Tag: pubmed

BMC Pediatr. 2025 Mar 4;25(1):166. doi: 10.1186/s12887-025-05487-x.

ABSTRACT

OBJECTIVE: The study investigates the impact of age at initial diagnosis on the prognosis of pediatric hepatoblastoma (HB) patients, aiming to provide a basis for optimizing risk stratification.

METHODS: Data from 403 patients with HB diagnosed at the First Affiliated Hospital of Sun Yat-sen University between February 2010 and September 2023 were collected. Kaplan‒Meier survival analysis, Cox regression analysis, and binary logistic regression were employed for statistical analysis.

RESULTS: The hazard ratios (HRs) for event-free survival (EFS) reduction in HB patients were 1, 0.862, 1.393, 2.008, 1.325, 1.859, 3.667 (P = 0.001), and 2.502 (P = 0.023) for first-diagnosis ages of 0-1, 1-2, 2-3, 3-4, 4-5, 5-6, 6-8, and ≥ 8 years, respectively. After adjusting for newly diagnosed alpha-fetoprotein (AFP), pretreatment extent of tumor (PRETEXT) stage, and PRETEXT stage annotation factors, the prognosis of HB for patients diagnosed at ≥ 6 years old and < 6 years old remained significantly different. Children diagnosed at age ≥ 6 years who received the full-course high-risk group chemotherapy regimen had a higher EFS compared to those who did not receive the full-course high-risk group chemotherapy regimen (P = 0.033).

CONCLUSION: Age ≥ 6 years is an independent risk factor for poor prognosis in HB patients. The inclusion of patients aged ≥ 6 years at first diagnosis in the high-risk group for risk stratification was deemed appropriate. This age factor can guide adjustments in chemotherapy intensity.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40038677 | DOI:10.1186/s12887-025-05487-x

BMC Pediatr. 2025 Mar 5;25(1):167. doi: 10.1186/s12887-024-05181-4.

ABSTRACT

INTRODUCTION: Meconium aspiration syndrome is a life-threatening respiratory disease due to the aspiration of meconium-stained amniotic fluid into the lungs, resulting in neonatal morbidity and mortality. Impacts of meconium aspiration syndrome include respiratory failure, intellectual disability, persistent pulmonary hypertension, and air leaks. But there is a paucity of literature in Ethiopia, especially in the study area regarding the study topic. The aim of this study is to assess the proportion of meconium aspiration syndrome and associated factors among neonates admitted at the neonatal intensive care unit in North West Comprehensive Specialized Hospital, Northwest Ethiopia, 2023.

METHODS: -An institutional-based cross-sectional study was conducted among 414mothers-neonate pairs from April 15-May 15/2023. Systematic random sampling was used to obtain study participants. Maternal interviews and a review of neonatal charts were used to gather data from 414 respondents. Then the collected data was entered and coded into EPi-Data version 4.6.0.2 and exported to STATA version 14 for analysis. Both the bi-variable and multi-variable logistic regression models were used for analysis. AOR and 95% CI were used to measure association and strength, with statistical significance assessed at a p-value < 0.05.

RESULTS: – A total of 414 neonate-mother pairs were involved with a 98% response rate. The overall prevalence of meconium aspiration syndrome was 23.43% with a 95% CI (19.6-27.8). Gestational age ≥ 41 wks (AOR = 4.8, CI = 2.02-11.22), labor duration ≥ 12 h (AOR = 2, 95%CI = 1.10-3.84), Premature Rupture of Membrane (AOR = 4.6, 95%CI = 1.12-10.12), oligohydramnios (AOR = 4.2, 95%CI, 2.17-8.14) and breech presentation (AOR = 6.9, 95%CI = 2.169-8.13) were significantly associated with meconium aspiration syndrome.

CONCLUSION AND RECOMMENDATION: The prevalence of meconium aspiration syndrome was relatively high. And Postterm gestation, oligohydramnios, duration of labor, Premature Rupture of Membrane, and breech presentation increased the prevalence of meconium aspiration syndrome. Therefore, to reduce the risk of meconium aspiration syndrome, Health professionals should assess laboring women for the presence of these factors and should stay alert to detect MSAF early for better fetal and maternal health outcomes.

PMID:40038672 | DOI:10.1186/s12887-024-05181-4

BMC Med Educ. 2025 Mar 4;25(1):331. doi: 10.1186/s12909-025-06918-0.

ABSTRACT

BACKGROUND: Sepsis is one of the most challenging and complex clinical states, with persistently high mortality rates. Guidelines recommend the early identification of sepsis patients and immediate initiation of the Hour-1 Bundle treatment to reduce mortality from sepsis. Emergency nurses play a vital role in the early screening of sepsis. Studies indicate that mind mapping and In-Situ Simulation (ISS) training not only aid healthcare professionals in reinforcing theoretical knowledge retention but also enhance skills in coordination, task management, and communication during simulation exercises. This, in turn, promotes the effective implementation of various treatments during resuscitation. The combination of theoretical and practical training methods is more effective than a single training approach. In June 2023, our hospital’s emergency department conducted training for emergency nurses on sepsis mind mapping combined with ISS.

OBJECTIVE: To explore the effect of mind mapping combined with ISS training in promoting the emergency nurses’ implementation of the Hour-1 Bundle in sepsis patients.

METHODS: Using mind mapping and ISS training methods, 24 emergency nurses were divided into 6 groups for a 12-week training period. The study compared their pre- and post-training knowledge of sepsis, identification and diagnostic time, Hour-1 Bundle treatment completion rate, and non-technical skill scores. Post-training, the emergency nurses evaluated the effectiveness of the training.

RESULTS: The scores for sepsis knowledge among emergency nurses before and after training were 44.17 ± 9.21 and 60.42 ± 5.29, respectively. The identification and diagnostic times (hours) were 0.63 ± 0.18 and 0.49 ± 0.13, respectively. The Hour-1 Bundle treatment completion rates were 58.33% and 85.7%, respectively. There was a significant increase in all non-technical skill scores, with statistical significance (P < 0.05, P < 0.001). After two ISS trainings, the SET-M scores progressively increased, indicating a high satisfaction rate among nurses with the mind mapping and ISS training.

CONCLUSION: The combination of mind mapping and ISS training enables emergency nurses to identify sepsis earlier and promotes the effective implementation of the Hour-1 Bundle treatment in sepsis patients, while also enhancing their cognitive understanding of sepsis and non-technical skills.

PMID:40038666 | DOI:10.1186/s12909-025-06918-0

BMC Public Health. 2025 Mar 4;25(1):856. doi: 10.1186/s12889-025-22067-x.

ABSTRACT

BACKGROUND: Treatment adherence is one of the major challenges in methadone maintenance treatment (MMT). This study aimed to investigate the effect of educational intervention using a transtheoretical model (TTM) on adherence to MMT.

METHODS: This quasi-experimental educational intervention study was conducted in Shiraz, Fars Province, Iran (2019), with 114 men aged 20 to 50 years. Participants were recruited using a two-stage cluster random sampling method. The mean age of the participants in the intervention group (n = 58) was 36.98 ± 7.76 years, while the control group (n = 56) had a mean age of 39.44 ± 6.54 years. The intervention group attended five educational sessions based on the Trans theoretical Model (TTM). Data analysis was conducted using SPSS with a significance level set at < 0.05. Statistical methods included Chi-square, paired t-test, independent t-test, and non-parametric tests when the data were not normally distributed.

RESULTS: The results indicated no significant difference between the two groups in terms of self-liberation, counter-conditioning, helping relationships, stimulus control, reinforcement management, temptation, confidence, and adherence to MMT before the intervention (p > 0.05). However, two months after the intervention, the intervention group showed a significant increase in each of the mentioned constructs (p < 0.05) except counterconditioning and MMT adherence.

CONCLUSION: The study’s findings indicate that the educational program successfully improved participants’ knowledge and skills regarding the processes of change, as well as their self-efficacy, which was assessed through two key constructs: temptation and confidence. However, the program did not succeed in enhancing participants’ adherence to treatment. Policymakers should consider integrating structured educational programs based on the Theory of Planned Behavior (TPB) into existing Medication Management Therapy (MMT) services. This approach aims to enhance patients’ understanding of their treatment processes and promote adherence. Furthermore, since the intervention positively impacted self-confidence and self-efficacy, it is advisable to develop policies that focus on educating patients to bolster their self-efficacy in resisting drug-related temptations. Future studies should also aim to include diverse populations, such as women and individuals from various age groups, to assess the generalizability of the findings beyond the male participants from specific regions.

PMID:40038646 | DOI:10.1186/s12889-025-22067-x

BMC Med Educ. 2025 Mar 4;25(1):334. doi: 10.1186/s12909-024-06623-4.

ABSTRACT

BACKGROUND: In dental radiography education, students typically observe instructor demonstrations and practice on mannequins or peers. However, owing to the large student-to-instructor ratio, providing individualized feedback is challenging. Repeated practice is also hindered by radiation exposure from dental radiography machines. Implementing three-dimensional (3D) object-based virtual reality (VR) simulations can address these concerns. We developed a 3D object-based VR-simulation tool for dental radiography learning (namely, 3DOVR-DR) and evaluated user experiences.

METHODS: For the development of 3DOVR-DR, a virtual dental radiography room was constructed using 3D objects. The intraoral radiography process was divided into 12 steps, and the Unity 3D engine was used to create an interactive VR environment for step-by-step learning. This study was a randomized controlled trial. To evaluate user experience, 79 participants were randomly assigned to a control group (n = 39), which used Google Cardboard for VR, or an experimental group (n = 40), which used 3DOVR-DR, to evaluate the user experience. A survey questionnaire of 22 items was administered to all participants. Statistical analyses included descriptive statistics and Mann-Whitney U test.

RESULTS: The 3DOVR-DR tool provided an immersive experience for simulating and learning the dental radiography process within a VR setting. Users performed step-by-step tasks related to dental radiography in the virtual space, adjusting and repeating the entire process or specific steps as needed for their learning. Users received guidance and practiced dental radiography using 3DOVR-DR. User-experience ratings were significantly higher in the experimental group (4.35±0.47) compared to the control group (3.63±0.66; P < 0.001).

CONCLUSIONS: The 3DOVR-DR tool shows potential as a learning medium for intraoral radiography education. Further analysis is needed to examine the impact and mediating effects of the 3D object-based VR experience on dental radiographic practice. Future research should include pedagogical analysis to evaluate the educational effectiveness of this learning tool.

PMID:40038644 | DOI:10.1186/s12909-024-06623-4

BMC Cancer. 2025 Mar 4;25(1):395. doi: 10.1186/s12885-025-13770-4.

ABSTRACT

BACKGROUND: The association between the oral pathogen Porphyromonas gingivalis (PG) and the gut microbiota in colorectal cancer (CRC) patients has been explored with inconsistent results. This study aims to systematically assess this potential association.

MATERIALS AND METHODS: A systematic review was conducted across three databases (Pubmed, Embase and Web of Science) from inception up to January 2023 and updated until November 2024. Inclusion criteria were observational studies examining PG in the microbiota of adults with CRC compared to healthy controls. Exclusion criteria were studies without control group of healthy individuals, other designs or without full-text access. Two reviewers independently selected and extracted data following a pre-registered protocol. Disagreements were resolved by consensus or with a third reviewer. Risk of bias (RoB) was assessed using the Newcastle-Ottawa Scale (NOS). Results were summarized with a flow diagram, tables, and narrative descriptions. Meta-analysis was not feasible, so Fisher’s method for combining p-values and the sign test were used as alternative integration methods.

RESULTS: Finally, 18 studies, with 23 analysis units were included, providing a total sample of 4,373 participants (48.0% cases and 52.0%controls), 38.2% men and 61.8% women, with a similar distribution among cases and controls. The mean (SD) age of cases was 63.3 (4.382) years old and 57.0 (7.753) years for controls. Most of the studies analyzed the presence of PG in feces (70.0%) collected before colonoscopy (55.0%) and were classified with good quality (70.0%) in the RoB assessment. Results suggested an effect (Fisher’s test, p = .000006) with some evidence towards a positive association of PG in CRC patients compared to healthy controls (Sign test, p = .039).

CONCLUSIONS: Results of the systematic review suggest that PG is associated with the microbiota of CRC patients. Lack of information to calculate the effect size prevented the performance of a meta-analysis. Future research should aim for standardized protocols and statistical approaches.

FUNDING: No funding was received for this work.

SYSTEMATIC REVIEW REGISTRATION: The research protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 2023 (registration number: CRD42023399382).

PMID:40038641 | DOI:10.1186/s12885-025-13770-4

BMC Public Health. 2025 Mar 4;25(1):866. doi: 10.1186/s12889-025-22103-w.

ABSTRACT

BACKGROUND: COVID-19 caused a significant impact on food security; particularly among low- and middle-income countries. The objective of the current study was to assess both the direct and indirect impact of COVID-19 on individuals’ food security in the metropolitan and regional context of Ethiopia.

METHODS: This project utilized a retrospective study design with a mixed methods approach. It assessed the food insecurity experience of individuals both before and after the emergence of COVID-19 through the Food Insecurity Experience Scale (FIES). Food sellers were interviewed to identify the factors that increased post-COVID-19 emergence food insecurity. Inferential analysis using ordinal logistic regression was undertaken based on the Polytomous Universal Model (PLUM) procedure.

RESULTS: The size of the family and the type of work for income generation were statistically associated (p < 0.05) with the food security of individuals, both before and after COVID-19 emergence. Location (p = 0.002, odds = 0.37), age (p = 0.002, odds = 2.57) and educational status (p = 0.001, odds = 0.24/) of individuals had a statistically significant effect on the food security of individuals before COVID-19 emergence only. The ordinal value of all FIES indicators increased after COVID-19 emergence compared with pre-pandemic food insecurity. Overall food security of individuals was reduced by 21.5%, with the moderate and severe food insecurity of individuals increasing by 13.1% and 15.9%, respectively. The COVID-19 preventive measures that affected the individuals’ food security, in the order of their priority, were: transport bans; food price increment; lockdown measures; job loss; market bans; social distance restrictions; fear of the pandemic; movement restrictions; over-buying; food inaccessibility; and, lack of cash due to bank closure. In addition, pre-existing non-pandemic related natural and man-made disasters played a role in the food security crisis, including drought, war, and desert locust emergence.

CONCLUSION: The COVID-19 pandemic has directly and indirectly affected individuals’ food security. Learning from the experiences of COVID-19 may assist governments in preparing for future pandemics. Suggested improvements include forming impact reduction task forces and establishing disease prevention strategies that will not compromise food security.

PMID:40038640 | DOI:10.1186/s12889-025-22103-w

Cancer Epidemiol Biomarkers Prev. 2025 Mar 4. doi: 10.1158/1055-9965.EPI-24-1442. Online ahead of print.

ABSTRACT

BACKGROUND: Recent genome-wide association studies (GWAS) have identified new susceptibility loci for melanoma, but their associations with multiple primary melanoma (MPM) are unclear.

METHODS: We investigated the associations of 69 single nucleotide polymorphisms (SNPs) in 39 GWAS-identified loci with odds of MPM relative to single primary melanoma (SPM) in the international, population-based Genes, Environment, and Melanoma (GEM) study. Per-minor allele odds ratios (ORs) and 95% confidence intervals (CIs) for individuals with MPM ‘cases’ (n=1,205) relative to SPM ‘controls’ (n=2,458) were estimated using multivariable logistic regression, and polygenic risk scores (PRS) were calculated and weighted based on a 2020 GWAS meta-analysis (57 of the 68 independent GWAS SNPs available).

RESULTS: Thirteen SNPs in 11 gene regions (PARP1, CYP1B1/RMDN3, TERT, RAPGEF5, TYRP1, MTAP, CDKN2A/CDKN2B, KLF4, TYR, SOX6, ASIP) were statistically significantly associated (P<0.05) with MPM adjusting for age, sex, age-by-sex interaction, and study center. The highest vs. lowest PRS quintile was associated with a 2.81-fold higher odds of MPM (95% CI: 2.10-3.78; P=7.5×10-13); this association was attenuated but remained statistically significant after excluding SNPs individually associated with MPM (OR=1.75, 95% CI: 1.32-2.31).

CONCLUSIONS: Inherited genetic variants spanning 11 gene regions were independently associated with MPM. Non-significant SNPs were associated with MPM when aggregated into a PRS, indicating their cumulative effect may influence MPM risk despite lacking individual statistical significance in our study population.

IMPACT: Our findings provide additional evidence that these loci are associated with melanoma risk and estimate the magnitude of their genetic effect on subsequent (multiple) primary melanoma risk.

PMID:40036058 | DOI:10.1158/1055-9965.EPI-24-1442

Cancer Epidemiol Biomarkers Prev. 2025 Mar 4. doi: 10.1158/1055-9965.EPI-24-1408. Online ahead of print.

ABSTRACT

BACKGROUND: Cervical cancer is the second leading cause of cancer death among women in Addis Ababa and other parts of Ethiopia. Yet, there are limited age-eligible city-wide data on cervical cancer screening prevalence in Addis Ababa to inform public policy.

METHODS: A population-based cross-sectional study was conducted among 1881 screening eligible women aged 30-49 years who were selected from 63 enumeration areas in Addis Ababa based on multistage sampling and proportional sample size allocation. Logistic regression was used to identify barriers to screening. All statistical tests were two-sided, p<0.05.

RESULT: 30.8% (95%CI: 28.8%, 33.0%) of study participants reported receipt of screening in the past 5 years. Overall, less than half (45.7%) of women reported that they received healthcare provider recommendation for screening, and only 15% of married women reported that they had spousal support for it. In the multivariable adjusted model, the odd of being screened was considerably higher in women with healthcare provider recommendation, with spousal support, and with good cervical cancer screening awareness and knowledge of risk factors for the disease. Factors associated with not seeking screening service included feeling healthy and perception of low risk for cervical cancer.

CONCLUSION: Cervical cancer screening uptake is low in Addis Ababa, and less than half received healthcare provider recommendation. Future studies should identify barriers to provider recommendations.

IMPACT: The findings underscore the need for a coordinated effort to enhance healthcare provider recommendations for cervical cancer screening and to raise awareness about the benefits of screening in the general population.

PMID:40036054 | DOI:10.1158/1055-9965.EPI-24-1408

Clin Orthop Relat Res. 2025 Feb 25. doi: 10.1097/CORR.0000000000003427. Online ahead of print.

ABSTRACT

BACKGROUND: Many musculoskeletal symptoms arise from the natural decline of cells and tissues with age (senescence). Among patients seeking care for those conditions, symptom intensity often corresponds more with thoughts and feelings about bodily sensations than with the severity of any pathophysiology. Population studies suggest that a large percentage of people manage to live with (accommodate) symptoms from these conditions without seeking care, and that as people age, healthy attitudes toward sensations from musculoskeletal senescence may help them accommodate these kinds of symptoms; to our knowledge, however, this has not been specifically studied.

QUESTIONS/PURPOSES: In a cross-sectional study of patients presenting for musculoskeletal specialty care, we asked: (1) Are there factors associated with accommodation of aging, including mindsets measured as levels of unhelpful thoughts, feelings of distress, and intolerance of uncertainty? (2) Are there any factors associated with pain intensity, including comfort with aging and mindset measures? (3) Are there any factors associated with level of capability, including comfort with aging and mindset measures?

METHODS: One hundred fifty-six English-speaking adults (age 18 to 89 years) presenting for initial or return specialist evaluation of a musculoskeletal problem (largely an unselected sample of patients with common lower and upper extremity problems) in a single large urban city in the United States agreed to participate. Among the 98% (153) who completed the survey and were analyzed, 57% (87) were women, the mean age was 53 ± 17 years, 69% (105) were non-Hispanic White, and 47% (72) had private insurance. Participants completed an 11-point ordinal measure of pain intensity, a measure of level of capability (a person’s perception of the level of difficulty of specific activities, distinct from objective impairment or incapacity), intolerance of uncertainty (that is, a negative regard for uncertainty), unhelpful thoughts (unhealthy misinterpretations) regarding sensations, feelings of distress (worry or despair) regarding sensations, and attitudes toward aging (quantified positive or negative regard for aging), all using instruments with evidence supporting their ability to measure these constructs. Factors associated with levels of accommodation of aging, pain intensity, and incapability were analyzed using multivariable regression models, limiting the models to a single mental health variable because of concerns about collinearity and selecting the best performing model based on the Akaike information criterion. To account for known and anticipated collinearity of the mental health measures, we also performed a k-means cluster analysis to identify statistical groupings of unhelpful thoughts regarding sensations, distress regarding sensations, and intolerance of uncertainty and tested for differences in attitudes toward aging, pain intensity, and capability using analysis of variance.

RESULTS: Accounting for potential confounders such as age, marital status, income status, unhelpful thoughts regarding symptoms, feelings of distress regarding symptoms, and intolerance of uncertainty that were associated in bivariate analysis, we found a small association between lower accommodation of aging and greater feelings of distress regarding symptoms (regression coefficient [RC] -0.17 [95% confidence interval (CI) CI -0.23 to – 0.11]; p < 0.01). Higher pain intensity had a modest association with greater feelings of distress (RC 0.4 [95% CI 0.2 to 0.5]; p < 0.001) and Medicaid insurance (RC 2.2 [95% CI -0.1 to 4.5]; p = 0.04) and a small inverse association with postcollege graduate education (RC -1.7 [95% CI -3.2 to -0.3]; p = 0.02). Higher levels of capability had a large association with less distress (RC -0.8 [95% CI -1.4 to -0.1]; p = 0.001), a small association with younger age (RC -0.2 [95% CI -0.3 to -0.1]; p = 0.005), and a medium association with postcollege graduate education (RC 5.9 [95% CI 0.4 to 11]; p = 0.04). The cluster analysis identified five statistical groupings of levels of unhelpful thoughts, feelings of distress, and intolerance of uncertainty that were associated with greater levels of healthier attitudes toward aging, pain intensity, and levels of capability.

CONCLUSION: The observation that people are less accommodative of aging to the degree that they experience greater intolerance of uncertainty, feelings of distress, and unhelpful thoughts about their body’s sensations-and that these factors are also associated with greater levels of discomfort and incapability-points to the importance of cultivating and maintaining a healthy mindset as we age. To help guide patients to a healthier regard for the aging body, musculoskeletal specialists and all clinicians can transition away from concepts of inflammation (tendinitis), injury (tear), or breakdown (bone-on-bone) toward more accurate and healthful words and concepts, such as those that emphasize expected changes in people’s bodies, that even painful activities are not off limits, and the importance of evolving one’s identity to match one’s body.

LEVEL OF EVIDENCE: Level III, prognostic study.

PMID:40036052 | DOI:10.1097/CORR.0000000000003427