To compare clinical outcomes following hip arthroscopy for femoroacetabular impingement syndrome using either limited interportal (IP) or T-capsulotomy (TC) technique, with routine capsular closure. This retrospective cohort study included patients ≤50 years old who underwent primary hip arthroscopy for femoroacetabular impingement syndrome between May 2021 and January 2024 with a minimum of 12-month follow-up. Patients were treated with either IP or TC, and all underwent standardized capsular repair. Patient-reported outcomes (PROs) were collected preoperatively and at final follow-up. Cohort-specific minimum clinically important difference thresholds were calculated for each PROs and compared between groups. Improvements in scores were compared with established thresholds for the patient acceptable symptomatic state (PASS). Statistical significance was set at P < .05. A total of 116 patients met the inclusion criteria (54 IP, 62 TC; mean age 34.5 ± 8.8 years; 55% female). Mean follow-up was 15.5 ± 5.4 months. Both groups showed significant improvements in all PROs. Although mean improvements were not statistically different, the interportal group showed consistently higher average postoperative scores. Cohort-specific minimum clinically important difference thresholds were achieved at similar rates in both groups, whereas exploratory analyses using previously published PASS thresholds showed higher PASS achievement in the interportal group for International Hip Outcomes Tool (76% vs 54%) and Patient Reported Outcome Measurement Information System Physical Function (58% vs 46%). No revisions or Clavien-Dindo grade ≥2 complications occurred in either group. Both IP and TC techniques led to significant improvements in PROs following hip arthroscopy with capsular repair, with similar rates of cohort-specific minimum clinically important difference achievement and no differences in revision surgery or major complications. Exploratory analyses showed higher PASS rates for International Hip Outcomes Tool and Patient Reported Outcome Measurement Information System Physical Function in the IP group, suggesting that a more limited capsulotomy may confer functional advantages. Level III, retrospective comparative case series.
Developing bioresorbable energy sources that eliminate the need for secondary surgery for device removal remains a major challenge in resorbtronics. In this work, we present an alternative fabrication strategy for new bioresorbable quasi-solid Na-ion batteries using Mo or Mg thin films as current collectors. The assembled batteries were characterized using scanning electron microscopy, spectroscopic techniques including X-ray photoelectron spectroscopy, physicochemical, and electrochemical characterization techniques. Results demonstrate that the choice of current collector strongly influences electrochemical performance. Mo-based batteries delivered a discharge capacity of 6.8 mAh cm- 2 at a C/2 rate, approximately twice that of Mg-based counterparts whose performance is limited by oxidation reactions. Moreover, Mo-based batteries exhibited stable cycling with 86% capacity retention after 100 cycles at 2C. In vitro cytotoxicity assays showed cell viability above the 70% threshold indicating that the tested materials are non-cytotoxic according to ISO 10993 guidelines. Implantation studies confirmed safe degradation of Mo-based batteries supported by in vivo monitoring of animal health behavior and ex vivo organ analyses, including organ weight, ALT measurements, and histological evaluation of skin at the implantation site after three months. Additionally, the operational lifetime of implanted batteries can be tuned from days to months by controlling encapsulation layer thickness.
The stable modulation of the local charge distribution behavior induced by unsaturation sites within photocatalysts continues to pose a significant challenge in the quest to achieve notable enhancements in photocatalytic activity. Herein, we harnessed the hydrogen annealing reduction technique to deliberately introduce oxygen vacancies (OVs) into the BiOCl lattice for constructing the OVs-Bi-O structure, which decreases the valence state of Bi, and diminishes the Bi─O coordination, further establishing a charge asymmetric region within the material. This distinctive structural arrangement facilitates the sufficient migration of electrons to adjacent Bi sites that are closely linked to the OVs, significantly promoting the capture capability of electrons, leading to more adsorption and activation of water and oxygen as well as the conversion of reactive oxygen radicals. The engineered OVs-BiOCl variant showcases potential photocatalytic prowess, boasting a satisfactory photocatalytic application than that of its unmodified BiOCl counterpart. Under low-light conditions, this variant impressively achieves a ∼98.1% removal efficiency for RhB, while concurrently achieving an almost complete elimination of E. coli. This finding presents an insightful approach for manipulating unsaturation coordination active sites through the strategic introduction of controllable defects and elucidates the impact of unsaturation coordination on photocatalytic efficiency.
Lateral lengthening calcaneal osteotomy (LLOT, Evans and Hintermann) is widely used to treat progressive collapsing foot deformity (PCFD). In the Evans osteotomy, the cut is performed proximal to the calcaneocuboid joint, carrying a risk of violating the anterior or middle subtalar facet. Hintermann proposed a modified technique placing the osteotomy between the middle and posterior facets to reduce risks. Although anatomical studies have shown potential facet involvement, clinical data on the actual incidence and its impact on long-term outcomes remain scarce. This study aimed to determine the incidence of subtalar facet penetration after LLOT and to evaluate its effect on clinical and radiographic results. All patients aged ≥18 years who underwent LLOT (Evans or Hintermann osteotomy) at our institution between January 1, 2010, and December 31, 2020, were included. Postoperative computed tomography (CT) was performed 6 weeks after surgery to assess possible subtalar facet violation. At a minimum follow-up of 5 years, magnetic resonance imaging (MRI) was obtained to evaluate cartilage and ligament integrity. Clinical outcomes at the time of MRI were assessed using the Foot Function Index (FFI) and the American Orthopaedic Foot & Ankle Society (AOFAS) score. Demographic variables, including type of osteotomy and outcome measures, were compared between patients with and without facet penetration. Thirty-one patients met inclusion criteria. Subtalar facet penetration was detected in 11 patients (35%) on postoperative CT. No significant differences were observed between groups with respect to demographic variables. MRI analysis revealed no relevant differences in cartilage degeneration. FFI and AOFAS scores were comparable between groups. Subtalar facet penetration occurred in one-third of patients after LLOT (Evans and Hintermann). With the numbers available, no significant differences in clinical or radiographic outcomes were detected at a minimum 5-year follow-up, suggesting that minor facet violations may have limited clinical relevance. Level III, retrospective cohort study.
Digital services allow patients to efficiently access healthcare. These services work more effectively than traditional paper-based systems by delivering better patient outcomes, helping address global health challenges, and promoting the universal adoption of health technology. This study examined the impact of digital healthcare adoption and service quality on patient satisfaction in Pakistan's public healthcare sector and the moderating effect of telehealth services on this relationship. This study adopted the technology acceptance model to understand technology sophistication and how electronic medical records, digital patient systems, and technology impact healthcare through efficiency and communication. Simultaneously, the study examined the role of doctor services, nurse services, pharmacy services, and laboratory services in the patient experience. Random sampling techniques were employed, and questionnaires were distributed to 573 respondents across five central districts of Punjab, Pakistan. The hypotheses were tested using IBM SPSS Statistics, Amos, and structural equation modeling. These findings show that digital healthcare adoption and service quality significantly improve patient satisfaction, whereas telehealth services reinforce these relationships by overcoming geographical and logistical hurdles. The conclusions of this study offer pragmatic guidance to policymakers and healthcare administrators for devising digital healthcare strategies to improve patient outcomes.
To describe public awareness of the Centre antipoison du Québec (CAPQ), expectations regarding acute poisoning management and service delivery, and satisfaction among prior users. We conducted a cross-sectional, bilingual online survey of Quebec residents aged ≥ 14 years between April 13, 2024, and June 27, 2025. The questionnaire collected demographic data, assessed awareness and prior use of the CAPQ, explored past poisoning events and expectations for acute poisoning management, and measured satisfaction among previous users using a 5-point Likert scale, with open-ended questions for qualitative input. Participants were recruited through convenience and snowball sampling via public settings, social media, and CIUSSS newsletters. Descriptive statistics summarized responses and explored trends. A total of 611 respondents were included; 541 (88.5%) were aware of the CAPQ, including 152 prior users, while 70 (11.5%) were unaware. Unawareness was more common among females (60.0%), non-healthcare workers (91.4%), respondents with a non-North American ethnic background (34.2% vs. 10.1%), and those not primarily French-speaking (12.9% vs. 3.0%). Regional variation was observed, with Capitale-Nationale contributing the largest number of unaware respondents (35/70) and Laurentides showing the highest proportion (26.7%). Among respondents without prior CAPQ use who reported a poisoning event, most contacted emergency services or presented to the emergency department. Expectations were similar among aware and unaware respondents, particularly for acute poisoning management, with nurses expected to respond within five minutes. Among prior users, overall satisfaction was high across all domains, though communication and outreach were identified as areas for improvement. Key service expectations included rapid 24/7 access (76.9%), responder expertise (69.9%), and clear, adapted recommendations (56.1%). Most respondents preferred French (84.9%), telephone communication (94.1%), and follow-up calls (81.7%). User satisfaction with the CAPQ was high, but gaps in public awareness and service expectations remain. These findings highlight opportunities to improve accessibility, communication and outreach strategies. RéSUMé: OBJECTIFS: Décrire la sensibilisation du public au Centre antipoison du Québec (CAPQ), les attentes concernant la gestion des intoxications aiguës et la prestation de services, ainsi que la satisfaction des utilisateurs antérieurs. MéTHODES: Nous avons mené une enquête en ligne transversale et bilingue auprès de résidents du Québec âgés de ≥14 ans entre le 13 avril 2024 et le 27 juin 2025. Le questionnaire a permis de recueillir des données démographiques, d’évaluer la connaissance et l’utilisation antérieure du CAPQ, d’explorer les événements d’intoxication passés et les attentes en matière de gestion des intoxications aiguës, et de mesurer la satisfaction des utilisateurs précédents à l’aide d’une échelle de Likert à 5 points, avec des questions ouvertes pour l’apport qualitatif. Les participants ont été recrutés par commodité et par échantillonnage de boules de neige via des lieux publics, les réseaux sociaux et les bulletins d’information du CIUSSS. Les statistiques descriptives résument les réponses et explorent les tendances. RéSULTATS: Un total de 611 répondants ont été inclus; 541 (88,5 %) étaient au courant du CAPQ, y compris 152 utilisateurs précédents, tandis que 70 (11,5 %) n’étaient pas au courant. L’ignorance était plus fréquente chez les femmes (60,0 %), les non-travailleurs de la santé (91,4 %), les répondants d’origine ethnique non nord-américaine (34,2 % contre 10,1 %) et ceux qui n’étaient pas principalement francophones (12,9 % contre 3,0 %). Une variation régionale a été observée, la Capitale-Nationale ayant contribué au plus grand nombre de répondants ignorants (35/70) et les Laurentides affichant la proportion la plus élevée (26,7 %). Parmi les répondants n’ayant pas utilisé le CAPQ qui ont signalé un événement d’empoisonnement, la plupart ont contacté les services d’urgence ou se sont présentés au service des urgences. Les attentes étaient similaires chez les répondants conscients et inconscients, en particulier pour la prise en charge des intoxications aiguës, les infirmières étant censées répondre dans les cinq minutes. Parmi les utilisateurs précédents, la satisfaction globale était élevée dans tous les domaines, bien que la communication et la sensibilisation aient été identifiées comme des domaines à améliorer. Les principales attentes en matière de services comprenaient un accès rapide 24/7 (76,9 %), l’expertise des intervenants (69,9 %) et des recommandations claires et adaptées (56,1 %). La plupart des répondants préfèrent le français (84,9 %), les communications téléphoniques (94,1 %) et les appels de suivi (81,7 %). CONCLUSIONS: La satisfaction des utilisateurs à l’égard du CAPQ était élevée, mais il subsiste des lacunes dans la sensibilisation du public et les attentes en matière de services. Ces résultats mettent en évidence les possibilités d’améliorer l’accessibilité, la communication et les stratégies de sensibilisation.
Hepatocellular carcinoma (HCC) is a lethal cancer. Early recurrence, i.e., recurrence within two years of curative treatment, is a major determinant of ultimate survival. We included 625 patients with newly diagnosed early-stage HCC, i.e., Barcelona Clinic Liver Cancer (BCLC) Stage 0 or A, and Child-Pugh Class A liver disease who underwent percutaneous radiofrequency ablation (RFA) between 2011 and 2021 at our institution with a follow-up period of > 2 years. The patients were divided into Group 1 (patients who developed nonlocal recurrence or died within two years after RFA; n = 300 [48.0%]) and Group 2 (patients who developed local recurrence within two years or were recurrence-free and were alive for two years after RFA; n = 325 [52.0%]). Multivariate analysis showed that a Model for End-Stage Liver Disease (MELD) score of > 9, anti-hepatitis C virus (HCV) positivity, the presence of image-defined cirrhosis, treatment with antiviral therapies for hepatitis B virus or HCV, alpha-fetoprotein ≥ 20 ng/mL, multiple tumors, and larger tumor size were independent factors associated with Group 1. A nomogram was developed based on these variables to predict Group 1, with a concordance index of 68.3% (95% CI = 64.1%-72.5%). The 10-year overall survival of Group 1 was 28%, and that of Group 2 was 64%. We developed a nomogram to predict true early recurrence (i.e., nonlocal recurrence) of HCC after RFA.
Ethnoveterinary medicine (EVM) remains central to livestock health management in Afar region of Ethiopia. However, this Indigenous knowledge is increasingly threatened by environmental degradation and socio-cultural transformation. This study aimed to document medicinal plants used by pastoralists in the Megale district, Afar region, Ethiopia. Ethnobotanical data were collected through semi-structured interviews and field observations involving 13 key informants. Medicinal plant specimens were collected and identified, and their nomenclature was verified using Plants of the World Online following the Angiosperm Phylogeny Group classification system. Data were analysed using descriptive statistics and quantitative ethnobotanical indices, including informant consensus factor (ICF), fidelity level (FL) and relative importance (RI). Twenty-seven medicinal plant species belonging to 14 families were documented. Euphorbiaceae (35.71%) and Fabaceae (28.57%) were the most represented families. Leaves were the most frequently utilized plant part (54.55%), and crushing was the predominant preparation method (61.77%). Dermal and oral routes accounted for over 70% of administrations. Wound management involved the highest number of plant species (20%), whereas musculoskeletal disorders showed the highest informant consensus (ICF = 0.67). Balanites rotundifolia (RI = 0.88) and Calotropis procera (RI = 0.78) were the most culturally important species. Ethnoveterinary medicinal plants remain integral to livestock healthcare in Megale district. High cultural consensus highlights key species priorities for conservation and future pharmacological investigation. The concentration of knowledge among elderly informants underscores the urgency of documentation, conservation and integration into community-based veterinary services.
Anterior cruciate ligament (ACL) injuries are frequently associated with meniscal tears. MRI diagnostic performance varies by tear pattern and location and may be influenced by imaging timing and reader variability. This study evaluated pattern-specific MRI accuracy compared with arthroscopic findings and assessed the impact of timing and inter-reader reliability. This retrospective study included consecutive patients undergoing ACL reconstruction with confirmed complete ACL tears and available preoperative MRI. Meniscal tears were classified as horizontal, vertical, radial, complex, and bucket-handle. Arthroscopy served as the reference standard. Diagnostic metrics, inter-reader agreement (κ), and time intervals between injury, MRI, and surgery were analyzed. A total of 143 patients were included. Medial meniscal tears were present in 81 patients (56.6%) and lateral tears in 69 (48.3%). MRI accuracy was 71.3% for medial tears (sensitivity 86.4%, specificity 51.6%) and 72.0% for lateral tears (sensitivity 88.4%, specificity 56.8%). Bucket handle tear patterns showed the highest inter-reader reliability (κ = 0.78), while radial tears demonstrated the lowest inter-reader reliability (κ = 0.16). In adjusted analyses, neither meniscal location nor any injury-MRI, MRI-surgery, or injury-surgery interval was significantly associated with diagnostic performance (all p ≥ 0.38). MRI shows moderate accuracy and fair-to-substantial reliability for meniscal tears in ACL-deficient knees, with the best performance in bucket-handle tear patterns. The greatest inter-reader variability was observed for radial tears. Although no significant association between timing intervals and diagnostic performance was identified, timing-related findings should be interpreted cautiously because of potential measurement error and the retrospective design. The study registration was not performed due to the retrospective design.
Fatty liver is highly prevalent in dairy cows and poses a significant challenge to the dairy industry by reducing both milk yield and quality, thereby inflicting substantial economic losses. Although dietary betaine supplementation has been demonstrated to enhance milk protein content, the underlying molecular mechanisms remain to be fully elucidated. This study aimed to elucidate the role of betaine in milk protein synthesis and the underlying mechanisms. Blood, liver and mammary gland samples were obtained from healthy and fatty liver-affected bovines. The serum NEFA levels, oxidation and antioxidant enzyme systems and milk protein synthesis-related proteins expression were determined. In vitro, the bovine mammary epithelial cells (BMECs) were pretreated with 25 mM betaine/10 mM N-acetyl-L-cysteine (NAC) and then stimulated with NEFA. The results indicated an elevation in serum NEFA levels accompanied by enhanced oxidative stress (OS) and reduced protein levels related to milk protein synthesis (phosphorylated (p)-mechanistic target of rapamycin (mTOR)/mTOR, p-ribosomal protein S6 kinase 1 (S6K1)/S6K1, p-Janus kinase 2 (JAK2)/JAK2, p-signal transducer and activator of transcription 5 (STAT5)/STAT5 and β-casein) in dairy cows with fatty liver. In vitro, the results revealed betaine decreased the hydrogen peroxide (H2O2), malondialdehyde (MDA), and oxygen free radicals (OFR) contents, and lactate dehydrogenase (LDH) activity in the supernatant, but increased the glutathione peroxidase (GPX), catalase (CAT), superoxide dismutase (SOD) and thioredoxin reductase (TrxR) activities; the reduced glutathione-to-oxidised glutathione (GSH/GSSG) ratio; and the total antioxidant capacity (T-AOC); and elevated protein levels related to milk protein synthesis in NEFA-treated BMECs. These findings indicate that betaine reduces NEFA-induced OS and enhances milk protein synthesis, suggesting its potential as a nutritional intervention for enhancing milk protein content in dairy cows with metabolic disorders.
Foot-and-mouth disease (FMD), caused by the FMD virus (FMDV), is a highly contagious transboundary animal disease of cloven-hooved animals that causes significant economic losses worldwide, including in Bangladesh. This cross-sectional study was designed to assess FMDV antibodies and associated risk factors among sheep and goats in selected districts of Bangladesh. The present study was conducted from July to December 2023 in three districts of Dhaka Division in Bangladesh to assess the seroprevalence of FMDV in unvaccinated sheep and goats. For this, a total of 372 (n = 372) blood samples were collected aseptically for serum separation and tested for antibodies against FMDV-nonstructural protein (NSP) using a commercially available ELISA kit. The hypothesized risk factors data were collected through a structured questionnaire and analysed via chi-square tests and logistic regression models to identify their association with FMD seropositivity. Overall seroprevalence of FMDV was 20.97% (78/372); sheep 50.0% (20/40), goats 17.5% (58/332). Firth's penalized multivariable logistic regression identified species (sheep) (AOR = 17.2, 95% CI = 6.77-48.2, p < 0.001), district (Narsingdi) (AOR = 0.32, 95% CI = 0.13-0.7, p < 0.001), (Gazipur) (AOR = 17.1, 95% CI = 5.21-69, p < 0.001), feeding system (grazing) (AOR = 9.53, 95% CI = 3.45-29.6, p < 0.001), river-basin ecology (AOR = 6.32, 95% CI = 2.09-22.8, p < 0.001), and animal introduction (AOR = 2.33, 95% CI = 1.02-5.45, p = 0.044) as independent risk factors for FMD seropositivity. This study observed a high seroprevalence of FMDV in sheep and goats within the Dhaka division and highlights the need for broader and routine surveillance of FMD in small ruminants across Bangladesh, alongside cattle and buffaloes, to better understand its epidemiology and inform control strategies.
Studies of health inequalities often examine the association between a single health indicator and a single socioeconomic indicator. Recent research has increasingly explored social disparities in self-reported quality of life. However, most evidences are based on cross-sectional survey and the role of health behaviours is frequently overlooked in these analyses. This study aims to integrate broader sets of socioeconomic and behavioural variables to better explain health disparities that emerge in later adulthood. Using longitudinal data from the Norwegian population-based Tromsø Study, we followed 11,313 adults aged 25-54 at baseline over 21 years. A series of self-reported outcomes were studied, particularly EQ-5D-5L values, EQ-VAS scores, and Self-Rated Health. Predictors included three socioeconomic indicators (childhood living standard, own and spouse's educational attainment) and three health behaviours (smoking, physical activity, obesity). Shapley value decompositions were used to quantify each predictor's contribution to explained variance. For all three health outcomes, health behaviours accounted for the majority of the explained variance compared to socioeconomic factors: 80% for EQ-5D-5L, 75% for EQ VAS, and 67% for Self-Rated Health. When adjusting for differences in baseline health, the relative importance of health behaviours increased slightly. This study underscores the critical role of health behaviours in explaining inequalities in quality of life, providing new insights into the mechanisms driving these disparities. While preventing childhood deprivation would have significant impact on adult health, potential health benefits of promoting healthy behaviours are substantial. Both types of policy interventions could thereby contribute to reducing health inequalities.
To determine if post-operative infection rates after rhinoplasty differ based on use of autologous versus irradiated cadaveric costal rib grafting and use of prophylactic antibiotics. Patients undergoing cosmetic or functional rhinoplasty or nasal valve repair with costal cartilage grafting during the years 2002-2025 were identified. Patients were separated into those who underwent autologous rib grafting versus irradiated homologous (cadaveric) costal cartilage grafting. Demographic data, rates of post-operative prescription of oral or IV antibiotics from post-operative day three to 30, and rates of return to OR for revision within the first 30 post-operative days were tabulated for each group and compared with chi-square and Fisher Exact tests. A total of 707 patients who underwent rhinoplasty with costal cartilage grafting were identified; 422 with autologous rib grafting (54% female; median age 48 years) and 285 with cadaveric costal cartilage grafting (52.6% female; median age 53 years). The rate of post-operative infection did not significantly differ between the autologous and cadaveric rib groups (2.3% vs. 2.3%, p = 0.99). One patient in the cadaveric group (0.34%) returned to the operating room for revision (washout of post-operative infection) within the first 30 post-operative days. Prescription of post-operative oral prophylactic antibiotics did not significantly decrease the post-operative infection rate (p = 0.13 for autologous group and p = 0.18 for cadaveric group). Post-operative infection rates after rhinoplasty did not significantly differ between patients undergoing cadaveric versus autologous rib grafting. The use of prophylactic antibiotics did not decrease the risk of post-operative infection.
A large variation in surgery rates can be indicative of its overuse. In Finland, surgeries for carpal tunnel syndrome (CTS) and ulnar nerve disorder (UN) are common, but regional differences in their incidence rates remain unexplored. This study examined how the incidence rates of these surgeries vary across hospital districts in Finland to evaluate regional consistency. We compared regional age- and sex-adjusted incidence rates per 100,000 person-years based on data from Finland's Care Register for Health Care for CTS and UN surgeries from 2010 to 2021, calculated relative to population size as reported by Statistics Finland. The study included 21 hospital districts in Finland. During the 4-year period from 2018 to 2021, the difference between the lowest (99.6 cases per 100,000 person-years (95% confidence interval (CI) 80.7-122)) and the highest (351 cases per 100,000 person-years (95% CI 336-367)) adjusted incidence rates for CTS surgery was 3.5-fold, with a median adjusted incidence rate of 213 cases per 100,000 person-years. Over the same period, the difference between the lowest (1.04 cases per 100,000 person-year (95% CI 0.03-5.78)) and the highest (81.9 cases per 100,000 person-years (95% CI 73.2-91.5)) adjusted incidence rates for UN surgery was up to 79-fold, with a median adjusted incidence rate of 17.8 cases per 100,000 person-years. Surgery for CTS shows up to a 3.5-fold variation across Finland's hospital districts. Although less common in absolute numbers, surgical treatment rates for UN vary up to 79-fold among these regions. Such significant variations are unlikely to be attributed solely to differences in population morbidity. Instead, the findings indicate that the criteria for performing these surgeries vary considerably across the Finland's hospital districts, suggesting a potential overuse in certain areas.
High-quality patient care relies on nurses' adherence to professional nursing standards. Effective pain management reduces disease severity, accelerates recovery, decreases the length of hospital stay, and improves care quality indicators. This study aimed to examine the effect of empowering nurses in pain management on the quality of care in pediatric intensive care units. This quasi-experimental study was conducted in two pediatric intensive care units in Tehran, Iran. Using a two-stage cluster randomization method, 60 nurses were allocated to test and control groups (30 per group). The intervention consisted of a structured pain management training program, including two 2-h theoretical sessions and one practical bedside session covering pediatric pain assessment, standardized pain scales, and evidence-based pain management strategies. Quality of nursing care was assessed at baseline and 1.5 months after the intervention using the QUALPAC questionnaire. Data were analyzed using SPSS Version 27 (p < 0.05). At baseline, no significant differences were observed between the test and control groups in quality of care across physical, communication, and psychosocial dimensions (p > 0.05). After the intervention, the test group showed significant improvements in all dimensions: physical (86.73 ± 9.51 to 91.13 ± 8.62, d = 1.06), communication (43.43 ± 6.63 to 47.13 ± 4.89, d = 0.921), psychosocial (108.20 ± 13.30 to 123.70 ± 10.34, d = 1.56), and total quality of care (238.36 ± 27.00 to 261.26 ± 22.11, d = 1.53) (p < 0.001). No significant changes occurred in the control group (p = 0.06 - 0.584). Postintervention analyses revealed significant between-group differences in all care-quality dimensions and in total quality of care (p ≤ 0.05), with a higher proportion of participants reaching the completely favorable level in the test group. Nurse empowerment in pain management significantly improved the quality of care in pediatric intensive care units. These findings highlight the importance of structured educational interventions to enhance nursing performance in pain management.
Precise control of chemical reactions using tailored laser pulses represents a frontier in modern chemistry. However, an accurate description of the molecular dynamics induced by laser fields remains a central challenge for the mixed quantum-classical (MQC) methods. In this study, the quantum trajectory mean-field method (QTMF), which self-consistently treats coherence evolution and decoherence through feedback interaction with nuclear motion, has been extended to simulate electron-nuclear dynamics triggered by a laser field (QTMF-LF). The LiH molecule was taken as a representative system, and its dynamics under the influence of short UV and long IR pulses were simulated with the extended QTMF-LF method. The time evolution of electronic population transfer and the variation of molecular dipole moment over time were all successfully captured by the extended QTMF-LF simulations, and the results are in close agreement with those derived from grid-based quantum dynamics simulations. This demonstrates that the extended QTMF-LF method can reliably simulate laser-controlled molecular dynamics.
Workers' compensation claims processes may exacerbate mental health symptoms for individuals with work-related mental health conditions (WR-MHCs). This study examined associations between mental health outcomes and contemporaneous claim status. Data of this cohort study were drawn from 153 general practice patients with WR-MHCs providing 422 observations, enrolled in the IMPRovE trial across Australia. Workers' compensation claim status (accepted, rejected, being assessed, or no claim), working status, and mental health outcomes (Depression Anxiety Stress Scale-21 (DASS-21) and Short-form health survey) were assessed via 3-monthly surveys. Mixed-effects linear regression models were used to assess the relationship between claim status and outcomes, adjusting for intervention status, working status, time-point, state, clinic size, location, age, and gender. On the DASS-21, patients with a claim application being assessed reported significantly poorer overall mental health outcomes than those with accepted claims (e.g. stress: β = 5.73, 95% CI 1.69-9.77), rejected claims (e.g. depression: β = 5.88, 95% CI 1.12-10.63), or no claim (e.g. overall mental health: β = 6.14, 95% CI 2.87-9.42). No significant differences were found between patients with accepted, rejected, or no claim. In this cohort, poorer mental health outcomes were observed amongst individuals with work-related mental health conditions whose workers' compensation claims were being assessed, compared with other claim statuses. No differences were observed between accepted, rejected, or no-claim groups. These findings indicate that the adjudication phase of the claims process may be particularly challenging for some individuals and warrant targeted clinical and system-level attention. Further research is needed to establish causality and design interventions that can address causal mechanisms.
To explore correlations between hematological inflammatory indices and oral immunity, systemic immunity, and gut microbiota in healthy term pregnant women. Twenty healthy term pregnant women were enrolled. Fecal, saliva, and peripheral blood samples were collected. Hematological inflammatory indices were correlated with immune parameters and gut microbiota using routine blood tests, flow cytometry, cytokine measurements, and 16S rRNA sequencing. Salivary IL-1β correlated positively with the Monocyte-to-Lymphocyte Ratio (MLR), the Systemic Immune-Inflammation Index (SII), and the Pan-Immune-Inflammation Value (PIV). The salivary IFN-γ/IL-4 ratio correlated positively with the Hemoglobin-to-Lymphocyte Ratio (HbLR). Peripheral IL-5 correlated positively with the Systemic Inflammation Response Index (SIRI) and PIV. CD4+ T cells correlated with HbLR, while the Th17/Treg ratio correlated with SII and MLR. Th1/Th2 ratio and Th1 cells correlated with the derived Neutrophil-to-Lymphocyte Ratio (dNLR) and Neutrophil-to-Lymphocyte Ratio (NLR); conversely, CD56brightCD16- NK cells correlated negatively with SIRI and PIV. Gut microbiota analysis showed negative correlations between Collinsella and SII/NLR, Blautia and SII, and Bifidobacterium and MLR, while Fusobacterium correlated positively with NLR, dNLR, and MLR; Phascolarctobacterium with NLR; and Bacteroides with platelet-to-lymphocyte ratio. Hematological inflammatory indices in healthy term pregnant women are closely associated with oral and systemic immunity, suggesting their potential as indicators of immune balance. These indices also show strong correlations with gut microbiota, indicating that probiotics may help maintain immune homeostasis, whereas certain microbial taxa may promote inflammatory responses.
Eosinophilic colitis (EC) is a rare eosinophilic gastrointestinal disorder with increasing frequency in recent years. Although normal eosinophil density varies substantially by colonic segment, several proposed eosinophil thresholds have been used in the literature to support the diagnosis in the appropriate clinical context. However, some patients with clinical features suggestive of eosinophilic colitis (EC) do not demonstrate increased tissue eosinophil counts on histopathologic examination. To compare eosinophil-derived cell-free granules based on expression of their surface markers between two groups of patients with symptoms consistent with EC: those with increased tissue eosinophils and those without tissue eosinophilia. This study included 10 pediatric patients with histologically confirmed EC and 13 patients with clinical suspicion of EC. Eosinophil-derived cell-free granules were evaluated in colonic tissue samples using immunohistochemistry (IHC), with antibodies against MBP and CCR3. Eosinophil-derived cell-free granules were detected in all specimens from patients with suspected EC and in the majority of specimens from patients with confirmed EC. Degranulating eosinophils were identified in all specimens from both groups, although the proportion of degranulating eosinophils varied among patients. Furthermore, the abundance of granules was significantly associated with the percentage of degranulating eosinophils. Our findings indicate that IHC can be used to detect eosinophil-derived granules in colonic tissue. The presence of cell-free eosinophil granules with varying abundance, along with evidence of eosinophil degranulation in all specimens from patients with suspected EC, may provide supportive histopathological features that contribute to improving the diagnostic assessment of EC.
Well-implemented vaccination programs can reduce infectious disease burden in an equitable and cost-effective manner. This rapid review used a strengths-based approach to identify enablers and barriers to vaccination for Aboriginal and Torres Strait Islander children aged 0-5 years, and identify the characteristics of effective programs to improve vaccination coverage and timeliness. Databases and grey literature sources were searched for articles published between 2013 and 2025. Following screening, an inductive coding process informed by Braun and Clarke's reflexive thematic analysis was utilised to consolidate qualitative data. Twelve studies discussing enablers, barriers and characteristics of successful programs to increase vaccination rates were included. These studies were heterogenous in design and population. Despite variability between settings and communities, service access barriers, such as lack of adequate transport and opening hours, were commonly cited throughout the included studies, as well as lack of cultural safety. This review emphasises the value of community ownership and local responsiveness of programs aimed at increasing vaccination timeliness and coverage, and the importance of strengthening the Aboriginal and Torres Strait Islander health workforce.