Tag: pubmed

Syst Rev. 2026 May 9. doi: 10.1186/s13643-025-02975-0. Online ahead of print.

ABSTRACT

BACKGROUND: There are currently two opposing hypotheses regarding the risk factors for acquisition, colonisation and infection with multidrug-resistant Pseudomonas aeruginosa (MDR-PA) in the intensive care unit (ICU). Acquisition could be either endogenous or exogenous or both. It is of great interest to estimate pooled prevalence and describe individual and environmental factors associated with the colonisation and infection with MDR Pseudomonas aeruginosa in intensive care units.

METHODS: This systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol of this review has been registered under CRD42021233832 in the International Prospective Register of Systematic Reviews (PROSPERO) and has been published on Systematic review on November 2022All types of studies carried out in intensive care units (ICUs) were included. MEDLINE (Pubmed), EMBASE (OVID), the Cochrane Library (Wiley), Web of Science, CINAHL (EBSCOHost), LILACS (BIREME), Google Scholar and Open Grey were searched from 1983 to 2023 and the results of electronic searches were uploaded to Rayyan software. The methodological quality of the studies was assessed using the National Heart, Lung, and Blood Institute Critical Appraisal Tools. The I² test was performed to assess the statistical heterogeneity among the included studies. The publication bias was assessed by using the funnel plot and Egger’s test. Descriptive analysis and meta-analysis were performed. Fixed effect model were used to calculate the surveyed prevalence and odds ratio (OR) with their respective 95% confidence intervals (95% CI).

RESULTS: A total of 10,791 articles were identified, of which 13 were retained for descriptive analysis and 8 for meta-analysis. The majority of these 13 studies were conducted in Western countries. Methods were heterogeneous and few studies addressed environmental factors. The pooled prevalence of MDR-PA in the ICU was 4% (95% CI: 0%-11%). Identified risk factors were: length of stay in ICU (> 8 days), mechanical ventilation with OR: 3.19; 95% CI: 2.25-4.53, use of invasive devices with OR: 2.97; 95% CI: 2.40-3.68 (use of central venous catheter with OR: 3.16 95% CI: 1.87-5.33, the use of urinary catheters with OR: 2.65; 95% CI: 2.05-3.44, the use of parenteral nutrition with OR: 2.43; 95% CI: 1.15-5.16 and the use of arterial catheters with OR: 7.00; 95% CI: 2.77-17.68) and the use of antibiotics with OR: 3.69; 95% CI: 3.16-4.27 (carbapenem with OR: 4.12; 95% CI: 3.29-5.16, quinolones with OR: 3.31; 95% CI: 2.45-4.47, bectalactam with OR: 3.58; 95% CI: 2.4-5.24, and aminoglycosides with OR: 3.32; 95% CI: 2.33-4.73) and environmental factors.

CONCLUSION: All this suggest that acquisition or infection by MDR-PA in ICU could be due to endogenous and exogenous transmission. Due to the few numbers of studies analysed, further investigation with more studies is needed to draw definitive conclusions.

SYSTEMATIC REVIEW REGISTRATION: The protocol of this review has been registered under CRD42021233832 in PROSPERO and has been published on Systematic review on November 2022. Eyebe et al. (Syst Rev 11:270, 2022).

PMID:42106844 | DOI:10.1186/s13643-025-02975-0

Scand J Trauma Resusc Emerg Med. 2026 May 9. doi: 10.1186/s13049-026-01618-0. Online ahead of print.

ABSTRACT

BACKGROUND: Eye-related symptoms ranging from mild irritation to acute vision loss can lead to emergency calls. While many cases are benign, others involve chemical exposures or trauma requiring urgent care to prevent permanent damage. Prehospital characteristics, dispatch categorization, and early management of eye-related emergencies remain unexplored. The aim of this study was to provide a systematic description of eye-related emergency calls, including patient characteristics, dispatch categorization, and prehospital management, within the framework of the Danish Index for Emergency Care.

METHODS: We conducted a retrospective cohort study of all emergency calls [1-1-2] in Region Zealand, Denmark, from November 2017 to June 2025, describing eye symptoms. We linked data from the Computer-Aided Dispatch (CAD) system, the Prehospital Patient Records (PPJ), and the Danish National Patient Registry (NPR). Patient demographics, paramedic assessment of primary problem, on-scene symptoms, prehospital treatments and hospital outcomes were analysed using descriptive statistics.

RESULTS: A total of 376 patients were identified calling 1-1-2 and registered with eye related symptoms as the main complaint. Of these, 36 (9.6%) were excluded due to missing patient identifiers or prehospital patient records, leaving 340 in the cohort. Median age was 49.5 years (IQR 29-68), and 62.1% were male. Most calls were categorized as priority B (urgent situation not assessed as acute life-threatening) (70.9%). The leading primary problems were chemical exposures (31.5%), vision loss (25.9%), and ocular trauma (18.2%). Vision disturbance (54.4%) was the most frequently prehospital reported symptom. Prehospital interventions were rarely documented, with irrigation being the most reported procedure (27.1%). Notably, 39 of 340 patients (11.5%) were suspected of stroke prehospitally, and among 283 admitted to hospital, 21 (7.4%) received a confirmed TIA or stroke diagnosis. The median length of stay was 3.7 h (IQR 2.0-7.7). Most frequent discharge diagnoses were injury of the eye and orbit (17.7%), burn and corrosion confined to eye and adnexa (9.9%), and foreign body on external eye (7.8%).

CONCLUSION: Eye-related emergency calls were primarily caused by chemical exposures, vision loss, and trauma, with relatively short hospital stays. Several patients classified as eye-related problems were later diagnosed with stroke, highlighting the need for better dispatcher recognition of visual stroke symptoms.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:42106843 | DOI:10.1186/s13049-026-01618-0

Fluids Barriers CNS. 2026 May 9. doi: 10.1186/s12987-026-00811-8. Online ahead of print.

ABSTRACT

BACKGROUND: Alterations in amine metabolism have been implicated in Alzheimer’s disease (AD), but the relationships between plasma and cerebrospinal fluid (CSF) amine levels remain insufficiently understood.

AIM: To investigate longitudinal changes in amines in plasma and CSF, as well as their cross-matrix correlations, in male and female TgF344-AD transgenic rats compared with wild-type (WT) controls.

METHOD: LC-MS-based targeted metabolomics was used to quantify 60 plasma amines and 55 CSF amines in male and female TgF344-AD and WT rats at 12, 25, 50 and 85 weeks of age. Generalized linear models, Pearson correlations, and Fisher’s r-to-z transformation were applied for statistical analysis.

RESULTS: In plasma, age- and sex-associated differences were observed. At 25 weeks, three amines (4-hydroxy-proline, homocitrulline, and hydroxylysine) showed significantly increased levels in male TgF344-AD rats after multiple-testing correction. Additional trend-level changes were observed at 12, 50, and 85 weeks. In CSF, no amines passed the significance threshold after multiple-testing correction, although descriptive age- and sex-associated patterns were observed, with earlier changes in males and later-stage trends in females. CSF-plasma correlations tended to be stronger in TgF344-AD rats than in WT rats, with relatively strong correlations for alpha-aminobutyric acid, citrulline, N6,N6,N6-trimethyl-lysine, and putrescine.

CONCLUSIONS: Body fluid, age- and sex-dependent amine alterations in CSF and plasma of TgF344-AD rats compared to WT controls provide important insights into AD disease processes and may aid early diagnosis and therapeutic targeting.

PMID:42106823 | DOI:10.1186/s12987-026-00811-8

Nutr Metab (Lond). 2026 May 9. doi: 10.1186/s12986-026-01130-3. Online ahead of print.

ABSTRACT

PURPOSE: Personalized nutrition (PN) shows promise for improving cardiometabolic health; however, evidence on its summarized methodologies and effectiveness remains limited and inconsistent. This review evaluates the effects of PN interventions on cardiometabolic outcomes in adults with overweight or obesity.

METHODS: We searched five databases for randomized controlled trials (RCTs) published up to March 2026. Eligible RCTs included at least one biological component to guide personalized dietary advice. Data were pooled using a random-effects meta-analysis, with heterogeneity assessed by Cochran’s Q statistic and quantified using I2. Risk of bias and certainty of evidence were assessed.

RESULTS: Fifteen RCTs met the inclusion criteria, each comparing PN with standard, non-personalized dietary interventions. PN implementation varied substantially in the quantity and type of individual-level features, algorithms applied, and personalization strategies used. No significant differences were observed between PN and controls in energy intake or macronutrient composition. 46.7% employed specific dietary patterns as controls or withheld nutritional counseling. Pooled analyses showed slightly greater reductions in body weight and body fat in the PN group compared with controls, but no effects on body mass index, waist circumference, lipid profile, or glycemic markers. GRADE certainty ranged from moderate to very low across the assessed outcomes.

CONCLUSION: PN interventions modestly reduce body weight and body fat. Importantly, the absence of a standardized PN framework hampers evaluation and comparison of the effectiveness of nutritional personalization strategies. Future research should aim to establish standardized PN definitions, harmonized individual-level features, and transparent reporting. REGISTRY AND REGISTRY NUMBER FOR SYSTEMATIC REVIEWS OR META-ANALYSES: CRD420251134855.

PMID:42106813 | DOI:10.1186/s12986-026-01130-3

BMC Nurs. 2026 May 9. doi: 10.1186/s12912-026-04706-9. Online ahead of print.

ABSTRACT

AIM: To assess Egyptian nursing students’ level of AI knowledge, perceptions of AI benefits, and fears regarding AI in nursing education and practice, and to examine associated sociodemographic factors.

BACKGROUND: The rapid integration of artificial intelligence (AI) into healthcare has generated both enthusiasm and apprehension among nursing professionals and students. While AI offers substantial potential benefits in clinical efficiency, decision support, and educational innovation, important concerns remain regarding individualised care, professional displacement, and data privacy. This combination of promise and concern suggests a cautiously receptive context in which nursing students may recognise AI’s value while remaining uncertain about its implications for practice and education. Therefore, evidence-based assessment of nursing students’ knowledge and perceptions is needed.

METHODS: A cross-sectional descriptive design was utilised in this study. A convenience sample of 2412 nursing students was drawn from two nursing faculties between May 2024 and January 2025. Data were collected using a structured three-part questionnaire covering individual sociodemographic characteristics, a dichotomous AI knowledge test, and an attitude scale measuring perceived benefits and fears regarding AI.

RESULTS: Approximately 46.4% of students demonstrated good AI knowledge (mean score 3.2 ± 1.3 out of 5). The mean perceived benefits score was 10.9 ± 3.5 (maximum 14), indicating generally favourable views of AI’s educational and clinical support applications. The mean fear score was 5.0 ± 1.6. Notably, 72.2% of students expressed concern that AI may replace nurses in the future, and 57.8% reported discomfort with using AI in educational settings. Statistically significant differences were observed across academic years for knowledge, perceived benefits, and fears, and across age groups for perceived benefits and fears; age-related differences in knowledge were smaller but remained statistically significant. No significant differences were found by gender or university.

CONCLUSION: Egyptian nursing students demonstrated a foundational understanding of AI and broadly recognised its benefits for education and clinical support. Nevertheless, substantial gaps in formal AI training and pronounced fears about professional displacement were identified. Structured, ethically grounded AI educational programs are urgently needed to enhance students’ digital competencies and ensure the safe and effective use of AI in nursing practice.

CLINICAL TRIAL REGISTRATION: Not applicable.

PMID:42106807 | DOI:10.1186/s12912-026-04706-9

BMC Nurs. 2026 May 9. doi: 10.1186/s12912-026-04708-7. Online ahead of print.

ABSTRACT

BACKGROUND: Intensive care unit (ICU) delirium is highly prevalent and has profound impacts on patient outcomes. ICU nurses are ideally positioned to implement delirium prevention and management strategies. However, the effectiveness of these interventions is significantly influenced by nurses’ knowledge, attitude, and practice regarding delirium. Currently, there is a lack of large-scale investigations into Chinese ICU nurses’ knowledge, attitude, and practice status concerning ICU delirium.

AIMS AND OBJECTIVES: This study aimed to evaluate the current status of knowledge, attitude, and practice regarding ICU nurses in China.

DESIGN: A nationwide cross-sectional survey study was conducted.

METHODS: An 82-item questionnaire was developed to evaluate ICU nurses’ knowledge, attitude, and practice regarding delirium.It included a self-rated knowledge item (0-100 scale), 26 objective knowledge questions (scored 0-26, converted to percentages), 27 attitude items, and 20 practice items (both on 5-point Likert scales). Data were collected via an online survey platform. Descriptive statistics, including percentages, medians, and interquartile ranges, are reported. Univariate and multivariate analyses were used to identify factors affecting knowledge, attitude, and practice scores. The primary outcomes of this study were ICU nurses’ scores of knowledge, attitude, and practice of ICU delirium. Secondary outcomes comprised factors associated with these primary outcomes. This study adhered to the STROBE reporting guidelines.

RESULTS: Of the 5,476 responses, 5,146 (94.0%) were included. The sample comprised 4,369 females (84.9%), and 60.5% of participants had received delirium-related training. Nurses’ self-assessed knowledge score (76.1 ± 15.5, out of 100) was significantly higher than their objective knowledge score (63.2 ± 13.3, converted to a percentage; t = 48.202, P < 0.01). Using a threshold of ≥ 60% for moderate and ≥ 80% for excellent performance, 49.3% of nurses achieved moderate knowledge scores and 12.4% achieved excellent scores. For the attitude dimension, 71.6% scored in the excellent range, whereas practice scores were notably lower, with only 9.0% achieving excellence.Multivariable regression analyses revealed the following significant factors: Knowledge scores were significantly associated with hospital level (B = 1.810, 95% CI: 0.733 to 2.887), educational background (B = 3.617, 95% CI: 2.673 to 4.562), professional title (B = 2.335, 95% CI: 1.698 to 2.972), ICU type (B = 1.477, 95% CI: 1.050 to 1.904), and prior delirium training (B = 2.991, 95% CI: 2.271 to 3.710) (all P < 0.01).Attitude scores were independently associated only with prior delirium training (B = 4.720, 95% CI: 3.762 to 5.678, P < 0.01).Practice scores were significantly associated with professional title (B = 1.394, 95% CI: 0.701 to 2.087), ICU type (B = -0.874, 95% CI: -1.574 to -0.175), and prior delirium training (B = -8.524, 95% CI: -9.702 to -7.346) (all P < 0.01). Total KAP scores were significantly associated with educational background (B = 4.234, 95% CI: 2.349 to 6.120), professional title (B = 4.207, 95% CI: 2.929 to 5.484), and years of ICU experience (B = -2.262, 95% CI: -3.716 to -0.808) (all P < 0.01).

CONCLUSIONS: ICU nurses demonstrated moderate knowledge levels regarding delirium and overestimated their actual knowledge. While they exhibit positive attitudes toward delirium care, their clinical practice remains suboptimal. Nursing administrators and educators should implement stratified training programs tailored to nurses’ levels, establish comprehensive ICU delirium care standards, and increase nurses’ willingness and capability in practice.

PMID:42106804 | DOI:10.1186/s12912-026-04708-7

BMC Health Serv Res. 2026 May 9;26(1):671. doi: 10.1186/s12913-026-14636-6.

ABSTRACT

BACKGROUND: The COVID-19 pandemic accelerated telehealth service adoption in physiotherapy, including telerehabilitation (TR). However, the extent of TR use and factors influencing its implementation in Germany remain unclear. This study aimed to evaluate TR use in physiotherapy (during COVID-19 lockdowns, current use, future intentions, conditions treated, content, setting, and session type) and identify barriers and facilitators from physiotherapists’ (PTs) perspectives.

METHODS: A mixed-methods sequential explanatory design was employed, combining a cross-sectional online survey (n = 152) with two focus group interviews (n = 9). The survey collected data on demographics, TR use, barriers, and facilitators. Focus groups explored themes emerging from the survey in greater depth. Data were analyzed using descriptive statistics and content analysis, integrating quantitative and qualitative findings. Quantitative and qualitative findings were integrated through explanatory linking and joint display in a comparative analysis table.

RESULTS: TR use peaked during COVID-19 lockdown (32.26%) but decreased to 18.06% by October 2022, with 26.45% intending future use and 43.87% considering it. Among TR users, musculoskeletal conditions were most commonly treated (75%), followed by sports (38%), pulmonology (33%), and neurology (27%). The primary barrier was lack of physical examination (74% agreement). While technical challenges were not reported as a major barrier in the survey, interviews revealed significant concerns about insufficient internet bandwidth and technical infrastructure. Common reasons for using TR included promoting patient self-management (78% agreement) and broadening therapy options (69% agreement). Qualitative data identified additional implementation facilitators, including structured implementation processes, appropriate technical infrastructure, and patient involvement in decision-making.

CONCLUSION: While TR implementation in German physiotherapy shows growth potential, several barriers currently limit its adoption. Successful implementation requires addressing PTs capabilities, knowledge gaps, professional identity concerns, and environmental factors. Addressing these issues could enhance patient care quality, increase service accessibility, and advance healthcare delivery models.

PMID:42106802 | DOI:10.1186/s12913-026-14636-6

Cardiovasc Diabetol. 2026 May 9. doi: 10.1186/s12933-026-03180-6. Online ahead of print.

ABSTRACT

BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) and cardiovascular-kidney-metabolic (CKM) syndrome are interrelated conditions with shared pathophysiological features; however, the genetic architecture underlying their relationship has not been fully elucidated. Deciphering this shared genetic basis holds promise for advancing mechanistic insights and therapeutic discovery.

METHODS: We performed an integrated genome-wide cross-trait analysis using GWAS summary statistics for MASLD and 38 CKM traits. Our analysis estimated genetic correlations, inferred causal relationships, and identified pleiotropic variants. Candidate causal genes and druggable targets were subsequently prioritized through integrating multi-omics data.

RESULTS: MASLD exhibited significant genetic correlations with 16 CKM traits, especially metabolic and cardiovascular conditions. Bidirectional causal relationships were observed between MASLD and T2D, adiposity, and lipid traits. We discovered 116 pleiotropic loci, including 65 shared causal variants such as rs429358 near APOE, which exerted influence across multiple traits. Gene-based analyses prioritized 152 unique candidate pleiotropic genes, enriched in lipid and cholesterol metabolism, and highly expressed in the liver, adipose, and immune-related cell types, such as macrophages and endothelial cells. Multi-omics integration validated 131 genes using eQTL and pQTL data from multiple tissues and cohorts. Notably, FTO and APOE emerged as central pleiotropic hubs, and druggability evaluation highlighted APOE, LPL, PPARG, and GPBAR1 as established therapeutic targets for metabolic diseases.

CONCLUSION: This study provides a comprehensive map of the shared genetic architecture between MASLD and CKM syndrome, reveals novel causal genes and repurposable drug targets, and offers insights into precision medicine approaches for cardiometabolic and liver diseases.

PMID:42106791 | DOI:10.1186/s12933-026-03180-6

BMC Health Serv Res. 2026 May 9. doi: 10.1186/s12913-026-14617-9. Online ahead of print.

ABSTRACT

BACKGROUND: Clinical pathways are increasingly adopted to control costs and enhance quality management, becoming a standardized approach in treatment. This study aims to develop a hospital-specific clinical pathway for non-small cell lung cancer (NSCLC) surgery based on national standards and actual treatment practices, and evaluate its service efficiency through simulation.

METHODS: We analyzed 94 electronic medical records of NSCLC surgeries performed between May 2020 and November 2022, evaluating the need for localization by statistically examining treatment process delays. A Time Petri Net model was established for this pathway, with simulations conducted to measure post-implementation changes in hospital length of stay (LOS).

RESULTS: The hospital’s existing processes were generally consistent with national standards. Validation of the Time Petri Net model confirmed its effectiveness. Simulation results showed that the average LOS was reduced from a baseline of 8.20 days to 7.76 days, saving a total of ~ 10.28 h (individual diagnostic/treatment processes were shortened by 0.15-5.04 h).

CONCLUSION: Implementing this tailored clinical pathway significantly improved service efficiency by aligning it with national guidelines, enabling better integration and optimization of medical resources while improving overall clinical pathway management quality.

PMID:42106790 | DOI:10.1186/s12913-026-14617-9

BMC Oral Health. 2026 May 9. doi: 10.1186/s12903-026-08360-0. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effect of adding graphene oxide (GO) to HEMA-containing and HEMA-free universal adhesives on water sorption/solubility and bonding effectiveness to dentin.

MATERIALS AND METHODS: GO was incorporated into universal adhesives (Scotchbond Universal and G-Premio Bond) at three weight percentages (0.5, 1, and 3%) and characterized by SEM. Clearfil SE Bond was used as the reference adhesive. Disk-shaped specimens were prepared to evaluate water sorption and solubility (n = 10). Microspecimens were prepared from ninety extracted human third molar. The µTBS of half of the specimens was tested after 24 h, and the remaining specimens were aged for 6 months. Failure mode was analyzed using a stereomicroscope. Statistical analyses were performed with one-way ANOVA, Duncan, and paired t-tests (p = 0.05).

RESULTS: Adding 3% GO increased water sorption of the adhesives (p < 0.05). Clearfil SE Bond exhibited the lowest water sorption and solubility (p < 0.05). 1% GO significantly increased the immediate µTBS of the adhesives, whereas 3% resulted in a significant decrease (p < 0.05). 0.5 and 1% GO significantly increased the aged µTBS of Scotchbond Universal, while only 1% improved the aged µTBS of G-Premio Bond (p < 0.05). 3% GO reduced the aged µTBS of the adhesives (p < 0.05). The highest immediate and aged µTBS were recorded for Clearfil SE Bond (p < 0.05).

CONCLUSIONS: The bonding performance of universal adhesives improved with 0.5% and 1% GO additions, whereas 3% GO had a detrimental effect on both bond strength and water sorption.

CLINICAL SIGNIFICANCE: Adding GO to adhesives may improve the long-term durability of bonded restorations.

PMID:42106783 | DOI:10.1186/s12903-026-08360-0