Category: Statistics

Int J Soc Psychiatry. 2026 Feb 20:207640251411971. doi: 10.1177/00207640251411971. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to assess the prevalence and predictors of depression, anxiety, and stress among medical residents in Tehran, Iran.

METHODS: This cross-sectional study was conducted from January 1 to February 28, 2022, as part of a broader investigation into mental health among medical residents A total of 353 medical residents from various universities in Tehran participated. Data were collected via an online questionnaire, including the Depression, Anxiety, Stress Scale-21 (DASS-21) and demographic variables. Statistical analyses, including Pearson’s Chi-square test and linear regression, were used to identify significant mental health predictors.

RESULTS: The prevalence of depression, anxiety, and stress was 69.3%, 63.2%, and 64.6%, respectively. Significant predictors included marital status, gender, number of children, housing situation, specialty type, and workload. First-year residents reported higher psychological distress than senior residents. Surgical residents exhibited the highest levels of depression, anxiety, and stress, followed by medical and paramedical specialties.

CONCLUSION: Our findings highlight the urgent need for targeted mental health interventions for medical residents in Tehran, addressing specific risk factors across specialties and residency years to enhance well-being and healthcare quality.

PMID:41717738 | DOI:10.1177/00207640251411971

Inorg Chem. 2026 Feb 20. doi: 10.1021/acs.inorgchem.5c05447. Online ahead of print.

ABSTRACT

The Ga-rich region of the Fe-Ni-Ga ternary system was investigated, by exploring a line of compositions Fe_xNi_3-xGa₄, with 0.5 ≤ x ≤ 2.5. The single-phase cubic material was found only at the composition Fe_1.5Ni_1.5Ga₄ and its immediate vicinity, representing a new phase in the Fe-Ni-Ga diagram. The homogeneity range of this phase was estimated by additionally exploring a set of compositions Fe_xNi_yGa_z around the central composition Fe_1.5Ni_1.5Ga₄. The structural model was constructed based on the structure of the binary Ni₃Ga₄ parent phase, which crystallizes in the cubic Ia 3̅ d space group. We have considered that by substituting Fe for Ni, the Ia 3̅ d structure is preserved, with the Fe and Ni being statistically distributed at their 48g Wyckoff site. The possibility of a symmetry-reduced chiral structural model I4₁32 driven by chemical ordering of Fe and Ni cannot be entirely ruled out on the basis of the crystallographic study. The magnetic study of the Fe_1.5Ni_1.5Ga₄ phase has revealed that the material forms a spin glass phase below the spin freezing temperature T_f ≈ 9 K. Since the spin glass ordering of the Fe and Ni magnetic moments is compatible with their random distribution, the magnetic study supports the disordered cubic Ia 3̅ d model.

PMID:41717735 | DOI:10.1021/acs.inorgchem.5c05447

Head Neck. 2026 Feb 20. doi: 10.1002/hed.70206. Online ahead of print.

ABSTRACT

BACKGROUND: Expiratory muscle strength training (EMST) is a non-invasive, evidence-based treatment that is used to improve swallowing in head and neck cancer (HNC) survivors. This prospective, pilot implementation study evaluated the feasibility, acceptability, and potential clinical effectiveness of a novel student-led tele-EMST program for HNC survivors.

METHODOLOGY: HNC survivors (n = 13) completed an eight-week tele-EMST program. Acceptability was measured using the Theoretical Framework of Acceptability Questionnaire (TFAQ) and the Telehealth Usability Questionnaire (TUQ). Feasibility was tracked weekly. Swallowing performance, airway clearance, and quality of life were evaluated using the Timed Water Swallow Test (TWST), peak expiratory flow rate (PEFR), and SWAL-QoL, respectively. Data were collected with REDCap. Descriptive and non-parametric statistics were performed.

RESULTS: Acceptability of the tele-EMST program was high, as evidenced by high ratings on the TUQ (mean: 88.1/100%, SD: 16.3) and significant improvement on the TFAQ (p < 0.05). Technical issues occurred in 24% of sessions but were all resolved. Swallowing performance (TWST, p < 0.05), self-reported dysphagia symptoms, and mental health scores (SWAL-QoL, p = 0.03; p = 0.02) significantly improved. No significant changes in PEFR were observed (p = 0.59).

CONCLUSION: The findings of this small pilot feasibility suggest that a student-led, tele-EMST program is a promising, scalable approach to reduce treatment inequities and support survivorship care for HNC survivors with dysphagia.

PMID:41717720 | DOI:10.1002/hed.70206

Circ Popul Health Outcomes. 2026 Feb 20:e013261. doi: 10.1161/CIRCOUTCOMES.125.013261. Online ahead of print.

ABSTRACT

BACKGROUND: Lp(a) (lipoprotein[a]) is a known cardiovascular risk factor; however, its role in cardiac remodeling and functional changes over time across diverse racial and ethnic groups remains underexplored.

METHODS: MESA is a prospective multi-ethnic cohort study of individuals without a history of cardiovascular disease on enrollment (2000-2002), conducted across 6 sites in the United States. Participants with baseline Lp(a) measurements and cardiac magnetic resonance imaging at both baseline and 10-year follow-up exam were included. Lp(a) was treated as both a log-transformed continuous variable (per SD log) and a categorical variable based on data-driven Lp(a) terciles. Multivariable regression models adjusted for sociodemographic, and cardiovascular risk factors, including coronary artery calcium and interim myocardial infarction, were used to assess associations between Lp(a) and longitudinal changes in left ventricular and atrial structure and function over a decade across different racial/ethnic groups.

RESULTS: A total of 2366 participants were included. The average age at baseline was 60±9 with 53% women, 43% White, 24% Black, 21% Hispanic, and 12% Chinese. Each 1-SD increase in log-transformed Lp(a) was associated with an increase in left ventricular end-systolic volume index (β, 0.60 [95% CI, 0.02-1.18]), and left atrial minimum volume index (β, 0.81 [95% CI, 0.09-1.52]), and a decline in left ventricular ejection fraction (β, -0.75 [95% CI, -1.34 to -0.17]), and total left atrial emptying fraction (β, -1.17 [95% CI, -2.09 to -0.24]) in Hispanic subjects over a decade. No significant associations were seen in White, Black, or Chinese participants. The observed findings persisted after adjusting for coronary artery calcium, interim myocardial infarction, and atrioventricular decoupling, and when Lp(a) was treated as a categorical variable with race-specific terciles.

CONCLUSIONS: Elevated Lp(a) levels were independently associated with maladaptive left ventricular and left atrial remodeling in Hispanic adults over a decade, while no statistically significant relationships were observed in White, Black, and Chinese participants. This suggests a unique susceptibility of Hispanic individuals to Lp(a)-mediated cardiovascular remodeling, independent of ischemic pathways.

PMID:41717692 | DOI:10.1161/CIRCOUTCOMES.125.013261

J Obstet Gynaecol Res. 2026 Feb;52(2):e70214. doi: 10.1111/jog.70214.

ABSTRACT

AIM: To evaluate the educational outcomes of a nationwide faculty development initiative tailored to obstetrician-gynecologists in Japan, addressing the gap in systematic faculty development implementation and assessment within the specialty.

METHODS: This observational study evaluated three online faculty development seminars conducted by the Japan Society of Obstetrics and Gynecology between December 2023 and August 2024. Using Kirkpatrick’s four-level model, we assessed participant satisfaction (Level 1), self-assessed knowledge gain (Level 2), and behavioral implementation in clinical practice (Level 3). Data were collected using post-seminar and longitudinal follow-up questionnaires.

RESULTS: Level 1 (Reaction): Among the 195 participants, 85.1% completed the post-seminar surveys, with satisfaction rates ranging from 87.9% to 93.0%. Level 2 (Learning): Self-assessed knowledge scores significantly improved across all three seminars (e.g., Seminar 1: from 4.0 to 7.0 on a 9-point scale, p < 0.05). Level 3 (Behavior): Among participants who attended multiple sessions, 74.1% reported implementing learned skills, such as feedback techniques and leadership strategies, with the majority noting positive educational outcomes.

CONCLUSIONS: Nationwide faculty development programs tailored to obstetrics and gynecology can enhance educational competence and promote behavioral change. Our findings highlight the feasibility and effectiveness of specialty-specific faculty development and indicate the need for long-term objective assessments to ensure a sustainable impact. These findings have significant implications for the field of obstetrics and gynecology, suggesting that targeted faculty development initiatives can play a crucial role in improving the quality of medical education and addressing workforce shortages.

PMID:41717673 | DOI:10.1111/jog.70214

Trop Med Int Health. 2026 Feb 20. doi: 10.1111/tmi.70094. Online ahead of print.

ABSTRACT

INTRODUCTION: Gonorrhoea remains a leading sexually transmitted infection worldwide, with an estimated 82 million new cases being reported annually. In Kenya, epidemiological and antimicrobial resistance data are fragmented and under-represent high-risk populations, hampering targeted interventions.

OBJECTIVE: To estimate the pooled prevalence of Neisseria gonorrhoeae and assess patterns of antimicrobial resistance in Kenya between 2019 and 2024.

METHODOLOGY: We searched PubMed, Google Scholar, OpenAlex and Research4Life following PRISMA guidelines, yielding 1116 records. Two reviewers independently screened studies against predefined inclusion criteria. Prevalence and resistance data were extracted, and a random-effects meta-analysis was performed to compute pooled estimates with 95% confidence intervals. Heterogeneity among studies was assessed using the I² statistic.

RESULTS: Eleven studies comprising 5170 participants met inclusion criteria. The pooled prevalence of N. gonorrhoeae was 22.5% (95% CI: 17.2-27.8). Key risk factors included sex work, low educational attainment and multiple sexual partners. Resistance rates were highest for tetracycline (98.0%), ciprofloxacin (96.7%) and penicillin (94.7%) and lowest for azithromycin (2.0%), cefixime (2.6%) and ceftriaxone (1.3%).

CONCLUSION: N. gonorrhoeae poses an urgent public health threat in Kenya. Strengthening surveillance, expanding access to reliable diagnostics and enforcing antibiotic stewardship are critical. Exploration of alternative therapies including phage therapy, alongside accelerated vaccine research, will be essential for sustainable disease control.

PMID:41717668 | DOI:10.1111/tmi.70094

Front Health Serv. 2026 Feb 4;6:1715517. doi: 10.3389/frhs.2026.1715517. eCollection 2026.

ABSTRACT

BACKGROUND: In the context of medical insurance payment reform in China, Computed tomography (CT), as a key type of large medical equipment, currently faces challenges of over-scanning or under-scanning. This study aims to identify the factors influencing the number of CT scans, perform risk adjustment on the number of CT scans, and evaluate the rationality of the number of CT scans for each major diagnostic category (MDC).

METHODS: In the public tertiary general hospital in Sichuan Province, the top 10 MDCs with the highest total number of CT scans in 2023 were selected. A risk-adjusted model was used to estimate the expected number of CT scans. The utilization of CT scans was classified as over-scanning, under-scanning, and rational scanning based on the ratio of observed to expected scan numbers.

RESULTS: The top 10 MDCs included 29,461 encounters and 37,672 CT scans. The number of CT scans varied across different MDCs: five exhibited over-scanning, three showed under-scanning, and two demonstrated rational scanning. The risk-adjusted model revealed that age, admission condition, first-time hospitalization, medical insurance, and length of stay were statistically significant in determining both the decision to perform a CT scan and the number of CT scans conducted.

CONCLUSIONS: This study evaluated the rationality of the number of CT scans across the top 10 MDCs, established a methodological framework for hospital to explore the rationality of the number of other medical examinations.

PMID:41717628 | PMC:PMC12913540 | DOI:10.3389/frhs.2026.1715517

Front Public Health. 2026 Feb 4;14:1732510. doi: 10.3389/fpubh.2026.1732510. eCollection 2026.

ABSTRACT

OBJECTIVE: Based on an epidemiological investigation of 2-h of daily physical activity among primary and secondary school students across China’s seven major administrative regions, this study analyzes the association between social support and cognitive factors, thereby providing recommendations for policy formulation.

METHODS: A cross-sectional study was conducted using random cluster sampling across seven Chinese administrative regions from May to July 2025. Data were collected using standardized scales measuring physical activity levels, achievement of the daily 2-h physical activity target, academic stress, and health cognition. Statistical analyses, including descriptive statistics, chi-square tests, and multivariable logistic regression, were performed using SPSS 26.0.

RESULTS: (1) The prevalence of insufficient 2-h daily physical activity showed significant differences across various demographic variables (all p < 0.001). Higher prevalence rates were observed among students in rural areas (30.50%), private schools (29.41%), boarding students (30.03%), and those with lower frequency of reunions with parents. (2) Key risk factors identified included lack of health cognition, low perceived value of physical activity, lack of sports facilities, insufficient allocated physical education time, and lack of access to smart devices. (3) Significant urban-rural/regional disparities were found regarding access to smart devices (t = 3.142, p = 0.002) and academic stress levels (t = 2.499, p = 0.012).

CONCLUSION: Health cognition, resource availability, and time allocation are significant factors associated with the insufficiency of daily 2-h physical activity among Chinese primary and secondary school students. The education department has increased the guarantee of student system construction, and has implemented differentiated management for higher grades.

PMID:41717627 | PMC:PMC12913497 | DOI:10.3389/fpubh.2026.1732510

Front Public Health. 2026 Feb 4;14:1736796. doi: 10.3389/fpubh.2026.1736796. eCollection 2026.

ABSTRACT

BACKGROUND: Helicobacter pylori (H. pylori) infection remains a global public health burden, particularly in developing countries. While its eradication is a cornerstone for gastric cancer prevention, management is challenged by high infection rates, rising antibiotic resistance, and suboptimal treatment efficacy. Compounding these issues, patient loss to follow-up (LTFU) has emerged as a critical factor directly undermining the success of eradication therapy.

OBJECTIVE: This study aimed to investigate the risk factors associated with LTFU after H. pylori eradication, and to develop a predictive model for assessing the risk of LTFU.

METHODS: We conducted a prospective cohort study (April 2023-September 2024) enrolling treatment-naïve patients from a tertiary gastroenterology clinic. Following data collection via questionnaires and follow-ups, a nomogram for predicting loss to follow-up (LTFU) was developed by applying LASSO regression for variable selection and logistic regression for model building. The model was evaluated by its area under the ROC curve (AUC), calibration, and decision curve analysis (DCA), with internal validation performed via 500 bootstrap resamples to confirm reliability.

RESULTS: A total of 145 (37.76%) patients failed to follow up. From 19 potential predictors, 6 variables were independent predictive factors. They were included in the risk score: BMI > 30 kg/m² (OR = 3.81, 95% CI: 1.16-12.50), government employee (OR = 2.10, 95% CI: 1.21, 3.63), distance to hospital >10 km (OR = 11.27, 95%CI: 6.29-20.18), alcohol consumption (OR = 1.82, 95% CI: 1.19-2.79), outpatient waiting time (OR = 1.01, 95% CI: 1.00-1.02), and lack of awareness of follow-up (OR = 3.32, 95% CI: 1.93-5.69). In the training set, the model demonstrated an AUC of 0.885 (95% CI: 0.843-0.918), with a sensitivity of 93.58% and a specificity of 67.92%. Comparatively, in the test set, the model achieved an AUC of 0.862 (95% CI: 0.794-0.925), with a sensitivity of 83.33% and a specificity of 77.50%, effectively forecasting the risk of patient LTFU in H. pylori eradication. DCA demonstrated the favorable clinical utility of the nomogram, suggesting its potential as a valuable auxiliary tool for predicting the risk of LTFU.

CONCLUSION: The nomogram effectively assessed the risk of LTFU after H. pylori eradication, thereby contributing to improved treatment management outcomes.

PMID:41717626 | PMC:PMC12913374 | DOI:10.3389/fpubh.2026.1736796

Front Public Health. 2026 Feb 4;14:1759966. doi: 10.3389/fpubh.2026.1759966. eCollection 2026.

ABSTRACT

BACKGROUND: Occupational fatigue among nurses has become a critical global public health concern. Endoscopy nurses, in particular, face unique occupational demands that significantly impact their physical and psychological well-being, as well as the quality of patient care. This study aimed to assess the prevalence of occupational fatigue among endoscopy nurses in China and examine its associated factors. Specifically, the mediating role of coping styles in the relationship between work-family conflict and occupational fatigue was analyzed, and the influence of social support was explored.

METHODS: A multicenter cross-sectional study was conducted involving 332 endoscopy nurses from 26 tertiary hospitals across 14 provincial regions in China. Standardized instruments were used to measure occupational fatigue, work-family conflict, coping styles, and perceived social support. Descriptive statistics, univariate analyses, Pearson correlations, multiple linear regression, and structural equation modeling (SEM) were applied.

RESULTS: Endoscopy nurses reported a high level of occupational fatigue (22.075 ± 2.588). Age, gender, marital status, daily working hours, and weekly working days were significantly associated with fatigue levels (p < 0.05). Work-family conflict was positively correlated with occupational fatigue, whereas social support and positive coping were negatively correlated. Negative coping was associated with increased fatigue. SEM revealed that work-family conflict exerted a direct positive effect on occupational fatigue (β = 0.637), and both positive (β = -0.360) and negative (β = 0.077) coping styles partially mediated this relationship. The model showed an acceptable fit (CFI = 0.853, TLI = 0.837, RMSEA = 0.079).

CONCLUSION: Occupational fatigue is prevalent among endoscopy nurses in China and is influenced by work-family conflict, coping styles, and social support. Interventions targeting scheduling optimization, the enhancement of social support, and the promotion of adaptive coping strategies are essential to mitigate fatigue and improve workforce well-being.

PMID:41717625 | PMC:PMC12913506 | DOI:10.3389/fpubh.2026.1759966