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Teaching MEDLINE to non-urban end users.

The University of Oklahoma Health Sciences Center (OUHSC) Library conducted a two-year program, funded by the National Library of Medicine (NLM), to teach Oklahoma's nonurban health professionals to perform searches of NLM's MEDLINE files using microcomputers. The training program included lectures, online demonstrations, and hands-on practice time. The initial target audience of non-urban physicians was later broadended to include other health professionals. Data collected on the 334 seminar participants included professions and specialties, previous microcomputer usage, and the size of their hospitals. On-site evaluation indicated a high degree of satisfaction with the trainers' communication skills, preparation, information imparted, and the visual aids used. The results of a follow-up survey to determine how many trainees subsequently obtained NLM codes, the amount of searching done, and the problems experienced await analysis.

Academic Medical Centers↗

Analysis of non-urban end users' MEDLINE training.

The University of Oklahoma Health Sciences Center (OUHSC) Library mailed a MEDLINE End User Practice Survey Form to 310 health professionals who had attended MEDLINE seminars supported by a two-year NLM grant. The survey sought to determine how many respondents had obtained NLM codes, reasons for not obtaining a code, searching time done since the seminar, differences in the use of information since taking the seminar, factors helpful in successful searching, and factors contributing to frustrations. The most prevalent reasons for not obtaining a code were lack of a microcomputer and modem, infrequent use of MEDLINE, cost, lack of time, complications, and ability to obtain free searches.

Computer User Training↗

Emergence of extensively and pan-drug resistance in clinical bacterial isolates: A systematic scoping review from Ethiopian public health perspective.

INTRODUCTION: The growing challenge of antimicrobial resistance in Ethiopia and itsprogression towards XDR and PDR has become a critical public health concern. Therefore, thisreview determined the current state of emerging XDR and PDR bacteria, including pre-XDR and XDR-TB, their contributing factors, advancements, and future perspectives against drug-resistant bacteria, as well as their implications for public health and insights for future research. METHODOLOGY: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. A systematic search of all available literature was conducted using PubMed/Medline, Scopus, EMBASE, Google Scholar, Hinari, Web of Science, ScienceDirect, Cochrane Library, and African Journals Online databases.This study included original articles published in English that reported XDR and PDR bacteria, Pre-XDR-TB, and XDR-TBb without limit on the study period and publication year. Descriptive statistics were used to summarize the findings. RESULTS: Twenty-five studies published between 2010 and 2025 were included in this review. Among 5620 bacterial isolates identified,1289 were XDR (22.9%), with the prevalence ranging from 5.7% to 43.2%. A total of 440 bacterial isolates were PDR (9.1%), with its prevalence in individual studies ranged from 0.8% to 19.1%. The most common XDR bacteria identified were Klebsiella species; 26.7% (2.8%-84.6%), followed by E. coli; 26.4%(14.6%-35.7%), Acinetobacter species; 24.9%(10.1%-58.3%), and P. aeruginosa; 18.7% (2.8%-44.4%). The most frequently identified PDR bacteria were Acinetobacter species; 17.3% (7.9%-50.0%), followed by Klebsiella species; 13.7%(2.7%-25.8%), E. coli; 10.2%(2.4%-22.6%), and P. aeruginosa; 5.7%(4.3%-33.3%). Additionally, from 1419 MDR-TB and 160 TB confirmed cases, Pre-XDR-TB was 3.4% (2.4%-5.7%) and XDR-TB was 1.5%(0.6%-10.0%). These isolates were identified from different clinical specimens, which represents a significant concern in community and hospital settings. CONCLUSION: The emergence of XDR and PDR represents a major threat to Ethiopian public health, resulting in increased morbidity, mortality, prolonged hospitalizations, high healthcare costs, and challenged treatment options. Urgent national surveillance and genomic detection of resistance mechanisms are needed to better track the spread of drug-resistant bacteria, promote antimicrobial stewardship, and enhance drug and vaccine trials.

Ethiopia↗

Effects of transcutaneous electrical nerve stimulation (TENS) on non-pain related cognitive and behavioural functioning.

An extensive search through nine electronic bibliographic databases (PubMed, Cochrane Library, Web of Science, ERIC, PsychINFO, Psyndex, Cinahl, Biological Abstracts, Rehabdata) was performed in order to review the effects of Transcutaneous Electrical Nerve Stimulation (TENS) on non-pain related cognitive and behavioural functioning. Eight studies were identified on neglect due to stroke, six studies on Alzheimer's disease (AD), one study on aging, and two studies on coma due to traumatic brain injury. The results of the various studies revealed that TENS has a variety of effects. These consist of enhancement of somatosensory functioning, visuo-spatial abilities and postural control in neglect, improved memory, affective behaviour and rest-activity rhythm in AD and acceleration of awakening in coma. Effectiveness of TENS is discussed in relation to various stimulation parameters: duration, frequency, pulse width and intensity. It is argued that arousal may underlie the beneficial influence of TENS in various conditions. Finally, suggestions are offered for future research.

Adolescent↗

From in vivo to in vitro/in silico ADME: progress and challenges.

High-throughput screening technologies in biological sciences of large libraries of compounds obtained via combinatorial or parallel chemistry approaches, as well as the application of design rules for drug-likeness, have resulted in more hits to be evaluated with respect to their ADME or drug metabolism and pharmacokinetic properties. The traditional in vivo methods using preclinical species, such as rat, dog or monkey, are no longer sufficient to cope with this demand. This editorial discusses the changes towards medium- to high-throughput in vitro and in silico ADME screening. In addition, much more attention is now put on early safety and risk assessment of promising lead series and potential clinical candidates.

Animals↗

Acupoint Selection Patterns and Potential Mechanisms of Acupuncture in Knee Osteoarthritis: A Combined Data Mining and Network Pharmacology Study.

OBJECTIVE: To identify the core acupoint prescription and Kellgren-Lawrence (K-L) grade-dependent compatibility patterns of acupuncture for KOA through complex network analysis, and to predict the potential molecular mechanisms underlying the core prescription via network pharmacology. METHODS: Literature was retrieved from PubMed, EMbase, Cochrane Library, Web of Science, CNKI, Wanfang, VIP, and SinoMed (inception to September 3, 2025). Frequency, association rule, complex network, and K-L grade subgroup analyses were applied. Potential targets of the core prescription were identified via network pharmacology and intersected with disease targets from OMIM, Therapeutic Target, GeneCards, and DrugBank. A protein-protein interaction (PPI) network was constructed, and Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed to explore the potential molecular mechanisms. RESULTS: We included 522 studies, yielding 582 prescriptions involving 123 acupoints. The core prescription comprised 24 acupoints, including Dubi (ST35), Neixiyan (EX-LE4), Liangqiu (ST34), Xuehai (SP10), Zusanli (ST36), Yanglingquan (GB34), Yinlingquan (SP9), among others. K-L subgroup analysis revealed ST35, GB34, SP9, and SP10 as universal core acupoints. The mild-to-moderate subgroup mainly used local acupoints, while the moderate-to-severe subgroup centered on ST35, with increased distal acupoint usage and higher degree values. Network pharmacology analysis identified 77 overlapping targets. Core targets included tumor necrosis factor (TNF), interleukin 6 (IL6), interleukin 1 beta (IL1B), tumor protein p53 (TP53), matrix metallopeptidase 9 (MMP9), signal transducer and activator of transcription 3 (STAT3), transforming growth factor beta 1 (TGFB1), caspase 3 (CASP3), and B-cell lymphoma 2 (BCL2), which were enriched in inflammation and immunity, cartilage metabolism, and tissue repair pathways. CONCLUSION: The core acupoint prescription for KOA features local acupoints combined with distal ones, exhibiting distinct patterns across K-L grades. Our computational findings suggest that core acupoints may potentially delay knee joint degeneration by synergistically regulating inflammation, cartilage metabolism, apoptosis, and tissue repair, although these predictions require experimental validation. These findings provide preliminary evidence and a theoretical basis for standardized clinical point selection and further mechanistic research.

KOA↗

Diagnostic Performance of Machine Learning for Systemic Lupus Erythematosus: Systematic Review and Meta-Analysis.

BACKGROUND: Early and accurate diagnosis of systemic lupus erythematosus (SLE) and its organ involvement is essential. Previous reviews of machine learning (ML) in SLE combined heterogeneous tasks and validation strategies and may have overinterpreted model performance. OBJECTIVE: This study evaluated the diagnostic performance of ML and deep learning (DL) models for 3 clinically distinct SLE-related tasks: SLE classification or diagnosis, lupus nephritis (LN) diagnosis, and neuropsychiatric systemic lupus erythematosus (NPSLE) discrimination. We also assessed methodological quality and certainty of evidence. METHODS: PubMed, Embase, Cochrane Library, Web of Science, and IEEE Xplore were searched from January 2014 to April 2026. Eligible peer-reviewed diagnostic accuracy studies developed or validated ML or DL models for 1 of the 3 prespecified tasks, used an accepted reference standard, and provided data for a 2×2 contingency table. Bivariate random-effects meta-analyses with the Hartung-Knapp-Sidik-Jonkman adjustment were used to pool sensitivity and specificity. We reported 95% prediction intervals (PIs), assessed risk of bias using the Quality Assessment of Diagnostic Accuracy Studies for Artificial Intelligence tool (QUADAS-AI; Viknesh Sounderajah [Imperial College London]), and evaluated certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation framework for diagnostic test accuracy. RESULTS: Twenty-nine studies were included: 17 for SLE classification, 5 for LN diagnosis, and 7 for NPSLE discrimination. In the primary task-stratified analysis, pooled sensitivity was 0.91 (95% CI 0.86-0.94; 95% PI 0.56-0.99), and pooled specificity was 0.94 (95% CI 0.91-0.96; 95% PI 0.69-0.99), with low heterogeneity (I²=23.9% and 22.9%, respectively). DL models showed a sensitivity of 0.93 and specificity of 0.95, compared with 0.88 and 0.94 for traditional ML models. Certainty of evidence was high for most analyses but low for LN diagnosis because of inconsistency and imprecision. All studies were retrospective, and only 9 of 29 (31%) performed independent external validation. Overall risk of bias was high or unclear in 22 of 29 (75.9%) studies. No study reported model calibration, decision-curve analysis, or net clinical benefit. CONCLUSIONS: ML models showed promising diagnostic accuracy across 3 distinct SLE-related tasks, but wide PIs, limited external validation, and pervasive risk of bias restrict conclusions about real-world generalizability. Prospective multicenter studies with standardized tasks and reference standards, independent external validation, and formal assessment of calibration and clinical utility are required before clinical implementation.

Humans↗

Endoscopic sinus surgery for the excision of nasal polyps: A systematic review of safety and effectiveness.

BACKGROUND: Functional endoscopic sinus surgery (FESS) has been used for >20 years for the management of sinus disease including the excision of nasal polyps. Our objective was to perform a systematic review of safety and effectiveness of FESS for the removal of nasal polyps. METHODS: The Cochrane Library, MEDLINE, Embase, Science Citation Index, other databases, and websites were searched in January and December 2005 using key words for nasal polyps and endoscopic surgery. All randomized controlled trials, nonrandomized comparative studies, and case series studies that described outcomes associated with FESS for the excision of nasal polyps were included. Forty-two publications were included from the 632 (6.6%) articles initially identified. Two reviewers assessed validity of included studies and extracted relevant data. RESULTS: Three randomized controlled trials, 4 nonrandomized comparative studies, and 35 case series studies were included in the review. FESS was compared with endoscopic polypectomy, Caldwell-Luc, radical nasalization, and intranasal ethmoidectomy. In general, studies were of poor quality and lacked description of important variables influencing surgical outcome. Overall complications for FESS from case series studies ranged from 0.3 to 22.4% (median, 7.0%). Major complications ranged from 0 to 1.5% (median, 0%) and minor complications ranged from 1.1 to 20.8% (median, 7.5%). The potentially most serious complications were cerebrospinal fluid leaks, injury to the internal carotid artery, dural exposure, meningitis, bleeding requiring transfusion, periorbital/orbital fat exposure, and orbital penetration. Symptomatic improvement ranged from 78 to 88% for FESS compared with 43 to 84% for comparative procedures. From case series, symptomatic improvement ranged from 40 to 98% (median, 88%). CONCLUSION: FESS may offer some advantages in safety and effectiveness over comparative techniques, but wide variation in reported results and methodological shortcomings of studies limit the certainty of these conclusions. Wide variation in complication rates suggests the need for audit of existing practice. Additional high-quality studies with a fuller description of potential confounding factors and effect modifiers will help to define the effectiveness of FESS more clearly.

Adolescent↗

Hyperbaric oxygen for the treatment of traumatic incomplete spinal cord injury: a systematic review and meta-analysis of randomized controlled trials.

The therapeutic efficacy of hyperbaric oxygen therapy for traumatic incomplete spinal cord injury remains a subject of debate. To comprehensively evaluate the impact of hyperbaric oxygen on motor function, sensory function, and activities of daily living in patients with traumatic incomplete spinal cord injury, we conducted a systematic review and meta-analysis. We performed a comprehensive search across PubMed, Embase, the Cochrane Library, Web of Science, and major Chinese databases for randomized controlled trials published through June 2025. A total of 15 randomized controlled trials were included. The pooled results indicated that hyperbaric oxygen therapy significantly improved the American Spinal Injury Association motor score (mean difference = 10.30, 95% confidence interval: 7.70-12.90), the total American Spinal Injury Association sensory score (mean difference = 29.29, 95% confidence interval: 18.82-39.75), the American Spinal Injury Association light touch score (mean difference = 9.84, 95% confidence interval: 6.15-13.53), and the American Spinal Injury Association pinprick score (mean difference = 8.75, 95% confidence interval: 4.40-13.11). Furthermore, hyperbaric oxygen therapy was associated with significant enhancements in the Barthel Index (mean difference = 16.60, 95% confidence interval: 10.51-22.68) and the Functional Independence Measure (mean difference = 17.41, 95% confidence interval: 10.83-23.98). In conclusion, adjunctive hyperbaric oxygen therapy appears to improve motor function, sensory function, and activities of daily living in patients with traumatic incomplete spinal cord injury compared to conventional treatments alone. However, due to methodological limitations and potential publication bias in the included studies, these findings should be interpreted with caution, and further high-quality, multi-center randomized controlled trials are warranted.

Humans↗

General health problems of inner-city sex workers: a pilot study.

OBJECTIVE: A pilot study was designed to determine the general health problems of inner city sex workers. SAMPLE: The researchers worked with an agency that provides outreach services to these sex workers. Through this agency, they had access to a purposive sample of sex workers in a large Midwest city. METHODS: Nonparticipant observation was used to gather information about their health problems, the nature of information they may need, and the barriers to obtaining health care and health information. RESULTS: Sex workers (N = 75) ranged in age from nineteen to sixty-one years old. They identified a number of physical or psychological problems, such as rape, depression, and tuberculosis. HIV/AIDS was never mentioned. A major barrier to health care is a lack of information about where to go for treatment or how to obtain health insurance. CONCLUSIONS: More research needs to be done by library and information science professionals to determine the information needs of sex workers and the agencies that provide them with health and social services.

Adult↗

Information needs at the end of life: a content analysis of one person's story.

During the last phase of life, a person may need a variety of information to help her or him cope with dying and death. This article describes the nature of information needed during this stage. A content analysis was done of a book of conversations between a husband who was dying and his wife who is a grief counselor to determine his information needs. Four categories of needs were proposed, including physical, emotional, spiritual, and financial. Information needs germane to each category were identified. More research needs to be done by library and information science professionals to determine the information needs of people who are dying, as well as those of their families and the health professionals who care for them.

Aged↗

The information seeking of on-duty critical care nurses: evidence from participant observation and in-context interviews.

OBJECTIVES: An observational study describes on-duty nurses' informative behaviors from the perspective of library and information science, rather than patient care,. It reveals their information sources, the kinds of information they seek, and their barriers to information acquisition. METHODS: Participant observation and in-context interviews were used to record in detail fifty hours of the information behavior of a purposive sample of on-duty critical care nurses on twenty-bed critical care unit in a community hospital. The investigator used rigorous ethnographic methods-including open, in vivo, and axial coding--to analyze the resulting rich textual data. RESULTS: The nurses' information behavior centered on the patient, seeking information from people, the patient record, and other systems. The nurses mostly used patient-specific information, but they also used some social and logistic information. They occasionally sought knowledge-based information. Barriers to information acquisition included illegible handwriting, difficult navigation of online systems, equipment failure, unavailable people, social protocols, and mistakes caused by people multitasking while working with multiple complex systems. Although the participating nurses understood and respected evidence-based practice, many believed that taking time to read published information on duty was not only difficult, but perhaps also ethically wrong. They said that a personal information service available to them at all hours of the day or night would be very useful. CONCLUSIONS: On-duty critical care nursing is a patient-centric information activity. A major implication of this study for librarians is that immediate professional reference service--including quality and quantity filtering-may be more useful to on-duty nurses than do-it-yourself searching and traditional document delivery are.

Communication↗

An evaluation of four end-user systems for searching MEDLINE.

This study compared features and determined which of four end-user systems (PaperChase, GRATEFUL MED, Med-Base, or Compact Cambridge: MEDLINE) would best serve the Medical Sciences and Optometry Libraries of Indiana University in providing biomedical information to faculty and graduate students through MEDLINE. Cost, ease of use, retrieval, training needs, equipment requirements, and adequacy of documentation were examined. The study consisted of a comparison of the features of each system based on available documentation; a controlled search performed by the investigators on each system and on regular NLM MEDLINE; and a user study based on observations, questionnaires, and interviews with eleven library patrons who performed the same search of their choice on each of the four systems.

Computer Systems↗

An evaluation of four end-user systems for searching MEDLINE.

This study compared features and determined which of four end-user systems (PaperChase, GRATEFUL MED, Med-Base, or Compact Cambridge: MEDLINE) would best serve the Medical Sciences and Optometry Libraries of Indiana University in providing biomedical information to faculty and graduate students through MEDLINE. Cost, ease of use, retrieval, training needs, equipment requirements, and adequacy of documentation were examined. The study consisted of a comparison of the features of each system based on available documentation; a controlled search performed by the investigators on each system and on regular NLM MEDLINE; and a user study based on observations, questionnaires, and interviews with eleven library patrons who performed the same search of their choice on each of the four systems.

Computer User Training↗

Going beyond information management: using the Comprehensive Accreditation Manual for Hospitals to promote knowledge-based information services.

In 1987, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) initiated the Agenda for Change, a major revision in the evaluation process for hospitals. An essential component of that change was to shift the emphasis away from standards for individual departments to standards for hospital-wide functions. In recent years, hospital librarians have focused their energy and attention on complying with the standards for the "Management of Information" chapter, specifically the IM.9 section on knowledge-based information. However, the JCAHO has listed the health sciences librarian and library services as having responsibilities in six other chapters within the Comprehensive Accreditation Manual for Hospitals. These chapters can have a major impact on the services of the hospital library for two reasons: (1) they are being read by hospital leaders and other professionals in the organization, and (2) they articulate specific ways to apply knowledge-based information services to the major functions within the hospital. These chapters are "Education"; "Improving Organizational Performance"; "Leadership"; "Management of Human Resources"; "Management of the Environment of Care"; and "Surveillance, Prevention, and Control of Infection." The standards that these chapters promote present specific opportunities for hospital librarians to apply knowledge-based information resources and service to hospital-wide functions. This article reviews these chapters and discusses the standards that relate to knowledge-based information.

Health Promotion↗

The association between head and cervical posture and temporomandibular disorders: a systematic review.

AIMS: To carry out a systematic review to assess the evidence concerning the association between head and cervical posture and temporomandibular disorders (TMD). METHODS: A search of Medline, Pubmed, Embase, Web of Science, Lilacs, and Cochrane Library databases was conducted in all languages with the help of a health sciences librarian. Key words used in the search were posture, head posture, cervical spine or neck, vertebrae, cervical lordosis, craniomandibular disorders or temporomandibular disorders, temporomandibular disorders, and orofacial pain or facial pain. Abstracts which appeared to fulfill the initial selection criteria were selected by consensus. The original articles were retrieved and evaluated to ensure they met the inclusion criteria. A methodological checklist was used to evaluate the quality of the selected articles and their references were hand-searched for possible missing articles. RESULTS: Twelve studies met all inclusion criteria and were analyzed in detail for their methodology and information quality. Nine articles that analyzed the association between head posture and TMD included patients with mixed TMD diagnosis; 1 article differentiated among muscular, articular, and mixed symptomatology; and 3 articles analyzed information from patients with only articular problems. Finally, 2 studies evaluated the association between head posture and TMD in patients with muscular TMD. Several methodological defects were noted in the 12 studies. CONCLUSION: Since most of the studies included in this systematic review were of poor methodological quality, the findings of the studies should be interpreted with caution. The association between intra-articular and muscular TMD and head and cervical posture is still unclear, and better controlled studies with comprehensive TMD diagnoses, greater sample sizes, and objective posture evaluation are necessary.

Head↗

Establishing a medical library technology program. The SUNY experience.

A two-year program in Medical Library Technology leading to the Associate in Applied Science degree was developed and approved by the State University of New York and the New York State Board of Regents as a joint endeavor of the Upstate Medical Center and the Onondaga Community College, with classes scheduled to begin in September 1969. The curriculum is designed to allow continuation of study towards the Bachelor of Science degree and includes a summer internship at one of several participating medical libraries. An increasing number of library technology programs are being offered by junior colleges in the U. S. and Canada. However, this represents a first attempt at a technician education program designed specifically for medical libraries.

Curriculum↗