Tag: statistics

JMIR Hum Factors. 2025 Oct 28;12:e70479. doi: 10.2196/70479.

ABSTRACT

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder affecting 3%-7% of children globally. Alternative treatments are needed to address the limitations of traditional pharmacotherapy and nonpharmacotherapy, such as drug side effects and substantial time and financial costs. In this light, digital therapeutics for childhood ADHD are emerging as an effective alternative, with the benefits of potentially being free from serious side effects associated with software-based treatments and facilitating easy home use without constraints on time or space.

OBJECTIVE: This study aims to evaluate whether a 4-week digital treatment program can improve symptoms, problem behaviors, and neurocognitive functions in children with ADHD, independent of medication status, while also gauging participant satisfaction with the program.

METHODS: We recruited 22 Korean children aged 6-12 years with a diagnosis of ADHD. During the preintervention visit, we collected data on ADHD symptoms, relevant behavior scales, and neurocognitive assessments. Participants then used the program 5 times per day, 5 days a week for 4 weeks at home. At the postintervention visit, we collected the same data as during the preintervention visit and gathered additional feedback on their experience over the 4 weeks.

RESULTS: A total of 19 participants were included in the statistical analysis, showing significant decreases in scores across various categories. These included the Korean ADHD Rating Scale (Total: P=.004; Inattentive: P=.004; and Hyperactive-impulsive: P=.01) and Korean Conners’ Parent Rating Scale (Total: P<.001; Impulsive-hyperactive: P=.001; and Conduct Problem I: P=.04). Significant improvements were also noted in the Stroop word (P=.004), color (P<.001), and color-word (P<.001) scores. No significant differences in treatment effects were found between medicated and unmedicated participants. Caregiver and child satisfaction surveys yielded mean ratings of 4.3 and 4.1 out of 5, respectively.

CONCLUSIONS: A 4-week gamified intervention improves attention and hyperactivity-impulsivity in children with ADHD, irrespective of medication status, demonstrating its potential effectiveness and acceptability as a treatment option. As this is a small pilot study and underpowered, larger studies with appropriate control groups are needed in future research.

PMID:41151037 | DOI:10.2196/70479

Otol Neurotol. 2025 Oct 28. doi: 10.1097/MAO.0000000000004647. Online ahead of print.

ABSTRACT

HYPOTHESIS: Photon-counting detector CT (PCD-CT) with deep learning-supported denoising can significantly reduce the radiation dose for cochlear implant (CI) planning without compromising the accuracy of cochlear duct length (CDL) measurements.

BACKGROUND: Optimal electrode placement in CI surgery requires detailed cochlear anatomy from CT scans, but reducing radiation exposure is critical. This study explores PCD-CT with denoising algorithms to lower doses while preserving diagnostic accuracy.

METHODS: Four body donors without inner ear malformations were scanned using PCD-CT at 100%, 50%, 25%, 10%, and 5% dose levels. Images were denoised with ClariAce, a deep learning algorithm, and CDL was measured using OTOPLAN software. Neurotologists compared the results to manual segmentations. Statistical analyses evaluated accuracy across dose levels, with Bland-Altman plots assessing systematic errors.

RESULTS: Automatic segmentation succeeded across all doses but showed increased failure below 50%. At 100% and 50% doses, CDL measurements closely matched the gold standard, with minor deviations (eg, -0.17 mm at 50%). Below 50%, CDL underestimation increased (-1.25 mm at 25% and -4.0 mm at 5%). Denoising improved segmentation but minimally affected CDL accuracy at low doses, where manual segmentation performed better.

CONCLUSIONS: PCD-CT enables significant dose reduction for CI planning, with reliable CDL accuracy down to 50%. Deep learning denoising enhances image quality but is less effective below 50%, necessitating manual segmentation. These findings align with ALARA principles and suggest further refinement of AI algorithms for lower-dose applicability in CI diagnostics.

PMID:41151028 | DOI:10.1097/MAO.0000000000004647

JMIR Form Res. 2025 Oct 28;9:e74208. doi: 10.2196/74208.

ABSTRACT

BACKGROUND: HIV incidence is increasing among Latino gay, bisexual, and other men who have sex with men (MSM) in the Atlanta metropolitan area. Mobile phone apps represent an innovative tool to promote pre-exposure prophylaxis (PrEP) use, HIV testing, and condom use.

OBJECTIVE: This study aimed to assess the acceptability and usability of Saludfindr, an Android-based HIV prevention app tailored to the needs of Latino MSM in the Atlanta area.

METHODS: We recruited adult Latino MSM to interact with the app for 4 months. Saludfindr included initial and periodic health assessments; provision of suggestions regarding PrEP, HIV testing, and condom use; in-app product ordering; customized motivational messages; a customized sexual health clinic list; and a “Contact Us” button. To assess acceptability, we measured use of each app feature, PrEP and HIV testing uptake, and participant ratings of the app’s usefulness. We assessed usability using the System Usability Scale.

RESULTS: We enrolled 31 participants; the median age was 27 (IQR 24.5-32) years, 97% (30/31) were cisgender men, 81% (25/31) identified as MSM, and 61% (19/31) used the app in Spanish. All participants completed the initial health screening, with 84% (26/31) and 77% (24/31) completing the 2- and 4-month health screenings, respectively. Of all participants, 52% (16/31) and 23% (7/31) ordered condoms and home HIV tests through the app at least once, respectively. During the study period, 71% (22/31) of the participants got tested for HIV, of whom 68% (15/22) accessed it through clinic-based HIV testing. Of the participants not on PrEP at baseline, 41% (7/17) initiated PrEP during the study, and all of them did so at one of the clinics listed on the app. Saludfindr reached a System Usability Scale score of 74.5/100 (excellent).

CONCLUSIONS: Saludfindr was highly acceptable and usable among Latino MSM participants in the Atlanta area. In-app assistance to access PrEP and clinic-based HIV testing referrals was well received. Further efforts are needed to increase users’ self-efficacy with home HIV self-testing.

PMID:41150996 | DOI:10.2196/74208

ACS Nano. 2025 Oct 28. doi: 10.1021/acsnano.5c10753. Online ahead of print.

ABSTRACT

The study of thin films and two-dimensional (2D) materials, including transition metal dichalcogenides such as WSe₂ offers opportunities to leverage their properties in advanced sensors, quantum technologies, and devices to optimize functional performance. In this work, we characterize thin WSe₂ samples with variable thicknesses using scanning electron microscope (SEM)-based techniques focused on analysis of the backscattered electron signal and Kikuchi diffraction patterns. These data were collected via a pixelated electron-counting direct electron detector positioned below the pole piece primarily configured for reflection Kikuchi diffraction (RKD), and a similar detector placed in the more conventional electron backscatter diffraction (EBSD) geometry. In addition to conventional pattern analysis for orientation microscopy, multivariate statistical methods (MSA) based on principal component analysis were applied to analyze diffraction patterns and differentiate thickness variations and crystal orientations within the thin films through data clustering. These results were compared with atomic force microscopy to validate thickness measurements. Our findings indicate that RKD combined with MSA is highly effective for characterizing 2D materials, enabling simultaneous assessment of thickness and crystallographic orientation. Systematic acceleration voltage variations in RKD experiments and comparisons with EBSD data suggest that the thickness dependency arises from inelastic scattering of diffracted electrons, which affects pattern contrast in the thin-film regime. Collection and analysis of patterns obtained from monolayer, bilayer, and trilayer of WSe₂ are also demonstrated. This work reinforces the utility of SEM-based techniques, such as RKD, as valuable tools for the materials characterization toolkit, particularly for thin films and 2D materials.

PMID:41150995 | DOI:10.1021/acsnano.5c10753

Salud Publica Mex. 2025 Sep 26;67(5 (sept-oct)):447-454. doi: 10.21149/16253.

ABSTRACT

OBJECTIVE: Describe the purchasing behavior reported by Mexican adults regarding the Mexican front-of-pack warning labeling system (FoPWL).

MATERIALS AND METHODS: Data from the Mexican National Health and Nutrition Survey 2021 labeling questionnaire were analyzed, and logistical modeling was performed. Frequencies, proportions, odds ratio, and 95% confidence intervals were reported.

RESULTS: 38.2% [95%CI 36.5,40.0] of the respondents modified their purchase behavior, representing 25 953 736 Mexicans, with females and participants ≥60 years making the greatest proportion of changes. Among those who modified their purchases, 30.5% [95%CI 28.1,32.9] chose a product with fewer “excess” labels, while 38.7% [95%CI 36.1,41.4] decided not to buy the product. Sweetened carbonated beverages and bakery items were the most modified purchases. The odds of making purchase changes are 1.6 [95%CI 1.35,1.91] times when looking at FoPWL.

CONCLUSION: The study identifies changes in purchase behavior in products with FoPWL, highlighting a positive impact on women and older people. These findings suggest that FoPWL, alongside other public policies, could contribute to improving food environments and the health of the Mexican population.

PMID:41150992 | DOI:10.21149/16253

Salud Publica Mex. 2025 Sep 26;67(5 (sept-oct)):455-465. doi: 10.21149/16485.

ABSTRACT

bjective. To identify dairy consumption patterns, trends, and associated characteristics in Mexican adults from 2012-2018.

MATERIALS AND METHODS: We used data from 25 218 adults aged ≥20 years participating in the Mexican National Health and Nutrition Survey (Ensanut, by its acronym in Spanish) 2012, 2016 and 2018. Through a semiquantitative food frequency questionnaire, we estimated the energy-adjusted intake of 23 dairy products. Dairy patterns were identified using the principal component analysis. To identify associated characteristics and trends, we used independent linear regression models for each pattern. We included survey year as an independent variable in trend estimation (stratified by sex and region).

RESULTS: We identified three dairy patterns: 1) skim milk/light yogurt, 2) fresh cheese/high-fat milk and yogurt, and 3) mature cheese/ cream. The highest consumption of all dairy patterns was associated with high education and/or socioeconomic level. Consumption of the “skim milk/light yogurt” and “mature cheeses/cream” patterns increased, whereas “fresh cheese/high-fat milk and yogurt pattern” decreased steadily. These changes were similar among women and men and in all regions.

CONCLUSION: Our findings support the existence of different population-specific dairy consumption patterns with variations over time, mainly determined by socioeconomic characteristics. This approach must be considered to evaluate the association between dairy consumption and health outcomes.

PMID:41150991 | DOI:10.21149/16485

Salud Publica Mex. 2025 Sep 26;67(5 (sept-oct)):485-493. doi: 10.21149/16774.

ABSTRACT

OBJETIVO: Describir las tendencias de los niveles de plomo en sangre (NPS) de la población menor de 16 años ambientalmente expuesta a plomo desde el año 2010 a 2022. Material y métodos. Se cuantificaron los NPS por espectrometría de absorción atómica de 34 261 niños entre el 1 de enero de 2010 y el 31 de diciembre de 2022 en sangre venosa. Se examinaron las tendencias en los NPS por año y edad de los niños.

RESULTADOS: Los NPS disminuyeron a partir de 2010 (mediana= 5.1 µg/dL; percentiles 5º y 95º= 2.1-12.9 µg/dL) a 2022 (3.3 µg/dL; 1.18-11.1 µg/dL). El porcentaje de niños con NPS superior a 5 µg/dL fue de 52.82% en 2010 y disminuyó a 30.21% en 2022. Por edad, los NPS alcanzan su máximo al año de edad en el periodo de estudio (5.5 µg/dL; 1.7-15.2 µg/dL), disminuyendo paulatinamente a partir de los dos años. Las mujeres tuvieron NPS más bajos en comparación con los hombres (3.4 y 3.8 µg/dL, respectivamente) y disminuyeron más rápido.

CONCLUSIONES: Los NPS han disminuido notablemente de 2010 a 2022, en parte debido a los esfuerzos de remediación ambiental y vigilancia epidemiológica, sin embargo, siguen siendo altos comparados con otras áreas nacionales e internacionales.

PMID:41150988 | DOI:10.21149/16774

Salud Publica Mex. 2025 Sep 26;67(5 (sept-oct)):441-443. doi: 10.21149/17518.

ABSTRACT

No disponible.

PMID:41150972 | DOI:10.21149/17518

Eur Heart J. 2025 Oct 28:ehaf917. doi: 10.1093/eurheartj/ehaf917. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Myocardial infarction with non-obstructive coronary arteries (MINOCA) is associated with a significant risk of mortality, rehospitalisation, and angina burden. Despite its clinical impact, no randomized clinical trials have hitherto evaluated optimal management strategy for MINOCA. The PROMISE trial was designed to assess whether a stratified treatment improves clinical outcomes in patients with MINOCA as compared to standard care.

METHODS: PROMISE is a multicentre randomised trial. Patients with MINOCA were randomised 1:1 to either a stratified treatment based on a comprehensive diagnostic workup aimed at identifying the underlying aetiology, or to standard care. The primary endpoint was the between-group difference in the change in angina status at 12 months, assessed by the Seattle Angina Questionnaire summary score (SAQSS). The secondary endpoint was the incidence of major adverse cardiovascular events (MACE), defined as the composite of all-cause mortality, myocardial infarction, stroke, heart failure hospitalization and repeated coronary angiography. The trial was terminated early upon recommendation by the Data and Safety Monitoring Board due to clear benefits observed in the intervention group and potential harm in the control group.

RESULTS: Of 101 randomized patients, 92 were confirmed as MINOCA and included in the final analysis (mean age 62±13 years, 48% women; stratified treatment n=45; standard care n=47). At 12-month follow-up, SAQSS was significantly higher in the stratified treatment than in standard care group, with a mean between-group difference of +9.38 in favour of the stratified treatment (95% confidence interval 6.81 to 11.95; p<0.001). MACE occurred in 1 patient (2.2%) in the stratified treatment and in 4 patients (8.5%) in the standard care group, though the difference was not statistically significant (p= 0.18).

CONCLUSIONS: In this first randomized trial of treatment strategies in MINOCA, a stratified treatment, based on comprehensive diagnostic assessment and aetiology-guided therapy, led to a significant improvement in angina-related health status. While the study findings provide the first evidence supporting individualized management in this heterogeneous and often under-recognized patient population, these results require confirmation in a larger prospective study with longer follow-up.

PMID:41150941 | DOI:10.1093/eurheartj/ehaf917

Salud Publica Mex. 2025 May 30;67(3 (may-jun)):259-268. doi: 10.21149/16060.

ABSTRACT

OBJETIVO: Estimar el porcentaje de población mexicana escolar, adolescente y adulta con cumplimiento a las Guías Alimentarias Saludables y Sostenibles (GASS) e identificar las características sociodemográficas asociadas. Material y métodos. Con información de 2 500 escolares, 1 750 adolescentes y 5 174 adultos proveniente del cuestionario semicuantitativo de frecuencia de consumo de alimentos de la Encuesta Nacional de Salud y Nutrición de 2020 a 2023 se estimó el consumo de porciones de grupos de alimentos y el porcentaje de población que cumplió con la recomendación de frutas, verduras, leguminosas, nueces y semillas, y carne, por grupo de edad. Se realizaron modelos de regresión logística múltiple para identificar características sociodemográficas asociadas con el cumplimiento de las recomendaciones.

RESULTADOS: El cumplimiento de verduras fue <30%; nueces y semillas 2-4%; carne de res >50%; leguminosas <1.4% y para frutas 45% en escolares, 36% en adultos y 27% en adolescentes. Las características asociadas al cumplimiento de las recomendaciones fueron el índice de condición de bienestar, sexo, localidad de residencia, escolaridad y edad, comportándose diferente entre grupos de edad y grupos de alimentos analizados. Conclusión. El cumplimiento de las recomendaciones de las GASS es muy bajo, por lo que es necesaria la participación intersectorial para promoverlas.

PMID:41150934 | DOI:10.21149/16060