Tag: pubmed

J Cardiothorac Surg. 2026 Jul 19. doi: 10.1186/s13019-026-04616-6. Online ahead of print.

ABSTRACT

OBJECTIVES: A systematic review and meta-analysis was performed to observe the incidence of perioperative stroke associated with selective and non-selective carotid ultrasound (CU) screening in the isolated coronary artery bypass grafting (CABG) population.

METHODS: PubMed, Scopus and CENTRAL databases were searched for studies published between January 1995 and October 2025. Inclusion criteria for the review focused on studies reporting primary data related to perioperative stroke in adult patients scheduled to undergo non-emergency isolated CABG who underwent either selective or non-selective preoperative CU screening. The primary outcome was perioperative stroke. Study quality was assessed using the ROBINS-I tool. Data related to the primary outcome was synthesised using an exploratory random-effects model meta-analysis. This review was reported as per PRISMA guidelines.

RESULTS: 2398 studies were identified to undergo title and abstract screening; 63 studies were identified to undergo full-text screening of which 15 studies were eligible for inclusion within the review (Total N = 25,931). For the 13 studies utilising a non-selective screening strategy, the pooled perioperative stroke rate was 1.78% (95% CI: [1.28;2.48]). Independently, the two cohorts utilising a selective screening strategy reported perioperative stroke rates of 1.16% and 1.23%. Due to the structural limitations of the existing literature these findings are presented as independent descriptive cohorts.

CONCLUSIONS: This review provides a descriptive synthesis of perioperative stroke rates across the two previously mentioned screening cohorts and does not establish comparative effectiveness. Although the low absolute event rates observed within the selective screening cohort align with current guideline recommendations, the structural limitations and high disproportion of the available evidence base prevent definitive comparison.

PMID:42471735 | DOI:10.1186/s13019-026-04616-6

Biol Sex Differ. 2026 Jul 18. doi: 10.1186/s13293-026-00954-1. Online ahead of print.

ABSTRACT

Hypoxia research has significantly advanced our understanding of how the human body responds to low-oxygen environments, yet women are still frequently studied without adequate consideration of hormonal status or reproductive life-course stage. This review examines the complex interactions between hormonal status across the female life course and the specific physiological responses of women to acute and chronic hypoxia, focusing on the menstrual cycle, hormonal contraception, pregnancy, menopausal status, hormone replacement therapy, gender-affirming hormone therapy, and reproductive health in high-altitude environments. Estrogen and progesterone significantly modulate ventilatory, cardiovascular, hematological, vascular, and muscular/metabolic responses to hypoxia, with distinct effects across different menstrual cycle phases, contraceptive regimens, and life-course states. Menopause introduces additional complexities, as declining hormone levels alter the body’s ability to acclimatize to low-oxygen conditions. Additionally, we examine how chronic and lifelong hypoxia impacts reproductive health, including fertility and pregnancy outcomes, in women living at high altitudes, highlighting both physiological adaptations and contextual factors. While current research has made progress, further studies are needed to better understand these sex-specific responses. We propose that future research should integrate stratified approaches, accounting for hormonal status (cycle phase, contraceptive use, pregnancy, HRT, GAHT) and reproductive status, to optimize health and performance recommendations for women exposed to hypoxic environments.

PMID:42471728 | DOI:10.1186/s13293-026-00954-1

World J Surg Oncol. 2026 Jul 18;24(1):302. doi: 10.1186/s12957-026-04496-z.

ABSTRACT

INTRODUCTION: Seroma is the most common postoperative complication following mastectomy and may result in additional postoperative interventions and increased treatment burden. However, its etiology and predictive factors remain insufficiently understood. This study aimed to identify predictors of postoperative seroma formation.

MATERIALS AND METHODS: We conducted a retrospective analysis of 245 patients (301 breasts) who underwent conventional mastectomy or skin-/nipple-sparing mastectomy, with or without immediate implant reconstruction and axillary surgery, at the University Hospital Leipzig between 2019 and 2023. Variables analyzed included epidemiological characteristics, neoadjuvant chemotherapy, tumor status, perioperative factors, and wound drainage output. Seroma formation was assessed via drains placed in the breast and axilla. Statistical analyses included univariable and multivariable regression and random forest modeling.

RESULTS: In univariable analyses, higher body mass index (BMI), longer surgical duration, diabetes mellitus, hypertension, advanced tumor stage, and elevated C-reactive protein levels were associated with increased breast seroma formation. Random forest analysis identified BMI, number of resected lymph nodes, surgical duration, hypertension, and diabetes as key predictors, all of which remained significant in multivariable models. For axillary seroma, BMI, number of resected lymph nodes, and tumor stage were significant in univariable analyses, while BMI and number of resected lymph nodes remained significant in multivariable models.

CONCLUSION: Seroma formation is primarily influenced by BMI, extent of lymph node removal, and surgical duration, with hypertension and diabetes as additional risk factors for breast seroma.

PMID:42471711 | DOI:10.1186/s12957-026-04496-z

BMC Med Inform Decis Mak. 2026 Jul 18. doi: 10.1186/s12911-026-03709-5. Online ahead of print.

ABSTRACT

OBJECTIVE: To develop and internally validate an interpretable prognostic model for cumulative clinical pregnancy in women with diminished ovarian reserve (DOR), and to explore, as a hypothesis-generating secondary aim, whether protocol-associated pregnancy rates differ across model-defined baseline-prognosis risk strata.

DESIGN: Retrospective cohort study.

SETTING: A single tertiary reproductive medicine center.

PATIENTS: 1,251 oocyte-retrieval cycles in women with DOR (AMH ≤ 1.1 ng/mL) at a single tertiary centre, January 2019-July 2024. Each record is one retrieval cycle; no patient identifier was available.

METHODS: From 37 candidate predictors, random-forest selection (training set only) retained eight; six algorithms were compared for discrimination (AUC, DeLong), calibration (slope, intercept, Brier) and clinical utility (decision-curve analysis), with SHAP for interpretability. Discrimination was further assessed by out-of-time validation (train ≤2022, test 2023-2024). Within model-defined risk strata, protocols were compared (chi-square/Fisher; bootstrap CIs; FDR and Bonferroni correction), with a pre-treatment-variable-only sensitivity analysis.

RESULTS: A parsimonious logistic regression gave the highest test AUC (0.739, 95% CI 0.688-0.790; Brier 0.200), not significantly better than more complex algorithms (DeLong p>0.10), and held up on out-of-time validation (AUC 0.726). The five most influential predictors (SHAP) were embryo quality, female age, male age, estradiol and AMH. In the exploratory analysis, low-probability cycles showed no protocol differences; among high-probability cycles only one association survived correction (long-acting GnRH-agonist fresh transfer vs HRT frozen transfer; absolute difference +48%, 95% CI 28-67%; FDR p=0.002), persisting in the baseline-only analysis.

CONCLUSIONS: In women with DOR, an interpretable logistic-regression model provided moderate, internally and temporally validated discrimination for cumulative clinical pregnancy at the pre-transfer decision point, though calibration drifted over time and warrants recalibration before use. The single protocol-related association is hypothesis-generating only. The model is best regarded as a pre-transfer prognostic counselling tool, not a basis for protocol selection, and requires prospective external validation.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:42471694 | DOI:10.1186/s12911-026-03709-5

BMC Nurs. 2026 Jul 18. doi: 10.1186/s12912-026-05041-9. Online ahead of print.

ABSTRACT

INTRODUCTION: Given the increasing use of artificial intelligence in the field of health and treatment, including nursing, it is necessary to draw students’ attention to this issue from the time of their education. Therefore, this study was conducted with the aim of investigating the relationship between attitudes towards artificial intelligence and moral sensitivity in nursing students.

METHODS: This cross-sectional study was conducted on nursing students from the 2nd to 8th semester of nursing at Kurdistan University of Medical Sciences. Participants were enrolled in the study through a census method. Demographic and ethical sensitivity questionnaires and attitudes towards artificial intelligence were used. Data were analyzed using descriptive and inferential statistical methods in SPSS-24 software.

RESULTS: Out of 155 participants, 61.29% had moderate moral sensitivity based on the Moral Sensitivity Questionnaire (MSQ), and 38.06% had low moral sensitivity. Regarding the Attitude toward Artificial Intelligence Questionnaire, 76.12% held a relatively favorable attitude and 19.36% a favorable one. A weak but statistically significant positive correlation was found between attitudes toward AI and moral sensitivity (*r* = 0.185, *p* = 0.012).

CONCLUSION: Given the weak yet statistically significant relationship between attitudes toward AI and moral sensitivity, integrating AI ethics education and targeted educational workshops into undergraduate nursing curricula may help strengthen students’ preparedness for ethical AI use. However, these findings should be interpreted cautiously because of the study’s cross-sectional design and single-center setting.

PMID:42471693 | DOI:10.1186/s12912-026-05041-9

BMC Nurs. 2026 Jul 18. doi: 10.1186/s12912-026-05053-5. Online ahead of print.

ABSTRACT

INTRODUCTION: As artificial intelligence (AI) becomes more common in healthcare, nursing students need to be both mentally and emotionally ready to use it. But feeling anxious about technology might hold them back. This study looked at whether there is a link between AI Readiness and technology anxiety among nursing students.

METHODS: We carried out a descriptive-correlational study with 297 nursing students at Qom University of Medical Sciences during the 2024-2025 academic year. We used census sampling, meaning we invited all eligible students to take part. Data were collected using a demographic form, the Abbreviated Technology Anxiety Scale (ATAS), and the Medical AI Readiness Scale for Medical Students (MAIRS-MS). Data were analyzed using descriptive statistics, Pearson correlation, independent t-tests, and multiple linear regression to identify predictors of AI Readiness.

RESULTS: The mean scores were 3.76 ± 0.54 for technology anxiety and 3.68 ± 0.61 for AI Readiness, indicating moderate-to-high levels. A strong inverse correlation was found between AI Readiness and technology anxiety (r = – 0.648, p < 0.001). Multiple linear regression showed that AI Readiness was a significant negative predictor of technology anxiety (B = – 0.32, p < 0.001), explaining 42% of the variance (R² = 0.420). No significant differences were observed based on gender, age, or marital status. Students in higher academic years reported lower technology anxiety (r = – 0.121, p = 0.026), and master’s students demonstrated significantly higher AI Readiness compared to bachelor’s students (p = 0.011).

CONCLUSION: These findings show that nursing students who feel more prepared for AI tend to be less anxious about technology. Adding AI training more consistently throughout the nursing curriculum and building digital skills may help reduce fear and make it easier for students to use AI tools in the future. Further longitudinal and interventional studies are needed to better understand causal relationships and to identify effective educational strategies.

PMID:42471688 | DOI:10.1186/s12912-026-05053-5

BMC Nurs. 2026 Jul 19. doi: 10.1186/s12912-026-05070-4. Online ahead of print.

ABSTRACT

BACKGROUND: In Sub-Saharan Africa, nursing professionals operate under intense occupational pressure characterized by high patient loads and an acute deficit of ergonomic support. These systemic constraints amplify the impact of mechanical low back pain (LBP) on work ability, the functional equilibrium between a clinician’s health status and their professional obligations. Guided by the biopsychosocial model, this study investigated the associations of physical activity (PA), pain intensity (PI), and health-related quality of life (HRQoL) with work ability among nurses experiencing mechanical LBP within a Nigerian tertiary clinical setting.

METHODS: A hospital-based, cross-sectional descriptive survey was conducted among 188 clinical nurses at a federal referral hospital in Gombe, Nigeria. Eligible participants were nurses who had experienced a diagnosis of mechanical LBP persisting for at least three months. Validated instruments were deployed: the Work Ability Index (WAI) captured the dependent variable, while the International Physical Activity Questionnaire (IPAQ), Visual Analogue Scale (VAS), and the Physical Component Summary (PCS) of the RAND-36 Health Survey quantified the independent variables. Data were analyzed using descriptive statistics, Pearson’s product-moment correlation, and multiple linear regression analysis (alpha = 0.05).

RESULTS: Bivariate analysis demonstrated significant positive correlations between work ability and both PA (r = 0.435, p = 0.002) and HRQoL (r = 0.388, p = 0.001), alongside a significant inverse correlation with PI (r = -0.312, p = 0.001). The multiple linear regression model was statistically significant, F(3, 184) = 12.525, p = 0.001, accounting for 21.5% of the total variance (R² = 0.215, Adjusted R² = 0.198). Notably, physical activity emerged as the most robust independent indicator in the model (beta = 0.412, t = 3.14, p = 0.002), displaying a substantially greater association with functional work ability than the subjective intensity of clinical pain symptoms.

CONCLUSION: This study demonstrates that physical activity, subjective pain intensity, and health-related quality of life are concurrent factors significantly associated with the work ability of Nigerian clinical nurses managing mechanical low back pain. The empirical findings indicate that higher physical activity levels and lower pain intensities are both independently linked to optimal work ability scores within this cohort. Consequently, occupational health strategies in resource-constrained Nigerian medical environments should consider a comprehensive approach that couples traditional pain management with structured, low-cost institutional physical activity and exercise rehabilitation programs to support the functional capacity of the healthcare workforce.

PMID:42471682 | DOI:10.1186/s12912-026-05070-4

BMC Womens Health. 2026 Jul 18. doi: 10.1186/s12905-026-04687-6. Online ahead of print.

ABSTRACT

BACKGROUND: De novo stress urinary incontinence (SUI) may reduce patient satisfaction following a pelvic organ prolapse (POP) surgery and may necessitate additional anti-incontinence surgery in the future. The aim of this study is to evaluate physical examination tests that can predict de novo SUI after POP surgery.

METHODS: A total of 30 patients diagnosed with stage 3-4 POP who underwent POP surgery were included in this study. The results of the Q-tip test, reduced stress test, and urodynamic stress urinary incontinence test, which were performed before the surgery, and stress test results for SUI at 3 and 6 months after the surgery were recorded. The physical examination tests were compared and occult SUI and de novo SUI rates were determined.

RESULTS: Occult SUI detection rates were found to be 46.7% for the Q-tip test, 20% for the reduced stress test, and 3.3% for the urodynamic test. The rates of de novo SUI were determined as 3.3% and 10%, respectively, at the 3rd and 6th months postoperatively. The presence of gravida, parity, and the number of living children increased the detection rate of occult SUI by the Q-tip test at statistically significant level. It was also determined that the high number of abortions statistically increased the risk of de novo SUI at 6 months postoperatively and occult SUI did not significantly affect the risk of de novo SUI.

CONCLUSION: Our findings suggest that less invasive and cost-effective physical examination tests may be considered in the preoperative evaluation of patients undergoing POP surgery; however, these results should be interpreted cautiously.

PMID:42471676 | DOI:10.1186/s12905-026-04687-6

BMC Ophthalmol. 2026 Jul 18. doi: 10.1186/s12886-026-05109-9. Online ahead of print.

ABSTRACT

BACKGROUND: Rotational stability is a critical determinant of the refractive performance of toric intraocular lenses (IOLs), as even small degrees of postoperative rotation may compromise astigmatic correction. This study aimed to compare the rotational stability of two toric IOLs with different designs.

METHODS: A retrospective comparative study was conducted including eyes that underwent cataract surgery with implantation of either a monofocal toric Ankoris IOL or a TECNIS ZCT toric IOL. Postoperative IOL rotation was evaluated at 1 day, 1 week, and 1 month after surgery. Rotational stability was assessed using the absolute value of rotation, regardless of direction. Secondary outcomes included the proportion of eyes with clinically significant rotation (> 10°) and the need for surgical repositioning. Statistical analyses were performed according to data distribution.

RESULTS: A total of 61 eyes were included, with 31 eyes in the Ankoris group and 30 eyes in the TECNIS ZCT group. At 1 month postoperatively, the Ankoris group showed a significantly greater absolute rotation compared with the TECNIS ZCT group (median 4° [IQR 3-8] vs. 3° [IQR 2-3], p = 0.047). Both IOLs demonstrated a tendency toward progressive stabilization over time; however, the TECNIS ZCT lens exhibited lower rotational variability at all evaluated time points. The proportion of eyes with rotation greater than 10° was low in both groups, with no statistically significant difference. Surgical repositioning was required in two eyes (6.5%) in the Ankoris group and in none of the TECNIS ZCT group (p = 0.49).

CONCLUSIONS: Both toric IOLs demonstrated clinically acceptable rotational stability during the first postoperative month. Among eyes demonstrating measurable postoperative rotation, the TECNIS ZCT lens exhibited lower rotational magnitude and less variability compared with the Ankoris lens, which may be clinically relevant when selecting toric IOLs for astigmatism correction.

PMID:42471673 | DOI:10.1186/s12886-026-05109-9

BMC Public Health. 2026 Jul 18. doi: 10.1186/s12889-026-28495-7. Online ahead of print.

ABSTRACT

BACKGROUND: The prevalence of obesity among children and adolescents and the number of cases of bariatric surgery among children and adolescents is increasing; the discussion on weight loss among children and adolescents is becoming polarized.

OBJECTIVES: To investigate the prevalence of overweight and obesity among a sample of Chinese children and adolescents and the perceptions and attitudes of a subset of Chinese residents towards obesity, weight loss, and MBS for weight loss in children and adolescents.

METHODS: Cross-sectional survey among a subset of Chinese residents, collected from August 5, 2022 to October 30, 2022. Participants were a subset of Chinese population, including adults, children, and adolescents.

RESULTS: A total of 3015 questionnaires were returned. Children and adolescents with overweight and obesity accounted for 16.6% and 9.4%. Gender, education, occupation and age were associated with the perceptions and attitudes of Chinese residents toward obesity and weight loss in children and adolescents; age, occupation and BMI were associated with the perceptions and attitudes toward MBS in children and adolescents. There are 10.8% of the respondents thought MBS was the most suitable method for children and adolescents, and 34.7% were unwilling to have MBS for their children. The percentage of respondents who thought it was appropriate for children and adolescents to undergo bariatric surgery at the age of 12-18 was 18.6%; 60.96% said they did not know enough about the surgery; most were aware that the effects of the surgery included weight loss (84.78%), improved self-confidence/ improved self-image (78.97%), improved disease (e.g., reduced drug use) (70.3%) and better performance in interpersonal interactions (51.70%).

CONCLUSIONS: A subset of Chinese residents are not fully aware of the harm of obesity among children and adolescents and its related complications. They have insufficient knowledge and trust in MBS and underestimate the benefits of the procedure. More health education is still required in these areas.

PMID:42471668 | DOI:10.1186/s12889-026-28495-7