Tag: pubmed

Mol Autism. 2025 Jun 14;16(1):35. doi: 10.1186/s13229-025-00664-2.

ABSTRACT

BACKGROUND: Autistic communities in Europe continue to face difficulties accessing services despite increasing rates of autism diagnosis in recent years.

METHODS: To investigate autistic people’s access to services in Europe and reasons for unsuccessful access, we conducted the ACCESS-EU survey comprising of 2322 formally diagnosed autistic people and family carers living within the European Union (EU) and the United Kingdom (UK). The survey also examined age group (adult vs. child) and gender (male vs. female) differences in results.

RESULTS: Overall, autistic people reported access to therapy (33.38%), mental health (29.89%), educational (27.05%), medical (34.28%), financial (26.66%), needs assessment (14.90%), information/referral (14.73%), social care (14.43%), employment (7.54%), housing (6.80%), legal (3.96%), helpline (3.40%) and other services (0.26%), and most (≥ 57.61%) had waited up to 6 months from referral to access most services. Several respondents were also unable to access therapeutic (13.53%), mental health (11.90%), autism diagnostic (5.92%), needs assessment (8.32%), financial (9.62%), educational (8.10%), social care (7.39%), information/referral (6.14%), medical (7.28%), housing (5.92%), employment (5.43%), legal (3.42%), and helpline services (2.34%). Reasons cited by respondents for their unsuccessful service access included service unavailability (23.08%), service unsuitability or participant ineligibility (20.04%), long waitlists (17.42%), service unaffordability (11.80%), and rejection from service due to autism diagnosis (9.87%), along with other reasons not listed in the survey (18.42%). Significant age group and gender differences were observed for successful access to services, waiting time, unsuccessful access and reasons for unsuccessful access. Among the five most represented countries in the survey-the UK (33.33%), Spain (14.04%), Poland (13.87%), France (11.07%) and Germany (6.03%)-overall service access was most inconsistent in Poland and the UK, highest in Germany and Spain but poorest in France.

LIMITATIONS: Issues related to survey presentation such as the languages in which the survey was conducted and the phrasing of some questions should be considered, as well as issues regarding subjectivity and ambiguity of data analysis such as translation of non-English responses into English.

CONCLUSIONS: Our findings suggest that service access among autistic people in Europe is inconsistent. Significant improvement to current policies is required to enhance access to services across Europe.

PMID:40517258 | DOI:10.1186/s13229-025-00664-2

J Health Popul Nutr. 2025 Jun 14;44(1):196. doi: 10.1186/s41043-025-00962-8.

ABSTRACT

BACKGROUND: Female Genital Mutilation (FGM) also referred to as female genital cutting or female circumcision, has become a global health concern. It is a deeply entrenched traditional practice involving partial or total removal of the external female genitalia for non-medical reasons. To inform effective policymaking and raise awareness about FGM’s health risks, understanding socioeconomic and demographic factors influencing the status of circumcision is crucial.

METHODS: The study employed logistic regression and maximum likelihood models to examine the association between mothers’ educational level and the circumcision status of under five girls in Ethiopia. The data used in this study was extracted from the 2016 Ethiopian Demographic and Health Survey (EDHS) report, which was conducted by the Central Statistical Agency (CSA).

RESULTS: The study found a strong association between mother’s educational level and the risk of circumcision of under five girls. The girls whose mothers have no education or primary education have significantly higher odds of being circumcised with crude odds ratios of 7.69 (2.27-26.02) and 5.54 (1.64-18.65), respectively, compared to those whose mothers have secondary or higher education. Additionally, children whose mothers are Muslims (AOR: 1.98, 1.55-2.53), rural residence (AOR: 1.83, 1.21-2.78), and paternal education level (no education AOR: 2.03, 1.24-3.35) were also significant factors.

CONCLUSIONS: The results highlight the importance of maternal education, religious beliefs, and geographic location in influencing circumcision practices in Ethiopia. We recommend that more public education on the effect of FGM on the girl child will be enrolled especially in the rural communities in Ethiopia.

PMID:40517256 | DOI:10.1186/s41043-025-00962-8

Diabetol Metab Syndr. 2025 Jun 14;17(1):213. doi: 10.1186/s13098-025-01766-w.

ABSTRACT

OBJECTIVE: Metabolic syndrome (MetS) has a high prevalence in the United States (US); however, limited research comprehensively evaluates the relationship between muscle quality index (MQI) and MetS. This study aims to investigate the association between MQI and MetS.

METHODS: Adults aged 20-60 years from the 2011-2014 National Health and Nutrition Examination Survey were included. Handgrip strength (HGS) was measured using a dynamometer, and appendicular skeletal muscle mass (ASM) was assessed via dual-energy X-ray absorptiometry. MQI_total was calculated as the sum of HGS from both hands divided by ASM. Weighted multivariable logistic regression models and restricted cubic splines (RCS) were used to explore the association between MQI_total and MetS, and subgroup, interaction, and sensitivity analyses were conducted.

RESULTS: A total of 4,503 US residents were included in the study, with 1,165 diagnosed with MetS, yielding a prevalence of 25.9% (1,165/4,503). The weighted multivariable logistic regression model indicated that after adjusting for multiple covariates, MQI was negatively associated with the risk of MetS (odds ratio [OR] = 0.49, 95%CI: 0.32-0.73). Among the different components of MetS, MQI was negatively associated with elevated waist circumference (OR = 0.19, 95%CI: 0.12-0.28), elevated high-density lipoprotein cholesterol (OR = 0.66, 95%CI: 0.51-0.85), and elevated serum triglycerides (OR = 0.66, 95%CI: 0.51-0.85). RCS revealed a negative linear relationship between MQI and MetS (P < 0.001, P_non-linear = 0.98).

CONCLUSION: Low MQI is associated with an increased risk of MetS, exhibiting a linear relationship. These findings suggest that improving muscle quality may be an effective strategy for the prevention of MetS.

PMID:40517241 | DOI:10.1186/s13098-025-01766-w

Int J Equity Health. 2025 Jun 15;24(1):175. doi: 10.1186/s12939-025-02515-1.

ABSTRACT

BACKGROUND: Assessing food and nutrition security among indigenous populations in Brazil is challenging due to their significant cultural and linguistic diversity. This study aimed to validate a national food insecurity measurement scale for indigenous peoples in Brazil (EBIA-I).

METHODS: A total of 495 indigenous households, from 15 rural communities and one urban area, were included in the analyses. Internal psychometric validity scale was tested with the Rasch Model, and external validity was examined with bivariate analyses.

RESULTS: An 8-item scale was internally valid (Infit values ranged between 0.7 and 1.3), 6 of the items referred to households with children under 16 years of age, 5 to households only with residents aged 16 years or more, with 3 being common to both. The external validity of the EBIA-I was high, as shown by the significantly lower prevalence of moderate or severe food insecurity, in households where some members regularly received income vs. those not receiving any income, 17.5% vs. 30.6%, respectively. Likewise, interviewees who self-reported good/very good health vs. poor/very poor health status were less likely to experience moderate or severe food insecurity (19.1% vs. 34.8%).

CONCLUSIONS: EBIA-I is a valid scale with strong potential to inform decisions by policymakers and to support indigenous organizations monitoring, addressing, and advocating for policies to prevent or mitigate food and nutrition insecurity in their communities.

PMID:40517230 | DOI:10.1186/s12939-025-02515-1

BMC Geriatr. 2025 Jun 14;25(1):425. doi: 10.1186/s12877-025-06090-6.

ABSTRACT

BACKGROUND: There is limited understanding regarding the patterns and trajectories of social participation and their associations with medical care utilization among rural older adults. We aimed to investigate the patterns and trajectories of social participation and their associations with medical care utilization among rural older adults in China using longitudinal data.

METHODS: In this longitudinal study, we used data from 1600 participants aged 60 years and above in the Chinese Longitudinal Healthy Longevity Survey (CLHLS). We included participants with social participation information in 2011 (T1) as the baseline and followed them up in 2014(T2) and 2018(T3). Latent profile analysis (LPA) and latent transition analysis (LTA) were employed to identify the latent classes of social participation and the transition probabilities between these classes. Multinomial logistic regression was used to examine the predictors of transitions, while a two-part model and cross-lagged model were utilized to clarify the longitudinal relationship between social participation and medical care utilization among rural older adults.

RESULTS: Three social participation classes were identified by LPA: low, moderate, and high social participation. The high social participation class exhibited strong stability, with rare transitions to other classes. Subjective economic status, self-rated health, and the number of chronic diseases significantly predicted social participation transition patterns (P < 0.05). Regarding outpatient care utilization, social participation consistently predicted more frequent outpatient visits in all waves (P < 0.05) but was associated with higher outpatient expenses only at T3 (P < 0.05). However, no significant association was observed between social participation and inpatient care utilization. This finding was further supported by cross-lagged modeling, demonstrating significant effects of social participation on outpatient care utilization (β = 0.016 to 0.018, SE = 0.004, P < 0.001).

CONCLUSIONS: This research reveals the social participation dynamics in rural older adults and their effects on medical care utilization in China. Social participation can significantly promote outpatient care utilization among rural older adults. Targeted policy and practice are needed for those with low levels of social participation in rural areas.

PMID:40517227 | DOI:10.1186/s12877-025-06090-6

Trials. 2025 Jun 14;26(1):206. doi: 10.1186/s13063-025-08906-7.

ABSTRACT

BACKGROUND: Antenatal multiple micronutrient supplementation (MMS) has been shown to be more effective than iron-folic acid (IFA) alone in reducing adverse pregnancy and birth outcomes. However, there is a concern that MMS containing 30 mg of iron may be less effective in reducing maternal anemia compared to IFA supplements containing 60 mg of iron. This poses a clinical and programmatic dilemma for countries with a high burden of maternal anemia (> 40% prevalence) where the World Health Organization (WHO) recommends using IFA with 60 mg of iron.

METHODS/DESIGN: We will conduct an individually randomized, quadruple-blind superiority trial of daily antenatal MMS in Dar es Salaam, Tanzania (n = 6381 pregnant women). Participants will be randomized to receive a daily MMS regimen during pregnancy containing 60 mg iron, 45 mg iron, or 30 mg iron at a ratio of 1:1:1. The trial participants, outcome assessors (research staff and care providers), investigators, trial statistician, and data analysts will be blinded. Pregnant women will be enrolled in the trial before 20 weeks of gestation and will receive the randomized MMS regimen from enrollment until the time of pregnancy outcome/delivery. The primary outcome is maternal third-trimester moderate or severe anemia (Hb < 10.0 g/dL). The proportion of women who have moderate or severe anemia at 32 weeks of gestation will be compared between MMS containing 60 mg iron versus MMS containing 30 mg iron, as well as MMS containing 45 mg iron versus MMS containing 30 mg iron. Secondary outcomes include maternal hemoglobin concentration, anemia, maternal iron deficiency, and maternal iron deficiency anemia at 32 weeks gestation and 6 weeks postpartum; preeclampsia, antepartum bleeding, postpartum hemorrhage, maternal peripartum infection, pregnancy-related death, symptoms consistent with depression, fatigue, and maternal malaria during pregnancy and 42 days following; fetal death, stillbirth, birth weight, low birthweight, gestational age at birth, preterm birth, birthweight for gestational age, and small-for-gestational age birth; infant hemoglobin concentrations, infant iron status, neonatal death, and infant death at 6 weeks of age; and maternal side effects. Relative risks for binomial outcomes and mean differences for continuous outcomes and their 95% confidence intervals will be calculated for all the primary and secondary outcomes.

DISCUSSION: This study will produce causal evidence on whether MMS containing 60 or 45 mg of iron is superior to MMS containing 30 mg of iron in reducing maternal anemia and improving other important maternal and infant health outcomes. The findings of this study will inform Tanzania and similar contexts on the optimal formulation of MMS as many countries begin transitioning from IFA to MMS.

TRIAL REGISTRATION: ClinicalTrials.gov NCT06079918. Registered on 2023-10-06.

TRIAL STATUS: The trial is recruiting. We report protocol version 1.7 dated March 2, 2025. Recruitment started with the first patient enrolled on March 3, 2025. At the submission of this manuscript on April 10, 2025, 111 participants have been randomized. Recruitment is ongoing and should be completed by December 2026.

PMID:40517226 | DOI:10.1186/s13063-025-08906-7

Spine Deform. 2025 Jun 14. doi: 10.1007/s43390-025-01120-0. Online ahead of print.

ABSTRACT

PURPOSE: Using patient-reported questionnaires (PROs), the impact of adolescent idiopathic scoliosis (AIS) on psychosocial well-being domains of Self-Image, Self-Esteem, Mental Health and Peer Relationships, and the interplay between these domains, physical function and clinical measures was investigated.

METHODS: 95 patients from a convenience cohort with AIS completed questionnaires (SRS-22r, SAQ, PODCI, PROMIS, and Harter’s Self-Perception Profile), and clinical data were collected. PRO scores analyses included descriptive statistics, unpaired t-test comparing typical peers and correlations. Scores on PRO domains for the lowest interquartile groups (LowIQR) were compared with the Remaining Cohorts (RC) using t tests, and differences were evaluated using Cohen’s d statistic.

RESULTS: The entire study cohort reported psychosocial well-being similar to their AIS and typical peers. Scores on PsychoSocial Self-Image measures and PODCI Happiness, a mental health domain, and physical function measures of PODCI Transfer&Mobility and Sports&Physical Function were worse than typical population. Curve severity and clinical measures were not linked to PRO scores. For LowIQR patients, scores were statistically worse than the RCs in many domains with effect sizes indicating clinically noticeable differences. Patients in LowIQRgroups reported scores below typical peers on Mental Health, Self-Esteem and global self-image measures, while RC did not.

CONCLUSIONS: This research enhances the clinical utility of PROs for assessing psychosocial well-being in patients with AIS by establishing thresholds for identification of patients reporting scores worse than their AIS peers. Interventions targeting psychosocial well-being may help mitigate the potential negative impact of scoliosis on adolescents.

PMID:40517211 | DOI:10.1007/s43390-025-01120-0

J Robot Surg. 2025 Jun 14;19(1):292. doi: 10.1007/s11701-025-02439-6.

ABSTRACT

Robotic ventral hernia repair (rVHR) is an advanced form of minimally invasive surgery that offers enhanced precision, reduced complications, and faster recovery time. However, direct comparisons between enhanced-view totally extraperitoneal (eTEP) and transabdominal preperitoneal (TAPP) approaches remain limited. This study aimed to compare the safety and clinical outcomes of eTEP and TAPP in rVHR. In this retrospective cohort study, 117 patients underwent rVHR (82 eTEP, 35 TAPP) between 2023 and 2024. Propensity score matching (PSM) (1:1) balanced baseline characteristics, resulting in 33 patients per group. Patient demographics, operative data, and postoperative outcomes were collected from electronic medical records. Statistical analyses were conducted using SPSS, with statistical significance defined as p < 0.05. Following matching, eTEP demonstrated significantly longer operative times (median 115 vs. 83 min, p = 0.004) and larger mesh sizes (420 cm² vs. 195 cm², p = 0.001). Surgical drains were more frequently used in eTEP (48.4% vs. 3%, p = 0.001). Postoperative outcomes, length of hospital stay, and pain scores did not differ significantly between the groups. Surgical site occurrences (SSOs) showed no significant difference between groups (18.1% eTEP vs. 9% TAPP, p = 0.475). Both eTEP and TAPP are safe and effective robotic approaches for ventral hernia repair with comparable clinical outcomes. The longer operative time and larger mesh size in eTEP suggests its preferential use in more complex hernia cases requiring detailed anatomical reconstruction.

PMID:40517208 | DOI:10.1007/s11701-025-02439-6

J Robot Surg. 2025 Jun 14;19(1):293. doi: 10.1007/s11701-025-02459-2.

ABSTRACT

An isthmocele, also called a cesarean scar defect or niche, is a defect in the lower uterine segment myometrium that occurs as a result of a cesarean delivery. This study aims to review our institution’s comprehensive data following robotic-assisted laparoscopic isthmocele repair (RA-IR) including birth outcomes and changes in the dimensions of the isthmocele. This was a retrospective case series at a single high-volume tertiary medical center in the United States with over 2500 gynecologic surgeries performed yearly. All women with an identified isthmocele who underwent RA-IR between 9/2015 and 12/2022 were included. Detailed chart review, imaging review with a pelvic radiologic specialist, and post-operative questionnaire were utilized in our analysis. Our primary outcome was post-operative live births. Secondary outcomes included post-operative fertility rate, radiologic changes, and symptom improvement. Twenty-eight patients underwent RA-IR during the study period. Of the 17 patients who attempted pregnancy, 94.1% were able to conceive status post-repair including 7 patients with a pre-operative diagnosis of primary or secondary infertility. Of these, 12 who continued their pregnancies achieved their goal of a live birth (n = 12 of 15, 80.0%). There were a total of 20 pregnancies post-repair, resulting in 12 live births, 6 miscarriages, 1 cesarean scar pregnancy, and 1 termination, which corresponds to a live birth rate per pregnancy of 60.0% (n = 12 of 20). There was a statistically significant improvement in myometrial depth, width, and residual myometrial thickness postoperatively (p < 0.1). The greatest difference was seen in the depth of the isthmocele. The residual myometrial thickness improved from mean of 0.63 mm before to 5.13 mm after surgery. Twelve patients completed a questionnaire regarding symptoms and obstetric outcomes. Symptom improvement was reported by 100% of patients, with 66.7% experiencing complete resolution. RA-IR results in improved defect width, depth, and residual myometrial thickness with preservation of fertility and good obstetric outcomes with a live birth yield of 80.0%.

PMID:40517207 | DOI:10.1007/s11701-025-02459-2

Calcif Tissue Int. 2025 Jun 14;116(1):85. doi: 10.1007/s00223-025-01389-3.

ABSTRACT

The relationship between muscle mass and visceral fat with mortality risk in diabetes has been extensively studied. This study investigates the association between the appendicular skeletal muscle mass-to-visceral fat area ratio (SVR) and cardiovascular and cancer-related mortality in diabetic patients in the United States. A nationwide cohort study was conducted using NHANES data (2011-2018), including 1439 diabetic patients with dual-energy X-ray absorptiometry (DXA) measurements. Weighted Cox proportional hazards models and restricted cubic splines (RCS) were employed to evaluate the association between SVR and cause-specific mortality rates. Weighted receiver operating characteristic (ROC) curves were used to assess the diagnostic performance of SVR and other conventional indicators in predicting mortality. After adjusting for multiple confounding factors, SVR showed a linear negative association with cardiovascular and cancer-related mortality in diabetes. Each 0.01-unit increase in SVR was associated with a 3% reduction in the risk of cardiovascular death and a 2% reduction in cancer-related death. However, SVR demonstrated weak diagnostic performance for both cardiovascular and cancer mortality, with weighted AUCs of 0.520 and 0.527, respectively, compared to other metrics including BMI, WC, ASM, and VFA. Although SVR was significantly associated with cardiovascular and cancer mortality, its predictive performance was not superior to that of simpler or more established indicators, suggesting that it has limited clinical utility for predicting mortality in diabetic patients.

PMID:40517189 | DOI:10.1007/s00223-025-01389-3