Category: Statistics

J Anim Physiol Anim Nutr (Berl). 2025 Nov 18. doi: 10.1111/jpn.70031. Online ahead of print.

ABSTRACT

Chronic kidney disease (CKD) is a known risk factor for hypercalcemia in cats. Phosphate-restricted diets have also been implicated in causing hypercalcemia, in part because phosphate restriction increases the Ca:P ratio. The primary objective of this study was to evaluate the impact of two different therapeutic renal foods on ionized (iCa) and total (tCa) calcium concentrations in cats with early-stage CKD. Twenty colony-housed cats with stage 1 or 2 CKD were enrolled, and 18 cats completed the study. Cats were randomly assigned to receive one of two diets formulated for renal disease for 140 days: a moderately phosphate restricted food (M-PR; n = 10 cats; 1.8 g/Mcal calcium; 1.5 g/Mcal phosphorus; Ca:P ratio, 1.2:1) or a more highly phosphate restricted food (H-PR; n = 8 cats; 2.3 g/Mcal calcium; 1.1 g/Mcal phosphorus; Ca:P ratio, 2.0:1). Blood and urine samples were collected on Days 0, 28, 84, and 140. Data were analyzed using a linear mixed model with fixed effects of diet, day, and diet by day interaction. At baseline, all cats had iCa within the normal reference interval (1.10─1.30 mmol/L). On d28 and thereafter, cats fed H-PR food had higher iCa compared with cats fed M-PR food (day 140 means: 1.42 mmol/L vs. 1.24 mmol/L, respectively; p < 0.001). Results were similar for tCa (day 140 means: 11.49 mg/dL vs. 9.51 mg/dL, respectively; p < 0.001; normal reference interval 8.80-10.00 mg/dL). This corresponded to higher fractional excretion of calcium in urine in cats fed H-PR food (Day 140 means 1.18% vs. 0.19%; p < 0.001), and increased calcium oxalate (CaOx) stone formation risk metrics (Day 140 means for CaOx RSS 4.54 vs. 3.13; Day 140 means for CaOx CORI risk index 563 vs. 30/L, respectively; all p < 0.020). Cats fed H-PR food also had higher FGF-23 concentrations compared with cats fed M-PR food (Day 140 means: 2329 vs. 204 pg/mL, respectively; p = 0.003; normal reference interval ≤ 299 pg/mL), and lower calcitriol concentrations (Day 140 means: 94 vs. 186 pmol/L, respectively; p = 0.021; normal reference interval 90-342 pmol/L). PTH concentrations in cats consuming H-PR food were significantly decreased from their baseline means and from cats consuming M-PR food at all timepoints (Day 140 means: < 0.05 vs. 3.1 pmol/L, respectively; p < 0.050; normal reference interval 0.7-3.4 pmol/L). Therapeutic renal diets impact calcium status in cats with early-stage CKD, but the effect is formulation dependent. Cats fed a M-PR food maintained normal iCa and tCa, which suggests this food is a safe and well-accepted option for cats with early-stage renal disease.

PMID:41252663 | DOI:10.1111/jpn.70031

JCO Oncol Pract. 2025 Nov 18:OP2500505. doi: 10.1200/OP-25-00505. Online ahead of print.

ABSTRACT

PURPOSE: This study assesses the accuracy of radiographic clinical staging by computed tomography (CT) of mismatch repair-deficient (dMMR) colon cancer, given emerging data for neoadjuvant immune checkpoint inhibitors (ICIs).

METHODS: Patients with stage I-III colon cancer treated with upfront surgical resection were retrospectively reviewed using the electronic medical record from a single institution from 2012 to 2023. We performed a cohort study of dMMR tumors with a stage-matched control cohort of mismatch repair-proficient (pMMR) tumors. The primary end point was the accuracy of clinical stage using preoperative CT compared with pathologic stage for dMMR colon cancer. Statistical analysis was performed using R.

RESULTS: We identified 78 patients with dMMR colon cancer. For dMMR tumors, T-stage clinical radiologic staging matched pathologic stage in 51% of cases and the nodal stage was accurately matched in 55% of cases. For stage I and IIA (low-risk) tumors, the overstaging rate on CT was 41% and for T4 or N+ (high-risk), the understaging rate was 25%. When comparing the dMMR and pMMR cohorts, pMMR nodal status was more likely to be understaged (P < .001). There was moderate to substantial interrater reliability for overall stage, T stage, and N staging between radiologists (kappa = 0.64, 0.60, and 0.63, respectively).

CONCLUSION: Radiographic tumor and nodal staging for dMMR colon tumors is unreliable with high rates of overstaging low-risk tumors where neoadjuvant treatment may not be indicated. The low accuracy of clinical staging demonstrates clear limitations to make systemic therapy decisions. Additional diagnostic modalities for lymph node status may be necessary to accurately clinically stage patients before neoadjuvant ICIs in patients with locally advanced disease.

PMID:41252662 | DOI:10.1200/OP-25-00505

J Craniofac Surg. 2025 Nov 14. doi: 10.1097/SCS.0000000000012129. Online ahead of print.

ABSTRACT

The review was performed to evaluate effect of maxillo-mandibular advancements (MMA) on patients with obstructive sleep apnea (OSA) for long term and subjective outcomes. Review was adhered to PRISMA guidelines 2020. Articles screening was done independently by two authors. Quality assessment was done through Newcastle Ottawa scale (NOS) and Cochrane risk of bias (ROB)-2 tool. Standardized mean difference (SMD) was used as summary statistic measure employing random effect model through Review manager (RevMan) version 5.3. Twelve studies (5 retrospective studies, 4 prospective studies and 3 clinical studies) were included for qualitative synthesis and ten studies for meta-analysis. Included studies evaluated subjective parameters like apnea index (AI), Apnea-Hypopnea Index (AHI), Desaturation Index (DI), Epworth Sleepiness Scale (ESS), Hypopnea index (HI), Respiratory Disturbance Index (RDI), Total Sleep Time (TST) and airway morphological parameters like Posterior Airway Space (PAS). Meta-analysis was conducted on AHI, mean SpO2, RDI, TST, ESS and airway morphological parameters like Al and PAS which indicated that post treatment witgh MMA had improved the overall quality of life (P<0.05). Included studies had presence of low to moderate risk of bias. No asymmetry was seen on funnel plot signifying absence of publication bias in meta-analysis. It was found that MMA is an ideal, reliable and most effective treatment modality for patients with OSA improving their overall quality of life with minimal complications with high success and cure rate.

PMID:41252649 | DOI:10.1097/SCS.0000000000012129

West Afr J Med. 2025 Jun 30;42(6):452-456.

ABSTRACT

BACKGROUND: Stroke remains one of the leading causes of disability worldwide. Arm function recovery is essential for stroke survivors’ ability to perform activities associated with daily living. Consequently, impairment in arm function is a significant target for stroke survivors’ physical or robotic rehabilitation. This study aims to explore the barriers and facilitators to the implementation of a robotic rehabilitation programme for stroke survivors in a resource-poor setting.

METHODS: A cross-sectional design with a qualitative approach was chosen. A semi-structured, interview-based questionnaire was administered and data were collected from stroke survivors presenting at the adult neurology clinic of two tertiary institutions in Nigeria. Data from the interview-based questionnaire were analyzed using descriptive statistics.

RESULTS: A total of 52 stroke survivors participated and were interviewed. More than half (55.8%) of the respondents were elderly, with a male-to-female ratio of 1.6:1. Majority of respondents (58%) had no idea about the use of robotics for stroke rehabilitation. About 44% of the respondents believe that the major determinant of interest in robotics will be favourable outcome after trials on other participants. Lack of financial support and transportation aid constitute barriers, while creation of awareness and the availability of transportation aid from home to hospital were the major facilitators to participation.

CONCLUSION: These findings highlight the fact that most stroke survivors in the resource-poor setting were not aware of the usefulness of robotics in stroke rehabilitation. Hence, increasing knowledge and creating awareness about robotic rehabilitation will make it more readily acceptable for stroke survivors. KEYWORDS: Barrier, Facilitator, Robotic rehabilitation, Stroke survivors, Implementation.

PMID:41252638

AIDS Educ Prev. 2025 Jul;6(1):1-11. doi: 10.1521/aeap.1994.6.1.1.

ABSTRACT

Heterosexual transmission of the human immunodeficiency virus (HIV) has become a significant health issue for women. The present study describes the extent to which a sample of women from an urban area report making efforts to protect themselves from becoming infected with HIV through several protective sexual behaviors. Secondly, we assess the extent to which adoption of these protective behaviors can be explained by health beliefs and previous HIV testing. Forty-nine percent of the sample reported having used a condom in the past year because of fear of AIDS and 48% reported having carried condoms. Women in this sample perceived themselves to be moderately susceptible to AIDS and they were well aware of the severity of the disease. Women tended to think that protecting themselves from AIDS would not be overly burdensome and that the recommended sexual protective behaviors were highly effective for preventing AIDS. Messages about the severity of AIDS and the effectiveness of protective sexual behaviors seem to be reaching women. Beliefs about personal susceptibility were consistently associated with the adoption of multiple protective behaviors, suggesting that messages emphasizing the ubiquity of risk, especially in demographically high-risk populations, may be particularly appropriate and effective.

PMID:41252637 | DOI:10.1521/aeap.1994.6.1.1

AIDS Educ Prev. 2025 Jul;6(1):12-26. doi: 10.1521/aeap.1994.6.1.12.

ABSTRACT

We examined correlates of condom use among heterosexual whites, blacks, and Hispanics (ages 20-45 years) with an human immunodeficiency virus (HIV) risk factor in a community-based longitudinal sample (San Francisco; n = 716). Lag models were used to examine hypothesized antecedents of condom use at wave 2. High levels of condom use were associated with labeling one’s sexual behavior as risky for HIV infection, high levels of condom enjoyment and commitment to use condoms, good sexual communication practices, gender (trend), and marital status. The results support the need for wide-ranging intervention programs that stimulate people to make personal risk assessments, teach basic sexual skills, and direct those in need of intensive help to appropriate agencies.

PMID:41252630 | DOI:10.1521/aeap.1994.6.1.12

J Med Internet Res. 2025 Nov 18;27:e80497. doi: 10.2196/80497.

ABSTRACT

BACKGROUND: Health disparities are closely associated with socioeconomic inequalities. Although this relationship is well recognized in the context of traditional health care access, its influence on online health-seeking behaviors such as posting questions on patient forums and seeking peer responses remains poorly understood, particularly in the context of resource-limited regions. Furthermore, it is unclear what types of questions are most frequently asked online and to what extent these questions receive helpful responses.

OBJECTIVE: This study aims to examine how socioeconomic status influences online health-seeking behavior by analyzing regional disparities in forum participation and their correlation with economic development. In addition, it aims to identify unmet informational needs among patients with lymphoma through large language model (LLM)-based forum thread classification and expert evaluation of forum responses by using data from the largest online blood cancer forum in China.

METHODS: We analyzed over 110,000 patient-initiated forum threads posted between 2012 and 2023, covering all the provinces of mainland China. Regional trends in forum participation rates were examined and correlated with economic development, as measured by gross regional product per capita. Second, an LLM was used to classify the threads into 6 predefined topics based on their semantic content, thereby providing an overview of the topics that users cared about. Additionally, an expert manual review was conducted based on relevance, accuracy, and comprehensiveness to assess whether users’ questions were adequately addressed within the forum discussions.

RESULTS: Regional forum participation rates were significantly associated with levels of regional economic development (Wilcoxon rank-sum test; P<.001), with the highest participation rates in the East Coast regions. Participation rates in less-developed regions steadily increased, reflecting the growing public demand for accessible health information. LLM-based analysis revealed that most discussions centered on medical concerns such as interpreting reports and selecting treatment plans across all regions. However, only 37% (117/316) of the user questions received useful responses, underscoring persistent gaps in access to reliable information.

CONCLUSIONS: To our knowledge, this study represents the most comprehensive real-world investigation to date of spontaneous online forum participation and information needs among patients with cancer. Our findings highlight the necessity for government and health care providers to implement initiatives such as artificial intelligence-driven information platforms and region-specific health education campaigns to bridge information gaps, reduce regional disparities, and improve patient outcomes across China.

PMID:41252192 | DOI:10.2196/80497

Mil Med. 2025 Nov 18:usaf571. doi: 10.1093/milmed/usaf571. Online ahead of print.

ABSTRACT

INTRODUCTION: Military medical students train in austere, high-stress environments that simulate prolonged casualty care and the cognitive and emotional demands of combat medicine. These scenarios can heighten stress and cognitive load, yet few curricula explicitly equip learners with structured strategies for psychological self-regulation. Mindfulness training has shown promise in clinical and operational contexts, but its educational role in military medical training is underexplored.

MATERIALS AND METHODS: We developed the Mental Strength and Resilience Training (MSRT), a brief, theory-informed mindfulness curriculum incorporating three 1-hour sessions and asynchronous video materials. Mental Strength and Resilience Training emphasized 5 mindfulness strategies-breathing, mantra, movement, stretching, and body scan-framed for transfer to prehospital operational environments. Ninety-seven third- and fourth-year medical students at the Uniformed Services University participated across 2 high-fidelity military medical field exercises: Operation Gunpowder (36 hours) and Operation Bushmaster (5 days). Outcomes were assessed with the Mindful Attention Awareness Scale (MAAS), Brief Resilience Scale (BRS), and Perceived Stress Scale (PSS) at 4 time points. These 4 time point measures were then analyzed using a repeated measures Analysis of Variance (ANOVA) model, and the relationships between each scale score were analyzed using correlations. Faculty observers also evaluated clinical performance at Operations Gunpowder and Bushmaster for all students. Performance comparisons between students involved in the study and students not involved were compared via independent samples t-testing. The relationships between study participants’ performance and their mindfulness, resilience, and stress were analyzed via correlations, with any significant correlations being entered into a regression model for further examination. This study was approved and deemed exempt by the Uniformed Services University Institutional Review Board (IRB) committee.

RESULTS: Learners demonstrated significant increases in mindfulness (η2p = 0.32, P < .001) and resilience (η2p = 0.06, P = .002), alongside reductions in perceived stress (η2p = 0.28, P < .001). Correlation analyses showed stress was consistently negatively associated with mindfulness and resilience. Faculty-rated performance scores did not differ significantly between the students involved in the study and non-participating students regularly enrolled at Operations Gunpowder and Bushmaster. However, pre-Bushmaster resilience predicted performance outcomes (P = .02) in the participating student sample.

CONCLUSIONS: Brief, theory-informed mindfulness training enhanced learners’ self-regulation and reduced stress during high-fidelity military medical exercises. Although performance gains were not statistically significant, the findings suggest mindfulness is a feasible and scalable approach to strengthen psychological readiness in military medical education, with potential applications across military and civilian health professions training.

PMID:41252179 | DOI:10.1093/milmed/usaf571

Environ Entomol. 2025 Nov 18:nvaf114. doi: 10.1093/ee/nvaf114. Online ahead of print.

ABSTRACT

One of the main challenges in improving agricultural productivity is the prevalence of pests and diseases, which are highly sensitive to extreme weather conditions. The interaction between weather patterns and pest infestations significantly affects crop yield. Traditional statistical methods often struggle to capture the complex temporal and geographical dynamics of these interactions. However, employing multivariate cointegration has proven valuable for estimating such interactions and quantifying the extent to which various environmental conditions influence pest populations. The study further investigated impulse response functions, which revealed substantial impacts of temperature and relative humidity on pest populations through unit standard deviation shocks to endogenous variables. Specifically, this research examined the dynamic causal relationships between major pest occurrences and environmental variables in 3 groundnut-growing states of India-Andhra Pradesh, Gujarat, and Tamil Nadu, using cointegration and Vector Error Correction Model techniques. The analysis incorporated key environmental variables, including temperature, relative humidity, and rainfall. Results from the Johansen test indicated a strong long-term equilibrium relationship between pest populations and climatic conditions, confirming the presence of at least one cointegrating vector at the 5% significance level. Granger causality tests further revealed that temperature and relative humidity had a unidirectional causal influence on the pest occurrence. Additionally, impulse response analysis further revealed that shocks to temperature and relative humidity produced significant and persistent effects on pest incidence over time.

PMID:41252177 | DOI:10.1093/ee/nvaf114

Proc Natl Acad Sci U S A. 2025 Nov 25;122(47):e2504913122. doi: 10.1073/pnas.2504913122. Epub 2025 Nov 18.

ABSTRACT

The architectures of biological neural networks result from developmental processes shaped by genetically encoded rules, biophysical constraints, stochasticity, and learning. Understanding these processes is crucial for comprehending neural circuits’ structure and function. The ability to reconstruct neural circuits, and even entire nervous systems, at the neuron and synapse level, facilitates the study of the design principles of neural systems and their developmental plan. Here, we investigate the developing connectome of Caenorhabditis elegans using statistical generative models based on simple biological features: neuronal cell type, neuron birth time, cell body distance, reciprocity, and synaptic pruning. Our models accurately predict synapse existence, degree profiles of individual neurons, and statistics of small network motifs. Importantly, these models require a surprisingly small number of neuronal cell types, which we infer and characterize. We further show that to replicate the experimentally observed developmental path, multiple developmental epochs are necessary. Our model’s predictions of the synaptic connections and their strength, using multiple reconstructions of adult worms, reflect that it identified much of the shared part of the connectivity graph. Thus, the accuracy of the generative statistical models we use here offers a general framework for studying how connectomes develop and the underlying principles of their design.

PMID:41252150 | DOI:10.1073/pnas.2504913122