Tag: statistics

Thyroid Res. 2025 Jun 12;18(1):26. doi: 10.1186/s13044-025-00242-x.

ABSTRACT

OBJECTIVE: Graves’ disease (GD) patients treated with radioactive iodine may face health risks from potential radiation exposure, both for themselves and their offspring. This systematic review aims to comprehensively evaluate the association between prior radioactive iodine (RAI) therapy for GD and subsequent pregnancy outcomes in women of childbearing age.

METHODS: A search of the bibliographic databases PubMed/MEDLINE and Web of Science was conducted up to December 2024 to identify relevant studies.

RESULTS: The final systematic review included 1055 patients from 5 articles, all of which were retrospective cohort studies. Two studies reported the incidence of miscarriage after RAI treatment of 2.3% (3/130) and 22.2% (6/27). One study indicated that the miscarriage rate in the RAI group was not significantly different from that in the control groups, while the other did not provide a statistical comparison between groups. Two studies reported the incidence of neonatal hyperthyroidism (NH) after RAI therapy of 11.3% (5/44) and 5.5% (8/145). Both studies indicated that high levels of serum TRAb during late pregnancy were significantly associated with NH (P < 0.05). One study reported the incidence of postpartum thyrotoxicosis (PT) after RAI therapy of 2.1%. Compared with surgical treatment and ATD treatment, patients with RAI therapy had a significantly lower incidence of PT (P < 0.05).

CONCLUSION: Based on the limited evidence from retrospective studies, current data does not demonstrate a statistically significant increase in the risk of miscarriage or postpartum thyrotoxicosis following RAI therapy, compared to ATDs or surgical treatment. Elevated maternal TRAb levels in late pregnancy were strongly associated with neonatal hyperthyroidism. However, the small sample sizes and heterogeneity in study designs preclude definitive conclusions. Further prospective studies are required to establish more comprehensive and reliable conclusions and to evaluate more pregnancy outcomes.

PMID:40500752 | DOI:10.1186/s13044-025-00242-x

BMC Palliat Care. 2025 Jun 11;24(1):164. doi: 10.1186/s12904-025-01777-4.

ABSTRACT

BACKGROUND: Palliative sedation is the monitored use of medications intended to reduce consciousness to relieve the burden of otherwise intractable suffering. Since 2016, the French Leonetti-Claeys law has granted patients the right to receive continuous deep sedation until death (CDSUD) for some indications. There are relatively few data in the literature assessing sedation practices in palliative care units (PCUs).

METHODS: This study aimed to compare sedation practices in six French PCUs, analyzing the frequency, types of sedation (CDSUD vs. proportional sedation), and use of sedative medications during the last 72 h of life. This retrospective study examined the data of patients who died in these units between July and December 2021.

RESULTS: The results revealed statistically significant variability in sedation practices. The overall prevalence of sedation practices (all types) was 22%. The prevalence for CDSUD was 12%. Some units had much higher or lower rates of sedation, suggesting differences in the interpretation of guidelines and regulations, possibly because of cultural or individual factors within the units. The study also found important variability in the use of sedative medication in terms of molecules and dosage. Midazolam was the most commonly used benzodiazepine but the dosage varied significantly depending on the units.

CONCLUSIONS: Further qualitative research is needed to understand the reasons for the observed variability in sedation practices and improve the standardization and clarity of palliative sedation.

PMID:40500746 | DOI:10.1186/s12904-025-01777-4

J Neuroeng Rehabil. 2025 Jun 11;22(1):132. doi: 10.1186/s12984-025-01665-1.

ABSTRACT

BACKGROUND: The practicality of implementing digital cognitive screening tests in primary health care (PHC) for the detection of cognitive impairments, particularly among populations with lower education levels, remains unclear. The aim of this study is to assess the validity and usability of digital cognitive screening tests in PHC settings.

METHODS: We utilized a randomized crossover design, whereby 47 community-dwelling participants aged 65 and above were randomized into two groups. One group completed the paper-based Mini-Mental State Examination (MMSE) and Clock Drawing Test (CDT) first, followed by the tablet-based digital version after a two-week washout period, while the other group did the reverse. Validity was assessed by Spearman correlation, linear mixed-effects models, sensitivity specificity, and area under the curve (AUC). Usability was assessed through the Usefulness, Satisfaction, and Ease of Use (USE) questionnaire, participant preferences and assessment duration. Regression analyses were conducted to explore the impact of usability on digital test scores, controlling for cognitive level, education, age, and gender.

RESULTS: Regarding validity, digital tests showed moderate correlations with paper-based versions and superior AUC performance. The AUC was 0.65 for the MMSE versus 0.82 for the electronic MMSE (eMMSE), and 0.45 for the CDT compared to 0.65 for the electronic CDT (eCDT). Regarding usability, while older participants gave positive feedback on digital tests (P < 0.001), they preferred paper-based versions. The eMMSE took significantly longer to complete than the MMSE, averaging 7.11 min versus 6.21 min (P = 0.01). Notably, digital test scores were minimally affected by subjective attitudes but strongly linked to test duration (β = -0.62, 95% CI: -1.07 to -0.17).

CONCLUSIONS: Digital cognitive tests are valid and feasible in PHC settings but face implementation challenges, especially in usability and adaptability among individuals with lower education levels.

PMID:40500744 | DOI:10.1186/s12984-025-01665-1

J Neuroeng Rehabil. 2025 Jun 11;22(1):133. doi: 10.1186/s12984-025-01647-3.

ABSTRACT

OBJECTIVES: To determine the evolution of lower-limb joint power values during walking across the lifespan.

DESIGN: Series of cross-sectional studies.

SETTING: This was a pooled analysis of the individual participant joint power data from six datasets, resulting in a sample size of 629 participants, between the ages of three to 91 years old.

MAIN OUTCOME MEASURES: Three function-on-scalar regression models were fitted on the outcome measures of joint hip, knee, and ankle power. The covariates of this analysis included sex, age, walking speed, stride length, height, the interaction between age and speed, and a random intercept for different studies.

RESULTS: Ankle push-off (A2) power peaked with a value of 2.46 (95%CI 2.41 to 2.50) W/kg in the 3rd decade of life. Hip early-stance power (H1) peaked in the 1st decade, which followed a sharp decline with age till the 3rd decade. Hip pull-off power (H3) increased sharply to 0.86 (95%CI 0.84 to 0.88) W/kg in the 5th decade and stabilised thereafter with older age.

CONCLUSION: Ankle push-off power appears to reach maturity in the 3rd decade of life. A strict temporal correspondence between a decline in ankle push-off power (A2) with age and a compensatory increase in hip pull-off power (H3) was not observed, challenging the distal-to-proximal alteration in propulsion strategy commonly attributed to the ageing process.

PMID:40500742 | DOI:10.1186/s12984-025-01647-3

BMC Public Health. 2025 Jun 11;25(1):2164. doi: 10.1186/s12889-025-22844-8.

NO ABSTRACT

PMID:40500740 | DOI:10.1186/s12889-025-22844-8

J Transl Med. 2025 Jun 11;23(1):646. doi: 10.1186/s12967-025-06642-9.

ABSTRACT

BACKGROUND: Human T-cell lymphotropic virus-1(HTLV-1) infection may lead to adult T-cell leukemia, HTLV-associated myelopathy/tropical spastic paraplegia, and various neurological diseases. Therefore, developing a rapid and accurate detecting method is crucial for preventing and controlling HTLV-1 infection. This study aims to develop and validate a detection assay for HTLV-1 proviral DNA by combining multienzyme isothermal rapid amplification(MIRA) and lateral flow dipstick(LFD) techniques.

METHODS: Primers and probes were designed based on the conserved sequence of the HTLV-1 Tax gene, and the MIRA-LFD method was established and optimized. Different concentrations of HTLV-1 plasmids were tested by the MIRA-LFD assay to verify the limit of detection(LOD) of the method. To evaluate the cross-reactivity, viral pathogens were detected by this assay, including hepatitis B virus(HBV), hepatitis C virus(HCV), hepatitis E virus(HEV), cytomegalovirus(CMV), herpes simplex virus-1/2(HSV-1/2), Epstein-Barr virus(EBV), Parvovirus B19(B19V), and human T-cell lymphotropic virus-2(HTLV-2). 500 clinical samples were simultaneously detected using real-time PCR(qPCR) and MIRA-LFD methods, and the consistency between the two methods was statistically analyzed. The qPCR was used as the reference method to determine the diagnostic sensitivity and specificity of the MIRA-LFD method.

RESULTS: The MIRA-LFD method can detect HTLV-1 within 20 min at 37℃. The LOD for HTLV-1 using this method was 200 copies/µL. This method had no cross-reaction with the other eight viruses, with good specificity. Using qPCR as the standard, the diagnostic sensitivity and specificity of the MIRA-LFD method for 500 clinical samples were 100%. The MIRA-LFD and qPCR methods had 100% consistency(kappa value = 1.00).

CONCLUSIONS: This study established a method based on MIRA-LFD for detecting HTLV-1 proviral DNA, which has the advantages of fast, accurate, good sensitivity, strong specificity, simplicity, and portability. This method meet the needs of rapid on-site detection and is easy to promote and use in grassroots medical institutions or blood stations.

PMID:40500737 | DOI:10.1186/s12967-025-06642-9

Lipids Health Dis. 2025 Jun 11;24(1):213. doi: 10.1186/s12944-025-02638-y.

ABSTRACT

BACKGROUND: The specific mechanisms by which poly – and polyfluoroalkyl substances (PFAS) influence the particular lipid levels of adolescents and the progression of early subclinical atherosclerosis remain unclear. A certain degree of correlation exists between folate and the exposure of adolescents to PFAS, the maintenance of lipid homeostasis, as well as cardiovascular health status. This study investigated the role and mechanisms of folate in the process through which PFAS can influence the blood lipid profiles of adolescents.

METHODS: We used data from the National Health and Nutrition Examination Survey 2005-2018. Weighted generalized linear regression analysis, Bayesian kernel machine regression, weighted quantile sum regression, mediation analysis, and network toxicology were employed to investigate the association between mixed exposures to perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate, and perfluorononanoic acid (PFNA) and lipids, as well as the atherogenic index of plasma (AIP), and to determine the impact of red blood cell folate or serum folate in the body.

RESULTS: A positive association was detected between low density lipoprotein cholesterol (LDL-C) and PFOS; between total cholesterol (TC) and both PFOS and PFOA; between triglycerides (TG) and PFNA, PFOS, and PFOA; and between AIP and PFNA, PFOS, and PFOA. Analysis identified a positive correlation between mixed PFAS and LDL-C, TC, TG, and AIP. Red blood cell folate suppressed the associations of PFOA, PFOS, PFNA, and total PFAS with TG, as well as PFOA, PFOS, and total PFAS with AIP. The suppression effect of red blood cell folate was more pronounced in female adolescents. PFAS was associated with certain targets, including albumin, peroxisome proliferator-activated receptor γ, and interleukin-10, and may influence lipid metabolism and atherosclerosis. PFAS and folate share caspase-1 and carbonic anhydrase 2 as targets for mechanisms associated with atherosclerosis.

CONCLUSIONS: PFAS exposure may be associated with dyslipidemia and impaired cardiovascular health in adolescents, while folate could potentially attenuate the direct association between PFAS exposure and these health outcomes. In the future, maintaining normal levels of folate in the body could be a key strategy in preventing disruptions to lipid metabolism and potential threats to cardiovascular health in adolescents caused by PFAS.

PMID:40500729 | DOI:10.1186/s12944-025-02638-y

BMC Med Educ. 2025 Jun 11;25(1):849. doi: 10.1186/s12909-025-07446-7.

ABSTRACT

BACKGROUND: Medical students navigate a complex landscape of digital tools with potential to enhance learning. The main objectives of the current study were to investigate which digital resources are being used, which background factors are associated with utilization, perceived advantages and disadvantages of different digital resources, and explore future directions.

METHODS: Cross-sectional, nationwide, online 25-item multiple-choice question survey and one free-text question enabling qualitative data analysis. Medical students at all seven universities with medical school programs in Sweden were invited to participate. Data were collected October – December 2024.

RESULTS: One thousand seven hundred sixty-six students responded to the survey, with an average response rate of 20.2% across sites. The five most frequently used digital resources were (percentage using at least on a weekly basis): University study platform (75.3%), videos (68.0%), flashcards (66.4%), student notes (53.4%) and external study platforms (47.3%). Flashcards were perceived to have a large to very large positive impact on development and maintenance of theoretical knowledge by 63.7% of students. Younger age (≤ 25 years) was strongly associated with higher use of flashcards (OR 1.98 (95% CI 1.54-2.54)) and generative artificial intelligence (AI) (OR 1.66 (1.29-2.15)), whereas having children at home was associated with more frequent use of videos (OR 2.32 (1.32-4.08)) and university digital platforms (OR 2.62 (1.26-5.45)), in multivariable logistic regression analyses. Most students (74.8%) reported finding their digital resources based on recommendations from more senior medical students. Perceived key advantages of digital resources in general were availability (90.9%), flexibility (80.6%), and more effective learning compared to traditional modalities (59.0%), while possible disadvantages included risk for distraction (49.6%) and uncertainty regarding reliability of content (45.4%). Qualitative data highlighted several areas of interest, including calls for universities and lecturers to provide high-quality, updated video material and flashcard decks tailored to the curriculum, and review and recommend third-party digital resources (e.g., YouTube channels).

CONCLUSIONS: Medical students extensively use digital resources, with perceived large positive learning effects and benefits. Several background factors influence usage patterns. These data may support institutions, program directors and teachers in their efforts to guide and improve use of digital learning tools in medical schools.

PMID:40500719 | DOI:10.1186/s12909-025-07446-7

J Prosthet Dent. 2025 Jun 10:S0022-3913(25)00455-X. doi: 10.1016/j.prosdent.2025.05.019. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Computer-aided manufacturing and computer-aided design (CAD-CAM) has been implemented less in complete removable prosthodontics because various factors affect the results and quality of complete dentures. Some clinical studies and systematic reviews have compared digitally fabricated complete dentures (DCDs) with conventional complete dentures (CCDs), but few have focused on the complications and number of postinsertion visits.

PURPOSE: The purpose of this systematic review was to compare CCDs and DCDs in terms of complications and postinsertion visits by evaluating outcomes that included occlusion, retention, and patient discomfort. The goal was to provide insights into the clinical implications of using digital versus conventional techniques for denture fabrication.

MATERIAL AND METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), the question: “Is there a difference in complications and postinsertion visits when CCDs are compared with digitally printed complete dentures?” was addressed. Two independent electronic searches up to March 2024 were done in the PubMed, Google Scholar, and Embase databases. The risk of bias in each study was assessed by using the Cochrane risk of bias tool and the Newcastle-Ottawa scale.

RESULTS: Of 63 articles, 11 were included. Outcomes were grouped into different kinds of complications: occlusion, retention or stability, pain, and number of postinsertion visits. In terms of all 4 complications, some statistically significant differences were reported.

CONCLUSIONS: The manufacturing technique for complete dentures influenced the number and type of complications. The digital technique showed a similar or greater number of follow-up visits, depending on the method used and the study design.

PMID:40500684 | DOI:10.1016/j.prosdent.2025.05.019

Z Evid Fortbild Qual Gesundhwes. 2025 Jun 10:S1865-9217(25)00126-6. doi: 10.1016/j.zefq.2025.05.002. Online ahead of print.

ABSTRACT

BACKGROUND: ‘Speak up’ refers to the act of raising safety concerns, which can greatly influence patient safety outcomes. In healthcare, hierarchical structures may inhibit nursing assistant trainees from voicing their concerns effectively. This study explored the speak-up behavior and perceptions of safety culture among nursing assistant trainees in Tyrol (Austria). It also investigated the reasons and barriers for speaking up, as well as potential differences in speak-up behavior based on macro-social characteristics.

METHODS: Between May and July 2023, a multicentric, exploratory quantitative cross-sectional study was conducted involving 508 trainees in nursing assistance and advanced nursing assistance across seven training institutions in Tyrol. Data were collected using the “Speaking Up about Patient Safety Questionnaire” (SUPS-Q). Descriptive statistics along with the Mann-Whitney U test were employed for data analysis.

RESULTS: A total of 358 nursing assistant trainee participated in the study. Most trainees reported perceiving safety concerns, actively speaking up about them, and experiencing a generally positive safety culture during their internships. However, common barriers to speaking up included fear of negative repercussions for their training (45.6%) and uncertainty about how to articulate their concerns (31.8%). The primary motivations for addressing safety concerns were the desire to prevent harm (71.3%) and a strong sense of duty (62.5%).

DISCUSSION: Compared to existing studies with nursing students, trainees in the nursing assistant professions seem to express their safety concerns more often. The reasons for this could be primarily intradisciplinary communication and a higher average age.

CONCLUSION: Trainees in nursing assistance professions tend to be more willing to voice their safety concerns than nursing students. Further multicenter studies should be undertaken to improve the transferability of results.

PMID:40500646 | DOI:10.1016/j.zefq.2025.05.002