Tag: pubmed

BMC Health Serv Res. 2026 Apr 10. doi: 10.1186/s12913-026-14512-3. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to evaluate the effectiveness of an intelligent interaction voice prompting system (IIVPS) for guiding medical staff in the removal of personal protective equipment (PPE).

METHODS: A total of 152 medical staff members were enrolled via convenience sampling. Using a one-group pretest-posttest design, system effectiveness was evaluated by comparing pre- and post-intervention PPE removal accuracy, psychological stress, and operational fatigue, with nonparametric tests for statistical analyses. User experiences and suggestions for improvement were collected via questionnaires and face-to-face interviews.

RESULTS: All participants achieved correct PPE-removal procedure adherence while using the IIVPS. The use of the IIVPS was associated with a significant increase in PPE-removal accuracy from 78% to 100% (P < 0.001). The median psychological stress score decreased from 3.00 (3.00, 4.00) to 2.00 (1.00, 2.00) (Z = -8.610, P < 0.001), and the median operational fatigue score decreased from 3.00 (3.00, 4.00) to 1.50 (1.00, 2.00) (Z = -9.172, P < 0.001). Significant differences in system mastery were observed based on PPE training history and familiarity (P < 0.05), while learning acceptance varied by age, work experience, and PPE familiarity (P < 0.05). Analysis of qualitative feedback revealed overwhelmingly positive responses (95.39%), with key themes including “effective operational guidance” and “stress reduction”.

CONCLUSIONS: The IIVPS may effectively guide medical staff in standardised PPE removal and potentially reduce psychological stress and operational fatigue. However, this study’s one-group design and short-term evaluation limit causal inferences, and long-term effectiveness requires verification via randomised controlled trials (RCTs). The system shows promising potential for clinical application and training.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:41964050 | DOI:10.1186/s12913-026-14512-3

Arthroplasty. 2026 Apr 10;8(1):25. doi: 10.1186/s42836-026-00380-z.

ABSTRACT

PURPOSE: Evaluate the impact of patient age, body mass index (BMI), medial/central patellofemoral arthritis, and anterior cruciate ligament (ACL) deficiency on five-year patient-reported outcome measures (PROMs) of fixed-bearing medial unicompartmental knee arthroplasty (UKA).

METHODS: A consecutive group of 229 patients (240 knees) received fixed-bearing medial UKA. At minimum two (n = 231 knees) and five years (n = 221 knees), patients completed the Oxford Knee Score (OKS), the EuoQol-5D (EQ-5D), Knee injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS), University of California, Los Angeles (UCLA) activity score, Forgotten Joint Score (FJS), and their level of satisfaction. Sub-group analyses compared PROMs in patients based on: (i) Grade III/IV vs. Grade 0-III medial/central patellofemoral arthritis, (ii) ACL deficiency vs. intact ACL, (iii) age groups (< 50, 50-59, 60-69, 70-79, > 80), and (iv) BMI categories (< 30, 30-35, 35-40, ≥ 40).

RESULTS: Satisfaction rates remained consistent at the 2- and 5-year follow-up points, with 96% being satisfied or very satisfied. The OKS, EQ-5D, KOOS PS, or FJS-12 were not statistically significantly different between 2 and 5 years. Five-year UCLA activity scores differed significantly across age groups (50-59 vs 80 + (MD = 1.5; p = 0.027), 60-69 vs 70-79 (MD = 0.9; p = 0.014), and 60-69 vs 80 + (MD = 1.7; p = 0.004)), and between patients with a BMI < 30 vs ≥ 40 (MD = 2.3; p = 0.045). These findings were supported by multivariable regression, which showed that increasing age and higher BMI were independently associated with worse UCLA activity scores. Grade III/IV patellofemoral arthritis was associated with worse EQ-5D scores but was not associated with worse OKS, UCLA, KOOS-PS, or FJS-12. ACL deficiency was associated with higher KOOS-PS scores.

CONCLUSION: Five-year outcomes following fixed-bearing medial UKA demonstrated high patient satisfaction, unchanged from two years. Although older age was associated with lower activity and higher BMI (> 40) with worse function, the effect sizes were small and not clinically meaningful. Patellofemoral arthritis and ACL deficiency had no negative functional impact. Therefore, age, BMI, patellofemoral arthritis, and ACL status should not be considered contraindications; instead, broad selection criteria for fixed-bearing UKA are supported.

PMID:41964036 | DOI:10.1186/s42836-026-00380-z

Lipids Health Dis. 2026 Apr 10. doi: 10.1186/s12944-026-02948-9. Online ahead of print.

NO ABSTRACT

PMID:41964021 | DOI:10.1186/s12944-026-02948-9

Perioper Med (Lond). 2026 Apr 11. doi: 10.1186/s13741-026-00679-0. Online ahead of print.

ABSTRACT

BACKGROUND: Perioperative diastolic dysfunction has been proposed as an independent predictor of postoperative major adverse cardiac events (MACE) after noncardiac surgery. However, prior studies have largely focused on elective procedures and employed heterogeneous echocardiographic approaches to assess diastolic function. We sought to evaluate the association between abnormal diastolic echocardiographic parameters and postoperative MACE and mortality in patients undergoing hip fracture surgery using a contemporary, multiparametric assessment of diastolic function.

METHODS: In this retrospective cohort study, adult patients undergoing hip fracture repair between April 2016 and June 2021 with available preoperative transthoracic echocardiography were included. Abnormal diastolic parameters were defined as average E/e’ >14, tricuspid regurgitant velocity (TRV) > 2.8 m/s, and left atrial volume index (LAVI) > 34 mL/m². Patients were stratified by the number of abnormal parameters into two groups: 0-1 abnormal versus 2-3 abnormal. The primary outcome was postoperative MACE, defined as myocardial infarction, heart failure, pulmonary edema, or death within 30 days of surgery. Secondary outcomes included 1-year and 2-year all-cause mortality.

RESULTS: Among 148 patients included in the analysis, postoperative MACE occurred in 15.5%. Patients with 2-3 abnormal diastolic parameters experienced higher rates of MACE compared with those with 0-1 abnormal parameter (23.9% vs. 8.6%, P = 0.011). One-year and two-year mortality were also higher in the 2-3 abnormal parameter group (31.3% vs. 13.6%, P = 0.009; and 43.3% vs. 19.8%, P = 0.002, respectively). Kaplan-Meier survival analysis demonstrated lower survival among patients with multiple abnormal diastolic parameters, with separation of survival curves evident early in the postoperative period and persisting throughout follow-up, although the overall time-to-event analysis did not reach statistical significance.

CONCLUSIONS: In patients undergoing hip fracture surgery, a higher burden of abnormal echocardiographic diastolic parameters is associated with increased risk of postoperative MACE and higher short- and intermediate-term mortality. The early separation of survival curves suggests that abnormal diastolic parameters identify patients at heightened risk during the immediate postoperative period, highlighting a potentially important window for targeted perioperative risk stratification and management.

PMID:41963984 | DOI:10.1186/s13741-026-00679-0

BMC Med Educ. 2026 Apr 10. doi: 10.1186/s12909-026-09132-8. Online ahead of print.

ABSTRACT

BACKGROUND: Proper margin width is one of the key factors determining the correct fabrication of a prosthetic crown. Digital technologies, such as intraoral scanners, are increasingly used to assess parameters of tooth preparation for prosthetic crowns. The study aimed to evaluate the conservativeness of tooth preparation performed by third-year dental students on phantom teeth based on margin width and the utility of an intraoral scanner for its assessment.

METHODS: A total of 432 model teeth (KaVo) prepared for crowns by third-year dental students were tested: 216 maxillary right first molars (tooth 16) with a chamfer, and 216 maxillary right first premolars (tooth 14) with a classical shoulder. Tooth 16 was prepared first, followed by tooth 14 one week later. After each preparation, students were evaluated and received instructor feedback. All teeth were scanned using a 3Shape TRIOS 3 intraoral scanner, finish line widths were measured and compared to ideal crown preparation standards. Continuous variables are presented as medians and interquartile ranges, and categorical variables are presented as counts and percentages. Margin widths were compared using the Mann-Whitney U test (with rank-biserial effect sizes), and categorical classifications were analyzed with the chi-square test. A significance level of p < 0.05 was adopted. Calculations were performed using IBM SPSS Statistics 29 and R software (version 4.4.2).

RESULTS: For tooth 16, median chamfer margin widths were: mesial 1.08 mm [IQR: 0.80-1.45], distal 1.17 mm [IQR: 0.79-1.55], lingual 1.17 mm [IQR: 0.87-1.41], and buccal 1.07 mm [IQR: 0.86-1.35]. Optimal widths were achieved by 22.9% (mesial), 21.9% (distal), 16.7% (lingual), and 15.7% (buccal) of students. For tooth 14, median widths were: mesial 0.67 mm [IQR: 0.51-0.93], distal 0.87 mm [IQR: 0.63-1.29], lingual 0.80 mm [IQR: 0.63-1.06], and buccal 0.78 mm [IQR: 0.60-1.01], with optimal widths achieved by 40% (mesial), 32.4% (distal), 41.4% (lingual), and 11.9% (buccal).

CONCLUSIONS: The study revealed significant variability in finish line width among students and tooth surfaces, with most preparations being excessively wide. An intraoral scanner may be a useful tool for assessing the margin width in prepared phantom teeth.

PMID:41963983 | DOI:10.1186/s12909-026-09132-8

BMC Nurs. 2026 Apr 10. doi: 10.1186/s12912-026-04622-y. Online ahead of print.

NO ABSTRACT

PMID:41963977 | DOI:10.1186/s12912-026-04622-y

BMC Psychol. 2026 Apr 11. doi: 10.1186/s40359-026-04187-0. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore the latent profiles of self-stigma and their relationship with meaning in life among individuals with substance use disorders(SUDs).

METHODS: A total of 1001 participants were recruited from six drug rehabilitation centers in Sichuan Province between July and August 2025 and completed the self-stigma Scale for Drug Addicts (SSSDA) and the Meaning in Life Questionnaire (MLQ). Latent profile analysis (LPA) was used to identify latent profiles of self-stigma. Multinomial logistic regression was employed to analyze influencing factors, and analysis of variance (ANOVA) was used to compare differences in meaning in life across the different profiles.

RESULTS: The self-stigma of individuals with SUDs can be categorized into four latent profiles: the “stigma-resistant profile”(10.0%), “moderate stigma-concealment profile”(46.3%), “internalized stigma profile”(19.5%), and “low internalization-adaptation profile”(24.3%). Among these, the “moderate stigma-concealment profile”, “internalized stigma profile”, and “low internalization-adaptation profile” represent categories with higher levels of self-stigma. Risk factors associated with these profiles include male sex, low income, a history of being left-behind children, low social support, multiple rehabilitation attempts, as well as mental illness or HIV infection. Statistically significant differences were found among the four profiles in the total score of meaning in life and its sub-dimensions-presence of meaning and search for meaning (p < 0.001). The “stigma-resistant profile” presented the highest level of MIL, whereas the “internalized stigma profile” presented the lowest level.

CONCLUSION: Significant heterogeneity exists in self-stigma among individuals with substance use disorders (SUDs), and the level of self-stigma is significantly negatively correlated with MIL.

PMID:41963971 | DOI:10.1186/s40359-026-04187-0

BMC Health Serv Res. 2026 Apr 10. doi: 10.1186/s12913-026-14474-6. Online ahead of print.

NO ABSTRACT

PMID:41963954 | DOI:10.1186/s12913-026-14474-6

BMC Med. 2026 Apr 10. doi: 10.1186/s12916-026-04858-0. Online ahead of print.

ABSTRACT

BACKGROUND: Central obesity is a major risk factor for colorectal cancer (CRC) and may better reflect obesity-related risk than body mass index (BMI). Its global burden, however, remains poorly quantified. We aimed to estimate the number and proportion of CRC cases attributable to central obesity in 2022 across global, regional, and national levels.

METHODS: We estimated population attributable fractions (PAFs) by combining sex-specific prevalence of central obesity from national surveys with pooled relative risks from meta-analysis. Central obesity was defined as elevated waist circumference using standardised sex- and ethnicity-specific thresholds, accounting for variation in definitions via probabilistic modelling. We addressed missing data through multiple imputation. CRC incidence estimates for 2022 were obtained from GLOBOCAN for 185 countries. Monte Carlo simulations propagated uncertainty in exposure prevalence and risk estimates.

RESULTS: In 2022, an estimated 311 418 (95% uncertainty interval 242 603-378 880) CRC cases were attributable to central obesity, corresponding to a global PAF of 16.2% (12.6-19.7). PAFs were higher in females (18.2%, 13.0-23.3) than in males (14.5%, 9.6-19.3), though age-standardised rates (ASRs) were slightly higher in males. The highest PAF was in North America, and the highest ASRs in Australia-New Zealand and northern Europe. PAFs and ASRs declined with decreasing income levels among males but not females. Regional variation in sex differences was substantial, with higher female PAFs in parts of Africa and Asia, and smaller or reversed gaps in high-income settings. In high-income countries, the estimated 10-year CRC risk at screening age (55-69 years) was 1.32% in males with central obesity versus 0.90% in those without, and 0.92% versus 0.64% in females, corresponding to one excess CRC case per 236 (180-353) men and 357 (279-502) women.

CONCLUSIONS: Central obesity accounts for a substantial share of the global CRC burden, with large geographical variability. Applying established waist circumference thresholds in surveillance and incorporating central obesity into individual risk stratification may inform more effective CRC screening and prevention strategies.

PMID:41963940 | DOI:10.1186/s12916-026-04858-0

J Ethnobiol Ethnomed. 2026 Apr 10. doi: 10.1186/s13002-026-00895-4. Online ahead of print.

ABSTRACT

BACKGROUND: European landscapes have developed into biocultural heritage over millennia of extensive livestock production. Much of this biodiversity and cultural richness has been preserved by small-scale farms; however, these farms are disappearing across Europe due to intense competition with industrial agriculture. Recognizing the interconnectedness of social and natural systems, this study examined the socio-cultural background of livestock keepers in Estonia. The main research question focused on understanding the context in which livestock keepers decide to begin or continue free-range livestock farming, viewed through the lens of culture and tradition.

METHODS: An anonymous, voluntary online survey was conducted among beef cattle and sheep keepers in Estonia, who are the primary users of semi-natural grasslands. In total, 88 completed questionnaires were received and analyzed using descriptive statistical methods.

RESULTS: Nearly one-third of respondents reported continuing a family tradition of livestock keeping. However, 62% of respondents had no prior experience in agriculture before starting their activities, and 58% managed only a single type of agricultural animal. The most frequently reported emotional motive was the desire to maintain aesthetically pleasing landscapes around their homes through grazing (74% of respondents). In addition, 56% of respondents indicated that grazing is the most effective management practice for their farmland. The most commonly cited constraints preventing herd expansion were the lack of additional pastures and the inability to manage larger herds. A slight majority of livestock keepers valued the preservation of national culture, and nearly 40% considered local knowledge, such as unwritten rules, important in their farming practices. Furthermore, more than half of respondents reported the presence of a natural area near their farm that they regard as sensitive or sacred. Livestock keepers generally do not celebrate any specific holidays associated with the traditional folk calendar; the only customary practise reported was giving bread to animals during the Christmas season. Moreover, 76% of respondents declared that they do not engage in any historically significant magical protection rituals aimed at safeguarding their livestock.

CONCLUSIONS: Grazing in heritage grasslands supported by nature conservation subsidies is increasingly carried out by a new generation of livestock keepers who are establishing their own traditions. To effectively understand and communicate with livestock keepers, it is essential to consider their socio-cultural background and the motives underlying their decisions. We conclude that, when transitioning to an agroecological system, livestock keepers are strongly motivated by the pursuit of personal well-being, which in turn contributes to the overall health of the environment and society. Supporting the social well-being of farmers therefore requires expanding the concept of livestock keepers as custodians of biodiversity beyond protected areas and recognizing the value of their everyday practices, which play a crucial role in slowing the decline of small farms and traditional livestock farming practices.

PMID:41963938 | DOI:10.1186/s13002-026-00895-4