Tag: pubmed

Sci Rep. 2025 Nov 21;15(1):41268. doi: 10.1038/s41598-025-25332-6.

ABSTRACT

Do climate conditions and extreme events fuel conflict and migration? This question has been widely studied using causal designs that exploit natural variation in climate variables, often analyzed with linear fixed-effects models. Yet in this setting, nonlinear relationships, distributional features of outcomes, and spatial heterogeneity can cause these models to violate core assumptions and yield unreliable inferences. We propose a multilevel Bayesian framework that accommodates such features while retaining identification strategies from natural experiments. We illustrate its potential with a representative analysis from the literature of the effect of temperature anomalies on conflict in Somalia. When outcome distributions suited to event counts are combined with partial pooling across regions, the apparent aggregate climate effect disappears and marked regional heterogeneity emerges, with positive associations in only a few southern regions and negative or uncertain effects elsewhere. Extending pooling across time further improves predictive ability. More broadly, the multilevel Bayesian framework offers a general strategy for strengthening both explanatory and predictive inferences about climate and social outcomes, supporting internal and external validity while efficiently accommodating heterogeneity even with small samples. This methodological bridge between econometric identification strategies and statistical modeling provides a robust foundation for interdisciplinary climate-conflict-migration research.

PMID:41271982 | DOI:10.1038/s41598-025-25332-6

Sci Rep. 2025 Nov 21. doi: 10.1038/s41598-025-25984-4. Online ahead of print.

ABSTRACT

We examined how a species inhabiting a latitudinal gradient, from warm oxygenated surface waters to cold oxygen-limited subsurface waters along the Eastern South Pacific (ESP) shelf, responds to latitudinal temperature shifts at low-oxygen isopleths. We combined temperature-oxygen sections from the World Ocean Database, historical records of pelagic/benthic Grimothea monodon occurrence across latitude, models with these data, and laboratory experiments assessing juveniles’ routine and postprandial metabolism under realistic temperature-oxygen conditions. The life habits (pelagic or benthic) of squat lobsters were related to temperature at the 2 mL O₂ L^-1 oxygen isopleth. At temperatures > 15 °C near the upper oxygen minimum zone isopleth, mostly pelagic individuals were observed, suggesting restricted vertical migration. The physiological performance of juveniles (main migratory stage) was negatively affected by high temperature-hypoxia interaction. Routine metabolic rates decreased by 60% under hypoxia at 21 °C, and postprandial metabolism (as Specific Dynamic Action) was also strongly reduced under those conditions. Grimothea monodon can shift between pelagic and benthic habitats across a range of ESP conditions, maintaining the intergenerational ability to alternate habitats. This plasticity, expressed as vertical expansion or restriction, may help maintain or expand its latitudinal ranges, with natural food webs and fisheries adjusting to its availability as key prey item.

PMID:41271967 | DOI:10.1038/s41598-025-25984-4

Sci Rep. 2025 Nov 21;15(1):41335. doi: 10.1038/s41598-025-25229-4.

ABSTRACT

Pediatric drug-resistant epilepsy (DRE) affects 30-40% of children with epilepsy, resulting in medical costs significantly higher than those of controlled epilepsy. Cranial epilepsy surgery (CES) and vagus nerve stimulation (VNS) are key interventions; however, their long-term economic impact remains ambiguous. Using South Korea’s National Health Insurance claims data (2007-2022), we examined healthcare utilization and costs among children with DRE treated with antiseizure medications (ASM) only, CES, or VNS. Of the cohort included 6020 patients, of whom 5407 (89.8%) received ASM-only treatment, 396 (6.6%) underwent CES, and 217 (3.6%) received VNS. Post-CES, emergency department (ED) visits declined by 65%, overall length of stay (LOS) by 45%, epilepsy-specific admissions by 49% and epilepsy-specific LOS by 83%. Interrupted time series analysis revealed a sustained monthly reduction in total costs, consistent with fewer high-risk encounters. Post-VNS, ED visits fell by 41%, admissions by 39%, and LOS by 44%, with reductions in epilepsy-related admissions; however, outpatient visits remained unchanged. Both CES and VNS significantly reduce acute-care needs in pediatric DRE. CES yields the greatest and most durable benefits, while VNS shifts care from emergency and inpatient settings to scheduled outpatient follow-up, offering a valuable alternative when surgery is not feasible.

PMID:41271932 | DOI:10.1038/s41598-025-25229-4

Sci Rep. 2025 Nov 21;15(1):41439. doi: 10.1038/s41598-025-25760-4.

ABSTRACT

Satellite images are critical for ecological monitoring and national security; thus, protecting its integrity is imperative. Nonetheless, existing encryption methods struggle to balance robustness and efficiency. This paper proposes a novel quantum chaos-based image encryption scheme (QCIES) combining a 4D hyperchaotic Lorenz system (4D-HLS) and quantum Fibonacci transform (QFT) addressing these limitations. During the encryption process, we first used The Generalized Quantum Image Representation (GQIR) technique to transform a conventional color image into quantum data. Then, 4D-HLS generates complex, unpredictable keys through bifurcation and sensitivity to initial conditions. 4D-HLS complex dynamics coupled with quantum pixel reorganization provide unprecedented resistance against statistical and brute-force attacks. Additionally, QFT with a quantum adder randomly encrypts pixel locations, producing the final encrypted image. Performance evaluation was conducted using Python to analyze key metrics including histogram distribution, information entropy, and adjacent pixel correlation. Extensive security testing revealed QCIES robust performance, achieving near-ideal correlation coefficients (< 0.004), information entropy (> 7.999), NPCR (99.64%), UACI (33.56%) and massive key space [Formula: see text]. The achieved [Formula: see text] key space notably exceeds the [Formula: see text] NIST standard, while maintaining computational efficiency through optimized quantum circuit design. These innovations establish a new benchmark for satellite image transmission in critical infrastructure applications.

PMID:41271918 | DOI:10.1038/s41598-025-25760-4

Sci Rep. 2025 Nov 21;15(1):41226. doi: 10.1038/s41598-025-25099-w.

ABSTRACT

The C-reactive protein-to-albumin ratio (CAR) is an emerging biomarker linked to cardiovascular disease. However, its role in predicting outcomes among acute decompensated heart failure (ADHF) patients, particularly when stratified by glycemic status, remains poorly defined. This retrospective study included 1,494 consecutive ADHF patients admitted between 2018 and 2023, with the primary endpoint being major adverse cardiac and cerebrovascular events (MACCEs). Patients were stratified into low- and high-CAR groups using an optimal cutoff of 0.29, derived from maximally selected rank statistics. To assess the relationship between CAR and MACCEs in different glucose metabolism states, multivariable Cox proportional hazards models, restricted cubic splines (RCS), and Kaplan-Meier survival curves were used. During a median follow-up of 528 days, 565 patients (37.8%) experienced MACCEs. After adjusting for potential confounders, higher CAR levels were significantly associated with an increased risk of MACCEs (Model 3: hazard ratio [HR]: 1.45, 95% confidence interval [CI]: 1.19-1.77, p < 0.001). When stratified by glycemic status, CAR as a robust predictor in diabetic patients (Model 3 HR: 1.91, 95% CI: 1.41-2.58, p < 0.001), whereas no significant associations were observed in prediabetic or normoglycemic individuals (all p > 0.05). In conclusion, CAR demonstrates independent prognostic value in ADHF patients with concomitant diabetes, highlighting its potential as a stratification tool for personalized risk assessment and therapeutic optimization in this high-risk population.

PMID:41271915 | DOI:10.1038/s41598-025-25099-w

Diabetes Metab Syndr. 2025 Nov 19;19(10):103328. doi: 10.1016/j.dsx.2025.103328. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: This systematic review and meta-analysis was conducted to evaluate the effects of artichoke supplementation on cardiometabolic health markers in adults.

METHODS: A comprehensive literature search of PubMed, Scopus, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials was conducted up to September 2024.

RESULTS: Artichoke supplementation significantly reduced body mass index (WMD = -0.51 kg/m², 95 % CI: 0.93 to -0.09) and waist circumference (WMD = -1.21 cm, 95 % CI: 2.24 to -0.17), while its effects on body weight and hip circumference were not statistically significant. Blood pressure outcomes revealed significant reductions in both systolic (WMD = -2.49 mmHg, 95 % CI: 4.33 to -0.65) and diastolic (WMD = -1.53 mmHg, 95 % CI: 3.01 to -0.05) pressures. Significant lipid profile improvements were observed in total cholesterol (WMD = -12.29 mg/dL, 95 % CI: 19.92 to -4.65), low-density lipoprotein cholesterol (WMD = -10.31 mg/dL, 95 % CI: 18.57 to -2.04), and triglycerides (WMD = -12.85 mg/dL, 95 % CI: 24.77 to -0.93), with no significant effect on high-density lipoprotein cholesterol. Regarding glycemic indices, insulin (WMD = -1.83 mU/L, 95 % CI: 3.33 to -0.32) and homeostatic model assessment for insulin resistance (WMD = -0.92, 95 % CI: 1.33 to -0.51) were significantly reduced, whereas fasting blood glucose and HbA1c were unaffected. Among liver function markers, alanine aminotransferase (WMD = -8.47 U/L, 95 % CI: 14.71 to -2.23) and alkaline phosphatase (WMD = -7.86 U/L, 95 % CI: 15.26 to -0.45) were significantly reduced, while aspartate aminotransferase showed a borderline non-significant effect. No significant change was observed in creatinine levels.

CONCLUSION: Artichoke supplementation may offer modest but significant improvements in several cardiometabolic risk markers.

PMID:41270328 | DOI:10.1016/j.dsx.2025.103328

J Emerg Med. 2025 Oct 24;80:74-80. doi: 10.1016/j.jemermed.2025.10.019. Online ahead of print.

ABSTRACT

BACKGROUND: There are only two antivenoms on the market approved for North American pit viper envenomations; crotalidae polyvalent immune Fab (ovine) and crotalidae immune F(ab’)₂ (equine). There is currently no consensus on which agent may be more effective.

OBJECTIVES: This study aimed to investigate the efficacy and safety of F(ab’)₂ compared with Fab regarding systemic and local effects of North American pit viper envenomation.

METHODS: Patients two years of age and older were retrospectively included and separated into groups if they received Fab or F(ab’)₂. The primary outcome compared the amount of Fab or F(ab’)₂ doses needed to achieve initial control. Secondary outcomes included incidence of recurrent coagulopathies, skin and soft tissue injury, 30-day readmission, length of stay, cost of drug therapy, and adverse events. Statistical significance was set at p < 0.05.

RESULTS: 114 patients were included, 57 in each group. F(ab’)₂ patients required less doses to achieve initial control (1 vs. 4 doses; p < 0.01) and had a shorter length of stay (36 vs. 46 hours, p < 0.01). There were no differences in recurrent coagulopathies [20 (F(ab’)₂) vs. 13 (Fab)], serious adverse events [1 (F(ab’)₂) vs. 0 (Fab)] and readmission within 30 days [1 (F(ab’)₂) vs. 0 (Fab)]. Non-serious adverse events were significantly greater in the F(ab’)₂ group (10 vs. 1 event; p < 0.01).

CONCLUSIONS: Patients treated with F(ab’)₂ antivenom for North American pit viper envenomation required less doses to achieve initial control, but experienced a greater incidence of non-serious adverse events.

PMID:41270323 | DOI:10.1016/j.jemermed.2025.10.019

J Emerg Med. 2025 Oct 14;80:44-50. doi: 10.1016/j.jemermed.2025.10.003. Online ahead of print.

ABSTRACT

BACKGROUND: The epidemiology of boxing-related upper extremity injuries in the United States (US) has been minimally described, with only one prior study examining data up to 2016.

OBJECTIVE: To update and extend national estimates of these injuries through 2023, highlighting post-2016 trends and the impact of the COVID-19 pandemic.

METHODS: The National Electronic Surveillance System database was queried for upper extremity boxing-related injuries presenting to US emergency departments from January 1, 2014, to December 31, 2023. Injuries were categorized by body part, diagnosis, and disposition. National estimates (NE) were calculated based on each hospital’s assigned statistical sample weight. Linear regression assessed trends over time.

RESULTS: A total of 106,903 boxing-related upper extremity injuries were identified. The hand (48.3%), wrist (18.9%), and shoulder (14.2%) were the most commonly affected areas. Fractures were the most frequent diagnosis (26.4%), followed by strains/sprains (24.1%), other injuries (21.3%), and contusions/abrasions (17.9%). Only 3.3% of cases required hospital admission. Injury counts dropped sharply in 2020 during the COVID-19 pandemic (NE = 7282; p < 0.01 compared to pre-COVID years of 2014-2019), followed by a rebound in subsequent years, peaking in 2023 (NE = 13,258). Linear regression showed a nonsignificant annual decrease of 76 injuries over 10 years (p = 0.70; coefficient = -75.6; 95% CI: -508.7 to 357.5).

CONCLUSION: Boxing-related upper extremities most commonly involve the hand, with fractures representing the most common diagnosis. In conclusion, the rebound in injury rates in 2023, which diverges from the pre-COVID trend of gradual decline, warrants attention.

PMID:41270318 | DOI:10.1016/j.jemermed.2025.10.003

J Emerg Med. 2025 Oct 22;80:23-32. doi: 10.1016/j.jemermed.2025.10.017. Online ahead of print.

ABSTRACT

BACKGROUND: While disparities in care between demographic groups (e.g., race/ethnicity, gender, age) have been demonstrated across the spectrum of health care, limited research exists for ST-segment elevation myocardial infarction (STEMI) patients in the prehospital setting.

OBJECTIVE: The purpose of this study was to describe disparities specific to the prehospital care of STEMI using data from a large urban fire-based emergency medical services (EMS) system.

METHODS: Electronic patient care records for all STEMI activations from 02/01/2020 to 09/01/2022 were reviewed. National benchmark variables evaluated included administration of analgesia (either fentanyl or nitroglycerin), nitroglycerin administration, aspirin administration, scene time, transport time, STEMI alert time, and electrocardiogram (ECG) time. Analyses were conducted using logistic and linear regression.

RESULTS: A total of 888 patients were evaluated. The average age was 63.9 years, 575 (63.9%) were male, and 479 (53.9%) were White. Black patients were less likely than White patients to be administered analgesia, as were patients 75 years and older compared to patients 60-74. Female patients were less likely than male patients to receive nitroglycerin or aspirin. Both Black and Hispanic patients were less likely to receive aspirin compared to White patients. Differences in age groups emerged for two-time metrics: Patients 75 years and older had longer scene times and STEMI alert times than patients 60-74. None of the demographic variables were statistically significant predictors of transport time or ECG time.

CONCLUSIONS: This evaluation of comprehensive demographic information from a large fire-based EMS system revealed disparities among STEMI patients in analgesia administration, specifically aspirin and nitroglycerin based on gender and race/ethnicity.

PMID:41270316 | DOI:10.1016/j.jemermed.2025.10.017

Psychoneuroendocrinology. 2025 Nov 15;184:107692. doi: 10.1016/j.psyneuen.2025.107692. Online ahead of print.

ABSTRACT

BACKGROUND: The maternal hypothalamic-pituitary-adrenal (HPA) axis undergoes substantial physiological changes during pregnancy and postpartum, reflected in altered cortisol secretion patterns. However, research has shown considerable heterogeneity in cortisol patterns across the peripartum period and in part contradictory findings. Individual courses of cortisol secretion and their determinants remain poorly understood.

METHODS: In a longitudinal cohort of 127 healthy pregnant women, we assessed salivary cortisol at five time points from late pregnancy (gestational weeks 34-36 and 40) to eight weeks postpartum. Group-based trajectory modeling was applied to three cortisol measures to identify distinct cortisol secretion patterns. Associations with sociodemographic and psychological covariates were explored.

RESULTS: Across all cortisol indices, two distinct trajectory groups emerged. The majority of women (79-86 %) exhibited stable, relatively lower cortisol levels during late pregnancy and postpartum, while a smaller subgroup (14-21 %) exhibited a consistently elevated and more variable cortisol trajectory. Trajectory groups showed high classification stability (98-99 %), but no sociodemographic or psychological variables significantly predicted group membership.

CONCLUSIONS: Our findings reveal two distinct maternal cortisol trajectory subgroups across the peripartum period, reflecting heterogeneity in HPA axis regulation. The lack of significant associations with the measured covariates raises the possibility that unmeasured mechanisms, such as genetic or epigenetic influences, may contribute to these patterns. These distinct cortisol trajectories may reflect differing modes of neuroendocrine regulation, offering a potential explanation for inconsistencies in prior peripartum cortisol research.

PMID:41270314 | DOI:10.1016/j.psyneuen.2025.107692