Tag: statistics

Int J Occup Med Environ Health. 2025 Nov 4:211458. doi: 10.13075/ijomeh.1896.02650. Online ahead of print.

ABSTRACT

OBJECTIVES: Burnout is a work-related syndrome with growing relevance in occupational health. This study explored the association between job stress factors and burnout in Korean workers at small- and medium-sized enterprises (SMEs).

MATERIAL AND METHODS: A total of 1024 employees from SMEs (50-299 workers) receiving outsourced occupational health services completed a cross-sectional survey. Job stress was measured using the Korean Occupational Stress Scale short form (KOSS), and burnout was assessed with the Korean version Burnout Syndrome Scale (KBOSS), aligned with International Classification of Diseases, 11th Revision (ICD-11) criteria. Burnout was evaluated across 3 dimensions: exhaustion, cynicism, and reduced efficacy. Burnout syndrome was defined as meeting all 3 dimensions. Multiple logistic regression analyses were performed to assess the associations between job stress factors and burnout.

RESULTS: Burnout syndrome was found in 3.3% of participants. Key findings with statistical measures include: 1) burnout syndrome association – high job demand (Q3: OR = 12.62, 95% CI: 2.03-78.41, p < 0.05) and high overall job stress (Q4: OR = 17.56, 95% CI: 1.40-220.76, p < 0.05); 2) exhaustion predictors – high job demand (Q3: OR = 10.71, 95% CI: 3.64-31.48, p < 0.001), inadequate compensation (Q4: OR = 2.06, 95% CI: 1.02-4.16, p < 0.05), and poor workplace culture (Q4: OR = 2.63, 95% CI: 1.11-6.24, p < 0.05); 3) paradoxical findings – low job autonomy associated with reduced exhaustion (Q4: OR = 0.23, 95% CI: 0.11-0.48, p < 0.001).

CONCLUSIONS: Specific job stressors differentially impact burnout dimensions in Korean SMEs: Job demand and overall stress critically predict burnout syndrome, while inadequate compensation and poor workplace culture significantly affect exhaustion. The counterintuitive protective effects of reduced autonomy warrant further investigation. Organizations should prioritize evidence-based workload management and compensation fairness aligned with ICD-11 diagnostic patterns. Int J Occup Med Environ Health. 2025;38(5).

PMID:41190368 | DOI:10.13075/ijomeh.1896.02650

Headache. 2025 Nov 5. doi: 10.1111/head.15093. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore the relationship between migraine attack onset in children and adolescents and Chinooks, which are dry and warm westerly winds that generally occur in the winter and bring about abrupt weather changes to the east of the Rocky Mountains in Southern Alberta, Canada.

METHODS: This was a prospective longitudinal clinical cohort study with recruitment from November 2020 to May 2024. Participants were: 8-18 years old, had migraine as per International Classification of Headache Disorders 3rd edition criteria, had 1-15 headache days/month, lived in the geographical location where Chinook winds occur, and had exposure to at least one pre-Chinook or Chinook day during the study period. Chinook days were defined using Nkemdirim’s criteria and Environment Canada data were used to categorize day type as either Chinook, pre-Chinook, or non-Chinook. Weather data were merged with data from daily headache diaries, completed for periods of 8-30 days. The primary outcome was attack onset, defined as a day with a new migraine attack of moderate or severe severity, as per the 4-point scale (0 = none, 1 = mild, 2 = moderate, and 3 = severe). Both univariate and adjusted models were used to determine if there was an association between migraine attack onset and day type (i.e., pre-Chinook, Chinook, or non-Chinook) at the aggregate study sample level. The adjusted models controlled for age and sex, and both models included a random intercept. Subsequently, individual n = 1 models were fitted to explore each individual participant’s personal odds of migraine attack onset on both pre-Chinook and Chinook days versus non-Chinook days. Pre-Chinook/Chinook sensitivity values were calculated for each individual by dividing the model’s regression coefficient by its standard error. Sensitivity values >1.96 suggest a significant association between pre-Chinook/Chinook days and attack onset.

RESULTS: Sixty youth with 1253 days of complete data, of which 144 (12%) were attack onset days, participated in the study. There were 158 Chinook (13%), 124 pre-Chinook (10%), and 971 non-Chinook days (77%). There were 39 female participants (39 of 60; 65%), with a median age of 14 years (quartile [Q] 1 = 12, Q3 = 16), and a median headache frequency of 6.2 days/month (Q1 = 4, Q3 = 11). Neither the univariate nor the adjusted models found any significant association between day type and attack onset at an aggregate level (pre-Chinook adjusted odds ratio [OR], 0.98; 95% confidence interval [CI], 0.54-1.78, p = 0.947; Chinook adjusted OR, 1.15; 95% CI, 0.69-1.91, p = 0.596). No individual participants met the threshold for statistically significant pre-Chinook or Chinook sensitivity.

CONCLUSION: We did not find a relationship between pre-Chinook and Chinook conditions and migraine attack onset. This may be due to the lack of an association between Chinooks and attack onset in youth with migraine, or due to a lack of statistical power in our study. Future studies with greater statistical power should aim to assess for a potential relationship between Chinooks and attack onset, as it could have important treatment implications.

PMID:41190359 | DOI:10.1111/head.15093

Assessment. 2025 Dec;32(8):1226-1234. doi: 10.1177/10731911241304214. Epub 2024 Dec 29.

ABSTRACT

Some recent studies have revived the approach of investigating extreme levels of self-reported depressive symptoms as indicative of gross exaggeration. While scores above 40 on the Beck Depression Inventory-Second Edition (BDI-II) were discussed as indicating exaggerated symptom claims, different cut scores for identifying noncredible responding are now being discussed. A consecutive sample of 242 patients referred for forensic psychological assessment (mean age: 46.0 years, 47.7% women) with full data sets on the BDI-II and the Structured Inventory of Malingered Symptomatology (SIMS) were assessed. Of all patients, 13.2% scored above 40 and BDI-II scores correlated with SIMS total scores at .62. For different SIMS cutoffs (>14, >16, >19, >23) used as criterion standard, optimal cut scores for the BDI-II were computed. When specificity was set at a minimum of 90%, sensitivity estimates were below 50% for all four SIMS levels. Extreme scores on the BDI-II should raise concern about the credibility of self-reported depressive symptom load. Diagnosis as well as severity estimates should not be based primarily on self-report instruments. To avoid significant risks of bias, the development of reliable cut scores for BDI-II elevations should be based on more studies with samples from diverse contexts.

PMID:41190357 | DOI:10.1177/10731911241304214

Int J Surg. 2025 Nov 5. doi: 10.1097/JS9.0000000000003745. Online ahead of print.

ABSTRACT

BACKGROUND: Restrictive cardiomyopathy (RCM) is an uncommon condition with heterogeneous causes. Amyloidosis, a major subtype, presents with diagnostic complexity, economic burden, and prognostic implications. This study aimed to apply machine learning (ML) techniques to improve the diagnosis of amyloidosis among RCM patients and assess the cost-effectiveness of laboratory tests.

METHODS: This study included patients with RCM who underwent transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging (MRI). Feature selection was performed using least absolute shrinkage and selection operator (LASSO) regression based on variables that showed statistically differences between groups. These selected features were then used to construct eight ML models, which were trained and validated using leave-one-out cross-validation. The best-performing model was evaluated for sample size and interpreted using Shapley additive explanations (SHAP) to enhance model transparency. Laboratory testing costs related to autoimmune, infectious, tumor-related, and amyloidosis evaluations were compared across subgroups.

RESULTS: The Random Forest (RF) model achieved the best performance, with an area under the curve (AUC) of 0.977, an accuracy of 0.908, a sensitivity of 0.869, and a specificity of 0.927. The model also showed a favorable Brier score and a satisfying effect size, indicating good performance in distinguishing amyloidosis from other RCM subtypes. Cost analysis revealed that patients without underlying autoimmune, infectious, or tumor-related etiologies incurred unnecessary expenditures. Multivariate regression identified key imaging features associated with amyloidosis, including left ventricular posterior wall (LVPW) and left ventricular ejection fraction (LVEF) from TTE, and left ventricular short axis (LVSA), LVEF, and interventricular septum (IVS) thickness from cardiac MRI.

CONCLUSION: This study established an interpretable ML model based on the RF algorithm and accurately distinguished amyloidosis among RCM patients. By guiding more targeted use of amyloidosis-specific testing, the model offers a potential cost-saving strategy while improving diagnostic efficiency. These findings support the clinical integration of ML-based tools to streamline decision-making and optimize the allocation of healthcare resources.

PMID:41190351 | DOI:10.1097/JS9.0000000000003745

BMJ Public Health. 2025 Jul 13;2(Suppl 1):e000873. doi: 10.1136/bmjph-2023-000873. eCollection 2024 Jul.

ABSTRACT

INTRODUCTION: Identifying SARS-CoV-2 infection in high-risk populations is critical. We examined SARS-CoV-2 case detection (CD) in ‘TA’ versus ‘screen-and-test’ models of rapid antigen testing integration in maternal neonatal and child health (MNCH), HIV and tuberculosis (TB) clinics in Cameroon (C) and Kenya (K).

METHODS: From May to October 2022, we conducted a cluster-randomised trial with 10 facilities per country randomised to the ‘test-all’ (TA) intervention arm or the standard ‘screen-and-test’ (ST) arm. Individuals aged >2 years attending HIV, TB and MNCH clinics were eligible for SARS-CoV-2 testing. The primary outcome was the SARS-CoV-2 CD, defined as the number of SARS-CoV-2 infections detected per 1 000 attendees in MNCH, HIV and TB clinics. We estimated the intervention arm-specific CDs by combining the facility-specific estimates using a weighted approach.

RESULTS: There were 80 828 attendee visits in the TA model (63 492 C, 17 336 K) and 71 254 in the ST model (56 589 C, 14 665 K). About 17.4% (K) and 29.0% (C) were tested under the TA model. The overall CD was 2.90 (95% CI:1.76 to 4.79) per 1 000 attendee visits in the TA model and 1.20 (95% CI:0.73 to 1.99) in the ST model (RR=2.41, 95% CI:1.18 to 4.91, p=0.018). The TA model had a significantly higher SARS-CoV-2 CD in MNCH clinics (2.91 vs 1.11, p=0.012), while CD estimates in HIV (2.88 vs 1.40, p=0.203) and TB (10.24 vs 4.57, p=0.051) clinics, although higher in TA model compared with ST model, were not statistically different.

CONCLUSIONS: The TA model identified more SARS-CoV-2 cases than the screen-and-test model, even with low testing coverage. The TA model could be considered in future epidemics for early detection of SARS-CoV-2 infection among vulnerable populations, but effective implementation requires additional human resources to manage testing in high volume clinics.

TRIAL REGISTRATION NUMBER: NCT05382130.

PMID:41190341 | PMC:PMC12581021 | DOI:10.1136/bmjph-2023-000873

Ecol Evol. 2025 Nov 2;15(11):e72410. doi: 10.1002/ece3.72410. eCollection 2025 Nov.

ABSTRACT

Hirudo verbana, a medicinal leech species of conservation concern, has long been considered rare and fragmented across its distribution range due to overexploitation and habitat alteration. In this study, we present the first predictive distribution model for H. verbana in Sicily, combining field occurrence data (time: 1980-2024) with environmental variables using an ensemble species distribution modeling (SDM) framework. Unlike its typical occurrence in temperate lowland wetlands of central-eastern Europe, the species in Sicily shows a marked shift toward upper hill and montane zones. Species presence was strongly associated with high NDVI values, reflecting a preference for areas with dense and structurally complex vegetation. In contrast, presence probability declined sharply with increasing terrestrial human footprint (THF), indicating a notable sensitivity to anthropogenic disturbance. Aquatic habitat type also emerged as a key predictor: the species was most likely to occur in lentic environments such as standing water bodies, and least likely in lotic systems or areas lacking aquatic habitats. Notably, most high-suitability areas overlapped with sites in the Natura 2000 network, emphasizing the importance of existing protected areas as refugia for the species. Moreover, some previously undocumented areas of high habitat suitability were identified, providing a spatially basis for refining monitoring strategies and informing conservation planning for this ecologically sensitive freshwater invertebrate.

PMID:41190312 | PMC:PMC12580294 | DOI:10.1002/ece3.72410

JPEN J Parenter Enteral Nutr. 2025 Nov 4. doi: 10.1002/jpen.70030. Online ahead of print.

ABSTRACT

BACKGROUND: Central line-associated bloodstream infection (CLABSI) persists as a clinical concern, contributing to increased morbidity, mortality, and healthcare costs. Prior studies have demonstrated that parenteral nutrition (PN) is associated with a small but statistically significant increase in CLABSI incidence. In this study, we evaluated the association between patients requiring PN via central venous catheter (CVC) and CLABSI, hypothesizing higher risk among patients receiving PN.

METHODS: We performed a retrospective cohort study of 25,502 adult inpatients with a CVC who were admitted to two affiliated hospitals in a large academic health system in New York City. Univariate and multivariate analyses were performed to examine the relationship between PN and CLABSI risk, with additional subgroup analyses focusing on patients in and out of the intensive care unit (ICU).

RESULTS: During the study period, 25,502 admissions were associated with a CVC, and 186 CLABSI cases were documented. When adjusting for confounders, PN was a significant risk factor for patients outside the ICU (odds ratio, 4.3; 95% confidence interval [CI], 2.4-7.9) but was not a significant risk factor for CLABSI in ICU patients. Hospital-wide, PN administration was associated with a higher risk of CLABSI when adjusting for confounders (2.3; 95% CI, 1.3-3.6).

CONCLUSION: PN is associated with an increased risk of CLABSI in ward patients but not in ICU patients, suggesting context-dependent risk. Further work is needed to determine effective strategies for reducing rates of CLABSI among patients receiving PN hospital-wide and to validate these findings in broader patient populations.

PMID:41189041 | DOI:10.1002/jpen.70030

Pneumonia (Nathan). 2025 Nov 5;17(1):31. doi: 10.1186/s41479-025-00178-8.

NO ABSTRACT

PMID:41189018 | DOI:10.1186/s41479-025-00178-8

Arthritis Res Ther. 2025 Nov 4;27(1):204. doi: 10.1186/s13075-025-03666-w.

ABSTRACT

BACKGROUND: Although patients with idiopathic inflammatory myopathy (IIM) have a higher cancer risk than the general population, this risk varies among IIM patients based on clinical factors such as IIM subtype, clinical features, and autoantibody profiles. This study aimed to establish a risk-stratification system to identify those with high-risk for cancer in patients with IIM.

METHODS: This study included 481 patients with IIMs from four independent cohorts in South Korea. The primary outcome was myositis-associated cancer, defined as cancers occurring within 3 years before or after the diagnosis of IIM. Logistic regression with Least Absolute Shrinkage and Selection Operator (LASSO) regularization was used to select predictors from 24 prespecified factors for the multivariable model. A scoring system, entitled the SCRIM score, was established based on the β coefficient of each predictor in the final model. A conditional inference tree analysis was used to identify the optimal cut-off point for group classifications. The cancer risk of each group compared to that of the general population was assessed using standardized incidence ratio (SIR), which was calculated using the 2022 age-matched general population in South Korea as the reference.

RESULTS: In the study population, 12.9% (n = 62) had myositis-associated cancer. The LASSO regression identified older age, male sex, current smoking status, dermatomyositis, and anti-TIF1γ as high-risk factors for cancer; however, anti-synthetase syndrome, overlap myositis, arthritis, and interstitial lung disease were associated with a lower cancer risk. The SCRIM score based on these factors showed excellent performance (AUROC 0.852 [95% CI 0.796-0.907]). Patients were stratified into the low-risk, intermediate-risk, and high-risk groups based on the SCRIM score, and the incidence of myositis-associated cancer increased significantly in a stepwise manner across groups. Patients in the low-risk group had a cancer incidence comparable to that of the general population (SIR 0.79), whereas those in the intermediate-risk (SIR 2.28) and high-risk (SIR 15.30) groups had significantly higher cancer incidences.

CONCLUSION: The SCRIM score precisely stratified the risk of myositis-associated cancer for patients with IIM, which can be an important basis for establishing an evidence-based screening cancer strategy.

PMID:41188999 | DOI:10.1186/s13075-025-03666-w

BMC Chem. 2025 Nov 4;19(1):296. doi: 10.1186/s13065-025-01655-3.

ABSTRACT

MnCeO_x/TiO₂ composite catalysts were synthesized and characterized to investigate their photocatalytic efficiency in methyl orange decolorization. Structural and textural analyses revealed mesoporous architectures with specific surface areas ranging from 31.38 to 68.46 m² g^-1, pore volumes of 0.252-0.505 cm³ g^-1, and average pore diameters of 14.75-29.50 nm. FT-IR, XRD, and UV-Vis/DRS confirmed successful MnCeOx incorporation and band gap tuning (2.87-3.46 eV), indicating enhanced charge transfer capabilities. Photocatalytic experiments demonstrated that MO decolorization is highly sensitive to solution pH, temperature, MnCeO_x/TiO₂ weight ratio, and reaction time. Optimal conditions-pH = 3, temperature ≈ 39.6 °C, MnCeO_x/TiO₂ = 0.31, and reaction time = 35 min-achieved a maximum photo decolorization efficiency of 41.93%. Kinetic studies revealed pseudo-first-order behavior (k = 0.04927 min^-1 for MCT-0.1), with performance strongly influenced by surface charge interactions and active site accessibility. A Response Surface Methodology-Central Composite Design model was developed, demonstrating excellent predictability (R² = 0.99, Pred R² = 0.96) and a desirability score of 0.97. ANOVA confirmed the significance of main effects and binary interactions, particularly between pH, MnCeO_x/TiO₂ ratio, and reaction time, on MO PDE.

PMID:41188994 | DOI:10.1186/s13065-025-01655-3