Journal of Multidisciplinary Healthcare最新文献

Background: Numerous studies focusing on physical activity in the context of thyroid cancer have been reported in recent years. However, there is no bibliometric analysis in this research field. This study aims to provide a comprehensive overview of the knowledge structure and research hotspots of physical activity in thyroid cancer through bibliometrics.

Methods: Publications related to physical activity in thyroid cancer were searched in the Web of Science Core Collection (WoSCC) and PubMed databases from January 1, 2001 to May 31, 2025. VOSviewers, CiteSpace and R package "bibliometrix" were used to conduct bibliometric analysis.

Results: This bibliometric analysis spanned from 2001 to 2025 and involved 1020 authors from 182 institutions across 46 countries who contributed to 173 papers in 111 academic journals on physical activity in thyroid cancer. There has been an exponential growth trend in research on thyroid cancer and physical activity since 2009, with the United States leading in terms of publication volume. The United States dominated both in publications and citations. The journal Thyroid led in both the number of publications and the frequency of citations. Studies predominantly focused on foundational clinical topics, with recent trends shifting towards metabolic health and patient-centered outcomes, reflecting global priorities in cancer survivorship care.

Conclusion: This bibliometric study charts the evolution of thyroid cancer and physical activity research toward metabolic health and patient-centered outcomes. The assembled body of evidence conclusively links physical activity to a lower disease risk and better clinical outcomes, highlighting its significant public health and clinical implications.

Background: Exercise therapy remains somewhat controversial in those with Long COVID (symptoms lasting >3 months), due to concerns for safety and the potential for harm.

Purpose: This study describes the safety and physical outcomes of an Australian multidisciplinary Long COVID Recovery Clinic that incorporates personalised exercise prescription including respiratory and peripheral muscle strengthening, carefully monitored cardiovascular training and pacing of activity.

Patients and methods: Prospective observational study of adults (≥18 years) engaging with a single site Long COVID Recovery Clinic (March 2022 to June 2023). Clinic eligibility required symptoms >12 weeks which impaired activities of daily living. Safety was pre-defined as <10% of participants experiencing a minor adverse event, and no serious disability or death as a result of participation in exercise. Physical outcomes included Modified COVID-19 Yorkshire Rehabilitation Scale, changes in exercise capacity (6-minute-walk-test), inspiratory muscle strength (maximum inspiratory pressure), Timed-Up-and-Go and ten-metre-walk-test. Data analysis included repeated measures Multivariate Analysis of Variance (MANOVA) to explore assessment and reassessment measures collectively, and repeated measures t-test.

Results: Of 207 consumers referred, (62% male, median age 45, range 18-84), 119 (57% of the total referred) enrolled to participate in the program. Of these, 72 (61%) completed the program, median participation duration 112 days (range 5-384). There were no adverse events as a result of participation in exercise. Consumers who completed the program showed improvement in Modified COVID-19 Yorkshire Rehabilitation Scale Other Symptoms (MD -1.5, p=0.003), Overall Health Score (MD1.3, p<0.001), Total Score (MD -6.5, p=0.02); maximum-inspiratory-pressure (MD 11.7 cmH₂O, p=0.002); Timed-Up-and-Go (MD -1.0 sec, p<0.001); ten-metre-walk-test comfortable speed (MD 0.7 m/sec, p=0.006) and fast speed (MD 0.2 m/sec, p<0.001); and 6-minute-walk-test distance (MD 63.0 m, p<0.001).

Conclusion: This multidisciplinary therapy program that incorporates exercise was safe and associated with improvements in physical and functional outcomes for participants who completed the program.

Objective: The aim of this study is to evaluate the effectiveness of a hierarchical management model based on the multidisciplinary team (MDT) concept in managing pre-hospitalized patients undergoing ophthalmic day surgery.

Methods: A cohort of 6178 patients who underwent elective ophthalmic day surgery between October and December 2022 prior to the implementation of the revised pre-hospitalization service model were selected as the control group, while 8,788 patients who underwent elective ophthalmic day surgery between October and December 2023 following the implementation of the new hierarchical management model for pre-hospitalized patients were included as the observation group. The conventional admission process for surgical patients was adopted in the control group, whereas the new MDT-based hierarchical management model for pre-hospitalized patients was implemented in the observation group. This innovative model encompassed three components: pre-hospitalization information management, a structured preoperative evaluation system, and hierarchical preoperative nursing management. The rates of day-of-surgery cancellations and hospitalization cancellations, as well as satisfaction levels among patients who had elective ophthalmic day surgery, were compared between the two groups.

Results: The rates of day-of-surgery cancellations and hospitalization cancellations in ophthalmic day surgery among patients in the observation group were significantly lower, while patient satisfaction was significantly higher compared to the control group (p < 0.05).

Conclusion: The implementation of an MDT-based hierarchical management model for pre-hospitalized patients proved effective in facilitating a closed-loop system for preoperative safety management during the perioperative period of ophthalmic day surgery, reducing the rates of day-of-surgery cancellations, improving patient satisfaction, and ensuring the efficient and safe conduct of ophthalmic day surgery procedures.

Background: Osteoarthritis (OA) is a common degenerative joint disease affecting many individuals worldwide. The relationship between vitamin D and OA has recently attracted attention from researchers, as the available data concerning the influence of vitamin D on OA progression are controversial. Here, we conducted a visualized analysis of the world research trends on vitamin D and OA from 2005 to 2024.

Methods: A search was conducted to identify papers published between 2005 and 2024 in the Web of Science Core Collection (WoSCC) database. A total of 400 publications on vitamin D and OA were included and analyzed using Microsoft Excel, VOSviewer, and CiteSpace. We reported the annual publication trends, leading countries, institutions, and authors. Co-authorship, co-citation, and keyword bursts were analyzed further to determine research foci and evolving trends.

Results: The volume of publications consistently increased, peaking in 2021. The United States was the leading country (70 publications), followed by China (49) and the United Kingdom (). The high centralities of Harvard University and Monash University highlight their strong role in international collaboration. Ding Changhai, Jones Graeme, and Wluka Anita were the most productive authors. "Vitamin D Deficiency" was found to be most influential. Five clusters were identified. Further analysis revealed the current interest in and future research directions related to the roles of vitamin D in OA.

Conclusion: Publication volume on vitamin D and OA increased steadily in the last two decades. Research focus evolved from basic bone metabolism to specific vitamin D metabolites and inflammation mechanisms. Investigations continue into vitamin D's role in specific OA phenotypes and inflammatory pathways. The underrepresentation of low and middle-income countries represents a critical research gap. Recent research explores vitamin D's potential for managing OA symptoms, with future work likely focusing on its biochemical and clinical effects in OA treatment.

Purpose: To explore how families support and adapt to their child's language development following cochlear implantation in Saudi Arabia. Although international research has explored these factors, fewer qualitative studies have examined how family dynamics, parental self-efficacy, and perceptions of professional services intersect in shaping parents' interpretations of their children's linguistic outcomes in the Saudi context.

Participants and methods: Eighteen parents (10 mothers and 8 fathers) of children with cochlear implants aged 2-12 years in Riyadh participated in semi-structured Arabic interviews. The parents' ages ranged from 27 to 45 years, and their educational backgrounds varied from high school to postgraduate degrees. Transcripts were analyzed thematically following Braun and Clarke's six-phase framework.

Results: Four themes emerged family support and engagement, parental self-efficacy and language strategies, perceptions of professional services, and early intervention. Parents emphasized consistent home practice, sibling involvement, and culturally appropriate communication routines but reported challenges related to limited access and coordination of services.

Conclusion: Findings highlight the need for family-centered, culturally responsive rehabilitation programs that strengthen parental confidence and ensure timely intervention to optimize language outcomes for children with cochlear implants.

Intensive care unit-acquired weakness (ICU-AW) is a common complication in critically ill patients, associated with multiple risk factors and significantly impacting long-term patient outcomes. Currently, early diagnosis remains a key challenge in managing ICU-AW: clinical scales are limited by subjectivity, while muscle ultrasound and emerging biomarkers (such as the creatinine/cystatin C ratio, miR-451a, and MuRF1), though showing potential for early identification, have not yet been widely adopted in clinical practice. In terms of management, prevention is paramount. The ABCDEF bundle emphasizes early mobilization (initiated within 24-72 hours), while nutritional strategies targeting molecular pathways (such as HMB and ω-3 fatty acids) help regulate protein metabolism balance. Novel targeted therapies (eg, the myostatin inhibitor Bimagrumab) have demonstrated potential to increase muscle mass in clinical trials. Currently, early diagnosis remains the critical barrier. This review aims to synthesize the latest evidence on the risk factors, diagnostic challenges, and management strategies for ICU-AW, providing insights for clinical practice. It also underscores the need for future research to focus on developing highly sensitive diagnostic tools, optimizing preventive strategies, and promoting the clinical translation of targeted therapies. Ultimately, this will help establish a comprehensive and precise multi-level intervention framework to improve patient outcomes.

Objective: The demand for mortality-related education among hospice care providers in China remains high; however, the overall level of death literacy in China is comparatively low. Given that nurses constitute the primary workforce in hospice and palliative care delivery, enhancing nursing education in death literacy is essential for the effective implementation of related services.

Methods: A Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis was conducted to examine the internal advantages and limitations, as well as external opportunities and challenges, associated with death literacy nursing education in China.

Results: The strengths lie in the strong policy support for healthcare and the advancement of palliative care pilot programs, as well as the growing demand for palliative and end-of-life care accompanied by the successful localization of international experience. The weaknesses include limited educational and faculty resources, a shortage of qualified professionals and institutions, and persistent cultural taboos and traditional moral barriers that hinder development in this field. The opportunities are from shifting public awareness toward end-of-life care, increased international collaboration, and the adoption of more diverse and innovative teaching methods. The threats involve the uneven distribution of medical resources, growing industry competition and talent loss, the complexity of legal, regulatory, and ethical issues, and the continuing challenges of achieving effective interdisciplinary collaboration.

Conclusion: This study is the first to systematically apply SWOT analysis to provide empirical evidence for the strategic planning of death literacy education in nursing in China. It suggests that to improve death literacy nursing education in China, it is recommended to enhance policy implementation, incorporate international best practices, and promote the integration of intelligent technologies and interdisciplinary collaboration. These efforts should aim to extend educational outreach and resource accessibility to community-level and primary care settings. These strategic initiatives are expected to directly enhance nurses' communication and care competence at the end of life, thereby improving patients' quality of life in their final stages and advancing the goals of the Healthy China 2030 initiative in the field of palliative care.

Hepatocellular carcinoma (HCC) remains one of the most common malignancies worldwide. Its high aggressiveness and complex pathophysiology contribute to diverse but often suboptimal treatment outcomes. The Multidisciplinary Team (MDT) integrates expertise from various specialties to provide personalized and optimal treatment strategies for individual patients. However, conventional MDT face limitations related to logistics, consensus-building, and patient communication. This review aims to discuss the current status and challenges of MDT in liver cancer management and explore emerging innovative technologies that can transcend the conventional model.

Objective: This study aims to investigate the cognition and application status of DeepSeek among surgical medical staff in Class III Grade A hospitals and analyse its influencing factors to optimise its clinical application.

Methods: From February to March 2025, a questionnaire survey was conducted among 440 surgical medical staff from Class III Grade A hospitals in 18 provinces in China by a convenience sampling method. The questionnaire covered, among others, basic information, cognition and use status, attitudes and barriers and training needs, and also evaluated the degree of understanding, user experience (operation convenience, results accuracy, system stability) and degree of trust concerning DeepSeek. The SPSS 25.0 software was used for data analysis, which included frequency, percentage, Mann-Whitney U-test, Kruskal-Wallis H-test and multivariate ordinal logistic regression analysis.

Results: A total of 424 valid questionnaires were collected (96.4%). The results indicated that 67.0% of the medical staff understood the basic functions of DeepSeek, and 70.3% used DeepSeek occasionally. It was mainly used for teaching and research support (43.2%), other life services (35.6%) and patient services (29.2%). Multivariate analysis showed that medical staff working in operating rooms and neurosurgery departments, those who were occasional users, and medical staff who primarily used DeepSeek for other life services demonstrated significantly higher levels of knowledge about DeepSeek.

Conclusion: Despite widespread awareness of DeepSeek's capabilities (67.0% understanding basic functions), significant implementation gaps persist, with limited clinical utilisation and predominant usage in low-risk applications. Key barriers include insufficient training (94.8% untrained), data privacy concerns (57.5%) and over-reliance fears (58.5%). These findings reveal a substantial untapped potential for AI integration in surgical practice, highlighting critical needs for targeted training interventions, enhanced data security frameworks and staged implementation protocols to bridge the awareness-utilisation gap and facilitate meaningful clinical adoption.

Purpose: Lower limb dysfunction is a common and debilitating consequence of stroke, significantly compromising patients' quality of life. This mini-review synthesizes clinical research on acupuncture for post-stroke lower limb dysfunction over the past five years, integrating traditional Chinese medicine (TCM) theories and modern evidence.

Methods: The review analyzed clinical studies and TCM theoretical perspectives. TCM attributes stroke pathogenesis to Yin-Yang disharmony, Qi-blood imbalance, and complex interactions of wind, phlegm, fire, stasis, and toxin.

Results: Acupuncture therapies, including body acupuncture, electroacupuncture, abdominal acupuncture, scalp-body acupuncture, specific acupoint stimulation, moxibustion, and combined techniques, demonstrate significant efficacy in improving motor coordination, reducing muscle tone, and enhancing voluntary movement. Mechanistically, acupuncture regulates cerebral blood flow, reduces ischemic-reperfusion injury, modulates neuroinflammation, and promotes neural regeneration. Clinical studies show that these approaches effectively alleviate symptoms, with total effective rates ranging from 70% to 95.5%.

Conclusion: Acupuncture shows considerable potential for post-stroke lower limb dysfunction, likely exerting effects through modulation of cerebral blood flow, neuroinflammation, oxidative stress, and neural plasticity. However, challenges remain, including the lack of standardized acupoint selection protocols, stimulation parameters, large multicenter trials, and in-depth mechanistic research.