Tag: statistics

BMC Res Notes. 2025 May 9;18(1):208. doi: 10.1186/s13104-025-07270-8.

ABSTRACT

BACKGROUND: Under 5 children diarrhea has been one of the major public health concerns in countries with limited resources such as Ethiopia. Understanding the association between under-5 diarrhea and meteorological factors will contribute to safeguarding children from adverse health effects through early warning mechanisms. Thus, this study aimed to explore the association between under-5 diarrhea and meteorological factors to reduce health risks.

METHODS: A time-series ecological study was used to explore the association between meteorological factors and under-5 diarrhea incidence. Spearman’s correlation was computed to test the correlation and a negative binomial regression model was fitted to determine the associations of meteorological factors with under-5 diarrhea incidence. The multicollinearity was checked using the variance inflation factor (VIF) before the multivariable regression analysis and the value was 5. aIRRs with 95% CIs and a significance level of 0.05 were used for all the statistical tests. Statistical analyses were conducted using STATA 14.2 software.

RESULTS: The highest under-5 diarrhea incidence morbidities was 180.9 per 1000 per year for under-five children. This study revealed a positive and negative correlation between the count of under-5 diarrhea and average monthly temperature and rainfall at 0 and 2 lag months with RRs of 1.0209 (95% CI: 1.0034-1.0387), RR 1.0202(95% CI:1.0022-1.0385), RR 0.999(95% CI:0.9985-0.9996), and RR 0.9992(95% CI:0.9987-0.9997) respectively.

CONCLUSION: There was an association between under 5 diarrhea incidence and meteorological factors in the Central Gondar Zone. The mean monthly temperature and rainfall were positively and negatively related to the incidence of diarrhea in children under 5 years old. The results showed that the observed association between meteorological factors and under-5 diarrhea incidence could be used as evidence for the use of early warning systems for the prevention of childhood diarrhea.

PMID:40346673 | DOI:10.1186/s13104-025-07270-8

Cardiovasc Diabetol. 2025 May 9;24(1):200. doi: 10.1186/s12933-025-02758-w.

ABSTRACT

BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is closely associated with insulin resistance (IR). However, the prognostic value of different alternative IR surrogates in patients with MASLD remains unclear. This study aimed to evaluate the association between various IR indices and all-cause mortality and cardiovascular mortality in MASLD patients.

METHODS: A total of 8,753 adults aged ≥ 20 years with MASLD from the National Health and Nutrition Examination Survey (NHANES, 2003-2018) were included, and their mortality data were obtained from the National Death Index (NDI). Insulin resistance surrogates [including the triglyceride-glucose (TyG) index, TyG-body mass index (TyG-BMI), TyG-waist circumference index, TyG-waist-to-height ratio index, and Homeostatic Model Assessment for IR] were stratified into quartiles. Cox proportional hazards models, receiver operating characteristic (ROC) curve analysis, restricted cubic spline (RCS), mediation analyses, and subgroup analyses were used to explore the associations between these indices and all-cause mortality as well as cardiovascular mortality in MASLD patients.

RESULTS: During a median follow-up of 98 months, 1,234 deaths were observed, including 409 cardiovascular disease (CVD)-related deaths. In the fully adjusted model, higher quartiles of TyG-related indices were significantly associated with an increased risk of all-cause mortality in MASLD patients. Furthermore, the TyG-BMI index was associated with both all-cause mortality and CVD mortality [all-cause mortality: HR (95% CI) 2.84 (1.73-4.67), P < 0.001; CVD mortality: HR (95% CI) 5.32 (2.26-12.49), P < 0.001]. The RCS analyses indicated a U-shaped relationship between TyG-BMI and mortality, with a threshold value of 270.49. Subgroup analyses demonstrated that TyG-related indices had stronger associations with mortality in elderly MASLD patients.

CONCLUSIONS: Our findings highlight the prognostic value of IR indices, particularly TyG-BMI index, in predicting all-cause mortality and CVD mortality in MASLD patients.

PMID:40346671 | DOI:10.1186/s12933-025-02758-w

Reprod Health. 2025 May 9;22(1):67. doi: 10.1186/s12978-025-02023-z.

ABSTRACT

BACKGROUND: Music therapy has been widely used in medical practices, demonstrating positive effects on diverse medical procedures. In the context of labor pain management, evidence suggests that music can positively influence pain perception and overall well-being during labor, serving as a distraction and stress reducer. This systematic review and meta-analysis aim to comprehensively evaluate the impact of music therapy on labor pain in primigravida women during vaginal delivery.

METHODS: Following PRISMA guidelines, a thorough literature search was conducted in Google Scholar, PubMed, and Cochrane Central Register of Controlled Trials up to November 2023. Nine randomized control trials (RCTs) met the inclusion criteria, involving primigravida women undergoing vaginal delivery with music therapy intervention. Quality assessment was performed using the Cochrane Risk of Bias assessment tool.

RESULTS: A meta-analysis of the fixed effects was performed using mean differences (MD). Pooled analysis of Visual Analog Scale (VAS) scores revealed statistically significant reductions in pain intensity during latent (MD: – 0.73; 95% CI – 1.01; – 0.45); during the active phase (MD: – 0.56; 95% CI – 1.06; – 0.07) and the second stage (MD: – 0.69; 95% CI – 0.85; – 0.54). The findings indicated no statistically significant variances related to the integration of music therapy in addressing anxiety, both in the latent phase (MD: – 0.88; 95% CI – 1.86; -2.02) and the active phase of labor (MD: -0.30; 95% CI – 1.74; 1.13).

CONCLUSIONS: In conclusion, the collective evidence presented in this systematic review underscores the potential of music, especially for women giving for the first time. in mitigating labor pain and anxiety across different stages, offering a holistic approach to enhance the overall childbirth experience for women.

PMID:40346658 | DOI:10.1186/s12978-025-02023-z

BMC Health Serv Res. 2025 May 10;25(1):674. doi: 10.1186/s12913-025-12843-1.

ABSTRACT

BACKGROUND: Elderly individuals with chronic conditions or acute illnesses are major drivers of hospitalization, with frail patients frequently utilizing emergency department (ED) services. To ease this burden, many countries offer home-based medical services. In Region Halland, Sweden, a mobile team intervention in municipal home care (MHC) was introduced to support frail elderly patients. This study aimed to assess whether the intervention reduced ED visits and hospitalizations among MHC recipients.

METHODS: The study population consisted of all patients aged ≥ 65 years enrolled in MHC in Halmstad, Sweden, from October 2014 – April 2016. Healthcare utilization during the seven months prior to the initiation of the intervention (October 2014 – April 2015) constituted the pre-intervention group and were compared with healthcare consumption during a seasonally matched seven-month period after the launch of the intervention (October 2015-April 2016). The primary outcome was the number of adverse events, defined as unplanned ED visits or hospital admission. Negative binomial regression was used to assess the association between exposure and adverse events, presented as Incidence Rate Ratios (IRRs) with 95% confidence intervals (CIs).

RESULTS: A total of 2163 patients were included in the pre-intervention group, and 2197 patients in the intervention group. Both groups had a mean age of 84 years, with no significant differences regarding sex. In the pre-intervention group, 64% had severe comorbidities, compared to 66% in the intervention group. Primary care home visits by physicians increased from an average of 0.9 in the pre-intervention group to 1.1 in the intervention group (p < 0.001). Risk for adverse events was elevated among patients with severe comorbidities (IRR = 3.14, 95% CI: 1.91-5.15, p = < 0.001). There was a slight decrease in the incidence rate for the intervention group; however, this reduction was not statistically significant (IRR = 0.91, 95% CI: 0.82-1.01, p = 0.09).

CONCLUSION: The mobile team intervention in MHC did not significantly reduce ED visits or hospitalizations among elderly MHC recipients, suggesting that physician-led interventions alone may be insufficient to lower acute care utilization in this population. This highlights the complexity of care needs among frail older adults and suggests that a more comprehensive, multidisciplinary approach may be required to achieve meaningful reductions in emergency care use.

PMID:40346643 | DOI:10.1186/s12913-025-12843-1

BMC Psychol. 2025 May 9;13(1):490. doi: 10.1186/s40359-025-02788-9.

ABSTRACT

BACKGROUND: Medical students commonly experience Medical Student Syndrome (MSS), a condition where they compare their vague symptoms to the medical problems and life-threatening diseases they are learning about in medical school, even though their health profile is free. Our research aims to investigate the symptoms of MSS (anxiety-related illness) and hypochondriasis, as well as their impact on the lives of students. Additionally, we aim to study various types of personalities and, finally, investigate the demographic determinants of MSS and their interactions with various personality types among medical students in Egypt in the period between September and December 2023.

METHODS: This analytical cross-sectional study targeted 300 students recruited from the medical field at Zagazig University. The data was collected using a self-administered questionnaire, which consisted of four main components: demographic data, the MSS questionnaire, the personality-type questionnaire, and the MSS’s impact. The collected data was coded and analyzed using R statistical software.

RESULTS: Out of the 300 medical field students recruited, 261 (87.0%) were Egyptian, 164 (54.67%) were female, and 216 (72.0%) were medical students without co-morbidity. 181 (60.33%) were aware of the MSS. Only 11 (3.67%) individuals met all criteria of the DSM-V for anxiety disorder, while 20 (6.67%) individuals met all criteria of the DSM-IV for hypochondriasis. The most common anxiety symptoms were difficulty sleeping (50.00%), lack of productivity or difficulty concentrating (44.0%), and rapid heart rate (31.67%). In terms of personality, being sympathetic and warm received the highest median of 6.00 while being critical and quarrelsome received the lowest median score of 2.00. The health anxiety score significantly negatively correlates with dependable and self-disciplined personality traits, while it significantly positively correlates with anxiety and upset personality traits.

CONCLUSION: Around one-third of the sample experienced preoccupation with fears of having a serious disease, with a trivial number of students meeting the criteria for anxiety disorder or hypochondriasis. More than one-third reported negative impacts on sleep, productivity, concentration, and heart rate. Females, Egyptian students, those from rural areas, and dentistry students had higher anxiety scores, whereas medical students had the lowest scores.

PMID:40346642 | DOI:10.1186/s40359-025-02788-9

Int J Behav Nutr Phys Act. 2025 May 9;22(1):54. doi: 10.1186/s12966-025-01757-0.

ABSTRACT

BACKGROUND: Randomized controlled studies (RCTs) targeting dietary changes may also lead to other, untargeted changes in lifestyle habits, as spillover effects. In particular, the isolated impact of the dietary intervention may be difficult to separate due to spillover effects from changes in physical activity and physical function. Therefore, the aim of this study was to investigate the spillover effect of a one-year dietary intervention in post-surgery colorectal cancer patients by comparing the changes in physical activity and physical function between the diet intervention group and the control group in a randomized controlled trial, called the CRC-NORDIET study.

METHODS: Men and women, aged 50-80 years were randomized into either the intervention group (n = 240) or the control group (n = 229). Both groups received similar incentives on physical activity. Activity sensors were used to collect data on physical activity at baseline, 6 months, and 12 months. Physical function was estimated by results from handgrip strength, 30 s sit-to-stand test and 6-min walking test. Anthropometric measurements and body composition were also measured.

RESULTS: We found a significantly higher increase in moderate-to-vigorous intensity physical activity (MVPA) of 0.18 h per day from baseline to 6 months in the diet intervention group compared to the control group, respectively. However, the spillover effect of the dietary intervention on physical activity diminished to 0.10 h per day at 12 months follow-up which was not statistically significantly different (p = 0.24) from the control group. All measures of physical function increased in both groups from baseline to 6 months with no further increase at the 12-month follow-up.

CONCLUSIONS: The dietary intervention did not induce a significant spillover effect on physical activity after 12 months of baseline, which was the main timepoint of the intervention. Providing identical physical activity guidance to both study groups during the 12-month intensive dietary intervention period, ensured comparable levels of physical activity across both study groups. This approach facilitated the isolation and analysis of the dietary intervention’s effects on primary endpoints, as well as effects of behaviour interventions in secondary preventions, such as the CRC-NORDIET study.

TRIAL REGISTRATION: The study is registered on the National Institutes of Health Clinical Trials website ( www.

CLINICALTRIALS: gov ; Identifier: NCT01570010).

PMID:40346639 | DOI:10.1186/s12966-025-01757-0

BMC Nutr. 2025 May 9;11(1):91. doi: 10.1186/s40795-025-01080-8.

ABSTRACT

OBJECTIVES: The increasing prevalence of type 2 diabetes (T2D) necessitates greater efforts to find effective therapeutic agents for this complex condition. This study conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effects of resistant dextrin (RD) supplementation on markers of glucose regulation in patients with T2D.

METHODS: The databases PubMed, Web of Science, Scopus, and the Cochrane Library were searched from inception to March 20, 2025 aiming to identify RCTs evaluating the effect of RD supplementation on fasting blood sugar (FBS), fasting insulin levels, and glycosylated hemoglobin (HbA1c) in patients with T2D. The meta-analysis was conducted using a random-effects model to calculate weighted mean differences (WMDs) and corresponding 95% confidence intervals (95% CI). The quality of the included RCTs was assessed using the Cochrane risk of bias tool. The outcome data was pooled using Stata software, version 11.2.

RESULTS: Four RCTs (260 participants) were included in the systematic review and meta-analysis. Meta-analyses indicated that RD supplementation was associated with a significant reduction in HbA1c levels (WMD: -0.30%; 95% CI: -0.56 to -0.03; P = 0.02; I²=0.0%). However, the effect of RD on FBS (WMD: -5.45 mg/dl, 95% CI: -12.38 to 1.93; P = 0.14; I²=55.3%) and fasting insulin levels (Hedges’ g: -0.26; 95% CI: -0.74 to 0.21; P = 0.28; I²=70.4%) was not statistically significant.

CONCLUSION: This systematic review and meta-analysis demonstrated that RD supplementation may effectively lower HbA1c levels in patients with T2D. However, it is crucial to conduct more clinical studies with adequate sample sizes and rigorous methodologies to develop evidence-based treatment guidelines.

PMID:40346635 | DOI:10.1186/s40795-025-01080-8

Syst Rev. 2025 May 9;14(1):105. doi: 10.1186/s13643-025-02856-6.

ABSTRACT

BACKGROUND: Vaccination is a crucial public health intervention that has significantly reduced the incidence of infectious diseases. Vaccine-related interventions refer to strategies implemented to enhance vaccination uptake, coverage, and effectiveness, like modes of delivery, types or dosages. Despite extensive research on vaccine efficacy, a comprehensive analysis of the variability in vaccine effectiveness across different interventions, settings, and populations is limited. This study aims to systematically review and meta-analyze the impact of various Vaccine-Related Interventions (VRIs).

METHODS: This review included 139 randomized controlled trials, cohort, and case-control studies evaluating VRIs from January 2015 to December 2023. The risk of bias was assessed using the ROB-2 and ROBINS-E tools. Statistical analyses were conducted to evaluate overall effect sizes, infection rates, and heterogeneity and subgroup analysis.

RESULTS: Of the 139 studies reviewed, 97 were included in the meta-analysis, comprising approximately 1.4 million participants. Populations across various settings were analyzed, with median vaccinated population sizes for the 1st dose (4598, IQR = 15,749), 2nd dose (6214, IQR = 13,817), and 3rd dose (3508, IQR = 5546). The overall total vaccinated population had a median of 4370 and an IQR of 16,475. The interventions showed a significant positive effect on vaccine efficacy, with an estimated effect size of 0.6432 (95% CI 0.4049 to 0.8815). Heterogeneity was negligible, with Tau² = 0, I² = 0.00%, and H² = 1.00. The Galbraith plot suggested minimal variability. The study utilized ROB-2 and ROBINS-E tools to evaluate bias, with Egger’s test (t = – 0.9941, p = 0.3227) confirming no significant publication bias. The funnel plot indicated minimal bias in the included studies.

CONCLUSION: The study supports the effectiveness of vaccine-related interventions in enhancing vaccine efficacy. The negligible heterogeneity and consistent effect sizes across diverse populations and settings provide a robust basis for implementing public health strategies aimed at improving vaccination outcomes.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42024543608.

PMID:40346627 | DOI:10.1186/s13643-025-02856-6

Reprod Biol Endocrinol. 2025 May 9;23(1):64. doi: 10.1186/s12958-025-01402-2.

ABSTRACT

BACKGROUND: The PPOS (Progestin Primed Ovarian Stimulation) protocol has been evaluated and has proved its effectiveness in preventing the LH (luteinizing hormone) surge. This protocol is often used for cryopreservation for social reasons because it is simpler and more cost-effective. The objective of our study was to evaluate the efficacy and the convenience of the PPOS protocol in the context of oocyte cryopreservation for social reasons.

METHODS: In this bicentric matched case‒control study, all PPOS cycles performed for nonmedical reasons between January 2021 and June 2023 were included. Each PPOS cycle was matched with 2 control cycles performed with the antagonist protocol on the basis of the antral follicle count (+/- 5), BMI (+/- 2 kg/cm²) and starting gonadotropin dose (+/- 75 UI). The primary endpoint was the number of mature oocytes. The secondary endpoints were other parameters and outcomes of COS. We evaluated the convenience of PPOS by analysing the frequency of monitoring sessions. Univariate analysis was performed via univariate conditional logistic regression. Multivariate analysis was performed via conditional multivariate logistic regression for significant parameters in the univariate analysis (p < 0.2).

RESULTS: The patient characteristics were comparable, except the median age, which was lower in the antagonist group (35.5 vs. 34.6 years, p < 0.001). Multivariate analysis revealed no statistically significant difference in the number of metaphase II (MII) oocytes between the groups (p = 0.91) or in the total number of COCs retrieved (0.94). There was no statistically significant difference between the groups in terms of the maturation rate or the OSI (p = 0.38 and p = 0.16). The number of monitoring sessions was significantly lower in the PPOS protocol group (p < 0.001).

CONCLUSION: The response to ovarian stimulation with the PPOS protocol for oocyte cryopreservation in patients with nonmedical indications does not differ statistically from that with the antagonist protocol in terms of the number of MII oocytes. This protocol offers the advantages of a more patient-friendly approach through oral administration, a significantly lower number of monitoring sessions with the same efficacy as the antagonist protocol and could be offered as a first line treatment.

CLINICAL TRIAL NUMBER: NA.

TRIAL REGISTRATION DATE: NA.

PMID:40346618 | DOI:10.1186/s12958-025-01402-2

BMC Oral Health. 2025 May 9;25(1):697. doi: 10.1186/s12903-025-05862-1.

ABSTRACT

BACKGROUND: Denture base fabrication techniques and hard relining resins play critical roles in the clinical durability of implant supported immediate provisional hybrid prostheses (IPHPs). This study aimed to investigate the effects of different denture base fabrication techniques and hard relining resins on the fixation of IPHPs to titanium cylinders using a push-out test, and observe the failure types.

METHODS: A total of 140 denture base acrylic resin specimens (diameter: 24 mm, height: 4 mm) were fabricated using four techniques: milling, 3D printing, injection molding, and conventional heat-polymerization. Holes in 10 mm diameter were drilled at the center of each specimen using an industrial drill. Then, titanium cylinders (Opus Implant) were fixed to the specimens using five hard relining resin materials: acrylic resin-based (Ufi Gel Hard)(UGH), heat-polymerized acrylic resin (Futura Basic Hot)(FBH), autopolymerizing composite resin (Quick Up)(QP), autopolymerizing denture repair resin based on diacrylate (Qu-resin)(QR), and autopolymerizing low shrinkage modelling acrylic resin (Pattern resin LS)(PR) (n = 7). Following 5000 thermal-cycles, a push-out test was performed using a universal testing machine (Test Control Systems). Data were statistically analyzed with two-way analysis of variance (ANOVA) and Tukey post-hoc test (SPSS26, p =.05).

RESULTS: Denture base fabrication techniques, hard relining resin materials, and their interactions had significant effects on the push-out forces (p <.001). Statistically significant differences among fabrication techniques were observed only in the QR group (p <.05), where heat-polymerization technique had the highest push-out forces. Among relining materials, PR exhibited the highest values for milling technique (p <.05). For 3D printing, PR (p =.007) and QR (p =.029) showed significantly higher values than UGH. For injection molding, PR was superior to QP (p =.012) and UGH (p =.001). For heat-polymerization technique, QR, PR and QP exhibited the higher values (p <.05). The most common failure type was adhesive failure between titanium cylinders and relining resins (ADHES-ti).

CONCLUSIONS: Denture base fabrication techniques and relining resin types had significant effects on the push-out force. Conventional heat-polymerization technique provided the most consistent performance, whereas milling and 3D printing required careful selection of relining materials. These results can inform clinical decisions to improve IPHP durability and reduce complications.

PMID:40346615 | DOI:10.1186/s12903-025-05862-1