Tag: pubmed

JMIR Res Protoc. 2025 Apr 1;14:e67737. doi: 10.2196/67737.

ABSTRACT

BACKGROUND: Glaucoma is the leading cause of irreversible blindness worldwide, causing continuous and progressively worsening damage to visual function, which leads to vision loss. Optic nerve protection is an important treatment for glaucoma with controlled intraocular pressure (GPCI), but to date, there is no universally accepted effective optic nerve protection agent. Acupuncture can protect the optic nerve by increasing blood flow to the eye. However, fear of pain or the limitations of treatment place and time lead to poor patient compliance. Press-needle therapy is a characteristic of traditional Chinese medicine (TCM) external treatment methods; its safety is high, the effect is fast and lasting, it is easy to conduct, and it has high patient compliance.

OBJECTIVE: The objective of the trial is to evaluate the safety and clinical efficacy of press-needle therapy and investigate whether it can improve visual function by regulating eye blood circulation in patients with GPCI.

METHODS: In total, 192 participants aged 18-75 years with GPCI from the Mianyang Central Hospital, the Mianyang Hospital of Traditional Chinese Medicine, and the Mianyang Wanjiang Eye Hospital will participate in this study. Participants will be allocated to 2 treatment groups (experimental and control groups) in a ratio of 1:1 and will undergo press-needle therapy and sham press-needle therapy, respectively, for the same 4-week period. Primary outcomes will include the best-corrected visual acuity (BCVA), optical coherence tomography angiography (OCTA), color Doppler flow imaging (CDFI), and visual field assessment results. Secondary outcomes will include the intraocular pressure (IOP) and traditional Chinese medicine (TCM) clinical symptom scales. The primary outcomes and safety assessments will be measured at baseline and 4 weeks thereafter, while the secondary outcomes will be measured at baseline and 1, 2, 3, and 4 weeks thereafter.

RESULTS: Recruitment and data collection began in February 2023. The final outcomes are expected in September 2025. As of October 2024, the project had recruited 220 eligible participants, of whom 192 (87.3%) will complete the study, exceeding initial projections for the study time frame. The remainder of the participants will provide the ability to explore cross-level interactions that could not be statistically powered at the outset. The strengths of the project include rigorous data collection, good retention rates, and high compliance rates.

CONCLUSIONS: This study will provide data on the effects of press-needle therapy on visual function and ocular circulation in patients with GPCI, and these results will help demonstrate whether acupuncture can improve patients’ visual function by regulating ocular circulation, thus providing a clinical and theoretical basis for the wider application of acupuncture therapy in GPCI.

TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2300067862；https://tinyurl.com/mrxd58x9.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/67737.

PMID:40168659 | DOI:10.2196/67737

Medwave. 2025 Apr 1;25(3):e3024. doi: 10.5867/medwave.2025.03.3024.

ABSTRACT

INTRODUCTION: Malignant neoplasms of the oral cavity represent a public health problem worldwide with an increasing incidence, especially in young populations. In Ecuador, the epidemiology of these conditions has been little studied, limiting timely diagnosis and management. The study aims to identify the distribution of hospitalizations and deaths from oral cavity malignant neoplasms in Ecuador during the pre-pandemic years, from 2015 to 2019, describing spatiotemporal patterns by province, gender, and age.

METHODS: An observational and descriptive study was conducted using the database of hospitalizations and deaths of the National Institute of Statistics and Census of Ecuador. Variables such as age, gender, province, and location of the neoplasms were analyzed, and frequencies, proportions, and crude rates were calculated.

RESULTS: Between 2015 and 2019, 4444 hospitalizations and 726 deaths were reported, with a notable increase in 2019. Males predominated in all the studied years. Malignant neoplasms of unspecified sites and other sites of the tongue had the highest frequency of cases and deaths. Geographically, the provinces of Loja, El Oro, Cañar, Carchi, and Bolivar had the highest rates.

CONCLUSIONS: The study shows an increase in hospitalizations and deaths due to malignant neoplasms of the oral cavity between 2015 and 2019, highlighting the urgency of implementing public health strategies aimed at prevention, early detection, and timely treatment of this disease.

PMID:40168654 | DOI:10.5867/medwave.2025.03.3024

JMIR Public Health Surveill. 2025 Apr 1;11:e69048. doi: 10.2196/69048.

ABSTRACT

BACKGROUND: Optimizing sentinel surveillance site allocation for early pathogen detection remains a challenge, particularly in ensuring coverage of vulnerable and underserved populations.

OBJECTIVE: This study evaluates the current respiratory pathogen surveillance network in Brazil and proposes an optimized sentinel site distribution that balances Indigenous population coverage and national human mobility patterns.

METHODS: We compiled Indigenous Special Health District (Portuguese: Distrito Sanitário Especial Indígena [DSEI]) locations from the Brazilian Ministry of Health and estimated national mobility routes by using the Ford-Fulkerson algorithm, incorporating air, road, and water transportation data. To optimize sentinel site selection, we implemented a linear optimization algorithm that maximizes (1) Indigenous region representation and (2) human mobility coverage. We validated our approach by comparing results with Brazil’s current influenza sentinel network and analyzing the health attraction index from the Brazilian Institute of Geography and Statistics to assess the feasibility and potential benefits of our optimized surveillance network.

RESULTS: The current Brazilian network includes 199 municipalities, representing 3.6% (199/5570) of the country’s cities. The optimized sentinel site design, while keeping the same number of municipalities, ensures 100% coverage of all 34 DSEI regions while rearranging 108 (54.3%) of the 199 cities from the existing flu sentinel system. This would result in a more representative sentinel network, addressing gaps in 9 of 34 previously uncovered DSEI regions, which span 750,515 km² and have a population of 1.11 million. Mobility coverage would improve by 16.8 percentage points, from 52.4% (4,598,416 paths out of 8,780,046 total paths) to 69.2% (6,078,747 paths out of 8,780,046 total paths). Additionally, all newly selected cities serve as hubs for medium- or high-complexity health care, ensuring feasibility for pathogen surveillance.

CONCLUSIONS: The proposed framework optimizes sentinel site allocation to enhance disease surveillance and early detection. By maximizing DSEI coverage and integrating human mobility patterns, this approach provides a more effective and equitable surveillance network, which would particularly benefit underserved Indigenous regions.

PMID:40168644 | DOI:10.2196/69048

J Phys Chem A. 2025 Apr 1. doi: 10.1021/acs.jpca.4c08371. Online ahead of print.

ABSTRACT

Accurate modeling of complex physical systems often requires accounting for many-body interactions. Traditional statistical physics methods, such as Monte Carlo, transfer matrix, cluster approximations, and others, face significant computational challenges. This study introduces a unified tensor algorithm that efficiently incorporates interactions up to the third nearest neighbor. We applied our algorithm to a system of 1,3,5-tris(4-pyridyl)benzene and copper on Au(111). Many-body interactions were considered in two ways: by expressing them through pairwise interactions and by explicitly considering DFT energies for each many-body configuration. This led to both quantitative and qualitative differences in the results. The most significant difference is the lower thermal stability of the “superflower” phase and its subsequent replacement by a disordered structure with higher density. The developed unified tensor algorithm opens up new possibilities for the accurate modeling of complex systems taking into account many-body interactions.

PMID:40168638 | DOI:10.1021/acs.jpca.4c08371

Chaos. 2025 Apr 1;35(4):043102. doi: 10.1063/5.0249690.

ABSTRACT

Multi-state quantum molecular dynamics is one of the most accurate methodologies for predicting rates and yields of different chemical reactions. However, the generation of potential energy surfaces (PES), transition dipoles, and non-adiabatic couplings from ab initio calculations become a challenge, especially because of the exponential growth of computational cost as the number of electrons and molecular modes increases. Thus, machine learning (ML) emerges as a novel technique to compute molecular properties using fewer resources. Yet, the validity of ML methodologies continues in constant development, particularly for high-energy regions where conventional ab initio sampling is reduced. We test the accuracy of the potential energy surfaces interpolated with machine learning (ML) techniques in the solution of the time-dependent Schrödinger equation for the conventional IR+UV bond-breaking process of semi-heavy water. We perform a statistical analysis of the differences in expectation values and dissociation probabilities, which depend on the number of ab initio points selected to generate the machine learning potential energy surface (ML-PES). The energy differences of the electronic excited state modify population transfer from the ground state by driving with a UV laser pulse. We consider as the exact solution the photodynamics implemented with analytical expressions of the electronic ground X~1A1 and excited A~1B1 states. The results of the mean bond distance and dissociation probabilities suggest that ML-PES is suitable for dynamics calculations around the Franck-Condon region, and that standard interpolation methods are more efficient for multistate dynamics that involve dissociative and repulsive energy regions of the electronic states. Our work contributes to the continued inclusion of ML tools in molecular dynamics to obtain accurate predictions of dissociation yields with fewer computational resources and non-written rules to follow in multi-state dynamics calculations.

PMID:40168612 | DOI:10.1063/5.0249690

Chaos. 2025 Apr 1;35(4):043106. doi: 10.1063/5.0233640.

ABSTRACT

In neuroscience, delayed synaptic activity plays a pivotal and pervasive role in influencing synchronization, oscillation, and information-processing properties of neural networks. In small rhythm-generating networks, such as central pattern generators (CPGs), time-delays may regulate and determine the stability and variability of rhythmic activity, enabling organisms to adapt to environmental changes, and coordinate diverse locomotion patterns in both function and dysfunction. Here, we examine the dynamics of a three-cell CPG model in which time-delays are introduced into reciprocally inhibitory synapses between constituent neurons. We employ computational analysis to investigate the multiplicity and robustness of various rhythms observed in such multi-modal neural networks. Our approach involves deriving exhaustive two-dimensional Poincaré return maps for phase-lags between constituent neurons, where stable fixed points and invariant curves correspond to various phase-locked and phase-slipping/jitter rhythms. These rhythms emerge and disappear through various local (saddle-node, torus) and non-local (homoclinic) bifurcations, highlighting the multi-functionality (modality) observed in such small neural networks with fast inhibitory synapses.

PMID:40168609 | DOI:10.1063/5.0233640

Ocul Immunol Inflamm. 2025 Apr 1:1-6. doi: 10.1080/09273948.2025.2487164. Online ahead of print.

ABSTRACT

PURPOSE: Adalimumab (ADA) is the only biologic agent approved for treating non-infectious uveitis (NIU). Anti-drug antibodies (AAA) may be an essential factor associated with treatment failure. We conducted a study to determine the clinical response to ADA treatment in patients with NIU. We also aimed to determine AAA’s frequency and clinical importance in these patients.

METHODS: This cross-sectional study included 60 NIU patients who used ADA therapy every other week or weekly for at least three months. The clinical findings recorded before starting ADA and on the day included in the study were compared. Serum AAA formation was evaluated. AAA-positive and AAA-negative patients were compared in terms of etiology, duration, and localization of uveitis, duration of ADA treatment, and additional IMT.

RESULTS: The increase in visual acuity, decrease in central macular thickness, improvement in the number of attacks/year, and decrease in need for CS were statistically significant with ADA treatment. AAA was positive in 15 (25%) patients. The improvement in median visual acuity, CMT, and number of attacks/year was statistically significant in both ADA-positive and negative patients. The effect of disease etiology, disease duration, uveitis localization, ADA treatment duration, and additional IMT use on serum AAA formation could not be demonstrated.

CONCLUSION: ADA is mostly associated with favorable clinical response in treating NIU. In insufficient clinical response, the dose escalation method may increase treatment success. AAA formation may not be the only factor in the ineffectiveness of treatment.

PMID:40168605 | DOI:10.1080/09273948.2025.2487164

NCHS Data Brief. 2025 Mar;(525).

ABSTRACT

OBJECTIVES: This report examines trends in neonatal intensive care unit (NICU) admission in the United States overall and by maternal age, race and Hispanic origin, gestational age and birthweight of the newborn, and state of residence of the mother from 2016 to 2023.

METHODS: Data are from the National Vital Statistics System birth files. The percentage of total NICU admissions in the United States from 2016 to 2023 are presented. Also presented are percentages of NICU admissions by maternal age, race and Hispanic origin, gestational age and birthweight of the newborn, and state of residence of the mother from 2016 to 2023.

KEY FINDINGS: The percentage of infants admitted to a neonatal intensive care unit (NICU) in the United States rose 13% from 2016 to 2023, from 8.7% to 9.8%. Increases from 2016 to 2023 were seen for all maternal age, race and Hispanic origin groups, gestational age and birthweight categories and in 40 states.

PMID:40168594

Pain Physician. 2025 Mar;28(2):E183-E189.

ABSTRACT

BACKGROUND: Lumbar epidural steroid injections (ESIs) are commonly used to alleviate pain associated with lumbar disorders. However, administering steroids to patients with osteoporosis may lead to a decline in bone mineral density (BMD) and increase fracture risk. While various steroids are utilized in ESIs, limited research exists on their effect on BMD.

OBJECTIVES: This study aimed to analyze the effect of dexamethasone-based ESI therapy on osteoporosis in patients receiving or not receiving denosumab, utilizing real-world clinical data.

STUDY DESIGN: Retrospective analysis.

SETTING: A university hospital orthopedic department.

METHODS: A retrospective review was conducted, incorporating patients who underwent denosumab therapy alongside ESIs for pain alleviation from January 2018 through April 2022. Eligibility criteria included patients with a minimum follow-up period of 12 months. Forty patients who had received an ESI and denosumab treatment were enrolled in Group One. Similarly, 35 patients who had only received an ESI (Group 2) and 33 patients who underwent denosumab treatment alone (Group 3) were enrolled and analyzed. Statistical analysis was performed using analysis of variance (ANOVA) to compare patient age, gender, lumbar and hip BMD, difference in lumbar and hip BMD at postinjection one year, serum vitamin D, calcium, phosphorus levels, and one-year cumulative steroid dosage.

RESULTS: In terms of patient demographics, the mean age of Group One was 71.73 (± 9.59) years, Group 2 was 70.00 (± 9.82) years, and Group 3 was 71.18 (± 5.64) years. The ANOVA analysis revealed no significant differences among groups. The BMD analysis showed that the lumbar BMD in Group One was 0.811 g/cm2, Group 2 was 0.831 g/cm2, and Group 3 was 0.822 g/cm2. Hip BMD in Group One was 0.696 g/cm2, Group 2 was 0.711 g/cm2, and Group 3 was 0.668 g/cm2. The change in BMD values showed that in Group One, lumbar BMD increased by 0.0411 g/cm2 compared to baseline, a 5.06% increase, while hip BMD increased by 0.0047 g/cm2, a 0.68% increase. In Group 2, lumbar BMD decreased by -0.0307 g/cm2, a 3.7% decrease, and hip BMD decreased by -0.036 g/cm2, a 5.02% decrease. In Group 3, lumbar BMD increased by 0.056 g/cm2, a 6.77% increase, while hip BMD increased by 0.005 g/cm2, a 0.69% increase.

LIMITATIONS: The number of patients recruited was relatively small and limited to specific age groups. Study design was retrospective.

CONCLUSION: Lumbar ESIs with dexamethasone reduce BMD in elderly patients with osteoporosis. However, when denosumab is administered alongside dexamethasone-based ESIs, the steroid does not significantly affect the decline of BMD.

PMID:40168571

Pain Physician. 2025 Mar;28(2):E157-E164.

ABSTRACT

BACKGROUND: Despite the availability of clinical practice guidelines, suboptimal adherence among general practitioners (GPs) in pain management remains a concern. The French Pain Society issued revised guidelines for pain management in 2020.

OBJECTIVES: This study aimed to evaluate the current adherence of French doctors to the updated guidelines for pain management.

STUDY DESIGN: A non-interventional, cross-sectional study.

SETTING: A panel of doctors from France, participated in an online questionnaire.

METHODS: Two selected vignettes describing patients with chronic neuropathic pain (central and peripheral) were completed. The ability to correctly prescribe appropriate first- and second-line treatments according to the 2020 French Pain Society guidelines was assessed.

RESULTS: A total of 191 physicians were recruited from a database of 3,380, representing a response rate of 5.7%. Of the participants, 182 (95.3%) completed the survey correctly and were included in the final analysis. Among those participants, 64% were general practitioners (GPs). Adherence to the guidelines for the management of l ocalized peripheral neuropathic pain was reported by 15.38% of participants, while 21% reported adherence for central neuropathic pain. A significant disparity was observed in the prescription of medications, with pregabalin being prescribed by 32.9% of participants and gabapentin by 22.5% for localized neuropathic pain. For central neuropathic pain, pregabalin use was reported by 30.7% of respondents and gabapentin by 26.3%. Following the failure of a second-line therapy, 66% of participants considered reorientation to be a viable treatment option for localized peripheral neuropathic pain, compared to 45% for central neuropathic pain.

LIMITATIONS: The number of participants is one of the main limitations in this study.

CONCLUSIONS: Despite the participants’ low adherence to guidelines, substantial variation in medication use, and limited support for reorientation after failed treatment, this study offers insight into management practices for neuropathic pain among French GPs in Burgundy.

PMID:40168568