Tag: pubmed

BMC Prim Care. 2025 Jun 21;26(1):200. doi: 10.1186/s12875-025-02881-3.

ABSTRACT

BACKGROUND: Managing patients with chronic non-cancer pain (CNCP) in outpatient healthcare is challenging. Long-term opioid therapy is an option for treatment responders with guideline recommended indications. However, opioid use poses risks of severe side effects, including misuse, and therefore needs to be integrated into a high-quality healthcare process. This analysis evaluates the association between healthcare quality according to the evidence-based Chronic Care Model (CCM) in the treatment process of patients receiving long-term opioid therapy for chronic back and/or arthrosis pain, and patient-related or healthcare related variables.

METHODS: A cross-sectional patient survey was sent to a random sample of 3,037 individuals with long-term opioid therapy and chronic back and/or arthrosis pain insured by a large nationwide German statutory health insurance. Healthcare quality according to the CCM was assessed by the Patient Assessment of Chronic Illness Care (PACIC-5A) questionnaire. Internal reliability of the assessment instrument was determined using Cronbach’s α. Descriptive analysis of the outcome scales were conducted, alongside subgroup analyses considering patient characteristics, patient’s health situation, and pain treatment aspects. Testing for statistical significance was performed by Mann-Whitney U test and Kruskal-Wallis test. Effect sizes, namely Eta and Spearman’s Rank correlation coefficient, were calculated.

RESULTS: The analysis included 661 individuals. Participants were predominantly female (76%) with an average age of 69 years (SD 12.5). PACIC-5A score ratings across all (sub)scales were low, with a summary score rating of 2.4 (on a scale ranging from 1 (worst) to 5 (best)). Positive correlations with treatment quality were observed in the subgroup analysis concerning guideline-compliant pain treatment aspects such as setting therapy goals or a comprehensive treatment concept. Patient characteristics showed little to no correlations, except for a positive correlation between higher PACIC-5A rating and both lower age and higher education. Patient’s health situation presented a mixed picture, with no clear correlation between pain intensity/impairment, and PACIC-5A scores.

CONCLUSIONS: The provision of healthcare for patients with long-term opioid therapy for CNCP seems to be inadequate according to the CCM. Guideline-recommended pain treatment aspects exhibited a positive correlation with healthcare quality according to CCM. Enhancing the implementation of the CCM in the outpatient healthcare process may improve healthcare quality.

TRIAL REGISTRATION: German Clinical Trials Register, DRKS00024854. Registered 04/28/2021.

PMID:40544254 | DOI:10.1186/s12875-025-02881-3

BMC Oral Health. 2025 Jun 21;25(1):955. doi: 10.1186/s12903-025-06345-z.

ABSTRACT

OBJECTIVES: This study aims to evaluate the quality and quantity of gained and maintained bone width after Ridge splitting utilizing autogenic bone wedge versus mixed bone particles for horizontal ridge augmentation in the anterior aesthetic zone.

MATERIALS AND METHODS: This randomized clinical trial included 20 patients with horizontally deficient anterior maxillary alveolar ridges. Patients were divided equally into two groups. Group I received an autogenous bone wedge harvested from the chin area to be placed intercotically after ridge splitting (intervention group). Group II received mixed bone particles of autogenic and xenogeneic bone placed intercortically after ridge splitting (control group). Radiographic assessment of gained and maintained alveolar bone width at three vertical levels was performed using CBCT at three-time intervals (preoperative, immediate postoperative, and 6 months postoperative). Histologic and histomorphometric analysis of core biopsy harvested immediately before implant placement was also performed to assess bone quality and % of newly formed bone area using H&E and Mansons trichrome stains. Collected data were conducted for statistical analysis.

RESULTS: The outcome of the studied grafts showed a significant increase of the immediate postoperative bone width in the control group more than the intervention group, with a mean difference from the preoperative bone width (2.17 ± 1.10) mm for the control group and only (1.44 ± 0.66) for the intervention group. In contrast, the 6-month postoperative bone width was decreased in both groups with a mean difference from the immediate postoperative bone width (1.21 ± 0.54) in the control group (p-value < 0.001) compared to only (0.41 ± 0.50) in the intervention group (p value = 0.135); this statistical data revealed that the bone wedge technique of the intervention group helped to maintain the gained bone width more than the packed bone particles of the control group. Moreover, the intervention group showed higher value and quality of newly formed mature bone with well-formed havarsian canals than the control group, which showed lower bone quality of osteoid and fibrous tissue with remnants of xenogenic bone particles microscopically.

CONCLUSIONS: The two-stage ridge-splitting procedure using an interposition bone wedge is an effective method for horizontal ridge augmentation in the horizontally deficient anterior maxilla.

CLINICAL RELEVANCE: The two-stage Ridge splitting with an inter-positional bone wedge ensures better bone width maintenance and quality.

TRIAL REGISTRATION: The study was registered on ClinicalTrials.gov on 24/07/2024 under the registry number “NCT06529653”. It adhered to the Declaration of Helsinki on medical research ethics and received approval from the Institutional Research Ethics Committee of the Faculty of Dentistry, Cairo University (IRB number: 161022).

PMID:40544250 | DOI:10.1186/s12903-025-06345-z

Diabetol Metab Syndr. 2025 Jun 21;17(1):237. doi: 10.1186/s13098-025-01801-w.

ABSTRACT

BACKGROUND AND AIMS: Nonalcoholic fatty liver disease (NAFLD) is strongly associated with dietary habits and the gut microbiota. The dietary index for the gut microbiota (DI-GM) is a newly proposed index that reflects gut microbial diversity based on dietary intake. However, its relationship with NAFLD remains unclear. This study aimed to explore the association between DI-GM and the risk of NAFLD.

METHODS: In this cross-sectional study, we utilized data from the NHANES 2009-2018. Multivariable logistic regression, restricted cubic spline curves (RCS), subgroup analysis, and mediation analysis were used to evaluate the association between DI-GM and the risk of NAFLD.

RESULTS: A total of 4,923 participants were included in the study. According to the fully adjusted model, a significant inverse association was observed between DI-GM and NAFLD (OR = 0.883, 95% CI: 0.835-0.932, P < 0.001). After stratification by quartiles, compared with participants in the first quartile of DI-GM score, those in the fourth quartile had a 36.5% lower odds of developing NAFLD (OR = 0.635, 95% CI: 0.481-0.839, P = 0.002). Mediation analysis revealed that 72.69% of the association between DI-GM and NAFLD was mediated by BMI (P < 0.001). Subgroup analysis suggested that the association between DI-GM and NAFLD might be influenced by race (P for interaction < 0.05). RCS analysis revealed a linear correlation between DI-GM and NAFLD (P for nonlinear = 0.883).

CONCLUSIONS: DI-GM is negatively associated with NAFLD risk, with BMI mediating this relationship and race being a significant influencing factor.

PMID:40544245 | DOI:10.1186/s13098-025-01801-w

Biomed Eng Online. 2025 Jun 21;24(1):75. doi: 10.1186/s12938-025-01410-8.

ABSTRACT

BACKGROUND: Plastic bronchitis (PB) is a rare but potentially life-threatening condition that requires particular attention in pediatric patients, specifically those presenting with severe Mycoplasma pneumoniae pneumonia (SMPP). This study aimed to identify risk factors associated with PB in children with SMPP and develop a comprehensive risk factor scoring system.

METHODS: A retrospective analysis was conducted on SMPP patients who underwent bronchoscopy between January 2018 and October 2023. Based on bronchoscopic and pathological examination results, patients were categorized into PB (n = 142) and non-PB (n = 274) groups. Clinical manifestations, laboratory data, and imaging findings were analyzed. Risk factors for PB in SMPP children were identified through univariate and multivariate logistic regression analyses. A nomogram model incorporating independent risk factors was developed, and a PB risk factor scoring system was established. Model validation was performed through a prospective validation study.

RESULTS: Among 416 SMPP children (197 males, 219 females), mean age at disease onset was 6.9 ± 2.9 years and 6.6 ± 2.8 years in the PB and Non-PB groups, respectively. Multivariate logistic regression analysis identified eight independent predictors of PB in SMPP children: dyspnea, decreased breath sounds, neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase (LDH), mean platelet volume to platelet ratio (MPV/PLT), pleural effusion, ≥ 2/3 lobe consolidation, and atelectasis. The nomogram prediction model demonstrated excellent discriminative ability (AUC = 0.92, 95% CI 0.892-0.948, P < 0.005) and strong calibration between predicted and observed outcomes. In the prospective validation cohort (n = 565), the scoring system effectively stratified patients into risk categories: high-risk (71.62% PB incidence), intermediate-risk (59.79%), and low-risk (5.33%), with statistically significant inter-group differences (P < 0.001). The PB group exhibited significantly longer hospitalization durations, extended glucocorticoid treatment periods, higher proportions of glucocorticoid therapy utilization, and a greater frequency of bronchoscopy interventions (≥ 2 sessions) compared to the Non-PB group (all P < 0.05).

CONCLUSIONS: In this study, we developed and validated a nomogram to PB in children with SMPP. This model serves as a clinically practical tool for early PB identification, enabling physicians to initiate timely interventions and optimize disease management strategies.

PMID:40544237 | DOI:10.1186/s12938-025-01410-8

Neuropsychopharmacology. 2025 Jun 21. doi: 10.1038/s41386-025-02147-7. Online ahead of print.

ABSTRACT

While numerous studies have examined the subjective response to alcohol as an intermediate phenotype to understand its variability, heritability, and predictive capacity for alcohol-related disorders, in-depth analyses linking alcohol reactivity indicators to genetic factors within a large cohort have been absent. Our study aimed to quantify the exact contribution of each genetic variant relevant to the alcohol metabolism to the variability in alcohol response. Specifically, we focused on two primary genes involved in alcohol metabolism (ALDH2 and ADH1B) and three additional loci (ALDH1B1, ALDH1A1, and GCKR) that have been shown to have significant associations with drinking behaviors in Japanese individuals. We conducted the first study to assess the relationship between subjective response to alcohol (SR), evaluated by various assessment subscales, and genetic factors using an intravenous clamp technique in 429 healthy Japanese young adults. By reducing the dimensionality of the data to assess similarity structures, we identified three distinct clusters of SRs and participants. Each participant cluster exhibited a distinct alcohol response profile shaped by specific genetic contributions. Participant cluster 1 demonstrated the strongest response, followed by participant cluster 2, and then participant cluster 3. Participant cluster 1 may also be the most strongly influenced by the allelic status of ALDH2 and ADH1B. SR patterns varied accordingly, and the enrichment of the ALDH2*2 and ADH1B*2, differed across both participant and subscale clusters. Notably, the three participant clusters closely aligned with the three subscale clusters, highlighting a consistent genotype-phenotype relationship. Furthermore, the proportion of variance explained by these genes also varied across subscale clusters. Contrary to known functions, ADH1B showed associations at later timings when ALDH2 associations attenuate. Our three-cluster classification may improve prevention by enabling early identification of individuals at health risk.

PMID:40544219 | DOI:10.1038/s41386-025-02147-7

Ann Surg Oncol. 2025 Jun 21. doi: 10.1245/s10434-025-17664-4. Online ahead of print.

ABSTRACT

BACKGROUND: Lynch syndrome (LS) is an inherited disorder associated with an increased risk of colorectal and extracolonic malignancies, including gastric cancer (GC). This study quantifies the association between specific risk factors and GC development in patients with LS.

PATIENTS AND METHODS: We searched the PubMed and Scopus databases for prospective and retrospective cohort studies that evaluated patients with genetically confirmed LS and reported associations between demographic, clinical, or genetic characteristics and GC. We conducted a meta-analysis to pool risk ratios (RR) for key risk factors, including sex, genetic mutations, family history of GC, and Helicobacter pylori (HP) infection. We assessed heterogeneity using Cochran’s Q test and the I² statistic.

RESULTS: A total of 14 studies comprising 29,170 patients with LS met the inclusion criteria, of which 13 were included in the meta-analysis. Male sex (RR 2.8; 95% CI 2.2, 3.6; p < 0.001; I² = 0%), MLH1 (RR 1.8; 95% CI 1.4, 2.3; p < 0.001; I² = 0%) and MSH2 variants (RR 2.5; 95% CI 2.0, 3.2; p < 0.001; I² = 0%), family history of GC (RR 3.5; 95% CI 2.0, 5.8; p < 0.001; I² = 0%), and HP infection (RR 2.8; 95% CI 1.2, 6.8; p = 0.023; I² = 12.8%) were associated with increased GC risk. In contrast, the MSH6 variant was associated with lower GC risk (RR 0.6; 95% CI 0.4, 0.8; p = 0.006; I² = 0%).

DISCUSSION: Our findings confirm that male sex, MLH1 and MSH2 variants, family history of GC, and HP infection are significant risk factors for GC in individuals with LS. These findings support the need for individualized surveillance strategies and targeted risk-reduction measures to improve early detection and patient outcomes.

PMID:40544206 | DOI:10.1245/s10434-025-17664-4

Commun Psychol. 2025 Jun 21;3(1):93. doi: 10.1038/s44271-025-00265-y.

ABSTRACT

Perception is biased by expectations and previous actions. Pre-stimulus brain oscillations are a potential candidate for implementing biases in the brain. In two EEG studies (43 and 39 participants) on somatosensory near-threshold detection, we investigated the pre-stimulus neural correlates of an (implicit) previous choice bias and an explicit bias. The explicit bias was introduced by informing participants about stimulus probability on a single-trial level (volatile context) or block-wise (stable context). Behavioural analysis confirmed adjustments in the decision criterion and confidence ratings according to the cued probabilities and previous choice-induced biases. Pre-stimulus beta power with distinct sources in sensory and higher-order cortical areas predicted explicit and implicit biases, respectively, on a single subject level and partially mediated the impact of previous choice and stimulus probability on the detection response. We suggest pre-stimulus beta oscillations in distinct brain areas as a neural correlate of explicit and implicit biases in somatosensory perception.

PMID:40544197 | DOI:10.1038/s44271-025-00265-y

Psychiatry Res. 2025 Jun 16;351:116595. doi: 10.1016/j.psychres.2025.116595. Online ahead of print.

ABSTRACT

Aggressive behaviours pose a significant threat to both individual and societal security. Increasing evidence suggests that individuals exhibiting such behaviours demonstrate altered neurochemical levels including metabolites, neurotransmitters and receptors. However, findings from previous studies have shown inconsistencies. This study aimed to elucidate these neurochemical alterations through a case-control meta-analysis. A comprehensive literature search was conducted using Web of Science, Medline, and PubMed databases, identifying forty eligible studies (registration number: CRD420251014162). The neurochemicals examined included indictors of serotonin (5-HT), dopamine, N-acetyl aspartate (NAA), glutamate, glutamine, choline, creatine, phosphocreatine, myo-inositol, gamma-aminobutyric acid, homovanillic acid, norepinephrine, 3-methoxy-4-hydroxy-phenylglycol, neuropeptide Y-like immunoreactivity, and substance P-like immunoreactivity. These studies investigated neurochemical changes in the cerebrospinal fluid (CSF) and various brain regions, including the prefrontal cortex, orbital frontal cortex, anterior cingulate cortex, middle temporal gyrus, medial temporal lobe, parietal cortex, striatum, thalamus, amygdala, hippocampus, midbrain, and brainstem. Our meta-analysis revealed a significant reduction in NAA levels in the prefrontal cortex of individuals exhibiting aggressive behaviours compared to controls. Furthermore, NAA levels demonstrated a negative correlation with the severity of aggressive behaviours. The findings for the other neurochemicals all did not reach statistical significance. These findings suggest that reduced prefrontal NAA levels may serve as a neurobiological correlate of aggressive behaviours, with implications for developing assessment tools and targeted interventions.

PMID:40543113 | DOI:10.1016/j.psychres.2025.116595

Auris Nasus Larynx. 2025 Jun 20;52(4):420-425. doi: 10.1016/j.anl.2025.06.001. Online ahead of print.

ABSTRACT

OBJECTIVE: Heightened listening effort in cochlear implant (CI) users may have a significant impact on their balance performance. This study aims to investigate the impact of listening effort on postural control in typical-hearing adults presented with CI-simulated speech in noise.

METHODS: The study participants were fifty-eight adults with typical hearing (aged 20-24 years). Turkish Hearing in Noise Test (HINT) sentences were used as the speech material. The Modified Clinical Test of Sensory Interaction in Balance (mCTSIB) was used to evaluate static balance and it was performed by using Computerized Static Posturography. In the experimental design of the study, healthy participants with typical hearing listened to non-simulated and CI-simulated sentences and repeated what they heard while the participants were performing the mCTSIB test on the force platform of static posturography.

RESULTS: In this study, the participants’ postural sway velocity rates were compared under three task conditions. The results demonstrated a statistically significant increase in participants’ sway velocity rates when listening to 12-channel filtered speech in noise material compared to those from the baseline mCTSIB assessment. There was no statistically significant differences in postural sway rate ratios when listening to unfiltered speech in noise material.

CONCLUSION: Increased listening effort for CI-simulated speech-in-noise resulted in poorer postural balance. A better understanding of such a difficulty may help us to evaluate postural balance from different perspectives and plan an appropriate vestibular rehabilitation program.

PMID:40543097 | DOI:10.1016/j.anl.2025.06.001

Intern Med J. 2025 Jun 21. doi: 10.1111/imj.70123. Online ahead of print.

ABSTRACT

AIM: To determine the status of the current rheumatology workforce and model projections for the future rheumatology workforce in Australia.

BACKGROUND: The rheumatology workforce in Australia is currently facing a significant shortage. Identification of the optimal number of rheumatologists for the Australian population is challenging, and requires assessment of the current workforce.

METHODS: A survey of Australian Rheumatology Association (ARA) full members was undertaken in 2021, collecting demographic data, information about type and location of rheumatology practice and other clinical and non-clinical work, work intentions and job satisfaction. Descriptive statistics and multivariable regression analyses were performed. The clinical full-time equivalent (cFTE) was estimated based on the reported number of half-days worked in clinical rheumatology practice. Using the age and gender distribution of rheumatology specialists from the Department of Health Workforce Data Tool, workforce projections were produced for the period from 2018 to 2038.

RESULTS: A total of 81% (323/404) of full members of the ARA completed the survey. The median (interquartile range (IQR)) rheumatology clinical half-days worked/week was 6 (4-8). Adjusted to survey response, the reported clinical workload equates to the cFTE of 231 adult and 13 paediatric rheumatologists. A current shortfall of 302 adult rheumatologists and 41 paediatric rheumatologists exists relative to optimal care estimates. Furthermore, 38% of rheumatologists are considering reducing clinical hours temporarily or permanently, predominantly within the next 2 years. Based on current supply models, the shortfall will improve but will not reach optimal levels by 2038.

CONCLUSION: Australia has an undersupply of both adult and paediatric rheumatologists compared to optimal care ideals. An ageing workforce, many part-time, and the significant number planning to reduce hours within 2 years will exacerbate this undersupply unless the supply of rheumatologists is substantially increased.

PMID:40543071 | DOI:10.1111/imj.70123