Tag: pubmed

Int J Pediatr Otorhinolaryngol. 2025 Nov 7;199:112641. doi: 10.1016/j.ijporl.2025.112641. Online ahead of print.

ABSTRACT

AIM: Gestational diabetes mellitus (GDM) is a common metabolic disorder that affects both maternal and fetal health, with potential long-term complications. While its impact on neonatal outcomes is well-documented, its association with newborn hearing loss remains unclear. This study aims to evaluate the relationship between GDM subtypes-diet-controlled (GDMA1) and insulin-treated (GDMA2) -and newborn hearing screening results, emphasizing the need for targeted public health interventions.

MATERIALS AND METHODS: This retrospective study included pregnancy records from Kartal Dr. Lütfi Kırdar City Hospital. Pregnant women were categorized into three groups: healthy pregnancies (n = 282), GDMA1 (n = 140), and GDMA2 (n = 68). Hearing screening was performed using the auditory brainstem response (ABR) test. Newborns failing two consecutive tests were referred for further audiological evaluation and classified as having an adverse outcome. One-way ANOVA and post-hoc Bonferroni tests were used for statistical comparisons, with a significance level set at p < 0.05. To control for potential confounding variables, an analysis of covariance (ANCOVA) was conducted.

RESULTS: Among the 490 newborns analyzed, the hearing screening failure rate was significantly higher in the GDMA2 group (26.5 %) compared to GDMA1 (10.0 %) and the control group (4.3 %) (p < 0.001). Additionally, GDMA2 pregnancies were associated with earlier delivery and higher birth weights compared to healthy pregnancies (p = 0.001). The study demonstrated a strong association between GDM severity and newborn hearing screening failure rates.

CONCLUSION: The findings indicate that newborns of GDM-affected pregnancies, particularly those requiring insulin treatment, have a higher risk of failing hearing screening tests. Given the potential long-term consequences of undetected hearing loss, early identification and intervention are crucial. Public health policies should incorporate enhanced prenatal monitoring and neonatal audiological screening programs for at-risk populations. Further research is needed to explore the underlying mechanisms linking GDM severity to auditory dysfunction.

PMID:41218228 | DOI:10.1016/j.ijporl.2025.112641

JMIR Res Protoc. 2025 Nov 11;14:e75628. doi: 10.2196/75628.

ABSTRACT

BACKGROUND: Substance use is a high-impact biopsychosocial problem in Chile, where 21% of adults have experienced a severe alcohol use episode. In the past year, the prevalence rates were 12.5% for marijuana, 0.8% for cocaine, and 0.4% for cocaine base paste. Cannabis prevalence in Chile is higher than the global (4.2%) and South American (3.58%) averages. Cocaine prevalence in Chile is lower than in South America (1.62%) but higher than the global average (0.42%). No international reports are available for cocaine base paste. Mental health and substance use programs in Chilean primary care involve psychologists and social workers. Solution-focused brief interventions (SFBIs) are based on solution-focused brief therapy, a strengths-based and person-centered approach in which practitioners adopt a stance of “not being the expert,” respecting clients’ needs and perspectives.

OBJECTIVE: This study aims to determine whether the SFBI implemented by psychosocial teams (psychologists and social workers) for individuals with alcohol and other drug use in primary health care centers leads to better outcomes than usual care.

METHODS: We will conduct a randomized controlled clinical trial (ClinicalTrials.gov registration pending) comparing a 3-session SFBI (experimental group) with a single session of brief counselling as usual care (control group) in primary care. Interventions will be delivered in person by a psychologist or social worker. A total of 320 participants are expected to be recruited during preventive routine checkups using the Alcohol, Smoking, and Substance Involvement Screening Test. Participants reporting intermediate- to high-risk substance use on this screening tool will be randomly assigned to each group. Research assistants will administer instruments at baseline and at 3-, 6-, and 9-month follow-ups and will be blinded to the assigned treatments. The primary outcome assessed will be substance use patterns, while secondary outcomes include background information, depressive symptoms, anxiety symptoms, and motivation for treatment. Statistical analyses, including t tests, ANOVA, and Fisher exact tests will be conducted depending on variable type and normality. A qualitative component to assess acceptability and pertinence will include focus groups with participants and practitioners, followed by a content analysis.

RESULTS: Funding for this study started in April 2024. As of the submission date of this protocol, 55 practitioners from 9 primary health care centers have been trained in SFBIs. Recruitment began in February 2025, with 73 participants enrolled and 23 who dropped out. Recruitment will continue until December 2026. No analyses have been conducted to date. Findings are expected to be published during the second half of 2028.

CONCLUSIONS: This study strengthens primary care by integrating targeted psychosocial interventions for substance use into existing programs, thereby enhancing real-world applicability. If effective, the intervention could be adopted into routine care and inform public policy on mental health and substance use.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/75628.

PMID:41218202 | DOI:10.2196/75628

JMIR Form Res. 2025 Nov 11;9:e81484. doi: 10.2196/81484.

ABSTRACT

BACKGROUND: Large language models such as ChatGPT offer significant opportunities for medical education. However, empirical data on actual usage patterns, perceived benefits, and limitations among medical students remain limited.

OBJECTIVE: This study aimed to assess how medical students in Germany use ChatGPT, their perceptions of its educational value, and the challenges and concerns associated with its use.

METHODS: A cross-sectional 17-item online survey was conducted between May and August 2024 among medical students from Philipps University Marburg, Germany. A mixed methods approach was applied, combining descriptive and inferential statistical analysis with qualitative content analysis of open-ended responses.

RESULTS: A total of 84 fully completed surveys were included in the analysis (response rate: 26.7%; 315 surveys started). Overall, 76.2% (64/84) of the participants reported having used ChatGPT for medical education, with significantly higher usage during exam periods (P=.003). Preclinical students reported higher overall usage than clinical students (P=.02). ChatGPT was primarily used for summarizing information by 60.7% (51/84) of students, for literature research by 57.7% (49/84), and for clarifying concepts by 47.1% (40/84). A total of 70.2% (59/84) felt that it helped them save time, and 51.2% (43/84) reported an improved understanding of content. In contrast, only 31% (26/84) saw benefits for applying knowledge and 15.5% (13/84) for long-term knowledge retention. Qualitative responses highlighted clear benefits such as time savings and support in exam preparation, while also pointing to potential applications in clinical documentation and expressing concerns about misinformation and source transparency. However, 73.3% (55/75) expressed concerns about misinformation, and 72.6% (61/84) reported lacking confidence in their artificial intelligence (AI)-related skills. Only 41.7% (35/84) stated that they trust ChatGPT’s outputs. Students who used the tool more frequently also reported higher levels of trust in ChatGPT’s outputs (r=0.374, P<.001). Over 70% of respondents indicated a strong desire for increased integration of AI-related education and practical applications within the medical curriculum.

CONCLUSIONS: ChatGPT was already widely used among medical students, especially in exam preparation and the early stages of training. Students valued its efficiency and support for understanding complex material, but its long-term influence on learning is limited. Concerns about reliability, source transparency, and data privacy remain, and AI skills played a key role in shaping usage. These findings underscore the need to integrate structured, practice-oriented AI education into medical training to support critical, informed, and ethical use of large language models.

PMID:41218187 | DOI:10.2196/81484

JMIR Res Protoc. 2025 Nov 11;14:e76501. doi: 10.2196/76501.

ABSTRACT

BACKGROUND: Primary insomnia (PI), commonly identified by difficulties in initiating and maintaining sleep, negatively impacts both physical and mental health and increases the risk of occupational and vehicular accidents. Previous research has indicated that shallow needling, a form of acupuncture, may ameliorate the symptoms of PI. Nevertheless, the scientific evidence regarding its efficacy in enhancing sleep quality remains limited.

OBJECTIVE: This trial aims to assess the therapeutic efficacy of shallow needling in the treatment of chronic PI in adults.

METHODS: A single-center, prospective, assessor-blinded randomized controlled clinical trial retrospectively registered with the International Traditional Medicine Clinical Trial Registry (ITMCTR2024000409). With 2 parallel arms, the trial will be conducted at the Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine. A total of 124 participants with PI will be randomly divided into the control group and the treatment group in a ratio of 1:1 (n=62 for each group). The control group will receive 1 mg eszopiclone orally, once a day for 4 weeks. In addition to taking eszopiclone, the treatment group will receive shallow needling therapy once daily, 5 times a week, for 4 weeks. Data will be collected at 3 time slots-before treatment, after treatment, and 4 weeks after treatment-and will be analyzed using SPSS (version 23.0). The primary outcome measure is the Pittsburgh Sleep Quality Index. The secondary outcome measures include the Hamilton Anxiety Scale, Insomnia Severity Index, serum neurotransmitter detection (including dopamine, norepinephrine, and melatonin), sleep parameters, and magnetic resonance spectroscopy of the thalamus.

RESULTS: Participant recruitment for this study is currently in progress. The first participant was enrolled in August 2023, marking the official commencement of the trial. Following the completion of recruitment, data processing and statistical analysis will be initiated. The final results of this study are expected to be prepared and submitted for publication in January 2026.

CONCLUSIONS: This study will evaluate the therapeutic effectiveness and safety of shallow needling in the treatment of chronic insomnia to provide the necessary scientific basis for the clinical application and promotion of shallow needling. The findings of this study may provide a scientific and standardized treatment protocol for shallow needling in adults with chronic insomnia.

PMID:41218184 | DOI:10.2196/76501

Retina. 2025 Nov 6. doi: 10.1097/IAE.0000000000004725. Online ahead of print.

ABSTRACT

PURPOSE: To introduce a vitrectomy technique for the submacular hemorrhage (SMH) combined with subretinal tenecteplase (TNK-tPA) injection, intravitreal conbercept administration, perfluoropropane (C3F8) gas tamponade, and to evaluate its efficacy and safety.

METHODS: In this single-center, prospective, interventional study, patients underwent 25-gauge vitrectomy with subretinal TNK-tPA and intravitreal conbercept injection, followed by 0.5-1.0 mL of pure C3F8 gas tamponade. The best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were assessed at baseline, and 1, 3, and 6 months post-operatively. Favorable outcome was defined as a BCVA ≤0.5 logarithm of the minimum angle of resolution (log MAR) at 6 months.

RESULTS: Twenty eyes of 20 patients with treatment-naïve spontaneous SMH (≤30 days) secondary to polypoidal choroidal vasculopathy (70%) or retinal arterial macroaneurysms (30%) were included. Mean CRT significantly decreased from 887.1±52.2μm to 276.7±83.8μm (P < 0.001) at 6 months. Notably, 75% of the treated eyes (13 out of 20) achieved a favorable outcome (BCVA ≤0.5 log MAR; Snellen equivalent ≈20/63). Pearson’s correlation analysis revealed that the SMH onset-vitrectomy interval (SOVI) was significantly negatively correlated with a favorable outcome (r = -0.452, P = 0.045). After adjusting for potential interaction effect, the SOVI remained a statistically significant predictor of worse log MAR BCVA (odds ratio [OR] = 1.023, 95% confidence interval [CI] 1.013-1.034, P < 0.001).

CONCLUSIONS: The present technique for treatment-naïve spontaneous SMH, in combination with subretinal TNK-tPA injection, intravitreal conbercept administration, and C3F8 gas tamponade, demonstrated potential for visual improvement in eyes treated within 30 days of SMH onset.

PMID:41218174 | DOI:10.1097/IAE.0000000000004725

Plast Reconstr Surg. 2025 Nov 11. doi: 10.1097/PRS.0000000000012609. Online ahead of print.

ABSTRACT

INTRODUCTION: Evaluation of the severity and progression of lymphedema is challenging and there is no universal, simple and accurate established method. We propose the use of ultra-high frequency ultrasound (UHFUS) to measure skin thickness to assess lymphedema.

METHODS: Skin thickness was measured twice at 8 points in the upper limbs of 40 women using UHFUS (20 with unilateral lymphedema secondary to breast cancer and 20 healthy volunteers). Measurements were statistically compared with limb circumferences. A ROC curve analysis and a multivariable linear model were also performed.

RESULTS: Differences were found in the skin thickness between the two limbs of lymphedema patients (p <0.001), but not in healthy volunteers. Mean UHFUS examination time per patient was 8 minutes (16 measurements twice). Mean intra-rater differences was 0.09mm. The most useful point for identifying lymphedema cases was the proximal volar forearm (point 7): a cut-off value of 1.46mm in skin thickness was established for identifying lymphedema (sensitivity 70%, specificity 100%). Differences in skin thickness between the two limbs above 0.28 mm at point 7 identified all included cases of lymphedema (sensitivity 100%, specificity 100%).

CONCLUSIONS: measuring skin thickness using UHFUS is a reproducible, reliable, objective and fast method to assess lymphedema, even in initial stages, and to identify the most affected areas in upper limbs. In addition, it gives more information than limb circumferences, especially at the hand, and it would be potentially useful for the follow-up.

PMID:41218167 | DOI:10.1097/PRS.0000000000012609

Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2025 Nov 11:1-9. doi: 10.1080/19440049.2025.2582049. Online ahead of print.

ABSTRACT

Salicylic acid is a non-steroidal anti-inflammatory drug and plant hormone widely used in pharmaceutical, cosmetic, and medical applications. This study analysed its presence in cow’s, goat’s, and sheep’s milk from farms in the Republic of Croatia, as well as in fresh pasteurised and long-life (UHT) milk from supermarkets. A total of 240 samples were analysed during 2023 and 2024. Sample preparation included hydrolysis, acetonitrile extraction, and solid-phase extraction (SPE) clean-up followed by ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) analysis. Salicylic acid was detected above the limit of quantification (LOQ) in 47.9% of the samples and above the decision limit (CCα) in 21.7%. The highest concentration was found in cow’s milk (411.3 µg kg^-1). No statistically significant differences were observed among cow’s, goat’s, and sheep’s milk, or between fresh pasteurised and UHT milk. The estimated daily intake (EDI) values ranged from 0.004 to 0.64 μg kg^-1 bw day^-1, and the hazard index (HI) from 0.0006 to 0.10. The HI remained below 1 for all consumer groups, indicating no potential health risks.

PMID:41218160 | DOI:10.1080/19440049.2025.2582049

Proc Natl Acad Sci U S A. 2025 Nov 18;122(46):e2423469122. doi: 10.1073/pnas.2423469122. Epub 2025 Nov 11.

ABSTRACT

Histological images offer a wealth of data. Mining these data holds significant potential for enhancing disease diagnosis and prognosis, though challenges remain, especially in noncancer contexts. In this study, we developed a statistical framework that links raw histological images and their derived features to the genotype, transcriptome, and chronological age of the samples. We first demonstrated an association between image features and genotypes, identifying 906 image quantitative trait loci (imageQTLs) significantly associated with image features. Next, we identified differentially expressed (DE) genes by stratifying samples into image-similar groups based on image features and performing DE comparisons between groups. Additionally, we developed a deep-learning model that accurately predicts gene expression in specific tissues from raw images and their features, highlighting gene sets associated with observed morphological changes. Finally, we constructed another deep-learning model to predict chronological age directly from raw images and their features, revealing relationships between age and tissue morphology, especially aspects derived from nucleus features. Both models are supported by a computational approach that greatly compresses gigapixel whole-slide images and extracts interpretable nucleus features, integrating both large-scale tissue morphology and smaller local structures. We have made all interpretable nucleus features, imageQTLs, DE genes, and deep-learning models available as online resources for further research.

PMID:41218125 | DOI:10.1073/pnas.2423469122

Eur Heart J Cardiovasc Imaging. 2025 Nov 11:jeaf305. doi: 10.1093/ehjci/jeaf305. Online ahead of print.

ABSTRACT

AIMS: This study aimed to investigate the prognostic and incremental value of epicardial adipose tissue (EAT) parameters, including volume index (EATVI) and regional fat thickness, assessed by cardiac magnetic resonance (CMR) in patients with hypertrophic cardiomyopathy (HCM).

METHODS AND RESULTS: In this retrospective cohort of 457 HCM patients who underwent CMR between 2018 and 2024, EATVI and regional fat thickness at key cardiac grooves were quantified along with conventional clinical and imaging risk factors. Over a median follow-up of 27.5 months (IQR 15.6-47.6), major adverse cardiovascular events (MACE) occurred in 18.1% of patients. Significantly higher EATVI (72.21±14.21 vs. 56.71±10.36 ml/m², P<.001) and increased regional fat thickness (all P<0.05) were observed in patients with MACE. In multivariable Cox regression, EATVI remained an independent predictor of MACE (HR 1.03, 95% CI 1.01-1.05, P<.001). Incorporating EATVI into the clinical-CMR model improved discrimination (C-statistic 0.82 to 0.84; P=0.002), enhanced calibration, and provided greater net clinical benefit on decision-curve analysis. When appended to the 2014 ESC HCM Risk-SCD model, EATVI further improved discrimination (C-statistic 0.80 vs 0.71; P<.001) and calibration. Kaplan-Meier analyses using quartiles and the 62.5 ml/m² cutoff showed progressively worse event-free survival with higher EATVI; within the ESC-defined low-risk subgroup, curves also separated significantly (log-rank P<0.05). Time-dependent Receiver Operating Characteristic analyses confirmed stable predictive performance of these parameters.

CONCLUSION: EATVI and regional fat thickness derived from CMR independently predict adverse outcomes in HCM and improve risk stratification. Comprehensive EAT assessment may serve as a promising imaging biomarker for personalized management.

PMID:41218064 | DOI:10.1093/ehjci/jeaf305

PLoS One. 2025 Nov 11;20(11):e0336666. doi: 10.1371/journal.pone.0336666. eCollection 2025.

ABSTRACT

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a global health concern associated with complications that significantly impact patients’ quality of life and place significant burdens on healthcare systems. While the prevalence of T2DM is rising in Ethiopia, the scope and factors contributing to its complications remain understudied. Hence, this study aimed to assess the burden and identify associated factors of chronic complications among Type 2 diabetes mellitus patients attending Wolaita Sodo University Comprehensive Specialized Hospital in Southern Ethiopia.

METHODS: A facility-based cross-sectional quantitative study was conducted from July 1 to August 30, 2024, involving 404 systematically sampled T2DM patients. Data on sociodemographic characteristics, clinical profiles, self-care practices, and chronic complications were collected through structured interviews and medical record reviews. Descriptive statistics summarized patient characteristics, while multivariable logistic regression identified factors associated with chronic complications. Results were reported as Adjusted Odds Ratios (AORs) with 95% Confidence Intervals (CIs), and a p-value < 0.05 was considered statistically significant.

RESULTS: A total of 404 type 2 Diabetes mellitus patients participated in the study, with a response rate of 97.58%. The mean age of participants was 44.80 ± 14.10 years, 41.09% had diabetes for more than 5 years, and 64.85% had suboptimal glycemic control. Among participants, 45.54% (95% CI: 40.61-50.54) had at least one chronic complication, and one in five had multimorbidity. The most common microvascular complications were peripheral neuropathy (14.85%) and nephropathy (9.65%), while macrovascular complications included congestive heart failure (14.11%) and cerebrovascular disorders (11.39%). Multivariable logistic regression identified older age (AOR = 2.74; 95% CI: 1.73, 4.37; p < 0.000), female sex (AOR = 2.14; 95% CI: 1.12, 4.16; p = 0.039), longer diabetes duration (AOR = 2.98; 95% CI: 1.41, 6.54; p = 0.007), poor glycemic control (AOR = 2.02; 95% CI: 1.33, 3.09; p = 0.001), hypertriglyceridemia (AOR = 2.00; 95% CI: 1.06, 3.80; p = 0.038), high salt intake (AOR = 1.57; 95% CI: 1.06, 2.32; p = 0.024), and physical inactivity (AOR = 1.75; 95% CI: 1.16, 2.64; p = 0.008) as significant factors associated with chronic complications.

CONCLUSION: Nearly half of patients with Type 2 diabetes in Southern Ethiopia experienced chronic complications, emphasizing the need for improved prevention and management strategies. Strengthening diabetes care should include routine lipid and blood pressure screening, HbA1c testing where feasible, and nurse-led foot assessment. Community-based interventions promoting physical activity and dietary modification, along with patient education on glycemic control, should be scaled up. Implementing these feasible, low-cost measures within Ethiopia’s existing chronic care framework can help reduce the burden and improve health outcomes.

PMID:41218056 | DOI:10.1371/journal.pone.0336666