Tag: statistics

Health Technol Assess. 2025 Oct;29(51):1-28. doi: 10.3310/JHGD7339.

ABSTRACT

BACKGROUND: Motor neuron disease is a progressive, fatal neurodegenerative disease for which there is no cure. Formal psychological therapies are not routinely part of United Kingdom standard motor neuron disease care due to a lack of evidence-based guidance resulting from a paucity of clinical trials. We aimed to evaluate the clinical and cost-effectiveness of Acceptance and Commitment Therapy plus usual care compared to usual care alone for improving psychological health in people living with motor neuron disease.

METHODS: We conducted qualitative interviews with 15 people living with motor neuron disease, 10 caregivers and 12 healthcare professionals. Findings were used to develop an Acceptance and Commitment Therapy intervention specifically for people living with motor neuron disease. Next, we examined its acceptability and feasibility in an uncontrolled feasibility study with 29 people living with motor neuron disease. Findings from qualitative interviews with 14 people living with motor neuron disease and 11 therapists were used to revise the intervention. Finally, we conducted a multicentre, parallel, two-arm randomised controlled trial in 16 United Kingdom motor neuron disease care centres/clinics. Eligible participants were aged ≥ 18 years with motor neuron disease. Participants were randomly assigned (1 : 1) to receive up to eight sessions of Acceptance and Commitment Therapy plus usual care or usual care alone and followed up at 6 and 9 months post randomisation by blinded outcome assessors. The primary outcome was total score on the McGill Quality of Life Questionnaire-Revised at 6 months. Secondary outcomes included health status using the EuroQol-5 Dimensions, five-level version. Primary analyses were by intention to treat.

RESULTS: Acceptance and Commitment Therapy was acceptable to people living with motor neuron disease, and it was feasible to recruit participants, hence trial progression criteria were met. From September 2019 to August 2022, 191 participants were recruited: 97 were allocated to Acceptance and Commitment Therapy plus usual care and 94 to usual care alone. Mean age was 61.9 years (standard deviation 11.4), 58% were male and 95% were White/White British. Acceptance and Commitment Therapy plus usual care was superior to usual care alone on the McGill Quality of Life Questionnaire-Revised at 6 months [adjusted mean difference 0.66 (95% confidence interval 0.22 to 1.10); Cohen’s d = 0.46 (95% confidence interval 0.16 to 0.77); p = 0.003] and 9 months [adjusted mean difference 0.76 (95% confidence interval 0.30 to 1.22); Cohen’s d = 0.53 (95% confidence interval 0.21 to 0.85); p = 0.001]. Mean differences in total costs and quality-adjusted life-years at 9 months between Acceptance and Commitment Therapy plus usual care versus usual care alone were not statistically significant [costs: £1019 (95% confidence interval -£34 to £2074); quality-adjusted life-years: 0.019 (95% confidence interval -0.07 to 0.05)]. The incremental cost-effectiveness ratio was £88,507/quality-adjusted life-year: this decreased to £13,817/quality-adjusted life-year in those with medium disease-related deterioration in subgroup analyses.

CONCLUSION: Acceptance and Commitment Therapy plus usual care is clinically effective at maintaining or improving psychological health, as measured by the McGill Quality of Life Questionnaire-Revised, in people living with motor neuron disease compared to usual care alone. It was not cost-effective overall when calculated using a standard health status measure (EuroQol-5 Dimensions, five-level version). However, it was cost-effective in a subgroup of people experiencing a medium rate of disease-related deterioration.

LIMITATIONS: Participants from ethnic minorities were under-represented, despite recruiting from sites with diverse communities. Between-group differences in outcomes may have been partly attributable to expectancy or non-specific therapeutic effects due to the lack of an active control. Cost-effectiveness analyses may have been underpowered to detect significant between-group differences.

FUTURE WORK: Studies should examine the effectiveness of Acceptance and Commitment Therapy in diverse populations, compared to an active control, using a more appropriate measure to assess cost-effectiveness, and in those with different rates of disease-related deterioration.

FUNDING: This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number 16/81/01.

PMID:41143590 | DOI:10.3310/JHGD7339

Ann Behav Med. 2025 Jan 4;59(1):kaaf082. doi: 10.1093/abm/kaaf082.

ABSTRACT

BACKGROUND: While intergenerational caregiving is increasingly prevalent among older individuals, longitudinal evidence on its associations with multidimensional health outcomes remains limited.

PURPOSE: This study examined the associations between childcare engagement in older adults and various health and behavioral outcomes at follow-up.

METHODS: We analyzed data from a cohort of >12 000 (range: 12 124-12 896) community-dwelling adults aged 70+ years, categorizing childcare engagement as never, <weekly, and ≥weekly. Using an outcome-wide approach, we assessed 42 outcomes across physical, cognitive/major health events, psychological, social, and behavioral domains. Follow-up assessments occurred at ∼2 years for most outcomes, with extended follow-up (median 6-9 years) for time-to-event outcomes. We performed gender-disaggregated regressions, adjusting for multiple covariates.

RESULTS: Participants were aged 70-95 years (mean: 75.2 ± 4.3) at baseline, and 54.5% were women. Childcare engagement was more common among women (46% vs. 40%). Key findings included: (1) social domain: both genders showed increased social contacts and community participation, with women additionally demonstrating reduced social isolation; (2) mortality: lower mortality was observed in men with a dose-response pattern, while only <weekly childminding was associated with lower mortality in women; (3) physical domain: men showed increased moderate-to-vigorous physical activity while women had higher pain reports and slower gait speed; and (4) null associations: most psychological outcomes, as well as certain physical and health events, showed no significant relationships.

CONCLUSION: Childcare engagement during older adulthood was linked to not only selected health outcomes, including notable social benefits and lower mortality, but also some physical trade-offs in women. These findings support considering intergenerational engagement in healthy ageing initiatives.

PMID:41143543 | DOI:10.1093/abm/kaaf082

J Chem Phys. 2025 Oct 28;163(16):164509. doi: 10.1063/5.0292952.

ABSTRACT

It is experimentally well-established that non-equilibrium long-range correlations of concentration fluctuations appear in free diffusion of a solute in a solvent, but it remains unknown how such correlations are established dynamically. We address this problem in a model of Donev, Fai, and Vanden-Eijnden (DFV), obtained from the high-Schmidt limit of the Landau-Lifshitz fluctuating hydrodynamic equations for a binary mixture. We consider an initial planar interface of the mean concentration field in an infinite space domain, idealizing prior experiments. Using methods borrowed from turbulence theory, we show both analytically and numerically that a quasi-steady regime with self-similar time decay of concentration correlations appears at long time. In addition to the expected “giant concentration fluctuations” with correlations ∝r for r ≲ L(t) = (Dt)1/2, with diffusivity D, a new regime with spatial decay ∝1/r appears for r ≳ L(t). The quasi-steady regime arises from an initial stage of transient growth ∝t, confirming the prediction of DFV for r ≳ L(t) and discovering an analogous result for r ≲ L(t). Our results give new insight into the emergence of non-equilibrium long-range correlations and provide novel predictions that may be investigated experimentally.

PMID:41143499 | DOI:10.1063/5.0292952

Physiother Theory Pract. 2025 Oct 27:1-12. doi: 10.1080/09593985.2025.2575073. Online ahead of print.

ABSTRACT

BACKGROUND: The estrogen reduction caused by endocrine therapy can lead to symptoms associated with pelvic floor dysfunction in patients with breast cancer. Identifying medication-related symptoms can help prevent or mitigate adverse effects.

PURPOSE: The objective of this study was to compare pelvic floor muscle function among women treated with tamoxifen, aromatase inhibitors, and cancer-free controls.

METHODS: Cross-sectional observational study comparing three groups of women: tamoxifen users, aromatase inhibitor users, and healthy controls. Pelvic floor muscle function was assessed through vaginal inspection and palpation. Symptoms of dysfunction and vaginal complaints were evaluated through the Pelvic Floor Bother Questionnaire and Incontinence Questionnaire Vaginal Symptoms Module. Descriptive statistics included frequencies and medians. Group comparisons used Kruskal-Wallis and Mann-Whitney U tests. Associations were assessed via odds ratios, Chi-square, Phi coefficient, and Spearman’s correlation. Multiple correspondence analysis, multiple linear regression, and binary logistic regression were also performed.

RESULTS: Ninety-three women were included – 31 in each group. A significantly higher prevalence of descended perineum was observed in the aromatase inhibitors group compared to the tamoxifen and control groups (12.9% vs 0% vs 0% respectively, p = .034). The prevalence of pelvic organ prolapse was higher in the groups on endocrine therapy (IA 19.4%, TAM 16.1%, control 0%, p = .037). The remaining pelvic floor muscle functions and dysfunctions were similar between the groups, as was the associated bother.

CONCLUSION: Women treated with endocrine therapy showed a higher prevalence of pelvic organ prolapse, with a descended perineum observed in the aromatase inhibitor group.

PMID:41143489 | DOI:10.1080/09593985.2025.2575073

Platelets. 2025 Dec;36(1):2572982. doi: 10.1080/09537104.2025.2572982. Epub 2025 Oct 27.

ABSTRACT

Platelets are increasingly recognized as key players not only in hemostasis, but also in immunity and inflammation. However, the mechanisms and markers underlying their activation remain incompletely understood. This study aimed to decipher how platelets respond to different stimuli and to identify specific molecular signatures using computational approaches. Platelets from 10 healthy donors were stimulated under seven conditions, including TRAP (PAR-1), AYPGKF (PAR-4), ADP, collagen, sCD40L, fibrinogen, and a control. A total of 47 markers-encompassing membrane proteins, soluble mediators, and intracellular signals-were analyzed. Statistical and machine learning methods, including hierarchical clustering and random forest algorithms, were used to classify and interpret the data. Distinct activation profiles emerged for each agonist. A reduced panel of six markers (AKT, CD40L, CD62P, PKC, RANTES, and TSLP) enabled identification of the stimulus with 86.8% accuracy. Machine learning further improved classification (87.9% multiclass accuracy). Differences were also observed across donors, highlighting inter-individual variability. This work supports a new paradigm in which platelets act as “biological sensors,” fine-tuning their responses to environmental cues. The identified biomarker panel provides a basis for further investigation into the characterization of platelet activation profiles, with potential relevance for future diagnostic and therapeutic applications in thromboinflammatory and immune-mediated conditions.

PMID:41143469 | DOI:10.1080/09537104.2025.2572982

JMIR Res Protoc. 2025 Oct 27;14:e76668. doi: 10.2196/76668.

ABSTRACT

BACKGROUND: Many mental health professionals face work-related stress due to high job demands, limited control, and inadequate institutional support. Connected mental health (CMH) technologies such as mobile apps and teletherapy platforms are increasingly being proposed as tools to alleviate these job demands. However, their actual influence on clinicians’ work environments-here understood as the organizational, social, and psychological conditions that shape their workload, job demands, autonomy, and overall well-being-remains underexplored. Existing reviews have primarily focused on traditional organizational interventions, leaving a critical gap in understanding how CMH technologies specifically influence the work environment of mental health clinicians.

OBJECTIVE: This systematic literature review aims to identify and summarize knowledge about the impact of CMH on the work environment of mental health clinicians.

METHODS: A systematic literature review will be performed. The review follows PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and has been registered in PROSPERO on April 23, 2025. A comprehensive search strategy was developed using the population, intervention, comparison, and outcome (PICO) framework in collaboration with an academic librarian. Studies will be sourced from the PubMed, Scopus, IEEE Xplore, and ACM Digital Library databases. Inclusion criteria are limited to empirical studies involving mental health clinicians using CMH tools, where outcomes explicitly relate to the work environment (eg, job demands, workload, autonomy, stress, or well-being). Eligible studies must be published in English. Data extraction will include publication trends, study methods, and types of CMH technologies. Additionally, the extraction will capture the study results, including qualitative and quantitative findings, along with the measurement instruments used. Two reviewers will independently select articles for review and extract data. Conflicts will be discussed, and a third reviewer will be consulted if a consensus cannot be reached. Descriptive statistics and thematic analysis (via NVivo) will be used to synthesize the findings.

RESULTS: This systematic literature review seeks to explore and synthesize existing research on how CMH technologies affect clinicians’ work environments and is expected to be completed by December 2025.

CONCLUSIONS: This review will offer a comprehensive overview of how CMH technologies affect the professional work environment of clinicians.

TRIAL REGISTRATION: PROSPERO CRD420251018685; https://www.crd.york.ac.uk/PROSPERO/view/CRD420251018685.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/76668.

PMID:41143459 | DOI:10.2196/76668

Turk J Ophthalmol. 2025 Oct 27;55(5):296-297. doi: 10.4274/tjo.galenos.2025.27715.

NO ABSTRACT

PMID:41143456 | DOI:10.4274/tjo.galenos.2025.27715

ACS Nano. 2025 Oct 27. doi: 10.1021/acsnano.5c15982. Online ahead of print.

ABSTRACT

Fivefold twinned noble-metal nanocrystals (NCs), particularly decahedral (Dh) structures, are of significant interest owing to their crystallographic structures and physicochemical properties. However, the precise and high-yield synthesis of Dh NCs remains a challenge, as they can adopt multiple shapes (e.g., star, Marks, pentagonal rod, Ino, and regular Dh) with comparable formation energies. In this study, we used in situ liquid cell transmission electron microscopy (LCTEM) to directly visualize the growth and shape evolution of gold Dh by systematically tuning experimental parameters including electron dose rate, precursor concentration, and ligand additives. By modulating the relative growth rates along the vertices (${\overline{v}}_v$) and the twin boundaries (${\overline{v}}_t$) of 5-fold twinned seeds, we achieve controllable structural transformation between star and regular Dh. Furthermore, the introduction of different surfactants leads to the structural transformation from Dh to a truncated or elongated pentagonal nanorod, respectively. Statistical quantitative analyses reveal a critical size threshold for the shape evolution of Dh, dependent on the growth rate, surfactant type, and concentration. Our study details the structural transformation routes among different Dh shapes, thereby deepening the understanding of their growth and shape evolution mechanisms.

PMID:41143442 | DOI:10.1021/acsnano.5c15982

Niger Postgrad Med J. 2025 Oct 1;32(4):439-446. doi: 10.4103/npmj.npmj_96_25. Epub 2025 Oct 27.

ABSTRACT

Adolescents and young women in sub-Saharan Africa (SSA) face disproportionately high rates of HIV infection and unintended pregnancy. As Internet access accelerates across SSA, its implications for adolescent sexual health demand urgent scrutiny. This correspondence examines the association between Internet use and risky sexual behaviours (RSBs) amongst 5920 unmarried, sexually active females aged 15-34, using Demographic and Health Survey (DHS) data from nine countries: Burkina Faso, Côte d’Ivoire, Ghana, Kenya, Lesotho, Madagascar, Mozambique, Rwanda and Tanzania. Data analysis employed logistic regression methods using R version 4.4.2. The prevalence of RSB was higher amongst Internet users (46.2% vs. 35.7%). It was as high as 72.2% in Lesotho, as low as 21% in Ghana. Internet users were 26% (adjusted odds ratio [aOR] = 1.26, 95% confidence interval [CI] = [1.09-1.45]) more likely to engage in RSBs. Additional drivers included age, media exposure, non-marital fertility, residence and country-specific factors. Relative to Kenya, elevated odds were found in Lesotho (aOR = 2.54, 95% CI = [1.88-3.46]), Burkina Faso (aOR = 2.13, 95% CI = [1.61-2.81]), Mozambique (aOR = 1.64 [1.26-2.13]) and Rwanda (aOR = 1.90, 95% CI = [1.35-2.70]). While digital platforms hold promise for expanding sexual education, these findings underscore the need for targeted content oversight and culturally responsive interventions to mitigate online health risks.

PMID:41143382 | DOI:10.4103/npmj.npmj_96_25

Niger Postgrad Med J. 2025 Oct 1;32(4):383-391. doi: 10.4103/npmj.npmj_303_24. Epub 2025 Oct 27.

ABSTRACT

BACKGROUND: The COVID-19 pandemic negatively disrupted health and education systems in Nigeria, especially clinical education, which requires hands-on training and physical assessment of patients. As a result of this peculiarity, an innovative Virtual model to TRain and Assess Clinical Students (VTRACS), a learner centred approach for teaching clinical healthcare professionals acceptability of this virtual reality (VR) model for clinical students’ training and examination, based on limited budget and cost, was developed to mirror a real-life in-class simulation.

AIMS: The purpose of this study was to evaluate the feasibility, appropriateness and acceptability of this virtual model for clinical students’ training and examination.

METHODS: A mixed-methods research design was employed using both descriptive quantitative data and in-depth interviews. The participants comprised 24 students from dentistry, nursing, medicine, obstetrics and gynaecology programmes and eight faculty members at a public University in Southwest Nigeria. All the participants were exposed to VTRACS for training and assessment.

RESULTS: The results showed a high level of feasibility (72%), appropriateness (85%) and acceptability (84%) for the virtual model. The findings from the qualitative data revealed varied views on the implementation of the virtual model for the training and assessment of clinical students. While a vast majority of the participants judged the intervention as effective in teaching and assessment, others expressed some challenges, including possible loss of empathy for patients, less effectiveness for complicated operations and unsuitability for some specific clinical examinations.

CONCLUSION: This study concluded that the model should be integrated and combined with physical training and assessment to optimise the benefits of Virtual Reality (VR) in medical education.

PMID:41143374 | DOI:10.4103/npmj.npmj_303_24