/s12904-025-01883-3.

ABSTRACT

BACKGROUND: Optimising hospital care to align with what matters most for people living with advanced serious illness is a global priority area for improvement. Collection and feedback of patient reported experience measures (PREMs) is one potential method to inform improvements. This study used the integrated Promoting Action on Research implementation in Health Services (i-PARIHS) framework to inform the implementation of a complex intervention that included collection and feedback of PREM data and facilitation to empower ward-based quality improvements for inpatients with advanced serious illness.

METHODS: A single-site pre-post quality improvement study within a large Australian hospital. The intervention titled Listen, Empower and Act to improve Palliative care (‘LEAP’ bundle’) included three phases: ‘Listen’ – collecting and analysing patient (PREM) and clinician perspectives to understand current care experience and local context; ‘Empower’ – collating PREM feedback and facilitating local stakeholder engagement to identify and prioritise areas for improvement; and ‘Act’ – facilitating clinician led innovation development and implementation informed and monitored by continuing PREM collection and feedback. Intervention fidelity was summarised descriptively from field notes and meeting records. The primary effectiveness outcome was change in ‘very good’ experiences over time, reported from an eight-question validated PREM designed for inpatients with serious illness (consideRATE). Analysis used mixed binary logistic regression with time period as fixed effect and ward as random effect.

RESULTS: The three participating wards completed the intervention with some adaptations, and each implemented different innovations. The proportion of ‘very good’ responses showed a statistically significant increase for all consideRATE questions in intervention periods 1-4 compared to period 0 (baseline). All questions except ‘attention to feelings’ (Q2) were significantly improved by the first measurement period, and all except ‘attention to affairs’ (Q6) remained significantly higher than baseline during the final measurement period.

CONCLUSIONS: Implementation of the LEAP bundle led to improved palliative care experience within three wards in one large tertiary hospital setting. Listening to patients and empowering clinical teams to collectively reflect on data and lead change was crucial to study success and required skilled facilitation. Testing the sustainability, transferability and scalability of the intervention will be important next steps.

PMID:41057840 | DOI:10.1186/s12904-025-01883-3

BMC Musculoskelet Disord. 2025 Oct 7;26(1):925. doi: 10.1186/s12891-025-09197-4.

ABSTRACT

OBJECTIVE: To investigate the relationship between spinal-pelvic parameters in the coronal and sagittal planes and preoperative coronal imbalance (CIB) in degenerative scoliosis, aiming to prevent preoperative CIB and restore coronal balance(CB) for improved surgical outcomes.

METHODS: From May 2018 to May 2024, adult patients who underwent full-length spine imaging, were analyzed at the Southwest Medical University Affiliated Hospital. The inclusion criteria were: (1) availability of clear full-length spinal images in the coronal and sagittal planes that allowed for measurement of relevant parameters; (2) complete demographic information; (3) a major curve angle greater than 10°; and (4) skeletal maturity. Exclusion criteria were as follows : (1) history of previous spinal surgery; (2) pre-existing spinal or pelvic deformities; (3) history of trauma to the spine or pelvis; and (4) history of spinal infectious disease.A total of 162 cases were collected based on the inclusion and exclusion criteria.The general and imaging data of 162 patients were collected. These included the major curve (MC), fractional curve (FC), L5 tilt angle (L5TA), coronal pelvic inclination (CPI), apical vertebra translation (AVT), the number of vertebrae in the primary curve, apical vertebral rotation (AVR), sacral slope (SS), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), and sagittal vertical axis (SVA). Pearson correlation analysis and linear regression were employed to assess the relationship of each parameter with preoperative coronal balance distance (CBD). CBD was then converted to a binary variable (Patients with a CBD less than 3.0 cm were categorized into the CB group, while those with a CBD of 3.0 cm or greater were placed in the CIB group.). Univariate screening, multivariate logistic regression, and receiver operating characteristic (ROC) curve analysis were conducted to identify associations between preoperative CIB and the specified parameters.A total of 162 patients were classified into three groups based on the classification criteria of the Gulou Hospital: Type A (120 cases), Type B (25 cases), and Type C (17 cases). The differences in imaging data among the three groups were compared.

RESULTS: Pearson analysis demonstrated that L5TA, CPI, number of vertebrae in the primary curve, LL, SS, and SVA were correlated with preoperative CBD (p < 0.05). Moreover, further linear regression indicated that merely L5TA (R² = 0.204, p < 0.05), CPI (R² = 0.128, p < 0.05), and SVA (R² = 0.172, p < 0.05) were substantially associated with preoperative CBD, despite the fact that the relationship was not strictly linear. Multivariate logistic regression and ROC curve analysis revealed that age < 60.5 years was a protective factor against preoperative CIB, while preoperative L5TA > 5.75°, CPI > 3.55°, and SVA > 5.305 cm were risk factors for preoperative CIB. Among the 162 patients, 120 were classified as Type A, 25 as Type B, and 17 as Type C. Significant differences in age and L5TA were observed between the A and C groups. CBD, CPI, and SVA exhibited statistically significant differences between the A group and both the B and C groups, whereas no significant difference was found between the B and C groups.

CONCLUSION: Preoperative L5TA is an independent risk factor for preoperative CIB. When the preoperative C7PL is located on the convex side of the major curve, L5 tilt becomes more pronounced. In the surgical treatment of DS, leveling the L5 vertebra can help reduce the incidence of postoperative CIB. Patients with degenerative scoliosis (DS) under 60.5 years of age might reduce CIB incidence through enhanced paraspinal muscle strength. Additionally, imbalances in CPI and SVA may contribute to preoperative CIB, and pelvic and sagittal alignment maintenance may offer spinal support essential for preserving coronal balance.

PMID:41057829 | DOI:10.1186/s12891-025-09197-4

BMC Med Educ. 2025 Oct 7;25(1):1363. doi: 10.1186/s12909-025-07969-z.

ABSTRACT

BACKGROUND: Evidence links the oral microbiome to systemic diseases, yet its integration into dental practice remains limited, particularly in Saudi Arabia, where non-communicable diseases are prevalent. Equipping dental practitioners with microbiome-related competencies is essential. This study evaluated the knowledge, confidence, and counseling practices of dental practitioners, identifying predictors and barriers to the clinical application of these practices.

METHODS: A convergent mixed-methods design involved 286 dental practitioners (general dentists, specialists, academics) across Saudi Arabia. Participants completed a 23-item validated questionnaire (13 assessing objective knowledge, 8 evaluating beliefs, confidence, and barriers, 2 open-ended). Quantitative data were analyzed using descriptive statistics, chi-square tests, and binary logistic regression. Qualitative data from 30 open-ended responses were qualitatively analyzed to explore contextual factors.

RESULTS: Practitioners exhibited moderate-to-high objective knowledge (mean score: 9.14 ± 1.87 out of 13), with 55.9% in the medium category, 28.3% high, and 15.7% low. Confidence in counseling was moderate, with 39.6% reporting high or very high confidence. Prior microbiome training (OR = 3.21, 95% CI: 1.82-5.65, p < 0.001), frequent participation in Continuing Professional Development (CPD), and journal use (OR = 2.15, 95% CI: 1.25-3.70, p = 0.006) predicted higher confidence. Barriers included lack of formal training (52.6%), time constraints (17.9%), and patient disinterest (29.5%). Social media was a key knowledge source (24.2%), while dental curricula were underutilized (14.4%). Qualitative themes reinforced barriers and highlighted conditional motivation linked to patient risk factors.

CONCLUSIONS: A notable knowledge-to-practice gap persists in oral microbiome counseling. We propose integrating microbiome science into dental curricula and utilizing mobile Continuing Professional Development (CPD) tools to enhance confidence and increase counseling frequency, thereby addressing training gaps and infrequent updates. Additionally, Electronic Health Record (EHR) prompts are recommended to overcome time constraints and patient disinterest, aligning with Saudi Vision 2030’s goals for preventive care.

PMID:41057822 | DOI:10.1186/s12909-025-07969-z

BMC Med Educ. 2025 Oct 7;25(1):1365. doi: 10.1186/s12909-025-08020-x.

ABSTRACT

BACKGROUND: Preclinical training is essential in dental education for developing psychomotor and clinical skills. Conventional phantom models are widely used, though they lack real-time tactile feedback. This study aimed to compare the effectiveness of conventional phantom training with that of advanced simulation-based systems in improving dental students’ tooth preparation skills. METHODS: This randomized controlled trial included 40 s-year dental students (N = 40) with no prior experience in simulation. Participants were randomly assigned to either conventional phantom training or virtual reality (VR) based simulation. Both groups received 10 h of training. Pre- and post-tests involved preparing tooth 46 with a chamfer finish line. Performances were assessed using five criteria: parallelism, occlusal reduction, taper angle, finish line standardization, and presence of undercuts. Each was scored on a 0-10 scale by a blinded evaluator. Statistical analyses were performed using ANOVA with post hoc tests at a significance level of p < .05.

RESULTS: Both groups showed improvement in post-test scores The simulation group’s post-test performance was found to be significantly higher than that of the other groups. Post hoc analysis confirmed that the simulation group outperformed both its own pre-test and the conventional group’s post-test results.

CONCLUSIONS: Simulation-based training led to significantly higher outcomes in tooth preparation compared to conventional methods. The integration of digital simulation into dental education may enhance clinical readiness by providing individualized, repeatable, and measurable learning environments.

PMID:41057821 | DOI:10.1186/s12909-025-08020-x

BMC Pulm Med. 2025 Oct 7;25(1):455. doi: 10.1186/s12890-025-03916-2.

ABSTRACT

RATIONALE: Limited data exists on the long-term comparative efficacy and tolerability of pirfenidone and nintedanib, the two approved treatments for idiopathic pulmonary fibrosis (IPF).

METHODS: We retrospectively enrolled IPF patients treated with either pirfenidone or nintedanib at our centre between 2017 and 2023. Progression-free survival (PFS), defined as time to death or ≥ 10% decline in % predicted forced vital capacity (FVC) and continuous FVC decline were compared between groups defined by antifibrotic type or treatment intensity (full or reduced). Time to drug dose reduction was also compared. Statistical analysis included Kaplan-Meier curves with Log-Rank tests, Cox proportional hazards models and linear mixed-effects models.

RESULTS: A total of 292 IPF patients treated with pirfenidone (n = 142) or nintedanib (n = 150) were included with a mean follow-up time of 32.3 months (SD = 14.5). No significant differences in efficacy were observed between groups by antifibrotic type. Dose reduction was more frequent in the nintedanib group (59.3%) than pirfenidone group (16.9%, p < 0.001). Multivariate analysis showed that patients on nintedanib had a 4-fold higher risk of dose reduction compared to those on pirfenidone (p < 0.001). There were no significant differences in clinical outcomes between patients with dose reduction and those maintaining the full dose, both in the overall population and when stratified by antifibrotic type.

CONCLUSION: Nintedanib and pirfenidone exhibited similar long-term efficacy. Dose adjustment was more frequent with nintedanib, however it did not have impact on clinical outcomes.

PMID:41057813 | DOI:10.1186/s12890-025-03916-2

BMC Ophthalmol. 2025 Oct 7;25(1):551. doi: 10.1186/s12886-025-04394-0.

ABSTRACT

BACKGROUND: Optical coherence tomography angiography (OCTA) has shown promise in assessing microvascular and structural alterations in the retina and optic nerve. This study primarily aimed to evaluate the utility of OCTA in distinguishing aquaporin-4 antibody-positive (AQP4-Ab+) neuromyelitis optica spectrum disorder (NMOSD) patients from healthy controls (HC). Additionally, exploratory analyses were conducted to examine differences between AQP4-Ab + and AQP4-Ab-, all MOG-Ab-negative(double-seronegative) groups in NMOSD patients.

METHODS: We retrospectively analyzed clinical data from NMOSD patients admitted to the Neurology Department of our First Hospital from January 2018 to December 2020. Patients were categorized into AQP4-Ab-positive (AQP4-Ab+) and double-seronegative groups, with an age-matched normal control group. OCTA examinations were conducted to compare differences in optic nerve fiber layer thickness, macular central thickness, optic disc, macular blood flow, and clinical characteristics among the three groups.

RESULTS: There were statistically significant gender differences among the three groups, with a higher proportion of females in the AQP4-Ab + group compared to the other two groups (P < 0.05). Structurally, significant differences were observed in all parameters between the AQP4-Ab + group and healthy controls (HC), as well as between the double-seronegative group and HC (all P < 0.05). Direct comparison between AQP4-Ab + and double-seronegative NMOSD patients revealed significant differences in specific OCTA parameters, including optic disc central vessel density (P < 0.001), inner optic disc ring vessel density (P = 0.010), inner optic disc ring superior vessel density (P = 0.008), and outer macular ring nasal vessel density (P = 0.042). However, most other OCTA parameters showed no statistically significant differences between the antibody-positive and antibody-negative subgroups (P > 0.05). The optic disc vessel density demonstrated the highest diagnostic efficiency overall, with the nasal side vessel density of the optic disc achieving an AUC of 0.829.

CONCLUSION: OCTA exhibits significant clinical utility in diagnosing AQP4-Ab + NMOSD. Differences between AQP4-Ab + and double-seronegative patients were explored and may provide further insight, although further research is required.

TRIAL REGISTRATION: Not applicable.

PMID:41057808 | DOI:10.1186/s12886-025-04394-0