Tag: pubmed

Front Psychol. 2025 Apr 28;16:1586278. doi: 10.3389/fpsyg.2025.1586278. eCollection 2025.

ABSTRACT

BACKGROUND AND AIMS: Mental toughness is a psychological construct related to resilience and perseverance, and quality of life encompasses physical, emotional, and social wellbeing, which are critical indicators of overall health and wellbeing. This study aims to investigate the effects of different levels of physical activity on mental toughness and quality of life in both male and female participants.

METHODS: This cross-sectional study consists of 220 participants with the age range of 18-31 years. The data were collected using the International Physical Activity Questionnaire, the Mental Toughness Questionnaire, and the World Health Organization Quality of Life. Gender specific differences were determined using an independent t-test (two-tailed). The effect of varying levels of physical activity in male and female participants was determined by analysis of variance.

RESULTS: Significant differences were found between male and female participants for physical activity levels as high (t = 4.21, p ≤ 0.001, d = 871.80), moderate (t = 3.72, p ≤ 0.001, d = 1309.59), and low (t = 3.21, p = 0.002, d = 520.91) physical activity participants. Statistically significant differences were also found between gender for mental toughness parameters [handling pressure (t = 17.96, p ≤ 0.001, d = 1.25), concentration (t = 16.07, p ≤ 0.001, d = 1.22), mental rebounding (t = 13.34, p ≤ 0.001, d = 1.45), winning attitude (t = 12.01, p ≤ 0.001, d = 1.17)] and quality of life parameters [physical (t = 13.16, p ≤ 0.001, d = 1.58), mental (t = 6.17, p ≤ 0.001, d = 1.69), social (t = 4.58, p ≤ 0.001, d = 2.05), environmental (t = 8.35, p ≤ 0.001, d = 4.95)].

CONCLUSION: Statistically significant differences were found between genders in levels of physical activity, mental toughness, and quality of life. Future research should aim to unravel the complex interlink between physical activity, mental toughness, and quality of life, using longitudinal designs and diverse populations to validate the findings and explore the underlying mechanisms further.

PMID:40357470 | PMC:PMC12066308 | DOI:10.3389/fpsyg.2025.1586278

Clin Ophthalmol. 2025 May 8;19:1531-1541. doi: 10.2147/OPTH.S508618. eCollection 2025.

ABSTRACT

Corneal ectasias are progressive conditions that impair vision and quality of life. Corneal collagen cross-linking (CXL) aims to halt disease progression by strengthening the cornea. This review compares two CXL methods, epithelium-on (epi-on) and epithelium-off (epi-off), to assess their safety and effectiveness for managing corneal ectasia. A systematic search up to July 2024 of PubMed, Medline, Web of Science, Cochrane Central, Google Scholar, and Scopus identified 13 randomized controlled trials (RCTs) involving 872 patients and 1041 eyes. Data were analyzed following PRISMA guidelines using fixed-effects and random-effects models. The primary outcome was the change in maximal keratometry (Kmax) at 12 months, with secondary outcomes including safety profile, best-corrected visual acuity (BCVA), uncorrected visual acuity (UCVA), spherical equivalent (SE), and endothelial cell count (ECC). The findings revealed no statistically significant differences between epithelium-on (epi-on) and epithelium-off (epi-off) CXL in Kmax, BCVA, UCVA, SE, or corneal curvature parameters. However, epithelium-off (epi-off) CXL was associated with less endothelial cell loss and higher rates of side effects, including corneal haze and postoperative discomfort. The choice of treatment should be tailored to individual patient needs, balancing clinical goals and safety considerations. This review highlights the need for further studies to optimize CXL approaches and improve outcomes while minimizing complications.

PMID:40357455 | PMC:PMC12068400 | DOI:10.2147/OPTH.S508618

J Public Health Res. 2025 May 11;14(2):22799036251336969. doi: 10.1177/22799036251336969. eCollection 2025 Apr.

ABSTRACT

BACKGROUND: Multidrug-Resistant Tuberculosis (MDR-TB) is fast becoming a major public health concern, with 80% of the reported global MDR-TB deaths occurring in high burden countries including Namibia where drug susceptibility testing is not routinely performed. Previous studies on TB in Namibia have primarily focused on TB and HIV co-infection and MDR-TB development. However, no study to date has specifically examined the epidemiology of MDR-TB mortality or its associated risk factors at a national level. Thus, this study aimed at examining the variation of mortality among MDR-TB patients in Namibia and identifying its risk factors.

DESIGN AND METHODS: The study adopted a retrospective cohort study design using the 2014-2017 MDR-TB records, and a Gompertz PH model with Gamma (shared) frailty for the frailty modelling of the MDR-TB mortality and its associated risk factors.

RESULTS: There were more MDR-TB deaths among females, HIV positive patients with pulmonary TB in the Khomas region. MDR-TB mortality was more likely to occur for patients who were aged 55 and above (HR = 3.57, p < 0.001, 95% CI: 2.18-5.91), HIV positive (HR = 2.07, p < 0.001, 95% CI: 1.39-3.08), and from the Khomas (HR = 3.68, p = 0.001, 95% CI: 1.72-7.87), Kunene (HR = 4.45, p = 0.022, 95% CI: 1.24-15.91), Omusati (HR = 2.70, p = 0.022, 95% CI: 1.15-6.31), and Oshana (HR = 2.51, p = 0.021, 95% CI: 1.15-5.48) regions.

CONCLUSIONS: It is therefore recommended that the Namibian government and policy makers consider conducting outreach sessions to increase awareness on MDR-TB including early detection and screening programmes, and patient’s adherence, especially among female patients aged 55 and above, with HIV and those living in these highlighted regions.

PMID:40357450 | PMC:PMC12066852 | DOI:10.1177/22799036251336969

Orthop Res Rev. 2025 May 7;17:189-198. doi: 10.2147/ORR.S514237. eCollection 2025.

ABSTRACT

STUDY DESIGN: Retrospective chart review.

OBJECTIVE: This study aims to investigate the application of robots in treating adult degenerative scoliosis (ADS) with circumferential minimal invasive surgery (cMIS).

BACKGROUND: The cMIS is useful but faces a lot of challenges in correcting ADS. One of the most important challenges is the difficulty in screw placement. Robot-assisted technique demonstrates lots of advantages but the data about its application in treating ADS is limited in literatures.

METHODS: A total of 51 cases diagnosed with ADS were retrospectively analyzed. All patients underwent cMIS technique with staged surgeries (OLIF and PPS fixation). Group A enrolled 21 patients and performed robot-assisted technique. Group B enrolled 30 patients and performed fluoroscopy guided technique. Clinical outcomes like the operation time, radiation exposure, pressure curve and post-operation VAS score were recorded. 3D-CT scan was also performed to evaluate the accuracy of the screws.

RESULTS: The average preparation time were much higher in group A (23.4 ± 2.8 vs 3.1 ± 1.0 min, p < 0.0001). But the total operation time was similar (62.7 ± 12.5 vs 55.7 ± 20.6 min, p = 0.174). The average fluoroscopic scan number were 9.4 ± 1.7 in group A, much lower than that of group A (27.7 ±5.9, p < 0.001). No statistical difference was found with the VAS scale between the groups (p = 0.631). No matter considers only screws of grade A as perfect screws (81.5% vs 73.8%) or considers both grade A and B as acceptable screws (93.8% vs 87.7%), group A demonstrated significant higher screw accuracy (p = 0.038, p = 0.018, respectively). Also, the robots demonstrated significant less facet joint violence (p < 0.0001), larger inward tilt angle (p < 0.0001), and longer screw length (p = 0.0008).

CONCLUSION: The robot-assisted technique demonstrated significant advantages like higher pedicle screw accuracy, better trajectory, less radiation exposure, but similar operation time compared with fluoroscopy guided technique in treating ADS with CMIS.

PMID:40357444 | PMC:PMC12067674 | DOI:10.2147/ORR.S514237

Front Cardiovasc Med. 2025 Apr 28;12:1531136. doi: 10.3389/fcvm.2025.1531136. eCollection 2025.

ABSTRACT

BACKGROUND AND AIMS: Progress in cardiology has extended the lifespan of patients with congenital heart defects (CHD). Cyanotic patients are exposed to typical diseases of adulthood, including atherosclerosis. Rheological changes typical of cyanosis affect the vascular endothelium’s function and may promote atherosclerosis development. We assessed the endothelial function and its relationship to biochemical parameters, particularly sphingosine-1-phosphate, in cyanotic CHD patients.

METHOD: A cross-sectional study including 36 adult CHD cyanotic patients [(12 males) (39 median, 19-73 years)] with arterial blood oxygen saturation less than 92% and 30 healthy controls [(11 males) (38.5 median, 26-59 years)] was performed. All patients underwent clinical examination, blood sampling, and ultrasonography, during which endothelial function was assessed using intima-media thickness (IMT) and flow-mediated dilatation (FMD).

RESULTS: We did not demonstrate any difference between CHD patients and the control group in the IMT complex and FMD. Patients with cyanosis are characterized by higher S1P serum levels (p = 0.04), lower ApoM (p = 0.04), and HDL concentrations (p = 0.02). Only FMD correlated positively with HDL cholesterol (p = 0.02) concentration. The IMT complex correlates positively only with BMI (p = 0.04). No factor was statistically significant in the multiple logistic regression model for FMD <6.5%.

CONCLUSIONS: The values of the analyzed biochemical and clinical factors (except for the reduced HDL fraction), the lack of inflammatory factor activity, and the increased S1P concentration indicate the dominance of antiatherosclerotic activity in this population. FMD and IMT are preserved, which suggests that the risk of early atherosclerotic changes in this group is comparable to the remaining population.

PMID:40357437 | PMC:PMC12066607 | DOI:10.3389/fcvm.2025.1531136

Actas Esp Psiquiatr. 2025 May;53(3):516-525. doi: 10.62641/aep.v53i3.1749.

ABSTRACT

BACKGROUND: Nasopharyngeal carcinoma (NPC) presents a substantial challenge for patients, impacting their physical and psychological well-being. Patients may experience moderate depression, anxiety, and reduced quality of life due to the disease and its treatments. Therefore, we retrospectively analyzed the adjunctive therapeutic potential of mindfulness-based stress reduction (MBSR) therapy for NPC patients with moderate depression.

METHODS: Psychological parameters were assessed using standardized scales, including the Hamilton Depression Scale-17 (HAMD-17), Self-Rating Depression Scale (SDS), Perceived Social Support Scale (PSSS), the Short-From-12 Health Survey (SF-12), and Mindfulness Attention Awareness Scale (MAAS). Statistical analyses were performed to compare the two groups.

RESULTS: A total of 131 patients including 67 patients with control group and 64 patients with Mindfulness-Based Stress Reduction therapy group were included. After 8 weeks of treatment, the MBSR therapy group showed significant improvements in psychological parameters, including depression, anxiety, perceived stress, quality of life, and mindfulness attention awareness (p < 0.05), compared to the control group. Additionally, the MBSR therapy group reported significantly higher overall satisfaction with treatment, willingness to recommend treatment, and perceived benefit from treatment (p < 0.05).

CONCLUSION: The study findings support the adjunctive therapeutic value of MBSR therapy in improving psychological outcomes and patient satisfaction among individuals with NPC-induced moderate depression.

PMID:40356009 | DOI:10.62641/aep.v53i3.1749

Actas Esp Psiquiatr. 2025 May;53(3):557-569. doi: 10.62641/aep.v53i3.1788.

ABSTRACT

OBJECTIVE: Surgery, as the preferred option to extend the survival of breast cancer patients, has increasingly garnered attention for its impact on patients’ mental status and quality of life (QoL). Therefore, this study aimed to identify the factors affecting the QoL and mental status of breast cancer patients with schizophrenia, thus enabling subsequent interventions to improve their mental status and QoL.

METHODS: This study included 125 breast cancer patients with schizophrenia, and their mental status and QoL were analyzed before and after surgery. The mental status of these patients was assessed using the Symptom Checklist-90 (SCL-90), and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) was used to score their QoL. Baseline characteristics were recorded, including age, marital status, education level, and per capita monthly household income. The clinical and demographic data were statistically analyzed to identify factors affecting patients’ mental status and QoL.

RESULTS: We observed that the mental status and QoL of breast cancer patients with schizophrenia at preoperative and postoperative stages were influenced by marital status, education level, tumor stage, tumor size, and monthly family income. Additionally, the type of surgery was significantly associated with postoperative mental status and QoL and was found to be a predictor influencing the overall QoL. Furthermore, surgery had a positive impact on patients across different treatment stages.

CONCLUSION: The psychological state and QoL of breast cancer patients with schizophrenia are influenced by various factors at different stages of treatment (preoperative and postoperative). Surgery significantly improves the patients’ psychological state and QoL.

PMID:40356007 | DOI:10.62641/aep.v53i3.1788

Actas Esp Psiquiatr. 2025 May;53(3):494-503. doi: 10.62641/aep.v53i3.1892.

ABSTRACT

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) refers to a set of symptoms, such as an inability to sustain attention, hyperactivity, and impulsivity, with a prevalence of 2.0% for the general population. Approximately 2.7% of American medical students report having some form of disability, with ADHD emerging as the most frequently self-disclosed condition. Medical students with a positive ADHD Self-Report Scale (ASRS) score present more depression symptoms in comparison with those with a negative ASRS score. Previous studies suggest that a low amount of time spent in physical activity and a high amount of time spent in sedentary behavior were associated with mental disorders (e.g., anxiety and depression). However, information in the literature on this association with symptoms of ADHD is limited, particularly in medical students.

METHODS: In this cross-sectional study, we investigated a sample of medical students aged 18 years or older. Individuals diagnosed with ADHD were excluded. Participants completed an online survey, which included questions about demographic and academic experiences, the ADHD Self-Report Scale, the International Physical Activity Questionnaire (IPAQ), and the Beck Anxiety Inventory (BAI). Statistical analysis was conducted using the SPSS 22 program, with a significance threshold of p = 0.05.

RESULTS: Out of ninety-nine medical students included, forty individuals (40.4%), demonstrated positive ASRS scores, suggesting a risk for ADHD. After dividing the participants into groups according to their ASRS scores (negative or positive ASRS), the Mann-Whitney comparison revealed that the negative ASRS group exhibited lower daily screen time (9.0 vs 12.0 hours per day; p < 0.01) and reduced anxiety symptoms (8.0 vs 16.0 points; p < 0.01) compared to the positive ASRS group. Furthermore, the linear multiple regression analysis indicated that screen time was a predictor of the ASRS score.

CONCLUSION: In a sample of medical students, the current study showed a prevalence of 40.4% of positive ASRS. The results suggest that medical students with a positive ASRS score have higher screen time, as well as more symptoms of anxiety. In addition, we found that screen time was a significant predictor of scores in the ASRS.

PMID:40355994 | DOI:10.62641/aep.v53i3.1892

Alzheimers Dement. 2025 May;21(5):e70153. doi: 10.1002/alz.70153.

ABSTRACT

INTRODUCTION: The spatial heterogeneity of tau deposition is closely linked to clinical variants of Alzheimer’s disease (AD). Detecting these patterns in the preclinical stage is challenging, but second-generation tau tracers provide a unique opportunity to do so.

METHODS: We used independent component analysis (ICA) and tau positron emission tomography (PET) imaging with the 18F-MK6240 tracer in 590 cognitively healthy adults (mean age 66.58 ± 5.13 years, 340 females) to identify tau patterns in the preclinical stage.

RESULTS: Using all individuals, seven distinct patterns emerged, with medial temporal lobe (MTL) involvement associated with age, Aβ burden, apolipoprotein E (APOE) genotype, and plasma total tau. Bilateral amygdala-hippocampus tau deposition was associated negatively with memory (t = -2.64, p < 0.01), while broader neocortical patterns, especially asymmetric ones, were linked to deficits in language (t < -3.13, p < 0.002) and reasoning (t < -2.63, p < 0.01).

DISCUSSION: These findings advance our understanding of preclinical tau heterogeneity, offering new insights for early AD intervention.

HIGHLIGHTS: Seven tau deposition patterns were identified in preclinical stages of AD, including medial temporal lobe and asymmetric neocortical patterns. Medial temporal lobe patterns were strongly linked to age, APOE genotype, Aβ burden, and plasma total tau levels. Neocortical patterns, especially asymmetric ones, were linked to domain-specific cognitive deficits, notably in language and reasoning. This research highlights the potential of using tau deposition patterns for early detection and tailoring interventions in preclinical AD.

PMID:40355988 | DOI:10.1002/alz.70153

Implement Sci Commun. 2025 May 12;6(1):58. doi: 10.1186/s43058-025-00746-5.

ABSTRACT

BACKGROUND: Pre-exposure prophylaxis (PrEP) is recommended for HIV prevention in pregnant and postpartum women at substantial ongoing risk for HIV. In resource-limited settings, there exist gaps in the integration of PrEP into antenatal care.

METHODS: We conducted a difference-in-differences analytic approach (3 months pre- and 3 months post) between January 2022 and July 2022 in 8 facilities (4 intervention and 4 comparison) in western Kenya. During the 6-month period, we tested a combination of 2 stakeholder selected implementation strategies – retraining health providers and fast tracking PrEP clients- to improve PrEP delivery. All study facilities dispensed PrEP in the Maternal and Child health clinics (MCH). We evaluated absolute changes in: PrEP penetration, PrEP fidelity, client PrEP knowledge, client satisfaction, and client waiting and service times as outcomes specified a priori while PrEP offer and HIV testing were outcomes specified post hoc. We measured acceptability and appropriateness by providers of the implementation strategies using AIM and IAM respectively.

RESULTS: We observed statistically significant improvements in PrEP penetration and PrEP offer (p < 0.05) and non-significant improvements in fidelity. PrEP penetration increased 6 percent points (p = 0.002), PrEP offer increased nearly 6 percentage points (p = 0.002), and PrEP fidelity increased 4 percentage points (p = 0.202) in intervention vs comparison facilities. Client PrEP knowledge increased 0.45 out of 7 total points (p < 0.001) and PrEP screening increased 13 percentage points (p = 0.001). We observed no significant changes in service time (0.13-min increase; p = 0.249), waiting time (0.03-min decrease; p = 0.796), or client satisfaction (0.04/24 total point decrease; p = 0.849) in intervention vs comparison facilities. HIV testing did not significantly change (7 percentage point decrease, p = 0.305). The implementation strategy bundle was deemed appropriate and acceptable by the providers (appropriateness: 18.5/20; acceptability: 18.5/20). Overall, the implementation strategy bundle was associated with larger increases in implementation outcomes among women receiving a visit other than their first ANC visit, as well as among sites without stockouts of HIV test kits.

CONCLUSIONS: A stakeholder-selected implementation strategy bundle that included retraining healthcare workers, fast tracking PrEP clients to reduce waiting time, and PrEP dispensing in MCH improved several implementation outcomes without significantly affecting waiting time or reducing service time.

PMID:40355972 | DOI:10.1186/s43058-025-00746-5