Tag: pubmed

Cancer Causes Control. 2025 Dec 27;37(1):12. doi: 10.1007/s10552-025-02089-x.

ABSTRACT

PURPOSE: The purpose of this study was to evaluate the willingness of gender diverse people assigned female at birth with a cervix for different high-risk HPV (hrHPV) methods of cervical cancer screening (CCS). We examined provider-collected hrHPV, at-home, self-collected hrHPV, and in-clinic, self-collected hrHPV, as well as their impact on gender dysphoria and screening barriers.

METHODS: This cross-sectional survey study was conducted in 2024 among transgender men, non-binary, genderqueer, and agender individuals at a single academic medical center. Data from 123 participants included demographics, gender dysphoria, screening barriers, past experiences, and willingness to receive hrHPV testing. Statistical analyses identified differences in gender dysphoria, barriers to CCS, past Pap test experiences, and hrHPV testing preferences via logistic regression analyses.

RESULTS: Most transgender men (63%) preferred at-home, self-collected hrHPV, and 37% of transgender men were unwilling to provider-collected hrHPV. Gender diverse people with gender dysphoria preferred at-home, self-collected hrHPV (60%), while those without gender dysphoria preferred alternating at-home, self-collected and provider-collected hrHPV (38%). Logistic regressions showed 78% (p < 0.005) and 53% (p < 0.001) lower odds of provider-collected hrHPV for those with gender dysphoria and screening barriers, respectively. Our findings showed that the concealment of procedural steps (Adjusted Odds Ratio = 0.01, p < 0.02), use of gendered language (AOR = 0.17, p < 0.01), and misgendering (AOR = 0.31, p < 0.05) reduced the willingness to undergo provider-collected hrHPV. However, these experiences did not show a difference between self-collected hrHPV testing methods.

CONCLUSION: This is one of the largest U.S. studies assessing the preferences for hrHPV testing among gender diverse people. Our findings emphasize that transgender men prefer at-home, self-collected hrHPV, which can reduce gender dysphoria and screening barriers. This underscores the need for patient-centered screening and gender-inclusive care to help reduce disparities in CCS among gender diverse people.

PMID:41454978 | DOI:10.1007/s10552-025-02089-x

Cancer Causes Control. 2025 Dec 27;37(1):10. doi: 10.1007/s10552-025-02103-2.

ABSTRACT

PURPOSE: Cancer and diabetes are the second and eighth leading causes of death in the United States (US), respectively. There are associations between diabetes and development of certain cancers yet a spatial analysis of their association has not been performed. This study examined the relationship between county-level diabetes prevalence and diabetes-associated cancer mortality in the US to identify disease hotspots and socioeconomic disparities.

METHODS: In this cross-sectional study of 3,108 counties in the continental US, we characterized county-level diabetes prevalence and diabetes-associated cancer mortality rates by conducting hotspot analyses using the Getis-Ord G* statistic to identify county clusters with similar high/low values of diabetes prevalence and cancer mortality rates. We compared demographic and socioeconomic factors among hotspot and coldspot overlaps.

RESULTS: Hotspots of diabetes prevalence were in the Mississippi Delta, Appalachian Kentucky and West Virginia, southeastern Virginia, southern Texas, New Mexico, and tribal areas of Arizona and South Dakota. Hotspots for diabetes-associated cancer mortality were in the Mississippi Delta, Appalachian Kentucky, south central Texas, and South Dakota tribal areas. Hot-hot overlaps occupied the Mississippi Delta, Appalachian Kentucky, southern Texas, and South Dakota tribal areas. Compared to cold-cold overlaps, hot-hot cluster counties were more rural with higher percentages of poorly educated, impoverished, and unemployed citizens. Racial economic segregation data suggest that hot-hot clusters are significantly disadvantaged.

CONCLUSIONS: Diabetes incidence and diabetes-associated cancer mortality share geographic, demographic, and socioeconomic risk factors. Providers should promote eligible cancer screenings and control of other risk factors among patients with diabetes to reduce mortality.

PMID:41454977 | DOI:10.1007/s10552-025-02103-2

Cancer Causes Control. 2025 Dec 27;37(1):8. doi: 10.1007/s10552-025-02104-1.

ABSTRACT

Despite the well-documented benefits of physical activity (PA) for cancer prevention and control, most PA interventions have not been tailored for Asian Americans (AsA), who face rising cancer incidence and a slower decrease in cancer mortality compared to other racial groups. This study aims to systematically review the PA interventions designed for AsA to prevent or manage cancer outcomes. A systematic search of five databases identified interventional studies with PA-promoting components in Asian American adults for cancer prevention or control, published before June 27, 2025, following the Cochrane Collaboration’s PRISMA guidelines. The systematic review identified 860 articles, with five studies meeting inclusion criteria, including four focused on cancer prevention and one on cancer control. Study populations included Filipinos (n = 2), Chinese (n = 1), Koreans (n = 1), and a mixed Asian and Hispanic group (n = 1). Studies were conducted in California (n = 2), Texas (n = 2), and New York (n = 1), with sample sizes ranging from 45 to 1,054 participants and program durations of 8 weeks to 18 months. Only one study exclusively targeted PA promotion; others included components like cancer screening and dietary interventions. All studies incorporated cultural adaptations, primarily language, while some featured culturally specific exercises and social apps. PA was self-reported in all studies, showing improvements post-intervention but limiting accuracy. These findings highlight the potential of PA interventions for AsA in cancer prevention and control, though their urban focus raises concerns about rural accessibility. Future efforts should prioritize rural outreach, enhance cultural adaptations, and assess long-term effectiveness and sustainability.

PMID:41454976 | DOI:10.1007/s10552-025-02104-1

Neurol Sci. 2025 Dec 27;47(1):55. doi: 10.1007/s10072-025-08713-7.

ABSTRACT

BACKGROUND: Primary headaches, particularly migraine, are common neurological disorders that need to be better defined in the growing elderly population. This study provides a comprehensive evaluation of headache, with a focus on migraine, across age groups in a tertiary headache center.

METHODS: We retrospectively analyzed 3023 patients admitted to the Headache Center, Bari General Hospital (2017-2025). Patients were divided into four groups: young adults (18-30 years), adults (31-45), middle-aged (46-59) and elderly (≥ 60). Data collected included headache characteristics, accompanying symptoms, disability, allodynia, fatigue, anxiety and depression. Statistical analyses included chi-square tests and Kruskal-Wallis ANOVAs.

RESULTS: Of the total sample, 404 patients (13.4%) belonged to the elderly, 925 (30.6%) to the middle-aged, 1016 (33.6%) to the adult group, and 678 (22.4%) to the young group. Elderly were more likely to have received a diagnosis of tension-type, other primary or secondary headache disorders and probable diagnoses (ps < 0.001). Among 2390 migraine patients, chronic migraine was more common in the elderly (40.3%, z = 3.23). Migraine with aura occurred slightly more often in younger individuals. Older patients reported longer disease duration, longer migraine attacks, and fewer accompanying symptoms (ps < 0.01). Excessive medication use was present in a relevant proportion of elderly. Fatigue was more frequent in older patients.

CONCLUSIONS: Headache types and migraine characteristics vary with age. In the elderly, chronic migraine predominates, with less autonomic impairment, longer attacks and increased fatigue. Medication overuse represents a significant concern. These findings highlight the need for age-specific diagnosis and tailored treatments in older adults.

PMID:41454973 | DOI:10.1007/s10072-025-08713-7

J Ultrasound Med. 2025 Dec 27. doi: 10.1002/jum.70157. Online ahead of print.

ABSTRACT

OBJECTIVES: To analyze obstetric ultrasound utilization and expenditures per live birth delivery among the commercially insured from 2016 to 2022 and present updated trends and variation in use by type of ultrasound and across subgroups.

METHODS: In this retrospective United States-based cohort study, obstetric ultrasound utilization and expenditures during pregnancy were measured for a cohort of all deliveries with at least 28-week gestation that resulted in a live birth between January 1, 2017 and December 31, 2022, using the Health Care Cost Institute commercial claims database. We report utilization trends and the clinical and sociodemographic factors correlated with utilization using descriptive statistics and negative binomial regression.

RESULTS: In our sample of 1,731,823 pregnancies, there were an average of 5.3 (SD ± 3.9) claims for obstetric ultrasounds per live birth delivery. After adjusting for covariates, the number of ultrasounds per live birth increased by 8.3% and inflation-adjusted spending for these ultrasounds increased 5.6% over the 7-year study period (p < .001); though utilization decreased during the COVID-19 pandemic in 2020. Follow-up ultrasound (CPT 76816) was the fastest growing procedure.

CONCLUSION: Obstetric ultrasound utilization and expenditures increased from 2016 to 2022. Information on the variation in patterns and trends related to obstetric ultrasound use may assist policy makers in their assessment of resource utilization and approach to reimbursement design, such as obstetric bundled payments.

PMID:41454739 | DOI:10.1002/jum.70157

Comput Assist Surg (Abingdon). 2026 Dec;31(1):2604610. doi: 10.1080/24699322.2025.2604610. Epub 2025 Dec 27.

ABSTRACT

Colorectal cancer represents a major global health concern and obesity adds complicates its surgical management. This meta-analysis aimed to evaluate the comparative effectiveness and safety of robotic-assisted surgery and standard laparoscopic surgery in obese colorectal cancer patients. A comprehensive literature search performed across databases from inception to April 2024. Pooled estimates included hospital stay duration, drainage tube removal time, first ventilation time, complication rates, re-admission rates and re-operative rates. Six studies involving 4215 patients were included. Robotic-assisted surgery was associated with a statistically significant but modest reduction in hospital stay time compared to laparoscopic surgery (p = 0.02). No significant differences were found for drainage tube removal time (p = 0.42) and first ventilation time (p = 0.27). Complication rates (OR [odds ratio] = 0.92, 95% confidence interval [CI]: 0.74 to 1.13, p = 0.41), re-admission rates (OR = 0.81, 95% CI: 0.31 to 2.13, p = 0.67) and re-operative rates (OR = 1.20, 95% CI: 0.77 to 1.86, p = 0.41) did not significantly differ between surgical approaches. Robotic-assisted surgery significantly provides a modest reduction in hospital stay duration without compromising patient safety for obese colorectal cancer patients. These findings should be interpreted with caution. Future randomized controlled trials are required to confirm these results.

PMID:41454717 | DOI:10.1080/24699322.2025.2604610

Urologia. 2025 Dec 27:3915603251406813. doi: 10.1177/03915603251406813. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to develop and validate an AI-assisted framework for the automated evaluation of uroflowmetry data in patients presenting with lower urinary tract symptoms. The primary goal was to overcome the limitations of traditional manual interpretations by leveraging advanced machine learning techniques to achieve higher diagnostic accuracy, objectivity, and clinical applicability in urological assessments.

MATERIALS AND METHODS: A retrospective analysis was conducted using a large, de-identified dataset comprising uroflowmetry recordings, patient-reported symptom scores, and comprehensive demographic data. The data underwent rigorous preprocessing-including noise reduction, baseline correction, normalization, and feature extraction-with key parameters such as peak flow rate, voided volume, average flow rate, and voiding time being analyzed. Multiple machine learning models-including a deep neural network, support vector machine, and random forest classifier-were developed and validated through cross-validation and extensive statistical testing. Performance metrics such as accuracy, sensitivity, specificity, and area under the ROC curve (AUC-ROC) were calculated, while multivariate regression analyses were performed to explore the relationships between uroflowmetry parameters and symptom severity.

RESULTS: The AI framework, particularly the deep neural network model, exhibited outstanding diagnostic performance with an accuracy of 92.5%, sensitivity of 90.0%, specificity of 94.0%, and an AUC-ROC of 0.96. Statistical analyses demonstrated significant correlations between key uroflowmetry parameters and clinical symptoms, with lower peak flow rates showing a strong association with increased symptom severity (p < 0.001). These findings confirm that the integration of multi-dimensional data through AI significantly enhances the objectivity and precision of urinary function evaluation compared to conventional methods.

CONCLUSION: The study successfully established an AI-assisted diagnostic framework that markedly improves the automated evaluation of uroflowmetry data and lower urinary tract symptoms. This innovative approach offers a robust alternative to traditional diagnostic practices by reducing subjectivity and enhancing diagnostic accuracy, thereby paving the way for more personalized and effective management of urinary disorders.

PMID:41454715 | DOI:10.1177/03915603251406813

Subst Use Misuse. 2025 Dec 27:1-8. doi: 10.1080/10826084.2025.2604637. Online ahead of print.

ABSTRACT

BACKGROUND: Evidence on the association between urban regeneration and alcohol use remains limited. This study examines the impact of urban environmental factors, specifically air pollution (measured by PM2.5, a common indicator of fine particulate matter), traffic congestion, and limited green space, on problematic alcohol use, and explores potential social and behavioral mechanisms underlying these relationships.

METHODS: A cross-sectional survey was conducted among 11,954 students from 50 universities across 43 Chinese cities. Individual-level data were collected via self-report questionnaires, while regional environmental data were obtained from the National Bureau of Statistics. Structural equation modeling (SEM) was applied to analyze the mediating pathways.

RESULTS: The prevalence of problematic alcohol use was 7.3%. Multilevel logistic regression showed that higher PM2.5 levels were positively associated with alcohol use (ORs = 2.98, 3.48), while more green space (ORs = 0.55, 0.23) and a higher proportion of paved roads (OR = 0.37) were protective factors. SEM results indicated that PM2.5 exerted both a direct effect on alcohol use (β = 0.358, p < 0.01) and an indirect effect mediated by uncertainty stress (indirect β = 0.011). Paved road area had a direct effect (β = -0.009, p < 0.01) and indirect effects through uncertainty stress (indirect β = -0.007) and life stress (indirect β = -0.001). Green space directly reduced alcohol use (β = -0.188, p < 0.01) and also indirectly via lower uncertainty stress (indirect β = -0.011).

CONCLUSION: Improving urban environmental quality, especially reducing air pollution and expanding green infrastructure, may help mitigate problematic alcohol use and promote mental health.

PMID:41454707 | DOI:10.1080/10826084.2025.2604637

OTJR (Thorofare N J). 2025 Dec 27:15394492251403433. doi: 10.1177/15394492251403433. Online ahead of print.

ABSTRACT

Occupational disruption (OD) is common during the perinatal period. Occupational therapy (OT) intervention may improve knowledge of perinatal occupational balance (OB) strategies. The aim of this exploratory study was to evaluate the effectiveness of an OT intervention in increasing knowledge of perinatal OB strategies among working first-time mothers (WFTMs). A total of 30 perinatal WFTMs attended a virtual OT educational workshop that addressed the OB constructs of stress management, energy conservation, sleep hygiene, and routine management. Pre- and post-intervention surveys measured OD and self-reported knowledge of OB strategies. Data were analyzed using descriptive statistics and paired samples t-tests. Participants reported moderate OD across all OB constructs. Statistically significant improvements were noted in knowledge of OB strategies to improve energy conservation (p = .003) and overall OB (p = .001). OT intervention can improve knowledge of OB strategies in perinatal WFTMs. Including OB education in routine perinatal care shows promise.

PMID:41454704 | DOI:10.1177/15394492251403433

Liver Int. 2026 Feb;46(2):e70490. doi: 10.1111/liv.70490.

ABSTRACT

INTRODUCTION: Metabolic dysfunction-associated steatotic liver disease (MASLD) and steatohepatitis (MASH) represent a spectrum of liver conditions that can gradually progress to cirrhosis. Sodium-glucose co-transporter-2 (SGLT-2) inhibitors have shown benefits in reducing hepatic steatosis and liver-related events in MASLD. This study aims to assess whether SGLT-2 inhibitors are associated with a reduced risk of all-cause mortality and disease-specific outcomes in patients with MASH cirrhosis and type 2 diabetes (T2D).

METHODS: A retrospective cohort study was performed using TriNetX. Patients with T2D and MASH cirrhosis on SGLT-2 inhibitors were matched 1:1 with other glucose-lowering drugs (oGLDs) based on demographics, comorbidities and medications. Primary outcomes included all-cause mortality, hepatic decompensation and major adverse liver outcomes (MALO). Cox-proportional hazards models were used to estimate hazard ratios (HRs) with 95% confidence interval (CI).

RESULTS: A total of 51 427 patients with MASH cirrhosis and T2D were identified, of which 6833 (13.28%) were on SGLT-2 inhibitors. Patients on SGLT-2 inhibitors (n = 6449, mean age 63.7 years, 52.9% female) were matched with 6449 individuals (mean age 63.9 years, 53.5% female) on oGLDs. The SGLT-2 inhibitors cohort had statistically significantly lower risk of all-cause mortality (HR: 0.58, 95% CI: 0.53-0.63), hepatic decompensation (HR: 0.85, 95% CI: 0.81-0.90) and MALO (HR: 0.88, 95% CI: 0.83-0.93).

CONCLUSION: SGLT-2 inhibitors are associated with a reduced risk of all-cause mortality in patients with MASH cirrhosis and T2DM, which may be partly attributable to a lower risk of hepatic decompensation and subsequent events. Further studies are warranted as SGLT-2 inhibitors may serve as an adjunctive therapy for patients with MASH cirrhosis.

PMID:41454700 | DOI:10.1111/liv.70490