Category: Statistics

Sci Rep. 2025 Nov 17;15(1):40094. doi: 10.1038/s41598-025-23965-1.

ABSTRACT

Good near-visual acuity is essential for the independent administration of insulin and monitoring of diabetes. Older individuals with diabetes often experience a significant rate of near-visual impairment, which can impact their future functional status and quality of life. Despite this, there is limited evidence regarding the prevalence of near-visual impairment and its associated factors in Africa, including Ethiopia. This study aimed to determine the prevalence and associated factors of near visual impairment among adult diabetic patients attending the diabetic care clinic of Adare General Hospital in southern Ethiopia, 2023. A hospital-based cross-sectional study was conducted on 503 adult diabetic patients at Adare General Hospital in southern Ethiopia from April 23 to June 8, 2023. Systematic random sampling was employed to select the participants for the study. Data were collected through face-to-face interviews, medical record reviews, and eye examinations. To identify potential factors associated with near visual impairment, binary logistic regression was performed. The strength of the associations was expressed as adjusted odds ratios with a 95% confidence interval. A variable with a P-value of less than 0.05 was considered statistically significant. The prevalence of NVI was 75% (95%CI: 71.1-78.7). Age greater than 65 years (AOR = 5.38, 95% CI: 2.00-14.48), being married (AOR = 4.09, 95% CI: 2.01-8.34), diabetes duration of ≥ 7 years (AOR = 2.43, 95% CI: 1.31-4.52), hypertension (AOR = 2.06, 95% CI: 1.02-4.21), distance visual impairment (AOR = 3.59, 95% CI: 1.35-9.55), and diabetic retinopathy (AOR = 7.46, 95% CI: 3.06-18.19) were positively associated with near visual impairment. This study revealed a high prevalence of near visual impairment among adult diabetic patients, significantly associated with older age, marital status, longer duration of diabetes, hypertension, distance visual impairment, and diabetic retinopathy. Routine near vision screening and timely optical correction should be considered as part of comprehensive diabetic care.

PMID:41249802 | DOI:10.1038/s41598-025-23965-1

Sci Rep. 2025 Nov 17;15(1):40141. doi: 10.1038/s41598-025-23881-4.

ABSTRACT

Metaheuristic algorithms are widely used to address complex real-world optimization problems, but many existing algorithms face challenges such as slow convergence, low accuracy, and susceptibility to local optima. The newly proposed Crested Porcupine Optimizer (CPO), while demonstrating effectiveness across domains, still suffers from these limitations in practical applications, restricting its performance in solving complex optimization tasks like wireless sensor network (WSN) deployment. To address these shortcomings, this study aims to enhance CPO’s overall performance by developing an improved version called the Enhanced Crested Porcupine Optimizer (ECPO). The methodology of ECPO integrates four key enhancement strategies: (1) Sobol sequences for population initialization, ensuring uniform distribution of initial solutions to boost global search capability; (2) a guided search strategy based on the global optimal solution, directing the algorithm toward optimal regions to reduce ineffective exploration; (3) an adaptive Lévy flight search strategy, maintaining population diversity and improving convergence accuracy; and (4) a centroid-based reverse learning strategy for population updates, expanding search space coverage and accelerating convergence. The performance of ECPO was validated on four authoritative benchmark suites (CEC2014, CEC2017, CEC2020, CEC2022) by comparing it with classical algorithms (e.g., PSO, DE), recently proposed algorithms (e.g., BKA, SBOA), and CEC-winning algorithms (e.g., LSHADE, AGSK). Statistical results show ECPO outperformed most comparison algorithms in 93.81%, 93.33%, 75.71%, and 86.90% of tests on the four benchmarks, respectively, exhibiting significant advantages in convergence speed, accuracy, and stability. Additionally, when applied to WSN node deployment optimization, ECPO achieved a higher coverage rate (average 84.95%) and better robustness than competing algorithms, with more rational node distribution and minimal resource waste. These findings confirm that ECPO effectively overcomes the limitations of the original CPO and outperforms many state-of-the-art optimizers. As a high-performance metaheuristic algorithm, ECPO not only excels in numerical optimization but also demonstrates broad applicability in practical engineering problems like WSN deployment, providing a reliable tool for solving complex optimization challenges.

PMID:41249790 | DOI:10.1038/s41598-025-23881-4

Sci Rep. 2025 Nov 17;15(1):40088. doi: 10.1038/s41598-025-23828-9.

ABSTRACT

Nigeria seeks to address the growing burden of hypertension and related diseases by reducing excessive dietary sodium through national dietary policymaking. This study aims to describe the levels and sources of dietary sodium intake among Nigerian adults to inform these policies. From June 2023 to July 2023, adults aged 18 to 69 years old were recruited from the Federal Capital Territory, Kano, and Ogun states to participate in a population-based, cross-sectional demographic health survey. Data were also collected to assess levels and dietary sources of sodium through four 24-h dietary recalls by trained study personnel. The primary analyses included the distribution of sodium intake and sources of sodium, in aggregate and by sex and state. Results were weighted to the Nigerian population. Multivariate regression models evaluated associations between baseline sociodemographic factors and sodium intake. Among 537 participants, 365 (68.0%) were female, median (IQR) age was 38 (27, 48) years, and 27.2% and 15.1% had a self-reported history of hypertension and cardiovascular disease, respectively. Most (90.7%) participants completed all 4 dietary recalls. Weighted median (IQR) daily sodium intake according to repeated 24-h dietary recalls was 3,876 (3,169, 4,783) mg per day with higher intake reported among males (3,832 [3,201, 4,658] mg/dl) compared with females (3,515 [2,859, 4,313], p < .0001). Nearly two-thirds (62.1%) of sodium came from discretionary sources, including 27.2% from salt and 32.5% from salty seasonings, 24.0% came from restaurant or street food, and 8.6% came from non-discretionary sources at home (i.e., sodium inherent in foods). Salt and salty seasonings added at the table accounted for 10.7% of sodium intake and was highest among females (21.6%) and males (16.2%) in Kano (p < .0001). On the other hand, sodium from street food was highest in males (35.7%) and females (34.2%) in Ogun. Older participants 60-69 years (adjusted beta [95% CI] = -332.8 mg (-639.0, -6.6) mg) had lower daily sodium intake compared to participants 30-44 years. Results were similar when excluding individuals with cardiovascular disease or hypertension. Adults in the Federal Capital Territory, Kano, and Ogun consume nearly twice the recommended level of dietary sodium. Most dietary sodium intake came from home cooked foods, nearly two-thirds of which were consumed from discretionary sources, which has important policy implications for dietary sodium policy implementation.

PMID:41249787 | DOI:10.1038/s41598-025-23828-9

Eur J Pediatr. 2025 Nov 17;184(12):768. doi: 10.1007/s00431-025-06598-4.

ABSTRACT

Epidemiological data on venous thromboembolism (VTE) in children and adolescents is sparse and available primarily for the USA. In Europe, the burden and management of VTE have rarely been subjects of nationwide analyses.We conducted a nationwide, retrospective, patient-level analysis of the Swiss medical statistics an administrative data collection including 1961 hospitalizations (1653 incident events) with VTE aged 19 or younger between 2004 and 2023. We estimated the disease-specific incidence rate, in-hospital case fatality rates, length of stay (LOS), and related admission to the intensive care unit (ICU). Furthermore, we evaluated therapeutic procedures.The incidence rate of incident VTE-related hospitalizations was 4.9 (95%CI 4.7; 5.2) per 100,000 children and adolescents per year. The in-hospital case fatality rate was 4.0% (95%CI 3.2; 5.0); the median LOS was 8 (Q1-Q3 4-24) days. Systemic thrombolysis, catheter-directed treatment, and inferior vena cava filters were used in less than 15% of patients. Among patients receiving systemic thrombolysis, the in-hospital case fatality rate was 19.4% (95%CI 12.6; 28.5), whereas patients managed with catheter-directed treatment had a rate of 8.0% (95%CI 3.2; 18.8). 39.3% of patients were admitted to ICU. Age- and sex-specific differences in incidence rate, proportion of hospital admissions, and in-hospital case fatality rate were observed, particularly among infants aged < 1 year and adolescents aged 15-19 years.

CONCLUSION: VTE among children and adolescents is rare with age- and sex-specific differences in incidence. Patients who underwent advanced treatment strategies presented with a substantial risk of in-hospital death despite treatment, especially evident among patients aged 0-9 years.

WHAT IS KNOWN: • Venous thromboembolism and in extension pulmonary embolism and deep vein thrombosis are rare diseases among children and adolescents.

WHAT IS NEW: • We provided national estimates for measures of occurrence of venous thromboembolism from a European country. • We analyzed the management of these patients with a focus on advanced treatment strategies, providing estimates on the in-hospital fatality rate.

PMID:41249729 | DOI:10.1007/s00431-025-06598-4

Arch Sex Behav. 2025 Nov 17. doi: 10.1007/s10508-025-03253-9. Online ahead of print.

ABSTRACT

We examined the association between sexual orientation at age 15.5 years and depressive symptoms at age 17 years and whether this association was explained by a path involving earlier pubertal timing leading to worse inhibitory control at age 15.5 years using the Avon Longitudinal Study of Parents and Children. A total number of 5,125 adolescents were included (46.65% adolescent males and 87.38% White). Age at peak height velocity was derived from multiple height assessments annually from childhood to adolescence and used as an objective measure of pubertal timing. We found that adolescents who were unsure of their sexual orientation did not differ statistically significantly from their heterosexual counterparts in either pubertal timing or depressive symptoms. Sexual minority adolescents reported both earlier pubertal timing and more depressive symptoms than heterosexual adolescents. Sexual orientation disparities in depressive symptoms could potentially be explained by earlier pubertal timing reported by sexual minority adolescents than heterosexual adolescents, but not by the indirect path through earlier pubertal timing leading to worse inhibitory control. The results were consistent across both sexes, suggesting that pubertal timing makes a small contribution to sexual orientation disparities in depressive symptoms.

PMID:41249693 | DOI:10.1007/s10508-025-03253-9

Eur Arch Otorhinolaryngol. 2025 Nov 17. doi: 10.1007/s00405-025-09760-8. Online ahead of print.

ABSTRACT

PURPOSE: Artificial intelligence (AI) has emerged as a potential tool in postoperative care, particularly for complex procedures like Endoscopic Transnasal Skull Base Surgery (ETSBS), where patient comprehension of recovery instructions is critical. This study aimed to compare the readability, understandability, and actionability of postoperative instructions generated by three AI platforms (ChatGPT, DeepSeek, and Gemini).

METHODS: Each platform was prompted to create ETSBS postoperative instructions. Readability was assessed using Flesch Kincaid Grade Level (FKGL) and Reading Ease (FKRE). The Patient Education Materials Assessment Tool for printable materials (PEMAT-P) was used to evaluate understandability and actionability. Two outputs per platform were analyzed. Statistical comparisons were conducted using Kruskal-Wallis tests and Pearson correlation coefficients.

RESULTS: Gemini had the highest FKRE score (52.18), followed by DeepSeek (46.46) and ChatGPT (39.85), though differences were not significant (p = 0.458). FKGL was lowest in Gemini (9.07), compared to DeepSeek (9.82) and ChatGPT (10.87) (p = 0.469). Understandability scores were highest in ChatGPT and DeepSeek (76.45%), while Gemini scored lower (63.30%, p = 0.005). ChatGPT showed the highest actionability (58.5%), followed by DeepSeek (51.0%) and Gemini (45.15%), with no significant difference (p = 0.645). A strong inverse correlation was found between FKRE and FKGL (r = -0.998, p = 0.000). Correlations with understandability and actionability were moderate and non-significant (p > 0.1).

CONCLUSION: While AI platforms generated similarly readable content, significant differences emerged in usability. None met optimal standards for patient education, highlighting the need for clinician review before clinical application.

PMID:41249683 | DOI:10.1007/s00405-025-09760-8

Eur Spine J. 2025 Nov 18. doi: 10.1007/s00586-025-09565-7. Online ahead of print.

ABSTRACT

PURPOSE: The aim was to study the developmental characteristics of the cartilaginous union anatomical structure at the base of odontoid process in normal children aged 1 to 6 years, analyze the factors influencing its fusion, and provide basic data for understanding its evolutionary patterns and application in clinical disease diagnosis and treatment. Additionally, the study aimed to conduct morphological staining observations of the anatomical features of the base of the odontoid process in normal children.

METHODS: A total of 140 cases of normal cervical spine CT images from children aged 1 to 6 years were collected and grouped by age, with 20 cases in the 1-year-old group and 30 cases in each of the other four groups. The original data of the cervical spine continuous CT scan images were imported into Mimics 21.0 software in DICOM format for the measurement of anatomical indexes including Transverse Diameter (TD), Sagittal Diameter (SD), Area (A), Perimeter (P), and the positional indexes including Distance from Upper Cartilage Border to Odontoid Process Base (DSB), Distance from Lower Cartilage Border to Odontoid Process Base (DIB), Distance from Left Cartilage Border to Left Transverse Process (DLT), Distance from Right Cartilage Border to Right Transverse Process (DRT). Additionally, the axis vertebra of a 3-year-old child’s cervical spine was extracted, and thin sections were prepared by hard tissue embedding and section techniques. Toluidine blue staining was performed to observe the histopathological characteristics of the cartilaginous intervertebral disc and bone tissue in the base region of the odontoid process.

RESULTS: TD, SD, A, and P values decreased gradually with increasing age. TD, A, and P values showed statistical differences between group E and the other groups (P < 0.05); SD values showed statistical differences between group E and groups A, B, and C (P < 0.05). DSB, DIB, DLT, and DRT values all increased with age. DLT values in groups A and B showed statistical differences with group E (P < 0.05); DRT values in group A showed statistical differences with groups D and E (P < 0.05). There was a high correlation between TD and SD, A and P, DLT and DRT, and a low correlation between TD and DSB, P and DLT, DRT. After staining, it was observed that the chondrocytes in the central region of the base of the odontoid process were scattered and spindle-shaped, while in the peripheral areas, chondrocytes formed oval-shaped clusters, with the cell nuclei stained blue and the matrix showing a light blue color, providing clear contrast with the intervertebral disc and bone tissue.

CONCLUSION: The ossification center of the base of odontoid process in children is in a continuous growth and change process and exhibits evident regularity. The measurement results of this study can provide anatomical data for the growth and developmental characteristics of this region. The cartilage at the base of the odontoid process in children is hyaline cartilage, with the characteristic of being relatively brittle and prone to fracture.

PMID:41249664 | DOI:10.1007/s00586-025-09565-7

J Gen Intern Med. 2025 Nov 17. doi: 10.1007/s11606-025-10042-6. Online ahead of print.

ABSTRACT

OBJECTIVE: To validate the RECOVER Post-Acute Sequelae of SARS-CoV-2 infection (PASC) score in a cohort of patients who develop long COVID (LC) or fully recover while iteratively improving the tool’s sensitivity and specificity.

METHODS: A cross-sectional study in 130 LC patients followed at LC clinics in Baltimore, MD, USA, who met the National Academies of Sciences, Engineering, and Medicine (NASEM) 2024 LC definition, and 60 SARS-CoV-2 exposed but fully recovered individuals. LC participants were required to have at least one neuropsychiatric symptom. Participants completed comprehensive surveys and questionnaires assessing symptoms based on published methods to determine PASC score. Using the NASEM 2024 LC definition as the “true” condition, we compared evaluation metrics for the RECOVER PASC score cutoff (PASC > 12) and the presence of individual/multiple symptoms. Evaluation metrics (e.g., sensitivity, specificity, F1) were calculated based on these classifications for the overall PASC score and symptom combinations.

RESULTS: The LC cohort (n = 130) had a mean age of 47.2 years and was predominantly female (72%), White (79%), and well-educated (77% > 16 years). Controls (n = 60) were similar demographically. LC diagnosis and PASC scores were significantly associated (χ² = 102.99, P < 0.001). The PASC score showed excellent specificity (100%) and positive predictive value (PPV; 100%) albeit limited sensitivity (80%), missing 20% of participants with LC. We found that loss of smell/taste, post-exertional malaise, or lack of sexual desire or capacity demonstrated 94% sensitivity, 92% specificity, and 96% PPV, 87% NPV, and an F1 score of 0.949.

CONCLUSION: Validation of the RECOVER PASC supports its utility and highlights the need for ongoing refinement of the LC definition. We call for national efforts to develop readily implementable clinical tools for LC diagnosis.

PMID:41249654 | DOI:10.1007/s11606-025-10042-6

J Gen Intern Med. 2025 Nov 17. doi: 10.1007/s11606-025-09950-4. Online ahead of print.

ABSTRACT

BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) effectively promote weight reduction and improve glycemic control, blood pressure, and lipid profiles in individuals with overweight or obesity. This systematic review and meta-analysis evaluates the durability of these therapeutic benefits following treatment discontinuation.

METHODS: We conducted a systematic search of PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP from inception to June 2024, to identify randomized controlled trials that assessed the effects of GLP-1RAs with a follow-up period of at least six months after treatment discontinuation. The outcomes were changes in weight, body mass index (BMI), waist circumference (WC), glycemia, blood pressure, and lipid profiles.

RESULTS: We screened 10,670 studies and ultimately identified 5 eligible studies, encompassing 719 patients. Compared to the control group, GLP-1RAs were associated with significant reductions in weight (mean difference (MD) = -5.70 kg, 95% confidence interval (CI): -9.52 to -1.88), BMI (MD = -2.94 kg/m², 95% CI: -5.60 to -0.28), WC (MD = -3.66 cm, 95% CI: -4.89 to -2.43), glycated hemoglobin A1c (HbA1c) (standardized mean difference (SMD) = -0.73, 95% CI: -1.14 to -0.32), and systolic blood pressure (SBP) (MD = -3.62 mm Hg, 95% CI: -5.51 to -1.73) after cessation of therapy. After discontinuation, there was a pronounced rebound in weight (MD = 4.13 kg, 95% CI: 1.60 to 6.65), BMI (MD = 0.84 kg/m², 95% CI: 0.37 to 1.32), WC (MD = 3.64 cm, 95% CI: 2.27 to 5.01), and HbA1c (SMD = 0.69, 95% CI: 0.50 to 0.89). From study baseline to the end of follow-up, GLP-1RAs treatment resulted in statistically significant decreases in weight (MD = -2.32 kg, 95% CI: -4.21 to -0.43) and BMI (MD = -0.82 kg/m², 95% CI: -1.47 to -0.17).

CONCLUSIONS: This meta-analysis demonstrated that although statistically significant weight reduction persists after GLP-1RAs discontinuation, the clinical significance and durability of this effect are limited. To achieve sustained therapeutic benefits, continued treatment with these agents may be necessary.

PMID:41249646 | DOI:10.1007/s11606-025-09950-4

Health Econ Rev. 2025 Nov 17;15(1):97. doi: 10.1186/s13561-025-00690-z.

NO ABSTRACT

PMID:41249635 | DOI:10.1186/s13561-025-00690-z