Tag: statistics

J Transl Med. 2025 May 23;23(1):575. doi: 10.1186/s12967-025-06570-8.

ABSTRACT

BACKGROUND: Incorporation of gene expression when estimating polygenic risk scores (PRS) in atopic dermatitis (AD) may provide additional insights in disease pathogenesis and enhance predictive accuracy. In this study, we developed polygenic transcriptome risk scores (PTRSs) derived from AD-enriched tissues and evaluated their performance against traditional PRS models and a baseline risk model incorporating eosinophil and lymphocyte counts in the prediction of AD.

METHODS: We conducted transcriptome-wide association studies (TWAS) using the PrediXcan framework to construct tissue-specific PTRSs. Risk score performance was assessed in 256,888 Europeans (10,816 cases) and validated in an independent cohort of 64,152 Europeans (2669 cases) from the UK Biobank.

RESULTS: We observed a modest correlation between PRS and PTRS, exerting independent effects on AD risk. While PRS demonstrated superior predictive performance compared to single-tissue PTRSs, combining both models significantly enhanced prediction accuracy, yielding a c-statistic of 0.646 (95% confidence intervals: 0.634-0.656). Notably, tissue-specific PTRSs revealed stronger associations with baseline risk factors, where Eppstein-Bar virus (EBV)-transformed lymphocytes and unexposed skin PTRSs tissues reported positive associations with lymphocyte counts.

CONCLUSIONS: Our findings highlight the value of integrating transcriptome-based risk models to incorporating additional omics layer to refine risk prediction and enhance our understanding of genetic architecture of complex traits.

PMID:40410830 | DOI:10.1186/s12967-025-06570-8

Perioper Med (Lond). 2025 May 23;14(1):59. doi: 10.1186/s13741-025-00535-7.

ABSTRACT

BACKGROUND: Epidural block stands as the prevailing, secure, and efficient approach to labor analgesia. Inadequate maternal cooperation not only hampers anesthesia effectiveness but also may lead to severe consequences, including nerve damage due to positional changes.

METHODS: A randomized controlled clinical trial with 200 participants was conducted to compare painless delivery with epidural alone versus a combination of butorphanol nasal spray preceding epidural administration for painless delivery. The objective was to assess the combined approach’s efficacy in diminishing maternal pain and enhancing maternal compliance.

RESULTS: Within 8-min post-anesthesia, the combined analgesic group (EXP group) exhibited significantly lower maternal pain intensity scores, improved maternal cooperation, reduced visual analogue scale (VAS) pain, and McGill scores compared to the epidural alone group (CTRL group). No statistically significant differences emerged in 24-h postpartum blood loss, labor duration, or lactation period. Neonatal indicators, including umbilical artery blood PCO2, base excess of extracellular fluid (BE-ecf), weight, and Apgar score, showed no significant differences between the EXP and CTRL groups. However, the EXP group demonstrated a higher umbilical artery blood pH than the CTRL group. The EXP group exhibited significantly higher probabilities of pain intensity scores ≤ 6, maternal cooperation scores ≤ 3, VAS scores ≤ 3 at 6-, 8-, and 10-min post-anesthesia, and McGill scores of 0 compared to the CTRL group.

CONCLUSION: Butorphanol nasal spray emerges as an effective means to alleviate pain during epidural puncture in labor analgesia, markedly improving maternal anesthesia adherence. This combined analgesic method proves to be a safe and efficacious approach for maternal pain relief during labor.

PMID:40410829 | DOI:10.1186/s13741-025-00535-7

BMC Chem. 2025 May 23;19(1):141. doi: 10.1186/s13065-025-01507-0.

ABSTRACT

An ecofriendly, sensitive, selective, precise, and accurate HPLC method with fluorescence detection (FD) has been developed and validated for simultaneous determination of two hypertensive drugs, felodipine and metoprolol in their pure samples, combined pharmaceutical dosage form and in spiked human plasma. Separation was carried out on Inertsil C₁₈ column (150 mm × 4.6 ID; Particle size 5 µm) and a mobile phase composed of ethanol and 30mM potassium dihydrogen phosphate buffer, adjusted to pH 2.5 using ortho-phosphoric acid (40:60, v/v) was used. A constant flow rate of 1.0 mL/min at an ambient temperature was adopted. Method validation was performed according to the ICH Q2 R2 and bioanalytical method validation was done according to FDA guidelines for determination of both drugs simultaneously in biological matrices. The method demonstrated excellent linearity over the concentration range of 0.01-1.00 µg/mL and 0.003-1.00 µg/mL that were selected with accordance to the C_max of both drugs with a correlation coefficient (r²) of 0.9998 and 0.9999 for felodipine and metoprolol, respectively in human plasma. The intra-day and inter-day precision were ≤ 2% in their pure forms and in spiked human plasma, and the accuracy was within ± 2% of the nominal concentration for both drugs in their pure forms and within ± 10% of the nominal concentration in human plasma. A statistical comparison was conducted between the proposed method and the reported method; it showed no significant difference between both methods regarding both accuracy and precision. The proposed method proved to be eco-friendly with three green assessment tools (AGREE calculator, MoGAPI, RGBfast study).

PMID:40410825 | DOI:10.1186/s13065-025-01507-0

BMC Res Notes. 2025 May 23;18(1):229. doi: 10.1186/s13104-025-07291-3.

ABSTRACT

OBJECTIVE: Vaccine Hesitancy (VH) challenges previously perceived attitudes of a simple dichotomy of “accept” or “reject”. This is not just due to people being uninformed or misinformed but rather due to multiple forms of distrust. It is criticized as a vague notion with an uncertain hypothetical background. Therefore, this study aimed to assess the baseline knowledge and immunization practices of postnatal mothers and their hesitancy after intervention with the health education tool ‘SuBaDRa’ and compare it with those of the control group.

RESULT: This hospital-based, single-blinded randomized control study was performed for 2 years with 272 (136 per group) postnatal mothers (booked cases with immunization cards and access to a smartphone) in Karnataka, India. ‘SuBaDRa’, a tailored health education tool, was used to counsel the intervention group: Presenting Sustainable initiatives by the government; assessing mothers’ Baseline immunization knowledge and postintervention revaluations via the ‘WHO SAGE questionnaire’, Dissipating knowledge via health education and Reinforcement with social media applications. The control group was counseled about essential newborn care. The vaccine delay of infants at birth and at 6, 10, and 14 weeks and 9 months of age was assessed. The secondary outcome measures mothers’ attitudes toward immunization postintervention. The vaccine was considered delayed if it was received later than 2 weeks after the recommended age. The characteristics of the study subjects, i.e., postnatal mothers with eligible newborns, were analyzed via descriptive statistics. These characteristics were compared between the intervention and control groups via the Chi-square (χ²) test and Fischer’s exact test. The results revealed that the intervention group vaccine delays at 6, 10, 14 weeks and 9 months were 5.9%, 3%, 0.7% and 11.9%, respectively, and the control group vaccine delays were 20%, 28.9%, 55.6% and 48.1%, respectively, with p values of 0.001 at 6 weeks and 0 for the rest, all of which were highly significant. Trial registration The study was registered on Clinical Trials Registry – India (CTRI) with the registration number (CTRI/2021/08/035749), registered on (18/08/2021).

PMID:40410821 | DOI:10.1186/s13104-025-07291-3

Part Fibre Toxicol. 2025 May 23;22(1):14. doi: 10.1186/s12989-025-00628-7.

ABSTRACT

BACKGROUND: Multiple effects of ultrafine particles (UFP) on human subjects are known but there is less knowledge of how relative exposure levels between ultrafine and fine particles as typically encountered in large cities affect lung function and cardiovascular parameters.

METHODS: Four sites with high/low levels of ultrafine particles and/or fine particles were selected in the city of Munich, Germany: control area (woodland), urban environment, heavy traffic site, biomass combustion (beech wood). In a randomized cross-over design, 26 young, healthy individuals were exposed at each site over 75 min to atmospheric pollutants, which were monitored continuously, while performing intermittent (5 min per 15 min) light exercise. Parameters assessed pre and post exposure comprised symptoms, spirometry, lung diffusing capacity for carbon monoxide (DLCO) and nitric oxide (DLNO), alveolar volume (AV), the fractional concentration of exhaled nitric oxide (FeNO), reactive hyperemia index (RHI), blood pressure, and heart rate. Outcomes were expressed as percent changes of parameters and analyses performed by either comparing the four sites or by multiple linear regression analyses using the measured pollutant levels.

RESULTS: The sites showed the planned pattern of exposure levels but with large overlap. Outcomes showed no statistically significant differences between sites, except for symptoms which were elevated with heavy traffic site exposure and biomass combustion. In regression analyses, AV decreased by 0.92 (95% confidence interval (CI): 0.28 to 1.57) % per 10,000/cm³ UFP; similarly, for LDSA (lung-deposited surface area), which was highly correlated with UFP. Overall, FeNO slightly increased after exposure, but this increase was attenuated by 5.4 (95% CI: 1.8 to 9.2) % per 10 ppb ambient NO₂. Heart rate decreased after exposures overall; this decrease was enhanced by 2.1 (95% CI: 0.3 to 4.0) % per 10,000/cm³ UFP.

CONCLUSIONS: Short-term exposures to UFP elicited a reduction in the lung volume (AV) accessible to gas transport by diffusion and convection. FeNO was slightly elevated after all exposures, but this increase was significantly smaller at higher ambient NO₂ concentrations. While these effects were too small to be clinically relevant, they demonstrated that typical levels of urban air pollution had measurable acute effects in young, healthy individuals.

PMID:40410818 | DOI:10.1186/s12989-025-00628-7

Scand J Trauma Resusc Emerg Med. 2025 May 23;33(1):95. doi: 10.1186/s13049-025-01416-0.

ABSTRACT

BACKGROUND: Prehospital physician-staffed services in the Nordic countries vary in crew structure, medical specialisation of crew and preparedness for major emergency surgical procedures. Performing emergency surgical procedures in prehospital settings requires equipment, training and clinical ability. This study aimed to explore the organisation of Nordic prehospital physician-staffed services and their preparedness for resuscitative thoracotomy, perimortem caesarean section and prehospital amputation.

METHODS: A cross-sectional survey was conducted among Nordic prehospital physician-staffed services. A web-based questionnaire was distributed to medical directors. The questions included local organisation, equipment, training, and the ability of the service to perform major emergency surgical procedures. The responses were analysed using descriptive statistics.

RESULTS: Out of 61 prehospital physician-staffed services, 54 responded (89% response rate). The various organisations showed variability in geographical coverage, staffing, and transportation options. Resuscitative thoracotomy had been carried out by 41% of the services, 85% had equipment for the procedure, and 48% had established local guidelines. Perimortem caesarean section had been performed by 7% of the services, 80% had equipment for the procedure, and 31% had established local guidelines. Prehospital amputations had been carried out by 35% of the services, 81% had equipment for the procedure, and 22% had established guidelines. Preparation for the procedures varied. 61% of the services carried out special training for resuscitative thoracotomy, 22% for perimortem caesarean section, and 39% for prehospital amputation.

CONCLUSIONS: Prehospital physician-staffed units need to be prepared and have a strategy and guidelines for the treatment of unusual but life-threatening conditions. To perform major surgical procedures outside a hospital, guidelines, training, equipment, and experience are required. The study has demonstrated significant differences between Nordic countries and regions in how major surgical procedures outside the hospital are addressed. Many services lack standardised procedures and training. Addressing these gaps by implementing protocols and training programs may improve patient care. However, the potential benefits for a small number of patients should be weighed against the investment to have the ability to perform major surgical procedures outside the hospital.

PMID:40410815 | DOI:10.1186/s13049-025-01416-0

BMC Oral Health. 2025 May 23;25(1):776. doi: 10.1186/s12903-025-06079-y.

ABSTRACT

BACKGROUND: This retrospective study aimed to assess the prevalence of maxillary sinus pathologies and their associations with odontogenic factors in dental implant candidates using cone beam computed tomography (CBCT). By identifying the most common sinus pathologies and their potential relationship with odontogenic conditions, this study provides insights into factors influencing preoperative planning for sinus augmentation and implant placement.

METHODS: 1,000 CBCT scans (500 males, 500 females), representing 2,000 maxillary sinuses, were analyzed. Sinus pathologies were classified based on demographic variations and odontogenic factors, including periapical lesions without root canal treatment (RCT), periapical lesions with RCT, root canal-treated teeth without lesions, and edentulism. The distinction between unilateral and bilateral occurrences was also assessed. The associations between these factors and sinus pathologies were statistically evaluated.

RESULTS: Sinus pathologies were identified in 39.5% of sinuses, affecting 54.8% of patients. The most common finding was mucosal thickening (61%), followed by cysts/polyps (27.6%) and opacifications (11.4%). Males had a higher prevalence of cysts/polyps (p =.020), while mucosal thickening showed no significant gender difference. Odontogenic factors were present in 65.2% of pathological sinuses, particularly in mucosal thickening cases. Periapical lesions-whether untreated or treated with RCT-were significantly associated with sinus pathology (p <.0001 and p =.013), while root canal-treated teeth without lesions showed no association (p =.411). The rate of complete sinus opacification, which may impact sinus augmentation procedures, was 5%. Patients aged 41-60 exhibited a higher incidence of bilateral sinus pathology (p <.0001). Mucosal thickening was more frequently bilateral, whereas sinus cysts were predominantly unilateral (p =.003).

CONCLUSIONS: This study highlights the high prevalence of sinus pathologies in dental implant candidates and their significant association with odontogenic factors. These findings underscore the importance of thorough preoperative radiographic evaluation to optimize implant planning and reduce complications. Identifying these relationships may enhance clinical decision-making before sinus augmentation procedures. Further research incorporating clinical examinations and patient records is warranted to strengthen these findings.

PMID:40410799 | DOI:10.1186/s12903-025-06079-y

BMC Med Educ. 2025 May 23;25(1):760. doi: 10.1186/s12909-025-07299-0.

ABSTRACT

BACKGROUND: Effective training of nurses who manage candidates for organ donation is a critical issue that can enhance nurses’ knowledge and attitudes, ultimately improving the quality and efficiency of donated organs. This study aims to compare the effects of e-learning and gamification-based training on ICU nurses’ knowledge and attitudes toward organ donation candidates based on the Improving Psychological Security and Empowerment (IPSE) model.

METHODS: This clinical trial used a pre- and post-intervention design with three groups and was conducted on 45 ICU nurses. Participants were randomly assigned to one of three groups: e-learning, gamification-based training, and a control group (15 participants per group). The e-learning group attended two two-hour webinars based on the IPSE model. After reviewing educational materials prepared based on the IPSE model, the gamification group completed six scenarios via email. The control group received no intervention. A questionnaire assessing the nurses’ knowledge and attitudes toward the care of organ donation candidates was administered before and after the intervention. To evaluate the retention of learning, the same questionnaire was completed again one month after the intervention. Data analysis was performed using mixed- ANOVA in SPSS (version 26) and R (version 4.1.2). The assumptions of mixed-ANOVA were checked. In both knowledge and attitude modeling, the normality assumption was confirmed by gg-plot. The homogeneity of variances assumption was tested and confirmed by Levene test. The sphericity assumption for the time effect as well as the interaction effect of time and group was tested and rejected, and we used Greenhouse-Geisser correction P-value.

RESULTS: The results revealed that, after the intervention, participants’ mean knowledge scores increased significantly in both the e-learning and gamification groups. The score of the e-learning group (Group 1) rose from 9.33 to 14.86, while in the gamification group (Group 2), it increased from 8.87 to 18.00. Both groups demonstrated statistically significant improvements in knowledge scores (P < 0.001). In the control group, the mean knowledge score increased from 9.93 to 12.80, which was also statistically significant (P < 0.001). Regarding attitudes, the e-learning group (Group 1) showed an increase in mean score from 45.73 to 56.86, while the gamification group (Group 2) improved from 47.33 to 61.46. Both groups exhibited statistically significant improvements in attitude scores post-intervention (P < 0.001). The control group’s mean attitude score also increased from 48.26 to 51.13, showing a statistically significant change (P < 0.001).

CONCLUSION: The results demonstrated that gamification-based training had a greater impact on nurses’ knowledge and attitudes than e-learning. Given the positive effects of both educational approaches, educational and medical center administrators should be familiarized with innovative approaches like gamification to enhance nurses’ learning by utilizing more engaging and practical methods.

PMID:40410793 | DOI:10.1186/s12909-025-07299-0

Reprod Health. 2025 May 24;22(1):91. doi: 10.1186/s12978-025-02036-8.

ABSTRACT

BACKGROUND: In December 2020, Argentina passed Law 27.610, legalizing elective abortion up to 14 + 6 weeks and beyond in cases of rape or health risks. This study aims to analyze the sociodemographic characteristics of users who opted or were referred for manual vacuum aspiration (MVA) services at an a ambulatory medical center in Argentina before and after the legal reform, and to assess the safety and effectiveness of outpatient MVA procedures for pregnancies up to 14 + 6 weeks.

METHODS: Observational study using clinical data from patients up to 14 + 6 weeks gestation (n = 1,861) who sought or were referred for outpatient MVA abortion at a public healthcare facility in Rosario, Argentina (2017-2023). We analyze changes in users’ sociodemographic characteristics before and after the legal reform and assess the safety and effectiveness of ambulatory MVA abortion by gestational age (< 13 weeks vs. 13-14 weeks). A logistic regression tested associations between sociodemographic, procedural, and reproductive factors, and receiving MVA after 12 weeks.

RESULTS: Of the 1,861 MVA abortions, 85% (n = 1,590) were provided before 13 weeks’ gestation, and 15% (n = 271) occurred between 13-14 weeks. After the legal reform, more users accessed outpatient MVA services beyond 12 weeks (7% vs. 22%; p < 0.05: before and after the legal change, respectively), including individuals with lower education levels (46% vs. 54%; p < 0.05:), informal employment (34% vs. 47%; p < 0.05), without healthcare insurance (72% vs. 90%; p < 0.05), and nulliparity (18% vs. 30%; p < 0.05). The success rate of ambulatory MVA abortion was 99.9%, with 0.4% (n = 7) adverse events; no statistically significant differences by gestational age groups (< 13 weeks vs. 13-14 weeks). The legal reform was positively associated with accessing MVA abortion after 12 weeks.

CONCLUSIONS: The legal reform improved access to safe ambulatory MVA abortion services up to 14 + 6 weeks’ gestation, particularly for socially disadvantaged users. MVA abortion, both before 13 weeks and at 13-14 weeks, demonstrated a high success rate (99.9%) with minimal adverse events.

PMID:40410790 | DOI:10.1186/s12978-025-02036-8

BMC Endocr Disord. 2025 May 23;25(1):135. doi: 10.1186/s12902-024-01821-z.

ABSTRACT

BACKGROUND: Hyperthyroidism poses challenges, and common treatments like Radioactive Iodine (RAI) have limitations, prompting exploration of adjunctive approaches. This meta-analysis evaluates the combined impact of RAI and Lithium carbonate (LiCO3) on cure rates and thyroid hormone levels.

METHODS: We systematically searched Cochrane Library, PubMed, Scopus, and Web of Science for studies comparing LiCO3 combined with RAI to RAI alone. Pooled results analyzed cure rates and Free T3/T4 changes. A subgroup analysis was conducted based on LiCO3 dosage and treatment duration, while meta-regression was performed to assess covariates such as the patient’s age, RAI dose, and lithium dose. The risk of bias was evaluated using ROB2, ROBINS-1, and NOS, while the statistical analyses were conducted using Revman software 5.4.1.

RESULTS: Analysis of 14 studies involving 2047 patients revealed a significantly increased cure rate with RAI and LiCO3 compared to RAI alone (RR 1.12, 95% CI [1.03,1.23], p = 0.01). Subgroup analysis revealed higher cure rates with short-duration intensified doses of LiCO3, while short-duration diluted doses reduced cure rates. No significant differences were noted in euthyroid and hypothyroid states. Changes in free T3 showed no significant difference between the arms at 7 days and the most common time point. A significant decrease in free T4 favored RAI with LiCO3 at 7 days (MD -4.90, 95% CI [-7.91, -1.89], p = 0.001), and the most common time point (MD -3.83, 95% CI [-7.45, -0.20], p = 0.04). Meta-regression analysis indicated better cure rates in older patients (p < 0.001) and lower total lithium doses (p < 0.001).

CONCLUSION: Treatment with RAI combined with LiCO3 significantly enhanced cure rates, particularly when using short-duration intensified doses of LiCO3. Additionally, LiCO3 effectively reduced T4 levels without altering T3 levels. Future research is needed to validate our findings.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40410789 | DOI:10.1186/s12902-024-01821-z