Tag: pubmed

Community Dent Health. 2025 Nov 26:265539X251400580. doi: 10.1177/0265539X251400580. Online ahead of print.

ABSTRACT

Background: Oral pathology (e.g. caries, periodontal disease, edentulism) contributes to poor overall health and negatively impacts quality of life. Ageing increases susceptibility to oral diseases and poor oral health is common among older adults. In contrast, dental attendance is low among this group. This descriptive study aims to examine dental utilisation patterns among older adults in Flanders, Belgium. Methods: The study included all members from the two largest Belgian healthcare insurance funds aged 65 and older, residing in Flanders (Belgium). Descriptive and bivariate analyses were performed with dental utilisation patterns as main outcome and socio-demographic data, care dependency and oral status as covariates. Statistical analysis was performed using chi-square tests, with effect sizes calculated using Cramér’s V. Results: Data from 911,159 older adults were analysed. Between 2020 and 2022, preventive care was regularly received by 36.8% of the participants, 37.0% had no contact with an oral health professional and 21.9% only received curative care. Lower utilisation of preventive care was observed in the following groups: the oldest-old (Cramér’s V = 0.136), individuals having an increased reimbursement (Cramér’s V = 0.171), residents of long-term care facilities (Cramér’s V = 0.090), recipients of domiciliary nursing care (Cramér’s V = 0.121), and edentulous older adults (Cramér’s V = 0.362). Conclusion: A significant proportion of older adults did not attend a dentist or only received curative care. Further research is needed to investigate whether health promotion campaigns and enhanced collaboration among health professionals can motivate these older adults to engage in preventive oral care.

PMID:41293800 | DOI:10.1177/0265539X251400580

OTJR (Thorofare N J). 2025 Nov 26:15394492251391678. doi: 10.1177/15394492251391678. Online ahead of print.

ABSTRACT

Chronic pain may impede occupational participation in older adults, but links among mobility, social networks, cognitive function, and pain-related factors remain unclear. To examine the relationships among these factors in relation to occupational participation in community-dwelling older Japanese adults. In this cross-sectional study, 130 adults more than 60 answered questions about occupational participation, mobility, social networks, cognitive function, and pain. Exploratory factor analysis was used to extract latent variables representing key constructs. These were incorporated into structural equation modeling to examine their associations with occupational participation. Latent factors combining mobility and social networks (standardized coefficient: 0.75), and cognitive functions (0.35), were directly and positively associated with occupational participation, while pain-related factors were strongly negatively correlated with mobility/social networks (-0.79, -0.73) but showed no direct association with participation. Interventions addressing both physical and social function and pain-related barriers may support occupational participation in older adults.

PMID:41293790 | DOI:10.1177/15394492251391678

OTJR (Thorofare N J). 2025 Nov 26:15394492251391664. doi: 10.1177/15394492251391664. Online ahead of print.

ABSTRACT

Many parents live with enduring health conditions; however, the impact of enduring health conditions on parenting roles is poorly understood. The aim of this study was to explore the experiences, support needs and preferences of parents in Ireland living with enduring health conditions. Data were collected using a custom e-survey, developed and refined using cognitive interviewing (n = 6). Quantitative data were analysed using descriptive statistics and group comparisons, while open-ended responses were analysed using interpretative content analysis. In total, 281 eligible parents completed the survey. Participants reported considerable difficulties with parenting tasks, particularly physically demanding tasks. Participants had limited access to formal services and many reported unmet needs and dissatisfaction with current services. Enduring health conditions have a significant impact on parenting capacity. There is a need for integrated support systems to ensure parents with enduring health conditions are supported to engage in parenting occupations and roles.

PMID:41293779 | DOI:10.1177/15394492251391664

ERJ Open Res. 2025 Nov 24;11(6):00044-2025. doi: 10.1183/23120541.00044-2025. eCollection 2025 Nov.

ABSTRACT

INTRODUCTION: Nontuberculous mycobacteria (NTM) are opportunistic pathogens primarily found in soil and water. Previous studies have linked higher population density and tropical/subtropical climates with increased NTM pulmonary disease (NTM-PD). However, the effects of meteorological parameters and population density on NTM incidence in European countries remain unclear. This study aimed to assess whether climate conditions (temperature, humidity, wind speed, precipitation) and urbanisation influence the occurrence of NTM-PD.

METHODS: We conducted a case-control study evaluating meteorological conditions (in the 12 months before the first NTM isolate) and urbanisation in the municipalities of residence of 1061 adults with NTM-PD enrolled in an Italian multicentre observational study (2017-2023), compared with a random sample of 10 000 adults from the Italian population.

RESULTS: The mean age of patients was 63.1 years, and 67.2% were female. Less densely populated areas were at lower risk for NTM-PD, even after adjusting for age, sex and meteorological parameters in a multivariable mixed-effects logistic regression model (OR 0.66 (95% CI: 0.56-0.78) and 0.68 (95% CI: 0.52-0.89) for semi-urban and rural areas, respectively, versus urban areas). Hotter climates were found to be at higher risk for NTM infection (OR 1.21 (95% CI: 1.10-1.33) for each °C increase in mean annual temperature). More ventilated climates with higher precipitation were at lower risk for NTM infection (OR 0.90 (95% CI: 0.86-0.95) for each km·h^-1 increase in mean annual wind speed; OR 0.99 (95% CI: 0.99-0.99) for each 10 mm increase in mean annual precipitation).

CONCLUSIONS: Climate change, particularly global warming and urbanisation, may increase NTM infections in regions with Mediterranean and continental climates.

PMID:41293774 | PMC:PMC12643029 | DOI:10.1183/23120541.00044-2025

Int J Womens Health. 2025 Nov 20;17:4705-4715. doi: 10.2147/IJWH.S537210. eCollection 2025.

ABSTRACT

This study aimed to analyze the changes in quality of life (QOL) and emotional well-being of patients undergoing diathermy ablation for cervical intraepithelial neoplasia 2/3 (CIN). A total of 40 patients were recruited for a prospective clinical trial, and the European Organization of Research and Treatment for Cancer (EORTC)-QLQ-C30 and EORTC-QLQ-CX24 questionnaires were used to assess QOL before surgery and at 3 and 6 months postoperatively. Friedman and Wilcoxon tests were employed for statistical analysis. The results showed significant improvements in emotional functioning, body image, symptom experience, and physical functioning after surgery. Vaginal discharge and abnormal bleeding decreased over time, indicating improved symptom control. Sexual activity was temporarily affected but eventually returned to preoperative levels at 6 months after surgery. This study highlights the positive impact of diathermy ablation on psychological well-being and QOL, and emphasizes the importance of patient-centered care in CIN treatment. These survey questionnaires will eventually enable us to compare global QOL assessments between patients undergoing various cervical cancer treatments, such as trachelectomy, and those with precancerous lesions.

PMID:41293763 | PMC:PMC12642790 | DOI:10.2147/IJWH.S537210

Risk Manag Healthc Policy. 2025 Nov 19;18:3689-3712. doi: 10.2147/RMHP.S553410. eCollection 2025.

ABSTRACT

INTRODUCTION: Stroke is the second leading cause of death worldwide and ranks third as a cause of disability. The American Heart Association/American Stroke Association (AHA/ASA) recommends that treatment begin within three hours of onset with intravenous thrombolysis therapy. This scoping review aimed to identify the factors that influence the delay in intravenous thrombolysis (IVT) management in patients with ischemic stroke.

METHODS: We searched relevant studies in PubMed, ScienceDirect, and EBSCO and this review includes studies on ischemic stroke patients that analyze the factors contributing to delays in intravenous thrombolysis therapy, and it demonstrates that such delays are present in the management of IVT.

RESULTS: A total of 48 studies were included in this study. Among pre-hospital factors, the most frequently reported contributors to delays in IVT for acute ischemic stroke (AIS) patients were the use of Emergency Medical Services (EMS) (12 studies), mode of hospital presentation (12 studies), comorbidities (6 studies), symptom recognition (5 studies), and timing of event (5 studies), with several studies reporting statistically significant associations (p<0.05). Emergency department use shortened hospital admission time by an average of 30 minutes, p<0.05Regarding in-hospital delay factors, the main contributors to delays included long scan times (5 studies), low NIHSS scores (5 studies), and limited implementation of stroke programs (5 studies). Other in-hospital delay variables included delayed activation of stroke codes (3 studies), inefficiency of human resources (3 studies), suboptimal triage processes (2 studies), diagnostic process (1 study), and logistics (1 study).

CONCLUSION: Delayed thrombolysis in ischemic stroke patients is caused by various factors, both pre-hospital and in-hospital. Community education and telemedicine can reduce delays by 30%. Collaboration between the community, stroke units, medical personnel, and the government through comprehensive programs is key in accelerating stroke treatment and improving patient clinical outcomes.

PMID:41293747 | PMC:PMC12640776 | DOI:10.2147/RMHP.S553410

Front Endocrinol (Lausanne). 2025 Nov 10;16:1690169. doi: 10.3389/fendo.2025.1690169. eCollection 2025.

ABSTRACT

BACKGROUND: Real-world studies on insulin degludec/aspart (IDegAsp) have been conducted in some Southeast Asian populations; however, data specific to Indonesia remain limited. The aim of this study was to evaluate the efficacy, safety profiles, and real-world clinical experience of IDegAsp after five years of implementation in diabetes care in Indonesia.

METHODS: This five-year, single-center, open-label, prospective, non-interventional study included adults with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) who had been on IDegAsp treatment for at least 12 months. Glycemic and metabolic outcomes-glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), postprandial glucose (PPG), and body mass index (BMI)-were assessed at baseline, 3, 6, and 12 months. The safety was evaluated based on hypoglycemia incidence. Clinical rationale for IDegAsp initiation and regimen models were also documented.

RESULTS: A total of 550 individuals (T1DM: 48; T2DM: 502) were included. At 12 months, both groups had significant reductions in HbA1c (T1DM: -3.60%, T2DM: -3.32%), FPG (T1DM: -119.39 mg/dL, T2DM: -105.60 mg/dL), and PPG (T1DM: -190.87 mg/dL, T2DM: -180.10 mg/dL) (all p < 0.001 compared to baseline). Slight but statistically significant increases in BMI were observed in both groups (both p < 0.001). No episodes of hypoglycemia were reported among T1DM patients, whereas in the T2DM cohort, it occurred in 3.0% of cases comprising 1.4% with a single episode and 1.6% with two episodes with no severe hypoglycemia reported. The most frequent reasons for initiating IDegAsp included suboptimal HbA1c and PPG levels, with T2DM patients more often citing the need for flexible injection time or schedule.

CONCLUSION: IDegAsp demonstrated sustained glycemic improvement at 3-, 6-, and 12-months follow-ups with a favorable safety profile over one year, in both T1DM and T2DM populations in Indonesia. These findings support its utility in routine clinical practice, particularly among patients with unmet glycemic targets or complex treatment needs.

PMID:41293743 | PMC:PMC12640829 | DOI:10.3389/fendo.2025.1690169

Front Endocrinol (Lausanne). 2025 Nov 10;16:1697797. doi: 10.3389/fendo.2025.1697797. eCollection 2025.

ABSTRACT

BACKGROUND AND AIM: Helicobacter pylori (H. pylori, HP) infection plays a significant role in the development and progression of various intra-gastric and extra-gastric diseases. Its infection is associated with numerous factors, including a series of metabolic-related diseases, and the potential connections between them remain highly controversial. Meanwhile, the prevalence of metabolic diseases has been increasing exponentially with changes in economic levels and lifestyles. Exploring the correlations and potential mechanisms between HP and metabolic diseases is crucial for future disease prevention and control. Due to the ongoing controversy surrounding its relevance and the absence of articles investigating the metabolic-related mediating mechanisms and threshold effects of related metabolic diseases leading to HP infection, this study holds significant importance for guiding future lifestyle and disease control.

METHODS: By collecting relevant test and examination indicators from 7,387 participants at Peking University Shenzhen Hospital, we analyzed the potential pathogenic mechanisms using statistical methods such as regression analysis, mediation analysis, and threshold analysis.

RESULTS: We found that factors such as blood glucose levels (fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c)), Body Mass Index (BMI), and blood pressure (Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP)) were the main risk factors influencing the target outcomes in this study, while higher levels of Albumin (Alb) may have a certain protective effect, with BMI playing a particularly significant role among these factors.

CONCLUSION: This discovery has deepened our understanding of metabolic diseases, BMI, related metabolic indicators, and HP infection.

PMID:41293740 | PMC:PMC12640847 | DOI:10.3389/fendo.2025.1697797

Front Endocrinol (Lausanne). 2025 Nov 10;16:1697617. doi: 10.3389/fendo.2025.1697617. eCollection 2025.

ABSTRACT

OBJECTIVE: To evaluate the associations between systemic inflammatory biomarkers-systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), pan-immune inflammation value (PIV), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR)-and prostate cancer (PCa) risk, and to assess their potential for risk in both general and clinical populations.

METHODS: A dual-cohort study was conducted using data from the National Health and Nutrition Examination Survey (NHANES; 2001-2010; N=7,354 males, 514 were classified as PCa) and a clinical validation cohort from the second affiliated hospital of Nanchang University (N=353, 175 with biopsy-confirmed PCa). Multivariable logistic regression, restricted cubic spline (RCS) analysis, and receiver operating characteristic (ROC) curve analysis were employed to examine linear/nonlinear relationships and predictive performance of the biomarkers. Models were adjusted for demographic, clinical, and laboratory covariates.

RESULTS: Elevated SII, NLR, PLR, SIRI, and PIV were significantly associated with increased PCa risk in both cohorts, while higher LMR was protective. In the clinical cohort, the highest quartile of SIRI (OR=6.265, 95% CI: 3.130-13.012) and PIV (OR=6.638, 95% CI: 3.343-13.665) showed the strongest risks. RCS analyses revealed nonlinear relationships between biomarkers and PCa risk, total PSA (tPSA), and free PSA (fPSA). Elevated SII, NLR, PLR, SIRI, and PIV were significantly associated with increased PCa risk in both cohorts, while a higher LMR was protective. In the clinical cohort, the highest quartile of SIRI (OR=6.265, 95% CI: 3.130-13.012) and PIV (OR=6.638, 95% CI: 3.343-13.665) exhibited the strongest risks. RCS analyses revealed nonlinear relationships between biomarkers and PCa risk, total PSA (tPSA), and free PSA (fPSA). ROC analysis indicated moderate discriminatory power for PIV (AUC=0.709, 95% CI: 0.655-0.763) and SIRI (AUC=0.704, 95% CI: 0.650-0.759) compared with tPSA in the clinical cohort. However, fPSA and SIRI did not demonstrate a clear advantage, and the DeLong test showed no significant statistical difference.

CONCLUSION: Systemic inflammatory biomarkers, particularly composite indices such as SIRI and PIV, are strongly associated with PCa risk and demonstrate nonlinear relationships with PSA parameters. These biomarkers may enhance risk stratification for PCa and serve as non-invasive tools to complement existing diagnostic approaches.

PMID:41293737 | PMC:PMC12640860 | DOI:10.3389/fendo.2025.1697617

Front Endocrinol (Lausanne). 2025 Nov 10;16:1687745. doi: 10.3389/fendo.2025.1687745. eCollection 2025.

ABSTRACT

BACKGROUND: Postoperative hyperglycemia (POH) is a common metabolic complication in non-diabetic patients undergoing surgery for gastric cancer, and it significantly increases the risk of adverse outcomes. However, current prediction models primarily rely on a limited set of perioperative variables and conventional statistical methods, which often lack accuracy and generalizability. This study aimed to develop and validate a machine learning-based model for the early prediction of POH risk in non-diabetic patients following radical gastrectomy.

METHODS: This single-center, retrospective cohort study included 393 non-diabetic patients who underwent radical gastrectomy for gastric cancer between March 2021 and September 2024. A total of 38 perioperative clinical features covering preoperative, intraoperative, and early postoperative periods were collected. The primary outcome was POH, defined as a fasting venous plasma glucose level ≥ 7.8 mmol/L within 24 hours post-surgery. Nine machine learning algorithms, including Support Vector Machine with a radial basis function kernel (SVM-radial), Random Forest, XGBoost, and Logistic Regression, were developed and compared. Model performance was evaluated using accuracy, the area under the receiver operating characteristic curve (AUC), recall, and F1-score. Shapley Additive Explanations (SHAP) analysis was employed to interpret the model and identify key predictive factors.

RESULTS: The incidence of POH was 42.7%. Among all models, the SVM-radial model achieved the best test-set performance (AUC = 0.758, accuracy = 0.724, F1 = 0.743, recall = 0.750, Brier score = 0.186, calibration slope = 1.07).The model exhibited excellent discrimination, predictive accuracy, and probability calibration, indicating strong generalization capabilities and potential clinical utility. Seven key predictors were identified: operation duration, nutritional risk score, sex, surgical approach 2 (robotic surgery), preoperative fasting blood glucose, thrombosis risk score, and alkaline phosphatase. SHAP analysis confirmed the non-linear contributions of these features to POH risk and supported their interpretability for clinical decision-making.

CONCLUSION: A novel machine learning-based model, utilizing multi-dimensional perioperative features, can accurately predict the risk of POH in non-diabetic patients with gastric cancer. The SVM-radial model demonstrated superior predictive performance and clinical interpretability, providing a viable tool for early risk stratification and personalized glycemic management in the surgical setting.

PMID:41293736 | PMC:PMC12640856 | DOI:10.3389/fendo.2025.1687745