Tag: statistics

BMC Infect Dis. 2025 Feb 25;25(1):271. doi: 10.1186/s12879-025-10679-y.

ABSTRACT

BACKGROUND: Opportunistic infections (OIs) in patients with advanced HIV disease remain a serious health issue, particularly in low-and middle-income countries.

OBJECTIVES: This study aims to describe the clinical characteristics and factors associated with mortality among hospitalized advanced HIV-infected men who have sex with men (MSM).

METHODS: A prospective cross-sectional study was conducted at the Hospital for Tropical Diseases in Ho Chi Minh City between March and June 2023. Data was collected through interviews and medical record reviews. A multivariate logistic regression model was employed to assess factors associated with hospitalization outcomes, with statistical significance set at p < 0.05.

RESULTS: The study included 121 participants, with 61.3% aged 25-34 years and 42.2% classified as underweight. Only 35.5% of patients received OI preventive treatment. Comorbidities were noted as follows: hepatitis B (12.4%), hepatitis C (2.5%), and syphilis (43.8%). A total of 41.3% of patients had at least one OI, with Mycobacterium tuberculosis being the most common (46.3%), followed by Pneumocystis jirovecii pneumonia (44.6%) and Cryptococcus neoformans (19%). Sepsis was present in 20.7% of patients. The in-hospital mortality rate was 19%. Factors significantly associated with mortality included being underweight, HBV coinfection, C. neoformans infection, lack of OI preventive treatment, and sepsis.

CONCLUSION: The study reveals a high inpatient mortality rate among advanced HIV-infected MSM, even among relatively young patients. Increased mortality was associated with being underweight, having sepsis, HBV coinfection, C. neoformans infection, and not receiving OI preventive treatment.

PMID:40001047 | DOI:10.1186/s12879-025-10679-y

BMC Public Health. 2025 Feb 25;25(1):782. doi: 10.1186/s12889-025-21955-6.

ABSTRACT

BACKGROUND: Morbidity is an immediate predictor of malnutrition. However, nutritional interventions to reduce frequent morbidities in adolescents were not conducted well based on behavioral models in low-income countries like Ethiopia. Hence, the aim of this study was to examine the effect of selected double-duty interventions on frequency of morbidities among adolescents based on health belief model in Debre Berhan Regiopolitan City, Central Ethiopia.

METHODS: A two-arm parallel cluster randomized controlled trial was conducted from October 13, 2022, to June 30, 2023, involving 356 adolescents in the intervention group (IG) and 352 adolescents in the control group (CG). The frequency of morbidity (FoM) was assessed through self-reported responses provided by the adolescents. To evaluate the impact of the intervention, a difference-in-differences analysis was employed along with a Generalized Estimating Equation (GEE) model using a Negative Binomial regression approach, which is suitable for analyzing count data with overdispersion. The statistical significance of the study was determined by setting a threshold of p-value less than 0.05.

RESULTS: The mean (± SD) score of FoM among IG and CG was – 4.5 (-1.82) and – 1.0 (-0.12), respectively. After the intervention had implemented, the IG had better reduction of mean score of FoM than CG. Moreover, adolescents in the endline measurements had 68% less likely to have higher FoM compared to the baseline measurements [IRR = 0.32, 95% CI (0.27, 0.37)]. Similarly, adolescents in the IG had 82.6% less likely to have higher FoM than CG [IRR = 0.72, 95% CI (0.12, 0.14)]. Likewise, adolescents in the time and treatment interaction category had 24.6% less likely to have higher FoM than adolescents who were not in the interaction category [IRR = 0.75, 95% CI (0.73, 0.78)].

CONCLUSION: The results showed that selected double-duty intervention packages based on the health belief model are effective in reducing FoM among adolescents. The findings suggest the need for integrating the double-duty intervention packages accompanied with behavioral models to the adolescent nutrition guideline and food and nutrition policy and strategy.

PMID:40001035 | DOI:10.1186/s12889-025-21955-6

BMC Cancer. 2025 Feb 25;25(1):340. doi: 10.1186/s12885-025-13671-6.

ABSTRACT

BACKGROUND: Discrepancies have been found between preoperative colposcopic biopsy results and histology results of loop electrical excision procedure (LEEP) specimens. GynTect^® is a six-methylation-marker assay that has demonstrated its potential as a triage tool for cervical lesion detection and prediction. The aim of this study was to evaluate the effectiveness of GynTect^® in predicting the histology outcomes of post-LEEP specimens.

METHOD: A retrospective analysis was conducted to evaluate the clinical profiles, GynTect^® results, and histology outcomes of postoperative specimens from 78 patients diagnosed with high-grade squamous intraepithelial lesion (HSIL) who underwent LEEP. The GynTect^® assay is a six-marker (ASTN1, DLX1, ITGA4, RXFP3, SOX17, and ZNF671) methylation detection assay for cervical prep cell samples. Preoperative cervical cytology, high-risk human papillomavirus (hrHPV) detection, and methylation analysis were obtained from each participant. Preoperative colposcopic impression and biopsy results were recorded. Statistical analysis and multivariate logistic regression were performed using IBM SPSS Statistics 25.

RESULTS: Among the negative-GynTect^® patients, 19 cases (57.6%) showed histology downgrading post-LEEP, while 14 cases (42.4%) showed sustained or upgrading histology results. In the positive-GynTect^® patients, 8 cases (17.8%) showed downgrading histology results post-LEEP and 37 cases (82.2%) showed sustained or upgrading histology. The difference was statistically significant (p = 0.001). Multivariate regression analysis identified positive GynTect^® outcomes and colposcopic impressions indicating HSIL on the day of surgery as independent predictors of pathological sustained or upgrading after LEEP.

CONCLUSIONS: This study underscores the potential of GynTect^® in predicting histology outcomes of post-LEEP specimens, thereby showcasing its promising ability to assist clinicians in selecting appropriate therapeutic regimens for patients with HSIL.

PMID:40001027 | DOI:10.1186/s12885-025-13671-6

BMC Nurs. 2025 Feb 25;24(1):210. doi: 10.1186/s12912-025-02847-x.

ABSTRACT

INTRODUCTION: Enhancing clinical outcomes and patient satisfaction can be achieved through interprofessional collaboration between physicians and nurses. Conversely, a lack of nurse-physician interprofessional collaboration compromises patient safety, care, and improvement, and creates moral discomfort for healthcare professionals. Studies indicate that failures in interprofessional collaboration between nurses and physicians lead to adverse medical events, including hospital-acquired infections, medication administration errors, and unnecessary health-related costs.

OBJECTIVE: This systematic review and meta-analysis aimed to investigate the pooled proportions of the interprofessional collaborations towards patient care and associated factors among nurses and physicians in Ethiopia, 2024.

METHODS: A comprehensive search was conducted to find articles on interprofessional collaboration towards patient care and associated factors among nurses and physicians in Ethiopia. The study included cross-sectional studies conducted in Ethiopia and published in English from inception up to August 20, 2024. Excluded were conference proceedings, qualitative research, commentaries, editorial letters, case reports, case series, and monthly and annual police reports. The search encompassed full-text publications written in English and databases such as PubMed/MEDLINE, African Journals Online (AJOL), Semantic Scholar, Google Scholar, and Google. A checklist from the Joanna Briggs Institute (JBI) was used to evaluate the quality of the studies. Two independent reviewers performed data extraction, critical appraisal, and article screening. Statistical analysis was performed using STATA-17 software. A random-effects model was employed to estimate pooled proportions, and effect sizes with 95% confidence intervals were used to analyze determinants of interprofessional collaboration in patient care among nurses and physicians. Funnel plots and Egger’s test were used to examine the possibility of publication bias (p-value < 0.10), and the trim-and-fill method by Duval and Tweedie was applied to adjust for publication bias.

RESULTS: Five studies with a total of 1686 study participants that are conducted in three Ethiopian regions and meet the inclusion criteria were reviewed and pooled for this evaluation. The pooled proportions of the interprofessional collaboration towards patient care in Ethiopia is 52.73% (95% CI = 44.66, 60.79%, I² = 91.5%). Factors such as attitude (favorable attitude towards collaboration) (OR = 1.13, 95% CI: 0.13, 9.89, I² = 97.7%) and organizational support (satisfaction towards organizational support) (OR = 0.38, 95% CI: 0.07, 2.10, I² = 97.5%) were not significantly associated with interprofessional collaboration towards patient care.

CONCLUSION: In summary, this systematic review and meta-analysis reveal that interprofessional collaboration between nurses and physicians in Ethiopia is moderately common, with a pooled proportion of 52.73%. This finding underscores the need for ongoing efforts to enhance collaborative practices to further improve patient care outcomes. Additionally, the review identified two potential contributors to interprofessional collaboration: satisfaction with organizational support and favorable attitudes towards collaboration. However, the pooled effects of these factors did not show a significant association with interprofessional collaboration. This highlights the necessity for further primary research to identify additional factors that may influence interprofessional collaboration and enhance patient care outcomes. Notable limitations of this study include significant variation among studies, a small number of studies, a focus solely on public hospitals, restriction to English-language publications, only observational studies, and limited access to databases such as EMBASE, CINAHL, and Web of Science.

REGISTRATION: This systematic review and meta-analysis was registered in Prospero with the registration ID and link as follows: CRD42024579370; https://www.crd.york.ac.uk/prospero/#recordDetails .

PMID:40001025 | DOI:10.1186/s12912-025-02847-x

BMC Public Health. 2025 Feb 25;25(1):770. doi: 10.1186/s12889-025-21988-x.

ABSTRACT

BACKGROUND: COVID-19 vaccine hesitancy (CVH) has become a critical public health issue, with attitudes toward vaccines emerging as a broader social issue. Public debates surrounding vaccines have expanded beyond health considerations to include issues of trust, misinformation, and societal values, making CVH a complex challenge that requires multifaceted solutions. Analyzing the various determinants of CVH is crucial for developing targeted strategies to improve vaccine acceptance in specific countries and to better prepare for future public health crises. However, no study to date has evaluated the determinants of CVH in a representative sample of the Czech population.

METHODS: A multiple hierarchical logistic regression was used to analyze the associations between various sociodemographic, trust and attitudinal factors with COVID-19 vaccine acceptance (CVA). The analysis utilized survey data from a representative longitudinal sample of the Czech population (N = 1,407).

RESULTS: After controlling for all other factors, trust in official statements from the Ministry of Health was the strongest predictor of CVA, followed by prior positive attitudes toward COVID-19 vaccination (prior to vaccine availability) and older age. Lower trust in COVID-19 misinformation also predicted CVA, while lower interest in COVID-19 media content was associated with CVA. Higher income initially predicted CVA but lost statistical significance after controlling for other variables. Interestingly, education did not play a role in CVA.

CONCLUSION: CVH was primarily driven by distrust in government-provided information. Notably, vaccine refusers demonstrated a higher motivation to seek information on the topic, offering a promising opportunity for health policy interventions. Our findings suggest that strategies to reduce CVH should prioritize building trust in state institutions and effectively combating misinformation.

PMID:40001023 | DOI:10.1186/s12889-025-21988-x

BMC Nephrol. 2025 Feb 25;26(1):99. doi: 10.1186/s12882-025-04008-3.

ABSTRACT

BACKGROUNDS: Patients with End-Stage Kidney Disease (ESKD) receiving Hemodialysis (HD) face significant psychosocial and physical challenges. Improving their resilience by integrating protective factors is important for effectively managing the difficulties associated with the disease and its treatment. This study intended to identify factors associated with resilience among patients with ESKD receiving HD.

METHODS: A cross-sectional analytical study was done among 143 patients with ESKD receiving HD in a Tertiary Hospital “A” in Nepal. A non-probability convenience sampling technique was used to select samples. Data were collected following ethical approval through face-to-face interviews. A Nepali version of socio-demographic and clinical characteristics-related questions and five standardized and structured instruments were used to measure resilience, family support, illness cognition, self-efficacy, and self-esteem. Data were analyzed with descriptive and inferential statistics (i.e., correlation and multiple linear regression) using the Statistical Package for Social Science Software version 16.

RESULTS: The respondents had intermediate (49.0%), low (27.3%), and high (23.7%) levels of resilience. Illness cognition, self-efficacy, and self-esteem had statistically significant positive associations with resilience. However, age was negatively associated with resilience. These associated variables account for 64.0% of the variance in resilience (Adjusted R² = 0.64).

CONCLUSIONS: The highest proportion of patients with ESKD receiving HD had an intermediate level of resilience. Factors such as illness cognition, self-efficacy, and self-esteem play an important role in enhancing resilience while advancing age appears to diminish it. Therefore, focusing on enhancing illness cognition, self-efficacy, and self-esteem with special care on older patients may be an effective strategy for improving resilience in patients with ESKD receiving HD.

TRIAL REGISTRATION: Not applicable.

PMID:40001022 | DOI:10.1186/s12882-025-04008-3

BMC Public Health. 2025 Feb 25;25(1):774. doi: 10.1186/s12889-025-22009-7.

ABSTRACT

BACKGROUND: The purpose of this study is to determine the factors related to women’s exposure to emotional violence by their spouses/partners in the 12 months prior to the survey, according to their place of residence (rural, urban) in Türkiye.

METHODS: Binary logistic regression analysis was utilized to determine the factors associated with women’s exposure to emotional violence from their spouses/partners. The independent variables of the study were those used in the National Research on Domestic Violence against Women in Türkiye (2014). A total of 6,458 women-4,404 from urban areas and 2,054 from rural areas-were included in the analysis.

RESULTS: The findings obtained from the analyses indicated that women’s exposure to emotional violence was associated with various factors such as age, educational level, marital status, and women’s higher income contribution to the household. It was also found that afraid of spouse/partner, controlling behavior of spouse/partner, and other variables related to spouse/partner were associated with women’s exposure to emotional violence. In rural, a woman with a higher income contribution to the household is less likely to be exposed to emotional IPV. A woman with no formal education, a primary and secondary school graduate spouse/partner is less likely to be exposed to emotional IPV than a woman with a high school graduate spouse/partner. The likelihood of a woman with a spouse/partner using drugs to be exposed to emotional IPV is lower than a non-user.

CONCLUSIONS: The results of the study are important in that they can be a source of information for policies and programs to prevent IPV against women. This study can also be a significant guide in determining priority areas for the resolution of emotional IPV against women. The study suggests developing proper strategies for reducing emotional violence, such as training and programs to help women pursue non-violent pathways in their relationships. It recommends expanding interventions to empower women economically that help prevent violence.

PMID:40001017 | DOI:10.1186/s12889-025-22009-7

Int Orthod. 2025 Feb 24;23(3):100992. doi: 10.1016/j.ortho.2025.100992. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate and compare the performance of OpenAI’s ChatGPT-4 and Microsoft Copilot in providing information on 3D-printed orthodontic appliances, with a focus on the accuracy, completeness of the content, and response generation time.

METHODS: This cross-sectional study proceeded in five stages. Initially, three orthodontists created a total of 125 questions concerning 3D printed orthodontic appliances of which 105 questions were finalized to be incorporated into the study by a panel of senior orthodontists. These questions were subsequently organized into 15 distinct domains. Both chatbots were presented with the questions under consistent conditions, using the same laptop and internet setup. A stopwatch was used to record response times. The responses were anonymized and evaluated by seven orthodontists with extensive experience, who scored accuracy and completeness based on standardized tools. Through discussion, evaluators reached a consensus on each score, ensuring reliability.

RESULTS: Spearman’s correlation revealed a moderate to strong negative correlation between accuracy and completeness for both chatbots (p≤0.001). The negative correlation observed between accuracy and completeness scores, particularly prominent in Copilot, indicates a trade-off between these qualities in some responses. Mann-Whitney U tests confirmed significant differences in accuracy and completeness between the chatbots (p≤0.001), though response time differences were not statistically significant (p=0.204). Cohen’s Kappa results implied little to no consistency between the two models on the assessed parameters (p>0.05).

CONCLUSION: ChatGPT-4 outperformed Microsoft Copilot in accuracy and completeness, providing more precise and comprehensive information on 3D-printed orthodontic appliances demonstrating a greater ability to handle complex, and detailed requests in this area.

PMID:39999543 | DOI:10.1016/j.ortho.2025.100992

J Hum Evol. 2025 Feb 24;201:103650. doi: 10.1016/j.jhevol.2025.103650. Online ahead of print.

ABSTRACT

Miocene apes represent snapshots in time of key transitions in hominoid evolution. While all extant apes are adapted to orthograde posture and suspensory behavior, many Miocene apes demonstrate evidence for pronogrady and habitual arboreal quadrupedalism or present ‘mosaic’ morphologies suggestive of locomotion and posture unlike any extant catarrhine. Here, we use three-dimensional geometric morphometrics to study penultimate lumbar vertebrae of extant anthropoids and those of three well-preserved Miocene apes: Ekembo nyanzae (KNM-MW 13142), Morotopithecus bishopi (UMP 67-28), and Pierolapithecus catalaunicus (IPS 21350-64), which have been interpreted as a pronograde arboreal quadruped, an orthograde suspensory or vertical climbing ape, and an orthograde vertical climber that was not adapted to suspensory behavior, respectively. Our results show that E. nyanzae shares three-dimensional shape space with terrestrial papionins, whereas M. bishopi and P. catalaunicus fall within overlapping morphospace shared by Ateles and hylobatids. Morotopithecus bishopi and P. catalaunicus share with hylobatids and brachiating atelids (Ateles and Brachyteles) well-established features such as dorsal lumbar transverse (costal) processes and a newly identified feature in this study, the presence of a convex pillar along the pars interarticularis that forms the lateral borders of the laminae. The latter feature is also shared with E. nyanzae. Together with their large body size estimates, we interpret these results to indicate that E. nyanzae was primarily a pronograde quadruped that may have been semiterrestrial rather than strictly arboreal, while M. bishopi and P. catalaunicus were adapted to both orthogrady and forelimb-dominated climbing and suspension.

PMID:39999514 | DOI:10.1016/j.jhevol.2025.103650

J Surg Res. 2025 Feb 24;307:93-99. doi: 10.1016/j.jss.2025.01.008. Online ahead of print.

ABSTRACT

INTRODUCTION: The COVID-19 pandemic limited many patients to an unhealthy, sedentary lifestyle, with literature specifically demonstrating an increasing trend of obesity in pediatric patients. The goal of this study is to assess the relationship between the COVID-19 pandemic and total number of laparoscopic cholecystectomies performed pre-COVID compared to during COVID.

METHODS: Data between 2017 and 2021 were collected from the National Surgical Quality Improvement Program on patients ≤18 ys who underwent elective or urgent cholecystectomies. Data was categorized as pre-COVID (2017-2018) or during COVID (2020-2021). Analysis subcategories included case acuity (elective versus urgent versus emergent), wound classification, race, weight, and complications.

RESULTS: There were 13,579 pediatric laparoscopic cholecystectomies from 2017 to 2021. The COVID group had 7605 (56.0%) cases, and pre-COVID group 5974 (44.0%). The COVID group had significantly greater average weight and body mass index (BMI) than pre-COVID group (P < 0.001). Increased BMI was associated with increased case acuity and complication rates. Minorities including African Americans and Native American/Pacific Islanders had an increase in number of cholecystectomies performed during COVID. Undergoing a cholecystectomy during COVID was more likely to be classified as urgent or emergent than pre-COVID (P < 0.0001). The COVID group overall had less favorable surgical wound classification as more were classified as class III or class IV cases.

CONCLUSIONS: There were increases in weight/BMI, case severity, and total laparoscopic cholecystectomies performed during COVID-19. A statistically significant difference in average weight may suggest a relationship between isolation during the COVID-19 pandemic and rates of cholecystectomy. Future research is encouraged to identify contributing factors in these trends.

PMID:39999510 | DOI:10.1016/j.jss.2025.01.008