Tag: statistics

Neural Netw. 2026 Jan 24;199:108641. doi: 10.1016/j.neunet.2026.108641. Online ahead of print.

ABSTRACT

Simulating turbulent flows is crucial for a wide range of applications, and machine learning-based solvers are gaining increasing relevance. However, achieving temporal stability when generalizing to longer rollout horizons remains a persistent challenge for learned PDE solvers. In this work, we analyze if fully data-driven fluid solvers that utilize an autoregressive rollout based on conditional diffusion models are a viable option to address this challenge. We investigate accuracy, posterior sampling, spectral behavior, and temporal stability, while requiring that methods generalize to flow parameters beyond the training regime. To quantitatively and qualitatively benchmark the performance of various flow prediction approaches, three challenging 2D scenarios including incompressible and transonic flows, as well as isotropic turbulence are employed. We find that even simple diffusion-based approaches can outperform multiple established flow prediction methods in terms of accuracy and temporal stability, while being on par with state-of-the-art stabilization techniques like unrolling at training time. Such traditional architectures are superior in terms of inference speed, however, the probabilistic nature of diffusion approaches allows for inferring multiple predictions that align with the statistics of the underlying physics. Overall, our benchmark contains three carefully chosen data sets that are suitable for probabilistic evaluation alongside various established flow prediction architectures.

PMID:41662807 | DOI:10.1016/j.neunet.2026.108641

Comput Biol Med. 2026 Feb 8;204:111537. doi: 10.1016/j.compbiomed.2026.111537. Online ahead of print.

ABSTRACT

OBJECTIVE: Neonatal sepsis (NS) poses a significant global health challenge, with mortality rates ranging from 11% to 19%. Despite its substantial burden, there is currently a lack of systematic understanding of the global epidemiological trends and influencing factors of NS.

STUDY DESIGN: We conducted a comprehensive pan-database analysis integrating data from 18 international databases across 201 countries (1990-2021). Through advanced statistical modeling, including correlation analyses, risk parsimonious modeling, and confounder adjustments, we examined temporal trends, regional disparities, and key determinants of NS.

RESULTS: While NS prevalence increased annually due to improved detection, age-standardized rates showed consistent declines. For NS incidence, novel correlates included European ancestry (strongest), systolic/diastolic blood pressure, and inverse associations with Human Development Index. We developed a parsimonious model incorporating diastolic blood pressure, Global Hunger Index, and European ancestry, which showed strong cross-regional predictive capability (r = 0.727). For mortality, socioeconomic factors were primary correlates: positive associations with Global Hunger Index and food insecurity, and inverse associations with Inequality Adjusted HDI.

CONCLUSION: This first comprehensive global analysis reveals that NS outcomes are determined by both medical and socioeconomic factors. While blood pressure metrics and genetic factors influence incidence, mortality is primarily driven by socioeconomic determinants. These findings suggest that reducing NS burden requires a dual approach: enhancing medical care while addressing fundamental socioeconomic disparities, particularly in resource-limited regions.

PMID:41662778 | DOI:10.1016/j.compbiomed.2026.111537

J Neural Eng. 2026 Feb 9. doi: 10.1088/1741-2552/ae4381. Online ahead of print.

ABSTRACT

OBJECTIVES: Neuron morphology plays a vital role in defining cellular identity and function, offering valuable insights for cell type classification and neurological disorder diagnosis. However, two main challenges hinder progress: the difficulty of learning meaningful representations from complex, tree-like structures, and the high cost of expert annotation for large-scale datasets.

APPROACH: To address these challenges, we propose MorphSys, a self-supervised contrastive learning framework that complements a Branch-Aware module and a GNN-based module. We present a branch-level representation of neuron morphology by introducing an Inter-Branch Attention, which captures inter-branch relationships that are overlooked by conventional tree-graph models relying on node-level message passing. We further demonstrate the effectiveness and interpretability of branch-level knowledge in learning meaningful representations of neuron morphology. Meanwhile, our GNN-based module shows a robust ability for various GNN architectures in learning local features of neuron tree graph, where we draw from results that GatedGraphConv with SumPool yields the superior performance.

MAIN RESULTS: Comprehensive experiments on multiple benchmark datasets indicate that MorphSys consistently outperforms existing methods in neuron cell type classification. On the BIL dataset, MorphSys achieves the KNN-Acc of 83.99%, surpassing the previous state-of-the-art by 2.99%. Ablation study is conducted to verify the efficacy of several components of MorphSys, while an in-depth discussion is performed to identify powerful approaches for branch feature extraction.

SIGNIFICANCE: These results highlight that MorphSys serves an effective tool for the representation learning of neuron morphology and morphology-driven neuronal analysis.

PMID:41662773 | DOI:10.1088/1741-2552/ae4381

Am J Trop Med Hyg. 2025 Dec 4;114(2):355-359. doi: 10.4269/ajtmh.25-0503. Print 2026 Feb 4.

ABSTRACT

Human papillomavirus (HPV) vaccination has been shown to reduce the HPV-related cervical cancer burden. The aim for the present study was to investigate the factors associated with the uptake of HPV vaccination among adolescent girls aged 13-18 years seeking health services at a health center in Uganda. This cross-sectional study was conducted at Naguru Teenage Information and Health Center, an adolescent clinic of Kiswa Health Center III in Kampala, Uganda. Information was obtained from 134 adolescent girls aged 13-18 years who were seeking services at the center. Bivariate and multivariable analyses were conducted to identify factors associated with HPV vaccine uptake. The uptake of a single dose of the HPV vaccine was 18.7% (25/134). Factors associated with HPV vaccine uptake included being from an ethnic group such as the Acholi/Lango (adjusted prevalence ratio [aPR] = 0.3; 95% CI: 0.09-0.6), being from an ethnic group such as Basoga (aPR = 0.2; 95% CI: 0.08-0.8), parents’ level of knowledge (aPR = 0.3; 95% CI: 0.1-0.8), perception of HPV vaccine benefits (aPR = 0.3; 95% CI: 0.1-0.9), knowledge of the location of the nearest HPV vaccination site (aPR = 0.3; 95% CI: 0.1-0.8), distance to the healthcare facility (aPR = 0.5; 95% CI: 0.2-0.7), and healthcare worker recommendations (aPR = 0.3; 95% CI: 0.1-0.7). The uptake of the HPV vaccine was low. There is a need to conduct awareness campaigns for parents, adolescents, and the community about the benefits of the HPV vaccine. This will increase HPV vaccine uptake and reduce the burden of cervical cancer in the community.

PMID:41662762 | DOI:10.4269/ajtmh.25-0503

Am J Trop Med Hyg. 2025 Nov 25;114(2):247-252. doi: 10.4269/ajtmh.25-0021. Print 2026 Feb 4.

ABSTRACT

Latent tuberculosis infection (LTBI) and Schistosoma mansoni are common in Africa, and helminth-induced immunomodulation may affect LTBI detection. This study aimed to assess whether S. mansoni infection affects LTBI detection by the QuantiFERON-TB Gold Plus (QFT-Plus) assay and alters serum interferon-γ (IFN-γ) concentrations in response to Mycobacterium tuberculosis (Mtb) antigens at baseline and after 1 year, during which participants with S. mansoni infection received praziquantel treatment. At baseline, 65 individuals with schistosome infection had lower average IFN-γ concentrations in TB1-stimulated QFT-Plus supernatants compared with 83 uninfected individuals (10.4 versus 51.9 pg/mL, P = 0.038). Although not statistically significant, QFT-Plus test positivity rate was unexpectedly slightly higher among adults with schistosome infection at baseline (26.2% versus 18.1%, P = 0.24). The incidence over 12 months was higher posttreatment in participants initially infected with S. mansoni compared with those uninfected (13.9% [n = 5/36] versus 4.2% [n = 2/48], P = 0.13). By 12 months, IFN-γ concentrations were comparable between the two groups (53.8 versus 33.5 pg/mL, respectively, P = 0.56). Individuals who cleared S. mansoni infection experienced a nearly 12-fold increase in IFN-γ levels relative to those who remained uninfected, although this difference did not reach statistical significance (P = 0.17). In conclusion, baseline S. mansoni infection was associated with suppressed IFN-γ responses to Mtb antigens, suggesting helminth-induced immune dampening. Praziquantel treatment may partially restore TB-specific immune responses and facilitate LTBI detection. These findings highlight the potential role of S. mansoni as a critical cofactor affecting LTBI diagnosis in schistosomiasis-endemic regions.

PMID:41662761 | DOI:10.4269/ajtmh.25-0021

Am J Trop Med Hyg. 2025 Dec 9;114(2):375-383. doi: 10.4269/ajtmh.24-0454. Print 2026 Feb 4.

ABSTRACT

Twenty percent of French Guiana’s population lives in remote villages surrounded by tropical forests, accessible only by plane or boat. Some specialists, including pediatricians, regularly visit these villages for consultation purposes. The main objective for the present study was to provide an epidemiological description of childhood diseases that require follow-up or consultation with pediatricians in remote health centers. A descriptive, retrospective, multicenter study of pediatricians’ consultations in these health centers was conducted from January 1, 2011 to December 31, 2019. A total of 1,458 patients were included in the current study. In 2011, at the beginning of the pediatric missions, 91 patients had at least one consultation with a pediatrician, whereas in 2019, 319 patients were seen by a pediatrician in remote health centers. Sixty-two percent of pediatric consultations were single. Twenty-three deaths were recorded between 2011 and 2019, representing 1.4% of all children seen by the pediatricians. Forty-five percent of the children were under 2 years old at the time of their first consultation. The most common diseases were cardiac, infections, developmental delays, prematurity, and genetic diseases, including sickle cell disease. The current study revealed that the rate of children being followed up by pediatricians in the field is high. Children with chronic conditions can be followed up regularly, and additional investigations or support can be provided as needed. However, this comprehensive study highlights the difficulties pediatricians face in providing care, often due to external factors, such as a lack of healthcare infrastructure, cultural and linguistic differences, and educational and social difficulties, and emphasizes the need to reduce these barriers.

PMID:41662759 | DOI:10.4269/ajtmh.24-0454

Am J Trop Med Hyg. 2025 Dec 9;114(2):384-391. doi: 10.4269/ajtmh.24-0705. Print 2026 Feb 4.

ABSTRACT

French Guiana has developed a health organization to respond to its geographical situation. Remote health centers provide primary and emergency care in isolated areas. The limited technical facilities at the remote health centers result in a significant number of patient transfers to the Cayenne emergency department (ED). The objective of this study was to describe the epidemiology and management of patients transferred to Cayenne ED. A retrospective observational study was conducted from January 1 to December 31, 2019, and it included all patients transferred from remote health centers to Cayenne ED. All sociodemographic, prehospital, hospital, and referral data were collected; 842 patients were transferred by remote health centers to the Cayenne ED. The male/female ratio was 1.27, with an age of 36 (±23) years old. The two main modes of transportation used were helicopter (36%) and plane (22%). The most frequent reasons for transfer were trauma (28%), digestive (9%), respiratory (9%), and infectious (8%) conditions. Patients were hospitalized in 71% of cases. Among patients who were not hospitalized, 7% did not require further examination or specialist advice in the ED. Our work underlines the important use of airborne resources, particularly medical ones; they were initially intended for the management of vital emergencies, but they are also used for nonurgent situations. The geography and road access in French Guiana make alternative means of transport difficult. Our work identifies a number of areas for optimizing care to decrease the number of transfers: improving biomedical equipment, improving imaging equipment, and use of telemedicine.

PMID:41662756 | DOI:10.4269/ajtmh.24-0705

Am J Trop Med Hyg. 2025 Dec 4;114(2):338-347. doi: 10.4269/ajtmh.24-0837. Print 2026 Feb 4.

ABSTRACT

The alarming growth of dengue worldwide, as well as its social and economic impact, has necessitated effective responses for its control. Brazil, the second country to use Dengvaxia® (Sanofi Pasteur, Paris, France) after the Philippines, has offered the vaccine to ∼500,000 residents in 30 municipalities, with ∼300,000 being vaccinated. In this population-based cohort study, the vaccine’s effectiveness (VE) is reported after a 6-year follow-up for a vaccination campaign. The primary outcome was probable dengue case (PDC). Laboratory-confirmed dengue, serotype, warning signs, and hospitalization were considered secondary endpoints. Approximately 60% of participants received at least one vaccine dose. A total of 50,658 PDCs were identified, of which 15,131 were laboratory-confirmed dengue cases. Overall, the VE was 34% (95% CI: 33% to 35%) for PDCs and 20% (95% CI: 17% to 23%) for laboratory-confirmed cases. Greater VE was observed in older individuals. Vaccination was effective in reducing dengue virus (DENV)-1 and DENV-4 cases but not DENV-2 cases. No DENV-3 cases were registered. Among the 1,129 hospitalizations, 619 (54.8%) occurred within the vaccinated population, including 16 severe cases, whereas 510 (45.2%) hospitalizations occurred within the non-vaccinated population, with 18 severe cases. The VE for PDC hospitalizations was 16.5% (95% CI: 5.5% to 26.3%). Five and nine dengue-related deaths occurred within the vaccinated and non-vaccinated populations, respectively. The low incidence of severe cases and warning signs compromised accuracy. Vaccination with at least one dose was associated with approximately a one-third reduction in PDC incidence and a significant reduction in DENV-1 and DENV-4 cases. Despite the VE falling below 50%, vaccination may be justifiable in regions with high disease burden.

PMID:41662753 | DOI:10.4269/ajtmh.24-0837

Am J Trop Med Hyg. 2025 Dec 2;114(2):216-223. doi: 10.4269/ajtmh.25-0440. Print 2026 Feb 4.

ABSTRACT

Antimicrobial resistance poses a growing threat to pediatric care, yet data on its clinical and economic burden in low-resource settings remain limited. The impact of antibiotic-resistant infections on mortality, hospital stay, and treatment costs was assessed among children admitted to a national referral hospital in Kenya in the present study. A retrospective review of medical records for pediatric patients (0-12 years) hospitalized with bacterial infections between January 2017 and December 2021 was conducted. Diagnoses included gastroenteritis, pneumonia, sepsis, urinary tract infections, meningitis, and others. Data on treatment, laboratory testing, outcomes, hospital stays, and costs were abstracted. Statistical analyses included Kaplan-Meier survival curves, Cox regression, and mixed-effects negative binomial and generalized linear models. Among 1,608 patients, 63% were infants, and 38% were referrals. Gastroenteritis (46%) and pneumonia (28%) were the most common diagnoses. Antibiotic-resistant infections occurred in 27% of participants and were associated with higher mortality (26% versus 9% in susceptible participants) and an attributable risk of 17%; the population attributable fraction was 65%. After adjustment, resistance was associated with increased mortality (HR 1.44), longer hospital stays (60% increase), and higher treatment costs (33% increase). Antimicrobial resistance significantly increases mortality, hospital stays, and healthcare costs in pediatric patients. Strengthening diagnostics, antimicrobial stewardship, and policy interventions is critical to address this threat.

PMID:41662743 | DOI:10.4269/ajtmh.25-0440

JMIR Hum Factors. 2026 Feb 9;13:e54431. doi: 10.2196/54431.

ABSTRACT

BACKGROUND: Over 1 million Dutch people have diabetes, of whom 90% have type 2 diabetes. Studies show that lifestyle plays an important role in the course of type 2 diabetes. MiGuide (MiGuide Ltd) is an online platform that helps people adopt and sustain lifestyle changes. The platform is integrated into existing diabetes care within primary care. Previous research has shown that implementing new (eHealth) interventions is challenging and may reduce effectiveness. Mapping out the barriers and success factors in the implementation process is essential so that eHealth interventions such as MiGuide can be used effectively in regular health care.

OBJECTIVE: This study aimed to evaluate the implementation of MiGuide within Dutch primary care.

METHODS: A qualitative study design was used, supplemented by quantitative data from patients. Five general practices participated. Three focus groups (FGs; at baseline, after 6 months, and after 12 months) were conducted with 3 general practitioners, 3 FGs with 8 specialized practice nurses (divided into 2 separate groups with 4 participants per group), 2 FGs (at 6 months and after 12 months) with 5 patients, and 2 FGs (at baseline and after 12 months) with 4 stakeholders from the management of the care group. The implementation process was discussed with health care professionals and management, and usage and user-friendliness were discussed with patients. The framework method was used to analyze the data. The following quantitative data were collected: patient characteristics, user data, and questionnaires at baseline and 6 months, assessing quality of life, usability, and diabetes self-care. The quantitative data were examined using exploratory analyses.

RESULTS: Four themes were found in the qualitative data: “innovation,” “capability, motivation, and opportunity,” “processes,” and “setting.” Different factors within these themes played an essential role throughout the implementation process, such as facilities, technical difficulties, motivation, COVID-19, and the work processes. Areas for improvement were also identified. The supplemented quantitative data showed that usability scored below average at 6 months (mean 53.8; SD 9.3; n=8). Participants had a mean score of 0.84 (SD 0.13) on the EuroQoL-5 dimension and 81.9 (SD 13.4) on the EuroQoL visual analogue scale at baseline. Moreover, the average number of days someone exercised was 4.2 (SD 1.7), and the number of days someone ate a generally healthy diet was 5.1 (SD 1.3). Insufficient data on quality of life and diabetes self-care were collected at 6 months and therefore not presented in this study.

CONCLUSIONS: Implementation is a complex process with multiple barriers and facilitators. It is essential to explore the use of context-specific strategies that are aligned with the implementation process phase. Further research is needed to evaluate the next version of the MiGuide platform, which is being implemented in another setting with lifestyle coaches.

PMID:41662702 | DOI:10.2196/54431