Development and validation of a clinical risk stratification model for lumbar vertebral compression fractures in patients with lumbar disc herniation.

Intratumoral flow void diameter on standard magnetic resonance imaging: a practical marker of vascularity in metastatic spinal tumors.

A Dynamic Study of Mandibular Movement Trajectories in Patients With Disc Displacement Without Reduction.

Detection of diabetic retinopathy 5-stages by denseNet, a CNN model

Low relative sit-to-stand power in Colombian older adults: Cut-off points and associations with frailty and functional decline.

Ambulant children with cerebral palsy (CP) are at a high risk of falls. It is important to identify characteristics associated with increased falls and understand which clinical measures are associated with falls in this population. This study explored parent-reported falls of 66 children with CP (Gross Motor Function Classification System [GMFCS] I - III) and the associations between lower limb functional measures (6-Minute Walk Test, Muscle Power Sprint Test, 10 Metre Walk Test, Sit-to-Stand, Lateral Step-up, Kneel-to-Stand) and the number of falls. Receiver operating characteristic (ROC) curve analysis identified score thresholds for the likelihood of falling more than average. 81% of children fell at least once in the previous month, with an average of 11 falls and 44% children who fell were injured. Children in GMFCS level II had the greatest number of falls. Poorer performance on Sit-to-Stand, Lateral-Step-Up and Kneel-To-Stand were associated with fall frequency. ROC thresholds for likelihood of above average fall frequency were identified for lateral step-up best side (score ≤17), sit-to-stand (score ≤15) and kneel-to-stand best side (score ≤ 4). Ambulant children with CP are at high risk of falls. Poor performance in several lower limb assessments incorporating balance ware associated with higher fall frequency.

Rheumatoid arthritis (RA) is a chronic autoimmune disease with high disability rates, necessitating early diagnosis. This study investigated the potential of circRNAs, specifically CircRNA_0001412 and CircRNA_0001566, as diagnostic biomarkers for RA. High-throughput transcriptome sequencing was performed on peripheral blood mononuclear cells (PBMCs) from RA patients and healthy controls to identify differentially expressed circRNAs. Reverse transcription quantitative PCR (RT-qPCR) was used to validate circRNA expression in an independent cohort of 78 RA patients and 82 healthy controls. Receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic value of the selected circRNAs. Correlation analyses with clinical markers such as CRP, ESR, CCP, RF, WBC, lymphocyte count, and monocyte count were also conducted. Bioinformatics analyses, including GO and KEGG pathway enrichment, were conducted to explore the functional roles of the identified circRNAs and associated miRNAs. A total of 54 circRNAs were identified as differentially expressed in RA, with 21 circRNAs upregulated and 33 downregulated. Among these, CircRNA_0001412 and CircRNA_0001566 were highly expressed in RA PBMCs and demonstrated good sensitivity and specificity as diagnostic biomarkers (AUC = 0.751 (95%CI 0.673, 0.830) and 0.605(95%CI 0.516, 0.694)). Combined analysis of these circRNAs further improved diagnostic performance (AUC = 0.776 (95%CI 0.702, 0.851)). Notably, CircRNA_0001412 showed a significant correlation with CRP, suggesting its potential as a biomarker for RA disease severity. Bioinformatics analysis predicted that CircRNA_0001412 and CircRNA_0001566 could promote T-cell activation via the PI3K-Akt signaling pathway, contributing to RA pathogenesis. CircRNA_0001412 and CircRNA_0001566 are promising diagnostic biomarkers for RA, with CircRNA_0001412 additionally serving as a potential indicator of inflammatory activity. These findings provide a basis for further research into the diagnostic and prognostic utility of circRNAs in RA.

Balancing anatomical limits and dynamic adaptation: Understanding the determinants of successful vaginal breech delivery.

ObjectivesWe aimed to develop a simple, cost-effective algorithm to predict the presence of oligoclonal IgM bands (OCMB) in patients with multiple sclerosis (MS), using surrogate markers such as the IgM Index (IgMi) and the Free Kappa Light Chains Index (FKLCi), with the aim of reducing the need for OCMB testing while maintaining high diagnostic accuracy.MethodsA retrospective study was conducted using paired serum and cerebrospinal fluid samples from patients diagnosed with MS at disease onset at Hospital Universitari i Politècnic La Fe. Receiver operating characteristic (ROC) curve analyses were performed for IgMi and FKLCi to evaluate their ability to predict OCMB positivity. Several combinations of cutoff values prioritizing high specificity and positive predictive value (PPV) were tested, and the best-performing threshold combination was selected.ResultsA total of 97 patients were included. The optimal model defined OCMB positivity as having either IgMi≥0.2 or FKLCi≥250. Applying this algorithm reduced the need for OCMB testing by 33 %, while achieving a specificity of 90 % and a PPV of 85 %.ConclusionsIgMi and FKLCi may serve as reliable predictors of OCMB positivity in MS, potentially reducing unnecessary testing and laboratory workload.

Predictive value of uterine artery pulsatility index for cesarean delivery in late-onset fetal growth restriction.

To assess the diagnostic performance of ultrasound attenuation analysis (USAT) in evaluating hepatic steatosis in patients with metabolic dysfunction-associated steatotic liver disease (MASLD), with magnetic resonance imaging proton density fat fraction (MRI-PDFF) as the reference. Participants were recruited. Each participant underwent both USAT and MRI-PDFF examinations on the same day. We employed MRI-PDFF thresholds to classify the stages of hepatic steatosis. Univariable and multivariable linear regression analyses were conducted to identify significant factors influencing USAT. Receiver operating characteristic (ROC) curve analysis was utilized to evaluate the diagnostic performance of USAT in predicting the grade of liver steatosis and compared with visual hepatic steatosis grade (VHSG) and clinical prediction models. A total of 145 patients took part in this study. The correlation coefficient between USAT and MRI-PDFF was 0.805 (p < .050). USAT varied significantly across different hepatic steatosis grade. Triglyceride (TG) and steatosis grade were significant determinant factors for USAT. The areas under the ROC curve of USAT for predicting steatosis ≥ S1, ≥ S2, and =S3 were 0.90 (cut-off value of 0.61 dB/cm/MHz), 0.92 (cut-off value of 0.71 dB/cm/MHz), and 0.92 (cut-off value of 0.82 dB/cm/MHz), respectively. The diagnostic performance of USAT was statistically better than that of VHSG, Hepatic steatosis index (HSI), and Framingham steatosis index (FSI). USAT is a promising quantitative tool for the quantitative assessment of hepatic steatosis in patients with MASLD, demonstrating a stronger correlation with MRI-PDFF.

Relationship between tibio-fibular overlap ratio and lower limb torsion in an Asian population.

Clinical validation of CD16b as a standardized biomarker for inherited GPI deficiencies.

Accurate assessment of tract-specific inflammatory activity remains difficult in perianal fistulizing Crohn's disease (pfCD), as current clinical and imaging indices incompletely reflect local activity. To evaluate fistula calprotectin (FiCP) as a tract-specific biomarker, focusing on diagnostic accuracy, associations with histological, clinical, and radiological indices, longitudinal responsiveness, and local infliximab exposure. In this single-center observational study (April 2023-July 2025; n = 105), patients with pfCD provided fistula exudate samples during surgical or outpatient assessment. FiCP concentrations were quantified by ELISA and correlated with histological inflammation, the Perianal Disease Activity Index (PDAI), the MRI-based modified Van Assche Index (mVAI), and total fistula volume (TFV). Diagnostic performance was analysed using receiver operating characteristic (ROC) curves with DeLong comparison, and treatment responsiveness was evaluated longitudinally using the standardised response mean (SRM). Serum and local infliximab concentrations were measured using ELISA. FiCP levels were significantly higher in fistulas with severe versus mild histological inflammation (p = 0.021) and in clinically or radiologically active tracts (both p < 0.001). FiCP correlated with PDAI (R = 0.61), mVAI (R = 0.40), and local infliximab concentration (R = -0.64). FiCP discriminated active from quiescent fistulas (AUC 0.843; 95% CI 0.758-0.928) and retained diagnostic value in patients with normal CDAI scores. FiCP levels declined significantly after therapy and showed greater responsiveness than PDAI and TFV. FiCP represents a minimally invasive, tract-specific biomarker that mirrors local inflammatory activity and dynamically tracks treatment response in pfCD. Multicenter validation is warranted to define its clinical utility.

Limbic free-water alterations as neuroimaging biomarkers for predicting phenoconversion in prodromal Parkinson's disease.

This study aimed to assess the validity and reliability of the Turkish version of the Rapid Sarcopenia Screening (RSS) tool, designed to provide a quick and practical method for identifying sarcopenia in older adults. A cross-sectional observational study was conducted among 150 individuals aged 60 years and older attending a geriatric outpatient clinic in Türkiye. The RSS underwent forward-backward translation and linguistic validation. Construct validity was examined by correlation with the SARC-F. Internal consistency was assessed using Cronbach's alpha, whereas intra-rater and inter-rater reliability were evaluated with intraclass correlation coefficients (ICCs). Discriminant validity was analysed using receiver operating characteristic (ROC) curves. The median age of participants was 75 years (range: 62-103), and 59% were female. According to EWGSOP2 criteria, 27% were diagnosed with sarcopenia. The RSS showed good internal consistency (Cronbach's alpha = 0.768). A strong inverse correlation with SARC-F scores (rho = -0.688, p < 0.001) supported construct validity. ROC analysis demonstrated good discriminatory power (AUC = 0.817). Reliability was also excellent, with intra-rater and inter-rater ICCs of 0.980 and 0.963, respectively. The Turkish RSS is a valid, reliable and practical screening tool for detecting sarcopenia in older adults. Its brevity and reliance on self-reported items support its feasibility for routine clinical practice and suggest its potential as an alternative screening method in Türkiye.

To identify factors linked to systemic inflammation and evaluate the predictive value of novel inflammatory biomarkers in peritoneal dialysis (PD) patients. We enrolled 111 maintenance PD patients, stratified by C-reactive protein (CRP) into a normal group (CRP<3mg/L) and an inflammation group (CRP ≥3mg/L). We compared clinical characteristics, laboratory parameters, and novel inflammatory biomarkers. Analyses included group comparisons, Spearman correlations between CRP and clinical parameters, multiple linear regression relating novel biomarkers to CRP, and binary logistic regression with receiver operating characteristic (ROC) analysis for predictive value. The inflammation group had significantly lower urine volume, hemoglobin (HGB), prealbumin (pre-ALB), potassium (K), magnesium (Mg), and transferrin saturation (TSAT), but higher serum ferritin (SF) and white blood cell count (WBC) (p<0.05). CRP positively correlated with age, neutrophils, monocytes, WBC, SF, glucose, glycated hemoglobin A1c (HbA1c), triglycerides, β2-microglobulin, and novel indices include systemic immune inflammation index (SII), platelet-lymphocyte ratio (PLR), platelet-albumin ratio (PAR), systemic inflammation response index (SIRI), albumin-prealbumin ratio (APR), and aggregate index of systemic inflammation (AISI) (p<0.05). Negative correlations existed with HGB, pre-ALB, residual urea clearance index (Kt/V), residual creatinine clearance (CCr), residual glomerular filtration rate (GFR), and electrolytes (Na, Cl, Mg) (p<0.05). Multiple linear regression identified AISI and APR as independent predictors of CRP levels. ROC analysis showed that the combination of AISI and APR had superior diagnostic utility for systemic inflammation compared to individual indices. Systemic inflammation in PD patients is associated with impaired nutrition, anemia, and reduced residual renal function. AISI and APR strongly correlate with CRP, and their combination significantly enhances prediction of systemic inflammation, providing a valuable clinical tool for risk stratification.

Differentiated risk factors for stroke recurrence in anterior versus posterior circulation intracranial atherosclerosis: A high-resolution vessel wall imaging study.

How to differentiate pediatric enteroviral meningoencephalitis from scrub typhus meningoencephalitis: A single-center retrospective study from Yunnan Province, China.

Prediction of Osteoporosis and Fragility Fracture Risk Using Proximal Humerus CT Value from Chest CT: A Development and Validation Study.