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Efficacy and safety of tip-bendable suction ureteral access sheath-assisted flexible ureteroscopic lithotripsy compared with mini-percutaneous nephrolithotomy for the management of 1-3 cm simple lower calyceal calculi: a prospective randomized controlled trial

World J Urol. 2025 Jul 5;43(1):410. doi: 10.1007/s00345-025-05792-1.

ABSTRACT

OBJECTIVE: To assess the efficacy and safety of flexible ureteroscopic lithotripsy (f-URL) assisted by the tip-bendable suction ureteral access sheath (SUAS) and mini-percutaneous nephrolithotomy (mPCNL) for the treatment of simple lower calyx renal calculi.

METHODS: A prospective randomized controlled trial was conducted on 102 patients with simple lower calyx renal calculi (with a diameter of 1 ~ 3 cm) admitted to the Second Hospital of Tianjin Medical University from December 2023 to February 2025. The patients were randomly assigned to the SUAS f-URL group (n = 49) and the mPCNL group (n = 53). The primary endpoint of the study was the immediate stone-free rate (SFR), while the secondary endpoints included operative time, anesthesia time, visual analogue scale (VAS) pain score, estimated blood loss, complication rate, length of hospital stay, hospitalization cost, and the SFR at 30 days postoperatively.

RESULTS: The two groups had comparable baseline characteristics. The SUAS f-URL group demonstrated a similar immediate SFR compared to the mPCNL group (67.35% vs. 66.04%, p = 0.889). Compared to the mPCNL group, the SUAS f-URL group had a shorter anesthesia time (78.08 ± 29.79 vs. 94.62 ± 34.22 min, p = 0.011), a shorter postoperative hospital stay (3.00 [1.50, 3.00] vs. 3.00 [2.00, 5.50] days, p = 0.003), and lower overall costs (3171.21 ± 373.34 vs. 5056.69 ± 358.97 USD, p < 0.001). There were no statistically significant differences between the two groups in terms of postoperative complications, estimated blood loss, pain scores, or SFR at 30 days postoperatively.

CONCLUSION: Compared to mPCNL, SUAS f-URL achieved a similar SFR while offering advantages such as less anesthesia time, shorter hospitalization, and lower hospitalization costs. Moreover, it did not increase the incidence of perioperative complications such as infection and blood loss. Therefore, SUAS f-URL would be a viable alternative supported by preliminary evidence for the management of 10-30 mm simple lower calyceal renal calculi.

PMID:40616669 | DOI:10.1007/s00345-025-05792-1

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10-year survival rate of an all-polyethylene tibia medial unicompartmental knee replacement: the royal Berkshire hospital NHS foundation trust experience

Eur J Orthop Surg Traumatol. 2025 Jul 5;35(1):293. doi: 10.1007/s00590-025-04406-1.

ABSTRACT

PURPOSE: This study aims to analyse the short- and long-term survival rate of an all-polyethylene tibia UKR, and the relationship with implant thickness and patient demographics including sex, age, ASA, and BMI.

METHODS: This was a single centre, retrospective, observational study of 388 consecutive medial fixed bearing all-polyethylene tibia UKRs done by a single surgeon between 2007 and 2019. We analysed the survival rate at 2, 5, 7, and 10 years and any relationship with sex, BMI, ASA, and implant thickness.

RESULTS: Cumulative implant survivorship was 98.7% at 2 years, 96.4% at 5 years, 95.3% at 7 years, and 91.9% at 10 years. The majority of patients had a BMI between 30 and 34 and were ASA 2; however, neither of these factors were associated with implant survival. The 7-mm all-polyethylene tibial component was most commonly used, and again, there was no association with implant size and survival. The most common reason for revision was progression of arthritis in the remaining compartments (40% of all revisions). There were no revisions due to loosening of the tibial component, and only 1.7% of revisions were due to femoral component loosening.

CONCLUSION: Fixed bearing medial all-polyethylene tibia UKR shows excellent survivorship at 2, 5, 7, and 10 years. There is no significant association with survivorship and sex, age, BMI, ASA grade, or implant thickness.

PMID:40616661 | DOI:10.1007/s00590-025-04406-1

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Safety of low-dose radiotherapy in newly diagnosed stage I/II extranodal NK/T-cell lymphoma: a single-center retrospective analysis

Ann Hematol. 2025 Jul 5. doi: 10.1007/s00277-025-06497-6. Online ahead of print.

ABSTRACT

This study aimed to investigate the feasibility and safety of low-dose radiotherapy (RT) (< 50 Gy) in patients with stage I/II Extranodal NK/T-cell lymphoma (ENKTCL). Clinical and treatment data from 158 stage I/II ENKTCL patients who received combined chemoradiotherapy at the First Affiliated Hospital of Zhengzhou University from 2020 to 2022 were retrospectively analyzed to compare locoregional control (LC) and survival outcomes between high-dose (≥ 50 Gy) and low-dose (< 50 Gy) RT groups. All patients achieved an objective response (OR) after treatment, with a median follow-up of 51 months. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 90.1% and 81.7% in the high-dose group (n = 130), compared to 84.0% and 68.2% in the low-dose group (n = 28), with no significant statistical differences between the two groups. Notably, no local recurrence was observed in the low-dose group (100% local control rate), and the incidence of grade ≥ 3 RT-related adverse events (AEs) was significantly lower in the low-dose group than in the high-dose group. Preliminary evidence suggests that for newly diagnosed stage I/II ENKTCL patients receiving combined chemoradiotherapy, low-dose radiotherapy may not compromise LC and survival outcomes while reducing the incidence of grade 3-4 adverse events, with 40-45 Gy appearing to be the optimal dose range within the examined parameters.

PMID:40616628 | DOI:10.1007/s00277-025-06497-6

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Difference in time and risk preferences: physicians and general population across genders

Health Econ Rev. 2025 Jul 5;15(1):56. doi: 10.1186/s13561-025-00653-4.

ABSTRACT

BACKGROUND: The alignment of preferences between physicians and patients can cause variations in treatment decision-making, thereby affecting health outcomes. However, research on the differences in preferences between physicians and the general population is scarce. This study examines the risk and time preferences of physicians compared with those of the general population, exploring the influence of gender concordance on health outcomes and decision-making in healthcare.

METHODS: We conducted an online field experiment in October and November 2022 in Japan and analyzed the responses of 469 individuals, including physicians and the general population. The survey was stratified by age and gender to align with the demographics of physicians nationally. Participants’ preferences were measured across the health and monetary domains by using a modified multiple price list test format.

RESULTS: The findings revealed that physicians tended to be more risk-averse than the general population in the health and monetary domains, although no statistically significant differences were observed. Physicians were found to be statistically significantly future-oriented, particularly regarding their significant health or monetary gains. Furthermore, while the female general population was more risk-averse in both domains, a gender difference in the physician group was observed only in the monetary domain.

CONCLUSION: The results affirm that preference differences between physicians and the general population exist in Japan and clarify the unique preference traits of female physicians.

PMID:40616619 | DOI:10.1186/s13561-025-00653-4

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The Nationwide Impact of COVID-19 on Lung Donation and Transplantation in Belgium

J Med Virol. 2025 Jul;97(7):e70486. doi: 10.1002/jmv.70486.

ABSTRACT

SARS-CoV-2 primarily infects the respiratory tract. Consequently, lung transplantation (LTx) programs have been significantly impacted by the COVID-19 pandemic. This study aimed to summarize the impact of the pandemic on LTx in Belgium. Eurotransplant recorded lung donation and transplantation rates from January 2015 to June 2024. Recipient mortality and LTx for COVID-19 patients were reported by all Belgian LTx centers from January 2016 to June 2023. With the onset of the pandemic, lung donation rates decreased abruptly, reaching their lowest point in the 1st half of 2020 and 2nd half of 2021, with a 44% decrease. Donation rates did not recover until the 2nd half of 2023. Concurrently, annual LTx activity decreased by 20% in 2020, 19% in 2021, and 18% in 2022, subsequently recovering in 2023. Recipient mortality peaked in the 1st half of 2022, with 42% of deaths attributed to COVID-19. Three patients received LTx for COVID-19, and all survived for more than 2 years. LTx programs should prepare for future respiratory virus pandemics. The rapid implementation of evidence-based donor screening; and the reservation of intensive care and operating room capacity can safeguard LTx activity. The high risk of breakthrough infections in LTx recipients requires close follow-up and prompt treatment.

PMID:40616591 | DOI:10.1002/jmv.70486

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3D prototyped macro-models as educational aid for teaching endodontic access in preclinical training: Assessment of students’ learning experience, confidence and performance

Int Endod J. 2025 Jul 4. doi: 10.1111/iej.14276. Online ahead of print.

ABSTRACT

AIM: This study evaluated the effectiveness of three-dimensional prototyped macro-models (3DPMM) as an educational aid for teaching endodontic access to dental students.

METHODOLOGY: A total of 72 students were randomly assigned to three groups (n = 24) and participated in study sessions with 3DPMM at different stages: before, during (intermediate) or after performing laboratory projects. The timing of the 3DPMM study sessions rotated across groups for different tooth types (anterior, premolar and molar). Each student performed endodontic access on nine teeth (four anterior, three premolars and two molars). Students completed a questionnaire evaluating their learning experience and confidence. Endodontic access projects were graded by masked instructors, and the data were statistically analysed (α = 0.05).

RESULTS: Students rated their learning experience with the 3DPMM positively, regardless of their differences based on group assignment, tooth type or timing of the study session (p > .05). Procedural errors were observed in 47% of the teeth, with 35.6% exhibiting one error and 11.4% exhibiting two errors. The most common errors included gouging (26.6%) and oversized access cavities (23.5%). Students who completed endodontic access before using the 3DPMM had a significantly higher frequency of multiple errors, oversized access cavities and retained pulp chamber roof (p < .05). Approximately 60% of participants reported increased confidence after using the models, regardless of group assignment, tooth type or study session timing (p > .05).

CONCLUSION: The findings suggest that integrating 3DPMM enhanced students’ understanding of internal tooth anatomy, increased their confidence and reduced procedural errors. Students appreciated the hands-on, interactive learning experience offered by the models, reinforcing the value of innovative educational tools in endodontic training.

PMID:40616197 | DOI:10.1111/iej.14276

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The health outcomes of vitamin D supplementation in Africa: a systematic review and meta-analysis

BMC Nutr. 2025 Jul 4;11(1):121. doi: 10.1186/s40795-025-01046-w.

ABSTRACT

BACKGROUND: Vitamin D supplementation is essential for health, yet its full benefits and optimal use remain incompletely understood, particularly given the global prevalence of deficiency, which affects around 50% of the population, with higher rates in high-latitude regions and among individuals with darker skin. This systematic review synthesizes evidence on the health outcomes of vitamin D supplementation in Africa, addressing gaps in regional and demographic-specific research.

METHODS: A comprehensive literature search was conducted using PubMed, Scopus, Epistemonikos, and Google Scholar, limited to English-language publications without date restrictions. Two independent reviewers evaluated study eligibility, data quality, and risk of bias. The findings were reported in accordance with PRISMA guidelines, employing narrative synthesis and meta-analyses to compare the effects of vitamin D supplementation against control groups. Heterogeneity and publication bias were assessed using Egger’s regression and Q statistics.

RESULTS: The review included 14 randomized controlled trials from 9 African countries, involving 11,259 participants. Half of the studies reported health benefits associated with vitamin D supplementation. Meta-analysis of seven studies demonstrated significant increases in serum vitamin D levels (odds ratio = 6.78, p < 0.001) and reduced viral load in patients with human immunodeficiency virus (odds ratio = 1.63, p = 0.033). However, supplementation did not significantly affect weight gain (odds ratio = 1.1, p = 0.18) or mortality rates in patients with tuberculosis and human immunodeficiency virus (odds ratio = 0.971, p = 0.638). Improvements in disease symptoms and biochemical markers were observed (odds ratio = 2.28, p = 0.028), with no significant heterogeneity or publication bias. Subgroup analysis was constrained by the diversity of diseases and insufficient studies.

CONCLUSIONS: Vitamin D supplementation showed significant benefits in half of the studies, elevating serum levels and reducing viral load in HIV patients. However, it did not affect weight gain or mortality in TB and HIV patients. While symptom and biomarker improvements were noted, further research is needed to explore subgroup effects and optimize strategies.

TRIAL REGISTRATION: PROSPERO registration number CRD42024620729.

PMID:40616195 | DOI:10.1186/s40795-025-01046-w

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Are there prophylactic effects of vitamin D among healthier adult patients? A systematic review of randomized controlled trials

BMC Nutr. 2025 Jul 4;11(1):118. doi: 10.1186/s40795-025-01107-0.

ABSTRACT

INTRODUCTION: In 2017, a study uncovered increasing trends in vitamin D supplementation, revealing that 18% of adults exceeded 1000 international units (IU) daily, and 3% surpassed the safe limit of 4000 IU, raising concern for severe hypercalcemia and associated pathological effects on the kidneys, heart, and vascular system. While vitamin D is well-established for prophylactic use against osteomalacia and osteoporosis, its extra-skeletal benefits for healthy individuals, such as improving insulin sensitivity and low-density lipoprotein, remain unclear. This study focuses on defining healthy adults and exploring the potential benefits and drawbacks of prophylactic vitamin D supplementation.

METHODS: Using PubMed, EMBASE, and Scopus databases, 10,155 articles on vitamin D prophylaxis were identified. Randomized controlled trials targeting healthy patients receiving vitamin D for prophylaxis were included, with exclusions based on language, absence of reported outcomes, and patient history. Articles were screened and evaluated by Covidence and the Cochrane Risk of Bias tool, respectively. Dosage, form, frequency, duration, follow-up care, outcomes, and complications of included articles were recorded. This study protocol has been registered to PROSPERO: CRD42023446944.

RESULTS: Out of 18 articles, 4,415 patients showed low bias risk by the Cochrane tool. Seven studies found significant improvements: protection against autoimmune reactions, elevated hematological and iron profiles, reduced influenza-like illness, and enhanced cognitive tasks. 5000 IU Vitamin D for four weeks significantly reduced cholesterol, unlike 1000 IU for 16 weeks. Conversely, 11 studies revealed no Vitamin D impact on outcomes including hemoglobin-A1c, lipoproteins, BMI, blood pressures, and respiratory infections.

CONCLUSION: Except for a few outcomes, most prophylactic Vitamin D supplementation was generally not found to have statistically significant benefits in the healthy adult population. Future directions can include additional prospective studies with larger sample sizes of healthy adults testing for benefits and adverse effects of prophylactic vitamin D use.

PMID:40616189 | DOI:10.1186/s40795-025-01107-0

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Zoonotic diseases in China: epidemiological trends, incidence forecasting, and comparative analysis between real-world surveillance data and Global Burden of Disease 2021 estimates

Infect Dis Poverty. 2025 Jul 4;14(1):60. doi: 10.1186/s40249-025-01335-3.

ABSTRACT

BACKGROUND: Zoonotic diseases remain a significant public health challenge in China. This study examines the temporal trends, disease burden, and demographic patterns of major zoonoses from 2010 to 2023.

METHODS: This study analyzed data from China’s National Notifiable Infectious Disease Reporting System (NNIDRS, 2010-2023) on nine major zoonoses, including echinococcosis, brucellosis, leptospirosis, anthrax, leishmaniasis, encephalitis (Japanese encephalitis), hemorrhagic fever, rabies, and schistosomiasis. Joinpoint regression was applied to assess annual trends in incidence rates, while autoregressive integrated moving average (ARIMA) and exponential smoothing models were used to forecast incidence trends from 2024 to 2035. To assess the performance of the Global Burden of Disease (GBD) 2021 model in China, disease-specific multipliers-defined as the ratio of GBD estimates to national surveillance data-along with their corresponding 95% confidence intervals (CIs) were calculated to quantify discrepancies and evaluate the consistency between modeled estimates and empirical observations.

RESULTS: From 2010 to 2023, the incidence rates of leptospirosis [average annual percent change (AAPC) = – 5.527%, 95% CI: – 11.054, – 0.485], encephalitis (AAPC = – 16.934%, 95% CI: – 23.690, – 11.245), hemorrhagic fever (AAPC = – 5.384%, 95% CI: – 7.754, – 2.924), rabies (AAPC = – 20.428%, 95% CI: – 21.076, – 19.841), and schistosomiasis (AAPC = – 28.378%, 95% CI: – 40.688, – 15.656) showed a declining trend in China. In contrast, brucellosis exhibited a modest but statistically significant increase (AAPC = 0.151%, 95% CI: 0.031, 0.272). For most diseases, incidence rates were consistently higher in males than females. Children aged 0-5 years accounted for a substantial proportion of encephalitis and leishmaniasis cases, while adults aged 14-65 years represented the primary affected group across the majority of diseases. Occupationally, farmers and herders were the most affected populations. Compared to national surveillance data, the GBD 2021 model substantially overestimated the burden of zoonotic diseases in China, particularly for echinococcosis (by 3.611-7.409 times) and leishmaniasis (by 3.054-10.500 times).

CONCLUSION: The study revealed significant decline in several major zoonoses in China, while brucellosis showed a continued upward trend. These findings highlight the urgent need for a One Health-based prevention and control system to interrupt cross-species transmission and reduce long-term public health risks.

PMID:40616187 | DOI:10.1186/s40249-025-01335-3

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The relationship between passive social network site use and sub-threshold depression among college students: a moderated mediation model

BMC Psychol. 2025 Jul 4;13(1):739. doi: 10.1186/s40359-025-02849-z.

ABSTRACT

BACKGROUND: Sub-threshold depression is a prevalent psychological adaptation issue among university students. Although prior research has explored the potential relationship between social media use and depressive symptoms, the findings have been inconsistent, and the potential mediating and moderating mechanisms remain unclear. This study aims to examine the relationship between passive social network site use and sub-threshold depression in college students from the perspective of the differential susceptibility to media effects model, investigating the mediating role of fear of missing out (FOMO) and the moderating role of coping styles.

METHODS: A total of 738 students from five universities were assessed using the Passive Social Network Site Use Scale, the Center for Epidemiologic Studies Depression Scale, the Fear of Missing Out Scale, and the Simplified Coping Style Questionnaire. Descriptive statistics and correlation analysis were conducted using SPSS 26.0, and a moderated mediation model was established using Mplus 8.3.

RESULTS: The findings revealed that: (1) After controlling for gender and age, passive social network site use was a significant positive predictor of sub-threshold depression; (2) FOMO mediated the relationship between passive social network site use and sub-threshold depression; (3) Negative coping styles moderated the relationship between FOMO and sub-threshold depression, such that higher levels of negative coping enhanced the predictive effect of FOMO on sub-threshold depression.

CONCLUSION: The results contribute to understanding the mechanisms through which passive social network site use influences sub-threshold depression in university students. The study suggests that reducing FOMO and enhancing students’ coping styles may help mitigate sub-threshold depression, thereby improving their psychological well-being.

PMID:40616186 | DOI:10.1186/s40359-025-02849-z