Nat Commun. 2025 Sep 18;16(1):8313. doi: 10.1038/s41467-025-64122-6.
NO ABSTRACT
PMID:40968170 | DOI:10.1038/s41467-025-64122-6
Category: Statistics
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J Perinatol. 2025 Sep 18. doi: 10.1038/s41372-025-02431-w. Online ahead of print.
ABSTRACT
OBJECTIVE: To analyse trends of outcomes of very low birth weight (VLBW) infants born after 27 weeks of gestation over 15 years in South Wales, UK.
STUDY DESIGN: Trends of clinical outcomes were analysed by deriving multivariable logistic regression models and presented as odds ratios (aOR) with 95% confidence intervals (95% CI). A p-value of <0.05 was considered to be statistically significant.
RESULTS: Between 2007 and 2021, 2321 infants were included in the cohort. There was a decline in the incidence of mortality (aOR 0.941; 95% CI 0.895, 0.988), severe brain injury (0.937; 0.893, 0.982), necrotising enterocolitis (0.911; 0.862, 0.964) and sepsis (0.949; 0.920, 0.978). At birth, odds of mechanical ventilation (0.909; 0.888, 0.930) & receipt of surfactant (0.920; 0.899, 0.942), and mechanical ventilation after admission (0.940; 0.919, 0.961) were significantly reduced. Analysis of a subgroup of 1797 preterm infants born before 32 weeks suggested significant improvement in all major outcomes studied.
DISCUSSION: Trends of care patterns and outcomes improved over time in this cohort of VLBW infants in South Wales, especially preterm infants below 32 weeks of gestation.
PMID:40968140 | DOI:10.1038/s41372-025-02431-w
Eur J Surg Oncol. 2025 Sep 2;51(11):110426. doi: 10.1016/j.ejso.2025.110426. Online ahead of print.
ABSTRACT
BACKGROUND: The Toumai® surgical robot, a cutting-edge medical assistance robot, was developed and launched in China.
OBJECTIVE: Compare the effectiveness and safety of the da Vinci robotic surgical system and the Toumai® surgical robot in RARP and RAPN surgeries(the Toumai® -RARP versus the DV-RARP, the Toumai®-RAPN versus the DV-RAPN).
DESIGN, SETTING, AND PARTICIPANTS: One randomized controlled trials were conducted among patients aged 18-77 years suspected of having T1a N0M0 renal cancer, and another randomized controlled trial was conducted among patients aged 55-79 years suspected of having T2 N0M0 prostate cancer.
REASULTS: The clinical characteristics of the two groups of patients undergoing the same surgical procedure showed no significant differences. All surgeries were successfully completed without the need for conversion from laparoscopic to open surgery. The operative time in the Toumai® group was significantly longer. Additionally, there were no significant differences between the two groups in key indicators such as blood loss, length of hospital stay, complication rates, and functional outcomes.
CONCLUSIONS: This comparative study on the efficacy and safety between the Toumai® system and the da Vinci system demonstrates that the Toumai® surgical robot and the da Vinci robotic system achieve comparable safety profiles, surgical outcomes, and postoperative expectations when performing RAPN and RARP procedures, with no statistically significant differences observed.
PMID:40966817 | DOI:10.1016/j.ejso.2025.110426
Sci Total Environ. 2025 Sep 17;1001:180509. doi: 10.1016/j.scitotenv.2025.180509. Online ahead of print.
ABSTRACT
Pollinators are critical contributors to the natural world as well as to humans. However, their population numbers have been rapidly declining, in part due to pesticide exposure. Using the systemic pesticide thiamethoxam and the ornamental species Bloomify™ rose lantana (Lantana strigocamara R. W. Sanders ‘UF-1011-2’), this study investigated the influence of application method (drench vs. spray), rate (control, low, medium, high), bud stage timing (pre-bud, immature, mature), and pruning (non-pruned or pruned) on the contamination of nectar in container-grown plants. A subset of plants was later transplanted into landscape conditions to determine how long it takes for the pesticides levels in nectar to drop to non-detectable levels. Results showed significant effects of application timing, rate, and method on the concentration of thiamethoxam (and its metabolite clothianidin) in nectar. While spray applied thiamethoxam was not observed at quantifiable concentrations in nectar, drench-applied thiamethoxam surpassed published LC50’s for several bee species. Overall, as the application times approached flower bud maturity and as higher application rates were used, concentrations of thiamethoxam and clothianidin in nectar increased. Additionally, the practice of pruning or non-pruning drenched plants did not affect thiamethoxam or clothianidin concentrations found in nectar. When container-treated plants were transferred to landscape plots, pesticide concentrations in nectar were nominal after 10 days and close to non-detectable after 29 days. These results provide insight into the development of nursery guidelines to help limit pesticide risk to pollinators before plants go to market.
PMID:40966811 | DOI:10.1016/j.scitotenv.2025.180509
J Mol Graph Model. 2025 Sep 13;142:109170. doi: 10.1016/j.jmgm.2025.109170. Online ahead of print.
ABSTRACT
Drug-target affinity (DTA) prediction facilitates accelerated drug screening and reduces development costs. To enhance prediction performance and generalization capability, this paper proposes a DTA prediction model based on discrete curvature, named Ricci-GraphDTA, which integrates molecular graph and protein sequence modeling for efficient and accurate DTA prediction. The model consists of three parts: feature encoding, input representation learning, and affinity prediction. In the feature encoding stage, drug molecules are modeled as graphs, where Forman curvature is introduced to adjust the weights of neighbor information aggregation. A GIN residual network is then used to capture the local geometric and topological features of molecules. Protein sequences are modeled using BiLSTM to extract global dependency features, enhanced by an attention mechanism to capture long-range dependencies and key residue interactions-overcoming the limitations of traditional CNNs in handling long-range dependencies. In the input representation learning stage, the high-level representations of drugs and proteins are concatenated and passed through multiple nonlinear transformations to extract cross-modal interaction features, which are then used for affinity prediction. Experimental results demonstrate that Ricci-GraphDTA exhibits significant performance across various evaluation metrics on the Davis and KIBA datasets. Further cold-start experiments demonstrate the strong generalization ability of Ricci-GraphDTA in scenarios involving unseen drugs or targets, highlighting its potential in real-world drug discovery applications. On average, it achieves a 22.5% reduction in MSE across three cold-start tasks, with over 42% reduction in the dual cold-start setting, showcasing excellent structural modeling capability and robustness.
PMID:40966797 | DOI:10.1016/j.jmgm.2025.109170
Pediatr Infect Dis J. 2025 Sep 17. doi: 10.1097/INF.0000000000005006. Online ahead of print.
ABSTRACT
BACKGROUND: Vancomycin therapeutic drug monitoring (TDM) is essential for optimizing efficacy and minimizing toxicity, particularly in acute kidney injury (AKI). However, recent guidelines favor area under the curve (AUC)-guided dosing over traditional trough monitoring to improve dosing. This study aimed to compare vancomycin TDM strategies in pediatric patients, examine the agreement between 1-point and 2-point sampling methods for AUC estimation, and explore the association between vancomycin exposure and clinical outcomes.
METHODS: This retrospective cohort study included pediatric patients (aged 2 months to 18 years) who underwent vancomycin TDM between 2017 and 2019 (trough-based dosing) and 2020 and 2022 (AUC-based dosing). The pharmacokinetic parameters were estimated using Bayesian software. AKI was defined according to the Kidney Disease: Improving Global Outcomes criteria. Receiver operating characteristic curve analysis was performed to identify the threshold values of AUC and trough concentrations for predicting AKI.
RESULTS: A total of 288 patients were included in the study: 164 were from 2017 to 2019 and 124 were from 2020 to 2022, respectively. A comparison of the 1-point and 2-point sampling methods for estimating the AUC showed no significant differences. The incidence of AKI was slightly lower in the 2020-2022 cohort (2.4%) than in the 2017-2019 cohort (6.7%), though the difference was not statistically significant. The AUC threshold for predicting AKI was similar between 1-point and 2-point sampling methods (588-621 mg h/L).
CONCLUSIONS: AUC-based vancomycin dosing was associated with a reduced incidence of AKI in pediatric patients, without compromising efficacy. Further studies are warranted to refine the exposure targets for bacteremia resolution.
PMID:40966765 | DOI:10.1097/INF.0000000000005006
Pediatr Infect Dis J. 2025 Sep 17. doi: 10.1097/INF.0000000000004993. Online ahead of print.
ABSTRACT
BACKGROUND: Mycoplasma pneumoniae (MP) is a common cause of lower respiratory tract infections in children. During the COVID-19 pandemic, a marked decline in MP infections was observed, with a delayed resurgence reported in some European countries. This study aimed to assess the epidemiological trends and clinical features of MP infections in a pediatric tertiary care academic hospital in Italy from 2017 to 2024.
METHODS: We conducted a retrospective, single-center study including immunocompetent patients 30 days to 17 years of age, hospitalized with confirmed MP infection. Clinical, laboratory, and radiologic data were analyzed across 3 periods: prepandemic (2017-2019), pandemic (2020-2022) and postpandemic (2023-2024). Statistical analyses were performed to compare incidence and clinical characteristics over time.
RESULTS: Of 303 included patients, 130 were hospitalized prepandemic and 148 postpandemics. The proportion of MP among acute respiratory infection hospitalizations nearly doubled, from 3.2% in 2019 to 6.1% in 2024. Despite the higher incidence, the need for respiratory support remained stable (25.7% overall; P = 0.3), the pediatric intensive care admissions were rare and unchanged (2.0% vs. 2.0%, P = 1.0) and median hospital stay was consistent across both periods (5 days, interquartile range 4-8; P = 0.803).
CONCLUSIONS: MP incidence increased significantly postpandemic, and clinical severity remained comparable to prepandemic levels. Ongoing epidemiologic surveillance is essential to better understand infection dynamics and to guide effective clinical management strategies.
PMID:40966764 | DOI:10.1097/INF.0000000000004993
Pediatr Infect Dis J. 2025 Sep 11. doi: 10.1097/INF.0000000000004991. Online ahead of print.
ABSTRACT
BACKGROUND: Urinary tract infection (UTI) is one of the most common bacterial infections in children. Early antibiotic treatment may prevent complications. Empirical treatment requires up-to-date knowledge of the local epidemiology. This study aims to describe trends in resistance rates in community-acquired UTI between 2017 and 2023, assess whether current recommendations for empirical treatment are valid and identify risk factors for resistance.
METHODS: Data were collected retrospectively from the computerized system of Maccabi Health Services for all children under 18 years old diagnosed with a UTI in 2017, 2022 and 2023. Data was evaluated using chi-square tests and regression models to identify resistance trends and associated risk factors.
RESULTS: A total of 24,592 urinary samples were included in the study. Escherichia coli was the most frequently isolated pathogen (76%-78%), with higher prevalence among females than males (78.3% vs. 59.3%, P < 0.001). Sensitivity to first-generation cephalosporins improved significantly (73% in 2017 to 82% in 2022, P < 0.001), while second- and third-generation cephalosporins showed minor fluctuations. Resistance to fluoroquinolones increased markedly, from 7% to 20% (P < 0.001). Female gender, older age, prior antibiotic use and urinary tract abnormalities were significant risk factors for resistance.
CONCLUSIONS: The increased resistance rate observed for most pathogens and antibiotics was statistically significant. Nevertheless, due to small absolute changes, the recommendations for empirical antibiotic treatment in Israel are still valid. Fluoroquinolones, which are not recommended as empirical treatment, should be avoided due to high levels of resistance.
PMID:40966754 | DOI:10.1097/INF.0000000000004991
J Pediatr Endocrinol Metab. 2025 Sep 16. doi: 10.1515/jpem-2025-0329. Online ahead of print.
ABSTRACT
OBJECTIVES: Testosterone therapy is recommended for management of puberty from the age of 12 years in boys with Duchenne muscular dystrophy (DMD). Height measurement is problematic in these adolescent boys as lower limb contracture can be common and estimated height from segmental body part measurements may over-estimate height.
METHODS: Bone growth was assessed using metacarpal and phalangeal measurements from hand radiographs. Raw length measurements were converted to Z-scores based on published normative data and compared by calculating the mean of each patient as ‘composite bone length Z-score’. Biochemical data was also collected to monitor the safety of testosterone therapy.
RESULTS: A total of 22 boys with DMD on daily glucocorticoid were included in the study. Mean age at commencement of testosterone therapy was 14.05 (SD 1.20). 13 boys were commenced on intramuscular testosterone therapy and nine were commenced on topical testosterone therapy. At baseline, 20/22 (91 %) were pre-pubertal (G1). At follow-up, 16/22 (77.3 %) were at early stages of puberty (G2 or G3) and 6/22 (22.7 %) were at late stages of puberty (G4 or G5). At baseline and follow up, composite bone length Z-scores for chronological age were significantly lower than zero, -2.7 (SD 1.07) (p<0.001 vs. zero) and -3.3 (SD 1.17), (p<0.001 vs. zero), respectively. There were no statistically significant differences between the topical and IM group at baseline (p=0.61) or 1 year (p=0.40).
CONCLUSIONS: Measurements of metacarpophalangeal bone length confirms that testosterone therapy enhanced long bone growth in boys with DMD but does not achieve full catch-up growth. Both IM and topical testosterone effectively promote secondary sexual characteristics with no significant side effects.
PMID:40966753 | DOI:10.1515/jpem-2025-0329
N Z Med J. 2025 Sep 19;138(1622):66-79. doi: 10.26635/6965.7025.
ABSTRACT
AIM: The aims of this study are to describe the current status of the heart failure nursing workforce in Aotearoa New Zealand, identify key challenges and provide recommendations.
METHOD: In March 2023, a survey coordinated by the Cardiac Society of Australia and New Zealand and the New Zealand Regional Heart Failure Working Group was distributed to all district health boards in Aotearoa New Zealand. The survey collected data on heart failure nursing resources, including full-time equivalent (FTE) per population, clinical versus non-clinical time, scope of practice, nurse-led services, and performance measures.
RESULTS: A total of 23 hospital responded, yielding a 100% response rate and revealing varied resource allocation across district health boards. While FTE rates have generally increased, nearly half of the boards reported less than one FTE per 100,000 population, with only three reaching the recommended two FTE per 100,000 as endorsed by the British Society for Heart Failure.
CONCLUSION: This foundational survey highlights the current status of the heart failure nursing workforce in Aotearoa New Zealand. It suggests that increasing the number of specialised nursing staff, particularly nurse practitioners (NP), to meet international standards would improve access to timely, effective and equitable treatment for all heart failure patients. Increasing NP FTE across hospital and community settings is likely to enhance healthcare and social outcomes, especially in under-served regions. Further research focussing on ethnicity, geographic distribution and workforce participation is recommended to guide targeted workforce development.
PMID:40966700 | DOI:10.26635/6965.7025