Tag: statistics

Proc Natl Acad Sci U S A. 2025 Jul 29;122(30):e2509354122. doi: 10.1073/pnas.2509354122. Epub 2025 Jul 21.

ABSTRACT

Understanding the drivers of spatial patterns in fossil communities is fundamental to paleoecology, yet direct evidence for biological mechanisms regulating interindividual spacing remains elusive. Brachiopod setae, hypothesized to function in feeding or defense, are exceedingly rare in the fossil record, especially among post-Cambrian taxa. Here, we present the report of exquisitely preserved setae from an exceptional in situ fossil assemblage of the early Silurian rhynchonelliform brachiopod Nucleospira calypta. Multiproxy analyses (scanning electron microscopy, X-ray fluorescence, and microcomputed tomography) revealed intricate ultrastructural details and diverse taphonomic pathways, leading to a reinterpretation of apparent calcitic preservation as primarily iron oxides with subsequent coating. Critically, the undisturbed nature of this aggregation allowed rigorous spatial point pattern analysis (Nearest-Neighbor Analysis, Thiessen polygons). This revealed a statistically significant, nonrandom, checkerboard-like distribution among individuals within the studied fossil deposit, indicative of active spacing regulation. Strikingly, the measured average interindividual spacing quantitatively relates to the length of the preserved setae. This provides the direct paleontological evidence demonstrating that these subtle morphological structures could have actively mediated spatial organization within a dense benthic community. Our findings illustrate a biological mechanism capable of shaping community structure, operating beyond passive environmental constraints or initial larval settlement preferences, and highlight the potential for subtle anatomical features to exert significant ecological influence in deep time.

PMID:40690671 | DOI:10.1073/pnas.2509354122

Proc Natl Acad Sci U S A. 2025 Jul 29;122(30):e2505418122. doi: 10.1073/pnas.2505418122. Epub 2025 Jul 21.

ABSTRACT

Global forests provide key ecosystem services, from climate regulation to biodiversity habitat, but are under increasing pressure from the combined impacts of climate and land use change. Here, we show that forest disturbance due to fire is growing globally, with the most dramatic increases in intact forest landscapes, highlighting an existential threat to remaining high biomass, high biodiversity forests. The global annual area of forest disturbance due to fire for 2023 and 2024 was highest since the beginning of monitoring in 2001. Compared to 2002-2022 average annual forest disturbance due to fire, the 2023-2024 average was 2.2 times higher globally and 3 times higher in the Tropics. More than ¼ of all 2024 forest disturbance from fire occurred in tropical forests. We found a statistically significant increasing trend of forest disturbance due to fire from 2002 to 2024 in all climate domains except Subtropical. High forest, low deforestation tropical countries were not exempt, with Guyana and the Republic of the Congo experiencing record forest disturbance due to fire. Our results agree with recently estimated increases in global forest fire emissions and active fire detections. The unprecedented scale of fires in the world’s most remote forests is a potential harbinger of ecosystem tipping points. Protecting these remaining unfragmented high conservation value forests from this threat poses a daunting and as yet undeveloped policy and capacity challenge.

PMID:40690667 | DOI:10.1073/pnas.2505418122

JMIR Mhealth Uhealth. 2025 Jul 21;13:e64889. doi: 10.2196/64889.

ABSTRACT

BACKGROUND: Mobile health (mHealth) technologies, such as smartphones and wearables, enable continuous assessments of individual health information. In chronic musculoskeletal conditions, pain flares, defined as periods of increased pain severity, often coincide with worsening disease activity and cause significant impacts on physical and emotional well-being. Using mHealth technologies can provide insights into individual pain patterns and associated factors.

OBJECTIVE: This study aims to characterize pain flares and identify associated factors in rheumatoid arthritis (RA) by (1) describing the frequency and duration of pain flares using progressively stringent definitions based on pain severity, and (2) exploring associations between pain flares and temporal changes in symptoms across emotional, cognitive, and behavioral domains.

METHODS: Our 30-day mHealth study collected daily pain severity and related symptoms (scores 1-5, higher are worse) via a smartphone app and passively recorded sleep and physical activity via a wrist-worn accelerometer. Pain flares were defined using a 5-point scale: (1) above average (AA): pain severity > personal median, (2) above threshold (AT): pain severity > 3, and (3) move above threshold (MAT): pain severity moves from 1, 2, 3 to 4 or 5. A case-crossover analysis compared within-person variations of daily symptoms across hazard (3 days before a pain flare) and control (3 days not preceding a pain flare) periods using mean and intraindividual standard deviation. Conditional logistic regression estimated the odds ratio (OR) for pain flare occurrence.

RESULTS: A total of 195 participants (160/195, 82.1% females; mean age 57.2 years; average years with RA: 11.3) contributed 5290 days of data. Of these, 88.7% (173/195) experienced at least 1 AA flare (median monthly rate 4, IQR 2.1-5). Nearly half experienced at least 1 AT or MAT flare (median monthly rate 2, IQR 1-4). These pain flares lasted 2 days (IQR 2-3) on average across definitions, with some extending up to 12 days. Worsening mood over 3 days was associated with a 2-fold increase in the likelihood of AT flares the following day (OR 2.04, IQR 1.06-3.94; P<.05). Greater variability in anxiety over 3 days increased the likelihood of both AT (OR 1.67, IQR 1.01-2.78; P<.05) and MAT flares (OR 1.82, IQR 1.08-3.07; P<.05). Similarly, greater variability in sleepiness (OR 1.89, IQR 1.03-3.47; P<.05) also increased the likelihood of AT flares. Sedentary time (%) consistently showed almost no influence across all definitions. Similarly, the simplest definition of AA demonstrated no significant associations across all symptoms.

CONCLUSIONS: Pain flares were commonly observed in RA. Changes in sleep patterns and emotional distress were associated with pain flare occurrences. This analysis demonstrates the potential of daily mHealth data to identify pain flares, opening opportunities for timely monitoring and personalized management.

PMID:40690663 | DOI:10.2196/64889

Med Educ Online. 2025 Dec;30(1):2535411. doi: 10.1080/10872981.2025.2535411. Epub 2025 Jul 21.

ABSTRACT

Sexual and gender minority (SGM) individuals in Japan experience significant health disparities. While Western curricula devote multiple hours to structured SGM health modules, Japanese medical schools offer only about 1 h, leaving future providers underprepared. This study aims to 1) develop a health equity education program on SGM for medical undergraduates in Japan, 2) assess the program’s effects while considering empathy levels and SGM identities, and 3) evaluate participant satisfaction with the program. A 3-h educational program was integrated into a psychology course for undergraduate freshmen within the faculty of medicine. Utilizing a pretest-posttest single-group design, the study evaluated outcomes through validated self-report measures and a satisfaction survey. ANOVA models examined the program effects on the awareness of inequities faced by SGM groups and attitudes towards them, while considering the moderating roles of empathy and SGM identities. Descriptive statistics examined program satisfaction. Among 112 participants (mean age 18.5 years, SD = 0.6), 2.7% identified as SGM, with 15.2% unsure. Awareness of SGM health disparities significantly increased from pre to postintervention (p < .001). Interaction analyses showed that this gain did not vary with empathy level (p = .286) or with SGM identity status (p = .445). Attitudes toward SGM individuals likewise improved (p < .001). Interaction analyses showed that this gain did not vary with empathy level (p = .699) or by identity (p = .414). Overall, 99.1% of participants reported satisfaction with the program, and all recognized its utility. The program appeared beneficial even for students who had not yet developed high levels of empathy or those with diverse identities. Our findings call for a sustained effort to embed such education within medical training programs, ensuring that future healthcare professionals are well-equipped to provide inclusive care to SGM individuals.

PMID:40690662 | DOI:10.1080/10872981.2025.2535411

WMJ. 2025;124(2):192-195.

NO ABSTRACT

PMID:40690646

WMJ. 2025;124(2):106-110.

ABSTRACT

INTRODUCTION: Climate change, a global crisis, affects health through changes such as more intense and longer lasting heatwaves. Some populations are more vulnerable to such events, including those with certain medical conditions, like heart failure. This study aimed to improve understanding of heat-related vulnerabilities and opportunities to enhance adaptive capacity of patients within an ambulatory heart failure clinic.

METHODS: Heart failure clinic patients at the Clement J. Zablocki VA Medical Center in Milwaukee, Wisconsin, voluntarily completed a 25-question multiple-choice survey. We present descriptive statistics of the survey responses with count and percentage for categorical responses.

RESULTS: We found that out of 60 survey respondents, 46.55% agreed or strongly agreed they would benefit from discussing heat illness risks with their physician, and 31.58% were not aware their heat illness risk is higher on days hotter than 90 °F (32.2 °C). Several vulnerability factors were common: 70.69% follow a prescribed fluid restriction, 33.33% live alone, 20.34% lack a car with air conditioning, and 20.00% worry about their ability to pay electric bills. Notable knowledge gaps included 65% do not check forecasted temperatures, 60% do not plan activities for the coolest times of day, 43.10% lacked awareness of cooling centers, 33.33% were unsure of heat illness symptoms, and 27.12% lacked awareness of Wisconsin’s Focus on Energy program.

CONCLUSIONS: A sizable portion of survey respondents indicated they would benefit from discussing their heat illness risk with their clinicians, and many underestimated their personal risk of heat illness. Additionally, multiple vulnerability factors were highly prevalent and knowledge gaps were demonstrated in this population. Our findings support adaptive capacity opportunities through heat illness education, anticipatory guidance, and increased resource awareness for patients with heart failure in an ambulatory setting.

PMID:40690627

WMJ. 2025;124(2):102-105.

ABSTRACT

INTRODUCTION: Community paramedicine (CP) is an expanding area of interest within the field of emergency medical services. Few studies have established operational metrics and outcome measures for CP programs. We aimed to evaluate change in 911 use and operational metrics among patients enrolled in a pilot, fire department-based, CP program.

OBJECTIVE: The purpose of this study was to determine if the ongoing CP program decreased unscheduled emergency health care utilization among high utilizers. It was hypothesized that the implementation of community paramedicine visits would reduce 911 calls among this cohort.

METHODS: A retrospective cohort study of adults enrolled in a CP program during 2016 to 2020 was performed. Patients were enrolled in the CP program if they frequently used a community emergency department or 911 services. This was defined as greater than 4 uses in the past 12 months. A select group of experienced paramedics received targeted training in relevant concepts. Paramedics frequently contacted patients via both in-home visits and phone calls based on perceived clinical need. Through a review of electronic medical records, we collected patient demographic and clinical information and program operational metrics. The primary outcome of interest was the change in 911 use after enrollment. These 2 groups were compared using a paired t test.

RESULTS: Of 33 patients who met inclusion criteria, 29 were successfully enrolled. Pre-enrollment 911 calls averaged 31.8 calls per month. Post-enrollment 911 calls averaged 14.2 calls per month. Average calls per month decreased by 54.2% (P = .003) post-enrollment, a reduction of 207 calls per year across the cohort. Length of program enrollment also was found to have a greater impact on 911 call reduction.

CONCLUSIONS: A fire-department based CP program effectively reduced 911 calls for high utilizer emergency medical services and emergency department patients by 54.2%. Program participation for 6 months or longer was associated with greater reductions in 911 calls, regardless of the number of existing comorbidities.

PMID:40690626

WMJ. 2025;124(2):91-95.

ABSTRACT

INTRODUCTION: To improve inferior vena cava (IVC) filter retrieval rates, an electronic health record prompt for scheduling retrieval before patient discharge was implemented.

METHODS: This retrospective comparative cohort study was conducted in a single Midwestern tertiary care medical center. Adult patients with IVC filters placed for a medical (Medical subgroup) or trauma (Trauma subgroup) indication before and after protocol implementation and who had follow-up documented in the electronic health record were included. IVC filter retrieval attempt rates both overall and by indication for placement before and after protocol implementation were compared.

RESULTS: Three hundred eighty-five patients met eligibility criteria: 223 before implementation (Before group) and 162 after implementation (After group). The attempted retrieval rate for the After group was 11.4% higher than the Before group (P = .012). Attempted retrieval rates in the Medical Before and After subgroups were 56.2% and 76.0%, respectively (P = .001). The Trauma subgroups’ rates were similar to each other (P = .594). Time to retrieval attempt was significantly shorter in the Medical After subgroup than in the Medical Before subgroup (P = .018) but similar in the Trauma subgroups.

CONCLUSIONS: Attempted retrieval rates were significantly higher in the After group and Medical After subgroup. Trauma subgroup rates were similar, likely because a previous intervention to increase retrieval in trauma patients was in place during the pre-implementation period of our study. Findings suggest that using an automated electronic health record-based prompt to facilitate IVC filter retrieval scheduling could greatly improve retrieval rates and patient safety.

PMID:40690624

Acc Chem Res. 2025 Jul 21. doi: 10.1021/acs.accounts.5c00219. Online ahead of print.

ABSTRACT

ConspectusMetal heterogeneous catalysis is the workhorse of the chemical industry, driving the conversion of reactants to desirable products. Traditional design approaches for metal catalysts rely on trial-and-error tests and take a lot of time to identify promising catalytic active species from the large candidate space. Over the decades, much focus has been placed on identifying the factors affecting the active sites, which, in turn, guides the design and preparation of more active, selective, and stable catalysts. In the context of theoretical design method for catalysts, the concept of the energy descriptor strategy provides correlations between the adsorption energy of key intermediates and catalytic reactivity. Such energy descriptors for catalytic reactivity can be used to predict the activity of candidate catalysts and understand trends among different catalysts.However, a more efficient descriptor strategy is still attractive and needed that avoids density functional theory calculation on the adsorption energy of each candidate and possesses the guidance power for the rational design of microstructural characteristics of catalytic active species. In this regard, bridging the gap between the electronic/atomic-level descriptions of the microscopic properties of the catalytic active species and the macroscopic catalytic performance of the desirable reaction, that is, the microscopic-to-macroscopic relationship, remains intriguing yet challenging, toward which progress leads to revolutionizing catalyst design.In this Account, we propose a structural descriptor strategy that for the first time maps the quantitative relationship between microstructural features and catalytic performances for metal catalysts, as well as its application in the high-throughput screening and rational design of catalytic active species. We begin with the analysis of the microstructural characteristics of the reaction center and its coordination environment and extract key feature parameters to build a mathematical expression of the structural descriptor. Next, through regression fitting, a mathematical correlation is built between the structural descriptor and the energetics involved with the reaction pathway. Finally, substituting the above statistical correlations into the rate equation derived from microkinetic model offers the structural descriptor-based prediction model for metal catalysts. The use of easily accessible structural descriptors has proven to be a powerful method to advance and accelerate the discovery and design of metal catalysts, including atomically dispersed metal catalysts, metal alloy catalysts, and metal cluster catalysts. Overall, the structural descriptor strategy not only demonstrates much potential to elucidate the quantitative interplay between microstructural features of catalytic active species and intrinsic catalytic reactivity but also provides a new approach in kinetics analysis to rationalize metal catalyst design. We conclude with an outlook for further constructing a universal structural descriptor and accelerating predictions on catalytic performance of metal catalysts by leveraging material databases and machine learning.

PMID:40690617 | DOI:10.1021/acs.accounts.5c00219

Med Mycol. 2025 Jul 21:myaf058. doi: 10.1093/mmy/myaf058. Online ahead of print.

ABSTRACT

Following the complete relaxation of COVID-19 epidemic control measures in China by the end of 2022, the number of patients with pulmonary mycosis admitted to hospitals across the country has exhibited a more pronounced upward trend. However, statistical data is lacking to determine whether there is a significant correlation between COVID-19 and pulmonary mycosis. This study collected baseline information, the first laboratory indicators after admission, the types of pathogens, and the prognosis data of patients with pulmonary fungal infections from a tertiary hospital in northern Anhui Province from January 1, 2017, to December 31, 2023, to reveal any association between COVID-19 infection and pulmonary fungal infections. The research results indicated that the G and GM test levels of patients who recovered from COVID-19 and those currently experiencing active infection with COVID-19 were significantly higher than those of patients with pulmonary fungal infections who had never been infected with COVID-19. Infection with COVID-19 and other viruses (excluding COVID-19), mechanical ventilation, and concurrent solid tumors were identified as independent risk factors for poor prognosis in patients with pulmonary fungal diseases. Among patients with viral infections, COVID-19 infection was the most common, with 25 cases (41.67%), followed by herpes simplex virus infection, with 15 cases (25.00%).

PMID:40690278 | DOI:10.1093/mmy/myaf058