Tag: pubmed

BMC Nutr. 2026 May 25. doi: 10.1186/s40795-026-01371-8. Online ahead of print.

ABSTRACT

BACKGROUND: Vitamin D deficiency remains a major public health concern in the Middle East and North Africa despite abundant sunlight. The public’s understanding of vitamin D sources, risk factors, and preventive practices may influence recognition and prevention of deficiency, yet data from Palestine remain limited. This study assessed awareness and knowledge of vitamin D deficiency among Palestinian adults recruited online and examined whether knowledge differed according to sociodemographic characteristics and vitamin D-related experiences.

METHODS: An analytical online cross-sectional study was conducted among Palestinian adults using an adapted Arabic self-administered questionnaire distributed through social media between November and December 2025. The instrument assessed sociodemographic characteristics, vitamin D-related experiences, and knowledge across benefits, sources/determinants, and toxicity domains. Knowledge scores ranged from 0 to 14, and scores greater than 7 were classified as adequate knowledge, consistent with the source instrument. Descriptive statistics, bivariate analyses, and multivariable logistic regression were performed using SPSS version 25.

RESULTS: A total of 756 respondents were included (mean age 27.5 ± 9.9 years; 79.1% female). The mean knowledge score was 10.21 ± 2.25, and 88.8% of participants were classified as having adequate knowledge. Correct responses were highest for skeletal benefits and the role of sun exposure in vitamin D production. Lower correct response rates were observed for items related to vitamin D toxicity, vegetarian-related risk, and the effect of darker skin pigmentation on deficiency risk. Higher mean knowledge scores were observed among males, single participants, participants without children, and those who had undergone vitamin D testing or had taken supplements. However, no independent predictors of adequate knowledge were identified in the adjusted logistic regression model.

CONCLUSIONS: Palestinian adults in this online non-probability sample demonstrated a generally high level of vitamin D knowledge, particularly regarding bone health and sun exposure. However, important gaps persisted in specific domains, especially toxicity and less commonly recognized risk factors. Because the sample was recruited online and was disproportionately female and highly educated, the findings should be interpreted as descriptive of this sampled group rather than representative of all Palestinian adults.

PMID:42178572 | DOI:10.1186/s40795-026-01371-8

Int J Ment Health Syst. 2026 May 24. doi: 10.1186/s13033-026-00713-0. Online ahead of print.

ABSTRACT

BACKGROUND: The practice of electroconvulsive therapy (ECT) is constrained by limited resources. Anticipating recurrent peaks in demand is therefore essential for optimizing resource planning within public healthcare systems. This study examined seasonal patterns of ECT utilization in France over an extended period.

METHOD: We analyzed data from the French national administrative and medical database. Seasonal patterns in monthly ECT utilization time series from 2017 to 2023 were investigated using robust statistical methods.

RESULTS: We observed a clear seasonal pattern with a 12-month periodicity in monthly ECT utilization, accounting for 16% of the variance in use, with a major peak in December and a mean relative amplitude of 13.1%. Seasonal variation was observed across sex, age and diagnostic subgroups, although it was less pronounced among patients aged 24 years or younger and those with schizophrenia. Across all subgroups, ECT activity consistently peaked at the onset of winter, between November and December.

CONCLUSION: These findings emphasize the need for ECT providers in France to anticipate recurrent winter peaks in activity. Proactive healthcare policies should ensure that medical staffing and equipements ressources are adjusted to accommodate predictable winter peaks in ECT demand.

PMID:42178564 | DOI:10.1186/s13033-026-00713-0

Popul Health Metr. 2026 May 25. doi: 10.1186/s12963-026-00487-0. Online ahead of print.

ABSTRACT

BACKGROUND: Gastric cancer has historically been driven by long‑standing Helicobacter pylori infection. The nationwide expansion of H. pylori eradication therapy beginning in 2013 created a unique opportunity to evaluate its population‑level impact on gastric cancer mortality. However, short‑term mortality trends following eradication are difficult to interpret because they reflect overlapping influences of ageing, cohort replacement, and cumulative infection history. This study aimed to provide a model‑based, population‑level assessment of the early impact of eradication during the first decade of nationwide implementation.

METHODS: We applied a two‑layer analytic framework consisting of a counterfactual analysis comparing observed mortality during 2013-2021 with expected mortality had eradication uptake remained at pre‑2013 levels, combined with a structured state‑transition (Markov) model with time‑dependent parameters. To estimate annual gastric cancer deaths prevented and the proportion of mortality reduction attributable to eradication, the model integrated age‑specific biological hazard, cumulative infection history, cohort‑specific H. pylori prevalence, and annual changes in eradication uptake.

RESULTS: Observed gastric cancer deaths declined from 48,632 in 2013 to 41,624 in 2021, whereas counterfactual gastric cancer deaths declined more modestly, from 49,779 to 49,453. The divergence between observed and counterfactual deaths steadily widened from 1,147 in 2013 to 7,829 in 2021. Model‑based estimates indicated that eradication prevented 6,461 gastric cancer deaths during 2013-2021, with annual deaths prevented increasing from 165 in 2015 to 1,604 in 2021, particularly among adults aged 60-79, who showed the most pronounced early benefit reflecting cumulative infection history and real-world uptake patterns.

CONCLUSIONS: The early population‑level impact of H. pylori eradication is consistent with a 16% reduction in gastric cancer deaths by 2021. These findings provide real‑world insight into how primary prevention can shape short‑term national cancer trends. This approach offers a quantitative framework to inform future prevention strategies in high‑prevalence settings seeking to evaluate early implementation effects.

PMID:42178557 | DOI:10.1186/s12963-026-00487-0

BMC Oral Health. 2026 May 25. doi: 10.1186/s12903-026-08639-2. Online ahead of print.

ABSTRACT

BACKGROUND: Additive manufacturing of cobalt-chromium (Co-Cr) and titanium (Ti-6Al-4 V) alloys is increasingly used in prosthetic dentistry. Acidic oral environments associated with gastroesophageal reflux disease (GERD) may negatively influence the surface integrity and corrosion resistance of dental materials. This in vitro study assessed the effects of simulated gastric acid on the corrosion resistance, surface morphology, and topographical changes of selective laser melting (SLM) Co-Cr and Ti-6Al-4 V alloys.

METHODS: Thirty-two additively manufactured specimens (n = 16 per alloy) were randomly distributed into acidic (pH 1.2) and neutral control (pH 6.7 distilled water) subgroups (n = 8). A cyclic static immersion protocol was used to simulate GERD-related acid exposure. Specimens in the acidic group were immersed for 2 min in acidic solution, rinsed without scrubbing to preserve the delicate surface topography, and stored in distilled water at 37 °C, repeated six times daily over nine days with a 24-hour interval maintained between each daily cycle. Control specimens were stored continuously in distilled water at 37 °C. Surface morphology, elemental composition, and topography were evaluated using scanning electron microscopy (SEM) and Abbott-Firestone curve analysis.

RESULTS: In the Co-Cr alloy, immersion in an acidic solution resulted in a decrease in the percentage of all elements, except O, which increased to 6.37 ± 1.77%, with the change being statistically significant (P ≤ 0.05). In contrast, Ti-6Al-4 V also showed a decrease in all elements after immersion, with O rising to 2.26 ± 1.22%, although no changes were statistically significant (P ≥ 0.05). SEM images indicated more oxide deposits on Co-Cr in an acidic solution, which also showed a notable increase in surface roughness, whereas Ti-6Al-4 V exhibited greater stability. The Abbott-Firestone analysis further confirmed that Co-Cr underwent more significant changes in peak formation and exploitation zones than Ti-6Al-4 V did in acidic environments.

CONCLUSIONS: Under simulated gastric acid exposure, Ti-6Al-4 V alloys exhibited superior corrosion resistance and surface stability compared with Co-Cr alloys. These findings support the clinical preference for Ti-6Al-4 V in dental restorations for patients experiencing frequent acidic challenges, such as those with severe GERD.

PMID:42178550 | DOI:10.1186/s12903-026-08639-2

BMC Public Health. 2026 May 25. doi: 10.1186/s12889-026-27841-z. Online ahead of print.

ABSTRACT

BACKGROUND: Female genital mutilation (FGM) and child marriage (CM) remain pervasive in Ethiopia, driven by entrenched social norms, gender inequalities, and economic factors. Despite legal prohibition, national prevalence stands at 65% for FGM and 40% for CM. In response, Population Media Center (PMC) collaborated with the United Nations Population Fund (UNFPA) to implement a multimedia social and behavior change (SBC) intervention to raise awareness, shift attitudes and norms, and reduce the practice of FGM and CM in 4 targeted woredas of southern Ethiopia. This mixed-method study evaluates if and how the intervention was associated with changes in knowledge, attitudes, social norms, and practices related to FGM and CM.

METHODS: A mixed-methods evaluation was conducted in May 2025 using a comparative cross-sectional survey and qualitative interviews. A total of 403(205 exposed and 198 unexposed) survey participants were selected through systematic random sampling. For the qualitative components, 70 participants were purposively selected: 62 participants across 8 focus group discussions and 8 individual in-depth interviews. Respondents were categorized by exposure to the PMC multimedia intervention. Differences in knowledge, attitudes, behavioral intentions, social norms, and practices related to FGM and CM were analyzed. Chi-square tests determined statistical significance (p < 0.05), and quantitative insights were triangulated with qualitative insights.

RESULTS: Of 403 survey participants (205 exposed; 198 non-exposed; 73.7% female), the exposed group demonstrated significantly higher awareness about FGM and CM (93.2% vs. 84.6%, p < 0.001), stronger anti-FGM attitudes (90.2% vs. 81.4%, p = 0.014), and stronger anti-CM attitudes (83.4% vs. 78.1%, p < 0.001) compared to non-exposed participants. Total prevalence was 32.7% for FGM and 4.9% for CM. Qualitative data revealed that FGM persists covertly; families bypass legal restrictions by temporarily relocating girls to other villages for secret procedures. Despite high levels of awareness, deeply rooted sociocultural norms, marriageability myths, economic factors, social acceptability, and religious beliefs continue to perpetuate both practices.

CONCLUSION: Exposure to PMC multimedia SBC engagement was associated with significant differences in awareness and attitudes. However, the continued practice of FGM through covert means underscores the power of interlinked sociocultural and religious norms. Accelerating the abandonment of FGM and CM requires scaling community dialogues, empowering girls and young people, fostering intergenerational dialogue, coordinating stakeholder efforts, and strengthening legal enforcement to move beyond individual attitude shifts toward collective social norm change.

PMID:42178547 | DOI:10.1186/s12889-026-27841-z

BMC Surg. 2026 May 25. doi: 10.1186/s12893-026-03861-9. Online ahead of print.

ABSTRACT

The present study aimed to investigate the efficacy of indocyanine green (ICG) fluorescence-guided laparoscopic hepatectomy for the treatment of liver metastases. Therefore, data from patients with liver metastases who underwent laparoscopic hepatectomy were retrospectively collected. A total of 69 patients were divided into the ICG group (fluorescence-guided) and conventional group, with 24 well-matched pairs analyzed after propensity score matching. Laparoscopic hepatectomy was successfully performed in all patients.The ICG group had significantly wider surgical margins than the conventional group (1.73 ± 0.57 cm vs. 1.04 ± 0.44 cm; P < 0.001). Pre-matching R0 resection rates were 91.9% (ICG) and 90.6% (conventional), with 100% R0 resection achieved in both groups post-matching. Operative time, intraoperative blood loss and postoperative ALT levels were numerically lower in the ICG group without statistical significance. The rates of overall/severe (Clavien-Dindo ≥IIIa) complications and 6-month recurrence were comparable between the two groups (all P > 0.05). In conclusion, ICG fluorescence-guided laparoscopic hepatectomy is safe and feasible for liver metastases, yielding significantly wider surgical margins. Although perioperative outcomes and 6-month recurrence rates were comparable between groups after matching, the ICG-guided approach achieved significantly wider surgical margins-a finding with potential implications for long-term oncological outcomes that warrant further investigation.

PMID:42178544 | DOI:10.1186/s12893-026-03861-9

BMC Neurol. 2026 May 25. doi: 10.1186/s12883-026-05010-4. Online ahead of print.

ABSTRACT

BACKGROUND: Intracerebral hemorrhage (ICH) is associated with poor prognosis, characterized by high acute mortality and long-term disability. Real-time risk stratification using dynamic biomarkers is urgently needed to improve patient outcomes. This study aimed to explore the association between temporal changes in the hemoglobin-to-red blood cell distribution width ratio (HRR) and in-hospital all-cause mortality in patients with ICH.

METHODS: We retrospectively analyzed 2,447 ICH patients from MIMIC-IV and externally validated findings in 3,142 patients from eICU. Cox regression analyzed the association between HRR (baseline and daily dynamic values) and in-hospital mortality. Restricted cubic spline (RCS) models assessed the non-linear relationship between baseline HRR and in-hospital mortality. An optimal baseline HRR cutoff for risk stratification was identified using the maximally selected log-rank statistic and subsequently externally validated. Pearson correlation analysis was applied to evaluate associations between daily HRR and in-hospital mortality, and receiver operating characteristic (ROC) curves were used to examine the time-specific predictive performance of serial HRR values.

RESULTS: HRR exhibited a consistent inverse association with in-hospital all-cause mortality in both cohorts. In fully adjusted Cox models, continuous baseline HRR was associated with lower mortality risk (HR approximately 0.51 in both cohorts), and the highest HRR quartile was associated with a reduced mortality risk compared with the lowest quartile. Both survivors and non-survivors showed progressive HRR declines during 14-day hospitalization. Non-survivors had more pronounced declines (daily reduction approximately 0.017 vs. 0.014 in MIMIC-IV; P for trend difference < 0.001) and consistently lower HRR levels at all time points. Daily HRR was inversely correlated with mortality throughout hospitalization (adjusted HRs < 1.0, P < 0.05), with the strength of this inverse association increasing notably from Day 1 (r = -0.141) to Day 4 (r = -0.225). HRR demonstrated predictive performance comparable to Hb and RDW across time points. In the MIMIC-IV test set, all indicators presented a temporal upward trend within the initial few days, with AUCs reaching 0.631 (HRR), 0.594 (Hb) and 0.630 (RDW) at Day 1, and 0.663, 0.632 and 0.645 at Day 3, respectively. Calibration curves revealed poor predictive performance with overestimation of mortality risk. A baseline HRR cutoff of ≤ 0.74 identified high-risk patients, who had significantly higher mortality (25.14% vs. 12.93% in MIMIC-IV; 17.64% vs. 12.72% in eICU, all P < 0.001).

CONCLUSIONS: This study preliminarily suggests that temporal changes in HRR are associated with in-hospital all-cause mortality in ICH patients. HRR may serve as a complementary dynamic prognostic marker with predictive performance comparable to Hb and RDW, though its utility is limited by poor calibration. Further prospective validation in dedicated ICH cohorts with severity and imaging data is warranted, and future studies should consider underlying diseases and inflammatory status.

PMID:42178542 | DOI:10.1186/s12883-026-05010-4

BMC Pregnancy Childbirth. 2026 May 25. doi: 10.1186/s12884-026-09333-5. Online ahead of print.

ABSTRACT

BACKGROUND: The placenta and umbilical cord play a crucial role in fetal growth, development, and neonatal survival. Although extensively studied in developed countries, quantitative data on placental and umbilical cord morphology in preeclampsia are scarce in Ghana. This study aimed to assess the gross morphometry of preeclamptic placentae and umbilical cords and their relationship with neonatal indices.

METHOD: A cross-sectional study was conducted on 152 freshly delivered placentae (100 normotensive; 52 preeclamptic) at the Holy Family Hospital, Berekum, Ghana. Maternal data collected included age, parity, blood pressure, and occupation. Standard anthropometric techniques were used for placental and umbilical cord measurements after they were fixed with 10% neutral buffered formalin. Statistical analyses included t-test, Chi-square, and Spearman correlation, with significance set at p < 0.05.

RESULTS: Placental and umbilical cord indices differed significantly between preeclamptic and normotensive groups, except for cord length. Moderate to strong correlations were observed between placental and cord indices and neonatal outcomes, but not with neonatal length. Placentae were more often oval, and cords were eccentrically inserted in preeclamptic births compared to normotensive births.

CONCLUSIONS: Preeclampsia is associated with altered placental and umbilical cord morphology and reduced neonatal growth indices. These findings provide baseline data to support multidisciplinary strategies for improved management and pregnancy outcomes in Ghana.

PMID:42178540 | DOI:10.1186/s12884-026-09333-5

BMC Med Educ. 2026 May 25. doi: 10.1186/s12909-026-09437-8. Online ahead of print.

ABSTRACT

BACKGROUND: The dental pulp is a vital tissue integral to tooth vitality and endodontic health. However, awareness and comprehension of pulpal functions among preclinical dental students remain inadequately characterized. Understanding baseline knowledge and attitudes in early dental education can inform pedagogical improvements in oral histology and foundational endodontic instruction. The study evaluates the awareness, knowledge, attitudes, and learning practices related to dental pulp and its functions among preclinical undergraduate dental students.

METHODS: A descriptive cross-sectional study was conducted among 225 preclinical (first and second-year) undergraduate dental students from multiple dental institutions. A validated 20-item structured questionnaire comprising four sections; demographics, knowledge assessment with 6 multiple-choice items, attitude evaluation using 5-point Likert scale with 6 items, and learning practice assessment with 5 items was administered via Google Forms. Data were analyzed using descriptive statistics, frequency distributions, percentages, and comparative analysis between academic years using chi-square and independent t-tests.

RESULTS: Second-year students demonstrated significantly higher knowledge accuracy (61.8%) compared to first-year students (38.2%, p < 0.05). The majority of students (92.4%) correctly identified mastication as a non-function of pulp, and 67.6% recognized A-delta fibers as responsible for sharp, localized pain. However, knowledge gaps were identified: 29.3% of students incorrectly attributed odontoblast function to enamel formation, and only 61.9% understood the physiological constraints limiting pulpal healing capacity. Attitude assessment revealed strong positive perception (mean Likert scores 3.16-4.37), with highest endorsement for understanding pulp structure (4.37) and learning pulp for endodontics (4.25). Exam-driven learning behavior was predominant (57.3%), while visual learning modalities were preferred (33.3% favored videos/3D models and 32.9% preferred textbook reading).

CONCLUSIONS: While preclinical students demonstrate commendable foundational understanding of pulpal anatomy and core functions, specific knowledge gaps and exam-centric learning patterns point the need for enhanced pedagogical approaches. Integration of visual aids, clinically relevant case-based learning, active learning modalities, and structured early clinical correlation could strengthen conceptual understanding and foster deeper engagement with pulp biology, ultimately enhancing preparedness for clinical endodontic practice.

PMID:42178531 | DOI:10.1186/s12909-026-09437-8

BMC Cardiovasc Disord. 2026 May 25. doi: 10.1186/s12872-026-06026-x. Online ahead of print.

ABSTRACT

BACKGROUND: There is a limited body of research examining the association between long COVID and major adverse cardiovascular events (MACE) as well as all-cause mortality. This study aimed to investigate the association between long COVID and both MACE and mortality.

METHODS: This retrospective cohort study utilized multicenter real-world data from the TriNetX research network platform, which contains electronic health records from multiple healthcare organizations. Patients aged 18 years and older who were diagnosed with COVID-19 between 2020 and 2023 were included. The exposure group comprised individuals diagnosed with long-COVID within 3 to 6 months after their initial COVID-19 diagnosis, while the comparison group included COVID-19 patients without a diagnosis of long-COVID. The primary outcomes were the risk of major adverse cardiovascular events (MACE) and all-cause mortality. Follow-up commenced 90 days after the index date and continued until the occurrence of the study outcome or the date of the last available medical record.

RESULTS: The risk of MACE was markedly higher in the long-COVID cohort compared to the non-long-COVID cohort. The overall hazard ratio (HR) for MACE was 4.48 (95% CI: 3.95-5.07). Specific conditions such as coronary artery disease and stroke exhibited particularly high HRs, at 6.48 (5.29-7.95) and 3.46 (2.96-4.04) respectively. Mortality was significantly higher in the long-COVID group, with an HR of 1.53 (1.38-1.69).

CONCLUSIONS: Compared to patients without long COVID, patients with long COVID had a higher risk of developing MACE.

PMID:42178526 | DOI:10.1186/s12872-026-06026-x