Tag: pubmed

BMC Oral Health. 2025 May 2;25(1):680. doi: 10.1186/s12903-025-06053-8.

ABSTRACT

BACKGROUND: The COVID-19 pandemic significantly disrupted healthcare systems, particularly affecting vulnerable populations such as children and individuals with special needs, causing delays and reductions in routine dental services. The aim of this study was to evaluate level of access and identify determinants of access to oral healthcare for children aged 0-13 during COVID-19 restrictions.

METHODS: Mixed-methods research design was adopted. This cross-sectional study included 270 children aged 0 to 13 years who visited Ege University Pediatric Dental Clinics between August 2021 and February 2022. Interviewer-administered questionnaires collected information about sociodemographic and economic characteristics, as well as dental service utilization during the pandemic. “Access” to receive oral health care to address existing dental problems is defined separately for each application to the institution. Statistical analyses were conducted using IBM SPSS Statistics 23, with Pearson’s Chi-Square, Fisher’s Exact, and Binary Logistic Regression tests applied to examine variable relationships. A 95% confidence interval and a significance level of p < 0.05 were adopted, with model fit assessed using the Hosmer-Lemeshow test and Nagelkerke R². Qualitative data from 16 in-depth interviews were analysed using thematic analysis to explore the barriers to accessing oral healthcare during the COVID-19 pandemic.

RESULTS: During the pandemic, 62.3% of dental institutions’ applications had limited access to care. Parental education, employment status, and household income significantly affected access (p < 0.005). Multiple logistic regression revealed that applying to university clinics (OR = 4.78; 95% CI 2.24-10.21) and private institutions (OR = 4.33; 95% CI 2.30-8.17) led to higher access rates when compared to public dental centres. The father’s regular employment (OR = 3.39; 95% CI 1.37-8.34) and the child’s previous dental contacts (OR = 2.37; 95% CI 1.21-4.62) increased the likelihood of accessing oral healthcare. The risk of contracting infections and income loss were pandemic related barriers. The most common barriers were those concerning the availability of services at public dental clinics. Children with disabilities faced further barriers due to the risk of infection, difficulty reaching institutions, and unmet dental needs for treatment under general anaesthesia.

CONCLUSION: Higher socioeconomic status and past contact with dentists had a positive effect on oral healthcare access. Dental services provided by public institutions had a lower level of access. The COVID-19 pandemic highlighted oral healthcare inequalities, particularly for those children with disabilities in Türkiye. Policymakers should strengthen public health crisis plans in order to improve children’s oral healthcare access.

PMID:40317032 | DOI:10.1186/s12903-025-06053-8

Trials. 2025 May 3;26(1):146. doi: 10.1186/s13063-025-08848-0.

ABSTRACT

BACKGROUND: Adhesive capsulitis (AC) is a progressive inflammatory condition of the shoulder that causes functional limitations and leads to long-term disability. The study aimed to elicit the effectiveness of proprioceptive neuromuscular facilitation (PNF) compared to standard physiotherapy approaches on AC.

METHODS: An assessor-blinded single-centre randomised control trial (RCT) was carried out on 80 AC patients between May 2022 and December 2023 in Bangladesh. Random assigned and concealed allocated patients were recruited equally (n = 40) to each PNF and conventional capsular stretching group. The experimental group received a PNF approach, and the control group received capsular stretching to the affected shoulder for 24 sessions in 6 weeks. Both groups received electrical modalities as standard treatment. The primary outcome was pain measured by the numeric pain rating scale (NPRS) and range of motion in a universal goniometer. The secondary outcome was functional limitation measured by the shoulder pain and disability index (SPADI). As per the distribution of data, non-parametric tests were employed to analyse the superiority between and within groups with intention-to-treat analysis.

RESULTS: Baseline compatibility was noted in all the key variables (p > 0.05). Both PNF and capsular stretching had a decrease in pain compared to baseline in all capsular pattern positions (p < 0.001), and PNF had more significant improvement compared to control (p < 0.001). Both groups had equal improvement in shoulder ROM (p < 0.001) except abduction (p < 0.05). Both groups had improvements in disability (p < 0.05), and PNF had statistical superiority of improvement (p < 0.001).

CONCLUSIONS: The findings of this study support the potential of PNF intervention for 6 weeks as a treatment for shoulder adhesive capsulitis, showing improvements in pain, ROM and functional disability. However, further multicentre trials with a follow-up design are needed to fully understand the superiority of PNF on shoulder AC, encouraging continued engagement in this area of research.

TRIAL REGISTRATION: The Australian New Zealand Clinical Trial Registry (ACTRN12621001299897). Registered on 27 September 2021, prospectively registered.

PMID:40317031 | DOI:10.1186/s13063-025-08848-0

BMC Med Educ. 2025 May 2;25(1):644. doi: 10.1186/s12909-025-07145-3.

ABSTRACT

BACKGROUND: Antimicrobial resistance, anticipated to cause 10 million deaths and cost $100.2 trillion by 2050, is particularly severe in West Africa. While bacteria naturally resist antibiotics over time, their misuse intensifies resistance. Given the rising trend of antibiotic misuse in Nigeria, especially among the youth, this study explores this misuse among Federal University of Technology Owerri (FUTO)undergraduates.

METHODS: Using a cross-sectional design, the study assessed FUTO undergraduate students’ knowledge, misuse, patterns, and perception of prescription needs, and identified commonly misused antibiotics. We categorized faculties as health-based or non-health-based. From these categories, students were randomly chosen and surveyed using a semi-structured questionnaire that was based on established research.

RESULTS: Out of 400 students surveyed, 60.0% (240 students) displayed inadequate knowledge (Fair) about antibiotic use and resistance, whereas 33.0% (132 students) demonstrated poor knowledge, and only a handful, 7% had good knowledge. More concerning, 67.0% (268 students) reported fair antibiotic usage practices, 26.5% had poor practice with only 6.5% had good practice. The most frequently misused antibiotics were Amoxcillin, Ampiclox, and Tetracycline, often for conditions like Typhoid, Cough, and Catarrh. A significant correlation (p < 0.037) was found between students’ antibiotic knowledge and their usage practices. However, no statistically significant difference in knowledge and practices was observed between students from health and non-health-based faculties.

CONCLUSION: Undergraduate students at FUTO exhibit both a knowledge gap and misuse patterns concerning antibiotics. Implementing educational interventions, like antimicrobial stewardship programs, is essential. Given these findings, especially in the West African context, the inclusion and education of undergraduate students remain crucial.

PMID:40317030 | DOI:10.1186/s12909-025-07145-3

Cardiovasc Diabetol. 2025 May 2;24(1):190. doi: 10.1186/s12933-025-02745-1.

ABSTRACT

BACKGROUND: Sodium-glucose co-transporter 2 (SGLT2) inhibitors are important for treating patients with preserved left ventricular (LV) ejection fraction (LVEF). Several studies have assessed the effects of SGLT2 inhibitors on LV diastolic function, with conflicting results. In this sub-analysis of the Program of Ipragliflozin for Endothelial Dysfunction in Chronic Kidney Disease and Type 2 Diabetes (PROCEED) trial-including patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD)-we examined the effect of ipragliflozin compared with non-SGLT2 inhibitor standard therapy (control) on changes in the maximum early diastolic velocity to average early diastolic peak velocity (E/e’) ratio (an index of LV diastolic function) via echocardiography.

METHODS: Of the entire PROCEED trial dataset, 57 participants (ipragliflozin group, n = 28; control group, n = 29) with available echocardiography data at baseline and 24 weeks were included. The primary endpoint was the change in the E/e’ ratio from baseline to 24 weeks. The effect of SGLT2 inhibitors on the endpoint was stratified by baseline LVEF, body mass index (BMI), N-terminal pro-brain natriuretic peptide (NT-proBNP) level, estimated glomerular filtration rate (eGFR), and urine albumin-to-creatinine ratio (UACR).

RESULTS: No significant difference in the E/e’ ratio changes was observed between the ipragliflozin and control groups (group difference: – 0.82 [95% CI: – 2.44 to 0.81]; P = 0.317). The E/e’ ratio was unaffected by baseline NT-proBNP, eGFR, and UACR levels. However, ipragliflozin significantly reduced the E/e’ ratio in patients with LVEF ≥ 60% (n = 21, group difference: – 1.42 [- 2.76 to – 0.08]; P = 0.038) or BMI ≥ 25 kg/m² (n = 19, group difference: – 1.95 [- 3.56 to – 0.34]; P = 0.020), but not in those with LVEF < 60% (n = 7, group difference: 1.83 [- 4.48 to 8.14]; P = 0.527) or BMI < 25 kg/m² (n = 9, group difference: 1.34 [- 1.65 to 4.34]; P = 0.363). Significant interactions were noted between patients with LVEF ≥ 60% and < 60% (P_{for interaction=}0.048) and BMI ≥ 25 kg/m² and < 25 kg/m² (P_{for interaction=}0.016).

CONCLUSIONS: In subgroups with higher LVEF and BMI, ipragliflozin improved diastolic function more than standard treatment. These results may partly support the beneficial effect of SGLT2 inhibitors on LV diastolic performance.

PMID:40317024 | DOI:10.1186/s12933-025-02745-1

BMC Vet Res. 2025 May 2;21(1):314. doi: 10.1186/s12917-025-04763-3.

ABSTRACT

BACKGROUND: Synbiotic products are those Functional foods/feeds that contain both probiotic and prebiotic strains and have health-promoting effects beyond probiotics or prebiotics alone. This study aimed to investigate the effect of synbiotic feed containing the probiotic strain Lactobacillus acidophilus La5 (10¹² cfu/g) and inulin (5%) on changes in Thyroid hormones (T3, T4), TSH, LH, FSH, and Testosterone in male dogs throughout 24 days.

MATERIALS AND METHODS: In addition to the basic feed, the dogs in the treatment group also received the synbiotic supplement at 5% in each of their three meals during 24 days. Then, the serum levels of LH, FSH, TSH, and Testosterone were measured with an ELISA kit and finally, the obtained data were statistically analyzed.

RESULTS: The results showed that the consumption of this formulated synbiotic feed had no negative effect on the profile of Thyroid hormones (T3: from 1.09 ± 0.51 to 0.95 ± 0.40 ng/ml [p > 0.05]; and T4: from 6.60 ± 4.33 to 4.70 ± 4.29 µg/dl [p > 0.05]) as well as TSH (from 0.07 ± 0.09 to 0.03 ± 0.00 mIU/L [p > 0.05]), Testosterone (from 1.56 ± 0.66 to 1.26 ± 0.93 ng/ml [p > 0.05]), FSH (from 4.72 ± 1.12 to 11.55 ± 3.42 mIU/ml [p = 0.008]), LH (from 0.56 ± 0.48 to 0.31 ± 0.15 mIU/ml [p > 0.05]), and the changes in the amounts of these hormones was in the normal range during 24 days.

CONCLUSION: It concluded that the consumption of synbiotic feed (L. acidophilus + inulin, at the rate of 5%) in male dogs has no significant adverse effects were observed within the study period on Thyroid, TSH, and sex hormones and it seems that it may be used for a long time to take health-promoting effects without harming hormonal activities.

PMID:40317022 | DOI:10.1186/s12917-025-04763-3

BMC Med Educ. 2025 May 2;25(1):643. doi: 10.1186/s12909-025-07255-y.

ABSTRACT

BACKGROUND: The national OSCE examination has recently been adopted in France as a prerequisite for medical students to enter accredited graduate education programs. However, the reliability and generalizability of OSCE scores are not well explored taking into account the national examination blueprint.

METHOD: To obtain complementary information for monitoring and improving the quality of the OSCE we performed a pilot study applying generalizability (G-)theory on a sample of 6th-year undergraduate medical students (n = 73) who were assessed by 24 examiner pairs at three stations. Based on the national blueprint, three different scoring subunits (a dichotomous task-specific checklist evaluating clinical skills and behaviorally anchored scales evaluating generic skills and a global performance scale) were used to evaluate students and combined into a station score. A variance component analysis was performed using mixed modelling to identify the impact of different facets (station, student and student x station interactions) on the scoring subunits. The generalizability and dependability statistics were calculated.

RESULTS: There was no significant difference between mean scores attributable to different examiner pairs across the data. The examiner variance component was greater for the clinical skills score (14.4%) than for the generic skills (5.6%) and global performance scores (5.1%). The station variance component was largest for the clinical skills score, accounting for 22.9% of the total score variance, compared to 3% for the generic skills and 13.9% for global performance scores. The variance component related to student represented 12% of the total variance for clinicals skills, 17.4% for generic skills and 14.3% for global performance ratings. The combined generalizability coefficients across all the data were 0.59 for the clinical skills score, 0.93 for the generic skills score and 0.75 for global performance.

CONCLUSIONS: The combined estimates of relative reliability across all data are greater for generic skills scores and global performance ratings than for clinical skills scores. This is likely explained by the fact that content-specific tasks evaluated using checklists produce greater variability in scores than scales evaluating broader competencies. This work can be valuable to other teaching institutions, as monitoring the sources of errors is a principal quality control strategy to ensure valid interpretations of the students’ scores.

PMID:40317009 | DOI:10.1186/s12909-025-07255-y

BMC Chem. 2025 May 2;19(1):115. doi: 10.1186/s13065-025-01480-8.

ABSTRACT

It was the first time that a spectrofluorimetric approach for the simultaneous analysis of remdesivir and levodropropizine had been achieved. This study aims to propose an accurate and sensitive second-derivative synchronous spectrofluorimetric approach for measurement of remdesivir and levodropropizine in different matrices simultaneously without the need for prior separation. The proposed approach measured the synchronous fluorescence intensity of pharmaceuticals under research at a constant wavelength difference (Δλ) = 130 nm. For the quantitative analysis of remdesivir and levodropropizine, the peak amplitudes of the second derivative were measured at 390 and 399 nm, respectively. The procedure was completely validated and demonstrated outstanding linearity in the concentration ranges of 5-150 ng mL^{– 1} and 10-600 ng mL^{– 1} for remdesivir and levodropropizine, respectively. The new method was used to quantitatively analyze both drugs in their pharmaceutical dosage form, synthetically formulated mixture and spiked human plasma. A statistical comparison of the results with other published analytical techniques revealed no significant difference. The validation of the procedure was successfully completed in compliance with ICH guidelines. In terms of greenness, EcoScale and GAPI greenness tools were used to evaluate the analytical methodology.

PMID:40317008 | DOI:10.1186/s13065-025-01480-8

BMC Nurs. 2025 May 2;24(1):486. doi: 10.1186/s12912-025-03123-8.

ABSTRACT

BACKGROUND: The clinical learning environment is crucial for developing essential clinical decision-making skills in nursing students. This study examined nursing students’ perceptions of clinical decision-making and the factors that impact it.

METHODS: A descriptive cross-sectional study was carried out using a self-administered questionnaire, which included a personal information form and the Clinical Decision-Making in Nursing Scale (CDMNS). The study was conducted across ten universities in the Aegean region. Data collection took place at times most convenient for the students, such as during class sessions or lunch breaks. Prior to participation, students were briefed on the study’s objectives and procedures. Those who agreed to participate provided informed consent before completing the questionnaire. Researchers remained present while students filled out the questionnaire to clarify any questions they had.

RESULTS: A considerable proportion of students (72.6%) had never received formal education on clinical decision-making. The average CDMNS score was 140.24 ± 17.04, aligning with findings from previous research. A statistically significant difference was observed in the total mean CDMNS score and sub-dimension scores (searching for alternatives, questioning goals and values, evaluating outcomes, seeking information, and objectively integrating new knowledge) based on the university attended (p < 0.001).

CONCLUSIONS: The findings suggest that nursing students in the Aegean Region demonstrated a moderate level of perceived clinical decision-making skills. To enhance these skills further, it is recommended that alternative educational approaches, such as simulation-based training, case study discussions, and mentoring programmes, be integrated into nursing education and their effectiveness assessed.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40317006 | DOI:10.1186/s12912-025-03123-8

BMC Oral Health. 2025 May 2;25(1):681. doi: 10.1186/s12903-025-06048-5.

ABSTRACT

BACKGROUND: Oral cancer is an underestimated and growing public health problem. The majority of cases are diagnosed at a late stage, even though oral cancer can be detected early by routine visual and tactile examination. Dental healthcare providers thus play a vital role in its early detection. This study assessed dental healthcare providers’ knowledge of diagnostic procedures and risk factors for oral cancer.

METHODS: A cross-sectional, observational study was conducted using a validated survey of 38 items focusing on knowledge of diagnostic procedures and risk factors, and questions on continuing education. From October to December 2023, the online survey invitation was sent via all German state Dental Associations to their members. Participants’ socio-demographic data and responses in the “knowledge, opinion and continuing education” section were analysed descriptively. Linear regressions assessed the associations between participants’ characteristics or opinions and their knowledge of oral cancer (knowledge score).

RESULTS: Overall, 8,132 participants began the survey. After filtering for reliability and completeness, data from 3,458, 3,472, and 2,933 participants were available for “socio-demographics”, “knowledge”, and “opinions and continuing education”, respectively. Most participants were women (60%), between 30 to 49 years old (48%). The majority knew the most common type of oral cancer and the most common lesions associated with it. Furthermore, almost 89% of the participants were aware that early detection improves survival rates. The main risk factors (tobacco, alcohol, prior oral cancer) were well known. However, the potential for improvement in knowledge of localisation, signs, stage of diagnosis and the specific age group at risk was noted. Fewer years in the dental profession and since attending the last continuing education course were associated with higher levels of knowledge.

CONCLUSIONS: Knowledge of localisation, signs, stage of diagnosis, and specific risk groups can be improved. These topics should thus be integral to the dental curriculum and addressed through structured continuing education programmes, as the study’s results suggest that knowledge declines over time without continuing education.

PMID:40317003 | DOI:10.1186/s12903-025-06048-5

BMC Oral Health. 2025 May 2;25(1):678. doi: 10.1186/s12903-025-06059-2.

ABSTRACT

BACKGROUND: Abnormal tongue development is a craniofacial deformity that affects dental-maxillofacial esthetics and function. Recent evidence has identified macrophages as multi-functional immune cells crucial for heart and brain development. However, it is still unknown whether macrophages affect tongue development. Therefore, this study aims to assess the distribution, phenotype, and roles of macrophages in the developing tongue.

METHODS: In this study, immunohistochemical (IHC) and multiplex immunofluorescence (mIF) staining were conducted on C57BL/6 mice at embryonic day (E) 13.5, E14.5, E16.5, and E18.5 to analyze the distribution and phenotype of macrophages. Hematoxylin-Eosin (HE), IHC, IF, and mIF staining were also performed on embryonic CX3 CR1-CreERT2; Rosa-DTA conditional macrophage-depleted mice to investigate the effects on fetal tongue development and elucidate mechanisms from myogenesis, vascularization, and cell apoptosis. Statistical significance between the two groups was determined using unpaired two-tailed Student’s t-tests. For comparisons involving three or more groups, one-way analysis of variance (ANOVA) followed by Tukey’s multiple comparison tests was utilized. A significance level of P < 0.05 was set for statistical significance.

RESULTS: Macrophages were present in the developing tongue from E13.5 to E18.5, with a majority being of the M2 phenotype. Depletion of macrophages resulted in abnormal tongue morphology, decreased tongue height, width, and size, as well as reduced and disorganized muscle fibers. Depletion of macrophages also increased apoptosis. Vascular morphogenesis was impacted, with reductions in the luminal and vascular wall cross-sectional areas of the lingual artery. Vascular endothelial cells were reduced and disorganized with decreased expression of VEGFA and TGF-β1. Moreover, macrophages were located near vascular endothelial cells and secreted pro-angiogenic factors, suggesting their involvement in promoting vascularization.

CONCLUSIONS: Our findings indicate that macrophages play crucial roles in fetal tongue development by affecting myogenesis, cell apoptosis, and vascular growth.

PMID:40316997 | DOI:10.1186/s12903-025-06059-2