Tag: statistics

Am J Speech Lang Pathol. 2025 Nov 7:1-12. doi: 10.1044/2025_AJSLP-25-00036. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to examine the Turkish version of the Short Behavioral Inhibition Scale (SBIS-TR) and to investigate its validity and reliability.

METHOD: The original Short Behavioral Inhibition Scale (SBIS) was translated into Turkish in accordance with the prescribed procedures for the cross-cultural adaptation of self-report measures. This translated version was administered to 227 children and their parents, including children who stutter (CWS) and children who do not stutter (CWNS). After 7-14 days, a random sample of 98 children completed the SBIS again. Reliability and validity were assessed using statistical analyses. Reliability was assessed using Cronbach’s alpha and the test-retest method. Validity was evaluated through confirmatory factor analysis, mean score comparisons between CWS and CWNS, and correlations with the Behavioral Inhibition Questionnaire Parent Form-Turkish version (BIQ-TR) and the Communication Attitude Test for Preschool and Kindergarten Children Who Stutter-Turkish version (KiddyCAT-TR).

RESULTS: SBIS-TR demonstrated high internal consistency, with a Cronbach’s alpha of .86 and a test-retest correlation coefficient of .96. Structural validity analysis confirmed that the single-factor model fits the data well, with all fit indices meeting the accepted thresholds. SBIS-TR scores showed significant negative correlations with BIQ-TR and KiddyCAT-TR scores. No significant difference was found in SBIS-TR scores between CWS and CWNS groups (p = .235), with a median SBIS score of 15 for both groups.

CONCLUSION: The SBIS-TR demonstrated strong reliability and evidence of convergent validity; however, the results did not fully support its construct validity due to the absence of the predicted group differences between CWS and CWNS.

PMID:41202306 | DOI:10.1044/2025_AJSLP-25-00036

JMIR Form Res. 2025 Nov 7;9:e75056. doi: 10.2196/75056.

ABSTRACT

BACKGROUND: The Break Method is a structured, behavior-based emotional reconditioning program designed to help individuals gain insight into patterns of emotional dysregulation and reprogram behavioral responses rooted in past experiences. Although it has been widely adopted in private and small-group settings, empirical evidence supporting its effectiveness remains limited. With increasing interest in accessible, scalable, and personalized mental health interventions, evaluating the outcomes of such programs is essential for informing future implementation and research.

OBJECTIVE: This pilot study aimed to evaluate changes in self-reported mental health status before and after participation in the Break Method program. Specifically, we sought to examine (1) overall trends in mental health improvement, (2) associations between specific reasons for joining the program and changes in mental health outcomes, and (3) latent clusters of participant motivations based on symptom profiles.

METHODS: Data were collected from 175 unique participants, yielding 195 total survey responses (as 15 participants completed the program more than once). Participants rated their mental health status on a 5-point Likert scale both before and after the program (this was not a validated clinical measure, limiting the interpretability and comparability of results). Descriptive statistics and paired 2-tailed t tests were used to assess pre- and postprogram differences in Likert scores. McNemar tests were conducted to compare categorical mental health status (Likert score ≥4 vs <4) before and after participation. Analyses of covariance examined score changes across groups stratified by reported reasons for joining. Multiple correspondence analysis was used to explore latent symptom clusters.

RESULTS: Before program participation, 186 of 195 (95.4%) responses reported Likert scores below 4. Following the program, 157 (80.5%) responses reported scores of 4 or higher. A significant improvement in mental health status was observed (preprogram mean score 2.07 SD 0.82, postprogram mean score 3.92 SD 0.73; P<.001). Significant, positive changes were associated with reasons including anxiety (β=0.332, 95% CI 0.073-0.591), obsessive-compulsive disorder (β=0.455, 95% CI 0.061-0.850), and a history of self-harm or suicidal ideation (β=0.511, 95% CI 0.091-0.931). The multiple correspondence analysis identified three clusters of participants based on symptom profiles: (1) low self-image (eg, depression, self-sabotage, and relationship issues); (2) life-development goals (eg, self-discovery and future planning); and (3) obsessive-compulsive disorder-related symptoms. The first cluster was significantly associated with improved mental health outcomes (β=0.348, 95% CI 0.060-0.636).

CONCLUSIONS: The Break Method appears to be a promising intervention for improving mental health, particularly among individuals reporting anxiety, low confidence, or a history of self-sabotage. However, due to the single-group, preprogram-postprogram design without a control group, causality cannot be inferred, and these findings should be interpreted as preliminary associations rather than confirmed efficacy. Future studies should incorporate standardized clinical tools, control groups, and longitudinal designs to validate these results and explore long-term outcomes across diverse populations.

PMID:41202293 | DOI:10.2196/75056

JMIR Hum Factors. 2025 Nov 7;12:e69305. doi: 10.2196/69305.

ABSTRACT

BACKGROUND: Telepsychiatry has gained considerable attention, particularly during the COVID-19 pandemic. Although various factors influence the choice between online and offline modalities, differences among populations remain underexplored.

OBJECTIVE: This study aims to compare adults seeking mental health support online and offline in private clinics.

METHODS: In this cross-sectional study, we assessed differences in sociodemographic factors, internet accessibility and usability, previous help-seeking history, personality traits assessed using the Arabic Big Five Personality Inventory, and levels of self-stigma measured using the Self-Stigma of Seeking Help Scale.

RESULTS: In total, 259 participants were included (136 online and 123 offline). The online group had a higher proportion of university graduates (P=.02), employed individuals (P<.001), and those with better internet access (P=.03) and higher internet usability (P=.001). The offline group showed higher levels of conscientiousness (P=.003). The primary reasons for choosing online therapy were ease of access and time-saving. Logistic regression identified previous use of online psychiatry as the strongest factor associated with choosing online services (odds ratio [OR] 28.90, 95% CI 11.739-71.165; P<.001). Employment (OR 5.01, 95% CI 1.781-14.080; P=.002), better internet usability (OR 1.69, 95% CI 1.069-2.664; P=.03), and agreeableness (OR 1.16, 95% CI 1.001-1.351; P=.05) were also significant factors. In contrast, previous in-person visits (OR 0.11, 95% CI 0.048-0.269; P<.001), openness (OR 0.85, 95% CI 0.748-0.975; P=.02), and conscientiousness (OR 0.86, 95% CI 0.758-0.971; P=.02) were negatively associated with online preference.

CONCLUSIONS: This study highlights key differences between online and offline mental health help seekers, enhances our understanding of treatment modality preferences, and paves the way for future research.

PMID:41202289 | DOI:10.2196/69305

J Neurosurg Spine. 2025 Nov 7:1-9. doi: 10.3171/2025.6.SPINE25376. Online ahead of print.

ABSTRACT

OBJECTIVE: Paraspinal involvement has been consistently reported as a negative predictor of local control following stereotactic body radiation therapy (SBRT) for spinal metastases. The aim of this study was to investigate the characteristics of paraspinal disease and determine the impact on outcomes.

METHODS: Patients who underwent SBRT for spinal metastases with paraspinal involvement, identified from a single-institutional prospective database, were retrospectively reviewed. Those with prior radiation therapy/surgery were excluded. The treated clinical target volume (CTV) was segmented into paraspinal (CTV_PS), neuroforaminal (CTV_NF), epidural (CTV_EP), and osseous bone (CTV_bone) components. The extent of extraosseous disease was classified according to the involvement of rib, neuroforamina, and muscle. Volume and dosimetric parameters were collected and dichotomized using recursive binary partitioning. The outcomes of interest were the cumulative incidence of local failure (LF), overall survival (OS), and reirradiation rates.

RESULTS: One hundred fourteen patients with 125 treated spinal sites were identified. There were 38% (47/125), 66% (82/125), and 19% (24/125) treated spinal sites with involvement of rib, neuroforamina, and muscle, respectively. The median follow-up duration of the cohort was 17.34 months (IQR 7.79-40.11 months). The 12-month and 24-month cumulative incidence rates of LF were 19.5% (95% CI 12.6%-27.4%) and 29.8% (95% CI 21.4%-38.7%), respectively. The 12-month cumulative incidence rates of LF were 12.0% (95% CI 5.9%-20.5%) and 36.3% (95% CI 20.2%-52.6%) for patients with CTV_PS < 42.9 mL and those with ≥ 42.9 mL (p < 0.001), respectively, and 55.6% (95% CI 28.7%-75.8%) and 12.2% (95% CI 6.5%-19.9%) for patients with and without muscle invasion (p = 0.001), respectively. In the multivariable analysis, only CTV_PS remained statistically associated with LF. CTV_PS ≥ 42.9 mL was associated with 2.3 times (95% CI 1.13-4.83, p = 0.02) increased risk of LF compared with CTV_PS < 42.9 mL. The 12-month and 24-month OS rates were 56% (95% CI 47%-65%) and 41% (95% CI 32%-50%), respectively. Patients with an Eastern Cooperative Oncology Group performance status score < 1 and oligometastatic disease (≤ 5 metastases) were associated with better OS in the multivariable analysis. The 12-month and 24-month reirradiation rates were 7.3% (95% CI 3.4%-13.3%) and 16.5% (95% CI 10.2%-24.1%), respectively.

CONCLUSIONS: Spinal metastases with high-volume paraspinal involvement were associated with increased risk of LF following SBRT, and strategies to optimize local control are required.

PMID:41202272 | DOI:10.3171/2025.6.SPINE25376

J Speech Lang Hear Res. 2025 Nov 7:1-12. doi: 10.1044/2025_JSLHR-25-00336. Online ahead of print.

ABSTRACT

PURPOSE: Intensive comprehensive aphasia programs (ICAPs) are a novel service delivery model incorporating best practice principles in aphasia rehabilitation. Despite increased evidence, adoption of this model into health care services remains limited. This study evaluated the feasibility and effectiveness of the comprehensive, high-dose aphasia treatment (CHAT) program, a modified-ICAP, when implemented by a public rehabilitation facility in Brisbane, Australia.

METHOD: A nonrandomized, Type II hybrid clinical implementation and effectiveness study design was employed. The CHAT program includes 50 hr of goal-directed aphasia rehabilitation, delivered over 8 weeks. Sixty-seven adults with poststroke aphasia consented to the study. Feasibility was evaluated using service statistics (i.e., referrals, adherence, dose) and analyzed using descriptive statistics. Effectiveness evaluated changes in participants’ language impairment, communication activity and participation, and quality of life at posttherapy and 3-month follow-up. Group-level data were analyzed using linear mixed models and Cohen’s d effect sizes. Minimal detectable change (MDC₉₀) was used to determine changes at the individual participant level.

RESULTS: Fourteen cohorts of CHAT were delivered from February 2021 to December 2023. Sixty-five participants completed CHAT, with an average dose of 46.6 hr of therapy. Group-level analyses revealed significant improvements in participants’ language impairment, communication activity and participation, and quality of life (p < .05) at posttherapy and 3-month follow-up. Most participants (89%) demonstrated significant improvements on at least one outcome measure.

CONCLUSIONS: The CHAT program was feasibly delivered within a public, health care context and resulted in positive and enduring changes in participants’ language impairment, communication function, and quality of life.

SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.30522767.

PMID:41202268 | DOI:10.1044/2025_JSLHR-25-00336

Phys Rev Lett. 2025 Oct 24;135(17):173401. doi: 10.1103/nkm3-1725.

ABSTRACT

Recent experiments have shown that raising the temperature of a dipolar gas under certain conditions leads to a transition to a supersolid state. Here, we employ the path integral Monte Carlo method, which exactly accounts for both thermal and correlation effects, to study that phenomenology in a system of ^{162}Dy atoms in the canonical ensemble. Our microscopic description allows the quantitative characterization of the emergence of spatial order and superfluidity, the two ingredients that define a supersolid state. Our calculations prove that temperature on its own can promote the formation of a supersolid in a dipolar system. Furthermore, we bridge this exotic phenomenology with the more usual melting of the supersolid at a higher temperature. Our results offer insight into the interplay between thermal excitations, the dipole-dipole interaction, quantum statistics, and supersolidity.

PMID:41202245 | DOI:10.1103/nkm3-1725

Hum Vaccin Immunother. 2025 Dec;21(1):2585544. doi: 10.1080/21645515.2025.2585544. Epub 2025 Nov 7.

ABSTRACT

Diabetes mellitus (DM) predisposes individuals to respiratory tract infections (RTIs), making vaccination an essential preventive measure; however, evidence regarding vaccination awareness, uptake, and barriers among DM patients in Saudi Arabia is limited. This study aimed to assess the awareness, uptake, and barriers related to influenza, pneumococcal, and COVID-19 vaccinations among adults with DM in Saudi Arabia. A cross-sectional survey was conducted between December 2023 and March 2025 among 1,556 adults with type 1 and type 2 DM attending endocrinology clinics across three sites. A structured questionnaire evaluated awareness, uptake, and barriers, and data were analyzed using descriptive statistics and chi-square tests. Uptake rates were 60.8% for influenza, 88.7% for COVID-19, and 27.1% for pneumococcal vaccines, with pneumococcal vaccination lower in type 1 than type 2 DM (23.2% vs. 28.5%; p = .002) and COVID-19 vaccination higher in type 2 DM (90.1% vs. 84.6%; p = .001). Influenza infection was more common in type 2 DM (58.6% vs. 52.4%; p = .030), while pneumonia was less frequent in type 1 DM (10.2% vs. 16.3%; p = .003). Overall, 82.6% recognized the purpose of vaccination and 70.4% agreed that DM patients should be vaccinated, though misconceptions persisted, especially regarding pneumococcal vaccine efficacy. Healthcare providers were the main information source for influenza (45.6%) and pneumococcal vaccines (23.6%), while social media predominated for COVID-19 (49.1%). Despite reasonable awareness, vaccine uptake remains suboptimal, highlighting the need for targeted education and stronger healthcare provider engagement.

PMID:41202216 | DOI:10.1080/21645515.2025.2585544

J Am Chem Soc. 2025 Nov 7. doi: 10.1021/jacs.5c11854. Online ahead of print.

ABSTRACT

Herein, we report a ligand-controlled chemodivergent bismuth-catalyzed coupling between arylboronic acids and N-fluorosulfonimide derivatives that enables the selective formation of either C(sp²)-N or C(sp²)-O bonds. Selectivity is achieved by the modulation of the electronic and steric properties of a common ligand framework for bismuth, thus establishing an unusual ligand-controlled chemodivergent platform in main group catalysis. Specifically, the use of an electron-enrich sulfone ligand led to the major formation of sulfonimide with selectivities ranging from 2:1 to more than 20:1. Conversely, a bismuth catalyst supported by an electron-deficient sulfoximine predominantly promoted the sulfonimidate product with ratios ranging between 5:1 and 15:1. To understand the underlying principles that control the selectivity, a comprehensive mechanistic investigation was conducted by combining experimental stoichiometric studies, DFT calculations, and statistical modeling. These studies support a catalytic high-valent bismuth redox cycle, where Bi(V) intermediates dictate product selectivity through either a three- or five-membered reductive elimination-ligand coupling event. By means of statistical modeling, we identified that the charge of the coordinating heteroatom through hypervalency, together with a steric parameter around the bismuth, is the key parameter responsible for the stabilization of the relevant transition states that lead to control over the reductive elimination process.

PMID:41202213 | DOI:10.1021/jacs.5c11854

JMIR Form Res. 2025 Nov 7;9:e71911. doi: 10.2196/71911.

ABSTRACT

BACKGROUND: Older adults undergoing surgeries face increased risks of postoperative neurocognitive disorders, which impair cognitive functions. Analog neurocognitive tests are commonly used, but digital tests offer faster, more accessible assessments.

OBJECTIVE: The primary aim of this study was to evaluate the feasibility of a digital cognitive test battery in older adults undergoing abdominal surgery. Feasibility included estimation of recruitment and retention rates, acceptability, perceived value, and usability of the test. The secondary aim was to explore outcome trajectories of cognition, depression, functional status, and quality of recovery.

METHODS: This nonrandomized feasibility study measured recruitment and retention rates using patient logs and expanded on these findings in semistructured interviews with nurses. Acceptability, perceived value, and usability were explored through interviews with patients and nurses, and the System Usability Scale (SUS). Cognitive functions were assessed with a digital cognitive test battery (Consortium to Establish a Registry for Alzheimer Disease [CERAD] word list learning test, Trail Making Test Parts A and B, Victoria Stroop Test, and Symbol Digit Pairing Test) and the Nursing Delirium Screening scale (NU-DESC), and depression with the Geriatric Depression Scale (GDS-15). Functional status was measured using the World Health Organization Disability Assessment Schedule (WHODAS), and postoperative recovery with the Swedish Quality of Recovery questionnaire (SwQoR-24). Quantitative data were analyzed using descriptive statistics and nonparametric tests and qualitative data with content analysis.

RESULTS: The test battery was feasible, acceptable, and demonstrated excellent usability. The mean SUS score was 87 (SD 17.9; 95% CI 78.9-95.2), and all predefined progression criteria were met. Recruitment spanned over 1.5 years, during which 24 patients were included (mean age of 77, SD 6.5 years; range: 63-90 years; n=13, 54% women). Most patients underwent laparoscopic colorectal cancer surgery. Three patients developed postoperative delirium for 1 day only. No patient developed delayed neurocognitive recovery or mild/major neurocognitive disorder at the postoperative follow-up. Qualitative data showed that both nurses and patients regarded the digital cognitive test battery as important for assessing cognitive function and found it easy to use and understand. Nurses reported that recruitment was challenging, partly because not all patients attended a preoperative in-person consultation before surgery.

CONCLUSIONS: The digital, self-administered cognitive test battery was found to be feasible, acceptable, and usable in older adults undergoing abdominal surgery. However, recruitment challenges and a small, homogeneous sample limit generalizability and warrant careful consideration in a larger-scale study.

PMID:41202209 | DOI:10.2196/71911

JMIR Form Res. 2025 Nov 7;9:e72468. doi: 10.2196/72468.

ABSTRACT

BACKGROUND: Osteoporosis-related fractures significantly impact older adults, often leading to disability and even premature death. While pharmacological and nonpharmacological interventions are widely recommended for managing osteoporosis, adherence to these interventions remains low. To address this challenge, we developed the Healthy Bone digital platform (desktop, mobile app, and smart TV internet-based) for use in clinical settings to improve disease management and treatment adherence. It integrates a multimedia health-related behavioral change program with a patient monitoring and management system.

OBJECTIVE: This study aimed to evaluate the usability and user experience of the desktop version of the Healthy Bone digital platform prototype from the patients’ perspective. The findings will provide valuable insights into optimizing the digital platform and enhancing its functionality.

METHODS: A mixed-methods study was conducted. During usability testing, patients completed tasks simulating real-world use of the platform while using a Think-Aloud approach. After each task, participants filled out an After Scenario Questionnaire to assess task satisfaction. Subsequently, participants completed the System Usability Scale (SUS) and the eHealth Usability Benchmarking Instrument (HUBBI) to measure usability quantitatively. Following this, semistructured interviews were conducted to explore participants’ experiences with the platform in greater depth. Descriptive statistics were used for quantitative analysis. Qualitative data analysis involved a combined deductive and inductive approach, ensuring a comprehensive evaluation of the platform’s usability and user experience. Deductive content analysis was guided by an ontology of eHealth usability components, while thematic analysis adhered to Braun and Clarke’s method to identify emerging themes.

RESULTS: Seven participants evaluated the digital platform, reporting high usability with a mean overall SUS score of 87.1 (SD 13.3). Similarly, good usability was reported across all categories of the HUBBI, except for the guidance and support category, which presented moderate levels of usability (mean 3.3, SD 1.1). Patients reported high levels of task satisfaction and identified 24 unique usability issues, predominantly related to the basic system performance, interface design, and navigation and structure categories of the eHealth usability ontology. Overall, patients had positive perceptions and acceptability of the digital platform, highlighting its simplicity, accessibility, utility, and potential to empower those with osteoporosis. Barriers to usage included limited skills, lack of suitable equipment, and time, while facilitators included motivation for behavior change, health benefits, and the decrease of potential inequalities.

CONCLUSIONS: This study provided valuable insights into the usability and user experience of the desktop version of the Healthy Bone digital platform prototype. These findings will play a key role in optimizing the platform to ensure it is effectively tailored to the needs of the target population. This platform adds an understanding of how various information and communication technology tools can support and benefit large numbers of osteoporosis patients in society.

PMID:41202207 | DOI:10.2196/72468