Tag: pubmed

BMC Health Serv Res. 2025 Dec 2;25(1):1566. doi: 10.1186/s12913-025-13712-7.

ABSTRACT

BACKGROUND: Delivering person-centred care is a core responsibility of community pharmacies. However, no validated Japanese scale currently exists to evaluate community pharmacy services from the perspective of patient experience. This study aimed to translate, culturally adapt, and validate the Perceived Service Quality Scale (pSQS) and its short-form (pSQS-SF6), originally developed to assess patient experiences in community pharmacies, into Japanese (pSQS-J and pSQS-J-SF6).

METHODS: Following the established process, the pSQS-J was translated and culturally adapted from the original English version. The pSQS-J-SF6 was created by selecting one item from each domain. A survey was conducted among pharmacy users in Wakayama City, and descriptive statistics were reported. Confirmatory factor analyses (CFA) were performed to explore psychometric properties.

RESULTS: The pSQS-J was systematically translated and culturally adapted through a rigorous process. An online survey including the 19 pSQS-J items, along with demographic and related characteristics, was completed by 231 participants across nine pharmacies. After minor modifications (i.e., deleting one item and re-specifying another to a different factor), a six-factor correlated CFA model demonstrated acceptable fit and provided evidence of convergent and discriminant validity. A six-factor bifactor model demonstrated improved fit, and inspection of reliability indices reinforced the multidimensionality of the pSQS-J. However, the CFA results for pSQS-J-SF6 indicated insufficient evidence of convergent validity.

CONCLUSION: The pSQS-J is a valid and reliable instrument for evaluating patient experience in Japanese community pharmacies and may facilitate the advancement of person-centred care.

PMID:41331650 | DOI:10.1186/s12913-025-13712-7

BMC Sports Sci Med Rehabil. 2025 Dec 2. doi: 10.1186/s13102-025-01452-4. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Recent investigations into carpal biomechanical and ligamentous properties associated with dynamic scapholunate (SL) instability have contributed to the development of conservative treatment approaches. The aim of this study was to investigate the impact of isolated neuromuscular electrical stimulation (NMES) training of the forearm muscles combined with structured exercise training on weight bearing, muscle strength, proprioceptive sensation and upper limb functionality in individuals diagnosed with SL instability.

METHODS: This randomized, single-blind, controlled study included 30 patients (26 females / 4 males) aged between 18 and 50 years, who had been diagnosed with SL instability. The patients were randomly assigned to one of two groups: the Exercise Group (EG), who received an exercise program alone, and the Neuromuscular Electrical Stimulation Group (NMESG), who received NMES in addition to the same exercise program. The NMES protocol was applied three days a week for eight weeks, with 15 min each for the abductor pollicis longus, flexor carpi radialis, extensor carpi radialis longus, and extensor carpi radialis brevis muscles, for a total of 60 min. Each patient also exercised daily at home throughout the eight-week period. Exercise training was prescribed seven days per week. On clinic days, one supervised session was completed in the clinic, followed by two additional unsupervised home-based sessions later the same day. On non-clinic days, patients performed three unsupervised home sessions each day. The primary outcome measure was upper extremity disability, assessed using the QuickDASH questionnaire. The secondary outcome measures included activity-related pain (assessed using the Visual Analog Scale during activity (VAS-a)), wrist range of motion (ROM), the weight-bearing tolerance test (WBT), isokinetic muscle performance, grip strength, and proprioceptive sense. Pain was evaluated five times in total: at baseline and every two weeks thereafter. All the other assessments were performed twice: at baseline and at the end of the 8th week.

RESULTS: Significant improvements from before to after the intervention were observed in all parameters in both groups (p < 0.001). Statistically significant improvements were observed in the NMESG compared to the EG in terms of QuickDASH scores, VAS-a, WBT, and endurance in flexion (p < 0.005). Decreases in pain levels during activity were more pronounced in the NMESG from baseline to the 2nd, 4th, and 8th weeks of follow-up (p < 0.05).

CONCLUSION: The study results demonstrated that the application of NMES to target muscle groups together with stability-enhancing exercise strategies supports functional recovery. These findings are instructive in determining the ideal rehabilitation strategies for NMES applications as a conservative treatment for SL instability.

TRIAL REGISTRATION: The study was registered at ClinicalTrials.gov under ClinicalTrials registration number NCT06627296 on 01/10/2024.

PMID:41331647 | DOI:10.1186/s13102-025-01452-4

BMC Public Health. 2025 Dec 2. doi: 10.1186/s12889-025-25789-0. Online ahead of print.

ABSTRACT

BACKGROUND: Sexual function is an integral component of overall well-being and is influenced by both biological and psychosocial factors. While psychological distress is known to affect health outcomes broadly, its specific impact on sexual function among adults attending primary health care services has not been well established. This study aims to examine the relationships between sexual functioning and depression, perceived stress, and sociodemographic variables among adults aged 18-45 who attend primary healthcare services, and to determine whether these psychological variables significantly predict sexual functioning.

METHODS: A descriptive cross-sectional study was conducted between January and March 2025 in five randomly selected family health centres located in Türkiye. The study was completed with a total of 573 participants. Data were collected using the Beck Depression Inventory (BDI) to assess levels of depression, the Perceived Stress Scale-10 (PSS-10) to measure perceived stress, and the Arizona Sexual Experiences Scale (ASEX) to evaluate sexual functioning. Statistical analyses included independent samples t-tests, one-way analysis of variance, correlation analyses, and multiple regression analyses to explore relationships between psychological factors and sexual health outcomes.

RESULTS: Analysis of ASEX scores by sociodemographic characteristics revealed significant differences among both male and female participants (p < 0.01). Correlation analyses showed no significant relationship between ASEX and BDI or PSS-10 scores in men, whereas significant positive correlations were found in women. Regression analyses indicated that BDI and PSS-10 explained only 0.3% of the variance in ASEX scores in men (adjusted R² = 0.003; p = 0.09), while their explanatory power was higher in women (adjusted R² = 0.114; p < 0.01).

CONCLUSIONS: The results indicate that the psychological variables assessed (depression and perceived stress) predict sexual functioning to a greater extent in women than in men. These findings highlight the importance of considering psychological factors such as depression and stress in the assessment of sexual functioning, particularly among female patients, and underscore the value of integrating such considerations into primary care services. Psychological assessments using tools like the BDI and PSS-10 may contribute to a better understanding of risk factors related to sexual functioning and support more holistic approaches within primary care settings.

PMID:41331634 | DOI:10.1186/s12889-025-25789-0

J Orthop Surg Res. 2025 Dec 2. doi: 10.1186/s13018-025-06533-1. Online ahead of print.

ABSTRACT

BACKGROUND: Calcaneal fractures are the most common tarsal fractures and often result in long-term disability. Although various treatment options exist, but the relationship between Essex-Lopresti subtypes, treatment methods, and dynamic functional recovery remains unclear.

METHODS: This retrospective study included 66 patients with intra-articular calcaneal fractures, treated between 2011 and 2021. Fractures were categorized according to the Essex-Lopresti classification (1 A-1 C, 2 A-2 C) and managed by conservative treatment, Steinmann pin fixation, or plate fixation. Functional outcomes were assessed, using the American Orthopaedic Foot and Ankle Society (AOFAS) score, radiographic parameters (Böhler and Gissane angles), and pedographic gait analysis with the Win-Track platform. Statistical analysis was performed using Kruskal-Wallis tests with Dunn-Bonferroni post-hoc analyses, Mann-Whitney U or independent-samples t-tests as appropriate, chi-square (or Fisher’s exact) tests for categorical variables, and Spearman’s rho for correlation.

RESULTS: Functional outcomes varied across subtypes and treatment methods. Across subtypes, the distribution of AOFAS categories did not differ significantly (χ², p = 0.587). Type 2 A fractures treated with Steinmann pin fixation demonstrated the highest AOFAS scores (80.4 ± 10.2; p = 0.587). Böhler’s angle was numerically higher in the conservative group (17.0 ± 11.4°) but did not correlate with AOFAS scores (ρ = 0.01, p = 0.94). Pedographic analysis showed that maximum plantar pressure was highest in the conservative group (1625 ± 142 kPa) and lowest in the plate fixation group (1437 ± 188 kPa; overall p = 0.033). Gait asymmetries-particularly prolonged swing and stride duration tended to be greater in the Type 2B and 2 C subgroups, although statistical significance was limited ((p = 0.195-0.795)).

CONCLUSION: Essex-Lopresti subtypes strongly influence clinical and gait outcomes following calcaneal fractures. Steinmann pin fixation is advantageous in Type 2 A fractures, while Type 2B fractures consistently show poor recovery. Radiographic angles alone are insufficient predictors of long-term outcomes, emphasizing the importance of integrating gait analysis with clinical scoring. Subtype-specific approaches may optimize treatment strategies and patient care.

IRB NUMBER: Ethics Committee of Fırat University (2022/04-04).

PMID:41331633 | DOI:10.1186/s13018-025-06533-1

Malar J. 2025 Dec 2. doi: 10.1186/s12936-025-05706-x. Online ahead of print.

ABSTRACT

BACKGROUND: Reports from East and Horn of Africa showed artemisinin resistance is threatening control efforts. The Pfkelch13 (k13) gene mutation in Plasmodium falciparum is essential for tracking artemisinin resistance, which significantly jeopardizes malaria treatment effectiveness. The objective of this study was to assess the occurrence and prevalence of k13 gene polymorphisms at selected public health facilities of Arbaminch and Mirab Abaya, Ethiopia.

METHODS: A cross-sectional study was conducted in Arbaminch and Mirab Abaya from May to December 2023. A total of 52 P. falciparum mono-infection samples confirmed by PCR were analysed. Sanger sequencing was used to obtain the sequences of k13 gene propeller domain, and phylogenetic analysis was performed using Molecular Evolutionary Genetic Analysis software version 11. Gene flow and differentiation were analysed with DnaSP6, while sequences from six other African countries were included from global database for haplotype network analysis using PopART 1.7.

RESULTS: Among the 52 participants, 28 (52.8%) were male and 24 (47.2%) were female. The median age was 19 years old with an interquartile range of 15 to 32 years. There was no polymorphism identified in the studied samples indicating high genetic conservation (pairwise similarity index = 0.982). Isolates from Mirab Abaya exhibited strong genetic homogeneity, while Arbaminch samples showed slight divergence and yet remained largely conserved. Ethiopian haplotypes contributed significantly to a dominant African haplotype, with no k13 mutations detected. Although mild genetic diversity was observed in some African countries, haplotype and nucleotide diversity were not statistically significant. A negative Fu and Li’s D statistic was observed, suggesting that low-frequency mutations could be due to selective sweep in the parasite population.

CONCLUSION: This study found no evidence of P. falciparum k13 gene mutations in isolates from Arbaminch and Mirab Abaya, indicating a high level of genetic conservation. Although minor genetic divergence was observed, particularly among Arbaminch isolates, the overall population remained genetically homogeneous. These findings highlight the continued effectiveness of artemisinin-based combination therapy in the region and emphasize the need for ongoing molecular surveillance to monitor potential resistance emergence.

PMID:41331631 | DOI:10.1186/s12936-025-05706-x

Ann Clin Microbiol Antimicrob. 2025 Dec 2. doi: 10.1186/s12941-025-00837-0. Online ahead of print.

ABSTRACT

BACKGROUND: Bloodstream infections remain a major cause of morbidity and mortality worldwide, with the increasing threat of antimicrobial resistance (AMR) complicating treatment options. This study aimed to describe the frequency, distribution, and patterns of AMR among blood culture isolates over 5 years at the University Teaching Hospital of Kigali, in Rwanda.

METHODS: A retrospective cross-sectional surveillance analysis was performed on 1352 bacterial isolates from 8301 blood cultures conducted between January 1, 2020, and December 31, 2024. The distribution of pathogens, antimicrobial resistance profiles, and comparisons of resistance patterns between isolates from outpatient and hospitalized patients were analyzed using SPSS version 28. A p-value less than 0.05 was considered statistically significant.

RESULTS: The most common isolates were Staphylococcus aureus (37.2%), Klebsiella pneumoniae (22.4%), Escherichia coli (13%), and Acinetobacter baumannii (11.6%). Nearly all isolates originated from inpatients (98.6%), with the pediatric unit accounting for 40.7%. Alarmingly high resistance rates were observed for ampicillin (94.2%), amoxicillin-clavulanic acid (92.5%), third-generation cephalosporins (79-86%), and ciprofloxacin (58.7%). Notably, vancomycin (1%) for Gram-positive bacteria, and polymyxin B (27.1%), imipenem (25.5%), and amikacin (15.6%) for Gram-negative bacteria generally exhibited lower resistance rates. Additionally, AMR was significantly more prevalent in isolates from hospitalized patients compared to ambulatory patients (p < 0.0001).

CONCLUSION: This study reveals a substantial burden of AMR in blood culture isolates, particularly affecting hospitalized and pediatric patients. The high resistance rates to commonly used antibiotics highlight an urgent need for strengthened antimicrobial stewardship programs, improved infection prevention measures, and enhanced diagnostic laboratory capacity to guide therapy.

PMID:41331622 | DOI:10.1186/s12941-025-00837-0

BMC Public Health. 2025 Dec 2. doi: 10.1186/s12889-025-25848-6. Online ahead of print.

ABSTRACT

OBJECTIVE: Previous nationally representative health surveys in China found that handgrip strength (HGS) of children and adolescents has declined since 2000. However, these data are not only lacking in updates but also have limitations in identifying high-risk groups. This paper aims to estimate the trends in HGS adjusted for height and weight among Chinese children and adolescents from 2000 to 2019 and to investigate differences in demographic characteristics and distribution.

METHODS: Height, weight, and HGS data among Chinese 1,082,296 children and adolescents aged 7-18 years (543,118 boys) were obtained from five waves of the Chinese National Surveillance on Students’ Constitution and Health from 2000 to 2019. General linear models were used to estimate trends in absolute HGS and HGS adjusted for height and weight in each sex-region-age group, respectively. Population-based trends were estimated by a post-stratification population weighting procedure. The trends in the distributional characteristics were visually described.

RESULTS: For the total population, HGS increased by an average of 2.2 kg (95% confidence interval [CI]: 2.1 to 2.1 kg) or 0.44 effect size (ES) (95% CI: 0.43 to 0.45 ES), with a small but statistically significant improvement. There was a moderate improvement (0.62 ES) among children aged 7-12 years and a small improvement (0.27 ES) among adolescents aged 13-18 years, respectively. However, HGS adjusted for height and weight increased by an average of 0.6 kg (95% CI: 0.5 to 0.7 kg) or 0.05 ES (95% CI: 0.04 to 0.06 ES), with a negligible improvement observed overall. Urban boys aged 7-9 years and urban girls aged 7-12 years experienced small improvements (ranging from 0.22 to 0.38 ES). Urban boys aged 15, 18 years and rural boys aged 15-18 years experienced small decreases (ranging from – 0.31 to -0.23 ES) In general, the distribution of trends was uneven, with decreases primarily observed at higher percentiles but improvements observed at lower percentiles.

CONCLUSION: No significant changes were observed in HGS adjusted for height and weight, but there were significant differences in sex, age and distribution. Policies and intervention strategies need to prioritize low-health groups, especially among post-pubertal boys or high-fitness performers.

PMID:41331609 | DOI:10.1186/s12889-025-25848-6

Implement Sci. 2025 Dec 2. doi: 10.1186/s13012-025-01471-2. Online ahead of print.

ABSTRACT

BACKGROUND: Over the past decade, implementation researchers have empirically identified factors influencing long-term sustainment of evidence-based practices (EBPs) to target in implementation efforts. We examined progress toward promoting sustainment by conducting a conceptual replication of a prior study (Hunter et al., 2015, Implementation Science) that measured sustainment of an exemplar EBP for youth substance use, the Adolescent Community Reinforcement Approach (A-CRA).

METHOD: Data were collected 1-5 years after initial implementation funding ended (M = 3.3 years) through interviews and surveys with clinicians and supervisors from service organizations that implemented A-CRA (n = 66). Using survival analysis, we calculated the probability of A-CRA sustainment (dichotomously reported [yes/no] in interviews) over time and examined associations with contextual factors across the multilevel domains of the Consolidated Framework for Implementation Research (CFIR). We also combined our data with Hunter et al. (n = 68) to test if sustainment status or interactions with contextual factors differed by sample, and used rapid qualitative analysis of interviews to further explore patterns in the quantitative findings.

RESULTS: In our sample, A-CRA sustainment probability decreased over time; 71% of organizations were sustaining A-CRA when funding ended, whereas only 33% were sustaining 5 years later; this survival curve did not statistically differ from Hunter et al. Sustainment was significantly associated with factors across CFIR domains: we replicated associations found by Hunter et al. (with e.g., funding stability, available clinicians, intervention complexity) and found unique associations (with e.g., program evaluation and strategic planning capacities, available supervisors, and perceived advantages and success of A-CRA). One association from the prior sample did not fully replicate (p < .10), but there were no significant interactions between contextual factors and sample. Qualitative findings further contextualized these results with service organization perspectives on factors influencing sustainment.

CONCLUSIONS: Our findings suggest that work over the past decade promoting sustainment of EBPs for youth substance use may not have produced measurable impacts. Future work needs to better incorporate growing knowledge on sustainment predictors into development and testing of robust, multilevel implementation strategies and system-level supports. This study also provides a useful illustration of a replication study in implementation science, which are important but rare.

PMID:41331606 | DOI:10.1186/s13012-025-01471-2

BMC Oral Health. 2025 Dec 2. doi: 10.1186/s12903-025-07434-9. Online ahead of print.

ABSTRACT

BACKGROUND: High-speed sintering has emerged as a promising innovation for enhancing the efficiency of dental prosthesis fabrication. However, its impact on marginal adaptation remains a critical factor in ensuring the long-term clinical success of restorations. The aim of the study to evaluate the marginal fit of high-speed and regular-speed-sintered zirconia crowns.

METHODS: A maxillary right second molar on a typodont was prepared for an all-ceramic crown. A PVS impression was taken and a Type V stone master cast was fabricated. This cast was scanned via a laboratory scanner to produce 20 milled zirconia crowns. The crowns were divided into two groups (n = 10). Group A was subjected to a fast-sintering program, whereas group B was sintered via a conventional-speed-sintering program. Marginal fit was assessed via a stereoscopic microscope at four well-defined points (mid-distal, mid-lingual, mid-mesial, and mid-buccal) on each crown. Three readings were taken at each point. The marginal gaps of both groups were compared via the Wilcoxon signed-rank test.

RESULTS: Statistically significant difference between groups A and B (p < 0.001) was revealed. Although the mean marginal gap in both groups was below the clinically acceptable limit (< 90 μm), the fast-sintering program produced restorations with a larger marginal gap than the restorations sintered via the conventional program.

CONCLUSION: Crowns produced via both sintering programs were clinically acceptable, although the regular-speed-sintering program yielded a significantly superior marginal fit.

PMID:41331599 | DOI:10.1186/s12903-025-07434-9

BMC Neurol. 2025 Dec 2. doi: 10.1186/s12883-025-04555-0. Online ahead of print.

ABSTRACT

BACKGROUND: Diabetes mellitus (DM), a globally prevalent metabolic disease, affects the nervous system through multiple mechanisms, leading to cranial neuropathies. Tolosa-Hunt syndrome (THS) is a rare disorder that, when occurring in diabetic patients, may present with clinical manifestations that overlap with diabetic cranial neuropathy (DCN), increasing the risk of misdiagnosis and delaying corticosteroid treatment. This study aims to systematically analyze the clinical characteristics of THS in diabetic patients and explore optimal management strategies.

METHODS: This study conducted a retrospective analysis, integrating data from previously published cases and cases diagnosed at our center. Inclusion criteria were based on the diagnostic standards for THS outlined in the ICHD-3, while cases with other potential causes of headache and ophthalmoplegia were excluded. Data collected included baseline characteristics, clinical manifestations, treatment regimens, and therapeutic outcomes. Statistical analysis was performed using Fisher’s exact test, t-test, and Wilcoxon rank-sum test.

RESULTS: A total of 19 cases of diabetes-associated THS were included (11 males, 8 females), with males presenting at a significantly younger age than females (P = 0.041). All patients experienced severe headaches, 89.47% had ptosis, 94.73% exhibited ophthalmoplegia, and 15.79% presented with facial sensory disturbances. Eight patients were initially misdiagnosed with DCN and received neurotrophic therapy without improvement, but they responded rapidly to corticosteroid treatment. All patients showed significant symptom improvement within six days of corticosteroid administration. Methylprednisolone and dexamethasone demonstrated therapeutic effects comparable to prednisone, though symptom resolution was slightly delayed in the prednisone group.

CONCLUSION: The clinical features of diabetes-associated THS include severe headache, ptosis, and ophthalmoplegia, which can be easily confused with DCN. Corticosteroid therapy demonstrated high efficacy in this cohort. Clinicians should consider the possibility of THS in diabetic patients presenting with ptosis and ophthalmoplegia to avoid misdiagnosis and ensure timely corticosteroid treatment, thereby improving patient outcomes.

PMID:41331592 | DOI:10.1186/s12883-025-04555-0