Tag: statistics

BMC Pulm Med. 2025 Nov 11;25(1):517. doi: 10.1186/s12890-025-03991-5.

ABSTRACT

BACKGROUND/AIM: Pneumonia is a significant cause of morbidity and mortality within the first year after autologous hematopoietic stem cell transplantation in patients with multiple myeloma (MM), and nutritional status may influence complications after transplantation. In our study, we aimed to investigate the relationship between geriatric nutritional index (GNRI), prognostic nutritional index (PNI) and CONUT score and the incidence of pneumonia and mortality within 1 year after transplantation .

MATERIALS AND METHODS: A total of 286 patients who underwent autologous stem cell transplantation (ASCT) secondary to the diagnosis of multiple myeloma between 2013 and 2023 were analyzed. Patients were stratified into two groups based on the development of pneumonia within the first year post-transplantation and survival status at one year. Pre-transplant GNRI, PNI, and CONUT scores were calculated using standard formulas derived from laboratory and clinical data obtained prior to transplantation.

RESULTS: In this retrospective analysis the median GNRI value was 86.14 ± 11.47 in patients without pneumonia and 87.98 ± 13.57 in those with pneumonia, showing no statistically significant difference. The median PNI values were 89.63 ± 7.22 and 88.67 ± 7.73, and the median CONUT scores were 2.39 ± 1.68 and 2.20 ± 1.37 in the non-pneumonia and pneumonia groups, respectively. There was no statistically significant difference in either comparison. The distribution of CONUT categories did not differ significantly between patients with and without pneumonia In addition, when the association between nutritional indices and one-year survival after ASCT was analyzed, none of the indices demonstrated a significant predictive value.

CONCLUSION: As the first study to examine GNRI, PNI, and CONUT in this context, we found no significant link between pre-transplant nutritional status and pneumonia or one-year mortality post-ASCT in multiple myeloma. Transplant-induced immunosuppression may overshadow baseline nutritional effects.

PMID:41219898 | DOI:10.1186/s12890-025-03991-5

Eur Rev Aging Phys Act. 2025 Nov 11;22(1):21. doi: 10.1186/s11556-025-00387-6.

ABSTRACT

BACKGROUND: As populations age, maintaining physical activity (PA) is essential to reduce chronic disease risk and preserve functional independence in older adults. Technology-supported interventions, such as wearables, mobile applications, and web-based platforms, have emerged as effective tools to promote PA. However, engagement with technology alone is not sufficient. Effectiveness depends on whether digital tools foster sustained adherence to prescribed PA, since health benefits are dose-dependent on activity levels. In this sense, adherence matters not just for short-term participation but for embedding long-term behaviour change, an especially pressing challenge for older adults, who are typically less active and may experience greater barriers to digital engagement. This scoping review aimed to identify psychological and motivational factors that influence adherence to both the physical activity component and the supporting technology.

METHODS: A systematic search was conducted across three databases (PubMed, Web of Science, Scopus) for studies published between 2000 and March 2023. Fifty-three studies were included, encompassing qualitative, quantitative, and mixed-methods designs. Behaviour Change Techniques (BCTs) were identified and categorised using the BCT Taxonomy v1, distinguishing between techniques delivered via technology and those delivered through human interaction. Data were synthesised, distinguishing between adherence to physical activity and adherence to technology use.

RESULTS: Frequently used BCTs included self-monitoring, goal setting, action planning, feedback, prompts/cues, and social support, with different techniques emphasised in digital versus human-facilitated delivery modes. From the qualitative data, 417 psychological and motivational factors were identified and grouped into 25 thematic categories. These were structured into five domains: (1) user factors related to technology adherence, (2) technology-related factors influencing technology adherence, (3) context factors related to technology adherence, (4) user factors related to PA adherence, and (5) context factors related to PA adherence. Key facilitators included ease of use, personalised content, motivational feedback, and social support, while key barriers included low digital literacy, repetitive content, and lack of guidance. Quantitative findings revealed 19 associations between psychological/motivational variables and adherence outcomes, of which 12 were statistically significant.

CONCLUSIONS: This review provides a comprehensive overview supporting the understanding of what determines adherence in technology-supported PA interventions for older adults from a psychological and motivational perspective. By differentiating between technology adherence and PA adherence, and considering the BCTs that are incorporated in the interventions, our findings offer actionable guidance for researchers and developers to design more inclusive, motivating, and sustainable interventions that promote active ageing.

PMID:41219896 | DOI:10.1186/s11556-025-00387-6

Conscious Cogn. 2025 Nov 10;137:103959. doi: 10.1016/j.concog.2025.103959. Online ahead of print.

ABSTRACT

Dreams offer insight into how individual differences shape conscious experience in the absence of external input or task demands. This study examines whether synesthesia is linked to distinct patterns in dream content, suggesting underlying differences in cognitive architecture. Leveraging the statistical power of large-scale, naturalistic data, we analyzed 2,337 dream reports from Reddit, comparing 1,169 reports from self-identified synesthetes with 1,168 matched controls. Semantic embedding models and logistic regression achieved modest classification performance, indicating group-level differences in language use. Topic modeling revealed four themes-digital, interpersonal regret, diverse worlds, and violent conflict-that were significantly more prevalent in synesthete dreams. These results suggest that trait-level cognitive organization, as expressed in synesthetic perception, extends across states of consciousness and shapes the thematic content of dreams. The findings support theoretical accounts of dreaming as continuous with waking cognition and demonstrate how stable neurocognitive traits manifest in unstructured, self-generated thought.

PMID:41218240 | DOI:10.1016/j.concog.2025.103959

Eur J Cancer. 2025 Nov 5;231:116100. doi: 10.1016/j.ejca.2025.116100. Online ahead of print.

ABSTRACT

INTRODUCTION: Epithelioid Haemangioendothelioma (EHE) is an ultra-rare sarcoma characterized by WWTR1-CAMTA1 or YAP1-TFE3 gene fusions. Clinical behaviour ranges from indolent to aggressive. Due to its rarity, this study aims to describe the presentation, management, and outcomes of EHE patients in Canada.

METHODS: Data was collected and entered to the Canadian Sarcoma Research and Clinical Collaboration (CanSaRCC) database. Patients of all ages with a documented diagnosis of EHE from Nov 1993 to Jan 2024 were included. Patient demographics, disease characteristics and treatment details were collected using a case report form and summarized using descriptive statistics. Kaplan-Meier method was used to estimate overall survival and event free survival. Cox regression was used to estimate factors influencing survival outcomes.

RESULTS: In total, 198 patients were included of which 94 (45.7 %) presented with metastatic disease. The diagnosis was incidental in 61 patients (31 %). The most frequent primary sites were liver (n = 56, 28.3 %), extremities (n = 31, 15.7 %) and lungs (n = 27, 13.6 %). Fusion testing was performed and positive in 43 (22 %) patients. At least one line of systemic therapy was used in 55 (27.8 %) patients with most common agents including sirolimus, pazopanib and paclitaxel. The median EFS was 5.5 years (95 % CI: 3.4-8.5), and the median OS was 8.6 years (95 % CI: 5.4 – 16.5). Liver transplant was performed in seven patients. In multivariate analysis, older age, pleural effusion, ascites, primary lung disease and metastatic disease were associated with poor survival outcomes.

CONCLUSION: This is the largest series of EHE patients describing sequential systemic therapies. The role of systemic therapy in EHE in improving survival remains unclear and prospective studies with comparative arms are needed to add further insight into this chronic disease.

PMID:41218239 | DOI:10.1016/j.ejca.2025.116100

Eat Behav. 2025 Nov 7;59:102050. doi: 10.1016/j.eatbeh.2025.102050. Online ahead of print.

ABSTRACT

The association between sociocultural pressure and muscle dysmorphia (MD) is well-documented, yet the psychological variables involved require further investigation. This cross-sectional study examined a statistical model in 95 male exercisers in Spain (M age = 34.40) to explore the roles of appearance motivation and cognitive flexibility. Specifically, it tested the indirect association between the perceived influence of appearance ideals and MD symptoms through appearance motivation, and whether cognitive flexibility moderated this relationship. The overall model accounted for 48 % of the variance in MD symptoms (R² = 0.48), controlling for age. Results indicated a significant indirect association through appearance motivation (b = 0.16, 95 % CI [0.03, 0.36]). Additionally, a significant moderation was found (p = .043); the positive association between the influence of appearance ideals and MD symptoms was weaker for individuals with higher levels of cognitive flexibility. These findings are consistent with a model where MD symptom endorsement is linked to appearance motivation, while higher cognitive flexibility is related to a less pronounced association between sociocultural pressures and MD symptoms. Cognitive flexibility is highlighted as a potential protective correlate, suggesting that interventions could target motivational patterns and cognitive skills.

PMID:41218236 | DOI:10.1016/j.eatbeh.2025.102050

Int J Pediatr Otorhinolaryngol. 2025 Nov 7;199:112641. doi: 10.1016/j.ijporl.2025.112641. Online ahead of print.

ABSTRACT

AIM: Gestational diabetes mellitus (GDM) is a common metabolic disorder that affects both maternal and fetal health, with potential long-term complications. While its impact on neonatal outcomes is well-documented, its association with newborn hearing loss remains unclear. This study aims to evaluate the relationship between GDM subtypes-diet-controlled (GDMA1) and insulin-treated (GDMA2) -and newborn hearing screening results, emphasizing the need for targeted public health interventions.

MATERIALS AND METHODS: This retrospective study included pregnancy records from Kartal Dr. Lütfi Kırdar City Hospital. Pregnant women were categorized into three groups: healthy pregnancies (n = 282), GDMA1 (n = 140), and GDMA2 (n = 68). Hearing screening was performed using the auditory brainstem response (ABR) test. Newborns failing two consecutive tests were referred for further audiological evaluation and classified as having an adverse outcome. One-way ANOVA and post-hoc Bonferroni tests were used for statistical comparisons, with a significance level set at p < 0.05. To control for potential confounding variables, an analysis of covariance (ANCOVA) was conducted.

RESULTS: Among the 490 newborns analyzed, the hearing screening failure rate was significantly higher in the GDMA2 group (26.5 %) compared to GDMA1 (10.0 %) and the control group (4.3 %) (p < 0.001). Additionally, GDMA2 pregnancies were associated with earlier delivery and higher birth weights compared to healthy pregnancies (p = 0.001). The study demonstrated a strong association between GDM severity and newborn hearing screening failure rates.

CONCLUSION: The findings indicate that newborns of GDM-affected pregnancies, particularly those requiring insulin treatment, have a higher risk of failing hearing screening tests. Given the potential long-term consequences of undetected hearing loss, early identification and intervention are crucial. Public health policies should incorporate enhanced prenatal monitoring and neonatal audiological screening programs for at-risk populations. Further research is needed to explore the underlying mechanisms linking GDM severity to auditory dysfunction.

PMID:41218228 | DOI:10.1016/j.ijporl.2025.112641

JMIR Res Protoc. 2025 Nov 11;14:e75628. doi: 10.2196/75628.

ABSTRACT

BACKGROUND: Substance use is a high-impact biopsychosocial problem in Chile, where 21% of adults have experienced a severe alcohol use episode. In the past year, the prevalence rates were 12.5% for marijuana, 0.8% for cocaine, and 0.4% for cocaine base paste. Cannabis prevalence in Chile is higher than the global (4.2%) and South American (3.58%) averages. Cocaine prevalence in Chile is lower than in South America (1.62%) but higher than the global average (0.42%). No international reports are available for cocaine base paste. Mental health and substance use programs in Chilean primary care involve psychologists and social workers. Solution-focused brief interventions (SFBIs) are based on solution-focused brief therapy, a strengths-based and person-centered approach in which practitioners adopt a stance of “not being the expert,” respecting clients’ needs and perspectives.

OBJECTIVE: This study aims to determine whether the SFBI implemented by psychosocial teams (psychologists and social workers) for individuals with alcohol and other drug use in primary health care centers leads to better outcomes than usual care.

METHODS: We will conduct a randomized controlled clinical trial (ClinicalTrials.gov registration pending) comparing a 3-session SFBI (experimental group) with a single session of brief counselling as usual care (control group) in primary care. Interventions will be delivered in person by a psychologist or social worker. A total of 320 participants are expected to be recruited during preventive routine checkups using the Alcohol, Smoking, and Substance Involvement Screening Test. Participants reporting intermediate- to high-risk substance use on this screening tool will be randomly assigned to each group. Research assistants will administer instruments at baseline and at 3-, 6-, and 9-month follow-ups and will be blinded to the assigned treatments. The primary outcome assessed will be substance use patterns, while secondary outcomes include background information, depressive symptoms, anxiety symptoms, and motivation for treatment. Statistical analyses, including t tests, ANOVA, and Fisher exact tests will be conducted depending on variable type and normality. A qualitative component to assess acceptability and pertinence will include focus groups with participants and practitioners, followed by a content analysis.

RESULTS: Funding for this study started in April 2024. As of the submission date of this protocol, 55 practitioners from 9 primary health care centers have been trained in SFBIs. Recruitment began in February 2025, with 73 participants enrolled and 23 who dropped out. Recruitment will continue until December 2026. No analyses have been conducted to date. Findings are expected to be published during the second half of 2028.

CONCLUSIONS: This study strengthens primary care by integrating targeted psychosocial interventions for substance use into existing programs, thereby enhancing real-world applicability. If effective, the intervention could be adopted into routine care and inform public policy on mental health and substance use.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/75628.

PMID:41218202 | DOI:10.2196/75628

JMIR Form Res. 2025 Nov 11;9:e81484. doi: 10.2196/81484.

ABSTRACT

BACKGROUND: Large language models such as ChatGPT offer significant opportunities for medical education. However, empirical data on actual usage patterns, perceived benefits, and limitations among medical students remain limited.

OBJECTIVE: This study aimed to assess how medical students in Germany use ChatGPT, their perceptions of its educational value, and the challenges and concerns associated with its use.

METHODS: A cross-sectional 17-item online survey was conducted between May and August 2024 among medical students from Philipps University Marburg, Germany. A mixed methods approach was applied, combining descriptive and inferential statistical analysis with qualitative content analysis of open-ended responses.

RESULTS: A total of 84 fully completed surveys were included in the analysis (response rate: 26.7%; 315 surveys started). Overall, 76.2% (64/84) of the participants reported having used ChatGPT for medical education, with significantly higher usage during exam periods (P=.003). Preclinical students reported higher overall usage than clinical students (P=.02). ChatGPT was primarily used for summarizing information by 60.7% (51/84) of students, for literature research by 57.7% (49/84), and for clarifying concepts by 47.1% (40/84). A total of 70.2% (59/84) felt that it helped them save time, and 51.2% (43/84) reported an improved understanding of content. In contrast, only 31% (26/84) saw benefits for applying knowledge and 15.5% (13/84) for long-term knowledge retention. Qualitative responses highlighted clear benefits such as time savings and support in exam preparation, while also pointing to potential applications in clinical documentation and expressing concerns about misinformation and source transparency. However, 73.3% (55/75) expressed concerns about misinformation, and 72.6% (61/84) reported lacking confidence in their artificial intelligence (AI)-related skills. Only 41.7% (35/84) stated that they trust ChatGPT’s outputs. Students who used the tool more frequently also reported higher levels of trust in ChatGPT’s outputs (r=0.374, P<.001). Over 70% of respondents indicated a strong desire for increased integration of AI-related education and practical applications within the medical curriculum.

CONCLUSIONS: ChatGPT was already widely used among medical students, especially in exam preparation and the early stages of training. Students valued its efficiency and support for understanding complex material, but its long-term influence on learning is limited. Concerns about reliability, source transparency, and data privacy remain, and AI skills played a key role in shaping usage. These findings underscore the need to integrate structured, practice-oriented AI education into medical training to support critical, informed, and ethical use of large language models.

PMID:41218187 | DOI:10.2196/81484

JMIR Res Protoc. 2025 Nov 11;14:e76501. doi: 10.2196/76501.

ABSTRACT

BACKGROUND: Primary insomnia (PI), commonly identified by difficulties in initiating and maintaining sleep, negatively impacts both physical and mental health and increases the risk of occupational and vehicular accidents. Previous research has indicated that shallow needling, a form of acupuncture, may ameliorate the symptoms of PI. Nevertheless, the scientific evidence regarding its efficacy in enhancing sleep quality remains limited.

OBJECTIVE: This trial aims to assess the therapeutic efficacy of shallow needling in the treatment of chronic PI in adults.

METHODS: A single-center, prospective, assessor-blinded randomized controlled clinical trial retrospectively registered with the International Traditional Medicine Clinical Trial Registry (ITMCTR2024000409). With 2 parallel arms, the trial will be conducted at the Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine. A total of 124 participants with PI will be randomly divided into the control group and the treatment group in a ratio of 1:1 (n=62 for each group). The control group will receive 1 mg eszopiclone orally, once a day for 4 weeks. In addition to taking eszopiclone, the treatment group will receive shallow needling therapy once daily, 5 times a week, for 4 weeks. Data will be collected at 3 time slots-before treatment, after treatment, and 4 weeks after treatment-and will be analyzed using SPSS (version 23.0). The primary outcome measure is the Pittsburgh Sleep Quality Index. The secondary outcome measures include the Hamilton Anxiety Scale, Insomnia Severity Index, serum neurotransmitter detection (including dopamine, norepinephrine, and melatonin), sleep parameters, and magnetic resonance spectroscopy of the thalamus.

RESULTS: Participant recruitment for this study is currently in progress. The first participant was enrolled in August 2023, marking the official commencement of the trial. Following the completion of recruitment, data processing and statistical analysis will be initiated. The final results of this study are expected to be prepared and submitted for publication in January 2026.

CONCLUSIONS: This study will evaluate the therapeutic effectiveness and safety of shallow needling in the treatment of chronic insomnia to provide the necessary scientific basis for the clinical application and promotion of shallow needling. The findings of this study may provide a scientific and standardized treatment protocol for shallow needling in adults with chronic insomnia.

PMID:41218184 | DOI:10.2196/76501

Retina. 2025 Nov 6. doi: 10.1097/IAE.0000000000004725. Online ahead of print.

ABSTRACT

PURPOSE: To introduce a vitrectomy technique for the submacular hemorrhage (SMH) combined with subretinal tenecteplase (TNK-tPA) injection, intravitreal conbercept administration, perfluoropropane (C3F8) gas tamponade, and to evaluate its efficacy and safety.

METHODS: In this single-center, prospective, interventional study, patients underwent 25-gauge vitrectomy with subretinal TNK-tPA and intravitreal conbercept injection, followed by 0.5-1.0 mL of pure C3F8 gas tamponade. The best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were assessed at baseline, and 1, 3, and 6 months post-operatively. Favorable outcome was defined as a BCVA ≤0.5 logarithm of the minimum angle of resolution (log MAR) at 6 months.

RESULTS: Twenty eyes of 20 patients with treatment-naïve spontaneous SMH (≤30 days) secondary to polypoidal choroidal vasculopathy (70%) or retinal arterial macroaneurysms (30%) were included. Mean CRT significantly decreased from 887.1±52.2μm to 276.7±83.8μm (P < 0.001) at 6 months. Notably, 75% of the treated eyes (13 out of 20) achieved a favorable outcome (BCVA ≤0.5 log MAR; Snellen equivalent ≈20/63). Pearson’s correlation analysis revealed that the SMH onset-vitrectomy interval (SOVI) was significantly negatively correlated with a favorable outcome (r = -0.452, P = 0.045). After adjusting for potential interaction effect, the SOVI remained a statistically significant predictor of worse log MAR BCVA (odds ratio [OR] = 1.023, 95% confidence interval [CI] 1.013-1.034, P < 0.001).

CONCLUSIONS: The present technique for treatment-naïve spontaneous SMH, in combination with subretinal TNK-tPA injection, intravitreal conbercept administration, and C3F8 gas tamponade, demonstrated potential for visual improvement in eyes treated within 30 days of SMH onset.

PMID:41218174 | DOI:10.1097/IAE.0000000000004725