Tag: pubmed

Int Breastfeed J. 2025 Nov 4;20(1):79. doi: 10.1186/s13006-025-00777-7.

ABSTRACT

BACKGROUND: Autism spectrum condition (ASC) is a neurodevelopmental disorder characterized by persistent difficulties in social communication and repetitive behaviors. Emerging evidence suggests that early nutrition, particularly reduced breastfeeding exposure, may be associated with an increased risk of ASC. However, this evidence is limited, especially in non-Western populations.

METHODS: We conducted an unmatched case-control study in Saudi Arabia to investigate the association between breastfeeding practices and ASC. Data were collected through an online questionnaire from mothers of children with and without ASC. Cases were children with a confirmed ASC diagnosis, and controls were neurotypical children without a diagnosis of ASC. Breastfeeding exposure was categorized according to the World Health Organization definitions (from highest to lowest exposure) as follows: exclusive, predominant, partial, or no breastfeeding. Logistic regression models were used to estimate odds ratios (OR) with 95% confidence intervals (CI).

RESULTS: Between 1 October 2024 and 25 January 2025, a total of 283 participants (126 cases and 157 controls) were recruited. A dose-response relationship was observed, where decreased breastfeeding exposure was associated with progressively higher odds of ASC (OR for trend: 1.58; 95% CI 1.24, 2.01). In univariable analyses, using exclusive breastfeeding as the reference category, partial breastfeeding was associated with increased odds of ASC (OR: 2.49; 95% CI 1.40, 4.42). Similarly, children who were not breastfed had significantly higher chance of ASC than the reference category (OR: 3.46; 95% CI 1.47, 8.13). The strength of these associations was attenuated after multivariable adjustment but remained statistically significant (OR: 2.28; 95% CI 1.22, 4.25 for partial versus exclusive breastfeeding and OR: 2.86; 95% CI 1.12, 7.26 for no breastfeeding versus exclusive breastfeeding).

CONCLUSIONS: Our findings suggest that reduced breastfeeding exposure is associated with increased odds of ASC. However, these results should be interpreted cautiously, considering the inherent limitation of case-control studies and the potential of reverse causality.

PMID:41188878 | DOI:10.1186/s13006-025-00777-7

J Orthop Surg Res. 2025 Nov 4;20(1):954. doi: 10.1186/s13018-025-06393-9.

ABSTRACT

BACKGROUND: Total knee arthroplasty (TKA) remains the definitive treatment for end-stage knee osteoarthritis (OA). Despite its success, post-operative rehabilitation continues to be challenged by limited access to care, inconsistent patient compliance, and a lack of standardized protocols. In response, smart device-assisted telerehabilitation has gained attention for its capacity to deliver real-time monitoring and individualized feedback. However, its comparative effectiveness relative to traditional rehabilitation approaches remains inconclusive.

METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing smart device-assisted telerehabilitation to conventional rehabilitation following TKA. Databases searched included PubMed, Web of Science, EMBASE, and Cochrane Library. Key outcomes assessed were pain (Visual Analog Scale (VAS)), functional recovery (Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)), and range of motion (ROM) (knee flexion and extension angles). Meta-analysis was performed using Stata 16.0, with heterogeneity evaluated via the I² statistic. Subgroup and sensitivity analyses were also conducted.

RESULTS: A total of 22 RCTs encompassing 2,181 participants were included. Overall, there were no significant differences between smart and conventional rehabilitation regarding VAS (SMD = 0.02, 95% CI: – 0.24 to 0.28) and WOMAC scores (SMD = – 0.27, 95% CI: – 0.60 to 0.06). Subgroup analyses revealed that augmented reality (AR) interventions were associated with greater pain reduction (VAS: SMD = – 1.12, 95% CI: – 1.98 to – 0.25), and virtual reality (VR) interventions led to significant functional improvement (WOMAC: SMD = – 0.47, 95% CI: – 0.82 to – 0.13). Furthermore, smart rehabilitation yielded superior outcomes in knee extension angle (SMD = – 0.15, 95% CI: – 0.28 to – 0.02). Sensitivity and publication bias analyses confirmed the stability of the results.

CONCLUSION: Smart device-assisted telerehabilitation is comparable to conventional rehabilitation in overall outcomes after TKA. However, AR and VR technologies demonstrate added value in specific domains of recovery, suggesting that future rehabilitation programs should consider integrating these modalities to enhance effectiveness and personalization of care.

PMID:41188876 | DOI:10.1186/s13018-025-06393-9

BMC Health Serv Res. 2025 Nov 4;25(1):1441. doi: 10.1186/s12913-025-13628-2.

ABSTRACT

BACKGROUND: Telemedicine has revolutionized healthcare delivery, significantly improving accessibility and efficiency. In China, the predominant mode of telemedicine service delivery is Business-to-Business (B2B). However, the utilization of B2B telemedicine is relatively low. Within the B2B context, primary care physicians (PCPs) are critical users. There is a lack of knowledge regarding PCPs’ continuous intention to use the B2B. To address this gap, the study aims to study and unveil factors affecting PCPs’ continuous usage intention for B2B telemedicine.

METHOD: This study proposes an integrated Technology-Individual-Environment theoretical framework to analyze factors and mechanisms influencing PCPs’ continuous usage intention for B2B telemedicine, considering exogenous, technology, and endogenous dimensions. We used Partial Least Squares Structural Equation Modeling (PLS-SEM) and fuzzy-set Qualitative Comparative Analysis (fsQCA) to test the research model. A cross-sectional study was conducted among PCPs with prior B2B telemedicine usage experience across more than 30 primary healthcare institutions in China. Overall, 421 (63.88%) out of 659 questionnaires were valid.

RESULTS: The PLS-SEM results revealed that within the individual dimension, attitude, perceived behavioral control, and intrinsic motivation positively influence PCPs’ continuous usage intention, while perceived risk had a negative impact. Within the technological dimension, assurance and reliability demonstrated direct positive effects on continuous usage intention, whereas tangibility indirectly influenced intention through attitudinal mediation. Notably, the environmental dimension showed no statistically significant effects on continuous usage intention. Complementing the PLS-SEM findings, fsQCA analysis identified three configurations that lead to high continuous usage intention and three configurations leading to low intention. Based on these results, factors influencing PCPs’ continuous usage intentions are classified into foundation factors, performance factors, and enhancement factors.

CONCLUSION: Within B2B telemedicine, this study focuses on the factors and mechanisms influencing PCPs’ continuous usage intention. These findings provide a robust theoretical foundation for policymakers and healthcare administrators seeking to enhance PCPs’ engagement with B2B telemedicine platforms, ultimately contributing to the advancement of integrated healthcare delivery systems.

PMID:41188874 | DOI:10.1186/s12913-025-13628-2

Malar J. 2025 Nov 4;24(1):371. doi: 10.1186/s12936-025-05614-0.

ABSTRACT

BACKGROUND: Malaria in pregnancy contributes significantly to poor maternal health outcomes, accounting for 17.6% of outpatient visits in Ghana. The Ashanti Region, particularly Sekyere South District, bears a high burden despite interventions, such as ITN distribution and intensified IPTp education. Limited evidence exists on how pregnant women’s knowledge, attitudes and practices (KAP) influence preventive behaviours and ANC use in this setting.

METHODS: A cross-sectional survey was conducted among 422 pregnant women using structured questionnaires. Descriptive statistics and logistic regression were applied to assess predictors of malaria prevention behaviours and ANC attendance.

RESULTS: Most respondents (78%) had adequate knowledge, though misconceptions persisted (56% believed malaria could spread person-to-person). Only 48% knew the recommended ≥ 3 IPTp doses, and ITN use was 63%, with non-use linked to heat discomfort and unavailability. Knowledge of IPTp dosage was significantly associated with uptake (p < 0.001), but socio-demographic factors were not predictors of ANC attendance.

CONCLUSION: Gaps in malaria prevention stem from misconceptions, incomplete IPTp adherence, and inconsistent ITN use rather than supply shortages. Priorities include strengthening ANC counselling, correcting myths, introducing reminder prompts, and expanding outreach with ITN replacement. Enhancing implementation fidelity is critical to improving maternal health outcomes.

PMID:41188873 | DOI:10.1186/s12936-025-05614-0

Arch Oral Biol. 2025 Oct 24;181:106422. doi: 10.1016/j.archoralbio.2025.106422. Online ahead of print.

ABSTRACT

AIM: The aim of this study was to assess the dose-dependent effects of radiotherapy on the progression of apical periodontitis (AP) in rats.

METHODS: Forty-five animals were divided into five groups based on radiation dose and apical periodontitis induction (n = 9): AP-RT7 (irradiated with a dose of 7.5 Gy + AP); AP-RT10 (10 Gy dose + AP); AP-RT15 (15 Gy dose + AP); AP (AP without radiation), and Control (no intervention). Radiation therapy was administered on the first day of the experiment. After seven days, the apical periodontitis induction was carried out in all groups except Control. All animals were euthanized after 21 days of AP progression (day 28), and the area and volume of AP were analyzed using radiography, micro-CT, and histological analyses. Inflammation intensity and extent were assessed histologically. Statistical analysis was performed using ANOVA and Student’s t test for quantitative data, and Kruskal-Wallis for ordinal data (P < 0.05).

RESULTS: The AP-RT15 group exhibited significantly larger apical periodontitis lesions compared to the AP-RT7.5, AP-RT10, and AP groups, as demonstrated by radiographic (p < 0.05), micro-CT (p < 0.0001), and histological analyses (p < 0.0001). Histological examination further revealed a more extensive and intense inflammatory response in the AP-RT15 group (p < 0.01). Overall, radiotherapy contributed to increased apical bone resorption and exacerbated inflammation in a dose-dependent manner.

CONCLUSIONS: The progression of apical periodontitis in irradiated animals follows a dose-dependent pattern, with higher radiation doses markedly amplifying the lesion’s area, volume, and inflammatory severity.

PMID:41187381 | DOI:10.1016/j.archoralbio.2025.106422

Arch Oral Biol. 2025 Oct 28;181:106443. doi: 10.1016/j.archoralbio.2025.106443. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to investigate the effect of the periodontal bacterium Filifactor alocis on proinflammatory cytokine production by osteoblasts. Specifically, we examined the mechanisms underlying interleukin (IL)-6 production by osteoblasts stimulated with live and lyophilized F. alocis, and F. alocis-derived extracellular vesicles (EVs).

DESIGN: MC3T3-E1 mouse osteoblasts were stimulated with live bacteria of F. alocis and, as a comparative control, P. gingivalis. Furthermore, cells were treated with F. alocis lyophilized whole cells or EVs, and IL-6 production was quantified by ELISA; cytokine expression profiled using membrane-based array; and mRNA expression analyzed by RT-qPCR. Signaling pathways were analyzed using specific inhibitors. Statistical analyses were performed using non-parametric tests with significance set at p < 0.05.

RESULTS: F. alocis live bacteria, lyophilized whole cells, and F. alocis-derived EVs induced IL-6, leukemia inhibitory factor, and chemokines in MC3T3-E1 cells. Mechanistically, IL-6 production by F. alocis involved osteoblast activation via Toll-like receptor (TLR) 2 on the bacterial surface or released EVs. Lyophilized F. alocis induced IκB-ζ mRNA expression in osteoblasts. Moreover, F. alocis-derived EVs induced IL-6 production in osteoblasts via protein kinase C (PKC).

CONCLUSIONS: Live and lyophilized F. alocis and F. alocis-derived EVs induce the production of proinflammatory cytokines by osteoblasts, including IL-6. Additionally, the induction of IL-6 by F. alocis-derived EVs involves the activation of TLR2 and PKC. Conclusively, these findings suggest that F. alocis-induced cytokine production by osteoblasts may induce osteoclast differentiation, highlighting its role in the pathogenesis of periodontitis.

PMID:41187379 | DOI:10.1016/j.archoralbio.2025.106443

Prev Vet Med. 2025 Oct 31;246:106734. doi: 10.1016/j.prevetmed.2025.106734. Online ahead of print.

ABSTRACT

Infectious bronchitis virus (IBV) remains a major respiratory pathogen of economic concern in the poultry industry. This study investigated the farm-level prevalence of IBV and evaluated associated risk factors in northern Vietnam by a cross-sectional study from June 2022 to June 2024. A total of 69 poultry farms were randomly selected across nine provinces, and pooled tracheal swab samples were purposively collected for IBV detection using RT-qPCR. The overall IBV farm-level prevalence was 34.78 % (95 % CI:23.71-47.21 %). Although no statistically significant differences were found across provinces, production types, age groups, or flock sizes, IBV was detected in all subgroups, indicating widespread circulation of the virus. A total of 22 potential risk factors were initially assessed using univariate logistic regression. Of these, six variables with P < 0.1, including farm size, number of poultry houses, presence of multiple age groups, vaccination at day-old, frequency of disinfection before chick placement, and proximity to live bird markets and residential areas, were selected for multivariable logistic regression. The final multivariable model retained two independent predictors: performing more than one disinfection before chick placement (P = 0.035), and administration of a live IB vaccine at one day of age (P = 0.006), both of which were significantly associated with reduced the odds of IBV infection at the farm level. These findings suggest that strategic vaccination and careful calibration of disinfection protocols are critical to minimizing IBV transmission at the farm level.

PMID:41187363 | DOI:10.1016/j.prevetmed.2025.106734

J Radiol Prot. 2025 Nov 4. doi: 10.1088/1361-6498/ae1b15. Online ahead of print.

ABSTRACT

Epidemiological studies of large groups of nuclear industry workers offer a significant opportunity to increase our understanding of the long-term effects on health of the protracted accumulation of dose received at a low dose rate from many discrete exposures to ionising radiation. The effects of such extended aggregation of doses form an important part of the everyday concerns of radiological protection against low-level exposures. For more than half a century, databases of nuclear workers have been assembled, and the numbers of workers currently included in studies, together with the numbers of deaths among them that have now occurred, are capable of generating reasonably precise risk estimates that should provide meaningful comparisons with those obtained from other studies, such as of the Japanese atomic bomb survivors. However, constructing, updating and maintaining these large databases, linking workers to occupational dose databases and to registers of deaths (and other outcomes, such as incident cancers) and their causes, and analyses of these data that endeavour to take account of other influential factors (such as smoking) are far from straightforward. A critical review of recent nuclear worker studies illustrates the difficulties in reliably interpreting reported statistical associations between rates of cancer and cumulative occupational doses because of the real possibility of distortions produced by biases, confounding and/or the interplay of radiation with other risk factors. This doesn’t mean that studies of nuclear workers should be abandoned, far from it, but it does mean that appropriate effort needs to be expended on these studies before confident conclusions about the levels of risks from radiation exposure can be drawn from them. Unexpected findings should be examined in depth to gain a proper understanding of their origin, including the impact of doses from intakes of radionuclides upon dose-responses derived using doses from external sources of radiation.

PMID:41187351 | DOI:10.1088/1361-6498/ae1b15

Am J Trop Med Hyg. 2025 Nov 4:tpmd240812. doi: 10.4269/ajtmh.24-0812. Online ahead of print.

ABSTRACT

The efficacy, best dosage, and safety of liposomal amphotericin B (LAB) in the treatment of cutaneous leishmaniasis (CL) caused by Leishmania braziliensis in elderly patients was determined by a randomized, controlled trial. We selected 28 patients of both sexes age 60 years old or older with CL diagnosis confirmed by detection of L. braziliensis DNA. The groups were treated with different total doses of LAB (group 1: 12 mg/kg; group 2: 18 mg/kg; and group 3: 24 mg/kg). Clinical and laboratory evaluations were carried out during a period of 180 days (day 0, day 15, day 30, day 60, day 90, and day 180). The highest cure rate (89%) was in group 3 (differences were not statistically significant) along with the lowest incidence of side effects (11%), suggesting that 24 mg/kg is the best dose of LAB to treat CL in elderly patients.

PMID:41187344 | DOI:10.4269/ajtmh.24-0812

Am J Trop Med Hyg. 2025 Nov 4:tpmd250483. doi: 10.4269/ajtmh.25-0483. Online ahead of print.

ABSTRACT

The objective of this study was to compare coronavirus disease 2019 (COVID-19) and influenza among US active-component service members (ACSMs) stationed at military installations near the US-Mexico border (Arizona, California, New Mexico, and Texas). A retrospective cohort study was conducted to assess diagnoses of influenza (2020-2024) and COVID-19 (2020-2023). Incidence rate ratios (IRRs) comparing influenza and COVID-19 at border and non-border locations were calculated for laboratory-confirmed and/or symptom-based encounter diagnoses. Forty-five percent of ACSMs included in the influenza (N = 650,505) and COVID-19 (N = 660,333) analyses were near the border. There was no statistically significant increase of either COVID-19 or influenza incidence among ACSMs stationed near the border compared with those located elsewhere in the same states. A statistically significantly reduced adjusted IRR (aIRR) of laboratory-confirmed influenza (aIRR: 0.93; 95% CI: 0.89, 0.98) and COVID-19 (aIRR: 0.97; 95%: CI: 0.96, 0.99) was observed among ACSMs stationed near the border compared with those located elsewhere in the same states for all states combined for the entire study period. Similarly, significantly lower aIRRs were observed for all diagnoses (laboratory-confirmed or symptoms-based encounter) of influenza (aIRR: 0.81; 95% CI:0.80, 0.82) among ACSMs near the border compared with ACSMs not near the border for all states combined for the entire duration of the study. However, incidence rates of COVID-19 and influenza varied across some specific states and time periods. By assessing the potential health threats of cross-border transmission, public health officials can more effectively deploy preventive and response measures among ACSMs living and working near the US-Mexico border.

PMID:41187337 | DOI:10.4269/ajtmh.25-0483