Tag: pubmed

Dermatol Surg. 2025 Sep 30. doi: 10.1097/DSS.0000000000004881. Online ahead of print.

ABSTRACT

BACKGROUND: Skin laxity and crepiness of the arms is a cosmetic concern that before the advent of noninvasive skin tightening technologies could only be treated with surgery. Ultrasound-based technologies deliver energy to the dermis which causes neocollagenesis and neoelastogenesis to rejuvenate the skin.

OBJECTIVE: This study evaluates and compares the efficacy of a high-intensity, parallel beam ultrasound-based skin tightening (HIUS) device with microfocused ultrasound with visualization (MFU-V) for improvement of upper arm skin laxity and crepiness.

MATERIALS AND METHODS: A prospective, single-center, blinded, split-body, randomized clinical study investigated HIUS and MFU-V for improvement of upper arm skin laxity and crepiness. Subjects received a single treatment to the upper arms.

RESULTS: Fourteen female subjects completed the study. Assessments compared Day 30 and Day 90 follow-up visits with baseline. HIUS was as effective as MFU-V in improving arm laxity and crepiness. Investigators and subjects rated improved arm laxity/crepiness at Day 90. Most subjects were satisfied with the improvement of arm laxity/crepiness. There was no statistically significant difference in pain scores observed between the HIUS and MFU-V. The MFU-V treatment took more time to perform than the HIUS treatment.

CONCLUSION: High-intensity, parallel beam ultrasound-based skin tightening was effective and delivered results with high patient satisfaction for improving upper arm skin laxity/crepiness.

PMID:41025649 | DOI:10.1097/DSS.0000000000004881

Disabil Rehabil Assist Technol. 2025 Sep 30:1-14. doi: 10.1080/17483107.2025.2565405. Online ahead of print.

ABSTRACT

Using web crawling and statistical regression models based on large-scale platform data, this study examines how previous anonymous and non-anonymous donations influence subsequent contributions on charitable crowdfunding platforms, with a particular focus on health-related campaigns. Through web crawling, this study collected 1,136 projects from Qingsongchou and empirically analysed the herding effect in donation behaviour. Results indicate a significant herding effect in both anonymous and non-anonymous donations, as well as in donation amounts. This effect is stronger among non-anonymous donors compared to anonymous ones. Furthermore, this study explore moderating channels and find that social media sharing weakens the herding effect for anonymous donations but does not significantly alter the differential herding behaviour between the two groups. By distinguishing between early and late fundraising stages, this study also observe that the herding effect difference is more pronounced in the early stage. These findings enhance understanding of the economic implications of anonymous donations under information asymmetry and offer practical insights for improving anonymity mechanisms in health-oriented charitable crowdfunding.

PMID:41025637 | DOI:10.1080/17483107.2025.2565405

Int J Health Plann Manage. 2025 Sep 30. doi: 10.1002/hpm.70027. Online ahead of print.

ABSTRACT

INTRODUCTION: The Southeast Asian region of World Health Organization (SEARO) comprising 11 countries, that is Bangladesh, Bhutan, Democratic People’s Republic of Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand, and Timor-Leste is home to a quarter of the world’s population where severe oral health disparities persist.

AIM: This study aims to collate the oral health financing landscape, evaluate the relationship between government health expenditure and the burden of oral diseases, assess the proportionality of oral health spending relative to its share of the overall disease burden, and examine the inclusion and funding of dental care within Universal Health Coverage (UHC) benefit packages in the SEARO region.

MATERIALS AND METHODS: Data for this study were sourced from publicly available databases and relevant national health statistics repositories of SEARO countries. These datasets provided information on health financing indicators, oral health coverage, and oral disease burden. Descriptive statistics were used to summarize indicators across SEARO countries. Correlation analyses were done to examine the interrelationship between health financing indicators and oral health outcomes and oral health coverage.

RESULTS: Increased government expenditure on health was significantly and positively correlated with insurance and oral health coverage. It was inversely correlated with out-of-pocket expenses (OOPE), private health expenditure, borrowing money to cover health expenses, and ‘All cause’ DALYs (Disability Adjusted Life Years). There was no significant correlation between government health spending and ‘Oral Disorders’ DALYs. Increased private expenditure was inversely correlated with domestic general government health expenditure as a percentage of current health expenditure and oral health coverage and positively correlated with Out-of-pocket expenses and borrowing money for covering health expenses. The allocation of government spending did not correspond proportionately to the burden of oral diseases.

DISCUSSION AND CONCLUSION: The lack of correlation between government health funding and the oral disease burden and the disproportionately low government expenditure on oral health relative to the burden of oral diseases when compared to their share of the total disease burden indicates not only a significant deficiency in funding but also misplaced funding priorities. There is a need to focus on the prevention of oral diseases and direct resources towards prevention, regular training, and education of healthcare workers and the public to identify early signs and symptoms of oral disease, rather than solely on treatment.

PMID:41025615 | DOI:10.1002/hpm.70027

Knee Surg Sports Traumatol Arthrosc. 2025 Sep 30. doi: 10.1002/ksa.70079. Online ahead of print.

ABSTRACT

PURPOSE: The peroneus longus tendon (PLT) has emerged as a promising autograft option for anterior cruciate ligament (ACL) reconstruction, but concerns persist regarding donor-site morbidity and ankle functional outcomes. This systematic review and meta-analysis aimed to evaluate ankle performance following PLT harvest for ACL reconstruction.

METHODS: This systematic review and meta-analysis performed by searching five databases (PubMed, Embase, Web of Science, Scopus, and the Cochrane Library) up to March 2025. Inclusion criteria included: ACL reconstruction using PLT autograft, ≥6-month follow-up, and validated ankle outcomes (American Orthopaedic Foot And Ankle Society [AOFAS]/Foot and Ankle Disability Index [FADI] scores). Pooled effect sizes were calculated using random-effects models using R software (version 4.4.3). Heterogeneity was assessed via I² statistics, and risk of bias was evaluated using JBI checklists.

RESULTS: Twenty articles (1024 patients) were identified, comprising eleven prospective cohort studies and nine randomised clinical trials (RCT), based on title, abstract, and quality assessments. Meta-analysis demonstrated excellent postoperative ankle function, with pooled AOFAS scores of 96.0 (95% confidence interval [CI]: 92.6-99.3) at 6 months, 96.1 (93.9-98.2) at 12 months, and 97.2 (93.9-100.6) at 24 months. FADI scores similarly improved to 97.4 (96.0-98.9) by 6 months and 99.4 (98.7-100.1) at 24 months. Meta-regression revealed no significant association between age and AOFAS outcomes (β = -0.23, p = 0.36). Minor complications (e.g., transient hypaesthesia) occurred in 13%-23% of patients but resolved within months. No studies reported major nerve injuries or ankle instability.

CONCLUSION: Peroneus longus tendon harvest for ACL reconstruction yields minimal donor-site morbidity, with consistently high AOFAS/FADI scores across all age groups. These findings support the safety of PLT autografts, though heterogeneity is evident, and the predominance of male participants and the regional focus of studies, mainly Asian populations, may affect generalisability.

LEVEL OF EVIDENCE: Level II.

PMID:41025611 | DOI:10.1002/ksa.70079

Knee Surg Sports Traumatol Arthrosc. 2025 Sep 30. doi: 10.1002/ksa.70074. Online ahead of print.

ABSTRACT

PURPOSE: The circles measurement is a newly validated in vivo method to evaluate acromioclavicular joint (ACJ) dislocations, but its postoperative and clinical relevance has not been evaluated. We hypothesised that the postoperative circles measurement would capture recurrent vertical as well as horizontal instability and that it would be associated with outcome scores in patients undergoing acute, bidirectional arthroscopically assisted ACJ stabilisation.

METHODS: Male patients (18-55 years) with an acute ACJ dislocation (Rockwood type V) were included retrospectively. Radiographs included a single, bilateral anteroposterior stress view and bilateral Alexander views preoperatively and postoperatively (final follow-up of minimum 2 years). Excluded were patients with previous injuries/minors/polytrauma or insufficient radiographs. The side-to-side difference (SSD) coracoclavicular distance (CCD), the degree of dynamic horizontal translation (DHT) and the SSD circles measurement as well as the ACJ instability (ACJI) and Taft (TF) score, subjective shoulder value (SSV) and Constant score were recorded at the final follow-up (minimum 2 years). The postoperative SSD circles measurement was analysed in relation to these. Statistical analysis comprised correlations and group comparisons.

RESULTS: Fifty-six patients (mean age, 38.9 ± 10.7 years) with a follow-up of 33.0 months (range, 24-55 months) were included. The postoperative SSD circles measurement demonstrated a correlation with recurrent vertical instability (SSD CCD: r = 0.37; p = 0.006), and with recurrent horizontal instability (DHT: r = 0.46; p < 0.001). A higher postoperative SSD circles measurement was associated with lower outcome scores (SSV: r = -0.31; p = 0.021; TF score: r = -0.29; p = 0.031; ACJI score: r = -0.35; p = 0.01). The cut-off values for lower scores (p < 0.05 by stepwise group comparison) were 0 mm for the SSV (p = 0.022); 2.2 mm for the TF score (p = 0.022) and 2.7 mm for the ACJI score (p = 0.024).

CONCLUSIONS: The postoperative circles measurement reflects both recurrent vertical and horizontal instability and correlates with lower outcome scores following arthroscopically assisted ACJ stabilisation, supporting its use as a radiographic adjunct.

LEVEL OF EVIDENCE: Level IV, retrospective case series.

PMID:41025591 | DOI:10.1002/ksa.70074

J Clin Nurs. 2025 Sep 30. doi: 10.1111/jocn.70124. Online ahead of print.

ABSTRACT

AIM: To analyse current Glasgow Coma Scale practice among emergency nurses in China and identify factors influencing assessment quality.

DESIGN: A quantitative, multicenter cross-sectional design.

METHODS: A convenience sample of 1740 emergency nurses from secondary and tertiary hospitals across 21 provinces completed a validated structured questionnaire between March and April 2025. Participants had at least 6 months of emergency nursing experience. Data analysis included descriptive statistics, chi-square tests, and multiple logistic regression to examine factors influencing correct Glasgow Coma Scale application.

RESULTS: Participants had a mean age of 29.8 years (SD = 6.2). Only 52.5% of nurses demonstrated correct Glasgow Coma Scale application despite 97.0% having theoretical knowledge of scoring criteria. While 56.8% had received Glasgow Coma Scale training, significant standardisation deficiencies emerged. Notably, 41.8% of departments lacked operational guidelines, and 53.7% of nurses experienced scoring disagreements with colleagues. Clinical utilisation varied substantially by patient population: traumatic brain injury (97.8%), neurological diseases (96.9%), and systemic critical illness (85.8%). Multivariate analysis identified six significant factors influencing correct application: standardised training (OR = 2.252, 95% CI: 1.789-2.825), manageable workload ≤ 4 patients/shift (OR = 1.652, 95% CI: 1.327-2.057), departmental guidelines (OR = 1.523, 95% CI: 1.233-1.881), extensive work experience ≥ 9 years (OR = 1.534, 95% CI: 1.182-1.992), while multidisciplinary collaboration issues (OR = 0.559, 95% CI: 0.439-0.712) and special patient experience (OR = 0.520, 95% CI: 0.406-0.666) were associated with reduced accuracy.

CONCLUSION: Substantial standardisation challenges exist in Glasgow Coma Scale practice among Chinese emergency nurses, characterised by significant gaps between theoretical knowledge and clinical application. Major barriers include insufficient standardised guidelines, inconsistent training approaches, and inadequate interdisciplinary collaboration.

IMPACT: Healthcare administrators should develop national standardised guidelines, implement simulation-based training programs, optimise emergency workflows, and integrate alternative assessment tools to enhance consciousness assessment accuracy and improve patient safety.

REPORTING METHOD: STROBE statement adherence.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

PMID:41025569 | DOI:10.1111/jocn.70124

J Transcult Nurs. 2025 Sep 30:10436596251372840. doi: 10.1177/10436596251372840. Online ahead of print.

ABSTRACT

INTRODUCTION: Nursing education plays a key role in addressing xenophobia. The aim of this study was to examine the effect of forum theater on nursing students’ attitudes toward immigrants.

METHOD: The study was a quasi-experimental research conducted with undergraduate nursing students. Forum theater was used as an educational technique in the study. The sample of the study consisted of n = 24 nursing students. Personal information form and Health Workers’ Attitudes Toward Immigrants Scale were used as data-collection tools. Wilcoxon Signed Ranks Test was used for statistical analysis.

RESULTS: The findings of the study show that the forum theater practice significantly changed nursing students’ attitudes toward racism and discrimination. As a result of the study, nursing students’ positive attitudes increased and negative attitudes decreased (p < .05).

DISCUSSION: Forum theater may be an effective educational tool for nursing students to decrease negative attitudes and increase positive attitudes toward racism and discrimination.

PMID:41025285 | DOI:10.1177/10436596251372840

Ann Geriatr Med Res. 2025 Sep;29(3):393-402. doi: 10.4235/agmr.25.0080. Epub 2025 Aug 13.

ABSTRACT

BACKGROUND: As the global population ages, including Thailand, health-promoting behaviors (HPBs) have emerged as critical challenges affecting the well-being of community-dwelling older adults. This situation calls for a deeper understanding of the modifiable protective factors involved. The current study aimed to examine the associations between frailty, depression, social support, health literacy (HL), and HPBs among community-dwelling older adults in Thailand.

METHODS: A cross-sectional study with a convenience sample of 250 older adults was employed. We collected using validated questionnaires-including Tilburg Frailty Indicator, Thai Geriatric Depression Scale, Social Support Scale, Health Literacy Scale, and Health Promoting Behaviors Scale. We analyzed using descriptive statistics and stepwise multiple linear regression.

RESULTS: This study involved a total of 250 community-dwelling older adults, with a mean age of 70.41 years. The participants had a mean frailty score of 6.78±1.95, indicating that most were classified as frail (score ≥5) based on the Tilburg Frailty Indicator. They also reported no significant depressive symptoms (3.80±2.62), moderate levels of social support (36.70±4.20), poor health literacy (33.15±2.71), and moderate health-promoting behaviors (101.19±7.67). Health literacy, social support, frailty, depression, and comorbidity conditions were significant predictors of health-promoting behaviors, collectively explaining 80.5% of the variance.

CONCLUSION: These findings emphasize that improved HL, greater social support, reduced frailty, and lower depression scores were associated with healthier behaviors in older adults. Multidisciplinary healthcare teams should consider these factors when designing their intervention strategies to gain a more comprehensive understanding and improve health outcomes.

PMID:41025274 | DOI:10.4235/agmr.25.0080

Ann Geriatr Med Res. 2025 Sep;29(3):384-392. doi: 10.4235/agmr.25.0047. Epub 2025 Jun 16.

ABSTRACT

BACKGROUND: To examine the association between participation frequency in the long-term care prevention program and frailty and locomotive syndrome (LS), stratified by sex.

METHODS: A total of 486 older adults residing in City A, Tochigi Prefecture, were included in this study. The participants were categorized into three groups based on the frequency of participation in the long-term care prevention program: low participation, medium participation, and high participation groups. Frailty was assessed using the Questionnaire for Medical Checkup of Old-Old (QMCOO), and LS was assessed using the 5-question Geriatric Locomotive Function Scale (GLFS-5). Frailty and LS were compared separately for men and women in three groups. Additionally, a binomial logistic regression analysis was conducted to examine the association between non-frailty and participation frequency in men.

RESULTS: A total of 141 participants (29.0%) were classified as having frailty, and 160 (32.9%) met the criteria for LS. Intergroup comparisons showed significant differences in frailty prevalence, QMCOO Q1, and Q5, and LS total GLFS-5 score and GLFS-5 Q3, Q4, and Q5 in men. In contrast, intergroup item comparisons showed no significant differences in women. High participation was associated with non-frailty in men across all models in the binomial logistic regression analysis.

CONCLUSIONS: For men, a higher frequency of participation in the long-term care prevention program was suggested to be associated not only with frailty but also with components of LS. These findings highlight the importance of promoting social participation among men, maintaining social participation among women, and adopting sex-specific approaches within community settings.

PMID:41025273 | DOI:10.4235/agmr.25.0047

Nord J Psychiatry. 2025 Sep 30:1-9. doi: 10.1080/08039488.2025.2565825. Online ahead of print.

ABSTRACT

BACKGROUND: The identification of patients in forensic psychiatric care within national health registries has historically posed significant challenges, limiting research to small-scale studies and restricting its scope. This study aims to evaluate the utility of the Danish National Patient Register (DNPR) for research purposes by assessing the criterion concurrent validity of administrative trajectory markers for identifying incident patients receiving forensic psychiatric care.

METHODS: We employed a population-wide design, analyzing data from the entire Danish population aged 15 years and older (almost 5 million individuals). Incident forensic psychiatric patients between January and December, 2022, were identified through a trajectory start marker in the DNPR. Validity was assessed by comparing these cases to confirmed cases from the Central Criminal Register (CCR). Test statistics, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value, were calculated.

RESULTS: A total of 323 forensic psychiatric patients were identified in the DNPR, of whom 289 (89.5%) were confirmed as incident cases in the CCR. The sensitivity of any trajectory start marker was .755 (.708-.797), and the PPV was .895 (.856, .926). PPV varied across the five Danish regions and between individual trajectory markers, with the highest PPV (.950) observed among patients sentenced to outpatient psychiatric treatment with the option of hospitalization.

CONCLUSIONS: The findings suggest that trajectory markers are a promising approach for reliably identifying incident forensic psychiatric cases within Danish national health registers. Further studies are needed to confirm their validity across different contexts, informing clinical practice and policy decisions in forensic psychiatry.

PMID:41025265 | DOI:10.1080/08039488.2025.2565825