Category: Statistics

Lipids Health Dis. 2025 Apr 24;24(1):155. doi: 10.1186/s12944-025-02580-z.

ABSTRACT

BACKGROUND: The remnant cholesterol inflammatory index (RCII) is a novel metric that combines remnant cholesterol and high-sensitivity C-reactive protein, reflecting the metabolic and inflammatory risk. This study investigates the association between RCII and long-term risks of all-cause and cause-specific mortality in middle-aged and elderly populations in the US and China.

METHOD: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) and the China Health and Retirement Longitudinal Study (CHARLS), including 7,565 and 12,932 participants aged 45 years and older, respectively. The participants were categorized into quartiles based on natural log-transformed RCII (lnRCII) values. Kaplan-Meier survival analysis, Cox proportional hazards models, restricted cubic splines (RCS) and mediation analysis were used to examine the relationship between lnRCII and mortality outcomes, adjusting for potential covariates.

RESULT: The mean age of the participants was 59.90 ± 10.44 years (NHANES) and 58.64 ± 9.78 years (CHARLS), with 53.28% and 52.50% female, respectively. Kaplan-Meier survival analysis showed that higher lnRCII quartiles (≥ 0.79 in NHANES, ≥ -0.13 in CHARLS) were significantly associated with increased all-cause mortality risk (p < 0.001). Each standard deviation (SD) increase in lnRCII corresponded to a higher risk of all-cause mortality, and the hazard ratios (HRs) and 95% confidence interval (CI) were 1.29 (95% CI: 1.21-1.36) in NHANES and 1.26 (95% CI: 1.15-1.38) in CHARLS. In NHANES, lnRCII was also associated with elevated risks of cardiovascular mortality (HR = 1.21, 95% CI: 1.08-1.35) and cancer mortality (HR = 1.30, 95% CI: 1.09-1.55). RCS analysis indicated a J-shaped relationship between lnRCII and both all-cause and cardiovascular mortality, and a linear association with cancer mortality. Mediation analysis showed that systolic blood pressure and fasting plasma glucose partially mediated these associations. Subgroup analyses suggested a stronger association between lnRCII and all-cause mortality in middle-aged US participants (p for interaction = 0.010).

CONCLUSIONS: Elevated RCII levels are significantly associated with increased all-cause mortality risk middle-aged and elderly populations in both the US and China. In the US population, RCII is also associated with increased risks of cardiovascular and cancer mortality. By integrating metabolic and inflammatory risk factors, RCII may serve as a valuable tool for mortality risk stratification and clinical decision-making.

PMID:40275392 | DOI:10.1186/s12944-025-02580-z

J Health Popul Nutr. 2025 Apr 24;44(1):135. doi: 10.1186/s41043-025-00866-7.

ABSTRACT

BACKGROUND: Diabetes is a common metabolic disease worldwide, is also a global major public health problem. We carried out this meta-analysis to evaluate the effects of olive oil(OO) consumption on diabetes.

METHODS: PubMed, Embase, Scopus, Web of Science and Cochrane Library databases were systematically searched until October 2024. Heterogeneity among studies was examined using Q and I² statistics. Combined risk ratio (RR) with their 95% confidence interval (CI) were calculated by using a random effects model. Also dose-response analysis and subgroup analysis were performed.

RESULTS: 10 studies (4 cohorts and 6 RCT) involved more than 50,0000 subjects and 2,0000 individuals with diabetes were included in the meta-analysis. A 13% (RR = 0.87, 95%CI = 0.83 – 0.92, P < 0.01) decreased risk of diabetes was shown in Cohort study and 22% (RR = 0.78, 95%CI = 0.70 – 0.88, P < 0.01) decreased risk in RCT study for the highest vs. lowest olive oil consumption. Subgroup analysis results showed that there was a better effect on reducing diabetes risk in age > 50 years(RR = 0.77, 95%CI = 0.70 – 0.89, P < 0.01), Europe(RR = 0.81, 95%CI = 0.72 – 0.86, P < 0.01) and extra virgin olive oil ( RR = 0.75, 95%CI = 0.65-0.87, P < 0.01). Dose-response analysis showed a significant nonlinear association of diabetes risk with OO intake(Pnon-linearity < 0.05) and when 10-20 g of olive oil is consumed daily, the effect amount is statistically significant, while more than 20 g there was not statistically significant. Begg’s and Egger’s regression test results indicated that there was no publication bias and the results were reliable.

CONCLUSIONS: Evidence from this meta-analysis suggested that OO consumption is associated with a decreased risk of diabetes, especially, 10-20 g OO daily may be beneficial for prevention and management of diabetes.

PMID:40275388 | DOI:10.1186/s41043-025-00866-7

Int J Behav Nutr Phys Act. 2025 Apr 24;22(1):50. doi: 10.1186/s12966-025-01741-8.

ABSTRACT

BACKGROUND: Food consumption patterns have changed tremendously since the mid-twentieth century, with a rapid global nutritional shift raising concerns, particularly in disadvantaged regions such as the Eastern Mediterranean region (EMR). Given that food intake is very context-specific, this research examines food consumption patterns in Jordan, Lebanon, Palestine, and Syria, representing the contemporary Levant region.

METHODS: A systematic review was conducted by searching PubMed, EMBASE, Web of Science, and CINAHL. The eligibility criteria were to include only original peer-reviewed observational studies reporting individual-level food consumption among local Jordanians, Lebanese, Palestinians, and Syrians. Extracted data were synthesized through descriptive statistics and presented in tables and charts. The risk of bias was assessed using the tool developed by Hoy et al. for prevalence studies.

RESULTS: A total of 43 articles that measured and reported food consumption at the individual level for the populations in these countries were included. Findings reveal that in the 1960s, diets in the region were primarily local, seasonal, and plant-based, with moderate to low animal product intake. By the 1990s, a noticeable shift occurred, marked by increased consumption of processed foods, refined carbohydrates, and animal products, with minimal increase in fruit and vegetable intake. Most studies were conducted in Lebanon, limiting the generalizability of findings across the Levant countries.

CONCLUSION: This review presents an understanding of food consumption changes on the level of food items, food groups, and dietary patterns specific to the Levant. Future studies on food consumption patterns should prioritize national surveys using valid, reliable, and cultural-specific measurement tools and provide detailed, age-disaggregated dietary data. Public health interventions are needed to address the ongoing dietary shift, which is unfolding amid political instability, economic crises, and food insecurity.

PMID:40275353 | DOI:10.1186/s12966-025-01741-8

J Comp Neurol. 2025 Apr;533(4):e70050. doi: 10.1002/cne.70050.

ABSTRACT

The absolute number of neurons and their spatial distribution yields important information about brain function and species comparisons. We studied thalamic parafascicular neurons and striatal cholinergic interneurons (CINs) because the parafascicular neurons are the main excitatory input to the striatal CINs. This circuit is of increasing interest due to research showing its involvement in specific types of learning and behavioral flexibility. In the Sprague-Dawley rat, the absolute number of thalamic parafascicular neurons and striatal CINs is unknown. They were estimated in this study using modern stereological counting methods. From each of six young adult rats, complete sets of serial 40 µm glycol methacrylate sections were used to quantify neuronal numbers in the right parafascicular nucleus (PFN). From each of five young adult rats, complete sets of serial 20 µm frozen sections were immunostained and used to quantify cholinergic neuronal numbers in the right striatum. The spatial distribution, in three dimensions, of striatal CINs was also determined from exhaustive measurement of the x, y, z coordinates of each large interneuron in 40 µm glycol methacrylate sections in sampled sets of five consecutive serial sections from each of two rats. Statistical analysis of spatial distribution was conducted by comparing observed three-dimensional data with computer models of 10,000 pseudorandom distributions, using measures of nearest neighbor distance and Ripley’s K-function for inhomogeneous samples. We found that the right PFN consisted, on average, of 30,073 neurons (with a coefficient of variation of 0.11). The right striatum consisted, on average, of 10,778 CINs (0.14). The statistical analysis of spatial distribution showed no evidence of clustering of striatal CINs in three dimensions in the rat striatum, consistent with previous findings in the mouse striatum. The results provide important data for the transfer of information through the PFN and striatum, species comparisons, and computer modeling.

PMID:40275352 | DOI:10.1002/cne.70050

BMC Psychol. 2025 Apr 24;13(1):434. doi: 10.1186/s40359-025-02642-y.

ABSTRACT

BACKGROUND: With the rising population age and the development of information technology in China, a growing number of older adults use social media as a means of social participation. The impact of posting on WeChat Moments on the mental health of older adults is worthy of attention.

AIM: The aim of this study is to identify posting on WeChat Moments as an active social media use and analyze its impact on the mental health of older adults.

METHOD: Using the survey data from the China Health and Retirement Longitudinal Study (CHARLS), we defined posting on WeChat Moments as an active social media use and used propensity score matching (PSM) to analyze the impact of such posting on the mental health of older adults.

RESULTS: The results of the study showed that posting statistically significantly improved the depression, self-rated health, and health satisfaction of older adults. Heterogeneity analysis showed that the female older-adult population and the younger older-adult population derived the most mental health benefit from posting on WeChat Moments.

CONCLUSION: Posting on WeChat Moments statistically significantly improved the depression, self-rated health, and health satisfaction of older adults. Older adults who use WeChat and post on WeChat Moments derive much benefit from their active social media use.

PMID:40275350 | DOI:10.1186/s40359-025-02642-y

BMC Chem. 2025 Apr 24;19(1):110. doi: 10.1186/s13065-025-01466-6.

ABSTRACT

This work presents two methods for the simultaneous determination of ibuprofen (IBU), paracetamol (PAR), and chlorzoxazone (CHZ) in the presence of three PAR impurities: p-aminophenol (PAP), p-nitrophenol (PNP), and p-chloroacetanilide (PCA). Furthermore, both methods attempt to quantify these hazardous impurities. The first method is a thin layer chromatography densitometric method (TLC), where separation was achieved on silica gel 60 F₂₅₄ plates using a mobile phase consisting of chloroform, toluene, ethanol, and ammonia (7.0: 1.0: 1.6: 0.2, by volume). Densitometric detection was performed at 220.0 nm. The second method is a high-performance liquid chromatographic method (HPLC), in which the analytes were separated on an Xterra C8 column (150 × 4.6 mm, 5 µm) using an isocratic mobile phase of acetonitrile and phosphate buffer (pH 7.5) in a 30:70 (v/v) ratio. The UV detector was set at 220.0 nm, and the flow rate was maintained at 0.7 mL/min. Both methods were validated following ICH guidelines and successfully applied to the determination of IBU, PAR, and CHZ in their commercial tablet formulations. A statistical comparison with a previously reported method confirmed no discernible differences in the results, demonstrating the reliability and accuracy of the proposed techniques.

PMID:40275344 | DOI:10.1186/s13065-025-01466-6

BMC Nurs. 2025 Apr 24;24(1):457. doi: 10.1186/s12912-025-03077-x.

ABSTRACT

BACKGROUND: Literature confirms the tangible educational benefits of participating in high-fidelity simulation exercises. However, the final assessment of such sessions is always a combination of the teacher’s actions, the project, the technical infrastructure, and the student. The aim of this study was to evaluate and conduct a comparative analysis of high-fidelity simulation sessions regarding applied educational practices, satisfaction levels, and self-confidence among nursing students at a university located in a major academic center in southern Poland.

METHODS: This cross-sectional study was conducted in May and June during the 2021/2022, 2022/2023, and 2023/2024 academic years on a group of 422 first-year undergraduate nursing students. Data from 412 students who participated in high-fidelity simulation sessions were analyzed. The study employed a custom questionnaire, the Educational Practice Questionnaire (EPQ), and the Student Satisfaction and Self-Confidence in Learning Scale (SSCL). The study used Spearman’s correlation coefficient, Kruskal-Wallis test, Dunn’s post-hoc analysis and multivariate linear regression. A significance level of p < 0.05 was adopted.

RESULTS: The students rated the attractiveness of the sessions, the development of competencies, and the conducted debriefing relatively highly (average score above 4). Statistically significant differences were found between academic years in the assessment of social competencies acquired (p = 0.008) and the evaluation of debriefing elements as a summary method (p = 0.009). Students indicated that collaboration (M = 4.81; SD = 0.44) was present in the proposed educational method and considered it the most valuable aspect (M = 4.59; SD = 0.66). A positive correlation (r > 0) was noted between the development of knowledge (r = 0.389, p < 0.001), practical skills (r = 0.44, p < 0.001), and social skills (r = 0.401, p < 0.001) and satisfaction. There was also a positive correlation (r > 0) between the applied techniques during simulation and the level of self-confidence in the learning process (p < 0.05). The applied multiple regression models identified the aspects of the sessions that had a direct and unimpeded impact on nursing students’ sense of satisfaction and self-confidence. These aspects included, among others, active learning and diverse learning methods.

CONCLUSIONS: This study confirmed the justification for organizing high-fidelity simulation sessions for nursing students due to the overall benefits for the student (in terms of satisfaction and increased self-confidence), the institution (student satisfaction with the university’s educational offerings), and the profession (high perception of increased nursing competencies).

PMID:40275323 | DOI:10.1186/s12912-025-03077-x

Malar J. 2025 Apr 24;24(1):134. doi: 10.1186/s12936-025-05328-3.

NO ABSTRACT

PMID:40275316 | DOI:10.1186/s12936-025-05328-3

BMC Med Educ. 2025 Apr 24;25(1):604. doi: 10.1186/s12909-025-07168-w.

ABSTRACT

OBJECTIVE: This study aims to investigate nursing staff’s current knowledge-attitude-practice(KAP) regarding nursing document quality control and to explore effective methods to enhance their awareness of nursing documents’ importance through intensive training.

METHODS: We developed the questionnaire based on a systematic literature review and two rounds of Delphi expert consultation. Then, we sent the questionnaire to the nurses before and after the intensive training.Data processing and statistical analysis were conducted using R 4.4.0 software.

RESULTS: Altogether, 722, 701, and 800 nurses participated in the questionnaire survey before the training and after two training rounds, respectively. There was no statistically significant difference between the respondents’ baseline data (gender, age, professional title, position, educational background, and working years) before and after the training. After two rounds of intensive quality control training, the nursing staff’s median scores in the knowledge, attitude, and practice dimensions increased from 45 points before the training to 49, 50, and 50 points, respectively, and the difference was statistically significant (P < 0.05). Regression analysis indicated that the longer the working years, the higher the scores of the nursing staff after the training (3-5 years, P < 0.01, 95% Confidence Interval (CI), 0.2-0.57), (6-10 years, P < 0.01, 95% CI, 0.35-0.73), (> 10 years, P = 0.003, 95% CI, 0.32-0.72).The nursing staff with the titles of Chief Nurse (P < 0.01, 95% CI, 0.2-0.54) and Deputy Chief Nurse (P < 0.01, 95% CI, 0.21-0.74) scored higher after the training.

CONCLUSION: This study shows that, after two rounds of training, nurses’ KAP of the quality control of nursing documents significantly improved. The training had a positive impact on their KAP, which is conducive to enhancing the quality of nursing documents and nursing care. Therefore, hospitals should emphasize the quality control of nursing documents and take effective measures to help nurses continuously improve the quality of nursing documents.

PMID:40275301 | DOI:10.1186/s12909-025-07168-w

World J Emerg Surg. 2025 Apr 24;20(1):36. doi: 10.1186/s13017-025-00614-6.

ABSTRACT

BACKGROUND: Guidance on managing acute mesenteric ischaemia (AMI) is largely based on expert opinion and retrospective studies pooling different subtypes of AMI. In clinical practice, management strategy is often selected based on the patient’s severity of illness, whereas randomized controlled trials or even adjusted analyses comparing different strategies are rarely available. We aimed to perform a systematic review and meta-analysis on the effect of different management options when adjusted for the baseline severity of illness.

METHODS: A literature search was performed in PubMed, the Cochrane Library, Web of Science and Scopus. Studies recruiting patients after the year 2000, assessing at least 10 adult patients with reliably confirmed AMI, and comparing different management approaches were considered for inclusion. Thirteen study questions on different management strategies in different subtypes of AMI were formulated a priori. We included studies reporting results of adjusted analyses or reporting any variables reflecting the severity of illness in both study groups under comparison.

RESULTS: A total of 3324 publications were identified, 321 were selected for full-text review and 31 included in the review and analysis. Most of the studies comparing different management strategies of AMI did not report the severity of illness in the groups under comparison. Any variable that could be considered to reflect the severity of illness was reported in 26 studies. The available data only allowed one meta-regression analysis comparing initial endovascular revascularization versus open surgery in arterial occlusive AMI, including four studies that reported white blood cell count and lactate. The results indicate that the significant advantage of the endovascular approach suggested in the crude analysis may be abolished when adjusting for the severity of the illness. Narrative summaries and raw data are presented for other research questions.

CONCLUSIONS: The severity of illness plays an important role in the selection of management strategy and largely determines the outcome of any treatment, yet is generally not considered in available studies assessing the management of AMI. There is a major gap in the literature precluding appropriate analyses on treatment effects. Future studies should report subtypes of AMI and the severity of illness for each group.

STUDY REGISTRATION: PROSPERO CRD42024568497, date of registration: July 20th, 2024.

PMID:40275298 | DOI:10.1186/s13017-025-00614-6