Tag: statistics

PLoS One. 2025 Aug 5;20(8):e0330029. doi: 10.1371/journal.pone.0330029. eCollection 2025.

ABSTRACT

BACKGROUND: Progress testing is a longitudinal assessment method used to monitor the acquisition and retention of knowledge throughout medical training. While progress tests (PTs) have been widely adopted internationally through collaborative networks of medical schools, in Peru, their implementation has been primarily institutional. This study aimed to evaluate longitudinal trends in PT scores at a Peruvian medical school.

METHODS: We conducted a longitudinal analysis using data from PTs administered annually between 2017 and 2024. The PT assessed students’ knowledge based on the subjects completed at the time of testing. Scores ranged from 0 to 250 and were converted to a 20-point scale. Independent variables included number of PTs taken (1-7), year of entry into medical school (entry cohort; 2017-2024), year of test administration (2017-2024), and sex. Generalized estimating equations (GEE) were used to assess score trends over time, applying an identity link function with a Gaussian distribution and robust standard errors clustered by student ID.

RESULTS: We included 1,899 test scores from 669 medical students. The mean score across all tests was 9.19 (standard deviation = 2.34). No consistent upward trend in PT scores was observed over the study period; scores decreased by 0.088 points per additional year (CI95% CI: -0.147 to -0.029, p = 0.003). Students who completed five PTs scored significantly higher than those who took four (β = 1.40; 95% CI: 0.79 to 2.01). When stratified by entry cohort, no sustained improvement in scores was observed within cohorts over time.

CONCLUSION: Over an eight-year period of administering a progress test at a Peruvian medical school, student performance remained stable, with an average of approximately 50% of questions answered correctly per test. Longitudinal analysis did not reveal a sustained increase in scores as students advanced through the curriculum. This pattern may be explained by the PT design, which assesses only the content covered by students at the time of each administration, in contrast to other PTs that measure end-of-curriculum knowledge across all cohorts. Nevertheless, an increase in median scores was observed during the transition from basic science to clinical subjects.

PMID:40763293 | DOI:10.1371/journal.pone.0330029

PLoS One. 2025 Aug 5;20(8):e0329893. doi: 10.1371/journal.pone.0329893. eCollection 2025.

ABSTRACT

Longitudinal studies that analyze the changes in the axial diffusivity (AxD) and radial diffusivity (RD) values over time can elucidate the progression of white matter damage and its causal relationship with cognitive decline. This study aimed to investigate the longitudinal changes in white matter integrity based on AxD and RD and their association with cognitive decline in patients with mild cognitive impairment (MCI) that progressed to Alzheimer’s disease (AD). Eighteen participants diagnosed with MCI at baseline and AD at the follow-up examination were selected from the AD Neuroimaging Initiative and included in this 2-year study Tract-based spatial statistics (TBSS) was used to assess longitudinal changes in WM. Voxel-wise and region-of-interest (ROI) analyses were conducted, and statistical models controlled for age, sex, education, and APOE ε4 status. Correlation and multiple regression analyses were performed to examine the association between AxD/RD changes and changes in clinical dementia rating (CDR) scores. Significant increases in AxD and RD were observed over 2 years in widespread WM tracts, including the corpus callosum, internal capsule, corona radiata, cingulum, superior longitudinal fasciculus, and fornix. AxD changes, particularly in the left retrolenticular internal capsule, left posterior corona radiata, left fornix, and right superior longitudinal fasciculus, showed significant correlations with cognitive decline. In contrast, RD changes were not significantly associated with CDR changes in any region. Multivariate regression analysis identified AxD in the left retrolenticular internal capsule as a significant independent predictor of CDR changes. AxD was sensitive to microstructural alterations in WM associated with cognitive decline during the transition from MCI to AD and may serve as a valuable biomarker for early detection and monitoring of AD progression. Longitudinal DTI analyses provide critical insights into the temporal dynamics of WM degeneration and its role in clinical deterioration.

PMID:40763286 | DOI:10.1371/journal.pone.0329893

PLoS One. 2025 Aug 5;20(8):e0329350. doi: 10.1371/journal.pone.0329350. eCollection 2025.

ABSTRACT

The essence of the influence maximization (IM) problem is how to identify the set of seed nodes so that the node numbers ultimately affected in the network reach the maximum under a certain spreading model. In the field of influence maximization research, the investigation of seed nodes identifying algorithms is a hot yet challenging work. Although conventional greedy algorithms and heuristic algorithms have high performance, their efficiency remains a challenge when applied to large-scale social networks. In recent years, swarm intelligence-based optimization algorithms have seen increasing application in addressing this problem, with notable improvements in performance. However, the efficiency of these swarm intelligence-based algorithms still needs to be improved in large-scale social networks. Based on this issue, a parallel discrete crow search algorithm (PDCSA) designed for parallel computing is proposed. Based on the evolution characteristics, PDCSA makes full use of the efficiency advantage of parallel computing to improve the time efficiency of solving IM problems.The results of experiments conducted on six datasets show that PDCSA achieves performance comparable to state-of-the-art algorithms, with the added advantages of high efficiency and robustness.

PMID:40763283 | DOI:10.1371/journal.pone.0329350

Blood Adv. 2025 Aug 5:bloodadvances.2025016117. doi: 10.1182/bloodadvances.2025016117. Online ahead of print.

ABSTRACT

High-grade B-cell lymphomas [HGBL, including double-hit/triple-hit (HGBL-DH/TH) and HGBL not otherwise specified (HGBL-NOS)] have a poor prognosis upon failure of first-line therapy. Anti-CD19 chimeric antigen receptor (CAR) T-cells for third-line aggressive large B-cell lymphomas resulted in long-term remission in up to 40% of patients. This study evaluated factors that can predict outcomes in HGBL compared to Diffuse Large B-cell lymphomas (DLBCL). We assessed the predictive value of the subtype (HGBL versus DLBCL) using weighted log-rank tests and weighted Cox models, and overall survival (OS) following CAR T-cells failure. The prospective study cohort comprised 432 patients [HGBL (n=78); DLBCL (n=354)] with a median follow-up of 22.8 months for HGBL and 18 months for DLBCL. Interestingly, there was no statistically significant difference in progression-free survival (PFS) and OS between patients with HGBL-DH/TH lymphomas versus other high-grade histotypes. CAR T-cells expansion in HGBL did not correlate with response. Before weighting, a significant difference in OS was observed between HGBL versus DLBCL (24-month OS: 37% vs. 49%, p=0.0036). After weighting, the difference in 2-year OS remained significant (37% versus 44%, p=0.0343), and it was related to an inferior survival following CAR T-cells failure. The 2-year NRM and incidence of secondary malignancies were similar in HGBL and DLBCL patients (11% versus 11%, p=0.830; 6.4% versus 11.4%, p=0.844). Among patients failing CAR T-cells, the 1-year OS post failure was significantly higher in transformed than de novo DLBCL and HGBL (59% versus 32% versus 11%, <0.0004). Earlier use of CAR T-cells may improve the outcome of HGBL. NCT06339255.

PMID:40763273 | DOI:10.1182/bloodadvances.2025016117

J Health Organ Manag. 2025 Aug 5:1-17. doi: 10.1108/JHOM-01-2025-0036. Online ahead of print.

ABSTRACT

PURPOSE: Understanding what drives turnover among nurses and how to address that is an important issue facing hospitals, society and organizational researchers. While turnover has many causes, the perception that organizations have failed to meet expected norms (a perceived psychological contract breach – PCB) is a salient cause. Due to dynamic changes in the workplace, PCBs increase in the workplace, and when PCBs are perceived, turnover intention (TI) increases. We investigate whether individual differences among nurses in the need to belong (NTB) determine exit or voice behavior when PCB is perceived.

DESIGN/METHODOLOGY/APPROACH: Using survey methodology and a sample of nurses currently employed, we tested the moderating effects of individual differences in NTB on the PCB-TI link.

FINDINGS: The strength of PCB leading to TI was significantly moderated by the level of NTB. After accounting for perceived job alternatives and the need for affiliation, the interaction between NTB and PCB was statistically significant ((Δ R2 = 0.02) in explaining TI.

ORIGINALITY/VALUE: There is limited research on the boundary conditions surrounding the PCB-TI relationship, and this study brings in a unique perspective by incorporating an individual difference on the PCB-TI relationship. The study has implications for the social exchange theory, refinement of the NTB construct and models of turnover, and its results highlight the importance of supervisors and managers honoring obligations and promises made to nurses.

PMID:40763245 | DOI:10.1108/JHOM-01-2025-0036

Hum Vaccin Immunother. 2025 Dec;21(1):2535755. doi: 10.1080/21645515.2025.2535755. Epub 2025 Aug 5.

ABSTRACT

Older adults and adults with certain chronic conditions are at increased risk for severe respiratory syncytial virus (RSV) disease. In 2023, RSV vaccines first became available in the United States (US) for adults aged ≥60 years. This retrospective database analysis evaluated RSV vaccination uptake from August 2023-February 2025 using IQVIA’s open-source pharmacy (LRx) and medical (Dx) claims data. The study included US adults aged ≥60 years with ≥1 claim in 2023. For those without RSV vaccination in 2023, ≥1 claim was also required between January 2024-February 2025. Uptake was assessed as the number and percentage of eligible adults who received an RSV vaccine during the study period. Multivariable logistic regression modeling explored factors associated with RSV vaccination. Nearly 12.8 million adults aged ≥60 years (16.4%) received RSV vaccination between August 2023-February 2025. Uptake generally increased with age and was higher among those with ≥1 potential risk factor for severe RSV disease. Disparities in uptake were observed by race, ethnicity, and other social determinants of health. In multivariable analyses, odds of RSV vaccination were nearly 24 times higher for those who received ≥1 non-RSV vaccine from August 2023-February 2025 versus those who had not. Despite the increased risk of severe RSV disease among older adults and those with certain risk factors, relatively limited RSV vaccination uptake was observed during the 2023-2025 seasons, with disparities observed. Additional efforts are needed to support RSV prevention among those at highest risk and to ensure equitable access to vaccination.

PMID:40763207 | DOI:10.1080/21645515.2025.2535755

Comput Inform Nurs. 2025 Aug 1. doi: 10.1097/CIN.0000000000001351. Online ahead of print.

ABSTRACT

Artificial intelligence, including chatbots that produce outputs in response to user prompts, is poised to revolutionize nursing education and program evaluation. This article summarizes a pilot evaluation of three core features in a chatbot system: (1) defining a persona or system prompt, (2) creating specific task prompts, and (3) developing an improvement mechanism. First, an “act as” system prompt was written to generate “Future-FLO” based on professional values. Second, a task prompt was written to generate outputs specific to program evaluation. Third, a separate ImproverBot was created to provide structured assessments of chatbot outputs. Human raters, knowledgeable about grant goals, provided feedback on AI-generated outputs from FLO and non-FLO system prompts. The ImproverBot rated the same outputs as the human raters on accuracy, completeness, and usefulness. Statistical tests were used to compare ratings across AI versions and rater types. The custom prompt provided no added benefits compared with using the standard model, as rated by human raters and the ImproverBot. The ImproverBot gave significantly higher ratings than human raters. Comments indicated that outputs were error-filled and unreliable. Engaging with artificial intelligence to support the work of grant evaluation will require ongoing efforts to develop chatbots and evaluate their outputs.

PMID:40763202 | DOI:10.1097/CIN.0000000000001351

PLOS Glob Public Health. 2025 Aug 5;5(8):e0004966. doi: 10.1371/journal.pgph.0004966. eCollection 2025.

ABSTRACT

Interventions are needed to reduce the global disparity in prostate cancer outcomes. Our research aimed to evaluate the acceptability, feasibility and appropriateness of a stakeholder-developed intervention for the early detection of prostate cancer in Nigeria. This was a mixed methods study conducted at three cities in Nigeria. The intervention mapping framework was utilized as the primary framework for the study. During intervention development, a six-member team developed an implementation research logic model and then conducted stakeholder engagement to prioritize the preliminary intervention strategies among 12 purposively selected stakeholders. This was followed by brainstorming sessions by the same intervention development team for the selection of multi-faceted intervention strategies. Key informant interviews were then conducted among 10 purposively selected Nigerian clinicians, institutional leaders, and policymakers for contextual inquiry on the developed intervention. Descriptive statistics and qualitative analysis were performed. At the end of the intervention development process, the primary intervention strategies included supported risk assessment and patient navigation. The secondary strategies were education and training, and cancer information communication. The main actors of the intervention were trained community-based healthcare providers while the targeted population were adult men 40 years and above. The informants strongly noted that the intervention actions were feasible. Regarding acceptability, informants strongly believed that the intervention had numerous relative advantages but noted its complexity and the potential risk for overdiagnosis. Informants also consistently acknowledged that the intervention was appropriate but had mixed disposition on implementation preparedness. Further adaptations were made to address the stakeholder-identified gaps. In conclusion, this study developed a prostate cancer early detection intervention with preliminary feasibility, the first rigorously developed systems-strengthening intervention to optimize the detection of early-stage prostate cancer in Nigeria. A pilot implementation trial will be helpful in further testing the intervention in the field setting.

PMID:40763189 | DOI:10.1371/journal.pgph.0004966

PLoS One. 2025 Aug 5;20(8):e0326745. doi: 10.1371/journal.pone.0326745. eCollection 2025.

ABSTRACT

INTRODUCTION: The integrated care model considers sequences of kidney replacement therapies rather than individual modalities. Data from conventional registries describing trajectories are partial. The aim was to provide a complete description of the peritoneal dialysis pathway.

METHODS: Patients undergoing peritoneal dialysis in France between January 1, 2009, and December 31, 2019, were included. Data from the national REIN (Renal Epidemiology and Information Network) registry and the SNDS (Administrative Database of Outpatient and Inpatient Care Consumption) database were used. Patient trajectories and status (peritoneal dialysis, hemodialysis, mixed and hybrid dialysis, kidney transplantation, and death) were reconstructed. Each dialysis session, even a single day, was recorded. The trajectory was described using a Sankey diagram.

RESULTS: A total of 5,053 patients in the REIN registry and the SNDS database underwent peritoneal dialysis at some point. The Sankey diagram showed the great diversity and complexity of care pathways. Only 1,652 (33%) of patients underwent peritoneal dialysis only. A total of 1,807 (36%) patients changed kidney replacement therapy 2 times or more. There was high permeability between peritoneal dialysis and hemodialysis: 1,358 (27%) patients transferred from hemodialysis to peritoneal dialysis and 2,018 (40%) transferred from peritoneal dialysis to hemodialysis. A total of 251 (5%) patients underwent hybrid dialysis. A total of 498 (10%) patients experienced an unstable period of mixed dialysis and managed to return to peritoneal dialysis for a significant time (median of 339 days). The causes of transfers were not available.

CONCLUSION: Our results describe a more precise view of the trajectories of peritoneal dialysis patients compared to data from conventional registries. Peritoneal dialysis is a component of a multimodal pathway, as two thirds are likely to receive another kidney replacement therapies. Ongoing information about other kidney replacement therapies regimens seems necessary for peritoneal dialysis patients. The organization of each dialysis center must integrate and facilitate these transfers.

PMID:40763188 | DOI:10.1371/journal.pone.0326745

PLoS One. 2025 Aug 5;20(8):e0329761. doi: 10.1371/journal.pone.0329761. eCollection 2025.

ABSTRACT

In recent years, public perceptions of patient safety have evolved significantly, driven by media coverage, healthcare reforms, and greater awareness during the coronavirus disease 2019 (COVID-19) pandemic. The present study aimed to examine trends in public perceptions of patient safety, knowledge and self-efficacy in Germany during this pandemic between 2019 and 2023. A repeated cross-sectional study was conducted, using data from TK Monitor of Patient Safety. TK Monitor of Patient Safety in a nationwide survey assessing public perceptions of safety in medical treatment and diagnosis. Self-reported data were collected annually from a randomly selected sample of 1,000 different adults aged 18 and older residing in Germany. Statistical analyses included descriptive statistics, chi-square tests, and linear regressions for trend analyses. Our results revealed high perceived patient safety risk during the years of the study. Up to one third of respondents considered it very likely or somewhat likely that patients would be harmed when receiving medical treatment in hospital or ambulatory care, with lower perceived levels of risk before the COVID-19 pandemic. Regarding perceived prevalence of preventable adverse events, over half of respondents considered it very likely or somewhat likely that an illness of theirs would be diagnosed incorrectly, or that they would contract a nosocomial infection, at some stage in their lives. The majority of respondents considered themselves overall well informed about patient safety and reported higher levels of self-efficacy with regard to error prevention before and after the pandemic than during it. Given the facts that patient safety remains an important issue and that the German public perceives the level of patient safety risk but also of patient safety knowledge, and self-efficacy as high, actively involving patients in safety initiatives is essential for shaping positive public perception.

PMID:40763169 | DOI:10.1371/journal.pone.0329761