Tag: pubmed

Palliat Med. 2025 Dec 6:2692163251395576. doi: 10.1177/02692163251395576. Online ahead of print.

ABSTRACT

BACKGROUND: Healthcare assistants play a critical role in providing palliative and end-of-life care in the community across many healthcare systems internationally. Despite working alone in emotionally demanding and unpredictable settings, no research has examined their psychological wellbeing or factors influencing turnover.

AIM: To investigate the correlations between mental wellbeing, intention to leave their role and workplace support in lone working healthcare assistants providing palliative and end-of-life care in the community.

DESIGN: Explanatory sequential mixed methods study, using cross-sectional survey (Warwick-Edinburgh Mental Well-being Scale and Turnover Intention Scale, project team-developed questions), followed by interviews. Quantitative data analysed using descriptive and inferential statistics, qualitative data analysed using framework approach.

SETTING/PARTICIPANTS: Lone working healthcare assistants from a UK non-profit organisation providing palliative and end-of-life care.

RESULTS: Among 218 survey respondents (22.5% response rate), 80% (n = 174) reported average to high mental wellbeing (mean = 52.2, SD = 8.6). Intention to leave was low (mean = 14.9, SD = 5.3). Higher wellbeing correlated with lower intention to leave (r(216) = -0.25, p < 0.001). Interviews (n = 14) and survey data revealed support from known individuals, particularly line managers, was most valued and accessed by 87.2% of respondents, significantly associated with higher wellbeing and lower turnover intention. Clinical supervision and peer support were frequently accessed and valued, though impact on wellbeing and retention varied. Anonymous online support services remained largely unused despite high awareness.

CONCLUSIONS: The study challenges assumptions about psychological distress experienced by this workforce while showing that targeted, personalised workplace support strategies could be key to retention, offering evidence-based pathways for strengthening workforce sustainability.

PMID:41351425 | DOI:10.1177/02692163251395576

Front Biosci (Landmark Ed). 2025 Nov 27;30(11):45912. doi: 10.31083/FBL45912.

ABSTRACT

BACKGROUND: The nucleotide “words” (k-mers) of the genome exhibit two essentially universal properties that follow probabilistically from the Conservation of Hartley-Shannon Information (CoHSI): (1) a Zipfian rank-ordered distribution of frequencies and (2) universal inverse symmetry. Here, we address the presence of these 2 properties in the transcriptome, a question of interest given the strong and specific structure/function constraints on RNAs, especially the protein-coding (CDS) sequences.

METHODS: CDS and ncRNA (non-coding RNA) databases were accessed at e!Ensembl. For determination of a power-law, statistical tests of both necessity (linearity) and sufficiency (confidence that a power-law distribution could not be rejected) were applied. Compliance with inverse symmetry was assessed by linearity and residual standard error.

RESULTS: The CDS and non-coding RNAs for 53 species were analyzed separately and the data presented as short movies. The results were consistent for all species analyzed, and taking the bonobo (Pan paniscus) as a representative species, the following results were obtained. For the Zipfian distribution of k-mer frequencies, statistically robust tests of both necessity (adjusted R-squared of 0.9932 and p ≤ 2.2 × 10^-16) and sufficiency were obtained for the CDS; for non-coding RNAs the test of necessity was robust (adjusted R-squared = 0.9982 and p ≤ 2.2 × 10^-16). Perturbations of inverse symmetry were observed in both CDS (slope = 0.91, adjusted R² = 0.77) and non-coding RNAs (slope = 1.02, adjusted R² = 0.84). The disruption of inverse symmetry in the CDS affected particularly the 3- and 6-mers and was shown to be associated with codon (especially stop codon) frequency in the open reading frame.

CONCLUSIONS: Whereas the CoHSI-predicted Zipfian distribution of k-mer frequencies was observed in both the protein-coding and non-coding RNAs of 53 species, in contrast the compliance with inverse symmetry was weaker. This weakening of compliance was seen to a greater extent in the CDS than in the non-coding portions of the transcriptome and may be associated with the necessity to maintain the integrity of the reading frame in the CDS. These results illustrate the general principle that local perturbations of an overall CoHSI-guided equilibrium state of a biological system can provide insight into the underlying causes of such perturbations.

PMID:41351398 | DOI:10.31083/FBL45912

Biomark Med. 2025 Dec 6:1-12. doi: 10.1080/17520363.2025.2597174. Online ahead of print.

ABSTRACT

OBJECTIVE: Colorectal cancer (CRC) is a major contributor to global cancer mortality. Reliable biomarkers like c-Jun and Interleukin-8 (IL-8) may improve prognosis and therapy. Considering the possible ethnic differences in CRC biomarkers, this study is the first to examine a distinct Southeast Asian cohort (Indonesia).

METHODS: A retrospective study analyzed 98 CRC patients using immunohistochemistry to evaluate c-Jun and IL-8 expression. Paraffin-embedded tissues were assessed for correlations with clinicopathological features. Statistical analyses were performed with p < 0.05 considered significant.

RESULTS: c-Jun expression was significantly higher in mucinous or serrated histology (median 1.80, range 0.90-2.30) compared to adenocarcinoma, NOS (median 1.60, range 0.70-2.50) (p = 0.04). Meanwhile, IL-8 expression showed no significant differences across all clinicopathological factors. Neither biomarkers showed significant association with most clinicopathological factors, including age, sex, tumor size, location, stage, grade, invasion, or metastasis.

CONCLUSIONS: c-Jun and IL-8 expression showed limited prognostic relevance for most clinicopathological features of CRC. However, elevated c-Jun expression may indicate its particular involvement in distinct CRC subtype pathogenesis.

PMID:41351394 | DOI:10.1080/17520363.2025.2597174

Rev Neurol. 2025 Nov 27;80(10):43204. doi: 10.31083/RN43204.

ABSTRACT

Although prospective studies directly estimate the influence of a factor on the onset of a disease, case-control sampling is often cheaper, faster, and sometimes the only feasible option. In these studies, a random sample of individuals with the disease (cases) is taken, and the proportion of them, P₁, who were exposed to the factor is evaluated. A random sample of individuals without the disease (controls) is also taken, and the proportion of them, P₀, who were exposed is evaluated. From these two proportions, the respective odds and their ratio, the odds ratio (OR), are calculated. When the incidence of the disease is small, say less than 10%, this OR value closely approximates the relative risk (RR), and therefore tells us, with good approximation, how much greater the risk of having the disease is if one is exposed to the factor. In all cases, case-control studies tend to have more confounding factors, which are not easily controllable, than prospective studies. However, under certain circumstances, they have a much higher statistical power than the prospective design.

PMID:41351392 | DOI:10.31083/RN43204

Public Health Res (Southampt). 2025 Dec 3:1-17. doi: 10.3310/GJMW1501. Online ahead of print.

ABSTRACT

BACKGROUND: The United Kingdom Soft Drinks Industry Levy was introduced in April 2018, resulting both in changes in sugar levels in drinks and purchases of drinks. Both mechanisms could impact on the incidence and prevalence of raised body weight, diabetes and diet-related diseases, and therefore, have implications for economic costs to the health sector.

OBJECTIVES: To model future impacts of the Soft Drinks Industry Levy on population health and health sector costs and to estimate net monetary benefit to the health system.

DESIGN AND METHODS: Proportional multistate lifetable modelling study – open and closed cohort analyses.

SETTING AND POPULATION: All children and adults in the United Kingdom.

INTERVENTION: The Soft Drinks Industry Levy is a two-tier levy of £0.18/l on drinks with between 5 and 8 g of total sugars/100 ml and of £0.24/l on drinks with ≥ 8 g of total sugars/100 ml.

MAIN OUTCOME MEASURES: We evaluated impact of the sugar reduction on: (1) prevalence of overweight and obesity, obesity-related diseases and dental health out to 2050 and (2) lifetime population health (measured in quality-adjusted life-years), change in costs to the health sector and the resulting net monetary benefit.

DATA SOURCES: We estimated a per person reduction in sugar from a previously published interrupted time series analysis, which found an 8.0 g/household/week (95% confidence interval 2.4 to 13.6) reduction in sugar at 1 year after implementation. Our multistate lifetable model is parameterised using data from population health monitoring surveys, the Global Burden of Disease project, the Human Mortality Database and the Office for National Statistics. Health sector costs were obtained from Department of Health and Social Care budget allocations.

RESULTS: The model predicts that the Soft Drinks Industry Levy will reduce the prevalence of overweight and obesity in the United Kingdom by 0.18% points (95% uncertainty interval: 0.059 to 0.31) for males and by 0.20% points (0.064 to 0.34) for females. In the first 10 years of implementation, the reductions in sugar and overweight/obesity are predicted to prevent 270,000 (35,000-600,000) dental caries, 12,000 (3700-20,000) cases of type 2 diabetes, 3800 (1200-6700) cases of cardiovascular diseases and 350 (110-590) cases of obesity-related cancer. For the current United Kingdom population, it is estimated that the Soft Drinks Industry Levy will add 200,000 quality-adjusted life-years (63,500-342,000) over their lifetime and avert £174 million (£53.6-319) in their costs of health care (discounted at United Kingdom Treasury rates). At a United Kingdom Treasury value of £60,000 per quality-adjusted life-year, it is estimated that the Soft Drinks Industry Levy will produce a net monetary benefit of £12.2 billion (£3.88-20.8) for the health system.

LIMITATIONS: Modelled results assume that the effect of the Soft Drinks Industry Levy remains constant into the future. The longevity of the effect of the Soft Drinks Industry Levy has not been tested.

CONCLUSION: This study of the United Kingdom Soft Drinks Industry Levy tiered tax on sugar content provides further evidence that sugar-sweetened beverage taxes have the potential to achieve meaningful improvements in population health and reduce health sector spending.

FUNDING: This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number 16/130/01.

PMID:41351382 | DOI:10.3310/GJMW1501

Cell Mol Biol (Noisy-le-grand). 2025 Dec 6;71(11):74-85. doi: 10.14715/cmb/2025.71.11.10.

ABSTRACT

This study aimed to evaluate the risk of hepatitis B virus reactivation (HBVr) in patients with HBV-related rheumatoid arthritis (RA) undergoing TNF inhibitor (TNFi) therapy. A systematic search of Embase, PubMed/MEDLINE, Scopus, Web of Science, ClinicalTrials.gov and the Cochrane Library was conducted, and pooled HBVr rates were calculated using random-effects models with subgroup analyses based on region, HBV serostatus, glucocorticoid use, antiviral prophylaxis, and TNFi type. Data from 15 studies, including 916 patients, were analyzed, revealing a pooled HBVr rate of 2% (95% CI: 0.01-0.03) with low heterogeneity (I² = 0.79%, p = 0.133). Regional variation was observed, with no HBVr cases in European studies (0.01; 95% CI: -0.01-0.03) and a 2% rate in Asian studies (95% CI: 0.01-0.04). HBsAg-positive patients demonstrated significantly higher HBVr rates (16%; 95% CI: 0.04-0.28) compared with HBsAg-negative patients (4%; 95% CI: -0.01-0.09), corresponding to an odds ratio (OR) of 12.60 (95% CI: 3.73-42.53). Patients receiving antiviral prophylaxis had a 6% HBVr rate compared to 3% in those without prophylaxis, though the difference was not statistically significant (OR: 1.30; p = 0.726). Similarly, glucocorticoid use did not significantly influence HBVr risk (6% vs. 5%; OR: 0.73; p = 0.563). HBVr rates also varied by TNFi type, with 4% for adalimumab, 3% for etanercept, and 2% for infliximab. Overall, TNFi therapy in HBV-related RA is associated with a low but clinically relevant risk of HBVr, with higher rates in HBsAg-positive patients and modest variation by region and drug type, while antiviral prophylaxis and glucocorticoid use appear to have no significant effect on risk.

PMID:41351367 | DOI:10.14715/cmb/2025.71.11.10

J Osteopath Med. 2025 Dec 8. doi: 10.1515/jom-2024-0133. Online ahead of print.

ABSTRACT

CONTEXT: The benefits of breastfeeding are well established, from reduced incidence of common childhood infections to decreased incidence of sudden infant death syndrome and infant mortality. Offering support to breastfeeding mothers should be a key aspect of care in the perinatal period.

OBJECTIVES: The purpose of this study was to evaluate whether utilization of a standardized osteopathic manipulative treatment (OMT) protocol as an adjunct to lactation support improves feeding dysfunction in breastfed newborns.

METHODS: This was a single-blinded, randomized, controlled, prospective pilot study of healthy, full-term neonates identified by an International Board Certified Lactation Consultant (IBCLC) as having feeding dysfunction. Neonates were subsequently randomized in an alternating fashion into an OMT protocol treatment vs. sham treatment. Infant LATCH (Latch, Audible swallowing, Type of nipple, Comfort of birth person, and Help birthing person needs holding infant to breast) scores were assessed by nurses and IBCLCs during hospitalization assessed with mean and median score improvement between groups.

RESULTS: Forty infants were included in the study, divided into a sham group (n=21) and OMT group (n=19). The groups had similar characteristics. The change between pre- and postintervention LATCH scores were calculated for each group, respectively. The mean LATCH score change in the OMT group was 2.0±1.8. The mean LATCH score change in the sham group was 0.9±1.2. The mean LATCH score change in the OMT group is statistically significantly greater than the mean LATCH score change in the sham group (p=0.030), indicating that the OMT group had greater improvement in their LATCH score compared to the sham group.

CONCLUSIONS: Healthy newborns with feeding dysfunction who were randomized to receive two OMT treatments during their hospitalization demonstrated a statistically significant moderate improvement in the changes in the median modified LATCH score compared with newborns randomized to the sham group. However, the effect size was moderate, at best. The LATCH score changes between groups cannot be highly attributed to the OMT interventions. However, there were no adverse effects of treatment. These findings suggest that OMT may be a safe adjunct to traditional lactation support in the care of healthy breastfed newborns with feeding dysfunction. Future studies could investigate other factors, such as the length of time that mothers breastfeed their infants after the two initial treatment sessions or potentially including a separate arm for neonates with ankyloglossia.

PMID:41351353 | DOI:10.1515/jom-2024-0133

Psychogeriatrics. 2026 Jan;26(1):e70121. doi: 10.1111/psyg.70121.

ABSTRACT

BACKGROUND: Previous research on caregiver depression has mainly focused on caregivers of late-onset dementia (LOD), whereas studies involving young-onset dementia (YOD) remain limited. This study aimed to examine the associations between psychosocial stressors and depression among YOD and LOD caregivers in Japan.

METHODS: A total of 1798 questionnaires were distributed to family caregivers affiliated with 214 organisations, including dementia family associations and care facilities. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D), and their associations with psychosocial stressors was analysed through multiple regression analysis both in the dementia onset group and in the total sample.

RESULTS: Of the 380 respondents, 194 were YOD caregivers and 186 were LOD caregivers. The prevalence of elevated depression scores (CES-D ≥ 16) was significantly higher in the YOD group than in the LOD group. Among YOD caregivers, financial difficulties were the strongest psychosocial stressor associated with CES-D scores, followed by caregiving-related lifestyle restrictions and social isolation. In contrast, among LOD caregivers, caregiving-related lifestyle restrictions were most strongly correlated with increased CES-D scores, with social isolation also being significant. Male sex was additionally associated with lower CES-D scores. A comprehensive hierarchical regression, including interaction terms, confirmed that the association between financial difficulties and depression was stronger among YOD caregivers, whereas the impact of caregiving-related lifestyle restrictions was weaker than among LOD caregivers.

CONCLUSIONS: The findings indicate differences between YOD and LOD caregivers in psychosocial stressors linked to depression. These findings underscore the necessity of multifaceted and adaptable support strategies tailored to the distinct characteristics of each group. Furthermore, over half of both caregiver groups exhibited depressive symptoms, with YOD caregivers demonstrating a particularly higher propensity for depression. These findings provide foundational evidence for developing effective support and interventions tailored to the specific stressors experienced by YOD and LOD caregivers to alleviate their depressive symptoms.

PMID:41351314 | DOI:10.1111/psyg.70121

Br J Clin Pharmacol. 2025 Dec 5. doi: 10.1002/bcp.70389. Online ahead of print.

ABSTRACT

AIMS: Post-mortem detection of a medicine following suicide can be due to two main reasons: the decedent was taking that medicine therapeutically before death, and/or the medicine was involved in the suicidal act (poisoning-related suicide). We aimed to investigate how antidepressant concentrations differed between poisoning and non-poisoning suicides. We hypothesized that the predictive value of these concentrations and the separation between poisoning and non-poisoning concentrations would improve by adjusting for dose dispensed to the decedent.

METHODS: We analysed post-mortem toxicology results from suicides in Australia, July 2013 to October 2019, linked to the individual’s dispensing history. Suicides were classified as poisoning- or non-poisoning-related by coroners. We analysed the distribution of concentrations through descriptive statistics, precision-recall curves and quantile regression to compare poisoning and non-poisoning concentrations. We adjusted concentrations by estimated daily dose and total drug quantity dispensed in 90 days and re-assessed model performance.

RESULTS: We had sufficient sample size to analyse nine antidepressants: amitriptyline (n = 149), mirtazapine (n = 399), citalopram (n = 116), escitalopram (n = 297), fluoxetine (n = 183), sertraline (n = 253), duloxetine (n = 122), venlafaxine (n = 261), desvenlafaxine (n = 194). Selective Serotonin Reuptake Inhibitor non-poisoning and poisoning concentrations were similar, with no high certainty threshold for poisoning for citalopram and sertraline. Amitriptyline had the best separation between poisoning and non-poisoning concentrations. Adjustment by estimated daily dose improved the separation of lower quantiles through quantile regression but did not help identify thresholds that separated poisonings and non-poisonings.

CONCLUSIONS: Dose adjustment generally did not improve the separation of poisoning vs non-poisoning suicides, indicating that post-mortem concentrations may not have clear dose-concentration relationships.

PMID:41351311 | DOI:10.1002/bcp.70389

J Agromedicine. 2025 Dec 5:1-7. doi: 10.1080/1059924X.2025.2591051. Online ahead of print.

ABSTRACT

OBJECTIVES: The primary objective of this study was to determine if workers occupationally exposed (WOE) to sheep, specifically shepherds and cheesemakers in central Portugal, are more likely to be seropositive for anti-Toxoplasma gondii IgG compared to the general population. Additionally, the study aimed to explore potential differences in seropositivity between shepherds and cheesemakers, while evaluating age, gender, and activity as possible risk factors for T. gondii infection.

METHODS: A total of 96 WOE, including 21 shepherds and 75 cheesemakers, were tested for anti-T. gondii IgG using a commercial enzyme-linked immunosorbent assay (ELISA). The control group consisted of 192 sera samples from blood donors matched by age, gender, and residence. Chi-square tests with Yates correction were used to compare seroprevalence between WOE and the general population, and between shepherds and cheesemakers. Univariate and multivariable logistic regression analyses were performed to evaluate potential associations between T. gondii seropositivity and factors such as activity, gender, and age.

RESULTS: The overall seroprevalence was 63.5% in the WOE and 52.6% in the general population, with no statistically significant difference (p = .101). Among WOE, 52.4% of shepherds and 66.7% of cheesemakers were seropositive, with no significant difference between the two groups (p = .344). Univariate and multivariable analyses indicated neither activity, age, nor gender were significant risk factors for seropositivity in the case population.

CONCLUSION: The study did not find a significant increased risk of T. gondii seropositivity among shepherds and cheesemakers compared to the general population. While high seroprevalence was observed in both groups, other factors unrelated to occupational exposure may be influencing the risk of T. gondii infection. More research is needed, particularly focusing on cheesemakers, to further explore potential occupational health risks related to T. gondii.

PMID:41351305 | DOI:10.1080/1059924X.2025.2591051