Tag: statistics

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

BMC Ophthalmol. 2025 Oct 9;25(1):557. doi: 10.1186/s12886-025-04321-3.

ABSTRACT

OBJECTIVE: To do the differential expression of long noncoding RNAs (lncRNAs) in pterygium was screened by gene chip technology, and the differentially expressed lncRNAs HOTTIP and RP1-261G23.7 were studied to explore their possible mechanisms in the pathogenesis of pterygium.

METHODS: Collected 40 specimens from June 2016 to May 2017 that underwent surgery in the Ophthalmology Department of Yanjishan Hospital of Wannan Medical College, including 20 pterygium tissue specimens (6 males and 14 females, aged 47-84 years, mean age 68.1 years), 20 cases of normal nasal bulbar conjunctival tissue in patients with strabismus (9 males and 11 females, aged 41-88 years, mean age 61.6 years). Four samples from each group were randomly selected to detect lncRNA expression by high-throughput gene chip detection technology; lncRNA HOTTIP, RP1-261G23.7 and corresponding target genes HOXA13, VEGFA were screened by quantitative real time polymerase chain reaction (qRT-PCR) to verify whether there is a significant difference between the two groups, and to analyze the correlation between the expression of the target genes HOXA13 and VEGFA.

RESULTS: (1) SPSS17.0 software was used for data processing in the experimental group and the control group. Gender and age were analyzed by the chi-square test. The statistical results were all P > 0.05, and there was no significant difference in statistics, (2) A total of 8271 differential lncRNAs were detected by high-throughput gene chip detection and compared with normal nasal bulbar conjunctival tissue in patients with strabismus. Among them, lncRNAs with a P-value < 0.05 and log fold change > 2 and Benjamini-Hochberg FDR correction (FDR < 0.05) had 612 upregulated genes and 743 downregulated genes. (3) The two highly differential lncRNAs were selected and verified by qRT-PCR. The results showed that lncRNAs HOTTIP and RP1-261 G23.7 and the corresponding target genes HOXA13 and VEGFA were highly consistent and highly expressed in the control group.

CONCLUSIONS: (1) LncRNAs are differentially expressed in pterygium; (2) Key lncRNA HOTTIP, RP1-261G23.7 may be new gene targets for pterygium.

PMID:41068700 | DOI:10.1186/s12886-025-04321-3

BMC Med Educ. 2025 Oct 9;25(1):1386. doi: 10.1186/s12909-025-07854-9.

ABSTRACT

BACKGROUND: Artificial intelligence (AI) is rapidly transforming healthcare, including dentistry, through its applications in diagnosis, prosthetic planning, and oral disease detection. As future professionals, dental students play a vital role in integrating AI into clinical practice. However, little is known about their attitudes toward AI, particularly in low-resource settings such as Palestine.

METHODS: A cross-sectional survey was conducted among 305 dental students from four Palestinian universities using a validated 22-item questionnaire. Data were analyzed using descriptive statistics and chi-square tests (p < 0.05).

RESULTS: Among the 305 participants (232 females, 73 males), 77% reported basic knowledge of AI, with social media being the most common source (66.2%). Female students were significantly more likely than males to believe that AI will bring major advancements to dentistry (p = 0.04), and that it can be used for diagnostic (p = 0.030), prognostic (p = 0.045), and treatment planning purposes (p = 0.015), as well as in postgraduate training (p = 0.017). Those with prior AI knowledge or awareness of its dental applications showed greater enthusiasm for its diagnostic use (p = 0.004) and integration into dental education (p = 0.004 and p = 0.009, respectively).

CONCLUSION: Palestinian dental students demonstrate strong awareness and positive attitudes toward the use of AI in dentistry. Gender-based differences and ethical concerns emphasize the need for structured, inclusive, and responsible AI training within dental curricula.

PMID:41068696 | DOI:10.1186/s12909-025-07854-9

BMC Surg. 2025 Oct 9;25(1):468. doi: 10.1186/s12893-025-03202-2.

ABSTRACT

BACKGROUND: To study the medical history, diagnosis, management, and treatment results of piriformis syndrome (PS).

METHODS: Articles published between 1980 and 2024 reporting cases of PS or piriformis muscle sciatica (PMs) case/case series were included. We excluded articles that did not report anagraphic data for singular cases, diagnostic procedure, therapy, and outcome for each case. We searched PubMed database and we retrieved articles from references. We used the Preferred Reporting Items of Systematic Reviews (PRISMA) guidelines to conduct a systematic review of the literature to identify all published cases of PS or piriformis muscle sciatica (PM). Data for all cases were collected in a database and analysed using statistical software (Statistical Package for the Social Sciences for Windows).

RESULTS: Of the 235 articles screened, 97 were included. Data from 212 patients (117 females and 95 males, mean age 43.6 ± 14.8) were collected. 38.2% of the patients in this study had a history of blunt / indirect pelvic trauma or piriform muscle (PM) stress due to vigorous physical activity/sport. 9.0% (19/212) of the patients had previously failed lumbar spine surgery. Before treatment, the diagnosis of PS/PMs was corroborated in 29.7% of patients by intrapelvic magnetic resonance imaging (MRI); 50.5% of the patients had a PS clinical diagnosis. Conservative treatments were effective in treating PS/PMs in 41.1% of patients; 58.9% of patients required surgical treatments. In the group of patients with PS diagnosis made without instrumental finding, the OR of surgical treatment failure occurrence was 5.3. After treatment, the most frequent causes of PS/PMs identified by intraoperative or instrumental findings were the anatomical variant of PM or SN (12.7%) followed by pyomyositis (9.4%) and PM hypertrophy (7.5%). 47.6% of the patients had no instrumental or intraoperative findings.

CONCLUSIONS: Intrapelvic MRI was the instrumental examination most frequently used to confirm the diagnosis of PS/PMs prior to treatment. The PS causes most frequently identified were the anatomical variant of PM or SN. In the group of patients with PS diagnosis made without instrumental finding, the OR of surgical treatment failure occurrence was 5.3. To reduce the number of cases of persistent pain after treatment for suspected PS, it is advisable to support the clinical diagnosis through all available instrumental diagnostic procedures. However, considering all the risks that SN surgery can cause, all nonsurgical treatments should be encouraged prior to surgery. TRIAL REGISTRATION: PROSPERO Reg. No. CRD42025641061.

PMID:41068685 | DOI:10.1186/s12893-025-03202-2

BMC Psychiatry. 2025 Oct 9;25(1):957. doi: 10.1186/s12888-025-07445-4.

ABSTRACT

BACKGROUND: Although antidepressant monotherapy is recommended for patients with major depressive disorder (MDD), they often do not respond to it, necessitating alternatives such as electroconvulsive therapy (ECT). However, maintenance pharmacotherapy after ECT has remained unestablished. This study, conducted at 240 facilities throughout Japan, aimed to explore maintenance pharmacotherapy after ECT for 3,749 inpatients with MDD.

METHODS: The patients were divided into two groups, one that underwent ECT (ECT group, N = 521) and another that did not (non-ECT group, N = 3,273), for the comparison of clinical characteristics and prescription details at discharge. The primary outcome of this study was the prescription rate of antidepressant monotherapy at discharge, while the secondary outcomes included prescription rates of specific combination regimens, such as antidepressant plus lithium.

RESULTS: We identified 198 prescription patterns involving antidepressants in the ECT group. Analysis by drug category revealed distinctive patterns: there was no statistically significant difference in prescription rates for antidepressant monotherapy between the ECT and non-ECT groups (N = 118, 22.6% vs. N = 932, 28.4%). In contrast, the prescription rate for the combination of antidepressant and antipsychotic medications was significantly higher in the ECT group (N = 188, 36.0% vs. N = 941, 28.7%). The combination of antidepressant and mood stabilizer was also more frequent in the ECT group (N = 35, 6.7% vs. N = 130, 3.9%), although this difference did not reach statistical significance after Bonferroni correction. At the drug level, additional distinctive patterns emerged: among antidepressant monotherapies, nortriptyline use was significantly more common in the ECT group (N = 9, 1.7% vs. N = 11, 0.3%). For mood stabilizers, restricting the analysis to lithium revealed a markedly higher rate in the ECT group (N = 30, 5.7% vs. N = 35, 1.0%).

CONCLUSIONS: These findings highlight the complexity of treatment decisions managing of MDD after ECT and emphasize the need for structured prospective research on the effectiveness of specific maintenance pharmacotherapies after ECT.

PMID:41068670 | DOI:10.1186/s12888-025-07445-4

BMC Gastroenterol. 2025 Oct 9;25(1):710. doi: 10.1186/s12876-025-04247-6.

ABSTRACT

BACKGROUND: Chronic Proton Pump Inhibitor (PPI) use after anti-reflux surgery (ARS) remains common. Which patient factors contribute to chronic PPI use after surgery is unclear. The primary aim was to provide a long-term outcome of ARS by evaluating PPI use in the years after surgery and identify determinants of chronic PPI use after surgery.

METHODS: Patients aged ≥ 18 years who underwent ARS between 2011 and 2020 in a single referral center were eligible. Patient data were retrospectively assessed by medical record review. PPI data were acquired from primary care pharmacies. Chronic PPI use was defined as ≥ 180 Defined Daily Doses (DDD) per year. Patient characteristics predisposing chronic PPI use were identified. Statistical analysis included descriptive statistics and multivariable logistic regressions and a Kaplan-Meier curve.

RESULTS: Only 45 out of 364 eligible patients (12%) had complete data for analysis. Chronic PPI use was present in 79.5% before surgery compared to 29.5% at 1 and 2 years and 32.0% for 5 years after surgery. A median difference in PPI use of -257 DDD was found for the year after surgery compared to the year before surgery. Male gender was associated with chronic PPI use after surgery but no other determinants were found.

CONCLUSION: Approximately a third of the patients use PPIs up to 5 years after surgery. Although ARS is recommended when PPI treatment fails or to avert lifelong PPI use, quality of life and PPI use may not correlate linearly. Adequate patient selection and expectation management before surgery is paramount.

PMID:41068664 | DOI:10.1186/s12876-025-04247-6

BMC Infect Dis. 2025 Oct 9;25(1):1262. doi: 10.1186/s12879-025-11595-x.

ABSTRACT

INTRODUCTION: Diarrhea is a public health challenge, the leading cause of malnutrition, morbidity, and mortality for children under five years globally. The disease is more common in low and middle-income countries such as Asia and Africa. While several studies were conducted on the prevalence of diarrheal disease among children under five, none of them showed the pooled prevalence of diarrheal disease. Therefore, this study aimed to determine the pooled prevalence and its determinants of diarrhea among children under five in East Africa.

METHODS: We searched articles published between January 01/2020, to October 31/2024, on the prevalence of diarrheal disease among children under five years old using different databases such as PubMed, Scopus, Science Direct, and Google Scholar. We included studies that were published only in the English language and report the prevalence of diarrhea among children under five in East African countries. To get the total number of children under the age of five in our study, we summed the sample sizes from chosen studies.We checked the quality of each study using the Newcastle Ottawa Scale (NOS) quality assessment scale, and we performed the analysis by random effect model using statistical software STATA version 17 and R version 4.4.2.

RESULT: A total of 162,388 children under five years were included in this review. About 93.33% of studies were conducted using cross-sectional study designs. The overall pooled prevalence of diarrhea among children under five in East Africa was 24.6% (95% CI: 22.7%, 26.6%). Improper waste disposal mechanism (OR = 1.67, 95% CI: 1.10, 2.53), large family size (OR = 1.38, 95% CI: 1.10, 1.72), two and above children under five years (OR = 1.6, 95% CI: 1.27, 2.03), unprotected source of water (OR=1.92, 95% CI: 1.39, 2.65), not vaccinated from rotavirus (OR = 2.06, 95% CI: 1.10, 3.85), unprotected toilet type (OR = 1.11, 95% CI: 1.01, 1.21), and households who spent more than thirty minutes to fetch water (OR = 1.35 95% CI: 1.05, 1.73) were risk factors responsible for the prevalence of diarrheal disease among children under five years.

CONCLUSIONS: The pooled prevalence of diarrhea among children under five in East Africa is still at a high level. The finding of this study recommends intervention on family planning initiatives, improving sanitation practices, increasing access to healthcare, providing access to clean water, rotavirus vaccination, and well-established waste disposal mechanisms, which could be the critical issues to reduce the prevalence of diarrheal disease among children under five years.

PMID:41068656 | DOI:10.1186/s12879-025-11595-x

BMC Public Health. 2025 Oct 9;25(1):3444. doi: 10.1186/s12889-025-24424-2.

ABSTRACT

BACKGROUND: Understanding the contraceptive preferences of currently married women who are not using any method but intend to do so in the future is critical for addressing unmet need and informing targeted family planning strategies. In Bangladesh, despite progress in contraceptive uptake, disparities persist across socio-demographic groups and geographic regions. This study examines the determinants of preferred future contraceptive methods among non-using but intending women in Bangladesh using a multilevel analytic framework.

METHODS: We used data from the 2014 Bangladesh Demographic and Health Survey (BDHS), focusing on 3,662 currently married women aged 15-49 who were not using any contraceptive method but intended to adopt one in the future. The outcome variable, preferred future contraceptive method, was categorized into three groups: Pill (reference), Injection, and Other methods (e.g., condom, sterilization, Norplant). A two-level multinomial logistic regression model was applied, with women (level 1) nested within administrative divisions (level 2), using a Bayesian estimation approach.

RESULTS: The Pill was the most preferred method overall (49%), followed by Other methods (30%) and Injection (21%). Preference patterns varied by age, education, parity, wealth, and place of residence. Women with higher education had significantly greater odds of preferring other methods over pills (OR = 1.68, 95% CI: 1.14-2.51), while those with more children were more likely to prefer injections. Urban women were more inclined to prefer other methods compared to rural women (OR = 1.38, 95% CI: 1.14-1.71). The analysis revealed significant variation across divisions, highlighting contextual influences on contraceptive preferences.

CONCLUSIONS: Contraceptive preferences among non-using but intending women in Bangladesh are shaped by a complex interplay of individual and regional factors. Programs aiming to reduce unmet need and method discontinuation should adopt tailored strategies that consider age, education, parity, and regional disparities. Enhancing method choice, promoting female education, and improving service delivery in underserved regions are essential for achieving reproductive health equity and advancing national and global family planning goals.

PMID:41068653 | DOI:10.1186/s12889-025-24424-2