Tag: pubmed

BMC Rheumatol. 2025 May 6;9(1):50. doi: 10.1186/s41927-025-00504-z.

ABSTRACT

BACKGROUND: Dermatomyositis (DM) is an immune-mediated myopathy characterized by proximal muscle weakness, inflammation, and cutaneous manifestations. Up to 25% of DM patients have an associated malignancy. Those with cancer-associated DM often face worse prognoses, poorer treatment responses, and reduced survival rates. Interestingly, anti TIF1γ-positive DM patients are notably at increased risk for malignancy, yet the underlying mechanisms and clinical correlation remain poorly understood. Nailfold video capillaroscopy (NVC) is a safe, non-invasive method for assessing vascular abnormalities, previously explored in various DM subsets but not specifically in anti TIF1γ-positive DM patients with malignancy. This study aims to characterize NVC findings in anti-TIF1γ-positive DM and assess their clinical relevance, particularly in malignancy-associated cases.

METHODS: A retrospective review at Mayo Clinic, Jacksonville from January 1st, 2010 to May 16th, 2024 was conducted. 19 cases with anti TIF1γ-positive DM and 18 idiopathic inflammatory myopathy controls were included.

RESULTS: We observed anti TIF1γ-positive DM cases to have significantly increased capillary density loss and higher microhemorrhages (p = 0.057). Cases also had higher frequencies of dilated capillaries, capillary ramifications, and capillary disorganization. Although no statistically significant differences in NVC pattern were identified in cancer vs. non-cancer anti TIF1γ-positive DM, there were greater hemorrhages and ramifications noted in the cancer anti TIF1γ-positive subset.

CONCLUSION: This study investigated NVC differences among anti TIF1γ-positive DM with malignancies versus idiopathic inflammatory myopathy controls. Our findings indicate promising microvascular differences with a potential for predicting cancer development that warrant further exploration in larger studies.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40329336 | DOI:10.1186/s41927-025-00504-z

BMC Surg. 2025 May 6;25(1):197. doi: 10.1186/s12893-025-02921-w.

ABSTRACT

BACKGROUND: Achieving the global spinal alignment, especially the pelvis, in spine surgeries is considered the most important factor in the success of these surgeries, which requires an accurate evaluation of the correction angles measured during surgery. This study aimed to evaluate the accuracy of the mobile C-arm X-ray machine (C-ARM) for measuring lumbar lordosis (LL) and pelvic incidence (PI) parameters during lumbar fixation.

METHODS: In this prospective study, 59 lumbar fixation candidates who underwent surgery between 2020 and 2022 at our medical center, were examined. PI and LL parameters were measured at the fusion site with fluoroscopy, during surgery with C-ARM, and after surgery with EOS locally.

RESULTS: The mean age was 54.69 ± 17.62 years. 42 (71.2%) were female. The mean PI based on intraoperative C-ARM and post-surgery EOS findings were 54.57 ± 11.19 and 54.83 ± 11.17, respectively, which this difference was not statistically significant (P = 0.9). The mean LL estimate based on C-ARM and EOS findings was similar (P: 0.44).A significant positive linear correlation was observed for the mean PI (r: 0.97, p: 0.001) and LL (r: 0.99, p: 0.001).

CONCLUSION: The mean PI and LL angle during operation (measured with C-ARM) was similar to the mean of these parameters in EOS imaging findings after surgery. C-ARM can be used as a convenient device in the operating room with high precision to measure PI and LL values in spine surgeries.

PMID:40329329 | DOI:10.1186/s12893-025-02921-w

BMC Health Serv Res. 2025 May 6;25(1):648. doi: 10.1186/s12913-025-12808-4.

ABSTRACT

BACKGROUND: People with disabilities experience significant health inequities compared with the general population. Addressing these inequities requires the development and implementation of tailored interventions, but a gap often exists between recommended best practices and the actual care provided. Successful implementation is complex, involving multiple organizational factors. Assessing organizational readiness for change is crucial to overcome barriers and improve health outcomes for people with disabilities. This study aims to examine managers’ perceptions of their organization’s readiness for change regarding the implementation of interventions within disability healthcare in Sweden.

METHODS: This descriptive cross-sectional study employs an embedded mixed-methods approach. The primary approach for the overall study is based on quantitative data, while qualitative data is analyzed to provide supplementary deepened information. Both types of data were collected simultaneously through a web-based survey. The data analysis involves various statistical techniques for the quantitative data and inductive content analysis for the qualitative data.

RESULTS: Several key factors influence managers’ perceptions of their organization’s readiness for change, including gender, age, tenure, organizational type, managerial level, and experience. Enabling factors for implementation include trust-based leadership, staff involvement, motivation, and engagement. Barriers include complex processes, lack of support, resistance and fear, and insufficient time and resources.

CONCLUSIONS: This study highlights the complexity of organizational readiness for disability healthcare interventions, shaped by both individual and organizational factors. In particular, managerial characteristics, organizational dynamics, and resource availability play key roles. These findings suggest that a comprehensive strategy can strengthen healthcare organizations’ ability to navigate implementation challenges effectively.

PMID:40329315 | DOI:10.1186/s12913-025-12808-4

BMC Public Health. 2025 May 6;25(1):1661. doi: 10.1186/s12889-025-22925-8.

ABSTRACT

BACKGROUND: Physical activity (PA), sedentary behavior (SB), metabolic syndrome (MetS), and non-alcoholic fatty liver disease (NAFLD) have been linked in previous studies. Nevertheless, it is unclear whether MetS has a mediating influence on the relationships among physical activity, sedentary behavior, and non-alcoholic fatty liver disease. This study aims to assess the connections between physical activity, sedentary behavior, and non-alcoholic fatty liver disease and to explore the extent to which metabolic syndrome acts as a mediator in this association.

METHODS: A total of 3351 adults from the National Health and Nutrition Examination Survey (NHANES) from 2017 to 2018 were included in our study. Physical activity and sedentary behavior were categorized as work activity (WA), recreational activity (RA), walking/bicycling (for commuting) and sedentary behavior to investigate the association with metabolic syndrome and non-alcoholic fatty liver disease. Besides, mediation analysis was utilized to determine the extent to which metabolic syndrome mediates the relationships among inadequate physical activity, prolonged sedentary behavior, and non-alcoholic fatty liver disease.

RESULTS: Regression analysis revealed that a reduced risk of developing NAFLD was associated with sufficient recreational activity (OR = 0.61, 95% CI: 0.44-0.83, P = 0.004), while an increased risk of MetS was observed in sedentary behavior group (OR = 1.28, 95% CI: 1.00-1.64, P < 0.05). In addition, strong associations were detected between MetS and NAFLD. Mediation analysis indicated that metabolic syndrome accounts for 17.9% of the influence that recreational activity has on the risk of NAFLD. Subgroup analysis indicated sex differences in these associations. Specifically, recreational activity may not significantly influence the risk of developing NAFLD in females, and the mediating role of MetS was no longer significant in both sex-specific subgroups.

CONCLUSION: In the general adult population, metabolic syndrome may account for nearly 18% of the association between insufficient recreational activity and non-alcoholic fatty liver disease.

PMID:40329313 | DOI:10.1186/s12889-025-22925-8

J Transl Med. 2025 May 6;23(1):507. doi: 10.1186/s12967-025-06400-x.

ABSTRACT

BACKGROUND: Chimeric antigen receptor T-cell (CAR T-cell) therapies have shown significant promise in treating cancers and other diseases. However, the manufacturing processes for CAR T-cell therapies exhibit considerable variability, which can affect treatment consistency and patient outcomes. While centralized manufacturing models dominate, local decentralized approaches, including point-of-care production, are being explored to address logistical and access challenges. This study aims to evaluate the current landscape of local CAR T-cell manufacturing at academic institutions.

METHODS: A comprehensive, cross-sectional survey was distributed to 130 FACT and/or JACIE accredited academic institutions globally. The survey, developed from semi-structured interviews with CAR T-cell manufacturing experts, assessed practices in cell modification methods, equipment protocols, and regulatory challenges. Data were analyzed using descriptive statistics, comparing responses across institutions and regions.

RESULTS: 45 of the 130 institutions (35 from the United States and 10 internationally, from the European Union, the United Kingdom, and Australia) responded to the survey (35% response rate). Of the 45 responding institutions, 40 were actively engaged or planning to engage in CAR T-cell production, while five had no plans to initiate manufacturing. Within the 40 institutions engaged in CAR T-cell production, 63% (25/40) reported active manufacturing, while 37% (15/40) were in the process of developing manufacturing capabilities. The most commonly reported barriers to local manufacturing were cost constraints (70%, 28/40), regulatory complexities (70%, 28/40), and facility requirements (57%, 17/40). Variability in product quality was cited by 73% (29/40) of institutions. Equipment costs and the need for specialized training emerged as major challenges, particularly for international institutions. Institutions also highlighted the need for automated platforms, with 60% (24/40) using the Miltenyi CliniMACS Prodigy and 50% (20/40) using the Lonza Cocoon.

CONCLUSIONS: This study highlights the widespread adoption of local CAR T-cell manufacturing and the significant variability in production processes across institutions. The findings emphasize the importance of establishing quality control benchmarks and data reporting frameworks to improve product consistency and access to CAR T-cell therapies. Addressing barriers such as cost, infrastructure, and regulatory challenges through standardization efforts and international collaboration could enhance the reproducibility, scalability, and accessibility of CAR T-cell therapies globally.

PMID:40329308 | DOI:10.1186/s12967-025-06400-x

J Med Internet Res. 2025 May 6;27:e66887. doi: 10.2196/66887.

ABSTRACT

BACKGROUND: Obesity is a growing public health concern worldwide, significantly contributing to premature mortality and noncommunicable diseases. Weight reduction through lifestyle interventions, including diet and physical activity, is the primary approach to combating obesity, with studies showing that a 5% to 10% reduction in body weight can notably reduce obesity-related complications. Recently, smartphone apps have emerged as popular tools to aid in weight loss. However, the effectiveness of smartphone-only apps for weight management in people with overweight or obesity without comorbidities remains unclear.

OBJECTIVE: This meta-analysis aims to evaluate the efficacy of these apps in supporting weight loss and improving body composition in such populations.

METHODS: A systematic review and meta-analysis were conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, with a search across databases including PubMed, Scopus, Cochrane Library, and others. The inclusion criteria were randomized controlled trials involving adults (aged ≥18 years) with overweight or obesity (BMI≥25 kg/m²) and assessing the use of smartphone-only apps for weight loss. Studies using additional devices or involving participants with comorbidities were excluded. Data extraction focused on weight loss, BMI, waist circumference, and body fat percentage, and the risk of bias was assessed using the Revised Cochrane Risk-of-Bias tool.

RESULTS: A total of 11 randomized controlled trials with 1717 participants were included in the meta-analysis. The interventions, lasting between 60 days and 12 months, involved diet and exercise monitoring via smartphone apps. At 4-6 months of follow-up, app-based interventions significantly reduced body weight (standardized mean difference -0.33, 95% CI -0.48 to -0.17; P<.001; I²=49%) and BMI (mean difference [MD] -0.76, 95% CI -1.42 to -0.10; P=.02). Reductions in body fat percentage were also observed at 3 months (MD -0.79, 95% CI -1.38 to -0.20; P=.009) and between 4 and 6 months (MD -0.46, 95% CI -0.71 to -0.20; P<.001). However, no significant effects on waist circumference were noted (P=.07).

CONCLUSIONS: Smartphone apps demonstrate a modest but statistically significant effect on weight loss and BMI reduction over a 4- to 6-month period in individuals with overweight or obesity. The effectiveness of these interventions appears limited beyond 6 months, with a tendency for weight regain. Many apps lack the personalized support necessary to sustain long-term weight loss, contributing to high dropout rates. Future development of weight loss apps should focus on enhanced customization to improve user adherence and long-term outcomes.

TRIAL REGISTRATION: PROSPERO CRD42024570999; https://tinyurl.com/2xw6j4fy.

PMID:40327853 | DOI:10.2196/66887

J Med Internet Res. 2025 May 6;27:e65272. doi: 10.2196/65272.

ABSTRACT

BACKGROUND: Worldwide, 30%-45% of adults have sleep disorders, which are linked to major health issues such as diabetes and cardiovascular disease. Long-term monitoring with traditional in-lab testing is impractical due to high costs. Wearable artificial intelligence (AI)-powered solutions offer accessible, scalable, and continuous monitoring, improving the identification and treatment of sleep problems.

OBJECTIVE: This scoping review aims to provide an overview of AI-powered wearable devices used for sleep disorders, focusing on study characteristics, wearable technology features, and AI methodologies for detection and analysis.

METHODS: Seven electronic databases (MEDLINE, PsycINFO, Embase, IEEE Xplore, ACM Digital Library, Google Scholar, and Scopus) were searched for peer-reviewed literature published before March 2024. Keywords were selected based on 3 domains: sleep disorders, AI, and wearable devices. The primary selection criterion was the inclusion of studies that utilized AI algorithms to detect or predict various sleep disorders using data from wearable devices. Study selection was conducted in 2 steps: first, by reviewing titles and abstracts, followed by full-text screening. Two reviewers independently conducted study selection and data extraction, resolving discrepancies by consensus. The extracted data were synthesized using a narrative approach.

RESULTS: The initial search yielded 615 articles, of which 46 met the eligibility criteria and were included in the final analysis. The majority of studies focused on sleep apnea. Wearable AI was widely deployed for diagnosing and screening disorders; however, none of the studies used it for treatment. Commercial devices were the most commonly used type of wearable technology, appearing in 30 out of 46 (65%) studies. Among these, various brands were utilized rather than a single large, well-known brand; 19 (41%) studies used wrist-worn devices. Respiratory data were used by 25 of 46 (54%) studies as the primary data for model development, followed by heart rate (22/46, 48%) and body movement (17/46, 37%). The most popular algorithm was the convolutional neural network, adopted by 17 of 46 (37%) studies, followed by random forest (14/46, 30%) and support vector machines (12/46, 26%).

CONCLUSIONS: Wearable AI technology offers promising solutions for sleep disorders. These devices can be used for screening and diagnosis; however, research on wearable technology for sleep disorders other than sleep apnea remains limited. To statistically synthesize performance and efficacy results, more reviews are needed. Technology companies should prioritize advancements such as deep learning algorithms and invest in wearable AI for treating sleep disorders, given its potential. Further research is necessary to validate machine learning techniques using clinical data from wearable devices and to develop useful analytics for data collection, monitoring, prediction, classification, and recommendation in the context of sleep disorders.

PMID:40327852 | DOI:10.2196/65272

Plast Reconstr Surg. 2025 May 5. doi: 10.1097/PRS.0000000000012179. Online ahead of print.

ABSTRACT

PURPOSE: Enophthalmos is an undesired outcome of orbital fracture repair (OFR). Risk factors for postoperative enophthalmos remain unclear. We sought to develop and validate a risk calculator for more accurate prediction of this outcome.

METHODS: We retrospectively reviewed adult trauma patients who underwent OFR at two trauma centers over 8 years. Patients with postoperative follow-up <2 weeks were excluded. Our primary outcome was incidence of postoperative enophthalmos at ≥2 weeks following OFR. The C-statistic (area under the ROC curve) and Hosmer-Lemeshow tests were used to assess the accuracy of the risk model.

RESULTS: Of 501 patients with OFR, 349 were included. Twenty-seven (7.7%) patients had postoperative enophthalmos. The risk model was developed and partially validated using patient data from 2015 to 2019 (n=253), and fully validated from 2020 to 2022 (n=96). Risk factors for postoperative enophthalmos were: older age, preoperative enophthalmos, medial wall involvement, near-total orbital floor defects, and delayed surgical repair beyond 1 month from injury. There was an incremental increase in the odds of postoperative enophthalmos with longer duration from injury to surgery. Our risk model showed very good discrimination (C-statistic=84.5%) and calibration (P=0.83). It was highly accurate in predicting enophthalmos using the validation dataset (C-statistic=0.89). For a risk cut-off of 9.5%, the sensitivity and negative predictive value were 85% and 99%, respectively.

CONCLUSION: We designed the first validated risk calculator that can be used to rule out enophthalmos following OFR. Our risk calculator enables surgeons to preoperatively predict the absence of postoperative enophthalmos in 99% of cases.

PMID:40327821 | DOI:10.1097/PRS.0000000000012179

Plast Reconstr Surg. 2025 May 5. doi: 10.1097/PRS.0000000000012178. Online ahead of print.

ABSTRACT

BACKGROUND: In Kienböck disease with carpal collapse, salvage procedures such as scaphocapitate fusion (SCF) and proximal row carpectomy (PRC) are mainstays of surgical treatment. This study analyzes objective (relative grip and range of motion) and patient-reported outcomes after SCF or PRC in laborers versus non-laborers.

METHODS: A retrospective cohort study of patients who underwent surgery for Kienböck disease within a single health system from 1976 to 2023 was conducted. Postoperative DASH and PRWE scores were surveyed from the available population. Labor status, grip, range of motion, and return to the operating room were collected in the medical record and radiographs were analyzed. Categorical comparisons were performed using Fisher’s exact test or Chi-square testing as deemed appropriate by count. Analysis of variance (ANOVA) was used for comparisons of continuous variables. An alpha of 0.05 was used for all statistical tests. Pairwise student t-testing was performed within groups for comparisons of continuous variables. Statistical analysis was performed in R (version 4.4.1) with an alpha of 0.05.

RESULTS: Sixty-four patients underwent PRC and 78 underwent SCF. Patients with PRC were significantly older than patients with SCF. Mean follow up was 29 (SD=53) months. There was no significant difference in post-operative range of motion or relative grip strength between the cohort groups. Laborers who underwent SCF demonstrated the least disability on DASH scores. There was no significant difference in postoperative DASH scores in PRC when comparing laborers versus non-laborers. In contrast, the DASH and PRWE scores of patients who underwent SCF postoperatively varied between laborers and non-laborers [mean (SD) 11.1 (13.9) vs. 30.5 (24.8) p=0.005 and 17.5 (19.4) vs. 42.3 (31.4) p=0.024]. Patients who underwent SCF had a greater rate of revision surgery compared to PRC (22/78 vs. 6/64, p=0.026). Wrist fusion rates were 19% for SCF compared to 1.6% for PRC (0.0007).

CONCLUSIONS: SCF and PRC demonstrated no difference in postoperative range of motion and grip based on labor status. Laborers with SCF had the least post-operative disability on DASH; however, SCF was associated with the need for additional surgical intervention and conversion to total wrist arthrodesis, likely due to the development of radiocarpal arthritis. Shared decision making remains paramount in discussion of the surgical treatment of Kienböck disease associated with carpal collapse.

PMID:40327820 | DOI:10.1097/PRS.0000000000012178

Plast Reconstr Surg. 2025 May 5. doi: 10.1097/PRS.0000000000012175. Online ahead of print.

ABSTRACT

BACKGROUND: Preoperative anemia is a significant concern in plastic surgery, particularly in procedures such as lipoabdominoplasty, where intraoperative blood loss can impact postoperative recovery. While oral iron supplementation is a common approach, its limited bioavailability and gastrointestinal intolerance often hinder effective anemia management.This study compares the efficacy of ferric carboxymaltose (Ferinject®) versus liposomal iron (Sideral Forte®) in optimizing preoperative iron levels and preventing postoperative anemia in patients undergoing 360° lipoabdominoplasty.

METHODS: A retrospective analysis was conducted on 44 female patients undergoing lipoabdominoplasty. Patients were divided into two groups:-Group A received oral liposomal iron (14 mg, twice daily) for one month preoperatively.-Group B received a single intravenous dose of ferric carboxymaltose (1000 mg) 72 hours before surgery.Hemoglobin, hematocrit, and ferritin levels were assessed preoperatively, on postoperative day 1, and on day 7. Statistical comparisons were performed using independent T-tests and Pearson correlation analysis.

RESULTS: Preoperative hemoglobin and hematocrit levels were comparable between groups. However, postoperative hemoglobin decline was significantly more pronounced in Group A (p < 0.05), while Group B showed a better preservation of iron stores and faster hematologic recovery. Ferritin levels remained significantly higher in Group B throughout the postoperative period (p < 0.05). No patients required blood transfusions or exhibited symptoms of acute anemia.

CONCLUSION: Intravenous ferric carboxymaltose is a superior strategy for preoperative iron optimization in lipoabdominoplasty, ensuring better perioperative stability, faster recovery, and reduced anemia-related complications compared to oral liposomal iron. Integrating this approach into perioperative protocols could enhance surgical outcomes.

PMID:40327819 | DOI:10.1097/PRS.0000000000012175