Tag: pubmed

BMC Vet Res. 2026 Jun 25. doi: 10.1186/s12917-026-05647-w. Online ahead of print.

ABSTRACT

BACKGROUND: Injection-site complications are a poorly recognised problem in small ruminant production in Ghana. The improper injection can lead to tissue damage, abscesses, fibrosis, drug residues, lower meat quality and carcass condemnation, which can cause economic and public health issues. Veterinarians are legally qualified to give injections, but in practice, para-veterinarians and animal herders often do so, as they are in close contact with livestock and are often responsible for immediate animal care. The aim of this study was to evaluate the knowledge, attitudes and practices of animal health providers on injection-site complications in Kumasi, Ghana.

METHODS: A comparative cross-sectional study was carried out among 230 respondents including veterinarians (59), para-veterinarians (18), animal herders (143) and meat handlers (10) with a structured questionnaire. Descriptive statistics and Chi-square tests were used to collect and analyse data on knowledge, attitudes, anatomical injection-site preferences and injection practices. Retrospective abattoir records from January to August 2025 were also reviewed to determine the prevalence and distribution of injection-site lesions in slaughtered small ruminants.

RESULTS: Occupation, age, gender, years of experience, and formal training were significantly associated with the level of knowledge (p < 0.05). Veterinarians had the highest awareness of injection-site complications and correct anatomical injection sites, whereas animal herders had lower awareness, especially about tissue necrosis, contamination-related infections, and improper drug absorption. The neck area was the most common site for intramuscular injection by veterinarians, while the thigh and gluteal muscles were the most common sites for para-veterinarians and animal herders. A total of 100 injection-site lesions were found in 43,483 slaughtered animals during abattoir inspection, with lesions mainly located in the thigh area. There was a significant association between formal training and positive attitudes with good injection practices (p < 0.05).

CONCLUSION: There were significant differences in knowledge and practices about injection-site complications among animal health providers in Kumasi. Injection administration by para-veterinarians and herders, and inappropriate injection-site selection, may be factors in the lesions seen during meat inspection. Injection safety, meat quality and animal welfare can be enhanced through targeted training and inclusive veterinary extension programs that engage all livestock handlers.

PMID:42351133 | DOI:10.1186/s12917-026-05647-w

BMC Med Educ. 2026 Jun 26. doi: 10.1186/s12909-026-09779-3. Online ahead of print.

ABSTRACT

BACKGROUND: Measles is a highly contagious infectious disease. The importance of vaccinating healthcare workers (HCW) and medical students as future HCW is underlined by the numerous measles outbreaks in health institutions. We aimed to assess the factors associated with complete vaccination, and measles serological status in relation to vaccination history among medical students in Catalonia (Spain).

METHODS: A cross-sectional study was conducted among medical students attending four university teaching-units during the 2023-2024 and 2024-2025 academic years. Medical students completed a questionnaire and provided blood samples for measles IgG testing. Associations between positive serology, vaccination status, and independent variables (age, sex, country of birth, degree year, future speciality, vaccination attitudes, and measles vaccination history) were assessed using the odds ratio (OR) and 95% confidence interval (CI).

RESULTS: Of the 255 participants, 79.2% were female, 92.5% were aged ≤ 24 years and 94.9% had received a complete schedule of two doses of measles vaccine. A complete vaccination schedule was associated with being a 5th-year student (aOR 5.26; 95% CI 1.43-20.48). Serological results were positive in 200 students (78.7%), and associated with none of the independent variables. Positive serology was observed in 79.3% and 58.3% of Spanish-born and non-Spanish-born students, respectively (aOR 0.38; 95%CI 0.12-1.27), but the difference was not statistically significant.

CONCLUSIONS: A high proportion of medical students in our sample had received two doses of measles vaccine. In line with public health recommendations, medical students as future HCW should be required to provide documented proof of two doses of measles-containing vaccine prior to starting clinical training.

PMID:42351131 | DOI:10.1186/s12909-026-09779-3

BMC Oral Health. 2026 Jun 26. doi: 10.1186/s12903-026-08896-1. Online ahead of print.

ABSTRACT

BACKGROUND: This prospective CBCT case series evaluated the pattern of maxillary molar movement during sequential distalization with clear aligners and vertical attachments, without adjunctive Class II elastics or skeletal anchorage, and assessed associated orthodontically induced inflammatory root resorption.

METHODOLOGY: Ten maxillary quadrants from seven adult patients with Class II molar relationships were included. All patients were treated using a standardized sequential molar distalization protocol with clear aligners. CBCT scans were obtained at baseline (T0) and immediately after completion of molar distalization (T1). Linear crown and root positional changes, as well as molar root length changes, were assessed using three-dimensional CBCT superimposition. Descriptive statistics and paired t-tests were used, with significance set at P < 0.05.

RESULTS: The maxillary first and second molars demonstrated significant distal displacement at the mesiobuccal cusp tips: 1.24 ± 0.64 mm and 1.02 ± 0.82 mm, respectively. Root apex displacement was limited, suggesting crown-dominant distal movement rather than true bodily distalization. The maxillary central incisors showed significant labial incisal-edge displacement of 1.93 ± 1.27 mm, while root apex position remained stable, indicating partial anterior anchorage loss under the tested protocol. Small but statistically significant reductions in molar root length were detected, ranging from 0.19 ± 0.21 mm to 0.47 ± 0.68 mm.

CONCLUSIONS: Within the limitations of this exploratory prospective case series, sequential maxillary molar distalization with clear aligners and vertical attachments produced modest crown-dominant distal molar movement. Mild anterior anchorage loss was observed under a protocol without adjunctive elastics or skeletal anchorage. Molar root length reductions were small and remained below 1 mm. Larger controlled studies incorporating planned vs. achieved movement analysis are required.

PMID:42351123 | DOI:10.1186/s12903-026-08896-1

J Neuroeng Rehabil. 2026 Jun 25. doi: 10.1186/s12984-026-01952-5. Online ahead of print.

ABSTRACT

BACKGROUND: Transcutaneous auricular vagus nerve stimulation (taVNS) paired with task-specific training has shown promise for improving upper-limb motor recovery after stroke but its effects on gait and balance remain unclear. This study evaluated the feasibility and safety of taVNS paired with task-specific training and explored preliminary effects on walking and balance outcomes in adults with chronic stroke.

METHODS: A double-blinded, sham-controlled trial was conducted to evaluate active versus sham taVNS paired with task-specific training (15 one-hour sessions over six weeks). Feasibility metrics included recruitment, participant experience, adverse events (AEs), and blinding effectiveness. Clinical outcomes (walking speed, endurance, gait parameters, and balance) were assessed at baseline, post-intervention, and ≥ 30 days post-intervention, supplemented by qualitative interviews.

RESULTS: Twenty-five adults with chronic stroke completed this study (18 males, mean age 64.99 ± 13.45 years; 41.80 ± 38.00 months post-stroke, 14 received active taVNS). Active taVNS was considered feasible and safe, with a 93% consent rate; 96% of participants found the intervention useful/helpful, and 100% found the stimulation acceptable. There were no serious AEs, with 16% of participants reporting mild side effects. Both groups improved across clinical outcomes. No statistically significant between-group differences were observed. Between-group effect sizes were small for gait, balance, disability, and self-efficacy, and small-to-moderate for walking endurance; however, confidence intervals crossed zero for all outcomes.

CONCLUSION: Active taVNS paired with task-specific training was feasible and well tolerated in chronic stroke. No definitive between-group effects were detected. Observed effect sizes should inform the design and sample size calculations of future adequately powered trials using optimised taVNS protocols.

PMID:42351122 | DOI:10.1186/s12984-026-01952-5

BMC Oral Health. 2026 Jun 26. doi: 10.1186/s12903-026-09053-4. Online ahead of print.

ABSTRACT

BACKGROUND: Postoperative pain and discomfort following tooth extraction are common complications that may negatively affect patients’ quality of life. The potential association between pre-existing sleep disturbances and postoperative discomfort remains insufficiently explored.

OBJECTIVE: This study aimed to investigate the association between pre-existing sleep disturbances and postoperative pain intensity, emotional impact, and limitations in daily activities in patients undergoing routine tooth extraction.

MATERIALS AND METHODS: This retrospective observational cohort study included 111 adult patients (18-65 years) who underwent tooth extraction at Hacettepe University. Preoperative sleep quality was assessed using the Jenkins Sleep Scale (JSS). Participants were classified into two groups: Group A (patients with sleep disturbances; JSS ≥ 12, n = 48) and Group B (patients without sleep disturbances; JSS < 12, n = 63). Postoperative outcomes were evaluated on postoperative day 1 using the American Pain Society Patient Outcomes Questionnaire-Revised (APS-POQ-R). The null hypothesis stated that there would be no difference in postoperative discomfort between the two groups. Statistical analyses included the Mann-Whitney U test and Chi-square test.

RESULTS: Patients with pre-existing sleep disturbances (Group A) demonstrated significantly higher pain intensity scores (p < 0.001), greater emotional impact (p = 0.030), and increased limitations in daily activities (p = 0.002) compared with Group B. Satisfaction of pain management was significantly lower in Group A (p = 0.016). No statistically significant differences were observed between groups regarding nausea, numbness, itching, or dizziness (p > 0.05).

CONCLUSION: Pre-existing sleep disturbances were significantly associated with increased postoperative discomfort and reduced satisfaction following tooth extraction. The null hypothesis was rejected. However, given the observational design and the lack of predictive analysis, these results should be interpreted cautiously, and further prospective studies are needed before clinical application can be recommended.

PMID:42351121 | DOI:10.1186/s12903-026-09053-4

Int J Equity Health. 2026 Jun 25. doi: 10.1186/s12939-026-02908-w. Online ahead of print.

ABSTRACT

BACKGROUND: Early motherhood remains a major public health and equity challenge in low- and middle-income countries, especially in Latin America. While poverty, education, gender norms, and barriers to sexual and reproductive health are well-established determinants, how household income translates into (or fails to translate into) delayed childbearing remains insufficiently understood-particularly in highly unequal settings marked by informality and fragmented social protection.

OBJECTIVE: To examine the association between household income and early motherhood in Mexico, and to disentangle direct and indirect socioeconomic pathways linking income to early childbearing.

METHODS: We conducted a population-based, multi-method analysis using harmonised municipal microdata from the 2000, 2010, and 2020 Mexican Population and Housing Censuses (n = 3.05 million women aged 12-24 years, representing 30.6 million individuals). Total household income was imputed using Quantile Random Forests trained on nationally representative income-expenditure surveys. Our analytical strategy combined: (1) machine learning models to identify key correlates and non-linear individual-level patterns of early motherhood; (2) Bayesian spatial models (INLA) to quantify subnational clustering and contextual heterogeneity; and (3) dynamic structural equation modelling to assess direct and lagged relationships among income, schooling-related indicators, union formation, and early motherhood outcomes.

RESULTS: Early motherhood prevalence declined modestly from 21.46% (2000) to 19.31% (2020) and remained concentrated in socioeconomically disadvantaged households. In individual-level models, marital status, age, household structure, and dependency ratio were the dominant correlates; income ranked eighth in feature importance. Partial dependence plots indicated a non-linear inverse L-shaped association: predicted risk increased up to approximately Int$ 1,760 (2018 PPP) per adult equivalent, then plateaued and declined slightly. Parity-specific models showed that income’s predictive relevance weakened with higher parity, with U-shaped patterns at the lowest income levels for second and ≥third births. Municipal analyses revealed persistent spatial clustering after adjustment for key predictors, and residual “place” effects consistent with unmeasured contextual constraints shaping early motherhood. In dynamic models, the direct income-early motherhood path was not statistically significant. Overall patterns were consistent with predominantly indirect linkages operating through schooling- and union-related indicators and reinforcing disadvantage dynamics at the municipal level.

CONCLUSIONS: In Mexico, early motherhood remains strongly shaped by intersecting social and territorial inequalities. Income gradients are modest and appear to operate mainly through schooling lag and union-formation pathways rather than as an isolated driver. Equity-oriented strategies are likely to be most effective when they integrate school retention, prevention of early unions, and youth-friendly sexual and reproductive health services, prioritising municipalities with persistently elevated risk.

PMID:42351120 | DOI:10.1186/s12939-026-02908-w

BMC Womens Health. 2026 Jun 25. doi: 10.1186/s12905-026-04622-9. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the risk factors associated with pathological progression of cervical lesions, specifically focusing on high-risk human papillomavirus (HR-HPV) infection, ThinPrep Cytologic Test (TCT), and PAX1/JAM3 gene methylation in a high-risk colposcopy-referred cohort.

METHODS: A total of 409 patients who underwent colposcopy-directed biopsy at the First Hospital of Hebei Medical University between January, 2023 and April, 2025 due to abnormal TCT results, HR-HPV infection, or positive PAX1/JAM3 gene methylation were analyzed. The sensitivities of different methods were compared, and unordered multivariate logistic regression was used to analyze the risk factors for high-grade cervical lesions and pathological progression.

RESULTS: Univariate analysis demonstrated that age, gravidity, age at first sexual intercourse, number of sexual partners, menopausal status, HR-HPV infection, TCT results, and PAX1/JAM3 methylation were significantly associated with pathological grade (all P < 0.05). In the multinomial regression analysis, compared to the inflammation group, both other high-risk HPV (OR = 3.930) and very-high-risk (16/18) HPV infections (OR = 3.725), as well as non-NILM TCT (OR = 2.435), were significantly associated with an increased risk of LSIL. For the progression to HSIL, very-high-risk HPV (OR = 6.801), non-NILM TCT (OR = 2.399), positive PAX1 methylation (OR = 4.145), and positive JAM3 methylation (OR = 8.215) were identified as strong independent risk factors.

CONCLUSION: In a high-risk colposcopy-referred cohort, HR-HPV infection, non-NILM TCT results, and positive PAX1/JAM3 gene methylation are independently associated with the presence of high-grade cervical lesions. These biomarkers have the potential to enhance clinical risk stratification and inform decision-making in cervical cancer screening. However, their clinical utility and cost-effectiveness need to be further evaluated through larger, prospective studies to validate their role in routine clinical practice.

PMID:42351112 | DOI:10.1186/s12905-026-04622-9

J Magn Reson Imaging. 2026 Jun 25. doi: 10.1002/jmri.70396. Online ahead of print.

ABSTRACT

BACKGROUND: Alterations in periarticular lipid composition are implicated in musculoskeletal diseases, yet short-term reliability of MRI-based triglyceride composition mapping in the knee is not fully established.

PURPOSE: To evaluate 1-week repeatability of proton-density fat fraction (PDFF) and triglyceride fatty-acid composition-saturated (SFA), monounsaturated (MUFA), and polyunsaturated (PUFA)-in periarticular knee tissues.

STUDY TYPE: Prospective.

POPULATION: Ten healthy adults (5 female, 5 male; age 32 ± 8 years; BMI 23.5 ± 2.4 kg/m²).

FIELD STRENGTH/SEQUENCE: 3T; 12-echo 3D spoiled gradient-echo acquisition for chemical shift-encoded fat quantification and a proton density-weighted SPACE sequence for segmentation (0.6 mm isotropic).

ASSESSMENT: Participants underwent repeated MRI 1 week apart. Femoral and tibial bone marrow, patella, Hoffa’s fat pad, prefemoral fat pad, quadriceps fat pad, posterior fat pad, and subcutaneous adipose tissue were segmented and rigidly aligned. Voxelwise spectral fitting was used to estimate PDFF and fatty acid composition, including SFA, MUFA, and PUFA components. Repeatability metrics included bias, within-subject standard deviation (wSD), within-subject coefficient of variation (wCV%), coefficient of repeatability, and intraclass correlation coefficient (ICC).

STATISTICAL TESTS: Paired t-tests assessed systematic differences (α = 0.05); ICCs used a two-way random-effects, absolute-agreement model (ICC(2,1)).

RESULTS: PDFF showed lowest variability across all regions (wCV: 1.5%-5.9%; ICC: 0.33-0.96). SFA demonstrated similar stability (wCV: 2.4%-12.6%; ICC: 0.19-0.87). MUFA exhibited anatomy-dependent reliability (wCV: 4.1%-21.1%; ICC: 0.17-0.97), with highest repeatability in subcutaneous adipose tissue (ICC: 0.97) and Hoffa’s fat pad (ICC: 0.85). PUFA displayed the greatest variability (wCV: 3.6%-52.8%; ICC: 0.10-0.94), with the greatest instability in periarticular fat pads. No paired comparisons were significant (all p > 0.05; range p = 0.14-0.98). Regional ordering remained consistent across sessions.

DATA CONCLUSION: A 12-echo chemical shift-encoded MRI protocol provides repeatable PDFF and SFA measurements over 1 week. MUFA reliability varies by tissue, while PUFA remains least stable.

EVIDENCE LEVEL: 2 (Prospective cohort).

TECHNICAL EFFICACY STAGE: 2 (Reproducibility/feasibility evaluation).

PMID:42348313 | DOI:10.1002/jmri.70396

Brain Behav. 2026 Jun;16(6):e71560. doi: 10.1002/brb3.71560.

ABSTRACT

BACKGROUND: Anti-CGRP antibodies are effective and safe in real-world migraine management, but guidelines recommend discontinuation after 12-18 months due to limited long-term data and remaining uncertainties regarding optimal treatment duration and sustained safety, highlighting the need for large-scale long-term real-world evidence. This study evaluated their safety and effectiveness in patients treated for ≥2 years.

METHODS: This multicenter retrospective study included patients from 13 headache units who received the same anti-CGRP antibody for ≥24 months, excluding discontinuation periods. Baseline characteristics, monthly headache days (MHD), monthly migraine days (MMD), and adverse events (AEs) were recorded at baseline, 6 months, 1, 2, 3, and 4 years. Descriptive statistics were used to summarize clinical characteristics, and appropriate parametric or non-parametric tests were applied for group comparisons. Multivariate analyses were performed to explore associations between baseline variables and long-term treatment response.

RESULTS: A total of 454 patients (91% female, mean age 48) were analyzed, with follow-up at 2 years (n = 454), 3 years (n = 135), and 4 years (n = 17). Treatments included erenumab (39%), galcanezumab (34%), and fremanezumab (27%). Fifty-seven percent maintained continuous therapy, while 43% restarted after discontinuation. Sustained reductions in MHD and MMD were observed at 2, 3, and 4 years (MHD from 20 to 6, 6, 5/MMD from 14 to 4, 4, and 2). Medication overuse decreased from 78% to 13%, 20%, and 18%. Loss of effectiveness occurred in 4.2% after 2 years. AEs appeared in <20%, mostly mild (>80%), leading to discontinuation in 0.4%. Multivariate analysis showed that shorter disease duration prior to anti-CGRP initiation, earlier anti-CGRP initiation, and greater MHD/MMD reduction at 6 months were associated with better long-term outcomes.

CONCLUSIONS: Anti-CGRP mAbs demonstrate sustained long-term safety and effectiveness, with consistent reduction in headache and migraine days and lower medication overuse. Early initiation and greater initial improvement predict better long-term outcomes. Findings support extending therapy beyond 12-18 months, supporting optimization of clinical protocols.

PMID:42348309 | DOI:10.1002/brb3.71560

Stat Med. 2026 Jul;45(15-17):e70650. doi: 10.1002/sim.70650.

ABSTRACT

Comparing future antibiotic resistance levels resulting from different antibiotic treatments is challenging because some patients may survive only under one of the antibiotic treatments. We embed this problem within a semi-competing risks approach to study the causal effect on resistant infection, treated as a nonterminal event time. We argue that existing principal stratification estimands for such problems exclude patients for whom a causal effect is well-defined and is of clinical interest. Therefore, we present a new principal stratum, the infected-or-survivors ( $ios$ ). The $ios$ is the subpopulation of patients who would have survived or been infected under both antibiotic treatments. This subpopulation is more inclusive than previously defined subpopulations. We target the causal effect among these patients, which we term the feasible-infection causal effect (FICE). We develop large-sample bounds under novel assumptions, and discuss the plausibility of these assumptions in our application. As an alternative, we derive FICE identification using two illness-death models with a bivariate frailty random variable. These two models are connected by a cross-world correlation parameter. Estimation is performed by an expectation-maximization algorithm followed by a Monte Carlo procedure. We apply our methods to detailed clinical data obtained from a hospital setting.

PMID:42348288 | DOI:10.1002/sim.70650