Tag: statistics

Arch Iran Med. 2025 Apr 1;28(4):207-216. doi: 10.34172/aim.31947. Epub 2025 Apr 1.

ABSTRACT

BACKGROUND: The increasing demand for healthcare services and some associated factors including lack of physicians, lack of trust in physicians, ineffectiveness of treatments and high costs may be have led to a rise in non-physician-provided services. This study aims to assess health services delivery by non-physicians and its associated factors in Iran.

METHODS: This study was a cross-sectional study conducted using a convenience sampling method in the Iranian community in 2023. A standard questionnaire with 45 questions was developed based on focus group discussions and a validation process to assess the status of receiving services in six medical areas including traditional medicine, abortion, traditional dentistry, obesity and slimming diets, bone setting, and addiction treatment. Data collection was carried out using online questionnaires on Iranian and non-Iranian social media platforms. Descriptive and analytical statistics were used to analyze the data, with logistic regression adjusting for various demographic factors.

RESULTS: Out of 1713 participants, 53.9% (95% CI: 51.5%-56.3%) were women, and the majority were in the 30-40 age group. Traditional Islamic medicine was the most commonly sought service, with 56% (95% CI: 51.2%-60.8%) of users receiving it from non-physicians. Satisfaction with non-physician services varied, with 32.1% (95% CI: 25.8%-38.4%) reporting high satisfaction for traditional medicine, but only 49.4% (95% CI: 40.5%-58.3%) for experimental dentistry. Key reasons for choosing non-physician providers included the effectiveness of traditional treatments and fear of modern medicine’s side effects.

CONCLUSION: The result showed that the use of non-physician services can be considerable and that necessary interventions should be designed to standardize treatments and deal with substandard providers who may be harmful to the health of the community.

PMID:40382692 | DOI:10.34172/aim.31947

Arch Iran Med. 2025 Apr 1;28(4):189-197. doi: 10.34172/aim.31306. Epub 2025 Apr 1.

ABSTRACT

BACKGROUND: Comparing the trends of mortality rates provides valuable insight for policy discussions and promotes awareness of health issues. This study aimed to investigate the changes in mortality rate and life expectancy from 2011 to 2021 and the effect of COVID-19 period on these indices.

METHODS: We investigated the data of all-cause deaths between 2011 and 2021 by age group, sex and year using Excel spreadsheets from the National Organization for Civil Registration (NOCR), via collected the census method. Joinpoint regression was used to calculate the trend of mortality rate during the study period.

RESULTS: During the study period, there were 262,708 deaths, of which 148,919 were men (56.68%). The trend of mortality rate in both sexes has been increasing. Life expectancy in men and women decreased from 76.71 and 80.82 in 2011 to 74.43 and 77.53 in 2021, respectively. From 2018 to 2021, there was a significant increase in standardized mortality rate in men (APC=14.74; 95% CI=5.73; 28.65) and women (APC=14.29; 95% CI=4.67; 28.97). However, from 2011 to 2018, we observed a yearly 2.65% decreasing trend in men which was statistically significant (APC=-2.95, 95% CI=-7.67, -0.84). In women, no significant trend was seen.

CONCLUSION: With the emergence of the COVID-19 epidemic in 2019, the trend of mortality rate and life expectancy changed completely, with additional deaths and decreasing life expectancy. Therefore, prevention, control and treatment of epidemic diseases should be a serious concern of policy makers.

PMID:40382690 | DOI:10.34172/aim.31306

Arch Iran Med. 2025 Apr 1;28(4):182-188. doi: 10.34172/aim.33193. Epub 2025 Apr 1.

ABSTRACT

BACKGROUND: A healthy diet is essential for managing metabolic syndrome (MetS), but moderation and dietary adequacy remain ambiguous.

METHODS: Data from the recruiting phase of the Shiraz University of Medical Sciences Employees Health Cohort Study (SUMS EHCS) were utilized to conduct this cross-sectional analysis. A validated 168-item semi-quantitative food frequency questionnaire (FFQ) was used to collect dietary data in the Persian cohort. In the current study, the healthy eating index (HEI-2015) includes two components, namely adequacy and moderation which were used to evaluate the quality of the diet.

RESULTS: The study included 3380 health workers, with a mean age of 41.81±7 years and 55.2% female. Among them, 22.3% met the ATP III criteria for MetS. The mean total HEI, adequacy, and moderation scores were 63.89±9.53, 41.03±5.88, and 20.13±4.90, respectively. Adjusted model analysis showed no significant correlation between diet adequacy and MetS or its components, but found a significant association between diet moderation and MetS (OR: 1.03 [1.008-1.05]), abdominal obesity (OR: 1.02 [1.003-1.04]), elevated serum triglycerides (TGs) (OR: 1.02 [1-1.03]), and elevated fasting blood sugar (FBS) (OR: 1.03 [1.005-1.05]).

CONCLUSION: This study found that there was a significant correlation between diet moderation and abdominal obesity, elevated serum TGs, elevated FBS, and MetS. Future studies on the topic are recommended.

PMID:40382689 | DOI:10.34172/aim.33193

Acta Otolaryngol. 2025 May 17:1-7. doi: 10.1080/00016489.2025.2504032. Online ahead of print.

ABSTRACT

BACKGROUND: Single-sided deafness (SSD) encompasses the presence of a profoundly deaf ear with a normal, contralateral one. Patients with SSD may have difficulty with speech intelligibility in noise and localizing sounds.

AIMS/OBJECTIVES: This retrospective study aims to evaluate the long-term effectiveness of bone conduction implant (BCI) in a group of patients with SSD.

MATERIAL AND METHODS: Audiologic benefit was assessed through conventional speech audiometry and adaptive Matrix test. Impact on quality of life was evaluated with the Glasgow Benefit Inventory (GBI) questionnaire. BCI usage data were also obtained from each subject.

RESULTS: Thirty-two patients were included. No statistically significant improvements were found at standard audiometric tests using BCI, but at Matrix test the mean SRT is reached at S/N -1.16 dB without BCI and -2.07 with BCI with a statistically significant difference (p = 0.026). The mean GBI score was 25.12, ranging from -8.3 to 47.2. Ten subjects (31%) discontinued the BCI use overtime.

CONCLUSIONS AND SIGNIFICANCE: Benefit assessment of BCI in SSD recipients can be difficult. Adaptive audiometric test could be useful. Quality of life measures seem to suggest potential ‘beyond-auditory’ benefits. SSD recipients can be inconsistent users of BCI.

PMID:40382679 | DOI:10.1080/00016489.2025.2504032

J Transl Med. 2025 May 17;23(1):557. doi: 10.1186/s12967-025-06553-9.

ABSTRACT

BACKGROUND: There is a dearth of population-based studies on the association between the diversity of the oral microbiome and the risk of chronic obstructive pulmonary disease (COPD). The study aims to investigate the association between oral microbiome diversity and COPD.

METHODS: In this cross-sectional study, data from the National Health and Nutrition Examination Survey (NHANES 2009-2012) were analyzed. The association between the oral microbiome α-diversity and COPD risk was examined via multivariable logistic regression, with Restricted cubic splines revealing potential non-linear trends. The β-diversity disparities between COPD and non-COPD groups were delineated using Principal Coordinate Analysis (PCoA) and Permutational Multivariate Analysis of Variance (PERMANOVA).

RESULTS: A total of 6061 participants were included in this study. For α-diversity, the observed ASVs were significantly associated with COPD risk (OR = 0.964, 95%CI: 0.936-0.993, P = 0.016). Similarly, Faith’s phylogenetic Diversity showed a significant association with COPD risk (OR = 0.955, 95%CI: 0.919-0.993, P = 0.020). The Shannon-Weiner index was also associated with COPD risk (OR = 0.829, 95%CI: 0.702-0.981, P = 0.029). For β-diversity, PCoA and PERMANOVA analysis showed statistically significant differences in Bray-Curtis, unweighted, and weighted UniFrac distances (all P < 0.01) between the COPD and non-COPD groups.

CONCLUSIONS: Significant differences in oral microbiome α-diversity and β-diversity were found between COPD and non-COPD populations, with α-diversity (observed ASVs, Faith’s Phylogenetic Diversity, Shannon-Weiner index) being negatively associated with the risk of COPD.

PMID:40382665 | DOI:10.1186/s12967-025-06553-9

Int Breastfeed J. 2025 May 17;20(1):38. doi: 10.1186/s13006-025-00726-4.

ABSTRACT

BACKGROUND: Despite the health benefits of breastfeeding only 57% of infants were exclusively breastfed at 4 months postpartum in Germany in 2017-2019. Due to the gap between the actual exclusive breastfeeding (EBF) rates and recommendations, we aimed at investigating further factors influencing breastfeeding duration.

METHODS: This prospective observational study conducted in Berlin, Germany from 11/2022-05/2024 implemented a mixed-methods design with concurrent triangulation. We present quantitative results here. First-time mothers were surveyed at birth and 2, 6 and 12 months postpartum. Breastfeeding status was assessed by asking “How are you currently feeding your child?” and, if anything other than EBF (defined as supply of breastmilk without liquids or solids) was indicated, “I breastfed exclusively until [date]”. Maternal perception was assessed by asking “How comfortable do you currently feel with breastfeeding/feeding your child?”, with comfort referring to well-being/statisfaction/feeling good (German = wohlfühlen). Obstetric and newborn characteristics were collected from recruiting hospital’s health records: an anthroposophic baby-friendly certified hospital (a-BF), a baby-friendly certified hospital (BF) and a university hospital not certified as baby-friendly (non-BF). Data were analysed descriptively and through multivariate analysis.

RESULTS: Most of the 326 participating mothers had initiated breastfeeding in the delivery room (94.7%). Mothers reported EBF for a median duration of 5.7 months, with 76.6% achieving ≥ 4 months. High levels of maternal comfort with breastfeeding 2 months postpartum were significantly associated with an EBF duration ≥ 4 months (aOR 7.25, CI 95% 2.11, 24.9). An intended EBF duration of 4-7 months (aOR 4.08, CI 95% 0.29, 57.77), higher breastfeeding comfort shortly after birth (aOR 1.79, CI 95% 0.49, 6.59), delivery in the a-BF clinic (aOR 1.59, CI 95% 0.41, 6.14) and high satisfaction regarding breastfeeding support in the hospital (aOR 1.39, CI 95% 0.41, 4.70) increased likeliness of EBF ≥ 4 months.

CONCLUSION: Our results emphasize the pivotal role of the mother’s comfort in the breastfeeding process and it’s impact on breastfeeding duration. Strategies to enhace maternal comfort therefore need to be specifically included in maternal care. To explore key aspects of maternal comfort qualitative interviews will address the individual experiences in the breastfeeding journey and identify parent-centred strategies for sustainable breastfeeding.

PMID:40382664 | DOI:10.1186/s13006-025-00726-4

Gerontol Geriatr Educ. 2025 May 17:1-13. doi: 10.1080/02701960.2025.2505648. Online ahead of print.

ABSTRACT

Interprofessional education (IPE) enhanced with simulation for pre-licensure health care students can be used to teach a collaborative interprofessional team approach to promote positive health outcomes in the older adult population. Little is known about outcome differences between in-person and virtual IPE. A multi-step, simulation-enhanced IPE was developed based on Wagner’s Chronic Care and Constructivism Active Learning theoretical frameworks and implemented in-person and virtually for cohort comparison. Learning outcomes were the advancement of interprofessional collaborative competencies. Two cohorts of students from nursing, pharmacy, counseling, social work, and speech therapy, participated in consecutive Fall semesters (n = 74 in-person, n = 74 virtual). Pre- and post-IPE measures of teamwork using the Interprofessional Socialization and Valuing Scale (ISVS) total and individual items showed within-group advancement of competencies (p = 0.0054 in-person, p = 0.0024 virtual). Comparison between groups of pre/post mean change scores on five ISVS items showed no statistically significant difference. Satisfaction ratings using a researcher-created survey of items on a 5-point Likert scale demonstrated significantly higher scores for in-person education on 7 out of 10 individual items and the overall satisfaction rating, (p < 0.5). Virtual learning has become more commonplace following the pandemic, and these results suggest there are benefits for both methods.

PMID:40381186 | DOI:10.1080/02701960.2025.2505648

Matern Child Health J. 2025 May 17. doi: 10.1007/s10995-025-04103-9. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this study is to estimate the maternal knowledge and practice levels regarding neonatal umbilical cord care and their associated factors in different provinces of Pakistan.

METHODS: A descriptive cross-sectional study design was used to collect data from the respondents. Multistage sampling techniques were carried out for this study. Semi-structured questionnaire was designed for collection of data after acquiring ethical approval and informed consent. Descriptive statistics were carried out by taking frequencies and percentages of the collected data and associated factors were analyzed by applying chi-square test at the p value of < 0.05.

RESULTS: 245 (65.3%) of the respondents had poor knowledge levels about umbilical cord care and 220 (58.7%) respondents practiced poor cord care. More than half of the respondents had poor knowledge. 285 (76%) about the usage of chlorhexidine (CHX) on the cord for seven consecutive days. Some conventional and unhygienic practices were also recorded in this study. More than half of the mothers used cord clamps for tying the cord 245 (65.3%) followed by tailor’s threads 77 (20.5%). The associated factors including parity, occupation and income were not showing statistically significant results at the p value of < 0.05 except for place of delivery (*p = 0.01), (*p = 0.005) and educational status (*p = 0.04), (*p = 0.03), which are showing statistically significant results.

CONCLUSION: Paucity in both knowledge and practices of umbilical cord care were observed among mothers attending postnatal care in the hospitals. Programs need to be initiated for the improvement of knowledge of UCC and discouragement of unhygienic practices.

PMID:40381154 | DOI:10.1007/s10995-025-04103-9

Obes Surg. 2025 May 17. doi: 10.1007/s11695-025-07926-1. Online ahead of print.

ABSTRACT

BACKGROUND: Obesity is a worldwide epidemic and is pervasive in the liver disease community. Given that liver disease is both caused and worsened by obesity, our study assesses the risks of bariatric surgery in patients with chronic liver disease.

METHODS: This retrospective study using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program 2023 database includes adult patients who underwent minimally invasive sleeve gastrectomy, Roux-en-Y gastric bypass, or gastric band placement procedures. Liver disease (LD) includes a spectrum of severity (borderline to moderate) and etiologies (including steatosis). LD and non-liver disease (non-LD) cohorts were compared using Chi-square and t-tests. Univariate and multivariate analyses were performed using logistic regression.

RESULTS: Our sample of 201,605 patients included 22,476 (11.2%) LD and 179,129 (88.9%) non-LD patients. Overall mean body mass index was 44.68 kg/m² (SD 7.86). The mortality rates were no different between groups (0.07% and 0.07%, p = 0.85). While multivariate subset analyses of each procedure showed a statistically slightly elevated risk of bleeding, infection, bowel obstruction, Clavien-Dindo I-III complications, and ICU admission for the liver group patients (odds ratios ranged from 1.42-1.76), rates of complications were clinically very low (3.1% and 0.8% for Clavien-Dindo I-III and IV).

CONCLUSION: Given the low 30-day complication rate, our study shows that in the appropriate candidates with mild-to-moderate chronic liver disease, minimally invasive bariatric surgery is safe in the short-term, and the documented benefits of weight loss likely outweigh the slightly elevated risk. Bariatric surgeons can feel more comfortable and informed operating in this context.

PMID:40381135 | DOI:10.1007/s11695-025-07926-1

Endocrine. 2025 May 17. doi: 10.1007/s12020-025-04259-y. Online ahead of print.

ABSTRACT

BACKGROUND: The fibrinogen to albumin ratio (FAR) is a novel inflammatory indicator correlating with the severity of coronary artery disease (CAD). An indicator of atherosclerosis is the Castelli Risk Index 2 (CRI-2=LDL-C/HDL-C). Yet, little research has focused on the link between both of indicators and CAD in different glucose metabolic states. Thus, this study aimed to investigate the association between FAR, CRI-2, and the severity of coronary artery lesions in patients with CAD in different glucose metabolic states.

METHOD: In this investigation, coronary angiography was performed about 2825 individuals suffering from symptomatic CAD at Tianjin Union Medical Center from 2016-2023.The number of stenotic arteries in the coronary arteries was counted. The Gensini scores were taken into account. Normal glucose regulation (NGR), pre-diabetes mellitus (Pre-DM), and diabetes mellitus (DM) were the three categories of glucose status according to the WHO diabetes guidelines. Patients were also divided into FAR index and CRI-2 quartiles to look into the link between FAR index and CRI-2 and coronary artery lesions in CAD patients with different glucose metabolic states. Receiver operating characteristic (ROC) curves were constructed to analyze the predictive value of the FAR index and CRI-2 for coronary artery lesions.

RESULT: According to logistic regression analysis, the FAR index and CRI-2 were statistically associated with coronary artery disease (P < 0.05). The FAR index was linked with severity of coronary artery lesions regardless of glucose metabolism states (P < 0.05). The CRI-2 was strongly linked with severity of coronary artery lesions in both NGR and DM status (P < 0.05). Yet, there was no statistical significance in Pre-DM states (P > 0.05). The FAR index and CRI-2 exhibited higher regions underneath the ROC curve in forecasting severity of coronary artery lesions.

CONCLUSION: The FAR index and CRI-2 were significantly associated with severity of coronary artery lesions in different glucose metabolic states. FAR index and CRI-2 have predictive value for coronary artery lesions.

PMID:40381131 | DOI:10.1007/s12020-025-04259-y