Tag: pubmed

Eur Spine J. 2025 Nov 18. doi: 10.1007/s00586-025-09565-7. Online ahead of print.

ABSTRACT

PURPOSE: The aim was to study the developmental characteristics of the cartilaginous union anatomical structure at the base of odontoid process in normal children aged 1 to 6 years, analyze the factors influencing its fusion, and provide basic data for understanding its evolutionary patterns and application in clinical disease diagnosis and treatment. Additionally, the study aimed to conduct morphological staining observations of the anatomical features of the base of the odontoid process in normal children.

METHODS: A total of 140 cases of normal cervical spine CT images from children aged 1 to 6 years were collected and grouped by age, with 20 cases in the 1-year-old group and 30 cases in each of the other four groups. The original data of the cervical spine continuous CT scan images were imported into Mimics 21.0 software in DICOM format for the measurement of anatomical indexes including Transverse Diameter (TD), Sagittal Diameter (SD), Area (A), Perimeter (P), and the positional indexes including Distance from Upper Cartilage Border to Odontoid Process Base (DSB), Distance from Lower Cartilage Border to Odontoid Process Base (DIB), Distance from Left Cartilage Border to Left Transverse Process (DLT), Distance from Right Cartilage Border to Right Transverse Process (DRT). Additionally, the axis vertebra of a 3-year-old child’s cervical spine was extracted, and thin sections were prepared by hard tissue embedding and section techniques. Toluidine blue staining was performed to observe the histopathological characteristics of the cartilaginous intervertebral disc and bone tissue in the base region of the odontoid process.

RESULTS: TD, SD, A, and P values decreased gradually with increasing age. TD, A, and P values showed statistical differences between group E and the other groups (P < 0.05); SD values showed statistical differences between group E and groups A, B, and C (P < 0.05). DSB, DIB, DLT, and DRT values all increased with age. DLT values in groups A and B showed statistical differences with group E (P < 0.05); DRT values in group A showed statistical differences with groups D and E (P < 0.05). There was a high correlation between TD and SD, A and P, DLT and DRT, and a low correlation between TD and DSB, P and DLT, DRT. After staining, it was observed that the chondrocytes in the central region of the base of the odontoid process were scattered and spindle-shaped, while in the peripheral areas, chondrocytes formed oval-shaped clusters, with the cell nuclei stained blue and the matrix showing a light blue color, providing clear contrast with the intervertebral disc and bone tissue.

CONCLUSION: The ossification center of the base of odontoid process in children is in a continuous growth and change process and exhibits evident regularity. The measurement results of this study can provide anatomical data for the growth and developmental characteristics of this region. The cartilage at the base of the odontoid process in children is hyaline cartilage, with the characteristic of being relatively brittle and prone to fracture.

PMID:41249664 | DOI:10.1007/s00586-025-09565-7

J Gen Intern Med. 2025 Nov 17. doi: 10.1007/s11606-025-10042-6. Online ahead of print.

ABSTRACT

OBJECTIVE: To validate the RECOVER Post-Acute Sequelae of SARS-CoV-2 infection (PASC) score in a cohort of patients who develop long COVID (LC) or fully recover while iteratively improving the tool’s sensitivity and specificity.

METHODS: A cross-sectional study in 130 LC patients followed at LC clinics in Baltimore, MD, USA, who met the National Academies of Sciences, Engineering, and Medicine (NASEM) 2024 LC definition, and 60 SARS-CoV-2 exposed but fully recovered individuals. LC participants were required to have at least one neuropsychiatric symptom. Participants completed comprehensive surveys and questionnaires assessing symptoms based on published methods to determine PASC score. Using the NASEM 2024 LC definition as the “true” condition, we compared evaluation metrics for the RECOVER PASC score cutoff (PASC > 12) and the presence of individual/multiple symptoms. Evaluation metrics (e.g., sensitivity, specificity, F1) were calculated based on these classifications for the overall PASC score and symptom combinations.

RESULTS: The LC cohort (n = 130) had a mean age of 47.2 years and was predominantly female (72%), White (79%), and well-educated (77% > 16 years). Controls (n = 60) were similar demographically. LC diagnosis and PASC scores were significantly associated (χ² = 102.99, P < 0.001). The PASC score showed excellent specificity (100%) and positive predictive value (PPV; 100%) albeit limited sensitivity (80%), missing 20% of participants with LC. We found that loss of smell/taste, post-exertional malaise, or lack of sexual desire or capacity demonstrated 94% sensitivity, 92% specificity, and 96% PPV, 87% NPV, and an F1 score of 0.949.

CONCLUSION: Validation of the RECOVER PASC supports its utility and highlights the need for ongoing refinement of the LC definition. We call for national efforts to develop readily implementable clinical tools for LC diagnosis.

PMID:41249654 | DOI:10.1007/s11606-025-10042-6

J Gen Intern Med. 2025 Nov 17. doi: 10.1007/s11606-025-09950-4. Online ahead of print.

ABSTRACT

BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) effectively promote weight reduction and improve glycemic control, blood pressure, and lipid profiles in individuals with overweight or obesity. This systematic review and meta-analysis evaluates the durability of these therapeutic benefits following treatment discontinuation.

METHODS: We conducted a systematic search of PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP from inception to June 2024, to identify randomized controlled trials that assessed the effects of GLP-1RAs with a follow-up period of at least six months after treatment discontinuation. The outcomes were changes in weight, body mass index (BMI), waist circumference (WC), glycemia, blood pressure, and lipid profiles.

RESULTS: We screened 10,670 studies and ultimately identified 5 eligible studies, encompassing 719 patients. Compared to the control group, GLP-1RAs were associated with significant reductions in weight (mean difference (MD) = -5.70 kg, 95% confidence interval (CI): -9.52 to -1.88), BMI (MD = -2.94 kg/m², 95% CI: -5.60 to -0.28), WC (MD = -3.66 cm, 95% CI: -4.89 to -2.43), glycated hemoglobin A1c (HbA1c) (standardized mean difference (SMD) = -0.73, 95% CI: -1.14 to -0.32), and systolic blood pressure (SBP) (MD = -3.62 mm Hg, 95% CI: -5.51 to -1.73) after cessation of therapy. After discontinuation, there was a pronounced rebound in weight (MD = 4.13 kg, 95% CI: 1.60 to 6.65), BMI (MD = 0.84 kg/m², 95% CI: 0.37 to 1.32), WC (MD = 3.64 cm, 95% CI: 2.27 to 5.01), and HbA1c (SMD = 0.69, 95% CI: 0.50 to 0.89). From study baseline to the end of follow-up, GLP-1RAs treatment resulted in statistically significant decreases in weight (MD = -2.32 kg, 95% CI: -4.21 to -0.43) and BMI (MD = -0.82 kg/m², 95% CI: -1.47 to -0.17).

CONCLUSIONS: This meta-analysis demonstrated that although statistically significant weight reduction persists after GLP-1RAs discontinuation, the clinical significance and durability of this effect are limited. To achieve sustained therapeutic benefits, continued treatment with these agents may be necessary.

PMID:41249646 | DOI:10.1007/s11606-025-09950-4

Health Econ Rev. 2025 Nov 17;15(1):97. doi: 10.1186/s13561-025-00690-z.

NO ABSTRACT

PMID:41249635 | DOI:10.1186/s13561-025-00690-z

Ann Biomed Eng. 2025 Nov 17. doi: 10.1007/s10439-025-03890-0. Online ahead of print.

ABSTRACT

PURPOSE: Digital twin (DT) cohorts are collections of models where each member represents an individual real-world asset. DT cohorts can be used for in-silico trials, outlier detection and forecasting, and are used across engineering, industry, and increasingly in personalised medicine. To increase the scalability of DT cohorts, researchers often train emulators to be used as cheap surrogates of computationally expensive mathematical models. Frequently, each cohort member is emulated individually, without reference to other members. We propose that instead, we can treat each DT as a thread in a larger network, and that these threads can be woven together into a digital tapestry using cohort learning methods.

METHODS: We propose two statistical approaches for transferring knowledge between threads. The first method, ‘latent-feature emulators’, utilises a latent representation of individual cohort members to generate a single emulator for the entire cohort. The second method, ‘discrepancy emulators’, learns the discrepancy between a new cohort member and existing members.

RESULTS: In two cardiac DT case studies, we show that these methods can reduce computational costs by more than 50% compared to the standard approach of training individual emulators, even in small cohorts.

CONCLUSIONS: We find that by transferring information between meshes, the cohort methods improve both the computational efficiency and the accuracy of emulators when compared to the standard approach of individually emulating each cohort member. As cohort size increases, the computational savings grow further. We focus on the use of Gaussian process emulators, but the transfer methods are applicable to other surrogate approaches such as neural networks.

PMID:41249625 | DOI:10.1007/s10439-025-03890-0

Cancer Gene Ther. 2025 Nov 17. doi: 10.1038/s41417-025-00988-4. Online ahead of print.

ABSTRACT

Thyroid cancer (TC) is an endocrine malignancy characterized by metabolic abnormalities, with its incidence continually on the rise. Understanding the pathogenesis of this cancer would help develop better diagnostic and therapeutic methods. We aimed to integrate single-cell transcriptomics, bulk transcriptomics, and GWAS data to identify causal associations with thyroid cancer at the gene level. We intended to utilize single-cell atlases to identify malignant cells and their characteristics, and employed SMR to search for genetic loci causally associated with thyroid cancer. We validated the expression differences of the genes at the single-cell level and bulk level, as well as through immunohistochemistry experimental results. We investigated the tumor immune microenvironment of patients, attempting to find immune subgroups with differential proportions. Based on these subgroups, we conducted multi-machine learning modeling to predict the likelihood of disease and developed a corresponding interactive web application. HMGA2, SDCCAG8, DLG5, MT1E, RABL2B, RERE, and NDUFA12 all demonstrated to varying degrees their roles in promoting or inhibiting the occurrence and development of thyroid cancer, with HMGA2 showing consistency across all analyses. We also identified some immune subtypes significantly associated with TC and chose markers of T_cell_C8_STMN1 to construct patient diagnostic models. Through various combinations of machine learning feature selection and model construction, we ultimately built 178 diagnostic models, with the combination of glmBoost+RF having the best diagnostic performance (Average AUPR: 0.9915). The predictive web pages ( https://zclab-cnp.shinyapps.io/TC-WEB/ ) can provide convenience and reference for clinical personnel.

PMID:41249621 | DOI:10.1038/s41417-025-00988-4

J Clin Immunol. 2025 Nov 18;45(1):162. doi: 10.1007/s10875-025-01959-y.

ABSTRACT

Flow cytometric immunophenotyping of lymphocytes and dendritic cells, and functional lymphocyte mitogen response tests are used in the diagnostics of inborn errors of immunity (IEI), especially in pediatrics. These routinely used tests lack sufficient age-matched reference values in children. We established reference values for lymphocyte and dendritic cell subsets for four age groups from 68 healthy children under 12 years of age. These values were then compared to prior publicly available articles and 46 clinical samples from children with confirmed IEI diagnosis. Mitogen response results were also compared between 27 children and 177 adults. In the literature review, we found considerable variability in lymphocyte subset definitions and statistical approaches. Most IEI patients had increased transitional and naïve B, and decreased memory B cells. CHH patients had increased γδ T and DNTs. Lymphocyte stimulation via FASCIA method provides weaker stimulation results in children than in adults, which seems to result from a larger proportional count of naïve lymphocytes in children. The established reference values can be used in diagnostics of pediatric immunological conditions in laboratories that use similar analytic methods. Lower lymphocyte mitogen response results in children need to be taken into consideration when interpreting the results of lymphocyte functional tests.

PMID:41249610 | DOI:10.1007/s10875-025-01959-y

Discov Oncol. 2025 Nov 17;16(1):2114. doi: 10.1007/s12672-025-03886-1.

ABSTRACT

BACKGROUND: Uterine leiomyosarcoma is a rare and aggressive malignancy with limited responsiveness to standard therapies. We conducted a real-world, multicenter study to compare the clinical efficacy and safety of two commonly used first-line chemotherapy regimens-doxorubicin-ifosfamide and gemcitabine-docetaxel-in patients with metastatic uterine leiomyosarcoma.

METHODS: This retrospective cohort included 271 patients with advanced or metastatic uterine leiomyosarcoma treated between 2010 and 2023 across 30 centers in Turkey. Patients received either doxorubicin-ifosfamide (n = 142) or gemcitabine-docetaxel (n = 129) as first-line therapy. The primary endpoint was overall survival; secondary endpoints included progression-free survival, objective response rate, disease control rate, and safety. Adverse events were graded according to the Common Terminology Criteria for Adverse Events version 5.0, while survival outcomes were estimated using the Kaplan-Meier method and further analyzed with Cox proportional hazards models.

RESULTS: Median overall survival was 19.7 months with doxorubicin-ifosfamide and 20.2 months with gemcitabine-docetaxel (P = .26). Median progression-free survival was 5.5 months with doxorubicin-ifosfamide and 7.0 months with gemcitabine-docetaxel (P = .62). The objective response rate was numerically higher with gemcitabine-docetaxel (35% vs. 26%), although not statistically significant (P = .11). Grade 3-4 neutropenia (16% vs. 12%) and febrile neutropenia (7% vs. 6%) were more frequent with doxorubicin-ifosfamide.

CONCLUSIONS: In this largest-to-date real-world cohort of metastatic uterine leiomyosarcoma, doxorubicin-ifosfamide and gemcitabine-docetaxel demonstrated comparable survival outcomes. Gemcitabine-docetaxel, however, was associated with a more favorable hematologic safety profile. These findings support the clinical utility of both regimens while underscoring the need for prospective, biomarker-driven studies to refine treatment selection and improve personalization in this rare malignancy.

PMID:41249604 | DOI:10.1007/s12672-025-03886-1

NPJ Precis Oncol. 2025 Nov 17;9(1):355. doi: 10.1038/s41698-025-01146-7.

ABSTRACT

The treatment of Epithelial Ovarian cancer (EOC) could benefit from the addition of bevacizumab (BEV) to standard chemotherapy in selected patients. Gene expression (GE) profiling and the evaluation of immune infiltration are used to define patients’ prognosis. However, their role as prognostic and/or predictive biomarkers for the efficacy of antiangiogenic therapy efficacy remains uncertain. In this study, we combined GE profiling and multiplex immunofluorescence (MIF) analyses on material from patients enrolled in the phase IV MITO16A/MaNGO OV-2 trial, assessing associations between immune infiltrate and patients’ prognosis. Patients were stratified into four molecular subtypes, and CIBERSORTx was applied to infer the cell-type-specific expression pattern of immune populations. MIF evaluated the presence of immune cells in the tumor and stromal compartments. These complementary experimental approaches revealed that immune infiltration is associated with shorter progression-free survival in BEV-treated patients, warranting future investigation to evaluate its use as a viable biomarker for patient stratification. Trial registration: NCT01706120, EudraCT number: 2012-003043-29, Date of registration 24 September 2012.

PMID:41249601 | DOI:10.1038/s41698-025-01146-7

J Perinatol. 2025 Nov 17. doi: 10.1038/s41372-025-02485-w. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effectiveness of implementing American Academy of Pediatrics (AAP) discharge guidelines in reducing unplanned hospital readmissions within 30 days post-discharge among term ansd late preterm newborns.

STUDY DESIGN: Retrospective observational study analyzing unplanned readmissions at a single-center neonatal unit from January 1, 2021, to December 31, 2024. Data were compared before (January 1, 2021-June 30, 2022) and after (July 1, 2022-December 31, 2024) guideline implementation, with subgroup analysis for the period after addition of structured support (July 1, 2023-December 31, 2024).

RESULT: AAP guideline implementation was associated with a statistically significant reduction in unplanned readmission rates among term infants (0.66% vs. 0.33%; P = 0.008). No reduction was evident among late preterm infants. Subgroup analysis showed further reductions post-structured support addition, though confounding by provider changes limits attribution.

CONCLUSION: The adoption of the AAP discharge guidelines, along with a structured process of mother and infant readiness, significantly decreassed unplanned readmission rates among term newborns.

PMID:41249592 | DOI:10.1038/s41372-025-02485-w