Category: Statistics

Emerg Microbes Infect. 2025 Nov 26:2595793. doi: 10.1080/22221751.2025.2595793. Online ahead of print.

ABSTRACT

Integrase strand transfer inhibitors (INSTIs) have emerged as cornerstone agents in global antiretroviral therapy, though growing drug resistance presents clinical challenges. Conventional Sanger sequencing may underestimate the burden of low-frequency variants. This global meta-analysis systematically assesses the actual INSTI resistance burden among people living with HIV (PLWH) through deep sequencing technology. Our comprehensive search across Web of Science, PubMed, Cochrane Library, Embase, and Scopus (PROSPERO ID: CRD42023495535) identified studies utilizing deep sequencing for HIV integrase resistance detection. Through meta-analysis and individual participant data (IPD) analysis using HIVdb (v9.8), we differentiated pretreatment (PDR) and acquired (ADR) drug resistance, quantifying mutation rates, resistance rates, and missed detection across thresholds (above-threshold, high-frequency, low-frequency). The analysis incorporated 40 studies with 46 datapoints involving 10,778 patients. Treatment-naïve PLWH demonstrated above-threshold, high-frequency, and low-frequency mutation rates of 9.92%, 7.29%, and 5.88%, respectively, corresponding to resistance rates of 2.60%, 0.09%, and 3.90%. Treated patients showed elevated mutation rates of 19.02%, 16.64%, and 10.23%, with resistance rates reaching 16.10%, 8.67%, and 6.95%. IPD analysis of 394 mutation-positive individuals revealed 8.52% low-frequency resistance to dolutegravir and bictegravir in treatment-naïve populations, while treated patients exhibited significantly increased intermediate/high-level resistance to first-generation INSTIs, including raltegravir and elvitegravir. Conventional sequencing thresholds missed 3.61% pretreatment and 2.46% acquired drug resistance. These findings demonstrate that deep sequencing reveals substantially underestimated INSTI resistance burdens in PLWH. Although second-generation INSTIs maintain lower resistance rates, cross-resistance risks necessitate clinical vigilance. Optimized resistance surveillance strategies incorporating low-frequency mutation detection offer critical evidence for advancing global HIV control efforts.

PMID:41293884 | DOI:10.1080/22221751.2025.2595793

Zhejiang Da Xue Xue Bao Yi Xue Ban. 2025 Nov 22:1-9. doi: 10.3724/zdxbyxb-2025-0146. Online ahead of print.

ABSTRACT

OBJECTIVES: To analyze the distribution of Y chromosome azoospermia factor (AZF) microdeletions and their association with testicular development in male pediatric patients with congenital reproductive system disorders, including hypospadias, cryptorchidism, and disorders of sex development (DSD).

METHODS: A prospective cohort study was conducted on pediatric patients admitted to the Department of Urology of Shanghai Children’s Hospital from November 2021 to December 2023. The observation group included boys with hypospadias, cryptorchidism, or DSD, while the control group comprised boys with phimosis, indirect inguinal hernia, or hydrocele. Blood samples were collected for AZF microdeletion analysis using multiplex PCR to detect 15 sequence-tagged sites. Testicular ultrasound was performed to record testicular position and volume. Propensity score matching (PSM) was used to balance the groups. After matching, testicular volume differences were assessed. Stratified analyses compared testicular volume among children with AZF microdeletions, the control group, and children without micro-deletions in observation group.

RESULTS: A total of 493 children were enrolled (observation group: 463; control group: 30). No Y chromosome microdeletions were detected in the control group. Four boys in the observation group had AZF microdeletions: one with cryptorchidism (AZFc+AZFd), one with isolated hypospadias (AZFc), and two with DSD (one with AZFb+AZFc+AZFd and one with AZFa). Ultrasonography measured 888 testicles. After PSM, testicular volume was significantly smaller in the observation group than in the control group (P<0.01). Stratified analysis revealed that among children under 9 years, those with AZF microdeletions tended to be older but had smaller testicular volumes compared to the control group and those without microdeletions in the observation group, although differences were not statistically significant (all P>0.05). Among children over 9 years, ages were comparable, but children with AZF microdeletions had smaller testicular volumes than the other two groups (statistical analysis was not performed due to small sample size).

CONCLUSIONS: The prevalence of Y chromosome microdeletions is higher in male children with congenital reproductive system disorders compared to the general population, particularly in those with DSD. Hypospadias, cryptorchidism, DSD, and AZF microdeletions may be associated with delayed testicular development in these children.

PMID:41293882 | DOI:10.3724/zdxbyxb-2025-0146

J Bronchology Interv Pulmonol. 2025 Nov 26;33(1):e1046. doi: 10.1097/LBR.0000000000001046. eCollection 2026 Jan 1.

ABSTRACT

BACKGROUND: Malignant pleural effusion (MPE) adversely impacts quality of life (QOL), carrying a significant health care burden and inpatient mortality. We hypothesize that multi-specialty management leads to nonstandardized approaches resulting in fragmented, inefficient and costly care. We aimed to design, implement, and evaluate a system-wide clinical pathway for MPE management to streamline care, reduce emergency visits, hospitalizations, pleural interventions and improve cost efficiency.

METHODS: We conducted a single-center study evaluating outcomes before and after pathway implementation. The pathway was developed through a multidisciplinary team (interventional pulmonology, thoracic surgery, oncology, emergency medicine, hospital medicine, and nurse navigation) using survey-driven gap analysis. Standardized workflows were integrated into the electronic medical record (EMR) system to enable early identification, direct triage, and expedited ambulatory pleural procedures. Pathway variations were tailored for inpatient, outpatient oncology, primary care, and surgical referrals. Patients were divided into 3 groups: a prepathway control cohort, an early postpathway cohort 1, and a late postpathway cohort 2 to assess both immediate and sustained impacts.

RESULTS: Implementation of the MPE pathway significantly reduced ER visits (control vs. cohort 1: 80 vs. 43, P = 0.0051; cohort 1 vs. cohort 2: 43 vs. 25, P = 0.028) and hospitalizations (71 vs. 37, P = 0.0046; 37 vs. 21, P = 0.021). Cost analysis showed average savings of $1145 per patient in direct variable ER and inpatient costs. The pathway also reduced pleural procedures and specialist involvement.

CONCLUSION: Centralized, protocolized care for MPE improves outcomes, reduces health care utilization and generates cost savings. Broader adoption may enhance QOL and efficiency in patients with advanced malignancies.

PMID:41293869 | DOI:10.1097/LBR.0000000000001046

J Endourol. 2025 Nov 24. doi: 10.1177/08927790251400302. Online ahead of print.

ABSTRACT

Background: The flexible and navigable suction sheath (FANS) is designed for the effective treatment of renal stones of various sizes. This study aimed to assess and compare the safety and postoperative outcomes at 30 days following FANS treatment for stones smaller and larger than 20 mm. Materials and Methods: From January to December 2024, patients undergoing retrograde intrarenal surgery performed with FANS were prospectively recruited and divided into two groups based on stone diameter (Group 1: DMAX <20 mm, Group 2: DMAX ≥20 mm). Baseline, perioperative, and follow-up characteristics were analyzed. Stone-free rate (SFR) was evaluated with a non-contrast CT scan at 1-month. Statistical analysis was performed using the unpaired Student’s t-test and chi-squared test with Yates’ correction. Results: A total of 140 patients were enrolled, with 77 having stones <20 mm and 63 having stones ≥20 mm. While a significant difference in stone diameters was observed, no discrepancies were noted regarding the mean stone density between the two groups, thus minimizing the potential for bias. No major Clavien-Dindo complications occurred in either group without differences in hospital length of stay, but Group 1 reported lower visual analogue scale pain. No significant differences in Grade A, B, and C SFR (all p > 0.05) and re-intervention (p = 0.58) were observed, suggesting similar efficacy for both stone sizes. Conclusions: This study demonstrates that the FANS as a valuable tool for enhancing patient safety and outcomes in managing larger stones, achieving adequate SFR, and reducing the need for re-intervention without major complications. In the future, FANS may effectively change the indications for stone’s treatment according to diameter.

PMID:41293857 | DOI:10.1177/08927790251400302

J Mater Chem B. 2025 Nov 26. doi: 10.1039/d5tb01945a. Online ahead of print.

ABSTRACT

In this work, we have developed hierarchically porous phosphate-based glasses (PPGs) as novel materials capable of promoting wound closure and simultaneously delivering antibacterial effects at the glass-biological tissue interface. PPGs are characterised by extended porosity, which enhances the controlled release of therapeutic ions, whilst facilitating cell infiltration and tissue growth. Two series of PPGs in the systems P₂O₅-CaO-Na₂O-CuO and P₂O₅-CaO-Na₂O-Ga₂O₃ with (CuO and Ga₂O₃ 0, 1, 5 and 10 mol%) were manufactured using a supramolecular sol-gel synthesis strategy. Significant wound healing promotion (up to 97%) was demonstrated using a human ex vivo wound model. A statistically significant reduction of the bacterial strains Staphylococcus aureus and Escherichia coli was observed in both series of PPGs, particularly those containing copper. All PPGs exhibited good cytocompatibility on keratinocytes (HaCaTs), and analysis of PPG dissolution products over a 7-day period demonstrated controlled release of phosphate anions and Ca, Na, Cu, and Ga cations. These findings indicate that Cu- and Ga-loaded PPGs are promising materials for applications in soft tissue regeneration given their antibacterial capabilities, in vitro biocompatibility with keratinocytes and ex vivo wound healing properties at the biomaterial-human tissue interface.

PMID:41293853 | DOI:10.1039/d5tb01945a

Respir Care. 2025 Nov 24. doi: 10.1177/19433654251391770. Online ahead of print.

ABSTRACT

Background: Breathing frequency is a sensitive indicator of a neonate patient’s condition and a crucial parameter in the neonatal ICU (NICU). However, conventional methods require sensors to be adhered to the newborn’s sensitive skin. This study assesses a noncontact respiratory monitor, using linear frequency modulation continuous wave radar, to determine the monitor’s accuracy when used in the NICU setting. Methods: An observational study was conducted on the noncontact respiration module produced by Mindray, connected to a BeneVisionN12 patient monitor. This unit collected data on breathing frequency; at the same time, the patient breathing frequency was also being measured using a CO₂ monitor (accepted standard). Statistical analyses were performed to assess the agreement between the 2 measurements and to assess whether this noncontact monitor is sufficiently accurate for clinical use. Results: 20 neonatal patients at 2 NICUs were enrolled in the study. The mean bias between the radar-derived and CO₂-derived breathing frequency was -0.29 bpm (95% CI: -0.53 to -0.04); root-mean-square error was 2.60 bpm; concordance correlation coefficient was 0.98; and Pearson correlation coefficient was 0.98. Subgroup analyses grouped by body weight show that the technology has particularly high accuracy and clinical utility for neonates with low body weight (<1.5 kg). Conclusions: The noncontact respiration monitoring technology and module developed by Mindray showed a high degree of agreement with the CO₂ reference standard and met the standard of accuracy required for clinical use.

PMID:41293852 | DOI:10.1177/19433654251391770

J Cosmet Dermatol. 2025 Dec;24(12):e70556. doi: 10.1111/jocd.70556.

ABSTRACT

BACKGROUND: Regenerating Skin Nectar with TriHex+ Technology (Nectar 2.0; Alastin Skincare Inc., Carlsbad, CA) is a next-generation anhydrous serum reformulated with Octapeptide-45 to improve skin healing and hydration. Clinical trials and case studies assessed the safety, effectiveness, and patient satisfaction of Nectar 2.0 across various aesthetic procedures, including nonablative and ablative laser treatments, as well as microcoring technology.

METHODS: A multimodal clinical approach was used, including a randomized, double-blind, split-face study for nonablative laser procedures, an in-use study assessing skin barrier function and hydration, and case studies for ablative laser and Ellacor microcoring treatments. Investigator and subject assessments, standardized photography, and bioinstrumentation measurements (TEWL and Corneometry) were utilized to evaluate outcomes.

RESULTS: Nectar 2.0 showed superior outcomes in reducing edema and enhancing tactile roughness and fine lines in nonablative laser procedures. In ablative and microcoring treatments, faster healing, less crusting, and decreased exudation were noted, along with higher patient satisfaction compared to the control. Bioinstrumentation confirmed statistically significant improvements in skin barrier recovery and hydration over 14 days. The product was well tolerated.

CONCLUSION: Regenerating Skin Nectar with TriHex+ Technology Serum (Alastin Skincare Inc., Carlsbad, CA) has proven to be a safe and effective periprocedural skincare solution that enhances healing, improves skin quality, and increases patient satisfaction across various aesthetic procedures. Its benefits are especially significant in deeper treatments, supporting its widespread use in clinical practice.

PMID:41293824 | DOI:10.1111/jocd.70556

Behav Med. 2025 Nov 26:1-14. doi: 10.1080/08964289.2025.2590430. Online ahead of print.

ABSTRACT

Young adults attending vocational education and training schools often engage in various health risk factors, including poor dietary habits. School canteens are key settings that can promote students’ healthy food choices. This study aims to enhance the skills of vocational school canteen staff in preparing healthy food, student-centered communication, and meal presentation. A mixed-methods approach incorporated participatory action research and grounded theory (GT) analysis. The participants included 17 staff members, aged 21 to 60 years, working at three canteens that serve 557 students. Over eight months, four workshops were conducted, with staff engaging in exploratory actions between sessions to enhance student interaction and create healthy meals accommodating student preferences. Data collected from observations, field notes, and interviews were analyzed using GT, while survey data on student meal preferences were described statistically. A one-week choice architecture intervention was implemented in one canteen, and receipt data were collected to assess the impact of the new meal presentations and assessed using binomial logistic regression. The GT analysis identified the core category: “A dialogical hospitality approach facilitates reassurance.” The workshops enhanced the staff’s skills in healthy food preparation, incorporating student preferences and boosting their confidence in employing a hospitality-based dialogical approach, reassuring students to make healthy food choices. The choice architecture intervention led to a significant increase in the sales of healthy meals. This study highlights the importance of involving staff in targeted training through participatory methods to promote students’ healthier food options in vocational school settings.

PMID:41293805 | DOI:10.1080/08964289.2025.2590430

Community Dent Health. 2025 Nov 26:265539X251400580. doi: 10.1177/0265539X251400580. Online ahead of print.

ABSTRACT

Background: Oral pathology (e.g. caries, periodontal disease, edentulism) contributes to poor overall health and negatively impacts quality of life. Ageing increases susceptibility to oral diseases and poor oral health is common among older adults. In contrast, dental attendance is low among this group. This descriptive study aims to examine dental utilisation patterns among older adults in Flanders, Belgium. Methods: The study included all members from the two largest Belgian healthcare insurance funds aged 65 and older, residing in Flanders (Belgium). Descriptive and bivariate analyses were performed with dental utilisation patterns as main outcome and socio-demographic data, care dependency and oral status as covariates. Statistical analysis was performed using chi-square tests, with effect sizes calculated using Cramér’s V. Results: Data from 911,159 older adults were analysed. Between 2020 and 2022, preventive care was regularly received by 36.8% of the participants, 37.0% had no contact with an oral health professional and 21.9% only received curative care. Lower utilisation of preventive care was observed in the following groups: the oldest-old (Cramér’s V = 0.136), individuals having an increased reimbursement (Cramér’s V = 0.171), residents of long-term care facilities (Cramér’s V = 0.090), recipients of domiciliary nursing care (Cramér’s V = 0.121), and edentulous older adults (Cramér’s V = 0.362). Conclusion: A significant proportion of older adults did not attend a dentist or only received curative care. Further research is needed to investigate whether health promotion campaigns and enhanced collaboration among health professionals can motivate these older adults to engage in preventive oral care.

PMID:41293800 | DOI:10.1177/0265539X251400580

OTJR (Thorofare N J). 2025 Nov 26:15394492251391678. doi: 10.1177/15394492251391678. Online ahead of print.

ABSTRACT

Chronic pain may impede occupational participation in older adults, but links among mobility, social networks, cognitive function, and pain-related factors remain unclear. To examine the relationships among these factors in relation to occupational participation in community-dwelling older Japanese adults. In this cross-sectional study, 130 adults more than 60 answered questions about occupational participation, mobility, social networks, cognitive function, and pain. Exploratory factor analysis was used to extract latent variables representing key constructs. These were incorporated into structural equation modeling to examine their associations with occupational participation. Latent factors combining mobility and social networks (standardized coefficient: 0.75), and cognitive functions (0.35), were directly and positively associated with occupational participation, while pain-related factors were strongly negatively correlated with mobility/social networks (-0.79, -0.73) but showed no direct association with participation. Interventions addressing both physical and social function and pain-related barriers may support occupational participation in older adults.

PMID:41293790 | DOI:10.1177/15394492251391678