Category: Nevin Manimala

BMC Med Educ. 2026 Feb 24. doi: 10.1186/s12909-026-08858-9. Online ahead of print.

ABSTRACT

BACKGROUND: Subspecialty choice plays a pivotal role in physicians’ career satisfaction and professional trajectory. However, decision regret regarding subspecialty selection has been underexplored, despite its potential impact on well-being and retention.

METHODS: A cross-sectional study was conducted among 615 young and middle-aged physicians (aged 25-55) from secondary and tertiary hospitals in China. Participants completed an online questionnaire including the Decision Regret Scale (DRS), a simplified Maslach Burnout Inventory (MBI), Minnesota Satisfaction Questionnaire (MSQ), and Connor-Davidson Resilience Scale (CD-RISC). Statistical analyses involved ANOVA, Spearman’s correlation, and multivariate linear regression to identify factors associated with decision regret.

RESULTS: Among participants, 9.4% reported high regret, 37.6% moderate regret, and 53.0% low regret. Higher regret was significantly associated with male gender (P = 0.039), younger age (P = 0.019), and higher professional title (P = 0.003). Regression analysis revealed that greater burnout (B = 1.521, P < 0.001) predicted higher regret, while higher job satisfaction (B = – 0.339, P < 0.001) and resilience (B = – 0.588, P = 0.001) were protective factors.

CONCLUSION: Nearly one in five young and middle-aged Chinese physicians experience high regret in subspecialty choice, influenced by gender, age, burnout, satisfaction, and resilience. Targeted interventions addressing these factors may mitigate regret and enhance physician well-being and retention.

PMID:41735953 | DOI:10.1186/s12909-026-08858-9

BMC Pediatr. 2026 Feb 24. doi: 10.1186/s12887-026-06583-2. Online ahead of print.

NO ABSTRACT

PMID:41735929 | DOI:10.1186/s12887-026-06583-2

BMC Infect Dis. 2026 Feb 24. doi: 10.1186/s12879-026-12576-4. Online ahead of print.

NO ABSTRACT

PMID:41735928 | DOI:10.1186/s12879-026-12576-4

BMC Cancer. 2026 Feb 24. doi: 10.1186/s12885-026-15779-9. Online ahead of print.

ABSTRACT

BACKGROUND: Colorectal cancer is one of the malignant tumors, and postoperative recurrence or metastasis is a key factor to the survival of patients.

METHODS: Patients who underwent colorectal cancer surgery between January 2016 and December 2020 were included. Multivariate Logistic regression was used to analysis statistically, including recurrence or metastasis, liver metastasis, lung metastasis and death respectively.

RESULTS: 419 cases of colorectal cancer were included in the clinical study according to the screening criteria. Multivariate Logistic regression analysis showed that Mesocolon fascia infiltration (OR,2.769; 95%CI, 1.374-5.579, P = 0.004), Total number of lymph nodes (OR,0.949; 95%CI, 0.99-0.988, P = 0.011), The number of metastatic lymph nodes (OR,1.173; 95%CI, 1.063-1.294, P = 0.001), Tumor TNM stage (P < 0.001), were independent risk factors for postoperative recurrence or metastasis of colorectal cancer. Mesocolic fascia infiltration (OR,3.113; 95%CI, 1.209-8.015, P = 0.019) and TNM stage (P = 0.014) were independent risk factor for postoperative liver metastasis of colorectal cancer. TNM stage of tumor (P = 0.037) was an independent risk factor for pulmonary metastasis after colorectal cancer surgery.

CONCLUSIONS: Multifactor logistic regression analysis showed mesocolon fascia infiltration, total number of lymph nodes, the number of metastatic lymph nodes and tumor TNM stage were independent risk factor for postoperative recurrence and metastasis of colorectal cancer.

PMID:41735923 | DOI:10.1186/s12885-026-15779-9

BMC Public Health. 2026 Feb 24. doi: 10.1186/s12889-026-26680-2. Online ahead of print.

ABSTRACT

BACKGROUND: Air pollution remains one of the most significant environmental health threats in urban areas. Ground-level O₃, a secondary pollutant formed through photochemical reactions of nitrogen oxides (NOx) and volatile organic compounds (VOCs) under sunlight, can lead to serious respiratory and cardiovascular effects. This study aimed to quantify the short-term mortality and economic burden attributable to O₃ exposure in Qom, central Iran, during the summer of 2019, providing local evidence to support air quality management policies.

METHODS: Hourly O₃ concentration data were collected from the Qom Environmental Protection Agency for April to August 2019. After data cleaning and interpolation, the daily maximum 8-h average O₃ concentration was calculated. Health impact and related economic burden were estimated using the U.S. EPA’s BenMAP-CE model (version 1.5.8.11). Relative risk (RR) and baseline incidence (BI) values for cardiovascular and respiratory mortality were obtained from previous epidemiological studies. The Value of Statistical Life (VSL) was adjusted for Iran’s gross domestic product (GDP) to estimate the economic cost. Descriptive statistics and concentration-response functions were applied to determine avoidable deaths and associated losses.

RESULTS: The mean 8-h maximum O₃ concentration during the study period was 0.16 ppm, exceeding the EPA guideline (0.07 ppm) by 2.18 times. Short-term exposure at this level was linked to an estimated 239 premature deaths, including 190 from cardiovascular and 49 from respiratory diseases. The highest impact was observed in adults aged 30-39 years. The total economic loss attributed to these deaths was approximately 43.6 million USD, indicating a substantial burden on public health and the economy.

CONCLUSIONS: This study highlights the urgent need for effective air quality management in Qom. Reducing emissions of O₃ precursors such as NOx and VOCs, especially during warm months, could yield considerable public health and economic benefits. Localized assessments using tools like BenMAP-CE can inform evidence-based policymaking and contribute to sustainable urban development.

PMID:41735903 | DOI:10.1186/s12889-026-26680-2

BMC Med Res Methodol. 2026 Feb 24. doi: 10.1186/s12874-026-02812-5. Online ahead of print.

ABSTRACT

OBJECTIVE: To address the challenge of constructing valid confidence intervals (CIs) for Poisson means in biomedical low-count experiments (e.g., radiation or molecular counting) with known background signals, where existing methods yield overly conservative intervals due to constraints in parameter space.

METHODS: We propose a fiducial framework that redefines the fiducial distribution by adjusting for conditional probability within the restricted parameter space. This computationally efficient approach eliminates empty intervals and leverages parameter constraints to ensure frequentist validity.

RESULTS: Numerical simulations demonstrate that the proposed CIs are narrower than conventional methods while maintaining nominal coverage probabilities, particularly near boundary conditions. The method was validated using three real-world biomedical/physics datasets.

CONCLUSION: The fiducial approach provides a robust, statistically efficient solution for Poisson mean inference in restricted spaces. It offers improved precision without compromising coverage, making it highly suitable for analyzing low-count data in biomedical and physical sciences.

PMID:41735893 | DOI:10.1186/s12874-026-02812-5

BMC Psychiatry. 2026 Feb 24. doi: 10.1186/s12888-026-07897-2. Online ahead of print.

NO ABSTRACT

PMID:41735884 | DOI:10.1186/s12888-026-07897-2

BMC Pediatr. 2026 Feb 24. doi: 10.1186/s12887-026-06616-w. Online ahead of print.

ABSTRACT

BACKGROUND: Motor skills of school-age children have an impact on learning, school results, and leading a healthy life. However, prevalence rates of motor developmental delays are increasing. Still there is a lack of understanding interrelationships between developmental domains of preschool aged children.

METHODS: We used data from the project “GIF MV”, a prospective dynamic cohort study. In this study, cross sectional data was used from the survey year 2023. To detect developmental delays of pre-schoolers a standardized, objective and valid screening method was used (“Dortmund Developmental Screening for Preschools-Revision (DESK 3-6 R)”). We determined associated variables for fine and gross motor developmental risks in preschoolers using Generalized Linear Mixed Models (n = 7,542 children).

RESULTS: Fine motor risks were observed in 16.8% of the children (gross motor risks: 12.2%). A gross motor developmental risk was strongest associated with a fine motor developmental risk (and vice versa). Nevertheless, gender and almost all other developmental domains are statistically significantly associated with motor developmental risks, e.g., with developmental risks in the DESK domains “Basic competencies in mathematics” (OR: 4.34, 95% CI: 2.03; 9.27) and “Attention and concentration” (OR: 3.77, 95% CI: 1.8; 7.91).

CONCLUSION: Since analysis on variables revealed statistically significant associations between motor risks and risks in the remaining developmental domains and gender, activities designed to promote motor skills should include more than just motor developmental domains.

TRIAL REGISTRATION: The study was retrospectively registered on 29 October 2018 in the German Clinical Trial Register (ID: DRKS00015134).

PMID:41735878 | DOI:10.1186/s12887-026-06616-w

J Pediatr Nurs. 2026 Feb 23;88:117-126. doi: 10.1016/j.pedn.2026.02.015. Online ahead of print.

ABSTRACT

AIM: To evaluate the effectiveness of nighttime use of eye masks and earplugs in preventing delirium and reducing pain levels among awake, spontaneously breathing pediatric intensive care patients aged 6-12 years.

STUDY DESIGN: This single-center, parallel-group, superiority randomized controlled trial was conducted at a tertiary university hospital in western Turkey between August 2024 and June 2025. Seventy-four children aged 6 to 12 years were randomly assigned in a 1:1 ratio to either the intervention group or the control group. The intervention group received standard care plus eye masks and earplugs at night, while the control group received standard care only. The primary outcome was the incidence of delirium assessed over three consecutive days using the Cornell Assessment of Pediatric Delirium, while the secondary outcome was pain severity assessed over the same period using a faces-based numeric pain rating approach.

CLINICALTRIALS: gov (NCT06867523).

RESULTS: The intervention group had a significantly lower incidence of delirium on Days 2 and 3 compared to the control group (Day 3: 2.7% vs 37.8%; OR = 21.91, 95% CI [2.69-178.07], p < 0.001). No statistically significant differences were observed between the groups regarding pain scores at any assessment point (p > 0.05).

CONCLUSIONS: Nighttime use of eye masks and earplugs significantly reduced early-onset delirium in awake, spontaneously breathing intensive care patients aged 6-12 years; however, no statistically significant effect on pain levels was observed.

PRACTICE IMPLICATIONS: Simple, low-cost environmental modifications such as eye masks and earplugs may help reduce early-onset delirium in stable, non-sedated PICU patients aged 6-12 years and can be feasibly integrated into routine nursing care.

CLINICAL TRIAL REGISTRATION: The trial was registered at ClinicalTrials.gov (NCT06867523).

PMID:41734419 | DOI:10.1016/j.pedn.2026.02.015

JACC Adv. 2026 Feb 23;5(3):102622. doi: 10.1016/j.jacadv.2026.102622. Online ahead of print.

ABSTRACT

BACKGROUND: Sex-based disparities persist in the management of patients with coronary artery disease undergoing complex percutaneous coronary intervention (PCI).

OBJECTIVES: The purpose of this study was to evaluate sex differences in early and late outcomes among patients undergoing mechanical circulatory support (MCS)-assisted complex PCI.

METHODS: We conducted a retrospective analysis of hemodynamically stable patients who underwent complex PCI assisted with either an intra-aortic balloon pump or Impella (Abiomed) at a single center between 2017 and 2022. The primary endpoint was 1-year major adverse cardiovascular events (MACE), defined as a composite of all-cause death, myocardial infarction, and stroke. Secondary endpoints included individual MACE components, target vessel revascularization, bleeding, and procedural complications.

RESULTS: Among the 605 included patients, 24% were women (n = 145). Women had a higher comorbidity burden, presented more frequently with non-ST-segment elevation myocardial infarction, and experienced significantly more in-hospital complications, particularly bleeding. At 1 year, women had higher rates of MACE compared with men (25.5% vs 13.8%; P = 0.002), driven largely by excess mortality (20.8% vs 10.2%; P = 0.003), irrespective of MCS device type. After multivariable adjustment, the difference in MACE was no longer statistically significant (adjusted HR: 1.34; 95% CI: 0.74-3.03; P = 0.337).

CONCLUSIONS: Women undergoing complex PCI with MCS support experienced higher procedural risk and worse early outcomes, yet adjusted 1-year MACE rates were comparable to men. The marked absolute differences in bleeding and mortality highlight the need for sex-specific approaches to patient selection, procedural planning, and post-PCI management in this high-risk population.

PMID:41734415 | DOI:10.1016/j.jacadv.2026.102622