Tag: pubmed

Womens Health (Lond). 2025 Jan-Dec;21:17455057251358011. doi: 10.1177/17455057251358011. Epub 2025 Aug 11.

ABSTRACT

BACKGROUND: Severe mental illness influences uptake of contraceptive services through a number of factors in developing countries including Uganda. The paucity of data on contraceptive use among females with severe mental illness in sub-Saharan Africa including Uganda impairs the provision of guidelines for proper interventions.

OBJECTIVES: This study aimed to determine the magnitude and factors associated with contraceptive use among females with severe mental illness attending the mental health outpatient’s clinic at Gulu Regional Referral Hospital.

DESIGN: This study used a cross-sectional design.

METHODS: This study purposely screened 377 women with severe mental illness who attended Gulu hospital between March and June 2023 for contraceptive use using a semi-structured questionnaire with questions specific to the different contraceptive methods used such as condom use, injectable use, and others. Descriptive and inferential analyses were performed to determine prevalence and factors associated with contraceptive use.

RESULTS: Out of a total of 377 participants, 331 of them ever used at least one contraceptive method after being diagnosed with severe mental illness, that is the prevalence of 87.7%. Not attending school (Adjusted Odds ratio (AOR): 0.08; 95% CI: 0.01-0.46; p = 0.005), being treated for bipolar affective disorder (AOR: 0.03; 95% CI: 0.01-0.54; p = 0.017), taking both antipsychotic and mood stabilizer (AOR: 13.84; 95% CI: 2.42-234.25; p = 0.007), ever being pregnant after being diagnosed with severe mental illness (AOR: 19.21; 95% CI: 3.40-108.34; p = 0.001), desire to have children (AOR: 9.91; 95% CI: 2.28-43.12; p = 0.002), and being aware of contraceptive use (AOR: 0.01; 95% CI: 0.01-0.29; p = 0.006) were more likely to use contraception.

CONCLUSION: Our results revealed that nearly nine-tenth women with severe mental illness use contraceptives which is associated with not attending school, being treated for bipolar affective disorder, taking both antipsychotic and mood stabilizer, ever being pregnant, desire to have children, and being aware of contraceptive use. The contraceptive facilities should be included directly in the mental health delivery for easy access, hence maximum use by women with severe mental illness.

PMID:40785454 | DOI:10.1177/17455057251358011

Womens Health (Lond). 2025 Jan-Dec;21:17455057251356806. doi: 10.1177/17455057251356806. Epub 2025 Aug 11.

ABSTRACT

BACKGROUND: Cesarean section delivery is a surgical way to safeguard maternal and neonatal health when medical risk is associated with delivering babies. Its rates have been increasing globally over the past few decades, with a significant rise recorded in low- and middle-income countries, which leads cesarean section to crucial public health concerns due to unnecessary surgical interventions and associated risks for maternal and neonatal.

OBJECTIVES: This study aims to identify the socioeconomic and demographic determinants contributing to the higher likelihood of cesarean section deliveries among Bangladeshi mothers residing in urban areas.

DESIGN: The initial survey employed a cross-sectional design to collect data.

METHODS: This research examined the Bangladesh Demographic and Health Survey (BDHS) dataset to identify the cesarean section among urban mothers. It utilized the chi-square test to measure associations, the Boruta algorithm, and a multivariable logistic regression model with a forest plot.

RESULTS: The study pointed out that urban mothers belonging in richer and richest families (adjusted odds ratio: 2.83, 95% confidence interval: 1.88-4.26 and adjusted odds ratio: 4.79, 95% confidence interval: 3.13-7.34) and higher educational attainment (adjusted odds ratio: 1.89, 95% confidence interval: 1.20-2.99) are significantly correlated with cesarean section. Divisional differences are also robust with the significance of Sylhet (adjusted odds ratio: 0.23, 95% confidence interval: 0.12-0.47) and Chottogram (adjusted odds ratio: 0.50, 95% confidence interval: 0.30-0.83) divisions. Media exposure (adjusted odds ratio: 1.54, 95% confidence interval: 1.27-1.87) and mothers gave birth at the age 20-24 and 25-34 (adjusted odds ratio: 1.67, 95% confidence interval: 1.31-2.14 and adjusted odds ratio: 3.15, 95% confidence interval: 2.03-4.89) are also highly significantly associated with the likelihood of cesarean section. Moreover, mothers working status (adjusted odds ratio: 0.53, 95% confidence interval: 0.43-0.65) and religion (adjusted odds ratio: 2.33, 95% confidence interval: 1.60-3.38) are also correlated with cesarean section.

CONCLUSION: The study reveals socioeconomic and sociodemographic reasons associated with the increase in cesarean section rates among urban mothers in Bangladesh, highlighting the need for targeted interventions to mitigate cesarean section rates and improve maternal and neonatal health.

PMID:40785446 | DOI:10.1177/17455057251356806

Ann Indian Acad Neurol. 2025 Aug 8. doi: 10.4103/aian.aian_225_25. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: The time taken to transport patients for thrombolytic therapy in stroke cases remains alarmingly high, compromising potential positive outcomes. Addressing these delays can enhance prehospital care and improve patient prognoses.

AIM: This study aimed to identify factors causing delays in treating acute stroke patients at a tertiary care hospital in southern India, to inform better practices and expedite care.

METHODS: Caregivers of ischemic stroke patients were interviewed about delays. Patients were divided into two groups: those who arrived within the critical four-and-a-half-hour window (Group A) and those who arrived later (Group B). Data collected included distance from home to hospital, transportation options, and mode of transport. A comparative analysis was performed between patients from stroke-ready facilities versus others, with data analyzed using SPSS software.

RESULTS: The study included 594 patients, with 73.4% arriving outside the recommended window. Women represented one-third of the population overall and 20% in Group A. Younger patients arrived sooner (P < 0.0001). The main reason for delays was a lack of awareness of stroke symptoms (53.2%), followed by initial care sought at non-stroke-ready hospitals (23%). Use of ambulances and vehicle ownership significantly correlated with faster arrivals (P < 0.0001), while distance to the hospital did not significantly affect timeliness. Though most of the variables showed statistical significance between those coming to the hospital within and outside the four-and-a-half hour window with univariate analysis, none of the variables showed a significant association when subjected to logistic regression.

CONCLUSIONS: Delays in stroke treatment are a major concern, linked to factors like age, gender, and transportation issues. No single factor independently predicted early hospital arrival. To improve outcomes, we need strategies that enhance public education, symptom recognition, and transportation-especially for vulnerable groups like women and the elderly.

PMID:40785019 | DOI:10.4103/aian.aian_225_25

Sci Rep. 2025 Aug 10;15(1):29234. doi: 10.1038/s41598-025-15188-1.

ABSTRACT

Alprazolam benzodiazepine misuse is increasingly a public health concern, evidenced by rising cases of overdose and toxicity. Timely and accurate diagnosis is crucial for effective emergency room treatment. This study investigates the use of Fourier Transform Infrared (FTIR) spectroscopy as a rapid diagnostic tool for assessing alprazolam toxicity using saliva samples. Saliva samples were collected from 30 individuals, including healthy subjects and patients with confirmed alprazolam poisoning. FTIR spectroscopy in the form of Attenuated Total Reflectance (ATR) was used to study the spectral profiles of the samples. Statistical analyses, such as Gaussian peak fitting and Receiver Operating Characteristic (ROC) tests, were carried out to assess the diagnostic ability of the found spectral features. The designed protocol was subsequently applied to 55 additional saliva samples obtained from emergency room patients with suspected alprazolam poisoning, some of whom may have also used other drugs, but without confirmed multi-drug toxicity. Spectral differences between the two groups were evident, particularly in the 1200-1400 cm⁻¹ and 3000-3600 cm⁻¹ regions. ROC analysis demonstrated high diagnostic accuracy, differentiating healthy subjects from poisoned ones with 90% classification accuracy at 1200-1400 cm⁻¹ and perfect separation with 100% sensitivity and specificity at 3000-3600 cm⁻¹. A Fisher’s exact test confirmed the diagnostic utility of this method for identifying alprazolam-poisoned individuals, yielding a p-value of less than 0.0002. The results affirm FTIR spectroscopy’s potential as a precise, non-invasive diagnostic tool for alprazolam intoxication. Its ability to quickly distinguish between toxic and non-toxic levels is crucial for improving patient care in emergencies. Moreover, its application was effective even in cases with potential co-medication, provided that alprazolam was the primary suspected agent. FTIR spectroscopy is an effective method for diagnosing alprazolam toxicity in saliva samples, offering a quick, efficient, and non-invasive alternative to traditional techniques. This study opens the door for further research on FTIR in toxicological screening, with the potential to transform clinical practices in drug overdose management.

PMID:40785013 | DOI:10.1038/s41598-025-15188-1

Brain Imaging Behav. 2025 Aug 11. doi: 10.1007/s11682-025-01046-1. Online ahead of print.

ABSTRACT

BACKGROUND: The neurobiological mechanism underlying adolescent borderline personality disorder (BPD) remains unclear. This study aimed to assess white matter (WM) microstructural abnormalities associated with emotional dysfunction and childhood trauma in adolescents with BPD.

METHODS: This study enrolled 53 adolescents aged 12-17 years with BPD and 39 healthy controls (HC). Radial diffusivity (RD) and axial diffusivity (AD) were generated using Tract-Based Spatial Statistics (TBSS) analysis of the diffusion tensor imaging (DTI) data. Correlation analysis was conducted to assess the relationship of the DTI parameters with non-suicidal self-injurious behavior (NSSI) and childhood trauma in adolescents with BPD.

RESULTS: Adolescents with BPD had lower AD values in the splenium of the corpus callosum, left anterior corona radiata and left external capsule, but higher RD values in the genu of the corpus callosum, body of the corpus callosum, right anterior corona radiata, and right uncinate fasciculus as compared to the HC group (p < 0.05, 5000 permutations). Increased RD values in the body of corpus callosum and right uncinate fasciculus were positively correlated with the NSSI score (p < 0.05). Increased RD value in the right anterior corona radiata was positively correlated with childhood trauma (p < 0.05).

CONCLUSIONS: This study identified alterations within the cortical-limbic system in adolescents with BPD, which was correlated with NSSI and childhood trauma. WM diffusivity parameters may serve as potential neuroimaging biomarkers in adolescents with BPD.

PMID:40785006 | DOI:10.1007/s11682-025-01046-1

J Med Ultrason (2001). 2025 Aug 11. doi: 10.1007/s10396-025-01557-w. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to objectively and quantitatively analyze fetal motor behavior using DeepLabCut (DLC), a markerless posture estimation tool based on deep learning, applied to four-dimensional ultrasound (4DUS) data collected during the second trimester. We propose a novel clinical method for precise assessment of fetal neurodevelopment.

METHODS: Fifty 4DUS video recordings of normal singleton fetuses aged 12 to 22 gestational weeks were analyzed. Eight fetal joints were manually labeled in 2% of each video to train a customized DLC model. The model’s accuracy was evaluated using likelihood scores. Intra- and inter-rater reliability of manual labeling were assessed using intraclass correlation coefficients (ICC). Angular velocity time series derived from joint coordinates were analyzed to quantify fetal movement patterns and developmental coordination.

RESULTS: Manual labeling demonstrated excellent reproducibility (inter-rater ICC = 0.990, intra-rater ICC = 0.961). The trained DLC model achieved a mean likelihood score of 0.960, confirming high tracking accuracy. Kinematic analysis revealed developmental trends: localized rapid limb movements were common at 12-13 weeks; movements became more coordinated and systemic by 18-20 weeks, reflecting advancing neuromuscular maturation. Although a modest increase in tracking accuracy was observed with gestational age, this trend did not reach statistical significance (p < 0.001).

CONCLUSION: DLC enables precise quantitative analysis of fetal motor behavior from 4DUS recordings. This AI-driven approach offers a promising, noninvasive alternative to conventional qualitative assessments, providing detailed insights into early fetal neurodevelopmental trajectories and potential early screening for neurodevelopmental disorders.

PMID:40785001 | DOI:10.1007/s10396-025-01557-w

J Med Ultrason (2001). 2025 Aug 11. doi: 10.1007/s10396-025-01558-9. Online ahead of print.

ABSTRACT

We aimed to compare the outcomes of endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) between elderly and non-elderly patients utilizing a systematic review and meta-analysis. Repositories of PubMed, Embase, Scopus, and Web of Science were searched up to 25 January 2025 for all comparative studies providing data on the adequacy of the sample obtained from the procedure, procedure duration, and complications. Random-effects meta-analysis was conducted. Six studies were eligible. Meta-analysis showed no statistically significant difference in procedure duration, inadequate sampling, and all complications between elderly and non-elderly groups. There was no statistically significant difference between elderly and non-elderly for specific complications like bleeding, cardiovascular events, and hypoxemia. Subgroup analysis based on the definition of elderly did not change the results of inadequate sampling and all complications. Descriptive analysis of the diagnostic accuracy of EBUS-TBNA for malignant lesions showed no difference between the two groups. EBUS-TBNA seems to have similar diagnostic yield and complication rates in the elderly as compared to the non-elderly population. More studies are needed to improve the quality of evidence.

PMID:40785000 | DOI:10.1007/s10396-025-01558-9

Ann Surg Oncol. 2025 Aug 10. doi: 10.1245/s10434-025-18000-6. Online ahead of print.

ABSTRACT

BACKGROUND: Despite treatment advancements, esophageal cancer survival remains poor due to high recurrence rates. Early detection of recurrence may allow for timely treatment and improved outcomes. This study evaluated recurrence patterns and detection methods using different imaging surveillance strategies after esophagectomy.

METHODS: A retrospective study reviewed patients who underwent esophagectomy for cancer at a high-volume National Cancer Institute (NCI)-designated comprehensive cancer center from 2007 to 2019. Postoperative surveillance followed a protocol based on the CROSS trial incorporating routine computed tomography (CT) imaging and clinical exams. Statistical analyses included independent t tests for continuous variables and chi-square tests for categorical variables. Times to recurrence and survival were calculated using Kaplan-Meier and compared by the log-rank test. Multivariate analysis used binary logistic regression.

RESULTS: Among 368 patients, 302 (82.1 %) received neoadjuvant chemoradiation. Recurrence occurred for 140 (38 %) patients, with more than 80 % of the recurrences detected within 2 years after surgery. In a multivariate analysis, lymphovascular invasion and clinical stage 3 disease were associated with recurrence. Clinically driven imaging discovered 61 (43.6 %) of the 140 recurrence cases, whereas routine surveillance imaging identified 77 (55 %) of the cases. The median time to recurrence was 9.4 months. The patients whose recurrence was detected through routine surveillance had a longer survival than those whose recurrence was detected by clinically driven imaging (median survival, 29.3 vs 17.7 months, respectively; p < 0.05).

CONCLUSIONS: The incidence of early recurrence is high after trimodality therapy (CROSS regimen) for esophageal cancer. Routine imaging surveillance combined with clinical examination as a surveillance protocol is necessary for early detection and timely treatment.

PMID:40784997 | DOI:10.1245/s10434-025-18000-6

Cell Tissue Bank. 2025 Aug 11;26(3):34. doi: 10.1007/s10561-025-10182-3.

ABSTRACT

The study explores the effects of the COVID-19 pandemic on the Musculoskeletal Tissue Bank (MSTB) in Milan, with a particular focus on tissue harvesting and its subsequent use in surgical procedures. A retrospective descriptive epidemiological analysis compared data from the pre-pandemic period (2018-2019) with that of the pandemic period (2020-2022), revealing a 24.8% reduction in tissue retrievals during the pandemic. Although there was a decrease in the number of eligible donors not collected (from 93 to 67, from 36.05 to 34.54%), this reduction was not statistically significant. The decline in tissue retrievals was due to decreased non-COVID-related pathologies, a lower number of potential donors from reduced accidents and increase in COVID-positive deaths. However, the MSTB successfully met tissue demands throughout this period. Notably, the reduction in retrievals at the MSTB was lower than national averages (- 24.8 vs. – 47.5%). Logistic regression analysis showed no significant organizational issues in donor collection. Despite the challenges, the MSTB remained resilient and adaptable, continuing its essential services. This underscores the broader impact of the pandemic on healthcare systems and emphasizes the importance of a flexible healthcare infrastructure during public health emergencies.

PMID:40784995 | DOI:10.1007/s10561-025-10182-3

Sci Rep. 2025 Aug 10;15(1):29244. doi: 10.1038/s41598-025-12267-1.

ABSTRACT

The integration of AI simulation models within smart electrical prosthetic systems represents a significant advancement in disability disease diagnosis. However, the selection and evaluation of these AI models interpret some multi-criteria decision-making dilemmas because of the presence of uncertainty and bipolarity (positive and negative aspects) of the selection criteria. Current literature lacks the selection and evaluation of AI simulation models that consider both bipolarity and uncertainty of the criteria, while prevailing Choquet integral aggregation operators despite their strong capabilities for handling information relationships, fail to efficiently process bipolar fuzzy information. The existence of this limitation makes it challenging to identify element interactions and non-linear relationships in uncertain environments containing both positive and negative aspects. To overcome these gaps, first, we develop two operators that are the bipolar fuzzy Choquet integral averaging and bipolar fuzzy Choquet integral geometric operators that uniquely integrate dual aspects (bipolarity) with criterion interaction modeling capabilities, fundamentally differing from traditional fuzzy approaches that cannot simultaneously process dual aspects of criterion. Secondly, we design a new multi-criteria decision-making approach using these operators to assess AI simulation models for prosthetic systems, since the criteria involved such as diagnostic accuracy, computational efficiency, and system reliability, have both positive and negative aspects that need to be considered together. Our method was applied in detail to select AI simulation models for smart electrical prosthetic systems and compared with some prevailing methods and standard Choquet integral approaches. This showed that our method is more precise and produces better evaluation results. It introduces a new theoretical basis for bipolar fuzzy Choquet integral aggregation and offers medical professionals a reliable way to pick the best AI simulation models for important prosthetic applications that influence patient outcomes and the functioning of prosthetics.

PMID:40784993 | DOI:10.1038/s41598-025-12267-1