Category: Statistics

BMC Public Health. 2025 Jul 17;25(1):2479. doi: 10.1186/s12889-025-23676-2.

ABSTRACT

BACKGROUND: The Human Immunodeficiency Virus/ Acquired Immunodeficiency Syndrome (HIV/AIDS) infection continues to cause enormous damage in the world despite the multiple strategies developed for the response. That’s why the Joint United Nations Programme on HIV/AIDS (UNAIDS) has adopted an acceleration strategy for this response with a view to eliminating HIV/AIDS by the year 2030. Nevertheless, access to screening, which remains underserved in Cameroon, is the first pillar on which actions must be taken to achieve this objective. This study aimed to identify factors associated with low HIV testing in Maroua 1 Health District (MHD1).

METHODS: A cross-sectional study was conducted among 808 participants aged 15 to 65 years living in the Maroua 1 Health District between September and December 2022. Data were collected by means of a non-probabilistic survey using a structured questionnaire sutured into socio-demographic characteristics, socio-cultural factors, and factors linked to the healthcare system. These factors were assessed by multiple logistic regression analysis, and associations were established by calculating Odds ratios, confidence intervals, and P-values. Statistical significance was declared at P < 0.05.

RESULTS: The results showed that the study participants had a mean age of 32.7 years (SD ± 11) and males (57.18%) outnumbered females (42.82%). A total number of 383 (47.40%) participants had already taken a screening test, and 97 (12%) had done so in the last 12 months. Furthermore, it was noted that being a man (AOR = 2.79; CI = 1.83-4.31; P-value < 0.001), young (AOR = 7.95; CI = 4.02-16.2; p -p-value < 0.001), single (AOR = 1.97; CI = 1.19-3.27; p-value = 0.02), informal education (AOR = 5.25; CI = 2.26-12.45; p-value < 0.001 ), having low knowledge about HIV (AOR = 8.77; CI = 4.60-17.24; p-value < 0.001), having a stigmatizing opinion (AOR = 2.46; CI = 1.36-4.38; p-value < 0.001), not being in a relationship with a partner (AOR = 1.70; CI = 1.04-2.79; p-value = 0.03), never been sensitized by a health worker (AOR = 1.82; CI = 1.21-2.75; p-value = 0.001), and not visiting a health facility during the last 12 months (AOR = 1.75; CI = 1.06-2.75; p-value = 0.02) were associated with low screening.

CONCLUSIONS: This study identified several factors associated with low HIV testing rates in the Maroua 1 health district in Cameroon, including male gender, young age, celibacy, lack of education, low HIV knowledge, stigmatizing attitudes, absence of a stable partner, lack of awareness by health care workers and low use of health services. Addressing these factors in HIV testing interventions is essential to achieving the UNAIDS 95-95-95 targets and eliminating HIV by 2030. Targeted public health policies and improved access to testing services are needed to combat the epidemic in this region.

PMID:40676626 | DOI:10.1186/s12889-025-23676-2

BMC Med Educ. 2025 Jul 17;25(1):1067. doi: 10.1186/s12909-025-07575-z.

ABSTRACT

BACKGROUND: The development of Pharmacovigilance (P.V) systems in Palestine remains in its early stages, with limited national infrastructure and underreporting of Adverse Drug Reactions (ADRs) posing ongoing challenges. Despite the growing global recognition of P.V as essential to ensuring the safety and efficacy of medications, its integration into pharmacy education in Palestine is still insufficient. Bachelor’s Degree of Pharmacy (BS Pharm) and Doctor of Pharmacy (Pharm D) students in Palestine as future pharmacists involved in health care profession, play a pivotal role in P.V activities. However, current curricula often lack structured and comprehensive P.V training, leading to significant gaps in students’ knowledge and preparedness. Also, researches concerning their knowledge and perceptions of P.V are still limited in Palestine.

OBJECTIVES: To assess the knowledge and perceptions regarding P.V activities among BS Pharm and Pharm D students in Palestine, and to evaluate influencing factors.

METHODS: Study design was cross-sectional; it was conducted from September to December 2024 across seven Palestinian universities. A structured, validated online questionnaire was administered among 412 final-year BS Pharm and Pharm D students. The questionnaire encompassed demographic data, assessment of knowledge regarding P.V and ADRs reporting, as well as perceptions of ADRs monitoring and reporting using a 5-point Likert scale. Data were analyzed using Statistical Package for Social Sciences (SPSS V. 28). Thus, descriptive statistics, binary logistic regression, and multiple logistic regression analysis were performed using odds ratios (ORs) with corresponding 95% confidence intervals (CIs) to assess knowledge, perceptions, and associated demographic factors. A P. value < 0.05 was considered statistically significant.

RESULTS: Two thirds (67.5%) exhibited poor knowledge regarding P.V, with a mean knowledge score of 4.0 ± 1.3. Female students (OR = 1.698; 95% CI: 1.096-2.629), those aged 21-24 years (OR = 2.874; 95% CI: 1.767-4.675), and students who had prior exposure to P.V concepts (OR = 1.984; 95% CI: 1.182-3.332) demonstrated significantly better knowledge (p < 0.05). While majority of students (80.8%) recognized the importance of ADRs reporting, substantial gaps were noted in understanding specific practices, such as reporting ADRs from herbal medicines and knowledge of national P.V guidelines.

CONCLUSION: The study highlights the need for structured integration of P.V education into BS Pharm and Pharm D curricula in Palestine. Addressing identified knowledge gaps and demographic disparities through targeted training programs can enhance students’ perceptions and professionalism in P.V activities, thus, improving medication efficacy, safety, and health outcomes.

PMID:40676624 | DOI:10.1186/s12909-025-07575-z

BMC Vet Res. 2025 Jul 17;21(1):475. doi: 10.1186/s12917-025-04907-5.

ABSTRACT

BACKGROUND: Echinococcosis, a severe zoonosis caused by Echinococcus spp., poses a significant public health challenge in the eastern Tibetan Plateau. This study aimed to investigate the interplay among seasonal shifts in definitive host ecology (Vulpes ferrilata and V. vulpes), dietary shifts, and infections with E. multilocularis and E. shiquicus within a high-altitude ecosystem.

RESULTS: Statistical analyses revealed that V. ferrilata dominated the local fox community (90.48%, n = 441), with the highest number of samples collected in fall (46.49%), likely linked to dispersal behaviors after the breeding season. Dietary analysis showed a strong predation preference, with lagomorphs (primarily Ochotona curzoniae) accounting for 79.57% (74/93) of the diet. There was also a significant seasonal shift: among Vulpes spp., the consumption of rodents increased to 26.92% in the fall from being absent in the summer. This dietary diversification correlated with seasonal resource scarcity, driving foxes to exploit alternative prey. The infection rates of Echinococcus in V. ferrilata displayed the U-shaped seasonal patterns. Specifically, the infections of E. multilocularis peaked in the fall (12.29%), which was significantly higher than that in the spring (2.38%) and summer (0.74%), showing a positive correlation with the predation proportion on rodents (R = 0.61, P = 0.036). Meanwhile, E. shiquicus infections peaked in fall (29.32%) and dipped in summer (17.65%), but showed no dietary association, suggesting alternative transmission factors.

CONCLUSIONS: These findings highlight that seasonal prey switching amplifies E. multilocularis transmission by increasing fox exposure to infected voles. The competitive pressure during resource-limited periods drives a shift in the predation strategies of the definitive hosts, inadvertently exacerbating the zoonotic risks of alveolar echinococcosis. The study underscores the importance of seasonally targeted interventions, providing a scientific foundation for alleviating echinococcosis in high-altitude regions under climate change pressures.

PMID:40676612 | DOI:10.1186/s12917-025-04907-5

BMC Vet Res. 2025 Jul 17;21(1):473. doi: 10.1186/s12917-025-04923-5.

ABSTRACT

BACKGROUND: Dermanyssus gallinae poses a significant global threat to poultry production by affecting animal health and welfare. Conventional acaricidal treatments are limited by the emergence of resistant mite populations and by the risk of chemical residues in eggs and meat. In this study, we evaluated an innovative control strategy based on a hydroxyethyl cellulose (HEC)- hydrogel as a delivery matrix for Eucalyptus globulus essential oil (EO) and the entomopathogenic fungus Beauveria bassiana. Mites were collected from naturally infested hen farms and divided by life stage. Bioassays were conducted under controlled laboratory conditions to compare the effects of treatments applied both with and without pre-incubation of the HEC matrix, expressed as lethal times (LT₅₀ and LT₉₀).

RESULTS: The EO treatment alone or in combination with B. bassiana and without pre-incubation achieved an LT₅₀ of 7.4 ± 0.2 days in adult mites, while the B. bassiana-only treatment exhibited a slightly prolonged LT₅₀ of 8.8 ± 0.2 days. Notably, pre-incubation markedly enhanced efficacy (p < 0.001); the combined treatment reduced the LT₅₀ to 4.9 ± 0.2 days and the LT₉₀ to 10.5 ± 0.3 days, underscoring the synergistic action of EO and B. bassiana. Similar patterns were observed in nymphs, which generally exhibited higher lethal times compared to adults, with strong statistical support.

CONCLUSIONS: The findings indicate that HEC-based hydrogel enriched with E. globulus EO and/or B. bassiana conidia is efficacious against D. gallinae. The significant reduction in LT₅₀ and LT₉₀ in adult mites highlights the potential of this approach for integrated pest management. This novel formulation, by harnessing the synergistic effects of E. globosus EO and B. bassiana within a stable hydrogel matrix, may provide a tool for controlling D. gallinae in the poultry industry, thus reducing the use of synthetic acaricides. Results need to be validated under field conditions to provide a sustainable strategy for controlling red mite infestations.

PMID:40676610 | DOI:10.1186/s12917-025-04923-5

BMC Nurs. 2025 Jul 17;24(1):935. doi: 10.1186/s12912-025-03601-z.

ABSTRACT

BACKGROUND: Ventilator-associated pneumonia (VAP) poses a significant challenge in critical care settings, impacting patient outcomes and healthcare costs. In Saudi Arabia, several studies have reported concerns regarding VAP, including variable VAP rates, inconsistent compliance with and knowledge of VAP prevention practices, and inadequate national data.

OBJECTIVES: To investigate the intensive and critical care nurses’ (ICCNs) self-reported perceived compliance with VAP prevention guidelines, barriers and challenges in caring for mechanically ventilated patients, the demographic variables that associate compliance and factors affecting VAP prevention, and the association between perceived compliance and the barriers affecting the care of mechanically ventilated patients.

METHODS: A descriptive, correlational, and cross-sectional design was used. ICCNs (n = 152) were conveniently recruited from two tertiary government-owned hospitals. Data were collected using self-report scales from April to June 2024. Descriptive and inferential statistics were used for data analyses.

RESULTS: Findings showed that 43% of ICCNs had high compliance with VAP prevention guidelines. The use of protective gloves at every approach to a patient (96.70%) was the VAP guideline that received the highest perceived compliance among ICCNs. Meanwhile, those with 11 to 15 years of experience were more compliant (p = 0.023) than other groups and demographics. Major barriers to compliance included nursing staffing shortages (94.10%) and limited resources (75.00%). Only ICCNs with 11 to 15 years of experience showed greater awareness of VAP prevention guidelines (p = 0.023). Nurses’ nationality, i.e., non-Saudi nurses (p = 0.024) and higher educational levels (p = 0.005), demonstrated greater awareness of barriers to managing and caring for mechanically ventilated patients. ICCNs perceived barriers negatively influenced their perceived compliance with VAP prevention (p = 0.002), indicating that increased barriers are associated with lower compliance. Finally, the considerable challenges in VAP prevention were time constraints and the need for more communication among the health team.

CONCLUSION: Staffing shortages and resource limitations impacted ICCNs’ compliance with VAP prevention guidelines. Furthermore, they became less compliant with higher VAP barrier perceptions. Time constraints and team communication were considerable challenges in VAP prevention. As a result, nurse managers could create comprehensive programs like long-term VAP prevention training and interdisciplinary collaboration in the ICU. Healthcare organization administrators should enhance resource allocation and policy formulation to foster compliance.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40676608 | DOI:10.1186/s12912-025-03601-z

BMC Public Health. 2025 Jul 17;25(1):2482. doi: 10.1186/s12889-025-23701-4.

ABSTRACT

INTRODUCTION: Anemia is a major public health issue that significantly affects health, as well as social and economic development worldwide. Among adolescent girls, the prevalence of anemia is higher due to increased demands for blood volume expansion associated with the onset of menstruation and the rapid growth during adolescence. Therefore, this systematic review and meta-analysis was conducted to estimate the pooled prevalence of anemia and its associated factors among adolescent girls in East and West African countries.

METHODS: All published and unpublished studies from East and West Africa available in PubMed, the Cochrane Library, Hinari, and Google Scholar were screened based on their titles, abstracts, study design, and full-text review before inclusion in the meta-analysis. Data were extracted after assessing the quality of evidence using the Joanna Briggs Institute (JBI) critical appraisal tool for cross-sectional studies. Microsoft Excel was used for data extraction, and STATA version 14 was employed for statistical analysis. A forest plot was used to display the pooled prevalence of anemia among adolescent girls in East and West Africa. Heterogeneity was assessed using random-effects models, subgroup analysis, meta-regression, and sensitivity analysis. Publication bias was evaluated using Egger’s regression test and funnel plot analysis. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to present the factors associated with anemia among adolescent girls.

RESULTS: A total of twenty-nine studies involving 12,905 participants were included in the analysis. The pooled prevalence of anemia among adolescent girls was 32.88% [95% CI: 24.62%, 41.14%], based on a random-effects model. The meta-analysis also identified significant associations between anemia and certain factors. Adolescent girls living in rural areas were more likely to have anemia compared to those in urban areas (OR = 4.19; 95% CI: 1.42, 12.41; I² = 76.2%, p = 0.006). Additionally, girls who had not heard about anemia had significantly higher odds of being anemic (OR = 12.25; 95% CI: 4.59, 32.64; I² = 81.1%, p < 0.01).

CONCLUSION: The pooled prevalence of anemia among adolescent girls in East and West African countries represents a moderate public health concern. Adolescent girls living in rural areas and those who had not heard about anemia were significantly more likely to develop the condition. Addressing this nutritional challenge requires strong intersectoral collaboration between the health and education sectors to promote awareness, prevention, and effective interventions targeting adolescent girls.

PMID:40676606 | DOI:10.1186/s12889-025-23701-4

BMC Med Res Methodol. 2025 Jul 17;25(1):175. doi: 10.1186/s12874-025-02618-x.

ABSTRACT

BACKGROUND: Individualized prediction of health outcomes supports clinical medicine and decision making. Our primary objective was to offer a comprehensive survey of methods for the dynamic prediction of Alzheimer’s disease (AD), encompassing both conventional statistical methods and deep learning techniques.

METHODS: Articles were sourced from PubMed, Embase and Web of Science databases using keywords related to dynamic prediction of AD. A set of criteria was developed to identify included studies. The correlation information for the construction of models was extracted.

RESULTS: We identified four methodological frameworks for dynamic prediction from 18 studies with two-stage model (n = 3), joint model (n = 11), landmark model (n = 2) and deep learning (n = 2). We reported and summarized the specific construction of models and their applications.

CONCLUSIONS: Each framework possesses distinctive principles and attendant benefits. The dynamic prediction models excel in predicting the prognosis of individual patients in a real-time manner, surpassing the limitations of traditional baseline-only prediction models. Future work should consider various data types, complex longitudinal data, missing data, assumption violations, survival outcomes, and interpretability of models.

PMID:40676602 | DOI:10.1186/s12874-025-02618-x

BMC Cancer. 2025 Jul 17;25(1):1183. doi: 10.1186/s12885-025-14065-4.

ABSTRACT

BACKGROUND: DNA damage and repair (DDR) is involved in the antitumor immune response, however, the correlation between DNA damage response with immunotherapy in NSCLC remain unclear. We examined the relationship between DDR alterations and expression of PD-L1 in non-small cell lung cancer.

METHODS: Tumor tissues, para-carcinoma and normal tissues, were obtained from 54 patients who were surgically resected NSCLC tumors. Patient characteristics, neoplasm staging and pathological information were collected. Immunohistochemical analysis of tissue samples was analyzed for γH2AX、RAD51, PARP-1 and PD-L1 protein expression.

RESULTS: A total of 54 patients with non-small cell lung cancer were included in this study, including 24 males and 30 females with ages ranging from 45 to 79 years (mean, 63.5 years). The high expression rate of γH2AX staining in lung cancer was 81.5%(44/54)and the expression levels of γH2AX protein were significantly higher in NSCLC than those in paired para-carcinoma 50%(27/54) and normal tissues 42.6%(23/54). The expression levels of RAD51 protein were significantly higher in lung cancer tissue 68.5%(37/54) than those in paired para-carcinoma 48.1%(26/54) and normal tissues 40.7%(22/54). There was a significant correlation between high RAD51 expression and male patients 87.5%(21/24) (p = 0.009) and a history of smoking 90%(18/20) (p = 0.014). The presence of any DDR alteration was showed with PD-L1. (1) HigherγH2AX expression was observed in the PD-L1 positive cases 90.6% (29/32) compared to the PD-L1 negative cases 68.2% (15/22). Lung cancers with higher γH2AX expression were associated with the higher expression of PD-L1 (p = 0.046, r = 0.284). (2) There was no statistically significant correlation between expression of PD-L1 and RAD51 (p = 0.221, r = 0.168). (3) Higher PARP-1 expression was observed in the PD-L1 negative cases 59.1% (13/22) compared to the PD-L1 positive cases 25% (8/32). Lung cancers with higher PARP-1 expression were associated with the lower expression of PD-L1 (p = 0.009, r=-0.344). (4) No statistically significant association was observed in relationship between expression of DDR Expression (γH2AX、RAD51) and PARP-1 of patients (p = 0.507 and p = 0.817,respectively).

CONCLUSION: Overall, our study shows that high expression of γH2AX, RAD51, and PARP1 proteins display in NSCLC and proves that DNA damage repair may be closely related to the occurrence and development of NSCLC. γH2AX could be a predictor of the adaptation of ICIs as an alternative to PD-L1, and NSCLC is expected to benefit from PARP-1 inhibitors combined with immunotherapy.

PMID:40676600 | DOI:10.1186/s12885-025-14065-4

J Hazard Mater. 2025 Jul 16;496:139257. doi: 10.1016/j.jhazmat.2025.139257. Online ahead of print.

ABSTRACT

Diabetes and kidney diseases are complex disorders influenced by organ-specific abnormalities and systemic dysregulation. Previous research suggests per- and polyfluoroalkyl substances (PFAS) can interfere with glucose metabolism and kidney function, but their impact on pancreas-kidney inter-organ crosstalk is unclear. In this study, we conducted a three-wave repeated-measures analysis, in a non-diabetic, non-chronic kidney disease (CKD) cohort. We assessed 23 PFAS, 23 amino acids, 5 glucose indicators, and 3 renal biomarkers across three visits. Our findings showed that perfluorooctane sulfonate (PFOS) was linked to both glucose and renal biomarkers, suggesting its potential role in impairing pancreas-kidney crosstalk. We also identified amino acids, particularly serine and citrulline, as key mediators in this process, implicating amino acid metabolism as a common mechanism through which PFOS influences inter-organ communication. Serine was found to positively mediate approximately 50 % of the total effect of PFOS exposure on insulin and glucose metabolism, while citrulline negatively mediated about 15 % of PFOS’s effects on kidney function biomarkers. These results highlight PFOS’s role in disrupting pancreas-kidney crosstalk within a non-diabetic, non-CKD cohort and provide new insights into amino acid regulation in metabolic and kidney diseases. This is the first study to demonstrate PFAS involvement in this inter-organ crosstalk and suggests a novel mechanism involving amino acids.

PMID:40674800 | DOI:10.1016/j.jhazmat.2025.139257

J Surg Res. 2025 Jul 16;313:222-229. doi: 10.1016/j.jss.2025.06.019. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aims to evaluate the accessibility of online health resources for nipple reconstruction in English and Spanish to identify areas of improving information access.

METHODS: A deidentified Google search was conducted using the search phrase “nipple reconstruction” in English and “reconstrucción del pezón” in Spanish. The first ten websites in English and Spanish were included. A quality assessment of these websites was performed using the Patient Education and Materials Assessment Tool, Cultural Sensitivity Assessment Tool, and Simple Measure of Gobbledygook to evaluate understandability and actionability, cultural sensitivity, and readability, respectively. Unpaired t-tests and Chi-square tests were used to analyze differences between the groups.

RESULTS: English sites scored similarly to Spanish sites on understandability (70.1% versus 71.0%, P = 0.82) and actionability (46.3% versus 37.5%, P = 0.27), although actionability scores were below the acceptable threshold (70%) in both groups. English sites were significantly more culturally sensitive than Spanish sites (60% versus 10%, P < 0.001). English sites had a statistically significant higher average reading grade level compared to Spanish sites (12.3 versus 10.4, P = 0.005); however both groups exceeded recommended reading grade levels for online health resources. For websites from the same organization, English websites tended to be difficult to read; however, more culturally sensitive, compared to Spanish ones.

CONCLUSIONS: These findings suggest areas of improvement for culturally competent care for reconstruction patients. Improving the readability of online health resources for nipple reconstruction is essential in enabling patients to create informed decisions about their reconstructed breast.

PMID:40674797 | DOI:10.1016/j.jss.2025.06.019