Tag: statistics

JMIR Mhealth Uhealth. 2025 Nov 6;13:e70987. doi: 10.2196/70987.

ABSTRACT

BACKGROUND: The expansion of mobile health app or apps has created a growing need for structured and predictive tools to evaluate app quality before deployment. The Mobile App Rating Scale (MARS) offers a standardized, expert-driven assessment across 4 key dimensions-engagement, functionality, aesthetics, and information-but its use in forecasting user satisfaction through predictive modeling remains limited.

OBJECTIVE: This study aimed to investigate how k-means clustering, combined with machine learning models, can predict user ratings for physical activity apps based on MARS dimensions, with the goal of forecasting ratings before production and uncovering insights into user satisfaction drivers.

METHODS: We analyzed a dataset of 155 MARS-rated physical activity apps with user ratings. The dataset was split into training (n=111) and testing (n=44) subsets. K means clustering was applied to the training data, identifying 2 clusters. Exploratory data analysis included box plots, summary statistics, and component+residual plots to visualize linearity and distribution patterns across MARS dimensions. Correlation analysis was performed to quantify relationships between each MARS dimension and user ratings. In total, 5 machine learning models-generalized additive models, k-nearest neighbors, random forest, extreme gradient boosting, and support vector regression-were trained with and without clustering. Models were hypertuned and trained separately on each cluster, and the best-performing model for each cluster was selected. These predictions were combined to compute final performance metrics for the test set. Performance was evaluated using correct prediction percentage (0.5 range), mean absolute error, and R². Validation was performed on 2 additional datasets: mindfulness (n=85) and older adults (n=55) apps.

RESULTS: Exploratory data analysis revealed that apps in cluster 1 were feature-rich and scored higher across all MARS dimensions, reflecting comprehensive and engagement-oriented designs. In contrast, cluster 2 comprised simpler, utilitarian apps focused on basic functionality. Component+residual plots showed nonlinear relationships, which became more interpretable within clusters. Correlation analysis indicated stronger associations between user ratings and engagement and functionality, but weaker or negative correlations with aesthetics and information, particularly in cluster 2. In the unclustered dataset, k nearest neighbors achieved 79.55% accuracy, mean absolute error=0.26, and R²=0.06. The combined support vector regression (cluster 1)+k-nearest neighbors (cluster 2) model achieved the highest performance: 88.64% accuracy, mean absolute error=0.27, and R²=0.04. Clustering improved prediction accuracy and enhanced alignment between predicted and actual user ratings. Models also generalized well to the external datasets.

CONCLUSIONS: The combined clustering and modeling approach enhances prediction accuracy and reveals how user satisfaction drivers vary across app types. By transforming MARS from a descriptive tool into a predictive framework, this study offers a scalable, transparent method for forecasting user ratings during app development-particularly useful in early-stage or low-data settings.

PMID:41213075 | DOI:10.2196/70987

Trends Psychiatry Psychother. 2025 Nov 10. doi: 10.47626/2237-6089-2025-1127. Online ahead of print.

ABSTRACT

OBJECTIVE: Cognitive-behavioral therapy (CBT) is a first-line treatment for anxiety and depressive disorders, but its preventive efficacy remains uncertain. This study systematically reviewed and meta-analyzed randomized controlled trials of universal CBT-based interventions across all age groups, evaluating their effects on anxiety, depression, and quality of life.

METHODS: We included randomized controlled trials of universal CBT programs delivered to general populations without prior risk or symptom screening. Eligible outcomes were depressive and anxiety symptoms and quality of life. Risk of bias was assessed using the Cochrane Risk of Bias tool. Separate three-level meta-analyses were conducted for each outcome, and subgroup analyses were performed by participant age and provider profession.

RESULTS: Seventeen RCTs (n = 10,809 participants) met inclusion criteria. Pooled effect sizes were SMD = -0.02 (95% CI: -0.12 to 0.09) for quality of life, SMD = -0.09 (95% CI: -0.20 to 0.01) for depressive symptoms, and SMD = -0.03 (95% CI: -0.18 to 0.13) for anxiety symptoms. None reached statistical significance. Subgroup analyses confirmed no significant effects in children/adolescents or adults. Interventions delivered by psychologists were more effective than those delivered by teachers (SMD = 0.18), although overall preventive effects remained negligible.

CONCLUSIONS: Universal CBT interventions did not demonstrate significant preventive benefits for anxiety, depression, or quality of life across age groups. These findings suggest that universal CBT should not be adopted as a population-wide prevention strategy, and future research should prioritize targeted, data-driven approaches.

PMID:41213072 | DOI:10.47626/2237-6089-2025-1127

J Long Term Eff Med Implants. 2025;35(4):69-77. doi: 10.1615/JLongTermEffMedImplants.2025056315.

ABSTRACT

The current study sought to assess the impact on quality of life in individuals with a single posterior tooth loss, as well as its improvement after a single-unit immediate implant loading in a 6-month follow-up. Forty patients with a single posterior tooth loss were evaluated for oral health-related quality of life using the OHIP-14 before and six months after rehabilitation, as well as anxiety and depression symptoms using the Hospital Anxiety and Depression Scale (HADS). The Two-Way ANOVA was used to compare OHIP-14 scores at the tooth loss site and after rehabilitation. Descriptive statistics were computed for the HADS and OHIP-14 domains. Thirty-three patients that remained in the sample presented significantly reduced OHIP-14 scores after 6 months of rehabilitation, regardless the tooth loss site. Physical pain, psychological discomfort, psychological disability, and physical disability were the four most affected OHIP-14 domains and presented improvement after the rehabilitation. The individuals presented HADS scores for anxiety and depressive symptoms majorly within the normal range. Posterior single tooth loss has a detrimental impact on oral health-related quality of life. Either function or psychological domains appear to be impacted. The patients’ rehabilitation was found to have a significant impact on quality-of-life improvement.

PMID:41213053 | DOI:10.1615/JLongTermEffMedImplants.2025056315

J Long Term Eff Med Implants. 2025;35(4):63-68. doi: 10.1615/JLongTermEffMedImplants.2025059317.

ABSTRACT

The interdental papilla plays a critical role in both the function and esthetics of the anterior maxilla. In implant dentistry, maintaining this delicate soft tissue is often challenging, particularly when implants are adjacent to each other, due to anatomical and vascular limitations. To evaluate the mean height of the peri-implant papilla in the maxillary anterior region and investigate its association with the type of adjacent structure (natural tooth or implant) and implant location (central incisor, lateral incisor, canine). This cross-sectional study included 298 patients with 342 implants and 684 contact areas in the anterior maxilla, with at least 1 year of functional loading. Sites were categorized into implant-tooth (n = 401) and implant-implant (n = 283) groups. Papilla height was measured and statistical analysis was performed using independent t-tests and ANOVA. Mean papilla height was significantly greater in implant-tooth contacts than implant-implant contacts (P < 0.05). At central incisors, papilla height was 3.4 ± 0.4 mm (implant-tooth) vs. 3.0 ± 0.3 mm (implant-implant); at lateral incisors, 2.8 ± 0.3 mm vs. 2.6 ± 0.1 mm; and at canines, 3.0 ± 0.4 mm vs. 2.8 ± 0.2 mm. Central incisors consistently showed the highest papilla values. Peri-implant papilla height is significantly greater at implant-tooth contact sites compared with implant-implant sites in the anterior maxilla. Among all locations, central incisor regions demonstrated the highest papilla levels.

PMID:41213052 | DOI:10.1615/JLongTermEffMedImplants.2025059317

J Long Term Eff Med Implants. 2025;35(4):51-61. doi: 10.1615/JLongTermEffMedImplants.2025060463.

ABSTRACT

Osseointegration is related to the stability of the screw and influences the success rate of implant-supported prosthetic rehabilitation, as it promotes natural healing and effective bone formation, facilitating the preservation of the implant in the recipient site. Factors such as surgical technique, insertion torque, the type of recipient bone, and the macro- and microstructure of the implant can affect screw stability. The objective of this study is to analyze in vivo the influence of insertion torque, recipient bone type, and peri-implant bone loss on the implant stability quotient (ISQ) values of cylindrical implants with external hexagon (EH) and Morse taper (MT) connections, featuring a new surface treatment called referenced acid etching (RAE). A total of 40 implants were placed in edentulous areas following predefined inclusion and exclusion criteria. Immediately after implant placement (t0), insertion torque, resonance frequency, digital periapical radiographs, and peri-implant evaluation were recorded. Resonance frequency analysis, periapical radiographs, and peri-implant evaluations were repeated after osseointegration (t1) and 180 d after rehabilitation (t2). The data obtained were statistically analyzed using specific tests for each type of analysis, with a significance level of 5%. Regarding the ISQ value at t1, it resulted in a high value, with a significant reduction at t2, for both types of connection, there was bone resorption for the HE and bone gain for the MT. The installation of the implants up to 180 d of prosthesis functionality, stability, bone gain or loss and type of bone, presented clinically acceptable conditions for all connections studied.

PMID:41213051 | DOI:10.1615/JLongTermEffMedImplants.2025060463

J Long Term Eff Med Implants. 2025;35(4):15-20. doi: 10.1615/JLongTermEffMedImplants.2025057382.

ABSTRACT

Biomarkers within peri-implant crevicular fluid (PICF) are emerging as pivotal diagnostic agents, promising heightened accuracy in identifying peri-implant diseases. The present study aimed to assess the impact of non-sur-gical therapy on PICF calprotectin levels in patients with peri-implantitis. A total of 40 individuals aged between 30 and 60 years were enrolled: Group I (n = 20 healthy peri-implant sites) and Group IIa (n = 20 peri-implantitis sites). Clinical parameters such as peri-implant probing depth (PPD) and clinical attachment level (CAL) were recorded. PICF samples were collected and assayed for calprotectin using enzyme-linked immunosorbent assay (ELISA). After clinical examination and PICF collection at baseline, mechanical debridement was done for peri-implantitis patients, and after 3 months, clinical examination and PICF collection was done (Group IIb). The results were statistically analyzed. The PICF calprotectin level was higher in Group IIa (43.76 ± 3.64 ng/mL) as compared with Group I (11.36 ±2.53 ng/mL). Between Groups IIa and IIb, there was a significant reduction in PPD, CAL, and calprotectin from baseline to 3 months (P < 0.05). Pearson correlation in Groups IIa and IIb revealed that the correlation between calprotectin and clinical parameters was strongly positive and statistically significant. The present study suggests that there was a significant reduction in PICF calprotectin levels among peri-implantitis patients after mechanical debridement. Also, there exists a positive correlation between PICF calprotectin and peri-implant health parameters.

PMID:41213047 | DOI:10.1615/JLongTermEffMedImplants.2025057382

JAMA Netw Open. 2025 Nov 3;8(11):e2548121. doi: 10.1001/jamanetworkopen.2025.48121.

ABSTRACT

IMPORTANCE: Home health aides (HHAs) frequently care for adults with heart failure (HF), but many lack HF training, confidence with HF caregiving, and cannot reach their nurse supervisors by telephone when they need guidance. This may have negative consequences for HHAs and patients.

OBJECTIVE: To examine the effectiveness of an education- and communication-based intervention among HHAs caring for patients with HF.

DESIGN, SETTING, AND PARTICIPANTS: This 2-group pilot randomized clinical trial was conducted in partnership with a large home care agency in New York, New York, from May 2022 to May 2024. HHAs caring for a patient with HF participated. Outcomes were ascertained on an intent-to-treat basis at baseline, mid-study (45 days after the training course), and 90 days.

INTERVENTIONS: The enhanced usual care (EUC) group received HF training, and the intervention group received HF training plus a mobile health application that allowed HHAs to message nurses.

MAIN OUTCOMES AND MEASURES: Co-primary outcomes were HF knowledge (assessed using the Dutch HF Knowledge Scale [DHFKS]; range 0-15; higher score indicates greater knowledge) and HF caregiver self-efficacy (assessed using the Caregiver Contribution to Self-Care in HF Index; range, 0-100; higher score indicates greater efficacy). The secondary outcome was self-reported preventable 911 calls. Exploratory outcomes included patient emergency department (ED) visits and hospitalizations. Mixed-effects models were used to compare trajectories of outcomes between and within study groups.

RESULTS: A total of 102 HHAs (mean [SD] age, 54 [10.5] years; 98 [96.1%] female) were assessed, including 50 in the EUC group and 52 in the intervention group. Overall, 62 HHAs (62.0%) were Black, 1 HHA (1.0%) was American Indian or Alaska Native, 7 HHAs (7.0%) were Asian, 9 HHAs (9.0%) were White, and 21 HHAs (21.0%) identified as other race; 27 HHAs (27.0%) were Hispanic. Within the intervention group, DHFKS scores improved at 90 days, from a median (IQR) score of 6.1 (5.5-6.7) points at baseline to 7.7 (7.0-8.4) points at 90 days (P = .02); however the change did not differ between groups. Across both groups, HHAs with the lowest baseline DHFKS and self-efficacy had the greatest increases at 90 days (median [IQR] change: DHFKS, 1.45 [0.84-2.04] points; self-efficacy, 8.06 [4.42-11.71] points). At 90 days, there were no statistically significant within-group differences in the proportion of HHAs reporting preventable 911 calls group (intervention: 0.51 [95% CI, 0.37-0.64] at baseline vs. 0.34 [95% CI, 0.2-0.49] at 90 days; P = .06; EUC: 0.42 [95% CI, 0.28-0.56] at baseline vs 0.54 [95% CI, 0.38-0.70] at 90 days; P = .21), but the difference between groups was statistically significant (P = .04). This pilot study was not powered for patient-level outcomes, so the risk of ED visits for patients of intervention HHAs (incidence rate ratio, 0.56 [95% CI, 0.25-1.28]; P = .17) should be considered exploratory.

CONCLUSIONS AND RELEVANCE: In this randomized clinical trial of HHAs caring for patients with HF, HF training improved HHAs’ knowledge and self-efficacy, with greatest gains among those with the lowest baseline scores. The ability to message nurses was associated with fewer preventable 911 calls among HHAs in the intervention group. These findings can inform the design of a large-scale trial to better support and integrate HHAs providing HF care.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04239911.

PMID:41213039 | DOI:10.1001/jamanetworkopen.2025.48121

Mol Pharm. 2025 Nov 10. doi: 10.1021/acs.molpharmaceut.5c00799. Online ahead of print.

ABSTRACT

A spray-dried powder formulation of 5-azacytidine (5-AZA) recently showed significantly improved tumor reduction and systemic exposure for the potential treatment of metastatic lung cancer. To support clinical use, the target product profile required double the active loading. Here, a series of powders were spray dried to increase 5-AZA loading in the formulation, and process parameters were varied to identify variables controlling powder properties. Formulations were sprayed via in-line mixing, where separate dimethyl sulfoxide (DMSO) and aqueous solutions were mixed immediately upstream of atomization. A core-shell structure was observed matching previous reports of spray-dried l-leucine with sugar from water and ethanol. To the best of our knowledge, this is the first study investigating the process and structure of spray-dried l-leucine and trehalose using DMSO and water as processing solvents. Powders with glass transition temperatures (T_g) below room temperature were successfully manufactured with high yields, attributed to the crystalline l-leucine shell surrounding the low T_g core. The residual DMSO was controlled by the DMSO:water ratio and the composition of the core. Perturbed-Chain Statistical Associating Fluid Theory (PC-SAFT) was employed to understand droplet drying processes by developing ternary phase diagrams and drying trajectories. This work enables the manufacture of both dry inhalable 5-AZA powder for the treatment of lung cancer and low T_g materials previously thought to be unmanufacturable via spray drying. It also highlights the importance of aligning experimental data and theoretical models to improve our understanding of complex processes.

PMID:41213010 | DOI:10.1021/acs.molpharmaceut.5c00799

Circulation. 2025 Nov 10. doi: 10.1161/CIRCULATIONAHA.125.077304. Online ahead of print.

ABSTRACT

BACKGROUND: Transthyretin amyloidosis with cardiomyopathy (ATTR-CM) is a progressive disease caused by the deposition of transthyretin as amyloid in the myocardium. Current therapies may slow disease progression but do not clear existing deposits. Coramitug is a humanized monoclonal antibody that targets misfolded transthyretin, designed to promote clearance of transthyretin amyloid through antibody-mediated phagocytosis.

METHODS: This phase 2, double-blind, placebo-controlled trial randomized participants with ATTR-CM to receive infusions every 4 weeks of either coramitug at two dosages (10 mg/kg or 60 mg/kg) or placebo in a 1:1:1 ratio for 52 weeks. The primary endpoints were the change from baseline to week 52 in the six-minute walk test (6MWT) and N-terminal pro-brain type natriuretic peptide (NT-proBNP) levels. Safety was assessed for up to 64 weeks by assessing treatment-emergent adverse events, all-cause mortality, and number of cardiovascular (CV) events comprising hospitalization due to CV events or urgent heart failure visits.

RESULTS: In total, 104 participants (median age 77 years; 93% men; 84% New York Heart Association class II; 13% with variant ATTR-CM) were randomized and dosed: 34 to coramitug 10 mg/kg, 35 to coramitug 60 mg/kg, 35 to placebo. Median NT-proBNP was 1985 pg/mL (interquartile range: 1224, 3406 pg/mL). In total, 90% of participants were on disease-modifying therapy; 84% were treated with tafamidis and 7 (6.7%) with TTR silencers (patisiran, n=4; vutrisiran, n=3). From baseline to week 52, coramitug 60 mg/kg significantly reduced NT-proBNP levels compared with placebo (-48%; 95% CI: -65%, -22%; P=0.0017). The change in 6MWT from baseline to week 52 was not statistically different from placebo with either dose. Coramitug 60 mg/kg was associated with improved functional echocardiographic parameters and was well tolerated.

CONCLUSIONS: This phase 2 trial showed that coramitug, an antibody targeting misfolded transthyretin in ATTR-CM, was well tolerated and at a dose of 60 mg/kg resulted in a statistically significant reduction in NT-proBNP, a validated marker of disease progression, with no statistically significant effect on 6MWT within 52 weeks.

PMID:41212997 | DOI:10.1161/CIRCULATIONAHA.125.077304

J Speech Lang Hear Res. 2025 Nov 10:1-16. doi: 10.1044/2025_JSLHR-24-00736. Online ahead of print.

ABSTRACT

PURPOSE: Reproducibility is a core principle of science, and access to a study’s data is essential to reproduce its findings. However, data sharing is uncommon in the discipline of communication sciences and disorders (CSD), often due to concerns related to privacy and disclosure risks. Synthetic data offer a potential solution to this barrier by generating artificial data sets that do not represent real individuals yet retain statistical properties and relationships from the original data. This study aimed to explore the feasibility and preliminary utility of synthetic data to promote transparency and reproducibility in the discipline of CSD.

METHOD: Ten open data sets were obtained from previously published research within the American Speech-Language-Hearing Association “Big Nine” domains (articulation, cognition, communication, fluency, hearing, language, social communication, voice and resonance, and swallowing) across a range of study outcomes and designs. Synthetic data sets were generated with the synthpop R package. General utility was assessed visually and with the standardized ratio of the propensity mean squared error (S_pMSE). Specific utility assessed whether inferential relationships from the original data were preserved in the synthetic data set by comparing model fit indices, coefficients, and p values.

RESULTS: All synthetic data sets showed strong general utility, maintaining univariate and bivariate distributions. Six of nine synthetic data sets that used inferential statistics showed strong specific utility, maintaining inferential relationships from the original analysis. Specific utility was low in three data sets with hierarchical structures.

CONCLUSIONS: Findings suggest that synthetic data can effectively maintain statistical properties and relationships across a wide range of nonhierarchical data commonly seen in the discipline of CSD. Other approaches for hierarchical data need to be explored in future work. Researchers who use synthetic data should assess its utility in preserving their results for their own data and use-case.

OPEN SCIENCE FORM: https://doi.org/10.23641/asha.30569957.

PMID:41212974 | DOI:10.1044/2025_JSLHR-24-00736