Category: Statistics

Eur J Med Res. 2025 Dec 16. doi: 10.1186/s40001-025-03693-y. Online ahead of print.

ABSTRACT

BACKGROUND: The CCAT2 gene is associated with carcinogenesis, but its effect on neuroblastoma, the most common extracranial tumor in children, remains unclear.

METHODS: We conducted a case-control study involving 402 children with neuroblastoma and 473 children without neuroblastoma. TaqMan genotyping of two CCAT2 polymorphisms (rs3843549 A > G and rs6983267 T > G) was conducted for all participants. Correlations were analyzed by calculating the odds ratio (OR) and 95% confidence interval (CI). Furthermore, we performed stratified analyses for both polymorphisms to evaluate their associations more comprehensively.

RESULTS: We performed a statistical analysis employing three distinct genetic models to evaluate the rs3843549 A > G polymorphism and the rs6983267 T > G polymorphism. Moreover, we further investigated the potential protective polymorphisms (rs3843549 AG/GG and rs6983267 TG/GG) by stratified analysis. There was no significant association between CCAT2 gene polymorphisms and neuroblastoma susceptibility.

CONCLUSION: CCAT2 gene polymorphisms (rs3843549 A > G and rs6983267 T > G) were not associated with susceptibility to neuroblastoma. However, the accuracy of this conclusion may be limited by various confounding factors. Future analyses would benefit from a more comprehensive approach that accounts for additional variables.

PMID:41402887 | DOI:10.1186/s40001-025-03693-y

BMC Sports Sci Med Rehabil. 2025 Dec 17. doi: 10.1186/s13102-025-01485-9. Online ahead of print.

ABSTRACT

OBJECTIVE: This systematic review and meta-analysis aimed to quantify the risk of subsequent all-cause, recurrent concussion, upper extremity, and lower extremity injuries in athletes with a history of sport-related concussion.

METHODS: Following PRISMA guidelines, cohort studies published from inception through August 2025 were retrieved from PubMed, Cochrane Library, Embase, Web of Science, and EBSCO. The methodological quality of included studies was evaluated using the Newcastle-Ottawa Scale (NOS). Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models. Pre-specified subgroup and meta-regression analyses were conducted to investigate sources of heterogeneity, including injury timing, study design, sport type, and athlete competition level.

RESULTS: Nineteen cohort studies involving 86,879 athletes were included. Athletes with a history of concussion had significantly higher odds of sustaining a subsequent all-cause injury (OR = 1.93; 95% CI = 1.39-2.68). The risk was most pronounced for recurrent concussion (OR = 3.06; 95% CI = 1.81-5.17), and was also significantly elevated for upper extremity (OR = 1.76; 95% CI = 1.10-2.81) and lower extremity injuries (OR = 1.49; 95% CI = 1.06-2.09). Given the high heterogeneity observed in the primary outcomes (I² > 90%), the pooled effect sizes should be interpreted with caution as average associations across varying study contexts, rather than as precise predictions applicable to all settings. Subgroup analysis revealed that injury risk was statistically significant in studies with follow-up periods beyond six months (OR = 1.94) but not for shorter durations. The association was strongest and statistically significant among college athletes (OR = 2.29; 95% CI = 1.53-3.44), while estimates for professional and high school athletes were not significant. Meta-regression identified sport type as a significant moderator of injury risk (p = 0.038).

CONCLUSION: A history of concussion significantly increases the risk of subsequent injuries, with the odds being highest for recurrent concussion. The persistence of this risk beyond six months suggests that clinical recovery does not equate to full functional recovery. These findings underscore the need for enhanced return-to-play protocols that incorporate objective functional assessments and targeted rehabilitation to mitigate the heightened vulnerability to injury in post-concussed athletes.

PMID:41402865 | DOI:10.1186/s13102-025-01485-9

BMC Nurs. 2025 Dec 17. doi: 10.1186/s12912-025-04214-2. Online ahead of print.

ABSTRACT

BACKGROUND: As the healthcare environment changes rapidly due to the spread of information and communication technology (ICT), nursing fields require nursing informatics competency to effectively utilize vast amounts of information, along with the ability to understand and utilize ICT. In addition, critical thinking competency, which is the ability to efficiently use nursing information systems and critically analyze and solve complex problems, has been emphasized. Previous studies have reported on nursing informatics competency and critical thinking or critical thinking disposition; however, few have identified moderators or mediators in these relationships. This study evaluated the mediating effect of self-control on the relationship between critical thinking disposition and nursing informatics competency.

METHODS: This study involved a secondary analysis of data from 235 questionnaires of undergraduate students from two Korean cities between October and November 2022. A direct questionnaire was used to collect the data. The study variables were analyzed using descriptive statistics, correlations, and a model tested using the Hayes PROCESS macro (Model 1) moderation model.

RESULTS: The mean scores for critical thinking disposition, self-control, and nursing informatics competency were 3.79 ± 0.52, 3.42 ± 0.60, and 3.80 ± 0.50, respectively. Critical thinking disposition and self-control were positively correlated with nursing informatics competency. In the moderation model, self-control had a conditional moderating effect on the relationship between critical thinking disposition and nursing informatics competency. The positive effect of critical thinking disposition on nursing informatics competency increased as self-control increased.

CONCLUSIONS: Critical thinking disposition and self-control may be important determinants of nursing informatics competency among undergraduate nursing students. To effectively increase nursing informatics competency, critical thinking disposition should be enhanced through educational programs or training with content, including increasing self-control.

PMID:41402858 | DOI:10.1186/s12912-025-04214-2

BMC Nurs. 2025 Dec 16. doi: 10.1186/s12912-025-04221-3. Online ahead of print.

ABSTRACT

INTRODUCTION: Radiotherapy for nasopharyngeal cancer (NPC) frequently induces malnutrition, which is a serious complication that adversely affects patients’ quality of life and prognosis. Although there are currently nutritional assessment procedures for such patients, their clinical effectiveness requires further investigation.

OBJECTIVE: This study aims to evaluate the impact of implementing an optimal nutritional assessment strategy on the nutritional management skills of nurses and patients and on the nutritional status of NPC patients undergoing radiotherapy.

METHODS: The project followed a three-phase approach. In the first phase, a systematic search and critical appraisal of evidence on nutritional management for NPC radiotherapy patients was conducted, yielding 17 best-practice items and 18 audit indicators. A baseline assessment of these indicators was subsequently performed in a radiotherapy ward between November 2024 and January 2025. The findings from this audit informed the second phase, where barriers and facilitators were analyzed using the Consolidated Framework for Implementation Research. This analysis led to the development of the 4 C Nutrition pathway as the core intervention strategy, which was implemented in the third phase from March to May 2025. The effectiveness was evaluated by comparing pre- and post-implementation data on audit compliance, knowledge levels of nurses, patients’ treatment adherence, and nutritional status indicators. Comparative analyses used paired or independent-sample t-tests for continuous variables and chi-square tests for categorical variables, with significance set at P < 0.05 (SPSS software, version 25.0).

RESULTS: A total of 51 patients were included pre-implementation, compared to 52 post-implementation. Following evidence translation, the implementation rates of nurse review indicator increased overall from a range of 0% to 90.2% pre-implementation to 50.00% to 100.00% post-implementation. Nurse nutrition management knowledge questionnaire scores increased from (68.22 ± 5.90) to (85.11 ± 7.10). Patients’ nutritional management adherence scores increased from (103.43 ± 12.92) to (117.00 ± 5.97). Moreover, at the 4-week follow-up, the hemoglobin level in the post-implementation group (126.38 ± 6.19) g/L was significantly higher than the pre-implementation level (109.58 ± 17.15) g/L. All these differences were statistically significant (P < 0.05).

CONCLUSIONS: The implementation effectively enhanced the standardization of clinical nutritional assessment for nurses, significantly narrowed the gap between clinical practice and best evidence, and improved the knowledge of nutritional management among nurses and patients.

TRIAL REGISTRATION: This study has been retrospectively registered with the China Clinical Trial Registry.

CLINICAL TRIAL NUMBER: ChiCTR2500107011. Registration date: 1 August 2025.

PMID:41402847 | DOI:10.1186/s12912-025-04221-3

Respir Res. 2025 Dec 16. doi: 10.1186/s12931-025-03447-8. Online ahead of print.

ABSTRACT

BACKGROUND: Flexible bronchoscopy (FB) is recommended for pediatric Mycoplasma pneumoniae pneumonia (MPP) with persistent consolidation or atelectasis, though substantial heterogeneity in treatment effects exists. This study aimed to develop a causal forest-based predictive model to identify pediatric MPP patients most likely to benefit from FB.

METHODS: This retrospective two-center study enrolled pediatric MPP patients in derivation (n = 753) and validation (n = 139) cohorts. Clinical, laboratory, and AI-quantified computed tomography (CT) data were analyzed. Individual treatment effects (ITEs) were estimated using causal forest algorithms. FB-beneficial subgroups were defined using receiver operating characteristic (ROC) analysis of ITEs, with the varying treatment effect across the subgroups validated via multivariable linear regression. Subgroup characteristics, feature importance, and heatmap-based feature interactions were also analyzed.

RESULTS: FB treatment significantly reduced total fever duration in identified FB-beneficial subgroups in both derivation (β = – 1.16, p < 0.001) and validation (β = – 0.68, p = 0.04) cohorts. These beneficial subgroups exhibited significantly higher consolidation/atelectasis volume (CAV), pneumonia attenuation (PA), and consolidation-to-pneumonia ratio (CAR) compared to non-beneficial groups (all p < 0.001). Heatmap analyses confirmed that increased CAV combined with elevated PA or lymphocyte counts could improve FB efficacy.

CONCLUSIONS: This study developed and validated an individualized prediction model to identify pediatric MPP patients most likely to benefit from FB treatment. Our model may serve as a tool to support clinicians in optimizing FB utilization, potentially reducing unnecessary interventions and associated risks. An accessible online tool of this model facilitates practical clinical implementation.

PMID:41402819 | DOI:10.1186/s12931-025-03447-8

BMC Oral Health. 2025 Dec 16;25(1):1912. doi: 10.1186/s12903-025-07225-2.

ABSTRACT

BACKGROUND: The aim of this study was to evaluate the effects of sintering speed and surface finishing on the optical, mechanical, microstructural, and surface properties of monolithic zirconia ceramics with different yttria content.

MATERIALS AND METHODS: Three different zirconia materials (Katana UTML, Katana STML, DD Cube Bio ZX²) were subjected to either speed or conventionally sintering, followed by the application of various surface treatments. Translucency parameters were measured before and after aging. The biaxial flexural strength was measured after aging. The microstructure of the specimens was examined using scanning electron microscopy (SEM) and X-Ray diffraction (XRD) analyses, while the surface roughness was analyzed using atomic force microscopy (AFM). Statistical analysis of the data was performed using three-way ANOVA, one-way ANOVA, the Kruskal-Wallis test, and Bonferroni post hoc comparisons.

RESULTS: The applied sintering speed, clinical adjustment, and aging processes did not produce a statistically significant effect on flexural strength (p = 0.245) or translucency (p = 0.478). The phase content of Katana UTML was not influenced by sintering speed or clinical adjustment either before or after aging. For the Katana STML material, phase content was unaffected by sintering speed and clinical adjustment prior to aging, but the monoclinic phase was detected in the structure after aging. In the DD Cube Bio ZX² material, the monoclinic phase was observed both before and after aging, and the proportion of the monoclinic phase increased after aging. SEM analysis revealed that speed sintering reduced the average grain size of monolithic zirconia. AFM analysis indicated that, after aging, the glazed samples of Katana UTML and Katana STML exhibited smoother surfaces compared to the grinding and polishing groups of the same materials. Furthermore, the speed sintering of DD Cube Bio ZX² material resulted in the formation of a more homogeneous surface. The increase in yttria content in the material decreased flexural strength and the amount of monoclinic phase formed after aging while increasing translucency, grain size, and the proportion of the cubic phase (p = 0.000).

CONCLUSION: Speed sintering, surface finishing, and aging did not significantly affect the translucency or flexural strength of monolithic zirconia. Polishing kits designed for zirconia can be used after speed sintering. Higher yttria content improved translucency, grain size, cubic phase, and aging resistance, but reduced flexural strength and monoclinic phase after aging.

PMID:41402817 | DOI:10.1186/s12903-025-07225-2

Proc Natl Acad Sci U S A. 2025 Dec 23;122(51):e2526690122. doi: 10.1073/pnas.2526690122. Epub 2025 Dec 16.

ABSTRACT

Strong coupling photonics, in which coupling strengths significantly exceed decay factors, holds great promise for applications in energy conversion and information processing. However, the effective and scalable design of strongly coupled polaritonic structures requires precise determination of the transition boundaries between strong and weak coupling regions. Traditional trial-and-error methods and classical machine learning (ML) algorithms struggle to achieve this due to the inherent difficulty in measuring decay factors during coupling. To address these challenges, we propose a hybrid ML framework that integrates physics-informed modeling with uncertainty quantification. This approach enables accurate determination of strong-weak coupling transition boundaries-even with inaccessible decay factors. By leveraging this capability, our method facilitates efficient and large-scale design of strongly coupled polaritonic structures with sparse data, achieving a computational speedup of ~10⁴ times compared to conventional simulations. Guided by this framework, we experimentally constructed a hexagonal boron nitride (hBN) polariton coupling structure and observed strong coupling via near-field spectroscopy. This work establishes a generalizable optimization methodology for strongly coupled photonic devices, opening a broad avenue for polariton-enhanced energy conversion and optical information modulation.

PMID:41400999 | DOI:10.1073/pnas.2526690122

Work. 2025 Dec 16:10519815251401871. doi: 10.1177/10519815251401871. Online ahead of print.

ABSTRACT

BackgroundShift work is a major occupational health issue, disrupting circadian rhythms and increasing risks for physical, psychological, and social problems. Its impact on sexual function and sexual quality of life among female healthcare workers remains underexplored.ObjectiveThis study examined the impact of shift work on sexual function and sexual quality of life among female healthcare workers and highlighted its occupational health implications within a prevention, assessment, and rehabilitation framework.MethodsA descriptive cross-sectional study was conducted with 390 female healthcare workers in Turkey employed in rotating shifts. Data were collected using a Participant Information Form, the Female Sexual Function Index (FSFI), and the Sexual Quality of Life Questionnaire-Female (SQOL-F). Analyses included descriptive statistics, independent t-tests, one-way ANOVA and Multivariable linear regression.ResultsLonger professional experience, working in high-stress units (intensive care/emergency), ≥ 4 monthly night shifts, and >45 weekly working hours were significantly associated with poorer FSFI and SQOL-F scores (p < 0.05). Conversely, ≥ 32 h of rest after shifts was linked to higher scores. In multivariable analysis, FSFI and FGSIS scores were lower among participants who reported that shift/on-call work affects sexual desire (p < 0.001).ConclusionsShift work negatively affects sexual function and sexual quality of life among female healthcare workers. These outcomes should be recognized as critical occupational health issues. Adequate rest periods, reduced night-shift frequency, and psychosocial support programs are essential preventive and rehabilitative strategies. Worker-centered institutional policies that balance service continuity with employee health may enhance both well-being and healthcare system sustainability.

PMID:41400989 | DOI:10.1177/10519815251401871

J Glaucoma. 2025 Dec 8. doi: 10.1097/IJG.0000000000002671. Online ahead of print.

ABSTRACT

PRECIS: An implantable IOP sensor study in glaucoma patients found that five evenly spaced daily measurements over 18 waking hours effectively reflect the 24-hour IOP rhythm, with peaks and troughs often occurring outside clinic hours.

PURPOSE: The availability of an implantable IOP sensor enables patients to obtain IOP measurements over 24 hours and on demand. The current study assesses the optimal frequency of daily IOP measurements required to reflect the 24-hour IOP rhythm in glaucoma patients.

METHODS: Twenty-two patients with primary open-angle glaucoma (POAG) who had previously been implanted with a sulcus-based IOP sensor (eyemate-IO, Implandata, Germany) as part of the prospective multicentric ARGOS-02 study were enrolled. The following parameters were used to characterize the 24-hour IOP rhythm: distribution of IOP measurements and timing of IOP peaks and troughs. To assess the optimal number of IOP values to predict the 24-hour rhythm, the daily count of IOP measurements and the time interval between the first and last daily measurements were used. The correlation with the detection of daily IOP variability was assessed via student T-test and a kernel-density estimate using Gaussian kernels and Earth Movers Distance.

RESULTS: Twenty-two patients (8 female and 14 male) with a mean age of 67.8±6.8 years were followed up over 6.6±1.7 years with a total of 80,495 IOP measurements. The percentage of peak IOP values was highest (50.6%) during the early morning hours (4 to 5 am), while trough measurements occurred predominantly (42.3%) during the late-night hours (between 11 pm and 12 pm). Five IOP measurements equally distributed over an 18-hour period were sufficient to characterize the 24-hour rhythm. Additional measurements did not yield any statistically significant value in the characterization of 24-hour IOP patterns.

CONCLUSIONS: Using an implanted telemetric sensor, the results of this study show that 5 daily IOP measurements evenly spread over 18 hours, provide sufficient information for assessment of the diurnal IOP rhythm. However, patients in practice recorded on average four measurements over 14 hours, highlighting the gap between the ideal recommendation and real-life adherence.

PMID:41400987 | DOI:10.1097/IJG.0000000000002671

Nutr Cancer. 2025 Dec 16:1-13. doi: 10.1080/01635581.2025.2598922. Online ahead of print.

ABSTRACT

Obesity is a significant lifestyle factor that affects the development and outcomes of endometrial tumors. Excess body weight can disrupt hormonal balance and promote cellular mutations, increasing the risk of endometrial cancer. We developed a three-step stochastic model that incorporates clonal proliferation at each stage to investigate how obesity affects cancer progression. The model was tested on two datasets: non-obesity-related cases from the SEER registry (2010-2020) and obesity-related cases in women from the CDC (2017-2021). Our results show that obesity mainly impacts the development of endometrial tumors by causing genetic mutations in women. The stochastic model indicates that fat increases the rates of both initial and later mutations. Body weight can affect the rate at which early intermediate cells multiply, especially in women who are still premenopausal. Understanding how these cellular changes happen is important for estimating an individual’s risk of developing endometrial cancer.

PMID:41400983 | DOI:10.1080/01635581.2025.2598922