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The impact of weight loss in early pregnancy on the incidence of late gestational diabetes: a retrospective cohort study

Front Nutr. 2025 Nov 17;12:1688268. doi: 10.3389/fnut.2025.1688268. eCollection 2025.

ABSTRACT

OBJECTIVE: To study the potential correlation between pregnancy weight gain (WG) and the incidence of gestational diabetes mellitus (GDM).

METHODS: Clinical records of women with singleton pregnancies who had a first visit at Fujian Maternity and Child Health Hospital before 14 weeks and delivered after 28 weeks were retrospectively analyzed. Based on the first trimester WG, the participants were grouped as inadequate (iWG-F), adequate (aWG-F), and excessive (eWG-F) WG groups. The outcomes of interest included GDM, gestational hypertension, preeclampsia, small for gestational age (SGA), LGA, low birth weight (LBW), preterm birth, macrosomia, primarily cesarean section (CS), and admission to the neonatal intensive care unit (NICU). Statistical analyses included logistic regression, interaction, and mediation analyses.

RESULTS: A total of 16,824 pregnancies were analyzed. GDM incidences of the iWG-F, aWG-F, and eWG-F groups were 24.53%, 26.62%, and 29.46%, respectively, with a statistically significant difference (p < 0.001). Multivariable logistic regression showed that inadequate WG correlated with reduced risk of GDM when adjusted for pre-pregnancy body mass index (PPBMI) of below 18.5 kg/m2 [adjusted odds ratio (aOR) = 0.68], and 18.5-23.9 kg/m2 (aOR = 0.88). The association of inadequate WG and reduced risk of GDM persisted when adjusted for age <30.5 years (aOR = 0.81), fasting glucose ≥4.9 mmol/L (aOR = 0.74), triglycerides <1.4 mmol/L (aOR = 0.84), and HDL <1.63 mmol/L (aOR = 0.85). WG in the second trimester was associated with GDM (β = -0.003, p = 0.036) and partially mediated the effect of eWG-F (-3.7% of the total effect). WG before OGTT showed no association with GDM.

CONCLUSION: First trimester WG is significantly associated with the occurrence of GDM. In contrast, there is only a minimal association between second-trimester and pre-OGTT WG and the risk of GDM. Inadequate first-trimester weight gain reduces GDM risk, especially in younger women, women with normal or low PPBMI, elevated fasting glucose, and low HDL or triglycerides, without increasing abnormal neonatal birth weight. Early pregnancy represents a critical window for GDM prevention. Minimal weight gain during this period may be a feasible and acceptable approach to reducing GDM risk.

PMID:41334337 | PMC:PMC12665526 | DOI:10.3389/fnut.2025.1688268

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The development and validation of Coffee Use Disorder and Coffee Addiction Scale (CUDCAS) and its correlation with insomnia and anxiety symptoms

Front Nutr. 2025 Nov 17;12:1674097. doi: 10.3389/fnut.2025.1674097. eCollection 2025.

ABSTRACT

BACKGROUND: Coffee is a globally consumed beverage. However, the impairments associated with its excessive use remain under-recognized. There is currently no standardized measurement for coffee use disorder based on DSM-5 application. This study describes the development and psychometric properties of the Coffee Use Disorder and Coffee Addiction Scale (CUDCAS)-a self-report tool developed specifically for this purpose.

METHODS: A cross-sectional survey was designed and delivered to 523 participants. Items from CUDCAS (11 items with reference cluster) indicate substance use disorder criteria taken from the DSM-5 and were rated on a three point Likert scale and used descriptive statistics; internal consistency (Cronbach’s α and McDonald’s ω); exploratory/confirmatory factor analysis (EFA, CFA); item response theory (IRT), and correlations with caffeine consumption, insomnia (AIS) and anxiety symptoms (GAD-7) were also examined.

RESULTS: CUDCAS was found to be a very reliable (α and ω = 0.86) measure of coffee use disorder symptoms. CFA results supported the unidimensional factor structure of the CUDCAS and the overall model fit was good (CFI = 0.92, TLI = 0.90, RMSEA = 0.07, SRMR = 0.04). The IRT analyses further demonstrated an appropriate distribution of item difficulties, measurement of item precision and subsequently, CUDCAS as an overall measurement of coffee use disorder that is responsive to coffee consumption. CUDCAS also demonstrated significant correlations with caffeine consumption (r = 0.54), insomnia (r = 0.37), and anxiety (r = 0.32), respectively, for construct validity.

CONCLUSIONS: The findings suggest that the CUDCAS is a reliable and valid tool to assess the symptoms of coffee use disorder, and the current results provide support for its use in research and clinical settings.

PMID:41334329 | PMC:PMC12665531 | DOI:10.3389/fnut.2025.1674097

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The Relationship Between Social Support and Health-Promoting Behaviors among Older Adults in Fasa, Iran: A Cross-sectional Study

J Prev Med Public Health. 2025 Dec 1. doi: 10.3961/jpmph.25.502. Online ahead of print.

ABSTRACT

OBJECTIVES: Health-promoting behaviors are essential for maintaining independence and enhancing quality of life in aging populations. This study aimed to investigate the relationship between social support and health-promoting behaviors among older adults in Fasa, Iran in 2024.

METHODS: A cross-sectional study was conducted involving 300 older adults attending a specialized outpatient clinic in Fasa, Iran. Data were collected using a demographic questionnaire, the Walker Health-Promoting Lifestyle Profile, and the Canty Perceived Social Support Scale, administered either through self-report or structured interviews. Statistical analyses were performed using SPSS version 23 and included descriptive statistics, analysis of variance, the chi-square test, and multiple linear regression analyses.

RESULTS: The mean age of participants was 68.9 ± 7.8 years. Most participants were female (56.6%), married (81.7%), and had less than a high school education (41.3%). The mean scores for health-promoting behaviors and perceived social support were 124.2 ± 31.3 and 24.4 ± 9.4, respectively. A statistically significant positive association was observed between perceived social support and health-promoting behaviors (r=0.1, p=0.04). Social support, gender, and education level were identified as significant predictors of health-promoting behaviors, collectively explaining 34% of the variance.

CONCLUSIONS: These findings emphasize the pivotal role of social support in promoting health-related behaviors among older adults. Interventions that strengthen social support networks, foster enabling environments, and address gender and educational disparities are recommended to improve health outcomes and quality of life in aging populations. Policymakers and healthcare planners should incorporate these determinants into the design of targeted, evidence-based interventions for older adults.

PMID:41331744 | DOI:10.3961/jpmph.25.502

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Efficacy and safety of autologous adipose-derived stem cells in subjects with moderate to severe atopic dermatitis: a multicenter, randomized, single-blind, placebo-controlled, phase 2 trial

Stem Cell Res Ther. 2025 Dec 2;16(1):671. doi: 10.1186/s13287-025-04763-y.

ABSTRACT

BACKGROUND: Atopic dermatitis (AD) is a chronic skin condition affecting patients’ well-being, but conventional treatments have limitations. Mesenchymal stem cells (MSCs) present a promising option for AD therapy, though large-scale clinical studies are scarce. This study aimed to assess the efficacy and safety of autologous adipose tissue-derived MSC (AtMSC) in moderate to severe AD refractory to conventional treatments.

METHODS: This multicenter, randomized, single-blind, placebo-controlled, phase 2 trial included 114 participants. Participants received two intravenous injections of AtMSCs or placebo at 4-week intervals. Clinical assessments, comprising Eczema Area and Severity Index (EASI), Scoring Atopic Dermatitis (SCORAD), and Investigator’s Global Assessment (IGA), were performed every 4 weeks for 16 weeks total. Biomarker analyses were conducted using ELISA.

RESULTS: Statistically significant differences between the treatment and placebo groups in EASI total score were observed at 8, 12, and 16 weeks (P = .0.017, 0.015, < 0.001). At week 16, 23.7% [14/59] of participants in the treatment group achieved a 75% or greater reduction in EASI total score (EASI-75), compared to 7.3% [4/55] in the placebo group, with a statistically significant difference (P = .016). In addition, SCORAD, disease severity, and IGA score were also improved in the treatment group compared to the placebo group. Furthermore, the change in TARC levels from baseline to week 16 was significantly different between the treatment and placebo groups.

CONCLUSIONS: AtMSC therapy improved moderate to severe AD, offering a promising treatment option with potential applications in chronic inflammatory diseases. Further investigation, including double-blind phase 3 trials, is needed to confirm these findings and explore additional biomarkers.

TRIAL REGISTRATION: ClinicalTrials.gov, Identifier: NCT04137562; October 21, 2019; https://clinicaltrials.gov/study/NCT04137562 .

PMID:41331725 | DOI:10.1186/s13287-025-04763-y

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Polyunsaturated Fatty Acids and Skin Cancer: Two-Sample Mendelian Randomization Study

Ann Dermatol. 2025 Dec;37(6):363-376. doi: 10.5021/ad.25.095.

ABSTRACT

BACKGROUND: Observational studies have suggested associations between dietary polyunsaturated fatty acids (PUFAs) and cancer risk; however, causal inference regarding skin cancer remains limited due to potential recall bias, confounding, and reverse causation.

OBJECTIVE: This study aimed to evaluate the causal association between genetically predicted circulating PUFA levels and the risk of skin cancers, including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma.

METHODS: We conducted a 2-sample Mendelian randomization (MR) study using genome-wide association study summary statistics from the UK Biobank (PUFAs, n=115,006) and the FinnGen consortium (BCC, n=26,272; SCC, n=4,663; melanoma, n=5,753). Genetic instruments were derived for omega-3, docosahexaenoic acid, omega-6, linoleic acid, and the omega-6:3 ratio. Multiple MR methods-including inverse-variance weighted, MR-Egger, weighted median, weighted mode, and MR-PRESSO-were applied to test for consistency and assess pleiotropy and heterogeneity.

RESULTS: A higher genetically predicted linoleic acid to total fatty acid ratio was associated with a significantly lower risk of BCC and SCC. Conversely, higher genetically proxied serum omega-3 levels were associated with increased risks of BCC, SCC, and melanoma. The risk effect on SCC was attenuated upon exclusion of rs174528, a variant in the fatty acid desaturase 1 (FADS1) gene, suggesting a role for endogenous PUFA metabolism in carcinogenesis.

CONCLUSION: This MR analysis supports a causal role of circulating PUFAs in skin cancer development and highlights the importance of FADS-mediated endogenous PUFA metabolism. These findings provide novel insights into the genetic and metabolic underpinnings of skin cancer susceptibility.

PMID:41331717 | DOI:10.5021/ad.25.095

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Probiotic ice cream influences gut and vaginal microbiota in women at high risk of preterm birth: a randomized controlled study

Matern Health Neonatol Perinatol. 2025 Dec 3;11(1):43. doi: 10.1186/s40748-025-00238-3.

ABSTRACT

BACKGROUND: Research into probiotic use in pregnancy typically focuses on general probiotic strains. We instead investigated the relation between intake of ice cream with vaginal commensal probiotics (L. crispatus, L. gasseri, L. jensenii, L. rhamnosus GR-1; these may govern a stable microbiota and may carry beneficial functions in the vagina), throughout pregnancy, and the impact on gut and vaginal microbiomes, in women at high risk of preterm birth.

METHODS: This was a randomised controlled feasibility trial where the impact on gut and vaginal microbiomes was assessed by using 16 S rRNA gene sequencing and qPCR. In total 43 pregnant women were randomized, with 29 assigned to the intervention group and 14 to the control group. Both groups provided vaginal and rectal swabs by self-sampling at gestational time points. Pregnancy outcomes were registered through hospital records, and ice cream adherence and study experience was recorded.

RESULTS: We observed statistically significant gut and vaginal Lactobacillus increase during first half of pregnancy in all women with a continued increase in the second half in women compliant with the intervention. L. crispatus was found more often in the intervention group, and L. gasseri, L. jensenii and L. rhamnosus GR-1 in the ice cream could be recovered in both rectal and vaginal samples. Finally, vaginal Prevotella spp, as well as gut Gardnerella and Atopobium spp, significantly decreased upon intervention. Adherence to the intervention varied but gradually decreased throughout the study with 30.4% displaying excellent adherence in the first time period.

CONCLUSIONS: We conclude that vaginal commensal probiotics administered in ice cream can be an effective method of optimizing the vaginal and intestinal health in pregnant women at high risk of preterm birth when administered regularly. We give recommendations for future studies.

TRIAL REGISTRATION: Clinicaltrials.gov registration number 18/27209. Date of registration 03/25/2019. Date of first enrolment 04/08/2019.

PMID:41331700 | DOI:10.1186/s40748-025-00238-3

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Efficacy and safety of anticoagulant therapy in patients with sepsis: a meta-analysis of randomized controlled trials

Thromb J. 2025 Dec 2. doi: 10.1186/s12959-025-00812-x. Online ahead of print.

ABSTRACT

BACKGROUND: Coagulation dysfunction significantly impacts sepsis prognosis. Standardized methods for evaluating anticoagulant efficacy and safety in this population remain lacking. This study aimed to assess the efficacy and safety of anticoagulant therapy in sepsis patients.

METHODS: We systematically searched PubMed, Embase, and Cochrane Library for randomized controlled trials (RCTs) comparing anticoagulants against placebo/no treatment in sepsis patients. The reduction in 28/30-day all-cause mortality or the regression of disseminated intravascular coagulation (DIC) was regarded as efficacy endpoints, while bleeding complications constituted the most prevalent adverse events.

RESULTS: Eighteen RCTs involving 8053 patients were included. Anticoagulant therapy demonstrated an 8% mortality risk reduction versus placebo (relative risk [RR] 0.92, 95% CI 0.86-0.98; P = 0.02). In six studies of baseline DIC patients, anticoagulants showed non-significant mortality reduction (RR 0.87, 95% CI 0.62-1.22; P = 0.42) but significantly enhanced DIC regression (RR 1.62, 95% CI 1.32-2.00; P < 0.00001). Anticoagulants increased bleeding risk (RR 1.32, 95% CI 1.16-1.49; P < 0.0001).

CONCLUSION: Anticoagulant therapy confers survival benefit in the overall sepsis population despite increased bleeding risk. While improving DIC regression in sepsis-associated DIC, mortality reduction in this subgroup lacked statistical significance. Further research should clarify anticoagulants’ role in DIC-specific sepsis management.

PMID:41331689 | DOI:10.1186/s12959-025-00812-x

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Medication-related problems and contributing factors in patients with cardiovascular disorders in Ethiopia: a systematic review and meta-analysis

Syst Rev. 2025 Dec 2;14(1):241. doi: 10.1186/s13643-025-02992-z.

ABSTRACT

BACKGROUND: Cardiovascular diseases (CVDs) are a leading cause of mortality and disability globally. In Ethiopia, the management of CVDs faces significant challenges, particularly in addressing medication-related problems (MRPs). This systematic review and meta-analysis aims to assess the prevalence of MRPs among CVD patients in Ethiopia.

METHODS: The review followed the PRISMA guidelines and was registered in the PROSPERO database (CRD42024501087). A comprehensive search was conducted across databases including PubMed, Hinari, Embase, and Scopus. Studies were included if they focused on the prevalence of MRPs among Ethiopian CVD patients, were observational in design, and were published in English. Quality assessment was performed using the JBI critical appraisal checklist. Data were analyzed using a weighted inverse random-effects model with subgroup analyses conducted based on various study characteristics. Heterogeneity was assessed using the I2 statistic and further explored through univariate meta-regression and sensitivity analysis.

RESULTS: From 405 potential studies, 22 met the inclusion criteria, comprising 5700 patient cases and identifying 7780 MRPs. The pooled prevalence of MRPs among CVD patients in Ethiopia was 74% (95% CI 66-81, I2 = 98.4%). The average number of MRPs per patient was 1.65 (95% CI 1.48-1.82, I2 = 98.3%). Common MRPs included patient noncompliance (18%), ineffective drug therapy (16%), and the need for additional drug therapy (15%). Polypharmacy, poor involvement in therapeutic decisions, advanced age, the presence of comorbidities, and prolonged illness duration were identified as commonly reported contributing factors. Despite significant heterogeneity among studies (I2 = 98.4%), subgroup analyses and univariate meta-regression did not identify sample size or study period as significant sources of this variability. Publication bias was suggested by Egger’s regression test (p-value < 0.001), though trim-and-fill analysis indicated no adjustments were necessary. Sensitivity analysis confirmed the stability of the pooled prevalence estimate.

CONCLUSIONS: The high prevalence of MRPs among CVD patients in Ethiopia highlights the need for targeted interventions to optimize medication management and improve patient outcomes. Healthcare providers should focus on individualized care, regular medication reviews, and patient education to address these problems effectively.

PMID:41331667 | DOI:10.1186/s13643-025-02992-z

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Comparison of anterior and posterior approaches for hip resurfacing arthroplasty: a gait analysis study

J Orthop Surg Res. 2025 Dec 2;20(1):1056. doi: 10.1186/s13018-025-06457-w.

ABSTRACT

BACKGROUND: Hip resurfacing arthroplasty (HRA) is now only rarely performed, but usually using the posterior approach (POS), while total hip arthroplasty is now commonly performed using the direct anterior approach (DAA). This study aims to compare outcomes between these two approaches for HRA using gait analysis, the oxford hip score (OHS), metabolic equivalent of task (MET).

METHODS: Seventeen unilateral DAA and 17 POS HRA males were matched for age and BMI. Patients underwent instrumented treadmill gait analysis and completed patient reported outcome scores (PROMs) at a mean of 1.5 (0.9-1.8) years post-operatively. Kinematics and kinetics were recorded using motion capture and force plate data. Group differences were assessed using statistical parametric mapping. These data were compared to a group of 19 healthy male controls matched for age and BMI.

RESULTS: Gait analysis postoperatively revealed no significant differences in hip kinematics in either the coronal or sagittal planes between the posterior and direct anterior approaches. Statistical parametric mapping showed no differences in vertical ground reaction forces across the stance phase. Spatiotemporal gait parameters, including top walking speed, cadence, step length, and step width, were comparable between groups and closely aligned with healthy controls. Both cohorts achieved similar postoperative OHS (mean:48, p = 0.651) and MET scores (POS:13.1 vs DAA:12.6, p = 0.856).

CONCLUSIONS: This is the first study to compare gait following HRA via both the POS and DAA. At one-year postoperatively, both approaches restored gait patterns comparable to healthy controls, with no significant differences in kinematics, kinetics, or spatiotemporal parameters. PROMs were similarly excellent across groups indicating high functional recovery and engagement in moderate-to-vigorous physical activity.

PMID:41331665 | DOI:10.1186/s13018-025-06457-w

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Sex Determination Based on Posterior Mandibular Measurements using Three-Dimensional Cone-Beam Computed Tomography Images

J Imaging Inform Med. 2025 Dec 2. doi: 10.1007/s10278-025-01755-5. Online ahead of print.

ABSTRACT

The objective of this study was to evaluate the reliability and predictive ability of specific anthropometric mandibular measurements on three-dimensional (3D) reconstructed surfaces of cone-beam computed tomography (CBCT) records for sex determination. The study sample analyzed volumetric data from cone-beam computed tomography (CBCT) records of 204 Greek individuals aged 18-70 years, who sought general dental treatment at the School of Dentistry, National and Kapodistrian University of Athens, Greece. Patient records were screened for eligibility based on predefined inclusion criteria. The sample was distributed by sex and further categorized into four distinct age groups. Volumetric data of 204 patients (equally distributed between sexes) were reprocessed with the ViewBox 4 software, according to inclusion-exclusion criteria. Ten anatomical landmarks visible on three-dimensional CBCT reconstructions were digitally traced using the ViewBox 4 software, including superior points of the right and left condyles, the most proximal points of the inner poles of the right and left condyles, the inferior points of the right and left sigmoid notches, the superior points of the right and left coronoid processes and the right and left Gonion. This cross-sectional study employed a binary logistic regression (BLR) model for statistical analysis. All linear parameters exhibited statistically significant differences between sexes whereas angular measurements did not demonstrate a statistically significant difference. The developed model yielded an accuracy of 83.4% in predicting sex. Specific linear measurements are reliable predictors of sex and may be applied in forensic science as a supplementary method.

PMID:41331657 | DOI:10.1007/s10278-025-01755-5