Tag: statistics

Cureus. 2025 Apr 25;17(4):e82966. doi: 10.7759/cureus.82966. eCollection 2025 Apr.

ABSTRACT

Introduction This study aimed to analyze the costs of emergency department (ED) visits among patients aged 65 years and older, with a particular focus on the financial burden of recurrent admissions within a one-year period. Methods A retrospective cross-sectional study was conducted on 143,909 ED visits recorded between January 1, 2014, and December 31, 2014, at the Emergency Department of Ankara Atatürk Training and Research Hospital, Ankara, Turkey. Data for patients aged 65 and older were extracted from the Hospital Information Management System. Cost data were based on the Social Security Institution billing system and converted into US dollars (USD) using the 2014 exchange rate. Patients were categorized by age, gender, diagnosis, and visit frequency. Nonparametric statistical tests were used due to the non-normal distribution of cost variables. A p-value < 0.05 was considered statistically significant. Results A total of 21,458 (15.0%) ED visits were made by patients aged 65 and older. The median cost per visit in this group was $58.16. Costs increased with age: $42.90 for patients aged 65-74, $76.67 for those aged 75-84, and $96.42 for those aged ≥85 (Kruskal-Wallis H = 1,125.3, df = 2, p < 0.001). Among the 19,159 elderly patients who visited the ED, 1,951 (10.2%) had recurrent visits. Within this subgroup, internal medicine diagnoses were most common (1,345 visits, or 68.9%), followed by pulmonary (320, or 16.4%), cardiovascular (211, or 10.8%), and non-specific complaints (231, or 11.8%) as the leading causes. This diagnostic distribution differed significantly from that of single-visit patients (χ² = 42.7, df = 3, p < 0.001). Recurrence rates varied significantly by diagnostic category (χ² = 89.4, df = 5, p < 0.001): the highest recurrence was observed in patients with hematologic conditions (56/355, or 15.8%; adjusted OR = 1.72, 95% CI: 1.28-2.31), followed by psychiatric (8/57, or 14.0%; adjusted OR = 1.45, 95% CI: 0.99-2.12) and pulmonary diagnoses (320/2,358, or 13.6%; adjusted OR = 1.38, 95% CI: 1.22-1.57), all above the overall recurrence rate of 10.2%. The median cost of the first ED visit was significantly higher in the recurrent group ($72.13) compared to the non-recurrent group ($59.76) (Mann-Whitney U = 14.2 × 10⁶, p < 0.001, r = 0.14). Among recurrent cases, the mean cost of the first visit ($101.84) exceeded the average cost of subsequent visits ($93.98) (Wilcoxon T = 2.4 × 10⁵, p < 0.001, r = 0.09). Conclusion Older patients generate disproportionately higher ED costs in Turkey, particularly those with recurrent visits and chronic conditions. These findings support the implementation of geriatric-focused emergency care models and preventive strategies to optimize resource utilization in aging populations.

PMID:40416294 | PMC:PMC12103731 | DOI:10.7759/cureus.82966

Cureus. 2025 Apr 24;17(4):e82946. doi: 10.7759/cureus.82946. eCollection 2025 Apr.

ABSTRACT

Background Patient safety in pediatric care is a critical concern, as hospital environments pose unique risks for children, particularly falls. Despite advancements in healthcare, falls remain a common safety issue, emphasizing the need for effective preventive measures. Nurses play a vital role in reducing fall risks, but gaps in their knowledge, attitudes, and practices (KAP) can hinder the success of these efforts. This study evaluates the impact of targeted education on enhancing nursing officers’ KAP of fall prevention. Materials and methods A quasi-experimental pre-test and post-test design was conducted in the pediatric units of a tertiary care hospital in Bhopal. Nursing officers with at least one year of pediatric experience participated. KAP was assessed before a structured educational intervention, which included a workshop and educational materials. One week post-intervention, data were collected to measure changes. Statistical analysis was performed using SPSS Statistics version 26 (IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp.), with paired t-tests assessing improvements in KAP and chi-square tests examining associations with demographic variables. Results A total of 64 nurses participated, with the majority being between 26 and 30 years old and holding a Bachelor of Science in Nursing degree. Pre-intervention knowledge levels indicated that most participants had average knowledge, which significantly improved post-intervention (mean score: 16.2 ± 4.20 to 24.0 ± 3.37, p<0.001). Attitudes toward fall prevention became more positive (mean score: 69.7 ± 6.07 to 73.5 ± 4.82, p<0.001), and preventive practices improved significantly (mean score: 10.7 ± 2.15 to 12.8 ± 1.50, p<0.001). Knowledge was significantly associated with age (p=0.029) and marital status (p=0.021), while attitudes and practices were linked to the department and the age group of the children in care. Conclusions Targeted educational interventions significantly improved nurses’ KAP of pediatric fall prevention. Although the intervention led to immediate improvements, further research is needed to assess long-term retention and sustainability. Continuous professional development, institutional policies, and interdisciplinary collaboration are essential to maintaining high standards of pediatric patient safety.

PMID:40416284 | PMC:PMC12103634 | DOI:10.7759/cureus.82946

Cureus. 2025 Apr 23;17(4):e82853. doi: 10.7759/cureus.82853. eCollection 2025 Apr.

ABSTRACT

Background Head and neck cancer (HNC) surrounds many malignancies that affect mucosal linings, lymphatic tissues, and salivary glands. The predominant subtypes include squamous cell carcinoma (SCC), Hodgkin lymphoma (HL), and pleomorphic adenoma (PA). One long non-coding RNA (lncRNA) known as B-cell lymphoma 1 (BCL1) has been observed to be a key regulator of tumor progression, metastasis, and resistance to chemotherapy. Objective This study aims to quantify the expression of BCL1 across HNC subtypes to evaluate its diagnostic and prognostic relevance. Materials and methodology A case-control study was conducted for nine months from February 2023 to October 2023. The study involved 160 HNC patients and 40 healthy controls. Blood samples were collected, and RNA extraction, cDNA synthesis, and RT-qPCR analysis were done afterward using BCL1-specific primers. Data were analyzed by using one-way analysis of variance (ANOVA) in SPSS v.26 (IBM Corp, Armonk, NY, US) with p<0.05 considered statistically significant. Results In patients with HNC, elevated relative gene fold levels of BCL1 highlighted malignancy in squamous cell carcinoma (SCC; 3.19±0.72), Hodgkin lymphoma (HL; 1.91±0.72), and pleomorphic adenoma (PA; 2.24±0.72), in comparison to the control group (1.07±0.72). SCC patients showed the highest expression, which correlated with advanced tumor stages (Stage IV: 60%). Conclusion There was an overexpression of BCL1 observed in HNC subtypes, which highlighted its role as an important biomarker for tumor aggressiveness and therapeutic resistance. This advocates its integration into frameworks of precision oncology.

PMID:40416279 | PMC:PMC12101792 | DOI:10.7759/cureus.82853

Cureus. 2025 Apr 23;17(4):e82879. doi: 10.7759/cureus.82879. eCollection 2025 Apr.

ABSTRACT

Introduction Complications such as acute rejection (AR) and acute tubular necrosis (ATN) following kidney transplantation can adversely affect graft function, complicating the treatment process and endangering patient health. Diffusion-weighted magnetic resonance imaging (DWI) has emerged as a promising imaging modality for detecting microscopic changes in renal tissue, particularly those affecting cellular structures. This study aims to evaluate the potential of DWI in detecting AR and ATN in kidney transplant patients. Methods A total of 24 patients who underwent kidney transplantation at the Department of Organ Transplantation, Ege University Faculty of Medicine, between January 2010 and December 2019 were included in the study. Fourteen patients with AR or ATN formed the study group, while the remaining 10 patients, who did not develop complications, constituted the control group. All patients underwent DWI using a 3 Tesla magnetic resonance imaging (MRI) device, and apparent diffusion coefficient (ADC) values were measured at different levels of the renal cortex and medulla. Results When evaluating the mean ADC values (×10⁻³ mm²/second) measured from the upper, middle, and lower poles of the kidneys, significantly lower values were observed in the study group compared to the control group. Statistically significant differences were found in all regions (p < 0.05). Conclusion In conclusion, this study highlights the potential utility of DWI as a non-invasive tool for assessing renal allograft function and detecting early graft injury in kidney transplant recipients.

PMID:40416269 | PMC:PMC12102636 | DOI:10.7759/cureus.82879

Cureus. 2025 Apr 23;17(4):e82845. doi: 10.7759/cureus.82845. eCollection 2025 Apr.

ABSTRACT

Psychogenic nonepileptic seizures (PNES), also referred to as functional seizures, are events that mimic epileptic seizures but are not triggered by abnormal electrical activity in the brain. According to the International Statistical Classification of Diseases (ICD)-11, PNES are classified as dissociative disorders. Transcranial magnetic stimulation (TMS) is a non-invasive brain stimulation therapy commonly used to treat major depression, particularly in cases where other treatments have not been effective. PNES has not been associated with TMS previously. Here, we describe a 52-year-old Caucasian male who presented to the acupuncture clinic with multiple episodes of sudden loss of consciousness following TMS for a long history of major depression. The episodes of unconsciousness occurred up to five times per day. During an electroencephalograph (EEG) session, the patient had an episode that included poor balance, “shaking,” head nodding, and a robotic/slowed voice, although no epileptic activity was captured on EEG. His illness was therefore diagnosed as PNES activity. He underwent treatment with body acupuncture and auricular acupressure and improved, with reduced number and duration of episodes. PNES following TMS has not been reported previously. A strong magnetic field can potentially disrupt normal neurotransmission and neuronal metabolism, resulting in PNES. The beneficial effects of acupuncture have been documented, but the mechanism of action has not been elucidated.

PMID:40416263 | PMC:PMC12102631 | DOI:10.7759/cureus.82845

Cureus. 2025 Apr 25;17(4):e82976. doi: 10.7759/cureus.82976. eCollection 2025 Apr.

ABSTRACT

Background Primary bladder neck obstruction (PBNO) in females is a rare condition with a tedious diagnostic process. The existing literature on bladder neck incision (BNI) to treat PBNO lacks a precise description of the surgical technique. Objective In this study, we provide a diagnostic protocol to streamline the evaluation of PBNO in females. We evaluate the outcomes of a precise surgical technique of BNI aimed at reducing the rates of known complications such as vesicovaginal fistula (VVF) and urinary incontinence. Methods This single-center prospective observational study, conducted over five years (2019-2024), included 20 patients diagnosed with PBNO who underwent BNI. Analyses included patient demographics, clinical presentation, treatment outcomes, and complications. Statistical analysis was performed using ANOVA, and univariate analysis was also conducted. Differences with P < 0.05 were considered statistically significant. Results At six months post-surgery, the mean maximum urinary flow rate (Qmax) increased from 6.49 ± 2.63 mL/sec to 12.41 ± 2.42 mL/sec (P = 0.0421). The mean post-void residual volume (PVR) decreased from 202.11 ± 70.20 mL to 53.11 ± 14.78 mL (P = 0.0152). The mean International Prostate Symptom Score (IPSS) decreased from 26.95 ± 2.84 to 14.74 ± 3.23 (P = 0.0325). The mean quality of life (QoL) score improved from 4.70 ± 0.80 to 1.60 ± 0.12 (P = 0.0067). None of the patients developed VVF or urinary incontinence in the post-operative period. One patient (5%) required re-surgery due to recurrence of bladder neck obstruction. Conclusion BNI for PBNO provides satisfactory results. A precise operative technique, with careful consideration of the depth and distal extent of the incision, helps avoid complications such as VVF and urinary incontinence.

PMID:40416261 | PMC:PMC12103814 | DOI:10.7759/cureus.82976

Cureus. 2025 Apr 25;17(4):e82965. doi: 10.7759/cureus.82965. eCollection 2025 Apr.

ABSTRACT

Introduction The anterior cruciate ligament (ACL) is essential for knee stability, and its injury significantly impacts athletic performance. Anterior cruciate ligament reconstruction (ACLR) is the standard treatment for active individuals, yet many fail to return to sport (RTS) due to factors like pain and kinesiophobia. This study explores these barriers in the Saudi Arabian population. Methodology This is a cross-sectional study using an online questionnaire targeting ACLR patients across five Saudi hospitals between 2017 and 2023. Tools included are the International Knee Documentation Committee’s (IKDC) scale and the Tampa Scale for Kinesiophobia (TSK-11) score. Data was analyzed using IBM SPSS Statistics software, version 29.0.0 (IBM Corp., Armonk, NY). Results Our study included 84 participants undergoing ACL reconstruction. Most were aged between 18 and 25 years (n=35, 41.7%), male (n=75, 89.3%), and employed (n=65, 77.4%). Only 44.0% (n=37) returned to their pre-injury level of sport. Moderate fear of re-injury was common (n=67, 79.8%), and fear significantly correlated with lower IKDC scores (r = -0.410, p < 0.001). Participants with minimal fear had the highest IKDC score (81.01 ± 9.47, p < 0.001). Functional limitation was significantly associated with RTS (p < 0.001); none with moderate/severe limitations returned. Lower pain scores (1.77 vs. 4.35, p = 0.005), lower TSK-11 scores (15.77 vs. 22.90, p < 0.001), and higher knee function (81.01 vs. 63.02, p < 0.001) were significantly linked to RTS. Height > 180 cm was also significantly associated with RTS (p = 0.011). Conclusion Our findings show that returning to sport after ACLR is strongly influenced by functional ability, pain severity, and fear of re-injury. Psychological readiness, particularly kinesiophobia, plays a critical role. Addressing both physical limitations and mental barriers is essential to improve RTS outcomes in post-ACLR patients.

PMID:40416260 | PMC:PMC12103728 | DOI:10.7759/cureus.82965

Cureus. 2025 Apr 24;17(4):e82955. doi: 10.7759/cureus.82955. eCollection 2025 Apr.

ABSTRACT

Polymerase chain reaction (PCR) tests are the gold standard for confirming COVID-19. Test results provide the cycle threshold (Ct) value, which is correlated to the patient’s viral load as well as hematological and biochemical parameters. The purpose of this study is to analyze the transmission dynamics of selected SARS-CoV-2 variants, both within hosts and between hosts, through statistics and data analysis of the Ct values and other metrics. Demographics data and Ct values from 1,041 patients with COVID-19 were collected and correlated with epidemiological indices, such as the positivity rate, hospitalizations, and deaths for each major wave of the pandemic, in Greece. The analysis showed that higher viral loads coincide with rising pandemic waves, while lower loads are observed during periods of decline. Notably, among all variants analyzed, the Delta variant, observed in mid-2021, exhibited the highest viral load values, which were associated with increased hospitalizations and mortality, despite a relatively low positivity rate. Consequently, variables associated with inter-host transmission dynamics show a significant correlation with those pertaining to intra-host dynamics. This correlation opens up the potential for predicting disease severity and forecasting the trajectory of the pandemic based on patient-related and other variables through data analysis. The analysis revealed that variations in Ct value yield valuable insights into the evolution of the pandemic and the risk stratification of patients. The study highlights that statistical measures derived from Ct values can provide insights into both intra-host and inter-host transmission dynamics, potentially supporting risk assessment and public health responses.

PMID:40416259 | PMC:PMC12103932 | DOI:10.7759/cureus.82955

Cureus. 2025 Apr 23;17(4):e82832. doi: 10.7759/cureus.82832. eCollection 2025 Apr.

ABSTRACT

Introduction Ebolaviruses are negative-stranded RNA viruses in the Filoviridae family. They are transmitted to humans through direct contact with the bodily fluids of infected individuals or animals, and they cause severe and often fatal hemorrhagic fever, with mortality rates ranging from 25% to 90%, depending on the outbreak and available healthcare resources. These viruses cause severe systemic disease with high mortality rates. Given the infectious nature of Ebola and the critical role of healthcare providers in managing outbreaks, educating nursing students on the virus’s transmission, prevention, and treatment is essential. Enhancing the knowledge of future healthcare professionals can improve healthcare system preparedness, ensuring effective response during outbreaks and reducing the virus’s impact. Methodology A quasi-experimental one-group pre-test post-test design was utilized to assess the effectiveness of a planned teaching program on Ebola virus knowledge among nursing students. A simple random sampling technique was employed to select participants from nursing colleges in Navi Mumbai. The teaching program, which covered Ebola virus transmission, prevention, and treatment, was administered to the selected students. A pre-test was conducted to assess baseline knowledge, followed by the teaching intervention, and a post-test was performed to measure knowledge gains. Data were analyzed using frequency and percentage distribution and paired t-tests to compare pre-test and post-test scores. Results A study was conducted with 50 second-year Bachelor of Science in Nursing students from MGM College of Nursing, Navi Mumbai, to assess the impact of an educational intervention. Participants included 41 females (82%) and nine males (18%), with most living in nuclear families (38 (76%)) and urban areas (45 (90%)). Before the intervention, the pre-test showed that participants’ knowledge levels varied: 10 (20%) had average knowledge, eight (16%) had poor knowledge, and 32 (64%) had good knowledge. After the intervention, there was a marked improvement: 32 participants (64%) exhibited excellent knowledge, 16 (32%) had good knowledge, and only two (4%) remained at the average level. This shift highlights the effectiveness of the intervention in enhancing participants’ understanding. Statistical analysis using paired t-tests confirmed a significant increase in knowledge, with no notable associations between demographic variables and pre-test scores. Conclusion The study concluded that the planned teaching program significantly enhanced the knowledge of nursing students regarding Ebola virus infection. A notable improvement was observed in the post-test, with most students demonstrating excellent and good knowledge compared to average and poor knowledge levels in the pre-test. These results suggest that targeted educational interventions are effective in improving healthcare students’ understanding of critical infectious diseases like Ebola. Furthermore, no significant associations were found between demographic variables and pre-test knowledge scores, indicating that the teaching program effectively reached all students. The findings underscore the importance of incorporating such teaching programs into nursing curricula to prepare students for managing future public health challenges.

PMID:40416252 | PMC:PMC12102646 | DOI:10.7759/cureus.82832

Cureus. 2025 Apr 23;17(4):e82820. doi: 10.7759/cureus.82820. eCollection 2025 Apr.

ABSTRACT

Introduction Pterygoid implants serve as an alternative for rehabilitating a posterior atrophic maxilla without requiring extensive bone grafting or sinus augmentation. This study aimed to evaluate the clinical outcomes and success rates of pterygoid implants over a one-year follow-up period and assess the influence of bone quality, complications, and other patient-related factors on implant success. Materials and methods A total of 34 patients with a posterior atrophic maxilla received 35 pterygoid implants. Preoperative cone-beam computed tomography (CBCT) was used to assess bone quality, and the implants were placed using a standardized surgical protocol. Clinical parameters, including primary stability, marginal bone loss, postoperative complications, and patient-reported outcomes, were recorded. Implant success was defined as the absence of pain, mobility, radiographic bone loss beyond 1.5 mm during one-year follow-up, or infection. Patient-reported outcomes were evaluated using the Oral Health Impact Profile (OHIP-14). Statistical analysis was conducted to determine the correlation between implant success and influencing factors such as bone density, complications, smoking history, age, and implant length. Results The overall success rate was 31 (88.57%) pterygoid implants within the one-year follow-up period. Bone quality significantly affected implant success, with D3 showing a higher failure rate than D2 (p = 0.029). Complications, including implant fracture, prosthetic failure, and nerve injury, were significantly associated with implant failure (p = 0.001). Marginal bone loss was higher in the failed implants, supporting its role as a predictive factor of long-term success. Patient age, sex, smoking history, and implant length did not significantly influence outcomes. OHIP-14 scores indicated that patients with successful implants reported improved function and quality of life. Conclusion The pterygoid implants demonstrated a high success rate and served as a viable treatment for posterior maxillary rehabilitation. Bone quality and complications were the key determinants of implant success, whereas age, sex, smoking history, and implant length had no significant impact. Marginal bone loss has emerged as a crucial factor for implant failure, highlighting the importance of postoperative monitoring.

PMID:40416251 | PMC:PMC12099467 | DOI:10.7759/cureus.82820