Tag: pubmed

Eur J Epidemiol. 2025 Dec 3. doi: 10.1007/s10654-025-01301-1. Online ahead of print.

ABSTRACT

Screening colonoscopy has been shown to reduce colorectal cancer incidence. However, the magnitude of this effect is debated. There is concern that some trial participants already had colorectal cancer at baseline. The screening procedure could not prevent disease occurrence in these participants, leading to “prevalence bias”. Some authors have argued that the effect of interest is confined to participants without disease at baseline, and failing to exclude prevalent cases supposedly leads to effect underestimation. Yet, the issue is debated, with other authors arguing that conventional randomized trials provide the effects that are most relevant to public health. Here we present new, formal arguments that clarify misconceptions in this debate. We show that, under mild assumptions, the so-called “prevalence bias” is not a concern when researchers are interested in estimating risk differences, rather than risk ratios. This is because of a statistical property of the causal risk difference when outcomes are rare, called “doomed-selection stability”.

PMID:41335397 | DOI:10.1007/s10654-025-01301-1

Eur Radiol. 2025 Dec 3. doi: 10.1007/s00330-025-12160-5. Online ahead of print.

ABSTRACT

OBJECTIVES: Arterial transit artefacts (ATAs) on pseudo-continuous arterial spin labelling (pCASL) MRI represent visual markers of delayed arterial transit. This study aimed to investigate their prevalence and distribution and to evaluate the effects of sex, ethnicity, intracranial arterial anatomy, and cardiovascular parameters in a subgroup of the UK tri-ethnic population-based Southall and Brent REvisited (SABRE) study.

MATERIALS AND METHODS: We analysed 360 participants-120 each of White European, South Asian, and African Caribbean origin-from the prospective SABRE cohort who underwent 3.0-T brain MRI and clinical assessment between 2014 and 2018. ATAs were visually rated across 40 predefined brain regions on pCASL perfusion images and summarised as percentage ATA scores. Intracranial arterial anatomy was classified on time-of-flight MR angiography, and cardiovascular parameters were obtained from clinical assessment. ATAs were compared by sex and ethnicity, and associations with demographic, anatomical, and cardiovascular factors were analysed using multivariable regression.

RESULTS: Of 360 participants, 284 (78.89%; mean age 70.12 ± 6.58 years; range 49-89; 139 women) had usable pCASL data. ATA prevalence varied across vascular territories and between women and men. African Caribbean participants showed a higher frequency of ATAs in the posterior circulation, whereas in most anterior territories they had fewer ATAs than White Europeans or South Asians.

CONCLUSION: Visual rating of ATAs revealed sex- and ethnicity-specific differences in ATA distribution, reflecting variations in arterial transit time influenced by intracranial vascular anatomy and cardiovascular parameters. These findings highlight the potential of ATAs as imaging markers for personalised cerebrovascular assessment and risk stratification.

KEY POINTS: Question Prevalence and distribution of arterial transit artefacts (ATAs) on arterial spin labelling MRI, and their relationship to sex, ethnicity, vascular anatomy, and cardiovascular parameters, have not been systematically investigated. Findings ATAs were most prevalent in African Caribbeans, particularly in MCA-PCA borderzones and PCA territories; no significant differences were found between White Europeans and South Asians. Clinical relevance Visual rating revealed substantial differences in the ATA distribution among ethnic populations, as well as between women and men. Recognising these specific patterns can help distinguish physiological from pathological perfusion, thereby enhancing diagnostic accuracy and treatment planning.

PMID:41335377 | DOI:10.1007/s00330-025-12160-5

Breast Cancer Res Treat. 2025 Dec 3;215(1):25. doi: 10.1007/s10549-025-07870-9.

ABSTRACT

PURPOSE: To evaluate and compare patient perceptions of artificial intelligence (AI) use in mammogram interpretation across academic and safety-net healthcare settings.

METHODS: We offered a 29-item survey to patients visiting our safety-net (SNH) and academic (ACH) hospital breast imaging clinics between 04/2024-06/2024 and 02/2023-08/2023, respectively. Demographic data was compared between populations using Chi-squared tests. We used ORs (95% CI) to estimate response odds by patient factors. Significant group differences were further analyzed via multivariable regression.

RESULTS: A total of 924 [ACH: 518(56.1%), SNH: 406(43.9%)] surveys were collected. Participants from the ACH were older (≥ 70 years: 20%vs3.1%, p < 0.001), mostly identified as Non-Hispanic White (56%vs7.2%, p < 0.001), had higher income (≥ $100,000: 49%vs3.2%, p < 0.001), higher education (≥ college: 71%vs20%, p < 0.001) and higher self-reported knowledge of AI (68%vs56%, p < 0.001) compared to SNH. Use of AI alone or as a second reader was accepted by 74%, with SNH participants being less likely to accept [OR(95%CI): 0.71(0.53-0.96), p = 0.02]. SNH participants were more likely to request a reading by AI following radiologist-interpreted abnormalities [1.83(1.35-2.49), p < 0.001], rate AI as the same or better than a radiologist at detecting cancer [1.54(1.12-2.15), p = 0.01], and have higher concern regarding data privacy [1.87(1.22-2.93), p = 0.01]. Higher education [1.99(1.33-2.99), p < 0.001] and self-reported AI knowledge [1.98(1.38-2.83), p < 0.001] were associated with higher acceptance of AI use, while Non-Hispanic Black race [0.40(0.25-0.65), p < 0.001] was associated with lower acceptance when controlled for other covariates.

CONCLUSION: Significant differences exist in patients’ views of AI between the demographically distinct academic and safety-net populations. Our study revealed lower educational attainment and Non-Hispanic Black race as independent factors associated with lower acceptance of AI.

PMID:41335376 | DOI:10.1007/s10549-025-07870-9

Clin Oral Investig. 2025 Dec 3;29(12):597. doi: 10.1007/s00784-025-06687-6.

ABSTRACT

OBJECTIVES: This study aimed to investigate the microbial spectrum and resistance patterns in surgically treated odontogenic infections and to assess the clinical impact of resistance, including systemic complications and hospitalization. Resistance rates were additionally evaluated in relation to reported penicillin hypersensitivity.

METHODS: A total of 740 inpatient cases with microbiological testing from surgically treated odontogenic infections at the Jena University Hospital from January 1, 2012, to December 31, 2023, were analyzed. Resistance rates were assessed at infection level. Time trends were analyzed using Poisson regression. Associations between resistance rates and clinical variables were evaluated using binary logistic regression.

RESULTS: Clindamycin resistance was observed in 38.9% of infections, while amoxicillin/clavulanate (6.9%) and moxifloxacin (4.5%) showed lower resistance rates. No statistically significant trends in resistance rates were observed. Moxifloxacin resistance increased the risk of systemic complications (OR: 10.875; 95%-CI: 2.364-50.017; p = 0.002), while no significant associations were found between antibiotic resistance and prolonged hospitalization. A history of penicillin hypersensitivity was associated with increased clindamycin resistance (OR: 2.156; 95%-CI: 1.038-4.480; p = 0.04).

CONCLUSIONS: Clindamycin exhibits high resistance rates in odontogenic infections and should be critically re-evaluated as empirical therapy, especially in patients with penicillin hypersensitivity. Given the overall low resistance rates to moxifloxacin, resistance to this agent indicated highly resistant infections and was associated with an increased risk of systemic complications.

CLINICAL RELEVANCE: Continuous resistance surveillance and adaptation of empirical therapy are essential for managing severe odontogenic infections and reducing life-threatening infection-related complications, emphasizing the need for antimicrobial stewardship.

PMID:41335374 | DOI:10.1007/s00784-025-06687-6

Bull Math Biol. 2025 Dec 3;87(12):182. doi: 10.1007/s11538-025-01548-5.

ABSTRACT

This study is based on using a novel sex-structured mathematical model to assess the effectiveness of vaccination and Pap screening against HPV and related cancers in South Korea. In addition to its disease-free equilibrium (DFE) being locally-asymptotically stable when the associated control reproduction number is less than one, the model could have one or three endemic equilibria, for a special case with negligible disease-induced mortality, if the reproduction number exceeds one. It’s shown, using a Krasnoselskii sublinearity argument, that this special case has a unique and locally-asymptotically stable endemic equilibrium, when the reproduction number is larger than one, if, additionally, the HPV vaccine is assumed to be perfect. The DFE of a simplified version of the model, which is calibrated using HPV-related cancer data in Korea, is globally-asymptotically stable when its reproduction number is less than one. Simulations of the full model showed that, although vaccine-derived herd immunity (needed for HPV elimination) cannot be achieved in Korea under the current vaccination coverage of females (of 88%), it can be achieved if, additionally, at least 65% of males are vaccinated at steady-state. While the current combined vaccination-screening strategy (termed Strategy A) will fail to eliminate HPV, extended strategies that include increased coverage of female vaccination (termed Strategy B) or additionally vaccinating boys (termed Strategy C) could lead to such elimination in Korea. The implementation of boys-only vaccination strategy induces a significant spillover benefit in reducing cervical cancer burden, which exceeds the corresponding spillover benefit achieved by implementing a girls-only vaccination strategy.

PMID:41335351 | DOI:10.1007/s11538-025-01548-5

J Phys Chem A. 2025 Dec 3. doi: 10.1021/acs.jpca.5c07380. Online ahead of print.

ABSTRACT

Electron energy loss spectra (EELS) of benzisoxazole reveal signatures of anionic resonances in the vicinity of 1.2 and 2.2 eV incident electron energies. Another low-energy resonance is likely present just below 0.5 eV, but its contributions are difficult to discern definitively because of the overlap with intense near-threshold scattering and thermionic emission features. The observed resonances decay via two competing mechanisms: the excitation of specific vibrational modes and emission of low-energy electrons following statistical thermalization of resonance energy among unspecific vibrations. The thermionic pathway is likely mediated and amplified by vibronic couplings between the resonance states and the weakly bound dipole-bound anion supported by the 3.2 D dipole moment of benzisoxazole. The existence of the stable dipole-bound and metastable π* resonance states is confirmed by equation-of-motion coupled-cluster theory calculations. The non-Hermitian theory using a complex absorbing potential to stabilize the temporary-anion states predicts three such states in benzisoxazole below 3 eV. These states are assigned to the observed experimental features and described as π₁^*, π₂^*, and π₃^* scattering resonances. Additional structureless features in the 3-6 eV range observed in the EELS excitation curves for some vibrations are tentatively ascribed to several additional resonances predicted in that range. The existence of the dipole-bound anion state and its role in resonance decay dynamics set benzisoxazole sharply apart from its isomer benzoxazole.

PMID:41335341 | DOI:10.1021/acs.jpca.5c07380

Adv Ther. 2025 Dec 3. doi: 10.1007/s12325-025-03424-z. Online ahead of print.

ABSTRACT

INTRODUCTION: Cluster headache (CH) is a debilitating condition with health-related and economic burden to patients, including reduced quality of life (QoL) and suicidality. Brazilian data on comorbidities, symptoms, or impact on QoL and productivity remain limited. This study aims to assess CH’s impact on patients’ QoL, overall health, and employment in Brazil from physicians’ and patients’ perspectives.

METHODS: Data were extracted from the Adelphi Real World CH Disease Specific Programme™, a real-world, cross-sectional survey of physicians and their patients with CH in Brazil from November 2021-July 2022. Physicians reported on demographics, clinical characteristics, comorbidities, and suicidality. Patients reported CH’s impact on feelings/reactions, suicidality, employment using the Work Productivity and Activity Impairment questionnaire, and QoL using the EuroQol 5 Dimension 5 Level survey. Data analyses were conducted with R Statistical software (v4.1.2).

RESULTS: Patients completed 177 forms, while physicians completed 450 forms. Patients had episodic CH (ECH, n = 355) and chronic CH (CCH, n = 95). Common comorbidities were anxiety, insomnia, hypertension, depression, and dyslipidemia. Stress and lack of sleep were key physician-reported CH triggers, and 10.34% of patients had considered suicide. The presence of CH may have led to absenteeism (11.45%) and presenteeism (30.08% overall work impairment, 29.38% activity impairment, and 29.36% impairment while working).

CONCLUSIONS: CH carries a significant disease burden and negative socioeconomic impact, especially among patients with CCH. Stress was the most common trigger for both attacks and bouts with notable rates of suicidality. This indicates a need among physicians and patients for targeted and more efficacious interventions to reduce CH’s burden, improving patients’ QoL.

PMID:41335330 | DOI:10.1007/s12325-025-03424-z

Adv Ther. 2025 Dec 3. doi: 10.1007/s12325-025-03410-5. Online ahead of print.

ABSTRACT

INTRODUCTION: Esophageal squamous cell carcinoma (ESCC) accounts for approximately 90% of all esophageal cancer cases and is associated with poor prognosis. However, recent advancements have transformed the treatment landscape. Tislelizumab, a humanized immunoglobulin G4 (IgG4) anti-programmed cell death protein 1 (PD-1) monoclonal antibody, was developed to overcome resistance mechanisms by minimizing binding to FcγR on macrophages. The RATIONALE-302 clinical trial showed statistically significant survival benefits of tislelizumab over chemotherapy in second-line ESCC highlighting the necessity of evaluating comparative efficacy with existing treatments. This study aimed to identify trials evaluating anti-PD-1 therapies for second-line ESCC and indirectly estimate the relative efficacy of tislelizumab versus existing anti-PD-1 therapies.

METHODS: A systematic literature review (SLR) was originally conducted in 2021 then updated in 2022 and 2023. A feasibility assessment (FA) was undertaken to evaluate required assumptions for indirect treatment comparisons (ITCs) and determined that anchored simulated treatment comparisons (STCs) were the most appropriate methodology. Assessed outcomes included overall survival (OS), progression-free survival (PFS), and grade ≥ 3 treatment-related adverse events (TRAEs). Analyses were conducted in the hazard ratio scale for OS and PFS and in the odds ratio scale for TRAEs, whilst uncertainty was expressed in 95% confidence intervals.

RESULTS: The SLR identified 13 studies, six of which evaluated immunotherapies and were included in the FA. All studies were deemed similar and considered in the ITC, except for RAMONA, which differed substantially in study design, inclusion criteria, and patient characteristics. Indirect estimates obtained from the STCs were not statistically significant, except for the comparison of TRAEs with tislelizumab versus camrelizumab, where tislelizumab was more favorable.

CONCLUSIONS: Tislelizumab appears comparable to existing anti-PD-1 therapies (nivolumab, pembrolizumab, camrelizumab, and sintilimab) in OS, PFS, and TRAEs of grade ≥ 3 for patients receiving second-line treatment for ESCC with a potentially more favorable TRAE grade ≥ 3 profile than camrelizumab that requires confirmation.

TRIAL REGISTRATION: NCT03430843.

PMID:41335329 | DOI:10.1007/s12325-025-03410-5

Eur Arch Paediatr Dent. 2025 Dec 3. doi: 10.1007/s40368-025-01145-z. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the sequelae of traumatic dental injuries to the primary dentition in permanent successors and identify associated factors.

METHODS: A retrospective observational study was conducted based on the analysis of dental records of children who suffered traumatic dental injuries to primary teeth and received care and clinical follow-up from 2007 to 2023 at a specialised dental trauma clinic in Belo Horizonte, Brazil. Data were collected on aspects related to the children, their families, injuries to primary teeth, treatments performed, and consequences for the permanent dentition. Statistical analysis involved descriptive statistics, the chi-square test, and Poisson regression with robust variance (p < 0.05; 95% CI).

RESULTS: A total of 324 teeth from 154 children were assessed. A total of 25% of the permanent successors of injured primary teeth had sequelae, the most common being defects in enamel formation (n = 70). Children up to three years of age at the time of the trauma had a higher risk of sequelae in their permanent successors (PR = 1.64; 95% CI: 1.12-2.40) and those who received delayed treatment (RR = 1.66; 95% CI: 1.01-2.73). Injuries occurring on the street were also associated with a greater risk of sequelae (RR = 1.97; 95% CI: 1.20-3.23). No statistically significant differences were found between dental sequelae in permanent successors and the different types of luxation or fractures.

CONCLUSION: Defects in enamel formation were the most common sequelae after trauma in primary teeth. Sequelae in permanent successors were associated with the age of the child, the environment in which the injury occurred, and delayed post-injury care.

PMID:41335324 | DOI:10.1007/s40368-025-01145-z

J Math Biol. 2025 Dec 3;92(1):5. doi: 10.1007/s00285-025-02322-w.

ABSTRACT

Cholera is an acute diarrheal disease caused by the bacterium Vibrio cholerae. With the consideration of the transmission mechanism and heterogeneity of population, an age-structured cholera epidemic model is proposed, involving saturation incidence rates that describe direct and indirect transmission pathways and all class-ages with the susceptible age of susceptible individuals, infection age of infected individuals and biological age of Vibrio cholerae. The focus is to investigate the global dynamics of the model by using the basic reproduction number $R_0$ . After establishing the well-posedness of the initial-boundary value problem of the model, we study the existence of endemic steady state and local stability of the disease-free steady state in terms of $R_0$ . Next asymptotic smoothness of the semi-flow is discussed in order to obtain the existence of a global attractor. Finally, global stability of the disease-free and endemic steady states is obtained by combining Volterra-type Lyapunov functionals and existence of global attractors. Numerical simulations are given to demonstrate the effect of age structures and to illustrate the theoretical results.

PMID:41335303 | DOI:10.1007/s00285-025-02322-w