Tag: pubmed

Emerg Radiol. 2025 Feb 26. doi: 10.1007/s10140-025-02321-w. Online ahead of print.

ABSTRACT

PURPOSE: Vertigo and dizziness are common complaints at emergency departments (ED), often leading to computed tomography (CT) and CT angiography (CTA) studies, which when used non-selectively, have low clinical utility. The study assesses whether two quality improvement interventions (educational rounds and clinical decision making support tool) can better align CTA ordering rates with clinical practice guidelines in the ED workup of vertigo/dizziness at a large community hospital.

METHODS: CTA head and neck imaging rates were collected for patients presenting to the hospital’s ED with dizziness/vertigo as the chief complaint during 6-month pre- and post-intervention periods and compared rates using the Chi-Square Test. The interventions were joint ED/Diagnostic Imaging/Stroke Neurology rounds discussing CTA head/neck indications and dissemination of a clinical decision making support tool.

RESULTS: The absolute reduction was 5.79% (N = 4,230, p < 0.001) in CTA rates for patients presenting with dizziness/vertigo between the pre- and post-intervention periods. For vertigo, the absolute reduction was 12.27% (N = 402, p < 0.005). For dizziness, the absolute reduction was 5.17% (N = 3828, p < 0.001). Despite the global decrease in CTA studies, there was no statistically significant decrease in CTA rates for the patients who were diagnosed with cerebrovascular accident or transient ischemic attack in the ED, indicating that the interventions were effective in limiting to the targeted CTA studies.

CONCLUSIONS: This project was effective in improving patient safety and system efficiency, while providing a framework for low-burden, effective, practice-modifying quality improvement initiatives.

PMID:40009296 | DOI:10.1007/s10140-025-02321-w

Biomech Model Mechanobiol. 2025 Feb 26. doi: 10.1007/s10237-025-01931-0. Online ahead of print.

ABSTRACT

In this work, we present the derivation of a novel model for the myocardium that incorporates the underlying poroelastic nature of the material constituents as well as the electrical conductivity. The myocardium has a microstructure consisting of a poroelastic extracellular matrix with embedded poroelastic myocytes, i.e. a double poroelastic material. Due to the sharp length scale separation that exists between the microscale, where the individual myocytes are clearly resolved from the surrounding matrix, and the length of the entire heart muscle, we can apply the asymptotic homogenization technique. The novel PDE model accounts for the difference in the electric potentials, elastic properties as well as the differences in the hydraulic conductivities at different points in the microstructure. The differences in these properties are encoded in the coefficients and are to be computed by solving differential cell problems arising when applying the asymptotic homogenization technique. We present a numerical analysis of the obtained Biot’s modulus, Young’s moduli as well as shears and the effective electrical activity. By investigating the poroelastic and electrical nature of the myocardium in one model, we can understand how the differences in elastic displacements between the extracellular matrix and the myocytes affect mechanotransduction and the influence of disease.

PMID:40009273 | DOI:10.1007/s10237-025-01931-0

Mol Neurobiol. 2025 Feb 26. doi: 10.1007/s12035-025-04783-y. Online ahead of print.

ABSTRACT

Post-stroke cognitive impairment (PSCI) leads to poor long-term stroke outcomes, severely increasing social and economic burdens. It is helpful to identify and intervene in PSCI in the early stage. This study intends to develop a new clinical risk score for identifying stroke survivors at significant risk of PSCI from the acute phase to 6 months of onset and to validate the new score using both internal and external cohorts. Analysis aiming to evaluate prognostic factors of acute-phase cognitive impairment lasting 6 months was carried out using two independent datasets, with one for model development and the other for validation. All enrolled patients completed baseline demographic, clinical, and imaging data collection and cognitive function scale assessment. The follow-up period was 6 months after the stroke, and interviews and cognitive function assessments were completed. A multivariate logistic regression analysis was performed, and the most important predictors were finally screened for modeling a prediction model. Six months post-stroke, 39.19% maintained PSCI in the development dataset. The final nine-point SHACEA (Stenosis, Hyperintensity, Age, Chronic cortical infarcts, Education, Atrophy) had an AUROC of 0.87 (95% CI 0.69-0.92) and was overall predictive of PSCI (LR χ² statistic of 89.34; p < 0.001). In the validation cohort, the SHACEA risk score was still relatively reliable in the validation cohort with an AUC of 0.74 (95% CI 0.71-0.80). The SHACEA risk score adequately identified acute stroke patients with cognitive impairment who are at an increased risk of developing PSCI after 6 months.

PMID:40009260 | DOI:10.1007/s12035-025-04783-y

Arch Dermatol Res. 2025 Feb 26;317(1):496. doi: 10.1007/s00403-025-03943-3.

ABSTRACT

Pain is the most impactful and burdensome symptom of hidradenitis suppurativa (HS) and profoundly affects patients’ quality of life. There is variation in how trials measure HS pain, with some reporting maximum and others reporting average 7-day pain. It remains unknown whether there is a difference between these measures and which is more strongly associated with quality of life in HS. This is a retrospective cross-sectional study of 257 adults with HS who received care in an HS Specialty Clinic from January 2019 to August 2021. Patients self-reported their average pain and maximum pain severity in the past 7 days measured on a numerical rating scale (0-10). The absolute difference between patient-reported average and maximum pain was calculated and assessed for statistical differences using a paired t-test. Multivariable linear regression was used to assess the correlation between the average versus maximum pain score with Skindex-16 quality of life (QoL) score. The maximum pain scores were significantly higher than the average, with a mean absolute difference of 0.83 points (95% CI: 0.74, 0.92) (p < 0.0001). The association between Skindex-16 QoL and average pain was not significantly different from Skindex-16 QoL correlation with maximum pain severity (p = 0.52). This study highlights a small but statistically significant difference in HS patients’ maximum and average 7-day pain severities. Both maximum and average 7-day score correlated with skin-related QoL, suggesting equipoise as outcome measures for clinical HS studies.

PMID:40009252 | DOI:10.1007/s00403-025-03943-3

Pediatr Surg Int. 2025 Feb 26;41(1):86. doi: 10.1007/s00383-024-05933-4.

ABSTRACT

PURPOSE: To explore differences based on level of pediatric spinal cord injury (SCI), we compared cervical and thoracic SCI in pediatric trauma patients (PTPs), hypothesizing higher mortality and length of stay (LOS) for cervical SCI.

METHODS: The 2017-2021 Trauma Quality Improvement Program was queried for all PTPs ≤ 17 years-old with cervical or thoracic SCI. Bivariate analyses compared the two groups. The primary outcome was mortality and secondary outcomes included hospital LOS and injury severity scores (ISS). Logistic regression models were used to determine independent risk factors for death and prolonged ventilation.

RESULTS: Of 5280 PTPs, 2538 (65.9%) had cervical SCI and 1316 (34.1%) had thoracic SCI. Motor vehicle collisions were the most common cause of both cervical and thoracic SCI (37.8 and 41.9%). PTPs with thoracic SCI had higher rates of positive drug screen as compared to cervical SCI (39.2 vs 29.8%, p = 0.001). PTPs with thoracic SCI had higher median ISS (25 vs 16, p < 0.001), while cervical SCI had higher mortality (13 vs 6.1%, p < 0.001) but decreased hospital LOS (median 9 vs 5 days, p < 0.001. Cervical SCI were associated with a nearly fourfold increase in the risk of death (95% CI 2.750-5.799, p < 0.001) and a 1.6-fold increase in the risk of prolonged ventilator requirement (95% CI 1.228-2.068, p < 0.001).

CONCLUSIONS: PTPs with cervical SCI have higher mortality while those with thoracic SCI have higher ISS and hospital LOS. Cervical SCI were associated with a fourfold higher risk of death. MVC was the most common cause of injury, and both groups had high rates of positive drug screens. Understanding differing outcomes may assist providers with prognostication and injury prevention.

PMID:40009251 | DOI:10.1007/s00383-024-05933-4

Exp Appl Acarol. 2025 Feb 26;94(3):40. doi: 10.1007/s10493-025-01009-7.

ABSTRACT

Species from various animal taxa have been found to use pheromonal communication underwater. Although the use of pheromones in water mites has been previously suggested, experimental evidence for it remains sparse. We examined the behavioral responses of male and female Arrenurus globator to water in which conspecifics of the same and the opposite sex had been kept, in order to test the hypothesis that chemical communication occurs between sexes. Results suggest a putative female-produced sex pheromone that stimulates at least the initial steps of mating behavior in males. Males exhibited arrestant behavior, leg fanning and readiness posture more in female-conditioned water than in male-conditioned or control water. In contrast, females showed no response to either male-conditioned water or female-conditioned water.

PMID:40009247 | DOI:10.1007/s10493-025-01009-7

Graefes Arch Clin Exp Ophthalmol. 2025 Feb 26. doi: 10.1007/s00417-025-06777-x. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the relationship between retinal layer thickness and cognitive function in elderly Chinese, accounting for the influence of axial length.

METHODS: The participants of the Beijing Eye Study 2011 which is a population-based cross-sectional study without any retinal or optic nerve disease underwent a series of ocular examinations including spectral-domain optical coherence tomography (OCT) of the retina. Using a multiple-surface OCT segmentation algorithm, the retina was automatically segmented into 9 layers. Cognitive function was evaluated applying the Mini Mental Statement Examination (MMSE). Cognitive impairment was defined as an MMSE score < 26.

RESULTS: The study included 2067 participants (56.7% women) (2067 eyes) with a mean age of 61.4 ± 8.4 years. After adjusting for age, gender and axial length, a lower cognitive function was related with a thinning of the ganglion cell layer (GCL) (P = 0.029, B = 0.04) and photoreceptor outer segment layer (POS) (P = 0.042, B = 0.04), while the retinal nerve fiber layer (RNFL) thickness (P = 0.144) was not significantly associated with the cognitive function score. For every unit decrease in MMSE score, the GCL and POS thickness separately decreased by 0.06 µm (95%CI: 0.01 µm, 0.12 µm), and 0.05 µm (95%CI: 0.002 µm, 0.10 µm). As compared with cognitively normal participants, those with cognitive impairment had a significantly thinner GCL (P = 0.019, OR = 1.04), and POS (P = 0.022, OR = 1.04) in multivariate logistic regression.

CONCLUSION: After adding axial length as dependence in multivariate analysis, cognitive impairment was not significantly associated with the thickness of RNFL, while the association between a lower cognitive function score and thinner GCL and POS was statistically associated in current study.

PMID:40009225 | DOI:10.1007/s00417-025-06777-x

Arch Dermatol Res. 2025 Feb 26;317(1):499. doi: 10.1007/s00403-025-04019-y.

ABSTRACT

This review addresses gaps in understanding isotretinoin’s side effects for acne vulgaris. While effective, the risks are often underestimated. It emphasizes careful patient selection and monitoring to optimize outcomes and minimize harm. By providing a comprehensive evaluation, the review aims to enhance patient safety and inform clinical decision-making. This review examined isotretinoin’s side effects through case reports and observational studies. A literature search on Google Scholar, PubMed, Scopus, and Web of Science covered publications from 2000 to 2024 using terms like “isotretinoin” and “side effects,” focusing on English-language studies. Inclusion criteria targeted studies detailing adverse effects across dermatological, musculoskeletal, psychiatric, ocular, gastrointestinal, endocrine, and renal areas. Data included population size, dosage, treatment duration, and side effects. No statistical analysis was performed. This review underscores a wide array of side effects associated with isotretinoin, ranging from common issues such as dry skin and cheilitis to more serious conditions including psychiatric disorders, musculoskeletal complications, and autoimmune diseases. Notably, rare side effects like psychosis and rhabdomyolysis have also been observed. The review emphasizes the necessity for meticulous patient selection, thorough risk assessment, and vigilant monitoring, especially for at-risk populations such as women of reproductive age. This review emphasizes the need for personalized evaluations and monitoring during isotretinoin treatment, particularly for high-risk groups like women of reproductive age. Healthcare providers must consider the risk-benefit ratio due to potential side effects. Regular check-ups and proactive management are crucial to optimize outcomes and minimize risks.

PMID:40009222 | DOI:10.1007/s00403-025-04019-y

J Math Biol. 2025 Feb 26;90(4):34. doi: 10.1007/s00285-025-02195-z.

ABSTRACT

In this paper, we propose a free boundary problem to model the spread of an epidemic by introducing a spatial segregation control strategy. The model consists of two coupled reaction-diffusion equations along with an ordinary differential equation, while the free boundary is described by an integro-differential equation. The results reveal a trichotomy in which the epidemic can shrink, reach equilibrium, or expand spatially. Moreover, we establish the final size of the cumulative number of infected populations and characterize the threshold phenomenon of epidemic outbreak using the principal eigenvalue of an elliptic operator. Additionally, we apply this model to simulate the spatial spread of the COVID-19 epidemic in Xi’an, China, during 2021-2022. This study provides valuable model references for dynamically designing spatial isolation control strategies for newly emerging major infectious diseases.

PMID:40009217 | DOI:10.1007/s00285-025-02195-z

Clin Teach. 2025 Apr;22(2):e70056. doi: 10.1111/tct.70056.

ABSTRACT

BACKGROUND: A teaching style is the approach a teacher uses in choosing instructional methods. Grasha’s model categorises them as ‘expert’, ‘formal authority’, ‘personal model’, ‘facilitator’ and ‘delegator’. The teaching styles of doctors in Singapore have yet to be studied. In the author’s department, teaching is often didactic. This study aimed to explore senior doctors’ preferred teaching styles and whether these styles explained the consistent use of didactic approaches.

METHODS: A web-based survey using Grasha’s Teaching Styles Inventory (TSI) was conducted among senior doctors in the Department of General Medicine at Sengkang General Hospital, Singapore from September 2020 to February 2021. Participants were recruited through convenience sampling. Due to non-normal distribution, TSI scores were analysed using non-parametric tests, while additional demographic data offered insights into factors influencing these preferences.

FINDINGS: Out of 68 senior doctors, 40 responded, showing the strongest preference for ‘facilitator’ teaching style. Female doctors were less likely to adopt ‘expert’, ‘formal authority’ and ‘personal model’ styles than males. Those with formal education training endorsed all teaching styles more than those without, although not all differences were statistically significant. Only 35% of the senior doctors preferred a combination of teaching styles associated with didactic lectures.

CONCLUSION: The study showed a preference for student-centred teaching styles among senior doctors and highlighted a disparity between actual teaching practices and preferred teaching styles. These findings provide valuable information for instructional designers to enhance their faculty development programmes and call for further investigation into the persistence of didactic lectures in medical education.

PMID:40008485 | DOI:10.1111/tct.70056