Tag: pubmed

AIDS Res Ther. 2025 Nov 11;22(1):121. doi: 10.1186/s12981-025-00818-5.

ABSTRACT

BACKGROUND: Common mental disorders (CMDs) and alcohol use disorder (AUD) are significant barriers to effective antiretroviral therapy (ART) adherence among people living with HIV (PLHIV), especially in sub-Saharan Africa. Suboptimal adherence to ART contributes to increased morbidity and mortality in this population. CMD and AUD frequently co-occur, with alcohol often serving as a maladaptive coping mechanism for psychological distress, thereby compounding the negative impact on treatment outcomes. Understanding the mediating role of AUD in the relationship between CMD and ART adherence is essential for designing targeted interventions aimed at improving HIV treatment success.

METHODS: A hospital-based cross-sectional analytical study was conducted between August and October 2023 in Moshi Municipality, Kilimanjaro. A multistage systematic sampling technique was used to recruit participants. Data were collected using structured sociodemographic and interviewer-administered, validated assessment tools. Statistical analyses included one-way ANOVA for continuous variables, chi-square tests for categorical variables, and logistic regression to estimate odds ratios (ORs) with 95% confidence intervals. Mediation analysis was conducted using R version 4.4.2, with significance set at p < 0.05.

RESULTS: The study involved 532 participants, with an average age of 46.6 ± 13.3 years; 71.4% were female. The prevalence of depression, anxiety, and ART non-adherence was 14.8%, 12.4%, and 10.7%, respectively. Among men, depression and anxiety were both significantly associated with ART non-adherence in model1 and 2 respectively (depression OR = 5.38, 95% CI: 1.80-16.08; OR = 5.10, 95% CI: 1.55-16.82. Anxiety OR = 5.12, 95% CI: 1.63-16.12; OR = 5.30, 95% CI: 1.48-18.92). Among women, only depression significantly increased ART non-adherence in all models, respectively (OR = 2.50, 95% CI: 1.16-5.36; OR = 2.51, 95% CI: 1.13-5.59; OR = 3.26, 95% CI: 1.34-7.95). Alcohol use disorder significantly mediated the relationship between depression and ART non-adherence more substantially than alcohol use alone, with mediation effects up to 45.5%.

CONCLUSION: Depression is significantly associated with ART non-adherence in both genders, and AUD is a key mediator, especially among male participants. These data support the integration of mental health and substance use care into HIV services, with attention to gender-specific risk factors.

PMID:41219929 | DOI:10.1186/s12981-025-00818-5

BMC Nephrol. 2025 Nov 11;26(1):626. doi: 10.1186/s12882-025-04513-5.

ABSTRACT

Living donor (LD) kidney transplantation is the optimal treatment for elective end-stage kidney disease (ESKD) patients. However, concerns about the long-term health risks for donors, including hypertension, remain incompletely defined. We aimed to determine the incidence and predictors of hypertension after kidney donation and to assess its association with estimated glomerular filtration rate (eGFR) trajectories over time. We conducted a retrospective cohort study of 300 LD who underwent nephrectomy between 1998 and 2020, after excluding those with pre-donation hypertension. Donors were followed for a mean of 6.4 ± 4.5 years The primary outcome was the development of de novo hypertension, defined by office blood pressure measurements exceeding 140/90 mmHg or initiation of antihypertensive therapy. Predictors of post-donation hypertension were evaluated using Cox regression analysis, and the association with longitudinal changes in eGFR was assessed using linear mixed-effects models. Hypertension developed in 30% of the cohort, with an incidence of 21% at 5 years and over 50% at 15 years post-donation. Higher body mass index (BMI) (HR 1.074 per Kg/m2, P = 0.039), dyslipidemia (HR 1.959, P = 0.035), and elevated systolic (HR 1.030 per mmHg, P = 0.009) and diastolic blood pressure (HR 1.036 per mmHg, P = 0.039) were independently associated with an increased risk of hypertension post-donation. The development of hypertension was associated with a modest but statistically significant decline in eGFR over time (-0.03 vs. +0.40 ml/min/year, P = 0.026). No donor progressed to ESKD during follow-up and cardiovascular events were rare in the cohort. In conclusion, hypertension was a frequent complication post-donation in this Southern European cohort and was associated with modifiable risk factors, as higher BMI and dyslipidemia. While the associated decline in renal function over time is modest, these findings highlight the importance of long-term monitoring and proactive management of cardiovascular risk factors in living kidney donors. These results should inform pre-donation counseling, post-donation follow-up strategies, and further research into interventions that may mitigate hypertension risk while preserving donor health.

PMID:41219926 | DOI:10.1186/s12882-025-04513-5

BMC Med Educ. 2025 Nov 11;25(1):1577. doi: 10.1186/s12909-025-08181-9.

ABSTRACT

BACKGROUND: Although artificial intelligence (AI) is increasingly shaping modern healthcare, its integration into dental education remains underexplored-particularly with regard to how students’ readiness and anxiety toward AI evolve throughout their academic progression. Existing studies primarily focus on medical cohorts, leaving a critical knowledge gap in understanding how dental students across different years perceive and adapt to these technological transformations. This study aims to address this gap by assessing both cognitive readiness and emotional responses to AI among current and future dental professionals.

METHODS: A cross-sectional survey was conducted with 420 participants, including first- to fifth-year dental students and recent graduates, using purposive sampling. Two validated instruments were employed: the Medical Artificial Intelligence Readiness Scale and the Artificial Intelligence Anxiety Scale. Descriptive statistics and one-way ANOVA were used to analyze differences across academic year, gender, age, AI familiarity, and prior training experience.

RESULTS: Significant differences in AI readiness were observed based on academic year, with second-year students demonstrating the highest readiness across subdomains (Cognition, Ability, Vision), while fifth-year students scored the lowest. Participants with prior AI-related knowledge or training consistently showed higher readiness and lower anxiety levels, although the reduction in anxiety was not always statistically significant. Gender-based analysis revealed that female participants reported higher AI anxiety in specific subdomains, including Learning and Surveillance, while overall readiness scores did not significantly differ by gender or age.

CONCLUSION: Findings emphasize the need for early, continuous, and practice-oriented AI education in dental curricula. Structured exposure to AI-related concepts not only enhances competence but may also reduce anxiety. Tailoring pedagogical approaches to different stages of training could foster a more balanced integration of AI in dentistry-addressing both technological proficiency and emotional resilience.

PMID:41219925 | DOI:10.1186/s12909-025-08181-9

World J Surg Oncol. 2025 Nov 11;23(1):429. doi: 10.1186/s12957-025-04080-x.

ABSTRACT

OBJECTIVE: Retrospective analysis of the safety and efficacy of radical right hemicolectomy combined with hyperthermic intraperitoneal chemotherapy in the treatment of appendiceal mucinous tumors.

METHOD: Data were extracted from inpatient and outpatient medical records. Using R software (version 4.3.2), we collected all cases of appendiceal mucinous tumors treated with HIPEC at Jingzhou Hospital Affiliated to Yangtze University from February 2015 to February 2022 for statistical analysis and visualization. Survival analysis was performed using the ‘survival’ package, survival curves were plotted with ‘survminer’, and boxplots and percentage bar charts were generated using ‘ggplot2’.

RESULT: This study included 61 patients with appendiceal mucinous tumors, of whom 31 received postoperative hyperthermic intraperitoneal chemotherapy (HIPEC) and 30 did not. At 2 years, recurrence occurred in 12.9% of the HIPEC group versus 46.7% of the control group (P = 0.004). The hazard ratio (HR) for recurrence-free survival (RFS) was 0.21 (95% CI: 0.07-0.63; P = 0.002). Overall survival (OS) at 2 years was 93.5% with HIPEC and 80.0% without, a difference that did not reach statistical significance (P = 0.147). Postoperative complication rates and baseline characteristics were comparable between groups.

CONCLUSION: Our findings demonstrate that radical right hemicolectomy combined with HIPEC significantly reduces postoperative recurrence rates in AMN patients while showing a non-significant trend toward improved overall survival.

PMID:41219906 | DOI:10.1186/s12957-025-04080-x

BMC Cancer. 2025 Nov 11;25(1):1747. doi: 10.1186/s12885-025-15095-8.

ABSTRACT

BACKGROUND: Non-invasive prediction of pathological complete response (pCR) in breast cancer patients undergoing neoadjuvant therapy (NAT) is crucial for adjusting surgical strategies and optimizing treatment plans. This study aims to develop a predictive model that integrates traditional radiomics and 3D deep learning features from early and peak phases of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to predict pCR after NAT.

METHODS: This retrospective study included 234 breast cancer patients from two hospitals who received neoadjuvant therapy. Dataset 1 (n = 204) was used for model development, and Dataset 2 (n = 30) was used for external validation. Traditional radiomics and 3D deep learning features were extracted from both the whole DCE-MRI image and the tumor region of interest (ROI). Features from different sources were integrated, followed by feature selection using independent sample t-tests and least absolute shrinkage and selection operator (LASSO) regression, and the top ten discriminative features were selected for model training. Logistic regression was used to build predictive models, and their performance was evaluated using receiver operating characteristic curves and area under curve (AUC). The DeLong test was used to assess differences between the AUC values of different models, and SHAP (SHapley Additive exPlanations) analysis was employed to examine the relationship between the features of the models and pCR.

RESULTS: For models using only traditional radiomics features, the combined model integrating early and peak phases of DCE-MRI provided the best pCR prediction. The performance of this combined model was further enhanced by adding 3D deep learning features. The optimal model (RD_EP), which integrated radiomics and deep learning features from early and peak phases of DCE-MRI, achieved AUC values of 0.892 (95% CI: 0.853-0.922) on Dataset 1 and 0.825 (95% CI: 0.713-0.886) on Dataset 2. The DeLong test showed that RD_EP had statistically significant differences compared to other prediction models (p < 0.05). SHAP analysis demonstrated that two radiomics texture features contributed the most to the model.

CONCLUSION: Integrating traditional radiomics and 3D deep learning features from different phases of DCE-MRI can accurately predict pCR to NAT in breast cancer accurately. Multi-phase imaging and diverse features are important to improve predictive accuracy and the constructed model may help guide personalized treatment strategies.

PMID:41219899 | DOI:10.1186/s12885-025-15095-8

BMC Pulm Med. 2025 Nov 11;25(1):517. doi: 10.1186/s12890-025-03991-5.

ABSTRACT

BACKGROUND/AIM: Pneumonia is a significant cause of morbidity and mortality within the first year after autologous hematopoietic stem cell transplantation in patients with multiple myeloma (MM), and nutritional status may influence complications after transplantation. In our study, we aimed to investigate the relationship between geriatric nutritional index (GNRI), prognostic nutritional index (PNI) and CONUT score and the incidence of pneumonia and mortality within 1 year after transplantation .

MATERIALS AND METHODS: A total of 286 patients who underwent autologous stem cell transplantation (ASCT) secondary to the diagnosis of multiple myeloma between 2013 and 2023 were analyzed. Patients were stratified into two groups based on the development of pneumonia within the first year post-transplantation and survival status at one year. Pre-transplant GNRI, PNI, and CONUT scores were calculated using standard formulas derived from laboratory and clinical data obtained prior to transplantation.

RESULTS: In this retrospective analysis the median GNRI value was 86.14 ± 11.47 in patients without pneumonia and 87.98 ± 13.57 in those with pneumonia, showing no statistically significant difference. The median PNI values were 89.63 ± 7.22 and 88.67 ± 7.73, and the median CONUT scores were 2.39 ± 1.68 and 2.20 ± 1.37 in the non-pneumonia and pneumonia groups, respectively. There was no statistically significant difference in either comparison. The distribution of CONUT categories did not differ significantly between patients with and without pneumonia In addition, when the association between nutritional indices and one-year survival after ASCT was analyzed, none of the indices demonstrated a significant predictive value.

CONCLUSION: As the first study to examine GNRI, PNI, and CONUT in this context, we found no significant link between pre-transplant nutritional status and pneumonia or one-year mortality post-ASCT in multiple myeloma. Transplant-induced immunosuppression may overshadow baseline nutritional effects.

PMID:41219898 | DOI:10.1186/s12890-025-03991-5

Eur Rev Aging Phys Act. 2025 Nov 11;22(1):21. doi: 10.1186/s11556-025-00387-6.

ABSTRACT

BACKGROUND: As populations age, maintaining physical activity (PA) is essential to reduce chronic disease risk and preserve functional independence in older adults. Technology-supported interventions, such as wearables, mobile applications, and web-based platforms, have emerged as effective tools to promote PA. However, engagement with technology alone is not sufficient. Effectiveness depends on whether digital tools foster sustained adherence to prescribed PA, since health benefits are dose-dependent on activity levels. In this sense, adherence matters not just for short-term participation but for embedding long-term behaviour change, an especially pressing challenge for older adults, who are typically less active and may experience greater barriers to digital engagement. This scoping review aimed to identify psychological and motivational factors that influence adherence to both the physical activity component and the supporting technology.

METHODS: A systematic search was conducted across three databases (PubMed, Web of Science, Scopus) for studies published between 2000 and March 2023. Fifty-three studies were included, encompassing qualitative, quantitative, and mixed-methods designs. Behaviour Change Techniques (BCTs) were identified and categorised using the BCT Taxonomy v1, distinguishing between techniques delivered via technology and those delivered through human interaction. Data were synthesised, distinguishing between adherence to physical activity and adherence to technology use.

RESULTS: Frequently used BCTs included self-monitoring, goal setting, action planning, feedback, prompts/cues, and social support, with different techniques emphasised in digital versus human-facilitated delivery modes. From the qualitative data, 417 psychological and motivational factors were identified and grouped into 25 thematic categories. These were structured into five domains: (1) user factors related to technology adherence, (2) technology-related factors influencing technology adherence, (3) context factors related to technology adherence, (4) user factors related to PA adherence, and (5) context factors related to PA adherence. Key facilitators included ease of use, personalised content, motivational feedback, and social support, while key barriers included low digital literacy, repetitive content, and lack of guidance. Quantitative findings revealed 19 associations between psychological/motivational variables and adherence outcomes, of which 12 were statistically significant.

CONCLUSIONS: This review provides a comprehensive overview supporting the understanding of what determines adherence in technology-supported PA interventions for older adults from a psychological and motivational perspective. By differentiating between technology adherence and PA adherence, and considering the BCTs that are incorporated in the interventions, our findings offer actionable guidance for researchers and developers to design more inclusive, motivating, and sustainable interventions that promote active ageing.

PMID:41219896 | DOI:10.1186/s11556-025-00387-6

Conscious Cogn. 2025 Nov 10;137:103959. doi: 10.1016/j.concog.2025.103959. Online ahead of print.

ABSTRACT

Dreams offer insight into how individual differences shape conscious experience in the absence of external input or task demands. This study examines whether synesthesia is linked to distinct patterns in dream content, suggesting underlying differences in cognitive architecture. Leveraging the statistical power of large-scale, naturalistic data, we analyzed 2,337 dream reports from Reddit, comparing 1,169 reports from self-identified synesthetes with 1,168 matched controls. Semantic embedding models and logistic regression achieved modest classification performance, indicating group-level differences in language use. Topic modeling revealed four themes-digital, interpersonal regret, diverse worlds, and violent conflict-that were significantly more prevalent in synesthete dreams. These results suggest that trait-level cognitive organization, as expressed in synesthetic perception, extends across states of consciousness and shapes the thematic content of dreams. The findings support theoretical accounts of dreaming as continuous with waking cognition and demonstrate how stable neurocognitive traits manifest in unstructured, self-generated thought.

PMID:41218240 | DOI:10.1016/j.concog.2025.103959

Eur J Cancer. 2025 Nov 5;231:116100. doi: 10.1016/j.ejca.2025.116100. Online ahead of print.

ABSTRACT

INTRODUCTION: Epithelioid Haemangioendothelioma (EHE) is an ultra-rare sarcoma characterized by WWTR1-CAMTA1 or YAP1-TFE3 gene fusions. Clinical behaviour ranges from indolent to aggressive. Due to its rarity, this study aims to describe the presentation, management, and outcomes of EHE patients in Canada.

METHODS: Data was collected and entered to the Canadian Sarcoma Research and Clinical Collaboration (CanSaRCC) database. Patients of all ages with a documented diagnosis of EHE from Nov 1993 to Jan 2024 were included. Patient demographics, disease characteristics and treatment details were collected using a case report form and summarized using descriptive statistics. Kaplan-Meier method was used to estimate overall survival and event free survival. Cox regression was used to estimate factors influencing survival outcomes.

RESULTS: In total, 198 patients were included of which 94 (45.7 %) presented with metastatic disease. The diagnosis was incidental in 61 patients (31 %). The most frequent primary sites were liver (n = 56, 28.3 %), extremities (n = 31, 15.7 %) and lungs (n = 27, 13.6 %). Fusion testing was performed and positive in 43 (22 %) patients. At least one line of systemic therapy was used in 55 (27.8 %) patients with most common agents including sirolimus, pazopanib and paclitaxel. The median EFS was 5.5 years (95 % CI: 3.4-8.5), and the median OS was 8.6 years (95 % CI: 5.4 – 16.5). Liver transplant was performed in seven patients. In multivariate analysis, older age, pleural effusion, ascites, primary lung disease and metastatic disease were associated with poor survival outcomes.

CONCLUSION: This is the largest series of EHE patients describing sequential systemic therapies. The role of systemic therapy in EHE in improving survival remains unclear and prospective studies with comparative arms are needed to add further insight into this chronic disease.

PMID:41218239 | DOI:10.1016/j.ejca.2025.116100

Eat Behav. 2025 Nov 7;59:102050. doi: 10.1016/j.eatbeh.2025.102050. Online ahead of print.

ABSTRACT

The association between sociocultural pressure and muscle dysmorphia (MD) is well-documented, yet the psychological variables involved require further investigation. This cross-sectional study examined a statistical model in 95 male exercisers in Spain (M age = 34.40) to explore the roles of appearance motivation and cognitive flexibility. Specifically, it tested the indirect association between the perceived influence of appearance ideals and MD symptoms through appearance motivation, and whether cognitive flexibility moderated this relationship. The overall model accounted for 48 % of the variance in MD symptoms (R² = 0.48), controlling for age. Results indicated a significant indirect association through appearance motivation (b = 0.16, 95 % CI [0.03, 0.36]). Additionally, a significant moderation was found (p = .043); the positive association between the influence of appearance ideals and MD symptoms was weaker for individuals with higher levels of cognitive flexibility. These findings are consistent with a model where MD symptom endorsement is linked to appearance motivation, while higher cognitive flexibility is related to a less pronounced association between sociocultural pressures and MD symptoms. Cognitive flexibility is highlighted as a potential protective correlate, suggesting that interventions could target motivational patterns and cognitive skills.

PMID:41218236 | DOI:10.1016/j.eatbeh.2025.102050