Tag: pubmed

Cir Cir. 2025;93(6):678-684. doi: 10.24875/CIRU.24000278.

ABSTRACT

OBJECTIVE: Determine the level of inclusion in hospital disaster risk management of the Mexican Social Security Institute.

METHODS: The methodology Disability Inclusion in Hospital Disaster Risk Management (INGRID-H) of the Pan American Health Organization was adapted for self-assessment in 276 hospitals. Expert advice sessions were conducted using a cascade format, including verification visits, and 180 days between each evaluation.

RESULTS: In the first self-assessment, 220 hospitals submitted their reports, and in the second, 236. 186 met inclusion criteria and were selected for analysis. In the first self-assessment the mean obtained for the level of inclusion was 36.70%, and in the second was 52.03%, with a correlation of 0.410 and p < 0.001, with a confidence interval of 95%, being statistically significant.

CONCLUSIONS: The adaptation of the INGRID-H tool using self-assessments and tutorials with experts made it possible to obtain a national diagnosis and increase the level of inclusion for disaster risk management in hospitals.

PMID:41558050 | DOI:10.24875/CIRU.24000278

Cir Cir. 2025;93(6):608-612. doi: 10.24875/CIRU.25000107.

ABSTRACT

OBJECTIVE: The objective of this study was to determine whether there is a change in feto-maternal circulation after amniocentesis (AS) using Doppler ultrasonography.

METHODS: In this prospectively designed study, fetuses with singleton pregnancies between 16 and 22 weeks of gestational age with an indication for invasive testing and a healthy AS result were included. Twin pregnancies, fetuses with major anomalies as determined by ultrasound evaluation, and fetuses with chromosomal or genetic diseases resulting from AS were excluded from the study.

RESULTS: A total of 73 patients who underwent AS according to the risky screening result were included in the study. Fetal Doppler measurements were performed at three different time periods. The parameters that were analyzed included the fetal umbilical artery, the ductus venosus, and the maternal right and left uterine arteries. The analysis revealed no statistically significant differences between the measurements.

CONCLUSIONS: It has been observed that AS, the most commonly used invasive diagnostic procedure in clinical practice, does not affect feto-maternal circulation and fetal heart function.

PMID:41558047 | DOI:10.24875/CIRU.25000107

Cir Cir. 2025;93(6):659-668. doi: 10.24875/CIRU.23000532.

ABSTRACT

OBJECTIVE: Different from physiological pain, post-operative pain is caused by surgical trauma. We aimed to systematically assess the effects of ropivacaine alone or in combination with dexmedetomidine on cesarean section and to conduct a meta-analysis.

METHODS: According to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement and Cochrane intervention system review manual, retrieval software and data analysis tools were used for literature retrieval, screening, exclusion and inclusion, data extraction, analysis and statistics, and risk assessment. A total of 37 literatures were retrieved, and 11 literatures were left after 26 duplicates were excluded.

RESULTS: A total of 37 literatures were retrieved in all databases, of which 11 literatures were left and finally 7 all published in English were obtained. They were seven randomized controlled trials on ropivacaine alone or in combination with dexmedetomidine applied in 502 parturients receiving cesarean section. The results of meta-analysis on main outcome indices showed that the number of parturients in need of rescue (c² = 28.62, p < 0.001, I² = 93%), incidence rate of adverse reactions (c² = 28.66, p = 0.007, I² = 55%), satisfaction (c² = 7.97, p = 0.05, I² = 62.3%), visceral respiratory response (c² = 19.26, p < 0.001, I² = 89.6%), satisfaction with muscle relaxation (c² = 6.92, p = 0.03, I² = 71.1%), and spinal anesthesia grade (c² = 25.89, p < 0.01, I² = 92.3%).

CONCLUSIONS: Ropivacaine combined with dexmedetomidine has a better prognostic effect on cesarean section and causes fewer adverse reactions.

PMID:41558045 | DOI:10.24875/CIRU.23000532

Cir Cir. 2025;93(6):620-627. doi: 10.24875/CIRU.24000285.

ABSTRACT

OBJECTIVE: We aimed to evaluate the role of attenuation values of perirenal fat calculated by computed tomography (CT) in differentiating aggressive renal masses.

METHODS: The data of 83 patients with histologically confirmed local stage renal cell carcinoma (RCC), who were treated with nephrectomy in our center, and 78 control group cases were analyzed. All measurements including renal mass volume, abdominal subcutaneous fat area and subcutaneous fat area pelvic subcutaneous fat area, and perirenal fat thickness and Hounsfield unit (perirenal fat tissue thickness [PFT]-hounsfield unit of perirenal fat [PFHU]) were performed on CT by the same radiologist.

RESULTS: In the statistical analysis of PFT and PFHU measurements between the groups, fat thickness was found to be lower in the patient group compared with the control group. However, hounsfield unit measurements were statistically significantly higher in the patient group (p < 0.0001). A cutoff value of -98.1 for the PFHU can identify the patient group with a sensitivity of 89.2% and a specificity of 84.6% (area under the curve = 0.9; 95% confidence interval: 0.86-0.95 p < 0.0001). In the multivariate logistic regression analysis, a PFHU ≥ -98.1 was independently associated with RCC after accounting for clinical and radiologic parameters.

CONCLUSION: We believe that measurement of the HU values of perirenal adipose tissue with the CT may be useful in differentiating aggressive renal masses and therefore in determining the appropriate treatment selection.

PMID:41558043 | DOI:10.24875/CIRU.24000285

Stat Methods Med Res. 2026 Jan 20:9622802251414594. doi: 10.1177/09622802251414594. Online ahead of print.

ABSTRACT

The identification of latent profile trajectories in longitudinal studies represents an important challenge for specialists since they could provide insights to better understand their problem of interest. The majority of the statistical methodologies for cluster analysis for longitudinal data are based on growth curve or mixed-effects models, and often incorporate covariates for a better adjustment. In particular, for Bayesian nonparametric methods, Dirichlet process mixture models are widely used together. We propose a clustering methodology for longitudinal data based on mixture models generated by a discrete random probability measure whose weights are decreasingly ordered by construction. Additionally, data is modeled without making use of covariates and assuming independence across time for individual measurements. Our approach also provides a straightforward procedure to merge some estimated groups, since it could happen that there are many of them, to be easily explained by experts. Our results suggest that, at least for a first analysis, this framework is enough to effectively detect groups in the data; further exploration of each group could incorporate extra information. We apply our methodology for detecting adiposity trajectories in Mexican children in a secondary analysis of the “Prenatal Omega-3 fatty acid Supplementation and Child Growth and Development” study (POSGRAD) cohort.

PMID:41558037 | DOI:10.1177/09622802251414594

Langmuir. 2026 Jan 20. doi: 10.1021/acs.langmuir.5c05989. Online ahead of print.

ABSTRACT

A unified energetic framework for Lewis acid-base interactions at solid surfaces is developed through a new model, which integrates linear, amphoteric, and polarization contributions of the polar adsorption enthalpy (-ΔH^p) into a quadratic thermodynamic expression by introducing explicit coupling and curvature terms, allowing simultaneous representation of donor-acceptor charge transfer, mutual polarization, and surface deformation (-ΔH_p) = K_ADN + K_DAN – KDN × AN + K_2A(DN)² +K_2D(AN)², where AN and DN are respectively the acceptor and donor numbers of solvents, K_A and K_D represent the Lewis acid and base coefficients of the solid, K is the coupling amphoteric constant, whereas K_2A and K_2D are the new second order surface parameters, respectively representing the quadratic curvature terms for acid and base centers. Using inverse gas chromatography (IGC), adsorption energetics were investigated on a broad range of solids─silica, alumina, ZnO, Zn, PMMA, β-zeolite, Rh-doped zeolites, and PMMA/silica hybrid interfaces. Statistical analysis (R², RMSE, AIC, BIC) across hierarchical models (2-5 parameters) revealed a universal convergence toward the five-parameter formulation, yielding R² ≥ 0.97 and significantly reduced RMSE values. The inclusion of amphoteric coupling (K) and bidirectional curvature (K_2A, K_2D) terms was found essential to reproduce experimental linearity and capture the physical duality of real surfaces. The new model thus transforms adsorption thermodynamics from an empirical linear model into a physically interpretable, statistically validated law. This formulation provides a unified energetic basis for describing the amphoteric and polarizable nature of oxides, polymers, and hybrid materials, and offers a predictive platform for future studies on temperature-dependent adsorption and electronic structure-surface energy correlations.

PMID:41558035 | DOI:10.1021/acs.langmuir.5c05989

Med Care. 2026 Jan 20. doi: 10.1097/MLR.0000000000002286. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine changes in persistent emergency department (ED) use by adult frequent ED (FED) users over time comparing prepandemic versus peripandemic periods, and to identify distinct characteristics of individuals who remained FED users over time during the pandemic versus the prepandemic era.

METHODS: We conducted a retrospective, secondary, longitudinal analysis in Texas, following 2 cohorts of ED users over 36 months (cohort 1: March 2017-February 2020; cohort 2: March 2019-February 2022). The main outcomes were whether a baseline FED (≥9 ED visits/12 mo) user remained a FED user persistently over the next 24 months and whether they were persistent FED users prepandemic or peripandemic. Multivariable regressions estimated changes in persistent FED use across cohorts and assessed differences between individuals who remained persistent FED users during the pandemic compared with the prepandemic period.

SETTING: All-payer Texas Hospital ED Research Data File from 2016 to 2022.

RESULTS: About 1 million individuals had at least one ED visit in the baseline years, totaling 4.6 million visits. Overall, FED users accounted for 8% of all ED users but over 40% of visits. Although more than half of FED users at baseline exhibited persistent FED use over the next 24 months, there was a 7% decline in the proportion of return FED users after the onset of COVID-19 which was statistically significant (AOR=0.82; 95% CI=0.80-0.84), and this effect was more pronounced when patients with any COVID-19-related ED visit during the study period were excluded (AOR=0.10; 95% CI=0.09-0.11). Individuals aged 45 years or older, those with congestive heart failure and diabetes with complications, and those with public insurance (when COVID-19-related visits were excluded) had higher odds of remaining persistent FED users during the pandemic.

CONCLUSIONS: Many FED users will seek ED care for multiple years, given their medical complexity. Future research should identify heterogeneous subgroups among persistent FED users to tailor interventions towards their needs.

PMID:41558015 | DOI:10.1097/MLR.0000000000002286

ACS Nano. 2026 Jan 20. doi: 10.1021/acsnano.5c19908. Online ahead of print.

ABSTRACT

Recently, nanocrystals in the regime of vanishing quantum confinement─termed bulk nanocrystals (BNCs)─have demonstrated optical gain characteristics. While their high-power lasing performance was demonstrated convincingly, the photophysics at low and intermediate powers─where charge-carrier populations are discrete─remain unexplored. Using single-photon avalanche diode (SPAD) array technology, we resolve the dynamics and energetics of six multicarrier excited states in individual CdSe/CdS core/shell BNCs, containing up to four electrons and two holes. Each state exhibits bimodal emission, indicative of thermal equilibrium between closely spaced electron and hole levels, confirmed via temperature-dependent single-particle measurements. Quantification of radiative and nonradiative decay channels reveals strongly suppressed Auger recombination through both the negative- and positive-trion pathways. We present a model that combines statistical scaling of rate constants with Fermi-Dirac thermal occupations of electron and hole levels, bridging the transitional regime between quantum-confined and bulk nanocrystals, and providing a comprehensive framework for understanding this emerging class of materials.

PMID:41558004 | DOI:10.1021/acsnano.5c19908

Hum Vaccin Immunother. 2026 Dec;22(1):2611475. doi: 10.1080/21645515.2025.2611475. Epub 2026 Jan 20.

ABSTRACT

The global rise in preterm infants presents specific challenges for hepatitis B prevention. Although hepatitis B vaccination is recommended, detailed understanding of immunogenicity patterns and influencing factors requires further investigation. We analyzed 699 preterm infants completing the hepatitis B vaccination series to assess immunogenicity via geometric mean concentration (GMC) and seroprotection rate (SPR). The regimen was highly immunogenic, with an overall SPR of 99.43% (GMC: 986.36 mIU/mL) and 95.28% of infants achieving high-level protection (anti-HBs ≥100 mIU/mL). Though SPR was consistently high across subgroups, notable GMC variations emerged: infants with gestational age <28 weeks markedly higher GMC (3,735.59 mIU/mL) than more mature subgroups. Statistically significant GMC differences were noted between immunization protocols, with uniform schedules yielding higher values (1,281.26 mIU/mL) than mixed approaches (691.91 mIU/mL; P < .001). Preterm infants of HBsAg-positive mothers maintained a high SPR (96.55%) despite a lower GMC (572.18 mIU/mL). This study confirms that hepatitis B vaccination induces a robust immune response at 1 to 2 months post-vaccination in preterm infants. Observed variations in antibody response magnitude related to vaccine expression system may inform optimization of initial vaccination strategies for preterm populations.

PMID:41557957 | DOI:10.1080/21645515.2025.2611475

J Med Internet Res. 2026 Jan 20;28:e78311. doi: 10.2196/78311.

ABSTRACT

BACKGROUND: Gender concordance (GC) between patients and physicians has been linked to trust and satisfaction in traditional health care. However, its role in telemedicine, especially in culturally complex settings like India, is underexplored. In India’s culturally diverse and gender-sensitive context, understanding GC becomes particularly relevant for specialties such as gynecology, dermatology, psychiatry, and urology, where discussions often involve intimate or stigmatized concerns. Despite rapid telemedicine expansion, little empirical evidence exists on whether GC affects patient-reported outcomes in this context.

OBJECTIVE: This study examined whether GC significantly influences patient satisfaction and self-reported recovery in teleconsultations across India, with a focus on specialty-specific effects in culturally sensitive specialties.

METHODS: We conducted a retrospective cross-sectional analysis of 286,196 anonymized teleconsultation records from a national telemedicine platform (January 2023-December 2024) spanning across 20 medical specialties using binary logistic regression. Records missing gender or satisfaction data were excluded from the analysis; recovery analyses included only consultations with completed day-21 follow-up surveys (n=1170, 0.4%). Outcomes included patient satisfaction (ratings 4-5 on a five-point scale) and self-reported recovery at follow-up. Logistic regression models (Stata 17.0) tested associations between GC and outcomes, controlling for consultation time, duration, and physician experience. Subgroup analyses were conducted for the top 5 specialties. Each record included key data on consultation duration, timing, physician experience, specialty type, patient satisfaction rating, and self-reported recovery status. The study excluded the pediatrics specialty from the analysis to control for the parental bias.

RESULTS: Of the 286,196 consultations, 164,008 (60.4%) were gender-concordant. Overall, 261,213 of 286,196 (91.3%) patients reported good satisfaction. GC had a statistically significant negative association with patient satisfaction (odds ratio [OR] 0.87, 95% CI 0.85-0.90; P<.001). Across gender, the male doctor received higher satisfaction. In gynecology, female patient-female doctor pairs had significantly higher odds of reporting recovery (OR 4.53, 95% CI 0.8-25.3; P=.099). Overall, consultation timing (OR 0.99, 95% CI 0.998-0.999; P<.001) and patient satisfaction (OR 20.13, 95% CI 12.06-35.38; P<.001) were stronger predictors of self-reported recovery than GC.

CONCLUSIONS: GC in telemedicine has a context-dependent impact. While it does not independently predict clinical recovery, it meaningfully shapes patient satisfaction. These findings highlight that gender sensitivity training and context-specific communication approaches may enhance telemedicine experiences in culturally sensitive domains. Integrating awareness of gender dynamics into telehealth design and policy could strengthen patient trust and engagement in virtual care. Future research should explore specialty-specific dynamics and improve follow-up response rates to better assess clinical outcomes.

PMID:41557951 | DOI:10.2196/78311