Tag: pubmed

Magn Reson Med. 2025 Oct 28. doi: 10.1002/mrm.70161. Online ahead of print.

ABSTRACT

PURPOSE: Spectral editing is the most common MRS approach for noninvasive in vivo measurement of low-concentration, strongly overlapped metabolites in the brain, such as γ-aminobutyric acid (GABA) and glutathione (GSH). Multi-metabolite editing methods, such as HERMES and HERCULES, enable the editing of multiple J-coupled metabolites in a single acquisition without increasing the total scan time. Yet little is known regarding the reliability of these methods. This study assessed the test-retest reliability of HERMES and HERCULES, where volume localization was achieved using both PRESS and sLASER.

METHODS: Sixteen healthy adult volunteers were scanned twice in two separate sessions. Single-voxel edited MRS data were acquired in the medial parietal lobe using the following sequences: (1) HERMES-PRESS; (2) HERMES-sLASER; (3) HERCULES-PRESS; (4) HERCULES-sLASER. Spectra were processed and metabolites were quantified relative to tCr. Data quality metrics and reliability statistics were estimated for all four acquisitions.

RESULTS: HERMES-sLASER produced lower within-subject coefficients of variation (CV_ws) for GABA + co-edited macromolecules (GABA+), GSH, glutamine (Gln), myo-inositol (mI), NAA, and total Cho (tCho), suggesting improved reliability compared to HERMES-PRESS. HERCULES-sLASER produced better reliability than HERCULES-PRESS for GABA+, GSH, aspartate, Gln, lactate, mI, NAA, and tCho with lower CV_ws. N-acetylaspartylglutamate (NAAG) showed higher CV_ws for HERCULES-sLASER, and Glu showed higher CV_ws for HERMES-sLASER and HERCULES-sLASER. Overall, these findings suggest that sLASER yields lower within-subject variability than PRESS for several metabolites for both HERMES and HERCULES, supporting improved measurement reliability.

CONCLUSION: sLASER yielded better test-retest reliability than PRESS for most metabolites than for multi-metabolite edited MRS.

PMID:41152151 | DOI:10.1002/mrm.70161

Magn Reson Med. 2025 Oct 28. doi: 10.1002/mrm.70162. Online ahead of print.

ABSTRACT

PURPOSE: To create virtual liver models simulating the concurrent presence of hepatic iron overload and steatosis based on human liver histology and to assess the accuracy and precision of R2* and fat fraction (FF) estimation at 0.55T compared to 1.5T.

METHODS: Virtual liver models simulating the coexistence of iron overload and steatosis were created, encompassing clinical liver iron concentration (LIC) (0-20 mg/g) and FF (0%-30%) ranges, using morphological characteristics derived from human liver histology. MRI signals were synthesized via Monte Carlo simulations under varying SNR conditions (SNR original (SNR_orig) and SNR enhanced (SNR_enh)) at 0.55T (SNR_orig,0.55T = 20; SNR_enh,0.55T = 50) and 1.5T (SNR_orig,1.5T = 50). Simulation results were validated using iron-fat phantoms (FF: 0%-40%; iron concentration: 0-8 μg/mL) scanned across varying SNRs using different signal averages (SNR_orig,0.55T, SNR_orig,1.5T = 1; SNR_enh,0.55T = 4). Accuracy and precision of 0.55T for estimating R2* and FF compared to 1.5T were assessed using boxplots, heatmaps, and Kruskal-Wallis statistical tests.

RESULTS: SNR_orig,0.55T demonstrated reduced or comparable FF estimation bias relative to SNR_orig,1.5T, with significantly lower bias for SNR_enh,0.55T, especially for severe iron overload and FF ≤ 20%. LIC estimation for SNR_orig,0.55T and SNR_enh,0.55T demonstrated higher accuracy compared to SNR_orig,1.5T with significant differences (p < 0.028) for all combinations of LIC and FF except for severe iron overload with FF > 10% (p > 0.183). Further, SNR_enh,0.55T showed improved precision for FF and LIC estimation compared to SNR_orig,1.5T. Phantom experiments showed reduced bias for both FF and LIC estimation for SNR_enh,0.55T compared to SNR_orig,1.5T.

CONCLUSION: 0.55T shows promising results for concurrent R2* and FF estimation, enhancing accuracy and precision compared to 1.5T, especially with enhanced SNR.

PMID:41152137 | DOI:10.1002/mrm.70162

Health Promot J Austr. 2026 Jan;37(1):e70123. doi: 10.1002/hpja.70123.

ABSTRACT

OBJECTIVE: In Australia, the beach is a favoured destination for recreational activities linked to physical, psychological, and social health benefits. Unfortunately, older people and people with disability face barriers to beach access that limit their participation in recreational activities. This study aimed to identify beach use behaviours, preferred beach activities, and perceived benefits for older people and people with disability in Australia.

METHODS: A 39-item anonymous online survey was administered. Descriptive statistics reported beach use, preferences, and benefits.

RESULTS: The survey had 350 respondents (69% female; mean age 52 years, range 2-90). Almost half (44.8%) could not visit the beach due to accessibility issues. Those who could visit did so year-round, with one third (34%) visiting weekly and 94% spending ≥ 30 min per visit. Factors for beach selection related to accessibility (95%) and the environment (76%). Preferred activities were swimming (56%), walking (51%), and socialising (49%). Perceived benefits included enjoyment/wellbeing (99%), reduced stress (95%), and physical benefits (86%).

CONCLUSION: Despite limited access, older people and people with disability engage or want to engage in beach-based activities and self-report a range of perceived health benefits. SO WHAT?: Removing the barriers to beach access would improve participation in beach-based health-promoting activities for older people and people with disability.

PMID:41152132 | DOI:10.1002/hpja.70123

Acad Radiol. 2025 Oct 27:S1076-6332(25)00962-6. doi: 10.1016/j.acra.2025.10.006. Online ahead of print.

ABSTRACT

RATIONALE AND OBJECTIVES: To develop and validate an interpretable radiomics model based on pituitary MRI to predict growth hormone deficiency (GHD) in children with short stature.

METHODS: This retrospective multicenter study enrolled 202 children (105 GHD, 97 idiopathic short stature [ISS]) as an internal cohort (7:3 ratio for training/testing cohorts) from institution I, and 138 children (61 GHD, 77 ISS) from institution II and institution III as an external validation cohort. Radiomics features were selected by SelectKBest and least absolute shrinkage and selection operator (LASSO), subsequently used to construct six machine learning models. Diagnostic performance of model was evaluated by the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and calibration curves. The interpretability of the model was assessed using Shapley additive explanations (SHAP).

RESULTS: A total of 17 radiomics features were selected. Among all classifiers, support vector machine (SVM)-based radiomics model exhibited the highest diagnostic performance, with AUCs of 0.877 (95% CI: 0.813, 0.928), 0.878 (95% CI: 0.786, 0.951), and 0.885 (95% CI: 0.833, 0.937) in training, testing, and external validation cohorts, respectively. The SVM-integrated clinical-radiomics model yielded comparable efficacy, with AUCs of 0.874 (95% CI: 0.812, 0.928), 0.878 (95% CI: 0.786, 0.952), and 0.889 (95% CI: 0.830, 0.939) across the same cohorts. Both radiomics-based models significantly outperformed the clinical model (all p<0.001), while no statistically significant difference was observed between the radiomics and clinical-radiomics models (all p>0.05). The SHAP analysis identified three key radiomics features with significant differences between GHD and ISS groups (all p<0.001).

CONCLUSIONS: The interpretable radiomics-driven SVM model effectively predicts GH levels, providing a clinically viable, non-invasive alternative to GH stimulation test in children with short stature.

PMID:41152101 | DOI:10.1016/j.acra.2025.10.006

Semin Pediatr Surg. 2025 Oct 15:151564. doi: 10.1016/j.sempedsurg.2025.151564. Online ahead of print.

ABSTRACT

BACKGROUND: Pancreatic trauma in the pediatric population is an uncommon but highly morbid injury. Its management remains controversial, with treatment strategies ranging from non-operative management (NOM) to upfront operative management (OM), primarily guided by the patient’s hemodynamic stability and the integrity of the main pancreatic duct. This systematic review and meta-analysis aim to elucidate the comparative effectiveness and safety of NOM versus OM for pediatric pancreatic trauma.

METHODS: Following PRISMA guidelines, a systematic search was conducted in seven major databases (including PubMed/MEDLINE, EMBASE, and Scopus) up to September 10, 2025. From 320 identified records, 17 observational studies met the eligibility criteria, comprising 1147 patients. A random-effects meta-analysis was performed to calculate pooled Odds Ratios (OR) with 95% Confidence Intervals (CI) for key outcomes, including mortality, overall complications, pancreatic pseudocyst, and fistula. Bayesian analysis was used for corroboration, and the certainty of evidence was assessed using the GRADE framework.

RESULTS: The analysis found no significant difference between NOM and OM for mortality (OR 0.89; 95% CI 0.48-1.66; I²=0%) or overall complications (OR 0.75; 95% CI 0.41-1.38; I²≈41%). However, a significant clinical trade-off emerged for specific complications. NOM was associated with a significantly higher risk of pancreatic pseudocyst (OR 2.56; 95% CI 1.55-4.23; I²=0%). Conversely, NOM was associated with a substantially lower risk of pancreatic fistula compared to OM (OR 0.27; 95% CI 0.11-0.69; I²=0%). Evidence for other secondary outcomes was largely inconclusive due to statistical imprecision. The certainty of evidence for all outcomes was rated as very low.

CONCLUSION: Non-operative management is a viable and safe primary strategy in selected pediatric patients with pancreatic trauma and does not appear to increase mortality. The therapeutic decision hinges on a crucial trade-off: NOM increases the risk of pseudocyst formation, while OM increases the risk of iatrogenic fistula. Despite the very low certainty of the available evidence-an inherent limitation of trauma research-these findings provide a critical framework for facilitating shared decision-making. Prospective, multi-center registry studies are urgently needed to establish more definitive guidelines.

PMID:41152091 | DOI:10.1016/j.sempedsurg.2025.151564

Med Intensiva (Engl Ed). 2025 Oct 27:502341. doi: 10.1016/j.medine.2025.502341. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze the effect of early physiotherapy (ePHYS) on patients’ functional quality of life one year after discharge.

DESIGN: Prospective observational study.

SETTINGS: Adult polyvalent ICU.

PATIENTS OR PARTICIPANTS: Patients with SARS-CoV2 pneumonia requiring invasive mechanical ventilation between March 2020 and July 2022.

INTERVENTION: Early physiotherapy.

MAIN VARIABLES OF INTEREST: Quality of life measured by CFS, Barthel and SF36 on ICU admission, at hospital discharge and one year after hospital discharge.

RESULTS: Ninety-nine patients included. In the raw data analysis we observed statistically significant differences in SAPS-3 (Mdn_No-ePHYS = 59 [53.5-64.5]; Mdn_Yes-ePHYS = 53 [47-58]; P = .001). After propensity score, we did not observe statistically significant differences except for two SF-36 items: social activities (Mdn_No-ePHYS = 56.2 [37.5-71.9]; Mdn_Yes-ePHYS = 75 [62.5-97.5]; P = .004; Wilcoxon r effect size = 0.5) and one-year health transition (Mdn_No-ePHYS = 50 [50-75]; Mdn_Yes-ePHYS = 75 [50-100]; P = .031; Wilcoxon r effect size = 0.29), where patients who belonged to NO-ePHYS had lower scores than those who did receive ePHYS.

CONCLUSIONS: Despite not having found statistically significant differences in most of the items assessed, we should highlight that patients who received ePHYS reported a clear positive influence on their lives.

PMID:41152078 | DOI:10.1016/j.medine.2025.502341

Health Promot J Austr. 2026 Jan;37(1):e70121. doi: 10.1002/hpja.70121.

ABSTRACT

Apartments are often located in dense, mixed-use neighbourhoods designed to encourage walking and support healthier lifestyles; however, the extent to which these environments benefit all population groups equally with respect to weight-related outcomes is unclear. We investigated the association between neighbourhood disadvantage (ND) and body mass index (BMI) amongst urban Australian apartment dwellers and the extent to which their local neighbourhood environment, apartment building environment, and health behaviours contributed to this relationship. We surveyed residents (n = 955) from recently constructed apartment complexes (n = 108) in areas of low, mid, and high disadvantage across Sydney, Melbourne, and Perth. Residents in more disadvantaged neighbourhoods had higher BMIs than those in more advantaged areas, with BMI differences of 0.80 kg/m² (95% CI: 0.18, 1.42) and 0.98 kg/m² (95% CI: -0.01, 1.98) for middle and high disadvantage groups, respectively. Apartment building characteristics and neighbourhood characteristics contributed only marginally to this association, whilst meal consumption practises and physical activity behaviours emerged as key influences. The findings further underscore the entrenched relationship between ND and BMI, with a socioeconomic gradient present even for a population group that lives in more urban, higher density neighbourhoods. To address obesity-related inequities in Australia, there is a need for multifaceted interventions that support healthier energy-balance related behaviours amongst disadvantaged populations.

PMID:41152072 | DOI:10.1002/hpja.70121

Sleep Health. 2025 Oct 27:S2352-7218(25)00176-7. doi: 10.1016/j.sleh.2025.08.006. Online ahead of print.

ABSTRACT

STUDY OBJECTIVES: The goal of this study was to examine feasibility, acceptability, and preliminary efficacy of WePAP, a novel, couples-based treatment to promote positive airway pressure adherence in patients with obstructive sleep apnea and sleep quality in patients and partners.

METHODS: Patients who were recently diagnosed with obstructive sleep apnea and intended to start positive airway pressure and their partners completed pre-treatment self-report measures of study constructs and actigraphy. Couples were randomly assigned to WePAP or information control groups. Post-PAP assessments and adherence downloads were completed at 1 month and 3 months. Primary analyses evaluated feasibility, acceptability, and preliminary efficacy between the WePAP and information control groups. Secondary analyses examined between- and within-group changes in sleep, mood, and quality of life.

RESULTS: The study enrolled 37 midlife and older adults (n=74, age m=62.97; SD=9.04). WePAP couples were 100% adherent with the 3 sessions. Compared with the information control group, patients and partners in WePAP rated the intervention more favorably and were more satisfied. Positive airway pressure adherence was high in both groups and the difference was not statistically significant (PAP use ≥4h=76% in WePAP and 72% in information control at 3 months). There were significant within-group differences for sleep quality, such that patients in both groups showed significant improvements in self-reported sleep, mood, and quality of life at 3 months. Patients in both groups showed improvements in sleep-related daytime impairment; however, only partners in the WePAP group showed improvement in sleep-related daytime impairment.

CONCLUSIONS: The results demonstrate that WePAP is feasible and well-liked by patients and partners, but it did not demonstrate greater adherence or improved sleep quality in this sample of highly adherent patients. Future studies should examine longer-term outcomes and enroll patients at greater risk for nonadherence to positive airway pressure.

PMID:41152068 | DOI:10.1016/j.sleh.2025.08.006

J Orthop Sci. 2025 Oct 27:S0949-2658(25)00289-1. doi: 10.1016/j.jos.2025.10.005. Online ahead of print.

ABSTRACT

BACKGROUND: The distal femoral closing wedge osteotomy is a common method for treating the femoral deformity in knee osteoarthritis. However, due to the lack of appropriate surgical devices, there are shortcomings: difficulty of positioning hinge area, complex calculation of corrective angle, and hinge damage. This study aimed to develop a positioning device to solve the above problems.

METHODS: Computer-aided design software and three dimensional (3D) printer were used to design, modify, and print the novel device. The Sawbones experiment was used for functional verification and preliminary clinical application was conducted to evaluate the effectiveness of the device.

RESULTS: In the Sawbones experiment, with assistance of the novel device, the angle of the first positioning was more accurate than the conventional method (p < 0.05) and retained the fixed hinge width (p < 0.05). In preliminary clinical application, the average time for accurate positioning hinge was 75s and the average fluoroscopy was 2 times. Hinge fracture occurred in 1 case. The average operation time was 47 min. The hip-knee-ankle angle (HKA) improved from preoperative (171.16 ± 2.65°) to postoperative (180.55 ± 1.21°) (p < 0.01) and the mechanical lateral distal femoral angle (mLDFA) was significantly improved compared with the pre-operation (94.45 ± 1.26° vs 87.31 ± 1.10°, p < 0.01). The angle between the anatomic axis of the femur and the Blumensaat’s line (AFBL) was no statistically significant difference compared with the pre-operation (p > 0.05). After 9 months, the american knee society score (AKSS) was from preoperative (63.64 ± 4.74) to postoperative (92.82 ± 2.71) (p < 0.01) and Lysholm score was significantly improved (56.82 ± 5.38 vs 91.27 ± 2.24, p < 0.01). The pain symptoms were relieved and the visual analogue scales (VAS) was significantly reduced compared with the pre-operation (p < 0.01).

CONCLUSIONS: The positioning device had the functions of calculation-free of corrective angle and hinge retention, which was an efficient device for the distal femoral closing wedge osteotomy.

PMID:41152049 | DOI:10.1016/j.jos.2025.10.005

J Prosthet Dent. 2025 Oct 27:S0022-3913(25)00793-0. doi: 10.1016/j.prosdent.2025.10.020. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Research on the mechanical performance, particularly the fracture resistance, of recently introduced glass-composite and hybrid ceramic resin materials used with additive manufacturing (AM) and subtractive manufacturing (SM) techniques, and indicated for definitive restorations, remains limited.

PURPOSE: The purpose of this in vitro study was to evaluate and compare the fracture resistance of AM or SM crowns in different resin-based materials through fatigue cyclic loading and load-to-fracture testing.

MATERIAL AND METHODS: A standardized maxillary molar preparation was used to fabricate a zirconia master die, which was then scanned and reproduced in resin using a digital light processing (DLP) 3-dimensional (3D) printer. Two resins for AM (Pro Resins Crown X and Flexcera Smile Ultra+) and 2 resins for SM (Shofu HC and Brilliant Crios), all containing inorganic fillers (glass or ceramic), were used to fabricate identical computer-aided design (CAD) crowns (n=15). These crowns were then cemented using a standard protocol. Specimens underwent fatigue cyclic loading via 1.2 million cycles at 49 N, followed by the load-to-fracture test using a universal testing machine. Statistical analysis included 1-way ANOVA and the Tukey post hoc test (α=.05).

RESULTS: All crowns withstood cyclic loading. A statistically significant difference in fracture load was observed across different crowns manufactured by using different resin-manufacturing technology pairs (P<.001). SM-S group exhibited the lowest fracture resistance (2184 ±660.2 N), whereas the other 3 groups exceeded 2500 N, with no significant differences among them (P>.05).

CONCLUSIONS: AM crowns demonstrated fracture resistance comparable to SM crowns during and after fatigue cyclic loading and load-to-fracture tests. All crowns showed fracture resistance loads higher than previously reported clinically acceptable load values, supporting their potential for clinical use.

PMID:41152036 | DOI:10.1016/j.prosdent.2025.10.020