Tag: statistics

J Health Popul Nutr. 2025 Jul 24;44(1):267. doi: 10.1186/s41043-025-01021-y.

ABSTRACT

BACKGROUND: Drug-resistant tuberculosis (DR-TB) is a significant challenge to the national tuberculosis (TB) control program in Ethiopia. The Tigray region in northern Ethiopia has shown a surge in the incidence of DR-TB cases. However, the determinants of DR-TB in the region are not studied. This study is aimed at identifying the factors associated with the development of DR-TB in the Tigray region of northern Ethiopia.

METHODS: The study used an unmatched case-control design to identify determinants of DR-TB in the Tigray region, northern Ethiopia, whereby 86 patients and 86 controls who registered for TB treatment follow-up in selected hospitals were recruited. Trained nurses collected both primary and secondary data, which were analyzed using descriptive statistics and binary logistic regression. The test statistics was conducted with a 95% confidence level, and a p-value of less than 0.05 was considered significant.

RESULTS: The study included 86 patients with DR-TB (cases) and an equal number of patients with drug-susceptible (controls). The case and control groups had 38 (44.2%) and 47 (54.7%) males, respectively. The study revealed the study participants with male gender (adjusted odds ratio [AOR] = 4.9, 95% confidence interval [CI: 1.2-19.9), single marital status (AOR = 13.6, 95% CI: 2.3-81.2), history of TB treatment (AOR = 58.2, 95% CI: 11.2-302.1), experienced a delay of more than 60 days before TB diagnosis (AOR = 4.8, 95% CI: 1.2-19.3), interrupted treatment at least once (AOR = 4.9, 95% CI: 1.02-23.9), and unsuccessful treatment outcome at first treatment (AOR = 7.6, 95% CI: 1.8-35.9) had a higher risk of DR-TB.

CONCLUSIONS: The study highlights determinants of DR-TB in the region, including gender, marital status, delayed diagnosis (over 60 days), previous treatment history, interrupted treatment, and unsuccessful treatment outcomes during initial treatment. It is recommended that healthcare providers focus on targeted interventions, such as supporting males and unmarried individuals, ensuring early diagnosis and prompt initiation of treatment, improving treatment adherence, and providing tailored support for patients with histories of incomplete treatment and unsuccessful initial treatment outcomes.

PMID:40708047 | DOI:10.1186/s41043-025-01021-y

Infect Dis Poverty. 2025 Jul 25;14(1):75. doi: 10.1186/s40249-025-01344-2.

ABSTRACT

BACKGROUND: Despite price advantages, local direct-acting antiviral agents (DAAs) for hepatitis C (hep C) have not been widely used in China compared with the imported ones. There is no evidence on their relative efficacy and safety, nor whether the small market share of local DAAs was attributable to the potential differences.

METHODS: This study systematically evaluated the efficacy and safety evidence of 5 local and 6 imported DAAs with valid Chinese registration numbers as of January 25, 2024. Meta-analyses, subgroup analyses and meta-regressions were performed to synthesize evidence and compared the outcomes by using the random-effects empirical Bayes model.

RESULTS: Nineteen randomized controlled trials and 82 single-arm trials (SATs) were included. The results demonstrated no statistically significant difference in 12-week sustained virological response [0.97, (95% confidence interval (CI) 0.95, 0.99) vs 0.96, (95% CI: 0.94, 0.98), P = 0.21], relapse [0.02, (95% CI: 0.01, 0.04) vs 0.02, (95% CI: 0.01, 0.03), P = 0.65], virological breakthrough [0.003, (95% CI: < 0.001, 0.02) vs 0.0000002, (95% CI: < 0.001, 0.0006), P = 0.51] and serious adverse events (SAEs) [0.04, (95% CI: 0.03, 0.06) vs 0.03, (95% CI: 0.02, 0.03), P = 0.12] between local and imported DAAs. By controlling for ethnicities of patients in multiple meta-regression, the local DAAs had a 33.7% higher rate of adverse events (AEs) [0.337, (95% CI: 0.188, 0.486), P < 0.001]. No statistically significant difference was found in the interaction test between local and imported pan-genotypic DAAs regarding the rate of AEs [0.72, (95% CI: 0.64, 0.79) vs 0.73, (95% CI: 0.65, 0.50), P = 0.81].

CONCLUSIONS: Current evidence demonstrates no statistically significant differences in efficacy and SAEs between local and imported DAAs. Given that simplified pan-genotypic DAA regimens are now standard care, local pan-genotypic DAAs hold potential to increase hepatitis C virus treatment rates in China. It is critical for local DAA developers to generate more evidence with expanded patient population in terms of age, treatment experience and genotype of hepatitis C virus, conducting head-to-head studies directly comparing the efficacy and safety. Clinical and policy decision-making should be adaptive and evolve as new evidence is generated.

PMID:40708038 | DOI:10.1186/s40249-025-01344-2

BMC Musculoskelet Disord. 2025 Jul 24;26(1):699. doi: 10.1186/s12891-025-08947-8.

ABSTRACT

PURPOSE: The management of displaced anterior glenoid rim fractures remains a topic of debate, particularly in elderly patients where surgical risks are heightened. While surgical intervention is often recommended to prevent instability and degenerative arthritis, some studies suggest that nonoperative treatment may yield satisfactory results. This study aims to evaluate whether nonoperative treatment of displaced anterior glenoid rim fractures leads to anterior shoulder instability in elderly patients.

METHODS: A retrospective review was conducted on patients over 60 years of age diagnosed with Ideberg type Ia anterior glenoid rim fractures (> 5 mm fragment) who underwent nonoperative treatment. Patients with associated injuries, neurological disorders, or dislocated fractures requiring reduction were excluded. Treatment involved sling immobilization for up to 4 weeks, followed by a structured rehabilitation program. Clinical outcomes were assessed using Constant Score (CS), American Shoulder and Elbow Surgeons (ASES) score, Subjective Shoulder Value (SSV), and range of motion. Radiographic evaluation included fracture healing, displacement, and osteoarthritis progression. Statistical analyses were performed using the Wilcoxon signed-rank test and Fisher exact test.

RESULTS: A total of 21 patients (mean age: 69 years, mean follow-up: 82 months) were included. No cases of subsequent instability (dislocation or subluxation) were observed. At final follow-up, 71% of fractures showed complete healing, while 28% exhibited partial healing with a ≤ 5 mm step. Functional outcomes were favorable, with mean CS of 86, ASES of 87, and SSV of 89%. External rotation in abduction was slightly limited compared to the contralateral side (p = 0.0026). Radiographic signs of new-onset osteoarthritis were present in 4 patients, but none reported instability-related symptoms.

CONCLUSION: Nonoperative treatment of displaced anterior glenoid rim fractures without dislocation in elderly patients provides satisfactory functional and radiographic outcomes, with no evidence of subsequent instability. This approach effectively avoids surgical risks and complications while preserving shoulder function, supporting its role as a viable treatment strategy in this population.

PMID:40708020 | DOI:10.1186/s12891-025-08947-8

BMC Res Notes. 2025 Jul 24;18(1):322. doi: 10.1186/s13104-025-07371-4.

ABSTRACT

The ongoing COVID-19 pandemic has seen the emergence of numerous SARS-CoV-2 variants, each posing distinct public health challenges. The XEC variant, a recombinant Omicron subvariant, has rapidly gained prevalence globally, raising critical questions about its potential implications on health systems and public policy. This paper examines the emergence, spread, and unique characteristics of XEC, especially in the context of the global decline of KP.3.1.1, another significant Omicron lineage. We discussed the public health implications, including vaccine effectiveness, genomic surveillance, and healthcare system preparedness, underscoring the need for adaptive strategies in response to evolving SARS-CoV-2 variants.

PMID:40708011 | DOI:10.1186/s13104-025-07371-4

J Health Popul Nutr. 2025 Jul 24;44(1):266. doi: 10.1186/s41043-025-01018-7.

ABSTRACT

BACKGROUND: Obesity is a significant manifestation of Circadian Syndrome (CircS), and the Body Roundness Index (BRI) is one of the anthropometric indicators associated with obesity. However, it remains unclear whether BRI is linked to the risk of CircS.

METHODS: In this population-based cross-sectional study, data from adults aged ≥ 20 years from the 2009-2018 National Health and Nutrition Examination Survey (NHANES) database were analyzed. Logistic regression analysis was employed to investigate the relationship between BRI and CircS after adjusting for various covariates. To further explore the trend of association between different BRI levels and CircS, BRI was categorized into four classes to enhance the robustness of the results. Restricted cubic spline (RCS) analysis was utilized to illustrate the dose-response relationship between BRI and CircS. Additionally, subgroup analyses were performed to assess the consistency and stability of the study results.

RESULTS: This study included 8,024 participants aged 20 years and older, of whom 2,634 had CircS. In fully adjusted models, BRI was positively associated with the prevalence of CircS (OR = 2.821, 95% CI: 2.038-3.768). When BRI was transformed from a continuous to a categorical variable, higher levels of BRI were correlated with a higher prevalence of CircS compared to the lowest quartile of BRI. RCS analyses demonstrated a positive association between BRI and CircS prevalence, with threshold effect analyses identifying a threshold value of BRI at 5.91. To the left of this threshold, each one-unit increase in BRI elevated the prevalence of CircS by a factor of 2.681 (OR = 2.681, 95% CI: 2.524-2.851). Stratified factorial subgroup analyses indicated that the positive association between BRI and CircS persisted.

CONCLUSION: The findings of our cross-sectional study indicate a significant positive correlation between elevated BRI and increased prevalence of CircS.

PMID:40708006 | DOI:10.1186/s41043-025-01018-7

BMC Nurs. 2025 Jul 24;24(1):969. doi: 10.1186/s12912-025-03618-4.

ABSTRACT

BACKGROUND: The leadership behaviours and practices of nurse managers play a pivotal role in shaping staff performance, retention, and the overall quality of patient care, making them critical components of healthcare system efficiency and outcomes. These behaviours and practices are attributed to different management strategies and leadership styles, which have a strong influence on how leaders act and make decisions.

AIM: This study aims to assess the leadership behaviours and practices of nurse managers within Riyadh Second Health Cluster.

METHODOLOGY: A cross-sectional quantitative study was conducted using the Leadership Practices Inventory (LPI), a validated 30-item self-assessment tool. A total of 342 nurse managers working in Riyadh Second Health were recruited using convenience sampling. Data were analyzed using descriptive statistics, independent t-tests, and ANOVA to examine differences across their demographics.

RESULTS: Significant differences were found in leadership behavior scores across gender, nationality, age, education, and experience, with female, non-Saudi, mid-career, and bachelor’s-prepared nurse managers demonstrating higher self-reported leadership practices across all domains. Nurse managers exhibited very high leadership scores across all five domains of the leadership practices (average M = 4.57); Model the Way (M = 4.57), Inspire a Shared Vision (M = 4.56), Challenge the Process (M = 4.56), Enable Others to Act (M = 4.57), and Encourage the Heart (M = 4.57).

CONCLUSION: The results indicated a very high level of all leadership practices among the nurse managers in Riyadh Second Health Cluster. The study findings highlight a strong leadership abilities among the nurse managers, emphasizing the need for continued investment in leadership training and development programs to enhance staff performance, retention, and quality of care.

PMID:40707968 | DOI:10.1186/s12912-025-03618-4

Hum Resour Health. 2025 Jul 24;23(1):36. doi: 10.1186/s12960-025-01011-5.

ABSTRACT

BACKGROUND: The turnover rate of newly graduated nurses is very high, and their turnover intention is affected not only by individual-level factors, but also by organizational-level factors. However, the multilevel factors reflecting the characteristics of newly graduated nurses in Generation Z and their turnover intention have not been identified previously.

OBJECTIVE: To identify the individual- and organizational-level factors that affect the turnover intention of newly graduated nurses in Generation Z.

METHODS: This study was a cross-sectional questionnaire survey. Online survey was performed from August to November 2022. Participants were a total of 283 newly graduated nurses and 45 nurse managers to respond to each individual and organization-level questionnaire. The collected data were analyzed for frequency, descriptive statistics, and multilevel analysis.

RESULTS: The multilevel analysis indicated that the individual-level factors that affected the lower turnover intention of newly graduated nurses in Generation Z were higher work-life balance (β = – 0.320, p < 0.001), higher organizational commitment (β = – 0. 384, p < – 0.001), and desired nursing unit placement (β = – 0.209, p < 0.001). The organization-level factors associated with lower turnover intention were lower average number of night shifts per month (β = 0.303, p < 0.05), higher salary (β = – 0.263, p < 0.05), longer orientation period (β = – 0.612, p < .01), preceptor-preceptee ratio of 1:1 (β = – 0.409, p < 0.05), and existence of a mentoring program (β = – 0.318, p < 0.05). Furthermore, the nursing work environment was the most influential factor, and a supportive environment for nursing work (β = – 0.630, p < 0.01), efficient computer-related environment (β = – 0.251, p < 0.05), and recognition and respect (β = – 0.564, p < 0.05) were associated with lower turnover intention.

CONCLUSIONS: The findings indicate that improvements to the nursing work environment and human resources of the organization should be prioritized to prevent the turnover of newly graduated nurses in Generation Z.

PMID:40707967 | DOI:10.1186/s12960-025-01011-5

J Intensive Care. 2025 Jul 24;13(1):40. doi: 10.1186/s40560-025-00811-0.

ABSTRACT

BACKGROUND: Prolonged mechanical ventilation is associated with an increased incidence of complications and higher mortality rates. Therefore, it is crucial to wean patients from mechanical ventilation as soon as possible. Recently, diaphragmatic ultrasound has been used in this decision-making process. This systematic review evaluated the effectiveness of diaphragmatic ultrasound to improve ventilator liberation outcomes.

METHODS: We searched three databases – MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials. We included randomized control trials that compared the use of diaphragmatic ultrasound to standard care in adult patients on mechanical ventilation via tracheal intubation. We assessed risk of bias for included trials with the Cochrane Risk of Bias Tool and certainty of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation tool. For dichotomous outcomes, we reported risk ratios (RRs) with 95% confidence intervals (CIs). For continuous outcomes, we reported mean differences (MD) with 95% CIs if all retrieved records provide data on the same scale. The primary outcome was incidence of reintubation within 48 h of extubation and the secondary outcomes included duration of mechanical ventilation, incidence of reintubation rate after 48 h, ICU length of stay, and adverse events.

RESULTS: We found five relevant randomized controlled trials involving a total of 508 participants on mechanical ventilation in ICU following respiratory failure or surgery. Three studies (268 participants) provided data on the incidence of reintubation within 48 h of extubation. Using diaphragmatic ultrasound to guide extubation decisions led to a significant reduction in the risk of reintubation within 48 h (RR 0.62, 95% CI 0.41 to 0.95, low certainty of evidence). No significant differences were found in the duration of mechanical ventilation (MD – 1.39 h, 95% CI – 17.5 to 14.71 h, three studies, 268 participants, very low certainty of evidence) or reintubation after 48 h (RR 0.38, 95% CI 0.11-1.29, two studies, 240 participants, moderate certainty of evidence). However, ICU length of stay was significantly reduced in the diaphragmatic ultrasound group (MD – 1.0 days, 95% CI – 1.74 to – 0.26 days, one study, 130 participants, low certainty of evidence).

CONCLUSION: Using diaphragmatic ultrasound in addition to standard clinical criteria to guide decisions around ventilator use and liberation resulted in a reduced risk of reintubation within 48 h of extubation when compared to standard clinical criteria alone.

SYSTEMATIC REVIEW REGISTRATION: This systematic review was registered with the Open Science Framework: https://osf.io/cn8xf .

PMID:40707960 | DOI:10.1186/s40560-025-00811-0

BMC Nurs. 2025 Jul 24;24(1):967. doi: 10.1186/s12912-025-03626-4.

ABSTRACT

BACKGROUND: Enteral nutrition (EN) is essential for ICU patients, but EN-associated diarrhea (ENAD) affects 48.6-89.0% of them, increasing complications and healthcare costs. ICU nurses’ knowledge, attitudes, and behavior in ENAD management significantly influence patient outcomes.

OBJECTIVE: We evaluated ICU nurses’ knowledge, attitudes, and behavior in ENAD management and explored their interrelationships using a social cognitive and behavior change framework.

METHODS: From June 2022 to March 2023, 371 ICU nurses from 11 Chinese ICUs completed a validated questionnaire. We analyzed data using descriptive statistics, regression, and structural equation modeling.

RESULTS: Knowledge (mean = 63.57, SD = 15.04), attitudes (mean = 44.19, SD = 4.76), and behaviors (mean = 56.32, SD = 9.15) were moderate. Knowledge was positively correlated with attitudes (ρ = 0.42, p < 0.001) and behaviors (ρ = 0.58, p < 0.001), and attitudes strongly correlated with behaviors (ρ = 0.65, p < 0.001). Attitudes mediated the knowledge-behavior relationship (β = 0.14, 95% CI [0.08, 0.21], p < 0.001). Master’s Degree (β = 0.10, p = 0.049), training participation (β = 0.18, p = 0.002), and frequent training (4 times/year, β = 0.22, p < 0.001) predicted better knowledge, while training and age (31-35 years) enhanced attitudes (p < 0.05).

CONCLUSION: Knowledge gaps hinder ICU nurses’ ENAD management, with attitudes critically mediating the translation of knowledge into practice. Targeted interventions, such as quarterly workshops and scenario-based simulations, are recommended to enhance knowledge, foster positive attitudes, and standardize behaviors, thereby improving patient care quality.

PMID:40707945 | DOI:10.1186/s12912-025-03626-4

Genome Biol. 2025 Jul 24;26(1):220. doi: 10.1186/s13059-025-03680-w.

ABSTRACT

Advances in single-cell technology enable large-scale generation of omics data, promising for clarifying gene regulatory networks governing different cell type/states. Nonetheless, prevailing methods fail to account for universal and reusable regulatory modules in GRNs, which are fundamental underpinnings of cell type landscape. We introduce cRegulon to infer regulatory modules by modeling combinatorial regulation of transcription factors based on diverse GRNs from single-cell multi-omics data. Through benchmarking and applications using simulated datasets and real datasets, cRegulon outperforms existing approaches in identifying TF combinatorial modules as regulatory units and annotating cell types. cRegulon offers new insights and methodology into combinatorial regulation.

PMID:40707940 | DOI:10.1186/s13059-025-03680-w