Tag: pubmed

Int Urol Nephrol. 2025 Oct 12. doi: 10.1007/s11255-025-04847-x. Online ahead of print.

ABSTRACT

INTRODUCTION: Cognitive and psychological disorders are among the most important outcomes of the end stage of renal disease. Treatments have neither definitely prevented the disorders’ progression nor cured them. This study aims at evaluating the effect of solving a Sudoku puzzle on memory and anxiety in hemodialysis (HD) patients.

MATERIALS AND METHODS: This randomized controlled clinical trial study was conducted on 64 HD patients. The samples were randomly assigned either to the control group (n = 32) or Sudoku (intervention) group (n = 32). The study lasted for four weeks. The anxiety and memory of the participants were measured by the Spielberger State Trait Anxiety Inventory (STAI-S) and Wechsler Memory Scale (WMS) at the beginning and end of the study. The intervention group solved the Sudoku puzzle within 20 min for four weeks, three times per week (12 times), 15 min after the HD onset, the control group received no intervention. To evaluate the effect of the Sudoku puzzle on momentary anxiety, the state anxiety of all samples was measured and recorded in the first session of the study, 40 min after the onset of the first HD session. The data were analyzed with SPSS software version 25.

RESULTS: The mean and standard deviation of the anxiety score were 82.71 ± 5.1 and 70.93 ± 18.0 in the Sudoku group (p = 0.001) and 82.43 ± 5.77 and 82.06 ± 4.55 in the control group at the beginning and the end of the study, respectively (p = 0.778). Moreover, the mean and standard deviation of the state anxiety score in the first session were 41.37 ± 3.29 and 38.5 ± 2.9 in the intervention group (p = 0.001) and 39.5 ± 2.9 and 42.15 ± 2.73 in the control group (p = 0.001) before the HD onset and 40 min after the HD onset, respectively. There was no statistically significant difference in memory scores in the Sudoku group before and after the intervention. However, the covariance test showed that at the end of the study, there was a statistically significant difference between memory scores in the control and intervention groups(p = 0.048). The results showed that there is a statistically significant difference in the post tests between the two groups in terms of anxiety, state anxiety and memory (p ≤ 0.05).

CONCLUSION: Sudoku solving seems to play an effective role in reducing anxiety and state anxiety in HD patients, but it has little effect in improving memory. Therefore, it is recommended to use it as an adjunctive treatment to control anxiety and improve memory in hemodialysis patients.

PMID:41077610 | DOI:10.1007/s11255-025-04847-x

J Egypt Natl Canc Inst. 2025 Oct 13;37(1):68. doi: 10.1186/s43046-025-00326-7.

ABSTRACT

BACKGROUND: Computed tomography imaging, a non-invasive tool, is used around the globe by medical professionals to identify and diagnose lung cancer; a lethal disease with high rates of occurrence and mortality globally. Radiomics extracted from medical images, including computed tomography, in tandem with machine learning frameworks has received considerable focus and research for lung nodule identification.This investigation can help out clinicians to reach radiomics-based better and quicker decision support system for treatments and early diagnosis. However, it is still foggy and unclear which radiomics feature(s) to use for the prediction of pulmonary nodule. Consequently, this work is offered with an endeavor to efficiently apply machine learning techniques and radiomics to classify CT pulmonary nodules.

METHODS: Lung Image Data Consortium (LIDC), containing 1018 CT cancer cases, is put to use. The Wavelet Packet Transform is used in conjunction with geometrical features, gray level run length matrix, gray level co-occurrence method and gray level difference method techniques to extract radiomics. Two techniques, boosted and bagged ensemble classification trees, are employed to choose an apposite set of features. The categorization of nodules as malignant or benign is assessed by the utilization of cutting-edge machine learning models: Support Vector Machines, Boosted Classification Ensemble Tree, Decision Trees, Bagged Classification Ensemble Tree, RUSBoosted Ensemble Trees, Subspace Discriminant Ensemble and Subspace KNN Ensemble.

RESULTS: The findings reveal that the Ensemble Subspace KNN gives best AUROC (93.4%), accuracy (88.3%) and F1-score (85.2%) using BACET feature selection method. The best sensitivity is produced by FGSVM (97.1%). RUSBOCET gives best precision and specificity of 93.4% and 83.1% respectively.

CONCLUSION: Lung Cancer remains the most common and deadly type of cancer. Early detection of lung lesions and nodules is crucial in the fight against lung cancer. The purpose of this study was to investigate radiomics based on geometrical, texture, and Daubechies WPT texture features for quantitative CT image analysis. The LIDC database was used in this study. Geometrical features, texture features based on three statistical methodologies (GLCM, GLDM GLRLM) and Daubechies WPT texture features are retrieved from the nodules. Using the ensemble EFS, BOCET and BACET, pertinent features were identified. Lastly, various cutting-edge ML classifiers were used to classify LC as malignant or benign. The out-turn shows that, using BACET EFS, Ensemble Subspace KNN gives best AUROC (93.4%), accuracy (88.3%) and F1-score (85.2%). FGSVM yields the best sensitivity of 97.1%. RUSBOCET gives best precision and best specificity of 93.4% and 83.1% respectively. Therefore, the methodology can be applied with efficacy to the CT based PN classification. Thus, the result can assist medical professionals in making better decisions and interventions.

PMID:41077595 | DOI:10.1186/s43046-025-00326-7

Environ Monit Assess. 2025 Oct 13;197(11):1199. doi: 10.1007/s10661-025-14646-7.

ABSTRACT

Surface sediments collected from Apapa-Badagry creeks (west of Lagos Lagoon) were investigated for the presence of organochlorine pesticides (OCPs) and polycyclic aromatic hydrocarbons (PAHs). The total OCP concentrations (∑OCPs) ranged from 231.72 to 1324.57 ng/g, while ∑PAHs ranged from 15.17 to 30.92 ng/g. Drins were the most prevalent pesticides detected across all sample stations. All low molecular weight (LMW) PAHs were below the detection limits, except for acenaphthylene. Urban runoff and nearby industrial and domestic discharges could be responsible for the high levels of OCPs and PAHs at station L_P2. Isomeric ratio analysis of DDT compounds indicated no recent inputs of technical DDT, whereas hexachlorocyclohexane (HCHs) suggested a lindane source. Diagnostic PAH ratios suggested mixed sources of pollution, which were pyrolytic and petrogenic. Principal component analysis of the OCPs and PAHs dataset extracted three principal factors, each representing distinct pollutant origins within the creek sediments. The sources of OCPs were mainly agricultural and industrial run-off, whereas PAHs were primarily attributed to industrial emissions, biomass and wood burning, and vehicular combustion. Ecological risk assessment indicated that adverse effects from p,p’-DDT would rarely occur, whereas those from p,p’-DDD would occur regularly in benthic organisms in Apapa-Badagry Creek.

PMID:41077593 | DOI:10.1007/s10661-025-14646-7

BMC Pediatr. 2025 Oct 13;25(1):807. doi: 10.1186/s12887-025-06038-0.

ABSTRACT

BACKGROUND: Pediatric drug clinical trials are essential for ensuring the accessibility and safety of medications intended for children. In recent years, the Chinese government has implemented various measures to foster the development of pediatric drug clinical trials, and these efforts have yielded noticeable results. This study analyzed pediatric drug trial data from ClinicalTrials.gov and the Drug Clinical Trial Registration and Information Publication Platform. Its primary purpose was to discuss the issues and challenges faced by pediatric drug clinical trials in China and propose potential solutions.

METHODS: This study conducted a cross-sectional analysis of concluded pediatric drug clinical trials (completed or discontinued) in mainland China from 2003 to 2023. Descriptive statistics were performed on the included data, and both univariate subgroup analysis and binary logistic regression were utilized to analyze the factors influencing completion duration and trial discontinuation.

RESULTS: A total of 722 concluded pediatric drug clinical trials were extracted, with the overall number increasing annually at an average annual growth rate of 21.5%. We found that there existed imbalance in various aspects such as drug type, diseases, age, and the types and distribution of trial institutions. The analysis of trial durations indicated a progressive reduction in the completion cycles of pediatric drug clinical trials conducted in China, with notable variations across different subgroups. Four variables-trial size, the establishment of Data Monitoring Committees (DMCs), control type, and disease-exerted significant influence on the discontinuation of pediatric drug clinical trials. The primary reasons for trial discontinuation are issues related to safety or efficacy as reflected in trial outcomes (27.2%), as well as adjustments in commercial strategies or trial plans (24.6%).

CONCLUSIONS: Despite the ongoing increase in the number of pediatric drug clinical trials in China, significant challenges and imbalances persist across various dimensions. To enhance the quality and efficiency of these trials and collectively advance pediatric drug research and development, it is imperative to refine the existing legal and regulatory frameworks, promote the professionalization and standardization of pediatric drug clinical trials, bolster the application of emerging methods and technologies, such as seamless design and artificial intelligence.

PMID:41077578 | DOI:10.1186/s12887-025-06038-0

Orthop Surg. 2025 Oct 12. doi: 10.1111/os.70184. Online ahead of print.

ABSTRACT

OBJECTIVE: Conversion to hip arthroplasty (cHA) is a widely utilized and effective surgical intervention for addressing the failure of internal fixation in intertrochanteric femoral fractures (FIF-INF). Although previous studies have confirmed that the failure rate of internal fixation is higher in unstable intertrochanteric femoral fractures, but whether the efficacy and complications of cHA after failure differ from those in stable fractures remains unclear. This study aimed to evaluate and compare the clinical and radiological outcomes, as well as the incidence of complications associated with hip arthroplasty over a minimum follow-up period of 3 years after the failure of internal fixation in both stable and unstable intertrochanteric femoral fractures.

METHODS: This multicenter study retrospectively analyzed patients who underwent hip arthroplasty subsequent to the failure of FIF-INF from December 2012 to December 2020 at various participating research centers. Cases demonstrating excellent and acceptable quality fracture reduction, as defined by the criteria established by Chang et al., were included. According to AO/OTA classification criteria of intertrochanteric fractures, the fractures were classified into stable fractures (31-A1) and unstable fractures (31-A2, A3). There were 47 patients with stable fractures and 56 patients with unstable fractures. Clinical and radiological evaluations were conducted for all patients. This study employed independent samples t-tests, χ² tests or Fisher’s exact test, and both univariate and multivariate logistic regression analyses.

RESULTS: A total of 103 patients were analyzed. The HHS in the stable group improved from a preoperative mean of 47.08 ± 5.50 to 89.13 ± 4.75 at the final follow-up, whereas that in the unstable group increased from 45.43 ± 6.36 to 83.87 ± 4.67. The improvement scores for the stable and unstable groups were 42.05 ± 4.69 and 38.81 ± 3.06, respectively, with a statistically significant difference (p < 0.0001). VAS scores decreased from the preoperative levels of 7.13 ± 0.92 and 7.61 ± 0.82 to 2.36 ± 0.87 and 2.91 ± 0.79, respectively, indicating a significant reduction in pain in both groups; however, the unstable group reported more severe postoperative pain (p = 0.001). The incidence of postoperative complications following cHA was significantly greater in the unstable group (28.57%) than in the stable group (10.64%) (p = 0.047).

CONCLUSION: cHA is an effective treatment modality for the failure of internal fixation in intertrochanteric femoral fractures. Compared with stable fractures, patients with initial unstable fractures that have failed experience a greater incidence of postoperative complications, relatively poorer joint function, and more pronounced pain following cHA.

PMID:41077565 | DOI:10.1111/os.70184

Orthop Surg. 2025 Oct 12. doi: 10.1111/os.70185. Online ahead of print.

ABSTRACT

OBJECTIVES: Knee osteoarthritis (OA) is a common cause of pain and disability, and conventional conservative treatments often provide only limited and temporary relief. Platelet-rich plasma (PRP) injections have emerged as a promising biological therapy; however, patient response is highly variable, and biomechanical factors such as lower extremity malalignment may influence treatment outcomes. This study aimed to evaluate the effect of the lower extremity mechanical axis angle (MAA) on the clinical efficacy of PRP injection therapy in improving knee function and pain in patients with OA.

METHODS: A total of 210 patients with knee OA who consented to PRP treatment between January 1, 2018, and January 1, 2023, were enrolled. Patients were stratified into three groups according to baseline varus angle: Group 1, 0°-5° (n = 70); Group 2, 6°-10° (n = 70); and Group 3, 11°-15° (n = 70). Clinical evaluations were performed at baseline and at 1, 3, 6, 12, and 24 months post-treatment using the Knee Injury and Osteoarthritis Outcome Score (KOOS), Kujala Patellofemoral Score, knee joint range of motion (ROM), MAA measurement, and a Visual Analogue Scale (VAS) for pain.

RESULTS: All groups demonstrated significant improvements in pain and functional scores over the 24-month follow-up compared to baseline (p < 0.001), with the most notable gains observed at 3 and 6 months. At 3, 6, and 12 months, Group 1 achieved significantly better VAS and KOOS Pain subscale scores than Group 3 (p < 0.05). Both Groups 1 and 2 had higher KOOS Total scores than Group 3 at these time points (p < 0.05). Spearman correlation analysis revealed moderate negative associations between baseline MAA and changes from baseline to 6 months in VAS (ρ = -0.58), KOOS Total (ρ = -0.54), and Kujala scores (ρ = -0.53) (all p < 0.001). Statistical analyses were conducted using ANOVA or Kruskal-Wallis tests as appropriate, and effect sizes (Cohen’s d) with 95% confidence intervals were calculated.

CONCLUSION: PRP injection therapy yields significant improvements in pain and functional outcomes in patients with knee OA. However, increased MAA is associated with reduced clinical benefit, indicating that baseline lower extremity alignment should be considered in treatment planning.

PMID:41077561 | DOI:10.1111/os.70185

J Child Psychol Psychiatry. 2025 Oct 12. doi: 10.1111/jcpp.70058. Online ahead of print.

ABSTRACT

BACKGROUND: There is limited evidence from systematic nationwide studies evaluating the impact of cannabis legalization on cannabis-related exposures among the pediatric population. Using the National Poison Data System (NPDS), we calculated the effects of medical and recreational cannabis dispensaries on reported pediatric cannabis exposures.

METHODS: We analyzed data from 36,161 reported cannabis-related exposures for individuals aged 2-20 between 2016 and 2021, comparing states with and without open medical cannabis dispensaries and states with open recreational cannabis dispensaries to states with open medical cannabis dispensaries. Using a difference-in-difference design, we estimated the effects of cannabis dispensary openings on semi-annual cannabis exposures by age group: young children (2-6 years old), children (7-11), adolescents (12-17), and young adults (18-20).

RESULTS: Patients aged 2-6 (96.3%) and 7-11 (82.4%) frequently incurred unintentional exposures, while patients aged 12-17 (79.9%) and 18-20 (77.5%) more often incurred intentional exposures. Medical cannabis dispensary openings were associated with a 52.3% increase (CI 37.5-67.0; p < .001) in cannabis-related exposure rates in individuals aged 2-6. However, we found a 42.4% decrease (95% CI: -62.2 to -22.6; p < .001) in the number of exposures occurring per 100,000 population when recreational dispensaries opened, relative to states with only medical cannabis dispensaries open. While we did not find statistically significant increases among children aged 7-11 following medical cannabis dispensary openings, we did see a 26.6% (95% CI: -45.1 to -8.1) decrease following recreational cannabis dispensary openings. We did not find statistically significant effects for other age groups.

CONCLUSIONS: Our findings indicate policymakers may need to invest in providing cannabis safety education when medical cannabis dispensaries open to avoid unintended exposures, though some of that effect appears to be mitigated by the time recreational dispensaries (eventually) open. Professionals that provide medical cannabis or provide care in medical cannabis states should consider providing education about how to safely use and store cannabis in the household to prevent cannabis-involved exposures.

PMID:41077545 | DOI:10.1111/jcpp.70058

Nutr Metab Cardiovasc Dis. 2025 Sep 12:104359. doi: 10.1016/j.numecd.2025.104359. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Whether uric acid-lowering therapy improves arterial stiffness (AS) still remain controversial. This study aimed to evaluate the effect of low-dose febuxostat on AS in elderly patients with asymptomatic hyperuricemia (HUA) and chronic kidney disease (CKD).

METHODS AND RESULTS: A total of 102 elderly patients (mean age 89.20 ± 3.20 years) were enrolled in this prospective cohort study and assigned to either a low-dose (20 mg/day), a normal-dose (40 mg/day), or a control group (lifestyle intervention). All patients underwent evaluations at baseline and the 3rd, 6th and 9th months. The primary endpoints were changes in SUA and brachial-ankle pulse wave velocity (baPWV). Multivariate analysis of variance was used for statistical analysis. Compared with those in control group, the SUA levels in both treatment groups fell to the lowest point at the 3rd month and remained low until the end of the study (intergroup, time, intergroup∗time; P < 0.001). Similarly, the baPWV in both treatment groups decreased by the 3rd month, followed by a gradual increase, and finally returned to the baseline levels (intergroup P = 0.003, time P = 0.487, intergroup∗time P = 0.872). Post-hoc multiple comparisons revealed significant differences in baPWV between each treatment group and the control group (low-dose vs. control: P = 0.001; normal-dose vs. control: P = 0.015), whereas no significant difference was observed between the two treatment groups (P = 0.374). No serious adverse events (AEs) were reported, but three gout attacks occurred in the normal-dose group.

CONCLUSIONS: Low-dose febuxostat demonstrated comparable urate-lowering efficacy to the normal-dose regimen and was also associated with a short-term improvement in arterial stiffness in elderly patients with asymptomatic HUA and CKD.

PMID:41077539 | DOI:10.1016/j.numecd.2025.104359

Eur J Intern Med. 2025 Oct 11:106543. doi: 10.1016/j.ejim.2025.106543. Online ahead of print.

ABSTRACT

BACKGROUND: The determinants and prognosis of left ventricular (LV) geometric remodeling remain uncharacterized in immunoglobulin A nephropathy (IgAN). We investigated the (1) clinicopathological correlates of LV hypertrophy (LVH), (2) longitudinal evolution of LV geometry, and (3) associations of LVH phenotypes with cardiorenal outcomes.

METHODS: In this retrospective study, 683 adults with biopsy-proven primary IgAN (2013-2021) underwent comprehensive echocardiographic phenotyping. Multivariable Cox regression modeled associations of baseline LV geometry with a composite renal endpoint (50 % estimated glomerular filtration rate [eGFR] decline or kidney failure) and a cardiovascular endpoint (major adverse cardiovascular events [MACE]).

RESULTS: Among 683 patients, 60 (8.8 %) had LVH at baseline. Age, hypertension, proteinuria, eGFR, and arteriolar hyalinosis were significant risk factors for LVH. Hemoglobin (hazard ratio = 1.03, P = 0.043) and endocapillary hypercellularity (hazard ratio = 2.87, P = 0.017) were significant risk factors for LVH deterioration. The most critical finding was that compared with normal LV geometry, concentric hypertrophy conferred a 4.14-fold renal risk (95 % confidence interval [CI]: 1.02-16.75, P = 0.047), while eccentric hypertrophy predicted a 3.42-fold MACE risk (95 % CI: 1.08-10.8, P = 0.036) independent of clinicopathological confounders.

CONCLUSIONS: In IgAN, age, hypertension, proteinuria, eGFR, and arteriolar hyalinosis are risk factors for LVH, while hemoglobin and endocapillary hypercellularity accelerate LVH progression. The key finding was that concentric LV remodeling signals renal risk, whereas eccentric hypertrophy independently portends MACE.

PMID:41077532 | DOI:10.1016/j.ejim.2025.106543

J Pediatr Urol. 2025 Sep 22:S1477-5131(25)00544-3. doi: 10.1016/j.jpurol.2025.09.024. Online ahead of print.

ABSTRACT

INTRODUCTION: Sacrococcygeal teratomas (SCT), which are the most common germ cell tumours in the neonatal period, have frequent long-term complications including gastrointestinal and urological problems due to the anatomical region of origin. This study evaluates the lower urinary tract and bowel functions in patients who underwent surgery for SCT.

PATIENTS AND METHODS: Fifteen patients who underwent sacrococcygeal teratoma surgery between 2007 and 2021 were retrospectively evaluated for lower urinary tract and bowel functions. Bladder function was assessed using patient interviews, urinalysis, voiding diaries, uroflowmetry, ultrasonography, and pressure-flow studies. In the bowel function evaluation, constipation and continence were assessed. Descriptive statistics were used to present the results as mean, standard deviation, median, frequency, and percentage.

RESULTS: Consequently, 15 patients were included, with a mean follow-up period of 8.5 years. The majority of patients were female, with a female-to-male ratio of 2.75:1. Based on the Altman classification, 73.3 % of the patients had type I SCT, 20 % had type II, and 6.6 % had type IV. The mean follow-up period of the patients was 8.5 years (2 years-15 years). Of the 15 patients whose lower urinary tract functions were assessed, 13 achieved full urinary continence and exhibited normal voiding volumes and frequency for their age. Ultrasonography findings were normal in all evaluated patients, with no residual urine or bladder abnormalities detected. Urodynamic tests showed normal detrusor activity and bladder capacities in most cases, though one patient exhibited a higher-than-expected bladder capacity during the filling phase. Voiding phase assessments revealed normal patterns in most patients, except for an 8-year-old case with Altman type IV SCT showing staccato voiding pattern and pelvic floor electromyography (EMG) activity. Anorectal examinations revealed normal anal anatomy, though fecalomas were detected in two cases. (Altman type II and IV SCT). Constipation, based on Rome IV criteria, was identified in 3 patients (1 Altman type I, 1 type II, and 1 type IV SCT). Based on the Holschneider scale, 11 patients achieved normal scores, while 3 (2 Altman type I, 1 Altman type II SCT). demonstrated good scores, reflecting overall satisfactory bowel control.

CONCLUSION: Bladder function was uneffected in Altman type I and II cases, except for dysfunction in one type IV case. Constipation was noted in one case each of types I, II, and IV, with no other bowel abnormalities detected. Non-invasive investigations should be prioritized for type I and II cases, while invasive methods may be necessary for those with intrapelvic extension.

PMID:41077518 | DOI:10.1016/j.jpurol.2025.09.024