Tag: pubmed

J Med Internet Res. 2025 Jun 30;27:e66631. doi: 10.2196/66631.

ABSTRACT

BACKGROUND: Digital health literacy describes an individual’s ability to use digital information and tools to improve their own health. Understanding how digital health literacy varies across populations could help improve health equity. However, the determinants of digital health literacy have been scarcely evaluated.

OBJECTIVE: This study aims to assess the levels of digital health literacy in 4 countries (United Kingdom, Sweden, Italy, and Germany) and explore potential associations between digital health literacy and demographic characteristics and self-perceived health status.

METHODS: A cross-sectional online survey was disseminated to participants from the United Kingdom, Italy, Germany, and Sweden in December 2020. Digital health literacy was self-reported using the validated eHealth Literacy Scale (eHEALS; range: 0-40); low digital health literacy has been previously defined as an eHEALS score<26. Participant characteristics collected were sex, age group, ethnicity, country, and perceived overall health status. A multivariable linear regression analysis was performed to explore associations between these variables and digital health literacy.

RESULTS: A total of 6331 participants were included (51.7% female, n=3272). The mean eHEALS score was 29.2 (SD 6.8). Participant age, sex, health status, and country of residence were included in the final multivariable model. Compared to the 45- to 54-year age group, the 55 years and older age group had lower digital health literacy (β=-1.0; 95% CI -1.4 to -0.5; P<.001), while digital health literacy was higher in those aged 25-34 years (β=0.9; 95% CI 0.3-1.5; P=.002) and 35-44 years (β=0.6; 95% CI 0.1-1.2; P=.03). Better health status was associated with greater digital health literacy (β=0.3; 95% CI 0.2-0.4; P<.001). Compared to participants from Germany, those from the United Kingdom (β=2.1; 95% CI 1.7-2.5; P<.001) and Sweden (β=2.9; 95% CI 2.4-3.4; P<.001) had higher digital health literacy scores, while there was no difference with Italian participants (P=.399). Sex and ethnicity did not have any significant effect on digital health literacy.

CONCLUSIONS: This study found significant variations in digital health literacy by age, health status, and country of residence. Targeted educational programs for vulnerable groups, particularly those of older age and poorer health status, are essential. Policies fostering accessible digital health solutions and mitigating health technology-related uncertainties for these populations are crucial for achieving optimal health outcomes.

PMID:40587845 | DOI:10.2196/66631

Rev Med Chil. 2025 Jun;153(6):448-457. doi: 10.4067/s0034-98872025000600448. Epub 2025 Jun 23.

ABSTRACT

Recovery times are a relevant problem in occupational health.

AIM: To identify the social health factors impacting workers’ longer recovery times affected by occupational accidents.

METHODS: A qualitative systematic review of the academic literature in English was carried out. A total of 4,409 articles were identified, applying the inclusion and exclusion criteria, 22 articles were selected.

RESULTS: The aging of the working population is a relevant issue for occupational health; after 45 years of age, workers require significantly longer recovery after an occupational accident. Men have the longest recovery days in the most severe accidents and are associated with the most severe accidents (e.g., traumatic amputations and falls from height). The circumstantial variables indicate that those accidents with longer recovery times happen towards the end of the week, at the end of the workday, and night, all of which would indicate that the fatigue and tiredness factor would be present in the accidents with the most severe consequences. Likewise, although the most significant number of accidents occur in large companies, to local workers, and at the workplace, the accidents with the most meaningful lost time ensue in small companies, to immigrant workers, and when commuting. In addition, the accidents with the highest lost time are related to fractures, internal injuries, and multiple injuries, with the prominent involvement of the limbs.

CONCLUSIONS: Knowing the social factors and circumstances related to occupational accidents involving longer recovery times provides additional elements for health decision-making and formulating public policies and occupational safety programs.

PMID:40587831 | DOI:10.4067/s0034-98872025000600448

Rev Med Chil. 2025 Jun;153(6):414-424. doi: 10.4067/s0034-98872025000600414. Epub 2025 Jun 23.

ABSTRACT

Suicide is a major cause of death among people aged 60 and over. Suicide attempts (SA) are a significant risk factor.

AIM: To describe and evaluate the relationship between sociodemographic and clinical characteristics with SA in elderly patients hospitalized in the Psychiatry Unit of Herminda Martin Hospital in Chillán, Chile, and to follow up on this behavior over 13 years.

METHODS: Correlational study with statistically based data and a 13-year case series follow-up. The study included 49 elderly individuals with SA and 194 without SA who were hospitalized in psychiatric care between January 1, 2011, and December 31, 2023. Follow-up continued until October 2024. Sociodemographic and clinical variables were analyzed. Descriptive and bivariate analysis was performed.

RESULTS: SA was significantly associated with older age groups (over 70 years), male sex, the presence of stress factors in the primary support group, and housing problems. The most common suicide methods were medication ingestion and asphyxiation by hanging. Suicidal behavior was significantly associated with psychiatric diagnoses, particularly depressive disorder, but not with comorbid medical illnesses. A considerable percentage had previous SA and repeated the behavior after discharge. The most cited precipitating factors and reasons for wanting to die were family conflicts and adverse emotions. During follow-up, one suicide, two deaths from complications of a new SA, and one death from medical conditions during hospitalization for SA were recorded.

CONCLUSIONS: The characteristics of SA in the elderly resemble those of suicide. In this age group, prevention efforts should focus not only on detecting and treating depression but also on addressing previous suicidal behavior, adverse psychosocial factors, and ensuring continuity of care with follow-up interventions.

PMID:40587828 | DOI:10.4067/s0034-98872025000600414

Rev Med Chil. 2025 Jun;153(6):392-400. doi: 10.4067/s0034-98872025000600392. Epub 2025 Jun 23.

ABSTRACT

Stroke is the third leading cause of death in Chile. The Explicit Health Guarantees Regime (GES) ensures that post-discharge evaluation of patients with ischemic stroke (IS) is performed within 10 days. The time to complete the etiological study of a stroke is crucial due to the high risk of recurrence in patients without a specific identified cause.

AIM: To estimate the times for control and etiological study in stroke patients at a high-complexity regional hospital. To identify factors associated with compliance with the GES follow-up guarantee.

METHODS: Consecutive patients with stroke from the vascular neurology clinic of Dr. Hernán Henríquez Aravena Hospital (HHHA) in Temuco between January 1, 2019, and December 31, 2023. Times for the first control and the performance of the etiological study exams were recorded.

RESULTS: 479 patients were included: 426 (88.9%) with IS and 53 (11.1%) with intracerebral hemorrhage (ICH). The median time for the first control was 23 days for IS and 42 days for ICH. Only 20.7% of IS patients were controlled within 10 days post-discharge. The medians for transthoracic echocardiography, transesophageal echocardiography, and Holter monitor were 9, 21, and 35.5 days, respectively. In the logistic regression model, only the year of admission to the clinic reached statistical significance for control within 10 days.

CONCLUSIONS: A low percentage of IS patients comply with the GES follow-up guarantee. The time to perform the etiological study is significantly longer than that reported in private clinics in Chile.

PMID:40587826 | DOI:10.4067/s0034-98872025000600392

Hum Reprod. 2025 Jun 30:deaf121. doi: 10.1093/humrep/deaf121. Online ahead of print.

ABSTRACT

STUDY QUESTION: What is the incidence of and risk factors for monozygotic twinning (MZT) following single embryo transfer (SET) in ART cycles in Australia and New Zealand?

SUMMARY ANSWER: MZT occurred in 1.5% of live births following SET, with blastocyst transfer and fresh embryo transfer identified as key risk factors, while vitrified-thaw transfers were associated with a lower MZT risk.

WHAT IS KNOWN ALREADY: ART has been associated with a higher incidence of MZT compared to natural conception. Previous studies have suggested younger maternal age, blastocyst culture, fresh embryo transfer, and certain ART techniques, such as assisted hatching and preimplantation genetic testing may elevate MZT risk. However, findings have been inconsistent, and with many prior studies underpowered and few reflecting contemporary ART practices.

STUDY DESIGN, SIZE, DURATION: This retrospective cohort study analyzed data from 590 441 SET cycles conducted between 2009 and 2021 in Australia and New Zealand. The analysis included 154 671 live births following autologous SET cycles recorded in the Australian and New Zealand Assisted Reproductive Technology Database (ANZARD).

PARTICIPANTS/MATERIALS, SETTING, METHODS: The study focused on autologous fresh and thawed SET cycles. MZT incidence was estimated by applying Weinberg’s differential rule, which assumes a 1:1 ratio of sex-concordant and sex-discordant dizygotic twins in the population of twins born following SET cycles. A multivariable logistic regression model with generalized estimating equations was used to identify risk factors for MZT, adjusting for potential misclassification of zygosity due to the absence of DNA confirmation.

MAIN RESULTS AND THE ROLE OF CHANCE: The MZT rate was 1.5% among live births following SET. Blastocyst transfer was associated with a nearly 2-fold increase in MZT risk compared to cleavage-stage transfer (adjusted odds ratio [aOR] = 1.99, 95% CI: 1.71-2.31), and vitrified-thaw transfers had a lower MZT risk than fresh transfers (aOR = 0.87, 95% CI: 0.79-0.95). Sensitivity analyses supported these findings, with consistent MZT risk patterns across subgroups by maternal age, fertilization technique, and embryo transfer type (fresh/frozen).

LIMITATIONS, REASONS FOR CAUTION: Zygosity estimation was based on Weinberg’s differential rule rather than DNA testing, which could lead to some misclassification. Additionally, the study lacked data on embryo quality, a variable with potential influence on MZT risk, and was limited to a retrospective design, potentially introducing treatment and information biases.

WIDER IMPLICATIONS OF THE FINDINGS: This large-scale study identifies blastocyst transfer and fresh embryo transfer as significant MZT risk factor in ART, with potential implications for patient counseling and obstetric care. Future research should further investigate the mechanisms underlying these associations.

STUDY FUNDING/COMPETING INTEREST(S): Funding was received from the Ferring Pharmaceuticals Pty Ltd as part of the Ferring FSANZ Leaders in Fertility Research and Education grant (to R.C.P.). The sponsors had no role in the design and conduct of the study; data collection, management, analysis, and interpretation; manuscript preparation, review, or approval; or the decision to submit for publication. FSANZ contracts National Perinatal Epidemiology and Statistics Unit (NPESU) of the University of New South Wales (UNSW) to prepare annual reports and benchmarking reports from the ANZARD: one of those datasets is used in this study. R.C.P. is a Research Fellow of the NPESU, UNSW; C.A.V. is affiliated with the NPESU, UNSW; G.M.C. is an employee of the UNSW and is the Director of the NPESU, UNSW. C.A.V., based at Aristotle University of Thessaloniki (Greece), is a member of the Executive Board of the Hellenic Society of Fertility and Sterility and serves as Senior Deputy of the Steering Committee for the SIG Reproductive Endocrinology of ESHRE. C.A.V. also reports lecture and advisory roles from Merck Ltd, Merck Sharpe & Dohme, Ferring, Organon, Gedeon-Richter, IBSA, Vianex, and Sonapharm; travel support from Merck Ltd, Merck Sharpe & Dohme, Ferring, Organon, Gedeon-Richter, and Vianex; and holds stock or stock options in Virtus Health Ltd, all outside the submitted work. O.F. reports funding from Ferring Pharmaceuticals Pty Ltd, unrelated to this study.

TRIAL REGISTRATION NUMBER: N/A.

PMID:40587819 | DOI:10.1093/humrep/deaf121

JCO Clin Cancer Inform. 2025 Jul;9:e2500023. doi: 10.1200/CCI-25-00023. Epub 2025 Jun 30.

ABSTRACT

PURPOSE: This study aimed to investigate whether changes in step count, measured using patients’ own smartphones, could predict a clinical adverse event in the upcoming week in patients undergoing systemic anticancer treatments using machine learning models.

METHODS: This prospective observational cohort study included patients with various cancer types receiving systemic anticancer treatment. Physical activity was monitored continuously using patients’ own smartphones, measuring daily step count for 90 days during treatment. Clinical adverse events (ie, unplanned hospitalizations and treatment modifications) were extracted from medical records. Models predicting adverse events in the upcoming 7 days were created using physical activity data from the preceding 2 weeks. Machine learning models (elastic net [EN], random forest [RF], and neural network [NN]) were trained and validated on a 70:30 split cohort. Model performance was evaluated using the AUC.

RESULTS: Among the 76 patients analyzed (median age 61 [IQR, 53-69] years, 39 [51%] female), 11 (14%) were hospitalized during the study period. The median step count during the first week of systemic treatment was 4,303 [IQR, 1926-7,056]. Unplanned hospitalizations in the upcoming 7 days could be predicted with high accuracy using RF (AUC = 0.88), NN (AUC = 0.84), and EN (AUC = 0.83). The models could not predict treatment modifications (AUC = 0.28-0.51) or the occurrence of any clinically relevant adverse event (AUC = 0.32-0.50).

CONCLUSION: A decline in daily step counts can serve as an early predictor for hospitalizations in the upcoming 7 days, facilitating proactive and preventive toxicity management strategies.

PMID:40587817 | DOI:10.1200/CCI-25-00023

JMIR Form Res. 2025 Jun 30;9:e65617. doi: 10.2196/65617.

ABSTRACT

BACKGROUND: Challenges in emergency medicine include overcrowding, insufficient emergency care resources, and extended emergency department (ED) waiting times. These issues contribute to delays in treatment and unfavorable outcomes. This situation worsens in events with large crowds and particularly worsened during the COVID-19 pandemic. The integration of augmented reality (AR) smart glasses could potentially enhance patient care in the ED.

OBJECTIVE: This study aims to assess the effectiveness of AR smart glasses in reducing patient care time in the ED during the 19th Asian Games and the Fourth Asian Para Games Hangzhou 2022 (HAG2022). The study specifically compares the prepreparation time (PPT) and consult response time (CRT) in patients receiving teleconsultations via AR smart glasses versus those receiving standard care without AR.

METHODS: This retrospective study was conducted between September 13, 2023, and October 28, 2023, during HAG2022. The data were gathered from AR smart glasses using 5G technology at the HAG2022 village and electronic health records at Sir Run Run Shaw Hospital, China. The study included 2 groups: the teleconsultation by augmented reality telemedicine system (ARTS) group and the non-ARTS group. The main data assessed were PPT and CRT in ED.

RESULTS: During the research period, 80 patients were divided into 2 cohorts: the ARTS cohort (n=10) and the non-ARTS cohort (n=70). Gender and age demographics showed no significant differences between the cohorts. The ARTS cohort had a significantly lower average PPT of 23 minutes compared to the non-ARTS cohort’s 40.3 minutes (P<.001). In addition, CRT in the ARTS cohort was significantly lower at 15.6 minutes compared to the non-ARTS cohort’s 164.8 minutes (P=.03). The outcomes suggest that smart glasses are effective in decreasing PPT and CRT.

CONCLUSIONS: AR smart glasses have the potential to enhance patient admission efficiency and reduce care time in EDs. However, despite these benefits, further research is needed to confirm their effectiveness, and additional studies are essential to identify the challenges and barriers to their successful implementation in emergency medicine.

PMID:40587811 | DOI:10.2196/65617

J Craniofac Surg. 2025 Jun 30. doi: 10.1097/SCS.0000000000011597. Online ahead of print.

ABSTRACT

BACKGROUND: A successful surgery is guaranteed by the preoperative planning lineation. Existing line drawing materials often fade or vanish after sterilization. To avoid the disappearance and movement of the preoperative drawing line, the authors looked for an ideal marking material-tattoo stickers that could retain stability and precision following disinfection.

METHODS: Four groups-Methylene Blue, Tattoo Sticker, Black Whiteboard Pen, and Red Marker Pen-were created for a surgical line drawing model. The 4 materials were used to make straight lines on the skin. After drying, the Black Whiteboard Pen and Red Marker Pen lines were fixed with iodine tincture. Subsequently, the marked area was sterilized thrice with iodine tincture to observe the residual rate of the marked lines. ImageJ software was used to analyze residual rates among groups. The experiments were repeated 10 times for each group.

RESULTS: The residual rate was significantly higher in the Tattoo Sticker group than other groups. The differences between Methylene Blue and Tattoo Sticker groups, Black Whiteboard Pen and Tattoo Sticker groups, and Red Marker Pen and Tattoo Sticker groups were statistically significant (P<0.001).

CONCLUSIONS: Tattoo stickers are ideal surgical line-drawing materials with good resistance to dissolution and stability, remaining visible even after surgical disinfection.

PMID:40587765 | DOI:10.1097/SCS.0000000000011597

Medicine (Baltimore). 2025 Jun 27;104(26):e42859. doi: 10.1097/MD.0000000000042859.

ABSTRACT

Employing a bidirectional 2-sample Mendelian Randomization (MR) approach, this study endeavors to assess the potential causal relationship between attention deficit hyperactivity disorder (ADHD) and atherosclerosis (AS). Single nucleotide polymorphism loci, associated with ADHD at a significant threshold (P < 5 × 10-8), were meticulously screened from genome-wide association studies datasets to serve as instrumental variables. The primary outcomes under investigation encompass AS, coronary atherosclerosis, and cerebral atherosclerosis. Employing inverse variance weighted method (IVW), MR-Egger regression, weighted median method, simple mode and weighted mode, MR analyses were executed to systematically evaluate the causal relationships between ADHD and AS, coronary atherosclerosis, and cerebral atherosclerosis. The MR analysis reveals a positive and statistically significant causal relationship between ADHD and AS (OR = 1.167, 95% CI = 1.003-1.359, P = .046). Notably, no discernible causal links were identified between ADHD and coronary atherosclerosis or cerebral atherosclerosis. Furthermore, there is a lack of evidence supporting an augmented risk of AS, coronary atherosclerosis, or cerebral atherosclerosis associated with ADHD. Through MR analysis, it was found that ADHD increases the risk of AS. However, no causal association has been identified in studies and reverse studies investigating the relationship between ADHD and both coronary atherosclerosis and cerebral atherosclerosis. Therefore, while ADHD may elevate the susceptibility to AS, further investigations are warranted to clarify the exact nature of this association.

PMID:40587750 | DOI:10.1097/MD.0000000000042859

Medicine (Baltimore). 2025 Jun 27;104(26):e43022. doi: 10.1097/MD.0000000000043022.

ABSTRACT

This study aimed to assess neutrophil-to-high-density lipoprotein cholesterol ratio (NHR) and other inflammatory and biochemical parameters as potential biomarkers for predicting gestational hypertension (GH) and preeclampsia (PE) in pregnant women. A total of 180 pregnant women were enrolled and divided into 3 groups: 58 with GH, 42 with PE, and 80 normotensive controls. Clinical, demographic, and laboratory data (inflammatory markers, lipid profiles, liver enzyme levels, and kidney function) were also collected. NHR and other biomarkers such as C-reactive protein (CRP) and white blood cell counts were compared across the groups. Statistical analyses, including univariate and multivariate regression, were conducted to identify significant predictors of GH and PE. The NHR was significantly higher in the GH (4.5 ± 1.1) and PE (5.2 ± 1.2) groups than in the normotensive controls (3.6 ± 1.1, P ˂ .001). Inflammatory markers, such as CRP, white blood cell count, and monocyte levels, were elevated in the GH and PE groups. In addition, the levels of glucose, creatinine, and liver enzymes were notably higher in the PE group. The NHR demonstrated a positive correlation with CRP levels. Regression analysis revealed that the NHR (P < .001), CRP (P = .002), and platelet count (P < .001) were independent predictors of GH and PE. The NHR may serve as an early inflammatory biomarker for predicting GH and PE. This finding suggests that NHR, along with other biomarkers, could be incorporated into clinical practice to improve the early identification and management of hypertensive disorders during pregnancy. Further prospective studies are needed to confirm these results and evaluate their clinical utility.

PMID:40587749 | DOI:10.1097/MD.0000000000043022