Tag: pubmed

ESC Heart Fail. 2025 Aug 12. doi: 10.1002/ehf2.15391. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Heart failure (HF) is a multifactorial disease for which peak oxygen uptake (VO₂peak) may potentially be a prognostic marker of adverse clinical outcomes. This systematic review and meta-analysis aimed to assess published data on the prognostic impact of VO₂peak in HF.

METHODS: A literature search of observational studies was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until January 2025. A meta-analysis was conducted using the random-effects inverse-variance model through hazard ratios (HRs). Increased heterogeneity among studies was evaluated through meta-regressions and publication bias via Egger’s test.

RESULTS: Sixty-four studies were included in this systematic review and meta-analysis. Per 1 mL/kg/min increase in VO₂peak, all-cause mortality [HR: 0.86, 95% confidence interval (CI) 0.82-0.90, I² = 85%, P < 0.01] and incident ventricular assist device, transplant and all-cause mortality (HR: 0.84, 95% CI 0.79-0.89, I² = 33%, P < 0.01) were significantly reduced, but statistical significance of VO₂peak with cardiovascular mortality was not observed (HR: 0.92, 95% CI 0.82-1.02, I² = 0%, P = 0.12) using adjusted models. Variance among studies was detected based on age, sex, body mass index, left ventricular ejection fraction, atrial fibrillation, hypertension, chronic kidney disease, diabetes and treatment. A significant risk of publication bias was evident.

CONCLUSIONS: VO₂peak is a prognostic marker for multiple causes of mortality and hospitalization in patients with HF, which may promote further insights into patient risk stratification for adverse events and targeted management.

PMID:40792415 | DOI:10.1002/ehf2.15391

Healthc Q. 2025 May;28(1):85-92. doi: 10.12927/hcq.2025.27626.

ABSTRACT

Little is known about domiciliary hostels (known as residential care facilities [RCFs] in Hamilton, Ontario) for those needing affordable housing and minimal supports. Our multiple-methods study examined the characteristics and health needs of 36 RCF tenants across four RCFs. We found that 64.4% of participants were 50+ years old, 22.2% had ever been unhoused, 77.4% had comorbid physical and mental illness and 83.3% had been hospitalized. Financial resources, capacity for work and physical pain were key quality-of-life concerns. A whole-systems approach involving healthcare, social care and housing is needed to serve this marginalized and aging population.

PMID:40792411 | DOI:10.12927/hcq.2025.27626

Healthc Q. 2025 May;28(1):12-15. doi: 10.12927/hcq.2025.27637.

ABSTRACT

The health workforce is the lifeblood of the Canadian health system. Comprehensive data is essential to inform policy and resources allocation and to address care gaps. While data collection challenges exist, Canadian Institute for Health Information’s (CIHI’s) new health workforce data standards and the establishment of Health Workforce Canada strive to improve data quality. Using findings from The State of the Health Workforce in Canada, 2023 report, this article provides insights into Canada’s health workforce and underscores the value of enhancing Canada’s data collection and reporting. Strengthening health workforce data will drive improvements, fostering a healthier population and a sustainable health workforce.

PMID:40792400 | DOI:10.12927/hcq.2025.27637

Healthc Q. 2025 May;28(1):7-11. doi: 10.12927/hcq.2025.27638.

ABSTRACT

People living with dementia require care from a variety of health professionals and in different settings to optimize their quality of life. A phase-based approach to costing health system use supports our understanding of the longitudinal costs of care through disease progression at a population level. This report estimates five-year and phase-based net health system costs of dementia.

PMID:40792399 | DOI:10.12927/hcq.2025.27638

Subst Use Addctn J. 2025 Aug 12:29767342251351751. doi: 10.1177/29767342251351751. Online ahead of print.

ABSTRACT

BACKGROUND: Stigma continues to be a barrier to accessing quality care for many patients with mental health conditions and/or substance use disorder (SUD), commonly referred to as addiction. This paper aims to evaluate the impact that undergraduate medical education (UME) has in reducing stigmatizing language use and potentially mitigating this barrier to care.

METHODS: A systematic review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines identified 2017 articles across 7 databases. Search terms related to stigma surrounding mental health, addiction, and suicide were incorporated into medical education. Blinded, double-reviewed papers meeting the inclusion criteria were further evaluated at full length to obtain information including sample size, variables, and outcomes.

RESULTS: Three studies met the review’s selection criteria: 1 pretest/posttest case series, 1 survey evaluating language stigma, and 1 qualitative essay review to discover common themes in medical students’ experience with patients with SUD. Statistically significant results included changes in characteristic association, attitudes based on language, and the effects of an educational intervention.

CONCLUSIONS: These results reinforce the importance of language and educational exposure in addressing stigma toward patients with mental health diagnoses. Although the results of all studies indicated some level of stigma associated with patients with a mental health diagnosis, there was limited consensus surrounding methods to reduce it in UME. Additional research on the implementation of medical school-focused mental health awareness programs is needed, preferably using rigorous randomized controlled trial study designs, longitudinal follow-up, and critical appraisal of texts to better understand effective interventions on persistent mental health stigma among medical students.

PMID:40792396 | DOI:10.1177/29767342251351751

Eur J Psychotraumatol. 2025 Dec;16(1):2536973. doi: 10.1080/20008066.2025.2536973. Epub 2025 Aug 12.

ABSTRACT

Background: Eye movement desensitisation and reprocessing (EMDR) therapy primarily aims to reduce the emotional intensity or subjective disturbance associated with traumatic memories. However, to date, only one study has investigated whether a reduction in emotional intensity is related to a reduction in post-traumatic stress disorder (PTSD) symptoms.Objective: Therefore, the purpose of the present study was to determine the relationship between changes in emotional intensity of traumatic memories during EMDR therapy and treatment outcomes.Method: One hundred twenty-five patients (88.8% female, M age = 36.4 years, SD = 11.40) with PTSD due to multiple traumatisation participated in a six-day intensive treatment programme consisting of a combination of six 90 min EMDR therapy sessions, six 90 min prolonged exposure sessions, six 60 min sessions of physical activity, and six 60 min psychoeducation sessions delivered at an academic outpatient mental healthcare clinic.Results: The results showed that a greater reduction in the emotional intensity of traumatic memory during EMDR therapy was associated with a larger decrease in PTSD symptoms at four weeks post-treatment.Conclusions: Clinicians should monitor changes in emotional intensity during treatment to assess treatment progress. Furthermore, the findings justify the use of memory disturbance as an outcome measure in experimental studies on EMDR therapy. Future research should focus on EMDR therapy processes and their relationship to treatment outcome, whereas replication of the present findings in other trauma populations is warranted.

PMID:40792392 | DOI:10.1080/20008066.2025.2536973

Phys Occup Ther Pediatr. 2025 Aug 12:1-17. doi: 10.1080/01942638.2025.2543271. Online ahead of print.

ABSTRACT

AIMS: Sensory differences are associated with disruption to daily occupations for both children and families. A one-to-one coaching approach with mothers is effective in increasing performance and satisfaction in children’s daily occupations, and in reducing maternal stress. The study aimed to pilot a brief online group coaching intervention for mothers of children with sensory differences.

METHODS: Eleven mothers participated in a brief online group coaching intervention of four x 90-minute sessions, based on Occupational Performance Coaching (OPC). Mothers gave both quantitative and qualitative feedback on their experience in the group. Mothers reported child occupational goals, maternal stress, and maternal sense of competence pre and post intervention.

RESULTS: Statistically significant improvement in child occupations and aspects of maternal stress were observed. Maternal sense of competence showed improvement but did not reach statistical significance. They valued the sensory focus and found the group safe and supportive; they also gave feedback on how groups could be improved.

CONCLUSIONS: For mothers of children with sensory differences and associated occupational concerns, a brief online group coaching intervention, based on OPC, has the potential to support child occupational performance and reduce maternal stress.

PMID:40792388 | DOI:10.1080/01942638.2025.2543271

Brain Behav. 2025 Aug;15(8):e70761. doi: 10.1002/brb3.70761.

ABSTRACT

OBJECTIVES: Therapeutic effects of hydrogen (H₂) on sepsis-associated encephalopathy (SAE), a severe neuroinflammatory disease, have been reported, but the underlying mechanism remains unclear. Metabolomic and phosphoproteomic analyses were utilized to explore the therapeutic mechanism of H₂.

METHODS: Caecal ligation and puncture (CLP) was used to establish an animal model of sepsis, after which the animals were treated with hydrogen. Mouse brains were obtained for analysis via tandem mass tag-based quantitative proteomics with IMAC enrichment of phosphopeptides and LC-MS/MS analysis to provide a broad overview of the metabolites. The metabolic profiles of mice in the SAE and SAE + H₂ groups were compared by multivariate statistical analysis. Different proteins (or enzymes) were verified by western blot (WB) and immunofluorescence (IF) analyses. ELISA was used to measure the level of DAG and PA. The influence of diacylglycerol kinase ζ (DGKζ) on glycerophospholipid metabolism in the mouse hippocampus was analyzed via coimmunoprecipitation (co-IP), and protein‒protein interactions were detected via LC‒MS/MS analysis.

RESULTS: A total of 1476 metabolites were identified, including 131 metabolic biomarkers in negative ion mode and 41 metabolic biomarkers in positive ion mode. These values were different from the standard, with variable importance for the projection (VIP) > 1 and p < 0.05. The correlated differential phosphoproteins found in the combined metabolomic and phosphoproteomic analyses participated in 131 pathways, and the differentially abundant metabolites were involved in 10 metabolic pathways, eight of which were related. The roles and interactions of these differentially expressed proteins and metabolites suggest that glycerophospholipid metabolism is activated in septic mice after the inhalation of hydrogen. Additionally, we quantified the downregulation of choline-phosphate cytidylyltransferase A (Pcyt1α)/CTP/CCTα and DGKζ and the upregulation of the metabolite sn-glycero-3-phosphoethanolamine in the glycerophospholipid metabolism pathway in mice in the SAE + H₂ group compared with mice in the SAE group. The WB and IF results revealed that DGKζ expression increased in septic mice but decreased after H₂ treatment. The ELISA showed that the expression of DAG was increased in SAE mice compared with Sham mice, while it decreased in SAE + H₂ mice compared with SAE mice. Correspondingly, the PA level was reduced in SAE group compared with Sham group and was increased after the inhalation of H₂. Furthermore, the regulation of DGKζ in hydrogen treatment in septic mice may be related to the interaction with phosphatase and tensin homolog (PTEN).

CONCLUSION: H₂ downregulates the levels of DGKζ and CCTα to alleviate brain damage in septic mice, and changes in DGKζ expression are balancing the transformation between the DAG anf PA, and it might also interact with PTEN. Thus, DGKζ may be a potential target in septic mouse therapy.

PMID:40792381 | DOI:10.1002/brb3.70761

Eur J Psychotraumatol. 2025 Dec;16(1):2535898. doi: 10.1080/20008066.2025.2535898. Epub 2025 Aug 12.

ABSTRACT

Background: Firefighters are considered to be high-risk professionals due to their frequent exposure to traumatic events. Although most firefighters will demonstrate resilience after trauma exposure, others develop symptoms of posttraumatic stress disorder (PTSD) or depressive symptoms. Insight in psychological predictors of these differential trajectories might inform the development of prevention programmes.Objective: To test the predictive validity of risk and protective factors for longitudinal trends of PTSD and depressive symptoms in firefighters using growth mixture modeling.Method: A total of 529 firefighters were followed for 3 years. Risk and protective factors (experiential avoidance, repetitive negative thinking (RNT), meaning in life, resilience and social support) as well as symptoms of PTSD and depression were assessed via self-report at the baseline assessment. PTSD and depressive symptoms were re-assessed over the following 3 years, with intervals of 6-12 months. Mixture growth models assigned individuals to latent classes for PTSD and depression symptoms separately. A 3-step approach was used to predict class membership by the included risk and protective factors.Results: Both for PTSD and depressive symptoms growth models, the 2-class solution showed the best fit. Experiential avoidance predicted both PTSD and depressive class membership, while RNT predicted only depressive class membership.Conclusions: Although the vast majority showed a generally stable low level of symptomatology, increased scores on experiential avoidance and RNT were associated with less favorable trajectories. Targeting these risk factors in prevention programmes might prevent development of posttrauma symptomatology and increase psychological resilience in firefighters and other high-risk professionals.

PMID:40792378 | DOI:10.1080/20008066.2025.2535898

Anesth Pain Med (Seoul). 2025 Jul;20(3):252-265. doi: 10.17085/apm.25264. Epub 2025 Jul 31.

ABSTRACT

BACKGROUND: Combining lidocaine with bupivacaine in brachial plexus blocks seeks to blend rapid onset with extended duration; yet, clinical advantages are uncertain. This systematic review assesses their efficacy against bupivacaine alone in ultrasound-guided brachial plexus blocks.

METHODS: A systematic search of PubMed, EMBASE, and Cochrane databases was conducted in May 2025. Randomized controlled trials (RCTs) comparing lidocaine-bupivacaine mixtures with bupivacaine alone in ultrasound-guided brachial plexus blocks were included. The primary outcome was sensory block onset time. Secondary outcomes included motor block onset time, sensory and motor block durations, and conversion to general anesthesia. Data were analyzed using a random-effects model, with heterogeneity assessed via I² statistics.

RESULTS: Of 1,490 identified articles, 7 RCTs (358 patients) met the inclusion criteria. No significant difference was found in sensory block onset time (mean difference [MD] -1.81 min, 95% confidence interval [CI] -3.92 to 0.29; P = 0.09; I² = 98%) or motor block onset time (MD 0.02 min, 95% CI -2.34 to 2.39; P = 0.99; I² = 95%) between groups. The mixture reduced sensory (MD -172.88 min, 95% CI -215.18 to -130.59; P<0.00001; I² = 90%) and motor block durations (MD -212.13 min, 95% CI -374.99 to -49.28; P = 0.01; I² = 93%).

CONCLUSIONS: No clinical benefit was observed from combining lidocaine with bupivacaine, as there was no improvement in block onset times and a reduction in block durations. Given the very low certainty of evidence, these findings should be interpreted with caution, and further high-quality RCTs are needed.

PMID:40792371 | DOI:10.17085/apm.25264