Category: Statistics

Virus Evol. 2025 May 20;11(1):veaf048. doi: 10.1093/ve/veaf048. eCollection 2025.

ABSTRACT

The evolution of HIV-1 virulence has significant implications for epidemic control. Recent phylogenomic analyses identified low-prevalence HIV-1 variants exhibiting significant differences in disease progression. We analysed 40 888 partial HIV-1 pol sequences from the UK HIV Drug Resistance Database (UKRDB) across subtypes B, C, A1, and CRF02AG. We identified phylotypes with putative differences in transmission/phylogenetic patterns and assessed their virulence trends using pretreatment viral loads, CD4 cell counts, and four statistical methods. We classified three subtype B phylotypes-PT.B.40.UK, PT.B.69.UK, and PT.B.133.UK -as variants of interest (VOIs) due to significantly higher viral loads and/or accelerated CD4 decline. PT.B.40.UK and PT.B.69.UK exhibited higher viral loads, 4.93 log₁₀ copies/ml (95% CI: 4.73-5.13) and 4.87 (4.65-5.10), representing 0.30-0.36 log₁₀ copies/ml higher than the reference group (4.57; 4.55-4.59). Despite uncertainties in baseline CD4 counts, all three VOIs reached the clinically relevant threshold of 350 CD4 cells/mm³ significantly faster than the reference group (3.5 years, 3.1-3.9 years): 2.3 years (1.0-5.1) for PT.B.40.UK, 2.0 years (10.8 months-4.4 years) for PT.B.69.UK, and 1.8 years (10.8 months-3.6 years) for PT.B.133.UK. These VOIs and their closest relatives have been circulating in the UK for decades with limited international spread and did not exhibit unusually rapid growth rates. Although these findings suggest a heritable high-virulence HIV-1 phenotype, we did not find evidence that convergent genetic polymorphisms or switches in coreceptor usage explained these differences. The small fraction of HIV-1 subtype B variants in the UK evolving towards higher virulence is unlikely to pose a public health concern, given the ongoing decline in new HIV diagnoses following the widespread adoption of pre-exposure prophylaxis and targeted prevention campaigns. However, this study-alongside the detection of the VB variant in the Netherlands-demonstrates that more virulent variants are not rare and can emerge independently in multiple countries. Consequently, HIV-1 genomic surveillance remains crucial to monitor HIV-1 virulence and mitigate its healthcare impact.

PMID:40662162 | PMC:PMC12257091 | DOI:10.1093/ve/veaf048

Curr Med Mycol. 2024 Dec 31;10:e2024.345311.1585. doi: 10.22034/cmm.2024.345311.1585. eCollection 2024.

ABSTRACT

BACKGROUND AND PURPOSE: Candida albicans is currently recognised as an opportunistic pathogen that can cause many invasive infections. Resistance mechanisms and fungal virulence factors play an important role in the effectiveness of treatment. The aim of this study was to investigate the relationship between fluconazole resistance, proteinase activity and ERG11 (sterol 14-demethylase)- SAP2 (secreted aspartic protease 2) gene expression levels in C.albicans strains.

MATERIALS AND METHODS: Candida albicans strains isolated from patient samples sent to Medical Microbiology laboratory of Düzce University from various clinics were included in the study. Fluconazole susceptibilities of the isolates were determined by broth microdilution method. The increase in fluconazole MIC values at 48 hours and proteinase activities of the isolates were analysed. ERG11 and SAP2 gene expression levels were measured by real time qPCR.

RESULTS: Fluconazole resistance rate was found to be 3.14% in 127 C. albicans strains. A moderate positive correlation was found between ERG11 and SAP2 values (p=0.029, r:0.655, p<0.001). There was no correlation between SAP2/ERG11 expression levels and fluconazole resistance. Proteinase positivity was detected in 81.1%, of 127 strains and no statistically significant correlation was found between proteinase activities and SAP2/ERG11 expression levels. While there was a statistically significant relationship between ERG11 expression levels and 48th hour MIC elevation, there was no statistically significant relationship between SAP2 levels and 48th hour MIC elevation.

CONCLUSION: In addition to the moderate positive correlation between ERG11 and SAP2 values, a significant correlation was found between ERG11 expression and fluconazole tolerance.

PMID:40662151 | PMC:PMC12257049 | DOI:10.22034/cmm.2024.345311.1585

Curr Med Mycol. 2024 Dec 31;10:e2024.345299.1579. doi: 10.22034/cmm.2024.345299.1579. eCollection 2024.

ABSTRACT

BACKGROUND AND PURPOSE: Today, with the development of critical patient care and the increase in intravascular invasive methods, the survival rate of patients diagnosed with hematological and solid organ malignancies is increasing, and unfortunately, the incidence of Candida parapsilosis candidemia is also increasing due to multiple risk factors. In this study, we aimed to determine the clinical-demographic characteristics of C. parapsilosis candidemia and the antifungal susceptibility profile of C. parapsilosis in pediatric patients with hematological and solid organ malignancies.

MATERIALS AND METHODS: The present study included pediatric patients with hematologic and solid organ malignancies presenting with signs and symptoms consistent with candidemia, in whom C. parapsilosis was isolated from blood and catheter cultures between January 2010 and August 2023.

RESULTS: Thirty (65.2%) of the patients had hematologic and 16 (34.8%) had solid organ malignancies. In all patients, 23 (50%) had non-catheter-related candidemia and 23 (50%) had catheter-related candidemia. At least one of the risk factors examined was detected in these patients. Catheter-related candidemia was found to be more common in patients diagnosed with hematologic malignancy. The difference was found to be statistically significant (p= 0.030). Drug resistance rates of C. parapsilosis were 6.5% for amphotericin B, 6.5% for fluconazole, 2.2% for voriconazole and 2.2% for micafungin. No patient with caspofungin resistance was detected. The mean treatment duration of the patients was 21 days (min 3-max 103) and it was observed that amphotericin B and caspofungin were used most frequently in the treatment regimen. The mortality rate of patients with candidemia was 6.5%.

CONCLUSION: Our study showed that patients with hematologic malignancies exhibited a higher susceptibility to catheter-related C. parapsilosis candidemia compared to patients with solid organ tumors. Caspofungin resistance was not detected in our study, and we believe that each center should know its own antifungal drug sensitivity, determine the treatment regimen accordingly, and that catheters should be removed rapidly in patients with catheter-related C. parapsilosis candidemia in malignant patients.

PMID:40662149 | PMC:PMC12257050 | DOI:10.22034/cmm.2024.345299.1579

Front Glob Womens Health. 2025 Jun 30;6:1599842. doi: 10.3389/fgwh.2025.1599842. eCollection 2025.

ABSTRACT

BACKGROUND: Anemia in pregnancy impacts the well-being of the women and the conception. Anemia is associated with increased risks of maternal mortality. In Ethiopia, three in ten pregnant women were affected by either mild, moderate, or severe anemia. The recent evidence was limited in the study locations of southern Ethiopia and needs to be updated. No report of anemia as relation to dietary factors observed in the region. This study therefore aimed to assess factors associated with anemia in pregnancy in the region.

METHODS: A multicenter, cross-sectional study was conducted from January 2 to 30, 2025, in five selected public health facilities in Arba Minch district, South Ethiopia.

RESULTS: A total of 476 (96%) respondents had participated in the survey. Explanatory variables were modeled in logistic regression to test for statistical associations at a P value of <0.05. The study participants were in the age range of 18 to 40 years. Of the respondents who completed the survey, 103 (21.6%, 95%CI 18.2-25.6%) were diagnosed as anemic. Participants who received iron-folic acid during the current pregnancy were 66% less likely to be anemic, AOR (95% CI), 0.34 (0.19, 0.61). Participants with high education status, sleeping under insecticide-treated bed nets (ITN), not being infected with malaria in the current pregnancy, and age category between 20-29 years were less likely to experience anemia in pregnancy. Evidence was limited to support association of women dietary diversity score (WDDS) and anemia in pregnancy, AOR (95%CI), 0.83 (0.49, 1.40).

CONCLUSIONS AND RECOMMENDATIONS: Anemia prevalence was a moderate public health problem in the study area. Healthcare workers should encourage antenatal women to receive iron and sleep under insecticide-treated bed nets (ITN) for anemia protection during pregnancy.

PMID:40662142 | PMC:PMC12256233 | DOI:10.3389/fgwh.2025.1599842

Front Cardiovasc Med. 2025 Jun 30;12:1612027. doi: 10.3389/fcvm.2025.1612027. eCollection 2025.

ABSTRACT

BACKGROUND: Patients with heart failure face a significantly elevated risk of cognitive impairment, yet clinical recognition remains inadequate-particularly among younger individuals and those with mild symptoms, leading to frequent underdiagnosis. The increasing prevalence among younger patients further worsens prognosis. This study aims to develop a tool to aid clinicians in the early identification of high-risk individuals and support informed clinical decision-making.

METHODS: Based on evidence-based literature and biopsychosocial holistic model of cardiovascular health, this study included 320 patients with heart failure hospitalized in the Second Hospital of Hebei Medical University from October 2023 to April 2024 to construct the model, and 80 patients from May to July 2024 were selected for temporal validation. MoCA was used to evaluate cognitive function. LASSO regression was used to select variables, Logistic regression was used to construct a nomogram model, and Bootstrap method (1,000 times) was used to evaluate the discrimination, calibration and clinical applicability of the model.

RESULTS: The incidence of cognitive impairment was 68.75% in the model group and 56.25% in the validation group. Finally, five variables including age, education level, coronary heart disease, cardiac diastolic function and physical frailty were included. The AUC of internal and temporal validation of the model were 80.2% and 72.44%, respectively, which had good prediction performance.

CONCLUSION: The calibration curve and decision curve of the model showed a high degree of fit, which had strong clinical practicability. This model provides a reliable tool for early identification of cognitive impairment in patients with heart failure.

PMID:40662139 | PMC:PMC12256441 | DOI:10.3389/fcvm.2025.1612027

Front Cardiovasc Med. 2025 Jun 30;12:1457554. doi: 10.3389/fcvm.2025.1457554. eCollection 2025.

ABSTRACT

OBJECTIVE: Compare the clinical efficacy of a minimally invasive small incision in the right axilla vs. traditional median sternotomy in the surgical treatment of tetralogy of Fallot (TOF).

METHODS: A retrospective analysis was conducted on 330 infants and young children under the age of 3 who underwent radical surgery for tetralogy of Fallot between March 2022 and March 2024. Patients were categorized into two groups based on the surgical approach. To ensure the consistency of preoperative baseline data (weight, gender, age, O₂ saturation, main pulmonary artery and pulmonary branches diameter, McGoon ratio) between the two groups, the propensity score matching method was applied for 1:1 matching, resulting in two cohorts of 228 cases. The minimally invasive group (n = 114) received surgery through a small incision in the right axilla, while the median sternotomy group (n = 114) underwent surgery via median sternotomy. Clinical parameters including demographic data (weight, gender, age, O₂ saturation, main pulmonary artery and pulmonary branches diameter, McGoon ratio), cardiopulmonary bypass metrics (duration of bypass, aortic cross-clamp time), duration of mechanical ventilation, intensive care unit (ICU) stay, postoperative chest drainage volume within 24 h, pulmonary valve regurgitation, and complications (reintubation, peritoneal dialysis, reoperation, extracorporeal membrane oxygenation (ECMO) use, infection, and mortality) were collected for comparison between groups.

RESULTS: No statistically significant differences were observed between the two groups in 24 h chest drainage volume, mortality, reintubation, reoperation, ECMO use, and infection. However, the minimally invasive group showed significantly shorter ventilator duration and ICU stay and a reduced rate of peritoneal dialysis (all p < 0.05).

CONCLUSION: In infants and children under 3 years old with TOF, surgical correction via a right axillary small incision achieves equivalent clinical outcomes to traditional median sternotomy, without increasing postoperative mortality or complication rates. In addition, the minimally invasive approach offers benefits of reduced surgical trauma and enhanced postoperative recovery.

PMID:40662136 | PMC:PMC12256465 | DOI:10.3389/fcvm.2025.1457554

Int J Dermatol. 2025 Jul 14. doi: 10.1111/ijd.17959. Online ahead of print.

ABSTRACT

Vitiligo is an autoimmune disorder marked by the progressive loss of skin melanocytes, increasingly linked to immune dysregulation as a key driver of disease onset and progression. Regulatory T (Treg) cells are essential for maintaining immune homeostasis by suppressing autoreactive immune responses. Mounting evidence implicates functional and numerical alterations in Treg cells in the pathogenesis of vitiligo. This study reviews findings on lesional and circulating Treg cells in vitiligo patients compared to healthy controls (HCs), examining Treg cell frequency, their ability to suppress CD4⁺ and CD8⁺ T cell activity, levels of the immunoregulatory cytokines interleukin-10 (IL-10) and transforming growth factor-β (TGF-β), expression of the key suppressive marker FOXP3, as well as levels of the pro-inflammatory cytokines interleukin-17 (IL-17) and interleukin-22 (IL-22). A comprehensive systematic search was performed across Embase, MEDLINE/PubMed, and Scopus databases to identify eligible studies. A total of 21 studies comprising 1016 vitiligo patients and 846 HCs were included in the review. The analysis revealed a significant reduction in peripheral Treg cell counts (p = 0.01), impaired overall suppressive capacity of CD4+ and CD8+ T cells (p = 0.01), reduced levels of IL-10 (p = 0.02), increased levels of IL-17 (p ≤ 0.01) and IL-22 (p ≤ 0.01) in the blood of vitiligo patients compared to HCs. No statistically significant difference was observed in circulating TGF-β levels (p = 0.1). Most studies reported reduced FOXP3 expression in both skin and blood of vitiligo patients. Current evidence suggests vitiligo involves both reduced numbers and impaired function of Treg cells, supporting further study of Treg pathways as targets for immunomodulatory therapy.

PMID:40660423 | DOI:10.1111/ijd.17959

J Health Popul Nutr. 2025 Jul 14;44(1):254. doi: 10.1186/s41043-025-00991-3.

ABSTRACT

BACKGROUND: The accumulation of abdominal visceral (VAT) and subcutaneous adipose tissue (SAT) has been closely correlated with an array of metabolic disorders and chronic inflammation. This study elucidated the joint effects of a dietary inflammatory index (DII) and vigorous intensity physical activity (PA) on VAT and SAT.

METHODS: The study enrolled 3,444 adults sourced from the National Health and Nutrition Examination Survey (NHANES). The NHANES is designed with a sophisticated, multistage probability sampling methodology and is specifically tailored to comprehensively assess the health and nutritional conditions of the non-institutionalized population. Utilizing the initial 24 h dietary recall data from the NHANES database, our analysis incorporated 28 distinct food parameters for calculating the DII score. Multiple linear regression models are used to calculate the β value and 95% confidence interval of independent and dependent variables.

RESULTS: Compared with the pro-inflammatory diet group, VAT and SAT in the anti-inflammatory diet group were lower [-21.60 (-32.63, -10.58, P < 0.01) and – 85.67 (-108.80, -62.55, P < 0.01)]. The VAT and SAT in the sufficient vigorous intensity PA group were lower than those in the insufficient vigorous intensity PA group [-27.13 (-38.40, -15.86), P < 0.01; -57.05 (-80.82, -33.27), P < 0.01]. There was a linear positive association between DII with VAT (P < 0.01, P for nonlinearity = 0.13) and SAT (P < 0.01, P for nonlinearity = 0.06). Additionally, there were significant L-shaped relationships between vigorous intensity PA with VAT and SAT (all log-likelihood ratio P < 0.05).

CONCLUSION: A lifestyle of anti-inflammatory diet incorporated with sufficient vigorous intensity PA was associated with lower VAT and SAT. Notably, the increase of vigorous intensity PA is associated with the decrease of VAT and SAT in the L-shaped relationships, suggesting that the vigorous intensity PA with at least 75 min per week may be related to greater benefits of VAT.

PMID:40660417 | DOI:10.1186/s41043-025-00991-3

Environ Microbiome. 2025 Jul 14;20(1):88. doi: 10.1186/s40793-025-00738-x.

ABSTRACT

Microbial biofilms colonize mineral and biological substrates exposed to fluid circulation at deep-sea hydrothermal vents, providing a biologically active interface along redox boundaries. Since many biofilms at deep-sea vents are associated with invertebrates, microbial distribution and abundance are not only constrained by local fluid geochemistry, but also through host-microbe interactions. This study examined the spatial distribution and diversity of established microbial biofilm communities collected from three distinct biological regimes characteristic of the East Pacific Rise (9°50 N, 104°17 W) vent system, as well as newly established biofilms on experimental microbial colonization devices. Transcripts from 16S rRNA-based amplicon sequencing revealed that Campylobacterota of the Sulfurimonas and Sulfurovum genera dominated newly-formed biofilms across all biological regimes. Statistical analyses using environmental chemistry data from each sampling site suggest that community composition is significantly impacted by biofilm age, temperature and sulfide concentration ranges, and to a lesser extent, locality. Further, metatranscriptomic analyses were used to investigate changes in community gene expression between seafloor and subseafloor biofilms. Our findings revealed differences in the type and abundance of transcripts related to respiratory pathways, carbon fixation and reactive oxygen species (ROS) detoxification. Overall, this study provides a novel conceptual framework for evaluating biofilm structure and function at deep-sea vents by showing a transition from a niche-specific pioneer microbial community in newly-formed biofilms, to a complex population of increased diversity in established biofilms and by identifying key changes in gene expression in taxonomically similar biofilms during the transition from the shallow subseafloor to the seafloor.

PMID:40660416 | DOI:10.1186/s40793-025-00738-x

Hereditas. 2025 Jul 14;162(1):131. doi: 10.1186/s41065-025-00501-9.

ABSTRACT

BACKGROUND: In thoracic surgery, the concept of Enhanced Recovery After Surgery (ERAS) has been extensively implemented. Although numerous studies have investigated ERAS in thoracic surgery, bibliometric analyses remain limited. In this study, the developmental trajectory, current research status, and prospective trends of ERAS in thoracic surgery were systematically analyzed through bibliometric and visual analysis techniques.

METHODS: Literature pertaining to ERAS in thoracic surgery was retrieved from the Web of Science Core Collection (WoSCC). Microsoft Excel 2019, R software (version 4.1.0), the Bibliometric Online Analysis Platform, VOSviewer (version 1.6.18), and Citespace (version 6.3.R1) were utilized for statistical analysis, bibliometric evaluation, and data visualization.

RESULTS: A total of 617 publications were retrieved over the past decade. The number of publications has generally demonstrated an upward trend from 2015 to 2024. China and Sichuan University ranked as the leading country and institution, respectively, in terms of publication volume. The Journal of Thoracic Disease was identified as the leading journal in both publication count and citation frequency. Henrik Kehlet was recognized as the most prolific and highly co-cited author. Current research hotspots include “video-assisted thoracic surgery,” “pain management,” and “multicenter clinical trials.”

CONCLUSION: ERAS-related research in thoracic surgery has been increasing steadily, highlighting it as a rapidly evolving and promising field. The ERAS concept plays a critical role in all perioperative phases-preoperative, intraoperative, and postoperative-and requires further in-depth investigation. Many existing ERAS studies in thoracic surgery lack high-quality evidence, underscoring the urgent need for rigorously designed research with robust methodological standards.

PMID:40660412 | DOI:10.1186/s41065-025-00501-9