Tag: pubmed

J Immigr Minor Health. 2026 Jun 23. doi: 10.1007/s10903-026-01945-5. Online ahead of print.

ABSTRACT

Increasing global migration has intensified the need for culturally competent healthcare, particularly in countries with high immigrant populations. This study aimed to examine the effect of intercultural competence training on cultural sensitivity and communication skills among nursing students caring for immigrant patients. This experimental study with a control group was conducted online with 69 first-year nursing students at a public university (33 experimental, 36 control). The intercultural competence training program, delivered via online, included lectures, case-based discussions, and interactive activities over four weeks. Data were collected using the Intercultural Sensitivity Scale (ISS) and the Communication Skills Scale (CSS). Statistical analyses were performed using SPSS version 25. The experimental group demonstrated a statistically significant increase in both ISS and CSS scores following the intervention (p < 0.05), whereas no significant changes were observed in the control group. Intercultural competence training effectively improves cultural sensitivity and communication skills among nursing students. These findings highlight the importance of integrating such training into nursing education to enhance the quality and equity of healthcare for immigrant populations. Further studies with larger samples and long-term follow-up are recommended.

PMID:42334737 | DOI:10.1007/s10903-026-01945-5

Sports Med Open. 2026 Jun 23;12(1):79. doi: 10.1186/s40798-026-01054-5.

ABSTRACT

BACKGROUND: Generalized joint hypermobility (GJH) has been associated with increased risk of second anterior cruciate ligament (ACL) injury. The clinical diagnosis of GJH relies on a binary threshold of positive joint hypermobility tests, based on age and patient sex, which may overlook the degree of hypermobility.

OBJECTIVES: To analyze the association between the number of positive joint hypermobility tests on the Beighton Score and the hazard of second anterior cruciate ligament (ACL) injury in patients who return to sport (RTS) after primary ACL reconstruction, which included secondary, stratified analyses of graft rupture and contralateral ACL injury.

DESIGN: Registry study.

METHODS: Data were extracted in January 2026 from an ACL-rehabilitation-specific registry, Project ACL. Included patients were 15-50 years who underwent primary ACL reconstruction with hamstring tendon or bone-patellar tendon-bone autograft, had a documented Beighton Score, participated in knee-strenuous sports before injury, had RTS, reported second ACL injury or had ≥ 1 year follow-up without second ACL injury after RTS. Multivariable Cox proportional hazard regression was used to estimate the cause-specific hazard ratio (HR) of second ACL injury (measured from RTS) based on the Beighton Score, adjusted for age, return to pre-injury physical activity level or higher, graft choice, knee hyperextension (≥ 10° knee extension), and patient sex, accounting for competing risks.

RESULTS: The analysis included 935 patients (mean age 23.7 ± 7.8 years, 51.4% female), with median Beighton Score of 2 (interquartile range: 4). The median follow-up time was 54.4 months. The cumulative incidence of second ACL injury after RTS was 13.1%. Specifically, the cumulative incidence for graft rupture was 7.4% and 5.7% for contralateral ACL injury. For the primary outcome, each additional positive joint hypermobility test on the Beighton Score was associated with a significantly increased hazard of second ACL injury (adjusted HR: 1.10 (95% CI 1.003-1.22, p = 0.044). For the secondary outcomes, each additional test was associated with an increased hazard of graft rupture (adjusted HR: 1.15, 95% CI 1.01-1.30, p = 0.031), whereas no statistically significant association was observed for contralateral ACL injury.

CONCLUSIONS: The HR of second ACL injury (graft rupture or contralateral ACL injury) after RTS in patients who had undergone primary ACL reconstruction increased by 10%, and by 15% for isolated graft rupture, for each positive joint hypermobility test on the Beighton Score, while no association was observed for contralateral ACL injury.

PMID:42334734 | DOI:10.1186/s40798-026-01054-5

Health Care Anal. 2026 Jun 23. doi: 10.1007/s10728-026-00583-0. Online ahead of print.

ABSTRACT

Assisted reproductive technologies (ART) have expanded rapidly in India, raising significant ethical and distributive justice concerns relating to accessibility, affordability and reproductive healthcare governance. Despite growing scholarly attention to ART regulation, empirical evidence examining public perceptions of access, perceived equity barriers and ethical governance within the Indian context remains limited. This study addresses this gap through an empirical bioethics analysis of public perceptions regarding ART accessibility and governance in India. A cross-sectional survey of 560 respondents from urban, semi-urban and rural settings was conducted using a structured questionnaire. Data were analysed using descriptive statistics, reliability analysis, correlation analysis and one-way ANOVA with Tukey post hoc comparisons. The findings reveal significant geographic disparities in access to ART services, with urban respondents reporting substantially greater access than semi-urban and rural respondents (F = 35.040, p < 0.001). Descriptive findings further indicate moderate levels of awareness and regulatory trust alongside lower perceptions of access and greater perceived equity barriers. The study highlights the continuing influence of structural inequality on reproductive healthcare accessibility in India and underscores the need for policy interventions aimed at improving equitable access, institutional accountability and inclusive reproductive healthcare governance.

PMID:42334729 | DOI:10.1007/s10728-026-00583-0

Ann Biomed Eng. 2026 Jun 23. doi: 10.1007/s10439-026-04251-1. Online ahead of print.

ABSTRACT

PURPOSE: Postural control matures during childhood alongside the musculoskeletal system, though development is often asynchronous and influenced by sex. In this process, foot morphology is especially relevant, as the plantar surface provides key somatosensory input to the central nervous system. However, the role of foot-ground interaction in balance regulation remains largely unexplored. In this study, we attempted to clarify the association between foot morphology-measured via footprint-based indices-and static balance through postural sway analysis.

METHODS: Using a pressure platform, we simultaneously collected data on center of pressure (COP) trajectories during quiet upright stance and plantar pressure distribution in a sample of 178 children aged 6-11. Raw data were processed to calculate sway area and COP path length, as well as the Arch Index, which was used to categorize foot morphology as cavus, normal, or flat.

RESULTS: Among girls aged 8-9 years, statistically significant differences in postural sway parameters were observed across foot morphology groups, with individuals presenting cavus feet exhibiting greater sway area and COP path length values. A comparable tendency was also identified in those aged 10-11. In contrast, boys aged 10-11 with flat feet displayed lower sway area values under the eyes-closed condition and reduced COP path length under the eyes-open condition compared with peers presenting normal or cavus foot morphology.

CONCLUSION: Overall, these findings suggest that postural control during childhood is influenced by the mechanical and sensory characteristics of the foot-ground interface, and that sex represents a relevant moderating factor in this relationship.

PMID:42334708 | DOI:10.1007/s10439-026-04251-1

Eat Weight Disord. 2026 Jun 23. doi: 10.1007/s40519-026-01886-w. Online ahead of print.

ABSTRACT

OBJECTIVES: The present study explored affective touch in anorexia nervosa (AN) by: (a) comparing patients with AN and healthy control subjects (HCs) on the quality and quantity of affective-touch experiences across the lifespan; (b) investigating the association between affective touch and body-image-related symptoms; (c) assessing the link between affective touch and interpersonal space (IPS).

METHODS: Participants (76 patients with AN and 77 HCs) completed self-report questionnaires measuring eating-related symptoms, anxiety, depression, and affective-touch experiences. IPS was assessed with a computer-based stop-distance task with different social conditions.

RESULTS: Patients with AN had higher general (i.e., anxiety and depression), and body-image-related (e.g., body checking, body dissatisfaction) symptoms than HCs; moreover, they reported lower quantity of affective touch both in childhood and adulthood and less comfort with affective touch, with a medium to large effect size; more frequent negative affective-touch experiences were also observed in patients than in HCs, with a medium effect size. In patients, lower experienced affective touch, both in childhood and adulthood, and reduced touch-related comfort were associated with larger IPS, independent of anxiety and depression, and with a high effect size after statistical adjustment. No associations with IPS emerged in HCs.

CONCLUSIONS: The results highlighted a link between negative and reduced affective touch and social difficulties and avoidance in AN. The study remarks the relevance of affective-touch experiences and their relation with implicit body-related mechanisms, suggesting addressing early tactile experiences and interpersonal functioning in clinical interventions.

LEVEL OF EVIDENCE: Level III, case-control study based on self-report questionnaires and a behavioral task.

PMID:42334701 | DOI:10.1007/s40519-026-01886-w

Eur J Orthop Surg Traumatol. 2026 Jun 23;36(1):247. doi: 10.1007/s00590-026-04840-9.

ABSTRACT

PURPOSE: Minimally invasive plate osteosynthesis (MIPO) has been introduced as an alternative technique for distal radius fracture fixation, aiming to minimize surgical trauma while preserving soft tissue integrity. The Wide-Awake Local Anesthesia No Tourniquet (WALANT) method enables intraoperative functional assessment and early active wrist motion. Comparative evidence between MIPO and conventional volar plate fixation performed under WALANT remains limited.

METHODS: A single-center, assessor-blinded, randomized controlled trial was conducted between October 2021 and February 2023. Sixty-six patients with isolated closed distal radius fractures were randomized to MIPO (n = 33) or conventional open volar locking plate fixation via a modified Henry approach (n = 33) under WALANT. The primary outcome was first postoperative day pain measured by the visual analogue scale (VAS). Secondary outcomes included morphine usage, QuickDASH score, grip and pinch strength, range of motion, operative time, aesthetic score, radiographic parameters, and complications. Minimum follow-up was six months.

RESULTS: The MIPO group showed a statistically lower POD1 VAS pain score than the conventional group that was below the minimal clinically important difference and therefore not clinically significant (mean 3.4 [SD 0.96] vs. 4.2 [SD 1.51]; mean difference 0.8, 95% CI 0.2-1.4; p = 0.012). Cosmetic outcomes were higher in the MIPO group (mean aesthetic score 3.3 vs. 2.8). Morphine consumption, QuickDASH scores, grip and pinch strength, range of motion, operative duration, and radiographic outcomes were similar between groups, whereas intraoperative fluoroscopy use was higher in the MIPO group. All patients achieved bone union within three months, and no major complications were reported.

CONCLUSION: In this randomized controlled trial, MIPO under WALANT achieved functional, radiographic, and safety outcomes equivalent to conventional volar plate fixation. The statistically lower POD1 pain score in the MIPO group fell below the minimal clinically important difference, indicating no clinically significant difference in early postoperative pain between the two techniques; the only consistent advantages were smaller incisions and better cosmetic scores. MIPO under WALANT is therefore a safe and viable alternative-chosen for its cosmetic benefit and at the cost of greater fluoroscopy use and a steeper learning curve-rather than a clinically superior technique.

LEVEL OF EVIDENCE II: Randomized controlled trial, Therapeutic study.

PMID:42334684 | DOI:10.1007/s00590-026-04840-9

Eur J Sport Sci. 2026 Jul;26(7):e70210. doi: 10.1002/ejsc.70210.

ABSTRACT

Activities of daily living (ADL) are associated with declines in physical fitness and subjective health. However, it remains unclear as to whether ADL impairments are related to specific components of physical fitness and health variables. Therefore, we examined differences between community-dwelling older persons with versus without ADL impairments with regard to various physical fitness components, physical complaints as well as subjective and objective health outcomes. Cross-sectional study among 254 participants aged ≥ 55 years [51% female; 84 with ADL impairments; mean (SD) age 62.1 (6.6) years] enrolled in the population-based “Gesundheit zum Mitmachen” study in Southwestern Germany. ADL, physical complaints and subjective health status were assessed using a self-report questionnaire, physical fitness (cardiorespiratory fitness, strength, gross motor coordination, flexibility, and functional mobility) was assessed using a fitness test battery, and objective health status was derived from health exam performed by a physician. We ran analyses of covariance, adjusted for age, sex, body mass index and education. Participants with ADL impairments had statistically significantly worse subjective (p < 0.001) and objective (p < 0.001) health and reported more physical complaints (p < 0.001) compared to those without ADL impairments. Regarding physical fitness, ADL-impaired participants performed worse in 10 out of 12 variables. The findings provide additional evidence that ADL impairments are related to decreased objective and subjective health and physical fitness in older community-dwelling adults. Future studies employing more comprehensive, preferably objective, ADL assessments and considering cognitive impairments, which may also impact ADL performance, are warranted.

PMID:42332358 | DOI:10.1002/ejsc.70210

Clin Transl Sci. 2026 Jul;19(7):e70640. doi: 10.1111/cts.70640.

ABSTRACT

This was a Phase 1, open label, randomized, crossover study to evaluate the safety and pharmacokinetics of multiple doses of intranasal naloxone (NCT05377255). Twenty-four healthy participants were enrolled at a single site in the US to one of two sequences. Participants received four doses of 4 mg intranasal (IN) naloxone using two two-dose devices (AP003; single dose at 0, 2.5, 5.0, and 7.5 min) or two doses of 4 mg naloxone using two one-dose devices (single dose at 0 and 2.5 min). Treatments were separated by a 48-h washout, the order being driven by the crossover sequence. Blood samples were collected predose and at defined timepoints post-dosing for analysis of free and total naloxone, which were used for the noncompartmental PK analysis. Safety was assessed through physical exams, vital signs, electrocardiograms, continuous cardiac monitoring, clinical labs, olfactory assessments, rhinoscopy, and treatment emergent adverse events. Of the 24 participants, most were Female (n = 14, 58.3%), White (n = 20, 83.3%), and Hispanic or Latino (n = 24, 100%), with a mean age of 38.1 years and baseline body mass index of 26.2 kg/m². Naloxone concentrations increased similarly over 15 min and doubled for the AP003 group at 20 min, thereby meeting the primary objective. There was a dose-dependent increase in C_max, AUC_0-inf, pAUC, and AUC_0-t; however, statistical significance for dose proportionality was not seen in AUC_0-inf, AUC_0-t, and C_max. All treatment emergent adverse events were mild or moderate in severity and no serious adverse events were reported.

PMID:42332351 | DOI:10.1111/cts.70640

Musculoskeletal Care. 2026 Jun;24(2):e70237. doi: 10.1002/msc.70237.

ABSTRACT

BACKGROUND: Frozen shoulder, also known as adhesive capsulitis, is a common and disabling condition that causes shoulder pain and progressive stiffness. Patient information leaflets (PILs) are produced by UK National Health Service (NHS) Trusts to help patients understand frozen shoulder and treatment options. However, the content and consistency of these PILs and their alignment with national clinical guidance are currently unclear.

OBJECTIVES: This study aimed to identify, analyse and describe the non-surgical management recommendations presented in publicly available NHS Trust PILs for frozen shoulder and to assess their alignment with the National Institute for Health and Care Excellence (NICE) Clinical Knowledge Summary and British Elbow and Shoulder Society (BESS) best practice resources.

METHODS: An online search was undertaken by one reviewer to identify publicly available PILs produced by NHS Trusts detailing non-surgical management of frozen shoulder. Relevant data were extracted and analysed by one reviewer and verified by five reviewers. Descriptive statistics were used to summarise findings.

RESULTS: Thirty-eight PILs were identified from 38 NHS Trusts with publication dates ranging from April 2013 to March 2025. Considerable variation was observed in the content, including reference to analgesia, activity modification, exercise prescription and corticosteroid injections. No single PIL reflected all key elements recommended in the NICE Clinical Knowledge Summary and BESS best practice.

CONCLUSION: The findings demonstrate substantial variation in content, frequent misalignment with current national guidance and best practice exercise recommendations. Such variation may limit and may reduce the clarity, consistency and usefulness of information provided to patients.

PMID:42332346 | DOI:10.1002/msc.70237

J Neurol. 2026 Jun 22;273(7):413. doi: 10.1007/s00415-026-13941-8.

ABSTRACT

INTRODUCTION: Endothelial activation and stress index (EASIX) is a biomarker of endothelial dysfunction and has been validated previously as a prognostic score for mortality in various diseases, including oncologic diseases, sepsis, and cardiac disease. Since endothelial dysfunction is an established mediator of adverse outcomes in acute ischemic stroke, this study investigates the prognostic value of EASIX for risk of mortality in these patients.

PATIENTS AND METHODS: We analyzed data from the Heidelberg (n = 4,188) and Vienna (n = 2,273) prospective acute ischemic stroke registries. EASIX was calculated as creatinine [mg/dL] × LDH [U/L] / platelet count [10⁹/L]. An EASIX cut-off was established using maximal Youden index. Validation was performed using Brier score and C-statistics.

RESULTS: Higher EASIX was associated with higher risk of mortality in the training cohort in a multivariable Cox regression (HR of all-cause mortality per log2 increase: 1.20 (95% CI 1.12-1.28), p < 0.001). An optimal EASIX cut-off value of 1.211 was identified in the derivation cohort. In the independent validation cohort, this cut-off was associated with risk of 3-month mortality in a multivariable binary logistic regression model (OR 1.86 (1.28-2.70), p < 0.01). Brier score and C-statistics validated the superior predictive performance of EASIX in the multivariable model.

DISCUSSION AND CONCLUSION: EASIX predicts mortality in acute ischemic stroke patients and retained prognostic validity across two heterogeneous European cohorts. Incorporation of EASIX improved risk stratification beyond established clinical scores. EASIX may serve as a useful tool for risk stratification and outcome prediction in acute ischemic stroke patients.

PMID:42332326 | DOI:10.1007/s00415-026-13941-8