Tag: pubmed

JAMA Netw Open. 2025 May 1;8(5):e259486. doi: 10.1001/jamanetworkopen.2025.9486.

ABSTRACT

IMPORTANCE: Medical gaslighting, in which a patient’s concerns are dismissed without proper evaluation, has been described anecdotally in vulvovaginal patient care, but has not been quantified.

OBJECTIVE: To use a patient-centered instrument to measure adverse experiences in vulvovaginal care.

DESIGN, SETTING, AND PARTICIPANTS: Common themes from National Vulvodynia Association patient testimonials were used to design a mixed-methods measure of patient experience that included both quantitative and qualitative questions. An instrument was created and submitted to officers from the National Vulvodynia Association and Tight-Lipped, another patient advocacy organization, for feedback. The measure was then completed by patients before their first appointment at a vulvovaginal disorder referral clinic from August 2023 to February 2024.

EXPOSURE: Participation in the survey.

MAIN OUTCOMES AND MEASURES: The primary outcome was the incidence of reported clinician behavior and consequent distress as reported on the survey instrument. Quantitative data were analyzed using simple descriptive statistics (mean [SD], median [IQR], and percentage). Narrative responses provided by patients were analyzed using the clinical-qualitative method for content analysis.

RESULTS: A total of 520 patients completed surveys; 5 were eliminated because the patient was younger than 18 years, 6 were eliminated for duplication, 6 were eliminated because they had no past clinician, and 56 were eliminated for completely blank responses. Thus, surveys of 447 patients (mean [SD] age, 41.7 [15.2] years) were analyzed (86% response rate). Patients had a mean (SD) of 5.50 (4.53) past clinicians. Patients reported that a mean (SD) of 43.5% (33.9%) of past practitioners were supportive, 26.6% (31.7%) were belittling, and 20.5% (30.9%) did not believe the patient. In total, 186 patients (41.6%) were told they just needed to relax more, 92 (20.6%) were recommended to drink alcohol, 236 (52.8%) considered ceasing care because their concerns were not addressed, 92 (20.6%) were referred to psychiatry without medical treatment, 72 (16.8%) felt unsafe during a medical encounter, and 176 (39.4%) said they were made to feel crazy, the most distressing surveyed behavior (rated at a mean [SD] of 7.39 [3.06] of 10 on a numerical rating scale of distress). A total of 1150 quotations were analyzed qualitatively; common themes included lack of clinician knowledge (247 quotations) and dismissive behaviors (211 quotations).

CONCLUSIONS AND RELEVANCE: In this cross-sectional study, a patient-centered measure of adverse experiences in vulvovaginal care was developed. Participants reported common past experiences with gaslighting and substantial distress; they frequently considered ceasing care. There is an urgent need for education supporting a biopsychosocial, trauma-informed approach to vulvovaginal pain and continued development of validated instruments to quantify patient experiences.

PMID:40338544 | DOI:10.1001/jamanetworkopen.2025.9486

Psychol Trauma. 2025 May 8. doi: 10.1037/tra0001948. Online ahead of print.

ABSTRACT

OBJECTIVE: The Roboski massacre, which took place on December 28, 2011, is remembered as a major tragedy resulting from a cross-border operation by the Turkish Air Force that led to the loss of 34 civilians, including 19 children. This event not only caused significant physical losses but also left a profound psychological, social, and political impact on those affected. An enhanced comprehension of prolonged grief disorder’s development can assist professionals in identifying bereaved individuals requiring assistance and augment the efficacy of treatments. The aim of this study is to examine the relationship between the grief process and symptoms of posttraumatic stress, perceived discrimination, and political trust within the framework of the theory of prolonged grief in a sample of the bereaved family members who lost their relatives in the Roboski massacre almost 12 years postloss.

METHOD: In total, 88 Kurdish individuals (M_age = 37.13, SD = 16.4; 53.4% males) who had lost their close relatives in the Roboski incident in 2011 participated in this study. The Prolonged Grief Scale, the Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the Perceived Discrimination Scale, and the Political Trust Scale were used to collect data.

RESULTS: The findings of the study revealed that, even approximately 12 years after the Roboski massacre, a significant portion of the participants continue to experience symptoms of prolonged grief and posttraumatic stress reactions. There was a positive correlation between prolonged grief symptoms and posttraumatic stress reactions (r = .71) as well as perceived discrimination (r = .53). It was also found that the subdimensions of posttraumatic stress, namely “reexperiencing” (β = .19, p < .05), “negative cognitive alterations” (β = .39, p < .05), and “perceived collective discrimination” (β = .11, p < .05), were significant predictors of prolonged grief.

CONCLUSIONS: Our findings revealed that professionals should focus on identifying bereaved people who experience prolonged grief after a traumatic loss. Targeting these symptoms may alleviate the exacerbation of persistent grief reactions several years after a traumatic loss. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

PMID:40338538 | DOI:10.1037/tra0001948

Psychol Trauma. 2025 May 8. doi: 10.1037/tra0001937. Online ahead of print.

ABSTRACT

OBJECTIVE: Natural disasters are a salient source of traumatic exposures for many youth, although not all youth exposed to these traumatic experiences go on to develop posttraumatic stress symptoms or other maladaptive reactions. Given the low resource context and high need for psychological support engendered by natural disasters globally, efficient, evidentiary, culturally appropriate tools for assessing risk are needed to effectively identify youth most in need of services.

METHOD: The present study used a sample of 96,108 Puerto Rican youth collected in 2018, 5-9 months after Hurricane Maria in 2017, to examine the psychometric properties of a Spanish translation of the University of California Los Angeles Posttraumatic Stress Disorder Reaction Index-Brief Form (RI-5-BF). Participants completed measures of hurricane exposure, posttraumatic stress symptoms, and depressive symptoms.

RESULTS: Results indicated a strong fit between the data and the four-factor Diagnostic and Statistical Manual of Mental Disorders, fifth edition, model of posttraumatic stress disorder (root-mean-square error of approximation = .030, 90% confidence interval [.029, .031], Tucker-Lewis index = .976, comparative fit index = .983) and multigroup factor analysis indicated measurement invariance by gender at the scalar level. Normative values for this population by grade and gender were also estimated by examining the descriptive statistics of participants’ responses and convergent validity analysis indicated a strong relationship between the University of California Los Angeles Posttraumatic Stress Disorder Reaction Index-Brief Form total score and a measure of depressive symptoms (r = .64).

CONCLUSIONS: The implications of psychometric research for improving global efforts to triage and respond to psychological distress in the aftermath of natural disasters are discussed, with an emphasis on the critical need for psychometric research to diversify through development and adaptation of instruments in global populations. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

PMID:40338537 | DOI:10.1037/tra0001937

Clin Implant Dent Relat Res. 2025 Jun;27(3):e70049. doi: 10.1111/cid.70049.

ABSTRACT

OBJECTIVES: To investigate the trueness of intraoral photogrammetry (IPG) technology for complete-arch implant digital impression and evaluate the effect of implant number.

MATERIAL AND METHODS: All data were fully anonymized in compliance with ethical standards, and a total of 30 complete-arch patient models with 4 (n = 13), 5 (n = 9), or 6 (n = 8) implants were selected from the archive. Digital impressions were taken with IPG and a desktop scanner. Test and reference standard tessellation language (STL) files were superimposed using a best-fit algorithm. For each implant position, mean linear (ΔX, ΔY, ΔZ axes) and angular deviations (ΔANGLE) and three-dimensional (3D) Euclidean distances (ΔEUC) were measured as primary outcomes with a dedicated software program (Hyper Cad S, Cam HyperMill, Open Mind Technologies) and reported as descriptive statistics. Secondary aim was to determine using linear mixed models whether implant number affected trueness. All statistical analyses were conducted using Stata 18 (Stata Corp, College Station) and significance was set at 0.05.

RESULTS: A total of 30 definitive casts with 4 (n = 13), 5 (n = 8), and 6 (n = 9) multi-unit abutment (MUA) analogs were analyzed (n = 146 implant positions). The mean deviations along the X-axis were -3.97 ± 32.8 μm, while along the Y-axis, they were -1.97 ± 25.03 μm. For the Z-axis, a greater deviation of -33 ± 34.77 μm was observed. The 3D Euclidean distance deviation measured 57.22 ± 27.41 μm, and the angular deviation was 0.26° ± 0.19°. Statistically significant deviations were experienced for ΔZ, ΔEUC, and ΔANGLE (p < 0.01). Additionally, the number of implants had a statistically significant effect only on the Z-axis deviation (p = 0.03).

CONCLUSIONS: Within study limitations, IPG technology was feasible for complete-arch digital implant impression with mean linear, angular, and 3D deviations far below the acceptable range for a passive fit. Reported IPG trueness might avoid a rigid prototype try-in. The implant number had no influence on trueness except for Z-axis deviations. Integrating photogrammetry with intraoral optical scanning (IOS) improved practicality, optimizing the digital workflow. Further clinical trials are needed to confirm these findings.

PMID:40338525 | DOI:10.1111/cid.70049

Curr Rev Musculoskelet Med. 2025 May 8. doi: 10.1007/s12178-025-09973-8. Online ahead of print.

ABSTRACT

PURPOSE OF REVIEW: Virtual reality (VR) simulation in orthopedic education has gained recent interest in the literature. VR simulation provides a virtual space to practice surgical steps accurately, creating a user-controlled environment for novice surgical trainee skill development. Despite the reported benefits, VR is not routinely incorporated into orthopedic residency core curriculum. This study reviews and synthesizes contemporary data assessing the efficacy of VR simulation in orthopedic surgical training.

RECENT FINDINGS: Twenty-three studies across six subspecialty areas were included. Seven hundred and forty-eight participants trained on over nine different VR simulators. Control groups included no additional training, surgical technique guides, surgical videos, and benchtop simulators. Outcome measurements included procedure-specific checklists, objective grading scales, time-to-task completion, and accuracy of implant placement, among others. No outcomes directly focused on patient safety or involved live patients. Across disciplines, VR simulation training improved outcomes when compared to controls, conferring quicker procedure times, higher correct step completion, and more accurate implant placement, although not always statistically significant. Virtual reality is a tool employed by various industries that offers immersive, interactive, and realistic learning experiences. In orthopedics, VR has the potential to enhance skills, improve safety, and increase trainee confidence. In most of the included studies, trainees performed better in the VR simulation groups when compared to control education modalities, and participants readily embraced VR. However, there is mixed evidence on its use, and future studies are needed involving longitudinal VR education to better assess the actual impact on trainee skills, as well as performance in the operating room and its impact on patient outcomes.

PMID:40338491 | DOI:10.1007/s12178-025-09973-8

Maxillofac Plast Reconstr Surg. 2025 May 8;47(1):9. doi: 10.1186/s40902-025-00463-y.

ABSTRACT

OBJECTIVE: Concha bullosa, a common anatomical variation characterized by air-filled cavities in the turbinate bones, can influence sinonasal function and surgical planning. This study aims to evaluate the distribution, laterality, and cranial skeletal type associations of concha bullosa (CB) among patients with confirmed CB findings on computed tomography (CT) scans.

METHODS: A retrospective cohort study was conducted on 774 patients who underwent cranial and facial CT scans between March 2023 and March 2024. Patients were classified into mesocephalic, brachycephalic, and dolichocephalic groups based on the cephalic index. The distribution and laterality of concha bullosa were assessed using CT scans, and statistical analyses were performed using the Chi-square test, with a significance level set at P < 0.05.

RESULTS: Among CB-positive patients, left-sided concha bullosa was most common (49.48%), followed by right-sided (31.91%) and bilateral (18.6%) involvement. Mesocephalic individuals constituted the largest proportion of CB-positive cases (55.56%), followed by dolichocephalic (22.86%) and brachycephalic (21.57%) individuals. A significant gender difference was observed in the mesocephalic (P = 0.001) and brachycephalic (P = 0.013) groups, with males exhibiting a higher prevalence of right-sided and bilateral concha bullosa.

CONCLUSION: Concha bullosa distribution varies significantly among cranial skeletal types among CB-positive patients, with mesocephalic individuals exhibiting the highest overall prevalence. Our findings underscore the influence of cranial morphology on the presentation of CB. This insight may enhance radiological evaluation and individualized surgical planning in CB-positive patients.

PMID:40338478 | DOI:10.1186/s40902-025-00463-y

Discov Oncol. 2025 May 8;16(1):688. doi: 10.1007/s12672-025-02453-y.

ABSTRACT

OBJECTIVE: To construct a machine learning (ML) model to predict the progression of chronic atrophic gastritis (CAG) to gastric cancer (GC), given its precancerous significance.

METHODS: Using medical records from the Affiliated Hospital of Qingdao University, common laboratory indicators were extracted. LASSO regression identified 10 core risk factors, which were further analyzed using binary logistic regression to develop a nomogram model in R. The model’s performance was evaluated using receiver operating characteristic (ROC) curves, the concordance index (C-index), calibration curves, and decision curve analysis (DCA).

RESULTS: The model showed excellent performance, with a C-index of 0.887. The key factors included sex, coagulation, blood cell indexes, and blood lipid levels. The ROC areas were 0.892 (quantitative) and 0.853 (qualitative), confirming model reliability.

CONCLUSION: A new nomogram model for assessing GC risk in CAG patients was successfully developed. However, due to data collection and time limitations, future studies should expand the sample size, perfect the validation process, and optimize the model to achieve more accurate risk prediction.

PMID:40338419 | DOI:10.1007/s12672-025-02453-y

Int Ophthalmol. 2025 May 8;45(1):179. doi: 10.1007/s10792-025-03532-3.

ABSTRACT

PURPOSE: Pars plana vitrectomy (PPV) with various forms of tamponade and retinopexy is often the primary treatment for retinal detachment. However, a rare but serious complication is sterile keratolysis. We therefore aimed to evaluate the prevalence and potential risk factors for the development of corneal ulceration following vitreoretinal surgery for retinal detachment.

METHODS: This is a single-centre retrospective study including 14 cases of patients presenting to our department with sterile keratolysis involving the stroma after one or more PPVs for retinal detachment or vitreous hemorrhage. Time of primary procedure, time of onset of corneal complications, comorbidities, type of tamponade used, use of endophotocoagulation, cryoretinopexy and number of surgeries were recorded. Patients with additional comorbidities confounding a possible correlation were excluded from the case series.

RESULTS: A total of 14 patients were identified with corneal complications after pars plana vitrectomy for retinal detachment. Multiple vitrectomies were performed in 86% (12/14) of the cases. Surgical treatment consisted of six (43%) perforating keratoplasties and seven (50%) amniotic membrane keratoplasties in all but one patient. At an average of three months after the onset of corneal symptoms, the first corneal surgery was performed. Repeated corneal surgery was required in 4 patients (29%) and consisted of two penetrating keratoplasties and four amniotic membrane transplantation. Visual acuity at the first presentation of corneal complications was reduced (2.1 ± 0.6 logMAR), but was not statistically different from the visual acuity at baseline (1.6 ± 0.7 logMAR). At the last follow-up, visual acuity remained reduced at 1.8 ± 0.8 logMAR (p = 0.2).

CONCLUSIONS: The risk of sterile keratolysis seems to increase with excessive laser or cryo-retinopexy, use of silicone oil and repeated procedures. The initial vitrectomy was a complex surgery in all cases and required a longer operating time. Ciliary nerve damage of neurotrophic origin may be the cause of sterile keratolysis, and controlled retinopexy sparing the long ciliary nerves and avoiding cryotherapy may reduce the risk. Controlled studies are needed to investigate the causality between vitreoretinal surgery and sterile keratolysis.

PMID:40338390 | DOI:10.1007/s10792-025-03532-3

Int Ophthalmol. 2025 May 8;45(1):180. doi: 10.1007/s10792-025-03534-1.

ABSTRACT

PURPOSE: The aim of this study was to assess the tear film and meibomian gland function before and after cataract surgery using the Lacrydiag ocular surface analyzer.

METHODS: This was an observational prospective study including 34 eyes that underwent phacoemulsification at the Ophthalmology Department of Menoufia University Hospital from October 2023 to January 2024. The patients were evaluated pre-operatively as well as 1 week, 1 month, and 3 months postoperatively. Dry eye symptoms were assessed using the Ocular Surface Disease Index (OSDI) questionnaire. Traditional tear break up time (TBUT) was performed as well as Schirmer I test. The Lacrydiag Ocular Surface Analyzer was used for assessment of the tear film and meibomian glands.

RESULTS: Ocular surface analyzer evaluations revealed statistically significant changes at 1 week, 1 month, and 3 months after surgery in comparison to the values before surgery. Significant reductions were observed in non-invasive tear break-up time (NITBUT) and tear meniscus height, as well as in Schirmer’s test without anesthesia, and fluorescein break-up time at each postoperative interval. Some improvements were observed at 1 month and 3 months, however, measurements did not return to the initial preoperative levels. Ocular Surface Disease Index (OSDI) scores significantly increased after 1 week, 1 month, and 3 months post-surgery compared to preoperative levels. The proportion of meibomian gland area loss did not significantly increase after surgery (no structural alterations were noted).

CONCLUSION: The study shows that phacoemulsification impacts both tear quantity and quality, affecting overall tear film stability and ocular surface health.

PMID:40338375 | DOI:10.1007/s10792-025-03534-1

J Psycholinguist Res. 2025 May 8;54(3):34. doi: 10.1007/s10936-025-10145-5.

ABSTRACT

This is a condensed version of a series of talks given by Bernard Maskit at the Referential Process Workshop Conference, at the New York Psychoanalytic Society and Institute (July, 2023). Dr. Maskit discusses the Discourse Attributes Analysis Program (DAAP) which he created to evaluate psychotherapy and other texts utilizing measures of the Referential Process, a theory developed in the context of multiple code theory (Bucci in Psychoanalysis and cognitive science: a multiple code theory, Guilford Press, New York, 1997, 2023). Dr. Maskit’s emphasis is for his audience to understand how his system can be used technically and conceptually, and to provide updates on how measures can be aligned with time to produce new insights. In the first days of the Workshop, Dr. Maskit reviewed the development of the DAAP and its measures; sections of these talks are summarized here with references to relevant publications. He then went on to focus on development of the new TimeDAAP and its crucial role in the Referential Process project. We note with sadness that Dr. Maskit died before he could review and edit his presentation for publication. Wilma Bucci participated in the work presented here and prepared Dr. Maskit’s talks for publication. We thank Sean Murphy, Michael Peral and Perry Suskind for their invaluable contributions to this paper.

PMID:40338374 | DOI:10.1007/s10936-025-10145-5