Background Polyendocrine Metabolic Ovarian Syndrome (PMOS), formerly referred to as polycystic ovary syndrome (PCOS), is an intricate endocrine disorder, defined by a constellation of hormonal, metabolic, and reproductive irregularities. Vitamin D deficiency and increased levels of interleukin-6 (IL-6) and interleukin-8 (IL-8) have been implicated in the pathogenesis of PMOS. Although vitamin D deficiency and low-grade inflammation have each been associated with PMOS, the relationship between vitamin D status and circulating inflammatory cytokines remains incompletely characterized. Thus, this study aimed to investigate the association of Vitamin D and inflammatory interleukins believed to play a key role in the pathogenesis of PMOS.Method The study involved 94 participants divided into two groups: 44 PMOS patients and 50 healthy controls. Age and BMI were recorded for each patient and plasma levels of Vitamin D, anti-Müllerian hormone (AMH), IL-6, and IL-8 were measured and compared between the two groups using the Enzyme-Linked Immunosorbent Assay.Results AMH (p < 0.02), IL-6 (p < 0.001) and IL-8 (p < 0.001) levels were significantly higher in PMOS patients than in controls. Lastly, vitamin D levels were found significantly lower in PMOS patients (18.59 ng/mL) than in controls (37.95 ng/mL; p < 0.001). However, no significant correlation was found between IL-6, IL-8 and Vitamin D.Conclusion Women with PMOS characterized by lower vitamin D concentrations alongside higher AMH, IL-6, IL-8, and BMI compared to healthy controls. Larger longitudinal and prospective interventional studies are required to clarify causality and determine if vitamin D supplementation improves clinical outcomes.
Background Cardiac arrest is a major global public health problem. This study aimed to explore factors influencing return of spontaneous circulation (ROSC) and develop a prediction model for out-of-hospital cardiac arrest (OHCA) patients.Methods We retrospectively collected electronic medical records of adult non-traumatic OHCA patients at Tianjin Emergency Medical Center from January 1, 2023 to December 31, 2024. The primary outcome was sustained ROSC up to emergency department arrival and handover to receiving-hospital staff. Multivariable mixed-effects logistic regression with clinician ID as random intercept adjusted clustering bias; predictors with p < 0.05 formed the nomogram. Patients were randomly split 7:3 for training and internal testing. Discrimination was assessed by ROC-AUC (acceptable threshold >0.7). We performed 1000 bootstrap resampling to correct C-index against overfitting. Calibration curves and decision curve analysis (DCA) further evaluated predictive consistency and net clinical benefit.Results Among 9,386 included cases, 678 (7.2%) achieved ROSC. Mixed-effects regression identified independent ROSC predictors: public location (aOR = 1.285, 95% CI:1.038–1.592), 06:00–12:00 onset (aOR = 1.308, 95% CI:1.018–1.682), prolonged emergency response time (aOR = 0.971, 95% CI:0.945–0.999), extended onset-to-ambulance intervals (5–10 min: aOR = 0.758;10–30 min: aOR = 0.578;>30 min:aOR = 0.498 vs ≤5 min), no OHCA occurred at emergency call (aOR = 1.540, 95% CI:1.048–2.262), male attending physicians (aOR = 1.255, 95% CI:1.077–1.464), longer physician practice years (aOR = 1.043, 95%CI: 1.022–1.065), intermediate physician title (aOR = 1.236, 95% CI:1.047–1.459), shockable initial rhythm (aOR = 2.850, 95% CI:2.390–3.397), endotracheal intubation (aOR = 2.294, 95% CI:1.936–2.718), epinephrine >5 mg (aOR = 0.765,95% CI:0.626–0.935). The nomogram AUC reached 0.775 (95% CI:0.756–0.794) in the training set and 0.775 (95% CI:0.745–0.805) in the test set; 1000 bootstrap internal validation gave an optimism-corrected C-index of 0.7679 with minimal optimism of 0.0071, showing negligible overfitting, good calibration and favorable net clinical benefit via DCA.Conclusion This study identified multiple factors significantly associated with ROSC in OHCA patients; the constructed model showed good predictive value.
Background Epidermolysis bullosa (EB) is a group of genetically and clinically heterogeneous diseases that presents as blisters, erosions, crusts, and scars.Materials and Method In this retrospective study, we report the clinical manifestations, genetic characteristics, and laboratory markers of patients with EB.Results Fifteen patients with EB were included in the study. The most common type was dystrophic EB (DEB) (n = 10), followed by EB simplex (EBS) (n = 3), junctional EB (JEB) (n = 1), and Kindler EB (n = 1). The disease onset was from birth in 13 patients. The most common cutaneous manifestations were erosions (n = 12), vesicles and bullae (n = 8), scars (n = 6), and milia (n = 6). Nail abnormalities were observed in 11 patients and mucosal involvement in seven patients. The most common genetic mutation was COL7A1 gene mutation (n = 10), followed by PLEC (n = 2), ITGB4 (n = 1), KRT5 (n = 1), and FERMT1 (n = 1). Laboratory examination revealed iron deficiency in 10 patients. One patient had moderate vitamin D deficiency, and five had mild vitamin D deficiency.Conclusion EB is a genetic disease that may associated with many systemic comorbidities. Multidisciplinary management of wound care is essential for the early management of severe EB to avoid wound progression into scars and deformities. The levels of vitamins such as ferritin and zinc, and the levels of hemoglobin and albumin, should be optimal levels to optimize wound healing.
Background While functional electrical stimulation (FES)-cycling benefits for spinal cord injury (SCI) are documented, user acceptance and sustained engagement remain underexplored. Understanding how sport participation history and values shape FES-cycling experiences is essential for predicting technology adoption beyond rehabilitation.Objective To explore FES-cycling user experiences within the context of participants’ sport participation history, examining how sport-related values, post-injury adaptations, and existing barriers influence device acceptance and attitudes towards sustained use.Methods Fifteen male individuals with SCI (mean age 43.9 ± 14.0 years; mean time since injury 11.2 ± 11.9 years) participated in the study, with 11 presenting complete and four incomplete SCI. They all completed a short FES-cycling training and semi-structured interviews exploring: sport experiences pre/post-injury, disability impact on participation, barriers and facilitators to sport access, FES-cycling user experience and future use perspectives. An inductive thematic analysis identified patterns across data, adopting a data-driven approach through line-by-line coding to identify emergent themes, subsequently organized within a higher-order thematic framework.Results Five themes emerged: (1) meanings attached to sport (competition, cooperation, escape, resilience, self-improvement); (2) post-injury sport changes (physical/psychological adaptations, renewed appreciation); (3) sport access (barriers: cost, infrastructure, time; facilitators: organizations, policies); (4) FES-cycling experience (physical/emotional benefits, frustrations); and (5) future perspectives (opportunities, limitations).Conclusions Sport-related values directly shaped how participants evaluated FES-cycling capabilities and practical viability. FES-cycling acceptance depends on whether the device aligns with users’ sport-related values and addresses their existing barriers to participation. Realistic implementation, supported by dialogue with participants about limitations and challenges, can help bridge the gap between rehabilitation and sustained engagement in physical activity.
Background Restless legs syndrome (RLS) is a common condition affecting 3% of the world′s population. Pharmacological treatments do not cure RLS, and symptoms substantially affect everyday life. However, knowledge of biopsychosocial (BPS) factors influencing patients’ everyday lives remains limited. This study aimed to explore and describe BPS barriers and facilitators influencing everyday life among patients with RLS.Methods A deductive, descriptive qualitative design grounded in the BPS model was employed. Semi-structured telephone interviews were conducted with 28 strategically selected patients from a national RLS organisation. Data were analysed using qualitative content analysis and structured according to biological, psychological, and social barriers and facilitators.Results Biological barriers included RLS-related symptoms, sleep disturbances, and fatigue, while physical activity and environmental adaptations facilitated symptom management. Psychological barriers involved despair and inadequate healthcare responses, whereas access to information and supportive healthcare interactions enhanced everyday life. Social barriers included limitations in daily activities and the need for lifestyle adjustments. Support from patient organisations and understanding social networks facilitated coping with RLS. Together, these findings highlight how interconnected BPS factors shape patients’ everyday experiences and ability to manage their condition.Conclusions Comprehensive RLS care should address biological, psychological, and social barriers, particularly sleep disturbances and care-related stress, while promoting facilitating factors such as lifestyle adaptations and social support. Future research should evaluate the effects of comprehensive care interventions on symptom severity and overall BPS functioning in RLS.
