Tag: pubmed

Diabetol Metab Syndr. 2025 Jun 11;17(1):205. doi: 10.1186/s13098-025-01764-y.

ABSTRACT

OBJECTIVE: This study aimed to utilize Mendelian randomization (MR) techniques to determine causal relationships between the plasma lipidome and the occurrence and progression of chronic kidney disease (CKD).

METHODS: Summary statistics for 179 lipid species and six CKD-related phenotypes were retrieved from published large-scale genome-wide association studies. A bidirectional two-sample MR analysis was performed using the inverse-variance weighting (IVW) as the primary MR method. Cochrane’s Q test, the MR‒Egger intercept analysis, and the MR-PRESSO were employed to evaluate heterogeneity and horizontal pleiotropy. The leave-one-out test was applied to ensure the stability of the MR findings, and Benjamini‒Hochberg (BH) correction was utilized to assess the robustness of causal links.

RESULTS: This study unveiled significant associations between 33 plasma lipid levels and various CKD-related outcomes by combining insights from both MR and sensitivity analyses. Various plasma lipid species were identified as having either positive or negative causal connections with kidney conditions, demonstrated by specific ranges of IVW-OR values (all P < 0.05). Following the BH correction, elevated sterol ester (27:1/18:2) levels (OR: 1.012 ~ 1.037, P < 0.05) and reduced phosphatidylcholine (16:1_20:4) levels (OR: 0.954 ~ 0.985, P < 0.05) consistently showed a strong causal relationship with increased urine albumin-creatinine ratio. These findings were robust across all sensitivity analyses.

CONCLUSION: This study revealed potential causal associations between specific types of lipidome other than conventional lipids and the occurrence and progression of CKD. These insights pave the way for the development of early diagnostic and prophylactic CKD interventions.

PMID:40495181 | DOI:10.1186/s13098-025-01764-y

Biomed Eng Online. 2025 Jun 10;24(1):72. doi: 10.1186/s12938-025-01403-7.

ABSTRACT

BACKGROUND: Despite therapeutic advances, acute leukemia (AL) continues to impose a substantial global health burden, with persistently high incidence and mortality rates. Notably, the prediction is that the number of incidence and mortality of acute myeloid leukemia (AML) cases will continue to increase to 184,287.88 and 165,537.59, respectively, by 2040. Using Global Burden of Disease Study (GBD) 2021 data, we assessed the worldwide AL burden from 1990 to 2021, analyzing trends by sex to inform public health strategies.

METHODS: To delineate the burden of AL, we reported incidence, prevalence, mortality, and disability-adjusted life year (DALY) rates at global, regional, and national levels, with these estimates including age-standardized rates (ASRs) per 100,000 population and average annual percentage changes (AAPCs) from 1990 to 2021 which were stratified by age, sex, and socio-demographic index (SDI), and computed ASRs and AAPCs using linear regression. Temporal trends were analyzed using an age-period-cohort (APC) model with intrinsic estimation (principal component regression). Risk factor attribution quantified contributions of 21 behavioral, environmental, and metabolic exposures to AL-related DALYs. For inequality assessment, we applied the Slope Index of Inequality and Concentration Index to evaluate absolute and relative disparities in AL burden across regions and countries. Future projections (2040) were modeled via a Bayesian APC framework with Integrated Nested Laplace Approximation. All statistical analyses were performed using R software (version R 4.4.1). The GATHER (Guidelines for Accurate and Transparent Health Estimates Reporting) statement provides a framework to ensure the transparency, reproducibility, and quality of health estimates reporting.

RESULTS: Between 1990 and 2021, global ASRs of AL declined, except for acute lymphoblastic leukemia (ALL) age-standardized prevalence rates (ASPR) (AAPC 0.84, 95% CI 0.59-1.10). Case numbers rose overall, though ALL mortality and DALYs decreased. AML burden correlated positively with SDI (ρ > 0, P < 0.001), with the highest number of incident and mortality cases in Western Europe. For ALL, SDI showed positive associations with ASIR and ASPR (ρ > 0, P < 0.001) but negative correlations with ASMR and ASDALR (ρ < 0, P < 0.001), with East Asia being the most severely affected region. High body mass index (BMI), smoking, and benzene/formaldehyde exposure were key AL DALY risk factors. High BMI and smoking predominate in developed countries, and the proportion of DALYs decreases progressively as SDI decreases. Occupational exposures prevailed in developing countries. Population growth drove most absolute increases. Males bore a greater AL burden. AML risk rose with age, whereas ALL displayed bimodal peaks (< 5 and > 40 years). Notably, while ASRs in AL are projected to decline slightly and the number of ALL to decrease by 2040, the number of AML is expected to increase, with the number of incidence and mortality cases increasing by 41.56% and 27.16%, respectively.

CONCLUSION: As a major public health concern, despite declining ALL-related mortality and DALYs (1990-2021), AL remains a growing global health challenge, with AML cases projected to rise significantly by 2040. Region-specific intervention strategies are required: high-SDI nations should prioritize smoking cessation and metabolic control to address smoking and high BMI-related AML risks while preparing for aging populations, whereas low/middle-SDI countries urgently need enhanced pediatric ALL diagnosis, treatment capacity, and occupational safety measures. Effective mitigation demands evidence-based health planning, including resource allocation guided by projected AL burden trends and targeted policy interventions to reduce healthcare disparities.

PMID:40495176 | DOI:10.1186/s12938-025-01403-7

J Physiol Anthropol. 2025 Jun 10;44(1):17. doi: 10.1186/s40101-025-00397-4.

ABSTRACT

BACKGROUND: Sleep deprivation and irregular sleep patterns can adversely affect physical and mental health. The COVID-19 pandemic presented a naturalistic opportunity to examine how reduced social time restrictions influence sleep behavior. This study aimed to investigate both group-level and individual-level changes in sleep patterns among Japanese university students before and during the pandemic and to explore how individual characteristics may contribute to these changes.

METHODS: Twenty-two female university students wore waist-worn actigraphy devices for approximately 16 weeks in both 2019 and 2020. Objective sleep data were collected alongside questionnaire assessments of chronotype, personality traits, and subjective sleep feeling.

RESULTS: In total, 4,432 valid days of actigraphy data were analyzed. Compared with the pre-pandemic year, sleep timing was delayed by approximately 20 min for bed-in time and 40 min for bed-out time in 2020. Time in bed (TIB) increased by about 20 min, while total sleep time (TST) remained largely unchanged. Sleep efficiency declined, but subjective sleep feeling remained stable. Individual-level analyses revealed substantial variability: 9 of 22 participants showed significant changes in TST, with both increases and decreases observed. Increased TIB was associated with later bed-out time, shorter baseline sleep duration, and lower neuroticism. A later bed-in time was associated with reduced TST.

CONCLUSIONS: These findings suggest that while social time restrictions can influence sleep timing and duration, the effects vary considerably across individuals. Earlier bedtimes may be more effective than simply extending TIB in promoting adequate sleep. Furthermore, individual characteristics such as personality traits may play a role in sleep adaptation under changing social contexts. Given the diversity of responses observed, both group- and individual-level perspectives are essential for understanding sleep behavior in real-world settings.

PMID:40495174 | DOI:10.1186/s40101-025-00397-4

BMC Public Health. 2025 Jun 10;25(1):2146. doi: 10.1186/s12889-025-23427-3.

ABSTRACT

BACKGROUND: Diphtheria remains a significant public health concern in Nigeria, with over 20,000 suspected cases and more than 500 deaths reported during the 2022-2023 outbreak period, particularly concentrated in the northern regions. Understanding public perceptions and behavior regarding diphtheria, including symptoms, transmission, and vaccination across different seasons, is vital for developing effective interventions. This study aimed to evaluate seasonal variations in public awareness of diphtheria, including knowledge of its symptoms and information sources. Additionally, it sought to assess the perceived at-risk groups and attitudes toward diphtheria vaccination in the country.

METHODS: A cross-sectional survey was conducted among residents aged 18 years and older in Kano, Katsina, Bauchi, Yobe, Borno, Kaduna, Jigawa, Kebbi, and the Federal Capital Territory (FCT). Data were collected by trained fieldworkers over 12 months via structured questionnaires divided into four sections: demographics, public awareness, perceived risk, and vaccination attitudes. Ethical approval was obtained, and verbal informed consent was secured from all participants. Data analysis involved descriptive statistics and statistical tests to examine associations between variables.

RESULTS: A total of 3,070 respondents participated in the study. Public awareness of common diphtheria symptoms such as fever (68.0%) and sore throat (60.5%) was high, whereas awareness of conjunctivitis (23.9%) was lower. Children under 5 years of age were consistently perceived as the most at-risk group (80.5%). The willingness to vaccinate against diphtheria remained high at 94.4%, with no significant seasonal variation (p-value 0.894; Chi-square test). Radio (53.1%) was identified as the primary information source, especially during the rainy season (54.6%). Seasonal variations in preventive and vaccination practices were minimal, indicating consistent public health behaviors throughout the year.

CONCLUSION: This study highlights the importance of maintaining robust public health education campaigns, leveraging both traditional and digital media to sustain high awareness and vaccination rates for public health interventions. Based on our findings, we recommend implementing targeted school-based health education programs and strengthening partnerships with community health workers to enhance diphtheria awareness, especially among caregivers of young children. Understanding sociodemographic and seasonal contexts is crucial for effective public health interventions, ensuring that at-risk groups are adequately protected.

PMID:40495171 | DOI:10.1186/s12889-025-23427-3

BMC Public Health. 2025 Jun 10;25(1):2160. doi: 10.1186/s12889-025-23325-8.

ABSTRACT

INTRODUCTION: Intestinal parasitic infections (IPIs) are a major public health concern, particularly among children in low- and middle-income countries, where limited resources and data hinder effective interventions. This meta-analysis consolidates current evidence on the prevalence of IPIs among preschool and school-aged children in Egypt, identifies key risk factors, and examines trends in prevalence over time.

METHODS: Six databases (African Journals Online, African Index Medicus, PubMed, Scopus, Google Scholar, and Web of Science) were systematically searched from January 1, 2010, to January 1, 2025. Studies conducted in Egypt on apparently healthy preschool or school-aged children were included if they reported IPIs prevalence or risk factors. A random-effects model was employed to estimate pooled prevalence or risk ratios. The meta-analysis was performed using the ‘meta’ package in R (version 4.4.1), with statistical significance set at p < 0.05.

RESULTS: This meta-analysis included 21 studies conducted between 2009 and 2021, involving 54,282 school and preschooler children from both Lower and Upper Egypt. The pooled prevalence of at least one IPI was 46.5% (95% CI: 40.5-52.5). Sensitivity analyses confirmed the robustness of the finding, with no evidence of publication bias. Meta-regression analysis revealed that the prevalence of at least one IPI remained consistent from 2009 to 2021. The most prevalent parasite was Entamoeba spp. (10.9%), followed by Giardia duodenalis (7.3%) and Enterobius vermicularis (4.9%). Less common parasites included Schistosoma mansoni (1.3%), Ancylostoma duodenale (1.0%), Schistosoma haematobium (0.6%), Heterophyes heterophyes (0.7%), Trichuris trichiura (0.5%), and Fasciola spp. (0.3%). Key risk factors included age 6-10 years (RR = 1.5), rural residence (RR = 1.4), low socioeconomic status (RR = 2.4), poor handwashing practices (RR = 2.1), consuming unwashed vegetables (RR = 1.5), and low maternal education (RR = 1.62).

CONCLUSION: These findings highlight the substantial burden of IPIs among Egyptian preschool and school-aged children, with nearly half infected by at least one parasite. The consistently high prevalence from 2009 to 2021 underscores the urgent need to reevaluate current control measures and prioritize interventions targeting the high-risk groups identified in this study.

PMID:40495169 | DOI:10.1186/s12889-025-23325-8

J Clin Psychopharmacol. 2025 Jun 6. doi: 10.1097/JCP.0000000000002027. Online ahead of print.

ABSTRACT

PURPOSE/BACKGROUND: Intramuscular (IM) lorazepam is administered to acutely agitated patients. During a lorazepam shortage, midazolam was selected as the IM benzodiazepine of choice at this study location. This study aims to explore the efficacy and safety of IM haloperidol, diphenhydramine, and midazolam in treating acutely agitated patients.

METHODS/PROCEDURES: A single center, retrospective chart review was conducted in adult patients who received IM diphenhydramine and haloperidol in combination with either midazolam (midazolam+) or lorazepam (lorazepam+) in a psychiatric emergency department (ED) during 2 identified lorazepam shortage periods. Multivariate ordinary least squares and logistic regression analyses were used to evaluate post-IM patients’ conditions in behavioral activity rating scale (BARS) scores and the safety and tolerability of IM administrations.

FINDINGS/RESULTS: A total of 174 patients met inclusion criteria, with 87 patients in the midazolam+ group (treatment) and 87 patients in the lorazepam+ group (control). Lorazepam+ was associated with a 9.4% greater decrease in BARS score than midazolam+ (P<0.01). Midazolam+ administrations achieved a goal BARS score of 4 more frequently than lorazepam+ (P<0.05). 18.4% more patients received a BARS score of 2, oversedation with lorazepam+ (P<0.05). Lorazepam+ patients took nearly 3 hours (176 min) longer than midazolam+ to return to “normal” baseline behavior (P<0.001). No statistically significant differences were detected in the incidence of hypotensive episodes or oxygen desaturation between groups.

IMPLICATIONS/CONCLUSIONS: This is the first study to examine coadministration of intramuscular midazolam with haloperidol and diphenhydramine. Midazolam+ was effective at managing agitation and may be an alternative to lorazepam+.

PMID:40493972 | DOI:10.1097/JCP.0000000000002027

NCHS Data Brief. 2024 Dec;(517):1. doi: 10.15620/cdc/168516.

ABSTRACT

INTRODUCTION: Influenza, also known as flu, is a viral respiratory infection. In the 2022-2023 flu season, an estimated 31 million people developed influenza, 360,000 were hospitalized with influenza, and 21,000 died from influenza. To prevent more serious illness, early identification and treatment of influenza is important. This report uses data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) to study trends in the use of influenza testing at hospital emergency department (ED)visits from 2013 through 2022.

METHODS: Data in this report are from NHAMCS, a nationally representative annual survey of nonfederal general and short-stay hospitals. Results are presented from 2013 to 2022. Estimates and their corresponding variances were calculated using SAS-callable SUDAAN software. Differences between percentages were evaluated using two-sided significance t tests at the 0.05 level. Linear regression was used to test the significance of slope.

KEY FINDINGS: ED visits by children ages 0-5 years had the highest percentage of influenza tests ordered or provided in 2013 and 2022. Percentages of ED visits with an influenza test ordered or provided increased between 2013 and 2022 for all age groups. Fever and cough were the most frequent first-listed reasons for ED visits at which an influenza test was ordered or provided in both 2013 and 2022. Percentages of ED visits with an influenza test ordered or provided increased within each region of the United States (Northeast, Midwest, South, and West) between 2013 and 2022.

PMID:40493962 | DOI:10.15620/cdc/168516

NCHS Data Brief. 2025 Apr;(212):1.

ABSTRACT

BACKGROUND: Synthetic data has been gaining popularity in many fields as an approach to retain data utility (the validity of inference using synthetic data) and protect confidentiality. However, creating synthetic data for complex surveys remains a challenge.

METHODS: This research compared three approaches to incorporate survey design information (stratification, clustering, and sampling weights) during the synthetic data-generating process using the Research and Development Survey (RANDS), a series of primarily web surveys conducted by the National Center for Health Statistics, Centers for Disease Control and Prevention. Both parametric (logistic and linear regression models) and nonparametric (classification and regression trees [CART]) methods were used to create synthetic data. Data utility and disclosure risk were evaluated via confidence interval overlap, propensity score measurement, and average matching probability for re-identification.

RESULTS: Using the original survey design information as predictors during the synthesis process improved data utility for the parametric method. However, the nonparametric method yielded results with better data utility but slightly higher disclosure risk.

PMID:40493961

Natl Vital Stat Rep. 2025 May 20;(5):1. doi: 10.15620/cdc/174590.

ABSTRACT

BACKGROUND AND OBJECTIVES: Beginning with the 2023 data year, the National Center for Health Statistics (NCHS) will use a different, expanded measure of perinatal mortality for standard publications. This measure, Definition III, includes fetal deaths at 20 weeks of gestation or more and infant deaths younger than 7 days. Definition III replaces Definition I (fetal deaths at 28 weeks of gestation or more and infant deaths younger than 7 days), which has been used in NCHS reports since the 1980s. This change is being made due to the implementation of national reporting of all fetal deaths at 20 weeks of gestation or more as of 2014, allowing for the use of Definition III, which more fully represents the perinatal events most likely to be affected by similar factors. This report describes the reason for this change and compares trends in perinatal mortality rates based on Definition I and Definition III from 2014 to 2022 and differences in the two measures by maternal race and Hispanic origin, age, and state of residence for 2022.

METHODS: Data for perinatal mortality are derived from NCHS’s National Vital Statistics System’s fetal death, birth, and period linked birth/infant death files. Perinatal mortality rates for Definition III are compared with those for Definition I.

RESULTS: In 2022, Definition III comprised 91.4% of perinatal deaths (fetal deaths at 20 weeks of gestation or more and infant deaths younger than 28 days) compared with 60.7% of perinatal deaths captured by Definition I. The perinatal mortality rate for Definition III was about 50% higher than that for Definition I (8.27 and 5.51, respectively, in 2022). Trends in perinatal mortality were similar for both measures during 2014-2022; rates were stable from 2014 through 2016 and then declined from 2016 through 2022. For 2022, patterns by maternal race and Hispanic origin and age were also similar, but more variation in patterns was observed by state.

PMID:40493960 | DOI:10.15620/cdc/174590

Plast Reconstr Surg. 2025 Jun 10. doi: 10.1097/PRS.0000000000012244. Online ahead of print.

ABSTRACT

BACKGROUND: To investigate key factors related to the velopharyngeal insufficiency (VPI) by evaluating velopharyngeal morphology, soft palate mobility and surgical recovery in cleft palate patients with different types of velopharyngeal function.

METHODS: CT data was used to compare morphology in 49 postoperative velopharyngeal competence (VPC), 39 VPI, and 49 non-cleft individuals. Ultrasound assessed surgical recovery in 87 VPC, 77 VPI, and 75 non-cleft individuals. Soft palate mobility was evaluated in 20 VPC and 17 VPI patients through cephalometric X-rays.

RESULTS: In terms of velopharyngeal morphology, both VPC and VPI groups exhibited shorter velar and hard palate ratios, longer pharyngeal ratio, and lower VP ratio compared to the non-cleft group (p < 0.05), but there were no significant differences between VPC and VPI (p > 0.05). Both groups exhibited significantly lower echo intensity (EI), higher intensity dispersion index (IDI) and lower logarithm unit color velocity (LUCV) values compared to the non-cleft group (p < 0.05). However, the differences in EI, IDI and LUCV between the VPC and VPI groups were not statistically significant (p > 0.05). In contrast, VPC group showed significantly better soft palate mobility compared to VPI, with greater elevation angle (p = 0.042) and higher closure rate (p = 0.001) during speech.

CONCLUSION: The VPC group showed significantly improved soft palate mobility compared to the VPI group; however it was interesting to note the lack of significant differences in velopharyngeal morphology and surgical recovery in postoperative cleft palate patients with VPC and VPI.

PMID:40493959 | DOI:10.1097/PRS.0000000000012244