Tag: pubmed

BMC Med Educ. 2025 Jul 15;25(1):1058. doi: 10.1186/s12909-025-07673-y.

ABSTRACT

BACKGROUND: Cone Beam Computed Tomography (CBCT) plays a critical role in oral and maxillofacial surgery (OMFS), yet the training needs of residents regarding CBCT viewer interfaces remain underexplored. Effective utilization of these interfaces is essential for accurate diagnosis and treatment planning. This study aims to assess OMFS residents’ competencies in CBCT viewer interfaces and identify training gaps through a usability framework.

METHODS: OMFS residents participated in a usability evaluation of five CBCT viewer interfaces (VIS: Icad Vision, NNT: Newtom, ODM: OnDemand, OVV: OneVolume Viewer, ROM: Planmeca Romexis). Effectiveness was measured through task completion rates, efficiency through task duration, mouse clicks, and cursor distance, and satisfaction using the System Usability Scale (SUS) and the Computer System Usability Questionnaire (CSUQ). Statistical analysis included Friedman and Dunn’s tests with Benjamini-Hochberg correction.

RESULTS: Residents reported receiving no hands-on CBCT training and relied only on verbal instruction during dental school, suggesting a lack of structured training. All of them successfully completed tasks on all interfaces, indicating 100% effectiveness. However, significant differences in efficiency and satisfaction were observed, reflecting varying levels of proficiency and highlighting areas where further training could be beneficial. VIS interface required significantly more time (198.4 ± 70.44 s) and mouse clicks (69.82 ± 33.17, p < 0.05) compared to other interfaces, suggesting a need for additional practice with this interface. The ODM interface achieved the highest SUS score (69.89 ± 22.79), while the VIS interface had the lowest (41.82 ± 22.90) (p < 0.05). Only ODM approached the industry-standard threshold for user satisfaction, while the remaining systems failed to meet this criterion.

CONCLUSIONS: This study highlights the need for structured training in CBCT viewer interfaces for OMFS residents. Findings suggest that a standardized, hands-on multi-software program should be integrated into residency curricula to improve efficiency, reduce cognitive load, and enhance clinical decision-making. Future research should focus on the long-term impact of usability-driven training on clinical performance and patient outcomes.

PMID:40665326 | DOI:10.1186/s12909-025-07673-y

Hum Resour Health. 2025 Jul 15;23(1):34. doi: 10.1186/s12960-025-01010-6.

ABSTRACT

BACKGROUND: The global nursing shortage is a growing concern, particularly in regions experiencing rapid population growth and healthcare transformation. This study examines trends and regional inequalities in Saudi Arabia’s nursing workforce distribution from 2019 to 2023 within the context of Saudi Vision 2030 and the Health Sector Transformation Program.

METHODS: Data from the Ministry of Health’s 2023 Statistical Yearbook were used for this study. Nurse-to-1 000 population ratios were calculated across 20 health regions. Inequality in the nursing distribution was assessed using Gini coefficients and Lorenz curves, disaggregated by sector (Ministry of Health vs. private health sector) and nationality (Saudi vs. non-Saudi).

RESULTS: The national nursing workforce increased by 9% from 2019 to 2023, reaching 213 110 nurses. However, nurse-to-population ratios varied significantly across regions, ranging from 3.13 to 9.89 per 1 000 people. The overall Gini coefficient was 0.48, indicating a relatively unequal distribution of nurses across regions. Inequalities were more pronounced in the private health sector (Gini coefficient = 0.69) and among non-Saudi nurses (Gini coefficient = 0.59). While Saudization efforts led to a modest increase-Saudi nationals comprised 44.22% of the nursing workforce in 2023-localization remained uneven across regions and healthcare sectors.

CONCLUSION: Despite workforce growth and increased localization, Saudi Arabia continues to face considerable regional inequalities in nursing distribution. These disparities require targeted workforce policy interventions, including expanding nursing education opportunities, optimizing working conditions, and implementing strategic workforce plans to distribute nursing resources more equitably. Additionally, offering incentives for deployment in underserved regions will be critical.

PMID:40665319 | DOI:10.1186/s12960-025-01010-6

Appl Physiol Nutr Metab. 2025 Jul 15. doi: 10.1139/apnm-2025-0095. Online ahead of print.

ABSTRACT

Metabolic carts are commonly used to estimate oxygen consumption (V̇O2) during exercise, but are largely limited to controlled laboratory settings. The V̇O2 Master Pro (VMP) is a newer, portable metabolic analyzer designed to address this limitation; however, few studies have evaluated the validity of this device at varying activity levels.

OBJECTIVE: To assess the validity of the VMP in measuring V̇O2 compared with a stationary metabolic cart, the COSMED Quark CPET (CQ), during sedentary activity and treadmill walking/jogging in a laboratory setting.

APPROACH: Twenty-seven healthy adults [mean age=22.1±7.6 years; female=51.8%] participated in two laboratory trials on separate days. In a counterbalanced order, participants used the CQ and VMP during 10-minute conditions of the following activities: sedentary activity (sitting quietly), slow walking (3.2 km/h), brisk walking (5.6 km/h), and jogging (7.2 km/h). The agreement between the two measures was evaluated using equivalence testing, mean absolute percentage error (MAPE), percentage bias, intraclass correlation coefficients (ICCs), and Bland-Altman analyses.

MAIN RESULTS: The devices showed low agreement and significant proportional biases across all activity levels [ICCs=0.135-0.323]. Equivalence testing did not demonstrate statistically significant equivalence between the devices (p>.05), with the VMP underestimating V̇O2. The smallest error appeared during jogging [MAPE=20.05%; percentage bias= -19.29%].

SIGNIFICANCE: The VMP underestimated V̇O2 at all tested intensities, demonstrating low accuracy and agreement relative to the reference measure. This may be attributed to limited ventilatory flow capture or sensor responsiveness during submaximal activities. Observed bias and within-subject variability suggest caution when using the VMP across different submaximal activity levels.

PMID:40663800 | DOI:10.1139/apnm-2025-0095

J Nurs Educ. 2025 Jul 16:1-5. doi: 10.3928/01484834-20250415-03. Online ahead of print.

ABSTRACT

BACKGROUND: Feedback-seeking behavior is crucial for the growth and adaptability of advanced learners. This project aimed to enhance feedback-seeking behaviors in Accelerated Bachelor of Science in Nursing (ABSN) students through an evidence-based educational intervention.

METHOD: Feedback-seeking behaviors were assessed via pre- and posttests. Quantitative data were analyzed using descriptive and inferential statistics, while open-ended responses underwent content analysis. The intervention included an in-person educational session on feedback-seeking behavior.

RESULTS: The intervention significantly boosted students’ confidence in seeking feedback, with 80% reporting higher confidence postintervention compared with 53.3% preintervention (mean difference = 0.73, p < .0104). Faculty responses supported these findings (mean difference = 1.33, p < .057). Students showed a strong preference for private feedback settings (100%) and sought feedback to enhance traits, abilities, and skills (80%).

CONCLUSION: The educational intervention positively influenced ABSN students’ feedback-seeking behaviors and is recommended for broader application. [J Nurs Educ. 2025;64(X):XXX-XXX.].

PMID:40663798 | DOI:10.3928/01484834-20250415-03

JMIR Hum Factors. 2025 Jul 15;12:e70034. doi: 10.2196/70034.

ABSTRACT

BACKGROUND: Malaysia, an upper middle-income country in the Asia-Pacific region, has an HIV epidemic that has transitioned from needle sharing to sexual transmission, mainly in men who have sex with men (MSM). MSM are the most vulnerable population for HIV in Malaysia. In 2022, our team developed a web-based artificial intelligence (AI) chatbot and tested its feasibility and acceptability among MSM in Malaysia to promote HIV testing. To enhance the usability of the AI chatbot, we made it accessible to the public through the website called MYHIV365 and tested it in an observational study.

OBJECTIVE: This study aimed to test the usability of an AI chatbot in promoting HIV testing among MSM living in Malaysia.

METHODS: This observational study was conducted from August 2023 to March 2024 among 334 MSM. Participants were recruited through community outreach and social-networking apps using flyers. The interactions between participants and the AI chatbot were documented and retrieved from the chatbot developer’s platform. Data were analyzed following a predefined metrics using R software (Posit Software, PBC).

RESULTS: The AI chatbot interacted with 334 participants, assisting them in receiving free HIV self-testing kits, offering information on HIV, pre-exposure prophylaxis (PrEP), and mental health, and providing details of 220 MSM-friendly clinics, including their addresses, phone numbers, and operating hours. After the study, 393 human-chatbot interactions were documented on the chatbot developer’s platform. Most participants (304/334, 91.0%) interacted with the AI chatbot once, 30 (9.0%) engaged 2 or more times at different intervals. Participants’ interaction time with the chatbot varied, ranging from 1 to 31 minutes. The AI chatbot properly addressed most participants’ questions (362/393, 92.1%) about HIV and PrEP. However, in 31 interactions, participants posed additional questions to the chatbot that were not programmed into the chatbot algorithms, resulting in unanswered interactions.

CONCLUSIONS: The web-based AI chatbot demonstrated high usability in delivering HIV self-testing kits and providing clinical information on HIV testing, PrEP, and mental health services. To enhance its usability in community and clinical settings, the chatbot must offer personalized health information and precise interaction, powered by sophisticated machine learning algorithms. In addition, establishing an effective connection between the AI chatbot and health care systems to eliminate stigma and discrimination toward MSM is crucial for the future implementation of AI chatbots.

PMID:40663792 | DOI:10.2196/70034

JMIR Public Health Surveill. 2025 Jul 15;11:e72322. doi: 10.2196/72322.

ABSTRACT

BACKGROUND: Influenza and respiratory syncytial virus (RSV) predominantly circulate during the winter season and cause acute respiratory illness (ARI). Deploying molecular point-of-care testing (POCT) in primary care can inform whether a patient presenting with an ARI has influenza or RSV. An early virological diagnosis could facilitate appropriate use of antivirals and enable better antimicrobial stewardship.

OBJECTIVE: This study aimed to report the impact of POCT for influenza and RSV on antimicrobial prescribing, including antiviral therapy in primary care.

METHODS: The impact of POCT for influenza on antimicrobial stewardship (PIAMS) in UK primary care was a nested cohort study undertaken from January 20 to May 31, 2023, after the period of peak virus circulation, within practices that contribute data to the English sentinel network. People presenting with ARI had a nasopharyngeal swab performed and were tested for influenza and RSV with a molecular POCT analyzer located within the practice. Data on antimicrobial prescribing and other study outcomes were collected by linking information from the analyzer to coded data from the patient’s computerized medical record.

RESULTS: In total, 323 swabs were collected from 10 PIAMS study practices. In total, 59.7% (197/323) of swabbed patients were female, and the mean age was 37.28 (SD 25.05) years. Furthermore, 2.9% (9/323) of all swabs were positive, with 0.3% (1/323) positive for influenza A, 1.6% (5/323) positive for influenza B, and 0.9% (3/323) positive for RSV. In total, 80 patients were prescribed antibiotics 7 days following POCT testing. There were no instances of antiviral prescribing in the 7 days post testing. A statistically significant difference in antibiotic prescribing given a positive POCT result compared with a negative test was not found with an unadjusted odds ratio (OR) of 7 days post testing. A statistically significant difference in antibiotic prescribing given a positive POCT result compared with a negative test was not found with an unadjusted OR of 1.54 (95% CI 0.38-6.30; P=.55) and adjusted OR of 1.21 (95% CI 0.00-1.78).

CONCLUSIONS: This study illustrates the risk of having a narrow study window; our observation period was not aligned with when influenza was circulating. The peak of weekly incidence of influenza in the sentinel network was in the last week of 2022, and RSV was circulating before this. Further evidence is needed to assess the impact of POCT on antimicrobial prescribing. The viruses tested for using POCT could be aligned with the circulating viruses identified by the sentinel network.

PMID:40663790 | DOI:10.2196/72322

JMIR Med Inform. 2025 Jul 15;13:e63036. doi: 10.2196/63036.

ABSTRACT

BACKGROUND: Between 2020 and 2022, the Philippine Primary Care Studies program, a government-funded initiative supporting universal health care implementation, piloted two electronic health records (EHR) systems across urban, rural, and remote primary care sites.

OBJECTIVE: The study aimed to evaluate the implementation of two EHR systems in diverse primary care settings in the Philippines over a three-year period.

METHODS: This implementation study used an explanatory mixed methods design. Two EHR systems were deployed: an Open Medical Records System (OpenMRS)-based platform in 2016, and a Microsoft-based system in 2021. Both systems integrated clinical documentation, pharmacy, laboratory, and reporting modules. Implementation strategies included training workshops and materials, iterative user feedback loops, and infrastructure cofinancing with local governments. Surveys were administered yearly to all end users. The primary outcome was behavioral intention to use the system. Quantitative data were supplemented by inductive content analysis of qualitative responses to explain observed trends.

RESULTS: A total of 351 survey responses were collected from 2020 to 2022. In 2020, the intention to use the OpenMRS-based EHR was high across all sites. By 2022, following the launch of the Microsoft-based EHR, acceptability declined significantly among doctors and administrative staff, particularly at the urban site. In contrast, the remote site which retained the OpenMRS-based system maintained high acceptability levels. Qualitative findings revealed that while the new EHR system provided a more privacy-focused design, users preferred a cross-platform EHR to allow more flexible access to patient data. At the rural site where the EHR was used to facilitate task-shifting among nurses involved in clinical management, users were less impacted by this shift.

CONCLUSIONS: The disparities in EHR acceptability across urban, rural, and remote sites were influenced by contextual, technical, and demographic factors. The decline in acceptability following the EHR system transition highlights the importance of implementation strategies that reflect the specific needs and capacities of each setting. These findings offer practical insights for adapting EHR systems to diverse primary care contexts.

PMID:40663789 | DOI:10.2196/63036

Blood. 2025 Jul 15:blood.2025029628. doi: 10.1182/blood.2025029628. Online ahead of print.

ABSTRACT

Advanced mycosis fungoides (MF) and Sézary syndrome (SS) have a poor prognosis with overall survival <5 years. Studies have found the current clinical staging (IA-IVB) inadequate for risk stratification. Developing a prognostic index in MF/SS will identify patients with poor outcomes and may allow better management decisions and improved survival.PROCLIPI (Prospective Cutaneous Lymphoma International Prognostic Index) Study was launched in 2015 at 46 international expert MF/SS Centers, prospectively collecting pre-defined datasets in newly diagnosed MF/SS patients to determine a cutaneous lymphoma IPI (CLIPI).552 advanced stage MF/SS patients were recruited. The 5-year overall survival (OS) was IIB=50.0%, IIIA=64.8%, IIIB=43.9%, IVA1=50.8%, IVA2=25.9%, IVB=36.9%. Factors at diagnosis associated with a significantly worse survival were N3 status; p<0.001, age>60yrs; p<0.001, raised serum lactate dehydrogenase; p=0.005 and large-cell transformation in skin; p=0.006. Modelling these 4 independent risk-factors into a CLIPI found there was a statistically significant worse OS in high-versus low-risk p<0.001, high-versus intermediate-risk p=0.002 as well as intermediate-versus low-risk p=0.010. 5 Year OS were 63.3%, 44.7% and 18.3% in the low-, intermediate- and high-risk PROCLIPI cohort respectively.In advanced stage MF/SS there was a low 5-year survival rate and increasing stage was not associated with worsening survival. The use of CLIPI to stratify patients into low, intermediate, and high-risk prognostic groups has the potential to improve patient outcomes by helping guide optimal treatment selection. CPMS ID 17662 (PROCLIPI), RRK4970, ClinicalTrials.Gov ID: NCT02848274.

PMID:40663780 | DOI:10.1182/blood.2025029628

Eur J Public Health. 2025 Jul 15:ckaf120. doi: 10.1093/eurpub/ckaf120. Online ahead of print.

ABSTRACT

We explored the association between education and academic ability in childhood and both outpatient appointments and hospital admissions in adulthood, accounting for adult factors, including long-term conditions. The analytical sample consisted of 7183 participants in the Aberdeen Children of the 1950s. Three outcomes were measured using routine Scottish medical records over a five-year period (2004-2008): (1) ≥5 outpatient appointments, (2) ≥2 hospital admissions, or (3) ≥3 outpatient appointments plus ≥1 hospital admission. We constructed a childhood (age 6-11) education and academic ability domain and calculated predicted risk scores of the three outcomes for each cohort member. Nested logistic regression models investigate the association between domain predicted risk scores and odds of each of the three outcomes accounting for childhood confounders and self-reported adult mediators. Adjusting for childhood confounders, lower childhood education and academic ability were positively associated with ≥5 outpatient appointments (OR 1.03, 95% CI 1.01-1.05), ≥2 hospital admissions (OR 1.04, 95% CI 1.03-1.6), and ≥3 outpatient appointments plus ≥1 hospital admissions (OR 1.04, 95% CI 1.02-1.06). Accounting for adult mediators, associations remained statistically significant, but their effect sizes were reduced. When school leaving age was included in the model, the association between the exposure and all three outcomes were attenuated. Education and academic ability in early life may be related to the burden of multiple hospital admissions and outpatient appointments later in life. However, the age at which the participant left school seems to substantially mediate this relationship underscoring the positive impact of time spent in education.

PMID:40663774 | DOI:10.1093/eurpub/ckaf120

JMIR Res Protoc. 2025 Jul 15;14:e63596. doi: 10.2196/63596.

ABSTRACT

BACKGROUND: The rapid proliferation of health care apps has transformed health care delivery, providing patients with unprecedented access to medical information and services. These apps facilitate remote consultations, appointment scheduling, medication reminders, and health monitoring, thereby enhancing patient engagement and improving health outcomes. Despite the widespread benefits, disparities in the adoption and usage of health care apps persist, influenced by demographic and socioeconomic factors. Understanding these disparities is crucial for designing interventions that promote equitable access to digital health tools.

OBJECTIVE: This systematic review aims to identify and synthesize empirical studies on health care app usage disparities, focusing on demographic and socioeconomic factors. This review seeks to inform stakeholders about the key factors influencing app usage and provide insights to improve accessibility and effectiveness. Specifically, this review addresses the following research questions: (1) what are the key demographic and socioeconomic factors associated with health care app usage disparities? (2) how do these factors influence the adoption and utilization of health care apps? and (3) what are the barriers to and facilitators of effective use of health care apps?

METHODS: This review will adhere to PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) guidelines. Eight databases-ACM Digital Library, CINAHL, IEEE Xplore, ProQuest Nursing and Allied Health Journals, PubMed/MEDLINE, ScienceDirect, Scopus, and Web of Science-were searched for studies published in English between January 1, 2014, and June 17, 2024. Eligibility criteria include journal papers focusing on health care app usage across different demographic and socioeconomic groups. Data management will involve using Zotero for reference management and Excel for screening and eligibility assessment. Two reviewers will independently extract the data and assess the study quality and risk of bias. Descriptive statistics will be used to summarize the study characteristics.

RESULTS: As of June 2025, the review is in the screening stage. The completion of data collection is anticipated by November 2025. The final results are expected to be published by late 2025. This review aims to provide comprehensive insights into the disparities in health care app usage.

CONCLUSIONS: The findings of this systematic review will offer valuable insights into demographic and socioeconomic disparities in health care app usage, informing stakeholders on how to address these disparities. By identifying the factors influencing app adoption and usage, this review will contribute to the development of targeted interventions and policies to enhance digital health equity.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/63596.

PMID:40663773 | DOI:10.2196/63596