Tag: statistics

Blood Adv. 2025 May 1:bloodadvances.2025015834. doi: 10.1182/bloodadvances.2025015834. Online ahead of print.

ABSTRACT

Anti-CD19 chimeric antigen receptor (CAR) T cells have shown impressive results in the treatment of relapsed/refractory aggressive large B-cell lymphomas (LBCLs). However, the prognostic value of the LBCL histological subtype in the context of CAR T cell therapy is unclear. Here, we report the prognostic value of transformed indolent non-Hodgkin lymphoma (TriNHL) (n=110) confirmed by an expert pathologic review (LYMPHOPATH) vs. de novo LBCL (n=391) in the context of CAR T cell therapy from 4 centers of the French DESCAR-T registry. After 1:1 propensity score matching (N=170, 85 TriNHL patients and 85 de novo LBCL patients), the median follow-up was 19.4 months (95% CI, 12.0-25.1) for TriNHL patients and 18.5 months (95% CI, 13.8-24.8) for LBCL patients. The 1-year progression-free survival rate was significantly better (55.8%, [95% CI, 43.6-66.4]) in the TriNHL group than in the de novo LBCL group (31.7%, [95% CI, 21.4-42.6]) (hazard ratio=0.54, [95% CI, 0.36-0.82], p=0.0034). The best overall response rate/complete response rate was 82.4%/63.5%, whereas it was 63.5%/50.6% for the TriNHL group compared with the de novo LBCL group. The 1-year overall survival was also longer in the TriNHL group than in the de novo LBCL group (72.1%, [95% CI, 59.6-81.4] vs. 50.7%, [95% CI, 38.2-62.0], p=0.031). Similar findings were found via an inverse probability weighting statistical approach. No difference was observed in terms of toxicity. In conclusion, our matched-comparison study revealed a greater efficacy of CAR T cell therapy, with a comparable toxicity profile for TriNHL patients than for LBCL patients.

PMID:40311067 | DOI:10.1182/bloodadvances.2025015834

Science. 2025 May;388(6746):532-537. doi: 10.1126/science.adn4381. Epub 2025 May 1.

ABSTRACT

Efforts to address declines of North American birds have been constrained by limited availability of fine-scale information about population change. By using participatory science data from eBird, we estimated continental population change and relative abundance at 27-kilometer resolution for 495 bird species from 2007 to 2021. Results revealed high and previously undetected spatial heterogeneity in trends; although 75% of species were declining, 97% of species showed separate areas of significantly increasing and decreasing populations. Populations tended to decline most steeply in strongholds where species were most abundant, yet they fared better where species were least abundant. These high-resolution trends improve our ability to understand population dynamics, prioritize recovery efforts, and guide conservation at a time when action is urgently needed.

PMID:40310906 | DOI:10.1126/science.adn4381

PLoS Med. 2025 May 1;22(5):e1004592. doi: 10.1371/journal.pmed.1004592. eCollection 2025 May.

ABSTRACT

BACKGROUND: Health data disaggregated by sex is vital for identifying the distribution of illness, and assessing risk exposures, service access, and utilization. Disaggregating data along a health pathway, i.e., the measurable continuum from risk factor exposure to final health outcome (death), and including disease prevalence and a three-step care cascade (diagnosis, treatment, and control), has the potential to provide a holistic and systematic source of information on sex- and gender-based health inequities and identify opportunities for more tailored interventions to reduce those inequities.

METHODS AND FINDINGS: We collected sex- and age-disaggregated data along the health pathway. We searched for papers using global datasets on the sex-disaggregated care cascade for eight major conditions and identified cascade data for only three conditions: hypertension, diabetes, and HIV and AIDS. For each condition, we collected risk factor prevalence, disease prevalence, cascade progression, and death rates. We assessed the sex difference for all steps along the pathway and interpreted inequities through a lens of gender analysis. Sex-disaggregated data on risk factors, disease prevalence, and mortality were found for all three conditions across 204 countries. Sex-disaggregated care cascades for hypertension, diabetes, and HIV and AIDS were found only for 200, 39, and 76 countries, respectively. Significant sex differences were found in each step along the pathways. In many countries, males exhibited higher disease prevalence and death rates than females, while in some countries, they also reported lower rates of healthcare seeking, diagnosis, and treatment adherence. Smoking prevalence was higher among males in most countries, whereas prevalence of obesity and unsafe sex were higher in females in most countries.

CONCLUSIONS: Findings support the increasing need to develop strategies that encourage greater male participation in preventive and healthcare service and underscore the importance of sex-disaggregated data in understanding health inequities and guiding gender-responsive interventions at different points along the pathway. Despite limitations in data availability and completeness, this study elucidates the need for more comprehensive and harmonized datasets for these and other conditions to monitor sex differences and implement sex-/gender-responsive interventions along the health pathway.

PMID:40310879 | DOI:10.1371/journal.pmed.1004592

J Frailty Aging. 2025 Apr 29;14(3):100049. doi: 10.1016/j.tjfa.2025.100049. Online ahead of print.

NO ABSTRACT

PMID:40310717 | DOI:10.1016/j.tjfa.2025.100049

Chaos. 2025 May 1;35(5):053101. doi: 10.1063/5.0244221.

ABSTRACT

A transformer-based Koopman autoencoder is proposed for linearizing Fisher’s reaction-diffusion equation. The primary focus of this study is on using deep learning techniques to find complex spatiotemporal patterns in the reaction-diffusion system. The emphasis is on not just solving the equation but also transforming the system’s dynamics into a more comprehensible, linear form. Global coordinate transformations are achieved through the autoencoder, which learns to capture the underlying dynamics by training on a data set with 60,000 initial conditions. Extensive testing on multiple data sets was used to assess the efficacy of the proposed model, demonstrating its ability to accurately predict the system’s evolution as well as to generalize. We provide a thorough comparison study, comparing our suggested design to a few other comparable methods using experiments on various PDEs, such as the Kuramoto-Sivashinsky equation and Burger’s equation. Results show improved accuracy, highlighting the capabilities of the transformer-based Koopman autoencoder. The proposed architecture is significantly ahead of other architectures, in terms of solving different types of PDEs using a single architecture. Our method relies entirely on the data, without requiring any knowledge of the underlying equations. This makes it applicable to even the data sets where the governing equations are not known.

PMID:40310706 | DOI:10.1063/5.0244221

J Otolaryngol Head Neck Surg. 2025 Jan-Dec;54:19160216251333359. doi: 10.1177/19160216251333359. Epub 2025 May 1.

ABSTRACT

ImportanceUnlike other head and neck cancers, head and neck soft tissue sarcoma (HN-STS) is staged similarly to sarcomas in the trunk and extremities. The current American Joint Committee on Cancer (AJCC) staging system has limitations that hinder accurate prognosis prediction for HN-STS.ObjectiveWe aimed to develop a novel location-grading-node-metastasis (LGNM) staging system based on the primary tumor location to more accurately stratify prognosis for HN-STS.DesignA retrospective case series from 1990 to 2021.Setting/ParticipantsThis study included 471 patients diagnosed with HN-STS at Sun Yat-sen University Cancer Center between 1990 and 2021.Main outcome measuresIn the primary analysis, we obtained the overall survival (OS) rate. Secondary measures included area under the receiver operating characteristic curve, Harrell’s C, Somers’ D, Gönen and Heller’s K, O’Quigley’s ρ2k, Royston’s R², the Bayesian information criterion for concordance, and variation in patient outcomes.ResultsThe eighth edition of AJCC T classification for tumor size inadequately conveys prognosis information. In contrast, the primary tumor location and local invasion are prognostic factors for HN-STS and categorized into 4 stages: L1 (low risk: scalp, face, supraclavicular, ear), L2 (intermediate risk: neck, paravertebral, pharynx, tonsil, eye, orbit), L3 (high risk: cavity, lip, palate, buccal mucosa, salivary gland, maxilla, mandible), and L4 (any location with local invasion). The new LGNM staging system effectively distributed patients into stages I to IV, with statistically-significant survival differences among these stages. Five-year OS rates were 96.9% for stage I, 78.4% for stage II, 37.1% for stage III, and 7.1% for stage IV (P < .001). Additionally, the LGNM staging system demonstrated superior predictive ability and concordance compared with the seventh and eighth editions of AJCC staging systems.Conclusions/RelevanceThe LGNM staging system shows better homogeneity and discriminatory power than the AJCC system, improving risk stratification and prognosis prediction in HN-STS.

PMID:40310697 | DOI:10.1177/19160216251333359

JMIR Res Protoc. 2025 May 1;14:e66982. doi: 10.2196/66982.

ABSTRACT

BACKGROUND: Malaria is a major health issue that is distributed across 85 countries globally including Indonesia. Indonesia is in the process of achieving malaria elimination. Currently, a high burden of malaria exists in the rural eastern part of the nation, including East Nusa Tenggara Province where the number of malaria cases increased significantly during COVID-19. To achieve malaria elimination, malaria awareness must be measurable and integrated into malaria policy. Currently, malaria awareness among rural communities in the region is low, and interventional studies aiming at improving malaria awareness in rural areas in Indonesia are poorly documented.

OBJECTIVE: This study aims to investigate the impact of a local wisdom-based health education campaign combining local music, the voice of subdistrict leaders, and loudspeaker announcements on malaria-related behaviors in rural communities. Specifically, we aim to assess the effect of this intervention on (1) improvement in the malaria awareness index among rural communities and their associated factors, (2) changes in appropriate malaria treatment-seeking behavior (AMTSB) and its associated factors, (3) enhancements in knowledge and practice of malaria prevention measures and their associated factors, and (4) increased use of long-lasting insecticide-treated nets and their associated factors.

METHODS: This study used a cluster-assigned quasi-experimental design with pretest and posttest assessments in control and intervention groups. The control group, consisting of 12 villages, received malaria education integrated into routine health services provided by local health centers. The intervention group, comprising 13 villages, received the same education as the control group, in addition to a malaria campaign conducted once a week for 20 weeks. Before and after the campaign, a household survey was conducted to assess behavioral aspects of malaria, including general knowledge of malaria, AMTSB, and malaria prevention measures knowledge and practice. Improvement in the malaria awareness index, AMTSB, good level of malaria prevention measure knowledge, and good level of malaria prevention measure practice will be determined based on the difference scores for each index before and after the intervention in both groups. The chi-square test will be used to assess score differences. Binary logistic regression analysis will be conducted to identify key risk factors associated with changes in each index.

RESULTS: The intervention was conducted from the last week of August 2024 to the second week of January 2025. A total of 894 respondents participated before and after the intervention. The project is currently in progress, with multiple papers being drafted for publication in peer-reviewed journals.

CONCLUSIONS: This study is expected to provide significant findings to comprehensively investigate the change in behavioral aspects of malaria due to a local wisdom-based malaria education campaign. The findings could assist stakeholders in Indonesia with developing malaria health policies that are contextually relevant, thereby supporting global efforts to achieve malaria-free status by 2030.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/66982.

PMID:40310678 | DOI:10.2196/66982

Interact J Med Res. 2025 May 1;14:e65213. doi: 10.2196/65213.

ABSTRACT

BACKGROUND: Physical activity and appropriate nutrition are essential for older adults. Improving physical health and quality of life can lead to healthy aging.

OBJECTIVE: This study aims to investigate the long-term effects of multihealth promotion programs on the physical and mental health of older adults in communities.

METHODS: A quasi-experimental method was used to recruit 112 older adults voluntarily from a pharmacy in central Taiwan between April 2021 and February 2023. Participants were divided into an experimental group receiving a multihealth promotion program and a control group with no specific intervention. The study measured frailty, nutritional status, well-being, and quality of life using standardized tools such as the Clinical Frailty Scale (CFS), Mini-Nutritional Assessment-Short Form (MNA-SF), Well-being Scale for Elders, and the EQ-5D-3L. Data were analyzed using descriptive statistics, independent t tests, Pearson correlation, and generalized estimating equations.

RESULTS: A total of 112 participants were recruited. There were 64 (57.1%) in the experimental group and 48 (42.9%) in the control group. The experimental group exhibited significantly better quality of life (EQ-5D index) at weeks 12 (β=-.59; P=.01) and 24 (β=-.44; P=.04) compared to the control group. The experimental group muscle mass significantly increased at weeks 24 (β=4.29; P<.01) and 36 (β=3.03; P=.01). Upper limb strength improved significantly at weeks 12 (β=3.4; P=.04) and 36 (β=5; P=.01), while core strength showed significant gains at weeks 12 (β=4.43; P=.01) and 36 (β=6.99; P<.01). Lower limb strength increased significantly only at week 12 (β=4.15; P=.01). Overall physical performance improved significantly at weeks 12 (β=5.47; P<.01), 24 (β=5.17; P<.01), and 36 (β=8.79; P<.01).

CONCLUSIONS: The study’s findings highlight the practical benefits of interventions, including physical and social activities and nutritional support, in enhancing the quality of life and general physical health of older adults. This study’s findings have significant implications for clinical practice. These findings can aid in the establishment of effective interventions for older adults.

TRIAL REGISTRATION: ClinicalTrials.gov NCT05412251; https://clinicaltrials.gov/study/NCT05412251.

PMID:40310677 | DOI:10.2196/65213

JMIR Mhealth Uhealth. 2025 May 1;13:e67151. doi: 10.2196/67151.

ABSTRACT

BACKGROUND: The digital education platform Doctorvice (iKooB Inc.) offers face-to-face physician-patient education during outpatient clinic visits, remote glucose monitoring, and the delivery of educational messages, and is expected to be effective for personalized diabetes care.

OBJECTIVE: This study aims to evaluate the effectiveness of the digital education platform for diabetes care by comparing cases that included both face-to-face education and remote monitoring with those that included only face-to-face education.

METHODS: This was a randomized clinical study conducted at the Diabetes Center of Seoul St. Mary’s Hospital. Participants were aged ≥19 years and had glycated hemoglobin (HbA_1c) levels between 7.5% and 9.5%. In the intervention group, physicians used the digital education platform to provide face-to-face education at enrollment and at the 3- and 6-month visits, along with remote monitoring during the first 3 months of the 6-month study period. The control group received conventional outpatient education. Both groups completed questionnaires-assessing satisfaction with diabetes treatment, diabetes-related stress, and adherence to diabetes medication-at the beginning and end of the study. The primary endpoint was the change in HbA_1c levels.

RESULTS: A total of 66 participants were enrolled between August 1, 2022, and August 31, 2023. Of these, 26 in the intervention group and 30 in the control group were analyzed, excluding 10 participants who dropped out of the study. The mean baseline HbA_1c levels were 8.3% (SD 0.6%) in the intervention group and 8.0% (SD 0.5%) in the control group. At the 3-month follow-up, mean HbA_1c decreased by 0.5%-7.8% (SD 0.9%; P=.01) in the intervention group and by 0.2%-7.8% (SD 0.7%) in the control group. HbA_1c levels substantially improved during the first 3 months with both face-to-face education and remote glucose monitoring. However, HbA_1c tended to increase during the 3- to 6-month follow-up in the intervention group without the remote monitoring service. Satisfaction with diabetes treatment significantly improved at the end of the study compared with baseline in the intervention group (mean change +3.6 points; P=.006). Medication adherence improved in both groups, with no significant difference at 6 months (P=.59), although the intervention group showed a greater increase from baseline. Subgroup analysis indicated that the reduction in HbA_1c was greater for patients with baseline HbA_1c levels ≥8.0%, those aged ≥65 years, smokers, drinkers, and those with obesity in the intervention group.

CONCLUSIONS: The digital education platform for personalized diabetes management may be beneficial for glycemic control in type 2 diabetes mellitus. Its effectiveness appears to be enhanced when physicians provide personalized face-to-face education combined with remote feedback.

TRIAL REGISTRATION: Clinical Research Information Service (CRiS) of Republic of Korea KCT0007953; https://cris.nih.go.kr/cris/search/detailSearch.do?seq=23507&search_page=L.

PMID:40310669 | DOI:10.2196/67151

JAMA Netw Open. 2025 May 1;8(5):e258072. doi: 10.1001/jamanetworkopen.2025.8072.

ABSTRACT

IMPORTANCE: Medicare covers gender-affirming surgical procedures on a case-by-case basis. The proportion of Medicare beneficiaries who receive gender-affirming surgical procedures is unknown.

OBJECTIVE: To examine the frequency and trends of gender-affirming surgical procedures for Medicare beneficiaries.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used national Medicare data to analyze transgender and gender diverse beneficiaries’ use of gender-affirming surgical procedures from January 1, 2016, to February 29, 2020, as well as use of the same surgical procedures by beneficiaries not identified as transgender. Transgender Medicare beneficiaries were identified using a claims-based algorithm; nontransgender individuals were selected using propensity score matching. Analyses were conducted from November 2022 through October 2024.

EXPOSURES: Race and ethnicity, Medicare-Medicaid dual status, age, original reason for Medicare entitlement, geographic area, and chronic conditions.

MAIN OUTCOMES AND MEASURES: Descriptive analyses and generalized estimating equations were used to assess gender-affirming surgical procedures and beneficiary characteristics associated with surgical procedures.

RESULTS: This study included transgender individuals (mean [SD] age, 60.0 [18.6] years; 43.2% transfeminine individuals, 33.0% transmasculine individuals, and 23.9% individuals with unclassified gender) and individuals (mean [SD] age, 62.7 [21.0] years; 55.5% women and 44.5% men) not identified as transgender. Of 142 703 total person-years, there were 2156 instances of transgender individuals having at least 1 gender-affirming surgical procedure in the calendar year. The rate of individuals receiving at least 1 surgical procedure decreased from between 2.1% and 2.2% in 2016 and 2017 to 1.4% in 2018 and 2019. There was substantial variability in surgical procedures across beneficiary characteristics. Transgender beneficiaries who underwent surgery were younger (31-40 years vs 61-65 years: adjusted odds ratio [AOR], 1.91 [95% CI, 1.55-2.34]) and had higher enrollment in Medicaid (AOR, 1.14 [95% CI, 1.02-1.26]), higher rates of chronic conditions (≥10 conditions vs 0: AOR, 2.10 [95% CI, 1.79-2.46]), and higher proportions of residents on the West Coast (Alaska, Idaho, Oregon, and Washington) vs the Northeast (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont) (AOR, 1.30 [95% CI, 1.05-1.61]) compared with those who did not undergo surgery. Geographically, the largest difference was observed when comparing the Northeast with the Southeast (Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee) (AOR, 0.70 [95% CI, 0.58-0.86]; P < .001) and other parts of the South (Arkansas, Louisiana, New Mexico, Oklahoma, and Texas) (AOR, 0.56 [95% CI, 0.44-0.71]; P < .001). There was no significant difference in receipt of surgical procedures across regions for those not identified as transgender.

CONCLUSIONS AND RELEVANCE: This cross-sectional study of the Medicare program found that gender-affirming surgical procedures were very rare, particularly for those who were older, were not dually enrolled in Medicare and Medicaid, and who resided in the South. Although there were substantive regional differences in receipt of gender-affirming surgical procedures among transgender Medicare beneficiaries, beneficiaries not identified as transgender did not experience regional differences. Further study is warranted to examine barriers to accessing gender-affirming surgery for transgender and gender diverse beneficiaries.

PMID:40310645 | DOI:10.1001/jamanetworkopen.2025.8072