Category: Statistics

Indian J Pediatr. 2025 Aug 6. doi: 10.1007/s12098-025-05690-9. Online ahead of print.

ABSTRACT

OBJECTIVES: To validate the disease-specific quality of life (QoL) instrument for pediatric inflammatory bowel disease (PIBD) patients in three Indian languages (Hindi, Tamil and Bengali). Additionally, also to reveal the significant factors which effect QoL of PIBD patients in India.

METHODS: One hundred and two (102) PIBD patients (mean age 13 ± 2.59 y) across 6 centres were enrolled. Each child completed two questionnaires – the IMPACT-III and Paediatric Quality of Life Inventory Version 4.0 Generic Core Scale (PedsQL™) – in one of the three languages. A uniform clinico-demographic proforma was completed for each recruit to reveal factors which determine QoL. During analysis authors used Cronbach’s alpha for internal consistency, principal component analysis for factor analysis, Spearman’s correlation between the questionnaires for concurrent validity and ANOVA analysis between IMPACT-III health-related quality of life (HRQoL) scores and disease severity to establish discriminant validity.

RESULTS: A five-domain structure was most suitable: ‘Concerns’, ‘Social acceptance’, ‘Mental disposition’, ‘Disease adjustment’ & ‘Self-confidence’, with good internal reliability (Cronbach’s α = 0.73-0.94). Concurrent and discriminant validity of the new questionnaire was also statistically significant (p < 0.001). Higher monthly family income led to better QoL scores in the ‘Concerns’ (p = 0.04) and ‘Disease adjustment’ (p = 0.03) domains while children with ulcerative colitis (UC) had better ‘Social acceptance’ scores than children with Crohn’s disease (CD) (p = 0.02).

CONCLUSIONS: Modified IMPACT-III questionnaire with a five-domain structure demonstrated good validity and reliability for Indian population. ‘Social acceptance’ was higher in patients with ulcerative colitis. There is a favourable impact of higher family income on ‘Concerns’ and ‘Disease adjustment’ in PIBD.

PMID:40768130 | DOI:10.1007/s12098-025-05690-9

Intern Emerg Med. 2025 Aug 6. doi: 10.1007/s11739-025-04072-5. Online ahead of print.

ABSTRACT

In cardiac arrest (CA) patients, arterial blood gas parameters, such as pH values, lactate concentrations, and base deficit (BD), are routinely evaluated in the emergency department (ED). We examined the relationship between BD and successful cardiopulmonary resuscitation (CPR), return of spontaneous circulation (ROSC), neurological surveys, and intensive care unit (ICU) hospitalization length for in-and out-of-hospital CA (IHCA and OHCA, respectively) patients. We included non-traumatic adult CA patients in the present study. Age, gender, arterial blood gas (ABG) test results, CPR duration, ROSC, ICU hospitalization length, 30-day surveys, and neurological surveys were obtained for each patient. We included 448 CA patients. The mean age of the study group was 62.80 ± 17.64 years. The number of OHCA patients was 251 (56%), and IHCA patients consisted of 197 (44%). Mean BD values of the non-surviving OHCA patients was – 16.67 ± 6.72. This corresponding value in survival patients value was – 14.89 ± 6.62, but the difference was not statistically significant (p = 0.420). In the IHCA group, a weak negative correlation between BD levels and CPR duration (p < 0.001, r = – 0.247) was found. A weak positive correlation between BD and ICU hospitalization length (p < 0.001, r = 0.342) was also found. CPR duration correlated weakly and negatively with BD in the OHCA group (p = 0.03, r = – 0.192). In the IHCA group, BD was related to both ROSC (p < 0.001) and 30-day survival (p < 0.001). In the OHCA group, BD was related to ROSC (p = 0.020) and 30-day surveys (p = 0.042). In the IHCA group, a weak negative correlation between BD levels and CPR duration in addition to a weak positive correlation between BD and ICU hospitalization length was found. CPR duration negatively correlated with BD in the OHCA group.

PMID:40768124 | DOI:10.1007/s11739-025-04072-5

Eur J Epidemiol. 2025 Aug 6. doi: 10.1007/s10654-025-01281-2. Online ahead of print.

ABSTRACT

Complex multidimensional data are becoming more widely available and are drastically affecting the way epidemiological studies are designed and conducted. Novel frameworks such as the exposome-which encompasses the comprehensive and cumulative set of exposures affecting individuals throughout their lifetime and the complex mechanisms through which they act – provide a unique opportunity to transform how public health recommendations are identified at the population and individual level. This data revolution is accompanied by a growing interest in analytical approaches that can handle the complexity of these novel research questions. These include semi-parametric and non-parametric statistical and machine learning methodologies that provide compelling frameworks for analyzing large-scale databases while mitigating overfitting. Nevertheless, interpreting results from these complex methods is often challenging. While discussions on interpretability have largely focused on statistical inference, causal considerations and the practical applicability of the findings to inform the design of tangible interventions have received less attention-despite being essential components of epidemiological research. With this commentary we provide a general overview of these three levels of interpretability-statistical, causal, and actionable-and discuss available tools that can aid epidemiologists to improve results interpretability as they start utilizing more complex analytical approaches.

PMID:40768123 | DOI:10.1007/s10654-025-01281-2

J Community Genet. 2025 Aug 6. doi: 10.1007/s12687-025-00824-0. Online ahead of print.

ABSTRACT

Sickle cell disease (SCD) is a significant genetic disorder that imposes a considerable global health burden. The notable prevalence of SCD in Tanzania, coupled with extensive economic, psychological, and social ramifications, underscores the importance of premarital genetic screening to carriers of the sickle cell trait. This study aimed to assess the determinants of perception and willingness to uptake premarital genotype screening test for sickle cell disease carriers (PMGS) among health sciences undergraduate students in Dar es Salaam, Tanzania. An analytical cross-sectional design was used among 470 undergraduate students selected using a stratified random sampling technique. A structured questionnaire was used to collect data using Google Forms. Data were analyzed using the Statistical Package for the Social Sciences, version 25. Descriptive and inferential statistical analyses were performed. A total of 448 questionnaires were completed and submitted, with a response rate of 95.3%. More than half of the students (57.24%) had a good perception of PMGS, and the majority (92.2%) expressed their intention to participate in PMGS. Respondents who received information from healthcare professionals had a significant association (p = 0.031) with good perception. Most students were willing to participate in the PMGS program. As healthcare students, they are an important group in the development of national screening programs; similar studies in other universities in Tanzania are needed to obtain representative samples of undergraduates nationwide.

PMID:40768122 | DOI:10.1007/s12687-025-00824-0

Clin Rheumatol. 2025 Aug 6. doi: 10.1007/s10067-025-07596-5. Online ahead of print.

ABSTRACT

BACKGROUND: There are no effective pharmacological treatments for calcium pyrophosphate deposition (CPPD) disease. We aim to identify potential therapeutic targets for CPPD disease by integrating various publicly available datasets.

METHODS: We integrated data from druggable genomes, cis-expression quantitative trait loci (cis-eQTL)/cis-protein quantitative trait loci (cis-pQTL) in human blood and skeletal muscle tissues, and genome-wide association study (GWAS) summary statistics related to CPPD disease. This integration aimed to investigate potential causal relationships between drug target genes and CPPD disease using Mendelian randomization (MR) method. To validate these causal links, we performed sensitivity analyses and Bayesian colocalization. Furthermore, we applied phenome-wide Mendelian randomization (Phe-MR) approach to assess potential side effects or alternative therapeutic indications for the identified drug targets. Finally, we explored actionable drugs for these target genes using existing databases.

RESULTS: MR analysis identified four druggable genes-ULK3, CSK, PPIE, and NFKB1-that may have potential causal associations with CPPD disease in human blood or skeletal muscle tissue. These genes were further confirmed by Bayesian colocalization (PPH4 > 80%). The upregulation of ULK3 (blood eQTL, beta: 0.62, 95% CI: 1.129-3.091, P = 0.015; muscle eQTL, beta: 0.93, 95% CI: 1.055-6.146, P = 0.037; blood pQTL, beta: 2.51, 95% CI: 1.199-126.169, P = 0.034), CSK (blood eQTL, beta: 0.69, 95% CI: 1.094-3.650, P = 0.024; muscle eQTL, beta: 0.98, 95% CI: 1.058-6.707, P = 0.037; blood pQTL, beta: 3.41, 95% CI: 1.509-606.864, P = 0.025), and PPIE (blood eQTL, beta: 0.52, 95% CI: 1.218-2.321, P = 0.001; muscle eQTL, beta: 0.85, 95% CI: 1.384-3.962, P = 0.001; blood pQTL, beta: 1.06, 95% CI: 1.094-7.565, P = 0.032) in blood and skeletal muscle tissues was positively associated with the risk of CPPD disease. Conversely, NFKB1 showed an inverse relationship with CPPD disease risk (blood eQTL, beta: – 0.99, 95% CI: 0.147-0.935, P = 0.035; muscle eQTL, beta: – 1.95, 95% CI: 0.046-0.437, P = 0.001; blood pQTL, beta: – 3.17, 95% CI: 0.002-0.762, P = 0.032). The Phe-MR analysis indicated that the four potential therapeutic targets for CPPD disease had no significant adverse effects.

CONCLUSIONS: Our research indicated that ULK3, CSK, PPIE, and NFKB1 may be promising targets for CPPD disease. Key Points • ULK3, CSK, PPIE, and NFKB1 may be drug target genes in CPPD disease.

PMID:40768106 | DOI:10.1007/s10067-025-07596-5

Support Care Cancer. 2025 Aug 6;33(9):758. doi: 10.1007/s00520-025-09813-y.

ABSTRACT

PURPOSE: Although digital health technologies (DHTs) are promising to improve health outcomes in older adults with cancer, the low adoption and limited use remain significant gaps in their effective digital health care. Little is known about their concerns about adopting and using DHTs in routine life, particularly in the continued use phase. This study aims to explore factors affecting the initial adoption and continued use of DHTs among older adults with cancer.

METHODS: A secondary analysis of qualitative data was conducted based on interviews with 21 older adults (≥ 65 years) with breast, prostate, lung, or colorectal cancer. The transcripts of interview recordings were analyzed using a thematic analysis.

RESULTS: Three major themes and several subthemes were identified as potential factors affecting the (1) initial adoption, (2) continued use, and (3) limited use of DHTs. Digitalized healthcare systems and access to technology influenced the initial adoption of DHTs. Perceived ease of use, perceived usefulness, expected timely care from providers, and increased sense of control emerged as leading factors to the continued use. The limited use of DHTs was influenced by a lack of knowledge and skills, a lack of direct interaction with providers, and concerns about digital communication quality.

CONCLUSIONS: Ensuring digital access and providing technology-based solutions that meet diverse patient needs is crucial to promoting the adoption and use of DHTs among older adults with cancer. Healthcare providers should address older adults’ low digital literacy and uncertainty to ensure the quality of cancer care provided through DHTs.

PMID:40768101 | DOI:10.1007/s00520-025-09813-y

Pediatr Radiol. 2025 Aug 6. doi: 10.1007/s00247-025-06293-4. Online ahead of print.

ABSTRACT

BACKGROUND: Our institution decided to implement an awake MRI scanning quality improvement project using audiovisual distraction (AVD) technology.

OBJECTIVE: To reduce the utilization of minimal/moderate sedation by at least 20% in children 4 to 18 years, while maintaining comparable diagnostic quality and adhering to allotted exam times, through the implementation of an awake MRI program.

MATERIALS AND METHODS: This project was conducted at a pediatric sedation clinic between October 2021 and January 2024. We included patients 4 to 18 years of age, scheduled for an MRI at the pediatric hospital, and eligible for either minimal/moderate sedation or AVD. The outcome measure was the percentage of patients referred to our sedation clinic who completed an MRI with AVD and without sedation, analyzed on a statistical process control (SPC) P-Chart. Process measures were the number of children eligible for AVD per month, analyzed on an SPC C-Chart. Balance measures were the number of studies that exceeded allotted exam time or were non-diagnostic.

RESULTS: Of 734 MRI referrals aged 4 to 18 years, 320 patients met inclusion criteria. Two hundred twenty-eight (71.3%) received minimal/moderate sedation (mean age [SD] 9.7 years [± 3.0]) and 92 (28.8%) underwent AVD (mean age 10.0 years [± 2.7]). The average monthly decrease in minimal/moderate sedation use was 28.8 percentage points. The average number of children considered eligible for AVD increased by special cause variation from 3.8 to 7 patients per month. All 92 MRI referrals triaged to AVD completed their MRI successfully without sedation; all studies were diagnostic, and 96% of studies were within the allotted exam time.

CONCLUSION: We implemented an awake MRI program with AVD that decreased monthly sedation needs by 28.8 percentage points while maintaining a high rate of diagnostic studies and no MRI delays.

PMID:40768097 | DOI:10.1007/s00247-025-06293-4

Cancer Control. 2025 Jan-Dec;32:10732748251362950. doi: 10.1177/10732748251362950. Epub 2025 Aug 6.

ABSTRACT

IntroductionHealth and psychosocial outcomes are often interdependent for people with cancer and their informal caregivers. However, few studies have examined interdependence among U.S. Black patients and their caregivers. In this prospective study, we analyzed whether Black women with breast cancer and their caregivers demonstrated interdependence in depressive symptoms and other outcomes over time.MethodsPatient and caregiver data were collected via telephone surveys at three timepoints (baseline, two months, four months). Actor-Partner Interdependence Models (random-intercept cross-panel models in Mplus) were used to analyze depressive symptoms (Center for Epidemiology Studies Depression scale; CES-D), physical and mental health quality of life, perceived social support, and health behaviors. We hypothesized patients and caregivers would demonstrate interdependence for these outcomes both cross-sectionally and over time.ResultsWe enrolled 210 participants. All patients and 93% of caregivers identified as Black/African American; 70% of caregivers identified as female. Two-thirds (66%) of dyads did not live together. Mean baseline CES-D score was 15.0 (SD = 10.9) for patients and 11.9 (SD = 9.0) for caregivers. We did not find prospective interdependence for any outcomes. Dyad members were moderately correlated in overall levels (intercepts) of physical health quality of life (r = .25), mental health quality of life (r = .28), social support (r = .37), and health behavior scores (r = .33).ConclusionThis study is one of the first longitudinal, dyadic examinations of outcomes for Black breast cancer patients and their informal caregivers. Although our hypothesis of prospective interdependence was not supported, we observed moderate correlations of overall levels of several measures. These results suggest that patients with lower social support, poor health behaviors, and worse quality of life may also have caregivers who could benefit from intervention.

PMID:40767116 | DOI:10.1177/10732748251362950

J Adv Nurs. 2025 Aug 6. doi: 10.1111/jan.70128. Online ahead of print.

ABSTRACT

AIM: To describe the experiences of Finnish registered nurses aged 45 and over working during menopause.

DESIGN: Multiple methods study.

METHODS: The data were collected from Finnish registered nurses aged 45 and over, using two different methods. Quantitative data (n = 3487), collected in January 2023, were analysed using descriptive statistical methods. Qualitative data were collected during the summer of 2023 through individual interviews (n = 23). The participants were recruited from a survey, where registered nurses (n = 3487) who responded to the survey indicated their willingness to participate in the interview study (n = 718). Participants for the interviews were selected through random sampling, and interviews were conducted until saturation was reached. The quantitative data were analysed with descriptive statistics, and qualitative data were analysed using inductive content analysis. The results of quantitative and qualitative data were combined in the discussion section.

RESULTS: Limited attention has been given to understanding the menopause and its consequences on the nursing workforce. Menopause remains a taboo topic, with a perceived divide between genders and generations, even within the healthcare sector. However, peer support from female colleagues of a similar age was considered invaluable. During menopause, nurses did not receive sufficient support from their managers or occupational health services, despite experiencing various challenges. Fatigue, for instance, was reported by 76% of nurses aged 45 and over. Nevertheless, nurses continued working despite their symptoms, as taking sick leave was perceived as difficult.

CONCLUSION: The consequences of menopause on nursing work are not yet sufficiently recognised within workplaces, or by the leadership and occupational health services. Support for nurses working during menopause seems to be insufficient. Open and informed discussions are needed across various levels of society to increase understanding of the problems of working during menopause.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The research findings can be used to develop improved occupational health and nursing management practices to support the well-being of menopausal nurses in the workplace.

IMPACT: Currently, there is insufficient knowledge about working as a registered nurse during menopause. However, research findings are enhancing our understanding of the impact of menopause on nursing work and the corresponding needs during this period.

REPORTING METHOD: The Standards for Reporting Qualitative Research (SRQR).

PMID:40767100 | DOI:10.1111/jan.70128

Tijdschr Gerontol Geriatr. 2024 Jun 5;55(2):16-32. doi: 10.54195/tgg18688.

ABSTRACT

INTRODUCTION: This study aimed to determine the association between the physical, social, and cognitive characteristics of acutely admitted older individuals and their discharge destination.

METHOD: Retrospective study including consecutive individuals aged 65 or older who were acutely admitted to an academic hospital. From these, patients who had been living independently and were clinically judged to have an increased risk of falling or physical limitations upon admission were selected. In addition to sociodemographic and medical characteristics, the following measurements of physical and cognitive functioning were conducted at admission or shortly thereafter: the Katz-ADL, handgrip strength, Timed-Up-and-Go test, 4-Meter-Walk Test, and the Six-item Cognitive Impairment Test (6-CIT). Univariate analysis and multivariable logistic regression analysis were used to compare the characteristics of patients discharged home or not.

RESULTS: Among the 49 patients who were included (mean age 81 (standard deviation ± 7,8) years, 24 (49% ) female), 20 (41%) were not discharged home. In the univariate comparisons, patients not discharged home were statistically significantly older, less often admitted for infection, and had worse scores on all measures of physical and cognitive functioning. In the multivariate analysis adjusted for age, only a worse Katz-ADL score was associated with not being discharged home.

CONCLUSION: In older, independently living vulnerable patients who were acutely admitted to a hospital physical functioning as measured by the Katz-ADL at admission was most strongly associated with the discharge destination.

PMID:40767078 | DOI:10.54195/tgg18688