Tag: pubmed

Sci Rep. 2025 Apr 3;15(1):11465. doi: 10.1038/s41598-025-91871-7.

ABSTRACT

The biological processes involved in diseases like human immunodeficiency virus (HIV) and tuberculosis (TB) require extensive research, particularly when both diseases occur together. This piece of research delves to explore a new fractional-order mathematical model that examines the co-dynamics of HIV and TB, taking into account the treatment effects. Although no definitive vaccine or cure for HIV exists, antiretroviral therapy (ART) can slow disease spread and prevent subsequent complications. The basic properties of the fractional model in the Caputo sense, including existence, uniqueness, positivity, and boundedness, are proved using crucial mathematical tools. The disease-free and endemic equilibria are determined for the co-infection model, along with the basic reproduction numbers [Formula: see text] for TB and [Formula: see text] for HIV, using the next-generation matrix technique. A comprehensive analysis is conducted to determine the local and global stability of the disease-free equilibrium point by applying the Routh-Hurwitz criteria and constructing a Lyapunov function, respectively. The stability of the disease-free state is also verified graphically by considering different initial conditions and observing the convergence of the curves to the disease-free equilibrium point. Furthermore, the model is examined under different scenarios by varying the reproduction numbers, specifically when [Formula: see text] and [Formula: see text], and when [Formula: see text] and [Formula: see text]. Using actual data from the USA from 1999 to 2022, crucial parameters are estimated. The final fitting of the model with real data demonstrates how effectively the model framework aligns with the data. Finally, computational simulations are performed for different cases to illustrate the behavior of the model solutions by varying the fractional order derivative, as well as examining the solution’s behavior with respect to the stability points.

PMID:40180970 | DOI:10.1038/s41598-025-91871-7

Nat Commun. 2025 Apr 3;16(1):2921. doi: 10.1038/s41467-025-57940-1.

ABSTRACT

Escherichia coli is the most widely studied microbe in history, but the population structure and evolutionary trends of its extrachromosomal elements known as plasmids remain poorly delineated. Here we used long-read technology to high-resolution sequence the entire plasmidome and the corresponding host chromosomes from an unbiased longitudinal survey covering two decades and over 2000 E. coli isolates. We find that some plasmids have persisted in lineages even for centuries, demonstrating strong plasmid-lineage associations. Our analysis provides a detailed map of recent vertical and horizontal evolutionary events involving plasmids with key antibiotic resistance, competition and virulence determinants. We present genomic evidence of both chromosomal and plasmid-driven success strategies adopted by distant lineages by independently inheriting the same genomic elements. Further, we use in vitro experiments to verify the importance of key bacteriocin-producing plasmids for clone success. Our study has general implications for understanding plasmid biology and bacterial evolutionary strategies.

PMID:40180894 | DOI:10.1038/s41467-025-57940-1

Pain Pract. 2025 Apr;25(4):e70031. doi: 10.1111/papr.70031.

ABSTRACT

BACKGROUND: Pain from musculoskeletal pain conditions is often persistent, bothersome, and negatively impacts physical function. Individuals with musculoskeletal pain report difficulty with walking and regular activities. For some, this may be related to overly negative pain cognitions, such as pain catastrophizing and kinesiophobia. In a geographically and racially diverse sample, we examined relationships between pain catastrophizing, kinesiophobia, and multimodal physical function (i.e., self-report, performance-based, objective).

METHODS: Participants were sedentary adults with ≥3 months of chronic musculoskeletal pain. Participants completed self-report measures of pain catastrophizing (Pain Catastrophizing Scale), kinesiophobia (Tampa Scale of Kinesiophobia), and physical function (World Health Organization Disability Assessment Scale 2.0). Performance-based physical function was assessed in-clinic with the Six-Minute Walk Test (6MWT). Physical function was objectively measured with ≥4 days of ActiGraph wear outside the clinic. We conducted descriptive, correlation, and linear regression statistics in SPSS.

RESULTS: Higher levels of pain catastrophizing (β = 0.42) and kinesiophobia (β = 0.25) were significantly associated with worse self-reported physical function. Neither pain catastrophizing nor kinesiophobia were related to performance-based or objectively measured physical function. The direction and significance of relationships between pain catastrophizing, kinesiophobia, and physical function measures were consistent in unadjusted and adjusted regression models.

CONCLUSIONS: Pain catastrophizing and kinesiophobia are associated with an individual’s perceived physical functioning. Behavioral interventions designed to enhance physical function may benefit from including cognitive restructuring to challenge catastrophic thoughts about pain, as well as thoughts about injuring oneself or worsening pain with movement. More work is needed to understand why neither pain catastrophizing nor kinesiophobia were significantly associated with performance-based or objective assessment of physical function. It is possible that other pain-related cognitions, for example self-efficacy for pain control, or variables (e.g., in vivo pain catastrophizing, mood, stress, sleep) assessed closer in time to performance-based or objective measures of physical function are more relevant.

PMID:40180886 | DOI:10.1111/papr.70031

J Pediatr Urol. 2025 Mar 20:S1477-5131(25)00148-2. doi: 10.1016/j.jpurol.2025.03.010. Online ahead of print.

ABSTRACT

BACKGROUND: Hypospadias is one of the most common congenital anomalies observed in childhood and treated surgically. This study was designed to compare the postoperative analgesic efficacy of caudal block with sacral ESP block in children following hypospadias surgery.

METHODS: This study was designed as a single-center, prospective, randomized, controlled, double-blinded study. A total of 68 male patients were included in the study, and they were divided into two groups: one with sacral ESP (Group ESP) and the other with caudal block (Group C), each group consisting of 34 patients. FLACC (Face, Legs, Activity, Cry, Consolability) scores of all patients were observed and recorded during the first 24 h postoperatively. FLACC scores were recorded at 5 min, 30 min, and 1, 2, 4, 6, 12, and 24 h postoperatively.

RESULTS: The duration of analgesia in Group C (9.7 ± 2.8 h) was statistically significantly longer than in Group ESP (6.3 ± 1.6 h) (p < 0.001). FLACC scores in Group C (2.2 ± 0.5, 2.6 ± 0.6, 3.5 ± 1.5) were statistically significantly lower at 4 and 6 h and statistically significantly higher at 12 h postoperatively than those of Group ESP (2.7 ± 0.7, 4.1 ± 2, 2.7 ± 0.9) (p < 0.001). Group ESP (2.2 ± 0.4) mean FLACC value was found to be statistically significantly higher than that of Group C (1.9 ± 0.3) (p = 0.001). Patient relatives’ satisfaction rate in Group C was statistically significantly higher than in Group ESP (p = 0.001).

CONCLUSION: In the present study, we found that caudal block resulted in a longer duration of postoperative analgesia and lower FLACC scores than ESP block in pediatric patients who underwent hypospadias surgery.

PMID:40180872 | DOI:10.1016/j.jpurol.2025.03.010

Clin Breast Cancer. 2025 Mar 10:S1526-8209(25)00051-5. doi: 10.1016/j.clbc.2025.03.005. Online ahead of print.

ABSTRACT

INTRODUCTION: Forequarter amputation (FA) or Interscapulothoracic disarticulation is indicated in patients with invasive breast carcinoma (BC) in selected cases: primary resection of a locally advanced or recurrent tumor, Stewart & Treves syndrome (STS), or sarcoma secondary to radiation due to breast cancer (radiation-induced sarcoma, RIS). However, no studies have robustly evaluated the indications, results, complications, recurrence and overall survival in the context of FA in patients with BC.

MATERIAL AND METHODS: We performed a systematic review of 8 databases according to the PICOS and PRISMA methodology through December 31, 2022. Descriptive statistics are presented, and Kaplan‒Meier survival curves were generated and compared with the log-rank method.

RESULTS: We identified 54 articles and collected data from 100 patients. The intention of FA was curative for 48 patients (57.1%) and palliative in 32 (38.1%). The procedure was performed due to STS (35%), upper limb dysfunction (18%), lymphedema (10%), recurrent axillary tumors (10%) and RIS (9%). Complications were low. The survival rates at 12, 24, 36, and 60 months were 65.6%, 42.8%, 36.4%, and 32.4%, respectively. The main factors associated with survival were tumor’s condition (P = .05) and surgical intent (P < .001; multivariate analysis).

CONCLUSION: FA has few complications and attenuates symptoms in patients treated with both curative and palliative intent. Surgery is justified in select cases, such as locally advanced tumors, infiltration of axillary structures, upper limb lymphedema with loss of function, and STS and RIS, and often represents the best chance for local disease control and improvement in quality of life.

PMID:40180864 | DOI:10.1016/j.clbc.2025.03.005

Farm Hosp. 2025 Apr 2:S1130-6343(25)00027-3. doi: 10.1016/j.farma.2025.03.008. Online ahead of print.

ABSTRACT

OBJECTIVE: Evaluate the impact on improving the appropriateness of prescribing following a pharmaceutical intervention based on the review and optimisation of sulfamethoxazole-trimethoprim prescriptions.

METHODS: A before-after intervention study was conducted in a tertiary hospital. The first period, or intervention period, was prospective and ran from September 2021 to January 2022. The second or post-intervention period was retrospective and covered the period March-December 2022. In case of discrepancy between indication and prescribed and recommended dosage, the physician was notified and the degree of acceptance was recorded. In the post-intervention period, we retrospectively analysed the adequacy of the dosage, checking whether any intervention had been carried out by the Pharmacy Department. Statistical analysis was performed using the chi-square test.

RESULTS: During the intervention period, 69 prescriptions were analysed, and 18 were found to be inappropriate (26%), 12 related to Stenotrophomonas maltophilia infection. In the post-intervention period, 129 prescriptions were reviewed, and 12 were considered inadequate (9%). Statistical analysis of the results obtained in both periods (18/69 and 12/129) showed statistically significant differences (p = 0.0082).

CONCLUSIONS: Pharmaceutical intervention in the review and optimisation of prescriptions improves the use of sulfamethoxazole-trimethoprim. The results obtained provide evidence of the importance of pharmaceutical review of such prescriptions.

PMID:40180863 | DOI:10.1016/j.farma.2025.03.008

Vaccine. 2025 Apr 2;53:127081. doi: 10.1016/j.vaccine.2025.127081. Online ahead of print.

ABSTRACT

BACKGROUND: In 2024, the reported incidence of pertussis in China has increased sharply. As a vulnerable group, neonates continue to be at highest risk of severe outcomes from pertussis infection. However, there have been no serological assessment of population immunity since the 2024 pertussis outbreak in China. This study aimed to ascertain the PT-antibody status of pregnant women and their newborns during the epidemic period and offer insights to maternal immunization in China.

METHODS: From April to June 2024, 227 newborn-mother pairs in Xiamen City were recruited to test serum anti-PT IgG levels by ELISA. The geometric mean, undetectable rate (< 5 IU/mL), seropositivity rate (≥ 40 IU/mL), recent infection rate (≥ 100 IU/mL), and newborn-to-maternal ratio of anti-PT IgG were calculated. Statistical analysis was made based on maternal age, gravidity, parity, delivery mode, gestational age and newborn sex.

RESULTS: The anti-PT IgG levels were positively correlated (R² = 0.761) between pregnant women and their newborns. We found that 97.8 % of participants were seronegative, and 75.3 % of pregnant woman and 64.3 % of newborn had anti-PT IgG levels below 5 IU/mL. The seropositive prevalence of them were both only 2.2 % (95 % CI 0.9-5.1). The newborn-to-maternal ratio was stable in the range of 1.1 to 1.3 across all groups. There was no significant difference in the anti-PT IgG level of all participants across maternal and neonatal demographic characteristics. There was also no significant difference in the prevalence of seropositivity across demographic characteristics, except for delivery mode among newborns.

CONCLUSIONS: Almost all of the pregnant women and their newborns in this study had anti-PT IgG levels low enough to suggest susceptibility to pertussis infection, especially during an epidemic period. Infants are unprotected until the onset of primary immunization series, which would support the rationale for maternal immunization.

PMID:40179439 | DOI:10.1016/j.vaccine.2025.127081

Geriatr Nurs. 2025 Apr 2;63:113-122. doi: 10.1016/j.gerinurse.2025.03.010. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this project was to establish an evidence-based practice program, and examine the effect on nurses’ knowledge levels, nurses’ compliance and patient satisfaction.

METHODS: We systematically searched six databases and five websites to summarize the best evidence. Next, we held stakeholder, EBP group and expert meetings to build the program. Finally, a noncontemporaneous controlled trial was applied.

RESULTS: After the implementation of the program, the knowledge scores of nurses improved significantly. The compliance with the nine audit criteria was over 80%, and the difference was statistically significant. The satisfaction of patients in the implementation group was significantly higher than that in the comparison group.

CONCLUSIONS: This was the first project of frailty screening and assessment in a clinical setting in China. The results showed that the implementation of the program could improve the knowledge level of nurses, regulate nursing behavior, and improve the satisfaction of patients.

PMID:40179436 | DOI:10.1016/j.gerinurse.2025.03.010

JMIR Res Protoc. 2025 Apr 3;14:e60790. doi: 10.2196/60790.

ABSTRACT

BACKGROUND: The human papillomavirus (HPV) vaccine is an effective way to prevent HPV and its associated cancers. Provider recommendation has been shown to be one of the most successful strategies for increasing the uptake of the HPV vaccine; however, more training and resources are needed to help boost health care providers’ confidence and communication skills in recommending the HPV vaccine to their patients, particularly in underserved Hispanic communities where vaccination rates among all ages are lower.

OBJECTIVE: This study aims to compare HPV educational and professional skills intervention effectiveness on improving provider recommendations and patient communication strategies with health care providers serving the El Paso United States-Mexico border region.

METHODS: We will conduct a randomized, blinded, multiple posttest-only controlled behavioral trial using a parallel group design that will examine the effectiveness of a fully automated, web-based, culturally tailored HPV education and professional skills intervention containing unique reading material and video role-play, as compared to a standard Centers for Disease Control and Prevention fact sheet and video about general communication skills. Participants were recruited using a purposive sampling technique, both internet-based and in-person outreach events. Study data are being collected and managed using REDCap (Research Electronic Data Capture; Vanderbilt University) hosted at the University of Texas at El Paso. Chi-square analyses, ANOVA, and other statistical tests will be used with 2-tail α to reject null hypotheses at .05 to analyze the self-assessed outcome data. The Mauchly test of sphericity for each ANOVA and the Huynh-Feldt epsilon test or Greenhouse-Geisser correction to the degrees of freedom of the F-ratio will be reported for each significant effect. We may use multiple imputation procedures to handle the missing data (if applicable). This study is being conducted in the west Texas or southeast New Mexico region of the United States. Chi-square analyses will be used to assess associations between variables reported on the baseline provider knowledge, attitudes, and practice scales. We seek to examine self-assessed changes in provider attitudes and behaviors regarding HPV vaccine recommendation 1 month after receiving our unique multimedia and culturally tailored intervention.

RESULTS: Research and data collection for this clinical trial began in December 2023. Participant recruitment was closed by May 2024 (N=128), with final data collection expected to be completed by December 2024.

CONCLUSIONS: This study team decided to report on the intervention protocol to help ensure transparency in the research process and facilitate the improvement of the research design. Tailored web-based educational programs for health care professionals, designed to address regional and patient population characteristics, may be a promising approach to enhancing the real-world implementation of clinical practice guidelines.

TRIAL REGISTRATION: ClinicalTrials.gov NCT05120869; http://clinicaltrials.gov/ct2/show/NCT05120869.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/60790.

PMID:40179382 | DOI:10.2196/60790

Anesthesiology. 2025 Apr 3. doi: 10.1097/ALN.0000000000005479. Online ahead of print.

ABSTRACT

BACKGROUND: The conscious state is maintained through intact communication between brain regions. However, studies on global and regional connectivity changes in unconscious state have been inconsistent. These inconsistencies could arise from unclear definition of unconsciousness, spatial and temporal limitations of neuroimaging modalities, and estimating only single connectivity measure. Here, we investigated global and regional changes in amplitude and phase based functional connectivity in propofol-induced unconsciousness, which is widely recognized as unconsciousness.

METHODS: We calculated amplitude and phase based functional connectivity using amplitude envelope correlation (AEC), weighted phase lag index (wPLI), and magnitude squared coherence (MSC) from intracranial electroencephalography data of 73 patients. Global changes in connectivity, complexity, and network efficiency were estimated. Regional connectivity changes between Brodmann areas, between 7 cortical lobes, and between resting state networks were assessed across all frequency bands. Additionally, we employed machine learning analysis to identify specific regions in classifying conscious and unconscious states.

RESULTS: In the unconscious state, global connectivity increased across all frequency bands, while global complexity and efficiency decreased, accompanied by increased delta and decreased high gamma power spectral density. Regional connectivity increased between entire cortical regions across all frequency bands. Machine learning analysis revealed that posterior connectivity was the most influential in classifying consciousness. Amplitude-based connectivity predominantly increased in the delta and theta bands, while phase-based connectivity predominantly increased from the beta to high gamma bands.

CONCLUSIONS: Propofol anesthesia suppresses cortical activity and induces oscillatory changes characterized by increased delta power and decreased high gamma power. These changes are accompanied by increased functional connectivity and reduced network complexity and efficiency. These changes limit the brain’s ability to generate a diverse repertoire of activity, ultimately leading to unconsciousness. Posterior connectivity, which showed high accuracy in predicting conscious states, would be crucial for sustaining consciousness.

PMID:40179374 | DOI:10.1097/ALN.0000000000005479