Category: Statistics

Cancer Med. 2025 Mar;14(5):e70757. doi: 10.1002/cam4.70757.

ABSTRACT

BACKGROUND: Black patients with non-small cell lung cancer (NSCLC) are more often diagnosed at a later stage and receive inadequate evaluation and treatment compared to White patients. We aimed to identify factors representing exposure to structural racism that mediate the association between race and NSCLC care.

METHODS: We queried Surveillance, Epidemiology, and End Results-Medicare for non-Hispanic Black and White patients ≥ 67 years diagnosed with NSCLC from 2013 to 2019. Our outcomes were localized diagnosis stage, receipt of stage-appropriate evaluation, receipt of stage-appropriate treatment, two-year survival, and receipt of “optimal” care, an aggregate metric comprising the first three listed outcomes. We estimated indirect effects of mediators on the association between race and outcomes.

RESULTS: Of 69,130 patients, 8.2% were Black. Medicare-Medicaid dual eligibility, a marker of individual-level socioeconomic status (SES), accounted for the largest proportion of mediating effects for most outcomes, ranging from 13.6% (p < 0.001) for localized diagnosis stage to 25.0% (p < 0.001) for two-year survival. Receipt of an influenza vaccine, a marker of health care access, had the second largest mediating effects on the associations between race and diagnosis stage (9.5%, p < 0.001), treatment (15.3%, p < 0.001), and optimal care (11.4%, p < 0.001). Neighborhood-level SES accounted for the third largest proportion of the effects of race on each outcome, explaining between 9% and 16% of the racial inequities at each phase (all p < 0.001).

CONCLUSIONS: Individual- and neighborhood-level structural factors partly explain inequities in NSCLC care, and their effects vary based on the phase of care. Interventions should be adapted to the phase of care.

PMID:40052387 | DOI:10.1002/cam4.70757

Turk J Pharm Sci. 2025 Mar 7;22(1):38-45. doi: 10.4274/tjps.galenos.2024.19947.

ABSTRACT

OBJECTIVES: This study aimed to explore the relationship between emotional labor, professional commitment, and self-efficacy among community pharmacists. Specifically, this study examined how self-efficacy influences professional commitment and the mediating role of emotional labor strategies in this relationship.

MATERIALS AND METHODS: A cross-sectional survey design was used to collect data from 396 community pharmacists. The study used a convenience sampling method and included standardized measures of emotional labor, professional commitment, and self-efficacy. Descriptive statistics were used to examine the levels of these variables among the participants. Multiple regression analyses were conducted to assess the interdependencies and mediating effects of emotional labor strategies.

RESULTS: General self-efficacy was positively correlated with emotional commitment (β=0.275, p<0.05) and continuance commitment (β=0.364, p<0.05), explaining 5% and 8% of their variances, respectively. A normative commitment was influenced by self-efficacy (β=0.464, p<0.05) and deep emotional labor (β=0.134, p<0.05), explaining 11% of its variance. Self-efficacy and deep emotional labor positively affected overall professional commitment (β=0.368, p<0.05), accounting for 15% of the variance.

CONCLUSION: The results highlight the crucial role of self-efficacy in managing the emotional demands of the pharmacy profession and in fostering stronger professional commitment. Enhancing pharmacists’ self-efficacy and emotional management skills can improve their job satisfaction and commitment to the profession. These findings have clinical implications for the development of training interventions aimed at supporting pharmacists in coping with the emotional aspects of their work and improving their overall professional well-being.

PMID:40052379 | DOI:10.4274/tjps.galenos.2024.19947

Otolaryngol Head Neck Surg. 2025 Mar 7. doi: 10.1002/ohn.1196. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine changes in trends of the incidence and characteristics of pediatric complicated rhinosinusitis with respect to the coronavirus disease 2019 (COVID-19) pandemic.

STUDY DESIGN: Retrospective cohort.

SETTING: Single tertiary-care center.

METHODS: A review of patients who presented to St. Louis Children’s Hospital (SLCH) with complicated rhinosinusitis from 2017 to 2022 was performed. Clinical and follow-up data were analyzed in association with COVID-19.

RESULTS: Eighty-three patients with complicated rhinosinusitis were identified and analyzed according to hospitalization before or after March 2020. No differences in demographic variables were found between the two groups. More patients had developmental comorbidities in the COVID-19 group (7 vs 1, P = .049). More patients with intracranial complications (55% vs 45%, P = .48) and Pott’s puffy tumor (78% vs 22%, P = .13) were observed in the COVID-19 era group; however, this difference was not statistically significant. In the COVID-19 group, more patients were found to have Streptococcus anginosus growth in their surgical cultures (67% vs 33%, P = .03). The incidence of complicated sinusitis correlated with the incidence of all viral cases at SLCH, particularly in 2021 and 2022, and increased following COVID-19.

CONCLUSION: Trends in complicated sinusitis vary before and after the onset of the COVID-19 pandemic. There was an increase in complications of sinusitis due to S. anginosus species in the COVID-19 era and trends towards increased intracranial complications and Pott’s puffy tumor. After an initial decrease, the incidence of complicated sinusitis per year increased following COVID-19.

PMID:40052376 | DOI:10.1002/ohn.1196

J Am Geriatr Soc. 2025 Mar 7. doi: 10.1111/jgs.19418. Online ahead of print.

ABSTRACT

BACKGROUND: Nonpharmacological pain interventions are effective but underutilized in people living with dementia (PLWD). Leveraging an implementation lens (i.e., the Readiness Assessment for Pragmatic Trials [RAPT] model) to scope the literature may reveal research gaps contributing to this underutilization. The purpose of this scoping review is to summarize the literature, map the studies to the RAPT model, and identify research gaps.

METHODS: Following Arksey and O’Malley’s framework and Preferred Reporting Items for Systematic Review and Meta-Analyses Extension for Scoping Reviews (PRISMA- ScR) guidelines, two reviewers screened, collated, extracted, and mapped data from eligible studies to the 9 RAPT domains (implementation, evidence, risk, feasibility, measurement, cost, acceptability, alignment, and impact). We used descriptive statistics to summarize the studies and the extent to which interventions were mapped to RAPT domains.

RESULTS: Of 81 studies covering 24 interventions, 64% were in long-term care facilities (LTCFs), 66% reported unspecified pain, and 32% reported unspecified dementia. Of the interventions, the Tailored Activities Program had literature informing the most domains (6 domains), followed by exercise, pain education, and stepwise approaches (5 domains each). Most studies were mapped to the evidence domain (33 studies), few studies to feasibility (7 studies), acceptability (5 studies), and implementation (10 studies) domains, one study to cost, and no studies to risk or impact.

CONCLUSION: Despite the variety of nonpharmacological pain interventions studied, there is a notable lack of literature that aligns with the RAPT model. Furthermore, there is limited consideration of the specific pain and dementia conditions, as well as the diverse environments where PLWD reside and receive care. These gaps underscore the need for robust and holistic research to ensure pain interventions are effectively tailored and implemented for PLWD. Starting with acceptability and feasibility studies can establish a foundation for building robust evidence, ensuring practical and well-received interventions before larger-scale clinical trials.

PMID:40052350 | DOI:10.1111/jgs.19418

BJU Int. 2025 Mar 7. doi: 10.1111/bju.16694. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the perioperative outcomes of papillary versus non-papillary access in percutaneous nephrolithotomy (PCNL), which is the ‘gold standard’ for managing large renal calculi.

PATIENTS AND METHODS: In this prospective, randomised trial, 70 patients with de novo renal stones amenable to PCNL were allocated to undergo either papillary (n = 35) or non-papillary (n = 35) access. Primary outcomes included haemoglobin drop and the need for blood transfusion. Secondary outcomes assessed were: operative time, stone-free rates (SFRs; initial and final), the need for auxiliary procedures, incidence and grading of complication rates.

RESULTS: There were no statistically significant differences between the papillary and non-papillary groups in terms of perioperative haemoglobin drop (P = 0.971) or transfusion rates (P = 0.69). Although the non-papillary group had a shorter mean operative time (83 vs 92 min, P = 0.103) and a marginally higher initial SFR (88.6% vs 82.9%, P = 0.495), these differences were not statistically significant. Final SFRs were similar (94.3% vs 97.1%, P = 0.555). Both groups experienced low and comparable complication rates, including fever, sepsis, and prolonged urinary leakage, with no significant difference between them.

CONCLUSION: Both papillary and non-papillary access approaches in PCNL show comparable safety and efficacy. While non-papillary access was associated with a slight reduction in operative time and a higher SFR, these findings were not statistically significant.

PMID:40052346 | DOI:10.1111/bju.16694

J Med Econ. 2025 Mar 7:1-9. doi: 10.1080/13696998.2025.2477342. Online ahead of print.

ABSTRACT

AIMS: Migraine leads to substantial healthcare utilization and associated costs. However, much higher costs are attributed to lost productivity. The impact of effective migraine treatment on these costs, at the individual level, has not been well established. Even less known is the impact of treatment failure. The objective of this study was to assess lost earnings as a measure of migraine-attributed burden among triptan non-responders in Denmark.

MATERIALS AND METHODS: We used data from the Danish National Prescription Register and Danish Income Statistics Register over the 27-year period 1995-2021. We identified 4,979 triptan non-responders (85.9% female) and matched them for sex, age and region of residence with 14,292 continuing users of triptans (triptan responders) and 13,592 individuals from the background population (triptan never-users). We then estimated average annual individual earnings, and compared those among triptan non-responders, from three years prior to and ten years after their last triptan redemption, with those among their matched triptan responders and triptan never-users over the same periods.

RESULTS: Triptan non-responders earned significantly less than both their matched triptan responders and their matched triptan never-users. The earnings gap was evident even three years prior to the last triptan prescription (€4,344 and €4,356 respectively). This gap widened substantially over time, so that average cumulative earnings over the 14-year period of follow-up for each triptan non-responder were €93,684 less than those of responders and €99,485 less than those of never-users.

LIMITATIONS: There are uncertainties with regard to the reasons for triptan discontinuation (whether non-response or otherwise), and to lack of diagnostic confirmation of migraine.

CONCLUSIONS: Triptan non-response represents failure of currently available acute treatment options. It is associated with substantial and cumulative lost earnings, highlighting a disproportionate economic burden. These findings underscore the potential economic benefit of recognizing, and rectifying, unmet treatment needs in migraine management.

PMID:40052331 | DOI:10.1080/13696998.2025.2477342

Med Mycol. 2025 Mar 6:myaf022. doi: 10.1093/mmy/myaf022. Online ahead of print.

ABSTRACT

Scedosporium and Lomentospora species are emerging fungal pathogens capable of causing severe infections in both immunocompetent and immunocompromised individuals. Previous environmental surveys have suggested potential associations between these fungi and various soil chemical parameters, though the relative influence of human activity versus environmental factors has not been systematically evaluated. Here, we conducted a comprehensive survey of 406 soil samples from 132 locations across Taiwan, analyzing fungal abundance alongside soil physicochemical parameters and the Human Footprint Index (HFI). We recovered 236 fungal isolates comprising 10 species, with S. boydii (32.2%), S. apiospermum (30.9%), and S. dehoogii (14.4%) being the most prevalent. The highest fungal burdens were observed in urban environments (up to 1293 CFU/g), particularly in public spaces and healthcare facilities. Statistical analysis revealed a significant positive correlation between fungal abundance and HFI (r = 0.143, P = 0.005), while soil chemical parameters including nitrogen, carbon, pH, electrical conductivity, and various base cations showed no significant associations despite their wide ranges. These findings indicate that anthropogenic disturbance of environments, rather than soil chemistry, is the primary driver of Scedosporium and Lomentospora distribution in Taiwan. This understanding holds important implications for predicting infection risks and developing targeted public health strategies, particularly in rapidly urbanizing regions. Future studies incorporating more specific indicators of human impact may further elucidate the mechanisms underlying these distribution patterns.

PMID:40052326 | DOI:10.1093/mmy/myaf022

Ulus Travma Acil Cerrahi Derg. 2025 Mar;31(3):276-282. doi: 10.14744/tjtes.2025.64644.

ABSTRACT

BACKGROUND: Traumatic injuries, particularly abdominal trauma, are a major cause of mortality worldwide. This study aimed to evaluate predictive factors for mortality and morbidity in abdominal trauma patients using simple, rapid, and accessible clinical and laboratory parameters, with a focus on developing scoring systems for emergency department decision-making.

METHODS: A retrospective cohort study was conducted in a Level 1 Trauma Center between October 2022 and March 2024. Patients aged 18 and older with abdominal trauma or multi-trauma were included, while cases with incomplete records, known chronic diseases, or a recent trauma history were excluded. Data on demographics, vital signs, laboratory results, imaging findings, clinical scores, and outcomes were collected. Logistic regression and receiver operating characteristic (ROC) analyses were performed to identify independent mortality predictors and their cut-off values.

RESULTS: Out of 693 patients, the mortality rate was 3.6%. The most common mechanisms of trauma were road traffic accidents (59.3%) and falls (23.4%). Independent predictors of mortality included age ≥54 years, Glasgow Coma Scale (GCS) ≤14, Injury Severity Score (ISS) ≥24, and Shock Index ≥1.08. ROC analysis revealed that GCS had the highest predictive value for mortality (area under the curve [AUC]: 0.828), followed by ISS, age, and Shock Index. Elevated levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate, and creatinine were associated with worse outcomes, aligning with findings in the literature.

CONCLUSION: Age, GCS, ISS, and Shock Index are strong predictors of mortality in abdominal trauma patients. Integrating these parameters into clinical decision-making can enhance risk stratification and improve patient management. Prospective multicenter studies and national trauma registries are necessary to refine trauma care and reduce mortality rates.

PMID:40052323 | DOI:10.14744/tjtes.2025.64644

Ulus Travma Acil Cerrahi Derg. 2025 Mar;31(3):242-248. doi: 10.14744/tjtes.2024.77756.

ABSTRACT

BACKGROUND: Effective management of postoperative analgesia following laparoscopic cholecystectomy (LC) is critical to ensure optimal patient comfort and recovery. This study evaluates the effects of erector spinae plane block (ESPB) and rectus sheath block (RSB) on opioid consumption to determine non-inferiority.

METHODS: This retrospective study analyzed 44 patients aged 18 to 75 years who underwent LC at our hospital between December 2022 and March 2023, with American Society of Anesthesiologists (ASA) scores of I-II. Patients were divided into two groups: ESPB (n=24) and RSB (n=20). The ESPB group received a preoperative bilateral injection of 20 mL of 0.25% bupivacaine, while the RSB group received a postoperative bilateral injection of 20 mL of 0.25% bupivacaine. The primary outcome measure was opioid consumption within the first 24 hours postoperatively.

RESULTS: The demographic characteristics of the RSB and ESPB groups were similar. Opioid consumption during the first 24 hours was 6.29+-1.73 mg in the ESPB group and 6.60+-3.41 mg in the RSB group, with no statistically significant difference between the two groups (95% confidence interval [CI]: -1.64 to 1.02; p=0.717). When the equivalence margin was set at -2 mg, opioid consumption in the RSB group was found to be similar to that in the ESPB group. Fentanyl rescue analgesia in the postoperative care unit was required by three patients in the ESPB group and five patients in the RSB group (p=0.400). Visual Analog Scale (VAS) pain scores and the number of patients who developed nausea and vomiting in the first 24 hours postoperatively were similar between the groups (p>0.05).

CONCLUSION: The erector spinae plane block and RSB demonstrated comparable analgesic efficacy. Rectus sheath block was found to be non-inferior to ESPB in LC surgery with respect to 24-hour opioid consumption. The groups were also similar regarding rescue analgesia, VAS scores, shoulder pain, and the frequency of nausea and vomiting.

PMID:40052318 | DOI:10.14744/tjtes.2024.77756

Ulus Travma Acil Cerrahi Derg. 2025 Mar;31(3):226-232. doi: 10.14744/tjtes.2024.73814.

ABSTRACT

BACKGROUND: This study was conducted methodologically to evaluate the Turkish validity and reliability of the Feeling Safe During Surgery Scale and to assess its suitability for the Turkish population.

METHODS: This methodological validity and reliability study collected data from 148 patients who underwent elective surgery with regional anesthesia in the general surgery clinics of a university hospital in Istanbul between December 1, 2021 and June 30, 2022. Data were obtained through face-to-face interviews with patients using the Patient Information Form, developed by the researchers based on the literature, and the Turkish version of the Feeling Safe During Surgery Scale, originally created in Swedish. The Statistical Package for the Social Sciences (SPSS) Amos 26 was used for data analysis.

RESULTS: The content validity index of the scale was determined to be 0.96. Confirmatory factor analysis indicated that the Turkish version of the Feeling Safe During Surgery Scale was acceptably compatible with the original scale. The adapted Turkish version was found to have a comprehensible language structure and appropriate content. Cronbach’s alpha coefficient for the total score was α=0.839, indicating a high level of reliability. Consequently, the Turkish version of the Feeling Safe During Surgery Scale was determined to be valid, reliable, and stable over time.

CONCLUSION: The Turkish version of the Feeling Safe During Surgery Scale is a valid and reliable instrument that can be used in the Turkish population for assessing the sense of safety in patients undergoing elective surgery with regional anesthesia in surgical units.

PMID:40052317 | DOI:10.14744/tjtes.2024.73814