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☐ ☆ ✇ BMJ Open

International perspective on healthcare provider gender bias in musculoskeletal pain management: a scoping review

Por: Wilford · K. F. · Mena-Iturriaga · M. J. · Vugrin · M. · Wainer · M. · Seeber · G. H. — Enero 12th 2026 at 15:08
Objective

Musculoskeletal pain is a global issue affecting millions of individuals. Healthcare provider gender bias (HCP-GB) in pain management or treatment may have implications. This study aimed to systematically (1) identify and map the scientific and grey literature as it relates to HCP-GB in the assessment, diagnosis and management of musculoskeletal pain, and (2) identify current gaps that necessitate further research.

Design

This scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).

Data sources

The following databases were searched: PubMed (National Library of Medicine), Embase (Elsevier), Scopus (Elsevier), CINAHL Complete (Ovid), Academic Search Complete (EBSCOhost), Pre-Prints Database (National Library of Medicine) and Rehabilitation Reference Center from inception to August 2022 and updated in May 2025. Relevant grey literature was identified.

Eligibility criteria for selecting articles

All screening was performed by two reviewers during title/abstract screening and full-text screening stages. Articles published in English, Spanish and German were included if they involved participants with musculoskeletal pain and examined HCP-GB as the dependent variable.

Data extraction and synthesis

Two reviewers independently extracted data from the bibliometric, study characteristics and pain science variables. Results were descriptively mapped, and the frequency of concepts, population and characteristics was narratively reported.

Results

21 full-text articles were included. All articles were published in North America and Europe. A total of 3694 healthcare providers from various specialty areas were examined. A majority of studies (57.1%; n=12) measured HCP-GB using written case vignettes, 33.3% (n=7) used case vignettes plus virtual human pictures/videos, and 9.5% (n=2) used real patients. The influence of patients’ sex in HCP pain assessment was reported in 28.5% (n=6) of the articles, while 42.9% (n=9) reported gender bias regarding HCP non-pharmacological treatment recommendations. Male patients were more likely to receive exercise recommendations for back pain and laboratory testing, whereas female patients received more psychological treatment recommendations and counselling from their HCP.

Conclusions

While there appears to be inconsistent use of the terms sex and gender, the literature informing this review suggests an existence of gender bias in the management of patients with musculoskeletal pain. Future research should be more purposeful in the use of sex/gender-related terms and consider exploring the impact of implicit bias training to rectify potential gender biases present in HCP.

☐ ☆ ✇ Journal of Nursing Scholarship

Parents' Experiences of Having an Adolescent With a Mental Disorder Admitted to a Public Hospital's Psychiatric Unit

Por: Hendrietta Vorster‐Mbontsi · Nompumelelo Ndlovu · Marie Poggenpoel — Enero 12th 2026 at 07:05

ABSTRACT

Introduction

Parents of adolescents with a mental disorder describe having overwhelming feelings regarding the psychiatric diagnosis, which they respond to with grief. Existing research indicates that these parents face unique challenges, such as self-blame and stigma. Parents are crucial in adolescent care, and healthcare professionals should find interventions that educate parents about the disorder, treatment and symptom management. The aim of this study was to explore and describe parents' experiences in having an adolescent with a mental disorder admitted to the psychiatric unit of a public hospital in Gauteng, South Africa.

Design

The study used Heidegger's interpretive phenomenological design.

Methods

A qualitative, exploratory, descriptive and contextual method was used. Data were collected through semi-structured telephonic interviews with 10 parents who had an adolescent with a mental disorder admitted to a public hospital in Gauteng, South Africa. Tesch's thematic coding steps were used for data analysis.

Results

The themes arising from the findings reflected (1) parents experienced that their lives were stuck amid grief for the loss of what their adolescent child used to be, and anxiety about what the future holds, (2) parents experienced that when they reached out for professional help, the healthcare system failed them due to a lack of guidance, information and support, (3) parents experienced that they prayed for divine intervention as a coping strategy, and (4) parents experienced stigma from the community.

Conclusion

The findings illustrate the need for psychiatric nurses to facilitate the mental health of parents of adolescents with a mental disorder. Furthermore, positive attitudes among parents are improved once they are empowered and receive the necessary support, and stigmatization will also be reduced. It is recommended that further research be conducted to explore the effectiveness of emotional and professional support in addressing the challenges parents experience with an adolescent who has a mental disorder.

Clinical Relevance

This paper contributes knowledge to nursing practice by exploring the experiences of parents who have an adolescent with a mental disorder in the South African context.

☐ ☆ ✇ International Wound Journal

What Primary Care Physicians Expect From Continuing Medical Education in Wound Management—A Survey Study

Por: Veerakaisa Koivunen · Tuukka Veija · Heli Lagus · Kirsi Isoherranen · Maarit Venermo · Virve Koljonen — Enero 9th 2026 at 16:40

ABSTRACT

We aimed to investigate the learning needs of general practitioners and their preferences as regards the most appropriate teaching session for continuing medical education in wound management. A survey targeting general practitioners at the public health centres in the City of Helsinki. Twenty-seven general practitioners participated in the study. The majority (74.1%) had received education in medical school, 40.7% from wound care nurses, and 40.7% from colleagues. Participants felt the most competent in wound diagnosis (59.3%) and etiological tests (55.6%) and requested training in these topics (74.1% and 74.1%). A peer-led lecture (88.9%) was the most preferred technique, followed by lectures by wound care nurses (55.6%), an educational video (44.4%), a specialist-led lecture (37.0%), an interactive wound product session (29.6%), and digital self-study (29.6%). Wound diagnostics and etiological tests are recognised as crucial topics for continuing medical education. Peer-led lectures were preferred over other techniques; however, we observed varying preferences regarding the most optimal technique. Based on our results, we propose a half-day training including lectures, interactive and hands-on activities, and reflection, led by a peer and a wound care nurse with supporting video materials. Future studies could assess its impact on learning outcomes and wound care quality.

☐ ☆ ✇ Journal of Advanced Nursing

Systematic Reviews of Psychosocial Interventions for Loneliness Among Older Adults in Community and Residential Care Settings: An Umbrella Review

ABSTRACT

Aim

To describe the latest information on types of psychosocial interventions and their effectiveness on loneliness reduction among older adults in community and residential care settings, and the experience with these interventions.

Design

Umbrella review.

Methods

The Joanna Briggs Institute methodology for umbrella reviews.

Data Sources

Cochrane Database of Systematic Reviews; Cumulative Index of Nursing and Allied Health Literature; Medline; Embase; Emcare; PsycINFO; ProQuest Dissertation & Thesis Global; Ovid Nursing Database; MedRxvi.

Results

Twenty-two reviews were included. Seven major types of psychosocial intervention were identified: (1) social facilitation interventions, (2) psychological therapies, (3) health and social care provision, (4) animal-assisted interventions, (5) befriending interventions, (6) leisure and skill development, and (7) other interventions. Social facilitation interventions that provide synchronised interaction, psychological therapies, health and social care provision, and animal (−assisted) interventions demonstrated positive effects while leisure/skill development and befriending interventions warrant more rigorous evidence. Group settings, synchronised interaction and purpose-driven are identified as facilitators, whereas technological issues and safety issues are barriers to participation.

Conclusion

Seven types of psychosocial interventions are currently available for loneliness among community-dwelling older adults, and a positive effect in reducing loneliness was demonstrated in some types. Facilitators and barriers to their participation were synthesised. Two future research directions are suggested: (1) reviews on meaning-centred interventions to provide a comprehensive understanding and (2) implementation studies employing community-based paraprofessionals to promote programme scalability and accessibility.

Implications for the Profession

Health and social care practitioners (e.g., nurses), researchers and policymakers are recommended to employ social facilitation interventions with synchronised interaction, psychological therapies, health and social care provision and animal-assisted interventions to address loneliness among community-dwelling older adults.

Impact

This review provided empirical information on available effective interventions to address loneliness among community-dwelling older adults. It also provided information for nurses to implement psychosocial interventions in the community.

Reporting Method

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines

Patient or Public Contribution

This study did not include patient or public involvement in its design, conduct or reporting.

Trial Registration

PROSPERO CRD 42023482852, registered 25/11/2023

☐ ☆ ✇ PLOS ONE Medicine&Health

Comparative study of advanced reasoning versus baseline large-language models for histopathological diagnosis in oral and maxillofacial pathology

Por: Viet Anh Nguyen · Van Hung Nguyen · Thi Quynh Trang Vuong · Quoc Thanh Truong · Thi Trang Nguyen — Diciembre 31st 2025 at 15:00

by Viet Anh Nguyen, Van Hung Nguyen, Thi Quynh Trang Vuong, Quoc Thanh Truong, Thi Trang Nguyen

Large language models (LLMs) are increasingly explored as diagnostic copilots in digital pathology, but whether the newest reasoning-augmented architectures provide measurable benefits over earlier versions is unknown. We compared OpenAI’s o3 model, which uses an iterative planning loop, with the baseline GPT-4o on 459 oral and maxillofacial (OMF) cases drawn from standard textbooks. Each case consisted of two to five high-resolution haematoxylin-and-eosin micrographs, and both models were queried in zero-shot mode with an identical prompt requesting a single diagnosis and supporting microscopic features. Overall, o3 correctly classified 31.6% of cases, significantly surpassing GPT-4o at 18.7% (Δ = 12.9%, P 
☐ ☆ ✇ Journal of Advanced Nursing

Does Self‐Compassion Play a Mediating Role Between Stress and Fertility Adjustment in Women Undergoing Infertility Treatment? A Structural Equation Analysis

Por: Gülşah Vural Aktan · Çiğdem Yücel Özçirpan · Fatma Uslu Şahan · Gülten Koç — Diciembre 23rd 2025 at 00:53

ABSTRACT

Aim

This study aimed to investigate the relationship between stress, self-compassion, and fertility adjustment in women undergoing infertility treatment in Turkey and to determine whether stress influences fertility adjustment through the mediating effect of self-compassion.

Design

A cross-sectional and descriptive design was used in the study.

Method

The study was conducted with 290 women who applied to the in vitro fertilisation unit in a university hospital in Ankara, Turkey. Descriptive statistics, Pearson correlation, and structural equation analysis were used for statistical analysis.

Results

According to the results of structural equation modelling, self-compassion was found not to affect fertility adjustment, while infertility-related stress directly influenced both self-compassion and fertility adjustment. Additionally, self-compassion was not found to mediate the relationship between stress and fertility adjustment in women undergoing infertility treatment.

Conclusion

The findings suggest that different dynamics may contribute to women's infertility-related stress and fertility adjustment.

Implications for the Profession

This study highlights the importance of developing strategies to enhance fertility adjustment in women receiving infertility treatment and underscores the need for nurses working in this field to evaluate women's attitudes toward themselves to provide individualised care aimed at alleviating infertility-related stress.

Impact

The findings indicate that self-compassion does not have the expected effect in coping with infertility. Specifically, the lack of a direct effect of self-compassion on fertility adjustment, along with the strong influence of stress on both self-compassion and fertility adjustment, suggests that stress management-focused interventions may take precedence. These results indicate that approaches aimed at stress management during infertility treatment can play a critical role in supporting women's adjustment processes.

Reporting Method

STROBE guidelines were followed for this study.

Patient or Public Contribution

There is no patient or public contribution.

☐ ☆ ✇ BMJ Open

Prognostic value of the PaO2/FiO2 ratio for mortality in acute respiratory distress syndrome: a retrospective observational study in a lower-middle-income country

Por: Luong · C. Q. · Dao · C. X. · Nguyen · M. H. · Pham · D. T. · Pham · Q. T. · Vu · T. T. · Truong · H. T. · Nguyen · H. H. · Nguyen · T. T. P. · Luong · H. T. T. · Nguyen · C. B. · Khuong · D. Q. · Dang · H. D. · Tran · C. H. · Nguyen · T. T. · Nguyen · T. A. · Pham · T. T. · Bui · G. T. H — Diciembre 17th 2025 at 11:54
Objectives

To evaluate the accuracy of the arterial oxygen partial pressure/inspired oxygen fraction (PaO2/FiO2) ratio in predicting mortality among acute respiratory distress syndrome (ARDS) patients in Vietnam.

Design

A retrospective observational study.

Setting

A central hospital in Vietnam.

Participants

Adult patients diagnosed with ARDS based on the Berlin definition and admitted to Bach Mai Hospital between August 2015 and August 2023. ARDS severity was converted from descriptive categories to the Berlin score, ranging from 1 (PaO2/FiO2>300 mm Hg) to 4 (PaO2/FiO2≤100 mm Hg).

Primary outcome

All-cause hospital mortality.

Results

Of 345 patients, 67.5% were male, and the median age was 55.0 years (IQR: 39.0–66.0). Hospital mortality was 61.2% (211/345). On the first day of admission, the PaO2/FiO2 ratio (areas under the receiver operating characteristic curves (AUROC): 0.585 (95% CI 0.522 to 0.649)) showed limited predictive ability for hospital mortality. Incorporating the PaO2/FiO2 ratio into the Berlin score did not substantially improve accuracy (AUROC: 0.578 (95% CI 0.516 to 0.641)). Both measures were less accurate than Sequential Organ Failure Assessment (SOFA) (AUROC: 0.650 (95% CI 0.590 to 0.711)), Acute Physiology and Chronic Health Evaluation II (APACHE II) (AUROC: 0.685 (95% CI 0.628 to 0.742)) and Confusion, Urea >7 mmol/L (20 mg/dL), Respiratory rate ≥30 breaths/min, Blood pressure (systolic 2/FiO2 values (adjusted OR, AOR: 0.988 (95% CI 0.979 to 0.996)) were independently associated with lower mortality risk, while higher Berlin (AOR: 2.477 (95% CI 1.190 to 5.156)), SOFA (AOR: 1.278 (95% CI 1.102 to 1.482)), APACHE II (AOR: 1.236 (95% CI 1.108 to 1.379)) and CURB-65 (AOR: 7.142 (95% CI 2.581 to 19.763)) scores were associated with increased mortality risk.

Conclusions

In this study of ARDS patients in Vietnam, the PaO2/FiO2 ratio demonstrated limited discriminatory ability for hospital mortality, and incorporating it into the Berlin score did not meaningfully improve performance. While less accurate than SOFA, APACHE II and CURB-65 scores, the PaO2/FiO2 ratio and Berlin score remained independently associated with mortality risk. These findings should be interpreted cautiously, given the retrospective design, single-centre setting and potential selection bias; further validation in larger, multicentre studies is warranted.

☐ ☆ ✇ Journal of Advanced Nursing

How Government Policies and Organisational and Sectoral Circumstances Influence Nurse Practitioner and Physician Assistant Employment and Training: A Realist Analysis Using Surveys

ABSTRACT

Aims

To explain how government policies affected decision-making on Nurse Practitioner and Physician Assistant employment and training within Dutch healthcare organisations, and how organisational and sectoral circumstances were influential.

Design

An online, cross-sectional survey study.

Methods

A literature- and interview-based program theory was tested using surveys. Respondents from hospital care, (nursing) home care, primary care, and intellectual disability services were recruited using convenience sampling. Data analysis used descriptive statistics and inferential tests. Open-ended responses were analysed using thematic synthesis techniques. Survey results were clustered to assess verification, falsification, or refinement of program theory elements.

Results

A total of 568 experts in hiring and training healthcare professionals participated. Respondents indicated that most government policies promoted employment and training. Organisational and sectoral circumstances caused significant variations in Nurse Practitioner and Physician Assistant deployment across healthcare sectors, shaping how decision-makers interpreted and acted on government policies. Specific circumstances within primary care hampered deployment.

Conclusion

Government policies stimulated training and employment by: (1) removing practice restrictions (scope of practice expansion, legal acknowledgment), (2) facilitating cost-effective training and deployment (training grants, billing options), (3) providing sectoral knowledge on deployment, training, and healthcare outcomes (funding research and a sectoral knowledge center), and (4) establishing sectoral agreements (on apprenticeships). Organisational and sectoral circumstances significantly influenced outcomes. Key circumstances included flanking policies, stakeholder support, labor market capacity, healthcare demand, organisational resources and aims, and type of decision-makers (medical doctor or manager/director). Familiarity with the professions stimulated deployment.

Impact and Implications

The refined and verified program theory supports designing effective skill-mix policies and facilitating Nurse Practitioner and Physician Assistant employment and training. Tailoring skill-mix policies can optimise outcomes. This offers opportunities for governments, healthcare funders, organisations, and professionals to contribute to healthcare quality, cost efficiency, and patient satisfaction.

Patient or Public Contribution

Healthcare professionals were part of the study population.

☐ ☆ ✇ BMJ Open

Determinants and implementation strategies to implement a reflection method for guideline-based informal caregiving in community nursing in the Netherlands: a mixed-method study

Por: Vullings · N. · Maas · M. · Adriaansen · M. · Vermeulen · H. · Van der Wees · P. · Heinen · M. — Diciembre 5th 2025 at 09:25
Aim

This study aims to identify key determinants and strategies for effectively implementing a reflection method to support adequate use of the ‘Informal Care’ guideline within community nursing. The SPARK (Self & Peer Assessment to Reflect on Quality Standards) reflection method, developed in an earlier participatory design-based study, is a structured group reflection approach designed to help nurses and nursing assistants reflect on and apply guideline recommendations in daily practice.

Design

A mixed method study.

Setting

Six community care organisations in the Netherlands.

Participants and interventions

This mixed-method study collected qualitative data through observations and video recordings of group meetings with community nurses, nursing assistants and a patient representative, alongside quantitative questionnaires. This project included design and test group meetings to develop and evaluate prototypes of the reflection method. Observations were discussed, and video recordings were thematically analysed. The Measurement Instrument for Determinants of Innovations questionnaire was used to identify key determinants for effective implementation. The questionnaire results were analysed descriptively, using the Tailored Implementation in Chronic Diseases (TICD) framework to present preliminary determinants for validation. Implementation strategies were then selected in a group meeting. Based on this input, the research group operationalised the selected implementation strategies.

Results

Twenty-nine determinants for implementing the reflection method were identified across seven TICD domains, including barriers such as limited support, knowledge and time, and facilitators such as team collaboration and prevention of caregiver overload. Based on these findings, three implementation strategies, namely knowledge enhancement, coaching development and leadership strengthening, were formulated to support integration into community nursing practice.

Conclusion

This study identified key determinants and strategies for implementing a reflection method in community nursing. While several determinants align with existing literature, context-specific determinants related to the heterogeneous group of registered nurses and certified nursing assistants also emerged. Strengthening guideline knowledge, coaching competencies and leadership is essential for sustainable, guideline-based reflection in practice.

☐ ☆ ✇ Journal of Advanced Nursing

Exploring Individual and Organisational Factors Related to Inclusive Leadership Among Healthcare Professionals: A Systematic Review and Meta‐Analysis

Por: Vanamo Vilokkinen · Suvi Kuha · Eeva Vuorivirta‐Vuoti · Jouko Miettunen · Outi Kanste — Diciembre 9th 2025 at 08:07

ABSTRACT

Aim

To offer a comprehensive overview of the individual and organisational factors related to inclusive leadership among healthcare professionals.

Design

Systematic review and meta-analysis.

Methods

The review was conducted following the Joanna Briggs Institute methodology for systematic reviews of effectiveness. Findings were synthesised using meta-analysis, a random effects model and narrative synthesis.

Data Sources

In January 2025, a systematic search was conducted with no time or geographical limits in the CINAHL, MEDLINE (PubMed), Mednar, ProQuest and Scopus databases. Studies in English, Swedish and Finnish were included.

Results

A total of 34 studies were included. The meta-analysis revealed a statistically significant positive relationship between inclusive leadership and psychological safety among healthcare professionals (n = 10). The narrative synthesis further identified individual and organisational factors related to inclusive leadership. Individual factors consisted of well-being at work, performance and productivity, social behaviour, innovativeness and creativity and psychological capacity. Organisational factors revealed work community cohesion and citizenship, as well as organisational fairness and appreciation.

Conclusions

Inclusive leadership is a promising leadership behaviour, with positive outcomes for healthcare professionals and organisations. By enhancing psychological safety, inclusive leadership offers broader benefits for individuals and organisations. As such, it could improve the retention of professionals and the attractiveness of organisations in the healthcare sector.

Implications for Healthcare Management

To strengthen the functioning of healthcare organisations, leaders should be educated in inclusive leadership and its practical benefits. Training should focus on developing inclusive leadership behaviours that foster belonging, value individual uniqueness and encourage participation across all professional groups, creating an environment where both individuals and organisations can thrive.

Reporting Method

The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were used to report the results.

Patient or Public Contribution

No patient or public contribution.

Trial Registration

The protocol was registered in the International Prospective Register of Systematic Reviews PROSPERO (ID: CRD42024503861)

☐ ☆ ✇ PLOS ONE Medicine&Health

Effects of manufacturing modality, primer, and adhesive polymerization on the shear bond strength of customized lingual brackets to glazed zirconia: An <i>in vitro</i> study

Por: Viet Anh Nguyen · Ngo The Minh Pham · Minh Ngoc Tran · Thi Bich Ngoc Ha · Thi Quynh Trang Vuong — Diciembre 4th 2025 at 15:00

by Viet Anh Nguyen, Ngo The Minh Pham, Minh Ngoc Tran, Thi Bich Ngoc Ha, Thi Quynh Trang Vuong

Introduction

Bonding fixed appliances to zirconia restorations is challenging, yet adult orthodontics increasingly involves ceramic crowns and patient-driven esthetic choices such as lingual appliances. Customized lingual brackets may improve fit and reduce adhesive thickness, but evidence on their bonding to zirconia is limited.

Materials and methods

This in vitro study evaluated the shear bond strength of customized lingual brackets bonded to glazed zirconia after airborne-particle abrasion. Bracket manufacturing was either three-dimensionally (3D) printed cobalt-chromium or cast nickel-chromium. Primers were a universal adhesive (Single Bond Universal, 3M) or a primer containing 10-methacryloyloxydecyl dihydrogen phosphate Z-Prime Plus (Bisco), and adhesives were a light-cure orthodontic composite or a dual-cure resin cement. One hundred twenty-eight specimens (n = 16 per group) were tested. Shear bond strength was analyzed with three-way ANOVA, followed by post-hoc Tukey tests. Adhesive Remnant Index (ARI) scores were evaluated with ordinal regression. Significance was set at α = 0.05.

Results

Manufacturing modality significantly affected bond strength, with additively manufactured cobalt-chromium exceeding cast nickel-chromium (P = 0.049). The primer category and polymerization mode showed no significant main effects (P > 0.20) and no significant interactions. Group means clustered 9–10 MPa, and all combinations met the clinically accepted threshold. Additively manufactured brackets exhibited lower ARI scores than cast brackets (P  Conclusions

On glazed, sandblasted zirconia, shear bond strength of customized lingual brackets showed a borderline main effect of fabrication method, whereas primer type and adhesive polymerization mode were not statistically significant. Failures were predominantly located at or near the zirconia–adhesive interface. Within this in vitro model, base manufacturing may warrant attention, whereas primer and curing mode may be selected for handling and workflow considerations, with clinical relevance yet to be established.

☐ ☆ ✇ PLOS ONE Medicine&Health

Single catheter strategy for transradial angiography and primary percutaneous coronary intervention enhances procedural efficiency, microvascular outcomes, and cost-effectiveness: Implications for STEMI healthcare in resource-limited settings

by Mohajit Arneja, Swetharajan Gunasekar, Dharaneswari Hari Narayanan, Joshma Joseph, Harilalith Kovvuri, Sharath Shanmugam, Pavitraa Saravana Kumar, Asuwin Anandaram, Vinod Kumar Balakrishnan, Jayanty Venkata Balasubramaniyan, Sadhanandham Shanmugasundaram, Sankaran Ramesh, Nagendra Boopathy Senguttuvan

Background

Faster time to reperfusion can be achieved by minimizing various patient and system-level delays that contribute to total ischemic time. Procedural delays within the catheterization laboratory represent a non-negligible and modifiable component in the chain of reperfusion, but remain unquantified by conventional metrics such as door-to-ballon (D2B) time. Universal catheter approaches have rapidly gained traction as an alternative to the traditional two catheter approach for transradial coronary interventions. However, their utility for both diagnostic angiography and subsequent angioplasty is limited, and the impact of this strategy on reperfusion outcomes has remained unexplored. We utilized a procedural metric termed fluoroscopy-to-device (FluTD) time to quantify the efficiency of a single catheter strategy, and assessed its impact on epicardial and myocardial perfusion.

Methods and results

In this retrospective study, consecutive STEMI patients undergoing transradial primary PCI (pPCI) at a tertiary care center in India between May 2022 to October 2024 were analyzed. Patients were divided into two groups: 51 underwent PCI using a single universal guiding catheter (UGC), and 51 underwent the conventional two-catheter (CTC) approach. The primary outcome of the study was a comparison of the FluTD time between the two procedural strategies. Secondary outcomes included myocardial blush grade (MBG), Thrombolysis in Myocardial Infarction (TIMI) flow grade, total fluoroscopy time, radiation dose, device safety and efficacy, and procedural success.The median FluTD time was significantly shorter in the UGC compared to the CTC group (3 minutes [IQR 3–4] vs. 10 minutes [IQR 8–17], p  Conclusion

A single catheter strategy for both angiography and pPCI in STEMI patients was associated with a significant reduction in FluTD time and improved microvascular perfusion, without compromising device safety or efficacy. In low- and middle-income countries (LMICs), where intra- and extra-procedural delays are often more pronounced, inclusion of the single catheter strategy can optimize catheterization workflows and yield substantial cost-savings.

☐ ☆ ✇ PLOS ONE Medicine&Health

Validation of an instrument to assess knowledge, attitudes, and practices regarding occupational accident prevention among rice farmers

Por: My Ha Nguyen · Toan Van Ngo · Linh Gia Vu · Dat Cong Truong · Hai Minh Vu — Noviembre 26th 2025 at 15:00

by My Ha Nguyen, Toan Van Ngo, Linh Gia Vu, Dat Cong Truong, Hai Minh Vu

Background

Despite the hazardous nature of rice farming, limited evidence exists regarding farmers’ knowledge, attitudes, and practices (KAP) toward accident prevention, and no standardized instrument is currently available to measure these dimensions in Vietnam or comparable contexts. This study aimed to develop and validate a psychometrically sound instrument for assessing rice farmers’ KAP related to occupational accident prevention.

Methods

Instrument development and validation were carried out in three stages. First, an initial item pool was generated through an extensive review of existing literature. Second, content validity was established through expert consultation involving professionals in agriculture, occupational health, and public health. Third, a pilot study was conducted with 168 rice farmers in Thai Binh Province, Vietnam, to evaluate the instrument’s psychometric properties.

Results

Exploratory factor analysis identified 20 items across five factors in the knowledge domain, nine items forming a single factor for attitudes, and 17 items grouped into four factors for practices, explaining 85.8%, 43.8%, and 72.3% of the total variance, respectively. Confirmatory factor analysis supported these structures, demonstrating satisfactory model fit across domains. The instrument exhibited high internal consistency, with Cronbach’s alpha values ranging from 0.894 to 0.969 for knowledge, 0.833 for attitudes, and 0.805 to 0.933 for practices.

Conclusion

The validated instrument provides a reliable and valid measure of rice farmers’ knowledge, attitudes, and practices concerning occupational accident prevention. It offers a robust foundation for future research, monitoring, and targeted interventions aimed at improving safety behaviors and reducing injury risks among agricultural workers.

☐ ☆ ✇ International Wound Journal

Determination of Hemodynamic Response Using fNIRS in Lower Extremity Amputee and Replant Patients

ABSTRACT

This study investigates cortical reorganisation and hemodynamic responses in individuals with lower extremity amputation and replantation using functional near-infrared spectroscopy (fNIRS). A total of 15 healthy controls, four left lower limb amputees and one replantation patient were included. Oxyhemoglobin (oxy-Hb) activations were measured during 10 unilateral lower limb motor tasks (toe, ankle, knee and hip movements). Non-parametric analyses revealed significant differences in cortical activation between amputees and controls, particularly during knee flexion and extension. Three-dimensional contrast maps demonstrated that oxy-Hb activity in amputees extended from the M1-leg area into somatosensory regions, reflecting neuroplastic remapping. In contrast, the replantation patient exhibited activation patterns closer to the control group, especially in knee and hip tasks. These findings indicate that fNIRS can sensitively capture hemispheric dynamics during unilateral lower limb movements and highlight neuroplastic adaptations following amputation and replantation. Such insights may guide future neuroprosthetic design and rehabilitation strategies.

☐ ☆ ✇ BMJ Open

Immune Profiling in Early Cognitive Disorders (IMPRINT) study protocol: a longitudinal cohort study exploring biomarkers of inflammation in early dementia with Lewy bodies and Alzheimers disease, as part of the Dementias Platform UK

Por: Crook · H. · Swann · P. · Fye · H. · Kigar · S. · Savulich · G. · Mckeever · A. · Herrero · E. · Turner · L. · Aimola · L. · Grey · G. D. · Blackburn · D. · Matthews · P. M. · Su · L. · Chouliaras · L. · Rowe · J. B. · Malhotra · P. · OBrien · J. T. — Noviembre 21st 2025 at 14:06
Introduction

Growing evidence points towards the integral role of both central and peripheral inflammation across all neurodegenerative diseases, including dementia with Lewy bodies (DLB) and Alzheimer’s disease (AD). The immune alterations observed in these diseases may occur long before the onset of clinical and cognitive symptoms; however, the exact timing and role of inflammation in the pathogenesis of neurodegenerative disease remains unclear. Findings to date are conflicting, with most work focused on AD rather than other dementias and most studies from single sites and cross-sectional. Through longitudinally examining detailed phenotypes of the peripheral immune system using mass cytometry, the Immune Profiling in Early Cognitive Disorders study aims to uncover specific immune signatures in early AD and DLB, how these signatures change over time and how they relate to disease progression and cognitive changes.

Methods and analysis

Blood, cerebrospinal fluid, saliva and urine samples will be collected from a cohort of participants with either prodromal (mild cognitive impairment) or early dementia due to Lewy bodies or AD (MCI-LB and DLB; and MCI-AD and AD), alongside healthy controls. Through immunophenotyping with mass cytometry, detailed immune fingerprints will be identified for these groups. We will assess which key combinations of immune cell clusters are predictive of disease phenotype, cognitive decline and progression to dementia. Samples will also be evaluated with novel techniques to measure markers of degenerative pathology and inflammation.

Ethics and dissemination

This study was approved by the Preston North West Research Ethics committee (21/NW/0314) and is registered with the ISRCTN registry (ISRCTN62392656). The study is ongoing (since June 2022). Baseline visits are being undertaken, and follow-up visits have started for some participants. Full data analyses will be completed and submitted for publication upon conclusion of the study.

☐ ☆ ✇ BMJ Open

Continuous non-invasive electrophysiological monitoring in high-risk pregnancies: study protocol of a cohort intervention random sampling study in a tertiary obstetrical care centre in the Netherlands (NIEM-O study)

Por: de Klerk · N. D. · Berben · P. B. Q. · de Vries · I. R. · Niemarkt · H. · Vullings · R. · van den Heuvel · E. R. · van der Ven · M. · Fransen · A. F. · Oei · S. G. · van Laar · J. O. E. H. — Noviembre 12th 2025 at 10:55
Introduction

Women with high-risk pregnancies (eg, pre-eclampsia, imminent preterm birth) are often hospitalised due to the need for foetal and maternal monitoring. They are monitored for 30–45 min up to three times a day with conventional cardiotocography (CTG). In the meantime, they reside at the hospital, but the foetal status is not monitored. Continuous foetal monitoring is currently not recommended using CTG, due to the potential temperature rise from consistent exposure to ultrasound waves. For safe 24/7 monitoring, newly developed devices using non-invasive electrophysiological cardiotocography (eCTG) instead of conventional CTG offer a promising alternative. Previous research into eCTG has shown favourable results in monitoring foetal heart rate throughout both pregnancy and labour. This study aims to investigate the effect of implementing continuous antepartum eCTG monitoring in hospitalised high-risk pregnancies on perinatal and maternal outcome.

Methods and analysis

In this single centre prospective cohort intervention random sampling study, eligible women will be included on the Obstetric High Care of Máxima MC Veldhoven, the Netherlands. In total, 511 pregnant women with a singleton pregnancy between 23+0 and 32+0 weeks of gestation requiring hospitalisation will be recruited. Eligible women will be prospectively included in the cohort receiving standard treatment: intermittent CTG monitoring. From these women, a random sample of the prospective cohort will be offered a new monitoring method: 24/7 eCTG monitoring. For the eCTG monitoring, a wireless abdominal electrode patch, the Nemo Foetal Monitoring System will be used. Additional data from a historical cohort (2014–2019) of 1400 women receiving standard treatment will be included. Perinatal and maternal outcome, along with satisfaction levels of both patient and caregivers, will be compared between groups.

Ethics and dissemination

The study is registered on 18 October 2022 to the Central Committee on Research Involving Human Subjects (NL82869.015.22) via https://www.toetsingonline.nl/to/ccmo_monitor.nsf/conceptabr?OpenForm and approved by the Medical Ethics Committee of Máxima MC (W22.070) on 7 November 2023. Results of the study will be disseminated in peer-reviewed scientific journals and conference presentations.

Trial registration number

NCT06151613.

☐ ☆ ✇ PLOS ONE Medicine&Health

High fructose corn syrup ınduced liver and heart damage are not reversed with hazelnut consumption: In vivo study

Por: Ayça Toprak-Semiz · Efsane Yavuz-Bedir · Hakan Yüzüak · Murat Usta · Demet Şengül — Noviembre 7th 2025 at 15:00

by Ayça Toprak-Semiz, Efsane Yavuz-Bedir, Hakan Yüzüak, Murat Usta, Demet Şengül

Hazelnut, antioxidant, anti-inflammatory effects, has an important role in a healthy diet. High fructose corn syrup (HFCS), used as a sweetener in ready-made food, beverages; causes hyperlipidemia, fatty liver, cardiovascular system damages; oxidative stress, inflammation play role in these damages. Based on these data, we aimed to examine liver and heart damage caused by HFCS in rats and to investigate possible role of hazelnut enriched food in preventing/improving these damages. During this process, weight change, food, liquid consumption were recorded. Biochemical parameters were measured with standard enzymatic techniques. Inflammatory cytokines were determined by ELISA. Liver and heart tissues were evaluated histopathologically, changes were scored, graded. HFCS decreased food, increased liquid consumption. Feeding with hazelnut reduced fluid consumption. HFCS increased weight gain, hazelnut did not reverse it. LDH, CK values increased in HFCS group due to heart damage. While damage occurred in livers of HFCS group due to increased levels of TNF-α and IL-1ß, feeding with hazelnut did not change it. In heart, inflammatory cytokines were similar between groups. In histopathological analysis, inflammation was observed both in livers, hearts of HFCS group. In hazelnut group, a significant decrease in damage was observed compared to HFCS, HFCS+H groups. According to our results, hazelnut supplementation reduced liquid intake and showed limited cardiac protection, but did not reverse HFCS-induced hepatic or cardiac injury.
☐ ☆ ✇ PLOS ONE Medicine&Health

Barriers and enablers to help-seeking for common mental disorders among young people in low-income settings: Perspectives from Zimbabwe

by Rufaro Hamish Mushonga, Tarisai Concilia Bere, Rebecca Jopling, Franklin Glozah, Maria Anyorikeya, Tiny Tinashe Kamvura, Suzanne Dodd, Arnold Maramba, Denford Gudyanga, Benedict Weobong, Dixon Chibanda, Melanie Abas, Moses Kumwenda

Methods

We utilised a qualitative research design and conducted 32 semi-structured interviews with young people (15–24 years) across high schools and the Friendship Bench (FB) in Harare between 20 December 2022 and 30 September 2023. Interviews were audiotaped and transcribed verbatim and then coded using an inductive approach to capture patterns grounded in participants’ experiences. Thematic analysis was utilised to develop relevant codes and identify relevant themes.

Results

Nine themes were generated including six themes related to barriers (factors that hinder help-seeking for CMDs) and three themes related to enablers (factors that facilitate help-seeking for CMDs). Barriers identified include perceived stigma, privacy and confidentiality issues, unavailability of services, lack of awareness, financial challenges and lack of incentives. Enablers identified include raising awareness, implementing school based initiatives and enhancing accessibility and affordability of mental health services.

Conclusion

This study revealed significant barriers and enablers to help-seeking for CMDs among young people in Zimbabwe. Addressing these multifaceted barriers and leveraging the identified enablers is key to creating supportive systems that encourage young people in low-resource settings to seek and engage with mental health services, ultimately improving their mental wellbeing and overall quality of life.

☐ ☆ ✇ BMJ Open

Host perceptions of an undergraduate semester abroad: strengthening partnerships in global health education

Por: Vuckovic · M. · Mulinge · J. · Ledet · S. · Baker · M. — Octubre 28th 2025 at 18:00
Objectives

As global health education becomes more embedded in university curricula, the availability of experiential learning opportunities in this field has expanded as well. These programmes offer students valuable exposure to diverse cultural perspectives and help develop essential competencies in global health. However, concerns have arisen regarding the persistence of colonial-era dynamics, power imbalances and the potential negative impacts on host organisations in low- and middle-income countries. Much of the existing literature on this topic centres on short-term medical student experiences and is focused on the perspectives of the sending organisations. This study aims to fill this gap by examining a semester-long undergraduate global health experiential learning programme through the perspectives of host organisation staff.

Design

This qualitative case study draws on interviews with 18 key informants from host organisations across seven countries. The research design, data collection and analysis were developed using an analytical framework based on recommendations made by previous studies.

Setting

Host organisations across seven countries participated in the study. Interviews were conducted remotely via Zoom. The interviews were audio-recorded, transcribed, coded in Dedoose software and analysed for emerging patterns and themes.

Participants

Eighteen key informants from host organisations were interviewed, representing seven countries — Tanzania, Ghana, Mexico, India, Bangladesh, Australia and the Philippines — and a range of institutions including research institutes, government agencies and UN bodies.

Results

Participants generally viewed their engagement in experiential learning courses positively. They emphasised the importance of their role in mentoring American and other foreign global health students, building their research skills and cultural competency, and providing valuable insights into power dynamics, local health systems and the wider context in which global health operates. Beyond financial remuneration, participants emphasised multiple non-financial benefits for host organisations. The study identified three key themes in developing strong programmes: partnership, communication and cultural competence. These findings reinforce the value of longer-term programmes and offer actionable recommendations for their continued evolution in global health education.

☐ ☆ ✇ BMJ Open

Access to maternal health services for young women with disabilities in Sub-Saharan Africa: a scoping review protocol

Por: Pebolo · P. F. · Kimera · E. · Nkulu Kalengayi · F. K. · Namatovu · F. — Octubre 21st 2025 at 08:30
Introduction

Young women with disabilities (WWDs) face multiple barriers in accessing maternal healthcare services in low-resource settings. Consequently, they are at an increased risk of adverse maternal health outcomes due to young age and having a disability. This review focuses on synthesising evidence regarding the extent of access to maternal healthcare services and the barriers faced by young WWDs in Sub-Saharan Africa.

Methods and analysis

We will conduct a scoping review guided by the updated Joanna Briggs Institute methodology for scoping reviews. A systematic search of MEDLINE, EMBASE, Scopus, CINAHL, Web of Science Core Collection, Global Health, African Journal Online and Women’s Studies International will be performed to identify relevant articles published in English from 2007 to 2025. A team of two reviewers will independently screen the retrieved articles for relevancy based on the inclusion criteria, and a thematic synthesis will be undertaken to develop a descriptive analysis.

Ethics and dissemination

Since this review will only involve the analysis of published data, it does not require ethical approval. The results will be published in a peer-reviewed journal.

Registration

This review has been registered with the Open Science Framework DOI; https://doi.org/10.17605/OSF.IO/Q7Y8S.

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