Tag: statistics

J Infect Public Health. 2025 Sep 1;18(11):102948. doi: 10.1016/j.jiph.2025.102948. Online ahead of print.

ABSTRACT

BACKGROUND: Bloodstream infections (BSIs) are a major cause of morbidity and mortality in patients with hematological malignancies (HMs).

METHODS: This 14-year retrospective study was conducted at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, from 2007 to 2021. It examined the epidemiological profile, microbial spectrum, resistance patterns, and outcomes of BSIs in HM patients. Microbial identification was based on aerobic and anaerobic blood cultures; PCR testing was used requested as needed. Statistical analysis was performed in Excel, including one-way ANOVA, Chi-square, and linear regression.

RESULTS: Among 2112 HM patients, 296 (14 %) experienced at least one BSI episode. Incidence peaked in 2014, 2016, and 2017, with a subsequent decline possibly reflecting improved infection control. Bacterial infections comprised 90 % of cases (n = 1341), the highest was Gram-negative organisms (n = 745) such as E. coli (n = 86) and Klebsiella pneumoniae (n = 77). Gram-positive pathogens (n = 596) included coagulase-negative Staphylococci (n = 319) and Staphylococcus aureus (n = 75). Fungal infections accounted for 4 % (n = 61), primarily Candida albicans. Resistance was high (21.1 %), particularly in Enterococcus (48.9 %), Acinetobacter (45.8 %), E. coli ESBL (40.3 %), and Klebsiella pneumoniae CRE/ESBL (45 %, 32.5 %). The overall mortality was 85 %, significantly higher for resistant Klebsiella pneumoniae (100 % vs. 88.7 %, p = 0.008) and notably elevated for E. coli ESBL (94.2 % vs. 83.1 %, p = 0.063). Adults had the highest incidence. Combined aerobic (69 %) and anaerobic (31 %) cultures improved diagnostic yield, especially in polymicrobial infections.

PMID:40902323 | DOI:10.1016/j.jiph.2025.102948

J Infect Public Health. 2025 Aug 26;18(11):102939. doi: 10.1016/j.jiph.2025.102939. Online ahead of print.

ABSTRACT

BACKGROUND: Taiwan experienced a major dengue outbreak in 2023 following the relaxation of COVID-19 border controls. The contributing factors remained unclear. This study investigated potential virological, immunological, and clinical drivers.

METHODS: We retrospectively analyzed laboratory-confirmed dengue virus (DENV) infections at a tertiary care hospital in southern Taiwan. Serotypes were identified by qRT-PCR. Viral origins were assessed through phylogenetic and envelope (E) gene amino acid analyses. Clinical features of DENV-1 and DENV-2 cases were compared. Neutralization and antibody-dependent enhancement (ADE) were evaluated using PRNT and ADE assays.

RESULTS: DENV-1 and DENV-2 were identified as the predominant circulating serotypes. Clinical analysis revealed that DENV-2 infection was significantly associated with older age, diabetes mellitus, hypertension, and elevated hematocrit levels (p < 0.05), and these associations remained statistically significant in multivariate analysis. Phylogenetic analysis showed that DENV-1 isolates belonged to genotypes I and IV, while DENV-2 strains were of the cosmopolitan genotype. These viruses clustered closely with strains from Southeast Asia. Amino acid analysis indicated that DENV-1 strains exhibited 2-10 substitutions relative to 2014 isolates, while DENV-2 strains closely matched those from 2015. Sera from the 2014-2015 outbreaks demonstrated potent homotypic but limited heterotypic neutralization. ADE was observed in heterotypic infection contexts.

CONCLUSIONS: The 2023 dengue outbreak in Taiwan was driven by co-circulation of DENV-1 and DENV-2, limited heterotypic immunity, and ADE. These findings highlight the importance of integrated virological surveillance, genotype monitoring, and immunological assessment to inform dengue control strategies in non-endemic regions experiencing imported viral threats.

PMID:40902322 | DOI:10.1016/j.jiph.2025.102939

Comput Med Imaging Graph. 2025 Sep 1;125:102642. doi: 10.1016/j.compmedimag.2025.102642. Online ahead of print.

ABSTRACT

An increasing number of publicly available datasets have facilitated the exploration of building universal medical segmentation models. Existing approaches address partially labeled problem of each dataset by harmonizing labels across datasets and independently focusing on the labeled foreground regions. However, significant challenges persist, particularly in the form of cross-site domain shifts and the limited utilization of partially labeled datasets. In this paper, we propose a GAMOS (Generic Abdominal Multi-Organ Segmentation) framework. Specifically, GAMOS integrates a self-guidance strategy to adopt diffusion models for partial labeling issue, while employing a self-distillation mechanism to effectively leverage unlabeled data. A sparse semantic memory is introduced to mitigate domain shifts by ensuring consistent representations in the latent space. To further enhance performance, we design a sparse similarity loss to align multi-view memory representations and enhance the discriminability and compactness of the memory vectors. Extensive experiments on real-world medical datasets demonstrate the superiority and generalization ability of GAMOS. It achieves a mean Dice Similarity Coefficient (DSC) of 91.33% and a mean 95th percentile Hausdorff Distance (HD95) of 1.83 on labeled foreground regions. For unlabeled foreground regions, GAMOS obtains a mean DSC of 86.88% and a mean HD95 of 3.85, outperforming existing state-of-the-art methods.

PMID:40902292 | DOI:10.1016/j.compmedimag.2025.102642

Placenta. 2025 Jul 23;170:87-96. doi: 10.1016/j.placenta.2025.07.084. Online ahead of print.

ABSTRACT

INTRODUCTION: Quantification of placental histopathological structures is challenging due to a limited number of perinatal pathologists, constrained resources, and subjective assessments prone to variability. Objective standardization of placental structure is crucial for easing the burden on pathologists, gaining deeper insights into placental growth and adaptation, and ultimately improving maternal and fetal health outcomes.

METHODS: Leveraging advancements in deep-learning segmentation, we developed an automated approach to detect over 9 million placenta chorionic villi from 1531 term placental whole slide images from the New Hampshire Birth Cohort Study. Using unsupervised clustering, we successfully identified biologically relevant villi subtypes that align with previously reported classifications – terminal, mature intermediate, and immature intermediate – demonstrating consistent size distributions and comparable abundance. We additionally defined tertile-based combinations of villi area and circularity to characterize villous geometry. This study applies these cutting-edge AI methods to quantify villi features and examine their association with maternal and infant characteristics, including gestational age at delivery, maternal age, and infant sex.

RESULTS: Increasing gestational age at delivery was statistically significantly associated (p = 0.003) with an increase in the proportion of mature intermediate villi and a decrease in the proportion of the smallest, most circular villi (p < 0.001). Maternal age and infant sex were not statistically significantly associated with measures of villous geometry.

DISCUSSION: This work presents a workflow that objectively standardizes chorionic villi subtypes and geometry to enhance understanding of placental structure and function, while providing insights into the efficiency, growth, and the architecture of term placentas which can be used to inform future clinical care.

PMID:40902262 | DOI:10.1016/j.placenta.2025.07.084

Environ Int. 2025 Aug 28;203:109762. doi: 10.1016/j.envint.2025.109762. Online ahead of print.

ABSTRACT

BACKGROUND: Testicular germ cell cancer (TGCC) originates during fetal life. Fetal exposure to environmental chemicals may contribute to its development, but epidemiological data are lacking. We investigated per- and polyfluoroalkyl substances (PFAS), which can act as endocrine disruptors during fetal development, and TGCC risk in adulthood.

METHODS: We conducted a nested case-control study of 549 mother-male offspring pairs (103 TGCC cases, 446 matched controls). The source population included over 100,000 pregnant women with biobanked serum samples collected during 1985-1994, a period before PFAS restrictions. Male offspring were followed for up to 38 years, and TGCC cases were identified from the Danish Cancer Registry based on histological confirmation. Eight PFAS were quantified in maternal serum using LC-MS/MS. Associations between individual PFAS and their mixtures with TGCC risk were assessed through Cox regression and quantile g-computation models.

RESULTS: Associations between individual PFAS and TGCC risk were modest and not statistically significant. Hazard ratios (HRs) for perfluoroalkyl sulfonic acids (PFOS, PFHxS, PFHpS) suggested higher TGCC risks per quartile increase in concentrations, but lower risks for perfluoroalkyl carboxylic acids (PFOA, PFNA, PFDA, PFHpA, PFUnDA). Mixture analyses supported this pattern, with higher TGCC risk for the joint effect of sulfonic acids (HR 1.13, 95 % CI: 0.89; 1.44). Stratified analyses by histological subtype showed higher risk for seminomas than for nonseminomas across all PFAS.

CONCLUSIONS: We found limited evidence of an association between fetal PFAS exposure and TGCC risk. Indications of a potential adverse effect of perfluoroalkyl sulfonic acids, particularly for seminomas, merit further research.

PMID:40902259 | DOI:10.1016/j.envint.2025.109762

J Behav Ther Exp Psychiatry. 2025 Aug 31;90:102069. doi: 10.1016/j.jbtep.2025.102069. Online ahead of print.

ABSTRACT

This study explored the relationships between dissociative experiences, childhood trauma, maladaptive schemas, schema modes, and schema coping in a nonclinical sample. Three theoretical models were tested: (1) dissociative experiences resulting from schema mode activation, (2) dissociative experiences as an innate trait shaping schema coping, and (3) dissociative experiences arising from childhood trauma that influence coping strategies. Data from 401 Dutch psychology students were analyzed using path analyses to compare model fit. While all models showed good fit, Model 2 emerged as the best based on AIC and BIC values. This model linked dissociative experiences to avoidance and surrender coping styles and specific schema modes, such as the punitive parent and detached self-soother. Findings suggest dissociative experiences shape responses to schema-related stress through disengagement or immersion. Future research in clinical populations is recommended to further explore these dynamics and their therapeutic relevance.

PMID:40902253 | DOI:10.1016/j.jbtep.2025.102069

Ecotoxicol Environ Saf. 2025 Sep 2;303:118981. doi: 10.1016/j.ecoenv.2025.118981. Online ahead of print.

ABSTRACT

BACKGROUND: Carotid atherosclerosis (CAS) is a major contributor to cerebrovascular incidence and mortality, yet its etiology in non-dyslipidemic individuals remains poorly understood. Emerging evidence suggests that environmental metal exposure may play a critical role in CAS development.

METHODS: We conducted a retrospective matched case-control study involving 1290 non-dyslipidemic middle-aged and elderly individuals to examine the association between urinary metal exposure and CAS. Twenty-eight urinary metals were measured using inductively coupled plasma mass spectrometry (ICP-MS), and statistical analyses-including conditional logistic regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR)-were applied to assess single and mixed-metal effects. Mediation analysis was performed to evaluate the potential role of metabolic and inflammatory clinical indicator.

RESULTS: Conditional logistic regression found that six metals (OR_Q4vsQ1=1.63, 95 %CI: 1.14-2.34 for lithium (Li); OR_Q4vsQ1= 1.65, 95 %CI: 1.16-2.35 for titanium (Ti); OR_Q4vsQ1= 1.53, 95 %CI: 1.07-2.22 for cobalt (Co); OR_Q4vsQ1= 1.77, 95 %CI: 1.24-2.51 for nickel (Ni); OR_Q4vsQ1= 1.93, 95 %CI: 1.33-2.79 for copper (Cu), and OR_Q4vsQ1= 2.14, 95 %CI: 1.45-3.18 for cadmium (Cd)) were significantly associated with increased CAS risk, while selenium (Se) (OR _Q2vsQ1 = 0.65, 95 %CI: 0.46-0.93, OR_Q2vsQ1 = 0.59, 95 %CI: 0.41-0.84) was negatively associated with the risk of CAS. Mixed-metal exposure analyses, including WQS (OR=1.35, 95 %CI 1.12-1.63) and BKMR, consistently demonstrated a positive correlation with CAS, primarily driven by Ti. Mediation analysis further revealed that 11.54 % of association between Cu and CAS explained by remnant cholesterol (RC).

CONCLUSION: Our findings revealed a significant correlation between environmental metal exposure and CAS, independent of traditional lipid abnormalities. Future prospective studies are warranted to confirm these associations and elucidate the underlying biological mechanisms, potentially guiding targeted prevention strategies.

PMID:40902247 | DOI:10.1016/j.ecoenv.2025.118981

Drug Alcohol Depend. 2025 Aug 22;276:112848. doi: 10.1016/j.drugalcdep.2025.112848. Online ahead of print.

ABSTRACT

INTRODUCTION: Through secondary data analyses, we investigated sex differences in the effects of IQOS, a heated tobacco product, on combustible cigarette smoking.

METHODS: Adults who smoke cigarettes (N = 118; 21-65 years old) completed a baseline ad-lib smoking period (days 1-5), two laboratory visits (days 6-7), and a 14-day period where they were instructed to switch from smoking cigarettes to using IQOS 3.0 (days 8-21). Models estimated the changes in cigarettes smoked per day (CPD) and the percentage of baseline CPD substituted by HeatSticks during the switch period. Bivariate statistics assessed sex differences in covariates and IQOS-associated effects (i.e., subjective reward, relative reinforcing value, craving relief, and withdrawal relief) for model inclusion.

RESULTS: Males and females significantly reduced their CPD to 29.8 % and 21.8 % of their baseline CPD by the end of the switch period, respectively. CPD slopes were significant for males (β =-0.46/day [CI95 % -0.97 to -0.04] p = 0.002) and females (β =-0.83/day [CI95 % -1.34 to -0.31] p < 0.001), although slopes did not significantly differ (p = 0.3). Males and females substituted HeatSticks at 83.2 % and 67.4 % of their baseline CPD across the switch period. The IQOS slopes were significant for males (β =1.136/day [CI95 % 0.59-2.14] p = 0.001) but not females (β =0.64/day [CI95 % -0.67-1.94] p = 0.34), although the slopes did not significantly differ (p = 0.36). There were no significant sex differences in IQOS-associated effects (all p values > 0.05).

CONCLUSIONS: Males and females do not appear to differ in IQOS-associated effects or the initial substitutability of IQOS for combustible cigarettes.

PMID:40902222 | DOI:10.1016/j.drugalcdep.2025.112848

Clin Nutr. 2025 Aug 23;53:109-118. doi: 10.1016/j.clnu.2025.08.025. Online ahead of print.

ABSTRACT

BACKGROUND & AIMS: The association between meat intake and breast cancer risk remains unclear. This study examined the relationship between specific types of meat intake and breast cancer risk in a prospective cohort study.

METHODS: This study included 71,264 women aged 40-69 years from the Health Examinees-Gem (HEXA-G) study (2004-2013). Cancer diagnosis was identified via the Korea Central Cancer Registry and death certificate-linked data were provided by the Korea National Statistical Office until 31 December 2018. Cox proportional hazards models were used to estimated multivariate hazard ratios (HRs) and 95 % confidence intervals (CIs) for breast cancer risk by meat intake.

RESULTS: During 655,566.9 person-years of follow-up, 713 breast cancer cases were identified. Women who consumed one or more servings of processed meat per week had a 57 % increased risk of breast cancer (HR = 1.57, 95 % CI: 1.09-2.27, p for trend = 0.003), compared to those who did not consume processed meat. Stronger associations were observed among women under 50 years of age (p for trend = 0.021), with no family history of breast cancer (p for trend = 0.001), no regular exercise (p for trend = 0.028), no alcohol consumption (p for trend = 0.002) and a body mass index (BMI) below 25 kg/m² (p for trend = 0.005). Beef intake was associated with a potential reduction in breast cancer risk (HR = 0.82, 95 % CI: 0.67-1.01, p trend = 0.051, for 2 or more servings per month vs. none). Also, reduction of breast cancer risk was observed in women who consumed alcohol (p for trend = 0.036). More pronounced associations were found in women without family history of breast cancer (p for trend = 0.049), and in women who did not engage in regular exercise (p for trend = 0.015).

CONCLUSIONS: Our results suggest that processed meat intake is linked to a higher risk of breast cancer, whereas beef consumption may reduce the risk of breast cancer.

PMID:40902216 | DOI:10.1016/j.clnu.2025.08.025

Semin Arthritis Rheum. 2025 Aug 28;74:152822. doi: 10.1016/j.semarthrit.2025.152822. Online ahead of print.

ABSTRACT

OBJECTIVE: A revision of the 2017 EULAR-ACR myositis classification criteria, namely EULAR-ACR funded Myositis Revision of Classification (MyoROC) project, is currently underway involving a large international group of experts. In the first phase of this project, we identified additional items to be tested in the criteria.

METHODS: We distributed an electronic survey to International Myositis Assessment and Clinical Studies (IMACS) members to identify new items. The identified items were discussed within the Steering Committee and a multi-step Delphi consensus process consisting of an open discussion and three rounds of e-voting were conducted to reach the final item list.

RESULTS: The IMACS survey results revealed 24 new items. After an open discussion with Steering Committee members, 14 items were dropped and five new items were added, resulting in a total of 15 items. After three rounds of e-voting, the following variables were agreed to be tested in addition to the original items: finger flexion, knee extension ≥ hip flexion weakness, myonecrosis pattern on biopsy, magnetic resonance imaging and electromyography findings of myositis, additional rashes, skin biopsy, capillaroscopy, interstitial lung disease, arthritis, Raynaud’s phenomenon, myositis-specific (MSA) and -associated autoantibodies, enzyme elevation at ≥2 time points, and aldolase.

CONCLUSION: The new items that will be tested in the revised criteria were generated with input from a wide range of stakeholders and included, most importantly, MSA, pattern of weakness, skin changes, and additional diagnostic modalities. The next steps of the project are data collection followed by statistical analysis for development and validation of the revised criteria.

PMID:40902212 | DOI:10.1016/j.semarthrit.2025.152822