Tag: pubmed

Sci Rep. 2026 Apr 2. doi: 10.1038/s41598-026-46957-1. Online ahead of print.

ABSTRACT

Since its nationwide implementation in 2014, China’s standardized residency training system has aimed for homogeneous clinical competency outcomes. In obstetrics and gynecology, where minimally invasive techniques now dominate, this goal faces significant challenges. The high volume of laparoscopic procedures necessitates efficient training, yet traditional apprenticeship models within real-world clinical settings are often inconsistent, time-intensive, and carry inherent patient safety concerns. These factors can hinder the systematic and equitable skill acquisition required for reliable, standardized proficiency across all trainees. This study aimed to evaluate the efficacy of a structured laparoscopic simulator curriculum in improving basic surgical skills and promoting skill-level convergence among obstetrics and gynecology residents at different training stages. A prospective educational intervention was conducted at a national residency training base. Thirty residents (PGY-1, n = 10; PGY-2, n = 10; PGY-3, n = 10) undertook a standardized four-week curriculum on a box-trainer, covering four core skill modules. Performance was assessed weekly by task completion time and analyzed using repeated-measures ANOVA. Significant improvements in task efficiency were observed among PGY-1 and PGY-2 residents over the training period (p < 0.05), whereas PGY-3 residents maintained stable, proficient performance. By the end of the curriculum, no statistically significant differences in performance were observed among the three groups at Week 4. A structured simulator-based curriculum can effectively enhance basic laparoscopic skills among residents and may help achieve comparable skill outcomes across different training levels, indicating its potential as a useful adjunct to traditional clinical training.

PMID:41927862 | DOI:10.1038/s41598-026-46957-1

Sci Rep. 2026 Apr 2. doi: 10.1038/s41598-026-45702-y. Online ahead of print.

ABSTRACT

This study aimed to assess male barbers’ knowledge, attitudes, and practices (KAP) in Herat City, Afghanistan, regarding HBV/HCV transmission and prevention. A cross-sectional survey using a structured, localized KAP questionnaire based on validated tools was conducted from April to June 2025, involving 283 practicing male barbers in Herat. Descriptive statistics summarized binary scores, while associations between KAP and sociodemographic factors were analyzed using chi-square or Fisher’s exact tests, and logistic regression has also been applied (p < 0.05). Among 283 male barbers, good knowledge was higher among those aged 31-50 years (73.7%) compared with those aged 21-30 years (58.5%) and 18-20 years (48.5%) (p = 0.008), and among those with > 8 years of work experience (70.5%) compared with those with ≤ 8 years (45.8%) (p < 0.001). Good preventive practice was higher among barbers who had formal training (68.8%) compared with those without training (48.0%) (p < 0.001). In multivariable analysis, barbers with > 8 years of work experience had higher odds of good knowledge than those with ≤ 8 years (AOR = 2.74; 95% CI 1.40-5.35) (p = 0.003). For attitude, barbers with fair economic status had lower odds of a positive attitude compared with those with good economic status (AOR = 0.25; 95% CI 0.06-0.97) (p = 0.046), while those working > 12 h per day had higher odds of a positive attitude than those working ≤ 12 h (AOR = 1.98; 95% CI 1.11-3.51) (p = 0.020). For practice, barbers aged 21-30 years had lower odds of good practice than those aged 18-20 years (AOR = 0.32; 95% CI 0.16-0.66) (p = 0.002), barbers serving > 5 customers/day had lower odds of good practice than those serving ≤ 5 customers/day (AOR = 0.50; 95% CI 0.29-0.88) (p = 0.016), and barbers without formal training had lower odds of good practice than those with training (AOR = 0.50; 95% CI 0.29-0.89) (p = 0.017). Male barbers in Herat City demonstrate commendable hygiene practices but exhibit significant gaps in their knowledge and attitudes regarding HBV/HCV. These findings highlight the need for targeted education and vaccination programs, integrated into barber training, to improve preventive attitudes and reduce the risk of viral transmission. Public health interventions that incorporate barbers into hepatitis control strategies are essential for mitigating the spread of HBV/HCV in the community.

PMID:41927830 | DOI:10.1038/s41598-026-45702-y

J Imaging Inform Med. 2026 Apr 2. doi: 10.1007/s10278-026-01934-y. Online ahead of print.

ABSTRACT

This study proposes a Residual Conditional Variational Autoencoder model (ResCVAE-Harmonizer) that integrates batch information and clinical covariates for multi-center feature harmonization and systematically and comprehensively evaluates its harmonization performance. This study collected 806 cases from 9 different centers. After preprocessing, three types of features were extracted from PET and CT images: low-dimensional radiomic features, high-dimensional radiomic features, and deep learning features based on 3D-DenseNet-121. Each feature type was harmonized using ComBat, CovBat, and the proposed ResCVAE-Harmonizer. Both harmonized and original features were included in a comprehensive evaluation framework comprising variance homogeneity analysis, multi-center classification test, and downstream task effectiveness evaluation. The ResCVAE-Harmonizer significantly improved cross-center feature consistency. Levene’s test results showed a general reduction in – log₁₀(p) values after harmonization, with more pronounced improvements observed in low- and high-dimensional radiomic features. In center classification tasks, ResCVAE-harmonized features demonstrated greater stability across four classifiers and outperformed the original features. For the downstream survival prediction task, PET deep learning features processed by ResCVAE achieved the highest C-index (0.8920, 95% CI 0.8514-0.9325), surpassing those of the original features (0.8765), ComBat (0.8909), and CovBat (0.8455). Similarly, the C-index for CT deep features improved to 0.8296 (95% CI 0.7715-0.8877). Kaplan-Meier survival stratification based on ResCVAE features showed clearer separation between high- and low-risk groups, with statistically significant log-rank test results. While slightly inferior to ComBat in linear variance consistency, ResCVAE-Harmonizer effectively eliminated both linear and nonlinear batch effects and significantly enhanced survival prediction performance, demonstrating strong research potential.

PMID:41927822 | DOI:10.1007/s10278-026-01934-y

Sci Rep. 2026 Apr 2. doi: 10.1038/s41598-026-47272-5. Online ahead of print.

ABSTRACT

Although radiation hazards are prevalent in the operating room, making radiation protection critical for occupational safety, the current status of radiation-related knowledge and compliance with radiation safety practices remains suboptimal in many operating rooms. This study aimed to evaluate the current status and identify the influencing factors of radiation protection knowledge, safety practices, and compliance among operating room personnel. A cross-sectional survey was conducted among operating room personnel in hospitals at various levels in Hunan Province, China, using the Healthcare Professional Knowledge of Radiation Protection (HPKRP) scale was employed to assess radiation-related knowledge and a self-designed questionnaire to evaluate participants’ radiation protection compliance. Collected data were analyzed using SPSS 27.0, with statistical significance set at p < 0.05. A total of 381 participants were surveyed, including 349 operating room nurses (91.6%), 13 anesthesiologists (3.41%), and 19 surgeons (4.99%). Among these participants, 206 (54.07%) participants had received radiation-related training and only 27.8% routinely used at least one type of personal protective equipment (PPE) during potential radiation exposure. Multivariate regression analysis indicated tertiary hospitals, departments with standardized radiation protection management, and radiation-related training were independent factors associated with both superior radiation-related knowledge and better radiation protection compliance. Higher knowledge scores (OR = 2.366, p < 0.001) and physicians (OR = 4.845, p = 0.001) were independently associated with better radiation protection compliance. This study demonstrated that radiation relative knowledge and protection compliance need to be strengthened among physicians and operating room nurses. Standardized training and radiation protection management should be adopted according to specific needs of different hospitals and staff. These results offer meaningful evidences for the optimization of occupational radiation protection management and policy-making.

PMID:41927799 | DOI:10.1038/s41598-026-47272-5

Environ Monit Assess. 2026 Apr 3;198(4):402. doi: 10.1007/s10661-026-15194-4.

ABSTRACT

Urban expansion presents escalating challenges to ecological connectivity, while comprehensive research on long-term corridor conservation remains limited. This study integrates Omniscape with land-use scenario simulation to assess urbanization impacts on ecological networks in China’s Beijing-Tianjin-Hebei (BTH), Yangtze River Delta (YRD), and Pearl River Delta (PRD) regions. Key findings indicate: (1) By 2035, 41, 29, and 24 critical disruption points are projected for PRD, BTH, and YRD, respectively, requiring prioritized protection; (2) the expansion-loss ratio (corridor loss per urban growth unit) exhibits significant regional variation, with PRD (1.75) demonstrating ratios approximately 15% and 9% of those in YRD (11.56) and BTH (6.88); and (3) regionally tailored conservation strategies are essential due to distinct vulnerability patterns.

PMID:41927789 | DOI:10.1007/s10661-026-15194-4

AAPS J. 2026 Apr 3;28(3):86. doi: 10.1208/s12248-026-01215-0.

ABSTRACT

We present an analysis of statistical type I error and safe space calculations in virtual bioequivalence (VBE) assessments using a previously published physiologically-based pharmacokinetic (PBPK) model for 3-month long-acting paliperidone palmitate (PP) injectable suspensions. The type I error for the two-one-sided t test (TOST) applied to virtual parallel design bioequivalence (BE) trials was estimated through approximation of ‘simulated BE boundaries’. This was defined as the range of formulation critical quality attribute values (CQA, which in this paper pertains to mean drug particle radius), corresponding to simulated population-level geometric mean ratios (GMRs) for key pharmacokinetic (PK) metrics of between 0.8 to 1.25. Monte Carlo simulations were then used to combine these limits with power calculations to display estimates of the safe space for BE extending from a predefined particle radius. Type I error for detecting formulation difference in the model was controlled at 5% for PK endpoints. The simulated BE boundaries for 3-month PP LAI suspension mean particle radius extended over 5 µm, but acceptable statistical power (≥ 80%) was obtained only when the mean particle radius was within 1 µm of the reference formulation. For PBPK models, type I error calculations are notably more complex than power calculations because the simulated BE boundaries for CQAs need to be determined before the error assessment. This study appears to be the first to discuss the intersection of type I error control and safe space estimation in PBPK modeling for a BE assessment. Our case study shows the conditions that allow for a controlled type I error in a VBE assessment. Safe space is shown to depend on both formulation characteristics and the statistical power afforded by BE studies, offering valuable insights for formulation design considerations.

PMID:41927781 | DOI:10.1208/s12248-026-01215-0

Optom Vis Sci. 2026 Feb;103(2):e70030. doi: 10.1002/ovs2.70030.

ABSTRACT

PURPOSE: Uncorrected, moderate hyperopia has been associated with poor emergent literacy skills. However, the eye movements of preschoolers have not yet been used to determine how well young, hyperopic children attend to text and pictures during storybook reading compared to emmetropic children. In this study, the percentage of visual on-task time during storybook reading for 4- and 5-year-old children with uncorrected, moderate hyperopia was compared to that of their emmetropic peers. The relationship between percentage visual on-task time and near visual function was also assessed.

METHODS: Children received an eye exam with cycloplegic refraction to identify hyperopia (+3.00D to +6.00D with astigmatism ≤1.50D and anisometropia ≤1.00D) or emmetropia (hyperopia ≤1.0D; astigmatism, anisometropia, and myopia<|1.0|D) and to rule out amblyopia, strabismus, and ocular health concerns. Infrared video eye tracking systems were used to monitor eye position during storybook reading. Fixations were “on-task” if the child was looking at text or a picture in the story. Statistical comparisons of percentage visual on-task time between the emmetropic and hyperopic children were performed, and correlations between the percentage visual on-task time and the participants’ near visual skills (visual acuity, stereoacuity, accommodative lag) were determined.

RESULTS: Fifty-five of 72 eligible children provided analyzable data. The average percentage visual on-task time for hyperopic children was 20% less than that of emmetropic children (Mann-Whitney U test, p = 0.02). Further, for all children combined, the percentage visual on-task time was moderately correlated with accommodative lag (Spearman, r = -0.32, p = 0.02) while there was no significant correlation between percentage visual on-task time and near acuity or near stereoacuity (p > 0.05).

CONCLUSIONS: Moderately hyperopic, uncorrected 4- and 5-year-old children showed a significantly lower percentage of visual on-task time during shared storybook reading compared to their emmetropic peers. The percentage on-task time was moderately correlated with increased accommodative lag for the combined group of emmetropic and hyperopic children.

PMID:41926782 | DOI:10.1002/ovs2.70030

Obstet Gynecol. 2026 Apr 2. doi: 10.1097/AOG.0000000000006255. Online ahead of print.

ABSTRACT

OBJECTIVE: To describe trends in pregnancy-related death ratios from 2018 to 2024, assess the contribution of coronavirus disease 2019 (COVID-19) to these trends, and evaluate whether pregnancy-related death ratios have recovered to prepandemic levels.

METHODS: We conducted an observational study that used vital statistics data to calculate the annual pregnancy-related death ratio (the number of pregnancy-related deaths per 100,000 live births) for female individuals aged 15-49 years between 2018 and 2024. We compared the pregnancy-related death ratios across prepandemic (2018-2019) pandemic (2020-2022), and postpandemic (2023-2024) periods; to assess the contribution of COVID-19, we calculated the pregnancy-related death ratio including and excluding COVID-associated deaths (ie, those with ICD-10 U07.1 listed as a cause). Pregnancy-related deaths were identified using International Statistical Classification of Diseases, Tenth Revision codes (A34, O00-O99), and the total pregnancy-related death ratio was decomposed into the early pregnancy-related death ratio (deaths during pregnancy or within 42 days after pregnancy) and the late pregnancy-related death ratio (deaths 43-365 days postpartum). We conducted subgroup analyses by maternal age, race and ethnicity, or geographic region.

RESULTS: From 2018 to 2024, there were 8,298 pregnancy-related deaths (32.3/100,000 live births). From the prepandemic period to the pandemic period, the early pregnancy-related death ratio increased by 7.5 deaths per 100,000 live births (95% CI, 6.1-8.8) and the late pregnancy-related death ratio increased by 3.7 deaths per 100,000 live births (95% CI, 2.7-4.6). Most of this increase (76% for the early pregnancy-related death ratio, 50% for the late pregnancy-related death ratio) was COVID-associated deaths. By 2023-2024, the early pregnancy-related death ratio had returned to prepandemic levels, but the late pregnancy-related death ratio remained elevated (1.4 additional deaths/100,000 live births; 95% CI, 0.4-2.4). Most subgroups experienced an increase in early and late pregnancy-related death ratios during the pandemic, but recovery varied. Notably, both early and late pregnancy-related death ratios remained substantially elevated among non-Hispanic Black mothers in 2023-2024 compared with the prepandemic period (early pregnancy-related deaths increased by 7.0/100,000 live births [95% CI, 1.3-12.8]; late pregnancy-related deaths increased by 5.4 /100,000 live births [95% CI, 1.3-9.5]).

CONCLUSION: Pregnancy-related death ratios increased dramatically during the COVID-19 pandemic, and by 2023-2024, recovery differed by the timing of death relative to pregnancy and across sociodemographic subgroups. Additional efforts are needed to identify drivers of differential recovery from the COVID-19 pandemic and inform clinical and policy initiatives to reduce pregnancy-related deaths, improve maternal health, and promote health equity.

PMID:41926774 | DOI:10.1097/AOG.0000000000006255

Rheumatology (Oxford). 2026 Apr 1:keag156. doi: 10.1093/rheumatology/keag156. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess the effectiveness and safety of anakinra in crystal-related disease (CRD) flares, and to identify factors associated with treatment failure and risk of infection.

METHODS: We conducted a single-centre, retrospective, observational study including adult patients treated with anakinra for a CRD flare between January 2011 and July 2024. Patients were identified in a hospital clinical data warehouse using an electronic query. CRD was confirmed by the presence of crystals in synovial fluid or by characteristic radiological features. Clinical and biological data were collected through medical record review. Treatment effectiveness was assessed retrospectively based on the treating physician’s global clinical judgment documented in medical records. Treatment failure was defined as insufficient clinical response requiring treatment escalation or persistent symptoms. Adverse events, including infections, were collected up to one month after anakinra initiation. Factors associated with treatment failure and infection were explored using univariable and multivariable analyses.

RESULTS: A total of 292 patients were included. Effectiveness of anakinra was observed in 92.8% of patients after a median treatment duration of 3 days. In multivariate analysis, longer CRD duration (OR 1.11, 95% CI 1.03-1.19) and a history of diabetes (OR 4.00, 95% CI 1.25-14.29) were independently associated with treatment failure. Thirteen patients (4.5%) developed an infection within one month after anakinra initiation, with a median delay of 11 days. No variable was independently associated with infection risk.

CONCLUSION: This large real-life study supports the effectiveness and overall safety of anakinra in the management of acute CRD flares.

PMID:41926750 | DOI:10.1093/rheumatology/keag156

JMIR Mhealth Uhealth. 2026 Apr 2;14:e85948. doi: 10.2196/85948.

ABSTRACT

BACKGROUND: Over-the-counter (OTC) medicines are frequently used during pregnancy. As these medicines are often used without medical supervision, accessible and reliable safety information is essential. However, finding reliable and understandable information on the safety of these medicines during pregnancy is often experienced as difficult. Hence, there is a need for a new easily accessible electronic health (eHealth) tool that empowers women to actively seek information to support safer self-medication practices during pregnancy and breastfeeding.

OBJECTIVE: This study aimed to describe the development and dissemination process of a Dutch mobile app providing reliable safety information on OTC medicines during pregnancy and breastfeeding using a development and formative evaluation approach.

METHODS: The app was developed over a 2-year project comprising 5 phases, including preparation, development, preimplementation, implementation, and evaluation. Mixed-method strategies, including questionnaires, focus groups, and user feedback rounds, were applied to involve the target population in the development process. Medicine safety information in the app was based on the latest scientific evidence. First-year app-usage outcomes included app downloads, usage patterns, and information-seeking behavior.

RESULTS: Input from 253 potential users formed the foundation for the development of the MediMama app (Netherlands Pharmacovigilance Centre Lareb), with users expressing a need for clear, reliable, and easily accessible information on medication safety during pregnancy and breastfeeding. The app was launched on Mother’s Day 2024 and provides safety information on over 250 OTC medicines, including supplements and herbal remedies, across 27 medicine categories. Promotion occurred through multiple online and offline channels. During its first year, the MediMama app was downloaded 22,415 times, with an average of 370 unique daily users, indicating substantial user engagement. Information on paracetamol (acetaminophen) and nasal sprays was most frequently accessed, reflecting the need for information on commonly used OTC medicines among the target population.

CONCLUSIONS: One year after its launch, the MediMama app is considered a promising tool in maternity care, meeting the target population’s need for accessible OTC medicine safety information. The app aims to support informed decision-making, contributing to safer medication use during pregnancy and breastfeeding. Further research is required to evaluate the effectiveness of the implementation strategy, as well as the app’s impact on maternal medication use behaviors and health outcomes.

PMID:41926731 | DOI:10.2196/85948