Tag: pubmed

JMIR Med Educ. 2025 Dec 31. doi: 10.2196/77702. Online ahead of print.

ABSTRACT

BACKGROUND: Ultrasound is very important in medicine and teaching, but there are not many formal training programs. We also don’t know much about what students think. To be good at using ultrasound, you need to learn technical, thinking, and seeing skills. This is especially true in regional anesthesia (RA), where mistakes in reading images can cause problems. Training with simulations is a safe and good way to learn these skills. Some models are helpful for teaching how to do procedures with ultrasound.

OBJECTIVE: This study aimed to evaluate the effectiveness, localization time, and success rate of traditional versus a new simulation-based teaching method for regional anaesthesia designed by the investigators in undergraduate medical students.

METHODS: A prospective, randomized controlled trial was conducted at the University of Salamanca from April 2022 to January 2023. Thirty-four medical students in their 4th to 6th academic years were randomly allocated to either a simulation-based training group utilizing the Haptic US Probe (HUSP) or a traditional teaching group. The simulation approach employed a realistic probe replica and a software-based ultrasound environment, while the traditional method comprised a theoretical lecture and curated audiovisual materials. Two days post-training, participants underwent a blinded assessment requiring the identification of peripheral nerve plexuses using an ultrasound device. The primary outcome measured was the successful identification of nerves, and the secondary outcome was the time taken to complete each procedure. Data were analyzed using an intention-to-treat approach.

RESULTS: A total of 34 medical students (4th to 6th year) were recruited to compare traditional teaching with simulation-based training in ultrasound-guided nerve localization. No statistically significant differences were found in the success rates between the groups. For the interscalene approach, the traditional group achieved a 100% success rate compared to 82.3% in the simulation group (p=0.07). The time to task completion was similar across most procedures. In the sciatic nerve division, the traditional group was significantly faster, with a mean time of 74.67 s (p = 0.02). The regression models showed no significant interaction between the intervention type and academic year. Both teaching methods had positive educational impacts.

CONCLUSIONS: Simulation-based learning effectively supports competency acquisition in regional anaesthesia and offers a safe, scalable alternative to traditional methods. Its integration into medical curricula may standardize training, improve skill consistency, and enhance patient safety. Further multicentre studies with larger, diverse cohorts are needed to validate these benefits and guide implementation in medical education.

PMID:41477696 | DOI:10.2196/77702

Int J Pediatr. 2025 Dec 12;2025:1501028. doi: 10.1155/ijpe/1501028. eCollection 2025.

ABSTRACT

BACKGROUND/OBJECTIVE: Delayed umbilical cord clamping (DCC) for 30-60 s after birth is recommended for both term and preterm infants. The additional neonatal blood volume rich in stem cells and immunoglobulins may protect the neonate from infections. We aim to compare the effect of DCC in term newborns on hyperbilirubinemia and respiratory infection-related pediatric emergency department (PED) encounters and hospitalizations within the first 6 months of life.

METHODS: We conducted a chart review of term infants born between January 1, 2022 and December 31, 2022 and grouped them as either having DCC or not having delayed umbilical cord clamping (nDCC) for 30-60 s after birth. Maternal and newborn characteristics, hyperbilirubinemia, respiratory infection-related PED encounters, hospitalizations, and length of stay in the initial 6 months after birth were compared. Data were analyzed using R software, a p value of < 0.05 was considered statistically significant.

RESULTS: Of the 2136 charts reviewed, 659 (31%) were in the DCC group. There were significantly fewer respiratory infection-related PED encounters (p < 0.001), fewer hospitalizations (p = 0.04), and a 5% lower incidence of hyperbilirubinemia in the DCC group (95% CI: 0.86%-8.6%; p = 0.02). The length of stay of each hospitalization was not significantly different between the two groups, p = 0.07.

CONCLUSIONS: We observed fewer respiratory infection-related PED encounters and hospitalizations in the initial 6 months of life and a lower incidence of hyperbilirubinemia among the infants who had DCC. The increased blood volume and its components appear to be supportive of the neonate’s developing immune system as seen in the lower disease burden up to 6 months of age.

PMID:41477680 | PMC:PMC12752858 | DOI:10.1155/ijpe/1501028

J Nurs Manag. 2025 Dec 29;2025:3338222. doi: 10.1155/jonm/3338222. eCollection 2025.

ABSTRACT

INTRODUCTION: Nursing home staff turnover remains a concern in long-term care facilities, with implications for job performance, organisational morale and patient outcomes. This study explored the factors influencing intention to leave among nursing home care staff in Singapore and focused on the influence of demographic variables, work environment and job satisfaction.

METHODS: A cross-sectional survey was employed to collect data from 167 care staff working at two nursing homes in Singapore. Instruments included the Practice Environment Scale of the Nursing Work Index (PES-NWI), Job Satisfaction Survey (JSS) and Intention to Leave Scale (ILS). Data were analysed using descriptive and inferential statistics, including hierarchical multiple regression, to examine relationships between demographic characteristics, work environment, job satisfaction and intention to leave.

RESULTS: The study found a moderate overall intention to leave (mean ILS = 9.18, SD = 2.494). Female staff, mid-career professionals (aged 30-39) and nursing aides exhibited the highest turnover intentions. Job satisfaction, particularly in terms of managerial support and staffing adequacy, emerged as a significant predictor of intention to leave. Work environment factors, especially staffing and resource adequacy, are crucial in turnover intentions.

DISCUSSION: This study highlights key factors driving turnover intentions among nursing home care staff in Singapore. Interventions to mitigate turnover and improve staff retention are recommended to improve staffing levels, managerial support and career development pathways.

PMID:41477676 | PMC:PMC12748931 | DOI:10.1155/jonm/3338222

J Nurs Manag. 2025 Dec 30;2025:4922972. doi: 10.1155/jonm/4922972. eCollection 2025.

ABSTRACT

BACKGROUND: Nurses’ well-being at work has become a global concern due to persistent stressors such as staff shortages, shift work, emotional demands and limited autonomy. Most existing studies take a deficit-centred perspective, focussing on burnout or work stress and ignoring the complexity of holistic well-being.

AIM: The aim of this study was to assess nurses’ levels of well-being at work across six well-being domains and explore its relationship with job satisfaction, health status and functional limitations.

METHODS: A cross-sectional survey was conducted among 767 nurses working in various healthcare institutions in Slovenia. The six-dimensional well-being scale for nurses, which was translated and psychometrically validated for this study, was used to assess physical, emotional, intellectual, social, occupational and spiritual well-being.

RESULTS: The overall median score for nurses’ well-being at work was 2.97 (on a scale of 1-5), slightly below the neutral midpoint (M = 3.00). Among the dimensions, physical (M = 3.12), emotional (M = 3.18) and spiritual (M = 3.21) were rated lowest, while social (M = 3.60) and occupational (M = 3.58) were rated highest. Nurses with long-term health conditions or activity limitations gave significantly lower scores for well-being in the physical, emotional and occupational domains (p < 0.001). Higher job satisfaction was positively correlated with general well-being (r _s = 0.327, p < 0.001). Age and length of service were weakly negatively correlated with several domains of well-being (p < 0.001).

CONCLUSIONS: Nurses’ well-being at work has many facets and is influenced by personal health, job satisfaction and professional context. A holistic model can highlight strengths and weaknesses that are often overlooked in traditional, burnout-centred approaches.

IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should incorporate well-being into HR policy through relationship-centred leadership, flexible working practises and values-led support. Interventions should include reflective spaces, mentoring and learning opportunities tailored to emotional, intellectual and spiritual development. Monitoring dimensions of well-being as a key performance measure can lead to sustainable improvements in healthcare.

PMID:41477675 | PMC:PMC12750141 | DOI:10.1155/jonm/4922972

J Nurs Manag. 2025 Dec 29;2025:4086275. doi: 10.1155/jonm/4086275. eCollection 2025.

ABSTRACT

INTRODUCTION: Nurses face numerous challenges in clinical settings that can negatively affect their well-being. Little is known about bedside nurses’ well-being in Saudi Arabia. Therefore, this study explored the well-being of nurses working in Saudi Arabia and identified the contributing factors.

METHODS: This was a cross-sectional study that utilized convenience sampling. Data were collected from 550 nurses working in the Saudi healthcare sector. The Nurse Well-Being Index was utilized to measure the well-being. Data were analyzed using descriptive statistics, analysis of variance, and logistic regression.

RESULTS: The findings showed that 74.2% of nurses were at an increased risk of poor well-being, with frontline nurses facing a further increased risk of poor well-being (83%). Results showed significant associations between nurses’ well-being and level of education (p = 0.002), workplace (p < 0.001), practice setting (p < 0.001), working region (p < 0.001), bed capacity (p = 0.017), quality of nursing care (p < 0.001), and job satisfaction (p < 0.001). The regression analysis revealed that nurses’ well-being was significantly influenced by years of experience (OR = 0.881, p = 0.027), working region-western region (OR = 2.720, p = 0.031), practice setting-critical care and medical-surgical (OR = 7.492, p < 0.001; OR = 3.222, p = 0.047, respectively), and quality of nursing care (OR = 4.639, p = 0.003).

DISCUSSION: This study revealed that most nurses were at an increased risk of poor well-being. It also provided insights into various individual, organizational, and job-related factors that contribute to well-being. Future studies are needed to identify different aspects of nurses’ well-being to develop strategies for improving their well-being and reduce burnout and other detrimental health outcomes.

PMID:41477674 | PMC:PMC12748531 | DOI:10.1155/jonm/4086275

Gastroenterol Res Pract. 2025 Dec 22;2025:5054381. doi: 10.1155/grp/5054381. eCollection 2025.

ABSTRACT

BACKGROUND: Transoral incisionless fundoplication (TIF) presents a minimally invasive, endoscopic treatment for the management of gastroesophageal reflux disease (GERD), known for its efficacy and safety in patients with normal esophageal motility. However, the use of TIF in ineffective esophageal motility (IEM) remains largely unexplored. This study examined the outcomes of TIF in IEM patients.

METHODS: Retrospective data from 164 patients, including 29 with IEM and refractory GERD, were analyzed to obtain assessments of disease-specific quality of life through the Gastroesophageal Reflux Disease Health-Related Quality of Life Questionnaire (GERD-HRQL) and proton pump inhibitor usage.

RESULTS: Statistically significant improvements were seen in total, heart burn, and regurgitation GERD-HRQL scores (p < 0.001, p < 0.001, p < 0.001) and reduction in PPI use (0 < 0.001) after TIF, with no significant difference in dysphagia risk (p < 0.2).

CONCLUSION: This study underscores durable improvements that TIF can provide in quality of life in patients with both GERD and IEM, without compromising the increased risk of dysphagia. Although some patients resume antisecretory medications within 3-6 months, most stopped taking PPI after the procedure.

PMID:41477667 | PMC:PMC12752835 | DOI:10.1155/grp/5054381

F1000Res. 2025 Aug 22;14:813. doi: 10.12688/f1000research.167793.1. eCollection 2025.

ABSTRACT

AIM & BACKGROUND: Women with autoimmune diseases usually require contraception. Various factors influence women with autoimmune diseases who do not use contraceptive methods. However, there has been no research on the unmet need for contraception in patients with autoimmune diseases. Therefore, this study aimed to determine the relationship between sociodemographic factors and unmet need for contraception in patients with autoimmune diseases.

METHODS: This was a cross-sectional study of female patients aged 15-49 years who had autoimmune diseases at the Internal Medicine Clinic of Dr. Cipto Mangunkusumo Hospital. The subjects were then asked to complete the informed consent form and questionnaire. Statistical analyses were performed using the chi-square test for bivariate analyses.

RESULTS: We included 92 subjects with a mean age of 35.6±6.26 years old, with an age range was 25-48 years old. Twenty (21.7%) subjects had an unmet need for contraception, while 72 (69.4%) used contraception or were planning for pregnancy. We found that education level (p=0.017) and Internet usage frequency (OR 3.42; 95%CI 1.02-11.45; p=0.037) were significantly associated with unmet need contraception in females with autoimmune disease.

CONCLUSION: This study found that education level and Internet usage frequency were significantly associated with unmet need contraception in females with autoimmune disease.

CLINICAL SIGNIFICANCE: The findings emphasize that education and Internet access are vital for meeting the contraceptive needs of women with autoimmune diseases.

PMID:41477650 | PMC:PMC12749561 | DOI:10.12688/f1000research.167793.1

Front Cardiovasc Med. 2025 Dec 16;12:1692351. doi: 10.3389/fcvm.2025.1692351. eCollection 2025.

ABSTRACT

PURPOSE: The ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) has recently been identified as a novel lipid marker for assessing the risk of atherosclerosis-related diseases. However, the relationship between NHHR and the risk of retinal vein occlusion (RVO) has not yet been thoroughly investigated. The objective of this study was to investigate the correlation between NHHR and patients with RVO.

METHODS: This retrospective study examined 54 patients diagnosed with RVO and 57 age- and gender-matched control subjects. Comprehensive ocular examinations and hematological assessments were conducted for all participants. Logistic regression analysis was employed to evaluate the association between lipid markers and the risk of RVO. The receiver operating characteristic (ROC) curve was utilized to analyze and determine the predictive value and optimal threshold of the NHHR, triglyceride-glucose (TyG) index, and other conventional lipid parameters for RVO.

RESULTS: Compared to the control group, patients with RVO exhibited significantly higher levels of triglyceride (TG), TyG index, and NHHR (P = 0.0004, P = 0.0006, and P < 0.0001, respectively). Additionally, the high-density lipoprotein cholesterol (HDL-C) index was significantly lower in the RVO group compared to the control group (P < 0.0001). Univariate analysis indicated that NHHR (OR: 3.41, P < 0.001), TyG index (OR: 3.32, P = 0.001) and TG (OR: 2.64, P = 0.003) were significantly associated with RVO. Multivariate analysis revealed that NHHR was remarkably associated with RVO (OR: 2.09, P = 0.037). After further adjustment for hypertension, TG, and the TyG index, this association remained statistically significant (OR: 3.13, P = 0.003). The areas under the ROC curve for TyG index, TG, HDL-C, and NHHR were 0.679, 0.692, 0.739, and 0.752, respectively. Notably, the AUC value for NHHR demonstrated a moderate sensitivity (50.88%) and high specificity (87.04%), indicating its potential as a promising biomarker for the diagnosis and prognosis of RVO.

CONCLUSION: The NHHR was significantly elevated in patients with RVO, suggesting that this novel lipid marker may play a crucial role in the risk of developing RVO.

PMID:41477647 | PMC:PMC12748148 | DOI:10.3389/fcvm.2025.1692351

Front Genet. 2025 Dec 16;16:1605675. doi: 10.3389/fgene.2025.1605675. eCollection 2025.

ABSTRACT

Almost half the mammalian genomes consist of transposable elements (TEs) and their derivatives. The distribution density of TEs can be associated with genomic regions of chromosomal rearrangements in different mammalian species and with the genomic localization of protein-coding genes that differ in length and function. To evaluate these characteristics at the local genomic level, an analysis of the distribution of various TEs (retrotransposons and DNA transposons) was performed in three mammalian species (human, cattle, and domestic rabbit) in genes with different functions and chromosomal localizations and their flanking regions. In humans and rabbits, melanophilin (MLPH) and myostatin (MSTN) are syntenic, but not in cattle. In the latter, MLPH and the leptin receptor (LEPR) are syntenic, but not in humans and rabbits. The alpha-thalassemia gene is always located on chromosome X. The results indicate that the frequencies of different TEs are species-specific and do not depend on the length of genes, their function, or chromosomal localization. There were also species-specific differences in the ratio of “ancient” and “young” short interspersed nuclear elements (SINEs) and long interspersed nuclear elements (LINEs). There was a statistically significant positive correlation between ancient SINE + LINE and LTR-ERV (p < 0.01) and a significant negative correlation between young SINE + LINE and DNA transposons (p < 0.05). Competitive relationships between TEs are probably defined by the presence of identical regulatory motifs in different TEs, associated with the reliance of TE amplification on the host’s own regulatory systems.

PMID:41477637 | PMC:PMC12748216 | DOI:10.3389/fgene.2025.1605675

Eur J Radiol Open. 2025 Dec 10;16:100716. doi: 10.1016/j.ejro.2025.100716. eCollection 2026 Jun.

ABSTRACT

INTRODUCTION: Optimizing the diagnostic approach to thyroid nodules remains a crucial challenge. Ultrasound-based risk stratification systems such as EU-TIRADS have shown reasonable sensitivity and specificity. Therefore, we conducted a systematic review and meta-analysis to assess the diagnostic performance of Artificial Intelligence (AI) models in differentiating benign from malignant thyroid nodules on ultrasound data.

METHODS: A comprehensive search of PubMed/MEDLINE, Scopus, and Web of Science was performed up to January 1, 2025. Eligible studies included patients with thyroid nodules undergoing ultrasound, where AI-based models were validated against cytological or histological findings. The AI algorithms were developed using different types of ultrasound-derived data, including B-mode images, radiomics features. Pooled sensitivity, specificity, and area under the curve (AUC) were estimated using a hierarchical summary receiver operating characteristic (HSROC) model.

RESULTS: Twenty-seven studies comprising 146,332 patients and over 600,000 ultrasound images met inclusion criteria. Overall, pooled sensitivity was 87 % (95 % CI: 84-89 %) and specificity 83 % (95 % CI: 79-86 %). The summary operating point indicated a sensitivity of 88 % and specificity of 83 %, with an AUC of 91.9 % (95 % CI: 90.0-93.2 %). Although subgroup analysis suggested higher accuracy when cytology was used as the reference standard compared to histology, the mixed-effects meta-regression did not confirm a statistically significant association (p = 0.238 for sensitivity; p = 0.188 for specificity).

CONCLUSION: AI-based algorithms show excellent diagnostic performance in distinguishing benign from malignant thyroid nodules, with robust validation across external datasets. These findings support the potential integration of AI into clinical thyroid nodule management, although further multicenter, non-Asian, and histology-based studies are warrantee.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO (CRD420251108149).

PMID:41477624 | PMC:PMC12752752 | DOI:10.1016/j.ejro.2025.100716