Tag: pubmed

Isr J Health Policy Res. 2025 Sep 18;14(1):56. doi: 10.1186/s13584-025-00718-z.

ABSTRACT

BACKGROUND: The gradual increase in referrals to the busy Emergency Departments (ED) raises concerns about the potential negative effect on the quality of medical care and patient satisfaction. Urgent Care Center (UCC) provides an alternative to the ED for non-life saving medical conditions. This study aimed to compare the admission rates, reasons for referrals and patient’s satisfaction amongst UCCs based on their distance from the nearest ED.

METHODS: This cross-sectional study included all medical records of four UCCs between 2017 and 2020. Admission rates, reasons for referrals, and patients’ satisfaction were compared between UCCs located near and ED located farther away.

RESULTS: The study included 216,903 patients with an average age of 32.4±24.4 years. Most referrals were independent, with 37.7% occurring on weekends. The average triage time and total time spent in the UCCs were approximately 5.3 minutes and 62.8 minutes, respectively. The proportion of residents visiting UCCs in cities with an ED was 14.4% with a level of satisfaction of 91.5%, compared with UCCs in cities without ED where these figures were 23.7% and 84.4%, respectively. UCCs in northern Israel treated more patients with trauma/injury (33.0%) than UCCs in southern Israel (28.2%).

CONCLUSIONS: UCCs in the two locations without an ED received a higher volume of patients, while their satisfaction levels were lower. UCC serves as an alternative to ED for non-lifesaving medical conditions.

PMID:40963136 | DOI:10.1186/s13584-025-00718-z

BMC Prim Care. 2025 Sep 18;26(1):283. doi: 10.1186/s12875-025-03007-5.

ABSTRACT

BACKGROUND: The German rehabilitation system has some peculiar features, such as the predominance of inpatient medical rehabilitation. Most patients receive inpatient rehabilitation due to chronic illnesses like chronic backpain or psychosomatic diseases. General practitioners play a special role in the German healthcare system as they are often the first point of contact for health issues. The study aims to provide an overview of the involvement of general practitioners in inpatient medical rehabilitation in Germany as well as identifying barriers and facilitators. By doing this, a basis for optimizing general practitioners’ involvement can be generated.

METHODS: A scoping review was conducted to ascertain the current state of scientific knowledge, employing the methodological approach of the Joanna Briggs Institute. The search was carried out between February and March 2024. Eight databases were screened: PubMed, Web of Science Core Collection, PubPsych, EBSCOhost, BeLit, LIVIVO, ProQuest, and German National Library. Publications in German and English in the publication period from 1980 to February 2024 were sought. A thematic analysis was conducted to evaluate the included publications. The research process and generation of findings were recorded utilizing the PRISMA-ScR checklist.

RESULTS: The search resulted in a total of 2231 records, of which 102 were screened on a full text level. Fifty-four publications were included in the review. Following the thematic analysis, fourteen themes were identified and assigned to four topic areas. In the area of access, general practitioners take on a gatekeeper function (addressed by 10 publications) among other things. In follow-up care, there is involvement in prescription (5 publications), like referral to outpatient medical specialists. Barriers to involvement relate, for example, to a lack of knowledge on the part of general practitioners (10 publications) and facilitators include education and training (10 publications).

CONCLUSIONS: The results confirm the important role of general practitioners in providing access to inpatient medical rehabilitation in Germany and follow-up care. However, various barriers for general practitioners’ involvement were revealed. In order to maintain and optimize the involvement, further scientific research and efforts based on this in practice are necessary, involving relevant stakeholders.

PMID:40963134 | DOI:10.1186/s12875-025-03007-5

BMC Nurs. 2025 Sep 17;24(1):1172. doi: 10.1186/s12912-025-03776-5.

ABSTRACT

BACKGROUND: Toxic leadership undermines morale, job satisfaction, and retention among nurses. While previous studies have established its detrimental effects, the moderating role of nurses’ agility-a capacity for adaptation and resilience-remains underexplored, especially in the Egyptian healthcare context.

OBJECTIVE: This study examines the direct impact of toxic leadership on nurses’ quality of work life and explores whether nurses’ agility can mitigate these negative effects.

DESIGN AND METHODS: A cross-sectional, correlational design was used involving 265 full-time nurses across three hospitals in the Beni-Suef governorate, Egypt. Data collection instruments included the Toxic Leadership Scale, the Work-Related Quality of Life Scale, and the Workforce Agility Scale. Statistical analyses involved Pearson’s correlation, multiple linear regression, and moderation analysis via Hayes’ PROCESS macro.

RESULTS: Toxic leadership had a statistically significant negative impact on nurses’ quality of work life (r = -0.503, p < 0.001). Conversely, agility was positively associated with both toxic leadership (r = 0.159) and quality of work life (r = 0.425). Moderation analysis showed that nurses’ agility significantly buffered the negative effect of toxic leadership on quality of work life (β = 0.0049, p < 0.05).

CONCLUSION: Toxic leadership erodes nurses’ quality of work life, but nurses with high agility experience less deterioration in work satisfaction and well-being. This suggests that agility operates as a protective factor.

IMPLICATIONS FOR NURSING & POLICY: Healthcare institutions must address toxic leadership through leadership development programs and should proactively enhance nurses’ agility through training in adaptability, stress management, and situational problem-solving. This dual strategy can improve nurse retention and ultimately, patient care outcomes.

PATIENT OR PUBLIC CONTRIBUTION: Not applicable.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40963132 | DOI:10.1186/s12912-025-03776-5

Isr J Health Policy Res. 2025 Sep 18;14(1):57. doi: 10.1186/s13584-025-00719-y.

ABSTRACT

BACKGROUND: Most older adults prefer to “age in place” within their communities. This preference cannot always be honored and dependent older adults may transfer to a long-term care facility. The Return Home is an Israel Ministry of Health initiated care model designed to prevent or delay a transfer of the dependent older adult to a long-term facility. The intervention team included a physician, nurse, social worker, occupational therapist, physical therapist, and a dietician, all participating in in-home visits. This study’s aim was to examine the Return Home model’s feasibility to prevent long-term care placement in a complex, dependent geriatric population.

METHODS: We analyzed data from the electronic medical record (EMR) of the provider. Participants were recruited by the Israeli Ministry of Health from July 2021 to November 2022 at the time of hospital discharge. Caregiver input was obtained from interviews at the beginning and end of the one-year intervention.

RESULTS: 138 patients were enrolled in the intervention. 86 (62%) completed the intervention in their homes, 39 (28%) died during the intervention, 5 (4%) were transferred to a long-term facility, 8 (6%) were dis-enrolled. Prescription medication usage declined by 0.79 medications per person on average. Forty patients had pressure ulcers at the time of admission; all of these ulcers healed during the program, after an average time of 1.5 months. Caregiver burden measured by the Zarit score, declined from 20.9 to 9.7, t (156) = 11.88, p < 0.001.

CONCLUSIONS: The Return Home intervention demonstrated the feasibility of preventing or delaying long-term care placement for a complex, dependent geriatric population. Further evaluation is needed to determine effectiveness and inform broader implementation.

PMID:40963130 | DOI:10.1186/s13584-025-00719-y

BMC Womens Health. 2025 Sep 17;25(1):429. doi: 10.1186/s12905-025-04002-9.

NO ABSTRACT

PMID:40963127 | DOI:10.1186/s12905-025-04002-9

BMC Oral Health. 2025 Sep 17;25(1):1413. doi: 10.1186/s12903-025-06918-y.

ABSTRACT

BACKGROUND: Low bone quality, as well as narrow ridge width, presents a challenge for implant placement and affects implant stability. To date, the effectiveness of a specific technique to enhance implant stability in low-bone quality, along with ridge expansion, is not well established. This study aimed to evaluate implant stability in low-quality bone using osseodensification technique (OD) versus ridge expanders.

METHODS: Twenty-two patients with one missing upper tooth and low-quality bone were recruited. The osteotomy site was prepared via either ridge expanders or the OD technique. The assessments included primary implant stability and secondary stability at 3 and 6 months, as well as bone width at different vertical levels (2, 4, and 8 mm), evaluated preoperatively, baseline (immediately postoperatively), at 3 and 6 months. Additionally, pain outcome (PO) was assessed.

RESULTS: Intergroup comparisons of implant stability between interventions revealed no statistically significant differences at baseline or 3 months (P > 0.05), whereas there was a statistically significant difference at 6 months (P = 0.0268) in favour of the OD group. The PO revealed no statistically significant differences at baseline or after 1 week (P > 0.05). The ridge width between interventions showed statistically significant differences at baseline and after 3 and 6 months (P < 0.05) at 2, 4, and 8 mm in favour of the OD group.

CONCLUSIONS: Considering the significant preoperative difference in crestal ridge width and the short follow-up period, the OD technique appears to be effective in low-quality bone, improving implant stability and enabling the expansion of narrow ridges with minimal postoperative pain.

TRIAL REGISTRATION: This study was registered at clinicaltrials.gov on April 2nd, 2022, with the registration number NCT05330546.

PMID:40963121 | DOI:10.1186/s12903-025-06918-y

BMC Genom Data. 2025 Sep 17;26(1):64. doi: 10.1186/s12863-025-01360-z.

ABSTRACT

BACKGROUND: Olfactory dysfunction is among the earliest signs of many age-related neurodegenerative diseases and has been associated with increased mortality in older adults; however, its genetic basis remains largely unknown. Therefore, here we aimed to elucidate its genetic architecture through a genome-wide association study meta-analysis (GWMA).

METHODS: This GWMA included the participants of European ancestry (N = 22,730) enrolled in four different large population-based studies followed by a multi-ancestry GWMA including participants of African ancestry (N = 1,030). Olfactory dysfunction was assessed using a 12-item smell identification test.

RESULTS: GWMA revealed a novel genome-wide significant locus (tagged by single nucleotide polymorphism rs11228623 at the 11q12 locus) associated with olfactory dysfunction. Gene-based analysis revealed a high enrichment for olfactory receptor genes in this region. Phenome-wide association studies demonstrated associations between genetic variants related to olfactory dysfunction and blood cell counts, kidney function, skeletal muscle mass, cholesterol levels and cardiovascular disease. Using individual-level data, we also confirmed and quantified the strength of these associations on a phenotypic level. Moreover, employing two-sample Mendelian Randomization analyses, we found evidence for causal associations between olfactory dysfunction and these phenotypes.

CONCLUSIONS: Our findings provide novel insights into the genetic architecture of the sense of smell and highlight its importance for many aspects of human health. Moreover, these findings could facilitate the identification and monitoring of individuals at increased risk of olfactory dysfunction and associated diseases.

PMID:40963118 | DOI:10.1186/s12863-025-01360-z

Respir Res. 2025 Sep 17;26(1):272. doi: 10.1186/s12931-025-03342-2.

ABSTRACT

BACKGROUND: Atrial fibrillation (AF) frequently occurs in patients with chronic obstructive pulmonary disease (COPD) and is associated with adverse clinical outcomes. We aimed to identify patients at risk for AF using amplified p-wave duration (APWD) analysis on electrocardiogram (ECG) as non-invasive tool to diagnose an atrial cardiomyopathy (AtCM) which is an established risk factor for AF.

METHODS: This subgroup analysis of the prospective COSYCONET cohort included 2,385 COPD patients from 31 study centers with baseline sinus rhythm ECG and at least one follow-up examination. Of these, 73 patients showed AF during follow-up and were propensity-score matched to controls. APWD was measured at baseline and future major adverse cardiac and cerebrovascular events (MACCE) and health related outcome were assessed.

RESULTS: 219 COPD patients (70 [64-74] years, 79.5% male) were analyzed during a follow-up of 586 (210-1137) days. APWD was significantly longer in patients with AF occurrence compared to controls (132 [125-141] ms vs. 124 [117-133] ms, p < 0.001) and remained significant in multivariate regression analysis (OR: 1.05 [1.01-1.09], p = 0.03). An APWD ≥ 131 ms was identified as best cut-off for AF prediction (62% sensitivity, 70% specificity, OR: 3.91 [2.58 to 5.95], p < 0.001). Patients with AF had a significantly higher MACCE rate (24.7% versus 8.2%, p = 0.001) and a significantly lower physical activity score (1,074 [264-4,776] vs. 2,706 [975-7,339], p = 0.008).

CONCLUSIONS: This study demonstrates that ECG-based AtCM diagnosis identifies COPD patients at risk for AF, which was associated with a substantially elevated MACCE rate and a significantly reduced physical activity. This easy, cost-effective and widely available digital biomarker might enable early therapy initiation and prevention of adverse clinical outcomes.

TRIAL REGISTRATION: NCT01245933 on Clinical-Trials.gov (Registration date: 22.11.2010).

PMID:40963108 | DOI:10.1186/s12931-025-03342-2

BMC Infect Dis. 2025 Sep 17;25(1):1112. doi: 10.1186/s12879-025-11556-4.

ABSTRACT

Toxoplasma gondii (TOX), Rubella virus (RUV), Cytomegalovirus (CMV) and herpes simplex virus (HSV) are major TORCH pathogens that can cause serious congenital infections and adverse pregnancy outcomes if primary infection occurs during pregnancy. This cross-sectional study assessed the serological status of TORCH infections among 388 women of reproductive age prior to conception referred to a clinical laboratory in Tabriz, Iran, between April 2024 and April 2025. The objective was to determine the prevalence of IgG and IgM antibodies against Toxoplasma gondii, Rubella virus, CMV, and the presence of Hepatitis B surface antigen (HBsAg). Serum samples were analyzed using a chemiluminescence immunoassay, and data were processed with SPSS software version 22. Results showed that IgG seropositivity for Toxoplasma gondii was 28.4% (95% CI: 23.7-33.5%), significantly increasing with age (p = 0.004), with the highest rate (40.2%, 95% CI: 31.5-49.4%) observed among women aged 36-45. Rubella IgG antibodies were detected in 95.6% (95% CI: 92.7-97.6%) of participants, with the highest prevalence (98.3%, 95% CI: 94.4-99.8%, p = 0.000) in the 26-35 age group. CMV IgG seropositivity was found in 99.7% (95% CI: 98.4-100%) of women, with no statistically significant differences across age groups. HBsAg was present in 1% (95% CI: 0.3-2.7%) of the participants, and although slightly higher in older women, the association with age was not statistically significant (p = 0.384). These findings highlight a high level of immunity against Rubella and CMV, moderate exposure to Toxoplasma gondii, and a low prevalence of active Hepatitis B infection. Routine TORCH screening in women of reproductive age is essential as part of preconception care to prevent congenital infections and associated complications.

PMID:40963106 | DOI:10.1186/s12879-025-11556-4

Genome Biol. 2025 Sep 17;26(1):282. doi: 10.1186/s13059-025-03735-y.

ABSTRACT

BACKGROUND: Data from Single-cell Assay for Transposase Accessible Chromatin with Sequencing (scATAC-seq) is highly sparse. While current computational methods feature a range of transformation procedures to extract meaningful information, major challenges remain.

RESULTS: Here, we discuss the major scATAC-seq data analysis challenges such as sequencing depth normalization and region-specific biases. We present a hierarchical count model that is motivated by the data generating process of scATAC-seq data. Our simulations show that current scATAC-seq data, while clearly containing physical single-cell resolution, are too sparse to infer true informational-level single-cell, single-region of chromatin accessibility states.

CONCLUSIONS: While the broad utility of scATAC-seq at a cell type level is undeniable, describing it as fully resolving chromatin accessibility at single-cell resolution, particularly at individual locus level, may overstate the level of detail currently achievable. We conclude that chromatin accessibility profiling at true single-cell, single-region resolution is challenging with current data sensitivity, but that it may be achieved with promising developments in optimizing the efficiency of scATAC-seq assays.

PMID:40963104 | DOI:10.1186/s13059-025-03735-y