Tag: pubmed

J Med Ultrasound. 2025 Nov 8;34(2):186-193. doi: 10.4103/jmu.JMU-D-25-00056. eCollection 2026 Apr-Jun.

ABSTRACT

BACKGROUND: Repetitive loading injuries of the rotator cuff tendons are common in baseball pitchers. Ultrasonography-based strain analysis shows promise for in vivo monitoring of cumulative tendon loading but faces technical challenges in the rotator cuff. We developed a novel ultrasonography-based strain analysis procedure to test the hypothesis that regular-season pitching increases the peak strain of the subscapularis tendon.

METHODS: Ultrasound image sequences of subscapularis tendon were obtained from the dominant shoulders of nine pitchers during isotonic motion in the preseason and regular season. Tendon displacement during the eccentric phase was estimated using optical flow tracking, validated against NCORR, a reliable software for quantifying material deformation.

RESULTS: Peak strain was significantly higher in the regular season (18.7 ± 3.1%) compared to the preseason (8.8 ± 2.7%), suggesting an elevated risk of tendon microdamage.

CONCLUSION: Our findings indicate that intense pitching during the season may elevate tendon strain, highlighting the potential of strain analysis for monitoring tendon loading-related changes. The proposed procedure is robust, reliable, and easy to implement, offering a practical tool for tracking in-season tendon loading in pitchers.

PMID:42492005 | PMC:PMC13379176 | DOI:10.4103/jmu.JMU-D-25-00056

ACI open. 2024 Jul;8(2):e89-e93. doi: 10.1055/a-2402-5937. Epub 2024 Dec 27.

ABSTRACT

OBJECTIVES: Computable or electronic phenotypes of patient conditions are becoming more commonplace in quality improvement and clinical research. During phenotyping algorithm validation, standard classification performance measures (i.e., sensitivity, specificity, positive predictive value, negative predictive value, and accuracy) are often employed. When validation is performed on a randomly sampled patient population, direct estimates of these measures are valid. However, studies will commonly sample patients conditional on the algorithm result prior to validation, leading to a form of bias known as verification bias.

METHODS: We illustrate validation study sampling design and naïve and bias-corrected validation performance through both a concrete example (1,000 cases, 100 noncases, 1:1 sampling on predicted status) and a more thorough simulation study under varied realistic scenarios. We additionally describe the development of a free web calculator to adjust estimates for people validating phenotyping algorithms.

RESULTS: In our illustrative example, naïve performance estimates corresponded to 0.942 sensitivity, 0.979 specificity, and 0.960 accuracy; these contrast proper estimates of 0.620 sensitivity, 0.999 specificity, and 0.944 accuracy after adjusting for verification bias using our free calculator. Our simulation results demonstrate increasing positive bias for sensitivity and negative bias for specificity as the disease prevalence approaches zero, with decreasing positive predictive value moderately exacerbating these biases.

CONCLUSION: Novel computable phenotypes of patient conditions must account for verification bias when calculating performance measures of the algorithm. The performance measures may vary significantly based on disease prevalence in the source population so use of a free web calculator to adjust these measures is desirable.

PMID:42491998 | PMC:PMC13379156 | DOI:10.1055/a-2402-5937

J Med Ultrasound. 2026 May 16;34(2):201-206. doi: 10.4103/jmu.JMU-D-25-00004. eCollection 2026 Apr-Jun.

ABSTRACT

BACKGROUND: The impact of family history of breast cancer (FHBC) on the texture features of the breast is poorly understood. We sought to examine the effect of FHBC on the image texture features of breast sonograms of young asymptomatic women.

METHODS: This study estimated texture features in breast sonograms with ImageJ software in a cohort of 360 young asymptomatic women aged 19-29 years. The sonographic assessment was performed using a digital color Doppler ultrasonic diagnostic instruments (Xuzhou Kaixin Electronic Instrument: Model – DCU7; SN-2331531). Texture analysis of each region of interest was performed using the gray-level co-occurrence matrix plugin of the ImageJ software. An independent samples t-test was used to compare the texture features of the breast in women with FHBC and the control.

RESULTS: Tissue homogeneity and uniformity were significantly lower in women with FHBC (P < 0.05), while tissue complexity (entropy) was significantly higher in subjects with FHBC (P = 0.02). Correlation and contrast were statistically the same between these groups contraceptive use showed no statistical association with breast image texture features (P > 0.05).

CONCLUSION: In this study, breast tissue complexity, homogeneity, and uniformity were affected by FHBC. Breast texture features should be considered when assessing risk in women with FHBC.

PMID:42491985 | PMC:PMC13379167 | DOI:10.4103/jmu.JMU-D-25-00004

Cureus. 2026 Jun 17;18(6):e111045. doi: 10.7759/cureus.111045. eCollection 2026 Jun.

ABSTRACT

INTRODUCTION: Antimicrobial resistance (AMR) is a major public health threat, particularly in low- and middle-income countries where inappropriate antibiotic use remains common. Community Health Workers (CHWs) are important providers of primary healthcare (PHC) in Nigeria, yet evidence on their AMR knowledge, stewardship training, and prescribing influences remains limited. This study assessed AMR/AMS knowledge, training exposure, prescribing attitudes, and factors influencing antimicrobial prescribing among CHWs in Kaduna State, Nigeria.

METHODS: A descriptive cross-sectional study was conducted among 286 CHWs selected from 27 government-owned PHC facilities in Kaduna State using multistage sampling. Data were collected between August and September 2025 using a structured self-administered questionnaire. Data were analyzed using IBM Statistical Package for the Social Sciences version 25.0 (IBM Corp., Armonk, NY). Descriptive statistics were presented as frequencies and percentages, while chi-square tests assessed associations between AMR/AMS training, knowledge level, and attitude level.

RESULTS: Most respondents had heard of AMR (87.4%), correctly identified bacteria as the target of antibiotics (90.9%), and recognized that inappropriate antibiotic use contributes to resistance (92.7%). Only 20.6% had received formal AMR/AMS training. Although many respondents reported guideline use (68.6%) and prescription documentation (70.3%), 62.3% prescribed antibiotics based on experience without diagnostic tools, while 38.1% reported patient demand-influenced prescribing decisions. Formal AMR/AMS training was significantly associated with both knowledge level and attitude level.

CONCLUSION: Despite generally good AMR knowledge, formal stewardship training among CHWs was limited. Strengthening AMR/AMS training, diagnostic support, supervision, and guideline-based prescribing may improve antimicrobial stewardship at the PHC level.

PMID:42491981 | PMC:PMC13378881 | DOI:10.7759/cureus.111045

J Educ Health Promot. 2026 Jun 30;15:250. doi: 10.4103/jehp.jehp_1342_25. eCollection 2026.

ABSTRACT

BACKGROUND: Prolonged QTc interval and reduced heart rate variability (HRV) are independent predictors of postexercise sudden cardiac death (SCD) in apparently healthy individuals. Offspring of hypertensive parents may exhibit early autonomic dysfunction, placing them at higher risk for future cardiovascular disease. This study evaluated the impact of submaximal aerobic exercise on QTc interval and its correlation with HRV in normotensive individuals with and without parental hypertension.

MATERIALS AND METHODS: A cross-sectional study was conducted on 100 healthy medical students (18-25 years), divided into normotensive offspring of hypertensive parents (NOHPs, n = 50) and sex-matched offspring of normotensive parents (NONPs, n = 50). HRV and lead-II ECG were recorded in supine rest and 10 minutes postexercise. Participants underwent a standardized submaximal treadmill test using a modified Bruce protocol, targeting 50% VO₂max to ensure uniform workload. HRV indices (LFnu, HFnu, LF/HF ratio) and QTc (Bazett’s correction) were analyzed with statistical significance set at P < 0.05.

RESULTS: Following exercise, NOHPs exhibited significantly prolonged QTc, higher LFnu, and elevated LF/HF ratio, alongside a reduction in HFnu compared with NONPs, indicating sympathovagal imbalance characterized by sympathetic predominance and vagal withdrawal. Correlation analysis revealed strong positive associations of QTc with LFnu and LF/HF ratio, and a negative association with HFnu in NOHPs during recovery.

CONCLUSION: Submaximal exercise unmasks latent autonomic dysfunction in NOHPs, reflected as impaired vagal reactivation and augmented sympathetic drive, which is closely linked to prolonged QTc during recovery. The study highlights that combined QTc-HRV assessment, particularly after standardized exercise using the modified Bruce protocol, may serve as a sensitive early marker of repolarization instability and elevated arrhythmic risk in young individuals with genetic predisposition to hypertension.

PMID:42491979 | PMC:PMC13378863 | DOI:10.4103/jehp.jehp_1342_25

J Educ Health Promot. 2026 Jun 30;15:241. doi: 10.4103/jehp.jehp_1956_24. eCollection 2026.

ABSTRACT

Clinical training plays a crucial role in the quality of medical education and student satisfaction. This study aimed to evaluate the effectiveness of e-learning in teaching nasogastric intubation skills compared with traditional face-to-face training among medical students. A quasi-experimental study was conducted in 2022 at Islamic Azad University, Najafabad Branch, involving 37 eighth-semester medical students selected through convenience sampling. Participants were divided into two groups: face-to-face training (n = 19) and e-learning (n = 18). Skill acquisition was assessed using a structured checklist, and student satisfaction was measured using a questionnaire. Data were analyzed using SPSS, employing independent and dependent t-tests, the Kolmogorov-Smirnov test, and the Mann-Whitney test. The results showed that the e-learning group achieved significantly higher skill scores compared with the traditional group (P = 0.003). Although satisfaction scores were higher in the e-learning group, the difference was not statistically significant (P = 0.61). These findings suggest that well-designed e-learning can be as effective as traditional methods for clinical skills training, offering a flexible and efficient alternative without reducing student satisfaction.

PMID:42491966 | PMC:PMC13378860 | DOI:10.4103/jehp.jehp_1956_24

J Educ Health Promot. 2026 Jun 30;15:254. doi: 10.4103/jehp.jehp_1585_25. eCollection 2026.

ABSTRACT

BACKGROUND: Telenursing, the application of telecommunications technology to deliver nursing care, is increasingly recognized as a strategy to enhance healthcare access and efficiency. Understanding undergraduate nursing students’ knowledge and perception of telenursing is critical for guiding curriculum development and promoting technology adoption in future practice.

MATERIALS AND METHODS: A descriptive cross-sectional study was conducted among 276 undergraduate nursing students at the University of Calabar, selected through stratified random sampling. Data were collected using a structured, self-administered questionnaire and analyzed with descriptive statistics and Chi-square tests. Perception was categorized as “good” when students scored ≥70% on the Likert scale section of the instrument.

RESULTS: Most students (96.0%) were aware of telenursing; however, only 22.8% had direct exposure to telenursing tools, and 13.4% were familiar with applications such as teleconferencing or teleconsultation. Less than half recognized its role in continuing nursing care (47.8%) or its usefulness in managing chronic conditions and surgical patients (34.1%). Overall, 49.3% of students demonstrated good perception, while 50.7% had poor perception. Significant associations were observed between perception and knowledge scores (P < 0.05), as well as between knowledge and students’ year of study and digital literacy levels (P < 0.05).

CONCLUSION: Despite high awareness of telenursing, practical exposure and comprehensive understanding remain limited among undergraduate nursing students in Nigeria. Integrating targeted telenursing training, enhancing digital literacy, and redesigning nursing curricula are recommended to improve readiness for technology-driven healthcare delivery.

PMID:42491963 | PMC:PMC13378809 | DOI:10.4103/jehp.jehp_1585_25

J Educ Health Promot. 2026 Jun 30;15:268. doi: 10.4103/jehp.jehp_257_25. eCollection 2026.

ABSTRACT

BACKGROUND: Empowering healthcare providers is a crucial strategy for enhancing the quality of primary healthcare. This study aimed to investigate the effect of online multimedia psychoeducational interventions on the psychological empowerment of healthcare providers.

MATERIALS AND METHODS: This quasi-experimental study was conducted in 2024 on 80 healthcare providers working in comprehensive health centers in Shiraz City, Iran. Convenience sampling was applied in this study. The intervention group received online multimedia psychoeducational interventions over 2 weeks. These interventions consisted of 14 daily modules. Participants completed the Spreitzer and Mishra Psychological Empowerment Questionnaire before the intervention and again 1 month afterward. Data were analyzed using SPSS version 26 [IBM Corp. Released 2015. IBM SPSS Statistics for Windows, version 23.0. Armonk, NY: IBM Corp.], employing t-test, independent t-test, Chisquare test, and Cohen’s effect size index.

RESULTS: The findings showed a significant difference in the psychological empowerment scores before and after the training program in the intervention group (P < 0.001) compared to the control group (P = 0.20). This result is further supported by a very large Cohen’s effect size (ES = 3.1).

CONCLUSION: The results indicate that online multimedia psychoeducational interventions can be an effective method for training and enhancing psychological empowerment. Psychological empowerment training programs should be integrated into the curriculum for students who will later be employed as healthcare providers in healthcare systems. This study was conducted on urban health centers. Future research should explore the impact of such interventions on healthcare providers working in rural health centers.

PMID:42491961 | PMC:PMC13378822 | DOI:10.4103/jehp.jehp_257_25

J Educ Health Promot. 2026 Jun 30;15:244. doi: 10.4103/jehp.jehp_1131_25. eCollection 2026.

ABSTRACT

BACKGROUND: Sewage treatment is the process of removing contaminants from wastewater, primarily household sewage and produce environmentally safe treated effluent which is done at the sewage treatment plants. International labor organization (ILO) classifies hazards among sewage treatment plant (STP) workers as accidental, physical, chemical, biological, ergonomical, and psychological. Current study was conducted to assess the occupational hazards and the various factors influencing it among the sewage treatment plant workers.

MATERIALS AND METHODS: A descriptive cross-sectional study was conducted among 112 sewage treatment plant workers working at 3 sewage treatment plants, in Bangalore, for a period of 2 months from May to June 2017. The data were collected from the subjects after obtaining informed consent using a pretested semistructured questionnaire by interview technique. The results were expressed using descriptive and inferential statistics.

RESULTS: In this study, majority, i.e., 82.0%, of the study subjects were men and the mean age was 36.39 ± 10.81 years. The most common hazards among the STP workers were musculoskeletal injuries (44.6%), lifting of heavy weights (36.6%), awkward working postures, discomfort to bad smells (35.7%), excessive noise (34.8%), and cuts and pricks by sharp tools (20.5%). Among the various factors assessed, work experience was significantly associated with occupational hazard (P < 0.05).

CONCLUSION: Most common occupational hazard among the STP workers was ergonomic related, i.e., musculoskeletal injuries (44.6%), and less work experience was significantly associated with it. Hazards can be reduced using ergonomically designed tools and proper training of the workers.

PMID:42491959 | PMC:PMC13378798 | DOI:10.4103/jehp.jehp_1131_25

J Educ Health Promot. 2026 Jun 30;15:263. doi: 10.4103/jehp.jehp_1720_25. eCollection 2026.

ABSTRACT

BACKGROUND: Opisthorchis viverrini (OV) infection remains a major public health issue in the Mekong Basin and a leading cause of cholangiocarcinoma (CCA). This study identified determinants of OV/CCA preventive behaviors in Champasak Province, Lao People’s Democratic Republic (PDR), using the theory of planned behavior and social support.

MATERIALS AND METHODS: A community-based cross-sectional study was conducted from January to March 2025 among 577 residents aged ≥20 years in one city and nine districts of Champasak Province, southern Lao PDR. Participants were selected using multi-stage random sampling. Data were obtained through a validated structured questionnaire covering demographics, knowledge, perceived behavioral control, social support, and preventive behaviors. Data were analyzed using descriptive statistics, Pearson’s correlation, and multiple linear regression at a significance level of P < 0.05.

RESULTS: Overall, 40.21% of participants had low knowledge, while 81.28% reported moderate preventive behaviors. Preventive behaviors were positively correlated with education, knowledge, perceived behavioral control, and social support, but negatively with age. Regression analysis showed that social support (β =0.36, 95% confidence interval [CI]: 0.28-0.44, P < 0.001), knowledge (β =0.21, 95% CI: 0.12-0.30, P < 0.001), and perceived behavioral control (β =0.18, 95% CI: 0.10-0.26, P < 0.001) were significant predictors. The final model explained 26.00% of the variance in preventive behaviors (adjusted R² =0.26, P < 0.001).

CONCLUSION: Social support, knowledge, and perceived behavioral control significantly influence preventive behaviors against OV/CCA. Strengthening community engagement and behavioral self-efficacy may improve long-term prevention outcomes.

PMID:42491955 | PMC:PMC13378850 | DOI:10.4103/jehp.jehp_1720_25