Tag: pubmed

J Pediatr Orthop. 2025 Mar 25. doi: 10.1097/BPO.0000000000002956. Online ahead of print.

ABSTRACT

INTRODUCTION: Clubfoot is the most common deformity seen in children with arthrogryposis. The primary method of treatment for this deformity is serial casting, which has a greater frequency of incomplete correction and recurrence than in idiopathic clubfoot. For both primary and recurring cases, surgical treatments vary from soft-tissue releases to talectomy. This research aimed to evaluate the effectiveness of bony surgical procedures in correcting clubfoot in ambulatory children with arthrogryposis.

METHODS: The study retrospectively examined ambulatory children with arthrogryposis, all of whom had at least 1 osteotomy procedure on their clubfoot. The treatment’s effectiveness was assessed using passive range of motion (PROM), dynamic foot pressure, and the pediatric outcomes data collection instrument (PODCI) utilizing paired t tests. The frequency of subsequent bone surgeries following the initial operation was documented.

RESULTS: The study reviewed 20 children who had 49 surgical procedures performed on 24 feet at age 15.1±4.5 years. PROM revealed enhanced ankle dorsiflexion and forefoot abduction (P<0.05). In addition, evaluating dynamic foot pressure, coronal plane pressure index (CPPI), and the timing of heel rise demonstrated significant improvement (P<0.05). PODCI demonstrated improvement in transfer basic mobility (from 80.57±17.31 to 86.50±13.46) and global function (from 69.64±15.03 to 74.50±13.91) (P<0.05). Pain (from 69.58±25.39 to 79.21±26.57; P=0.067) and happiness (from 70.68±27.66 to 79.32±20.02; P=0.052) also improved and approached statistical significance. Moreover, a CPPI of <-94 was found to be predictive for suggesting the necessity of external fixator use according to the receiver operating characteristic analysis done based on our findings (area under the curve: 0.79, P=0.0007). Two children required an additional procedure at 26-months and 37-months postindex surgery because of residual equinus deformity and insufficient correction of forefoot adduction, respectively.

CONCLUSION: This research highlights the substantial role surgical procedures can play in improving ankle PROM, hindfoot-forefoot alignment, dynamic foot position, and functional mobility in children with clubfoot secondary to arthrogryposis. It establishes a basis for future inquiries to delve into the longevity of these benefits and the overall outcomes.

LEVEL OF EVIDENCE: Level III-retrospective study.

PMID:40130424 | DOI:10.1097/BPO.0000000000002956

Orthod Craniofac Res. 2025 Mar 25. doi: 10.1111/ocr.12922. Online ahead of print.

ABSTRACT

OBJECTIVE (S): To evaluate and compare the long-term skeletal and dentoalveolar outcomes of conventional rapid palatal expansion (RPE) and mini-screw-assisted RPE (MARPE) in adolescent patients.

MATERIALS AND METHODS: Fourteen patients were recruited from a cohort of patients previously treated with RPE or MARPE appliances with a history of > 10 years post-treatment. Of the initial larger sample population, these 14 patients agreed to return for a follow-up appointment. For the study purposes, the cone-beam computed tomography (CBCT) images acquired at pre-treatment (T0), after maxillary expansion and 6 months of retention (T1), and 10-year post-treatment follow-up period (T2) were utilized. The study variables obtained from the CBCT images comprised skeletal width, palatal suture assessment, buccal and palatal bone thickness, dental tipping, and alveolar bone bending measurements. Statistical comparisons were performed using Mann-Whitney U tests. The level of significance was set at p < 0.05 for all tests.

RESULTS: MARPE resulted in more stable skeletal expansion and fewer dental side effects compared to RPE treatment. Patients treated with RPE exhibited an 80% relapse in buccal maxillary width at the premolar after 10 years, compared to a 30% relapse among those treated with MARPE. Several additional parameters showed enhanced relapse in the RPE group compared to the MARPE group, suggesting MARPE treatment results in improved long-term dentoskeletal stability.

CONCLUSION: Treatment with MARPE resulted in more stable long-term skeletal expansion and fewer dental side effects compared to conventional RPE 10 years after the completion of orthodontic treatment.

PMID:40130401 | DOI:10.1111/ocr.12922

Worldviews Evid Based Nurs. 2025 Apr;22(2):e70014. doi: 10.1111/wvn.70014.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has exacerbated the global nursing shortage, leading to increased turnover intentions among nurses due to heightened workplace stress, burnout, and job dissatisfaction. This study investigates the mediating effects of burnout and job satisfaction on the relationship between professional identity, occupational stress, and nurses’ turnover intentions. Additionally, it explores the impact of socio-demographic factors on these relationships in the post-pandemic era.

METHODS: A cross-sectional study of 338 nurses across 4 hospitals in Israel was conducted between June 2023 and January 2024. Self-reported questionnaires were utilized to measure turnover intention using the Turnover Intention Scale, with professional identity and occupational stress as predictors and burnout and job satisfaction as mediators. A fixed effect path analysis approach was employed to assess the hypothesized mediation model, controlling for hospital-level variance and socio-demographic variables.

RESULTS: The findings revealed that professional identity was negatively associated with burnout (β = -0.26, p < 0.001) and positively associated with job satisfaction (β = 0.25, p < 0.001). Occupational stress was positively associated with burnout (β = 0.57, p < 0.001) and negatively associated with job satisfaction (β = -0.42, p < 0.001). Burnout (β = 0.35, p < 0.001) and job satisfaction (β = -0.10, p = 0.025) were both significantly associated with turnover intentions. Mediation analysis indicated that job satisfaction and burnout fully mediated the relationship between professional identity and turnover intentions, and partially mediated the relationship between occupational stress and turnover intentions.

LINKING EVIDENCE TO ACTION: The study highlights that professional identity mitigates nurse turnover by increasing job satisfaction and reducing burnout, while occupational stress drives turnover intentions by increasing burnout and decreasing job satisfaction. Tailored interventions aimed at enhancing professional identity and addressing occupational stress, particularly in light of pandemic-related challenges, are essential for improving nurse retention and well-being in the post-pandemic era.

PMID:40130391 | DOI:10.1111/wvn.70014

J Genet Couns. 2025 Apr;34(2):e2002. doi: 10.1002/jgc4.2002.

ABSTRACT

Despite the pivotal role of communication skills in genetic counseling, communication strategies employed by genetic counselors in their current practice remain largely unexplored. The field of genetic counseling could benefit from updated simulated genetic counseling sessions conducted by genetic counselors illustrating a diversity of skills. This paper outlines the development and evaluation of updated simulations used to develop an online training course to identify genetic counseling skills and to assess how commonly these skills are used. Practicing genetic counselors in the United States were recruited to counsel trained standardized patients across six pretest and posttest simulated sessions in cancer, prenatal, and cardiology genetics settings. Sessions were coded using the novel Genetic Counseling Skills Checklist to identify which communication and counseling skills were utilized. Standardized patients were asked to provide session quality ratings and written feedback, which were analyzed using descriptive statistics and content analysis, respectively. Results from 64 recorded sessions involving 20 counselors from a variety of training programs, racial and ethnic backgrounds, states of residence, and with varying years of clinical experience revealed utilization of a broad array of skills across specialty types and clinical indications. The total number of unique skills used varied widely from 12 to 49, with an average of 35.8 out of 56 possible skills checked per session. Differences in skill usage were observed between pretest and posttest sessions. Standardized patient comments were predominantly positive with a focus on information delivery and empathetic responses. Perceptions of areas of improvement were giving less information, having clearer delivery, and expressing more empathy. This work led to the creation of a training course showcasing various skills used by practicing genetic counselors, which summarizes commonly used skills and other promising but less frequently utilized ones.

PMID:40130387 | DOI:10.1002/jgc4.2002

Int Health. 2025 Mar 25:ihaf026. doi: 10.1093/inthealth/ihaf026. Online ahead of print.

ABSTRACT

BACKGROUND: Multidrug-resistant organisms (MDROs) are important in clinical practice worldwide. As whole genome sequencing (WGS) technologies are adopted, it is key to understand the nature of MDROs before the introduction of WGS in resource-poor settings.

METHODS: A hospital-based surveillance study was conducted in the largest referral health facility in northern Nigeria. A rectal swab sample was collected from each patient and samples were investigated for extended spectrum beta-lactamases and carbapenemase-resistant Enterobacterales (i.e. ESBL-PE and CRE, respectively). These MDROs were subjected to antimicrobial susceptibility testing and multiplex PCR. Statistical analyses were used to identify any associations between MDROs and selected antibiotics.

RESULTS: The prevalence of MDROs among participants (N=168) was 87.5% (n=147) for ESBL-PE and 4.2% (n=7) for CRE. All isolates were resistant to tetracycline and co-trimoxazole; however, most MDROs were susceptible to meropenem, ceftazidime-avibactam and fosfomycin (≥70%). blaSHV (33.3%; n=49) was the predominant ESBL gene carried by the isolates, followed by combinations of blaSHV, blaCTX and blaTEM. Although no carbapenemase genes were found, all CRE isolates had the blaOXA-48 gene, which may not be associated with phenotypic carbapenem resistance observed (χ2=0.056, p=0.81).

CONCLUSIONS: Research utilising WGS and bioinformatics will elucidate more of the molecular landscape of MDROs in resource-poor settings.

PMID:40130385 | DOI:10.1093/inthealth/ihaf026

Int J Gynaecol Obstet. 2025 Mar 25. doi: 10.1002/ijgo.70080. Online ahead of print.

ABSTRACT

INTRODUCTION: Properly prepared delivery rooms are crucial for enhancing women’s delivery experiences and reducing postpartum complications. Effective communication between healthcare providers and women is equally essential for delivering respectful maternity care. This study aimed to assess delivery room appropriateness and communication effectiveness at Al-Shifa Medical Complex.

METHODS: This cross-sectional study surveyed all women who delivered at Al-Shifa Medical Complex during a 2-week period. A self-constructed questionnaire with 18 items evaluated communication during delivery, and a mini-scale assessed delivery room appropriateness. The Kruskal-Wallis test determined associations between communication, satisfaction, and sociodemographic factors (significance level, P < 0.05).

RESULTS: A total sample of 406 women was interviewed and included in the study, with a median age of 26 years (interquartile range, 23-30 years). Of the overall sample, 189 (46.6%) had a bachelor’s degree and 187 (46.1%) had completed their secondary school. The number of deliveries ranged between 1 and 9, with a median of 3 (interquartile range, 2-4). The majority of women demonstrated an excellent communication level with the medical staff (median score, 7). A total of 319 (78.6%) women were satisfied with the way medical services were provided by the medical staff (4 or 5 out of 5). Using the mini-scale, the delivery rooms were appropriate, with 64.7% of the standardized equipment and measures implemented. There was a statistically significant association between satisfaction with medical services and educational level, and the number of previous deliveries (P = 0.002 and P = 0.018, respectively).

CONCLUSIONS: While communication levels in delivery rooms were generally good, improvements are necessary to align practices with global guidelines and ensure consistently respectful care for women during delivery.

PMID:40130375 | DOI:10.1002/ijgo.70080

Iran J Immunol. 2025 Mar 25;22(1). doi: 10.22034/iji.2025.104236.2887. Online ahead of print.

ABSTRACT

BACKGROUND: COVID-19 (2019) clearly demonstrates an imbalanced immune response. Variations in the function and subtypes of dendritic cells (DCs) may have effects on immune responses in COVID-19 patients and contribute to immunopathology.

OBJECTIVE: To assess the phenotype and frequency of Plasmacytoid dendritic cells (pDCs), Conventional DCs (cDCs), and double-positive DCs in COVID-19 patients admitted to the ICU and non-ICU compared to the healthy control group.

METHODS: The study included 10 healthy individuals and 25 COVID-19 patients. In the second week of their illness, Peripheral blood mononuclear cells (PBMCs) were isolated from the patients and labeled with targeted antibodies for HLA-DR, CD123, and CD11c. The samples were then analyzed using flow cytometry. The COVID-19 patients were divided into two ICU and non-ICU groups and were closely monitored throughout the study.

RESULTS: In comparison to healthy controls, COVID-19 patients exhibited a significantly lower pDCs ratio (P=0.04). Patients were categorized into two groups: (A) the ICU group (n=11; 44%) and (B) the non-ICU group (n=14; 56%). The frequency of pDC was significantly lower in ICU patients than in non-ICU patients (P<0.01). Although not statistically significant, ICU patients had a lower frequency of cDCs and double positive DCs compared to non-ICU patients. Additionally, a significant association between the age of COVID-19 patients and cDC levels was observed (p=0.049).

CONCLUSION: SARS-CoV-2 can evade attacks from the immune response by reducing the number of DCs and suppressing their function of DCs, ultimately resulting in weakened development of both innate and adaptive immunity.

PMID:40130356 | DOI:10.22034/iji.2025.104236.2887

J Mater Chem B. 2025 Mar 25. doi: 10.1039/d4tb01941e. Online ahead of print.

ABSTRACT

Biomaterials play a crucial role in modern medicine through their use as medical implants and devices. However, they can support biofilm formation and infection, and lack integration with the surrounding human tissue at the implant site. This work reports the development of novel poly(ethyl acrylate) (PEA) based copolymers that address both issues. These PEA materials were molecularly designed polymeric surfactants (surfmers) synthesised via controlled radical polymerisations to achieve different polymeric architectures, (i.e., statistical and block copolymers). These were both deposited as structured 2D films on glass coverslips and used to manufacture monodisperse 3D micro-particles with functional surfaces (via microfluidics). ToF-SIMS was used to analyse these 2D and 3D surfaces to understand: (a) the surface arrangement of the monomer sequences exhibited by the different polymer structures and (b) how this surface monomer arrangement influenced mammalian fibroblast cell and/or Staphylococcus aureus behaviour at these film/particle surfaces. In addition, the form of the fibronectin (FN) network assembly’s importance in promoting growth factor (GF) binding was probed using atomic force microscopy (AFM) on the 2D films. This confirmed that specific surfmer molecular surface organisations were achieved during film/micro-particle fabrication, which presented exterior functionalities that either prevent biofilm attachment or promote the formation of structured FN networks for GF binding.

PMID:40130352 | DOI:10.1039/d4tb01941e

Pediatr Int. 2025 Jan-Dec;67(1):e15889. doi: 10.1111/ped.15889.

ABSTRACT

BACKGROUND: A target unplanned extubation (UE) rate of <1/100 ventilator days has been recommended. Our hospital has 21 NICU beds (12 beds in NICU 2 and 3 for extremely low birth weight [ELBW] infants). In 2020, we experienced an abrupt UE increase, leading to the initiation of the Stop UNplanned eXtubation (SUNX) project. At that time, UE rate was 1.30/100 ventilator days. The aim of the SUNX project was to keep the low UE rate.

METHODS: We collected data on UE rates from April 2019 to March 2024. The intervention was implemented through Plan-Do-Study-Act cycles. Cause analysis with the Pareto chart led to the drivers, we had to deal with: judicious use of sedations, Endotracheal tube (ETT) tape loosening, and stuff number during infant care. Additionally, we did simulation training for sudden SpO₂ decrease and UE event review. We also gathered data about ELBW infant admission and their NICU stay.

RESULTS: The UE rate in total NICU was kept lower than 1/100 ventilator days after the intervention. After our intervention, we found no special cause variation. It meant that our intervention was not statistically significant. However, our intervention gradually penetrated into the NICU daily practices; judicious use of sedation, ETT tape template, body position change by two nurses, UE event review, and so on. We continued a systematic approach to preventing UE.

CONCLUSIONS: Although abrupt UE increase in 2020 might be a special cause variation, SUNX activities brought us systematic approach for UE prevention.

PMID:40130339 | DOI:10.1111/ped.15889

Multivariate Behav Res. 2025 Mar 25:1-17. doi: 10.1080/00273171.2025.2473935. Online ahead of print.

ABSTRACT

Latent class (LC) analysis is a model-based clustering approach for categorical data, with a wide range of applications in the social sciences and beyond. When the data have a hierarchical structure, the multilevel LC model can be used to account for higher-level dependencies between the units by means of a further categorical LC variable at the group level. The research interest of LC analysis typically lies in the relationship between the LCs and external covariates, or predictors. To estimate LC models with covariates, researchers can use the one-step approach, or the generally recommended stepwise estimators, which separate the estimation of the clustering model from the subsequent estimation of the regression model. The package multilevLCA has the most comprehensive set of model specifications and estimation approaches for this family of models in the open-source domain, estimating single- and multilevel LC models, with and without covariates, using the one-step and stepwise approaches.

PMID:40130336 | DOI:10.1080/00273171.2025.2473935