Tag: pubmed

Int J Behav Nutr Phys Act. 2025 Feb 25;22(1):22. doi: 10.1186/s12966-025-01720-z.

ABSTRACT

BACKGROUND: In a stepped wedge design, schools are randomised to a sequence of measurements, with each sequence transitioning to intervention status at a different time. There are several advantages to such designs, including increased statistical power, logistical benefits and the ability to explore change over time. However, stepped wedge designs have not previously been used to evaluate school-based physical activity interventions in children. This paper aimed to explore the feasibility of this design, by identifying school constraints, balancing these with statistical considerations and exploring the power of this chosen design under different scenarios.

METHODS: We conducted three interlinked studies, with the results from one informing the next. Study 1 was a qualitative study to identify school constraints that inform the choice of stepped wedge configuration. Study 2 used simulation to choose a configuration that balanced these school constraints and statistical properties. Study 3 explored the statistical power for the chosen design for different school and pupil sample sizes, using an open cohort design (a mixture of new and repeated pupils).

RESULTS: School staff considered the proposed data collection feasible, and supported a maximum of 3-4 measurements per year and an implementation period of one school term. Study 2 therefore considered incomplete stepped wedge designs with five steps. Statistically, the best designs had a mix of control and intervention measurements in terms 2-4 and a spread of measurements across the whole study duration. Power depended on a combination of the overall recruitment rate and the retention rate. For 20 schools with an eligible class size of 30 pupils, we would be able to detect a 6 min difference in average weekday moderate-to-vigorous physical activity with 80% power, provided there were > 50% of pupils measured per school at each time. A similarly powered cluster randomised controlled trial would require 42 schools.

CONCLUSION: Stepped wedge trials are a viable design for evaluating school-based physical activity interventions. Incomplete designs, where not all schools are measured at each point, offer the flexibility to work around practical constraints.

PMID:40001100 | DOI:10.1186/s12966-025-01720-z

BMC Ophthalmol. 2025 Feb 25;25(1):95. doi: 10.1186/s12886-025-03928-w.

ABSTRACT

BACKGROUND: We examined the relationship between contrast sensitivity (CS) and visual field stage/severity in patients with open-angle glaucoma (OAG), and correlated CS with Quality of Vision (QOV) scores.

METHODS: CS was measured under photopic (100 cd) and mesopic (10 cd) conditions in 218 eyes of 109 patients with OAG aged < 60 years. The glaucoma stages were divided into four groups according to the mean deviation (MD) of the Humphrey Field Analyzer (HFA) 24 – 2 or 10 – 2 Swedish Interactive Thresholding Algorithm (SITA) standard, and their relationship with CS was examined.

RESULTS: The results of the Japanese version of the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) in 79 patients were converted into Rasch scores and correlated with CS. Both HFA24-2 and 10 – 2 showed statistically significant improvements in all items except 10.2 cycles per degree (cpd) under mesopic conditions where CS decreased significantly (p < 0.05). Correlations between CS and NEI VFQ-25 Rasch scores were stronger in the worse eye (WE) at HFA24-2, 10 – 2, and foveal sensitivity thresholds. The measurement results strongly correlated under photopic conditions. Comparing the correlations at HFA24-2, 10 – 2, and foveal sensitivity thresholds, the correlation was strongest at the foveal sensitivity threshold.

CONCLUSIONS: CS declines with progression in the visual field stage or severity. QOV score tends to decreases with a decline in CS.

PMID:40001099 | DOI:10.1186/s12886-025-03928-w

BMC Psychiatry. 2025 Feb 25;25(1):168. doi: 10.1186/s12888-025-06612-x.

ABSTRACT

OBJECTIVE: This study investigates the association between the Weekend Warrior (WW) pattern and the risk of anxiety among American adults, offering insights into a more flexible exercise strategy for individuals with limited time for regular exercise during weekdays.

METHODS: We analyzed data from the 2007-2012 National Health and Nutrition Examination Survey (NHANES) to examine the relationship between different physical activity (PA) patterns and the risk of anxiety. Multivariate logistic regression, subgroup interaction, restricted cubic spline analysis (RCS), and sensitivity analyses were conducted to assess this association.

RESULTS: Compared to inactive individuals, those engaging in WW pattern (OR = 0.65, 95% CI: 0.48-0.90, p = 0.010), insufficiently active (OR = 0.71, 95% CI: 0.62-0.82, p < 0.001), or regularly active pattern (OR = 0.75, 95% CI: 0.65-0.87, p < 0.001) showed significantly lower risk of anxiety. Subgroup interaction analyses revealed significant effect modification in the poverty income ratio (PIR) and diabetes subgroups (P for interaction < 0.05), while no significant interactions were observed for other variables. RCS analysis showed a significant nonlinear relationship between recreational moderate to vigorous intensity physical activity and risk of anxiety (P for nonlinear < 0.001). Sensitivity analyses further confirmed the stability of the findings.

CONCLUSION: The WW pattern was associated with a lower risk of anxiety. For individuals unable to exercise consistently throughout the week, the WW pattern offers a practical alternative for reducing the risk of anxiety, particularly among those with lower income levels or diabetes.

PMID:40001092 | DOI:10.1186/s12888-025-06612-x

J Transl Med. 2025 Feb 25;23(1):226. doi: 10.1186/s12967-024-06030-9.

ABSTRACT

BACKGROUND: Osteonecrosis (ON) is a debilitating orthopedic condition characterized by bone cell death due to impaired blood supply, leading to structural changes and disability. Osteoporosis (OP), a systemic skeletal disease, results in reduced bone density and quality, making bones fragile and prone to fractures. Although distinct, OP and ON share several risk factors such as corticosteroid use and smoking. This study aims to investigate the causal relationships between OP, bone mineral density (BMD), and ON using a bidirectional two-sample Mendelian randomization (MR) approach.

METHODS: This study utilized genome-wide association study (GWAS) data for OP from the FinnGen database, and BMD data for the lumbar spine and femoral neck from the Genetic Factors for Osteoporosis (GEFOS) consortium. ON data were also obtained from the FinnGen database. All participants were of European descent. Genetic instruments were selected based on genome-wide significance, linkage disequilibrium, and strength (F-statistic). Bidirectional MR analysis was performed using inverse-variance weighted (IVW), MR-Egger regression, and weighted median methods to assess causality. Sensitivity analyses, including Cochran’s Q test and MR-PRESSO, were conducted to evaluate heterogeneity and pleiotropy.

RESULTS: MR analysis demonstrated a positive causal effect of OP on ON using the IVW method, with an odds ratio (OR) of 1.223 (95% CI: 1.026-1.459, P = 0.025). The weighted median method also confirmed this result with an OR (95% CI) 1.290 (1.021-1.630), P = 0.033. No significant causal effects were found between BMD (lumbar spine and femoral neck) and ON. Furthermore, ON did not exhibit a causal effect on OP or BMD. Sensitivity analyses confirmed the robustness of the results, showing no evidence of heterogeneity or pleiotropy.

CONCLUSION: This study provides evidence of a unidirectional causal relationship between OP and ON, suggesting that individuals with a genetic predisposition to OP have an increased risk of developing ON. These findings highlight the importance of early OP detection and management to potentially reduce ON incidence. The lack of a significant causal relationship between BMD and ON indicates that factors other than bone density, such as vascular health, may play a crucial role in ON development. Future research should explore these mechanisms further to inform clinical interventions.

PMID:40001090 | DOI:10.1186/s12967-024-06030-9

BMC Musculoskelet Disord. 2025 Feb 25;26(1):190. doi: 10.1186/s12891-025-08392-7.

ABSTRACT

OBJECTIVE: To evaluate the effectiveness and cost-effectiveness of physiotherapy, chiropractic care, and the combination of physiotherapy and chiropractic care compared with information and advice for the treatment of patients with nonspecific chronic low-back pain (CLBP) in Sweden.

DESIGN: A multicentre pragmatic randomized controlled trial.

SETTING: Ten primary care rehabilitation units in Sweden.

PARTICIPANTS: Eighty-eight participants with nonspecific CLBP.

INTERVENTIONS: The participants were randomly assigned to receive physiotherapy, chiropractic care, combination treatment, or information and advice.

MAIN OUTCOME MEASURES: This study measured the Oswestry Disability Index (ODI), health-related quality of life (HRQoL), quality-adjusted life-years (QALYs), working status, and costs.

RESULTS: The study revealed no statistically significant differences in any of the outcome measures when physiotherapy, chiropractic care, and combination treatment with information and advice were compared (p > 0.05). The ODI changes between baseline and the 6-month follow-up ranged from 6.13 to 12.56 across the treatment groups, indicating reduced disability in all groups. Compared with the other treatment options, the combination treatment resulted in the greatest QALY gain (0.418) and lowest cost (SEK 3,081).

CONCLUSION: Compared with alternative standalone treatment options, the combination treatment strategy resulted in greater QALY gain and lower costs from a heath care perspective. Although the study did not detect statistically significant differences in outcomes or costs among the treatment options, the combination treatment showed promising potential for cost-effectiveness. Given the small sample size and low statistical power of the study, further clinical trials with fewer treatment arms and a focus on the combination group are warranted to confirm these findings. The insights gained from this study are important for informing the design and conduct of future clinical studies investigating the effectiveness, costs and cost-effectiveness of treatments for CLBP.

TRIAL REGISTRATION: The study is registered in the ISRCTN registry (2017-02-20: ISRCTN15830360).

PMID:40001085 | DOI:10.1186/s12891-025-08392-7

J Orthop Surg Res. 2025 Feb 25;20(1):199. doi: 10.1186/s13018-025-05621-6.

ABSTRACT

OBJECTIVE: To systematically evaluate the effects of vertebroplasty (VP) and kyphoplasty (KP) on pain and spinal imaging parameters in patients with osteoporotic vertebral compression fractures (OVCF).

METHODS: A comprehensive search of eight databases was conducted from inception to November 2024 to identify randomised controlled trials (RCTs) published in Chinese and English. Eligible studies included clinical RCTs comparing KP and VP in patients with OVCF, assessing vertebral pain and imaging parameters. Risk of bias and methodological quality were assessed using the Cochrane Appraisal Tool. Combined effects were calculated using a random effects model. Heterogeneity was assessed using the I² test.

RESULTS: A total of 16 randomised controlled trials involving 1738 patients were included. The analysis revealed no statistically significant difference between KP and VP in pain reduction (SMD = 0.08, 95% CI = -0.04 to 0.20, P = 0. 19) or spinal function (SMD = 0.04, 95% CI = -0.11 to -0.19, P = 0. 62). However, KP demonstrated significantly better outcomes than VP in vertebral compression rate (SMD = 1.39, 95% CI = 0.81 to 1.96, P < 0. 00001), Cobb angle (SMD = 1.83, 95% CI = 0.99 to 2.68, P < 0. 0001) and the incidence of cement leakage (OR = 1.92, 95% CI = 1.41 to 2.62, P < 0. 0001).

CONCLUSION: Our results suggest that KP is more effective than VP in improving postoperative vertebral compression rate and Cobb angle, and reducing the incidence of cement leakage.

PMID:40001072 | DOI:10.1186/s13018-025-05621-6

BMC Public Health. 2025 Feb 25;25(1):775. doi: 10.1186/s12889-025-21990-3.

ABSTRACT

BACKGROUND: This study explores the impact of HIV/AIDS on urban slum dwellers in Dhaka, Bangladesh, addressing unique socio-economic challenges and limited health resources. Despite low overall prevalence, gender inequalities, economic disparities, and awareness gaps persist. The aim is to assess HIV/AIDS-related knowledge, attitudes, and practices among this population, informing targeted interventions.

METHODS: A cross-sectional survey was conducted using face-to-face interviews in Dhaka’s slum areas between October and November 2023. The sample size was calculated as 453 participants through non-probability (convenient sampling) sampling. A structured questionnaire in Bengali assessed socio-demographic factors, HIV/AIDS-related knowledge, attitudes, and prevention practices. Data were analysed using descriptive statistics, bivariate, and multivariable linear regression by SPSS (version 26) and STATA (version 14).

RESULTS: Urban slum dwellers exhibited limited average HIV/AIDS knowledge of 33.00%, favouring males. Positive association was found between daily physical exercise and knowledge, while insufficient sleep and lack of social media access were negative predictors. Average attitudes were generally positive (81.06%), influenced by factors such as gender, employment status, family history of STDs, and daily physical exercise. The average score of prevention practices was 60.6%, with positive predictors including male gender, cooperative family members, STD history, family history of STDs, acquaintance with HIV patients, and social media usage over 2 h. Younger age was negatively associated with prevention practices.

CONCLUSION: This study pinpoints factors influencing HIV/AIDS knowledge and behaviours in Bangladeshi urban slum dwellers. Tailored interventions focusing on gender, and social media can enhance preventive measures. Acknowledging limitations, the study urges cautious interpretation due to potential biases in convenience sampling and self-reporting.

PMID:40001071 | DOI:10.1186/s12889-025-21990-3

BMC Psychiatry. 2025 Feb 25;25(1):175. doi: 10.1186/s12888-025-06625-6.

ABSTRACT

INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) is among the most common neurodevelopmental diseases affecting children and adolescents all over the world. There is limited evidence on the magnitude of ADHD among children in the Southern Nation and Nationality region in Ethiopia. Therefore, this study aimed to assess the magnitude and associated factors of ADHD among children aged 6-17 years in Arba Minch town, Southern Ethiopia.

METHODS: A community-based cross-sectional study was conducted in Arba Minch city from April 5 to May 5, 2023. A study included 520 participants. A multistage sampling followed by systematic random sampling was used to select the study participants. The Vanderbilt ADHD diagnostic DSM-IV criteria using a pre-tested, structured questionnaire with a face-to-face interview were used to assess the outcome. For data entry and analysis, Epi Info version 7 and STATA version 14 software were used, respectively. Variables with a p < 0.25 from the bivariate analysis were considered for the multivariable analysis. The multivariable logistic regression analysis was performed to identify statistically significant variables with a p-value of < 0.05. The adjusted odds ratio presented the strength of the association with a 95% confidence interval.

RESULT: The prevalence of ADHD was found to be 9.77% (95% CI; 7.47-12.66) in Arbaminch city. Family history of mental illness (AOR = 2.27; 95% CI: 1.15-4.45), children with a history of previous mental health problems (AOR = 7.11; 95% CI: 1.66-30.41), children whose mothers used alcohol during pregnancy (AOR = 3.36; 95% CI: 1.41-7.99), and children whose mothers smoked tobacco during their lifetime (AOR = 4.17; 95% CI: 1.05-16.89) were significantly associated with attention-deficit hyperactivity disorder.

CONCLUSION: According to this study, one in ten children in Arbaminch City, Ethiopia, is diagnosed with ADHD. Key predictors of ADHD include a prior history of mental illness in the child, maternal smoking, alcohol consumption during pregnancy, and a family history of mental disorders. Consequently, children with previous mental health issues and those from families with a history of mental illness should receive special attention. Additionally, expectant mothers must be informed about the harmful effects of alcohol and tobacco consumption on fetal development.

PMID:40001069 | DOI:10.1186/s12888-025-06625-6

BMC Public Health. 2025 Feb 25;25(1):776. doi: 10.1186/s12889-025-21963-6.

ABSTRACT

BACKGROUND: The increasing use of online platforms as sources of medical information has led to a growing concern regarding the accuracy, reliability, and quality of the content available. YouTube, one of the most widely accessed platforms, serves as a prominent source for health-related information, including topics like tympanostomy tubes. However, the variability in the quality of uploaded videos and the lack of standardization raise questions about their utility for patient education and decision-making. This study aims to evaluate the quality and reliability of the information provided by YouTube videos about tympanostomy tubes along with some key metrics of the videos.

METHODS: In this cross-sectional study, a search was conducted on YouTube on June 6, 2024, using the keywords tympanostomy tubes, ear tubes, ventilation tubes, myringotomy, and grommet insertion. A total of 68 videos with over 10,000 views that met the inclusion criteria were included. Video Power Index (VPI) and Global Quality Scale (GQS), Modified DISCERN and JAMA scores obtained by 2 independent otolaryngologists were statistically analysed.

RESULTS: Only 13.2% of the videos mentioned complications, and 39.7% addressed anesthesia techniques, with informative videos mentioning anesthesia techniques more frequently than surgical videos (P = 0.003). The average length of the videos was 223.3 ± 155.4 s, the average number of views was 153,884 ± 320,786, and the average VPI was 59.73 ± 93.19. The average quality scores for all videos were 2.81 ± 1.01 for GQS, 3 ± 1.43 for Modified DISCERN, and 2.75 ± 0.9 for JAMA, with the quality scores for informative videos being statistically significantly higher than for surgical videos (P < 0.001, P = 0.007, P = 0.010, respectively). The quality and reliability of the videos varied significantly depending on the uploader, with medical schools/universities and private hospitals generally providing higher quality content.

CONCLUSIONS: Our findings indicate that while YouTube can be an additional source of information about tympanostomy tubes, there are significant deficiencies in content quality. We believe that patients and their relatives should consider videos uploaded by professionals rather than relying on the number of views and likes when using YouTube as an information source.

PMID:40001067 | DOI:10.1186/s12889-025-21963-6

BMC Cancer. 2025 Feb 25;25(1):335. doi: 10.1186/s12885-025-13701-3.

ABSTRACT

BACKGROUND: Emerging research suggested a potential role of immune cells in colorectal cancer (CRC) development. However, the causal relationship between immune phenotypes and CRC remains elusive. Hence, this two-sample Mendelian randomization (MR) study aimed to explore the causal association.

METHODS: In this study, a bidirectional, two-sample MR analysis and multivariate MR was conducted, leveraging public genetic data. Four types of immune phenotypes were employed. A comprehensive sensitivity analysis was carried out to validate the robustness, heterogeneity, and horizontal pleiotropy of the results, with Bonferroni correction applied for accurate interpretation.

RESULTS: It was revealed that four immune cell phenotypes were significantly associated with CRC risk. Specifically, lymphocyte % leukocyte in the T-cell/B-cell/NK-cell (TBNK) group (odds ratio (OR) = 1.0013, 95% confidence interval (CI): 1.0005-1.0017, P = 0.0003, P_Bonferroni = 0.011) and CD3 on CM CD8br in the maturation stages of T cell group (OR = 1.0014, 95% CI: 1.0006-1.0022, P = 0.0007, P_Bonferroni = 0.023) were positively correlated with the risk of CRC. Conversely, DN (CD4^–CD8^–) %leukocyte in the TBNK group (OR = 0.9990, 95% CI: 0.9984-0.9997, P = 0.0020, P_Bonferroni = 0.063) and herpesvirus entry mediator (HVEM) on CD8br in the maturation stages of T cell group (OR = 0.9989, 95% CI: 0.9982-0.9997, P = 0.00431, P_Bonferroni = 0.137) exhibited a negative association with the risk of CRC. This study did not detect any statistically significant impact of CRC on immune phenotypes.

CONCLUSIONS: This study inferred an association between immune cells and CRC risk. Nevertheless, further clinical and experimental studies are warranted to validate these findings and elucidate the underlying mechanisms.

PMID:40001057 | DOI:10.1186/s12885-025-13701-3