Category: Statistics

Front Cardiovasc Med. 2025 Jul 7;12:1650107. doi: 10.3389/fcvm.2025.1650107. eCollection 2025.

ABSTRACT

[This corrects the article DOI: 10.3389/fcvm.2023.1191055.].

PMID:40693223 | PMC:PMC12278133 | DOI:10.3389/fcvm.2025.1650107

J Orthop Surg Res. 2025 Jul 21;20(1):684. doi: 10.1186/s13018-025-06088-1.

ABSTRACT

OBJECTIVE: This study aims to assess and compare the six-month postoperative clinical outcomes of Arthroscopic-assisted Uni-portal Spinal Surgery (AUSS), unilateral biportal endoscopy (UBE), and percutaneous interlaminar endoscopic discectomy (PEID) for lumbar spinal stenosis (LSS). Additionally, muscle injury associated with these procedures is evaluated by analyzing changes in creatine kinase (CK) and C-reactive protein (CRP) levels.

METHODS: A total of 288 patients diagnosed with single-segment unilateral LSS and treated between January 2021 and June 2024 were included in this study. Patients were assigned to the AUSS group (n = 129), UBE group (n = 86), or PEID group (n = 73). Surgical parameters, including operative time, incision length, intraoperative blood loss, and postoperative facet joint preservation rate, were recorded. Clinical outcomes were assessed preoperatively and at 3 days, 3 months, and 6 months postoperatively using the Visual Analog Scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), EQ-5D-5 L quality of life index, and the modified Macnab criteria. The extent of muscle injury was quantified through serum CK and CRP levels measured preoperatively and on postoperative days 1, 3, 5, and 7. Descriptive statistics and multiple comparison analyses were used to assess clinical parameters among the three groups. Longitudinal data were analyzed using a generalized mixed linear model.

RESULTS: The AUSS group demonstrated significantly shorter operative times and smaller incision lengths compared to the UBE and PEID groups (P < 0.001). Postoperative VAS scores decreased significantly in all three groups, with the greatest improvement observed in the AUSS group (P < 0.05). ODI and EQ-5D-5 L scores indicated superior postoperative quality of life in the AUSS group compared to the UBE and PEID groups (P < 0.05). However, no statistically significant differences were observed in the modified Macnab criteria outcomes or postoperative complication rates among the three groups (P > 0.05). The PEID group exhibited the lowest postoperative CK and CRP levels as well as the least intraoperative blood loss (P < 0.05), suggesting minimal muscle injury. The AUSS group showed lower muscle injury levels than the UBE group (P < 0.05).

CONCLUSION: Arthroscopic-assisted Uni-portal Spinal Surgery (AUSS), unilateral biportal endoscopic (UBE) technique, and percutaneous endoscopic interlaminar discectomy (PEID) are all effective minimally invasive approaches for lumbar spinal stenosis (LSS). AUSS offers shorter operative time and better preservation of anatomical structures. PEID minimizes intraoperative tissue damage and reduces inflammatory response, while UBE balances visualization with operational flexibility. All three techniques demonstrate good short-term clinical outcomes. The surgical approach should be tailored to each patient’s symptoms and individualized needs. Although AUSS demonstrated certain intraoperative advantages, this study did not show that AUSS is superior to UBE or PEID in clinical efficacy or complication control. As a novel technique, AUSS may improve postoperative pain and quality of life, providing a valuable addition to the minimally invasive treatment options for lumbar spinal stenosis.

PMID:40691813 | DOI:10.1186/s13018-025-06088-1

BMC Nurs. 2025 Jul 21;24(1):951. doi: 10.1186/s12912-025-03595-8.

ABSTRACT

OBJECTIVE: This study explains the impact of organizational innovation climate on nurses’ innovation behavior in a tertiary specialized oncology hospital, while examining the chain mediation roles of achievement motivation and creative self-efficacy.

METHODS: In this online cross-sectional survey, 857 nurses from a tertiary specialized oncology hospital in Guangdong province, China were selected by convenience sampling method. SPSS Statistics v26.0 and AMOS v29.0 were used for data analysis. The reporting followed the STROBE checklist.

RESULTS: The nurses’ innovation behavior was below the medium level. Organizational innovation climate was significantly positively related to nurses’ innovation behavior, achievement motivation, and creative self-efficacy. Achievement motivation was positively correlated with both creative self-efficacy and nurses’ innovation behavior. Creative self-efficacy was positively correlated with nurses’ innovation behavior. Mediation analysis identified two pathways: creative self-efficacy independently mediated the relationship between organizational innovation climate and nurses’ innovation behavior, while achievement motivation and creative self-efficacy served as a chain mediator between the organizational innovation climate and nurses’ innovation behavior.

CONCLUSION: Our study highlights the critical role of organizational innovation climate in enhancing nurses’ innovation behavior in specialized oncology hospitals. Specifically, it demonstrates that achievement motivation and creative self-efficacy play a chain mediation role between organizational innovation climate and nurses’ innovation behavior. Healthcare administrators should prioritize constructing innovation-supportive climates, implement achievement motivation interventions, and strengthen creative self-efficacy development programs to systematically foster nurses’ innovation capabilities in oncology settings.

PMID:40691798 | DOI:10.1186/s12912-025-03595-8

BMC Public Health. 2025 Jul 21;25(1):2521. doi: 10.1186/s12889-025-21771-y.

ABSTRACT

BACKGROUND: The Integrated Management of Childhood Illnesss (IMCI) strategy has a lower coverage. The World Health Organization (WHO) introduced the concept of distance learning IMCI in 2014 to improve uptake of the strategy. This study was conducted to evaluate the effectiveness of a distance learning IMCI training compared with the standard IMCI training in the correct management of children presenting to primary health centers.

METHODS: This cluster randomized controlled trial with a 1:1 parallel design was conducted at 26 Basic Health Units (BHUs) in Pakistan. Healthcare workers in BHUs (n = 13) randomized to the intervention arm were trained as per the dIMCI protocols while those (n = 13) randomized to the control arm were trained as per the standard protocol. The trained heathcare workers were followed for around five months and were evaluated in the management of childhood illnesses at their respective health facilities. Correct management, the principal outcome, was defined based on a case being correctly assessed (proficiency score of ≥ 6 out of the total score of 10), classified (compared to the gold standard physician), treated (compared to the gold standard physician), and counseled (proficiency score of ≥ 5 out of the total score of 7). Descriptive statistics, binary logistic regression, and 95% confidence interval were calculated using Stata version 18 adjusted for the clusters. P-values < 0.05 were regarded as significant.

RESULTS: Under-five children presented to the two arms were mostly similar in gender, age, duration of consultation with the healthcare worker, and presenting complaints. On logistic regression, the dIMCI training was found to be a significant factor in the correct classification (OR = 1.77, 95% CI 1.22-2.58), correct counseling (OR = 6.11,95% CI 3.06 – 12.19), and the overall management of children (OR = 3.35, 95% CI 2.03 – 5.52) with strong evidence against the model hypothesis at this sample size. The dIMCI training showed weak evidence against the model hypothesis in the domains of correct assessment (OR = 1.84, 95% CI 0.99-3.40) and correct treatment (OR 1.46, 95% CI 0.92 – 2.31).

CONCLUSIONS: Health policymakers could consider the dIMCI an effective, feasible, and flexible alternative to standard IMCI training for scaling up the IMCI strategy.

TRIAL REGISTRATION: Registered with www.chictr.org.cn , under ChiCTR1900027201 on 05/11/2019.

PMID:40691783 | DOI:10.1186/s12889-025-21771-y

BMC Nurs. 2025 Jul 21;24(1):948. doi: 10.1186/s12912-025-03428-8.

ABSTRACT

BACKGROUND: Nurses are vital to healthcare systems, yet their psychological well-being remains underexplored despite its critical impact on professional performance and job satisfaction. Essential attributes such as self-esteem, psychological empowerment, and assertiveness play a crucial role in effective decision-making and advocacy. In Qatar, the National Health Strategy (2024-2030) emphasizes healthcare worker empowerment; however, research on the interplay of these psychological constructs among nurses is scarce.

AIM: This study aims to evaluate the levels of self-esteem, psychological empowerment, and assertiveness among nurses in Qatar and examine their interrelationships, particularly the mediating role of self-esteem between empowerment and assertiveness.

METHODOLOGY: A quasi-experimental one-group pre-posttest design was employed, focusing on baseline data from 144 registered nurses across Hamad Medical Corporation (HMC) facilities. Data were collected using validated tools, including the Rosenberg Self-Esteem Scale, Psychological Empowerment Scale, and the Rathus Assertiveness Schedule. Statistical analyses, including structural equation modeling and ANOVA, were conducted to identify relationships and demographic associations.

RESULTS: Findings indicated moderate levels of assertiveness (mean = 67.1 ± 10.9) and empowerment (mean = 51.1 ± 5.9), along with high self-esteem (mean = 27.1 ± 2.9). Empowerment significantly influenced assertiveness (β = 0.207, p = 0.009); however, self-esteem did not mediate this relationship. Significant demographic variations in self-esteem were observed, with higher levels reported among early-career nurses and general registered nurses, while assertiveness and empowerment remained consistent across demographic groups.

CONCLUSION: The study underscores the importance of fostering empowerment, self-esteem, and assertiveness among nurses through targeted interventions such as assertiveness training and supportive organizational policies. Future research should explore longitudinal changes in these psychological dynamics to enhance sustained professional development.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40691780 | DOI:10.1186/s12912-025-03428-8

Genome Biol Evol. 2025 Jul 3;17(7):evaf130. doi: 10.1093/gbe/evaf130.

ABSTRACT

Palms (family Arecaceae) are integral to understanding the evolution of tropical rainforests due to their long evolutionary history, high species richness, and hyper dominance in these ecosystems. Some palm genera, like Geonoma, are regionally and locally species-rich and abundant in Neotropical rainforests, but factors contributing to their divergence and ultimately their diversification remain poorly explored. A recent phylogenomic study identified the Geonoma undata complex, with high levels of genetic distinctiveness of different geographically proximal groups, describing it as a hyper-cryptic radiation. Here, we seek to disentangle the factors that contribute to genetic divergence in the G. undata cryptic species complex in the Northern Colombian Andes, where various forms ascribable to different taxonomic, morphological, and genetic groups exist. To address this, we pursued three main aims using nuclear single nucleotide polymorphisms distributed along over 4,000 genomic regions from 156 individuals. (i) We identified populations and used diversity metrics to understand evolutionary scenarios across pairwise comparisons of those populations. Geographically sympatric populations display evidence for allopatric selection that is likely explained by elevational segregation. (ii) Tajima’s D was used to infer broad genomic trends in selection and drift. In general, divergence between populations is enhanced by drift through population expansions. (iii) Lastly, we used outlier divergence and selection statistics to identify genes with outstanding divergence under significant positive selection. Two genes were identified that fit this description and are found to play functional roles in phenology, such as light response and flowering time.

PMID:40691772 | DOI:10.1093/gbe/evaf130

Acta Neurol Belg. 2025 Jul 21. doi: 10.1007/s13760-025-02839-3. Online ahead of print.

ABSTRACT

INTRODUCTION: Idiopathic Parkinson’s Disease (IPD) is a progressive neurodegenerative disorder characterized by tremor, rigidity, akinesia, and postural instability. Dysfunction in lysosomal autophagy, involving proteins like IGF-1(insulin like growth factor) and IGF-2, contributes to neuroinflammation and neuronal death. Reliable biomarkers for IPD diagnosis and monitoring remain elusive. This study investigates serum IGF-1 and IGF-2 levels to evaluate their biomarker potential.

METHODS: Eighty-four individuals (43 IPD patients, 41 controls) aged 18-79 were included. Diagnoses followed the UK Brain Bank Criteria; disease severity was assessed with Hoehn & Yahr (H&Y) and UPDRS scales. Serum IGF-1 and IGF-2 levels were measured using ELISA. Statistical analyses were performed using SPSS v30.0. Normality was assessed via the Shapiro-Wilk test. Based on data distribution, Independent Samples t-test, Mann-Whitney U, Chi-square, Kruskal-Wallis, Spearman correlation, and ROC analysis were applied. A p-value < 0.05 was considered statistically significant.

RESULTS: Serum IGF-2 levels were significantly higher in patients compared to controls (p = 0.006), while IGF-1 levels showed no significant difference. Both IGF-1 and IGF-2 levels displayed negatively correlated with disease duration (p = 0.044 and p = 0.008). Although IGF-1 and IGF-2 levels appeared elevated at H&Y stage 2, the differences were not statistically significant. No significant associations were observed between IGF levels and UPDRS scores or medication use.

CONCLUSION: Elevated serum IGF-2 levels indicate its potential as a biomarker for IPD. These findings contribute to a better understanding of the role of IGF-1 and IGF-2 in IPD pathophysiology, suggesting that further multicenter studies are needed to clarify their diagnostic and therapeutic potential.

PMID:40691745 | DOI:10.1007/s13760-025-02839-3

Eye (Lond). 2025 Jul 21. doi: 10.1038/s41433-025-03929-5. Online ahead of print.

ABSTRACT

PURPOSE: To compare the efficacy and safety between a first and a second injection of fluocinolone acetonide implants (FAc-I) in the treatment of diabetic macular oedema (DMO).

METHODS: This retrospective, multicentre cohort study included eyes with chronic DMO that received two consecutive FAc-I injections. We analysed visual and anatomical outcomes, additional DMO treatments, and intraocular pressure (IOP)-related adverse events.

RESULTS: We included 61 eyes from 44 patients. Stable or improved BCVA was observed in 100% of eyes after the first injection and in 93% after the second, demonstrating statistical equivalence within a ±15% margin (p = 0.005). Statistical equivalence was also found for the lowest CRT (±10% margin, p < 0.001) and for the proportion of eyes with ≥20% CRT decrease (±20% margin, p = 0.026). The proportion of patients requiring additional treatments during the first year was equivalent between injections (p = 0.036), with a therapeutic burden reduction of 63% and 59%, respectively. Regarding peak IOP, equivalence was observed between the two injections (±5 mmHg margin, p < 0.001). The incidence of OHT was numerically higher after the second injection (19.7% vs 11.5%, p = 0.302), but this difference was not statistically significant.

CONCLUSION: Multiple FAc-I injections are a safe and effective treatment option for chronic DMO in real life. The second injection maintained similar functional and anatomical outcomes to the first, supporting the sustainability and repeatability of the treatment.

PMID:40691728 | DOI:10.1038/s41433-025-03929-5

Osteoporos Int. 2025 Jul 21. doi: 10.1007/s00198-025-07614-x. Online ahead of print.

ABSTRACT

PURPOSE: Osteostrong proposes that exercise on proprietary machines once weekly for 10 minutes increases bone mineral density. Because OsteoStrong franchises are open/opening in multiple countries, healthcare providers must be able to answer questions about OsteoStrong’s efficacy and safety. Our objective was to synthesize current research on the efficacy and safety of OsteoStrong for healthcare providers who must be able to answer patients’ questions about OsteoStrong’s efficacy and safety.

METHODS: We conducted a rapid scoping review with searches in five databases. We included studies in English involving OsteoStrong machines, in any population and using any comparator, that measured falls, fractures, or bone strength. Screening and data abstraction were completed by two independent reviewers using Covidence. We used tables and descriptive statistics to chart data.

RESULTS: The search resulted in 1388 studies and nine were included; five were abstracts or unpublished. Seven studies were observational studies (e.g., case study/series, non-randomized trial) and two were randomized trials comparing OsteoStrong to exercise. There were no randomized controlled trials comparing OsteoStrong to a control group. Most studies had small sample sizes and potential conflicts of interest. The two largest studies included individuals on concurrent anti-resorptive treatment. Two of the trials reported on fractures, falls, or adverse events. Most trials reported on bone mineral density (BMD) at the lumbar spine and proximal femur. Effects on BMD were inconsistent across trials.

CONCLUSIONS: The research on OsteoStrong is mainly limited to small observational studies that are at risk of bias because of conflict of interest, imprecision, publication in a predatory journal, participants on anti-resorptive medications, or poor-quality research reporting. The effects of OsteoStrong on bone strength outcomes are inconsistent, and currently there is little data on safety of this intervention.

PMID:40691713 | DOI:10.1007/s00198-025-07614-x

Sci Rep. 2025 Jul 21;15(1):26487. doi: 10.1038/s41598-025-11407-x.

ABSTRACT

Achieving an apical seal is critical for apexification treatment of nonvital immature teeth. While this is commonly accomplished using biocompatible mineral trioxide aggregate (MTA), its limitations, such as prolonged setting time, discoloration, and challenging handling, have driven the search for alternative materials. This study aimed to compare the clinical and radiographic success of bioceramic putty Well-Root PT apical plug compared to MTA in the treatment of nonvital immature permanent incisors. Fifty immature nonvital maxillary permanent central incisors in thirty-eight children aged 8-11 years were randomly divided into two groups (25 teeth/group). Group I received MTA apical plugs, and Group II was treated with Well-Root PT apical plugs. Both groups were recalled at 6 and 12 months for clinical and radiographic evaluations. Statistical analysis was done for the gathered data. Both groups showed improved clinical signs and symptoms during all follow-up periods with no statistically significant difference. Regarding the periapical radiolucency (PAR) area, at twelve months, the mean PAR area in the Well-Root PT group was (0.14 ± 0.08) compared to (2.3 ± 0.9) in the MTA group, with highly statistically significant differences (p < 0.001). The mean periapical bone radiodensity in the Well-Root PT group was (178.2 ± 5.4) compared to (164.8 ± 9.4) in the MTA group at twelve-month follow-up, with highly statistically significant differences(p < 0.001). Well-Root PT, with its reduced technical sensitivity, demonstrates satisfactory clinical and radiographic success as an apical plug for nonvital immature permanent incisors compared to MTA.

PMID:40691703 | DOI:10.1038/s41598-025-11407-x