Tag: statistics

BMC Cancer. 2025 May 26;25(1):943. doi: 10.1186/s12885-025-14323-5.

ABSTRACT

BACKGROUND: Numerous studies suggest that young adult cancer survivors (YA-CS) experience unmet needs regarding informational exchange about their disease and emotional support from peers. Currently, there is a lack of evaluated peer support interventions in Germany. This study aimed to evaluate the effectiveness of “Peer2Me”, a three-month one-to-one peer mentoring program, designed to improve self-efficacy among YA-CS.

METHODS: This study conducted a bi-center comprehensive cohort design and enrolled YA-CS (18-39 years old) undergoing acute treatment in Leipzig and Hamburg (Germany) across all tumour entities diagnosed within the last six months. YA-CS were allocated by preference to the intervention (IG, receiving peer mentoring) and comparison group (CG, care as usual). Following mentor training, tandems were matched by diagnosis, age, and gender. YA-CS completed questionnaires at baseline (t1), post-intervention (3 months later, t2) and three months post-intervention (t3). The primary outcome was self-efficacy measured with the Generalized Self-Efficacy Scale (GSES) and the Cancer Behaviour Inventory (CBI-B). Statistical analyses included mixed-design ANOVA and ANCOVA, controlling for baseline scores.

RESULTS: Out of 274 eligible YA-CS, a total of 106 YA-CS (IG: n = 77, CG: n = 29) completed the study. Two-thirds of YA-CS (66.7%) expressed a clear preference to be allocated to the IG. Baseline differences in coping behaviors were noted, with the IG demonstrating lower scores, suggesting a higher need for support. The ANCOVA revealed no group effects for the change of mean GSES scores from t1 to t2 (p =.897) or from t1 to t3 (p =.779). Also, no significant differences in the improvement of mean CBI-B scores between groups could be found from t1 to t2 (p =.903) or from t1 to t3 (p =.995).

CONCLUSIONS: The “Peer2Me” program did not demonstrate a significant effect on improving self-efficacy among YA-CS during acute treatment. Although interest in peer mentoring was high, the intervention showed no measurable benefit in comparison with standard care. While the need for support was evident, further research is required to optimize peer interventions for this group.

TRIAL REGISTRATION: The study was retrospectively registered on February 4, 2022 at clinicaltrials.gov (NCT05336318).

PMID:40420294 | DOI:10.1186/s12885-025-14323-5

BMC Psychol. 2025 May 27;13(1):564. doi: 10.1186/s40359-025-02897-5.

ABSTRACT

BACKGROUND: While belief in a just world has been extensively studied, the object of this belief still requires further specification. This study distinguishes two sources of uncertainty in future returns-nature and other people-and investigates whether belief in a just world is specifically directed toward human-sourced uncertainty but not nature-sourced uncertainty.

METHODS: To test this hypothesis, an experiment was conducted in which participants decided whether to make an investment based on their beliefs about the return they would receive from another player. The identity of the other player was varied (computer or human, representing nature-sourced uncertainty and human-sourced uncertainty, respectively), and participants’ level of belief in a just world was manipulated using a priming method. Multiple statistical analyses were conducted to examine the differences in investment behavior and expected returns between computer and human conditions.

RESULTS: When interacting with human players, participants in the just-world priming condition showed significantly higher investment rates and expected returns compared to those in the unjust-world priming condition. In contrast, when interacting with computer players, the differences between just-world and unjust-world conditions were non-significant, both for investment rates and expected returns. Mediation analysis further revealed that expected return mediated the relationship between priming condition and investment behavior in the human player condition.

CONCLUSION: These findings demonstrate that belief in a just world influences decision-making when interacting with human players but not with computer players, supporting our hypothesis that belief in a just world mainly targets human-sourced uncertainty but not nature-sourced uncertainty. This research advances our theoretical understanding of belief in a just world and contributes to our understanding of its functions for both individuals and society.

PMID:40420290 | DOI:10.1186/s40359-025-02897-5

Crit Care. 2025 May 26;29(1):214. doi: 10.1186/s13054-025-05452-1.

ABSTRACT

BACKGROUND: The optimal time for initiating kidney replacement therapy (KRT) in acute kidney injury (AKI) has been extensively studied in recent years. In contrast, there are currently insufficient data on the best time to discontinue KRT. One diagnostic option to unmask tubular reserve and indirectly estimate the glomerular filtration rate is the furosemide stress test (FST).

METHODS: We conducted a prospective, observational single-center trial. A FST was carried out in patients who developed spontaneous diuresis (SD) during ongoing KRT with a urine output of at least 400 ml in 24 h without any diuretic therapy. A positive FST was defined with urine output > 200 ml within 2 h following intravenous furosemide application. Follow-up was performed for 7 days and the need to restart KRT was assessed daily.

RESULTS: After 100 patients were enrolled in the trial, 98 patients were eligible for further evaluation. 76 patients were FST-positive, while 22 patients were FST-negative. Resumption of KRT within the 7-day follow-up was required in only 14.5% of the FST-positive, but 72.7% of the FST-negative patients (p < 0.001). The urine output after FST was also significantly associated with successful release from KRT (AUC 0.87; p < 0.001).

CONCLUSIONS: In critically ill patients with recovery of SD > 400ml/d during ongoing KRT, the FST helps to identify patients who can be successfully liberated from KRT. By detecting the tubular reserve using FST, the possibility of short-term kidney recovery after AKI can be estimated.

TRIAL REGISTRATION: German Clinical Trials Registry (DRKS00030560); date of registration 18/11/2022. https://drks.de/search/de/trial/DRKS00030560 .

PMID:40420285 | DOI:10.1186/s13054-025-05452-1

BMC Med Res Methodol. 2025 May 26;25(1):142. doi: 10.1186/s12874-025-02596-0.

ABSTRACT

BACKGROUND: Evaluating recurrent events within a time-to-event analysis framework effectively utilizes all relevant information to address the clinical question of interest fully and has certain advantages in randomized controlled trials (RCTs). However, the Prentice, Williams, and Peterson (PWP) model disrupts the randomness of the risk set for subsequent recurrent events other than the first and consequently introduces bias in estimating effects. This study aimed to propose a weighted PWP model, evaluate its statistical performance, and assess the potential consequences of using common practices when each recurrence has different baseline hazard functions.

METHODS: We proposed adjusting the estimate of treatment effect through a weighting strategy that constructed a virtual population balanced between groups in each risk set. A simulation study was carried out. The characteristic of the simulation data was the baseline hazard changed with the number of events. The proposed weighted PWP model was compared with current methods, including Cox for time-to-first-event, Poisson, negative binomial (NB), Andersen-Gill (AG), Lin-Wei-Yang-Ying (LWYY), and PWP models. Model performance was evaluated by bias, type I error rates, and statistical power. All models were applied to a real case from a randomization trial of Chemoprophylaxis treatment for Recurrent Stage I Bladder Tumors.

RESULTS: The results showed that the proposed weighted PWP model performed best with the lowest bias and highest statistical power. However, other models, including the Cox for time-to-first-event, Poisson, NB, AG, LWYY, and PWP models, all showed different degrees of bias and inflated type I error rates or low statistical power in the case of the baseline hazard changed with the number of events. Covariate adjustment via outcome regression can lead to inflated type I error rates. When the number of recurrent events was restricted, all weighting strategies yielded stable and nearly consistent results.

CONCLUSIONS: Recurrent event data should be analyzed with caution. The proposed methods may be generalized to model recurrent events. Our findings serve as an important clarification of how to deal with collider bias in the PWP model in RCTs.

PMID:40420279 | DOI:10.1186/s12874-025-02596-0

BMC Med Imaging. 2025 May 26;25(1):185. doi: 10.1186/s12880-025-01730-0.

ABSTRACT

BACKGROUND: Age-related liver diffusion metrics changes have been described. We aim to further clarify these questions: 1) whether an age-related reduction of liver perfusion can be observed by DDVD (diffusion derived vessel density) in older males; 2) whether there is a male female difference in liver perfusion; 3) whether liver ADC values and spleen ADC values are correlated. It is known that, physiologically, males’ liver has a higher iron level (thus a shorter T2) than females’ liver; pre-menopausal females have a lower liver iron level (thus a longer T2) than post-menopausal females. The observations of this study will be interpreted with the recently gained knowledge of the T2 contribution to diffusion metrics.

METHODS: Included in this healthy volunteer’s study were 68 males (mean age:50.22 years, range: 25-70 years) and 43 females (mean age 45.56 years, range:20-71 years). DWI images with b-values of 0, 2, 10, 20, 60, and 600 s/mm² were acquired at 1.5T. DDVD were calculated with b = 0, b = 2, b = 10, and b = 20 s/mm² images. ADC were calculated with b = 0, b = 2, b = 60 and b = 600 s/mm² images.

RESULTS: There was a statistically significant age-related decline of liver DDVD values for females (p = 0.024). A similar trend was observed for males, though statistical significance was not achieved (p = 0.113). Liver DDVD values were all higher in females than in males (p < 0.001). There was a statistically significant age-related decline of liver ADC values both for males (ADC_(b0b600), p = 0.009) and for females (ADC_(b0b600), p = 0.016). Liver ADC values and spleen ADC values were positively correlated (ADC_(b0b600), r = 0.33 for males and 0.31 for females, p < 0.05). When the spleen ADC was used to normalize the liver ADC, then the age-related trend was largely removed, both for males and for females (p > 0.05).

CONCLUSION: Females have a larger liver perfusion volume than males. There is an age-related decrease of DDVD and ADC, both for males and females. Liver ADC values and spleen ADC values are positively correlated. These gender and age-related changes are unlikely mainly caused by the liver T2 relaxation time variations.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40420278 | DOI:10.1186/s12880-025-01730-0

BMC Nurs. 2025 May 26;24(1):598. doi: 10.1186/s12912-025-03243-1.

ABSTRACT

BACKGROUND: Workplace violence is a global public health concern, especially in developing nations. Nurses, due to the nature of their professional duties, often face an elevated risk of workplace violence. This risk is further exacerbated by the lack of adequate safety precautions and the presence of multiple potential perpetrators, making the work environment particularly hazardous for them.

OBJECTIVES: This systematic review explores workplace violence against nurses in Ethiopia, its prevalence, causes, Perpetrators of violence in the Nurses’ profession, consequences, influence on the profession, and strategies to prevent incidents based on relevant literature review.

REVIEW METHOD AND DATA SOURCES: The study sourced evidence from electronic databases like PubMed, Science Direct Scopus, Web of Science, and Google Scholar till January 30, 2024. The data was extracted from February 01-10 and later analyzed from February 15-March 15, and the report generation from March 15 to April 05, 2024, and reported findings per Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. The study used pooled odds ratio and pooled proportion to assess exposure and outcomes. A meta-analysis was conducted using compressive met-analysis V4 packages, with forest plots for visual representation. Heterogeneity was evaluated using Cochran’s Q-test and I² statistic. Sensitivity analysis was performed by systematically excluding one study.

RESULT: In Ethiopia, workplace violence against nurses was a significant issue, with an incidence ranging from 26.7 to 64%. The most common form of violence was verbal abuse, followed by physical, psychological, and sexual harassment. Factors like age, gender, marital status, job type, work environment, and staffing levels contribute to the issue. Over half of nurses change shifts due to concerns about violence, community dissatisfaction, unsatisfactory treatment, and challenging nurse-patient relationships.

CONCLUSION: The prevalence of WPV among nurses in Ethiopia is increasing. Nurses face a high risk of workplace violence due to direct patient contact and the nature of the profession. Thus, healthcare organizations can work towards creating a safer and more supportive environment for nurses, enforce a zero-tolerance policy, improve patient-nurse relationships, and provide psychological support to ultimately reduce the prevalence of workplace violence and ensure the well-being of healthcare professionals.

PROSPERO REGISTRATION NUMBER: CRD42024601317.

PMID:40420275 | DOI:10.1186/s12912-025-03243-1

Lipids Health Dis. 2025 May 26;24(1):191. doi: 10.1186/s12944-025-02618-2.

ABSTRACT

OBJECTIVE: The uric acid-to-high-density lipoprotein cholesterol ratio (UHR) is an established biomarker for metabolic and inflammatory disorders but has received little attention in relation to osteoarthritis (OA). This investigation examines the UHR‒OA risk correlates.

METHODS: This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) 1999-2016. Descriptive analyses, univariate and multivariate logistic regression models, as well as generalized additive and segmented regression models were used to investigate the nonlinear correlation and threshold effect of UHR-OA.

RESULTS: A total of 20,727 U.S. adults were included, 2,900 of whom (13.99%) were diagnosed with osteoarthritis (OA). A nonlinear relationship with a significant threshold effect was observed between the UHR and OA. When the UHR was less than 0.109, it was strongly inversely related to OA (OR = 0.028, 95% CI: 0.002-0.345, P < 0.01). The odds ratio increased when the UHR surpassed 0.109 but was not statistically significant (OR = 0.625, 95% CI: 0.162-2.421, P > 0.05). According to the unadjusted logistic regression model, the UHR was not significantly correlated with OA (P > 0.05). Following adjustment for confounders, including sex, age, ethnicity, education, marriage, BMI, income, hypertension, diabetes, coronary heart disease, and hypercholesterolemia, a notable inverse relationship emerged (OR = 0.259, 95% CI: 0.093-0.718, P < 0.01). Univariate linear regression studies revealed an intense inverse relationship between UA and HDL-C (OR = -3.2, 95% CI: -3.3 to -3.0, P < 0.001). In addition, stratified studies revealed that the negative relationships between the UHR and OA were more pronounced in elderly individuals (≥ 50 years old), women, drinkers, non-Hispanic whites, individuals with higher education levels and individuals without metabolic disorders (those with no hypertension, diabetes, coronary heart disease, or hypercholesterolemia) and did not show obvious heterogeneity in smoking status, BMI, marriage, or income level.

CONCLUSIONS: This study revealed a nonlinear relationship between the UHR and OA, with a threshold at UHR = 0.109. Below this level, the UHR was significantly negatively associated with OA, especially in older adults (≥ 50 years old), females, drinkers, non-Hispanic Whites, and those with an education level above high school, or no metabolic diseases.

PMID:40420274 | DOI:10.1186/s12944-025-02618-2

BMC Nurs. 2025 May 26;24(1):596. doi: 10.1186/s12912-025-03266-8.

ABSTRACT

INTRODUCTION: Nurse burnout negatively impacts patient care quality, safety, and outcomes, while harming nurses’ mental health, job satisfaction, and retention. It also imposes financial burdens on healthcare organizations through absenteeism, reduced productivity, and higher turnover costs, highlighting the need for research to address these challenges. The umbrella review methodology was selected to integrate evidence from multiple systematic reviews and meta-analyses, offering a broad and in-depth summary of existing research to guide practice and policy. This approach equips stakeholders with a holistic understanding of the multifaceted impacts of nurse burnout, facilitating the design of effective interventions that support nurses, enhance healthcare delivery, and optimize patient outcomes. Consequently, this umbrella review aims to evaluate the global prevalence and contributing factors of nurse burnout.

METHODS: This umbrella review included 14 systematic reviews and meta-analyses identified from various databases. The quality of each study was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR II). Data were extracted using Microsoft Excel and analyzed with STATA 17.0. Heterogeneity was measured using Higgin’s I² Statistics, and summary prevalence estimates were calculated with the Der Simonian-Laird random-effects model. Meta-regression and subgroup analyses were conducted to identify the source of high heterogeneity. Publication bias was assessed using funnel plots and Egger’s regression test, with the former providing a visual assessment of bias and the latter offering a statistical method to detect asymmetry.

RESULTS: The global prevalence of nurse burnout was evaluated in three areas: emotional exhaustion (33.45%, 95% CI 27.31-39.59), depersonalization (25.0%, 95% CI 17.17-33.00), and low personal accomplishment (33.49%, 95% CI 28.43-38.55). Emotional exhaustion was most common among nurses working during the COVID-19 pandemic (39.23%, 95% CI 16.22-94.68). Oncology nurses experienced the highest rate of depersonalization (42%, 95% CI 16.71-77.30), while nurses in intensive care units reported the highest rate of low personal accomplishment (46.02%, 95% CI 43.83-48.28).

CONCLUSIONS: Nurse burnout is prevalent worldwide, often marked by a sense of low personal accomplishment. Several factors contribute to this issue, including role conflict, negative emotions, family problems, moral distress, stress, commuting distance, predictability of work tasks, and workplace advancement.

PMID:40420259 | DOI:10.1186/s12912-025-03266-8

BMC Oral Health. 2025 May 26;25(1):795. doi: 10.1186/s12903-025-06205-w.

ABSTRACT

BACKGROUND: Occlusion plays a crucial role in maintaining masticatory function and temporomandibular joint (TMJ). Single implant supported restorations are widely used for posterior tooth replacement, but they require careful occlusal adjustment due to the absence of periodontal ligament. Digital occlusal analysis methods, such as digital impressions and Occlusense, provide quantitative assessments of occlusal contacts and force distribution. However, their accuracy and clinical relevance remain uncertain.

METHODS: In this prospective clinical study, occlusal force distribution was evaluated before and after placement of single implant supported restoration using the Medit i700 intraoral scanner and OccluSense system. Measurements were performed before and after prosthesis under standardised conditions. Occlusal contact areas and force distributions were analysed using CloudCompare and ImageJ software. Statistical analysis was performed using Kruskal-Wallis test and Kendall’s Tau-B correlation analysis.

RESULTS: A total of 20 patients were included in the study. Post-restoration measurements revealed significant changes in occlusal force distribution in different segments of the dental arch (p < 0.001). Strong correlations were observed between Medit and OccluSense measurements (p < 0.001).

CONCLUSION: Single-unit implant restorations significantly alter the occlusal force distribution, affecting not only the restored tooth but also the adjacent and opposing teeth. Both Medit i700 and OccluSense provided valuable information, with OccluSense providing a more detailed representation of occlusal force density. These findings suggest that digital occlusal analysis methods can help optimise occlusal adjustments for implant restorations.

TRIAL REGISTRATION: The current study was registered in ClinicalTrials.gov (ID: NCT06862973) First posted: 07/03/2025. Retrospectively registered.

PMID:40420258 | DOI:10.1186/s12903-025-06205-w

Respir Res. 2025 May 26;26(1):199. doi: 10.1186/s12931-025-03243-4.

ABSTRACT

BACKGROUND: Mindfulness-based interventions (MBIs) are effective in improving mental and physical health in various chronic conditions. While the GOLD 2024 report recommends MBIs for chronic obstructive pulmonary disease (COPD), scientific evidence in this specific population is scarce. This prospective randomised controlled pilot study investigated the feasibility of an 8-week digital MBI and its preliminary effects on mental and physical health in COPD.

METHODS: Psychologically burdened COPD patients (63 ± 7 years, 61% female, FEV1% 41 ± 19) were randomly allocated to the MBI group (n = 14; daily 10-15-minute audio-guided meditation via smartphone) or a waitlist control group (n = 16). Primary outcomes included the intervention’s feasibility (dropouts, MBI usage rates, interview and questionnaire responses) and its preliminary effects on symptoms of anxiety and depression (Hospital Anxiety and Depression Scale, HADS). Secondary outcomes included its preliminary effects on the COPD Assessment Test (CAT), Chronic Respiratory Disease Questionnaire (CRQ-SAS), Perceived Stress Scale (PSS-10), and biological stress markers. Exploratory outcomes included momentary subjective stress, anxiety, and dyspnoea after meditating.

RESULTS: The results indicated that the intervention was feasible (81% usage rate; 93% and 71% found the MBI enjoyable and helpful, respectively), with 21% dropout. A statistically significant intervention (time x group) effect was found for anxiety (HADS-A, p =.010, η_p² = 0.11) and emotional functioning (CRQ-SAS, p =.004, η_p² = 0.14), but not for depression (HADS-D, p =.060, η_p² = 0.06) or any other secondary outcome after 8 weeks. Momentary subjective stress (p <.001, η_p² = 0.75), anxiety (p =.022, η_p² = 0.75), and dyspnoea (p <.001, η_p² = 0.70) were significantly reduced after meditating.

CONCLUSIONS: The digital MBI was feasible, with preliminary effects indicating improvements in anxiety and emotional functioning after 8 weeks as well as momentary outcomes after meditating. Future large-scale trials should further assess the effectiveness of digital MBIs in this context. However, the findings suggest that digital MBIs might be promising and effective low-threshold add-on treatments in clinical settings.

TRIAL REGISTRATION: The article has been preregistered at ClinicalTrials.gov (identifier: NCT04769505, date: 23rd February 2021).

PMID:40420253 | DOI:10.1186/s12931-025-03243-4