Category: Statistics

Psychol Methods. 2025 Feb 20. doi: 10.1037/met0000730. Online ahead of print.

ABSTRACT

Confirmatory bifactor models have become very popular in psychological applications, but they are increasingly criticized for statistical pitfalls such as tendency to overfit, tendency to produce anomalous results, instability of solutions, and underidentification problems. In part to combat this state of affairs, many different reliability and dimensionality measures have been proposed to help researchers evaluate the quality of the obtained bifactor solution. However, in empirical practice, the evaluation of bifactor models is largely based on structural equation model fit indices. Other critical indicators of solution quality, such as patterns of general and group factor loadings, whether all estimates are interpretable, and values of reliability coefficients, are often not taken into account. In addition, in the methodological literature, some confusion exists about the appropriate interpretation and application of some bifactor reliability coefficients. In this article, we accomplish several goals. First, we review reliability coefficients for bifactor models and their correct interpretations, and we provide expectations for their values. Second, to help steer researchers away from structural equation model fit indices and to improve current practice, we provide a checklist for evaluating the statistical fit of bifactor models. Third, we evaluate the state of current practice by examining 96 empirical articles employing confirmatory bifactor models across different areas of psychology. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

PMID:39977687 | DOI:10.1037/met0000730

Salud Publica Mex. 2024 Apr 29;66(3, may-jun):256-266. doi: 10.21149/15253.

ABSTRACT

OBJECTIVE: To estimate usual intake and the prevalence of excessive intake (PE) and insufficient intake (PI) of trans fatty acids (FAs) and other dietary FAs in the Mexican adult population in 2012 and 2016, and to compare these time points.

MATERIALS AND METHODS: Data were collected through dietary recall using the five-step multiple-pass method of the 2012 and 2016 Mexican National Health and Nutrition Surveys. Prevalences were estimated using the Iowa State University method. Linear and logistic regressions were used for analytic comparisons.

RESULTS: Both in 2012 and 2016, we observed high PE in trans FA, saturated FA, and total fat. High PI was found for polyunsaturated FA, omega 6, omega 3, Eicosapentaenoic Acid (EPA) + Docosahexaenoic Acid (DHA). In 2016, PE was lower in trans FAs (29.1 vs. 38.4%), total fat (14.9 vs. 17.8%), saturated FAs (45.6 vs. 54.6%). PI was also lower in omega 3 FA (90.7 vs. 92.8%), omega 6 FA (39.8 vs. 62.2%), and EPA + DHA FA (96.3 vs. 99.6%; p<0.05) (p<0.05) vs 2012.

CONCLUSION: Mexican adults showed notably high PE in trans FA, saturated FA, and total fat, as well as high PI in polynsaturated FA, omega 6, omega 3, and EPA. Given the associated health risks, it is critical to implement nutrition policies that regulate trans and saturated FAs in Mexico and faciliate improved dietary quality towards more polyunsaturated and omega 3 FAs, and less trans and saturated FAs.

PMID:39977071 | DOI:10.21149/15253

Salud Publica Mex. 2024 Jan 26;66(2, mar-abr):119-129. doi: 10.21149/14856.

ABSTRACT

OBJECTIVE: To compare Covid-19 risk factors, self-reported Covid-19 testing and infection, and Covid-19 vaccination among H-2A workers and agricultural workers without H-2A visas.

MATERIALS AND METHODS: Farmworkers completed surveys at randomly selected sites in five U.S. states from March – August 2022. Descriptive statistics and bivariate analyses were conducted for key characteristics and outcomes.

RESULTS: A total of 532 H-2A workers and 748 non-H-2A workers participated in the surveys. H-2A workers had significantly higher Covid-19 primary vaccine series uptake than non-H-2A workers (94.7 vs. 65.9%). More than one in four H-2A workers (29.6%) continued working while ill or positive with Covid-19. Fewer H-2A than non-H-2A workers reported receiving a Covid-19 test (51.5 vs. 59.2%, respectively) and a positive test result for Covid-19 (24.5 vs. 44.9% among those tested).

CONCLUSIONS: Although H-2A workers had a lower self-reported prevalence of Covid-19 and higher Covid-19 primary vaccine series uptake than non-H-2A workers, findings such as reporting to work while ill or positive for Covid-19 indicate areas for improvement by binational public health leaders.

PMID:39977040 | DOI:10.21149/14856

Am J Hypertens. 2025 Feb 20:hpaf026. doi: 10.1093/ajh/hpaf026. Online ahead of print.

ABSTRACT

INTRODUCTION: Evidence on left ventricular (LV) mechanics, assessed by speckle tracking echocardiography (STE), in children and adolescents with elevated blood pressure (BP)/hypertension is scanty.

AIM: The aim of the present meta-analysis was to provide an updated information on LV systolic function phenotyped by global longitudinal strain (GLS) and LV ejection fraction (LVEF) in the setting of pediatric hypertension.

METHODS: Following the PRISMA guidelines, systematic searches were conducted across bibliographic databases (Pub-Med, OVID, EMBASE and Cochrane Library) to identify eligible studies from inception up to November 30th 2024. Clinical studies reporting data on LV mechanics in pediatric hypertension and controls were included. The statistical difference of the echocardiographic variables of interest between groups such as LVEF and GLS was calculated by standardized mean difference (SMD) with 95% confidence interval (CI) using random-effects models.

RESULTS: Eight studies including 719 individuals with elevated BP/hypertension and 1653 age-matched healthy controls were considered for the analysis. Pooled average LVEF values were 72.4±1.6% in the healthy control group and 72.5±1.8% in the elevated BP/hypertensive group (SMD: 0.08±0.15,CI: -0.21/0.36, p=0.60); the corresponding values of GLS were -19.6±1.1% and 18.5±0.9% (SMD:-0.96±0.25, CI: -1.46/-0.47, p< 0.0001). A parallel impairment of global circumferential strain (GCS) also emerged from pooled data of 3 studies (SMD: -0.96±0.25, CI: -1.46/-0.47, p< 0.0001).

CONCLUSIONS: Our data suggest that LVEF is unable to detect early alterations in systolic function in pediatric hypertension, and the implementation of STE may be highly useful in unmasking systolic dysfunction in this setting.

PMID:39977013 | DOI:10.1093/ajh/hpaf026

Am J Respir Crit Care Med. 2025 Feb 20. doi: 10.1164/rccm.202411-2169OC. Online ahead of print.

ABSTRACT

RATIONALE: Extended continuous positive airway pressure (eCPAP) in the neonatal intensive care unit (NICU) for stable preterm infants increases lung volumes. Its effect on lung growth after discharge is unknown.

OBJECTIVE: To assess whether 2-weeks of eCPAP in stable preterm infants is associated with increased alveolar volume (V_A) at 6-months corrected age.

METHODS: Randomized controlled trial conducted at Oregon Health & Science University. Outpatient assessors unaware of treatment assignment. 100 infants randomized to eCPAP versus CPAP discontinuation (dCPAP) to room air.

MEASUREMENTS: The primary outcome was V_A by the single breath hold technique at 6-months corrected age. Secondary outcomes included lung diffusion capacity to carbon monoxide (D_L) and forced expiratory flows (FEFs). Functional residual capacity (FRC) was measured in the NICU.

MAIN RESULTS: Infants randomized to eCPAP (n=54) versus dCPAP (n=46) had the following measurements shown as adjusted mean [SE] : V_A (500.2 [24.9 ] vs 418.1 [23.4] mL; adjusted mean difference, 82.1 [ 95% CI, 8.3-155.9]; p =0.033); D_L (3.4 [0.2] vs 2.8 [0.1] mL/min/mmHg; adjusted mean difference, 0.6 [95% CI, 0.1-1.1]; p = 0.018); FEF₅₀ (500.6 [18.2] vs 437.9 [17.9] mL/sec; adjusted mean difference, 62.7 [95% CI 4.5-121.0]; p = 0.039); FEF_25-75 (452.0 [17.4] vs 394.4 [17.4] mL/sec; adjusted mean difference, 57.5 [95% CI 1.3-113.8]; p=0.046).

CONCLUSIONS: Infants randomized to eCPAP vs dCPAP had significantly increased V_A at 6-months corrected age. D_L and FEFs were also increased. Extending CPAP in stable preterm infants in the NICU may be a non-pharmacologic and safe therapy to promote lung growth. Clinical trial registration available at www.

CLINICALTRIALS: gov, ID: NCT04295564.

PMID:39977011 | DOI:10.1164/rccm.202411-2169OC

Clin Exp Rheumatol. 2025 Feb 13. doi: 10.55563/clinexprheumatol/4g8g9q. Online ahead of print.

ABSTRACT

OBJECTIVES: Rheumatoid arthritis (RA) is a prevalent autoimmune disorder. This study examines the comparative efficacy of Janus kinase inhibitors (JAKi) and adalimumab (ADA) in managing RA.

METHODS: As of May 2024, four electronic databases were systematically reviewed: PubMed, Web of Science, Embase, and the Cochrane Library. Data were analysed using Review Manager (RevMan) software. The risk ratio (RR) and its 95% confidence interval (CI) represented dichotomous outcomes. Evaluated outcome measures included ACR20, ACR50, ACR70, Clinical Disease Activity Index (CDAI), Simplified Disease Activity Index (SDAI), and Disease Activity Score 28-4 (C-reactive protein) (DAS28-4(CRP)).

RESULTS: The analysis encompassed 6 studies, totalling 4048 patients with RA. There was no statistically significant difference in efficacy between JAKi and ADA when assessing ACR20 (p=0.25) and DAS28-4(CRP) (p=0.57). However, JAKi demonstrated superior efficacy compared to ADA for ACR50 (RR=1.20; p=0.02), ACR70 (RR=1.24; p=0.03), CDAI (RR=1.17; p=0.01), and SDAI (RR=1.19; p=0.006) outcomes. Longitudinal analysis revealed that over a 52-week period, JAKi did not exhibit superior efficacy to ADA for ACR50 (RR=1.16; p=0.19) and ACR70 (RR=1.10; p=0.26). Specifically, the tofacitinib subgroup outperformed ADA (RR=1.49; p=0.003), while other JAKi treatments did not show a significant difference (RR=1.19; p=0.11) compared to ADA.

CONCLUSIONS: JAKi generally offers better efficacy than ADA in the treatment of RA, though this advantage appears to be influenced by the duration of treatment.

PMID:39977004 | DOI:10.55563/clinexprheumatol/4g8g9q

J Am Chem Soc. 2025 Feb 20. doi: 10.1021/jacs.4c16922. Online ahead of print.

ABSTRACT

Triplet-triplet annihilation (TTA) enables photon upconversion by combining two lower-energy triplet excitons to produce a higher-energy singlet exciton. This mechanism enhances light-harvesting efficiency for solar energy conversion and enables the use of lower-energy photons in bioimaging and photoredox catalysis applications. The magnetic modulation of such high-energy excitons presents an exciting opportunity to develop molecular quantum information technologies. While the spin dynamics of triplet exciton pairs are sensitive to external magnetic fields, the magnetic field effects (MFEs) associated with these pairs are generally limited by spin statistics to at most 10% at low fields (<1 T), making them challenging to apply in technological advancements. In contrast, MFEs on spin-correlated radical pairs (SCRPs) can be significantly greater, surpassing those on triplet pairs. By using SCRPs-based molecular qubits as triplet sensitizers in the sensitized TTA scheme, we can magnetically modulate TTA and consequently, the delayed fluorescence of annihilators. In our current system, we have achieved more than 70% magnetic modulation of delayed fluorescence, effectively harnessing and even amplifying magnetic modulation within SCRPs to influence high-energy excitons. This work opens new opportunities for advancing spin-controlled chemical reactions and molecular quantum information technologies.

PMID:39976998 | DOI:10.1021/jacs.4c16922

Transplantation. 2025 Mar 1;109(3):496-503. doi: 10.1097/TP.0000000000005178. Epub 2024 Aug 28.

ABSTRACT

BACKGROUND: The number of deceased donor kidney transplants has been increasing and is at a record high, yet nonuse of kidneys recovered for transplantation has risen to 25.8% following circular kidney allocation system based on 250-nautical-mile circles implemented on March 15, 2021 (KAS250).

METHODS: Using Scientific Registry of Transplant Recipients data, we studied all deceased donor kidneys recovered for transplant from March 15, 2019, to January 31, 2023. We calculated the association of multiple factors with kidney nonuse, including increasing recovery of kidneys from nonideal donors, delays in offer acceptance observed under KAS250, and impacts of COVID-19.

RESULTS: In the 2 y before KAS250, the nonuse rate was 21.2%. Had this rate continued, 2334 more kidneys would have been transplanted through January 2023. We estimated that about 769 of these nonused kidneys (33%) were associated with offer acceptance delays under KAS250; about 994 of these nonused kidneys (43%) were associated with increased prevalence of nonideal donors: donation after circulatory death donors, older donors, and donors with elevated peak serum creatinine; and about 542 of these nonused kidneys (23%) were associated with an otherwise unexplained gradual upward trend in nonuse of recovered kidneys across the pre-KAS250 and KAS250 eras. The overall impact of COVID-19 on the nonuse rate was not significant.

CONCLUSIONS: The rise in kidney nonuse rate was significantly associated with both increased recovery of nonideal donors, and with KAS250 allocation complexity and delays. Increasing recovery of kidneys from nonideal donors benefits patients because recovering more kidneys increases the number of kidneys available for transplant.

PMID:39976985 | DOI:10.1097/TP.0000000000005178

JAMA Otolaryngol Head Neck Surg. 2025 Feb 20. doi: 10.1001/jamaoto.2024.5251. Online ahead of print.

ABSTRACT

IMPORTANCE: The internet has changed the way that medical information by journals is disseminated, with a shift toward online distribution. Given this, it is important to include alternative metrics that measure online attention when determining the influence of otolaryngology journals.

OBJECTIVE: To describe a ranking system for otolaryngology journals that reflects the amount of publicity received online and to determine factors associated with these rankings.

DESIGN AND SETTING: In this cross-sectional study, online attention was measured using Altmetric Attention Scores obtained for all 26 112 articles published by the 43 journals classified under the Journal Citation Reports category of otorhinolaryngology from 2018 to 2022. Data were analyzed from January to June 2023.

MAIN OUTCOMES AND MEASURES: Altmetric journal rankings were created from the top 500 articles with the highest Altmetric Attention Scores, using a rank sum weight-based method to assign credit for an article’s attention online to its respective journal. The association of article content, study design and type, and social media presence on X (formerly Twitter) with ranking was examined. Comparisons between Altmetric journal rankings and bibliometric rankings (5-year Impact Factor) were also performed.

RESULTS: Of 43 otolaryngology journals, JAMA Otolaryngology-Head & Neck Surgery had the highest Altmetric journal ranking. Most articles in the Altmetric top 500 were nonoperative clinical studies (220 articles [43.5%]) or described the natural history of disease (176 articles [34.9%]) and involved otology/neurotology (158 articles [29.9%]) or rhinology/allergy (134 articles [25.4%]). The COVID-19 pandemic was a common topic (169 articles [33.5%]). The presence of an active X account for the entire 5-year period was associated with a higher Altmetric total rank sum score for journals (η2 = 0.07; 95% CI, 0.02-0.13 [moderate effect size]). There was a moderate statistically significant correlation between Altmetric journal rankings and 5-year Impact Factor rankings (r = 0.5; 95% CI, 0.2-0.7).

CONCLUSIONS AND RELEVANCE: This cross-sectional study demonstrates that metrics based on online attention provide an alternative way to assess the reach and influence of medical journals. Journals seeking to expand their influence online may benefit from a presence on social media.

PMID:39976975 | DOI:10.1001/jamaoto.2024.5251

JAMA Netw Open. 2025 Feb 3;8(2):e2460565. doi: 10.1001/jamanetworkopen.2024.60565.

ABSTRACT

IMPORTANCE: Newborn mortality accounts for approximately 47% of all mortality of children under the age of 5 years. Virtual simulation may be a viable approach to support retention of essential newborn care knowledge and skills among health care professionals in low- and middle-income countries.

OBJECTIVE: To evaluate the association between mobile virtual simulation using Virtual Essential Newborn Care (vENC) and knowledge and skills retention in early newborn care in low-resource settings and to propose a frequency of virtual simulation use for among health care professionals who care for newborns in low-resource settings.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study was conducted at 23 primary, secondary, and tertiary health care facilities in Lagos, Nigeria, for 6 months between December 1, 2022, and June 30, 2023. Participants included nurses and midwives who participated in deliveries and provided newborn care. Potential participants who attended a Helping Babies Breathe or Essential Newborn Care (ENC) course within the past 1 year were excluded.

EXPOSURES: All participants received in-person training using the World Health Organization ENC 1 and ENC 2 curricula along with virtual simulation practice at variable recommended frequencies for 6 months after course completion.

MAIN OUTCOMES AND MEASURES: Primary outcomes included assessments of bag-valve-mask (BVM) ventilation skills, and performance on ENC 1 and ENC 2 case A and B scenarios conducted by trained research assistants before, immediately after, and 6 months after the in-person course. All scores ranged from 0% to 100%, with higher scores indicating better performance.

RESULTS: Of 70 enrolled participants (67 of 69 [97%] female), 62 (89%) completed the 6-month follow-up. Immediate posttraining performance (median [IQR] scores: BVM ventilation skills, 93% [86%-100%]; ENC 1 case scenario A, 72% [61%-78%]; ENC 1 case scenario B, 76% [68%-88%]; ENC 2 case scenario A, 80% [73%-87%]; and ENC 2 case scenario B, 88% [70%-95%]) improved compared with pretraining performance for all skill assessments (median [IQR] scores: BVM ventilation skills, 57% [29%-64%]; ENC 1 case scenario A, 39% [28%-50%]); ENC 2 case scenario A, 33% [20%-45%]) (all P < .001). There were further gains in performance at the 6-month follow-up assessment for BVM ventilation (median [IQR], 100% [86%-100%]; P = .04) and the ENC1 and ENC2 assessments by case scenario (case scenario A: ENC 1 median [IQR] score, 78% [72%-83%]; P = .001 and ENC 2 median [IQR] score, 87% [80%-93%]; P = .008; and case scenario B: ENC 1 median [IQR] score, 88% [76%-92%]; P = .009 and ENC 2 median [IQR] score, 93% [80%-100%]; P = .004) relative to the immediate postcourse assessment scores.

CONCLUSIONS AND RELEVANCE: Findings of this cohort study suggest that the app-based simulations may be effective in supporting the retention of knowledge and skills following ENC training and may contribute to further performance gains for health care professionals in low- and middle-income countries. More clinical and implementation research is needed to explore the impact of virtual simulations on health professionals’ clinical practices and neonatal outcomes.

PMID:39976968 | DOI:10.1001/jamanetworkopen.2024.60565