Tag: pubmed

J Assist Reprod Genet. 2025 Oct 7. doi: 10.1007/s10815-025-03670-8. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to determine the feasibility of implementing non-invasive PGT-A (niPGT-A) in clinical practice. Informativity and concordance rates between three sample types (embryonic cell-free DNA [cfDNA] present in spent blastocyst medium [SBM], trophectoderm [TE] biopsy, and whole blastocyst [WB]) from the same embryo were evaluated.

METHODS: This was a prospective, multicenter study conducted between February 2022 and November 2022 at seven Japanese IVF centres. 212 blastocysts were donated for research. The cfDNA released into the SBM was analysed, and the results were compared against the corresponding TE biopsy and WB sample.

RESULTS: Overall informativity rates for SBM, TE, and WB were 81.6% (173/212), 98.6% (209/212), and 98.6% (209/212), respectively. There was no difference between TE and WB; however, SBM was significantly different to both (p < 0.001). The informativity rate in SBM samples significantly varied among the seven centres, ranging between 72.7 and 97.1% (p = 0.041). Ploidy concordance (SBM-TE) also varied across the centres, ranging between 68.2 and 90.9%; however, this did not reach statistical significance (p = 0.63). Ploidy concordance rates in SBM-TE, SBM-WB, and TE-WB were 77.4% (130/168), 77.4% (130/168), and 90.5% (152/168), respectively. There was no statistical difference for SBM-TE and SBM-WB, but both were statistically different to TE-WB (p = 0.0054).

CONCLUSION: We have shown results that are consistent with the existing literature, indicating the feasibility of applying the niPGT-A protocol described here, and thus using the SBM result to establish a priority for embryo transfer.

TRIAL REGISTRATION INFORMATION: The study was approved by Tokushima University Hospital Life Science and Medical Research Ethics Review Committee (Permission number: 4057).

PMID:41055878 | DOI:10.1007/s10815-025-03670-8

Med Biol Eng Comput. 2025 Oct 7. doi: 10.1007/s11517-025-03459-y. Online ahead of print.

ABSTRACT

Over the past few years, there has been an increase of clinical interest aimed at looking for correlations between morphology, extracted through statistical shape models (SSMs), and hemodynamics, extracted through computational fluid dynamics (CFD) simulations, in cardiovascular diseases. This study explores correlations between aortic morphology and hemodynamics in the thoracic aorta (TA). Existing research often simplifies geometries by excluding supra-aortic vessels due to software limitations in non-rigid registration. To overcome this, a novel algorithm was used to include these vessels in TA analysis. Principal component analysis reduced dimensionality, followed by automatic CFD simulations and correlation analysis between geometric and hemodynamic parameters. The first ( $M_0$ ) and second ( $M_1$ ) SSM modes explained 46.9 $\%$ and 22.4 $\%$ of dataset variance, respectively. Significant correlations were identified between $M_0$ and ascending TA aneurysm volume (Pr = 0.69), and $M_1$ and TA tortuosity (Pr = 0.60). Ten TA shapes were generated by varying standard deviations of $M_0$ and $M_1$ from -2 to +2, and CFD simulations revealed links between wall shear stress (WSS) indicators and TA morphology. This study presents a novel pipeline to analyze geometric and hemodynamic correlations using realistic TA geometries generated via SSM.

PMID:41055863 | DOI:10.1007/s11517-025-03459-y

Odontology. 2025 Oct 7. doi: 10.1007/s10266-025-01226-x. Online ahead of print.

ABSTRACT

The aim of this study is to evaluate the effects of thermocycling and material thickness on the radiopacity values of various universal composite resins. A total of 18 different composite resin materials were tested, including 7 single-shade, 6 polyshade, and 5 simply-shade composites. Disk-shaped specimens with a diameter of 5 mm and thicknesses of 1 mm and 2 mm were prepared from each material. Radiographic images of all specimens were taken alongside an aluminium step-wedge and tooth sections (enamel and dentin) of corresponding thickness. Using the ImageJ software, the mean gray values (MGV) of each specimen, the 15 steps of the aluminium wedge, and the enamel and dentin sections were measured. These values were converted into aluminium equivalents (mm Al). Differences among materials were analyzed using one-way ANOVA and Tukey’s multiple comparison test, while differences related to thickness and aging were evaluated with two-way ANOVA and Tukey’s test. The level of statistical significance was set at p < 0.05. All composite resin samples exhibited significantly higher radiopacity values than dentin (p < 0.05). The 2 mm thick samples showed greater radiopacity than those with 1 mm thickness (p = 0.000). The material with the highest radiopacity was Charisma Diamond. Among the 1 mm thick specimens before thermocycling, the lowest radiopacity was observed in Omnichroma. In other parameters, Clearfil Majesty ES-2 exhibited the lowest radiopacity values. All tested composite resins demonstrated higher radiopacity values compared to dentin and met the criteria set by the International Organization for Standardization (ISO). Material thickness significantly affected radiopacity. However, radiopacity values varied among materials after thermocycling through thermocycling.

PMID:41055856 | DOI:10.1007/s10266-025-01226-x

Ir J Med Sci. 2025 Oct 7. doi: 10.1007/s11845-025-04111-2. Online ahead of print.

ABSTRACT

BACKGROUND: Young-onset type 2 diabetes mellitus (T2DM) is an increasingly prevalent condition characterized by rapid progression. Apart from adipose tissue, there has been growing attention to the relationship between T2DM and total body skeletal muscle mass (SMM).

AIM: This study investigated the relationships between body composition indicators and glycemic parameters in young-onset T2DM patients versus young, healthy adults, aiming to identify predictive markers with optimal cutoff values for the early identification of young-onset T2DM.

METHODS: A cross-sectional study was conducted among 252 participants aged 18-40 years, including 96 young-onset T2DM patients and 156 non-T2DM individuals. Glycemic parameters and body composition variables were assessed via bioelectrical impedance analysis. Statistical analysis included correlation, multiple logistic regression, and receiver operating characteristic curve analysis to determine optimal SMM% cutoff values for young-onset T2DM prediction.

RESULTS: The SMM% displayed a significant negative correlation with HbA1c (p = – 0.624) and FBG (p = – 0.656). VF demonstrated a positive correlation with both HbA1c (p = 0.636) and FBG (p = 0.580). Logistic regression analysis identified SMM, VF, and subcutaneous fat as significant predictors of HbA1c levels. Receiver operating characteristic analysis revealed gender-specific SMM% cutoff values of 23.14% for females and 28.6% for males, with high sensitivity and specificity.

CONCLUSION: Reduced SMM% and increased VF are significant predictors of young-onset T2DM. The study established the optimal gender-specific cutoff value of SMM% for identifying individuals at risk of young-onset T2DM in the Indian population. Incorporating body composition assessments into clinical practice may facilitate early detection and targeted interventions.

PMID:41055852 | DOI:10.1007/s11845-025-04111-2

Oral Radiol. 2025 Oct 7. doi: 10.1007/s11282-025-00868-5. Online ahead of print.

ABSTRACT

OBJECTIVES: This study investigated the association between the apical surface area measurement (ASAM) of impacted mandibular third molars (IMTM) and chronological age at varying impaction levels, as well as ASAM differences among levels.

METHODS: A total of 446 IMTM (227 right, 219 left) from 257 Malaysian patients aged 15.0 to 25.9 years were included and grouped into 0.9-year intervals. All CBCT images were analysed using Mimics and 3-matic software (Materialise NV, Belgium, version 21.0) to calculate the apical surface area. Impaction level was categorised according to the Pell and Gregory classification system. Spearman’s correlation and Welch’s ANOVA were conducted to assess the relationship between ASAM and age and to compare ASAM across the four levels (A, B, modified B/C, and C). Differences between left and right IMTM were assessed using an independent t-test, and analysed with SPSS (version 26).

RESULT: ASAM showed an inverse correlation with age (ρ = -0.89, ρ² = 0.79), with a median of 4.86 mm² (IQR: 2.35-11.92). The steepest decline was observed between 17-18 years, followed by a plateau from 21 years onwards. Left and right IMTM were not statistically different (p = 0.53) and subsequently pooled. ASAM increased with impaction depth; however, only level C exhibited significantly larger ASAM than levels A and B (p < 0.001), with an effect size of ω² = 0.13, indicating a notable delay in maturation.

CONCLUSIONS: This study demonstrates the relationship between ASAM in IMTM and age, with potential applicability in dental age estimation. However, caution is advised for level C impactions, as the estimated age may be biased.

PMID:41055825 | DOI:10.1007/s11282-025-00868-5

J Med Syst. 2025 Oct 7;49(1):127. doi: 10.1007/s10916-025-02276-y.

ABSTRACT

Artificial intelligence (AI), specifically large language models (LLM), have gained significant popularity over the last decade with increased performance and expanding applications. AI could improve the quality of patient care in medicine but hidden biases introduced during training could be harmful. This work utilizes GPT-4o-mini to generate patient communications based on systematically generated, synthetic patient data that would be commonly available in a patient’s medical record. To evaluate the AI generated communications for disparities, GPT-4o-mini was used to score the generated communications on empathy, encouragement, accuracy, clarity, professionalism, and respect. Disparities in scores associated with specific components of a patient’s history were used to detect potential biases. A patient’s sex and religious preference were found to have a statistically significant impact on scores. However, further work is needed to evaluate a wider collection of LLMs utilizing more specific and human validated scoring criteria. Overall, this work proposes a novel method of evaluating bias in LLMs by creating synthetic patient histories to formulate AI generated communications and score them with opportunities for further investigation.

PMID:41055822 | DOI:10.1007/s10916-025-02276-y

J Med Syst. 2025 Oct 7;49(1):126. doi: 10.1007/s10916-025-02270-4.

ABSTRACT

Normative ranges for vital signs under general anesthesia are well established for healthy pediatric patients, but the influence of The American Society of Anesthesiologists Physical Status (ASA-PS) classification on these normative ranges remains unexplored. The purpose of this study is to develop age-based normative ranges for heart rate (HR) and blood pressure (BP) in patients undergoing general anesthesia for noncardiac surgery in our institution and assess differences by ASA-PS classification. This is a retrospective observational single-center study. We reviewed all anesthetic records from the Hospital for Sick Children, Canada between March 1st and December 31st, 2023. We extracted physiological data from our in-house high-resolution physiological data repository (AtriumDB) to develop normative ranges for physiological parameters and compared them according to ASA-PS classification. We developed age-based normative ranges for BP and HR. We found significant differences between ASA-PS groups, most notably between ASA-PS 1 and 5. We found a statistically significant difference between ASA-PS 1-2 and 3-5 across all physiological parameters. This study validates existing pediatric anesthesia reference ranges while demonstrating the feasibility of incorporating patients across the spectrum of ASA-PS. Further multicenter studies are needed to generalize these findings.

PMID:41055817 | DOI:10.1007/s10916-025-02270-4

Clin Exp Nephrol. 2025 Oct 7. doi: 10.1007/s10157-025-02777-7. Online ahead of print.

ABSTRACT

BACKGROUND: Elevated parathyroid hormone (PTH) levels are associated with cardiovascular events, bone disease, and mortality in patients undergoing maintenance hemodialysis. Although PTH levels vary widely in patients undergoing hemodialysis, whether this affects mortality is unclear.

METHODS: A total of 315 maintenance hemodialysis patients who underwent PTH measurements at least twice a year were enrolled. The association between all-cause mortality, cardiovascular events, and fractures was evaluated in patients with PTH concentrations of 60-240 pg/mL (time-in-target range (TTR) 100%) and those with TTR values of 75% ≤ TTR < 100%, 50% ≤ TTR < 75%, and TTR < 50%.

RESULTS: There were 122 patients with TTR 100%, 81 patients with 75% ≤ TTR < 100%, 52 patients with 50% ≤ TTR < 75%, and 74 patients with TTR < 50%. Over the 4-year observation period, patients with TTR of 100% had significantly lower all-cause mortality than those with TTR < 50%. (HR 2.26, 95% CI 1.33-3.86) Subgroup analysis by presence or absence of pharmacological intervention showed no statistically significant difference in all-cause mortality in the treatment group (HR 2.08, 95% CI 1.16-3.72), but showed significant differences in the no-treatment group (HR 1.58, 95% CI 0.92-2.70).

CONCLUSION: A prolonged period of deviation from the optimal PTH range was associated with increased all-cause mortality, particularly among patients not receiving SHPT medication. However, this effect was not observed in patients who received pharmacological interventions. These results suggest that early intervention is desirable when PTH levels vary from the optimal range in patients with secondary hyperparathyroidism.

PMID:41055807 | DOI:10.1007/s10157-025-02777-7

Eur J Pediatr. 2025 Oct 7;184(11):660. doi: 10.1007/s00431-025-06531-9.

ABSTRACT

The increasing use of assisted reproductive technology has raised concerns about its long-term effects on offspring, including pubertal development. Evidence from large, population-based studies in non-Western countries remains limited. Using data from the Taiwan Birth Cohort Study, a nationally representative cohort of children born in 2005, we examined pubertal development at age 12 based on caregiver reports. Among 21,642 children with conception data, 172 were conceived via intrauterine insemination (IUI), 311 via in vitro fertilization (IVF), and 21,159 spontaneously (SC). Propensity score matching (1:1) yielded a final sample of 966 children. Ordinal logistic regression and parametric survival analysis assessed associations between conception method and pubertal milestones, including age at menarche. Among 966 matched children (546 boys, 420 girls), most associations between fertility treatments and pubertal development at age 12 were small and not statistically significant. Boys and girls conceived via IUI did not show a trend toward earlier or later puberty. In IVF-conceived children, odds ratios for pubertal development were near 1.0, not statistically significant and with wide 95% confidence intervals. No significant differences were found in age at menarche, either.

CONCLUSION: In this nationally representative cohort, we found no statistically significant differences in pubertal development or age at menarche by conception method at age 12. Continued follow-up is warranted to assess long-term reproductive outcomes.

WHAT IS KNOWN: • Children conceived through fertility treatment may be at risk for altered pubertal timing, but most existing evidence is from Western populations. • Prior large-scale studies suggest trends toward earlier puberty in IVF-conceived girls and later puberty in IVF-conceived boys.

WHAT IS NEW: • This study provides the first large-scale, nationally representative Asian evidence on the long-term pubertal outcomes of children conceived through fertility treatment, addressing a major geographic gap in the literature. • We did not detect statistically significant differences in pubertal stage or age at menarche at age 12 between children conceived via IUI/IVF and those conceived spontaneously.

PMID:41055806 | DOI:10.1007/s00431-025-06531-9

J Robot Surg. 2025 Oct 7;19(1):664. doi: 10.1007/s11701-025-02858-5.

ABSTRACT

Reducing surgical waiting lists remains a key national priority for healthcare systems such as the NHS in the UK. High-intensity theater (HIT) lists, designed to increase surgical throughput by optimizing theater time and perioperative care, have been proposed as a solution. However, comparative data evaluating their safety and efficiency remain limited. To evaluate the productivity and safety of robotic HIT operating lists for benign gynecological surgery, as compared to standard weekday NHS operating lists. This was a retrospective cohort study using a prospectively maintained hospital registry. Robotic gynecological procedures performed on five HIT lists between Nov 2023 and July 2024 were compared with standard elective NHS lists during the same period. Patient demographics, operative times, complication rates, and length of stay were analyzed. A total of 194 cases were included (164 standard, 30 HIT). Case complexity was lower in the HIT cohort (p = 0.049). Mean operative time was significantly reduced in the HIT group (72.5 vs. 129.3 min, p < 0.001), with no increase in postoperative complications (13% vs. 29%, p > 0.05). HIT patients had significantly shorter hospital stays (0.4 vs. 1.2 days, p < 0.001), and comparable rates of readmission and training case involvement. HIT robotic gynecological operating lists enable efficient, safe surgical care with shorter operative times and earlier discharge, without compromising training or patient safety. Wider adoption of this model may help to reduce NHS surgical backlogs and optimize theater utilization.

PMID:41055804 | DOI:10.1007/s11701-025-02858-5