Category: Statistics

BMC Oral Health. 2025 Jul 11;25(1):1144. doi: 10.1186/s12903-025-06500-6.

ABSTRACT

BACKGROUND: Mobile dental photography is increasing in relevance in the diagnosis of oral diseases. This study aimed to evaluate the diagnostic accuracy of intraoral mobile photography in assessing caries experience intensity (decayed, missing/extracted, filled teeth [DMFT/deft]), simplified oral hygiene index, and modified gingival index.

METHODS: This study included 358 children of 7-12 years of age. A clinician evaluated DMFT/deft; simplified oral hygiene; and modified gingival indices by visual examination. Simultaneously, dental students recorded intraoral photographs with a mobile phone in eight predetermined projections. Another oral professional calculated indices based on the photographs. Sensitivity, specificity, and positive and negative predictive values of dental photography were evaluated, and Cohen’s kappa was calculated.

RESULTS: A total of 2864 photographs were evaluated in this study. The sensitivity and specificity of mobile photography for DMFT; deft; simplified oral hygiene, and modified gingival indices were 95.8 (95% confidence interval: 93.4-98.3) and 89.2 (83-95.5); 100.0 (100-100) and 88.6 (79.3-98); 89.7 (85.8-93.5) and 91.4 (86.3-96.5); and 77.6 (67.6-87.6) and 93.8 (91-96.6), respectively; positive predictive values were 96.2, 97.7, 95.6, and 74.3; negative predictive values 88.3, 100.0, 80.9, and 94.8; and Cohen’s Kappa values were 0.848, 0.928, 0.784, and 0.702, respectively.

CONCLUSIONS: Intraoral mobile photography, based on appropriate guidelines, is reliable for assessing DMFT/deft; simplified oral hygiene; and modified gingival indices in children and could be a useful tool in dental public health, supporting the involvement of dental students in similar research studies.

PMID:40646524 | DOI:10.1186/s12903-025-06500-6

BMC Oral Health. 2025 Jul 11;25(1):1145. doi: 10.1186/s12903-025-06202-z.

ABSTRACT

BACKGROUND: This study aimed to evaluate the effects of the COVID-19 pandemic on the lives, daily routines, health, and oral and dental health status of primary school children and their parents. In addition, the data of sociodemographic factors and various parameters were cross compared and analysed.

METHODS: This cross-sectional questionnaire study was conducted in 12 primary schools. The questionnaire included 55 questions about the socio-demographic characteristics of the children and their parents, the impact of the COVID-19 pandemic on their lives, daily routines, health, and oral and dental health, as well as their knowledge about these topics. Descriptive statistical methods were used to evaluate the data. Chi-square test was mainly used to analyze the relationships between categorical variables.

RESULTS: The study included the data of 2.466 children and their parents. The prevalence of stress was high in parents (63.7%) and their children (52.1%). The proportion of those whose sleep patterns changed was higher among parents and children who were stressed by the pandemic (p < 0.01). During the pandemic, 59.9% of children increased their screen time. Among parents and children who experienced stress, the proportion of those whose dietary habits changed was higher than those who did not (p < 0.01). For both parents (68.9%) and children (68.5%), the proportion of those who experienced changes in daily routines was high, and who experienced stress due to the pandemic changed their daily routines more (p < 0.01). The rate of unchanged oral hygiene habits was higher for both parents (74.0%) and their children (77.1%). Monthly income, education level of parents and class grade of the child were found significant on these alterations.

CONCLUSION: The pandemic had an impact on the stress levels, sleep patterns, dietary habits, daily routines, and screen time of primary school-aged children and their parents. In future studies, it would be beneficial to address the consequences of the negative effects of the pandemic and the effectiveness of the strategies developed.

PMID:40646522 | DOI:10.1186/s12903-025-06202-z

BMC Psychiatry. 2025 Jul 11;25(1):695. doi: 10.1186/s12888-025-07011-y.

ABSTRACT

INTRODUCTION: Community-based peer support complements regional mental health services by supporting individuals in their personal recovery process. This study aimed to investigate the effectiveness of the ‘Paths to everyday life’ (PEER) intervention, which adds group-based peer support to service as usual (SAU) for individuals with mental health difficulties, compared to SAU alone.

METHODS: A randomized controlled trial in five Danish municipalities compared the PEER intervention added to SAU to SAU alone. Participants were municipality social service users and self-referrals. The primary outcome was personal recovery, measured by Questionnaire about the Process of Recovery (QPR-15) at post-intervention. Intention-to-treat analyses were used for primary and safety outcomes.

RESULTS: Of the 296 participants included from December 7, 2020, to October 16, 2022, 145 participants received the PEER intervention, and 151 participants received SAU alone. Primary outcome results showed model estimated marginals means in the PEER group [37.3; 95% CI: 35.4 to 39.1] versus SAU alone [32.1; 95% CI: 30.2 to 34.1]. A statistically significant mean difference in QPR-15 scores was seen in the PEER group [5.1; 95% CI: 2.4 to 7.8; p < 0.001] versus SAU alone, corresponding to Cohen’s d of 0.43. No significant between-group differences in hospital admissions or bed days, and no deaths or detectable self-harm were registered during follow-up.

CONCLUSIONS: The primary outcome, personal recovery, showed a significant difference that exceeded the clinically meaningful change, with a small to medium effect size, among adults with mental health difficulties. If the PEER intervention proves cost-effective, implementation in the communities is recommended.

CLINICAL TRIAL REGISTATION: ClinicalTrials.gov: NCT04639167, registered Nov. 19, 2020, finished May 20, 2024.

PMID:40646520 | DOI:10.1186/s12888-025-07011-y

BMC Nurs. 2025 Jul 11;24(1):907. doi: 10.1186/s12912-025-03543-6.

ABSTRACT

BACKGROUND: Role-play’- one of the teaching techniques utilised in contemporary teaching appears to be a new trend that has been developing in the field of education.

PURPOSE: This study aimed to determine the effect of the ‘role-play’ technique implemented on the fourth-year students attending the Faculty of Nursing at the Near East University in Northern Cyprus on their attitudes towards student-centred teaching techniques.

METHODS: This study was designed as a single group quasi-experimental study with pretest and posttest. The study was conducted with the fourth-year nursing students (n = 131). The data were collected using the ‘Data Collection Form’ and ‘Scale of Attitudes Towards Using Student-Centred Teaching Methods and Techniques’. After conducting the pretest, the students were divided into twelve groups. A script was drafted for each group and the role-play was performed in front of the class. After the practices were completed, posttest was applied. All necessary permissions were obtained to conduct the study. The collected data were evaluated in the SPSS 25.0. Data were evaluated with 95% confidence interval and p = 0.05 error margin.

RESULTS: A statistical difference was found between the pretest (96.16 ± 12.00) and posttest (99.29 ± 8.51) mean scores of the students on the ‘scale of attitudes towards using student-centred teaching methods and techniques’ (p = 0.006).

CONCLUSION: The integrated use of the role-play technique in the vocational course of nursing had a positive effect on students’ attitudes towards student-centred techniques. This situation contributes to the development of students’ knowledge and skills in vocational courses.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40646514 | DOI:10.1186/s12912-025-03543-6

Accid Anal Prev. 2025 Jul 10;220:108147. doi: 10.1016/j.aap.2025.108147. Online ahead of print.

ABSTRACT

Incorporating random parameters (RPs) into generalized linearized models (GLMs) – such as the negative binomial (NB) regression model used to predict crash frequencies – has been shown to improve model fit and better address issues such as unobserved heterogeneity. However, applying models with RPs to make predictions for observations outside the sample used to estimate the model is not straightforward. Recent studies have proposed various methods to incorporate RPs in out-of-sample predictions, but these tend to provide biased estimates or are computationally intensive to apply. This paper applies fundamental statistical theory to leverage properties of the underlying RP distributions incorporated into GLMs to provide more direct and accurate predictions, as well as directly estimate prediction variance for out-of-sample observations. Methods are provided for several common RP distributions – including the normal/Gaussian, lognormal, triangular, uniform, and gamma distributions – combined within log-link GLM framework. Additionally, closed-form equations for elasticities and marginal effects for the random parameters are provided. The proposed methods are tested using crash frequency prediction models developed using data from the Highway Safety Information System (HSIS). The results suggest that the proposed exact method provides more accurate predictions than the computational-intensive simulation-based approximation approaches while also being simple to apply. The method is suitable for the widespread use of RPs in research and in practical applications of GLMs.

PMID:40644756 | DOI:10.1016/j.aap.2025.108147

Explore (NY). 2025 Jun 25;21(4):103201. doi: 10.1016/j.explore.2025.103201. Online ahead of print.

ABSTRACT

The aim of this study was to determine the effect of laughter yoga on hemodialysis patients’ disease acceptance, treatment adherence and comfort levels. This randomized controlled study was conducted with 42 patients (experimental group=21, control group=21) who were treated in the hemodialysis unit. Hemodialysis patients in the experimental group received 12 sessions of laughter yoga for four weeks, three days a week. Data were collected using Patient Information Form, Disease Acceptance Scale, End-Stage Renal Disease Adherence Questionnaire, and Hemodialysis Comfort Scale. A significant difference was found between the disease acceptance scale (t(41) = 4.39, p < 0.001, d = 1.364), end-stage renal failure adaptation scale (t(41) = 2.69, p = 0.010, d = 0.830) and hemodialysis comfort scale (t(41) = 5.58, p = 0.010, d = 1.710) of hemodialysis patients who underwent laughter yoga. In addition for the Disease Acceptance Scale, the SD of the pre-test scores was 7.51. Accordingly, the MCID thresholds were calculated as 3.75 (0.5 SD), 3.11 (1 SEM), and 6.09 (1.96 SEM). For the End-Stage Renal Disease Adherence Questionnaire, the SD was 178.79, and the MCID was calculated as 89.40 (0.5 SD), 63.47 (1 SEM), and 124.39 (1.96 SEM). For the Hemodialysis Comfort Scale, the SD was 6.43, resulting in MCID estimates of 3.21 (0.5 SD), 2.01 (1 SEM), and 3.94 (1.96 SEM). Laughter yoga practiced during hemodialysis increased acceptance of the disease, adherence to treatment, and comfort (p < 0.05). In contrast, no statistically significant difference was found in the control group (p > 0.05). Increasing hemodialysis patients’ acceptance of the disease, adherence to treatment, and comfort levels ensure the successful continuation of the disease management process. The practice of laughter yoga in clinics during hemodialysis sessions is recommended to increase disease acceptance, adherence to treatment and comfort levels.

PMID:40644747 | DOI:10.1016/j.explore.2025.103201

Semin Arthritis Rheum. 2025 Jun 27;74:152777. doi: 10.1016/j.semarthrit.2025.152777. Online ahead of print.

ABSTRACT

OBJECTIVE: To test the discriminating capacity of different thresholds of the Assessment of SpondyloArthritis international Society Health Index (ASAS HI) in placebo-controlled trials of patients with axial spondyloarthritis (axSpA), including radiographic (r-axSpA) and non-radiographic (nr-axSpA) subtypes.

METHODS: The discriminating capacities of absolute (≥2.0-≥4.0 points) and relative (≥20%-≥50%) ASAS HI improvement thresholds were evaluated in patients with axSpA from three COAST trials (COAST-V, COAST-W, and COAST-X) of ixekizumab every 4 weeks (IXE Q4W) vs. placebo. Threshold-based response rates at Week 16 were compared between trial arms using Fisher’s exact test. Odds ratios and phi coefficients were used to evaluate how strongly each improvement threshold was associated with treatment allocation in a given trial. Missing data were handled using non-responder imputation.

RESULTS: ASAS HI data were available at baseline and Week 16 for 587 patients in IXE Q4W and placebo arms. The ASAS HI ≥30% improvement threshold effectively discriminated treatment allocation in all trials; significant differences were observed between IXE Q4W and placebo in r-axSpA (COAST-V: p = 0.026; COAST-W: p = 0.023) and nr-axSpA (COAST-X: p = 0.040). Lower absolute (≥2.0-≥3.0 points) and relative (≥20%-≥30%) thresholds discriminated effectively in COAST-W, whereas higher absolute (≥3.5-≥4.0 points) and relative (≥30%-≥50%) thresholds discriminated effectively in COAST-V. In COAST-X, ≥30%, ≥40%, and ≥50% thresholds discriminated effectively. Phi coefficients were small (<0.3) across all trials and thresholds.

CONCLUSIONS: Several ASAS HI improvement thresholds discriminated axSpA patients in treatment vs. placebo arms at Week 16. The ASAS HI ≥30% improvement threshold discriminated across all three COAST trials.

PMID:40644736 | DOI:10.1016/j.semarthrit.2025.152777

J Neurosurg. 2025 Jul 11:1-12. doi: 10.3171/2025.3.JNS241757. Online ahead of print.

ABSTRACT

OBJECTIVE: The Neurosurgery Research & Education Foundation (NREF) Medical Student Summer Research Fellowship (MSSRF) is a prominent research fellowship offered to medical students. The authors investigated how gender and academic characteristics of the MSSRF applicant pool have evolved since the fellowship’s inception. Likewise, they evaluated the impact of the MSSRF on career progression, scholarly productivity, and subsequent grant funding within neurosurgery.

METHODS: A list of MSSRF awardees (2008-2023) and nonawardee applicants (2015-2023) was provided by the NREF. Demographic and career progression variables were obtained through publicly available platforms, and scholarly productivity metrics were collected using Clarivate Web of Science. The Fisher’s exact test was used to compare categorical variables, the Mann-Whitney U-test was used to compare continuous variables, and the Mann-Kendall test was used to assess trends. Binary logistic regression was utilized to explore factors associated with matching into neurosurgery.

RESULTS: A total of 297 awardees from 2008 to 2023, 183 awardees from 2015 to 2023, and 355 nonawardees from 2015 to 2023 were included. A greater percentage of awardees attended a top 20 medical school than nonawardees (p = 0.002). There was a statistically significant upward trend in the percentage of female awardees since 2010 (p = 0.01). Between 2015 and 2023, there was no difference in the percentage of awardees who matched into neurosurgery compared to nonawardees (60.5% vs 50.2%, p = 0.07), but awardees matched into better Doximity-ranked neurosurgery residency programs (p = 0.04). While there was no difference in the number of total publications or first author publications before residency between awardees and nonawardees who matched into neurosurgery since 2015, awardees had a higher h-index (5.0 vs 4.0, p = 0.03). Specifically among awardees who pursued neurosurgery since 2008, there was a statistically significant upward trend in the median number of total publications before residency (p < 0.001), first author publications (p = 0.001), and h-index (p = 0.007). Among neurosurgery attending physicians who received MSSRF awards, 64.7% practiced in an academic setting. Across academic neurosurgery attending physicians who received MSSRF awards, the ratio of NREF MSSRF award dollars to subsequent National Institutes of Health (NIH) grant funding dollars was $1:$9.05.

CONCLUSIONS: The NREF MSSRF is associated with high-quality research and strong academic productivity among aspiring medical students, with a high proportion of awardees pursuing neurosurgery and matching into top-ranked residency programs. Likewise, this early-career fellowship has a substantial return on investment in terms of subsequent NIH grant funding.

PMID:40644721 | DOI:10.3171/2025.3.JNS241757

JMIR Med Inform. 2025 Jul 11;13:e68143. doi: 10.2196/68143.

ABSTRACT

BACKGROUND: Electronic health records (EHRs) provide valuable insights to address clinical and epidemiological research concerning HIV, including the disproportionate impact of the COVID-19 pandemic on people living with HIV. To identify this population, most studies using EHR or claims databases start with diagnostic codes, which can result in misclassification without further refinement using drug or laboratory data. Furthermore, given that antiretrovirals now have indications for both HIV and COVID-19 (ie, ritonavir in nirmatrelvir/ritonavir), new phenotyping methods are needed to better capture people living with HIV. Therefore, we created a generalizable and innovative method to robustly identify people living with HIV, preexposure prophylaxis (PrEP) users, postexposure prophylaxis (PEP) users, and people not living with HIV using granular clinical data after the emergence of COVID-19.

OBJECTIVE: The primary aim of this study was to use computational phenotyping in EHR data to identify people living with HIV (cohort 1), PrEP users (cohort 2), PEP users (cohort 3), or “none of the above” (people not living with HIV; cohort 4) and describe COVID-19-related characteristics among these cohorts.

METHODS: We used diagnostic and laboratory measurements and drug concepts in the National Clinical Cohort Collaborative to create a computational phenotype for the 4 cohorts with confidence levels. For robustness, we conducted a randomly sampled, blinded clinician annotation to assess precision. We calculated the distribution of demographics, comorbidities, and COVID-19 variables among the 4 cohorts.

RESULTS: We identified 132,664 people living with HIV with a high level of confidence, 36,088 PrEP users, 4120 PEP users, and 20,639,675 people not living with HIV. Most people living with HIV were identified by a combination of medical conditions, laboratory measurements, and drug exposures (74,809/132,664, 56.4%), followed by laboratory measurements and drug exposures (15,241/132,664, 11.5%) and then by medical conditions and drug exposures (14,595/132,664, 11%). A higher proportion of people living with HIV experienced COVID-19-related hospitalization (4650,132,664, 3.5%) or mortality (828/132,664, 0.6%) and all-cause mortality (2083/132,664, 1.6%) compared to other cohorts.

CONCLUSIONS: Using an extensive phenotyping algorithm leveraging granular data in an EHR repository, we have identified people living with HIV, people not living with HIV, PrEP users, and PEP users. Our findings offer transferable lessons to optimize future EHR phenotyping for these cohorts.

PMID:40644699 | DOI:10.2196/68143

J Strength Cond Res. 2025 Jul 9. doi: 10.1519/JSC.0000000000005177. Online ahead of print.

ABSTRACT

Kumar, NTA, Oliver, JL, Pedley, JS, Dobbs, IJ, Wong, MA, Lloyd, RS, and Radnor, JM. Maturity-related adaptations to combined strength and plyometric training in pre- and postpeak height velocity boys. J Strength Cond Res XX(X): 000-000, 2025-This study examined the effects of a 12-week training intervention on drop jump kinetics in pre- and post-peak height velocity (PHV) boys. Forty boys from a range of sports, aged 9-17 years, were categorized into two maturity groups (pre- and post-PHV) and subdivided to an experimental (EXP) or control (CON) group. The EXP groups completed twice weekly combined traditional resistance and plyometric training program, whereas the CON groups continued regular sports activities. Drop jump ability was quantified by examining performance variables (jump height, ground contact time, and reactive strength index [RSI]), absolute and relative kinetic variables (force, impulse, and power), and movement strategy variables (spring-like correlation, peak center of mass [COM] displacement, and COM velocity). Differences in all variables were analyzed using 2 × 2 × 2 (maturity × group × time) mixed-model ANOVA. Statistical significance was determined as p < 0.05. There were significant maturity × group × time interactions observed for jump height, RSI, mean and peak breaking force, relative breaking force, net impulse, and for all absolute and relative power variables. The results indicate that maturity status influences responsiveness to combined training in boys, with the post-PHV group showing greater adaptations in drop jump performance than their less mature peers. Practitioners aiming to develop stretch-shortening cycle function in post-PHV youth should program a combination of resistance training and plyometrics. Longer interventions with more focused exposure to plyometric training might be required to elicit more meaningful improvements in drop jump performance in pre-PHV children.

PMID:40644677 | DOI:10.1519/JSC.0000000000005177