Tag: pubmed

Clin Drug Investig. 2025 Jan 11. doi: 10.1007/s40261-024-01417-4. Online ahead of print.

ABSTRACT

PURPOSE: The REDUCE-IT randomized trial demonstrated a cardiovascular benefit of icosapent ethyl (IPE) but also raised potential safety signals for atrial fibrillation (AF) and serious bleeding. We aimed to evaluate the real-world safety of IPE versus mixed omega-3 polyunsaturated fatty acid (OM-3) formulations.

METHODS: This retrospective active comparator new-user cohort study compared rates of new-onset AF and major bleeding (MB) among adult new users of IPE versus OM-3 in 2020-2024 US Veterans Affairs data. Daily drug exposure was determined via prescription dispensing dates. AF and MB outcomes were identified via validated algorithms based on the International Statistical Classification of Diseases and Related Health Problems, 10th revision, clinical modification. Confounding was accounted for via nearest-neighbor pairwise propensity score (PS) matching. The PS, constructed via logistic regression, was informed by expert-identified variables meeting the disjunctive cause criterion. Cox regression was used to estimate adjusted hazard ratios (aHRs), interpretable as average treatment effects for the treated.

RESULTS: Cohorts for analyses of AF and MB endpoints included 1927 and 2015 people, respectively, in each of the IPE and OM-3 exposure groups. The median age was 70 years, and the groups exhibited a predominance of white (80%) males (93%). The median follow-up time was 1.29 years per person. Baseline covariates were well balanced by treatment arm after PS matching. Incidence rates for AF were 7.29 versus 7.48 per 100 person-years among new users of IPE versus OM-3. The aHR for AF was 1.15 (95% confidence interval 0.82-1.63). Incidence rates for MB were 3.27 versus 3.35 per 100 person-years among new users of IPE versus OM-3. The aHR for MB was 1.22 (95% confidence interval 0.87-3.02).

CONCLUSIONS: Our measures of association were consistent with the null, but we were unable to rule out harms from IPE (vs. OM-3) more modest than a 63% increased rate of AF and threefold increased rate of MB.

PMID:39797933 | DOI:10.1007/s40261-024-01417-4

Am J Orthod Dentofacial Orthop. 2025 Jan 9:S0889-5406(24)00526-2. doi: 10.1016/j.ajodo.2024.11.012. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aimed to assess the root resorption and alveolar bone changes of maxillary incisors volumetrically and 3-dimensionally in patients with Class II Division 1 malocclusion who underwent treatments involving the extraction of 4 first premolars with conventional fixed appliances (FAs) vs clear aligners (CAs).

METHODS: A total of 320 maxillary incisors from 80 patients were assessed and divided into 2 groups (FAs and CAs), each possessing similar baseline characteristics. Pretreatment and posttreatment cone-beam computed tomography scans were used to analyze linear and volumetric orthodontically induced inflammatory root resorption, alveolar bone thickness (ABT), alveolar bone height (ABH), as well as anteroposterior and vertical movements of maxillary incisors.

RESULTS: Both groups revealed a significant reduction in palatal ABT and an increase in labial ABT in both the central and lateral incisors. The total ABT reduction was more pronounced in the FAs group than in the CAs group (P <0.005). In terms of ABH, FAs treatment resulted in more labial and palatal marginal alveolar bone resorption around the maxillary incisors. The root length and volume losses in the CAs group were significantly less than those in the FAs group: 0.90 ± 0.97 vs 1.85 ± 1.18 mm and 19.59 ± 8.75 vs 24.28 ± 10.05 mm³, respectively. The axial inclination was significantly less in the CAs group than in the FAs group: 8.83 ± 8.73 vs 2.64 ± 12.31°.

CONCLUSIONS: Treatments of Class II Division 1 malocclusion with FAs and CAs appeared to cause a statistically significant palatal ABT reduction and maxillary incisors root resorptions, with the FAs treatment causing a more significant effect. Both treatment modalities significantly reduced the ABH, with the greatest reduction found on the lateral incisors’ palatal side in the FAs group. The CAs treatment resulted in a more significant incisor lingual tipping.

PMID:39797866 | DOI:10.1016/j.ajodo.2024.11.012

J Nutr Educ Behav. 2025 Jan 10:S1499-4046(24)00529-3. doi: 10.1016/j.jneb.2024.12.001. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore dietary salt-related knowledge, attitudes, and behaviors of New Zealand (NZ) adults aged 18-65 years and assess differences by demographic subgroups.

DESIGN: Cross-sectional online survey conducted between June 1, 2018 and August 31, 2018.

SETTING: Participants were recruited in shopping malls, via social media, and a market research panel.

PARTICIPANTS: English-speaking adults residing in NZ.

VARIABLES MEASURED: An amended version of The Pan American and World Health Organization Knowledge, Attitudes, and Behaviors standardized survey tool was used. Demographic data (age, sex, ethnicity, and educational attainment) were also collected.

ANALYSIS: Descriptive statistics reported. Chi-square test for independence to assess differences by demographics.

RESULTS: The survey was completed by 1,131 adults (mean age 36 ± 15 years; n = 876 [78%] female; n = 661 [78%] NZ European/other; n = 210 [19%] Asian; n =164 [15%] Māori). In addition, 865 participants (83%) knew the primary dietary source of salt; 406 (40%) knew the recommended salt intake; 946 (95%) believed food manufacturers are responsible for sodium reduction; 563 (55%) supported government regulations; and 259 (26%) used food labels. Females and NZ European/other participants reported more favorable salt-reducing behaviors, such as avoiding fast-food and packaged, ready-to-eat foods (P < 0.001).

CONCLUSIONS AND IMPLICATIONS: Improving salt-related knowledge, attitudes, and behaviors in NZ is particularly important for men, underserved populations, and adults aged 45-65 years. A multicomponent, national NZ salt reduction program based on research addressing engagement and effectiveness for at-risk groups is warranted.

PMID:39797828 | DOI:10.1016/j.jneb.2024.12.001

J Wound Care. 2025 Jan 2;34(1):48-58. doi: 10.12968/jowc.2022.0095.

ABSTRACT

OBJECTIVE: Deep sternal wound infection (DSWI) is a rare but devastating complication that is estimated to occur in 1-2% of patients after median sternotomy. Current standard of care (SoC) comprises antibiotics, debridement and negative pressure wound therapy (NPWT). Hyperbaric oxygen therapy (HBOT) appears to be an effective adjuvant therapy for osteomyelitis. The aim of this study was to determine the effectiveness of HBOT and real-time fluorescence imaging (RTFI) in a DSWI treatment protocol and their benefits on infection control.

METHOD: A retrospective analysis of DSWI management was performed. Enrolled patients were divided into two groups: HBOT group and RTFI group. Patients in the HBOT group received SoC, HBOT, NPWT and reconstructive flap surgery. Patients in the RTFI group received the same therapeutic plan as well as treatment with a RTFI device (MolecuLight i:X (MolecuLight, Inc., Canada) to achieve high-quality debridement. Infection status and short-term outcomes within three months were measured. Long-term outcomes were analysed at a 12-month follow-up.

RESULTS: Of the 55 patients enrolled: 22 in the HBOT group and 33 in the RTFI group. Infection control status, evaluated in terms of white blood cell counts and C-reactive protein levels, antibiotic use duration, antibiotic costs, reinfection rate and osteomyelitis recurrence rate, were statistically significantly improved in the RTFI group (<0.001, <0.001, 0.042, 0.022, 0.049 and 0.022, respectively). Length of total intensive care unit stay and duration of complete healing were statistically significantly decreased in the RTFI group (<0.001 and 0.046, respectively).

CONCLUSION: Patients with DSWI can benefit from HBOT, especially in terms of in-hospital mortality. RTFI can be used to eliminate bacterial burden and achieve high-quality debridement, which considerably improves infection control and clinical outcomes.

PMID:39797755 | DOI:10.12968/jowc.2022.0095

J Nurs Adm. 2024 Dec 1;54(12):683-688. doi: 10.1097/NNA.0000000000001513.

ABSTRACT

OBJECTIVE: This study aimed to investigate the mediating role of psychological distress in the relationship between work-family conflict and nurse managers’ (NMs’) professional and organizational turnover intentions.

BACKGROUND: Work-family conflict is prevalent among NMs. It can have a significant impact on their intent to leave their organization and the profession. However, the role of psychological distress as a potential mediator in the relationship between work-family conflict and turnover intentions has not been studied in the context of NMs.

METHODS: A cross-sectional design was used, and data were collected from a sample of 260 NMs using self-report questionnaires.

RESULTS: NMs experienced a moderate level of work-family conflict and psychological distress. Organizational turnover intention was moderate, whereas professional turnover intention was low. Higher levels of work-family conflict among NMs contributed to increased psychological distress, which, in effect, influenced their desire to leave the organization.

CONCLUSION: To support NMs and mitigate turnover intentions, healthcare organizations need to prioritize the creation of a work environment that promotes work-life balance and reduces psychological distress.

PMID:39793106 | DOI:10.1097/NNA.0000000000001513

Proc Natl Acad Sci U S A. 2025 Jan 7;122(1):e2414972121. doi: 10.1073/pnas.2414972121. Epub 2024 Dec 30.

ABSTRACT

We study the adoption of ChatGPT, the icon of Generative AI, using a large-scale survey linked to comprehensive register data in Denmark. Surveying 18,000 workers from 11 exposed occupations, we document that ChatGPT is widespread, especially among younger and less-experienced workers. However, substantial inequalities have emerged. Women are 16 percentage points less likely to have used the tool for work. Furthermore, despite its potential to lift workers with less expertise, users of ChatGPT earned slightly more already before its arrival, even given their lower tenure. Workers see a substantial productivity potential in ChatGPT but are often hindered by employer restrictions and a perceived need for training.

PMID:39793088 | DOI:10.1073/pnas.2414972121

Proc Natl Acad Sci U S A. 2025 Jan 7;122(1):e2414009121. doi: 10.1073/pnas.2414009121. Epub 2024 Dec 30.

ABSTRACT

Collective migration of cancer cells is often interpreted using concepts derived from the physics of active matter, but the experimental evidence is mostly restricted to observations made in vitro. Here, we study collective invasion of metastatic cancer cells injected into the mouse deep dermis using intravital multiphoton microscopy combined with a skin window technique and three-dimensional quantitative image analysis. We observe a multicellular but low-cohesive migration mode characterized by rotational patterns which self-organize into antiparallel persistent tracks with orientational nematic order. We analyze the deformations induced by the cells in the extracellular matrix and find broadly distributed strain bands with a prevalence of compression. A model of active nematic hydrodynamics is able to describe several statistical features of the experimentally observed flow, suggesting that collective cancer cell invasion can be interpreted as a nematic active fluid in the turbulent regime. Our results help elucidate the migration patterns of cancer cells in vivo and provide quantitative guidance for the development of realistic in vitro and in silico models for collective cell migration.

PMID:39793073 | DOI:10.1073/pnas.2414009121

Proc Natl Acad Sci U S A. 2025 Jan 7;122(1):e2422543121. doi: 10.1073/pnas.2422543121. Epub 2024 Dec 30.

ABSTRACT

Among the most pressing problems societies face today are economic inequality and the erosion of democratic norms and institutions. In fact the two problems-inequality and democratic erosion-are linked. In a large cross-national statistical study of risk factors for democratic erosion, we establish that economic inequality is one of the strongest predictors of where and when democracy erodes. Even wealthy and longstanding democracies are vulnerable if they are highly unequal (though national wealth might provide some resiliency). The association between inequality and risk of democratic backsliding is robust, and holds under different measures and structures of both income inequality and wealth inequality. The association is unlikely to be a case of reverse causation. For concerned citizens seeking to understand why so many democracies are eroding and how to stop this process, our study indicates that policies for ameliorating inequality are a promising path forward.

PMID:39793070 | DOI:10.1073/pnas.2422543121

Proc Natl Acad Sci U S A. 2025 Jan 7;122(1):e2411348121. doi: 10.1073/pnas.2411348121. Epub 2024 Dec 30.

ABSTRACT

Collaborative management partnerships (CMPs) between state wildlife authorities and nonprofit conservation organizations to manage protected areas (PAs) have been used increasingly across Sub-Saharan Africa since the 2000s. They aim to attract funding, build capacity, and increase the environmental effectiveness of PAs. Our study documents the rise of CMPs, examines their current extent, and measures their effectiveness in protecting habitats. We combine statistical matching and Before-After-Control-Intervention regressions to quantify the impact of CMPs, using tree cover loss as a proxy. We identify 127 CMPs located in 16 countries. CMPs are more often located in remote PAs, with habitats that are least threatened by human activity. Our results indicate that, on average, each year in a CMP results in an annual decrease in tree cover loss of about 55% compared to PAs without CMPs. Where initial anthropogenic pressure was low, we measure no effect. Where it was high, we see a 66% decrease in tree cover loss. This highly heterogeneous effect illustrates the importance of moving beyond average effect size when assessing conservation interventions, as well as the need for policy makers to invest public funds to protect the areas the most at risk.

PMID:39793059 | DOI:10.1073/pnas.2411348121

J Med Internet Res. 2025 Jan 10;27:e55066. doi: 10.2196/55066.

ABSTRACT

BACKGROUND: Objective structured clinical examinations (OSCEs) are a widely recognized and accepted method to assess clinical competencies but are often resource-intensive.

OBJECTIVE: This study aimed to evaluate the feasibility and effectiveness of a virtual reality (VR)-based station (VRS) compared with a traditional physical station (PHS) in an already established curricular OSCE.

METHODS: Fifth-year medical students participated in an OSCE consisting of 10 stations. One of the stations, emergency medicine, was offered in 2 modalities: VRS and PHS. Students were randomly assigned to 1 of the 2 modalities. We used 2 distinct scenarios to prevent content leakage among participants. Student performance and item characteristics were analyzed, comparing the VRS with PHS as well as with 5 other case-based stations. Student perceptions of the VRS were collected through a quantitative and qualitative postexamination online survey, which included a 5-point Likert scale ranging from 1 (minimum) to 5 (maximum), to evaluate the acceptance and usability of the VR system. Organizational and technical feasibility as well as cost-effectiveness were also evaluated.

RESULTS: Following randomization and exclusions of invalid data sets, 57 and 66 participants were assessed for the VRS and PHS, respectively. The feasibility evaluation demonstrated smooth implementation of both VR scenarios (septic and anaphylactic shock) with 93% (53/57) of students using the VR technology without issues. The difficulty levels of the VRS scenarios (septic shock: P=.67; anaphylactic shock: P=.58) were comparable to the average difficulty of all stations (P=.68) and fell within the reference range (0.4-0.8). In contrast, VRS demonstrated above-average values for item discrimination (septic shock: r’=0.40; anaphylactic shock: r’=0.33; overall r’=0.30; with values >0.3 considered good) and discrimination index (septic shock: D=0.25; anaphylactic shock: D=0.26; overall D=0.16, with 0.2-0.3 considered mediocre and <0.2 considered poor). Apart from some hesitancy toward its broader application in future practical assessments (mean 3.07, SD 1.37 for VRS vs mean 3.65, SD 1.18 for PHS; P=.03), there were no other differences in perceptions between VRS and PHS. Thematic analysis highlighted the realistic portrayal of medical emergencies and fair assessment conditions provided by the VRS. Regarding cost-effectiveness, initial development of the VRS can be offset by long-term savings in recurring expenses like standardized patients and consumables.

CONCLUSIONS: Integration of the VRS into the current OSCE framework proved feasible both technically and organizationally, even within the strict constraints of short examination phases and schedules. The VRS was accepted and positively received by students across various levels of technological proficiency, including those with no prior VR experience. Notably, the VRS demonstrated comparable or even superior item characteristics, particularly in terms of discrimination power. Although challenges remain, such as technical reliability and some acceptance concerns, VR remains promising in applications of clinical competence assessment.

PMID:39793025 | DOI:10.2196/55066