Tag: pubmed

Urol J. 2025 Jul 20. doi: 10.22037/uj.v22i.8280. Online ahead of print.

ABSTRACT

PURPOSE: This study aims to investigate the therapeutic efficacy and complications of low-frequency acupuncture therapy based on Midnight-Noon Acupuncture in the central neurogenic bladder (CNB).

MATERIALS AND METHODS: This study is a prospective, randomized controlled trial. Sixty patients diagnosed with CNB without prior treatment were randomly divided into two groups: the control group (n=30) was treated with basic rehabilitation training, and the treatment group (n=30) was treated with basic rehabilitation training plus low-frequency acupuncture therapy based on Midnight-Noon Acupuncture flow injection for 4 weeks. The fixed acupuncture points selected were: Sanyinjiao (bilateral), Zhongji (unilateral), and Diji (unilateral). The study compared pre- and post-treatment clinical curative effects, urodynamic indicators, urination status, the Neurogenic Bladder Symptom Score (NBSS), the Urinary Symptom Distress Scale (USDS), the World Health Organization Quality of Life Brief Inventory (WHOQOL-BREF), and the occurrence of adverse reactions and complications between the control group and treatment group.

RESULTS: The overall efficacy rate of 96.67% in the treatment group was significantly higher than the control group (P<0.05). After treatment, the MBC, MFR, Pdet, DASUV, and WHOQOL-BREF scores significantly increased, while the RUV, DUF, DAUL, NBSS scores, and USDS scores all decreased between the two groups, with the treatment group showing significantly better results than the control group (P<0.05). There was no statistically significant difference in adverse reactions and complication rates between the two groups (P>0.05).

CONCLUSION: Low-frequency acupuncture therapy based on Midnight-Noon Acupuncture significantly improves bladder function and alleviates urinary difficulties in CNB, demonstrating good safety and considerable clinical applicability.

PMID:40684275 | DOI:10.22037/uj.v22i.8280

Urol J. 2025 Jul 16. doi: 10.22037/uj.v22i.8348. Online ahead of print.

ABSTRACT

PURPOSE: This study was designed to evaluate effectiveness of dynamic neuromuscular stabilization (DNS) training in children with non-neurogenic lower urinary tract dysfunction (LUTD) and compare it with biofeedback (BF) treatment.

MATERIALS AND METHODS: Total of 15 participants aged 6-15 years with non-neurogenic LUTD were divided into three groups: Group I, “DNS exercise training”; Group II, “BF training”; and Group III, “DNS plus BF training.” Participants’ Dysfunctional Voiding and Incontinence Scoring System (DVISS) scores, uroflowmetry parameters, uroflow curve, post voiding residual (PVR) values, deep trunk muscle strength were evaluated at baseline and at 4, 8 and 12 weeks after treatment.

RESULTS: It was observed that total DVISS scores of individuals in Groups I and III significantly decreased after 12 weeks, while individuals in Group II showed significant decrease in total DVISS score after 4 and 8 weeks (P < .05). When examining changes in deep trunk muscle strength between groups at all time periods, it was determined that improvement in Groups I and III after 4 and 8 weeks was significantly greater than that in Group II (P < .05). In Group I, average flow rate value significantly increased after 4 weeks, while flow time value significantly decreased after 12 weeks (P < .05). When examining PVR values between groups, it was determined that there were statistically significant decreases in individuals in Group I after 12 weeks and in individuals in Group III after 8 weeks (P < .05).

CONCLUSION: According to results, DNS and BF training are effective in improving symptoms in patients with non-neurogenic LUTD. However, groups in which DNS exercises were applied were superior in improving some parameters.

PMID:40684271 | DOI:10.22037/uj.v22i.8348

Age Ageing. 2025 Jul 1;54(7):afaf197. doi: 10.1093/ageing/afaf197.

ABSTRACT

BACKGROUND: Delirium is a serious, acute neuropsychiatric condition associated with fluctuating attention and altered arousal. Delirium in Parkinson’s disease (PD) is common but often missed in hospital due to shared clinical features. This study aimed to evaluate the accuracy of current tools used to identify delirium in inpatients with PD.

METHODS: People with PD admitted to all hospital wards were invited to take part. Participants completed a standardised delirium assessment based on the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) criteria, in addition to standard bedside tools including the 4 As Test (4AT), arousal and cognition. This was a secondary analysis of a prospective observational study; bedside tools were not completed independently of, or blinded to, the DSM-5 criteria. Accuracy was assessed using Receiver Operating Characteristic area under the curve (AUROC).

RESULTS: Participants included 115 people with PD (200 hospital admissions); 66.1% (n = 76/115) had delirium. Considering all admissions, the diagnostic accuracy of tools was good, ranging from 74% to 89% (AUROC = 0.764-0.923, P < .001 for all). The 4AT scores had the highest sensitivity (96.7%, AUROC = 0.922, P < .001). However, accuracy decreased in those with underlying cognitive impairment (AUROC = 0.499-0.886).

CONCLUSIONS: Current bedside tools can accurately identify delirium in PD inpatients. Although tools were comparable, the 4AT may have greater clinical utility as it had high sensitivity, is quicker to complete and already widely used clinical. However, caution is recommended as tools did not differentiate between symptoms typical in PD and acute symptoms associated with delirium; this should be a focus for future research.

PMID:40684269 | DOI:10.1093/ageing/afaf197

HGG Adv. 2025 Jul 18:100482. doi: 10.1016/j.xhgg.2025.100482. Online ahead of print.

ABSTRACT

Genome-wide association studies (GWAS) from multiple ancestral populations are increasingly available, offering opportunities to improve the accuracy and equity of polygenic scores (PGS). Several methods now aim to leverage multiple GWAS sources, but predictive performance and computational efficiency remain unclear, particularly when individual-level tuning data are unavailable. This study evaluates a comprehensive set of PGS methods across African (AFR), East Asian (EAS), and European (EUR) ancestries for 10 complex traits, using summary statistics from the Ugandan Genome Resource, Biobank Japan, UK Biobank, and the Million Veteran Program. Single-source PGS were derived using methods including DBSLMM, lassosum, LDpred2, MegaPRS, pT+clump, PRS-CS, QuickPRS, and SBayesRC. Multi-source approaches included PRS-CSx, TL-PRS, X-Wing, and combinations of independently optimised single-source scores. All methods were restricted to HapMap3 variants and used linkage disequilibrium reference panels matching the GWAS super population. A key contribution is a novel application of the LEOPARD method to estimate optimal linear combinations of population-specific PGS using only summary statistics. Analyses were implemented using the open-source GenoPred pipeline. In AFR and EAS populations, PGS combining ancestry-aligned and European GWAS outperformed single-source models. Linear combinations of independently optimised scores consistently outperformed current jointly optimised multi-source methods, while being substantially more computationally efficient. The LEOPARD extension offered a practical solution for tuning these combinations when only summary statistics were available, achieving performance comparable to tuning with individual-level data. These findings highlight a flexible and generalisable framework for multi-source PGS construction. The GenoPred pipeline supports more equitable, accurate, and accessible polygenic prediction.

PMID:40684263 | DOI:10.1016/j.xhgg.2025.100482

Postgrad Med J. 2025 Jul 20:qgaf107. doi: 10.1093/postmj/qgaf107. Online ahead of print.

NO ABSTRACT

PMID:40684261 | DOI:10.1093/postmj/qgaf107

Alzheimers Dement. 2025 Jul;21(7):e70485. doi: 10.1002/alz.70485.

ABSTRACT

INTRODUCTION: Cognitive impairment is common but often overlooked due to motor symptoms in progressive supranuclear palsy-Richardson syndrome (PSP-RS). This study investigates whether cognitive deficits predict disease progression in PSP-RS.

METHODS: A total of 146 PSP-RS from the Tilavonemab trial were evaluated at baseline and over 52 weeks using the PSP-Rating Scale (PSPRS), the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and the Unified Parkinson’s Disease Rating Scale Part-II (UPDRS-II). Multiple linear regression analyses were performed between the RBANS, UPDRS-II, and the PSPRS change. Clinical scores, gray matter volumes, and neurofilament-light chain (NfL) were compared using analyses of covariance (ANCOVAs) and linear mixed models between language score-groups.

RESULTS: Lower RBANS-language at baseline predicted greater PSPRS worsening over time. The low language-score group showed poorer cognitive performance, elevated NfL, and reduced gray matter volume in language-related areas.

DISCUSSION: Speech/language deficits predict worse prognosis in PSP-RS, emphasizing the value of including language scores in clinical trials.

HIGHLIGHTS: Speech and language deficits predict a worse prognosis in progressive supranuclear palsy-Richardson syndrome (PSP-RS). Lower language scores are associated with worse cognitive performance over time. Lower language scores related to higher neurofilament-light chain (NfL) at baseline. The low language-score group presented greater atrophy in language-related brain areas. Stratifying PSP-RS cases using language scores may improve clinical trials.

PMID:40684253 | DOI:10.1002/alz.70485

J Health Popul Nutr. 2025 Jul 19;44(1):261. doi: 10.1186/s41043-025-01019-6.

ABSTRACT

One of the most significant global public health concerns for women of reproductive age is the unmet need for modern contraceptives. The goal of increasing the use of modern contraceptives is to lower mother and child mortality and morbidity. Since East African nations are part of sub-Saharan Africa, a region primarily composed of low-income countries, they face significant challenges in accessing modern contraceptives due to limited healthcare infrastructure, economic constraints, and socio-cultural barriers. The objective of this study was to investigate the prevalence and factors associated with modern contraception utilization among reproductive-age East African women.

METHODS: The data was taken from the individual records (IR) of the ten East African countries’ Demographic and Health Surveys. The study included 112,810 women of reproductive age. The primary outcome was modern contraceptive utilization, defined as a binary variable (yes = use of modern methods; no = use of traditional/folkloric or no methods). Key predictors included age, place of residence, marital status, sex of household head, wealth index, exposure to media (newspaper, radio, television), pregnancy termination history, and number of living children. Bivariate analysis was utilized to select the variables for multivariable analysis. At last, 95% CIs for the odds ratio and percentage were presented.

RESULTS: Among women of reproductive age, 33.81% of them used modern contraceptives, with a 95% CI of [33.53-34.09]. Individuals aged 20-24, 25-29, 30-34, and 35-39 demonstrate the following statistically adjusted odds ratios (AOR) and confidence intervals (CI): AOR = 1.68, 95% CI (1.68, 1.79); P = 0.0001; AOR = 1.56, 95% CI (1.46, 2.65); P = 0.0001; AOR = 1.43, 95% CI (1.33, 1.54); P = 0.0001; and AOR = 1.34, 95% CI (1.24, 1.44); P = 0.0001, respectively. urban residence is associated with an AOR of 1.06, 95% CI (0.91, 0.97); P = 0.001; being married [AOR: 1.20, 95% CI (1.13, 1.28); P = 0.0001]; belonging to the highest wealth quantile [AOR: 1.34, 95% CI (1.27, 1.43); P = 0.0001]; reading magazines at least once a week [AOR: 1.07 (1.00, 1.14); P = 0.032]; listening to the radio almost daily [AOR: 1.91 (1.69, 2.17); P = 0.0001]; watching television daily [AOR: 1.62 (1.45, 1.82); P = 0.0001]; and having 3-4 children [AOR: 11.68, 95% CI (10.78, 12.66); P = 0.0001] were found positively associated with modern contraceptive utilization. Conversely, having a history of pregnancy termination [AOR: 0.83 (0.80, 0.87); P = 0.0001] and belonging to a household headed by a woman [AOR: 0.95 (0.92, 0.99); P = 0.037] were found to be inversely associated with modern contraceptive utilization.

CONCLUSION AND RECOMMENDATION: This study identified key factors influencing modern contraceptive use among women in East Africa. Higher utilization was associated with being aged 20-39, urban residence, being married, higher wealth status, media exposure, and having more children. In contrast, lower use was observed among women living in female-headed households and those with a history of pregnancy termination. Despite these influencing factors, modern contraceptive use in East Africa remains below the 2030 Sustainable Development Goal (SDG) target. Therefore, to improve uptake among women of reproductive age, healthcare providers and policymakers should design and implement targeted interventions focusing on adolescents, rural residents, women with a history of pregnancy termination, and socioeconomically disadvantaged groups to enhance contraceptive use and reproductive health outcomes in the region.

PMID:40684244 | DOI:10.1186/s41043-025-01019-6

J Orthop Surg Res. 2025 Jul 19;20(1):683. doi: 10.1186/s13018-025-06086-3.

ABSTRACT

BACKGROUND: Screw placement in lateral plating of calcaneal fractures presents a challenge due to the proximity of medial neurovascular structures. This study aims to identify high-risk zones, determine appropriate screw lengths, and define optimal fluoroscopic angles to enhance intraoperative visualisation and improve surgical safety.

METHODS: Thirty-three fresh-frozen cadaveric specimens were used. Following a lateral extensile approach, locking screws were inserted through an anatomical plate into seven predefined zones using sleeve-guided drilling, without plate bending or freehand angulation. For each screw, the appropriate length was initially measured, but to facilitate identification during subsequent medial dissection, longer screws were intentionally inserted. Following screw insertion, medial dissection was performed to expose neurovascular and tendinous structures. Distances from each screw were measured at two points: (1) the actual exit point on the medial cortex, and (2) the projected trajectory of the screw. Based on these measurements, risk scores were assigned using a validated scoring system. In a separate step, fluoroscopic angle measurements were conducted. K-wires were placed into the posterior facet and the sustentacular sulcus, and the required cranial and medial angulations of the C-arm relative to the plantar referenced axis were determined for the optimal visualisation of the joint and medial cortex.

RESULTS: Zone 4 (subchondral zone) demonstrated the highest risk, with medial plantar vessels, medial plantar nerve, lateral plantar vessels, and flexor hallucis longus at significant risk, particularly at the projection point. In contrast, Zone 2 inferior and Zones 3 had lower risk scores. The anticipated screw lengths ranged from 35.49 mm to 38.73 mm across different zones. Nearly all distances between screw exit points and projections showed statistically significant differences (p < 0.05), highlighting the importance of screw length. Inter- and intra-observer reliability was good to excellent across all measurements (ICC > 0.75). Fluoroscopic analysis revealed that rotating the C-arm cranially by 34.7° relative to a plantar reference axis optimised posterior facet visualisation, while a combination of 26.09° cranial and 17.79° medial angulation provided the best imaging of the medial cortex at the sustentacular sulcus.

CONCLUSIONS: This study identifies Zone 4 (subchondral zone) as the highest-risk area for neurovascular injury in lateral calcaneal plating and highlights the importance of screw length selection, particularly reconsidering screws exceeding 40 mm, and optimal fluoroscopic visualisation of medial high-risk zones. These findings are crucial for enhancing intraoperative safety in calcaneal fracture fixation.

PMID:40684243 | DOI:10.1186/s13018-025-06086-3

BMC Psychol. 2025 Jul 19;13(1):808. doi: 10.1186/s40359-025-03067-3.

ABSTRACT

BACKGROUND: Entrepreneurial learning is widely recognized as a critical factor in enhancing entrepreneurial performance. However, the specific impact of entrepreneurial learning on the performance of female entrepreneurs and the underlying mechanisms involved remain underexplored. The main purpose of this study is to explore the impact mechanism of entrepreneurial learning on entrepreneurial performance among female entrepreneurs and to reveal the mediating roles of psychological capital and opportunity recognition and development in this relationship.

METHOD: This study employs a quantitative research approach, conducting empirical analysis using survey data from 558 Chinese female entrepreneurs. Utilizing AMOS statistical software, we construct structural equation models to examine the relationship between entrepreneurial learning and business performance among female entrepreneurs.

RESULTS: The findings reveal that: (1) Entrepreneurial learning among female entrepreneurs has a direct and positive impact on entrepreneurial performance, and (2) Psychological capital and opportunity recognition and development serve as key mediators in this relationship.

CONCLUSIONS: Grounded in entrepreneurial learning theory, this study proposes a pathway model that illustrates how female entrepreneurs can leverage entrepreneurial learning to improve their performance. By shedding light on the mechanisms through which entrepreneurial learning influences performance, this study extends the application of entrepreneurial learning theory within the context of female entrepreneurship and provides practical insights for enhancing the entrepreneurial success of female entrepreneurs.

CLINICAL TRIAL REGISTRATION: Not applicable.

PMID:40684238 | DOI:10.1186/s40359-025-03067-3

J Exp Clin Cancer Res. 2025 Jul 19;44(1):214. doi: 10.1186/s13046-025-03473-w.

ABSTRACT

BACKGROUND: Glioblastoma (GBM), the most common and aggressive type of primary brain tumor, engages multiple survival mechanisms, including autophagy. GBM exploits both degradative and secretory autophagy pathways to support tumor growth and limit the efficacy of standard-of-care treatments. We have previously shown that lucanthone, a blood-brain barrier permeable autophagy inhibitor, reduces tumor burden. However, although lucanthone-treated tumors are significantly smaller in size, they are not completely obliterated, suggesting compensatory survival mechanisms. A critical factor for GBM survival is communication with the tumor microenvironment (TME), which can be programmed by glioma cells to support growth and immunosuppression. Plasminogen activator inhibitor-1 (PAI-1), a secreted serine protease inhibitor, has been implicated in the progression of several cancers, including GBM, and has been shown to be modulated by autophagy in other cancers. The role of PAI-1 in GBM, namely its relationship with intracellular autophagy dysregulation and extracellular TME as a mechanism of tumor survival, remains incompletely understood.

METHODS: Murine glioma models were established using intracranial injection of GL261 cells in C57BL/6 mice, followed by autophagy inhibition with intraperitoneal lucanthone and/or PAI-1 inhibition with MDI-2268 chow, and tumors were assessed by immunohistochemistry. In culture, glioma cell lines were challenged with MDI-2268, lucanthone, mitoxantrone, or siRNA-LNPs targeting PAI-1, and assessed by MTT assay, q-RT-PCR, ELISA, invasion assay, immunoblot, and immunocytochemistry. Lysosomal markers and transient transfection with fluorescent vesicular proteins were utilized to evaluate PAI-1 intracellular localization via confocal microscopy. Synergy was analyzed using the HSA model in Combenefit, and statistical analyses included t-tests, ANOVA, and log-rank tests for survival.

RESULTS: Lucanthone treatment increased intracellular PAI-1 and autophagy markers while reducing active extracellular PAI-1. PAI-1 colocalized with lysosomal markers, suggesting impaired secretory autophagy. PAI-1 inhibition reduced glioma cell viability and invasion. Combination therapy with lucanthone and MDI-2268 drastically decreased tumor volume, prolonged survival, and promoted a pro-inflammatory state in the tumor microenvironment.

CONCLUSIONS: Our findings suggest that PAI-1 may be a compensatory survival mechanism in GBM after autophagy inhibition, and that dual targeting of autophagy and PAI-1 disrupts tumor progression and enhances anti-tumor immunity, providing promising evidence for targeting this axis.

PMID:40684232 | DOI:10.1186/s13046-025-03473-w