Category: Statistics

Front Artif Intell. 2026 Aug 3;9:1825189. doi: 10.3389/frai.2026.1825189. eCollection 2026.

ABSTRACT

Artificial Intelligence (AI) is increasingly used in educational administration to automate routine tasks, support data-informed decision-making, and improve institutional efficiency. This study examined the perceptions of principals, supervisors, and teachers regarding the utilization of AI to support administrative decision-making in special education institutions and investigated whether these perceptions differed according to professional role, years of experience, and AI-related training. The sample comprised 173 participants working in public schools providing special education services in Riyadh, Saudi Arabia. A descriptive cross-sectional design was employed, and participants were recruited using non-probability convenience sampling. Data were collected using a 23-item questionnaire and analyzed using descriptive statistics and non-parametric tests. The overall questionnaire score reflected a moderate level of perceptions toward AI utilization (M = 3.22). Participants reported high agreement regarding the importance and usefulness of AI in administrative processes (M = 3.96). In contrast, the ethical considerations dimension yielded a low score (M = 2.38), indicating limited perceived ethical, legal, and professional acceptability of AI utilization and notable reservations regarding the safeguards and conditions governing its responsible use. Perceptions of AI-supported administrative decision-making were moderate (M = 3.07), suggesting that AI was viewed primarily as a supportive resource rather than as a substitute for professional judgment. No statistically significant differences were found according to professional role, H(2) = 4.286, p = 0.117, or years of experience, H(2) = 2.249, p = 0.325. Significant differences were found according to AI-related training, H(2) = 9.282, p = 0.010. Holm-adjusted pairwise comparisons indicated that participants who had completed three to five courses and those who had completed more than five courses obtained significantly higher overall scores than those who had completed fewer than three courses, whereas no statistically significant difference was found between the two higher-training groups. The findings highlight the importance of targeted professional development, ethical safeguards, regulatory clarity, and continued human oversight in the responsible use of AI in special education administration.

PMID:42609535 | PMC:PMC13478143 | DOI:10.3389/frai.2026.1825189

Gastroenterol Res Pract. 2026 Aug 16;2026:6636000. doi: 10.1155/grp/6636000. eCollection 2026.

ABSTRACT

Gastric cancer is a major global public health challenge, with high incidence and mortality rates, particularly in Costa Rica. Like most oncological diseases, it significantly wastes nutritional status, often leading to malnutrition, which in turn worsens prognosis and survival. Early identification of malnutrition is therefore critical. The Global Leadership Initiative on Malnutrition (GLIM) has proposed standardized diagnostic criteria to systematically diagnose malnutrition across diverse clinical settings. However, validation has not been performed versus reference methods in many conditions, such as gastric cancer, although it is essential before widespread adoption. This study is aimed at validating the GLIM criteria for the timely detection of malnutrition in patients newly diagnosed with gastric cancer. We conducted a cross-sectional analysis in which GLIM-based assessments were compared against the Patient-Generated Subjective Global Assessment (PG-SGA) as the gold standard. Diagnostic performance was evaluated through sensitivity, specificity, and positive and negative predictive values; agreement was assessed with kappa statistics. Survival probability was further examined using Kaplan-Meier curves to estimate the prognostic relevance of nutritional status. A total of 72 patients were included. GLIM criteria demonstrated a sensitivity of 81.9% and specificity of 81.8% compared with PG-SGA, with moderate agreement (kappa = 0.48). Survival analysis revealed that both GLIM and PG-SGA consistently identified better outcomes among patients with preserved nutritional status. In conclusion, the GLIM criteria represent a valid and practical tool for the early detection of malnutrition in gastric cancer patients at diagnosis, supporting their integration into routine clinical practice to improve patient management and survival outcomes.

PMID:42609532 | PMC:PMC13478726 | DOI:10.1155/grp/6636000

Cureus. 2026 Jul 17;18(7):e112886. doi: 10.7759/cureus.112886. eCollection 2026 Jul.

ABSTRACT

Background Humeral shaft fractures are common long-bone injuries that can be managed either conservatively or surgically, depending on fracture characteristics and patient-related factors. Medial plating through an anterolateral approach is an alternative surgical technique for fixation of mid-third humeral shaft fractures. This study aimed to evaluate functional outcomes and fracture healing following medial plating through an anterolateral approach for acute mid-third humeral shaft fractures, including radiological union, postoperative complications, and the association between injury-to-surgery interval and radiological union time. Methodology A prospective observational study was conducted in the Department of Orthopedics between March 2025 and September 2025. Forty-eight patients with acute mid-third humeral shaft fractures underwent open reduction and internal fixation using medial plate osteosynthesis through an anterolateral approach. Patients were followed for a minimum period of six months and a maximum of one year. Functional outcome assessment using the Rodríguez-Merchán criteria was performed at the final study assessment (six months). Radiological union, time to union, postoperative complications, and the association between time to surgery and union time were evaluated. Results The mean age of the study population was 47.0 ± 17.7 years. Road traffic accidents accounted for 32 (66.7%) of injuries, and males comprised 28 (58.3%) of the study population. At the final follow-up, excellent and good functional outcomes were achieved in 18 (37.5%) and 22 (45.8%) patients, respectively, resulting in an overall satisfactory outcome rate of 40 (83.3%). All fractures achieved radiological union, with a mean radiological union time of 14.9 ± 4.9 weeks. Delayed union occurred in four patients (8.3%). Postoperative complications included superficial surgical site infection in three patients (6.3%), radial nerve palsy in two patients (4.2%), and implant failure in one patient (2.1%). A statistically significant positive correlation was observed between the interval from injury to surgery and radiological union time (Pearson’s r = 0.565, P < 0.001). Conclusions Medial plating through an anterolateral approach was associated with satisfactory functional outcomes, a high fracture union rate, and a low complication rate in patients with acute mid-third humeral shaft fractures. A longer interval from injury to surgery was associated with a longer radiological union time.

PMID:42609531 | PMC:PMC13478259 | DOI:10.7759/cureus.112886

Front Public Health. 2026 Aug 3;14:1892098. doi: 10.3389/fpubh.2026.1892098. eCollection 2026.

ABSTRACT

BACKGROUND: Acute bronchiolitis, mainly attributed to respiratory syncytial virus (RSV), is the leading cause of infant hospitalization for lower respiratory tract disease worldwide. Nirsevimab and maternal RSVpreF (Abrysvo) confer about 6 months of protection, so timing relative to the season affects their impact. Ecuador spans the equator from sea level to valleys above 4,000 m and is considering introducing these products, yet lacks subnational evidence on the seasonality of bronchiolitis, altitudinal patterning, or post-pandemic stability.

METHODS: We conducted a national ecological time-series analysis of hospital discharges from the Ecuadorian Statistics Institute, 2007-2024 (19,788,097 discharges; 204 of 224 cantons had complete data and formed the analytic panel). The primary outcome was acute bronchiolitis (ICD-10 code J21) in children younger than 12 months (n = 23,190 nationally; 22,724 in the panel), with secondary outcomes across three RSV-relevant age bands, ICD-10 code J21 under 5 years, and two RSV-specific ICD-10 codes (J12.1 and J20.5; 2018-2024). K35 (appendicitis) was a negative control. Analyses combined circular seasonality metrics with block-bootstrap confidence intervals (CIs), year-by-year disaggregation, and complementary sensitivity analyses [Moving Epidemics Method (MEM), Bai-Perron breaks, and lagged climate correlations].

RESULTS: The weighted circular peak month of infant bronchiolitis hospitalizations shifted after the pandemic in Costa (+2.16 months), Sierra (+1.22), and Amazonía (+1.91), attenuating with altitude from +2.19 months below 500 m to +0.88 at 1,500-3,000 m. Costa was stable across 2022-2024; Sierra and, more so, Amazonía varied widely year to year (Amazonía peak ranged March-July, n = 37-42/year), so the pooled estimate should be read with caution. The composite RSV-coded outcome tracked ICD-10 code J21’s timing closely in Costa (0.15-month difference) and Sierra (0.40), supporting ICD-10 code J21 as a reasonable RSV proxy in both, and the three regional peaks now span 2 months.

CONCLUSION: Bronchiolitis seasonality in Ecuador changed after the pandemic, most clearly and stably in Costa; Sierra showed a transient 2022 perturbation with partial reversion by 2023-2024, and Amazonía’s estimates remained unstable and underpowered. As region-tailored estimates are less stable in Sierra and Amazonía than in Costa, a single national window (nirsevimab February-April; maternal RSVpreF for pregnancies expected to deliver January-May) is a more defensible starting point, pending confirmation from further seasons and, ideally, laboratory-confirmed surveillance.

PMID:42609519 | PMC:PMC13478267 | DOI:10.3389/fpubh.2026.1892098

Front Public Health. 2026 Aug 3;14:1921819. doi: 10.3389/fpubh.2026.1921819. eCollection 2026.

ABSTRACT

BACKGROUND: Publicly accessible large language model (LLM) chatbots are increasingly used to seek nutrition advice. Although vegetarian and vegan nutrition advice is often perceived as low risk, it may involve supplementation, vulnerable life stages, chronic disease, and symptoms that require clinical assessment.

OBJECTIVE: To compare the safety, accuracy, empathy, reliability, information quality, and readability of five publicly accessible LLM chatbot products in responding to public-facing vegetarian and vegan nutrition advice questions.

METHODS: In this cross-sectional comparative study, 58 predefined public-facing vegetarian and vegan nutrition advice questions were submitted once in English to ChatGPT, Gemini, Microsoft Copilot, DeepSeek, and Doubao through their official web interfaces. The final dataset included 290 chatbot responses. Five blinded raters with clinical nutrition training evaluated safety, accuracy, and empathy using predefined reference-answer anchors, and assessed reliability and information quality using four established instruments: the DISCERN instrument, Ensuring Quality Information for Patients (EQIP), Journal of the American Medical Association (JAMA) benchmark criteria, and Global Quality Score (GQS). Readability was assessed using six formula-based indices: the Automated Readability Index (ARI), Coleman-Liau Index (CL), Flesch-Kincaid Grade Level (FKGL), Gunning Fog Index (GFI), Simple Measure of Gobbledygook (SMOG), and Flesch Reading Ease Score (FRES). Model comparisons were paired by question.

RESULTS: Inter-rater agreement was high for all human-rated outcomes. Potentially harmful responses occurred in all models, although adjusted pairwise safety comparisons were not statistically significant. Recurring harm patterns involved vitamin B12 source reliability, uncontrolled iodine or selenium intake, vulnerable life stages, chronic disease, symptom triage, and poorly traceable or overconfident statements. Accuracy, empathy, reliability, information quality, and readability differed significantly across models. ChatGPT, Copilot, and DeepSeek showed higher accuracy; ChatGPT showed higher empathy; Copilot performed best on DISCERN and EQIP; and Gemini produced the most readable responses.

CONCLUSION: Publicly accessible LLM chatbots can provide useful general information on vegetarian and vegan nutrition, but their performance is uneven and safety limitations remain. Chatbot-generated advice should be interpreted cautiously, especially for supplementation, vulnerable groups, chronic disease, and symptoms requiring clinical assessment. Future systems should improve safety guidance, referral cues, source traceability, and plain-language communication.

PMID:42609511 | PMC:PMC13478225 | DOI:10.3389/fpubh.2026.1921819

Health Sci Rep. 2026 Aug 17;9(8):e73059. doi: 10.1002/hsr2.73059. eCollection 2026 Aug.

ABSTRACT

BACKGROUND AND AIMS: Hepatitis B virus (HBV) poses a major occupational risk to healthcare workers (HCWs), particularly in moderate-to-high‑prevalence settings such as Zambia. Despite the availability of a safe and effective vaccine, coverage among HCWs remains suboptimal. Among HCWs, volunteer HCWs face unique challenges, including financial barriers, that increase their risk. However, they are often overlooked in research. The present study aimed to determine HBV vaccination uptake and its predictors among volunteer HCWs in Zambia.

METHODS: This national cross-sectional study utilized a self-administered semi-structured online questionnaire to collect data from volunteer HCWs from October 3 to November 26 2024. Using R version 4.6.0 and Stata version 17, descriptive and inferential statistical analyses were performed. A two-sided p value < 0.05 was considered statistically significant.

RESULTS: Among the 173 participants, 51 (29.5%) reported being vaccinated. Of the 51, 23 (45.1%) had received one dose, 4 (7.8%) two doses, and 24 (47.1%) at least three doses (fully vaccinated). In the multivariable Firth penalized logistic regression model, participants who had access to HBV vaccination programs during training were significantly more likely to be vaccinated than those without such programs (p < 0.001). Availability of HBV testing services at the health facility was also independently associated with vaccination uptake (p = 0.006). Increasing age was associated with slightly higher odds of vaccination (p = 0.025). Gender and place of education were not independently associated with vaccination uptake after adjustment.

CONCLUSION: HBV vaccination coverage among volunteer HCWs in Zambia was low. Vaccination programs during training, age and the availability of HBV testing services were important factors associated with vaccine uptake. Strengthening institutional HBV prevention programs may improve vaccination coverage and reduce occupational risk among HCWs.

PMID:42609506 | PMC:PMC13478847 | DOI:10.1002/hsr2.73059

Front Public Health. 2026 Aug 3;14:1888753. doi: 10.3389/fpubh.2026.1888753. eCollection 2026.

ABSTRACT

BACKGROUND: Dengue fever poses a pervasive, yet escalating public health burden in Mexico and abroad.

METHODS: We conducted a 41-year spatiotemporal analysis of dengue fever across Mexico (1985-2025), integrating monthly case surveillance with climate, land cover, vegetation, and novel disaster severity covariates derived from the Emergency Events Database. Four supervised regression models were trained on 1990-2021 data, with models evaluated on a 2022-2023 temporal holdout and against observed 2024-2025 surveillance totals. Five supplementary hazard analyses examined temporal correlation, disaster type breakdown, spatial co-occurrence, pre/post event trajectories, and sensitivity to scoring weight assumptions.

RESULTS: Mann-Kendall trend analysis identified statistically significant increasing dengue incidence in 15 of 32 states (9 inland), evidencing geographic expansion over four decades. Z-score analysis confirmed 2024 as a profound anomaly across both endemic and emerging states. Hazard features were significantly associated with national monthly dengue counts at lags 0-2 months across the full 1985-2025 series. A + 613% case increase following the June 2024 tropical storm. Sensitivity analyses confirmed the project’s developed ‘Severity Score’ performed comparably to four theoretically motivated differential weighting schemes.

CONCLUSION: This study provides the first structured integration of disaster severity covariates in a dengue forecasting framework for Mexico. Geographic expansion into inland states, the 41-year trend analysis, and the hazard adjustment results collectively support a differentiated public health response that targets both endemic coastal states and newly affected inland regions. The analytical framework is directly transferable to emerging dengue risk contexts in the United States and Central America, geographic neighbors also experiencing increased dengue virus transmission.

PMID:42609501 | PMC:PMC13478283 | DOI:10.3389/fpubh.2026.1888753

Front Psychiatry. 2026 Aug 3;17:1921655. doi: 10.3389/fpsyt.2026.1921655. eCollection 2026.

ABSTRACT

Seasonal affective disorder (SAD) and bipolar disorder (BD) with a seasonal pattern are conventionally framed as disorders of photoperiod and circadian timing, yet affected individuals also show a striking, reproducible metabolic rhythm-carbohydrate craving and weight gain in winter, appetite reduction and weight loss in summer-that has rarely been integrated into mechanistic models of seasonal mood cycling. Building on an evolutionary “metabolic plasticity” view, in which seasonal shifts in energy storage are conserved adaptations that can become maladaptive in predisposed individuals, we propose the Seasonal Metabolic Oscillation (SMO) hypothesis: that the seasonal expansion and contraction of adipose tissue is not merely a passive symptom but a candidate mediator and amplifier of seasonal mood cycling. We advance two claims of deliberately unequal evidentiary strength. The better-supported core claim is that winter adiposity amplifies and helps maintain the depressive phase, by promoting low-grade neuroinflammation and indoleamine 2,3-dioxygenase (IDO1) activation, which diverts tryptophan into the kynurenine pathway, and by adding leptin resistance and stress-axis dysregulation that together bias the brain toward depression. The more tentative, exploratory claim is that the spontaneous loss of adiposity in summer relieves this inflammatory burden and, through photoperiod-driven changes in dopaminergic and circadian signaling, may lower the threshold for mood elevation in predisposed individuals. Pleiotropic circadian and metabolic variants, including ZBTB20 and NPAS2, are proposed to confer joint vulnerability to SAD, obesity, and bipolar spectrum illness. The model yields a central, falsifiable prediction-that within the same individuals seasonal swings in adiposity statistically precede and account for a defined share of seasonal mood change-and is directly testable through weight-stabilization experimental-medicine trials, within-subject longitudinal biomarker tracking, and Mendelian randomization. We stress that the model’s two central assumptions-that seasonal adiposity change temporally precedes mood change, and that a swing of the modest magnitude typical of SAD is quantitatively sufficient to move central neurochemistry-remain experimentally undemonstrated, and that photoperiod is a plausible common cause of both adiposity and mood that only designs decoupling the two can exclude. If supported, SMO would reframe seasonal mood disorders as recurrent metabolic-neuroimmune-mood conditions and motivate metabolically informed screening, pharmacotherapy, and chronotherapy.

PMID:42609474 | PMC:PMC13478500 | DOI:10.3389/fpsyt.2026.1921655

Front Nutr. 2026 Aug 3;13:1853929. doi: 10.3389/fnut.2026.1853929. eCollection 2026.

ABSTRACT

INTRODUCTION: Olive, walnut, flaxseed, and camellia oils are premium edible oils rich in unsaturated fatty acids, yet they exhibit distinct fatty acid profiles: olive and camellia oils are high in monounsaturated fatty acids, while walnut and flaxseed oils are abundant in polyunsaturated fatty acids. Despite their market value and nutritional importance, a systematic comparative metabolomic analysis covering both volatile and non‑volatile compounds under unified conditions has been lacking.

METHODS: We performed a comprehensive metabolomic comparison of the four oils using headspace solid‑phase microextraction/gas chromatography‑mass spectrometry (HS‑SPME/GC‑MS) for volatile compounds and ultra‑high‑performance liquid chromatography‑high‑resolution mass spectrometry (UHPLC‑HRMS) for non‑volatile metabolites. Multivariate statistical methods, including principal component analysis (PCA), partial least‑squares discriminant analysis (PLS‑DA), and relative odor activity value (ROAV) calculation, were applied to identify differential metabolites and characteristic biomarkers.

RESULTS: A total of 100 volatile and 1,186 non‑volatile metabolites were identified, covering alcohols, aldehydes, fatty acids, terpenes, phenolics, and others. PCA and heatmap analyses showed clear separation among the four oils. Common flavor markers included hexanal, ethanol, and ethyl hexanoate, while specific biomarkers such as hydroxytyrosol (olive oil), juglone (walnut oil), lignans (flaxseed oil), and camelliasaponin (camellia oil) were distinguished. ROAV analysis highlighted key flavor‑active volatiles, and differential metabolites were significantly correlated with flavor attributes, oxidative stability, and nutritional characteristics.

DISCUSSION: Our integrated volatile‑non‑volatile metabolomic approach provides a systematic foundation for comparing the compositional, flavor, and quality differences among high‑unsaturated fatty acid vegetable oils. The identified biomarkers and their correlations offer valuable tools for oil authentication, quality control, and functional product development, demonstrating the superiority of combined metabolomic profiling over single‑platform analyses.

PMID:42609451 | PMC:PMC13478218 | DOI:10.3389/fnut.2026.1853929

Front Hum Neurosci. 2026 Aug 3;20:1902938. doi: 10.3389/fnhum.2026.1902938. eCollection 2026.

ABSTRACT

INTRODUCTION: Transcranial direct current stimulation (tDCS) has been proposed as a potential tool for enhancing the benefits of cognitive training, but its added value for working memory in healthy adults remains unclear. This systematic review and robust variance estimation meta-analysis examined whether active tDCS combined with cognitive training improves post-training working memory performance compared with sham tDCS combined with the same training, and whether the effect varies by outcome type, assessment time point, and training characteristics.

METHODS: PubMed, Scopus, and Web of Science were searched from database inception to January 2026. Eligible studies were randomized controlled trials involving healthy adults, comparing active tDCS plus structured cognitive training with sham tDCS plus otherwise identical training, and reporting at least one post-training working memory outcome. Multiple correlated effect sizes within studies were synthesized using robust variance estimation. Outcomes were classified as trained-task outcomes or untrained working-memory outcomes, and both immediate post-test and follow-up assessments were included.

RESULTS: A total of 23 studies contributing 135 effect sizes were included. Active tDCS combined with cognitive training produced a small but statistically significant improvement in post-training working memory performance, Hedges’ g = 0.191, 95% CI [0.062, 0.320], p = 0.006. Effects were significant for trained-task outcomes, whereas effects on untrained working-memory outcomes were smaller and not statistically significant; however, the direct difference between the two outcome categories was not significant. Immediate post-test effects were significant, whereas follow-up effects remained positive and similar in magnitude but lay at the conventional alpha threshold, with no significant difference between time points. Stimulation timing, age group, and training type did not significantly moderate the effect. Sensitivity analyses confirmed the stability of the overall estimate, and no clear evidence of small-study effects was detected.

DISCUSSION: These findings suggest that tDCS may provide a small adjunctive benefit when combined with cognitive training in healthy adults, with the most consistent benefits observed for trained-task performance and more limited evidence for transfer to untrained working-memory outcomes.

PMID:42609444 | PMC:PMC13478250 | DOI:10.3389/fnhum.2026.1902938