Tag: pubmed

Virol J. 2025 Jan 15;22(1):11. doi: 10.1186/s12985-025-02623-y.

ABSTRACT

INTRODUCTION: Organ transplant recipients face a substantial risk of developing posttransplant lymphoproliferative disorders (PTLD). In over 90% of cases with B-cell PTLD following solid organ transplantation, the Epstein-Barr virus (EBV) genome is promptly identified, usually within the initial year. A continuing discussion revolves around the efficacy of antiviral prophylaxis in mitigating the incidence of PTLD in solid organ transplant (SOT) patients. This study aimed to conduct a systematic review and meta-analysis to investigate this issue.

METHOD: A comprehensive search was conducted up to December 31, 2023, in databases including PubMed, Embase, and the Cochrane Library for retrospective and prospective studies comparing antiviral prophylaxis effects on EVB viremia and PTLD incidence in SOT recipients. Fixed or random effect models were applied based on the heterogeneity assessed via the I² statistic, using Stata 16.0 software for data analysis.

RESULTS: In total, 22 eligible studies involving 13,498 patients were analyzed. Antiviral prophylaxis was associated with a significant reduction in EBV viremia incidence in SOT recipients, as demonstrated in 10 studies (relative risk (RR) 0.69, 95% CI 0.54 to 0.88). The rate of PTLD was significantly lower among those who received antiviral prophylaxis compared to those who did not, as reported in 18 studies (RR 0.77, 95% CI 0.63 to 0.94). No significant difference was observed in the subgroup of high-risk recipients based on EBV serology (RR 1.13, 95% CI 0.72 to 1.78). Additionally, a notable reduction in PTLD incidence was seen in the pediatric subgroup (RR 0.58, 95% CI 0.43 to 0.79) using antiviral prophylaxis, while no significant differences were observed in the subgroup of adults (RR 0.88, 95% CI 0.64 to 1.21). Administration of antiviral prophylaxis can significantly reduce the incidence of PTLD among kidney (RR 0.63, 95% CI 0.46 to 0.87) and heart transplant patients (RR 0.61, 95% CI 0.39 to 0.96). PTLD incidence was significantly reduced among recipients of T-cell depletion or steroid-based immunosuppression using antiviral prophylaxis (RR 0.54, 95% CI 0.39-0.74 and RR 0.55, 95% CI 0.41-0.73, respectively).

CONCLUSION: This meta-analysis revealed that administering antiviral prophylaxis to patients after solid organ transplantation reduces PTLD and EBV viremia occurrences, especially among pediatric recipients, individuals undergoing kidney or heart transplantation, and those receiving high-intensity immunosuppression regimens. Post-transplant lymphoproliferative disorders (PTLD) and other EBV syndromes are among the most serious complications following solid organ transplantation (SOT), primarily due to the necessity for prolonged immunosuppressive therapy. Among the strategies for preventing EBV-related complications, the use of antiviral prophylaxis is a subject of ongoing debate. This systematic review and meta-analysis found that antiviral prophylaxis significantly reduced EBV viremia incidence (risk ratio (RR) 0.69, 95% confidence interval (CI) 0.54 to 0.88) compared to those without prophylaxis. In the sub-analysis related to high-risk EBV serologically mismatched SOT recipients (EBV D+/R-), the result did not show a significant difference in terms of PTLD incidence (RR 1.13, 95% CI 0.72 to 1.78). Antiviral prophylaxis significantly impacted the occurrence of PTLD events among pediatric SOT patients (RR 0.58, 95% CI 0.43 to 0.79), but not among adult patients (RR 0.88, 95% CI 0.64 to 1.21). Antiviral prophylaxis significantly impacted the occurrence of PTLD events among kidney/simultaneous pancreas and kidney (RR 0.63, 95% CI 0.46 to 0.87) and heart (RR 0.61, 95% CI 0.39 to 0.96) transplant patients but not liver (RR 0.5, 95% CI 0.23 to 1.08) transplant recipients.

PMID:39815274 | DOI:10.1186/s12985-025-02623-y

J Cardiothorac Surg. 2025 Jan 15;20(1):63. doi: 10.1186/s13019-024-03260-2.

ABSTRACT

BACKGROUND: This article aims to use high-throughput sequencing to identify miRNAs associated with ferroptosis in myocardial ischemia-reperfusion injury, select a target miRNA, and investigate its role in H9C2 cells hypoxia-reoxygenation injury.

METHODS: SD rats and H9C2 cells were used as subjects. ELISA kits quantified MDA, SOD, GSH, LDH, and ferritin levels. TTC staining evaluated infarction size. HE staining observed histopathological changes. DCFH-DA fluorescent probe detected ROS. CCK-8 kit measured cell viability. HiSeq 2000 sequencing performed differential expression analysis of miRNAs. qRT-PCR and Western blots assessed the expression levels of GPX-4, ACSL-4, HO-1, TFR-1 and TFR-2. SPSS 21.0 software conducted statistical analysis.

RESULTS: Myocardial ischemia-reperfusion injury resulted in decreased levels of SOD and GSH, increased levels of LDH and MDA, up-regulation of ferritin, ACSL-4, HO-1, and TFR-2, down-regulation of GPX-4, increased tissue damage, and accumulation of ROS. However, DFO treatment reversed these changes. Subsequently, the target gene miRNA-541-5p was obtained by miRNA sequencing screening, and further validation revealed that miRNA-541-5p expression was increased in the myocardial tissues of rats in the I/R injury model group compared with those of rats in the NC group, P < 0.05. Subsequently, by constructing H9C2 cell lines with miRNA-541-5p overexpression and miRNA-541-5p expression inhibition, miRNA-541-5p expression was inversely correlated with the survival of H9C2 cells after hypoxia-reoxygenation injury. miRNA-541-5p up-regulation led to a decrease in SOD and GSH, an increase in ferritin and MDA, and an accumulation of ROS. wb and qRT-PCT demonstrated that high miRNA-541-5p expression up-regulated the expression of protein/mRNA expression of ACSL-4, HO-1, ferritin, and TFR-1, but down-regulated protein/mRNA expression of GPX-4. In addition, ADAM 7, FNIP 2, HOXD 10, HCCS and STK 3 were preliminarily identified as potential candidate target genes for miRNA-541-5p by bioinformatics analysis. Among them, ADAM7 emerges as the most suitable potential target gene based on the selection criteria.

CONCLUSION: In summary, miRNA-541-5p may be a biomarker of myocardial I/R damage diseases and can regulate oxidative stress and iron death by inhibiting the expression of miRNA-541-5p, thereby reducing mechanisms of I/R injury.

PMID:39815273 | DOI:10.1186/s13019-024-03260-2

BMC Health Serv Res. 2025 Jan 15;25(1):80. doi: 10.1186/s12913-025-12228-4.

ABSTRACT

BACKGROUND: The continued healthcare crisis in the United States (US) is worrisome, especially as workforce shortages, particularly for nurses, are highlighted, often in some of the highest need areas. As the need for healthcare services grows, especially for services that nurses can deliver, the inability to meet those needs exacerbates existing disparities in access to care and can jeopardize the quality and timeliness of healthcare delivery in underserved communities. Prior investigations have used varying definitions to describe underserved, under-resourced, rural, or health professional shortage areas to examine the relationship between these areas and workforce shortages. Therefore, this study examines the relationship between changes in the nursing labor force changes and metropolitan medically underserved areas (MUA), defined by Health Resources and Services Administration (HRSA).

METHODS: Secondary data were utilized to conduct descriptive and regression analyses of the nursing workforce population in metropolitan statistical areas from 2012 to 2022. The key outcome variable for the analyses was nurse workforce change per 10,000 population. Occupational Employment and Wage dataset from the Bureau of Labor Statistics was used to determine the number of nurses employed, at the level of the metropolitan statistical area from 2012 to 2022. The Index of Medical Underservice was extracted for each MUA from HRSA and geographically weighted to the metropolitan area.

RESULTS: The results of descriptive trends for nursing professions show that all nursing occupations reviewed have experienced positive change over both five- and ten-year periods. However, the results of nurse change models show that neither the change in Registered Nurses nor Nurse Practitioners is correlated with medically underserved areas.

CONCLUSIONS: These results emphasize the need for adaptive strategies in the nursing workforce to respond to the evolution of healthcare requirements over time. The findings from this study suggest the need for careful planning in workforce policy and education to grow the nurse workforce needs to meet evolving healthcare needs effectively.

PMID:39815266 | DOI:10.1186/s12913-025-12228-4

BMC Med Inform Decis Mak. 2025 Jan 15;25(1):27. doi: 10.1186/s12911-025-02849-4.

ABSTRACT

Electronic health records (EHRs) provide a rich source of observational patient data that can be explored to infer underlying causal relationships. These causal relationships can be applied to augment medical decision-making or suggest hypotheses for healthcare research. In this study, we explored a large-scale EHR dataset on patients with asthma or related conditions (N = 14,937). The dataset included integrated data on features representing demographic factors, clinical measures, and environmental exposures. The data were accessed via a service named the Integrated Clinical and Environmental Service (ICEES). We estimated underlying causal relationships from the data to identify significant predictors of asthma attacks. We also performed simulated interventions on the inferred causal network to detect the causal effects, in terms of shifts in probability distribution for asthma attacks.

PMID:39815256 | DOI:10.1186/s12911-025-02849-4

BMC Ophthalmol. 2025 Jan 15;25(1):20. doi: 10.1186/s12886-025-03864-9.

ABSTRACT

BACKGROUND: The quality of life for low vision patients is a comprehensive concept that involves multiple aspects, including physical, psychological, and social aspects. Visual impairment is an important factor in the decline of patients’ quality of life. The purpose of this study is to investigate the impact and feasibility of carrying out low vision rehabilitation nursing on the quality of life and nursing burden of low vision patients.

METHODS: Select 18 low vision patients who received treatment at a tertiary ophthalmic hospital in Shantou City and randomly divide them into an experimental group and a control group. The control group received routine low vision health education, while the experimental group received intervention measures based on low vision rehabilitation nursing plans. A questionnaire survey was conducted on two groups of study subjects and their caregivers using the Low Vision Quality of Life Questionnaire, General Self-Efficacy Scale, and Zarit Burden Interview before intervention, at week 4 after intervention, and at week 8 after intervention. The scores of each scale in the experimental group and the control group were statistically analyzed.

RESULT: The quality of life and self-efficacy scores of the experimental group patients were higher than those of the control group in the 4th and 8th week after intervention; The caregiver burden of the experimental group patients was lower than that of the control group caregivers in the 4th and 8th weeks after intervention.

CONCLUSION: Implement a low vision rehabilitation nursing plan, provide rehabilitation intervention and support to low vision patients, help patients find new ways to adapt to low vision conditions, and improve their quality of life. Low vision rehabilitation nursing interventions not only enable patients to regain the ability to independently complete daily activities, but also improve their self-efficacy, help rebuild confidence, and reduce the caregiving burden on their caregivers.

PMID:39815249 | DOI:10.1186/s12886-025-03864-9

BMC Infect Dis. 2025 Jan 11;25(1):56. doi: 10.1186/s12879-025-10486-5.

ABSTRACT

INTRODUCTION: Dengue viruses cause either symptomatic infections or asymptomatic seroconversion. Symptomatic dengue has a wide clinical spectrum ranging from self-limiting infection to severe manifestations, mostly characterized by plasma leakage with or without hemorrhage. World Health Organization classification in 2009 classified dengue into dengue without warning signs, dengue with warning signs, and severe dengue. This study aimed to determine patient characteristics and hematological parameters (leukopenia, and thrombocytopenia) in patients with dengue infection in the emergency department of a tertiary center.

METHODS: A cross-sectional study was conducted among 252 patients with dengue confirmed by serological testing against dengue-specific nonstructural protein 1 (NS1) antigen and immunoglobulin M (IgM) by enzyme-linked immunosorbent assay from September to November 2022 who presented in the emergency department of a tertiary hospital in Nepal after ethical approval was obtained. Dengue was categorized according to the World Health Organization 2009 classification. Hematological parameters were recorded by reviewing patients’ laboratory records. Data analysis was done using descriptive statistical parameters and a chi-square test.

RESULTS: Dengue without warning signs was present in 166 (65.87%) patients, while dengue with warning signs and severe dengue was present in 68 (26.89%) and 18 (7.14%) patients, respectively. Leukopenia (< 4000 cells/mm³⁾ was present among 163 (64.68%) patients. The lowest recorded leukocyte count was 1440. Similarly, thrombocytopenia (< 150000 cells/mm³) was present among 102 patients (40.48%). The lowest recorded platelet count was 26,000 cells/mm³. A significant association was found between the severity of dengue infection and leukopenia (χ² 13.268, p-value 0.001) and thrombocytopenia (χ² 43.924, p value < 0.001).

CONCLUSIONS: Monitoring of warning signs and clinical parameters is important for identifying the progression of dengue infection to the critical phase. Leukopenia and thrombocytopenia are present among many dengue-infected patients presenting in the emergency department. The severity of the disease will usually only be apparent around defervescence, which often coincides with the onset of the critical phase. Leukopenia and thrombocytopenia could indicate progression to severe disease during emergency department admission.

PMID:39815245 | DOI:10.1186/s12879-025-10486-5

Child Abuse Negl. 2025 Jan 14;161:107246. doi: 10.1016/j.chiabu.2025.107246. Online ahead of print.

ABSTRACT

BACKGROUND: Neonatal abstinence syndrome (NAS), or withdrawal from prenatal opioid exposure at birth, can trigger a referral to child protective services (CPS). However, there is some evidence of selection into NAS diagnosis because NAS screening is not universal. Such referrals may protect the infant, help connect the mother to services, or cause harm.

OBJECTIVE: To study the relation between prenatal opioid exposure, NAS diagnosis, and CPS involvement during the (early) neonatal period.

PARTICIPANTS AND SETTING: We analyzed data (N = 236,868 Medicaid-covered live births) from the Wisconsin Administrative Data Core using linked birth records, Medicaid claims, CPS records, and benefit/earnings data from 2010 to 2018.

METHODS: We identified opioid exposure using Medicaid claims and CPS investigations within 7 and 28 days of life. We estimate linear probability models with and without the inclusion of NAS diagnosis and interactions of prenatal opioid exposure and NAS diagnosis.

RESULTS: Prenatal opioid exposure is positively associated with CPS involvement, but after controlling for NAS diagnosis, exposure to opioid medications used to treat pain (non-MOUD) or opioid use disorder (MOUD) are not statistically significantly associated with CPS investigations, whereas illicit opioid exposure is associated with increased CPS investigations. Fully interacted models suggest that, for infants diagnosed with NAS, non-MOUD and MOUD exposure are protective and reduce the likelihood of CPS involvement.

CONCLUSIONS: Understanding the type of opioid exposure during pregnancy, NAS diagnosis, and access to treatment OUD is important for referrals to child welfare agencies.

PMID:39813738 | DOI:10.1016/j.chiabu.2025.107246

J Med Internet Res. 2025 Jan 15;27:e59598. doi: 10.2196/59598.

ABSTRACT

BACKGROUND: Some scholars who are skeptical about open-access mega journals (OAMJs) have argued that low-quality papers are often difficult to publish in more prestigious and authoritative journals, and OAMJs may be their main destination.

OBJECTIVE: This study aims to evaluate the academic quality of OAMJs and highlight their important role in clinical medicine. To achieve this aim, authoritative journals and representative OAMJs in this field were selected as research objects. The differences between the two were compared and analyzed in terms of their level of disruptive innovation. Additionally, this paper explored the countries and research directions for which OAMJs serve as publication channels for disruptive innovations.

METHODS: In this study, the journal information, literature data, and open citation relationship data were sourced from Journal Citation Reports (JCR), Web of Science (WoS), InCites, and the OpenCitations Index of PubMed Open PMID-to-PMID citations (POCI). Then, we calculated the disruptive innovation level of the focus paper based on the local POCI database.

RESULTS: The mean Journal Disruption Index (JDI) values for the selected authoritative journals and OAMJs were 0.5866 (SD 0.26933) and 0.0255 (SD 0.01689), respectively, showing a significant difference. Only 1.48% (861/58,181) of the OAMJ papers reached the median level of disruptive innovation of authoritative journal papers (MD_AJ). However, the absolute number was roughly equal to that of authoritative journals. OAMJs surpassed authoritative journals in publishing innovative papers in 24 research directions (eg, Allergy), accounting for 40.68% of all research directions in clinical medicine. Among research topics with at least 10 authoritative papers, OAMJs matched or exceeded MD_AJ in 35.71% of cases. The number of papers published in authoritative journals and the average level of disruptive innovation in each country showed a linear relationship after logarithmic treatment, with a correlation coefficient of -0.891 (P<.001). However, the number of papers published in OAMJs in each country and the average level of disruptive innovation did not show a linear relationship after logarithmic treatment.

CONCLUSIONS: While the average disruptive innovation level of papers published by OAMJs is significantly lower than that of authoritative journals, OAMJs have become an important publication channel for innovative research in various research directions. They also provide fairer opportunities for the publication of innovative results from limited-income countries. Therefore, the academic community should recognize the contribution and value of OAMJs to advancing scientific research.

PMID:39813675 | DOI:10.2196/59598

J Med Internet Res. 2025 Jan 15;27:e65122. doi: 10.2196/65122.

ABSTRACT

BACKGROUND: A greater understanding of the effectiveness of digital self-management programs and their ability to support longer-term weight loss is needed.

OBJECTIVE: This study aimed to explore the total weight loss and patterns of weight loss of CSIRO (Commonwealth Scientific and Industrial Research Organisation) Total Wellbeing Diet Online members during their first 12 months of membership and examine the patterns of platform use associated with greater weight loss.

METHODS: Participants were Australian adults who joined the program between October 2014 and June 2022 and were classified as longer-term members, meaning they completed at least 12 weeks of the program, had baseline and 12-week weight data, and had a paid membership of ≥1 year (N=24,035). Weight loss and percentage of starting body weight loss were calculated at 3, 6, 9, and 12 months using 3 statistical approaches: (1) multiple imputations method, (2) all available data, and (3) complete data only. Among members with complete data (6602/24,035, 27.5%), patterns of weight loss and gain were examined, and how this related to total weight loss was explored.

RESULTS: Members were mostly female (19,972/24,035, 83.09%), aged 31 to 50 years (9986/24,035, 41.5%) or 51 to 70 years (12,033/24,035, 50.06%), and most members were classified as overweight or obese (23,050/24,035, 95.9%). Using multiple imputations, the average estimated weight loss was 5.9 (SE 0.0245) kg at 12 weeks, 6.7 (SE 0.0348) kg at 6 months, 6.2 (SE 0.0400) kg at 9 months, and 5.5 (SE 0.0421) kg at 12 months. At 12 months, more than half the members (12,573/24,035, 52.3%) were at least 5% below their starting body weight and 1 in 4 (5865/24,035, 24.4%) were at least 10% below their starting body weight. In the subsample with complete data, the average weight loss at 12 months was 7.8 kg. The most common (961/6602, 14.56% members) weight loss pattern over the first 12 months was 6 months of weight loss, followed by 6 months of weight maintenance. This group had an average weight loss of 10.6 kg at 12 months (11.9% of their starting body weight). In a subgroup of participants who consistently lost weight over the 12-month period (284/6602, 4.3% of the sample), weight loss reached up to 22.3 kg (21.7% of their starting body weight). Weekly platform use was positively associated with total weight loss (r=0.287; P<.001). Members who used the platform >30 times per week (approximately >4 times/d) were more likely to lose weight in the first 6 months of the program.

CONCLUSIONS: This commercial weight loss program was shown to be effective, with 1 in 2 members achieving clinically significant results after 1 year. Greater engagement with the platform was associated with consecutive periods of weight loss and greater weight loss success overall.

PMID:39813669 | DOI:10.2196/65122

J Med Internet Res. 2025 Jan 15;27:e62645. doi: 10.2196/62645.

ABSTRACT

BACKGROUND: Health inequalities among older adults become increasingly pronounced as aging progresses. In the digital era, some researchers argue that access to and use of digital technologies may contribute to or exacerbate these existing health inequalities. Conversely, other researchers believe that digital technologies can help mitigate these disparities.

OBJECTIVE: This study aimed to investigate the relationship between the digital divide and health inequality among older adults and to offer recommendations for promoting health equity.

METHODS: Data were obtained from the 2018 and 2020 waves of the China Health and Retirement Longitudinal Study. Physical, mental, and subjective health were assessed using the Activities of Daily Living (ADL) scale, the Instrumental Activities of Daily Living scale, the Mini-Mental State Examination scale, and a 5-point self-rated health scale, respectively. The chi-square and rank sum tests were used to explore whether internet use and access were associated with health inequality status. After controlling for confounders, multiple linear regression models were used to further determine this association. Sensitivity analysis was conducted using propensity score matching, and heterogeneity was analyzed for different influencing factors.

RESULTS: The 2018 analysis highlighted widening health disparities among older adults due to internet access and use, with statistically significant increases in inequalities in self-rated health (3.9%), ADL score (5.8%), and cognition (7.5%). Similarly, internet use widened gaps in self-rated health (7.5%) and cognition (7.6%). Conversely, the 2020 analysis demonstrated that internet access improved health disparities among older adults, reducing gaps in self-rated health (3.8%), ADL score (2.1%), instrumental ADL score (3.5%), and cognition (7.5%), with significant results, except for ADL. Internet use also narrowed disparities, with significant effects on self-rated health (4.8%) and cognition (12.8%). The robustness of the results was confirmed through propensity score-matching paired tests. In addition, the study found heterogeneity in the effects of internet access and use on health inequalities among older adults, depending on sex, age, education, and region.

CONCLUSIONS: The impact of internet access and use on health inequalities among older adults showed different trends in 2018 and 2020. These findings underscore the importance of addressing the challenges and barriers to internet use among older adults, particularly during the early stages of digital adoption. It is recommended to promote equitable access to the health benefits of the internet through policy interventions, social support, and technological advancements.

PMID:39813666 | DOI:10.2196/62645