Tag: pubmed

Anat Sci Educ. 2026 May 16. doi: 10.1002/ase.70257. Online ahead of print.

ABSTRACT

In medical and anatomy education, serious games (SGs) are increasingly recognized as promising pedagogical tools. Educators seeking to adopt SG may choose whether to build games or buy commercially available serious games (CASGs). However, exploration of the commercial market remains scarce as existing reviews focus on bibliographic databases. This study aimed to explore the commercial market for SG aimed at medical education and analyze the pedagogical underpinnings of SG for anatomy education. An environmental scan was conducted across five search areas targeting digital interactive games intended for healthcare professionals. Out of 4330 potential games identified, 1585 CASG for medical education were included after screening and eligibility assessment. Subsequently, 879 CASG for anatomy education were systematically evaluated against 15 pedagogical principles adapted from instructional and game design frameworks. Data extraction, scoring, and statistical analysis explored the presence of pedagogical principles and influencing factors. Findings show that the commercial market offers a range of CASG for medical education, primarily targeting knowledge acquisition in human anatomy for undergraduates. Most SG were quiz-based, designed for single player, and lacked affiliation with academic institutions. Systematic analysis of CASG for anatomy education shows few incorporations of pedagogical principles with in-game feedback and game rules being most common, while principles supporting engagement, adaptivity, and collaboration were scarce. In conclusion, while the commercial market offers SG for anatomy education, their educational potential remains constrained by limited pedagogical depth, which may limit their potential as pedagogical tools. These findings suggest opportunities to develop pedagogically robust games in anatomy education.

PMID:42141858 | DOI:10.1002/ase.70257

Health Promot Pract. 2026 May 16:15248399261445966. doi: 10.1177/15248399261445966. Online ahead of print.

ABSTRACT

This mixed-methods study explored the impact of community-based arts programming on psychosocial outcomes associated with trauma recovery among adults with low-to-no-income engaged in active recovery from homelessness, domestic abuse, substance use, and other forms of trauma. Conducted in partnership with Path with Art, the study assessed mental well-being, social connectedness, and self-efficacy using validated pre- and post-intervention surveys alongside qualitative exit-surveys. Participants (N = 80) demonstrated statistically significant improvements in mental well-being (p < .01), loneliness (p < .01), and self-efficacy (p = .02), following participation in 8-week community-based arts classes. Analysis of qualitative responses (N = 103) revealed five interconnected themes: social connection and community; mental and emotional well-being; personal growth and empowerment; motivation and purpose; and creative and educational engagement. Participants reported feeling less isolated, more confident and motivated, and described the arts as a meaningful tool for navigating challenges related to trauma recovery. The findings suggest community-based arts engagement supports psychosocial processes central to trauma recovery. While limitations such as self-selection bias and lack of a control group should be addressed in future research, the study contributes to growing evidence that arts programming can positively influence health outcomes in trauma-affected populations. These insights may inform public health strategies and community-based care models focused on recovery and resilience.

PMID:42141855 | DOI:10.1177/15248399261445966

Helicobacter. 2026 May-Jun;31(3):e70132. doi: 10.1111/hel.70132.

ABSTRACT

BACKGROUND: Vonoprazan-based dual therapy has been proposed as a simplified strategy for Helicobacter pylori eradication, but head-to-head comparisons of different antibiotic partners are limited. We compared the efficacy, safety, and adherence of vonoprazan-based dual regimens with those of bismuth-containing quadruple therapy (BQT).

METHODS: In this randomized controlled trial, H. pylori-infected patients were allocated (1:1:1:1) to receive VA (vonoprazan [20 mg, bid] plus amoxicillin [1000 mg, tid]), VT (vonoprazan [20 mg, bid] plus tetracycline [500 mg, tid]), VM (vonoprazan [20 mg, bid] plus minocycline [100 mg, bid]), or VACB (vonoprazan [20 mg, bid], amoxicillin [1000 mg, bid], clarithromycin [500 mg, bid], and bismuth [220 mg, bid]) for 14 days. The primary endpoint was the H. pylori eradication rate, and the secondary endpoints were the incidence of adverse events and patient adherence.

RESULTS: The ITT eradication rates were 83.0% (83/100), 74.0% (74/100), 82.0% (82/100), and 83.0% (83/100) in the VA, VT, VM, and VACB groups, respectively (p = 0.304). The PP eradication rates were 90.2% (83/92), 83.1% (74/89), 88.2% (82/93), and 92.2% (83/90), respectively (p = 0.262). Adverse events occurred in 21.5% of the patients overall and differed across groups (10.0%, 15.0%, 29.0%, and 32.0% in VA, VT, VM, and VACB, respectively; p < 0.001); nausea and dizziness were more frequent with VM, whereas bitter taste and black stool were more frequent with VACB. All adverse events were mild or moderate, and no severe events were recorded. Adherence was high and comparable across groups (VA 100.0%, VT 96.0%, VM 99.0%, VACB 99.0%; p = 0.107).

CONCLUSION: Vonoprazan-based regimens showed no statistically significant between-group differences in eradication and were associated with good adherence overall. In our setting, VA and VM may represent practical simplified options, whereas VT appeared less robust as an empiric regimen. These exploratory findings warrant confirmation in larger, adequately powered randomized trials.

TRIAL REGISTRATION: ClinicalTrials.gov (NCT07068607).

PMID:42141850 | DOI:10.1111/hel.70132

Eur J Neurol. 2026 May;33(5):e70616. doi: 10.1111/ene.70616.

ABSTRACT

BACKGROUND: Elevated blood pressure (BP) after spontaneous intracerebral hemorrhage (ICH) is associated with poor outcomes, but the prognostic value of prehospital BP, particularly in relation to onset-to-arrival time, remains unclear. We investigated time-dependent associations of prehospital BP, arrival BP, and their early difference with in-hospital outcomes.

METHODS: We conducted a retrospective cohort study using a prospectively maintained stroke registry at a tertiary medical center in Taipei, Taiwan (2016-2022). Adults (≥ 18 years) with spontaneous ICH transported by emergency medical services within 24 h of symptom onset and with available prehospital BP were included. First prehospital and hospital-arrival BP were analyzed. Outcomes were in-hospital mortality and stroke in evolution (SIE) within 72 h of hospital admission. Patients were stratified by onset-to-arrival time (< 3 vs. ≥ 3 h). Multivariable logistic regression and restricted cubic splines were applied.

RESULTS: Six hundred ninety patients were included (mean age 64.7 years, 63.1% male; 336 < 3 h, 354 ≥ 3 h). In patients arriving ≥ 3 h, higher prehospital systolic BP, mean arterial pressure, and pulse pressure were independently associated with increased odds of in-hospital mortality, and higher arrival pulse pressure was also associated with mortality. Associations with SIE and early BP differences were weaker and were attenuated in fully adjusted models. Restricted cubic spline showed no nonlinear associations. No significant associations between BP measures and outcomes were observed in patients arriving < 3 h.

CONCLUSIONS: Higher prehospital BP was associated with increased in-hospital mortality among patients presenting ≥ 3 h after onset, whereas such associations are not evident within 3 h.

PMID:42141839 | DOI:10.1111/ene.70616

Acta Paediatr. 2026 May 16. doi: 10.1111/apa.70593. Online ahead of print.

ABSTRACT

AIM: Varicella is a highly contagious disease affecting approximately 90% of children before the age of 10, constituting a substantial health and societal burden. This study investigates the association between socio-demographic and socio-economic factors and uptake of varicella vaccination in Denmark, 2019-2024.

METHODS: This Danish cohort study included 1 356 841 individuals aged 1-18 years. Socio-demographic and socio-economic factors for children and their parents were obtained from Statistics Denmark’s registers and linked to varicella vaccination status in the Danish Vaccination Register. We estimated yearly vaccination initiation and cumulative vaccine coverage. Associations were assessed using crude and adjusted multivariable logistic regression models.

RESULTS: As of 2024, 16 903 1-18 year olds had received at least one dose of the varicella vaccine, of whom 84% completed the series. Coverage increased markedly from 2019 to 2024 and was highest in the Capital Region and metropolitan municipalities. Vaccination was more likely among children of parents with higher education (aOR: 4.98, 95% CI: 4.05-6.12), higher income (aOR: 3.08, 95% CI: 2.85-3.33) and a background in medicine or nursing (aOR: 1.79, 95% CI: 1.72-1.88).

CONCLUSION: Varicella vaccination uptake is higher among children from families with high socio-economic status, and this pattern persists over a 6-year period.

PMID:42141828 | DOI:10.1111/apa.70593

BMC Psychol. 2026 May 16. doi: 10.1186/s40359-026-04697-x. Online ahead of print.

ABSTRACT

BACKGROUND: Little is known about the association of the cumulative effects of excess weight with depressive and anxiety symptoms in Chinese adolescents and the role of sleep quality in the above-mentioned association. This study aimed to assess this issue.

METHODS: A cohort study was conducted annually during 2021 (wave 1), 2022 (wave 2) and 2023 (wave 3). The cumulative effects of excess weight, based on body mass index, from wave 1 to wave 3 were calculated using the trapezoid rule. We evaluated sleep quality, depressive symptoms, and anxiety symptoms based on the Pittsburgh Sleep Quality Index, 9-item Patient Health Questionnaire, and 7-item Generalized Anxiety Disorder Questionnaire in wave 3, respectively. We performed sensitivity analyses using overweight/obesity-years to define the cumulative effects of excess weight.

RESULTS: This study included 39,442 participants (male: 51.6%; mean age: 13.7 years) without depressive and anxiety symptoms in wave 1 and 2. Logistic models with restricted cubic splines showed a significant linear association between the cumulative effect of excess weight and depressive symptoms. We noted a mediating role of sleep quality in the above-mentioned association (percentage of mediation = 9.7%; P < 0.001). Compared with participants without the incident cumulative effect of excess weight and sleep disturbance, those with the above-mentioned two conditions were more likely to have anxiety symptoms (odds ratio = 5.94; P < 0.001). The sensitivity analyses yielded similar results.

CONCLUSION: Our results indicate that the cumulative effect of excess weight may directly affect depressive symptoms, and indirectly affect anxiety symptoms through sleep quality.

PMID:42141495 | DOI:10.1186/s40359-026-04697-x

Trials. 2026 May 15. doi: 10.1186/s13063-026-09761-w. Online ahead of print.

ABSTRACT

BACKGROUND: Therapeutic exercises that help reduce stress and anxiety, both mentally and physically, are called relaxation techniques. In order to ascertain the benefits of the two relaxation techniques on pain, urine incontinence, sleep quality, and activities of daily living, this study will compare them with the conventional physiotherapy exercise in lower segmental cesarean sections (LSCS).

METHODS: Forty-six LSCS subjects with pain, urine incontinence, sleep quality, and activities of daily life will participate in a comparative study that is a blinded (statistical) analysis. The participants will be divided into two groups following randomization: (1) Benson’s relaxation and (2) Mitchell’s relaxation, and both groups will receive exercises from conventional physiotherapy. Every group will go through the initial evaluation and a post-intervention assessment.

DISCUSSION: This study is anticipated to improve pain, urinary incontinence, sleep quality, and activities of daily living following a lower segmental cesarean section. Following the completion of the study, the data will be published. If the benefits are demonstrated, Benson’s or Mitchell’s relaxation approach is used in conjunction with conventional physiotherapy exercises after lower-segmental cesarean sections.

RESULT: The protocol would be given for 4 weeks. The initial assessment would be conducted before the intervention, and the post-assessment would be performed after the completion of the 4 weeks of intervention.

TRIAL REGISTRATION: Trial REF/2025/03/102462, Registration number- CTRI/2025/04/085318. Date of registration-22/04/2025.

PMID:42141474 | DOI:10.1186/s13063-026-09761-w

BioData Min. 2026 May 15. doi: 10.1186/s13040-026-00559-9. Online ahead of print.

ABSTRACT

BACKGROUND: Survival analysis in high-dimensional (HD) and multi-block (MB) settings, such as omic and multi-omic studies, poses major methodological challenges due to multicollinearity, low events-per-variable ratios, and limited model interpretability. While Cox Proportional Hazards models remain widely used, their applicability is restricted in HD scenarios. Machine learning approaches can handle such complexity but often lack interpretability. Survival models based on Partial Least Squares (PLS) offer an attractive compromise, yet existing implementations provide limited support for model optimization, evaluation, and interpretation.

RESULTS: To overcome these limitations, we introduce Coxmos, a CRAN R package that integrates adapted Cox regression models with HD-adapted variable selection, and optimized PLS-based approaches tailored for HD and MB data. Coxmos also provides validation, comparison, interpretation, and visualization tools. Benchmarking on a diverse set of clinical, single-omic, and multi-omic cancer datasets – including breast (BRCA), head and neck (HNSC), and ovarian (HGSOC) cancer – demonstrated that Coxmos outperformed other state-of-the-art machine learning methods, while enhancing interpretability. We illustrated the package’s functionalities through two case studies (HGSOC and HNSC), showing how Coxmos facilitates model selection, validation, and biological interpretation in a complex HD and MB survival analysis.

CONCLUSIONS: Coxmos provides a robust, flexible, and interpretable solution for survival analysis in HD and MB data. By combining optimized PLS-based methodologies with rigorous evaluation and rich visualization tools, Coxmos enables reliable survival prediction and facilitates the identification of relevant risk and protective factors in complex biomedical studies. The package fills an important methodological gap and represents a valuable resource for reproducible and interpretable survival modeling in the big data scenario.

AVAILABILITY: Coxmos is available at CRAN repository: https://cran.r-project.org/web/packages/Coxmos.

PMID:42141472 | DOI:10.1186/s13040-026-00559-9

Nutr J. 2026 May 16. doi: 10.1186/s12937-026-01333-7. Online ahead of print.

ABSTRACT

BACKGROUND: Carotenoids are common natural anti-inflammatory antioxidants produced by plants and some microorganisms. However, there are limited reports on the association between carotenoids and risk of rheumatoid arthritis (RA).

METHODS: We analyzed data of participants from the National Health and Nutrition Examination Survey (NHANES) and UK Biobank (UKB). In the NHANES, a total of 40,410 and 13,440 participants were included to evaluate the association of dietary carotenoid intake and serum carotenoid levels with RA, respectively. Among 179,171 participants in the UKB, 2,156 individuals developed RA over a median follow-up of 7.74 years. A weighted multivariable logistic regression model and quantile G-Computation (QGC) model were established to investigate single and joint effect of carotenoid levels (alpha-carotene, beta-carotene, beta-cryptoxanthin, lycopene, lutein and zeaxanthin) on RA in NHANES by cross-sectional study design. Furthermore, Cox proportional hazards regression model was used to validate the potential association in UKB cohort, and restricted cubic spline (RCS) regression was applied to estimate the possible nonlinear association.

RESULTS: Compared to the lowest quartile (Q1), dietary intake level of alpha-carotene in Q3 were consistently associated with a decreased risk of RA in NHANES (odds ratio [OR]: 0.771, 95% confidence interval [CI]: 0.628 to 0.946, P-value = 0.013) and UKB (hazards ratio [HR]: 0.875, 95% CI: 0.775 to 0.987, P-value = 0.030). At serum level, all kinds of carotenoids in Q4 were significantly inversely associated with RA when compared with Q1. In QGC model, each one-quartile increase in the intake (OR: 0.886, 95% CI: 0.841 to 0.933, P-value < 0.001) or serum levels (OR: 0.795, 95% CI: 0.732 to 0.864, P-value < 0.001) of the six carotenoids showed a negative correlation against of RA in NHANES. RCS analysis indicated that dietary intake of total carotene (P-value = 0.0020 for nonlinear), alpha-carotene (P-value = 0.0175 for nonlinear), and beta-carotene (P-value = 0.0021 for nonlinear) exhibited a nonlinear relationship with the risk of RA in UKB. The protective effects against RA were found within the ranges of log natural transformation for total carotene (5.28 to 8.69 µg/day), and beta-carotene (5.18 to 8.61 µg/day).

CONCLUSION: Both cross-sectional and prospective studies indicate that carotenoids, as natural and effective anti-inflammatory antioxidants, were negatively associated with RA. Daily intake of an appropriate dose can significantly reduce the risk of RA.

PMID:42141470 | DOI:10.1186/s12937-026-01333-7

Nurs Open. 2026 May;13(5):e70602. doi: 10.1002/nop2.70602.

ABSTRACT

OBJECTIVES: To examine whether nurses’ job well-being is associated with their innovative behaviour and whether knowledge sharing mediates that relationship.

DESIGN: A cross-sectional study.

METHOD: This study used convenience sampling to select 1,025 nurses from 8 hospitals. The data was collected between June and November 2023 using the Nurses Job Well-being Scale, Nurses Innovative Behaviour Scale, and Knowledge Sharing Scale. The data analysis process included descriptive statistics, correlation analysis, multivariate regression, and hypothesis testing.

RESULTS: Job well-being was positively correlated with innovative behaviour (r = 0.63, p < 0.001) and with knowledge sharing (r = 0.73, p < 0.001). Knowledge sharing was also significantly associated with innovative behaviour (r = 0.55, p < 0.001). Regression analysis indicated that both job well-being (β = 0.38, p < 0.001) and knowledge sharing (β = 0.23, p < 0.001) significantly predicted innovativebehaviour. Mediation analysis showed a significant indirect effect of job well-being on innovative behaviour through knowledge sharing (indirect effect = 0.52, 95% CI [0.44, 0.60]).

CONCLUSION: Nurses’ job well-being promotes innovative behaviour both directly and indirectly through knowledge sharing. Interventions targeting psychological well-being and structured knowledge-sharing mechanisms may enhance innovation in nursing practice.

PATIENT OR PUBLIC CONTRIBUTION: This study did not involve patients or the public in the design, conduct, or reporting of the research.

PMID:42141459 | DOI:10.1002/nop2.70602