Tag: pubmed

Hong Kong Physiother J. 2025 Jun;45(1):11-22. doi: 10.1142/S1013702525500015. Epub 2024 Mar 21.

ABSTRACT

BACKGROUND: Correct goal setting for patients is one of the most important aspects of physical therapy.

OBJECTIVE: The purpose of this study was to investigate the effect of physical therapy using goal attainment scaling (GAS) scores to assess the gait function in patients with subacute stroke and related factors.

METHODS: This retrospective cohort study was conducted using the medical records of 129 patients with subacute stroke who had been treated with intensive rehabilitation intervention. This study was approved by the Institutional Review Board of Bundang Cha Hospital (2021-06-008). The functional ambulation category (FAC) was used to set goals with the involvement of patients and their caregivers after the initial assessment, and raw GAS scores were calculated according to whether the goals were achieved through assessment one month later based on the FAC score. The groups were then divided according to the raw GAS scores (-1, 0, 1, or 2), and the general characteristics and clinical assessment scores were statistically analysed.

RESULTS: From our results, there were differences in clinical assessment scores based on raw scores on the GAS ( p < 0 . 05 ) and correlation between raw scores on the GAS and improvement scores on the clinical assessment items ( p < 0 . 05 ). Moreover, when the gait function measured by FAC was used as a GAS in subacute stroke patients, the better the function of Rivermead mobility index ( β = 0 . 613 , p < 0 . 05 ) and Korean-mini-mental state examination ( β = 0 . 217 , p < 0 . 05 ) than the other clinical factors, the higher the goal attainment raw score.

CONCLUSION: Functions, including cognitive function, should be included when setting goals to improve the gait function and should be considered when developing the neurological physiotherapy programmes. This study helps physicians and physical therapists who first apply functional gait assessment as a GAS to set the initial goals and improves patient and caregiver motivations by applying GAS to patients with lower initial cognitive levels.

PMID:40535979 | PMC:PMC12171774 | DOI:10.1142/S1013702525500015

J Health Monit. 2025 Jun 11;10(2):e13178. doi: 10.25646/13178. eCollection 2025 Jun.

ABSTRACT

BACKGROUND: Coronary heart disease (CHD) is the leading cause of death in Germany. Comprehensive analyses of long-term trends in CHD mortality that also distinguish between acute myocardial infarction (AMI) and non-AMI-related chronic CHD are currently lacking.

METHOD: Age-specific and age-standardised CHD mortality rates for the period 1998 – 2023 were calculated based on data from the cause-of-death statistics of the Federal Statistical Office of Germany. Annual percentage changes (APC) and average annual percentage changes (AAPC) were estimated using joinpoint regression analysis.

RESULTS: Between 1998 and 2023, the average annual change in age-standardised CHD mortality rates for women was -3.9 % ((-4.1) – (-3.7)) per year, compared with -3.2 % ((-3.3) – (-3.0)) for men. However, since the 2010s, the downward trend in CHD mortality has flattened, particularly among those aged 60 to 74 years. In the analysis by ICD subgroups, mortality rates for chronic CHD declined less sharply than for AMI over the entire period 1998 – 2023, especially among men.

CONCLUSIONS: The flattening of the CHD mortality trend, particularly among middle-aged adults over the last decade, and the smaller decline in chronic CHD mortality, especially among men, require further exploration in order to identify unmet needs at various levels of prevention for specific life stages. In addition, the influence of the COVID-19 pandemic on CHD mortality trends should be further investigated.

PMID:40535977 | PMC:PMC12175194 | DOI:10.25646/13178

Clin Epidemiol. 2025 Jun 14;17:551-565. doi: 10.2147/CLEP.S520168. eCollection 2025.

ABSTRACT

PURPOSE: Multi-database studies may provide heterogeneous results despite using common protocols, leading to challenges in interpretation, but also providing an opportunity to gain insights on populations or healthcare systems. The objectives of these analyses were to develop a framework for exploring sources of statistical heterogeneity and apply it to the multi-database EXACOS-CV (EXAcerbations of COPD and their OutcomeS on CardioVascular diseases) program.

METHODS: A conceptual framework to systematically assess sources of statistical heterogeneity in multi-database studies was developed. This framework distinguishes between methodological diversity and true clinical variation. Methodological diversity includes differences in study design and database selection, while true variation considers population and healthcare differences. Possible sources of methodological diversity were identified via a novel checklist and explored. In turn, hypotheses were generated about true variation. The framework and checklist were applied to EXACOS-CV cohort studies in Germany, Canada, the Netherlands, and Spain which deviated least from the common protocol and so were included. Focus was on adjusted hazard ratios (aHR) for post-exacerbation associations with decompensated heart failure (HF) and all-cause death, for which results were most and least heterogeneous, respectively.

RESULTS: Across EXACOS-CV studies, the adjusted hazard ratios (aHR) for HF in the first 1-7 days post-exacerbation, compared to non-exacerbation periods, ranged from 2.6 (95% CI, 2.3, 2.9) in Germany to 72.3 (64.4, 81.2) in Canada, and the association with death, relative to non-exacerbation periods, ranged from 3.5 (2.4, 5.3) in the Netherlands to 22.1 (19.9, 24.4) in Spain. Completed methodological diversity checklists linked differences in aHRs to possible variation in ability to capture pre-existing cardiovascular comorbidities across studies, as well as differences in confounder measurement. Standardizing adjusted models across studies did not fully explain heterogeneity, suggesting other contributing factors. Heterogeneity may result from genuine variation in prevalence of CV disease. It was hypothesized that patients with pre-existing CV disease have more accurate diagnoses and management of post-exacerbation CV events, possibly leading to lower risks of such events.

CONCLUSION: Multi-database studies can provide directional insights on the study research question while considering healthcare system and population differences. The developed framework aids assessment of heterogeneity sources.

PMID:40535967 | PMC:PMC12176119 | DOI:10.2147/CLEP.S520168

J Mens Health. 2025 Jan;21(1):39-50. Epub 2025 Jan 30.

ABSTRACT

BACKGROUND: African American men (AAM) have persistently had the highest incidence and mortality rates for prostate cancer (PrCa) in the United States. Considering that current guidelines recommend the practice of shared decision-making to determine whether or not to undergo a Prostate-Specific Antigen (PSA) test for the early detection of PrCa, this study focuses on the identification of key factors influencing AAM decisions regarding having or not having PSA screenings.

METHODS: Cross-sectional study of 152 AAM who completed study surveys. Statistical analysis included frequencies, means, and distributions and methods to test for differences in knowledge confidence, satisfaction and, self-efficacy when making decisions.

RESULTS: 94% of participants would get a PSA test if offered, only 57% knew that the PSA test is a blood test. Participants who reported having had a PSA test before the baseline had significantly higher mean scores than their counterparts in the knowledge about the definition of the PSA and biopsy exams (p = 0.04), and in the confidence (p = 0.005) and efficacy (p = 0.002) scales when making PSA screening decisions. Older participants were more likely to have had a PSA test (p < 0.0001) and to intend to screen (p = 0.0441).

CONCLUSIONS: Significant differences in the satisfaction scale by clinical site (p < 0.001) may underscore the influence of clinicians’ practices in participants’ satisfaction with their decisions. Results suggest that patients’ experience of care has the potential to positively influence PSA screening. It is our call that type of health insurance, knowledge about PrCa and PSA, and having had a PSA test in the past, as well as the patient’s characteristics (age, race and family history of PrCa) be considered when discussing with patients the harms/benefits of PSA screening and their preferences to have or not have the PSA test.

PMID:40535958 | PMC:PMC12176403

Cureus. 2025 Jun 16;17(6):e86127. doi: 10.7759/cureus.86127. eCollection 2025 Jun.

ABSTRACT

Background There is a growing interest in the use of biomaterials to treat chondral and osteochondral knee lesions, given their ability to replicate the biological and functional properties needed for simultaneous cartilage and bone regeneration. A novel aragonite-based, cell-free biomimetic scaffold (CARTIHEAL AGILI-C^TM, Smith + Nephew, UK) was developed for treating chondral and osteochondral defects in traumatic and osteoarthritic joints. A short-term follow-up study was designed to assess the safety and feasibility of this scaffold. Materials and methods This retrospective review included data from nine centers in the United States (US) between August 22, 2023 and December 30, 2024. Adult patients (≥18 years of age) who received the aragonite-based scaffold as standard of care for the treatment of knee chondral/osteochondral lesions in accordance with the manufacturer’s instructions for use were eligible. There were no prespecified exclusion criteria. All patients underwent magnetic resonance imaging (MRI) for radiologic assessment of knee cartilage lesions, which informed the development of presurgical plans. A diagnostic arthroscopy was performed before arthrotomy to confirm the radiographic findings obtained for preoperative planning. The primary endpoint was the incidence of early clinical and radiographic complications occurring within at least 30 days after the operation. Secondary endpoints included an assessment of the accuracy of presurgical planning relative to intraoperative findings, proportion of implants determined to be improperly implanted based on the first postoperative X-rays, change in the numeric pain rating score from baseline, and the proportion of patients cleared for various postoperative activities. Results A total of 33 patients (34 knees; mean age, 47.2 years; 18 (52.9%) male) were included. After a mean postoperative follow-up of 45.7 days (standard deviation, 14.4), one patient (2.9%) experienced a postoperative complication (pain, with no associated infection). Success rate was 96.97% (95% CI, 84.24-99.92). In 27 (79.4%) cases, the presurgical plan based on MRI was modified following arthroscopic visualization of the knee joint surface. Postoperative radiography revealed no complications for the 28 patients with data. Mean postoperative numeric pain rating significantly improved from 6.6 at baseline to 3.9 at follow-up (p<0.05). The majority of patients (n=24; 70.6%) were cleared for partial or full weightbearing by the 30-day postoperative follow-up visit. Conclusions This case series across multiple centers in the US demonstrates the clinical safety and feasibility of aragonite scaffold implantation. The flexibility of the scaffold in accommodating intraoperative findings and the low rate of early complications are encouraging.

PMID:40535950 | PMC:PMC12174689 | DOI:10.7759/cureus.86127

R Soc Open Sci. 2025 Jun 18;12(6):241934. doi: 10.1098/rsos.241934. eCollection 2025 Jun.

ABSTRACT

We construct a multiscale model of dispersion of mountain pine beetles in western North American forests. Dispersion is modelled at a macroscale (regional scale) by a novel nonlinear stochastic process for population density. This is coupled to a microscale (tree scale) model of population dynamics using a sequential approach, which assumes that dispersion occurs on a slower time scale than local dynamics. We conduct a numerical investigation of the multiscale model properties. While the model depends on a relatively small number of parameters, it can produce a wide range of behaviours, including dispersion patterns qualitatively similar to those of mountain pine beetle infestations. We also conduct a Bayesian calibration for key parameters in the model using synthetic and real data.

PMID:40535940 | PMC:PMC12174937 | DOI:10.1098/rsos.241934

Front Plant Sci. 2025 Jun 4;16:1555607. doi: 10.3389/fpls.2025.1555607. eCollection 2025.

ABSTRACT

INTRODUCTION: Tropical montane cloud forests (TMCFs) host specialized plant species reliant on persistent atmospheric humidity, including fog immersion obligates and relict assemblages. Understanding anatomical and morphological adaptations in TMCF woody angiosperms is critical for elucidating their acclimation strategies to hydric stress under shifting fog regimes. This study investigates interspecific variability in wood and leaf traits among 10 TMCF tree species in Mexico’s Medio Monte Natural Protected Area, hypothesizing that distinct anatomical strategies emerge in response to climatic stressors.

METHODS: Wood anatomical (e.g., vessel density, hydraulic diameter, fiber length) and leaf morphological traits (e.g., lamina length, vein density, leaf organization) were analyzed across species. Traits were correlated with climatic variables-mean maximum/minimum temperatures, monthly precipitation, and evapotranspiration-to identify adaptive patterns. Statistical analyses quantified interspecific differences and assessed trait-climate relationships.

RESULTS: Significant interspecific divergence occurred in both wood and leaf traits. Wood anatomy was strongly influenced by mean maximum temperature, precipitation, and evapotranspiration, affecting vessel density, vulnerability index, ray dimensions, and fiber length. Leaf traits correlated with temperature extremes and evapotranspiration, driving variation in leaf size, apex/base morphology, venation complexity, and marginal teeth. Notably, hydraulic efficiency (e.g., wider vessels) aligned with higher precipitation, while drought-associated traits (e.g., denser veins) linked to elevated temperatures.

DISCUSSION: TMCF species exhibit trait-based strategies balancing hydraulic safety and efficiency, reflecting niche partitioning under microclimatic gradients. Temperature and water availability differentially shape wood and leaf adaptations, with vessel architecture and venation patterns acting as key regulators of water loss. These findings underscore the functional diversity of TMCF trees and their capacity to acclimate to environmental variability. Conservation efforts must prioritize microclimate preservation to safeguard these adaptive traits amid climate change.

PMID:40535929 | PMC:PMC12175852 | DOI:10.3389/fpls.2025.1555607

Contemp Clin Trials Commun. 2025 Jun 6;46:101507. doi: 10.1016/j.conctc.2025.101507. eCollection 2025 Aug.

ABSTRACT

The purpose of this study is to examine the efficacy of the Stress Management and Resilience Training (SMART) in increasing the resilience of U.S. Air Force personnel. We aim to recruit up to 500 active component Air Force personnel and provide a two-arm randomization modality to make SMART more accessible and adaptive to the personnel’s schedules. Two-arm randomization will be used to assign three sites for participants to choose in-person or computer-based training (CBT) and two sites where participants are randomized into their training type (in-person or CBT). The use of two-arm randomization will enable the examination of the difference between real-world settings within the framework of causal inference, as well as, differences based upon self-selection and a randomized control trial. We propose to examine the intervention effects at 12, 24 and 36-weeks post-intervention. Initial analysis will include descriptive statistics to characterize demographic status, military grade, duty location, and military occupation. The objectives of our analyses will include testing and estimating the intervention effects by comparing pre-post intervention changes in resilience, stress, anxiety, and QoL at each follow-up. Scores will also be pooled to test for overall intervention effects over time. Intervention effectiveness will be reported by comparing mean or median effects using 95 % confidence intervals and effect size estimates. An analysis of the longitudinal trend over the study period will be conducted by simultaneously examining data from all follow-ups using mixed-effects models in which random effects will be used to characterize between and within-subject variations.

PMID:40535922 | PMC:PMC12174564 | DOI:10.1016/j.conctc.2025.101507

Food Sci Nutr. 2025 Jun 17;13(6):e70441. doi: 10.1002/fsn3.70441. eCollection 2025 Jun.

ABSTRACT

This study aimed to explore the effectiveness of monosodium glutamate (MSG) as a flavor enhancer in increasing vegetable intake compared to sodium chloride (NaCl) alone combined with a digital culinary medicine education program. A two-phase randomized controlled trial (RCT) was conducted from February to November 2023. Phase one involved a five-week intervention where participants received a designated seasoning and logged their vegetable intake using the MyFitnessPal app. Phase two involved a sensory evaluation, assessing the palatability of green beans and sweet potatoes seasoned with NaCl/MSG mixtures using a Likert scale and triangle tests to determine preference and palatability. Phase one; 60 participants were assigned to one of three groups: 100% NaCl (control), 50/50 NaCl/MSG, and 70/30 NaCl/MSG. Phase two; 88 participants and all seasoning groups received a digital culinary medicine education program with recipes and videos. The 50/50 NaCl/MSG group showed a mean increase in vegetable intake from 1.46 to 1.55 cups/day, while the NaCl group showed a decrease from 1.33 to 0.95 cups/day (p = 0.46). Preference tests indicated favorability trends for MSG mixtures, particularly with green beans seasoned with the 50/50 NaCl/MSG mixture (p = 0.07). Although the differences in vegetable intake were not statistically significant, the findings suggest that MSG could enhance vegetable palatability and intake, aligning with the principles of culinary medicine. This represents a promising strategy for improving dietary habits. Further research is warranted to confirm these findings. Trial Registration: Clinicaltrials.gov identifier: NCT05591612.

PMID:40535918 | PMC:PMC12173827 | DOI:10.1002/fsn3.70441

Food Sci Nutr. 2025 Jun 18;13(6):e70463. doi: 10.1002/fsn3.70463. eCollection 2025 Jun.

ABSTRACT

This study aimed to evaluate the oxidative stability and vitamin A retention of fortified sunflower oil intended for edible use, under different storage conditions over a six-month period. Sunflower oil samples were enriched with retinyl palmitate in four concentrations (15,30,60,90 μg/g) and stored in transparent and brown glass bottles under daylight and dark conditions for six months. Oxidative stabilities of the samples (Rancimat) were measured at the beginning of the study. The other analysis including retinyl palmitate levels, peroxide value, conjugated diene and triene, and free fatty acids contents were performed at the beginning and monthly intervals over a six-month storage period. The results were evaluated using some statistical tests at significance levels of p < 0.05 and p < 0.001. The analysis revealed that, at the end of the sixth month, the highest levels of retinyl palmitate were retained in the groups fortified with 90 μg/g and stored in dark conditions, specifically in transparent bottles (89.39 ± 1.38 μg/g) and brown bottles (80.87 ± 4.05 μg/g). The highest peroxide values were observed after storage in the control group stored under light conditions in transparent bottles (43.92 ± 4.65 meq O₂/kg oil), and in the group fortified with 15 μg/g under the same conditions (55.66 ± 14.12 meq O₂/kg oil). Enriched sunflower oil exhibited a statistically significant increase in free fatty acid contents over time. In conclusion, storage time, light exposure, and bottle color significantly influenced oxidation and quality parameters. Proper storage conditions, particularly protection from light, are essential for maintaining the stability of retinyl palmitate-enriched sunflower oil. Based on these findings, it is recommended that vitamin A-enriched sunflower oils be stored in brown or light-resistant bottles, kept away from direct light, and consumed relatively promptly to minimize oxidative degradation and preserve vitamin A stability.

PMID:40535913 | PMC:PMC12174659 | DOI:10.1002/fsn3.70463