Category: Statistics

Disabil Rehabil Assist Technol. 2025 Oct 7:1-13. doi: 10.1080/17483107.2025.2569791. Online ahead of print.

ABSTRACT

PURPOSE: Endometriosis is a common condition affecting around 10% of women of childbearing age worldwide. Currently, adapted physical activities (APA) are increasingly used in the context of chronic diseases, often in conjunction with digital devices to help overcome some of the barriers to regular practice. However, it is essential to examine the technological acceptability to optimise the future use of these devices. The main aim of this study is to analyse the intention of women with endometriosis to use digital tools offering physical activities and to identify the factors most likely to predict this intention.

MATERIALS AND METHODS: Participants completed an online survey, which included socio-demographic and medical questions, as well as subscales derived from the HITAM model on intention to use digital tools. The data were analysed using univariate and multivariate logistic regressions.

RESULTS AND CONCLUSION: A total of 313 women (Mean age = 34.4; SD = 8.69) met the inclusion and exclusion criteria. The statistical analyses showed that the intention to use a digital APA program was fairly high, with a preference for technologies that offer a high degree of freedom in practice. Analyses of the theoretical model showed in particular the importance of a favourable social discourse. The final model (perceived threat, norms, perceived ease of use, perceived usefulness, and age) explained 57.74% of the variance in intention. Findings should be interpreted with caution due to the self-selected online sample and the high dropout rate (899 incomplete responses).

PMID:41054937 | DOI:10.1080/17483107.2025.2569791

Head Neck. 2025 Oct 7. doi: 10.1002/hed.70066. Online ahead of print.

ABSTRACT

BACKGROUND: Head and neck squamous cell carcinoma (HNSCC) is an aggressive malignancy, with 50% of patients recurring. A subset of patients experience rapid recurrence (RR) postoperatively but prior to adjuvant therapy. This study identifies factors associated with RR and additional recurrence intervals: short-interval recurrence (SIR) and standard recurrence (SR).

METHODS: Retrospective 10-year review of 246 HNSCC patients undergoing surgery with adjuvant therapy. Recurrence was categorized as RR (prior to initiation of adjuvant therapy), SIR (≤ 6 months post-adjuvant therapy), and SR (> 6 months post-adjuvant therapy). Univariate analysis (UVA), multivariate analysis (MVA), and machine learning Random Forest models were employed to identify predictors of each recurrence interval.

RESULTS: Of the 246 patients, 89 recurred (45 SR, 27 SIR, 17 RR). On MVA, skin invasion (OR = 3.492, p = 0.039) was a unique predictor of RR. Random Forest feature importance also revealed skin invasion, along with nodal status, tobacco pack-years, and tumor size as predictors with strong performance (accuracy 93%, AUC 0.96, F1 0.93).

CONCLUSION: Skin invasion is a unique independent predictor of RR, confirmed by two statistical models. These patients warrant further study.

PMID:41054923 | DOI:10.1002/hed.70066

Am J Epidemiol. 2025 Oct 7:kwaf223. doi: 10.1093/aje/kwaf223. Online ahead of print.

ABSTRACT

Phenotype classification with electronic health record (EHR) data is increasingly performed with ML, however their performance in diverse populations remains understudied. We compared an ICD-based algorithm with an ML phenotyping pipeline to classify myocardial infarction (MI) in a general and self-reported Black population. We determined the impact of differential performance by replicating a published MI risk factor study with MI defined by the ICD or ML algorithms. Individuals followed in the Veterans Health Administration (VHA) EHR with data from 2002 to 2019 were examined: 11,523,175 Veterans, mean age 67.5 years, 93.8% male, 14.3% Black, 79.1% White. MI was classified using a published rule-based ICD algorithm and an ML pipeline, PheCAP which incorporates natural language processing. Algorithms were trained and validated against n=403 Veterans randomly selected and chart-reviewed for MI (gold standard), oversampled for self-reported Black. Among chart-reviewed Veterans, the ICD algorithm had high PPV and low sensitivity (all race, PPV:0.97, sensitivity:0.17; Black Veterans, PPV:0.94, sensitivity:0.24). PheCAP MI had good PPV and higher sensitivity (all race, PPV:0.90, sensitivity:0.66; Black, PPV:0.81, sensitivity:0.79). Applying PheCAP MI to the entire VHA population to classify MI provided increased power to replicate findings from the published MI risk factor study compared to the ICD algorithm.

PMID:41054913 | DOI:10.1093/aje/kwaf223

Nurs Crit Care. 2025 Nov;30(6):e70178. doi: 10.1111/nicc.70178.

ABSTRACT

BACKGROUND: Patients in the intensive care unit (ICU) require complex care with rapidly changing conditions, and missed nursing care (MNC) can lead to severe consequences. Investigating the current status and influencing factors of MNC in the ICU is essential to enhance patient safety, optimise care quality and improve nurse job satisfaction, providing evidence-based strategies for ICU nursing management.

AIMS: The aims of this study were to investigate the current status of MNC in ICU and to analyse its causes, providing insights to reduce missed care and improve the quality of nursing for critically ill patients.

STUDY DESIGN: This is a cross-sectional study, using convenience sampling, 191 ICU nurses from five tertiary hospitals in Sichuan Province were selected as participants from 1 June 2024 to 30 June 2024. Data were collected through a general information questionnaire and the Missed Nursing Care in Intensive Care Units Scale.

RESULTS: A total of 191 questionnaires were sent out in this survey, and finally, 185 were included for data analysis. The score for MNC in ICU was 72.14 ± 15.61 points. All nurses reported experiencing at least one instance of missed care during their shifts. The most frequently missed care items were as follows: assisting and guiding patients in early rehabilitation, analgesia and sedation management and psychosocial assessment of critically ill patients. Statistical analysis revealed that MNC in ICU was significantly influenced by nurses’ gender, education level, professional title, ICU type and patient load (p < 0.05). The score for reasons behind MNC was 63.24 ± 18.53 points. The primary contributing factors were as follows: heavy nurse workload, excessive patient transfers, high frequency of patient condition changes and emergency events. ICU type (Internal Medicine ICU/comprehensive ICU), patients load (≥ 4 patients/nurse) and characteristics (master’s degree and above, intermediate nurse) emerged as modifiable risk factors for MNC.

CONCLUSION: Missed nursing care occurs frequently in ICU and is influenced by multiple factors. These findings suggest that nursing administrators should ensure adequate nurse staffing levels and enhance training programmes on MNC awareness, and improve nurses’ understanding of this phenomenon. These measures would effectively reduce missed care occurrences and subsequently improve ICU nursing quality.

RELEVANCE TO CLINICAL PRACTICE: This study identifies missed nursing care (MNC) in intensive care units (ICUs), particularly in rehabilitation, pain management and psychosocial support.

KEY FINDINGS: Staffing/workload (≥ 4 patients/nurse) and unit type (medical/general ICUs) significantly increase MNC. Non-urgent but critical care (e.g., psychological support) is often deprioritised.

SOLUTIONS: Implement safe staffing ratios, train nurses on MNC consequences and optimise workflows (e.g., standardised handoffs).

PMID:41054904 | DOI:10.1111/nicc.70178

J Interpers Violence. 2025 Oct 7:8862605251378991. doi: 10.1177/08862605251378991. Online ahead of print.

ABSTRACT

Research on aggression towards family/caregivers in childhood and adolescence (AFCCA) is still emerging, particularly within the Canadian context. To better understand this behaviour, we examined potential changes in the severity and frequency of different AFCCA types as well as in caregiver-child relationships and disruptions to families’ lives during the COVID-19 pandemic. In this convergent/parallel mixed-method research study, 168 Canadian caregivers living with a young person who exhibited AFCCA completed an online survey that contained self-report questionnaires and open-ended questions. The sample consisted primarily of adoptive mothers. Descriptive and hybrid thematic analyses indicated that around half the sample reported an increase in the severity (verbal 43.9%, threats 39.8%, emotional/psychological 49.2%, physical 44.3%) and frequency (verbal 51.2%, threats 47.8%, emotional/psychological 54.6%, physical 48.3%) of most AFCCA types. The quality of the caregiver-child relationship also worsened significantly after the pandemic (t[115] = 3.5, p = .001). Qualitative analyses supported this finding. While there was no statistically significant difference in AFCCA-related disruptions to families’ lives during the pandemic, thematic analyses revealed increased caregiver disruptions to both personal aspects (e.g. self-care practices, alcohol/substance use) and professional obligations (e.g. missed work). This study underscores the need for sustained and accessible (online and in-person) supports that are grounded in intersectionality, responsive to families’ unique needs and sensitive to young people’s experiences with past adversity.

PMID:41054876 | DOI:10.1177/08862605251378991

Scand J Public Health. 2025 Oct 7:14034948251380639. doi: 10.1177/14034948251380639. Online ahead of print.

ABSTRACT

AIMS: The aim was to investigate short (1-3 days) sickness absence (SA) and remote work in 2019-2023 among a cohort of Finnish knowledge workers. A specific aim was to investigate the role of working hours and the associations between remote work and SA and if the associations would differ before, during, or after the COVID-19 pandemic.

METHODS: Employer-owned register data of 5535 knowledge workers for working hours (daily and weekly working hours), remote workdays/week, and short, 1-3 days, SA from 2019 to 2023 were investigated with a fixed-effects Poisson regression analysis for incidence rate ratios (IRRs) with 95% confidence intervals (95%CI).

RESULTS: The overall associations between remote work and short SA indicated that each 1-day increase in remote workdays was associated with higher odds of short SA (IRR 1.27, 95%CI 1.24, 1.30). The comparison across the years 2019-2023 showed varying associations. In the pre-pandemic year, 2019, there was no statistically significant association between remote workdays and short SA. Since 2021, doing no remote work has been associated with a lower likelihood of short SA. Instead, working remotely for 1-2 days or 3-5 days/week was associated with higher likelihood only when compared with no remote work.

CONCLUSIONS: Among knowledge workers, remote work seems related to short, 1-3 days of SA only after the COVID-19 pandemic. The possibility of working remotely might be an important factor in mitigating infections, while our results raise the assumption that presenteeism might be prevalent in remote work.

PMID:41054839 | DOI:10.1177/14034948251380639

Hum Vaccin Immunother. 2025 Dec;21(1):2565927. doi: 10.1080/21645515.2025.2565927. Epub 2025 Oct 7.

ABSTRACT

The COVID-19 pandemic prompted strict measures and rapid vaccine deployment in Benin and Senegal. This longitudinal study uses Generalized Estimating Equations (GEE) to analyze the evolution of vaccination intent and its determinants, focusing on attitudes, risk perceptions, and social influence. This descriptive and analytical longitudinal study included 546 Beninese and 319 Senegalese individuals aged 18 and above, selected using marginal quotas. Data were collected via Random Digit Dialing (RDD) based on a questionnaire informed by the Theory of Planned Behavior (TPB) and the Health Belief Model (HBM). Influential factors were assessed using GEE models. Vaccination intent increased more significantly in Senegal (+12.5 points, p = .000) than in Benin (+5.0 points, p = .089). There was a statistically significant increase in vaccine intent among women (+19.9 points) and individuals under 25 (+15.6 points) in Senegal, whereas in Benin, younger respondents showed a decrease (-11.5 points). In both countries, individuals surveyed in the second phase were significantly more likely to express vaccination intent (Benin: OR = 6.9; Senegal: OR = 5.0). Common positive determinants included perceived benefits, social influence, and favorable attitudes toward vaccination. Differences emerged: perceived efficacy and behavioral control were significant in Benin, while safety concerns were a major barrier in Senegal. This study highlights common and context-specific determinants of vaccination intent in Benin and Senegal. It emphasizes the need for tailored communication strategies and efforts to strengthen public trust to enhance vaccine uptake across West Africa.

PMID:41054838 | DOI:10.1080/21645515.2025.2565927

Int Health. 2025 Oct 7:ihaf112. doi: 10.1093/inthealth/ihaf112. Online ahead of print.

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic was associated with unprecedented healthcare, economic and social disruptions that impacted persons with diabetes mellitus (PWDM). We aimed to establish how the quality of life (QoL) of persons with diabetes in rural Uganda was impacted by the COVID-19 pandemic, using the pre-pandemic, pandemic and post-pandemic self-reported QoL scores.

METHODS: We surveyed 410 PWDM ≥30 y of age from three rural districts in south-western Uganda. Median QoL scores were computed and variations across the three time periods were analysed using the Friedman analysis of variance and McNemar tests as appropriate. Logistic regression was used to identify factors associated with QoL. A p-value <0.05 indicated statistical significance.

RESULTS: The overall median QoL scores were 67.2 (pre-pandemic), 62.4 (pandemic) and 68.8 (post-pandemic) (p<0.001). There was a 75% increase in the proportion of participants with unsatisfactory QoL during the pandemic (p<0.001). Having diabetes complications (p<0.001), chronic comorbidity (p=0.012), no formal education (p<0.003) and travelling for healthcare using non-motorised transport (<0.001) were all independently associated with post-pandemic unsatisfactory QoL.

CONCLUSIONS: The COVID-19 pandemic caused significant deterioration in QoL among rural PWDM, raising the need for policies to prioritise the consideration of their evolving needs while designing measures for future similar widespread emergencies.

PMID:41054795 | DOI:10.1093/inthealth/ihaf112

Psychol Med. 2025 Oct 7;55:e300. doi: 10.1017/S0033291725101773.

ABSTRACT

BACKGROUND: The use of cannabis in adolescence and early adulthood, critical phases for brain development, is linked to psychotic-like experiences (PLEs). The underlying mechanisms, however, remain unclear. This research examined the relationship between recreational cannabis use and PLEs, emphasizing the connectivity of the salience network (SN), which plays a role in salience processing and psychosis. To determine whether this relationship reflects shared genetic or environmental contributions, twin modeling was used.

METHODS: We included 232 healthy adolescent Turkish twins who underwent diffusion MRI and psychometric assessment. SN connectivity was quantified using graph theory metrics. Linear mixed models were used to examine the associations among cannabis use, SN factors, and PLEs. Mediation analyses assessed whether SN parameters explained the cannabis-PLEs association. Twin models disentangle genetic and environmental contributions to these traits and their covariation.

RESULTS: Cannabis use was significantly associated with higher overall PLE frequency. A specific SN factor predicted both total and positive PLEs. However, SN connectivity did not mediate the cannabis-PLEs relationship. Twin modeling showed that cannabis use and PLEs were mainly influenced by unique environmental factors. No significant phenotypic covariations were found among cannabis use, PLEs, and SN parameters.

CONCLUSIONS: Recreational cannabis use during adolescence and young adulthood is associated with heightened PLEs, although this association is not mediated by SN connectivity. The environment plays an important role during adolescence in shaping these traits independently. The findings underscore the need for longitudinal and genetically informed studies to clarify the mental health effects of adolescent cannabis use.

PMID:41054791 | DOI:10.1017/S0033291725101773

Surg Infect (Larchmt). 2025 Oct 7. doi: 10.1177/10962964251385387. Online ahead of print.

ABSTRACT

Background: Ventricular reservoir infections and cerebrospinal fluid (CSF) shunt infections are diagnosed when bacteria are recovered from microbiological cultures of CSF samples from these devices. We applied high throughput sequencing (HTS) to understand the course of changes in ventricular reservoir and shunt infection microbiota. Objectives: Evaluate the utility of monitoring microbiota in CSF (1) from ventricular reservoirs to detect development of an infection and (2) during treatment of CSF shunt infections to assess treatment response. Methods: Study populations included (1) neonates with temporizing ventricular reservoirs who developed reservoir infection and (2) children undergoing treatment for conventional culture-confirmed CSF shunt infection. The V4 region of the 16S ribosomal RNA gene was amplified and sequenced. Comparison of taxonomic results of HTS with standard microbiological culture results (when available) was described for each CSF sample. A robust HTS signal was defined by a microbial load of ≥1e5 microbial genome equivalents/mL. Results: In none of the five ventricular reservoir infection cases was there a robust HTS signal for the responsible bacteria immediately prior to infection. In six of the seven CSF shunt infection cases, there was a robust HTS signal for the genus of the responsible bacteria in the sample at the time of positive CSF culture. The proportion of sequences from the genus associated with the responsible bacteria decreased during infection treatment. Conclusions: These pilot data suggest limited utility in using HTS for surveillance for ventricular reservoir infections, as they emerge abruptly. In CSF shunt infection, HTS demonstrates a return to heterogeneous microbiota when bacterial cultures become negative.

PMID:41054788 | DOI:10.1177/10962964251385387