Category: Statistics

BMC Infect Dis. 2025 Jun 2;25(1):784. doi: 10.1186/s12879-025-11009-y.

ABSTRACT

BACKGROUND: Antiretroviral therapy (ART) and ART adherence are crucial for preventing HIV transmission and prolonging the lifespan of people living with HIV (PLWH). Serostatus disclosure is a significant factor influencing both ART initiation and ART adherence. However, studies evaluating the impact of disclosure on ART initiation and ART adherence in mainland China have yielded inconsistent findings. This systematic review and meta-analysis aim to examine the associations between disclosure and both ART initiation and adherence.

METHODS: We systematically reviewed English databases (MEDLINE, Embase, Web of Science and the Cochrane Library) and Chinese databases (CNKI, WanFang, CQVIP, and SinoMed) to identify literature on factors that influence ART initiation and ART adherence from inception to Sep 24, 2024. Microsoft Excel 2019 sheet was used for data extraction. The data extraction sheet included information on the author’s names, publication year of the study, study design, study population, sample size, definition of adherence to ART, and study quality score. The Joanna Briggs Institute (JBI) critical appraisal checklist for prevalence studies was employed to assess the quality of the selected articles. Data were analyzed using STATA 17.0, and a random effects model was utilized to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs). Sensitivity analyses were conducted through the sequential exclusion of studies. Publication bias was assessed using Begg’s test and Egger’s test.

RESULTS: Our search yielded 517 results, of which 21 were eligible and included in the final meta-analysis. The analysis found that PLWH who disclosed their HIV serostatus were 2.59 times more likely to initiate ART compared to those who did not disclose (OR = 2.59, 95%CI: 1.92-3.49). However, we found no statistically significant association between HIV serostatus disclosure and ART adherence (OR = 1.21, 95%CI: 0.89-1.65). Additionally, no significant associations were identified between HIV serostatus disclosure and ART adherence in any subgroup analyses based on the subjects of disclosure, participants, or adjusted effect estimates for confounding factors.

CONCLUSIONS: We found evidence that serostatus disclosure is likely to positively associated with ART initiation, but not with ART adherence. Encouraging serostatus disclosure among PLWH, while simultaneously increasing public awareness about HIV and fostering a supportive environment for disclosure, may enhance ART adherence.

PMID:40457351 | DOI:10.1186/s12879-025-11009-y

BMC Public Health. 2025 Jun 2;25(1):2032. doi: 10.1186/s12889-025-23036-0.

ABSTRACT

OBJECTIVE: To analyze the epidemiological profile of women who experienced physical violence before and during the coronavirus disease (COVID-19) pandemic from reports of corpus delicti performed at the Forensic Medical Institute, Curitiba, Paraná, Brazil.

MATERIALS AND METHODS: This study used a retrospective cross-sectional design and secondary data analysis of cases of injuries caused by physical violence against women between 2019 and 2021 contained in Forensic Medical Institute reports. Only records of physical violence examinations performed on women were eligible for inclusion. Reports that did not allow for the identification of the victim’s gender, as well as those referring to other physical violence that did not involve aggression, were excluded. Data were collected electronically. The variables analyzed were age, ethnicity, marital status, sex, and relationship with the aggressor. A bivariate analysis using Pearson’s chi-square test was conducted to assess associations between the outcome (year) and independent variables. For significant associations, pairwise comparisons of proportions were made using the Z-test, with Bonferroni correction applied to control for Type I errors. Variables with p-values ≤ 0.05 were considered significant. Statistical analyses were performed using SPSS version 25.0.

RESULTS: In total, 5033 reports of physical violence against women were included in the study. In 2020, a greater proportion of personal injury examinations were observed in white women than in 2019 and 2021 (p < 0.001). Single women are the most vulnerable to physical violence in 2020 and 2021 (p < 0.001). During the same years, assaults by men, partners, former partners, and family members were more prevalent than in 2019 (p < 0.001). The Women’s Police Station was the sought-after place for reporting cases.

CONCLUSION: Over the two pandemic years analyzed, a significant reduction in the number of physical violence examinations conducted at the Forensic Medical Institute was observed. Nevertheless, single women, particularly those subjected to male-perpetrated violence, including by partners, ex-partners, and relatives, sought forensic services with greater frequency compared to the pre-pandemic period. Furthermore, the Women’s Police Station was the most frequently utilized facility for reporting such incidents.

PMID:40457344 | DOI:10.1186/s12889-025-23036-0

BMC Public Health. 2025 Jun 2;25(1):2035. doi: 10.1186/s12889-025-23100-9.

ABSTRACT

BACKGROUND: Medical and non-medical expenses could be incurred during antenatal care, however, few studies about it in Beijing were found. Hence, this study assesses the cost of antenatal care in Beijing and explores it’s influencing factors, aiming to inform targeted strategies.

METHODS: A cross-sectional study was conducted in Beijing from October 14 to December 16, 2024. A cluster sampling technique was used to select subjects. Data were collected through an in-person questionnaire. The cost of antenatal care includes direct costs and indirect costs. The demographic characteristics were statistically described. Univariate analysis and quantile regression model were applied.

RESULTS: A total of 253 pregnant women in Beijing were recruited in this study, and the cost of antenatal care was USD 2,198. The results of the univariate analysis showed statistically significant differences between antenatal cost and pregnant women’s age, family size, gravidity, parity, pregnancy complication, whether or not to hire caregivers, whether the caregiver missed work or not and outpatient visits times (P < 0.05). The results of the quantile regression modeling showed that age, pregnancy complications, whether or not to hire caregivers, whether the caregiver missed work or not, and outpatient visits times can affect the cost of antenatal care at one or more quantiles (P < 0.05).

CONCLUSION: There are high proportion of direct medical costs. It is suggested that reducing the lost wages of pregnant women and caregivers by increasing leaves for them, and controlling complications to alleviate the financial burden of pregnancy.

PMID:40457342 | DOI:10.1186/s12889-025-23100-9

BMC Oral Health. 2025 Jun 2;25(1):881. doi: 10.1186/s12903-025-06243-4.

ABSTRACT

BACKGROUND: Chronic temporomandibular disorder (TMD) pain with pain catastrophizing (PC) is associated with altered brain morphology; however, its neuroanatomical underpinnings remain unclear. This study aimed to investigate gray matter volume (GMV) in the brain regions of chronic TMD pain patients with PC using voxel-based morphometry.

METHODS: A case-control study was conducted with 28 participants, including 14 chronic TMD pain patients with high PC and 14 age- and sex-matched healthy controls. T1-weighted magnetic resonance imaging (MRI) data were acquired using a 3-Tesla scanner and analyzed with Statistical Parametric Mapping 12 (SPM12). Whole-brain and Region-of-Interest (ROI) analyses were performed to assess GMV differences and associations between GMV with clinical variables.

RESULTS: Whole-brain analysis revealed no significant GMV differences between groups. However, ROIs analyses showed significantly smaller GMV in the bilateral hippocampus, left parahippocampal gyrus, and right putamen in the patient group. Additionally, GMV in the orbital part of the inferior frontal gyrus was negatively associated with pain duration.

CONCLUSION: This study suggests that central nervous system alterations are linked to chronic TMD pain condition with pain catastrophizing. These findings contribute to understanding the neurobiological basis of chronic musculoskeletal pain and highlight the need for further research into the role of cognitive-emotional factors in pain-related neural adaptations.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40457334 | DOI:10.1186/s12903-025-06243-4

BMC Nurs. 2025 Jun 2;24(1):627. doi: 10.1186/s12912-025-03252-0.

ABSTRACT

BACKGROUND: Self-management and empowerment are critical components in the treatment of diabetes, a chronic condition that has become an increasingly significant global health issue. While standard diabetes education is essential for effective disease management, personalized interventions aligned with the patient’s preferences are also necessary. One promising solution is the integration of coaching approaches into chronic disease management.

METHODS: This study was designed as a randomized controlled trial with a pretest-posttest design and three parallel arms: a Holistic Nurse Coaching group (n = 34), a Diabetes Education (n = 34) group, and a control group (n = 34). Data were collected through a Sociodemographic Data Collection Form, a Diabetes Data Collection Form, the Type 2 Diabetes Mellitus Self-Management Scale and the Diabetes Empowerment scale. The aim was to evaluate the effect of Holistic Nurse Coaching on glycemic control, diabetes self-management, and empowerment in individuals with type 2 diabetes. The Holistic Nurse Coaching group received nine individualized holistic nurse coaching sessions over a three-month period. The Diabetes Education group participated in nine group-based diabetes education sessions over the same period. The control group received no intervention. Mean comparison tests, correlation tests and multiple regression analysis techniques were employed in the statistical analysis. A 5% margin of error (p < 0.05) was adopted to determine statistical significance.

RESULTS: Following the holistic nurse coaching intervention, statistically significant improvements were observed in participants’ diabetes self-management, empowerment, and HbA1c levels (d = 3.752, d = 3.104, and d = 1.147, respectively; p < 0.001). A strong, positive, and statistically significant correlation was identified between posttest diabetes self-management and empowerment scores. Furthermore, the diabetes empowerment scores accounted for approximately 68.5% of the variance in diabetes self-management scores (p < 0.05).

CONCLUSIONS: Holistic nurse coaching was found to significantly enhance diabetes self-management and empowerment. These findings suggest that holistic nurse coaching may serve as an effective, person-centered intervention to support individuals with type 2 diabetes in managing their condition.

TRIAL REGISTRATION: The study was registered in ClinicalTrials NCT05545722. Retrospectively registered. 16/09/2022.

PMID:40457333 | DOI:10.1186/s12912-025-03252-0

BMC Cancer. 2025 Jun 2;25(1):984. doi: 10.1186/s12885-025-14389-1.

ABSTRACT

BACKGROUND: Numerous studies have explored the histological overlap between endometrial carcinoma and adenomyosis, yet the clinical implications of their co-occurrence remain ambiguous. This study aims to evaluate the impact of adenomyosis on the staging, progression, and prognosis of endometrial cancer.

METHOD: This retrospective cohort study analyzed 388 endometrial cancer (EC) patients undergone hysterectomy with lymphadenectomy between January 2019 to Decmber 2024 after ethical approval (No.: 2024-KY-0671-001). The diagnostic criterion for adenomyosis was the identification of endometrial glands and stroma infiltrating the myometrium at a depth of ≥ 2.5 mm from the endometrial-myometrial junction. Variables included demographics, surgery type, histopathology, stage, molecular markers, treatment, and survival. Kaplan-Meier and log-rank tests assessed survival. Statistical analysis used Mann-Whitney U and Chi-square tests (P < 0.05). Multivariate Cox regression was unfeasible due to limited recurrence events and disease-free survival outcomes are provided as supplementary material.

RESULTS: Among 388 EC patients, 73 (18.8%) had adenomyosis and 315 (81.2%) did not. The adenomyosis group was younger (median age 52 vs. 55 years, P = 0.011) and had a lower menopause rate (63% vs. 75.2%, P = 0.049). Adjuvant therapy was less frequent in the adenomyosis group (21.9% vs. 37.8%, P = 0.015), while concurrent endometrial hyperplasia was more common (64.4% vs. 32.4%, P < 0.001). No significant differences were observed in tumor characteristics, complications, TCGA subtypes, or survival outcomes. Median follow-up was 56 months for the adenomyosis group and 61 months for the non-adenomyosis group.

CONCLUSION: This study shows that adenomyosis does not affect tumor progression or survival outcomes, indicating a neutral role in endometrial cancer prognosis. However, the interpretation of survival statistics is limited by the low recurrence rate. Patients with adenomyosis are younger, have a lower menopause rate, and require less adjuvant therapy. The higher prevalence of endometrial hyperplasia suggests a potential link to tumor pathogenesis. Overall, adenomyosis appears to be an incidental co-occurrence rather than a biological contributor to endometrial cancer.

PMID:40457332 | DOI:10.1186/s12885-025-14389-1

Matern Health Neonatol Perinatol. 2025 Jun 3;11(1):14. doi: 10.1186/s40748-025-00210-1.

ABSTRACT

BACKGROUND: The enduring conflict in Somalia has precipitated significant humanitarian crises, including severely weakened health systems and poor health indicators. The situation has led to almost two million Somalis living abroad, often as refugees or asylum seekers in more high-resource settings in the Global North. To understand outcomes of care of pregnant women and their babies in host countries, this systematic review and meta-analysis aims to synthesise existing evidence on adverse maternal and perinatal outcomes among Somali migrant women compared to host populations.

METHODS: We conducted a comprehensive search across multiple electronic databases, including PubMed, Scopus, CINAHL Plus, and the Directory of Open Access Journals, using tailored keyword combinations. No language or date restrictions were applied, and the search concluded on June 30, 2024. Following data extraction and quality assurance using the STROBE Checklist, we conducted a meta-analysis for outcomes with sufficient data, using a random-effects model to account for heterogeneity across populations. Subgroup analyses were conducted by host country, with heterogeneity assessed using I² and τ² statistics. Potential publication bias was evaluated through Egger’s test and funnel plots. The results provide pooled estimates of maternal and perinatal outcomes.

RESULTS: Across all databases, 116 articles were retrieved, with 17 meeting the eligibility criteria. From these articles, pregnancy-related data from 1978 to 2018 on 55,119 Somali migrant women and 5,190,459 women from the host population was extracted. Somali migrant women, compared to host populations, had significantly increased odds of emergency caesarean section (CS) (pooled OR 2.54, 95%CI: 2.22-2.86), non-progressing/induced labour (pooled OR 1.25, 95%CI: 1.19-1.31). Their babies had higher odds of small for gestational age (SGA) (pooled OR 2.03, 95%CI: 1.89-2.17), neonatal morbidity (pooled OR 1.51, 95%CI: 1.40-1.61), and neonatal mortality (pooled OR 1.39, 95%CI: 1.25-1.54). Conversely, Somali migrant women had lower odds of assisted instrumental delivery (OR 0.72, 95%CI: 0.66-0.78), post-partum depression (OR 0.27, 95% CI: 0.12-0.63), preterm birth (OR 0.92, 95%CI: 0.88-0.96), and low birth weight (OR 0.87, 95% CI: 0.80-0.94) compared to host populations.

CONCLUSION: Significant disparities in maternal and perinatal outcomes between Somali migrant women and host populations exist. Though more research is needed, available evidence points to the need for more culturally aware obstetric services that address the specific needs of Somali migrant women.

PMID:40457329 | DOI:10.1186/s40748-025-00210-1

Am J Hosp Palliat Care. 2025 Jun 2:10499091251345723. doi: 10.1177/10499091251345723. Online ahead of print.

ABSTRACT

BackgroundImplicit bias pervades health care, decreases quality of care, and disproportionately affects health outcomes for persons of color. Little is known about the use of biased language in the care of seriously ill children as documented in the electronic health record (EHR).ObjectiveTo describe the use of biased language in the EHR of critically ill pediatric patients and to assess if there is a difference based on patient demographics and clinical characteristics.Setting/ParticipantsA retrospective review of EHRs was conducted on patients admitted to a Pediatric Intensive Care Unit (PICU) with a palliative care consult at a large, urban academic center in the United States in 2019.MeasurementsDemographics and clinical characteristics were compared between patients with and without biased language in their EHR in univariate and multivariate analyses. Frequencies of descriptor usage and health care team members using the descriptor were recorded. Exemplar quotes using biased language were recorded.ResultsIn 63 patients, no differences were found in demographic or clinical characteristics between patients with and without positively and negatively biased language. In adjusted analysis, there was no effect of demographics or clinical characteristics on the odds of having at least 1 instance of negatively biased language. Physicians and social workers used more biased language than other health care team members.ConclusionDespite no statistically significant difference noted in this pilot study, linguistic biases exist in the EHR of seriously ill children, which may lead to testimonial injustice. Efforts to combat bias and racism in pediatric health care documentation may focus on revising note templates and educating across disciplines.

PMID:40456187 | DOI:10.1177/10499091251345723

Medwave. 2025 Jun 2;25(5):e3022. doi: 10.5867/medwave.2025.05.3022.

ABSTRACT

INTRODUCTION: The impact of confinement on eating habits has been associated with mental health, gender, and socioeconomic status. This study examined the consumption of sugar-sweetened beverages and fast food during the COVID-19 confinement period in Chile, a country with a history of high consumption of processed foods.

METHODS: A cross-sectional design was done from responses obtained through an online survey between May and August 2020. Data were collected and managed using the SurveyMonkey® electronic tool (hosted at the Institut d’Investigació en Atenció Primària (IDIAP) Jordi Gol i Gurina, Barcelona, Spain). We recruited through online platforms and social networks using convenience and snowball sampling. People aged 18 years and older were included. The consumption of sugar-sweetened beverages and fast food was analyzed in relation to socioeconomic and sociodemographic variables. Logistic and log-binomial regression models were evaluated using Stata v18. P<0.05 was considered statistically significant.

RESULTS: 6971 (93%) people completed the questionnaire. The participants were predominantly born in Chile (94.6%), with a majority being women (63.5%) and under 50 years old (74%). The prevalence of consumption of sugary drinks and fast food was 15.4% (men, 14.6%; women, 15.9%) and 19.6% (men, 17.2%; women, 21%), respectively. Age 40 years and older was a protective factor for both women and men. Factors associated with the consumption of sugar-sweetened beverages included a change in employment status (prevalence ratio 1.26; 95% confidence interval 1.02 to 1.45) and, for fast food consumption, being female (1.18; 1.06 to 1.32).

CONCLUSIONS: Sex, age, and change in income were associated with increased consumption of sugar-sweetened beverages and fast food during the COVID-19 pandemic. These results reaffirm the importance of implementing social and communicational strategies that promote healthy eating, especially during health emergency scenarios.

PMID:40456140 | DOI:10.5867/medwave.2025.05.3022

JMIR Res Protoc. 2025 Jun 2;14:e72672. doi: 10.2196/72672.

ABSTRACT

BACKGROUND: A substantial proportion of patients require acute hospital care after hospital discharge post surgery, and many regions and countries have surgical backlogs.

OBJECTIVE: The Post Discharge After Surgery Virtual Care with Remote Automated Monitoring Technology-3 (PCV-RAM-3) trial tests the hypothesis that informing surgeons and patients of virtual care with remote automated monitoring (VC-RAM) assignment will promote earlier discharge, thereby reducing the index length of hospital stay, and that postdischarge VC-RAM will reduce acute hospital care.

METHODS: The PVC-RAM-3 trial is a randomized controlled trial that compares VC-RAM to standard postdischarge care among 2500 adults undergoing elective noncardiac surgery in 3 Canadian hospitals. Following the randomization of patients prior to surgery, surgeons and patients are immediately notified whether the patient has been allocated to the VC-RAM or control group. Outcome adjudicators remain blinded to each participant’s group assignment. Patients in the intervention arm learn to use a Health Canada-approved cellular modem-enabled tablet computer and Bluetooth-enabled remote automated monitoring technology from Cloud DX to take daily wound photos for 7 days and measure daily vital signs (ie, blood pressure, heart rate, oxygen saturation, temperature, and weight) three times daily on days 1-7 and twice daily on days 8-14 post discharge, along with completing a brief recovery survey. Nurses review these data and conduct scheduled virtual visits (days 1, 3, 7, and 14). Nurses will escalate care to a preassigned and available perioperative care physician if predetermined vital sign thresholds are exceeded, concerning symptoms arise, or a medication error is detected. These physicians manage the issues and add or modify treatments as needed. The standard care group will receive postdischarge care as per the standard of care at the hospital where they undergo surgery. The coprimary outcomes are acute hospital care and the index hospital length of stay within the first 30 days after randomization.

RESULTS: Study recruitment and follow-up are completed, and analysis of the study results is underway.

CONCLUSIONS: This trial will offer insights into the role of VC-RAM in reducing acute hospital care and index length of hospital stay among adults undergoing elective surgery.

TRIAL REGISTRATION: ClinicalTrials.gov NCT05171569; https://clinicaltrials.gov/ct2/show/NCT05171569.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/72672.

PMID:40456137 | DOI:10.2196/72672