Tag: statistics

J Obstet Gynaecol Res. 2026 Feb;52(2):e70214. doi: 10.1111/jog.70214.

ABSTRACT

AIM: To evaluate the educational outcomes of a nationwide faculty development initiative tailored to obstetrician-gynecologists in Japan, addressing the gap in systematic faculty development implementation and assessment within the specialty.

METHODS: This observational study evaluated three online faculty development seminars conducted by the Japan Society of Obstetrics and Gynecology between December 2023 and August 2024. Using Kirkpatrick’s four-level model, we assessed participant satisfaction (Level 1), self-assessed knowledge gain (Level 2), and behavioral implementation in clinical practice (Level 3). Data were collected using post-seminar and longitudinal follow-up questionnaires.

RESULTS: Level 1 (Reaction): Among the 195 participants, 85.1% completed the post-seminar surveys, with satisfaction rates ranging from 87.9% to 93.0%. Level 2 (Learning): Self-assessed knowledge scores significantly improved across all three seminars (e.g., Seminar 1: from 4.0 to 7.0 on a 9-point scale, p < 0.05). Level 3 (Behavior): Among participants who attended multiple sessions, 74.1% reported implementing learned skills, such as feedback techniques and leadership strategies, with the majority noting positive educational outcomes.

CONCLUSIONS: Nationwide faculty development programs tailored to obstetrics and gynecology can enhance educational competence and promote behavioral change. Our findings highlight the feasibility and effectiveness of specialty-specific faculty development and indicate the need for long-term objective assessments to ensure a sustainable impact. These findings have significant implications for the field of obstetrics and gynecology, suggesting that targeted faculty development initiatives can play a crucial role in improving the quality of medical education and addressing workforce shortages.

PMID:41717673 | DOI:10.1111/jog.70214

Trop Med Int Health. 2026 Feb 20. doi: 10.1111/tmi.70094. Online ahead of print.

ABSTRACT

INTRODUCTION: Gonorrhoea remains a leading sexually transmitted infection worldwide, with an estimated 82 million new cases being reported annually. In Kenya, epidemiological and antimicrobial resistance data are fragmented and under-represent high-risk populations, hampering targeted interventions.

OBJECTIVE: To estimate the pooled prevalence of Neisseria gonorrhoeae and assess patterns of antimicrobial resistance in Kenya between 2019 and 2024.

METHODOLOGY: We searched PubMed, Google Scholar, OpenAlex and Research4Life following PRISMA guidelines, yielding 1116 records. Two reviewers independently screened studies against predefined inclusion criteria. Prevalence and resistance data were extracted, and a random-effects meta-analysis was performed to compute pooled estimates with 95% confidence intervals. Heterogeneity among studies was assessed using the I² statistic.

RESULTS: Eleven studies comprising 5170 participants met inclusion criteria. The pooled prevalence of N. gonorrhoeae was 22.5% (95% CI: 17.2-27.8). Key risk factors included sex work, low educational attainment and multiple sexual partners. Resistance rates were highest for tetracycline (98.0%), ciprofloxacin (96.7%) and penicillin (94.7%) and lowest for azithromycin (2.0%), cefixime (2.6%) and ceftriaxone (1.3%).

CONCLUSION: N. gonorrhoeae poses an urgent public health threat in Kenya. Strengthening surveillance, expanding access to reliable diagnostics and enforcing antibiotic stewardship are critical. Exploration of alternative therapies including phage therapy, alongside accelerated vaccine research, will be essential for sustainable disease control.

PMID:41717668 | DOI:10.1111/tmi.70094

Front Health Serv. 2026 Feb 4;6:1715517. doi: 10.3389/frhs.2026.1715517. eCollection 2026.

ABSTRACT

BACKGROUND: In the context of medical insurance payment reform in China, Computed tomography (CT), as a key type of large medical equipment, currently faces challenges of over-scanning or under-scanning. This study aims to identify the factors influencing the number of CT scans, perform risk adjustment on the number of CT scans, and evaluate the rationality of the number of CT scans for each major diagnostic category (MDC).

METHODS: In the public tertiary general hospital in Sichuan Province, the top 10 MDCs with the highest total number of CT scans in 2023 were selected. A risk-adjusted model was used to estimate the expected number of CT scans. The utilization of CT scans was classified as over-scanning, under-scanning, and rational scanning based on the ratio of observed to expected scan numbers.

RESULTS: The top 10 MDCs included 29,461 encounters and 37,672 CT scans. The number of CT scans varied across different MDCs: five exhibited over-scanning, three showed under-scanning, and two demonstrated rational scanning. The risk-adjusted model revealed that age, admission condition, first-time hospitalization, medical insurance, and length of stay were statistically significant in determining both the decision to perform a CT scan and the number of CT scans conducted.

CONCLUSIONS: This study evaluated the rationality of the number of CT scans across the top 10 MDCs, established a methodological framework for hospital to explore the rationality of the number of other medical examinations.

PMID:41717628 | PMC:PMC12913540 | DOI:10.3389/frhs.2026.1715517

Front Public Health. 2026 Feb 4;14:1732510. doi: 10.3389/fpubh.2026.1732510. eCollection 2026.

ABSTRACT

OBJECTIVE: Based on an epidemiological investigation of 2-h of daily physical activity among primary and secondary school students across China’s seven major administrative regions, this study analyzes the association between social support and cognitive factors, thereby providing recommendations for policy formulation.

METHODS: A cross-sectional study was conducted using random cluster sampling across seven Chinese administrative regions from May to July 2025. Data were collected using standardized scales measuring physical activity levels, achievement of the daily 2-h physical activity target, academic stress, and health cognition. Statistical analyses, including descriptive statistics, chi-square tests, and multivariable logistic regression, were performed using SPSS 26.0.

RESULTS: (1) The prevalence of insufficient 2-h daily physical activity showed significant differences across various demographic variables (all p < 0.001). Higher prevalence rates were observed among students in rural areas (30.50%), private schools (29.41%), boarding students (30.03%), and those with lower frequency of reunions with parents. (2) Key risk factors identified included lack of health cognition, low perceived value of physical activity, lack of sports facilities, insufficient allocated physical education time, and lack of access to smart devices. (3) Significant urban-rural/regional disparities were found regarding access to smart devices (t = 3.142, p = 0.002) and academic stress levels (t = 2.499, p = 0.012).

CONCLUSION: Health cognition, resource availability, and time allocation are significant factors associated with the insufficiency of daily 2-h physical activity among Chinese primary and secondary school students. The education department has increased the guarantee of student system construction, and has implemented differentiated management for higher grades.

PMID:41717627 | PMC:PMC12913497 | DOI:10.3389/fpubh.2026.1732510

Front Public Health. 2026 Feb 4;14:1736796. doi: 10.3389/fpubh.2026.1736796. eCollection 2026.

ABSTRACT

BACKGROUND: Helicobacter pylori (H. pylori) infection remains a global public health burden, particularly in developing countries. While its eradication is a cornerstone for gastric cancer prevention, management is challenged by high infection rates, rising antibiotic resistance, and suboptimal treatment efficacy. Compounding these issues, patient loss to follow-up (LTFU) has emerged as a critical factor directly undermining the success of eradication therapy.

OBJECTIVE: This study aimed to investigate the risk factors associated with LTFU after H. pylori eradication, and to develop a predictive model for assessing the risk of LTFU.

METHODS: We conducted a prospective cohort study (April 2023-September 2024) enrolling treatment-naïve patients from a tertiary gastroenterology clinic. Following data collection via questionnaires and follow-ups, a nomogram for predicting loss to follow-up (LTFU) was developed by applying LASSO regression for variable selection and logistic regression for model building. The model was evaluated by its area under the ROC curve (AUC), calibration, and decision curve analysis (DCA), with internal validation performed via 500 bootstrap resamples to confirm reliability.

RESULTS: A total of 145 (37.76%) patients failed to follow up. From 19 potential predictors, 6 variables were independent predictive factors. They were included in the risk score: BMI > 30 kg/m² (OR = 3.81, 95% CI: 1.16-12.50), government employee (OR = 2.10, 95% CI: 1.21, 3.63), distance to hospital >10 km (OR = 11.27, 95%CI: 6.29-20.18), alcohol consumption (OR = 1.82, 95% CI: 1.19-2.79), outpatient waiting time (OR = 1.01, 95% CI: 1.00-1.02), and lack of awareness of follow-up (OR = 3.32, 95% CI: 1.93-5.69). In the training set, the model demonstrated an AUC of 0.885 (95% CI: 0.843-0.918), with a sensitivity of 93.58% and a specificity of 67.92%. Comparatively, in the test set, the model achieved an AUC of 0.862 (95% CI: 0.794-0.925), with a sensitivity of 83.33% and a specificity of 77.50%, effectively forecasting the risk of patient LTFU in H. pylori eradication. DCA demonstrated the favorable clinical utility of the nomogram, suggesting its potential as a valuable auxiliary tool for predicting the risk of LTFU.

CONCLUSION: The nomogram effectively assessed the risk of LTFU after H. pylori eradication, thereby contributing to improved treatment management outcomes.

PMID:41717626 | PMC:PMC12913374 | DOI:10.3389/fpubh.2026.1736796

Front Public Health. 2026 Feb 4;14:1759966. doi: 10.3389/fpubh.2026.1759966. eCollection 2026.

ABSTRACT

BACKGROUND: Occupational fatigue among nurses has become a critical global public health concern. Endoscopy nurses, in particular, face unique occupational demands that significantly impact their physical and psychological well-being, as well as the quality of patient care. This study aimed to assess the prevalence of occupational fatigue among endoscopy nurses in China and examine its associated factors. Specifically, the mediating role of coping styles in the relationship between work-family conflict and occupational fatigue was analyzed, and the influence of social support was explored.

METHODS: A multicenter cross-sectional study was conducted involving 332 endoscopy nurses from 26 tertiary hospitals across 14 provincial regions in China. Standardized instruments were used to measure occupational fatigue, work-family conflict, coping styles, and perceived social support. Descriptive statistics, univariate analyses, Pearson correlations, multiple linear regression, and structural equation modeling (SEM) were applied.

RESULTS: Endoscopy nurses reported a high level of occupational fatigue (22.075 ± 2.588). Age, gender, marital status, daily working hours, and weekly working days were significantly associated with fatigue levels (p < 0.05). Work-family conflict was positively correlated with occupational fatigue, whereas social support and positive coping were negatively correlated. Negative coping was associated with increased fatigue. SEM revealed that work-family conflict exerted a direct positive effect on occupational fatigue (β = 0.637), and both positive (β = -0.360) and negative (β = 0.077) coping styles partially mediated this relationship. The model showed an acceptable fit (CFI = 0.853, TLI = 0.837, RMSEA = 0.079).

CONCLUSION: Occupational fatigue is prevalent among endoscopy nurses in China and is influenced by work-family conflict, coping styles, and social support. Interventions targeting scheduling optimization, the enhancement of social support, and the promotion of adaptive coping strategies are essential to mitigate fatigue and improve workforce well-being.

PMID:41717625 | PMC:PMC12913506 | DOI:10.3389/fpubh.2026.1759966

Front Public Health. 2026 Feb 4;14:1742648. doi: 10.3389/fpubh.2026.1742648. eCollection 2026.

ABSTRACT

BACKGROUND: College students are considered a high-risk group for post-traumatic stress disorder (PTSD). Existing non-pharmacological interventions, although effective and accessible, still have notable limitations. Regular aerobic exercise, as a potential mental health promotion strategy, requires empirical validation in real campus environments to determine its specific effects on reducing anxiety, depression, and PTSD symptoms, as well as its role in enhancing psychological resilience.

METHOD: This study employed a single-group pre-test/post-test design and was conducted in August 2025 at a comprehensive university in Sichuan, China. Using convenience sampling, 47 participants with elevated PTSD symptoms were recruited for the “School-Based Regular Aerobic Exercise” intervention trial (operationalized as a 21-Day Exercise Check-In Activity). All participants engaged in 30 min of aerobic exercise daily for 3 weeks. Before and after the intervention, participants completed the PTSD Checklist for DSM-5 (PCL-5), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Connor-Davidson Resilience Scale (CD-RISC).

RESULT: All 47 participants completed the 21-day intervention. Significant pre- to post-intervention improvements were observed in PTSD symptoms, anxiety, depression, and psychological resilience. Clinical significance analysis showed that 57.45% of participants fell below the PTSD clinical cutoff after the intervention, and 87.23% demonstrated reliable change. Exploratory change-score analyses indicated that improvements in resilience were significantly associated with reductions in anxiety and PTSD symptoms, but not depression.

CONCLUSION: In a real-world campus setting, this 21-day school-based regular aerobic exercise intervention appears feasible and is associated with improvements in PTSD-related symptoms and psychological resilience. However, because the study lacked randomization and a control group, causal inferences regarding effectiveness and underlying mechanisms cannot be made. Randomized controlled trials with longer follow-up periods and objective activity measures are warranted.

PMID:41717623 | PMC:PMC12913432 | DOI:10.3389/fpubh.2026.1742648

Front Public Health. 2026 Feb 4;14:1704501. doi: 10.3389/fpubh.2026.1704501. eCollection 2026.

ABSTRACT

INTRODUCTION: In the context of heightened economic uncertainty and frequent extreme events, enhancing the resilience of pharmaceutical supply chains, safeguarding their security and stability, and promoting high-quality development in China’s pharmaceutical industry have become pressing issues requiring in-depth research.

METHODS: This study takes China’s pharmaceutical industry from January 1, 2012, to March 31, 2023, as the research subject. The TENET method is employed to construct a tail risk network for the pharmaceutical supply chain. We examine its structural characteristics and dynamic temporal patterns, while analyzing variations in risk spillover effects across different tail risk events. Results: At the overall supply chain level, tail risks exhibit notable time-varying characteristics, with total connectedness rising significantly during risk events. At the module level, the production module serves as the primary source of both risk input and output. Cross-module analysis reveals clustering characteristics in risk spillovers between the production and distribution modules. Additionally, bidirectional spillovers are observed between the service and distribution modules, as well as between these modules and the production module. At the institutional level, the in-degree and out-degree of pharmaceutical institutions are not correlated with market capitalization. Hengrui Pharmaceuticals, Aier Eye Hospital, and Fosun Pharma are identified as systemically important institutions in the supply chain. Furthermore, the characteristics of the risk network vary under different tail risk events: financial crises elevate the overall risk level of the supply chain, whereas public health events do not significantly impact the overall risk level. Nonetheless, tail events universally increase the frequency of risk propagation within the supply chain.

DISCUSSION: While the TENET model employed in this study serves as a powerful tool for analyzing tail risk networks, it possesses inherent limitations. Future research could integrate structured econometric models, such as the introduction of exogenous instrumental variables, or adopt high-frequency data causal discovery techniques. These approaches would help disentangle intrinsic causal pathways and further reveal the “topology of risk transmission.

PMID:41717622 | PMC:PMC12913452 | DOI:10.3389/fpubh.2026.1704501

Front Public Health. 2026 Feb 4;14:1715356. doi: 10.3389/fpubh.2026.1715356. eCollection 2026.

ABSTRACT

BACKGROUND: In December 2023, the local HIV confirmatory laboratory in a Southwestern city of China conducted molecular network analysis on newly reported cases of young students and nonstudent men who have sex with men (MSM) from 2018 to 2023 and identified a key molecular cluster. The aim of the study is to analyze the transmission network characteristics and elucidate the potential transmission dynamics within this cluster, and prevent further spread of the disease.

METHODS: A cluster was designated as a key molecular cluster based on node characteristics, internal network density, and whether young students were involved. For the key cluster, a face-to-face epidemiological investigation was conducted, and detailed information on sociodemographic characteristics, histories of high-risk sexual behavior and sexual partners was collected. For those individuals identified through sexual partner tracing, HIV nucleic acid extraction, HIV-1 pol gene amplification, and sequencing were performed. Molecular network and ML phylogenetic tree analyses were conducted to verify whether they belong to the same molecular cluster.

RESULTS: All 20 individuals in the key molecular cluster were male, with 9 being young students and 11 being nonstudent MSM The investigations revealed that three young students (A, B, C) provided the geosocial networking app (Blued) account information of the same high-risk sexual partner (H, was not included in the aforementioned molecular cluster), who actively solicited unprotected anal sex with these three individuals. H was contacted through Blued by local MSM organizations, and tested HIV-positive. After sexual partner tracing of H, he provided information on one high-risk sexual partner (D). Cross-referencing H’s Blued data with local AIDS sexual partner tracing databases linked him to two young students diagnosed with HIV (E, F). Laboratory molecular network analysis confirmed that H belonged to the same molecular cluster as the aforementioned six people living with HIV (PLWH).

CONCLUSION: By combining molecular transmission network analysis with epidemiological investigations, one individual with multiple high-risk sexual links who was initially not included in the molecular cluster was promptly detected, potentially preventing further transmission by creating awareness of HIV status and provision of HIV treatment services. It is necessary to improve the molecular network monitoring and conduct high-quality epidemiological investigation on the identified key molecular clusters as soon as possible to find persons who would benefit from HIV treatment and prevention services.

PMID:41717618 | PMC:PMC12913388 | DOI:10.3389/fpubh.2026.1715356

Front Public Health. 2026 Feb 4;14:1706377. doi: 10.3389/fpubh.2026.1706377. eCollection 2026.

ABSTRACT

PURPOSE: This study aims to explore the correlation between Fundamental Movement Skills (FMS) and Aquatic Competence (AC) acquisition in preschool children aged 4-6 years.

METHODS: A total of 120 preschool children aged 4-6 years with no swimming learning experience (60 boys and 60 girls) were recruited in Beijing. All subjects were stratified and randomly divided into an experimental group and a control group (30 boys and 30 girls). Before and after a 6-week (twice a week, total of 12 sessions) aquatic movement skills course in the experimental group, all children underwent FMS and AC testing. Descriptive statistics were performed on the results of the two tests, and the Mann-Whitney U test was used to compare the ΔAC of the two groups of subjects. Analysis of covariance (ANCOVA) and rank-transformed ANCOVA were used for inter-group difference analysis. Spearman rank correlation analysis was used to explore the correlation between FMS and AC acquisition.

RESULTS: The locomotor skills, object control, and FMS scores of the experimental group and the control group in the post-test were all higher than those in the pre-test, and the AC post-test score of the experimental group was higher than the pre-test. The improvement levels of locomotor skills (F = 18.98, p < 0.01, η² = 0.14), object control (F = 32.19, p < 0.01, η² = 0.22), FMS (F = 45.85, p < 0.01, η² = 0.28), and AC (F = 1663.96, p < 0.01, η² = 0.93) in the experimental group were significantly better than those in the control group. At the same time, the improvement level of Aquatic Competence (ΔAC) in the experimental group was significantly higher than that of the control group (Z = -9.48, p < 0.01). Correlation analysis indicates that the acquisition of AC in boys is significantly positively correlated with object control skills (r = 0.419, p = 0.021) and FMS (r = 0.388, p = 0.034).

CONCLUSION: Learning aquatic movement skills can significantly enhance the fundamental movement skills and aquatic competence of preschool children aged 4-6 years. The control skills of boys are related to their aquatic competence acquisition. Therefore, during the preschool stage, focusing on and cultivating children’s fundamental movement skills, especially object control abilities, is of great significance for their effective development of future aquatic competence.

PMID:41717617 | PMC:PMC12913400 | DOI:10.3389/fpubh.2026.1706377