Category: Statistics

BMC Public Health. 2025 Apr 12;25(1):1383. doi: 10.1186/s12889-025-22607-5.

ABSTRACT

BACKGROUND: Studies focusing on the return for young employees are scarce. The aim of this study was to investigate the return to work process after a period of sick leave due to common mental disorders among young male and female employees, with a specific focus on promoting and hindering factors. A gender perspective was applied to examine potential patterns of similarities and differences in the study participants’ experiences.

METHODS: A qualitative approach with an applied gender perspective was used to capture both young employees’ and managers’ experiences of the return to work process. The data consisted of interviews with 12 young male and 13 young female employees (aged 20-29) and 23 interviews with managers with experience of supervising at least one young employee during return to work. An inductive, conventional content analysis was conducted.

RESULTS: The analysis resulted in three main categories and five subcategories describing hindering and promoting factors in young employees’ return to work processes. The main and subcategories were (1) “Coordinating, planning, and timing the return to work process” (with subcategories “Lack of coordination and support from key stakeholders”, “The importance of a return to work plan and follow-up”, and “The timing of the return to work”); (2) “Gaining sufficient support and having personal resources” (with subcategories: “Level and quality of support in the work environment”, and “Resources and obstacles on a personal level”); and (3) “Poor match between the young employees’ capabilities and the work demands or working conditions”.

CONCLUSION: The study participants identified similar factors that promoted and hindered the return to work process. Young employees need more support from employers and various welfare agencies. Managers need to know more about the return to work process and the responsibility of involved stakeholders. No expressed gender differences were identified.

PMID:40221752 | DOI:10.1186/s12889-025-22607-5

J Orthop Surg Res. 2025 Apr 12;20(1):371. doi: 10.1186/s13018-025-05774-4.

ABSTRACT

The aim of this study is to evaluate the effects of midshaft femoral derotation surgery on the alignment of the lower limbs in the coronal and sagittal planes, as well as its impact on pelvic parameters in patients with significant femoral anteversion or retroversion.A retrospective review was conducted on patients who underwent femoral derotation procedures using a minimally invasive patient-specific external guide system from January 2014 to January 2022 at Macquarie University Hospital. The surgery was done using preoperative 3D modeling and patient-specific external guides. Inclusion criteria comprised patients presenting with hip, knee, or patellofemoral symptoms due to high femoral anteversion who had complete EOS scans performed preoperatively and postoperatively. The EOS imaging system was utilized for accurate assessment and comparative analysis of alignment changes following the femoral derotation.There were 22 limbs from 15 patients with an average age at operation of 30.41 ± 10.14 years (range 16.77-47.50). The average preoperative 3D EOS measurement of the femoral version in anteversion and retroversion groups were 32.84 ± 7.53° and – 22.67 ± 13.32°, respectively. The postoperative femoral version in anteversion and retroversion groups were 13.39 ± 12.90° and 3.67 ± 9.29° having p < 0.001 and p < 0.014, respectively. Paired t-test was employed to calculate statistical values. Other parameters, including Hip-knee-shaft (HKS) angle, knee angle, pelvic tilt, pelvic incidence, mechanical lateral distal femoral angle (mLDFA), and coronal plane alignment of the knee, were not statistically significant differences.This study provides evidence that femoral midshaft derotation surgery using patient-specific instrumentation (PSI) guides is an effective approach for correcting femoral anteversion and retroversion with no significant impact on coronal and sagittal lower limb alignment except femoral neck offset.

PMID:40221750 | DOI:10.1186/s13018-025-05774-4

J Neuroeng Rehabil. 2025 Apr 12;22(1):82. doi: 10.1186/s12984-025-01621-z.

ABSTRACT

BACKGROUND: Stroke often results in gait dysfunction, impairing daily activities and quality of life. Overground robotic exoskeletons hold promise for post-stroke rehabilitation. This study primarily aimed to assess the safety of hands-free Atalante exoskeleton training in post-stroke subjects, with a secondary aim to assess gait and balance.

METHODS: Forty subjects (10.2 ± 12.1 months post-stroke) with gait dysfunction (Functional Ambulation Category [FAC] score ≤ 3) underwent five training sessions over three weeks with a hands-free exoskeleton (Atalante, Wandercraft, France). Safety, the primary outcome, was evaluated by the number and severity of adverse events (AEs), judged by an independent clinical evaluation committee (CEC). A usability test was performed during the fifth training session followed by the exoskeleton use questionnaire. Gait and balance were assessed pre/post-training via walking capacity score (FAC), gait speed by 10-meter walk test (10MWT), walked distance by 6-minute walk test (6MWT), and balance by Berg Balance Scale (BBS). Spasticity was assessed with the Modified Ashworth scale. Anxiety and depression were quantified using the Hospital Anxiety and Depression Scale. Safety outcomes were analyzed using the Wilson, Lee and Dubin methods for proportions, and occurrence rates were computed. Within-group differences were compared using Wilcoxon, McNemar, and Friedman tests, with significance set at P < 0.05.

RESULTS: Thirty-one subjects completed the training sessions, while nine discontinued. The study reported two serious adverse events (SAE) (vertigo, dysarthria) and six AEs, with the CEC concluding that no SAE was linked to the device/study procedure. The average AE rate per session was 2.5 ± 1.4%, including four events possibly linked to the device/study procedure (knee pain [n = 1], skin lacerations [n = 3]), classified as negligible or minor by the CEC. A high proportion (82.6%) successfully completed the usability test and reported satisfaction (90%) on the exoskeleton use questionnaire. For gait and balance, favorable changes were observed in FAC, 10MWT, 6MWT, and BBS scores Post-training (p < 0.05, respectively). Spasticity, anxiety, and depression remained unchanged.

CONCLUSIONS: This study indicates that the hands-free Atalante exoskeleton is safe, feasible, and well-tolerated for gait and balance rehabilitation in post-stroke subjects, warranting larger randomized controlled trials to assess its efficacy.

TRIAL REGISTRATION: Evaluation of the Use of the Atalante Exoskeleton in Patients Presenting an Hemiplegia Due to Cerebrovascular Accident (INSPIRE) trial was registered at ClinicalTrials.gov (NCT04694001, registered on 20201231).

PMID:40221748 | DOI:10.1186/s12984-025-01621-z

World J Surg Oncol. 2025 Apr 12;23(1):143. doi: 10.1186/s12957-025-03767-5.

ABSTRACT

BACKGROUND: In recent years, triple therapy (molecular targeted agent + PD-1 inhibitor + transarterial therapy) has emerged as a promising strategy for unresectable hepatocellular carcinoma (uHCC). However, the optimal molecular targeted agent choice within triple therapy remains unclear. Donafenib is currently the only targeted drug with superior survival benefits compared with sorafenib monotherapy. This study aimed to compare donafenib-based versus sorafenib-based triple therapy in patients with uHCC, providing preliminary evidence to guide molecular targeted agent selection in this emerging treatment paradigm.

METHODS: This retrospective study enrolled 106 patients with initially uHCC who received triple therapy combining either donafenib or sorafenib with PD-1 inhibitors and transarterial therapies. A 1:2 nearest neighbour propensity score matching was used to minimize selection bias. The primary endpoints were overall survival (OS) and progression-free survival (PFS) based on Kaplan-Meier analysis. The secondary endpoints included objective response rate (ORR), surgical conversion rate and adverse events (AEs). Statistical comparisons used Cox regression for survival data and chi-squared/ t-tests for other metrics, with p < 0.05 indicating significance.

RESULTS: After matching, 30 patients received sorafenib-based triple therapy (Sor-P-T/H group) and 50 patients received donafenib-based triple therapy (Don-P-T/H group). Although the median OS was not attained, the Don-P-T/H regimen demonstrated a statistically significant survival advantage (HR = 0.317, P = 0.004). Moreover, the Don-P-T/H group demonstrated significantly higher median PFS (9.00 vs. 4.62 months, P = 0.005), ORR (64% vs. 40%, P = 0.037) and surgical conversion rate (26.0% vs. 3.3%, P = 0.01) compared to the Sor-P-T/H group. The two groups showed no notable difference in the overall severity of adverse events but the Don-P-T/H group demonstrated less liver impairment.

CONCLUSION: Donafenib may be more advantageous than sorafenib in triple therapy for patients with uHCC.

PMID:40221746 | DOI:10.1186/s12957-025-03767-5

Stem Cell Res Ther. 2025 Apr 12;16(1):171. doi: 10.1186/s13287-025-04278-6.

ABSTRACT

BACKGROUND: Poor ovarian response (POR) significantly reduces the success rates of fertility treatments. This study investigates the long-term efficacy and potential complications associated with autologous menstrual blood-derived mesenchymal stromal cells (MenSCs) therapy in improving fertility outcomes for women with POR.

OBJECTIVE: To evaluate the long-term efficacy and potential complications associated with MenSC therapy in improving fertility outcomes for women with POR.

METHODS: This longitudinal, single-center retrospective observational study included 105 POR patients who received autologous MenSC injections from August 2018 to September 2021. Participants were monitored for at least 3 years, and demographic, menstrual, and fertility data were collected. Potential complications were also assessed during this period. Statistical analyses were performed to determine pregnancy rates and possible complications.

RESULTS: The average age of participants at the time of injection was 37.91 years. During the follow-up period, 36.19% of women became pregnant, with a live birth rate of 30.48% per treatment cycle. The treatment showed no significant difference in pregnancy rates between women with regular and irregular menstrual cycles. The spontaneous pregnancy rate was also notably higher within the first three months post-injection. No significant complications such as endometriosis, ovarian malignancies, or autoimmune disorders were observed. Only one case of an ovarian cyst, which resolved without intervention, was reported. MenSC treatment did not increase the risk of congenital anomalies or infant mortality.

CONCLUSION: Intra-ovarian injection of MenSCs is a safe and promising method for improving pregnancy outcomes in women with POR.

PMID:40221741 | DOI:10.1186/s13287-025-04278-6

BMC Nurs. 2025 Apr 12;24(1):413. doi: 10.1186/s12912-025-03068-y.

ABSTRACT

BACKGROUND: Emotional intelligence plays a crucial role in work performance, especially in high-stress ICU settings. Understanding emotional intelligence’s role can inform targeted interventions to support nurse well-being, enhance resilience, and improve patient outcomes.

METHODS: This descriptive cross-sectional study involved 226 ICU nurses in Palestine, recruited through a convenience sampling method. Data were collected using self-administered questionnaires, including the Schutte Emotional Intelligence Test and a job performance scale. Descriptive statistics, correlation analyses, and regression models were used to analyze predictors of job performance.

RESULTS: The study included 226 nurses, mostly male (74.3%), aged 21-30 years (71.2%), with a bachelor’s degree (68.1%) and less than five years of ICU experience (59.3%). Emotional intelligence scores were high, with an average of 151.9 ± 1.9, and perception of emotions had the highest subscale score. Work performance was also high, averaging 4.3 ± 0.7, with job quality and job quantity scoring the highest. A strong positive correlation (r = 0.611, P < 0.05) was found between EI and work performance. EI and educational level were significant predictors of work performance (β = 0.123, p < 0.01), explaining 39.3% of the variance.

CONCLUSION: the study highlights the critical role of emotional intelligence in improving ICU nurses’ work performance, particularly in job quality and quantity. Higher emotional intelligence helps nurses meet ICU demands, while educational level serves as a key predictor of performance. These findings highlight the need for EI training in nursing education, professional development, and workplace policies. Structured programs can enhance nurses’ decision-making, communication, and stress management, ultimately improving performance, patient care quality, and safety. Future research should adopt longitudinal or experimental designs to establish causality and evaluate the impact of EI training on nursing performance.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40221734 | DOI:10.1186/s12912-025-03068-y

BMC Womens Health. 2025 Apr 12;25(1):176. doi: 10.1186/s12905-025-03712-4.

ABSTRACT

BACKGROUND: Although violence is reported in women with premenstrual syndrome (PMS), preventive interventions are among the essential responsibilities of nurses. This study aimed to determine the effect of progressive muscle relaxation exercises (PMRE) given to women with PMS on PMS symptoms and violent tendencies.

METHODS: The study was conducted experimentally with a pre-test/post-test control group between January and August 2024 in a province located in the southeastern Anatolia region of our country. The study included 106 participants, 53 experimental and 53 control, who had PMS. Participants were provided with a PMRE application for eight weeks. Data were collected through the ‘Personal Information Form, PMS Scale and Violence Tendency Scale (VTS).’ Data were analysed using descriptive statistics, chi-square, independent samples t-test and one-way multivariate analysis of variance.

RESULTS: Participants in the intervention group had significantly lower mean scores on the post-test PMS scale and the VTS than participants in the control group (p < 0.05). The difference between the PMS scale’s pre-test and post-test mean scores was statistically significantly lower in the experimental group (P < 0.001). The difference between the groups was statistically significant in terms of the combined dependent variables, including the pre-test and post-test change in the mean scores of the PMS scale and the VTS (F(2,103) = 158.77, P < 0.001; V = 0.245; ηp² = 0.755). This difference explained 75.5% of the variance in the dependent variable.

CONCLUSION: PMRE administration has a high level of efficacy in reducing PMS and violence tendencies.

TRIAL REGISTRATION: ClinicalTrials ID: NCT06208670 Dated:22.12.2023.

PMID:40221724 | DOI:10.1186/s12905-025-03712-4

J Appl Clin Med Phys. 2025 Apr 11:e70092. doi: 10.1002/acm2.70092. Online ahead of print.

ABSTRACT

PURPOSE: To assess the predictive capability of CT radiomics features for early recurrence (ER) of pancreatic ductal adenocarcinoma (PDAC).

METHODS: Postoperative PDAC patients were retrospectively selected, all of whom had undergone preoperative CT imaging and surgery. Both patients with resectable or borderline-resectable pancreatic cancer met the eligibility criteria in this study. However, owing to the differences in treatment strategies and such, this research mainly focused on patients with resectable pancreatic cancer. All patients were subject to follow-up assessments for a minimum of 9 months. A total of 250 cases meeting the inclusion criteria were included. A clinical model, a conventional radiomics model, and a deep-radiomics model were constructed for ER prediction (defined as occurring within 9 months) in the training set. A model based on the TNM staging was utilized as a baseline for comparison. Assessment of the models’ performance was based on the area under the receiver operating characteristic curve (AUC). Additionally, precision-recall (PR) analysis and calibration assessments were conducted for model evaluation. Furthermore, the clinical utility of the models was evaluated through decision curve analysis (DCA), net reclassification improvement (NRI), and improvement of reclassification index (IRI).

RESULTS: In the test set, the AUC values for ER prediction were as follows: TNM staging, ROC-AUC = 0.673 (95% CI: 0.550, 0.795), PR-AUC = 0.362 (95% CI: 0.493, 0.710); clinical model, ROC-AUC = 0.640 (95% CI: 0.504, 0.775), PR-AUC = 0.481 (95% CI: 0.520, 0.735); radiomics model, ROC-AUC = 0.722 (95% CI: 0.604, 0.839), PR-AUC = 0.575 (95% CI: 0.466, 0.686); and deep-radiomics model, which exhibited the highest ROC-AUC of 0.895 (95% CI: 0.820, 0.970), PR-AUC = 0.834 (95% CI: 0.767, 0.923). The difference in both ROC-AUC and PR-AUC for the deep-radiomics model was statistically significant when compared to the other scores (all p < 0.05). The DCA curve of the deep-radiomics model outperformed the other models. NRI and IRI analyses demonstrated that the deep-radiomics model significantly enhances risk classification compared to the other prediction methods (all p < 0.05).

CONCLUSION: The predictive performance of deep features based on CT images exhibits favorable outcomes in predicting early recurrence.

PMID:40217563 | DOI:10.1002/acm2.70092

Acta Epileptol. 2025 Jan 15;7(1):6. doi: 10.1186/s42494-024-00192-1.

ABSTRACT

BACKGROUND: Electronic medical records (EMR) can be utilized to understand the impact of the disruption in care provision caused by the pandemic. We aimed to develop and validate an algorithm to identify persons with epilepsy (PWE) from our EMR and to use it to explore the effect of the pandemic on outpatient service utilization.

METHODS: EMRs from the neurology specialty, covering the period from January 2018 to December 2023, were used. An algorithm was developed using an iterative approach to identify PWE with a critical lower bound of 0.91 for negative predictive value. Manual internal validation was performed. Outpatient visit data were extracted and modeled as a time series using the autoregressive integrated moving average model. All statistical analyses were performed using STATA version 14.2 (Statacorp, USA).

RESULTS: Four iterations resulted in an algorithm, with a negative predictive value 0.98 (95% CI: 0.95-0.99), positive predictive value of 0.98 (95% CI: 0.85-0.99), and an F-score accuracy of 0.96, which identified 4474 PWE. The outpatient service utilization was abruptly reduced by the pandemic, with a change of -902.1 (95%CI: -936.55 to -867.70), and the recovery has also been slow, with a decrease of -5.51(95%CI: -7.00 to -4.02). Model predictions aligned closely with actual visits with median error of -3.5%.

CONCLUSIONS: We developed an algorithm for identifying people with epilepsy with good accuracy. Similar methods can be adapted for use in other resource-limited settings and for other diseases. The COVID pandemic appears to have caused a lasting reduction of service utilization among PWE.

PMID:40217558 | DOI:10.1186/s42494-024-00192-1

J Act Sedentary Sleep Behav. 2025 Feb 13;4(1):2. doi: 10.1186/s44167-025-00072-0.

ABSTRACT

BACKGROUND: Physical activity (PA) in childhood is critical for establishing a healthy lifestyle across the lifespan, particularly to treat and prevent obesity. This study aimed to explore PA and sedentary behaviour (SED) in 6-12-year-old children with obesity and their parents, and possible associations in these behaviours between children and parents.

METHODS: Children referred to outpatient paediatric healthcare for obesity treatment and one of their parents wore accelerometers (Axivity) on their hip during seven consecutive days. Accelerometer data were processed using the 10 Hz frequency extended method. Correlations between child and parent PA and SED, respectively, were analysed using intra-class correlation coefficient.

RESULTS: Thirty-nine children (19 female) and 38 parents (20 female) were included. The mean age of the children was 9.7 years (SD 2.0) and the mean parent age was 42.2 years (SD 6.1). The mean child BMI-SDS was 3.0 (SD 0.4). Fifty-seven % of the parents were born in Sweden, 16% in other European countries, and 27% outside Europe. Children spent an average of 9.8 h/day in SED, while parents spent an average of 12.3 h/day. The mean daily time spent in low-intensity PA was 3.9 h for children and 3.4 h for parents, while moderate-to-vigorous intensity PA averaged 0.7 h/day for children and 0.3 h/day for parents. Only six of the children (15%) reached the recommended minimum of 60 min of moderate-to-vigorous intensity PA per day and only two parents (5%) reached the recommended weekly minimum of 150 min of moderate intensity PA. Child and parent SED was significantly correlated, although the correlation was weak (ICC 0.14; p = 0.017). No statistically significant correlations were found for any of the analysed PA intensity levels.

CONCLUSIONS: The findings indicate an association between children’s and parents’ SED in this sample of school-aged children with obesity, while no association was observed in PA behaviour. Generalisability of our findings is limited and more research is needed- in larger samples, other settings, and using longitudinal designs- to better understand the potential links between the PA patterns of children with obesity and that of their parents.

PMID:40217557 | DOI:10.1186/s44167-025-00072-0