Nevin Manimala

Phys Eng Sci Med. 2025 Feb 10. doi: 10.1007/s13246-025-01520-6. Online ahead of print.

ABSTRACT

Low-radiation techniques should be used to detect and follow lung nodules on CT images, but reducing radiation dose to ultra-low-dose CT with submilliSievert dose level would drastically impede image quality and sensitivity for nodule detection. This study investigated the feasibility of using DenseNet to suppress image noise in ultra-low-dose CT for lung cancer screening. DenseNet was trained using input-label pairs from 1, 2, 4, and 6 patients. After training, the model was tested with chest CT from 14 patients that were not used in training process. Seven patients have solid nodules and 7 patients have subsolid nodules. Root mean square error (RMSE) and peak signal-to-noise ratio (PSNR) were calculated to quantify the difference between reference and test images. The contrast-to-noise ratio (CNR) between lung nodule and lung parenchyma was calculated to evaluate the target detectability of chest CT. Subjective image quality assessment was performed using 4-point ranking scale to evaluate the visual quality of CT images perceived by end user. Substantial improvements in RMSE and PSNR were observed after denoising. The lung nodules in denoised images could be distinguished more easily in comparison with those in the original ultra-low-dose CT, which is supported by the CNRs and subjective image quality scores. The comparison of intensity profiles for lung nodules demonstrated that the image noise in ultra-low-dose CT could be suppressed effectively after denoising without causing edge blurring or variation in Hounsfield unit (HU) values. A two-sample t-test revealed no statistically significant differences between full-dose CT and denoised ultra-low-dose CT in the evaluation of lung nodules, lung parenchyma, paraspinal muscle, or vertebral body. Since the linear no-threshold model suggests that no amount of ionizing radiation is entirely risk-free, the quest for further dose reduction remains a consistently important focus in radiology. Overall, our findings suggest that DenseNet could be a viable approach for reducing image noise in ultra-low-dose CT scans used for lung cancer screening.

PMID:39928290 | DOI:10.1007/s13246-025-01520-6

Phys Eng Sci Med. 2025 Feb 10. doi: 10.1007/s13246-025-01517-1. Online ahead of print.

ABSTRACT

Sudden cardiac death (SCD) is a critical cardiovascular issue affecting approximately 3 million individuals globally each year, often occurring without prior noticeable symptoms. While the precise etiology of SCD remains elusive, ventricular fibrillation is believed to play a pivotal role in its pathophysiology. Given that symptoms typically manifest only an hour before the event, timely prediction is crucial for effective cardiac resuscitation. This study aims to predict SCD using time-frequency analysis of ECG signals. We utilized two online datasets: the Sudden Cardiac Death Holter dataset and the MIT-BIH Normal Sinus Rhythm dataset. Our proposed method involves segmenting the 60-min interval preceding ventricular fibrillation into one-minute segments, which are then decomposed into time-frequency sub-bands using empirical mode decomposition (EMD). Nonlinear features are extracted from these decomposed signals, followed by classification using support vector machines (SVM) and K-nearest neighbors (KNN) algorithms. To enhance classification accuracy, we employed two statistical feature selection techniques: T-test and ANOVA. Results indicate that using the ANOVA feature selection method in conjunction with SVM and KNN algorithms achieves high accuracy in predicting SCD. Specifically, the average accuracy rates for the 60 min preceding SCD were 93.51% for ANOVA-SVM and 93% for ANOVA-KNN. With T-test feature selection, the average accuracy rates were 93.29% for SVM and 93.41% for KNN. These findings demonstrate the promising performance of our proposed approach in predicting SCD, potentially contributing to improved early intervention strategies and patient outcomes.

PMID:39928289 | DOI:10.1007/s13246-025-01517-1

Biochem Genet. 2025 Feb 10. doi: 10.1007/s10528-025-11050-1. Online ahead of print.

ABSTRACT

miR-34a and miR-449 are key miRNAs involved in sperm function and male fertility, with their dysregulation potentially contributing to male infertility. ADAM proteins, specifically ADAM2 and ADAM7, are also implicated in sperm function. This study investigates the interactions between miR-34a, miR-449, and ADAM2/ADAM7, exploring their roles in male infertility through both experimental analyses and molecular docking. In this case-control study, 15 infertile males and 15 healthy controls were included. Gene expression levels of miR-34a, miR-449, and SOX30 were measured using real-time PCR, while protein levels of ADAM7 and ADAM2 in sperm were assessed through western blotting. Additionally, molecular docking was performed to analyze the binding affinities between miR-34a/miR-449 and ADAM2/ADAM7, with docking scores and confidence levels evaluated. Expression levels of ADAM7 and ADAM2 proteins in sperm from the infertile group showed significant differences compared with the control group (P ≤ 0.05). A significant difference was observed in the expression of miR-449, miR-34a, and SOX30 genes between the control and infertile groups (P < 0.05). A significant correlation between miR-34a expression, ADAM7 protein expression, and sperm morphology was observed. However, no statistically significant correlation was found between miR-34a expression and sperm motility, sperm count, blastocyst, or embryo rates in ICSI and IVF (P ≥ 0.05). Molecular docking and dynamics studies revealed strong interactions between miR-34a/miR-449 and ADAM proteins. The ADAM7/miR-34a complex showed the highest binding affinity with a docking score of – 372.40 and a confidence score of 0.9884, followed by ADAM7/miR-449. Hydrogen bond analysis indicated stable binding, with 9 bonds for ADAM2/miR-34a and 7 for ADAM7/miR-34a. These interactions suggest a significant role in regulating sperm morphology and function.miR-34a, miR-449, ADAM7, and ADAM2 protein expression appear to be involved in the molecular mechanisms of male infertility. These parameters show potential as biomarkers in assisted reproductive technology techniques, particularly by influencing sperm morphology and function.

PMID:39928278 | DOI:10.1007/s10528-025-11050-1

Diabetes Ther. 2025 Feb 10. doi: 10.1007/s13300-025-01694-y. Online ahead of print.

ABSTRACT

INTRODUCTION: Type 2 diabetes mellitus (T2DM) is a common chronic disease with high rates of complications. Although there are successful treatments, rates of medication non-adherence remain high. This study aims to evaluate the impact of financial incentives on medication adherence in people living with T2DM.

METHODS: PubMed, Scopus, and Embase were searched via the terms “medication adherence,” “diabetes,” and “financial/economic incentive.” Data on study characteristics, incentive type, and impact were extracted. The outcome measures included the proportion of days covered (PDC), mean possession ratio (MPR), percent adherent (PDC/MPR > 80%), and others. Two pooled Bayesian meta-analyses were conducted, analyzing the mean differences in PDC or MPR and the percentage of adherent patients (MPR > 80%).

RESULTS: The search yielded 8244 results with 126 full-text articles reviewed. In total, 22 studies that met the inclusion criteria were included. Among these 22 studies, 16 reported that financial incentives significantly increased medication adherence in all, four reported that they did not lead to significant changes in adherence, and two studies reported differing results per subgroup. For the pooled meta-analyses, the effect of financial incentives on percent adherent was significant in three studies (weighted Cohen’s D: 0.03, P = 0.02) and in the ten studies assessed PDC/MPR, financial incentives significantly increased adherence (weighted Cohen’s D: 0.02, 95%, P < 0.01).

CONCLUSION: This systematic review and meta-analysis demonstrated that financial incentives lead to statistically significant but possibly clinically irrelevant increases in medication adherence for patients living with T2DM.

PMID:39928226 | DOI:10.1007/s13300-025-01694-y

Diabetes Ther. 2025 Feb 10. doi: 10.1007/s13300-024-01683-7. Online ahead of print.

ABSTRACT

INTRODUCTION: Diabetic kidney disease (DKD) represents a significant microvascular complication associated with diabetes and serves as a major contributor to end-stage renal disease. While many studies have highlighted the renal protective effects of the anti-aging protein Klotho, the potential link between Klotho and DKD within individuals with diabetes remains a subject of debate, and comprehensive studies utilizing large population-based databases are still needed.

METHODS: This cross-sectional study, which is representative of the national population, examined data from US patients with diabetes aged 40-79 years, collected during the 2007-2016 cycles of the National Health and Nutrition Examination Survey (NHANES). Serum α-Klotho levels were determined using enzyme-linked immunosorbent assay (ELISA) techniques. Given that serum Klorho levels are not normally distributed, our analysis is based on values converted from the natural logarithm of Klotho. To assess the association between Klotho levels and the prevalence of DKD, multivariate regression models were utilized, taking into account potential confounding factors. Furthermore, we applied smooth curve fitting and segmented regression analyses to investigate possible threshold effects and identify inflection points. Subgroup analyses and cross-tests were performed to assess the consistency of associations in the general population.

RESULTS: The investigation included 4490 individuals with diabetes, with an median age of 60.0 years and 48.2% of them being male. Among these participants, 1352 (30.1%) were diagnosed with DKD. The fully adjusted model (model 3) indicated a significant inverse relationship between Klotho levels and DKD prevalence. Statistical analysis showed that in fully adjusted model 3, each 1-unit increase in log-transformed Klotho was associated with a 42% reduction in DKD prevalence [OR 0.58, 95% CI (0.42, 0.80), p = 0.002]. Further analysis using smooth curve fitting revealed a U-shaped relationship between Klotho levels and DKD prevalence, with an inflection point at 6.82 (after natural logarithm conversion).

CONCLUSIONS: This study identified a U-shaped relationship between Klotho levels and the prevalence of DKD in middle-aged and older adults with diabetes in the USA, with an inflection point of 6.82 (after natural logarithm conversion). Prior to this threshold, the relationship between Klotho and DKD prevalence was negatively correlated, while after the inflection point, the relationship became positive. Future studies are recommended to investigate the causal relationship behind this relationship.

PMID:39928222 | DOI:10.1007/s13300-024-01683-7

Neuroinformatics. 2025 Feb 10;23(2):20. doi: 10.1007/s12021-024-09702-5.

ABSTRACT

Research in hearing science often relies on auditory models to describe listener’s behaviour and its neural underpinning in acoustic environments. These models gather empirical evidence from behavioural data to address research questions on the neural mechanisms underlying sound perception. Despite seemingly similar statistical methods, auditory models are often implemented for each study separately, which hinders reproducibility and across-study comparisons, thus limiting the advancement at a field level. Here, we introduce a framework for studying neural mechanisms of sound perception by employing auditory modeling based on Bayesian inference (FrAMBI), a MATLAB/Octave toolbox. FrAMBI provides a standardized structure to implement an auditory model following the perception-action cycle and enables the automatic application of statistical analysis with behavioural data. We show FrAMBI’s capabilities in several examples with increasing levels of complexity within the context of sound source localisation tasks: a basic implementation for a static scenario, iterating over the perception-action cycle with a moving sound source, the definition of multiple model variants testing different neural mechanisms, and the procedure for parameter estimation and model comparison. Being integrated into the widely used auditory modelling toolbox (AMT), FrAMBI is planned to be maintained in the long term and expanded accordingly, fostering reproducible research in the field of neuroscience.

PMID:39928214 | DOI:10.1007/s12021-024-09702-5

Clin Oral Investig. 2025 Feb 10;29(2):126. doi: 10.1007/s00784-025-06203-w.

ABSTRACT

OBJECTIVES: People with intellectual disabilities often have poor oral hygiene and depend on carers’ support. We aimed to investigate, whether automatic toothbrushes could benefit people with Down syndrome (DS).

MATERIALS AND METHODS: In a randomized, single-blinded cross-over study we compared the cleansing efficacy of a horse-shoe shaped automatic toothbrush with that of rotating-oscillating toothbrushing in unassisted domestic use over four weeks by persons with DS. Rustogi Modified Navy Plaque Index (RMNPI) and Gingival Bleeding Index (GBI) were assessed before and after each intervention period. Wilcoxon Signed-Rank Test was used for statistical analysis.

RESULTS: Fifteen participants (mean age 31 ± 8.33 years) finished the study. There were no statistically significant differences in RMNPI between the two brushing modalities after four weeks of unassisted home use, neither in full mouth (Y-brush®: median 59.2%; range 24.8 – 76.7; rotating-oscillating toothbrush: 54.6%; 6.4 – 71.3) (p = 0.484) nor in subgroup analyses. RMNPI was statistically significantly higher after four weeks of automated brushing than baseline. There was no statistically significant difference for full-mouth GBI between the two brushing modalities.

CONCLUSIONS: Both, oscillating-rotating and automated toothbrushing resulted in unsatisfactory plaque control after unassisted use by people with DS.

CLINICAL RELEVANCE: Further studies should investigate the impact of caregivers’ assistance with auto-cleaning devices to persons with disabilities on plaque removal efficacy. Customization of mouthpieces and simplification of handling modalities might effect a higher cleansing capacity and should be future goals for automatic brushing device manufacturers.

PMID:39928199 | DOI:10.1007/s00784-025-06203-w

Genet Med. 2025 Feb 7:101373. doi: 10.1016/j.gim.2025.101373. Online ahead of print.

ABSTRACT

BACKGROUND: Although alglucosidase alfa (AGL) has been the standard treatment for Pompe disease, its efficacy is limited, partially because of its low mannose-6-phosphate content. Avalglucosidase alfa (AVA), a glycoengineered recombinant human acid α-glucosidase, has shown improved receptor-mediated uptake compared with AGL. Herein, we report the long-term efficacy and safety of AVA in patients with infantile-onset Pompe disease (IOPD) previously treated with AGL.

MATERIALS AND METHODS: This retrospective cohort study included nine patients with IOPD who transitioned from AGL to AVA; these patients were diagnosed and treated after being detected with IOPD via newborn screening. We analyzed the clinical status, biomarker levels (serum creatine kinase [CK] and urine glucose tetrasaccharide ([Glc4]), and functional assessments before and after AVA treatment of these patients. Statistical analyses were performed using the Wilcoxon matched-pair signed-rank test.

RESULTS: All nine patients received AGL at dosages exceeding the label recommendations owing to inadequate responses. After transitioning to AVA at a dosage of 40 mg/kg every other week for a median duration of 4.9 years, the patients experienced significant reductions in biomarker levels (CK levels decreased by 63% and Glc4 levels decreased by 69%). Functional assessments, including pulmonary function and 6-min walk tests, showed improvement in young patients but remained stable in older patients. Safety analyses revealed manageable infusion-associated reactions (IARs). Immune modulation therapy for antidrug antibodies (ADA) was administered to one IOPD patient.

CONCLUSION: The transition from a high dose of AGL to AVA demonstrated sustained improvements in biomarker levels and motor function in patients with IOPD. Early initiation of AVA is crucial for patients with IOPD.

PMID:39927452 | DOI:10.1016/j.gim.2025.101373

Neurourol Urodyn. 2025 Feb 10. doi: 10.1002/nau.70009. Online ahead of print.

ABSTRACT

INTRODUCTION: Urinary incontinence (UI) is a very common hygiene and health problem in adults which has an enormous impact on quality of life (QoL). Noninvasive treatment options are the first line of treatment. It would be beneficial to know when the bladder reaches its maximum capacity, to enable to prompt going to the bathroom on time and thereby potentially prevent an UI event. Recently, a wearable bladder sensor was developed, the TENA SmartCare Bladder Sensor (Bladder Sensor), which is intended to support children ( ≥ 6 years) and adults (BMI ≤ 25 kg/m²). The Bladder Sensor tracks the bladder filling status and notifies the user when it is time to go to the bathroom by a vibration of the device and/or a notification in an app on a mobile device (e.g., smartphone and/or Apple Watch®). The primary objective of this first pivotal study was to demonstrate that the Bladder Sensor can detect the bladder before urination among adult intended users. The secondary objectives were to collect real-life data to evaluate performance, safety, usability, and subject satisfaction with the device as well as impact on QoL. The primary hypothesis was to evaluate if the median bladder detection rate in the evaluated population is greater than the threshold of 85% (H0: ≤ 0.85, H1: > 0.85, p-value < 0.05).

PATIENTS & METHODS: Adults ( ≥ 18 years) suffering from UI during day and/or night tested the Bladder Sensor independently at home for 1 week. Device performance, safety, usability, user satisfaction and self-reported disease specific information, and QoL were assessed at pre-defined times. Intra-individual results were compared. Any episodes of urination and/or urine loss were documented by subjects in a paper diary. Raw data of the Bladder Sensor was analyzed to evaluate the bladder detection rate and full bladder notification rate(s).

RESULTS: 30 adults (female/male: 67%/33%; median age: 53 years (Interquartile range (IQR) 32-61 years); median BMI of 22.6 kg/m² (IQR 20.7-23.8 kg/m²)) completed the study testing the Bladder Sensor at home for 6.9 days on average. The median bladder detection rate was 89.8% (IQR 82.6-95.3%) in a sample without statistically and clinically identified outliers (n = 28). The null hypothesis was rejected among those (z = 69, p < 0.05). The median actual full bladder notification rate was 63.1% (IQR 50.0-71.4%), and the median perceived full bladder notification rate was 94.4% (IQR 87.0-105.6%). The device showed to have a positive effect on subjects’ UI problems (e.g., 67% reduced number of unwanted leakages) and QoL.

CONCLUSION: It was demonstrated that the Bladder Sensor can detect the bladder under real-life conditions among its intended users and can support in the prevention of UI. This seemed dependent on anatomical limitations (e.g., BMI and body shape), bladder volume (low bladder detection rate < 100 mL), and/or proper fixation. The device had a positive effect on the subject’s urinary incontinence, their Qo,L and overall well-being while testing it for 1 week. It is assumed that this effect will be strengthened when users incorporate the use of the device into their daily life. Long-term benefits of the Bladder Sensor as an adjunct tool in continence care management needs to be investigated.

TRIAL REGISTRATION: Registration number is NL81246.000.22.

PMID:39927426 | DOI:10.1002/nau.70009

Am J Clin Oncol. 2025 Feb 10. doi: 10.1097/COC.0000000000001173. Online ahead of print.

ABSTRACT

OBJECTIVES: The National Accreditation Program for Rectal Cancer (NAPRC) was established in 2017 to decrease rectal cancer treatment variation and improve oncologic outcomes. Initiating curative intent treatment <60 days of first evaluation is one NAPRC standard. We evaluated whether oncologic outcomes improved with timely treatment and factors associated with its receipt.

METHODS: Using the NCDB, we identified stage I to III rectal cancer patients treated from 2004 to 2020 treated with curative-intent surgery. Patients were stratified into 2 cohorts (timely [<60 d], delayed [≥60 d]) for survival analysis and exploration of variables associated with timely treatment.

RESULTS: We included 117,459 patients with a median age of 61 years (interquartile range: 52 to 70 y). Most patients were male (61.1%), White (86.2%), Charlson 0 (77.1%) with stage II (33.5%) or III (44.3%) cancer treated with chemoradiation (58.1%), or surgery (27.0%) first. Timely treatment was associated with improved overall survival (OS; median OS: 153.26 vs. 128.59 m). Patients in the highest income bracket (odds ratio [OR] 1.30) with stage II (OR: 1.27) or III (OR: 1.50) cancer receiving neoadjuvant chemotherapy (OR: 2.24) or chemoradiation (OR: 1.73) as the first treatment received more timely treatment. Patients with Charlson ≥2 (OR: 0.83) of Black (OR: 0.56) or Hispanic (OR: 0.73) race received more delayed treatment (all P<0.01).

CONCLUSIONS: Timely rectal cancer treatment is associated with improved survival. Socioeconomic disparities limit timely treatment with attendant worse survival, supporting national homogenization of care. As multimodal care for rectal cancer becomes increasingly complex, timely treatment remains paramount.

PMID:39927425 | DOI:10.1097/COC.0000000000001173