Search Results (386)

Background: Individuals with mental health conditions frequently experience stigmatization and discrimination. Among the primary objectives in the fight against stigma is to examine groups that play a crucial role in addressing it, such as healthcare professionals. Although research has examined stigma among healthcare professionals, few studies have specifically addressed how nurses perceive and contribute to the stigmatization of individuals with mental health conditions. Objective: The aim of this review was to compile and compare the scientific literature addressing nurses’ stigma toward individuals with mental health conditions. Methods: Following the methodological guidelines of the Joanna Briggs Institute and in accordance with the PRISMA 2020 guidelines, an integrative review was conducted of MEDLINE (PubMed), EMBASE, APA PsycInfo (EBSCO), and CINAHL Complete (EBSCO). Database-specific indexing terms were combined with the Boolean operators AND/OR. Studies with quantitative or qualitative methodologies, published in Spanish or English and without restrictions by year of publication, were included. Two independent reviewers selected the studies and performed the critical appraisal. Results: The search retrieved 4256 records, of which 32 articles were finally included. A content analysis of the selected studies was conducted. Most studies used validated questionnaires to assess stigma and its associations with various variables, while only a limited number employed qualitative designs. Across the 32 studies (n = 6283 nurses from 29 countries), stigma was observed across settings but tended to be lower among mental health specialists. Insufficient training and limited contact were consistently associated with higher levels of stigma, whereas specialization and positive contact were linked to lower levels. Associative stigma emerged as a recurrent theme with implications for psychiatric nursing identity. Conclusions: Nurses working in mental health settings generally demonstrate more positive attitudes toward individuals with mental health conditions compared with those in other clinical areas; however, stigma persists across all settings. Associative stigma may be influencing the development and advancement of psychiatric nursing. Specific academic training, capacity building, and specialization in mental health are essential to counteract stigma. Further qualitative research is required to achieve a deeper understanding of this phenomenon. Full article

(1) Background: Prosthesis–patient mismatch (PPM) after aortic valve replacement (AVR) impairs left ventricular (LV) recovery and is more common in women due to smaller aortic dimensions. Although the Perceval sutureless valve provides larger effective orifice areas, sex-specific PPM outcomes remain unclear. This study evaluated sex-related differences in PPM incidence, severity, and early impact after Perceval AVR. (2) Methods: We retrospectively analyzed 139 patients (68 males, 71 females) who underwent Perceval AVR between 2016 and 2020. PPM was defined per Valve Academic Research Consortium-3 (VARC-3) criteria using indexed effective orifice area (EOAi) and stratified by body-mass-index (BMI) (<30 vs. ≥30 kg/m²). Echocardiography assessed hemodynamic performance. (3) Results: PPM was markedly more frequent in women than men (74.6% vs. 22.1%, p < 0.001). Among non-obese patients, 47.9% of females versus 16.2% of males developed PPM (p < 0.001). Women received smaller valves and consistently exhibited lower EOAi despite similar gradients. Postoperatively, females had reduced EOAi (0.8 vs. 0.9 cm²/m², p < 0.001) but higher LV ejection fraction (55.8% vs. 49.5%, p = 0.004). Early clinical outcomes were comparable between sexes. (4) Conclusions: Despite favorable hemodynamics of sutureless AVR, anatomical sex differences result in persistently higher PPM rates in women, predominantly of moderate severity. Tailored strategies—including aortic root enlargement and sex-specific EOAi thresholds—may improve prosthesis selection and outcomes in female patients. Full article

Background: The nursing profession is currently facing a critical challenge with a noticeable decline in interest among young people to pursue nursing as a career. Objectives: This study examined academics’ perceptions of factors driving low enrollment in Greek baccalaureate nursing programs and explored incentives that could motivate young people to pursue nursing careers. Methods: We performed a cross-sectional study. We collected our data during October 2025 through an anonymous questionnaire. Source population included all academics in the nine nursing departments in Greece. Response rate was 54.2% (90 out of 166). Results: We classified the factors contributing to the low interest in baccalaureate nursing education programs into four groups: (a) poor working conditions, (b) negative social and cultural perceptions, (c) educational constraints, and (d) impact of the COVID-19 pandemic. Academics identified negative social and cultural perceptions of nursing and poor working conditions as the primary drivers of low interest in baccalaureate nursing programs. The COVID-19 pandemic was viewed as having a moderate influence on young people’s career choices, while educational constraints were considered least important overall. Academics in nursing departments based in Greece’s capital perceived the pandemic’s impact as more substantial than colleagues outside the capital and attributed greater importance to educational constraints. Respondents without prior clinical nursing experience emphasized educational barriers more strongly. To attract students, academics prioritized improving working conditions, increasing salaries, and expanding scholarships and support. Conclusions: Academics reported that unfavorable nursing work environments, intensified during COVID-19, influence students’ career choices, underscoring the need for urgent policy and organizational actions informed by this study and existing evidence. Full article

Background and Objectives: Academic point-of-care (POC) manufacturing enables the in-hospital design and production of patient-specific medical devices within certified environments, integrating clinical practice, engineering, and translational research. This model represents a new academic ecosystem that accelerates innovation while maintaining compliance with medical device regulations. Gregorio Marañón University Hospital has established one of the first ISO 13485-certified academic manufacturing facilities in Spain, providing on-site production of anatomical models, surgical guides, and custom implants for oral and maxillofacial surgery. This study presents a retrospective review of all devices produced between April 2017 and September 2025, analyzing their typology, materials, production parameters, and clinical applications. Materials and Methods: A descriptive, retrospective study was conducted on 442 3D-printed medical devices fabricated for oral and maxillofacial surgical cases. Recorded variables included device classification, indication, printing technology, material type, sterilization method, working and printing times, and clinical utility. Image segmentation and design were performed using 3D Slicer and Meshmixer. Manufacturing used fused deposition modeling (FDM) and stereolithography (SLA) technologies with PLA and biocompatible resin (Biomed Clear V1). Data were analyzed descriptively. Results: During the eight-year period, 442 devices were manufactured. Biomodels constituted the majority (approximately 68%), followed by surgical guides (20%) and patient-specific implants (7%). Trauma and oncology were the leading clinical indications, representing 45% and 33% of all devices, respectively. The orbital region was the most frequent anatomical site. FDM accounted for 63% of the printing technologies used, and PLA was the predominant material. The mean working time per device was 3.4 h and mean printing time 12.6 h. Most devices were applied to preoperative planning (59%) or intraoperative use (35%). Conclusions: Academic POC manufacturing offers a sustainable, clinically integrated model for translating digital workflows and additive manufacturing into daily surgical practice. The eight-year experience of Gregorio Marañón University Hospital demonstrates how academic production units can enhance surgical precision, accelerate innovation, and ensure regulatory compliance while promoting education and translational research in healthcare. Full article

This scoping literature review examines the outcomes and institutional adaptations of pathway programs designed to increase diversity in medical and allied health professions. These programs address systemic barriers faced by students from underrepresented (UR) backgrounds through a targeted focus on improving their academic performance and preparedness for healthcare careers. Utilizing a scoping approach, peer-reviewed publications from 2014 to March 2024 were analyzed, focusing on pathway programs within the United States. Following PRISMA-ScR guidelines, no formal quality appraisal was conducted. The review highlights the geographical distribution of these programs, particularly in the Greater Philadelphia area, and evaluates their success rates and key components, such as mentorship, academic support, and clinical exposure. Key thematic findings include the importance of sustained mentorship, financial and emotional support, early exposure to health careers, and comprehensive academic preparation. The study also discusses the recent implications of the Supreme Court rulings on race-conscious admissions and the resulting institutional strategies to maintain diversity within legal constraints. By providing a comprehensive overview of the literature, this review aims to inform the development and implementation of pathway programs that can improve diversity in the healthcare workforce. Full article

Background/Objectives: Real-world data on the therapeutic use of FLT3 inhibitors in Turkey remain limited. Therefore, we retrospectively evaluated outcomes from 13 academic centers nationwide, focusing on the multikinase inhibitor midostaurin in patients with newly diagnosed FLT3-mutated acute myeloid leukemia (AML). Methods: We collected comprehensive information regarding treatment efficacy, safety, and tolerability. Results: The overall response rate to intensive chemotherapy (3 + 7) plus midostaurin was 87.7%, with a complete remission rate of 84.2%, consistent with previously reported clinical trial results. Treatment discontinuation due to intolerance or toxicity was low (3.5%). One patient discontinued therapy because of septic shock during induction, and another due to a drug–drug interaction during consolidation. Median overall survival was 21.4 months. Allogeneic stem cell transplantation was performed in first remission in 52.6% of patients. Five patients (8.8%) were refractory to induction therapy, and relapse occurred in 21.1% (12 patients). Conclusions: These findings support the effectiveness and acceptable tolerability of midostaurin in routine clinical practice for FLT3-mutated AML. Full article

Background and Objectives: Transcatheter aortic valve implantation (TAVI) has become the mainstay of treatment for symptomatic aortic stenosis (AS) in patients over 70 years of age. It is also indicated for younger patients with significant comorbidities, for valve-in-valve interventions, and in selected patients with severe aortic insufficiency. We aimed to evaluate procedural and clinical outcomes of transfemoral TAVI performed over the course of 12 years by the same operators using different bioprosthetic valves. Materials and Methods: Between 2012 and 2023, 375 patients underwent TAVI in our clinic, with six types of bioprosthetic valves (Edwards Sapien XT, Medtronic Valves [CoreValve and Evolut R], Portico, Myval, Acurate Neo, and Direct Flow Medical). A transfemoral approach was used in all patients. The procedural and clinical outcomes were defined according to Valve Academic Research Consortium-3 (VARC-3) criteria. Results: The mean age of the patients was 78.4 ± 7.3, and their median STS score was 4.2 (2.9–5.9). Of the 375 patients, 361 had severe AS, 4 had severe aortic insufficiency, 5 were valve-in-valve, and 5 were valve-in-TAVI. Seven patients required a second valve implantation: four due to embolization of the prosthetic valve and three due to deep implantation of the prosthetic valve. Based on the VARC-3 criteria, the rates of technical success and device success were 90.4% and 85.3%, respectively. Major vascular complications were observed in 18 (4.8%) patients. Also, 42 (11.2%) patients required permanent pacemaker implantation. The incidence of moderate or worse paravalvular leak was 2.9%. The peri-procedural, 30-day, 1-year, and 5-year mortality rates were 5.1%, 4.3%, 15.2%, and 45.6%, respectively. STS scores (HR:1.129, 95%CI: 1.068–1.192, p < 0.001) and post-TAVI acute kidney injury (HR:3.993, 95%CI:1.629–9.785, p = 0.002) were detected as independent predictors of mortality in Cox regression analysis. Conclusions: This registry demonstrated the evolution of TAVI procedures at a single center over 12 years. A high level of collaboration between experienced operators and innovations in devices seem to be the key features for achieving high procedural success and low complication rates. Full article

Medical students experience fluctuations in their motivation, influenced by various factors, including curricular rigor, mental health, and institutional factors. Based on Self-Determination Theory (SDT) and the Four Pillars of Academic Engagement (HPEE), this study, conducted at a private Mexican university, examined motivational variation according to academic year, curricular impact, gender differences, and its relationship with mental health. Methods: A quantitative, cross-sectional, descriptive study was conducted using qualitative tools for contextualization (n = 1326). Mann–Whitney U tests, Kruskal–Wallis tests, logistic regression, and psychological network analysis were performed. Results: Motivation showed cross-sectional variation: high in preclinical years 1 and 2, decreasing in clinical years 3 and 4 (p < 0.001), and rebounding in year 6. The reformed curriculum (elective subjects, student-centered active learning) resulted in greater motivation (OR = 10.68, p < 0.001). Women tended to have slightly higher motivation (p = 0.050), higher grade point averages (p < 0.001), but also greater stress (p < 0.001). Network analysis revealed that intrinsic achievement (centrality = 1.11) and curiosity about knowledge (predictability = 84.5%) are the main drivers, while demotivation was linked to the later years. The qualitative part of the study showed altruism/curiosity as the main motivators; mistreatment/workload (demotivators). Conclusions: Motivation is context-sensitive, peaks in the preclinical stage, and recovers with autonomy but is vulnerable during clinical immersion. Autonomy in course selection, active student-centered pedagogies, and gender-sensitive support foster sustained participation. The centrality of intrinsic factors in the network highlights that achievement motivation and knowledge are general and independent motivators. Qualitative data reveal systemic barriers. Stage-specific interventions, such as mentoring, student support programs, and reporting mistreatment, can be crucial for strengthening resilience and performance. Longitudinal and multi-institutional studies are needed to validate the causality and generalizability of this study. Full article

Background: The healthcare industry demands nurses with both clinical proficiency and leadership skills. However, formal leadership training remains limited among undergraduate nursing students, underscoring the need for clinical mentorship to support leadership development. Purpose: This study investigated the association between clinical mentorship quality and leadership competencies among undergraduate nursing students enrolled at a public university in northern Saudi Arabia. Methods: Data were collected using a cross-sectional design from 224 nursing students through a self-administered online survey, which comprised three sections: demographic information, students’ perceptions of clinical mentorship quality, and a standardized assessment of leadership competencies. Results: Students reported positive perceptions of their leadership competencies, with an average score of 2.82. A strong positive correlation was observed between mentorship quality and leadership competencies, particularly in strategic thinking, emotional intelligence, influence, and teamwork. Differences were observed based on sex and academic performance, with female students and those with higher GPAs exhibiting stronger leadership competencies. Regression analysis revealed mentorship quality (β = 0.642, p < 0.001) and academic performance (β = 0.131, p = 0.013) as significant predictors of leadership competencies, while gender and academic year were not statistically significant. Conclusions: High-quality clinical mentorship substantially contributes to the development of leadership competencies among nursing students, with academic performance providing additional support. Integrating structured mentorship programs into nursing curricula may enhance preparedness for leadership roles within healthcare settings. Full article

Background and Clinical Significance: Synchronous gastrointestinal tumors are exceptionally rare, particularly when combining histologically distinct benign and malignant components. Schwannomas represent uncommon mesenchymal tumors of the gastrointestinal tract, most frequently arising in the stomach, while rectal localization is exceedingly unusual. Papillary adenocarcinoma of the gallbladder is an aggressive malignant entity derived from intracholecystic papillary–tubular neoplasms (ICPNs). The coexistence of these two unrelated neoplasms has not been previously reported, making this case of dual tumor pathogenesis clinically and academically significant. Case Presentation: A 68-year-old female was admitted for surgical management of grade IV uterovaginal prolapse. Preoperative imaging incidentally revealed a well-circumscribed rectal wall mass and gallstones. A combined abdominopelvic operation was performed, including total hysterectomy with bilateral adnexectomy (Wiart procedure), rectosigmoid resection with colorectal anastomosis, and bipolar cholecystectomy. Intraoperatively, a firm intramural rectal lesion and a friable papillary mass in the gallbladder fundus were identified. Histopathologic examination confirmed a benign rectal schwannoma (S-100 positive, CD117/DOG-1 negative) and a papillary adenocarcinoma of the gallbladder, pT3N0M0, with clear resection margins and no lymphovascular or perineural invasion. The postoperative course was uneventful, and the patient remained disease-free at six-month follow-up. Conclusions: This case represents an exceedingly rare benign–malignant synchronous tumor association. The simultaneous occurrence of rectal schwannoma and gallbladder papillary adenocarcinoma underscores the importance of thorough intraoperative exploration and histopathologic evaluation. Complete resection with negative margins and multidisciplinary follow-up remains crucial for optimal outcomes and contributes to understanding dual tumor pathogenesis within the gastrointestinal tract. Full article

Background/Objectives: Dental training is known for its demanding academic pace, early clinical exposure, and constant performance pressure. These stressors may contribute to behavioral and physical manifestations, including bruxism and temporomandibular disorder (TMD). This study aimed to better understand the multidimensional burden experienced in this educational setting by investigating the relationship between education-related stress, bruxism patterns, and temporomandibular symptoms (TMD-related symptoms) in dental students. Methods: A cross-sectional survey was conducted at the Ankara University Faculty of Dentistry in 2025 and completed by 287 undergraduate dental students. The questionnaire collected sociodemographic information, self-reported bruxism status, TMD-related symptoms via the Fonseca Anamnestic Index (FAI), and education-related stressors using the Dental Environment Stress (DES) scale. Descriptive statistics, group comparisons, and Spearman correlation analyses were conducted. Results: Bruxism was reported by 76% of students and was significantly more common among females (p < 0.05). Students with bruxism demonstrated higher DES (3.34 ± 0.84) and FAI (41.81 ± 20.32) scores compared with those without bruxism (p < 0.001). DES and FAI scores showed a significant positive correlation (r = 0.229, p < 0.001). Stressors related to workload, examinations, limited rest time, clinical uncertainty, patient responsibility, and financial concerns were strongly associated with bruxism, while inconsistent academic feedback emerged as a key distinguishing factor. Conclusions: Education-related stress is closely linked to bruxism and TMD-related symptoms among dental students. Beyond overall stress intensity, the nature of experienced stressors plays a critical role. These findings highlight the importance of supportive learning structures, targeted stress-management strategies, and curriculum-level improvements to promote student wellbeing and resilience. Full article

Background/Objectives: Type 1 diabetes (T1D) is a common childhood condition with rising global incidence. Because early-onset T1D coincides with key periods of brain maturation, affected children may face neurocognitive risks. This review summarizes current evidence on the neurocognitive impact of pediatric T1D and related clinical implications. Methods: A structured search of PubMed, Scopus, and Web of Science (inception–October 2025) used combinations of terms related to T1D, cognitive outcomes, and brain imaging. Studies involving participants under 18 years that reported cognitive or neuroimaging findings were included. Results: Diabetic ketoacidosis (DKA) at diagnosis is consistently linked with acute and longer-term neurological injury, including reduced brain volume and potential persistent deficits in memory and executive functioning. Severe or recurrent hypoglycemia disproportionately affects the hippocampus, contributing to lasting learning and memory impairments. Chronic hyperglycemia is a major driver of progressive neurocognitive decline; higher HbA1c is associated with smaller brain volumes and poorer executive function, attention, and processing speed. Early-onset disease and longer duration further increase vulnerability. These neurocognitive effects translate into modest reductions in academic performance and quality of life, especially with poor glycemic control. Emerging evidence suggests that continuous glucose monitoring, insulin pumps, and hybrid closed-loop systems improve metabolic stability and may support healthier brain development. Conclusions: T1D children experience subtle but meaningful neurocognitive risks shaped by glycemic extremes and early disease onset. Routine neuropsychological monitoring, strengthened academic support, and wider use of advanced diabetes technologies may help preserve cognitive development. Larger, longitudinal neuroimaging studies are needed to guide targeted neuroprotective strategies. Full article

This study examined the relationship between academic performance in pre-clinical assessments and clinical placement outcomes among entry-level physiotherapy students in cardiorespiratory physiotherapy. It also compared academic and clinical performance across genders and investigated the correlations between these two areas within the context of cardiorespiratory physiotherapy. The results from two cohorts of physiotherapy students in a single educational institution underwent retrospective analysis. The study compared academic performance data from pre-clinical assessments with clinical placement outcomes, further examined gender differences and investigated correlations between academic and clinical performance. Consistent academic performance was demonstrated across written assessments, but it correlated weakly with clinical placement outcomes. The findings highlight the importance of professional attributes, such as learning and work integration, professionalism, communication, problem-solving, adaptability, and teamwork, which were not assessed in pre-clinical assessments. No significant gender differences were found in academic or clinical performance, except in practical exams. The study suggests that clinical success, in addition to academic results, relies on additional skills not evaluated in pre-clinical assessments. It emphasises the need for holistic assessment frameworks to better bridge the gap between academic and clinical training, ensuring future physiotherapists are prepared for diverse clinical challenges. Full article

Background/Objective: The objective was to evaluate the standalone performance of an AI system, Transpara 1.7.1 (ScreenPoint Medical), in screening mammography cases proceeding to stereotactic biopsy using histopathological results as ground truth. Methods: This retrospective study included 202 asymptomatic female patients (mean age: 57.8 years) who underwent stereotactic biopsy at a multicenter academic institution between October 2022 and September 2023 with a preceding screening mammogram within 14 months. Transpara AI risk scores were compared to pathology results (benign versus malignant). Performance metrics for AI including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve (AUC) were calculated. Results: Transpara AI classified 20 of 39 malignant findings (51%) as elevated risk compared with 50 of 211 total findings (24%). AI score was positively correlated with malignancy (r = 0.29, p < 0.001). Sensitivity for detecting malignancy (classifying as intermediate or elevated risk) was 94.9% (95% CI: 81.4–94.1), specificity was 24.4% (95% CI: 18.3–31.7), PPV was 22.2% (95% CI: 16.3–29.4), and NPV was 95.5% (95% CI: 83.3–99.2). Transpara had fair performance in detecting breast cancer with AUC 0.73 (95% CI: 0.63–0.82). Conclusions: Transpara AI is a useful screening mammography triage tool. Given its high sensitivity and high negative predictive value, AI may be used to guide radiologists in making biopsy or follow up recommendations. However, the high false-positive rate and presence of two false negatives underscore the need for radiologists to use caution and clinical expertise when interpreting AI results. Full article

Background/Objective: Culturally adapted frailty screening tools are essential for improving health outcomes, facilitating clinical decision-making, promoting effective care planning, and ensuring accurate frailty assessment across diverse cultural contexts; their use among clinicians and academics is therefore supported. The purpose of this study was to assess internal consistency, test–retest reliability, and validity of the Arabic FRAIL scale (FRAIL-AR scale) for Arabic-speaking populations with colorectal cancer (CRC). Methods: This cross-sectional study included 137 participants diagnosed with CRC who completed the FRAIL-AR scale, the EORTC QLQ-C30 physical function subscale, and functional performance-based Timed Up and Go (TUG) and Five Times Sit-to-Stand (5xSTS) tasks. Internal consistency was assessed using Kuder–Richardson formula 20 (KR-20), and test–retest reliability was determined using the two-way random intraclass correlation coefficient ICC _(2.1). Convergent validity was evaluated by assessing the correlation between the FRAIL-AR scale against the EORTC QLQ-C30 physical function scale, TUG, and 5xSTS. Results: The FRAIL-AR scale exhibited good internal consistency (KR-20 = 0.80) and test–retest reliability (ICC _(2.1) = 0.89, 95% CI 0.77–0.94). Correlation analysis showed a weak negative correlation between the overall FRAIL-AR scale scores and EORTC QLQ-C30 physical function scale scores (r = −0.38, p < 0.05), while it exhibited a moderate positive correlation with TUG (r = 0.75, p < 0.01) and 5xSTS (r = 0.63, p < 0.01) scores. FRAIL-AR scores showed significant known-groups validity with higher frailty scores in older-age individuals (p < 0.01), females (p < 0.05), and those with comorbid conditions (≥5) (p < 0.05). Conclusion: The FRAIL-AR scale’s validity and reliability make it an appropriate tool for geriatricians, oncologists, and healthcare providers to evaluate and monitor frailty among Arabic-speaking colorectal cancer patients. Full article