Tag: pubmed

Ann Med. 2025 Dec;57(1):2496798. doi: 10.1080/07853890.2025.2496798. Epub 2025 Apr 28.

ABSTRACT

BACKGROUND: Psychomotor impairments due to alcohol consumption may lead to a series of negative consequences. However, the influence of sex and ALDH2 polymorphism on psychomotor dysfunction has not yet been investigated.

METHODS: One-hundred and three participants, genotyped for ALDH2 rs671, were administered a dose of 1.0 g/kg of white spirits. The blood ethanol concentration (BEC) and acetaldehyde concentration (BAAC) were measured at specific time intervals before and after alcohol consumption. Additionally, auditory simple reaction time (ASRT), visual choice reaction time (VCRT), pursuit tracking task (PTT) and digit-symbol substitution test (DSST) were used to evaluate psychomotor function. Linear mixed-effects model was used to analyze the effects of sex and the ALDH2 genotype on alcohol metabolism and psychomotor function..

RESULTS: Acetaldehyde metabolism depended on both ALDH2 genotype and sex. Women with ALDH2*1/*1 genotype exhibited 2.21 to 18.27 µmol/L higher BAAC levels than men with the same genotype. Conversely, among participants with ALDH2*1/*2 genotype, BAAC levels of women were 0.25 to 31.32 µmol/L lower than men. The impact of ALDH2 genotype on psychomotor function varied across the four tests. VCRT increased significantly in men with ALDH2*1/*2 genotype compared to those with ALDH2*1/*1 at 2-4 h post-consumption. In the PTT test, the percentage of time on target decreased by 3.83% and 3.11% in women relative to men at 1 and 2 h post-consumption, respectively. Notably, ASRT performance was significantly correlated with BAAC levels. No effects of ALDH2 genotype and sex were observed on DSST performance.

CONCLUSIONS: ALDH2 genotype and sex independently or interactively contribute to alcohol-related psychomotor impairment.

PMID:40289679 | DOI:10.1080/07853890.2025.2496798

Addiction. 2025 Apr 28. doi: 10.1111/add.70080. Online ahead of print.

ABSTRACT

AIMS: We measured the effects of public health-oriented cannabis access compared with the illegal market on cannabis use and related mental health outcomes in adult cannabis users.

DESIGN: This was a two-arm, parallel group, open-label, randomized controlled trial. Follow-up outcome measurement took place after 6 months.

SETTING: The study was conducted in Basel-Stadt, Switzerland.

PARTICIPANTS: A total of 378 adult (aged ≥18 years) cannabis users were enrolled and randomized between August 2022 and March 2023, although only 374 users who completed baseline measures could be included.

INTERVENTION AND COMPARATOR: Participants were randomly assigned to the intervention group with public health-oriented recreational cannabis access in pharmacies (regulated cannabis products, safer use information, voluntary counseling, no advertisement; 189/188) or the illegal market control group (continued illicit cannabis sourcing; 189/186).

MEASUREMENTS: The primary outcome was self-reported severity of cannabis misuse after 6 months, as measured by the Cannabis Use Disorders Identification Test – Revised (range 0-32). Secondary outcomes involved depressive, anxiety, and psychotic symptoms, cannabis consumption amount, alcohol, and drug use.

FINDINGS: Ten participants were not followed (2.7%). Primary analysis included those with complete data (182 vs. 182). There was some evidence of a difference in cannabis misuse between the legal cannabis intervention group (mean [M] = 10.1) and the illegal market control group (M = 10.9; β = -0.69, 95% confidence interval [CI] = -1.4 to 0.0, P = 0.052). These results were supported by an intention-to-treat multiple imputation analysis (n = 374). Additional sub-group analysis by whether the participant used other drugs or not suggested that any reduction in cannabis misuse was confined to those in the legal cannabis intervention group who used other drugs (P_Interaction < 0.001). We found no statistically significant changes in any of the secondary outcomes.

CONCLUSIONS: Public health-oriented recreational cannabis access may decrease cannabis use and cannabis-related harms, especially among those using other drugs.

PMID:40289676 | DOI:10.1111/add.70080

Twin Res Hum Genet. 2025 Apr 28:1-8. doi: 10.1017/thg.2025.15. Online ahead of print.

ABSTRACT

Incorporating genetic data from diverse populations is crucial for understanding genetic contributions to diseases and ensuring health equity in healthcare practices. However, existing reference panels either capture a limited number of populations or have small sample sizes. We examine the UK Biobank’s performance as a reference for clustering genetically similar individuals. Leveraging data from participants of diverse origins, we aim to improve population representation and mitigate bias caused by the limited number of populations in other reference panels. We combined countries of birth and ethnic backgrounds data fields from the UK Biobank and genetic information to infer genetically similar population labels. A random forest model was then trained on genetic principal components to identify each individual’s most genetically similar population. The model’s performance was validated using the 1000 Genomes and the CARTaGENE biobank data. We identified more diverse reference populations than present in datasets such as 1000 Genomes, covering 19 populations worldwide. Our model achieved medium to high precision and recall for most labeled populations, although lower rates were observed in closely related groups. For instance, we identified 519 people in CARTaGENE most genetically similar to the Middle Eastern reference sample derived in the UK Biobank (there are no Middle Eastern samples in 1000 Genomes), yielding an 81.1% precision and a 97.0% recall rate compared to demographic-based information. This practical approach of clustering genetically similar individuals utilizing existing biobank data may facilitate downstream analyses, such as genomewide association studies or polygenic risk scores in underrepresented populations in genetic studies.

PMID:40289653 | DOI:10.1017/thg.2025.15

Psychol Med. 2025 Apr 28;55:e119. doi: 10.1017/S0033291725000947.

ABSTRACT

BACKGROUND: This study examines the prospective associations of alcohol and drug misuse with suicidal behaviors among service members who have left active duty. We also evaluate potential moderating effects of other risk factors and whether substance misuse signals increased risk of transitioning from thinking about to attempting suicide.

METHOD: US Army veterans and deactivated reservists (N = 6,811) completed surveys in 2016-2018 (T1) and 2018-2019 (T2). Weights-adjusted logistic regression was used to estimate the associations of binge drinking, smoking/vaping, cannabis use, prescription drug abuse, illicit drug use, alcohol use disorder (AUD), and drug use disorder (DUD) at T1 with suicide ideation, plan, and attempt at T2. Interaction models tested for moderation of these associations by sex, depression, and recency of separation/deactivation. Suicide attempt models were also fit in the subgroup with ideation at T1 (n = 1,527).

RESULTS: In models controlling for socio-demographic characteristics and prior suicidality, binge drinking, cannabis use, prescription drug abuse, illicit drug use, and AUD were associated with subsequent suicidal ideation (AORs = 1.42-2.60, ps < .01). Binge drinking, AUD, and DUD were associated with subsequent suicide plan (AORs = 1.23-1.95, ps < .05). None of the substance use variables had a main effect on suicide attempt; however, interaction models suggested certain types of drug use predicted attempts among those without depression. Additionally, the effects of smoking/vaping and AUD differed by sex. Substance misuse did not predict the transition from ideation to attempt.

CONCLUSIONS: Alcohol and drug misuse are associated with subsequent suicidal behaviors in this population. Awareness of differences across sex and depression status may inform suicide risk assessment.

PMID:40289652 | DOI:10.1017/S0033291725000947

Psychol Med. 2025 Apr 28;55:e122. doi: 10.1017/S003329172500090X.

ABSTRACT

BACKGROUND: Individuals with long-term physical health conditions (LTCs) experience higher rates of depression and anxiety. Conventional self-report measures do not distinguish distress related to LTCs from primary mental health disorders. This difference is important as treatment protocols differ. We developed a transdiagnostic self-report measure of illness-related distress, applicable across LTCs.

METHODS: The new Illness-Related Distress (IRD) scale was developed through thematic coding of interviews, systematic literature search, think-aloud interviews with patients and healthcare providers, and expert-consensus meetings. An internet sample (n = 1,398) of UK-based individuals with LTCs completed the IRD scale for psychometric analysis. We randomly split the sample (1:1) to conduct: (1) an exploratory factor analysis (EFA; n = 698) for item reduction, and (2) iterative confirmatory factor analysis (CFA; n = 700) and exploratory structural equation modeling (ESEM). Here, further item reduction took place to generate a final version. Measurement invariance, internal consistency, convergent, test-retest reliability, and clinical cut-points were assessed.

RESULTS: EFA suggested a 2-factor structure for the IRD scale, subsequently confirmed by iteratively comparing unidimensional, lower order, and bifactor CFAs and ESEMs. A lower-order correlated 2-factor CFA model (two 7-item subscales: intrapersonal distress and interpersonal distress) was favored and was structurally invariant for gender. Subscales demonstrated excellent internal consistency, very good test-retest reliability, and good convergent validity. Clinical cut points were identified (intrapersonal = 15, interpersonal = 12).

CONCLUSION: The IRD scale is the first measure that captures transdiagnostic distress. It may aid assessment within clinical practice and research related to psychological adjustment and distress in LTCs.

PMID:40289643 | DOI:10.1017/S003329172500090X

Int J Low Extrem Wounds. 2025 Apr 28:15347346251337264. doi: 10.1177/15347346251337264. Online ahead of print.

ABSTRACT

The current study aimed to evaluate the clinical outcomes of patients admitted for diabetic foot ulcers (DFUs) located in the heel. The study is a retrospective observational study including a population of patients admitted for DFUs from April 2024 to September 2024. According to the wound location, patients were divided in two groups: those with heel ulcers and those with forefoot/midfoot ulcers without calcaneal involvement. All patients have been managed through a limb salvage protocol in the respect of international guidelines. The following hospital outcomes were evaluated: minor and major amputation, mortality, length of stay, need for regenerative surgery by using dermal-epidermal graft. Overall, 150 patients were included. The mean age was 70.2 ± 12.2 years, most patients were male (76.0%), had type 2 diabetes (92.7%) with a mean duration of 22.1±13.2 years; 27 (18%) patients had heel ulcers, while 123 (82%) had forefoot/midfoot lesions. Outcomes for patients with heel location and without were: minor amputation (18.5 vs 32.5%, p = 0.1), major amputation (7.4 vs 0.8%, p = 0.02), mortality (0 vs 0.8%, p = 0.5), length of hospital stay (17.5 ± 8.5 vs 14.4 ± 8.7 days, p = 0.08), need for regenerative therapy using dermal-epidermal substitutes (48.1 vs 19.5%, p = 0.003) respectively. In addition, heel ulcer was found to be an independent predictor for major amputation [OR 5.06, CI95% (3.1-11.4), p = 0.02] and length of stay [OR 6 CI95% (3.6-10.9), p = 0.003]. In patients admitted for DFUs, wounds located in the heel were associated to an increased risk of major amputation, need for regenerative therapy and length of stay (even though in the limit of statistical difference) than wounds not located in the heel. These data underline the need for tailored management strategies in this high-risk subgroup of patients.

PMID:40289631 | DOI:10.1177/15347346251337264

Stat Methods Med Res. 2025 Apr 28:9622802251314195. doi: 10.1177/09622802251314195. Online ahead of print.

ABSTRACT

Clinical trials often face the challenge of post-randomization events, such as the initiation of rescue therapy or the premature discontinuation of randomized treatment. Such events, called “intercurrent events” (ICEs) in ICH E9(R1), may influence the estimation and interpretation of treatment effects. According to ICH E9(R1), there are five strategies for handling ICEs. This study focuses on the composite strategy, which incorporates ICEs in the outcome of interest and defines the treatment effects using composite endpoints that combine the measured continuous variables and ICEs. An advantage of this strategy is that it avoids the occurrence of missing data because they are defined as part of the outcome of interest. In this study, we propose a new composite estimand: the difference in the partial areas under the curves (pAUCs) of the cumulative distribution function. While the pAUC is closely related to the trimmed mean approach proposed by Permutt and Li, it offers the advantage of allowing pre-specification of the cutoff value for a “good” response based on clinical considerations. This ensures that the pAUC can be calculated irrespective of the proportion of ICEs. We describe the causal interpretation of our method and its relationship with two other strategies (treatment policy and hypothetical strategies) using a potential outcome framework. We present simulation results in which our method performs reasonably well compared to several existing approaches in terms of type I error, power, and the proportion of undefined test statistics.

PMID:40289630 | DOI:10.1177/09622802251314195

Work. 2025 Apr 28:10519815251331802. doi: 10.1177/10519815251331802. Online ahead of print.

ABSTRACT

BackgroundDuring the COVID-19 pandemic, healthcare workers were exposed to intense stress in the emergency departments and sudden changes in their daily lives.ObjectiveThe study aimed to investigate the impact of the pandemic on performance and participation in the activities of daily living, personal lives, and overall well-being of the healthcare workers in an emergency department.MethodsSeventy-eight people working in an emergency department of a university hospital (100% of those eligible) participated in the study during June-July 2022. A self-report survey, cross-sectional design was used to collect data. Participants completed the Perceived Stress Scale-10 (PSS) and the Canadian Occupational Performance Measure (COPM). Independent sample t-tests, Pearson correlation, and multiple regression analysis were used for statistical analysis.ResultsThere was a significant negative correlation between PSS and COPM Performance (r = -0.524) as well as between PSS and COPM Satisfaction (r = -0.508), indicating that higher levels of stress were associated with lower performance and satisfaction. In addition, work-related factors, including working experience, daily working hours, and time available for rest at work, were significantly associated with PSS, COPM Performance, and Satisfaction (p < 0.05). The strongest multivariate associations (p = 0.001) were found between lacking time to rest at work and PSS (direct) and COPM Performance and Satisfaction (inverse).ConclusionThe stress experienced by emergency healthcare workers during COVID-19 negatively impacted their performance, daily activities, personal lives, and well-being. A potential implication is that policy-makers addressing work-related factors and implementing regulations could improve the well-being of these workers in their professional practices.

PMID:40289629 | DOI:10.1177/10519815251331802

Br J Clin Pharmacol. 2025 Apr 27. doi: 10.1002/bcp.70066. Online ahead of print.

ABSTRACT

AIMS: Prescribing pharmaceuticals is essential to improve health, but it also has substantial environmental impact. This study investigated the extent to which Swedish general practitioners (GPs) are willing to integrate environmental aspects into treatment decisions and their opinions on policies to reduce pharmaceutical pollution.

METHODS: A questionnaire assessing environmental considerations in prescribing was developed and distributed to 1233 Swedish GPs and physicians in training (response rate: 22%) between September 2023 and June 2024. It included 3 patient cases to assess trade-offs between therapeutic effect and environmental impact of pharmaceuticals used for pain management, blood pressure reduction, and contraception. Questions about attitudes to policies to reduce the environmental impact of pharmaceuticals were also included. Data were analysed using descriptive and inferential statistics.

RESULTS: Most respondents were willing to prescribe a less effective pharmaceutical if it was environmentally preferable, 77% for pain management and blood pressure reduction, and 50% for contraception. Environmental impact was ranked as the least important factor in prescribing decisions when compared to cost, regional treatment guidelines, dosage intervals, and user-friendliness. A total of 68% of respondents agreed that physicians should consider environmental aspects when prescribing, however only a few often searched for environmental information when prescribing. Policies directed towards other stakeholders, such as authorities and the pharmaceutical industry, received substantial support.

CONCLUSION: Swedish GPs are willing to consider environmental factors when prescribing. However, other factors are more often considered and GPs attribute higher responsibility to other actors. Improving access to environmental information about pharmaceuticals could support greener prescribing.

PMID:40289270 | DOI:10.1002/bcp.70066

Br J Clin Pharmacol. 2025 Apr 27. doi: 10.1002/bcp.70068. Online ahead of print.

ABSTRACT

AIMS: Clinical trials have shown an increased risk of death in patients with recent myocardial infarction who received antiarrhythmic drugs such as flecainide, encainide or moricizine, especially in the presence of associated structural heart disease such as cardiac dysfunction. This study aimed to evaluate the safety outcomes of propafenone use in atrial fibrillation patients with heart failure when compared to those of amiodarone use.

METHODS: This population-based cohort study used the National Health Insurance Research Database in Taiwan. Eligible patients were those who had atrial fibrillation or atrial flutter diagnosis, had heart failure diagnosis, and first received propafenone or amiodarone between 2002 and 2018. The primary endpoints were death due to arrhythmia and the composite proarrhythmic outcome, which consisted of sudden cardiac arrest, arrhythmic death, ventricular arrhythmia and implantation of defibrillator.

RESULTS: After propensity score matching, the study cohort consisted of 7235 propafenone and 14 470 amiodarone users. Compared to amiodarone, propafenone was associated with significantly lower risk of the composite proarrhythmic outcome (adjusted hazard ratio: 0.52; 95% confidence interval: 0.42-0.64; P < .001). Propafenone users also had lower risk of death owing to arrhythmia compared to amiodarone users (adjusted hazard ratio: 0.22; 95% confidence interval: 0.08-0.65; P = .006). Subgroup analysis and sensitivity analysis showed similar trends, favouring propafenone.

CONCLUSION: Propafenone was not significantly associated with increased risk of proarrhythmia and mortality when compared to amiodarone in atrial fibrillation patients with heart failure in contemporary real-world settings. Prospective studies are needed to determine whether propafenone should definitely be avoided in these patients.

PMID:40289259 | DOI:10.1002/bcp.70068