Search Results (186)

The evidence for photobiomodulation in reducing postoperative pain after endodontic instrumentation is classified as low or very low certainty, indicating a need for further research. Longitudinal pain assessments over 24 h are crucial, and studies should explore these pain periods. Background/Objectives: This double-blind, randomized controlled clinical trial evaluated the effect of PBM on pain following single-visit endodontic treatment of maxillary molars at 4, 8, 12, and 24 h. Primary outcomes included pain at 24 h; secondary outcomes included pain at 4, 8, and 12 h, pain during palpation/percussion, OHIP-14 analysis, and frequencies of pain. Methods: Approved by the Research Ethics Committee (5.598.290) and registered in Clinical Trials (NCT06253767), the study recruited adults (21–70 years) requiring endodontic treatment in maxillary molars. Fifty-eight molars were randomly assigned to two groups: the PBM Group (n = 29), receiving conventional endodontic treatment with PBM (100 mW, 333 mW/cm², 9 J distributed at 3 points near root apices), and the control group (n = 29), receiving conventional treatment with PBM simulation. Pain was assessed using the Visual Analog Scale. Results: Statistical analyses used chi-square and Mann–Whitney tests, with explained variance (η²). Ten participants were excluded, leaving 48 patients for analysis. No significant differences were observed in postoperative pain at 24, 4, 8, or 12 h, or in palpation/percussion or OHIP-14 scores. Pain frequencies ranged from 12.5% to 25%. Conclusions: PBM does not influence post-treatment pain in maxillary molars under these conditions. These results emphasize the importance of relying on well-designed clinical trials to guide treatment decisions, and future research should focus on personalized dosimetry adapted to the anatomical characteristics of the treated dental region to enhance the accuracy and efficacy of therapeutic protocols. Full article

Air pollution is linked to childhood mortality and morbidity in low- and middle-income countries globally. There is growing evidence linking air pollution to asthma and other respiratory diseases in children. Studies have shown that children are likely to experience asthma due to their narrow airways and their heightened sensitivity to environmental irritants. This study aims to investigate the relationship between ambient air pollution and respiratory diseases in children under the age of 5. The study will be conducted in the informal township of Alexandra, north of Johannesburg, South Africa. A quantitative approach will be used in this cross-sectional analytical study. Data will be collected using different tools that include a questionnaire to determine the prevalence of asthma and respiratory disease and potential risk factors. While environmental air pollution will be measured using Radiello passive samplers and Gillian pumps. Data will be analyzed using the latest version of the STATANow/MP 19.5 software. Furthermore, health risk assessment will be conducted for lifetime non-carcinogenic and carcinogenic risk estimation following the USEPA framework. The study will identify environmental triggers that exacerbate asthma and other respiratory conditions in other similar community settings and will contribute to the body of knowledge in public health. Ethical approval was obtained from the Research Ethics Committee, Faculty of Health Sciences at the University of Johannesburg. Full article

Background/Objectives: Extracting meaningful medical information from chest X-ray images and transcribing it into text is a complex task that requires a high level of expertise and directly affects clinical decision-making processes. Automatic reporting systems for this field in Turkish represent an important gap in scientific research, as they have not been sufficiently addressed in the existing literature. Methods: A deep learning-based approach called Model-SEY was developed with the aim of automatically generating Turkish medical reports from chest X-ray images. The Swin Transformer structure was used in the encoder part of the model to extract image features, while the text generation process was carried out using the cosmosGPT architecture, which was adapted specifically for the Turkish language. Results: With the permission of the ethics committee, a new dataset was created using image–report pairs obtained from Elazıg Fethi Sekin City Hospital and Indiana University Chest X-Ray dataset and experiments were conducted on this new dataset. In the tests conducted within the scope of the study, scores of 0.6412, 0.5335, 0.4395, 0.4395, 0.3716, and 0.2240 were obtained in BLEU-1, BLEU-2, BLEU-3, BLEU-4, and ROUGE word overlap evaluation metrics, respectively. Conclusions: Quantitative and qualitative analyses of medical reports autonomously generated by the proposed model have shown that they are meaningful and consistent. The proposed model is one of the first studies in the field of autonomous reporting using deep learning architectures specific to the Turkish language, representing an important step forward in this field. It will also reduce potential human errors during diagnosis by supporting doctors in their decision-making. Full article

Background: Cardiovascular diseases (CVDs) remain a leading cause of morbidity and mortality, despite advances in treatment. Early detection of vascular aging is critical, as preclinical atherosclerosis often remains undiagnosed. AI-determined vascular age, originally developed using carotid-femoral pulse wave velocity (cf-PWV), may help to identify individuals at elevated risk. This study aimed to evaluate the clinical utility of an alternative AI-determined vascular age model based on the arterial velocity pulse index (AVI) and arterial pressure volume index (API) in a Japanese hospital-based cohort. Methods: This retrospective, exploratory study analyzed electronic health records of 408 patients from Yokohama City University Hospital. This study was approved by the Clinical Research Ethics Committee (approval numbers: B180300040, F240500007), and patient consent was obtained through an opt-out process. AI-determined vascular age was estimated using a Generalized Additive Model (GAM) with backward stepwise regression, substituting cf-PWV with AVI and API. Correlations with chronological age were assessed, and comparisons of cardiovascular and renal function markers were performed across age-stratified groups. Results: AI-determined vascular age showed a strong correlation with chronological age (p < 0.05). Significant differences were observed in cardiac diastolic function parameters, B-type natriuretic peptide (BNP), and estimated glomerular filtration rate (eGFR) between the highest and lowest quintiles of AI-determined vascular age. Conclusions: AI-determined vascular age using AVI and API appears to be a feasible surrogate for cf-PWV in clinical settings. This index may aid in stratifying vascular aging and identifying individuals who could benefit from early cardiovascular risk management. Full article

The COVID-19 pandemic and its associated lockdowns had widespread psycho-social implications globally. However, the unique experiences of young adults in under-researched rural communities, such as Lonely Park in South Africa’s North West Province, remain poorly documented. This study explores the psycho-social well-being of young adults aged 18–24 in the Lonely Park community during the national COVID-19 lockdown from 23 March 2020 to 30 April 2020, with a particular focus on their emotional, psychological, and social experiences. Using a qualitative, phenomenological design rooted in Bronfenbrenner’s Ecological Systems Theory (EST), data were collected from 14 purposively sampled participants through two focus group discussions. Thematic analysis was conducted following Braun and Clarke’s six-phase framework. Ethical clearance was obtained from the Health Research Ethics Committee, and participants provided informed consent. Two main themes emerged, (1) psychological and (2) social well-being. Six sub-themes were identified: (1) negative emotions linked to lockdown, (2) fear of COVID-19 and its consequences, (3) rumination and anxiety, (4) disruption of social and educational routines, (5) coping strategies, and (6) structural limitations of healthcare and support systems. Participants experienced intense fear, boredom, isolation, and a sense of helplessness. Yet, coping mechanisms such as communication, spirituality, exercise, and adherence to public health regulations provided resilience. Some reported depression and financial strain due to job loss and school disruptions. The findings highlight the complex interplay of psychological, emotional, and social stressors in rural young adults during the pandemic. Policymakers and mental health practitioners must prioritise targeted psycho-social interventions for youth in under-resourced rural settings. A call is made for culturally responsive mental health programmes that incorporate local voices, especially in rural African contexts. Full article

Background/Objective: Nurses play a critical role in addressing climate change. They are instrumental in both mitigation and adaptation to its effects. Through care provision, education, management, policy development, and research, nurses can undertake a variety of specific actions in response to climate change. However, their perceptions of this challenge remain under-researched. This study aims to investigate Spanish nurses’ knowledge of climate change and its impact on health. Methods: This is a qualitative descriptive study based on the constructivist paradigm. Purposive and snowball sampling strategies were used to recruit nurses from emergency services, geriatrics, cardiology, respiratory medicine and primary care in nine different regions of Spain. Semi-structured online interviews were conducted. Data analysis was carried out by three researchers via a three-stage inductive thematic analysis approach. Results: The sample consisted of 31 nurses, predominantly women (77.42%), with a mean age of 41 years. Seventy percent of the participants had less than 15 years of experience in the service. Four categories were identified: (i) general knowledge of climate change; (ii) knowledge of climate change and health; (iii) knowledge of actions to address climate change; and (iv) knowledge development. Overall, the nurses demonstrated awareness of the risks posed by climate change as well as actions to respond. However, barriers such as a lack of formal training and eco-anxiety affect their knowledge acquisition. Conclusions: Nurses play an important role in the response to climate change. However, more comprehensive and higher-quality educational programmes, provided by academic institutions, workplaces, and professional associations, are needed. This study was prospectively registered with the Clinical Research Ethics Committee of the Cuenca Health Area on 25 January 2022 (registration number 2021/PI3721). Full article

Histopathological images represent a valuable data source for pathologists, who can provide clinicians with essential landmarks for complex pathologies. The development of sophisticated computational models for histopathological images has received significant attention in recent years, but most of them rely on free datasets. Materials and Methods: Motivated by this drawback, the authors created an original histopathological image dataset that resulted from an animal experimental model, acquiring images from normal female rats/rats with experimentally induced diabetes mellitus (DM)/rats who received an antidiabetic therapy with a synthetic compound (AD_SC). Images were acquired from vaginal, uterine, and ovarian samples from both MD and AD_DC specimens. The experiment received the approval of the Medical Ethics Committee of the “Gr. T. Popa” University of Medicine and Pharmacy, Iași, Romania (Approval No. 169/22.03.2022). The novelty of the study consists of the following aspects. The first is the use of a diabetes-induced animal model to evaluate the impact of an antidiabetic therapy with a synthetic compound in female rats, focusing on three distinct organs of the reproductive system (vagina, ovary, and uterus), to provide a more comprehensive understanding of how diabetes affects female reproductive health as a whole. The second comprises image classification with a custom-built convolutional neural network (CB-CNN), the extraction of textural features (contrast, entropy, energy, and homogeneity), and their classification with PyCaret Auto Machine Learning (AutoML). Results: Experimental findings indicate that uterine tissue, both for MD and AD_DC, can be diagnosed with an accuracy of 94.5% and 85.8%, respectively. The Linear Discriminant Analysis (LDA) classifier features indicate a high accuracy of 86.3% when supplied with features extracted from vaginal tissue. Conclusions: Our research underscores the efficacy of classifying with two AI algorithms, CNN and machine learning. Full article

The present study addresses the need for valid and reliable tools to assess employability thinking among young people in training. In a labor market increasingly shaped by transversal skill demands, the objective was to construct and validate a scale adapted for secondary and post-secondary non-tertiary students. Grounded in strategic frameworks such as the Europe 2020 Strategy, the European Skills Agenda, and relevant Spanish legislation, an abbreviated version of the Graduate Skills and Attributes Scale (GSAS) was administered to a representative sample of 949 Andalusian students enrolled in compulsory secondary education, baccalaureate, or vocational training. A cross-sectional and exploratory research design was adopted, with all procedures conducted in accordance with ethical and legal standards and approved by the University of Granada’s ethics committee. Exploratory and confirmatory factor analyses were performed, leading to a refined 28-item version of the instrument. Items were grouped into four well-defined factors: ethical self-regulation and achievement orientation, effective communication and collaborative working, proactivity and commitment to learning, and analytical thinking and information handling. The factors demonstrated high internal consistency and structural validity. These findings indicate that the scale is a clear and effective tool for assessing employability-related competencies and may assist in the design of educational interventions aimed at improving students’ professional development. Full article

Background/Objectives: Hepatic glycogen storage diseases (GSDs) are inherited metabolic disorders that affect glycogen synthesis or breakdown, primarily involving the liver and muscles. Treatment typically consists of strict dietary management, including the consumption of uncooked cornstarch. However, there is limited research on feeding challenges and the associated stress experienced by parents of children with GSDs. This study aims to assess feeding difficulties in children with GSDs and the level of parental stress. Methods: A total of 29 caregivers of children aged 6 months to <7 years participated. Feeding difficulties were evaluated using the Brazilian Infant Feeding Scale (Escala Brasileira de Alimentação Infantil—EBAI), while parental stress was measured using the Parental Stress Scale (Escala de Estresse Parental—EEPa). Data were collected in 2020, and the study was approved by the ethics committee. Results: The majority of the children were male (19/10), with a mean age of 47.75 months and an average age of diagnosis of 8.39 months. GSD type Ia (n = 15) and type Ib (n = 5) were the most prevalent, followed by types III and IX (n = 2). Among the participants, 22 out of 29 (76%) reported feeding difficulties, categorized as mild (n = 7, 24%), moderate (n = 7, 24%), and severe (n = 8, 28%). EBAI scores were higher in female patients and in those who did not eat meals with their family. Only one caregiver exhibited high levels of parental stress, as measured by the EEPA scale. No significant correlation was found between feeding difficulties and parental stress. Conclusions: The findings confirm a high prevalence of feeding issues in children with GSDs, which significantly affects caregivers’ quality of life. Although no significant link between feeding difficulties and parental stress was identified, further research is needed to improve GSD management and provide better support for caregivers. Full article

Background: Chronic kidney disease (CKD) has a significant impact on patients’ physical, psychological, and social well-being. Emotional disorders are common and contribute to a higher prevalence of symptoms compared to that in the general population. This study aimed to analyze the relationship between the emotional profiles and symptomatology in patients undergoing hemodialysis (HD). Methods: A multicenter, cross-sectional, observational/analytical study was developed in seven centers of the Spanish Renal Foundation in the Community of Madrid (Spain). The study protocol was reviewed and approved by the Clinical Research Ethics Committee of Hospital Clínico San Carlos, Madrid (C.I. 20/685-E). In the study, two validated measurement scales were used: the Mood Rating Scale (EVEA) to assess the “emotional profile” and the Palliative care Outcome Scale, Renal Symptoms (POS-S Renal) to evaluate “symptomatology”. Results: The sample (245 patients) was predominantly male (65.7%; n = 161), with a mean age of 63.52 years (SD = 14.99) and an average HD treatment duration of 81.44 months (SD = 96.62). The analysis of the symptom–emotion relationships revealed that patients with a sadness–depression profile had a higher probability of experiencing weakness or a lack of energy (OR = 1.741; CI 95% 1.01–3.00) and feelings of depression (OR = 3.236; CI 95% 1.98–5.30). Additionally, patients with an anger–hostility profile exhibited a significant association with pain (OR = 3.463; CI 95% 1.34–8.94) and excessive sleepiness (OR = 3.796; CI 95% 1.21–11.95), indicating that this emotional state substantially increases the likelihood of developing these symptoms. Conclusions: The emotional profiles of CKD patients undergoing HD significantly influence their symptomatology. While positive emotions may play a protective role in preventing debilitating symptoms, negative emotions increase the risk of their onset. These findings highlight the importance of addressing emotional well-being as part of comprehensive care for HD patients. Full article

The aging population and the increasing prevalence of chronic diseases necessitate new healthcare models. Case-Management Nurses (CMNs) emerge as a promising alternative to enhance patient care. Objective: To explore CMNs’ perceptions of the impact on health, resources, and professional satisfaction. Methods: A qualitative study using semi-structured interviews was conducted with CMNs from a southern Spanish province. This study adheres to the Standards for Reporting Qualitative Research (SRQR). The population consisted of 61 CMNs. Three analytical categories of a theoretical or deductive nature were identified, directly related to this study’s objective. This study was approved by the Andalusian Biomedical Research Ethics Committee (Code: 1139-N-22) and conducted in accordance with the Declaration of Helsinki. Data analysis was performed using ATLAS.ti. Results: The sample was comprised of 31 CMNs (24 women). The mean age was 56.3 years. A total of 12 CMNs had more than 20 years of experience. Interviews were conducted between October and November 2022. Within each category, different emerging subcategories were identified: 1. Impact on health: Patients and caregivers. 2. Impact on resources: Computer tools, effectiveness/efficiency of the CMNs, and material resources. 3. Impact on professional satisfaction: Positive professional satisfaction and negative professional satisfaction. Conclusions: The findings suggest that the practice of CMNs in primary care improves the health and quality of life of patients and their caregivers while reducing healthcare resource utilization. CMNs reported high levels of job satisfaction. These findings support the implementation of this care model to optimize the management of chronic patients in home and residential care settings. However, larger-scale quantitative studies are needed to confirm these results and explore their generalizability. Full article

Background and Objectives: Ovarian cancer is a highly lethal gynecological malignancy and the fifth leading cause of cancer-related deaths. Diagnosis mainly involves gynecological examination and transvaginal ultrasonography. To evaluate the diagnostic performance of the Gynecology Imaging Reporting and Data System (GI-RADS) with regard to its ability to evaluate adnexal masses preoperatively, considering a definitive histopathological diagnosis. Materials and Methods: This study was approved by the ethics committee, and informed consent was obtained from all the patients. This research was conducted at Beni-suef University Hospital between June 2021 and January 2023 on 100 women who experienced pelvic pain due to an adnexal mass. Results: Our study results revealed that the combination of IV-V GI-RADS had high specificity (92.2%), sensitivity (87%), and a negative predictive value (95.9%), but moderate other diagnostic characteristics for predicting adnexal mass malignancy. Conclusions: The GI-RADS classification system is a reliable method for reporting ovarian masses, with high diagnostic accuracy for predicting malignancy. It aids in patient triage and clinical decision making. To optimize care, it is essential to inform referring clinicians about the objectives of the GI-RADS before its implementation in a treatment plan. Full article

Background/Objectives: This study aims to determine the validity of a recently developed and published index (the modified Composite Radiographic Index—CRIm) as an indicator of disease gravity and progression in the CBCT scans of patients with medication-related osteonecrosis of the jaw (MRONJ) and to detect possible correlations between the radiologic findings and clinical staging of the disease. Methods: This study included 43 MRONJ patients with CBCT scans from the School of Dentistry of National and Kapodistrian University of Athens, approved by the Research Ethics Committee. Clinical staging (0–3) was provided based on AAOMS 2022 guidelines. A total of 52 CBCT scans were analyzed, with maxillae and mandibles evaluated separately when both were involved. Two independent observers assessed eight radiologic features, including lytic changes, sclerosis, periosteal reaction, sequestration, non-healing extraction sockets, and other findings (sinus involvement, inferior alveolar canal involvement, and jaw fracture). The CRIm was applied to quantify osseous changes, scoring each feature (0 (absent), 1 (localized/single), 2 (extensive/multiple)), yielding a range of 0–12. For the statistical analysis, Fisher’s exact test and Spearman’s correlation coefficient were used. Results: Clinical Stage 1 consisted of 19 jaws, Stage 2 consisted of 16 jaws, and Stage 3 consisted of 17 jaws. No affected jaws were recorded with Stage 0. A statistically significant correlation between the clinical stage and lytic changes, sequestration, and inferior alveolar canal involvement was found (p-value < 0.05). Extensive lytic changes, sclerosis, sequestration, periosteal bone formation, and inferior alveolar canal involvement were mostly observed in clinical Stage 3. Furthermore, a statistically significant correlation between clinical stage and CRIm classification was found (rho = 0.446; p-value < 0.001). Conclusions: The CRIm tends to increase as the clinical stages of MRONJ advance, suggesting a correlation between them. Full article

Background: It has been reported that forest bathing significantly reduced negative emotions and increased the positive feelings in both healthy males and females, as well as increasing blood serotonin in healthy males, indicating the potential for a beneficial effect on depressive status. However, an improvement effect of forest bathing on participants with depression has not been reported so far. Therefore, in order to fill this gap, this study examined the effect of forest bathing on depression in female participants with depression/depressive tendencies. Methods: Thirty-one females aged 40.1 ± 2.4 years with depression/depressive tendencies were recruited after obtaining informed consent. The study employed a randomized crossover design to compare forest bathing with city walking. They participated in day trips to a Japanese cypress forest park and to a city area of Nagano Prefecture as a control in June 2023. On both trips, they walked 2.5 km (for 90 min) in the morning and afternoon, respectively, for a total of 5.0 km per day. Blood samples were taken at 4 pm for the measurements before forest bathing on the first day and after the walking in forest and unban sites on the second and third days, at the same hospital. Concentrations of oxytocin, IGF-1, serotonin and lactic acid in blood were measured. SDS scores were calculated and the POMS test and questionnaires for subjective fatigue symptoms and sleep quality were administered before and after each trip. Temperature, humidity and illuminance were also measured in the forest and urban environments. The Nippon Medical School Central Ethics Committee approved this study. Results: Forest bathing significantly decreased SDS scores compared to city walk and the baseline, and the effect lasted for one week after forest bathing. Forest bathing also significantly increased the concentrations of blood serotonin in participants who were not taking antidepressants, significantly increased the levels of oxytocin and IGF-1 in blood, significantly increased the scores for positive feelings, and reduced the scores for negative emotions compared with city walking in the POMS test. In addition, forest bathing reduced subjective fatigue symptoms and improved sleep quality. Conclusions: These findings provided scientific evidence to contribute to understanding forest bathing as a potential intervention for preventing depression, and future research on males should further explore these effects. Full article

Background/Objectives: Comprehensive care is crucial in emergency healthcare. In intensive care units, a holistic approach may be difficult to implement due to the conditions of the patients and existing work protocols aimed at maintaining vital functions for the survival of patients. The present study aims to explore and describe the knowledge, attitudes, and perceptions of critical care and emergency health professionals regarding the implementation of integrated care practices within intensive care units, with the goal of identifying barriers and facilitators to adopting a holistic approach in emergency healthcare settings. Methods: This study implemented an exploratory and descriptive qualitative design with a phenomenological approach through semi-structured interviews with health professionals who had worked in intensive care units or emergency services for both public and private health institutions in Spain (n = 25). The study was conducted during the years 2023 and 2024, using a convenience sampling method along with snowball sampling, and a narrative discourse analysis was performed. The MAXQDA 2022 software program was used. This study was granted due permission by the Research Ethics Committee belonging to the Junta de Andalucía, under protocol code 0768-N-20. Results: The total sample consisted of 25 healthcare professionals from critical care and emergency services in Spain. The main themes, as key findings, were knowledge and perception, determining factors, resources and infrastructure, the bioethical dimension, perspectives on comprehensive care, and multidimensional impact. Most of the professionals were familiar with comprehensive care, but lack of resources and time prevented them from carrying it out in their units. Conclusions: For critical care and emergency professionals, comprehensive care is important to their clinical practice, but barriers to its realization still exist. Understanding the importance to these professionals of the application of comprehensive care is fundamental to establishing measures for its implementation in these services. It is also a motivation to continue providing humanized and compassionate care that respects the patient’s dignity. It is a priority to provide the necessary infrastructure and human resources so that patients admitted to these units can be cared for with this tool. Full article