Tag: statistics

Int J Legal Med. 2025 Apr 21. doi: 10.1007/s00414-025-03496-0. Online ahead of print.

ABSTRACT

The Suchey-Brooks (S-B) standard is one of the most frequently applied approaches for age-at-death estimation in modern forensic practice. However, classification accuracy is known to vary across different populations. At present, there is a paucity of research related to the assessment of biological attributes in Indonesia, particularly the estimation of age-at-death. The use of computed tomography (CT) in S-B phase assignments has been validated in the literature. In considering further validating the use of CT, transition analysis (TA), and Bayesian statistics in age-at-death estimation, this study evaluated the accuracy of the S-B standard on a sample obtained from Indonesia. TA and Bayesian statistics are incorporated to address methodological issues such as age mimicry. A total of 378 multi-slice CT scans were analysed in OsiriX^®. TA and Bayesian statistics were used to derive age-at-death estimation models. Overall bias values were at – 6.0 years for females and – 13.1 years for males, while inaccuracy was at 9.6 years for females and 14.6 years for males. When applying the original S-B age ranges, 92.0% of females and 73.3% of males were correctly classified. Likewise, mean ages per S-B phase were higher in the Indonesian sample, except for females assigned to Phase VI. TA and Bayesian statistics derived age-at-death distribution models specific to the Indonesian population. The dissemination of an appropriate age-at-death estimation standard in the literature is of considerable benefit to casework conducted domestically in Indonesia, and also serves to further inform aspects of general forensic practice globally.

PMID:40254709 | DOI:10.1007/s00414-025-03496-0

Clin Transl Oncol. 2025 Apr 21. doi: 10.1007/s12094-025-03919-9. Online ahead of print.

ABSTRACT

BACKGROUND: The research activity is fundamental to improve knowledge in Medicine. In the setting of clinical oncology, radiotherapy (RT) represents a cornerstone for patients treated with curative intent.

PURPOSE: The aim of this snapshot was to investigate the number and the characteristics of clinical trials currently ongoing in the Lombardy (Italy) RT divisions highlighting involved resources and eventual needs to improve the process of study activation.

METHODS: In April 2024, a survey composed of two parts, a snapshot of clinical and research activity and a database to report data on ongoing clinical trials, was proposed to the 30 RT centers in Lombardy. The snapshot consisted of 19 short answer questions.

RESULTS: A total of 26 (87%) centers answered the survey. The total number of active studies was 161. The median age among principal investigators was 51 years. Most studies were multicentric (61%) national (76%). Among 72 studies with available phase, 43% resulted phase III studies. Fifty-three (33%) studies were sponsored. IRCCS (Istituti di Ricovero e Cura a carattere scientifico) RT have a median of 11 active studies vs versus 6 in non-IRCCS structures. More resources are available in IRCCS centers compared to non-IRCCS: data management service 50% vs 25%, dedicated scientific nurses 20% vs 0%, clinical statistics services 60% vs 25%. The main difficulties in conducting clinical trials were bureaucratic difficulties with ethics committees (5 centers), time constraints (5 centers), and a lack of resources and staff (15 centers). The most frequently (58% of the centers) proposed solution was an increase in resources and staff.

CONCLUSION: While the RT centers in Lombardy demonstrate a commendable commitment to clinical research, disparities in resources and infrastructure remain significantly challenging.

PMID:40254696 | DOI:10.1007/s12094-025-03919-9

Emerg Radiol. 2025 Apr 21. doi: 10.1007/s10140-025-02344-3. Online ahead of print.

ABSTRACT

PURPOSE: Artificial Intelligence (AI) algorithms in radiology are currently deployed as tools to augment radiologists rather than autonomous readers. An augmentative tool should improve performance above and beyond the baseline performance achieved by the user alone. We conducted a meta-analysis to elucidate the added value of augmentative AI to radiologists for detecting Pulmonary Embolism (PE) on CT scan.

METHODS: Using PRISMA guidelines, studies in which both AI and Human Interpreter (HI) assessed CT scans for pulmonary emboli were selected. Data extracted from these studies were used to compare diagnostic performance of AI and HI with an emphasis on the performance of AI above and beyond that of HI.

RESULTS: Both HI and AI performed similarly with no statistically significant difference in the pooled estimates of sensitivity, specificity, PPV, NPV and accuracy. Subsequent analysis focusing on the differences between performance of AI and HI within each study, followed by pooled estimate, also did not demonstrate any significant difference (p < 0.05).

CONCLUSIONS: In a meta-analysis of nearly sixteen thousand CTs, AI and HI had similar performance for detection of pulmonary emboli. On one hand, this buttresses AI’s use for triaging and for second reads. On the other hand, the outcomes may or may not be different when AI is added-on. The findings of this meta-analysis can be used to re-examine the use-scenarios of AI and to re-calibrate its value proposition.

PMID:40254693 | DOI:10.1007/s10140-025-02344-3

Emerg Radiol. 2025 Apr 21. doi: 10.1007/s10140-025-02340-7. Online ahead of print.

ABSTRACT

OBJECTIVE: This study explored POCUS knowledge, attitudes, confidence, barriers, enablers, and their associated factors among radiologists and emergency physicians in Jordan.

METHODS: A cross-sectional questionnaire-based study covered five sections: socio-demographics, knowledge, attitude, confidence, and barriers and enablers. Summary statistics, correlation, and regression analyses were performed.

RESULTS: A total of 164 physicians participated, with an average age of 33.8 (± 7.69) years; 52.4% were radiologists and 47.6% were emergency physicians. Participants exhibited good knowledge, attitudes, and confidence. Higher attitude scores (β = 0.28; p < 0.001) and having a POCUS machine (β = 1.70; p = 0.01) were associated with higher knowledge. Higher knowledge (β = 0.64; p < 0.001) predicted better attitudes, while attitude (β = 0.21; p = 0.01), specialty radiologist (β = 8.5; p < 0.001), age (β = 0.23; p < 0.001), and number of monthly scans (β = 0.01; p = 0.01) predicted confidence.

CONCLUSION: Radiologists and emergency physicians in Jordan demonstrated good POCUS knowledge, attitudes, and confidence. Specialty and usage frequency influenced these factors. Future studies should explore training effects on skill acquisition. The study found different factors that are associated with knowledge, attitude, and confidence levels such as specialty, frequency of using POCUS, and the levels of knowledge, attitude and confidence. Future studies, including large prospective studies and/or experimental studies that examine the effect of training on skill acquisition among various healthcare professionals are warranted.

PMID:40254692 | DOI:10.1007/s10140-025-02340-7

Neurol Sci. 2025 Apr 21. doi: 10.1007/s10072-025-08183-x. Online ahead of print.

ABSTRACT

BACKGROUND: Chronic unilateral vestibulopathy (CUVP) is one of the most common causes of chronic dizziness/vertigo. The brain functional mechanisms of CUVP are currently unclear. The study aimed to clarify changes in brain topological properties and subnetwork functional connectivity in CUVP patients, elucidating the neural mechanisms behind their poor dynamic compensation.

METHODS: A total of 44 participants were included (22 CUVP patients and 22 age- and sex-matched healthy controls). Resting-state functional MRI was performed on all subjects. Network-Based Statistics (NBS) analysis was conducted to identify abnormal neural circuits in CUVP. Graph-theoretical analysis (GTA) was performed to elucidate changes in brain network topological properties. Correlation analysis was conducted to examine the relationship between brain network changes and clinical symptom severity.

RESULTS: NBS analysis revealed an abnormal neural network in CUVP patients, with key nodes including the parieto-insular vestibular cortex, sensory-motor cortex, occipital visual cortex, brainstem, and cerebellum. The most significant functional connectivity abnormalities were observed between the brainstem and visual/sensorimotor networks. Graph-theoretical analysis indicated increased characteristic path length, decreased global and local efficiency in CUVP patients. Node properties showed reduced node efficiency and clustering coefficients in multiple nodes within the visual and sensorimotor networks. Correlation analysis indicated that brain network topology and changes in brainstem-sensorimotor network connectivity were negatively correlated with DHI scores.

CONCLUSION: CUVP patients exhibit multisensory integration abnormalities and changes in brain network topology at both the brainstem/cerebellar and cortical levels, which may underlie the potential neural basis for poor vestibular compensation in CUVP patients.

PMID:40254685 | DOI:10.1007/s10072-025-08183-x

Clin Exp Med. 2025 Apr 21;25(1):121. doi: 10.1007/s10238-025-01650-x.

ABSTRACT

This study aims to evaluate the utility of gastric ultrasound in assessing gastric emptying dysfunction in patients with hepatitis B cirrhosis and its correlation with alterations in portal venous flow and liver stiffness. Gastric motility and emptying parameters, portal venous flow parameters, and liver stiffness were measured by ultrasound in 42 patients with hepatitis B cirrhosis and 48 healthy controls. Statistical analysis was performed to compare the differences in these parameters between the two groups and to analyze the correlation between gastric ultrasound parameters and alternations in portal venous blood flow and liver stiffness. Firstly, the Gastric Motility Index was significantly lower in the experimental group than in the control group, while other gastric ultrasound parameters were significantly higher (p < 0.01). Secondly, measurements obtained from two-dimensional ultrasound, Color Doppler Flow Imaging, and two-dimensional Shear Wave Elastography revealed that Portal Vein Diameter (PVD) and Liver Stiffness (LS) were significantly higher in the experimental group compared to the control group, while the maximum portal vein velocity (PVmax) was significantly lower (p < 0.01). Finally, correlation analysis demonstrated that gastric ultrasound parameters correlated with PVD, PVmax, and LS. Gastric function is significantly impaired in patients with hepatitis B cirrhosis compared to controls, and gastric ultrasound parameters demonstrate a notable correlation with PVD, PVmax, and LS. Gastric ultrasound effectively evaluates gastric motility and emptying function in these patients, offering a reliable foundation for clinical diagnosis and management.

PMID:40254679 | DOI:10.1007/s10238-025-01650-x

Sci Rep. 2025 Apr 20;15(1):13632. doi: 10.1038/s41598-025-98517-8.

ABSTRACT

Testosterone deficiency seriously affects male reproductive function, growth and development, and quality of life. There is a certain association between inflammation and testosterone. PIV, a novel immune-inflammatory biomarker, has emerged. However, little is known about the relationship between PIV and serum testosterone. This study aims to investigate the relationship between PIV and serum testosterone. In this cross-sectional study, we analyzed data from 7389 participants in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2016. Serum total testosterone levels were measured using precise isotope dilution liquid chromatography and tandem mass spectrometry. PIV was calculated as (neutrophil count × monocyte count × platelet count)/lymphocyte count. Weighted t tests or chi-square tests were utilized to analyze the basic characteristics of the population. Weighted logistic regression analysis, smooth-fit curves, threshold effects, and subgroup analysis were conducted to investigate the correlation between the PIV and testosterone deficiency. Using PIV Quartile 1 as the reference, in the fully adjusted model, the odds ratios (OR) and 95% confidence intervals (CI) for Quartile 2 to Quartile 4 participants were 1.14 (0.93, 1.40), 1.28 (0.99, 1.65), and 1.51 (1.18, 1.95), respectively (P for trend < 0.001), with participants in the highest quartile of PIV having a 51% increased risk of testosterone deficiency compared to those in the lowest quartile of PIV. Smooth-fit curves and threshold effect analysis revealed a nonlinear relationship between PIV and testosterone deficiency, with a turning point at 565.89. The subgroup analysis results showed that, except for obesity, there was no statistically significant difference in the relationship between PIV and testosterone deficiency among different subgroups (P > 0.05). Our study results indicate a positive correlation between PIV and the risk of testosterone deficiency. This suggests that PIV may serve as a potential indicator for testosterone deficiency.

PMID:40254668 | DOI:10.1038/s41598-025-98517-8

Neurol Ther. 2025 Apr 20. doi: 10.1007/s40120-025-00735-9. Online ahead of print.

ABSTRACT

INTRODUCTION: Approximately 20% of patients with stroke are anemic, and previous studies have identified a U-shaped relationship between hemoglobin levels and all-cause mortality in stroke survivors. However, these studies have not specifically focused on patients with stroke taking antiplatelet agents. This study investigates the impact of anemia and hemoglobin (HGB) on mortality in this population.

METHODS: This study included 356 stroke survivors from the National Health and Nutrition Examination Survey 1999-2018 who were taking antiplatelet agents. It analyzed the impact of HGB levels and anemia on all-cause mortality using Cox regression, examined the nonlinear relationship between HGB and mortality through restricted cubic splines (RCS), and illustrated survival over time using Kaplan-Meier survival curves.

RESULTS: RCS analysis revealed no nonlinear relationship between HGB and all-cause mortality (P for overall < 0.01, P for nonlinear = 0.36), with lower HGB levels associated with an increased risk of all-cause mortality. Cox regression analysis showed that HGB was negatively associated with mortality risk across all models (Model 4: hazard ratio = 0.81, 95% confidence intervals 0.73-0.91, P < 0.01). Additionally, anemia significantly increased the risk of mortality in all models (Model 4: hazard ratio = 2.05, 95% confidence intervals 1.43-2.95, P < 0.01). Kaplan-Meier survival curves demonstrated that the survival rate in the anemic group was significantly lower than that of the non-anemic group (P < 0.01).

CONCLUSION: In stroke survivors taking antiplatelet agents, anemia is associated with an increased risk of all-cause mortality, while HGB levels are negatively correlated with mortality risk.

PMID:40254666 | DOI:10.1007/s40120-025-00735-9

Sci Rep. 2025 Apr 21;15(1):13657. doi: 10.1038/s41598-025-98111-y.

ABSTRACT

Accurate traffic sign recognition (TSR) is critical for enhancing the safety and reliability of autonomous driving systems. This study proposes an optimized YOLOv5-based framework to address challenges such as small-scale detection, environmental variability, and real-time processing constraints. Three key innovations are introduced: (1) k-means++ clustering for anchor box optimization, achieving a 77.55% average IoU (vs. 75.95% for traditional k-means) to enhance small-target detection; (2) comprehensive comparative analysis of YOLOv5 variants (s/m/x), revealing precision-speed trade-offs (99.3-99.5% [email protected] vs. 32-45 ms inference time) for deployment flexibility; and (3) systematic hyperparameter tuning to maximize robustness across diverse scenarios. Leveraging the CCTSDB dataset (13,830 annotated images), experiments demonstrate the framework’s superiority: it attains 98.1% mean average precision (mAP), 98.6% recall, and 99.3% precision, outperforming Faster-RCNN and SSD by 5-8% in mAP while maintaining 45 FPS throughput. The YOLOv5s variant achieves optimal balance with 99.3% [email protected] and 32 ms per-image inference, validated through rigorous statistical analysis (Tukey HSD). Robust performance in challenging conditions (e.g., small sample, backlit sample, foggy scenes) is evidenced by detection confidence exceeding 0.90. These results highlight the framework’s applicability in latency-sensitive intelligent transportation systems.

PMID:40254650 | DOI:10.1038/s41598-025-98111-y

Sci Rep. 2025 Apr 20;15(1):13631. doi: 10.1038/s41598-025-95699-z.

ABSTRACT

Tuberculosis (TB) is a significant global public health concern. The incidence of extrapulmonary tuberculosis (EPTB) is increasing; however, comprehensive data on its epidemiological and clinical characteristics remain limited, especially among populations who are co-infected with human immunodeficiency virus (HIV) or hepatitis C virus (HCV). This study aimed to assess the incidence and predictors of EPTB in patients co-infected with HIV or HCV in Egypt. We conducted a retrospective cohort study on patients infected with TB who are treated in Egyptian chest hospitals from January 1 to December 31, 2023. Patients were categorized into pulmonary TB (PTB) and EPTB. Clinical data, including HIV or HCV co-infection status, were analyzed to identify risk factors and comorbidities associated with EPTB. Multilevel logistic regression was employed to examine predictors of EPTB. Among 7,245 TB patients, 42.5% were diagnosed with EPTB. Determinant of EPTB were HIV-positive (OR = 0.46, 95% CI: 0.30-0.71, p < 0.001), being male (OR = 0.31, 95% CI: 0.27-0.35, p < 0.001 ), age (particularly children under 5 years) (OR = 4.75, 95% CI: 2.29-9.84, p < 0.001 ), urban residency (OR = 1.05, 95% CI: 0.87-1.27, p < 0.05), and comorbidities (OR = 0.59, 95% CI: 0.35-0.98, p < 0.05). The most common sites for EPTB were the lymph nodes (27.10%) and pleural cavity/effusion (24.60%). EPTB represents a substantial proportion of TB cases in Egypt, particularly among younger individuals and females. Despite the low percentage of HIV or HCV co-infection in EPTB cases, further analysis and diagnostic testing of undiagnosed patients are required. These findings underscore the need for targeted interventions and comprehensive care models for TB patients, especially in the context of HIV co-infection.

PMID:40254648 | DOI:10.1038/s41598-025-95699-z