Tag: statistics

BMC Pulm Med. 2025 Jul 24;25(1):352. doi: 10.1186/s12890-025-03813-8.

ABSTRACT

BACKGROUND: Interstitial lung disease (ILD) and pulmonary sarcoidosis (PS) constitute major global health challenges, characterized by progressive respiratory symptoms and diverse epidemiological trends. Although the incidence and mortality rates of ILD and PS have increased following the COVID-19 pandemic, comprehensive research examining their burden and associated risk factors remains limited. Therefore, the present study aimed to analyze the spatiotemporal distribution, gender-specific and age-related disparities, and sociodemographic determinants of ILD and PS from 1990 to 2021 to facilitate evidence-based targeted interventions.

METHODS: By using data from the Global Burden of Disease 2021 database, we analyzed age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized disability-adjusted life year rate (ASDR) across 204 countries/regions. Temporal trends were evaluated using average annual percentage change (AAPC), age-period-cohort (APC), and Bayesian APC (BAPC) models. Decomposition analysis and Pearson’s correlation analysis were conducted to assess the impact of aging, population growth, and sociodemographic index (SDI). Joinpoint regression was used to identify inflection points in trends. Future disease burdens (2021-2050) were projected through BAPC modeling.

RESULTS: Global ILD and PS cases increased from 157,441.17 in 1990 to 390,267.11 in 2021, with an annual increase in ASIR, ASMR, and ASDR by 0.61%, 1.32%, and 0.83%, respectively. High-SDI regions exhibited the highest ASIR (71.4/100,000) and ASMR (25.5/100,000). Males exhibited greater disease burdens than females ASDR 57.79/100,000 vs. 39.49/100,000 in 2021), with a peak incidence in the 70-74 age group. SDI showed positive correlations with ASIR and ASMR, exhibiting U-shaped relationships in certain regions. Projections indicated stable ASMR but increasing ASIR and ASDR by 2050, particularly among males.

CONCLUSIONS: The global burden of ILD and PS has increased markedly since 1990, influenced by population aging, industrial development, and socioeconomic disparities. Prioritizing early screening (e.g., high-resolution computed tomography and serum biomarkers), minimizing environmental and occupational exposures, and implementing gender-/age-specific interventions are critical measures. Strengthening healthcare infrastructure in low-SDI regions and integrating advanced diagnostic technologies are crucial for reducing future disease burdens.

PMID:40707937 | DOI:10.1186/s12890-025-03813-8

BMC Med Educ. 2025 Jul 24;25(1):1106. doi: 10.1186/s12909-025-07666-x.

ABSTRACT

BACKGROUND AND OBJECTIVE: Cultural competence intentionally enhances the quality improvement process in healthcare. Therefore, the goal of this study was to evaluate the knowledge, skills, and comfort level of cultural competence and determine the important factors contributing to health disparities among male nursing students.

METHODS: A cross-sectional, descriptive paper-based study was conducted among male nursing students at a Saudi University between March and May 2024. Data was collected using structured, pre-validated 47-item questionnaires and analyzed using the statistical package for social science version 27. For bivariate analysis, Chi-square or Fisher’s Exact test was employed. A p-value < 0.05 was considered statistically significant.

RESULTS: The response rate obtained was 86%. Approximately half of the students (50.8%; n = 131) believed they were somewhat knowledgeable about the demographics of diverse racial and ethnic groups, while only 5% (n = 13) were very knowledgeable. Lifestyle (14%) and environment (12%) were important factors contributing to health disparities. The mean score for knowledge and skills of cultural competence was 67.99 ± (SD = 16.21), while it was 31.29 ± (SD = 12.31), for cross-cultural encounters and 43.32 ± (SD = 13.72) for factors contributing to health disparities. In this study, 50.4% (n = 130) of students reported good levels of knowledge and skills of cultural competence, and 53.5% (n = 138) of students showed good attitudes towards factors contributing to health disparities. There was a significant association between students’ grade point average (GPA) and knowledge and skills in cultural competence, with those having higher GPAs demonstrating higher levels of knowledge and those with GPAs above 3.5 reporting higher levels of comfort than those with GPAs below 2 (p = 0.045). Conversely, a significant association was found between students’ age group and GPA and their attitudes regarding variables contributing to health disparities (p = 0.0001). In addition, findings reveal that there is a statistically significant linear relationship between knowledge and skills of cultural competence and comfort in dealing with cross-cultural encounters (r = 0.438, p = 0.01) and factors contributing to health disparities (r = 0.376, p = 0.01).

CONCLUSION: This study found that male nursing students demonstrated a relatively good level of cultural competence, showing comfort in interacting with diverse cultural backgrounds and awareness of social, economic, and cultural determinants of health inequities. To further enhance their preparedness for diverse patient populations, structured training programs, real-world exposure, and reflective learning are recommended.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40707933 | DOI:10.1186/s12909-025-07666-x

Confl Health. 2025 Jul 25;19(1):48. doi: 10.1186/s13031-025-00690-0.

ABSTRACT

BACKGROUND: Access to sexual and reproductive health services is an explicit element of the Sustainable Development Goals, and is critical for achieving family planning goals and broader well-being of young people. Youth (15-24 years) face many barriers to accessible, quality services, and refugees often experience additional barriers due to physical, economic, legal and/or social exclusion. This study explored these barriers in the context of Jordan, a country that has one of the highest proportions of refugees globally.

METHODS: This concurrent mixed-methods study utilizes the 2022-2023 Gender and Adolescence: Global Evidence survey data collected from 313 married female youth living in Jordan to describe utilization of contraceptives among Jordanians and Syrian refugees, exploring the role of residence (formal refugee camp, host community or informal tented settlement) and factors associated with contraceptive use among Syrian refugees. A multivariable linear probability model and qualitative data from in-depth individual interviews and focus group discussions were used to explore underlying factors driving differences in contraceptive utilization among Syrian refugee youth.

RESULTS: The survey found that 63.4% of Jordanian youth and 42.8% of Syrian refugee youth were recently using contraception, with notable differences in type of contraceptive method used by both refugee status and residence. Among Syrian refugee youth, living in a host community emerged as a key factor associated with contraceptive use, as it was associated with a 19.6 percentage point increase in the likelihood of using contraception compared to those living in refugee camps. Qualitative themes nuance these findings, suggesting that living in a refugee camp where there is more restricted access to healthcare services, more salient social norms, and limited knowledge about reproductive health present barriers to contraceptive use for Syrian refugee youth.

CONCLUSIONS: These results highlight that youth-friendly reproductive health services are having mixed efficacy in Jordan. Understanding barriers to contraception should inform family planning services for marginalized groups like Syrian refugee youth. There is a need for evidence-informed efforts to expand provision of family planning counselling and access to contraceptives for young married couples in Jordan, and especially for those living in formal refugee camps.

PMID:40707927 | DOI:10.1186/s13031-025-00690-0

Cardiovasc Diabetol. 2025 Jul 24;24(1):298. doi: 10.1186/s12933-025-02868-5.

ABSTRACT

BACKGROUND: The combined predictive value of type 2 diabetes mellitus (T2DM) and coronary microvascular dysfunction (CMD) in rotational atherectomy (RA) patients during the PCI remains unclear. The study examined whether the co-occurrence of DM and CMD, determined by angiography-derived index of microcirculatory resistance in RA patients influences clinical outcomes.

METHODS: This was a retrospective, multicenter, observational study involving 452 patients at 3 medical centers. The primary endpoint was the occurrence of major adverse cardiac events (MACEs) at 24 months after the procedure, encompassing cardiac death, myocardial infarction, target vessel revascularization, and readmission for unstable angina.

RESULTS: The post-PCI angio-IMR was lower in the non-DM group compared to the DM group (17.40 [13.86-21.34] vs. 18.53 [14.63-23.01], p = 0.037). Patients with DM had a higher risk of MACEs at 24 months than those without DM (17.42% vs. 9.49%, p = 0.011). CMD was defined as post-PCI angio-IMR ≧ 25.Patients with CMD demonstrated a statistically significant elevated risk of MACEs at the 24-month follow-up, when compared to individuals without CMD (26.77% vs. 10.54%, p < 0.001). In comparison to others, patients with both DM and CMD had the highest incidence of MACEs. Specifically, DM combined with CMD was the strongest independent predictor of MACEs (DM + CMD; HR: 5.61, 95% CI, 2.606-12.083, p < 0.001).

CONCLUSION: This study reveals that both T2DM and CMD are associated with the risk of MACEs in RA patients during the PCI. Combing T2DM and CMD can further improve the accessibility to predict the risk of MACEs.

PMID:40707926 | DOI:10.1186/s12933-025-02868-5

Confl Health. 2025 Jul 25;19(1):49. doi: 10.1186/s13031-025-00695-9.

ABSTRACT

BACKGROUND: Chronic diseases represent a major global health burden, with their impact becoming even more pronounced in conflict settings. In such environments, the mental health and quality of life of chronic disease patients often deteriorate due to the disruptions caused by war. This study aimed to assess mental health issues among chronic disease patients and evaluate their quality of life during the ongoing armed conflict in Sudan.

METHODS: A cross-sectional study was conducted among chronic disease patients in the safest states of Sudan during the current war. Mental health was assessed with the Patient Health Questionnaire-9 for depression and Generalized Anxiety Disorder-7 for anxiety, and quality of life was evaluated using the EuroQol 5-Dimension 5-Level scale. Chi-square tests and Spearman’s rank examined associations between socio-demographic factors and mental health outcomes. Multiple linear regression identified predictors influencing mental health issues, with statistical significance set at p ≤ 0.05.

RESULTS: Among 1116 chronic disease patients, the median depression score was 7 (IQR = 8), with 50.3% reporting mild to moderate depression, while the median anxiety score was 6 (IQR = 8), with 47.1% experiencing mild to moderate anxiety. Depression showed significantly strong positive correlation with anxiety (ρ = 0.810, p < 0.00). In terms of health-related quality of life, the pain/discomfort domain showed 40.7% of patients reporting moderate to extreme problems, followed by the anxiety/depression domain at 43.4%, making these the most affected areas.

CONCLUSION: This study revealed high levels of depression and anxiety among Sudanese chronic disease patients during the war, alongside a notably poor quality of life. The findings underscore the urgent need for intervention to implement targeted mental health support programs, aiming to improve the quality of life for this vulnerable population.

PMID:40707924 | DOI:10.1186/s13031-025-00695-9

Sleep Med Rev. 2025 Jul 17;83:102137. doi: 10.1016/j.smrv.2025.102137. Online ahead of print.

ABSTRACT

Sleep abnormalities are core features of bipolar disorders (BD), but they have not been thoroughly examined across mood phases. This meta-analysis investigated sleep disturbance prevalence and sleep characteristics differences in BD across mood phases. A systematic search through September 2024 identified 44 studies (7614 BD cases, 3164 controls), including 11 prevalence and 34 case-control studies. Poor sleep quality prevalence was 52% during euthymia, and insomnia prevalence was 63% during the depressive phase. Individuals with euthymic BD reported worse sleep quality and objectively measured longer total sleep time and sleep onset latency than controls. Depressive phase BD showed higher rapid eye movement percentages, while manic/mixed phase exhibited shorter total sleep time, lower sleep efficiency, and longer sleep onset latency. During euthymia, BD demonstrated greater variability in sleep duration and continuity, and more prominent sleep differences when assessed with sleep diary versus objective sleep measures, highlighting the importance of integrating objective assessments and patient-reported outcomes. Overall, these findings indicate that poor sleep quality and insomnia are highly prevalent in BD, and that some sleep parameter differences are present during euthymia, while others occur during depressive and manic phases, emphasizing the need for sleep assessments and tailored management throughout the course of BD.

PMID:40706099 | DOI:10.1016/j.smrv.2025.102137

Hematology. 2025 Dec;30(1):2538318. doi: 10.1080/16078454.2025.2538318. Epub 2025 Jul 24.

ABSTRACT

BACKGROUND: Acute lymphoid leukaemia (ALL) is a significant cause of morbidity and mortality globally, with increasing incidence rates observed in Saudi Arabia. Despite advances in treatment, there is a lack of localized, sex-specific forecasts to guide public health interventions.

OBJECTIVE: This study aims to forecast the future incidence of acute lymphoid leukaemia in males and females using ARIMA models.

METHODS: Saudi national cancer registries data from 1990 to 2019 were used. The dataset was divided into training (80%) and testing (20%) sets. ARIMA models were developed for male and female incidence, with model parameters determined using ACF and PACF plots. Stationarity was assessed using the Augmented Dickey-Fuller test, and model accuracy was validated using MAE, MSE, and MAPE. Forecasts included point estimates and 95% confidence intervals.

RESULTS: For males, the ARIMA (3, 3, 3) model forecasted an increase in ALL incidences from 957 cases in 2020 to 2181 cases in 2029. For females, the ARIMA (4, 3, 0) model projected an increase from 1019 cases in 2020 to 2159 cases in 2029. The models demonstrated high accuracy, with MAE of 1.19895 and 2.749188, MSE of 62.33 and 31.83, and MAPE of 0.6805807 and 1.443453 for males and females, respectively.

CONCLUSION: Forecasts indicate a substantial rise in ALL incidence among both sexes, highlighting the urgent need for improved surveillance, early detection, and healthcare capacity planning. Incorporating ARIMA modelling into routine monitoring could support proactive resource allocation. Further studies should integrate additional predictive variables to enhance model precision.

PMID:40706089 | DOI:10.1080/16078454.2025.2538318

JMIR Infodemiology. 2025 Jul 24;5:e73619. doi: 10.2196/73619.

ABSTRACT

BACKGROUND: In recent years, there has been a dramatic increase in the popularity and use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for weight loss. As such, it is essential to understand users’ real-world discussions of short-term, long-term, and co-occurrent adverse events associated with currently used GLP-1 RA medications.

OBJECTIVE: This study aims to quantitatively analyze temporal and co-occurrent GLP-1 RA adverse event trends through discussions of GLP-1 RA weight loss medications on Facebook from 2022 to 2024.

METHODS: We collected 64,202 Facebook posts (59,293 posts after removing duplicate posts) from January 1, 2022, to May 31, 2024, through CrowdTangle, a public insights tool from Meta. Using English language social media posts from the United States, we examined discussions of adverse event mentions for posts referencing 7 GLP-1 RA weight loss product categories (ie, semaglutide, Ozempic, Wegovy, tirzepatide, Mounjaro, Zepbound, and GLP-1 RA as a class). All analyses were conducted using Python (version 3; Python Software Foundation) in a Google Colab environment.

RESULTS: Temporal time series analysis revealed that the GLP-1 RAs’ adverse event mentions on social media aligned with several key events: the Food and Drug Administration’s approval of Wegovy for pediatric weight management in December 2022, increased media coverage in August 2023, celebrity endorsement in December 2023, and Medicare Part D coverage expansion for weight loss medications in March 2024. Gastrointestinal (GI)-related adverse events (general term) were most prevalent for posts mentioning the GLP-1 RA class (210/4885, 4.30%) and Mounjaro (241/4031, 5.98%). In contrast, the most prevalent adverse event mentions noted for tirzepatide were headache (78/4202, 1.86%) and joint pain (71/4202, 1.69%). Hypertension (13/1769, 0.73%) was frequently mentioned in Zepbound posts, while pancreatitis was commonly associated with Mounjaro posts (44/4031, 1.08%), and 2.85% (139/4885) of posts broadly referring to the GLP-1 RA class. Furthermore, an integrated node network analysis revealed 3 distinct GLP-1 RA adverse events-mentioned clusters: cluster 1 (purple) contained allergies, anxiety, depression, chronic obstructive pulmonary disease, fatigue, fever, hypertension, indigestion, insomnia, gastroesophageal reflux disease, hives, swelling, restlessness, and seizures. Cluster 2 (pink) contained constipation, dehydration, headache, diarrhea, dizziness, hypoglycemia, sweating, and jaundice. Cluster 3 (brown) contained GI symptoms, such as nausea, pancreatitis, rash, and vomiting. The GI symptoms, such as nausea, vomiting, pancreatitis, diarrhea, and indigestion, were strongly associated together (≥100 co-occurrence mentions), while the mentioned neurological symptoms, such as anxiety, depression, and insomnia, were highly correlated with each other (50-100 co-occurrence mentions).

CONCLUSIONS: This social media study highlights the adverse event mention patterns for posts referencing GLP-1 RA medications. While further research is needed to rigorously examine and validate these findings, this study demonstrates the importance of monitoring social media discussions to predict novel, underreported, or rare drug adverse events, thereby improving patient care, clinical research, and health policy interventions.

PMID:40706081 | DOI:10.2196/73619

Bol Med Hosp Infant Mex. 2025;82(3):145-151. doi: 10.24875/BMHIM.24000104.

ABSTRACT

BACKGROUND: Orotracheal intubation can cause complications such as stridor and airway obstruction, which favors weaning failure. The objective of this study was to assess the usefulness of airway ultrasound prior to extubation to predict stridor and extubation failure.

METHOD: Cross-sectional descriptive study, from March 2023 to June 2024. A total of 50 patients were studied, admitted to the pediatric emergency service of the Children’s Hospital of the State of Sonora, under mechanical ventilation ≥ 24 hours and in whom the first extubation attempt. An ultrasound of the airway was performed, calculating the peritube free space and the width of the air column before extubation, and the total number of patients who presented post-extubation stridor and extubation failure were identified.

RESULTS: The mean peritube free space in patients who presented stridor was 3.2 mm (0.3-6.2), with a statistically significant difference (p = 0.012) compared to patients who did not present stridor. The mean width of the air column in patients who presented stridor was 1.21 mm (0.16-4.78 mm), but it did not show a statistically significant difference (p = 0.153) compared to patients who did not present stridor. There were no statistically significant differences in both measurements for the outcome of extubation failure.

CONCLUSIONS: Airway ultrasound seems to have a good correlation with the risk of post-extubation stridor.

PMID:40706076 | DOI:10.24875/BMHIM.24000104

J Med Internet Res. 2025 Jul 24;27:e70118. doi: 10.2196/70118.

ABSTRACT

BACKGROUND: Incorporating initial serum chloride levels as a prognostic indicator in the intensive care environment has the potential to refine risk stratification and tailor treatment strategies, leading to more efficient use of clinical resources and improved patient outcomes.

OBJECTIVE: Quantitative analysis of the relationship between serum chloride levels at intensive care unit (ICU) admission and in-hospital mortality, and the establishment of a personalized survival curve prediction deep learning model to enhance risk stratification and clinical decision-making.

METHODS: A large-scale, cross-country, multicohort study of 189,462 ICU patients from four cohorts was conducted: 70,370 from Medical Information Mart for Intensive Care IV (MIMIC-IV), 112,457 from eICU Collaborative Research Database (eICU-CRD; 2 US cohorts), 4653 from Yantai Yuhuangding Hospital, and 1982 patients from Zigong Fourth People’s Hospital (2 Chinese cohorts). We collected demographics, underlying diseases, ICU complications, electrolyte levels, biochemical parameters, and vital signs at ICU admission, along with length of stay and in-hospital survival outcomes. Causal graph analysis pinpointed clinical variables linked to mortality. Nonlinear associations between chloride levels and mortality were evaluated using restricted cubic splines and Cox proportional hazards models, validated with the Cox frailty model, Kaplan-Meier curves, and sensitivity analyses. A deep learning model was created for individualized survival predictions.

RESULTS: Causal inference revealed a significant association between admission serum chloride levels and 28-day mortality. The median serum chloride level at ICU admission was 104 (IQR 100-108) mEq/L. In analyzing all 42 variables, restricted cubic splines identified thresholds at 103 mEq/L and 115 mEq/L, categorizing patients into three groups: ≤103 mEq/L, 103-115 mEq/L, and >115 mEq/L. Cox proportional hazards models revealed higher death risks for patients outside this range, with hazard ratios (HRs) of 1.36 (95% CI 1.29-1.43) for ≤103 mEq/L and 1.27 (95% CI 1.14-1.41) for >115 mEq/L. Four cross-cohort validations confirmed these critical ranges. For the eICU-CRD dataset, the HRs for the key intervals are 1.30 (95% CI 1.24-1.36) and 0.97 (95% CI 0.89-1.06). In the Yantai Yuhuangding Hospital affiliated with Qingdao University (YHD-HOSP) dataset, the HRs for the key intervals are 1.23 (95% CI 1.09-1.38) and 1.58 (95% CI 1.27-1.96). In the Sichuan Zigong Fourth People’s Hospital (SCZG-HOSP) dataset, the HR for the key interval is 2.20 (95% CI 1.43-3.39). The Causal SurvivalNet accurately predicted individual survival curves using admission chloride levels and other factors, achieving Brier scores of 0.09, 0.12, and 0.15. Results from cohort analyses in both China and the United States consistently and closely correlate the critical range of chloride with the prognosis of ICU patients.

CONCLUSIONS: Using initial serum chloride levels enhances prognostic accuracy and facilitates tailored treatment plans for ICU patients in critical care settings.

PMID:40706028 | DOI:10.2196/70118