Tag: pubmed

J Orthop Surg Res. 2025 Nov 4;20(1):951. doi: 10.1186/s13018-025-06408-5.

ABSTRACT

BACKGROUND: Gait analysis of patients with spinal disorders at different walking speeds helps clinicians diagnose conditions and investigate treatment/rehabilitation effectiveness. A subject-specific database for trunk muscle forces and lumbar spine loads of healthy individuals during different walking speeds is therefore useful.

METHODS: Ten healthy participants walked at three speeds (slow, normal, and fast) while motion and force-plate data were collected. Force in trunk muscles and loads on the lumbar spine discs were estimated using subject-specific musculoskeletal simulations in OpenSim. Model predictions at different walking speeds were statistically compared.

RESULTS: The time-dependent subject-specific force in all major trunk muscles and compression/shear loads at all lumbar spine discs (T12-S1) were reported for all walking speeds. Significant differences were observed in the average of peak compression between the fast and both slow/normal walking speed conditions across all lumbar discs (p < 0.001). With the exception of the L4-S1 discs, significant differences in the average of peak anterior-posterior and medio-lateral shear loads were also found between the fast and both slow/normal walking speed conditions. Significant differences (p < 0.007) in the average of peak muscle forces were generally found between the fast and both slow/normal walking speed conditions.

CONCLUSIONS: This study presents a normative, subject-specific database of lumbar loading and muscle forces during walking at multiple speeds. These data provide a useful reference for future research in spinal biomechanics and musculoskeletal modeling. Furthermore, the database may serve as a baseline for assessing altered gait patterns and spinal loads in individuals with spinal disorders, supporting future clinical applications.

PMID:41188961 | DOI:10.1186/s13018-025-06408-5

Nutr Metab (Lond). 2025 Nov 4;22(1):131. doi: 10.1186/s12986-025-01027-7.

ABSTRACT

BACKGROUND: Metabolic Syndrome (MetS) involves several cardiovascular risk factors, with hypertension being a critical component that significantly impacts cardiovascular outcomes. As guidelines support blood pressure control in populations with high cardiovascular risk factors, we evaluated BP control in MetS patients.

METHODS: We conducted a cross-sectional analysis of probability samples of adults aged ≥ 18 years with MetS from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2020 to assess changes in BP control. MetS was identified by meeting at least three of the following criteria: (1) waist circumference ≥ 102 cm in men and ≥ 88 cm in women; (2) fasting glucose ≥ 100 mg/dl; (3) BP ≥ 130/85 mmHg; (4) triglycerides ≥ 150 mg/dl; and (5) high-density lipoprotein cholesterol (HDL-C) < 40 mg/dl in men and < 50 mg/dl in women. BP control was defined as systolic BP < 130 mmHg and diastolic BP < 80 mmHg. All analyses accounted for differences between survey years, complex sampling design, and survey weights.

RESULTS: From 1999-2002 to 2015-2020, the prevalence of MetS increased from 19% to 24% (P < 0.001). Among MetS patients, the proportion of those self-reporting hypertension or taking BP medications increased from 65% in 1999-2002 to 72% in 2015-2020 (P = 0.001). Over time, both the use and quantity of antihypertensive medications increased significantly, and according to current guidelines, BP control among MetS patients has improved significantly. Similar trends were observed across subgroups stratified by gender, diabetes status, and CKD status.

CONCLUSION: BP management in MetS patients showed significant improvement from 1999 to 2020, with increasing control rates despite fluctuations.

PMID:41188950 | DOI:10.1186/s12986-025-01027-7

BMC Glob Public Health. 2025 Nov 4;3(1):98. doi: 10.1186/s44263-025-00220-3.

NO ABSTRACT

PMID:41188943 | DOI:10.1186/s44263-025-00220-3

Orphanet J Rare Dis. 2025 Nov 4;20(1):559. doi: 10.1186/s13023-025-04091-7.

ABSTRACT

INTRODUCTION: Autoimmune nodopathy (AN) is a recently recognized, rare immune-mediated neuropathy characterized by autoantibodies targeting nodal and paranodal proteins such as neurofascin-155 and contactin-1. Since its classification as a distinct entity in 2021 by European Academy of Neurology/Peripheral Nerve Society, scientific interest in AN has rapidly increased. This study aimed to conduct a comprehensive bibliometric analysis to identify research trends, influential publications, leading authors, institutions, and collaboration networks in the field of AN between 2005 and 2025.

METHODS: A literature search was performed in the Web of Science Core Collection using AN-related keywords. A total of 109 original English-language articles were included based on defined inclusion and exclusion criteria. VOSviewer and CiteSpace were used for network visualization and citation burst analysis. Descriptive statistics and trend projections were conducted using SPSS and Microsoft Excel.

RESULTS: A marked increase in publications was observed after 2021, coinciding with the formal definition of AN. The most productive countries were France, Germany, Spain, and Japan. Querol Luis, Sommer Claudia, and Doppler Kathrin emerged as leading authors. Highly cited articles focused on the pathogenesis and antibody profiles of AN. Keywords such as “neurofascin,” “IgG4,” and “autoimmune nodopathy” dominated the thematic clusters.

CONCLUSION: This is first bibliometric analysis to systematically examine the scientific landscape of AN. Despite growing research interest, there remains a significant gap in large-scale epidemiological studies and randomized controlled trials. Our findings provide a roadmap for future research, highlighting the importance of international collaboration and antibody-based stratification in the diagnosis and treatment of AN.

PMID:41188921 | DOI:10.1186/s13023-025-04091-7

BMC Health Serv Res. 2025 Nov 4;25(1):1440. doi: 10.1186/s12913-025-13613-9.

ABSTRACT

BACKGROUND: The medicines’ pathway in nursing homes (NHs) is complex and challenging, resulting in processes that are prone to medication errors and lack person-centredness. There is a clear need for quality improvement initiatives, for which a systems approach – rather than isolated interventions – is considered more effective. In this context, the Process Optimization Of the Medicines’ pAthway in nursing Homes (POOMAH) study was established. The study aims to evaluate the effectiveness of different formats and intensities of support provided to NHs to improve the quality of the medicines’ pathway.

METHODS: The intervention includes four arms, each offering a different level of support: access to toolbox, intervision meetings, external coaching and integration of a coordinating pharmacist. In total, 100 NHs participate in this study, with stratified randomization used to allocate them to the intervention arms. The primary outcome is the overall quality of the medicines’ pathway, through the calculation of performance scores. The key secondary outcome is the number of (psychoactive) medications used by NHRs. Other secondary outcomes include the quality of specific processes and KAs of the medicines’ pathway, represented by process-specific and activity-specific performance scores, and the number of falls and hospitalizations of NHRs. A comprehensive process evaluation will also be conducted. Both quantitative and qualitative data will be collected and analyzed using (generalised) linear mixed models and content/thematic analysis, respectively.

DISCUSSION: The POOMAH study will assess and compare the effectiveness of four support levels aimed at improving the quality of the medicines’ pathway in NHs. The findings will contribute to the evidence base on quality improvement in this context and inform future strategies, including the role of pharmacists in optimizing medication management.

CLINICAL TRIAL NUMBER: Not applicable. Although this study was not classified as a clinical trial by the ethics committee, it was retrospectively registered in the ISRCTN registry (ISRCTN17231220) on 07 May 2025 ( https://www.isrctn.com/ISRCTN17231220 ).

PMID:41188918 | DOI:10.1186/s12913-025-13613-9

Respir Res. 2025 Nov 4;26(1):306. doi: 10.1186/s12931-025-03378-4.

ABSTRACT

BACKGROUND: There is limited real-world evidence on the use and positioning of inhaled long-acting muscarinic antagonists (LAMAs) for treating severe asthma.

OBJECTIVE: We aimed to assess the differences in clinicians’ perspectives on prescribing LAMA for severe asthma across Europe.

METHODS: Within the Severe Heterogeneous Asthma Research collaboration, Patient-centred (SHARP) network, we conducted a multi-country survey of 470 respiratory clinicians in 2023-24.

RESULTS: Most participants were pneumonologists (83%). 68% reported using specific criteria for prescribing LAMA for severe asthma, primarily fixed bronchial obstruction (68%), frequent asthma exacerbations (65%), and a history of smoking (53%). Improved quality of life, lung function improvement, and reduction of asthma exacerbations were the three expected outcomes of LAMA treatment that showed the largest agreement across clinicians (85-95%). As compared to non-severe asthma specialists (about 50% of the sample), severe asthma specialists were more likely to report always prescribing LAMA before biologics (54 vs. 41%) and before oral corticosteroids (OCS) (51 vs. 40%). Approximately 90% of participants prioritised tapering or discontinuing OCS before stopping LAMA. Overall, participants in Northern (n = 73) and Western Europe (n = 71) appeared less prone to prescribe LAMA and less confident in their benefits compared to those from Eastern (n = 88) and Southern Europe (n = 238). In particular, most participants from Latvia (91%) and Lithuania (67%) reported that LAMAs are not reimbursed for severe asthma in their countries. Most participants who expressed their opinion favoured triple therapy (n = 236) over single inhaler therapy (n = 91).

CONCLUSION: Our findings show that barriers and heterogeneous approaches still limit LAMA prescription for severe asthma in Europe, potentially leading to the underuse of this treatment option. Establishing a clear role for LAMA within a precision medicine framework is crucial; this aspect is not yet firmly supported by current international recommendations.

PMID:41188910 | DOI:10.1186/s12931-025-03378-4

Child Adolesc Psychiatry Ment Health. 2025 Nov 4;19(1):119. doi: 10.1186/s13034-025-00974-6.

ABSTRACT

BACKGROUND: The severity of tics may influence executive function in children and adolescents diagnosed with tic disorders. The underlying mechanism is still inadequately researched. This study investigates the mediating role of premonitory urges in the relationship between tic severity and executive functioning, alongside the moderating effect of comorbidities.

METHODS: A total of 154 children and adolescents, aged 6 to 15 years, diagnosed with tic disorders, were recruited from Fujian, China. The Yale Global Tic Severity Scale (YGTSS), Premonitory Urges for Tics Scale (PUTS), and Behavior Rating Inventory of Executive Function (BRIEF) were utilized to evaluate tic severity, premonitory urges, and executive functioning. R software version 4.4.3 was used for descriptive statistics and Pearson correlation studies. The moderated mediator models were tested using Bayesian Structural Equation Modeling (BSEM).

RESULTS: A Bayesian simple mediation model revealed that the premonitory urge fully mediated the association between tic severity and executive functioning. Additionally, comorbidity was found to independently predict both the premonitory urge and executive functioning. In the context of a moderated mediation model, comorbidity intensified the association between tic severity and the premonitory urge, resulting in more pronounced indirect effects on behavioral regulation (BRI) and metacognition (MI). The Index of Moderated Mediation was significant for both BRI and MI, thereby confirming the enhancement of the mediation pathway driven by comorbidity.

CONCLUSIONS: This study is the first application of BSEM to clarify the mediating mechanism through which tic severity affects executive functioning via the premonitory urge, while concurrently validating the moderating effect of comorbidities. This finding supports the optimization of clinical assessment and intervention strategies.

PMID:41188908 | DOI:10.1186/s13034-025-00974-6

J Transl Med. 2025 Nov 4;23(1):1219. doi: 10.1186/s12967-025-07227-2.

ABSTRACT

BACKGROUND: Large language models (LLMs) are increasingly being applied in healthcare; however, their performance in specialized fields, such as oncology, is subject to temporal factors, including knowledge decay and concept drift. The impact of these temporal dynamics on LLM question-answering accuracy in oncology remains inadequately evaluated. This study aims to systematically assess the temporal evolution of LLM accuracy in responding to oncology-related questions using real-world data.

METHOD: We systematically collected relevant literature through 2025 by searching LLM-related keywords in PubMed, Google Scholar, and Web of Science databases. The inclusion criteria were as follows: (1) cancer-related research; (2) clear and complete question descriptions; and (3) complete answers. The final sample (n = 23) contained 614 research questions, comprising subjective questions (n = 223) and multiple-choice questions (n = 391). Following randomization of responses generated by three LLMs (ChatGPT-3.5, ChatGPT-4, and Gemini), we evaluated their accuracy across different cancer categories using both original scoring criteria and Likert scale scoring methods. Data analysis was performed using R statistical software, employing random or fixed effects models to calculate pooled mean differences (MD) and relative risks (RR) with their 95% confidence intervals (CI).

RESULTS: The findings demonstrated that in both subjective and objective oncology assessments, ChatGPT-3.5 (subjective questions MD = -3.30; objective questions RR = 0.92) and ChatGPT-4 (subjective questions MD = -7.17; objective questions RR = 0.93) showed declining performance trends over time, while Gemini exhibited significant improvements over time (subjective questions MD = 11.48; objective questions RR = 1.15). Notably, ChatGPT-3.5’s performance on subjective questions revealed a significant turning point between March 14, 2023, and April 26, 2023, shifting from initially superior performance on newer questions to inferior performance compared with original questions, with the performance gap progressively widening.

CONCLUSIONS: Our meta-analysis reveals temporal performance degradation in ChatGPT-3.5 and ChatGPT-4, which contrasts with the consistent improvement observed in Gemini. These findings provide essential guidance for the evidence-based deployment of LLMs in oncology.

PMID:41188901 | DOI:10.1186/s12967-025-07227-2

BMC Med Educ. 2025 Nov 4;25(1):1543. doi: 10.1186/s12909-025-08122-6.

ABSTRACT

BACKGROUND: Head trauma is the most common injury from accidents, making rapid and accurate assessment crucial. Incorrect evaluations can lead to serious complications, including brain dysfunction and death. Thus, it is vital to teach nursing students proper assessment techniques. This study evaluates the effectiveness of a digital game-based study guide for enhancing nursing students’ knowledge and practical skills in head trauma assessment.

METHODS: This quasi-experimental study involved nursing students in their 8th semester at Shahid Beheshti University of Medical Sciences in 2024, randomly assigned to control and intervention groups. Data collection occurred from May to July 2024. Both groups received two 2-hour face-to-face educational sessions in one week. The intervention group then utilized the digital game-based study guide. Knowledge and practical skills were assessed using a trauma evaluation tool and compared between groups, with data analyzed using SPSS version 20.

RESULTS: Ninety-three nursing students participated (44 males and 49 females), with a mean age of 22.78 years (SD = 1.24). A paired samples t-test showed statistically significant knowledge improvement in both groups (P < 0.05). An independent samples t-test indicated statistically significant differences in knowledge and practical skills between groups post-intervention (P < 0.05).

CONCLUSION: The study shows that a digital game-based study guide significantly enhances nursing students’ knowledge and skills in head trauma assessment.

TRIAL REGISTRATION: This study was registered in the Iranian Registry of Clinical Trials ( https://irct.behdasht.gov.ir ) with the IRCT ID: IRCT20210131050189N10, and it received approval on July 21, 2024.

PMID:41188890 | DOI:10.1186/s12909-025-08122-6

BMC Med Educ. 2025 Nov 4;25(1):1540. doi: 10.1186/s12909-025-08113-7.

ABSTRACT

BACKGROUND: Malnutrition and poor dietary intake are major health challenges today. There are well-established benefits of nutrition interventions, but a lack of formalized nutrition training in medical school and residency. There is also little published information regarding nutrition training impact on residents. Physicians lack knowledge, skills, confidence, and training to effectively counsel in daily practice. Consequently, there is urgent need to improve nutrition training in medicine.

METHODS: This pre-post study evaluated the impact of an online nutrition course provided to family medicine residents. Time was provided at Academic Half Day to complete the course as well as pre- and post-course surveys with knowledge tests through SurveyMonkey. Descriptive statistics were used to evaluate responses. The project was approved by the University of Saskatchewan Behavioural Research Board (Beh 4433).

RESULTS: Thirteen residents completed the pre-course questionnaire (response rate = 54%). Of these, ten (77%) felt they had received inadequate nutrition training, and all thought patients would benefit from improved nutrition counselling. Six residents completed the post-course questionnaire (response rate = 24%). All post-course respondents thought the course was beneficial and that it should be offered to all Canadian family medicine residents, with majority believing it should be mandatory. Respondents’ nutrition knowledge, confidence, beliefs on importance of nutrition counselling, and nutrition counselling in practice appear to increase/improve after training.

CONCLUSIONS: Implementation of formal nutrition training during residency is important and has the potential to positively influence family medicine residents’ nutrition knowledge, attitudes, and rates of nutrition counselling.

RECOMMENDATIONS: Future research with larger sample sizes is needed to support these conclusions and improve nutrition training during residency. Future studies should look at nutrition training in other specialties as well as examine the rate and quality of nutrition counselling after residency completion.

PMID:41188879 | DOI:10.1186/s12909-025-08113-7