Tag: statistics

Adv Rheumatol. 2025 Jul 7;65(1):31. doi: 10.1186/s42358-025-00464-5.

ABSTRACT

OBJECTIVE: To determine the prevalence of metabolic syndrome (MetS) in patients with childhood onset Systemic Lupus Erithematosus (cSLE) and controls from Northeastern Brazil and to verify its association with specific SLE parameters and cardiovascular risk factors.

METHODS: The prevalence of MetS was assessed cross-sectionally in 58 patients with cSLE and 33 age -matched controls. Information was collected by clinical examination and standardized questionnaires, investigating personal and family history of cardiovascular disease and obesity and socioeconomic and demographic characteristics.

RESULTS: The prevalence of MetS was higher in cSLE patients than in controls according to both ABRAN criteria (8.6% vs. 0%; p = 0.083) and IDF criteria (10,3% vs. 3.0%; p = 0.208), but without statistical significance. Importantly, 91.4% of patients were from a low-income household. Patients with MetS according to ABRAN also had lower ESR levels (p = 0.039), higher total cholesterol (p = 0.013), HDL-c (p = 0.007) and triglycerides (p = 0.001) and a lower albumin level (p = 0.016). Patients with MetS according to IDF had higher SDI scores (p = 0.039) and higher C3 and C4 levels (p < 0.001 and p < 0.001, respectively). The multivariate logistic regression identified higher levels C4 (OR = 32.6; 95% CI = 1.0-544.0; p = 0.015) and increase in the number of leukocytes (OR = 1.9, 95%CI = 1.1-3.2; p = 0.022) as independent risk factors for MetS in patients with cSLE.

CONCLUSION: The prevalence of Mets in the patients with cSLE seems to be low in this population. There was association of MetS with higher cumulative damage indices and levels of complement. We did not observe any association with clinical manifestations, autoantibody profile and dose of corticosteroids.

PMID:40624660 | DOI:10.1186/s42358-025-00464-5

BMC Med Educ. 2025 Jul 7;25(1):1020. doi: 10.1186/s12909-025-07622-9.

ABSTRACT

BACKGROUND: Manual dexterity is a critical component of dental education, especially during the early stages of preclinical training. Recent advancements in simulation technology, such as virtual reality (VR) haptic simulators and layered tooth models such as Caviprep (hereafter referred to as the layered model), offer promising tools to enhance psychomotor skills. This study aimed to explore their combined and individual effects on manual skills development in novice dental students. We hypothesized that combined training with VR and layered models would result in greater improvements in manual skills than either modality alone or conventional methods.

METHODS: Forty-eight second-semester dental students were randomly assigned to four groups: Group 1 (the layered model + VR), Group 2 (the layered model only), Group 3 (VR only), and Group 4 (Control; extracted teeth only). All students received identical theoretical instruction and standardized demonstrations for occlusal amalgam cavity preparation. Manual dexterity was assessed using a standardized evaluation form completed by three blinded evaluators. Statistical analyses were conducted using SPSS 23.0, with significance set at p < 0.05.

RESULTS: A significant difference was observed among groups in terms of cavity depth accuracy (p = 0.001), with the control group (Group 4) performing significantly worse. There were no statistically significant differences in other evaluated parameters including cavity outline, floor smoothness, internal line angles, marginal ridge integrity, retention form, or cavity width (p > 0.05).

CONCLUSIONS: The integration of VR simulators and layered models enhances depth control during cavity preparation exercises in early dental training. These tools may provide valuable benefits in developing the manual skills essential for clinical competence.

TRIAL REGISTRATION: Not applicable.

PMID:40624647 | DOI:10.1186/s12909-025-07622-9

BMC Nurs. 2025 Jul 7;24(1):874. doi: 10.1186/s12912-025-03488-w.

ABSTRACT

BACKGROUND: Education has continuously evolved to keep pace with advancements in information technology. Virtual reality (VR) has emerged as an innovative and effective learning approach that enhances student engagement, particularly in developing problem-solving and critical thinking skills. Since its introduction in the early 1980s, VR has gained increasing attention in nursing education due to its potential to improve learning outcomes and skill acquisition. However, there is a need for further research to explore its impact on critical thinking disposition among nursing students.

METHODS: This quasi-experimental pretest-posttest study was conducted with a convenience sample of 190 nursing students from Damietta University’s Faculty of Nursing. Participants were assessed on their critical thinking disposition and VR-related knowledge at three time points: before the intervention, immediately after, and two months post-intervention.

AIM: The VR-based educational program aimed to improve students’ critical thinking disposition and assess their knowledge of virtual reality before, during, and after the program.

RESULTS: A statistically significant improvement in students’ mean scores for critical thinking disposition was observed across all evaluations (p < 0.001). The effect size (η²p ≥ 0.14) indicated a substantial impact, reinforcing the effectiveness of the VR-based educational program in fostering higher-order cognitive skills. Additionally, students demonstrated increased retention of VR-related knowledge when assessed immediately after the program and again after two months.

CONCLUSIONS: This study highlights the transformative potential of VR as an educational tool in nursing. VR-based learning promotes active engagement, knowledge retention, and skill development in a safe and controlled environment. By integrating VR programs into nursing education, institutions can enhance students’ critical thinking, collaboration, and communication skills, ultimately preparing them for real-world clinical practice. Given these findings, educational institutions should consider incorporating VR technology to support the continuous development of essential nursing competencies.

TRIAL REGISTRATION: This study is formally registered on ClinicalTrials.gov (Identifier Code: NCT06622811; Registration Date: 01/10/2024).

PMID:40624646 | DOI:10.1186/s12912-025-03488-w

BMC Nurs. 2025 Jul 7;24(1):860. doi: 10.1186/s12912-025-03506-x.

ABSTRACT

BACKGROUND: Peritoneal dialysis (PD) is a widely used form of home dialysis. However, the efficacy of telehealth care in long-term management for PD patients remains unclear.

OBJECTIVE: The objective of this study is to assess the effectiveness of a smart management system in improving adherence, quality of life, and clinical outcomes in PD patients.

METHODS: The study was a retrospective cohort analysis on PD patients who underwent new catheter placement between January 2022 and June 2023. The smart PD management system, an artificial intelligence (AI)-driven, nurse-led, patient-centered management system, was used to remotely monitor patients’ health at home and assist healthcare team in patient management, serving as a complement to conventional clinic visits. Patient data, including dialysis diary, symptoms, laboratory test results, and medication records, were collected through a smartphone app and uploaded to a cloud server. An AI system conducted real-time data analysis and promptly notified the healthcare team upon detecting any abnormalities. Online health coaches and nurses provided personalized guidance and interventions to patients, addressing issues in real-time. The primary endpoints of the study were changes and achievement rates in blood pressure and laboratory test results associated with complications. Secondary endpoints included changes in adherence and quality of life at recruitment and end of follow-up.

RESULTS: A total of 127 patients participated in the smart management system from January 2022 to June 2023 were included in the analysis. Most of them (94.5%) were receiving continuous ambulatory PD (CAPD). Over an average follow-up period of 11.0 (IQR 5.0-16.0) months, the average systolic blood pressure of the patients decreased from a baseline of 132.1 (SD 13.2) mmHg to 122.6 (SD 14.1) mmHg (P < 0.001). The overall blood pressure achievement rate (< 140/90 mmHg) increased from 61.4% at baseline to 79.5% (P = 0.001) at the end of the follow-up period. Regarding anemia, the average hemoglobin and the achievement rate increased from 98.8 (SD 19.8) g/L at baseline to 114.4 (SD 18.4) g/L (P < 0.001), and from 50.0 to 78.4% (P < 0.001), respectively. Improvements of varying degrees were observed in mineral and bone disorder, electrolyte balance, and nutritional status, even though they did not reach statistical significance. The patients’ adherence to uploading dialysis diaries significantly increased from 78 to 95.7% (P < 0.001) during the last week of follow-up period compared to the first week after enrollment. Furthermore, there were observed improvements in the quality of life, including diet, sleep, and daily activities.

CONCLUSIONS: The utilization of the smart PD management system was associated with enhanced patient adherence, improved quality of life, and superior clinical outcomes in PD patients.

PMID:40624644 | DOI:10.1186/s12912-025-03506-x

BMC Public Health. 2025 Jul 7;25(1):2401. doi: 10.1186/s12889-025-23608-0.

ABSTRACT

BACKGROUND: The prevalence of eating disorders among youth has increased in recent decades, with significant health consequences. Depression, loneliness and social anxiety are associated with eating disorders. However, the underlying mechanisms of these associations remain insufficiently explored. Considering the possibility that mental disorders increase the risk of smartphone addiction and that smartphone addiction is associated with eating disorder in adolescents, this study aims to investigate whether smartphone addiction mediates the association between mental disorders and eating disorders.

METHODS: Between October and November 2023, we conducted an online survey among youth across 31 provincial-level administrative divisions (PLADs) in China. To align our sample composition with official statistics for each PLAD in terms of gender and school type, we applied sample weights to each respondent. Structural equation modeling (SEM) was used to examine the mediating effects. To assess the consistency of these results, we also performed analyses for each gender and age group.

RESULTS: Among 10,000 weighted participants, 51.7% are male, with a median age of 16 years (IQR: 14-19). About 40% of youth experienced eating disorders. Smartphone addiction partially mediated the association between depression, loneliness, social anxiety, and eating disorders, contributing 24.69% (95% confidence interval: 20.60%-28.79%), 32.33% (95% CI: 27.53%-37.12%), and 37.35% (95% CI: 31.79%-42.91%) of the total effects, respectively. No heterogeneity was observed when analyses were stratified by gender and age group.

CONCLUSION: Smartphone addiction must be taken into account when designing strategies to prevent eating disorders in adolescents, which requires the cooperation of schools, parents and the government.

PMID:40624640 | DOI:10.1186/s12889-025-23608-0

BMC Med Educ. 2025 Jul 7;25(1):1019. doi: 10.1186/s12909-025-07610-z.

ABSTRACT

BACKGROUND: Medical simulation is a global trend that improves disease interpretation, diagnostic skills, and clinical abilities, transforming them into skills for the practitioner. Simulator classes should be part of continuing medical education, generating advances that make it necessary for technical development and specialization in complex, complicated, or difficult-to-reproduce scenarios that students may face, based on clinical problems with negative feedback, allowing for learning from mistakes. The objective of the review is to identify the usefulness of simulation in teaching the new medicine.

METHODS: Using the PRISMA 2020 declaration, articles published in the last 5 years on simulation teaching in neurology were reviewed. These articles were sourced from databases such as PubMed, Mendeley, Wiley, Web of Science, Cochrane, Latindex, and Google Scholar. In the summary of results, only those studies that met the inclusion criteria were selected for analysis.

RESULTS: Twenty-six randomized clinical trials on medical education and training were selected. The analysis showed that simulation improved skill scores to support simulation-based medical diagnosis and treatment.

CONCLUSION: Simulation-based education has demonstrated statistical benefits in learning, skill acquisition, feedback, and stress reduction, particularly in the specialties of ophthalmology, emergency medicine, neurology, neurosurgery, neuroanatomy, and neuropathology, providing great relevance to the present review. No study reported beneficial effects or effects on mortality: despite improved surgical skill times among participants, no statistically significant data were found on a reduction in operative complications. Simulation technologies such as artificial intelligence, mixed reality, and robotics are under development, the impact of which on improving the quality of care is still unknown.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40624635 | DOI:10.1186/s12909-025-07610-z

BMC Nurs. 2025 Jul 7;24(1):865. doi: 10.1186/s12912-025-03505-y.

ABSTRACT

BACKGROUND: Due to high intensity, workloads and shift work, nurses have become a high prevalence group of pain. If not promptly intervened, pain may become chronic pain through the mechanisms of peripheral sensitization and central sensitization, which in turn induces psychological symptoms such as anxiety and depression, forming a vicious circle of “pain-mental health comorbidity”. In addition, long-term pain may accelerate the transition from acute pain to chronic pain, which will cause more serious damage to nurses’ health. However, few studies have deeply explored the association between chronic pain and multidimensional mental health outcomes (anxiety, depression, fatigue, burnout, loneliness, and well-being) among nurse populations.

METHODS: This study surveyed 147,832 nurses from 67 tertiary hospitals in China between December 2023 and January 2024, using cluster sampling and online questionnaires. Statistical analyses included descriptive analyses, correlation analysis, multivariable logistic regression, and binary logistic regression. This study followed the STROBE guidelines.

RESULTS: Significant and robust associations were found between chronic pain and mental health among nurses’ occupational group. The correlation coefficients between chronic pain and six mental health symptoms ranged from 0.106 to 0.179, with the three largest correlation coefficients for depression (r = 0.179, P < 0.001), anxiety (r = 0.168, P < 0.001) and fatigue (r = 0.159, P < 0.001). Of all pain sites, head pain had the greatest correlation with depression (r = 0.167, P < 0.001) and low back pain had the greatest correlation with fatigue (r = 0.144, P < 0.001). Moreover, subgroup analyses by sex showed that among nurses with chronic pain, males are more likely to be fatigued. For multisite pain, the strength of the association with mental health increased significantly as the number of pain sites increased.

CONCLUSION: In this study, both chronic pain and number of pain sites were significantly associated with nurses’ mental health and showed site variability. After progressively controlling for variables such as sociodemographic, lifestyle, and work-related factors, this association remained robust and showed consistency across sex and age groups.

CLINICAL TRIAL REGISTRATION NUMBER: Not applicable. This study was not a clinical trial.

PMID:40624631 | DOI:10.1186/s12912-025-03505-y

BMC Gastroenterol. 2025 Jul 7;25(1):505. doi: 10.1186/s12876-025-04081-w.

ABSTRACT

OBJECTIVE: This meta-analysis aims to evaluate the efficacy and safety of ultrasound-guided percutaneous microwave ablation (MWA) for hepatocellular carcinoma (HCC) located at specific anatomical sites of the liver compared with non-specific sites.

METHODS: A systematic search was conducted across five databases, covering literature from database inception to September 30, 2024. Eligible studies included prospective and retrospective cohorts involving ultrasound-guided percutaneous MWA for HCC. Data extraction and analysis were performed using Stata 15.1. The primary outcomes were 1-year, 3-year, and 5-year overall survival (OS) rates, complete ablation rates, and incidence of major complications. Pooled results were expressed as odds ratios (ORs) with 95% confidence intervals (CIs).

RESULTS: Nine studies involving 2,381 patients were included. Among them, 1,047 patients had HCC located at specific anatomical sites, and 1,334 at non-specific sites. The pooled ORs (95% CI) for OS at 1, 3, and 5 years were 0.89 (0.59-1.35), 0.83 (0.66-1.05), and 1.12 (0.91-1.38), respectively. The OR for complete ablation was 0.97 (0.61-1.53), and for major complications, 1.44 (0.59-3.51).

CONCLUSION: Ultrasound-guided percutaneous MWA demonstrates comparable efficacy and safety for treating HCC at specific anatomical sites of the liver relative to non-specific sites, with no statistically significant differences in survival outcomes, ablation success, or complication rates.

PMID:40624629 | DOI:10.1186/s12876-025-04081-w

BMC Ophthalmol. 2025 Jul 7;25(1):393. doi: 10.1186/s12886-025-04227-0.

ABSTRACT

BACKGROUND: To analyze the poor mental status of patients with primary closed-angle glaucoma(PACG), and to explore the correlation between mental status and ocular and systemic indices in patients with PACG.

METHODS: We collected patients’ axial length (AL), anterior chamber depth (ACD), nerve fiber layer thickness (RNFL), cup-to-disc ratio (C/D), antinuclear antibody (ANA), toxoplasmosis antibody (anti-Toxoplasma gondii IgM), and anxiety and depression scores (HAMA and HAMD scales). Statistical analysis was utilized to analyze the data for each of the patients in the PACG and cataract patient groups.

RESULTS: The results showed that there was a statistically significant difference between the glaucoma group and the cataract group in terms of anxiety and depression scores, AL, ACD, RNFL, C/D, ANA, and Anti-Toxo IgM (P < 0.05). Anxiety scores of glaucoma patients were positively correlated with AL and C/D (P < 0.05), negatively correlated with RNFL (P < 0.05), and correlation existed with ANA and Anti-Toxo IgM (Eta² > 0.16). Depression scores in glaucoma patients were positively correlated with C/D (P < 0.05), negatively correlated with AL and RNFL (P < 0.05), and correlated with ANA and Anti-Toxo IgM (Eta² > 0.16). In addition,RNFL and C/D can be considered significant predictors of anxiety status. AL and C/D can be considered significant predictors of depression status.

CONCLUSION: Patients with primary angle-closure glaucoma have higher anxiety and depression scores than the general population, and clinically we can predict the patient’s mental status by their ocular and systemic indicators so that appropriate treatment can be taken in time.

PMID:40624620 | DOI:10.1186/s12886-025-04227-0

BMC Cancer. 2025 Jul 8;25(1):1153. doi: 10.1186/s12885-025-14570-6.

ABSTRACT

BACKGROUND: Neoadjuvant chemotherapy (NAC) is gaining attention as a treatment for advanced colorectal cancer owing to its potential to improve surgical outcomes and prognosis. However, reliable biomarkers to predict the response to NAC are lacking. We aimed to investigate the predictive value of cell-free DNA (cfDNA) integrity index for NAC response, using machine learning to compensate for the small cohort size.

METHODS: This retrospective study included 31 locally advanced colorectal cancer patients who underwent NAC and surgery at the Nippon Medical School Hospital between 2016 and 2020. Blood samples were collected pre-post-NAC to assess cfDNA levels using quantitative polymerase chain reaction. The cfDNA integrity index was calculated based on the ratio of long to short fragments in the long-interspersed element-1 repeat sequence. Statistical analyses, including random forest modeling, were performed to evaluate the predictive value of the cfDNA integrity index for treatment response.

RESULTS: Of the 31 patients, 19 (61.3%) were classified as responders and 12 (38.7%) as non-responders. The post-NAC cfDNA integrity index was significantly different between the groups (P = 0.002, odds ratio = 16.0). Random forest analysis identified changes in the cfDNA integrity index as the most important predictor of NAC response (%IncMSE: 15.79; IncNodePurity: 2.21), while sex, age, tumor site, and pre-NAC cfDNA levels were not significant predictors.

CONCLUSIONS: Variability in the cfDNA integrity index shows promise as a biomarker for predicting NAC efficacy in colorectal cancer.

PMID:40624619 | DOI:10.1186/s12885-025-14570-6