Tag: pubmed

Cartilage. 2025 Feb 21:19476035251320747. doi: 10.1177/19476035251320747. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this research was to investigate the relationship between quantitative texture parameters and degenerative cartilage damage in knee osteoarthritis (KOA) by conducting a full-volume texture analysis of infrapatellar fat pad (IFP). In addition, this study also explored if the quantitative texture parameter models outperform semi-quantitative model in cartilage damage classification tasks.

MATERIALS AND METHODS: This retrospective study involved 202 patients who were diagnosed with KOA using imaging and clinical examinations. Texture parameters of the IFP were extracted from sagittal FSE PDWI fat-suppressed sequence images, and least absolute shrinkage and selection operator regression was used for feature selection. Spearman correlation analysis was conducted to assess the relationship between semi-quantitative parameter (Hoffa-synovitis score), quantitative parameters, and cartilage damage. Five multi-classification logistic regression models were developed to predict cartilage damage grade by using Hoffa-synovitis score, texture parameters, and clinical characteristics as independent variables. Subsequently, the performance of these models was compared.

RESULTS: Eight texture features were screened out in this study. Correlation analysis showed that Hoffa synovitis score, texture parameters, and cartilage damage grade were significantly correlated (all P < 0.05). The strongest correlation was found between Hoffa-synovitis score and cartilage damage, demonstrating a moderate positive relationship (r = 0.62). In terms of texture features, the Correlation parameter exhibited a moderate positive correlation with cartilage damage (r = 0.49), while other texture parameters had a slight positive correlation degree of positive or negative correlation. In the task of classifying cartilage damage, the model’s macro-average area under the curve (AUC) only using the Hoffa-synovitis score was 0.73 (95% confidence interval (CI): 0.64, 0.83), while the model using only selected texture parameters achieved a macro-average AUC of 0.84 (95% CI: 0.68, 0.94). Furthermore, the model that combined texture parameters and clinical features also achieved a macro-average AUC of 0.84 (95% CI: 0.72, 0.94). By integrating the Hoffa-synovitis score, texture parameters, and clinical features, the model’s macro-average AUC experienced a slight improvement to 0.85 (95% CI: 0.74, 0.93). Notably, the model combining only Hoffa-synovitis score and texture parameters had the best classification performance, with a macro-average AUC of 0.88 (95% CI: 77, 0.97). The performance of the 4 models incorporating texture parameters outperformed that of the Hoffa-synovitis score alone (all P < 0.05), however with no significant statistical difference observed among the 4 models (all P > 0.05).

CONCLUSIONS: There existed a correlation between the texture parameters of the infrapatellar fat IFP and cartilage damage in KOA. The models using texture parameters demonstrated better performance in classifying cartilage damage compared to the models using only semi-quantitative parameter. Thus, we can infer that texture parameters had the potential to be valuable imaging biomarkers for evaluating cartilage damage.

PMID:39981646 | DOI:10.1177/19476035251320747

J Glob Health. 2025 Feb 21;15:04010. doi: 10.7189/jogh.15.04010.

ABSTRACT

BACKGROUND: Sex and gender are important determinants of health. Gender-based health inequities in the paediatric population have been reported in various countries, but data remain limited. In Mozambique, research on this topic is very scarce. Here we aimed to explore whether boys and girls in Manhiça district, southern Mozambique, differ in access to and provision of healthcare.

METHODS: This retrospective analysis includes data on all paediatric (<15 years old) visits to six outpatient clinics and admissions to one hospital in Manhiça district from 2004 to 2020, collected through the morbidity surveillance system of the Manhiça Health and Demographic Surveillance System (HDSS). We compared characteristics and outcomes between boys and girls using descriptive statistics, standardised mean differences, and logistic regression. Post-discharge events were analysed using Cox proportional hazards regression and Fine-Gray competing risk regression. Minimum community-based incidence rates of outpatient clinic visits and hospitalisations were calculated using demographic surveillance data from the Manhiça HDSS and analysed with negative binomial regression.

RESULTS: Girls represented 49.2% (560 630 out of 1 139 962) of paediatric visits to outpatient clinics and 45.1% (18 625 out of 41 278) of hospitalisations. The girls-to-boys incidence rate ratio (IRR) for hospitalisations was 0.81 (95% confidence interval (CI) = 0.79-0.84). Both boys and girls experienced symptoms for a median duration of one day (interquartile range (IQR) = 1-2) before seeking care. Severe manifestations at presentation to an outpatient clinic or upon hospitalisation tended to be less frequent in girls (girls-to-boys odds ratios (ORs) = 0.71-1.11). Girls were less frequently referred or admitted to hospital after an outpatient clinic visit (OR = 0.82; 95% CI = 0.79-0.86 and OR = 0.85; 95% CI = 0.84-0.87, respectively). The hospital case fatality ratio was 4.1% in boys and 4.2% in girls. The median duration of hospitalisation was three days (IQR = 2-5) and did not differ between boys and girls. Revisits to outpatient clinics, hospital readmissions, and hospital post-discharge mortality were similar in both groups.

CONCLUSIONS: Girls had fewer referrals and admissions to hospital in Manhiça district, but they were also less likely to present with severe manifestations. Other studied indicators of healthcare access and provision were overall similar for boys and girls. Further research is needed to continue assessing potential gender biases and sex differences in paediatric healthcare in Mozambique.

PMID:39981643 | DOI:10.7189/jogh.15.04010

J Glob Health. 2025 Feb 21;15:04058. doi: 10.7189/jogh.15.04058.

ABSTRACT

BACKGROUND: Fee exemption policies are key strategies for reducing the barriers to accessing maternal health services and improving maternal and child health outcomes. This study used pooled national data to determine the impact of Ghana’s user fee exemption policy on maternal health service utilisation since it was implemented in 2008.

METHODS: Using four rounds of cross-sectional data from national surveys on women with live births, we conducted an inverse probability of treatment weighting analysis to evaluate the causal effects of Ghana’s user fee exemption policy intervention on the timing of first antenatal care (ANC) visit, completion of four or more ANC visits and facility-based delivery as indicators of maternal health service utilisation.

RESULTS: The average treatment effect of the fee exemption policy was an increase of 8, 9, and 21% in the utilisation of timely first ANC visit, completion of the recommended number of ANC visits, and facility-based delivery, respectively. Wealth index categorisation showed a clear stepwise increase in the likelihood of facility-based delivery. Compared to the poorest group, the odds were 1.48 times higher for the poorer group adjusted odds ratio (aOR) = 1.48 (95% confidence interval (CI) = 1.33-1.66), 2.27 times higher for the middle group aOR = 2.27 (95% CI = 1.95-2.64), 3.84 times higher for the rich group aOR = 3.84 (95% CI = 3.13-4.69), and 5.96 times higher for the richest group aOR = 5.96 (95% CI = 4.43-8.02). Women who reside in the Upper East region were more likely to utilise maternal health services.

CONCLUSIONS: Ghana’s fee exemption policy positively impacts maternal health service utilisation among pregnant women. However, there still exist disparities across geographical regions and wealth indexes.

PMID:39981639 | DOI:10.7189/jogh.15.04058

J Intensive Care Med. 2025 Feb 21:8850666251318692. doi: 10.1177/08850666251318692. Online ahead of print.

ABSTRACT

INTRODUCTION: Biostatistics is an increasing focus in both the United States Medical Licensing exams (USMLE) and medical school curricula. Nonetheless, literature has documented that it is poorly understood among both practicing physicians and physician trainees. Our purpose is to narrow this knowledge gap by offering readers a “how-to” guide that both supplements essential biostatistics knowledge and assists in constructing research projects.

METHODS: In Part II of our tandem manuscripts, we expand our Part I biostatistics analysis of research articles in the Journal of Intensive Care Medicine (JICM) with explanations and practical use of biostatistics, addressing the most common statistical terms and tests used in the JICM.

RESULTS: Understanding biostatistics requires interpreting the type of study, type of data collected, statistical tests available for all types of data, and results of the statistical tests.

CONCLUSION: Gaining proficiency in biostatistics will improve the precision of evidence-based medical outcomes, helping close the current knowledge gap among practicing physicians and trainees.

PMID:39981632 | DOI:10.1177/08850666251318692

Eur J Ophthalmol. 2025 Feb 21:11206721251314541. doi: 10.1177/11206721251314541. Online ahead of print.

ABSTRACT

INTRODUCTION: Myopia is a refractive error where distant objects are not clearly seen and appear blurred. Goal of this study was to evaluate long-term effectiveness of Repeated Low-Level Red Light (RLRL) therapy for children with myopia, which primarily focused on Axial length (AL) and Spherical Equivalent Refraction (SER) as primary endpoints.

METHODS: The research compared outcomes between RLRL treatment with Single Vision Spectacles (SVS) for childhood myopia management. We performed a systematic literature search in the PubMed, Embase and Cochrane databases using “Myopia” and ” Repeated Low-Level Red Light “. Mean differences (MD) were estimated and the effects of therapies measured. Publication bias and heterogeneity analysis were carried out by Inverted Precision Effect Test-Precision Effect Estimate Standard Error (PET-PEESE) (and subsequent Search Sequential Analysis) and Tau test. Bayesian meta-analysis was performed using Jaffrey Amazing Statistical Package (JASP).

RESULTS: This meta-analysis comprised 1,714 participants: 824 in RLRL and 890 in SVS group. Pooled effect size for AL reduction was 0.953 ± 0.294, (95% credible interval (CI) 0.775 to 0.980). Pooled effect size for SER reduction was 1.521 ± 0.662 (95% CI 0.102 to 2.736). PET-PEESE analysis revealed no significant publication bias (p-value 0.407). Random effects models were employed for presence of significant heterogeneity (3.9 and 5.7 for AL; 5.7 for SER), alongside degree of variation (0.828 & 1.665) for Tau (τ), which estimates the between-study variance.

CONCLUSION: Long-term observations indicate that RLRL treatment significantly influences myopia management, leading to considerable reductions in both AL and SER. Additional research is essential to investigate potential long-term rebound effects.

PMID:39981627 | DOI:10.1177/11206721251314541

Radiat Prot Dosimetry. 2025 Feb 21:ncaf012. doi: 10.1093/rpd/ncaf012. Online ahead of print.

ABSTRACT

The UKHSA radon detectors with polyallyldiglycol carbonate sensing material produced from 2010 onward were used to confirm that they are purely radon detectors only with negligible interference from thoron presence. The statistical analysis of results, after following standard detector processing procedures, showed that such devices can only detect 2.4% ± 0.3% of the total thoron activity concentration compared to the calibrated reference device. It was also demonstrated that thoron, unlike radon, can only travel a very short distance from the source to be effectively measured. Based on the above, it has been concluded that interference of thoron in radon measurement is negligible (within the statistical measurement error), and hence can be ignored in standard indoor and outdoor measurements.

PMID:39981623 | DOI:10.1093/rpd/ncaf012

Cancer Med. 2025 Feb;14(4):e70651. doi: 10.1002/cam4.70651.

ABSTRACT

OBJECTIVE: This study aimed to analyze disease cost levels among colorectal cancer (CRC) patients, examining differences in disease costs between those with type 2 diabetes mellitus (T2DM) and those without T2DM while considering various demographic characteristics.

METHODS: The study included respondents from colorectal cancer patients diagnosed and managed within the population-based cancer registry system of the Shanghai Municipal Center for Disease Control and Prevention from 2020 to 2022. Diabetic colorectal cancer cases were matched with nondiabetic colorectal cancer controls using propensity scores, maintaining a 1:1 ratio between cases and controls; bias for the majority of the matched variables is below 10%. Direct, indirect, and intangible costs were estimated for study subjects.

RESULTS: After propensity score matching, the analysis encompassed 376 cases of T2DM-related CRC and 376 non-T2DM CRC cases. The T2DM group exhibited higher direct medical costs (¥57,059.65 vs. ¥48,933.93, p < 0.05), direct nonmedical costs (¥9292.45 vs. ¥7969.35), indirect costs (¥300.13 vs. ¥241.11), intangible costs (¥3601.70 vs. ¥2631.96), and total disease costs (¥70,253.93 vs. ¥59,776.36, p < 0.05) compared to the non-T2DM group. In Stage II CRC, direct medical costs were ¥74,008.39 for the T2DM group versus ¥57,368.84 for the non-T2DM group. Among surgical patients, direct medical costs were ¥57,658.81 for the T2DM group versus ¥1337.00 for the non-T2DM group, and ¥49,061.52 for the non-T2DM surgical group versus ¥1089.00 for the non-T2DM nonsurgical group.

CONCLUSION: Colorectal cancer imposes a substantial economic burden. Patients with CRC and concurrent T2DM experience a higher economic burden compared to nondiabetic patients. Notably, individuals with both T2DM and Stage II cancer face a significantly higher economic burden, whereas surgical patients exhibit a significantly greater disease burden than nonsurgical patients. Efforts should concentrate on primary prevention and secondary prevention to alleviate the economic burden associated with colorectal cancer.

PMID:39981614 | DOI:10.1002/cam4.70651

Bipolar Disord. 2025 Feb 21. doi: 10.1111/bdi.70012. Online ahead of print.

ABSTRACT

BACKGROUND: The link between ventricular enlargement and asymmetry with other indices of brain structure remains underexplored in individuals with bipolar (BD) and depressive (DD) disorders. Our study compared the lateral ventricular size, ventricular asymmetry, and cortical myelin content in individuals with BD versus those with DD versus healthy controls (HC).

METHODS: We obtained T1w and T2w images from 149 individuals (age = 27.7 (SD = 6.1) years, 78% female, BD = 38, DD = 57, HC = 54) using Magnetic Resonance Imaging (MRI). The BD group consisted of individuals with BD Type I (n = 11) and BD Type II (n = 27), while the DD group consisted of individuals with major depressive disorder (MDD, n = 38) and persistent depressive disorder (PDD, n = 19) Cortical myelin content was calculated using the T1w/T2w ratio. Elastic net regularized regression identified brain regions whose myelin content was associated with ventricular size and asymmetry. A post hoc linear regression examined how participants’ diagnosis, illness duration, and current level of depression moderated the relationship between the size and asymmetry of the lateral ventricles and levels of cortical myelin in the selected brain regions.

RESULTS: Individuals with BD and DD had larger lateral ventricles than HC. Larger ventricles and lower asymmetry were observed in individuals with BD who had longer lifetime illness duration and more severe current depressive symptoms. A greater left asymmetry was observed in participants with DD than in those with BD (p < 0.01). Elastic net revealed that both ventricular enlargement and asymmetry were associated with altered myelin content in cingulate, frontal, and sensorimotor cortices. In BD, but not in other groups, ventricular enlargement was related to altered myelin content in the right insular regions.

CONCLUSIONS: Lateral ventricular enlargement and asymmetry are linked to myelin content imbalance, thus potentially leading to emotional and cognitive dysfunction in mood disorders.

PMID:39981613 | DOI:10.1111/bdi.70012

J Clin Ultrasound. 2025 Feb 21. doi: 10.1002/jcu.23940. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the correlation among semi-quantitative scoring of blood flow by superb microvascular imaging (SMI), hypersensitive C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), and serum uric acid (SUA) levels in different gout duration.

METHODS: 103 patients (total 157 affected joints) with clinically confirmed acute gout attack from January 2021 to May 2022 were performed with laboratory tests (hs-CRP, ESR, SUA), routine joint ultrasound scanning, along with semi-quantitative scoring of SMI, and correlations between which were analyzed.

RESULTS: Statistically significant differences were found in semi-quantitative scoring of SMI in the affected joints between different disease duration. The differences between SMI scoring in gouty tophi, synovial hyperplasia, and the levels of different hs-CRP and ESR subgroups of the affected joints were statistically significant (p < 0.05). R values between SMI scoring in synovial hyperplasia as well as gouty tophi and hs-CRP levels were 0.711 and 0.579, respectively, and those of ESR were 0.430 and 0.418, respectively, while those of SUA levels were -0.227 and 0.120, respectively.

CONCLUSION: With a prolonged progression of gout, hs-CRP and ESR levels amplify, along with a concurrent intensification in the SMI scorings of blood flow signals in the affected joints (grades 2 and 3). In the acute gout attack, SMI blood flow scoring showed a moderate correlation to hs-CRP, a low correlation to ESR, and no correlation to SUA, among which the best correlation was found between SMI scoring and hs-CRP levels in the synovial hyperplasia.

PMID:39981591 | DOI:10.1002/jcu.23940

Arthritis Care Res (Hoboken). 2025 Feb 21. doi: 10.1002/acr.25510. Online ahead of print.

ABSTRACT

OBJECTIVE: Estimate the prevalence of allergic, neurodevelopmental, and autoimmune diagnoses in children born to anti-Ro antibody positive mothers.

METHODS: A cohort study of children born to anti-Ro antibody positive mothers followed in the Neonatal Lupus Erythematosus clinic (NLE) at SickKids Hospital. Participants ≥ 1 year of age were invited to complete a health status questionnaire. Prevalence of allergic, neurodevelopmental, and autoimmune disease diagnoses were compared between from the NLE cohort and the non-NLE population-based CHILD Cohort Study. Descriptive statistics were used for demographics, NLE manifestations and outcomes. Fisher’s exact tests compared the prevalence of diagnoses between subgroups. We tested the association between allergies and neurodevelopmental conditions and NLE with logistic regression models. A P-value of <0.006 was considered significant.

RESULTS: We included 321 participants with anti-Ro antibody positive mothers. Median age at survey completion: 6 years, 51% female, 50% (n=162) NLE. No significant difference in any disease prevalence between children with and without NLE manifestations (p = 0.57) nor between children born to mothers with and without a rheumatic disease (p = 0.11). Disease prevalence was similar between the NLE and CHILD cohorts, allergic disease 30% vs 22%, p= 0.25, neurodevelopmental conditions 5% vs 2%, p=0.45, autoimmune disease 4% vs 2%, p=0.68.

CONCLUSIONS: In a large, multiethnic cohort of infants born to anti-Ro antibody positive mothers, there was no significant difference in the prevalence of allergic, neurodevelopmental, or autoimmune diseases between children with and without NLE, nor between those born to anti-Ro antibody positive mothers and a population-based, non-NLE cohort.

PMID:39981584 | DOI:10.1002/acr.25510