Tag: pubmed

Yonsei Med J. 2025 Nov;66(11):790-796. doi: 10.3349/ymj.2024.0490.

ABSTRACT

PURPOSE: We aimed to investigate the association between the results of color vision tests and simulation tests for police tasks among participants with color vision deficiencies (CVDs) and those with normal vision, and to assess the agreement between the results of various color vision tests.

MATERIALS AND METHODS: Participants with CVDs and healthy controls were recruited. Participants in the CVD group were classified into three subgroups (mild weakness, severe weakness, and color blindness). All participants performed simulation tests (bloodstain identification, traffic light test, and analysis of dashboard camera recordings) and clinical color vision tests. We statistically analyzed the association between color vision tests and simulation tests and quantitatively assessed the agreement between various color vision tests.

RESULTS: We evaluated 25 participants with normal vision (92.0% male) and 21 with CVDs (95.2% male). Even in the mild CVD group, the scores for the traffic light test and dashboard camera recordings were lower than those of the control group (9.40±0.57 vs. 9.06±0.84, and 1.80±0.40 vs. 1.44±0.77, all p<0.05). However, no difference in the bloodstain identification test scores was observed between the control and CVD groups (p=0.190). Additionally, the association with anomaloscope results was strongest in the following order: Ishihara, Hardy-Rand-Rittler, Farnsworth-Munsell 100 hue, and Farnsworth D-15 tests.

CONCLUSION: This study demonstrated a correlation between the results of clinical color vision tests and police-related simulation tests. Particularly, the score for recognizing traffic signs or analyzing dashboard camera recordings was lower even in those with mild CVD than in those with normal vision.

PMID:41145314 | DOI:10.3349/ymj.2024.0490

Yonsei Med J. 2025 Nov;66(11):722-730. doi: 10.3349/ymj.2025.0058.

ABSTRACT

PURPOSE: Pneumocystis jirovecii pneumonia (PJP) is a life-threatening infection. The prevalence of PJP in patients without human immunodeficiency virus (HIV) (non-HIV-PJP) is increasing. Previous studies have separately evaluated the clinical characteristics of PJP patients with and without HIV infection. Therefore, this study aimed to comparatively analyze the clinical characteristics of PJP patients with and without HIV.

MATERIALS AND METHODS: We retrospectively reviewed patients with PJP who were admitted to a single tertiary center for 15 years. PJP patients were classified according to the presence or absence of HIV, and differences in their clinical characteristics and prognoses were analyzed. Forty-four HIV-PJP patients and 175 non-HIV-PJP patients were included.

RESULTS: Cough, dyspnea, typical computed tomography findings of PJP, and cytomegalovirus (CMV) pneumonitis co-infection were more common in the HIV-PJP group. The durations from symptom onset to PJ polymerase chain reaction (PCR) testing and to the start of treatment were longer in the HIV-PJP group; however, the time from the PJ PCR test to antibiotic administration was shorter in the HIV-PJP group. The 28-day survival rates were 68.6% and 88.6% in the non-HIV-PJP and HIV-PJP groups, respectively (p=0.011). The survival rate of patients with CMV pneumonitis co-infection in the non-HIV-PJP group was significantly lower.

CONCLUSION: The clinical characteristics of patients with HIV-PJP and non-HIV-PJP were statistically different. The initial clinical features appeared to be worse in the HIV-PJP group; however, the 28-day mortality rate was higher in the non-HIV-PJP group.

PMID:41145307 | DOI:10.3349/ymj.2025.0058

Am J Hosp Palliat Care. 2025 Oct 27:10499091251393485. doi: 10.1177/10499091251393485. Online ahead of print.

ABSTRACT

BackgroundEarly-onset Alzheimer’s disease is a rapidly progressing condition that severely disrupts quality of life. Early palliative care incorporation helps identify patients’ needs and facilitates family decision-making and advanced care planning for later stages.AimThe study aimed to assess palliative care needs, level of suffering, and most frequent symptoms in Early-onset Alzheimer’s patients.MethodsWe present a preliminary observational analysis as part of a larger, 18-month longitudinal study of patients with early-onset Alzheimer’s disease. Patients with the PSEN1-E280 A variant of Early-onset Alzheimer’s disease attending the Antioquia Neuroscience Group at the University of Antioquia in Medellín, Colombia, participated. Data were collected using NECPAL, Edmonton Symptom Assessment System Revised, Global Deterioration Scale/Functional Assessment Staging (GDS/FAST), Pain Assessment in Advanced Dementia (PAINAD), and a numeric rating scale. Regarding data analyses from visit 1 (V1), variables were described according to their nature. A Poisson regression was performed, and prevalence ratios, 95% confidence intervals, and P values were obtained. Statistical significance was defined with an alpha value of 5%.ResultsThirty-six patients participated in V1. Median age was 53. Most of them were women and lived in urban areas. The prevalence of palliative care needs was 22.22%. Poisson regression showed an association between clinician-perceived need for palliative care and dysphagia, pressure ulcers, asthenia, insomnia, functional decline, resource utilization, positive surprise question in NECPAL instrument, and scores of the PAINAD and GDS/FAST scales.ConclusionPatients with Early-onset Alzheimer’s have palliative care needs associated with symptoms related to disease progression, prognosis, resource utilization, and pain.

PMID:41144993 | DOI:10.1177/10499091251393485

Am J Hosp Palliat Care. 2025 Oct 27:10499091251388625. doi: 10.1177/10499091251388625. Online ahead of print.

ABSTRACT

Palliative Care Consultation (PCC) is an established intervention that prioritizes goals of care conversations and assists patients with complex medical decision-making. Evidence suggests that PCC can reduce the amount of non-goal concordant care patients receive such as fewer invasive procedures, less mechanical ventilation, and quicker transition to hospice and referral to appropriate resources, if that aligns with patient wishes. This results in decreased resource utilization, reduced anxiety for patients and their family members, and decreased moral distress for the health care team. Studies generally agree that benefits of PCC are greater the quicker the time to intervention, but results are mixed regarding hospital and intensive care unit (ICU) length of stay (LOS). LOS is a surrogate marker for goal-concordant care, and shorter LOS has been associated with decreased health care costs. This systematic literature review seeks to clarify the effects of early PCC versus standard PCC on length of stay. From an extensive search of CINAHL, EMBASE, Scopus, and PubMed, 17 articles met criteria to be reviewed. These articles include 2 randomized controlled trials (RCTs), 6 prospective cohort studies, and 9 retrospective cohort studies. Nine studies found statistically significant results linking early PCC with shorter length of stay. These results indicate that a change in practice could be considered given the multiple positive outcomes associated with early PCC. Further research is recommended with larger sample sizes across multiple institutions to improve generalizability of these initial findings, and to examine the different modalities of implementing early PCC into existing ICU workflows.

PMID:41144983 | DOI:10.1177/10499091251388625

Ann Intern Med. 2025 Oct 28. doi: 10.7326/ANNALS-25-01519. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with irritable bowel syndrome (IBS) frequently seek dietary advice, but few evidence-based options exist. Major societal guidelines recommend traditional dietary advice (TDA) as first-line therapy, with the cumbersome and resource-intensive low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet reserved as second-line therapy. Recent pilot data suggest that the Mediterranean diet (MD), renowned for its general health benefits, improves IBS symptoms, but whether it can be considered another first-line dietary option is unknown.

OBJECTIVE: To determine if the MD is noninferior to TDA in managing IBS symptoms.

DESIGN: Randomized noninferiority clinical trial. (ClinicalTrials.gov: NCT05985018).

SETTING: Online virtual platform.

PARTICIPANTS: 139 persons with IBS from across the United Kingdom.

INTERVENTION: 6 weeks of the MD (n = 68) or TDA (n = 71).

MEASUREMENTS: Primary end point was the proportion achieving clinical response, defined as 50-point or greater reduction in IBS Symptom Severity Scale (IBS-SSS). Secondary outcomes included changes in IBS-SSS scores, psychological health, somatic symptom reporting, quality of life, diet satisfaction, and Mediterranean Diet Adherence Screener (MEDAS).

RESULTS: Baseline characteristics (mean age, 40.4 years [range, 19 to 65 years]; 80% women) and IBS-SSS (mean, 309 [SD, 90]) were similar between groups. On modified intention-to-treat analysis, the primary end point was met by 62% (95% CI, 50% to 73%) following a MD versus 42% (CI, 31% to 55%) following TDA. The difference in clinical response favored the MD (difference, 20 percentage points [CI, 4 to 36 percentage points]; P = 0.017), demonstrating noninferiority and superiority. There was a greater reduction in the mean IBS-SSS after a MD than TDA (-101.2 vs. -64.5; Δ-36.7 [CI,-70.5 to -2.8]; P = 0.034). No statistically significant differences were seen between the groups with regard to changes in mood, somatic symptoms, quality of life, or diet satisfaction. The MEDAS significantly increased after a MD compared with TDA (P < 0.001).

LIMITATION: No long-term data.

CONCLUSION: The MD showed noninferiority and superiority to TDA in managing IBS symptoms. It represents a viable first-line dietary intervention for IBS.

PRIMARY FUNDING SOURCE: None.

PMID:41144975 | DOI:10.7326/ANNALS-25-01519

Issues Ment Health Nurs. 2025 Oct 27:1-13. doi: 10.1080/01612840.2025.2567886. Online ahead of print.

ABSTRACT

This study examined the effect of a self-compassion-oriented mindfulness-based psychoeducation program on internalized stigma in individuals diagnosed with schizophrenia. This single-blind, randomized controlled experimental study was conducted with individuals with schizophrenia who were receiving follow-up care at a Community Mental Health Center in a province in northern Türkiye between June and August 2024. Following the administration of pretest assessments, the sample was randomly allocated into an experimental group (n = 21) and a control group (n = 21) through simple randomization. The psychoeducation program, adapted to the specific needs of this population, was administered to the experimental group. Data were collected using the Internalized Stigma of Mental Illness (ISMI) scale and the Descriptive Characteristics Form. Posttest measurements revealed a statistically significant difference between the experimental and control groups in the total score and the subdimensions of Alienation, Stereotype Endorsement, Perceived Discrimination, and Social Withdrawal (p < 0.05). However, no significant difference was observed between the groups in the Stigma Resistance subdimension scores (p > 0.05). The psychoeducation program significantly reduced the total scores on the ISMI among individuals diagnosed with schizophrenia, demonstrating a large effect size of 17.3% (η2 = 0.173; p = 0.006). These findings suggest that a self-compassion-oriented mindfulness-based psychoeducation program, adapted specifically for individuals with schizophrenia, is an effective intervention for reducing internalized stigma in this population.

PMID:41144956 | DOI:10.1080/01612840.2025.2567886

JMIR Mhealth Uhealth. 2025 Oct 27;13:e78036. doi: 10.2196/78036.

ABSTRACT

BACKGROUND: Chinese Americans with type 2 diabetes (T2D) face many linguistic, cultural, and social determinants of health-related barriers to accessing evidence-based diabetes interventions. Our team developed the culturally and linguistically tailored Chinese American Research and Education (CARE) program to provide evidence-based diabetes education and support to this group and demonstrated the feasibility, acceptability, and potential efficacy of the intervention on improving hemoglobin A_1c levels. However, it remains unclear whether the CARE program also improves diabetes self-efficacy and psychosocial outcomes in the same study sample.

OBJECTIVE: This is a secondary analysis to examine the potential efficacy of the CARE program on secondary outcomes, including diabetes self-efficacy, self-care activities, beliefs in diabetes self-care activities, and diabetes distress among Chinese Americans with T2D.

METHODS: A 2-arm, pilot randomized controlled trial was conducted to evaluate the CARE program between March 1, 2021, and April 21, 2023. The trial included 60 Chinese Americans aged 18 to 70 years who had a diagnosis of T2D and a baseline hemoglobin A_1c level of 7% or higher. Participants were recruited from various health care settings in New York City, including community health centers, private primary care providers, and NYU Langone Health and its affiliates, and were randomly assigned to either the CARE intervention group (n=30) or a waitlist control group (n=30). The intervention consisted of 2 culturally and linguistically tailored educational videos per week for 12 weeks, covering diabetes self-care topics such as healthy eating, physical activity, and medication adherence. These videos were delivered via the WeChat app. In addition, community health workers provided support calls to assist them in setting goals, problem-solving, and addressing social determinants of health barriers every 2 weeks. Secondary outcomes included patient self-reported diabetes self-efficacy, self-care activities, beliefs in diabetes self-care activities, and diabetes distress. Outcomes were assessed at baseline, 3 months, and 6 months.

RESULTS: Participants had a mean age of 54.3 (SD 11.5) years and 62% (37/60) were male, 78% (47/60) were married, 58% (35/60) were employed, 70% (42/60) had a high school education or lower, and 88% (53/60) reported limited English proficiency. Intervention participants demonstrated statistically significant improvements in self-efficacy at 3 months (estimated difference in change: 8.47; 95% CI 2.44-14.5; adjusted P=.02), diabetes distress at 6 months (estimated difference in change: -0.43; 95% CI -0.71 to -0.15; adjusted P=.009), and adherence to a healthy diet at both 3 months (estimated difference in change: 1.61; 95% CI 0.46-2.75; adjusted P=.02) and 6 months (estimated difference in change: 1.64; 95% CI 0.48-2.81; adjusted P=.02).

CONCLUSIONS: The culturally and linguistically tailored intervention showed promise in improving self-efficacy and diabetes self-care activities among Chinese Americans with T2D, warranting validation through a large-scale randomized controlled trial.

TRIAL REGISTRATION: ClinicalTrials.gov NCT03557697; https://clinicaltrials.gov/study/NCT03557697.

PMID:41144955 | DOI:10.2196/78036

J Med Internet Res. 2025 Oct 27;27:e76947. doi: 10.2196/76947.

ABSTRACT

BACKGROUND: Large language models (LLMs) have the potential to revolutionize ophthalmic care, but their evaluation practice remains fragmented. A systematic assessment is crucial to identify gaps and guide future evaluation practices and clinical integration.

OBJECTIVE: This study aims to map the current landscape of LLM evaluations in ophthalmology and explore whether performance synthesis is feasible for a common task.

METHODS: A comprehensive search of PubMed, Web of Science, Embase, and IEEE Xplore was conducted up to November 17, 2024 (no language limits). Eligible publications quantitatively assessed an existing or modified LLM on ophthalmology-related tasks. Studies without full-text availability or those focusing solely on vision-only models were excluded. Two reviewers screened studies and extracted data across 6 dimensions (evaluated LLM, data modality, ophthalmic subspecialty, medical task, evaluation dimension, and clinical alignment), and disagreements were resolved by a third reviewer. Descriptive statistics were analyzed and visualized using Python (with NumPy, Pandas, SciPy, and Matplotlib libraries). The Fisher exact test compared open- versus closed-source models. An exploratory random-effects meta-analysis (logit transformation; DerSimonian-Laird τ²) was performed for the diagnosis-making task; heterogeneity was reported with I² and subgrouped by model, modality, and subspecialty.

RESULTS: Of the 817 identified records, 187 studies met the inclusion criteria. Closed-source LLMs dominated: 170 for ChatGPT, 58 for Gemini, and 32 for Copilot. Open-source LLMs appeared in only 25 (13.4%) of studies overall, but they appeared in 17 (77.3%) of evaluation-after-development studies, versus 8 (4.8%) pure-evaluation studies (P<1×10^-5). Evaluations were chiefly text-only (n=168); image-text tasks, despite the centrality of imaging, were used in 19 studies. Subspecialty coverage was skewed toward comprehensive ophthalmology (n=72), retina and vitreous (n=32), and glaucoma (n=20). Refractive surgery, ocular pathology and oncology, and ophthalmic pharmacology each appeared in 3 or fewer studies. Medical query (n=86), standardized examination (n=41), and diagnosis making (n=29) emerged as the 3 predominant tasks, while research assistance (n=5), patient triaging (n=3), and disease prediction (n=3) received less attention. Accuracy was reported in most studies (n=176), whereas calibration and uncertainty were almost absent (n=5). Real-world patient data (n=45), human performance comparison (n=63), non‑English testing (n=24), and real-world deployment (n=4) were relatively absent. Exploratory meta-analysis pooled 28 diagnostic evaluations from 17 studies: overall accuracy was 0.594 (95% CI 0.488-0.692) with extreme heterogeneity (I²=94.5%). Subgroups remained heterogeneous (I²>80%), and findings were inconsistent (eg, pooled GPT-3.5>GPT-4).

CONCLUSIONS: Evidence on LLM evaluations in ophthalmology is extensive but heterogeneous. Most studies have tested a few closed-source LLMs on text-based questions, leaving open-source systems, multimodal tasks, non-English contexts, and real-world deployment underexamined. High methodological variability precludes meaningful performance aggregation, as illustrated by the heterogeneous meta-analysis. Standardized, multimodal benchmarks and phased clinical validation pipelines are urgently needed before LLMs can be safely integrated into eye care workflows.

PMID:41144954 | DOI:10.2196/76947

J Clin Lab Anal. 2025 Oct 27:e70126. doi: 10.1002/jcla.70126. Online ahead of print.

ABSTRACT

BACKGROUND: Hemorrhagic fever with renal syndrome (HFRS) is an endemic disease occurring in various parts of the world. Prompt access to care with proper treatment is essential for preventing patients from developing renal failure and unfavorite outcomes. This study aimed to elucidate laboratory parameters associated with HFRS severity and prognosis to predict disease course and initiate prompt clinical management.

METHODS: Retrospective analysis of laboratory data was performed on HFRS patients from December 2016 to January 2022 in Baoji City of Shaanxi Province in China using different statistical methods.

RESULTS: The WBC and neutrophils in peripheral blood, RBC in urine sediments, blood, protein, and glucose in urine, PT/INR, aPTT, TT, AST, ALT, AST/ALT, MAO, AD, urea, creatinine, cystatin C, CK-MB, LDH, α-HBDH, mAST, triglycerides, glucose, amylase, ferritin, and PCT in serum increased in HFRS patients along with disease severity, while the lymphocytes, monocytes, platelets, plateletcrit, fibrinogen, serum total protein, albumin, HDL-c, magnesium, complement C3 and C4, IgG, triiodothyronine, thyroxine, and free triiodothyronine were reduced. Results also indicated that in uncured HFRS patients, the NEUT%, CRP, cast, PT/INR, aPTT, D-dimer, AST/ALT, CK-MB, LDH, α-HBDH, m-AST, ferritin, and PCT were significantly higher than in cured patients, while platelets, C3, and C4 in uncured patients were significantly lower than in cured patients. The NEUT%, CRP, AST/ALT, and LDH were associated with patients’ prognosis.

CONCLUSIONS: Laboratory data are helpful in predicting HFRS patients’ progress, severity, and prognosis, thus, these parameters are useful in guiding prompt clinical management of patients.

PMID:41144944 | DOI:10.1002/jcla.70126

Psychol Health Med. 2025 Oct 27:1-20. doi: 10.1080/13548506.2025.2575410. Online ahead of print.

ABSTRACT

Breast cancer is the most common cancer type among women, and it is a life-threatening disease. Although women with breast cancer may experience psychological distress, they may also experience posttraumatic growth (PTG). Therefore, this pilot study aimed to develop and test the effectiveness of an online group intervention focused on posttraumatic growth (PTGG) in women diagnosed with breast cancer. The sample of the randomized controlled trial consisted of 49 women with a mean age of 45.94 (7.57) years, ranging from 28 to 64 years, who were randomly assigned to eight weekly group sessions of PTGG, support groups (SG), and waitlist control groups (WLG). PTG, depression, anxiety, and stress scores were assessed at the pretest, posttest, and one-month follow-up. ANCOVA results indicated that PTGG was effective in promoting PTG on both the total and subscales and in reducing depression, compared with the other groups. These improvements were maintained at follow-up in favor of PTGG. However, no statistically significant differences were found between PTGG, SG, and WLG for anxiety and stress, indicating that no advantages were found in favor of either PTGG or SG. It was observed that the intervention effect was significant in analyses that included only clinically distressed individuals. Clinically depressed and anxious individuals in the PTGG reported greater improvements than those in the control group. Concerning these findings, our results also suggest that PTGG could be considered an effective online group intervention for distressed individuals with scores above the threshold, particularly for depression and anxiety. In conclusion, online PTGG can be used as an effective approach to enhance PTG and reduce psychological distress in women with breast cancer.

PMID:41144939 | DOI:10.1080/13548506.2025.2575410