Tag: statistics

Aliment Pharmacol Ther. 2025 Dec 14. doi: 10.1111/apt.70490. Online ahead of print.

ABSTRACT

BACKGROUND: Hepatitis B virus (HBV) reactivation is a serious complication in patients receiving chronic immunosuppression. Anti-CD20 agents such as Rituximab are considered high risk for HBV reactivation (> 10%); therefore, antiviral prophylaxis is recommended for all anti-HBc positive patients. Some studies have suggested that patients with resolved HBV infection and higher hepatitis B surface antibody (anti-HBs) titer have a higher level of protection against reactivation.

AIM: The purpose of this study was to systematically review the role of anti-HBs titer on HBV reactivation in patients on rituximab while not on antiviral therapy/prophylaxis.

METHODS: We systematically reviewed all studies that discussed HBV reactivation in patients on rituximab therapy with resolved HBV infection, defined as HBsAg negative and anti-HBc positive, which discussed anti-HBs titer. The search was conducted in PubMed, Embase via Elsevier, Scopus, and Cochrane CENTRAL inclusive July 2025. We evaluated the incidence of HBV reactivation from cohort studies that described anti-HBs categorically based on anti-HBs titer: ‘negative’ (titer < 10 iU/L), ’10-100 iU/L’, or ‘> 100 iU/L’. Meta-analysis statistics describe the proportion and risk difference for different anti-HBs levels.

RESULTS: The overall reactivation rate was 12.6%. There was a significant difference in HBV reactivation depending on titer: anti-HBs negative 27.3% (51/195) (20.0%-36.0%), titer < 100 iU/L 13.8% (47/379) (8.8%-20.8%), and titer > 100 iU/L 3.5% (8/339) (1.8%-6.9%).

CONCLUSIONS: Those with anti-HBs titer > 100 iU/L can be considered lower risk for HBV reactivation and may not require antiviral therapy, but monitoring with initiation of antiviral therapy if titer falls below 100 iU/L.

PMID:41390946 | DOI:10.1111/apt.70490

Scand J Psychol. 2025 Dec 14. doi: 10.1111/sjop.70060. Online ahead of print.

ABSTRACT

Major depressive disorder (MDD) is associated with reduced quality of life and relapse risk. However, few studies have investigated how quality of life is associated with cognitive deficits following MDD and is affected by cognitive training. This study investigated the long-term effects of computer-based working memory training (CWMT) on health-related quality of life (HRQL) in remitted MDD, and the association between executive functions (EF) and HRQL. Twenty-nine remitted participants (M age 36.21, SD = 10.8) were included in a pre-post pilot study of CWMT with 1- and 2-year follow-up. Twenty participants completed 5 weeks of CWMT, 12 participants were included at the 1-year follow-up, and 10 participants returned for the 2-year follow-up. The 36-item Short-Form Health Survey was used to assess HRQL. Associations between subjective and objective cognitive EF and HRQL were measured by the Behavior Rating Inventory of Executive Function for Adults (BRIEF-A) and a neuropsychological test battery of EF. Significant moderate improvements were found in aspects of HRQL after 2 years (d = 0.66). There were negative correlations between HRQL and BRIEF-A pre-intervention (r = 0.47-0.65). However, the study did not find significant associations between improved EF and improved HRQL. Preliminary results indicate long-term improvements in HRQL following CWMT. Subjective EF deficits were associated with poorer HRQL. However, due to limitations including small sample size and multiple statistical comparisons, larger controlled studies are needed to investigate and replicate the potential effects of CWMT on HRQL.

PMID:41390937 | DOI:10.1111/sjop.70060

Med Sci Monit. 2025 Dec 14;31:e951084. doi: 10.12659/MSM.951084.

ABSTRACT

BACKGROUND This study sought to evaluate the diagnostic performance of the non-invasive fibrosis scores Fibrosis-4 Index (FIB-4) and Aspartate Aminotransferase-to-Platelet Ratio Index (APRI) in predicting liver fibrosis among patients with chronic hepatitis B (CHB) in immune-tolerant, inactive, and gray zone phases. MATERIAL AND METHODS This retrospective cross-sectional study included 230 patients with CHB, as determined by laboratory and clinical criteria, and who underwent liver biopsy. Patients were grouped based on FIB-4 and APRI fibrosis scores of <3 and ≥3. The FIB-4 and APRI scores were calculated, and their diagnostic accuracy was assessed, using receiver operating characteristic (ROC) curve analysis. RESULTS The mean age of the patients was 44.4±12.2 years, and 53.9% were female. A total of 37.4% (86/230) of the patients met the criteria for treatment. Both FIB-4 (1.53±0.90 vs 0.91±0.55, P=0.003) and APRI (0.44±0.23 vs 0.29±0.15, P=0.001) scores were significantly higher in patients with fibrosis score ≥3. The area under the curve (AUC) was 0.70 (cut-off >1.06) for FIB-4 and 0.68 (cut-off >0.38) for APRI. Both scores had a negative predictive value of 87%. The difference between AUC values was not statistically significant (P=0.80). CONCLUSIONS FIB-4 and APRI are helpful non-invasive tools for ruling out advanced fibrosis in CHB patients. However, due to their limited diagnostic power, they should be considered as supportive tools rather than definitive alternatives to liver biopsy.

PMID:41390934 | DOI:10.12659/MSM.951084

Eur J Cardiothorac Surg. 2025 Dec 13:ezaf444. doi: 10.1093/ejcts/ezaf444. Online ahead of print.

ABSTRACT

OBJECTIVES: Dynamic compression bracing (DCB) systems have been proven safe and effective for a non-surgical treatment of Pectus Carinatum (PC). This study aimed to identify potential prognostic factors for PC correction using DCB.

METHODS: From 2011 to 2020, all patients treated with DCB for PC at the University Hospital of Saint-Etienne were retrospectively reviewed. The primary outcome was a reduction ≤ 50% in pectus height (PH) at 6 months follow-up, measured by radiation-free imaging. Two statistical models adjusted for compliance with treatment were used.

RESULTS: A total of 297 patients were treated with DCB (mean age: 15.4 ± 3.9 years). 42% of deformities were symmetrical. Baseline mean PH and pressure for initial correction (PIC) were 2.97 ± 1.02 cm and 6.5 ± 2.0 psi, respectively. The median total treatment duration was 13.1 months (9.2-17.9). Among the 114 (46.5%) patients with available PH data, the median decrease in PH was -35.8% (-62.4% to -10.0%) after 6 months of DCB, with 61 patients (53.5%) achieving a reduction ≥ 50% in PH. In multivariate analysis, only PIC (OR = 1.34; 95% CI: 1.09 to 1.64; p = 0.005) was significantly associated with PH reduction in model 1, and PIC ≥ 7.5 psi (OR = 2.53; 95% CI: 1.13 to 5.67; p = 0.024) in model 2. Patient compliance was 85.2% at 6 months. The recurrence rate was 11.3% (n = 26).

CONCLUSIONS: The PIC value appears to be a potential prognosis factor for PH reduction after 6 months of DCB treatment. These results will be validated in an ongoing prospective study.

CLINICAL TRIAL: The study was approved by the Ethical Committee “Terres d’Ethique” (IRBN902020/CHUSTE) and registered at Clinicaltrials.gov (NCT04452721).

PMID:41390917 | DOI:10.1093/ejcts/ezaf444

Clin Rheumatol. 2025 Dec 13. doi: 10.1007/s10067-025-07771-8. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate and compare the quality and readability of patient education materials (PEM) related to ankylosing spondylitis (AS) generated by four AI-based large language models (LLMs): ChatGPT-4o, ChatGPT-3.5, DeepSeek R1, and DeepSeek V3.

METHODS: On May 1, 2025, the ten most frequently searched AS-related questions were identified using Google Trends (Turkey). These questions were posed to the four LLMs, and the responses were recorded without modification. Quality was assessed by two independent rheumatologists. The quality was evaluated using the DISCERN tool. Readability and comprehensibility were assessed using the Flesch Reading Ease Score (FRES) and the Flesch-Kincaid Grade Level (FKGL). Inter-rater reliability was analyzed using the intraclass correlation coefficient (ICC). Mean scores and 95% confidence intervals (CI) were reported.

RESULTS: ChatGPT-4o achieved the highest average DISCERN score (72.38), followed by DeepSeek R1 (69.76), ChatGPT-3.5 (68.82), and DeepSeek V3 (68.79). Inter-rater reliability for DISCERN was excellent (ICC, 0.931). ChatGPT-4o had the highest mean DISCERN score, although the difference was not statistically significant. For readability analysis, DeepSeek V3 had the highest FERS score (14.93). This suggested that DeepSeek V3 was more easily understandable than other LLMs. ChatGPT-3.5 received the lowest score (5.29). FKGL scores varied within a narrow range (15.33-15.93) across models. Therefore, it was interpreted that the data required university-level reading skills. Conclusion For AS, AI-generated PEMs were generally complex enough to meet the needs of highly educated patients. The responses were information-dense and complex, requiring excessive expertise regardless of the recipient’s educational level. In the future, improving the clarity and comprehensibility of the language according to personal characteristics (educational level, etc.) and providing evidence-based citations could help make LLMs more useful in clinical settings or for the public. Key Points • This study compared how different AI chatbots explain ankylosing spondylitis to patients. • Although the information quality was high, the language used was too complex for most patients. • ChatGPT-4o gave the most accurate content, while DeepSeek V3 used the easiest words. • Future AI tools should use simpler language and include reliable references to better support patient education.

PMID:41390886 | DOI:10.1007/s10067-025-07771-8

Eur J Pediatr. 2025 Dec 13;185(1):17. doi: 10.1007/s00431-025-06682-9.

ABSTRACT

Social adversity is linked to poor maternal and early childhood outcomes. However, limited evidence exists regarding the associations between mothers’ and children’s health outcomes in early childhood in adversity, particularly within well-established health systems. This study examines the association between mothers’ and their children’s health during the first 5 years in an Australian cohort facing psychosocial and socioeconomic adversity. The study population consisted of children under five and their mothers. Using a longitudinal panel dataset, a mixed-effects logistic regression model was applied to explore the association between maternal health (exposure) and child health (outcome) across five time points, adjusting for explanatory variables. The children’s very good/excellent health was associated with the mother’s very good/excellent health, the mother’s age at childbirth, and being the firstborn. Conversely, poor/fair/good health in children was associated with immigrant parents, premature birth, frequent GP visits, and living in a disadvantaged area.

CONCLUSION: Despite the efforts of well-established health systems, poor child health remains connected to social adversities during the first 5 years. This indicates that current efforts are insufficient for mothers and children facing adversity. Further research and policy actions are essential to address poor maternal and child health outcomes in vulnerable communities to reduce early childhood disparities and support children’s full potential in early childhood and beyond.

WHAT IS KNOWN: • The first 5 years of the child’s life lay the foundation for future years and evidence shows an association between maternal health and children’s health during early childhood. • However, no evidence has been found to support this association in populations experiencing adversity within well-established healthcare systems.

WHAT IS NEW: • Maternal health is a primary determinant of a child’s health during the first 5 years in psychosocial and socioeconomic adversity. When experiencing adversity, better child health during the first 5 years was strongly associated with good maternal health, older maternal age at childbirth, and being the firstborn. • In contexts of adversity, poor child health during the first 5 years was strongly associated with having immigrant parents, premature birth, residing in socioeconomically disadvantaged neighborhoods, and experiencing frequent general practice visits.

PMID:41390885 | DOI:10.1007/s00431-025-06682-9

Sci Rep. 2025 Dec 13. doi: 10.1038/s41598-025-31900-7. Online ahead of print.

ABSTRACT

Predicting the critical crack propagation length (CCPL) of sustainable additive-enhanced concrete (SAEC) is a significant challenge in structural durability analysis and fracture mechanics. Experimental and numerical techniques often face limitations of complexity, cost, and computational inefficiency. To overcome these limitations, this paper presents a comprehensive machine learning framework that integrates ensemble, kernel-based, and deep learning models. A high-quality experimental dataset of 800 SAEC samples, incorporating nine key features and controlled curing, mixing, and fracture testing, was prepared. Model performance was evaluated using different statistical indices under both hold-out and k-fold cross-validation. Among all the machine learning models, the novel Neural Tangent Kernel Gaussian Process (NTK-GP) achieved the best predictive performance with R² = 0.95‒0.96, RMSE = 0.74‒0.90 mm, MAPE = 0.09‒0.14, and VAF = 0.95‒0.96. The NTK-GP’s hybrid architecture, which unites the flexibility of neural representations with Bayesian uncertainty quantification, enabled accurate, smooth, and stable predictions even under nonlinear, high-dimensional data. Statistical significance tests, such as the Friedman and Nemenyi tests, confirmed that the NTK-GP is statistically comparable to several state-of-the-art models. Explainable AI analysis using SHAP revealed that fiber type (FT) and fiber volume content (FVC) are the most influential features, accounting for over 65% of the model’s variance in CCPL. SHAP interaction and dependency plots showed strong combined influences between FT and FVC, especially with steel and basalt fibers at higher volumes. This supports the idea that these fibers bridge cracks and dissipate energy. Bootstrap-based 95% confidence intervals were applied for uncertainty quantification, confirming the predictive reliability by showing consistent coverage across the dataset. This study pioneers the use of NTK-GP for fracture mechanics. It demonstrates that integrating explainable machine learning with uncertainty-aware regression provides a data-efficient, robust, and interpretable alternative to experimental and numerical methods. The proposed framework not only enhances CCPL prediction accuracy and computational efficiency but also contributes to the broader goal of designing sustainable, fracture-resistant concrete materials through intelligent and data-driven modeling.

PMID:41390865 | DOI:10.1038/s41598-025-31900-7

Sci Rep. 2025 Dec 13. doi: 10.1038/s41598-025-32653-z. Online ahead of print.

ABSTRACT

Intestinal parasitic infections remain a major global public health concern, particularly in tropical and subtropical regions of Africa, Asia, and Latin America. This study aimed to determine the prevalence of intestinal parasites, identify associated risk factors, and compare diagnostic techniques among school children in both central and rural areas of Shendi locality, Sudan. A school-based cross-sectional study was conducted from January 2021 to April 2024. A total of 1,200 students were selected using a simple random sampling method. Data were collected through direct interviews using a pretested questionnaire. Stool specimens were collected in clean, labeled plastic containers and examined microscopically for eggs, cysts, and trophozoites using three diagnostic techniques: Wet preparation, Formol-ether concentration (FECT), and Flotation (FLO). Data were analyzed using SPSS^V22 software. The overall prevalence of intestinal parasitic infections was 35.3% (423/1200; 95% CI: 32.7-38.0), with a mean infection intensity of 12.04 ± 1.9 eggs per gram (EPG), (Estimation of Egg Per Gram (EPG); mean ± standard deviation (SD)). Prevalence was higher in males (38.1%) than females (33.7%) but the difference was not statistically significant (p = 0.09). Infection decreased significantly with increasing age (p < 0.001); It peaked among children aged 5-7 years (47.0%), then declined to 33.8% at 8-10 years and 27.0% at 11-13 years. Regarding diagnostic performance, FECT tended to show slightly higher fecal egg counts (mean = 7.1 ± 1.2 EPG) compared to FLO (mean = 5.1 ± 0.8 EPG), (where ± represents the standard deviation). Six genera of intestinal parasites were identified: protozoa (Entamoeba coli 11.7%, Entamoeba histolytica 8.8%, Giardia duodenalis 7.3%) and helminths (Enterobius vermicularis 2.6%, Hymenolepis nana 4.7%, Taenia spp. 0.3%). Infection prevalence showed significant variation by residential area, age group, awareness of transmission, handwashing practices, and presence of symptoms (p < 0.05). The study demonstrated a moderate prevalence of intestinal parasitic infections among school-aged children in Shendi locality (35.3%), with higher rates among younger children and those residing in rural areas. Six parasite genera were identified. Infection was significantly associated with hygiene behaviors, handwashing practices, and awareness of transmission (p < 0.05). The formol-ether concentration technique showed higher diagnostic sensitivity than flotation. These findings highlight the need for integrated interventions combining deworming, water, sanitation and hygiene (WASH) improvements, and school-based health education to reduce reinfection and achieve sustainable parasite control in Shendi and similar settings.

PMID:41390864 | DOI:10.1038/s41598-025-32653-z

Sci Rep. 2025 Dec 13. doi: 10.1038/s41598-025-30887-5. Online ahead of print.

ABSTRACT

Obstetrician-Gynecologist (OB-GYNs) mothers, serving dual roles as healthcare providers and patients, present an interesting demographic for studying this dynamic, particularly in China where empirical data on this subject is limited. The study aimed to determine whether OB-GYNs experience better pregnancy outcomes compared to non-physician women, hypothesizing that their medical background could lead to different health behaviors and outcomes. This was a retrospective matched cohort study conducted at the Women’s Hospital, Zhejiang University School of Medicine. It included 100 OB-GYNs who gave birth between January 2012 and April 2022 and a matched control group of 200 non-medical background women. Outcomes measured were Cesarean section rates, emergency cesarean section, operative vaginal delivery, birth weight, Apgar score, and various pregnancy and childbirth complications. Statistical analysis was performed using descriptive statistics, generalized estimating equation model and Fisher’s exact tests. Cesarean section rates were similar between OB-GYNs (32%) and non-physicians (36.5%). OB-GYNs had similar incidences of pregnancy complications compared with non-physicians except postpartum hemorrhage (0% in OB-GYNs vs. 5.5% in non-physicians, P = 0.018). The findings indicate that OB-GYNs do not differ significantly from non-physician women in terms of Cesarean section rates and incidences of pregnancy complications except postpartum hemorrhage.

PMID:41390862 | DOI:10.1038/s41598-025-30887-5

Sci Rep. 2025 Dec 13. doi: 10.1038/s41598-025-31857-7. Online ahead of print.

ABSTRACT

End-stage kidney disease (ESKD) is a growing health issue, especially among the very elderly. The optimal dialysis method for very elderly patients with ESKD remains uncertain, and there is a lack of evidence regarding the survival benefits of hemodialysis (HD) versus peritoneal dialysis (PD). This study is a multicenter cohort investigation that included 234 very elderly patients aged 75 years and older with ESKD who received HD or PD across six hospitals in China from January 2013 to December 2020. We employed Propensity Score Matching (PSM) to minimize the influence of confounding factors. Survival analyses were conducted using Kaplan-Meier curves, log-rank tests, and multivariable Cox proportional hazards regression models for the matched cohorts. In the multicenter cohort study with 234 very elderly ESKD patients, PSM was employed, with each group consisting of 56 participants, averaging 79.76 ± 4.15 years in age and having a male composition of 47.44%. Kaplan-Meier survival analysis indicated with no significant difference in survival rates (log-rank p = 0.123). Further analysis, excluding participants with less than 3 months of survival, also showed no significant differences. Cox regression with multiple variables indicated a HR of 0.73 (95% CI: 0.49, 1.10) for HD versus PD, with a p-value of 0.132. This investigation did not demonstrate a statistically significant difference in survival between PD and HD among very elderly patients with ESKD.

PMID:41390859 | DOI:10.1038/s41598-025-31857-7