Tag: statistics

Front Aging. 2025 Oct 23;6:1652588. doi: 10.3389/fragi.2025.1652588. eCollection 2025.

ABSTRACT

INTRODUCTION: As the global population ages, trauma among middle aged and older adults has become a significant public health concern, particularly in emergency care settings. In Saudi Arabia, the number of adults aged ≥50 years is steadily increasing, particularly in urban centers such as Jeddah, where multigenerational households and chronic health conditions influence injury patterns and healthcare utilization. Middle aged and older adults face higher rates of injury-related hospitalizations than younger populations, often exacerbated by physiological vulnerability and comorbid conditions. This retrospective study aimed to evaluate the sociodemographic factors, prevalent injury types, associated comorbidities, and clinical outcomes of middle aged and older adult’s patients presenting to the emergency department (ED) with trauma.

METHODS: A retrospective cohort study was conducted on patients aged ≥50 years who presented to the ED with trauma between January 2021 and December 2023. The assessed variables included sociodemographic data, injury severity, injury patterns, comorbidities, clinical management, and outcomes. Statistical analysis was performed using chi-square tests and logistic regression to identify the associations and predictors of surgical intervention.

RESULTS: A total of 248 middle aged and older adult patients with trauma were analyzed. Male patients sustained more severe injuries, with a statistically significant association between gender and injury severity (p = 0.028). No significant correlation was found between injury severity, age, and comorbidities. Logistic regression revealed that the mode of arrival and lower body injuries were significant predictors of surgical intervention (OR = 2.714, p = 0.046). Patients arriving by walk-in (OR = 7.560, p = 0.002) or personal vehicle (OR = 5.231, p = 0.006) were more likely to undergo surgery than those transported by ambulance. Surgical intervention was inversely associated with injury recurrence (OR = 0.214, p = 0.019), whereas the presence of comorbidities significantly increased the likelihood of surgical management (OR = 2.024, p = 0.031).

CONCLUSION: Middle aged and Older adult trauma patients represent a complex and vulnerable population in emergency care. Male gender, lower limb injuries, comorbidities, and non-ambulance transport modes are significant predictors of surgical intervention. Identifying these factors can guide early triage, optimize care, and inform preventive strategies to improve outcomes and reduce the healthcare burden.

PMID:41209421 | PMC:PMC12589095 | DOI:10.3389/fragi.2025.1652588

Lancet Reg Health West Pac. 2025 Oct 21;63:101706. doi: 10.1016/j.lanwpc.2025.101706. eCollection 2025 Oct.

ABSTRACT

BACKGROUND: Secondary education, and early marriage and childbirth are major determinants of health and wellbeing. We aimed to describe the long-term trends and inequalities of these three indicators in Chinese adolescents over three decades of dramatic social and economic change.

METHODS: Using data from Chinese population censuses and 1% population sample surveys from 1990 to 2020 (the most recent survey), we calculated the senior secondary school participation rate in 20-24-year-olds, the ever-married rate in 15-19-year-olds, and the age-specific fertility rate in 15-19 year-old females, by urban-rural location and province.

FINDINGS: In urban areas, the secondary school participation rate substantially increased, from 34.7% in 1990 to 82.4% in 2020 for females and from 38.7% to 77.0% for males. The participation rate in rural areas also greatly increased, from 5.0% in 1990 to 55.7% in 2020 for females and from 9.1% to 51.0% for males, but remained markedly lower than in urban areas at all time points. The ever-married rate decreased dramatically from 1990 to 2005, rebounded between 2005 and 2015, and then dropped so that the rate in 2020 was at a level comparable to that in 2005 (0.7% [95% CI 0.7-0.7] for urban females, 2.2% [2.1-2.2] for rural females, 0.2% [0.2-0.2] for urban males, and 0.5% [0.5-0.5] for rural males). In urban areas, the fertility rate decreased from 10.1 per 1000 in 1990 to 2.4 (2.3-2.4) per 1000 in 2000, but then largely stabilised between 2000 and 2020. For rural adolescents, the fertility rate also decreased dramatically from 25.9 per 1000 in 1990 to 8.5 (8.2-8.8) per 1000 in 2005. The fertility rate rebounded to 15.4 (14.9-15.9) per 1000 in 2015 and decreased to 12.5 (12.3-12.7) in 2020 in rural areas. These three indicators greatly varied by province in 2020, with more negative patterns in western provinces.

INTERPRETATION: China has seen dramatic changes in adolescent education, and early marriage and fertility over the past three decades but large inequities persist between urban-rural areas and by province. Government investments are needed to promote education in rural areas and western regions to promote more equitable health, development and wellbeing in Chinese adolescents.

FUNDING: National Nature Science Foundation of China.

PMID:41209392 | PMC:PMC12589909 | DOI:10.1016/j.lanwpc.2025.101706

J Inflamm Res. 2025 Nov 4;18:15283-15292. doi: 10.2147/JIR.S541842. eCollection 2025.

ABSTRACT

OBJECTIVE: To investigate the prognostic value of clinical and inflammatory markers predicting response to nivolumab in patients with metastatic non-small cell lung cancer (NSCLC).

MATERIALS AND METHODS: Clinical, demographic and laboratory data of stage 4 NSCLC patients who were treated between February 2021 and November 2024 were analyzed. Before nivolumab treatment, inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), prognostic nutritional index (PNI), hemoglobin-albumin-lymphocyte-platelet score (HALP), neutrophil-to-eosinophil ratio (NER) and C-reactive protein-to-albumin ratio (CAR) were calculated. Factors affecting overall survival (OS) were determined by Cox regression analysis, and ROC curve analysis was used to calculate the ideal cut-off.

RESULTS: The study included 229 NSCLC patients and the median age of the patients was 63 years. The majority were male (84.3%) and had right lung localization (56.8%). Median overall survival was calculated as 21.2 months (95% CI: 17.4-25.0). In univariate cox-regression analysis, the presence of brain metastases (HR: 2.08; p=0.004), liver metastases (HR: 1.85; p=0.014) and adrenal metastases (HR: 1.64; p=0.045) negatively affected the treatment response. Inflammatory markers such as high NLR (HR: 2.04; p<0.001), high SII (HR: 1.96; p<0.001), high CAR (HR: 1.84; p=0.001), high PLR (HR: 1.60; p=0.009) and high SIRI (HR: 1.51; p=0.021), low PNI (HR: 0.48; p<0.001), low HALP (HR: 0.49; p<0.001) and low LMR (HR: 0.65; p=0.016) were associated with poor prognosis. In multivariate analysis, the presence of brain metastasis (HR: 2.84; p<0.001), adrenal metastasis (HR: 1.64; p=0.046) and low PNI (HR: 0.44; p<0.001) together predicted poor prognosis and formed a statistical model on treatment response.

CONCLUSION: In patients with metastatic NSCLC, nivolumab treatment response is predicted by inflammatory markers and the presence of brain and adrenal metastases. It was concluded that low PNI among inflammatory markers is a strong prognostic indicator in this patient group.

PMID:41209385 | PMC:PMC12595935 | DOI:10.2147/JIR.S541842

AI Soc. 2025;40(7):5181-5194. doi: 10.1007/s00146-025-02272-3. Epub 2025 Mar 21.

ABSTRACT

The concept of alignment has undergone a remarkable rise in recent years to take center stage in the ethics of artificial intelligence. There are now numerous philosophical studies of the values that should be used in this ethical framework as well as a technical literature operationalizing these values in machine learning models. This article takes a step back to address a more basic set of critical questions: Where has the ethical imperative of alignment come from? What is the ethical logic of alignment-how, exactly, does it propose to regulate machines’ and peoples’ conduct? And what are the social and political implications of this ethics? After discussing the logical and normative implications of the term itself-in what sense alignment can have an ethical meaning-we undertake a four-part “anatomy” of alignment in contemporary large language models (LLMs): first, a relatively technical sense in sequence modeling; second, a more normative sense relating to how outputs of pre-trained models are ethically evaluated; a third sense where external values are introduced using fine-tuning techniques to manage undesired model behaviors; and fourth sense, where alignment is given extreme ethical stakes in philosophical discussions of existential risks. We find that the ethics of alignment is fundamentally concerned with the problem of control, with unintended model behaviors that arise from divergences between training objectives and the normative expectations that govern the contexts in which they are used. Alignment serves to bridge the gap between what we call an “is” normativity, of statistical patterns identified by models and an “ought” normativity where values are technically introduced in models to steer them away from undesired behaviors. By problematizing control, the ethics of alignment weakens capacities to both make more substantive ethical judgments and also political decisions about how to live with AI.

PMID:41209378 | PMC:PMC12594722 | DOI:10.1007/s00146-025-02272-3

Int J Exerc Sci. 2025 Nov 1;18(8):1175-1185. doi: 10.70252/HSMV3009. eCollection 2025.

ABSTRACT

This study explored how age affects postural stability (PS) in firefighters by focusing on two key objectives: 1) determining if age affects right-to-left anterior (ANT) reach distance asymmetry (ASYM) during the Motor Control Screen (MCS) test and 2) assessing whether the proportion of firefighters not meeting the greater than two-foot length (2FL) criterion for ANT reach differs across age groups. Data from 95 male firefighters were analyzed using the MCS ANT reach test, part of the Y-Balance Test (YBT). The key outcomes were the difference in ANT reach distances between legs (ASYM) and the proportion reaching less than or equal to 2FL. Statistical analyses used Mann-Whitney U tests for ASYM and chi-square tests for proportions. No statistical difference in ASYM was found between younger and middle-aged firefighters (U=1025, p=0.501, r=-.069). Similarly, the proportion of firefighters not meeting the greater than 2FL criterion did not significantly differ across age groups for both right and left ANT reaches (p= 0.997, ϕ=.000 for right and p= 0.547, ϕ=-.062 for left). These findings indicate that age does not significantly influence right-to-left ANT reach ASYM or the likelihood of failing to meet the greater than 2FL criterion in this firefighter population. The results suggest that PS, as measured by ANT reach ASYM and the greater than 2FL criterion, does not significantly decline with age among firefighters. This may be due to the physical demands of firefighting. Future research should explore how ANT reach measures relate to injury risk and evaluate age-specific balance training interventions.

PMID:41209371 | PMC:PMC12591606 | DOI:10.70252/HSMV3009

Int J Exerc Sci. 2025 Nov 1;18(8):1212-1227. doi: 10.70252/ERIN2946. eCollection 2025.

ABSTRACT

This study aimed to examine weekly variations and within-subject relationships between internal training intensity (ITI), perceived recovery (TQR), neuromuscular performance (CMJ), and perceived muscle soreness (PMS) during a four-week preseason period in professional soccer players. Twenty-three soccer players (age 24.8 ± 4.4 years; height 182 ± 7 cm; body mass 74.6 ± 6.7 kg) classified as Tier 3 athletes from the Croatian Second Soccer League were monitored using session rating of perceived exertion, TQR scales, countermovement jump tests, and PMS questionnaires. A significant reduction in ITI and concurrent improvement in TQR scores were observed across the preseason, with the highest intensity in week 1 and the lowest recovery in week 2. CMJ height performance declined during peak fatigue but rebounded as training intensity tapered. Repeated-measures correlations revealed negative associations between weekly ITI and TQR of the following week (r_rm = -0.72), and between ITI and CMJ (r_rm = -0.55), indicating that greater training intensities may impair both perceptual and neuromuscular recovery. The training stimulus-recovery difference index was positively associated with next-day TQR, suggesting it may serve as a sensitive marker of session-level readiness. These findings highlight the interplay between intensity, recovery, and fatigue, emphasizing the utility of low-cost subjective and objective tools for monitoring preseason responses and guiding individualized training strategies in elite soccer settings.

PMID:41209368 | PMC:PMC12591601 | DOI:10.70252/ERIN2946

J Alzheimers Dis Rep. 2025 Nov 6;9:25424823251395304. doi: 10.1177/25424823251395304. eCollection 2025 Jan-Dec.

ABSTRACT

BACKGROUND: The prevalence of Alzheimer’s disease or dementia is rising among the elderly population in the United States and globally. Sociodemographic, cancer, and neurological disorders are associated with cognitive impairment of people living in rural communities.

OBJECTIVE: This study identified the association of cognitive impairment with cancer and neurological disorders of the elderly in Cochran and Parmer Counties of rural West Texas.

METHODS: Pearson’s chi-squared, two-sample independent proportions, binary logistic regression, and multivariable logistic regression methods were utilized to analyze data.

RESULTS: Individuals aged 70 and above experiencing memory loss in Cochran and Parmer Counties had a statistically significant association with cognitive impairment (p < 0.001). In Parmer County, females diagnosed with breast cancer demonstrated a significant relationship with cognitive impairment (p < 0.05). Neurological factors, including muscle strength, cerebellar function, ability to rise from a chair, and Romberg test results, were significantly associated with an increased risk of cognitive impairments among females in both counties. After adjusting for covariates, males aged 60-69 in Parmer County, as well as memory loss among both genders, were significantly associated with cognitive impairment (p < 0.001). Additionally, females with cognitive impairment in Cochran County exhibited higher dependence on mental health services compared to males (p < 0.05).

CONCLUSIONS: Examining the association between cognitive impairment or Alzheimer’s disease and cancer and neurological disorders is important for developing interventions aimed at reducing their prevalence in underserved rural West Texas Counties.

PMID:41209366 | PMC:PMC12592674 | DOI:10.1177/25424823251395304

Resusc Plus. 2025 Oct 10;26:101127. doi: 10.1016/j.resplu.2025.101127. eCollection 2025 Nov.

ABSTRACT

BACKGROUND: In 2018 the prehospital Emergency Medical System (EMS) in Luxembourg underwent a major reorganization by the creation of a single EMS structure. We aimed to study the impact of this reorganization on outcome after out-of-hospital cardiac arrest (OHCA).

METHODS STUDY DESIGN: We conducted a before-and-after study on outcome after OHCA in Luxembourg taking advantage of the existing EuReCa studies protocols and case report forms. The first period extended from October 2017 to September 2018, and the second from September 2021 to August 2022.

SETTING: Nationwide observational database on OHCA.

PARTICIPANTS: All OHCA patients within the territory of the Grand Duchy of Luxembourg reported through an emergency call.

INTERVENTION: None.

MAIN OUTCOMES AND MEASURES: The primary outcome was the survival rate after OHCA. Secondary outcomes were rates of bystander and phone cardio-pulmonary resuscitation (CPR), return of spontaneous circulation (ROSC) rates and arrival times of EMS.

RESULTS: Over the 2 time periods, the incidence of OHCA emergency calls remained stable, whereas the confirmed OHCA increased from 236 to 375 cases per year. Bystander and phone CPR rates significantly increased, by 1.5 and 5-fold, respectively. EMS response time was significantly reduced (16:19 min vs 11:03 min, p < 0.001) and associated with significantly improved survival (OR per minute 0.83, 95 % CI 0.73-0.95). Hospital admission with ROSC increased non-significantly from 19 % to 24 % (p = 0.08) and 1-month survival increased significantly from 9 (3.8 %) to 37 survivors (9.8 %) (p = 0.006), corresponding to 28 additional lives saved within one year. No statistically significant difference could be shown on 1-month survival or ROSC rate when phone CPR or bystander CPR were performed.

CONCLUSION: Over 4 years, major structural and organizational EMS changes led to significantly shorter EMS response times and were accompanied by a significant increase of survival after OHCA. Whether other factors also have contributed to better survival remains unclear.

PMID:41209354 | PMC:PMC12593640 | DOI:10.1016/j.resplu.2025.101127

Front Netw Physiol. 2025 Oct 23;5:1664280. doi: 10.3389/fnetp.2025.1664280. eCollection 2025.

ABSTRACT

INTRODUCTION: In this work, we introduce a novel approach to one of the historically fundamental questions in neural networks: how to encode information? More particularly, we look at temporal coding in spiking networks, where the timing of a spike as opposed to the frequency, determines the information content. In contrast to previous temporal-coding schemes, which rely on the statistical properties of populations of neurons and connections, we employ a novel synaptic plasticity mechanism that allows the timing to be learnt at the single-synapse level.

METHODS: Using a formal basis from information theory, we show how a phase-coded spike train (relative to some ‘reference’ phase) can, in fact, multiplex multiple different information signals onto the same spike train, significantly improving overall information capacity. We furthermore derive limits on the channel capacity in the phase-coded spiking case, and show that the learning rule also has a continuous derivative in the input-output relation, making it potentially amenable to classical learning rules from artificial neural networks such as backpropagation.

RESULTS: Using a simple demonstration network, we show the multiplexing of different signals onto the same connection, and demonstrate that different synapses indeed can adapt using this learning rule, to specialise to different interspike intervals (i.e., phase relationships). The overall approach allows for denser encoding, and thus energy efficiency, in neural networks for complex tasks, allowing smaller and more compact networks to achieve combinations of tasks which traditionally would have required high-dimensional embeddings.

DISCUSSION: Although carried out as a study in computational spiking neural networks, the results may have insights for functional neuroscience, and suggest links to mechanisms that have been shown from neuroscientific studies to support temporal coding. To the best of our knowledge, this is the first study to solve one of the outstanding problems in spiking neural networks: to demonstrate that distinct temporal codings can be distinguished through synaptic learning.

PMID:41209333 | PMC:PMC12589081 | DOI:10.3389/fnetp.2025.1664280

Front Bioeng Biotechnol. 2025 Oct 23;13:1653208. doi: 10.3389/fbioe.2025.1653208. eCollection 2025.

ABSTRACT

BACKGROUND: Return to sports following total hip arthroplasty (THA) is important to an increasingly younger and active clientele. However, knowledge about in vivo joint forces during sports is scarce and often only estimated. As skiing is controversially debated as an activity following THA, we measured in vivo joint loads in instrumented THAs during cross-country ski simulation.

METHODS: Five untrained subjects who had previously received instrumented THAs were instructed to perform double poling and diagonal poling exercises on a ski simulator and to walk on a treadmill at 4 km/h as a reference exercise. The joint contact force, bending moment, and torsion torque on the implant were determined. Time-load patterns were generated. Loading peaks were compared intra-and inter-individually to walking. Statistical parameter mapping was used to visualise significant differences between exercises across the movement cycle.

RESULTS: Loading maxima were mostly lower or adjacent to loading maxima of walking, except for diagonal poling with foot lift. Differences in execution of double poling resulted in different time-load patterns of torsion torque. Diagonal bending moments exceeded walking bending moments slightly. Outliers were observed.

CONCLUSION: Double or diagonal poling can be safely practiced by THA patients on a ski simulator in the late postoperative period due to mostly lower or adjacent loading forces to walking. Unilateral standing phases should be minimized. Patient’s experience and bone quality affect recommendation of this sport. Limitations concern limited generalizability of small cohort and simulated environment.

PMID:41209304 | PMC:PMC12589080 | DOI:10.3389/fbioe.2025.1653208