J Ethnobiol Ethnomed. 2025 Feb 27;21(1):11. doi: 10.1186/s13002-025-00763-7.
NO ABSTRACT
PMID:40016792 | DOI:10.1186/s13002-025-00763-7
BMC Health Serv Res. 2025 Feb 28;25(1):324. doi: 10.1186/s12913-025-12438-w.
ABSTRACT
BACKGROUND: In recent years, the Moroccan Ministry of Health and Social Protection has invested considerable resources in implementing electronic health record (EHR) systems to provide citizens with quality healthcare services through efficient structures. However, the rhythm of EHR deployment across the country is very slow, requiring urgent evaluation to remove barriers to successful EHR adoption.
OBJECTIVE: This study aims to investigate the critical factors affecting healthcare providers’ performance post-EHR implementation in Moroccan public hospitals.
METHODS: A cross-sectional study was conducted in three hospitals affiliated with Hassan II University Hospital Center in Fez. Data were collected using a questionnaire survey administered to a sample of 368 healthcare providers from March 2021 to July 2021. Clinician performance was assessed using a proposed research model that integrates the Information System Success Model and the Technology-Organization-Environment framework. The final model was analyzed and tested by using structural equation modeling. Statistical analyses were conducted using SPSS version 25 and Amos version 26.
RESULTS: The findings highlighted that the most critical factors influencing clinician performance are clinician satisfaction (β = 0.5, p < 0.001), followed by organization (β = 0.28, p < 0.001), and system quality (β = 0.17, p = 0.01). Additionally, information quality indirectly affects clinician performance (β = 0.19, p < 0.001). However, the environmental factor does not appear to have a significant impact (β = -0.004, p = 0.94).
CONCLUSION: This study, performed for the first time in Morocco, identifies key factors for policymakers and healthcare organizations to enhance the successful implementation of EHR systems. Additionally, it serves as a valuable framework for future studies in this area.
PMID:40016779 | DOI:10.1186/s12913-025-12438-w
BMC Health Serv Res. 2025 Feb 27;25(1):323. doi: 10.1186/s12913-025-12463-9.
ABSTRACT
BACKGROUND: Ensuring comprehensive and quality healthcare access is necessary to promote good health and well-being and to secure health equity. Barriers to healthcare access result in unmet health needs. Moreover, there is limited empirical evidence on specific types of barriers to women’s general health-seeking in India. This study investigates women’s perceived household-level, logistic, and facility-level barriers to healthcare access and its individual, household, and community-level determinants.
METHODS: The study used data from the fifth round of the National Family Health Survey (NFHS-5), with a total sample of 108,785 women aged 15-49 drawn from the state module of the survey. The primary outcome variables were household, logistic, and facility-level barriers to healthcare access. A set of individual, household, and community-level predictors was assessed using multivariate binary logistic regression due to the dichotomous nature of the outcome variables. The adjusted odds ratio (AOR) with the corresponding 95% confidence intervals (CI) was used to present the regression results. The Hosmer-Lemeshow test and ROC curve statistics were carried out to enhance the robustness of the analysis and validity of the model.
RESULTS: The study found a considerable proportion of women (84%) with at least one perceived barrier to accessing healthcare, with significant inter-state variations. Facility-level (55%) and logistic barriers (51%) were the predominant obstacles to healthcare access. Women aged 35-49, with higher education levels, exposed to mass media, working in professional/technical/managerial/clerical jobs, access to bank accounts, having mobile phones, and from rich households had lower odds of perceived household, logistic, and facility-level barriers to healthcare access.
CONCLUSION: Most women perceive barriers to healthcare access, though a wide inter-state variation exists. Facility-level barriers such as the unavailability of drugs and healthcare providers are major concerns to healthcare access. Distance to health facilities continues to be a logistic barrier, along with getting money for treatment at the household level. Illiteracy, non-exposure to mass media, working in the agricultural sector, no access to a bank account and a mobile phone, rural residency, and poor wealth status are significant factors adversely affecting the perceived barriers to healthcare access. The findings recommend strengthening the existing health system and increasing health literacy among poor, less educated, and rural women to reduce disparity in healthcare access.
PMID:40016775 | DOI:10.1186/s12913-025-12463-9
J Orthop Surg Res. 2025 Feb 27;20(1):208. doi: 10.1186/s13018-025-05622-5.
ABSTRACT
OBJECTIVE: This study is designed to investigate the roles of MMP-2, MMP-9, and MMP-13 in intervertebral disc destruction resulting from different types of spinal infections and their correlations with clinical quantitative data.
METHODS: Disc tissue samples were collected from 60 patients with spinal infections (20 cases each of STB, BS, and PS in the infection group) and 20 patients with intervertebral disc herniation (control group). The expressions of MMP-2, MMP-9, and MMP-13 were detected by RT-qPCR. Correlation analysis was carried out with clinical quantitative data such as preoperative erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), interleukin-6 (IL-6), procalcitonin (PCT), and related blood routine indicators in the infection group.
RESULTS: In the analysis between the infection group and the control group, MMP-13 was expressed in the diseased intervertebral disc tissue of STB patients, but the result was not statistically significant (P = 0.2172). There was a significant difference in the expression of MMP-13 in the diseased intervertebral discs of BS and PS patients. The expressions of MMP-9 and MMP-2 were markedly increased in the diseased intervertebral disc tissue of STB, BS, and PS patients (all P < 0.05). In the inter-group analysis of the infection group, the expression of MMP-13 in the diseased intervertebral disc tissue of PS patients was significantly different from that of STB and BS (P < 0.0001), while there was no significant difference between the STB and BS groups (P = 0.2393). The expression of MMP-9 in the diseased intervertebral disc tissue of STB patients was significantly different from that of BS and PS (P < 0.0001), but there was no statistically significant difference between the BS and PS groups (P = 0.9643). There was no statistically significant difference in the expression of MMP-2 among the STB, BS, and PS groups. In the correlation analysis with clinical quantitative data, MMP-13 was positively correlated with CRP, ESR, IL-6, WBC, and NEUT levels (r values were 0.7346, 0.3465, 0.3326, 0.6347, and 0.5152 respectively), and negatively correlated with LYM level (r = -0.5152, P < 0.05), and had no correlation with PCT and MXD levels. MMP-9 was positively correlated with ESR level (r = 0.3412, P < 0.05) and had no correlation with CRP, IL-6, PCT, WBC, NEUT, and LYM levels. MMP-2 was positively correlated with NEUT and LYM levels (r values were 0.3021 and 0.3306 respectively, P < 0.05) and had no correlation with ESR, CRP, IL-6, PCT, and WBC levels.
CONCLUSION: MMP-2, MMP-9, and MMP-13 play crucial roles in intervertebral disc destruction due to spinal infections. The differential expression of MMPs may be one of the reasons for the varying degrees of intervertebral disc destruction in different types of spinal infections. Moreover, when clinical indicators such as CRP, ESR, IL-6, WBC, and NEUT increase, it suggests that the expression of MMP-13 in the intervertebral disc at the lesion site significantly rises, and it may become a new target for the treatment of spinal infections in the future.
PMID:40016774 | DOI:10.1186/s13018-025-05622-5
J Transl Med. 2025 Feb 27;23(1):238. doi: 10.1186/s12967-025-06251-6.
ABSTRACT
BACKGROUND: Clear cell renal cell carcinoma (ccRCC) is a prevalent urogenital malignancy characterized by heterogeneous patterns. Stemness is a pivotal factor in tumor progression, recurrence, and metastasis. Nevertheless, the impact of stemness-related long non-coding RNAs (SRlncRNAs) on the prognosis of ccRCC remains elusive. In this study, we aimed to delve into the SRlncRNAs of ccRCC and develop a signature for risk stratification and prognosis prediction.
METHOD: Gene-expression and clinical data were downloaded from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. We calculated RNA stemness scores (RNAss) for the samples to evaluate their stemness. SRlncRNAs and stemness-related mRNAs (SRmRNAs) in ccRCC were identified through weighted correlation network analysis (WGCNA), which employed sophisticated statistical methodologies to identify interconnected modules of related genes. Enrichment analysis was performed to explore the potential functions of SRmRNAs. Multiple machine learning algorithms were employed to construct a prognostic signature. Samples from TCGA-KIRC and GSE29609 cohorts were designated as the training and validation cohorts, respectively. Based on their risk scores, samples were stratified into low- and high-risk groups. Prognosis analysis, immune infiltration assessment, drug sensitivity prediction, mutation landscape, and gene set enrichment analysis (GSEA) were conducted to investigate the distinct characteristics of the low- and high-risk groups. Additionally, a web-based calculator was developed to facilitate clinical application. Expression and effects of SRlncRNAs in ccRCC were further corroborated through the utilization of single-cell RNA-seq (scRNA-seq), as well as in vitro and in vivo experiments.
RESULTS: SRlncRNAs and SRmRNAs were identified based on RNAss and WGCNA. The least absolute shrinkage and selection operator (LASSO) in combination with multivariate Cox regression was selected as the optimal approach. Six SRlncRNAs were used to construct the prognostic signature. Samples in the low- and high-risk groups exhibited distinct characteristics in terms of prognosis, GSEA pathways, immune infiltration profiles, drug sensitivity, and mutation status. A nomogram and a web-based calculator were developed to facilitate the clinical application of the model. ScRNA-seq and RT-qPCR demonstrated the differential expression of SRlncRNAs between ccRCC tumors and normal tissues. In vitro and in vivo experiments demonstrated that downregulation of EMX2OS and LINC00944 affected the proliferation, migration, invasion, apoptosis, and metastasis of ccRCC cells.
CONCLUSION: We uncovered the crucial associations between SRlncRNAs and the prognosis of ccRCC. By leveraging these findings, we developed a novel SRlncRNA-related signature and a user-friendly web calculator. This signature holds great potential in facilitating risk stratification and guiding tailored treatment strategies for ccRCC patients. Both in vitro and in vivo experiments confirmed the role of SRlncRNAs in the progression of ccRCC.
PMID:40016772 | DOI:10.1186/s12967-025-06251-6
BMC Endocr Disord. 2025 Feb 28;25(1):57. doi: 10.1186/s12902-025-01889-1.
ABSTRACT
PURPOSE: Hip fracture is the most dangerous and potentially lethal fracture, described as “the last fracture of life” in older adults. Previous studies have shown that excessive immunoinflammatory response and nutrient deficiency may be involved. Nevertheless, a predictor for hip fracture risk that combines a thorough evaluation of immunoinflammatory with malnutritional conditions in postmenopausal women with type 2 diabetes mellitus (T2DM) remains scarce. This study explored the relationship between the SII/ALB ratio (SAR) and fragility fracture risk in postmenopausal older adults with T2DM.
METHODS: Between January 2014 and January 2021, a total of 509 postmenopausal female participants with T2DM were recruited from the Medical Record Database of the People’s Hospital of Guangxi Zhuang Autonomous Region. Finally, 363 participants with an age median of 69.00 (64.00-75.00), were eligible for inclusion in this analysis. According to the statistical tertiles of the SAR, all participants were split into three groups: low-level (≤ 98.24, n = 121), moderate-level (98.24-157.25, n = 121), and high-level (≥ 157.25, n = 121). The participants were followed up for seven years, with a median follow-up time of 45.9 months (1389 person-years). The relationships between the SAR and a real-world fragility fracture event and an individualized future 10-year probability of major osteoporotic fracture (MOF) and hip fracture (HF) calculated by the fracture risk assessment tool (FRAX) were evaluated through Spearman’s partial correlation analysis, restricted cubic spline (RCS) model, Cox proportional hazards regression model, and Kaplan-Meier survival analysis. Furthermore, some indicators such as geriatric nutritional risk index (GNRI), prognostic nutritional index (PNI), and SII were also calculated and compared to their diagnostic efficacy and the clinical application value through the receiver operating characteristic (ROC) curve analysis and the decision curve analysis (DCA), respectively.
RESULTS: Of the 363 participants, 69 suffered a real-world fragility fracture event (19%). Spearman’s partial correlation analysis indicated that SAR was negatively related to femoral neck (FN) bone mineral density (BMD) (r = -0.108, P = 0.041) and total hip (TH) BMD (r = -0.118, P = 0.025), but not lumbar spine (LS) BMD (all Models P > 0.05); positively correlated with an individualized future 10-year probability of MOF (r = 0.136, P = 0.010) and HF (r = 0.139, P = 0.008) calculated by FRAX, especially in hip fracture risk. The RCS model demonstrated the relationship between the SAR and a fragility fracture endpoint event in a J-shaped dose-dependent manner (P for overall < 0.001, P for nonlinear = 0.866). Multivariate Cox regression analysis indicated that the SAR was positively associated with fragility fracture risk (P < 0.001). Kaplan-Meier survival analysis showed that patients with higher levels of SAR had a greater probability of fragility fracture risk (log-rank, P < 0.0001). The ROC curve demonstrated an optimal SAR cut-off value of 146.209 with an area under the curve (AUC) of 0.740, a sensitivity of 0.681, and a specificity of 0.701 (P < 0.001). According to the AUC values, the ROC curve analysis combined with the DCA illustrated that the diagnostic efficacy and the clinical application benefit ranked as follows: SAR > SII > PNI > GNRI, respectively.
CONCLUSION: Our findings show the SAR is a novel dual-dimensional powerful predictor for fragility fracture risk, especially hip fracture, and as an effective tool for developing fragility fracture prevention strategies in postmenopausal females with T2DM. Consequently, monitoring SAR levels in usual clinical practice to focus on immunoinflammatory and nutritional status to identify individuals at high risk of hip fracture and implement timely fracture interventions is particularly essential.
CLINICAL TRIAL NUMBER: Not applicable.
PMID:40016771 | DOI:10.1186/s12902-025-01889-1
BMC Med Educ. 2025 Feb 27;25(1):321. doi: 10.1186/s12909-025-06849-w.
ABSTRACT
BACKGROUND: The purpose of this study was to evaluate the performance of widely used artificial intelligence (AI) chatbots in answering prosthodontics questions from the Dentistry Specialization Residency Examination (DSRE).
METHODS: A total of 126 DSRE prosthodontics questions were divided into seven subtopics (dental morphology, materials science, fixed dentures, removable partial dentures, complete dentures, occlusion/temporomandibular joint, and dental implantology). Questions were translated into English by the authors, and this version of the questions were asked to five chatbots (ChatGPT-3.5, Gemini Advanced, Claude Pro, Microsoft Copilot, and Perplexity) within a 7-day period. Statistical analyses, including chi-square and z-tests, were performed to compare accuracy rates across the chatbots and subtopics at a significance level of 0.05.
RESULTS: The overall accuracy rates for the chatbots were as follows: Copilot (73%), Gemini (63.5%), ChatGPT-3.5 (61.1%), Claude Pro (57.9%), and Perplexity (54.8%). Copilot significantly outperformed Perplexity (P = 0.035). However, no significant differences in accuracy were found across subtopics among chatbots. Questions on dental implantology had the highest accuracy rate (75%), while questions on removable partial dentures had the lowest (50.8%).
CONCLUSION: Copilot showed the highest accuracy rate (73%), significantly outperforming Perplexity (54.8%). AI models demonstrate potential as educational support tools but currently face limitations in serving as reliable educational tools across all areas of prosthodontics. Future advancements in AI may lead to better integration and more effective use in dental education.
PMID:40016760 | DOI:10.1186/s12909-025-06849-w
J Orthop Surg Res. 2025 Feb 28;20(1):214. doi: 10.1186/s13018-025-05612-7.
ABSTRACT
BACKGROUND: Adolescent idiopathic scoliosis (AIS) is one of the most prevalent spinal abnormalities. Core stabilization exercise (CSE) has become a common approach in the treatment of AIS. However, the efficacy of CSE in AIS remains a subject of debate.
OBJECTIVE: To determine the efficacy of CSE in the patients with AIS in comparison with different intervention programs.
METHODS: A comprehensive search was conducted across PubMed, Embase, The Cochrane Library, Web of Science, Wan Fang, Wei Pu, and CNKI databases, encompassing literature from their inception through December 31st, 2024. Two independent reviewers screened the studies, with inter-rater agreement evaluated via kappa scores. Randomized control trials that focus on the efficacy and safety of CSE in AIS population were included in this systematic review. The risk of bias assessment was performed utilizing the National Institutes of Health Quality Assessment Tools (NIH-QAT). After quality assessments and information extraction, the meta-analysis was conducted with Review manager and the standard mean difference (SMD) was pooled among the measurement data derived from different studies. Cobb angle, angle of trunk rotation, apical vertebral rotation, Walter Reed Visual Assessment Scale, Posterior Trunk Symmetry Index, forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, SRS-22,, were focused as outcomes.
RESULTS: A total of 10 studies involving 449 subjects were included in this systematic review. The average Cobb angle was 22.86° ± 8.79°, and the intervention duration varied from 8weeks to 6months. The kappa score was 0.93. Subgroup analyses were performed based on the different control groups, National Institutes of Health Quality Assessment Tools (NIH-QAT) results, and intervention durations. The results indicated that CSE could have greater effect sizes than the blank control group on Cobb angle (MD = -4.37, P < 0.05), angle of trunk rotation (MD = -1.07, P < 0.05), apical vertebral rotation (MD = -0.44, P < 0.05), quality of life as SRS-22 (MD = 0.22, P < 0.05). Notably, the efficacy of CSE appears to be weaker than that of the three-dimensional exercise group in terms of Cobb angle (MD = 3.95, P < 0.05), angle of trunk rotation (MD = 1.69, P < 0.05) and WASRS scores (MD = 0.89, P < 0.05). Other subgroup analyses yielded no statistically significant differences.
CONCLUSIONS: The present study showed that core stabilization exercise may be beneficial for the patients with mild to moderate adolescent idiopathic scoliosis, albeit less effective than three-dimensional exercises following short-term follow-up. The evidence on the efficacy of CSE is limited due to heterogeneity, small sample sizes, and multiple comparisons. The clinical trials focusing on patient compliance and training quality with long-term follow-up are warranted.
PROSPERO REGISTRATION NUMBER: CRD 42022367714.
PMID:40016756 | DOI:10.1186/s13018-025-05612-7
World J Surg Oncol. 2025 Feb 27;23(1):67. doi: 10.1186/s12957-025-03725-1.
ABSTRACT
BACKGROUND: To explore the safety and feasibility of the modified approach for accessing the superior mesenteric artery (SMA) in total laparoscopic radical resection for right colon cancer.
METHODS: This single-center retrospective study included 107 patients who underwent total laparoscopic radical resection of right colon cancer at The First Affiliated Hospital of Wannan Medical College between August 2022 and December 2023. 53 patients were in the modified SMA approach (modified group) and 54 patients were in the traditional SMA approach (control group). The control group and modified group underwent total laparoscopic radical resection of right colon cancer, and the following baseline and pathological characteristics of the two groups were compared: intraoperative condition, postoperative recovery, and postoperative complications. Our modified surgical method was to isolate the mesocolon using a cranial(the ligament of Treitz) -to- caudal(the pedicle of ileocolic) pathway and the orderly ligation of blood vessels in the SMA.
RESULTS: There was no statistically significant difference in the baseline characteristics or pathological data between the two groups. Compared with the traditional SMA approach, the modified SMA approach had a shorter surgical time(P < 0.001) and vascular dissection time (P < 0.001) and less intraoperative blood loss (P = 0.000). There was no statistically significant difference in the number of total harvested lymph nodes or positive harvested lymph nodes between the two groups of patients (P > 0.05); There was no statistically significant difference in postoperative hospital stay, time to first flatus, time to pull out drainage tube and drainage between the two groups of patients (P > 0.05), and there was no statistically significant difference in the incidence of complications between the two groups of patients (P > 0.05).
CONCLUSION: The modified SMA approach in totally laparoscopic radical resection for right colon cancer can shorten the surgical and vascular dissection time, reduce intraoperative bleeding and reduce the surgical difficulty and intraoperative risk of the SMA approach for right colon cancer. In clinical practice, its safety and feasibility are relatively high, and it is worth promoting.
TRIAL REGISTRATION: The study was approved by the Ethics Committee of The First Affiliated Hospital of Wannan Medical College and registered with the China Clinical Trials Registry (ChiCTR2300075919, Date of Registration:2023-09-19- retrospective registration) http://www.chictr.org.cn/index.aspx .
PMID:40016739 | DOI:10.1186/s12957-025-03725-1
BMC Oral Health. 2025 Feb 27;25(1):313. doi: 10.1186/s12903-025-05676-1.
ABSTRACT
BACKGROUND: This study aimed to evaluate the prevalence of palatogingival groove (PGG) in maxillary incisors and its association with periapical lesions and periodontal bone loss.
METHODS: CBCT images from 943 patients were included. Age, sex, and the presence of PGG were recorded. PGG type was determined according to the Gu classification. All maxillary incisors of patients with PGG teeth were evaluated for periapical lesions and periodontal bone loss. Statistical analysis was performed with the Pearson chi-square test and Fisher’s exact test.
RESULTS: PGGs were present in 107 maxillary incisors (2.8%) of 89 patients (9.4%). PGGs were observed significantly less frequently in maxillary central incisors than in maxillary lateral incisors (p < 0.001). The most common PGG was type I (75.7%), followed by type II (15.9%) and type III (8.4%). PGGs were associated with periapical lesions and periodontal bone loss (p < 0.001). PGG teeth without periapical lesions or periodontal bone loss were mostly type I. When the PGG was type II or III, the teeth mostly had periapical lesions and periodontal bone loss (p < 0.001). A significant relationship was detected between the periapical lesion status and bone loss status in PGG teeth (p < 0.05).
CONCLUSIONS: PGGs were found mostly in maxillary lateral incisors. Most teeth with type II and III PGGs were characterized by periodontal bone loss and periapical lesions. Additionally, most PGG teeth with periodontal bone loss had periapical lesions. These findings imply that the presence of a PGG should be suspected in a maxillary incisor with a narrow periodontal pocket and periapical lesion but no caries, cracks, or restorations.
PMID:40016732 | DOI:10.1186/s12903-025-05676-1