Tag: pubmed

Sci Rep. 2025 Apr 10;15(1):12235. doi: 10.1038/s41598-025-90975-4.

ABSTRACT

Pulmonary arterial hypertension (PAH) poses a substantial burden, including hospitalizations. This study assessed the impact of treatment escalation on rehospitalization. The Komodo Research Data (10/2015-03/2022) was used to identify adults with ≥ 1 PAH-related hospitalization (index: first hospitalization). Patients on monotherapy pre-index were assigned to the Escalation-to-combination cohort (treatment added ≤ 90 days post-index) or the Monotherapy cohort (no treatment change ≤ 90 days post-index). A sensitivity analysis was conducted among all patients who were treated pre-index. Entropy balancing was used to create cohorts with similar characteristics. All-cause hospitalizations per-patient-per-month (PPPM) during ≤ 12 months post-index were compared across balanced cohorts. A total of 203 and 1252 patients were included in the Escalation-to-combination and Monotherapy cohorts, respectively (mean age: 61 vs. 62 years; 67% vs. 68% female); most received PDE5i monotherapy pre-index (65.3% vs. 75.9%). Post-index, 84.5% of the Escalation-to-combination cohort increased to dual therapy, most commonly PDE5i + ERA (39.4%) and PDE5i + PPA (24.7%). Rehospitalization was lower in the Escalation-to-combination than Monotherapy cohort (incidence rate ratio [95% confidence interval]: 0.69 [0.55-0.90]; p < 0.001); the sensitivity analysis yielded similar results. Treatment escalation was associated with a lower rehospitalization rate, suggesting that earlier escalation and broader use of combination therapy may reduce PAH burden.

PMID:40210983 | DOI:10.1038/s41598-025-90975-4

Sci Rep. 2025 Apr 10;15(1):12288. doi: 10.1038/s41598-025-97180-3.

ABSTRACT

Historically overshadowed by communicable diseases, the burden of non-communicable diseases (NCDs) has surged over the past two decades, posing a significant threat to public health, and necessitating urgent attention. This study examines the mortality burden from four major groups/categories of NCDs including cancers, cardiovascular diseases (CVD), chronic respiratory diseases (CRD) and diabetes, prevalence of four NCD associated risk factors including tobacco use, alcohol consumption, physical inactivity and overweight, availability of NCD essential medicines and progress indicators of the NCD response in the WHO African region. The data used in this study were obtained from the WHO NCD data portal, Global Health Observatory, and Global Health Estimates, covering the most recent available data for each indicator, ranging from 2000 to 2019 to assess how trends in NCD mortality burden have evolved, as well as the current status of the four main risk factors, availability of essential medicines, and key NCD response indicators. The analysis focused on descriptive statistics for globally used, disease-specific key indicators to examine trends and variations across countries: (i) age-standardized mortality rates (ASMR) for major NCDs (cancers, CRD, CVD and diabetes), (ii) prevalence of NCD risk factors (tobacco use, alcohol consumption, physical inactivity, and overweight), (iii) availability of essential medicines for NCDs in public health facilities, and (iv) national NCD response indicators, such as the presence of NCD targets, mortality data, risk factor reduction measures, and surveillance. Mortality was reported as ASMR or percentages; risk factors as prevalence, except alcohol (litres per capita). Changes in mortality were calculated as absolute and relative differences, with tables and figures generated in Microsoft Excel. Between 2000-2019, NCD-related deaths and the percentage of deaths due to NCDs increased from 24.2 to 37.1% resulting in 12.9 and 53.3% absolute and relative increases. The ASMR decreased by 130.6 per 100,000 population resulting in an 18.2% relative decrease, during the same period; however, it remains consistently higher than the global average. In 2019, 64% of NCD deaths were among people 70 years or younger and the percentage of premature deaths from NCDs ranged from 36.5 to 72.1%. Despite the burden of NCDs, the availability of essential medicines and health services was sub-optimal in public health facilities. The prevalence of key risk factors such as tobacco use, physical inactivity, overweight, and alcohol consumption per capita varied by sex and across the region, with the prevalence of tobacco use and consumption of alcohol higher among men, while the prevalence of insufficient physical activity and overweight higher among women. Public health responses to NCDs remained sub-optimal due to limited national NCD targets, inadequate surveillance, risk factor reduction measures, and access to essential medicines. Though the NCD ASMR has decreased, there has been an increase in NCD-related deaths and the percentage of deaths due to NCDs over the last two decades in the WHO African Region. The mortality burden of NCDs and the prevalence of risk factors remains relatively high, while mounting a public health response for preventing and controlling these NCDs remains challenging. Accelerated action is essential to meet global and regional NCD reduction targets. Strengthening national NCD targets, improving surveillance, ensuring access to essential medicines, and scaling up risk factor reduction strategies are critical to reversing current trends and achieving the 2030 SDG NCD targets.

PMID:40210980 | DOI:10.1038/s41598-025-97180-3

Sci Data. 2025 Apr 10;12(1):603. doi: 10.1038/s41597-025-04925-w.

ABSTRACT

Accurate snow depth datasets are crucial for water resource management, comprehensive climate change evaluations, and the sustainable advancement of the ice-and-snow economy in the context of rapid climate change. To create a high-resolution monthly snow depth dataset tailored for the Northern Hemisphere winter months (NHMSD), this study employed the Delta statistical downscaling method, in conjunction with a spatial feature transfer technique, to refine snow depth data derived from 21 major general circulation models and four shared socioeconomic pathways sourced from the CMIP6 project. The NHMSD stands as the world’s pioneering long-term 0.05° snow depth dataset, encompassing the historical era from 1980 to 2014 and extending into future projections from 2015 to 2100. Validation using 2062 ground snow depth observations has confirmed that NHMSD outperforms reanalysis datasets, including ERA5-Land and GLDAS, in terms of root mean square error, bias, and mean absolute error for the periods 1980-2014 and 2015-2023. This dataset facilitates the exploration of potential alterations in snow depth under future scenarios in the Northern Hemisphere.

PMID:40210961 | DOI:10.1038/s41597-025-04925-w

Sci Rep. 2025 Apr 10;15(1):12293. doi: 10.1038/s41598-025-96305-y.

ABSTRACT

This study provides a comprehensive analysis of seismic activity and structural characteristics in Shandong Province, China, with a focus on identifying seismic belts and potential epicentral zones critical for regional seismic safety. A detailed database was developed, integrating regional seismicity statistics, earthquake distribution patterns, significant geotectonic movements, and recent neotectonic activities. The results reveal that seismic activity in Shandong is heterogeneously distributed, with moderate to strong earthquakes predominantly associated with active fault zones and exhibiting zonal clustering. Earthquakes are generally shallow, occurring within the middle to upper crust, with historical destructive events averaging a focal depth of 19 km, while recent minor seismic events average 14.9 km in depth. These activities span North China Plain and Tan-Lu Seismic Statistical Areas. Projections indicate sustained or heightened seismic activity over the next century, with the potential for earthquakes up to magnitude 5. The geological framework is dominated by Luxi Fault Block and Tan-Lu Fault Zone, characterized by episodic uplift and subsidence driven by neotectonic movements. The prevailing horizontal tectonic stress regime supports the likelihood of strike-slip faulting as the predominant mechanism.

PMID:40210951 | DOI:10.1038/s41598-025-96305-y

Sci Rep. 2025 Apr 10;15(1):12337. doi: 10.1038/s41598-025-96133-0.

ABSTRACT

A nexus of natural and human variables mediate the success of non-native species that threaten global biodiversity and ecological stability. However, the relative importance and interplays among relevant factors has not been holistically approached. To identify spatial differences and potential connections in relevant natural and human drivers, we analyzed the number of non-native species established in European countries using a newly collated database of established non-native species. We employ a series of broadscale national predictors classified into ‘research’, ‘economy’, ‘environment & culture’, and ‘land-use’ to predict successful establishment. Our null models, which assume the distribution of non-native species mirrors that of each predictor, accurately predicted non-native species numbers across European countries. However, a few countries were identified as outliers, having significantly over- or underrepresented non-native species numbers based on adjusted quasi-Poisson distribution quantiles. A network analysis of non-native species compositions identified these regions to be central hubs (e.g. Germany, France, and Switzerland), but also highlighted distinct spatial similarities across European countries. Combinations of the predictors ‘economy’, ‘research’, and ‘environment & culture’ explained the largest shares of differences in the number of established non-native species among European countries as well as their reporting rates over time. Individual drivers alone were insufficient to wholly explain national differences, whereas interacting driver categories ultimately accounted for the largest shares of variance. This analysis demonstrates the breadth of predictors that mediate successful establishment, and particularly highlights the relevance of overlooked historical-cultural facets affecting biological invasions.

PMID:40210947 | DOI:10.1038/s41598-025-96133-0

Sci Rep. 2025 Apr 11;15(1):12375. doi: 10.1038/s41598-025-96460-2.

ABSTRACT

The goal of this study was to explore the impact of psychological resilience on the QOL of cancer patients and the multiple mediating roles of stigma and self-perceived burden. This study utilized a cross-sectional design. The study population consisted of 364 cancer patients selected by convenience sampling method between November 2022 and May 2023 in two tertiary hospitals in Jinzhou City, Liaoning Province. All participants volunteered to participate in the study and signed an informed consent form. Data were collected using questionnaires. The questionnaires included the General Information Questionnaire, the Psychological Resilience Scale, the Stigma Scale, the Self-Perceived Burden Scale, and the Quality of Life Questionnaire. SPSS 25.0 and PROCESS 3.5 macros were employed for description statistics and related analyses of the data, as well as multiple mediation effect tests. Psychological resilience directly affects QOL (β = 0.929, 95% CI 0.729-1.130) and indirectly through three mediating pathways: stigma (β = 0.275, 95% CI 0.154-0.398, 19.76% of total effect), self-perceived burden (β = 0.115, 95% CI 0.046-0.205, 8.26% of total effect), and both stigma and self-perceived burden (β = 0.073, 95% CI 0.029-0.132, 5.24% of total effect), accounting for 33.26% of the overall mediated effect. Stigma and self-perceived burden act as mediators in influencing psychological resilience and QOL of cancer patients. Enhancing psychological resilience and reducing stigma and self-perceived burden is crucial for improving their QOL.

PMID:40210934 | DOI:10.1038/s41598-025-96460-2

Sci Rep. 2025 Apr 10;15(1):12289. doi: 10.1038/s41598-025-96347-2.

ABSTRACT

Cervical cancer is a preventable disease and ranks as the fourth most common cancer, as well as a major cause of cancer deaths among women globally. Despite initiatives by the World Health Organization to reduce cervical cancer incidence through vaccination, screening, and treatment, significant inequalities in healthcare access persist, particularly in low-income regions where economic and infrastructural barriers hinder access to screening services. Therefore, this study aimed to examine wealth-related inequalities in cervical cancer screening among women in Sub-Saharan African countries. The study analyzed 138,605 weighted samples of reproductive-aged women from DHS data spanning 2015 to 2023 across SSA countries. To assess socioeconomic-related inequality in cervical cancer screening uptake, the Erreygers normalized concentration index and its concentration curve were utilized. Additionally, a decomposition analysis was conducted to identify factors contributing to this inequality. The weighted Erreygers normalized concentration index was 0.25 with a standard error of 0.0078 (P value < 0.0001), indicating a statistically significant pro-rich distribution of wealth-related inequalities in cervical cancer screening uptake among reproductive-aged women. The decomposition analysis identified media exposure (20%), wealth index (15.58%), educational status (6.23%), and place of residence (2.18%) significantly contribute to screening inequalities. To address cervical cancer screening disparities in SSA, targeted strategies such as awareness campaigns for low-income groups, free screening services, mobile units in rural areas, and health literacy programs are recommended. Training community health workers and policy advocacy are also crucial. Comprehensive interventions should enhance media outreach, health education, and healthcare accessibility in both urban and rural areas to ensure equitable screening rates.

PMID:40210933 | DOI:10.1038/s41598-025-96347-2

Sci Rep. 2025 Apr 10;15(1):12277. doi: 10.1038/s41598-025-96275-1.

ABSTRACT

Hypothermia remains a leading contributing factor to neonatal mortality. This study reports testing of a thermoregulatory device-‘Thermal Jacket’ that includes a reusable chemical warming pad (CWP) and an insulating jacket designed for hypothermia management. The laboratory experiments were conducted in two distinct phases between February’21 and June’22. In phase 1, a ternary composite of Sodium-Acetate-Trihydrate, Glycerol, Paraffin, and water contained in a high-density polyethylene-pouch named ‘CWP’ was finalised, and an insulating jacket was designed for targeted heat retention. In phase 2, the device’s efficacy was evaluated using a mannequin in a controlled setting. The sample size was 81 events. Welch’s t-test, ANOVA, and GEE were used to assess any significant differences between successful and failed events. Among 81 events, approximately 93% events of CWP and 98% events of insulating jacket successfully maintained temperature within 36-38°C for 120 minutes. Moreover, ambient temperature, reuse of CWPs, humidity did not have any significant effect on the success rate of the CWP and insulating jacket. Thermal Jacket had achieved and sustained the temperature range of 36-38°C for 2 hours. While this study used mannequin, clinical trial with preterm or low birthweight neonates is imperative to assess its effectiveness for thermal care management.

PMID:40210918 | DOI:10.1038/s41598-025-96275-1

ESMO Open. 2025 Apr 9;10(4):104543. doi: 10.1016/j.esmoop.2025.104543. Online ahead of print.

ABSTRACT

BACKGROUND: Germline (likely) pathogenic variants (PVs) are identified in 5%-10% of patients with breast cancer (BC) and play a critical role in guiding clinical management, including the use of targeted therapies such as poly (ADP-ribose) polymerase (PARP) inhibitors (PARPi). High-risk genes such as BRCA1, BRCA2, and PALB2, and moderate-risk genes such as CHEK2 and ATM, influence BC risk and treatment decisions. This study evaluates the prevalence and clinical impact of PVs in a large consecutive cohort.

MATERIALS AND METHODS: A retrospective analysis was conducted on 912 individuals with BC who underwent germline testing at the Hospital Clinic of Barcelona from 2016 to 2023. Genetic testing for 14 BC and Lynch syndrome genes was carried out using the TruSight Hereditary Cancer Panel. Statistical analyses were carried out to assess associations between germline results and clinical characteristics, including eligibility for PARPi therapy.

RESULTS: Of the 912 individuals, 129 (14.1%) had a PV, with BRCA2 (31.8%) and BRCA1 (24%) being the most frequently altered genes. Additionally, 16.2% carried variants of uncertain significance, most commonly in ATM and BRCA2 genes. Patients with PV were younger compared with PV-negative individuals (median age: 43.5 versus 48.2 years, P = 0.006), more likely to have bilateral BC (13.3% versus 5.8%, P = 0.002), and more frequently diagnosed with triple-negative BC (TNBC; 28.7% versus 20.8%, P = 0.046). Of those with PVs, 39.1% completed a bilateral mastectomy, 36.7% had a risk-reducing salpingo-oophorectomy, and 22.7% had both surgeries. PV detection was associated with higher stages at diagnosis (stage IV: 13.0% versus 5.9%, P < 0.001). In the metastatic cohort, 12.9% received PARPi therapy, with 80.7% harboring BRCA1/2 PVs. In early BC, 13.1% met the criteria for adjuvant PARPi.

CONCLUSIONS: The identification of germline PVs significantly influences surgical decisions and systemic therapies. Genetic testing for patients with BC optimizes care, particularly in selecting candidates for PARPi in both early and advanced BC, improving management and prevention strategies.

PMID:40209283 | DOI:10.1016/j.esmoop.2025.104543

Nurse Educ. 2025 Apr 10. doi: 10.1097/NNE.0000000000001869. Online ahead of print.

ABSTRACT

BACKGROUND: Despite playing an important role in patient care and advocacy, nurses are consistently underrepresented and quoted in <4% of health care media coverage. Media training may address this gap.

PURPOSE: The aims of this study were to develop, implement, and evaluate a media training program to assess whether, after program completion, nurses experience improvements in belief, understanding, confidence, and commitment toward media engagement.

METHODS: A program was developed based on the 10 published media competencies for nurses and assessed using Kirkpatrick’s evaluation model. A prospective pre-post observational study design was used.

FINDINGS: Participants self-reported improvement in all measured categories. Paired t-tests showed statistical significance in understanding the media’s benefit in promoting population health (P = .026) and increased confidence in performing necessary media skills (P = .0005).

CONCLUSION: Developing a media training program for nurses is a critical first step. The findings underscore the importance of equipping nurses with the skills and confidence necessary for impactful media engagement.

PMID:40209267 | DOI:10.1097/NNE.0000000000001869