Tag: statistics

Infect Agent Cancer. 2025 Oct 9;20(1):69. doi: 10.1186/s13027-025-00699-3.

ABSTRACT

BACKGROUND: Methylation of host genes is promising for the triage of women with high-risk human papillomavirus (HR-HPV) infections. This study aimed to validate the potential value of Glycophorin C (GYPC) methylation (GYPC^m) in the early detection of cervical cancer.

METHODS: We recruited HR-HPV-positive women at the hospital outpatient clinic between August and December 2023, using cytology triage. The remaining exfoliated cervical cells were subjected to GYPC^m testing. A total of 549 cases were finally included for analysis: 156 cervicitis, 303 cervical intraepithelial neoplasia (CIN)1, 49 CIN2, 37 CIN3, and 4 CC.

RESULTS: The difference of GYPC^m ΔCp values between CIN1 and CIN2 was statistically significant in the pathology results of 549 participants (P < 0.001). The optimal threshold value of GYPC^m for detecting CIN2 + was 6.35. The GYPC^m adjusted ORs for CIN2 + and CIN3 + were 31.23 (95%CI: 16.53-58.99) and 34.68 (95%CI: 11.90-101.11), respectively. In all individuals, the sensitivity of GYPC^m for CIN2 + and CIN3 + was consistent with that of cytology (CIN2 + 83.3%; CIN3 + 90.2%), with higher specificity than that of cytology (CIN2 + 85.8 vs. 29.4%; CIN3 + 79.7 vs. 28.7%, all P < 0.001). The sensitivity and negative predictive value (NPV) of HPV16/18 combined GYPC^m for CIN3 + were not statistically different from those of HPV combined with cytology (sensitivity 95.1 vs. 97.6%, P = 0.317; NPV 99.4 vs. 99.0%, P = 0.613). The net reclassification improvement for HPV16/18 combined GYPC^m and its combined cytology to classify CIN2 + vs. < CIN2 was 48.8% (95%CI: 39.7-57.9%, P < 0.001), with a relative colposcopy referral rate of 50.1% (95%CI: 45.5-54.7%).

CONCLUSION: GYPC^m has a higher CIN2 + OR and higher specificity and positive predictive value than cytology in HR-HPV-positive women and is a potential molecular biomarker for triaging HR-HPV (+) to detect cervical (pre)cancer.

PMID:41068755 | DOI:10.1186/s13027-025-00699-3

BMC Med Educ. 2025 Oct 9;25(1):1384. doi: 10.1186/s12909-025-08003-y.

ABSTRACT

BACKGROUND: Academic burnout is a significant concern for dental students, often resulting from prolonged stress and a lack of support in the learning environment. This study investigates academic burnout among dental students, focusing on its relationship with their perceptions of the quality of the learning environment and the mediating role of dental environmental stress.

METHODS: In this cross-sectional study, 300 undergraduate dental students were recruited using a convenience sampling method in Isfahan, Iran, in 2022. Data were collected online via WhatsApp and Telegram platforms. In addition to demographic data, the Burnout Clinical Subtype Questionnaire, the Dental School Learning Environment Survey, and the Dental Environmental Stress Questionnaire were employed. Structural equation modeling was conducted using the Partial Least Squares approach to analyze the relationships among variables (p < 0.05).

RESULTS: The study indicated moderate levels of academic burnout (2.61/5), perceived quality of the learning environment (2.92/5), and dental environmental stress (2.80/4). The quality of the learning environment accounted for 2.8% of the variance in the dental environmental stress. The combined quality of the learning environment and dental stress accounted for 22.1% of the variance in academic burnout. Statistically significant relationships were found between the quality of the learning environment and dental environmental stress (p = 0.001), the quality of the learning environment and academic burnout (p = 0.026), and dental environmental stress and academic burnout (p < 0.001). Furthermore, dental environmental stress significantly mediated the relationship between the quality of the learning environment and academic burnout (p = 0.003).

CONCLUSIONS: The results highlighted the pivotal role of the learning environment in shaping dental students’ academic experiences, particularly concerning stress and burnout. Considering the mediating role of dental environmental stress, the findings emphasize the need for supportive, well-structured, and engaging learning environments.

PMID:41068734 | DOI:10.1186/s12909-025-08003-y

Int J Equity Health. 2025 Oct 9;24(1):263. doi: 10.1186/s12939-025-02493-4.

ABSTRACT

BACKGROUND: During the covid-19 pandemic, despite sexual and reproductive health (SRH) services being considered essential, in Brazil, only 55% of abortion services remained in operation. This restriction of access could lead to an increase in unplanned pregnancies, unsafe abortion practices, and, consequently, an increase in the maternal mortality rate. In addition to the difficulty of consolidating information for monitoring and evaluating SRH services. In this scenario, postabortion contraception (PAC) during hospital admission is essential, especially with the postabortion use of long-acting reversible methods (LARC), such as intrauterine devices (IUDs), since they are effective, economical, safe and with immediate contraception.

OBJECTIVE: To evaluate postabortion contraceptive methods, mainly LARC, during hospital admission after spontaneous abortion and legal termination of pregnancy and their associated factors through the abortion surveillance network.

METHODS: a cross-sectional study with women of any age admitted for spontaneous abortions or legal interruption procedures at the Women’s Hospital at State University of Campinas (UNICAMP), Brazil, between July 2017 and November 2022. The study was approved by the Research Ethics Committee from UNICAMP. The dependent variable was IUD insertion. The independent variables were clinical, sociodemographic characteristics, vulnerable groups and period of hospitalization (pre-pandemic: until 10/03/2020; pandemic: from 11/03/2020). For statistical analysis, Cochran-Armitage trend tests and an adjusted logistic regression model were used, with the significance of the coefficients evaluated by the p-value, obtained through the Wald statistics associated with each parameter, as well as the confidence interval.

RESULTS: 675 women were hospitalized during the period, 547 for spontaneous abortions and 128 for legal termination. Of these, 499 (79%) had at least one vulnerable factor and 45.2% started PAC during hospital stay, as injectables (48.5%), oral contraceptive pills (34.8% ) and IUDs (13.4%). There was a trend towards increased use of IUDs before hospital discharge (p < 0.01), especially in hospitalizations that occurred during the pandemic period, in the most vulnerable groups (p < 0.01) and women with previous abortions (p < 0.05). The factors independently associated with a higher frequency of IUD insertion were presence of 3 or more vulnerability factors (coefficient 4.50; 95% confidence interval [CI] 1.12 to 7.88; p = 0.01); hospitalization during the pandemic period (coefficient 2.56; CI 1.14-3.99; p < 0.01) and the number of abortions (coefficient 0.61; CI 0.09-1.13; p = 0. 02).

CONCLUSION: Reducing access barriers to highly effective and long-acting contraceptives is an important step towards curbing the rates of unplanned pregnancies. Increasing rates of postabortion IUD use in vulnerable populations and in the context of the pandemic reinforce the importance of the epidemiological surveillance strategy in reducing exposure to preventable risks such as unsafe abortion and managing SRH policy strategies to reduce the maternal mortality rate.

PMID:41068730 | DOI:10.1186/s12939-025-02493-4

BMC Oral Health. 2025 Oct 9;25(1):1583. doi: 10.1186/s12903-025-06961-9.

ABSTRACT

OBJECTIVES: This randomized clinical trial aimed to evaluate the effect of calcium hydroxide-based, calcium silicate-based and epoxy resin-based root canal sealers on postoperative pain (PP) after a single session of non-surgical endodontic retreatment of the teeth with chronic apical periodontitis.

MATERIALS AND METHODS: Ninety-six participants who had teeth with previously root canal treatment, asymptomatic, a single root and single canal, chronic apical periodontitis, were included in the study and then were randomly allocated to one of three experimental groups. (n = 32 per group).An endodontic specialist performed same retreatment protocols in a single visit. Participants were asked to rate the intensity of PP on a visual analogue scale at 6, 12, 24, and 48 h, and 3, 4,5, 6, and 7 days, and to mark whether they had taken analgesic (400 mg Ibuprofen) during the same periods after retreatment. All statistical analyses were performed using a software program (IBM SPSS Statistics, Version 22), and the significance level was set at P < 0.05.

RESULTS: There was no significant difference between the groups in PP and analgesic intake at any of the time intervals evaluated(P > 0.05).A strong positive correlation was observed at 48 h and 96 h when the correlation between PP and analgesic intake was evaluated regardless of the type of root canal sealer. PP level was associated with age, gender, Periapical Index (PAI) score, and jaw type.(P < 0 0.05).

CONCLUSIONS: Epoxy resin, Calcium silicate, and calcium hydroxide-based root canal sealers resulted in statistically similar postoperative pain levels.

CLINICAL SIGNIFICANCE: Each of the epoxy resin, calcium silicate, and calcium hydroxide-based root canal filling materials could be used safely in patients when considering PP.

TRIAL REGISTRATION: ClinicalTrial.gov, NCT06803277, record date: 2025-01-17, retrospectively registered.

PMID:41068727 | DOI:10.1186/s12903-025-06961-9

BMC Pediatr. 2025 Oct 10;25(1):798. doi: 10.1186/s12887-025-05832-0.

ABSTRACT

BACKGROUND: Autism Spectrum Disorder (ASD) is characterized by physical, communication, and behavioral challenges that often require comprehensive interventions. This study aimed to evaluate the combined efficacy of physiotherapy, occupational and speech therapies in improving physical and behavioral outcomes among children with ASD.

MATERIALS AND METHODS: This assessor-blinded randomized clinical trial was conducted at Proyash (Institute of Special Education), Jashore, Bangladesh, involving seventy children with ASD. Outcomes were assessed using the modified SF-36 for physical status and GARS-3 for behavioral status at baseline and after six weeks of intervention. Data were analyzed using SPSS version 25.0, with descriptive statistics (median and IQR) and inferential tests (Mann-Whitney U and Wilcoxon signed-rank), maintaining a 95% confidence level.

RESULTS: The average age of participants was 10.66 ± 3.28 years in Group A and 9.17 ± 2.83 years in Group B. Group A had a higher BMI of 21.86 ± 7.96 kg/m² compared to 19.53 ± 4.85 kg/m² in Group B. Post-intervention analysis revealed significant improvements in both physical and behavioral outcomes. Between-group comparisons yielded p-values < 0.01 for both measures. Within-group analysis showed significant improvements in Group A (p < 0.01), whereas changes in Group B were not statistically significant.

CONCLUSION: The combined rehabilitation program demonstrated significant improvements in physical and behavioral outcomes and showing greater effectiveness overall. These findings emphasize the importance of customized rehabilitation approaches in enhancing both physical and behavioral health, particularly when tailored to specific participant profiles.

TRIAL REGISTRATION: CTRI/2024/07/070209 (Prospectively Registered).

PMID:41068726 | DOI:10.1186/s12887-025-05832-0

BMC Public Health. 2025 Oct 9;25(1):3427. doi: 10.1186/s12889-025-24439-9.

ABSTRACT

BACKGROUND: The Vital Capacity Weight Index (VCWI) serves as a pivotal indicator of cardiopulmonary function among children and adolescents, reflecting their tissue oxygenation capacity and athletic potential. This study delves into the influence of environmental greenness and physical activity on VCWI in children residing in China’s economically prosperous provinces, who are exposed to air pollutants, namely PM_2.5 and O₃.

METHODS: We performed a cross-sectional analysis using data from the 2019 Chinese National Survey on Students’ Constitution and Health (CNSSCH), involving 62,987 students from the top eight provinces by GDP. Exposure to PM_2.5 and O₃ was estimated using data from the Tracking Air Pollution in China (TAP) platform. Greenness surrounding schools was assessed based on the China Land Cover Dataset (CLCD). Daily physical activity duration was used to classify participants into moderate or vigorous activity groups. Associations with VCWI were examined using univariate and multivariate logistic regression models. Interaction effects between air pollution and greenness or physical activity were assessed using additive models.

RESULTS: Higher concentrations of PM_2.5 and O₃ were significantly associated with lower VCWI. In contrast, greater greenness coverage and engagement in vigorous physical activity were linked to better VCWI outcomes. Interaction analysis showed that increased greenness may enhance the protective effect of lower air pollution levels on VCWI, while the interaction between physical activity and air pollution was not statistically significant.

CONCLUSIONS: These findings highlight the potential of green environments and active lifestyles in buffering the negative respiratory effects of air pollution among children. The results provide evidence to inform integrated urban planning and public health initiatives aimed at improving children’s lung health.

PMID:41068724 | DOI:10.1186/s12889-025-24439-9

BMC Public Health. 2025 Oct 9;25(1):3423. doi: 10.1186/s12889-025-24588-x.

ABSTRACT

BACKGROUND: Childhood vaccination coverage in Sierra Leone remains unsatisfactory despite multiple efforts made by health authorities to enhance collective immunity of the population, especially for children aged 12 to 23 months. This study aimed at identifying the factors associated with incomplete vaccination or non-vaccination among children aged 12 to 23 months in Sierra Leone in 2019.

METHODS: This was a cross-sectional study that used the 2019 Sierra Leone Demographic and Health Survey data. Descriptive statistics was performed to describe the sample, ascending hierarchical classification following a multiple correspondence analysis was employed to establish the profile of children with incomplete vaccination or non-vaccination status, and a binary logistic regression was used to identify the factors associated with incomplete vaccination or non-vaccination.

RESULTS: Of the 966 children aged 12 to 23 months involved in the study, 42.9% (95% CI[39.2; 46.6]) were incompletely vaccinated or unvaccinated, of which, 43.5% (95% CI[37.9; 49]) among male children and 42.4% (95% CI[37.3; 47.4]) among their female counterparts. The Northern (AOR 1.683, 95% CI[1.131; 2.503]) and the North Western (AOR 1.847, 95% CI[1.208; 2.825]) survey regions, delivery in a place other than a health facility (AOR 1.404, 95% CI[1.001; 2.042]), the mother’s age group 35 to 49 years (AOR 0.437, 95% CI[0.251; 0.762]) and the child’s birth order 7th or higher (AOR 2.640, 95% CI[1.452; 4.800]) turned out to be significant factors of incomplete vaccination or non-vaccination.

CONCLUSION: Incomplete vaccination or non-vaccination among children was high in Sierra Leone in 2019. In order to increase childhood vaccine uptake, we recommend the development of initiatives geared towards optimizing facility-based service delivery, intensifying health education focusing more on vaccination, enhancing community engagement, addressing barriers to vaccine access, establishing and ensuring proper functioning of immunization defaulter tracking systems.

PMID:41068721 | DOI:10.1186/s12889-025-24588-x

BMC Pregnancy Childbirth. 2025 Oct 9;25(1):1057. doi: 10.1186/s12884-025-08245-0.

ABSTRACT

BACKGROUND: Incomplete antenatal care (ANC) follow-up remains a significant public health issue, especially in low- and middle-income countries, where it poses serious risks to both maternal and fetal health. Although ANC plays a critical role in improving maternal and child health outcomes, data on regional disparities and high rates of incomplete ANC follow-up in Ethiopia are limited. Understanding the local factors contributing to these geographic variations is essential for targeted public health interventions. This study aimed to assess the spatial variation and determinants of incomplete ANC follow-up in Ethiopia.

METHODS: This study utilized data from the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS), employing a stratified, two-stage cluster sampling design. A total of 3,926 women gave their consent and were included in the study. Spatial analysis, including hotspot analysis, interpolation, and spatial statistics (SaTScan), was conducted using ArcGIS 10.8, SaTScan 9.6, and STATA 17. Additionally, spatial regression analyses, including ordinary least squares regression and geographically weighted regression (GWR), were performed to identify hotspot areas and geographical predictor variables.

RESULTS: The study found that 56.75% (95% CI: 54.32%, 59.14%) of pregnant women had incomplete ANC follow-up. Spatial autocorrelation analysis revealed a Global Moran’s I value of 0.660 (p < 0.001), indicating significant spatial clustering of incomplete ANC follow-up across Ethiopia. Hotspot areas were identified in the Southern, Somali, Gambela, Afar, and Oromia regions. GWR analysis indicated that being from rural areas, in the poorest wealth index, and lacking formal education were significant positive determinants of spatial variation in incomplete ANC follow-up.

CONCLUSION: This study revealed that over half of pregnant women in Ethiopia had incomplete ANC follow-up, with significant spatial clustering observed across the country. The GWR analysis also indicated that rural residence, low household wealth, and lack of formal education were spatially varying determinants associated with incomplete ANC follow-up. These findings suggest that targeted interventions in the identified hotspot areas and addressing the spatially varying determinants may help improve ANC follow-up.

PMID:41068716 | DOI:10.1186/s12884-025-08245-0

BMC Public Health. 2025 Oct 9;25(1):3431. doi: 10.1186/s12889-025-24662-4.

ABSTRACT

BACKGROUND: The mediation effect of 24-hour physical activities on the association between type 2 diabetes and mortality is unclear. Additionally, Little evidence was found on the isotemporal substitution effect of 24-hour physical activities components on changing Life expectancy among patients with type 2 diabetes diagnosed. To address the abovementioned research gap, the study has a two-fold aims: first, to examine the mediation effect of 24-hour physical activities in type 2 diabetes and mortality; and second, to address how reallocating time on different daily activities would affect life expectancy.

METHODS: Analysis was conducted on the accelerometer data of 103,359 participants in the UK Biobank, with a median age of 57 years (range 39 to 70). Compositional mediation cox model was conducted to analyze the mediating effects of 24-hour physical activities. Additionally, the cohort Life table method was utilized to estimate the changes of Life-years over the next 10 years resulting from the substitution effect of different physical activities.

RESULTS: During a mean follow-up of 13.95 (range 2.95-16.28) years, 2,649 deaths were recorded. Diabetes was significantly associated with increased time spent engaging in sedentary behavior (SB), and reduced time spent on moderate-to-vigorous physical activity (MVPA) and light-intensive physical activity (LPA), thereby demonstrating an association with higher mortality risk. The indirect effect of physical activity (HR = 1.27, 95% CI 1.23-1.30) accounted for 41.9% of the total effect of diabetes on mortality. Furthermore, the Life expectancy gains with a maximum of 1.32 years over the next 10 years was found when reallocating SB time to MVPA.

CONCLUSION: The results revealed that 24-hour physical activities might mediate the association between diabetes and mortality. Therefore, promoting participation in MVPA and reducing sedentary activities among diabetes patients was expected to have a positive effect on Life expectancy over the next 10 years.

PMID:41068706 | DOI:10.1186/s12889-025-24662-4

BMC Nurs. 2025 Oct 9;24(1):1252. doi: 10.1186/s12912-025-03910-3.

ABSTRACT

BACKGROUND: The way of Foley insertion and required cares after that are key factors to prevent catheter-associated urinary tract infection. Nurses play the main role in catheter placement and care, so their knowledge and performance are important. This study aims to determine Correlation Between Nurses’ Knowledge and Practices in prevention of catheter-associated urinary tract infection with Urinary Tract Infection Incidence in Intensive Care Unit.

METHODS: This correlational study was conducted with the cross-sectional method. 105 nurses from five Intensive Care Unit wards was selected with census sampling. The data about nurses’ knowledge and practice to prevent catheter-associated urinary tract infection was collected through standard questionnaires with self-reporting. The incidence of Urinary Tract Infection in the last six months according to statistics recorded by the hospital infection control center was considered. The descriptive results of nurses’ knowledge, their practice, Urinary Tract Infection prevalence, and the correlation between these factors was examined.

RESULTS: The average work experience of nurses was 2.90 ± 1.57 years. Only 16.20% of nurses had taken part in workshops related to Urinary Tract Infection prevention. The average score of knowledge was 73.26, and for practice was 2.85 ± 0.37, which both were in a low level. The overall incidence of Urinary Tract Infection in the mentioned period was 2.99%. Urinary Tract Infection prevalence had an inverse and significant correlation with nurses’ knowledge and practice, 0.461 and 0.491 respectively.

CONCLUSION: Nurses’ knowledge and practice to prevent catheter-associated urinary tract infection were at poor level. Therefore, considering the negative and significant correlation of these variables with incidence of Urinary Tract Infection in this study, it is required that nurses be trained about specialized trainings related to urinary catheter care.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:41068702 | DOI:10.1186/s12912-025-03910-3