Healthc (Amst). 2025 Sep 4;13(2):100767. doi: 10.1016/j.hjdsi.2025.100767. Online ahead of print.
NO ABSTRACT
PMID:40911956 | DOI:10.1016/j.hjdsi.2025.100767
Oral Oncol. 2025 Sep 4;169:107670. doi: 10.1016/j.oraloncology.2025.107670. Online ahead of print.
ABSTRACT
OBJECTIVE: Oral squamous cell carcinoma (OSCC) with bone invasion are staged as pT4a, potentially upstaging smaller tumors. This study aimed to evaluate the oncological benefit of postoperative radiotherapy (PORT) in pT4aN0 OSCC with respect to tumor size and without other risk factors.
METHODS: This retrospective matched cohort study included pT4aN0 OSCC patients with bone invasion treated surgically (R0) between 2010 and 2022. Each case was 1:1 matched to a pT1-3 N0 OSCC patient based on tumor size, but without bone invasion. The primary endpoint was overall survival (OS), secondary endpoints included the recurrence-free survival and outcome predictors.
RESULTS: A total of 156 patients were analyzed (78 per group). There were no statistically significant differences in 3-year OS between both groups in general (78.2%, 95%CI: 68.6-87.8 vs. 80.0%, 95%CI: 68.4-91.6). After stratification for pT2 criteria, there was also no significant difference between both groups if PORT was omitted (63.9%, 95%CI: 44.2-92.4 vs. 70.5%, 95%CI: 55.0-90.0). Multivariate analysis identified age and poor differentiation (grade III) as significant predictors of worse OS, while PORT showed no independent survival benefit.
CONCLUSION: In small OSCC staged pT4a due to bone invasion and lacking other risk factors, PORT demonstrated no statistically significant improvement in OS when matched for tumor size. Further prospective trials and larger cohorts are warranted to confirm these findings.
PMID:40911948 | DOI:10.1016/j.oraloncology.2025.107670
Curr Pharm Teach Learn. 2025 Sep 4;17(12):102467. doi: 10.1016/j.cptl.2025.102467. Online ahead of print.
ABSTRACT
OBJECTIVE: To develop and evaluate the effectiveness of a two-step training pilot program in the Doctor of Pharmacy curriculum to prepare students to utilize medical language interpreters during patient interactions.
METHODS: The Advanced Communications and Counseling Skills course was a two-step program developed to train professional year two (P2) student pharmacists to effectively utilize interpreters during patient encounters. Training included completion of virtual modules and in-person standardized patient encounters where the use of an interpreter was required to counsel. Students then demonstrated the communication skills acquired at a health fair for patients that spoke a language other than English. Student perspective, comfort, and confidence of using interpreter services were measured and compared pre and post program implementation. Patient satisfaction with P2 communication skills were also assessed.
RESULTS: A total of 23 P2 students completed the program. Overall, summary statistics indicate trends for student improvement in all areas, with students’ confidence in using an interpreter improved. All students were satisfied with the training modules (100.0 %) and the majority felt prepared in using an interpreter (94.4 %). Patients were very satisfied (76.5 %) or satisfied (23.5 %) with the students’ ability to utilize an interpreter during the patient encounter at the health fair.
CONCLUSION: The Two-Step program provides students with training on how to utilize interpreters. Students are receptive to participating in the course and satisfied with the communication skills acquired. Embedding this course in the pharmacy curriculum could increase student confidence and have a positive impact on patient communication experience.
PMID:40911947 | DOI:10.1016/j.cptl.2025.102467
J Int Med Res. 2025 Sep;53(9):3000605251370327. doi: 10.1177/03000605251370327. Epub 2025 Sep 5.
ABSTRACT
ObjectiveThis study aimed to assess the prevalence and associated factors of male sexual dysfunction in a population of young men using validated tools to evaluate erectile function and its contributing factors.MethodsA community-based cross-sectional study was conducted between April 2023 and August 2024 among married men aged ≤40 years in Saudi Arabia. Participants were randomly selected from public gatherings across five regions and interviewed using the International Index of Erectile Function and Sexual Health Inventory for Men. Sociodemographic and clinical data were collected, including comorbidities, body mass index, physical activity, income, educational level, job, and depression screening result. Statistical analyses included descriptive statistics, nonparametric tests, and multivariable linear regression to identify factors associated with erectile dysfunction.ResultsA total of 196 men participated in the study. Of these, 77 (39.2%) were diagnosed with erectile dysfunction. According to the Sexual Health Inventory for Men score categories, 119 (60.7%) men had no significant erectile dysfunction, 29 (14.8%) had mild erectile dysfunction, 19 (9.7%) had mild-to-moderate erectile dysfunction, 15 (7.6%) had moderate erectile dysfunction, and 14 (7.14%) had severe erectile dysfunction. Multivariable linear regression analysis revealed several significant associated factors for better erectile function (based on the International Index of Erectile Function score), namely, higher income and an initial negative screening result for depression. The International Index of Erectile Function score was 12.65 points (95% confidence interval: -17.37 to -7.92; p < 0.0001) lower in participants with an initial positive screening result for depression than in those with an initial negative screening result for depression.ConclusionsThese results suggest that sexual dysfunction in younger men is not only influenced by physical health but also closely linked to psychosocial factors such as low income and depression. Further longitudinal research and multidisciplinary approaches are required to develop comprehensive targeted interventions for sexual dysfunction in young men, with an emphasis on mental health and socioeconomic conditions.
PMID:40911929 | DOI:10.1177/03000605251370327
JMIR Ment Health. 2025 Sep 5;12:e73702. doi: 10.2196/73702.
ABSTRACT
BACKGROUND: Suicide-related internet use encompasses various web-based behaviors, including searching for suicide methods, sharing suicidal thoughts, and seeking help. Research suggests that suicide-related internet use is prevalent among people experiencing suicidality, but its characteristics among mental health patients remain underexplored.
OBJECTIVE: This study aimed to examine the sociodemographic, clinical, and suicidality-related characteristics of suicidal mental health patients who engage in suicide-related internet use compared with those who do not.
METHODS: A cross-sectional survey was conducted from June to December 2023, recruiting participants aged 18 years and older with recent contact with secondary mental health services in the United Kingdom. The survey assessed sociodemographic characteristics, psychiatric diagnoses, suicidal thoughts and behaviors, and engagement in suicide-related internet use. Statistical analyses included chi-square tests, Wilcoxon tests, and multivariable logistic regression to identify predictors of engaging in suicide-related internet use.
RESULTS: Of 696 participants, 75% (522) engaged in suicide-related internet use in the past 12 months. Those who engaged in suicide-related internet use were almost 3 times as likely to have attempted suicide in the past year (32.5% vs 9.2%, P<.001). They were more likely to have a diagnosis of personality disorder (34.4% vs 18.5%, P<.001) and to disclose suicidal thoughts to someone (87.8% vs 72.8%, P<.001). They also reported higher levels of suicidal ideation intensity (median =6.6 vs 5.1, P<.001). There were no significant sociodemographic differences between groups, including age.
CONCLUSIONS: The findings suggest that suicide-related internet use is a common behavior among suicidal mental health patients across various age groups, challenging the notion that it is primarily a concern for younger populations. The association between suicide-related internet use and increased suicidality highlights the need for clinicians to incorporate discussions about web-based behaviors in suicide risk assessments. Given the high rate of disclosure of suicidal thoughts among suicide-related internet users, clinicians may have an opportunity to engage in open, nonjudgmental discussions about their patients’ internet use.
PMID:40911924 | DOI:10.2196/73702
Am J Sports Med. 2025 Sep 5:3635465251366318. doi: 10.1177/03635465251366318. Online ahead of print.
ABSTRACT
BACKGROUND: No model exists to predict which patients with elbow ulnar collateral ligament (UCL) injuries will successfully return to play (RTP) after nonoperative treatment. The reported rates for successful RTP after the nonoperative management of UCL injuries are limited and vary widely. Furthermore, patient and injury characteristics that influence the failure of nonoperative treatment have not been established.
PURPOSE: To identify patient- and injury-specific factors predictive of successful RTP after the nonoperative management of UCL injuries in baseball players.
STUDY DESIGN: Retrospective cohort study; Level of evidence, 3.
METHODS: A total of 205 patients with a UCL injury were enrolled from 2010 to 2020. Of these patients, 130 underwent nonoperative treatment and were either cleared for RTP (n = 46) or eventually underwent a surgical intervention (n = 84) after a minimum 1-month trial of nonoperative management. The Elbow UCL Injury Prognosis Score is a close approximation of a logistic regression model that was developed by recursively selecting features using a combination of the backward stepwise and best subset methods. The criteria considered for feature selection included P values using the Fisher exact test, variable importance from intermediary logistic models, and accuracy and sensitivity of the final model. The final logistic model was tested and validated using 5-fold cross-validation, and the score was validated against the logistic model.
RESULTS: The Elbow UCL Injury Prognosis Score provided an individualized prediction of each patient’s need for surgery based on age, magnetic resonance imaging findings, and paresthesia of the fifth digit. The final model achieved an average accuracy of 78.7% and a consistently perfect sensitivity and negative predictive value on the test dataset. The area under the curve was 0.86. A simplified score to allow for calculation at the bedside was created by standardizing the weights from the logistic equation of the final model. The lower the score, the more likely that patients would successfully RTP without surgery.
CONCLUSION: The Elbow UCL Injury Prognosis Score was created to predict which patients would succeed with nonoperative management and avoid unnecessary surgery while simultaneously identifying patients for whom nonoperative management would delay the inevitable need for a surgical intervention. Patients with a score ≥8 had a >80% chance of requiring surgery. Overall, the Elbow UCL Injury Prognosis Score is a statistically rigorous and practical tool that can be used at the bedside to help counsel patients on their chances of needing surgery.
PMID:40911922 | DOI:10.1177/03635465251366318
J Neurosurg Spine. 2025 Sep 5:1-9. doi: 10.3171/2025.4.SPINE241232. Online ahead of print.
ABSTRACT
OBJECTIVE: The objective of this study was to introduce and evaluate foraminoplastic inferior pedicle subtraction osteotomy (FiPSO), a novel technique that involves downward resection of the pedicle and vertebral body, aimed at addressing rigid lower lumbar kyphosis.
METHODS: The clinical records were reviewed of the patients who underwent corrective surgery from January 2012 through December 2021 for adult spinal deformity using a combination of procedures: pedicle subtraction osteotomy (PSO) at the lumbar level and spinopelvic fixation. Inclusion criteria included patients older than 40 years with sagittal imbalance symptoms and significant radiographic findings: sagittal vertical axis (SVA) > 50 mm, pelvic tilt (PT) > 25°, or pelvic incidence (PI) minus lumbar lordosis (LL) > 10°. Patients were categorized into three groups: L1-3 PSO, L4-S1 PSO, and FiPSO. The authors assessed thoracic kyphosis, LL, lower LL (LLL), PI, PT, sacral slope, SVA, global tilt (GT), and Global Alignment and Proportion (GAP) score preoperatively, postoperatively, and at the last follow-up. Complications were also analyzed.
RESULTS: A total of 65 patients were included in the final analysis: 25 in the L1-3 PSO group, 29 in the L4-S1 PSO group, and 11 in the FiPSO group. The FiPSO group showed significantly larger postoperative LLL (39.2° ± 7.7° vs 29.7° ± 10.7°, p < 0.05) and smaller PI-LL mismatch (9.6° ± 10.3° vs 24.6° ± 13.4°, p < 0.01) compared to the L4-S1 PSO groups. At the last follow-up, the FiPSO group maintained larger LLL (38.3° ± 8.9° vs 27.1° ± 10.0°, p < 0.05), lower PT (23.1° ± 9.9° vs 33.3° ± 10.7°, p < 0.05), and good global sagittal alignment (SVA, 64.0 ± 43.8 mm vs 106.8 ± 55.7 mm, p < 0.05; GT, 28.7° ± 13.9° vs 43.5° ± 15.5°, p < 0.05) compared to the L4-S1 PSO group. The FiPSO group had higher nerve deficits (45%) but lower proximal junctional kyphosis (18%) and revision surgery rates (9.1%) than the L1-3 or L4-S1 PSO groups. However, the differences were not statistically significant.
CONCLUSIONS: FiPSO provides effective lower lumbar correction and long-term sagittal alignment with comparable complication rates, offering a valuable option for overcoming the challenges associated with PSO in the lower lumbar spine.
PMID:40911915 | DOI:10.3171/2025.4.SPINE241232
J Neurosurg. 2025 Sep 5:1-10. doi: 10.3171/2025.4.JNS242393. Online ahead of print.
ABSTRACT
OBJECTIVE: Major depressive disorder is a significant cause of disability, impacting an estimated 193 million individuals worldwide. Forty percent are estimated to have little to no response to standard pharmacological therapies. Deep brain stimulation (DBS) has emerged as a favorable neuromodulation therapy for treatment-resistant depression, but it remains unclear which brain targets are optimal.
METHODS: The authors performed a systematic literature review and meta-analysis of articles published through January 2022 to examine the efficacy of DBS targets in reducing depressive symptoms in patients with treatment-resistant depression. The primary outcome was the reduction in depression severity measured by the Montgomery-Asberg Depression Rating Scale and Hamilton Rating Scale for Depression. Secondary outcomes were responder and remission rates.
RESULTS: The authors analyzed 22 trials, 15 of which were sham-controlled studies. This network meta-analysis identified that stimulation of the medial forebrain bundle (MFB) was associated with the greatest reduction in depressive symptoms, compared with stimulation of the subcallosal cingulate gyrus (SCG) and ventral capsule/ventral striatum (VC/VS). Stimulation of the MFB also exhibited a higher responder rate (86%) than stimulation of the SCG or anterior limb of the internal capsule. Stimulation of the rostral extension of the prefrontal cortex was associated with the highest remission rate (60%), but this was not statistically significant compared with stimulation of other brain regions.
CONCLUSIONS: The MFB shows promise as a DBS target for treatment-resistant depression, possibly a result of its involvement in the mesocortical and mesolimbic pathways mediating depression. However, additional trials directly comparing stimulation of different brain regions are necessary to establish MFB as the optimal neurostimulation target.
PMID:40911913 | DOI:10.3171/2025.4.JNS242393
JMIR Med Educ. 2025 Sep 5;11:e66766. doi: 10.2196/66766.
ABSTRACT
BACKGROUND: Learning style is a biologically and developmentally imposed configuration of personal characteristics that makes the same teaching method effective for some and ineffective for others. Studies support a relationship between learning style and career choice, resulting in learning style patterns observed in distinct types of residency programs, which can also be applied to general surgery, from medical school to the latest stages of training. The methodologies, populations, and contexts of the few studies pertinent to the matter are very different from one another, and a scoping review on this theme will unequivocally enhance and organize what is already known.
OBJECTIVE: The goal of this study is to identify and map out data from studies that report on learning styles in medical students, surgical residents, medical staff, and surgical teachers.
METHODS: The search strategy was performed on September 25, 2023, by a librarian and digital search strategy expert, through the descriptors “learning, style” and “surgery.” The databases consulted were Embase, SCOPUS, Web of Science, and PubMed through descriptors and their synonyms, according to MeSH (Medical Subject Headings). Of the 213 articles found, 135 articles remained after the exclusion of duplicates. The remaining 78 articles were analyzed by 3 of the researchers independently. A total of 27 articles were selected, and 2 articles were excluded because the full article was not found.
RESULTS: A total of 25 articles were included in the review. A total of 96% (n=24) of the articles used cognitive theories as their theoretical basis. Regarding learning style instruments, 36% (n=9) articles used the visual, aural, read, and kinesthetic learning method instrument, and 40% (n=10) articles chose Kolb’s learning style inventory. The papers concentrate especially on the 2010s, and most of them are from North America (16/25, 64%) or Europe (6/25, 24%). The smallest study had 15 participants and the biggest had 1549 participants. The included studies primarily focused on surgical residents (21/25, 84%), with fewer targeting faculty and staff (9/25, 36%). The primary objectives of the studies were to investigate the relationship between learning styles and performance (15/25, 60%), gender differences (7/25, 28%), changes over time (4/25, 16%), and motivation (3/25, 12%).
CONCLUSIONS: This scoping review reveals a limited and geographically concentrated body of research on learning styles in surgery education, primarily focusing on surgical residents and using Kolb’s learning style inventory and visual, aural, read, and kinesthetic learning method instruments. Considerable gaps exist regarding geographical diversity and the study of medical staff and faculty. These findings underscore the need for future research with a broader scope to better inform educational strategies in surgery.
PMID:40911902 | DOI:10.2196/66766
JMIR Form Res. 2025 Sep 5;9:e71570. doi: 10.2196/71570.
ABSTRACT
BACKGROUND: Measurement-based care (MBC), including remote MBC, is increasingly being considered or implemented for mental health treatment and outcomes monitoring in routine clinical care. However, little is known about the health equity implications in real-world practice or the impact on patient-provider relationships in lower-resource systems that offer mental health treatment for diverse patients.
OBJECTIVE: This hypothesis-generating study examined the drivers of MBC implementation outcomes, the implications for health equity, and the impact of MBC on therapeutic alliance (TA). The study was conducted 1 year after the implementation of remote MBC at 3 outpatient adult clinics in a diverse, safety-net health system.
METHODS: This explanatory sequential mixed methods study used quantitative surveys and qualitative focus groups with mental health care providers. Repeated surveys were first used to understand mental health care provider experiences over a 6-month period, at least 1 year after MBC implementation. Surveys were analyzed to refine focus group prompts. Six mental health providers participated in repeated surveys over 6 months, after which the same 6 providers and 1 additional mental health provider took part in focus groups.
RESULTS: Surveys revealed stable acceptability and utility ratings, concerns that MBC was not equally benefiting patients, little endorsement that MBC improved TA, and slightly decreasing feasibility scores. In focus groups, mental health care providers shared concerns about the acceptability, appropriateness, feasibility, and equity of processes for collecting MBC data. These providers had less first-hand experience with sharing and acting upon the data but still voiced concerns about the processes for doing so. TA both impacted and was impacted by MBC in positive and negative ways. The potential drivers of the findings are discussed using qualitative data.
CONCLUSIONS: More than 1 year after the implementation of remote MBC for mental health, mental health care providers had enduring concerns about its implications for health equity as well as its bidirectional relationship with TA. These findings suggest that further study is needed to identify system-level strategies to mitigate potential negative effects of real-world MBC implementations on health equity, particularly in low-resource settings with diverse populations.
PMID:40911865 | DOI:10.2196/71570