Tag: pubmed

J Orthop Surg Res. 2025 Jul 8;20(1):620. doi: 10.1186/s13018-025-05996-6.

ABSTRACT

BACKGROUND: Avascular necrosis (AVN) of the talus presents considerable clinical challenges and is frequently associated with poor treatment outcomes. While 3D-printed customized talar prosthesis has shown promising potential in total talar replacement (TTR), current materials create a hard-soft mismatch with native cartilage, increasing local stress, accelerating wear, and causing complications. The objective of this study was to identify the most suitable combination of buffering layer material and thickness for talar prosthesis.

METHODS: This study employed dynamic biplane radiography (DBR) integrated with finite element analysis (FEA) to systematically evaluate how prosthetic material selection and buffering layer thickness affect periprosthetic cartilage biomechanics. We investigated the effects of mechanical stress on prosthesis adjacent cartilage (PAC) in 8 participants using 9 commonly used prosthetic materials with varying elastic moduli, combined with different cushioning layer thicknesses, across 5 gait phases. Statistical analyses included repeated measures ANOVA, Tukey’s HSD post hoc tests, and a linear mixed-effects model to assess the impact of material properties and thickness on PAC stress.

RESULTS: Compliant buffering layers composed of 3 mm polycarbonate urethane (PCU) effectively restored cartilage stress distributions to physiologically native levels during key phases of gait. We also found that soft prosthetic materials significantly reduce PAC stress compared to conventional hard materials. All hard prosthesis (Al2O3, Ti-6Al-4 V, CoCrMo, PyC and PEEK) showed higher stress than native group (p < 0.01). Notably, a buffering layer thickness of 1.5 mm with an elastic modulus below 43.32 MPa, or a 3 mm layer with an elastic modulus below 96.94 MPa, significantly reduced PAC stress to levels comparable to the native condition.

CONCLUSIONS: Our results indicate that when the prosthesis incorporates a 1.5-mm buffering layer with an elastic modulus below 43.32 MPa, or a 3 mm layer with an elastic modulus below 96.94 MPa, the peak stress in the PAC closely approximates that of the native condition. Furthermore, our findings indicate that a 3 mm PCU layer shows potential as a buffering component for talar prostheses. These findings provide preliminary insights for optimizing the material selection and structural design of talar prosthesis in TTR.

PMID:40629372 | DOI:10.1186/s13018-025-05996-6

Malar J. 2025 Jul 8;24(1):221. doi: 10.1186/s12936-025-05472-w.

ABSTRACT

BACKGROUND: Malaria remains a significant global health challenge, particularly in sub-Saharan Africa (SSA), where asymptomatic cases contribute to ongoing transmission and hinder elimination efforts. Asymptomatic individuals act as hidden reservoirs, sustaining onward malaria transmission. This study aimed to determine the prevalence and risk factors of asymptomatic malaria in Mwandi District, Zambia.

METHODS: A cross-sectional study was conducted between January to May 2024 in Mwandi District. Blood samples were collected for malaria diagnosis and simultaneously tested using rapid diagnostic tests and Giemsa-stained blood smear microscopy techniques to detect Plasmodium infections. Structured questionnaires were administered to gather demographic data and information on potential risk factors. Descriptive statistics were used to summarize the data while categorical variables were compared using the chi-square test or Fisher’s exact test. Logistic regression was used to assess associations between outcomes and independent variables, with statistical significance set at p < 0.05.

RESULTS: A total of 370 participants were enrolled in the study, with females comprising the majority (52.4%) and a median age of 24 years (IQR: 9-30). The overall prevalence of asymptomatic malaria was (4.1%), as determined by microscopy. Logistic regression analysis showed that females had significantly lower odds of asymptomatic malaria compared to males (AOR: 0.20, 95% CI 0.05-0.68; p = 0.010). Additionally, participants residing in Matoya and Sikute were more likely to have asymptomatic malaria, with adjusted odds ratios of 4.56 (95% CI 1.10-18.80; p = 0.036) and 4.72 (95% CI 1.03-21.50; p = 0.045), respectively. No significant associations were found with insecticide-treated net use, indoor residual spraying, or socioeconomic status.

CONCLUSION: The findings highlight the need for targeted surveillance and interventions in high-risk groups and locations to curb silent transmission. Despite limitations in diagnostic sensitivity, the study underscores the importance of integrating asymptomatic malaria screening into control programmes to advance elimination efforts in Zambia and similar endemic regions.

PMID:40629364 | DOI:10.1186/s12936-025-05472-w

BMC Palliat Care. 2025 Jul 8;24(1):193. doi: 10.1186/s12904-025-01833-z.

ABSTRACT

BACKGROUND: Patients with palliative care needs often rely on emergency departments for management of acute symptoms due to limited access to timely and appropriate outpatient care, however they can be poorly equipped to meet patients’ complex needs. Rapid access clinics exist for addressing health issues such as chest pain but are not routinely established for palliative care. In 2020, the Sunshine Coast Health Palliative Care Service introduced a rapid access clinic to address patients’ unmet acute care needs. This research aimed to understand the impact on clinical outcomes.

METHODS: A retrospective observational analysis of patient health records was undertaken for 283 admissions for 172 patients who attended the clinic between 1 January 2020 and 31 December 2022, and included demographic and diagnostic information, reason for admission and date of death. Statistical analysis of differences using the chi squared test was conducted for age (< 70 years vs. ≥ 70 years), gender and mortality at 30 days after discharge from the clinic. Fisher’s exact test was used to assess associations between the type of admission and the likelihood of preventing an emergency department visit. Confidence interval was set at 95%.

RESULTS: Attendance at the rapid access clinic was judged to likely result in avoidance of an emergency department visit for 11.7% of admissions. A potentially avoided emergency department visit was associated with mortality within 30 days (22.9%), X² (1)= 9.82, p =.002, and urgent admission to the rapid access clinic (31.5%), p <.001, OR = 22.6 (95% CI: 7.63, 66.87). There were more planned (67.5%) than urgent admissions. Mortality within 30 days of presentation to the clinic was 24.6%, and significantly associated with male gender (31.3%), X² (1) = 6.02, p =.014 and urgent admission (34.8%), X² (1) = 6.7, p =.008.

CONCLUSIONS: A newly established palliative care rapid access clinic addressed acute symptoms in a timely manner and may offer a valuable alternative to emergency department care, particularly for patients nearing the end of life. Further prospective research using control groups and validated patient outcome measures would provide more robust evidence about the clinic’s effectiveness in optimising end-of-life care and reducing the burden on our emergency departments.

PMID:40629363 | DOI:10.1186/s12904-025-01833-z

World J Surg Oncol. 2025 Jul 8;23(1):269. doi: 10.1186/s12957-025-03932-w.

ABSTRACT

BACKGROUND: The study investigates the prognostic differences between breast-conserving surgery (BCS) and mastectomy in patients with invasive ductal carcinoma of the breast who achieve a complete response (CR) after neoadjuvant chemotherapy.

METHODS: This study analyzed data from 9,411 patients diagnosed with invasive ductal carcinoma of the breast who achieved complete response following neoadjuvant chemotherapy, using data from the SEER database between 2010 and 2019, comprising 4,219 patients in the BCS group and 5,192 in the mastectomy group. Propensity score matching (PSM) was employed to control for confounding variables, and univariate and multivariate analyses were performed to identify variables associated with overall survival (OS) and cancer-specific survival (CSS). Kaplan-Meier survival curves were used to evaluate the prognosis of patients in the two groups.

RESULTS: The multivariate Cox regression analysis demonstrated that histological subtype, T stage, N stage, surgical method, and radiotherapy were risk factors for CSS, while age, histological subtype, T stage, and N stage were associated with OS (p < 0.05). Following matching, the Kaplan-Meier survival analysis curve suggested that the BCS group had higher CSS than the mastectomy group (p < 0.05), although there was no statistically significant difference in OS between the two groups (p = 0.16). Subgroup analysis revealed that, among patients aged ≤ 50, of White ethnicity, with grade 3 tumors, and HR+/HER-2- subtype, the BCS group exhibited superior CSS compared to the mastectomy group (p < 0.05).

CONCLUSION: Patients with invasive ductal carcinoma of the breast who achieve complete response following neoadjuvant chemotherapy experience better CSS benefits with BCS compared to undergoing mastectomy.

PMID:40629357 | DOI:10.1186/s12957-025-03932-w

BMC Health Serv Res. 2025 Jul 8;25(1):941. doi: 10.1186/s12913-025-13081-1.

ABSTRACT

INTRODUCTION: Magnetic resonance imaging (MRI) holds transformative potential for advancing clinical practice and professional growth in radiography. However, African radiographers face limited opportunities to engage in evidence-based practice through research. This study evaluates the level of MRI research engagement among, the factors motivating their participation, and the barriers impeding their progress.

METHODS: A cross-sectional study was conducted among 312 radiographers recruited through convenience sampling. Participants completed a self-administered online questionnaire via Google Forms. Due to the open online distribution through professional networks, a response rate could not be precisely calculated. Descriptive and inferential statistical analyses assessed associations between categorical variables, with a significance threshold of p < 0.05.

RESULTS: Of the 312 participants, 21.2% reported prior involvement in MRI research. Engagement was higher among radiographers with postgraduate qualifications (39.6%). Also, radiographers in academic roles were 47.4%, those working in both public and private facilities were 32.3%, and those with access to MRI scanners were 25.0%. Motivating factors included peer support (10.3%), membership in research groups (8.7%), research training (8.7%), and mentorship (8.3%). A significant association was observed between MRI scanner availability and interest in research (p = 0.0001). Barriers included insufficient funding (68.3%), time constraints (51.9%), and inadequate research skills (37.2%).

CONCLUSION: Despite a strong interest in MRI research, the surveyed cohort of radiographers from the 18 Sub-Saharan African countries encounter significant barriers, resulting in low engagement levels. Addressing these challenges through targeted training, mentorship, and the creation of dedicated research roles is essential to fostering evidence-based practice and innovation in radiography.

IMPLICATIONS FOR PRACTICE: The findings emphasize establishing protected research time, fostering regional and international collaborations, and implementing structured skill development programs. Such measures can enhance research activity, promote innovation, and improve patient care and diagnostic outcomes in African radiography practice.

PMID:40629356 | DOI:10.1186/s12913-025-13081-1

BMC Oral Health. 2025 Jul 8;25(1):1127. doi: 10.1186/s12903-025-06507-z.

ABSTRACT

BACKGROUND: Restoring first permanent molars after endodontic treatment in children is challenging. Improved mechanical properties and adhesion of ceramic materials have led to the emergence of endocrown as a conservative and esthetic restorative option for endodontically treated molars in adults and offer dentists a restorative treatment for endodontically treated first permanent molars in children. The purpose of this study was clinical and radiographic evaluation of both endocrowns fabricated from 2 different materials and SSCs restoring endodontically treated first permenant molars in children over one year.

METHODS: Thirty children were selected (18 girls and 12 boys) with an age range of 10-13 years old, with an endodontically treated first molar. Children were randomly divided into 3 groups: PMC group (restored with preformed SSCs), EMX group (restored with litium disilicate endocrown), and COP group (restored with indirect reinforced composite endocrown) (n = 10). Evaluation was done in terms of parent satisfaction, radiograph (base line and 12 months), the restoration survival after 12 months, plaque index (PI), and gingival index (GI) at base line, 6 months, and 12 months.The data were analyzed using the Kruskal-Wallis H-test, which was used to compare an ordinal variable, and Friedman’s test was used to compare an ordinal variable (P ≤.050).

RESULTS: Parent satisfaction showed statistically significant differences between PMC (mean rank = 7.5) and both EMX and COP (mean rank = 19.5) (P <.001), but not between the EMX and COP groups (P = 1.00). At 6 and 12 months, the PMC group’s PI values were statistically significantly higher than those of the EMX and COP groups (P =.001 and P <.001, respectively). The GI values of the EMX and COP groups did not change significantly through different intervals (P = 1.000 and P =.135, respectively), whereas the GI values of the PMC group did (P =.050). At various intervals, it was found that there was no significant difference in the GI values between the three groups.

CONCLUSIONS: The survival rates of endorowns and SSCs were comparable. Compared to SSCs, endocrowns demonstrated a higher parental satisfaction, less plaque buildup, and improved gingival response.

TRIAL REGISTRATION: The study protocol was retrospectively registered on Clinical Trials under No. (NCT06432049-29/05/2024).

PMID:40629344 | DOI:10.1186/s12903-025-06507-z

BMC Nurs. 2025 Jul 8;24(1):882. doi: 10.1186/s12912-025-03493-z.

ABSTRACT

BACKGROUND: The skull base exhibits a complex structure that contains numerous important nerves and blood vessels; furthermore, it is adjacent to important organs in the maxillofacial region. Skull base fractures are relatively common in cases involving traumatic brain injuries (TBI). Most skull base fractures are treated conservatively through absolute bed rest, which entails numerous challenges for nursing care. The use of a combination of virtual reality (VR) technology with 3D printing technology can offer a vivid and three-dimensional presentation of the location and type of skull base fractures alongside their relationships with important surrounding structures. This approach can increase patients’ knowledge of skull base fractures and help patients better understand their treatment plans, thereby improving their treatment compliance, reducing complications, and alleviating the workload faced by nurses.

METHODS: Patients with skull base fractures were randomly divided into a traditional nursing group and a combined VR and 3D printing nursing group. Evaluations were conducted to address multiple issues, including patients’ disease awareness, treatment compliance, complications, psychological assessment, and nurses’ work efficiency.

RESULTS: Patients in the nursing group combining traditional nursing teams with VR and 3D printing were randomly divided into 30 cases each. An analysis of the general data collected regarding these two groups of patients revealed no statistically significant differences between the groups in terms of age, gender, level of education, fracture site, cause of injury, or time of admission (P > 0.05). The questionnaire survey that was used to investigate patients’ awareness of skull base fractures indicated that participants in the observation group outperformed those in the control group in multiple dimensions (P > 0.05). In terms of treatment compliance, all the compliance indicators were significantly better among participants in the observation group than among those in the control group (P < 0.05). No statistically significant differences were observed between the observation group and the control group in terms of the rates at which various complications (such as increased intracranial hemorrhage, infection, and nerve injury) occurred (P > 0.05). The total psychological scores attained by patients in the observation group were superior to those attained by patients in the control group, as were their scores on multiple dimensions (P < 0.05). Moreover, the self-efficacy scale was used to evaluate the psychological states of nurses with the same number of years of work experience after different methods of health education were used. The results revealed that participants in the observation group obtained results that were better than those obtained by participants in the control group with regard to their total scores as well as their scores on multiple specific items (P < 0.05).

CONCLUSIONS: This research indicates that a nursing model that integrates VR with 3D printing can improve the quality of the care provided to patients with skull base fractures and should be considered for broader implementation in clinical nursing practice.

PMID:40629309 | DOI:10.1186/s12912-025-03493-z

BMC Nurs. 2025 Jul 8;24(1):883. doi: 10.1186/s12912-025-03442-w.

ABSTRACT

BACKGROUND: Nowadays, declining fertility rates are a significant societal challenge that particularly affects working women. While research has examined a variety of contributing factors, there is a significant lack of studies specifically on nurses, whose demanding clinical schedules and work environments may significantly influence their childbearing intentions. This study, using the theory of planned behavior, examines these factors for nurses in Yazd teaching hospitals. The results provide valuable data for policymakers to design targeted strategies and support systems to encourage nursing professionals to pursue parenting responsibilities and ultimately reduce the negative effects of low fertility rates.

METHODS: This cross-sectional study was conducted on female nurses working in teaching hospitals in Yazd, Iran (2024). To do so, 190 nurses were selected using stratified proportional random sampling and a 14-item questionnaire developed by Nakhaei et al. study was completed. Data were analyzed using descriptive statistics (mean and standard deviation) and inferential statistics including independent samples T-test, one-way ANOVA, Mann-Whitney test, Kruskal-Wallis, Pearson correlation coefficient, Spearman correlation coefficient, and logistic regression.

RESULTS: Based on our findings, 35% of nurses intended to have children in the next three years. Based on the results of the Pearson correlation coefficient test, a significant inverse correlation was observed between the subjective norm towards having children and the number of children (P < 0.001, r=-0.450). A statistically significant difference was reported in the mean score of perceived control over childbearing in terms of childbearing intention (P = 0.019); besides, a statistically significant difference was observed regarding childbearing in terms of age group (P = 0.004). Multivariate regression analysis with the effect of background variables considered constant, only the number of children had a significant effect on subjective norm (P < 0.001), meaning that for each added child, the score of subjective norm towards childbearing decreased meanly by 1.657 points.

CONCLUSIONS: Given the negative impact of increasing age on perceived control and childbearing intention, health policymakers and hospital administrators can help ameliorate perceived control and foster the childbearing intention by creating more flexible working conditions and incentive policies, including financial support for female nurses. Moreover, programs that focus on encouraging childbearing in younger women can be more effective.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40629307 | DOI:10.1186/s12912-025-03442-w

BMC Nurs. 2025 Jul 8;24(1):878. doi: 10.1186/s12912-025-03530-x.

ABSTRACT

BACKGROUNDS: Understanding how nurses perceive anxiety and stress during an epidemic is essential for curbing the spread of disease and implementing effective public health strategies. This study aims to evaluate the levels of epidemic anxiety, perceived stress, and compliance with isolation measures among nurses working in Turkey in relation to monkeypox.

METHODS: This descriptive, cross-sectional study was conducted with a sample of 335 nurses employed at a hospital in Izmir, Turkey. Data were collected through face-to-face interviews between September 15 and November 30, 2024, using a structured questionnaire. The data collection instruments included a Demographic Information Form, the Epidemic Anxiety Scale, the Perceived Stress Scale, and the Compliance with Isolation Precautions Scale.

RESULTS: The mean age of the nurses was 28.41 ± 6.26 years. The average total score was 79.37 ± 10.01 on the Compliance with Isolation Precautions Scale, 49.16 ± 15.44 on the Epidemic Anxiety Scale, and 26.39 ± 7.76 on the Perceived Stress Scale. Statistically significant differences in the total scores of the Compliance with Isolation Precautions Scale were observed based on gender, prior experience working in a pandemic-designated hospital, and current department of employment (p <.005). A statistically significant but weak negative correlation was found between the Compliance with Isolation Precautions Scale and both the Epidemic Subscale (r = -.124; p =.031) and the Economic Subscale (r = -.129; p =.023). Additionally, a statistically significant moderate positive correlation was identified between the Perceived Stress Scale and the Epidemic Anxiety Scale (r =.399; p <.001).

CONCLUSION: The study revealed that nurses experienced a moderate level of epidemic-related anxiety. Moreover, it was found that a substantial majority of nurses (95.8%) had not received any formal training on monkeypox. The findings also indicated that nurses’ perceived stress levels increased in parallel with their levels of epidemic anxiety.

PMID:40629306 | DOI:10.1186/s12912-025-03530-x

BMC Pediatr. 2025 Jul 8;25(1):539. doi: 10.1186/s12887-025-05897-x.

ABSTRACT

AIM: This study aimed to investigate the effects of a coordination-based training program on physical fitness, motor competence, and inhibition control in preschool children.

METHOD: Fifty-one preschool children aged 5 to 6 years (M = 6.03, SD = 0.30), were randomly assigned to either an exercise group (EG; n = 26), which received a coordination-based training program, or a control group (CG; n = 25), which continued their routine activities. All participants were recruited from a preschool. Physical fitness (PF) was assessed through agility, static and dynamic balance, and vertical jump tests. Motor competence (MC) was measured using the Körperkoordinationstest für Kinder 3+ (KTK3+), and inhibition control (IC) was evaluated via the Go/No-Go test.

RESULT: The group-time interaction showed that the exercise group’s score increase was significantly higher than that of the CG in vertical jumping (F_(1-49) = 14.569, p < 0.001, η_p² = 0.229) and KTK Balancing Backwards (F_(1-49) = 14.051, p < 0.001, η_p² = 0.223) variables. Also, CG’s score increase was significantly higher than that of the EG in KTK Moving Sideways (F_(1-49) = 9.984, p < 0.01, η_p² = 0.169). However, statistically significant differences were not found in the comparison of group x time interaction in all other variables (p > 0.05).

CONCLUSION: The coordination-based training provided to the exercise group led to significant improvements in vertical jump performance (an indicator of lower extremity strength) and KTK Balancing Backwards scores (an indicator of dynamic balance) compared to the control group. These findings suggest that coordination-based training can enhance lower extremity strength and dynamic balance in preschool children.

PMID:40629304 | DOI:10.1186/s12887-025-05897-x