Category: Statistics

Dementia (London). 2025 Mar 29:14713012251330689. doi: 10.1177/14713012251330689. Online ahead of print.

ABSTRACT

Dementia is a progressive and neurodegenerative condition that leads to a gradual deterioration of the individual’s functional capacity and social relations. Engaging in meaningful activities is considered an effective approach to maintaining and increasing the well-being of people living with dementia. Digital media has the potential to improve the quality of life for people living with dementia, allowing them to engage in activities that are personally meaningful. This study sought to understand the needs and preferences people with early-stage dementia living in Portugal have for receiving information on meaningful activities. It also explored their relationship with technologies and digital media. Focus groups and interviews were carried out with people living with dementia (n = 21), informal carers (n = 9) and healthcare professionals (n = 8). Descriptive statistics were used for sample characterization and the verbatim transcriptions of interviews and focus groups were subjected to inductive thematic analysis. We developed three main themes: (i) engagement of people living with dementia in meaningful activities; (ii) experiences of people living with dementia with technology and digital resources; and (iii) the importance of a support network. This last theme is associated with the first two. The study identified several meaningful activities, such as household chores and intellectual hobbies, some of which were mediated by technology. People living with dementia reported to primarily use digital media, particularly computers and smartphones, for socialization and entertainment. The barriers identified for technology use and engagement in meaningful activities were both related to mobility problems and cognitive complaints. The support network emerged as essential for the use of digital technologies and engagement in meaningful activities. This study highlights a need to further research and design digital media that offer the opportunity for people living with dementia to be informed and engaged in meaningful activities.

PMID:40156603 | DOI:10.1177/14713012251330689

Cytotherapy. 2025 Mar 12:S1465-3249(25)00071-4. doi: 10.1016/j.jcyt.2025.03.002. Online ahead of print.

ABSTRACT

We evaluated the impact of center volume on outcomes in patients with B-cell acute lymphoblastic leukemia following their second allogeneic hematopoietic stem cell transplantation (allo-HSCT). Our cohort included 299 patients with relapse and 68 patients with graft failure after their first allo-HSCT between 2003 and 2017. Patients were stratified into low- and high-volume groups based on the number of allo-HSCT performed at each center. The primary endpoint was 5-year overall survival (OS) following the second allo-HSCT. In the relapse cohort, the high-volume group demonstrated significantly better 5-year OS (21.1% vs 13.6%, P = 0.0062) and progression-free survival (16.1% vs 10.6%, P = 0.010). Multivariate analysis showed that high-volume group was a favorable factor for OS (hazard ratio [HR]: 0.72, 95% confidence interval [CI]: 0.56-0.94, P = 0.016). This survival benefit was consistent in both Philadelphia chromosome-negative (HR: 0.71, 95% CI: 0.51-0.99, P = 0.042) and positive (HR: 0.61, 95% CI: 0.39-0.95, P = 0.030) subcohorts. In the graft failure cohort, the high-volume group showed a trend toward better 5-year OS (41.6% vs 24.4%, P = 0.098) and lower 5-year nonrelapse mortality (NRM) (55.9% vs 75.6%, P = 0.067). Multivariate analysis confirmed the protective effect of the high-volume group on NRM (HR: 0.55, 95% CI: 0.30-0.99, P = 0.044). Our findings demonstrate that center volume significantly impacts outcomes after the second allo-HSCT regardless of indication, highlighting the need for inter-center collaboration and standardized management strategies for this high-risk population.

PMID:40156598 | DOI:10.1016/j.jcyt.2025.03.002

J Nutr Educ Behav. 2025 Mar 28:S1499-4046(25)00052-1. doi: 10.1016/j.jneb.2025.02.011. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the feasibility and acceptability of a novel Digital Choice model at an urban food pantry from customer and staff perspectives.

DESIGN: Focus groups, cross-sectional survey, and in-depth interviews.

SETTING: New York City.

PARTICIPANTS: Thirty Digital Choice customers participated in 3 focus groups, 326 Digital Choice and non-Digital Choice customers completed the survey, and 8 program staff were interviewed.

INTERVENTIONS: The Digital Choice model used text messaging/online forms to allow customers to preorder 1 of 4 pantry boxes for pickup at 1 of 3 community sites.

PHENOMENA OF INTEREST: Feasibility, acceptability.

ANALYSIS: Themes were identified in interviews and focus groups using inductive and deductive approaches, and descriptive statistics were produced from survey and order data.

RESULTS: Digital Choice customers indicated high overall satisfaction with the program (96% rated the experience positively), and staff found the program feasible to implement at the current scale. However, among the broader population of Digital Choice and non-Digital Choice customers, 40% indicated challenges with technology.

CONCLUSIONS AND IMPLICATIONS: This evaluation suggests that incorporating digital technology to facilitate customer choice and partnering with community sites in the food pantry process is feasible and acceptable for many, but not all, customers.

PMID:40156591 | DOI:10.1016/j.jneb.2025.02.011

Circ Cardiovasc Qual Outcomes. 2025 Mar 29:e011991. doi: 10.1161/CIRCOUTCOMES.125.011991. Online ahead of print.

ABSTRACT

BACKGROUND: Although Medicare Advantage (MA) plans provide coverage to >50% of Medicare beneficiaries, it is unclear whether MA claims can be used similarly to Medicare Fee-For-Service (FFS) claims for clinical outcomes assessment. In this study, we evaluate the accuracy of claims algorithms previously validated in FFS to assess comorbidities and outcomes in MA patients after aortic valve replacement.

METHODS: We compared the concordance of 11 claims-based covariates (diabetes, hypertension, atrial flutter/fibrillation, myocardial infarction) and outcomes (stroke, disabling stroke, transient ischemic attack, major vascular complication, bleeding, permanent pacemaker implantation, death) among FFS and MA patients with the covariates and adjudicated outcomes in the multinational Evolut Low-Risk Trial (2016-2018). We used claims algorithms for 1-year outcomes and calculated sensitivity, specificity, positive predictive value, negative predictive value, and kappa, using adjudicated outcomes as the reference. We compared the kappa for MA versus FFS using the 2-sample z-test with a significance level of P<0.05.

RESULTS: Among 1139 US patients aged 65+ years old in the Evolut Low-Risk Trial, 782 patients (175 MA and 607 FFS) were linked to claims data and had complete comorbidity data. Among all covariates, claims algorithms for covariates had sensitivities ≥85% for identifying diabetes, atrial flutter/fibrillation, and hypertension in MA and FFS. For the outcomes, sensitivities were ≥85% for bleeding (comprehensive), permanent pacemaker implantation, and death. The kappa was higher in MA versus FFS for diabetes (P=0.03) and hypertension (P=0.025) but was lower in myocardial infarction (P<0.0001). There was no statistically significant difference in the kappa agreement between MA versus FFS for any of the selected outcomes.

CONCLUSIONS: Medicare claims have a similar level of kappa agreement in MA versus FFS for most covariates and outcomes. As patients shift to MA, ascertainment of outcomes using Medicare claims in postapproval studies remains valid for select outcomes.

PMID:40156581 | DOI:10.1161/CIRCOUTCOMES.125.011991

Vasc Endovascular Surg. 2025 Mar 29:15385744251330930. doi: 10.1177/15385744251330930. Online ahead of print.

ABSTRACT

Background and AimThe aim of this study is to estimate the incidence of periprocedural outcomes after carotid revascularization with special emphasis on myocardial infarction and assess the safety of carotid artery stenting (CAS) and carotid endarterectomy (CEA) through systematic review and meta-analysis.MethodsA multiple electronic search was performed in Medline (database provider PubMed), Web of Science Core Collection, EMBASE (database provider Ovid) and Cochrane Central Register of Controlled Trials databases for articles from 2000 up to 2023 reporting outcomes after carotid revascularization. Randomized control trials comparing the perioperative events (30-day results) after CAS and CEA stating the perioperative risk of myocardial infarction were included in the present meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.ResultsA total of twelve randomized control trials (RCTs) with 11 153 patients were identified and considered eligible. The pooled risk of periprocedural stroke was found to be reduced after CEA compared to CAS [OR: 1.6, CI 95%:1.3-2.1, P < 0.05], while PMI was found to be more frequent after CEA, favoring CAS [OR: 0.4, CI 95%: 0.2-0.7, P < 0.05]. Periprocedural mortality was lower but not reaching statistical significance in the CEA compared to CAS [OR: 1.1, CI 95%: 0.6-2.1, P = 0.68]. The pooled OR for composite endpoint of stroke, MI or death was in favor of CEA as safer treatment [OR: 1.3, CI 95%: 1-1.5, P < 0.05].ConclusionsPMI risk was lower after CAS, although the currently available data do not demonstrate any increase in mortality rates.

PMID:40156572 | DOI:10.1177/15385744251330930

Int J Inj Contr Saf Promot. 2025 Mar 29:1-14. doi: 10.1080/17457300.2025.2485040. Online ahead of print.

ABSTRACT

Statistical modeling and data-driven studies on bicycle accidents are widespread, however, explanations of the underlying mechanisms remain limited, particularly regarding the impact of key risk factors on the bicycle crash frequency across different crash severities. This study aims to examine the effects of various risk factors on the frequency of bicycle crashes using Random Forest and Shapley Additive Explanations (RF-SHAP), taking into account the different crash severity levels. Data from three years of London crash data (2017 to 2019) is utilized. Population demographics, land use, road infrastructure, and traffic flows, are collected in Greater London. In addition to providing superior predictive accuracy, our proposed method identified critical risk factors at different levels of severity associated with bicycle crashes. The distinct contribution of this study is the identification of the primary factors influencing the severity of bicycle collisions in London through the use of RF-SHAP. The study quantifies both the main and interactive effects of various severity risk factors on bicycle collisions. Results suggest that the proportion of building areas and population density are most critical to bicycle crash numbers in different severity levels. Also, the interaction effects of the risk factors on bicycle crashes are revealed. Specifically, results reveal a negative correlation between traffic flow and overall bicycle crash frequency when the average road network connectivity is below 2.25. After controlling the population density, the proportion of residential areas shows a three-stage pattern of influence on the slight injury crash frequency. Furthermore, a boundary value of 6.3 is identified for the safety impact of road density on fatal and severely-injured bicycle crashes. Study findings should provide insights into cost-effective safety countermeasures for bicycle infrastructures, traffic controls, and safety education. Bicycle safety can be improved through these measures over the long term.

PMID:40156566 | DOI:10.1080/17457300.2025.2485040

Indian J Dent Res. 2024 Oct 1;35(4):454-458. doi: 10.4103/ijdr.ijdr_500_24. Epub 2025 Mar 29.

ABSTRACT

BACKGROUND: Composite resin restoration is technique sensitive, where there is poor control over moisture leading to incomplete polymerization of the monomers. Hence, it is imperative to study a material which improves the mechanical and physical properties of the resin composite in the moist, oral environment, which is less affected by the saliva.

AIM: The aim of this study was to synthesize composite resin by combining water soluble photoinitiator such as 2,4,6-trimethylbenzoyl phosphine oxide (TPO) (type II) and camphorquinone (CQ) photoinitiator (type I) and to investigate mechanical and physical properties with and without salivary contamination when compared to traditional composite with CQ alone.

METHODOLOGY: Experimental composite resin was synthesized by combining water soluble photoinitiator such as 2,4,6-trimethylbenzoyl phosphine oxide (TPO) with CQ photoinitiator. Samples were prepared based on ISO 4049 guidelines and divided into experimental composite with salivary contamination (n = 50), and without salivary contamination (n = 50) and traditional composite (SOLARE X-GC company) with salivary contamination (n = 50) and without salivary contamination (n = 50). Properties such as compressive strength, tensile strength, shear bond strength, degree of conversion, and depth of cure were evaluated.

RESULTS: Experimental composite with salivary contamination had shown statistically significant difference in mechanical and physical properties when compared to traditional composite.

CONCLUSION: This study concluded that combining water soluble photoinitiator such as TPO (type II) with CQ (type I) provides a synergistic effect by increasing the mechanical properties under salivary conditions.

PMID:40156531 | DOI:10.4103/ijdr.ijdr_500_24

Indian J Dent Res. 2024 Oct 1;35(4):443-448. doi: 10.4103/ijdr.ijdr_146_24. Epub 2025 Mar 29.

ABSTRACT

BACKGROUND: Composites are prone to time-dependent bond degradation. Many measures have been taken to stabilize the bond.

AIM: This in vitro study aims to evaluate the effect of pretreatment with 1,2,3,4-Butane Tetracarboxylic acid (BTCA) on the micro-tensile bond strength (µTBS) of composite resin to dentine and to compare it with the pretreatment using 2% chlorhexidine (CHX).

MATERIALS AND METHODS: Permanent molars (40) extracted for periodontal reasons were selected. Dentine surfaces were exposed using a diamond bur, preconditioned with BTCA for the test group (SIGMA-ALDRICH) and with CHX for the control group, followed by the application of self-etch adhesive (GC G-Premio bond) and composite restoration (GC Solare X). Each group was subdivided to be tested as: Group 1A: after 24 hours with BTCA; Group 1B: after 1 month with BTCA; Group 2A: after 24 hours with CHX; Group 2B: after 1 month with CHX. The µTBS was tested using a universal testing machine. The mode of failure was determined using a stereomicroscope and a scanning electron microscope (SEM).

RESULT: BTCA pretreatment was able to preserve the bond slightly better than the control group, though not statistically significant either at 24 hours (P = 0.492) or 1 month (P = 0.181). There was no significant reduction in the µTBS between immediate testing and 1-month storage for both groups (P = 0.213 for acid; P = 0.914 for CHX). The mode of failure was predominantly cohesive for both groups, with fewer adhesive failures.

CONCLUSIONS: BTCA pre-conditioning is capable of preserving the dentin-composite bond as efficiently as CHX.

PMID:40156530 | DOI:10.4103/ijdr.ijdr_146_24

Indian J Dent Res. 2024 Oct 1;35(4):438-442. doi: 10.4103/ijdr.ijdr_308_24. Epub 2025 Mar 29.

ABSTRACT

INTRODUCTION: Tooth preparations have traditionally been graded using a visual system that either subjectively assigns a single mark (global grading) or objectively divides the grade into several smaller categories. (analytical grading using rubrics). The objective of this study is to determine how effectively rubrics work for evaluating dental students’ performance in crown preparation.

MATERIAL AND METHODS: In this double-blind study, 89 fourth-year dental students and three senior faculty members with master’s degrees in operative dental sciences participated. To create a metal-ceramic crown, the students prepared an acrylic tooth. The parameters for evaluating the preparation were explained in detail to the students. The three senior faculty members evaluated different aspects of the preparation using an analytical rubric based on a 10-point scale. For statistical analysis, post hoc Tukey tests, ANOVA, and descriptive statistics were employed.

RESULT: One-way ANOVA showed no significant differences among the seniors for all criteria except for margin placement and two-plane reduction. There were no significant differences in the total degree of student performance among seniors; however, the highest score was given by Senior 2 (6.421 ± 1.2058), and the lowest score was given by Senior 3 (6.042 ± 1.9085). The weakest areas in the student’s tooth preparations were two-plane reduction and preservation of adjacent teeth, which received the lowest student scores (48.10% and 49.10%, respectively).

CONCLUSION: An analytical rubric is a useful tool for identifying dental students’ mistakes and areas of weakness.

PMID:40156529 | DOI:10.4103/ijdr.ijdr_308_24

Acta Ophthalmol. 2025 Mar 29. doi: 10.1111/aos.17491. Online ahead of print.

ABSTRACT

PURPOSE: To design a vergence-based lens power formula based on the classical Haigis formula for better outcomes while retaining the original formula architecture.

METHODS: Four new formula variants (A-D) incorporating a sum of segments correction for axial length, harmonic mean of corneal radii instead of arithmetic mean (all variants), and differing combinations of lower keratometer index (C, D) and an additional term (a3) representing the lens thickness in the effective lens position (B, D) were assessed in an analysis based on four datasets of IOLMaster 700 biometric data for eyes treated with the Hoya Vivinex lens (dataset 1), Alcon SA60AT lens (2), Johnson & Johnson ZCB00 lens (3), and the Bausch & Lomb MX60 lens (4). All parameters (formula constants and keratometer index) were calculated by nonlinear iterative optimisation techniques for minimising the root mean squared prediction error (RMSPE). Performance was assessed in terms of the final RMSPE.

RESULTS: All four variants showed reductions in RMSPE ranging from 2.8% to 12.6% over the original Haigis formula. For each of the four datasets, variants B and D (with the additional a3 constant) performed better in this respect than variants A and C. In all four cases, variants C and D (with the adjusted keratometer index) performed slightly better than A and B, respectively.

CONCLUSION: Although not amenable to statistical analysis, the % improvements in RMSPE would appear to be clinically relevant. However, the benefit has to be proven in a prospective multicentric study with a large sample size.

PMID:40156502 | DOI:10.1111/aos.17491