Nutr Metab (Lond). 2026 Jan 13. doi: 10.1186/s12986-025-01073-1. Online ahead of print.
NO ABSTRACT
PMID:41530755 | DOI:10.1186/s12986-025-01073-1
Hum Resour Health. 2026 Jan 13. doi: 10.1186/s12960-026-01047-1. Online ahead of print.
ABSTRACT
BACKGROUND: In 2008, Kazakhstan introduced a structured ophthalmology residency program. Between 2008 and 2020, two parallel training pathways coexisted: a three-year residency program and short-term ophthalmology training courses lasting up to six months. After 2020, only the residency program remained in place. This study aims to examine the associations between these medical education reforms and the observed trends in the absolute numbers and per million population (PMP) rates of ophthalmologists in Kazakhstan from 1998 to 2022. Furthermore, it explores temporal patterns in cataract surgery performance by ophthalmologists across the country.
METHODS: Interrupted Time Series (ITS) analysis using ARIMA models was conducted to examine the associations between medical education reforms and the number and PMP rates of ophthalmologists in Kazakhstan, as well as their performance in conducting cataract surgeries.
RESULTS: Throughout the study period, the PMP rates of ophthalmologists ranged from 59.73 to 90.48, demonstrating an overall upward trend. The ITS model identified a statistically significant negative level change in both the number and PMP rates of rural ophthalmologists at the time of the residency program’s introduction in 2008, whereas no statistically significant association was observed for urban ophthalmologists. The discontinuation of short-term training courses exerted a minor, statistically insignificant negative effect on the numbers and PMP rates of ophthalmologists. The number of cataract surgeries performed varied between 9,550 and 19,018, corresponding to a cataract surgical rate ranging from 639.72 to 1,067.88, with marked regional disparities.
CONCLUSION: This evaluation provides exploratory evidence on how medical education reforms may be associated with temporal changes in the ophthalmology workforce and cataract surgery performance, and can inform future policy discussions on ophthalmology training and service provision in Kazakhstan.
PMID:41530750 | DOI:10.1186/s12960-026-01047-1
BMC Surg. 2026 Jan 13. doi: 10.1186/s12893-025-03453-z. Online ahead of print.
ABSTRACT
BACKGROUND: Postoperative complications (POC) following hepatic cystic echinococcosis (HCE) surgery remains a challenge. Frailty indices (FIs) as predictors of POC in this context has not been investigated. We aimed to evaluate the predictive value of three frailty assessment tools (mFI-11, FRAIL scale, and PRISMA-7 questionnaire), for POC in patients with HCE undergoing elective surgical treatment.
METHODS: Nested case-control study in a concurrent cohort. Consecutive patients who underwent elective open surgery for HCE between 2012 and 2020 with a minimum follow-up of 4 years were included. Cases were frail patients with mFI-11 ≥ 0.27, PRISMA-7 ≥ 3, or FRAIL ≥ 3. Cases and controls were matched in a 1:1 based on age, sex, cyst diameter, history of HCE surgery, ultrasonographic characteristics, and cyst location. Primary outcome was overall and severe POC. Sample size was based on overall POC of 28% for cases and 11% for controls, assuming 5% type I error and 80% statistical power. Descriptive and bivariate statistics were applied. Odds ratios (OR) and 95% confidence intervals were calculated, and predictive performance evaluated using area under the receiver operating characteristics curve (AUC), and its comparison applying DeLong test.
RESULTS: 70 cases and 70 controls were included. mFI-11 ≥ 0.27 and PRISMA-7 ≥ 3 were identified as prognostic factors for overall and severe POC (p < 0.001 and p = 0.02; and p = 0.02 and p = 0.03, respectively); and FRAIL as an independent factor for overall POC (p = 0.005). Logistic regression adjusting for potential confounding variables confirmed mFI-11 ≥ 0.27 as an independent prognostic factor for overall POC (OR 4.8; p = 0.0001; AUC: 0.762) and severe POC (OR 10.7; p = 0.022; AUC: 0.763).
CONCLUSION: The mFI-11 index showed the strongest predictive performance for both overall and severe POC in patients underwent HCE.
PMID:41530742 | DOI:10.1186/s12893-025-03453-z
BMC Complement Med Ther. 2026 Jan 13. doi: 10.1186/s12906-025-05223-z. Online ahead of print.
ABSTRACT
BACKGROUND: Tobacco dependence poses significant health and economic burdens globally, with over one billion smokers and eight million deaths annually. Current smoking cessation strategies, including pharmacotherapy and behavioral treatments, often have limited efficacy and potential side effects. Acupuncture, a potential alternative treatment, has shown promise in previous studies, but its mechanism and long-term effects on craving remain unclear.
METHODS/DESIGN: This two-center, randomized, controlled clinical trial will enroll 192 patients with moderate to severe tobacco dependence and randomly assign them to Acupuncture, sham-Acupuncture, or basic smoking cessation intervention groups in a 1:1:1 ratio. Blinding will be performed on participants in the Acupuncture, sham-Acupuncture groups and statistical analysts. The 12-week trial will involve 8 weeks of treatment and 4 weeks of follow-up. The primary outcome is abstinence rate at week 8. Secondary outcomes include assessment with the following instruments: craving levels via the Visual Analog Scale and Tobacco Craving Questionnaire, withdrawal symptoms via the Minnesota Withdrawal Scale, working memory via the Sternberg paradigm, and response inhibition ability via the Go/NoGo task. Adverse events will be recorded. The study will adhere to SPIRIT guidelines.
DISCUSSION: This trial will investigate the efficacy of acupuncture for tobacco dependence by including a sham control and examining long-term craving effects. Findings will contribute to understanding the potential of acupuncture as a safe and effective treatment option for tobacco dependence.
TRIAL REGISTRATION: This trial was registered on the International Traditional Medicine Clinical Trial Registry (Registration number: ITMCTR2024000817) on November 18, 2024.
PMID:41530741 | DOI:10.1186/s12906-025-05223-z
BMC Med Educ. 2026 Jan 14. doi: 10.1186/s12909-025-08509-5. Online ahead of print.
ABSTRACT
INTRODUCTION: Health disparities in West Texas disproportionately affect rural and underserved communities, contributing to limited healthcare access and adverse health outcomes. The 2nd Annual West Texas Health Disparities Symposium brought together over 100 healthcare professionals, researchers, and students to explore socioeconomic, geographic, and cultural factors driving these disparities. This study assesses the symposium’s impact on attendees’ knowledge and perceptions through pre- and post-symposium surveys.
METHODS: Electronic surveys were distributed before and after the 2024 symposium. Questions assessed familiarity with topics, including regional health disparities, policy impacts on healthcare practices, and intervention strategies. The data were analyzed via descriptive statistics and Wilcoxon rank-sum tests.
RESULTS: Among the 139 registrants, 56 completed the presurvey, and 36 completed the post-survey. The survey respondents were predominantly female (66.0%), White (61.0%), Asian (20.0%), and aged 18-24 years (34.0%). Most were healthcare professionals (48.5%) or students (42.4%). While 73.0% had previously attended a symposium, only 36.0% had prior experience with health disparity events. Primary motivations for attendance included education on health disparities (86.0%), new research (63.0%), and networking (57.0%). Post-symposium results revealed significant increases in familiarity with policy impacts on healthcare (p = 0.01), understanding policy change avenues (p ≤ 0.01), recognition of regional health disparities (p = 0.017), and ability to present relevant data (p ≤ 0.001). Additionally, participants reported improved ability to propose interventions (p ≤ 0.001). Nearly all respondents (94.0%) felt that the symposium met their expectations, and 90.0% would recommend it to others.
CONCLUSIONS: The symposium significantly enhanced participants’ understanding of regional health disparities while equipping them with practical strategies to address these challenges. The overwhelmingly positive feedback underscores the importance of targeted educational incentives in fostering understanding, shaping perceptions, and informing public health discussions, thereby reinforcing efforts to reduce healthcare disparities in West Texas.
PMID:41530733 | DOI:10.1186/s12909-025-08509-5
BMC Public Health. 2026 Jan 13. doi: 10.1186/s12889-026-26201-1. Online ahead of print.
ABSTRACT
BACKGROUND: Infectious disease surveillance is an essential component of public health for preventing and mitigating outbreaks. Systematically applying statistical methods for anomaly detection to surveillance data can expedite outbreak response through early warning. A commonly used approach is the usage of spatiotemporal scan statistics as implemented in SaTScan, a software that analyzes spatiotemporal data to identify clusters of events over space and time that deviate from expected values. Some health departments identify outbreaks and prioritize resources using SaTScan for early cluster detection for diseases such as salmonellosis, legionellosis, and COVID-19. However, as a standalone software, SaTScan v10.2.1 does not provide functionality to easily disseminate visual cluster results over time in a way that is tailored to epidemiologists’ needs for real-time disease surveillance.
RESULTS: We developed an open source dashboard that provides a customizable framework for displaying results and facilitating the use of SaTScan for public health surveillance. The California Clustering for Operational Real-time Visualization of Infectious Diseases (CalCORVID) dashboard is built using RShiny, is specifically designed for SaTScan outputs, and can be easily adapted to display any jurisdiction’s results. This dashboard features a map and corresponding results table, the option to view historical results, integration of the Social Vulnerability Index (SVI) to contextualize clusters, and interactive elements to enhance usability for epidemiologists.
CONCLUSIONS: We present CalCORVID as a complementary tool to native outputs of SaTScan v10.2.1, allowing users to visualize, customize, and distribute their results for specific public health use cases. Epidemiologists currently using SaTScan can adapt the provided code repository and dashboard template to display their own jurisdictions’ results, facilitating dissemination of cluster results for real-time, ongoing disease surveillance.
PMID:41530727 | DOI:10.1186/s12889-026-26201-1
BMC Pregnancy Childbirth. 2026 Jan 14. doi: 10.1186/s12884-025-08628-3. Online ahead of print.
ABSTRACT
BACKGROUND: Spontaneous abortion (SA) is a natural process of abortion that endangers public health, and early identification of its risk factors plays a significant role in prevention. This study employed Mendelian randomization to explore the influencing factors of SA, with the aim of informing early monitoring and intervention strategies.
METHODS: We performed a two-sample Mendelian randomization (MR) to evaluate the causal effects between 42 modifiable risk factors and intermediate phenotypes and spontaneous abortion. Single nucleotide polymorphisms associated with widely recognized confounders were removed based on current research and ensured sufficient F-statistics with the remaining SNPs. The primary statistical model was inverse-variance-weighted (IVW), and we performed sensitivity analyses for pleiotropy and heterogeneity. Outliers were detected and removed using MR-PRESSO. We found no statistical evidence of directional pleiotropy (based on MR-Egger intercepts and MR-PRESSO global tests), and traits showing heterogeneity were analyzed using the IVW random-effects model. Finally, to assess the robustness of the primary MR analysis findings, we employed an additional Genome-Wide Association Study (GWAS) dataset to validate the observed statistically significant results.
RESULTS: The results from the IVW model were reported primarily. Our analysis revealed that HLA-DR expression on monocytes (including the proportion of HLA-DR + + monocytes in leukocytes and HLA-DR on CD14 + monocytes) and the habit of cycling were positively corelated with an increased risk of SA (both with [OR] > 1 and p-adjust < 0.05). Conversely, the absolute count of CD14 + CD16- monocytes, age at first sexual intercourse, never smoking, and education level were negatively associated with SA (all with [OR] < 1 and p-adjust < 0.05). Following a validation analysis, our research has ultimately revealed statistically significant associations between SA and the following factors: age at first sexual intercourse and never smoking. Given dense LD across the extended MHC, these associations are best interpreted as locus-level (MHC) signals rather than HLA-DR-specific effects. We therefore avoid mechanistic attribution to HLA-DR per se.
CONCLUSIONS: The preliminary two-sample MR findings suggest immune signals (e.g., monocyte-related phenotypes) and highlight lifestyle correlates as potential priorities. Genetic instruments within the extended MHC region were associated with spontaneous abortion; however, given dense linkage disequilibrium across the locus, these signals are best interpreted as MHC-region associations rather than HLA-DR-specific effects. These results also require triangulation with complementary approaches-including polygenic risk score (PRS) analyses and prospective epidemiologic studies-before any causal interpretation or prevention guidance can be established.
PMID:41530719 | DOI:10.1186/s12884-025-08628-3
BMC Public Health. 2026 Jan 14. doi: 10.1186/s12889-025-26155-w. Online ahead of print.
ABSTRACT
INTRODUCTION: The rapid digitalisation of workplaces presents both challenges and opportunities for older workers. This scoping review examines how digital technologies impact social support for older workers, focusing on emotional, informational, and instrumental support within professional environments. While social support is critical for well-being and productivity in ageing workforces, the effects of digitalisation on social support dynamics remain insufficiently understood.
METHODS: Following Joanna Briggs Institute and PRISMA-ScR guidelines, a comprehensive search strategy was conducted across databases like ERIH, Web of Science, Scopus, and PubMed from anytime to 2023 to identify peer-reviewed studies involving digital technologies used by older workers, generally considered as workers aged 50 years or older. Covidence software facilitated the screening of over 5000 scientific papers, study selection, and data extraction, and the Mixed Methods Appraisal Tool (MMAT) assessed quality. Findings were synthesized through descriptive statistics and narrative analysis.
RESULTS: Forty-three studies met inclusion criteria. Digital technologies were found to enhance various forms of social support: remote work tools, messaging apps, and telemedicine platforms facilitated emotional connection and informational exchange. However, digitalisation also introduced barriers, some older workers reported isolation, reduced informal contact, and technostress, underscoring disparities in digital literacy and adaptation.
DISCUSSION: Digitalisation exerts a dual impact on social support for older workers: it can strengthen professional connectedness yet also heighten vulnerability to stress and exclusion. Targeted digital literacy initiatives and sustained managerial engagement are crucial to ensure that technology enhances, rather than undermines, well-being and productivity among ageing employees.
PMID:41530715 | DOI:10.1186/s12889-025-26155-w
BMC Gastroenterol. 2026 Jan 13. doi: 10.1186/s12876-026-04603-0. Online ahead of print.
ABSTRACT
BACKGROUND: Developing inflammatory bowel disease (IBD) affects platelet counts (PLT), which are involved in blood coagulation. However, the predictive or diagnostic utility of platelet characteristics in assessing IBD disease activity of inflammatory bowel disease. We conducted thisremains unknown. This meta-analysis was conducted to quantitatively evaluate changes in platelet parameters during the active phase of IBD using a large sample size.
METHODS: PubMed, Embase, Wiley Online Library, Web of Science, and Google Scholar databases were searched to identify studies. Platelet parameter data were collected, pooled, examined, and assessed from studies that met the inclusion criteria and were evaluated for risk of bias using the Newcastle Ottawa Scale. The enzyme-linked immunosorbent assay was used to determine the difference in PF4 levels between normal and DSS-induced UC mice.
RESULTS: A total of 18 articles were included in this study, with 2,160 patients, including 1,107 patients with Crohn’s disease (CD) and 1,053 with ulcerative colitis (UC). There were 410 active and 697 inactive patients with CD, while 443 active and 610 inactive patients with UC. Of the 18 studies, 1 was retrospective, 2 were cross-sectional, and 15 were prospective cohort studies. Data on platelet count (PLT), the primary outcome measure of this study, were given in 15 studies, whereas mean platelet volume (MPV), fibrinogen (FIB), and PF4 were secondary outcomes. The pooling of effect size for CD patients in active and inactive phases was as follows: (PLT, MD = 55.51, 95% confidence interval [CI] (35.87, 67.16), Z = 6.45, P < 0.0001), (MPV, MD = – 0.42, 95% CI (-0.84, 0.01), Z = – 1.92, P = 0.05), (PF4, MD = 12.27, 95% CI (3.78, 20.76), Z = 2.83, P = 0.0046), (FIB, MD = 104.09, 95% CI (38.43, 169.75), Z = 3.11, P = 0.002). The pooled effect sizes of patients with UC in active and inactive phases were as follows: (PLT, MD = 58.48, 95% CI (38.71, 78.26), Z = 5.80, P < 0.0001), (MPV, MD = – 0.70, 95% CI (-0.93, – 0.47), Z = – 5.99, P < 0.0001), (PF4, MD = 3.03, 95% CI (-4.03, 10.10), Z = 0.84, P = 0.40), (FIB, MD = 109.73, 95% CI (45.64, 173.81), Z = 3.36, P = 0.001). PF4 levels were markedly elevated in DSS-induced UC mice. The heterogeneity sources analysis revealed that “Study type” was a statistically significant source of heterogeneity. Egger’s test identified publication bias (t = 0.74, P = 0.47), indicating no significant asymmetry in the funnel plot.
CONCLUSIONS: Platelet parameters varied at different stages of IBD disease activity. Active patients had significantly higher PLT, PF4, and FIB levels and significantly lower MPV levels than inactive patients. Continuous monitoring of platelet parameters is an effective strategy to learn about the activity of IBD disease and an efficient means of reducing negative outcomes.
PMID:41530700 | DOI:10.1186/s12876-026-04603-0
BMC Med Educ. 2026 Jan 14. doi: 10.1186/s12909-026-08575-3. Online ahead of print.
ABSTRACT
BACKGROUND: Service user involvement (SUI) in healthcare education is reported to foster more patient-centred practitioners. However, there is limited guidance as to how authentic SUI can be embedded within educational practice. This study aimed to describe current practices and explore how SUI may be better embedded in the delivery of healthcare education.
METHODS: A convergent mixed-methods study was undertaken in a higher-level healthcare education department in Ireland. Data were collected via an online survey completed by educators (n = 27) and semi-structured interviews with service users (n = 6). Survey data were analysed using descriptive statistics and content analysis. Thematic analysis of interview transcriptions was undertaken.
RESULTS: Most educators indicated that SUI was limited to ‘one-off’ interactions or case-based learning and that there was ‘probably’ (75%) or ‘definitely’ (9%) not enough SUI. Both staff and service users reinforced the value of SUI in healthcare education, yet the potential of the role of the service users was not fully realised. Service users described the benefits of their involvement in humanising patients beyond the context of their condition/illness. Several challenges were highlighted, including limited resources, lack of empowerment and insufficient knowledge of the scope of SUI.
CONCLUSIONS: The need to educate all stakeholders about the potential for SUI beyond one-off contributions was highlighted. Additionally, engaged leadership is needed to facilitate the contextual integration of processes and procedures to embed the role of service users in higher education. Further investment is needed to advance SUI, which may require additional encouragement from funders, policy makers and regulators.
PMID:41530697 | DOI:10.1186/s12909-026-08575-3