Nevin Manimala

Cent Eur J Public Health. 2026 Jun;34(2):117-122. doi: 10.21101/cejph.a8463.

ABSTRACT

OBJECTIVE: Preventable medical errors are recognized as an important public health problem. The aim of this study was to evaluate the awareness of adults in the community about patient safety, medical errors and patient participation; and to determine their experiences of medical errors.

METHODS: Adults older than 18 years living in the Konya city centre in Türkiye were included in the study. The implementation of the questionnaire took approximately two months, and a total of 780 valid questionnaires were obtained. Participants were asked questions about their views and attitudes towards medical errors. In addition, participants’ engagement in behaviours recommended by the Agency for Healthcare Research and Quality (AHRQ) to prevent medical errors was evaluated using a 4-point Likert scale.

RESULTS: Twenty-six percent of the participants stated that they or one of their family members had suffered a medical error. Those who were exposed to the error (n = 201) mostly experienced physical problems (44.3%). Other reported consequences included psychological problems (19.4%), disability (10.9%), loss of employment (5.5%), and death (2.5%). When the answers given to the questions about exposure to medical error and “whether the patients are responsible for preventing the errors” were compared with the socio-demographic characteristics, a statistically significant difference was found between age, education status, socioeconomic status, and experiencing with medical error (p < 0.05).

CONCLUSION: A significant part of the participants were harmed while receiving healthcare services. In addition, their awareness of protecting themselves from this harm was low. The findings of this study can guide healthcare professionals for patient safety training for patients.

PMID:42444430 | DOI:10.21101/cejph.a8463

Cent Eur J Public Health. 2026 Jun;34(2):88-97. doi: 10.21101/cejph.a8809.

ABSTRACT

OBJECTIVES: Limited evidence exists on how working-age adults perceive the impact of ischaemic stroke (IS) during the first months post-event, and longitudinal data on health-related quality of life (HRQoL) are scarce. The aim of the study was to examine 12-month changes in HRQoL, functional outcomes, cognitive function, and psychosocial sequelae in working-age adults after IS, and to explore age-related differences (< 50 vs. ≥ 50 years).

METHODS: In this prospective cohort study, 220 patients aged 18-65 years with first-ever IS were assessed before hospital discharge, 3-, 6-, and 12-month post-discharge. Measures included the Stroke Impact Scale (SIS 3.0), Neuro-QoL, Fatigue Severity Scale (FSS), Montreal Cognitive Assessment (MoCA), Hospital Anxiety and Depression Scale (HADS), Brief Pain Inventory, and Multidimensional Scale of Perceived Social Support (MSPSS). Longitudinal changes were analysed using the Wilcoxon signed-rank, Bowker’s test, and the Mann-Whitney U test with Bonferroni correction.

RESULTS: Significant improvements in HRQoL, cognitive function, and psychosocial outcomes occurred mainly within the first three months. FSS scores indicated clinically relevant fatigue. SIS domains – strength, emotion, communication, activities of daily living (ADL), mobility, hand function, and social participation – improved, while memory remained unchanged. Neuro-QoL T-scores increased for satisfaction with social roles, positive affect, and physical function. Changes after three months were generally not statistically significant. Post-stroke pain and perceived social support remained stable. Age subgroup analysis revealed no significant differences.

CONCLUSION: Recovery in HRQoL, cognitive function, and psychosocial outcomes typically occurs within the first three months post-IS, with a subsequent plateau. Younger and older working-age adults exhibit similar trajectories, underscoring the importance of early comprehensive rehabilitation interventions adapted to the patient’s condition and deficit.

PMID:42444426 | DOI:10.21101/cejph.a8809

Brain Behav. 2026 Jul;16(7):e71596. doi: 10.1002/brb3.71596.

ABSTRACT

OBJECTIVE: This research seeks to explore the effects of repetitive transcranial magnetic stimulation (rTMS) as an intervention on a depression mouse model and its impact on blood tryptophan metabolism.

METHODS: In this study, 24 mice were randomly divided into three groups: Sham, CUMS, and CUMS + rTMS, with each group comprising eight mice. The depression model was established using the chronic unpredictable mild stress (CUMS) method. High-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) was employed to measure the levels of tryptophan and its metabolites in the mice’s blood. The CUMS + rTMS group received rTMS treatment in addition to CUMS. Depressive-like behaviors of mice in the CUMS group and the CUMS + rTMS group were evaluated and compared through the sucrose preference test, open field test, and tail suspension test.

RESULTS: Blood serotonin levels, a tryptophan metabolite, were notably lower in the CUMS group than in the Sham group. Conversely, the levels of 5-hydroxyindole-3-acetic acid, xanthurenate, and indole-3-acetaldehyde were significantly higher in the CUMS group than in the Sham group. Additionally, the sucrose preference rate was lower, and the duration of immobility during the tail suspension test was longer in the CUMS group than in the Sham group; all these differences were statistically significant (p < 0.05). Following rTMS treatment, the CUMS+ rTMS group showed significantly lower blood levels of 5-hydroxyindole-3-acetic acid, xanthurenate, and indole-3-acetaldehyde, while serotonin levels were significantly higher than those in the CUMS group. Compared with the CUMS group, mice in the CUMS + rTMS group showed higher sucrose preference and shorter immobility duration in the tail suspension test (p < 0.05).

CONCLUSION: rTMS can affect tryptophan metabolism in the blood of mice and reduce symptoms similar to depression, providing new insights into the antidepressant properties of rTMS.

PMID:42444411 | DOI:10.1002/brb3.71596

J Korean Med Sci. 2026 Jul 13;41(27):e180. doi: 10.3346/jkms.2026.41.e180.

ABSTRACT

BACKGROUND: Hip fractures and other orthopedic surgeries are often associated with poor post-operative outcomes, including thrombus formation, delirium, and mortality. Systemic inflammatory markers, such as the systemic immune-inflammatory index (SII) and systemic inflammation response index (SIRI), have shown potential for predicting adverse outcomes in cancer and cardiovascular diseases. This meta-analysis evaluates the predictive value of SII and SIRI for complications following orthopedic surgeries, aiming to establish them as practical tools for risk stratification to assist the surgeons’ decision for optimal treatments.

METHODS: A systematic search was conducted in PubMed, Embase, and Web of Science through January 2025, adhering to PRISMA guidelines. Cohort studies reporting the relationship between pre-operative SII/SIRI and post-operative complications were included. Outcomes included thrombus formation, delirium, and mortality. Random-effects models were used for meta-analyses, and heterogeneity was assessed with I² statistics. Sensitivity analyses were performed to mitigate the heterogeneity.

RESULTS: Nineteen studies with 8,315 patients published up to January 2025 were included. High pre-operative SII was associated with post-operative delirium (standardized mean difference, 1.28; 95% confidence intervals, 0.25-2.32; I² = 96.5%; P = 0.015). Based on two studies, elevated pre-operative SIRI showed a trend toward higher delirium risk (pooled odds ratios, 3.07; 95% confidence intervals, 2.66-3.48; no heterogeneity; P < 0.001). Sensitivity analysis suggested a potential association, but statistical significance was not achieved.

CONCLUSION: SII and SIRI show promise as predictors for post-operative delirium but have limited evidence for thrombus formation or mortality. Future research should focus on prospective studies with standardized cut-offs to validate their clinical utility.

PMID:42444379 | DOI:10.3346/jkms.2026.41.e180

J Sports Sci. 2026 Jul 14:1-15. doi: 10.1080/02640414.2026.2702737. Online ahead of print.

ABSTRACT

Performing under time pressure is critical, yet limited research has examined how psychophysiological and affective factors influence temporal estimation in sport competition. This study investigated the influence of psychophysiological exertion, fatigue, and affect on time perception during a simulated biathlon competition. Thirty-two biathletes (14 men, 18 women; age M = 21.3, SD = 3.9 y) completed five laps of roller-skiing separated by four shooting rounds (prone-standing-prone-standing). Prospective Time Production (PTP) and Prospective Verbal Estimation (PVE) were assessed alongside heart rate, perceived exertion, fatigue, and affective valence. Participants produced shorter intervals than the PTP target duration (29 s) post-competition (p < .001, d = 0.85), indicating time was perceived to pass faster relative to chronometric time under cumulative psychophysiological load. PVE accuracy differed by shooting position (p < .001, η² = .22), with time in prone perceived shorter than standing. Within-participant analyses showed higher heart rate, exertion, fatigue, and negative affect predicted greater temporal distortions during roller-skiing and shooting. These findings indicate that time perception in biathlon is dynamically shaped by interactions between physiological strain, affect, and task-specific attentional demands. Applied implications highlight integrating time perception calibration and affect regulation into pressure-training to improve pacing, shooting rhythm, and performance consistency.

PMID:42444369 | DOI:10.1080/02640414.2026.2702737

BMC Med Educ. 2026 Jul 13. doi: 10.1186/s12909-026-09860-x. Online ahead of print.

ABSTRACT

AIM: This study aimed to examine the effects of a story-based example-developed by the author and centered on the commonly used active ingredient “fluoxetine” in child psychiatry clinical practice-on the academic performance of medical students, compared with traditional teaching methods. Additionally, the study sought to evaluate medical students’ views, perceptions, and attitudes toward this educational approach.

MATERIALS AND METHODS: A total of 54 volunteer third-year students from the Faculty of Medicine at Zonguldak Bülent Ecevit University in the 2025-2026 academic year were included in the study. Participants were allocated into two groups using a matched allocation procedure based on age and sex to ensure baseline comparability between groups. One group received training through the text titled “Worlds Colored By The Journey With Fluoxetine”, written by the researcher, in which the mechanism of action, side effects, indications, and contraindications of fluoxetine were presented in a narrative format. The other group was taught the same content using a traditional instructional method. The impact on students’ academic performance was assessed through pre-test and post-test evaluations.

RESULTS: There were no statistically significant differences between the theoretical and story-based education groups in terms of age, gender, income, place of residence, presence of comorbid medical conditions, or psychiatric history (p>0.05). In both groups, fluoxetine quiz scores increased significantly from pre-test to post-test (p < 0.001 and p < 0.001). However, the rate of improvement in the story-based group was found to be significantly higher than in the theoretical group (p = 0.004).

CONCLUSION: Story-based instruction was associated with greater improvement in fluoxetine knowledge scores compared with traditional instruction, and students generally reported positive attitudes toward this educational approach. These findings suggest that storytelling may be a useful complementary method for teaching psychopharmacological concepts in medical education. Further studies are needed to evaluate its broader applicability and long-term educational effects.

PMID:42443890 | DOI:10.1186/s12909-026-09860-x

BMC Med Genomics. 2026 Jul 14. doi: 10.1186/s12920-026-02427-1. Online ahead of print.

ABSTRACT

BACKGROUND: Non-communicable diseases (NCDs) account for over 70% of deaths worldwide, and metabolic risk factors such as obesity, dyslipidemia, and hypertension greatly increase the incidence of NCDs. Lifestyle changes have exacerbated these conditions in Pakistan; therefore, a better knowledge of their underlying mechanisms is required. This study investigates the relationship between fibroblast growth factor 1 (FGF1) blood levels, the rs152524 gene polymorphism, and metabolic risk factors.

METHOD: We conducted a hospital-based, cross-sectional study of 199 adults recruited from outpatient departments between September 2023 and June 2024. After written informed consent, demographic, medical, and biochemical data were collected. FGF1 rs152524 was genotyped using tetra-primer ARMS PCR and serum FGF1 levels were quantified by ELISA at the National Health Research Complex and Lahore College for Women University. Statistical analyses were performed using SPSS v.26; p < 0.05 was considered significant.

RESULTS: There were no significant differences in age or BMI between males and females. However, females demonstrated significantly higher median (IQR) of FGF1 levels [333 pg/ml (250-467) vs. 292 pg/ml (212-374); p = 0.011]. Fasting blood glucose, LDL-cholesterol and hypertension were the three main predictors of FGF1 levels, according to regression analysis. Within the participant population, 38.7% carried the AA genotype of rs152524. The allelic frequencies of reference A and alternative G alleles were 0.5955 and 0.4045 respectively. AA genotype was substantially associated with both hypertension (p < 0.001) and overweight/obesity (p = 0.002). The highest median (IQR) FGF1 blood levels 351(263-546) pg/ml were observed among AA genotype carriers. At the same time, a substantial rise in HDL-cholesterol 36(32-42) was found among carriers of the GG genotype.

CONCLUSION: This hospital-based study identified a potential association between the FGF1 rs152524 AA genotype and obesity and hypertension. The AA genotype was present in 38% of participants, with risk rising per ‘A’ allele, while the G allele appeared protective. These preliminary findings require validation in larger, population-based cohorts before clinical relevance can be assessed.

PMID:42443887 | DOI:10.1186/s12920-026-02427-1

BMC Vet Res. 2026 Jul 13. doi: 10.1186/s12917-026-05724-0. Online ahead of print.

ABSTRACT

BACKGROUND: Alopecia X (AX)-also referred to as hair cycle arrest or Alopecia X-like syndrome-is a non-inflammatory disorder common in Pomeranians, though it frequently affects other breeds such as Alaskan Malamutes, Chow Chows, Schipperkes, and Poodles. Historically known by various names including growth hormone-responsive alopecia, castration-responsive alopecia and congenital adrenal hyperplasia-like syndrome, this condition represents a complex follicular arrest of “plush-coated” breeds. The etiopathogenesis remains unclear, and reliable, minimally invasive diagnostic biomarkers are lacking. Insulin-like growth factor-1 (IGF-1) is essential for hair follicle cycling, and systemic deficiency has been hypothesized to contribute to canine alopecia. This study aimed to determine if serum IGF-1 concentrations differ between Pomeranian dogs with AX and healthy controls, and to evaluate the effect of neuter status on IGF-1 levels.

RESULTS: Thirty client-owned Pomeranian dogs (11 AX, 19 healthy controls) were enrolled. Serum IGF-1 concentrations were measured via a human competitive ELISA kit validated in-house for canine samples. Data were non-normally distributed and analyzed via Mann-Whitney U tests. No significant difference in serum IGF-1 was detected between alopecic (median: 62.0 ng/mL; range: 7.31-151) and healthy dogs (median: 51.8 ng/mL; range: 7.43-209.76) (U = 74, p = 0.200). Neuter status was significantly imbalanced between groups (63.6% of cases neutered vs. 10.5% of controls, p = 0.002). While neutered dogs exhibited numerically higher mean IGF-1 values than intact dogs within the alopecic group, this difference was not statistically significant (p = 0.412). No correlation was found between IGF-1 and age or body weight.

CONCLUSIONS: Serum IGF-1 concentrations are not reduced in Pomeranian dogs with Alopecia X compared to healthy controls. Routine measurement of serum IGF-1 is not recommended as a diagnostic test for AX. The role of gonadectomy in modulating the GH/IGF-1 axis in this breed requires further investigation with larger, balanced cohorts.

PMID:42443886 | DOI:10.1186/s12917-026-05724-0

BMC Oral Health. 2026 Jul 13. doi: 10.1186/s12903-026-09166-w. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of this prospective study was to investigate the prevalence of sella turcica bridging (STB) and to check whether sella can be considered as diagnostic marker for class II malocclusion. Secondarily, any possible association between STB and dental anomalies was evaluated.

METHODS: Panoramic and cephalometric radiographs taken for pre-orthodontic evaluation of 150 subjects (75 female and 75 males) in the age from 13 to 25 years were evaluated. The malocclusion and other dental anomalies were identified through clinical examination and radiographic confirmation of the diagnosis. The presence, extent of the bridging and dimensions of the sella turcica were evaluated on cephalometric radiographs. The link between STB and malocclusion was explored by chi square test and the student’s unpaired t test.

RESULTS: Of one hundred and fifty subjects, 47 displayed Sella turcica bridging (STB); the majority had partial bridging (Type II, n = 34). The sellar anatomical types with regard to bridging were not linked to gender, but significant differences were observed among different category of malocclusion. Between subjects with STB and existence of class II malocclusion, highly significant (P = 0.0001) association was recorded. A statistically significant correlation (P = 0.0001) was discovered between the prevalence of STB (both partial and total) and the existence of teeth crowding. STB did not vary regarding the impaction of maxillary canines.

CONCLUSIONS: The findings of the current study indicate a definite link between Sella turcica bridging and class II malocclusion and teeth crowding. Sella turcica bridging STB did not vary in subjects with impaction of the maxillary canine, and gender does not influence it.

PMID:42443882 | DOI:10.1186/s12903-026-09166-w

BMC Oral Health. 2026 Jul 13. doi: 10.1186/s12903-026-09136-2. Online ahead of print.

ABSTRACT

BACKGROUND: Pulpitis is one of the major causes of acute orofacial pain globally, yet public understanding of its early signs and the importance of timely intervention remains insufficient. Despite the growing use of social media platforms for sharing health-related information, no systematic evaluation has been conducted on the quality of pulpitis-related content available on these platforms. This study aims to assess the completeness, quality, reliability, understandability and actionability of pulpitis-related videos on Douyin, Xiaohongshu, and Bilibili, with particular attention to the role of dental practitioners in shaping video quality.

METHODS: Three hundred twenty-nine videos from Douyin, Xiaohongshu and Bilibili were included in the analysis. For each video, data were collected on duration, likes, comments, collections, number of days online, uploader’s follower count and video source. Content completeness was assessed using a self-developed checklist, while video quality was evaluated using the Global Quality Score (GQS), modified DISCERN (mDISCERN) and the Patient Education Materials Assessment Tool (PEMAT). Statistical analysis was performed using non-parametric tests, the Fisher’s exact test and Spearman’s correlation.

RESULTS: Among the 329 videos analyzed, Xiaohongshu consistently outperformed Bilibili across all evaluated metrics (p < 0.05), and surpassed Douyin in all measures except understandability (p < 0.05 except PEMAT-U). Bilibili had the longest median video duration (145 s) but received the lowest quality scores (p < 0.05 except mDISCERN compared with Douyin), whereas Douyin demonstrated the highest level of user engagement (Likes, Comments, Collections, p < 0.01) alongside the shortest median duration (40 s). Videos uploaded by dental practitioners achieved significantly higher reliability scores across all three platforms (p < 0.05). Within the practitioner-generated subgroup, Xiaohongshu ranked highest in content completeness, quality, reliability and actionability (p < 0.05). On Douyin, video duration correlated positively with all five quality metrics (ρ = 0.222-0.468, p < 0.05); on Xiaohongshu, significant positive correlations were found for four metrics (ρ = 0.204-0.388, p < 0.05).

CONCLUSIONS: Among the three platforms examined, Xiaohongshu demonstrated higher quality and content scores in the sampled recommended videos, suggesting it may be a more suitable source for pulpitis-related health information. Dental practitioners were found to consistently enhance video quality and reliability, and video duration was positively associated with content quality. These findings underscore the potential value of developing educational videos that are not only comprehensive but also understandable and actionable. Greater engagement by dental practitioners in creating such content may facilitate more effective dissemination of health information and could support public education on pulpitis.

PMID:42443880 | DOI:10.1186/s12903-026-09136-2