Tag: statistics

BMC Nurs. 2025 May 2;24(1):486. doi: 10.1186/s12912-025-03123-8.

ABSTRACT

BACKGROUND: The clinical learning environment is crucial for developing essential clinical decision-making skills in nursing students. This study examined nursing students’ perceptions of clinical decision-making and the factors that impact it.

METHODS: A descriptive cross-sectional study was carried out using a self-administered questionnaire, which included a personal information form and the Clinical Decision-Making in Nursing Scale (CDMNS). The study was conducted across ten universities in the Aegean region. Data collection took place at times most convenient for the students, such as during class sessions or lunch breaks. Prior to participation, students were briefed on the study’s objectives and procedures. Those who agreed to participate provided informed consent before completing the questionnaire. Researchers remained present while students filled out the questionnaire to clarify any questions they had.

RESULTS: A considerable proportion of students (72.6%) had never received formal education on clinical decision-making. The average CDMNS score was 140.24 ± 17.04, aligning with findings from previous research. A statistically significant difference was observed in the total mean CDMNS score and sub-dimension scores (searching for alternatives, questioning goals and values, evaluating outcomes, seeking information, and objectively integrating new knowledge) based on the university attended (p < 0.001).

CONCLUSIONS: The findings suggest that nursing students in the Aegean Region demonstrated a moderate level of perceived clinical decision-making skills. To enhance these skills further, it is recommended that alternative educational approaches, such as simulation-based training, case study discussions, and mentoring programmes, be integrated into nursing education and their effectiveness assessed.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40317006 | DOI:10.1186/s12912-025-03123-8

BMC Oral Health. 2025 May 2;25(1):681. doi: 10.1186/s12903-025-06048-5.

ABSTRACT

BACKGROUND: Oral cancer is an underestimated and growing public health problem. The majority of cases are diagnosed at a late stage, even though oral cancer can be detected early by routine visual and tactile examination. Dental healthcare providers thus play a vital role in its early detection. This study assessed dental healthcare providers’ knowledge of diagnostic procedures and risk factors for oral cancer.

METHODS: A cross-sectional, observational study was conducted using a validated survey of 38 items focusing on knowledge of diagnostic procedures and risk factors, and questions on continuing education. From October to December 2023, the online survey invitation was sent via all German state Dental Associations to their members. Participants’ socio-demographic data and responses in the “knowledge, opinion and continuing education” section were analysed descriptively. Linear regressions assessed the associations between participants’ characteristics or opinions and their knowledge of oral cancer (knowledge score).

RESULTS: Overall, 8,132 participants began the survey. After filtering for reliability and completeness, data from 3,458, 3,472, and 2,933 participants were available for “socio-demographics”, “knowledge”, and “opinions and continuing education”, respectively. Most participants were women (60%), between 30 to 49 years old (48%). The majority knew the most common type of oral cancer and the most common lesions associated with it. Furthermore, almost 89% of the participants were aware that early detection improves survival rates. The main risk factors (tobacco, alcohol, prior oral cancer) were well known. However, the potential for improvement in knowledge of localisation, signs, stage of diagnosis and the specific age group at risk was noted. Fewer years in the dental profession and since attending the last continuing education course were associated with higher levels of knowledge.

CONCLUSIONS: Knowledge of localisation, signs, stage of diagnosis, and specific risk groups can be improved. These topics should thus be integral to the dental curriculum and addressed through structured continuing education programmes, as the study’s results suggest that knowledge declines over time without continuing education.

PMID:40317003 | DOI:10.1186/s12903-025-06048-5

BMC Oral Health. 2025 May 2;25(1):678. doi: 10.1186/s12903-025-06059-2.

ABSTRACT

BACKGROUND: Abnormal tongue development is a craniofacial deformity that affects dental-maxillofacial esthetics and function. Recent evidence has identified macrophages as multi-functional immune cells crucial for heart and brain development. However, it is still unknown whether macrophages affect tongue development. Therefore, this study aims to assess the distribution, phenotype, and roles of macrophages in the developing tongue.

METHODS: In this study, immunohistochemical (IHC) and multiplex immunofluorescence (mIF) staining were conducted on C57BL/6 mice at embryonic day (E) 13.5, E14.5, E16.5, and E18.5 to analyze the distribution and phenotype of macrophages. Hematoxylin-Eosin (HE), IHC, IF, and mIF staining were also performed on embryonic CX3 CR1-CreERT2; Rosa-DTA conditional macrophage-depleted mice to investigate the effects on fetal tongue development and elucidate mechanisms from myogenesis, vascularization, and cell apoptosis. Statistical significance between the two groups was determined using unpaired two-tailed Student’s t-tests. For comparisons involving three or more groups, one-way analysis of variance (ANOVA) followed by Tukey’s multiple comparison tests was utilized. A significance level of P < 0.05 was set for statistical significance.

RESULTS: Macrophages were present in the developing tongue from E13.5 to E18.5, with a majority being of the M2 phenotype. Depletion of macrophages resulted in abnormal tongue morphology, decreased tongue height, width, and size, as well as reduced and disorganized muscle fibers. Depletion of macrophages also increased apoptosis. Vascular morphogenesis was impacted, with reductions in the luminal and vascular wall cross-sectional areas of the lingual artery. Vascular endothelial cells were reduced and disorganized with decreased expression of VEGFA and TGF-β1. Moreover, macrophages were located near vascular endothelial cells and secreted pro-angiogenic factors, suggesting their involvement in promoting vascularization.

CONCLUSIONS: Our findings indicate that macrophages play crucial roles in fetal tongue development by affecting myogenesis, cell apoptosis, and vascular growth.

PMID:40316997 | DOI:10.1186/s12903-025-06059-2

Cell Biosci. 2025 May 2;15(1):58. doi: 10.1186/s13578-025-01395-w.

ABSTRACT

BACKGROUND: Dysregulation of N6-methyladenosine (m6A) modifications has been implicated in various cancers, including hepatocellular carcinoma (HCC). This study aimed to elucidate the role of m6A modifications in HCC prognosis and the molecular mechanisms involved, particularly focusing on the demethylase FTO.

METHODS: We analyzed m6A expression in a cohort of 323 HCC patients using immunohistochemical (IHC) staining. The expression of m6A-related genes (FTO, ALKBH5, METTL3, METTL14) was evaluated by qRT-PCR in 120 paired HCC tissues. Further, we established HCC cell lines with altered FTO expression to assess its impact on cell proliferation, invasion, and metastasis through various in vitro assays and in vivo orthotopic HCC mouse models. Statistical analyses included Pearson chi-square test, Kaplan-Meier survival analysis, and both univariate and multivariate Cox regression analyses.

RESULTS: IHC staining revealed elevated m6A levels in HCC tissues compared to adjacent non-tumorous tissues, with 57.3% of HCC patients showing increased m6A expression. High m6A levels were correlated with poorer overall survival (OS) and recurrence-free survival (RFS) rates. FTO, a demethylase, was significantly downregulated in HCC tissues and cell lines, particularly in highly metastatic lines. Overexpression of FTO in HCC cells reduced proliferation, migration, and invasion, whereas FTO knockdown had the opposite effect. In vivo, FTO overexpression decreased tumor growth and metastasis. RNA-Seq analysis identified VEGFA as a key gene downregulated by FTO, implicating its role in angiogenesis and tumor progression.

CONCLUSIONS: Our findings suggest that elevated m6A levels are associated with poor prognosis in HCC patients. FTO downregulation contributes to aberrant m6A modifications, promoting HCC progression and metastasis. FTO acts as a tumor suppressor by negatively regulating VEGFA expression, highlighting its potential as a therapeutic target for HCC treatment. These results highlight the significance of m6A modifications in HCC and provide a foundation for future research on targeted therapies.

PMID:40316995 | DOI:10.1186/s13578-025-01395-w

BMC Med Ethics. 2025 May 2;26(1):55. doi: 10.1186/s12910-025-01218-0.

ABSTRACT

INTRODUCTION: Patient satisfaction is a significant measure of healthcare service quality as the patient is the center of any surgical procedure. Patient satisfaction refers to the extent to which a patient’s expectations of optimal care align with their perception of the care received. Patient satisfaction during informed consent is enhanced when written informed consent is accompanied by verbal consent in the preoperative period. Satisfied patients are more inclined to adhere to therapy, engage actively in their care, utilize healthcare services, willingly partake in decision-making, and remain with a healthcare provider. This research examines the practical and ethical considerations of obtaining informed consent during surgical procedures. To better understand and make informed decisions, this study aims to assess the efficacy of present consent methods and pinpoint obstacles patients encounter.

METHODOLOGY: A cross-sectional study was conducted from April to December 2024. Data were gathered by second-year students from Koya University’s Faculty of General Medicine by interviewing postoperative patients who had undergone general surgical procedures. The results were entered into a Google form and analyzed using SPSS27.

RESULTS: In interviews with participants, 430 out of 572 patients (75%) indicated trust in their surgeons performing the surgery, while 525 patients (91%) expressed respect for their surgeons’ opinions. However, 41% (239 patients) reported not reading the informed consent form, and a similar percentage denied that the details of the form were explained by the medical staff responsible for the surgery as there are some medical terms or situations in the form that are challenging to assume if not explained.

CONCLUSION: Compared to others, participants with a higher educational level sought extensive time from the responsible surgeons to discuss every detail of the surgery before signing the informed consent, with a statistically significant difference observed. A similar difference was noted between private and public hospitals.

PMID:40316992 | DOI:10.1186/s12910-025-01218-0

BMC Nurs. 2025 May 2;24(1):485. doi: 10.1186/s12912-025-03112-x.

ABSTRACT

BACKGROUND: Nurses, as the most critical and largest professional group providing care to children and families, play a crucial role in collaborating with the parents of hospitalized children. The foundation of nursing care is based on a family-centered approach, where families are actively involved in the care process. The provision of family-centered care in educational and medical centers requires skilled nurses with high self-efficacy. Nurses with high self-efficacy are believed to demonstrate high competence in collaborating with children, parents, and colleagues. Therefore, the present study examines the relationship between nurses’ professional self-efficacy and parents’ perceptions of family-centered care.

METHODS: The present descriptive-correlational study was conducted in 2024 at the Pediatric Specialty Center of Ardabil in northwest Iran. 200 nurses were selected using a census method, and 220 parents of hospitalized children were selected through stratified random sampling. Data were collected using two valid and reliable tools: the Professional Self-Efficacy Questionnaire for Nurses, and the Perception of Family-Centered Care for Parents Questionnaire. The data were analyzed using independent t-tests, one-way analysis of variance, Pearson correlation coefficient, and multiple linear regression tests using SPSS version 24.

RESULTS: According to the results, 54% of the nurses and 78% of the parents reported their level of professional self-efficacy and perception of family-centered care as moderate, respectively. Statistical analysis has not revealed significant correlations between demographic variables professional self-efficacy and perception of family center care. Multiple linear regression analysis showed that professional self-efficacy and subscales were predictors of parents’ perception of family-centered care. The selected predictors accounted for 2.6% of the total variance in the perception of family-centered care (F = 2.79, P = 0.041).

CONCLUSIONS: The present study revealed a limited association between nurses’ professional self-efficacy and parents’ perceptions of family-centered care. Consequently, there is a clear imperative for nursing leadership to implement targeted interventions to bolster nurses’ self-efficacy. Specifically, organizing workshops designed to enhance nurses’ confidence and foster collaborative partnerships with parents is recommended. Such initiatives have the potential to significantly improve the delivery of high-quality nursing care to hospitalized children, ultimately optimizing patient outcomes and family satisfaction.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40316991 | DOI:10.1186/s12912-025-03112-x

BMC Nurs. 2025 May 2;24(1):489. doi: 10.1186/s12912-025-03125-6.

ABSTRACT

BACKGROUND: This study examines the impact of non-care-related stressors and resilience factors on the mental health of caregivers for chronically ill and disabled children. It aims to identify the daily stressors and protective factors most relevant to caregiver well-being.

METHODS: A total of 202 caregivers (predominantly female, aged 25-59) participated in a survey measuring exposure to daily micro-stressors, such as household tasks and financial pressures, and macro-stressors, such as significant life events. Resilience factors, including social support and internal locus of control, were also assessed. Descriptive statistics and regression analyses explored the relationship between stressors, resilience factors, and psychological distress.

RESULTS: Micro-stressors were strongly associated with higher levels of psychological distress, underscoring the cumulative burden of frequent, daily stressors. In contrast, macro-stressors had no significant impact on distress, possibly due to their lower frequency or differences in perception. Resilience factors, particularly social support and internal locus of control, buffered against distress, demonstrating their protective role. Internal locus of control moderated the relationship between micro-stressors and distress, indicating that caregivers who felt greater personal control over their circumstances were better able to manage the negative effects of daily stressors.

CONCLUSIONS: The findings highlight the significant toll of daily micro-stressors on caregivers’ mental health and emphasize the important role of resilience factors in mitigating this burden. Strengthening caregivers’ social networks and fostering internal control beliefs could be key components of interventions designed to improve their well-being. These results suggest that supporting caregivers is essential not only to enhance their quality of life but also to sustain their caregiving roles. Further research should investigate the long-term effects of interventions targeting resilience and explore additional protective factors that may buffer against daily stressors in this vulnerable population. These findings have important implications for disability and rehabilitation services aiming to provide holistic caregiver support.

TRIAL REGISTRATION: DRKS00027465, 2022-01-04 (German Clinical Trials Register); NCT05418205, 2022-03-01 (ClinicalTrials.gov).

PMID:40316988 | DOI:10.1186/s12912-025-03125-6

BMC Public Health. 2025 May 2;25(1):1637. doi: 10.1186/s12889-025-22786-1.

ABSTRACT

BACKGROUND: Early-life interventions are essential for improving public health since lifestyle behaviours are established already in childhood. Child healthcare (CHC) plays a crucial role in this context. The ‘Saga Stories in health talk’ (SSiHT) material includes a flipchart with colourful illustrations to facilitate CHC nurses’ routine health talks with parents and their children, and a hand-out material kit to support healthy lifestyle behaviours in the families. Our aim was to evaluate the effectiveness of the SSiHT intervention at the 5-year routine visit at CHC on parental self-efficacy (primary outcome) and children’s health-related behaviours (secondary outcomes). Implementation aspects for using the SSiHT material in routine practice for health talks at the 5-year visit were simultaneously evaluated.

METHODS: A hybrid type 1 effectiveness-implementation design was used to evaluate the intervention in six health regions across Sweden. A cluster-randomised controlled trial was conducted to evaluate effectiveness, where 40 CHC centres (98 nurses) were randomised into two arms: use the SSiHT material in routine care (intervention), or standard care (control). Parents (n = 698) of 5-year-olds were recruited. Outcome measures were assessed using digital questionnaires before the health talk (baseline), and two months later (follow-up). Linear mixed-effect models were used to contrast differences in outcomes between groups, in accordance with the study protocol. Acceptability, appropriateness, feasibility, fidelity, and adoption were evaluated using questionnaires and checklists to CHC nurses in the intervention group.

RESULTS: No statistically significant intervention effects were found on parental self-efficacy to promote healthy lifestyle behaviours in their children (-0.61 score on a scale 0-160; p = 0.56), nor children’s intake of vegetables, fruits/berries, and sweet drinks or screen time (p > 0.05 for all). However, CHC nurses overall reported that the SSiHT material was feasible and appropriate to use in the health talks with families, and they used it in 83% of their health talks.

CONCLUSION: Although the SSiHT material was well accepted by the CHC nurses, there was no intervention effect on parental self-efficacy (primary outcome) nor health-related behaviours in children when evaluated in Swedish CHC. This warrants further research to better understand how to effectively empower parents through CHC health talks.

TRIAL REGISTRATION: Registered 2 February 2022 at Clinicaltrials.gov NCT05237362; https://www.

CLINICALTRIALS: gov/study/NCT05237362 .

PMID:40316984 | DOI:10.1186/s12889-025-22786-1

Appl Radiat Isot. 2025 Apr 24;222:111859. doi: 10.1016/j.apradiso.2025.111859. Online ahead of print.

ABSTRACT

PURPOSE: The X-ray examination of the pelvis is one of the procedures with the highest radiation dose and the most common X-ray examination. For this reason, this study investigated whether the alternative posteroanterior (PA) projection can be used instead of the established anteroposterior (AP) projection to perform pelvic radiography in an erect position.

METHODS: The study was conducted in a clinical setting on 100 patients who were referred to erect pelvic radiography. The patients were randomly divided into two equal groups of 50; the first group was imaged in the AP projection, and the second group in the PA projection. Weight and height were measured for each patient, from which the body mass index was calculated. During imaging, the source-to-patient was measured, and the tube voltage, tube current and time product, Dose Area Product (DAP), source-to-image receptor distance, and primary field size were collated. Based on these data, the entrance surface dose (ESD) and the effective dose, as well as the dose to selected organs, were calculated. In addition to measured dosimetric values, image quality was also assessed by three experienced radiologists using ViewDEX 2.57 software.

RESULTS: No statistically significant differences were found between the AP and PA projection of erect pelvic radiography for DAP and ESD. On the other hand, a statistically significant difference of 51.5 % (p < 0.001) was found when comparing the effective dose. There were no statistically significant differences between the image quality of the radiographs taken in the PA in AP projection.

CONCLUSION: Based on the above results, we can conclude that PA projection should be the method of choice when performing an erect pelvic radiography due to a significant decrease in effective dose.

PMID:40315538 | DOI:10.1016/j.apradiso.2025.111859

Phys Rev Lett. 2025 Apr 18;134(15):150402. doi: 10.1103/PhysRevLett.134.150402.

ABSTRACT

Steady-state quantum thermal machines are typically characterized by a continuous flow of heat between different reservoirs. However, at the level of discrete stochastic realizations, heat flow is unraveled as a series of abrupt quantum jumps, each representing an exchange of finite quanta with the environment. In this work, we present a framework that resolves the dynamics of quantum thermal machines into cycles classified as enginelike, coolinglike, or idle. We analyze the statistics of individual cycle types and their durations, enabling us to determine both the fraction of cycles useful for thermodynamic tasks and the average waiting time between cycles of a given type. Central to our analysis is the notion of intermittency, which captures the operational consistency of the machine by assessing the frequency and distribution of idle cycles. Our framework offers a novel approach to characterizing thermal machines, with significant relevance to experiments involving mesoscopic transport through quantum dots.

PMID:40315534 | DOI:10.1103/PhysRevLett.134.150402