Category: Statistics

J Orthop Surg Res. 2025 Jul 11;20(1):640. doi: 10.1186/s13018-025-06051-0.

ABSTRACT

INTRODUCTION: Nonunion of pediatric femoral neck fractures is a difficult situation for orthopedic surgeons. It can result in devastating results if left untreated. The purpose of the present study was to assess and compare the results of the treatment of nonunited pediatric femoral neck fractures by closed reduction and subtrochanteric valgus osteotomy with two different fixation methods.

PATIENTS AND METHODS: Seventeen patients with nonunion femoral neck fractures were treated with closed reduction, subtrochanteric osteotomy and fixation with either the proximal humerus internal locking system (PHILOS plate) (group A) (10 patients) or the Wagner technique (group B) (7 patients). The mean age of the patients was 7 years, and the mean follow-up period was 16 months.

RESULTS: At the end of the follow-up, all patients, the fractures were united. We did not observe any cases of implant failure. There was a statistically significant improvement in the neck shaft angle in both groups from 88.70 ± 3.36 to 129.35 ± 7.34 in group A and from 87 ± 1.91 to 126.78 ± 4.06 in group B. Regarding the clinical outcome and according to the Ratliff concept, half of the cases were good in group A and 57.1% were good in group B. There was no statistically significant difference between the groups regarding time to union, degree of coxa vara correction or the Ratliff concept.

CONCLUSION: Both the PHILOS plate and the Wagner technique offer good stable fixation options for nonunited pediatric femoral neck fractures.

PMID:40646543 | DOI:10.1186/s13018-025-06051-0

AIDS Res Ther. 2025 Jul 11;22(1):67. doi: 10.1186/s12981-025-00767-z.

ABSTRACT

BACKGROUND: This multi-institutional, retrospective cohort study using TriNetX database aims to explore the relationship between HIV infection and uveitis.

METHODS: HIV patients were propensity-matched to individuals from our non-HIV cohort (1:1 ratio) based on variables such as age (every 5 year), sex, ethnicity, race, and relevant comorbidities. The Cox proportional hazards regression model was utilized to assess the impact of variables on uveitis risk, reporting hazard ratios (HRs) with 95% confidence intervals (CIs). Kaplan-Meier survival analysis and log-rank tests were applied to estimate the cumulative incidence of uveitis. Statistical significance was set at a two-sided p-value < 0.05.

RESULTS: We found that adult patients with HIV infection had a significantly increased risk of developing uveitis compared to non-HIV counterparts, with an overall HR of 3.02 (95% CI: 2.70 – 3.39). The risk remained elevated across designated follow-up intervals of 1 year (HR = 4.68 [3.69 – 5.92]), 2 years (HR = 4.44 [3.65 – 5.41]), and 3 years (HR = 4.06 [3.42 – 4.81]), with consistent increases noted when dividing into different uveitis types except for anterior uveitis. The risk was higher among patients with acquired immunodeficiency syndrome (AIDS) compared to asymptomatic HIV (HR = 2.64 [1.30 – 5.35]). Furthermore, HIV patients receiving treatment within three months exhibited a notably increased risk (HR = 2.87 [2.33 – 3.54]).

CONCLUSIONS: This study reveals that individuals with HIV face a significantly heightened risk of developing uveitis. Our findings indicate that this risk is most substantial for intermediate and posterior uveitis, challenging the long-held belief that anterior uveitis is the predominant form in this population.

PMID:40646533 | DOI:10.1186/s12981-025-00767-z

BMC Med Educ. 2025 Jul 11;25(1):1035. doi: 10.1186/s12909-025-07628-3.

ABSTRACT

BACKGROUND: High quality professional education requires good educators who show engagement with teaching in addition to content knowledge and didactic skills. In health professions education it is common that teaching faculty combine their teaching role with roles in patient care and/or research. However, previous studies on work engagement have mainly focused on jobs as a whole and not considered people who combine roles or tasks that could have different demands. This study aims to describe how health professions educators’ work engagement in teaching, in combination with research and patient care, evolved over time at an academic medical center in the Netherlands.

METHODS: All teaching faculty at the center were invited to complete the same online questionnaire in 2011, 2016, and 2022, where their work engagement was measured using the Utrecht Work Engagement Scale (UWES-9) and they rated 22 items affecting their engagement in teaching. We calculated descriptive statistics; computed engagement score means for overall work and individual task areas (teaching, research, and patient care); and compared means across groups with various task area combinations and across years. We also performed content analysis of responses to the open-ended questions in the questionnaire.

RESULTS: Work engagement scores overall and for each task area (teaching, research, and patient care) fluctuated over time. Job-related aspects enhancing engagement in teaching included ‘autonomy’ and ‘appreciation.’ ‘Teaching about my own specialty’ consistently scored high.

CONCLUSION: Teaching faculty in our center are engaged with teaching tasks and their work engagement is consistently high over time. Combining roles might be positively related to teaching engagement by maintaining balance when job demands in other tasks increase. To maintain and increase teaching engagement, organizations should focus on the provision of time, autonomy, and support to health professions educators. Teaching engagement may increase more through content knowledge and autonomy in teaching than by facilitating educational research and dissemination opportunities.

PMID:40646526 | DOI:10.1186/s12909-025-07628-3

BMC Oral Health. 2025 Jul 11;25(1):1144. doi: 10.1186/s12903-025-06500-6.

ABSTRACT

BACKGROUND: Mobile dental photography is increasing in relevance in the diagnosis of oral diseases. This study aimed to evaluate the diagnostic accuracy of intraoral mobile photography in assessing caries experience intensity (decayed, missing/extracted, filled teeth [DMFT/deft]), simplified oral hygiene index, and modified gingival index.

METHODS: This study included 358 children of 7-12 years of age. A clinician evaluated DMFT/deft; simplified oral hygiene; and modified gingival indices by visual examination. Simultaneously, dental students recorded intraoral photographs with a mobile phone in eight predetermined projections. Another oral professional calculated indices based on the photographs. Sensitivity, specificity, and positive and negative predictive values of dental photography were evaluated, and Cohen’s kappa was calculated.

RESULTS: A total of 2864 photographs were evaluated in this study. The sensitivity and specificity of mobile photography for DMFT; deft; simplified oral hygiene, and modified gingival indices were 95.8 (95% confidence interval: 93.4-98.3) and 89.2 (83-95.5); 100.0 (100-100) and 88.6 (79.3-98); 89.7 (85.8-93.5) and 91.4 (86.3-96.5); and 77.6 (67.6-87.6) and 93.8 (91-96.6), respectively; positive predictive values were 96.2, 97.7, 95.6, and 74.3; negative predictive values 88.3, 100.0, 80.9, and 94.8; and Cohen’s Kappa values were 0.848, 0.928, 0.784, and 0.702, respectively.

CONCLUSIONS: Intraoral mobile photography, based on appropriate guidelines, is reliable for assessing DMFT/deft; simplified oral hygiene; and modified gingival indices in children and could be a useful tool in dental public health, supporting the involvement of dental students in similar research studies.

PMID:40646524 | DOI:10.1186/s12903-025-06500-6

BMC Oral Health. 2025 Jul 11;25(1):1145. doi: 10.1186/s12903-025-06202-z.

ABSTRACT

BACKGROUND: This study aimed to evaluate the effects of the COVID-19 pandemic on the lives, daily routines, health, and oral and dental health status of primary school children and their parents. In addition, the data of sociodemographic factors and various parameters were cross compared and analysed.

METHODS: This cross-sectional questionnaire study was conducted in 12 primary schools. The questionnaire included 55 questions about the socio-demographic characteristics of the children and their parents, the impact of the COVID-19 pandemic on their lives, daily routines, health, and oral and dental health, as well as their knowledge about these topics. Descriptive statistical methods were used to evaluate the data. Chi-square test was mainly used to analyze the relationships between categorical variables.

RESULTS: The study included the data of 2.466 children and their parents. The prevalence of stress was high in parents (63.7%) and their children (52.1%). The proportion of those whose sleep patterns changed was higher among parents and children who were stressed by the pandemic (p < 0.01). During the pandemic, 59.9% of children increased their screen time. Among parents and children who experienced stress, the proportion of those whose dietary habits changed was higher than those who did not (p < 0.01). For both parents (68.9%) and children (68.5%), the proportion of those who experienced changes in daily routines was high, and who experienced stress due to the pandemic changed their daily routines more (p < 0.01). The rate of unchanged oral hygiene habits was higher for both parents (74.0%) and their children (77.1%). Monthly income, education level of parents and class grade of the child were found significant on these alterations.

CONCLUSION: The pandemic had an impact on the stress levels, sleep patterns, dietary habits, daily routines, and screen time of primary school-aged children and their parents. In future studies, it would be beneficial to address the consequences of the negative effects of the pandemic and the effectiveness of the strategies developed.

PMID:40646522 | DOI:10.1186/s12903-025-06202-z

BMC Psychiatry. 2025 Jul 11;25(1):695. doi: 10.1186/s12888-025-07011-y.

ABSTRACT

INTRODUCTION: Community-based peer support complements regional mental health services by supporting individuals in their personal recovery process. This study aimed to investigate the effectiveness of the ‘Paths to everyday life’ (PEER) intervention, which adds group-based peer support to service as usual (SAU) for individuals with mental health difficulties, compared to SAU alone.

METHODS: A randomized controlled trial in five Danish municipalities compared the PEER intervention added to SAU to SAU alone. Participants were municipality social service users and self-referrals. The primary outcome was personal recovery, measured by Questionnaire about the Process of Recovery (QPR-15) at post-intervention. Intention-to-treat analyses were used for primary and safety outcomes.

RESULTS: Of the 296 participants included from December 7, 2020, to October 16, 2022, 145 participants received the PEER intervention, and 151 participants received SAU alone. Primary outcome results showed model estimated marginals means in the PEER group [37.3; 95% CI: 35.4 to 39.1] versus SAU alone [32.1; 95% CI: 30.2 to 34.1]. A statistically significant mean difference in QPR-15 scores was seen in the PEER group [5.1; 95% CI: 2.4 to 7.8; p < 0.001] versus SAU alone, corresponding to Cohen’s d of 0.43. No significant between-group differences in hospital admissions or bed days, and no deaths or detectable self-harm were registered during follow-up.

CONCLUSIONS: The primary outcome, personal recovery, showed a significant difference that exceeded the clinically meaningful change, with a small to medium effect size, among adults with mental health difficulties. If the PEER intervention proves cost-effective, implementation in the communities is recommended.

CLINICAL TRIAL REGISTATION: ClinicalTrials.gov: NCT04639167, registered Nov. 19, 2020, finished May 20, 2024.

PMID:40646520 | DOI:10.1186/s12888-025-07011-y

BMC Nurs. 2025 Jul 11;24(1):907. doi: 10.1186/s12912-025-03543-6.

ABSTRACT

BACKGROUND: Role-play’- one of the teaching techniques utilised in contemporary teaching appears to be a new trend that has been developing in the field of education.

PURPOSE: This study aimed to determine the effect of the ‘role-play’ technique implemented on the fourth-year students attending the Faculty of Nursing at the Near East University in Northern Cyprus on their attitudes towards student-centred teaching techniques.

METHODS: This study was designed as a single group quasi-experimental study with pretest and posttest. The study was conducted with the fourth-year nursing students (n = 131). The data were collected using the ‘Data Collection Form’ and ‘Scale of Attitudes Towards Using Student-Centred Teaching Methods and Techniques’. After conducting the pretest, the students were divided into twelve groups. A script was drafted for each group and the role-play was performed in front of the class. After the practices were completed, posttest was applied. All necessary permissions were obtained to conduct the study. The collected data were evaluated in the SPSS 25.0. Data were evaluated with 95% confidence interval and p = 0.05 error margin.

RESULTS: A statistical difference was found between the pretest (96.16 ± 12.00) and posttest (99.29 ± 8.51) mean scores of the students on the ‘scale of attitudes towards using student-centred teaching methods and techniques’ (p = 0.006).

CONCLUSION: The integrated use of the role-play technique in the vocational course of nursing had a positive effect on students’ attitudes towards student-centred techniques. This situation contributes to the development of students’ knowledge and skills in vocational courses.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40646514 | DOI:10.1186/s12912-025-03543-6

Accid Anal Prev. 2025 Jul 10;220:108147. doi: 10.1016/j.aap.2025.108147. Online ahead of print.

ABSTRACT

Incorporating random parameters (RPs) into generalized linearized models (GLMs) – such as the negative binomial (NB) regression model used to predict crash frequencies – has been shown to improve model fit and better address issues such as unobserved heterogeneity. However, applying models with RPs to make predictions for observations outside the sample used to estimate the model is not straightforward. Recent studies have proposed various methods to incorporate RPs in out-of-sample predictions, but these tend to provide biased estimates or are computationally intensive to apply. This paper applies fundamental statistical theory to leverage properties of the underlying RP distributions incorporated into GLMs to provide more direct and accurate predictions, as well as directly estimate prediction variance for out-of-sample observations. Methods are provided for several common RP distributions – including the normal/Gaussian, lognormal, triangular, uniform, and gamma distributions – combined within log-link GLM framework. Additionally, closed-form equations for elasticities and marginal effects for the random parameters are provided. The proposed methods are tested using crash frequency prediction models developed using data from the Highway Safety Information System (HSIS). The results suggest that the proposed exact method provides more accurate predictions than the computational-intensive simulation-based approximation approaches while also being simple to apply. The method is suitable for the widespread use of RPs in research and in practical applications of GLMs.

PMID:40644756 | DOI:10.1016/j.aap.2025.108147

Explore (NY). 2025 Jun 25;21(4):103201. doi: 10.1016/j.explore.2025.103201. Online ahead of print.

ABSTRACT

The aim of this study was to determine the effect of laughter yoga on hemodialysis patients’ disease acceptance, treatment adherence and comfort levels. This randomized controlled study was conducted with 42 patients (experimental group=21, control group=21) who were treated in the hemodialysis unit. Hemodialysis patients in the experimental group received 12 sessions of laughter yoga for four weeks, three days a week. Data were collected using Patient Information Form, Disease Acceptance Scale, End-Stage Renal Disease Adherence Questionnaire, and Hemodialysis Comfort Scale. A significant difference was found between the disease acceptance scale (t(41) = 4.39, p < 0.001, d = 1.364), end-stage renal failure adaptation scale (t(41) = 2.69, p = 0.010, d = 0.830) and hemodialysis comfort scale (t(41) = 5.58, p = 0.010, d = 1.710) of hemodialysis patients who underwent laughter yoga. In addition for the Disease Acceptance Scale, the SD of the pre-test scores was 7.51. Accordingly, the MCID thresholds were calculated as 3.75 (0.5 SD), 3.11 (1 SEM), and 6.09 (1.96 SEM). For the End-Stage Renal Disease Adherence Questionnaire, the SD was 178.79, and the MCID was calculated as 89.40 (0.5 SD), 63.47 (1 SEM), and 124.39 (1.96 SEM). For the Hemodialysis Comfort Scale, the SD was 6.43, resulting in MCID estimates of 3.21 (0.5 SD), 2.01 (1 SEM), and 3.94 (1.96 SEM). Laughter yoga practiced during hemodialysis increased acceptance of the disease, adherence to treatment, and comfort (p < 0.05). In contrast, no statistically significant difference was found in the control group (p > 0.05). Increasing hemodialysis patients’ acceptance of the disease, adherence to treatment, and comfort levels ensure the successful continuation of the disease management process. The practice of laughter yoga in clinics during hemodialysis sessions is recommended to increase disease acceptance, adherence to treatment and comfort levels.

PMID:40644747 | DOI:10.1016/j.explore.2025.103201

Semin Arthritis Rheum. 2025 Jun 27;74:152777. doi: 10.1016/j.semarthrit.2025.152777. Online ahead of print.

ABSTRACT

OBJECTIVE: To test the discriminating capacity of different thresholds of the Assessment of SpondyloArthritis international Society Health Index (ASAS HI) in placebo-controlled trials of patients with axial spondyloarthritis (axSpA), including radiographic (r-axSpA) and non-radiographic (nr-axSpA) subtypes.

METHODS: The discriminating capacities of absolute (≥2.0-≥4.0 points) and relative (≥20%-≥50%) ASAS HI improvement thresholds were evaluated in patients with axSpA from three COAST trials (COAST-V, COAST-W, and COAST-X) of ixekizumab every 4 weeks (IXE Q4W) vs. placebo. Threshold-based response rates at Week 16 were compared between trial arms using Fisher’s exact test. Odds ratios and phi coefficients were used to evaluate how strongly each improvement threshold was associated with treatment allocation in a given trial. Missing data were handled using non-responder imputation.

RESULTS: ASAS HI data were available at baseline and Week 16 for 587 patients in IXE Q4W and placebo arms. The ASAS HI ≥30% improvement threshold effectively discriminated treatment allocation in all trials; significant differences were observed between IXE Q4W and placebo in r-axSpA (COAST-V: p = 0.026; COAST-W: p = 0.023) and nr-axSpA (COAST-X: p = 0.040). Lower absolute (≥2.0-≥3.0 points) and relative (≥20%-≥30%) thresholds discriminated effectively in COAST-W, whereas higher absolute (≥3.5-≥4.0 points) and relative (≥30%-≥50%) thresholds discriminated effectively in COAST-V. In COAST-X, ≥30%, ≥40%, and ≥50% thresholds discriminated effectively. Phi coefficients were small (<0.3) across all trials and thresholds.

CONCLUSIONS: Several ASAS HI improvement thresholds discriminated axSpA patients in treatment vs. placebo arms at Week 16. The ASAS HI ≥30% improvement threshold discriminated across all three COAST trials.

PMID:40644736 | DOI:10.1016/j.semarthrit.2025.152777