Category: Statistics

Arch Public Health. 2025 Jul 3;83(1):176. doi: 10.1186/s13690-025-01623-2.

ABSTRACT

BACKGROUND: Globally, health insurance is viewed as a viable health financing option for improving access to healthcare. In Tanzania, as in other countries, it is actively promoted to enhance service accessibility. However, there are limited empirical studies on the association between having health insurance and women visiting health facilities. The available studies covered small areas and used small sample size. This study aimed to determine the relationship between health insurance status and utilisation of healthcare among women aged 15-49 using Tanzania Demographic and Health Survey (TDHS).

METHODOLOGY: This study analysed secondary data of 15,254 women drawn from the 2022 (TDHS). The survey is conducted after every five years by the National Bureau of Statistics. The dependent variable was healthcare utilisation status and the key independent variable was health insurance status of a woman. The analysis took into account for complex sampling design. The analysis involved descriptive analysis to get frequency and percentage distribution of respondents. Bivariable analysis and multivariable logistic regression were conducted to assess the magnitude of association between dependent and independent variables. A cut-off point of p-value < 0.05 was used to determine the significant level of statistical significance.

RESULTS: The prevalence of healthcare utilisation among Tanzanian women was 53%. After controlling for other covariates, women who were covered by health insurance had 1.37 times higher odds of healthcare utilisation compared to those who were not covered by health insurance (AoR:1.37, 95% CI: 1.14, 1.65), women aged 25-34 years had 1.38 times higher odds of healthcare utilisation compared to those who were aged 15-24 years (AoR:1.38, 95% CI: 1.24, 1.54). Women who were in union had 2 times higher odds of healthcare utilisation compared to those who were not in union (AoR: 2.1, 95% CI: 1.88, 2.35). Women who were working had 1.71 times higher odds of utilising healthcare services compared to those who were not working (AoR: 1.71, 95% CI: 1.56, 1.88). Women who watched or listened to mass media at least once a week had 1.37 times higher the odds of healthcare utilisation compared to those who did not watch or listen to mass media at all (AoR:1.37, 95% CI: 1.2, 1.56). However, place of residence was not a significant factor.

CONCLUSION: The present study shows a statistically significant association between being insured and the utilisation of healthcare services among women aged 15-49 years. This indicates that insurance status helps women utilise healthcare services in Tanzania. The findings from this study also highlighted demographic factors including age, marital union, working, and use of mass media as important factors influencing utilisation of healthcare among women. It is imperative to educate the community on the importance of health insurance so that more women can enroll in health insurance schemes, including the improved Community Health Fund (iCHF), the National Health Insurance Fund (NHIF), and private health insurance schemes, thereby breaking financial barriers to healthcare utilisation.

PMID:40611298 | DOI:10.1186/s13690-025-01623-2

J Transl Med. 2025 Jul 3;23(1):738. doi: 10.1186/s12967-025-06531-1.

ABSTRACT

BACKGROUND: The pathogenesis of inflammatory bowel disease (IBD) involves complex molecular mechanisms, and achieving clinical remission remains challenging. This study aims to identify IBD-potential biomarkers, analyze their correlation with immune cell infiltration, and identify genes that have a causal relationship with IBD.

METHODS: RNA-seq datasets for IBD were retrieved from GEO, stratified into discovery (GSE75214), validation (GSE36807), and independent testing cohorts (GSE179285, GSE47908). Through comparative expression profiling of the discovery cohort, IBD-associated differentially expressed genes (DEGs) were detected. Core candidate genes were subsequently prioritized using protein-protein interaction network analysis, further refined through machine learning approaches (Random Forest/Support Vector Machines). Immune cell abundance quantification and statistical correlation analyses with IBD-associated transcripts were conducted via the CIBERSORTx deconvolution algorithm. To complement these findings, blood expression quantitative trait loci (eQTL) data from GTExv8.ALL.Whole_Blood were integrated with IBD genome-wide association statistics from the FinnGen consortium. This multi-omics integration framework employed: (1) Bayesian colocalization to assess shared causal variants, (2) HEIDI heterogeneity testing, and (3) summary Mendelian randomization (SMR) for causal inference validation.

RESULTS: Three genes, IRF1, GBP5, and PARP9, demonstrated significant IBD-promoting effects. The characteristic biomarkers of IBD were associated with immune cell infiltration. SMR analysis based on eQTL data showed that IRF1 was significantly associated with the risk of IBD. Moreover, IRF1 passed the HEIDI test of > 0.05 on gene expression, and IRF1 demonstrated the ability to promote the development of IBD.

CONCLUSIONS: This integrative analysis identifies IRF1, GBP5, and PARP9 as potential genes associated with IBD pathogenesis. SMR analysis based on eQTL data revealed that IRF1 was significantly associated with the risk of IBD. The relationship between IRF1 and IBD risk highlights its potential as both a therapeutic target and diagnostic biomarker.

PMID:40611294 | DOI:10.1186/s12967-025-06531-1

J Orthop Surg Res. 2025 Jul 3;20(1):617. doi: 10.1186/s13018-025-06050-1.

ABSTRACT

OBJECTIVE: Effects of first-stage Halo-pelvic traction (HPT) combined with second-stage surgery in patients with severe scoliosis and pulmonary insufficiency.

METHODS: A retrospective analysis was conducted on the clinical data of 100 patients with scoliosis and pulmonary insufficiency admitted to the Beijing Da Wang Road Emergency Rescue Hospital from January 2021 to October 2024. All patients underwent primary HPT traction treatment and secondary scoliosis correction surgery. Changes in imaging and lung function indicators of patients before traction, after the last traction follow-up, and after internal fixation surgery. Pearson’s statistical correlation analysis was used to investigate the effect of the Cobb angle of the principal curvature on lung function indicators.

RESULTS: The lung function results of the included patients showed that restrictive ventilation function parameters increased to varying degrees (P < 0.05) before traction, during the last traction follow-up, and after the internal fixation surgery. Correlation analysis showed that as the Cobb angle of the main bend decreased, there was a significant negative correlation between lung restrictive ventilation function parameters (P < 0.05).

CONCLUSION: HPT traction can effectively correct severe scoliosis and improve respiratory function, making it a safe and effective adjunctive treatment.

PMID:40611293 | DOI:10.1186/s13018-025-06050-1

J Transl Med. 2025 Jul 3;23(1):739. doi: 10.1186/s12967-025-06679-w.

ABSTRACT

BACKGROUND: Corticosteroids are widely used in obstetric clinical practice for cases with signs of preterm labor to promote fetal lung maturity and reduce neonatal morbidity and mortality. Although short-term use is considered safe, there is ongoing debate regarding the dosage, therapeutic window, neonatal benefits, and maternal-fetal side effects, especially in high-risk pregnancies such as twins, where the impact remains unclear.

METHODS: This retrospective study included 1,997 twin pregnancies, divided into two groups: those who received antenatal corticosteroid therapy (ACS) and those who did not. To correct for baseline imbalances, the optimal overlap weighting scheme was selected by calculating the Absolute Standardized Mean Difference (ASMD) to minimize intergroup differences. The primary outcome, neonatal respiratory distress syndrome (NRDS), and other adverse outcomes in twin neonates were analyzed for the effect of ACS using logistic regression, with subgroup and interaction analyses based on key maternal pregnancy characteristics. Lastly, the Restricted cubic spline (RCS) method was used to examine the effect of ACS on neonatal respiratory disease incidence across different gestational ages at delivery.

RESULTS: After propensity score overlap weighting, results showed that although ACS treatment did not significantly improve the respiratory composite outcome in the overall preterm group, it effectively reduced the incidence of NRDS and pneumonia, while also decreasing the risk of low birth weight, small for gestational age (SGA), neonatal purpura, and neonatal hypoproteinemia. Notably, the risk of neonatal hypoglycemia and hyperbilirubinemia was significantly increased in the ACS treatment group. In both early and late preterm groups, there was no significant difference in the impact of ACS on NRDS and respiratory composite outcomes, but it remained effective in reducing the risks of neonatal pneumonia, low birth weight, and hypoproteinemia. In late preterm pregnancies, ACS significantly reduced the incidence of neonatal enteritis, lower gastrointestinal bleeding and neonatal infections, while in early preterm pregnancies, it significantly lowered the risk of neonatal hyperlacticemia. Subgroup analysis showed that for early preterm twin pregnancies with gestational diabetes mellitus (GDM), ACS treatment increased the incidence of NRDS and the neonatal respiratory composite outcome. Similarly, for twin pregnancies complicated by preeclampsia (PE), ACS treatment raised NRDS incidence in both overall and early preterm subgroups. Finally, RCS analysis indicated that ACS treatment may help reduce the risk of NRDS and other respiratory outcomes across different gestational ages at delivery, although this trend did not reach statistical significance. Sensitivity analysis showed similar results.

CONCLUSION: Antenatal corticosteroids, whether in early or late preterm births, may not prevent NRDS and respiratory composite outcomes in twin neonates, but they are effective in reducing adverse neonatal outcomes such as pneumonia, low birth weight, and hypoproteinemia. However, the occurrence of neonatal hypoglycemia and hyperbilirubinemia should be noted.

PMID:40611291 | DOI:10.1186/s12967-025-06679-w

BMC Nurs. 2025 Jul 3;24(1):835. doi: 10.1186/s12912-025-03510-1.

ABSTRACT

BACKGROUND: Previous studies have primarily examined overall resilience about coping strategies and demographics, overlooking individual heterogeneity. This study identifies distinct resilience profiles among nursing students, examines their associations with spiritual coping strategies, and determines demographic factors associated with these profiles.

METHOD: A cross-sectional study of 1,223 nursing students was conducted using convenience sampling from May 13 to 24, 2024. Latent profile analysis identified resilience subgroups, while the Bolck-Croon-Hagenaars approach assessed how spiritual coping strategies varied across profiles. The Three-Step Approach for Auxiliary Variables evaluated demographic predictors.

RESULT: Four resilience profiles emerged: low resilience-low strength (Profile 1), low resilience-balanced development (Profile 2), high resilience-balanced development (Profile 3), and high resilience-high tenacity (Profile 4). Positive spiritual coping strategies demonstrated progressively increasing mean scores, which were statistically significant from Profile 1 to 4. In negative spiritual coping strategies, the mean scores decreased progressively from Profile 1 to 3, with each decrease being statistically significant. Female students were likelier in Profiles 1 (β = -1.01, p < 0.05), 2 (β = -1.02, p < 0.001), and 3 (β = -0.73, p < 0.01) compared to Profile 4; Students with leadership experience were more often found in Profiles 3 (β = 0.66, p < 0.001) and 4 (β = 0.74, p < 0.01) compared to Profile 2, and students who live in urban areas were more likely to belong to Profile 4 than Profile 1 (β = 0.77, p < 0.05).

CONCLUSION: There was notable individual heterogeneity in resilience among students, with distinct differences in the use of spiritual coping strategies across these profiles. Future educational interventions promoting positive spiritual coping strategies could consider resilience as a core element. The primary focus of future resilience research and education should be on female students living in rural areas and students without leadership experience during college.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40611276 | DOI:10.1186/s12912-025-03510-1

BMC Health Serv Res. 2025 Jul 3;25(1):914. doi: 10.1186/s12913-025-13006-y.

NO ABSTRACT

PMID:40611273 | DOI:10.1186/s12913-025-13006-y

Ann Gen Psychiatry. 2025 Jul 3;24(1):42. doi: 10.1186/s12991-025-00579-5.

ABSTRACT

BACKGROUND: The causal relationship between keloid and mental disorders remains unclear. The aim of this study was to investigate whether keloid was causally associated with the risk of bipolar disorder (BD), anxiety, schizophrenia (SCZ), major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) using a bidirectional Mendelian randomization (MR) analysis.

METHODS: The large available genome-wide association study (GWAS) dataset of keloid, BD, anxiety, SCZ, MDD and PTSD was used for summary statistics. The bidirectional MR analyses were performed using a variety of methods of analysis including inverse variance weighting, MR-Egger regression, weighted median, simple modal and weighted modal methods. Sensitivity analyses were conducted using Cochran’s Q to estimate heterogeneity, and the MR-Egger method was used to estimate horizontal pleiotropy.

RESULTS: MR analysis showed that keloid susceptibility was associated with an increased risk of BD (OR = 1.027, 95% CI: 1.005-1.049, p = 0.015) and SCZ (OR = 1.023 (95% CI: 1.006-1.040, p = 0.006). We also observed a negative association between keloid and PTSD (OR = 0.903, 95% CI: [0.835-0.977], p = 0.011). There was no evidence for a causal relationship between keloid and anxiety (OR = 0.982, 95% CI: 0.961-1.004, p = 0.110) and MDD (OR = 0.997, 95% CI: 0.987-1.006, p = 0.476). Reverse MR analysis revealed that there was no causal relationship between keloid and the mental disorders.

CONCLUSION: This study provides evidence that there is a link between BD, SCZ, PTSD and keloid. However, there was no causal relationship between anxiety, MDD and keloid. This study may provide important clues and references for the study of keloid and mental disorders. We urge that the mental conditions of keloid patients should be taken into account in clinical practice and that necessary psychological support should be provided.

PMID:40611270 | DOI:10.1186/s12991-025-00579-5

J Neuroeng Rehabil. 2025 Jul 3;22(1):143. doi: 10.1186/s12984-025-01677-x.

ABSTRACT

BACKGROUND: Virtual reality (VR) technology offers immersive and interactive experiences and is increasingly being explored for rehabilitation therapies. However, concerns about side effects such as nausea and dizziness-collectively referred to as VR sickness-are holding back clinical translation. Sensorimotor mismatches, while potentially beneficial for motor learning, may exacerbate these effects. The age groups in VR applications differ, with younger users common in gaming and older adults prevalent in rehabilitation. This study investigated whether sensorimotor mismatches in a VR-based motor task make the experience more uncomfortable and whether older adults are more affected by these mismatches.

METHODS: We conducted a randomized controlled trial with 104 healthy right-handed adults, including elderly participants up to 84 years old, to cover the relevant demographics for rehabilitation. Participants were divided into three intervention groups and performed a VR ball-throwing task using an Oculus Rift S head-mounted display. The groups differed in task difficulty and exposure to deliberately induced sensorimotor mismatches. The design avoided visual-vestibular conflicts typically responsible for VR sickness and instead introduced proprioceptive mismatches during hand-object interaction. VR sickness was measured using the Simulator Sickness Questionnaire (SSQ), and user experience was assessed through a self-developed questionnaire. Statistical analysis was performed using rank-transformed ANOVA, ordinal logistic regression, and Spearman’s rho with FDR correction for multiple comparisons.

RESULTS: Results indicated no significant differences in SSQ scores among the three intervention groups, suggesting that sensorimotor mismatches do not increase VR sickness. However, the Mismatch group reported higher levels of exhaustion and frustration compared to the Error-based and Errorless groups, indicating the impact of cognitive strain and task difficulty on user experience. Interestingly, younger participants reported higher (worse) SSQ scores, while older participants experienced weaker symptoms.

CONCLUSIONS: VR environments with sensorimotor mismatches during hand-object interaction tasks may be feasible for rehabilitation, as they did not lead to significant discomfort in this setting. Moreover, despite concerns about age-related susceptibility to dizziness, older adults showed high tolerance to VR, supporting its potential for broader applications in rehabilitation settings. This study was reported in accordance with the CONSORT guidelines. It was registered in the German Clinical Trials Register (DRKS00034901).

PMID:40611269 | DOI:10.1186/s12984-025-01677-x

Lipids Health Dis. 2025 Jul 3;24(1):230. doi: 10.1186/s12944-025-02648-w.

ABSTRACT

BACKGROUND: This study employed representative data from the U.S. and China to delve into the correlation among migraine prevalence, the triglyceride‒glucose index, a marker of insulin resistance, and the composite indicator of obesity.

METHODS: Cross-sectional data were acquired from the National Health and Nutrition Examination Survey conducted between 1999 and 2004, as well as from the China Longitudinal Study of Health and Retirement (CHARLS) performed from 2011 to 2012. Weighted logistic regression analysis, subgroup analysis, smooth curve fitting and threshold effect analysis were used to ascertain the intricate relationships among triglyceride glucose-body mass index (TyG-BMI), triglyceride glucose-waist circumference (TyG-WC), triglyceride glucose-waist height ratio (TyG-WHtR) and migraine. Boruta’s algorithm and nine machine learning models were applied. SHapley Additive Explanations (SHAP) values were used to analyze leading models, highlighting influential features.

RESULTS: The analysis included 6,204 U.S. participants and 9,401 Chinese participants. TyG-BMI as well as TyG-WHtR were shown to be strongly correlated with the incidence of migraine among U.S. adults (TyG-BMI: OR = 1.28, 95% CI 1.14-1.44, P < 0.001; TyG-WHtR: OR = 1.17, 95% CI 1.09-1.26, P < 0.001). However, this correlation was not detected in Chinese adults. TyG-BMI indicated a strong positive association beyond the threshold of 206, while TyG-WHtR demonstrated a significant positive link below the cutoff of 7.4. In addition, age was an important interaction factor between TyG-BMI and TyG-WHtR and migraine. The XGBoost model showed excellent performance, with higher AUC values for TyG-BMI than for TyG-WHtR (0.929/0.926).

CONCLUSIONS: The TyG-BMI, relative to the TyG-WHtR, may provide clinicians with information about patients’ insulin sensitivity, thus helping to develop individualized treatment strategies. These findings contribute to population-level health interventions aimed at mitigating metabolic and neurological disease burdens, ensuring healthy lives and promoting well-being.

PMID:40611268 | DOI:10.1186/s12944-025-02648-w

Crit Care. 2025 Jul 3;29(1):269. doi: 10.1186/s13054-025-05429-0.

ABSTRACT

BACKGROUND: Despite advances in noninvasive neuromodulation for disorders of consciousness (DoC), the available evidence is inconclusive. We sought to elucidate the efficacy and safety of these interventions for DoC.

METHODS: We systematically searched Embase, EBSCO, CINAHL, Medline, PsycINFO, the Cochrane Library, and Web of Science from inception until 15 Mar, 2025, supplemented by manual searches from other sources. Randomised controlled trials (RCTs) comparing any noninvasive neuromodulation (e.g., transcranial direct current stimulation [tDCS], repetitive transcranial magnetic stimulation [rTMS], median nerve stimulation [MNS], trigeminal nerve stimulation [TNS], or transauricular vagus nerve stimulation [tVNS]) with sham control for DoC were selected. Relevant data were extracted. Primary efficacy outcome (change in levels of consciousness post intervention) and safety outcome (adverse events and dropout) were assessed. Effect sizes were pooled for standard pairwise meta-analyses using random-effects model and reported as Hedges’ g or risk ratio (RR) with 95% confidence interval (CI). Studies with less than five stimulation sessions were excluded. Methodological quality was assessed by the PEDro scale, risk of bias was evaluated using the RoB 2 tool. Heterogeneity was measured using τ² and I² statistic. The quality of evidence was performed using the Grade approach.

RESULTS: We included 24 studies and six studies (147 participants) provided data for meta-analysis. The methodological quality was good for all trials according to the PEDro scale, while most studies (18 out of 24 studies, 75%) were rated high risk of bias by the RoB 2 tool. For efficacy, the effect of rTMS (g = 0.49, 95% CI = 0.01, 0.98) and TNS (g = 0.59, 95% CI = 0.08, 1.10) for DoC compared with sham stimulation was medium, while tDCS was not more effective than sham control. No difference was found for dropout in TNS or rTMS compared with sham control.

CONCLUSIONS: Our findings provide evidence that rTMS and TNS showed more positive effects for DoC, while tDCS was no better than sham stimulation. While, due to the small number of patients in the different studies, the small number of studies and potential risk of bias in the meta-analysis, robust evidence of noninvasive neuromodulation for patients with DoC is lacking. These findings highlight the importance of precision in targeting noninvasive neuromodulation for patients with DoC, RCTs with high-quality methodological design, conduct and reporting. Trial registration PROSPERO Identifier: CRD42024499177. Registered 20 January 2024.

PMID:40611258 | DOI:10.1186/s13054-025-05429-0