Tag: statistics

Brain Behav. 2025 Oct;15(10):e70958. doi: 10.1002/brb3.70958.

ABSTRACT

OBJECTIVE: To develop and validate a machine learning (ML)-based predictive model for intensive care unit (ICU) readmission in patients with cerebral infarction using neurophysiological and clinical data from the MIMIC-IV database.

METHODS: A retrospective cohort of 3,348 patients diagnosed with cerebral infarction was identified from the MIMIC-IV database. Feature selection was conducted using the least absolute shrinkage and selection operator (LASSO) regression, followed by multivariable logistic regression analysis. Various ML models, including Decision Tree, K-Nearest Neighbors, LightGBM, Naïve Bayes, Random Forest, Support Vector Machine, and XGBoost, were developed and evaluated based on model performance metrics.

RESULTS: The logistic regression model achieved the highest area under the receiver operating characteristic curve (AUC) of 0.682 (95% CI: 0.630-0.733). Significant predictors of ICU readmission included peptic ulcer disease, glucocorticoid use, potassium levels, and red blood cell count.

CONCLUSIONS: This study demonstrates that ML models can effectively predict ICU readmission in CI patients. Logistic regression provides a clinically interpretable approach for risk stratification.

PMID:41076549 | DOI:10.1002/brb3.70958

J Health Popul Nutr. 2025 Oct 11;44(1):357. doi: 10.1186/s41043-025-00945-9.

ABSTRACT

BACKGROUND: Global health risk factors contribute significantly to mortality and morbidity worldwide, with diverse impacts across socio-economic groups. This study developed a composite index for health risk factors and subdomains, including nutrition, environmental risks, and non-communicable diseases, across 100 countries stratified by human development index (HDI) from 2015 to 2019. The index tracks disparities, trends, and associations with human development, aiding in resource allocation and informed policy-making for reducing health risks and improving global health outcomes.

METHODS: A panel dataset comprising 100 countries, categorized into four HDI groups, was analyzed for the period 2015 to 2019. Health indicators were selected to construct a Health Risk Factors Index based on the World Health Organization’s Global Reference List 2018. The development of the composite index and its sub-domains followed the United Nations Development Programme’s methodology for data normalization, utilized Principal Component Analysis to determine weights, and employed the inverse normalized Euclidean distance formula for aggregation. Spearman’s rank correlation was used to examine the relationships between the composite Health Risk Factors Index, its sub-indices, and the HDI.

RESULTS: The study revealed that very high HDI countries excelled in the Health Risk Factors Index and sub-indices for nutrition and environmental risks, indicating lower health risks. While low and medium HDI groups performed better in the non-communicable diseases index. Singapore achieved the highest health risk factors index scores in 2015 and 2019. A strong positive correlation was observed between HDI with composite and sub-indices of health risk factors and a negative correlation with sub-index of noncommunicable disease during 2015-2019.

CONCLUSION: The study highlights significant disparities in health risk factors across HDI groups, underscoring the need for tailored interventions. In general, very high and high HDI countries require focused efforts on noncommunicable disease-related health risk factors, while low and medium HDI countries should prioritize nutrition and environmental risks. Composite indices like the health risk factor index facilitate benchmarking and policy development, promoting accountability and targeted strategies for global health improvement.

PMID:41076528 | DOI:10.1186/s41043-025-00945-9

BMC Pulm Med. 2025 Oct 11;25(1):466. doi: 10.1186/s12890-025-03860-1.

ABSTRACT

BACKGROUND: Pulmonary eosinophilic syndromes (PES) are a heterogeneous group of respiratory disorders characterized by eosinophilic infiltration of lung tissues and/or elevated eosinophil counts in peripheral blood. Accurate diagnosis and understanding of PES are crucial for effective management, especially in underrepresented regions such as Saudi Arabia.

OBJECTIVES: To evaluate the clinical, radiological, and biomarker profiles of PES in a Saudi Arabian cohort and to identify factors associated with disease presentation and severity.

METHODS: This retrospective case-control study included 95 patients diagnosed with PES at Mouwasat Hospital, Jubail, Eastern Province, Saudi Arabia, from January 2023 to January 2024. Clinical data, laboratory findings (including eosinophil counts, IgE, and FeNO levels), pulmonary function tests, and radiological imaging were analyzed. Statistical analysis was performed using SPSS, with descriptive and inferential methods to assess associations.

RESULTS: The cohort had a mean age of 40.5 ± 12.9 years, with a majority being male (65.3%) and Saudi nationals (87%). Elevated eosinophil counts and FeNO levels were significantly associated with PES (p < 0.05). Patients exhibited characteristic radiological patterns such as ground-glass opacities and consolidations. Pulmonary function tests showed reduced FEV₁ and small airway impairment in cases versus controls (p = 0.027). The study observed strong correlations between eosinophilia, airway obstruction, and higher BMI. Smoking was associated with increased symptom severity.

CONCLUSIONS: The study underscores the distinct clinical, radiological, and biomarker features of PES in the included population. Integrating multi-modal assessments can improve diagnostic accuracy. These findings emphasize the importance of standardized pathways for PES diagnosis, especially in regions with potential underdiagnosis, and highlight the need for increased awareness among healthcare professionals.

PMID:41076527 | DOI:10.1186/s12890-025-03860-1

BMC Oral Health. 2025 Oct 11;25(1):1602. doi: 10.1186/s12903-025-06825-2.

ABSTRACT

BACKGROUND: Participation in decision-making is crucial for patients with malocclusion. It is important to assess the extent to which patients are actively involved in such decision-making. Therefore, this study developed an instrument that evaluates patient participation in treatment decision-making among adults with malocclusion and tested its reliability and validity.

METHODS: A cross-sectional instrument-development methodological approach was adopted. Guided by the concept of participation and shared decision-making theory, an initial scale was developed through literature analysis, qualitative interviews, expert evaluation, and a pre-survey. From September to December 2023, 257 patients from three tertiary general hospitals in Shanghai were selected for a questionnaire survey, item analysis, and exploratory factor analysis. From January to May 2024, 269 patients from these hospitals were selected to conduct a questionnaire survey for confirmatory factor analysis and criterion-related validity.

RESULTS: The final scale included 21 items across three dimensions. The Cronbach’s α coefficient was 0.953; split-half reliability, test-retest reliability, and the scale level content validity index were 0.957, 0.885, and 0.926 respectively. The correlation coefficients between each dimension and the total score of the scale and SDM-9 scores were 0.590-0.650 (P < 0.05). Exploratory factor analysis extracted three common factors; the Kaiser-Meyer-Olkin value was 0.974 and the Bartlett’s sphericity test χ² value was 5652.33 (P < 0.001); the cumulative variance explained was 60.920%. The fit indices of the scale model tested in the confirmatory factor analysis were as follows: χ²/df = 1.059, RMR = 0.033, GFI = 0.936, CFI = 0.968, TLI = 0.964, NFI = 0.641, RMSEA = 0.015. Confirmatory factor analysis revealed that the scale’s factor structure was stable.

CONCLUSIONS: This instrument is a reliable and valid measurement tool for assessing adult patients’ level of participation in decision-making regarding treatment for malocclusion.

PMID:41076522 | DOI:10.1186/s12903-025-06825-2

Arch Sex Behav. 2025 Oct 11. doi: 10.1007/s10508-025-03242-y. Online ahead of print.

ABSTRACT

Prior research has shown that women tend to be more responsive to infant cues than men. However, the influence of different aspects of social gender, like gender norms associated with femininity and masculinity, on individual responses to infant cues, has received no attention to date. This study is the first to investigate how gender roles, conceptualized as continuous traits of femininity and masculinity, are associated with electrophysiological responses to facial stimuli from infants and adults. Electroencephalography was used to record the neural activity of 60 nonparent adults (50% women) while they completed an emotion recognition task displaying infant and adult faces expressing happy, neutral, or sad emotions. Participants also completed an Italian translation of the Bem Sex Role Inventory to assess levels of femininity and masculinity. Results showed that higher levels of femininity were statistically significantly associated with a larger N170 amplitude in response to infant faces. This finding indicates that individuals who adhere more to sociocultural roles associated with femininity exhibit enhanced perceptual processing of infant faces at a very early stage. Our evidence underscores the potential contribution of cultural norms associated with gender to infant cue processing and highlights the need to consider different aspects of social gender in research in this area.

PMID:41076502 | DOI:10.1007/s10508-025-03242-y

Eur J Pediatr. 2025 Oct 12;184(11):679. doi: 10.1007/s00431-025-06516-8.

ABSTRACT

Despite vaccination advances, childhood meningitis remains a major global threat, disproportionately affecting low- and middle-income countries (LMICs). This study analyzes its burden trends from 1990 to 2021, with a focus on LMICs. Using data from the Global Burden of Disease Study 2021, we estimated mortality and disability-adjusted life years (DALYs) for children aged 0-14 years across 117 countries and territories grouped by low, low-middle, and middle Sociodemographic Index (SDI). Temporal trends were assessed with estimated annual percentage change (EAPC). We examined correlations between SDI and disease burden and applied decomposition analysis to attribute deaths and DALYs changes to aging, population growth, and epidemiological shifts. Frontier analysis was used to evaluate health system efficiency relative to SDI. Between 1990 and 2021, childhood meningitis deaths decreased in LMICs. Nevertheless, these regions accounted for 98.5% of global deaths in 2021, with low-SDI regions alone responsible for 61.0%. Streptococcus pneumoniae and Neisseria meningitidis were the leading pathogens. The disease burden was strongly inversely correlated with SDI, highlighting the key role of socioeconomic development. Decomposition analysis showed that in low-SDI regions, epidemiological improvements contributed substantially to mortality reduction (+ 513.02%), but were largely offset by population growth (- 417.38%), yielding only a modest net reduction. Frontier analysis revealed major health system inefficiencies in certain low-SDI countries, such as South Sudan and Nigeria.

CONCLUSION: The concentrated burden of childhood meningitis in LMICs calls for context-specific strategies. Health system inefficiencies and rapid population growth threaten to offset intervention gains. Precision public health approaches that combine targeted vaccination, health system strengthening, and socioeconomic development are essential to reduce inequities and achieve global control goals.

WHAT IS KNOWN: • Childhood meningitis remains a leading infectious cause of mortality and long-term disability globally, with the highest burden concentrated in low-income regions. • Significant progress has been made in vaccine development, leading to declines in mortality globally; yet implementation and coverage gaps persist in resource-limited settings.

WHAT IS NEW: • Decomposition analysis quantifies for the first time how rapid population growth in low-SDI regions nearly cancels out the benefits of epidemiological improvements, whereas middle-SDI regions achieved reductions almost solely through epidemiological progress. • Frontier analysis identifies profound health system inefficiencies in specific low-SDI countries (e.g., South Sudan, Nigeria), where observed mortality and DALYs rates are higher than the optimum achievable given their SDI level.

PMID:41076501 | DOI:10.1007/s00431-025-06516-8

Ann Biomed Eng. 2025 Oct 11. doi: 10.1007/s10439-025-03861-5. Online ahead of print.

ABSTRACT

PURPOSE: Emerging technologies to improve transbronchial sampling of lung lesions include mobile C-arm cone-beam CT (CBCT) and robotic assistance. Surgical Process Modeling (SPM) was used to quantify performance in such procedures performed using a conventional bronchoscope with guidance via 2D fluoroscopy and radial probe endobronchial ultrasound (RP-EBUS) (“Conventional Bronchoscopy”) compared to robot-assisted bronchoscopy with CBCT guidance (“CBCT-Guided RAB”).

METHOD: Statistical SPMs were implemented for Conventional Bronchoscopy and CBCT-Guided RAB for simulation and analysis of procedural outcomes, including cycle time, radiation dose, and geometric accuracy. The SPMs were parameterized and validated with respect to clinical observation, published literature, and expert input. 9000 simulation runs were computed for each method, analyzing differences in performance and evaluating the influence of body mass index (BMI), lesion location (upper, middle, or lower lobe), and lesion size.

RESULTS: The SPMs exhibited reasonable agreement with retrospective clinical evaluation of cycle time and dose, and variations in geometric accuracy were consistent with clinical literature. CBCT-Guided RAB resulted in a 14% increase in median cycle time (45.3 min) compared to Conventional Bronchoscopy (39.6 min) and increased median dose to the patient by 3.2 × (41.6 Gy cm² compared to 12.9 Gy cm²). Geometric targeting improved with CBCT-Guided RAB, reducing the rate of geometric miss from 22% under Conventional Bronchoscopy to 2%. 3D visualization of individual runs gave clear depiction of median and outlier performance and a basis for communicating and standardizing complex workflows.

CONCLUSIONS: SPMs yielded quantitative performance comparison in lung lesion biopsy by conventional and robot-assisted bronchoscopy. The approach quantified increases in cycle time and dose for CBCT-Guided RAB, accompanied by substantial gains in geometric accuracy. Such modeling provided valuable insight on the benefits of emerging technologies at early stages of implementation and a means to optimize and standardize clinical workflow.

PMID:41076493 | DOI:10.1007/s10439-025-03861-5

Eur J Orthop Surg Traumatol. 2025 Oct 11;35(1):431. doi: 10.1007/s00590-025-04518-8.

ABSTRACT

OBJECTIVE: This retrospective study aimed to compare the safety and cost-effectiveness of intramedullary fixation versus plate fixation in patients with rib fractures. Each technique was performed at a separate hospital center.

METHODS: We retrospectively reviewed consecutive patients who underwent surgical fixation for rib fractures from February 2021 to January 2024. Eligible patients had fractures meeting surgical criteria and were treated with either intramedullary or plate fixation. Intraoperative parameters, postoperative outcomes, and costs were compared between the two groups.

RESULTS: A total of 89 patients were included, with 45 receiving intramedullary fixation and 44 receiving plate fixation. Baseline characteristics were similar between the groups. Intraoperative and postoperative outcomes-including operative time, hospital stay, drain removal, complications, healing rates, and pain scores-were comparable. Notably, intramedullary fixation was significantly less expensive than plate fixation.

CONCLUSION: Intramedullary fixation offers similar safety and efficacy to plate fixation for rib fractures while providing a clear cost advantage, suggesting potential economic benefits for healthcare systems.

PMID:41076490 | DOI:10.1007/s00590-025-04518-8

Eur J Pediatr. 2025 Oct 11;184(11):677. doi: 10.1007/s00431-025-06511-z.

ABSTRACT

The respiratory management of neonates with hypoxic-ischemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH) is a challenging issue, but remains poorly standardized. The aim of this study was to describe current practice regarding respiratory management, particularly tracheal intubation, in neonates undergoing TH in France and French-speaking Belgium. In this binational cross-sectional study, current practices about respiratory management were collected by an online-based survey sent to all tertiary neonatal intensive care units providing TH in France and French-speaking Belgium. Practices were analyzed to assess their heterogeneity and compared between centers that routinely intubate for TH and those that did not. The survey was completed by 57/68 (84%) centers. Routine intubation during TH was reported by 33 (58%) centers. Motivations behind routine intubation during TH included concerns about pain, discomfort, and neuroprotection. Among the 24 other centers, there was significant heterogeneity in the respiratory care of patients, while practices regarding sedation-analgesia appeared more consensual. The country was the only characteristic independently associated with routine intubation during TH (France vs Belgium: OR = 9.333, 95% CI 1.035-84.202, p = 0.047).

CONCLUSION: Respiratory management of neonates with HIE undergoing TH is highly heterogeneous. Most centers routinely intubate neonates undergoing TH, especially in France. These findings highlight the need for more evidence-based studies and guidelines to optimize respiratory care during TH.

WHAT IS KNOWN: • For neonates with hypoxic-ischemic encephalopathy, evidence to guide respiratory management during therapeutic hypothermia remains scarce. • Yet, ventilation is a crucial aspect of the neuroprotective management of these neonates.

WHAT IS NEW: • This binational survey reveals that most centers routinely intubate neonates undergoing therapeutic hypothermia. • Our findings also suggest significant heterogeneity and may help to design future studies.

PMID:41076488 | DOI:10.1007/s00431-025-06511-z

Environ Monit Assess. 2025 Oct 11;197(11):1198. doi: 10.1007/s10661-025-14644-9.

ABSTRACT

Understanding spatial and temporal patterns of river water quality over a multi-year period is crucial for effective basin management and pollution control. This study applies functional data analysis (FDA) to evaluate monthly water quality index (WQI) data from 16 monitoring stations across the Klang River Basin, Malaysia, covering the period from 2020 to 2023, which spans both pre- and post-pandemic conditions. By treating water quality index (WQI) measurements as smooth functions over time, FDA captures underlying trends and variations that are not readily detected using classical statistical techniques. Functional principal component analysis (FPCA) reveals that the first component accounts for 97% of the total variation, reflecting the dominant pattern in water quality over time, which is characterized by relatively stable upstream conditions and gradual deterioration downstream. The second and third components capture seasonal fluctuations and short-term disturbances, potentially linked to monsoonal cycles and shifts in human activities during the pandemic. Functional clustering based on FPCA scores groups stations according to their temporal behavior, distinguishing upstream areas with stable conditions from downstream areas experiencing greater variability. Spatial interpretation of these clusters offers additional insight into localized pollution sources and environmental stressors. Compared to classical PCA, FDA provides a more detailed, curve-based understanding of time-dependent and location-specific changes in water quality. The result underscore the value of FDA in environmental monitoring, particularly for detecting pre- and post-pandemic shifts, and support its application in guiding adaptive and spatially targeted management strategies for river basins.

PMID:41076480 | DOI:10.1007/s10661-025-14644-9