Tag: pubmed

Neurosurg Rev. 2025 Oct 11;48(1):692. doi: 10.1007/s10143-025-03830-5.

ABSTRACT

The Pipeline is currently the most widely used flow-diverting device worldwide, yet research on its long-term efficacy remains limited, primarily based on small to medium-sized sample cohorts. The objective of this study was to evaluate the long-term safety and efficacy of the Pipeline device in treating intracranial aneurysms. Additionally, the study aimed to analyze the risk factors associated with long-term incomplete occlusion of the aneurysm and stenosis of the parent artery. This multicenter retrospective study included patients with intracranial aneurysms treated with the Pipeline flow-diverting device between 2015 and 2020. The analysis encompassed clinical and imaging outcomes, including clinical presentation, comorbidities, aneurysm characteristics, procedural details, and postoperative follow-up data. This study included 190 patients(122 females)with a mean age of 54.6 ± 11.7 years and 204 aneurysms. At one year postoperatively, the complete aneurysm occlusion rate was 69.9%, parent artery stenosis was 3.7%, and complications occurred in 3.3% of cases. During long-term follow-up, the occlusion rate increased to 93.1%, stenosis rose to 6.4%, and complications decreased to 2.1%. Three perforator occlusions were reported: two during the short-term follow-up and one during the long-term follow-up, resulting in severe impairment (mRS 4). The Pipeline flow-diverting device demonstrated favorable long-term safety and efficacy in the treatment of intracranial aneurysms, with no significant differences in safety or effectiveness between vertebral artery aneurysms and anterior circulation aneurysms. Statistical analysis identified advanced age and male gender as risk factors for long-term incomplete occlusion. Furthermore, the results suggest that postoperative antiplatelet therapy and imaging follow-up were continued for only one year, which is considered safe and effective.

PMID:41074981 | DOI:10.1007/s10143-025-03830-5

J Gastroenterol. 2025 Oct 11. doi: 10.1007/s00535-025-02306-z. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Hepatitis B e antigen (HBeAg) seroclearance is crucial in the natural history of chronic hepatitis B (CHB). Little is known about the role of hepatitis B core-related antigen (HBcrAg) levels in predicting spontaneous HBeAg seroclearance.

METHODS: This retrospective cohort study included 484 treatment-naïve HBeAg-positive CHB patients with an extended follow-up period at National Taiwan University Hospital. The primary endpoint was spontaneous seroclearance of HBeAg. The association between baseline HBcrAg levels and their kinetic patterns with spontaneous HBeAg seroclearance was assessed.

RESULTS: Of 484 patients with a mean follow-up period of 7.80 years, 331 (68.4%) achieved spontaneous HBeAg seroclearance, corresponding to an annual rate of 8.76%. Lower baseline HBcrAg levels correlated with an increased likelihood of HBeAg seroclearance (log-rank P < .001). When HBcrAg kinetics were assessed based on baseline and year 3 levels, patients with HBcrAg levels persistently < 10⁵ KU/mL (HR: 2.66; 95% CI: 1.75-4.04) and those declining to < 10⁵ KU/mL (HR: 2.31; 95% CI: 1.50-3.55) had an increased likelihood of HBeAg seroclearance when compared to those with persistently high HBcrAg levels. This association remained statistically significant in multivariate analysis after adjusting for baseline viral factors. In addition, HBcrAg kinetics were consistently associated with HBeAg seroclearance in immune-tolerant patients.

CONCLUSIONS: HBcrAg < 10⁵ KU/mL, or a decline to this threshold, identified HBeAg-positive CHB patients with higher likelihood of spontaneous HBeAg seroclearance. Persistently high HBcrAg may indicate earlier CHB phases and inform management strategies.

PMID:41074980 | DOI:10.1007/s00535-025-02306-z

Clin Oral Investig. 2025 Oct 11;29(11):502. doi: 10.1007/s00784-025-06566-0.

ABSTRACT

PURPOSE: This study aimed to clarify the relationship between diurnal awake bruxism (AB) awareness, tooth-contacting habit (TCH) awareness, and the electromyographic (EMG) waveform integral value.

MATERIALS AND METHODS: Unilateral masseteric EMG recordings during the daytime were performed on the habitual masticatory side using an ultraminiature wearable EMG device. One hundred and seven participants (50 and 57 with and without diurnal tooth clenching (d-TC) awareness, respectively) were included. d-TC awareness and TCH awareness were assessed using questionnaires. The standardized burst integral (S-integral) value was calculated for each participant.

RESULTS: There was a statistically significant association between d-TC awareness and TCH awareness. The S-integral values were not significantly associated with the awareness d-TC or TCH. The frequency distribution of EMG waveforms of the awareness and non-awareness groups exhibited wide-range overlaps both for d-TC and TCH.

CONCLUSION: d-TC or TCH awareness showed no clear correlation with the S-integral value, suggesting that it is important to evaluate AB and TCH based on objective and quantitative test results, such as the masseter muscle’s EMG data.

CLINICAL RELEVANCE: Diagnosis, treatment, and management of AB and TCH are important issues in dental medicine. The obtained results regarding the actual state of awareness of AB and TCH, and the EMG integral value that was one of the important EMG indices, were considered useful information for establishing diagnostic and assessment methods for AB and TCH in future clinical dentistry.

PMID:41074973 | DOI:10.1007/s00784-025-06566-0

Influenza Other Respir Viruses. 2025 Oct;19(10):e70174. doi: 10.1111/irv.70174.

ABSTRACT

INTRODUCTION: Respiratory syncytial virus (RSV) is increasingly recognized as an important cause of acute respiratory infections (ARI) in older adults. However, primary care data on RSV infections are scarce.

METHODS: We conducted a prospective cohort study over two winter seasons (2022-2023 and 2023-2024) in Italy and the Netherlands (NCT06318936). Older adults (≥ 60 years) presenting to primary care with ARI were tested for RSV and influenza. Clinical and socioeconomic burden was assessed through questionnaires on Days 1, 14, and 30. In secondary analyses, we compared between RSV- and influenza-positive patients and estimated RSV-ARI incidence in Dutch primary care.

RESULTS: Of 703 older adults tested, 93 (13.2%) were RSV-positive and 100 (14.2%) influenza-positive. In RSV patients (mean age: 76 years [SD: 8], 63% ≥ 1 comorbidity), mean illness duration was 17 days (SD: 10). Repeat primary care visits occurred in 38% (33/87), emergency department referral in 5% (4/88), and hospitalization in 2% (2/88) of RSV patients. The mean costs per RSV episode were €78.1 (95%CI: 74.4-81.8) and €279.7 (95%CI: 245.5-318.2) from a healthcare system and societal perspective, respectively. The annual RSV-ARI incidence rate was 10.3 episodes per 1000 person-years. RSV patients were significantly older, and had less often fever, muscle pain, and fatigue than influenza patients, but clinical and socioeconomic burdens were comparable.

CONCLUSIONS: This prospective study is the first sufficiently large to demonstrate that the primary care burden of RSV infections among older adults is substantial and comparable with influenza. These findings are highly relevant for informing public health decisions on novel RSV vaccines.

PMID:41074665 | DOI:10.1111/irv.70174

Biochem Mol Biol Educ. 2025 Oct 11. doi: 10.1002/bmb.70018. Online ahead of print.

ABSTRACT

One type of active learning technique that instructors can incorporate is the use of various drawing activities. This study investigates the impact of drawing during biology lecture classes on student learning. Undergraduate students in two lecture sections of an introductory cellular and molecular biology course completed worksheets that either required them to draw (learner-generated) or required them to interpret a drawing (instructor-generated). The four topics that were assessed were amino acid polymerization, nucleotide polymerization, cellular respiration, and photosynthesis. Student learning was assessed using multiple-choice and short-answer exam questions. Students who completed the learner-generated worksheet related to amino acid polymerization performed significantly better than students who completed the instructor-generated worksheet. Differences in student learning were not statistically significant for the other three topics; however, trends indicated that for some topics, the learner-generated worksheet increased student understanding while for other topics the students who completed the instructor-generated worksheet performed better. These findings indicate that it is important to carefully align the type of drawing activity with the complexity of the topic. When the drawings were too complex, students did not gain as much from creating their own images. Instructors are encouraged to thoughtfully integrate various types of drawing activities into their courses to increase student learning.

PMID:41074661 | DOI:10.1002/bmb.70018

Ann Med. 2025 Dec;57(1):2570798. doi: 10.1080/07853890.2025.2570798. Epub 2025 Oct 11.

ABSTRACT

BACKGROUND: Venous-Origin Chronic Pelvic Pain (VO-CPP), a subgroup of Pelvic Venous Disorders (PeVD) can significantly affect Quality of Life (QoL). Previous papers have highlighted the lack of evaluations measuring QoL of patients before and after embolization. The aim of this study was to evaluate the effectiveness of embolization in reducing a variety of symptoms and improving QoL in patients with VO-CPP.

METHODS: A prospective analysis of 40 female patients (mean 36.9 years) diagnosed with VO-CPP, undergoing venous embolization between June 2020 and May 2023 was conducted. Patients with extrinsic compressions, other pelvic conditions, and S₃V₃ without S₂ in SVP Classification were excluded. Patients were evaluated before and after treatment at mid-term (MT) (9.4 ± 5.1 months) and long-term (LT) (29.6 ± 6.94 months). The severity of 12 different symptoms were assessed using VAS scale (pelvic, postcoital, standing, back, hip, leg and abdominal pain; nausea frequency, urinary discomfort, sleep disturbance and dysmenorrhoea), while QoL was measured using the SF-36 questionnaire. Patient satisfaction was assessed using the Likert scale.

RESULTS: Significant reductions in all measured symptoms were observed between pre-treatment and MT and LT follow-ups (p < 0.0001). No statistically significant differences were found between MT and LT scores, indicating a sustained relief. The greatest benefits were observed in reducing daytime pelvic pain (6.25 ± 1.93 to 2.49 ± 2.47), standing (7.43 ± 1.65 to 3.41 ± 2.43) and postcoital pain (6.40 ± 2.63 to 2.54 ± 2.22). QoL scores in both physical and mental health showed statistically significant and sustained improvement after the procedure. Most patients were satisfied with the procedure (81%), with 86% willing to undergo it again and 89% to recommend it.

CONCLUSION: Embolization provides significant, sustained improvements in symptom relief while enhancing QoL in VO-CPP patients. Randomized controlled trials are needed to confirm these effects and exclude a placebo response.

PMID:41074660 | DOI:10.1080/07853890.2025.2570798

Health Soc Care Deliv Res. 2025 Oct;13(36):1-22. doi: 10.3310/TDAS1298.

ABSTRACT

BACKGROUND: Ethnic minority women face worse maternity outcomes and increased risk of perinatal mental health issues, yet research on the accessibility and acceptability of perinatal mental health services for these groups is limited.

OBJECTIVES: (1) To explore access to and utilisation of mental health services during the perinatal period among ethnic minority women; (2) to explore care pathways to community and inpatient perinatal mental health services; (3) to explore the attitudes, experiences and service improvement suggestions of ethnic minority women with perinatal mental health problems, as well as those of their partners, family members and healthcare professionals and (4) to produce recommendations for improving clinical practice.

METHODS: Mixed-methods study was conducted during 2018-23, encompassing four studies aligned with specific aims: (1) a population-based study of 615,092 women who gave birth in National Health Services hospitals in England, using data from the National Commissioning Data Repository; (2) a retrospective evaluation of patients accessing community perinatal mental health services in Birmingham and London (n = 228) and inpatient services in Birmingham, London and Nottingham (n = 198) using an adapted World Health Organization care pathways questionnaire; (3) a qualitative study with four cohorts across England: service users (n = 37), non-users or those who disengaged (n = 23), partners/family (n = 15) and healthcare professionals (n = 24); (4) findings informed recommendations for practice improvements, coproduced with individuals with lived experience of perinatal mental illness and of being in a minoritised ethnic group. Data were analysed using quantitative and qualitative approaches.

RESULTS: Access issues to mental health services were evident for Black African, Asian and White other women compared to White British women. Variability in patient journeys to community perinatal mental health services seem to stem from service-level factors rather than patient needs. Asian patients had more emergency admissions to Mother and Baby Units, while Black patients were less likely to experience multiple services before Mother and Baby Unit admission. Barriers to access included limited service awareness, fear of child removal, stigma, remote clinical appointments and unresponsive services. Despite these challenges, many women found services helpful. Family members noted gaps in family-focused care. Recommendations for improvement include raising awareness, monitoring access for different ethnic groups and addressing concerns about child removal, with a focus on consistent care, family involvement and cultural sensitivity.

CONCLUSION: These findings shed light on health inequalities in perinatal mental health care for ethnic minority women. The results can be utilised to address existing barriers and improve outcomes for mothers, infants and families.

LIMITATIONS: Diversity within merged ethnic groups; limited sample of non-English-speaking women; reliance on self-reported measures; use of pre-COVID-19 data; under-representation of Black women who did not engage with services, and over-representation of Black and Asian patients in Birmingham and London samples in the study exploring patient pathways to Mother and Baby Units (compared to maternity population).

FUTURE WORK: Implementation of good practices in perinatal mental health care, targeted interventions to address the fear of child removal, innovative strategies to recruit Black and non-English-speaking women and exploring the experiences of ‘White other’ women.

FUNDING: This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number 17/105/14.

PMID:41074656 | DOI:10.3310/TDAS1298

Birth Defects Res. 2025 Oct;117(10):e2536. doi: 10.1002/bdr2.2536.

ABSTRACT

BACKGROUND: Congenital neurosurgical anomalies, such as neural tube defects (NTDs) and hydrocephalus, are prevalent central nervous system disorders. This study investigates their prevalence and factors statistically associated with their occurrence.

METHODS: A retrospective cross-sectional study at Mbeya Zonal Referral Hospital (MZRH) from May 2023 to April 2024 included 978 patients. Data from 145 children with CNS anomalies were analyzed using Microsoft Excel and STATA-15, with binary logistic regression to identify potential risk factors associated with these conditions.

RESULTS: The prevalence of congenital neurosurgical conditions was 14.3% (145/978). Hydrocephalus occurred in 8.3% (81/978), NTDs in 5.01% (49/978), Chiari malformations in 0.92% (9/978), and encephalocele in 0.61% (6/978). Logistic regression found that folate deficiency associated with delayed antenatal care was linked to a higher likelihood of NTDs and hydrocephalus (OR 2.56, p ≤ 0.005). Other factors showing statistical associations included prematurity, low birth weight, pregnancy infections, unprescribed drug use, malnutrition, gestational diabetes, and hypertension.

CONCLUSION: Key factors statistically associated with congenital CNS anomalies in this cohort include low birth weight, prematurity, inadequate folic acid intake, gestational diabetes, maternal hypertension, and unprescribed drug use. These findings highlight the importance of early prenatal care and maternal health optimization to potentially reduce the occurrence of these anomalies.

PMID:41074652 | DOI:10.1002/bdr2.2536

Hum Brain Mapp. 2025 Oct 1;46(14):e70357. doi: 10.1002/hbm.70357.

ABSTRACT

Although substantial progress has been made in mapping the connectivity of cortical networks responsible for conscious awareness, neuroimaging analysis of subcortical networks that modulate arousal (i.e., wakefulness) has been limited by a lack of robust segmentation procedures for ascending arousal network (AAN) nuclei in the brainstem. Automated segmentation of brainstem AAN nuclei is an essential step toward elucidating the physiology of human consciousness and the pathophysiology of disorders of consciousness. We created a probabilistic atlas of 10 AAN nuclei built on diffusion MRI scans of 5 ex vivo human brain specimens imaged at 750 μm isotropic resolution. The neuroanatomic boundaries of AAN nuclei were manually annotated with reference to 200 μm 7 Tesla MRI scans in all five specimens and nucleus-specific immunostains in two of the scanned specimens. We then developed a Bayesian segmentation algorithm that utilizes the probabilistic atlas as a generative model and automatically identifies AAN nuclei in a resolution- and contrast-adaptive manner. The segmentation method displayed high accuracy when applied to in vivo T1 MRI scans of healthy individuals and patients with traumatic brain injury, as well as high test-retest reliability across T1 and T2 MRI contrasts. Finally, we show through classification and correlation assessments that the algorithm can detect volumetric changes and differences in magnetic susceptibility within AAN nuclei in patients with Alzheimer’s disease and traumatic coma, respectively. We release the probabilistic atlas and Bayesian segmentation tool to advance the study of human consciousness and its disorders. Trial Registration: ClinicalTrials.gov: NCT03504709.

PMID:41074651 | DOI:10.1002/hbm.70357

Orthop Surg. 2025 Oct 11. doi: 10.1111/os.70189. Online ahead of print.

ABSTRACT

Thoracolumbar fractures are a prevalent clinical disease, with several surgical techniques, including traditional freehand pedicle screw fixation (TFPSF), conventional fluoroscopy (C-arm) percutaneous pedicle screw fixation (CPPSF), O-arm-assisted percutaneous pedicle screw fixation (OPPSF), and robot-assisted percutaneous pedicle screw fixation (RPPSF), being currently applied. However, a comprehensive comparison of their relative efficacy across multiple perioperative and functional outcomes is lacking, leading to uncertainty in optimal technique selection. This network meta-analysis (NMA) evaluates and compares the clinical efficacy of these four surgical techniques to identify the most effective intervention and guide clinical decision-making. Researchers independently searched PubMed, Embase, the Cochrane Central Register of Controlled Trials, and Web of Science for studies published before September 20, 2024. Studies were selected based on stringent eligibility criteria. Randomized controlled trials (RCTs) were assessed using RoB 2.0, while cohort studies were evaluated with the Newcastle-Ottawa Scale (NOS). After data extraction, Bayesian network analysis was executed using R 4.2.2 and Stata 16.0. Nineteen studies were included, encompassing 1344 patients with thoracolumbar fractures. For screw accuracy, OPPSF ranked highest (SUCRA = 92.7%), significantly outperforming TFPSF (RR 1.12; 95% credible intervals [CrI] [1.04, 1.23]) and CPPSF (RR 1.12; 95% CrI [1.04, 1.22]), with RPPSF also surpassing both. OPPSF showed superior intraoperative blood loss reduction (SUCRA = 79.8%) while TFPSF had significantly more bleeding than others. For hospitalization, RPPSF ranked highest (SUCRA = 65.0%) but CPPSF significantly shortened stays versus TFPSF (MD -2.24; 95% CrI [-4.48, -0.03]). CPPSF also showed better pain control (SUCRA = 77.9%) with significantly lower VAS scores versus TFPSF (MD -1.02; 95% CrI [-1.71, -0.37]). RPPSF demonstrated the lowest complication risk (SUCRA = 94.9%), with both CPPSF and RPPSF showing significant reductions versus TFPSF. Additionally, although CPPSF ranked first in SUCRA for both operative time (SUCRA = 81.6%) and Cobb angle (SUCRA = 72.4%), the pairwise comparisons did not demonstrate statistical significance, necessitating cautious interpretation. In summary, OPPSF tends to demonstrate superior precision and blood loss control, CPPSF may optimize rehabilitation efficiency, while RPPSF appears to be the safest technique. Technique selection should balance clinical outcomes, economic feasibility, and patient-specific priorities.

PMID:41074646 | DOI:10.1111/os.70189