Tag: pubmed

BMC Sports Sci Med Rehabil. 2025 Nov 5;17(1):319. doi: 10.1186/s13102-025-01336-7.

ABSTRACT

INTRODUCTION: Hamstring strains commonly occur late in football matches. Hamstring injury risk rises with age and fatigue. This study investigated eccentric hamstring strength and perceived hamstring soreness after a football match in younger and older players.

METHODS: Maximal eccentric hamstring strength and perceived soreness were assessed in younger (n = 11, 20.2 ± 1.1 years, total playing time: 34.5 ± 8.8 min) and older (n = 10, 27.4 ± 3.7 years, total playing time: 44 ± 10.5 min) professional male football players before and after a friendly match aimed at selecting the primary team for the upcoming season. A two-way mixed model ANOVA was employed for statistical analyses. Furthermore, Hedges’ (adjusted) g effect sizes were calculated to evaluate the magnitude of effects.

RESULTS: The older group experienced significant reductions in absolute (-20 N ± 38.5, g = 0.58, p = 0.027) and relative (-0.26 N/kg ± 0.5, g = 0.43, p = 0.038) maximal eccentric hamstring strength, while younger group showed no changes (absolute: 3 N ± 36.1, g = 0.07, p = 0.773; relative: -0.037 N/kg ± 0.54, g = 0.07, p = 0.783). There was no statistically significant difference between groups for the absolute (p = 0.195; g = 0.45) and relative (p = 0.226, g = 0.43) eccentric strength changes. On the other hand, both groups reported increases in perceived hamstring soreness after the match (older: 29% ± 14.1, p < 0.001; younger: 40% ± 14.9, p < 0.001), with the younger group reporting more significantly higher soreness changes than the older group (11% ± 17.2, p = 0.025). A significant negative association existed between age and eccentric strength changes (R = -0.447, R² = 0.2, p = 0.007).

CONCLUSIONS: The older group showed significant declines in eccentric hamstring strength after the match, with age as a predictor. Specialists should focus on enhancing eccentric strength in older players and monitor their recovery to minimise injury risk. Future psycho-physiological research should examine muscle soreness perceptions and force production in fatigued younger and older football players. The results must be interpreted with caution due to the shorter playing time, unaccounted match workload, and limited sample size. Moreover, future research is necessary, including workload and performance metrics over a longer play duration for each player, with a larger sample size to achieve more reliable conclusions.

PMID:41194178 | DOI:10.1186/s13102-025-01336-7

Cancer Imaging. 2025 Nov 5;25(1):126. doi: 10.1186/s40644-025-00942-5.

ABSTRACT

OBJECTIVE: To evaluate the efficiency of diffusion weighted imaging (DWI), the mean apparent diffusion coefficient (ADCmean) and the minimum apparent diffusion coefficient (ADCmin) values with different b-values (800 s/mm² and 1000 s/mm²) in the diagnosis and staging of endometrial carcinoma (EC).

METHODS: Preoperative DWI images of 412 patients with EC and 134 patients with benign endometrial lesions were analyzed retrospectively. The performance of DWI images, ADCmean and ADCmin values with different b-values (800 s/mm² and 1000 s/mm²) for the diagnosis and staging (deep myometrial invasion, cervical stromal invasion and lymph node metastasis) of EC was assessed by using receiver operating characteristic curve (ROC). The comparison between AUCs was performed using the DeLong test, and a P value < 0.05 was considered statistically significant.

RESULTS: The area under the curves (AUCs) of DWI protocol with b = 1000 s/mm² for qualitative assessment of EC diagnosis and staging (0.850, 0.837, 0.906, and 0.820 for diagnosis, deep myometrial invasion, cervical stromal invasion and lymph node metastasis, respectively) were higher than those of b = 800 s/mm² (0.821, 0.795, 0.860 and 0.814, respectively) (all p < 0.05). The AUCs for the quantitative assessment of EC diagnosis and staging with ADCmean and ADCmin values with b = 1000 s/mm² were higher than those of b = 800 s/mm² (all p < 0.05).

CONCLUSIONS: DWI images, ADCmean and ADCmin values with b = 1000 s/mm² had higher performance than those of b = 800 s/mm² in the assessment of EC diagnosis and staging. This study highlights the potential of using b = 1000 s/mm² as an optimized protocol for EC assessment in clinical practice.

PMID:41194176 | DOI:10.1186/s40644-025-00942-5

Trials. 2025 Nov 5;26(1):470. doi: 10.1186/s13063-025-09188-9.

ABSTRACT

BACKGROUND: Hearing loss is a prevalent condition that impacts on social, mental and physical health, and has a significant economic burden. Hearing aids can improve the quality of life for those living with hearing loss; however, low and inconsistent use remains common. Within the National Health Service (NHS), follow-up care for new hearing aid users is highly variable and often lacks structure, which may contribute to low use. The FAMOUS trial investigates whether a structured care model for follow-up, combined with evidence-based behaviour change interventions, improves hearing aid use compared to usual care.

METHODS: FAMOUS is a multi-centre, two-arm parallel-group cluster randomised controlled trial (CRCT) with integral internal pilot, economic, and process evaluations. The trial involves 36 NHS audiology services and compares two types of follow-up for new adult hearing aid users: structured care, which includes personalised action plans, early monitoring, and routine follow-up at 6 weeks post-fitting, to usual care, which includes the offer of a follow-up 6-12 weeks after fitting. Recruitment is conducted through participating services over 3 months, with pseudo-anonymised routine data collected from electronic medical records of all patients who attend. Consent and outcomes are then collected from patients at 12 weeks post-fitting. For patients who provide consent to future contact, the primary outcome (self-reported daily hearing aid use) is collected at 12 months post-fitting. Secondary outcomes (quality-of-life (QoL), hearing-related disability, and economic measures) are collected at both timepoints. Qualitative interviews with a subset of patients and hearing professionals in the intervention arm will assess the acceptability and implementation of the intervention. Statistical analyses, including mixed-effects regression modelling, will be conducted under an intention-to-treat framework.

DISCUSSION: FAMOUS addresses a critical evidence gap regarding the potential benefits of follow-up care for new hearing aid users. If the intervention is successful, it can be rolled out nationally using existing facilities with limited impact on resources, identified in the economic analysis, and would improve hearing aid use and quality of life for those living with hearing loss.

TRIAL REGISTRATION: Prospectively registered with the International Standard Randomised Controlled Trial Number (ISRCTN) 10589817. Date of registration: 01/09/2022.

PMID:41194160 | DOI:10.1186/s13063-025-09188-9

BMC Med Educ. 2025 Nov 5;25(1):1550. doi: 10.1186/s12909-025-07972-4.

ABSTRACT

BACKROUND: Perineal injury repair skills should be taught to students in midwifery education. One of these methods is peer-supported simulation training in simulation environments. This study aimed to determine the effect of peer-assisted episiotomy and perineal injury repair simulation on midwifery students’ anxiety and self-efficacy.

METHODS: A pretest-posttest, one-group quasi-experimental design. The study was carried out with 39 third-year midwifery students studying at a foundation university. Episiotomy repair simulation was carried out peer-assisted using sponge and chicken breast. The “Introductory Information Form,” the “State-Trait Anxiety Inventory,” and the “General Self-Efficacy Scale” were used as data collection tools. In the analysis of the data, descriptive statistics and dependent group t-tests were employed to evaluate the difference between the pre-test and post-test.

RESULTS: The mean age of the students was 21.44 ± 1.68 years (Min = 20; Max = 30). According to the results, there was a significant decrease in the mean scores of the State and Trait Anxiety scales in the pre-and post-simulation periods (Pre: State Anxiety mean 34.41 ± 9.58, Trait Anxiety 44.79 ± 9.57; Post: State Anxiety mean 30.48 ± 9.31, Trait Anxiety 41.33 ± 10.82; p < 0.05). While no difference was observed between the pre-test and post-test in the total score of general self-efficacy (Pre: mean 62.48 ± 9.74; Post: mean 62.59 ± 11.92; p > 0.05) of the students, there was a significant difference in the sub-dimension of Sustaining Effort & Persistence (p < 0.05).

CONCLUSIONS: The findings of this study demonstrated that peer-assisted episiotomy repair simulation training effectively reduced students’ anxiety. It is recommended that peer support be included in pre-clinical episiotomy and perineal injury repair simulation practice.

PMID:41194158 | DOI:10.1186/s12909-025-07972-4

Asian J Psychiatr. 2025 Oct 28;114:104758. doi: 10.1016/j.ajp.2025.104758. Online ahead of print.

ABSTRACT

OBJECTIVE: This meta-analysis aimed to systematically evaluate the specific, adjunctive efficacy of repetitive transcranial magnetic stimulation (rTMS) when combined with non-pharmacological interventions-namely, transcranial direct current stimulation (tDCS), Tai Chi, or cognitive training (CT)-in patients with Alzheimer’s disease (AD) or mild cognitive impairment (MCI). The goal is to isolate the net therapeutic contribution of rTMS beyond the effects of the base interventions alone.

METHODS: A comprehensive search of Chinese and English databases was conducted from their inception until April 26, 2025. Randomized controlled trials (RCTs) that compared “a non-pharmacological intervention plus active rTMS” versus “the same non-pharmacological intervention plus sham rTMS”.This “add-on” study design was selected to precisely isolate the effect of rTMS. The risk of bias was assessed using the PEDro scale and Cochrane tools. Statistical analyses were performed using Review Manager 5.4 software.

RESULTS: 9 studies involving 391 participants were included. The pooled analysis revealed that the adjunctive use of rTMS was significantly superior to the sham control in improving global cognitive function at the immediate post-treatment assessment (SMD=0.38, 95 %CI[0.20,0.56], P < .001, n = 9). This benefit was consistent across the MMSE (SMD=0.38, n = 6), MoCA (SMD=0.37, n = 2), and ADAS-cog (SMD=0.39, n = 3) scores. Subgroup analysis suggested that the rTMS-tDCS combination might offer a short-term advantage in improving MMSE scores (MD=4.67, P = .008). Furthermore, the adjunctive effect of rTMS was sustained, as particularly evidenced by the ADAS-cog at follow-up (SMD=0.74, P = .02). The pooled analysis indicated that rTMS combined with non-pharmacological therapy demonstrated a short-term, sustained (4-8weeks) improvement in global cognitive function (SMD=0.34, 95 % CI[0.07, 0.60], P = .01). Subgroup analysis revealed that this sustained benefit reached statistical significance on the ADAS-cog scale (SMD = 0.41, 95 %CI[0.01, 0.81], P = .04) but showed a non-significant positive trend on the MMSE (SMD=0.26, 95 %CI[-0.19, 0.72], P = .26). However, a key limitation was that most studies did not systematically report outcomes related to activities of daily living or behavioral function.

CONCLUSION: The evidence indicates that rTMS as an adjunct to non-pharmacological interventions provides a significant specific effect on global cognitive function in patients with AD and MCI shortly after treatment, which may be sustained in the short-term. However, long-term follow-up data are extremely limited, and the effect on activities of daily living remains to be validated. The combination of rTMS and tDCS shows promise,but conclusions are constrained by the small number of studies,limited sample sizes,and heterogeneity in intervention protocols. Future large-scale studies incorporating long-term, standardized follow-up and assessments of daily living abilities are warranted to confirm the specific clinical value of rTMS as an augmentative therapy.

PMID:41192010 | DOI:10.1016/j.ajp.2025.104758

Int J Rheum Dis. 2025 Nov;28(11):e70449. doi: 10.1111/1756-185X.70449.

ABSTRACT

BACKGROUND: Ankylosing spondylitis (AS) is a chronic inflammatory disorder that imposes a significant economic burden through high healthcare costs. Prior studies have explored AS-related expenditures, but a comprehensive analysis of cost-related factors is lacking. This study aims to fill this gap.

METHODS: We analyzed data from 6149 AS patients (2018-2024) at two tertiary hospitals in Guangxi, China, and classified them as surgical or non-surgical; inpatients were categorized by catastrophic health expenditures (CHE; > 50% of household income). Descriptive statistics and the Kruskal-Wallis test were used to assess patient characteristics and cost differences, whereas propensity score matching and multivariable logistic regression were used to identify independent CHE predictors.

RESULTS: A total of 6149 AS patients were included. Surgical patients were older and incurred significantly higher inpatient costs (USD 9457.21 vs. USD 1177.10 for non-surgical patients). General medical service costs, imaging examination costs, Western medicine costs, and medical supply costs are risk factors affecting CHE in hospitalized patients.

CONCLUSION: AS imposes a substantial economic burden, particularly on surgical patients. Key cost drivers, including general medical services, imaging, pharmaceuticals, and medical supplies, markedly increase the risk of catastrophic expenditures. Implementing policy reforms to enhance insurance coverage, alongside clinical cost-control strategies such as rational imaging use, adoption of generic medicines, and optimized management of medical supplies, is essential to alleviate financial strain and improve the sustainability of AS care.

PMID:41191978 | DOI:10.1111/1756-185X.70449

JMIR Form Res. 2025 Nov 5;9:e71971. doi: 10.2196/71971.

ABSTRACT

BACKGROUND: Over the past two decades, use of social media has grown among US adults. Common social media platforms include Facebook, YouTube, Instagram, X, LinkedIn, and TikTok. People proactively use social media for a variety of purposes including searching for health information, peer-to-peer social support, and health-related information sharing. As these platforms often serve as sources of health information, understanding how, if at all, people use them may inform future behavioral interventions delivered via social media. Additionally, a better understanding of social engagement may have implications for public health messaging and patient-centered communication.

OBJECTIVE: Using a nationally representative sample of US adults, we explored how factors including subjective numeracy (ie, ease of understanding medical statistics), interpersonal communication with family and friends, and perceived discrimination influence whether people ever watched versus never watched health-related videos on social media platforms.

METHODS: We analyzed the National Cancer Institute’s Health Information National Trends Survey data, which were collected from March to November 2022 (n=6252). After excluding participants who did not have complete data for all variables of interest, we analyzed responses from 4543 participants. Respondents were asked, “In the past 12 months, how often did you watch a health-related video on a social media site (eg, YouTube)?” Response options included: almost every day, at least once a week, a few times a month, less than once a month, and never. We collapsed answers into ever or never watched. Odds ratios (OR), 95% CIs, and P values were calculated. A multivariate logistic regression model was considered using all factors that were univariately significant (P<.10). Using backward elimination, factors that were not significant with P>.05 were removed one by one until remaining factors were all significant collectively (P<.05).

RESULTS: Of 4543 adults analyzed, 61.5% reported watching at least one health-related video in the past 12 months, whereas 38.5% had never watched one. In the multivariable analysis, all age group categories over 50 years were less likely to watch health-related videos compared to those aged 18-34 years, with respondents aged ≥75 years having the lowest odds of all groups for watching a health-related video (OR 0.16, P<.001). Higher odds of watching health-related videos were observed among respondents who were Black (OR 1.59, P<.01), Hispanic (OR 1.54, P=.01), and from “Other” minority groups (OR 2.07, P=.01) compared to White respondents. College graduates (OR 1.71, P<.01) and those who found medical statistics easy to understand (OR 1.29, P=.04), talked about health with friends or family (OR 1.68, P<.01), or experienced racial discrimination in medical care (OR 1.59, P=.02) also had higher odds of watching health-related videos on social media.

CONCLUSIONS: Findings from this study may help target health communication campaigns on social media designed to improve screening, lifestyle changes, medication adherence, and disease management.

PMID:41191957 | DOI:10.2196/71971

Med Sci Sports Exerc. 2025 Nov 4. doi: 10.1249/MSS.0000000000003883. Online ahead of print.

ABSTRACT

PURPOSE: Physical activity (PA) is a key strategy in preventing and treating metabolic syndrome (MetS). The purpose is to investigate the associations of leisure-time PA (LTPA) trajectories across adulthood and current PA with MetS at age 61.

METHODS: Participants were 159 Finnish adults (52% women). LTPA frequency was assessed at ages 27, 42, 50, and 61 with a single question. Current PA at age 61 included self-reported vigorous, muscle-strengthening, commuting, and occupational PA. Cardiometabolic risk factors at age 61 included waist circumference, blood pressure, high-density lipoprotein (HDL) cholesterol, triglycerides, and glucose. MetS was defined based on the ATP III criteria. LTPA trajectories were conducted using k means for longitudinal data.

RESULTS: Of the three LTPA trajectories found, consistently inactive (N=34) and increasingly active (N=58) had a higher risk of MetS compared to consistently active (N=67) (odds ratio [95% confidence interval]: 3.93 [1.55, 10.01] and 2.39 [1.14, 4.99], respectively). Only the difference between consistently inactive and consistently active remained statistically significant when the current PA indicators were included in the model. Considering the individual components of MetS, those who were consistently inactive and increasingly active had higher waist circumference, lower HDL, and higher triglyceride levels compared to consistently active. These differences did not remain statistically significant when current PA was included.

CONCLUSIONS: Although consistently inactive and increasingly active individuals had higher cardiometabolic risk at age 61 compared to those who were consistently active across adulthood, current PA participation at the beginning of late adulthood attenuated these risks. These findings emphasize the importance of promoting and sustaining PA throughout life to reduce the burden of MetS in the aging population.

PMID:41191956 | DOI:10.1249/MSS.0000000000003883

Rheumatology (Oxford). 2025 Nov 4:keaf585. doi: 10.1093/rheumatology/keaf585. Online ahead of print.

ABSTRACT

OBJECTIVES: It is unclear whether clinicians agree which manifestations of AAV are associated with necrotizing granulomas or if their presence affects clinical decision-making.

METHODS: We surveyed physicians experienced in caring for individuals with AAV, querying: experience with AAV; beliefs concerning how granulomas affect the diagnosis, treatments, and outcomes of AAV; beliefs concerning the frequency with which granulomas are found in 36 manifestations of AAV; and degree to which granulomas change choice of induction therapy for specific manifestations of AAV. We analyzed responses using descriptive statistics and multivariable linear regression.

RESULTS: We received 142 responses from 35 countries. Responses had a median Likert response ≥5 on a 7-point scale (equal to ‘partially agree’) that granulomatous manifestations respond differently to therapy, increase risk of relapse, and increase organ damage. Four of 36 manifestations were believed to be caused by granulomas in a median of ≥ 75% of cases (on a scale of 0 = never to 100 = always caused by granuloma), 19 in a median of ≤ 25% of cases, and 13 in intermediate medians. The perceived degree to which granulomas caused manifestations was not associated with changes in therapy to induce remission in severe AAV (p-values 0.26-0.93 across scenarios).

CONCLUSIONS: Physicians experienced in vasculitis generally agree on which manifestations of AAV are and are not caused by granulomas and that granulomatous inflammation alters the natural history and treatment of AAV. However, the presence of granulomatous manifestations did not alter treatment choices to induce remission in severe AAV.

PMID:41191924 | DOI:10.1093/rheumatology/keaf585

JMIR Form Res. 2025 Nov 5;9:e69103. doi: 10.2196/69103.

ABSTRACT

BACKGROUND: Cardiopulmonary resuscitation (CPR) is vital for improving patient outcomes in medical emergencies. Both laypersons and health care professionals often seek guidance on performing CPR. In today’s digital age, many turn to easily accessible platforms such as YouTube for practical skills.

OBJECTIVE: This study evaluates the didactic and content quality of CPR videos on YouTube using comprehensive checklists and investigates the association between the assigned quality scores and type of publisher, view count, and video rankings.

METHODS: Videos were included based on defined search terms and exclusion criteria. Two emergency physicians rated each video independently using validated checklists concerning content and didactic quality. Linear regression analysis was performed to assess the relationships between video quality scores and view counts, as well as video rankings.

RESULTS: Of the 250 videos identified, 74 (29.6%) met the inclusion criteria. On the content checklist, videos scored an average of 56.5% (SD 19.2%), and on the didactic checklist, they scored 66.6% (SD 14.3%); none achieved the maximum score. Videos from official medical institutions scored significantly higher in content quality compared to nonofficial sources (P=.04). Video quality scores were not associated with video rankings or view counts.

CONCLUSIONS: The study highlights substantial variability in the didactic and content quality of CPR-related videos on YouTube. For medical educators, this underlines the need to curate and recommend reliable online resources or to develop new high-quality content aligned with established checklists. For the general public, the findings caution against relying on popularity metrics as indicators of accuracy and emphasize the importance of guidance from trusted institutions.

PMID:41191922 | DOI:10.2196/69103