Tag: pubmed

Zhonghua Yu Fang Yi Xue Za Zhi. 2025 Mar 6;59(3):277-285. doi: 10.3760/cma.j.cn112150-20240802-00618.

ABSTRACT

Objective: To investigate the multimorbidity of myopia and obesity, as well as myopia and malnutrition, among children and adolescents aged 7-18 in Guangdong Province and analyze their epidemiological characteristics and related factors. Methods: A stratified random cluster sampling method was used to select 274 939 children and adolescents aged 7-18 from 21 cities in Guangdong Province in 2023. Physical examination information such as height, weight, distance vision, and diopter, as well as questionnaire survey information on dietary behavior, physical activity, screen behavior, sleep time, etc., were collected to analyze the current status and trends of multimorbidity between myopia and obesity, myopia and malnutrition. The multivariate logistic regression model was used to analyze the related factors of multimorbidity. Results: The multimorbidity rates of myopia and obesity, myopia and malnutrition in children and adolescents aged 7-18 in Guangdong Province in 2023 were 4.43% and 6.40%, respectively. The multimorbidity rates for males were 5.44% and 6.88%, respectively, which were higher than those for females, about 3.31% and 5.88% (both P<0.001). The multimorbidity rates of urban students were 5.03% and 6.73%, respectively, which were higher than those of county students at 4.03% and 6.18% (both P<0.001). The multimorbidity rates of myopia and obesity, myopia and malnutrition increased with the increase of academic stage (all P<0.001). The multimorbidity rates of myopia and obesity, as well as myopia and malnutrition, fluctuated with age, with the first decrease occurring at the age of 12. The multivariate logistic regression analysis showed that compared to children and adolescents aged 7-18 who had daily after-school tutoring <2 hours, daily screen time <2 hours, did not consume sugary drinks every day, sleep time that could meet health requirements daily, and exercised≥60 minutes of moderate-to vigorous-physical activity ≥60 minutes for at least 3 days per week, those who had daily after-school tutoring ≥2 hours (OR=1.18, 95%CI: 1.11-1.26), daily screen time ≥2 hours (OR=1.09, 95%CI: 1.02-1.16), consumed sugary drinks every day (OR=1.20, 95%CI: 1.11-1.30), daily sleep time that could not meet the health requirements (OR=1.16, 95%CI: 1.09-1.23), and no exercise per week (OR=1.09, 95%CI: 1.01-1.18) had a higher risk of multimorbidity of myopia and obesity. Compared to children and adolescents who exercised≥60 minutes of moderate-to vigorous-physical activity ≥60 minutes for at least 3 days per week, those who exercised <3 days per week (OR=1.20, 95%CI: 1.17-1.34) had a higher risk of multimorbidity of myopia and malnutrition. Conclusion: The multimorbidity rates of myopia and obesity, as well as myopia and malnutrition, in children and adolescents aged 7-18 in Guangdong Province are relatively low and fluctuate with age. Physical activity, screen time, consumption of sugary drinks, and sleep time may be associated with these multimorbidities.

PMID:40107777 | DOI:10.3760/cma.j.cn112150-20240802-00618

Korean J Pain. 2025 Mar 20. doi: 10.3344/kjp.24343. Online ahead of print.

ABSTRACT

BACKGROUND: This study compared the quality and duration of analgesia between the superior trunk (ST) and the clavipectoral fascial plane (CFP) blocks in conjunction with a selective supraclavicular nerve (SCN) block for clavicular surgeries.

METHODS: Fifty patients undergoing mid-third clavicular procedures were randomly assigned to the ST group (received an SCN block followed by blockage of the ST of the brachial plexus) and the CFP group (received an SCN block followed by the CFP block). The primary outcome was the time until the first rescue analgesia. Secondary outcomes included total nalbuphine dosage and numerical rating scale (NRS) scores within the first 24 hours, the onset of sensory block, as well as deltoid and biceps muscle function using the modified Bromage score (MBS), diaphragmatic excursion, along with satisfaction levels.

RESULTS: The ST group exhibited a more prolonged duration until the first request for rescue analgesia compared to the CFP group (18.76 ± 0.89 hours vs. 15.34 ± 1.38 hours), with a mean difference of 3.42 hours (95% confidence interval: 2.76 to 4.08, P < 0.001). The ST group consumed less nalbuphine and reported lower NRS scores at 6, 8, 12, 16, and 24 hours than the CFP group. Additionally, the ST group exhibited a lower MBS and diaphragmatic excursion than the CFP group. However, the differences in the onset of sensory block and satisfaction levels were not statistically significant.

CONCLUSIONS: The ST group demonstrated superior outcomes in pain control with less favorable outcomes concerning diaphragmatic excursion and upper limb motor function.

PMID:40107773 | DOI:10.3344/kjp.24343

Genome Res. 2025 Mar 19. doi: 10.1101/gr.279281.124. Online ahead of print.

ABSTRACT

In cancer, genetic and transcriptomic variations generate clonal heterogeneity, leading to treatment resistance. Long-read single-cell RNA sequencing (LR scRNA-seq) has the potential to detect genetic and transcriptomic variations simultaneously. Here, we present LongSom, a computational workflow leveraging high-quality LR scRNA-seq data to call de novo somatic single-nucleotide variants (SNVs), including in mitochondria (mtSNVs), copy number alterations (CNAs), and gene fusions, to reconstruct the tumor clonal heterogeneity. Before somatic variant calling, LongSom reannotates marker gene-based cell types using cell mutational profiles. LongSom distinguishes somatic SNVs from noise and germline polymorphisms by applying an extensive set of hard filters and statistical tests. Applying LongSom to human ovarian cancer samples, we detected clinically relevant somatic SNVs that were validated against matched DNA samples. Leveraging somatic SNVs and fusions, LongSom found subclones with different predicted treatment outcomes. In summary, LongSom enables de novo variant detection without the need for normal samples, facilitating the study of cancer evolution, clonal heterogeneity, and treatment resistance.

PMID:40107722 | DOI:10.1101/gr.279281.124

Can J Surg. 2025 Mar 19;68(2):E108-E116. doi: 10.1503/cjs.015923. Print 2025 Mar-Apr.

ABSTRACT

BACKGROUND: Strategies to address inequities, bias, and discrimination that disadvantage Canadian physicians from marginalized groups are urgently needed. We describe a multilevel needs assessment of equity, diversity, and inclusion (EDI) in 2 departments of surgery that focused on identifying evidence-based interventions.

METHODS: We invited members of the departments of surgery at the University of Calgary and the University of Saskatchewan to complete the Diversity Engagement Survey (DES), a 22-item instrument designed to understand workplace engagement and inclusion among physicians, with higher scores indicating greater engagement and inclusion. Leaders completed a Leadership EDI Readiness Assessment to understand their own barriers to EDI work and an Organizational EDI Readiness Assessment to understand structures for EDI in their division. Leaders were provided resources and interventions to address the identified gaps in these assessments.

RESULTS: The most common organizational gaps in structures for EDI work in surgical divisions and training programs (n = 34, 37.4%) were in community outreach and measurement and reporting. Surgeons who identified as cisgender men (n = 101) felt more engaged and included than those who identified as cisgender women (n = 43; 3.81 [standard deviation (SD) 0.73] v. 3.51 [SD 0.78]; p = 0.04). White cisgender men (n = 66) had the highest feelings of engagement and inclusion (mean 3.95 [SD 0.62]). Participating surgical sections and training programs were directed to evidence-informed initiatives to improve community outreach and measurement and reporting to address EDI in their settings.

CONCLUSION: Our findings support that gender and racial or ethnic identities influence the workplace experiences of surgeons in Canada. A multilevel approach to EDI work in surgical departments can direct leaders to areas for intervention.

PMID:40107712 | DOI:10.1503/cjs.015923

Can J Surg. 2025 Mar 19;68(2):E97-E107. doi: 10.1503/cjs.014923. Print 2025 Mar-Apr.

ABSTRACT

BACKGROUND: Trauma educational opportunities for general surgery residents in Canada are uncharacterized. We aimed to characterize these opportunities for and identify factors associated with such opportunities.

METHODS: We performed a prospective cross-sectional study characterizing trauma educational opportunities within Canadian trauma programs. Data were collected during 1 summer week and 1 winter week. We summarized educational opportunities by trauma site and season and used multivariable modelling to evaluate factors associated with increased likelihood of procedure opportunities.

RESULTS: Nine academic trauma centres participated. Most consults (93.9%) and trauma team activations (TTAs) (72.3%) were for blunt injuries, and most presentations were during the summer (67.2% TTAs + consults, 69.3% TTAs). Trauma services cared for a median of 14 (interquartile range [IQR] 10-20) inpatients, 4 (IQR 1-6) patients in the intensive care unit, and 0 (IQR 0-2) patients admitted to another service but subsequently followed by a trauma physician (i.e., consulting patients), which varied across hospitals (p < 0.001). Consult, TTA, nonoperative, and operative procedure volumes varied across sites. The most common operative procedures were laparotomies (36.4%), with 1.33 laparotomies per week per site. For nonlaparotomy operations, the maximum volume was 6 over 2 weeks. More operations occurred during summer (74.2%) than winter. Multivariable modelling determined that penetrating mechanisms (odds ratio [OR] 1.87, 95% confidence interval [CI] 1.11-3.15) and TTAs with a trauma surgeon present (OR 2.37, 95% CI 1.59-3.54) were associated with increased likelihood of procedures.

CONCLUSION: Trauma educational opportunities remain heterogeneous across Canada. Higher volumes of patients with trauma were seen during the summer. Penetrating mechanism and TTAs with a trauma surgeon present appear to increase opportunities to perform procedures. Our results can inform general surgery training programs to optimize resident trauma training in Canada.

PMID:40107711 | DOI:10.1503/cjs.014923

Nurs Health Sci. 2025 Mar;27(1):e70081. doi: 10.1111/nhs.70081.

ABSTRACT

The study explored the challenges and needs in diabetes care for people with diabetes and comorbid cognitive impairment from the triangular perspectives of diabetes educators, patients, and family caregivers. The study employed a phenomenological research design with qualitative data collection, involving semi-structured interviews with 8 diabetes educators, 7 patients, and 6 caregivers. The data were gathered from a health education center in a hospital in Taiwan. Thematic analysis was utilized to analyze the qualitative data. Three categories with eight themes emerged. Challenges included “care challenges in compliance”, “limited family involvement”, and “caregiver distress”. Needs were identified as “training for educators on cognitive impairments”, “caregiver education”, and “standard care procedures”. Clinical realities showed “inconsistent awareness” and “lack of consensus on resource referrals among professionals”. Diabetes care for people with cognitive impairment faces challenges including poor compliance and limited family cooperation, requiring better comorbidity training for educators and caregivers, and standardized care procedures for healthcare professionals. Findings can guide future training programs and serve as a resource for caregivers.

PMID:40107710 | DOI:10.1111/nhs.70081

BMJ Open. 2025 Mar 18;15(3):e086150. doi: 10.1136/bmjopen-2024-086150.

ABSTRACT

OBJECTIVES: The aim of this study was to compare the cost-effectiveness of total shoulder arthroplasty (TSA) and hemiarthroplasty (HA) and explore variation by age and gender.

DESIGN: Cost-effectiveness analysis using a lifetime cohort Markov model.

SETTING: National population registry data.

PARTICIPANTS: Model parameters were informed by propensity score-matched comparisons of TSA and HA in patients with osteoarthritis and an intact rotator cuff using data from the National Joint Registry.

INTERVENTIONS: TSA and HA.

PRIMARY OUTCOME MEASURES: Quality-adjusted life years (QALYs) and healthcare costs for age and gender subgroups. A probabilistic sensitivity analysis was performed.

RESULTS: In all subgroups, TSA was more cost-effective, with the probability of being cost-effective about 70% for TSA versus 30% for HA at any willingness-to-pay threshold above £1100 per QALY. TSA was dominant in young patients (≤60 years) with a mean cost saving of £463 in men and £658 in women, and a mean QALY gain of 2 in both men and women. In patients aged 61-75 years, there was a mean cost saving following HA of £395 in men and £181 in women, while QALYs remained superior following TSA with a 1.3 gain in men and 1.4 in women. In the older cohort (> 75 years), the cost difference was highest and the QALY difference was lowest; there was a cost-saving following HA of £905 in men and £966 in women. The mean QALY gain remained larger after TSA: 0.7 in men and 0.9 in women.

CONCLUSION: TSA was more cost-effective than HA in patients with osteoarthritis. QALYs were superior following TSA in all patient groups. Cost differences varied by age and TSA was dominant in young patients.

PMID:40107707 | DOI:10.1136/bmjopen-2024-086150

BMJ Open. 2025 Mar 18;15(3):e082952. doi: 10.1136/bmjopen-2023-082952.

ABSTRACT

OBJECTIVE: This study examines the risk factors associated with non-communicable diseases (NCDs), specifically diabetes mellitus (DM) and hypertension (HTN), among adults in Bangladesh, a lower-middle-income country. Given the rising prevalence of DM and HTN and their significant public health burden, this research aims to identify key socioeconomic, demographic and lifestyle-related determinants to inform targeted interventions.

DESIGN: The study used nationally representative cross-sectional data extracted from the Bangladesh Demographic and Health Survey conducted in 2017-2018.

SETTING: Bangladesh.

PARTICIPANTS: The study included 8013 women and 6691 men aged 18 and older who were eligible for blood pressure and blood glucose measurements.

PRIMARY OUTCOMES: Type 2 DM, HTN.

RESULTS: HTN was significantly associated with higher odds of diabetes (adjusted OR (AOR)=1.28, 95% CI: 1.14 to 1.43), while diabetes was associated with increased odds of HTN (AOR=1.24, 95% CI: 1.11 to 1.39). Individuals aged 40 years and older had 74.8% higher odds of diabetes (AOR=1.748, 95% CI: 1.58 to 1.993) and were 3.21 times more likely to have HTN (AOR=4.208, 95% CI: 3.781 to 4.685). Overweight individuals had 2.15 times higher odds of HTN compared with those with normal weight (AOR=2.154, 95% CI: 1.98 to 2.34). Wealthier individuals also showed significantly higher odds of both DM and HTN.

CONCLUSIONS: This study highlights the strong association between DM and HTN and identifies age, overweight status and higher socioeconomic class as key risk factors. These findings underscore the need for integrated public health strategies targeting NCD prevention and management in Bangladesh. Further research should explore longitudinal trends and the impact of targeted interventions on reducing the burden of NCDs.

PMID:40107706 | DOI:10.1136/bmjopen-2023-082952

JMIR Cancer. 2025 Mar 19;11:e64809. doi: 10.2196/64809.

ABSTRACT

BACKGROUND: Cancer is the second leading cause of death in the United States. Compelling evidence shows screening detects colorectal cancer (CRC) at earlier stages and prevents the development of CRC through the removal of precancerous polyps. The Healthy People 2030 goal for CRC screening is 68.3%, but only 36.5% of Missouri federally qualified health center patients aged 50-75 years are up-to-date on CRC screening. For average risk patients, there are three commonly used screening tests in the United States-two types of stool tests collected at home (fecal immunochemical test [FIT]-immunochemical fecal occult blood test [FOBT] and FIT-DNA, such as Cologuard) and colonoscopies completed at procedural centers.

OBJECTIVE: This study aims to examine variation by month for the three types of CRC testing to evaluate consistent patient care by clinical staff.

METHODS: Data from 31 federally qualified health center clinics in Missouri from 2011 to 2023 were analyzed. A sample of 34,124 unique eligible “average risk” patients defined as persons not having a personal history of CRC or certain types of polyps, family history of CRC, personal history of inflammatory bowel disease, and personal history of receiving radiation to the abdomen or pelvic to treat a previous cancer or confirmed or suspected hereditary CRC syndrome. Another eligibility criterion is that patients need to be seen at least once at the clinic to be included in the denominator for the screening rate calculation. Descriptive statistics characterize the sample, while bivariate analyses assess differences in screening types by month.

RESULTS: Completion of CRC screening yielded statistically significant differences for patients completing the different types of CRC screening by month. October-January had the highest proportions of patients (644-680 per month, 8.5%-10.2%) receiving a colonoscopy, while February-April had the lowest (509-578 per month, 6.9%-7.8%), with 614 being the average monthly number of colonoscopies. For FIT-FOBT, June-August had the higher proportions of patients receiving this test (563-613 per month, 8.9%-9.6%), whereas December-February had the lowest (453-495 per month, 7.1%-8%), with 541 being the average monthly number of FIT-FOBT kits used. For FIT-DNA, March was the most popular month with 11.3% (n=261 per month) of patients using the Cologuard test, followed by April, May, and November (207-220 per month, 8.7%-9.4%), and January and June (168-171 per month, 7.2%-7.3%) had the lowest proportion of patients using Cologuard, with 193 being the average monthly number of FIT-DNA kits used. Combining all tests, February had the fewest CRC tests completed (1153/16,173, 7.1%).

CONCLUSIONS: Home-based tests are becoming popular, replacing the gold standard colonoscopy, but need to be repeated more frequently. Monthly variation of screening over the course of a year suggests that CRC screening efforts and patient care may be less than ideal. Months with lower rates of screening for each type of CRC test represent opportunities for improving CRC screening.

PMID:40106833 | DOI:10.2196/64809

Oral Dis. 2025 Mar 19. doi: 10.1111/odi.15316. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to evaluate the status of periodontitis patients and changes in their quality of life (QoL) after non-surgical and surgical periodontal treatment using OHIP-14, OHRQoL-UK questionnaires, and VAS.

METHODS: Of the 50 periodontitis patients included in the study, 27 received only non-surgical treatment. The remaining 23 individuals received additional surgical treatment because full recovery was not achieved with non-surgical periodontal treatment. OHIP-14, OHRQoL-UK questionnaires, and VAS were administered to these patients before periodontal treatment and after (4th and 12th weeks) to assess QoL measurements.

RESULTS: OHRQoL-UK results found that there was a statistically significant increase in the 3rd month (T2) values after the flap operation compared to the initial session (T0) (p < 0.05). Compared to non-surgical periodontal treatment (T1) with T2, the difference was not statistically significant except in the pain/discomfort category (p > 0.05). Although the results of the OHIP-14 questionnaire at T1 and T2 showed a significant difference compared to T0 values (p < 0.05), no significant difference was found between T1 and T2 (p > 0.05). An increase in some values was observed in VAS results compared to T0, but it was not significant (p > 0.05).

CONCLUSIONS: VAS, OHIP-14, and OHRQoL-UK questionnaires have shown that periodontal treatment improves the QoL of patients with periodontitis.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT06539364.

PMID:40106822 | DOI:10.1111/odi.15316