Tag: pubmed

Mol Autism. 2026 May 14. doi: 10.1186/s13229-026-00719-y. Online ahead of print.

ABSTRACT

BACKGROUND: Sensory perception in autism is strikingly heterogeneous, with individuals showing both hypo- and hypersensitivity across different sensory domains. While sensory differences are widely recognized as a core feature of autism, the structure and underlying patterns of this variability remain poorly understood. Previous studies have yielded mixed findings, often examining sensory processing in isolation within single domains, thereby limiting a comprehensive understanding of sensory sensitivity in autism.

METHODS: We compiled psychophysical data from 107 autistic and 408 age- and IQ-matched non-autistic individuals across 32 experimental conditions spanning multiple perceptual domains, including size, brightness, orientation, pitch, and face processing. Two complementary statistical approaches were used: segmented regression and a Bayesian hierarchical model.

RESULTS: Despite substantial inter- and intra-individual variability, both models revealed a consistent domain-specific pattern: on average, autistic individuals showed reduced sensitivity to faces and speech, while performance on basic non-social tasks was comparable to or exceeded that of the comparison group. Bayesian modelling further indicated that social relevance, rather than domain alone, accounted for the primary source of divergence between groups.

LIMITATIONS: This study focused on sensory sensitivity thresholds and did not assess perceptual biases or changes in subjective appearance of the stimuli. A full account of perception in autism requires considering these broader alterations.

CONCLUSIONS: The current findings suggest that sensory differences in autism reflect a structured perceptual profile shaped by social relevance, stimulus complexity, and individual variability. The results highlight the importance of individualized sensory profiling and may inform both theoretical models and personalized approaches to intervention in autism.

PMID:42135798 | DOI:10.1186/s13229-026-00719-y

BMC Med Educ. 2026 May 14;26(1):760. doi: 10.1186/s12909-026-09434-x.

ABSTRACT

BACKGROUND: Standardized residency training constitutes a pivotal element of postgraduate medical education in China, playing an essential role in augmenting clinical competence and ensuring patient safety. In the gastroenterological sphere, the complexity of diseases and the need to deal with acuteness of cases require residents to develop strong critical thinking abilities and flexibility. The conventional method of ward round teaching has some limitations, and the scenario-based simulation and video-assisted debriefing have shown that they might be beneficial. In this research, the researchers examine the effectiveness of combining these new practices in improving the training of residents.

METHODS: The study encompassed 80 trainees who underwent standardized residency training in the department of Gastroenterology at Dongguan People’s hospital from August 2023 to October 2024. Participants were randomly assigned into two groups: the traditional teaching group (control group) and the scenario-based simulation ward rounds combined with video feedback teaching group (intervention group), with 40 trainees in each cohort. Evaluations were conducted using a 100-point standardized assessment form for teaching rounds, the Chinese version of the Critical Thinking Disposition Inventory (CTDI-CV, score range 70-420), and a 25-item satisfaction questionnaire (5-point Likert scale). Statistical analysis was performed using SPSS software (version 29.0). Continuous data were analyzed using t-tests, and categorical data were analyzed using chi-square tests.

RESULTS: 1. Upon completion of the course, the assessment scores for teaching ward rounds in the intervention group were significantly higher than those in the control group (87.10 ± 3.24 vs. 80.20 ± 2.30, P < 0.001). 2. The critical thinking scores in the intervention group also exceeded those of the control group (307.20 ± 14.25 vs. 273.03 ± 13.20, P < 0.001). 3. Teaching satisfaction levels were higher in the intervention group compared to the control group (96.70 ± 4.64 vs. 90.88 ± 3.58, P < 0.001).

CONCLUSION: The integration of scenario-based simulation ward rounds with video feedback is more effective than traditional teaching methods in enhancing critical thinking abilities and teaching satisfaction in the standardized residency training of gastroenterology. This approach could serve as a novel clinical teaching model.

TRIAL REGISTRATION: Chinese Clinical Trials Registry, ChiCTR2600124086. Registered on 7 May 2026. Retrospectively registered.

PMID:42135796 | DOI:10.1186/s12909-026-09434-x

BMC Oral Health. 2026 May 14. doi: 10.1186/s12903-026-08589-9. Online ahead of print.

ABSTRACT

This study was conducted to assess the knowledge, attitude, and clinical practices of undergraduate dental students in their clinical years about the use of advanced endodontic instruments. A cross-sectional, questionnaire-based study was executed over six months among all 220 undergraduate dental students from three dental colleges in Saudi Arabia: King Saud University, Imam Abdurrahman University, and King Faisal University. Information was gathered using a pre-validated, self-administered questionnaire that included sections on demographics, knowledge, clinical practices, and attitudes. Statistical analysis was performed using SPSS version 23. The chi-square and Fisher’s exact tests were applied to explore the influence of gender and the clinical years on the knowledge, attitude and practices. A p-value of less than 0.05 considered statistically significant. Among 220 respondents, 156 (70.9%) were male, with most in the sixth year (30.9%) and from King Saud University (40.0%). Knowledge of rotary instruments was moderate; 137 (62.3%) correctly identified the effect of increased pitch, with significant improvement across academic years (p = 0.005). Awareness of reduced fracture risk also increased significantly (p = 0.002). Knowledge of electronic apex locators was high, with 193 (87.7%) correctly identifying the need to remove metallic restorations, showing significant improvement with academic year (p < 0.001). Attitudes were predominantly positive, as 158 (71.8%) strongly agreed that combined use of rotary files and EALs reduces chair time, with positivity increasing significantly across academic years (p = 0.031). This study concluded that knowledge, clinical practice, and positive attitudes toward rotary endodontic files and electronic apex locators improved significantly with increasing academic year. Senior students and interns showed greater understanding, higher clinical exposure, and more favorable perceptions of the effectiveness and convenience of these technologies.

PMID:42135771 | DOI:10.1186/s12903-026-08589-9

BMC Musculoskelet Disord. 2026 May 14. doi: 10.1186/s12891-026-09971-y. Online ahead of print.

ABSTRACT

PURPOSE: Increasing numbers of spine surgery cases and an aging society led to challenges during revision surgery with osteoporotic bone. Safe and stable operative techniques are required.

METHODS: In this ex vivo study, human lumbar vertebrae were prepared and then screened for assessing bone density. Eighteen donors (65 vertebrae) with osteoporotic conditions were included. Primary dorsal instrumentation was performed using either standard pedicle screws (6.35 mm diameter; Group A, n = 50) or vertebroplasty screws (VT, 6.35 mm; Group B, n = 15). This was followed by a standardized pull-out test cycle, after which the vertebrae of group A exhibited pedicle perforations replicating revision conditions. Subsequently, 50 vertebrae from Group A were reassigned to simulate revision conditions and divided into two subgroups (n = 25 each): Group A1 received conventional pedicle screws with an increased diameter (7.5 mm), while Group A2 was treated with cement-augmented pedicle screws (VT, 6.35 mm). A second pull-out test was performed, and statistical analysis was conducted.

RESULTS: The specimens with conventional screws had a lower mean pull-out strength compared to primarily cement-augmented screws during the first pull-out cycle 662.8 ± 365.1 N vs. 1066.1 ± 213.7 N. In the revision model, cement-augmented screws (Group A2) demonstrated a significant higher median pull-out strength compared to larger-diameter conventional screws (Group A1) (687.5 N [IQR: 448.8-1137.5 N]; vs. 486.5 N [IQR: 338.8-605.0 N]).

CONCLUSION: In this ex vivo revision model of osteoporotic bone, increasing screw diameter alone resulted in reduced pull-out strength compared to primary instrumentation, whereas cement-augmented pedicle screws consistently demonstrated superior fixation in both test cycles. These findings highlight the limited effectiveness of increasing screw diameter under revision conditions and support cement augmentation as a biomechanically advantageous strategy in osteoporotic bone, while clinical validation remains necessary.

PMID:42135770 | DOI:10.1186/s12891-026-09971-y

BMC Public Health. 2026 May 14;26(1):1560. doi: 10.1186/s12889-026-27712-7.

ABSTRACT

BACKGROUND: Parenting practices, such as emotional support and warmth, are key determinants of adolescent mental health, whereas the role of parental knowledge is less well understood. Parental warmth is thought to foster openness and disclosure, raising the question of whether parental knowledge independently predicts mental health outcomes or primarily reflects the quality of the parent-adolescent relationship. The present study used prospective data to test whether parental knowledge in late adolescence contributes independently to depression and anxiety symptoms in young adulthood after accounting for parental warmth and relevant covariates.

METHODS: Data from two waves of the national Swedish cohort study Futura01 were used (n = 2,697). Parental warmth and parental knowledge were measured at age 18, each using two items. Depression and anxiety symptoms were measured at age 21 with the Patient Health Questionnaire-4 (PHQ-4). Covariates included participant sex, parental education, immigration background, living arrangements at age 18, and indicators of mental health problems at age 18. Linear probability models were performed.

RESULTS: In unadjusted analyses, higher parental warmth and parental knowledge during late adolescence were both associated with a lower probability of reporting depressive and anxiety symptoms in young adulthood. However, when mutually adjusting for parental warmth and parental knowledge, the effect of parental knowledge was no longer statistically significant, indicating that its association with mental health outcomes was confounded by parental warmth. In contrast, parental warmth remained significantly associated with lower probabilities of both depression and anxiety symptoms, even after accounting for parental knowledge, sociodemographic characteristics, and earlier mental health problems. There were no significant interactions between parental warmth and parental knowledge, and participant sex did not moderate the associations.

CONCLUSION: This study highlights the protective role of parental warmth during late adolescence for depression and anxiety symptoms in young adulthood, with warmth showing a consistent association with lower probabilities of these outcomes. However, parental knowledge did not demonstrate an independent effect on mental health after accounting for warmth and covariates. The findings underscore the importance of fostering warm, supportive parent-adolescent relationships during late adolescence, as these relationships appear to have lasting benefits into young adulthood.

PMID:42135768 | DOI:10.1186/s12889-026-27712-7

BMC Public Health. 2026 May 14;26(1):1559. doi: 10.1186/s12889-026-27638-0.

ABSTRACT

BACKGROUND: Adherence to COVID-19 measures depended on a range of factors, including trust in authorities, knowledge of the virus, and public perception. This study compares Germany and India to examine the association of these factors on compliance and contributes to the debate between knowledge and trust. It also explores public acceptance of virus-deactivating technologies, which could reduce reliance on individual preventive behaviours and surveillance tools, offering new insights for pandemic response and public health strategies.

METHODS: Data was collected through an online primary survey using stratified random sampling in India and Germany. The questionnaire consisted of five sections: socio-demographics, knowledge, trust, preventive behaviours, and technology acceptance. The data was analysed using descriptive statistics and statistical analyses of linear regression and ordinal logistic regression.

RESULTS: Almost all preventive behaviours were more frequent in India than in Germany, while German respondents had higher overall knowledge scores. The regression analysis showed no significant relationship between knowledge and trust in India. In contrast, Germany showed a weak positive association, indicating knowledge is modestly associated with trust, though other factors are also significant. The logistic regression analysis highlighted that trust was associated with all preventive behaviours during the COVID-19 pandemic in India and Germany, consistently emerging as a significant factor. While socio-demographic factors like age, education, and income also predicted some behaviours, knowledge had only a limited association. Similar results were found for the acceptance of virus-deactivating air-purification technologies in both Germany and India. Specifically, UV-light-based air purification systems, seen as a potential replacement for measures like masks and school closures, showed high acceptance: 76% in Germany and 57% in India, suggesting a likelihood of real-world implementation.

CONCLUSIONS: This study adds to existing discussions on the role of knowledge, finding that trust showed a stronger association with adherence to COVID-19 measures. Comparing Germany and India, findings show that despite vast differences in healthcare systems and priorities, trust played a similarly crucial role in both contexts for preventive behaviours and acceptance of virus-deactivating technologies. Transparent communication, co-design and co-creation approaches, as well as reflexive socio-technical collaboration may support trust-building and improve public health strategies during crises.

PMID:42135767 | DOI:10.1186/s12889-026-27638-0

Confl Health. 2026 May 14. doi: 10.1186/s13031-026-00800-6. Online ahead of print.

ABSTRACT

BACKGROUND: Maintaining routine health services during epidemics and humanitarian crises is instrumental to reduce preventable mortality and morbidity. Given the health service disruptions observed during the COVID-19 pandemic worldwide, we aimed to investigate the evolution of health care service utilization for acute and routine chronic care among refugees in Jordan during distinct phases of the COVID-19 pandemic and discuss the interventions that may have contributed to the observed changes in utilization.

METHODS: We conducted a mixed-methods study with three components: (1) interrupted time-series analysis of routine health data in Azraq and Zaatari camps; (2) a household survey among refugees in and out-of-camps (descriptive statistics and comparisons across pandemic periods using Poisson models with household-correlated robust variance estimation); 3) focus group discussions among refugees in and out-of-camps (inductive and deductive thematic content analysis). The analyses compared outcomes across four study periods: (1) Pre-COVID-19 (January 2018-March 2020); (2) Lockdown (April 2020-June 2021); (3) Post-lockdown (July 2021-April 2022); (4) Normalization (May 2022-March 2023), and three refugee groups (Syrian in-camps, Syrian out-of-camps, non-Syrian out-of-camps). Study outcomes included health care utilization for acute and chronic conditions (average number of outpatient consultations per person per year) and self reported health care seeking behaviour.

RESULTS: Acute care utilization declined sharply during the lockdown and recovered gradually to pre-pandemic level during the post-lockdown period. Diabetes care utilization was low before the pandemic across groups. After a reduction during lockdown, it increased significantly during the normalization phase to above pre-pandemic rates. A package of service adaptations was introduced to facilitate access to services and medicines: multi-months drug prescription; new distribution system for medication home delivery; home visits; telephonic follow-up; hotline for questions. Study participants reported different experiences in accessing care, from spontaneous support to perceived barriers and limited access. While challenges were highlighted (waiting time, transportation, cost), most participants appreciated the intervention package and praised the comprehensiveness of the provided services.

CONCLUSIONS: This paper investigates changes in health care services utilization of acute and routine chronic care among refugees in Jordan during the COVID-19 pandemic. We learned that acute care will likely rebound back to pre-shock levels and that the utilization of chronic care benefitted from introduced changes in the approach of service delivery, namely a package of complementary interventions that proved helpful in facilitating access to care and medicines for NCD patients while reducing COVID-19 exposure. By documenting UNHCR’s and partners’ efforts, we provide examples of concrete interventions that should be implemented to improve future pandemic responses.

PMID:42135758 | DOI:10.1186/s13031-026-00800-6

Confl Health. 2026 May 14. doi: 10.1186/s13031-026-00798-x. Online ahead of print.

ABSTRACT

BACKGROUND: Mortality surveys in conflict-affected settings are essential for documenting the human cost of armed conflict, guiding the humanitarian response, and promoting accountability. The success of such studies relies on the participation of the affected populations. Yet, we know little about how the public in conflict-affected countries perceives such studies, their willingness to participate, or the barriers they face to participate. This study aimed to explore public perceptions, willingness and barriers to participate in mortality surveys in six conflict-affected countries of the Eastern Mediterranean Region.

METHODS: An exploratory, cross-sectional mixed-methods study was conducted in Sudan, Somalia, Syria, Lebanon, Iraq, and Yemen between March and June 2025. An online self-administered questionnaire captured both quantitative and qualitative data. Quantitative data were analyzed using descriptive statistics and bivariate tests, while qualitative responses underwent inductive content analysis.

RESULTS: Among 3455 participants (median age 29 years; 56.5% female), 94% (n = 3254) considered mortality surveys during armed conflicts important. Two-thirds (66.7%, n = 2306) expressed willingness to participate in mortality surveys, with a preference for electronic surveys. Willingness to participate was positively associated with older age, male sex, nationality, presence in the country during conflict, comfort with data sharing in social media, and absence of perceived cultural and religious barriers (p < 0.05). More than 40% of respondents reported trusting to provide death data to the government (44.3%, n = 1529) and international organizations (43.8%, n = 1515). Respondents reporting no trust to provide this data mentioned lack of credibility and political bias were the main reasons for distrust. Only 13.1% (n = 453) of the respondents perceived mortality surveys as harmful; key concerns included retaliation, political manipulation, and psychological distress. 19% (n = 658) cited cultural or religious barriers, most linked to sectarianism, honor, and the sanctity of death, as an obstacle to participation.

CONCLUSION: Perceptions captured across the six conflict-affected EMR countries among the digitally-active adult respondents reflect both recognition of the importance of mortality surveys and concerns about safety, trust, and cultural sensitivities. Enhancing confidentiality, engaging trusted institutions in data collection, and adopting culturally sensitive approaches are critical to strengthening participation and ensuring the ethical implementation of mortality surveys in conflict zones.

PMID:42135757 | DOI:10.1186/s13031-026-00798-x

BMC Med Educ. 2026 May 14. doi: 10.1186/s12909-026-09436-9. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of this study is to comparatively examine the dental caries and periodontal health status of dental (DS) and medical students (MS) and to evaluate their quality of life related to oral health using the Oral Health Impact Profile-14 (OHIP-14) scale.

MATERIALS AND METHODS: The cross-sectional study included a total of 400 systemically healthy volunteers from 1st-5th year DS (n = 200) and MS (n = 200) students of Recep Tayyip Erdoğan University. Participants’ body mass index was recorded; clinical dental (decayed, missing, and filled teeth (DMFT)) and periodontal parameters (plaque index (PI), gingival index (GI), bleeding on probing index (BOP), and probing pocket depth (PPD)) were measured. Oral Health-Related Quality of Life (OHRQoL) was assessed using the OHIP-14 questionnaire. Statistical analyses were performed to compare the two faculties across all academic years (1st-5th year) and evaluate the associations between variables. Additionally, adjusted multiple linear regression analyses were conducted to determine the independent effect of academic year on oral health parameters while controlling for gender and body mass index. The significance level was set at p < 0.05.

RESULTS: In DS, the PI, GI, BOP, and PPD parameters were found to be significantly lower than in MS (p < 0.05). In intra-faculty comparisons, DS generally showed a positive trend in dental, periodontal, and OHRQoL as their class level increased, while the opposite was observed in MS. In inter-faculty comparisons at each class level, significant differences were obtained at all parameters in all classes except the first year (p < 0.05). Class level was determined to be an associated factor for all oral health parameters in students of both faculties.

CONCLUSION: This cross-sectional study showed that, unlike DS, lower levels were observed in dental and periodontal health status and OHRQoL were observed in MS as their class level increased. In this context, including topics related to oral health awareness and daily care habits in MS curricula could be beneficial.

TRIAL REGISTRATION: This study was retrospectively registered at ClinicalTrials.gov (Identifier: NCT07425860) on February 10, 2026.

PMID:42135748 | DOI:10.1186/s12909-026-09436-9

BMC Med Res Methodol. 2026 May 14;26(1):116. doi: 10.1186/s12874-026-02875-4.

ABSTRACT

Joint models offer an unbiased statistical approach for analyzing the effects of longitudinal biomarkers on time-to-event outcomes, providing an alternative to time-varying Cox proportional-hazards regression and the two-stage approach. However, whether available implementations of these methods perform reliably across different practically relevant scenarios remains insufficiently studied. We conducted a simulation study based on the Berlin Initiative Study examining kidney function and survival in older adults. In a manner comparable to phase IV studies in clinical research, our evaluation aims to provide insights into the practical performance of commonly used R package implementations of these methods, mostly under their default settings. By varying data generating scenarios, we assessed how different numbers of events and longitudinal measurements affect performance of Bayesian (JMbayes2) and frequentist joint model implementations (JM and joineRML), time-varying Cox PH regression (survival), and the two-stage approach (nlme and survival), focusing on bias in parameter estimates. Results revealed substantial variability across implementations. The JM package exhibited considerable bias and frequent convergence issues. In contrast, joineRML performed robustly with approximately unbiased estimates for association parameters and high convergence frequencies comparable to the implementations of the simpler methods across diverse scenarios. However, both frequentist packages systematically underestimated the effects of baseline covariates in the survival model. The Bayesian JMbayes2 was largely unbiased, but performance deteriorated under two conditions: with few events (< 70), convergence was low and bias persisted even in converged models; and with observation-to-event ratios below 2, convergence declined, although estimates from converged models remained approximately unbiased. Time-varying Cox PH regression and the two-stage approach showed more bias than JMbayes2 in certain settings but tended to achieve more robust performance and convergence across most scenarios.

PMID:42135742 | DOI:10.1186/s12874-026-02875-4