Tag: pubmed

J Med Internet Res. 2025 Jan 22;27:e54148. doi: 10.2196/54148.

ABSTRACT

BACKGROUND: Medication-related adverse events are common in pregnant women, and most are due to misunderstanding medication information. The identification of appropriate medication information sources requires adequate medical information literacy (MIL). It is important for pregnant women to comprehensively evaluate the risk of medication treatment, self-monitor their medication response, and actively participate in decision-making to reduce medication-related adverse events.

OBJECTIVE: This study aims to examine the effectiveness of a medication education course on a web-based platform in improving pregnant women’s MIL and decision self-efficacy.

METHODS: A randomized controlled trial was conducted. Pregnant women were recruited from January to June 2021 in the Department of Obstetrics and Gynecology of a large hospital in a major city in central China. A total of 108 participants were randomly divided into a control group (CG), which received routine prenatal care from nurses and physicians, and an intervention group (IG), which received an additional 3-week web-based medication education course based on the theory of planned behavior as part of routine prenatal care. Participants completed a Medication Information Literacy Scale and a decision self-efficacy questionnaire at baseline, upon completion of the intervention, and at a 4-week follow-up. Generalized estimation equations (GEE) were used to analyze the main effect (time and grouping) and interaction effect (grouping×time) of the 2 outcomes. The CONSORT-EHEALTH (V 1.6.1) checklist was used to guide the reporting of this randomized controlled trial.

RESULTS: A total of 91 pregnant women (48 in the IG and 43 in the CG) completed the questionnaires at the 3 time points. The results of GEE indicated that there was no statistically significant difference in time×group interactions of MIL between the 2 groups (F₂=3.12; P=.21). The results of the main effect analysis showed that there were statistically significant differences in MIL between the 2 groups at T1 and T2 (F₁=17.79; P<.001). Moreover, the results of GEE indicated that there was a significant difference in decision self-efficacy regarding the time factor, grouping factor, and time×group interactions (F₂=21.98; P<.001). The results of the simple effect analysis indicated a statistically significant difference in decision self-efficacy between the 2 groups at T1 (F₁=36.29; P<.001) and T2 (F₁=36.27; P<.001) compared to T0. Results showed that MIL and decision self-efficacy in the IG were found to be significantly higher than those in the CG (d=0.81; P<.001 and d=1.26; P<.001, respectively), and they remained significantly improved at the 4-week follow-up (d=0.59; P<.001 and d=1.27; P<.001, respectively).

CONCLUSIONS: Web-based medication education courses based on the theory of planned behavior can effectively improve pregnant women’s MIL and decision self-efficacy, and they can be used as supplementary education during routine prenatal care.

TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2100041817; https://www.chictr.org.cn/showproj.html?proj=66685.

PMID:39841986 | DOI:10.2196/54148

J Med Internet Res. 2025 Jan 22;27:e57636. doi: 10.2196/57636.

ABSTRACT

BACKGROUND: Parental technoference, the interruption of parent-child interactions by technology, has been associated with negative outcomes in children’s media use. However, the magnitude of this relationship and its moderating factors remain unclear.

OBJECTIVE: This study aims to systematically examine the relationship between parental technoference and child problematic media use, as well as to identify moderating factors such as age, parental technoference group, study design, and type of problematic media use.

METHODS: Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a comprehensive literature search was conducted up to August 2024 across multiple databases, including Web of Science, EBSCO, ProQuest, PubMed, PsycINFO, and China National Knowledge Infrastructure, using predefined search strings. A total of 53 studies with a total of 60,555 participants (mean age of 13.84, SD 1.18 years) were included. Inclusion criteria comprised studies involving children under the age of 22 years, assessing the association between parental technoference and child problematic media use with valid measures, and reporting necessary statistical data. Exclusion criteria included studies focusing on other child outcomes, having sample sizes <30, or being case reports or review papers. The risk of bias was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. A random-effects meta-analysis was performed using R (version 4.2.1; R Foundation for Statistical Computing) with the meta and metafor packages to evaluate the association and conduct moderator analyses.

RESULTS: The meta-analysis identified a significant positive association between parental technoference and child problematic media use (r=0.296, 95% CI 0.259-0.331). Moderator analyses revealed that both parental technoference group (P<.001) and study design (P=.008) significantly influenced this relationship. Specifically, the association was stronger when both parents engaged in technoference compared to when only 1 parent did, and in cross-sectional studies compared to longitudinal studies. Age, gender, publication status, and type of problematic media use did not significantly moderate the relationship (all P>.05).

CONCLUSIONS: This meta-analysis provides robust evidence of the association between parental technoference and child problematic media use. The findings highlight the need for family-based interventions and underscore the importance of longitudinal research to understand the temporal dynamics of this relationship better.

TRIAL REGISTRATION: PROSPERO CRD42023471997; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=471997.

PMID:39841982 | DOI:10.2196/57636

Psychol Health Med. 2025 Jan 22:1-17. doi: 10.1080/13548506.2025.2450545. Online ahead of print.

ABSTRACT

Patients with type 2 diabetes mellitus (T2DM) are susceptible to mental health issues, impacting medication adherence and diabetes control. This study aimed to evaluate factors associated with depression and anxiety among T2DM patients in Indonesia and Malaysia. A cross-sectional study was conducted in Indonesia and Malaysia from October 2022 to April 2023 among T2DM patients. The study utilised an instrument with patient and disease data and three validated tools to assess depression, anxiety, and medication adherence. Statistical analysis, including binary logistic regression, was performed using SPSS® version 28 software. A study of 606 T2DM patients revealed that 56.5% were at risk of depression, while 41.6% were at risk of anxiety. Older patients with T2DM had lower rates of depression (AOR = 0.41, 0.25-0.68) and anxiety than younger patients. Normal-weight patients were less likely to experience depression and anxiety (AOR = 0.44, 0.27-0.72) than overweight patients. Patients without diabetic foot ulcers had a lower risk of depression (AOR = 0.34, 0.21-0.55) and anxiety than those with foot ulcers. Patients with a shorter duration of diabetes had a higher risk of depression (AOR = 3.27, 1.70-6.30) and anxiety than those with a longer duration. Patients on insulin-based regimens had higher rates of depression and anxiety (AOR = 2.28, 1.20-4.30) than those on metformin-based regimens. Nonadherent patients were more likely to experience depression and anxiety (AOR = 4.30, 2.22-8.32) than patients who adhered to their medication. The prevalence of depression and anxiety is concerning and influenced by factors such as age, diabetes duration, the presence of diabetic foot ulcers, and the prescribed medication regimen. Further efforts are necessary to enhance the mental health of T2DM patients and improve management outcomes.

PMID:39841970 | DOI:10.1080/13548506.2025.2450545

Diabetes Care. 2025 Feb 1;48(2):212-219. doi: 10.2337/dc24-1537.

ABSTRACT

OBJECTIVE: The goal of this study was to assess the additive value of considering type 2 diabetes (T2D) polygenic risk score (PRS) in addition to family history for T2D prediction.

RESEARCH DESIGN AND METHODS: Data were obtained from the All of Us (AoU) research database. First-degree T2D family history was self-reported on the personal family history health questionnaire. A PRS was constructed from 1,289 variants identified from a large multiancestry genome-wide association study meta-analysis for T2D. Logistic regression models were run to generate odds ratios (ORs) and 95% CIs for T2D. All models were adjusted for age, sex, and BMI.

RESULTS: A total of 109,958 AoU research participants were included in the analysis. The odds of T2D increased with 1 SD PRS (OR 1.75; 95% CI 1.71-1.79) and positive T2D family history (OR 2.32; 95% CI 2.20-2.43). In the joint model, both 1 SD PRS (OR 1.69; 95% CI 1.65-1.72) and family history (OR 2.06; 95% CI 1.98-2.15) were significantly associated with T2D, although the ORs were slightly attenuated. Predictive models that included both the PRS and family history (area under the curve [AUC] 0.794) performed better than models including only family history (AUC 0.763) or the PRS (AUC 0.785).

CONCLUSIONS: In predicting T2D, inclusion of a T2D PRS in addition to family history of T2D (first-degree relatives) added statistical value. Further study is needed to determine whether consideration of both family history and a PRS would be useful for clinical T2D prediction.

PMID:39841967 | DOI:10.2337/dc24-1537

Diabetes Care. 2025 Feb 1;48(2):292-300. doi: 10.2337/dc24-1678.

ABSTRACT

OBJECTIVE: To provide an updated synthesis on effects of glucagon-like peptide 1 receptor agonists (GLP-1 RAs) on weight, BMI, and waist circumference incorporating newer randomized controlled trials (RCTs), particularly in individuals with overweight or obesity.

RESEARCH DESIGN AND METHODS: We systematically searched PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) for RCTs published from inception to 4 October 2024. The search was limited to RCTs evaluating the use of GLP-1 RAs for mean differences from baseline in weight, BMI, and waist circumference in adults with obesity or overweight with or without diabetes. Two independent reviewers performed the literature search and data extraction, resolving disagreements via consensus or third-reviewer consultation.

RESULTS: Forty-seven RCTs were included, with a combined cohort of 23,244 patients. GLP-1 RAs demonstrated a mean weight reduction of -4.57 kg (95% CI -5.35 to -3.78), mean BMI reduction of -2.07 kg/m2 (95% CI -2.53 to -1.62), and mean waist circumference reduction of -4.55 cm (95% CI -5.72 to -3.38) compared with placebo. This effect was consistent across diabetes status, GLP-1 RA used, and route of administration. The greatest treatment benefit appeared to favor patients who were younger, female, without diabetes, with higher baseline weight and BMI but lower baseline HbA1c, and treated over a longer duration. Limitations include substantial statistical heterogeneity, in part due to broad inclusion criteria. However, this heterogeneity may improve generalizability by reflecting a wide range of study designs and patient populations.

CONCLUSIONS: GLP-1 RAs demonstrated significant weight, BMI, and waist circumference reduction benefits in this meta-analysis.

PMID:39841962 | DOI:10.2337/dc24-1678

JCO Clin Cancer Inform. 2025 Jan;9:e2400042. doi: 10.1200/CCI.24.00042. Epub 2025 Jan 22.

ABSTRACT

PURPOSE: Undifferentiated pleomorphic sarcomas (UPSs) demonstrate therapy-induced hemosiderin deposition, granulation tissue formation, fibrosis, and calcification. We aimed to determine the treatment-assessment value of morphologic tumoral hemorrhage patterns and first- and high-order radiomic features extracted from contrast-enhanced susceptibility-weighted imaging (CE-SWI).

MATERIALS AND METHODS: This retrospective institutional review board-authorized study included 33 patients with extremity UPS with magnetic resonance imaging and resection performed from February 2021 to May 2023. Volumetric tumor segmentation was obtained at baseline, postsystemic chemotherapy (PC), and postradiation therapy (PRT). The pathology-assessed treatment effect (PATE) in surgical specimens separated patients into responders (R; ≥90%, n = 16), partial responders (PR; 89%-31%, n = 10), and nonresponders (NR; ≤30%, n = 7). RECIST, WHO, and volume were assessed for all time points. CE-SWI T2* morphologic patterns and 107 radiomic features were analyzed.

RESULTS: A Complete-Ring (CR) pattern was observed in PRT in 71.4% of R (P = 7.71 × 10^-6), an Incomplete-Ring pattern in 33.3% of PR (P = .2751), and a Globular pattern in 50% of NR (P = .1562). The first-order radiomic analysis from the CE-SWI intensity histogram outlined the values of the 10th and 90th percentiles and their skewness. R showed a 280% increase in 10th percentile voxels (P = .061) and a 241% increase in skewness (P = .0449) at PC. PR/NR showed a 690% increase in the 90th percentile voxels (P = .03) at PC. Multiple high-order radiomic texture features observed at PRT discriminated better R versus PR/NR than the first-order features.

CONCLUSION: CE-SWI morphologic patterns strongly correlate with PATE. The CR morphology pattern was the most frequent in R and had the highest statistical association predicting response at PRT, easily recognized by a radiologist not requiring postprocessing software. It can potentially outperform size-based metrics, such as RECIST. The first- and high-order radiomic analysis found several features separating R versus PR/NR.

PMID:39841956 | DOI:10.1200/CCI.24.00042

J Clin Oncol. 2025 Jan 22:JCO2401829. doi: 10.1200/JCO-24-01829. Online ahead of print.

ABSTRACT

PURPOSE: Radiotherapy (RT)/cetuximab (C) demonstrated superiority over RT alone for locally advanced squamous head and neck cancer. We tested this in completely resected, intermediate-risk cancer.

METHODS: Patients had squamous cell carcinoma of the head and neck (SCCHN) of the oral cavity, oropharynx, or larynx, with one or more risk factors warranting postoperative RT. Patients were randomly assigned 1:1 to intensity-modulated RT (60-66 Gy) with once-per-week C or RT alone. The primary hypothesis was that RT + C would improve overall survival (OS) in randomly assigned/eligible patients, with a prespecified secondary plan to test this in the human papillomavirus (HPV)-negative subpopulation. Disease-free survival (DFS) and toxicity were secondary end points. OS and DFS were tested via stratified log-rank test; toxicity was compared via Fisher’s exact test.

RESULTS: We enrolled 702 patients from November 2009 to March 2018; 577 were randomly assigned/eligible. Most (63.6%) had oral cavity cancer and most (84.6%) had high epidermal growth factor receptor expression. There were fewer deaths (184) than expected. OS (median follow up, 7.2 years) was not significantly improved (hazard ratio [HR], 0.81; one-sided P = .0747; 5-year OS 76.5% v 68.7%), but DFS was (HR, 0.75; one-sided P = .0168; 5-year DFS 71.7% v 63.6%). Benefit of RT + C was only seen in the HPV-negative subpopulation (80.2% of patients in the trial). Grade 3-4 acute toxicity rates were 70.3% (RT + C) versus 39.7% (RT; two-sided P < .0001), mostly skin and/or mucosal effects. Late grade ≥3 toxicity rate was 33.2% (RT + C) versus 29.0% (RT; two-sided P = .3101). There were no grade 5 toxicities in either arm.

CONCLUSION: RT + C significantly improved DFS, but not OS, with no increase in long-term toxicity, compared with RT alone for resected, intermediate-risk SCCHN. RT + C is an appropriate option for carefully selected patients with HPV-negative disease.

PMID:39841939 | DOI:10.1200/JCO-24-01829

Psychiatry. 2025 Jan 22:1-16. doi: 10.1080/00332747.2024.2447219. Online ahead of print.

ABSTRACT

Objective: The armed conflict in Ukraine and its impact on Europe’s economy have led to an war and economic crisis, potentially affecting the mental health of women during the perinatal period. This study aimed to assess the severity of depressive symptoms and labor anxiety among Polish women in perinatal period during this crisis.

Methods: From June 2, 2022, to April 11, 2023, 152 women completed three sets of online surveys-two during pregnancy (before 33 weeks and/or between 33 and 37 weeks) and one postpartum (4 weeks after childbirth). The questionnaires used to evaluate the anxiety and depressive symptoms included Edinburgh Postnatal Depression Scale (EPDS), Beck Depression Inventory (BDI-2), Labor Anxiety Questionnaire (LAQ), and team-developed questionnaires evaluating war-related anxiety (WAQ) and global situation anxiety (GSAQ) Statistical analyses included U-Mann Whitney, Kruskal-Wallis, Wilcoxon signed-rank, Friedman tests and Spearman’s correlations, with a significance level set at p < .05.

Results: Among Polish pregnant women aged 23-43, 31.6% of participants experienced depressive symptoms, while 70.4% reported increased labor-related anxiety. Additionally, 24.3% experienced significant anxiety due to the war, and 25% suffered from severe anxiety related to the global situation. Positive correlations were noted between EPDS and GSAQ scores (R = 0.34, p < .001) and LAQ and WAQ scores (R = 0.21, p = .008).

Conclusions: The prevalence of perinatal depression is high during war and economic crisis, underscoring the urgent need to improve screening for perinatal depression in Poland. Further, the manuscript did not discuss symptom patterns across the three time points.

PMID:39841920 | DOI:10.1080/00332747.2024.2447219

J Cardiovasc Med (Hagerstown). 2025 Feb 1;26(2):81-87. doi: 10.2459/JCM.0000000000001690. Epub 2024 Dec 26.

ABSTRACT

INTRODUCTION: Cardiac amyloidosis typically causes restrictive cardiomyopathy, in which the impairment of diastolic function is dominant. Echocardiography provides prognostic information through some important parameters: left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS). However, LVEF often remains preserved despite disease progression, and GLS is not routinely performed as it is limited by suboptimal image quality. The stroke volume index (SVi) has already been shown to correlate with mortality in heart failure patients; still, its prognostic role in transthyretin cardiac amyloidosis (TTR-CA) is poorly studied.

PURPOSE: This prospective study aimed to evaluate the role of SVi in predicting mortality and heart failure hospitalizations in patients with cardiac amyloidosis, comparing it to other parameters of left ventricular performance.

METHODS: Baseline clinical transthoracic echocardiogram and laboratory data were collected prospectively in 115 patients with diagnosed TTR-CA. The outcome was the occurrence of the composite of heart failure hospitalization and death and its association with SVi, LVEF, GLS and MCF was tested by Cox proportional hazard modelling.

RESULTS: Over a mean follow-up of 16.1 months (interquartile range 7.4-24.9 months), 29 patients died, and 19 were hospitalized for heart failure. SVi was associated with the composite outcome of death and heart failure hospitalization [hazard ratio 0.96; 95% confidence interval (CI) 0.93-0.99] and remained an independent predictor of outcome after adjustment for NAC stage, mitral regurgitation degree, age and the use of disease-modifying treatment. The best cut-off of SVi to predict outcome was 35 ml/m2 (hazard ratio 2.30; 95% CI 1.03-5.17).

CONCLUSION: SVi is superior to LVEF, MCF, and GLS for prognostication in patients with TTR amyloidosis.

PMID:39841913 | DOI:10.2459/JCM.0000000000001690

Ann Plast Surg. 2025 Feb 1;94(2):212-216. doi: 10.1097/SAP.0000000000004220.

ABSTRACT

International medical graduates (IMGs) represent a significant portion of the US physician workforce, comprising 25% across all specialties with a strong presence in internal medicine and primary care. However, their representation in plastic surgery remains limited at only 10%. Matching into a US plastic surgery residency is highly competitive for both US medical graduates and IMGs. This study aimed to quantify and identify trends in academic contributions from IMGs applicants in a plastic surgery residency program over the past 13 years, hypothesizing that IMG applicants have increasingly contributed to collaborative research projects.Data from National Resident Matching Program annual reports were analyzed, focusing on publications, research experience, and match status. An analysis of variance revealed significant differences between US MDs and IMGs in terms of publications and research experience. IMGs had a higher number of publications and work experience compared to matched US MDs, while US MDs had more research experiences than IMGs.The findings underscore the importance of research for IMGs, who often engage in additional research experiences to enhance their competitiveness for residency positions. The study showed that IMGs have a greater research output, contributing significantly to academic publications within the plastic surgery field. This productivity benefits the IMGs in securing residency positions and enriches the academic research environment of the residency programs.IMGs bring unique perspectives and innovative approaches to research, often collaborating internationally, which enhances the scope and quality of research projects. Their contributions are vital to the advancement of plastic surgery and the broader medical field. As the demand for physicians in the US grows, integrating IMGs into the healthcare system through strategic inclusion in research and clinical training is essential. This study highlights the critical role of IMGs in driving medical research and underscores the need for supportive policies to facilitate their integration into the US healthcare workforce.

PMID:39841900 | DOI:10.1097/SAP.0000000000004220