Tag: pubmed

Traffic Inj Prev. 2026 Mar 11:1-7. doi: 10.1080/15389588.2026.2628947. Online ahead of print.

ABSTRACT

OBJECTIVES: Road traffic injuries (RTIs) are a major cause of morbidity and mortality among children and adolescents in India. Despite legislative mandates requiring helmet use for all motorized two-wheeler riders aged 4 years and older, adherence remains poor, particularly among children. This study aimed to assess the prevalence and patterns of helmet use among parents and children commuting to school on motorized two-wheelers through direct observation.

METHODS: A cross-sectional observational study was conducted in October 2024 at 4 schools located on roads of differing traffic densities in southern Bangalore. Observations were made during morning drop-off hours recording helmet use among parents and their accompanying children using an online tally counter. Helmet use was categorized as proper helmet, cap helmet, or no helmet. Statistical analysis included chi-square tests for differences between parents and children and across schools, with odds ratios and 95% confidence intervals (CIs) calculated.

RESULTS: A total of 785 parent riders and 966 child pillion riders were observed. Proper helmet use was recorded in 42.0% of parents and only 4.5% of children, while 33.3% of parents and 92.7% of children did not wear any helmet. No child was observed wearing a helmet when their parent did not. Children were 25.3 times less likely to wear a helmet than their parents (95% CI: 19.05-33.6). Significant inter-school variation was observed (p < 0.001), but differences were primarily in the distribution of proper versus cap helmets rather than overall helmet use.

CONCLUSIONS: Helmet use among child pillion riders in Bangalore remains alarmingly low despite legal requirements. The study highlights a large gap between parent and child compliance, reflecting poor awareness, lack of enforcement, and limited availability of child-sized helmets. Strengthening enforcement, improving access to child helmets, and implementing school-based education and parent awareness programs are essential to enhance compliance and reduce preventable head injuries among children in India.

PMID:41811303 | DOI:10.1080/15389588.2026.2628947

Health Promot Chronic Dis Prev Can. 2026 Mar;46(3):92-103. doi: 10.24095/hpcdp.46.3.03.

ABSTRACT

INTRODUCTION: Few studies have analyzed the impact of public investments in indoor and outdoor recreational spaces, and even fewer have assessed this impact longitudinally. This hinders informed decision-making about returns on investments made with limited public budgets. We assessed the impact of a 2008 municipal plan to revitalize existing urban and rural public indoor facilities and outdoor spaces by evaluating changes in usage levels before and after implementation of Phase 1 (2009-2013) of the revitalization plan.

METHODS: A quasi-experimental study involving a telephone survey of 750 participants was conducted before and after Phase 1. A region with similar demographics and public recreational indoor and outdoor infrastructure was used for comparison.

RESULTS: Our analysis found no changes in usage of recreational venues over time whether indoor (e.g. multipurpose recreational facilities, community halls) or outdoor (e.g. golf courses, off-leash dog parks, multiuse trails), in either the intervention or comparison region. Only one rural multipurpose indoor recreational facility showed a statistically significant increase in usage during Phase 1.

CONCLUSION: Strategies targeting only physical infrastructure may not result in increased usage across a municipal population. To address existing inequities in access to publicly funded community resources that support health, both the built and social environments must be considered.

PMID:41811292 | DOI:10.24095/hpcdp.46.3.03

J Hand Surg Am. 2026 Mar 11:S0363-5023(26)00143-7. doi: 10.1016/j.jhsa.2026.01.029. Online ahead of print.

ABSTRACT

PURPOSE: Foveal tears of the triangular fibrocartilage complex (TFCC) are a major cause of distal radioulnar joint instability and often require surgical repair to restore forearm function. Although foveal repair is increasingly performed, postoperative immobilization protocols remain variable and poorly standardized. This systematic review and meta-analysis evaluated the effects of different immobilization methods and durations on clinical outcomes after TFCC foveal repair.

METHODS: Comparative clinical studies assessing postoperative immobilization after TFCC foveal repair were identified through a systematic review of MEDLINE, EMBASE, Web of Science, and the Cochrane Library. Outcomes included pain (visual analog scale), Disabilities of the Arm, Shoulder and Hand scores, wrist range of motion, grip strength, and complications. For quantitative analysis, studies were grouped according to immobilization method: elbow-restricted immobilization versus forearm-restricted immobilization permitting elbow motion. Studies evaluating immobilization duration or timing of motion initiation were analyzed descriptively.

RESULTS: Five comparative studies (288 patients) met the inclusion criteria; four evaluated immobilization methods, and 2 assessed immobilization duration or initiation of forearm rotation. Three studies were included in the meta-analysis. No significant differences were found between elbow-restricted and forearm-restricted immobilization in final pain visual analog scale (mean difference [MD] -0.34; 95% CI, -0.91 to 0.24), Disabilities of the Arm, Shoulder and Hand scores (MD -1.67; 95% CI, -6.71 to 3.38), grip strength (MD +0.38%; 95% CI, -9.69 to 10.45), or wrist range of motion, and complication rates were similarly low across groups. Studies investigating immobilization duration demonstrated that restricting pronation and supination for approximately 4-6 weeks yielded better pain relief and functional recovery than immediate rotation, without causing persistent elbow stiffness.

CONCLUSIONS: Based on currently available comparative studies, postoperative immobilization after TFCC foveal repair may benefit more from restricting forearm rotation than from restricting elbow motion. Additional restriction of elbow flexion and extension has not shown a consistent advantage in reported outcomes, whereas delaying forearm pronation and supination for up to 6 weeks may help protect the repair while still permitting early functional recovery. Further studies are needed to establish standardized guidelines.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III.

PMID:41811284 | DOI:10.1016/j.jhsa.2026.01.029

JMIR Med Educ. 2026 Feb 2. doi: 10.2196/71455. Online ahead of print.

ABSTRACT

BACKGROUND: Simulation-based training is essential for preparing medical interns to manage high-stakes emergencies. Although virtual reality (VR)-based simulation has been rapidly integrated into medical education, there remains limited evidence directly assessing its effectiveness relative to established high-fidelity simulation (HFS) methodologies.

OBJECTIVE: This study aimed to assess the perceived educational effectiveness of VR and HFS in enhancing novice physicians’ confidence, satisfaction, and perceived preparedness for managing acute oxygen desaturation.

METHODS: A randomized controlled trial was conducted with 168 medical interns from Seoul National University Hospital. Participants were randomly assigned to VR group (n = 81) or HFS group (n = 87). Four participants were excluded due to incomplete surveys, leaving 164 for analysis (VR:79; HFS: 85). Both groups were trained to manage simulated patients with low oxygen saturation. Confidence (10-point Likert scale) and satisfaction (7-point Likert scale) were measured using pre- and post-training surveys. Usability was assessed with the User Experience Questionnaire-Short. Between-group comparisons were conducted using t-tests and chi-square tests, while within-group confidence changes were analyzed using paired t-tests and repeated-measures analysis of variance. To account for correlated data and estimate effect sizes, generalized estimating equations were applied, with statistical significance set at P < .05. Focus group interviews (FGIs) at one- and five-months post-training explored real-world application and behavior transfer. Transcripts were independently reviewed by two researchers and thematically analyzed to identify recurring patterns and insights related to clinical behavior.

RESULTS: Confidence in managing oxygen desaturation significantly improved from a mean [SD] 3.78 [2.12] to 6.20 [2.02] across VR and HFS groups (t(163) = -14.04, P < .001), with no significant difference between groups (F(1,162) = 3.28, P = .07). Satisfaction was high overall (mean [SD] 6.07 [1.02]), but significantly greater in the HFS group than in the VR group (6.23 [0.92] vs. 5.89 [1.10]; t(162) = 2.29, P = .02). HFS participants rated tutor guidance (6.49 [0.86] vs. 6.10 [1.02]; P = .008) and authenticity (6.24 [1.05] vs. 5.77 [1.15]; P = .006) higher, whereas both groups scored usability above 5 on all items. Qualitative analyses revealed complementary strengths. Interns valued VR for its immersive environment, focused repetition, and reduced distractions that facilitated stepwise problem-solving. HFS was praised for palpable realism, hands-on practice with equipment, and immediate feedback that reinforced team communication and role clarity. Across follow-up interviews, interns reported improved recognition of desaturation, more structured initial responses (airway assessment, oxygen delivery adjustments, escalation), and greater willingness to act promptly under pressure-suggesting perceived transfer of learning to clinical practice beyond the simulation lab.

CONCLUSIONS: VR may complement HFS in emergency response training. Both modalities were associated with improvements in interns’ self-reported confidence and perceived preparedness. The scalability and accessibility of VR suggest its potential value in diverse training contexts.

CLINICALTRIAL: ClinicalTrials.gov NCT06295887.

PMID:41811271 | DOI:10.2196/71455

J Surg Orthop Adv. 2026 Spring;35(1):27-30.

ABSTRACT

This study sought to characterize patient interest in utilizing telemedicine for orthopaedic surgery clinic visits in a primarily Medicaid population. The authors hypothesized that interest in telemedicine would be associated with higher education level, lower age, private insurance, and internet access. Patients who called the clinic between October 2020 and February 2021 were asked to participate in a 5-question phone survey. The association between willingness to use telemedicine and other variables was determined using statistical analysis. Two hundred and fifty-six patients participated; they were predominantly female (50.8%), Black (57.6%), 50 – 60 years old (33.6%), with public insurance (83.2%). In total, 76.6% were interested in telemedicine. No significant association was observed between interest in telemedicine and education level or insurance. Patients who were younger and had internet access were significantly more interested in utilizing telemedicine services. Contrary to our hypothesis, no association was noted between interest in telemedicine and education level or insurance. (Journal of Surgical Orthopaedic Advances 35(1):027 – 030, 2026).

PMID:41811258

Pharmacogenomics. 2026 Mar 11:1-16. doi: 10.1080/14622416.2026.2641750. Online ahead of print.

ABSTRACT

INTRODUCTION: Polymorphisms in transporter (P-gp, OATP) genes affect digoxin pharmacokinetics and are crucial for predicting toxicity due to its narrow therapeutic index. However, evidence regarding their effects on digoxin serum concentrations remain inconsistent. This systematic review and meta-analysis aimed to evaluate the influence of transporter polymorphisms on digoxin serum concentrations.

METHODS: A systematic search of EBSCOhost, Scopus, PubMed, Web of Science and ClinPGx was conducted up to May 2025. Study quality was evaluated using the Newcastle-Ottawa Scale. Mean differences with 95% confidence intervals were calculated for digoxin serum concentrations (C_max, AUC, and SDC) using a random-effects model. Statistical heterogeneity was assessed using the I² statistic, and subgroup analyses were performed.

RESULTS: Nineteen eligible studies were identified. A significant association was observed between ABCB1 C3435T polymorphism and elevated digoxin C_max across multiple genetic models, with the largest effect observed between codominant T/T versus C/C (MD: 0.40 ng/mL; 95% CI: 0.14-0.66). Conversely, opposite associations were observed in the Japanese population, where C allele carriers had higher digoxin AUC_{0-4 hr}.

CONCLUSION: The ABCB1 C3435T polymorphism influences digoxin serum concentrations and may inform genotype-guided therapy. However, the limited number of studies in meta-analysis warrants further well-designed studies.This systematic review and meta-analysis was not registered in any protocol registry.

PMID:41811250 | DOI:10.1080/14622416.2026.2641750

Nurs Educ Perspect. 2026 Jan-Feb 01;47(1):30-35. doi: 10.1097/01.NEP.0000000000001485.

ABSTRACT

BACKGROUND: US Latines face many challenges and barriers that lead to inequalities in their health care. Failure to include specific Latine culture in health education intensifies this issue. Diverse teaching strategies are needed to address Latine culture in nursing education.

METHOD: A convenience sample of prelicensure baccalaureate students who completed an overseas cultural program (OCP) was evaluated to determine changes in cultural competence. A convergent mixed-methods design was used. Students’ journal entries, a focus group, and the Transcultural Self-Efficacy Tool were analyzed.

RESULTS: Statistically significant quantitative responses to changes were seen in pre- versus posttest data. Qualitative data gathered from journal entries and a focus group supported quantitative findings.

CONCLUSION: Including nursing students in a service-learning OCP improves cultural sensitivity and competency. Using data integration from qualitative and quantitative sources reinforced findings. As such, giving students a service-learning opportunity is a viable option to improve cultural care of Latines.

PMID:41811241 | DOI:10.1097/01.NEP.0000000000001485

J Physiol. 2026 Mar 11. doi: 10.1113/JP290527. Online ahead of print.

NO ABSTRACT

PMID:41811215 | DOI:10.1113/JP290527

Vet Med Sci. 2026 Mar;12(2):e70884. doi: 10.1002/vms3.70884.

ABSTRACT

BACKGROUND: Blackbuck is a species of antelope native to the Indian subcontinent. This study aimed to investigate the prevalence, diversity, and concurrency of gastrointestinal parasites in the blackbuck population of the Blackbuck Conservation Area in Nepal.

METHODS: A total of 150 blackbuck faecal samples were collected and examined using the iodine wet mount and concentration technique.

RESULTS: The findings showed that gastrointestinal parasites were prevalent in 96% of the population, with a higher frequency in females than males. There was no significant statistical association between sex and parasite prevalence across genera (χ² = 9.141, p > 0.05). Ten different genera of parasites belonging to protozoa, cestode, trematode, and nematode groups were identified. Paramphistomum sp. was the most common, with 55.33% of the cases followed by Strongyloides sp. (52%), Fasciola sp. (36%), Haemonchus sp. (26%), Moniezia sp. (24%), Trichostrongylus sp. (21.33%), Eimeria sp. (19.33%), Entamoeba sp. (15.33%), Ascaris sp. (8.67%), and Trichuris sp. (7.33%). The study revealed mixed infections ranging from one to six genera in each sample, with triple infections being the most prevalent. Most blackbucks exhibited light infection, while five specific parasite types showed heavy infection levels.

CONCLUSIONS: The identification of a significant prevalence and variety of gastrointestinal parasites indicates that parasitism may be an overlooked factor affecting the health of the blackbuck population. This emphasizes the importance of integrating parasite monitoring into wildlife health and conservation efforts.

PMID:41811208 | DOI:10.1002/vms3.70884

Ann Plast Surg. 2026 Mar 6. doi: 10.1097/SAP.0000000000004707. Online ahead of print.

ABSTRACT

BACKGROUND: Implant-based reconstruction represents the most common method of breast reconstruction today. Many surgeons approach implant-based breast reconstruction in 2 stages, with the first stage being placement of a tissue expander at the time of mastectomy. Neoadjuvant chemotherapy can have systemic effects that may place patients at risk for TE/implant loss, infection, wound, and other complications.

METHODS: A retrospective review of all cases of TE breast reconstruction at a single institution between 2017 and 2024 was performed. A total of 210 patients, representing 319 total breasts that underwent reconstruction, met the inclusion criteria. Sixty-five patients underwent neoadjuvant chemotherapy and 145 did not. Patients were separated into neoadjuvant chemotherapy (NACT) and nonneoadjuvant chemotherapy (non-NACT) cohorts. Primary outcomes of TE loss, wound, infection, and seroma were analyzed. Regression analysis was performed, matching patients for known risk factors.

RESULTS: The rate of all-cause TE loss in patients who underwent NACT was 18%, and 11% for patients who did not. The rate of pathologic TE loss was significantly higher at 14% in patients who underwent NACT and 7% in patients who did not undergo NACT (P=0.032). On regression analysis, neoadjuvant chemotherapy increased the rate of all-cause and pathologic TE loss by 17% (P<0.05). There were no statistically significant differences in wound, seroma, and infection.

CONCLUSIONS: In this study, neoadjuvant chemotherapy is an independent risk factor for TE loss after immediate tissue expander-based breast reconstruction. Further analysis of adjuncts, implant factors, and specific chemotherapeutic agents is needed.

PMID:41811191 | DOI:10.1097/SAP.0000000000004707