Tag: statistics

JMIR Res Protoc. 2025 Jan 3;14:e64871. doi: 10.2196/64871.

ABSTRACT

BACKGROUND: Cancer is a leading cause of global mortality, accounting for nearly 10 million deaths in 2020. This is projected to increase by more than 60% by 2040, particularly in low- and middle-income countries. Yet, palliative and psychosocial oncology care is very limited in these countries.

OBJECTIVE: This study describes a protocol for the development, implementation, and evaluation of a psychosocial oncology and palliative care course on Cameroonian practicing nurses’ knowledge, self-perceived competence, and confidence in palliative and psychosocial oncology care provision for patients with cancer.

METHODS: A single group pre-posttest design, incorporating both quantitative and qualitative methods will be used. First, a psychosocial oncology and palliative care course for practicing nurses in Cameroon will be developed. This course will then be implemented with 50 practicing nurses purposefully selected from 2 oncology units in the Littoral region and 4 hospitals in the Southwest region of Cameroon. Finally, to assess the impact of the training program we will undertake a pre and posttest survey of nurses’ palliative and psychosocial oncology competences, a pre and post training audit of patients’ nursing records to examine nurses’ practice of palliative and psychosocial oncology care and undertake a critical-incident interview of nurses’ transfer of learning to practice. Descriptive and inferential statistics will be used to analysis quantitative data, while qualitative data will be analyzed using the framework approach.

RESULTS: This study was funded in September 2023. The training program development was initiated in March 2024 and completed in June 2024. Baseline data collection commenced in May 2024 and as of September 2024, we had collected data from 300 patient record. Training implementation is planned for October-December 2024, and post intervention data will be started in October 2024 and continue till April 2025. Data analysis will commence in October 2024 and we aim to publish study findings in peer review journals by November 2025.

CONCLUSIONS: This study will improve our understanding of Cameroonian nurses’ palliative and psychosocial oncology competency gaps. It will result in the development of a palliative care and psychosocial oncology course and in the training of 50 nurses in psychosocial oncology and palliative care in Cameroon. This study will inform strategies for future psychosocial oncology and palliative care training initiatives in Cameroon and other low- and middle-income countries.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/64871.

PMID:39752719 | DOI:10.2196/64871

J Neurosurg Pediatr. 2025 Jan 3:1-6. doi: 10.3171/2024.10.PEDS24228. Online ahead of print.

ABSTRACT

OBJECTIVE: Intraventricular baclofen (IVB) administration is used for the treatment of secondary dystonia associated with cerebral palsy (CP), but it has not been reported as a first-line infusion technique for spasticity. In this study, the authors report outcomes of patients with mixed or isolated spasticity treated with IVB administration.

METHODS: A retrospective analysis was performed of consecutive patients treated with IVB between 2019 and 2023. Demographics, baseline clinical variables, and complications data were collected. The primary outcome of the study was the change in spasticity and dystonia as measured by the modified Ashworth Scale (MAS) and Barry-Albright Dystonia Scale (BADS) scores, respectively. Wilcoxon rank-sum tests were performed to compare the change in the pre- and postoperative scores.

RESULTS: Fifteen patients were implanted with IVB pumps for spasticity related to CP between 2019 and 2023. The median change in the MAS score was 2 (interquartile range [IQR] = 1) and the median change in the BADS score was 1 (IQR = 2). The Wilcoxon rank-sum test revealed a statistically significant change in both scores following IVB pump placement (BADS z = 2.90, p = 0.003; MAS z = 3.2, p = 0.001). Three patients (20%) experienced minor perioperative complications, all of which were self-limiting and none required additional surgery.

CONCLUSIONS: This study reported on 15 cases of mixed or isolated spasticity and showed a relative improvement in the MAS and BADS scores after IVB pump placement. These results provide evidence that IVB can be a safe and effective treatment for spasticity-related CP in addition to dystonia. IVB may be advantageous when an intraventricular route of baclofen administration is preferred.

PMID:39752717 | DOI:10.3171/2024.10.PEDS24228

Phys Rev Lett. 2024 Dec 20;133(25):257401. doi: 10.1103/PhysRevLett.133.257401.

ABSTRACT

The random-energy model (REM), a solvable spin-glass model, has impacted an incredibly diverse set of problems, from protein folding to combinatorial optimization, to many-body localization. Here, we explore a new connection to secret sharing. We derive an analytic expression for the mutual information between any two disjoint thermodynamic subsystems of the REM. Our analyses reveal that the correlations in the REM exhibit extreme synergy, equivalent to that in a secure secret-sharing scheme. We formulate a secret-sharing scheme based on the REM and determine the ranges of temperatures and secret lengths over which the REM satisfies the requirement of secure secret sharing. We show further that a special point in the phase diagram exists at which the REM-based scheme is physically optimal in its information encoding. Our results for the thermodynamic limit are in good qualitative agreement with numerical simulations of finite systems, for which the strict security requirement is replaced by a tradeoff between secrecy and recoverability. Our work offers a new language to characterize synergistic correlations in many-body systems and a further example of information theory as a unifying concept, connecting problems in statistical physics to those in computation.

PMID:39752688 | DOI:10.1103/PhysRevLett.133.257401

Phys Rev Lett. 2024 Dec 20;133(25):251003. doi: 10.1103/PhysRevLett.133.251003.

ABSTRACT

We investigate the implications of the baryon acoustic oscillations measurement released by the Dark Energy Spectroscopic Instrument for interacting dark energy (IDE) models characterized by an energy-momentum flow from dark matter to dark energy. By combining Planck-2018 and Dark Energy Spectroscopic Instrument data, we observe a preference for interactions, leading to a nonvanishing interaction rate ξ=-0.32_{-0.14}^{+0.18}, which results in a present-day expansion rate H_{0}=70.8_{-1.7}^{+1.4} km/s/Mpc, reducing the tension with the value provided by the SH0ES Collaboration to less than ∼1.3σ. The preference for interactions remains robust when including measurements of the expansion rate H(z) obtained from the relative ages of massive, early-time, and passively evolving galaxies, as well as when considering distance moduli measurements from Type Ia supernovae sourced from the Pantheon-plus catalog using the SH0ES Cepheid host distances as calibrators. Overall, the IDE framework provides an equally good, or better, explanation of both high- and low-redshift background observations compared to the lambda cold dark matter model, while also yielding higher H_{0} values that align more closely with the local distance ladder estimates. However, a limitation of the IDE model is that it predicts lower Ω_{m} and higher σ_{8} values, which may not be fully consistent with large-scale structure data at the perturbation level.

PMID:39752687 | DOI:10.1103/PhysRevLett.133.251003

J Med Internet Res. 2025 Jan 3;27:e52786. doi: 10.2196/52786.

ABSTRACT

BACKGROUND: Acute kidney injury (AKI) is a common complication in hospitalized older patients, associated with increased morbidity, mortality, and health care costs. Major adverse kidney events within 30 days (MAKE30), a composite of death, new renal replacement therapy, or persistent renal dysfunction, has been recommended as a patient-centered endpoint for clinical trials involving AKI.

OBJECTIVE: This study aimed to develop and validate a machine learning-based model to predict MAKE30 in hospitalized older patients with AKI.

METHODS: A total of 4266 older patients (aged ≥ 65 years) with AKI admitted to the Second Xiangya Hospital of Central South University from January 1, 2015, to December 31, 2020, were included and randomly divided into a training set and an internal test set in a ratio of 7:3. An additional cohort of 11,864 eligible patients from the Medical Information Mart for Intensive Care Ⅳ database served as an external test set. The Boruta algorithm was used to select the most important predictor variables from 53 candidate variables. The eXtreme Gradient Boosting algorithm was applied to establish a prediction model for MAKE30. Model discrimination was evaluated by the area under the receiver operating characteristic curve (AUROC). The SHapley Additive exPlanations method was used to interpret model predictions.

RESULTS: The overall incidence of MAKE30 in the 2 study cohorts was 28.3% (95% CI 26.9%-29.7%) and 26.7% (95% CI 25.9%-27.5%), respectively. The prediction model for MAKE30 exhibited adequate predictive performance, with an AUROC of 0.868 (95% CI 0.852-0.881) in the training set and 0.823 (95% CI 0.798-0.846) in the internal test set. Its simplified version achieved an AUROC of 0.744 (95% CI 0.735-0.754) in the external test set. The SHapley Additive exPlanations method showed that the use of vasopressors, mechanical ventilation, blood urea nitrogen level, red blood cell distribution width-coefficient of variation, and serum albumin level were closely associated with MAKE30.

CONCLUSIONS: An interpretable eXtreme Gradient Boosting model was developed and validated to predict MAKE30, which provides opportunities for risk stratification, clinical decision-making, and the conduct of clinical trials involving AKI.

TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2200061610; https://tinyurl.com/3smf9nuw.

PMID:39752664 | DOI:10.2196/52786

JMIR Med Inform. 2025 Jan 3;13:e63538. doi: 10.2196/63538.

ABSTRACT

BACKGROUND: Mental health chatbots have emerged as a promising tool for providing accessible and convenient support to individuals in need. Building on our previous research on digital interventions for loneliness and depression among Korean college students, this study addresses the limitations identified and explores more advanced artificial intelligence-driven solutions.

OBJECTIVE: This study aimed to develop and evaluate the performance of HoMemeTown Dr. CareSam, an advanced cross-lingual chatbot using ChatGPT 4.0 (OpenAI) to provide seamless support in both English and Korean contexts. The chatbot was designed to address the need for more personalized and culturally sensitive mental health support identified in our previous work while providing an accessible and user-friendly interface for Korean young adults.

METHODS: We conducted a mixed methods pilot study with 20 Korean young adults aged 18 to 27 (mean 23.3, SD 1.96) years. The HoMemeTown Dr CareSam chatbot was developed using the GPT application programming interface, incorporating features such as a gratitude journal and risk detection. User satisfaction and chatbot performance were evaluated using quantitative surveys and qualitative feedback, with triangulation used to ensure the validity and robustness of findings through cross-verification of data sources. Comparative analyses were conducted with other large language models chatbots and existing digital therapy tools (Woebot [Woebot Health Inc] and Happify [Twill Inc]).

RESULTS: Users generally expressed positive views towards the chatbot, with positivity and support receiving the highest score on a 10-point scale (mean 9.0, SD 1.2), followed by empathy (mean 8.7, SD 1.6) and active listening (mean 8.0, SD 1.8). However, areas for improvement were noted in professionalism (mean 7.0, SD 2.0), complexity of content (mean 7.4, SD 2.0), and personalization (mean 7.4, SD 2.4). The chatbot demonstrated statistically significant performance differences compared with other large language models chatbots (F=3.27; P=.047), with more pronounced differences compared with Woebot and Happify (F=12.94; P<.001). Qualitative feedback highlighted the chatbot’s strengths in providing empathetic responses and a user-friendly interface, while areas for improvement included response speed and the naturalness of Korean language responses.

CONCLUSIONS: The HoMemeTown Dr CareSam chatbot shows potential as a cross-lingual mental health support tool, achieving high user satisfaction and demonstrating comparative advantages over existing digital interventions. However, the study’s limited sample size and short-term nature necessitate further research. Future studies should include larger-scale clinical trials, enhanced risk detection features, and integration with existing health care systems to fully realize its potential in supporting mental well-being across different linguistic and cultural contexts.

PMID:39752663 | DOI:10.2196/63538

J Neurosurg. 2025 Jan 3:1-7. doi: 10.3171/2024.8.JNS24915. Online ahead of print.

ABSTRACT

OBJECTIVE: Intraventricular hemorrhage (IVH) is a serious condition with high mortality rates and poor functional outcome in survivors. Treatment includes external ventricular drains (EVDs), which are associated with several complications. This study reports the clinical outcome and complication rate in patients with primary IVH (pIVH) and secondary IVH treated with EVDs.

METHODS: The authors conducted a retrospective observational study using the Danish National Patient Registry. Patients treated with EVDs for pIVH or secondary IVH between September 2012 and August 2022 at Aarhus University Hospital were included. Demographic data, clinical treatment, and outcomes were extracted and analyzed.

RESULTS: A total of 436 patients with 615 EVDs were included. Of these, 4.1% had pIVH, 60.6% had IVH secondary to subarachnoid hemorrhage, and 35.3% had IVH secondary to intracerebral hemorrhage. During EVD treatment, 38.8% of patients experienced complications, including complete occlusion (17.2%), partial occlusion (16.1%), ventriculitis (7.1%), and other complications (9.6%). Of patients surviving the initial 30 days, 34.2% received a ventriculoperitoneal shunt, and 29.9% remained shunt dependent 6 months after inclusion. Mortality rates were 28.9% at 30 days and 33.7% at 90 days. A total of 31.0% of patients had good functional outcomes at 90 days.

CONCLUSIONS: This study provides a comprehensive historical reference of complications, mortality rate, and functional outcome of EVD-treated patients with pIVH and secondary IVH. These findings provide a baseline for evaluating novel catheter-based interventions in IVH management.

PMID:39752661 | DOI:10.3171/2024.8.JNS24915

J Med Internet Res. 2025 Jan 3;27:e64668. doi: 10.2196/64668.

ABSTRACT

BACKGROUND: Young gay, bisexual, and other men who have sex with men have been referred to as a “hard-to-reach” or “hidden” community in terms of recruiting for research studies. With widespread internet use among this group and young adults in general, web-based avenues represent an important approach for reaching and recruiting members of this community. However, little is known about how participants recruited from various web-based sources may differ from one another.

OBJECTIVE: This study aimed to determine how young gay, bisexual, and other men who have sex with men recruited from various web-based sources differ from one another in terms of participant characteristics and study engagement.

METHODS: Data were collected as part of a randomized controlled trial of Outsmart HPV, a web-based human papillomavirus (HPV) vaccination intervention for young gay, bisexual, and other men who have sex with men. From 2019 to 2021, we recruited young gay, bisexual, and other men who have sex with men in the United States who were aged 18-25 years and not vaccinated against HPV (n=1227) through various web-based avenues. We classified each participant as being recruited from either (1) social media (eg, Facebook, Instagram, Snapchat), (2) a dating app (eg, Grindr, Scruff), or (3) some other digital recruitment source (eg, existing research panel, university-based organization). Analyses compared participants from these 3 groups on demographic and health-related characteristics and metrics involving study engagement.

RESULTS: Most demographic and health-related characteristics differed by web-based recruitment source, including race or ethnicity (P<.001), relationship status (P<.001), education level (P<.001), employment status (P<.001), sexual self-identity (P<.001), health insurance status (P<.001), disclosure of sexual orientation (P=.048), and connectedness to the LGBTQ (lesbian, gay, bisexual, transgender, queer) community (P<.001) The type of device used by participants during study enrollment also differed across groups, with smartphone use higher among participants recruited via dating apps (n=660, 96.6%) compared to those recruited via social media (n=318, 78.9%) or other digital sources (n=85, 60.3%; P<.001). Participants recruited via social media were more likely than those recruited via dating apps to complete follow-up surveys at 3 different timepoints (odds ratios 1.52-2.09, P=.001-.008). These participants also spent a longer amount of time viewing intervention content about HPV vaccination (3.14 minutes vs 2.67 minutes; P=.02).

CONCLUSIONS: We were able to recruit a large national sample of young gay, bisexual, and other men who have sex with men for a web-based HPV vaccination intervention via multiple methodologies. Participants differed on a range of demographic and health-related characteristics, as well as metrics related to study engagement, based on whether they were recruited from social media, a dating app, or some other digital recruitment source. Findings highlight key issues and considerations that can help researchers better plan and customize future web-based recruitment efforts of young gay, bisexual, and other men who have sex with men.

TRIAL REGISTRATION: ClinicalTrials.gov NCT04032106; https://clinicaltrials.gov/study/NCT04032106.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/16294.

PMID:39752644 | DOI:10.2196/64668

J Forensic Odontostomatol. 2024 Dec 30;42(3):39-52. doi: 10.5281/zenodo.14505540.

ABSTRACT

The age estimation of skeletal remains still represents a central issue not only for the reconstruction of the so-called “biological profile,” but mostly for the palaeodemographic investigation. This research aims at verifying the feasibility of the adult age estimation method developed on living people by Pinchi et al. (2015 and 2018), for estimating the age at the death of 37 subjects from ancient populations found in two different Italian necropolis of archaeological interest (Mont’e Prama and Florence, X-IX century B.C and V-VI century A.D respectively). The method is conservative and based on a geometrical approximation of dental volumes of the upper central left incisors on CBCT scans. The statistical distribution of the age and errors followed the Bayesian approach proposed by Sironi et el. (2018) applying the “a priori” values according to the estimates/classification obtained with anthropological methods (morphological). Results show higher accuracy for Mont’e Prama remains than for the Florentine sample due to the different characteristics of the two ancient populations (estimates varying from 18.4 up to 28.7 years with a maximum error of 6,14 years for Mont’e Prama, and from 15.88 up to 43.37 years with a minimum error of 1 year up to a maximum error of 7,85 years for Florence). The method proposed and validated on modern living people can represent a reliable tool for estimating the age of ancient human remains with a significant palaeodemographic value for archaeologists/anthropologists. Mont’e Prama sample could be defined as a homogenous group of males aged around 20-30 years, probably warriors, soldiers, or athletes; Florentine sample as an inhomogeneous group of males and females from different families buried all together in a small area out of the city due to the probable occurrence of a special healthy emergency in the city.

PMID:39752638 | DOI:10.5281/zenodo.14505540

PLoS One. 2025 Jan 3;20(1):e0298495. doi: 10.1371/journal.pone.0298495. eCollection 2025.

ABSTRACT

INTRODUCTION: This meta-analysis examined the relationship between age-related hearing loss (ARHL) and depression in older adults, and further explored whether this relationship is moderated by age and gender.

METHODS: We searched in 4 English databases: PubMed, Embase, Web of Science, and Cochrane Library. Ultimately, we identified 9 studies, involving 3 cohort studies and 6 cross-sectional studies. We used Hedges’ g as the effect size, and all pooled analyses were performed using random-effects models.

RESULTS: ARHL patients had higher depressive symptom scores than non-ARHL older adults (g = 0.52). When divided into subgroups based on study type, a large effect size was demonstrated in the cross-sectional study group (g = 0.68) and was not statistically different in the cohort study group (g = 0.06). Meta-regression results showed that the effect size of depression in older adults with ARHL was significantly associated with the percentage of females (t = 5.97, p = 0.000) and not significantly associated with age (t = 0.94, p = 0.364).

CONCLUSIONS: Patients with ARHL are more likely to be depressed than older adults with normal hearing, and this relationship is influenced by the gender of the patients.

PMID:39752630 | DOI:10.1371/journal.pone.0298495