Tag: pubmed

Disaster Med Public Health Prep. 2025 Oct 6;19:e289. doi: 10.1017/dmp.2025.10199.

ABSTRACT

OBJECTIVE: Earthquakes cause significant mortality and morbidity, particularly through crush injuries and their complications. This study aimed to evaluate whether systemic immune inflammation index (SII) and Pan-immune inflammatory values (PIV) obtained from complete blood count parameters can predict intensive care needs, dialysis requirements, and mortality in patients with crush injuries following earthquake.

METHODS: We retrospectively analyzed data from 76 patients with crush injuries admitted to a university hospital following the earthquake. Blood samples were collected upon admission. SII and PIV were calculated and compared with conventional laboratory markers for their ability to predict clinical outcomes.

RESULTS: Intensive care unit (ICU) admission was required in 40.8% of patients, and 21.1% required dialysis. In ROC analysis, an SII value above 1372 predicted ICU admission with 67.7% sensitivity and 66.7% specificity (P < .001), while an SII value above 1735 predicted dialysis requirement with 75.0% sensitivity and 73.3% specificity (P < .001). Similarly, a PIV value above 1345 predicted ICU admission with 74.2% sensitivity and 73.3% specificity (P < .001), and a value above 1906 predicted dialysis requirement with 81.3% sensitivity and 78.3% specificity (P < .001).

CONCLUSIONS: Complete blood count-derived inflammatory markers may serve as accessible, early indicators to complement clinical assessment for resource allocation following earthquake-related crush injuries, particularly in resource-limited disaster settings. These tools may aid in patient triage and care planning when comprehensive laboratory testing is limited.

PMID:41047911 | DOI:10.1017/dmp.2025.10199

J Matern Fetal Neonatal Med. 2025 Dec;38(1):2566235. doi: 10.1080/14767058.2025.2566235. Epub 2025 Oct 6.

ABSTRACT

OBJECTIVE: To evaluate neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and other related indices measured at the time of admission for threatened preterm labor and their association with the risk of preterm birth.

METHODS: A prospective observational cohort study was conducted between January 2021 and December 2023 at two regional maternity hospitals. Blood samples were collected from all patients upon hospitalization, prior to the administration of any medical treatment. Patients were categorized into two groups based on delivery time: preterm birth and term delivery. The preterm birth group was further subdivided into early preterm birth (<34 weeks) and late preterm birth (34-36.6 weeks). Demographic characteristics, complete blood count parameters, and systemic inflammatory indices were compared across these groups. To identify independent predictors of preterm birth and early preterm birth, multivariate logistic regression analysis was performed.

RESULTS: The final analysis included 311 pregnant women admitted for threatened preterm labor. The preterm birth group had a higher maternal age and a lower gestational age at admission compared to the term delivery group (p = 0.04, p = 0.02, respectively). The preterm group was statistically associated with higher WBC, neutrophil count, monocyte count, and platelet count. Furthermore, the median NLR, SII, and SIRI values were significantly higher in the preterm group. After adjusting for confounders multivariate regression analysis showed that higher levels of NLR and SII were independently associated with an increased risk of preterm birth.

CONCLUSION: We found that NLR and SII are independent prognostic markers for preterm birth in patients with TPTL, and they demonstrate superior prognostic ability compared to single hemogram parameters.

PMID:41047899 | DOI:10.1080/14767058.2025.2566235

Jpn J Nurs Sci. 2025 Oct;22(4):e70026. doi: 10.1111/jjns.70026.

ABSTRACT

AIM: To evaluate the feasibility of a breast stimulation program using a breast pump shortly after cesarean section (CS) to enhance the onset of lactogenesis II.

METHODS: We used a convergent mixed-methods design. It provided an overall picture through quantitative results, which were complemented by qualitative findings. The results were presented using a joint display. Participants were full-term women who underwent CS at a regional perinatal hospital and nurse-midwives from January to March 2025. The program included: (1) providing information about breastfeeding after CS; and (2) providing breast pump-mediated nipple stimulation, starting within 6 h postpartum and continuing until day 2, at least four times daily under researcher supervision. Main outcomes focused on the feasibility of the program, including acceptability, practicality, and implementation. An eight-item questionnaire and open-ended questions were administered. Quantitative data were analyzed using descriptive statistics; qualitative data were analyzed using content analysis.

RESULTS: Seven full-term women with planned CS and 29 nurse-midwives. Most used a breast pump four times within the first 24 h after CS. Women were satisfied with painless nipple stimulation and early milk expression. Both designs complemented each other, and the program was deemed acceptable based on early postpartum breast milk volume data. Identified challenges included pump operability, individual adaptation, and preparation time.

CONCLUSION: The breast stimulation program initiated shortly after CS was feasible, well accepted, and aspects of breast milk volume. A future randomized controlled trial should consider individual differences and adjustments in the frequency of breast pump usage.

PMID:41047890 | DOI:10.1111/jjns.70026

Disaster Med Public Health Prep. 2025 Oct 6;19:e276. doi: 10.1017/dmp.2025.10206.

ABSTRACT

OBJECTIVES: To compare the effectiveness of tabletop exercises (TTX) and high-fidelity in-person simulations (IPS) in improving knowledge, confidence, and perceived preparedness in disaster medicine among emergency medicine residents.

METHODS: A prospective, randomized educational intervention was conducted across 2 urban emergency medicine residency programs. Sixty-three residents were randomized to TTX or IPS groups. Each group completed a preintervention knowledge and confidence assessment, participated in their assigned exercise based on a simulated mass casualty incident (MCI), and underwent a structured debrief. Postintervention surveys assessed change in knowledge and self-reported comfort levels. A paired 2-tailed Student’s t-test was utilized to compare results. Statistical significance was defined as P < 0.01.

RESULTS: Both groups demonstrated increased self-reported confidence and knowledge regarding management of MCIs. TTX participants showed higher median post-test scores (77.4%, N = 38) compared to IPS participants (67.4%, N = 25). Results were not statistically significant (P = 0.079).

CONCLUSIONS: TTX is an effective modality for disaster medicine education, with outcomes comparable to IPS. While TTX may better align with knowledge-based assessments, IPS remains essential for practicing real-time decision-making under stress. Combining these 2 modalities may provide both the knowledge base and psychological duress required for robust disaster scenario training.

PMID:41047872 | DOI:10.1017/dmp.2025.10206

J Fish Biol. 2025 Oct 6. doi: 10.1111/jfb.70245. Online ahead of print.

ABSTRACT

The John Dory Zeus faber is a commercially exploited demersal fish species with a known distribution ranging from the Northeast Atlantic to parts of the Indian and Pacific oceans. A previous genetic survey using cytochrome c oxidase subunit I (COI) DNA barcodes suggested the presence of two geographically segregated taxonomic units within Z. faber. We revisit this hypothesis by expanding the number and geographic coverage of DNA barcodes, addressing a major data gap along parts of the Atlantic coast of Africa and conducting a comprehensive phylogeographic analysis. Our findings consolidated the existence of two highly divergent mitochondrial clades, Clade A and Clade B (mean K2P distance: 7.4%), with the transition zone between them located along the Atlantic coast of Morocco. Clade A exhibited no phylogeographic structure, with haplotypes shared between Northeast Atlantic and Mediterranean populations. Conversely, four geographically structured subclades (mean K2P distance: 0.9%) were detected within Clade B, extending south and eastward from Morocco to Japan and New Zealand. Historical demographic events driving allopatric divergence, along with oceanographic and environmental factors, likely shaped the current geographic distribution of the two clades. These findings not only prompt the need to re-evaluate the taxonomic status of Z. faber but also highlight the probable existence of multiple evolutionarily significant units (ESUs) that must be considered in the scope of stock assessment, fisheries management and conservation purposes.

PMID:41047867 | DOI:10.1111/jfb.70245

Health Promot Pract. 2025 Oct 6:15248399251368310. doi: 10.1177/15248399251368310. Online ahead of print.

ABSTRACT

Adolescence is a critical period for young people’s sexual and reproductive health (SRH), emphasizing the need for support with regards to the prevention of unintended pregnancy or sexually transmitted infections. Multi-level, community-wide initiatives are a widely promoted approach to support young peoples’ SRH, yet research evaluating their impact is scarce, limiting the opportunity for these initiatives to be incorporated into evidence-based practice. This study responds to this evidence gap by estimating the early effects of a city-wide youth sexual health initiative on population-level youth sexual health indicators (condom use, birth control use, combined method use, abstinence, early sex (<15 years), number of sexual partners). A quasi-experimental, difference-in-differences design with propensity weighting was employed using a nearby city as a comparison group and Youth Risk Behavior survey data from from 6,978 high school students. Estimates were generated using logistic regression. Overall, no statistically significant effects on youth sexual health indicators were detected, although the direction of non-significant findings was promising. Effect heterogeneity was detected by grade and race, suggesting that younger and Black/African American youth experienced more favorable impacts of the initiative. This study contributes to the small but growing evaluation research on multi-level, community-wide youth sexual health initiatives and provides a blueprint approach to evaluate similar initiatives using a publicly available data source. Findings highlight the potential for community-wide sexual health initiatives to address disparities in adolescent SRH, support continued effect estimation over longer time periods, and emphasize the value of culturally responsive sexual health programming.

PMID:41047855 | DOI:10.1177/15248399251368310

Ophthalmic Res. 2025 Oct 4:1-12. doi: 10.1159/000548751. Online ahead of print.

ABSTRACT

PURPOSE: Previous studies have demonstrated the efficacy of Faricimab where the intervention in treatment-resistant neovascular age-related macular degeneration (nAMD) had been switched from Aflibercept to Faricimab. This exploratory study aimed to assess the clinical anatomical and functional outcomes of a single intravitreal Faricimab (IVF) injection in those with treatment-resistant nAMD who switched from Aflibercept, in a single tertiary ophthalmology centre.

METHODS: This retrospective, observational real-world study assessed 20 patients (21 eyes) with treatment-resistant nAMD who were switched from intravitreal Aflibercept (IVA) to Faricimab due to persistent subretinal fluid (SRF) despite frequent Aflibercept injections. Patients were switched to a regimen of Faricimab consisting of three loading doses administered at 4-weekly injections. Anatomical and functional measures were assessed at two time points: immediately before the initial Faricimab injection and approximately 4 weeks later, before the second Faricimab injection. The outcome measures were: visual acuity, central macular thickness (CMT), macular volume, and the presence of SRF were evaluated pre- and post-switch.

RESULTS: Twenty-one eyes from 20 patients were analyzed. Statistically significant reductions in CMT (from 570.2 to 482.7 μm; p < 0.01) and macular volume (from 8.57 to 7.87 mm³; p = 0.02) were observed post-switch, while the change in visual acuity did not reach statistical significance (p = 0.051). The number of eyes with SRF decreased from 21 pre-switch to 9 post-switch.

CONCLUSION: The findings from this exploratory study suggests that switching from Aflibercept to Faricimab demonstrated significant physiological improvements among patients with treatment-resistant nAMD. Faricimab may serve as an effective and safe option in this patient population. The exploratory study also identifies changes in CMT and macular volume as outcome measure candidates for future large-scale investigations.

PMID:41047829 | DOI:10.1159/000548751

Diagnosis (Berl). 2025 Oct 7. doi: 10.1515/dx-2025-0089. Online ahead of print.

ABSTRACT

OBJECTIVES: Clinical reasoning skills are required for safe care, yet they are not consistently taught to advanced practice providers (APPs). In hospital medicine, where APPs work semi-independently, gaps in clinical reasoning can increase the likelihood of error. To address this, we developed a module that uses diagnostic root cause analysis (RCA) to teach clinical reasoning skills to hospital medicine APP fellows.

METHODS: The curriculum was delivered from July 2021 to March 2025. Fellows selected real-world diagnostic errors encountered during clinical rotations, created cognitive fishbone diagrams, and presented their analysis in small-group.

RESULTS: Twenty-seven fellows completed the module and pre-post assessment surveys. Statistically significant improvements were observed across all six domains of knowledge and confidence related to identifying error contributors, analyzing cases, and setting goals. Free-text responses highlighted the module’s emotional safety, peer learning value, and normalization of diagnostic reflection. Two learners published their projects as academic posters, and one graduate now co-facilitates the sessions.

CONCLUSIONS: This module offers a scalable, time-efficient approach to clinical reasoning education that is adaptable across learner levels and specialties. Its peer-led design fosters psychological safety, reflective practice, and creates a natural pathway for APPs to engage in microscholarship – addressing a critical gap in both education and academic inclusion.

PMID:41047825 | DOI:10.1515/dx-2025-0089

Ann Saudi Med. 2025 Sep-Oct;45(5):295-303. doi: 10.5144/0256-4947.2025.295. Epub 2025 Oct 2.

ABSTRACT

BACKGROUND: Recurrent laryngeal nerve injury (RLNI) is a wellknown complication of thyroidectomy that can lead to vocal cord palsy (VCP). Identifying risk factors and reducing the incidence of RLNI are essential for improving surgical outcomes.

OBJECTIVES: To assess the incidence of permanent VCP after thyroidectomy and evaluate its possible associated risk factors.

DESIGN: A retrospective cohort study.

SETTING: A multicenter study conducted in Makkah, Saudi Arabia.

METHODS: The study assessed incidence of permanent RLNI and its associated risk factors in 314 patients who underwent thyroidectomy at our centers in Makkah, Saudi Arabia, between December 2014 and December 2024. The data were gathered on general characteristics, clinical findings, and surgical details. Statistical analyses were performed to identify significant risk factors.

MAIN OUTCOMES MEASURES: Incidence of permanent RLNI and the associated risk factors.

SAMPLE SIZE: 314 patients.

RESULTS: Overall incidence of permanent VCP was 9 (2.9%). The left vocal cord was affected in 3 (1%) of cases, while the right vocal cord was affected in 6 (1.9%). Significant risk factors included age over 45 years (P=.043), male patients (P=.04), prior thyroid surgery (P=.006), and high cumulative doses of radioactive iodine (P=.008). However, no significant associations with factors such as family history of thyroid disease, carcinoma, or incidental disease onset.

CONCLUSION: Post-thyroidectomy VCP is influenced by several factors, including age, gender, previous thyroid surgery, and radioactive iodine dose. These findings highlight the importance of careful pre-operative risk assessment and the use of preventive measures, such as Intra-Operative Nerve monitoring, use of optical magnification and pre-operative predicting of thyroidectomy difficulty to reduce RLNI risk.

LIMITATIONS: Possibility of selection bias due to the retrospective design. In addition to lack of use of certain analytical tests and detailed subgroup analysis due to the moderate sample size.

PMID:41047809 | DOI:10.5144/0256-4947.2025.295

J Dtsch Dermatol Ges. 2025 Oct 5. doi: 10.1111/ddg.15911. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Social media is increasingly establishing itself as an important source of information for skin health. Although demand among users is high, very few dermatologists outside the Anglo-American region use these platforms to provide patient information, and the majority of content is provided by non-medical sources. This study investigated the influence of social media on skincare and preventive behavior among young adults, and the relevance of medically qualified content.

METHODS: An anonymized 34-item online questionnaire was distributed to 454 students at the University of Innsbruck, assessing social media usage, skincare routines, prevention behavior, and perception of dermatological content. Descriptive and inferential statistics (chi-square tests, p < 0.05) were applied.

RESULTS: A significant association was found between time spent on social media and perceived impact on personal skin health (p = 0.014). Participants exposed to dermatologist-created content were significantly more likely to follow a skincare routine (p < 0.001). The majority expressed a desire for more professionally qualified information.

CONCLUSIONS: Social media offers significant potential for providing information about skin conditions and educating patients. A more comprehensive presence of content reviewed by medical professionals may help minimize the spread of misinformation and promote health education, especially among young users.

PMID:41047803 | DOI:10.1111/ddg.15911