{"title":"Tracking Clinical Competency Growth: A Longitudinal Study of Medical Students in a Multidisciplinary Emergency Department Internship Program.","authors":"Tzu-Ching Sung, Hsin-I Shih, Takeshi Kawaguchi, Chih-Hsien Chi, Hsiang-Chin Hsu","doi":"10.2147/JMDH.S530887","DOIUrl":"10.2147/JMDH.S530887","url":null,"abstract":"<p><strong>Background: </strong>Emergency department (ED) internships are essential for developing core clinical competencies in medical students. This study evaluates the weekly progression of key competencies during a structured three-week ED internship and examines the impact of extending the program from two to three weeks. Additionally, it considers how such training supports students' readiness for multidisciplinary, team-based healthcare environments.</p><p><strong>Methods: </strong>This retrospective longitudinal study analyzed a total of 2068 workplace-based assessment (WBA) forms collected from June 2018 to May 2020. Each WBA evaluated ten key clinical competencies: learning attitude, history taking, clinical judgment, medical knowledge, prescription, communication, patient education, literature appraisal, oral presentation, and documentation. A subgroup of 133 medical students who completed the full three-week internship with complete WBA records was included in the longitudinal analysis. Generalized Estimating Equations (GEE) modeling assessed performance trends and inter-cohort differences between 2018 and 2019.</p><p><strong>Results: </strong>Significant improvements were observed across all competencies, with the most notable gains in history taking, clinical judgment, communication, prescription, and documentation. Learning attitude scores increased from 4.46 (SD = 0.66) in Week 1 to 4.58 (SD = 0.58) in Week 3. Prescription and documentation improved from 3.85 and 4.17 to 4.06 and 4.32, respectively. GEE analysis confirmed significant performance gains by Week 3 (p = 0.0064). Students in 2019 outperformed those in 2018 (p = 0.0318), suggesting that curriculum refinements enhanced educational outcomes.</p><p><strong>Conclusion: </strong>A structured three-week ED internship significantly enhances medical students' clinical competencies, particularly in areas fundamental to multidisciplinary care such as communication, clinical judgment, and documentation. The extended duration promotes deeper clinical immersion and fosters skill reinforcement through real-time feedback and collaborative practice. These findings underscore the importance of sustained, structured clinical experiences in preparing students to function effectively within interdisciplinary healthcare teams. Further research should investigate optimal training durations and integrative teaching strategies to support competency-based, team-oriented medical education.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"3877-3890"},"PeriodicalIF":2.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sleep and Sugar: Deciphering the 2003-2023 Research Landscape on Sleep Disorders and Diabetes Mellitus via Bibliometric Study.","authors":"Ziquan Jiang, Jianhui Tan, Zhongming Zhou, Huihui Zheng, Yanpo Li, Haiting Wang, Qiuping Yang, Huiting Tian, Haolin Chen, Jiayi Xie, Zhiyang Li, Yexi Chen","doi":"10.2147/JMDH.S506219","DOIUrl":"10.2147/JMDH.S506219","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to provide a bibliometric analysis of the research landscape on sleep disorders and diabetes mellitus, exploring the volume and impact of scholarly publications, identifying leading contributors, and discerning emerging trends and hotspots within this field.</p><p><strong>Methods: </strong>Utilizing the Web of Science™ Core Collection, we conducted a detailed search and analysis of publications related to sleep disorders and diabetes from January 2003 to December 2023. Tools like CiteSpace and VOSviewer were employed for data visualization, highlighting the contributions of authors, institutions, countries, and journals.</p><p><strong>Results: </strong>We identified 816 publications, with a notable increase in research output over time. The analysis revealed significant contributions from the USA and prominent institutions like Johns Hopkins University. Critical research hotspots include the bidirectional relationship between sleep disorders and diabetes, pathophysiological mechanisms, and the impact of targeted interventions on disease management.</p><p><strong>Conclusion: </strong>The growing body of literature underscores the complex interplay between sleep disorders and diabetes mellitus, pointing to a need for further investigation into their bidirectional relationships, underlying mechanisms, and the efficacy of interventions. This study offers a roadmap for future research, suggesting an integrated approach to understanding and managing these conditions.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"3859-3875"},"PeriodicalIF":2.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Erratum: A Bibliometric Analysis of Research Trends in Spousal Support for Breast Cancer Patients [Corrigendum].","authors":"","doi":"10.2147/JMDH.S549114","DOIUrl":"https://doi.org/10.2147/JMDH.S549114","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.2147/JMDH.S476838.].</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"3849-3850"},"PeriodicalIF":2.7,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12244197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Uncovering Diagnostic Correlations Between Traditional Chinese and Western Medicine Using Instrumental Variable Models in Cardiometabolic Patients: Evidence from 1.2 Million Records.","authors":"Jingjing Zhou, Shangcheng Zhou, Huijing Chen, Xiyin Chen, Guanyang Zou, Yulin Gao, Shangwen Jing, David Makram Bishai, Jinxin Li, Ailin Zhong, Zhenyuan Liu, Ailing Liu","doi":"10.2147/JMDH.S524976","DOIUrl":"10.2147/JMDH.S524976","url":null,"abstract":"<p><strong>Background: </strong>Little is known about the relationship between syndromes in Traditional Chinese Medicine (TCM) and chronic diseases coded by Western Medicine (WM). TCM hospitals where both WM and TCM are practiced offer an opportunity to assess this relationship. TCM, based on syndrome differentiation and treatment, may aid in guiding treatment and predicting length of stay and healthcare costs. However, inconsistent coding of TCM syndromes arises due to variations in diagnostic interpretation, subjective assessment, and lack of standardized coding practices. The objective was to assess the correlation between WM diagnoses and TCM syndromes, accounting for diagnostic miscoding in the data.</p><p><strong>Methods: </strong>We examined discharge data from 1,218,224 records for patients aged 45 and above, diagnosed with cardiometabolic diseases and admitted to TCM hospitals between 2017 and 2022, stays ranging from 24-hours to 90 days. Latent class analysis (LCA) was used to measure the correlation between TCM syndromes and WM. To address potential diagnostic errors, we applied bivariate probit models with instrumental variable (IV).</p><p><strong>Results: </strong>There were 580,698 (47.67%) records for males, while 989,702 (81.24%) records from Tertiary-A hospitals. The LCA and probit models revealed that TCM syndrome diagnoses had a high ratio of noise to signal. After correcting for diagnostic errors, significant associations were found between WM diagnoses and TCM syndromes. Notably, diabetes mellitus was strongly associated with syndrome/pattern of qi and yin deficiency (coefficient = 2.711); cerebrovascular diseases showed strong associations with syndrome/pattern of qi deficiency with blood stasis (coefficient = 2.433) and syndrome/pattern of wind and phlegm blocking collaterals (coefficient = 3.176). All patterns had strong marginal effects (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>This large-scale study quantitatively maps the relationship between TCM and WM diagnoses. It introduces a new statistical approach to understanding the correlation between these two diagnostic systems, offering insights into integrated medicine for secondary prevention.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"3827-3841"},"PeriodicalIF":2.7,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mir Sadat-Ali, Hussain Khalil Al Omar, Muath M Alneghaimshi, Abdallah M AlHossan, Abdullah M Baragabh
{"title":"Role of Artificial Intelligence in Minimizing Missed and Undiagnosed Fractures Among Trainee Residents.","authors":"Mir Sadat-Ali, Hussain Khalil Al Omar, Muath M Alneghaimshi, Abdallah M AlHossan, Abdullah M Baragabh","doi":"10.2147/JMDH.S525183","DOIUrl":"10.2147/JMDH.S525183","url":null,"abstract":"<p><strong>Background and objectives: </strong>Traumatic Fractures and dislocations are missed up to 10% at the first line of defense in the emergency room and by the junior orthopedic residents in training. This review was done to evaluate the accuracy of AI-assisted fracture detection and to compare with the residents in training.</p><p><strong>Methods: </strong>We searched all related electronic databases for English language literature between January 2015 and July 2023, Pub Med, Scopus, Web of Science, Cochrane Central Ovid Medline, Ovid Embase, EBSCO Cumulative Index to Allied Health Literature, with keywords of Artificial Intelligence, fractures, dislocations, X-rays, radiographs and missed diagnosis. The data extracted included a number of patients/images studied, site of fractures analyzed, algorithms used, the accuracy of the report based on the algorithm, sensitivity, and specificity, area under the curve (AUC), comparison between the algorithm, junior orthopedic resident, emergency physicians, and board certified radiologists.</p><p><strong>Results: </strong>Twenty-seven publications fulfilled our objectives and were analyzed in detail. Ninety-two thousand two hundred and thirty-six images were analyzed for fractures, which showed that the overall accuracy of the correct diagnosis was 90.35±6.88%, sensitivity 90.08±8.2%, specificity 90.16±7 and AUC was 0.931±0.06. The accuracy of the AI model was 94.24±4.19, and that of orthopedic resident was 85.18±7.01 (P value of <0.0001), with sensitivity 92.15±7.12 versus 86.38±7.6 (P<0.0001) and specificity of 93.77±4.03 versus 87.05±12.9 (P<0.0001). A single study compared 1703 hip fracture images between the AI model versus orthopedic resident and board-certified radiologist and found the accuracy to be 98% versus 87% and 92% (P value of <0.0001).</p><p><strong>Conclusion: </strong>This review accentuates AI's potential for accurate diagnosis of fractures. We believe the AI algorithm should be incorporated in the emergency rooms where trainee residents and junior orthopedic residents could routinely use AI so that the incidence of missed fractures can be curtailed.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"3851-3858"},"PeriodicalIF":2.7,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lijun Liang, Ang Hou, Hongwei Xi, Jinming Yang, Caixia Liu
{"title":"Changes in Respiratory Function Before and After Cardiopulmonary Bypass in Children with Congenital Heart Disease with Increased or Decreased Pulmonary Blood Flow.","authors":"Lijun Liang, Ang Hou, Hongwei Xi, Jinming Yang, Caixia Liu","doi":"10.2147/JMDH.S530886","DOIUrl":"10.2147/JMDH.S530886","url":null,"abstract":"<p><strong>Objective: </strong>Cardiopulmonary bypass (CPB) is a fundamental approach for managing complex congenital heart diseases (CHD). This study aims to examine the changes in respiratory function before and after CPB in children under 12 years diagnosed with CHD with different types of shunts.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 60 pediatric patients with CHD admitted to the hospital between January 2022 and December 2023. Based on shunt type, the patients were divided into Group A (increased pulmonary blood flow, n = 30) and Group B (decreased pulmonary blood flow, n = 30). Changes in the diameters of the pulmonary artery and aorta, as well as respiratory mechanics before and 24 hours after CPB, were assessed in both groups.</p><p><strong>Results: </strong>There were no significant differences in general characteristics between the two groups (<i>p</i> > 0.05). The external diameter of the pulmonary artery among patients in Group A was significantly larger than that in Group B (2.50±0.38 vs 1.31±0.29 cm, <i>p</i> < 0.05), while the external diameter of the aorta was significantly smaller in those in Group A compared to Group B (1.60±0.26 vs 1.91±0.37, <i>p</i> < 0.05). Significant differences were observed in the respiratory mechanics indexes before and after CPB within and between the two groups, including peak airway pressure, plateau airway pressure, inspiratory resistance, expiratory resistance, and lung-thorax compliance (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Significant differences in the diameters of the pulmonary artery and aorta were observed among pediatric patients with CHD, depending on the type of shunt used. Dynamic monitoring of respiratory mechanics before and after CPB is essential for optimizing clinical respiratory management to facilitate timely adjustments in respiratory support strategies.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"3843-3847"},"PeriodicalIF":2.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Application of Multidisciplinary Rehabilitation Nursing in Patients with Brucellar Spondylitis and Its Effects on Pain, Inflammation, and Immune Function.","authors":"Ying Zhang, Xianhong Zuo, Xiao Yang, Rui Li, Huan Wang, Jiantao Yu, Xinming Yang","doi":"10.2147/JMDH.S528741","DOIUrl":"10.2147/JMDH.S528741","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the effects of multidisciplinary rehabilitation nursing on postoperative outcomes in patients with brucellar spondylitis, focusing on pain, inflammation, immune function, emotional state, sleep quality, spinal mobility, adverse reactions, and patient satisfaction.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 87 patients who underwent surgery for brucellar spondylitis between January 2020 and June 2024. Patients were divided into two groups: the Routine Group (n=43, receiving standard nursing care) and the Combined Group (n=44, receiving additional multidisciplinary rehabilitation nursing). Outcomes were assessed using the Visual Analog Scale (VAS), inflammatory markers (CRP, ESR, WBC), immune indicators (CD4+, CD8+, CD4+/CD8+), emotional scales (SAS, SDS), sleep quality (PSQI), spinal function (ODI), incidence of adverse reactions, and satisfaction (NSNS).</p><p><strong>Results: </strong>The combined group exhibited significantly greater improvements than the routine group across most parameters. Postoperative pain (VAS) decreased more markedly at days 1 and 7. Inflammatory markers (CRP, ESR, WBC) and immune function (increased CD4+, CD4+/CD8+ and decreased CD8+) improved significantly by postoperative day 7, particularly in the combined group. Psychological status (SAS, SDS), sleep quality (PSQI), and spinal mobility (ODI) also improved more in the combined group. Adverse reaction rates were comparable between groups. However, patient satisfaction was significantly higher in the combined group (89.13%) than in the routine group (71.74%).</p><p><strong>Conclusion: </strong>Multidisciplinary rehabilitation nursing, when integrated with conventional care, significantly improves pain control, inflammatory response, immune function, emotional well-being, sleep quality, and spinal mobility in patients with brucellar spondylitis, without increasing adverse events, and results in higher patient satisfaction.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"3813-3826"},"PeriodicalIF":2.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jianhua Guan, Liang Ding, Yifei Wang, Zhongsheng Zhu, Mingmang Pan, Li Du, Nuo Yin
{"title":"Association Between Dietary Patterns and All-Cause Mortality in Individuals with Hypertension and Osteoporosis: A Retrospective Cohort Study.","authors":"Jianhua Guan, Liang Ding, Yifei Wang, Zhongsheng Zhu, Mingmang Pan, Li Du, Nuo Yin","doi":"10.2147/JMDH.S518980","DOIUrl":"10.2147/JMDH.S518980","url":null,"abstract":"<p><strong>Objective: </strong>To explore the association of dietary patterns with all-cause mortality in individuals with hypertension and osteoporosis.</p><p><strong>Methods: </strong>Data on individuals aged ≥20 years who completed bone mineral density tests were retrieved from the National Health and Nutrition Examination Survey database. Three dietary patterns were Mediterranean Diet Score (MeDS), Alternative Health Eating Index (AHEI) and Dietary Approaches to Stop Hypertension (DASH). The relationships between osteoporosis (OS), hypertension (HTN) and all-cause mortality were assessed by multivariate and univariate Cox proportional hazard models, with hazard ratios (HRs) and confidence intervals (CIs). Interaction of OS and HTN on overall mortality was evaluated by the attributable proportion (AP), relative excess risk due to interaction (RERI), and synergy index (S). Associations of three dietary patterns with all-cause mortality were explored in different groups, including adults with HTN or OS only, and adults with or without OS and HTN. Subgroups of gender and menopausal state were further evaluated these associations.</p><p><strong>Results: </strong>Of the total 16,358 participants, 1383 (5.84%) died during the follow-up duration. Participants who had HTN (HR=1.272, 95% CI: 1.083-1.494) or OS (HR=1.674, 95% CI: 1.262-2.221) had a higher risk of overall mortality. There was an interaction between HTN and OS on overall mortality (RERI=0.677, 95% CI: 0.070-1.285; AP=0.293, 95% CI: 0.094-0.492; SI=2.070, 95% CI: 1.124-3.813). The AHEI-2010, MeDS, and DASH were related to overall mortality in individuals with OS and HTN. The MeDS and DASH were concerned with all-cause mortality in HTN patients without OS. The MeDS and AHEI-2010 were linked to overall mortality in adults without OS and HTN.</p><p><strong>Conclusion: </strong>The impacts of different dietary patterns were differences in multi-feature population. It was suggested that reasonable dietary management is beneficial to the prognosis of different populations.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"3781-3791"},"PeriodicalIF":2.7,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Long Zhao, Sha Li, Yansong Liu, Zhijuan Di, Hongling Li
{"title":"Analysis of Prognostic Risk Factors in Children with Disorders of Consciousness Undergoing Hyperbaric Oxygen Therapy.","authors":"Long Zhao, Sha Li, Yansong Liu, Zhijuan Di, Hongling Li","doi":"10.2147/JMDH.S517708","DOIUrl":"10.2147/JMDH.S517708","url":null,"abstract":"<p><strong>Background and objective: </strong>Disorders of consciousness (DOC) are serious neurological conditions in children, often caused by brain injury, infection, or hypoxia, with limited effective treatments. Hyperbaric oxygen therapy (HBOT) has emerged as a promising adjunctive approach due to its potential to improve cerebral oxygenation and promote neural repair. However, the prognostic factors influencing treatment outcomes in pediatric DOC remain unclear. This study aimed to identify the risk factors for prognosis of children with DOC undergoing HBOT.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 255 children diagnosed with DOC who received HBOT at the Second Hospital of Hebei Medical University from January 2010 to January 2024. Clinical data, including demographic information, etiology, Glasgow Coma Scale (GCS) scores, Coma Recovery Scale-Revised (CRS-R), treatment timing, and comorbidities, were collected. According to the Glasgow Outcome Scale (GOS) score, the children were divided into poor prognosis group and good prognosis group. Logistic regression analysis was performed to identify independent risk factors for poor prognosis.</p><p><strong>Results: </strong>Age < 12 years (OR: 0.319, 95% CI: 0.113-0.901), late timing of HBOT intervention (OR: 41.667, 95% CI: 2.122-818.296), low HBOT frequency (OR: 0.092, 95% CI: 0.019-0.441), low GCS score before HBOT (OR: 0.523, 95% CI: 0.362-0.756), low CRS-R score before HBOT (OR: 0.419, 95% CI: 0.226-0.780), and hypoxic-ischemic encephalopathy (OR: 4.885, 95% CI: 1.508-15.826) were risk factors for poor prognosis in DOC children (P < 0.05). Low GCS score before treatment was an independent risk factor for poor prognosis in DOC children after traumatic brain injury (P < 0.05), low CRS-R score before treatment was an independent risk factor for poor prognosis in DOC children after encephalitis (P < 0.05), and late timing of HBOT, low HBOT frequency and low CRS-R score before HBOT were independent risk factors for poor prognosis in DOC children after hypoxic-ischemic encephalopathy (P < 0.05).</p><p><strong>Conclusion: </strong>This study highlights the clinical value of early HBOT intervention and baseline neurological status in predicting recovery in children with DOC. Identifying these risk factors can help optimize treatment decisions and improve long-term neurological outcomes.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"3803-3812"},"PeriodicalIF":2.7,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Manli Zhang, Junzhi Sang, Chunpeng Yang, Haiyan Liu, Yang Xiao, Jinfeng Li, Guangwei Li
{"title":"Cone-Beam Computed Tomography and Magnetic Resonance Imaging in Temporomandibular Joint Disorder Diagnosis: A Comparative Study.","authors":"Manli Zhang, Junzhi Sang, Chunpeng Yang, Haiyan Liu, Yang Xiao, Jinfeng Li, Guangwei Li","doi":"10.2147/JMDH.S521279","DOIUrl":"10.2147/JMDH.S521279","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the imaging characteristics of temporomandibular joint disorder (TMD) using cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI), and to compare their diagnostic performance.</p><p><strong>Methods: </strong>Clinical data from 53 TMD patients and 53 healthy controls were retrospectively reviewed. All participants underwent both CBCT and MRI within a two-week interval. Key measurements included condylar dimensions and joint space assessments. The study evaluated each modality's ability to detect TMD-related abnormalities in the temporomandibular joint (TMJ) and masticatory muscles, such as joint space narrowing, bone changes, disc displacement, and muscle pathology. Statistical analysis compared diagnostic findings between the imaging techniques.</p><p><strong>Results: </strong>Image quality was comparable between CBCT and MRI (P > 0.05). Both modalities showed no significant differences in superior and anterior joint spaces between TMD and control groups, but the posterior joint space, condylar width, and anteroposterior diameter were significantly different (P < 0.05). Across all participants, significant differences were observed between CBCT and MRI measurements for superior and anterior joint spaces (P < 0.05). Among TMD patients, 69.81% had pain disorders and 30.19% had joint disorders. Both modalities demonstrated high inter- and intra-observer consistency (P < 0.05). CBCT showed high agreement for most bony abnormalities but only moderate for disc and muscle pathology. MRI had high agreement for most findings but was moderate in detecting bone hyperplasia and sclerosis. MRI detected significantly more soft tissue abnormalities, including disc displacement and joint effusion (P < 0.05), while CBCT was more effective in identifying bone hyperplasia, sclerosis, and condylar deformation (P < 0.05).</p><p><strong>Conclusion: </strong>Both CBCT and MRI are highly valuable tools for differentiating and assessing TMD. CBCT excels in evaluating bone-related changes, whereas MRI is superior for assessing the articular disc and soft tissue abnormalities.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"3793-3802"},"PeriodicalIF":2.7,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}