Tag: pubmed

PLoS One. 2025 Jun 17;20(6):e0310163. doi: 10.1371/journal.pone.0310163. eCollection 2025.

ABSTRACT

BACKGROUND: Dengue is an acute febrile illness that is a significant public health problem. Peru is an endemic region for vector-borne diseases such as dengue, zika, and chikungunya, which initially manifest with febrile illness and can complicate differential diagnosis. Therefore, the present study aimed to determine the prevalence of positive results for dengue or dengue antibodies in Peruvian patients with febrile illness using diagnostic tools such as RT-PCR and ELISA NS1, IgM, and IgG.

METHODS: A literature search was conducted in eight databases or search tools (PubMed, Scopus, Embase, Web of Science, ScienceDirect, Google Scholar, Virtual Health Library, and Scielo) until June 9, 2024. Medical Subject Headings (MeSH) terms such as “dengue” and “Peru” were used, together with the free term “febrile illness”, combined using the Boolean operators AND and OR. We included observational studies with a control group of patients with fever but no dengue infection and a non-control group of febrile patients who tested positive for dengue. Pooled estimates and 95% confidence intervals (CI) were calculated using random-effects models. Study quality and risk of bias were assessed using the Joanna Briggs Institute Statistical Meta-Analysis Assessment and Review Instrument. Heterogeneity was assessed using the I2 statistic, and statistical analysis was performed with R version 4.2.3.

RESULTS: We included 15 observational studies that met the inclusion criteria developed in 10 regions of Peru and published between 2002 and 2022, with a total of 12,355 patients with febrile illness. The pooled prevalence of positive results for dengue or dengue antibodies in these patients was 21% (95% CI: 9%-36%; 2022 participants; 5 studies; I2 = 98%) for IgG ELISA, 16% (95% CI: 11%-21%; 10891 participants; 10 studies; I2 = 97%) for IgM ELISA, 19% (95% CI: 9%-31%; 2086 participants; 5 studies; I2 = 98%) for NS1 ELISA, and 20% (95% CI: 13%-28%; 3107 participants; 9 studies; I2 = 96%) for RNA PCR.

CONCLUSION: Our results suggest a high prevalence of positive results for dengue or dengue antibodies among febrile patients in Peru, which varies depending on the diagnostic method used. Despite this variability, the use of accurate diagnostic methods is essential for the early detection and prevention of serious complications. The findings underline the need to strengthen dengue control strategies, improve diagnostic capacity in health centers, and optimize epidemiological surveillance in high-incidence regions. It is recommended that public health policies focus on these key areas for better management of the disease.

PMID:40526741 | DOI:10.1371/journal.pone.0310163

PLoS One. 2025 Jun 17;20(6):e0326315. doi: 10.1371/journal.pone.0326315. eCollection 2025.

ABSTRACT

Type 2 diabetes (T2D) is considered a significant global health concern. Hemoglobin A1c level (HbA1c) is recognized as the most reliable indicator for its diagnosis. Genetic, family, environmental, and health behaviors are the factors associated with the disease. T2D is linked to substantial economic costs and human suffering, making it a primary concern for health planners, physicians, and those living with the disease. Saudi Arabia currently ranks seventh worldwide in terms of prevalence rate. Despite this high rate, the country lacks focused research on T2D. This study aims to develop hybrid prediction models that integrate the strengths of multiple algorithms to enhance HbA1c prediction accuracy while minimising the number of significant Key Performance Indicators (KPIs). The proposed model can help healthcare practitioners diagnose T2D at an early stage. Analyses were conducted in a case-control study in Saudi Arabia involving cases (patients with HbA1c levels ≥ 6.5) and controls with normal HbA1c levels (< 6.5). Medical records from 3,000 King Abdulaziz University Hospital patients containing demographic, lifestyle, and lipid profile data were used to develop the models. For the first time, we utilized recommended machine learning algorithms to develop hybrid prediction models to reduce the number of significant KPIs while enhancing HbA1c prediction accuracy. The hybrid model combining Random Forest (RF) and Logistic Regression (LR) with only 4 out of 10 KPIs outperformed other models with an accuracy of 0.93, precision of 0.95, recall of 0.90, F-score of 0.92, an AUC of 0.88, and Gini index of 0.76. The significant variables identified by the model through backward elimination are age, body mass index (BMI), triglycerides (TG), and high-density lipoprotein (HDL). The proposed model helps healthcare providers identify patients at risk of T2D by monitoring fewer key predictors of HbA1c levels, enhancing early intervention strategies for managing diabetes in Saudi Arabia.

PMID:40526740 | DOI:10.1371/journal.pone.0326315

J Clin Exp Neuropsychol. 2025 Jun 17:1-18. doi: 10.1080/13803395.2025.2521019. Online ahead of print.

ABSTRACT

OBJECTIVE: Emotional priming is modulated by word concreteness, yet the literature is inconsistent. This study investigates the effects of affect, lexical features, depressive symptoms, and rumination on emotional priming for abstract and concrete words.

METHODS: Eighty-one healthy participants (48 female, age = 24.12 ± 8.56 years) completed a valence categorization task in which they were asked to decide whether a target word, presented for 500 ms following a 65 ms prime, was pleasant, neutral, or unpleasant. Priming effect (PE) was defined as the RT difference between incongruent and congruent conditions for pleasant and unpleasant primes. Linear mixed-effects models were used to assess priming effects and error rates, with fixed effects for prime valence, concreteness, subscales of Positive and Negative Affect Scale, Beck Depression Inventory score, subscales of Rumination Response Scale, semantic relatedness and Levenshtein distance (LD). Model selection was performed using the buildmer algorithm. Post-hoc analyses of interactions and continuous predictor trends across categorical levels were performed using emmeans and emtrends. All statistical analyses were conducted by R 4.4.3.

RESULTS: PEs were stronger for concrete than abstract words, irrespective of prime valence. Positive affect predicted higher error rates for unpleasant targets and enhanced PEs for unpleasant primes, particularly in abstract words. Depressive symptoms were associated with fewer errors for unpleasant targets but did not predict PE. Brooding was associated with larger PEs for abstract words, independent of valence. Lastly, greater semantic relatedness amplified PEs for abstract items, whereas smaller LD both strengthened PEs and increased errors in valence‑incongruent trials.

CONCLUSION: This study highlights the role of emotional and clinical traits in word processing, showing that abstract word priming is driven by the interaction of affect and stimulus value. Future studies examining biases in abstract emotional word processing may guide the development of methods to identify individuals at risk for depression.

PMID:40525403 | DOI:10.1080/13803395.2025.2521019

J Prim Care Community Health. 2025 Jan-Dec;16:21501319251347133. doi: 10.1177/21501319251347133. Epub 2025 Jun 17.

ABSTRACT

BACKGROUND: Chronic Kidney disease (CKD) accounts for approximately 82 billion dollars of Medicare spend. Implementing culturally competent, community-based programs may be a strategy for changing utilization behaviors and lowering cost while maintaining quality in this population.

METHODS: A longitudinal claims based study was carried out from April 2023 to August 2024 in the state of CA to assess the impact of the program on cost, utilization, and quality metrics. A propensity matched approach was leveraged yielding of 203 pairs of CKD Medicare Advantage (MA) enrollees. A comparison of the difference of differences was performed between utilization, and available claims-based quality metrics.

RESULTS: Enrollees in the peer support program, Connect For Life (CFL) generated significantly lower costs of $461 pmpm (95% CI = -1037 to -10 037; P = .016) significantly lower inpatient utilization of 172 per 1000 (95% CI = -10 to -330; P = .037) and significantly higher outpatient utilization of 1212 per 1000 (95% CI = 90 to 2340; P = .035). No differences were found in available quality metrics.

CONCLUSIONS: For CKD MA enrollees in the intervention population, more efficient utilization patterns and lower costs while maintaining quality were observed. The tight propensity match left the study underpowered to detect significant changes for other care settings or individual stages of CKD.

PMID:40525376 | DOI:10.1177/21501319251347133

Clin Ter. 2025 May_Jun;176(3):376-385. doi: 10.7417/CT.2025.5237.

ABSTRACT

AIM: The Italian Society of Urology conducted a comprehensive survey across Italy’s urology specialists to assess the prevalence and integration of robotic surgery in the country’s medical landscape. The survey aimed to examine the diffusion and acceptance of robotic surgical platforms and to ascertain surgeons’ preferences regarding the most frequently performed urological procedures.

MATERIALS AND METHODS: The Italian Society of Urology surveyed Italian urologists via SURVEYMONKEY. Emails were sent to society members and clinic heads, covering geographic location, robotic practices, and procedures. The 44-question survey, open from March to June 2023, gathered data on clinic location, equipment, cases, and techniques. Descriptive statistics were used, reporting median and inter-quartile range for continuous variables, and rates for categorical ones. Analysis included respondent characteristics, robotic surgery availability, applications, and technical modifications. Stata 16 conducted statistical analyses (StataCorp LP, College Station, TX, USA).

RESULTS: The study included 339 urologists with varied institutional and professional backgrounds, investigating aspects like the availability of robotic technology, preferences in procedures, surgical methodologies, and training programs. Participants included 50% affiliated with university hospitals, 25% with non-university hospitals, and 25% with IRCCS institutions and accredited private hospitals. The survey showcased significant geographic diversity, receiving responses from urologists across all regions of Italy, with Lombardy being the most represented (19.7%), followed by Lazio (12.9%) and Veneto (11.2%). Notably, 93.7% of respondents associated robotic surgery with economic benefits, attributing to reduced hospital stays and increased facility attractiveness. Among urological procedures, robotic-assisted techniques were preferred for Radical Prostatectomies (88%), partial nephrectomy (87%), and pyeloplasty (79%), while cystectomies and radical nephrectomy were commonly performed using open or lap-aroscopic approaches.

CONCLUSION: The survey findings highlight the widespread use and influence of robotic surgery in Italian urology, showcasing enhanced patient care but also indicating technique discrepancies and restricted access in certain facilities. Standardization, accessibility, and ongoing training are vital for maximizing robotic surgery’s potential across specialties.

PMID:40525372 | DOI:10.7417/CT.2025.5237

Clin Ter. 2025 May_Jun;176(3):363-370. doi: 10.7417/CT.2025.5235.

ABSTRACT

INTRODUCTION: Workplace safety is continually improving in many developed countries, but, despite this, work-related injuries, including fatal ones, are on the rise. Furthermore, in all cases of serious non-fatal accidents, a high morbidity rate for workers has been documented, burdened by an equally large expense that the State will have to sustain as damage compensation. Often, in case of fatal accidents, it is necessary to reconstruct the dynamics that caused the death, which makes it necessary to analyze all the lesions detectable on corpses. In this perspective, postmortem computed tomography (PMCT) has become essential to increase the speed and diagnostic accuracy, especially in case of lesions affecting the bone structures.

METHODS: A retrospective analysis aimed at evaluating the data collected from judicial autopsies performed between January 2019 and the recent month of March 2023 was carried out, focusing on those related to fatal accidents occurred at work.

RESULTS: According to the inclusion criteria, 18 out of the 204 autopsies carried out during the pre-established time frame were included, as certainly classifiable as “occupational deaths”. Among the 18 enrolled corpses, 16 were male and 2 female subjects. The traumatic events responsible of the death were analysed: 40% were related to falls from heights greater than 2 meters, 28% to explosion, 22% to accidental crush, 5% to electrocution and 5% to semi-truncation.

DISCUSSION AND CONCLUSIONS: Among fatal accidents, those related to falls from great heights and crushing are described as the most common, while among the least common are deaths due to electrocution. With reference to the location of injuries, those involving the head are considered the most fatal, while rib fractures are considered as the most common. In this context, postmortem computed tomography can be very helpful, not only for the two- and three-dimensional reconstruction of fractures, but also for understanding the dynamics with which fatal accidents develop in the workplace. This can both ensure a better assessment of the responsibilities of workers and/or the employer, and lead to the evaluation of the suitability of protective devices, also allowing to make them safer.

PMID:40525370 | DOI:10.7417/CT.2025.5235

Clin Ter. 2025 May_Jun;176(3):336-343. doi: 10.7417/CT.2025.5231.

ABSTRACT

OBJECTIVE: The pervasiveness of social media has led to a growing cause for concern regarding potential adverse effects that may stem from excessive social media usage, particularly in relation to its psychological effects. The authors in this study investigated problematic social media use and it’s predictors among emerging adults in the Indian context.

METHODS: We employed stratified cluster sampling technique in this cross-sectional study to select a sample of 204 students from government and private institutions. The inclusion criteria was specific to emerging adults aged 18 to 22 years. Tools included a proforma on socio-demographic data, the Social Media Disorder Scale and Rosenberg’s Self-Esteem Scale. We examined the prevalence and predictors of problematic social media use from self-reports of emerging adults.

RESULTS: Prevalence of problematic social media use was measured at 7.8%. There was a negative correlation observed (r = -0.270, p<0.0001) between problematic social media use and self-esteem of the participants. Living in low-income households and signing up on a single social media platform were protective while lower age at initially signing up and and having a felt need for followers on social media networks increased the odds of problematic social media use.

CONCLUSION: Problematic social media use is inversely correlated with self-esteem of emerging adults. Characteristics of social media usage such as the age at signing up, the number of platforms signed up on and the need for followers significantly predicted problematic social media usage among emerging adults.

PMID:40525366 | DOI:10.7417/CT.2025.5231

Clin Ter. 2025 May_Jun;173(3):310-316. doi: 10.7417/CT.2025.5227.

ABSTRACT

OBJECTIVES: This study aimed to determine the efficacy of the De Ritis ratio, which is cheaper and easily accessible compared to celiac antibodies, in the diagnosis of celiac disease and in predicting dietary compliance in follow-up.

MATERIAL AND METHODS.: 152 patients over 18 years of age who were diagnosed with celiac disease during a 4-year period in the gastroenterology department of a tertiary care regional hospital and 237 patients without celiac disease as control group were included. Endoscopy and pathology results, laboratory values and pre-diagnostic De Ritis ratios of both groups were compared. Patients with celiac disease were divided into 2 groups as diet-compliant and diet-incompliant. Laboratory values and De Ritis ratios of these 2 groups at diagnosis and at the end of the first year were compared.

RESULTS: There were 152 patients in the celiac group and 237 patients in the control group. AST (p<0.001) and AST/ALT mean value (p<0.001) were higher in the celiac patient group compared to the control group. AST/ALT ratio at the time of diagnosis was similar to the AST/ALT ratio at the end of first year in the diet non-compliant group, but the difference between them was not statistically significant (p=0.945). However, AST/ALT ratio at the end of the first year in diet-compliant celiac patient group was lower than at the time of diagnosis (1.17; 1.02, p<0.001).

CONCLUSION: De Ritis ratio may be a promising inexpensive, simple and easily accessible candidate to help clinicians differentiate Celiac disease and assess disease activity and dietary adherence.

PMID:40525362 | DOI:10.7417/CT.2025.5227

Clin Ter. 2025 May_Jun;176(3):301-309. doi: 10.7417/CT.2025.5226.

ABSTRACT

OBJECTIVE: Pediatric low-grade gliomas (pLGGs) and pediatric high-grade gliomas (pHGGs) reportedly exhibit variations in outcomes and treatment. This study aimed to investigate whether histogram analysis (HA) of diffusion-weighted imaging (DWI) imaging using a manually segmented three-dimensional (3D) volume of interest (VOI), excluding cystic or necrotic portions, could demonstrate a higher correlation with the tumor characteristics than an entire tumor VOI, therefore could improve the preoperative evaluation of supratentorial pediatric gliomas.

MATERIALS AND METHODS: In a current prospective study, 31 pediatric patients with pathologically-confirmed gliomas who underwent baseline DWI were enrolled. The patients were classified by histopathology according to tumoral grade: 15 had pLGGs and 16 had pHGGs. Tumoral VOIs were calculated and transferred to apparent diffusion coefficient (ADC) maps. Histogram analysis (HA) was performed to determine mean, maximum (max), minimum (min), kurtosis, skewness, entropy, standard deviation (SD), mean of positive pixels (MPP), and uniformity of positive pixel (UPP) values for ADC. Comparisons of the values of each ADC parameter within the entire tumoral VOIs (VOI 1) and the tumoral VOIs excluding cystic or necrotic portions (VOI 2) were performed.

RESULTS: In VOI 1 placement, ADCmin and rADCmin were significantly lower in pHGG compared with pLGG with p = 0.004 and 0.002, respectively. In VOI 2 placement, ADCmean, ADCmedian, ADCmin, ADC MPP, rADCmean, rADCmedian, rADCmin and rADC MPP were significantly lower in pHGG compared with pLGG with p < 0.001. The HA parameters and the ratio of HA parameters of peritumoral edema were not statistically significant difference between LGG and HGG groups with p < 0.05. In VOI 1 placement, the ratio of ADCmin had higher diagnostic ability (AUC = 0.838) compared with ADCmin (AUC = 0.800). In VOI 2 placement, ADCmin had highest diagnostic ability with AUC = 0.904. The optimal cut-off for ADCmin was 587×10-6 mm2/s with Se of 93.3%, Sp of 81.2% and Youden index of 0.746. Other parameters such as ADCmean, ADCmedian, ADC MPP, rADCmin, rADC mean, rADCmedian and rADC MPP also showed higher AUC values compared with AUC values in VOI 1 placement.

CONCLUSION: The HA parameters showed value in grading pediatric gliomas. Excluding cystic and necrotic portions from the entire tumor in measuring HA parameters had higher diagnostic value than the entire tumor VOI method. By using this segmentation, ADCmin had the highest performance in the prediction of histological glioma grading, followed by ADCmean, ADCmedian, ADC MPP, rADCmin, rADC mean, rADCmedian and rADC MPP.

PMID:40525361 | DOI:10.7417/CT.2025.5226

J Prim Care Community Health. 2025 Jan-Dec;16:21501319251346417. doi: 10.1177/21501319251346417. Epub 2025 Jun 17.

ABSTRACT

INTRODUCTION/OBJECTIVE: Surgery-induced losses in physical fitness may have detrimental consequences for patients with low reserve capacity at start. Our objective was to evaluate the effect of preoperative exercise on physical fitness in older patients with low physical fitness scheduled for colorectal cancer surgery.

METHODS: In this randomized, controlled trial, patients ≥65 years of age, who were scheduled for colorectal cancer surgery were included if they had a low maximal walking speed. Exercise for 2 to 3 weeks before surgery was home-based, high-intensity, and partly supervised by a primary care physiotherapist. The intervention consisted of inspiratory muscle training, aerobic, and strength exercises. A control group underwent usual preoperative care. Physical fitness was assessed with the 6-min walk test (primary outcome), the 30-s chair stand test and maximal inspiratory pressure which estimates inspiratory muscle strength (secondary outcomes). The effect of preoperative exercise on these outcomes before and after surgery was analyzed with linear mixed-models for the 6-min walk test and maximal inspiratory pressure and with a non-parametric Friedman rank sum test for the 30-s chair stand test. To evaluate adherence, physical activity was measured and compared for both groups.

RESULTS: A total of 52 participants were included. Analyses showed a statistically significant effect of preoperative exercise on postoperative inspiratory muscle strength. We did not find an effect of preoperative exercise on 6-min walk test or 30-s chair stand test performance. Regarding preoperative physical activity, the intervention group engaged more in high-intensity physical activity in relation to their total stepping time compared to the control group.

CONCLUSIONS: Short-term exercise before colorectal cancer surgery can provide benefits in terms of increased postoperative inspiratory muscle strength in older patients with low physical fitness. While we could not demonstrate an effect of preoperative exercise on any other outcomes, these results should be interpreted with caution due to a small sample size.

TRIAL REGISTRATION: Clinicaltrials.gov, identification number: NCT04878185, URL: Study Details | Optimizing Physical Function Before Cancer Surgery in Older People at Risk | ClinicalTrials.gov.

PMID:40525350 | DOI:10.1177/21501319251346417