Tag: pubmed

BMC Endocr Disord. 2025 Feb 28;25(1):57. doi: 10.1186/s12902-025-01889-1.

ABSTRACT

PURPOSE: Hip fracture is the most dangerous and potentially lethal fracture, described as “the last fracture of life” in older adults. Previous studies have shown that excessive immunoinflammatory response and nutrient deficiency may be involved. Nevertheless, a predictor for hip fracture risk that combines a thorough evaluation of immunoinflammatory with malnutritional conditions in postmenopausal women with type 2 diabetes mellitus (T2DM) remains scarce. This study explored the relationship between the SII/ALB ratio (SAR) and fragility fracture risk in postmenopausal older adults with T2DM.

METHODS: Between January 2014 and January 2021, a total of 509 postmenopausal female participants with T2DM were recruited from the Medical Record Database of the People’s Hospital of Guangxi Zhuang Autonomous Region. Finally, 363 participants with an age median of 69.00 (64.00-75.00), were eligible for inclusion in this analysis. According to the statistical tertiles of the SAR, all participants were split into three groups: low-level (≤ 98.24, n = 121), moderate-level (98.24-157.25, n = 121), and high-level (≥ 157.25, n = 121). The participants were followed up for seven years, with a median follow-up time of 45.9 months (1389 person-years). The relationships between the SAR and a real-world fragility fracture event and an individualized future 10-year probability of major osteoporotic fracture (MOF) and hip fracture (HF) calculated by the fracture risk assessment tool (FRAX) were evaluated through Spearman’s partial correlation analysis, restricted cubic spline (RCS) model, Cox proportional hazards regression model, and Kaplan-Meier survival analysis. Furthermore, some indicators such as geriatric nutritional risk index (GNRI), prognostic nutritional index (PNI), and SII were also calculated and compared to their diagnostic efficacy and the clinical application value through the receiver operating characteristic (ROC) curve analysis and the decision curve analysis (DCA), respectively.

RESULTS: Of the 363 participants, 69 suffered a real-world fragility fracture event (19%). Spearman’s partial correlation analysis indicated that SAR was negatively related to femoral neck (FN) bone mineral density (BMD) (r = -0.108, P = 0.041) and total hip (TH) BMD (r = -0.118, P = 0.025), but not lumbar spine (LS) BMD (all Models P > 0.05); positively correlated with an individualized future 10-year probability of MOF (r = 0.136, P = 0.010) and HF (r = 0.139, P = 0.008) calculated by FRAX, especially in hip fracture risk. The RCS model demonstrated the relationship between the SAR and a fragility fracture endpoint event in a J-shaped dose-dependent manner (P for overall < 0.001, P for nonlinear = 0.866). Multivariate Cox regression analysis indicated that the SAR was positively associated with fragility fracture risk (P < 0.001). Kaplan-Meier survival analysis showed that patients with higher levels of SAR had a greater probability of fragility fracture risk (log-rank, P < 0.0001). The ROC curve demonstrated an optimal SAR cut-off value of 146.209 with an area under the curve (AUC) of 0.740, a sensitivity of 0.681, and a specificity of 0.701 (P < 0.001). According to the AUC values, the ROC curve analysis combined with the DCA illustrated that the diagnostic efficacy and the clinical application benefit ranked as follows: SAR > SII > PNI > GNRI, respectively.

CONCLUSION: Our findings show the SAR is a novel dual-dimensional powerful predictor for fragility fracture risk, especially hip fracture, and as an effective tool for developing fragility fracture prevention strategies in postmenopausal females with T2DM. Consequently, monitoring SAR levels in usual clinical practice to focus on immunoinflammatory and nutritional status to identify individuals at high risk of hip fracture and implement timely fracture interventions is particularly essential.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40016771 | DOI:10.1186/s12902-025-01889-1

BMC Med Educ. 2025 Feb 27;25(1):321. doi: 10.1186/s12909-025-06849-w.

ABSTRACT

BACKGROUND: The purpose of this study was to evaluate the performance of widely used artificial intelligence (AI) chatbots in answering prosthodontics questions from the Dentistry Specialization Residency Examination (DSRE).

METHODS: A total of 126 DSRE prosthodontics questions were divided into seven subtopics (dental morphology, materials science, fixed dentures, removable partial dentures, complete dentures, occlusion/temporomandibular joint, and dental implantology). Questions were translated into English by the authors, and this version of the questions were asked to five chatbots (ChatGPT-3.5, Gemini Advanced, Claude Pro, Microsoft Copilot, and Perplexity) within a 7-day period. Statistical analyses, including chi-square and z-tests, were performed to compare accuracy rates across the chatbots and subtopics at a significance level of 0.05.

RESULTS: The overall accuracy rates for the chatbots were as follows: Copilot (73%), Gemini (63.5%), ChatGPT-3.5 (61.1%), Claude Pro (57.9%), and Perplexity (54.8%). Copilot significantly outperformed Perplexity (P = 0.035). However, no significant differences in accuracy were found across subtopics among chatbots. Questions on dental implantology had the highest accuracy rate (75%), while questions on removable partial dentures had the lowest (50.8%).

CONCLUSION: Copilot showed the highest accuracy rate (73%), significantly outperforming Perplexity (54.8%). AI models demonstrate potential as educational support tools but currently face limitations in serving as reliable educational tools across all areas of prosthodontics. Future advancements in AI may lead to better integration and more effective use in dental education.

PMID:40016760 | DOI:10.1186/s12909-025-06849-w

J Orthop Surg Res. 2025 Feb 28;20(1):214. doi: 10.1186/s13018-025-05612-7.

ABSTRACT

BACKGROUND: Adolescent idiopathic scoliosis (AIS) is one of the most prevalent spinal abnormalities. Core stabilization exercise (CSE) has become a common approach in the treatment of AIS. However, the efficacy of CSE in AIS remains a subject of debate.

OBJECTIVE: To determine the efficacy of CSE in the patients with AIS in comparison with different intervention programs.

METHODS: A comprehensive search was conducted across PubMed, Embase, The Cochrane Library, Web of Science, Wan Fang, Wei Pu, and CNKI databases, encompassing literature from their inception through December 31st, 2024. Two independent reviewers screened the studies, with inter-rater agreement evaluated via kappa scores. Randomized control trials that focus on the efficacy and safety of CSE in AIS population were included in this systematic review. The risk of bias assessment was performed utilizing the National Institutes of Health Quality Assessment Tools (NIH-QAT). After quality assessments and information extraction, the meta-analysis was conducted with Review manager and the standard mean difference (SMD) was pooled among the measurement data derived from different studies. Cobb angle, angle of trunk rotation, apical vertebral rotation, Walter Reed Visual Assessment Scale, Posterior Trunk Symmetry Index, forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, SRS-22,, were focused as outcomes.

RESULTS: A total of 10 studies involving 449 subjects were included in this systematic review. The average Cobb angle was 22.86° ± 8.79°, and the intervention duration varied from 8weeks to 6months. The kappa score was 0.93. Subgroup analyses were performed based on the different control groups, National Institutes of Health Quality Assessment Tools (NIH-QAT) results, and intervention durations. The results indicated that CSE could have greater effect sizes than the blank control group on Cobb angle (MD = -4.37, P < 0.05), angle of trunk rotation (MD = -1.07, P < 0.05), apical vertebral rotation (MD = -0.44, P < 0.05), quality of life as SRS-22 (MD = 0.22, P < 0.05). Notably, the efficacy of CSE appears to be weaker than that of the three-dimensional exercise group in terms of Cobb angle (MD = 3.95, P < 0.05), angle of trunk rotation (MD = 1.69, P < 0.05) and WASRS scores (MD = 0.89, P < 0.05). Other subgroup analyses yielded no statistically significant differences.

CONCLUSIONS: The present study showed that core stabilization exercise may be beneficial for the patients with mild to moderate adolescent idiopathic scoliosis, albeit less effective than three-dimensional exercises following short-term follow-up. The evidence on the efficacy of CSE is limited due to heterogeneity, small sample sizes, and multiple comparisons. The clinical trials focusing on patient compliance and training quality with long-term follow-up are warranted.

PROSPERO REGISTRATION NUMBER: CRD 42022367714.

PMID:40016756 | DOI:10.1186/s13018-025-05612-7

World J Surg Oncol. 2025 Feb 27;23(1):67. doi: 10.1186/s12957-025-03725-1.

ABSTRACT

BACKGROUND: To explore the safety and feasibility of the modified approach for accessing the superior mesenteric artery (SMA) in total laparoscopic radical resection for right colon cancer.

METHODS: This single-center retrospective study included 107 patients who underwent total laparoscopic radical resection of right colon cancer at The First Affiliated Hospital of Wannan Medical College between August 2022 and December 2023. 53 patients were in the modified SMA approach (modified group) and 54 patients were in the traditional SMA approach (control group). The control group and modified group underwent total laparoscopic radical resection of right colon cancer, and the following baseline and pathological characteristics of the two groups were compared: intraoperative condition, postoperative recovery, and postoperative complications. Our modified surgical method was to isolate the mesocolon using a cranial(the ligament of Treitz) -to- caudal(the pedicle of ileocolic) pathway and the orderly ligation of blood vessels in the SMA.

RESULTS: There was no statistically significant difference in the baseline characteristics or pathological data between the two groups. Compared with the traditional SMA approach, the modified SMA approach had a shorter surgical time(P < 0.001) and vascular dissection time (P < 0.001) and less intraoperative blood loss (P = 0.000). There was no statistically significant difference in the number of total harvested lymph nodes or positive harvested lymph nodes between the two groups of patients (P > 0.05); There was no statistically significant difference in postoperative hospital stay, time to first flatus, time to pull out drainage tube and drainage between the two groups of patients (P > 0.05), and there was no statistically significant difference in the incidence of complications between the two groups of patients (P > 0.05).

CONCLUSION: The modified SMA approach in totally laparoscopic radical resection for right colon cancer can shorten the surgical and vascular dissection time, reduce intraoperative bleeding and reduce the surgical difficulty and intraoperative risk of the SMA approach for right colon cancer. In clinical practice, its safety and feasibility are relatively high, and it is worth promoting.

TRIAL REGISTRATION: The study was approved by the Ethics Committee of The First Affiliated Hospital of Wannan Medical College and registered with the China Clinical Trials Registry (ChiCTR2300075919, Date of Registration:2023-09-19- retrospective registration) http://www.chictr.org.cn/index.aspx .

PMID:40016739 | DOI:10.1186/s12957-025-03725-1

BMC Oral Health. 2025 Feb 27;25(1):313. doi: 10.1186/s12903-025-05676-1.

ABSTRACT

BACKGROUND: This study aimed to evaluate the prevalence of palatogingival groove (PGG) in maxillary incisors and its association with periapical lesions and periodontal bone loss.

METHODS: CBCT images from 943 patients were included. Age, sex, and the presence of PGG were recorded. PGG type was determined according to the Gu classification. All maxillary incisors of patients with PGG teeth were evaluated for periapical lesions and periodontal bone loss. Statistical analysis was performed with the Pearson chi-square test and Fisher’s exact test.

RESULTS: PGGs were present in 107 maxillary incisors (2.8%) of 89 patients (9.4%). PGGs were observed significantly less frequently in maxillary central incisors than in maxillary lateral incisors (p < 0.001). The most common PGG was type I (75.7%), followed by type II (15.9%) and type III (8.4%). PGGs were associated with periapical lesions and periodontal bone loss (p < 0.001). PGG teeth without periapical lesions or periodontal bone loss were mostly type I. When the PGG was type II or III, the teeth mostly had periapical lesions and periodontal bone loss (p < 0.001). A significant relationship was detected between the periapical lesion status and bone loss status in PGG teeth (p < 0.05).

CONCLUSIONS: PGGs were found mostly in maxillary lateral incisors. Most teeth with type II and III PGGs were characterized by periodontal bone loss and periapical lesions. Additionally, most PGG teeth with periodontal bone loss had periapical lesions. These findings imply that the presence of a PGG should be suspected in a maxillary incisor with a narrow periodontal pocket and periapical lesion but no caries, cracks, or restorations.

PMID:40016732 | DOI:10.1186/s12903-025-05676-1

BMC Nurs. 2025 Feb 27;24(1):222. doi: 10.1186/s12912-025-02870-y.

ABSTRACT

BACKGROUND: Occupational violence is a significant issue for nurses worldwide, impacting their well-being, job satisfaction, and patient care quality. This study investigated the prevalence, types, and effects of such violence on nursing staff in surgical wards in Murzuq locality hospitals, Libya, to inform effective prevention strategies.

METHODS: This cross-sectional study examined occupational violence against nursing staff in surgical wards across three hospitals in Murzuq, Libya. Using a convenience sampling approach, data were collected from 50 nurses in general surgical and emergency surgical wards over four weeks through a self-administered questionnaire. The variables included demographic data (gender, experience) and information on violence types, sources, impacts, and reduction strategies. The data were analysed via SPSS v27, with descriptive statistics applied. For inferential statistics, the chi-square test and Fisher’s exact test were conducted at a significance level of 0.05. Ethical approval was obtained from the academic research committee of Fezzan University, and informed consent was secured from all participants.

RESULTS: Verbal insults (60%) and discrimination (64%) were the most reported types of violence. Patient companions (68%) were identified as the primary source, followed by patients (40%) and colleagues (28%). Occupational violence significantly impacted nurses’ lives, with 62% reporting stress, 48% experiencing decreased job satisfaction, and 28% considering leaving their jobs. Additionally, 40% reported difficulty concentrating due to violence. Significant associations were found between gender and sources of violence (p ≤ 0.001) and between years of experience and types, sources, and impacts of violence (p ≤ 0.001).

CONCLUSION: These findings underscore the need for gender-sensitive interventions, comprehensive training, and support mechanisms to address workplace violence. Future research should explore the long-term effects of violence on nursing staff and the effectiveness of tailored interventions in different healthcare settings. The results highlight the critical role of improving work conditions and organizational policies to enhance workplace safety for nurses.

PMID:40016728 | DOI:10.1186/s12912-025-02870-y

BMC Womens Health. 2025 Feb 27;25(1):89. doi: 10.1186/s12905-025-03608-3.

ABSTRACT

PURPOSE: The aim of this study was to investigate the expression and clinical implications of CCN family member 5 (CCN5) and the oestrogen receptor (ER) in advanced breast cancer (BC).

METHODS: A total of 130 patients with advanced BC were selected for the study. Samples of normal breast tissue, ductal carcinoma in situ (DCIS), and invasive carcinoma were collected. The expression levels of CCN5 and ER in these tissues were examined using immunohistochemical methods. The correlation between expression of CCN5 and ER in different tissues and also differences in expression in invasive carcinoma were analysed. In addition, the relationship between CCN5 expression in advanced BC tissues and clinical pathological features was examined.

RESULTS: CCN5 and ER had low expression in normal breast tissues and invasive carcinoma tissues, but high expression in DCIS, with this difference being statistically significant (X² = 119.899, P < 0.001; X² = 113.524, P < 0.001, respectively). The expression of CCN5 and ER in different tissues of patients with advanced BC showed a positive correlation. Significant differences were also observed in the positive and negative expression of CCN5 and ER (X² = 56.358, P < 0.001). Moreover, the expression of CCN5 protein in advanced BC showed a statistically significant associations (P < 0.05) with the expression of the progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2), Ki-67, and P53, tumor diameter, histological grade, lymph node metastasis, pathological molecular subtype, and clinical staging.

CONCLUSION: High expression of CCN5 and ER was observed in DCIS tissues of patients with advanced BC, with their expression being positively correlated. These findings suggest that CCN5 and ER may have a potential synergistic role in the progression of BC that influences the progression of advanced BC and can also be used to predict the effectiveness of endocrine therapy.

PMID:40016720 | DOI:10.1186/s12905-025-03608-3

BMC Public Health. 2025 Feb 27;25(1):799. doi: 10.1186/s12889-025-22062-2.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has had repercussions in several areas. The indirect effects of the pandemic on healthy living behaviours are multiple and complex to assess. The aim is to assess the impact of the outbreak of COVID-19 pandemic in Italy on the most relevant modifiable behaviours risks for non-communicable diseases (NCDs).

METHODS: PASSI 2008-2023 data referring to a sample of 18-69-year-olds residing in Italy was used to estimate the prevalences of smoking, alcohol, fruit and vegetable consumption, and physical inactivity lifestyle. For each of these risks was used an interrupted time series (ITS) study with Generalized Least Squares (GLS) model to assess trends before and after the pandemic’s outbreak in Italy (March 2020). The “intervention” period is postulated as March 2020, and the “post-intervention” period extends from April 2020 to December 2023. In these models, the hypothetical situation without “intervention” and with the trend remains unchanged is commonly known as the ‘counterfactual’ scenario. Through ITS model both “counterfactual data” and “factual data” were obtained.

RESULTS: From 2008 to 2023, 532,115 people were interviewed. Results showed, during “post-intervention” period, significant differences between factual and counterfactual prevalences started in 2022 and strengthened during 2023 and for all of the four behavioural indicators analysed: smoking, high-risk alcohol consumption, fruit and vegetable consumption (both all three of them worsening) and physical inactivity (which appears to decrease). Current smokers exhibited similar prevalences in March 2020 (24.5% vs. 24.3%), followed by a plateau throughout the entire ‘post-intervention’ period. By December 2023, however, the counterfactual prevalence was significantly lower than the observed rate (24.5% factual vs. 22.7% counterfactual). The initial improvement observed in the prevalence of high-risk drinkers in March 2020 (13% factual vs. 17% counterfactual) was followed by a rapid worsening and in December 2023 the prevalence was significantly higher than expected (19.7% vs. 16.9%). The fruit and vegetable consumption worsened and the factual prevalence of five-a-day in December 2023 was significantly lower than counterfactual (6.6% vs. 9.0%). Physical inactivity following an initial worsening in March 2020 (albeit not statistically significant), appeared to decrease in December 2023, with the factual prevalence lower than counterfactual (26.9% vs. 32.4%).

CONCLUSIONS: Results found in this article showed at the end of studied period the achievement of a plateau for current smokers, a worsening in the high-risk alcohol consumption, in fruit and vegetable intakes and a reduction in physical inactivity. Understanding shifts in these lifestyle indicators is crucial for the proper design of interventions aimed at reducing the burden of NCDs.

PMID:40016716 | DOI:10.1186/s12889-025-22062-2

BMC Public Health. 2025 Feb 27;25(1):797. doi: 10.1186/s12889-025-22083-x.

ABSTRACT

BACKGROUND: Tuberculosis (TB) is a major public health problem, and understanding the geographic distribution of the disease is critical in planning and evaluating intervention strategies. This manuscript illustrates the application of Group-Based Trajectory Modeling (GBTM), a statistical method that analyzes the evolution of an outcome over time to identify groups with similar trajectories. Specifically, we apply GBTM to identify the evolution of the number of TB notifications over time across various geographic locations, aiming to identify groups of locations with similar trajectories. Locations sharing the same trajectory may be considered geographic TB clusters, indicating areas with similar TB notifications. We used data abstracted from clinic records in Limpopo province, South Africa, treating the clinics as a proxy for the spatial location of their respective catchment areas.

METHODS: Data for this analysis were obtained as part of a cluster-randomized trial involving 56 clinics to evaluate two active TB patient-finding strategies in South Africa. We utilized GBTM to identify groups of clinics with similar trajectories of the number of TB patients.

RESULTS: We identified three trajectory groups: Groups 1, comprising 57.8% of clinics; Group 2, 33.9%; and Group 3, 8.3%. These groups accounted for 30.8%, 44.4%, and 24.8% of total TB-diagnosed patients, respectively. The estimated mean number of TB-diagnosed patients was highest in trajectory group 3 followed by trajectory group 2 across the 12 months, with no overlap in the corresponding 95% confidence intervals. The estimated mean number of TB-diagnosed patients over time was fairly constant for trajectory groups 1 and 2 with exponentiated slopes of 0.979 (95% CI: 0.950, 1.004) and 1.004 (95% CI: 0.977, 1.044), respectively. In contrast, there was a statistically significant 3.8% decrease in the number of TB patients per month for trajectory group 3 with an exponentiated slope of 0.962 (95% CI: 0.901, 0.985) per month.

CONCLUSIONS: GBTM is a powerful tool for identifying geographic clusters of varying levels of TB notification when longitudinal data on the number of TB diagnoses are available. This analysis can inform the planning and evaluation of intervention strategies.

PMID:40016712 | DOI:10.1186/s12889-025-22083-x

Burns. 2025 Feb 18;51(4):107427. doi: 10.1016/j.burns.2025.107427. Online ahead of print.

ABSTRACT

INTRODUCTION: Split-thickness skin autografts are the gold standard for surgical treatment of burns. In preclinical studies, the use of SKINHEALTEX PLGA, an electrospun poly(lactic-co-glycolide) acid (PLGA) bioveil, placed between autografts and their bed has shown potential to stimulate dermal regeneration, increase graft take and improve scar quality. These properties have not yet been evaluated in human clinical trials.

OBJECTIVE: The primary goal of this study was to evaluate tolerability and safety of SKINHEALTEX PLGA on human tissues, specifically, split-thickness skin autografts and wound beds of debrided burns.

MATERIALS AND METHODS: A double-blind randomised controlled clinical trial was conducted with adult patients with deep burns requiring surgical treatment, for 4 years (November 2018 to September 2022). Each patient acted as their own control, and they were followed for 12 months. In the control area a skin autograft was applied, while in the treatment area SKINHEALTEX PLGA was interposed between the autograft and the bed. The outcome variables were incidence of adverse events, the percentage of graft take (evaluated clinically), and Vancouver Scar Scale and Patient and Observer Scar Assesment Scale scores.

RESULTS: The bioveil was well tolerated in the 26 patients that were recruited. No adverse events related to SKINHEALTEX PLGA were observed. No statistically significant differences were observed in split-thickness skin autograft take and subsequent scar quality between the control group (split-thickness skin autografts alone) and the autograft and SKINHEALTEX PLGA group.

CONCLUSION: This is the first clinical trial investigating the application of an electrospun biomaterial in the treatment of burns using skin autografts. SKINHEALTEX PLGA is a biocompatible and safe product that can be applied as an interface between autografts and the debrided bed of a burn without reducing graft take. Further research is needed to assess the value of SKINHEALTEX PLGA for burn wounds and its potential as an administration route of molecules than enhance dermal regeneration in burn patients.

PMID:40014884 | DOI:10.1016/j.burns.2025.107427