Tag: statistics

Clin Neuropharmacol. 2025 Sep 11. doi: 10.1097/WNF.0000000000000656. Online ahead of print.

ABSTRACT

OBJECTIVES: High treatment costs remain a major barrier for people with epilepsy (PWE), leading to significant treatment gaps. At the University of Malaya Medical Centre (UMMC), levetiracetam (LEV) is sold at a retail price (self-paying), but some patients receive subsidization. This study aimed to study the impact of medication costs on adherence, dosing, and quality of life among self-paying versus subsidized patients.

METHODS: This cross-sectional study was conducted at a tertiary care center in Kuala Lumpur, Malaysia. A structured questionnaire was used to assess the medication adherence, dosing, and quality of life among patients prescribed LEV, incorporating the Malaysian Medication Adherence Scale (MALMAS) and the Quality of Life in Epilepsy Inventory (QOLIE-31).

RESULTS: Among the 172 respondents, those under the subsidization scheme (86, 50%) had a higher mean maximum dose (2055.2 mg vs. 1688.4 mg, P=0.013) and were less likely to reduce LEV intake due to cost concerns (7.7% vs. 23.7%, P=0.021). In the self-paying group, more patients had low adherence (23.3% vs. 17.6%), the seizure-free rate was lower (22.1% vs. 29.1%), and the mean QOLIE-31 score was lower (60.5 vs. 62.4) than the subsidized group, but the differences were not statistically significant.

CONCLUSIONS: Financial support is crucial in optimizing LEV dosing and adherence, with subsidized patients receiving higher doses and being less likely to reduce intake due to cost.

PMID:40939014 | DOI:10.1097/WNF.0000000000000656

PLoS Comput Biol. 2025 Sep 12;21(9):e1013403. doi: 10.1371/journal.pcbi.1013403. Online ahead of print.

ABSTRACT

Neural activity sequences are ubiquitous in the brain and play pivotal roles in functions such as long-term memory formation and motor control. While conditions for storing and reactivating individual sequences have been thoroughly characterized, it remains unclear how multiple sequences may interact when activated simultaneously in recurrent neural networks. This question is especially relevant for weak sequences, comprised of fewer neurons, competing against strong sequences. Using a non-linear rate -based and a spiking model with discrete, pre-configured assemblies, we demonstrate that weak sequences can compensate for their competitive disadvantage either by increasing excitatory connections between subsequent assemblies or by cooperating with other co-active sequences. Further, our models suggest that such cooperation can negatively affect sequence speed unless subsequently active assemblies are paired. Our analysis characterizes the conditions for successful sequence progression in isolated, competing, and cooperating assembly sequences, and identifies the distinct contributions of recurrent and feed-forward projections. This proof-of-principle study shows how even disadvantaged sequences can be prioritized for reactivation, a process which has recently been implicated in hippocampal memory processing.

PMID:40939008 | DOI:10.1371/journal.pcbi.1013403

PLoS Med. 2025 Sep 12;22(9):e1004734. doi: 10.1371/journal.pmed.1004734. Online ahead of print.

ABSTRACT

METHODS AND FINDINGS: We collected longitudinal serum samples from 84 infants at five time points between January 2021 and October 2023, and cross-sectional samples from 798 healthy individuals aged 0-86 years between December 2022 and June 2024. For participants under 18 years of age, a written consent was obtained from parents or guardians, with assent from the child where appropriate, individuals aged 18 years and above provided written informed consent directly. Rotavirus-specific IgG and IgA concentrations were measured using a gold standard enzyme-linked immunosorbent assay (ELISA). Rotavirus gastroenteritis case data were extracted from ongoing surveillance during the same period. All participants were recruited from the Southern region of Malawi, a rotavirus high-burden setting. We applied linear mixed-effects and generalised linear models with natural splines to assess age-dependent trends in antibody levels. Prior to scheduled Rotarix rotavirus vaccine dose 1, the median maternally derived rotavirus-specific IgG levels were significantly lower in infants who were seropositive following vaccination compared with those who remained seronegative (5,745.0 IU/ml versus 9,689.8 IU/ml; Wilcoxon-test, p = 0.015). Infants with the lowest maternal IgG levels were over five times more likely to seroconvert (odds ratio [OR] = 5.8, 95% confidence interval (CI): 1.6-24.2; Chi-square test, p = 0.012). An exponential decay model estimated that the median IgG concentration in non-seroconverters crossed the seroconversion-probability threshold at 6.2 months. Population-level analyses revealed IgG concentrations reached their nadir at 8.4 months, coinciding with a peak in severe rotavirus gastroenteritis cases at 9 months. Serum IgA levels peaked at 9 months and were associated with a decline in disease incidence between 9 and 17 months. Key limitations include the small number of non-seroconverting infants (n = 27) who were unexposed during follow-up and the observational study design. These factors may influence interpretation, but the findings nonetheless provide important insights into rotavirus antibody dynamics.

CONCLUSIONS: These findings suggest that administering a booster dose between 6 and 8 months of age, when maternal antibody titer is low and severe rotavirus gastroenteritis risk is high, may enhance the immunogenicity and effectiveness of the rotavirus vaccine in LMICs.

PMID:40938968 | DOI:10.1371/journal.pmed.1004734

PLoS One. 2025 Sep 12;20(9):e0331122. doi: 10.1371/journal.pone.0331122. eCollection 2025.

ABSTRACT

Proper design and periodic evaluation of center pivot irrigation systems are essential for ensuring uniform water distribution and improving water use efficiency in irrigated agriculture. This study assessed the impact of collector spacing and sampling methods, including a single-level collector line and combinations of multiple lines at different irrigated locations, on water distribution uniformity. Additionally, strategies for selecting emitter nozzles were analyzed. Uniformity assessments were conducted on two center pivots (P180 and P360) using collectors spaced at 1 m, with simulated spacings of up to 12 m by omitting intermediate readings. Collector lines were placed perpendicular to the pivot’s movement at 50% regulation and were evaluated three times. Data were analyzed individually for each line position and in groups, following layout recommendations from the literature. The mean water depth (LM), weighted mean depth (LW), and modified Christiansen’s uniformity coefficient (CUCHH) were used as evaluation metrics. Flow rate measurements were performed, with three repetitions per nozzle number. Nozzle selection considered the required flow rate and nozzle diameter for both constant and doubled spacing between emitters in the first two spans. Measured flow rates resulted in higher simulated water depths and lower CUCHH values compared to simulated reference flow rates. However, the average field CUCHH exceeded 90% for both pivots, being classified as excellent. Evaluation methods combining different collector line positions showed no significant differences between means, nor did the combined effect of collector spacing and single-line positioning. No significant differences were found between collector spacings alone. However, collector line positioning influenced results, with P180 showing differences in LW and P360 in LM, LW, and CUCHH. Estimated evaporation and wind drift losses were 14.21% for P360 and 13.49% for P180. The evaluated nozzle selection combinations showed a theoretical CUCHH higher than the simulated values based on the original nozzle listing for both pivots.

PMID:40938957 | DOI:10.1371/journal.pone.0331122

PLoS One. 2025 Sep 12;20(9):e0330788. doi: 10.1371/journal.pone.0330788. eCollection 2025.

ABSTRACT

OBJECTIVE: This study evaluated the effects of opaque porcelain (OP) on color parameters and aesthetic outcomes of all-ceramic implant restorations with varying abutment types and restoration thicknesses.

METHODS: Four types of zirconia discs were fabricated:(A) 1.5 mm zirconia; (B) 1.4 mm zirconia + 0.1 mm OP; (C) 2.0 mm zirconia; (D) 1.9 mm zirconia + 0.1 mm OP. These discs were bonded to titanium (t) or all-ceramic (c) backgrounds to form At, Ac, Bt, Bc, Ct, Cc, Dt, and Dc specimens,to simulate the aesthetic results of implant restorations with or without OP on titanium or all-ceramic abutments. The assembled specimens were placed at the center of a dark backboard in a specialized constructed photography platform, and a professional camera was used to acquire images of the specimens. Eight regions of interest on the image were selected, and color parameters in the form of L*, a*, and b* values and variations determined via the CIELAB color measurement system were analyzed using Adobe Photoshop software.Color differences (ΔE) between samples were quantified. Statistical comparisons of color parameters were conducted using the Kruskal-Wallis H test and Welch’s t-test.

RESULTS: There were significant differences in L*, a*, and b* between all-ceramic and titanium backgrounds in all types of zirconia specimens (p < 0.001). The application of OP influenced the brightness and chroma of zirconia restorations on titanium backgrounds. ΔE values between restorations with metal substrate and OP, and those with all-ceramic substrate but without OP, (△E (Ac/Bt)= 1.99 ± 0.86; △E(Cc/Dt)= 1.31 ± 0.83) indicated that OP effectively mitigated the color compromise caused by metallic implant abutments. The greater the thickness of the restoration, the smaller the color difference caused by the titanium background.

CONCLUSION: This study revealed that titanium abutments can affect the color of implant-supported restorations. The application of OP on restorations reduces the titanium abutment’s color impact, and this effect improves with increased zirconia thickness.

PMID:40938956 | DOI:10.1371/journal.pone.0330788

Int J Oral Maxillofac Implants. 2025 Sep 12;0(0):1-31. doi: 10.11607/jomi.11539. Online ahead of print.

ABSTRACT

The present study was aimed to evaluate the findings of Laser-Lok® (LL) dental implants in various clinical indications, inserted in a private practice setting and monitored for more than 20 years, statistically analyzing the associate failure risk factors.

MATERIALS AND METHODS: Data of patients receiving LL dental implants and whose prosthetic reconstruction in the period 2000-2005 in a private practice clinic were retrospectively evaluated and statistically analyzed. Kaplan-Meier survival curve was used to determine the cumulative survival rate (CSR), and a binary generalized estimating equation model (GEE) was used to evaluate the influence of various factors on CSR.

RESULTS: Between January of 2000 and December of 2005, 730 LL implants were placed in 312 patients for a variety of clinical indications. Following implant placement, patients were checked at follow-up visits every six months for an average of 16.8 years. The Kaplan-Meier cumulative survival rate (CSR) at 5, 10, 15, and 20 years were 98.2%, 97.1%, 95.8%, and 95.3% respectively. Seven factors were identified associated with late implant failures: male, smoking, maxillary posterior area, immediate dental implant placement and immediate loading protocol, (D4) bone quality, and ≥ 35 Ncm insertion torque.

CONCLUSION: LL dental implants monitored for up to 20 years showed high CSRs and low rates of marginal bone loss.

PMID:40938951 | DOI:10.11607/jomi.11539

Transcult Psychiatry. 2025 Sep 12:13634615251371010. doi: 10.1177/13634615251371010. Online ahead of print.

ABSTRACT

The term “dual pandemics” refers to the intersection of the COVID-19 pandemic and ongoing systemic racism faced by Black Americans, highlighted by police killings during COVID-19. This study aimed to understand how these dual pandemics impacted Black college students’ mental health. Data from 102 participants over 18 years of age was collected via an open-ended qualitative question on Qualtrics and analyzed using thematic analysis. Three themes emerged: 1) Cognitive, emotional, and physiological reactions to the killings, 2) Increased awareness of racial insensitivity and cruelty, and 3) Increased distrust of systems. The findings provide insight into how the dual pandemics exacerbate existing disparities, systemic trauma, and stress for Black college students, underscoring the urgent need for systemic change. We advocate for racial trauma-informed mental health support in response to police violence.

PMID:40938635 | DOI:10.1177/13634615251371010

J Neuromuscul Dis. 2025 Sep 12:22143602251370577. doi: 10.1177/22143602251370577. Online ahead of print.

ABSTRACT

Background and objectivesThe severity of the phenotype of spinal muscular atrophy (SMA) is highly variable, yet little is known about the phenotypic variation among siblings. We systematically investigated the phenotypic variability of therapy-naïve 5q-SMA siblings leveraging a large multicentre cohort from the SMArtCARE registry.ResultsClinical information was available from 132 siblings of 65 families. There were 24 (18.2%) type 1, 38 (28.7%) type 2, 54 (40.9%) type 3 patients, and 16 (12.1%) presymptomatic individuals. In 17 families (32.1%), there was discordance in the type of SMA among symptomatic siblings. We found no influence of gender on discordance in SMA type among siblings (p = 0.528). The median age at disease onset within all sibships varied by 6 months (interquartile range (IQR) = 1-30). There was no correlation in age of onset among siblings (r = 0.405; p = 0.052). Among siblings who lost ambulation, the median interval between the start of wheelchair use was 12 months, but the maximal interval was 18 years. In one pair of siblings, one sibling lost the ability to walk at the age of 13, whereas the other sibling was still ambulatory at the age of 54. In 6 sibling pairs (9.5%), only one of both siblings had a history of scoliosis surgery. Analysing SMN2 copy numbers, in one sibling pair (1.8%) 1 SMN2 gene copy was detected, while 10 (17.5%) had 2 copies, 23 (40.4%) had 3 copies, and 17 (29.8%) had 4 copies. Concordance in SMN2 copy numbers across siblings was observed in 90% of families. With increasing SMN2 copy number, the median differences in age of onset among siblings increased without reaching statistical significance.ConclusionThis study reports considerable phenotypic variability in therapy-naïve SMA sibships that cannot solely be explained by differences in SMN2 copy numbers.

PMID:40938628 | DOI:10.1177/22143602251370577

Am J Audiol. 2025 Sep 12:1-10. doi: 10.1044/2025_AJA-24-00265. Online ahead of print.

ABSTRACT

PURPOSE: This study aims to determine the most common management strategies for vestibular neuritis and labyrinthitis (VNL) by ear, nose, and throat (ENT) providers and identify sociodemographic variations in vestibular rehabilitation therapy (VRT) referral rates and VNL patient performance on baseline VRT assessments.

METHOD: A retrospective study of all adult patients with a single diagnosis of VNL who visited a multiprovider tertiary ENT clinic (n = 168) was conducted. Demographic information, treatment recommendations, and baseline vestibular rehabilitation performance information were extracted from ENT clinical notes and initial VRT notes. Chi-square and Fisher’s exact tests were performed to evaluate sociodemographic differences, and p ≤ .003 was considered statistically significant.

RESULTS: VRT was the most popular treatment recommendation made by ENT providers, and VRT referral rates did not vary according to sociodemographic factors. 68.8% of referred patients initiated VRT. The number of patients with abnormal baseline VRT assessments did not differ by sex or race. More public insurance holders had abnormal Dynamic Gait Index assessment scores (p = .001) and gait speeds than did private insurance holders (p < .001).

CONCLUSIONS: VRT was the most frequent clinical management strategy recommended to VNL patients by ENT providers, and referral rates did not vary by sex, race, or insurance status. Most VRT patients had vestibular dysfunction on baseline assessments, suggesting appropriate referral of VRT by ENT. VNL patients’ baseline vestibular function did not vary by sex or race but did vary by insurance status. Further work is needed to investigate study generalizability and elucidate the impact of insurance type on fall risk.

SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.30053206.

PMID:40938624 | DOI:10.1044/2025_AJA-24-00265

JAMA Health Forum. 2025 Sep 5;6(9):e253045. doi: 10.1001/jamahealthforum.2025.3045.

ABSTRACT

IMPORTANCE: It is important to monitor changes in the biomedical literature and its funding. China has surpassed the US in publications and, in some analyses, in some impact indicators.

OBJECTIVE: To evaluate changes over time in the profiles of the most highly cited biomedical publications.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study assessed 100 top-cited biomedical articles (based on Scopus) published in each of 3 time periods (2003-2004, 2013-2014, and 2023-2024) for corresponding authors, types of publications represented, and funding sources, with an emphasis on funding from the US National Institutes of Health (NIH), which has been traditionally considered the major funder of biomedical research.

MAIN OUTCOMES AND MEASURES: The main outcomes of interest are descriptive and include provenance (country of corresponding author), type of publication, type of funding, overall NIH funding, and NIH funding as the sole funding source.

RESULTS: Among 100 top-cited biomedical publications, corresponding authors from the US decreased over time (59 of 100 articles in 2003-2004, 58 of 100 in 2013-2014, 45 of 100 in 2023-2024). Corresponding authors from China represented 0 top-cited publications in 2003-2004, 1 in 2013-2014, and 4 in 2023-2024. There was an increase in consensus articles (10 in 2003-2004 vs 24 in 2023-2024) and in reference statistics articles (1 in 2003-2004, 10 in 2013-2014, and 11 in 2023-2024). Reviews remained common among top-cited articles, but almost always were nonsystematic. NIH funding was listed in 45 publications in 2003-2004, 50 in 2013-2014, and 23 in 2023-2024. All other countries combined surpassed US public funding in 2023-2024. Funding by NIH in combination with other funders increased from 13 articles in 2003-2204 to 22 and 21, respectively, in 2013-2014 and 2023-2024, but funding by NIH alone decreased in the last decade (32 of 100 in 2002-2003, 28 of 100 in 2013-2014, and 2 of 100 in 2023-2024). More commonly listed funding from nonprofit organizations, societies, and institutions complemented the NIH funding decline. The first authors of 7 of 45 and the corresponding authors of 14 of 45 top-cited US-based articles of 2023-2024 were listed as leaders of active NIH grants in RePORTER as of February 2025. Citation gaming became more obvious in 2023-2024 with the advent of some atypical highly cited papers and a larger share of nonsystematic reviews and consensus documents.

CONCLUSIONS AND RELEVANCE: Results of this study suggest that, overall, the US remains a world leader regarding the most highly cited biomedical research and NIH funding retains a substantial presence among top-cited articles. However, NIH influence had decreased overall, and top-cited articles funded exclusively by NIH have almost disappeared. Strengthening public funding is essential to secure research that serves the common good.

PMID:40938617 | DOI:10.1001/jamahealthforum.2025.3045