Tag: pubmed

BMC Med Educ. 2025 Jul 4;25(1):1003. doi: 10.1186/s12909-025-07584-y.

ABSTRACT

BACKGROUND: The appropriate management of traumatic dental injuries (TDIs) in immature permanent teeth is critical for predicting prognosis and preserving injured teeth. However, providing accurate treatment is always challenging for dental students due to their limited knowledge of TDIs. This study aimed to assess TDIs in immature permanent teeth in terms of knowledge, attitudes, and clinical practice among Chinese dental undergraduates and residents.

METHODS: Dental undergraduates (in 3rd -, 4th -, and 5th -years) and residents (in 1st -, 2nd -, and 3rd -years) at the School of Stomatology, Wuhan University (763 in total, from May to June 2024), were distributed with a structured electronic questionnaire containing 22 items. The obtained data was statistically analyzed via the Chi-square (χ²) test (p < 0.05) using SPSS.

RESULTS: Participants from various academic levels completed 502 questionnaires, with a response rate of 65.79%. Approximately half of the participants (58.6%) were familiar with TDIs, chiefly through traditional classroom learning (90.0%). Participants had limited knowledge on correct emergency treatment for TDIs, including tooth replantation timing (51.6%), fixation method (43.8%), and time (25.5%), with 3rd -year undergraduates reporting the lowest percentage (10.2%) (p < 0.05). Most participants agreed that vital pulp preservation (95.0%) and additional examination (91.0%) are essential for TDI management. Besides, only 29.9% of participants had ever treated a clinical TDI case independently. The majority of participants expressed a strong desire to gain comprehensive knowledge of TDIs (90.0%) and additional training (96.4%).

CONCLUSIONS: Dental students at the undergraduate and postgraduate levels lacked sufficient knowledge and practice with TDIs but had a positive attitude toward TDI management. Thus, it would be enormously beneficial for dental students to gain a better understanding of TDIs through improved dental education, including multiple teaching methodologies and more clinical practice.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40616076 | DOI:10.1186/s12909-025-07584-y

BMC Surg. 2025 Jul 4;25(1):288. doi: 10.1186/s12893-025-02989-4.

ABSTRACT

OBJECTIVE: To evaluate the effectiveness of preoperative 3D reconstruction combined with intraoperative augmented reality fluorescence guidance system in laparoscopic liver surgery by establishing a retrospective cohort study.

METHODS: A retrospective cohort study was conducted from March 2023 to December 2024, with patients’ data from the medical record system. Patients were divided into two groups according to their surgical protocols: 46 cases in the control group (conventional laparoscopic liver surgery) and 50 cases in the observation group (preoperative 3D reconstruction combined with intraoperative augmented-reality fluorescence guiding system in laparoscopic liver surgery). We compared perioperative indexes (operation time, intraoperative bleeding, time to first flatus, drainage tube removal time, hospitalization time), preoperative and postoperative liver function indexes [alanine aminotransferase (ALT), albumin (ALB), total bilirubin (TBIL)], stress indexes [angiotensin II (AT II), norepinephrine (NE), epinephrine (AD)], and complication rates between the two groups.

RESULTS: The operation time of patients in the observation group was shorter than that of patients in the control group (110.75 ± 20.56 vs. 122.35 ± 20.48 min, 95% CI of difference: 2.52-20.68 min, p = 0.013), and the amount of intraoperative bleeding was less (300.80 ± 32.70 vs. 320.76 ± 35.84 mL, 95% CI of difference: 7.62-32.30 mL, p = 0.002). There was no statistically significant difference in the comparison of time to first flatus, drain removal time, hospitalization time and complication rate between the two groups (p > 0.05). Preoperatively, the comparison of ALT, ALB, TBIL, AT II, NE, AD levels of patients in the two groups were not statistically significant (p > 0.05); postoperatively, the AT II, NE, AD levels of patients in the observation group were lower than those of patients in the control group, with statistically significant differences (p < 0.001), while the differences in ALT, ALB, TBIL levels were not statistically significant (p > 0.05). For malignant cases, the R0 resection rate was similar between groups (92.3% vs. 89.5%, p = 0.724).

CONCLUSION: Preoperative 3D reconstruction combined with intraoperative augmented reality fluorescence guidance system is potentially beneficial for laparoscopic liver surgery, which can modestly shorten the operation time, reduce intraoperative bleeding, and alleviate postoperative stress reactions.

PMID:40616072 | DOI:10.1186/s12893-025-02989-4

BMC Surg. 2025 Jul 4;25(1):290. doi: 10.1186/s12893-025-03007-3.

ABSTRACT

BACKGROUND: Acute appendicitis is one of the most common surgical emergencies, predominantly affecting young adults who form the backbone of the workforce. While its diagnosis and treatment are well-studied, limited research exists on the perioperative factors affecting post-operative outcomes and health-related quality of life in resource-limited settings like Palestine. Understanding these factors is essential to enhance patient care and recovery.

METHODS: This prospective, single-center observational study was conducted at Secondary Surgical Hospital, Nablus, Palestine, from April 2021 to February 2022. Patients aged ≥ 18 years diagnosed with acute appendicitis and treated surgically were included. Data were collected using structured forms covering preoperative (sociodemographics, clinical characteristics, imaging, and laboratory findings), intraoperative (timing, technique, and surgical findings), and postoperative (pain using Visual Analogue Scale), complications, and Health-Related Quality of Life using European Quality of Life-5 Dimensions-3 Levels variables. Follow-ups were conducted at discharge, one week, and two weeks post-surgery. Statistical analyses were performed using SPSS, with p < 0.05 considered significant.

RESULTS: Ninety-three patients participated, with a mean age of 31.14 years (63.4% ≤ 31 years, 65.6% male). Sociodemographic factors, including smoking (41.9%), educational level (76.4% grade 12 or less), and COVID-19 history (18.3%), were significantly associated with post-operative outcomes. Complicated appendicitis was observed in 43.3% of cases, particularly in older patients and those with delayed presentation (> 48 h, 16.3%). Pain was assessed postoperatively with scores that were significantly higher in females (VAS > 7, p < 0.001) and showed gradual improvement within 24 h post-surgery. Health-Related Quality of Life improved significantly over two weeks, with the European Quality of Life-5 Dimensions-3 Levels index rising from 0.569 at discharge to 0.827 at two weeks. Gender, age, and delayed presentation were strongly associated with worse outcomes, including increased anxiety, reduced mobility, and prolonged recovery.

CONCLUSION: Perioperative factors such as age, gender, smoking, educational level, and pre-hospital delay significantly impact pain and HRQoL after appendectomy. Females and older patients experienced worse outcomes, highlighting the need for tailored care. These findings underscore the importance of addressing sociodemographic disparities and optimizing perioperative management. Tailored surgical planning should prioritize early intervention in high-risk groups such as females, older adults, and patients with delayed presentation to reduce complications and improve recovery. Furthermore, the significant role of anxiety and depression in post-operative outcomes suggests that stress-reduction strategies and mental health support should be integrated into patient care. Future research should aim for longer follow-up and broader populations to establish more comprehensive post-appendectomy care guidelines.

PMID:40616063 | DOI:10.1186/s12893-025-03007-3

JMIR Med Inform. 2025 Jul 4;13:e62710. doi: 10.2196/62710.

ABSTRACT

BACKGROUND: Concerns have been expressed about the abundance of new clinical prediction models (CPMs) proposed in the literature. However, the extent of this proliferation in prediction research remains unclear.

OBJECTIVE: This study aimed to estimate the total and annual number of CPM development-related publications available across all medical fields.

METHODS: Using a validated search strategy, we conducted a systematic search of literature for prediction model studies published in Pubmed and Embase between 1995 and the end of 2020. By taking random samples for each year, we identified eligible studies that developed a multivariable model (ie, diagnostic or prognostic) for individual-level prediction of a health outcome across all medical fields. Exclusion criteria included development of models with a single predictor, studies not involving humans, methodological studies, conference abstracts, articles with unavailable full text, and those not available in English. We estimated the total and annual number of published regression-based multivariable CPM development articles, based on the total number of publications, proportion of included articles, and the search sensitivity. Furthermore, we used an adjusted Poisson regression to extrapolate our results to the period 1950-2024. Additionally, we estimated the number of articles that developed CPMs using techniques other than regression (eg, machine learning).

RESULTS: From a random sample of 10,660 articles published between 1995 and 2020, 109 regression-based CPM development articles were included. We estimated that 82,772 (95% CI 65,313-100,231) CPM development articles using regression were published, with an acceleration in model development from 2010 onward. With the addition of articles that developed non-regression-based CPMs, the number increased to 147,714 (95% CI 125,201-170,226). After extrapolation to the years 1950-2024, the number of articles increased to 156,673 and 248,431 for regression-based models and total CPMs, respectively.

CONCLUSIONS: Based on a representative sample of publications from the literature, we estimated that nearly 250,000 articles reporting the development of CPMs across all medical fields were published until 2024. CPM development-related publications continue to increase in number. To prevent research waste and close the gap between research and clinical practice, focus should shift away from developing new CPMs to facilitating model validation and impact assessment of the plethora of existing CPMs. Limitations of this study include restriction of search to articles available in English and development of the validated search strategy prior to the popularity of artificial intelligence and machine learning models.

PMID:40614260 | DOI:10.2196/62710

Cir Cir. 2025 Jul 4. doi: 10.24875/CIRU.24000028. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effect of the neck specific exercise (NSE) program through telerehabilitation on the functional recovery of adults with grade I and II acute cervical sprain at the first level of care.

METHODS: Quasi-experimental before-and-after study in a family medicine unit. Subjects with grade I and II cervical sprain were included, and a specific telerehabilitation program for the neck was applied. The effect of the program on functionality and pain was determined by means of the neck disability index and the visual analog scale. Program participants completed a 6-week intervention that included five weekly sessions, performing baseline measurements, at 2 and 6 weeks.

RESULTS: The EEC program using telerehabilitation after 6 weeks demonstrated a statistically significant decrease compared to baseline measurement in functional recovery (11 points) and pain (6.5 points).

CONCLUSIONS: The findings suggest that the application of the EEC program through telerehabilitation is effective in both improving functional recovery and reducing pain in patients with grade I and II acute cervical sprain at the first level of care.

PMID:40614245 | DOI:10.24875/CIRU.24000028

Am Surg. 2025 Jul 4:31348251358431. doi: 10.1177/00031348251358431. Online ahead of print.

ABSTRACT

ObjectiveThe gold standard for resuscitation in traumatic hemorrhagic shock is 1:1:1 transfusion (FFP:PLT:RBC). However, this practice guideline was established based on patients who received low-volume blood transfusions. Therefore, this study sought to investigate the relationship of transfusion ratios on mortality in trauma patients undergoing ultra-massive transfusion (UMT) (≥20 units of red blood cell product/24 hours).MethodsA multicenter retrospective review of patients receiving UMT was conducted across 11 level I trauma centers from 2016 to 2024. Patients were analyzed based on the following categories: FFP:RBC or Platelet:RBC <1:2 (low), 1:2-1:1 (moderate), and ≥1:1 (high). The primary outcome of interest was mortality.ResultsAcross the centers, 1155 patients received UMT with an overall mortality rate of 62.9%. They were predominantly males (81.6%) with a median age of 32 years (IQR 25-48). The majority (72.4%) received moderate FFP:RBC transfusion ratios and either low (44.8%) or moderate (42.6%) Platelet:RBC ratios. As Platelet:RBC ratio trended higher, the mortality rate decreased with a 24-hour mortality of 70.8% in the low group, 59.1% in the moderate, and 47.6% in the high. Transfusion ratio of Platelet:RBC was an independent risk factor for mortality, with OR 0.54 in the moderate group (P < 0.001) and OR 0.39 in the higher group (P < 0.001).ConclusionOur analysis utilizes one of the largest, multicenter cohorts of UMT patients and found a statistically significant decrease in mortality with more balanced Platelet:RBC transfusion ratios. These findings suggest that perhaps earlier and more aggressive transfusion of platelets may confer a survival benefit for trauma patients undergoing UMT.

PMID:40614227 | DOI:10.1177/00031348251358431

J Chem Inf Model. 2025 Jul 4. doi: 10.1021/acs.jcim.5c00291. Online ahead of print.

ABSTRACT

Organic semiconductors (OSCs) composed of π conjugated molecules have attracted significant interest in studying bulk properties such as molecular arrangements and electron mobility. However, current traditional force fields (FFs) offer limited torsion types, failing to cover the full chemical space of π conjugated molecules and hindering further molecular dynamics simulation in deducing bulk properties through statistical mechanics. In this study, we introduce OSCFF, a GAFF2-compatible FF that supports diverse torsions for conjugated molecules and enables high-accuracy RESP charge prediction through a neural network (NN). To develop the OSCFF, we construct two expansive and diverse molecular data sets: one consists of around 56,000 fragment geometries with torsion profiles and another consists of around 472,000 optimized molecular geometries with RESP charges. Using these data sets, we train NN models to predict RESP charges and fit the missing dihedral parameters in GAFF2 through automatic differentiation techniques. We further demonstrate that OSCFF achieves high accuracy in predicting torsional energy profiles, RESP charges, and radial distribution functions for conjugated systems. Additionally, we release the data sets, dihedral parameters, and RESP model as open-source resources. We believe OSCFF will serve as a valuable tool for advancing the study of bulk properties in OSCs.

PMID:40614220 | DOI:10.1021/acs.jcim.5c00291

Int J Qual Stud Health Well-being. 2025 Dec;20(1):2508421. doi: 10.1080/17482631.2025.2508421. Epub 2025 Jul 4.

ABSTRACT

PURPOSE: The DenBalo study in Burkina Faso aimed to examine biological vulnerability in preterm versus full-term newborns but recorded fewer preterm births than expected based on routine health centre statistics. To investigate this discrepancy, a qualitative study was conducted to understand how healthcare workers assess gestational age in urban Burkina Faso.

METHODS: Ten in-depth interviews and four focus groups were conducted with health workers across four centres in Bobo-Dioulasso. Thematic analysis revealed five key themes: definitions of preterm birth, gestational age estimation methods, preterm birth reporting, care challenges, and proposed improvements.

RESULTS: Health workers varied in their definitions of preterm birth, using either gestational age (<37 weeks) or birth weight (<2.5 kg). Gestational age is often estimated from the last menstrual period, though considered unreliable. While early ultrasound is preferred for its accuracy, limited access leads to reliance on less precise fundal height measurements. Documentation of preterm births is inconsistent, and challenges include data collection issues, resource shortages, and parental reluctance to seek specialized care. Respondents emphasized the need for greater community awareness, improved infrastructure, and ongoing staff training to enhance preterm care.

CONCLUSION: Standardized gestational age estimation and improved data recording can enhance preterm birth surveillance and help reduce neonatal mortality in low-resource settings.

PMID:40614168 | DOI:10.1080/17482631.2025.2508421

Biom J. 2025 Aug;67(4):e70065. doi: 10.1002/bimj.70065.

ABSTRACT

In medical, ecological, and psychological research, there is a need for methods to handle multiple testing, for example, to consider group comparisons with more than two groups. Typical approaches that deal with multiple testing are mean- or variance-based which can be less effective in the context of heavy-tailed and skewed data. Here, the median is the preferred measure of location and the interquartile range (IQR) is an adequate alternative to the variance. Therefore, it may be fruitful to formulate research questions of interest in terms of the median or the IQR. For this reason, we compare different inference approaches for two-sided and noninferiority hypotheses formulated in terms of medians or IQRs in an extensive simulation study. We consider multiple contrast testing procedures combined with a bootstrap method as well as testing procedures with Bonferroni correction. As an example of a multiple testing problem based on heavy-tailed data, we analyze an ecological trait variation in early and late breeding in a medium-sized bird of prey.

PMID:40614164 | DOI:10.1002/bimj.70065

IEEE Trans Cybern. 2025 Jul 4;PP. doi: 10.1109/TCYB.2025.3581309. Online ahead of print.

ABSTRACT

Domain adaptation (DA) techniques are becoming increasingly proficient in cross-domain fault diagnosis tasks. However, DA-based methods are not always applicable due to the target domain data is not always accessible. Although there have been some interesting domain generalization methods for fault diagnosis under unseen conditions, most of them can only be used to mine the fault features on source domain distributions, and the improvement of model generalization performance is limited. To solve this problem, the multiplicative noise Gaussian perturbation strategy and the additive noise linear fusion strategy are proposed to capture fault information beyond source domain distributions. The former is used to randomly perturb feature statistics of multisource domains to simulate the uncertainty of domain shift, while the latter is used to perform the additive noise linear operation on feature statistics of multiple source domains to ensure the authenticity of the generated feature styles. Further, the feature statistics generated by both strategies are mixed with random convex weights to obtain new feature styles, achieving the best compromise between reliability and diversity. The network can learn more fault information from features with diversified styles. Extensive experimental results on both public and real datasets verify the effectiveness of our approach.

PMID:40614158 | DOI:10.1109/TCYB.2025.3581309