Category: Statistics

Virol J. 2025 Nov 7;22(1):366. doi: 10.1186/s12985-025-02985-3.

ABSTRACT

BACKGROUND: Although the annual number of newly reported human immunodeficiency virus (HIV) infections in Beijing has shown a continuous decline since 2016, the population of people living with HIV (PLWH) has maintained a persistent upward trend. This retrospective study aimed to analyse data from newly diagnosed PLWH from 2015 to 2023 in Beijing to develop precision interventions.

METHODS: All newly diagnosed PLWH were subjected to sequence splicing, quality control, information matching, and analysis for pretreatment drug resistance (PDR) and molecular transmission network. The Stanford Drug Resistance Database was used to analyse drug resistance, and Hyphy and Cytoscape software were used to construct a molecular transmission network with the gene distance threshold of 0.015.

RESULTS: A total of 3,569 newly diagnosed PLWH were included in this study. A total of 42 HIV-1 subtypes were identified, with CRF01_AE being the most common subtype, followed by the CRF07_BC and B subtypes. However, for the first time, the dominant strain shifted from CRF01_AE to CRF07_BC in 2023. A total of 340 drug-resistant sequences were obtained, and the overall prevalence of PDR was 9.53% from 2015 to 2023. The most common mutations were distributed among V179, K103, M184, S68 and M46, which presented diverse distributions and combined mutation features. A total of 64 transmission clusters were identified in the network, among which CRF07_BC was dominated by large spreading clusters, whereas CRF01_AE was dominated by small- and medium-sized spreading clusters. The largest cluster for CRF07_BC expanded rapidly from 8 cases in 2015 to 161 cases in 2023.

CONCLUSIONS: This study revealed the prevalence of HIV-1 drug resistance and molecular transmission network in Beijing. The change in the dominant HIV strain of participants should be emphasized. Subtype CRF07_BC is prone to forming fast-spreading clusters, and targeted interventions should be designed to prevent high-risk transmission sources and reduce new HIV infections.

PMID:41204314 | DOI:10.1186/s12985-025-02985-3

World J Surg Oncol. 2025 Nov 7;23(1):421. doi: 10.1186/s12957-025-04079-4.

ABSTRACT

BACKGROUND: Although several studies have suggested that sarcopenia is associated with adverse outcomes in kidney cancer patients undergoing nephrectomy, the results have been inconsistent. Therefore, this meta-analysis was conducted to investigate the relationship between sarcopenia and post-nephrectomy survival in kidney cancer patients.

METHODS: A thorough search was executed across multiple databases, including MEDLINE, Embase, and the Cochrane Library, to identify pertinent studies up to August, 2025. By employing random/fixed effects models, we calculated multivariate-adjusted hazard ratios (HRs) accompanied by their respective 95% confidence intervals (CIs), in strict compliance with the guidelines delineated in the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement.

RESULTS: A total of thirteen studies encompassing 3,142 patients who underwent nephrectomy fulfilled the inclusion criteria. Regarding the thirteen aggregated multivariate estimates, sarcopenia was found to be associated with reduced OS (HR = 1.63, 95% CI: 1.25-2.01) and CSS (HR = 1.93, 95% CI: 1.40-2.45). Nevertheless, our findings suggest that sarcopenia is not correlated with inferior PFS in kidney cancer patients post-nephrectomy (HR = 1.17; 95% CI: 0.92-1.41). The robustness of these findings is substantiated by sensitivity and meta-regression analyses.

CONCLUSIONS: Sarcopenia has been demonstrated to be independently correlated with inferior OS and CSS in individuals who have undergone nephrectomy for kidney carcinoma. These empirical observations highlight the critical necessity of sarcopenia evaluation in the context of risk stratification, patient advisement, and therapeutic strategy formulation.

PMID:41204305 | DOI:10.1186/s12957-025-04079-4

Nutr Metab (Lond). 2025 Nov 7;22(1):134. doi: 10.1186/s12986-025-01028-6.

ABSTRACT

BACKGROUND: Overweight and obesity are widespread in Mexico, often linked to dyslipidemia and higher cardiovascular risk. The search for safe and effective treatments has promoted interest in natural supplements such as Ashwagandha (Withania somnifera), recognized for its adaptogenic and potential lipid-lowering properties.

OBJECTIVE: To assess the impact of Ashwagandha supplementation on serum lipid profiles and anthropometric parameters in Mexican adults with overweight and obesity.

METHODS: A double-blind, randomized, placebo-controlled pilot clinical trial was carried out with 43 adults (n = 17 in the control group and n = 21 in the intervention group) over 40 days. Participants followed a monitored diet and received one daily capsule containing 500 mg of Ashwagandha or a placebo, in addition to a guided unrestricted dietary plan. Anthropometric and biochemical measurements were taken at baseline and after the intervention. In silico analysis was also performed to examine the binding affinity of Ashwagandha bioactive compounds to key proteins involved in lipid metabolism.

RESULTS: Ashwagandha supplementation did not produce statistically significant changes in body weight, body mass index (BMI), or waist circumference (WC). However, significant reductions were observed in triglyceride and VLDL-c levels (p = 0.0082 and p = 0.0321, respectively). In silico results supported these findings, showing favorable interactions between compounds such as withanolide A and lipid metabolism targets, including AMPK, CETP, and LPL.

CONCLUSIONS: Ashwagandha supplementation improved serum lipid profiles in adults with overweight and obesity, suggesting potential lipid-lowering effects when combined with a prescribed dietary plan. Also, it was possible to elucidate some metabolic pathways in which Ashwagandha composition has an influence on producing the reported effects. Further long-term studies with controlled dietary intake are needed to confirm these findings and clarify the underlying molecular mechanisms.

PMID:41204297 | DOI:10.1186/s12986-025-01028-6

Popul Health Metr. 2025 Nov 7;23(1):62. doi: 10.1186/s12963-025-00425-6.

ABSTRACT

BACKGROUND: The disability weight quantifies the severity of health states from diseases and injuries. It is a fundamental index to estimate the disability-adjusted life year in the Global Burden of Disease studies. Disability weight estimates have been shown to vary across different national populations, suggesting the influence of cultural differences. However, survey data of disability weights in the Global Burden of Disease study is still limited worldwide.

OBJECTIVES: To more accurately reflect the true health conditions of global populations, this study aims to systematically summarize the disability weight values from international authoritative surveys, and explore the influential factors of disability weight estimates.

METHODS: Based on the Global Burden of Disease study, surveys used paired comparison questions wherein respondents considered two hypothetical individuals with different health states and specified which person was healthier. This study comprehensively searched multiple databases, including PubMed, Web of Science, Science Direct, and Google Scholar. We identified disability weight studies that utilized the paired comparison method and were conducted in national populations, published in international peer-reviewed journals. A meta-regression analysis was conducted to estimate the overall summary effect of disability weight values for 235 unique health states. These health states were estimated for all non-fatal consequences of disease and injury, including infectious diseases, cancer, cardiovascular diseases, diabetes, chronic respiratory diseases, neurological disorders, mental, behavior, and substance use disorders, hearing and vision loss, musculoskeletal diseases, injuries and others. Heterogeneity was assessed using the I² statistics. Univariate meta-regression analysis was conducted to explore the impact of age, sex, education, population composition, and survey regions, respectively, on the summarized effect of each health state.

RESULTS: The total analysis sample consisted of 610,818 respondents from the Global Burden of Disease 2013 disability weight surveys, the Japanese disability weight survey, and the Chinese disability weight survey. The summarized disability weights of health states ranged from mild anaemia (summarized disability weight = 0.008, 95% uncertainty interval 0.001-0.016, I² = 0.95) to heroin and other opioid dependence (moderate to severe) (summarized disability weight = 0.737, 0.651-0.823, I² = 0.823). Pearson correlation analysis showed that high correlation was observed between the set of overall summary disability weights of 235 health states from this meta-analysis and those from all included disability weight studies (all Pearson’s r > 0.9, P < 0.001). Univariate meta-regression analysis indicated that age, sex, education level, panel composition of survey populations, and the survey regions were associated with the summarized disability weights of some health states.

CONCLUSIONS: The overall summary of disability weights obtained from this meta-analysis is reliable. This study indicates that respondents’ sociodemographic characteristics may impact a population’s preference for health states, which should be considered in future disability weight assessments.

PMID:41204294 | DOI:10.1186/s12963-025-00425-6

Malar J. 2025 Nov 7;24(1):383. doi: 10.1186/s12936-025-05601-5.

ABSTRACT

BACKGROUND: Malaria remains a major health concern in Nigeria. Rapid diagnostic tests (RDTs) are widely used in health facilities to confirm malaria before treatment. However, concerns remain about healthcare workers (HCWs) adherence to, and reporting of test results. This study assessed the accuracy of RDT results recorded in health facility registers in two states of Nigeria by comparing them with an unbiased reference standard and explored factors influencing interrater agreement.

METHODS: A mixed-method evaluation was conducted in 16 health facilities across Oyo and Sokoto States. RDTs performed by HCWs were photographed using a digital RDT reader and independently re-interpreted by a trained, independent, objective panel. Surveys of health facilities and HCWs collected data on factors that could influence RDT recording. Interrater agreement between RDT results recorded by HCWs in facility registers and the external panel was assessed using Cohen’s kappa. A meta-analytical approach was used to calculate a pooled summary kappa value across facilities, and potential moderators of agreement were examined, including characteristics of facilities, HCWs and RDTs.

RESULTS: Out of 19,586 RDTs captured, 18,319 were included in the analysis. Overall, 6.2% of RDTs were misrecorded as positive and 3.7% as negative in health facility registers, yielding a positive predictive value of 87.2% (95% confidence interval [CI] 86.4%, 87.8%) and negative predictive value of 92.9%. The overall percentage agreement was 90.2% (95% CI 89.7%, 90.6%), and the pooled kappa statistic was 0.80 (95% CI 0.75, 0.85), indicating strong agreement. However, kappa values varied substantially across facilities (range: 0.59, 0.92). Lower agreement was observed in facilities in Sokoto State and in areas with lower malaria prevalence and test positivity. Faint test lines, found in 8.8% of RDTs, were associated with a significantly increased likelihood of results misrecorded as negative. HCWs were more likely to misrecord RDT results as positive when a malaria diagnosis or antimalarial prescription had been made.

CONCLUSION: While overall agreement between facility registers and panel-interpreted RDT results was strong, the proportion of results misrecorded as positive and negative highlight the need for improved training, supportive supervision, and mechanisms to promote accurate RDT interpretation and recording. Targeted interventions are essential to ensure the reliability of routine malaria data and support national control efforts.

PMID:41204290 | DOI:10.1186/s12936-025-05601-5

J Transl Med. 2025 Nov 7;23(1):1244. doi: 10.1186/s12967-025-07251-2.

ABSTRACT

BACKGROUND: As key metabolic regulators, the roles of GDF15 and FGF21 in mediating the effects of modified ketogenic diet (MKD) on weight loss and lipoprotein remodeling in obese patients require further investigation.

PATIENTS AND METHODS: This study enrolled 30 metabolically healthy obese participants (BMI ≥ 28 kg/m²) for a 2-week MKD intervention. Using a self-controlled pre-post design, we performed measurements including body composition analysis, fasting serum GDF15 and FGF21 levels measurement, and serum lipoprotein subclass quantification at both baseline and post-intervention time points.

RESULTS: Following a 2-week MKD intervention, participants exhibited statistically significant reductions in body weight (96.14 ± 27.23 kg vs. 91.63 ± 26.47 kg; Δ4.8%, P < 0.001) and BMI (33.99 ± 6.08 kg/m² vs. 32.41 ± 5.95 kg/m²; Δ4.7%, P < 0.001). Body fat parameters significantly improved, with body fat mass (BFM) and visceral fat area (VFA) decreasing by > 5%. Meanwhile, lean mass indices (SMM, SLM, FFM) remained stable (change < 3%). Serum biomarker analysis revealed that GDF15 levels increased significantly by 5.76% (P = 0.0377), whereas FGF21 levels decreased markedly by 51.91% (P = 0.0001). The apolipoprotein B/A1 ratio (t = 5.381, P < 0.001) and the LDL-c/HDL-c ratio (t = 5.095, P < 0.001) increased significantly. Furthermore, larger HDL-c subfractions (H1FC/H2FC) showed an upward trend, while smaller HDL-c subfractions (H3FC/H4FC) exhibited a downward trend. Among these changes, H2FC levels demonstrated the most pronounced elevation (t = 6.119, P < 0.001).

CONCLUSION: The short-term MKD intervention significantly improved adiposity metrics while elevating GDF15 and reducing FGF21 levels. These rapid metabolic adaptations induced potentially beneficial remodeling of HDL-c subclasses, highlighting novel effects beyond conventional lipid ratios.

TRIAL REGISTRATION: ChiCTR, ChiCTR2300071823. Registered 25 May 2023 – Prospective Registered, https://www.chictr.org.cn/bin/project/edit?pid=198176 .

PMID:41204286 | DOI:10.1186/s12967-025-07251-2

Malar J. 2025 Nov 7;24(1):384. doi: 10.1186/s12936-025-05625-x.

ABSTRACT

BACKGROUND: Despite increased malaria interventions, the Upper River Region of The Gambia still faces a higher malaria burden compared to other parts of the country. This issue may be related to the population’s knowledge of malaria, as well as environmental and socioeconomic factors that influence their prevention and treatment choices. Therefore, this study focused on assessing the level of malaria knowledge, perceptions, and attitudes among the residents of the Upper River Region, as limited studies have been conducted across the region’s seven districts.

METHODS: To achieve the study’s objectives, a descriptive research survey using a parallel mixed method was adopted, with a robust multistage sampling approach for selecting 381 household heads involved in the quantitative study, 31 key informants, and 7 focus group discussions for the qualitative study. Descriptive statistics were performed on the assessed variables using StataSE18, and the association of socio-demographic factors with malaria prevalence was analyzed using Chi-square (Χ2). Thematic analysis was conducted for the qualitative part using NVivo.

RESULTS: The results indicate a very high level of knowledge of basic malaria concepts, with a percentage index of 81. There is a statistically significant influence from factors such as district, number of health centers in the region, gender, distance to the health centre, and occupation, all at < 5%. Using a treated bed net was the most effective prevention tool, while hospital visits and herbs remain the main treatment options among the population. The trend of malaria infection shows a general decrease across most communities, although a few still experience an increase over the year. Malaria profile data reveal an 87% reduction in cases for individuals above 5 years old and a 45% reduction for those under five. Additionally, mortality rates have decreased by 98% and 89%, respectively, over the 12 years (2011-2023).

DISCUSSION AND CONCLUSION: This study examined knowledge, perception, and attitudes toward malaria prevention and treatment. Results showed a high level of understanding of basic malaria concepts among the population, which influenced their perceptions and fostered a positive attitude toward managing and preventing the infection. However, differences in knowledge levels exist across districts, along with some contradictions in perceptions and attitudes. An overall decline in malaria cases has been observed across the districts and communities in the region, with a few exceptions. These findings are expected to inform the national malaria prevention efforts and assist policymakers in planning the next steps for the malaria elimination campaign.

PMID:41204275 | DOI:10.1186/s12936-025-05625-x

Malar J. 2025 Nov 7;24(1):385. doi: 10.1186/s12936-025-05537-w.

ABSTRACT

BACKGROUND: Intermittent preventive treatment of malaria in pregnancy (IPTp-SP) is an important strategy for preventing malaria in pregnant women and their unborn children. Ghana has adopted IPTp-SP as part of its National Malaria Control Programme, but its uptake remains suboptimal. This study examined the association between adequacy of antenatal care (ANC) and the uptake of at least three doses of IPTp-SP.

METHODS: This cross-sectional study utilized data from the 2022 Ghana Demographic and Health Survey (n = 3692). The adequacy of ANC was assessed based on the receipt of the recommended number of ANC visits, the timing of the first ANC visit, receipt of all components of ANC, and receipt of ANC from a skilled provider. Descriptive statistics and multivariable regression analyses were performed.

RESULTS: Overall, the uptake of at least three doses of IPTp-SP was 61.3%. Approximately 39.2% of participants had at least 8 ANC visits, 63.6% had their first ANC visit within the first trimester, 75.4% reported receiving all components of ANC and 95.5% received ANC from a skilled provider. In the multivariable model, the odds of receiving at least three doses of IPTp-SP were higher among those who had eight or more ANC visits 1.50 (1.18, 1.90; p = 0.001), who had their first ANC visit within the first trimester 1.74 (1.44, 2.09; p < 0.001), and those who received all components of ANC 1.62 (1.29, 2.03; p < 0.001).

CONCLUSIONS: Receipt of adequate ANC services is positively associated with the uptake of at least three doses of IPTp-SP. This association is independent of potential confounders. These findings highlight the need for targeted interventions to improve access to and the quality of ANC services, thereby increasing the uptake of IPTp-SP during pregnancy.

PMID:41204273 | DOI:10.1186/s12936-025-05537-w

Trop Med Health. 2025 Nov 7;53(1):155. doi: 10.1186/s41182-025-00831-4.

ABSTRACT

BACKGROUND: Female Anopheles mosquitoes are the primary vectors for malaria transmission within communities, significantly contributing to the high burden of malaria in Africa overall and Uganda specifically. Many tropical plants have insect-repellent properties and have traditionally been used in their native regions to prevent mosquito bites.

METHODS: A cross-sectional ethnobotanical survey was conducted between January 2025 and May 2025 in five districts of the West Nile Subregion: Adjumani, Moyo, Madi-Okollo, Pakwach, and Obongi. Semi-structured questionnaires were used to collect data on indigenous knowledge about mosquito repellents from 57 respondents, who were selected through purposive and snowball sampling techniques. The ethnobotanical data were analyzed using descriptive statistics, the informant consensus factor, and preference ranking.

RESULTS: A total of 42 plant species from 40 genera and 25 families were documented as being used to repel mosquitoes. The plants most commonly used for this purpose were: Azadirachta indica A.Juss. (9), Boswellia papyrifera (Caill.) (7), Aeschynomene americana L. (6), Mesosphaerum suaveolens (L.) Kuntze. (6), and Ocimum gratissimum L. (5). The most common indigenous method for repelling mosquitoes involves burning either dry cow dung (32%) or dry goat droppings (20%). Most of the plant species belong to the families Fabaceae (10), Lamiaceae (4), and Asteraceae (3). The majority of the plant species used were trees (43%) and herbs (42%), with leaves (42%) and seeds (12%) being the most frequently used plant parts. Except for Cymbopogon citratus (DC.) Stapf and M. suaveolens, which are used as live plants for repelling mosquitoes, all other plant species used were prepared by burning or smoking indoors.

CONCLUSIONS: Communities in the West Nile Subregion, especially those living along the River Nile, possess rich indigenous knowledge and practices used to repel mosquitoes in their efforts to control deadly malaria.

PMID:41204263 | DOI:10.1186/s41182-025-00831-4

BMC Sports Sci Med Rehabil. 2025 Nov 7;17(1):322. doi: 10.1186/s13102-025-01333-w.

ABSTRACT

BACKGROUND: Chronic ankle instability (CAI) is associated with balance disorders and functional deficits in soccer players. Impaired gluteal muscle function contributes significantly to these issues, as these muscles play a crucial role in maintaining lower limb stability and balance. This study aimed to evaluate the effects of Kinesio-taping (KT) on the electromyographic (EMG) activity of gluteal muscles, ankle function, and dynamic balance in male soccer players with CAI.

METHODS: In this randomized clinical trial, 30 male soccer players with CAI were randomly assigned to either the gluteal KT group (case) or the sham control group. Gluteal EMG activity, onset time, ankle function (Single-Leg Hop Test), and dynamic balance (modified Star Excursion Balance Test, mSEBT) were assessed pre-taping, immediately post-taping, and 48 h later.

RESULTS: The case group demonstrated significant increases in gluteus medius EMG activity (P < 0.05) and reductions in gluteus maximus onset time (P < 0.05) at both immediate and 48-hour follow-ups. Statistically significant improvements were also observed in single-leg hop distance (P = 0.001) and dynamic balance (P < 0.05) in the KT group compared to the control group. However, changes did not consistently meet minimal clinically important difference (MCID) thresholds for the mSEBT (4-5 cm per direction) or single-leg hop test (8-10 cm).

CONCLUSION: KT enhances gluteus medius activation, reduces gluteus maximus onset time, and improves ankle function and dynamic balance in soccer players with CAI. While statistically significant, the observed improvements may require integration with other rehabilitation strategies to achieve clinically meaningful outcomes. Future studies should explore long-term effects, diverse populations, and combined interventions to optimize functional gains.

TRIAL REGISTRATION: IRCT2015021015932N10, Date of registration: 04/11/2015.

PMID:41204260 | DOI:10.1186/s13102-025-01333-w