Tag: pubmed

Environ Monit Assess. 2025 Jun 14;197(7):752. doi: 10.1007/s10661-025-14246-5.

ABSTRACT

This study examines the spatial and temporal characteristics of heatwaves (HWs) in Türkiye, a region predominantly characterized by an arid-semiarid macro-Mediterranean climate, which is susceptible to frequent droughts. Using daily maximum temperature data from 277 meteorological stations across Türkiye (1970-2022), the research analyzes HW frequency, duration, and intensity, adopting a definition aligned with the World Meteorological Organization (WMO). Temporal trends were assessed using statistical trend analysis, while spatial patterns were evaluated through spatial autocorrelation methods. The findings indicate a statistically significant increase in the frequency of heatwaves over time, with the annual average number of events rising from approximately 5 in the 1970s to over 10 since the 2000s. This trend is particularly evident in the Marmara, Aegean, and Black Sea regions. Trend analysis results reveal that heatwave duration has exhibited a statistically significant increase throughout the study period in 96.4% of the analyzed stations. The most pronounced increases have been observed in the Marmara, Black Sea, and Eastern Mediterranean regions. These results underscore the growing impact of climate change on Türkiye and highlight the need for targeted adaptation and mitigation strategies. Insights from this study can inform the development of early warning systems, resource allocation, and public health preparedness, ultimately enhancing community and ecosystem resilience to climate-related challenges.

PMID:40515861 | DOI:10.1007/s10661-025-14246-5

Arch Orthop Trauma Surg. 2025 Jun 14;145(1):344. doi: 10.1007/s00402-025-05914-9.

ABSTRACT

INTRODUCTION: Hip fractures are among the most common injuries sustained by geriatric patients. Expedient surgery is advocated, but striking the balance of early surgical intervention and medical optimization remains a challenge. Prior studies have shown that preoperative transthoracic echocardiography (TTE) delays hip fracture surgery, but indications for TTEs are unclear. As such, the purpose of our study was to determine the proportion of TTEs for geriatric hip fracture patients that were indicated per established guidelines: American College of Cardiology/American Heart Association (ACC/AHA) guidelines, history of pulmonary hypertension, syncope/stroke work-up.

MATERIALS AND METHODS: A retrospective case control study of 113 consecutive geriatric hip fracture patients who underwent preoperative TTEs from 1/2018 to 12/2019 at 2 Academic Level 1 Trauma Centers were examined. 113 matched (age±5 years, sex, fracture type, surgery, surgery within 1 year of TTE patient) hip fracture patients who did not undergo preoperative TTE were identified for comparison. The primary outcome was the proportion of TTEs that were indicated per established guidelines. Secondary outcome measures included: change in perioperative management, time to surgery, length of stay (LOS), 90-day complications and mortality, and 2-year mortality.

RESULTS: Eighty-one (71.7%) TTEs were indicated. Seventeen (15.0%) patients underwent additional preoperative interventions. More TTE patients had an arterial (p < 0.0001) and/or central line (p < 0.03). The TTE group had longer time to surgery with median time to surgery of 44.8 h vs. 24.2 h for the non-TTE group (p < 0.0001). LOS was longer for TTE patients with median LOS of 7 days vs. 5 days for the non-TTE patients (p < 0.0001). There was higher 90-day mortality for the TTE group (odds ratio 4.4, 95% confidence interval 1.3-14.7, p < 0.03) but no difference at 2-years.

CONCLUSION: Preoperative TTEs are associated with delay in surgery and higher 90-day mortality even though many of these TTEs are indicated per established guidelines and may result in changes in perioperative management. These results highlight the need for expedient preoperative evaluation of hip fracture patients.

PMID:40515855 | DOI:10.1007/s00402-025-05914-9

Urolithiasis. 2025 Jun 14;53(1):114. doi: 10.1007/s00240-025-01780-7.

ABSTRACT

Accurate estimation of stone fragment size during ureteroscopy facilitates safe extraction. We aimed to determine whether training experience improves the accuracy of estimating fragment size. Six mock stones (range 1.2-7.4 mm) were placed in a renal model for simulated flexible ureteroscopy. Urology residents and high-volume ureteroscopy surgeons estimated fragment size and extractability through a 12/14-French sheath. Responses were compared among 3 training levels (PGY 1-2, PGY 3-5, and surgeons) and analyzed by objective measures of surgical experience and technical skill. Categorical and continuous variables were analyzed using ANOVA and Pearson correlation, respectively. 16 residents and 6 surgeons were included. Participants underestimated fragment size by 30% overall. As fragment size increased, the discrepancy between estimates and true size also increased. There was no statistical difference in accuracy among training groups and no association with experience or skill. Participants nearly always (98%) correctly identified < 4 mm fragments as extractable; in contrast, participants identified > 4 mm fragments as not extractable only 59% of the time. There was similarly no difference in predicting extraction by training level, experience, or skill. Both novice and experienced surgeons substantially underestimate fragment size during ureteroscopy, which may increase the risk of unsafe extraction. Technologies that enable real-time measurement may improve accuracy, regardless of surgeon experience.

PMID:40515834 | DOI:10.1007/s00240-025-01780-7

Pediatr Radiol. 2025 Jun 14. doi: 10.1007/s00247-025-06284-5. Online ahead of print.

ABSTRACT

BACKGROUND: The standard method for diagnosing Meckel diverticulum and identifying ectopic gastric mucosa is ^{99 m}Tc-pertechnetate imaging. Premedication with H₂ receptor antagonists enhances the scan’s sensitivity by reducing the washout of ^{99 m}Tc-pertechnetate activity from the intestinal lumen.

OBJECTIVE: After the withdrawal of ranitidine, we compared the efficacy of the proton pump inhibitor pantoprazole as an alternative premedication agent for ^{99 m}Tc-pertechnetate Meckel diverticulum imaging.

MATERIALS AND METHODS: This study assessed the scan quality of 141 children (aged 1 month to 204 months (median = 84 months)) who underwent Meckel scintigraphy over 10 years at a single institution. Before its withdrawal in December 2020, ranitidine was utilized for premedication, while pantoprazole was used thereafter. Therefore, patients were divided into two premedication groups: ranitidine (n = 88) and pantoprazole (n = 53). A high-quality scan was defined as having no ^{99 m}Tc-pertechnetate activity in the duodenal and other intestinal lumens. The effectiveness of pantoprazole in reducing ^{99 m}Tc-pertechnetate release in the duodenum and other intestinal lumens was compared to that of ranitidine. Differences in scan quality between the groups were analyzed using the two-proportion Z-test. In patients with positive scans, the lesion-to-background activity ratio of the Meckel diverticulum was measured and compared between the premedication groups.

RESULTS: Premedication with pantoprazole resulted in 47.2% of scans showing no ^{99 m}Tc-pertechnetate release, 37.7% with activity localized either in the duodenum or other intestine, and 15.1% exhibiting activity in both regions. In comparison, ranitidine resulted in 45.5% of scans with no ^{99 m}Tc-pertechnetate release, 40.9% with activity localized either in the duodenum or other intestine, and 13.6% showing activity in both regions. P-values were not found to be significant in all comparisons. Twelve scans were positive; all patients had Meckel diverticulum confirmed at surgery. For positive scans, the lesion-to-background activity ratio for the Meckel diverticulum was similar between the ranitidine and pantoprazole groups.

CONCLUSION: This study demonstrates that pantoprazole is statistically non-inferior to ranitidine regarding scan quality and lesion-to-background activity ratios for Meckel diverticulum detection. Pantoprazole offers a reliable alternative for clinical protocols in the absence of ranitidine.

PMID:40515817 | DOI:10.1007/s00247-025-06284-5

Graefes Arch Clin Exp Ophthalmol. 2025 Jun 14. doi: 10.1007/s00417-025-06874-x. Online ahead of print.

ABSTRACT

PURPOSE: To analyze choriocapillaris (CC) perfusion using swept-source optical coherence tomography angiography (SS-OCTA) and spectral-domain optical coherence tomography angiography (SD-OCTA) in five CC slabs in patients with intermediate age-related macular degeneration (iAMD).

METHODS: This is a cross-sectional study of 23 eyes of 20 patients who underwent three 3 × 3 mm OCTA, one with SS-OCTA and two with SD-OCTA, a non-averaged scan (V1) and a four-scan volume (V4). Percentage of flow deficits (FD%), average size of FD (µm2), total area of FD (mm2) and number of FD were calculated in different CC slabs (automatic, 11-21 μm, 21-31 μm, 31-41 μm, 16-31 μm).

RESULTS: There was a statistically significant difference in all parameters and all slabs analyzed, when comparing SS-OCTA versus SD-OCTA V1 and SD-OCTA V1 versus SD-OCTA V4. Nevertheless, when comparing SS-OCTA versus SD-OCTA V4, significant differences were only found for the automatic and the 31-41 μm slab. When comparing the FD% between different slabs on the same device, significant differences were also found.

CONCLUSION: Quantification of CC FD% is impacted by the CC slab, the type of OCTA used, and volume averaging in SD-OCTA. Given the significant impact on quantitative results, comparisons between studies and instruments and/or with/without averaging are difficult, even at the same slab depth.

PMID:40515815 | DOI:10.1007/s00417-025-06874-x

Lasers Med Sci. 2025 Jun 14;40(1):279. doi: 10.1007/s10103-025-04528-2.

NO ABSTRACT

PMID:40515796 | DOI:10.1007/s10103-025-04528-2

J Hazard Mater. 2025 Jun 10;495:138894. doi: 10.1016/j.jhazmat.2025.138894. Online ahead of print.

ABSTRACT

Large-scale mining and smelting activities have led to widespread heavy metal contamination in mining cities, with atmospheric dust serving as a key carrier. However, identifying and quantifying metal sources remain challenging due to overlapping pollution sources. This study analyzed heavy metal concentrations, ecological risks, and Cd isotopes in atmospheric road dust from Panzhihua, a major mining city in Southwest China. The results indicate that mining-related metals (V, Cr, Mn, Ni, Co) showed low exceedance rates and ecological risks. In contrast, Cd, a dispersed element in V-Ti magnetite, significantly exceeded background levels and posed the highest risk. The PCA and PMF were first used to constrain potential source categories, followed by Cd isotope analysis for precise quantification. The results revealed vehicular emissions (45 %), coal combustion (29 %), and smelting (26 %) as major Cd sources. Smelting contributions were higher in downwind residential areas (1.5-5 km) due to prevailing southwest winds and thermal uplift. These findings highlight the unexpected dominance of traffic emissions over industrial sources and provide location-specific insights for pollution control. The study underscores the need to address both industrial and non-industrial sources when managing metal pollution in mining cities and offers a transferable approach for complex urban settings.

PMID:40513162 | DOI:10.1016/j.jhazmat.2025.138894

Public Health. 2025 Jun 12;246:105798. doi: 10.1016/j.puhe.2025.105798. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to investigate smoking patterns and their relationship with uncontrolled blood pressure in Iranian adults with hypertension.

STUDY DESIGN: A cross-sectional study was conducted to explore the research objectives.

METHODS: This study used data from the 2021 national Stepwise Approach to Chronic Disease Risk Factor Surveillance (STEPS) survey, which employed a clustered sampling technique to recruit Iranian adults aged ≥18 years from urban and rural areas across 31 provinces. Hypertension was defined as a systolic blood pressure (SBP) ≥140 mmHg, diastolic blood pressure (DBP) ≥90 mmHg, a history of hypertension diagnosis or use of antihypertensive medication. Smoking behaviours, including cigarette and hookah use, were assessed using the STEPS questionnaire. Data on sociodemographic variables, physical activity (min/weeks) and comorbidities were also collected. This study used t-tests and chi-square tests, as well as multivariable regression models adjusting for covariates, to examine the relationship between smoking status and blood pressure.

RESULTS: Among 27,874 participants, 8883 with hypertension were included in the analysis. The weighted prevalence of uncontrolled hypertension was 71.25 %. Smoking patterns revealed that 58.75 % were never smokers, 3.47 % were ex-smokers, 12.13 % were current smokers and 25.65 % were passive smokers. Current smokers had a higher prevalence of controlled hypertension (31.43 %) compared to ex-smokers (26.05 %), but the differences were not statistically significant (p = 0.225). Current smokers had 44 % lower odds of being ≥60 years (versus 18-39-year-olds) and were 8.32 times more likely to be male than female. Higher body mass index (BMI) and a higher wealth index were each associated with reduced odds of smoking, whereas alcohol consumption was linked to increased odds. Current smoking was associated with a 0.24 mmHg increase in SBP and a 0.35 mmHg decrease in DBP, but these associations were not statistically significant.

CONCLUSIONS: This study revealed a high prevalence of smoking among hypertensive individuals, especially among younger males, those with lower BMI and alcohol users. These findings underscore the need for culturally tailored smoking cessation programmes and longitudinal research to clarify the causal pathways of tobacco use in this high-risk group.

PMID:40513154 | DOI:10.1016/j.puhe.2025.105798

J Infect Dis. 2025 Jun 13:jiaf321. doi: 10.1093/infdis/jiaf321. Online ahead of print.

ABSTRACT

No large studies have evaluated whether the human oral microbiome is directly associated with mortality. We evaluated prospective associations between the oral microbiome, measured using 16S rRNA gene sequencing, from participants aged 20-69 years in the 2009-2012 cycles of the National Health and Nutrition Examination Survey (NHANES) and all-cause mortality (N=7,721, representing ∼194 million individuals). Alpha diversity was inversely associated with mortality, and some significant associations were observed with the beta diversity matrices. Higher relative abundances of Granulicatella and Lactobacillus were associated with increased risk, while Bacteroides was associated with decreased all-cause mortality at the genus level. Results suggest oral bacterial communities may be important contributors to health and disease.

PMID:40513117 | DOI:10.1093/infdis/jiaf321

JMIR Mhealth Uhealth. 2025 Jun 13;13:e60569. doi: 10.2196/60569.

ABSTRACT

BACKGROUND: Monitoring hydration is crucial for maintaining health and preventing dehydration. Despite the potential of wearable devices for continuous hydration monitoring, health research hasn’t fully explored this application, and clear design guidelines are absent. This scoping review aimed to address this gap by analyzing current research trends and assessing the potential impact of wearable technologies for hydration monitoring.

OBJECTIVE: This review comprehensively examined recent advancements in wearable hydration-monitoring technologies, focusing on their capabilities, limitations, and research and prototype designs. It explored various sensors and technologies used to track hydration, compared their advantages and disadvantages, identified trends in wearable hydration-monitoring devices, evaluated their accuracy and reliability against established benchmarks, and reviewed commercially available products to bridge research findings and practical applications.

METHODS: Following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, we systematically searched PubMed, IEEE Xplore, and Google Scholar for studies (2014-2024) on noninvasive wearable devices that used physiological biomarkers. Validation with human participants or comparisons with gold standards was required. Data extraction covered study characteristics, sensor technologies, validation methods, and commercial product analysis. In addition to academic research papers, gray literature was included through a Google Scholar search to investigate commercial products in the field of hydration monitoring. This approach ensured a broader perspective on technological advancements and market trends.

RESULTS: The review synthesized 63 articles selected from 156 included for full-text analysis. The literature was categorized based on sensor types, including electrical, optical, thermal, microwave, and multimodal sensors. Most studies (47/63, 75%) examined the effects of hydration on physiological parameters, with some (16/63, 25%) focusing on hydration status during physical activity or in specific environmental conditions. Commercially available products from 8 companies were also evaluated for their technological features, functionalities, and applications. The dominance of electrical sensors in research was highlighted due to their ease of use and integration into wearable devices. While fewer in number, optical sensors demonstrated higher precision and provided molecular-level insights. The emergence of multimodal sensors suggests a trend toward combining technologies to improve accuracy, as reflected by their increasing publication share. Other sensors, such as thermal and microwave-based sensors, occupied specialized niches. The growing acceptance of optical-based wearables in the market reflects their cost-to-precision effectiveness.

CONCLUSIONS: Wearable hydration-monitoring devices provide real-time assessments of hydration status, but challenges remain in ensuring their reliability, accuracy, and applicability across diverse populations and conditions. Future directions for research include standardized protocols, extensive clinical trials, sensor miniaturization, and enhanced wearability. Multimodal systems that integrate various sensors with artificial intelligence-driven analysis hold promise for personalized hydration management. This review offers detailed insights into the strengths and challenges of sensor technologies, paving the way for practical skin hydration-monitoring solutions.

PMID:40513095 | DOI:10.2196/60569