Tag: pubmed

BMC Med Educ. 2026 May 14. doi: 10.1186/s12909-026-09389-z. Online ahead of print.

ABSTRACT

BACKGROUND: Physiotherapy (PT) education must foster both clinical competencies and non-technical skills such as communication, empathy, and self-efficacy to prepare students for professional practice. Simulation-Based Learning (SBL) offers a structured and safe environment to develop these skills. While the benefits of SBL have been documented in nursing and medical education, evidence in PT programs, particularly across different academic years, remains limited. This study examined changes in perceived self-efficacy, academic engagement, and empathy following SBL participation, and to explore differences between second-, third-, and fourth-year PT students.

METHODS: A prospective quasi-experimental study was conducted between December 2023 and June 2024 involving second-, third-, and fourth-year undergraduate PT students from a single Spanish university (corresponding to the fourth, sixth, and eighth semesters, respectively). Students participated in SBL sessions designed according to international standards and adapted to their academic level. Outcomes were assessed pre- and post-SBL through validated questionnaires: the Academic Situation-Specific Perceived Self-Efficacy Scale, the Utrecht Work Engagement Scale for Students, and the Jefferson Scale of Empathy. All instruments demonstrated adequate internal consistency in the study sample (Chronbach’s α ≥ 0.80). Post-SBL perceptions were further assessed using the Student Satisfaction and Self-Confidence in Learning Questionnaire and the Educational Practices Questionnaire-Spanish Version.

RESULTS: Out of 451 eligible students, 409 participated in the baseline assessment and 378 completed post-SBL assessments. Statistically significant improvements were found in self-efficacy (p = 0.001), academic engagement (vigor, absorption, and total score; p = 0.008; p = 0.007, and p = 0.023, respectively), and empathy (compassionate care and total score; p < 0.001, and p = 0.007, respectively) across the full sample. When results were examined by academic year, patterns of change differed, with third- and fourth-year students showing consistent improvements across most dimensions, while second-year students exhibited more variable responses, including small decreases in selected engagement and empathy subscales. Post-SBL evaluations indicated high levels of satisfaction and self-confidence in learning, with large effect sizes observed in the more advanced academic years. Students’ perceptions indicated strong endorsement of SBL practices, especially in high expectations and learning diversity.

CONCLUSIONS: SBL was associated with improvements in key learning-related competencies, particularly among students in more advanced academic years. Differences across cohorts highlight the need to tailor SBL design to students’ developmental stage, especially during early exposure. Future studies should incorporate control groups, qualitative data, and follow-up assessments to better understand the sustainability and contextual factors influencing SBL outcomes.

TRIAL REGISTRATION: NCT06852482 (registered on 28 February 2025).

PMID:42135739 | DOI:10.1186/s12909-026-09389-z

BMC Med Educ. 2026 May 14. doi: 10.1186/s12909-026-09443-w. Online ahead of print.

ABSTRACT

BACKGROUND: Simulation-based training (SBT) has emerged as a structured educational strategy to support safe transition into clinical imaging practice. In nuclear medicine technology (NMT), where high-risk procedures require precision and adherence to radiation protection standards, variability in clinical-based training (CBT) exposure may affect skill acquisition. Evidence evaluating structured simulation integration within undergraduate nuclear medicine education remains limited. This study aimed to evaluate performance outcomes associated with SBT and CBT using a structured OSCE framework to assess competency acquisition, procedural performance, and radiation safety preparedness among undergraduate nuclear medicine students.

METHODS: A comparative educational evaluation was conducted involving two undergraduate NMT cohorts from separate institutions in Riyadh, Saudi Arabia (SBT, n = 30; CBT, n = 30). Students underwent a structured four-station objective structured clinical examination (OSCE) in a controlled hot laboratory environment assessing theoretical knowledge, radiopharmaceutical dose preparation, dose calibrator operation, and radiation safety management. Normality of the data was assessed using the Shapiro-Wilk test, and homogeneity of variances was evaluated using Levene’s test. Independent-samples t-tests with Welch’s correction were used to compare group means between SBT and CBT groups. For variables where assumptions were violated, the non-parametric Mann-Whitney U test was applied. Bonferroni correction was applied to account for multiple comparisons (p < 0.0125).

RESULTS: Students trained using simulation demonstrated higher mean scores across all OSCE stations compared with clinically trained peers. Statistically significant differences were observed in stations 2, 3, and 4 (all p < 0.001), favoring the SBT group and remaining significant after Bonferroni correction. Higher mean performance was also observed in theoretical knowledge; however, this difference was not statistically significant.

CONCLUSIONS: Simulation-based training was associated with higher mean performance across assessed competencies, with statistically significant differences observed in practical and safety-related OSCE stations (stations 2-4). While no significant difference was observed in theoretical knowledge, these findings suggest that structured simulation may enhance procedural readiness and reinforce radiation safety behaviors in undergraduate nuclear medicine education when integrated alongside clinical training.

PMID:42135738 | DOI:10.1186/s12909-026-09443-w

BMC Nurs. 2026 May 14. doi: 10.1186/s12912-026-04723-8. Online ahead of print.

ABSTRACT

AIM/OBJECTIVE: This study aimed to examine the role of perceived academic mentorship and self-efficacy in enhancing self-directed learning readiness (SDLR) among undergraduate nursing students.

BACKGROUND: Self-directed learning readiness is essential for nursing students to effectively manage their learning in complex and evolving healthcare environments. While academic mentorship and self-efficacy have been associated with learning outcomes, their combined relationships with SDLR remain insufficiently explored.

METHODS: A descriptive correlational cross-sectional design was used. Data were collected from 500 undergraduate nursing students at the Faculty of Nursing, Damanhour University, Egypt, during the 2025-2026 academic year. Data were collected using three validated self-report scales measuring perceived academic mentorship, self-directed learning readiness, and self-efficacy. Data were analyzed using descriptive statistics, correlation, regression, and mediation analysis.

RESULTS: Perceived academic mentorship showed moderate positive correlations with self-directed learning readiness (r = 0.48, p < 0.01) and self-efficacy (r = 0.52, p < 0.01), while self-efficacy was also positively correlated with SDLR (r = 0.46, p < 0.01). Regression analysis indicated that demographic and academic variables explained 26.9% of the variance in SDLR. Mediation analysis revealed that self-efficacy partially mediated the relationship between perceived academic mentorship and SDLR (β = 0.15, 95% CI [0.10-0.20]).

CONCLUSIONS: The findings indicate that students’ readiness for self-directed learning is not shaped by academic mentorship alone, but by how mentorship experiences translate into stronger beliefs in their ability to manage learning demands. This suggests that efforts to enhance students’ readiness for self-directed learning should prioritize mentorship approaches that move beyond guidance alone toward intentionally fostering students’ confidence, independence, and engagement in their learning processes.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:42135737 | DOI:10.1186/s12912-026-04723-8

BMC Surg. 2026 May 14. doi: 10.1186/s12893-026-03819-x. Online ahead of print.

ABSTRACT

BACKGROUND: Postoperative abdominal wall dehiscence (AWD) or burst abdomen (BA) is a relevant complication after abdominal surgery that causes additional surgical procedures, prolonged hospital stays and long-term morbidity. Several underlying risk factors exist and have been described in literature and consist of surgical and medical factors. Recently, CT-derived body composition is of rising interest to provide new prognostic factors in surgical patients. The present study aims to explore the association between CT-defined body composition and postoperative BA.

MATERIALS AND METHODS: A database of patients who underwent abdominal surgery and developed post-operative wound infections in our institution between 2015 and 2018, was assembled. The subgroup of patients with BA was compared to a control group without BA. CT-defined body composition was evaluated in L3-level measuring skeletal muscle index (SMI) for sarcopenia assessment, visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT). Clinical risk factors and CT-defined body composition were used to predict the occurrence of postoperative BA using discriminatory and binary logistic regression analyses.

RESULTS: A total of 118 patients, 92 (78%) with BA and 26 (22%) without BA were included in the analysis. CT derived body composition parameters for visceral obesity and sarcopenia showed statistically significant differences between the two cohorts. Patients with burst abdomen showed higher VAT (157.6 cm² vs. 84.9 cm², p = 0.001) and a significantly lower SMI (46.9 cm²/m² vs. 53.8 cm²/m², p = 0.016). Consequently, visceral obesity and sarcopenia were significantly more frequent in patients with BA (p = 0.02 and 0.01, respectively). In the multivariable Firth’s penalized logistic regression, visceral obesity (OR = 4.87, 95% CI 1.32-21.91 p = 0.02), sarcopenia (OR = 5.94, 95% CI 1.65-26.68 p = 0.006), intestinal resection (OR = 9.33, 95% CI 2.33-55.65 p < 0.001) and length of the surgical wound (OR = 1.12, 95% CI 1.04-1.22 p = 0.001) were independently associated with the occurrence of burst abdomen.

CONCLUSION: CT-defined body composition with sarcopenia and visceral obesity are strongly associated with postoperative BA. This analysis should be further acknowledged as a potentially important risk factor in surgical care and could aid in clinical decision making.

PMID:42135717 | DOI:10.1186/s12893-026-03819-x

J Cardiothorac Surg. 2026 May 14. doi: 10.1186/s13019-026-04094-w. Online ahead of print.

ABSTRACT

BACKGROUND: Sepsis is a critical condition that leads to significant morbidity and mortality. Accurate prediction of patient outcomes is essential for effective management. This meta-analysis evaluates the prognostic value of echocardiographic cardiac function parameters, particularly left ventricular ejection fraction (LVEF) and left ventricular global longitudinal strain (LVGLS), in predicting short-term outcomes in sepsis patients.

METHODS: A systematic search of PubMed, Embase, Web of Science, and the Cochrane Library was conducted from inception to January 19, 2026, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Cohort studies assessing echocardiographic parameters and short-term mortality in adult sepsis were included. Random-effects meta-analysis was performed using standardized mean differences (SMDs). Sensitivity analyses included leave-one-out procedures and restricted maximum likelihood with Hartung-Knapp adjustment. Publication bias was evaluated using funnel plots and Egger’s regression test.

RESULTS: Nine cohort studies published between 2014 and 2021 were included. LVGLS was significantly more impaired in non-survivors than in survivors (SMD – 0.40, 95% confidence interval [CI] – 0.62 to – 0.18; I² = 51.1%). Results remained robust with Hartung-Knapp adjustment (SMD – 0.55, 95% CI – 0.79 to – 0.30). In a septic shock-only sensitivity analysis, the association persisted (SMD – 0.76, 95% CI – 1.01 to – 0.51; I² = 0%). Subgroup analysis showed no significant difference between Sepsis-2 and Sepsis-3 studies (P = 0.45). LVEF was not associated with short-term mortality (SMD 0.06, 95% CI – 0.08 to 0.20; I² = 27.2%). Funnel plot inspection showed no clear asymmetry, and Egger’s test was not statistically significant.

CONCLUSIONS: LVGLS is associated with short-term mortality in sepsis and may provide incremental prognostic information beyond conventional LVEF assessment. Prospective studies are needed to define clinically meaningful thresholds and evaluate incremental value over established risk scores.

PMID:42135714 | DOI:10.1186/s13019-026-04094-w

Immunobiology. 2026 May 12;231(3):153187. doi: 10.1016/j.imbio.2026.153187. Online ahead of print.

ABSTRACT

Despite the proliferation of prognostic gene signatures for glioma, clinical translation remains stalled by poor reproducibility and overfitting. In this study, we address this stability crisis by developing a robust “Dual-Signature Framework” using stability selection-a rigorous resampling method-rather than standard regression. Analyzing RNA-seq data from 1351 patients across the TCGA (n = 694) and CGGA (n = 657) cohorts, we constructed two distinct models. The primary 20-gene “Data-Driven” signature achieved superior predictive accuracy (C-index: 0.7392), significantly outperforming 14 published benchmark models and the current best single-gene predictor (HOXA5). In parallel, we derived a 7-gene “Biology-Driven” signature (including HOXA5, CHI3L1, MMP14) that retained 98% of the predictive power (C-index: 0.7252) while prioritizing mechanistic interpretability. Both models successfully stratified patients into distinct risk groups with high statistical significance (Log-rank p < 0.001) in external validation. Comprehensive subgroup analyses across 19 clinical and molecular subgroups demonstrated robust performance (C-index range: 0.59-0.85), with extended calibration analysis confirming excellent probability estimation (Brier score 0.20 for 5-year predictions). By integrating stability-driven feature selection with biological pathway constraints, this study provides a reproducible, high-performance alternative to unstable “black box” models, offering a translation-ready tool for personalized glioma risk assessment.

PMID:42134029 | DOI:10.1016/j.imbio.2026.153187

Am J Public Health. 2026 May 14:e1-e4. doi: 10.2105/AJPH.2026.308528. Online ahead of print.

ABSTRACT

Objectives. To describe mortality rates by occupation among working-age men in the United States in 2022 and 2023. Methods. I obtained data on the occupation of decedents from death certificate data published by the National Center for Health Statistics for men aged 20 to 64 years. I calculated mortality rates and rate ratios for occupation groups. Results. Mortality rates were more than double for construction and extraction workers compared with all other workers. Mortality rates and rate ratios for workers in manual, blue-collar occupations were significantly higher than those for workers in other occupations. Conclusions. There were notably higher mortality rates for workers in manual, blue-collar occupations. Occupation groups with higher mortality rates also generally had a larger share of men in their workforce. Public Health Implications. Further research should examine work-related risk factors for occupational disparities in all-cause mortality. The workplace can be a convenient setting for interventions to prevent premature death among working-age men. Including occupation at the time of death in public health data can improve the validity and precision of future studies of the occupational causes of mortality. (Am J Public Health. Published online ahead of print May 14, 2026:e1-e4. https://doi.org/10.2105/AJPH.2026.308528).

PMID:42133997 | DOI:10.2105/AJPH.2026.308528

Genome. 2026 May 14. doi: 10.1139/gen-2025-0065. Online ahead of print.

ABSTRACT

Human-mediated change has resulted in the expansion of many species into novel habitats. Range expansions have been described demographically as either pulled or pushed, depending on the number of individuals on the leading front, and can leave distinct genomic signatures within the genome. The recent expansions of Agrilus planipennis, Lycorma delicatula, and Dendroctonus ponderosae represent different types of range expansion which can be analyzed by coupling rigorous monitoring of recent expansions with whole-genome assemblies to provide a strong comparative framework with which to study the genomic signatures of expansion type. Here, we synthesize range expansion theory in the context of these recent expansions and generate hypotheses on the expected patterns of genomic change. We then outline statistical and genome-structural methods that can be used to identify putatively adaptive loci, leveraging the increased genomic resolution provided by whole-genome assemblies. Finally, we complement the overarching expansion hypotheses with a discussion of using a top-down approach to identify loci under selection, using cold tolerance traits as an example. With these methods we can better understand the risk of further spread and persistence of these expanding insect populations, as well as establish a framework for quantifying the adaptive potential of other expanding species.

PMID:42133990 | DOI:10.1139/gen-2025-0065

JMIR Mhealth Uhealth. 2026 May 14;14:e77778. doi: 10.2196/77778.

ABSTRACT

BACKGROUND: Digital tools are known to promote public health interventions such as vaccine delivery. The recommendation that health care professionals (HCPs) use vaccination-related mobile apps or web-based applications has contributed to improving vaccine awareness and acceptance in the United States. The state of Texas, which has one of the lowest human papillomavirus (HPV) vaccination rates, has seen a significant increase in HPV vaccine hesitancy, particularly during the COVID-19 pandemic.

OBJECTIVE: This study aimed to examine the association between changes in HPV vaccine hesitancy observed by HCPs among patients in Texas and promotion of vaccination-related applications at the health care facilities where they practiced during the COVID-19 pandemic.

METHODS: A population-based cross-sectional survey was administered in 2021 by the MD Anderson Cancer Center to HCPs working in Texas using email addresses obtained from the LexisNexis Master Provider Referential Database. HCPs were asked if they assessed HPV vaccination status during every patient encounter. Those who responded “Often/Always” or “Sometimes” were subsequently asked whether they observed any change (“Decreased,” “No change,” “Increased,” or “Not sure”) in HPV vaccine hesitancy during the COVID-19 pandemic. Additionally, HCPs were asked whether their practice offers HPV vaccination. Those who responded “Yes” to this question were further asked whether vaccination-related applications are promoted at the facility where they practice, with response options being “Yes,” “No,” or “I don’t know.” Logistic regression analysis was performed to examine the association between changes in HPV vaccine hesitancy observed by HCPs and promotion of vaccination-related applications at the facility where they practice.

RESULTS: A total of 1283 HCPs completed the survey. Of the 730 HCPs who observed changes in HPV vaccine hesitancy, 51 (7%) reported a decrease in their patients’ HPV vaccine hesitancy. Of these 730 HCPs, 578 (79.2%) responded to the questions regarding vaccination-related applications, of whom 104 (18%) reported that vaccination-related applications were promoted at their facilities. Compared to HCPs who reported not promoting vaccination-related applications, those who reported doing so at their facilities had significantly higher odds of observing a decrease in HPV vaccine hesitancy among patients (adjusted odds ratio [aOR] 2.48, 95% CI 1.10-5.55; P=.03). HCPs working at federally qualified health centers or city, county, or public health care facilities (aOR 4.02, 95% CI 1.33-12.14; P=.01) and HCPs who administered the HPV vaccine under standing orders at their facilities (aOR 2.91, 95% CI 1.11-7.63; P=.03) had significantly higher odds of observing a decrease in HPV vaccine hesitancy at their practices.

CONCLUSIONS: Our findings suggest that promoting vaccination-related applications at health care facilities in areas with high HPV vaccine hesitancy such as Texas could further decrease HPV vaccine hesitancy in the population. This may be potentially applicable across diverse health care settings, particularly in the context of pandemic preparedness.

PMID:42133976 | DOI:10.2196/77778

JMIR Public Health Surveill. 2026 May 14;12:e86435. doi: 10.2196/86435.

ABSTRACT

BACKGROUND: Although health care providers are the most trusted sources of health information, service establishments within communities represent important, yet underused, sources of health information. Specifically, food and beauty establishments can act as alternative settings for health communication, facilitating broader engagement with the general population.

OBJECTIVE: This study examined factors associated with willingness to receive health information from these non-health care service establishments among community-dwelling adults in Singapore.

METHODS: A cross-sectional survey was conducted among residents in 2 neighborhoods in central Singapore between November 2024 and April 2025. Data on sociodemographic characteristics, trust in information from health care and non-health care services, and willingness to receive health information were collected anonymously. The primary outcome was willingness to receive health information from non-health care services (yes or no), assessed among respondents with no prior exposure to health information from such services. Multivariable logistic regression was used to identify factors independently associated with willingness to receive health information from non-health care services.

RESULTS: Among the 403 respondents, most were aged ≥50 years (n=223, 55.3%), female (n=219, 54.3%), Chinese (n=350, 86.9%), and highly educated (n=302, 74.9%). Of the 339 respondents without prior exposure to health information from non-health care services, approximately one-third (n=106, 31.3%) reported that they were willing to receive health information in the future. In adjusted analysis, greater trust in health information (adjusted odds ratio [AOR] 3.71, 95% CI 1.50-9.19) and high health information orientation (AOR 1.89, 95% CI 1.11-3.21) were associated with increased willingness to receive health information from non-health care services. Trust in health information was positively associated with willingness among those aged 21 to 34 years (AOR 4.96, 95% CI 1.35-18.30), those aged 35 to 49 years (AOR 8.02, 95% CI 2.62-24.59), and male respondents (AOR 6.22, 95% CI 2.79-13.89) to receive health information from these sources, but not among those aged ≥50 years (AOR 1.92, 95% CI 0.92-4.02) or female respondents (AOR 1.85, 95% CI 0.87-3.96).

CONCLUSIONS: Nearly one-third of community-dwelling adults expressed willingness to receive health information from non-health care (food and beauty) services, highlighting the potential for leveraging these establishments as alternative health communication channels. Willingness was positively associated with higher health information orientation and greater trust. Additionally, trust in non-health care (food and beauty) services was associated with higher odds of willingness to receive health information among those aged 21 to 49 years and male respondents. This suggests the need for tailored trust-building strategies to strengthen engagement through such alternative channels.

PMID:42133973 | DOI:10.2196/86435