Category: Statistics

BMC Oral Health. 2025 Oct 6;25(1):1547. doi: 10.1186/s12903-025-06707-7.

ABSTRACT

BACKGROUND: This research explores the prevalence of fimA genotype variants of Porphyromonas gingivalis (P. gingivalis) in individuals with periodontitis and healthy controls within the United Arab Emirates (UAE). It seeks to examine the relationship between these genotypes and both periodontal health and disease. The study aims to improve our understanding of the involvement of P. gingivalis in periodontal diseases among the UAE population.

METHODS: This research involved 127 individuals diagnosed with periodontitis and 127 healthy participants matched for age and gender. Subgingival plaque samples were collected and examined for fimA genotypes (types I, II, III, IV, and V) employing polymerase chain reaction (PCR). A statistical evaluation using the chi-squared test was conducted to explore the relationship between fimA genotypes and periodontal condition, providing insights into the relationship between microbial profiles and periodontal health and disease.

RESULTS: The study found a significant link between specific fimA genotypes and periodontitis. The fimA genotype II was most common in periodontitis patients (41.7%) compared to healthy individuals (7.1%), with a strong association (p < 0.001). fimA genotype type IV was also more frequent in patients (15.0%) than in controls (2.4%), showing a significant correlation (p < 0.001). Other genotypes, such as fimA I, III, and V, were more frequently observed in patients, suggesting their involvement in disease development.

CONCLUSION: This study highlights a significant link between specific P. gingivalis fimA genotypes, particularly types II and IV fimA genotype combinations, and periodontitis in the UAE population. These findings provide insights into the prevalence of genotypes and suggest future research into their pathogenic mechanisms, potentially leading to new therapeutic interventions for periodontitis.

PMID:41053650 | DOI:10.1186/s12903-025-06707-7

BMC Public Health. 2025 Oct 6;25(1):3355. doi: 10.1186/s12889-025-24287-7.

ABSTRACT

BACKGROUND: Foodborne diseases are a serious public health problem that cause a heavy burden of illness. We aimed to analyze the characteristics of foodborne disease outbreaks (FBDOs) in Jiaxing and provide scientific support for foodborne disease prevention and control.

METHODS: Descriptive epidemiological methods were used to statistically analyze the data reported by seven county-level Centers for Disease Control and Prevention (CDCs) in Jiaxing City through the Foodborne Disease Outbreak Surveillance System (FDOSS) from 2013 to 2023.

RESULTS: During the study period, 128 FBDOs were reported, which resulted in 900 cases, 117 hospitalizations, and one death. Bacteria accounted for the highest proportion of outbreaks (58 outbreaks, 45.31%) and cases (623 cases, 69.22%), followed by poisonous mushrooms (28 outbreaks and 70 cases). Households were the setting for the highest proportion of outbreaks (57.03%). Poisonous mushrooms were the most common single food reported (28 outbreaks, 21.88%), followed by aquatic products (17 outbreaks, 13.28%) and meat and meat products (13 outbreaks, 10.16%). In the 58 bacterial FBDOs, the most important setting was households (20 outbreaks, 34.48%), followed by restaurants (15 outbreaks, 25.86%) and rural banquets (13 outbreaks, 22.41%). Outbreaks caused by poisonous mushrooms occurred mainly in households (27 outbreaks, 96.43%). Different types of bacteria tended to be responsible for outbreaks involving different food categories, e.g., Vibrio parahaemolyticus was mainly found in aquatic products (64.71%). From 2018 to 2023, the proportion of outbreaks caused by poisonous mushrooms increased from 22.22 to 76.92%. From 2021, poisonous mushrooms became the predominant factor for FBDOs in Jiaxing City.

CONCLUSIONS: Households are the most important settings for FBDOs. Poisonous mushrooms and microbial pathogens are the main factors causing FBDOs. Since 2018, the proportion of FBDOs caused by poisonous mushrooms has been increasing annually. Food safety policies targeting high-risk settings and pathogens identified by surveillance data should be formulated to reduce the risk of FBDOs.

PMID:41053642 | DOI:10.1186/s12889-025-24287-7

J Psychiatr Res. 2025 Oct 3;191:491-500. doi: 10.1016/j.jpsychires.2025.09.081. Online ahead of print.

ABSTRACT

OBJECTIVE: Clozapine (CZP) is not commonly prescribed mainly because of the risk of serious adverse effects, particularly neutropenia. It can also cause blood disorders, ranging from mild to severe, affecting different blood cell types. The aim of this study was to investigate the incidence of hematological abnormalities in a Pakistani cohort of patients treated with antipsychotics using a comprehensive hematological monitoring program.

METHODS: The study included 288 patients categorized into three clinical groups based on antipsychotic treatment: Group TA (typical antipsychotics), Group AA (atypical antipsychotics), and Group CZP. During the initial 20-week treatment period, patients were regularly monitored hematological to assess changes in their blood profiles. The occurrence of various hematological abnormalities was investigated and analyzed using statistical models.

RESULTS: Blood dyscrasias were observed more frequently in patients in the CZP group than in the other groups. Specifically, neutropenia was seen in a few patients in group CZP. Notably, a positive clinical response to CZP treatment was significantly correlated with transient leukocytosis, transient neutrophilia, and persistent anemia. In contrast, poor clinical response to CZP medication was associated with transient leukopenia.

CONCLUSION: CZP treatment resulted in more blood disorders than TA or AA treatments. While blood abnormalities were common with CZP, severe neutropenia was rare. Certain blood changes were linked to better treatment outcomes. Therefore, regular blood monitoring is recommended to optimize treatment effectiveness and manage side effects.

PMID:41052486 | DOI:10.1016/j.jpsychires.2025.09.081

JMIR Form Res. 2025 Oct 6;9:e79032. doi: 10.2196/79032.

ABSTRACT

BACKGROUND: The high prevalence of type 2 diabetes (T2D) and associated complications disproportionately affect low-income Latino populations, who also experience disparities in diabetes self-management (DSM), including poor medication adherence, physical activity, diet, and glycemic control.

OBJECTIVE: This study examined, through an academic-community partnership, the effectiveness of ¡Salud, Salud! (an evidence-based, family-centered diabetes self-management education and support [DSMES] program) on primary (glycemic control and quality of life) and secondary (social, psychological, and behavioral factors related to T2D management) outcomes among low-income Latino adults with T2D or prediabetes.

METHODS: In total, 81 adults (mean age 48.90 years, SD 12.57; n=57, 70.4%, female; n=66, 81.5%, Latino) with T2D or prediabetes were enrolled in a 12-week, single-arm quasi-experimental study conducted in two Central Texas Young Men’s Christian Association (YMCA) locations. ¡Salud, Salud! incorporated individual coaching by community health workers (CHWs), online family-centered DSMES training lessons, and a YMCA family membership. The delivery of ¡Salud, Salud! was supported and facilitated by digital technologies, including a dashboard to deliver intervention content and monitor participants’ engagement in intervention activities. Outcomes measured at baseline and 12 weeks (ie, postintervention) included hemoglobin A1c (HbA1c); quality of life; anthropometrics; self-reported physical activity and diet; mindfulness; perceived stress; and diabetes-related knowledge, self-efficacy, and support. Participant engagement in program activities was assessed via four index variables that underlay multiple dimensions of influences on ¡Salud, Salud! uptake: family engagement and support, participation in self-management education, program support and facilitation, and participation in self-monitoring. Paired t-tests and McNemar chi-square tests were used to examine the change in outcomes from baseline to 12 weeks. The number of program activities participants completed for each engagement index variable was converted to percentages to estimate the mean proportion of activities completed.

RESULTS: In total, 48 (59.3%) participants completed the 12-week posttest. At the end of the program, participants demonstrated a marginally significant reduction in HbA1c (-0.30%, P≤.09) and a significant increase in participants reporting good-to-excellent health from baseline (n=19, 39.6%) to posttest (n=28, 58.3%; P≤.003). There were significant reductions in body weight (-1.30 kg, P=.02), body fat percentage (-1.26%, P=.01), perceived stress (-0.28, P=.02), added sugar intake (-2.15 teaspoons/day, P=.001), and time spent sedentary per week (-70.27 minutes, P=.003) from baseline to posttest. Mindfulness increased significantly (2.21, P=.01). Participant engagement in ¡Salud, Salud! varied, with participants exhibiting a high completion rate in program support and facilitation activities (88%) and a moderate-to-low completion rate in self-management training (66%), self-monitoring (56%), and family engagement and support (49%) activities.

CONCLUSIONS: ¡Salud, Salud! shows promising preliminary effects on key diabetes-related outcomes. Future research should investigate how to enhance participant engagement and optimize uptake of evidence-based T2D self-management practices among low-income Latino adults with diabetes.

PMID:41052435 | DOI:10.2196/79032

JMIR Res Protoc. 2025 Oct 6;14:e74174. doi: 10.2196/74174.

ABSTRACT

BACKGROUND: Most nursing home residents do not meet physical activity guidelines. Many interventions to promote physical activity and prevent falls in nursing home residents have low adherence rates, lack a theoretical foundation, or require much time from staff for preparation or delivery.

OBJECTIVE: This study aims to describe the rationale, development, and implementation approach of the BeSt Age app through a cluster randomized controlled trial. We also provide baseline characteristics of the study sample and discuss possible implications for further app developments.

METHODS: We iteratively developed a novel, tablet-based mobile app (BeSt Age) that enables nursing home staff to deliver individualized physical exercise training to residents with or without motor or cognitive impairments. The app was designed and developed based on an intervention-mapping approach. A needs assessment was performed, followed by defining objectives, theory-based methods, program development, implementation, and evaluation. We took several steps to ensure that the app was based on a sound theoretical background and considered limitations identified in prior research. For implementation and evaluation purposes, we conducted a study among 229 older adults from 19 nursing homes (171 females, 58 males; mean age 85, SD 7 years). Results will be used to examine the effectiveness of the app with regard to different outcomes. Primary outcomes among participating nursing home residents are quality of life, fall risk evaluated through 2 performance-oriented balance tests, and fall incidence. Secondary outcomes include motor performance, cognition, activities of daily living, physical activity behavior, and fall efficacy. In this paper, we examined differences between intervention group (IG) and control group (CG) participants at baseline using the chi-square test, the Mann-Whitney U test, or the t test.

RESULTS: The IG (n=137 from 11 nursing homes) received a 12-week intervention with the BeSt Age app in small, homogenous groups of 5-7 nursing home residents, with 2 exercise sessions per week, each lasting 25-30 minutes. The CG (n=92 from 8 nursing homes) received usual care. At baseline, the IG had a statistically significantly larger number of females, participants had a higher BMI, and more participants rated attending physical activity programs as important. There were no further statistically significant differences between the groups. Results with regard to the effectiveness of the BeSt Age app are expected to be published in spring 2026.

CONCLUSIONS: If proven effective, the BeSt Age app may be a viable solution for physical activity promotion and fall prevention among older adults residing in nursing homes, thereby contributing to maintaining quality of life and overall well-being in this vulnerable population. The app can support nursing home staff in delivering exercise training to residents with minimal additional workload and without requiring specific resources.

PMID:41052426 | DOI:10.2196/74174

JMIR Cancer. 2025 Oct 6;11:e77214. doi: 10.2196/77214.

ABSTRACT

BACKGROUND: Traditional education for patients with cancer faces challenges related to timeliness, accessibility, and a personalized approach. Social media has emerged as a novel platform for delivering cancer-related educational content, garnering growing academic interest. However, a comprehensive assessment of the current research landscape in this domain is lacking.

OBJECTIVE: This study aimed to identify research hotspots; trace the evolution of social media-based education for patients with cancer; and map the leading journals, institutions, and international collaboration networks in this field.

METHODS: A bibliometric and thematic analysis was conducted using tools, such as VOSviewer, Bibliometrix, and CiteSpace, to examine articles indexed in the Web of Science Core Collection from 2011 to 2025. The analysis explored publication trends, author and institutional collaboration networks, keyword co-occurrence, factor analysis, thematic clusters, and the evolution of disciplinary keyword categories.

RESULTS: A total of 119 publications were retrieved. The Journal of Medical Internet Research was the most productive journal in this field, publishing 13 articles (10.9%). The University of Minnesota was the most productive institution, contributing 6 publications (5.0%). The United States accounted for the largest proportion of publications (56/119, 47.1%), with 5 of the top 10 institutions based in the country. The United States also led the international collaboration network. Keyword analysis identified key research hotspots, including platform-specific information dissemination, tailored educational interventions for diverse patient populations, efforts to enhance quality of life, and challenges related to health misinformation. Thematic evolution demonstrated a shift from basic information-seeking behaviors to broader topics such as digital health and health equity, indicating a multidimensional and interdisciplinary research trajectory.

CONCLUSIONS: This study represents the first bibliometric analysis of social media-based cancer education, providing actionable insights to inform digital health literacy strategies and advance patient-centered, equitable health care.

PMID:41052420 | DOI:10.2196/77214

JMIR Form Res. 2025 Oct 6;9:e73279. doi: 10.2196/73279.

ABSTRACT

BACKGROUND: Depression and anxiety are associated with excess morbidity and mortality, constituting a major health care challenge. The prevalence of these conditions is increasing. In the United States, the health-related burden of depression and anxiety may disproportionately affect Black adults, who face unique stressors impacting their mental health and barriers to accessing treatment, including but not limited to systemic racism, discrimination, underdiagnosis of common mental health concerns (ie, depression, anxiety), limited access to culturally sensitive care, and mental health stigma within and outside Black communities.

OBJECTIVE: This study aimed to explore the mental health experiences of nontreatment-seeking Black adults, and how these experiences relate to their needs and preferences for the design of digital mental health (DMH) tools through user-centered design methods.

METHODS: This study included 25 nontreatment-seeking Black adults (aged 18-61 years) with experiences of depression or anxiety to share their perspectives on how DMH tools can meet their needs. Participants were recruited either through social media advertisements or depression and anxiety questionnaires. All participants engaged in an asynchronous online discussion group in which they discussed their past and current mental health experiences, distinct challenges faced by Black Americans, and perceptions of DMH tools, as well as how such tools can be tailored to meet their mental health needs. Participants also completed a technology probe in which they used an automated mental health self-management text messaging tool (Small Steps SMS; Audacious Software) for 18 days. They shared their perceptions of the tool and ideas for specific design improvements in the discussion group. A subset (n=6) completed follow-up interviews to elaborate on their online discussion group posts.

RESULTS: All participants reported significant mental health concerns and difficulty managing related symptoms. A majority of participants (22/25, 88%) expressed that racism and mental health stigma severely impacted their mental health and limited opportunities to discuss their experiences within and outside Black communities. They were interested in the use of DMH tools for mental health self-management and nearly all participants (23/25, 92%) endorsed text messaging as a convenient way to introduce techniques for coping with symptoms of depression and anxiety; however, some participants strongly advocated for additional design features that they believed would improve the program, including the integration of content that centers the experiences of Black individuals, creating nonjudgmental spaces for discussing mental health experiences, and linking formal mental health treatment resources for those who want them.

CONCLUSIONS: These findings suggest that our participants hold generally favorable views toward DMH tools, which can provide psychoeducation, self-management support tailored to the needs of Black adults, and a safe environment to address mental health concerns. Furthermore, it is critical to consider the role of racial discrimination and mental health stigma when designing inclusive and culturally sensitive DMH tools.

PMID:41052419 | DOI:10.2196/73279

JMIR Form Res. 2025 Oct 6;9:e76723. doi: 10.2196/76723.

ABSTRACT

BACKGROUND: YouTube has become a major source of health information, with 2.5 billion monthly users. Despite efforts taken to promote reliable sources, misinformation remains prevalent, particularly regarding medical cannabis.

OBJECTIVE: This study aims to evaluate the quality and reliability of medical cannabis information on YouTube and to examine the relationship between video popularity and content quality.

METHODS: A systematic review of YouTube videos on medical cannabis was conducted. Search terms were selected based on Google Trends, and 800 videos were retrieved on July 8, 2024. After applying exclusion criteria, 516 videos were analyzed. Videos were categorized by content creators: (1) nonmedical educational channels, (2) medical education channels, and (3) independent users. Two independent reviewers (SK and SE) assessed content quality using the DISCERN grade and the Health on the Net (HON) code. Statistical analysis included one-way ANOVA and Pearson correlation coefficient.

RESULTS: Of the 516 videos analyzed, 48.5% (n=251) were from the United States, and 17.2% (n=89) from the United Kingdom. Only 12.2% (n=63) were produced by medical education channels, while 84.3% (n=435) were by independent users. The total views reached 119 million, with nonmedical educational channels having the highest median views with 274,957 (IQR 2161-546,887) and medical education channels having the lowest median views at 5721 (IQR 2263-20,792.50). The mean DISCERN and HON code scores for all videos were 34.63 (SD 9.49) and 3.93 (SD 1.20), respectively. Nonmedical educational creators had the highest DISCERN score (mean 47.78, SD 10.40) and independent users had the lowest score (mean 33.5, SD 8.50; P<.001). Similarly, nonmedical educational creators had the highest HON code score (mean 5.33, SD 1.22), while independent users had the lowest (mean 3.78, SD 1.10; P=.007). Weak positive correlations were found between video views and DISCERN scores (r=0.34, P<.001) and likes and DISCERN scores (r=0.30, P<.001).

CONCLUSIONS: YouTube is a key source of information on medical cannabis, but the credibility of videos varies widely. Independent users attract the highest viewers but have reduced reliability according to the DISCERN and HON scores. Educational channels, despite increased reliability received the least engagement. The weak correlation between views and content quality emphasizes the need for content moderation to ensure that the most reliable and accurate information on health issues is widely disseminated. Future research should identify strategies to promote verified sources of information and limit misinformation.

PMID:41052415 | DOI:10.2196/76723

West Afr J Med. 2025 May 30;42(5):413-418.

ABSTRACT

INTRODUCTION: Kidney transplantation is the optimal treatment for improving survival and quality of life for patients with end-stage kidney disease. There was no kidney transplant surgery and acute transplant care services in Southeast Nigeria until 2017 when our institution commenced kidney transplant surgery and acute transplant care. This study aims to share our first eight year experience including graft and patient outcome.

OBJECTIVES: To obtain the transplant rate, short and long term complications and the graft and patient survival over an eight year period in a tertiary hospital in Southeast Nigeria.

METHOD: A retrospective review of the transplant register for patients referred to the kidney transplant unit over an eight year period from January 2017 to January 2025.

RESULT: Complete data for ninety-three patients were analyzed. Out of these, twelve were transplanted giving a transplantion rate of 13%. Financial constraint is the leading reason (40%) for failure to get a kidney transplant done. Hypertension, hyperkalemia, anemia and urinary tract infection were the leading acute complications encountered while cytomegalovirus infection, recurrence of native disease, chronic graft loss and death were the major long term complications. The three-month, one-year, three-year and five-year patient survival in our program were 100%, 90%, 80% and 80% respectively while the graft survival were 90%, 90%, 70% and 60% respectively.

CONCLUSION: The transplant conversion rate is low and a review of atient selection criteria will improve access kidney transplant. Acute complications were treatable in most cases. The patient and graft outcomes appear similar with other centres in Nigeria.

PMID:41052413

JMIR Nurs. 2025 Oct 6;8:e73621. doi: 10.2196/73621.

ABSTRACT

BACKGROUND: This study aimed to adapt a stress and well-being intervention delivered via a mobile health (mHealth) app for Latinx millennial caregivers. This demographic, born between 1981 and 1996, represents a significant portion of caregivers in the United States, with unique challenges due to higher mental distress and poorer physical health than noncaregivers. Latinx millennial caregivers face additional barriers, including higher rates of being uninsured and increased caregiving burdens.

OBJECTIVE: We used a community-informed and user-centered design approach to tailor an existing mHealth app to better meet the stress and well-being needs of Latinx millennial caregivers.

METHODS: We used a 2-step, multifeedback approach. In step 1, Latinx millennial caregivers participated in focus groups to evaluate wireframes for the proposed mHealth app. In step 2, participants engaged in usability testing for 1 week, concluding with short interviews for feedback. Participants were recruited through various channels, including social media and community clinics. Data were analyzed inductively using a rapid qualitative content analysis approach.

RESULTS: A total of 29 caregivers (n=20, 69% women) participated in the study. Participants had a mean age of 31 (SD 4.10) years, with most (n=28, 97%) caring for an adult and 3% (1/29) caring for children with chronic conditions. All participants completed the step 1 focus groups, with a subset of 10% (3/29) of the caregivers completing the usability testing in step 2. The most liked features included (1) the stress rating scale because it helped them understand stress and mental health; (2) the mindfulness options, which allowed for flexible timing of activities; (3) the journaling prompts for addressing daily challenges and positive experiences; and (4) the resource list for its employment and financial content. One concern was that the journaling prompts may take too much time to complete after a long and hard day. Some suggestions for improvement included a better tracking system, gamification, caregiving education, a checklist of emotions to use with the journal, tailored resources, and ways to connect with other caregivers. During step 2, participants noted that the app was user-friendly but had some glitches and unclear privacy policies. Participants liked the meditation options, resource variety, and daily stress log but wanted more journaling space, longer meditations, and additional relaxation activities.

CONCLUSIONS: Future iterations should consider integrating more personalized and community-specific resources, leveraging platforms such as podcasts for broader engagement, and the use of information-based videos to support caregiver skill acquisition. Caregivers expressed needs beyond the scope of the app, such as resource access, demonstrating the need for upstream and downstream interventions. This study reinforces that user-informed design is an ongoing and iterative process that requires balancing the needs of stakeholders and the feasibility of the recommended adaptations.

PMID:41052408 | DOI:10.2196/73621