Tag: statistics

J Glob Health. 2025 May 23;15:04177. doi: 10.7189/jogh.15.04177.

ABSTRACT

BACKGROUND: Some surveillance systems for influenza, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and respiratory syncytial virus (RSV) utilise International Classification of Diseases (ICD)-coded data and are useful for analysing trends and enhancing quick, evidence-based decisions against the epidemic potential that threatens global health security. With variations in the design of systems globally, the World Health Organization requested a systematic review to identify key characteristics of influenza, SARS-CoV-2, and RSV surveillance systems that utilise ICD-coded data, and to assess their performance.

METHODS: We searched EMBASE, MEDLINE, and Global Health to identify relevant studies reporting on influenza, SARS-CoV-2, and RSV surveillance systems that use ICD-coded data. We independently assessed studies for the ICD codes used, their statistical estimates and limitations. We appraised included studies using Joana Briggs Institute’s critical appraisal tools and synthesised using narrative synthesis.

RESULTS: We identified 77 studies, reporting on 71 surveillance systems – 33 systems recorded surveillance data only, 15 systems recorded burden of disease data only, and 23 systems recorded both surveillance and burden of disease data. Surveillance systems utilised ICD-10 codes (75%), ICD-9 codes (22%), or both (3%). ICD-10 codes J09 and J10 were frequently used for influenza, U07.1 for COVID-19, and B97.4, J12.1, J20.5, and J21.0 for RSV. ICD-9 codes 487 and 488 were mostly used for influenza, and codes 466.11 and 480.1 for RSV. ICD-10 codes had low-to-moderate sensitivity (6.60-79.87%) and high specificity (97.40-99.72%) for influenza, low-to-high sensitivity (30.00-98.4%) and specificity (39.50-99.80%) for COVID-19, and low-to-high sensitivity (6.00-99.80%) and specificity (12.10-100.00%) for RSV. ICD-9 codes had low sensitivity (45.60%) and high specificity (97.90%) for influenza. Underestimation of infections or mortality attributable to influenza, SARS-CoV-2, or RSV is a major limitation to using ICD-coded data across surveillance systems.

CONCLUSIONS: The performance of ICD codes for syndromic- or disease-specific surveillance remains inconclusive, although using only ICD-coded data within these systems may underestimate influenza, SARS-CoV-2, or RSV-attributable morbidity and mortality. Future studies should assess the accuracy of ICD code combinations for surveillance of influenza, SARS-CoV-2, and RSV.

PMID:40406976 | DOI:10.7189/jogh.15.04177

J Adv Nurs. 2025 May 23. doi: 10.1111/jan.17084. Online ahead of print.

ABSTRACT

AIMS: Nurse migration remains a significant issue in global healthcare, often driven by economic incentives, work environment factors, and professional development opportunities. Greece’s prolonged economic crisis and low nurse-to-population ratios have further intensified the outflow of skilled nursing personnel. We aimed to examine how demographic, educational, and professional factors, along with working conditions and perceived challenges, influence Greek nurses’ motivation to migrate after the COVID-19 pandemic.

DESIGN: This quantitative study surveyed 121 Greek nurses-both employed and unemployed, from various regions.

METHODS: Structured questionnaires featuring closed-ended, Likert-scale, and open-ended items were used. Questions covered demographics, working conditions, migration motives, and perceived challenges. Data were analysed using Pearson’s Chi-Square, Likelihood Ratio tests, and correlation coefficients, with statistical significance set at p < 0.05.

RESULTS: Economic prospects, quality of life, and access to language support emerged as key “pull” factors. Conversely, family obligations, emotional attachments to Greece, fear of discrimination, and inadequate language skills served as barriers to migration. Age and marital status both shaped participants’ attitudes; younger nurses were generally more optimistic about overseas opportunities, while those with multiple children expressed greater reluctance. Increased computer literacy and higher education correlated with reduced concerns, and leadership responsibilities were linked to heightened caution about relocating.

CONCLUSION: Findings underscore the complexity of nurse migration decisions. Policymakers and healthcare institutions should consider providing enhanced career development, language support, and better working conditions to retain Greek nurses and mitigate the impact of ongoing workforce shortages.

IMPACT: This study highlights critical factors influencing nurse migration, informing policies to improve retention and address workforce shortages in Greece.

PATIENT OR PUBLIC CONTRIBUTION: Participants provided insights on migration motives, enriching understanding of healthcare workforce dynamics and informing policy development for retention.

PMID:40406975 | DOI:10.1111/jan.17084

Adipocyte. 2025 Dec;14(1):2499500. doi: 10.1080/21623945.2025.2499500. Epub 2025 May 23.

ABSTRACT

Inflammatory changes in perivascular adipose tissue are associated with atherosclerotic lesions in the adjacent artery and can also be used as a marker in patient workup. While adipocyte size is known to be closely related to adipose tissue dysfunction and inflammation, it has not been widely studied in perivascular adipose tissue obtained from healthy human subjects without clinical atherosclerosis. In this cross-sectional study, we addressed this issue by measuring adipocyte size and defining its relationship to cardiovascular risk factors in a healthy cohort of living kidney donors. The presence of cardiovascular risk factors was established by a standardized questionnaire, clinical measurements and body composition analyses. Adipocyte size was measured in the perivascular depot. The proportions of various macrophage subtypes were determined by flow cytometry. To confirm the results, the proportion of CD68 + macrophages was additionally assessed by immunohistochemistry. A correlation and principal component analyses were performed to explore associations. Adipocyte size in perivascular adipose tissue correlated with markers of lipid metabolism, inflammation, and glucose metabolism. Further, the positive correlation with the pro-inflammatory subpopulation of macrophages suggests a strong local effect of perivascular adipose tissue. Perivascular adipocyte size was associated with cardiovascular risk factors and markers of inflammation in a healthy cohort of living kidney donors. This further supports the local role of adipose tissue dysfunction and inflammation in early atherosclerosis development and detection.

PMID:40406925 | DOI:10.1080/21623945.2025.2499500

JAMA Neurol. 2025 May 23. doi: 10.1001/jamaneurol.2025.1522. Online ahead of print.

ABSTRACT

IMPORTANCE: Nontraumatic subarachnoid hemorrhage (SAH) represents the third most common stroke type with unique etiologies, risk factors, diagnostics, and treatments. Nevertheless, epidemiological studies often cluster SAH with other stroke types leaving its distinct burden estimates obscure.

OBJECTIVE: To estimate the worldwide burden of SAH.

DESIGN, SETTING, AND PARTICIPANTS: Based on the repeated cross-sectional Global Burden of Disease (GBD) 2021 study, the global burden of SAH in 1990 to 2021 was estimated. Moreover, the SAH burden was compared with other diseases, and its associations with 14 individual risk factors were investigated with available data in the GBD 2021 study. The GBD study included the burden estimates of nontraumatic SAH among all ages in 204 countries and territories between 1990 and 2021.

EXPOSURES: SAH and 14 modifiable risk factors.

MAIN OUTCOMES AND MEASURES: Absolute numbers and age-standardized rates with 95% uncertainty intervals (UIs) of SAH incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) as well as risk factor-specific population attributable fractions (PAFs).

RESULTS: In 2021, the global age-standardized SAH incidence was 8.3 (95% UI, 7.3-9.5), prevalence was 92.2 (95% UI, 84.1-100.6), mortality was 4.2 (95% UI, 3.7-4.8), and DALY rate was 125.2 (95% UI, 110.5-142.6) per 100 000 people. The highest burden estimates were found in Latin America, the Caribbean, Oceania, and high-income Asia Pacific. Although the absolute number of SAH cases increased, especially in regions with a low sociodemographic index, all age-standardized burden rates decreased between 1990 and 2021: the incidence by 28.8% (95% UI, 25.7%-31.6%), prevalence by 16.1% (95% UI, 14.8%-17.7%), mortality by 56.1% (95% UI, 40.7%-64.3%), and DALY rate by 54.6% (95% UI, 42.8%-61.9%). Of 300 diseases, SAH ranked as the 36th most common cause of death and 59th most common cause of DALY in the world. Of all worldwide SAH-related DALYs, 71.6% (95% UI, 63.8%-78.6%) were associated with the 14 modeled risk factors of which high systolic blood pressure (population attributable fraction [PAF] = 51.6%; 95% UI, 38.0%-62.6%) and smoking (PAF = 14.4%; 95% UI, 12.4%-16.5%) had the highest attribution.

CONCLUSIONS AND RELEVANCE: Although the global age-standardized burden rates of SAH more than halved over the last 3 decades, SAH remained one of the most common cardiovascular and neurological causes of death and disabilities in the world, with increasing absolute case numbers. These findings suggest evidence for the potential health benefits of proactive public health planning and resource allocation toward the prevention of SAH.

PMID:40406922 | DOI:10.1001/jamaneurol.2025.1522

J Int Med Res. 2025 May;53(5):3000605251340304. doi: 10.1177/03000605251340304. Epub 2025 May 23.

ABSTRACT

ObjectiveThis retrospective cohort study aimed to develop and validate a nomogram for predicting in-hospital mortality among patients with community-acquired pneumonia admitted to the intensive care unit.MethodsData of patients meeting the inclusion criteria were extracted from the Medical Information Mart for Intensive Care-IV database, and the patients were randomly allocated into training (n = 3798, 70%) and validation (n = 1629, 30%) cohorts. First-day intensive care unit admission parameters were averaged. Least Absolute Shrinkage and Selection Operator regression and multivariate logistic regression analyses were used to identify mortality risk factors in the training cohort, followed by nomogram construction. Model performance was evaluated based on discrimination (area under the curve), calibration (Hosmer-Lemeshow test and bootstrap resampling), and clinical utility (decision curve analysis). Data from emergency intensive care unit were used to perform external validation of the value of the model.ResultsIn total, 5427 patients were included. Age, red cell distribution width, Sequential Organ Failure Assessment, Acute Physiology Score-III, blood urea nitrogen-to-serum creatinine ratio, anion gap, osmolarity, and sepsis were identified as independent risk factors for hospital mortality. The nomogram demonstrated superior discrimination compared with Sequential Organ Failure Assessment and Acute Physiology Score-III in the validation (area under the curve: 0.772 vs. 0.685-0.724) and training (area under the curve: 0.787 vs. 0.708-0.740; p < 0.05) sets. Calibration and decision curve analyses confirmed robust performance (Hosmer-Lemeshow p = 0.11; net benefit threshold: 20%-80%). In both cohorts, calibration and decision curve analyses showed that the nomogram had good calibration degree, discriminative ability, and clinical benefits. Data from emergency intensive care unit showed that the area under the curve of the model was 0.7864 (95% confidence interval, 0.76-0.81), area under the curve of Sequential Organ Failure Assessment was 0.7217 (95% confidence interval, 0.69-0.75), and area under the curve of Acute Physiology Score-III was 0.7055 (95% confidence interval, 0.68-0.73).ConclusionsThis nomogram provides moderate predictive accuracy for hospital mortality in critically ill patients with community-acquired pneumonia and may aid prognosis assessment.

PMID:40406909 | DOI:10.1177/03000605251340304

Chem Commun (Camb). 2025 May 23. doi: 10.1039/d5cc00856e. Online ahead of print.

ABSTRACT

Herein, we investigate a two-point crosslinked amyloid-β (Aβ) dimer, which forms an intermolecular β-sheet. The atomic force microscopy statistical results indicate that the heights of these dimers are approximately 0.37 nm, providing a baseline for the Aβ peptide sizes and improving our understanding of Aβ oligomers in Alzheimer’s disease.

PMID:40406894 | DOI:10.1039/d5cc00856e

Anal Methods. 2025 May 23. doi: 10.1039/d5ay00426h. Online ahead of print.

ABSTRACT

A bio-chip substrate made from amorphous carbon was successfully developed as an innovative and practical biodetection system. This peptide-microarray biochip was based on a novel principle for protein detection in diagnostics. The carbon material as a substrate carrier offered significant advantages over conventional glass slides with regard to its surface chemistry. The biochip detection system used the measurement of fluorescent intensity changes caused by the interactions between capture molecules (labelled structured peptides arrayed on the substrate) and analytes. Fluorescent intensity changes with and without analytes were dose-dependent and could be visualized as “protein fingerprints”. In this recognition system, interactions are not limited to one-to-one correspondence as in ELISA. Hence, this method can even be applied to analytes containing uncharacterized molecules. Statistical data handling, such as multivariate analyses, enabled discrimination of complex analytes such as body fluids. The present biochip used with an in-house developed detection device could be re-used 10-20 times with the same or different analytes. The captured molecules in this system were immobilized on the chip-surface through stable amide bonds, which allowed washing and even scrub cleaning. This unique material has a potential for dual detection thorough fluorescent intensity changes and mass spectrometric analyses when the chip is used as a sample tray, since this material has high electric conductivity. Thus, this dual detection allows the possibility of discovering marker candidates.

PMID:40406893 | DOI:10.1039/d5ay00426h

Euro Surveill. 2025 May;30(20). doi: 10.2807/1560-7917.ES.2025.30.20.2400655.

ABSTRACT

BackgroundBetween 2020 and 2023, ECDC has supported 21 of 30 EU/EEA and six Western Balkan countries by enhancing severe acute respiratory infection (SARI) surveillance to monitor trends, detect unexpected events, evaluate public health interventions, identify risk factors and support vaccine effectiveness studies. Using diverse strategies, countries have implemented SARI surveillance and reported data at national/European levels.AimWe evaluated European-level SARI surveillance and provided recommendations to achieve objectives and improve key attribute performance.MethodsWe analysed 2022/23 surveillance data for completeness. We administered a questionnaire, targeting country-level representatives, to evaluate surveillance attributes (meeting objectives, usefulness, acceptability, timeliness, representativeness) and identify strengths, weaknesses, opportunities and threats.ResultsThirteen countries (13/27) reported data at European level. Data showed good overall completeness but varied across countries and some variables need improvement (vaccination, sequencing). The questionnaire was completed by all 27 countries. Most countries (23/27) reported that the system effectively monitored trends and considered it useful and acceptable (25/27), but only 16 found it timely and 14 representative. Challenges included insufficient case-based data, data linkage issues and insufficient data completeness. Slow/inefficient manual data extraction affected timeliness, while insufficient geographical coverage affected representativeness. Multi-pathogen surveillance was identified as the main strength, heterogeneity of systems the main weakness, improvements of hospital information systems the main opportunity, and lack of sustainable funding the main threat.ConclusionsSARI surveillance was perceived as effective in monitoring trends, useful and acceptable. To achieve additional objectives and enhance timeliness and representativeness, we recommend improving data completeness, digitalisation/automation and geographical coverage.

PMID:40406887 | DOI:10.2807/1560-7917.ES.2025.30.20.2400655

Euro Surveill. 2025 May;30(20). doi: 10.2807/1560-7917.ES.2025.30.20.2400797.

ABSTRACT

BackgroundData on economic costs of respiratory syncytial virus (RSV) infections among children in primary care are scarce, although most RSV-infections are managed in this setting.AimTo estimate outpatient costs for RSV-positive children aged < 5 years.MethodsIn the RSV ComNet prospective cohort, children < 5 years with acute respiratory infection were recruited for RSV testing through primary care physicians in Belgium, Italy, the Netherlands, Spain and the United Kingdom (UK) during RSV seasons 2020/21 (UK only), 2021/22 and 2022/23. Outpatient healthcare utilisation and parental work absence were assessed over 30 days through parental questionnaires. Average costs per RSV episode were calculated from outpatient healthcare sector and societal perspectives, stratified by country and age.ResultsWe included 3,414 children and 1,124 (33%) tested RSV-positive. Physicians completed reports for 878 episodes, with follow-up questionnaire data for 819 (93%). Outpatient costs ranged from EUR 97 (95% CI: 91-104) in the Netherlands to EUR 300 (95% CI: 287-312) in Spain and were higher for infants than children aged 1-5 years. Societal costs ranged from EUR 454 (95% CI: 418-494) in the UK to EUR 994 (95% CI: 938-1,053) in Belgium. For children aged 1-5 years, societal costs were primarily driven by parental work absence. In infants, the main societal cost driver varied by country, but overall outpatient healthcare costs represented a higher proportion of societal costs vs older children.ConclusionRSV infections in children attending primary care result in substantial economic costs per episode, although differences exist across countries. This study provides essential data to inform cost-effectiveness analyses on novel RSV immunisations.

PMID:40406885 | DOI:10.2807/1560-7917.ES.2025.30.20.2400797

Health Informatics J. 2025 Apr-Jun;31(2):14604582251345328. doi: 10.1177/14604582251345328. Epub 2025 May 23.

ABSTRACT

Objectives: Advances in technology have improved the lives of Indonesians. For example, the health sector. This is indicated by the emergence of telemedicine to facilitate health services. This study aims to test the effect of individual trust on the intention to use telemedicine applications. Therefore, the Technology Acceptance Model (TAM) and the Unified Theory of Acceptance and Use of Technology (UTAUT) are used as the basis for answering the questions posed by this research. Methods: Sampling was conducted online and involved 402 respondents who all came from the Indonesian island of Java. Validity, reliability, and hypothesis testing used Structural Equation Modeling (SEM) with Smart-PLS 4 tools. Result: The results show that effort expectancy, performance expectancy, and social influence have a positive influence on individual belief; intention to use is influenced by individual belief and behavioral intentions. The results of the hypothesis testing show that behavioral intention has the greatest influence on intention to use with a t value of 31.315 and a β value of 0.801. Conclusion: The novelty of this study is that it includes individual belief variables that are influenced by variables from UTAUT, namely effort expectancy, performance expectancy, social influence, and facilitating conditions.

PMID:40406860 | DOI:10.1177/14604582251345328