Tag: pubmed

Intern Med J. 2025 Jun 20. doi: 10.1111/imj.70117. Online ahead of print.

ABSTRACT

BACKGROUND: Socio-economic status (SES) is strongly associated with health outcomes, yet it remains relatively difficult to measure, particularly for longitudinal comparisons.

AIM: We have developed an interactive online tool (available at bit.ly/SEIFA-POA) that facilitates SES assessment based on postcodes (POA).

METHODS: By utilising percentiles of socio-economic indices for areas (SEIFA) derived from postcode-based rankings across Australia, this tool enables comparisons of SEIFA indices provided by the Australian Bureau of Statistics (ABS) censuses from 1986 through to 2021. A percentile-based methodology preserves the relative socio-economic position of areas over time, thereby circumventing the methodological inconsistencies inherent in SEIFA calculations across different census periods. The tool simplifies SES assessment, offering researchers and policymakers a practical solution for both cross-sectional and longitudinal studies.

RESULTS: In 6051 participants of the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) trial from Australia, we demonstrated that favourable SES is associated with a lower frequency of vascular complications in the participants’ medical history. The absence of an observed association between SES and on-trial complications may be attributed to the relatively short 5-year average time horizon of the analysis.

CONCLUSION: Our SES assessment tool provides a more nuanced understanding of SES disparities and their implications for health and well-being.

PMID:40540631 | DOI:10.1111/imj.70117

JBJS Rev. 2025 Jun 20;13(6). doi: 10.2106/JBJS.RVW.25.00064. eCollection 2025 Jun 1.

ABSTRACT

BACKGROUND: Cerebral palsy (CP) is the most common motor disability of childhood, predominantly characterized by spasticity. A frequent complication of spastic CP is equinovarus deformity, resulting in pain, instability, and altered gait, significantly affecting ambulation. Surgical intervention, particularly the split posterior tibialis tendon transfer (SPOTT), is often required to correct deformity when conservative management fails. However, the variability in outcomes and recurrence rates across different patient subtypes and surgical techniques remains unclear. This systematic review aimed to evaluate the recurrence rate of equinovarus deformity in children with CP after SPOTT, with a focus on factors such as age, CP subtype, and functional status.

METHODS: A systematic search of MEDLINE, Embase, and Emcare databases was performed to identify observational studies reporting recurrence rates after SPOTT in pediatric patients with CP (aged ≤18 years). Studies with short follow-up periods (<12 months), non-English articles, conference abstracts, and those involving concomitant bony procedures were excluded. Statistical analyses used random-effects meta-analysis models to calculate pooled recurrence rates. All statistical analyses were performed, and forest plots were generated using R (version 4.3.2).

RESULTS: Nine studies (325 patients, 366 feet) met the inclusion criteria. The mean age at surgery was 10.35 years, with a mean follow-up duration of 76.18 months. The overall pooled recurrence rate of equinovarus deformity after SPOTT was 11.4% (95% confidence interval 5.0-17.8), with substantial heterogeneity (I2 = 71.9%). Subgroup analysis revealed higher failure rates among nonambulatory patients with quadriplegic CP (47.6%) compared with ambulatory hemiplegic patients (6.6%). The optimal age window for SPOTT seemed to be between 6 and 10 years as younger patients demonstrated increased risks of valgus deformity, whereas older patients had higher recurrence rates. Variations in surgical techniques, including interosseous membrane versus circumtibial routing, were identified as potential sources of heterogeneity.

CONCLUSION: SPOTT seems to be an effective intervention for correcting equinovarus deformity in ambulatory patients with CP, particularly those with hemiplegia or diplegia. However, nonambulatory and quadriplegic patients are at higher risk of recurrence, warranting careful patient selection. These conclusions should be interpreted with caution because of substantial study heterogeneity and the variability in surgical techniques reported. Further high-quality studies with standardized reporting and direct comparisons between surgical techniques are necessary to optimize outcomes and inform clinical practice.

LEVEL OF EVIDENCE: Therapeutic Level IV, systematic review. See Instructions for Authors for a complete description of levels of evidence.

PMID:40540630 | DOI:10.2106/JBJS.RVW.25.00064

Public Health Res Pract. 2025 Jun;35:PU24025. doi: 10.1071/PU24025.

ABSTRACT

Background In Victoria, Aboriginal maternal and infant health services are funded by the Victorian Government with coordination led by the Victorian Aboriginal Community Controlled Health Organisation (VACCHO). This research aims to compare the distribution of these services with the Aboriginal infant population across all local government areas (LGAs) of Victoria and identify gaps in service availability. Method Statewide mapping of Aboriginal maternal and infant health services in Victoria was undertaken in 2023, and Aboriginal and Torres Strait Islander population data for each LGA in Victoria were sourced from the 2021 Australian Bureau of Statistics Census. Data relating to the geographical location of Aboriginal-specific maternal and infant health services were collected from the websites of VACCHO and the Victorian Department of Health. These data were geocoded and overlaid onto LGAs using a geographical mapping software program. Data were analysed via SPSS, a statistical analysis program. Results There was considerable variation in the availability of Aboriginal-specific maternal and infant health services across both metropolitan and regional areas of Victoria. Only 21 of 79 (27%) Victorian LGAs offered Aboriginal-specific services in either pregnancy or early childhood, and 12 (15%) offered continuity of care throughout pregnancy and early childhood specifically for Aboriginal families. Twenty-seven out of 79 (34%) LGAs offered no specific Aboriginal maternal and infant services. However, the median population of Aboriginal infants in LGAs with some services was significantly higher than in LGAs offering no services (81.0 vs 19.5, P 100 Aboriginal infants had no specific Aboriginal maternal and infant health service. Conclusion Aboriginal-specific maternal and infant health services have been addressing the healthcare needs of Aboriginal families across Victoria since their inception. There does, however, need to be further targeted investment in Aboriginal Community Controlled Health Organisations so that developing communities within Victoria can access continuity of maternal and infant healthcare across the perinatal periods to improve the overall health of future generations of Aboriginal children and families.

PMID:40540625 | DOI:10.1071/PU24025

Proc Natl Acad Sci U S A. 2025 Jun 24;122(25):e2425530122. doi: 10.1073/pnas.2425530122. Epub 2025 Jun 20.

ABSTRACT

It is increasingly recognized that participation bias can pose problems for genetic studies. Recently, to overcome the challenge that genetic information of nonparticipants is unavailable, it is shown that by comparing the IBD (identity by descent) shared and not-shared segments between participating relative pairs, one can estimate the genetic component underlying participation. That, however, does not directly address how to adjust estimates of heritability and genetic correlation for phenotypes correlated with participation. Here, we demonstrate a way to do so by adopting a statistical framework that separates the genetic and nongenetic correlations between participation and these phenotypes. Crucially, our method avoids making the assumption that the effect of the genetic component underlying participation is manifested entirely through these other phenotypes. Applying the method to 12 UK Biobank phenotypes, we found eight that have significant genetic correlations with participation, including body mass index, educational attainment, and smoking status. For most of these phenotypes, without adjustments, estimates of heritability and the absolute value of genetic correlation would have underestimation biases.

PMID:40540605 | DOI:10.1073/pnas.2425530122

PLoS Med. 2025 Jun 20;22(6):e1004634. doi: 10.1371/journal.pmed.1004634. Online ahead of print.

ABSTRACT

BACKGROUND: There is no universally agreed upon obstetric growth standard for use during pregnancy. We aimed to design a simple novel growth standard, which incorporates key beneficial features identified in prior research.

METHODS AND FINDINGS: We developed the Fetal Region-specific Optimized Growth Standard (FROGS), then validated it following International Federation of Gynaecology and Obstetrics (FIGO) guidelines. FROGS follows the shape of the fetal (ultrasound-based) Hadlock curve. It is region-specific; allowing adjustment for the mean birthweight and standard deviation of babies born at term in the local population where it will be applied. It provides an exact centile for each gestational day (rather than rounding off by weeks) and is optionally adjustable for fetal sex. Further, FROGS provides an ‘estimate range’ for the estimated fetal weight centile, assuming a 10% ultrasound measurement error. Following development, we validated FROGS in a retrospective cohort study by comparing its ability to identify small babies with an increased risk of adverse perinatal outcomes to four charts in current use: (1) population birthweight chart (Australian Institute of Health and Welfare, AIHW chart); (2) Hadlock’s 1991 fetal chart; (3) Mikolajczyk’s global fetal and birthweight centile chart; and (4) INTERGROWTH-21st fetal growth standards. To do this, we identified infants classified as small for gestational age (<10th centile) by each chart. We then identified non-overlapping <10th centile populations, i.e., infants classified as small by one chart, but not another. We compared rates of stillbirth and adverse perinatal outcomes between the non-overlapping populations. All charts except INTERGROWTH classified similar proportions of infants as <10th centile (10.4% FROGS, 9.3% AIHW, 11.1% Hadlock, 10.9% global, 4.4% INTERGROWTH). Of the three charts that classified similar proportions as <10th centile, infants classified by FROGS were at the highest risk of adverse perinatal outcomes. The infants classified as <10th centile by only FROGS had significantly increased relative risk (RR) of stillbirth, compared to the infants classified as <10th centile by only AIHW (RR 13.1, 95% CI 6.5-26.5), only Hadlock (RR 2.1, 95% CI 1.28-3.56) or only the global chart (RR 1.54, 95% CI 1.00-2.37). The FROGS chart outperformed these three charts in identifying infants at risk of other adverse perinatal outcomes associated with being small for gestational age, such as neonatal intensive care admission, Apgar scores <7 at 5 min, and operative (instrumental) vaginal birth for suspected fetal compromise. The cohort of infants classified as small for gestational age by INTERGROWTH was, in size and risk, closer to the cohort classified as <3rd centile by FROGS (3.4% of infants <3rd). This study is limited in that it retrospectively assesses birthweight, which may have different implications to a prospective evaluation of estimated fetal weight.

CONCLUSIONS: Compared to currently used charts, the Fetal Region-specific Optimized Growth Standard outperforms existing charts that classify a similar proportion of infants as small for gestational age in identifying small infants at increased risk of stillbirth and other serious perinatal outcomes. The FROGS centile algorithm is simple and transparent. It has the potential to be adapted to other local populations, or applied to clinical and research settings globally.

PMID:40540533 | DOI:10.1371/journal.pmed.1004634

PLoS One. 2025 Jun 20;20(6):e0309634. doi: 10.1371/journal.pone.0309634. eCollection 2025.

ABSTRACT

BACKGROUND: Synergistic effects of diverse social supports (informational, tangible, emotional and belonging) on cardiovascular disease risk factors (CVRF), by gender, is unknown.

AIM: To quantify gender differences in the singular and combined associations of four different forms of social support with cardiovascular disease risk factors (CVRF) in aging adults.

METHODS: Cross-sectional study of 28,779 adults (45-85 years) in the Canadian Longitudinal Study on Aging Comprehensive cohort (2011-15); independent variables were self-reported measures of informational, tangible, emotional and belonging support; dependent variables were clinically measured BMI, waist circumference and blood pressure. We used stratified multivariable linear and logistic regression with principal component regression with cross-product terms to post-estimate adjusted means and 95% CIs for combined associations.

RESULTS: All low-low support combinations were consistently associated with the highest adjusted mean BMI and WC levels among women. Adjusted mean BMI differences were largest among women with low informational and low tangible supports (27.95 kg/m2 [27.93, 27.97]), compared to women with high informational and high tangible supports (27.34 kg/m2 [27.30, 27.38]). Similarly, the greatest difference in adjusted mean WC was seen among women with low informational and low emotional supports (88.69 cm [88.62, 88.76]) compared to the high-high combination (86.88 cm [86.75, 87.01]). Women with low availability of informational support, with or without deficits in a second support type, had the highest adjusted mean SBP levels (range: 119.94 to 119.95 mmHg). Among men, mean CVRFs were not consistently worse for combinations of dual deficits in social support. Results were null for DBP.

CONCLUSION: Women with two deficits in social supports, particularly combinations with low informational support, showed worse CVRF measures than one social support deficit. Results indicated no antagonistic/synergistic effects of social support on CVRFs. Heart health care and prevention for aging women would benefit from ensuring informational support with other supports is available.

PMID:40540518 | DOI:10.1371/journal.pone.0309634

PLoS One. 2025 Jun 20;20(6):e0326216. doi: 10.1371/journal.pone.0326216. eCollection 2025.

ABSTRACT

BACKGROUND: Toripalimab, a monoclonal antibody designed to target PD-1, has recently received approval from the U.S. Food and Drug Administration (FDA) for use as a first-line treatment in adults diagnosed with metastatic or recurrent locally advanced nasopharyngeal carcinoma (NPC). The purpose of this study is to utilize the FAERS database and bibliometric analysis to examine adverse events associated with toripalimab in real-world settings, thereby enhancing the safety management of clinical medications.

METHODS: This research implemented a disproportionality analysis to assess the safety of toripalimab by reviewing all adverse event reports from the FAERS database dating back to 2004, wherein toripalimab was recognized as the main suspected medication. Various statistical techniques were applied in the analysis, such as the reporting odds ratio (ROR), proportional reporting ratio (PRR), multi-item gamma Poisson shrinker (MGPS), and Bayesian confidence propagation neural network (BCPNN), to evaluate the adverse events linked to toripalimab. CiteSpace is utilized to search for authors, countries, keywords, and various indicators within research fields, facilitating the identification of research hotspots and future trends.

RESULTS: From 2004 to 2024, 441 AEs linked to toripalimab were recorded across 27 SOCs. The top five SOCs were procedural complications, investigations, blood/lymphatic disorders, gastrointestinal disorders, and skin/subcutaneous disorders. At the PT level, the top five AEs by ROR were myelosuppression (n = 192, ROR 687.41), decreased granulocyte count (n = 11, ROR 515.72), immune-mediated hepatic disorder (n = 7, ROR 343.20), immune-mediated myocarditis (n = 3, ROR 214.68), and bicytopenia (n = 3, ROR 117.49). Additionally, 91.62% of AEs occurred within the first 30 days, and immune-related AEs were highlighted in bibliometric analysis.

CONCLUSION: This research provides initial safety information regarding the real-world application of toripalimab, affirming previously acknowledged adverse effects and concurrently uncovering new possible risks. These results could act as important cautionary evidence for healthcare professionals and pharmacists engaged in administering toripalimab for NPC.

PMID:40540517 | DOI:10.1371/journal.pone.0326216

PLoS One. 2025 Jun 20;20(6):e0325206. doi: 10.1371/journal.pone.0325206. eCollection 2025.

ABSTRACT

BACKGROUND: The arterial switch operation (ASO) is the standard surgical treatment for transposition of the great arteries (TGA). Postoperative complications such as branch pulmonary artery (PA) stenosis are commonly observed. This study aimed to investigate the possible potential anatomical mechanisms contributing to isolated branch PA stenosis using cardiac computed tomography (CCT).

METHODS: A retrospective, single-center study was conducted on pediatric patients under 18 years of age diagnosed with TGA, with or without ventricular septal defect (VSD), who underwent ASO and cardiac CCT between January 2004 and October 2022. Baseline characteristics, echocardiographic data, and CCT findings were compared between patients with and without isolated branch PA stenosis. Special attention was given to the angle between the PA bifurcation and the ascending aorta (AAO).

RESULTS: Among 30 patients enrolled, 46.67% (14/30) had isolated branch PA stenosis, while 53.33% (16/30) had no stenosis. Baseline and echocardiographic variables showed no significant differences between groups, except for the PA bifurcation angle relative to the AAO. Patients with isolated right PA (RPA) stenosis demonstrated significantly greater leftward angulation (median angle: 25° [IQR: 24, 30]) compared to the no-stenosis group (median angle: -2° [IQR: -8, 6.5]). Similarly, isolated left PA (LPA) stenosis was associated with greater rightward angulation (median angle: -22° [IQR: -32, -20]) compared to the no-stenosis group (P = 0.042).

CONCLUSION: Alterations in the PA bifurcation angle relative to the AAO may contribute to the development of isolated branch PA stenosis following ASO. Preoperative planning to optimize the PA bifurcation angle to within ±20 degrees may help reduce the risk of postoperative stenosis. A larger study incorporating advanced cardiac imaging into routine ASO follow-up is warranted.

PMID:40540492 | DOI:10.1371/journal.pone.0325206

Genetics. 2025 Jun 20:iyaf118. doi: 10.1093/genetics/iyaf118. Online ahead of print.

ABSTRACT

Epistasis can profoundly influence evolutionary dynamics. Temporal genetic data, consisting of sequences sampled repeatedly from a population over time, provides a unique resource to understand how epistasis shapes evolution. However, detecting epistatic interactions from sequence data is technically challenging. Existing methods for identifying epistasis are computationally demanding, limiting their applicability to real-world data. Here, we present a novel computational method for inferring epistasis that substantially reduces computational costs without sacrificing accuracy. We validated our approach in simulations and applied it to study HIV-1 evolution over multiple years in a data set of 16 individuals. There we observed a strong excess of negative epistatic interactions between beneficial mutations, especially mutations involved in immune escape. Our method is general and could be used to characterize epistasis in other large data sets.

PMID:40540490 | DOI:10.1093/genetics/iyaf118

PLoS One. 2025 Jun 20;20(6):e0322228. doi: 10.1371/journal.pone.0322228. eCollection 2025.

ABSTRACT

OBJECTIVE: Acute kidney injury (AKI) is one of the common complications after hip fracture in the elderly, and its hospitalization rate, mortality rate and medical expenses are high, resulting in serious social and economic burden. Therefore, we aim to systematically evaluate the incidence and risk factors of postoperative AKI in elderly patients with hip fracture, so as to identify the occurrence of postoperative AKI in elderly patients with hip fracture early, so as to prevent it in advance.

METHODS: This meta-analysis adhered to PRISMA guidelines and was registered in PROSPERO (CRD42024498009).We systematically searched Embase, Pubmed, web of science, the cochrane Library, CBM, VIP, CNKI, and Wanfang Data to collect studies on the incidence or influencing factors of postoperative acute kidney injury in elderly patients with hip fracture published up to 18 December 2023. All studies were screened, relevant data extracted, and quality assessed by two independent authors, and meta-analysis was performed using Stata 15.0 software.

RESULTS: A total of 22 articles were included, with a total sample size of 25195 cases and 16 influencing factors. The results of meta-analysis showed that the incidence of postoperative AKI in elderly patients with hip fracture was 17.2% [95%CI (14.3% ~ 20%), P < 0.0001], and there were 6 statistically significant influencing factors, which were baseline serum potassium [OR(95%CI)=2.23 (1.22, 4.05)], hypertension [OR(95%CI)=3.00 (1.75, 5.88)], and chronic kidney disease [OR(95%CI)=4.40 (1.10, 14.75)], diabetes mellitus [OR (95% CI) = 1.84 (1.19, 2.83)], intraoperative hypotension [OR (95% CI) = 5.61 (3.36, 9.35)], and operative time [OR (95% CI) = 1.01 (1.00, 1.02)].

CONCLUSIONS: Our study indicated that the incidence of postoperative AKI in elderly patients with hip fracture was 17.2%. Baseline serum potassium, hypertension, chronic kidney disease, diabetes, operative hypotension and operation time were the influencing factors of postoperative AKI in elderly patients with hip fracture. PROSPERO registration number for this study: CRD42024498009.

PMID:40540489 | DOI:10.1371/journal.pone.0322228