Tag: pubmed

Harv Rev Psychiatry. 2025 Jan-Feb 01;33(1):1-7. doi: 10.1097/HRP.0000000000000414.

ABSTRACT

LEARNING OBJECTIVE: After participating in this CME activity, the psychiatrist should be better able to:• Explain current understanding of the relationship between chronic benzodiazepine use and dementia.

BACKGROUND: Chronic use of benzodiazepines (BZ) for managing conditions such as anxiety disorders, depression, sleep disorders, and other chronic diseases is widespread; yet, there is considerable controversy regarding its potential links to dementia risk. This systematic review and meta-analysis aims to clarify this relationship by synthesizing and analyzing the available evidence to provide a clearer understanding of whether prolonged BZ use contributes to developing dementia.

METHODS: This study adheres to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered with PROSPERO to ensure methodological rigor and transparency. The research strategy incorporated terms such as “benzodiazepines” OR “benzodiazepine” AND “cognitive dysfunction” OR “dementia” AND “adult” OR “elderly” OR “aged.” We included prospective and retrospective observational studies, as well as case-control studies. Data were meticulously extracted regarding chronic BZ use and dementia risk. Each study’s risk of bias was assessed to ensure result validity. Statistical analysis was performed using hazard ratios (HR) as the primary meta-analysis summary measure to provide a precise evaluation of associated risk.

RESULTS: Analysis of five studies showed that chronic BZ use was associated with a nonsignificant risk of dementia-without specification of cause-with an HR of 1.17 (95% CI: 0.96-1.43). Regarding Alzheimer’s disease, three studies found no significant association with an HR of 1.00 (95% CI: 0.87-1.15).

CONCLUSIONS: Our findings did not reach statistical significance, suggesting no strong link between chronic BZ use and dementia. Further research is needed to clarify this potential association.

PMID:39761441 | DOI:10.1097/HRP.0000000000000414

Top Stroke Rehabil. 2024 Dec 30:1-11. doi: 10.1080/10749357.2024.2448392. Online ahead of print.

ABSTRACT

AIMS: To investigate the association between pre-stroke frailty and discharge destination in hospitalized older adults in China.

METHODS: We conducted this prospective cohort study in a tertiary care hospital in China. We enrolled patients aged 60 years and older admitted to the hospital for acute stroke from January 2022 to May 2022. We used telephone tracking to record the destination of participants after discharge. Generalized estimating equations were used to determine the association between pre-stroke frailty and post-discharge destination.

RESULTS: Among the 230 participants enrolled, the prevalence of pre-stroke frailty was 75.2% and about 75.7% of participants chose to go home at discharge. 70.5% of pre-stroke frail patients chose to go home, compared with 91.2% for non-pre-stroke frail patients. The generalized estimating equation showed a statistical difference between the frailty and non-frailty groups in the post-discharge destination of acute stroke patients between different time points (Waldχ² 36.428 and 13.893, P < 0.001 and 0.008, respectively). After adjustment for the group, the model showed an interaction effect of time and pre-stroke frail status on the post-discharge destination (P < 0.001). The results confirm the importance of pre-stroke frail status in predicting patients’ post-discharge outcomes.

CONCLUSIONS: Pre-stroke frailty is related to the post-discharge destination and stroke prognosis in elderly Chinese. For Chinese families, most acute stroke patients choose to go home when they are discharged from the hospital, even those who are frail before acute stroke occurs. Further research is needed to confirm this finding and to actively intervene in the pre-stroke frail population.

PMID:39761425 | DOI:10.1080/10749357.2024.2448392

Comput Inform Nurs. 2025 Jan 6. doi: 10.1097/CIN.0000000000001247. Online ahead of print.

ABSTRACT

End-of-program predictive examinations have been in existence in nursing education for over 10 years. Nursing schools have used these examinations to prepare students on the testable content from National Council of State Boards of Nursing (NCSBN), which has been delivering the NCLEX-RN since 1994. Nursing students, in the final semester of the nursing program, took the Predictable Ability Measurement Readiness (PAMR) 1 and/or 2. The 100-question exam was developed by nursing subject matter experts following the 2019 NCLEX-RN blueprint content, item types, and scoring. The PAMR scores were examined and compared with the results of the nursing students on the NCLEX-RN. Statistical analysis revealed that the students who passed the NCLEX-RN on their first attempt had higher scores on the PAMR1. A cut-point scale using regression modeling was developed to determine a minimal score compared with the probability of passing NCLEX-RN. Nursing faculty have a reliable and predictable exam to use to prepare students to take the NCLEX-RN. The PAMR 1 and 2 have demonstrated the ability to predict passing on the NCLEX-RN and can be used confidently in nursing programs for licensure examination preparation.

PMID:39761389 | DOI:10.1097/CIN.0000000000001247

Diabetes. 2025 Jan 6:db240380. doi: 10.2337/db24-0380. Online ahead of print.

ABSTRACT

Circulating proteins may be promising biomarkers or drug targets. Leveraging genome-wide association studies of type 1 diabetes (18,942 cases and 501,638 controls of European ancestry) and circulating protein abundances (10,708 European ancestry individuals), Mendelian randomization analyses were conducted to assess the associations between circulating abundances of 1,560 candidate proteins and the risk of type 1 diabetes, followed by multiple sensitivity and colocalization analyses, horizontal pleiotropy examinations, and replications. Bulk tissue and single-cell gene expression enrichment analyses were performed to explore candidate tissues and cell types for prioritized proteins. After validating Mendelian randomization assumptions and colocalization evidence, we found that genetically predicted circulating abundances of CTSH (OR=1.17 per one standard deviation increase; 95% CI:1.10-1.24), IL27RA (OR=1.13; 95% CI:1.07-1.19), SIRPG (OR=1.37; 95% CI:1.26-1.49), and PGM1 (OR=1.66; 95% CI:1.40-1.96) were associated with the risk of type 1 diabetes. These findings were consistently replicated in other cohorts. CTSH, IL27RA, and SIRPG were strongly enriched in immune system-related tissues, while PGM1 was enriched in muscle and liver tissues. Amongst immune cells, CTSH was enriched in B cells and myeloid cells, while SIRPG was enriched in T cells and natural killer cells. These proteins may be explored as biomarkers or drug targets for type 1 diabetes.

PMID:39761376 | DOI:10.2337/db24-0380

Vet Med Sci. 2025 Jan;11(1):e70151. doi: 10.1002/vms3.70151.

ABSTRACT

BACKGROUND: In the United Kingdom, spay surgery is routinely performed in dogs and cats by general practitioners. Data from a decade ago showed that, despite an increased attentiveness of veterinarians to peri-operative pain compared to the past, analgesia could be further improved.

OBJECTIVES: To investigate the current veterinary practice and attitude towards anaesthesia and analgesia for spay surgery in the United Kingdom.

METHODS: An electronic questionnaire composed of 57 questions organised in 6 sections was designed using the Checklist for Reporting Results of Internet E-Surveys (CHERRIES guidelines) and distributed online via a hyperlink. Participants were recruited through both personalised email invitation and publication of the hyperlink on social media. Data were analysed with descriptive statistics, analysis of means and analysis of proportions, using commercially available software.

RESULTS: Entries from 150 participants were used for data analysis. The proportion of participants who were confident in treating pain did differ by decade of graduation, with a lower proportion of confident colleagues graduated before 2001 (6%) and from 2021 (14%), compared to those graduated in the decades 2001-2010 (43%) and 2011-2020 (37%) (p = 0.007). Colleagues reported to implement multimodal analgesia for spay procedures of cats and dogs in 43% and 44% of cases, respectively. The proportions of participants who reportedly used locoregional blocks, mostly with lidocaine, in dogs (82%), were higher than that in cats (43%) (p < 0.001). Post-spay surgery pain was perceived by the participants as more intense in dogs than in cats (p < 0.001).

CONCLUSIONS: Despite an overall good level of attentiveness of British veterinary professionals to feline and canine analgesia during and following spay surgery, this study identified as areas of improvements perception and assessment of feline pain and implementation of locoregional anaesthetic techniques, particularly in cats.

PMID:39761362 | DOI:10.1002/vms3.70151

Comput Inform Nurs. 2025 Jan 6. doi: 10.1097/CIN.0000000000001248. Online ahead of print.

ABSTRACT

The global population is aging, and there is a concomitant increase in surgery for the elderly. In geriatric patients, where postoperative pain assessment is difficult, technological tools that perform automatic pain assessment are needed to alleviate the workload of nurses and to accurately assess patients’ pain. This study offers a more reliable and rapid assessment tool for assessing the pain of elderly patients undergoing surgery. The study aimed to develop a machine learning-based pain assessment application for postoperative geriatric patients. A methodological study was conducted with 68 patients in the general surgery clinic of a hospital between October 2022 and June 2024. Data were collected using a Sociodemographic Data Collection Form, the Numeric Rating Scale, and the Wong-Baker FACES Pain Scale. Then, machine learning was used. Data are summarized using descriptive statistics and presented using narrations, tables, and graphs. The study reveals that nurses assigned lower scores to patients’ pain levels. In the categorical classification, a high level of agreement was observed between the patient and the machine learning for each measurement. A machine learning-based pain assessment application is an efficacious method for assessing pain following geriatric surgery. It facilitates nursing care and supports the advancement of geriatric nursing.

PMID:39761361 | DOI:10.1097/CIN.0000000000001248

Chronobiol Int. 2025 Jan 6:1-14. doi: 10.1080/07420528.2024.2449015. Online ahead of print.

ABSTRACT

Seven-day actigraphy was performed within 1 month in 122 community-dwelling adults (mean age 24.40 y, 31 (25.4%) men) in the same city of Tyumen, Russia. Groups with different COVID-19 status (present, COVID-19(+), n = 79 vs absent, COVID-19(-), n = 43) did not differ in mean age, gender distribution, or body mass index. Vaccination status was equally represented in the COVID groups. We found that COVID-19 status, a history of SARS-CoV-2 infection, was differentially associated with daylight susceptibility. Daylight exposure was estimated using parametric and non-parametric indices: 24-h Amplitude, MESOR or M10 of white and blue light exposure (BLE) and compared between the groups. Distinctively in COVID-19(+) individuals, a smaller normalized 24-h amplitude of BLE (NAbl) was associated with lower circadian robustness, assessed by a smaller relative non-parametric amplitude (RA), a lower circadian function index (CFI), later bedtime, later onset of least active 5 h (L5), shorter total sleep duration, later phase and smaller circadian amplitude of physical motor activity. Such associations were absent in the overall COVID-19(-) population or in the vaccinated COVID(-) group. Considering COVID-status and light hygiene, defined as NAbl ≥ 1 versus NAbl < 1, only those with COVID(+) and NAbl < 1 (poorer light hygiene) had a statistically significantly delayed phase of activity and sleep, reduced circadian amplitude of physical activity, and lower circadian robustness. Accounting for gender and BMI, participants diagnosed with COVID-19 at an earlier date were older and had poorer circadian light hygiene. Altogether, our data suggest that those with COVID-19 were more vulnerable to circadian disruption due to poor circadian light hygiene, manifested as phase delay, small amplitude, a less robust circadian pattern of activity, and as delayed sleep. Our data suggest that the need for optimal circadian light hygiene is greater in individuals with a history of SARS-CoV-2 infection.

PMID:39761104 | DOI:10.1080/07420528.2024.2449015

Diabetes Technol Ther. 2025 Jan 6. doi: 10.1089/dia.2024.0472. Online ahead of print.

ABSTRACT

Objective: The recommended threshold for the time spent on continuous glucose monitoring (CGM) is established at 70%. However, glucose outcomes in children with type 1 diabetes (CwD) using CGM for a different proportion of time within this threshold have not been evaluated yet. The study aims to compare glycemic parameters among CwD who spent 70%-89% and ≥90% on CGM using the population-wide data from the Czech national pediatric diabetes registry ČENDA. Methods: CwD aged <19 years who used real-time CGM >70% of the time and did not change the type of therapy throughout the year 2023 were included and divided into two groups based on the time they spent on CGM-70%-89% versus ≥90%. HbA1c, times in standard glycemic ranges, mean glucose, and coefficient of variability (CV) were compared between the groups and by treatment modalities. Results: Data from 1977 CwD (1035 males and 942 females) were evaluated. Among them, 404 participants (20.4%) used CGM 70%-89% of the time, and 1573 participants (79.6%) ≥90% of the time. Compared with the 70-89% group, the ≥90% CGM users achieved significantly lower HbA1c levels (51 mmol/mol, 6.8% vs. 58 mmol/mol, 7.4%, P < 0.001), higher time in range (72% vs. 60%, P < 0.001), and lower mean glucose and CV (8.1 mmol/L, 146 mg/dL vs. 9.1 mmol/L, 164 mg/dL and 37% vs. 40%, respectively, both P < 0.001). Analogous results were seen irrespective of the treatment modality. The differences persisted after propensity score adjustment. Conclusion: CGM use for ≥90% is associated with tighter glycemic control compared with 70%-89% use. Therefore, it is essential to motivate CwD to use CGM for the longest possible time and search for suitable options to overcome barriers in uninterrupted CGM monitoring.

PMID:39761072 | DOI:10.1089/dia.2024.0472

JAMA Netw Open. 2025 Jan 2;8(1):e2452883. doi: 10.1001/jamanetworkopen.2024.52883.

ABSTRACT

IMPORTANCE: Intraventricular hemorrhage (IVH) has proven to be a challenging and enduring complication of prematurity. However, its association with neurodevelopment across the spectrum of IVH severity, independent of prematurity, and in the context of contemporary care remains uncertain.

OBJECTIVE: To evaluate national trends in IVH diagnosis and the association with survival and neurodevelopmental outcomes at 2 years of age.

DESIGN, SETTING, AND PARTICIPANTS: This whole-population cohort study was conducted using data from the UK National Neonatal Research Database. Infants born at less than 29 weeks’ gestation with any grade of IVH between January 2013 and December 2019 in England were included and matched with controls. Data analysis occurred from November 2023 to June 2024.

EXPOSURE: IVH grades 1 to 4 (Papile classification).

MAIN OUTCOMES AND MEASURES: The primary outcome was survival without severe neurodevelopmental impairment (NDI) at 2 years’ corrected age including severe delays (inability to understand or use >5 words or signs; being unable to walk, sit, or use hands; blindness; or uncorrectable hearing impairment). Secondary outcomes included gross and fine motor function, receptive and expressive communication, vision, hearing, and overall developmental progress. Outcomes were derived from clinician-entered data and analyzed using multiple logistic regression.

RESULTS: Between 2013 and 2019, of 26 756 infants born at less 29 weeks’ gestation in England, 8461 received a diagnosis of IVH (5570 low-grade and 2891 high-grade, and 8328 were included in the study. Overall, 5519 included infants had low-grade IVH with a median [IQR] gestational age of 26 (25-27) weeks, of which 2477 (48.88%) were male. Of the 2809 included infants with high-grade IVH, the median (IQR) gestational age was 25 (24-26) weeks and 1710 (60.88%) were male. The mean (SD) incidence of high-grade IVH (108 [6.7] per 1000 live extremely preterm births) and low-grade IVH (208 [10.4] per 1000 live extremely preterm births) increased between 2013 and 2019, although this did not reach statistical significance for high-grade IVH. Survival without severe NDI decreased significantly after high-grade IVH (a 74% reduction; aOR, 0.26; 95% CI, 0.22-0.31), and to a lesser extent after low-grade IVH (a 12% reduction; aOR, 0.88; 95% CI, 0.79-0.98). Although low-grade IVH was associated with functional impairments, most survivors, 2283 of 4379 infants (52.15%), had no NDI, and the association with NDI was accounted for by grade 2 IVH. Decreased survival without severe NDI was observed with increasing grade of IVH, decreasing gestation, bilateral compared to unilateral injuries, and increasing morbidity count (severe retinopathy of prematurity, bronchopulmonary dysplasia, and surgical necrotizing enterocolitis). Impairments in gross motor function and communication were common, especially among those with high-grade IVH (with prevalences of 44.55% [715 of 1605 infants] and 48.91% [784 of 1603 infants], respectively).

CONCLUSIONS AND RELEVANCE: In this cohort study, IVH was highlighted as a persistent issue with substantial neurodevelopmental implications despite advances in care. This study offers useful data for counseling families; however, follow-up to school age is necessary to grasp the full impact of these injuries on children’s lives.

PMID:39761048 | DOI:10.1001/jamanetworkopen.2024.52883

JAMA Netw Open. 2025 Jan 2;8(1):e2453292. doi: 10.1001/jamanetworkopen.2024.53292.

ABSTRACT

IMPORTANCE: Characterizing hospital-level factors associated with adverse outcomes following operative vaginal delivery (OVD) is crucial for optimizing obstetric care.

OBJECTIVE: To assess the association between hospital OVD volume and adverse outcomes.

DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective cohort study of OVDs in California between 2008 and 2020. OVD was determined using birth certificate and International Classification of Diseases, Ninth Revision, Clinical Modification or International Statistical Classification of Diseases, Tenth Revision, Clinical Modification codes. This study used linked vital statistics and hospital discharge data from California. The study included singleton, nonanomalous, full-term deliveries with vertex presentation. Data analysis was performed between June 10 and October 23, 2024.

EXPOSURE: Hospital OVD volume was categorized by the proportion of OVDs performed among all deliveries, grouped into low (<5.2%), medium (5.2%-7.4%), and high (≥7.4%) volume.

MAIN OUTCOMES AND MEASURES: Adverse outcomes for birthing individuals included obstetric anal sphincter injuries, cervical lacerations, and postpartum hemorrhage. Neonatal outcomes included shoulder dystocia, subgaleal hemorrhage, intracranial hemorrhage, facial nerve injury, and brachial plexus injury (BPI). χ2 and multivariable Poisson regression analyses were used to assess the association between hospital OVD volume and outcomes.

RESULTS: Among 306 818 OVDs (mean [SD] birthing parent’s age, 28.5 [6.2] years; 155 157 patients with public insurance [50.6%]), hospitals with low OVD volume had an increased proportion of obstetric anal sphincter injury compared with hospitals with medium and high volumes (12.16% [7444 patients] vs 11.07% [10 709 patients] vs 9.45% [14 064 patients]). Hospitals with low volume also had a higher proportion of adverse neonatal outcomes, including shoulder dystocia (3.84% [2351 patients] vs 3.50% [3386 patients] vs 2.80% [4160 patients]), subgaleal hemorrhage (0.27% [165 patients] vs 0.18% [172 patients] vs 0.10% [144 patients]), and BPI (0.41% [251 patients] vs 0.30% [291 patients] vs 0.20% [301 patients]) compared with hospitals with medium and high volume. In multivariable analyses, low OVD volume remained associated with increased risk of obstetric anal sphincter injury (adjusted risk ratio [aRR], 1.36; 95% CI, 1.14-1.62), shoulder dystocia (aRR, 1.30; 95% CI, 1.10-1.52), subgaleal hemorrhage (aRR, 2.57; 95% CI, 1.55-4.24), and BPI (aRR, 1.73; 95% CI, 1.30-2.2.29) compared with hospitals with high OVD volume. After multivariable analysis, medium OVD volume remained associated with increased risk of subgaleal hemorrhage (aRR, 1.72; 95% CI, 1.04-2.86) and BPI (aRR, 1.35; 95% CI, 1.02-1.79) compared with high OVD volume.

CONCLUSIONS AND RELEVANCE: This study found that undergoing OVD at hospitals with low OVD volume was associated with adverse perinatal outcomes compared with hospitals with medium and high OVD volumes. Further exploration of the reasons for these differences and prevention of these differences is needed to improve obstetric outcomes.

PMID:39761043 | DOI:10.1001/jamanetworkopen.2024.53292