Category: Statistics

BMC Sports Sci Med Rehabil. 2025 Jun 4;17(1):144. doi: 10.1186/s13102-025-01187-2.

ABSTRACT

BACKGROUND: Prediabetes significantly increases the risk of cardiovascular disease (CVD), including myocardial infarction, stroke, and cardiovascular death. However, the relative effectiveness of different types of exercise interventions in reducing CVD risk in this population is unclear. The aim of this systematic evaluation and network meta-analysis (NMA) was to compare the effectiveness of aerobic exercise (AE), resistance training (RT), mind-body training (MBT), and combined aerobic and resistance training (AE + RT) interventions on CVD events and their associated risk factors.

METHODS: Randomized controlled trials (RCTs) published up to May 2025 were systematically searched in PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database, and VIP Database. Studies were required to report the effect of exercise interventions on cardiovascular event metrics such as Framingham score, 10-year CVD risk, and ICVD score. Two investigators independently completed screening, data extraction, and quality assessment. Network meta-analysis was performed using Stata 17.0, and intervention effects were ranked based on Surface Under the Cumulative Ranking (SUCRA) values.

RESULTS: A total of 6 RCTs involving 1,265 subjects were included. The results showed that RT was the most effective in reducing cardiovascular risk, showing the lowest SUCRA values for Framingham score, ICVD score, and insulin resistance (HOMA2-IR). This effect was statistically significant. AE + RT had the most significant advantage in reducing glycated hemoglobin (HbA1c, SUCRA = 26.7%, 95% CI [0.02, 0.89]) and triglycerides (TG, SUCRA = 9.1%). MBT had the optimal effect in improving lipids, as evidenced by higher High-Density Lipoprotein Cholesterol (SUCRA = 85.3%, 95% CI [4.05, 56.83]) and lower Low-Density Lipoprotein Cholesterol, both of which were statistically significant. No significant publication bias or consistency issues were identified in this study.

CONCLUSION: Different types of exercise interventions have differentiated advantages on cardiovascular risk and metabolic outcomes in prediabetic populations. RT is more suitable for controlling blood glucose and insulin resistance, AE + RT has the best effect on improving dual indexes of blood glucose and blood lipids, and MBT has a prominent role in lipid regulation. Compared with the traditional Meta-analysis, this study is the first to evaluate the relative effects of multiple exercise interventions through a network meta-analysis, which can provide a scientific basis for developing individualized and risk-oriented exercise prescriptions.

PMID:40468402 | DOI:10.1186/s13102-025-01187-2

BMC Psychol. 2025 Jun 4;13(1):601. doi: 10.1186/s40359-025-02646-8.

ABSTRACT

BACKGROUND: Parental emotional adjustment refers to the degree of distress associated with the parenting role and can be correlated with increased use of negative parenting practices. Parenting programs are a critical strategy globally to help ensure children reach their full developmental potential; however, their effects on parental mental health outcomes are inconsistent.

METHODS: Cross-sectional self-report survey data from mothers, fathers, and caregivers (e.g., grandmother) from Afghanistan, Indonesia, Kyrgyzstan, Malaysia, and Uzbekistan were analysed to explore: (1) the relative contributions of parental adjustment on parenting practices as measured by the Parenting and Family Adjustment Scales, and (2) differences in parenting practices across diverse contexts. Descriptive statistics were used to characterise the sample. Multiple logistic regression was used to explore the relationship between parental adjustment and parenting generally and parental consistency, coercive parenting, positive encouragement, and behaviours supporting the parent-child relationship specifically.

RESULTS: A total of 642 participants (mean age = 33.2 years; 79% female; 89.9% partnered) from Afghanistan (n = 111), Indonesia (n = 157), Kyrgyzstan (n = 118), Malaysia (n = 103), and Uzbekistan (n = 153) completed the survey. Results showed that parental adjustment was significantly positively associated with parenting practices, explaining 5.9% of the unique variance. Specifically, better parental adjustment was significantly positively associated with the use of positive parenting practices, including praise, attention, affection, and displays of pride, but not significantly associated with negative parenting practices such as spanking, shouting, and getting angry with children. Finally, significant differences in parental consistency, coercive parenting, positive encouragement, and parenting practices supporting the parent-child relationship were found across the five LMICs.

CONCLUSIONS: A robust literature demonstrates the importance of supporting parents’ mental health and emotional adjustment to improve both parent and child outcomes. Our results highlight that better emotional adjustment is associated with more positive parenting practices, suggesting that interventions that support a parent’s ability to cope with the parenting role will increase the use of responsive and nurturing childrearing practices. However, further research is now required to understand how best to integrate mental health-related content with other key intervention material (e.g., training in responsive caregiving), including with regards to the optimal ‘dose’ of each component, to optimise effectiveness.

PMID:40468380 | DOI:10.1186/s40359-025-02646-8

J Health Popul Nutr. 2025 Jun 4;44(1):185. doi: 10.1186/s41043-025-00849-8.

ABSTRACT

BACKGROUND: The university period is an important period in which eating habits and lifestyles are shaped, digital addiction due to digital media use increases, and psychosocial changes are observed. During this period, in addition to changes university students eating behavior, unhealthy eating behavior trends such as increased night time eating behavior and increased consumption of ultra-processed foods can be observed. This cross-sectional study aimed to investigate the relationship between night eating syndrome, ultra-processed food consumption and digital addiction in university students.

METHODS: This descriptive and cross-sectional study was conducted with 2512 university students with a mean age of 21.36 ± 2.04. The research data were collected by the researchers via a web-based survey form (Google form) created using the snowball sampling method, email and whatsapp. Demographic characteristics of the participants (gender, age, living space), eating behaviors (number of main and snacks), frequency of eating using visual mediaregular physical activity, daytime and nighttime sleep durations, digital media usage time, and anthropometric measurements (body weight and height) were examined. Ultra-processed food consumption was assessed with the screening questionnaire of highly processed food consumption. The Night Eating Questionnaire (NEQ) was used to measure the severity of Night Eating Syndrome and the digital addiction scale was used to measure digital addiction. The Statistical Package for Social Sciences (version 27.0) software was used for all analyses.

RESULTS: In this study, correlations were found between the total score of the night eating scale and the total score of the Digital Addiction Scale, the total score of ultra-processed food consumption, BMI, daytime sleep duration, nighttime sleep duration and time spent on digital media (r = 0.202, r = 0.177, r = 0.101, r = 0.100, r=-0.080, r = 0.094 respectively). Digital Addiction Scale total score It was determined that it was significantly affected by possible variables such as gender, night sleep duration, Night Eating Syndrome Scale total score, digital media use and ultra processed food consumption (p < 0.001). Similarly, the total score of the Night Eating Syndrome Scale, It was found that it was significantly affected by possible variables such as gender, body mass index (BMI), night sleep time, daytime sleep time and Digital Addiction Scale total score (p < 0.001).

CONCLUSIONS: This study highlights a relationship between digital addiction, night eating syndrome and ultra-processed food consumption. Our study suggests that this eating disorder, Night Eating Syndrome, may be affected by possible variables such as gender, body mass index (BMI), night sleep duration, daytime sleep duration, and digital addiction. These findings offer a different perspective in developing strategies for the prevention and management of NES in university students.

PMID:40468376 | DOI:10.1186/s41043-025-00849-8

BMC Med Educ. 2025 Jun 4;25(1):838. doi: 10.1186/s12909-025-07218-3.

ABSTRACT

BACKGROUND: Over the last decade there has been a recognition of the need for better dementia education for undergraduate healthcare professionals. Time for Dementia is an innovative educational programme in the UK whereby students learn about the condition directly from a two-year longitudinal contact with a person living with dementia and their families. There is evidence that such programmes have positive outcomes for students in terms of improved attitudes and knowledge, however, students’ evaluations of these programmes are scarce.

OBJECTIVES: To understand the satisfaction of the students taking part in Time for Dementia and their perceptions of the programme.

METHODS: A cross-sectional survey, with Likert responses, was completed to assess overall levels of satisfaction for students enrolled in Time for Dementia. 1,225 students consented and completed the satisfaction survey at five universities in England. Factors that might predict satisfaction were explored using multiple regression analysis. A qualitative framework thematic analysis explored the best aspects of the programme and possible improvements, as recorded by student responses to open text questions.

RESULTS: 78% of students agreed or strongly agreed that Time for Dementia had increased their knowledge of psychosocial issues, and 69% enjoyed the programme. The multiple regression analysis found satisfaction was statistically significantly higher for students who completed more visits; took part after the onset of the COVID-19 pandemic; were of Black or Asian ethnicities (compared to White British/European); and were relatively older. The themes related to the best aspects of the programme were that Time for Dementia provides relational learning, understanding the impact of dementia on family and thinking psychosocially. Improvements include preferred programme structure, the need for clarity of expectations and addressing barriers to learning.

CONCLUSIONS: This study supports the value of Time for Dementia as assessed by students. Key considerations to ensure satisfaction include the fidelity of programme experience and clear expectations.

PMID:40468368 | DOI:10.1186/s12909-025-07218-3

Radiat Oncol. 2025 Jun 4;20(1):93. doi: 10.1186/s13014-025-02672-1.

ABSTRACT

OBJECTIVE: This research focused on determining the optimal cycles of induction chemotherapy (IC) in high-risk locoregionally advanced nasopharyngeal carcinoma (LA-NPC).

METHODS: The retrospective analysis was conducted on 885 patients. Potential bias was minimized by propensity score matching (PSM). Overall survival (OS) served as the primary endpoint. Survival outcomes were analyzed using Kaplan-Meier curves, with statistical comparisons performed via the log-rank test. Prognostic determinants were identified through multivariate cox regression analysis. A nomogram model was constructed to quantify individualized prognosis.

RESULTS: Patients were divided into 2/3-cycle (IC = 2/3) and 4-cycle IC (IC = 4) groups. After PSM, 446 patients remained and were categorized into distinct risk groups according to independent predictors, including clinical stage and pre-treatment Epstein-Barr virus DNA (pre-EBV DNA). For the high-risk cohort (stage IVa with pre-EBV DNA ≥ 4000 copies/mL), the IC = 4 regimen showed higher 5-year OS (70.4% vs. 54.7%, P = 0.036) than the IC = 2/3 regimen. In the low- and middle-risk cohorts, the IC = 2/3 regimen exhibited OS comparable to the IC = 4 regimen. The established nomogram model demonstrated superior prognostic power compared to individual factors. Given the adverse effects, the IC = 4 regimen was associated with significantly higher rates of grade 3-4 neutropenia (24.6% vs. 15.5%, P = 0.017) and thrombocytopenia (8.0% vs. 3.7%, P = 0.049) compared to the IC = 2/3 regimen.

CONCLUSION: The developed nomogram offers personalized guidance on selecting individual IC cycles for LA-NPC patients.

PMID:40468367 | DOI:10.1186/s13014-025-02672-1

BMC Womens Health. 2025 Jun 4;25(1):277. doi: 10.1186/s12905-025-03808-x.

ABSTRACT

BACKGROUND: Endometriosis (EM) is a prevalent gynecological condition impacting roughly 10% of women of reproductive age worldwide, causing chronic pain, infertility, and menstrual irregularities. Traditional diagnosis typically relies on invasive surgical methods, and non-invasive diagnostic techniques remain underdeveloped. This study seeks to investigate the association between creatinine levels and endometriosis through cross-sectional analysis and mendelian randomization (MR) analysis, while also developing and assessing diagnostic models.

METHOD: This research integrates data from the NHANES database (1999-2006) and the affiliated hospital of Jining Medical College in China. The study cohort consists of women aged 20-60, with data collection covering age, race, education level, marital status, family income, weight, height, body mass index(BMI), and serum creatinine levels. Logistic regression models were used for univariate and multivariate analyses. Bidirectional MR analysis, utilizing genetic variation data from Large Genome Association Studies (GWAS), was performed to evaluate causal relationships using the inverse variance weighted (IVW) method, complemented by sensitivity analysis. A diagnostic model based on data from top-tier hospitals in China was constructed and its performance assessed through receiver operating characteristic(ROC) curves, area under the curve(AUC) values, and calibration curves.

RESULT: In the NHANES dataset, univariate analysis indicated a significant correlation between creatinine levels and endometriosis (OR = 1.01, 95% CI: 1.00-1.01, P = 0.0048), while multivariate analysis maintained significant results after adjustment (OR = 1.00, 95% CI: 1.00-1.01, P = 0.0431). Bidirectional MR analysis demonstrated a causal relationship between creatinine levels and endometriosis, with a positive IVW result of 1.001 (95% CI: 1.00-1.002, P = 0.0350). In the chinese tertiary hospital dataset, the AUC for the diagnostic model on both training and validation sets were 0.721 and 0.730, respectively. An increase of 10 μmol/L in creatinine levels raised the risk of endometriosis by approximately 8% (OR = 1.08, 95% CI: 1.07-1.09, P < 0.001).

CONCLUSION: This study establishes a significant link between creatinine levels and endometriosis, confirming creatinine as an independent risk factor. Elevated creatinine levels could be used as non-invasive biomarkers for the early detection and diagnosis of endometriosis. Future research should aim to validate these findings in larger, multicenter studies and delve into the specific biological mechanisms, paving the way for novel therapeutic strategies.

PMID:40468362 | DOI:10.1186/s12905-025-03808-x

BMC Health Serv Res. 2025 Jun 4;25(1):802. doi: 10.1186/s12913-025-12884-6.

ABSTRACT

BACKGROUND: In recent years, Ireland has seen a decline in the number of private general dental practitioner (GDP) contractors delivering state funded dental care. Meanwhile, the National Oral Health Policy – Smile agus Sláinte, proposes contracting more state funded care to private GDPs including care for all children and vulnerable adults. Understanding Irish GDP workforce characteristics will be key in evaluating services and informing workforce planning into the future. This study describes the primary oral healthcare system and GDP workforce indicators in Ireland and compares private GDPs by current state dental scheme participation.

METHODS: Documentary analysis was used to describe and trace the origins of Ireland’s current primary oral healthcare services. Secondary analysis of publicly available data was undertaken to map GDP workforce indicators to critical dimensions of the World Health Organization (WHO) ‘Dimensions of Universal Health Coverage (UHC) relating to Human Resources for Health’ framework. Private GDPs were compared by state dental scheme participation utilising available demographics. Descriptive statistics were computed using STATA/SE 17 software.

RESULTS: Private GDP contractors have participated in the delivery of state-funded dental care in Ireland since the early 1950s. The number of private GDPs holding Dental Treatment Services Scheme (DTSS) contracts fell from 1,664 in 2016 to 787 in August 2023, while the number holding Dental Treatment Benefit Scheme (DTBS) contracts increased from 1,959 in 2016 to 2,384 in 2023. The number of private GDPs submitting claims on the DTSS has also declined from 1,318 in 2016 to 831 in 2022. DTSS contractors are more likely to be male and qualified longer (> 20 years) than GDPs holding only DTBS contracts.

CONCLUSION: These findings are very relevant and timely to the planned policy implementation given that Smile agus Sláinte is reliant on the greater provision of publicly funded care by private GDPs. There is a potential lack of GDP supply into the public system as the Irish Government seeks to implement Smile agus Sláinte and meet its WHO obligations on developing UHC for oral health.

PMID:40468361 | DOI:10.1186/s12913-025-12884-6

J Ovarian Res. 2025 Jun 4;18(1):121. doi: 10.1186/s13048-025-01703-5.

ABSTRACT

BACKGROUND: Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by ovulatory dysfunction, hyperandrogenism, and polycystic ovaries, significantly impacting reproductive health. Obesity, prevalent in 50-80% of PCOS patients, exacerbates metabolic disturbances and negatively influences assisted reproductive technology outcomes. This study investigates how obesity alters the proteomic profile of follicular fluid-derived small extracellular vesicles (FF-sEVs), aiming to elucidate mechanisms underlying reproductive impairments in this population.

METHODS: This study included women undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), categorized into PCOS and non-PCOS control groups, further divided by BMI. Follicular fluid was collected, and sEVs isolated via ultracentrifugation. Proteomic analysis utilized data-independent acquisition (DIA) technology, with bioinformatics tools applied for Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses, along with protein-protein interaction (PPI) analysis. Statistical comparisons were performed using Analysis of variance (ANOVA) and t-tests to identify differentially expressed proteins. Correlation analysis assessed relationships between sEV protein profiles and reproductive outcomes, employing the Pearson correlation coefficient.

RESULTS: Proteomic profiling of sEVs revealed that the overweight/obese PCOS group had 180 upregulated and 256 downregulated proteins compared to lean counterparts. Additionally, differential functional analysis and PPI analysis indicated significant pathway and key proteins alterations in the PCOS group related to inflammation, while non-PCOS women demonstrated metabolic reprogramming and anti-inflammatory responses, suggesting a differential response to obesity that may preserve oocyte quality. Correlation analysis revealed significant associations between specific differentially expressed proteins and IVF/ICSI outcomes, while a protective role for Heat Shock Protein 90 Beta Family Member 1 (HSP90B1) protein was observed in the non-PCOS group. Lastly, validation through Western blot confirmed critical protein expression changes, particularly for S100 Calcium-binding Protein A8 (S100A8), emphasizing the impact of obesity on reproductive health outcomes in PCOS patients.

CONCLUSIONS: In conclusion, our findings indicate that obesity exacerbates inflammation and oxidative stress in PCOS women, adversely affecting oocyte development and IVF/ICSI outcomes. In contrast, non-PCOS women exhibit protective metabolic and inflammatory adaptations. These insights underscore the necessity for tailored fertility management approaches, including weight loss strategies and specific interventions for PCOS patients, to optimize reproductive outcomes and enhance pregnancy success rates.

PMID:40468347 | DOI:10.1186/s13048-025-01703-5

BMC Med Educ. 2025 Jun 4;25(1):831. doi: 10.1186/s12909-025-07438-7.

ABSTRACT

BACKGROUND: The integration of ChatGPT with educational settings is happening at an unprecedented rate, and there is a growing trend for students to use ChatGPT for various academic work. Although numerous studies have evaluated the knowledge, attitudes, and practices related to ChatGPT among students in diverse medical fields, there remains a notable absence of such research within the Chinese context.

METHODS: The questionnaire survey was conducted to a sample of 1,133 medical students from various medical colleges across Sichuan Province, China, between May 2024 and November 2024 to explore the awareness and attitudes of medical students towards ChatGPT. Descriptive statistics were used to tabulate the frequency of each variable. A chi-square test and multiple regression analysis were employed to investigate the factors influencing participants’ positive attitudes toward the prospective use of ChatGPT.

RESULTS: The findings revealed that 62.9% of participants had employed ChatGPT in their medical studies, with 16.5% having utilized the tool in a published article. Participants primarily used ChatGPT for searching information (84.4%) and completing academic assignments (60.4%). However, concerns were expressed regarding the potential for ChatGPT to disseminate misinformation (76.9%) and facilitate plagiarism or complicate its detection (65.4%). Despite these concerns, 64.4% of respondents indicated a willingness to use ChatGPT to seek assistance with learning problems. Overall, a majority of participants (60.7%) maintained a positive attitude on the future use of ChatGPT in the medical field.

CONCLUSION: Our research showed that while most medical students perceived ChatGPT as a valuable tool for academic study and research, they remained cautious about its potential risks, particularly regarding misinformation and plagiarism concerns. Despite these reservations, a majority participants indicated a willingness to incorporate ChatGPT into their academic workflow, specifically for problem-solving tasks, and maintained optimistic perspectives regarding its potential integration into medical education and clinical practice. It is therefore essential to improve student literacy about AI, develop clear guidelines for its acceptable use, and implement support systems to ensure that medical students are fully prepared for the upcoming integration of AI into medical education.

TRIAL REGISTRATION: Not applicable.

PMID:40468340 | DOI:10.1186/s12909-025-07438-7

Chiropr Man Therap. 2025 Jun 4;33(1):23. doi: 10.1186/s12998-025-00587-y.

ABSTRACT

BACKGROUND: In the realm of biomedical research articles, authors typically utilize descriptive statistics to outline the characteristics of their study samples. The standard deviation (SD) serves to illustrate variability among the individuals in a sample, whereas the standard error of the mean (SEM) conveys the level of uncertainty associated with the sample mean’s representation of the population mean. It is not unusual for authors of scientific articles to incorrectly utilize the SEM rather than the SD when explaining data variability. This is problematic because the SEM is consistently smaller than the SD, which could cause readers to underestimate variation in the data. In medical journals, inappropriate use has been found in 14-64% of articles. Moreover, in the field of musculoskeletal health and manual medicine, there is a noticeable absence of literature on the appropriate presentation of statistics.

AIM: The aim of this study was to map the frequency of inappropriate reporting of SEM in articles published over a three-year period in three prominent journals in manual medicine.

METHODS: In this critical analysis, all articles in three journals – BMC Chiropractic and Manual Therapies (CMT), Journal of Manipulative and Physiological Therapeutics (JMPT) and Musculoskeletal Science and Practice: An International Journal of Musculoskeletal Physiotherapy (MSP) – published between 2017 and 2019 were analysed based on descriptive statistics that inappropriately or vaguely reported SEMs.

RESULTS: In total, 790 articles were analysed from the three journals, 487 of which were found to report the SEM. Among these articles, we identified a frequency of 1.4% of inadequate SEM use. The investigation also showed that in 2.5% of the cases, authors did not clarify whether the ± sign presented in text, tables or figures expressed SDs or SEMs.

CONCLUSION: There was a low frequency (1.4%) of inaccurately reported SEMs in scientific journals focusing on manual medicine, which was notably lower than studies conducted in other fields. Additionally, it was noted that in 2.5% of the articles, the ± sign was not adequately defined, which could lead to confusion among readers and hinder the interpretation of the results.

PMID:40468335 | DOI:10.1186/s12998-025-00587-y