Tag: pubmed

Diabetes Obes Metab. 2025 Feb 10. doi: 10.1111/dom.16238. Online ahead of print.

ABSTRACT

AIMS: The associations of glucagon-like peptide-1 receptor agonists (GLP-1RAs) and outcomes among patients with obesity according to the presence of cardiovascular risk factors (metabolically healthy obesity (MHO) or metabolically unhealthy obesity (MUHO)) remain unclear. We examined the associations of GLP-1RAs with mortality and adverse cardiovascular events in patients with MHO and MUHO.

METHODS: The TriNetX network was utilized to select a cohort of patients with MHO or MUHO, and use or non-use of GLP-1RAs with propensity score matching (1:1). Cardiovascular events were identified during follow-up.

RESULTS: A total of 2 983 151 patients with obesity (512 434 with MHO and 2 470 717 with MUHO) were included in the study. Among these, 416 713 (13.9%) were GLP-1RA users. After propensity score matching, GLP-1RA use in MUHO was associated with a significantly lower risk of mortality (HR 0.580 [95% CI, 0.566-0.595]), ischemic stroke (HR 0.921 [0.890-0.953]), AF (HR 0.913 [0.888-0.938]) and hospitalization for HF (HR 0.925 [0.900-0.949]) during follow-up compared with non-use of GLP-1RA. Patients with MHO had a markedly lower risk of clinical events than those with MUHO. A trend towards a lower risk of cardiovascular events associated with GLP-1RA was seen among patients with MHO. There was no statistical interaction in the risk of cardiovascular outcomes with GLP-1RA use for MHO and MUHO patients.

CONCLUSIONS: The use of GLP-1RAs was associated with lower rates of cardiovascular events than no use in patients with MUHO. Similar but non-statistically significant trends were seen in patients with MHO.

PMID:39930557 | DOI:10.1111/dom.16238

Diabetes Obes Metab. 2025 Feb 10. doi: 10.1111/dom.16231. Online ahead of print.

ABSTRACT

AIM: This post hoc analysis of ONWARDS 1-5 assessed the efficacy and hypoglycaemia outcomes with once-weekly insulin icodec (icodec) versus once-daily basal insulin comparators (degludec, glargine U100 or glargine U300) in insulin-naive (ONWARDS 1, 3 and 5) and insulin-experienced (ONWARDS 2 and 4) adults (aged ≥18 years) with type 2 diabetes (T2D) by kidney function subgroup.

MATERIALS AND METHODS: Treatment outcomes were analysed by trial according to kidney function subgroup (estimated glomerular filtration rate [eGFR] ≥90; eGFR 60-<90; eGFR 30-<60; eGFR <30; all mL/min/1.73m²). Severe kidney function impairment (eGFR <30) at screening was an exclusion criterion for ONWARDS 1-4, but not ONWARDS 5.

RESULTS: ONWARDS 1-5 included 3765 participants; 3763 were included in this analysis. In ONWARDS 1, 3 and 5, there were no statistically significant treatment interactions by kidney function subgroup for change in glycated haemoglobin (HbA1c) from baseline to end of treatment (EOT); there were statistically significant subgroup interactions in ONWARDS 2 and 4 (both p-interaction <0.05). Change in body weight (baseline to EOT) across kidney function subgroups was comparable between treatment arms. Across trials, there was no consistent trend by kidney function subgroup for mean weekly insulin dose during the last 2 weeks of treatment or rates of combined clinically significant or severe hypoglycaemia. There were no statistically significant treatment interactions by kidney function subgroup for the achievement of HbA1c <7% without clinically significant or severe hypoglycaemia; all p-interaction >0.05.

CONCLUSIONS: Efficacy and hypoglycaemia outcomes of icodec versus once-daily comparators were generally consistent among adults with T2D, regardless of kidney function.

PMID:39930546 | DOI:10.1111/dom.16231

BMC Psychol. 2025 Feb 10;13(1):108. doi: 10.1186/s40359-025-02429-1.

ABSTRACT

BACKGROUND: Parenting today is characterized by numerous challenges and stressors. As a well-researched contextual factor for parenting, social support may help parents reduce parenting stress and adopt more positive parenting practices. However, the direct and indirect pathways linking social support to parenting outcomes remain largely unexplored. This study aimed to investigate whether and how the association between social support and parent-child relationships was mediated by the presence of meaning in parenthood and parental self-efficacy.

METHODS: As part of a parent education project, a total of 1,242 Chinese parents (87.2% female) participated in questionnaire surveys conducted by this cross-sectional study in Hong Kong. Data were analyzed using SPSS Statistics 26.0 and PROCESS Macro v4.1 for correlation analysis and serial mediation analysis.

RESULTS: The results indicated that the presence of meaning in parenthood and parental self-efficacy mediated the association between social support and parent-child relationships, both individually and serially. Furthermore, the mediating effect of the presence of meaning in parenthood was significantly greater than that of parental self-efficacy, as well as the serial mediating effect of the presence of meaning in parenthood and parental self-efficacy.

CONCLUSIONS: Social support is positively associated with parent-child relationships, both directly and indirectly, via the presence of meaning in parenthood and parental self-efficacy. Future research could employ the serial mediation model to explore the effects of social support on the well-being of parents and children. Additionally, future practice may prioritize the presence of meaning in parenthood as a crucial outcome indicator for parenting interventions.

PMID:39930538 | DOI:10.1186/s40359-025-02429-1

BMC Psychol. 2025 Feb 10;13(1):109. doi: 10.1186/s40359-025-02445-1.

ABSTRACT

OBJECTIVES: This study presents the German version of the Bergen Yale Sex Addiction Scale (BYSAS). The questionnaire screens for different risk levels of problematic excessive sexual behavior (“hypersexuality”).

METHODS: Based on an online sample (N = 492), a confirmatory factor analysis as well as other reliability analysis were conducted. Demographic characteristics of the sample were also assessed. The BYSAS was validated with psychiatric symptoms.

RESULTS: Global fit statistics indicate a one-factorial structure of the BYSAS. Cronbach’s α was 0.77. 2.03% of the study participants were categorized as “high risk” regarding sex addiction.

DISCUSSION: Initial results suggest that the German version of the BYSAS is a promising screening instrument for sex addiction. However, further validation in clinical populations is essential to ensure generalizability and clinical utility. In addition, different risk levels as well as the mechanisms underlying hypersexuality need to be examined more closely.

PMID:39930524 | DOI:10.1186/s40359-025-02445-1

BMC Res Notes. 2025 Feb 10;18(1):60. doi: 10.1186/s13104-025-07129-y.

ABSTRACT

INTRODUCTION: Pertussis remains among the top ten most common fatal aetiologies of acute respiratory infections worldwide. This study reports findings from the first laboratory-confirmed pertussis outbreak among primary schoolchildren in Burkina Faso.

METHODS: A cross-sectional study was conducted during an outbreak in the districts of Sabou and Sapouy following an alert from the national surveillance system. Suspected pertussis cases were investigated, with oropharyngeal/nasopharyngeal samples and sociodemographic and clinical data collected. Samples were analyzed using multiplex rRT-PCR and the FTD-33 Kit (Fast Track Diagnostics, Luxembourg). Descriptive statistics were conducted, and factors associated with pertussis positive cases were assessed using the Chi-square test and univariate logistic regression.

RESULTS: A total of 92 suspected pertussis cases with no fatal outcomes were identified among the schoolchildren in two different clusters during the investigation. The overall attack rate of the two clusters were 18.4% (92/499). Fifteen (16.6%) cases were biologically confirmed. The average age was 8.9 years, and 62% (57/92) were female. Rhinovirus (17.3%) and adenovirus (7.6%) were the most prevalent respiratory viruses detected among the suspected cases. Streptococcus pneumoniae (58.7%) and Haemophilus influenzae (56.5%) were the most common bacteria detected. A significant association was found between sore throat and confirmed cases (OR = 3.5, CI 95% [1.01-11.9]).

CONCLUSION: Despite extensive vaccination in several countries, pertussis can still cause outbreaks. Preventive measures, such as booster vaccinations for children outside the Expanded Program of Immunization (EPI) target age, are necessary.

PMID:39930513 | DOI:10.1186/s13104-025-07129-y

BMC Health Serv Res. 2025 Feb 10;25(1):223. doi: 10.1186/s12913-024-12162-x.

ABSTRACT

BACKGROUND: According to the WHO, assistive technology (AT) is defined as the superset of technologies that improve or maintain the functioning of different senses, mobility, self-care, well-being, and inclusion of patients. ATs also include technologies for healthcare workers (HCWs) to reduce workloads and improve efficiency and patient care outcomes. Software ATs for HCWs include communication software, artificial intelligence (AI), text editors, planning tools, decision support systems, and health records. Hardware ATs for HCWs can range from communication devices, sensors, and specialized medical equipment to robots.

AIMS: With this indicative study, we explore HCW utilization, perceptions, and adoption barriers of ATs. We emphasize ATs role in enhancing HCWs’ efficiency and effectiveness in healthcare delivery.

METHODS: A cross-sectional online survey was conducted through August 2024 with HCWs in Bavaria via a network recruiting approach. We used convenience sampling but ensured that only HCWs were part of our study population. Our survey included (i) usage, (ii) usefulness, and (iii) perceptions regarding ATs. The survey comprised 11 close-ended and three open-ended questions, including story stems evaluated by a deductive qualitative template analysis. Our mixed-method evaluation also employed descriptive and bivariate statistics.

RESULTS: Three hundred seventy-one HCWs (♂63.9 %, ♀36.1 %) participated in our survey, primarily 133 administrators, 116 nurses, and 34 doctors. More than half of the study participants (58.6 %) reported having advanced technical skills. Regarding usage, communication platforms (82.2 %) and communication devices (86 %) were the most commonly used ATs. Advanced ATs such as body-worn sensors, medical devices with interfaces, identification devices, and robots were underutilized in our sample. ATs were reported to be helpful in all job roles but need improvements in capacity and integration. Key barriers to adoption included outdated infrastructure, interoperability, and a lack of training.

CONCLUSION: Our study suggests that HCWs may want to incorporate ATs into their workflows as they see how, in theory, these technologies would improve HCW’s efficiency, resulting in better patient care. However, to realize this potential, efforts in ATs integration and accessibility are essential. Given this study’s modest sample size and generalizability limitations, further research is needed to explore the adoption, implementation, and impact of ATs in healthcare.

PMID:39930473 | DOI:10.1186/s12913-024-12162-x

J Ovarian Res. 2025 Feb 10;18(1):25. doi: 10.1186/s13048-025-01608-3.

ABSTRACT

BACKGROUND: Exosomes, extracellular vesicles with an average diameter of 30 ~ 150 nm, are pivotal in mediating the cellular microenvironment (CM) through their cargo-carrying capability. Despite extensive studies, the dynamic and regulatory mechanisms of exosomal cargoes, including lipids, proteins, nucleic acids, and metabolites, remain poorly understood.

METHODS: In this study, we collected culture medium of ovarian cancer cells at four different time points (12, 24, 36, 48 h). Exosomes were isolated using ultracentrifugation, and miRNA sequencing was performed for exosomes from each group (T12, T24, T36, and T48).

RESULTS: A total of 131 miRNAs were identified in all groups. Specifically, 41, 115, 63, and 24 miRNAs were detected in the T12, T24, T36, and T48 groups, respectively. Among these, 15 miRNAs were common to the all groups, while 3, 57, 10, and 3 miRNAs were unique to the T12, T24, T36, and T48 groups, respectively. Functional analyses of the target genes for both common and specific miRNAs indicated that numerous target genes were involved in signaling pathways and cancer-related processes.

CONCLUSION: It suggested that exosomal miRNAs might be critical in intercellular communication and in dynamically remodeling the tumor microenvironment. These insights could enhance our understanding of the role of exosomal miRNAs in cancer biology and inform the development of novel therapeutic strategies.

PMID:39930447 | DOI:10.1186/s13048-025-01608-3

BMC Public Health. 2025 Feb 10;25(1):532. doi: 10.1186/s12889-024-21007-5.

ABSTRACT

BACKGROUND: Malaria is a significant health challenge in Sierra Leone, particularly affecting pregnant women and children under five years of age. Despite efforts to reduce malaria cases, its prevalence remains high. The Sierra Leone National Malaria Elimination Strategic Plan (NMESP) 2021-2025 aims to reduce the malaria burden significantly through universal access to Insecticide Treated Nets (ITNs).

OBJECTIVE: This study evaluates the knowledge and utilization of ITNs for malaria control in the Moyamba and Bo districts of Sierra Leone (at the Njala University’s Main Campus in Moyamba District and Towama Location on Bo Campus in Bo District). It assesses awareness levels, factors associated with ITN use, and the effectiveness of current campaign strategies.

METHODS: A cross-sectional survey was conducted from July to September 2023, involving 742 participants from the Moyamba and Bo districts. Data were collected using a pretested interview guide covering ITN ownership, usage, and challenges. Descriptive statistics and Pearson’s Chi-squared test were used for data analysis.

RESULTS: Of the respondents, 84.8% received training on ITN usage, primarily from health workers (46.1%). Most participants (94.7%) understood that ITNs provide protection against mosquitoes, and 84.5% believed in their effectiveness in preventing malaria. Sociodemographic factors like age, sex, education, marital status, and sources of information were significantly associated with ITN knowledge and utilization. Moreover, health workers’ campaigns and interpersonal networks (community leaders, plus family and friends) play crucial roles in promoting ITN utilization, while mass media campaigns alone may not suffice. However, 48.2% of the participants found current ITN campaign strategies effective.

CONCLUSION: While awareness and ownership of ITNs are high in the Moyamba and Bo districts, utilization is hindered by various factors, including availability and alternative uses. Enhanced campaign strategies and increased ITN distribution are necessary to improve usage and reduce malaria incidence.

PMID:39930445 | DOI:10.1186/s12889-024-21007-5

BMC Public Health. 2025 Feb 10;25(1):547. doi: 10.1186/s12889-025-21722-7.

ABSTRACT

BACKGROUND: Men can play a crucial role in the effective use of contraceptives, both by utilizing themselves and by supporting their partners in preventing unwanted pregnancies; and addressing reproductive health issues. This study aims to examine the association of men’s contraceptive knowledge, attitudes, and behaviors (KAB) with the use of modern contraceptives.

METHODS: This study utilized data from the Nepal Demographic and Health Survey 2022, which included a total weighted sample of 2,649 married men aged 15-49 years. The Demographic and Health Survey is a nationally representative cross-sectional study. A weighted analysis of the samples was carried out accounting for the complex survey design. Bivariable and multivariable logistic regression analyses were conducted and the odds ratio (OR) with 95% confidence intervals (CIs) were presented to determine the association between men’s KAB and the use of modern contraception in Nepal.

RESULTS: The findings revealed that half of the married men (51.2%; CI: 48.5, 53.9) or their spouses have used some form of modern contraceptives. Interestingly, all men (100%) knew at least one type of modern contraceptive, while only one-third (33.7%; CI 3.12, 3.64) were aware of the ovulatory cycle period. Men with no knowledge of the ovulatory cycle (aOR: 1.31; CI: 1.07, 1.60), men who disagreed that women using contraceptives may become promiscuous (aOR: 1.27; CI:1.01,1.61) and men who discussed family planning with health workers (aOR: 1.72; CI:1.30, 2.28) were more likely to use modern contraceptives. Additionally, the use of modern contraceptives was more likely among men aged 20 to 29 (aOR: 8.04; CI: 2.19, 22.18), 30 to 39 (aOR: 17.11; CI: 6.20, 47.20), and 40 to 49 years (aOR: 23.25; CI: 8.41, 64.30) than their counterparts less than 20 years, as well as among men living in rural areas (aOR: 1.33; CI: 1.05, 1.67). Conversely, modern contraceptive use was less likely among highly educated men (aOR: 0.57; CI: 0.33, 0.97) and men living in Gandaki province (aOR: 0.87; CI: 0.59, 1.29).

CONCLUSION: This study highlights significant role of men’s KAB in the utilization of modern contraception among married men in Nepal. Contraceptive use can be promoted by enhancing the knowledge of men, developing a positive attitude, and encouraging supportive behaviors regarding reproductive health. The appropriate use of contraceptives can improve the reproductive health outcomes of both men and women. Providing a conducive environment for men to learn more about reproductive health including contraception is a key to positive health outcomes in Nepal.

PMID:39930441 | DOI:10.1186/s12889-025-21722-7

BMC Nurs. 2025 Feb 10;24(1):152. doi: 10.1186/s12912-024-02569-6.

ABSTRACT

BACKGROUND: Shared decision-making (SDM) is a collaborative patient-centred process for arriving at informed healthcare decisions. Decision coaching can help support SDM when combined with patient decision aids. As part of a meta-curriculum “Ready for SDM” for training different healthcare professionals in SDM, we developed and pilot-tested a new module designed to train nurses as decision coaches. The study assessed nurses’ perceptions of a decision coach training module, focusing on its feasibility, acceptability and its role in developing decision coaching capabilities.

METHODS: We used a two-phase approach guided by the Knowledge-to-Action Framework. In the first phase, we developed a decision coach training module. The second phase involved preliminary testing, using a descriptive design with qualitative and quantitative methods. We recruited a convenience sample of participants from two hospitals. Participants completed questionnaires at the end of Part A (classroom training). The assessment was informed by Kirkpatrick’s first three levels of educational outcomes: reaction (acceptability), learning (self-reported attitudes, intentions and confidence) and behaviour (practical application of decision coaching). A post-hoc inquiry investigated low participation in Part B of the coach training. Qualitative data underwent content analysis and quantitative data were analysed using descriptive statistics.

RESULTS: The development resulted in a decision coach training comprising a Part A (6 h) on SDM and decision coaching fundamentals and a Part B (1 h) which involved practical application of decision coaching in the participants’ own practice (audio recorded) with self-appraisal and individualised feedback. In preliminary testing with 19 nurses from seven clinical departments, 90% of participants rated Part A as acceptable and relevant to practice. Only one nurse completed Part B due to reluctance to audio record coaching sessions. The most reported perceived barrier was time constraints. Key perceived facilitators identified were interprofessional collaboration, management support and additional practical training.

CONCLUSION: Decision coach training was feasible to deliver in the classroom. Participants reported Part A as acceptable and relevant to their practice. The second part, including an audio recording component, proved unfeasible. Further research should explore alternative methods for skill assessment and feedback in clinical practice. The results from this study will inform further refinement of the Norwegian Ready for SDM meta-curriculum and implementation strategies, particularly regarding the practical training components.

TRIAL REGISTRATION: Retrospectively registered (14.02.2023) at ISRCTN (ISRCTN44143097).

PMID:39930431 | DOI:10.1186/s12912-024-02569-6