Tag: pubmed

Nurs Crit Care. 2025 Sep;30(5):e70145. doi: 10.1111/nicc.70145.

ABSTRACT

BACKGROUND: Healthcare contributes 4%-5% to global carbon emissions. The intensive care unit (ICU) produces three times more carbon emissions per patient-day than that of the general ward. Over-ordering of laboratory investigations contributes to the carbon footprint in the ICU.

AIM: To evaluate the carbon footprint arising from laboratory investigations in the ICU over an 8-month period.

STUDY DESIGN: We conducted a retrospective single-centre clinical practice baseline evaluation within a Sustainability in Quality Improvement (SusQI) project in the Surgical ICU in Singapore General Hospital. The number and types of laboratory investigations ordered for all patients admitted from May to December 2023 were extracted from the electronic medical records system. Existing process-based Life Cycle Assessment (LCA) data were used to determine the carbon footprint of the investigations ordered.

RESULTS: In total, 285 patients were admitted to the ICU, amounting to 1464 patient-days. An average of 12.3 investigations were ordered per patient-day. The total carbon emissions over this period were 1560 kg carbon dioxide equivalent (kgCO₂e) or an average of 1.07 kgCO₂e per patient-day. The most common investigation ordered was urea, electrolytes and creatinine (UECr), while the liver panel ± gamma-glutamyl transpeptidase (LFT ± GGT) generated the highest total carbon emissions (337.7 kgCO₂e). A total of 20.7% of investigations lacked available LCA data.

CONCLUSION: Our study quantified the carbon footprint contributed by laboratory investigations in ICU from available LCA data. Although laboratory investigations contribute a small proportion of the total carbon footprint in the ICU, it is an area that can be targeted to reduce unnecessary carbon footprint as part of a holistic approach to environmental sustainability.

RELEVANCE TO CLINICAL PRACTICE: This study highlights the environmental impact of laboratory investigations. Clinicians should be aware of this fact and avoid unnecessary laboratory investigations.

PMID:40785569 | DOI:10.1111/nicc.70145

Tijdschr Psychiatr. 2025;67(6):327-332.

ABSTRACT

BACKGROUND: In relationships where partner violence occurs, the agreement between partners about the violence is often low. This can have various causes and implications.

AIM: To investigate what partners in outpatient forensic treatment for intimate partner violence report about the occurring violence and if indications for psychopathology are related to differences in reporting.

METHOD: Seventy couples, of which the man had entered intimate partner violence treatment, completed questionnaires about the severity and frequency of different types of violence by themselves and their partners and psychopathology.

RESULTS: There was poor to moderate agreement between intimate partner violence reports of women and men. Women reported more violence than their partners attributed to them, men less. There was more agreement about violence by women than about violence by men. In addition, some indications of psychopathology appear to be moderately or weakly positively correlated with differences in reporting.

CONCLUSION: It’s valuable to gather information from both partners regarding any violence involved and to explore how differences in their accounts might impact (both the content and approach of) the treatment.

PMID:40785562

Circulation. 2025 Aug 11. doi: 10.1161/CIRCULATIONAHA.124.073592. Online ahead of print.

ABSTRACT

BACKGROUND: Stalking is one of the most common forms of interpersonal violence, with nearly 1 in 3 women experiencing it in their lifetime. Restraining orders are a legal remedy aimed at protecting women who experience the most severe forms of stalking and interpersonal violence. Previous work has shown associations between experiences of violence and cardiovascular health among women, but little is known about the link between being stalked or obtaining a restraining order and risk of cardiovascular disease (CVD).

METHODS: We examined whether being stalked or obtaining a restraining order considered an indicator of severe violence) were associated with a greater risk of incident CVD over 20 years in the Nurses’ Health Study II cohort. We conducted Cox proportional hazards regression models among women free of CVD in 2001 when their exposure status was ascertained (n=66 270). CVD events included self-reported myocardial infarction or stroke through 2021. Analyses were adjusted for a range of covariates. Secondary analyses included examining stroke and myocardial infarction separately and confirmed (through medical records) or corroborated cases of CVD as the outcomes.

RESULTS: The mean (SD) age in our sample was 46.3 (4.7) years in 2001. Overall, 7721 women (11.7%) reported experiencing stalking, and 3686 women (5.6%) reported obtaining a restraining order. Over follow-up (median [interquartile range] 19.9 [19.5, 20.0] years), a total of 1879 women (2.8%) reported new-onset CVD. Compared with women who had not been stalked, women who reported experiencing stalking had an increased risk of self-reported incident CVD (hazard ratio, 1.41 [95% CI, 1.24-1.60]), adjusting for sociodemographic and childhood or family factors. Women who had, versus had not, obtained a restraining order also had an increased risk of self-reported incident CVD (adjusted hazard ratio, 1.70 [95% CI,1.44-1.98]). Results were similar when considering self-reported myocardial infarction and stroke as separate outcomes and confirmed or corroborated CVD. Results were slightly attenuated but remained statistically significant when adjusted for health behaviors, medications, health conditions, childhood abuse, and depressive symptoms.

CONCLUSIONS: Experiences of stalking and obtaining a restraining order are both associated with an increased risk of developing CVD in women. Common experiences of violence among women may affect cardiovascular health and warrant consideration alongside more traditional risk factors.

PMID:40785542 | DOI:10.1161/CIRCULATIONAHA.124.073592

ESC Heart Fail. 2025 Aug 11. doi: 10.1002/ehf2.15390. Online ahead of print.

ABSTRACT

BACKGROUND: Nutritional status is a critical determinant of clinical outcomes in patients with chronic heart failure (CHF), potentially contributing to adverse prognosis and suboptimal therapeutic response. Despite growing interest, the interplay between malnutrition and frailty syndrome (FS) in the CHF population remains inadequately elucidated.

AIMS: The study aims to evaluate the association between malnutrition risk and the presence of FS in individuals hospitalized with CHF.

METHODS: A total of 200 patients (mean age: 72.28 years) hospitalized due to CHF were enrolled. Data collection included retrospective analysis of medical records and application of validated instruments: the Mini Nutritional Assessment (MNA) for nutritional evaluation and the Fried phenotype criteria for frailty assessment.

RESULTS: Based on MNA, 63.5% of participants demonstrated normal nutritional status, 35.0% were at risk of malnutrition and 1.5% were malnourished (mean MNA score: 24.25). According to the Fried phenotype, 35% were classified as pre-frail and 65% as frail (mean frailty score: 2.67). A statistically significant association was identified between MNA score and frailty status (P < 0.05), with the highest prevalence of frailty observed in malnourished individuals (P = 0.002). No significant correlations were found between frailty and anthropometric parameters such as calf circumference (P = 0.17), arm circumference (P = 0.687) or body mass index (BMI) (P = 0.643).

CONCLUSIONS: These findings highlight the clinical importance of routine, comprehensive nutritional screening in patients with CHF. Early identification and management of malnutrition may play a pivotal role in mitigating frailty and enhancing clinical outcomes in this high-risk population.

PMID:40785522 | DOI:10.1002/ehf2.15390

Nanoscale Horiz. 2025 Aug 11. doi: 10.1039/d5nh00021a. Online ahead of print.

ABSTRACT

The effects of quantum confinement on the energy-related properties of nanoscale materials and structures are critical for understanding their electronic, optical, and thermal behaviors. This study investigates these effects through a finite-size statistical mechanics framework, integrating theoretical analysis with experimental validation. By examining key material systems, this work provides insights into the mechanisms governing energy-related behaviors at the nanoscale, with implications for advanced applications in energy storage, conversion, and photonics.

PMID:40785520 | DOI:10.1039/d5nh00021a

J Glob Health. 2025 Aug 11;15:04232. doi: 10.7189/jogh.15.04232.

ABSTRACT

BACKGROUND: Interventions using mobile phones, otherwise known as mHealth interventions, are increasingly being used in low- and middle-income countries to remind families about scheduled child immunisations. Despite this, few studies examined impact on zero-dose children – those who failed to receive a single dose of a routine vaccine. As disparities in mobile phone ownership may limit the effectiveness of mHealth interventions, we assessed associations between mobile phone ownership, gender, wealth, residence, and zero-dose and modelled their potential impact for reaching unvaccinated children.

METHODS: We analysed 70 nationally representative surveys with data on immunisations and mobile phone ownership by households and mothers, and correlated ownership with household wealth and place of residence. We performed analyses at the individual child level and pooled across all countries weighted by national populations. We modelled the mHealth interventions’ potential impact on zero-dose prevalence by estimating how many unvaccinated children are reachable via mobile phones.

RESULTS: The surveys included 163 527 children aged 12-23 months, with 13.4% being zero-dose. Among them, 34% of mothers and 73% of households had a mobile phone, compared to 60% and 89% for vaccinated children. Mobile phone ownership by mothers ranged from 32% in the poorest to 86% in the wealthiest quintile. A hypothetical 100% effective intervention using household mobile phones would reduce zero-dose prevalence from 13% to 4%, while one using similar effectiveness assumptions for mothers’ phones would reduce national prevalence to 10%. Interventions with effectiveness ranging from 10% to 50% would lead to smaller impact levels. The largest impact is expected in countries like Guinea and Cote d’Ivoire, where both zero-dose prevalence and mobile phone ownership are high.

CONCLUSIONS: The potential impact of mHealth interventions for reaching zero-dose children may be limited by mobile phone ownership among mothers and families, particularly among the poor, where we find the greatest number of unvaccinated children.

PMID:40785513 | DOI:10.7189/jogh.15.04232

Cancer Sci. 2025 Aug 11. doi: 10.1111/cas.70170. Online ahead of print.

ABSTRACT

Although mTOR signaling plays a key role in acute myeloid leukemia (AML), mTOR inhibitors have shown limited efficacy against AML in clinical trials. In this study, we found that the anti-leukemic effect of mTOR inhibition was mediated in part through the TP53 pathway. mTOR inhibition by rapamycin and TP53 activation by DS-5272 collaboratively induced the downregulation of MYC and MCL1 partly through miR-34a, thereby inducing cell cycle arrest and apoptosis in AML cells. Joint non-negative matrix factorization (JNMF) and statistical regression analysis using public AML databases revealed that monocytic AMLs with distinctive gene expression profiles were highly sensitive to mTOR inhibition, leading to the generation of an 11-gene score (Rapa-11) to predict the rapamycin sensitivity of each monocytic AML. Consistent with our in silico prediction, mouse AML cells expressing MLL-AF9, the monocytic AML with a low Rapa-11 score, were highly sensitive to rapamycin, whereas those expressing RUNX1-ETO or SETBP1/ASXL1 mutations were not. Co-treatment with rapamycin and DS-5272 had a dramatic in vivo effect on MLL-AF9-driven AML, curing 85% of the leukemic mice. Thus, machine learning-based predictive approaches identified monocytic AML with wild-type TP53 and low Rapa-11 score as a rapamycin-sensitive AML subtype and an ideal target for mTOR/p53 co-targeting therapy.

PMID:40785506 | DOI:10.1111/cas.70170

Technol Cancer Res Treat. 2025 Jan-Dec;24:15330338251365334. doi: 10.1177/15330338251365334. Epub 2025 Aug 11.

ABSTRACT

IntroductionSCINTIX^® therapy, a form of biology-guided radiotherapy using real-time positron emission tomography (PET) imaging on the RefleXion^® X1 platform, recently received FDA clearance for FDG-guided treatment of lung and bone tumors. This study evaluates the feasibility and dosimetric quality of Biology-Guided Radiotherapy (BgRT) plans for FDG-avid lesions in anatomical sites beyond current indications using processed diagnostic PET (dPET) images.MethodsEleven previously treated FDG-avid lesions in ten patients (sites: liver, head and neck, pancreas, kidney, pelvic/abdominal nodes) were retrospectively analyzed. dPET images were processed to emulate RefleXion X1 PET characteristics. BgRT plans were generated using a non-clinical version of the RefleXion treatment planning system, delivering stereotactic body radiation therapy-level doses (48Gy/3fx for liver, 40Gy/5fx for other sites). Plan deliverability was evaluated based on normalized target signal (NTS >2.7) and activity concentration (AC > 5 kBq/ml). Plans were categorized based on the presence of dose-limiting organs at risk (OAR) constraints. Dosimetric parameters were assessed according to institutional standards. Statistical analyses examined relationships between dPET standardized uptake value (SUV), PET-derived parameters, planning target volume (PTV) characteristics, and plan complexity.ResultsBgRT plans were successfully generated for all lesions. All met the NTS threshold (mean = 9.3); 72.7% met the AC goal (mean = 12.1 kBq/ml). Among cases with dPET SUV > 6, 87.5% met AC criterion, supporting this threshold as a reasonable selection criterion. Plans without dose-limiting OARs (n = 6) achieved higher PTV coverage (V100%=94.4%, conformity index (CI) = 1.08) compared to plans with OAR constraints (n = 5, V100%=78.0%, CI = 1.4). All plans were deemed clinically acceptable despite observed heterogeneity within target regions. MLC modulation intensity correlated strongly with target volume (r = 0.907) and superior-inferior extent (r = 0.896) rather than OAR proximity.ConclusionBgRT planning using processed dPET is feasible for non-lung/bone FDG-avid lesions. SUV > 6 may serve as a reasonable threshold, though feasibility is affected by tumor location, FDG background, and nearby critical structures. Findings support clinical potential of SCINTIX expansion into new anatomical sites.

PMID:40785471 | DOI:10.1177/15330338251365334

Small. 2025 Aug 11:e05452. doi: 10.1002/smll.202505452. Online ahead of print.

ABSTRACT

Scanning tunneling microscopy (STM) studies have shown that protein wires based on the consensus tetratricopetide repeat (CTPR) conduct with an electrical resistance proportional to length of the protein, consistent with long-range hopping transport along the long axis of the protein. However, the attempts to measure similar currents across proteins mounted in fixed-gap devices have not been successful. Here, the study reports conducting atomic force microscopy studies of CTPR8 and CTPR4, ≈8 and 4 nm in length, finding that substantial contact force (>50 nN) is required to observe conduction in CTPR8. Scrape-tests indicate that the probe penetrates the film by ≈1 nm at this force. Importantly, electrical contacts that resemble the STM data are rare-approximately 1% of all contacts. STM reports only successful contacts, so it does not predict statistically how the proteins will behave in a fixed junction.

PMID:40785470 | DOI:10.1002/smll.202505452

Curr Med Res Opin. 2025 Aug 11:1-22. doi: 10.1080/03007995.2025.2544596. Online ahead of print.

ABSTRACT

OBJECTIVE: To estimate preferences of adolescents and caregivers of children with food allergies (FA) for food allergy for attributes for treatments intended to prevent exposure-induced severe reactions and to examine how these vary by clinical and demographic factors.

METHODS: A discrete choice experiment (DCE) was conducted between May and June 2024 among US-resident individuals, aged 13-17 years or caregivers of a child with FA aged ≤12 years, self-reporting physician-diagnosed FA. The survey comprised treatment-attribute focused DCE choice sets; the Intolerance of Uncertainty─12 Scale (IUS-12); the Food Allergy Independent Measure (FAIM); and clinical/demographic questions. Conditional logistic regression analyses were conducted overall and among subgroups and presented as odds ratios (ORs) with 95% confidence intervals (CIs). Relative importance of attributes was also calculated.

RESULTS: Participants were adolescents (n = 73, mean age 15.9 years) and caregivers (n = 228, mean age 37.1 years). Overall, treatment attributes associated with statistically significant odds for preferring a treatment included a 95% relative reduction in moderate-to-severe allergic reaction risk vs no reduction (p < 0.001); oral administration over subcutaneous (p < 0.001); administration in a home vs clinical setting (p < 0.05); less frequent vs daily administration (every two weeks: p < 0.001; every four weeks: p < 0.001). Respondents were disinclined to prefer treatment attributes when risk of gastrointestinal symptoms (p < 0.001) or anaphylaxis (p < 0.001) increased. Efficacy (75% decrease in relative risk of a moderate-to-severe allergic reaction) was the top ranked attribute (OR = 1.61 (1.49, 1.75).

CONCLUSION: Overall, respondents indicated significant preferences for more efficacious, safer, and convenient (oral, at-home, and less frequent) treatments. Treatment efficacy was the most highly ranked treatment feature.

PMID:40785461 | DOI:10.1080/03007995.2025.2544596