Tag: pubmed

Iran J Allergy Asthma Immunol. 2026 Jun 3;25(4):554-564.

ABSTRACT

To investigate the feasibility and effectiveness of targeted lung recruitment and the titration of optimal positive end-expiratory pressure (PEEP) in neonates under the guidance of lung ultrasound. The atelectasis neonates from June 2022 to June 2024 in the Neonatology Department of People’s Hospital of Pidu were collected and randomly divided into a lung ultrasound scoring (LUS) group and an oxygen (OXY) group, both of which were given mechanical ventilation treatment. The lung recruitment and optimal PEEP were performed by the LUS and OXY methods, respectively. The optimal PEEP and the respiratory and hemodynamic indexes of the two groups were compared before and after lung recruitment and after the optimal PEEP was titrated. After the intervention, the dynamic lung compliance (Cdyn) in the LUS group increased by 38.2% compared with the baseline (from 30.6 ± 4.3 to 42.3 ± 5.1 mL/cmH2O), which was significantly higher than the 21.4% increase in the OXY group (from 29.8 ± 4.1 to 35.6 ± 4.8 mL/cmH2O). The improvement in PaO2/FiO2 in the LUS group was 22.5% higher than in the OXY group. There was no statistically significant difference in the incidence of complications between the two groups. Lung ultrasound can guide neonatal lung recruitment and optimal PEEP titration, improving lung compliance and oxygenation without affecting the safety of treatment.

PMID:42437315

Iran J Allergy Asthma Immunol. 2026 Jun 3;25(4):517-528.

ABSTRACT

Postoperative infections (POIs) significantly contribute to morbidity and mortality following partial hepatectomy for hepatocellular carcinoma (HCC). While the Systemic Immune-Inflammation Index (SII) and Prognostic Nutritional Index (PNI) are recognized biomarkers for immune-inflammatory and nutritional status, their combined predictive value for POIs in liver surgery requires further investigation. This study evaluates SII and PNI as preoperative predictors for infections in this patient population. A retrospective observational study was conducted on 300 patients undergoing partial hepatectomy between 2022 and 2024. Preoperative laboratory data were used to calculate SII and PNI, with POIs identified within 30 days based on CDC guidelines. Statistical analyses, including multivariate logistic regression, were performed to compare infected and non-infected cohorts and identify independent predictors of infection. Of the 300 patients, 96 (32%) developed POIs. The infected group exhibited significantly higher SII (1142 ± 618 vs 792 ± 450) and lower PNI (40.1 ± 5.8 vs 46.4 ± 5.9) than the non-infected group. Multivariate analysis confirmed high SII (OR 2.85) and low PNI (OR 3.26; 95% CI, 2.01-5.12) as independent predictors. Furthermore, infections were associated with prolonged hospitalization, increased ICU admissions, and higher 30-day mortality. Preoperative SII and PNI are effective, independent predictors of POIs in patients undergoing hepatectomy for liver cancer. Integrating these biomarkers into routine evaluation enhances risk stratification and guides perioperative optimization. Early identification through these indices allows for targeted interventions, such as nursing-led nutritional support and intensified surveillance, to reduce complications and improve surgical outcomes.

PMID:42437312

Malays Fam Physician. 2026 Jun 4;21:32. doi: 10.51866/oa.1006. eCollection 2026.

ABSTRACT

INTRODUCTION: Menopause is a substantial life transition for women, signifying the end of reproductive capability, with implications for symptoms, long-term health and well-being. Women’s experiences during menopause can differ widely, affecting their attitudes towards this transition. This study aimed to investigate knowledge and attitudes towards menopause among midlife women in Malaysia.

METHODS: A community-based cross-sectional online survey using non-probability sampling was conducted among Malaysian women aged 40-60 years residing in an urban setting. A validated online questionnaire was used to assess the study parameters. Knowledge and attitudes were quantified, and associations with sociodemographic factors were examined using the Kruskal-Wallis test. Descriptive statistics and Spearman’s correlation analysis were performed using the IBM Statistical Package for the Social Sciences Statistics version 26.0.

RESULTS: Of the 300 respondents, the majority were Malay (94.7%), married (85.3%) and aged 55-60 years (27.3%). Over half (52.0%; mean score=12.98±6.77 [22 max score]) demonstrated poor knowledge, while 45.3% held negative attitudes towards menopause. The average attitude score was 33.48±6.58 [56 max score], indicating a generally negative orientation towards menopause. A weak but significant positive correlation was observed between knowledge and attitudes (r=0.249, P<0.01).

CONCLUSION: Targeted educational initiatives may be beneficial in enhancing menopause-related knowledge and fostering more positive attitudes among midlife Malaysian women. Future research should rigorously assess changes in knowledge, attitudes and related clinical behaviours after such interventions to inform policy and practice.

PMID:42437304 | PMC:PMC13355863 | DOI:10.51866/oa.1006

Malays Fam Physician. 2026 Jun 26;21:33. doi: 10.51866/oa.1109. eCollection 2026.

ABSTRACT

INTRODUCTION: Sarcopaenia is underdiagnosed in primary care due to limitations in available tools. The SARC-F questionnaire is a recommended screening tool, but its diagnostic accuracy among Malaysian community-dwelling older adults is not well established. This study aimed to determine the diagnostic accuracy of the SARC-F score against hand grip strength (HGS) for identifying possible sarcopaenia among community-dwelling older adults.

METHODS: A cross-sectional study was conducted from January to November 2024 across 11 public health clinics. Community-dwelling older adults aged ≥60 years were recruited. Sarcopaenia risk was assessed using the SARC-F questionnaire, with scores of ≥4 indicating a high risk. HGS was measured using a Jamar dynamometer, with possible sarcopaenia defined according to the Asian Working Group for Sarcopenia 2019 criteria (<28 kg for men, <18 kg for women). Statistical analysis included the Mann-Whitney U test to compare mean rank distributions of HGS between SARC-F risk groups and Cohen’s kappa to assess the agreement between the SARC-F score- and HGS-based classifications. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the discriminatory performance of the SARC-F score in identifying possible sarcopaenia, using HGS as the reference standard.

RESULTS: Among 578 participants, the median HGS was significantly lower in the high-risk SARC-F group for both men (19.0 kg vs 28.0 kg, P<0.001) and women (14.0 kg vs 18.0 kg, P<0.001). The agreement between the SARC-F score- and HGS-based classifications was poor to fair (kappa=0.219). The SARC-F score demonstrated low sensitivity (34.7%) but high specificity (87.5%); it showed poor discriminative ability in detecting possible sarcopaenia (area under the ROC curve=0.67; 95% confidence interval=0.622-0.710; P<0.001). The positive predictive value was 74.6%; negative predictive value, 55.9%; and overall accuracy, 60.4%.

CONCLUSION: While a high SARC-F score is significantly associated with low HGS, the low sensitivity of the SARC-F score limits its use as a standalone screening tool in primary care. A two-step approach, using the SARC-F questionnaire followed by objective HGS measurement, may enhance early detection efforts in primary care.

PMID:42437303 | PMC:PMC13355861 | DOI:10.51866/oa.1109

Malays Fam Physician. 2026 Jun 7;21:26. doi: 10.51866/rv.1027. eCollection 2026.

ABSTRACT

INTRODUCTION: Ischaemic heart disease (IHD) remains a major cause of mortality among individuals with type 2 diabetes mellitus (T2DM) in Malaysia. Conventional cardiovascular risk models, such as the Framingham risk score, often show limited calibration in Asian populations. Artificial intelligence (Al)-calibrated models have emerged as potential alternatives, yet their generalisability and clinical utility across different populations remain uncertain. This narrative review aimed to summarise existing prognostic models for IHD in patients with T2DM and identify methodological gaps relevant to the development of a locally calibrated model.

METHODS: This narrative review employed a structured search strategy guided by PRISMA principles but was not conducted as a full systematic review. We synthesised evidence from epidemiological and prognostic research. Studies comparing conventional statistical approaches (e.g. logistic regression and Cox models) with AI-calibrated models such as extreme gradient boosting, random forest and support vector machines were reviewed.

RESULTS: Eleven studies met the inclusion criteria; four used conventional statistical methods, and seven applied AI or machine learning algorithms. The reported discrimination (area under the curve=0.66-0.94) varied widely. Conventional models commonly lacked external validation and demonstrated restricted applicability beyond their original cohorts. AI-calibrated models showed promising discrimination in some datasets but similarly experienced limited validation and lacked benchmarking against traditional statistical methods. Across the studies, limited calibration and validation reduced generalisability to heterogeneous Malaysian populations.

CONCLUSION: Developing a locally AI-calibrated i-IHD score could enable early risk identification, guide targeted interventions and support national health initiatives, including the Health White Paper 2023 and 13th Malaysia Plan.

PMID:42437302 | PMC:PMC13355864 | DOI:10.51866/rv.1027

SAGE Open Nurs. 2026 Jul 10;12:23779608261468455. doi: 10.1177/23779608261468455. eCollection 2026 Jan-Dec.

ABSTRACT

BACKGROUND: Digital health technologies are increasingly embedded in Neonatal Intensive Care Units (NICUs), yet the role of nurse-led governance in shaping safe, sustainable implementation for high-risk neonates remains underexplored. This review synthesized evidence on nursing leadership and digital health integration in NICUs.

METHODS: Following PRISMA 2020, six databases were searched (January 2013-January 2025), supplemented by grey literature, reference-list screening, and forward citation tracking. The protocol was prospectively registered with PROSPERO. Eligible empirical studies (n = 18) addressed formal nurse-led governance, operational governance enactment by nurses, or leadership-relevant determinants. Risk of bias was appraised with design-specific tools (Cochrane RoB 2, ROBINS-I, JBI, MMAT); synthesis combined structured narrative and reflexive thematic analysis.

RESULTS: Findings are presented as associations, not causal effects. Favorable signals included a 60% reduction in high-stage device-related pressure injuries in one quality-improvement initiative; 30-day readmission rates of 13.8% among enrolled versus 30.9% among non-enrolled caregivers in a nurse-led post-discharge telehealth intervention; and an approximately 12-day shorter length of stay favoring the intervention in one randomized trial of nurse-led developmental care. Using conservative, author-reported coding, organizational/leadership support (17/18; 94%) and structured training (8/18; 44%) were most frequently documented; funding/IT (22%) and clinical champions (17%) less so. Nurse-led governance could not be statistically separated from co-occurring implementation activities.

CONCLUSION: Across a predominantly observational, low-to-moderate-certainty evidence base, nurse-led governance was consistently associated with stronger implementation processes and selected family- and clinical-level signals when embedded in coordinated training, workflow redesign, and audit-and-feedback. Findings are hypothesis-generating. Comparative-effectiveness and economic evaluations decomposing leadership from co-occurring implementation components are needed.

PMID:42437296 | PMC:PMC13354904 | DOI:10.1177/23779608261468455

Cureus. 2026 Jun 11;18(6):e110670. doi: 10.7759/cureus.110670. eCollection 2026 Jun.

ABSTRACT

Background Hamstring tendon (HT) autografts are commonly used in anterior cruciate ligament reconstruction (ACLR), although graft dimensions may vary among patients. Smaller graft diameters have been associated with higher graft failure rates, emphasizing the clinical importance of understanding factors related to the graft size. Consequently, preoperative anthropometric measurements have been investigated for their association with hamstring graft dimensions. However, findings from previous studies remain inconsistent across different populations, and data from Southeast Asian populations are still limited. Therefore, this study aimed to examine the relationship between preoperative anthropometric parameters and intraoperative hamstring graft dimensions, including diameter and length, in single-bundle ACLR patients using a five-strand hamstring autograft. Methods We retrospectively analyzed 91 patients who underwent primary single-bundle ACLR from 2018 to 2023 at a single institution. Preoperative data, including age, gender, height, weight, body mass index (BMI), and thigh circumference, were collected. Intraoperative graft diameter and length were obtained from the operative records. Pearson correlation and simple linear regression analyses were used to evaluate associations between anthropometric parameters and graft diameter. A p-value < 0.05 was considered statistically significant. Results Graft diameter showed a positive correlation with weight (r = 0.22, p = 0.040) and height (r = 0.51, p < 0.001), while graft length was positively correlated with height (r = 0.31, p = 0.003). Regression analysis confirmed a significant association between height and graft diameter (F (1, 89) = 30.649, p < 0.001), with height showing moderate explanatory power (R² = 0.256) and the strongest predictive relationship. In contrast, weight showed a statistically significant but weak association with graft diameter, explaining only a minimal proportion of variance (R² = 0.046). Conclusion Patient height showed a significant yet modest association with five-strand hamstring autograft diameter. These findings may provide supportive reference data for preoperative assessment in similar populations. Further studies are required to refine and validate predictive models for graft size estimation.

PMID:42437261 | PMC:PMC13355849 | DOI:10.7759/cureus.110670

Cureus. 2026 Jun 11;18(6):e110672. doi: 10.7759/cureus.110672. eCollection 2026 Jun.

ABSTRACT

Introduction Acne scarring represents a permanent structural sequela of acne vulgaris and is predominantly characterized by atrophic morphological patterns. Beyond cosmetic disfigurement, facial acne scars may contribute to significant psychosocial distress, including body image disturbance and quality-of-life impairment. Limited data are available correlating scar morphology with body image concerns and scar-specific quality-of-life impairment in the Indian population. Objectives The objectives of this study are to examine the morphological profile of facial acne scars, evaluate the body image concerns and quality of life among patients with acne scars, and determine the correlation of facial acne scarring with body image concerns and quality-of-life impairment. Materials and methods This cross-sectional observational study was conducted in the Department of Dermatology, Venereology and Leprosy, Adichunchanagiri Hospital and Research Centre, Karnataka, over a period of 18 months. It included 150 patients of either gender, aged 18-40 years, with facial acne scars. Morphological assessment was performed under standardized illumination. Scar severity was graded using the Goodman and Baron qualitative grading system and the Self-assessment of Clinical Acne-Related Scars (SCARS) questionnaire. The Body Image Concern Inventory (BICI) and Facial Acne Scar Quality of Life (FASQoL) questionnaires were used for fulfilling the respective objective. Statistical analysis was performed using Epi Info software. Correlations were assessed using Spearman’s rank correlation coefficient. A p-value of < 0.05 was considered statistically significant. Results The majority of participants (63.3%; n=95) were aged 21-25 years, and 69.3% (n=104) were female. Icepick scars were the most common morphological type at 78.7% (n=118), followed by boxcar scars at 61.3% (n=92). Clinician-based grading revealed that 72.6% (n=109) of participants had moderate to severe acne scarring. Based on a SCARS assessment, 36.0% (n=54) had mild, 30.0% (n=45) had moderate, and 15.3% (n=23) had severe/very severe scarring. Mean BICI scores increased significantly across SCARS severity categories (p<0.001). The mean FASQoL score was 6.79 ± 7.11, with higher scores observed in severe scarring (p<0.001). Moderate positive correlations were observed between SCARS and BICI (rₛ=0.419, p<0.001), SCARS and FASQoL (rₛ=0.500, p<0.001), Goodman-Baron grade and FASQoL (rₛ=0.448, p<0.001), and Goodman-Baron grade and BICI (rₛ=0.367, p<0.001). Conclusion Body image concern is evident across domains of dissatisfaction with appearance, preoccupation with perceived flaws, and mirror-checking behaviors. Scar-specific quality-of-life impairment manifests as emotional distress, social self-consciousness, and reduced interpersonal confidence. Patient-perceived severity demonstrates a particularly strong relationship with psychosocial burden, underscoring the importance of integrating clinician-based grading with validated patient-reported outcome measures for comprehensive assessment and patient-centered management.

PMID:42437257 | PMC:PMC13355855 | DOI:10.7759/cureus.110672

Cureus. 2026 Jun 11;18(6):e110683. doi: 10.7759/cureus.110683. eCollection 2026 Jun.

ABSTRACT

Chronic low back pain (LBP) is a major cause of disability around the world, and pharmaceutical treatments like opioids are often used to treat it. However, the efficacy and safety of opioids in LBP continue to be controversial due to inconsistent results and associated side effects. This systematic review assesses the effectiveness and safety of opioid medication in the treatment of LBP. A systematic search was performed utilising various electronic databases, including PubMed, Scopus, Google Scholar, MEDLINE, the Cochrane Library, and Web of Science, following a structured methodology in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) principles. Randomised controlled trials that were published in English within the past two decades and evaluated the use of opioids in adults with LBP were included. The Cochrane Risk of Bias tool and the Critical Appraisal Skills Programme (CASP) checklist were used to screen for bias, and a narrative synthesis was done because the studies were not all the same. There were six randomised, double-blind, placebo-controlled trials involving between 83 and 905 people. Opioid formulations, including buprenorphine, hydrocodone, oxycodone/naloxone, and oxymorphone, exhibited overall efficacy in diminishing pain intensity relative to placebo, especially in opioid-naïve individuals. But the magnitude and consistency of the advantage varied across studies, and some treatments showed only a small statistical difference. There were only a few reports of functional improvement, and they were not always constant. Nausea, constipation, and drowsiness were common side effects, although long-term safety outcomes were not fully evaluated. In general, opioids may help with short-term pain relief in people with LBP, but they aren’t very useful in the long term because they aren’t very effective and very safe and there isn’t much evidence for their long-term use. It is advisable to select patients and use them with caution. More high-quality research is needed to understand their role in long-term management better.

PMID:42437252 | PMC:PMC13355912 | DOI:10.7759/cureus.110683

Cureus. 2026 Jun 11;18(6):e110639. doi: 10.7759/cureus.110639. eCollection 2026 Jun.

ABSTRACT

Background and aim Artificial intelligence (AI) has become an indispensable component of medical practice. Studies have shown that medical students worldwide are often ill-prepared to take full advantage of these technologies in their future practice due to inadequate training and a shortage of qualified instructors. These factors hinder the adoption of AI-focused curricula; therefore, this study aims to explore medical students’ and faculty’s knowledge and attitudes toward AI applications in the medical field, as well as their readiness for its integration into the medical curriculum, highlighting both the benefits and barriers. Methods A cross-sectional study was conducted on medical students (years 1-5) and faculty members from the University of Sharjah College of Medicine (UOSCOM), Sharjah, UAE. They were recruited via convenience sampling between February and March 2023. Students and faculty completed self-administered questionnaires, both online and in person. Analysis was performed using IBM SPSS Statistics for Windows, Version 26 (Released 2018; IBM Corp., Armonk, NY, USA). Results Of a total of 413 participants, 74.3% (faculty and students) agreed that the medical field has benefited from AI. Interestingly, 54.3% of students agreed on implementing AI in the curriculum, and 79.3% believe it is necessary, as they see it as a way to empower their careers in the future. However, 51.9% expressed concerns regarding the increase in workload. Of the 45 faculty participants, 66.7% believe that teaching AI would be an addition to their CVs, while 40% disagree that adding the course will increase their workload. Moreover, 77.8% are willing to participate in the course. Conclusions and recommendations The findings revealed a general positive perception, with both groups acknowledging the benefits of AI in medicine. Students show awareness of AI applications in education and healthcare, while faculty express willingness to teach AI courses for professional development. However, we recommend that future studies assess students’ baseline computer knowledge and correlate faculty members’ specialty fields with their willingness to teach.

PMID:42437241 | PMC:PMC13355148 | DOI:10.7759/cureus.110639