Tag: pubmed

Ann Med. 2025 Dec;57(1):2476040. doi: 10.1080/07853890.2025.2476040. Epub 2025 Mar 10.

ABSTRACT

OBJECTIVE: This study aimed to construct a model based on machine learning to predict new HIV infections in HIV-negative men who have sex with men (MSM).

METHODS: This is a secondary analysis of a previous random clinical trial aiming to evaluate the preventive effects of PrEP on new HIV infection in MSM. During 2013-2015, 1455 HIV-negative MSM were enrolled. Participants were divided into treatment group and control group and regularly followed up until they seroconverted to HIV positive or until the 2-year endpoint reached. Five machine-learning approaches were applied to predict the risk of HIV infection. Model performance was evaluated using Harrel’s C-index and area under the receiver operator characteristic curve (AUC) and validated in an external validation cohort. To explain this model, shapley additive explanation (SHAP) values were calculated and visualized.

RESULTS: During the observation period, 102 MSM developed HIV infection. Thirteen parameters are selected to construct the model. The random survival forest model showed the best performance in the validation cohort, with a C-index of 0.7013, and could significantly categorize MSM into three groups. Our model indicated that MSM with younger age, receptive anal intercourse, and multiple male sexual partners had an increased risk of HIV infection, and those with higher AIDS knowledge scores had a lower risk.

CONCLUSION: We presented a machine learning-based model to predict their risk of developing HIV infection. This model could be applied to recognize MSM who are at a higher risk of developing HIV infection.

PMID:40059791 | DOI:10.1080/07853890.2025.2476040

Otol Neurotol. 2025 Feb 24. doi: 10.1097/MAO.0000000000004469. Online ahead of print.

ABSTRACT

HYPOTHESIS: Simvastatin enhances radiation cytotoxicity of primary vestibular schwannoma (VS) and NF2-mutant human Schwann (HS01) cells.

BACKGROUND: Approximately 10% of VS progress after radiotherapy. Simvastatin is a lipid-lowering medication that promotes apoptosis, inhibits cell proliferation, and enhances radiation response in various cancers. In this study, we determine the effect of simvastatin on the viability of irradiated and nonirradiated primary VS and HS01 cells.

METHODS: Primary VS (N = 5) and HS01 cells were pretreated with simvastatin (0 or 1 μM) prior to irradiation (0 or 18 Gy). A cell-based assay was used to measure cell viability. Immunocytochemistry was performed for γH2AX (DNA damage marker) and RAD51 (DNA repair protein). Statistical analysis was conducted with parametric and nonparametric one-way analysis of variance tests.

RESULTS: Radiation initiated double-stranded breaks in DNA in both VS and HS01 cells. Two VS were radiation-resistant and the remaining three VS were radiation-sensitive. In response to radiation, radiation-resistant VS cells activated RAD51-mediated DNA repair. Simvastatin blocked RAD51 activation in radiation-resistant VS, increased levels of lethal DNA damage, and enhanced radiation-induced cell death. Simvastatin also enhanced radiation-induced cell death in radiation-sensitive VS cells through RAD51-independent mechanisms. However, simvastatin was not effective as a radiosensitizer in HS01 cells.

CONCLUSION: Simvastatin improved radiation response of radiation-resistant primary VS cells by inhibiting RAD51-related DNA repair. Although through RAD51-independent mechanisms, simvastatin also improved radiation response in radiation-sensitive VS cells. Additional preclinical investigations are warranted to evaluate the mechanisms of action and efficacy of statin drugs as radiosensitizers for VS patients.

PMID:40059781 | DOI:10.1097/MAO.0000000000004469

COPD. 2025 Dec;22(1):2468328. doi: 10.1080/15412555.2025.2468328. Epub 2025 Mar 10.

ABSTRACT

BACKGROUND: Clinical trials have shown beneficial results from lung volume reduction with endobronchial coils in patients with emphysema, but comprehensive safety data are not yet available for a new coil type, Coil #4. The objective of this study is to generate real-world data (RWD) on the safety and efficacy of endobronchial Coil #2 and Coil #4.

METHODS: This is a cohort study of prospectively collected data from the multicenter German Lung Emphysema Registry e.V. (LE-Registry) for patients with advanced lung emphysema undergoing lung volume reduction. All patients treated with Coil #2 or Coil #4 were evaluated at baseline and at 3 months for pulmonary function tests (FEV₁, FVC, RV, DLCO, pCO₂), exercise capacity, quality of life (mMRC, CAT, SGRQ), and adverse events. Descriptive statistics were used to analyze response rates and changes in clinical outcomes.

RESULTS: Data from 73 patients (37 Coil #2, 36 Coil #4) enrolled between 2017 and 2024 were evaluated. At 3 months, outcome data were available for 32 Coil #2 and 26 Coil #4 patients. In the Coil #2 cohort significant improvements in RV and SGRQ were observed. The Coil #4 cohort shows significant improvements in FVC, RV, SGRQ, and CAT. Complications occurred in 37% of Coil #2 and 37% of Coil #4 patients, with 26% of patients treated with Coil #4 experiencing pneumothorax.

CONCLUSIONS: The outcomes observed in this RWD study are consistent with other published coil studies. The higher pneumothorax rate with Coil #4 is surprising and should be minimized by adapting the technique.

TRIAL REGISTRATION: DRKS00021207 registered on 29/05/2020.

PMID:40059773 | DOI:10.1080/15412555.2025.2468328

J Child Adolesc Psychopharmacol. 2025 Mar 10. doi: 10.1089/cap.2024.0130. Online ahead of print.

ABSTRACT

Introduction: Prior studies have demonstrated that, in both adults and youth, bipolar disorder (BD) is a polygenic illness. However, no studies have examined polygenic risk scores (PRSs) in relation to the longitudinal course of mood symptoms in youth with BD. Methods: This study included 246 youth of European ancestry with BD (7-20 years old at intake) from the Course and Outcome of Bipolar Youth study and Centre for Youth Bipolar Disorder. Mood symptom severity was assessed at intake and, for 168 participants, prospectively for a median of 8.7 years. PRSs for BD, schizophrenia (SCZ), major depressive disorder (MDD), and attention-deficit/hyperactivity disorder (ADHD) were constructed using genome-wide summary statistics from independent adult cohorts. Results: Higher BD-PRS was significantly associated with lower most severe lifetime depression score at intake (β = -0.14, p = 0.03). Higher SCZ-PRS and MDD-PRS were associated with significantly less time spent in euthymia (SCZ-PRS: β = -0.21, p = 0.02; MDD-PRS: β = -0.22, p = 0.01) and more time with any subsyndromal mood symptoms (i.e., any mania, mixed, or depression symptoms; SCZ-PRS: β = 0.15, p = 0.04; MDD-PRS: β = 0.17, p = 0.01) during follow-up. PRSs for BD and ADHD were not significantly associated with any longitudinal mood variable. Conclusions: This exploratory analysis was the first to examine psychiatric PRSs in relation to the prospective course of mood symptoms among youth with BD. Results from the current study can serve to guide future youth BD studies with larger sample sizes on this topic.

PMID:40059772 | DOI:10.1089/cap.2024.0130

Acta Orthop. 2025 Mar 10;96:243-249. doi: 10.2340/17453674.2025.43189.

ABSTRACT

BACKGROUND AND PURPOSE: Return to work (RTW) following primary total hip arthroplasty (THA) is important for patients and society. We aimed to investigate the association between markers of socioeconomic status (SES) and RTW after primary THA, and whether the association is influenced by sex, age, and comorbidity.

METHODS: Using Danish population-based registries we included 9,431 patients aged 18 to 59 years, undergoing primary THA for osteoarthritis from 2008-2018. Exposure was individual-level data on SES markers (education, income, and cohabitation). Work status information before and after THA was obtained from the Danish Register for Evaluation of Marginalization. We computed cumulative incidence of RTW up to 24 months after THA. The association between SES and RTW was analyzed using Cox regression by hazard ratios with 95% confidence intervals (CI).

RESULTS: The median time to RTW was 54 days. Cumulative incidence of RTW was 86% by 6 months and 93% by 24 months. The adjusted hazard ratio for RTW was 1.9 (CI 1.8-2.0) for high vs low education, 2.2 (CI 2.1-2.3) for high vs low income, and 1.3 (CI 1.3-1.4) for cohabiting vs living alone. Associations were stronger in male than female patients for all SES markers.

CONCLUSION: Most patients returned to work within 24 months, with the largest proportion within 6 months. Markers of low SES were associated with delayed RTW, highlighting the importance of enhanced focus on THA patients in socially vulnerable positions to reduce health and financial implications of delayed RTW.

PMID:40059766 | DOI:10.2340/17453674.2025.43189

Acta Orthop. 2025 Mar 10;96:235-242. doi: 10.2340/17453674.2025.43086.

ABSTRACT

BACKGROUND AND PURPOSE: We primarily aimed to report the results of ulnar shortening osteotomy (USO) in cases of ulna impaction syndrome (UIS), and secondarily to assess the influence of etiology, radiographic parameters, and comorbidities on the outcome.

METHODS: Patients with USO performed for UIS between 2014 and 2022 at our department were included in the study. Demographic, surgical, and postoperative data, including complications and revisions, were recorded retrospectively. An additional study-specific follow-up was performed in all available cases, including subjective outcome measures as Patient Related Wrist Evaluation (PRWE) and Quick Disability of the Arm Shoulder and Hand (Quick-DASH) scores, and standardized 90-90° wrist radiographs.

RESULTS: 47 patients were treated with USO at mean age 45.8 years (standard deviation [SD] 16.7); 28 were female; median follow-up was 37 months (interquartile range [IQR] 22-57). Isolated USO was performed in 27 cases; the rest received a combination of procedures, e.g., wrist arthroscopy. USO-specific devices were used in all cases. Reoperations were performed in 12 cases, with implant removal in 11. Postoperative complications such as chronic regional pain syndrome or pseudoarthrosis were detected in 9 patients. 29 patients were additionally examined at median 36 months (IQR 22-49) follow-up. A median PRWE score of 7 (IQR 0-19) and a median Quick-DASH score of 4.5 (IQR 0-15.9) were reported. The subjective improvement was rated as very high by 24 patients. Radiographs showed a mean ulnar shortening of 2.9 mm (SD 1.1) and bone consolidation was achieved in all osteotomies at last follow-up. Relevant comorbidities weakly correlated with worse outcome scores (ρ = 0.41, 95% confidence interval [CI] -0.05 to 0.74 for PRWE and ρ = 0.40, CI -0.06 to 0.73 for Quick-DASH). No statistically significant difference could be detected in any other variables, including UIS etiology.

CONCLUSION: We found that USO had good subjective results measure scores, but with relatively high complication and revision rates, including implant removal.

PMID:40059765 | DOI:10.2340/17453674.2025.43086

Nurse Educ Today. 2025 Mar;146:106559. doi: 10.1016/j.nedt.2024.106559. Epub 2024 Dec 24.

ABSTRACT

BACKGROUND: Empathy is a crucial attribute in healthcare, benefiting both professionals and patients. It also plays an important role in the midwife-woman relationship, contributing to the implementation of respectful maternity care. Witnessing acts of disrespect towards childbearing women in the clinical setting may impair students’ perceptions of respectful maternity care, as they may come to view disrespect as normative. However, empathy may moderate this effect among pre-registration nursing and midwifery students.

OBJECTIVES: To measure empathy levels and associated factors among pre-registration nursing and midwifery students, and the mediating role of empathy on perceptions of disrespectful and respectful maternity care.

DESIGN: A cross-sectional survey.

SETTINGS: Eight universities/colleges.

PARTICIPANTS: A total of 694 pre-registration nursing and midwifery students.

METHODS: Participants completed an online survey with questions from the Jefferson Scale of Empathy (Health Profession Students), Students’ Perceptions of Respectful Maternity Care and a list of items to measure exposure to disrespectful maternity care.

RESULTS: Students reported a mean empathy score of 103 out of 140. Factors such as female, Han ethnicity, fourth year of the program, midwifery major, and a hybrid mode of clinical practicum (online and in-person) were found to be associated with higher empathy levels. Empathy mediated the impact of witnessing disrespectful care on students’ perceptions of respectful maternity care.

CONCLUSION: Pre-registration education should consider the different needs of students based on their gender, ethnicity, and different stages of clinical training. Enabling clinical learning environments with empathetic role models may cultivate students’ empathy during their clinical training.

PMID:40059753 | DOI:10.1016/j.nedt.2024.106559

Otol Neurotol. 2025 Feb 20. doi: 10.1097/MAO.0000000000004459. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine comfort (C) and threshold (T) levels in adult cochlear implant (CI) recipients over the first 18 months postactivation.

STUDY DESIGN: Retrospective review of longitudinal CI programming data.

SETTING: Tertiary academic center.

PATIENTS: A total of 480 CIs among 428 adult CI recipients.

INTERVENTIONS: Cochlear implantation with Cochlear Ltd. devices with subsequent programming to behavioral standards using Custom Sound® fitting software.

MAIN OUTCOME MEASURES: Charge levels needed to achieve C and T levels were measured longitudinally using Custom Sound®, from time of activation to a minimum of 6 and a maximum of 18 months postactivation. Charge (nC) levels were calculated as the product of pulse width (μs) and current amplitude (μA) to standardize among implant models. Changes in C and T charge levels over time were evaluated using repeated-measures analysis of variance.

RESULTS: When considering the entire electrode, the largest increases were seen at 1 month postactivation, and C and T charge levels did not increase significantly after 6 and 12 months, respectively. These findings were consistent across patient age at implantation and sex. When considering proximal electrodes only, C and T levels did not increase significantly after 6 months. In distal electrodes only, C levels did not increase significantly after 6 months, but T levels continued to demonstrate small, but statistically significant increases up to 18 months postactivation.

CONCLUSIONS: Across the entire electrode, we observed the largest changes in C and T charge levels at 1 month postactivation. Small increases in C and T levels continued out to 6 and 12 months, respectively, but may be of limited clinical significance. The stability of programming levels over time may support selective de-escalation of CI follow-up after the initial postactivation period, but, given small yet persistent increases with time, most notably in the distal electrodes, alternatives for follow-up or remote programming may still be encouraged.

PMID:40059752 | DOI:10.1097/MAO.0000000000004459

Forensic Sci Int. 2025 Feb;367:112357. doi: 10.1016/j.forsciint.2024.112357. Epub 2024 Dec 25.

ABSTRACT

The history of torture and other forms of ill-treatment or abuse is relied largely upon asylum seekers’ self-reporting given that several forms of torture don’t leave permanent marks. To the extent, however, that physical findings exist they are valuable confirmatory evidence in support of an asylum application. The aim of this study was to retrospectively document the self-reported history of torture and other forms of abuse, alongside the physical evidence and the degree of consistency observed during examinations of asylum seekers conducted at the Department of Legal Medicine, University Hospital of Montpellier, France, during a 4-year period. The information was retrieved through retrospective analysis of all consecutive cases of the asylum seekers examined from January 1, 2019, to December 30, 2022. Exclusion criterion was age under 18 years old. A total number of 495 asylum seekers were included in the study for the aforementioned period (males 68.1 % and females 31.9 %). Mean of age was 29.90 years. The majority of the sample was originated from Sub-Saharan Africa (76.6 %). The most common method of torture/abuse was blunt force impact (88.5 %). A history of incised wounds (stabs and cuts), burns, gunshot use, and food deprivation were mentioned in 31.2 %, 21.4 %, 7.9 % and 5.6 % of the cases, respectively. Psychological abuse and sexual abuse were reported by 58.0 % and 22.9 % of the asylum seekers, respectively. Female genital mutilation was reported by 34.0 % of the female asylum seekers, coming almost exclusively from Sub-Saharan Africa. The perpetrator was a member of the family in 30.6 % of the cases, followed by police/army (27.7 %). Old injuries were observed on head in 56.4 %, on neck in 3.6 %, on trunk in 58.8 %, on upper extremities in 77.2 %, on lower extremities in 74.3 % and on genital/anal area in 13.3 % of the cases. Regarding the type of injuries observed during forensic clinical examination, history of blunt forces was positively associated with scars (p = 0.004), teeth injuries (p = 0.014) and fractures (p = 0.009). A positive statistical association was shown between compatibility grading 2-4 and burns (p = 0.015), as well as female genital mutilation (p < 0.001). A positive statistical association was shown between compatibility grading 1 and the method of torture/abuse when this was reported to be sexual abuse ((p = 0.008) and blunt force impact (p < 0.001). The results of the study will contribute to the gained knowledge about torture invoked injuries, improving thus the capability of forensic examiners to conduct comprehensive medical evaluations regarding alleged torture survivors.

PMID:40059743 | DOI:10.1016/j.forsciint.2024.112357

J Athl Train. 2025 Mar 10. doi: 10.4085/1062-6050-0700.24. Online ahead of print.

ABSTRACT

Scientific inquiry aims to minimize bias and ensure accurate conclusions. A critical yet often overlooked issue in sports medicine and exercise science research is the family-wise error rate (FWER) and experimental-wise error rate (EWER), which increase with multiple statisticalinferences, inflating the risk of Type I errors. While FWER corrections are standard in post-hoc ANOVA tests, they are inconsistently applied in broader research contexts. Using an example from our research team of over 67 million regression models, we illustrate how failing to correct for FWER can create spurious findings. Approximately 3 million (4.4%) models werestatistically significant (p<0.05), aligning with the expected false-positive rate. This underscores the necessity of solutions such as preregistration, false discovery rate control, and Bayesian approaches. Without proper corrections, erroneous conclusions may mislead clinical decision- making and potentially harm patients, highlighting the importance of rigorous statistical methods in evidence-based sports medicine.

PMID:40059734 | DOI:10.4085/1062-6050-0700.24