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Nevin Manimala Statistics

Analysis of cross-platform health communication with a network approach

Biometrics. 2025 Oct 8;81(4):ujaf154. doi: 10.1093/biomtc/ujaf154.

ABSTRACT

Online health communities (OHCs) provide a platform for patients and those related to share and communicate, making complex medical information more digestible and actionable. Health communication within OHCs can be impacted by other information sources. This study examines cross-platform health communication by mining Breastcancer.org (the largest online breast cancer community) and Twitter (now X). Early analyses of OHCs, Twitter, and other online platforms often adopt simple measures like word frequency, and more recent research has shifted towards word co-occurrence network analysis. Relatively, cross-platform communication analysis is limited, and the adopted techniques have drawbacks. We propose a new cross-platform communication model that collectively analyzes word co-occurrence networks and word frequency vectors. Here, the former describe the structural contents of health communication, and the latter describe the volumes. This model offers a nuanced perspective, accommodates temporal variations, and is examined for its theoretical and numerical properties. Collected from January 2010 to December 2020, the analyzed data contains over 1 395 000 tweets and 517 000 posts. Our analysis suggests that the Twitter’s topics on breast cancer significantly impact the contents and volumes in the OHC. Distinct time phases are observed, with notable peaks during 2012-2013 and 2015-2018. This study can provide a venue for better understanding health communication and new insights into two highly important online platforms.

PMID:41273214 | DOI:10.1093/biomtc/ujaf154

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Nevin Manimala Statistics

Association of preoperative chronic opioid use with 1-year revision rate, mortality, and patient-reported outcomes after primary hip and knee arthroplasty: age, sex and BMI matter – a Dutch register-based study

Acta Orthop. 2025 Nov 22;96:857-866. doi: 10.2340/17453674.2025.44597.

ABSTRACT

BACKGROUND AND PURPOSE: Our aim was to study the association between chronic preoperative opioid use and 1-year revision rate, mortality, and patient-reported outcomes (PROs) after primary total knee and hip arthroplasty (TKA/THA). We also investigated whether age, sex, or BMI modified these associations.

METHODS: TKAs and THAs performed for osteoarthritis between 2013 and 2018, originating from the Dutch Arthroplasty Register, were linked to the Dutch Foundation for Pharmaceutical Statistics. Chronic preoperative opioid use was defined as > 1,800 morphine mg equivalent dispensed 1 year before surgery and ≥ 1 opioid prescribed 30 days before surgery. Outcomes were 1-year revision rate, mortality, self-reported physical functioning, pain, and quality of life (QoL). Incidence rates were calculated; Cox regression and linear mixed models were used. We assessed effect modification by assessment of supra-additive effects.

RESULTS: Preoperative chronic opioid use occurred in 4.5% of 29,739 THAs and 3.4% of 27,873 TKAs. Chronic opioid use doubled mortality and revision rates for both TKAs and THAs (range of hazard ratios 1.7-2.1). The association of preoperative opioid use with 1-year revision rate was larger in males, in patients with a BMI ≤ 30 (THA) and > 30 (TKA), and 66-75-year-olds. Younger patients exhibited a more pronounced association between opioid use and reduced physical functioning and QoL, and increased pain. Sex and BMI had no modifying effects on PROs.

CONCLUSION: Preoperative chronic opioid use was associated with a higher likelihood of 1-year revision and mortality and worse PROs. The associations with revision risk were modified by age, sex, and BMI. Age also had a modifying effect on PROs.

PMID:41273199 | DOI:10.2340/17453674.2025.44597

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Nevin Manimala Statistics

Enhancing statistical analysis of real world data

Database (Oxford). 2025 Jan 18;2025:baaf073. doi: 10.1093/database/baaf073.

ABSTRACT

The National Health and Nutrition Examination Survey (NHANES) provides extensive public data on demographics, health, and nutrition, collected in 2-year cycles since 1999. Although invaluable for epidemiological and health-related research, the complexity of NHANES data, involving numerous files and disjoint metadata, makes accessing, managing, and analysing these datasets challenging. This paper presents a reproducible computational environment built upon Docker containers, PostgreSQL databases, and R/RStudio, designed to streamline NHANES data management, facilitate rigorous quality control, and simplify analyses across multiple survey cycles. We introduce specialized tools, such as the enhanced nhanesA R package and the phonto R package, to provide fast access to data, to help manage metadata, and to handle complexities arising from questionnaire design and cross-cycle data inconsistencies. Furthermore, we describe the Epiconnector platform, established to foster collaborative sharing of code, analytical scripts, and best practices, which taken together, can significantly enhance the reproducibility, extensibility, and robustness of scientific research using NHANES data.

PMID:41273197 | DOI:10.1093/database/baaf073

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Nevin Manimala Statistics

Post Hoc and Precarious: A Cautionary Note on Terlipressin in Early-Stage ACLF

Liver Int. 2025 Dec;45(12):e70456. doi: 10.1111/liv.70456.

NO ABSTRACT

PMID:41273186 | DOI:10.1111/liv.70456

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Nevin Manimala Statistics

PTSD-Like Symptoms Among Postpartum Black Women: The Lasting Impact of High-Risk Pregnancies, Birth Trauma, and Mistreatment During Perinatal Care

Res Nurs Health. 2025 Nov 22. doi: 10.1002/nur.70032. Online ahead of print.

ABSTRACT

Black, Hispanic, and multiracial women in the U.S. experience higher rates of discrimination and mistreatment in perinatal care compared to White women, which can lead to fear, anxiety, and reduced engagement with obstetric healthcare providers. Black women are also more likely to experience high-risk pregnancies and health complications such as gestational diabetes and hypertensive disorders. As a result, Black women face a heightened risk of birth trauma and subsequent posttraumatic stress disorder (PTSD) in the postpartum period. Despite these inequities, little is known about Black birthing individuals’ experiences of healthcare interactions. This study explores Black women’s accounts of negative experiences of perinatal care in the context of high-risk pregnancy. Fourteen individuals from across the U.S. participated in semi-structured interviews conducted within 6 months postpartum between September 2022 and December 2024. Interview responses were analyzed using directed content analysis, with coding of their emotional distress guided by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) definition of PTSD. Their accounts aligned with the four DSM-5-TR symptom clusters: intrusive symptoms, avoidance, negative alterations in cognition or mood, and alterations in arousal and reactivity. PTSD-like symptoms resulted from pregnancy complications, traumatic birth experiences, mistreatment by clinicians or a combination of these factors. The findings suggest that birth trauma and mistreatment in perinatal care have significant emotional and behavioral impacts on Black women. The study results underscore the urgent need for trauma-informed, antiracist approaches in perinatal care to address these disparities and improve outcomes for Black birthing individuals.

PMID:41273178 | DOI:10.1002/nur.70032

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Nevin Manimala Statistics

Lower Extremity Symmetry and Normative Values During Functional Performance Tests in Entry-Level U.S. Marines

Mil Med. 2025 Nov 22:usaf572. doi: 10.1093/milmed/usaf572. Online ahead of print.

ABSTRACT

INTRODUCTION: The limb symmetry index (LSI) is a common tool for evaluating functional performance across a variety of populations. An LSI of ≥90% is a common, generally accepted clinical threshold for patients with musculoskeletal injuries to achieve before returning to activity. This study’s aims were to: (1) describe normative symmetry characteristics and evaluate the influence of sex and limb dominance during functional tasks in healthy, entry-level U.S. Marines, and (2) describe the relationship between symmetry performance across all functional tasks.

MATERIALS AND METHODS: This was a cross-sectional study including 651 active duty U.S. Marines with no current injuries (187F/464M, 19.9 ± 2.4 years, limb dominance 59L/592R, 4.8 ± 3.2 months of service). Limb dominance was defined as the preferred limb to kick a soccer ball. Participants completed 5 repetitions of bodyweight bilateral squats and maximal effort vertical jumps using a natural arm swing. Peak eccentric and concentric force (N) were recorded bilaterally on dual force plates for the squat and jump. Participants completed an isometric midthigh pull (IMTP) by standing atop force plates with their knees and hips flexed at approximately 40-50° and 35°, respectively. A fixed bar was positioned at the midpoint between the hips and knees. Participants pulled up as hard and as fast as possible and held a maximal effort for 3-5 seconds for 3 repetitions. Peak vertical force (N) was recorded bilaterally. Force values were normalized to participants’ body mass (N/kg). Limb symmetry index was calculated as nondominant limb/dominant limb*100%. Independent sample t-tests determined significant differences in LSI force variables and sexes. Paired t-tests evaluated significant differences in loading between dominant and nondominant limbs. Effect sizes were evaluated via Cohen’s d values. Pearson correlations coefficients (r) described the relationship between all dependent variables across all tasks.

RESULTS: Across all tasks and variables, there were no differences in LSI values across sexes (P > .05). Regardless of sex, participants loaded more of their body mass on their dominant limb compared to their nondominant limb with weak-to-small effect sizes (d: 0.22-0.34). Squat LSI had a weak-to-moderate positive relationship with LSI during the vertical jump (r: 0.13-0.69). No other significant relationships were observed (P > .05).

CONCLUSIONS: Our study provides stakeholders (e.g., military personnel, clinicians, researchers, etc.) normative ranges of LSI performance values during a bodyweight bilateral squat, vertical jump, and IMTP tasks in a large healthy active duty population. Sex does not appear to influence LSI performance; however, limb dominance may influence loading patterns during these specific functional tasks. Given the similarities between the squat and vertical jump performance, future work should be conducted to determine if stakeholders should eliminate one of these tasks from the testing battery to mitigate the temporal burden required when completing functional task assessments in healthy active individuals.

PMID:41273162 | DOI:10.1093/milmed/usaf572

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Nevin Manimala Statistics

Efficacy of Bispectral Index-Guided Sevoflurane Administration in Pediatric Patients Undergoing General Anesthesia: An up-To-Date Systematic Review and Meta-Analysis

Paediatr Anaesth. 2025 Nov 22. doi: 10.1111/pan.70080. Online ahead of print.

ABSTRACT

BACKGROUND: The bispectral index (BIS) represents a promising tool for monitoring the depth of hypnosis. However, its utility in guiding sevoflurane administration during general anesthesia in pediatric patients is not well known.

METHODS: We performed a systematic review and meta-analysis of randomized controlled trials comparing BIS-guided versus standard practice sevoflurane administration in pediatric patients. PubMed/MEDLINE, Embase, and the Cochrane Central Register of Clinical Trials were searched for trials published up to May 2025. Analyses were conducted using RevMan 5.4.1., and heterogeneity was assessed using the I2 statistic.

RESULTS: We included nine studies randomizing a total of 730 pediatric patients, of whom 359 (49.2%) were managed with BIS monitoring. BIS-guided anesthesia was associated with significantly lower mean end-tidal sevoflurane concentrations, both during the maintenance phase (MD -0.46; 95% CI: -0.62 to -0.29; p < 0.00001) and at the end of surgery (MD -0.31; 95% CI: -0.47 to -0.14; p = 0.0003). Furthermore, the BIS-guided group experienced a shorter time to airway removal (MD -1.69 min; 95% CI: -2.84 to -0.55 min; p = 0.004) and a shorter time to post-anesthesia care unit discharge (MD -11.82 min; 95% CI: -17.80 to -5.84 min; p = 0.0001). No significant difference was observed in Pediatric Anesthesia Emergence Delirium score between groups (MD -0.35; 95% CI: -1.90 to 1.19; p = 0.65).

CONCLUSIONS: BIS-guided monitoring offers a strategy to reduce end-tidal sevoflurane concentrations, shortening time to airway removal and post-anesthesia care unit discharge in pediatric patients undergoing sevoflurane anesthesia.

STUDY REGISTRATION: PROSPERO, review no. CRD420251067409.

PMID:41273159 | DOI:10.1111/pan.70080

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Nevin Manimala Statistics

Disrupting oviposition behavior of spotted-wing drosophila, Drosophila suzukii (Diptera: Drosophilidae) in blueberries with volatile blends

J Econ Entomol. 2025 Nov 22:toaf320. doi: 10.1093/jee/toaf320. Online ahead of print.

ABSTRACT

Drosophila suzukii (Matsumura), spotted-wing drosophila, is an invasive pest native to East Asia that causes significant economic losses in soft-skinned high-value fruit like blueberries. Current management strategies heavily rely on insecticide applications, raising concerns about resistance and sustainability. This study evaluated the efficacy of plant-derived volatile blends, including Decoy Attract and Kill (A&K) (Batch no. 24026021), Combi-protec (Batch no. SP2211XXUS), Decoy (Batch no. 42022121, 10% citric acid), and fermentation-based volatiles of Scentry experimental blend (SEB) (Batch no. SBI2024200-005), and Droski drink (acetic acid) as potential behavioral disruptors that reduce D. suzukii oviposition without insecticide use. These five volatile blends, except Decoy and Droski drink have undisclosed active ingredients. Three concentrations of Decoy A&K (0.5, 2, and 5 mM) and four other blends were tested using Drosophila activity monitor (DAM), electroantennography (EAG), laboratory behavioral trials, and exclusion cage semi-field oviposition trials. DAM quantified positional preference and dwell time to blends, while EAG measured antennal responses to Decoy A&K. Laboratory behavioral trials assessed oviposition and dwelling behaviors, while exclusion caged semifield trials evaluated oviposition behavior alone. Decoy A&K, Combi-protec, and Decoy significantly increased dwell time and reduced oviposition on blueberries, both in controlled and semi-field conditions. EAG responses showed that D. suzukii can detect Decoy A&K volatiles through olfaction, likely mediating the observed behavioral results. These findings highlight the potential of selected volatile blends as tools for behavioral disruption, supporting their application in integrated pest management strategies, including push-pull or attract-and-kill systems for D. suzukii.

PMID:41273152 | DOI:10.1093/jee/toaf320

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Nevin Manimala Statistics

sTREM-1 as a biomarker for sepsis diagnosis and prognosis following abdominal surgery

Lab Med. 2025 Nov 22:lmaf074. doi: 10.1093/labmed/lmaf074. Online ahead of print.

ABSTRACT

INTRODUCTION: Sepsis represents a critical response to infection; it is characterized by systemic inflammation, shock, and potential organ failure. Soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) has been identified as a crucial marker in sepsis, connecting the activation of innate immunity to systemic inflammation.

METHODS: This prospective nested case control study was carried out in the intensive care unit and surgery department from March 2018 to June 2019. Adults undergoing abdominal surgery, with and without sepsis, were included in the study, and sTREM-1 and cytokine levels were measured.

RESULTS: A total of 120 patients were included in the study, comprising 31 noninfected individuals, 37 with sepsis, and 52 with septic shock. sTREM-1 levels were statistically significantly elevated in patients with sepsis and septic shock compared with noninfected individuals (P < .001). Receiver operating characteristic curve analysis revealed an area under the curve of 0.722 for sTREM-1 in the prediction of septic shock.

DISCUSSION: Elevated sTREM-1 levels are associated with the severity of sepsis and may function as a prognostic biomarker. Additional research is required to confirm these findings and investigate therapeutic interventions aimed at the sTREM-1 pathway.

PMID:41273150 | DOI:10.1093/labmed/lmaf074

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Nevin Manimala Statistics

Asymmetric Gingival Margins of Maxillary Central Incisors: Does It Matter to Lay Persons and Professionals

Orthod Craniofac Res. 2025 Nov 22. doi: 10.1111/ocr.70060. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to assess the aesthetic judgements made by lay people and professionals relating to an asymmetric maxillary central incisors’ gingival margin position.

SETTING: Multi-center institutional study.

MATERIALS AND METHODS: A high-quality intra-oral photograph of a previously treated case was manipulated (six images). Parents of children undergoing conventional orthodontic treatment (PCT), parents of children undergoing combined surgical-orthodontic treatment for a unilateral impacted maxillary central incisor (PI) and professionals (dental and orthodontic specialists) were asked to evaluate and rank the images in terms of aesthetics and provide free-text responses to support their rankings (least and most attractive). All data was analysed statistically with regressions at 5% and a thematic analysis of the free-text responses was performed.

RESULTS: The responses from 120 participants (mean age 42.2 years; Standard Deviation [SD] 8.6 years; 62.2% female) were analysed (30/group). Image E (symmetrical gingival margins with the lateral incisor gingival margins 0.5-1.0 mm below both the gingival margin of the maxillary canine and central incisor which are at the same level in relation to each other) was ranked the most attractive (60.8%). The presence of an asymmetric gingival margin between the maxillary central incisors was rated the least attractive (Images D and F; 30.9% and 39.2%, respectively). The highest and lowest mean ranking scores (adjusted for gender) were Image E (5.12 points; 95% CI: 4.76-5.48 points) and F (1.83 points; 95% CI: 1.57-2.10 points) A similar trend was evident within groups. The PCT group scored Image D the lowest (2.17 points; 95% CI: 1.72-2.62 points). Gender influenced the ranking of the images. Themes to support the ranking of the most attractive image were related to the importance of overall symmetry. Themes to support the ranking of the least attractive image were based on overall asymmetrical (uneven) appearance (n = 117).

CONCLUSION: An asymmetric gingival margin position between the maxillary central incisors negatively influences the rating/perception of attractiveness by lay persons and professionals.

PMID:41273137 | DOI:10.1111/ocr.70060