Tag: pubmed

Clin Kidney J. 2025 Jul 1;18(7):sfaf203. doi: 10.1093/ckj/sfaf203. eCollection 2025 Jul.

ABSTRACT

BACKGROUND: Targeted release formulation (TRF) budesonide (Nefecon), targeting galactose-deficient immunoglobulin A1 (Gd-IgA1) production and IgA immune complex formation, has been approved for IgA nephropathy (IgAN) treatment. In this study we explored whether early changes in these biomarkers can predict the clinical response to Nefecon therapy.

METHODS: Plasma samples from 27 IgAN patients treated with Nefecon and followed at least 6 months were collected during routine visits. We measured the levels of Gd-IgA1 and poly-IgA during the treatment, analysing the association between their baseline levels or changes and proteinuria reduction.

RESULTS: The mean proteinuria level was 1.3 ± 0.8 g/day and the estimated glomerular filtration rate was 47.1 ± 21.7 ml/min/1.73 m² at baseline. During the follow-up, proteinuria slowly decreased, with alterations of -0.12 g/day, -0.42 g/day, -0.58 g/day and -0.86 g/day at 3, 6, 9 and 12 months, respectively. The plasma levels of Gd-IgA1, poly-IgA and total IgA decreased after Nefecon treatment, with an obvious decrease at 2 months in Gd-IgA1 by -1067.3 ng/ml and poly-IgA by -1.18 mg/l. All biomarker reductions were strongly associated with a proteinuria decrease (P < .0001). Importantly, the early reduction in poly-IgA during the first 2 months was associated with a proteinuria reduction at 6 months (R = 0.47, P = .01). Similar trends were observed for Gd-IgA1, though not statistically significant.

CONCLUSIONS: The early changes in Gd-IgA1 or poly-IgA, especially poly-IgA, were associated with future proteinuria reduction, supporting the potential of Gd-IgA1 and poly-IgA as biomarkers for predicting Nefecon response in IgAN.

PMID:40678796 | PMC:PMC12268327 | DOI:10.1093/ckj/sfaf203

Arthroplast Today. 2025 Jul 2;34:101746. doi: 10.1016/j.artd.2025.101746. eCollection 2025 Aug.

ABSTRACT

BACKGROUND: Previous studies have reported initial and proficiency phases of the learning curve among individual surgeons when robotic-assisted total knee arthroplasty (raTKA) into their practices. The purpose of this study was to assess the number of raTKA cases needed to achieve proficiency in the operative time (OT) across a group of surgeons.

METHODS: A retrospective analysis comparing raTKA to manual Total Knee Arthroplasty (mTKA) was performed at a single-site comprised of 6 orthopaedic surgeons. The first 90 patients who underwent raTKA at the institution divided chronologically into 3 groups of 30 each and compared to 30 previous mTKA cases. Tourniquet time was used as the measure for OT, range of motion (ROM) was measured preoperatively and at 2 and 6 weeks postoperative.

RESULTS: Average OT was significantly shorter in the mTKA group in comparison with all the raTKA groups. A statistically significant difference was found in OT when comparing the succeeding raTKA groups (mean time of 97.6, 86.6, and 76.7 min P value<.001). The change in ROM at 6 weeks postoperative was found to be greater in the first raTKA group in comparison to the second raTKA group (mean of 0.9° vs -17.1°; P = .04) and the mTKA group (mean of 0.9° vs -7.9°; P = .04). However, when controlling for preoperative ROM and performing surgeon, there was no difference in ROM at 6 weeks postoperative between defined time periods (P = .78). No difference was found when comparing rate of complications (P value>.05).

CONCLUSIONS: When evaluating the group learning curve, this study showed average shorter operating time with every 30 cases (mean time of 97.6; 86.6- and 76.7-min P value<.001) and no difference in complication rate (P value>.05). These findings suggest continued proficiency over time; however, adoption of the technology is associated with longer OTs.

PMID:40678787 | PMC:PMC12269883 | DOI:10.1016/j.artd.2025.101746

Arthroplast Today. 2025 Jul 2;34:101745. doi: 10.1016/j.artd.2025.101745. eCollection 2025 Aug.

ABSTRACT

BACKGROUND: Impacts of asymptomatic perioperative coronavirus disease 2019 (COVID-19) on total knee (TKA) and hip arthroplasty (THA) outcomes remains unknown.

METHODS: We retrospectively reviewed asymptomatically screened COVID-19 cases undergoing primary TKA or THA between 2020 and 2022. Ninety-day complications, inpatient resources, repeat hospitalizations, and functional outcomes were measured for COVID-19 patients and age- and sex-matched controls. The sample size was determined based on a priori power analysis. Statistics consisted of 2 sample t-tests or Fisher’s exact test based on variable type with α = 0.01 to correct for multiple comparisons.

RESULTS: Of 1914 TKA and 1424 THA patients, 20 and 28 with asymptomatic COVID-19 were compared to 75 and 105 controls, respectively. While there was no statistically significant increase in relative risk for major (TKA P = .04|THA P = .12) or thromboembolic (TKA P = .21|THA P = .04) complications, the COVID-19 group experienced mortality, ischemic stroke, pulmonary embolism, and deep vein thrombosis. There was no significant difference in admission length (TKA P = .29|THA P = .22), physical therapy (TKA P = .36|THA P = .36), labs (TKA P = .57|THA P = .82), nonhome discharge (TKA P = 1|THA P = 1), or mobility (TKA P = .18|THA P = .21).

CONCLUSIONS: The current study suggests that, while perioperative risk of asymptomatic COVID-19 does not meet the threshold for statistical significance, arthroplasty surgeons should be aware of potential mortality and morbidity and engage in shared decision-making regarding deferral of surgery, especially for patients with other comorbidities.

PMID:40678785 | PMC:PMC12269793 | DOI:10.1016/j.artd.2025.101745

Front Nutr. 2025 Jul 3;12:1576478. doi: 10.3389/fnut.2025.1576478. eCollection 2025.

ABSTRACT

OBJECTIVE: In the competitive market for nutrition products, advertising strategies play a pivotal role in shaping consumer behavior. This study investigated how advertising language styles (disruptive vs. sustaining) influence consumer purchase intentions for nutrition products, examining information processing fluency as a mediator and information credibility as a moderator.

METHODS: A multi-group experiment was conducted with 852 participants, recruited via a professional survey platform, in a controlled simulated environment. Data on participants’ gender, exposure to advertising language styles (disruptive vs. sustaining), purchase intentions, information processing fluency, and information credibility (high vs. low) were collected using an online questionnaire. PROCESS models (Model 4 for mediation, Model 1 for moderation) and ANOVA (for main effects) were used for statistical analysis.

RESULTS: Disruptive advertising language, compared to sustaining styles, significantly enhanced consumers’ attention, interest in product innovations, and purchase intentions. Information processing fluency mediated the positive relationship between advertising language style and purchase intention, highlighting the importance of clarity and ease of understanding.

CONCLUSIONS: Disruptive advertising language, fluent information processing, and high information credibility are key factors in enhancing consumers’ purchase intentions for nutrition products.

PMID:40678774 | PMC:PMC12269493 | DOI:10.3389/fnut.2025.1576478

Asia Pac J Oncol Nurs. 2025 Jun 6;12:100738. doi: 10.1016/j.apjon.2025.100738. eCollection 2025 Dec.

ABSTRACT

OBJECTIVES: This study aims to systematically synthesize studies that applied group-based trajectory modeling to examine the trajectories of supportive care needs (SCNs) among cancer survivors and to identify associated influencing factors.

METHODS: A comprehensive literature search was conducted in the following databases: CINAHL, Cochrane Library, Embase, PubMed, Web of Science, CNKI, SinoMed, VIP, and Wanfang. Studies were screened and assessed independently by two reviewers using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Cohort Studies and the Guidelines for Reporting on Latent Trajectory Studies (GRoLTS) checklist. Key study characteristics and findings were extracted and synthesized narratively.

RESULTS: Ten studies met the inclusion criteria. Five distinct SCNs trajectories were identified across studies, including high-stable, moderate-stable, low-stable, decreasing, and increasing patterns. A total of 18 statistically significant influencing factors were identified and categorized according to the five domains of the Social-Ecological Model (SEM). Most factors were related to demographic characteristics, clinical variables, and individual symptoms.

CONCLUSIONS: SCNs trajectories among cancer survivors exhibit substantial heterogeneity. While individual- and disease-level factors are commonly reported, limited evidence exists regarding the role of social support, healthcare system factors, and community-level influences. Future research should incorporate broader socio-environmental determinants to enhance understanding of SCNs patterns and inform tailored survivorship care.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42024586557.

PMID:40678771 | PMC:PMC12269420 | DOI:10.1016/j.apjon.2025.100738

Proc Mach Learn Res. 2024;231:22.

ABSTRACT

Complex systems are characterized by intricate interactions between entities that evolve dynamically over time. Accurate inference of these dynamic relationships is crucial for understanding and predicting system behavior. In this paper, we propose Regulatory Temporal Interaction Network Inference (RiTINI) for inferring time-varying interaction graphs in complex systems using a novel combination of space-and-time graph attentions and graph neural ordinary differential equations (ODEs). RiTINI leverages time-lapse signals on a graph prior, as well as perturbations of signals at various nodes in order to effectively capture the dynamics of the underlying system. This approach is distinct from traditional causal inference networks, which are limited to inferring acyclic and static graphs. In contrast, RiTINI can infer cyclic, directed, and time-varying graphs, providing a more comprehensive and accurate representation of complex systems. The graph attention mechanism in RiTINI allows the model to adaptively focus on the most relevant interactions in time and space, while the graph neural ODEs enable continuous-time modeling of the system’s dynamics. We evaluate RiTINI’s performance on simulations of dynamical systems, neuronal networks, and gene regulatory networks, demonstrating its state-of-the-art capability in inferring interaction graphs compared to previous methods.

PMID:40678737 | PMC:PMC12269789

Front Pharmacol. 2025 Jul 3;16:1548126. doi: 10.3389/fphar.2025.1548126. eCollection 2025.

ABSTRACT

BACKGROUND: Postoperative pain following total joint arthroplasty is a critical factor influencing patient recovery. This meta-analysis evaluated the efficacy and safety of single-dose, repeated-dose, and split-dose perioperative dexamethasone regimens for managing postoperative pain in patients undergoing total joint arthroplasty.

METHODS: Randomized controlled studies (RCTs) comparing repeated or split-dexamethasone to single intravenous dexamethasone in patients having total knee/hip arthroplasty were retrieved from Pubmed, the Cochrane Library, Web of Science and Embase databases from inception to October 2024. Using RevMan 5.2, a meta-analysis was performed to evaluate primary outcomes including pain scores, length of stay, and incidence of postoperative rescue analgesia, as well as secondary outcomes such as the incidence of adverse events. Heterogeneity was assessed via I² statistics, and study bias was evaluated using the Cochrane Risk of Bias Assessment Tool.

RESULTS: Twelve trials were included. The results showed that repeated-dose dexamethasone did not differ from single-dose dexamethasone in rest or movement pain scores at 24 h, but significantly reduced both rest (mean difference [MD] = -0.45, 95% confidence interval [CI]: -0.62 to -0.29, P < 0.00001, I ² = 41%) and movement (MD = -0.69, CI: -0.83 to -0.55, P < 0.00001, I ² = 36%) pain scores at 48 h. They also had shorter stays (MD = -0.28, 95% CI: -0.47 to -0.09, P = 0.004, I ² = 71%), lower rates of needing postoperative rescue analgesia (relative risk [RR] = 0.26, 95% CI: 0.11 to 0.63, P = 0.003, I ² = 72%) and postoperative nausea and vomiting [PONV] (RR = 0.47, 95% CI: 0.24 to 0.95, P = 0.04, I ² = 60%). Moreover, patients receiving a single dose of dexamethasone had lower movement scores 24 h postoperatively (MD = 0.26, 95% CI: 0.03 to 0.48, P = 0.02, I ² = 61%) compared to patients with a split-dose of dexamethasone. No significant differences in adverse event rates were observed between single-dose and split-dose dexamethasone.

CONCLUSION: Compared to patients receiving a single-dose or split-dose of dexamethasone, the administration of repeated doses of dexamethasone can mitigate postoperative pain, reduce the requirement for supplementary opioids, shorten the duration of hospitalization, and decrease the incidence of PONV following arthroplasty.

SYSTEMATIC REVIEW REGISTRATION: https://inplasy.com/inplasy-2023-10-0023/.

PMID:40678724 | PMC:PMC12267163 | DOI:10.3389/fphar.2025.1548126

Adv Med Educ Pract. 2025 Jul 12;16:1217-1227. doi: 10.2147/AMEP.S528051. eCollection 2025.

ABSTRACT

PURPOSE: This study aims to assess the level of interest in pathology among medical students in Saudi Arabia and identify factors influencing their decision to pursue pathology as a career.

PATIENTS AND METHODS: This cross-sectional study was conducted across multiple universities in Saudi Arabia, including Umm Al Qura University, King Faisal University, King Saud bin Abdulaziz University for Health Sciences, Imam Abdulrahman bin Faisal University, Jazan University, and King Khalid University. Data was collected from medical students at different academic levels, including first-year students through interns using an online questionnaire via Google Forms. Responses were cleaned in Microsoft Excel and analyzed using SPSS version 23. Descriptive statistics and Chi-square tests were used, with significance set at p < 0.05.

RESULTS: A total of 612 valid responses were received, with an almost equal distribution of male (49.8%) and female (50.2%) participants. Overall, 45.3% of students expressed interest in pathology, while 54.7% were not interested. Female students (52.1%) showed a greater interest compared to males (38.4%). The most influential factors attracting students to pathology included lifestyle (37.4%), research opportunities (35.9%), and fewer on-call duties (33.2%). The most common deterring factors reported by those interested in pathology was the perceived challenge of the discipline (56.9%), other career interests (41.5%), and limited job opportunities (35.3%).

CONCLUSION: Several factors influence medical students’ decisions regarding pathology as a career choice. Notably, female students demonstrated a higher level of interest in pathology than their male counterparts. Future studies should explore strategies to enhance the visibility and appeal of pathology, such as increasing early exposure to the field within the medical curriculum.

PMID:40678713 | PMC:PMC12267822 | DOI:10.2147/AMEP.S528051

AlterNative (Nga Pae Maramatanga (Organ)). 2024 Mar;20(1):167-177. doi: 10.1177/11771801241235206. Epub 2024 Mar 11.

ABSTRACT

Today, the Hawaiian community faces high rates of health disparities, as well as loss of land, language, and culture due to colonization. However, Hawaiians continue to keep their culture alive, and cultural reclamation theory argues that Indigenous Peoples are healthier when they have opportunities to engage with their cultural practices. This theory points to culture as a possible intervention. We analyze data from the 2019 Native Hawaiian Survey, which examines Hawaiian identity through a sample of over 1,000 participants across Hawai’i who are 18 years or older and have Hawaiian ancestry. Drawing upon what it means to identify as Hawaiian, we expect a positive relationship between activities that increase connection to Hawaiian culture and life satisfaction. We find statistical significance in consideration of sacred spaces, pride in being Hawaiian, and sense of belonging to America and discuss implications for Hawaiian well-being based on these findings.

PMID:40678700 | PMC:PMC12269521 | DOI:10.1177/11771801241235206

EClinicalMedicine. 2025 Jun 27;85:103314. doi: 10.1016/j.eclinm.2025.103314. eCollection 2025 Jul.

ABSTRACT

BACKGROUND: Children lacking parental protection may tend to miss out on essential services. We investigated whether orphans and children without parental care were at risk of sub-optimal vaccination.

METHODS: Cross-sectional analyses of 189 UNICEF Multiple Indicator Cluster Surveys from 82 predominantly low- and middle-income countries, conducted from January 1, 2005 to December 31, 2022. We used two-level logistic fixed-effects models with individual community-dwelling children aged 12-59 months nested within MICS sampling cluster to estimate the effects of orphanhood (one or both parents deceased) and lack of parental care (children residing with no biological parents) on missed vaccinations. We report the adjusted odds of being a “zero-dose” child (failure to receive any diphtheria-tetanus-pertussis-containing (DTP) vaccine doses), an under-immunised child (failure to receive three DTP doses), failure to receive any measles-containing vaccine (MCV), and failure to receive all eight basic vaccine doses.

FINDINGS: The analysis included 739,506 children of which 20.6% (n = 152,314) were zero-dose, 50.4% (n = 372,568) were under-immunised, 50.3% (n = 372,089) had not received any MCV, and 57.8% (n = 427,558) had not received all 8 basic vaccine doses. Orphans had a consistently higher risk of sub-optimal vaccination. Adjusted odds ratios were similar for all binary outcomes (zero-dose (OR_adj 1.59; 95% CI: 1.48-1.71, p < 0.001), no DPT3 (OR_adj 1.46; 95% CI: 1.38-1.54, p < 0.001), and no MCV and basic incomplete (OR_adj 1.42; 95% CI: 1.34-1.50, p < 0.001 for both)). Children lacking parental care experienced similarly elevated risks of sub-optimal vaccination (p < 0.001 for all outcomes).

INTERPRETATION: To better support children at risk and uphold their rights, vaccination programmes should prioritise service delivery to orphans and children lacking parental care.

FUNDING: Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Canadian Institutes for Health Research.

PMID:40678695 | PMC:PMC12269469 | DOI:10.1016/j.eclinm.2025.103314