Tag: nevin manimala

BMC Musculoskelet Disord. 2025 May 27;26(1):523. doi: 10.1186/s12891-025-08671-3.

ABSTRACT

INTRODUCTION: This study conducted statistical analysis of clinical data from cases of acute hematogenous osteomyelitis (AHO) with or without concomitant septic arthritis, with the objective of identifying factors that are indicative of concomitant septic arthritis. Predictive models will be developed to predict coexisting infections, with one that is independent of MR findings and another that incorporates MRI data.

METHODS: A retrospective review of 127 children (132 cases of AHO) treated for AHO was performed. All patients underwent MRI. The data encompassed various demographic, clinical, and diagnostic factors. Graphical and logistical regression analysis was used to determine variables independently predictive of adjacent infection. Optimal cutoff values were determined for each variable and a prediction model was created. Finally, the model was applied to our patient database and each patient with isolated AHO, or concomitant infection was stratified based upon the number of positive predictive factors.

RESULTS: The overall incidence of coexisting septic arthritis in patients with AHO was 52.2% (69/132). Four risk factors (age below 4 years, a history of preceding infection, platelet count > 390.5 × 10^9/L, and absolute neutrophil count < 5.45 × 10^3 cells/ml) were found to be predictive of concomitant infection and were included in the algorithm. Patients with ≥ 2 risk factors were classified as high risk for AHO with concomitant infection (Sensitivity: 79.41% (95% CI: [64.10%, 94.71%]), Specificity: 76.56% (95% CI: [58.61%, 94.51%]), Positive Predictive Value (PPV): 78.26% (95% CI: [63.43%, 93.09%]), and Negative Predictive Value (NPV): 77.78% (95% CI: [61.02%, 94.54%]). In MRI, joint effusion was the primary indicator of concomitant septic arthritis in patients with AHO, followed by the absence of subperiosteal abscess. The presence of subperiosteal abscess in the absence of joint effusion was highly correlated with isolated AHO, showing a 100% occurrence rate (39/39).

CONCLUSIONS: Our study successfully identified several risk factors and radiologic signs associated with concomitant septic arthritis in patients with AHO. These findings can assist clinicians in early recognition and management of coexisting infections, especially in situations where MRI is not readily available or when its findings are inconclusive. Timely identification of these factors is crucial for appropriate treatment planning and improved patient outcomes.

PMID:40426147 | DOI:10.1186/s12891-025-08671-3

BMC Nurs. 2025 May 27;24(1):604. doi: 10.1186/s12912-025-03224-4.

ABSTRACT

BACKGROUND: Due to the theory-practice gap, new ICU nurses often struggle to manage critically ill patients and high-risk conditions. While structured training programs exist, they lack standardized content and implementation path. This study aims to explore the impact of clinical pathway teaching combined with OSCE on new ICU nurses’ nursing performance and clinical competence.

METHODS: Used sampling, a quasi-experimental with non-randomized two-group study design. We selected new nurses (n = 52) who joined their ICU from August 2020 to January 2022 and divided the subjects chronologically into two groups. The experimental group used clinical pathway teaching combined with the OSCE evaluation, while the control group took the routine method. We used the six-dimension scale of nursing performance scale (6-D) and the Nursing Clinical Competence Questionnaire (CNCQ) to collect the new ICU nurses’ data before and after a two-month training cycle. Statistical analysis was performed using t-tests and χ2-test, with a significance level set at P < 0.05.

RESULTS: After training, the nurses of the experimental group had higher scores on the Nursing Clinical Competence Questionnaire (93.46 ± 11.20) compared to the control group (85.92 ± 12.19), and this difference was significant (P < 0.05). The nurses of the experimental group had lower scores on the 6-D scale before training (154.19 ± 38.32) compared to the control group (187.15 ± 32.20), the difference was significant(P < 0.05), but there was no significant difference after training (P>0.05).

CONCLUSION: Clinical pathway teaching combined with OSCE improve the clinical competence of new ICU nurses, and promote nursing performance. However, job experience and clinical environment might influence nursing performance.

PMID:40426134 | DOI:10.1186/s12912-025-03224-4

Biomed Eng Online. 2025 May 27;24(1):66. doi: 10.1186/s12938-025-01397-2.

ABSTRACT

PURPOSE: Design an algorithm to calculate the bending angle of the puncture needle for transjugular intrahepatic portosystemic shunt (TIPS) procedures and achieve three-dimensional visualized path planning.

MATERIALS AND METHODS: Based on enhanced CT images, a thresholding segmentation method was used to perform three-dimensional reconstruction of the hepatic vasculature, with the target puncture point selected by the interventional physician. The puncture needle was modeled using second-order Bézier curves and arcs. Subsequently, the bending points were selected, and the optimal bending angles were calculated based on the target puncture point. The puncture pathway was then verified and visualized in three dimensions using Mimics software. Data from 32 patients who successfully underwent TIPS procedures were retrospectively collected for clinical validation and statistical analysis.

RESULTS: The error between the tip position of the puncture needle catheter modeled with Bézier curves and the actual puncture needle was 0.15 cm, while the error for the arc modeling was 0.19 cm. The optimal bending angle of the puncture needle calculated by this algorithm was validated in Mimics software, successfully achieving path planning. Among the 32 patients, the difference between the actual bending angle of the puncture needle and the calculated bending angle was 1.06° ± 1.82° (95% CI 0.41-1.72°). The equivalence test results indicated that there was a significant equivalence between the measured angle and the angle calculated by the algorithm (p < 0.001).

CONCLUSION: This study successfully designed an algorithm for calculating the bending angle of the puncture needle in TIPS procedures, which demonstrated equivalence with the clinically observed bending angles.

PMID:40426132 | DOI:10.1186/s12938-025-01397-2

BMC Med Inform Decis Mak. 2025 May 27;25(1):199. doi: 10.1186/s12911-025-03016-5.

ABSTRACT

BACKGROUND: This study explored workflow pathways followed by patients seeking secondary healthcare services at a local hospital in a rural part of Turkey using process mining to improve hospital resource management.

METHODS: The study used process mining to discover process flows as patient pathways implied by hospital records for in-patient, out-patient, biochemical laboratory, and radiology services. Utilizing its flexibility, visualizations and robustness, authors implemented fuzzy-miner algorithm. First, we processed the relevant data from patient records. Then, this data was transformed into event and activity logs. Subsequently, all data components were collected into a data warehouse, and the process mining algorithm was applied. The process mining specified resource usage levels and workload, service waiting times, associated bottlenecks in hospital services, and related statistics/measures.

RESULTS: The results from the proposed process mining analysis offer insights and decision support to improve hospital resource management. For example, the resulting statistics indicate the high waiting times (e.g., median of waiting times around 2 h within the selected time period) in the General Surgery and Cardiology services, whose resources were highly utilized (2,699 and 6,162 times). Overloads at laboratories and radiological imaging seem to be contributing to these long waiting times, and capacities for the associated services may need to be improved. Waiting times and resource workloads are higher on specific dates related to local commercial and social activities.

CONCLUSIONS: Process mining successfully identified the real work flows, bottlenecks, and long waiting times at services within the considered local hospital and provided insights to the hospital management for improving their practices. Moreover, the analyses revealed unique challenges in providing care at a local hospital located far from the city center, emphasizing the potential of process mining to improve healthcare delivery tailored to the specific hospital environment.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40426129 | DOI:10.1186/s12911-025-03016-5

BMC Med Educ. 2025 May 27;25(1):786. doi: 10.1186/s12909-025-07387-1.

ABSTRACT

BACKGROUND: Exploring the impact of professional identity on the academic performance of students is crucial for improving teaching effectiveness and educational outcomes in this field. Forensic medicine is a niche interdisciplinary discipline in the medical system. However, current educational literature on professional identity development does not adequately address forensic medicine students.

AIM: This study aimed to assess the professional identity among forensic medicine students, explore factors associated with professional identity, and determine the role of professional identity in shaping students’ learning engagement and their subsequent academic achievements.

METHODS: A cross-sectional study was executed for forensic medicine students from a medical university in Jiangsu Province, East China between November and December 2023. Using the method of cluster sampling, 159 undergraduates majoring in forensic medicine were investigated. Data were collected using the demographic questionnaire, and the scales of professional identity, learning engagement, and academic achievement. Linear regression was used to explore professional identity-associated factors. Pearson correlation and mediation analysis were used to analyze the relationship between professional identity, learning engagement, and academic achievement.

RESULTS: The mean score of professional identity was 3.85. Grade (senior: β = 0.353, P = 0.004; fifth-year: β = 0.392, P = 0.001), student leader experience (β = 0.157, P = 0.037), specialty selection (major assignment: β=-0.215, P = 0.014), knowledge of the specialty before enrollment (β = 0.095, P = 0.033), and current knowledge of the specialty (β = 0.245, P = 0.000) were the statistically significant factors influencing professional identity. Professional identity, learning engagement, and academic achievement were positively correlated (P < 0.001). Learning engagement played an intermediate role between professional identity and academic achievement, accounting for 49.445% of the total effect.

CONCLUSION: These findings highlight the pivotal role of professional identity as a strategic mechanism for improving academic achievement in forensic medicine education, with learning engagement serving as the primary mediating factor. As a multifaceted and evolving construct, professional identity is shaped by an interplay of personal, specialty and perception factors. Generating awareness and taking measures among forensic educators to enhance students’ professional identity across stages may be crucial for promoting the quality of forensic talent training.

PMID:40426126 | DOI:10.1186/s12909-025-07387-1

BMC Musculoskelet Disord. 2025 May 27;26(1):525. doi: 10.1186/s12891-025-08776-9.

ABSTRACT

BACKGROUND: Treatment options for spiral/oblique metacarpal shaft fractures (MSFs) include both operative and non-operative approaches. Non-operative treatment with early mobilization has been shown to reduce treatment costs and sick leave, while maintaining grip strength despite metacarpal shortening. However, the impact of metacarpal shortening on strength at the metacarpophalangeal (MCP) or proximal interphalangeal (PIP) joints remains unclear. This study aimed to evaluate whether a shortening of more than 2 mm in spiral/oblique MSFs affects the strength of a single finger.

METHODS: A total of 23 patients with metacarpal shortening greater than 2 mm following a spiral/oblique MSF were included. The primary outcomes were flexion and extension strength in the MCP and PIP joints, compared to the uninjured hand. Secondary outcomes included range of motion, grip strength, metacarpal shortening, DASH score, patient satisfaction, pain levels, and return to work.

RESULTS: There were no differences observed in grip strength, range of motion, or MCP joint extension. However, PIP joint flexion and extension, as well as MCP joint flexion, were significantly reduced. The DASH scores were generally low (mean 4, range 0-23), with patients reporting no pain and high satisfaction.

CONCLUSIONS: In conclusion, finger strength was statistically significantly reduced, but its clinical relevance remains unclear. Despite these findings, the low DASH scores and high patient satisfaction suggest that the functional impact of these changes may be minimal for most patients. We recommend discussing these findings with individuals who heavily rely on dexterity, such as professional musicians or other precision skill workers.

LEVEL OF EVIDENCE: IV.

PMID:40426125 | DOI:10.1186/s12891-025-08776-9

BMC Health Serv Res. 2025 May 27;25(1):753. doi: 10.1186/s12913-025-12915-2.

ABSTRACT

BACKGROUND: Health research projects can be complex challenges for those who undertake them and include substantial work that is not, in itself, a part of the scientific discipline. This work relates to the ever-evolving requirements of legislation, administration, and secure IT facilities, and the tasks can prove to be a significant barrier for researchers with inadequate access to research infrastructure and resources. Additionally, inappropriately applied study designs or statistical methods may result in studies which add little value to their field, but these issues may be avoidable if the necessary infrastructure and support is available. The aim of this paper is to describe the structure of a research support unit in the Region of Southern Denmark and how the unit has grown over time, followed by a discussion addressing challenges which may arise when building such research infrastructure.

METHODS: This paper presents a descriptive case on the structure of the research support unit OPEN (Open Patient data Explorative Network). It outlines the establishment, growth, and challenges through semi-structured interviews with founders and users of OPEN, user experience surveys, internal and official documents, and internal database reports on projects that have used or are going to use OPEN’s facilities.

RESULTS: OPEN was established in 2008 to support researchers in collecting and storing data and biological material from research projects, and has since evolved and grown, providing support and infrastructure in nearly all aspects of the research process, and continuously adapting to meet the changing needs of the researchers. From 2008 to 2022, a total of 1814 health research projects have received support from OPEN, with 255 of these being admitted as new projects in 2022. User satisfaction surveys and interviews showed high levels of satisfaction in support and services, but also highlighted areas of infrastructure which can be developed further.

CONCLUSIONS: OPEN has experienced significant growth since it was founded, evolving into a one-stop shop for research support. A flexible framework and agile adaptation to user needs have been important factors in this expansion. The challenges and successes of this process may inspire others working with health administration and research infrastructure.

PMID:40426119 | DOI:10.1186/s12913-025-12915-2

BMC Pregnancy Childbirth. 2025 May 27;25(1):615. doi: 10.1186/s12884-025-07647-4.

ABSTRACT

BACKGROUND: Missed nursing care is a newly defined concept and refers to any aspect of required patient care that is omitted or delayed. This study aimed to determine the effectiveness of electronic reminders on missed care in NICU.

METHOD: This is a two groups (before and after) quasi experimental study. A random sampling technique was employed to collect a sample of 70 nurses among two NICUs in an educational hospital in the south east of Iran. Miss care questionnaire was used to determine Missed care before, immediate, and one month after the intervention. The study intervention includes sending electronic reminders regarding nursing care of NICU hospitalized neonate. Data were analysed using SPSS₂₀ software, descriptive (frequency, percentage, mean, and standard deviation), and analytical statistics. The level of significance was considered as 0.05.

RESULTS: The results showed that the mean score of missed care was decreased after intervention in the intervention group (6.74 ± 8.47) rather than the control group (18.57 ± 14.59) (P = 0.001). The highest and the lowest mean score of missed care before and after the intervention was in general care and oxygen therapy domains in both groups. The second time intervention was one month after did not show any significant differences in the two groups. But decreasing in missed care was shown in both groups.

DISCUSSION: Using informational technologies like WhatsApp is an easy, low cost and available method which could help nurses decrease missed nursing care. More studies with a longer duration could probably have a greater impact on reducing missed care.

PMID:40426111 | DOI:10.1186/s12884-025-07647-4

BMC Pregnancy Childbirth. 2025 May 27;25(1):617. doi: 10.1186/s12884-025-07735-5.

ABSTRACT

BACKGROUND: Malaria and anaemia in pregnancy remain public health problems because they increase the risk of adverse pregnancy outcomes. This study assessed malaria and anaemia prevalence and associated risk factors among pregnant women initiating antenatal care in selected districts of 2 regions of Ghana.

METHODS: An analytical cross-sectional study was conducted using data obtained from 5196 pregnant women at their booking antenatal care (ANC) visit. Women of any age, gestational age, parity and at any ANC visit, who consented were enrolled consecutively into the study. Data on socio-demographic and obstetric characteristics, bed net ownership and use were obtained using structured questionnaires. Haemoglobin concentration and malaria, Schistosoma and helminth infections were determined using an automated haematology analyser and microscopy, respectively. Summary statistics to describe study variables and chi-square test and logistic regression set at p < 0.05 to determine risk factors for anaemia and malaria were conducted using Stata SE14.

RESULTS: Overall malaria prevalence was 5.74% [95% CI: 5.1-6.4] and anaemia prevalence was 55.22% [ 95% CI: 53.85-56.58]. Living in Volta region (p < 0.001), being secondi- (p = 0.003) or multigravida (p < 0.001) and being of lower middle socio-economic status (p = 0.004) reduced the women’s risk of malaria parasite infection. Being anaemic (p = 0.001) and reporting a symptom (p < 0.001) increased the odds of Plasmodium infection among the women. Residing in Volta region (p < 0.001), having malaria infection (p < 0.001), and booking ANC in the 2nd (p < 0.001) and 3rd trimesters (p < 0.001) increased the odds of anaemia among the women. Age 25-34 years (p < 0.001) and ≥ 35 years (p = 0.008) and belonging to middle (p = 0.009), upper middle (p = 0.006) or upper-level (p < 0.001) quintile of wealth index reduced the odds of anaemia among the women at their booking ANC visit.

CONCLUSIONS: More than half the women were anaemic signifying a severe public health problem. Malaria prevalence, though low, was a significant risk factor for anaemia. Existing malaria and anaemia control strategies through ANC need strengthening, especially among young, first-time pregnant women. This study further highlights socio-economic status as an important risk factor for anaemia in pregnancy.

TRIAL REGISTRATION: Not applicable.

PMID:40426109 | DOI:10.1186/s12884-025-07735-5

BMC Pediatr. 2025 May 27;25(1):424. doi: 10.1186/s12887-025-05730-5.

ABSTRACT

BACKGROUND: Depressive symptoms in the perinatal period as well as difficulties developing an emotional bond towards the child have been described as potential risk factors for poor child development. Few studies have investigated the mediating role of parent-child bonding for the association between prenatal depressive symptoms and child outcomes. Research on this association is especially scarce regarding the paternal perspective. This study investigated the prospective association between both parents’ prenatal depressive symptoms and child development, taking the mediating role of parent-child bonding into account.

METHODS: Data of 1,178 mothers and 743 fathers were drawn from the prospective longitudinal cohort study “Dresden Study on Parenting, Work, and Mental Health” (DREAM). To investigate the prospective association between depressive symptoms during pregnancy and eight weeks postpartum (self-report, Edinburgh Postnatal Depression Scale), parent-child bonding at eight weeks postpartum (self-report, Postpartum Bonding Questionnaire), and child development at 14 months postpartum (parent-report, Ages and Stages Questionnaire-3), multiple regression and mediation analyses were conducted individually for both parents, including the confounders parental age, education, child’s sex assigned at birth, prematurity, and perceived social support.

RESULTS: In both parents, a statistically significant small-sized mediating effect of parent-child bonding for the association between prenatal depressive symptoms and child development was found, with higher depressive symptoms being associated with more parent-child bonding impairment, which was associated with poorer child development. Paternal depressive symptoms were not directly associated with child development, whereas higher levels of maternal prenatal depressive symptoms were directly associated with better child development at 14 months postpartum. After additionally controlling for postpartum depressive symptoms, the association between prenatal depressive symptoms and parent-child bonding was no longer significant, and a positive association between paternal prenatal depressive symptoms and child development emerged.

CONCLUSIONS: Our results underline the importance of addressing depressive symptoms in the context of perinatal care to support parents experiencing mental health problems or struggles with the adjustment to parenthood early on. Future research on the complex dynamics of mental health, parent-child bonding, and child development is needed to replicate our findings. Our study highlights the relevance of including the perspective of both parents into research and clinical practice.

PMID:40426107 | DOI:10.1186/s12887-025-05730-5