Search Results (4,681)

In a previous study, we demonstrated that a novel surface treatment applied to laser-melted Ti6Al4V substrates supports osteoblast-like cell adhesion, proliferation, and the activation of early osteogenic pathways. Building on these preliminary findings, the present work aimed to further investigate the ability of the same surface to promote extracellular matrix (ECM) deposition, organization, and osteogenic maturation, which are critical events for the establishment of a stable bone–implant interface in subperiosteal dental implants. Human osteoblast-like MG-63 cells were cultured on Ti6Al4V discs subjected to different surface treatments, including a proprietary surface modification (ATcs) specifically designed for subperiosteal applications. ECM formation and maturation were evaluated through scanning electron microscopy coupled with energy-dispersive spectroscopy, immunofluorescence, and semiquantitative analyses of osteogenic markers type I collagen (COL1A1), secreted protein acidic and rich in cysteine (SPARC), and dentin matrix protein 1 (DMP1) through Western blotting. The results showed that, while all tested surfaces supported cell adhesion, the ATcs surface promoted a distinct osteogenic profile characterized by enhanced DMP1 expression, organized collagen deposition, and the formation of calcium–phosphate–rich mineralized structures. Compared to surfaces that primarily stimulated cell proliferation or early matrix production, ATcs appeared to favour progression toward late-stage osteogenic maturation and matrix mineralization. Taken together, these findings extend our previous observations and indicate that this novel surface treatment not only supports osteoblast viability and early differentiation but also promotes extracellular matrix maturation, a key prerequisite for effective osseointegration. Although further in vivo studies are required, the present data provide additional biological rationale for the use of ATcs-treated Ti6Al4V surfaces in next-generation custom-made subperiosteal implant designs. Full article

Bioethics education has become established as an essential component for addressing the ethical challenges associated with biomedical development, biotechnology, and decision-making in the healthcare field. Although numerous studies have analyzed the teaching of bioethics among medical students and other health professions, empirical research on bioethics literacy in religious formation contexts remains limited. The objective of this study was to evaluate the level of bioethical knowledge (here operationalized as bioethics literacy) among Catholic seminarians in Colombia and to explore the psychometric properties of a questionnaire designed to measure bioethics literacy in this population. A cross-sectional observational study was conducted through the administration of a structured questionnaire consisting of 32 multiple-choice items with a single correct answer addressing philosophical foundations, personalist bioethics, bioethical principles, clinical bioethics, and issues related to biotechnology. A total of 216 complete questionnaires were analyzed using descriptive statistics and exploratory psychometric analyses, including item difficulty and discrimination, internal consistency, and exploratory factor analysis. The results showed a moderate overall level of bioethics literacy, with better performance in applied domains such as clinical bioethics and bioethical principles, and lower levels of correct responses in philosophical foundations and personalist bioethics. The questionnaire showed moderate internal consistency and a preliminary factorial structure, suggesting its usefulness as an exploratory tool for assessing bioethical knowledge in seminary educational contexts. These results highlight the importance of strengthening the integration between philosophical and theological education and the applied analysis of bioethical problems in seminary educational programs. Full article

Background: Empathy and a positive attitude are essential competencies in healthcare, particularly when caring for older adults. Their development is therefore a critical component of undergraduate dental education. This study evaluates whether using aging simulation suits can enhance empathy and improve attitudes toward older adults among dental students. Methods: Third- to fifth-year dental students from the University Clinics of Dental Medicine in Geneva, Switzerland, participated in an aging-simulation experience using the GERonTologic age simulation suit (GERT^®), which replicates age-related physical impairments. Students performed tasks in four predefined scenarios, both with and without the suit. Changes in empathy and attitudes were measured using the Jefferson Scale of Empathy-Health Profession Students’ version (JSE-HPS) and the Geriatric Attitudes Scale (GAS) questionnaires. Perceptions of the intervention were evaluated using a 5-point Likert scale questionnaire. Results: Sixty-three undergraduate students (45 women, 18 men), aged 20–53 years, participated. The suit significantly impaired their physical abilities (p < 0.001). Empathy improved post-intervention (p = 0.038), particularly in the third-year group. Attitude towards older adults improved significantly post-intervention (p = 0.001), mainly among fourth- and fifth-year students. All participants endorsed the positive value of the intervention. Conclusions: The intervention’s impact varied by clinical experience: empathy increased mainly in less experienced students, while attitudes improved in those with more exposure to elderly care. This suggests that the timing of simulation within the curriculum influences outcomes. Aging simulation represents a promising educational approach to enhance empathy, improve attitudes toward older adults, and prepare dental students for the clinical and psychosocial aspects of geriatric care. Full article

The evolving digital landscape, including artificial intelligence (AI) and its generative forms, is changing how younger generations learn. As students utilize generative AI systems, they cultivate trust in such technology to support their current and long-term learning. The objective of this study was to investigate the relationship between generative AI use among students in health professions and their trust in this technology to support their lifelong learning as future health professionals. This study employed a survey methodology using a cross-sectional study design. The survey included sociodemographic variables and questions regarding students’ generative AI use and their trust in this technology to support their lifelong learning. Descriptive and inferential statistical procedures were used to analyze the data. A total of 558 students representing various health professions responded to the survey. In the regression analysis, after controlling for student’s sex and location variables, greater generative AI use was associated with students’ increased trust in this technology to support their lifelong learning (beta = 0.58, p < 0.001), explaining close to 40% of the total variance. Given the rapidly evolving digital landscape, this finding warrants further study, with implications for training of the future health workforce. Full article

Lyme disease is the most common vector-borne disease in North America. Predicting Lyme disease incidence is a key component of public health preparedness. Previously, we demonstrated that the volume of data searches on Google Trends for terms related to Lyme disease, such as “Lyme” and “tick bite”, can be used as a tool to predict monthly human Lyme disease incidence at the state level. The objective of this project was to build upon our previous work by adding environmental and canine data to our predictive models for the prediction of state-level human and canine Lyme disease incidence. Human data were acquired from state health departments. Canine data were acquired from IDEXX Laboratories. We hypothesized that incorporating a One Health approach with human, animal, and environmental data would improve the predictive ability of the models. The One Health model performed significantly better (Mean Absolute Error [MAE] = 12.1) in predicting human disease incidence in 6 out of 16 states compared to the environmental data model (MAE = 16.5), human search terms model (MAE = 21.4), canine data (search terms + case count) model (MAE = 31.1), and the canine case data model (MAE = 32.0). For canine Lyme disease incidence, the One Health model performed worse (MAE = 330.5) compared to the canine search data model (MAE = 282.3), the human data (search terms + cases) model (MAE = 248.4), and the environmental data (MAE = 221.5) model. However, even the best-performing models had large prediction errors, which limit practical utility. Future studies should incorporate alternative data streams, such as electronic health records and insurance claims, to test predictive ability. Full article

Background: Propofol is widely used for anesthesia in colorectal cancer surgery, but is frequently associated with hypotension and respiratory depression. Remimazolam, a novel ultra-short–acting benzodiazepine, may offer improved hemodynamic stability with similar anesthetic depth and recovery characteristics. However, evidence directly comparing remimazolam and propofol in the setting of colon cancer surgery remains limited. Therefore, the aim of this study was to systematically evaluate the efficacy, safety, perioperative hemodynamic stability, and recovery outcomes of remimazolam versus propofol in older adults undergoing colon cancer surgery. Methods: We conducted a systematic review and meta-analysis of randomized controlled trials and comparative cohort studies evaluating remimazolam versus propofol in adult patients undergoing colon or colorectal cancer surgery. PubMed, Scopus, and Web of Science were searched from the start of each database to October 2025. Outcomes included perioperative hemodynamics (MAP and HR), recovery parameters, intraoperative remifentanil consumption, anesthesia duration, and adverse events. Random-effect models were used to calculate pooled mean differences (MDs) or risk ratios (RRs) with 95% confidence intervals (CIs). Results: Six studies involving 542 patients (remimazolam n = 276; propofol n = 266) were included. Remimazolam produced significantly higher perioperative MAP (overall MD = 2.86 mmHg, 95% CI 1.52–4.21; p < 0.0001) and slightly higher HR (MD = 2.30 bpm, 0.08–4.52; p = 0.04). Differences were largest immediately after incision and at the end of surgery. No significant differences were found in PACU stay, overall recovery duration, remifentanil consumption, or anesthesia duration. Postoperative nausea and vomiting were comparable (RR = 0.93; p = 0.86), while respiratory depression was numerically lower with remimazolam (RR = 0.49; p = 0.17). Conclusions: Remimazolam provides anesthetic efficacy comparable to propofol in colon cancer surgery while offering modest, but clinically meaningful improvements in intraoperative hemodynamic stability. Recovery times, opioid requirements, and adverse-event rates were similar between agents. Remimazolam may be particularly advantageous for elderly or hemodynamically vulnerable patients undergoing major colorectal procedures. Larger, high-quality trials are warranted to clarify long-term and oncologic outcomes. Full article

Background and Objectives: Burnout syndrome is a major challenge among healthcare workers, affecting both mental and physical health. Although stress may influence physiological systems, this study does not directly assess biological mechanisms, and interpretations should remain associative. Stress-related associations may be reflected in body composition, but objective data are limited. This study aims to assess the associations between burnout, body composition, and quality of life in medical staff, using bioimpedance as the main tool. Material and methods: The cross-sectional study included 95 medical staff (36 resident doctors, 13 specialists/consultants, 31 nurses, 15 nursing assistants), 75.8% women, mean age 38 ± 10 years, conducted in the medical and surgical departments of Dr. C.I. Parhon Clinical Hospital, Iași, between January and March 2024. Burnout was assessed using the Maslach Burnout Inventory; quality of life was evaluated with SF-12; body composition was measured by bioimpedance (BMI, muscle mass, fat mass, bone mass, hydration, basal metabolism, metabolic age). Statistical analyses included ANOVA, Kruskal–Wallis, and Spearman correlations. Results: Resident physicians had higher muscle, bone mass and basal metabolism, with lower adipose tissue compared to other categories (p < 0.05). Total burnout and exhaustion were positively correlated with muscle mass (r = 0.247, p = 0.016), bone mass (r = 0.219, p = 0.033), basal metabolism (r = 0.219, p = 0.033) and negatively with QoLM (r = −0.315, p = 0.002). Other body variables, including BMI, total adipose tissue, and water level, showed no significant correlations. These associations may be influenced by age, sex, and professional category and do not imply causality. Conclusions: Age, profession, and work seniority are associated with burnout and specific changes in body composition. However, these findings are correlational, and bioimpedance-derived parameters do not reflect direct biological stress mechanisms. Full article

Spiritual care competence (SCC) is increasingly recognized as relevant in mental health, yet no validated tool exists in Slovenia. This study aimed to translate and validate the Spiritual Care Competence Questionnaire (SCCQ) in a Slovene sample of mental-health professionals. Guided by this aim, our research question was the following: to what extent does the SCCQ demonstrate a replicable seven-factor structure, acceptable reliability, construct validity, and coherent group differences in a Slovene sample of mental-health professionals? In a cross-sectional survey (n = 291) across outpatient, inpatient, private, and other settings, we administered the SCCQ together with measures of spiritual sensitivity (SSS), spiritual transcendence (STS), and the BFI-S. Following forward–backward translation and expert review, we conducted item analysis, exploratory and confirmatory factor analyses, and assessed reliability and construct validity. After removing seven psychometrically weak items, a 35-item, seven-factor structure—perception of spiritual needs, team spirit, documentation/tools, spiritual self-awareness, knowledge of other religions, conversation, and empowerment/proactive opening—showed borderline to acceptable fit (TLI = 0.917, CFI = 0.892, RMSEA = 0.068, SRMR = 0.073) and internal consistency (Cronbach’s alpha = 0.67–0.87). Convergent validity was supported by positive associations with SSS/STS, while expected correlations with Big Five traits were small but significant (negative for Emotional Instability). Older age and psychotherapist profession predicted higher SCC. The Slovene SCCQ is a confession-neutral, psychometrically adequate instrument for assessing SCC in mental-health services. Findings highlight curricular needs—especially documentation/tools and team-based engagement—and enable research, education, and quality improvement aligned with international SCCQ validations. Full article

Background and objective: Adverse drug reactions (ADRs) cause substantial harm, and a considerable proportion may be preventable, but under-reporting persists and weakens pharmacovigilance. Spontaneous reporting depends on clinicians, yet under-reporting persists and weakens pharmacovigilance. To map barriers to adverse drug reaction reporting among physicians, a comparison of nurses and pharmacists in single-country studies was carried out between high-income countries (HICs) and low- and middle-income countries (LMICs). Methods: A scoping review was conducted following PRISMA-ScR guidance. PubMed and Web of Science were searched for studies published from 2016 onward. Eligible studies were single-country primary empirical studies including physicians, nurses, or pharmacists and examining ADR reporting. Only barriers that were measured or explicitly explored and reported as extractable results were included. Barriers were coded into 12 domains and summarised by income group and profession. Results: A total of 44 studies were included, with 18 from HICs and 26 from LMICs. Survey designs were most common. Pharmacists were the most frequently studied cadre. Knowledge and training barriers were reported in all studies in both income groups. Fear of legal or punitive concerns was reported in 13/18 (72.2%) HIC studies and 17/26 (65.4%) LMIC studies. Time and workload barriers were reported in 10/18 (55.6%) HIC studies and 11/26 (42.3%) LMIC studies. Access barriers to tools, forms, and information technology showed the clearest income group difference: these were reported in 5/18 (27.8%) HIC studies versus 16/26 (61.5%) LMIC studies. Lack of feedback or acknowledgement was reported in 8/18 (44.4%) HIC studies and 10/26 (38.5%) LMIC studies. Conclusions: Barriers extend beyond individual knowledge in all settings. The main income group difference was the greater prominence of reporting system access barriers in LMICs compared with workflow and time pressure barriers in HICs. Addressing fear and building a supportive non-punitive reporting culture remains a cross-cutting priority because these were common issues in both income groups and can limit reporting even when infrastructure and training exist. Full article

This paper evaluates the impact of a Service-Learning (SL) project designed to promote vocations in Civil Engineering. Two university students from UPM presented their Final Degree Projects to 73 high school students at a rural school in Torrelaguna (Madrid, Spain). A mixed-methods approach was used, with pre- and post-activity surveys for the high school students and a focus group with the university presenters. The quantitative results show that knowledge of the profession rose from 7% to 41% and specific interest in the degree doubled from 4% to 8%, although the perception of the field’s high difficulty remained largely unchanged. The activity was rated very positively by 85% of attendees. Qualitative analysis revealed that the university students, who began with low expectations, significantly improved their capacity for improvisation and adaptive communication through audience interaction. The experience also reinforced their vision of engineering’s social impact by connecting it to the youths’ daily realities. The study concludes that the near-peer SL model is a promising tool, generating bidirectional benefits. Full article

Mytilus galloprovincialis is a significant indicator species due to its ability to bioaccumulate environmental pollutants, such as lead (Pb), which can hinder essential reproductive molecular processes. This study aimed to examine the effect of exposure to lead (0.5, 1.5 and 5 μg/L PbCl₂) on the state of protamine-like (PL) proteins—the primary components of sperm nuclear basic proteins—and their interaction with DNA. PL proteins were analysed using acetic acid–urea PAGE and SDS-PAGE, after which their ability to bind and protect DNA from oxidative damage was also assessed. Exposure to lead resulted in SDS-PAGE-detectable alterations of the PL, particularly at levels of 1.5 µg/L and 5 µg/L of PbCl₂ and modified their capacity for DNA-binding at all doses of PbCl₂. Experiments testing the release of PLs from sperm nuclei further confirmed this, revealing a reduced release. In addition, the ability of PL proteins to protect DNA from oxidative damage was reduced at the highest exposure dose, suggesting improper condensation of sperm chromatin. Computational analyses of human protamines in the presence of lead indicated the formation of coordination complexes with Pb²⁺ in PLI-II and PL-III, potentially impairing DNA binding. Overall, our study demonstrates that exposure to lead alters the function of PL proteins and potentially destabilises the sperm chromatin of M. galloprovincialis. This provides valuable insights into the reproductive toxicity of this metal. Full article

This paper examines the development process that frames the professionalization of social work in Jordan between 2019 and 2023, situated within the European Union-funded Support to Social Protection Programme: Helping Deliver Social Inclusion. Working in collaboration with the Ministry of Social Development (MoSD), the initiative sought to strengthen the professional infrastructure through legislative development, specialist training, and the establishment of accredited university-level curricula to support a coherent, national career pathway for social workers. This paper critically analyses the transition from semi-professional to full professional status, with particular attention to the model used to facilitate ownership by four Jordanian universities and harness and strengthen the practice of social work. It further examines the academic framework underpinning the development of a national Common Core Curriculum for Social Work, drawing on established curriculum theories to guide the negotiated application of global approaches within the Jordanian context, with sensitivity to indigenous knowledge and cultural awareness. Reflections on the strengths and limitations of the development process are informed by stakeholder feedback, current outcomes, and anticipated future developments, with an emphasis on the value of interagency collaboration and networking approaches. Full article

Tick-borne encephalitis virus (TBEV) is primarily transmitted by Ixodes spp. and poses significant health risks, leading to morbidity and mortality in humans. Two of the five subtypes, Siberian and Far Eastern are known to circulate in Mongolia. In 2021, Ixodes persulcatus ticks were collected from Bulgan aimag (province) using flagging and dragging methods and subsequently screened for TBEV using PCR. Positive samples underwent sequencing using an Oxford Nanopore Technologies-based hybrid capture approach, resulting in two coding-complete TBEV genomes from separate tick pools. Phylogenetic analysis classified both genomes within the Siberian subtype, grouping them with other Mongolian sequences from I. persulcatus collected in 2014, 2020, 2021, and 2023. The study sequences, PX654173 and PX654174, showed high genetic similarity (99.9% and 99.8%, respectively) to the sequence PQ479142, obtained from I. persulcatus ticks in Selenge, Mongolia, in 2021. The estimated time to most recent common ancestor (TMRCA) of the Siberian genotype was approximately 981 CE (95% HPD: 646–1347) with the emergence of a distinct Mongolian clade of TBEV around 1888 CE (95% HPD: 1834–1934). These findings highlight the value of expanded whole-genome sequencing to improve our understanding of TBEV’s genetic diversity and evolutionary history in Central Asia. Full article

Accurate dry weight assessment is crucial for hemodialysis (HD) fluid management, yet traditional clinical methods often lack precision. A significant scientific gap exists in the availability of a standardized multimodal framework for integrating objective tools, leaving clinicians without clear guidance on combining results from multiple devices. To address this gap, this narrative review provides a qualitative clinical synthesis of bioimpedance spectroscopy (BIS), lung ultrasound (LUS), and inferior vena cava diameter (IVCD). A structured literature search was conducted across PubMed, Scopus, and CINAHL for English-language studies published between 2012 and 2024. Studies focusing on dry weight assessment using these tools in adult HD patients were included, and findings from 22 core studies were synthesized narratively. BIS and LUS are valuable tools for identifying fluid overload. BIS assesses systemic fluid distribution across compartments, whereas LUS allows non-invasive detection of extravascular lung water. In contrast, IVCD primarily reflects intravascular volume status. While the integrated use of these tools shows potential clinical utility, individual methods, particularly IVCD, require further validation owing to interpatient variability. A multimodal approach that integrates these objective methods with clinical judgment offers a comprehensive evaluation of dry weight. Integrating these assessment strategies may improve outcomes and decision-making in nephrology care. Full article