Tag: pubmed

J Health Popul Nutr. 2025 Apr 9;44(1):113. doi: 10.1186/s41043-025-00736-2.

ABSTRACT

BACKGROUND: While existing studies conducted in South Asian countries have provided valuable insights into the nutritional status of the marginalized third-gender population and highlighted suboptimal nutritional conditions, regrettably such data is lacking in Bangladesh. Addressing this data gap is crucial to understanding and improving the nutritional condition of the third-gender community. Therefore, this study was conducted to estimate their nutritional status, dietary protein intake, lifestyle, social behavior, nutritional knowledge, and prevalence of diseases.

METHODS: The cross-sectional study was conducted in Dhaka City, Bangladesh. Fifty participants from the third-gender community were selected. Study subjects were individually interviewed through a structured questionnaire to gather specific data. SPSS was used for statistical analysis. Logistic Regression, Shapiro-Wilk Test, Kruskal-Wallis Test, and Chi-square tests were carried out to measure the associations among the variables.

RESULTS: The average age of the participants was 32.74 ± 9.30 years, with 26% lacking formal education and 72% engaged in money collection as a primary occupation. 36% earned less than BDT 5,000 monthly, with only 2% exceeding BDT 20,000. The mean height and mean body weights were 163 ± 5.21 cm and 60.64 ± 13.61 kg (mean ± SD) respectively. Mean Body Mass Index (BMI) was 23.02 ± 5.04 kg/m², among whom 14% were underweight, 56% were normal, 20% were overweight, and 10% were obese. 48% of the participants had poor nutritional knowledge, and 46% had average. 50% of the participants had smoking habits and 34% of the participants consumed alcohol. Nutritional intake was skewed towards plant proteins (72%), with inadequate access to healthcare reported by 56% of subjects. Two-thirds (66%) of the respondents had no illness, and non-communicable diseases (NCDs) affected 34% of participants, with diabetes (12%) and low pressure (8%) prevalent. Smoking significantly correlated with lower normal BMI (AOR = 0.26, 95% CI: 0.07-0.84, p < 0.05). Unhealthy food intake was significantly associated with underweight risks (AOR = 0.17, 95% CI: 0.03-0.92, p < 0.05). When compared with male and female Bangladeshi populations, third-gender individuals had higher overweight prevalence, moderate normal BMI rates, and lower malnutrition than males.

CONCLUSION: The research identified suboptimal nutritional status among the third-gender population in Bangladesh, highlighting higher rates of both obesity and underweight, as well as a prevalence of non-communicable diseases, particularly diabetes.

PMID:40205527 | DOI:10.1186/s41043-025-00736-2

BMC Res Notes. 2025 Apr 9;18(1):152. doi: 10.1186/s13104-025-07237-9.

ABSTRACT

OBJECTIVE: Cerebral edema is a severe and potentially fatal complication of diabetic ketoacidosis (DKA), particularly in pediatric patients. Despite its clinical significance, limited data exist on its incidence and associated risk factors in resource-limited settings. This study aimed to determine the incidence of cerebral edema in pediatric patients with DKA and investigate potential contributing factors. This retrospective study analyzed data from 270 pediatric DKA patients admitted to the Children’s Medical Center Hospital, Tehran, between March 2018 and March 2020. Patients aged 1 day to 18 years were included based on standard DKA diagnostic criteria (blood glucose > 250 mg/dL, pH < 7.3, bicarbonate < 18 mEq/L, and ketonemia/ketonuria). Patients with incomplete records or pre-existing neurological conditions were excluded. The statistical analyses included independent t-tests and Fisher’s exact tests.

RESULTS: The incidence of cerebral edema was 6.67%. Elevated blood glucose levels at admission were significantly associated with cerebral edema (P = 0.01), suggesting a potential role in its pathophysiology. Additionally, a strong correlation was observed between cerebral edema and ICU admission (P < 0.001), indicating a more severe disease course. The results suggest that early glucose control and neurological monitoring are critical for preventing adverse outcomes such as cerebral edema in pediatric DKA patients.

PMID:40205526 | DOI:10.1186/s13104-025-07237-9

Int J Drug Policy. 2025 Apr 8;139:104797. doi: 10.1016/j.drugpo.2025.104797. Online ahead of print.

ABSTRACT

BACKGROUND: In March 2020, Ontario, Canada, implemented COVID-19 public health measures, including school and non-essential business closures, physical distancing, border restrictions, and modified health services. We examined their association with changes in opioid toxicity mortality and assessed variations across age, sex, health region, and drug type.

METHODS: We conducted an interrupted time series using opioid toxicity death records (March 2019 to February 2021) from the Office of the Chief Coroner for Ontario. Using a generalized linear model (Poisson or negative binomial), we estimated changes in weekly death counts following the first (March 17th to May 19th, 2020) and second (November 23rd, 2020, to February 14th, 2021) lockdowns, as well as the entire post-COVID-19 period, modelling interventions as level shifts in opioid toxicity deaths.

RESULTS: Of 3844 individuals who died within the study period, 74.4 % were male, and the median age was 40 (interquartile range: 31 to 51). Weekly deaths ranged from 9 to 72. Following the province-wide state of emergency and first lockdown, there was a step increase in the number of deaths, with an estimated Rate Ratio (RR) of 1.21 (95 % CI 1.02 to 1.52). Over the duration of the post-COVID-19 period, an overall sustained increase in the number of opioid toxicity deaths (RR 1.11 [95 % CI 1.02 to 1.41]) was observed across the province.

IMPLICATIONS: The period after initial COVID-19 measures was associated with increases in opioid toxicity mortality. Future responses to public health emergencies must proactively mitigate the potential unintended consequence of toxic drug-related harms among substance-using populations.

PMID:40203470 | DOI:10.1016/j.drugpo.2025.104797

J Surg Educ. 2025 Apr 8;82(6):103509. doi: 10.1016/j.jsurg.2025.103509. Online ahead of print.

ABSTRACT

OBJECTIVE: The gender disparity in orthopedic surgery is multifactorial, driven by the lack of female mentorship, limited female leadership in academic roles, and challenges in pursuing academic positions. Research productivity and authorship are areas where these disparities manifest, with women being significantly underrepresented. The primary objective of this study is to evaluate whether gender disparities in orthopedic research productivity are apparent as early as medical school.

DESIGN, SETTING, AND PARTICIPANTS: A comprehensive analysis was conducted on orthopedic surgery residents from 208 ACGME-accredited programs across the United States. Data were collected between February and April 2024 from publicly accessible resources, covering 4320 residents (927 females, 3393 males). Pre-residency and residency publication data were gathered using Elsevier Scopus Application Programming Interface (APIs). The study compared total publications and first author publications between male and female residents, categorizing them as preresidency or residency publications. p-values were calculated using unpaired t-tests to evaluate gender differences.

RESULTS: Among the 2723 residents with preresidency publications, there was no statistically significant difference between male and female residents in the mean number of publications (p = 0.1267) or first authorship publications (p = 0.9389). During residency, however, male residents had a significantly higher mean number of publications than female residents (p = 0.0002), although no significant difference was observed in first authorships (p = 0.2538).

CONCLUSION: Our results suggest that while gender disparities in research productivity are not apparent preresidency, they emerge during residency, with male residents producing more publications. This difference is likely influenced by the lack of mentorship and female representation within the field of orthopedic surgery. Addressing these disparities requires targeted efforts to increase female mentorship and support within orthopedic residency programs.

PMID:40203465 | DOI:10.1016/j.jsurg.2025.103509

Phys Sportsmed. 2025 Apr 9. doi: 10.1080/00913847.2025.2491111. Online ahead of print.

ABSTRACT

OBJECTIVES: Females participate in clinical research at a much lower rate than males, leading to clinical outcome disparities. The objective of this study was to determine whether gender-based disparities exist in orthopedic sports medicine injury research on NCAA college student-athletes.

METHODS: A PubMed search was conducted in September 2023 using the search terms ‘NCAA,’ ‘injury,’ and each of the 24 individual NCAA sports between 1980 and 2023. Statistical analysis was performed via determination of adjusted correlation coefficient R² and multiple linear regression models. Gender was the independent variable, number of studies was the dependent variable.

RESULTS: Of 1,553 studies initially identified, 790 met inclusion criteria and underwent full text review. Of NCAA studies that assessed injury rates (injury rate studies) and those that evaluated other outcomes such as performance (non-injury rate studies), 468 of 790 (59%) discussed male collegiate athletes and 318 (40%) discussed females. For females, there was a negative association between athlete-exposure rate and injury rate studies (expected decrease of 0.31 studies per 100,000 athlete-exposures) and between athlete-exposure rate and non-injury rate studies (decrease of 0.007). For males, there was a positive association for each (increase of 1.15 and 1.96). Injury rates were positively associated with injury rate study numbers for both males and females (increase of 3.71). There was no significant relationship between injury rates and non-injury rate study numbers for either gender.

CONCLUSION: This study demonstrates gender disparities in orthopedic sports medicine injury research for collegiate athletes. There was a negative association between athlete-exposure rate and injury rate or non-injury rate studies for female NCAA athletes, but a positive association for males.

CLINICAL RELEVANCE: It is important to ensure that sports medicine research is focused on both male and female NCAA athletes to be able to evaluate injuries, outcomes, and opportunities for injury prevention.

PMID:40203455 | DOI:10.1080/00913847.2025.2491111

Pak J Pharm Sci. 2025 Jan-Feb;38(1):299-313.

ABSTRACT

This study aimed to develop SNEDDS to address the issue of low water solubility of escitalopram (ETP), which consequently leads to inadequate oral bioavailability. The formulation consisted of Tween 80, geranium oil, and polyethylene glycol 400. An evaluation was conducted to determine the surface charge and particle size of ETP-SNEDDS. The stability and compatibility of excipients were evaluated by TGA, DSC and FTIR. Studies were carried out to examine the dissolution, digestion, permeability, in in-vitro, in-vivo, and ex-vivo settings. ETP-SNEDDS bioavailability was assessed in a group of six albino rats under normal conditions. The synthesized SNEDDS exhibited thermodynamic stability, characterized by a 145nm droplet size with a polydispersity index of 0.120 and a minute emulsification duration. Developed SNEDDS containing ETP in FSSIF had a dissolution rate of 96%. Based on the permeation results, the SNEDDS demonstrated a 4.2-fold and 3.1-fold increase in drug penetration relative to standard powder-ETP drug and a reference tablet, correspondingly. Statistically significant improvements (p<0.05) were reported in in-vitro digestion, dissolution and ex-vivo permeability. SNEDDS exhibited a 5.34-fold increase in Cmax and a 4.71-fold rise in AUC compared to the reference. Based on findings, the formulated SNEDDS have a valuable method for enhancing ETP oral bioavailability.

PMID:40203451

Pak J Pharm Sci. 2025 Jan-Feb;38(1):219-232.

ABSTRACT

The structure of active compounds determines their functions. This study investigates the phytochemical composition of five plant species, tests their capacity to obstruct the growth of four pathogenic bacteria (Bacillus subtilis, Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli) and to scavenge free radicals and inspects the relationship between the biological activities and the phytochemical structural frameworks. GC-MS analysis was employed for specifying phytochemicals. The plant methanolic and ethanolic extracts and the antibiotic (AMC30), were evaluated for antibacterial capability utilizing the disc diffusion method. For assessing antioxidant activity, the DPPH method was used. Achillea fragrantissima exhibited the highest phytochemical diversity. Gram-negative bacteria were less sensitive to plant extracts. Pulicaria undulata and Pulicaria incisa demonstrated greater efficacy in suppressing bacterial proliferation. Artemisia judaica and P. undulata extracts showed higher free radicle scavenging relative to other species. The antioxidant action, antibacterial properties against B. subtilis, S. aureus and E. coli exhibited a statistically significant correlation with aromatic monocyclic compounds. A significant negative correlation was also observed between aliphatic polycyclic compound contents and E. coli growth inhibition, indicating that this compound category may have an E. coli growth stimulating capacity. This study proposes research into phytochemical frameworks and their target-specific properties.

PMID:40203443

Medwave. 2025 Apr 9;25(3):e2937. doi: 10.5867/medwave.2025.03.2937.

ABSTRACT

The study aimed to assess the quality and applicability of current maternal-fetal health clinical practice guidelines that countries can adopt or adapt. A systematic search was conducted in the International Database of GRADE Guidelines (BIGG) for practice guidelines developed with the GRADE system (Grades of Recommendation, Assessment, Development, and Evaluation) and related to maternal-fetal care. The selected guidelines were evaluated with the AGREE-REX (Appraisal of Guidelines REsearch and Evaluation-Recommendations Excellence) tool to assess clinical applicability (domain-1), values and preferences (domain-2) and applicability (domain-3). The variables were presented descriptively, and a statistical analysis was performed on the domains according to institution and country of origin. Of 1,212 clinical practice guidelines, 72 met the inclusion criteria. According to the type of collaborating organization, the World Health Organization predominated with 58.3%, versus specialized medical societies. Domain 1, “Clinical applicability,” was the best rated by the reviewers (68.5%) compared to domain 2, “Values and preferences” (60%). According to the type of institution that developed the clinical practice guideline, a significant difference was demonstrated in domains 1 (p= 0.000), 2 (p= 0.006) and 3 (p= 0.000). Only domains 1 (p= 0.000) and 3 (p= 0.018) were statistically significant based on country of origin. This study emphasizes the importance of improving the quality of maternal-fetal clinical practice guidelines developed by organizations and governmental institutions and the need to strengthen the institutionalization of the use of evidence to develop, adapt and implement practice guidelines in countries such as the United Kingdom, Canada, Spain, Colombia, the United States, among others.

PMID:40203435 | DOI:10.5867/medwave.2025.03.2937

Issues Ment Health Nurs. 2025 Apr 9:1-12. doi: 10.1080/01612840.2025.2475356. Online ahead of print.

ABSTRACT

While antipsychotic medications remain the primary treatment for schizophrenia, they often have limitations in addressing all symptoms and can lead to adverse side effects, prompting researchers to explore complementary approaches such as physical activity to enhance overall patient outcomes. This study investigates the effectiveness of physical activity on psychosis and sleep quality in patients with schizophrenia. This quasi-experimental study involved 70 male inpatients with schizophrenia, divided into an activity group (structured physical activity program) and a control group (standard care). The intervention group showed significant improvements across multiple symptom domains (positive and depression-anxiety) with large effect sizes (η² ranging from 0.553 to 0.705) compared to the control group. These improvements, including reductions in grandiosity, emotional withdrawal, and anxiety, were maintained at the 3-month follow-up. The study group also exhibited significant improvements in several aspects of sleep quality, including subjective sleep quality (p < 0.001, η² = 0.612), sleep duration (p < 0.001, η² = 0.877), and sleep disturbances (p < 0.001, η² = 0.623). The physical activity program demonstrated significant improvements in sleep quality and various symptoms of schizophrenia, notably hallucinations and unusual thought content. Although the changes in negative symptoms were not statistically significant between groups, the overall findings suggest that physical activity can play a beneficial role in symptom management and enhance sleep quality for patients with schizophrenia.

PMID:40203433 | DOI:10.1080/01612840.2025.2475356

J Med Internet Res. 2025 Apr 9;27:e66366. doi: 10.2196/66366.

ABSTRACT

BACKGROUND: Considering that most patients with low or no significant risk factors can safely undergo noncardiac surgery without additional cardiac evaluation, and given the excessive evaluations often performed in patients undergoing intermediate or higher risk noncardiac surgeries, practical preoperative risk assessment tools are essential to reduce unnecessary delays for urgent outpatient services and manage medical costs more efficiently.

OBJECTIVE: This study aimed to use the Observational Medical Outcomes Partnership Common Data Model to develop a predictive model by applying machine learning algorithms that can effectively predict major adverse cardiac and cerebrovascular events (MACCE) in patients undergoing noncardiac surgery.

METHODS: This retrospective observational network study collected data by converting electronic health records into a standardized Observational Medical Outcomes Partnership Common Data Model format. The study was conducted in 2 tertiary hospitals. Data included demographic information, diagnoses, laboratory results, medications, surgical types, and clinical outcomes. A total of 46,225 patients were recruited from Seoul National University Bundang Hospital and 396,424 from Asan Medical Center. We selected patients aged 65 years and older undergoing noncardiac surgeries, excluding cardiac or emergency surgeries, and those with less than 30 days of observation. Using these observational health care data, we developed machine learning-based prediction models using the observational health data sciences and informatics open-source patient-level prediction package in R (version 4.1.0; R Foundation for Statistical Computing). A total of 5 machine learning algorithms, including random forest, were developed and validated internally and externally, with performance assessed through the area under the receiver operating characteristic curve (AUROC), the area under the precision-recall curve, and calibration plots.

RESULTS: All machine learning prediction models surpassed the Revised Cardiac Risk Index in MACCE prediction performance (AUROC=0.704). Random forest showed the best results, achieving AUROC values of 0.897 (95% CI 0.883-0.911) internally and 0.817 (95% CI 0.815-0.819) externally, with an area under the precision-recall curve of 0.095. Among 46,225 patients of the Seoul National University Bundang Hospital, MACCE occurred in 4.9% (2256/46,225), including myocardial infarction (907/46,225, 2%) and stroke (799/46,225, 1.7%), while in-hospital mortality was 0.9% (419/46,225). For Asan Medical Center, 6.3% (24,861/396,424) of patients experienced MACCE, with 1.5% (6017/396,424) stroke and 3% (11,875/396,424) in-hospital mortality. Furthermore, the significance of predictors linked to previous diagnoses and laboratory measurements underscored their critical role in effectively predicting perioperative risk.

CONCLUSIONS: Our prediction models outperformed the widely used Revised Cardiac Risk Index in predicting MACCE within 30 days after noncardiac surgery, demonstrating superior calibration and generalizability across institutions. Its use can optimize preoperative evaluations, minimize unnecessary testing, and streamline perioperative care, significantly improving patient outcomes and resource use. We anticipate that applying this model to actual electronic health records will benefit clinical practice.

PMID:40203300 | DOI:10.2196/66366