Tag: pubmed

JMIR Form Res. 2025 Aug 8;9:e76958. doi: 10.2196/76958.

ABSTRACT

BACKGROUND: Technology-enhanced learning (TEL) has become increasingly vital in global medical education, offering significant advantages in knowledge acquisition, communication, motivation, and student engagement. In Syria, a country facing prolonged crises, there is an urgent need to evaluate the integration of technology within medical education to address institutional limitations and support student learning.

OBJECTIVE: The aim of this study is to evaluate the awareness, perceived challenges, and needs regarding the integration of technology in medical education from the perspectives of students and faculty at Syrian medical colleges.

METHODS: A cross-sectional survey was conducted during the 2023-2024 academic year across Syrian universities. Stratified random sampling was used to recruit 500 medical students and 200 faculty members. Two tailored, self-administered questionnaires were used, covering motivation, perceived benefits, challenges, and suggestions for technology integration. Validity was assessed through expert review and pilot testing (n=30), and internal consistency was confirmed (Cronbach α=0.6-0.7). Quantitative data were analyzed using descriptive statistics, t tests, ANOVA, and Kruskal-Wallis tests.

RESULTS: Among medical students, 94% (470500) agreed that integrating technology into medical education is essential, with similar agreement from 93.5% (187200) of faculty. No significant differences were found in student responses based on specialization (P=.32) or university type (P=.11). Likewise, faculty perspectives did not significantly differ by academic qualification or years of experience (P>.05). There were several perceived benefits; for instance, 93.2% (n=466) of students reported that technology kept them up to date with new developments, 88% stated it enhanced research skills, and 86.8% found TEL more enjoyable than traditional learning methods. Most respondents (95% n=475) said TEL created a flexible, interactive environment. Among faculty, 77% (n=154) agreed TEL improves clinical skill development. Respondents noted there were some challenges; specifically, 57% (n=285) of students cited poor internet service, 33% (n=165) noted the financial burden, and 82.2% (n=411) called for behavioral guidelines. Among faculty, 85.5% (n=171) cited lack of institutional support and 90% (n=180) emphasized the need for training. Both groups supported the development of communication platforms, curriculum revisions, and faculty development programs.

CONCLUSIONS: There is a strong consensus among Syrian medical students and faculty on the value and necessity of integrating technology in medical education. Despite infrastructure and administrative challenges, both groups recognize TEL as a powerful tool for improving clinical competencies, student motivation, and academic engagement. Institutional commitment, curricular reform, and tailored training are essential to achieving sustainable, effective technology integration.

PMID:40779753 | DOI:10.2196/76958

Traffic Inj Prev. 2025 Aug 8:1-9. doi: 10.1080/15389588.2025.2531410. Online ahead of print.

ABSTRACT

OBJECTIVES: While the prevalence of posttraumatic stress disorder (PTSD) after road traffic accidents (RTA) has been widely studied, there is a gap in research in the context of China. Therefore, this study aimed to provide a pooled estimation of PTSD prevalence after RTA based on Chinese data and compare it to existing international prevalence.

METHODS: A systematic literature search of English and Chinese databases was performed from their inception dates to December 31, 2024. Chinese patients admitted to a hospital or emergency department after RTA, and without traumatic brain injury following RTA or without PTSD before RTA were included, regardless of type of RTA and whether fracture was sustained. Subgroup analyses were performed on the basis on demographics, assessment methods, income, and comorbidity.

RESULTS: The inclusion criteria were met by 21 studies. The pooled prevalence of acute stress disorder (ASD) and PTSD was 30% (95% CI, 22%-37%) and 27% (95% CI,22%-32%), respectively, which is higher than the global prevalence of 16% ASD and 22% PTSD. The transition rate of ASD to PTSD was 77% (95% CI, 63%-91%). Females, older adults, and those with lower income had a higher prevalence of PTSD. In addition, the prevalence of PTSD increased with age. Older survivors with comorbidities including anxiety, depression, complication (such as pain, hemorrhagic shock, hypoxemia), diabetes, and hypertension were more likely to suffer from PTSD than older survivors without those comorbidities.

CONCLUSIONS: PTSD after RTA is common, with more than one in four RTA survivors reporting PTSD. Pooled prevalence was higher than that of meta-analysis that had no restrictions on world region.

PMID:40779750 | DOI:10.1080/15389588.2025.2531410

Traffic Inj Prev. 2025 Aug 8:1-10. doi: 10.1080/15389588.2025.2530074. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to enhance the accuracy and stability of traffic accident loss prediction in China by utilizing machine learning techniques. Specifically, it explores the application of the Extra Trees model combined with feature importance screening to predict key accident indicators such as the number of accidents, deaths, injuries, and property losses.

METHODS: Relevant transportation industry indicators were collected from national statistical sources. A two-step feature screening approach was employed based on average importance and importance ratio to reduce dimensionality and improve model performance. The Extra Trees algorithm was used for prediction modeling, and prediction accuracy was evaluated across multiple experimental runs to assess stability. Additionally, correlation, regression effects, and global importance scores were calculated to quantify the influence of each indicator. Polynomial fitting was conducted to explore the relationship between key indicators and predicted values.

RESULTS: The proposed feature screening approach improved both the accuracy and interpretability of the prediction model. The average prediction errors for the number of accidents, deaths, injuries, and property losses were 4.66%, 1.92%, 10.03%, and 5.01%, respectively. Among all targets, the number of deaths showed the highest predictive accuracy. Polynomial fitting confirmed a strong relationship between selected indicators and predicted values, with a quadratic fit achieving an R² of 0.957. The analysis identified 30 influential indicators, of which 12 had multi-target effects. Highway mileage, grade highway mileage, and average freight distance emerged as the most impactful indicators, with global importance scores exceeding 9.5%. Furthermore, the study demonstrated that prediction stability could be maintained across different data intervals, with error fluctuations remaining within acceptable bounds.

CONCLUSIONS: This study confirms the effectiveness of integrating feature importance screening with the Extra Trees model for predicting traffic accident losses. The methodology not only enhances prediction accuracy but also ensures stable performance across different accident indicators. The quantitative assessment of indicator importance offers valuable insights into the factors contributing to accident severity and provides a data-driven foundation for traffic safety policy and planning.

PMID:40779748 | DOI:10.1080/15389588.2025.2530074

J Med Internet Res. 2025 Aug 8;27:e72637. doi: 10.2196/72637.

ABSTRACT

BACKGROUND: Attitude-targeted interventions are important approaches for promoting vaccination. Educational approaches alone cannot effectively cultivate positive vaccine attitudes. Artificial intelligence (AI)-driven chatbots and motivational interviewing (MI) techniques show high promise in improving vaccine attitudes and facilitating readiness for vaccination.

OBJECTIVE: This study aimed to evaluate the effectiveness of a theory and evidence-based, MI-oriented AI digital assistant in improving COVID-19 vaccine attitudes among adults in Hong Kong.

METHODS: This 2 parallel-armed randomized controlled trial was conducted from October 2022 to June 2024. Hong Kong adults (N=177) who were vaccine-hesitant were randomly assigned into 2 study groups. The intervention group (n=91) interacted with the AI digital assistant over 5 weeks, including receiving a web-based education program comprising 5 educational modules and communicating with an AI-driven chatbot equipped with MI techniques. The control group (n=86) received WhatsApp (Meta) messages directing them to government websites for COVID-19 vaccine information and knowledge, with the same dosage as the intervention group. Primary outcomes included vaccine hesitancy. Secondary outcomes included vaccine readiness, confidence, trust in government, and health literacy. Outcomes were measured at baseline, postintervention, 3-month, and 6-month follow-up. Focus group interviews were conducted postintervention. Intervention effects were analyzed using the generalized estimating equation model. Interview data were content analyzed.

RESULTS: Decreases in vaccine hesitancy were observed while no statistically significant time-by-group interaction effects were found. The intervention showed significant time-by-group interaction effects on vaccine readiness (P=.04), confidence (P=.02), and trust in government (P=.04). Significant between-group differences with medium effect sizes were identified for vaccine readiness (Cohen d=0.52) and trust in government (Cohen d=0.54) postintervention, respectively. Increases in vaccine-related health literacy were observed, and a significant time effect was found (P=.01). In total, three categories were summarized from interview data: (1) improved vaccine literacy, confidence, and trust in government; (2) hesitancy varied while readiness improved; and (3) facilitators, barriers, and recommendations of modifications on the intervention.

CONCLUSIONS: The intervention indicated promising yet significant effects on vaccine readiness while the effects on vaccine hesitancy require further confirmation. The qualitative findings; however, further consolidate the significant effects on participants’ attitudes toward vaccines. The findings provide novel evidence to encourage the adoption and refinement of a MI-oriented AI digital assistant in vaccine promotion.

PMID:40779743 | DOI:10.2196/72637

J Clin Oncol. 2025 Aug 8:JCO2500618. doi: 10.1200/JCO-25-00618. Online ahead of print.

ABSTRACT

PURPOSE: New therapies for glioblastoma are needed, especially MGMT-unmethylated (uMGMT) disease. NRG Oncology BN002 (phase I) demonstrated safety and suggested efficacy of ipilimumab (ipi) with nivolumab (nivo) in newly diagnosed glioblastoma, leading to this phase II/III trial.

METHODS: Adults with newly diagnosed uMGMT glioblastoma and Karnofsky performance status (KPS) ≥70 were randomly assigned to radiotherapy with either immunotherapy (ipi and nivo) or temozolomide (TMZ), stratified by recursive partitioning analysis (RPA) class and intention to use tumor treating fields. With 95% power to detect a hazard ratio (HR) ≤0.58 for progression-free survival (PFS) at a one-sided significance level (P) of .15, superior PFS with immunotherapy in phase II would lead to phase III overall survival (OS) testing. Corticosteroids were disallowed when starting immunotherapy. Diagnosis, biomarkers, and PFS were centrally assessed.

RESULTS: One hundred fifty-nine participants were randomly assigned (79 immunotherapy and 80 TMZ). Arms were well balanced for age (median 60 years, range, 28-79), sex (male n = 105, 66%), KPS (90-100 n = 97, 61%), resection extent (gross total, n = 103, 65%), and RPA class (III, n = 16, 10%; IV, n = 116, 73%; V, n = 27, 17%). A preplanned analysis of phase II data conducted after 100 centrally determined PFS events showed no significant PFS improvement for ipi and nivo versus TMZ (median 7.7 months v 8.5 months, HR, 1.47 [70% CI, 1.19 to 1.83]; one-sided P = .96 [95% CI, 0.98 to 2.2]). OS is immature (>50% alive) but with no observed difference between arms (median approximately 13 months each, HR, 0.95 [95% CI, 0.61 to 1.49]; P = .36).

CONCLUSION: Ipi and nivo did not improve PFS among patients with newly diagnosed uMGMT glioblastoma versus TMZ. Accrual closed permanently; the trial will not proceed to phase III. No new safety signals were identified. Molecular correlative analyses and survival follow-up are ongoing.

PMID:40779733 | DOI:10.1200/JCO-25-00618

Am J Speech Lang Pathol. 2025 Aug 8:1-17. doi: 10.1044/2025_AJSLP-25-00029. Online ahead of print.

ABSTRACT

PURPOSE: Reading proficiency is an important life skill that contributes to improved quality of life and becoming an active member in society. This pilot randomized clinical trial tested the effects of a functional literacy intervention in young adults with intellectual and/or developmental disabilities (IDDs).

METHOD: Participants included 44 young adults with IDD between 18 and 26 years old. Participants were randomly assigned to the Functional Reading Activities to Motivate and Empower (FRAME) treatment group or a “business-as-usual” control group. Participants participated in 24 twice-weekly sessions in which they were taught reading comprehension strategies in the context of functional text stimuli or activities of daily living that require reading (e.g., text messages, e-mails). The primary outcome measure was the number of reading comprehension strategies used. Secondary outcomes included (a) multiple-choice comprehension questions, (b) text message response, (c) e-mail response, (d) summarization, and (e) verbal responses to functional text samples.

RESULTS: Young adults with IDD in the treatment group made statistically significant gains in use of reading comprehension strategies (d = 1.09, p = .002) and multiple-choice comprehension questions (d = 0.79, p = .038) as compared with the control group. There were no statistically significant differences on the remaining outcome measures.

CONCLUSIONS: This study provides preliminary support for the short-term effects of the FRAME intervention for young adults with IDD, with particular emphasis on explicit reading comprehension strategy instruction within a functional context. Therapeutic services typically end during the transition period for young adults with disabilities. However, it is essential that evidence-based literacy supports are available as this is a skill that continues to develop throughout the lifespan and has the potential to transform an individual’s transition to adulthood and independence. Future research should include a larger clinical trial and evaluate mediators of intervention effects.

PMID:40779715 | DOI:10.1044/2025_AJSLP-25-00029

J Bras Nefrol. 2025 Oct-Dec;47(4):e20250037. doi: 10.1590/2175-8239-JBN-2025-0037en.

ABSTRACT

INTRODUCTION: Infections represent a major cause of morbidity and mortality in kidney transplant recipients. Preservation fluid (PF) contamination is considered a potential infectious source; however, its clinical relevance remains controversial.

AIM: To evaluate whether PF contamination acts as a source of early post-transplant infections (within 30 days) and its association with acute rejection, graft loss, and mortality within 90 days.

METHODS: This was a retrospective, observational, and descriptive study based on medical records of patients aged ≥18 years who underwent kidney transplantation between January 2021 and December 2023. Collected variables included demographic, clinical, and post-transplant outcome data.

RESULTS: Among 246 recipients with available PF culture data, 27.6% (68/246) presented with PF contamination. Gram-positive cocci accounted for 64.7% of isolates, Gram-negative bacilli, for 35.3%, and fungi, for 2.9%. Coagulase-negative staphylococci (CoNS) were the most frequent isolate (36.8%). Microbiological concordance between PF isolates and pathogens responsible for early infection were observed in 13.23% (9/68) of cases, with Klebsiella pneumoniae being the predominant pathogen (66.6%). Although the infection rate was higher among patients with positive PF cultures (72%) compared to those with negative cultures (64%), this difference was not statistically significant (p = 0.2992). No significant associations were found with mortality (p = 1.000), graft loss (p = 0.8199), or acute rejection (p = 0.5635).

CONCLUSION: PF contamination was frequent and may contribute to early post-transplant infections, reinforcing the importance of microbiological surveillance and preventive strategies.

PMID:40779694 | DOI:10.1590/2175-8239-JBN-2025-0037en

J Bras Nefrol. 2025 Oct-Dec;47(4):e20250028. doi: 10.1590/2175-8239-JBN-2025-0028en.

ABSTRACT

INTRODUCTION: Stress hyperglycemia in patients with sepsis has not been consistently associated with an increased risk of acute kidney injury (AKI).

OBJECTIVE: To evaluate the effect of blood glucose levels on the occurrence of AKI requiring dialysis in critically ill patients with sepsis.

METHODS: Retrospective cohort study of patients with sepsis admitted to the ICU of a private hospital between December 2017 and August 2021. Clinical, laboratory, and severity variables were collected. Mean blood glucose levels in the first week of ICU stay (primary exposure variable) were stratified into tertiles. The effect of blood glucose on the occurrence of dialysis-requiring AKI was assessed using multivariate logistic regression.

RESULTS: Of the 1,317 patients evaluated, 86.6% had clinical conditions as the underlying cause of sepsis. AKI requiring hemodialysis occurred in 12.2% of the sample. Patients with mean blood glucose levels above the third tertile (≥160 mg/dl), compared to those with mean blood glucose levels below the first two tertiles (<160 mg/dl), had a higher prevalence of diabetes (69.1% vs. 7.1%; p < 0.001). Patients with mean blood glucose levels ≥160 mg/dl had a 62% higher odds of developing AKI requiring dialysis compared to those with mean blood glucose levels < 160 mg/dl (crude OR = 1.62; 95% CI 1.16-2.26; p = 0.005). After adjustment for other variables, mean blood glucose levels ≥180 mg/dl did not increase the likelihood of AKI (OR = 1.27; 95% CI 0.76-2.12; p = 0.359).

CONCLUSION: In this patient group, sepsis and mean blood glucose levels ≥160 mg/dl were not independently associated with the occurrence of dialysis-requiring AKI.

PMID:40779693 | DOI:10.1590/2175-8239-JBN-2025-0028en

Clin Drug Investig. 2025 Aug 8. doi: 10.1007/s40261-025-01470-7. Online ahead of print.

ABSTRACT

BACKGROUND: SHR7280 is an oral small-molecule gonadotropin-releasing hormone (GnRH) antagonist that can be developed as therapeutic agent for the treatment of hormone-dependent pathologies, including prostate, breast, and ovarian cancers. SHR7280 dry suspension formulation is being developed to provide an alternative mode of administration for order patients, those using nutritional tubes, and those unable to swallow solid dosage forms.

OBJECTIVE: This study evaluated the relative bioavailability, pharmacokinetics (PK), and safety of SHR7280 dry suspension and tablets administered in a single dose in healthy Chinese volunteers.

METHODS: A randomized, open, two-preparation, two-sequence, two-cycle, double-crossover design was used in this study. The plasma drug concentration was determined by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The main PK parameters of the two formulations of SHR7280 were calculated by noncompartmental analysis using Phoenix WinNonlin (version 8.3.4) software. A total of 16 healthy participants were randomized to receive SHR7280 (200 mg) as tablets (n = 8) or dry suspension (n = 8) formulation.

RESULTS: The geometric least squares mean ratio (90% confidence interval [CI]) for maximum concentration of drug in blood plasma (C_max) and area under the plasma concentration-time curve from time 0 to t (AUC_0-t) and from time 0 to infinity (AUC_0-∞) between the dry suspension of SHR7280 and its tablets were calculated as follows: C_max-101.90% (90% CI 79.50-130.62), AUC_0-t-111.58% (90% CI 91.71-135.76), and AUC_0-∞-111.44% (90% CI 91.70-135.43). A total of nine (56.3%) subjects experienced treatment-emergent adverse events (TEAEs).

CONCLUSIONS: The bioavailability of SHR7280 tablets was found to be comparable to that of dry suspension. The safety profile of two formulations was favorable. No serious adverse events or adverse drug reactions were reported.

TRIAL REGISTRATION: ClinicalTrials.gov (NCT05868057; 22 May 2023).

PMID:40779283 | DOI:10.1007/s40261-025-01470-7

Obes Surg. 2025 Aug 8. doi: 10.1007/s11695-025-08155-2. Online ahead of print.

ABSTRACT

BACKGROUND: Endoscopic sleeve gastroplasty (ESG) has been shown to be effective for inducing weight loss. Liraglutide, a glucagon-like peptide-1 agonist, has been successfully used for weight loss and remission of comorbidities in patients with obesity. So far, there are no clinical studies comparing short-term outcomes in patients treated with ESG or Liraglutide. The aim of the study is to assess the efficacy and safety of ESG versus Liraglutide in patients with obesity over a 12 months follow-up period.

METHODS: A prospective, randomized controlled, monocentric study was performed. A total of 43 patients with class I and II obesity were included in the study. Twenty-three patients underwent ESG, and 20 patients were treated with Liraglutide. All participants received standardized follow-up protocols with assessments by both surgeon and nutritionist in the bariatric ambulatory setting. Weight loss outcomes, including the percentage of excess weight loss (%EWL), total weight loss (%TWL), and resolution of obesity-related comorbidities were assessed at 3, 6, and 12 months post-intervention.

RESULTS: After 3 and 6 months, %EWL and %TWL were greater in the ESG group (P = 0.001). However, at 12 months, these differences were no longer statistically significant, suggesting that the ESG group was experiencing some weight regain, while the Liraglutide group had a slower but more consistent weight loss. Regarding the resolution of comorbidities, there were no statistically significant differences at 3, 6 and 12 months between the two groups. None of the patients had major complications or significant side effects.

CONCLUSIONS: Both ESG and Liraglutide guarantee weight loss and remission of comorbidities in class I and II obesity patients. However, ESG induces a more rapid weight loss in the first six months, after which two patients seem experience weight regain. Liraglutide provides a slower weight loss in terms of %EWL and %TWL but patients continue losing weight also after six months. Larger samples with a longer follow-up are needed to confirm our results.

PMID:40779281 | DOI:10.1007/s11695-025-08155-2