Category: Statistics

J Speech Lang Hear Res. 2025 Nov 7:1-12. doi: 10.1044/2025_JSLHR-25-00336. Online ahead of print.

ABSTRACT

PURPOSE: Intensive comprehensive aphasia programs (ICAPs) are a novel service delivery model incorporating best practice principles in aphasia rehabilitation. Despite increased evidence, adoption of this model into health care services remains limited. This study evaluated the feasibility and effectiveness of the comprehensive, high-dose aphasia treatment (CHAT) program, a modified-ICAP, when implemented by a public rehabilitation facility in Brisbane, Australia.

METHOD: A nonrandomized, Type II hybrid clinical implementation and effectiveness study design was employed. The CHAT program includes 50 hr of goal-directed aphasia rehabilitation, delivered over 8 weeks. Sixty-seven adults with poststroke aphasia consented to the study. Feasibility was evaluated using service statistics (i.e., referrals, adherence, dose) and analyzed using descriptive statistics. Effectiveness evaluated changes in participants’ language impairment, communication activity and participation, and quality of life at posttherapy and 3-month follow-up. Group-level data were analyzed using linear mixed models and Cohen’s d effect sizes. Minimal detectable change (MDC₉₀) was used to determine changes at the individual participant level.

RESULTS: Fourteen cohorts of CHAT were delivered from February 2021 to December 2023. Sixty-five participants completed CHAT, with an average dose of 46.6 hr of therapy. Group-level analyses revealed significant improvements in participants’ language impairment, communication activity and participation, and quality of life (p < .05) at posttherapy and 3-month follow-up. Most participants (89%) demonstrated significant improvements on at least one outcome measure.

CONCLUSIONS: The CHAT program was feasibly delivered within a public, health care context and resulted in positive and enduring changes in participants’ language impairment, communication function, and quality of life.

SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.30522767.

PMID:41202268 | DOI:10.1044/2025_JSLHR-25-00336

Phys Rev Lett. 2025 Oct 24;135(17):173401. doi: 10.1103/nkm3-1725.

ABSTRACT

Recent experiments have shown that raising the temperature of a dipolar gas under certain conditions leads to a transition to a supersolid state. Here, we employ the path integral Monte Carlo method, which exactly accounts for both thermal and correlation effects, to study that phenomenology in a system of ^{162}Dy atoms in the canonical ensemble. Our microscopic description allows the quantitative characterization of the emergence of spatial order and superfluidity, the two ingredients that define a supersolid state. Our calculations prove that temperature on its own can promote the formation of a supersolid in a dipolar system. Furthermore, we bridge this exotic phenomenology with the more usual melting of the supersolid at a higher temperature. Our results offer insight into the interplay between thermal excitations, the dipole-dipole interaction, quantum statistics, and supersolidity.

PMID:41202245 | DOI:10.1103/nkm3-1725

Hum Vaccin Immunother. 2025 Dec;21(1):2585544. doi: 10.1080/21645515.2025.2585544. Epub 2025 Nov 7.

ABSTRACT

Diabetes mellitus (DM) predisposes individuals to respiratory tract infections (RTIs), making vaccination an essential preventive measure; however, evidence regarding vaccination awareness, uptake, and barriers among DM patients in Saudi Arabia is limited. This study aimed to assess the awareness, uptake, and barriers related to influenza, pneumococcal, and COVID-19 vaccinations among adults with DM in Saudi Arabia. A cross-sectional survey was conducted between December 2023 and March 2025 among 1,556 adults with type 1 and type 2 DM attending endocrinology clinics across three sites. A structured questionnaire evaluated awareness, uptake, and barriers, and data were analyzed using descriptive statistics and chi-square tests. Uptake rates were 60.8% for influenza, 88.7% for COVID-19, and 27.1% for pneumococcal vaccines, with pneumococcal vaccination lower in type 1 than type 2 DM (23.2% vs. 28.5%; p = .002) and COVID-19 vaccination higher in type 2 DM (90.1% vs. 84.6%; p = .001). Influenza infection was more common in type 2 DM (58.6% vs. 52.4%; p = .030), while pneumonia was less frequent in type 1 DM (10.2% vs. 16.3%; p = .003). Overall, 82.6% recognized the purpose of vaccination and 70.4% agreed that DM patients should be vaccinated, though misconceptions persisted, especially regarding pneumococcal vaccine efficacy. Healthcare providers were the main information source for influenza (45.6%) and pneumococcal vaccines (23.6%), while social media predominated for COVID-19 (49.1%). Despite reasonable awareness, vaccine uptake remains suboptimal, highlighting the need for targeted education and stronger healthcare provider engagement.

PMID:41202216 | DOI:10.1080/21645515.2025.2585544

J Am Chem Soc. 2025 Nov 7. doi: 10.1021/jacs.5c11854. Online ahead of print.

ABSTRACT

Herein, we report a ligand-controlled chemodivergent bismuth-catalyzed coupling between arylboronic acids and N-fluorosulfonimide derivatives that enables the selective formation of either C(sp²)-N or C(sp²)-O bonds. Selectivity is achieved by the modulation of the electronic and steric properties of a common ligand framework for bismuth, thus establishing an unusual ligand-controlled chemodivergent platform in main group catalysis. Specifically, the use of an electron-enrich sulfone ligand led to the major formation of sulfonimide with selectivities ranging from 2:1 to more than 20:1. Conversely, a bismuth catalyst supported by an electron-deficient sulfoximine predominantly promoted the sulfonimidate product with ratios ranging between 5:1 and 15:1. To understand the underlying principles that control the selectivity, a comprehensive mechanistic investigation was conducted by combining experimental stoichiometric studies, DFT calculations, and statistical modeling. These studies support a catalytic high-valent bismuth redox cycle, where Bi(V) intermediates dictate product selectivity through either a three- or five-membered reductive elimination-ligand coupling event. By means of statistical modeling, we identified that the charge of the coordinating heteroatom through hypervalency, together with a steric parameter around the bismuth, is the key parameter responsible for the stabilization of the relevant transition states that lead to control over the reductive elimination process.

PMID:41202213 | DOI:10.1021/jacs.5c11854

JMIR Form Res. 2025 Nov 7;9:e71911. doi: 10.2196/71911.

ABSTRACT

BACKGROUND: Older adults undergoing surgeries face increased risks of postoperative neurocognitive disorders, which impair cognitive functions. Analog neurocognitive tests are commonly used, but digital tests offer faster, more accessible assessments.

OBJECTIVE: The primary aim of this study was to evaluate the feasibility of a digital cognitive test battery in older adults undergoing abdominal surgery. Feasibility included estimation of recruitment and retention rates, acceptability, perceived value, and usability of the test. The secondary aim was to explore outcome trajectories of cognition, depression, functional status, and quality of recovery.

METHODS: This nonrandomized feasibility study measured recruitment and retention rates using patient logs and expanded on these findings in semistructured interviews with nurses. Acceptability, perceived value, and usability were explored through interviews with patients and nurses, and the System Usability Scale (SUS). Cognitive functions were assessed with a digital cognitive test battery (Consortium to Establish a Registry for Alzheimer Disease [CERAD] word list learning test, Trail Making Test Parts A and B, Victoria Stroop Test, and Symbol Digit Pairing Test) and the Nursing Delirium Screening scale (NU-DESC), and depression with the Geriatric Depression Scale (GDS-15). Functional status was measured using the World Health Organization Disability Assessment Schedule (WHODAS), and postoperative recovery with the Swedish Quality of Recovery questionnaire (SwQoR-24). Quantitative data were analyzed using descriptive statistics and nonparametric tests and qualitative data with content analysis.

RESULTS: The test battery was feasible, acceptable, and demonstrated excellent usability. The mean SUS score was 87 (SD 17.9; 95% CI 78.9-95.2), and all predefined progression criteria were met. Recruitment spanned over 1.5 years, during which 24 patients were included (mean age of 77, SD 6.5 years; range: 63-90 years; n=13, 54% women). Most patients underwent laparoscopic colorectal cancer surgery. Three patients developed postoperative delirium for 1 day only. No patient developed delayed neurocognitive recovery or mild/major neurocognitive disorder at the postoperative follow-up. Qualitative data showed that both nurses and patients regarded the digital cognitive test battery as important for assessing cognitive function and found it easy to use and understand. Nurses reported that recruitment was challenging, partly because not all patients attended a preoperative in-person consultation before surgery.

CONCLUSIONS: The digital, self-administered cognitive test battery was found to be feasible, acceptable, and usable in older adults undergoing abdominal surgery. However, recruitment challenges and a small, homogeneous sample limit generalizability and warrant careful consideration in a larger-scale study.

PMID:41202209 | DOI:10.2196/71911

JMIR Form Res. 2025 Nov 7;9:e72468. doi: 10.2196/72468.

ABSTRACT

BACKGROUND: Osteoporosis-related fractures significantly impact older adults, often leading to disability and even premature death. While pharmacological and nonpharmacological interventions are widely recommended for managing osteoporosis, adherence to these interventions remains low. To address this challenge, we developed the Healthy Bone digital platform (desktop, mobile app, and smart TV internet-based) for use in clinical settings to improve disease management and treatment adherence. It integrates a multimedia health-related behavioral change program with a patient monitoring and management system.

OBJECTIVE: This study aimed to evaluate the usability and user experience of the desktop version of the Healthy Bone digital platform prototype from the patients’ perspective. The findings will provide valuable insights into optimizing the digital platform and enhancing its functionality.

METHODS: A mixed-methods study was conducted. During usability testing, patients completed tasks simulating real-world use of the platform while using a Think-Aloud approach. After each task, participants filled out an After Scenario Questionnaire to assess task satisfaction. Subsequently, participants completed the System Usability Scale (SUS) and the eHealth Usability Benchmarking Instrument (HUBBI) to measure usability quantitatively. Following this, semistructured interviews were conducted to explore participants’ experiences with the platform in greater depth. Descriptive statistics were used for quantitative analysis. Qualitative data analysis involved a combined deductive and inductive approach, ensuring a comprehensive evaluation of the platform’s usability and user experience. Deductive content analysis was guided by an ontology of eHealth usability components, while thematic analysis adhered to Braun and Clarke’s method to identify emerging themes.

RESULTS: Seven participants evaluated the digital platform, reporting high usability with a mean overall SUS score of 87.1 (SD 13.3). Similarly, good usability was reported across all categories of the HUBBI, except for the guidance and support category, which presented moderate levels of usability (mean 3.3, SD 1.1). Patients reported high levels of task satisfaction and identified 24 unique usability issues, predominantly related to the basic system performance, interface design, and navigation and structure categories of the eHealth usability ontology. Overall, patients had positive perceptions and acceptability of the digital platform, highlighting its simplicity, accessibility, utility, and potential to empower those with osteoporosis. Barriers to usage included limited skills, lack of suitable equipment, and time, while facilitators included motivation for behavior change, health benefits, and the decrease of potential inequalities.

CONCLUSIONS: This study provided valuable insights into the usability and user experience of the desktop version of the Healthy Bone digital platform prototype. These findings will play a key role in optimizing the platform to ensure it is effectively tailored to the needs of the target population. This platform adds an understanding of how various information and communication technology tools can support and benefit large numbers of osteoporosis patients in society.

PMID:41202207 | DOI:10.2196/72468

JCO Clin Cancer Inform. 2025 Nov;9:e2500122. doi: 10.1200/CCI-25-00122. Epub 2025 Nov 7.

ABSTRACT

PURPOSE: We developed and validated a dual-purpose, open-access Rural-Urban Commuting Area (RUCA) tool to standardize geographic coding for cancer disparities research, addressing National Institutes of Health (NIH) Helping to End Addiction Long-term (HEAL) Initiative Common Data Element requirements while supporting institutional catchment area analyses.

METHODS: This web-based tool¹⁶ integrates US Department of Agriculture RUCA codes with census tract data and electronic health record systems, meeting NIH HEAL Initiative Findable, Accessible, Interoperable, and Reusable (FAIR) data ecosystem requirements. We implemented the tool using Wake Forest Cancer Center’s 2023 registry data (n = 21,219) and conducted systematic comparison with county-level Rural-Urban Continuum Code (RUCC) classifications using 18,714 cancer cases across 336 ZIP codes, focusing on breast, colon, and lung cancers to demonstrate enhanced geographic granularity.

RESULTS: Among 21,219 patients with cancer, 19.51% (n = 4,140) resided in rural areas, with 4.81% (n = 1,022) in the most rural census tracts (RUCA codes 7-10). Comparative analysis revealed 9.4% disagreement between RUCA and RUCC classifications, affecting 1,765 patients. Twenty-eight ZIP codes classified as rural by RUCA were located within metropolitan counties according to RUCC, encompassing 109 patients with cancer who would be misclassified using county-level measures. As a separate use case, integration with NIH HEAL Initiative standardized rurality data collection across 15 research studies.

CONCLUSION: The RUCA tool addresses critical gaps in geographic data standardization by providing census tract-level precision that county-level classifications miss. This dual-application framework aligns institutional catchment analyses with national standardization efforts, identifying 109 patients with cancer who would be misclassified as urban residents using traditional county-level approaches, thereby enhancing targeted interventions for rural cancer care access.

PMID:41202192 | DOI:10.1200/CCI-25-00122

JCO Clin Cancer Inform. 2025 Nov;9:e2500086. doi: 10.1200/CCI-25-00086. Epub 2025 Nov 7.

ABSTRACT

PURPOSE: Partial nephrectomy has been advocated as the preferred surgical approach for small kidney tumors over total nephrectomy. However, partial nephrectomy is associated with increased perioperative risk. Estimating renal function after nephrectomy can facilitate personalized patient counseling, guide surgical approach, and identify patients who could benefit from perioperative interventions. Existing prediction models have several limitations including the lack of external validation or a user-friendly tool or application, and most have used traditional statistical methods.

METHODS: We used data from two academic medical institutions and machine learning (ML) methods to develop and externally validate renal function after nephrectomy-machine learning (RFAN-ML), a model to estimate long-term renal function after partial or total nephrectomy. Boruta feature selection was used to select four routinely available clinical features, specifically age, BMI, preoperative renal function, and nephrectomy type. In the training set of 1,932 patients, we compared six ML regression models representing a set of both ensemble and nonensemble ML algorithms and optimized for root mean squared error (RMSE). This model was evaluated in a test set of 1,995 patients, and the best performing model was selected as RFAN-ML.

RESULTS: We compared RFAN-ML with existing renal function prediction benchmarks and found that RFAN-ML outperformed or had competitive performance with benchmarks on RMSE (16.6 [95% CI, 15.6 to 17.5]), R², and mean absolute error.

CONCLUSION: We developed and externally validated RFAN-ML, a ML model to predict renal function after nephrectomy, and have deployed our model online. RFAN-ML has the potential to improve the care and outcomes in patients with kidney tumors by informing personalized patient counseling and guiding surgical planning.

PMID:41202191 | DOI:10.1200/CCI-25-00086

PLoS One. 2025 Nov 7;20(11):e0336111. doi: 10.1371/journal.pone.0336111. eCollection 2025.

ABSTRACT

The trans-theoretical model of behavior change (TTM) is widely used to assess an individual’s readiness to perform the new behavior and categorizes the behavior change into five stages: “pre-contemplation, contemplation, preparation, action, and maintenance.” This study focuses on assessing smoking cessation counseling practices (SCC) among Jordanian healthcare providers (HCPs) across various settings using the TTM. A cross-sectional study was conducted among HCPs (i.e., pharmacists, nurses, physicians, and dentists) working in private and public healthcare settings, using an online self-administered questionnaire. A total of 443 HCPs were included. One-third of HCPs reported asking patients if they smoked at their “first visit only.” Only 24.2% advised every patient to stop smoking, while 17.6% went beyond to assist smokers to make quit attempts, and (16.5%), assessed the willingness of the patients to quit and arrange follow-up quit attempts (10.6%). Only 28.4% of HCPs received training on SCC techniques. The majority of HCPs had a moderate level of confidence in performing SCC practices. HCPs in the private sector were more likely to be active in SCC practices than those in the public sector. Dentists and physicians were more involved in SCC practices than nurses and pharmacists. The study found a significant relationship between HCPs’ stage of change, self-efficacy, and performing SCC practices. This study affords a better understanding of the HCPs’ SCC practices. HCPs are found not to fully perform the “5 As” guidelines in their practices. Future efforts should focus on training and developing education programs that encourage HCPs to perform SCC practice.

PMID:41202117 | DOI:10.1371/journal.pone.0336111

PLoS One. 2025 Nov 7;20(11):e0335445. doi: 10.1371/journal.pone.0335445. eCollection 2025.

ABSTRACT

The coral microbiome can strongly influence coral health, development, and resilience. While larval settlement is fundamental for coral restoration efforts using assisted larval propagation, post-settlement survival remains a major challenge. The study of lab-bred Orbicella faveolata settlers (LBOFS) microbiome has been proposed due to its potential role in coral adaptation processes. However, there is limited information about LBOFS bacterial communities and comparisons between different growth conditions and life-cycle stages have not been conducted. Using 16S rRNA high-throughput sequencing, we analyzed the structure and composition of LBOFS-associated bacteria and compared them to those from outplanted LBOFS and wild settlers. We also compared the microbiomes of settlers to adult colonies. The LBOFS bacterial community was composed of 4224 ASVs with the Orders Kiloniellales, Rhodobacterales, Cytophagales, Cyanobacteriales, and Flavobacteriales being the most abundant across the samples, with a rare biosphere consisting of 44.6% relative abundance. A Principal Coordinates Analysis and a PERMANOVA indicated significantly different bacterial community structures based on settler growth conditions and life-cycle stage. Linear discriminant analysis Effect Size analysis identified specific taxa whose differential abundances contributed to the observed differences. For settler growth conditions, the differences were mainly due to the Order Cyanobacteriales for LBOFS, SAR202 clade for outplanted settlers, and Microtrichales for wild samples. Statistical analysis of functional prediction showed significant differences only in nitrogen fixation for LBOFS. For life-cycle stage, LEfSe revealed that the Orders Cytophagales and Cyanobacteriales exhibited the highest differential abundances in adults and settlers, respectively. Functional prediction revealed that nitrogen fixation and oxygenic photoautotrophy were more enriched in settlers, whereas nitrate reduction and anaerobic chemoheterotrophy were more enriched in adults. This study highlighted the bacterial taxa and predicted metabolic processes that could potentially contribute to coral settler functioning, providing a valuable baseline for future research to enhance their survival rates using probiotics.

PMID:41202107 | DOI:10.1371/journal.pone.0335445