Tag: statistics

BMC Infect Dis. 2025 Dec 30. doi: 10.1186/s12879-025-12489-8. Online ahead of print.

ABSTRACT

BACKGROUND: Mortality remains high among people living with HIV (PLHIV) undergoing maintenance hemodialysis (MHD). However, data on the survival of MHD patients in first-tier Chinese cities are limited. This study aimed to analyze the clinical characteristics and survival of PLHIV receiving MHD in Shanghai.

METHODS: We conducted a retrospective cohort study at the Blood Purification Center of Shanghai Public Health Clinical Center. Clinical data were collected for PLHIV and HIV-negative controls who initiated MHD between November 2011 and September 2023. Survival was compared using Kaplan-Meier curves, and risk factors were identified through Cox regression analyses.

RESULTS: The study included 45 PLHIV and 54 HIV-negative individuals who underwent MHD for over three months. PLHIV were significantly younger at MHD initiation and had a higher proportion of males compared to controls (54.4 ± 14.4 vs. 61.6 ± 16.5 years, p = 0.025; 88.9% vs. 64.8%, p = 0.005). At baseline, the mean CD4 count for PLHIV was 261.1 ± 155.2 cells/µL, and 66.7% (30/45) had undetectable viral loads. The maximum follow-up durations were 145 months for PLHIV and 107 months for controls, with median survival times of 45 months and 61 months, respectively. Survival rates at 12, 24, 36, and 60 months were lower in the HIV group than in the control group (74.8% vs. 88.7%, 71.4% vs. 80.2%, 67.2% vs. 67.7%, and 33.2% vs. 67.7%), with a statistically significant difference observed only at 60 months (p = 0.0343). The overall difference in cumulative survival probability between the two groups was not significant (Log-rank test, p = 0.15). After adjusting for covariates, age ≥ 60 years at MHD initiation was significantly associated with reduced survival in both PLHIV (hazard ratio [HR] 3.14, 95% confidence interval [CI]: 1.15-8.54, p = 0.025) and the entire patient cohort (HR 3.15, 95% CI: 1.31-7.58, p = 0.01).

CONCLUSION: PLHIV initiated MHD at a younger age but exhibited lower long-term survival rates, particularly at 60 months, compared to HIV-negative individuals. Age ≥ 60 years at dialysis initiation was an independent risk factor for mortality in PLHIV.

TRIAL REGISTRATION: Not applicable.

PMID:41469861 | DOI:10.1186/s12879-025-12489-8

Jpn J Clin Oncol. 2025 Dec 31:hyaf211. doi: 10.1093/jjco/hyaf211. Online ahead of print.

ABSTRACT

The ARASENS trial demonstrated a significant overall survival (OS) benefit for a triplet regimen in metastatic castration-sensitive prostate cancer (mCSPC). We aimed to determine whether this benefit is synergistic or additive. Using a mathematical model of independent drug action and published data from the ARASENS and ARANOTE, we compared the observed OS of the triplet regimen to a predicted OS curve. Reconstructed individual patient data were compared using a Cox model. The observed OS was statistically superior to the predicted OS (hazard ratio [HR] 0.82, 95% CI 0.68-0.99; P = .047), indicating a clinical benefit ~18% greater than the expected additive effect. To address confounding by subsequent therapies, we analyzed time to initial subsequent anticancer therapy, which showed an even more pronounced greater-than-additive benefit (HR 0.57, 95% CI 0.44-0.74; P < .001). These findings suggest the triplet regimen provides an early therapeutic advantage that exceeds additive expectations, supporting an upfront combination strategy in mCSPC.

PMID:41469858 | DOI:10.1093/jjco/hyaf211

Arch Gynecol Obstet. 2025 Dec 30;313(1):1. doi: 10.1007/s00404-025-08277-z.

ABSTRACT

OBJECTIVE: The purpose of this study was to compare oral estradiol valerate and estradiol transdermal gel for clinical pregnancy outcomes in patients undergoing frozen-thaw embryo transfer (FET).

METHODS: This was a prospective study performed between March 1, 2017 and October 30, 2019. Totally 244 HR FET cycles were included, with 123 cycles using oral estrogen tablets (oral group) and 121 applying estradiol transdermal gel (gel group). The primary aim of this study was to compare implantation (IR), clinical pregnancy (CPR), miscarriage (MR) and live birth (LBR) rates between the two groups. The secondary aim was to assess liver function, specifically measuring alanine transaminase (ALT) and aspartate transaminase (AST) levels at 12 weeks of gestation.

RESULTS: There were no significant differences in EPR, IR, and CPR between the two groups. Meanwhile, the gel group had a higher live birth rate (55.37% versus 51.20%, p = 0.302) and a lower miscarriage rate (5.79% versus 10.57%, p = 0.173) compared with the oral group, but statistical significance was not reached. The oral group had higher ALT (16.58 ± 6.13 versus 23.78 ± 7.17, p < 0.001) and AST (19.70 ± 3.58 versus 23.78 ± 7.17, p = 0.001) levels at 12 weeks of gestation.

CONCLUSION: Estradiol transdermal gel is a safe and feasible alternative for endometrial preparation in frozen embryo transfer cycles, yielding comparable ongoing pregnancy rates to the standard oral regimen.

PMID:41469840 | DOI:10.1007/s00404-025-08277-z

Sci Rep. 2025 Dec 30. doi: 10.1038/s41598-025-34198-7. Online ahead of print.

ABSTRACT

Recurrent implantation failure (RIF) occurs in 10-15% of IVF cycles with evidence from a few randomized control trials (RCTs) that local endometrial injury (LEI) leads to higher live birth rates whose exact mechanism is currently unknown. During the implantation period, modulation in immune milieu occur in tandem with profound morphologic and functional changes in the endometrium. The landscape of immune cells in the endometrium in pre- and post-LEI in RIF is currently unknown. Thirty-seven women with RIF (age 34.6 ± 3.3 years old) underwent LEI by two sequential mid-luteal phase endometrial biopsies prior to embryo transfer. To characterize the immunological landscape alterations in LEI, we performed immunophenotypic assessment with flow cytometry to provide insights into the basal (first biopsy) and altered (second biopsy) biology of dendritic cells (DC), macrophages, natural killer (NK), T and B cells in the RIF population before and after LEI. Clinical pregnancies occurred in seventeen women (46%). Among analysed immune cells, T (34.6%) and NK cells (26.2%) predominate in the mid-luteal endometrium. A consistent increase in lymphocytes and decrease in antigen presenting cells (APCs) were observed between the two biopsies although not statistically significant. Interrogation of the immune milieu in patients who either fell pregnant or not did not show any differences once cases with endometriosis were taken out of the analyses. There were no further difference in any of the other measured immune cell subsets between the first and second endometrial biopsy. We found limited changes in the immune cell compartments after LEI. Further research with higher resolution methods may provide more information on the effects of LEI.

PMID:41469836 | DOI:10.1038/s41598-025-34198-7

Sci Rep. 2025 Dec 30. doi: 10.1038/s41598-025-34050-y. Online ahead of print.

ABSTRACT

This study investigates the influence of Bacillus pumilus-induced calcium carbonate precipitation (MICP) on the flexural performance and durability of jute fibre-reinforced concrete (JFRC). A nominal 1:2:4 concrete mix with 1% jute fibre (treated and untreated) was prepared and dosed with three bacterial concentrations (B1.5, B12, and B24). Prismatic beams (150 × 150 × 500 mm) were cured and tested at 7, 14, 21, and 28 days under three-point bending, and a total of twelve beams per mix (n = 12), corresponding to three replicate specimens at each curing age, were evaluated. Fresh properties (slump and compaction factor), mass and dimensional loss, SEM microstructural observations, and statistical analysis (two-way ANOVA and Tukey HSD) were used to interpret results. Findings show that bacterial dosage strongly governs performance: low dosage (B1.5) produced minor early-age gains; moderate dosage (B12) yielded delayed but measurable improvements; and high dosage (B24) produced the greatest 28-day flexural enhancement, although with reduced workability. Durability tests indicated improved resistance to acid attack and lower mass and dimensional loss for bacterial mixes, with B1.5 and B24 dosages showing the most favourable performance depending on the metric assessed. SEM observations confirmed progressive CaCO₃ deposition with increasing bacterial concentration, enhancing fibre-matrix bonding and reducing microcrack connectivity. Overall, the study demonstrates a measurable synergy between jute fibres and microbially induced calcite precipitation, indicating that appropriately dosed B. pumilus can significantly enhance the flexural behaviour and durability of JFRC. These findings provide insight into the development of low-cost, bio-enhanced natural-fibre composites for sustainable construction applications.

PMID:41469828 | DOI:10.1038/s41598-025-34050-y

J Med Imaging Radiat Oncol. 2025 Dec 30. doi: 10.1111/1754-9485.70063. Online ahead of print.

ABSTRACT

INTRODUCTION: Cancer is the current leading cause of death in Australia, with a mortality and morbidity burden that is expected to rise with the aging population. Despite radiotherapy being indicated in 52% of cancer cases and contributing to 40% of cancer survival, radiation oncology (RO) research has not been prioritised by domestic or international research funding groups.

METHODS: This study reviewed the past 5 years of publicly available oncology grant funding data from Australia’s largest funding organisations, including commonwealth, individual state and territory governments, and philanthropic organisations. Data were retrieved from individual organisations’ websites and GrantConnect. Grants for potential RO projects were identified using search terms. Additional descriptive information was retrieved using search engines. The combined data were assessed to determine inclusion/exclusion from the final RO grant pool. Descriptive statistics were generated using Microsoft Excel.

RESULTS: Our analysis identified 1660 oncology grants, of which 74 (4.5%) were deemed to be RO grants. The total value of oncology grants was AUD$1.89 B, and RO grants was $60 M (3.2%). Of the RO grants, 39% were provided by philanthropic organisations, 39% by the Commonwealth Government and 22% by state and territory governments. Only 9% of RO grants were awarded to radiation oncologists.

CONCLUSIONS: This study demonstrates the low proportion of Australian oncology research funding awarded to RO projects. The gap between the clinical importance of RO and the funding it receives risks delays in more effective and less toxic radiation therapy reaching Australian cancer patients.

PMID:41469816 | DOI:10.1111/1754-9485.70063

Sci Rep. 2025 Dec 30. doi: 10.1038/s41598-025-34387-4. Online ahead of print.

ABSTRACT

Newcastle disease virus (NDV) remains a major threat to the poultry industry worldwide. Recombinant DNA vaccine against NDV offers a promising solution to current Newcastle disease (ND) challenges. Present study describes the development of a DNA vaccine (rDNA-NDV-F) using the fusion (F) gene from NDV genotype VII strain isolated from Rawalpindi, Pakistan. While conventional NDV vaccines reduce mortality in commercial poultry, they do not provide complete protection or prevent viral shedding. To address this issue, genotype-matched vaccines have been proposed. Here, we developed and evaluated the efficacy of the rDNA-NDV-F vaccine against genotype VII challenge. NDV was isolated from a field strain and propagated in embryonated chicken eggs (ECE). Virus activity was confirmed using Hemagglutination assay (HA), HA inhibition (HAI), and Mean Death Time (MDT) assay. Polymerase Chain Reaction (PCR) and sequencing confirmed the genotype VII.2 strain. The DNA vaccine was constructed using the fusion (F) protein gene cloned into the expression plasmid pcDNA3.1. Gene insertion was verified by PCR and restriction digestion, while protein expression was confirmed via immunofluorescence assay. To assess vaccine efficacy, 120 chickens (14 days old) were divided into four groups: G1 (rDNA-NDV-F), G2 (empty vector), G3 (PBS control), and G4 (non-vaccinated, non-challenged control). Serological responses were measured using ELISA on days 0, 7, 14, 21, and 28. Birds were challenged with NDV genotype VII (10⁵ EID₅₀). Virus shedding from tracheal and cloacal swabs was analyzed on days 3, 7, and 10 post-challenge. Clinical signs and mortality rates were also recorded. The rDNA-NDV-F vaccine induced strong immune responses, with peak ELISA (6180) titers at 28 days. Virus shedding was detected in three birds on day 3 but was absent by day 10. No virus shedding was observed in cloacal swabs, indicating restriction in the digestive system. Vaccinated birds showed mild clinical signs in only two cases, with no neurological symptoms or mortality. In contrast, negative and vector control groups exhibited severe clinical signs and 90-100% mortality. Statistical analysis confirmed significant differences (P < 0.05). This study highlights the effectiveness of genotype-matched recombinant NDV vaccines in providing effective protection for poultry.

PMID:41469801 | DOI:10.1038/s41598-025-34387-4

Sci Rep. 2025 Dec 30. doi: 10.1038/s41598-025-34095-z. Online ahead of print.

ABSTRACT

Crayfish play an important role in freshwater ecosystems, and sex classification is crucial for analyzing their demographic structures. This study performed binary classification using traditional machine learning and deep learning models on tabular and image datasets with an imbalanced class distribution. For tabular classification, features related to crayfish weight and size were used. Missing values were handled using different methods to create various datasets. Kolmogorov-Arnold networks demonstrated the best performance across all metrics, achieving accuracy rates between 95 and 100%. Image data were generated by combining at least five images of each crayfish. Autoencoders were employed to extract meaningful features. In experiments conducted on these extracted features, support vector machines achieved 84% accuracy, and multilayer perceptrons achieved 82% accuracy, outperforming other models. To enhance performance, a novel architecture based on stacked autoencoders was proposed. While some models experienced performance declines, Kolmogorov-Arnold networks showed an average improvement of 3.5% across all metrics, maintaining the highest accuracy. To statistically evaluate performance differences, McNemar’s and Wilcoxon tests were applied. The results confirmed significant differences between Kolmogorov-Arnold networks, support vector machines, multilayer perceptrons, and naive Bayes. In conclusion, this study highlights the effectiveness of deep learning and machine learning models in crayfish sex classification and provides a significant example of hybrid artificial intelligence models incorporating autoencoders.

PMID:41469793 | DOI:10.1038/s41598-025-34095-z

Br J Clin Pharmacol. 2025 Dec 30. doi: 10.1002/bcp.70433. Online ahead of print.

ABSTRACT

BACKGROUND AND AIM: Mineralocorticoid receptor antagonists (MRAs) effects on glucose metabolism and diabetes risk are inconsistently reported. We conducted a meta-analysis to evaluate the association between MRA use and glycaemic profile change as well as the risk of diabetes occurrence and progression.

METHODS: Eligible studies enrolling adult patients receiving spironolactone, eplerenone or finerenone for any clinical indication were included. The primary outcomes were new-onset diabetes mellitus and change in HbA1c (%) levels. A secondary outcome was alterations in glucose levels.

RESULTS: This meta-analysis of 20 studies evaluated the effects of MRAs on glycaemic parameters. Spironolactone significantly reduced endpoint HbA1c (%) compared to placebo (mean difference -0.27%, 95% CI: -0.38 to -0.15; P < 0.00001; I² = 31%) and in change-from-baseline fasting glucose (-0.24 mmol/L, 95% CI: -0.27 to -0.21; P < 0.00001; I² = 0%) over 4-24 weeks. Similarly, change-from-baseline HbA1c (%) was significantly lowered (-0.19%, 95% CI: -0.29 to -0.08; P = 0.0004; I² = 33%). In a head-to-head comparison, spironolactone and eplerenone showed no significant difference in HbA1c (%) change (-0.03%, 95% CI: -0.50 to 0.43; P = 0.89; I² = 88%). In the FINEARTS-HF trial, finerenone significantly reduced the risk of developing new-onset diabetes by 24%. Lastly, finerenone was associated with slightly lower rates of insulin initiation (8.1% vs. 9.0%) and escalation in glucose-lowering medication classes (32.1% vs. 34.0%) compared to placebo.

CONCLUSIONS: Spironolactone use is associated with modest but statistically significant improvements in HbA1c and glucose levels compared to placebo, suggesting a potential glycaemic benefit.

PMID:41469771 | DOI:10.1002/bcp.70433

J Ultrasound Med. 2025 Dec 30. doi: 10.1002/jum.70151. Online ahead of print.

ABSTRACT

BACKGROUND: Gestational diabetes mellitus (GDM) is a common complication observed during pregnancy, with its global prevalence increasing in recent years. GDM has been linked to adverse myocardial remodeling in the fetus and impaired fetal cardiac function. This study seeks to evaluate the impact of GDM on fetal global cardiac function using dual-gate Doppler ultrasound (DD) technology, and to investigate the potential benefits and advantages of DD technology in assessing fetal cardiac function.

METHODS: A cohort consisting of 56 pregnant women diagnosed with gestational diabetes mellitus between 24 and 28 weeks of gestation (GDM group) was selected, alongside a control group of 55 pregnant women with normal glucose levels at the same gestational age. Both the conventional pulsed combined method and the dual-gate (DD) method were utilized to evaluate the ultrasound parameters of fetal global cardiac function in both groups. These parameters included isovolumic contraction time (ICT), isovolumic relaxation time (IRT), and ejection time (ET), from which the Tei index was subsequently calculated.

RESULTS: The ICT, IRT, and Tei index of the left heart in the GDM group were significantly elevated compared to the control group (P < .05). Although ET in the GDM group, as assessed by the combined method, demonstrated a decreasing trend, this difference did not achieve statistical significance (P > .05). Conversely, the ET determined by the DD method in the GDM group was significantly reduced compared to the control group (P < .05). Right ventricular Tei index measurements showed poor consistency, with intraobserver ICCs of 0.56 for the separated measurement and 0.58 for the DD method, and interobserver ICCs of 0.50 and 0.53. As a result, right ventricular Tei indices were excluded from the final analysis.

CONCLUSION: Pregnant women with GDM will cause an increase in the Tei index of the fetal left global cardiac function, indicating that the intrauterine hyperglycemic environment can cause damage to the global fetal cardiac function. The global fetal cardiac function was impaired in both the well-controlled and poorly controlled GDM groups, suggesting that early detection of GDM and the fetal cardiac dysfunction caused by GDM are necessary. The measurement of the Tei index of the left heart in the fetus using dual-gate Doppler technology can help detect the fetal cardiac dysfunction caused by GDM at an early stage, while the application of dual-gate Doppler technology in the overall cardiac function of the right heart still faces significant challenges.

PMID:41469769 | DOI:10.1002/jum.70151