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Nevin Manimala Statistics

Highly Elevated Scores on the Beck Depression Inventory-Second Edition as an Indicator of Noncredible Symptom Report

Assessment. 2025 Dec;32(8):1226-1234. doi: 10.1177/10731911241304214. Epub 2024 Dec 29.

ABSTRACT

Some recent studies have revived the approach of investigating extreme levels of self-reported depressive symptoms as indicative of gross exaggeration. While scores above 40 on the Beck Depression Inventory-Second Edition (BDI-II) were discussed as indicating exaggerated symptom claims, different cut scores for identifying noncredible responding are now being discussed. A consecutive sample of 242 patients referred for forensic psychological assessment (mean age: 46.0 years, 47.7% women) with full data sets on the BDI-II and the Structured Inventory of Malingered Symptomatology (SIMS) were assessed. Of all patients, 13.2% scored above 40 and BDI-II scores correlated with SIMS total scores at .62. For different SIMS cutoffs (>14, >16, >19, >23) used as criterion standard, optimal cut scores for the BDI-II were computed. When specificity was set at a minimum of 90%, sensitivity estimates were below 50% for all four SIMS levels. Extreme scores on the BDI-II should raise concern about the credibility of self-reported depressive symptom load. Diagnosis as well as severity estimates should not be based primarily on self-report instruments. To avoid significant risks of bias, the development of reliable cut scores for BDI-II elevations should be based on more studies with samples from diverse contexts.

PMID:41190357 | DOI:10.1177/10731911241304214

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Characteristics, cost/effect consideration of clinical examinations, and construction of machine learning models of restrictive cardiomyopathyinsights from peking union medical college hospital

Int J Surg. 2025 Nov 5. doi: 10.1097/JS9.0000000000003745. Online ahead of print.

ABSTRACT

BACKGROUND: Restrictive cardiomyopathy (RCM) is an uncommon condition with heterogeneous causes. Amyloidosis, a major subtype, presents with diagnostic complexity, economic burden, and prognostic implications. This study aimed to apply machine learning (ML) techniques to improve the diagnosis of amyloidosis among RCM patients and assess the cost-effectiveness of laboratory tests.

METHODS: This study included patients with RCM who underwent transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging (MRI). Feature selection was performed using least absolute shrinkage and selection operator (LASSO) regression based on variables that showed statistically differences between groups. These selected features were then used to construct eight ML models, which were trained and validated using leave-one-out cross-validation. The best-performing model was evaluated for sample size and interpreted using Shapley additive explanations (SHAP) to enhance model transparency. Laboratory testing costs related to autoimmune, infectious, tumor-related, and amyloidosis evaluations were compared across subgroups.

RESULTS: The Random Forest (RF) model achieved the best performance, with an area under the curve (AUC) of 0.977, an accuracy of 0.908, a sensitivity of 0.869, and a specificity of 0.927. The model also showed a favorable Brier score and a satisfying effect size, indicating good performance in distinguishing amyloidosis from other RCM subtypes. Cost analysis revealed that patients without underlying autoimmune, infectious, or tumor-related etiologies incurred unnecessary expenditures. Multivariate regression identified key imaging features associated with amyloidosis, including left ventricular posterior wall (LVPW) and left ventricular ejection fraction (LVEF) from TTE, and left ventricular short axis (LVSA), LVEF, and interventricular septum (IVS) thickness from cardiac MRI.

CONCLUSION: This study established an interpretable ML model based on the RF algorithm and accurately distinguished amyloidosis among RCM patients. By guiding more targeted use of amyloidosis-specific testing, the model offers a potential cost-saving strategy while improving diagnostic efficiency. These findings support the clinical integration of ML-based tools to streamline decision-making and optimize the allocation of healthcare resources.

PMID:41190351 | DOI:10.1097/JS9.0000000000003745

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Integrating SARS-CoV-2 rapid antigen testing in maternal, neonatal and child health, HIV and tuberculosis services in Cameroon and Kenya: a cluster randomised trial of two testing models

BMJ Public Health. 2025 Jul 13;2(Suppl 1):e000873. doi: 10.1136/bmjph-2023-000873. eCollection 2024 Jul.

ABSTRACT

INTRODUCTION: Identifying SARS-CoV-2 infection in high-risk populations is critical. We examined SARS-CoV-2 case detection (CD) in ‘TA’ versus ‘screen-and-test’ models of rapid antigen testing integration in maternal neonatal and child health (MNCH), HIV and tuberculosis (TB) clinics in Cameroon (C) and Kenya (K).

METHODS: From May to October 2022, we conducted a cluster-randomised trial with 10 facilities per country randomised to the ‘test-all’ (TA) intervention arm or the standard ‘screen-and-test’ (ST) arm. Individuals aged >2 years attending HIV, TB and MNCH clinics were eligible for SARS-CoV-2 testing. The primary outcome was the SARS-CoV-2 CD, defined as the number of SARS-CoV-2 infections detected per 1 000 attendees in MNCH, HIV and TB clinics. We estimated the intervention arm-specific CDs by combining the facility-specific estimates using a weighted approach.

RESULTS: There were 80 828 attendee visits in the TA model (63 492 C, 17 336 K) and 71 254 in the ST model (56 589 C, 14 665 K). About 17.4% (K) and 29.0% (C) were tested under the TA model. The overall CD was 2.90 (95% CI:1.76 to 4.79) per 1 000 attendee visits in the TA model and 1.20 (95% CI:0.73 to 1.99) in the ST model (RR=2.41, 95% CI:1.18 to 4.91, p=0.018). The TA model had a significantly higher SARS-CoV-2 CD in MNCH clinics (2.91 vs 1.11, p=0.012), while CD estimates in HIV (2.88 vs 1.40, p=0.203) and TB (10.24 vs 4.57, p=0.051) clinics, although higher in TA model compared with ST model, were not statistically different.

CONCLUSIONS: The TA model identified more SARS-CoV-2 cases than the screen-and-test model, even with low testing coverage. The TA model could be considered in future epidemics for early detection of SARS-CoV-2 infection among vulnerable populations, but effective implementation requires additional human resources to manage testing in high volume clinics.

TRIAL REGISTRATION NUMBER: NCT05382130.

PMID:41190341 | PMC:PMC12581021 | DOI:10.1136/bmjph-2023-000873

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Predictive Distribution Modeling of the Medicinal Leech Hirudo verbana Carena, 1820 (Hirudinea, Hirudinidae) in Sicily: Implications for Conservation

Ecol Evol. 2025 Nov 2;15(11):e72410. doi: 10.1002/ece3.72410. eCollection 2025 Nov.

ABSTRACT

Hirudo verbana, a medicinal leech species of conservation concern, has long been considered rare and fragmented across its distribution range due to overexploitation and habitat alteration. In this study, we present the first predictive distribution model for H. verbana in Sicily, combining field occurrence data (time: 1980-2024) with environmental variables using an ensemble species distribution modeling (SDM) framework. Unlike its typical occurrence in temperate lowland wetlands of central-eastern Europe, the species in Sicily shows a marked shift toward upper hill and montane zones. Species presence was strongly associated with high NDVI values, reflecting a preference for areas with dense and structurally complex vegetation. In contrast, presence probability declined sharply with increasing terrestrial human footprint (THF), indicating a notable sensitivity to anthropogenic disturbance. Aquatic habitat type also emerged as a key predictor: the species was most likely to occur in lentic environments such as standing water bodies, and least likely in lotic systems or areas lacking aquatic habitats. Notably, most high-suitability areas overlapped with sites in the Natura 2000 network, emphasizing the importance of existing protected areas as refugia for the species. Moreover, some previously undocumented areas of high habitat suitability were identified, providing a spatially basis for refining monitoring strategies and informing conservation planning for this ecologically sensitive freshwater invertebrate.

PMID:41190312 | PMC:PMC12580294 | DOI:10.1002/ece3.72410

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Association between parenteral nutrition and central line-associated bloodstream infection in hospitalized adults with a central venous catheter: A retrospective cohort study

JPEN J Parenter Enteral Nutr. 2025 Nov 4. doi: 10.1002/jpen.70030. Online ahead of print.

ABSTRACT

BACKGROUND: Central line-associated bloodstream infection (CLABSI) persists as a clinical concern, contributing to increased morbidity, mortality, and healthcare costs. Prior studies have demonstrated that parenteral nutrition (PN) is associated with a small but statistically significant increase in CLABSI incidence. In this study, we evaluated the association between patients requiring PN via central venous catheter (CVC) and CLABSI, hypothesizing higher risk among patients receiving PN.

METHODS: We performed a retrospective cohort study of 25,502 adult inpatients with a CVC who were admitted to two affiliated hospitals in a large academic health system in New York City. Univariate and multivariate analyses were performed to examine the relationship between PN and CLABSI risk, with additional subgroup analyses focusing on patients in and out of the intensive care unit (ICU).

RESULTS: During the study period, 25,502 admissions were associated with a CVC, and 186 CLABSI cases were documented. When adjusting for confounders, PN was a significant risk factor for patients outside the ICU (odds ratio, 4.3; 95% confidence interval [CI], 2.4-7.9) but was not a significant risk factor for CLABSI in ICU patients. Hospital-wide, PN administration was associated with a higher risk of CLABSI when adjusting for confounders (2.3; 95% CI, 1.3-3.6).

CONCLUSION: PN is associated with an increased risk of CLABSI in ward patients but not in ICU patients, suggesting context-dependent risk. Further work is needed to determine effective strategies for reducing rates of CLABSI among patients receiving PN hospital-wide and to validate these findings in broader patient populations.

PMID:41189041 | DOI:10.1002/jpen.70030

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Nevin Manimala Statistics

Time to death and its predictors among under-five children with acute pneumonia: a Bayesian parametric survival analysis

Pneumonia (Nathan). 2025 Nov 5;17(1):31. doi: 10.1186/s41479-025-00178-8.

NO ABSTRACT

PMID:41189018 | DOI:10.1186/s41479-025-00178-8

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Nevin Manimala Statistics

The SCRIM score: a clinical tool for cancer risk-stratification in patients with idiopathic inflammatory myopathy

Arthritis Res Ther. 2025 Nov 4;27(1):204. doi: 10.1186/s13075-025-03666-w.

ABSTRACT

BACKGROUND: Although patients with idiopathic inflammatory myopathy (IIM) have a higher cancer risk than the general population, this risk varies among IIM patients based on clinical factors such as IIM subtype, clinical features, and autoantibody profiles. This study aimed to establish a risk-stratification system to identify those with high-risk for cancer in patients with IIM.

METHODS: This study included 481 patients with IIMs from four independent cohorts in South Korea. The primary outcome was myositis-associated cancer, defined as cancers occurring within 3 years before or after the diagnosis of IIM. Logistic regression with Least Absolute Shrinkage and Selection Operator (LASSO) regularization was used to select predictors from 24 prespecified factors for the multivariable model. A scoring system, entitled the SCRIM score, was established based on the β coefficient of each predictor in the final model. A conditional inference tree analysis was used to identify the optimal cut-off point for group classifications. The cancer risk of each group compared to that of the general population was assessed using standardized incidence ratio (SIR), which was calculated using the 2022 age-matched general population in South Korea as the reference.

RESULTS: In the study population, 12.9% (n = 62) had myositis-associated cancer. The LASSO regression identified older age, male sex, current smoking status, dermatomyositis, and anti-TIF1γ as high-risk factors for cancer; however, anti-synthetase syndrome, overlap myositis, arthritis, and interstitial lung disease were associated with a lower cancer risk. The SCRIM score based on these factors showed excellent performance (AUROC 0.852 [95% CI 0.796-0.907]). Patients were stratified into the low-risk, intermediate-risk, and high-risk groups based on the SCRIM score, and the incidence of myositis-associated cancer increased significantly in a stepwise manner across groups. Patients in the low-risk group had a cancer incidence comparable to that of the general population (SIR 0.79), whereas those in the intermediate-risk (SIR 2.28) and high-risk (SIR 15.30) groups had significantly higher cancer incidences.

CONCLUSION: The SCRIM score precisely stratified the risk of myositis-associated cancer for patients with IIM, which can be an important basis for establishing an evidence-based screening cancer strategy.

PMID:41188999 | DOI:10.1186/s13075-025-03666-w

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Photocatalytic decolorization of methyl orange using MnCeO(x)-TiO(2) composite catalyst: experimental evaluation and statistical analysis

BMC Chem. 2025 Nov 4;19(1):296. doi: 10.1186/s13065-025-01655-3.

ABSTRACT

MnCeOx/TiO2 composite catalysts were synthesized and characterized to investigate their photocatalytic efficiency in methyl orange decolorization. Structural and textural analyses revealed mesoporous architectures with specific surface areas ranging from 31.38 to 68.46 m2 g-1, pore volumes of 0.252-0.505 cm3 g-1, and average pore diameters of 14.75-29.50 nm. FT-IR, XRD, and UV-Vis/DRS confirmed successful MnCeOx incorporation and band gap tuning (2.87-3.46 eV), indicating enhanced charge transfer capabilities. Photocatalytic experiments demonstrated that MO decolorization is highly sensitive to solution pH, temperature, MnCeOx/TiO2 weight ratio, and reaction time. Optimal conditions-pH = 3, temperature ≈ 39.6 °C, MnCeOx/TiO2 = 0.31, and reaction time = 35 min-achieved a maximum photo decolorization efficiency of 41.93%. Kinetic studies revealed pseudo-first-order behavior (k = 0.04927 min-1 for MCT-0.1), with performance strongly influenced by surface charge interactions and active site accessibility. A Response Surface Methodology-Central Composite Design model was developed, demonstrating excellent predictability (R2 = 0.99, Pred R2 = 0.96) and a desirability score of 0.97. ANOVA confirmed the significance of main effects and binary interactions, particularly between pH, MnCeOx/TiO2 ratio, and reaction time, on MO PDE.

PMID:41188994 | DOI:10.1186/s13065-025-01655-3

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The relationship between digital burnout and academic procrastination and the mediating roles of life satisfaction and the fatigue in this relationship

BMC Psychol. 2025 Nov 4;13(1):1223. doi: 10.1186/s40359-025-03510-5.

ABSTRACT

BACKGROUND: In parallel with developing technologies, university students may experience digital burnout and postpone their academic tasks because of the need to be in digital environments. This study aimed to examine the relationship between digital burnout and academic procrastination and the mediating roles of life satisfaction and fatigue in this relationship. For this purpose, the direct relationships between the variables and the indirect effects of digital burnout on academic procrastination through the mediating variables were tested.

METHODS: A total of 277 sport sciences students participated in the study conducted with the relational survey model. The Personal Information Form, Digital Burnout Scale, Satisfaction with Life Scale, Calder Fatigue Scale, and Academic Procrastination Scale were used as data collection tools. Descriptive statistics, Pearson correlation, SEM and mediation analysis were used in the analysis of the data. Mediation analysis is a popular statistical procedure for testing hypotheses about the mechanisms by which a causal effect operates. Path analysis of the research model was conducted.

RESULTS: References numbered 53 in Question 7 and 107 and 126 in Question 10 were retrieved from the Turkish National Thesis Center, where the corresponding thesis titles can be located through the database search function. Additionally, Reference 116 is available as an open-access source provided by the University of Alabama. As no specific citation guidelines for theses were supplied, these references have been formatted in accordance with the available information. I look forward to your response and any suggestions you may have. Sincerely,The results revealed that digital burnout had a negative effect on life satisfaction, a positive effect on fatigue and academic procrastination, and that life satisfaction and fatigue had positive and significant effects on academic procrastination. It was concluded that digital burnout had a positive and significant effect on academic procrastination in the absence of other mediating variables and that life satisfaction and fatigue had a partial mediating effect on the effect of digital burnout on academic procrastination.

CONCLUSIONS: Negative and significant relationships were found between digital burnout and life satisfaction, as well as between life satisfaction and academic procrastination. In contrast, positive and significant relationships were observed between digital burnout and fatigue, and between digital burnout and academic procrastination. Furthermore, both digital burnout and fatigue were found to increase academic procrastination. The analyses indicated that life satisfaction and fatigue played a partial mediating role in the relationship between digital burnout and academic procrastination. Future research may investigate potential strategies to reduce the effects of digital burnout on academic procrastination (e.g., social activities, sports). Additionally, longitudinal data could be used in various disciplines to examine differences in mediation effects across demographic variables, and cultural differences could be explored in samples from diverse cultural contexts.

PMID:41188990 | DOI:10.1186/s40359-025-03510-5

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Depressive symptoms among migrant Chinese grandparents and intergenerational family conflict: a moderated mediation model

BMC Psychol. 2025 Nov 3;13(1):1219. doi: 10.1186/s40359-025-03540-z.

ABSTRACT

BACKGROUND: Amid China’s rapid urbanization and demographic aging, the population of migrant grandparents who relocate to cities to provide intergenerational care has been steadily expanding. This group is particularly vulnerable to depressive symptoms due to the accumulation of multiple stressors, and they face an elevated risk of intergenerational family conflict. This study aims to examine the relationship between depression among migrant grandparents and intergenerational conflict within families, with a particular focus on the mediating role of hostile attribution bias and the moderating role of collective family efficacy.

METHODS: Using the Short Form of the Center for Epidemiological Studies Depression Scale (CES-D), the Collective Family Efficacy Questionnaire, the Hostile Attribution Bias Scale, and the Multidimensional Intergenerational Relationship Quality Scale, a questionnaire survey was conducted among 432 representative migrant grandparents in Zhengzhou, China, between March and May 2023. Data analysis included descriptive statistics, correlation analysis, and moderated mediation modeling.

RESULTS: (1) Depressive symptoms were found to be positively and significantly associated with intergenerational family conflict (β = 0.336, 95%CI[0.253,0.418]). Hostile attribution bias demonstrated a significant mediating effect in the relationship between depressive symptoms and intergenerational family conflict (β = 0.175, 95%CI[0.097,0.257]). (2) Furthermore, collective family efficacy moderated the mediating role of hostile attribution bias. When collective family efficacy was at a low level, the mediating pathway of hostile attribution bias was significant (β = 0.486, 95%CI[0.374,0.597]); when collective family efficacy was at a high level, the mediating pathway was no longer significant (β = 0.058, 95%CI[-0.063,0.179]).

CONCLUSION: Within the co-residential, multi-generational caregiving arrangements involving migrant grandparents in China, hostile attribution bias mediates the relationship between depressive symptoms and intergenerational family conflict, while collective family efficacy moderates the mediating pathway of hostile attribution bias on intergenerational family conflict. The findings provide a theoretical basis for designing targeted preventive interventions. Future interventions are recommended to focus on reducing hostile attribution bias and enhancing collective family efficacy to mitigate the negative relationship between depressive symptoms and intergenerational family conflict, thereby promoting the intergenerational well-being of migrant grandparents.

PMID:41188972 | DOI:10.1186/s40359-025-03540-z