Annals of medicine最新文献

{"title":"Who feels safe calling 911: are prior experiences of anti-Black racial discrimination associated with hesitancy seeking emergency medical services in the event of accidental drug overdose? - a study protocol.","authors":"O Trent Hall, Candice Trimble, Stephanie Garcia, Sydney Grayson, Lucy Joseph, Parker Entrup, Oluwole Jegede, Jose Perez Martel, Jeanette Tetrault, Myra Mathis, Ayana Jordan","doi":"10.1080/07853890.2024.2439540","DOIUrl":"10.1080/07853890.2024.2439540","url":null,"abstract":"<p><strong>Background: </strong>Racial discrimination is associated with health disparities among Black Americans, a group that has experienced an increase in rates of fatal drug overdose. Prior research has found that racial discrimination in the medical setting may be a barrier to addiction treatment. Nevertheless, it is unknown how experiences of racial discrimination might impact engagement with emergency medical services for accidental drug overdose. This study will psychometrically assess a new measure of hesitancy in seeking emergency medical services for accidental drug overdose and examine prior experiences of racial discrimination and group-based medical mistrust as potential corollaries of this hesitancy.</p><p><strong>Method: </strong>Cross-sectional survey of 200 Black adults seeking treatment for substance-use-related medical problems (i.e. substance use disorder, overdose, infectious complications of substance use, etc.). Participants will complete a survey including sociodemographic information, the Discrimination in Medical Settings Scale, Everyday Discrimination Scale, Group-Based Medical Mistrust Scale, and an original questionnaire measuring perceptions of and prior engagement with emergency services for accidental drug overdose. Analyses will include exploratory factor analysis, Cronbach's alpha, and non-parametric partial correlations controlling for age, gender, income, and education.</p><p><strong>Conclusions: </strong>This article describes a planned cross-sectional survey of Black patients seeking treatment for substance use related health problems. Currently, there is no validated instrument to measure hesitancy in seeking emergency medical services for accidental drug overdose or how experiences of racial discrimination might relate to such hesitancy. Results of this study may provide actionable insight into medical discrimination and the rising death toll of accidental drug overdose among Black Americans.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2439540"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regarding: research progress of femoral head necrosis in HIV-infected patients.","authors":"Yanli Wang, Xiaoshu Zhou, Ying Wen","doi":"10.1080/07853890.2025.2484666","DOIUrl":"10.1080/07853890.2025.2484666","url":null,"abstract":"","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2484666"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access to healthcare: waiting time until the surgical procedure.","authors":"Cassiane de Santana Lemos, Ana Maria Muller Magalhães, Danielle Saraiva Tuma Dos Reis, Alessandra Yuri Takehana de Andrade, Karla Cristina de Almeida, Fabiana Zerbieri Martins, Nancy Reynolds, Vanessa de Brito Poveda","doi":"10.1080/07853890.2025.2452358","DOIUrl":"10.1080/07853890.2025.2452358","url":null,"abstract":"<p><strong>Background: </strong>Understanding the determinants that limit the population's access to surgical care in health services is highly relevant in order to provide data to support political interventions.</p><p><strong>Objective: </strong>This study aimed to evaluate the time between diagnosis and elective surgery in adult patients with the longest waiting lists in Brazil; identify the determinants that interfere with access to the health service to perform surgery; and analyze the quality of life after the indicative diagnosis of surgical intervention.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with adult patients treated at three hospitals in the Southeast, North and South regions of Brazil, from October 2020 to October 2022. Data collection included socio-demographic data and assessment of quality of life using the WHOQOL-Bref instrument in the immediate postoperative period and one month after surgery.</p><p><strong>Results: </strong>A total of 250 patients participated in the study, 55.6% patients from the Southeast, 20.4% patients from the North and 24% patients from the South, with a mean age of 51.86 (SD = 14.27) years and clinical history such as arterial hypertension (<i>p</i> < 0.001). The longest mean waiting time for surgery identified was 26.23 (SD = 17.62) months in the South region, with a significant difference between the evaluated institutions (<i>p</i> = 0.02). Differences were observed between the first place of care of the evaluated patients (<i>p</i> < 0.001). There was a difference in the perception of quality of life between the immediate and late postoperative periods (<i>p</i> = 0.007) and in the physical domain, with an increase in scores among older patients (<i>p</i> = 0.004) and previous clinical history (<i>p</i> = 0.03).</p><p><strong>Conclusion: </strong>Access to the health system varies by region and does not meet the standards proposed by the Brazilian health system. In addition, it seems that longer waiting times for surgery more perceptibly affect the quality of life of older adults and those with other associated diseases.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2452358"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Workload-capacity imbalances and their impact on self-management complexity in patients with multimorbidity: a multicenter cross-sectional study.","authors":"Binyu Zhao, Yujia Fu, Jingjie Wu, Erxu Xue, Chuyang Lai, Dandan Chen, Qiwei Wu, Jianing Yu, Qiaoyu Wu, Zhihong Ye, Jing Shao","doi":"10.1080/07853890.2025.2451195","DOIUrl":"10.1080/07853890.2025.2451195","url":null,"abstract":"<p><strong>Introduction: </strong>Multimorbidity is increasing globally, emphasizing the need for effective self-management strategies. The Cumulative Complexity Model (CuCoM) offers a unique perspective on understanding self-management based on workload and capacity. This study aims to validate the CuCoM in multimorbid patients and identify tailored predictors of self-management.</p><p><strong>Methods: </strong>This multicenter cross-sectional survey recruited 1920 multimorbid patients in five primary health centres and four hospitals in China. The questionnaire assessed workload (drug intake, doctor visits and follow-up, disruption in life, and health problems), capacity (social, environmental, financial, physical, and psychological), and self-management. Data were analyzed using latent profile analysis, chi-square, multivariate linear regression, and network analysis.</p><p><strong>Results: </strong>d Patients were classified into four profiles: low workload-low capacity (10.2%), high workload-low capacity (7.5%), low workload-high capacity (64.6%), and high workload-high capacity (17.7%). Patients with low workload and high capacity exhibited better self-management (β = 0.271, <i>p</i> < 0.001), while those with high workload and low capacity exhibited poorer self-management (β=-0.187, <i>p</i> < 0.001). Social capacity was the strongest predictor for all profiles. Environmental capacity ranked second for 'high workload-high capacity' (R² = 3.26) and 'low workload-low capacity' (R² = 5.32) profiles. Financial capacity followed for the 'low workload-high capacity' profile (R² = 5.40), while psychological capacity was key in the 'high workload-low capacity' profile (R² = 6.40). In the network analysis, socioeconomic factors exhibited the central nodes (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Personalized interventions designed to increase capacity and reduce workload are essential for improving self-management in multimorbid patients. Upstream policies promoting health equity are also crucial for better self-management outcomes.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2451195"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune infiltration landscape and potential drug-targeted implications for hepatocellular carcinoma with 'progression/hyper-progression' recurrence.","authors":"Jing-Xuan Xu, Yue-Xiang Su, Yuan-Yuan Chen, Yi-Yue Huang, Zu-Shun Chen, Yu-Chong Peng, Lu-Nan Qi","doi":"10.1080/07853890.2025.2456113","DOIUrl":"10.1080/07853890.2025.2456113","url":null,"abstract":"<p><strong>Background and aims: </strong>Hepatocellular carcinoma (HCC) recurrence was previously characterized into four types, and patients with progression/hyper-progression recurrence (type III-IV) have an extremely poor prognosis. However, the immune background of resectable HCC, particularly in patients who experience recurrence, remains underexplored. Therefore, this study aimed to describe the immune landscape of resectable HCC, especially postoperative type III-IV recurrent HCC, and explore potential immune-targeted anti-relapse strategies for treated populations.</p><p><strong>Methods: </strong>The differences in gene expression in patients with recurrent HCC (type I-II (solitary or multi-intrahepatic oligo recurrence) vs. type III-IV) were investigated using bulk sequencing. Multiple immune infiltration methods (single-sample gene set enrichment analysis (GSEA), Microenvironment Cell Populations-counter and ESTIMATE) were used, and patients were divided into four groups to identify four distinct immune subtypes: immune-enrichment/matrix-poor (IE1), immune-enrichment/matrix-rich (IE2), immune intermediate/matrix-rich (ITM) and immune desert/matrix-poor (ID). Co-expression and protein interaction analyses were used to identify characteristic genes in ITM closely associated with type III-IV recurrence, which was matched with drug targets for Huaier granules (HG) and lenvatinib. Virtual docking was used to identify potential therapeutic targets, and the results were verified using single-nuclei RNA sequencing and histological analysis.</p><p><strong>Results: </strong>ITM was closely related to type III-IV recurrence and exhibited immunotherapy potential. The potential efficacy of inhibiting CCNA2, VEGFA, CXCL8, PLK2, TIMP1, ITGB2, ALDOA, ANXA5 and CSK in ITM reversal was determined. Molecular docking demonstrated that the proteins of these genes could bind to HG or lenvatinib. The immunohistochemical findings demonstrated differential VEGFA (<i>p</i> < .01) and PLK2 (<i>p</i> < .001) expression in ITM type and ID in type III-IV recurrent HCC.</p><p><strong>Conclusions: </strong>Three primary immunotypes of resectable HCC (IE2, ITM and ID) were identified, and HG and lenvatinib could potentially overcome immune checkpoint blockade (ICB) resistance in ITM patients with HCC, particularly those classified as type III-IV.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2456113"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erector spinae plane block spread patterns and its analgesic effects after computed tomography-guided hepatic tumour ablation: a randomized double-blind trial.","authors":"Wei-Han Chou, Wen-Yun Niu, Po-Chin Liang, Shih-Han Lin, Jen-Ting Yang, Chih-Peng Lin, Ming-Shiang Wu, Chun-Yu Wu","doi":"10.1080/07853890.2025.2480255","DOIUrl":"10.1080/07853890.2025.2480255","url":null,"abstract":"<p><strong>Introduction: </strong>Spread patterns of the erector spinae plane block (ESPB) in a larger cohort of living subjects remain inadequately understood. This study investigated the spread of local anaesthetics or saline with contrast in patients undergoing computed tomography-guided radiofrequency ablation of hepatic tumours.</p><p><strong>Patients and methods: </strong>Thirty patients participated in a double-blinded randomized controlled trial, 14 April 2021 and 18 January 2023. These patients were randomized into two groups: the ESPB group, which received local anaesthetic with contrast, and the sham group, which received saline with contrast. The spread of the drug was assessed regarding vertebral levels and its correlation with the patient characteristics. Pain intensity and morphine consumption were also evaluated.</p><p><strong>Results: </strong>The ESPB consistently spread cranio-caudally to the dorsal erector spinae muscle in all patients, with a median (IQR) spread of 9 (8-11) vertebral levels, and to the intercostal space with a median (IQR) spread of 4 (3-6) vertebral levels. Paravertebral spread occurred in 90% of patients (27 out of 30) with a median (IQR) spread of 3 (2-5) vertebral levels, while epidural spread was observed in 36.7% of patients (11 out of 30) with a median (IQR) spread of 0 (0-2) vertebral levels. Cranio-caudal spread negatively correlated with back muscle thickness (<i>r</i>= -0.4; <i>p</i> = 0.035), and females exhibited significantly more intercostal spread levels than males (5.8 ± 1.0 vs. 4.3 ± 1.6 levels in females and males, respectively; <i>p</i> = 0.021). However, no significant difference was found in pain intensity and morphine consumption between the two study groups.</p><p><strong>Conclusion: </strong>This study provides insights into the drug spread patterns of ESPB in living subjects. However, a unilateral ESPB did not yield sufficient analgesic effects for radiofrequency ablation of hepatic tumours.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2480255"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cumulative associations between health behaviours, mental well-being, and health over 30 years.","authors":"Tiia Kekäläinen, Johanna Ahola, Emmi Reinilä, Tiina Savikangas, Marja-Liisa Kinnunen, Tuuli Pitkänen, Katja Kokko","doi":"10.1080/07853890.2025.2479233","DOIUrl":"https://doi.org/10.1080/07853890.2025.2479233","url":null,"abstract":"<p><strong>Background: </strong>Both the number of risky health behaviours and the duration of exposure to these behaviours over time may increase the risk of later adverse outcomes. This study examined cumulative associations of risky health behaviours with both positive and negative aspects of mental well-being and health. It has a uniquely long follow-up period of over 30 years, from early adulthood to the beginning of late adulthood.</p><p><strong>Materials and methods: </strong>The data were from the Jyväskylä Longitudinal Study of Personality and Social Development. The participants represent the Finnish age cohort born in 1959. This study utilized data collected at ages 27 (1986), 36 (1995), 42 (2001), 50 (2009), and 61 (2020-2021) (<i>n</i> = 206-326). Risk scores indicating the current number of risky behaviours of smoking, heavy alcohol consumption, and physical inactivity and their temporal accumulation over time were calculated. The associations of risk scores with mental well-being (depressive symptoms, psychological well-being) and health (self-rated health, number of metabolic risk factors) from age 36 onwards were analyzed with linear multilevel models adjusted for gender and education.</p><p><strong>Results: </strong>More current risky behaviours were associated with more depressive symptoms (<i>B</i> = 0.10, <i>p</i> = 0.032), lower psychological well-being (<i>B</i> = -0.10, <i>p</i> = 0.010), lower self-rated health (<i>B</i> = -0.45, <i>p</i> < 0.001), and more metabolic risk factors (<i>B</i> = 0.53, <i>p</i> = 0.013). The associations of temporal risk scores with the outcomes were even stronger (depressive symptoms: <i>B</i> = 0.38, <i>p</i> < 0.001; psychological well-being: <i>B</i> = -0.15, <i>p</i> = 0.046; self-rated health: <i>B</i> = -0.82, <i>p</i> < 0.001; metabolic risk factors: <i>B</i> = 1.49, <i>p</i> < 0.001). Among individual behaviours, the temporal risk score of alcohol consumption was negatively associated with most outcomes, while smoking was associated with poorer mental well-being and physical inactivity with poorer health.</p><p><strong>Conclusions: </strong>The current and temporal accumulation of multiple risky health behaviours were associated with poorer mental well-being and health. Preventing these behaviours early in adulthood and midlife is crucial to avoid their accumulation and subsequent health risks.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2479233"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12024514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kaili sour soup in alleviation of hepatic steatosis in rats via lycopene route: an experimental study.","authors":"Yi Li, Shuo Cong, Rui Chen, Juan Tang, Liqiong Zhai, Yongmei Liu","doi":"10.1080/07853890.2025.2479585","DOIUrl":"https://doi.org/10.1080/07853890.2025.2479585","url":null,"abstract":"<p><strong>Background: </strong>Nonalcoholic fatty liver disease (NAFLD) is one of the most prevalent chronic liver diseases, with a range of manifestations, such as hepatic steatosis. Our previous study showed that Kaili Sour Soup (KSS) significantly attenuated hepatic steatosis in rats. This study explored the main components of KSS and the mechanisms by which it exerts its protective effects against NAFLD.</p><p><strong>Methods: </strong>Twenty-four 6-week-old male Sprague-Dowley (SD) rats were randomly assigned to three treatments: feeding a normal standard diet, a high-fat diet, or a high-fat diet plus gavage KSS. The effects of KSS treatment on hepatic lipid accumulation were assessed using biochemical, histological, and molecular experiments. The amounts of KSS ingredients were measured using biochemical assays. Network pharmacology analyses were performed to identify the hub genes of KSS targets and enriched pathways. CCK-8 assay was used to determine the effect of free fatty acids (FFA), lycopene, and estrogen on HepG2 viability. Quantitative Real-Time polymerase chain reaction (qRT-PCR) and Western blot assays were performed to determine the effect of KSS or lycopene on estrogen signaling and expression of lipid metabolism-related molecules. Statistical analyses were performed using GraphPad Prism and SPSS.</p><p><strong>Results: </strong>KSS alleviated fat deposition in rat liver tissue and affected the expression of hepatic lipid synthesis, catabolism, and oxidative molecules. Lycopene was identified as the ingredient with the highest amount in KSS. Network pharmacology analyses showed that the hub genes were enriched in the estrogen signaling pathway. Cellular experiments showed that lycopene increased the expression of Estrogen Receptor α (ERα), Carnitine palmitoyltransferase 1 A (<i>CPT1A</i>), Peroxisome proliferator-activated receptor α (<i>PPARα</i>) (all <i>p</i> < 0.01), and Hormone sensitive lipase (<i>HSL</i>) (<i>p</i> < 0.05), and reduced the expression of lipid metabolism-related factors <i>1c(SREBP-1c</i>) (<i>p</i> < 0.01), Acetyl-CoA carboxylase 1 (<i>ACC</i>) and Lipoprotein lipase (<i>LPL</i>) (all <i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>KSS ameliorated abnormal lipid metabolism in patients with NAFLD. Lycopene was the major component of KSS, and it affected estrogen signaling and the expression of lipid metabolism molecules. In short, both KSS and LYC could change lipid metabolism by lowering lipid accumulation and raising lipolysis.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2479585"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of oxysterol 4β-hydroxycholesterol and liver X receptor alleles in pre-eclampsia.","authors":"Lassi Kaartinen, Tiina Jääskeläinen, Eeva Sliz, Gamze Yazgeldi Gunaydin, Satu Wedenoja, Shintaro Katayama, Eero Kajantie, Valtteri Rinne, Seppo Heinonen, Juha Kere, Heta Merikallio, Eeva Sliz, Hannele Laivuori, Janne Hukkanen","doi":"10.1080/07853890.2025.2495763","DOIUrl":"https://doi.org/10.1080/07853890.2025.2495763","url":null,"abstract":"<p><strong>Background: </strong>Liver X receptors (LXRs) are expressed in placenta and may be associated with pre-eclampsia (PE). Oxysterols act as agonists for LXRs. We recently proposed a new blood pressure-regulating circuit with oxysterol 4β-hydroxycholesterol (4βHC) acting as a hypotensive factor <i>via</i> LXRs.</p><p><strong>Materials and methods: </strong>This study investigated the association between maternal plasma 4βHC, blood pressure (BP) indices, placental expression of LXR target genes, and patient characteristics using data from the Finnish Genetics of Pre-Eclampsia Consortium (FINNPEC) cohort. Plasma samples of 144 women with PE and 38 healthy pregnant controls as well as 44 PE and 40 control placental samples were available. In addition, genetic data from the FinnGen project was utilized to explore the associations of LXR alleles with PE and pregnancy hypertension.</p><p><strong>Results: </strong>There were no significant associations between 4βHC and BP or maternal and perinatal characteristics in FINNPEC cohort. However, plasma 4βHC was inversely correlated with the maternal body mass index. There were no associations with the genetic variants of LXRs with PE in FinnGen. LXR target genes APOD, SCARB1, TGM2, and LPCAT3 were expressed differently between PE and normal pregnancies in placental samples of FINNPEC.</p><p><strong>Conclusions: </strong>Our results demonstrate that plasma 4βHC and genetic LXR variants do not play a major role in PE and BP regulation during pregnancy. However, key LXR target genes involved in lipid metabolism were expressed differently in normal and PE pregnancies. Further research is needed to understand the complexities of oxysterols, LXRs, and their potential contributions to placental function and pregnancy outcomes.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2495763"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"I thought it would be difficult, but this is actually something I can do - experiences with Virtual Reality-based cognitive training in persons with TBI.","authors":"Truls Johansen, Martin Matre, Sveinung Tornås, Marianne Løvstad, Jennie L Ponsford, Alexander Olsen, Anne Lund","doi":"10.1080/07853890.2025.2490218","DOIUrl":"https://doi.org/10.1080/07853890.2025.2490218","url":null,"abstract":"<p><strong>Introduction: </strong>Virtual reality (VR) has been suggested as a promising technology for delivering cognitive training to persons with traumatic brain injury (TBI), as it can provide situations resembling everyday activities. Studies have demonstrated that persons with TBI manage utilizing VR in clinical settings; however, no studies have investigated VR use in home settings. The aim of this study was to explore how persons with TBI experience utilizing VR for rehabilitation at home and how they experience VR as cognitive training.</p><p><strong>Methods: </strong>Individual qualitative interviews were conducted with ten persons with TBI, aged 18-65. Participants had experience using VR, as they were recruited from the intervention group in a randomized controlled trial investigating VR in cognitive training. The data were analyzed using thematic analysis.</p><p><strong>Results: </strong>Participants highlighted the importance of creating new routines when fitting VR into everyday life. They addressed how being in a virtual world contributes to their motivation for cognitive training. Three themes were developed: 'Fitting VR-training into everyday life', 'Navigating through change' and 'Being in two worlds at the same time'.</p><p><strong>Conclusion: </strong>This study shows that participants experienced VR as motivating, engaging, and easy to use, regardless of prior experiences with VR. The participants demonstrated how they included VR in everyday life by creating new routines when they performed cognitive training. Therewere few reports of adverse events. However, some experienced that VR had a negative impact on their energy level. Participants described the importance of therapeutic involvement for individual tailoring of the intervention.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2490218"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}