Tag: pubmed

Malar J. 2026 Jul 12. doi: 10.1186/s12936-026-06031-7. Online ahead of print.

ABSTRACT

BACKGROUND: In October 2024, Sudan introduced the malaria vaccine, beginning in Al-Qadarif and Blue Nile states amidst an ongoing armed conflict. Vaccine acceptance among healthcare providers (HCPs) is critical for a successful national rollout. This study assessed malaria vaccine knowledge, acceptability, concerns, and their independent predictors among HCPs in these conflict-affected regions.

METHODS: A descriptive cross-sectional study was conducted from January to February 2025 et al.-Qadarif and Al-Damazin teaching hospitals. An online questionnaire was administered to 342 HCPs. Multivariable linear regression was employed to identify factors associated with continuous knowledge scores. Subsequently, a multivariable logistic regression model was utilized to determine the independent predictors of high vaccine acceptability, incorporating the knowledge score as a continuous independent variable.

RESULTS: Among the 342 respondents, general vaccine acceptability was promising, yet specific operational knowledge remained limited. Significant overall concern about the vaccine was prevalent (64.0%), primarily regarding adverse effects (57.0%), cold-chain handling conditions in Sudan (56.4%), and vaccine effectiveness (42.7%). Social media (48.5%) and peers (45.0%) were the most common information sources. Multivariable linear regression indicated that older age (p = 0.004)and hospital of work (p < 0.001) significantly predicted higher knowledge. In the multivariable logistic regression, the continuous knowledge score emerged as the only statistically significant independent predictor in this model of high vaccine acceptability (adjusted odds ratio: 1.15, 95% confidence interval: 1.01-1.32, p = 0.033), with no significant influence from demographic variables.

CONCLUSIONS: Despite a generally favorable attitude toward the malaria vaccine, Sudanese HCPs exhibit critical knowledge gaps and valid systemic concerns. Our findings suggest a sequential pathway wherein accumulated clinical experience (older age) enhances technical knowledge, which in turn acts as the primary independent driver of vaccine acceptability. Consequently, health authorities must pivot from generalized promotional campaigns to targeted, technical educational interventions. Leveraging secure digital professional networks is urgently needed to bridge these knowledge gaps, optimize provider confidence, and ensure a successful vaccine rollout in this fragile setting. Trial registration Not applicable.

PMID:42437930 | DOI:10.1186/s12936-026-06031-7

Nutr J. 2026 Jul 13. doi: 10.1186/s12937-026-01364-0. Online ahead of print.

ABSTRACT

BACKGROUND: Short-chain fatty acids produced by microorganisms living in the gastrointestinal tract are known to have numerous beneficial effects. Because certain probiotic strains may influence short-chain fatty acid production, probiotic supplementation has been proposed as a potential strategy to modify faecal short-chain fatty acid concentrations. Our aim was to investigate whether probiotics modify faecal short-chain fatty acid levels in healthy populations via systematic review and meta-analysis.

METHODS: We performed a systematic search of the MEDLINE, Embase, and Cochrane databases on 12/04/2024. We analysed exclusively randomized controlled trials meeting all the following criteria: population: healthy people; intervention: probiotic supplementation; control: no probiotic supplementation; outcome: faecal short-chain fatty acid concentrations. A total of 9217 articles were reviewed, 21 of which met the preset inclusion criteria. Twelve articles, including 541 subjects, were eligible for meta-analysis of changes in faecal short-chain fatty acid concentrations. The standardized mean difference (SMD, Hedges’ g) was chosen as the effect indicator due to the different measurement techniques used. A random-effects model was used to estimate SMD with 95% confidence interval (CI) due to the expected heterogeneity.

RESULTS: No statistically significant differences were detected in the faecal butyrate (SMD = 0.07, 95%CI:[(-)0.16 – 0.30]), acetate (SMD = 0.06, 95%CI:[(-)0.14 – 0.27]), and propionate (SMD = 0.09, 95%CI:[(-)0.07 – 0.25]) levels between individuals taking and not taking probiotics.

CONCLUSIONS: Our results suggest that probiotic intake has a minor effect on faecal short-chain fatty acid concentrations, but this effect is not statistically detectable in healthy individuals. Thus, there is insufficient evidence of statistically significant effect of probiotic supplementation on stool short-chain fatty acid concentrations in healthy individuals.

TRIAL REGISTRATION: Research protocol was registered in PROSPERO (CRD42022286137).

PMID:42437924 | DOI:10.1186/s12937-026-01364-0

BMC Med Educ. 2026 Jul 13. doi: 10.1186/s12909-026-09928-8. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of this study is to compare the performance of three large language models (ChatGPT 5, Microsoft Copilot, and Google Gemini 3), with that of dental students using their responses to multiple-choice questions (MCQs) in restorative dentistry. Accuracy of responses were analyzed across the knowledge and cognitive process dimensions of the revised Bloom’s taxonomy (RBT), as well as across subject areas.

METHODS: The restorative dentistry exam questions used in this study were drawn from Turkish Dentistry Specialization Entrance Exam (DUS) administered between 2020 and 2025. The 90 five-option, single-best-answer MCQs were classified according to the RBT to ensure cognitive diversity. Following the exclusion of one exam question which had been annulled by the examination authority, the data analysis was performed on the remaining 89 exam questions. Accuracy of AI models and dental students was compared using Pearson’s chi-square test and Monte Carlo-corrected Fisher’s exact test. Pairwise comparisons were carried out via Bonferroni-corrected Z-test. The results were presented as frequencies and percentages, and p < 0.050 was considered statistically significant.

RESULTS: Microsoft Copilot and Gemini 3 showed similar performance in answering MCQs, both models achieved higher accuracy than ChatGPT 5 and students (p < 0.001). ChatGPT 5’s overall accuracy was found to be significantly higher than that of the students. Accuracy of responses varied according to Bloom’s taxonomy levels and subject areas. Microsoft Copilot exhibited over 90% accuracy in all categories of Bloom’s knowledge and cognitive process dimensions. At the application level of the cognitive process dimension, all chatbots descriptively achieved 100% accuracy; however, this subgroup difference did not reach statistical significance. Chatbot performance was generally superior to that of students across the subject areas of adhesive dentistry, dentin hypersensitivity, dental caries, tooth whitening, aesthetic restorative procedures, contemporary restorative materials, preventive dentistry, lasers, and saliva.

CONCLUSION: AI-based chatbots demonstrate considerable potential in answering questions about restorative dentistry. At the same time, the differences in performance observed among different models suggest there could be variation in the accuracy values of these systems depending on both the taxonomic level and the subject area of restorative dentistry. The findings support the potential use of chatbots as complementary learning resources in dental education. However, the reliability of such systems should be consistently verified and tested in both an academic and clinical setting under the direct supervision of experts. Moreover, students should be equipped with critical thinking skills to appropriately evaluate and use these systems.

PMID:42437914 | DOI:10.1186/s12909-026-09928-8

BMC Oral Health. 2026 Jul 13. doi: 10.1186/s12903-026-09019-6. Online ahead of print.

ABSTRACT

OBJECTIVES: The purpose of study is to compare early failure rate in patients with self-reported penicillin allergy (SRPA) who take clindamycin after implant surgery with non-allergic patients.

MATERIALS AND METHODS: This retrospective cohort study was conducted on patients who had dental implant surgery. The predictor variable was the type of antibiotics. SRPA patients who received clindamycin were obtained from database. The patients in non-allergic group were randomly selected to be identical to allergic patients in terms of age, gender, diabetes, and surface features of implant. Kruskal-Wallis tests were used analysis early implant failure rate between the two groups implant level. The Pearson chi-square test was used to compare categorical data. Multivariate logistic regression analysis was performed with Hosmer and Lemeshow Test.

RESULTS: The study completed with 406 patients. The mean age was 49.64 ± 13.72 years. 104 were male and 302 were female. The patients in both groups were the same in terms of age, gender, and implant surface characteristics. The failure rate of the implant 10(4.93%) in clindamycin group and 4(1.97%) at patient level. The failure rate of the implant 17(1.56%) in amoxicillin group and 9(0.75%) at implant level. There was no statistically significant difference between the groups in terms of failure rate at patient (p = 0.172) and implant level (p = 0.106). The failure rate in male patients was 4.11 time higher than female patients (p = 0.011).

CONCLUSION: The results showed that clindamycin use in SRPA patients did not significantly increase the implant failure with the limitations of this study.

CLINICAL RELEVANCE: This is first study compared early implant failure rate in patients with who received clindamycin after implant surgery with non-allergic patients with similar age, gender, health status.

PMID:42437912 | DOI:10.1186/s12903-026-09019-6

BMC Musculoskelet Disord. 2026 Jul 13. doi: 10.1186/s12891-026-10199-z. Online ahead of print.

ABSTRACT

BACKGROUND: Medial opening wedge high tibial osteotomy (MOWHTO) is a standard treatment for knee osteoarthritis. However, lateral hinge fractures occur in 19-25% of cases, with Type 2 fractures causing significant instability. While lateral plating is recommended, it requires an additional incision. This study investigated whether medial-only fixation using a 4.5 mm cortical screw inserted into the Tomofix plate’s oval hole could provide sufficient stability for Type 2 hinge fractures.

METHODS: Twelve fresh pig knees underwent MOWHTO with a 6 mm opening. They were divided into two groups: Group I (intact lateral hinge) and Group F (induced Type 2 hinge fracture fixed with a medial 4.5 mm cortical screw in the Tomofix oval hole). Specimens were subjected to 2,000 cycles of axial loading (up to 800 N), representing early postoperative partial weight-bearing conditions. Displacement during cycling, and changes in the anterior gap (AG), posterior gap (PG), and posterior tibial slope (PTS) were measured.

RESULTS: Group F exhibited significantly greater displacement during cyclic loading compared to Group I (p = 0.0029), indicating significantly greater construct displacement. There were no statistically significant differences between the groups regarding changes in AG (p = 0.15), PG (p = 0.53), or PTS (p = 0.22).

CONCLUSIONS: Fixation with a 4.5 mm cortical screw in the Tomofix oval hole did not restore stability comparable to an intact lateral hinge for Type 2 lateral hinge fractures during an ex vivo porcine MOWHTO model.

PMID:42437910 | DOI:10.1186/s12891-026-10199-z

BMC Public Health. 2026 Jul 13. doi: 10.1186/s12889-026-28512-9. Online ahead of print.

ABSTRACT

BACKGROUND: Hypertension and diabetes are rising causes of morbidity and mortality in sub-Saharan Africa, yet rural community-level data remain limited. National surveys often obscure local variation, hindering targeted prevention.

METHODS: We conducted a population-based cross-sectional study in Kakum-Kombewa, Siaya County, Kenya (Dec 2024-Jun 2025). Multistage sampling identified 816 households, yielding 1,046 adults aged ≥ 18 years. Participants underwent household screening for blood pressure, random blood glucose, and anthropometry. Individuals with screened positive values were referred to linked primary healthcare facilities for diagnostic confirmation. Prevalence was estimated using descriptive statistics, and associations were assessed with chi-square tests and generalized linear models.

RESULTS: The prevalence of known hypertension, diabetes, and comorbidity was 13.9%, 8.7%, and 4.9%, respectively. Diagnostic confirmation identified an additional 4.2% newly confirmed hypertension, 2.3% newly confirmed diabetes, and 2.5% newly confirmed comorbidity, yielding total prevalence estimates of 18.1% (95% CI: 15.8-20.6), 11.0% (95% CI: 9.2-13.1), and 7.4% (95% CI: 5.9-9.2). Risk factors included age ≥ 50 years, overweight/obesity, central adiposity, family history, and physical inactivity. Female sex, central adiposity, low activity, and family history remained significant predictors in multivariable models.

CONCLUSION: This study reveals a substantial burden of both known and previously undiagnosed hypertension and diabetes in rural Western Kenya. Community-based screening, followed by referral and confirmatory testing, was effective in detecting new cases and identifying poor disease control among those with prior diagnoses. Strengthening routine NCD screening and linkage to primary care could improve early detection and management in similar rural settings.

PMID:42437904 | DOI:10.1186/s12889-026-28512-9

BMC Cardiovasc Disord. 2026 Jul 13. doi: 10.1186/s12872-026-06256-z. Online ahead of print.

ABSTRACT

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is a critical life-support intervention for patients with severe respiratory and circulatory failure. Nevertheless, identifying the optimal timing of ECMO initiation and its correlation with survival, mortality, and complication rates continues to pose significant clinical challenges.

PURPOSE: This study intends to conduct a systematic review of the existing medical literature to clarify ECMO initiation timing and its association with patient outcomes, aiming to furnish evidence-based recommendations for clinical decision-making.

METHODS: We performed systematic searches across PubMed, Embase, Scopus, The Cochrane Library, and Web of Science for eligible cohort and case-control studies. Studies combining ECMO with other extracorporeal life-support modalities were excluded to eliminate survival confounding. Inclusion criteria encompassed adult ECMO recipients with reported initiation timing and at least one outcome measure. Study quality was evaluated using the Newcastle-Ottawa Scale (NOS).

RESULTS: From 1583 identified records, 30 studies were finally included, comprising 2 prospective cohorts, 1 case-control, and 27 retrospective cohorts. ECMO initiation timing was heterogeneously defined across multiple time intervals and clinical scenarios. Of the full set of 30 included studies, 23 performed statistical analyses examining the link between ECMO initiation delay and mortality; 18 of these 23 studies (60% of all 30 included studies) reported that prolonged ECMO initiation time was significantly associated with higher in-hospital or long-term mortality. Five of the 23 mortality-analyzing studies detected no statistically significant timing-mortality correlation, while the remaining 7 studies only reported organ complication outcomes and did not conduct any statistical testing of mortality as an endpoint. Quality appraisal demonstrated only one low-quality study, with all others graded as medium to high quality.

CONCLUSION: For patients with severe ARDS, cardiogenic shock, drug-induced shock, cardiac arrest, or post-cardiotomy shock, early ECMO initiation-such as within 7 days of mechanical ventilation-can effectively decrease mortality and reduce the incidence of neurological, hepatic, and renal complications.

TRIAL REGISTRATION: This study has been registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD420250652365).

PMID:42437887 | DOI:10.1186/s12872-026-06256-z

BMC Prim Care. 2026 Jul 13. doi: 10.1186/s12875-026-03470-8. Online ahead of print.

ABSTRACT

BACKGROUND: The digital transformation in healthcare has led to an increase in the use of telemedicine and artificial intelligence (AI)based applications. This study aims to examine the associations between e-health literacy, attitudes toward AI, and acceptance of telemedicine, and to test whether attitudes toward AI statistically mediate the association between e-health literacy and acceptance of telemedicine.

METHODS: Our study was conducted between January 1 and March 1, 2026. This cross-sectional study included 277 participants who visited a family health center. Data were collected using a sociodemographic information form, the General Attitude Scale toward Artificial Intelligence in Health Services, the Attitude Scale toward Telemedicine, and the e-Health Literacy Scale. Hierarchical regression analysis and mediation analysis using the bootstrap method (5,000 resamples) were performed.

RESULTS: The mean age of the participants was 30.52 ± 9.95, and 57.4% were female. In the hierarchical regression analysis, e-health literacy (β = 0.28, p < .001) and a positive attitude toward AI (β = 0.23, p = .010) were found to positively predict telemedicine acceptance, while a negative attitude toward AI (β = -0.28, p = .002) was found to negatively predict it. In the mediation analysis, it was determined that e-health literacy has a strong direct effect on telemedicine acceptance (β = 0.545, p < .001), but AI attitudes do not play a mediating role in this relationship (p > .05).

CONCLUSION: E- health literacy is a strong and direct determinant of telemedicine acceptance, independent of attitudes toward AI. Negative attitudes toward AI were associated with lower acceptance of telemedicine services. The results of our study suggest that strategies aimed at improving e- health literacy and addressing AI related concerns may be effective in promoting the widespread adoption of telemedicine, particularly in primary care settings.

PMID:42437877 | DOI:10.1186/s12875-026-03470-8

Cogn Res Princ Implic. 2026 Jul 13. doi: 10.1186/s41235-026-00740-y. Online ahead of print.

ABSTRACT

Educators face persistent challenges in fostering deep understanding of abstract STEM concepts. Theories of embodied cognition propose that grounding abstract ideas in bodily action and perception can enhance learning. Teachers often intuitively use embodied pedagogies such as gesturing and hand-drawing in the classroom, both by performing these themselves or asking students to do these actions, yet the comparative effects of these different types of embodied pedagogies are not well understood. Furthermore, the effect of these pedagogies needs to be put into perspective of students’ varying levels of prior understanding. It is unlikely that a single pedagogy will suit all learners. Building on research examining how embodied pedagogies interact with prior knowledge, we contrasted gesture-based and hand-drawing-based instruction in a college-level introductory statistics and data science course. Students were randomly assigned to view instructional videos that enacted either drawing or gesture then reenacted the demonstrated actions. Results showed that prior knowledge significantly moderated instructional effectiveness: For low-prior-knowledge learners, gesture-based instruction outperformed drawing-based instruction, whereas no difference emerged for high-prior-knowledge learners. The findings of this study contribute to our theoretical understanding of how embodied pedagogies impact learning and offer practical insights for tailoring embodied pedagogies to learners’ prior knowledge in the classroom.

PMID:42437864 | DOI:10.1186/s41235-026-00740-y

Lasers Med Sci. 2026 Jul 13;41(1):149. doi: 10.1007/s10103-026-04940-2.

ABSTRACT

Leishmaniasis, a zoonotic disease caused by parasites of the genus Leishmania, poses a significant medical and veterinary importance worldwide. This study was designed to explore the potential of SERS-based plasmonic substrate combined with advanced multivariate statistical analysis for differentiation of three prevalent Old World Leishmania species. In the present study, we investigated the potential of Raman spectroscopy and surface-enhanced Raman spectroscopy (SERS) combined with machine-learning-based analytical approaches for differentiation of three prevalent Old World Leishmania species. Previously characterized ITS1 PCR products corresponding to Leishmania infantum, Leishmania tropica, and Leishmania major were used as target molecules for spectroscopic analysis. Species identity of the samples had been confirmed previously using ITS1 PCR, sequencing, and PCR-RFLP analysis. Raman and SERS spectra were acquired using a HORIBA Raman microspectrometer equipped with a He-Ne laser. Silver nanoparticle-based SERS substrates were synthesized using a modified Tollens’ method to enhance Raman signal intensity. Spectral datasets were preprocessed and analyzed using principal component analysis (PCA), combined with linear discriminant analysis (PCA-LDA). The PCA-LDA technique reduced data dimensionality and facilitated visualization of spectral separation between species. A support vector machine (SVM) classifier was also utilized as an exploratory approach to visualize potential decision boundaries among species based on the SERS data. SVM classifiers on the ITS1 product spectra suggested the potential ability of SERS-derived spectral features to distinguish among three prevalent Old World Leishmania species. The obtained classifications were fully consistent with the previously confirmed molecular identification results. The findings demonstrate that SERS coupled with multivariate statistical analysis and machine-learning approaches can provide a promising analytical framework for species-level differentiation of Leishmania parasites based on ITS1 PCR products. This preliminary study highlights the potential application of Raman/SERS-based molecular profiling for future diagnostic and epidemiological investigations. Broader sampling across geographically diverse isolates and independent validation datasets will be required in future investigations to determine the reproducibility, specificity, and potential translational value of this analytical approach.

PMID:42437820 | DOI:10.1007/s10103-026-04940-2