Tag: pubmed

JMIR Med Inform. 2025 Mar 27;13:e67591. doi: 10.2196/67591.

ABSTRACT

BACKGROUND: Integrated clinical databases from national biobanks have advanced the capacity for disease research. Data quality and completeness filters are used when building clinical cohorts to address limitations of data missingness. However, these filters may unintentionally introduce systemic biases when they are correlated with race and ethnicity.

OBJECTIVE: In this study, we examined the race and ethnicity biases introduced by applying common filters to 4 clinical records databases. Specifically, we evaluated whether these filters introduce biases that disproportionately exclude minoritized groups.

METHODS: We applied 19 commonly used data filters to electronic health record datasets from 4 geographically varied locations comprising close to 12 million patients to understand how using these filters introduces sample bias along racial and ethnic groupings. These filters covered a range of information, including demographics, medication records, visit details, and observation periods. We observed the variation in sample drop-off between self-reported ethnic and racial groups for each site as we applied each filter individually.

RESULTS: Applying the observation period filter substantially reduced data availability across all races and ethnicities in all 4 datasets. However, among those examined, the availability of data in the white group remained consistently higher compared to other racial groups after applying each filter. Conversely, the Black or African American group was the most impacted by each filter on these 3 datasets: Cedars-Sinai dataset, UK Biobank, and Columbia University dataset. Among the 4 distinct datasets, only applying the filters to the All of Us dataset resulted in minimal deviation from the baseline, with most racial and ethnic groups following a similar pattern.

CONCLUSIONS: Our findings underscore the importance of using only necessary filters, as they might disproportionally affect data availability of minoritized racial and ethnic populations. Researchers must consider these unintentional biases when performing data-driven research and explore techniques to minimize the impact of these filters, such as probabilistic methods or adjusted cohort selection methods. Additionally, we recommend disclosing sample sizes for racial and ethnic groups both before and after data filters are applied to aid the reader in understanding the generalizability of the results. Future work should focus on exploring the effects of filters on downstream analyses.

PMID:40146917 | DOI:10.2196/67591

JMIR Serious Games. 2025 Mar 27;13:e54312. doi: 10.2196/54312.

ABSTRACT

BACKGROUND: The exponential growth of new technologies has resulted in the need for updating the field of education. From the educational point of view, there are some studies that have promoted the implementation of new technologies. These facts have raised the need to implement augmented reality in the university environment, especially among students of health sciences. The use of augmented reality can mean a new approach to teaching by teachers and better learning by students.

OBJECTIVE: We aimed to analyze the degree of usability of two augmented reality applications and to compare the academic performance between the control group and the experimental group at the Universities of Cádiz and Málaga. The students at the University of Málaga used the Zapworks augmented reality software, while those at the University of Cádiz used the Aumentaty augmented reality software for their respective experimental groups. The secondary objective was to measure the relationships between all the studied variables.

METHODS: This was a quasi-experimental design with a posttest as the only evaluation measure. We followed the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) statement and the ethical and legal aspects of the Principles of the Declaration of Helsinki. An intervention was carried out using two augmented reality applications on the subject of General Procedures in Physiotherapy II at the Universities of Málaga and Cádiz.

RESULTS: A total of 199 participants took part in the study. Demographic variables, ratings, and usability were assessed, followed by statistical analysis, with the results and their interpretation being described in the study. Significant differences (P<.001) were found in the ratings at both the universities. In addition, significant differences (P<.001) were found between the experimental group and the control group. Regarding the degree of usability in the univariate analysis, no significant differences were found (P=.049). A multiple regression analysis of the rating and usability was performed. The rating showed significant differences, with a beta of 1.4 (P<.001), and usability was also significant (P=.03) in favor of the Aumentaty group.

CONCLUSIONS: Significant differences were observed in those who used augmented reality compared to the control group, with higher values observed in the University of Cádiz. There are no correlations between the variables of usability and qualifications.

PMID:40146914 | DOI:10.2196/54312

J Eval Clin Pract. 2025 Mar;31(2):e70059. doi: 10.1111/jep.70059.

ABSTRACT

BACKGROUND: This study was conducted to determine the prevalence of breast milk and breastfeeding myths during pregnancy among Turkish, Turkish-Romani, and Syrian pregnant women and compare the similarities and differences between the countries.

METHODS AND STUDY DESIGN: The sample of the study consisted of 330 pregnant women who presented to a hospital. Data were collected with a ‘Descriptive Information Form’ and ‘Breast Milk and Breastfeeding Myths Form’ developed by the researchers. The Breast Milk and Breastfeeding Myths Form consists of items expressing common beliefs about breast milk and breastfeeding, and each item is evaluated with one of the following three options: ‘yes,’ ‘no,’ and ‘no idea.’ The forms were applied face to face to the pregnant women who came to the outpatient clinic. The data were evaluated on the SPSS (14.0) software package, and chi-square and advanced analyses were used for the statistical analysis.

RESULTS: Turkish, Turkish-Romani, and Syrian pregnant women who made up the study sample had similar socio-demographic characteristics. It was determined that there were intercultural differences in 28 out of 30 myths evaluated by Turkish, Turkish-Romani, and Syrian mothers regarding breast milk and breastfeeding.

CONCLUSION: It was determined that Turkish pregnant women had different myths about breast milk and breastfeeding from Syrian and Turkish-Romani pregnant women. It can be said that false beliefs and attitudes about breast milk and breastfeeding are common.

PMID:40146878 | DOI:10.1111/jep.70059

Proc Natl Acad Sci U S A. 2025 Apr;122(13):e2422968122. doi: 10.1073/pnas.2422968122. Epub 2025 Mar 27.

ABSTRACT

The origin of eukaryotes represents one of the most significant events in evolution since it allowed the posterior emergence of multicellular organisms. Yet, it remains unclear how existing regulatory mechanisms of gene activity were transformed to allow this increase in complexity. Here, we address this question by analyzing the length distribution of proteins and their corresponding genes for 6,519 species across the tree of life. We find a scale-invariant relationship between gene mean length and variance maintained across the entire evolutionary history. Using a simple model, we show that this scale-invariant relationship naturally originates through a simple multiplicative process of gene growth. During the first phase of this process, corresponding to prokaryotes, protein length follows gene growth. At the onset of the eukaryotic cell, however, mean protein length stabilizes around 500 amino acids. While genes continued growing at the same rate as before, this growth primarily involved noncoding sequences that complemented proteins in regulating gene activity. Our analysis indicates that this shift at the origin of the eukaryotic cell was due to an algorithmic phase transition equivalent to that of certain search algorithms triggered by the constraints in finding increasingly larger proteins.

PMID:40146859 | DOI:10.1073/pnas.2422968122

Science. 2025 Mar 28;387(6741):1391-1397. doi: 10.1126/science.adp4642. Epub 2025 Mar 27.

ABSTRACT

Describing the distribution of genetic variation across individuals is a fundamental goal of population genetics. We present a method that capitalizes on the rich genealogical information encoded in genomic tree sequences to infer the geographic locations of the shared ancestors of a sample of sequenced individuals. We used this method to infer the geographic history of genetic ancestry of a set of human genomes sampled from Europe, Asia, and Africa, accurately recovering major population movements on those continents. Our findings demonstrate the importance of defining the spatiotemporal context of genetic ancestry when describing human genetic variation and caution against the oversimplified interpretations of genetic data prevalent in contemporary discussions of race and ancestry.

PMID:40146820 | DOI:10.1126/science.adp4642

Science. 2025 Mar 28;387(6741):1397-1401. doi: 10.1126/science.adp5357. Epub 2025 Mar 27.

ABSTRACT

Prior research on racial profiling has found that in encounters with law enforcement, minorities are punished more severely than white civilians. Less is known about the causes of these encounters and their implications for our understanding of racial profiling. Using high-frequency location data of rideshare drivers in Florida (N = 222,838 individuals), we estimate the effect of driver race on citations and fines for speeding using 19.3 million location pings. Compared with a white driver traveling the same speed, we find that racial or ethnic minority drivers are 24 to 33% more likely to be cited for speeding and pay 23 to 34% more money in fines. We find no evidence that accident and reoffense rates explain these estimates, which suggests that an animus against minorities underlies our results.

PMID:40146819 | DOI:10.1126/science.adp5357

PLoS Med. 2025 Mar 27;22(3):e1004565. doi: 10.1371/journal.pmed.1004565. eCollection 2025 Mar.

ABSTRACT

BACKGROUND: Adverse drug reactions (ADRs) harm patients and are costly for healthcare systems. Genetic variation contributes to variability in medication response and prospective knowledge of these variants can decrease risk of ADRs, as shown in the PREPARE trial. Reduction in ADRs would affect only those reactions to drugs contained in well-validated pharmacogene-drug pairs. The scope of ADRs represented by these drugs on a population scale is unclear. The objective of this study was to characterize the pharmacogene-drug-associated ADR reporting landscape from a national regulatory pharmacovigilance dataset to elucidate the scale of potential ADR mitigation by pharmacogenomics (PGx) implementation.

METHODS AND FINDINGS: All publicly available Yellow Card ADR reports to the United Kingdom Medicines and Healthcare Products Regulatory Agency, from 1963 to 2024, were compiled using programmatic data extraction. The ADRs were analysed with descriptive statistics, stratified by PGx status and by associated genes. Prescribing prevalence from the literature was compared with age range matched ADR reports for PGx-associated drugs. There were 1,345,712 ADR reports, attributed to 2,499 different substances. 115,789 adverse drug reports (9%) were associated with drugs for which ADR risk can be modified based on pharmacogenomic prescribing guidance. Seventy-five percent of these (n = 87,339) were due to medicines which interact with only three pharmacokinetic pharmacogenes (CYP2C19, CYP2D6, SLCO1B1). Forty-seven percent of all the PGx mitigatable ADRs identified were attributed to psychiatric medications (n = 54,846), followed by 24% attributed to cardiovascular medications (n = 28,279). Those experiencing PGx mitigatable ADRs, as compared with non-PGx mitigatable ADRs, were older and the ADRs more often consisted of severe non-fatal reactions. Many PGx-associated psychiatric drug ADRs were overrepresented as compared with prescribing prevalence, but fatal cardiac arrhythmias were uncommon consequences, comprising only 0.4% of these ADRs (n = 172 of n = 48,315 total ADRs). Limitations of this data source include under reporting of ADRs and reporting bias. These findings are based on analysis of the Yellow Card dataset described and may not represent all ADRs from a generalised patient population.

CONCLUSIONS: Nine percent of all reported ADRs are associated with drugs where a genetic variant can cause heightened risk of an ADR and inform prescribing. A panel of only three pharmacogenes could potentially mitigate three in every four PGx modifiable ADRs. Based on our findings, Psychiatry may be the single highest impact specialty to pilot PGx to reduce ADRs and associated morbidity, mortality and costs.

PMID:40146782 | DOI:10.1371/journal.pmed.1004565

Int J Surg. 2025 Mar 28. doi: 10.1097/JS9.0000000000002363. Online ahead of print.

ABSTRACT

BACKGROUND: Percutaneous nephrolithotomy (PCNL) is widely regarded as the first-line treatment for upper urinary tract stones larger than 2 cm, as recommended by major urological associations. However, a growing body of research highlights the safety and effectiveness of retrograde intrarenal surgery (RIRS) for managing stones of this size in the upper urinary tract, especially with the advent of suction-assisted techniques in RIRS. This study aims to systematically evaluate the safety and efficacy of negative pressure aspiration-assisted retrograde intrarenal surgery (NPAA-RIRS) in comparison to traditional PCNL.

METHOD: Eligible studies were found by searching the PubMed, Embase, Web of Science and the CNKI databases for relevant reports published until July 2024. Outcome measures included initial and final stone-free rate (SFR), secondary operation, operation time, hemoglobin level reduction, blood transfusion, interventional embolization, postoperative hospital stay, complications. The assessment of publication bias was conducted using a funnel plot. Ten studies from nine articles were included, involving 1,259 patients.

RESULTS: NPAA-RIRS group showed lower hemoglobin level reduction (WMD = – 1.31, 95% CI [-1.64, – 0.99], P < 0.001), less blood transfusion (RR = 0.15, 95% CI [0.05, 0.50], P = 0.002), shorter postoperative hospital stay (WMD: – 1.93, 95% CI [-2.54, – 1.32], P < 0.001), lower Clavien-Dindo I-II complication rate (RR: 0.51, 95% CI [0.38, 0.67], P < 0.001), and lower overall complication rate (RR = 0.52, 95% CI [0.40, 0.68], P < 0.001) compared to the PCNL group. The PCNL group had shorter operation time (WMD = 0.68, 95% CI [0.22, 1.13], P = 0.003), higher initial SFR (RR = 0.87, 95% CI [0.83, 0.92], P < 0.001), and lower rate of secondary operation (RR = 2.51, 95% CI [1.52, 4.12], P < 0.001) compared to the NPAA-RIRS group. There were no statistically significant differences between the two groups in interventional embolization (RR = 0.28, 95% CI [0.06, 1.33], P = 0.11), final SFR (RR = 0.98, 95% CI [0.94, 1.01], P = 0.740), and Clavien-Dindo III-IV complication rate (RR: 0.65, 95% CI [0.28, 1.51], P = 0.316).

CONCLUSION: For upper urinary tract stones larger than 2 cm, both NPAA-RIRS and PCNL are equally safe and effective, achieving comparable final SFR. NPAA-RIRS offers advantages in terms of reduced complications, whereas PCNL shows benefits in shorter operation times and a lower likelihood of requiring secondary procedures. Clinicians can therefore select the most suitable approach based on individual patient circumstances.

PMID:40146778 | DOI:10.1097/JS9.0000000000002363

PLoS One. 2025 Mar 27;20(3):e0320689. doi: 10.1371/journal.pone.0320689. eCollection 2025.

ABSTRACT

Elder mistreatment (EM) of older persons with cognitive impairment is thought to be grossly underestimated in part due to communication barriers experienced by victims and a lack of consistent screening and reporting, which can skew current understandings of this problem. To improve EM risk and prevalence screening in relation to cognitive impairment, it is important to understand specific approaches for implementing assessment tools and interventions for members of this population. Accordingly, this scoping review (OSF registration osf.io/759k3) will identify, summarize, and compare methodological considerations adopted in studies assessing EM risk and occurrence among older persons with varying degrees of cognitive impairment. Through mapping out existing strategies and approaches used to develop, test, and implement EM screening tools or interventions, this review will outline previously identified recommendations and challenges pertinent to future EM assessment, reduction, and prevention efforts. We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines and apply the Arksey and O’Malley (2005) scoping review framework. We will identify relevant studies by comprehensively searching electronic databases, including Ovid (Medline), Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane Trials (CENTRAL), and Elsevier’s Scopus. Reference lists of included studies will also be examined. For article selection, we will use Covidence software to guide a two-step process of title/abstract and full article screening, which will allow us to identify eligible studies based on our inclusion and exclusion criteria that follows the Study Design, Data, Methods, Outcomes (SDMO) framework. A standardized data extraction tool will be used to collect information related to authors, year of publication, research objectives, sample and study design characteristics, measures, analysis, outcomes, limitations, and study conclusions and implications related to cognition. Data will be analyzed using a thematic approach and presented through the reporting of descriptive statistics and summaries.

PMID:40146770 | DOI:10.1371/journal.pone.0320689

Ophthalmol Ther. 2025 Mar 27. doi: 10.1007/s40123-025-01128-9. Online ahead of print.

ABSTRACT

INTRODUCTION: Amblyopia is a neurodevelopmental disorder characterized by a reduction in best-corrected visual acuity (BCVA). This meta-analysis aimed to analyze the effectiveness of perceptual learning and video game training for adults with amblyopia.

METHODS: Following Cochrane guidelines (PROSPERO CRD42024504502), we conducted a systematic search across multiple databases. Randomized controlled trials (RCTs) on adults with amblyopia receiving behavioral therapies were included. Data on interventions, sample size, and logMAR visual acuity were extracted and analyzed using Review Manager 5.4 and Stata 17.0.

RESULTS: A total of 6439 studies were identified, with 22 meeting the inclusion criteria after screening. The meta-analysis included 422 adult patients with amblyopia across these studies. Quality assessment revealed that 78% of studies had a low risk of bias. The analysis showed a statistically significant standardized mean difference (SMD) of -0.68 in the experimental group compared with controls, indicating an improvement in visual acuity (P < 0.05). Subgroup analyses indicated that perceptual learning and video game training also resulted in visual improvement (P < 0.05). In addition, the results indicated a significant improvement in visual acuity with dichoptic training or monocular training, reaching visual acuity improvement (P < 0.05).

CONCLUSIONS: These findings indicate that targeted visual training facilitates neural plasticity, reduces interocular suppression, and reinforces neural pathways associated with visual processing. While video game-based interventions represent a viable and engaging rehabilitation strategy, a combined approach may be most effective in enhancing monocular and binocular functions. Future research should focus on refining training protocols to enhance both monocular and binocular visual function more effectively.

PMID:40146483 | DOI:10.1007/s40123-025-01128-9