Tag: pubmed

Eur J Med Res. 2025 Nov 14;30(1):1120. doi: 10.1186/s40001-025-03388-4.

ABSTRACT

BACKGROUND: Metabolic disorders represented by insulin resistance (IR) are at risk of chronic kidney disease (CKD). Estimated glucose disposal rate (eGDR) reflects IR. The relationship between eGDR and CKD was unclear. This study aimed at discussing the association between eGDR and the prevalence of CKD in general population and the mortality of CKD patients, and compare it with other IR indicators.

METHODS: The data from the National Health and Nutrition Examination Survey (NHANES) were used to conduct a cross-sectional study with linked mortality follow-up. The association between eGDR and CKD prevalence was determined using logistic regression, restricted cubic spline (RCS) analysis and stratified analysis. Receiver-operating characteristic (ROC) curves, weighted quantile sum (WQS) model, random forest and extreme gradient boost (XGBoost) machine learning models were performed to explore the importance of IR indicators components and CKD risk factors. The association between eGDR and mortality was analyzed by sub-distribution hazard model in CKD patients.

RESULTS: Among 29,621 participants finally included, the median eGDR was 8.64 mg/kg/min and the CKD prevalence was 12.47%. Logistic regression and stratified analysis showed eGDR was associated with CKD prevalence independently, especially in people aged 40-60 years, with overweight or impaired glucose tolerance. RCS curve indicated the association between decreased eGDR and increased CKD risk was a U-shaped curve. ROC analysis showed eGDR assessed the CKD prevalence better. WQS model implied blood glucose control level was the main influencing factor in IR components. In machine learning models, the weights of age, eGDR, uric acid and heart failure were high. During 71 months follow-up, the all-cause mortality was 23.33% and cardiovascular disease (CVD) mortality was 8.9%. Sub-distribution hazard model showed eGDR independently predicted all-cause mortality rather CVD mortality in CKD patients after adjusting for confounding factors.

CONCLUSIONS: eGDR was a better indicator to assess CKD risk in general population and could predict all-cause mortality rather CVD mortality in CKD patients.

PMID:41239541 | DOI:10.1186/s40001-025-03388-4

Trop Med Health. 2025 Nov 14;53(1):163. doi: 10.1186/s41182-025-00812-7.

ABSTRACT

BACKGROUND: Diarrhea is a common cause of morbidity and mortality, and its incidence worldwide has changed little over the past four decades. Therefore, to estimate the disease burden of diarrhea, this study aimed to assess the prevalence, risk factor, and determinants of health-seeking behavior in people with diarrhea in Chongqing.

METHODS: This cross-sectional study was conducted in Chongqing, China, between May and June 2024. An online questionnaire was used to survey respondents’ demographic information, experience of diarrhea symptoms, and treatment-seeking behaviors in the past 6 months (from October 2023 to April 2024). Descriptive statistics, univariate and multivariate logistic regression analyses were used to summarize the data and identify the possible determinants of medical treatment-seeking behaviors.

RESULTS: Among 27,150 respondents, 7.98% were young children (≤ 5 years). Diarrhea prevalence was 25.38% overall, and higher among children ≤ 5 years (29.5%) and adults ≥ 60 years (26.7%). Only 23.23% (1601/6891) of diarrhea cases sought medical care, primarily due to perceived mild severity or treatment unnecessary. Higher odds of healthcare-seeking behaviors were observed in children aged ≤ 5 years, rural residents, and those with higher household incomes (particularly ≥ 12,000 yuan). Proximity to primary healthcare facilities (< 1 km), poorer self-rated health, fewer diarrhea episodes, more severe symptoms, longer duration of illness (especially ≥ 7 days), and greater perceived impact of diarrhea were also positively associated with healthcare-seeking behaviors. The main reasons individuals with diarrhea did not seek medical care were that they felt their condition was not serious and that a visit to a medical facility was unnecessary (71.40%).

CONCLUSION: Diarrhea is highly prevalent in Chongqing, especially among young children and the elderly, coupled with a low rate of medical seeking. The findings underscore the influence of socioeconomic, geographic, clinical severity, and perceptual factors on healthcare-seeking behavior. Targeted interventions should focus on high-risk groups and improving accessibility and awareness to encourage appropriate care for diarrhea.

PMID:41239540 | DOI:10.1186/s41182-025-00812-7

Eur J Med Res. 2025 Nov 14;30(1):1127. doi: 10.1186/s40001-025-03381-x.

ABSTRACT

OBJECTIVE: To investigate the potential links between soluble transferrin receptor (sTfR), the monocyte/HDL cholesterol ratio (MHR), and heart failure with preserved ejection fraction (HFpEF), in order to provide new biomarkers for clinical evaluation of HFpEF and new ideas for disease treatment.

METHOD: 66 patients diagnosed with HFpEF who visited the cardiology department of Cangzhou Central Hospital from January 2023 to October 2023 were selected as the study group, and 70 healthy participants from concurrent physical examinations at the hospital’s examination center were designated as controls. Record demographic data, hematological/biochemical parameters (including sTfR, MHR), and echocardiographic measures of cardiac structure and function. Compare these indices between groups to assess for statistically significant differences. Conduct a multi-factor analysis of the risk factors obtained from the single factor analysis above to explore the independent risk factors of HFpEF. Conduct subgroup analysis on the research group to explore the correlation between sTfR and cardiac structure, function, and activity tolerance in HFpEF patients. Follow up with the patients in the research group for 1 year and analyze their prognosis.

RESULT: Female representation (69.7% vs 51.4%), left atrial diameter (37.52 ± 3.57 mm vs 35.04 ± 2.83 mm), and sTfR [3.29 (2.76, 3.57) mg/L vs 2.43 (2.08, 2.78) mg/L] were significantly greater in the study group compared to the control group across both cohorts (P < 0.05); There were no significant intergroup differences in terms of age, demographic and clinical histories (smoking, alcohol use, hypertension, diabetes), blood lipid profile, hepatic and renal function, other biochemical parameters, or MHR (P > 0.05 for all). Multivariable analysis identified sTfR (OR 1.293, P = 0.012) and LAD (OR 15.229, P < 0.01) as independent risk factors for HFpEF. Their predictive performance, assessed by ROC curve analysis, yielded AUC values of 0.835 for sTfR and 0.609 for LAD. The corresponding optimal diagnostic thresholds for predicting HFpEF were 3.05 mg/L and 37.5 mm, respectively. Subgroup analysis revealed significantly higher BNP and LAD, but lower 6MWT, in patients with high versus low sTfR expression (all P < 0.05). Over the 1-year follow-up, cumulative event-free survival did not differ significantly between patients with high versus low sTfR expression (median 11.17 vs. 11.65 months; Log-Rank χ² = 0.174, P = 0.676).

CONCLUSION: Serum sTfR correlates with HFpEF severity and prognosis, offering a potential biomarker for disease assessment and outcome prediction.

PMID:41239525 | DOI:10.1186/s40001-025-03381-x

Perioper Med (Lond). 2025 Nov 14;14(1):126. doi: 10.1186/s13741-025-00618-5.

ABSTRACT

BACKGROUND: Peritoneal symptoms, including visceral pain, abdominal discomfort, and vagal responses (e.g., nausea, bradycardia), are common during abdominal surgeries under spinal anesthesia. This study compared intrathecal dexmedetomidine and fentanyl for their effectiveness in controlling these symptoms during appendectomy.

METHODS: This randomized, double-blinded clinical trial included 150 patients of the American Society of Anesthesiologists I, II physical status scheduled for emergency open appendectomy. Participants were randomly assigned to receive either intrathecal dexmedetomidine (5 μg, Group D) or fentanyl (25 μg, Group F), both combined with 0.5% hyperbaric bupivacaine.

RESULTS: Dexmedetomidine significantly reduced the incidence of peritoneal symptoms compared to fentanyl: abdominal discomfort (9.5% vs. 33.3%), visceral pain (10.8% vs. 53.3%), nausea (9.5% vs. 34.7%), and vomiting (6.8% vs.34.7%) (P < 0.001). The time to first rescue analgesia was significantly longer in the dexmedetomidine group (396 vs. 243 min; P < 0.001). Bradycardia was more frequent in group D (25.7% vs. 1.3%, P < .001); no cases of respiratory depression were observed. Hypotension occurred slightly more frequently in group D, whereas shivering was more prevalent in group F; however, neither difference reached statistical significance. The VAS was significantly higher in group F than in group D at four and six hours postoperatively (P < 0.001).

CONCLUSIONS: Dexmedetomidine provides superior peritoneal symptom control and prolonged analgesia compared to fentanyl as an intrathecal adjuvant in spinal anesthesia for appendectomy. Despite a higher incidence of bradycardia, its opioid-sparing benefits and overall safety make it a valuable alternative, particularly for procedures involving significant visceral manipulation.

PMID:41239518 | DOI:10.1186/s13741-025-00618-5

Alzheimers Res Ther. 2025 Nov 14;17(1):247. doi: 10.1186/s13195-025-01898-1.

ABSTRACT

BACKGROUND: Alzheimer’s Disease Spectrum (ADS) progresses from preclinical stages to dementia, with dynamic functional connectivity (dFC) changes emerging early. This study aimed to investigate the dynamic changes in brain networks across different stages of ADS and their underlying molecular mechanisms.

METHODS: This cross-sectional study included 239 participants: 69 Healthy Controls (HC), 83 with Subjective Cognitive Decline (SCD), 56 with Mild Cognitive Impairment (MCI), and 31 with Alzheimer’s disease (AD). All participants underwent neuropsychological testing and resting-state functional magnetic resonance imaging (rs-fMRI). Leading Eigenvector Dynamics Analysis (LEiDA), a data-driven method that captures time-resolved whole-brain dFC, was applied to identify transient brain states and calculated their occupancy rate, dwell time, and transition probabilities. Group differences in these dynamic metrics were assessed using a General Linear Model (GLM), and their correlations with cognitive performance were examined. To explore the molecular basis of significant dFC alterations, we performed gene-category enrichment analysis. This analysis integrated the spatial maps of altered brain states with regional gene expression data from the Allen Human Brain Atlas (AHBA), using spin permutations to ensure statistical robustness.

RESULTS: We identified ten recurring brain states and characterized how their transition patterns, stability, and frequency differed as a function of disease severity. Specifically, early disruptions appeared as altered transition probabilities between states, while later stages showed pronounced changes in the dwell time and occurrence rates of specific states, closely associated with cognitive decline. Notably, one brain state marked by synchronized activity in attention, salience, and default mode networks emerged as a critical hub linked to both cognitive deterioration and excitatory-inhibitory imbalance. Genes associated with this state were enriched in glycine-mediated synaptic pathways and expressed in both excitatory and inhibitory neurons, showing spatial and temporal patterns that extended from early development into late disease stages.

CONCLUSIONS: Our study uncovered the stage-dependent dFC changes and their molecular underpinnings of brain network dysfunction across the ADS.

PMID:41239516 | DOI:10.1186/s13195-025-01898-1

Lipids Health Dis. 2025 Nov 14;24(1):364. doi: 10.1186/s12944-025-02689-1.

ABSTRACT

BACKGROUND: Self-harm is a significant public health concern, with increasing prevalence globally. Omega-3 fatty acids (FAs), particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are known for their health benefits, including potential mental health improvements. This study explores the association between omega-3 FAs and self-harm behaviors using data from the UK Biobank (UKBB).

OBJECTIVES: To investigate the relationship between plasma levels of omega-3 FAs and various measures of self-harm, including passive suicidal ideation and deliberate self-harm, within a large cohort study.

METHODS: This observational study analyzed data from a random subset of 258,012 participants with plasma omega-3 FA levels, covariate data, and self-harm records. Omega-3 levels were measured using Nuclear Magnetic Resonance (NMR) and are expressed as a percent of total FAs. Self-harm outcomes were assessed through self-reported questionnaires and medical records. Covariates included demographic, health, and lifestyle factors. Statistical analyses involved logistic regression and Cox proportional hazards models, adjusting for relevant covariates. Adjusted odds ratios (aORs) are presented and 95% confidence intervals.

RESULTS: Higher levels of DHA, non-DHA (ALA+EPA+DPA) and total omega-3 were generally inversely associated with passive suicidal ideation, history of self-harm, and future self-harm, with both DHA and non-DHA showing some of the strongest associations. Participants in the highest quintile of non-DHA had a 14% lower risk of passive suicidal ideation in the last year (aOR = 0.86; 95% CI 0.75, 0.99), and the highest DHA levels were associated with a 33% lower odds of history of self-harm (aOR = 0.67; 95% CI 0.55, 0.83). These associations were generally stronger for medical record-based outcomes than for self-reported data.

CONCLUSIONS: This study provides evidence that higher omega-3 FA levels, both DHA and non-DHA, are associated with reduced risks of self-harm and suicidal ideation. These findings suggest that omega-3 FAs may play a protective role in mental health, highlighting the potential of dietary interventions to mitigate self-harm behaviors.

PMID:41239514 | DOI:10.1186/s12944-025-02689-1

Mil Med Res. 2025 Nov 14;12(1):79. doi: 10.1186/s40779-025-00670-8.

ABSTRACT

BACKGROUND: The global increase in the incidence of early-onset cancers (defined as cancers diagnosed at 20-49 years old) is a serious public health problem. We investigated 1) whether the incidence trend of early-onset cancers differs from that of later-onset cancers and 2) whether both the incidence and mortality of early-onset cancers have increased concurrently.

METHODS: We utilized age-standardized incidence and mortality rates for early-onset and later-onset cancers diagnosed between 2000 and 2017 from the Cancer Incidence in Five Continents and World Health Organization (WHO) mortality databases. The national obesity prevalence among adults aged 20-49 years was obtained from the National Clinical Database. Using joinpoint regression models, we calculated average annual percentage changes (AAPCs) for cancer incidence and mortality by cancer types and countries. We additionally conducted human development index (HDI)-stratified analyses and assessed the correlation between the obesity prevalence in younger populations and early-onset cancer incidence by country. To investigate the more recent trend of early-onset cancer mortality, we extended our mortality analysis after 2017 for cancer types and countries with statistically significant positive AAPCs in both incidence and mortality of early-onset cancers between 2000 and 2017.

RESULTS: Our analysis showed that 10 early-onset cancer types (thyroid cancer, breast cancer, melanoma, uterine cancer, colorectal cancer, kidney cancer, cervical cancer, pancreatic cancer, multiple myeloma, Hodgkin lymphoma) in females and 7 early-onset cancer types (thyroid cancer, kidney cancer, testis cancer, prostate cancer, colorectal cancer, melanoma, leukemia) in males had statistically significant positive AAPCs in at least 10 countries. Among these, the following early-onset cancer types had significantly higher AAPCs than later-onset cancer types in females: colorectal cancer (6 countries; AAPC range: 1.8-3.8%), cervical cancer (6 countries; AAPC range: 1.2-3.3%), pancreatic cancer (5 countries; AAPC range: 2.3-13.0%), and multiple myeloma (5 countries; AAPC range: 3.1-9.8%); in males: prostate cancer (12 countries; AAPC range: 3.9-18.4%), colorectal cancer (8 countries; AAPC range: 1.8-3.2%), and kidney cancer (6 countries; AAPC range: 2.0-6.0%). We observed statistically significant positive AAPCs in both the incidence and mortality of the following early-onset cancer types: uterine cancer (5 countries) and colorectal cancer (3 countries in females and 5 countries in males). The steeper increases in early-onset cancers compared with later-onset cancers were mainly observed in the very high-HDI country group, including early-onset colorectal cancer (AAPC = 2.4%, 95% CI 2.1-2.6 in females; AAPC = 2.0%, 95% CI 1.7-2.4 in males) to later-onset colorectal cancer (AAPC = -0.1%, 95% CI -0.2 to 0 in females; AAPC = -0.2%, 95% CI -0.3 to 0 in males). We observed strong positive correlations between the increasing obesity prevalence and the rising incidence of early-onset obesity-related cancers in several countries, including Australia (7 cancer types), United Kingdom (7 cancer types), Canada (7 cancer types), Republic of Korea (7 cancer types), and USA (6 cancer types) in females and United Kingdom (7 cancer types), Canada (6 cancer types), Australia (5 cancer types), Sweden (5 cancer types), and Republic of Korea (4 cancer types) in males. Although we did not observe an apparent spike after 2017 in many countries, we observed continued increases in the mortality of certain cancer types, such as uterine cancer (Japan, Republic of Korea, United Kingdom, USA, and Ecuador) in females and colorectal cancer (Argentina, Canada, United Kingdom, and USA) in males.

CONCLUSIONS: The increase in many early-onset cancer types was significantly higher than that of later-onset cancers, and the incidence and mortality of certain early-onset cancer types (such as colorectal cancer) increased simultaneously. Our study highlights global differences in cancer incidence and mortality trends of early-onset and later-onset cancers.

PMID:41239501 | DOI:10.1186/s40779-025-00670-8

Malar J. 2025 Nov 14;24(1):398. doi: 10.1186/s12936-025-05536-x.

ABSTRACT

BACKGROUND: Malaria is a major cause of illness and death in Liberia. Given the high burden of disease and limited resources, Liberia implemented a subnational tailoring (SNT) approach. This approach involved stakeholder engagement, data review, and advanced analytics to update transmission risk assessment, optimize intervention targeting, and revise the national operational plan.

METHODS: An SNT team was established to determine intervention targeting criteria, compile and analyse relevant data sources, and stratify malaria risk and its determinants to inform geographical targeting of interventions. The analysis was performed at the district level. Data collected and reviewed included routine malaria data from health facilities, the national survey on malaria indicators, entomological data, demographic and health surveys, and modelled malaria burden metrics.

RESULTS: Epidemiological stratification was conducted based on modelled parasite prevalence (PfPR), incorporating results from the 2022 Malaria Indicator Survey, to inform intervention strategies. Additional indicators relevant for decision-making, such as insecticide resistance, historical malaria interventions, and access to healthcare, were also stratified. The median PfPR across the 98 health districts was 29% (SD = 4.8%), ranging from 17 to 37%. The stratification identified 84 districts as moderate transmission and 14 as high transmission, with no districts classified as low transmission. Appropriate malaria control interventions were proposed based on these strata. Findings from the SNT analysis informed the revision of the national operational plan and facilitate resource mobilization for the scale-up of dual-active nets and expanding vaccination.

CONCLUSION: This NMCP-led subnational malaria stratification for Liberia effectively informed the targeting of eight key interventions and highlighted data gaps for future refinement. This work not only provides a framework for monitoring progress and accelerating malaria burden reduction through tailored approaches but also sets the stage for continuously data-driven decision-making, emphasizing future prioritization based on projected impact, cost, and resource availability.

PMID:41239496 | DOI:10.1186/s12936-025-05536-x

Behav Brain Funct. 2025 Nov 14;21(1):38. doi: 10.1186/s12993-025-00308-8.

ABSTRACT

BACKGROUND: Depression involves abnormal neural oscillations. Photobiomodulation (PBM) modulates such oscillations but lacks behavioral electrophysiological mechanistic studies. We explored PBM’s effects on hippocampal CA1 oscillations and phase-amplitude coupling (PAC) in a depression model.

METHODS: Male C57BL/6J mice were randomly divided into saline, LPS (2 mg/kg i.p.), and LPS + PBM groups (n = 10/group for behavioral tests, n = 8/group for electrophysiology). LPS groups received lipopolysaccharide to induce neuroinflammation. The LPS + PBM group underwent 810 nm PBM (20 mW/cm², 12 min/day × 4 days) starting day 4 post-injection. Anxiety- and depression-like behaviors were assessed via open field, elevated plus-maze, and tail suspension tests. Wireless electrophysiology recorded CA1 local field potentials (LFP) during rest and behaviors. Oscillations and PAC were analyzed. Data are presented as mean ± SD; group differences were evaluated by one-way ANOVA with Bonferroni post-hoc correction and ɳ² effect sizes, with two-tailed p < 0.05 taken as statistically significant.

RESULTS: PBM (20 mW/cm²) alleviated LPS-induced anxiety and depressive behaviors. Electrophysiologically, PBM restored resting-state δ power (LPS + PBM: 0.0499 ± 0.0282, LPS: 0.1491 ± 0.0887; p < 0.01) and enhanced δ-γ coupling (LPS + PBM: 2.049 ± 0.447, LPS: 0.230 ± 0.298; p < 0.05). During anxiety tasks, PBM suppressed γ power (LPS + PBM: 0.3709 ± 0.1569, LPS: 0.5165 ± 0.06896; p < 0.05) and strengthened δ-γ PAC (LPS + PBM: 0.741 ± 0.508 vs. LPS: 0.217 ± 0.218, p < 0.05). In depression tests, PBM normalized δ power (LPS + PBM: 0.0261 ± 0.0182, LPS: 0.1315 ± 0.0619; p < 0.001) and reduced γ power (LPS + PBM: 0.2848 ± 0.0921, LPS: 0.4067 ± 0.0892; p < 0.05). No significant PAC changes was observed during depression tasks.

CONCLUSION: PBM therapy ameliorates LPS-induced depression and anxiety behaviors while normalizing hippocampal CA1 oscillations and cross-frequency coupling. Its effects are state-dependent, modulating distinct frequency bands and PAC across rest and behavioral contexts, revealing potential electrophysiological therapeutic mechanisms.

PMID:41239492 | DOI:10.1186/s12993-025-00308-8

Malar J. 2025 Nov 14;24(1):400. doi: 10.1186/s12936-025-05642-w.

ABSTRACT

BACKGROUND: The antirelapse efficacy of primaquine is related to the total dose administered, whereas the risks of haemolysis and gastrointestinal intolerance are associated with the daily dose administered. National Malaria Control Programmes require local information on efficacy, tolerability and safety to optimize antimalarial treatment policies for Plasmodium vivax malaria control and elimination efforts.

METHODS: A living systematic review identified efficacy studies of uncomplicated P. vivax malaria including patients treated with daily primaquine regimens, published since January 1, 2000. Available data were pooled and an R Shiny app was developed to integrate statistical analyses performed using R and Stata that assessed the impact of primaquine mg/kg dose on efficacy, hematological safety and gastrointestinal tolerability.

RESULTS: As of January 16, 2025, a total of 9,270 individual patient data records from 41 studies have been collated into the standardized repository. Open-access automated reports were generated for user-selected countries or regions to investigate location specific effects of primaquine dose on efficacy, safety and tolerability. The reports include visual and tabular displays of the outcomes.

CONCLUSIONS: These automated reports leverage a large database to provide accessible data for national and regional policy makers and researchers to assess the clinical consequences of different primaquine regimens in different endemic settings. The reports will inform local and regional policy decisions and research priorities in vivax-endemic areas.

PMID:41239453 | DOI:10.1186/s12936-025-05642-w