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Nevin Manimala Statistics

Investigating the effect of experience sampling study design on careless and insufficient effort responding identified with a screen-time-based mixture model

Psychol Assess. 2025 May 8. doi: 10.1037/pas0001379. Online ahead of print.

ABSTRACT

When using the experience sampling method (ESM), researchers must navigate a delicate balance between obtaining fine-grained snapshots of phenomena of interest and avoiding undue respondent burden, which can lead to disengagement and compromise data quality. To guide that process, we investigated how questionnaire length and sampling frequency impact careless and insufficient effort responding (C/IER) as an important yet understudied aspect of ESM data quality. To this end, we made use of existing experimental ESM data (Eisele et al., 2022) from 163 students randomly assigned to one of two questionnaire lengths (30/60 items) and one of three sampling frequencies (3/6/9 assessments per day). We employed a novel mixture modeling approach (Ulitzsch, Nestler, et al., 2024) that leverages screen time data to disentangle attentive responding from C/IER and allows investigating how the occurrence of C/IER evolved within and across ESM study days. We found sampling frequency, but not questionnaire length, impacted C/IER, with higher frequencies resulting in higher overall C/IER proportions and sharper increases of C/IER across, but not within days. These effects proved robust across various model specifications. Further, we found no substantial relationships between model-implied C/IER and other engagement measures, such as self-reported attentiveness, attention checks, response-pattern-based attentiveness indicators, and compliance. Our findings contrast previous studies on noncompliance, suggesting that respondents may employ different strategies to lower the different types of burden imposed by questionnaire length and sampling frequency. Implications for designing ESM studies are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

PMID:40338562 | DOI:10.1037/pas0001379

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Nevin Manimala Statistics

Depression and Heart Failure in US Veterans

JAMA Netw Open. 2025 May 1;8(5):e259246. doi: 10.1001/jamanetworkopen.2025.9246.

ABSTRACT

IMPORTANCE: Depression and heart failure (HF) affect millions of US adults. Incident HF risk following depression diagnosis is understudied.

OBJECTIVE: To examine the association between incident HF and prevalent depression among veterans.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study analyzed sociodemographic and clinical data of US veterans participating in the Veterans Affairs (VA) Birth Cohort. Data were obtained from the VA Corporate Data Warehouse between January 1, 2000, and October 1, 2015. Participants were born between 1945 and 1965, were free of HF at baseline, and met a medical home definition (had 3 outpatient visits within 5 years). Statistical analysis was performed from May 2022 to February 2025.

EXPOSURES: Prevalent depression, defined as 1 inpatient or 2 outpatient visits with International Classification of Diseases, Ninth Revision (ICD-9) or International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes for depression.

MAIN OUTCOMES AND MEASURES: The primary outcome was time to incident HF, defined as time from baseline to documented date of the first inpatient or second outpatient visit with ICD-9 or ICD-10 codes for HF. A Cox proportional hazards regression model adjusted for relevant covariates was used to assess the association of depression and incident HF.

RESULTS: A total of 2 843 159 veterans (median [SD] age, 54 [49-59] years; 2 677 919 males [94.2%]; 556 914 [19.6%] self-identified as Black, 144 485 [5.1%] as Hispanic, 1 975 068 [69.5%] as White, and 99 011 [3.5%] as other race and ethnicity) were included. Participants were followed up for incident HF over a median (IQR) duration of 6.9 (3.4-11.0) years. Generally, 8.0% of participants (226 247 of 2 843 159) had prevalent depression at baseline. Females made up a larger percentage of those with vs without depression (11.4% vs 5.3%). Participants with depression demonstrated higher unadjusted incident HF rates compared with those without depression (136.9 [95% CI, 132.2-141.7] cases per 10 000 person-years vs 114.6 [95% CI, 113.4-115.9] cases per 10 000 person-years, respectively). After adjusting for sociodemographic and cardiovascular risk factors, depression was associated with an increase in incident HF hazard of 14.0% (hazard ratio [HR], 1.14; 95% CI, 1.13-1.16), with an estimated adjusted median (IQR) incidence rate difference of 16.0 (14.9-18.3) cases per 10 000 person-years. Among patients without comorbidities, depression was associated with a higher increase in incident HF hazard (HR, 1.58; 95% CI, 1.39-1.80), with an estimated adjusted median (IQR) rate difference of 14.2 (9.5-19.5) cases per 10 000 person-years.

CONCLUSIONS AND RELEVANCE: In this cohort study, depression among veterans was associated with an increased hazard of incident HF after controlling for demographic and cardiovascular risk factors. Higher incident HF rates in patients with depression remained consistent in an otherwise low-risk cohort.

PMID:40338547 | DOI:10.1001/jamanetworkopen.2025.9246

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Nevin Manimala Statistics

Experiences of Care and Gaslighting in Patients With Vulvovaginal Disorders

JAMA Netw Open. 2025 May 1;8(5):e259486. doi: 10.1001/jamanetworkopen.2025.9486.

ABSTRACT

IMPORTANCE: Medical gaslighting, in which a patient’s concerns are dismissed without proper evaluation, has been described anecdotally in vulvovaginal patient care, but has not been quantified.

OBJECTIVE: To use a patient-centered instrument to measure adverse experiences in vulvovaginal care.

DESIGN, SETTING, AND PARTICIPANTS: Common themes from National Vulvodynia Association patient testimonials were used to design a mixed-methods measure of patient experience that included both quantitative and qualitative questions. An instrument was created and submitted to officers from the National Vulvodynia Association and Tight-Lipped, another patient advocacy organization, for feedback. The measure was then completed by patients before their first appointment at a vulvovaginal disorder referral clinic from August 2023 to February 2024.

EXPOSURE: Participation in the survey.

MAIN OUTCOMES AND MEASURES: The primary outcome was the incidence of reported clinician behavior and consequent distress as reported on the survey instrument. Quantitative data were analyzed using simple descriptive statistics (mean [SD], median [IQR], and percentage). Narrative responses provided by patients were analyzed using the clinical-qualitative method for content analysis.

RESULTS: A total of 520 patients completed surveys; 5 were eliminated because the patient was younger than 18 years, 6 were eliminated for duplication, 6 were eliminated because they had no past clinician, and 56 were eliminated for completely blank responses. Thus, surveys of 447 patients (mean [SD] age, 41.7 [15.2] years) were analyzed (86% response rate). Patients had a mean (SD) of 5.50 (4.53) past clinicians. Patients reported that a mean (SD) of 43.5% (33.9%) of past practitioners were supportive, 26.6% (31.7%) were belittling, and 20.5% (30.9%) did not believe the patient. In total, 186 patients (41.6%) were told they just needed to relax more, 92 (20.6%) were recommended to drink alcohol, 236 (52.8%) considered ceasing care because their concerns were not addressed, 92 (20.6%) were referred to psychiatry without medical treatment, 72 (16.8%) felt unsafe during a medical encounter, and 176 (39.4%) said they were made to feel crazy, the most distressing surveyed behavior (rated at a mean [SD] of 7.39 [3.06] of 10 on a numerical rating scale of distress). A total of 1150 quotations were analyzed qualitatively; common themes included lack of clinician knowledge (247 quotations) and dismissive behaviors (211 quotations).

CONCLUSIONS AND RELEVANCE: In this cross-sectional study, a patient-centered measure of adverse experiences in vulvovaginal care was developed. Participants reported common past experiences with gaslighting and substantial distress; they frequently considered ceasing care. There is an urgent need for education supporting a biopsychosocial, trauma-informed approach to vulvovaginal pain and continued development of validated instruments to quantify patient experiences.

PMID:40338544 | DOI:10.1001/jamanetworkopen.2025.9486

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Nevin Manimala Statistics

12 years after Roboski: Prolonged grief and posttraumatic effects

Psychol Trauma. 2025 May 8. doi: 10.1037/tra0001948. Online ahead of print.

ABSTRACT

OBJECTIVE: The Roboski massacre, which took place on December 28, 2011, is remembered as a major tragedy resulting from a cross-border operation by the Turkish Air Force that led to the loss of 34 civilians, including 19 children. This event not only caused significant physical losses but also left a profound psychological, social, and political impact on those affected. An enhanced comprehension of prolonged grief disorder’s development can assist professionals in identifying bereaved individuals requiring assistance and augment the efficacy of treatments. The aim of this study is to examine the relationship between the grief process and symptoms of posttraumatic stress, perceived discrimination, and political trust within the framework of the theory of prolonged grief in a sample of the bereaved family members who lost their relatives in the Roboski massacre almost 12 years postloss.

METHOD: In total, 88 Kurdish individuals (Mage = 37.13, SD = 16.4; 53.4% males) who had lost their close relatives in the Roboski incident in 2011 participated in this study. The Prolonged Grief Scale, the Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the Perceived Discrimination Scale, and the Political Trust Scale were used to collect data.

RESULTS: The findings of the study revealed that, even approximately 12 years after the Roboski massacre, a significant portion of the participants continue to experience symptoms of prolonged grief and posttraumatic stress reactions. There was a positive correlation between prolonged grief symptoms and posttraumatic stress reactions (r = .71) as well as perceived discrimination (r = .53). It was also found that the subdimensions of posttraumatic stress, namely “reexperiencing” (β = .19, p < .05), “negative cognitive alterations” (β = .39, p < .05), and “perceived collective discrimination” (β = .11, p < .05), were significant predictors of prolonged grief.

CONCLUSIONS: Our findings revealed that professionals should focus on identifying bereaved people who experience prolonged grief after a traumatic loss. Targeting these symptoms may alleviate the exacerbation of persistent grief reactions several years after a traumatic loss. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

PMID:40338538 | DOI:10.1037/tra0001948

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Nevin Manimala Statistics

Measurement invariance of the Spanish University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index for the Diagnostic and Statistical Manual of Mental Disorders, fifth edition-brief form in Puerto Rico following Hurricane Maria

Psychol Trauma. 2025 May 8. doi: 10.1037/tra0001937. Online ahead of print.

ABSTRACT

OBJECTIVE: Natural disasters are a salient source of traumatic exposures for many youth, although not all youth exposed to these traumatic experiences go on to develop posttraumatic stress symptoms or other maladaptive reactions. Given the low resource context and high need for psychological support engendered by natural disasters globally, efficient, evidentiary, culturally appropriate tools for assessing risk are needed to effectively identify youth most in need of services.

METHOD: The present study used a sample of 96,108 Puerto Rican youth collected in 2018, 5-9 months after Hurricane Maria in 2017, to examine the psychometric properties of a Spanish translation of the University of California Los Angeles Posttraumatic Stress Disorder Reaction Index-Brief Form (RI-5-BF). Participants completed measures of hurricane exposure, posttraumatic stress symptoms, and depressive symptoms.

RESULTS: Results indicated a strong fit between the data and the four-factor Diagnostic and Statistical Manual of Mental Disorders, fifth edition, model of posttraumatic stress disorder (root-mean-square error of approximation = .030, 90% confidence interval [.029, .031], Tucker-Lewis index = .976, comparative fit index = .983) and multigroup factor analysis indicated measurement invariance by gender at the scalar level. Normative values for this population by grade and gender were also estimated by examining the descriptive statistics of participants’ responses and convergent validity analysis indicated a strong relationship between the University of California Los Angeles Posttraumatic Stress Disorder Reaction Index-Brief Form total score and a measure of depressive symptoms (r = .64).

CONCLUSIONS: The implications of psychometric research for improving global efforts to triage and respond to psychological distress in the aftermath of natural disasters are discussed, with an emphasis on the critical need for psychometric research to diversify through development and adaptation of instruments in global populations. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

PMID:40338537 | DOI:10.1037/tra0001937

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Nevin Manimala Statistics

Intra Oral Photogrammetry: Trueness Evaluation of Novel Technology for Implant Complete-Arch Digital Impression In Vitro

Clin Implant Dent Relat Res. 2025 Jun;27(3):e70049. doi: 10.1111/cid.70049.

ABSTRACT

OBJECTIVES: To investigate the trueness of intraoral photogrammetry (IPG) technology for complete-arch implant digital impression and evaluate the effect of implant number.

MATERIAL AND METHODS: All data were fully anonymized in compliance with ethical standards, and a total of 30 complete-arch patient models with 4 (n = 13), 5 (n = 9), or 6 (n = 8) implants were selected from the archive. Digital impressions were taken with IPG and a desktop scanner. Test and reference standard tessellation language (STL) files were superimposed using a best-fit algorithm. For each implant position, mean linear (ΔX, ΔY, ΔZ axes) and angular deviations (ΔANGLE) and three-dimensional (3D) Euclidean distances (ΔEUC) were measured as primary outcomes with a dedicated software program (Hyper Cad S, Cam HyperMill, Open Mind Technologies) and reported as descriptive statistics. Secondary aim was to determine using linear mixed models whether implant number affected trueness. All statistical analyses were conducted using Stata 18 (Stata Corp, College Station) and significance was set at 0.05.

RESULTS: A total of 30 definitive casts with 4 (n = 13), 5 (n = 8), and 6 (n = 9) multi-unit abutment (MUA) analogs were analyzed (n = 146 implant positions). The mean deviations along the X-axis were -3.97 ± 32.8 μm, while along the Y-axis, they were -1.97 ± 25.03 μm. For the Z-axis, a greater deviation of -33 ± 34.77 μm was observed. The 3D Euclidean distance deviation measured 57.22 ± 27.41 μm, and the angular deviation was 0.26° ± 0.19°. Statistically significant deviations were experienced for ΔZ, ΔEUC, and ΔANGLE (p < 0.01). Additionally, the number of implants had a statistically significant effect only on the Z-axis deviation (p = 0.03).

CONCLUSIONS: Within study limitations, IPG technology was feasible for complete-arch digital implant impression with mean linear, angular, and 3D deviations far below the acceptable range for a passive fit. Reported IPG trueness might avoid a rigid prototype try-in. The implant number had no influence on trueness except for Z-axis deviations. Integrating photogrammetry with intraoral optical scanning (IOS) improved practicality, optimizing the digital workflow. Further clinical trials are needed to confirm these findings.

PMID:40338525 | DOI:10.1111/cid.70049

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Nevin Manimala Statistics

Virtual Reality Simulation in Orthopedic Surgery Education Improves Immediate Procedural Skill and Knowledge Acquisition, But Evidence on Cost-Effectiveness and Skill Retention Remains Lacking

Curr Rev Musculoskelet Med. 2025 May 8. doi: 10.1007/s12178-025-09973-8. Online ahead of print.

ABSTRACT

PURPOSE OF REVIEW: Virtual reality (VR) simulation in orthopedic education has gained recent interest in the literature. VR simulation provides a virtual space to practice surgical steps accurately, creating a user-controlled environment for novice surgical trainee skill development. Despite the reported benefits, VR is not routinely incorporated into orthopedic residency core curriculum. This study reviews and synthesizes contemporary data assessing the efficacy of VR simulation in orthopedic surgical training.

RECENT FINDINGS: Twenty-three studies across six subspecialty areas were included. Seven hundred and forty-eight participants trained on over nine different VR simulators. Control groups included no additional training, surgical technique guides, surgical videos, and benchtop simulators. Outcome measurements included procedure-specific checklists, objective grading scales, time-to-task completion, and accuracy of implant placement, among others. No outcomes directly focused on patient safety or involved live patients. Across disciplines, VR simulation training improved outcomes when compared to controls, conferring quicker procedure times, higher correct step completion, and more accurate implant placement, although not always statistically significant. Virtual reality is a tool employed by various industries that offers immersive, interactive, and realistic learning experiences. In orthopedics, VR has the potential to enhance skills, improve safety, and increase trainee confidence. In most of the included studies, trainees performed better in the VR simulation groups when compared to control education modalities, and participants readily embraced VR. However, there is mixed evidence on its use, and future studies are needed involving longitudinal VR education to better assess the actual impact on trainee skills, as well as performance in the operating room and its impact on patient outcomes.

PMID:40338491 | DOI:10.1007/s12178-025-09973-8

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Nevin Manimala Statistics

Distribution and laterality of concha bullosa in patients with different cranial skeletal types: a retrospective analysis among cases with concha bullosa

Maxillofac Plast Reconstr Surg. 2025 May 8;47(1):9. doi: 10.1186/s40902-025-00463-y.

ABSTRACT

OBJECTIVE: Concha bullosa, a common anatomical variation characterized by air-filled cavities in the turbinate bones, can influence sinonasal function and surgical planning. This study aims to evaluate the distribution, laterality, and cranial skeletal type associations of concha bullosa (CB) among patients with confirmed CB findings on computed tomography (CT) scans.

METHODS: A retrospective cohort study was conducted on 774 patients who underwent cranial and facial CT scans between March 2023 and March 2024. Patients were classified into mesocephalic, brachycephalic, and dolichocephalic groups based on the cephalic index. The distribution and laterality of concha bullosa were assessed using CT scans, and statistical analyses were performed using the Chi-square test, with a significance level set at P < 0.05.

RESULTS: Among CB-positive patients, left-sided concha bullosa was most common (49.48%), followed by right-sided (31.91%) and bilateral (18.6%) involvement. Mesocephalic individuals constituted the largest proportion of CB-positive cases (55.56%), followed by dolichocephalic (22.86%) and brachycephalic (21.57%) individuals. A significant gender difference was observed in the mesocephalic (P = 0.001) and brachycephalic (P = 0.013) groups, with males exhibiting a higher prevalence of right-sided and bilateral concha bullosa.

CONCLUSION: Concha bullosa distribution varies significantly among cranial skeletal types among CB-positive patients, with mesocephalic individuals exhibiting the highest overall prevalence. Our findings underscore the influence of cranial morphology on the presentation of CB. This insight may enhance radiological evaluation and individualized surgical planning in CB-positive patients.

PMID:40338478 | DOI:10.1186/s40902-025-00463-y

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Development of a nomogram for predicting the risk of carcinoma in chronic atrophic gastritis

Discov Oncol. 2025 May 8;16(1):688. doi: 10.1007/s12672-025-02453-y.

ABSTRACT

OBJECTIVE: To construct a machine learning (ML) model to predict the progression of chronic atrophic gastritis (CAG) to gastric cancer (GC), given its precancerous significance.

METHODS: Using medical records from the Affiliated Hospital of Qingdao University, common laboratory indicators were extracted. LASSO regression identified 10 core risk factors, which were further analyzed using binary logistic regression to develop a nomogram model in R. The model’s performance was evaluated using receiver operating characteristic (ROC) curves, the concordance index (C-index), calibration curves, and decision curve analysis (DCA).

RESULTS: The model showed excellent performance, with a C-index of 0.887. The key factors included sex, coagulation, blood cell indexes, and blood lipid levels. The ROC areas were 0.892 (quantitative) and 0.853 (qualitative), confirming model reliability.

CONCLUSION: A new nomogram model for assessing GC risk in CAG patients was successfully developed. However, due to data collection and time limitations, future studies should expand the sample size, perfect the validation process, and optimize the model to achieve more accurate risk prediction.

PMID:40338419 | DOI:10.1007/s12672-025-02453-y

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Sterile keratolysis following pars plana vitrectomy for retinal detachment

Int Ophthalmol. 2025 May 8;45(1):179. doi: 10.1007/s10792-025-03532-3.

ABSTRACT

PURPOSE: Pars plana vitrectomy (PPV) with various forms of tamponade and retinopexy is often the primary treatment for retinal detachment. However, a rare but serious complication is sterile keratolysis. We therefore aimed to evaluate the prevalence and potential risk factors for the development of corneal ulceration following vitreoretinal surgery for retinal detachment.

METHODS: This is a single-centre retrospective study including 14 cases of patients presenting to our department with sterile keratolysis involving the stroma after one or more PPVs for retinal detachment or vitreous hemorrhage. Time of primary procedure, time of onset of corneal complications, comorbidities, type of tamponade used, use of endophotocoagulation, cryoretinopexy and number of surgeries were recorded. Patients with additional comorbidities confounding a possible correlation were excluded from the case series.

RESULTS: A total of 14 patients were identified with corneal complications after pars plana vitrectomy for retinal detachment. Multiple vitrectomies were performed in 86% (12/14) of the cases. Surgical treatment consisted of six (43%) perforating keratoplasties and seven (50%) amniotic membrane keratoplasties in all but one patient. At an average of three months after the onset of corneal symptoms, the first corneal surgery was performed. Repeated corneal surgery was required in 4 patients (29%) and consisted of two penetrating keratoplasties and four amniotic membrane transplantation. Visual acuity at the first presentation of corneal complications was reduced (2.1 ± 0.6 logMAR), but was not statistically different from the visual acuity at baseline (1.6 ± 0.7 logMAR). At the last follow-up, visual acuity remained reduced at 1.8 ± 0.8 logMAR (p = 0.2).

CONCLUSIONS: The risk of sterile keratolysis seems to increase with excessive laser or cryo-retinopexy, use of silicone oil and repeated procedures. The initial vitrectomy was a complex surgery in all cases and required a longer operating time. Ciliary nerve damage of neurotrophic origin may be the cause of sterile keratolysis, and controlled retinopexy sparing the long ciliary nerves and avoiding cryotherapy may reduce the risk. Controlled studies are needed to investigate the causality between vitreoretinal surgery and sterile keratolysis.

PMID:40338390 | DOI:10.1007/s10792-025-03532-3