Online Questionnaire Research Articles

ARFID InitiativE Sweden (ARIES): study protocol for a large-scale genetic and registry-linked cohort study on avoidant/restrictive food intake disorder

IntroductionThe ARFID InitiativE Sweden (ARIES) investigates the genetic and environmental factors contributing to avoidant/restrictive food intake disorder (ARFID) in children and adolescents aged 6–14 years. ARIES will establish a national...

Body image disturbances in women of childbearing age with polycystic ovary syndrome: a cross-sectional study

DisignThis is a cross-sectional study.ObjectivesThis study aimed to identify the risk factors associated with body image disturbances in patients with polycystic ovary syndrome (PCOS).MethodsThis study included married women diagnosed with PCOS who required fertility assistance. Participants were recruited from the reproductive centers of three tertiary hospitals in Jiangsu Province between December 2022-June 2023. We collected 333 patient data through an online questionnaire, body image was assessed by the Chinese version of Body Image Disturbance Questionnaire (BIDQ). The demographic information and clinical data of patients were collected. At the same time, the relevant information of sleep quality, personality traits, intimate relationship, family care and psychological resilience of the patients were collected through various scales. Univariate analysis and a generalized linear model were employed to analyze the factors affecting body image disturbances in women with PCOS.ResultsThis cross-sectional study included 333 women of childbearing age with PCOS. Univariate analysis revealed that body image was associated with factors such as the body mass index (BMI), occupation, menstrual disturbances, a family history of PCOS, hair loss, acne, hirsutism, scores on the Family Apgar Index, psychological resilience levels, sleep quality, intimate relationship, and personality traits. The generalized linear model demonstrated that occupation, BMI, hair loss, acne, hirsutism, intimate relationship, family care, and psychological resilience were independent risk factors for body image issues.ConclusionThe influencing factors of body image disturbance in patients with polycystic ovary syndrome of childbearing age come from many aspects, including occupation, acne, hair loss, hirsutism, BMI, intimate relationship, family care and psychological resilience. Consequently, medical professionals in obstetrics and gynecology should recognize the body image concerns of women with PCOS and implement specific interventions to support these women during their childbearing years.

Knowledge, awareness, attitudes, and practices toward Parkinson’s disease among the general population in Saudi Arabia

BackgroundParkinson’s disease is a progressive disease that causes damage to parts of the brain, especially the substantia nigra. It is the most common motor brain condition.ObjectiveTo investigate the knowledge, awareness, attitudes, and practices toward Parkinson’s disease among the general population in Saudi Arabia.MethodsThis cross-sectional study was conducted in Saudi Arabia from July 20 to November 20, 2024, targeting adults aged 18 years and older. Participants (n = 385) were randomly selected via social media platforms, using a bilingual (Arabic and English) online questionnaire. The survey included demographics, knowledge, awareness, attitudes, and practices. Data was analyzed using SPSS (version 28), with ethical approval obtained.ResultsA total of 330 participants were surveyed, mostly young (292, 88.5% aged 18–24), female (269, 81.5%), and students (281, 85.2%). Nearly half (162, 49.1%) had heard of PD, but only 81 (24.5%) showed good knowledge, with misconceptions about causes and treatment. Commonly recognized symptoms included hand tremors (292, 88.5%) and poor balance (210, 63.6%), while awareness of non-motor symptoms was low. Most participants (319, 96.7%) supported public education, and 310 (93.9%) recommended social support for PD patients.ConclusionThis study emphasizes the lack of public knowledge and awareness regarding Parkinson’s disease, its symptoms, and its causes in Saudi Arabia. The results highlight the need for educational efforts to improve understanding and address misconceptions.CategoriesNeuroscience.

Deep carious lesion management in vital primary teeth: approach and practice of dental practitioners in Jordan.

Diverse treatment modalities are available for managing deep caries in primary dentition, with a growing interest in minimally invasive approaches. It remains unclear which treatment modality is applied by dentists in daily practice. This study aimed to explore the general dental practitioners' (GDP), and paediatric dentists' (PD) approaches to managing deep caries in primary molars. An online questionnaire was distributed using the Google Form survey tool to dentists across Jordan. Descriptive data analysis was performed. Chi-square was used to analyse correlations (P < 0.05). A total of 376 responses were analysed. Almost two-thirds of participants were GDPs (58.8%), 23.4% were PDs, 14.1% were paediatric PGs and 3.7% were academics. For asymptomatic teeth, indirect pulp capping (IPC) was the most opted treatment among all participants (N = 129; 34.3%) followed by the Hall technique (N = 70;18.6%). IPC and Hall techniques were significantly more selected by PDs (P < 0.001). For teeth with symptoms of reversible pulpitis, most participants preferred pulpotomy (N = 152; 40.4%), followed by IPC (N = 125; 33.2%). IPC was significantly more selected by PDs (P < 0.001). For teeth with symptoms of irreversible pulpitis, pulpotomy was preferred by most participants (N = 263; 69.9%). The PD approach favours less invasive biologically based interventions for managing asymptomatic and reversibly inflamed primary molars. GDPs require further education on less invasive biologically based interventions.

Effects of continuing medical education on emergency trainees’ rare disease knowledge and attitude: a single-center study

BackgroundRare diseases (RDs) affect 10% of the global population but have inadequate medical resources. Early detection and treatment are crucial, yet many emergency physicians lack awareness of RDs. This study aims to evaluate the effects of continuing medical education (CME) on the knowledge and attitude of emergency physicians.MethodsThis retrospective study was conducted from April to June 2023, involving 218 Chinese emergency physicians. The online questionnaire consisted of four groups and 30 questions, covering demographic data, knowledge, and attitudes regarding RDs. Respondents were divided into two groups based on their recent CME training experience with RDs.ResultsTwo hundred and eighteen emergency physicians completed the questionnaire, of which 108 received RD CME training and 110 did not receive RD CME training. Most respondents (98.2%) felt their knowledge about RDs was insufficient. The CME training group showed increased awareness of RD incidence (p = 0.047) and improved case analysis after training, but only slight improvement in knowledge of RD professional websites. Among the CME training group, CME was identified as the most prominent avenue for acquiring knowledge about RDs, with 72 respondents (66.7%, p < 0.001). In contrast, in the non-training group, clinical work was identified as the primary source of learning, with 47 respondents (42.7%, p < 0.001).ConclusionEmergency physicians generally lacked knowledge about rare diseases. CME training can improve their awareness and knowledge of RDs.

Prognostic understanding among patients with advanced cancer recently referred to an enhanced supportive care service: results from the cross-sectional ProgESC study.

Prognostic understanding among patients with life-limiting diseases may help patient to make informed decisions about their care. The aim of our study was to assess the level of prognostic understanding among patients recently referred to an enhanced supportive care (ESC) service, to explore the factors associated with prognostic understanding and its association with patient-relevant outcomes. Adult patients with metastatic cancer referred to the ESC service between November 13th, 2023, and August 31st, 2024, at the University College Hospital Macmillan Cancer Centre London were eligible and completed a structured online questionnaire. The primary endpoint was patients' prognostic understanding assessed with the Prognosis and Treatment Perception Questionnaire. Secondary endpoints included symptoms of anxiety and depression, measured with the General Anxiety Disorder 2-item (GAD-2) and Patient Health Questionnaire-2 (PHQ-2), respectively. Out of 311 patients referred to the ESC, 91 were included in the study. Of these 91 patients, 34 (37.4%) were unaware of their incurable prognosis. In a regression model adjusted for age and gender, being in a relationship was significantly associated with good prognostic understanding (adjusted OR 2.75, 95% CI 1.11 to 6.8, p = 0.03). Patients who had a good prognostic understanding reported fewer symptoms of anxiety (16% vs. 36%; adjusted OR 0.32, 95% CI 0.12 to 0.88, p = 0.03) and depression (23% vs. 45%; adjusted OR 0.35, 95% CI 0.13 to 0.91, p = 0.03). A significant proportion of patients with metastatic cancer were unaware that their cancer was not curable at referral to the ESC service. Improving prognostic understanding may help to reduce psychological distress and enhance emotional well-being, supporting better patient-centred ESC care.

Attitudes Toward COVID-19 Vaccination and Clinical Trials Among Saudi University Students

BackgroundThe implementation of a global COVID-19 vaccination campaign has been one of the most effective interventions in controlling the pandemic. However, vaccine hesitancy remains a major public health challenge, extending to COVID-19 vaccines. This cross-sectional study aimed to assess attitudes toward COVID-19 vaccination and willingness to participate in clinical trials among Saudi university affiliates.MethodsAn anonymous online questionnaire was distributed between June 2021 and June 2022 to affiliates of four major universities in Riyadh, Saudi Arabia. Attitudes toward vaccination were assessed using the 12-item Vaccination Attitudes Examination (VAX) scale, while attitudes toward clinical trial participation were evaluated through statements rated on a 5-point Likert scale. Statistical analyses were conducted to determine associations between vaccine acceptance, clinical trial participation, and demographic factors.ResultsA total of 365 respondents participated in the study. The majority were healthcare students, with most in their fourth academic year. Overall, 50.4% of the study sample exhibited vaccine and clinical trial hesitancy. Females exhibited significantly higher vaccine acceptance than males (P = 0.013), though hesitancy rates were only borderline significant between genders (P = 0.063). Healthcare students had significantly higher vaccine acceptance (P < 0.0001) and greater willingness to participate in clinical trials (P < 0.0001) compared to students from science and humanities disciplines. While most participants believed in vaccine safety and effectiveness, many expressed hesitancy regarding the motivations of pharmaceutical companies. Although attitudes toward clinical trials were generally favorable, only 37.8% expressed willingness to participate, and this figure dropped to 32.9% for COVID-19 vaccine trials. Vaccine acceptors were significantly more likely to be willing to participate in clinical trials (P < 0.0001).ConclusionsUnderstanding university students' perspectives on vaccination and clinical trials can help shape targeted public health campaigns to address vaccine hesitancy. Future research is needed to explore determinants of vaccine hesitancy and barriers to clinical trial participation in this population.

Alveolar ridge augmentation in Oral and Maxillofacial Surgery: a study on current practices, patient management and innovations in Germany

IntroductionThis study identifies current practices, patient management concepts and innovations in alveolar ridge augmentation (ARA) in Oral and Maxillofacial Surgery (OMFS) in Germany.Material and methodsA survey with a dynamic online questionnaire with up to 40 questions was designed to collect general and specific data on ARA, such as case numbers, imaging, surgical techniques, (bio-)materials, and case management in OMFS. After internal and external validation, 1863 OMF surgeons within the German Association for Oral and Maxillofacial Surgery (DGMKG) were invited via email to participate. Data management was anonymized and descriptively.Results324 OMF surgeons participated in the study (response rate 17.39%). Most participants (60.8%) work in private practices without inpatient care. 62.03% of participants insert > 200 implants, and 28.70% perform > 200 ARA annually. About 30.86% also provide implant-based prosthetic restorations. Cone-beam computed tomography (CBCT) is the imaging method most preferred by 87.74% of participants. The most common ARA techniques are external and internal sinus lift (SL) and bone block augmentation (97.31%, 90.57%, and 73.4%, respectively). Intraoral harvested autogenous bone grafts (ABG) are most commonly used for ARA (96.63%). The oblique line is the participants’ preferred donor site for ABG (93.27%). ABG and xenogeneic bone substitutes are the most frequently used graft combinations (72.73%). Platelet-rich fibrin (PRF) is used by 58.59% of participants for ARA, mostly in SL procedures (76.44%). PRF is the most common substitute used to biofunctionalize biomaterials (48.16%). Oral antibiotics are used by 86.40% pre-/intraoperatively and by 88.97% postoperatively for ARA. Most participants believe the surgical technique (94.49%) and the surgeon's experience (92.28%) are the most critical factors for ARA success. 46.32% of participants aim to perform ARA within the skeletal envelope.ConclusionThe findings highlight current practices, patient management, and innovations in ARA in OMFS in Germany. They show standard practices and numerous variations in several aspects.Clinical relevanceSurgical technique, experience, patient health and compliance are relevant ARA success factors. This underlies the importance of extended surgical training and careful patient selection.

Unravelling cyberbullying among Egyptian adolescents: the protective influence of self-control and moral identity with gender and socioeconomic dynamics

BackgroundCyberbullying presents a significant challenge for adolescents, leading to severe psychological and social consequences. This study explores the relationships between cyberbullying, self-control, and moral identity among Egyptian school students, considering gender and socioeconomic factors from a nursing perspective.MethodsA cross-sectional, descriptive correlational study was conducted among 304 preparatory and secondary school students aged 12–20 years in Egypt. Data were collected through a validated online questionnaire incorporating standardized tools to assess cyberbullying involvement, self-control, and moral identity. Statistical analyses included correlation and regression to examine the relationships between study variables. Ethical approval was secured, and informed consent was obtained from participants and legal guardians.ResultsFindings revealed that 78.6% of students had low cyberbullying involvement, 58.6% exhibited moderate self-control, and 78.6% demonstrated high moral identity. Self-control showed a significant negative correlation with cyberbullying (r = -0.32, p < 0.001) and emerged as a strong predictor of lower cyberbullying engagement (β = -0.287, p < 0.001). Although moral identity did not directly predict cyberbullying, gender moderated its influence (β = -0.221, p = 0.006). Socioeconomic status did not significantly mediate the relationships among self-control, moral identity, and cyberbullying.ConclusionSelf-control serves as a critical protective factor against cyberbullying among adolescents, while moral identity’s role appears to be gender dependent. These findings emphasize the necessity of targeted interventions in school health programs to enhance self-regulation and ethical awareness among students. Psychiatric and school nurses should integrate cyberbullying prevention strategies into educational initiatives, reinforcing self-control development and ethical reasoning. Future research should further explore psychological and social determinants of cyberbullying and evaluate the effectiveness of nursing-led interventions in adolescent populations.Clinical trial numberNot applicable.

The Effect of Online Brand Experience and Online Brand Community on Brand Leadership in E-Commerce: The Role of Brand Relationship Quality

This research focused on studying the influence of online brand experiences and online brand communities on brand leadership through the role of an intermediary in brand relationship quality on e-commerce business context. The data were collected using an online questionnaire with 400 Thai consumers and analyzed using structural equation model analysis. The results showed that the online brand experience, directly and indirectly, influences brand leadership through brand relationship quality. At the same time, online brand communities indirectly influence brand leadership through brand relationship quality. The research results could explain 88% of the relationship with brand leadership, which e-commerce businesses can apply as a guideline for online marketing in the current era.

Community pharmacists' knowledge, confidence, and perceived need for training on fall-risk increasing drugs and fall prevention: a cross-sectional study in Selangor, Malaysia.

Community pharmacists (CPs) can offer fall prevention services to minimize fall risks among older people. To effectively perform fall prevention activities, CPs need sufficient knowledge about fall prevention and fall-risk increasing drugs (FRIDs), as well as the confidence to execute fall prevention activities. This study aims to identify gaps in CPs' knowledge about fall prevention and FRIDs, as well as assess their confidence in implementing fall prevention activities and perceived-need for training. A cross-sectional study using an online questionnaire was undertaken over 4 weeks from 21 June to 19 July 2023, among CPs in the state of Selangor, Malaysia. Overall, 369 attempted the survey (response rate: 99.5%). However, the completion rate was 79.9% (295/369). Most were female (67.8%, 200/295) and aged 25-30 (43%, 127/295). Many CPs were unaware that FRIDs such as antiepileptics, centrally acting antihypertensives, diuretics, and medications for overactive bladder and incontinence could increase fall risks. CPs had limited knowledge of resources for identifying FRIDs, with only 35.6% (105/295) of them aware of the Beers criteria. Furthermore, knowledge gaps were identified among CPs regarding fall prevention activities, particularly concerning the deprescribing of FRIDs. CPs had limited confidence in recommending deprescribing and offering advice to minimize medication-related fall risks. Most CPs believed that they received inadequate training in fall prevention and FRIDs and recognized the importance of such training. Knowledge and confidence gaps were identified among CPs regarding fall prevention and FRIDs. Enhanced education and training for CPs are essential for effective fall prevention.

Trajectories of medical students’ empathy nowadays: a longitudinal study using a comprehensive framework of empathy

BackgroundFor more than a decade, the literature has been dominated by the notion that medical students may paradoxically lose their empathy during medical school. However, medical curricula have significantly evolved, and the question is whether this is still the case. The present study aimed to describe the trajectories of different dimensions of empathy from the beginning to the end of a six-year medical curriculum and explore the influence of different psychosocial and health-related factors.MethodsIn an open cohort design, all medical students at the University of Lausanne (Switzerland) were invited to complete four waves of yearly online questionnaires. Cognitive, affective, and behavioral empathy were measured with three validated instruments, and emotion recognition was assessed with a performance test. For each measure, linear mixed models including an array of psychosocial and health-related potential covariates were modelled. Different temporal variance–covariance structures and nonlinear trajectories were tested.ResultsThe final sample included 3224 questionnaires completed by 1667 medical students. The cognitive and affective dimensions of empathy significantly increased in the first half of medical school, followed by a plateau, whereas behavioral empathy remained stable. For emotion recognition, a significant linear increase was observed. The only covariate with substantial influence was gender: students identifying as male presented similar trajectories of empathy and emotion recognition but with overall lower scores than students identifying as female or nonbinary.ConclusionsThis study revealed significant increases in cognitive empathy, affective empathy, and emotion recognition. Developments in today’s medical curricula may have contributed to the observed increase in empathy. Future multisite studies are warranted to identify the features of the educational environment that impact the trajectories of empathy during medical school.

Relationship between the birdwatching practice and the human nature connectedness: a cross-sectional study

The theory of nature connectedness implies that the human relationship with the natural environment affects directly the physical, mental, and general well-being of people. Although birdwatching enables humans to connect with nature, the impact of this practice on health has been little explored. This research evaluated the profile of the Brazilian birdwatchers and their connectedness to nature, considering their sociodemographic characteristics and birding practices. An analytical cross-sectional observational study was conducted with birders who answered an online questionnaire, which contained sociodemographic data, birdwatching profile, and connectedness to nature scale (CNS). A total of 444 birdwatchers participated in the survey; most of them were male, aged between 19 and 77 years (mean = 41); the majority had a university degree and had been practicing the activity for more than 5 years. The main reasons that motivated them to start birding were to feel more connected to nature, to improve mental wellness, and to collaborate with citizen science. The CNS score was high. The higher the birdwatching frequency, the higher the CNS, and daily birding activities raised it to 9.30 points. Therefore, the practice of birdwatching can lead to a greater connection with nature and in this way can become a tool to promote human wellbeing and environmental health.

A Study On Sleep Deprivation And Academic Performance Of College Students

Abstract : The human body needs sufficient sleep to ensure optimal physiological, psychological and cognitive functions. Sleep loss can lead to numerous procedural mistakes, which can be harmful for the individuals. Inadequate sleep adversely impacts the nervous system, leading to inadequate brain function. Due to the cognitive impairment related to sleep loss, academic achievement is usually impaired. To minimize sleep deprivation, positive lifestyle and healthy sleep hygiene should be incorporated. For students, academic pressures can cause physiological stress, which potentially leads to poor sleep quality. Specifically, poor sleep quality, insomnia, and daytime sleepiness are reportedly common among college students. It is, therefore, imperative that the consequences of sleep deprivation among university students are further researched and interventions aimed at reducing the issue be extensively researched.This research employs a quantitative research method with an online questionnaire to explore the correlation between sleep deprivation and academic performance in college students aged between 18 and 25. Convenience sampling was employed in participant recruitment, ensuring easy and prompt data collection. This study seeks to shed light on how sleep deprivation affects academic performance among this particular population.

Raising to conformity without strictness: is it achievable?

BackgroundThe prevailing belief that parental strictness is optimal for children is not uniformly supported by recent research. Contrary to the traditional notion that strictness is necessary to ensure children’s conformity to social norms, contemporary studies question its necessity. This study aims to analyze how two main parenting dimensions, warmth and strictness, are related to the psychosocial adjustment of children.MethodA sample of 1,224 Spanish adolescents and young adults was examined, divided into two groups: adolescents aged 12–18 years (51.14%) and young adults aged 19–35 years (48.86%). Adolescent participants were recruited from high schools while young adults were recruited from university courses. Children (i.e., adolescent and young adult offspring) responded to an online questionnaire that included all measures: parenting dimensions (warmth and strictness) and children’s psychosocial adjustment criteria (emotional self-concept, self-esteem, social competence, and conformity). Power analyses (a priori and sensitivity analyses) were applied to ensure sufficient sample sizes to achieve adequate power. Cohen’s d values from correlation analyses and multiple linear regression analyses were performed. Beta confidence intervals were analyzed to relate parenting dimensions, sex and age to self-concept, self-esteem, social competence, and conformity.ResultsThe statistical analysis plainly indicated that parental warmth was positively associated with criteria for child psychosocial adjustment, including self-esteem, social competence, and conformity. This relationship was consistent across both adolescents and young adults. Conversely, parental strictness was either negatively related to or not significantly associated with these criteria.ConclusionThis study clearly suggests that, completely contrary to expectations that strict parenting might be a need component to achieving psychosocial adjustment, parental warmth, rather than strictness, is more effective in promoting children’s psychosocial adjustment.

The attitudes of pregnant or breastfeeding polish women towards COVID-19 vaccinations: a cross-sectional survey study.

Pregnant women are at higher risk of severe course of COVID-19. The vaccination against COVID-19 is recommended in pregnant and breastfeeding women. The aim of the study was to assess the attitude towards vaccination against COVID-19 among Polish pregnant or breastfeeding women. A cross-sectional survey study was performed from April 20th, 2021, to October 23rd, 2021, using an online questionnaire distributed via social media. Women who weren't Polish or didn't live in Poland were excluded from the study. The study group consisted of 662 women. Their median age was 32.5 years (interquartile range IQR: 27.25-33.75 years). Most of the women lived in acity with over 500000 inhabitants (333/662, 50.30%), were in a relationship (658/662, 99.40%), had higher education (559/662, 84.44%), were currently employed (326/662, 49.25%), but not in a medical field (574/662, 86.71%). Willingness to be vaccinated was expressed in 231/662 (34.89%) of the surveyed women. A positive attitude towards vaccinations was more common among women working in the medical field (p = 0.006679), with higher education (p = 0.000054), who trusted their doctors (p = 0.003900), thought that vaccines against COVID-19 were effective (p < 0.00001), and those afraid of COVID-19 (p < 0.00001). The study showed that only one third of the surveyed women wanted to be vaccinated against COVID-19. Women working in the medical field, with higher education, who trusted their doctors, thought that vaccines against COVID-19 were effective, and those afraid of COVID-19 were more prone to be vaccinated against COVID-19 with recommended vaccines. Educational role of healthcare workers might be crucial for increasing the COVID-19 vaccine coverage in pregnant and breastfeeding women.

Comparison of prednisolone and alternative glucocorticoid dosing protocols for canine hypoadrenocorticism: insights from a survey-based study

ObjectivesThe aim of the study was to analyze glucocorticoid (GC) dosing protocols in dogs with hypoadrenocorticism (HA), and to identify predictors for optimal clinical outcomes during both the acute and chronic phases of the disease, as well as during long-term therapy.MethodsThis observational cross-sectional study utilized a case-based online questionnaire. Practicing veterinarians across Germany were invited to participate. The survey collected data in the disease course and follow-ups. Responses were analyzed using descriptive statistics, single and multiple comparisons, and a multivariable logistic regression model.ResultsFor 103 dogs the questionnaire was fully completed and analyzed. Of these, 85 dogs (82.5%) were hospitalized, and they received either prednisolone (52.9%), dexamethasone (31.8%) or hydrocortisone (11.8%). Hydrocortisone therapy was associated with a shorter hospitalization time and faster normalization of electrolytes compared to prednisolone. Follow-up data were available for 85 dogs, with 82.35% (n = 70/85) achieving an optimal or well-adjusted clinical outcome. Multivariable logistic regression analysis indicated that the eukalemic and eunatremic form was significantly less associated with the presence of azotemia and the occurrence of an acute adrenal crisis. Dividing the daily GC dosage was associated with poorer clinical outcomes and a reduced likelihood of achieving optimal medication adjustment.ConclusionOur findings provide new, relevant recommendations for the therapeutic management of HA in dogs. Hydrocortisone appears to be a promising treatment for managing HA during hospitalization, highlighting its potential use in clinical practice. Once-daily administration of prednisolone is advisable for long-term therapy. To achieve the best possible outcome, implementing an optimal treatment protocol is essential, which veterinarians should tailor based on the needs of both owners and animals. The main limitations of the study include its retrospective nature and the limited number of participants. Future studies, particularly prospective ones, could further validate the beneficial effects of hydrocortisone and evaluate long-term therapy in comparison to prednisolone.

The symptom network structure of postpartum posttraumatic stress disorder among women in Shanghai, China.

Previous studies have investigated various factors influencing postpartum posttraumatic stress disorder (PP-PTSD). However, limited understanding exists regarding the network structure and interconnections among symptoms of PP-PTSD. This study aims to explore the complex relationship by applying network analysis among postpartum women in Shanghai, China. A total of 2,552 postpartum women completed the online questionnaire using the 14-item Chinese version of the Perinatal Posttraumatic Stress Disorder Questionnaire. For network analysis, 671 individuals were meticulously chosen from the upper quartile of the Perinatal Posttraumatic Stress Disorder Questionnaire scores, representing the top 25% (cutoff score ≥ 9). Subsequently, Walktrap cluster detection, a method for identifying clusters in networks, was performed on the estimated networks. Additionally, Network Comparison Tests were conducted to examine the variations among individuals based on parity and mode of birth. The symptoms "distant" (Item 8, felt isolated and disconnected from others) and "numb" (Item 9, had difficulty showing tenderness or love toward others) were found to be the most central and exhibited the strongest correlation (r partial = 0.373). This study identified three symptom clusters: "reexperiencing and avoidance" symptom cluster, "negative alterations in cognitions and mood and arousal" symptom cluster, and "hyper and guilt" symptom cluster. To mitigate PP-PTSD among postpartum women, effective strategies targeting the central symptoms of "distant" and "numb" are crucial. Prioritizing interventions that address these key symptoms can enhance overall treatment and support effectiveness for individuals with PP-PTSD. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Treatment strategies in oligo-metastatic prostate cancer - a nation-wide survey.

Metastasis-directed therapy (MDT) is a promising approach for recurrent or de novo oligo-metastatic castration-sensitive prostate cancer (omCSPC). The aim of this study was to evaluate the treatment approaches in omCSPC among German physicians. An anonymous online questionnaire was sent via survio.com to the members of the German Societies of Urology and Radiooncology. Participants (n=166; 33% urologists, 66% radiooncologists) define omCSPC as ≤ 3 (31%) or ≤ 4 (58%) metastases. Multimodal therapy consisting of local therapy of the primary tumor, MDT and androgen deprivation therapy (ADT) was favored. For local therapy, radiotherapy was the preferred approach (radiotherapy: 84%, prostatectomy: 16%). 77% and 76% considered MDT as (very) highly important in synchronous and metachronous omCSPC, respectively. 80% would complement MDT with time-limited ADT. Compared to urologists, radiooncologists more often include cases with ≥ 3 metastases (p=0.006), see a higher importance of radiotherapy (p=0.023), a lower importance of prostatectomy (p<0.001) as well as a higher importance of MDT (in de novo p=0.038, in metachronous p=0.010). In conclusion, MDT with time-limited ADT is a common treatment strategy in omCSPC. Especially in synchronous omCSPC, radiotherapy as local treatment for the primary is the preferred option rather than radical prostatectomy.

Comparison of postoperative pain after instrumentation with TruNatomy or ProTaper Next Ni-Ti systems in mandibular molars with asymptomatic apical periodontitis: a randomized clinical trial

BackgroundNi-Ti instruments with varying design features may lead to different levels of postoperative pain, which is a significant clinical concern, particularly in previously asymptomatic teeth. Therefore, the purpose of this randomized clinical trial is to compare postoperative pain following instrumentation with TruNatomy versus ProTaper Next Ni-Ti systems in mandibular molars with asymptomatic apical periodontitis.Methods90 healthy participants were randomly assigned to two groups: TruNatomy (TN) or ProTaper Next (PTN) instruments. After single-visit root canal treatments, participants were asked to rate their postoperative pain levels at 6, 12, 24, 48, and 72 h and seven days later, using the Numerical Rating Scale (NRS) through an online questionnaire. In cases of pain, 400 mg of ibuprofen was prescribed. Data from 80 participants were finally included in the analysis. Data were analyzed using the Mann-Whitney U, Friedman, and Fisher’s Chi-Square tests (p < 0.05).ResultsThere was no statistically significant difference in postoperative pain intensity at 6, 12, 24, and 48 h and seven days between the groups (p > 0.05). At the 72-hour time point, TN group showed statistically higher postoperative pain intensity (p < 0.05). No statistically significant differences in the incidence of postoperative pain were observed at any of the time points (p > 0.05). Analgesic intake and flare-up incidence were not significantly different between the groups (p > 0.05).ConclusionPostoperative pain levels were not significantly influenced by the type of rotary Ni-Ti instrument. Both TN and PTN instruments led to low-level and similar postoperative pain intensity, minimal analgesic use, and a low incidence of flare-ups in teeth with asymptomatic apical periodontitis.Trial registrationClinicalTrials.gov ID NCT06545773, Registration Date 8 August 2024 (retrospectively registered).