Category: Statistics

Nurs Open. 2025 Jul;12(7):e70282. doi: 10.1002/nop2.70282.

ABSTRACT

BACKGROUND: Workplace bullying is an important issue confronting the nursing profession, with victims described as being part of an oppressed group. The number of attacks and acts of violence that staff direct at each other in the workplace is alarmingly high and cannot be ignored.

AIM: This study assessed the prevalence and impact of workplace bullying of nurses by other nurses among those working in three major hospitals in the Tamale Metropolis, Ghana.

METHODS: Data for this study were collected from Tamale Teaching Hospital, Tamale Central Hospital, and Tamale West Hospital using a descriptive cross-sectional multi-facility study design with a quantitative approach to data collection. A proportionate stratified random sampling technique was used to recruit 338 nurses from the three hospitals. A structured questionnaire was used to collect data, following approval from the Tamale Teaching Hospital Research and Development Unit and the Northern Regional Health Directorate, from January 2022 to March 2022. Stata for Windows V16.0 was used to analyse the data. Bivariate and multivariable logistic regression models were used to explore the factors associated with the prevalence of perceived workplace bullying among nurses. Confidence intervals were computed at a 95% confidence level, and a p-value of 0.05 or less was considered statistically significant.

RESULTS: The majority of respondents (85.5%) indicated they had observed workplace bullying before, and 50.6% had witnessed the bullying of a nurse by another nurse. A little over one-third had been victims of workplace bullying. Females constituted a higher proportion of both the perpetrators (53.0%) and the main targets (80.2%) of workplace bullying. Additionally, 34.6% reported having the intention to travel abroad to practise nursing as a result of observing bullying or being victims themselves. Multivariable analysis showed that the odds of experiencing workplace bullying were 63% lower among nurses working in the surgical ward compared to those in the Outpatient Department (AOR: 0.37, 95% CI: 0.15-0.91, p = 0.030).

CONCLUSION: This study revealed that workplace bullying is prevalent among nurses in the three main hospitals within the Tamale Metropolis. Most respondents had witnessed workplace bullying, and a little over one-third had been victims themselves. Workplace bullying is a measurable issue that negatively affects nurses’ mental health and job performance. Therefore, nursing leaders should organise regular sensitisation programmes to raise awareness of the impact of workplace bullying. Additionally, hospital management should encourage nurses to report instances of bullying, establish disciplinary committees to address such cases, punish offenders, and protect those who witness or are victims of bullying.

PMID:40684434 | DOI:10.1002/nop2.70282

Orv Hetil. 2025 Jul 20;166(29):1132-1138. doi: 10.1556/650.2025.33334. Print 2025 Jul 20.

ABSTRACT

Bevezetés: A humán metapneumovírus (hMPV) influenzaszerű tüneteket okozó légúti patogén, és bizonyos társbetegségek fennállása esetén súlyos légúti szövődményekhez vezethet. A tanulmány aktualitását a COVID–19-világjárvány során szerzett tapasztalatok, valamint a Kínai Népköztársaság Járványügyi és Betegségmegelőzési Központja által 2024 végén észlelt, folyamatosan növekvő hMPV-esetszámok indokolják. Célkitűzés: A tanulmány célja a Dél-pesti Centrumkórház – Országos Hematológiai és Infektológiai Intézetben 2019 és 2024 között diagnosztizált hMPV-esetek epidemiológiai jellemzőinek és klinikai lefolyásának retrospektív elemzése. Módszer: Egycentrumos, retrospektív kohorszvizsgálatot végeztünk, amelybe bevontunk minden, 2019. december és 2024. december között valós idejű polimeráz-láncreakcióval (RT-PCR) igazolt hMPV-fertőzött felnőtt beteget. Rögzítettük a klinikai adatokat (demográfia, komorbiditások, kezdeti klinikai kép, virális koinfekció) és a komplikációkat (hospitalizáció, oxigénigény, pneumonitis, intenzív osztályos kezelés, mechanikai ventiláció, kórházi halálozás). A primer végpont összetett végpont volt, amely a kórházi elhalálozáson, az intenzív osztályos kezelés vagy a mechanikai ventiláció szükségességén alapult, ez határozta meg a komplikált lefolyást is. Eredmények: Összesen 80 beteget vontunk be, átlagéletkoruk 58 ± 30 év, többségük férfi (n = 47; 58,8%) volt. A fertőzött betegek 10%-ánál (n = 8) komplikált lefolyást észleltünk, amely szignifikánsan gyakrabban fordult elő idős betegek körében (66 ± 10 vs. 55 ± 31 év, p = 0,05). Pneumonitis 45%-ban (n = 36), hospitalizáció 42,5%-ban (n = 34), oxigénigény 30%-ban (n = 24), intenzív osztályos kezelés 8,75%-ban (n = 7), mechanikai ventiláció 6,25%-ban (n = 5), kórházi elhalálozás 6,25%-ban (n = 5) fordult elő. Az intenzív osztályos felvétel és a kórházi elhalálozás nem minden esetben volt közvetlenül a hMPV következménye. Megbeszélés: Vizsgálatunk tanulsága alapján a hMPV klinikai jelentősége kiemelkedően fontos immunszupprimált, idős és krónikus légzőszervi betegeknél, mivel náluk a fertőzés súlyos légúti szövődményekhez vezethet. Következtetés: Összefoglalva, hMPV-fertőzés gyanúja esetén hMPV irányában is javasolt diagnosztikai vizsgálatokat kezdeményezni, különösen a nagy kockázatú csoportokban, mivel a korai diagnózis és a megfelelő terápia kulcsfontosságú a súlyos kimenetelek megelőzésében. Orv Hetil. 2025; 166(29): 1132–1138.

PMID:40684432 | DOI:10.1556/650.2025.33334

Orv Hetil. 2025 Jul 20;166(29):1139-1152. doi: 10.1556/650.2025.33330. Print 2025 Jul 20.

ABSTRACT

Bevezetés: Az infertilitás prevalenciája széles skálán mozog: vilagszerte mintegy 186 millió embert érint. A reproduktív életkorban lévő párok 12–17%-a küzd termékenységi zavarral. A meddőség nagy arányú előfordulása növekvő igényt támaszt az asszisztált reprodukciós technikák alkalmazására, amelyek közül az in vitro fertilizáció az egyik legszélesebb körben alkalmazott technika. Célkitűzés: Kutatásunk célja, hogy a magyarországi közfinanszírozott egészségügyi rendszerben elemezzük az in vitro fertilizációs eljárások igénybevételi mutatóit. Módszer: A vizsgálat retrospektív, kvantitatív jellegű volt, amelyhez a szükséges adatokat a Nemzeti Egészségbiztosítási Alapkezelő adatbázisából, valamint az Országos Kórházi Főigazgatóság Pulvita Egészségügyi Adattárházából igényeltük. A kutatás során elemeztük a 2010 és 2023 közötti időszakban az aktív fekvőbeteg-szakellátásban elszámolt in vitro fertilizációs esetszámokat. További elemzéseket végeztünk az ellátóintézmények, a betegek vármegye szerinti lakhelye és életkora, valamint az elszámolt homogén betegségcsoportok alakulásáról. A változók elemzéséhez leíró statisztikai és lineáris regressziós próbákat végeztünk. Eredmények: A vizsgálati időszakban mindösszesen 127 616 esetszámot teljesítettek a szolgáltatók közfinanszírozott, aktív fekvőbeteg-szakellátás keretében. 2019-től jelentős esetszám-emelkedés figyelhető meg. Az esetek 2023-ban több mint két és félszeres mértékben haladták meg a 2010. évi esetszámot. Az igénybevételben területi egyenlőtlenségek találhatók. A vizsgált betegkör átlagéletkora emelkedő tendenciát mutatott 2010 és 2020 között. Következtetés: A 2019-től kezdődő fokozott állami szerepvállalás érzékelhető hatást gyakorolt az esetszámok emelkedésére. Bár az in vitro fertilizációs esetszámokban lineáris irányú emelkedést láthatunk évről évre, a korábban meglévő területi egyenlőtlenségek továbbra is fennállnak. Orv Hetil. 2025; 166(29): 1139–1152.

PMID:40684430 | DOI:10.1556/650.2025.33330

Eur J Orthop Surg Traumatol. 2025 Jul 20;35(1):310. doi: 10.1007/s00590-025-04436-9.

ABSTRACT

OBJECTIVES: To examine hemoglobin trends following isolated femoral shaft fractures (FSF) and characterize patient profiles associated with transfusion needs for optimized patient management.

METHODS: Design: Retrospective cohort study.

SETTING: Level 1 trauma center. Patient Selection Criteria: Patients aged > 18 years undergoing isolated femur fracture fixation (ICD-10 and CPT 27506). Outcome Measures and Comparisons: Hemoglobin (Hgb) was recorded at the ER, pre-operatively, and daily post-operatively and compared to baseline Hgb (pre-injury or ≥ 3 months post-injury). Total Hgb loss was calculated, correcting for transfusions. Demographics, injury mechanism (high/low energy), number of transfusions, and length of stay were collected. SPSS was used for analysis.

RESULTS: 540 patients were included. Baseline Hgb was 14.6 g/dL for males and 13.1 g/dL for females. Post-injury Hgb decreased to 13.8 g/dL and 11.9 g/dL, respectively. 48.5% of patients required transfusion (40.7% males, 61% females, p = 0.001). The age threshold for increased risk of receiving a transfusion was 60 years old. Patients between the ages of 60-80 had a higher rate of transfusions (65.94%) when compared to patients between the ages of 40-60 (38.38%). 80.49% of patients above the age of 80 received a transfusion and were 6.2 times more likely to receive a transfusion compared to patients under 40. The median length of stay (LOS) of a patient receiving a transfusion was 4 days, while the median LOS for a patient not receiving a transfusion was 2 days.

CONCLUSIONS: Hemoglobin (Hgb) progressively declines after femoral shaft fractures (FSFs), with the most significant drop occurring post-operatively. Older age and female sex were associated with increased transfusion needs. Transfusion is associated with an increase in the LOS. These findings emphasize the importance of monitoring Hgb trends and considering age and injury mechanisms when assessing transfusion risk in FSF patients.

LEVEL OF EVIDENCE: Prognostic Level III.

PMID:40684417 | DOI:10.1007/s00590-025-04436-9

J Robot Surg. 2025 Jul 20;19(1):405. doi: 10.1007/s11701-025-02489-w.

ABSTRACT

Robotic-assisted surgery has transformed hernia repair by improving precision, minimizing postoperative complications, and accelerating recovery. This study evaluates three robotic techniques-robotic transabdominal preperitoneal (rTAPP), robotic Rives (rRives), and robotic transabdominal retromuscular umbilical prosthetic (rTARUP)-for treating primary ventral and incisional hernias. Following PRISMA guidelines, a systematic review and meta-analysis were conducted. Databases such as PubMed, Embase, Cochrane Library, and Web of Science were searched for studies comparing rTAPP, rRives, and rTARUP. Key outcomes included recurrence rates, surgical duration, and postoperative complications, with secondary outcomes assessing hospital stay and cost-effectiveness. Statistical analyses were performed using RevMan 5.4 and STATA 16, calculating pooled odds ratios (OR) and mean differences (MD). Heterogeneity was measured via I² statistics, and publication bias was evaluated using the Egger test. The analysis included 18 studies encompassing 1,500 patients. rTAPP showed shorter operative times (MD: – 25.3 min, 95% CI: – 30.1 to – 20.5, *p* < 0.05) and reduced recurrence rates (OR: 0.45, 95% CI: 0.30-0.68, *p* < 0.01) compared to rRives and rTARUP. However, rTARUP was linked to fewer postoperative complications (OR: 0.65, 95% CI: 0.50-0.85, *p* < 0.05). No significant publication bias was detected (Egger test, *p* = 0.12). Robotic hernia repair techniques offer unique benefits: rTAPP is more efficient, while rTARUP reduces complications. These results emphasize the need for personalized surgical approaches.

PMID:40684413 | DOI:10.1007/s11701-025-02489-w

Cardiovasc Toxicol. 2025 Jul 20. doi: 10.1007/s12012-025-10044-0. Online ahead of print.

ABSTRACT

There have been concerns about potential adverse cardiovascular (CV) events associated with prokinetics that enhance gastrointestinal (GI) motility. To evaluate whether prokinetics use was associated with increased CV risk. We conducted a self-controlled case series (SCCS) study using the National Health Claims Database in South Korea. Age-adjusted incidence rate ratios (IRR) for the development of CV events (composite of myocardial infarction and stroke) were estimated by comparing the incidence during the risk period with prokinetics and the control period without prokinetics. This SCCS study included 15,621 participants who experienced CV events and exposure to prokinetics between 2004 and 2019. The risk period with prokinetics had a significantly increased risk for CV events compared to the control period (IRR 1.56, 95% CI 1.48-1.66). When the risk period was categorized according to the time from initiation of prokinetics, CV risk was highest in the first 7 days (IRR 2.29, 95% CI 2.13-2.47), and declined to non-significance in ≥ 15 days (IRR 1.03, 95% CI 0.94-1.13). In the analysis according to the class of prokinetics, CV risk was highest in the order of central dopamine type 2 (D2) receptor antagonist (IRR 2.14, 95% CI 1.95-2.34), peripheral D2 receptor antagonist (IRR 1.37, 95% CI 1.24-1.51), and selective 5-hydroxytryptamine 4 receptor agonist (IRR 1.29, 95% CI 1.17-1.42). The use of prokinetics was associated with an increased risk of CV adverse events, particularly in the early period following initiation of central D2 receptor antagonists.

PMID:40684411 | DOI:10.1007/s12012-025-10044-0

Pediatr Cardiol. 2025 Jul 20. doi: 10.1007/s00246-025-03955-w. Online ahead of print.

ABSTRACT

Pulmonary vein stenosis (PVS) in pediatric patients is associated with significant morbidity and requires repeated transcatheter interventions to maintain pulmonary vein patency. While these procedures can improve clinical outcomes, they come with inherent risks, and data on safety and post-procedural outcomes are limited. This single-center, retrospective study included pediatric patients who underwent transcatheter interventions for PVS between 2015 and 2024. Data were collected on patient demographics, procedural details, post-procedure disposition, adverse events (AEs), and hospital length of stay. Statistical analysis was performed to identify predictors of AEs. A total of 224 catheterization procedures were performed on 67 children with PVS. The overall AE rate was 11%, with the most common events including puncture site bleeding (5 cases), followed by pulse loss (4 cases), pulmonary hemorrhage (3 cases), stent embolization (3 cases), cerebrovascular accident (2 cases), contained vascular tear of pulmonary veins (2 cases), heart block (2 cases), supraventricular tachycardia (SVT, 2 cases), intra-abdominal hemorrhage associated with transhepatic access (1 case), and ST-segment changes (1 case). Despite these risks, most patients, particularly those treated on an outpatient basis, experienced short hospital stays. Operator experience and multidisciplinary care were critical in optimizing safety and outcomes. No statistically significant predictors of AEs were identified. Percutaneous interventions for PVS can be performed safely with strict adherence to standardized protocols, allowing for a controlled rate of complications despite increasing case volumes. While serious AEs such as cerebrovascular events and pulmonary hemorrhage remain a concern, targeted strategies may contribute to improved safety outcomes.

PMID:40684406 | DOI:10.1007/s00246-025-03955-w

Eur J Orthop Surg Traumatol. 2025 Jul 20;35(1):311. doi: 10.1007/s00590-025-04421-2.

ABSTRACT

BACKGROUND: There is growing but so far inconclusive evidence about the value of three-dimensional (3D) fluoroscopy in calcaneal fracture care. The aim of this study was to retrospectively review our own cohort of calcaneus fractures before and after the implementation of 3D fluoroscopy and compare their outcome in terms of quality of reduction and amendments made based on the additional information gained by 3D imaging.

METHODS: Between March 2012 and October 2022, we operated on 28 calcaneal fractures in 25 patients of whom eight were treated with the aid of 3D fluoroscopy (= hybrid group). In all cases, a sinus tarsi approach (STA) and an angular stable plate were used. Intra- and postoperative scans were analyzed based on the Delphi Consensus criteria evaluating quality of reduction and radiographic outcome. Statistical analyses were performed to check for statistical significance and inter-rater reliability.

RESULTS: We found no difference between the two groups (one group treated with conventional fluoroscopy and the other with 3D fluoroscopy) in terms of quality of reduction and radiographic outcome. Nevertheless, in more than half of our patients in the hybrid group, amendments were made based on the information gained through 3D fluoroscopy. Median radiation dose and surgical time was prolonged in the hybrid group but not leading to an increased infection rate.

CONCLUSION: We found satisfactory outcomes in osteosynthesis of calcaneus fractures using the STA, regardless of whether conventional or 3D fluoroscopy was used intraoperatively. However, no significant improvement due to usage of intraoperative 3D fluoroscopy imaging in terms of restoration of the anatomy and quality of reduction could be found. Nevertheless, 3D fluoroscopy helps to avoid revision surgeries due to intra-articular placed screws and does not seem to lead to more cases of infection despite slightly prolonged operation times.

PMID:40684401 | DOI:10.1007/s00590-025-04421-2

Disabil Rehabil. 2025 Jul 20:1-14. doi: 10.1080/09638288.2025.2534090. Online ahead of print.

ABSTRACT

PURPOSE: Early rehabilitation can support functional recovery and prevent deconditioning in hospital, though practice remains variable. This study aimed to evaluate an emerging model for delivering early, multidisciplinary rehabilitation parallel to acute specialist medical care; in-reach rehabilitation.

METHODS: Consecutive in-reach rehabilitation episodes delivered as part of standard care at a tertiary hospital between 2015-2023 were included in a retrospective evaluation. Routine data including case characteristics, rehabilitation goals and functional independence before and after in-reach rehabilitation were extracted from records and analyzed via descriptive statistics and mixed-effects linear modeling.

RESULTS: 967 participants were included (64% male, mean age 58.4 ± 15.4 years). In-reach episodes were delivered over a median 11 [7-18] days for heterogenous diagnoses, most commonly reconditioning (31.3%), cardiopulmonary transplant (22.1%), and neurological impairments (20.1%). Functional Independence Measure scores increased with in-reach rehabilitation (mean gain 24.0 points [95% CI 22.9-25.1]); with younger age, earlier in-reach commencement and certain diagnoses associated with larger gains in multivariable modeling. In-reach goals prioritized activities and participation, with high observed goal attainment (90.5%).

CONCLUSIONS: In-reach rehabilitation is feasible in an acute general hospital setting for patients with heterogenous diagnoses. In-reach rehabilitation was associated with functional improvements and high rates of goal attainment in routine care.

PMID:40684378 | DOI:10.1080/09638288.2025.2534090

Equine Vet J. 2025 Jul 20. doi: 10.1111/evj.14558. Online ahead of print.

ABSTRACT

BACKGROUND: Strangles (Streptococcus equi infection) remains endemic in the UK, with ~300 laboratory diagnoses annually. Sub-clinically infected long-term carriers are considered a key driver of endemicity. Analysing genomes of circulating strains could provide valuable transmission insights of this pathogen.

OBJECTIVES: To determine the population structure and diversity of UK S. equi isolates and to model transmission using epidemiological and whole genome sequencing data.

STUDY DESIGN: Retrospective cross-sectional epidemiological and genomic surveillance.

METHODS: A dated phylogenetic tree derived from 511 S. equi isolates collected from UK horses between 2015 and 2022 was reconstructed. Bayesian Analysis of Population Structure (BAPS) identified clusters of related genomes, while iGRAPH identified clusters of sequences appropriate for transmission analysis, performed using Transphylo.

RESULTS: BAPS identified nine groups, with 82% of strains clustering into two (McG-BAPS3, McG-BAPS5). A statistically significant association (p < 0.001) was found between the year of recovery and trends in the frequency of McG-BAPS groups, with McG-BAPS3 increasing and McG-BAPS5 decreasing in prevalence over the study period. Eight transmission clusters encompassing 64% of total sequences (n = 286/447) underwent analysis. Sixteen direct transmission pairs were identified; 10 were between horses from different UK regions. A transmission chain extending over a 6-month period was inferred from isolates from nine horses.

MAIN LIMITATIONS: Bacterial strains from sub-clinically infected carrier horses may be underrepresented due to data collection via positive laboratory diagnoses. Furthermore, a low sampling proportion relative to overall UK cases provided only a snapshot of broader, unsampled transmission events.

CONCLUSIONS: The rapid change in S. equi population structure indicates acutely infected/recently convalesced short-term carrier horses play a more influential role in transmission than long-term carriers. Our work provides novel insights to our understanding of S. equi transmission dynamics. Transmission of genetically related strains across diverse regions suggests a real-time sequence-based surveillance system could inform interventions to minimise transmission.

PMID:40684376 | DOI:10.1111/evj.14558