Tag: pubmed

Ochsner J. 2025 Spring;25(1):2-10. doi: 10.31486/toj.24.0017.

ABSTRACT

BACKGROUND: Weekend vs weekday hospital admission has been associated with poorer mortality rates for many conditions. Studies evaluating weekend admission for hip fractures have resulted in contradictory conclusions regarding outcomes.

METHODS: We conducted a retrospective analysis of all patients who underwent surgery for a fragility hip fracture at a quaternary level teaching hospital during a 6-year period. A total of 1,164 patients were included: 796 weekday admissions (Monday through Friday) vs 368 weekend admissions (Saturday and Sunday). Patients were subdivided based on surgeon experience level (473 consultants vs 690 nonconsultants). Statistical tests included chi-square tests and logistic regression. Demographic data included age, sex, prior hip fracture, fracture type, operation, and American Society of Anesthesiologists grade. The primary outcome was 1-year mortality. Secondary outcomes were acute mortality (<24 hours), subacute mortality (1 to 30 days), change in mobility from baseline at 1 year, preoperative delay (>48 hours), and surgical duration.

RESULTS: The weekend admission cohort had a higher 1-year mortality rate than the weekday admission cohort (30.4% vs 23.2%; P=0.029), while subacute mortality trended toward significance (P=0.083). No significant difference was seen in acute mortality (P=0.5). Hemiarthroplasty was associated with increased mortality at 12 months (P=0.012) compared to the other operative interventions. The median duration of surgery was lower in the weekend cohort vs the weekday cohort (1.15 hours [69 minutes] vs 1.23 hours [73.8 minutes]; P<0.001). Consultants performed surgeries 16.2 minutes faster than nonconsultants (P<0.001) and trended toward a lower 1-year mortality rate (22.1% vs 27.9%; P=0.058). No significant difference was seen in mobility change at 1 year in both the consultant vs nonconsultant analysis (P>0.9) and in the weekday vs weekend analysis (P>0.12).

CONCLUSION: A significantly increased 1-year mortality rate and a shorter surgical duration were observed among patients admitted on the weekends.

PMID:40123930 | PMC:PMC11924973 | DOI:10.31486/toj.24.0017

Front Endocrinol (Lausanne). 2025 Mar 7;16:1546290. doi: 10.3389/fendo.2025.1546290. eCollection 2025.

ABSTRACT

OBJECTIVE: This study aims to provide reference data for sperm morphology in a healthy, fertile male population providing a foundation for future studies on male infertility assessment and sperm selection in assisted reproductive technologies.

METHODS: The study included 21 healthy male participants, all of whom had partners who conceived within the past 12 months. Sperm samples were collected according to WHO guidelines and stained using the Papanicolaou method. Sperm morphology parameters, including head length, width, area, perimeter, ellipticity, and acrosome area, were measured using the Suiplus SSA-II Computer-Assisted Sperm Analysis (CASA) system. Statistical comparisons were made between CASA and traditional manual methods.

RESULTS: The percentage of sperm with normal head morphology was 9.98%. Detailed sperm head measurements, including length, width, and area, were provided as reference values for the healthy male population. The CASA system demonstrated the ability to reduce subjective errors and showed no significant differences in sperm count and motility compared to traditional methods.

CONCLUSION: This study provides precise sperm morphology reference values that enhance male infertility diagnostics and treatment, particularly in sperm selection for assisted reproductive technologies like ICSI.

PMID:40123889 | PMC:PMC11925775 | DOI:10.3389/fendo.2025.1546290

Fatigue. 2025;13(2):1-11. doi: 10.1080/21641846.2024.2444826.

ABSTRACT

BACKGROUND: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a serious, debilitating illness affecting millions of people worldwide. Patients with ME/CFS often feel misunderstood and report facing barriers to healthcare utilization.

OBJECTIVE: We report on a Voice of the Patient (VOP) series that used tenets from photovoice and hermeneutic phenomenology methods. The approach prioritized respecting and engaging patients as they share individual experiences of living with ME/CFS.

METHODS: We developed a 5-step process that could be replicated for interviewing patients in their own words. The process prioritized respecting patients while developing, documenting, and sharing individual accounts of living with ME/CFS. The standardized process for gathering each VOP story enabled individuals to share and participate on their own terms.

RESULTS: Over four years, eight VOP stories were completed and posted on CDC’s ME/CFS website. The stories received over 196,000 page views. Each story was completed in approximately six months. Participants expressed gratitude for the opportunity to share experiences and were appreciative of the process that involved them in the development of stories.

CONCLUSIONS: Qualitative methods guided the process for participants taking a central role in sharing stories, which in turn may help educate about patient experiences with ME/CFS. Standardization of steps enabled consistency and transparency. Building flexibility into the process allowed interviewing a range of people with ME/CFS (i.e. bed bound to working) and enabled patients to give narratives in their voice. This process may help to share experiences of people with other chronic diseases or infection associated chronic conditions.

PMID:40123856 | PMC:PMC11926923 | DOI:10.1080/21641846.2024.2444826

Front Cell Dev Biol. 2025 Mar 7;13:1530953. doi: 10.3389/fcell.2025.1530953. eCollection 2025.

ABSTRACT

BACKGROUND: Endometrial thickness (EMT) is a crucial indicator of endometrial receptivity in assisted reproductive technology (ART). However, its relationship with pregnancy outcomes remains unclear, especially across different cycle types such as fresh in vitro fertilization-embryo transfer (IVF-ET), frozen-thawed embryo transfer (FET), and preimplantation genetic testing for aneuploidy embryo transfer (PGT-ET). The clinical significance of EMT and its optimal range for improving ART outcomes remain subjects of debate.

METHODS: This retrospective cohort study analyzed data from 80,585 ART cycles conducted between July 2008 and December 2022 at a private reproductive center, including 25,683 fresh IVF-ET, 33,112 FET, and 1,071 PGT-ET cycles. EMT was measured via ultrasound on the day of HCG administration and grouped into ranges for comparison. Primary outcomes included live birth rates (LBR) and clinical pregnancy rates (CPR) across EMT ranges. Statistical analyses, including chi-square tests, receiver operating characteristic (ROC) analysis, and adjusted risk ratio (aRR) calculations, were performed to evaluate the association between EMT and pregnancy outcomes.

RESULTS: The relationship between EMT and LBR was non-linear, with no single cutoff value. LBR varied significantly across EMT ranges, peaking at approximately 12 mm in fresh IVF-ET cycles and around 10 mm in FET and PGT-ET cycles. Higher EMT was generally associated with improved LBR and CPR, but predictive power was limited (AUC: 0.56-0.60). Compared to an EMT of 10-11.9 mm, fresh IVF-ET cycles with EMT <10 mm had significantly lower LBR (aRR: 0.60-0.86), while those with EMT ≥12 mm had higher LBR (aRR: 1.12-1.17). Similar trends were observed in FET and PGT-ET cycles, although sensitivity to EMT variations was lower, particularly in PGT-ET cycles. Miscarriage rates (MR) showed no significant differences across EMT groups.

CONCLUSION: This study demonstrates that EMT has a non-linear association with LBR and CPR across fresh IVF-ET, FET, and PGT-ET cycles, with no single cutoff value. While higher EMT generally correlates with improved outcomes, its overall predictive value for LBR is limited. The findings underscore the need for individualized evaluation of EMT based on cycle type to optimize reproductive outcomes in ART.

PMID:40123852 | PMC:PMC11925890 | DOI:10.3389/fcell.2025.1530953

Health Equity. 2025 Jan 29;9(1):100-105. doi: 10.1089/heq.2024.0117. eCollection 2025.

ABSTRACT

INTRODUCTION: Children with a language for care other than English (LOE) are at risk for inequitable care. We examined the association of isolation precautions in the care of hospitalized children with LOE through the frequency of professional interpreter use and timing of in-person consultation.

METHODS: Retrospective cohort study of children in a strict isolation unit (SIU) between 2/2020 and 12/2021. Negative binomial regression was used to assess both differences in interpretation rates between SIU and non-SIU, and within 72-h/in-person consultation rates within the SIU between English-speaking and LOE encounters.

RESULTS: We identified 487 encounters in the SIU; 126 (26%) involved patients with LOE. The median interpretations per day were 4.5 (Interquartile Range [IQR]: 2.0-6.7). Among patients with LOE, there was an observed difference in median interpretations per day in the SIU (3.9, IQR: 1.7-6.4) versus encounters in non-SIU acute care units (5.0, IQR: 1.2-8.2). However, this difference was not statistically significant (Incidence Rate Ratio [IRR]: 0.89; 95% confidence interval [CI]: 0.70-1.13). Sub-specialty consultations were requested for 410 (84%) encounters within the SIU; 282 (69%) were completed in person within 72 h. A small difference between the percentage of completed consultations for encounters with LOE (n = 61, 64%) and English-speaking patients’ encounters (n = 221, 70%) was noted, which again was not statistically significant (IRR: 0.93; 95% CI: 0.71-1.21).

CONCLUSION: Despite the increased barriers of strict isolation, we exceeded institutional standards for interpretations per day and had similar rates of interpretation for encounters with LOE admitted to medical units regardless of isolation status.

PMID:40123837 | PMC:PMC11848053 | DOI:10.1089/heq.2024.0117

Internet Interv. 2025 Feb 18;40:100814. doi: 10.1016/j.invent.2025.100814. eCollection 2025 Jun.

ABSTRACT

Opp is a universal mental health-promoting mobile application (app) developed for adolescents, with the aim of promoting mental health and well-being and preventing mental health problems. In this randomized controlled trial, the effectiveness of Opp was tested among Norwegian adolescents aged 13 to 25 years. Mental health, well-being, self-efficacy, self-esteem, help-seeking behavior, and sleep quality were assessed at two measurement points (T1 and T2), that were approximately 11 weeks apart. Only the participants that answered at both measurement points were included in the main analyses (N = 399; 75 % girls; Mage = 16.90 years, SD = 1.40). The results demonstrated a statistically significant effect of the app on mental health, as measured by the SDQ Total Difficulties scale (F(1,790) = 4.35, p = .037), while no statistically significant effects were observed on the other outcomes. These results provide important insights, and a broader understanding of how mental health apps can influence the mental health and well-being of a general sample of adolescents.

PMID:40123821 | PMC:PMC11929045 | DOI:10.1016/j.invent.2025.100814

Int J Gen Med. 2025 Mar 17;18:1481-1495. doi: 10.2147/IJGM.S507375. eCollection 2025.

ABSTRACT

OBJECTIVE: Tuberous Sclerosis Complex (TSC) is a rare autosomal dominant genetic disorder primarily characterized by neurological symptoms. This study aimed to evaluate the current disease burden in Chinese patients with TSC and to identify the potential influencing factors.

METHODS: A cross-sectional study design was employed using an online questionnaire survey. The questionnaire covered demographics, diagnosis and treatment status, medication use, and disease burden. Descriptive statistics were used to summarize the data, and multivariate logistic regression analysis was performed to examine factors influencing the disease burden in pediatric and adult patients with TSC.

RESULTS: The survey involved a total of 840 patients or their caregivers, comprising 691 pediatric and 149 adult patients, with an average age at diagnosis of 1.77 years for pediatric patients and 15.28 years for adult patients. The most prevalent clinical manifestations were seizures (75.1% in pediatric, 43.6% in adult), brain calcification spots/nodules (87.8% pediatric, 82.5% adult), and hypomelanotic macules (89.5% pediatric, 72.4% adult). Intellectual disability (ID) was reported in 29.6% of pediatric patients and 19.4% of adult patients. Catastrophic health expenditure (CHE) was reported by 29.6% of patients. Factors influencing the disease burden included ID, misdiagnosis, and use of anti-seizure medications (ASMs) and mammalian target of rapamycin (mTOR) inhibitors for pediatric patients or educational attainment, medication use (such as ASMs and mTOR inhibitors), and ID for adult patients.

CONCLUSION: The study demonstrated that Chinese patients with TSC are confronted with a considerable disease burden. Comprehensive care strategies, tailored educational support for pediatric patients, and multidisciplinary approaches for early diagnosis are crucial for managing TSC.

PMID:40123818 | PMC:PMC11927571 | DOI:10.2147/IJGM.S507375

Int J Gen Med. 2025 Mar 18;18:1543-1553. doi: 10.2147/IJGM.S511426. eCollection 2025.

ABSTRACT

OBJECTIVE: This study examined CXCR4 expression in primary lesions of recurrent metastatic breast cancer patients, analyzing its association with clinicopathological features, chemotherapy efficacy, and prognosis.

METHODS: Eighty-five early surgical specimens of advanced BCa were examined for CXCR4 expression using immunohistochemical staining. The relationships between CXCR4 expression and clinical pathological factors, such as tumor size, lymph node metastasis, tumor stage, and metastatic site, were statistically analyzed, along with their effect on the efficacy of platinum-based chemotherapy and prognosis in patients with advanced BCa.

RESULTS: Significant associations were found between high CXCR4 levels in primary lesions of recurrent metastatic BCa and more frequent visceral metastases (p = 0.010), along with a higher rate of lymph node metastases (p = 0.022). Patients with advanced BCa showing high CXCR4 expression had lower efficacy with platinum-based chemotherapy (p = 0.002). Patients with high CXCR4 expression exhibited shorter disease-free survival (DFS) and overall survival (OS) compared to those with low expression, though the differences lacked statistical significance.

CONCLUSION: Patients with recurrent metastatic BCa with high expression of CXCR4 in primary lesions have poor efficacy with platinum-based chemotherapy, shorter DFS and OS, and poor prognosis. CXCR4 may be an important biomarker in metastatic BCa. It can be used not only as a predictor of metastasis and prognosis, but also as a therapeutic target and a tool to monitor treatment efficacy.

PMID:40123816 | PMC:PMC11929416 | DOI:10.2147/IJGM.S511426

Int J Gen Med. 2025 Mar 17;18:1529-1542. doi: 10.2147/IJGM.S496799. eCollection 2025.

ABSTRACT

INTRODUCTION: Foodborne disease outbreaks (FBDOs) pose a significant threat to public health globally, leading to substantial morbidity, mortality, and economic losses. However, the underlying causes and impacts of FBDOs often remain underexplored in specific regions, limiting the effectiveness of targeted prevention strategies.

METHODS: This study aimed to investigate the epidemiological characteristics, causes, and economic burden of FBDOs in Jinhua city, Zhejiang province, China, between 2018 and 2022. Data were collected from the national surveillance system, encompassing 63 FBDOs with 305 cases. FBD cases were defined as patients with diarrhea, vomiting, or toxic symptoms suspected to be caused by food consumption, with outbreaks referring to incidents where two or more individuals presented similar symptoms after consuming the same food. Descriptive statistics were used to analyze numerical and categorical variables, focusing on outbreak sources, pathogenic factors, and economic consequences.

RESULTS: Data analysis revealed that catering services were the most common source of FBDOs, likely due to the widespread consumption of prepared meals and potential lapses in hygiene. Approximately 50% of the outbreaks were linked to unidentified pathogens. The reported microorganisms, including Norovirus, Nontyphoidal Salmonella, and Vibrio parahaemolyticus, were among the target pathogens of the national surveillance system and are also recognized as common causes of FBDOs globally. Among the identified causes, Mushroom toxin (19.05%) was the leading factor, followed by Norovirus (12.70%) and Nontyphoidal Salmonella (6.35%). Norovirus caused the highest number of cases (52). The total economic burden of FBDOs was estimated at 228,078.74 yuan, with a median cost of 648.29 yuan per case. Two fatalities were attributed to wood ear and nitrite consumption.

DISCUSSION: The findings highlight high-risk foods and vulnerable populations, underscoring the significant public health and economic impacts of FBDOs. To address these challenges, enhanced surveillance systems, the establishment of regional laboratory centers, and the application of new diagnostic technologies are crucial. Collaborative efforts among governments, the food industry, and consumers are essential to strengthening food safety and reducing the burden of foodborne diseases.

PMID:40123815 | PMC:PMC11928438 | DOI:10.2147/IJGM.S496799

Int J Gen Med. 2025 Mar 17;18:1497-1507. doi: 10.2147/IJGM.S506941. eCollection 2025.

ABSTRACT

BACKGROUND: Coronary microvascular dysfunction (CMD) after percutaneous coronary intervention (PCI) is a critical prognostic factor in acute coronary syndrome (ACS). This study aimed to evaluate the combined predictive value of the triglyceride-glucose index (TyG) and non-HDL-C/HDL-C ratio (NHHR) for CMD in ACS patients post-PCI.

METHODS: A retrospective analysis of 542 ACS patients undergoing PCI (2021-2023) was conducted. Patients were classified into CMD (n=273) and non-CMD (n=269) groups based on CMD presence post-PCI. Baseline characteristics and biochemical markers were analyzed. TyG index and NHHR were calculated, and univariate and multivariate analyses were performed to identify predictors of CMD. ROC curves evaluated the predictive value of TyG combined with NHHR, while net reclassification index (NRI) and integrated discrimination improvement (IDI) assessed incremental predictive value.

RESULTS: CMD patients exhibited significantly higher levels of TyG and NHHR compared to non-CMD patients. Multivariate logistic regression indicated that TyG (OR = 1.89, 95% CI: 1.24-2.88, P = 0.003) and NHHR (OR = 1.34, 95% CI: 1.11-1.62, P = 0.011) were independent predictors of CMD. The combined model showed significant improvement in discrimination (C-statistic increased from 0.750 to 0.782, P < 0.001) and reclassification (NRI = 0.458, IDI = 0.051, both P < 0.001).

CONCLUSION: TyG and NHHR are novel predictors of CMD post-PCI, with combined use improving risk stratification. Given the retrospective nature of the study, further multicenter prospective research is required to validate these findings.

PMID:40123809 | PMC:PMC11928440 | DOI:10.2147/IJGM.S506941