Tag: pubmed

Anesth Pain Med (Seoul). 2025 Jul;20(3):230-241. doi: 10.17085/apm.25207. Epub 2025 Jul 31.

ABSTRACT

BACKGROUND: Intravenous (IV) fluid therapy is essential and widely used; however, it is associated with high error rates, largely due to human factors, necessitating constant and careful monitoring by medical staff. Gravity-based systems are prone to errors, whereas electronic pumps, though more accurate, are limited by size, cost, and complexity. In this study, the impact of single-drop weight measurement and real-time light source monitoring on the accuracy of gravity-based infusion systems was evaluated.

METHODS: Gravity-based IV sets with IV infusion flow regulators (IIFRs) from three manufacturers were tested using 1,000 ml of 0.9% saline. The drops per min and the drop weight were recorded using a pulse oximeter, which served as a light source. The flow rates from the pulse oximeter group (PO) were compared with those from the manufacturer’s drop volume (C) and the IIFR groups. The mean absolute percentage error (MAPE) of predicted versus actual volumes was analyzed along with correlations between the residual volume and drop rate.

RESULTS: The PO group values were statistically closer to those of the actual measurements than the C and IIFR groups values (P < 0.05), demonstrating higher accuracy and lower MAPE, except at 300 ml/h when than those of the C group, independent of residual volume. The residual volume strongly correlated with the drop rate (r > 0.9).

CONCLUSIONS: Real-time drop measurements using light sources combined with single-drop weight assessment improve the accuracy of these systems. Integrating pulse oximeters into IV sets may enhance clinical precision and reduce provider workload.

PMID:40792368 | DOI:10.17085/apm.25207

Brain Behav. 2025 Aug;15(8):e70758. doi: 10.1002/brb3.70758.

ABSTRACT

OBJECTIVE: To explore the relationship between children’s eating behaviors, parental feeding behaviors, and child temperament among Turkish preschoolers aged 3-6 years.

METHODS: A cross-sectional survey study was conducted between September 2021 and January 2022. Participants included 203 parents of preschool-aged children (aged 3-6 years) attending nursery and kindergartens, as well as those seeking help from the Department of Child and Adolescent Psychiatry. Analyses were performed utilizing IBM SPSS Statistics version 23.0. Categorical variables are summarized in tables, showing counts and percentages in the descriptive statistics section. The association between continuous variables was assessed through Spearman correlation analysis. In this study, a significance level of p < 0.05 was established.

RESULTS: Emotional feeding was positively associated with emotional overeating and a desire to drink in children (r = 0.316, p < 0.01; r = 0.266, p < 0.01). Emotional overeating correlated negatively with instrumental feeding (r = -0.158, p < 0.05) but positively with encouragement feeding (r = 0.215, p < 0.01). The temperamental trait of surgency was positively associated with the desire to drink (r = 0.177, p < 0.05) and satiety responsiveness (r = 0.226, p < 0.01). Negative affect correlated negatively with enjoyment of food (r = -0.255, p < 0.01) and food fussiness (r = -0.225, p < 0.01) but positively with satiety responsiveness (r = 0.347, p < 0.01) and slowness in eating (r = 0.282, p < 0.01). Effortful control exhibited negative associations with emotional overeating (r = -0.207, p < 0.01) and the desire to drink (r = -0.141, p < 0.05).

CONCLUSIONS: This study identifies significant associations between specific parental feeding behaviors and children’s eating habits, along with the influence of child temperament traits on these behaviors. Key findings highlight the positive relationship between emotional feeding and children’s emotional overeating, along with the significant negative impacts of effortful control on emotional overeating and the desire to drink. Other noteworthy results include the strong negative association between negative affect and enjoyment of food, as well as its positive correlation with satiety responsiveness and slowness in eating. These results suggest that both parental feeding strategies and individual temperamental traits significantly influence preschoolers’ eating behaviors. Interventions tailored to enhance parental feeding styles while considering children’s temperaments may promote healthier eating practices in young children.

PMID:40792357 | DOI:10.1002/brb3.70758

Cureus. 2025 Jul 12;17(7):e87786. doi: 10.7759/cureus.87786. eCollection 2025 Jul.

ABSTRACT

Introduction This study addresses the global controversy over routine bone scans for newly diagnosed prostate cancer patients, focusing on the Ghanaian population. It aims to assess the predictive value of prostate-specific antigen (PSA) for bone metastasis and the role of serum alkaline phosphatase (ALP) in enhancing prediction. Methods This study was conducted at Korle Bu Teaching Hospital over 14 months and included 258 treatment-naïve prostate cancer patients. Clinical evaluation, PSA and ALP tests, and technetium-99 bone scans were performed. Chi-square and t-tests identified significant predictors of bone metastasis. The predictors were regressed logistically into a model, which was validated, trained, updated, and programmed into a digital risk calculator. All analysis was at a 0.05 significance level. Findings The mean age of participants was 68.18 ± 7.34 years (68.83 and 67.77 years for the metastatic and non-metastatic groups, respectively). Increasing PSA (OR=4.59, p<0.001), ALP (OR=4.24, p<0.001), DRE risk group (OR=1.60, p<0.05), and International Society of Urological Pathology (ISUP) (OR=1.72, p<0.05) were associated with increasing risk of bone metastasis. A two-unit rise along the D-Amico risk strata was associated with a 28-fold increase in the odds of metastasis (low risk vs high risk, OR=29.56, p<0.001; low risk vs intermediate risk, OR=2.80, p=0.368). Among participants with more than 30% of their core-biopsy volume involved with adenocarcinoma, 54.0% had bone metastasis (OR=1.33, p=0.06). Also, 57% of those with perineural invasion had bone metastasis (OR=4.0, p=0.01). Perivascular invasion was not a statistically significant predictor (p=0.346). All patients with cribriform pattern histology had bone metastasis (100%; OR=9.40, p=0.04). Of those with bone pain, 48.4% had bone metastasis (OR=2.25, p=0.002). PSA and ALP exhibited strong independent associations with bone metastasis, with PSA outperforming other predictors (AUC under ROC curve of 81.65% vs 77.97% for ALP, 69.73% for DRE, and 79.19% for ISUP. On multivariate logistic regression, the combined AUC for PSA and ALP was 89.28%, while that for combined PSA, ALP, DRE, and ISUP was 92.3%). A PSA cut-off of 18.95 ng/mL or an ALP cutoff of 59.48 IU/L, individually, detected 97.5% of bone metastasis. Combining a PSA cut-off of 20.85 ng/mL with an ALP cut-off of 44.0 IU/L yielded a 100% detection rate, while PSA above 20 ng/mL, DRE >T2c, and Gleason score >7 predicted 95% of bone metastasis in this cohort. In a logistic regression model, ALP, ISUP, and DRE stage significantly improved the bone metastasis detection rate of PSA in prostate cancer (z-statistic gain at p=0.05 was 2.41; new AUC=92.29%). The inclusion of bone pain, cribriform pattern histology, perineural invasion, and percentage core involvement of adenocarcinoma yielded just marginal gains (maximum z-statistic gain at p=0.05 was 0.61; new AUC: 93.90%). Conclusion For high-risk prostate cancer, bone scans are recommended. In Ghana, a PSA cut-off of 18.95 ng/mL could safely exclude 20% of bone scans, missing only 2.5% of bone metastases, saving $170 per patient ($55,000 nationally per year). Combining this with an ALP cut-off of 44.0 IU/L (0% false-negative rate) detects 100%. A validated risk model combining PSA, ALP, ISUP, and DRE achieves an AUC of 92.3%, sensitivity of 89.9%, specificity of 78.8%, and accuracy of 85.6%, offering a practical, digitally deployed, decision support tool.

PMID:40792342 | PMC:PMC12338857 | DOI:10.7759/cureus.87786

Cureus. 2025 Jul 12;17(7):e87764. doi: 10.7759/cureus.87764. eCollection 2025 Jul.

ABSTRACT

Introduction Calcium oxalate stone formation is driven by urinary supersaturation, pH, and imbalances in promoters and inhibitors, with acidic nighttime urine (pH <6) promoting crystal nucleation due to low citrate levels. Hence, the purpose of this pilot study was to evaluate the effectiveness of Subap Plus capsule, a polyherbal Ayurvedic formulation, for its preventive effects on early morning pH, 24-hour urinalysis parameters, and supersaturation indices in recurrent calcium oxalate stone formers. Methodology A two-week nonrandomized, uncontrolled pilot study was conducted at Ace Hospital, Pune, India, with 58 patients (20-60 years) with confirmed recurrent calcium oxalate stones. Patients received Subap Plus capsules twice daily alongside dietary advice. Baseline and post-intervention assessments included early morning urinary pH, 24-hour urinalysis (uric acid, oxalate, calcium, citrate, sodium, phosphorus, potassium, and magnesium), and supersaturation indices of calcium oxalate, calcium phosphate, and uric acid. Paired t-tests compared pre- and post-intervention values, and the statistical significance was set to p ≤ 0.05. Results Significant improvements included increased early morning pH (5.55 ± 0.39 to 5.80 ± 0.51, p = 0.001), decreased uric acid (311.38 ± 161.87 mg/day to 275.12 ± 149.82 mg/day, p = 0.017), increased potassium (28.09 ± 14.58 mmol/day to 35.16 ± 16.30 mmol/day, p = 0.002), and decreased uric acid supersaturation (0.53 ± 0.45 to 0.37 ± 0.38, p = 0.006). Citrate showed a trend toward an increase (623.16 ± 429.93 mg/day to 702.99 ± 429.50 mg/day, p = 0.068), and calcium oxalate supersaturation decreased nonsignificantly (2.87 ± 3.27 to 2.37 ± 1.66, p = 0.206). Calcium phosphate supersaturation increased in 37 (63.79%) of patients (p = 0.263). Conclusions The study concluded that the Subap Plus capsule demonstrated effectiveness in modulating early morning pH and urinary parameters to prevent calcium oxalate stone recurrence. The current study supports the role of Ayurvedic polyherbal formulations in urolithiasis management. However, large, randomized controlled trials are essential to confirm efficacy and address limitations, such as the short intervention duration. Hence, future research should optimize the formulation to enhance preventive effects.

PMID:40792340 | PMC:PMC12337062 | DOI:10.7759/cureus.87764

Cureus. 2025 Jul 12;17(7):e87759. doi: 10.7759/cureus.87759. eCollection 2025 Jul.

ABSTRACT

BACKGROUND AND OBJECTIVES: Diabetic neuropathy is a common microvascular complication of type 2 diabetes mellitus (T2DM), like diabetic retinopathy and nephropathy. The neutrophil count is raised during infection and inflammation, and the lymphocyte count is decreased in immunocompromised patients. The platelet count suggests the thrombotic and inflammatory conditions. Hence, the neutrophil-lymphocyte ratio (NLR) is the ratio of absolute counts of neutrophils to lymphocytes. The systemic immune-inflammation index (SII) is the product of NLR and platelet count. These indicate the immuno-inflammatory status of the patient. There is a dearth of literature assessing the SII of individuals with diabetic neuropathy. Hence, we mapped this study to evaluate and compare complete blood count (CBC), NLR, and SII of diabetic patients with and without neuropathy. We also correlated NLR and SII values of the study population.

METHODS: This cross-sectional study was conducted from April 2024 to March 2025 at Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar, India. We included adult diabetic patients admitted to the KIMS medicine ward. Hemoglobin, total leucocyte count (TLC), neutrophil count, lymphocyte count, platelet count, length of T2DM, and glycated hemoglobin (HbA_1c) were all measured shortly after their hospitalization. NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count. We obtained the SII value by multiplying the platelet count by NLR. R software version 4.4.3 (R Core Team, Vienna, Austria) was used for statistical analysis.

RESULTS: One hundred ninety-three diabetic patients were found eligible for this study. Their median age was 66 (55-73) years. Of them, 92 (47.7%) were women. The study population’s median white blood cell (WBC) was 9.88 (8.72-11.24) × 10⁹/L. The median counts of lymphocytes and neutrophils were 2214 (1720-2647)/µL and 6864 (5796-8256)/µL, respectively. The study population’s median platelet counts were 250 (189-293) × 10⁹/L. The study population’s median HbA_1c was 8.61 (7.57-9.31)%. The study population’s median duration of diabetes mellitus was 11 (6-18) years. The study population’s median SII and NLR were 755.3 (521.4-1002.2) × 10⁹ cells/L and 2.93 (2.40-4.21), respectively. NLR and SII values were positively correlated (r = 0.92, p < 0.001). Regardless of neuropathy, the association between NLR and SII was identical among the study subjects.

CONCLUSION: Diabetes patients without neuropathy and those with neuropathy had comparable CBC, NLR, and SII values. The results of our study cannot be extrapolated due to the limited sample size and failure to account for several variables, including concurrent medications, comorbidities, and length of hospital stay.

PMID:40792338 | PMC:PMC12336742 | DOI:10.7759/cureus.87759

Cureus. 2025 Jul 12;17(7):e87787. doi: 10.7759/cureus.87787. eCollection 2025 Jul.

ABSTRACT

Background Pulse oximetry is a vital tool for screening critical congenital heart disease (CCHD) in newborns. However, fixed thresholds may not account for physiological variations caused by altitude. This study evaluates the impact of elevation on normal neonatal oxygen saturation (SpO₂) in Jordan, spanning sites from moderate altitude to below sea level. Methods In a cross-sectional study, 149 healthy, full-term newborns were screened at three hospitals located at 1,050 m (Amman), sea level (Aqaba), and 420 m below sea level (Dead Sea). Preductal and postductal SpO₂ measurements were taken between 24 and 72 hours of life using standardized protocols. Statistical analyses, including analysis of variance (ANOVA) and Tukey’s honestly significant difference (HSD), were used to compare SpO₂ levels across altitudes. Results Mean upper-limb SpO₂ was significantly lower at 1,050 m (96.6%) compared to sea level (98.0%) and sub-sea level (97.8%) (p < 0.001). Similar trends were observed for lower-limb SpO₂. No significant differences were found between sea-level and sub-sea-level sites. Despite lower SpO₂ at moderate altitude, no newborns met the American Academy of Pediatrics (AAP) criteria for CCHD. Conclusion Moderate altitude results in a statistically significant, but modest, reduction in neonatal SpO₂, potentially increasing false-positive rates in CCHD screening. Our findings support the development of altitude-specific screening protocols to improve diagnostic accuracy and reduce unnecessary interventions. Further research with larger and more diverse populations is needed to inform altitude-adjusted guidelines, particularly in geographically varied regions like Jordan.

PMID:40792335 | PMC:PMC12338855 | DOI:10.7759/cureus.87787

Cureus. 2025 Jul 12;17(7):e87760. doi: 10.7759/cureus.87760. eCollection 2025 Jul.

ABSTRACT

Background Chronic rhinosinusitis (CRS) significantly impacts patients’ quality of life. Accurate diagnosis is crucial for effective management, with diagnostic nasal endoscopy (DNE) and computed tomography (CT) being primary tools. It significantly impacts patients’ quality of life, causing symptoms like nasal congestion, facial pain, decreased sense of smell, and nasal discharge. This study aimed to evaluate the sensitivity and specificity of DNE in comparison to CT, the gold standard, for CRS diagnosis. Methodology A prospective observational study was conducted at Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur. A total of 109 patients presenting with CRS symptoms for more than 12 weeks were included. All participants underwent both DNE and CT of the paranasal sinuses. Correlations between radiological and endoscopic findings were evaluated to identify patterns and inform treatment decisions. Results A statistically significant correlation was found between endoscopic and radiological findings (χ² = 55.20, p < 0.00000001), indicating strong diagnostic concordance. DNE achieved a sensitivity of 93.42%, specificity of 75.75%, positive predictive value (PPV) of 89.33%, and negative predictive value (NPV) of 83.33%. These findings highlight the diagnostic utility of DNE for detecting mucosal abnormalities, while also emphasizing the superior anatomical detail provided by CT imaging. Conclusion DNE is a valuable, minimally invasive tool for diagnosing CRS, offering high sensitivity in detecting mucosal inflammation. However, CT remains essential for a complete anatomical assessment, particularly in complex or refractory cases.

PMID:40792313 | PMC:PMC12336917 | DOI:10.7759/cureus.87760

Cureus. 2025 Jul 11;17(7):e87750. doi: 10.7759/cureus.87750. eCollection 2025 Jul.

ABSTRACT

The COVID-19 pandemic had a widespread impact on healthcare systems globally, particularly affecting older adults. This study was conducted to investigate long-term changes in hip fracture (HF) incidence before and during the COVID-19 pandemic in a rural and aged Japanese community. We retrospectively reviewed HF cases (femoral neck and trochanteric fractures) in patients aged ≥65 years at the Shonai Amarume Hospital in the Yamagata prefecture, Japan, from January 1, 2015, to December 31, 2024. Cases were divided into pre-pandemic (2015-2019) and pandemic (2020-2024) periods. Statistical analysis was performed using the Wilcoxon rank-sum and Kruskal-Wallis tests. A total of 78 HFs occurred in the pre-pandemic period and 134 during the pandemic. There were no significant differences in patient age or sex ratio between the two groups. Statistical analysis showed a significant increase in HF incidence during the pandemic (Wilcoxon p = 0.0461; Kruskal-Wallis p = 0.0495) in this rural and aged community. These findings suggest the need for targeted fall prevention and social support systems for older adults, particularly in aging regions, during public health crises.

PMID:40792309 | PMC:PMC12335979 | DOI:10.7759/cureus.87750

Front Med (Lausanne). 2025 Jul 28;12:1604280. doi: 10.3389/fmed.2025.1604280. eCollection 2025.

ABSTRACT

INTRODUCTION: As for global brachial plexus avulsion, the recoveries of intrinsic muscles are not satisfying after nerve transfers.

METHODS: A retrospective review of 31 patients treated with different CC7 transfers after GBPA was carried out. The modified group: CC7 transfer to median nerve and DBUN by medial antebrachial cutaneous nerve (MACN). The conventional group: CC7 transfer to median nerve. The mean follow-up period was 3 years.

RESULTS: After CC7 transfers, one patient got M3, one patient got M2 and two patients got M1 in abductor digiti minimi (ADM) in the modified group, while no patients had recovery in ADM in the conventional group. The recoveries of abductor pollicis brevis (APB) were similar between two groups. Motor unit potentials (MUP) of ADM and dorsal interosseous muscle (DIM) appeared in 4 and 2 patients respectively after surgery in the modified group. Nobody gained MUP of ADM or DIM in the conventional group. There were no statistical differences of MUP in APB, compound motor action potential (CMAP) in FDPI and FCR between two groups.

DISCUSSION: CC7 transfer to median nerve and DBUN by pedicled ulnar nerve and MACN could initially make intrinsic muscles regeneration in patients with GBPA, while not affect the recovery of median nerve.

PMID:40792305 | PMC:PMC12336263 | DOI:10.3389/fmed.2025.1604280

Sci Rep. 2025 Aug 11;15(1):29372. doi: 10.1038/s41598-025-04561-9.

ABSTRACT

Intensive mono-cropping and abiotic stresses in the tea (Camellia sinensis L.) growing areas caused soil nutrient degradation and low crop productivity. Site-specific management requires understanding the mechanism of the geographical setting and its variability that plays a pivotal role in the growth and quality of tea crops. The present study targeted the tea-growing soils of India to determine their nutrient status as well as profile mineralogical composition to establish soil and land use management strategies for the region. Collected surface soil samples were analyzed for soil parameters. Soil profile sampling was done for clay mineral characterization of the area by using X-ray diffraction method. The Geo-statistical approach was used in this study-A method for analyzing geographical distribution and variability that is evolved from classical statistics. Study revealed that soil reaction was acidic to normal (3.95-6.80); non-saline (0.05-0.47 dS m^-1) and soil organic carbon (SOC) range was low to medium (0.06-0.62%). Macronutrients, available nitrogen (N) status was low (62.5-237 kg ha^-1), whereas available phosphorus (P) (3.0-59 kg ha^-1) and potassium (K) (100-403 kg ha^-1) levels were low to high. Micronutrients, iron (Fe) and manganese (Mn) was deficient to sufficient, whereas, zinc (Zn) and copper (Cu) were sufficient in range. Descriptive statistics and geostatistical methods of the analysis revealed that soil pH, electrical conductivity (ECe), SOC, available K, Fe and Mn were strongly spatial dependent, whereas N, Zn, and Cu, were moderately spatial dependent, caused by both random factors as well as structural factors (soil texture, soil type, fertilization, and local ecological restoration management). Clay mineralogical characterization of soil profile (surface and subsurface) revealed the dominance of illite clay minerals followed by kaolinite and smectite and less concentration of chlorite and quartz showing greater forms of K presence in the soils. Therefore, the recommendation is that, application of balance fertilizers with combination of inorganic (macro and micronutrients) and organic sources of nutrients might be beneficial for sustainable tea production in this region. It will ultimately improve soil fertility, enhance tea yield and support the socio-economic well-being of tea growers.

PMID:40790121 | DOI:10.1038/s41598-025-04561-9