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An Observational Study Evaluating the Safety of Neoadjuvant Immunotherapy Combined With Chemotherapy in Patients Undergoing Surgery for Non-Small Cell Lung Cancer

Thorac Cancer. 2025 Feb;16(3):e70002. doi: 10.1111/1759-7714.70002.

ABSTRACT

OBJECTIVE: This study was conducted to investigate the safety of neoadjuvant immunotherapy combined with chemotherapy in patients undergoing surgery for resectable stage III non-small cell lung cancer (NSCLC).

METHODS: Overall, 68 surgical patients with stage III NSCLC who underwent neoadjuvant therapy at the Thoracic Surgery Department of Beijing Chaoyang Hospital from June 2019 to September 2021 were included, including 19 patients who underwent neoadjuvant chemotherapy combined with immunotherapy and 49 who underwent neoadjuvant chemotherapy alone. Both groups of patients were diagnosed with NSCLC before treatment and had resectable stage III tumors. The surgical duration, blood loss volume, average postoperative hospital length of stay, intensive care unit length of stay, and complication rate were compared between the two groups.

RESULTS: The group treated with neoadjuvant chemotherapy combined with immunotherapy demonstrated higher values than the group treated with chemotherapy alone for surgical duration, blood loss volume, and rate of conversion to thoracotomy; however, the differences were not statistically significant. The incidence of postoperative complications in the group treated with neoadjuvant immunotherapy combined with chemotherapy was significantly higher than that of the group treated with neoadjuvant chemotherapy alone (p = 0.02).

CONCLUSION: Neoadjuvant immunotherapy combined with chemotherapy was safe and effective and did not increase the difficulty of surgery for NSCLC; however, it was associated with a higher incidence of complications than neoadjuvant chemotherapy alone (p < 0.05).

PMID:39940044 | DOI:10.1111/1759-7714.70002

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Troponin i-induced cardiac inflammation and dysfunction in mice: a comparative study with the AT-3 tumor-bearing model

Cardiooncology. 2025 Feb 12;11(1):16. doi: 10.1186/s40959-025-00315-8.

ABSTRACT

BACKGROUND: Myocarditis is a potentially fatal condition, with a mortality rate of up to 50% in severe cases. Studies, including those by Nobel Laureate Honjo, have implicated autoantibodies against cardiac troponin I (cTnI) in driving cardiac inflammation in mice. Research has also identified autoantibodies under baseline conditions in some cancer models. However, data on the effects of recombinant cTnI on autoantibody production, myocardial inflammation, and contractile function remain limited. This study investigated cTnI-associated myocardial inflammation and autoantibody formation in both tumor-free and tumor-bearing mouse models.

METHODS: Female BALB/c mice were immunized with recombinant cTnI combined with adjuvants and compared to adjuvant-only controls. Cardiac function was assessed using gated cardiac MRI, including myocardial velocities, acceleration, deceleration, and standard volumetric parameters including ejection fraction (EF). Anti-cTnI autoantibodies were quantified using a custom-designed ELISA, while myocardial inflammation was assessed by analyzing T-cell subsets (CD4 + and CD8 +) in myocardial tissue samples. Baseline autoantibody reactivity was evaluated in tumor-bearing mice and tumor-free controls for comparison.

RESULTS: The left ventricular ejection fraction trended lower in the cTnI + adjuvant group (57.80 ± 1.7%) compared to controls (61.67 ± 4.1%), but the difference was not statistically significant (p = 0.073). Myocardial velocity, reflecting contraction speed, was significantly reduced in cTnI-treated mice (control:-1.2 ± 0.8 cm/s; cTnI:-1.05 ± 0.07 cm/s; p = 0.015). Anti-cTnI autoantibody levels increased significantly in cTnI-treated mice at 8 weeks (control:0.1 ± 0.02; cTnI:0.77 ± 0.28; p = 0.007). Additionally, the density of CD8 + T-cells in myocardial tissue was significantly higher in the cTnI group (control:2.2 ± 1.2 cells/mm2; cTnI:4.4 ± 2 cells/mm2; p = 0.013), indicating an enhanced cytotoxic T-cell response. The CD4/CD8 ratio was significantly lower in cTnI-treated mice (control: 8.2 ± 6.8; cTnI:3.1 ± 0.9; p = 0.029), further suggesting a shift toward a cytotoxic immune profile. Baseline autoantibody reactivity in tumor-bearing mice was not significantly different from controls (tumor-bearing: absorbance 0.049 ± 0.029; control: absorbance 0.068 ± 0.05 at 450 nm), indicating no inherent autoimmune reactivity in the tumor-bearing model.

CONCLUSIONS: Recombinant cTnI induces myocardial contractile dysfunction and promotes a cytotoxic immune response, supporting its role as an autoantigen in myocarditis. Advanced cardiac MRI revealed subtle functional impairments that EF alone could not detect. These findings highlight the potential for therapies targeting cTnI-induced autoimmunity, particularly in patients with ICI-associated myocarditis.

PMID:39940032 | DOI:10.1186/s40959-025-00315-8

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Psychometric analysis of work organization and fatigue instruments and their relationship with occupational accidents: a structural equation modeling approach

BMC Health Serv Res. 2025 Feb 12;25(1):239. doi: 10.1186/s12913-025-12369-6.

ABSTRACT

BACKGROUND: Work organization significantly impacts occupational incidents and fatigue in hospital settings, particularly among nurses. This study aimed to evaluate the psychometric properties of instruments measuring work organization and fatigue and to examine their relationship with occupational accidents.

METHODS: A cross-sectional study was conducted in 2019 with 200 nurses working in hospitals in Qom, Iran using the stratified sampling method. Data were collected using three standardized tools: the Work Organization Questionnaire, the Fatigue Checklist, and a demographic information questionnaire. Structural equation modeling was employed to analyze the data, while instrument validity and reliability were assessed through Cronbach’s alpha, composite reliability, and average variance extracted (AVE). Analysis was performed using Smart PLS and SPSS V20.

RESULTS: The analysis revealed a significant relationship between work organization and occupational accidents (t = 3.22, p < 0.05). However, the relationships between work organization and fatigue (t = 0.03) and between fatigue and occupational accidents (t = 1.49) were not statistically significant. The Work Organization Questionnaire (WOAQ) demonstrated robust validity and reliability, making it suitable for assessing occupational risks in hospital environments. In contrast, the Fatigue Questionnaire (CIS) exhibited acceptable validity but insufficient reliability (Cronbach’s alpha < 0.7), highlighting the need for further refinement.

CONCLUSION: This study revealed that the Work Organization Questionnaire has acceptable validity and reliability, making it suitable for hospital settings, while the Fatigue Questionnaire requires further revision. It is recommended that hospital administrators optimize work schedules and provide fatigue management training, and policymakers utilize validated tools to reduce occupational risks and enhance workplace safety.

PMID:39940007 | DOI:10.1186/s12913-025-12369-6

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Impact of COVID-19 on orthopedic trauma patients from 2021 to 2022 when restrictions were lifted, compared with the pre-pandemic period

J Orthop Surg Res. 2025 Feb 12;20(1):158. doi: 10.1186/s13018-025-05554-0.

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic restricted the activities of the general population and affected health systems, which adapted medical resources to manage COVID-19 treatment. During the initial lockdown, trauma volumes decreased. However, it is unknown whether trauma volumes changed from 2021 to 2022, the late pandemic period when COVID-19 vaccination began and restrictions were gradually lifted.

METHODS: The first objective of this study was to investigate changes in the number and types of trauma from 2021 to 2022, the late pandemic period, compared with 2018 to 2019, the pre-pandemic period. The second objective was to investigate the direct impact of COVID-19 on the clinical practice in orthopedic trauma units during the late pandemic period. Records of patients admitted to our institution and diagnosed with at least one fracture were retrospectively reviewed.

RESULTS: Patient demographics in the pre-pandemic period (n = 980) and the late pandemic period (n = 1058) were not significantly different for sex (p = 0.89) and age (p = 0.55). The proportion of trauma types was not significantly different between these periods (p = 0.45). The proportion of patients followed up at our hospital after discharge was significantly higher in the late pandemic period (79%) than in the pre-pandemic period (64%) (p < 0.001). During the late pandemic period, the proportion of trauma patients infected with COVID-19 during hospitalization was significantly higher in the second half of the late pandemic, compared with the first half (first half vs. second half: 0.8% vs. 3%) (p = 0.011).

CONCLUSIONS: This finding suggested that from 2021 to 2022, one year after the start of the pandemic and when restrictions had been eased, the number of trauma cases returned to pre-pandemic levels. From 2021 to 2022, the medical practice of orthopedic trauma units could be maintained and managed by the efforts of medical staff, despite the increase in the number of infected patients who had to be admitted for surgery and whose discharge had to be postponed. These results are based on observations in Japan and cannot be compared with other countries.

PMID:39940006 | DOI:10.1186/s13018-025-05554-0

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Is ketamine efficacious for rapid treatment of acute suicidal ideation in an emergency setting? Lessons learned from a pilot randomized controlled trial

BMC Res Notes. 2025 Feb 12;18(1):65. doi: 10.1186/s13104-024-07029-7.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the efficacy of a single infusion of ketamine in inducing rapid remission of severe suicidal ideation, compared to Midazolam, in a population with acute suicidal thoughts. In a double-blind randomized controlled trial conducted in Tehran, Iran, from January to July 2022 (IRCT20220118053756N1), 36 inpatients with acute severe suicidal ideation were enrolled. Participants were randomly assigned to receive either a single dose of ketamine (0.5 mg/kg) or Midazolam (0.02 mg/kg). Suicidality was assessed using the Beck Scale for Suicide Ideation (BSSI) and the Suicide-Visual Analog Scale (S-VAS) before the intervention and at 12 and 24 h post-administration.

RESULTS: At baseline, the Midazolam group exhibited significantly higher BSSI scores and a higher rate of borderline personality disorder than the Ketamine group. Mean BSSI and S-VAS scores at 12 and 24 h after the treatment decreased significantly compared to baseline in both groups. Despite these observations, no statistically significant differences were found between the groups in terms of BSSI and S-VAS scores.

TRIAL REGISTRATION: The protocol for this RCT was registered at the Iranian Registry of Clinical Trials (IRCT). The trial registration details are as follows: IRCT registration number IRCT20220118053756N1, with the registration date being June 12, 2022 (1401/03/22). It is important to note that this trial was retrospectively registered.

PMID:39940002 | DOI:10.1186/s13104-024-07029-7

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Comparative analysis of electrical signals in facial expression muscles

Biomed Eng Online. 2025 Feb 12;24(1):17. doi: 10.1186/s12938-025-01350-3.

ABSTRACT

BACKGROUND: Facial expression muscles serve a fundamental role in the orofacial system, significantly influencing the overall health and well-being of an individual. They are essential for performing basic functions such as speech, chewing, and swallowing. The purpose of this study was to determine whether surface electromyography could be used to evaluate the health, function, or dysfunction of three facial muscles by measuring their electrical activity in healthy people. Additionally, to ascertain whether pattern recognition and artificial intelligence may be used for tasks that differ from one another.

RESULTS: The study included 24 participants and examined three muscles (m. Orbicularis Oris, m. Zygomaticus Major, and m. Mentalis) during five different facial expressions. Prior to thorough statistical analysis, features were extracted from the acquired electromyographs. Finally, classification was done with the use of logistic regression, random forest classifier and linear discriminant analysis. A statistically significant difference in muscle activity amplitudes was demonstrated between muscles, enabling the tracking of individual muscle activity for diagnostic and therapeutic purposes. Additionally other time domain and frequency domain features were analyzed, showing statistical significance in differentiation between muscles as well. Examples of pattern recognition showed promising avenues for further research and development.

CONCLUSION: Surface electromyography is a useful method for assessing the function of facial expression muscles, significantly contributing to the diagnosis and treatment of oral motor function disorders. Results of this study show potential for further research and development in this field of research.

PMID:39939995 | DOI:10.1186/s12938-025-01350-3

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Digital health readiness – insights from healthcare leaders in operational management: a cross-sectional survey

BMC Health Serv Res. 2025 Feb 12;25(1):240. doi: 10.1186/s12913-024-12129-y.

ABSTRACT

BACKGROUND: Developing countries’ public health systems struggle with digital health implementation, and reports of low digital health readiness exist within the workforce. This study investigates the perceived digital health readiness of healthcare leaders in operational management to implement digital health tools.

METHODS: A cross-sectional survey using the E-Ready 2.0 scale was used to measure digital health readiness (n = 329) in 11 hospitals in the Western Cape, South Africa (September 2023 – March 2024). Descriptive statistics summarised respondent characteristics and the E-Ready 2.0 subscales: conditions for change at the workplace and among individuals, support and engagement from management, colleagues’ readiness, consequences for the status quo and workplace attitudes. Statements scoring 60% or more were considered to have higher readiness. Chi-square and Mann-Whitney U tests were used to examine associations between demographic variables and subscale statements.

RESULTS: A total of 143 healthcare leaders responded (56.1% response rate) (n = 114 nurses [79.7%], n = 29 medical doctors [20.3%]). The average age was 46.4 ± 10.0 years. Overall, higher levels of readiness (above 70%) were observed with statements related to workplace attitudes, whereas conditions for change at the workplace and among individuals showed lower readiness (below 50%).

CONCLUSION: Despite significant investment in digital health tools, there remains limited digital health readiness among those responsible for leading these implementations.

PMID:39939988 | DOI:10.1186/s12913-024-12129-y

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Impact of breast cancer awareness program on breast screening utilization among women in the United Arab Emirates: A cross-sectional study

BMC Public Health. 2025 Feb 12;25(1):578. doi: 10.1186/s12889-025-21512-1.

ABSTRACT

BACKGROUND: Breast cancer is the most common type of cancer and the leading cause of cancer death among women worldwide. In 2020, approximately 2.3 million women were newly diagnosed with breast cancer, resulting in around 685,000 deaths globally. The high incidence and prevalence of breast cancer have made it a major public health problem in both developed and developing nations, leading to overburdened health systems and increased direct medical expenditure. This research was conducted to assess the impact of breast cancer awareness programs on breast screening utilization among women in the United Arab Emirates.

METHODS: A cross-sectional study using a content-validated interviewer-administered questionnaire was conducted among 959 women aged ≥ 20 years from 31st May 2023 to 31st October 2024, in the United Arab Emirates. Data on sociodemographics, awareness program participation, screening utilization, and barriers were analyzed using descriptive statistics and chi-square tests.

RESULTS: Among the study participants,304 (31.7%) had attended awareness programs. Attendance was associated with younger age, higher education, and being single (p < 0.001). Among those who have ever attended any breast cancer awareness programs who had utilized the screening were 38.5% compared to 13.3% non-attendees (p < 0.001). The study concluded that age, education level, and marital status were significantly associated with participation in breast cancer awareness programs (p-value < 0.05). Key barriers included a lack of physician recommendations (24.3%), knowledge gaps (23%), and cost concerns (22.6%).

CONCLUSIONS: The study shows that participation in the awareness programs varied based on age, education and marital status, additionally, those with lower educational levels had a higher attendance at the awareness programs, emphasizing the significance of educational initiatives. The study showed a link between attending breast cancer awareness programs and the use of screening services, furthermore, notable gap in screening utilization such as emotional and perceived barriers were noted. Thus, its necessary to overcome these challenges for enchaning early detection and treatment outcomes. Interventions such as targeted educational campaigns, improved screening facility and better communication between physicians and patients can aid in addressing these challenges.

PMID:39939986 | DOI:10.1186/s12889-025-21512-1

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Anti-glycaemic effect of the Chinese modified DASH diet combined with 23% low-sodium salt in patients with hypertension and type 2 diabetes: a clinical trial

Diabetol Metab Syndr. 2025 Feb 12;17(1):55. doi: 10.1186/s13098-025-01618-7.

ABSTRACT

BACKGROUND: Although many previous trials have formalized the blood glucose-lowering effect of the DASH diet, relevant reports in China remain limited. This study aimed to explore the anti-hyperglycaemic effect of the Chinese Modified Dietary Approaches to Stop Hypertension diet combined with 23% low-sodium salt and meal packs in patients with hypertension and type 2 diabetes.

METHODS: We conducted a randomized controlled single-blinded trial with a semi-open design; 100 participants were randomly assigned to Group A (control), Group B (23% low-sodium salt), and Group C (meal packs) for 8 weeks of dietary intervention. All participants were followed up weekly to collect glycaemia data (standardized meal tolerance test), salt use, and adverse events.

RESULTS: Generalized estimating equation analysis indicated that fasting blood glucose decreased in all three groups following the intervention when compared to baseline. Group A decreased by 0.72 mmol/L (P = 0.008), while Groups B and C decreased by 2.02 mmol/L and 2.06 mmol/L, respectively (both P < 0.001). Although the latter two groups experienced greater reductions than Group A, the differences among the groups were not statistically significant (P = 0.450). For postprandial blood glucose, Group C showed the most pronounced decrease. The three groups recorded reductions of 2.43 mmol/L, 2.52 mmol/L, and 4.29 mmol/L, respectively (all P < 0.001), with again no significant difference observed between the groups (P = 0.088). The most notable enhancement in postprandial glucose was observed in Group C, which demonstrated a 51.5% improvement in its control rate. However, there was no statistically significant difference between the groups. No serious adverse events occurred during the trial.

CONCLUSION: The CM-DASH diet combined with 23% low-sodium salt and meal packs demonstrates potentially beneficial effects on glycemic control in patients with hypertension and type 2 diabetes. This intervention reduces salt intake and fosters the development of healthy eating habits, thereby contributing to the improvement of patients’ blood glucose. However, larger studies are necessary to confirm these findings. Trial registration ChiCTR2000029017. Registered January 11, 2020-Prospective registration, http://www.chictr.org.cn/.

PMID:39939983 | DOI:10.1186/s13098-025-01618-7

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The influence of strategic foresight on quality of healthcare services in the presence of artificial intelligence solutions in Jordan

BMC Nurs. 2025 Feb 13;24(1):165. doi: 10.1186/s12912-024-02518-3.

ABSTRACT

BACKGROUND: Healthcare organizations are distinguished by intricate systems that undergo continual modifications and unpredictability. This greatly hinders the ability to estimate the exact consequences of any changes accurately. Therefore, scholars prove that strategic foresight enables leaders to anticipate future challenges and possibilities. The utilization of artificial intelligence (AI) in management is on the rise, mostly because of its ability to provide intelligent services, reduce medical errors, and improve operational efficiency.

PURPOSE: To examine the impact of strategic foresight on the quality of healthcare services provided by Jordanian nurses in the context of AI solutions in governmental hospitals.

METHOD: A cross-sectional descriptive correlational analysis was conducted. A convenience sampling approach was used in the four selected Jordanian governmental hospitals. The study’s target population consisted of nurses. Over three weeks between January and February 2024, 240 self-reported questionnaires were received using a five-point Likert scale, with a response rate of 88.9%. The completed surveys were suitable for analysis using AMOS SPSS v. 26 and SPSS.

RESULTS: Simple linear regression and (Pearson’s r) test results showed that (R = .279, R square = 0.078) between strategic foresight and the quality of healthcare services. (R = .543, R square = 0.295) between strategic foresight and the adoption of AI-based solutions. And (R = .432, R square = 0.187) between adopting AI-based solutions and the quality of healthcare services. That reveals a statistically significant, positive correlation coefficient relationship between the variables. In the presence of the mediator, the direct relationship between strategic foresight and healthcare service quality was not statistically significant (b = 0.063, p = .398). The path analysis test indicates a linear relationship between the variables sequentially, and the AI-based solutions completely mediate the relationship between strategic foresight and the quality of healthcare services.

CONCLUSIONS: A positive and significant correlation between the variables suggests that a simulation-proposed model for a healthcare quality forecasting system, which the researcher built and included in the study recommendations, has to be designed. Therefore, AI-based forecasting systems should incorporate health service quality parameters to facilitate high efficiency and prompt patient demand fulfillment.

PMID:39939972 | DOI:10.1186/s12912-024-02518-3