Tag: pubmed

Commun Med (Lond). 2025 Apr 13;5(1):114. doi: 10.1038/s43856-025-00846-2.

ABSTRACT

BACKGROUND: Various factors associated with long COVID have been evidenced, but the heterogeneity of definitions and epidemiological investigations has often hidden risk pathways relevant for understanding and preventing this condition.

METHODS: This nationwide random sampling survey conducted in France after the Omicron waves in autumn 2022 assessed eight sets of factors potentially associated with long COVID in a structured epidemiological investigation based on a conceptual model accounting for the relationships between these sets of factors. A representative sample of 1813 adults of whom 55% were infected with SARS-CoV-2 was assessed for infection dates and context, post-COVID symptoms and these factors. Four definitions of long COVID, including the World Health Organisation’s, were used.

RESULTS: Female sex, household size (≥2), low financial security, negative impact of COVID-19 pandemic on occupation and work conditions, number of comorbidities (≥2), presence of respiratory disease, mental and sensory disorders, number of SARS-CoV-2 infections (≥2) and initial symptoms (≥6), perceived high severity of COVID-19 are positively and consistently associated with long COVID. Age ≥ 75 years, retirement, SARS-CoV-2 vaccination (≥2 doses) and good perceived information regarding long Covid are negatively associated with the condition.

CONCLUSIONS: The broad spectrum of factors confirmed here strongly suggests that long COVID should be regarded not only as a direct complication of SARS-CoV-2 infection but also as driven by a broader network of contextual, medical, psychological and social factors. These factors should be better considered in strategies aimed at limiting the long COVID burden in the general population.

PMID:40223130 | DOI:10.1038/s43856-025-00846-2

Sci Rep. 2025 Apr 13;15(1):12715. doi: 10.1038/s41598-025-96745-6.

ABSTRACT

Ischaemic heart disease (IHD) remains a major public health threat globally. The aim of this study was to evaluate the short-term burden of air pollution exposure on years of life lost (YLLs) from IHD in Pudong New Area, Shanghai. Data on air pollutants, meteorological factors, and daily IHD deaths were collected from 2013 to 2021. A distributed lag nonlinear model (DLNM) combined with linear (for YLLs) and quasi-Poisson (for mortality) regression models was applied to analyse the association between air pollution exposure and the IHD burden. A stratified analysis was conducted according to sex, age, education level, and residence registration. Each 10 µg/m³ increase in PM₁₀, SO₂, and NO₂ exposure was associated with YLL increases of 0.40 (95% CI: -0.32, 1.11), 4.38 (95% CI: 0.83, 7.92), and 0.67 (95% CI: -0.71, 2.04) years, respectively, at lag0-3. The corresponding YLL increase due to PM_2.5 exposure was 0.28 (95% CI: -0.24, 0.80) years at lag0-1. The impacts of air pollution exposure on YLLs and daily IHD deaths were greater for male and urban groups than for female and rural groups. Furthermore, the difference in SO₂ exposure was statistically significant among sex-stratified groups. Air pollution exposure was positively associated with IHD-related YLL increases in Pudong New Area, Shanghai.

PMID:40223129 | DOI:10.1038/s41598-025-96745-6

Sci Rep. 2025 Apr 13;15(1):12726. doi: 10.1038/s41598-025-95371-6.

ABSTRACT

Stroke is a serious public health problem in developing countries like India, leading to rising deaths and disability-adjusted life years related to stroke. Pre-hospital delay is a major concern in most acute stroke cases, affecting timely interventions and treatment outcomes. Hence the current study aimed to identify the factors influencing the time from stroke onset to arrival at the emergency department and to map the spatial distribution of stroke cases from the tertiary care hospital. We conducted a hospital-based cross-sectional study among stroke patients presenting to the emergency department of a tertiary care hospital in Mysuru. Data on sociodemographic, clinical, and pre-hospital factors, along with detailed addresses of the place of stroke onset, first and second consultation, and their proximal first referral units were collected. GIS mapping was done using the software ArcGIS v10.8.2, and statistical analysis was performed using SPSS v25. Most of the study participants were men, over 60 years of age, and residents from rural areas of Mysuru and its neighboring districts. The study found that only 25% of the stroke cases arrived within 4.5 h of symptom onset, with hemiparesis and slurred speech being the most common presenting complaints. Almost all the cases were within a 20 km radius of the first referral units with factors such as age group (p = 0.028), diabetes as a comorbid condition (p = 0.007), the decision taken for symptom onset (p < 0.01), the person involved in decision-making (p = 0.006), and the mode of arrival at the hospital (p = 0.004) being significantly associated with the duration from stroke onset to arrival at the hospital. This highlights the need for public awareness campaigns on stroke symptoms, the importance of early hospital presentation following stroke onset, and the capacity building of first referral units to provide timely emergency stroke care for people residing in rural areas.

PMID:40223117 | DOI:10.1038/s41598-025-95371-6

J Health Popul Nutr. 2025 Apr 13;44(1):116. doi: 10.1186/s41043-025-00852-z.

ABSTRACT

OBJECTIVE: To explore the clinical efficacy of commonly used conservative treatments for adenomyosis using both TCM and Western medicine.

METHODS: 210 patients with adenomyosis were selected and divided into 3 groups: Group A (Dan’e Fukang), Group B (Dienogest), and Group C (Goserelin + Mirena), with 70 cases in each group. Afterward, indicators were collected for comparison.

RESULTS: Different treatment approaches exhibited varying effects on uterine VAS, and PBAC among the 3 groups (P < 0.001). The effects of different treatment approaches on serum levels of estradiol (E2), FSH, and CA125 also differed among the 3 groups (P < 0.001). After 3 months of treatment, the incidence of adverse reactions among the 3 groups was significantly different (P < 0.001), with further comparison indicating a lower incidence of adverse reactions in Groups A and B than in Group C (P < 0.017). Meanwhile, statistically significant differences in the incidence of adverse reactions among the 3 groups were observed again after 6 months of treatment (P = 0.004), with further comparison revealing a lower incidence of adverse reactions in Group B than in Group C. Additionally, the comparison of uterine volume (P < 0.001) and VAS (P < 0.001) among the 3 groups was different after 12 months of treatment, and further comparison revealed that the uterine volume was ranked as Group B > Group C > Group A, while the pelvic pain VAS scores were ranked as Group C > Group B = Group A.

CONCLUSION: Dan’e Fukang Decoction is markedly effective in alleviating pain; Goserelin + Mirena exhibits significant efficacy in reducing bleeding.

PMID:40223114 | DOI:10.1186/s41043-025-00852-z

BMC Med. 2025 Apr 14;23(1):216. doi: 10.1186/s12916-025-04034-w.

ABSTRACT

BACKGROUND: Differential attainment (DA), or differences in performance of groups (rather than individual differences), has been observed in a number of postgraduate medical specialty examinations used in UK medical training. Until now, much of the published research on DA has been limited in scope and size to one specialty, one examination or one type of assessment. This retrospective cohort study addressed this gap by examining the relationship between numerous sociodemographic differences and performance in almost all UK postgraduate medical examinations using a dataset of more than 180,000 examination attempts by UK and international medical graduates, adjusting for prior academic attainment.

METHODS: This retrospective cohort study used the UK Medical Education Database (UKMED) to analyse the impact of a range of sociodemographic factors on performance in all UK postgraduate medical examinations aggregated into written and clinical exams. Pass/fail data at the first examination attempt were analysed for all candidates (UK medical school graduates (UKG) and those from non-UK schools (IMG)) sitting an examination between 2014 and 2020. Univariate analyses identified variables to carry forward into multivariate logistic regression models. Informed by previous research, all models were adjusted for prior academic attainment.

RESULTS: 180,890 examination first-attempts were made by UKG and IMG candidates, and 121,745 (67.3%) passed at the first attempt. Multivariate regression models showed that place of primary qualification (UKG vs IMG), gender, age, ethnicity, religion, sexual orientation, disability status and working less than full-time were all statistically significant, independent predictors of examination outcomes for all examination candidates. Additionally, there were significant associations between socioeconomic backgrounds and performance for UKGs alone. The strongest independent predictors of failing written and clinical examinations were graduating from a non-UK medical school, having a minority ethnic background and having a registered disability.

CONCLUSIONS: This, the largest study of UK postgraduate medical examination outcomes, identified sociodemographic differences that were independently predictive of performance in written and clinical postgraduate medical examinations. Further analysis is now required to ascertain whether these group-level differences exist in each postgraduate medical examination, the majority or a select few.

TRIAL REGISTRATION: Not applicable.

PMID:40223107 | DOI:10.1186/s12916-025-04034-w

Echo Res Pract. 2025 Apr 14;12(1):9. doi: 10.1186/s44156-025-00072-5.

ABSTRACT

BACKGROUND: Out-of-hospital cardiac arrest (OHCA) is associated with high mortality, highlighting the importance of identifying prognostic factors to guide treatment escalation plans. This study investigates the short-term prognostic potential of transthoracic echocardiogram (TTE), a commonly performed investigation in OHCA patients. This study is among the first to report left ventricle (LV) global longitudinal strain (LVGLS) in OHCA patients.

METHODS: This single-center retrospective cohort study included 54 patients treated between 2019 and 2022, during the COVID-19 pandemic. Patient characteristics were reported using the 2015 Utstein template, and echocardiographic parameters were assessed following British Society of Echocardiography guidelines. Univariate analyses compared TTE parameters by survival-to-discharge and implantable cardioverter-defibrillator implantation outcomes. Correlations between LV ejection fraction (LVEF) derived from cardiac magnetic resonance imaging (cMRI) and echocardiographic LV systolic parameters were evaluated.

RESULTS: The survival-to-discharge rate was 77.8%. Non-survivors had a significantly larger right atrium (RA) area (RAA) (20.8 cm² vs. 15.2 cm² in survivors; p = 0.003). No statistically significant differences were observed for other right or left heart parameters. The median LVGLS was reduced at -11.4% (interquartile range: -14.0 to -7.6). LVEF correlates well on cMRI and TTE (Pearson correlation coefficient = 0.830).

CONCLUSION: This study identifies a novel association between larger RAA and short-term mortality following OHCA, alongside a higher survival rate in a tertiary center. Further research should consider incorporating RA parameters into analyses to refine prognostic assessments.

PMID:40223106 | DOI:10.1186/s44156-025-00072-5

BMC Pediatr. 2025 Apr 14;25(1):289. doi: 10.1186/s12887-025-05646-0.

ABSTRACT

BACKGROUND: In Japan, the number of pharmaceuticals with pediatric indications is low, and some are approved only in Europe or the USA but not in Japan. As the approval review report by the Japanese health authority contains any detailed items considered for drug approval, this study aimed to analyze the review reports and elucidate data types that facilitate the approval of pediatric drugs in Japan.

METHODS: We identified products approved in Japan, extracted relevant product- and review-related information, and summarized the characteristics of pediatric drug clinical data and drug approval procedures.

RESULTS: Among 625 products (approved 04/2019-02/2024), 171 with pediatric indications were analyzed. The approval review considered orphan drug designation for 56 products, public knowledge-based application for 16 products, mandatory post-marketing surveillance for 42 products, and investigator-initiated studies for 11 products. For only 10 products, confirmatory studies were completed exclusively in Japanese children. Among the other 161 products, extrapolation from non-Japanese children and Japanese adults and/or older children was discussed for 93 and 100 products, respectively. Extrapolation-based reviews focused on ethnic and population factors and consistency of exposure dose, efficacy, and safety. Statistical confirmation is not always necessary for approval. Administrative incentives are often applied, including for orphan drugs and Sakigake designation and public knowledge-based applications.

CONCLUSIONS: The appropriateness or sufficiency of the clinical data package can refer to the PMDA. By considering joining a multinational study and determining the required number of Japanese patients, a path toward the approval of pediatric drugs in Japan can be identified.

PMID:40223100 | DOI:10.1186/s12887-025-05646-0

J Health Popul Nutr. 2025 Apr 13;44(1):117. doi: 10.1186/s41043-025-00861-y.

ABSTRACT

OBJECTIVE: To investigate the relationship between dietary microorganism intake and mortality risk among hypertensive adults with depression in the United States.

METHODS: This study utilizes data from the 2005-2018 National Health and Nutrition Examination Survey, focusing on individuals with hypertension. The Kaplan-Meier (K-M) curve is employed to preliminarily explore the relationship between dietary microorganism intake, depression, and mortality risk in hypertensive individuals. The Cox proportional hazards model is used for both individual and combined analyses of these relationships. Mediation analysis assesses the mediating effect of depression on the association between dietary microorganisms and mortality, while subgroup and sensitivity analysis evaluates the stability of the model.

RESULTS: This cohort study included 11,602 hypertensive participants (5,904 men and 5,698 women), with 1,201 having depression. During follow-up period, 2,085 died from all causes, 692 due to cardiovascular events. Preliminary analysis using the K-M curve reveals that hypertensive individuals with higher dietary microorganism intake and those without depression have lower mortality risks. Cox proportional hazards model analysis shows that increased dietary microorganism intake is associated with reduced mortality risk in hypertensive individuals (HR_ALL-cause=0.654, 95%CI: 0.555-0.771; HR_CVD-cause:0.675, 95%CI: 0.472,0.967). High intake of diets rich in dietary microorganisms may mitigate the ALL-cause mortality risk of depression in hypertensive populations(HR_ALL-cause=0.493, 95%CI: 0.256-0.947). Mediation analysis revealed that depression serves as a partial mediator in the process of dietary microorganisms improving the long – term prognosis of the hypertensive population. Results of subgroup analysis and sensitivity analysis showed that the beneficial effect of dietary microorganism intake on prognosis remained stable in most of the hypertensive population.

CONCLUSION: Patients with depression among those suffering from hypertension can reduce the risk of all-cause mortality caused by depression by increasing their intake of dietary microorganisms. This provides clinicians with a new non-pharmacological intervention approach and offers a direction for the optimization of clinical combined treatment regimens.

PMID:40223098 | DOI:10.1186/s41043-025-00861-y

Respir Res. 2025 Apr 13;26(1):141. doi: 10.1186/s12931-025-03216-7.

ABSTRACT

BACKGROUND: Despite significant advances in the treatment of lung cancer (LC), there are no reliable biomarkers to effectively predict therapy response and overall survival (O/S) in non-small cell lung cancer (NSCLC) subtypes. While targeted therapies have improved survival rates in lung adenocarcinoma (LUAD), effective treatment options for lung squamous cell carcinoma (LUSC) are still limited. Recent evidence indicates that exosome-bound WNT5A may significantly contribute to disease progression. Our study assessed the WNT5A protein as a potential biomarker for diagnosing patients and predicting prognosis to assist in therapy selection.

METHODS: Primary tumor tissue and serum samples were collected from a cohort of 60 patients with histologically confirmed NSCLC before therapy. Healthy serum donors served as controls. Exosomes were isolated, then exosome number and size were measured, and WNT5A protein levels were identified in tissue and in vesicle-free, vesicle-bound fractions of the serum by ELISA.

RESULTS: Extensive statistical analysis (ROC, AUC, Cox, etc.) revealed that elevated WNT5A levels on the serum-exosome surface correlated with distant metastasis, advanced disease stage, and lymph node involvement in LUSC but not in LUAD patients. Moreover, a high WNT5A exosome surface expression was associated with a poor response to therapy and shorter O/S in LUSC patients. Additionally, serum-exosome surface + cargo WNT5A content distinguished LUAD and LUSC subtypes.

CONCLUSIONS: WNT5A, particularly its serum exosome-bound form, may serve as a valuable biomarker after further validation for differentiating NSCLC subtypes and predicting disease progression. Importantly, the information can become available from a simple serum sample at the time of diagnosis.

PMID:40223089 | DOI:10.1186/s12931-025-03216-7

BMC Oral Health. 2025 Apr 13;25(1):567. doi: 10.1186/s12903-025-05959-7.

ABSTRACT

BACKGROUND: It has been reported that periodontitis was a risk factor for metabolic dysfunction-associated steatotic liver disease (MASLD). The aim of this study is to investigate the impact of periodontitis on all-cause and cause-specific mortality of MASLD patients.

METHODS: We included 11,019 individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) from the National Health and Nutrition Examination Survey. Multivariable Cox proportional hazards models were utilized to analyze the estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality and cause-specific mortality among participants with different periods of periodontitis status. Additionally, we employed restricted cubic splines (RCS) curves to explore the dose-response relationship between clinical attachment level (CAL) and pocket probing depth (PPD) and mortality rates. Finally, a series of sensitivity analyses and stratification analyses were conducted to test the reliability and robustness of the results.

RESULTS: In this study, moderate to severe periodontitis significantly increased the all-cause mortality (HR 1.29, 95% CI 1.08-1.55; P = 0.003) and cardiovascular disease (CVD)-related mortality (HR 1.41, 95% CI 1.10-1.79; P = 0.006) among MASLD participants. However, no significant effects of different periodontal statuses on cancer mortality were observed among MASLD participants.

CONCLUSIONS: A nationwide large-sample longitudinal study indicated that MASLD patients with moderate to severe periodontitis experienced significantly higher all-cause and CVD-related mortality rates compared to those with no or mild periodontitis.

PMID:40223086 | DOI:10.1186/s12903-025-05959-7