Tag: pubmed

Disabil Rehabil Assist Technol. 2025 Sep 12:1-15. doi: 10.1080/17483107.2025.2558215. Online ahead of print.

ABSTRACT

PURPOSE: This scoping review aimed to explore and map wheelchair outcome measurement instruments for children in the literature.

MATERIALS AND METHODS: A scoping review was conducted following the Joanna Briggs Institute (JBI) methodology. The review focused on children (≤18 years) manual or motorised wheelchair users, and included primary sources of literature on wheelchair outcome measurement instruments. A search was conducted in nine electronic databases, including grey literature. Data on general characteristics, psychometric properties (validity, reliability, responsiveness) were extracted and analysed descriptively.

RESULTS: A total of 27 studies and 33 instruments were included, mostly focused on manual wheelchair users (n=23). Performance-based outcomes instruments were the most common (n=15). Construct validity (n=19) and test-retest (n=19) were the most assessed psychometric property. Responsiveness (n=3) and intra-rater (n=3) were the least reported. The most frequently conducted statistical analyses were: minimal detectable difference (MDD) (n=12), standard error of measurement (SEM) (n = 12), intraclass correlation coefficient (ICC) (n=16) and Pearson correlation (n=9). The most common construct was propulsion perfomance in a manual wheelchair (n=6).

CONCLUSION: Wheelchair outcome measurement instruments for children mainly assess manual wheelchairs, emphasising propulsion perfomance as the primary outcome. Responsiveness and intra-rater are underreported, highlighting a gap for future research. Standardised methodologies and detailed reporting, including sample size specifications, are essential for advancing research and clinical practice.

PMID:40937612 | DOI:10.1080/17483107.2025.2558215

Public Health Rep. 2025 Sep 12:333549251358671. doi: 10.1177/00333549251358671. Online ahead of print.

ABSTRACT

OBJECTIVE: Nonfatal overdoses provide critical insights into the substance use crisis, offering opportunities for timely interventions and prevention. This study pilots a nonfatal overdose biosurveillance strategy to analyze the demographic, clinical, and toxicological profiles of overdose patients, aiming to identify patterns and risk factors associated with these incidents.

METHODS: We assessed residual urine specimens collected from emergency department patients experiencing a nonfatal overdose at 2 hospitals in Wisconsin from August 2022 through February 2024. We collected data on patient demographic characteristics, results of clinical toxicology screening, manner of overdose, risk factors for overdose, and discharge status. Statistical analyses identified associations and odds ratios (ORs) among patient characteristics, detected drugs, and discharge status.

RESULTS: Of the 79 patients in the study, many had risk factors for overdose, including substance use disorder (48%), history of a mental health condition (43%), and polysubstance use (72%). Synthetic opioids had a strong positive association with a history of overdose (OR = 3.86). The presence of stimulants and antidepressants showed moderate sex-based associations, while race was linked to differing discharge status. Polysubstance use had a positive association with some drug combinations, such as narcotic analgesics and cocaine (OR = 4.00).

CONCLUSIONS: This study highlights the prevalence of polysubstance use and identifies key demographic and clinical factors associated with nonfatal overdoses. These findings underscore the need for comprehensive, real-time biosurveillance to inform targeted public health interventions and improve patient outcomes. Enhanced understanding of these patterns can lead to more effective strategies for overdose prevention and management, addressing a critical gap in current public health approaches.

PMID:40937595 | DOI:10.1177/00333549251358671

Glob Chang Biol. 2025 Sep;31(9):e70484. doi: 10.1111/gcb.70484.

ABSTRACT

Leaf phenology, a critical determinant of plant fitness and ecosystem function, is undergoing rapid shifts due to global climate change, yet its complex genetic and environmental drivers remain incompletely understood. Understanding the genetic basis of phenological adaptation is crucial for forecasting forest responses to a changing climate. Here, we integrate multi-year satellite-derived phenology from 46 Fagus sylvatica (European beech) populations across Germany with a population-based genome-wide association study to dissect the environmental and genetic drivers of leaf-out day (LOD) and leaf shedding day (LSD). We show that environmental factors, particularly temperature forcing and water availability, are the primary drivers of LOD variation, while LSD is influenced by a more complex suite of climatic cues. Our genomic analysis identifies candidate genes associated with LOD and LSD, primarily linked to circadian rhythms and dormancy pathways, respectively. Furthermore, genomic prediction models incorporating these loci accurately reconstruct past phenological dynamics, providing a powerful framework to forecast forest vulnerability and adaptation to future climate change.

PMID:40937575 | DOI:10.1111/gcb.70484

J Med Internet Res. 2025 Sep 5;27:e74052. doi: 10.2196/74052.

ABSTRACT

BACKGROUND: Guilt proneness and shame proneness are interconnected yet distinct personality traits that are gaining attention in addiction research. However, studies examining their differential associations with internet gaming disorder (IGD) and mediation mechanisms explaining these associations remain scarce. Theoretical and empirical evidence suggests that emotional dysregulation could be a potential mediator of the associations between guilt proneness and shame proneness and IGD.

OBJECTIVE: This study aimed to investigate the associations between guilt proneness in cognitive (guilt-negative behavior-evaluations) and behavioral (guilt-repair) domains and shame proneness in cognitive (shame-negative self-evaluations) and behavioral (shame-withdrawal) domains and IGD, as well as related mediation mechanisms via emotional dysregulation.

METHODS: A multicenter, cross-sectional, anonymous online survey was conducted among medical undergraduate students in seven Chinese cities (Wenzhou, Dali, Nanning, Harbin, Baotou, Qiqihar, and Shantou) from December 2023 to February 2024. In total, 12,912 invitations were sent out, of which 8522 eligible cases were included; the mean response rate was 71.0%. The 9-item DSM-5 IGD Checklist was used to screen for IGD cases; the 16-item Guilt and Shame Proneness Scale was used to assess guilt and shame proneness; the Cognitive Emotional Regulation Questionnaire was used to assess emotional dysregulation. Univariate logistic regression analysis was conducted to examine the associations between background factors and IGD. Structural equation modeling (SEM) was performed to test the mediation mechanism, with the adjustment of background factors.

RESULTS: Of all participants, the prevalence of IGD was 7.5%. Background factors of male sex (vs female, OR 2.78, 95% CI 2.36, 3.28) and self-reported poor household financial situation (vs good, odds ratio [OR] 1.96, 95% CI 1.51, 2.55) were significantly associated with a higher risk of IGD; the associations involving study city, year of study, study major, and origin (residency) of students were statistically nonsignificant. SEM showed that shame proneness in both cognitive (β=.29, 95% CI 0.26, 0.33) and behavioral (β=.20, 95% CI 0.18, 0.22) domains and emotional dysregulation of rumination, catastrophizing, and self-blame (β=.36, 95% CI 0.32, 0.40) were positively associated with IGD, while guilt proneness in both cognitive (β=-.08, 95% CI -0.12 to -0.03) and behavioral domains (β=-0.10, 95% CI -0.14 to -0.06) was negatively associated with IGD. Furthermore, emotional dysregulation partially mediated the association between guilt proneness and shame proneness in both domains and IGD (mediation effect size ranged from 22.0% to 45.8%).

CONCLUSIONS: This study observed relatively high prevalence of IGD among medical undergraduate students in China. Furthermore, the associations between shame and guilt proneness and IGD were differential. Shame proneness and guilt proneness in cognitive and behavioral domains were both directly and indirectly (via emotional dysregulation) associated with IGD, suggesting that future intervention studies may reduce maladaptive shame proneness or shift from shame towards adaptive guilt to reduce the risk of IGD.

PMID:40937544 | DOI:10.2196/74052

J Cosmet Dermatol. 2025 Sep;24(9):e70424. doi: 10.1111/jocd.70424.

ABSTRACT

BACKGROUND: Genitourinary syndrome of menopause (GSM) is prevalent among breast cancer survivors (BCS), often exacerbated by oncologic treatments and compounded by contraindications to hormone-based therapies. Vaginal Erbium:YAG laser has emerged as a promising non-hormonal alternative, though long-term safety and efficacy data remain scarce.

METHODS: This prospective pilot study initially enrolled twelve breast cancer survivors (BCS) presenting with moderate to severe genitourinary syndrome of menopause (GSM). The study consisted of two phases: in phase 1, patients underwent 3 monthly sessions of fractional Erbium:YAG (erbium: yttrium-aluminum garnet) laser and were evaluated before the first laser and 1 month after the third session. In Phase 2, patients were evaluated 1 year after the beginning of the treatment (first laser session). Clinical evaluations were carried out at baseline and after each study phase using the Vaginal Health Index (VHI), the Female Sexual Function Index (FSFI), and a customized Symptom Intensity Questionnaire. Vaginal biopsies and cytological samples were obtained at baseline and at the end of the first phase. H&E staining, Picrosirius Red, glycogen deposits, and epithelial thickness were evaluated in all samples. A Likert scale was administered at the end of each phase to assess patient satisfaction. Statistical analyses were performed using paired t-tests, bootstrap resampling techniques, and logistic regression models to evaluate treatment outcomes and response predictors.

RESULTS: 12 patients enrolled in the study, ten completed phase one, and eight completed Phase 2. Mean VHI scores improved significantly from 10.75 ± 2.4 to 23.38 ± 3.1 (p < 0.0001). Symptom severity decreased significantly (p = 0.0078). FSFI scores showed clinical improvement (from 15.52 ± 7.20 to 25.05 ± 6.81), though not statistically significant (p = 0.0889); bootstrap and simulation analyses confirmed robustness. Histological findings indicated epithelial remodeling without adverse tissue effects. All patients gave the best satisfaction scores to the treatment (Likert = 5). No adverse events were reported.

CONCLUSIONS: Vaginal Erbium:YAG laser therapy appears to be a safe and potentially effective option for GSM management in BCS. Further randomized controlled trials are needed to validate these findings.

PMID:40937542 | DOI:10.1111/jocd.70424

Int J Comput Vis. 2025;133(9):6491-6512. doi: 10.1007/s11263-025-02492-6. Epub 2025 Jun 15.

ABSTRACT

Existing level set models employ regularization based only on gradient information, 1D curvature or 2D curvature. For 3D image segmentation, however, an appropriate curvature-based regularization should involve a well-defined 3D curvature energy. This is the first paper to introduce a regularization energy that incorporates 3D scalar curvature for 3D image segmentation, inspired by the Einstein-Hilbert functional. To derive its Euler-Lagrange equation, we employ a two-step gradient descent strategy, alternately updating the level set function and its gradient. The paper also establishes the existence and uniqueness of the viscosity solution for the proposed model. Experimental results demonstrate that our proposed model outperforms other state-of-the-art models in 3D image segmentation.

PMID:40937463 | PMC:PMC12420715 | DOI:10.1007/s11263-025-02492-6

BMJ Public Health. 2025 Sep 8;3(2):e003073. doi: 10.1136/bmjph-2025-003073. eCollection 2025.

ABSTRACT

INTRODUCTION: The WHO Housing and Health Guidelines have highlighted the impact of housing quality on cardiovascular diseases (CVDs), including pathways such as cold-induced hypertension. Major factors influencing housing quality include architectural type (detached houses vs flats) and tenure (owned vs rented), but few studies have examined their effects on CVDs.

METHODS: 46 850 occupants were included during the follow-up period from 1 January 2012 to 31 December 2017 in the Japan Gerontological Evaluation Study. By linking survey data with cause-of-death records, the Kaplan-Meier curves were constructed. Competing risk regression models were applied to calculate the subdistribution HRs (SHRs) for cardiovascular mortality risks across housing statuses, adjusted for demographics, socioeconomic factors and lifestyle behaviours. Sex-stratified analyses and Cox regression analyses were also conducted to calculate the HRs.

RESULTS: A total of 38 731 participants (46.6% men) were analysed, with a mean age of 73.6 years and a median follow-up period of 2091 days. The cardiovascular mortality rate was 3.97 per 1000 person-years, with 2.3% experiencing CVD-related deaths. The Kaplan-Meier curve indicated higher cardiovascular mortality for those living in rental flats and owned detached houses compared with those in owned flats. Competing risk regression models indicated a significantly higher risk of cardiovascular deaths among occupants living in rental flats compared with those in owned flats (SHR=1.78; 95% CI 1.05-3.02). For men, the risk was notably higher (SHR=2.32; 95% CI 1.13-4.75), though not statistically significant in women. Sensitivity analyses using Cox regression supported these findings, showing higher risk estimates for men (HR=2.36; 95% CI 1.16-4.82).

CONCLUSIONS: Rental housing and detached houses are likely to have lower temperatures and greater temperature instabilities, raising blood pressure and increasing CVDs. Improving housing quality can contribute to cardiovascular health at the population level.

PMID:40937432 | PMC:PMC12421178 | DOI:10.1136/bmjph-2025-003073

BMJ Public Health. 2025 Sep 8;3(2):e002828. doi: 10.1136/bmjph-2025-002828. eCollection 2025.

ABSTRACT

INTRODUCTION: The UK has promoted increased availability of alcohol-free and low-alcohol drinks (no/lo, ≤1.2% alcohol by volume) as a public health strategy. To be effective, no/lo beverages must replace, and not supplement, standard alcoholic drinks. Emerging evidence suggests that the reasons people drink alcohol may be an important determinant of the potential public health impact of these drinks. This study aimed to determine whether alcohol drinking motives were associated with no/lo consumption after accounting for sociodemographic characteristics and alcohol consumption.

METHODS: A cross-sectional sample of adults residing in Great Britain (aged 16-93) who had drunk alcohol in the past year were recruited via the Alcohol Toolkit Study (N=2555; 49.0% female). The dependent variable was frequency of no/lo consumption (less than vs at least monthly). Five questions captured respondents’ alcohol drinking motives (enhancement, social, conformity, coping-anxiety, and coping-depression), derived from the Drinking Motives Questionnaire-Revised. Sociodemographic characteristics, including age, gender, social grade, education, Index of Multiple Deprivation (a UK-wide measure of relative deprivation for small geographic areas), and hazardous alcohol use (Alcohol Use Disorder Identification Test), were also assessed. Descriptive analysis presents the proportion of respondents drinking no/lo at least monthly among low endorsement (ie, drinking for a motive less than half the time) versus high endorsement (ie, drinking for a motive at least half the time) of each drinking motive. Quasibinomial regression modelling explored relationships between alcohol drinking motives and no/lo consumption, accounting for sociodemographic characteristics and hazardous drinking.

RESULTS: Drinking alcohol to conform was associated with an increased likelihood of at least monthly no/lo consumption after accounting for sociodemographic characteristics and hazardous drinking (OR 1.10, 95% CI 1.00 to 1.21, p=0.041).

CONCLUSIONS: No/lo drinks may facilitate reduced alcohol consumption by offering an alternative for individuals wishing to participate in alcogenic environments. However, those who drink alcohol to conform are not typically higher-risk drinkers, which may limit the public health benefit of no/lo drinks. Further research is needed to explicitly explore substitution effects.

PMID:40937431 | PMC:PMC12421153 | DOI:10.1136/bmjph-2025-002828

Front Endocrinol (Lausanne). 2025 Aug 27;16:1572675. doi: 10.3389/fendo.2025.1572675. eCollection 2025.

ABSTRACT

INTRODUCTION: Elderly population is more susceptible to both hypothyroidism and chronic kidney disease (CKD) independently and it is very crucial to assess kidney function in elderly hypothyroid patients in relation to autoimmunity. There are previous studies showing a correlation between eGFR and TSH, T3, and T4 in the elderly population but no such studies correlating the estimated GFR (eGFR) with the anti-thyroid antibodies of elderly hypothyroid patients are available. This study aimed to assess renal function in newly diagnosed elderly hypothyroid patients and correlate findings with anti-thyroid peroxidase (anti-TPO) levels.

METHODS: We conducted a cross-sectional study with 128 participants aged 60 years and above after obtaining ethics committee approval. All cases were newly diagnosed patients of hypothyroidism whether clinical or subclinical. The control group consisted of age and sex matched individuals with normal thyroid profile status. Fasting blood samples were collected and serum thyroid parameters, glycemic and renal markers were evaluated, and statistical analyses were performed.

RESULTS: Hypothyroid patients exhibited elevated anti-TPO levels and markers of renal dysfunction, including increased urea, uric acid, and urine albumin/creatinine ratio. Multiple regression analysis identified anti-TPO as an independent predictor of kidney function. Subgroup analysis revealed significantly lower eGFR and elevated renal markers in anti-TPO positive patients.

DISCUSSION: The interplay between thyroid dysfunction and renal impairment is particularly significant in the elderly, who are more vulnerable to both conditions. Elevated anti-TPO levels are associated with renal dysfunction in elderly hypothyroid patients, suggesting a potential role for anti-TPO in renal impairment.

PMID:40937419 | PMC:PMC12420214 | DOI:10.3389/fendo.2025.1572675

Front Endocrinol (Lausanne). 2025 Aug 27;16:1599423. doi: 10.3389/fendo.2025.1599423. eCollection 2025.

ABSTRACT

BACKGROUND: Diabetic nephropathy (DN) is a major complication of diabetes, contributing significantly to end – stage renal disease. Irisin, an exercise – induced myokine, has been linked to metabolic disorders, but its relationship with DN remains unclear. This study aims to comprehensively and accurately explore the association between serum irisin levels and DN through a systematic review and meta – analysis.

METHODS: The research was conducted following the Meta – analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Multiple electronic databases, including Cochrane Library, Embase, Web of Science, PubMed, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBM), and Wanfang Database, were systematically searched using relevant keywords related to irisin and DN. Studies were included if they were randomized controlled trials (RCTs) or observational studies that stratified Type 2 diabetes mellitus (T2DM) patients based on the presence or absence of DN, measured serum irisin levels in both groups, and provided data in a suitable format. Two independent reviewers performed literature screening, data extraction, and quality assessment. The Jadad scale was used for RCTs, and the Newcastle – Ottawa Scale (NOS) was applied for cohort and case – control studies. Statistical analysis was carried out using RevMan 5.3 software, with heterogeneity evaluated by Q and I² tests, and appropriate models (fixed – effects or random – effects) selected accordingly. INPLASY registration number:202530056.

RESULTS: A total of seven studies, comprising 453 DN patients and 346 non-DN controls, were included in the final meta-analysis. The pooled results demonstrated that serum irisin levels were significantly lower in patients with diabetic nephropathy, particularly those with more advanced stages of albuminuria. Specifically, irisin levels were significantly reduced in patients with microalbuminuria (MD = 30.84, 95% CI: 7.81 to 53.87, I² = 96%) and macroalbuminuria (MD = 30.84, 95% CI: 7.81 to 53.87, I² = 98%) compared to those with normoalbuminuria. Furthermore, a direct comparison between microalbuminuria and macroalbuminuria also revealed significantly lower irisin levels in the latter group (MD = 12.53, 95% CI: 3.46 to 21.59, I² = 89%). In terms of renal function, patients with eGFR < 60 mL/min/1.73 m² exhibited lower irisin concentrations than those with preserved renal function (MD = 3.43, 95% CI: -2.90 to 9.75, I² = 90%), though this difference was not statistically significant. Given the substantial heterogeneity among the included studies, random-effects models were applied for all analyses. Funnel plot assessment showed general symmetry in most comparisons, indicating a low to moderate risk of publication bias, although asymmetry was observed in the microalbuminuria vs. macroalbuminuria subgroup, suggesting potential small-study effects.

CONCLUSIONS: This meta-analysis provides evidence for an association between serum irisin levels and DN. Lower serum irisin levels were related to more severe albuminuria and decreased eGFR in T2DM patients. However, considering the limitations of this study, such as potential missing data and methodological differences, further large – scale, multi-center, and high-quality RCTs are needed to validate these findings and elucidate the underlying mechanisms.

SYSTEMATIC REVIEW REGISTRATION: INPLASY.COM, identifier 202530056.

PMID:40937412 | PMC:PMC12420281 | DOI:10.3389/fendo.2025.1599423