Category: Statistics

Parasit Vectors. 2025 Jul 15;18(1):284. doi: 10.1186/s13071-025-06917-6.

ABSTRACT

BACKGROUND: Chagas disease, caused by the protozoan Trypanosoma cruzi, remains a significant public health issue in South America, with increasing concern over its potential transmission in the USA. Triatoma sanguisuga, a triatomine vector, is found in Southern states of the USA, including Texas, raising questions about the local transmission dynamics of T. cruzi. This study aims to characterize Trypanosoma cruzi infection in Triatoma sanguisuga collected from dog kennels in Bulverde and Spring Branch, Texas, with a focus on parasite prevalence and load, genotypic diversity, and blood-feeding sources.

METHODS: A total of 48 T. sanguisuga insects were collected from kennels in Bulverde (N = 37) and Spring Branch (N = 11). DNA extraction was followed by quantitative polymerase chain reaction (qPCR) to detect and quantify T. cruzi, genotyping via Oxford Nanopore Sequencing of the Miniexon gene, and blood-feeding source identification using the 12S rRNA gene was also conducted. Statistical analysis was performed to assess differences in parasitic load among the locations.

RESULTS: Of the 48 insects, 81.1% from Bulverde and 100% from Spring Branch tested positive for T. cruzi. The median parasitic load was log₁₀ 8.09 equivalent parasites/mL, with significant differences in parasitic load between locations. Genotyping revealed that all samples were infected with TcI, with some co-infection of TcI and TcIV. Blood meal analysis identified multiple feeding sources, including dogs (Canis lupus), humans (Homo sapiens), and wildlife species.

CONCLUSIONS: This study provides insights into T. cruzi transmission dynamics in southern Texas, demonstrating the active role of domestic dogs and wildlife in the local cycle of infection suggesting endemism of T. cruzi in this region. These findings emphasize the need for continued surveillance and vector control measures to mitigate the risk of Chagas disease transmission in the USA.

PMID:40665373 | DOI:10.1186/s13071-025-06917-6

Child Adolesc Psychiatry Ment Health. 2025 Jul 15;19(1):77. doi: 10.1186/s13034-025-00942-0.

ABSTRACT

BACKGROUND: Burnout symptoms and secondary traumatic stress are especially high among Child Welfare Workers (CWWs) and psychotherapists and might have increased since the recent increase in refugee numbers. Little is known about the wellbeing of CWW and psychotherapists working with unaccompanied young refugees (UYR), especially in German child and youth welfare facilities where they work closely together. This study aims to assess levels of compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) in German CWWs and psychotherapists, examining connections to demographic variables and group differences.

METHODS: N = 198 CWW and N = 97 psychotherapists were assessed via the Professional Quality of Life Scale (ProQOL). Descriptive statistics, t-test for independent samples, correlations between the ProQOL scales and hierarchical regression analyses with demographic variables as predictors were computed.

RESULTS: Both samples showed average to high levels of CS, and low to average levels of BO and STS. CWWs scored significantly higher than psychotherapists on BO and STS. In CWW, demographic variables were not associated with CS, BO or STS. Among psychotherapists, previous experiences in working with UYR (β = 0.38; p <.001) were positively associated with CS. Factors such as weekly therapy sessions (β = – 0.35, p =.001) and the psychotherapist’s migration background (β = – 0.20, p =.048) were negatively associated with STS. The number of PTSD cases treated (β = 0.27, p =.018) and additional training (β = 0.31, p =.006) were positively associated with STS.

CONCLUSION: Among psychotherapists, prior experience in working with UYRs may contribute to elevated levels of CS, whereas a higher number of previously treated PTSD cases appears to be associated with increased STS. Further research on the influence of sociodemographic variables is needed for CWWs to identify protective and risk factors. Supporting and training CWWs and psychotherapists is crucial for quality treatment of traumatized UYRs.

PMID:40665365 | DOI:10.1186/s13034-025-00942-0

Cardiovasc Diabetol. 2025 Jul 15;24(1):289. doi: 10.1186/s12933-025-02824-3.

ABSTRACT

BACKGROUND: We investigated the risk of type 2 diabetes (T2DM) and related comorbidities including cardiovascular disease (CVD), and mortality, based on changes in metabolic dysfunction associated steatotic liver disease (MASLD).

METHODS: We analyzed data from the Korean National Health Insurance Service for individuals aged ≥ 20 years. MASLD was defined as a fatty liver index (FLI), a prediction formula based on metabolic parameters, with a cutoff of ≥ 60. FLI measurements were compared within each individual over a 2 years period. Based on changes in FLI between two health checkups, individuals were classified into four categories; never MASLD (FLI consistently < 60), incident MASLD (FLI < 60 to ≥ 60), regressed MASLD (≥ 60 to < 60), and persistent MASLD (FLI consistently ≥ 60). The primary outcome was T2DM occurrence in the general population and myocardial infarction (MI), ischemic stroke, heart failure (HF) and mortality events in individuals with preexisting T2DM with adjustment for age, sex, smoking, alcohol drinking, and regular exercise.

RESULTS: In 4,397,808 individuals without T2DM, 229,475 (5.2%) developed T2DM during a median follow-up period of 7.3 years. The risk of incident T2DM was the highest in individuals with persistent MASLD compared to those who never had MASLD (HR = 5.28, 95% CI = 5.22-5.34). Individuals with incident or regressed MASLD also had increased risk of developing T2DM (HR = 3.30, 95% CI = 3.25-3.35 for incident MASLD, HR = 2.87, 95% CI = 2.82-2.92 for regressed MASLD). In a cohort of 636,520 individuals with preexisting T2DM followed for a median of 6.2 years, those with persistent MASLD had a higher risk of HF (HR = 1.28, 95% CI = 1.25 to 1.32), MI (HR = 1.15, 95% CI = 1.10 to 1.20), stroke (HR = 1.14, 95% CI = 1.09 to 1.19) and all-cause mortality (HR = 1.11, 95% CI = 1.09-1.14) compared to individuals who never had MASLD. Similarly, both incident and regressed MASLD were associated with an increased risk for HF, MI, stroke and all-cause mortality.

CONCLUSIONS: Persistent MASLD is associated with an increased risk of incident T2DM, and further elevates the risk of CVD, and mortality among individuals with T2DM. Even individuals with incident or regressed MASLD exhibit an increased risk of these adverse outcomes compared to those who never had MASLD.

TRIAL REGISTRATION: N/A.

PMID:40665356 | DOI:10.1186/s12933-025-02824-3

BMC Vet Res. 2025 Jul 15;21(1):468. doi: 10.1186/s12917-025-04919-1.

ABSTRACT

BACKGROUND: Non-invasive temperature measurement using infrared cameras has become increasingly important for monitoring physiological changes and stress responses in animals, offering advantages over traditional rectal thermometry. However, previous methods often suffered from limitations such as environmental interference, instantaneous measurement, and inaccurate region of interest (ROI) selection due to manual settings. To overcome these limitations, studies have combined infrared cameras with AI-based segmentation to enable accurate ROI detection and to capture temporal temperature change patterns in cattle. Furthermore, the interpretability of eye and muzzle temperature measurements can vary depending on which subregions are analyzed, as areas with richer vascularization tend to display more representative temperature characteristics. To address these issues, the present study applied AI-based segmentation to infrared thermography and focused on the analysis of high-temperature, vascularized subregions within the eyes and muzzles of calves. By doing so, we aimed to enhance the clarity and reliability of temperature change pattern analysis for non-invasive monitoring of physiological status in cattle.

METHODS: Thermal images were captured using a mobile infrared camera, and video recordings were obtained simultaneously from 11 calves. AI-based segmentation, utilizing previously trained weights, was used to automatically extract eye and muzzle ROIs from video images. 33 imaging sessions where the majority of frames exhibited reliable segmentation were selected for analysis. In Experiment 1, temperature data corresponding to the mean, top 10%, and top 30% values within each ROI underwent preprocessing steps (outlier rejection, standardization, and low-pass filtering) to derive temperature change patterns. This process generated six patterns per session (three for eyes and three muzzle regions), yielding a total of 198 patterns across all 33 image sessions. Cosine similarity analysis was then applied to quantify similarity within the same session. In Experiment 2, each ROI was divided into a 3 × 3 grid to map the distribution of high temperature values for spatial analysis. Statistical analyses included Kruskal-Wallis tests with Bonferroni corrections to assess regional differences.

RESULTS: In Experiment 1, for the eyes, the patterns derived from the top 10% and 30% of temperatures had high cosine similarity (0.94). In contrast, the patterns based on the mean values had relatively lower similarities with the top 10% and 30% patterns (0.81 and 0.86, respectively). A similar trend was observed for the muzzle: the top 10% and 30% patterns had a high cosine similarity (0.93), while the patterns based on the mean values showed lower similarities (0.80, and 0.86). In Experiment 2, for the eyes, the top 10% of temperature values were mainly in the bottom region. In comparison, the top 30% of values were more evenly distributed in the mid and bottom regions. For the muzzles, the top 10% of temperature values were mainly distributed in both the top and bottom regions, and the top 30% of values were concentrated in the mid region.

CONCLUSION: This study demonstrates that integrating AI-based segmentation with infrared thermography enables precise identification of thermally reliable subregions within the eyes and muzzles of calves, leading to the extraction of temperature change patterns with high temporal consistency. The top 10% and 30% temperature values within these regions show higher pattern similarity than mean values, with distinct spatial distributions reflecting underlying vascular anatomy. Focusing on these high-temperature, vascularized subregions enhances the interpretability and reliability of temperature change pattern analysis for non-invasive monitoring of stress and physiological status in cattle, contributing to enhanced animal welfare.

PMID:40665350 | DOI:10.1186/s12917-025-04919-1

J Orthop Surg Res. 2025 Jul 15;20(1):659. doi: 10.1186/s13018-025-06092-5.

ABSTRACT

BACKGROUND: Novel oral anticoagulants (NOACs), including rivaroxaban, apixaban, edoxaban and dabigatran, are increasingly used for orthopaedic surgery patients. The aim of this study was to evaluate the efficacy and safety of NOACs in preventing venous thromboembolism (VTE) among patients with lower limb fractures.

MATERIALS AND METHODS: This meta-analysis included randomized controlled trials (RCTs). The PubMed, Embase, Cochrane Library, and Web of Science databases were comprehensively searched from inception to November 27, 2024. We evaluated the risk of bias via the Cochrane Risk of Bias Tool 2.0 (RoB 2.0). The efficacy outcomes focused on VTE, deep vein thrombosis (DVT), and pulmonary embolism (PE), and the safety outcomes focused on major bleeding events. Two researchers screened the literature on the basis of the inclusion and exclusion criteria, evaluated the quality of the included studies, extracted the data, and conducted a meta-analysis using RevMan 5.4.1.

RESULTS: The systematic search yielded 2,873 unique citations after deduplication. Ultimately, five RCTs involving 4,092 participants (2,066 participants in the NOAC group (rivaroxaban and edoxaban) and 2,026 participants in the LMWH group) were included. Pooled analysis revealed that NOACs reduced the incidence rate of DVT [OR = 0.48, 95% CI (0.23-0.97), P = 0.04; I²=10%]. However, there was no significant difference in the incidence of VTE [OR = 0.42, 95% CI (0.16-1.11), P = 0.08; I²=34%], PE [OR = 0.33, 95% CI (0.05-2.08), P = 0.24; I²=0%] or major bleeding [OR = 1.01, 95% CI (0.57-1.77), P = 0.98; I²=0%] between the LMWH group and the NOACs group.

CONCLUSIONS: Compared with LMWH, NOACs were associated with a lower risk of DVT in patients with lower limb fractures, although there was no statistically significant difference in preventing VTE, PE and major bleeding.

CLINICAL TRAIL NUMBER: No. CRD42024619453.

PMID:40665327 | DOI:10.1186/s13018-025-06092-5

BMC Med Educ. 2025 Jul 15;25(1):1058. doi: 10.1186/s12909-025-07673-y.

ABSTRACT

BACKGROUND: Cone Beam Computed Tomography (CBCT) plays a critical role in oral and maxillofacial surgery (OMFS), yet the training needs of residents regarding CBCT viewer interfaces remain underexplored. Effective utilization of these interfaces is essential for accurate diagnosis and treatment planning. This study aims to assess OMFS residents’ competencies in CBCT viewer interfaces and identify training gaps through a usability framework.

METHODS: OMFS residents participated in a usability evaluation of five CBCT viewer interfaces (VIS: Icad Vision, NNT: Newtom, ODM: OnDemand, OVV: OneVolume Viewer, ROM: Planmeca Romexis). Effectiveness was measured through task completion rates, efficiency through task duration, mouse clicks, and cursor distance, and satisfaction using the System Usability Scale (SUS) and the Computer System Usability Questionnaire (CSUQ). Statistical analysis included Friedman and Dunn’s tests with Benjamini-Hochberg correction.

RESULTS: Residents reported receiving no hands-on CBCT training and relied only on verbal instruction during dental school, suggesting a lack of structured training. All of them successfully completed tasks on all interfaces, indicating 100% effectiveness. However, significant differences in efficiency and satisfaction were observed, reflecting varying levels of proficiency and highlighting areas where further training could be beneficial. VIS interface required significantly more time (198.4 ± 70.44 s) and mouse clicks (69.82 ± 33.17, p < 0.05) compared to other interfaces, suggesting a need for additional practice with this interface. The ODM interface achieved the highest SUS score (69.89 ± 22.79), while the VIS interface had the lowest (41.82 ± 22.90) (p < 0.05). Only ODM approached the industry-standard threshold for user satisfaction, while the remaining systems failed to meet this criterion.

CONCLUSIONS: This study highlights the need for structured training in CBCT viewer interfaces for OMFS residents. Findings suggest that a standardized, hands-on multi-software program should be integrated into residency curricula to improve efficiency, reduce cognitive load, and enhance clinical decision-making. Future research should focus on the long-term impact of usability-driven training on clinical performance and patient outcomes.

PMID:40665326 | DOI:10.1186/s12909-025-07673-y

Hum Resour Health. 2025 Jul 15;23(1):34. doi: 10.1186/s12960-025-01010-6.

ABSTRACT

BACKGROUND: The global nursing shortage is a growing concern, particularly in regions experiencing rapid population growth and healthcare transformation. This study examines trends and regional inequalities in Saudi Arabia’s nursing workforce distribution from 2019 to 2023 within the context of Saudi Vision 2030 and the Health Sector Transformation Program.

METHODS: Data from the Ministry of Health’s 2023 Statistical Yearbook were used for this study. Nurse-to-1 000 population ratios were calculated across 20 health regions. Inequality in the nursing distribution was assessed using Gini coefficients and Lorenz curves, disaggregated by sector (Ministry of Health vs. private health sector) and nationality (Saudi vs. non-Saudi).

RESULTS: The national nursing workforce increased by 9% from 2019 to 2023, reaching 213 110 nurses. However, nurse-to-population ratios varied significantly across regions, ranging from 3.13 to 9.89 per 1 000 people. The overall Gini coefficient was 0.48, indicating a relatively unequal distribution of nurses across regions. Inequalities were more pronounced in the private health sector (Gini coefficient = 0.69) and among non-Saudi nurses (Gini coefficient = 0.59). While Saudization efforts led to a modest increase-Saudi nationals comprised 44.22% of the nursing workforce in 2023-localization remained uneven across regions and healthcare sectors.

CONCLUSION: Despite workforce growth and increased localization, Saudi Arabia continues to face considerable regional inequalities in nursing distribution. These disparities require targeted workforce policy interventions, including expanding nursing education opportunities, optimizing working conditions, and implementing strategic workforce plans to distribute nursing resources more equitably. Additionally, offering incentives for deployment in underserved regions will be critical.

PMID:40665319 | DOI:10.1186/s12960-025-01010-6

Appl Physiol Nutr Metab. 2025 Jul 15. doi: 10.1139/apnm-2025-0095. Online ahead of print.

ABSTRACT

Metabolic carts are commonly used to estimate oxygen consumption (V̇O2) during exercise, but are largely limited to controlled laboratory settings. The V̇O2 Master Pro (VMP) is a newer, portable metabolic analyzer designed to address this limitation; however, few studies have evaluated the validity of this device at varying activity levels.

OBJECTIVE: To assess the validity of the VMP in measuring V̇O2 compared with a stationary metabolic cart, the COSMED Quark CPET (CQ), during sedentary activity and treadmill walking/jogging in a laboratory setting.

APPROACH: Twenty-seven healthy adults [mean age=22.1±7.6 years; female=51.8%] participated in two laboratory trials on separate days. In a counterbalanced order, participants used the CQ and VMP during 10-minute conditions of the following activities: sedentary activity (sitting quietly), slow walking (3.2 km/h), brisk walking (5.6 km/h), and jogging (7.2 km/h). The agreement between the two measures was evaluated using equivalence testing, mean absolute percentage error (MAPE), percentage bias, intraclass correlation coefficients (ICCs), and Bland-Altman analyses.

MAIN RESULTS: The devices showed low agreement and significant proportional biases across all activity levels [ICCs=0.135-0.323]. Equivalence testing did not demonstrate statistically significant equivalence between the devices (p>.05), with the VMP underestimating V̇O2. The smallest error appeared during jogging [MAPE=20.05%; percentage bias= -19.29%].

SIGNIFICANCE: The VMP underestimated V̇O2 at all tested intensities, demonstrating low accuracy and agreement relative to the reference measure. This may be attributed to limited ventilatory flow capture or sensor responsiveness during submaximal activities. Observed bias and within-subject variability suggest caution when using the VMP across different submaximal activity levels.

PMID:40663800 | DOI:10.1139/apnm-2025-0095

J Nurs Educ. 2025 Jul 16:1-5. doi: 10.3928/01484834-20250415-03. Online ahead of print.

ABSTRACT

BACKGROUND: Feedback-seeking behavior is crucial for the growth and adaptability of advanced learners. This project aimed to enhance feedback-seeking behaviors in Accelerated Bachelor of Science in Nursing (ABSN) students through an evidence-based educational intervention.

METHOD: Feedback-seeking behaviors were assessed via pre- and posttests. Quantitative data were analyzed using descriptive and inferential statistics, while open-ended responses underwent content analysis. The intervention included an in-person educational session on feedback-seeking behavior.

RESULTS: The intervention significantly boosted students’ confidence in seeking feedback, with 80% reporting higher confidence postintervention compared with 53.3% preintervention (mean difference = 0.73, p < .0104). Faculty responses supported these findings (mean difference = 1.33, p < .057). Students showed a strong preference for private feedback settings (100%) and sought feedback to enhance traits, abilities, and skills (80%).

CONCLUSION: The educational intervention positively influenced ABSN students’ feedback-seeking behaviors and is recommended for broader application. [J Nurs Educ. 2025;64(X):XXX-XXX.].

PMID:40663798 | DOI:10.3928/01484834-20250415-03

JMIR Hum Factors. 2025 Jul 15;12:e70034. doi: 10.2196/70034.

ABSTRACT

BACKGROUND: Malaysia, an upper middle-income country in the Asia-Pacific region, has an HIV epidemic that has transitioned from needle sharing to sexual transmission, mainly in men who have sex with men (MSM). MSM are the most vulnerable population for HIV in Malaysia. In 2022, our team developed a web-based artificial intelligence (AI) chatbot and tested its feasibility and acceptability among MSM in Malaysia to promote HIV testing. To enhance the usability of the AI chatbot, we made it accessible to the public through the website called MYHIV365 and tested it in an observational study.

OBJECTIVE: This study aimed to test the usability of an AI chatbot in promoting HIV testing among MSM living in Malaysia.

METHODS: This observational study was conducted from August 2023 to March 2024 among 334 MSM. Participants were recruited through community outreach and social-networking apps using flyers. The interactions between participants and the AI chatbot were documented and retrieved from the chatbot developer’s platform. Data were analyzed following a predefined metrics using R software (Posit Software, PBC).

RESULTS: The AI chatbot interacted with 334 participants, assisting them in receiving free HIV self-testing kits, offering information on HIV, pre-exposure prophylaxis (PrEP), and mental health, and providing details of 220 MSM-friendly clinics, including their addresses, phone numbers, and operating hours. After the study, 393 human-chatbot interactions were documented on the chatbot developer’s platform. Most participants (304/334, 91.0%) interacted with the AI chatbot once, 30 (9.0%) engaged 2 or more times at different intervals. Participants’ interaction time with the chatbot varied, ranging from 1 to 31 minutes. The AI chatbot properly addressed most participants’ questions (362/393, 92.1%) about HIV and PrEP. However, in 31 interactions, participants posed additional questions to the chatbot that were not programmed into the chatbot algorithms, resulting in unanswered interactions.

CONCLUSIONS: The web-based AI chatbot demonstrated high usability in delivering HIV self-testing kits and providing clinical information on HIV testing, PrEP, and mental health services. To enhance its usability in community and clinical settings, the chatbot must offer personalized health information and precise interaction, powered by sophisticated machine learning algorithms. In addition, establishing an effective connection between the AI chatbot and health care systems to eliminate stigma and discrimination toward MSM is crucial for the future implementation of AI chatbots.

PMID:40663792 | DOI:10.2196/70034