Tag: pubmed

Harm Reduct J. 2025 Jan 15;22(1):8. doi: 10.1186/s12954-025-01154-7.

ABSTRACT

BACKGROUND: People in justice settings experience higher rates of psychiatric morbidity, including alcohol and drug use disorders, compared with the general population. However, our understanding of opioid-related harms in justice settings is limited. This study used ambulance data to examine opioid-related harms and experiences of care in New South Wales (NSW), Australia, during periods of incarceration or detention.

METHODS: This mixed-methods study used data from the National Ambulance Surveillance System (NASS) for patients aged 18 and older with an opioid-related ambulance attendance between December 2020 and April 2023. People in justice settings were identified using ambulance billing codes and manual review of paramedic case notes. Descriptive statistics described the patterns and modalities of opioid-related harms in justice settings, and a qualitative thematic analysis of paramedic case notes was used to contextualise findings. Results Over the study period, 328 opioid-related ambulance attendances for people in justice settings were identified (51% heroin; 41% opioid agonist therapy (OAT) medication). Symptoms of opioid withdrawal were noted in 35% of attendances, most commonly for heroin (51%) and withdrawal from OAT medications (48%). Three interconnected themes were identified using qualitative analysis: trust and mistrust in justice settings, systemic barriers to providing OAT, and other harm reduction strategies, and experiences of withdrawal in justice settings.

CONCLUSION: Our study demonstrated the utility of ambulance data in identifying opioid-related harms for people in justice settings in NSW. Qualitative findings highlight current barriers to effective opioid care in justice settings and identify opportunities for intervention, including targeted harm reduction programs, as well as policies that promote continuity of care particularly during transitions in and out of justice settings.

PMID:39815283 | DOI:10.1186/s12954-025-01154-7

BMC Res Notes. 2025 Jan 15;18(1):16. doi: 10.1186/s13104-024-07071-5.

ABSTRACT

INTRODUCTION: The attachment a mother feels for her fetus intensifies her duty to care for it, leading to a heightened desire to engage in behaviors that promote health. This research explored the association between maternal-fetal attachment (MFA) and adherence to health-related behaviors among pregnant women.

METHODS: This cross-sectional study focused on 220 pregnant women in Jahrom City, and was conducted using a multi-stage random sampling strategy. The data were collected using the Maternal-Fetal Attachment Scale paired with a questionnaire that addressed health behaviors relevant to pregnancy. The data were analyzed using SPSS18 software, employing linear regression and the Pearson correlation test. A p-value of less than 0.05 was deemed significant.

RESULTS: The mean age of participants was 28.06 ± 5.12 years. The adherence to health behaviors in pregnant women yielded a mean score of 174.51 ± 20.20. Pearson’s correlation test revealed a significant statistical association between MFA and adherence to health behaviors (r = 0.54, p < 0.001). The linear regression analysis showed that the dimensions of interaction with the fetus (β = 0.19) and the act of surrendering to the fetus (β = 0.27) could explain 35% of the variance in adherence to health behaviors (F = 14.12, R2 = 0.35, p < 0.001).

CONCLUSION: This study highlights a significant association between MFA and adherence to health behaviors throughout pregnancy. Supportive measures may strengthen MFA, promoting self-care practices and behaviors, ultimately resulting in improved health for both the mother and her fetus.

PMID:39815281 | DOI:10.1186/s13104-024-07071-5

BMC Pulm Med. 2025 Jan 15;25(1):21. doi: 10.1186/s12890-025-03486-3.

ABSTRACT

Genome-wide association studies (GWAS) have identified genetic variants robustly associated with asthma. A potential near-term clinical application is to calculate polygenic risk score (PRS) to improve disease risk prediction. The value of PRS, as part of numerous multi-source variables used to define asthma, remains unclear. This study aims to evaluate PRS and define most informative thresholds in relation to conventional clinical and physiological criteria of asthma using a multivariate statistical method. Clinical and genome-wide genotyping data were obtained from the Quebec City Case-Control Asthma Cohort (QCCCAC), which is an independent cohort from previous GWAS. PRS was derived using LDpred2 and integrated with other asthma phenotypes by means of Principal Component Analysis with Optimal Scaling (PCAOS). PRS was considered using ‘ordinal level of scaling’ to account for non-linear information. In two dimensional PCAOS space, the first component delineated individuals with and without asthma, whereas the severity of asthma was discerned on the second component. The positioning of high vs. low PRS in this space matched the presence and absence of airway hyperresponsiveness, showing that PRS delineated cases and controls at the same extent as a positive bronchial challenge test. The top 10% and the bottom 5% of the PRS were the most informative thresholds to define individuals at high and low genetic risk of asthma in this cohort. PRS used in a multivariate method offers a decision-making space similar to hyperresponsiveness in this cohort and highlights the most informative and asymmetrical thresholds to define high and low genetic risk of asthma.

PMID:39815278 | DOI:10.1186/s12890-025-03486-3

Virol J. 2025 Jan 15;22(1):11. doi: 10.1186/s12985-025-02623-y.

ABSTRACT

INTRODUCTION: Organ transplant recipients face a substantial risk of developing posttransplant lymphoproliferative disorders (PTLD). In over 90% of cases with B-cell PTLD following solid organ transplantation, the Epstein-Barr virus (EBV) genome is promptly identified, usually within the initial year. A continuing discussion revolves around the efficacy of antiviral prophylaxis in mitigating the incidence of PTLD in solid organ transplant (SOT) patients. This study aimed to conduct a systematic review and meta-analysis to investigate this issue.

METHOD: A comprehensive search was conducted up to December 31, 2023, in databases including PubMed, Embase, and the Cochrane Library for retrospective and prospective studies comparing antiviral prophylaxis effects on EVB viremia and PTLD incidence in SOT recipients. Fixed or random effect models were applied based on the heterogeneity assessed via the I² statistic, using Stata 16.0 software for data analysis.

RESULTS: In total, 22 eligible studies involving 13,498 patients were analyzed. Antiviral prophylaxis was associated with a significant reduction in EBV viremia incidence in SOT recipients, as demonstrated in 10 studies (relative risk (RR) 0.69, 95% CI 0.54 to 0.88). The rate of PTLD was significantly lower among those who received antiviral prophylaxis compared to those who did not, as reported in 18 studies (RR 0.77, 95% CI 0.63 to 0.94). No significant difference was observed in the subgroup of high-risk recipients based on EBV serology (RR 1.13, 95% CI 0.72 to 1.78). Additionally, a notable reduction in PTLD incidence was seen in the pediatric subgroup (RR 0.58, 95% CI 0.43 to 0.79) using antiviral prophylaxis, while no significant differences were observed in the subgroup of adults (RR 0.88, 95% CI 0.64 to 1.21). Administration of antiviral prophylaxis can significantly reduce the incidence of PTLD among kidney (RR 0.63, 95% CI 0.46 to 0.87) and heart transplant patients (RR 0.61, 95% CI 0.39 to 0.96). PTLD incidence was significantly reduced among recipients of T-cell depletion or steroid-based immunosuppression using antiviral prophylaxis (RR 0.54, 95% CI 0.39-0.74 and RR 0.55, 95% CI 0.41-0.73, respectively).

CONCLUSION: This meta-analysis revealed that administering antiviral prophylaxis to patients after solid organ transplantation reduces PTLD and EBV viremia occurrences, especially among pediatric recipients, individuals undergoing kidney or heart transplantation, and those receiving high-intensity immunosuppression regimens. Post-transplant lymphoproliferative disorders (PTLD) and other EBV syndromes are among the most serious complications following solid organ transplantation (SOT), primarily due to the necessity for prolonged immunosuppressive therapy. Among the strategies for preventing EBV-related complications, the use of antiviral prophylaxis is a subject of ongoing debate. This systematic review and meta-analysis found that antiviral prophylaxis significantly reduced EBV viremia incidence (risk ratio (RR) 0.69, 95% confidence interval (CI) 0.54 to 0.88) compared to those without prophylaxis. In the sub-analysis related to high-risk EBV serologically mismatched SOT recipients (EBV D+/R-), the result did not show a significant difference in terms of PTLD incidence (RR 1.13, 95% CI 0.72 to 1.78). Antiviral prophylaxis significantly impacted the occurrence of PTLD events among pediatric SOT patients (RR 0.58, 95% CI 0.43 to 0.79), but not among adult patients (RR 0.88, 95% CI 0.64 to 1.21). Antiviral prophylaxis significantly impacted the occurrence of PTLD events among kidney/simultaneous pancreas and kidney (RR 0.63, 95% CI 0.46 to 0.87) and heart (RR 0.61, 95% CI 0.39 to 0.96) transplant patients but not liver (RR 0.5, 95% CI 0.23 to 1.08) transplant recipients.

PMID:39815274 | DOI:10.1186/s12985-025-02623-y

J Cardiothorac Surg. 2025 Jan 15;20(1):63. doi: 10.1186/s13019-024-03260-2.

ABSTRACT

BACKGROUND: This article aims to use high-throughput sequencing to identify miRNAs associated with ferroptosis in myocardial ischemia-reperfusion injury, select a target miRNA, and investigate its role in H9C2 cells hypoxia-reoxygenation injury.

METHODS: SD rats and H9C2 cells were used as subjects. ELISA kits quantified MDA, SOD, GSH, LDH, and ferritin levels. TTC staining evaluated infarction size. HE staining observed histopathological changes. DCFH-DA fluorescent probe detected ROS. CCK-8 kit measured cell viability. HiSeq 2000 sequencing performed differential expression analysis of miRNAs. qRT-PCR and Western blots assessed the expression levels of GPX-4, ACSL-4, HO-1, TFR-1 and TFR-2. SPSS 21.0 software conducted statistical analysis.

RESULTS: Myocardial ischemia-reperfusion injury resulted in decreased levels of SOD and GSH, increased levels of LDH and MDA, up-regulation of ferritin, ACSL-4, HO-1, and TFR-2, down-regulation of GPX-4, increased tissue damage, and accumulation of ROS. However, DFO treatment reversed these changes. Subsequently, the target gene miRNA-541-5p was obtained by miRNA sequencing screening, and further validation revealed that miRNA-541-5p expression was increased in the myocardial tissues of rats in the I/R injury model group compared with those of rats in the NC group, P < 0.05. Subsequently, by constructing H9C2 cell lines with miRNA-541-5p overexpression and miRNA-541-5p expression inhibition, miRNA-541-5p expression was inversely correlated with the survival of H9C2 cells after hypoxia-reoxygenation injury. miRNA-541-5p up-regulation led to a decrease in SOD and GSH, an increase in ferritin and MDA, and an accumulation of ROS. wb and qRT-PCT demonstrated that high miRNA-541-5p expression up-regulated the expression of protein/mRNA expression of ACSL-4, HO-1, ferritin, and TFR-1, but down-regulated protein/mRNA expression of GPX-4. In addition, ADAM 7, FNIP 2, HOXD 10, HCCS and STK 3 were preliminarily identified as potential candidate target genes for miRNA-541-5p by bioinformatics analysis. Among them, ADAM7 emerges as the most suitable potential target gene based on the selection criteria.

CONCLUSION: In summary, miRNA-541-5p may be a biomarker of myocardial I/R damage diseases and can regulate oxidative stress and iron death by inhibiting the expression of miRNA-541-5p, thereby reducing mechanisms of I/R injury.

PMID:39815273 | DOI:10.1186/s13019-024-03260-2

BMC Health Serv Res. 2025 Jan 15;25(1):80. doi: 10.1186/s12913-025-12228-4.

ABSTRACT

BACKGROUND: The continued healthcare crisis in the United States (US) is worrisome, especially as workforce shortages, particularly for nurses, are highlighted, often in some of the highest need areas. As the need for healthcare services grows, especially for services that nurses can deliver, the inability to meet those needs exacerbates existing disparities in access to care and can jeopardize the quality and timeliness of healthcare delivery in underserved communities. Prior investigations have used varying definitions to describe underserved, under-resourced, rural, or health professional shortage areas to examine the relationship between these areas and workforce shortages. Therefore, this study examines the relationship between changes in the nursing labor force changes and metropolitan medically underserved areas (MUA), defined by Health Resources and Services Administration (HRSA).

METHODS: Secondary data were utilized to conduct descriptive and regression analyses of the nursing workforce population in metropolitan statistical areas from 2012 to 2022. The key outcome variable for the analyses was nurse workforce change per 10,000 population. Occupational Employment and Wage dataset from the Bureau of Labor Statistics was used to determine the number of nurses employed, at the level of the metropolitan statistical area from 2012 to 2022. The Index of Medical Underservice was extracted for each MUA from HRSA and geographically weighted to the metropolitan area.

RESULTS: The results of descriptive trends for nursing professions show that all nursing occupations reviewed have experienced positive change over both five- and ten-year periods. However, the results of nurse change models show that neither the change in Registered Nurses nor Nurse Practitioners is correlated with medically underserved areas.

CONCLUSIONS: These results emphasize the need for adaptive strategies in the nursing workforce to respond to the evolution of healthcare requirements over time. The findings from this study suggest the need for careful planning in workforce policy and education to grow the nurse workforce needs to meet evolving healthcare needs effectively.

PMID:39815266 | DOI:10.1186/s12913-025-12228-4

BMC Med Inform Decis Mak. 2025 Jan 15;25(1):27. doi: 10.1186/s12911-025-02849-4.

ABSTRACT

Electronic health records (EHRs) provide a rich source of observational patient data that can be explored to infer underlying causal relationships. These causal relationships can be applied to augment medical decision-making or suggest hypotheses for healthcare research. In this study, we explored a large-scale EHR dataset on patients with asthma or related conditions (N = 14,937). The dataset included integrated data on features representing demographic factors, clinical measures, and environmental exposures. The data were accessed via a service named the Integrated Clinical and Environmental Service (ICEES). We estimated underlying causal relationships from the data to identify significant predictors of asthma attacks. We also performed simulated interventions on the inferred causal network to detect the causal effects, in terms of shifts in probability distribution for asthma attacks.

PMID:39815256 | DOI:10.1186/s12911-025-02849-4

BMC Ophthalmol. 2025 Jan 15;25(1):20. doi: 10.1186/s12886-025-03864-9.

ABSTRACT

BACKGROUND: The quality of life for low vision patients is a comprehensive concept that involves multiple aspects, including physical, psychological, and social aspects. Visual impairment is an important factor in the decline of patients’ quality of life. The purpose of this study is to investigate the impact and feasibility of carrying out low vision rehabilitation nursing on the quality of life and nursing burden of low vision patients.

METHODS: Select 18 low vision patients who received treatment at a tertiary ophthalmic hospital in Shantou City and randomly divide them into an experimental group and a control group. The control group received routine low vision health education, while the experimental group received intervention measures based on low vision rehabilitation nursing plans. A questionnaire survey was conducted on two groups of study subjects and their caregivers using the Low Vision Quality of Life Questionnaire, General Self-Efficacy Scale, and Zarit Burden Interview before intervention, at week 4 after intervention, and at week 8 after intervention. The scores of each scale in the experimental group and the control group were statistically analyzed.

RESULT: The quality of life and self-efficacy scores of the experimental group patients were higher than those of the control group in the 4th and 8th week after intervention; The caregiver burden of the experimental group patients was lower than that of the control group caregivers in the 4th and 8th weeks after intervention.

CONCLUSION: Implement a low vision rehabilitation nursing plan, provide rehabilitation intervention and support to low vision patients, help patients find new ways to adapt to low vision conditions, and improve their quality of life. Low vision rehabilitation nursing interventions not only enable patients to regain the ability to independently complete daily activities, but also improve their self-efficacy, help rebuild confidence, and reduce the caregiving burden on their caregivers.

PMID:39815249 | DOI:10.1186/s12886-025-03864-9

BMC Infect Dis. 2025 Jan 11;25(1):56. doi: 10.1186/s12879-025-10486-5.

ABSTRACT

INTRODUCTION: Dengue viruses cause either symptomatic infections or asymptomatic seroconversion. Symptomatic dengue has a wide clinical spectrum ranging from self-limiting infection to severe manifestations, mostly characterized by plasma leakage with or without hemorrhage. World Health Organization classification in 2009 classified dengue into dengue without warning signs, dengue with warning signs, and severe dengue. This study aimed to determine patient characteristics and hematological parameters (leukopenia, and thrombocytopenia) in patients with dengue infection in the emergency department of a tertiary center.

METHODS: A cross-sectional study was conducted among 252 patients with dengue confirmed by serological testing against dengue-specific nonstructural protein 1 (NS1) antigen and immunoglobulin M (IgM) by enzyme-linked immunosorbent assay from September to November 2022 who presented in the emergency department of a tertiary hospital in Nepal after ethical approval was obtained. Dengue was categorized according to the World Health Organization 2009 classification. Hematological parameters were recorded by reviewing patients’ laboratory records. Data analysis was done using descriptive statistical parameters and a chi-square test.

RESULTS: Dengue without warning signs was present in 166 (65.87%) patients, while dengue with warning signs and severe dengue was present in 68 (26.89%) and 18 (7.14%) patients, respectively. Leukopenia (< 4000 cells/mm³⁾ was present among 163 (64.68%) patients. The lowest recorded leukocyte count was 1440. Similarly, thrombocytopenia (< 150000 cells/mm³) was present among 102 patients (40.48%). The lowest recorded platelet count was 26,000 cells/mm³. A significant association was found between the severity of dengue infection and leukopenia (χ² 13.268, p-value 0.001) and thrombocytopenia (χ² 43.924, p value < 0.001).

CONCLUSIONS: Monitoring of warning signs and clinical parameters is important for identifying the progression of dengue infection to the critical phase. Leukopenia and thrombocytopenia are present among many dengue-infected patients presenting in the emergency department. The severity of the disease will usually only be apparent around defervescence, which often coincides with the onset of the critical phase. Leukopenia and thrombocytopenia could indicate progression to severe disease during emergency department admission.

PMID:39815245 | DOI:10.1186/s12879-025-10486-5

Child Abuse Negl. 2025 Jan 14;161:107246. doi: 10.1016/j.chiabu.2025.107246. Online ahead of print.

ABSTRACT

BACKGROUND: Neonatal abstinence syndrome (NAS), or withdrawal from prenatal opioid exposure at birth, can trigger a referral to child protective services (CPS). However, there is some evidence of selection into NAS diagnosis because NAS screening is not universal. Such referrals may protect the infant, help connect the mother to services, or cause harm.

OBJECTIVE: To study the relation between prenatal opioid exposure, NAS diagnosis, and CPS involvement during the (early) neonatal period.

PARTICIPANTS AND SETTING: We analyzed data (N = 236,868 Medicaid-covered live births) from the Wisconsin Administrative Data Core using linked birth records, Medicaid claims, CPS records, and benefit/earnings data from 2010 to 2018.

METHODS: We identified opioid exposure using Medicaid claims and CPS investigations within 7 and 28 days of life. We estimate linear probability models with and without the inclusion of NAS diagnosis and interactions of prenatal opioid exposure and NAS diagnosis.

RESULTS: Prenatal opioid exposure is positively associated with CPS involvement, but after controlling for NAS diagnosis, exposure to opioid medications used to treat pain (non-MOUD) or opioid use disorder (MOUD) are not statistically significantly associated with CPS investigations, whereas illicit opioid exposure is associated with increased CPS investigations. Fully interacted models suggest that, for infants diagnosed with NAS, non-MOUD and MOUD exposure are protective and reduce the likelihood of CPS involvement.

CONCLUSIONS: Understanding the type of opioid exposure during pregnancy, NAS diagnosis, and access to treatment OUD is important for referrals to child welfare agencies.

PMID:39813738 | DOI:10.1016/j.chiabu.2025.107246