Tag: pubmed

Eur Spine J. 2025 Feb 16. doi: 10.1007/s00586-025-08703-5. Online ahead of print.

ABSTRACT

PURPOSE: CT is considered the gold standard to assess bone morphology, whereas MRI is the imaging modality of choice to assess soft tissue. To reduce the ionising radiation exposure of the patient from CT, new MRI technologies have been developed to obtain images of bone. Two promising methods include MRI-based synthetic CT (sCT) and T1-weighted isotropic MRI.

METHODS: A prospective study including twenty-four adult patients receiving lumbar or sacral spine stabilisation surgery was performed. For each patient, two scans were acquired: a 3D dual echo T1-weighted gradient image, from which a sCT was reconstructed, and a 3D isotropic T1-weighted MRI sequence. Three observers assessed the sCT images for adequate visualisation of relevant vertebral anatomies and confidence using sCT in preoperative planning compared to the isotropic MRI based on a series of statements scored using a Likert-scale. Summary statistics and intraclass correlation coefficients were calculated.

RESULTS: All observers agreed that the sCT provided adequate visualization (94% of cases). Compared to the isotropic MRI, the sCT provided added value (89% of cases) and improved confidence (92% of cases) for the preoperative planning stage. No unexpected poor intraclass correlations were identified. The observers diagnosed patients with spondylolysis, scoliosis, arthrosis, spina bifida occulta, various Castellvi classifications, or without pathology.

CONCLUSIONS: sCT adequately visualised vertebral structures relevant for surgical spine planning with good confidence and added value for sCT compared to 3D T1-weighted isotropic MRI is shown. sCT could be a valuable method to reduce the radiation exposure associated with CT.

PMID:39956884 | DOI:10.1007/s00586-025-08703-5

Sci Rep. 2025 Feb 16;15(1):5686. doi: 10.1038/s41598-025-90462-w.

ABSTRACT

To investigate the causal relationship between inflammatory bowel disease (IBD) and uveitis, we conducted a two-sample bidirectional Mendelian randomization (MR) analysis utilizing summary data from genome-wide association studies (GWAS). The primary statistical analysis was performed using the inverse-variance weighted (IVW) method. False discovery rate (FDR) correction was used to control for false positives in multiple testing. In addition, sensitivity analyses were carried out using the MR Egger intercept test and Cochran’s Q test. The MR analysis revealed that genetically determined IBD (OR = 1.141, 95% CI 1.080-1.205, P = 2.21 × 10^-6, P_FDR = 6.90 × 10^-6), ulcerative colitis (UC) (OR = 1.113, 95% CI 1.032-1.201, P = 0.006, P_FDR = 0.009), and Crohn’s diseases (CD) (OR = 1.073, 95% CI 1.017-1.133, P = 0.010, P_FDR = 0.011) had a causal effect on uveitis. Conversely, the reverse MR analysis did not reveal significant causal link of uveitis on IBD, including its two subtypes. Furthermore, the results of the MR-Egger and weighted median methods were consistent with the IVW method. No evidence of heterogeneity or pleiotropy was detected by sensitivity analysis. Our findings confirm that IBD and its main subtypes had a causal connection with uveitis. Further research is needed to elucidate the underlying pathophysiological mechanisms driving this association.

PMID:39956872 | DOI:10.1038/s41598-025-90462-w

Eur J Drug Metab Pharmacokinet. 2025 Feb 16. doi: 10.1007/s13318-025-00937-4. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Atorvastatin is dosed in its active acid form although it exists in equilibrium with its inactive lactone form in vivo. Although in vitro atorvastatin acid displays pH-dependent conversion to the lactone metabolite, pharmacokinetic (PK) data on the effect of elevated gastric pH on atorvastatin and major atorvastatin-related species are not currently available. In this dedicated study, we investigated the effect of food and acid-reducing agents on the PK of atorvastatin and its three major metabolites in humans.

METHODS: This was an open label, randomized, crossover study conducted in 17 healthy volunteers. Part 1 examined the PK of a 10-mg dose of atorvastatin co-administered with or without a 600-mg dose of sodium bicarbonate in fasted and fed states. Part 2 was a single assessment to examine the PK of a 10-mg dose of atorvastatin in the fasted state following a 5-day treatment course of 40-mg daily esomeprazole. Gastric pH was monitored during treatments using Heidelberg capsules. A linear mixed effects model was used to derive ratios for PK parameters of atorvastatin and metabolites between treatments.

RESULTS: Similar to previous food effect studies, food significantly decreased the maximum concentration (C_max) and increased the time to C_max (t_max) of atorvastatin, with minimal effect on total exposure of atorvastatin or metabolites. Neither sodium bicarbonate, in the fed or fasted state, nor treatment with esomeprazole had a clinically meaningful effect on the exposure of atorvastatin or its metabolites.

CONCLUSIONS: According to these results, atorvastatin PK does not appear to be sensitive to changes in gastric pH.

PMID:39956861 | DOI:10.1007/s13318-025-00937-4

Sci Data. 2025 Feb 16;12(1):280. doi: 10.1038/s41597-025-04533-8.

ABSTRACT

Historical population grids are scarce or rather non-existent. This work represents a first effort in this direction. Using historical cadastral data and homogeneous population data at municipal level, we generate, for the whole of Spain, population grids with 100 m × 100 m and 1 km × 1 km resolutions and all census years from 1900 to 2021. These grids are top-down. The methods used are like those employed in the generation of population grids for the entire globe in the last decades by combining satellite imagery with demographic information from censuses. Given the richness of cadastral information, and the possibility of going much further back in time than satellite information, we can generate much older population grids. Although far from perfect, these grids provide a better approximation to the spatial distribution of the population in those years than the simple consideration of the municipal population or the count in the settlements derived from the gazetteers associated with the censuses. The possibility of taking our estimates up to 2021, where we have a bottom-up population grid from the Spanish National Statistical Institute (INE) derived from the 2021 census allows us to validate our methods, albeit only for the most recent dates.

PMID:39956832 | DOI:10.1038/s41597-025-04533-8

Sci Data. 2025 Feb 16;12(1):277. doi: 10.1038/s41597-025-04550-7.

ABSTRACT

This paper provides the background, methodology and validation for constructing a representation of the European high-voltage grid (AC lines from 220 to 750 kV and all DC lines) based on OpenStreetMap data. Grid components include commissioned substations, transmission lines and cables, transformers, and converters as well as technical parameters based on standard types. The data is provided as easy-to-access comma-separated values files which makes it suitable for model-independent, large-scale electricity and energy system modelling. For further ease-of-use, an interactive map is included to enable visual inspection. To assess the data quality, this paper compares the dataset with official statistics and representative model runs using PyPSA-Eur based on different electricity grid representations. The dataset and workflow are provided as part of PyPSA-Eur, an open-source, sector-coupled optimisation model of the European energy system. By integrating with the codebase for initiatives such as PyPSA-Earth, the benefits of this work of this work extend to the global context. The dataset is published under the Open Data Commons Open Database (ODbL 1.0) licence.

PMID:39956804 | DOI:10.1038/s41597-025-04550-7

Int J Health Plann Manage. 2025 Feb 16. doi: 10.1002/hpm.3914. Online ahead of print.

ABSTRACT

This paper addresses regional disparities in the allocation of medical professionals within the Portuguese National Health Service (NHS) and its policy implications, drawing recommendations to address these inequalities. In a country with a universal and comprehensive healthcare system, ensuring equitable geographical distribution of healthcare professionals is crucial for the effectiveness and equity of the health system. The analysis uses data from the NHS payroll system (RHV), covering the period from 2017 to 2023, and focuses on active medical workers, including those on duty and retired but still in service, distributed among the five Regional Health Administrations that then existed. The analysis is based on Full-Time Equivalents to provide a more realistic picture of the healthcare workforce. Population data comes from the official source. The Dissimilarity Index is used to measure regional disparities, focusing on the medical workforce (specialist doctors). The study aims to identify disparities in the distribution of these healthcare professionals throughout the five regions within the NHS and inform evidence-based policies to address such inequalities in resource allocation of the healthcare workforce. The findings reveal that while the overall density of NHS healthcare workers per 1000 inhabitants grew, and global disparities in the allocation of NHS workers slightly diminished, some regional disparities have worsened, as it was the case of the distribution of specialist doctors among the territory. The Dissimilarity Index indicates increasing inequality among the allocation of the medical workforce in the national territory, with statistically significant growth in disparity over time. The study underscores the urgent need for targeted policies to address these growing inequalities in allocating specialist doctors within the NHS.

PMID:39956786 | DOI:10.1002/hpm.3914

Nurs Health Sci. 2025 Mar;27(1):e70067. doi: 10.1111/nhs.70067.

ABSTRACT

Chronic wounds are a substantial health burden, adversely affecting patients’ overall quality of life. This study explored the association between positive psychological well-being and quality of life and the mediating roles of illness perceptions and attitudes toward medical help-seeking among people with chronic wounds. A total of 208 people with chronic wounds from three hospitals in China were recruited. Data were collected using the Brief Illness Perception Questionnaire, Attitudes Toward Medical Help-Seeking Scale, the Well-being in Wounds Inventory, and the Questionnaire on Quality of Life with Chronic Wounds. Participants reported poor health-related quality of life. The structural equation model revealed that the overall indirect impact of positive psychology on quality of life was 38.93%. This impact was divided into three components: disease perception accounted for 26.67% of the total indirect effect, attitude toward medical care accounted for 8.50%, and the combined effect of both factors accounted for 3.75%. This suggests that higher positive psychological well-being may lead to higher quality of life by reducing illness perception and improving attitudes toward medical help-seeking.

PMID:39956774 | DOI:10.1111/nhs.70067

Disabil Health J. 2025 Feb 11:101784. doi: 10.1016/j.dhjo.2025.101784. Online ahead of print.

ABSTRACT

BACKGROUND: The dearth of disability-focused education in United States residency programs fuels health care disparities faced by persons with disabilities (PWD). However, it has yet to be demonstrated that physicians-in-training feel less comfortable managing disability-specific health concerns than they do other medical conditions.

OBJECTIVE OR HYPOTHESIS: To assess Internal Medicine (IM) residents’ level of comfort in managing disability-specific versus general internal medical (GIM) concerns. We hypothesized that: 1) IM residents are less comfortable managing disability-specific health conditions than other GIM conditions; 2) IM residents feel increasingly comfortable handling GIM conditions over the course of their training, but not in addressing disability-specific concerns, and; 3) prior exposure to PWD improves IM residents’ comfort in managing disability-specific conditions.

METHODS: An exploratory study utilizing a Likert Scale-based survey assessing IM residents’ level of comfort in managing GIM and disability-focused conditions was developed then distributed through 3 IM programs. Main measures included residents’ level of comfort in managing a variety of medical conditions, including those pertaining to the care of PWD. Data analysis included descriptive statistics, ANOVAs, and independent sample t-tests.

RESULTS: The survey was distributed to 298 residents and 127 completed it (response rate of 42.6 %). Participants were less comfortable providing disability-focused care than GIM care. Upper-level residents were more comfortable than first-year residents in managing GIM conditions, but not in providing disability-focused care.

CONCLUSIONS: Internal medicine residents are inadequately trained to provide care for PWD. There is a need to incorporate disability-specific learning objectives into graduate medical program requirements and curricula.

PMID:39956754 | DOI:10.1016/j.dhjo.2025.101784

Soc Sci Med. 2025 Jan 16:117703. doi: 10.1016/j.socscimed.2025.117703. Online ahead of print.

ABSTRACT

The prevalence of loneliness is higher among older people; however, few studies have examined its longitudinal patterns and associated risk factors, particularly social network resources. Using data from six waves of the English Longitudinal Study of Ageing (2008/09 to 2018/19, N = 4740) and group-based trajectory modelling (GBTM), we identified five groups of loneliness trajectories: three with stable levels (37% “stable low”; 26% “stable medium”; 9% “stable high”) and two with time-varying scores of loneliness (8% “increasing”; 20% “decreasing”). Multinomial regression models and GBTM were used to examine baseline and time-varying factors associated with these trajectories. We created composite measures to capture the presence and key facets of social network resources (including size, support, closeness, and frequency of contact) for four different social relationship domains (partner, children, immediate family, and friends). Our results show that, among those with family or friends, older people with higher social network resources and those who maintained or improved them over time reported lower levels of loneliness. Findings also suggest that all social relationship domains contributed to feelings of loneliness in later life. Also, we find that respondents in poor health and depressed, as well as those whose health deteriorated over time, were more likely to have stable high or increasing levels of loneliness. The study highlights the need to investigate loneliness from a life course perspective, account for the complexity of social relationships in later life beyond their mere presence or absence, and include their quality and quantity as well as multiple domains of family and intergenerational relationships.

PMID:39956740 | DOI:10.1016/j.socscimed.2025.117703

J Surg Educ. 2025 Feb 15:103463. doi: 10.1016/j.jsurg.2025.103463. Online ahead of print.

ABSTRACT

OBJECTIVE: Compare scoring outcomes between interviewers blinded to scores/grades/MSPE and those with the full applicant file to evaluate the effect of blinding on interview scores and ensure applicants can be confidently evaluated when blinding is used.

DESIGN, SETTING AND PARTICIPANTS: Nineteen interviewers were purposively randomized to receive a complete application or file with all information except applicant grades/MSPE/USMLE score(s) of 90 applicants prior to 218 interviews during 2022 to 2023 general surgery recruitment. Blinding was randomly assigned while ensuring blinded and nonblinded interviews for both interviewers and applicants. Two program leaders involved in study implementation were excluded from blinding. All other aspects of the selection process remained unchanged from historic methods. Each applicant had 3 to 4 interviews. Each interview was scored prior to discussion with other faculty using a 10-point scale. Descriptive and univariate statistics analyzed scoring patterns. Qualitative data regarding the experiences of blinded interviewers was analyzed to generate themes.

RESULTS: There were no differences in interview scores or difference from the applicants’ mean scores between blinding groups. This remained true for within-applicant analyses and for all but 1 interviewer (95%) for within-interviewer analyses. Between-interviewer score differences were seen for interview scores across all interviewers and when comparing nonblinded vs. nonblinded scores across interviewers, but not when comparing blinded vs. blinded scores across interviewers. Qualitative data support the ability to confidently evaluate interview performance when blinded, frequent practice of “self-blinding” to limit bias even when given scores/grades/MSPE, and belief that scores/grades/MSPE are relevant for screening, but the interview has separate priorities.

CONCLUSIONS: Blinding of interviewers to scores/grades/MSPE did not significantly change interview scoring outcomes. Interviewer experiences support the ability to confidently evaluate interview performance when blinded. Given that negative effects of blinding were not found and prior work supports that bias may be mitigated by blinded interviews, we support its use in residency recruitment.

PMID:39956727 | DOI:10.1016/j.jsurg.2025.103463