Tag: pubmed

BMC Med Educ. 2025 Jun 19;25(1):853. doi: 10.1186/s12909-025-07460-9.

ABSTRACT

BACKGROUND: Medical encounters often involve complex information that can be challenging to process, especially in emotionally charged situations. Providing patients with audio recordings of their medical encounters, termed consultation recordings, has shown promising benefits such as improved information recall and understanding. In prior research, patients largely reported favorable attitudes toward consultation recordings; physicians were more skeptical, particularly regarding legal risks. To date, consultation recordings are rare in Germany. This study aimed at understanding medical students’ attitudes toward consultation recordings, as they are the healthcare professionals of the future and could therewith play a crucial role in further implementation efforts.

METHODS: We conducted a nationwide cross-sectional quantitative online survey with medical students in Germany, assessing attitudes toward and desire for future consultation recordings. Data was analyzed using descriptive statistics.

RESULTS: Two hundred twenty-two participants were included. 56% of participants expressed positive attitudes toward consultation recordings, acknowledging benefits such as information recall and preparation for follow-up consultations. However, they also expressed significant concerns about potential misuse, legal implications, and physicians feeling pressured. About 16% of participants expressed a clear willingness to offer consultation recordings in the future, while 44% were hesitant.

CONCLUSIONS: Our findings that medical students recognize potential benefits of consultation recordings, while simultaneously expressing concerns about this intervention, are comparable to results from studies conducted in physician samples. Medical students’ limited clinical experience and the low prevalence of consultation recordings in Germany likely contribute to these apprehensions. These mixed attitudes could be addressed by providing opportunities for positive experiences with consultation recordings during medical and postgraduate education as well as in clinical practice. Providing role models who support patient-centered care could also foster greater acceptance. Future research should focus on the integration of patient-centered interventions such as consultation recordings in the medical curricula. Overall, consultation recordings have the potential to become a valuable tool in routine healthcare if current barriers are effectively addressed.

PMID:40537780 | DOI:10.1186/s12909-025-07460-9

J Orthop Surg Res. 2025 Jun 19;20(1):603. doi: 10.1186/s13018-025-06015-4.

ABSTRACT

BACKGROUND: Locking plates and screws are essential in orthopedic surgeries, including opening-wedge high tibial osteotomy (OWHTO), owing to their ability to provide angular stability and support under mechanical stress. However, screw breakage at the head and neck junction remains a significant issue, compromising fixation and requiring revision surgery. This study aimed to determine whether increasing the diameter of the locking screws at the head and neck junctions enhances biomechanical stability.

METHODS: Sixty screws, divided into two groups (n = 30 per group) -a non-reinforced group with a standard design and a reinforced group with an increased head and neck diameter- were tested. Both groups consisted of 5.0 mm locking screws, each with a length of 80 mm. Biomechanical testing, which included compression, fatigue, and torsional strength tests, was conducted to reflect clinically relevant conditions.

RESULTS: The reinforced screws demonstrated significantly superior biomechanical performance. In the compression test, they exhibited a higher load to failure (909.0 ± 30.4 N vs. 757.5 ± 46.2 N, p < 0.001). In the fatigue test, the reinforced screws endured more cycles before failure (70788.6 ± 6310.6 cycles vs. 23016.2 ± 5,157.9 cycles, p < 0.001) and had a greater displacement distance (3.0 ± 0.4 mm vs. 2.3 ± 0.3 mm, p = 0.001). The torsional test showed higher torque at failure for the reinforced screws (17.3 ± 0.3 Nm vs. 16.5 ± 0.4 Nm, p < 0.001), although the angular displacement differences were not statistically significant (202.0° ± 63.9° vs. 247.2° ± 64.9°, p = 0.105).

CONCLUSIONS: Reinforcing the head and neck junction of locking screws significantly improves their biomechanical performance. These findings suggest that structural modifications can reduce hardware failure risks in high-stress procedures such as OWHTO, enhancing implant durability and clinical outcomes.

PMID:40537777 | DOI:10.1186/s13018-025-06015-4

J Neurodev Disord. 2025 Jun 19;17(1):33. doi: 10.1186/s11689-025-09615-7.

ABSTRACT

BACKGROUND: 16p11.2 deletion syndrome (16p11.2DS) is a recurrent CNV that occurs de novo in approximately 70% of cases and confers risk for neurodevelopmental disorders, including intellectual disability (ID) and autism spectrum disorders (ASD). The current study focusses on developmental milestones, cognitive profiles and longitudinal cognitive trajectories.

METHODS: In-person assessments, digital medical records and parental interviews on developmental history of 24 children (5-16 years) with a confirmed BP4-BP5 16p11.2DS were reviewed and analysed for developmental milestones (motor, language, continence). Standardised intelligence tests were administered in all children, and longitudinal IQ-data were available for a subgroup (79%, 19/24).

RESULTS: Motor, language, and continence milestones were delayed. Average IQ was in the borderline range (IQ 71) with 46% (11/24) having borderline IQ (IQ 70-84). Both intra- and interindividual variability were found across the five cognitive domains with significant discrepancies between verbal and non-verbal skills in 55% (11/20). Longitudinal IQ-data indicate that school-aged children with 16p11.2DS perform statistically significantly lower at the second time point (p < 0.001) with 58% showing a growing into deficit trajectory.

CONCLUSION: Delayed motor, language and continence milestones are common in 16p11.2DS carriers. School-aged children with 16p11.2DS show increasing cognitive impairments over time, pointing to the need for early diagnosis, regular cognitive follow-up and individualised intervention. The high prevalence of disharmonic IQ-profiles highlights the importance of expanding the focus beyond full-scale IQ (FSIQ) outcomes. Future studies in larger cohorts including carrier relatives are needed to gain more insight into the penetrance and phenotypic variability of 16p11.2DS.

PMID:40537766 | DOI:10.1186/s11689-025-09615-7

Int J Emerg Med. 2025 Jun 19;18(1):107. doi: 10.1186/s12245-025-00915-2.

ABSTRACT

BACKGROUND: Mild traumatic brain injury (mTBI) is a common diagnosis among elderly patients treated in emergency departments. It is often complicated by age-related physiological changes such as brain atrophy, cognitive impairment, and frailty. While sex differences are increasingly recognized in TBI pathophysiology and clinical management, limited research has explored their impact on geriatric mTBI complicated by intracranial bleeding. This study aimed to investigate sex-stratified patterns in injury mechanisms, clinical presentation, and associated injuries among older adults with mTBI.

METHODS: We conducted a retrospective, single-center cohort study of geriatric patients (≥ 65 years) hospitalized at the Louis Pasteur University Hospital in Košice, Slovakia with mTBI complicated by intracranial bleeding over a 30-month period (July 2022- December 2024). Patient data were extracted from electronic health records, including demographic characteristics, injury mechanisms, symptomatology, radiological findings, and clinical outcomes. Statistical analysis was performed using descriptive and comparative methods.

RESULTS: A total of 117 patients (55 females, 62 males) met the inclusion criteria. The median age was 77.0 years (IQR: 12.0), with females presenting at a higher median age than males (80 vs. 75.5 years). Causes of injury differed significantly between sexes (p < 0.001); while mechanical falls were predominant in both groups, alcohol-related injuries were significantly more common in males (37.1% vs. 7.3%). Symptom presentation also varied, with females exhibiting a higher prevalence of multiple symptoms, while males more frequently reported amnesia or loss of consciousness (p = 0.029). Additional injuries showed sex-related differences, with skull fractures more prevalent in males (41.9% vs. 21.8%) and pelvic (0 vs. 7.3%) or upper limb fractures (0 vs. 12.7%) more common in females (p = 0.005).

CONCLUSION: Sex-based differences in the presentation and symptomatology of geriatric patients with mTBI and intracranial bleeding highlight the need for tailored diagnostic and management approaches. Recognizing these differences could improve clinical assessment and individualized care. Further research is needed to refine sex-specific diagnostic and therapeutic strategies in this vulnerable population.

PMID:40537750 | DOI:10.1186/s12245-025-00915-2

BMC Public Health. 2025 Jun 19;25(1):2166. doi: 10.1186/s12889-025-23520-7.

ABSTRACT

BACKGROUND: Parental gambling disorder has detrimental financial, psychological, physiological, familial, and behavioral implications for the offspring, making these children highly vulnerable. In Germany, population-based estimates on how many minor children have parents with gambling disorder are lacking; thus, the immediacy of need for corresponding (public) health care policies remains unknown.

METHODS: Based on the population-representative German Gambling Survey 2023, we estimated the number of children having parents with gambling disorder, including estimates for rates at each parental gambling disorder severity level (mild, moderate, severe). Both cohabiting children and separate living children were considered. To extrapolate lower and upper bounds of estimates, data on number of parents in the household and average number of children was combined with official population statistics.

RESULTS: Of 282 participants with gambling disorder, 46.8% (n = 132) cohabit with 1.55 children on average; 16.7% (n = 47) are parents of 1.51 separate living children on average. Therefore, in Germany 574,079 to 604,966 children have a parent with gambling disorder, with about 84.0% of them (482,076 to 508,712) cohabiting with the gambling parent. The likelihood of cohabiting decreases with increasing gambling disorder severity (mild: 97.7%; moderate: 85.0%; severe: 72.2%).

DISCUSSION: In Germany about 1 in 25 children has a parent with gambling disorder. Given that parental gambling disorder is an established risk factor for developing own gambling problems, more comprehensive addiction care and health policy are needed to address this issue. Integrated care and counselling offers targeting both gambling parents and their children may be a promising starting point. Special attention should be paid to separate living children in these approaches.

PMID:40537747 | DOI:10.1186/s12889-025-23520-7

BMC Gastroenterol. 2025 Jun 19;25(1):439. doi: 10.1186/s12876-025-03696-3.

ABSTRACT

BACKGROUND AND AIM: Several animal studies have shown that Branched-chain amino acids (BCAAs) may prevent acute liver injury, although its effects in humans are as yet undetermined. Thus the purpose of this study is to evaluate the impact of intravenous BCAAs infusion on liver profile post-liver surgery in the intensive care unit (ICU).

METHODS: A randomized study that was applied for post liver surgery patients who were randomly allocated to receive either intravenous BCAA immediately post-operative or placebo.

MEASUREMENTS: Follow-up liver profile, Child-Pugh, and SOFA scores during the first week post-surgery.

MAIN RESULTS: A significant decline of bilirubin and ALT on day three and five in the BCAA group compared to the control group respectively. There was a significant improvement of PT on day seven 12.5 in the BCAA group versus 12.9 in the control group, p-value 0.01. Total bilirubin levels decreased by 75% in the BCAA group, whereas in the control group saw an increase of 6.25% from the baseline which was statistically significant, p-value 0.0376. SOFA score was markedly improved in the BCAA group (p-value 0.013). In addition to a significantly shorter ICU stay in the BCAA group than in the control group (p-value 0.018).

CONCLUSION: There are beneficial effects of BCAAs infusion post-liver surgery; including improved metabolic profile (liver function tests), and shorter ICU stay.

TRIAL REGISTRATION: (Clinicaltrials.gov registration number:NCT03448848), 28/02/2018.

PMID:40537743 | DOI:10.1186/s12876-025-03696-3

BMC Public Health. 2025 Jun 19;25(1):2167. doi: 10.1186/s12889-025-23388-7.

ABSTRACT

BACKGROUND: Mental health is a term frequently used to describe mental health problems. However, mental health includes both mental health problems and well-being. Therefore, mental health can be seen as having two distinct yet related dimensions, as described in the two-continua model of mental health (Westerhof & Keyes, 2010) where an individual can simultaneously experience any combination of well-being and problems, suggesting four classes: (i) high well-being, low problems; (ii) high well-being, high problems; (iii) low well-being, low problems; and (iv) low well-being, high problems. Through this framework an understanding of differences in putative risk and protective factors can be gained when compared across classes. While the model has received support, it is unclear how it applies to children. In particular, children with disabilities, as disabilities pose a risk factor to poor mental health. A greater understanding of similarities and differences between children with and without disabilities, and of risk and protective factors, could help tailor support focused on enhancing well-being, both as a goal and as a means to better self-management of mental health.

METHODS: The present project utilizes Sweden Statistics (SCB) study (barnULF) to measure life conditions. Nearly 4000 children aged 10-18, with and without disabilities, and their caregivers (ULF/SILC) were studied through yearly interview-based sample surveys conducted between 2013 and 2019. Latent class analysis was performed to assess whether the data fit a 4-class model in line with the two-continua model. Possible factors influencing mental health, including participation, were compared across the identified classes and between children with and without disabilities.

RESULTS: The analysis confirmed the predicted model. Each class showed distinct features regarding putative risk and protective factors of mental health and demographics in both the child and caregiver. These features differed significantly between children with and without disabilities, especially relating to participation, social bonds, family functioning, digital media use, and perceived safety. Age, disability, and gender predicted class adversity.

CONCLUSIONS: The results suggest that mental health problems and well-being are two related but separate constructs, highlighting the importance of promoting participation and recognizing well-being and not just mental health problems when planning interventions. The results also highlight the importance of providing support for not only the child but also their caregiver.

PMID:40537737 | DOI:10.1186/s12889-025-23388-7

Reprod Sci. 2025 Jun 19. doi: 10.1007/s43032-025-01908-5. Online ahead of print.

ABSTRACT

BACKGROUND: Infertility affects approximately 15% of reproductive-age couples, with polycystic ovary syndrome and poor ovarian reserve being major contributing factors. Metabolomic profiling of follicular fluid offers insights into the underlying metabolic disturbances associated with these infertility phenotypes. This study aims to identify metabolic biomarkers distinguishing PCOS, POR, and male factor infertility, which may facilitate improved diagnostic and therapeutic strategies.

METHODS: A total of 119 participants were categorized into three groups: PCOS (n = 39), POR (n = 40), and NOR (n = 40). Liquid chromatography-high-resolution mass spectrometry was used for untargeted metabolomic profiling. Metabolites were identified using HMDB, MassBank, and MoNA, while pathway analysis was performed using KEGG. Statistical analyses were conducted using R and Python, including one-way ANOVA, t-tests, and Mann-Whitney U tests, with False Discovery Rate correction applied.

RESULTS: Distinct metabolic alterations were observed among the groups. Trehalose-6-phosphate, taurocholate, and N,N-dimethylglycine emerged as the most significantly altered metabolites, showing strong discriminatory potential between PCOS and POR. PCOS patients exhibited reduced levels of taurocholate, mycalemide, and trehalose-6-phosphate, whereas NOR patients showed elevated levels of N,N-dimethylglycine and argininosuccinate. The POR group demonstrated increased levels of 1-methyl-2-pyrrolidone and haplopine, along with a broader metabolite distribution.

CONCLUSION: This study reveals phenotype-specific metabolic signatures in PCOS and POR, identifying taurocholate, mycalemide, and N,N-dimethylglycine as potential follicular biomarkers. These findings contribute to a deeper understanding of the metabolic basis of infertility and highlight the potential of follicular fluid metabolomics for precision medicine in reproductive health.

PMID:40537734 | DOI:10.1007/s43032-025-01908-5

Biol Futur. 2025 Jun 19. doi: 10.1007/s42977-025-00265-3. Online ahead of print.

ABSTRACT

To better understand the consequences of stress in realistic scenarios, police cadets were tasked with performing a police intervention under differing expectations. One group was led to anticipate a dangerous mission, while the other expected a routine event. In the field, however, both groups faced the same challenging situation. The warned group exhibited strong pre-intervention stress responses, which was minimal in the other group. By contrast, the unwarned group experienced a sudden surge in stress within the first minute of the intervention, as reality clashed with their expectations. A similar sudden stress response by the beginning of the intervention was missing from the warned group. A significant portion of cadets unlawfully attacked suspects, a behavior linked to intense stress displayed at the onset of the intervention. This emotional, illegitimate aggression was driven primarily by the noradrenergic stress response, with no indication of cortisol involvement. Traditional statistical methods (group comparisons, univariate, and multivariate regressions) suggested that psychological traits had little impact compared to acute stress effects. However, machine learning revealed that psychological characteristics-such as those assessed by the Reactive-Proactive Aggression Questionnaire, Buss-Perry Aggression Questionnaire, Big Five Personality Test, and Barratt Impulsiveness Scale-played a crucial role in conjunction with stress responses. Multivariate analyses yielded data similar to those obtained through machine learning, but only when the dependent variables were selected to match those identified as crucial by the latter. These findings highlight the power of machine learning in uncovering complex interactions that traditional methods might overlook.

PMID:40537691 | DOI:10.1007/s42977-025-00265-3

Spine Deform. 2025 Jun 19. doi: 10.1007/s43390-025-01133-9. Online ahead of print.

ABSTRACT

OBJECTIVES: The role of facet joint tropism (FJT) in degenerative spinal disorders such as disc herniation, spondylolisthesis, and lumbar canal stenosis is well-established. However, its association with adult spinal deformity (ASD) remains underexplored. Hence, we aim to study the correlation of FJT with spinopelvic parameters and lumbar paraspinal muscle morphology in ASD patients.

MATERIALS AND METHODS: We analysed 117 patients with ASD from 2021 to 2024. An absolute value difference (ΔFJA) of more than 10 degrees between the right- and left-facet joint angle (FJA) was defined as FJT. We considered patients with FJT at the apex vertebra as the FJT + group and with ASD but without FJT as the FJT- group.

RESULTS: The mean ΔFJAs between the FJT + (n = 45) and FJT- (n = 45) were 17.14 and 5.38, respectively. For Cobb angle (CA) > 40˚ (n = 13), 84.6% (n = 11) belonged to the FJT + group. For CA 10-19˚(n = 28), 78.6% (n = 22) belonged to the FJT- group. Of the radiological parameters, differences in CA (p = 0.012), pelvic incidence (PI) (p = 0.031), grades of vertebral body rotation (VBR) (p = 0.022), facet joint osteoarthritis grades (FJOA) (p = 0.040) and cross-sectional area (CSA) of concave multifidus muscle (MF) (p = 0.010) were statistically significant between both the groups. The CSA of MF was decreased on the concave side (2.45 cm²) compared to the convex side (3.70 cm²) and was negatively correlated with ΔFJA (R² = 0.642, p = 0.020). The ΔFJA had significant positive correlation with CA (R² = 0.550, p = 0.010), PI (R² = 0.624, p = 0.030), grades of VBR (R² = 0.610, p = 0.007), and grades of FJOA (R² = 0.780, p = 0.005).

CONCLUSIONS: Patients with ASD and FJT exhibited greater Cobb angle, higher PI, higher grades of FJOA and VBR, and lower CSA of concave MF. However, the role of facet joint tropism in adult spinal deformity-whether causal or compensatory-warrants validation through longitudinal, long-term studies.

LEVEL OF EVIDENCE: Level III.

PMID:40537686 | DOI:10.1007/s43390-025-01133-9