Laryngoscope. 2025 Oct 29. doi: 10.1002/lary.70064. Online ahead of print.
NO ABSTRACT
PMID:41159249 | DOI:10.1002/lary.70064
Tag: pubmed
J Res Health Sci. 2025 Sep 15;25(4):e00662. doi: 10.34172/jrhs.9131. Epub 2025 Sep 15.
ABSTRACT
BACKGROUND: The urban poor represent a vulnerable population within society, particularly in terms of maternal health. Economic and access-related limitations often prevent this group from accessing healthcare services, especially in the institutional delivery process. This study aimed to analyze the barriers to institutional delivery among Indonesia’s poor urban society. Study Design: This study employed a cross-sectional design.
METHODS: Data were obtained from the 2023 Indonesian Health Survey, including 7,548 participants. Eight independent variables were analyzed, including age, education, marital status, employment, wealth, insurance, and parity, with institutional delivery used as the dependent variable. Binary logistic regression was employed for analysis.
RESULTS: Approximately 38.1% of Indonesian pregnant women had non-institutional deliveries. All age groups showed a higher likelihood of non-institutional delivery compared to those aged≥45. Lower education levels were associated with a heightened probability of choosing non-institutional delivery. Married women were 0.704 times less likely than divorced or widowed women to give birth in non-institutional settings (AOR: 0.704; 95% CI: 0.693-0.716). Unemployed women had 1.218 times higher likelihood of engaging in non-institutional delivery compared to employed women (AOR: 1.218; 95% CI: 1.1210-1.226). The poorest women were 0.973 times less likely than the poorer group to have non-institutional delivery (AOR: 0.973; 95% CI: 0.967-0.980). Uninsured women were 2.364 times more likely than insured women to give birth outside of healthcare institutions(AOR: 2.364; 95% CI: 2.345-2.379). Women with all other parity levels were less likely than grand multiparous women to have non-institutional deliveries.
CONCLUSION: Seven barrier factors to institutional delivery were younger age, low education, divorced/widowed marital status, unemployment, lower wealth status, lack of insurance, and grand multiparity.
PMID:41159206 | DOI:10.34172/jrhs.9131
J Res Health Sci. 2025 Sep 15;25(4):e00661. doi: 10.34172/jrhs.11317. Epub 2025 Sep 15.
ABSTRACT
BACKGROUND: Substance use is common among street adolescents and is strongly associated with sexual risk behavior as well as vulnerability to sexually transmitted infections. Therefore, this study was conducted to explore patterns of substance use and the association with sexual risk behavior among street adolescents in Central Java, Indonesia. Study Design: A cross-sectional study.
METHODS: In this cross-sectional study, data were collected from 248 street adolescents through face-to-face interviews using a validated questionnaire. Data analysis was conducted using descriptive statistics, chi-square tests, and multivariate logistic regression in SPSS version 25.0.
RESULTS: More than a quarter of adolescents reported engaging in high-risk sexual behavior. Heavy smoking, alcohol use, and frequent exposure to pornography were prevalent. Alcohol use was significantly associated with sexual risk behavior, with adjusted odds ratios ranging from 3.26 to 4.38 across Models I-III. Furthermore, frequent exposure to pornography showed a strong association, with odds ratios of 3.02 (Model I) and 4.20 (Model II). These associations remained significant after adjusting for demographic and behavioral variables.
CONCLUSION: Substance use, particularly alcohol consumption, and frequent exposure to pornography were significantly associated with sexual risk behavior among street adolescents. Therefore, interventions should be developed to address the specific needs of this population. Adolescents engaged in high-risk behavior, such as substance use and sexual risk behavior, required high attention and specific treatment options.
PMID:41159205 | DOI:10.34172/jrhs.11317
Front Neurol. 2025 Oct 13;16:1678379. doi: 10.3389/fneur.2025.1678379. eCollection 2025.
ABSTRACT
OBJECTIVE: To evaluate the efficacy of 5 Hz repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (left DLPFC) for consciousness recovery in children with disorders of consciousness (DOC) following traumatic brain injury (TBI).
METHODS: This randomized controlled trial included 98 pediatric patients aged ≥2 years with DOC after TBI, admitted to Kunming Children’s Hospital from January 2023 to July 2025. Patients were randomly divided into an experimental group (n = 49) and a control group (n = 49). The experimental group received 5 Hz rTMS targeting the left DLPFC (80% resting motor threshold, 1,000 pulses per session, totaling 20 min), combined with conventional rehabilitation therapy (once daily for 3 weeks). The control group received only conventional rehabilitation therapy. The primary efficacy outcomes included serum neuron-specific enolase (NSE) level, Coma Recovery Scale-Revised (CRS-R) score, Glasgow Coma Scale (GCS) score, and level of consciousness before and after treatment.
RESULTS: After 3 weeks of intervention, the experimental group demonstrated statistically significant improvements compared to both baseline status and the control group (p < 0.05). The experimental group demonstrated a significant reduction in serum NSE levels, a significant increase in CRS-R and GCS scores, and a significant improvement in the level of consciousness. No adverse events (including seizures) were observed throughout the treatment.
CONCLUSION: This study provided the first clinical evidence that the combined application of 5 Hz rTMS targeting the left DLPFC is a safe and effective intervention for promoting the recovery of consciousness in children with DOC following TBI. Significant improvements in behavioral scales (CRS-R, GCS) and reduced levels of the neurological injury marker (serum NSE) suggest that this protocol exerts dual effects of promoting arousal and neuroprotection. This novel treatment approach, designed based on the characteristics of pediatric neurological development, offers a promising non-invasive neuromodulation strategy for this challenging patient population, filling a critical evidence gap in this field.
PMID:41159198 | PMC:PMC12554438 | DOI:10.3389/fneur.2025.1678379
Endocrinol Diabetes Metab. 2025 Nov;8(6):e70121. doi: 10.1002/edm2.70121.
ABSTRACT
BACKGROUND: Recent human studies have indicated the beneficial effects of yacon on diabetes and metabolic syndrome; however, no meta-analysis has investigated the effects of yacon on glycemic control and lipid profiles.
METHODS: Searches were conducted in five databases-PubMed, Web of Science, Scopus, Google Scholar, Cochrane Library-and relevant randomised controlled trials (RCTs) until June 2024. The random-effects model was employed to compute the effect size, thereafter represented as a weighted mean difference (WMD) and a 95% confidence interval (CI). This study’s registration number in PROSPERO is CRD420251028504.
RESULTS: This study integrated seven RCTs with 239 participants. The results demonstrated that yacon consumption had no statistically significant effects on fasting blood sugar (FBS, p = 0.33), insulin levels (p = 0.76), homeostasis model assessment for insulin resistance (HOMA-IR, p = 0.42), total cholesterol (TC, p = 0.17), low-density lipoprotein (LDL, p = 0.12), high-density lipoprotein (HDL, p = 0.42), or triglycerides (TG, p = 0.75). However, subgroup studies indicated that yacon consumption reduced FBS levels over an exceeding 8-week duration in both sexes and in persons over 40. Furthermore, yacon intake resulted in a decrease in LDL-cholesterol levels for more than 8 weeks, particularly in women and individuals over 40. Additionally, it led to a decrease in LDL-cholesterol levels among women and individuals over 40 who consumed yacon for more than 8 weeks, and HDL-cholesterol levels increased in those aged 40 and above.
CONCLUSION: Overall, this meta-analysis indicates that yacon use in adults does not lead to significant improvements in lipid profiles or glycemic parameters.
PMID:41152200 | DOI:10.1002/edm2.70121
Colorectal Dis. 2025 Nov;27(11):e70291. doi: 10.1111/codi.70291.
ABSTRACT
AIM: Individual components of surgical quality in locally advanced rectal cancer (LARC) – circumferential and distal resection margins and mesorectal completeness – are known prognostic factors. However, their combined prognostic value as a composite score remains underexplored. This study aimed to evaluate the impact of a composite quality total mesorectal excision (TME) score on oncological outcomes, and how this effect may vary with intervals from neoadjuvant therapy (NAT) to surgery.
METHOD: This retrospective, multicentre cohort study included patients with LARC treated between 2005 and 2020 across six referral centres in the CRONOS study. Patients were categorised by the composite quality TME (successful/unsuccessful) and by the NAT-to-TME interval: short (≤8 weeks), intermediate (>8 to ≤12), or long (>12). Primary outcomes were locoregional recurrence (LR), systemic recurrence (SR), and overall survival (OS) in the unsuccessful group. The interaction between the composite score and NAT-to-TME interval was assessed as a secondary outcome.
RESULTS: Of 1485 patients, 191 (12.9%) had an unsuccessful composite quality TME. This was significantly associated with increased risk of LR (HR 4.63, 95% CI: 3.04-7.05), SR (HR 2.10, 95% CI: 1.56-2.81), and reduced OS (HR 2.31, 95% CI: 1.79-2.98). Short and intermediate intervals increased the risk of LR in the unsuccessful group (pinteraction = 0.06).
CONCLUSION: Patients with an unsuccessful composite quality TME are at high risk of recurrence and death. The link between shorter NAT-to-surgery intervals and poorer outcomes in this subgroup suggests that extending the interval beyond 12 weeks may help optimise results in selected patients.
PMID:41152188 | DOI:10.1111/codi.70291
Alzheimers Dement. 2025 Oct;21(10):e70864. doi: 10.1002/alz.70864.
ABSTRACT
INTRODUCTION: Evidence is needed to evaluate whether low vitamin B12 from mid- to late life, either alone or in the presence of elevated folate, is associated with cognitive decline.
METHODS: Participants from the Framingham Heart Study without baseline dementia who had ≥ 2 measures of a three-component vitamin B12 indicator (3cB12) and neuropsychological factor scores were included (n = 1994; mean age: 60 years). Adjusted linear mixed effects models estimated annual changes in each factor score between 3cB12 quartiles. Interaction by folate status was also evaluated.
RESULTS: Participants in the highest 3cB12 quartile had slower declines in memory, executive function, and language compared to the lowest quartile (memory: β = 0.0071, 95% confidence interval [CI] = 0.003-0.01; executive function: β = 0.0056, 95% CI = 0.0009-0.01; and language: β = 0.0090, 95% CI = 0.004-0.01). Findings were largely robust by folate status (elevated: ≥ 20 ng/mL; non-elevated: 6-19 ng/mL).
DISCUSSION: Improving B12 status in dementia-free older adults may help mitigate cognitive decline into later life.
HIGHLIGHTS: Higher vitamin B12 status is associated with slower annual cognitive decline. Higher B12 was linked with 0.05 to 0.09 standard deviation less cognitive decline over 10 years. B12 and memory findings are robust for elevated, not non-elevated, folate status.
PMID:41152187 | DOI:10.1002/alz.70864
Clin Implant Dent Relat Res. 2025 Dec;27(6):e70099. doi: 10.1111/cid.70099.
ABSTRACT
OBJECTIVE: To assess and compare the effectiveness of different bone grafting techniques, including unmasked meshes and graft-masked meshes approaches, for augmenting alveolar bone defects using 3D-printed titanium mesh (3D-TM).
MATERIALS AND METHODS: This retrospective study included 34 patients (69 teeth with alveolar bone defects) who underwent guided bone regeneration (GBR) using 3D-printed titanium mesh (3D-TM). Patients were assigned to two groups: the unmasked meshes group (n = 17, 34 treatment sites) and the graft-masked meshes group (n = 17, 35 treatment sites). Cone beam computed tomography (CBCT) data of pre- and post-operative 3D-TM implantation were digitally reconstructed, with a minimum 6-month follow-up period. Clinical outcomes included titanium mesh exposure rates, pseudo-periosteum rates, and osteogenic efficiency metrics such as bone volume, vertical bone height/width, and bone contour. Bone volume was analyzed using samples t-tests, vertical bone height/width was analyzed using a generalized estimating equations (GEE) model, and bone contour was analyzed using the Mann-Whitney U test. Categorical outcomes were evaluated via Fisher’s exact probability test.
RESULTS: Clinical complications analysis revealed distinct outcomes between the two groups. Titanium mesh exposure occurred in 7 cases overall, with no statistically significant difference between the unmasked meshes group (5/17, 29.4%) and the graft-masked meshes group (2/17, 11.8%) (Fisher’s exact test, p = 0.398). In contrast, pseudo-periosteum demonstrated a significant discrepancy, observed in 14/17 cases (82.4%) in the unmasked meshes group compared to 4/17 cases (23.5%) in the graft-masked meshes group (Fisher’s exact test, p = 0.002). Notably, no infections occurred in either group. Analysis of osteogenic efficacy revealed significant intergroup differences in bone volume ratio (Independent samples t-test, df = 32, p < 0.05), vertical bone height ratio, and width ratio (GEE, df = 1, p < 0.05), and bone contour accuracy at the minimum and 25% percentiles (Mann-Whitney U test, p < 0.05). No significant differences were observed at the 50%, 75% percentile, or maximum value.
CONCLUSION: The graft-masked meshes technique in 3D-TM guided bone regeneration surgery is a reliable and effective method for augmenting alveolar bone defects. This method effectively reduces procedure-related complications, including titanium mesh exposure and pseudo-periosteum, thereby improving osteogenic efficacy.
PMID:41152184 | DOI:10.1111/cid.70099
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2025 Oct 25;42(5):1076-1084. doi: 10.7507/1001-5515.202503075.
ABSTRACT
With the rising incidence of breast cancer among women, neoadjuvant chemotherapy (NAC) is becoming increasingly crucial as a preoperative treatment modality, enabling tumor downstaging and volume reduction. However, its efficacy varies significantly among patients, underscoring the importance of predicting pathological complete response (pCR) following NAC. Early research relied on statistical methods to integrate clinical data for predicting treatment outcomes. With the advent of artificial intelligence (AI), traditional machine learning approaches were subsequently employed for efficacy prediction. Deep learning emerged to dominate this field, and demonstrated the capability to automatically extract imaging features and integrate multimodal data for pCR prediction. This review comprehensively examined the applications and limitations of these three methodologies in predicting breast cancer pCR. Future efforts must prioritize the development of superior predictive models to achieve precise predictions, integrate them into clinical workflows, enhance patient care, and ultimately improve therapeutic outcomes and quality of life.
PMID:41152181 | DOI:10.7507/1001-5515.202503075
Alzheimers Dement. 2025 Oct;21(10):e70841. doi: 10.1002/alz.70841.
ABSTRACT
INTRODUCTION: Older adults with cognitive impairment (CI) face challenges to aging in the community. Little is known about the housing characteristics of US older adults with CI.
METHODS: Using the 2022 National Health and Aging Trends Study, we describe housing characteristics of community-living older adults ≥ 65 years with CI (n = 968) using descriptive statistics (frequencies) and conduct chi-squared tests to compare characteristics of those who lived with others (n = 707) versus alone (n = 261).
RESULTS: Renting (41%), home modifications (59% had ≥ 2), and interior home disorder (45%) were prevalent among older adults with CI. Those living alone more commonly rented, lived in an apartment or mobile home (vs. house), and had more home modifications than those living with others (all p < 0.05).
DISCUSSION: Further study should examine how housing characteristics support or deter daily function and inform the long-term services and supports needed by this high-needs, understudied population.
HIGHLIGHTS: There are 5.5 million older adults living in the community with cognitive impairment (CI). Of this population, 26% live alone. Older adults living alone with CI are primarily female, older, with lower incomes. Nearly half of older adults living alone with CI are renters. Home accessibility modifications were very common in this population.
PMID:41152155 | DOI:10.1002/alz.70841