Journal of Multidisciplinary Healthcare最新文献

Purpose: The importance of vitamin D metabolism has been confirmed in various pregnancy complications. It is unknown, henceforth how vitamin D metabolism contributes to the occurrence of recurrent pregnancy loss (RPL). This study aimed to elucidate its potential mechanisms through bioinformatics analysis.

Methods: Weighted Gene Co-expression Network Analysis (WGCNA) was used to identify module genes linked to vitamin D metabolism after transcriptome datasets were examined to identify differentially expressed genes (DEGs). Machine learning was utilized to refine and identify candidate biomarkers, while Mendelian randomization (MR) assessed their causal relationships with RPL. In addition, the expression was further verified by RT-qPCR and Western blotting. Finally, scRNA-seq uncovered cellular heterogeneity and intercellular communication networks.

Results: We identified 379 DEGs in RPL samples. WGCNA revealed two key modules strongly correlated with vitamin D metabolism. The intersection of DEGs and key module genes yielded 27 candidate genes related to vitamin D metabolism. Machine learning identified DOCK11 and ETV2 as biomarkers, showing consistent expression trends across training and validation sets, both demonstrating AUC values greater than 0.7 in ROC analysis. Functional enrichment analysis indicated that DOCK11 and ETV2 were co-enriched in the pathways of inflammatory responses, interferon gamma response, and TNAF signaling via NFKB. Experimental validation yielded the same results. Single-cell analysis revealed 16 distinct cellular clusters with significant enrichment of DOCK11 and ETV2 in Natural Killer cells, highlighting altered immune interactions in RPL through enhanced signaling from NK cells and cytotoxic CD8+ T cells while reducing signals from macrophages.

Conclusion: This study identified DOCK11 and ETV2 as biomarkers for RPL, revealing the important involvement of NK cells in RPL and providing new directions for the treatment of RPL.

Objective: To comprehensively analyze the international trends and dynamics in rheumatoid arthritis and bone erosion research over the past 10 years, identifying research hotspots and challenges to provide references for future research directions and therapeutic strategies.

Methods: A bibliometric analysis was conducted by retrieving relevant literature published between 2015 and 2024 from the Web of Science (WoS) database. A further bibliometric analysis and visualization of the relevant literature was conducted using CiteSpace, VOSviewer, Scimago Graphica, and Excel. Further, disease-related targets were retrieved from Genecards using "rheumatoid arthritis" and "bone erosion" as keywords, followed by PPI network analysis to identify core targets and KEGG pathway enrichment analysis to elucidate key signaling pathways.

Results: A total of 1,502 publications were included through a search of the WoS database. The number of publications initially showed a gradual increase but declined sharply after 2021. China and the United States ranked as the top two contributors, with China's proportion of publications increasing while the US proportion decreased. Cluster analysis of institutional collaboration networks revealed significant regional clustering. Arthritis Research & Therapy published the most articles in this field, while Schett, Georg ranked first in both the number of publications (34) and citations (1,436). Keyword cluster analysis indicated that research primarily focused on imaging and mechanistic exploration. PPI and KEGG analyses revealed that rheumatoid arthritis (RA) and bone erosion are closely associated with inflammatory factors and inflammation-related signaling pathways.

Conclusion: This study highlights the evolving trends in rheumatoid arthritis and bone erosion research from 2015 to 2024, demonstrating China's growing research contributions while international collaboration remains regionally concentrated. Future efforts should emphasize interdisciplinary integration and global cooperation to advance the understanding of bone erosion mechanisms and precision medicine approaches.

Background: Arrhythmias in pregnancy have become an increasingly significant concern for maternal and fetal well-being, reflecting a rising prevalence trend. This bibliometric analysis sought to delineate global research trajectories, pinpoint principal contributors, and underscore nascent areas of interest in this domain.

Methods: We retrieved publications concerning arrhythmias in pregnant women from 1996 to 2025 from the Web of Science Core Collection. A bibliometric analysis was performed utilizing VOSviewer, CiteSpace, and the R package "bibliometrix" to delineate co-authorship networks, institutional collaborations, and patterns of keyword co-occurrence.

Results: In total, 1042 publications were identified with an annual growth rate of 4.9%. The USA led in total publications (300, 28.8%). Productive institutions featured the University of Toronto (95) and Harvard University (94). The American Journal of Cardiology contributed the highest number of articles (25). Roos-Hesselink JW was identified as a foremost researcher, with 23 publications and an H-index of 19. Keyword analysis revealed "management" as a central theme, while "outcome", "long QT syndrome", and "cardiovascular disease" were emerging themes.

Conclusion: This bibliometric study presents a thorough overview of international research on arrhythmias in pregnant women. It identifies key contributors, influential institutions, and developing research topics, offering potential insights for optimizing pregnancy management, enhancing clinical outcomes, and progressing the treatment of cardiovascular and heart-related conditions during gestation.

Background: High-flow nasal cannula (HFNC) has emerged as a promising non-invasive oxygen therapy for patients with chronic obstructive pulmonary disease (COPD), particularly those with mild to moderate hypercapnia. Despite its growing use, no studies in Saudi Arabia have explored healthcare providers' clinical practices or perceived barriers related to HFNC application in this patient population. This study aimed to assess the current clinical use and implementation challenges of HFNC among physicians and respiratory therapists (RTs) in Saudi Arabia.

Methods: A cross-sectional survey was conducted among physicians and RTs across Saudi Arabia from October 27, 2024, to May 20, 2025. The survey, distributed via several channels, collected data on HFNC practices, initial settings, weaning approaches, and perceived barriers. Descriptive statistics presented as frequencies and percentages. Chi-square tests were used to assess differences between physicians and RTs, with a significance level set at p < 0.05.

Results: A total of 1724 healthcare providers completed the survey, including 636 (36.9%) physicians and 1,088 (63.1%) RTs. Significant variations were found between the two groups regarding who initiates HFNC, preferred flow rates, and temperature settings (p < 0.05). The most common flow rate selected was 30-40 L/min (47.2%), and initial FiO₂ levels typically ranged between 41% and 60%. Regarding weaning, 43% of respondents reduced flow by 5-10 L/min every 2-4 hours, and 48% disconnected HFNC when the flow rate dropped below 20 L/min. The primary barriers reported by both groups included lack of standardized protocols, insufficient training, and limited HFNC knowledge.

Conclusion: There is an inconsistent clinical practice regarding HFNC use in mild to moderate COPD among healthcare providers in Saudi Arabia. Addressing knowledge gaps and standardizing protocols may enhance the effective implementation of HFNC therapy and improve patient outcomes.

Self-Determination Theory (SDT) posits that satisfying the needs for autonomy, competence, and relatedness enhances motivation, which may influence return to work (RTW) outcomes. However, its specific impact on RTW remains unclear, warranting further investigation.Following PRISMA-ScR guidelines, we searched PubMed, Web of Science, Embase, Scopus, CINAHL and PsycINFO up to September 2025 for studies examining SDT constructs in RTW contexts. Eleven studies met with inclusion, covering diverse work disability populations. Evidence suggests that greater SDT need satisfaction is associated with higher quality motivation and more sustained RTW engagement, potentially reducing RTW duration and improving employment stability. SDT-informed interventions appear to promote need satisfaction and motivational internalization, with Motivational Interviewing and SDT-aligned tele-rehabilitation or organizational supports identified as common effective components. Our findings support SDT as a coherent framework for understanding RTW dynamics and imply that SDT-guided interventions may enhance vocational rehabilitation outcomes across populations. Future multidisciplinary work should develop explicit SDT-based theories, standardized measures, and integrated intervention pathways to optimize RTW trajectories and long-term employment outcomes.

Introduction: Pediatric cancer treatments significantly affect children's physical, emotional, and social well-being. Virtual reality (VR) is emerging as a promising non-pharmacological tool to enhance quality of life during hospitalization, yet little is known about parents perceive its potential role in supportive care.

Methods: This qualitative study used semi-structured interviews with five parents of children in remission from cancer. It explored their experiences during chemotherapy and their perspectives on how VR could help support children and families during treatment.

Results: Parents described multiple challenges during hospitalization, including emotional distress, physical side effects, social isolation, logistical difficulties, and communication issues. While most had limited prior exposure to VR, they expressed openness toward its use to reduce anxiety, boredom, and loneliness. Parents emphasized that VR should complement, not replace, human interaction, and suggested age-specific applications, interactive content for adolescent and calming, passive experiences for younger children.

Discussion: This study provides novel insights by integrating parental voices early in the co-design process of VR interventions for pediatric oncology. It identifies concrete psychosocial needs and offers recommendations to ensure future digital tools are developmentally appropriate and family-centered. While the small, homogeneous sample and absence of child participants limit generalizability, the in-depth qualitative approach offers valuable groundwork for future participatory research and VR intervention development in pediatric cancer care.

Background: Fear of disease progression is a prevalent psychological challenge among breast cancer survivors, often leading to significant psychological dysfunction and serious sequelae, such as post-traumatic stress syndrome and impaired immunity. However, the factors influencing this dysfunction in the early postoperative period remain unclear. Therefore, this study aimed to identify the influencing factors and construct a risk-prediction model for psychological dysfunction in breast cancer patients with postoperative fear of disease.

Methods: Using convenience sampling, we selected 202 patients who underwent breast cancer surgery in a Class III Grade A hospital in Jiangsu Province, between January and August 2024. All patients completed a general information questionnaire (which collected data on tumor stage), disease-related scales, the Fear of Progression Questionnaire-Short Form, a breast cancer quality-of-life scale, the Posttraumatic Growth Inventory, and the Fear of Cancer Recurrence-Short Form.

Results: Of the 202 patients, 75 (37.1%) developed psychological dysfunction. Single-factor analyses revealed that factors such as tumor stage, education level, surgical method, fear of cancer recurrence, and quality of life (P < 0.05) were significantly related to psychological dysfunction. Logistic regression revealed education level, surgical method, fear of cancer recurrence, and quality of life as influencing factors for psychological dysfunction (P < 0.05). The Hosmer-Lemeshow goodness-of-fit test of the model showed a result of χ² = 4.179 (P = 0.841). The area under the receiver operating characteristic curve was 0.860 (95% confidence interval: 0.807-0.912). The Youden index was 0.617; the sensitivity and specificity of the optimal cut-off value were 0.853 and 0.764, respectively.

Conclusion: Breast cancer patients with postoperative fear of disease have a high risk of psychological dysfunction, which is influenced by factors such as surgical method, education level, postoperative quality of life, and fear of cancer recurrence.

As neurosurgical nursing continues to evolve alongside technological advancements, a systematic examination of its research landscape has become increasingly imperative. This study employed bibliometric analysis to investigate global research trends in neurosurgical nursing from 2014 to 2024, utilizing 5677 records extracted from the Web of Science Core Collection (WOSCC). Through the application of bibliometric techniques and CiteSpace visualization tools, we quantitatively analyzed publication outputs, geographical distributions, institutional contributions, and keyword evolution patterns. Our temporal analysis revealed three key findings: (1) a steady annual growth in publication volume (average increase of 12.3% per year), with the United States contributing 39.90% of total publications; (2) dominant institutional contributors including Harvard University, the University of California System, and the University of Toronto, which collectively accounted for 28.5% of high-citation publications; and (3) emerging research foci centered on seven primary themes: clinical interventions ("clinical article", "external ventricular drain"), patient populations ("neurosurgical patients"), treatment modalities ("radiotherapy"), evidence synthesis ("meta analysis"), care delivery models ("patterns"), and anatomical considerations ("central nervous system"). These findings provided empirical evidence for understanding current research priorities, identifying knowledge gaps, and forecasting future developmental trajectories in neurosurgical nursing. The study established a foundational bibliometric framework that may guide strategic research planning and international collaboration in this specialized nursing field.

Objective: To evaluate the effectiveness of discharge planning interventions in improving health outcomes among individuals with stroke and heart conditions, synthesizing evidence from randomized controlled trials and quasi-experimental studies.

Methods: Following PRISMA guidelines, seven electronic databases (PubMed/MEDLINE, Scopus, ScienceDirect, CINAHL Plus with Full Text, Web of Science, Ovid, and ClinicalKey Nursing) were searched for studies published between 2019 and 2024. Eligible studies included adults with stroke or heart conditions who received discharge planning interventions, with outcomes compared to usual care or alternative interventions. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool for randomized controlled trials and ROBINS-I for quasi-experimental studies. Data were extracted with a standardized chart and synthesized using a convergent integrated approach in accordance with the Joanna Briggs Institute methodology.

Results: Sixteen studies (11 randomized controlled trials and 5 quasi-experimental studies) met the inclusion criteria, representing diverse populations across 11 countries. Interventions included structured discharge programs, early supported discharge, interdisciplinary planning, family-based care, nurse-led eHealth rehabilitation, and technology-enhanced approaches such as SMS, telephone, and interactive voice response systems. Six major outcome themes emerged: (1) healthcare utilization and cost outcomes, (2) patient activation and health behavior change, (3) psychological well-being, (4) functional recovery, (5) health-related quality of life, and (6) caregiver outcomes and support. Although mortality and long-term outcomes showed mixed results, most interventions demonstrated positive short-term effects across clinical, behavioral, and psychosocial domains.

Conclusion: Discharge planning interventions improve transitional care and support recovery in stroke and heart disease populations, with particular benefits when multidisciplinary, nurse-led, or digitally supported. This review highlights the value of structured and innovative discharge planning models for clinical practice. Incorporating patient- and caregiver-centered strategies can reduce readmissions, strengthen adherence, and improve long-term health outcomes.

Tuberculosis remains a common and clinically significant infectious disease in elderly Homo sapiens aged 60 and above, characterized by atypical manifestations and complex treatment. This review provides a comprehensive analysis of tuberculosis-related pulmonary damage in elderly Homo sapiens, evaluates current care practices, and discusses associated challenges. Key areas of discussion include early detection and diagnosis, optimized management of medication regimens, provision of adequate nutritional support, rehabilitation-focused care, and psychosocial support. The necessity of regular follow-up and long-term management is emphasized to prevent complications and promote functional recovery. Future research and clinical practice directions should focus on developing personalized, technology-integrated care strategies to enhance care quality, improve clinical outcomes, and support the overall health of this Homo sapiens population.