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Nevin Manimala Statistics

Fostering transparency and reproducibility in psychological science

Can J Exp Psychol. 2025 Jun 9. doi: 10.1037/cep0000381. Online ahead of print.

ABSTRACT

Psychological science is hard. This short article focuses on two issues. One has to do with the importance of understanding statistical power and how post hoc data explorations and selective reporting can lead to exaggerated estimates of the size of effects and the strength of relationships (which in turn contribute to replication failures). The other topic is tools research psychologists can use to improve the reproducibility of their procedures and analyses. The article closes with a comment on the deeper challenge of improving the usefulness and testability of theories in psychology. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

PMID:40489205 | DOI:10.1037/cep0000381

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Nevin Manimala Statistics

Insights into workforce development: An exploratory study of primary care psychology internship graduate careers

Fam Syst Health. 2025 Jun 9. doi: 10.1037/fsh0000998. Online ahead of print.

ABSTRACT

INTRODUCTION: As demand for integrated behavioral health services grows, understanding specialized training programs’ contribution to workforce development becomes crucial. This study examines the career trajectories of graduates from a primary care psychology internship program in Puerto Rico to inform integrated care workforce strategies.

METHOD: We analyzed data from an annual program survey conducted between March and June 2024 with 62 graduates (71% response rate) from a primary care psychology internship program (2007-2023 cohorts). The survey captured professional credentials, employment characteristics, and service patterns. Hispanic women comprised 85.5% (n = 53) of participants, who represented consecutive cohorts over 15 years. We analyzed descriptive statistics for licensure status, employment settings, leadership roles, and the population served.

RESULTS: Most graduates (72.6%, n = 45) obtained psychology licensure. While 32.3% (n = 20) completed postdoctoral training, most entered practice directly. Currently, 41.9% (n = 26) work in primary care settings, and 51.6% (n = 32) in integrated care environments. Half of the sample (50.0%, n = 31) hold leadership positions. Most (61.3%, n = 38) work with underserved populations, with 46.8% (n = 29) working with people who experience substance use disorders.

DISCUSSION: The findings suggest that program graduates are engaged in roles within integrated care and underserved areas. However, structural barriers, including limited postdoctoral opportunities and regional economic factors, influence career development paths. This study highlights the need to systematically examine the career trajectories of integrated care internship graduates while considering the contextual factors that shape workforce development. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

PMID:40489186 | DOI:10.1037/fsh0000998

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Effectiveness of psychotherapy: Synthesis of a “meta-analytic research domain” across world regions and 12 mental health problems

Psychol Bull. 2025 May;151(5):600-667. doi: 10.1037/bul0000465.

ABSTRACT

The scientific output generated in psychology has surged in recent decades, including the number of studies investigating psychological treatments. To keep track of all this evidence, we developed the “Metapsy” meta-analytic research domain: a comprehensive system of open databases and tailored software that allows for rapid evidence generation. We leverage this novel infrastructure to summarize the effect of psychological treatment across 12 mental health problems and trace back the global expansion of psychotherapy research over the past 50 years. Including 1,029 studies with 85,952 patients, our results indicate small to moderate average benefits in treating psychosis (g = 0.32), suicidal ideation (g = 0.34), borderline personality disorder (g = 0.46), and prolonged grief (g = 0.49). In contrast, psychological interventions have large average effects on depression (g = 0.73), problem gambling (g = 0.80), panic (g = 0.83), generalized anxiety (g = 0.86), social anxiety (g = 0.95), obsessive-compulsive (g = 1.18), posttraumatic stress disorder (g = 1.18), and phobias (g = 1.25). Most available evidence (83.4%-86.1%) comes from high-income and Western countries, but their dominance is declining. We found no indication that psychotherapy is less effective in low- and middle-income countries (g = 0.38-2.41) or non-Western cultures (g = 0.74-2.20). We discuss ways to further enhance psychotherapy’s public health impact, as well as how the meta-analytic research domain concept may be extended to other types of psychological research in the future. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

PMID:40489181 | DOI:10.1037/bul0000465

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Testing measurement invariance of self-report and interview measures of borderline personality disorder across ethnic/racial groups of inpatient adolescents

Psychol Assess. 2025 Jun 9. doi: 10.1037/pas0001401. Online ahead of print.

ABSTRACT

Borderline personality disorder (BPD) is a severe mental disorder that onsets during adolescence. Research examining sociocontextual differences in BPD presentation is limited and provides mixed results, highlighting the importance of further investigation and the evaluation of potential measure effects. This study assessed measurement invariance of two widely used adolescent measures (self-report-the Borderline Personality Features Scale for Children and semistructured interview-Childhood Interview of Diagnostic and Statistical Manual Borderline Personality Disorder) of BPD. Comparisons across inpatient psychiatric settings (n = 521 at a private inpatient; n = 378 at a public inpatient) and across self-identified Hispanic/Latinx (n = 193), Black (n = 132), and White (n = 584) adolescents were conducted. Baseline models revealed inadequate model fit for a single-factor structure, requiring modifications to the intended structure of these measures. With these modifications, results identified partial scalar invariance across settings and racial/ethnic groups for both measures and full measurement invariance for the modified CI-BPD across settings. This study is the first to test whether these measures of BPD function differently based on an indicator of socioeconomic functioning and across racial/ethnic groups among inpatient adolescents. Results suggest that modifications to these measures should be explored further, which are discussed with the goal of achieving measures that can accurately assess and compare BPD severity in adolescents. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

PMID:40489150 | DOI:10.1037/pas0001401

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Nevin Manimala Statistics

Study on the Correlation between ipa and ipc of Electrode in Vanadium Flow Batteries by In-Situ Weak Measurement Imaging

Small. 2025 Jun 9:e2505051. doi: 10.1002/smll.202505051. Online ahead of print.

ABSTRACT

Traditional characterization techniques for vanadium flow batteries (VFBs) electrodes demonstrate significant limitations in resolving spatially heterogeneous reaction characteristics on electrode surfaces and efficiently characterizing large-scale working electrodes. Consequently, mapping electrode activity distributions and establishing efficient screening strategies for high-performance electrodes are critical for advancing VFBs research. Building on prior studies, this work employs weak measurement imaging (WMi) methodology to spatially characterize reaction activity distributions on VFBs positive electrode surfaces and quantitatively analyze electrode reaction parameters (ipa and ipc). By statistically comparing extensive electrochemical data from working electrodes (randomly sampled from large graphite felt substrates and tested via electrochemical workstation, EW) with WMi-derived data from individual electrodes, a pronounced linear correlation between oxidation and reduction peak current densities (ipa and ipc) in VFBs working electrodes is identified. Systematic investigations of graphite felt (GF) and thermally activated graphite felt (TGF) electrodes under varied operational conditions confirmed this statistical relationship between ipa and ipc while validating the reliability of the WMi sensing system. This findings demonstrate that the WMi sensing system serves as a robust and versatile analytical tool for quantitatively characterizing electrode performance parameters. This approach facilitates efficient screening of high-performance VFBs working electrodes, thereby accelerating the development of flow battery technologies.

PMID:40489124 | DOI:10.1002/smll.202505051

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Nevin Manimala Statistics

Silver Diamine Fluoride vs Atraumatic Restoration for Managing Dental Caries in Schools: A Cluster Randomized Clinical Trial

JAMA Netw Open. 2025 Jun 2;8(6):e2513826. doi: 10.1001/jamanetworkopen.2025.13826.

ABSTRACT

IMPORTANCE: Dental caries is a pervasive and inequitable chronic disease stemming from a lack of access to preventive and therapeutic care. Minimally invasive interventions may be provided in schools to treat caries in children.

OBJECTIVE: To compare the effectiveness of silver diamine fluoride (SDF) with atraumatic restorative treatment (ART) in the control of dental caries among US schoolchildren.

DESIGN, SETTING, AND PARTICIPANTS: The CariedAway study was a cluster randomized clinical trial conducted from February 1, 2019, to June 1, 2023, in 48 primary schools in New York City. Participants were followed up for up to 4 years. Schools with a student population of at least 50% Black and/or Hispanic or Latino students and 80% receiving free or reduced-cost lunch were eligible. Within enrolled schools, any child with parental informed consent was eligible. Treatment was provided biannually. Analysis was restricted to children aged 5 to 13 years who completed at least 1 follow-up observation and had at least 1 tooth surface with dental caries.

INTERVENTIONS: Participants were randomized at the school level to receive SDF or ART.

MAIN OUTCOMES AND MEASURES: Any surface lesion with an International Caries Detection and Assessment System score of 5 or 6 was recorded as caries. The primary outcome was the number of carious surfaces that had a recurrence of caries. Analysis was performed on an intent-to-treat basis.

RESULTS: Of the 17 741 children eligible, 7418 were randomized (mean [SD] age at baseline, 7.6 [1.9] years; 4006 girls [54.0%]), and 1668 were analyzed (mean [SD] age at baseline, 6.8 [1.5] years; 881 girls [52.8%]; 861 in the SDF group and 807 in the ART group). The total surface-level failure in the SDF group was 38.3% (2167 of 5651 carious surfaces) compared with 45.5% (2116 of 4647) in the ART group. There were 2167 surface failures observed among SDF participants over 1372 person-years compared with 2116 ART surface failures over 1291 person-years (incidence rate ratio, 0.96 [95% CI, 0.91-1.02]). At the person level, 45.5% of SDF recipients (392 of 861) experienced at least 1 surface failure compared with 53.3% of ART recipients (430 of 807; odds ratio, 0.51 [95% CI, 0.39-0.66]). There were no significant differences in the risk of recurrent surface failure between treatments (hazard ratio, 0.92 [95% CI, 0.82-1.04]).

CONCLUSIONS AND RELEVANCE: In this study of treatments for caries, similar failures in surface control were observed among children receiving SDF or ART. These results support the use of secondary preventive therapies for caries in schools.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03442309.

PMID:40489112 | DOI:10.1001/jamanetworkopen.2025.13826

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Nevin Manimala Statistics

Active Travel Mode and Incident Dementia and Brain Structure

JAMA Netw Open. 2025 Jun 2;8(6):e2514316. doi: 10.1001/jamanetworkopen.2025.14316.

ABSTRACT

IMPORTANCE: Active travel modes, such as walking and cycling, are feasible and readily embraced forms of physical activity, but their association with dementia risk and brain structure remains unclear.

OBJECTIVES: To investigate the long-term association between travel modes and dementia risk and brain structural metrics and to evaluate whether genetic predisposition could modify the association between travel modes and dementia risk.

DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study included data collected from the UK Biobank from March 13, 2006, to October 1, 2010. Data were analyzed from March to October 2024.

EXPOSURES: Travel modes assessed using the question “In the last 4 weeks, which forms of transport have you used most often to get about (not including any journeys to and from work)?” and categorized into 4 groups: nonactive, walking, mixed-walking, and cycling and mixed-cycling mode.

MAIN OUTCOMES AND MEASURES: The incidence of all-cause dementia (including young-onset dementia [YOD] and late-onset dementia [LOD]) was the primary outcome, and dementia subtypes, such as Alzheimer disease (AD) and brain structure, were the secondary outcomes; all were identified through hospital records and death registers. Brain structure was measured by a magnetic resonance imaging scan. Travel mode and risk of incident dementia were assessed using Cox proportional hazards regression models with hazard ratios and 95% CIs.

RESULTS: The study encompassed 479 723 participants (mean [SD] age, 56.5 [8.1] years; 260 730 females [54.4%]), including 271 690 in the YOD analyses and 334 939 in the LOD analyses. Over a median follow-up of 13.1 years (IQR, 12.8-13.5 years), 8845 cases of dementia (1.8%) and 3956 cases of AD (0.8%) were recorded. Compared with a nonactive travel mode, multivariable-adjusted hazard ratios for cycling and mixed-cycling were 0.81 (95% CI, 0.73-0.91) for all-cause dementia, 0.78 (95% CI, 0.66-0.92) for AD, 0.60 (95% CI, 0.38-0.95) for YOD, and 0.83 (95% CI, 0.75-0.93) for LOD. A significant interaction between travel mode and genetic susceptibility in the all-cause dementia analysis (P = .02 for interaction) and the LOD analysis (P = .04 for interaction) was observed; specifically, for the cycling and mixed-cycling groups, the risks of all-cause dementia and LOD were lower among those without apolipoprotein E ε4 (APOE ε4) carrier status (all-cause dementia: hazard ratio [HR], 0.74 [95% CI, 0.63-0.87]; LOD: HR, 0.75 [95% CI, 0.63-0.89]) compared with those with APOE ε4 carrier status (all-cause dementia: HR, 0.88 [95% CI, 0.76-1.02]; LOD: HR, 0.91 [95% CI, 0.78-1.05]). The cycling and mixed-cycling mode was significantly associated with a higher hippocampal volume (β, 0.05 [95% CI, 0.02-0.08]). Genetic risk significantly modified the association with all-cause dementia (P = .02 for interaction) and LOD (P = .04 for interaction). Specifically, for the cycling and mixed-cycling groups, the risk of all-cause dementia was lower among those without APOE ε4 (HR, 0.74 [95% CI, 0.63-0.87]) compared with those with APOE ε4 (HR, 0.88 [95% CI, 0.76-1.02]). Similarly, the risk of LOD was lower among those without APOE ε4 (HR, 0.75 [95% CI, 0.63-0.89]) compared with those with APOE ε4 (HR, 0.91 [95% CI, 0.78-1.05]).

CONCLUSIONS AND RELEVANCE: The findings of this cohort study suggest an association between active travel mode and incident dementia and brain structure. The cycling and mixed-cycling mode was associated with a reduced risk of all-cause dementia, including YOD, LOD, and AD, as well as an increased hippocampal volume, suggesting a promising approach for maintaining brain health.

PMID:40489111 | DOI:10.1001/jamanetworkopen.2025.14316

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Nevin Manimala Statistics

Generating Timely Estimates of Overdose Deaths for the US Using Urine Drug Test Data

JAMA Netw Open. 2025 Jun 2;8(6):e2514402. doi: 10.1001/jamanetworkopen.2025.14402.

ABSTRACT

IMPORTANCE: Provisional estimates of fatal drug overdoses in the US are lagging by 6 months. Efforts to estimate the overdose burden for this 6-month lag window require up-to-date data, such as real-time urine drug test (UDT) data, capable of identifying sudden changes in the overdose trajectory, such as the increase in overdose deaths experienced at the beginning of the COVID-19 pandemic.

OBJECTIVE: To evaluate the utility of using aggregated UDT data to estimate national-level drug overdose deaths for the 6-month lag window in which overdose data are unavailable.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study included 3 135 748 urine samples submitted for UDT by Millennium Health from patients aged 18 years or older in substance use disorder treatment health care facilities across the US between January 1, 2015, and January 31, 2025. Urine drug test results were aggregated to generate monthly positivity rates and mean creatinine-normalized levels of fentanyl and methamphetamine (among the sample testing positive for fentanyl). Monthly, national drug overdose mortality counts were obtained from the Centers for Disease Control and Prevention.

EXPOSURES: Urine drug testing.

MAIN OUTCOMES AND MEASURES: Drug overdose death totals were estimated for every 6-month period from January to June 2019 through August 2024 to January 2025 by training generalized linear models with a negative binomial distribution on the preceding 4 years of data and using monthly UDT data to generate overdose estimates for the 6-month lag window of interest. Mean absolute error (MAE), mean absolute percentage error (MAPE), and root mean squared error (RMSE) were calculated by comparing projected monthly estimates with observed overdose death totals.

RESULTS: A total of 3 135 748 UDT specimens (57.2% from men; mean [SD] age, 38.1 [12.4] years) were included in this study. From 2019 to August 2024, 537 104 people died of an overdose in the US, with a substantial increase in early 2020 at the onset of the COVID-19 pandemic. The UDT modeling strategy (MAPE, 7.1%; MAE, 540.9 deaths per month; RMSE, 659.4) outperformed the baseline autoregressive integrated moving average model (MAPE, 9.0%; MAE, 704.9 deaths per month; RMSE, 1075.8) across all metrics. Furthermore, the model detected the sudden increase in overdose deaths at the start of the COVID-19 pandemic.

CONCLUSIONS AND RELEVANCE: In this cross-sectional study, findings suggested that aggregated UDT data may be used to estimate up-to-date overdose death trends. Model implementation can be improved by introducing additional exposure variables, such as those related to drug seizures and syndromic surveillance.

PMID:40489110 | DOI:10.1001/jamanetworkopen.2025.14402

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Long-Term Coronary Microvascular and Cardiac Dysfunction After Severe COVID-19 Hospitalization

JAMA Netw Open. 2025 Jun 2;8(6):e2514411. doi: 10.1001/jamanetworkopen.2025.14411.

ABSTRACT

IMPORTANCE: COVID-19 can lead to long-term cardiopulmonary symptoms and is associated with coronary microvascular dysfunction (CMD). However, long-term data on CMD after severe COVID-19 are lacking.

OBJECTIVE: To investigate long-term left ventricular function and the presence of CMD after severe COVID-19.

DESIGN, SETTING, AND PARTICIPANTS: This case-control study was conducted among patients at a single center from the prospective Follow-Up of Patients With Severe COVID-19 (UppCov) study, with follow-up multiparametric perfusion cardiovascular magnetic resonance (CMR) at 10 months after discharge from November 2020 to February 2021. Patients previously hospitalized due to severe COVID-19 (ventilatory support, oxygen flow ≥5 L/min, or both) with or without cardiac involvement (troponin t > 14 ng/L, pulmonary artery pressure >34 mm Hg, or both) were compared with historical sex- and age-matched volunteers without symptomatic ischemic heart disease. Standard contraindications to adenosine CMR were applied. Data were analyzed between March 2023 and March 2025.

EXPOSURE: Hospitalization due to severe COVID-19.

MAIN MEASURES AND OUTCOMES: Comprehensive CMR included native T1, native T2, extracellular volume, adenosine stress and rest perfusion mapping, gadolinium enhancement, and cine imaging. Comorbidities, medications, symptoms at follow-up, and details regarding hospitalization were obtained from patient records.

RESULTS: The study included 37 patients with COVID-19 (mean age, 56 years [95% CI, 53 to 61 years]; 28 male [75.7%]) and 22 healthy volunteers (mean age, 51 years [95% CI, 45 to 57 years]; 12 male [54.4%]). Patients with COVID-19 compared with healthy patients demonstrated reduced mean stress perfusion (2.80 mL/min/g [95% CI, 2.53 to 3.07 mL/min/g] vs 3.43 mL/min/g [95% CI, 3.13 to 3.74 mL/min/g]; P = .003), impaired mean global longitudinal strain (-17% [95% CI, -18% to -16%] vs -19% [-20% to -18%]; P = .003), and impaired mean global circumferential strain (-16% [95% CI, -17% to -15%] vs -19% [-20% to -18%]; P = .001). There were no differences in stress perfusion or myocardial perfusion reserve in the COVID-19 group between patients with vs without cardiovascular risk factors or cardiac symptoms.

CONCLUSIONS AND RELEVANCE: In this study, patients with COVID-19 exhibited long-term reduced stress perfusion indicating CMD, along with declined left ventricular function by global longitudinal strain and global circumferential strain. Lack of variation in stress perfusion between patients with and without cardiovascular risk factors may suggest CMD due to severe COVID-19, warranting further investigation to elucidate mechanisms and guide potential therapies.

PMID:40489109 | DOI:10.1001/jamanetworkopen.2025.14411

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Efficacy and safety of low-dose prasugrel as dual antiplatelet therapy in patients with ischemic heart disease: a systematic review and network meta-analysis of randomized controlled trials

Cardiovasc Interv Ther. 2025 Jun 9. doi: 10.1007/s12928-025-01129-2. Online ahead of print.

ABSTRACT

Low-dose prasugrel could provide a better balance between adverse ischemic and bleeding events compared to other P2Y12 receptor inhibitors as part of dual antiplatelet therapy (DAPT) for patients with ischemic heart disease. This study evaluated these risks of adverse events associated with low-dose prasugrel and other P2Y12 receptor inhibitors. A network meta-analysis was conducted, searching for randomized controlled trials (RCTs) comparing clopidogrel (75 mg), low-dose (3.75 mg) and standard-dose (10 mg or 5 mg) prasugrel, or ticagrelor (180 mg). The primary endpoint was major adverse cardiovascular events (MACE), a composite of cardiovascular death, myocardial infarction, or stroke. The secondary endpoint was major bleeding, cardiovascular death, myocardial infarction, and stroke. Across 13 RCTs, neither low-dose prasugrel, standard-dose prasugrel, nor ticagrelor showed a statistically significant difference in MACE compared to clopidogrel [risk ratio (RR): 0.73, 95% confidence interval (CI) 0.49-1.09; RR: 0.86, 95% CI 0.68-1.09; RR: 1.02, 95% CI 0.62-1.67, respectively]. However, the standard dose of prasugrel was associated with a significantly higher risk of bleeding events compared to clopidogrel (RR, 0.72; 95% CI 0.35-1.49; RR, 1.26; 95% CI 1.01-1.58; RR, 1.26; 95% CI 0.82-1.96). The surface under the cumulative ranking curves was highest for low-dose prasugrel for both MACE and bleeding events (17.3 and 64.6 for clopidogrel, 84.5 and 84.9 for low-dose prasugrel, 62.0 and 11.8 for standard-dose prasugrel, and 36.2 and 38.7 for ticagrelor, respectively). Low-dose prasugrel may be a viable option in addition to standard P2Y12 receptor inhibitors.

PMID:40489021 | DOI:10.1007/s12928-025-01129-2