Tag: pubmed

Syst Rev. 2025 Feb 20;14(1):45. doi: 10.1186/s13643-025-02755-w.

ABSTRACT

BACKGROUND: Diabetic retinopathy (DR) is a leading cause of vision impairment and blindness among individuals with diabetes. Traditional Chinese medicine (TCM) has been explored as an alternative treatment for DR, but the quality of evidence remains uncertain. A comprehensive evidence mapping study is necessary to synthesize existing SRs, identify gaps in the literature, and highlight areas requiring further research.

OBJECTIVE: This study aims to evaluate the reporting and methodological quality of SRs on TCM for DR and to assess the effectiveness of TCM interventions using an evidence-mapping approach.

METHODS: A comprehensive search of major biomedical databases to identify relevant SRs published up to November 2023. The reporting quality of the included SRs was assessed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, while the methodological quality was evaluated using the Assessment of Multiple Systematic Reviews 2 (AMSTAR 2) tool.

RESULTS: A total of 51 SRs involving 131,084 participants were included in the analysis. Evidence mapping indicated that TCM is relatively effective in treating DR. However, the methodological quality and reporting standards of these SRs were generally suboptimal. According to the AMSTAR 2 assessment, only one SR (2%) was rated as high quality, 29 SRs (56.9%) were of moderate quality, 20 SRs (39.2%) were of low quality, and one SR (2%) was of critically low quality. While all studies adequately reported the PICO components, risk of bias assessment, and statistical methods, none provided information on funding sources. Furthermore, only one study (2%) included a list of excluded studies with reasons, and eight SRs (15.7%) documented pre-specified protocols. Common reporting deficiencies included incomplete protocol and registration details, unclear review rationales, and insufficient presentation of relevant outcome data.

CONCLUSION: This evidence mapping study highlights the potential benefits of TCM for treating DR while identifying significant gaps in the existing literature. Although TCM interventions show potential benefits for treating DR, the overall quality of SRs is suboptimal. Future research should focus on addressing these gaps, particularly in areas such as funding disclosure and methodological rigor, to enhance the reliability of evidence on TCM interventions for DR.

PMID:39980075 | DOI:10.1186/s13643-025-02755-w

Breast Cancer Res. 2025 Feb 20;27(1):26. doi: 10.1186/s13058-025-01963-5.

ABSTRACT

PURPOSE: CALGB 40903 (Alliance) was a phase II single arm multicenter trial conducted in postmenopausal patients diagnosed with estrogen-receptor (ER) positive breast ductal carcinoma in situ (DCIS) without invasion. Patients were treated with the aromatase inhibitor (AI) letrozole for 6 months prior to surgery with change in magnetic resonance imaging (MRI) enhancement volume compared to baseline as the primary endpoint. In the current study, we performed sequence analysis of pre- and post-treatment specimens to determine gene expression and DNA copy number parameters associated with treatment and response.

EXPERIMENTAL DESIGN: Paraffin sections from pretreatment biopsies and post-treatment surgical specimens were evaluated for presence of DCIS. Proliferation based on KI67 staining was quantified by a study pathologist. Macrodissection of the DCIS components from thin sections was the source of RNA and DNA. Whole-transcriptome RNA and shallow whole-genome DNA sequencing were performed. PAM50 analysis to assign intrinsic subtypes with associated probability of class membership was performed. Differential gene expression comparing responders versus non-responders and pre- versus post-treatment specimens was performed using a two-tiered approach based on candidate genes and a whole genome survey with appropriate multiple testing corrections.

RESULTS: Based on availability of specimens and presence of DCIS component, 29 patients (from the 70 who completed the treatment trial) were included in the final data set, including five who had a pathologic complete response (pCR). Response to treatment was qualified categorically based on a threshold of 10% KI67 in the post-treatment surgical specimen or pCR. Based on this criterion, six of the 29 DCIS were considered non-responders (> 10% KI67) and five subjects with pCR were assigned to the responder group. No standard clinical variables were associated with response. On the basis of gene expression analysis, 19 of the pre-treatment samples were classified as luminal A, all of which were classified as responders. PAM50 classification of the other ten pre-treatment samples included luminal B, HER2, basal, and normal-like, six of which were non-responders. PAM50 class membership shifted from baseline to post-treatment in eight cases, most often from luminal A to normal-like (five cases). Selected genes associated with estrogen receptor levels in invasive breast cancer were higher in AI responsive tumors. AI treatment resulted in reductions in estrogen and proliferation related genes.

CONCLUSIONS: Letrozole treatment produced an effective growth response, particularly in DCIS initially classified as luminal A. Study inclusion criteria of DCIS with at least 1% ER positive cells resulted in the inclusion of other subtypes that failed to respond. Treatment also induced both minor and major changes in intrinsic subtype based on PAM50 probabilities. Overall, these data indicate that response to AI treatment in ER( +) DCIS is variable and analogous to that observed in invasive breast cancers.

TRANSLATIONAL RELEVANCE: Treatment for breast DCIS ranges from active surveillance to mastectomy, often combined with adjuvant endocrine therapy. The work presented here based on a unique neoadjuvant trial provides direct information on hormone therapy responsiveness of this disease and further couples the biology of invasive breast cancer to its non-obligate precursor.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01439711.

PMID:39980051 | DOI:10.1186/s13058-025-01963-5

BMC Res Notes. 2025 Feb 20;18(1):78. doi: 10.1186/s13104-025-07145-y.

ABSTRACT

OBJECTIVE: COVID-19 data exhibit various biases, not least a significant weekly periodic oscillation observed in case and death data from multiple countries. There has been debate over whether this may be attributed to weekly socialising and working patterns, or is due to underlying biases in the reporting process. We investigate these periodic reporting trends in epidemics of COVID-19 and cholera, and discuss the possible origin of these oscillations.

RESULTS: We present a systematic, global characterisation of these weekly biases and identify an equivalent bias in the current Haitian cholera outbreak. By comparing published COVID-19 time series to retrospective datasets from the United Kingdom (UK), we demonstrate that the weekly trends observed in the UK may be fully explained by biases in the testing and reporting processes. These conclusions play an important role in forecasting healthcare demand and determining suitable interventions for future infectious disease outbreaks.

PMID:39980045 | DOI:10.1186/s13104-025-07145-y

Reprod Biol Endocrinol. 2025 Feb 20;23(1):25. doi: 10.1186/s12958-025-01364-5.

ABSTRACT

BACKGROUND: Follitropin delta (hrFSH) is the first recombinant follicle-stimulating hormone produced in a human cell line and more closely resembles native human FSH than follitropin alfa/beta (rFSH). Its efficacy and safety have been demonstrated in numerous clinical trials. However, to date, no real-world study has evaluated the reproductive outcomes associated with controlled ovarian stimulation (COS) with hrFSH compared to rFSH.

METHODS: This study was a retrospective analysis of real-world data prospectively collected by the German IVF Registry (D-I-R; Deutsches IVF-Register). Data from women undergoing COS in Germany between 2017 and 2022 were included, specifically from centers using both hrFSH and rFSH for COS (N = 74). Propensity score matching (PSM) was used to match groups to minimize potential confounders. Matching criteria included age, year of stimulation, stimulation protocol, reproductive procedure, treatment indication, preconditions, and patient sterility factors. Outcomes were number of oocytes retrieved, pregnancy rate (PR) and cumulative PR (followed up to 12/31/2022 and 12/31/2021, respectively), and LBR and cumulative LBR (followed up to 12/31/2021 and 12/31/2020, respectively).

RESULTS: Before and after matching, the mean number of oocytes retrieved was similar between the two groups. Prior to matching, there was no statistically significant difference in PR or LBR per embryo transfer (ET) between women who received hrFSH or those who received rFSH (PR: 38.0% vs. 36.8%; p = 0.1090; LBR: 29.4% vs. 28.2%; p = 0.1103). When examining the cumulative pregnancy rates (PR) and live birth rates (LBR) for all fresh and frozen/thawed embryo transfers (FET) following the initial oocyte retrieval, notable differences emerged between the groups. The use of hrFSH was linked to higher percentages compared to rFSH, with cumulative PR at 68.0% versus 64.9% (p < 0.05) and cumulative LBR at 57.3% versus 51.9% (p < 0.01). After matching, the cumulative LBR remained significantly higher when hrFSH was used for ovarian stimulation compared to rFSH (57.4% vs. 50.7%; p < 0.05).

CONCLUSION: In this large retrospective analysis of a prospectively collected real-world data set, the higher cumulative LBR with hrFSH compared to rFSH supports the use of an individualized fertility treatment approach based on hrFSH.

PMID:39980039 | DOI:10.1186/s12958-025-01364-5

BMC Public Health. 2025 Feb 20;25(1):704. doi: 10.1186/s12889-025-21917-y.

ABSTRACT

BACKGROUND: The unmet need for family planning (FP) occurs when women want to limit or delay childbearing but lack access to contraception, leading to unintended pregnancies and increased maternal and child mortality, especially in developing countries. This study uses the 2021 PMA-Ethiopia survey to assess unmet need for family planning (FP) among reproductive age women, addressing limitations in previous research that relied on outdated and non-representative data. The findings offer valuable insights to help policymakers address local challenges and improve reproductive health outcomes in Ethiopia.

METHODS: This study utilized secondary data from the Performance Monitoring for Action Ethiopia survey conducted in 2021. A total of 5,203 reproductive-aged women were included in this study. STATA version 16 was used to cross-tabulate and fit the models. To account for the hierarchical structure of the data, we employed multilevel logistic regression. We estimated four statistical models: a null model (Model 0) to assess between-community variations, Model I incorporating individual-level predictors, Model II adding community-level factors, and Model III including both. To select the best-fitting model, we conducted model comparison using BIC, AIC, deviance, and log-likelihood ratio (LLR) to assess model performance. We calculated adjusted odds ratios along with their corresponding 95% confidence intervals (CIs). Furthermore, a significance level of p < 0.05 was considered as strong evidence of statistical significance.

RESULTS: The prevalence of unmet need for family planning among reproductive-age women was 23.60% [95% CI: 22.46%, 24.78%]. Model comparison indicated that Model III exhibited the best fit, with the lowest AIC (5306) and DIC (5300) values, along with an improved log-likelihood (-2650). Factors positively associated with unmet need included women aged 45-49 [AOR = 4.7, 95% CI: (2.97, 7.43)], 40-44 [AOR = 3.21, 95% CI: (2.23, 4.61)], 35-39 [AOR = 2.47, 95% CI: (1.78, 3.44)], and 30-34 years [AOR = 2.42, 95% CI: (1.76, 3.33)] compared to those aged 15-19 years. Conversely, having 1-2 children [AOR = 0.47, 95% CI: 0.39, 0.56], having 3-4 children [AOR = 0.50, 95% CI: 0.39, 0.63], and having five or more children [AOR = 0.51, 95% CI: 0.39, 0.66] were factors negatively associated with unmet need compared to women who are para 0. Furthermore, the spatial pattern of unmet need for family planning exhibited clustering (Moran’s index = 0.25, p-value = 0.0039). The primary cluster is located in the central part of Oromia, northern SNNP, northwest of Sidama, and northeastern part of Southwest Ethiopia.

CONCLUSION: This study affirms the ongoing high prevalence of unmet need for family planning in Ethiopia. It identified women’s age and parity as crucial factors correlated with unmet need for FP. Additionally, there exists an unequal distribution of the burden of unmet need for FP across the country. To address the varying reproductive health needs at different life stages and parity levels, the interventional plan needs to be based on women’s age and the number of children they have. Moreover, location-tailored interventional plans should be employed to optimize family planning related service inequalities.

PMID:39980036 | DOI:10.1186/s12889-025-21917-y

BMC Nurs. 2025 Feb 20;24(1):198. doi: 10.1186/s12912-025-02824-4.

ABSTRACT

OBJECTIVE: To explore the moderating effect of working years on nurses’ medical narrative ability and empathy ability.

METHODS: A multi-center cross-sectional survey was conducted among 1920 clinical nurses from 12 general hospitals of different levels in 7 cities of Hunan Province. Data were collected using a general information questionnaire, Narrative Competence Scale (NCS), and the Jefferson Empathy Health Professional Scale (JSE-HP). The general situation, medical narrative ability and empathy ability were investigated by questionnaires. The correlations among nurses’ working years, medical narrative ability and empathy ability were analyzed. The group regression method was used to analyze the moderating effect of different working years on nurses’ medical narrative ability and empathy ability, and the differences of regression coefficients were further analyzed to understand the specific effects of different working years.

RESULTS: A total of 1852 valid questionnaires were collected, and the effective recovery rate was 96.46%. Medical narrative ability was positively correlated with empathy ability (r = 0.198, P < 0.05), working years was positively correlated with medical narrative ability (r = 0.047, P < 0.05), and there was no correlation between medical narrative ability and empathy ability (P > 0.05). Working years had a moderating effect on the relationship between medical narrative ability and empathy ability (β=-0.174, P < 0.001). Group regression analysis showed that with the increase of nurses’ working years, the regression coefficient of medical narrative ability and empathy ability decreased gradually (0.077 > 0.036 > 0.019). The difference of regression coefficient was statistically significant (P < 0.05).

CONCLUSIONS: Nurses with different working years have different effects on empathy. With the increase of working years, the positive effect of medical narrative ability on empathy is gradually weakened. It suggests that nursing managers should carry out hierarchical intervention for nurses with different working years.

PMID:39980016 | DOI:10.1186/s12912-025-02824-4

Diabetol Metab Syndr. 2025 Feb 21;17(1):66. doi: 10.1186/s13098-025-01606-x.

ABSTRACT

BACKGROUND: Women with prior gestational diabetes mellitus (GDM) are at increased risk of type 2 diabetes, and lifestyle intervention (LSI) offered a decade after pregnancy is effective in preventing diabetes. However, since diabetes frequently onsets in the initial years following pregnancy, preventive actions should be implemented closer to pregnancy. We aimed to assess the effect of lifestyle interventions, compared to standard care, in reducing the incidence of diabetes following a pregnancy complicated by GDM.

METHODS: We searched the Cochrane Library, Embase, MEDLINE, and Web of Science from inception to July 21, 2024, to identify randomized controlled trials (RCTs) testing LSI to prevent diabetes following gestational diabetes. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We evaluated the risk of bias with the Cochrane Collaboration Risk of Bias tool RoB-2 and the certainty of the evidence with GRADE methodology. We used the DerSimonian-Laird random effects pooling method and evaluated heterogeneity with the I² statistic and the Chi² test.

RESULTS: We identified 24 studies involving 9017 women. In studies without high risk of bias (18 studies; 8,357 women), LSI reduced the incidence of diabetes by 19% (RR = 0.81; 95%CI 0.71.0.93). The effect was significant and more protective (RR = 0.78; 0.65, 0.94) in studies evaluating women with GDM identified specifically as at a higher risk of diabetes, compared to those intervening on women with GDM irrespective of risk (RR = 0.85; 0.70, 1.04). Similarly, when expressed in absolute terms, the overall number needed to treat (NNT) was 56 considering all studies, 71 for women with GDM irrespective of risk, and 31 for women with GDM at high risk. The intervention produced a lower weight gain (mean difference=-0.88 kg;-1.52, -0.23 for all studies; -0.62 kg;-1.22, -0.02 for studies without high risk of bias). The effects were robust in sensitivity analyses and supported by evidence of moderate certainty for diabetes and weight change.

CONCLUSIONS: LSI offered to women with GDM following pregnancy is effective in preventing type 2 diabetes, despite the small postpartum weight change. The impact of LSI on incidence reduction was greater for women with GDM at a higher diabetes risk.

PROSPERO: Registration number CRD42024555086, Jun 28, 2024.

PMID:39980013 | DOI:10.1186/s13098-025-01606-x

Contracept Reprod Med. 2025 Feb 20;10(1):13. doi: 10.1186/s40834-025-00342-x.

ABSTRACT

BACKGROUND: Despite efforts to improve its uptake, contraceptive use in Nigeria remains low. Understanding regional disparities and sociodemographic determinants of contraceptive intention is crucial for developing effective family planning strategies. This study aimed to investigate these factors in women of reproductive age in Nigeria.

METHODS: This cross-sectional study analysed data from 36,179 women aged 15-49 participating in the 2018 Nigerian Demographic and Health Survey (NDHS). Bivariate and multivariable logistic regression analyses were conducted to assess the association between sociodemographic factors and contraceptive use intention.

RESULTS: The overall prevalence of contraceptive intentions was 39.18%, with significant regional variation. South East had the highest intention at 44.85%, while North East had the lowest intention at 34.76%. Education was a strong predictor, with those with higher education showing 2.657 times greater odds of using contraception (AOR: 2.657, 95% CI: 2.339-3.019, p < 0.001). Muslim women and rural residents exhibited lower odds of intention, while women aged 20-24 years had the highest odds (AOR: 1.305, 95% CI: 1.187-1.435, p < 0.001).

CONCLUSION: There were significant regional disparities and complex sociodemographic patterns in contraceptive intention among Nigerian women. Tailored interventions addressing educational, religious, economic, and geographical barriers are required to increase contraceptive uptake and improve reproductive health outcomes.

PMID:39980009 | DOI:10.1186/s40834-025-00342-x

Diabetol Metab Syndr. 2025 Feb 20;17(1):64. doi: 10.1186/s13098-025-01605-y.

ABSTRACT

THE AIM OF THE STUDY: Using the method of spectral-probability analysis, to evaluate the possibility of predicting an unfavorable outcome of acute decompensation of diabetes mellitus in patients hospitalized in the intensive care unit using a mathematical model. In relation to clinical practice, the implementation of the proposed algorithm for mathematical processing of a set of test data provides the physician with an additional significant criterion for assessing the probability of a tendency to develop type 1 diabetes in healthy children being examined whose brothers or sisters suffer from this disease.

MATERIALS AND METHODS: A retrospective analysis of 103 medical records of patients hospitalized in the intensive care unit for acute decompensation of diabetes mellitus was conducted.

RESULTS: With regard to the set of analyses of patients with acute decompensation of diabetes mellitus, carried out at the time of admission to hospital, a group of mathematical criteria has been defined that makes it possible to identify patients with a high risk of an unfavorable course of the disease.

PMID:39980006 | DOI:10.1186/s13098-025-01605-y

BMC Psychol. 2025 Feb 20;13(1):144. doi: 10.1186/s40359-025-02474-w.

ABSTRACT

BACKGROUND: It has been proposed that nursing students experience emotional and mental issues due to their educational demands, which influence their academic success. This study aims to explore the relationship between students’ attitudes and intentions toward seeking professional psychological help and focus on exploring a mediating role of emotional intelligence.

METHODS: This study used a descriptive correlational design. A convenience sample was used to recruit 514 undergraduate nursing students in the central region of Saudi Arabia. Data were collected using self-administered tools from three nursing colleges. Data were analyzed using both descriptive, inferential, and structural equation modeling statistics.

RESULTS: The current study results indicate that university students had moderate positive attitudes, moderate positive intentions toward seeking help for mental health concerns, and a positive level of emotional intelligence. Attitudes toward seeking help and emotional intelligence had a significant positive relationship on professional mental help-seeking intentions. Other factors that predict students’ intention to seek help include the history of consulting a mental health professional and students who were unsure of the availability of the on-campus counseling center (p <.001). Emotional intelligence has a significant mediation effect on the relationship between mental help-seeking intention and mental help-seeking attitudes toward professional psychological help.

CONCLUSIONS: Based on the results, students with emotional intelligence and positive attitudes toward seeking mental help were significantly correlated to their intentions of seeking professional mental help. This study proposes the importance of implementing interventional programs to increase nursing students’ intentions to use the university counseling center for optimum mental health and well-being.

PMID:39979999 | DOI:10.1186/s40359-025-02474-w