Tag: pubmed

J Orthop Surg Res. 2026 Jul 15. doi: 10.1186/s13018-026-07094-7. Online ahead of print.

ABSTRACT

OBJECTIVE: Previous meta-analyses often lacked explicit time and included heterogeneous case types and surgical strategies. This led to substantial heterogeneity and limited the clinical applicability of these meta-analyses. This study focuses on evidence from the past 15 years, systematically comparing percutaneous pedicle screw fixation (PPSF) with open pedicle screw fixation (OPSF) for unstable traumatic thoracolumbar fractures (TTF). We aim to evaluate perioperative outcomes and radiographic correction based on contemporary practice.

METHODS: Randomized controlled trials (RCTs) published in English between January 2011 and January 2026 were retrieved from PubMed, Embase, the Cochrane Library, and the Web of Science Core Collection. Studies were screened using predefined inclusion and exclusion criteria. Six RCTs involving 305 patients were included, with 151 patients in the experimental group and 154 in the control group. Meta-analysis was performed using Review Manager 5.4. Mean difference (MD) was used as the effect size. Heterogeneity was assessed with the I² statistic. Sensitivity analysis was used to identify the main source of heterogeneity. Publication bias was evaluated using Egger’s test.

RESULTS: The random-effects meta-analysis showed that the experimental group had significantly less intraoperative blood loss (MD = – 32.51 mL, 95% CI – 57.52 to – 7.51, P = 0.01), shorter postoperative hospital stay (MD = – 2.09 d, 95% CI – 3.89 to – 0.29, P = 0.02), and smaller postoperative Cobb angle (MD = – 1.06°, 95% CI – 1.67 to – 0.46, P < 0.001). There was no significant difference in operative time (MD = – 10.15 min, 95% CI – 28.75 to 8.46, P = 0.29) or postoperative vertebral wedging angle (MD = 0.25°, 95% CI – 1.73 to 2.24, P = 0.80) between groups. Sensitivity analyses identified the study by Yang et al. as the main source of heterogeneity for operative time. After excluding this study, the fixed-effects model showed a shorter operative time in the experimental group (MD = – 8.85 min, 95% CI – 12.74 to – 4.95, P < 0.001). Perioperative outcomes showed high heterogeneity, whereas radiographic outcomes showed low to moderate heterogeneity. Egger’s test indicated no significant publication bias. Risk-of-bias assessment classified four RCTs as having a low risk of bias and two as having some concerns; no study was judged to have a high risk of bias.

CONCLUSION: PPSF may offer perioperative advantages over OPSF in selected unstable traumatic thoracolumbar fractures, mainly by reducing visible intraoperative blood loss and shortening postoperative hospital stay. PPSF was also associated with a modestly smaller postoperative segmental Cobb angle, although its clinical relevance and long-term durability remain uncertain. The operative-time finding should be interpreted cautiously because it became significant only in exploratory sensitivity analysis.

PMID:42458487 | DOI:10.1186/s13018-026-07094-7

BMC Med Educ. 2026 Jul 15. doi: 10.1186/s12909-026-09946-6. Online ahead of print.

ABSTRACT

BACKGROUND: The social model of disability acknowledges that the difficulties faced by persons who stutter (PWS) stem not only from speech dysfluency but also from societal barriers, misconceptions, and stigmatizing attitudes that limit participation and inclusion. As future healthcare professionals, health sciences students play an important role in promoting early detection, proper referral, and supportive care. However, there is limited research about their knowledge, beliefs, and attitudes around stuttering, particularly in Palestine and underserved areas.

METHODS: A cross-sectional study was carried out on 603 students enrolled in 14 health-related fields at An-Najah National University in Palestine. Participants completed an online questionnaire that assessed their knowledge and attitudes toward stuttering. SPSS version 25 was used to conduct descriptive statistics and chi-square tests to investigate the relationships between responses and gender, residence, and academic discipline.

RESULTS: Significant misconceptions persisted even though the majority of participants acknowledged the significance of early identification (87.9%) and disputed the idea that stutterers are less intelligent (83.3%). Less than half (38.1%) were aware of nearby treatment facilities, and only 22.9% recognized stuttering as a genetic problem. Many participants thought stutterers were quiet or shy (69.5%), more susceptible to mental health issues (73.6%), and socially ignored (46.1%). Gender, place of residence, and academic discipline all showed significant disparities. While students from a number of other disciplines showed more doubt and misconceptions, students in audiology and speech consistently showed the highest levels of knowledge and more evidence-informed attitudes.

CONCLUSION: This study reveals considerable knowledge gaps and persistent stigmatizing attitudes toward people who stutter among health sciences students, with marked disparities across disciplines. Targeted curricular interventions are warranted to address misconceptions about people who stutter.

PMID:42458485 | DOI:10.1186/s12909-026-09946-6

J Transl Med. 2026 Jul 15. doi: 10.1186/s12967-026-08654-5. Online ahead of print.

ABSTRACT

BACKGROUND: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) in children, young people (CYP) lacks validated diagnostic biomarkers. Post-exertional malaise (PEM) is central to case definitions and is usually assessed by patient report. We evaluated the feasibility and clinical value of handgrip strength (HGS) testing in PEM-reporting CYP referred for suspected ME/CFS.

METHODS: In this prospective observational study at the Munich Chronic Fatigue Center for Young People (November 2022-November 2024), 147 patients (10-25 years) referred for the assessment of ME/CFS with positive DSQ-PEM screening and 83 healthy controls (HC) completed two HGS sessions (10 maximal grips/session; 3-s contraction/5-s rest; 60-minute inter-session break) using a digital dynamometer. We derived maximal force (Fmax), mean force (Fmean), fatigue ratio (FR = Fmax/Fmean), and recovery ratio (RR = Fmean session 2 / session 1). Analyses used repeated-measures ANCOVA, linear regression, partial Spearman correlations (adjusted for sex, age, and BMI), and proportional odds models for group membership (HC, noME/CFS, ME/CFS), reporting accuracy, and the C-statistic. Sensitivity analyses compared noME/CFS with confirmed CCC-ME/CFS.

RESULTS: After clinical work-up, 84/147 (57%) patients were classified as ME/CFS (confirmed or probable) and 63/147 (43%) as noME/CFS. HGS test completion rate was high (session 1: 146/147, 99.3%; session 2: 142/147, 96.6%). Compared with HC, patients had substantially lower HGS (mean difference -9.93 kg, 95% CI: -12.00 to -7.85), and HGS indices correlated modestly with physical functioning (SF-12 PCS), but not with PEM duration. Both noME/CFS and ME/CFS groups differed from HC in absolute strength indices (Fmean, Fmax) and FR. RR differed between ME/CFS and HC, whereas no HGS index significantly separated noME/CFS from ME/CFS. In proportional odds models, each HGS index improved fit (all p < 0.001), but discrimination across HC, noME/CFS, and ME/CFS patients was moderate (accuracy 49.2-57.3% vs no-information rate 36.5%, with best performance for Fmean in session 2). In the CCC-restricted sensitivity analysis, discrimination between confirmed CCC-ME/CFS and noME/CFS was moderate (accuracy 62.8-70.7%; C-statistic 0.63-0.73), with best performance for absolute strength indices and RR.

CONCLUSIONS: Standardized two-session repeated HGS testing is feasible in CYP with chronic fatigue and self-reported PEM and provides an objective marker of functional impairment that aligns with physical health status but not with PEM duration. However, HGS alone shows limited ability to discriminate ME/CFS from other fatiguing noME/CFS conditions. HGS may be useful for quantitative phenotyping, patient stratification, and longitudinal outcome assessment rather than as a standalone diagnostic biomarker.

TRIAL REGISTRATION: Not applicable.

PMID:42458481 | DOI:10.1186/s12967-026-08654-5

J Transl Med. 2026 Jul 15. doi: 10.1186/s12967-026-08625-w. Online ahead of print.

ABSTRACT

BACKGROUND: Chronic lung diseases impose a massive global burden, yet translating genetic findings into biologically interpretable target hypotheses remains challenging. We aimed to prioritize genetically supported candidate gene-cell type-disease associations and characterize pharmacological annotations for asthma, chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), and bronchiectasis (BE).

METHODS: We integrated immune-cell-specific single-cell cis-eQTL data (14 immune cell subsets) with two-sample cis-Mendelian randomization and Bayesian colocalization. Using FinnGen R12 and UK Biobank as independent outcome cohorts, we developed a cross-cohort tiered framework to rank candidate gene-cell type-disease associations based on MR evidence, colocalization support, and cross-cohort consistency.

RESULTS: Asthma yielded the most robust signals, highlighting 6 “Tier 1” candidates (e.g., CD247, FADS1) with replicated colocalization support across both cohorts. We mapped 17 prioritized druggable genes to existing drug-, compound-, or metabolite-related annotations via DrugBank, DGIdb, and HMDB. These annotations nominate CD247, FADS1, and other loci for mechanistic and pharmacological follow-up, but they should not be interpreted as direct evidence of clinical repurposing readiness. The limited peripheral immune signals observed in IPF and BE suggest that local tissue niches, together with limited power and phenotype heterogeneity, may influence signal detection.

CONCLUSIONS: By bridging single-cell genomics with pharmacological databases, our tiered prioritization framework provides a statistically grounded map of genetically supported candidate genes for chronic respiratory diseases. The results refine broad genetic loci into cell-contextualized candidate genes and pharmacological annotations that require independent, functional, and pharmacological validation before therapeutic inference. These findings should be interpreted as hypothesis-generating prioritization evidence rather than proof of therapeutic efficacy, clinical utility, or drug-repurposing readiness.

PMID:42458479 | DOI:10.1186/s12967-026-08625-w

BMC Oral Health. 2026 Jul 15;26(1):1271. doi: 10.1186/s12903-026-09231-4.

ABSTRACT

OBJECTIVE: To investigate, using micro-computed tomography (micro-CT), the apical anatomy of mandibular second primary molar roots in Egyptian children, with emphasis on the spatial relationship between the apical foramen and the anatomic apex, and the morphology and dimensions of the root canal at the apical foramen level.

MATERIALS AND METHODS: Fifty extracted human mandibular second primary molars (150 canals: 50 distal, 50 mesiobuccal, 50 mesiolingual) with complete root length and minimal resorption were scanned using high-resolution micro-CT (15.24 μm voxel size). The distance between the apical foramen and the apex, canal major diameter, and roundness at the foramen level were measured using CTAn software. Descriptive statistics were calculated, and exploratory canal-type comparisons were performed using one-way ANOVA followed by Tukey post-hoc tests. (α = 0.05).

RESULTS: The apical foramen did not coincide with the anatomic apex in any canal. The mean apex-to-foramen distance was 0.57 ± 0.44 mm. Mean apical canal diameter was 0.63 ± 0.24 mm and mean roundness was 0.48 ± 0.17, indicating predominantly oval canal shapes. The overall comparison suggested variation in apex-to-foramen distance among canal types (p = 0.040), but post-hoc comparisons did not confirm statistically significant pairwise differences between individual canal types. Distal canals exhibited significantly larger diameters than both mesial canals (p < 0.05), whereas the difference between mesiobuccal and mesiolingual canals was not significant. Roundness did not differ significantly among canal types (p = 0.079).

CONCLUSIONS: In Egyptian children, the apical foramen of mandibular second primary molar is consistently offset from the anatomic apex. The distal canals demonstrated the largest major canal diameter at the apical foramen level.

CLINICAL RELEVANCE: Because the apical foramen rarely coincides with the apex and complete mechanical enlargement to the true apical diameter is often clinically unrealistic, pediatric endodontic treatment should prioritize accurate working-length determination (e.g., electronic apex locators) and combine conservative shaping with effective chemical disinfection to optimize apical cleaning while preserving root integrity.

PMID:42458474 | DOI:10.1186/s12903-026-09231-4

BMC Nurs. 2026 Jul 15. doi: 10.1186/s12912-026-05046-4. Online ahead of print.

ABSTRACT

BACKGROUND: Major Depressive Disorder (MDD) is a debilitating psychiatric condition that severely impairs patients’ self-care capabilities, self-esteem, and resilience. Dorothea Orem’s Self-Care Deficit Theory offers a systematic nursing framework to transition patients from passive care recipients to active self-managers. This study aimed to evaluate the effects of a nursing intervention based on Orem’s self-care model on self-esteem and resilience among hospitalized patients with MDD.

METHODS: This randomized controlled trial was conducted from February to May 2026 among 60 patients diagnosed with MDD who were hospitalized in the psychiatric ward of Shahid Madani Hospital in Khoy, Iran. Patients were selected via convenience sampling and randomly assigned to either the intervention group (n = 30) or the control group (n = 30) using block randomization. The intervention group received 5 sessions of a tailored self-care program based on Orem’s supportive-educative system, alongside routine clinical care. The control group received only standard hospital care. Data were collected at baseline (pre-test), immediately post-intervention (post-test), and at a one-month follow-up using the Rosenberg Self-Esteem Scale (RSES) and the Connor-Davidson Resilience Scale (CD-RISC). Data were analyzed using SPSS software via descriptive statistics and Repeated Measures ANOVA.

RESULTS: Baseline demographic and clinical characteristics were homogeneous between the two groups (P > 0.05). Mauchly’s test confirmed sphericity for both self-esteem (W = 0.992, P = 0.788) and resilience (W = 0.953, P = 0.252) variables. The Repeated Measures ANOVA demonstrated a significant time-group interaction effect for both self-esteem (F = 10.11, P < 0.001, Partial Eta Squared = 0.15) and resilience (F = 6.59, P = 0.002, Partial Eta Squared = 0.10). At post-test, the intervention group exhibited significantly higher self-esteem (Mean = 18.33, 95% CI: [17.08, 19.58]) and resilience (Mean = 55.70, 95% CI: [52.00, 59.40]) compared to the control group (Self-esteem Mean = 12.03, 95% CI: [10.78, 13.28]; Resilience Mean = 42.07, 95% CI: [38.37, 45.77]) (P < 0.001), which remained stable at the one-month follow-up.

CONCLUSION: Psychiatric nurses can integrate this structured, low-cost, and empowering model into routine clinical practice to foster autonomy and reinforce essential psychological capacities-specifically self-esteem and resilience-in hospitalized psychiatric patients.

TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT20250723066609N3. Registered on February 6, 2026.

PMID:42458470 | DOI:10.1186/s12912-026-05046-4

J Transl Med. 2026 Jul 15. doi: 10.1186/s12967-026-08576-2. Online ahead of print.

ABSTRACT

OBJECTIVES: To examine whether patients with autoimmune diseases receive differential cardiometabolic and inflammatory laboratory monitoring compared to matched controls in primary care, and to identify predictors of monitoring patterns.

METHODS: We conducted a matched case-control study using electronic health records from the Primary Health Care Corporation (PHCC), Qatar (January 2015 to December 2024). Adults with Hashimoto’s thyroiditis, rheumatoid arthritis (RA), or systemic lupus erythematosus (SLE) were matched 1:2 to controls without autoimmune disease on age and sex. Primary outcomes were receipt of cardiometabolic tests (haemoglobin A1c [HbA1c], complete lipid panel) and inflammatory markers (C-reactive protein [CRP], erythrocyte sedimentation rate [ESR]). We used conditional logistic regression adjusting for comorbidities, medications, and healthcare utilisation.

RESULTS: Among 27,911 participants (9,356 cases, 18,555 controls; mean age 46.7 years; 74.4% female) in 9,356 matched sets, we observed divergent monitoring patterns. Compared to controls, patients with RA had significantly lower odds of HbA1c monitoring (OR 0.77, 95% CI 0.69-0.85) and complete lipid panels (OR 0.74, 95% CI 0.67-0.82). Similar patterns were observed for SLE (HbA1c: OR 0.67, 95% CI 0.57-0.80; lipid: OR 0.60, 95% CI 0.51-0.70). Conversely, RA patients had 4.2-fold higher odds of CRP testing and 4.4-fold higher odds of ESR testing; SLE patients showed similar elevations (3.7-fold and 4.2-fold, respectively). Hashimoto’s patients showed modestly increased monitoring across all test types (HbA1c: OR 1.45, 95% CI 1.23-1.70).

CONCLUSIONS: Despite elevated cardiovascular risk, patients with systemic autoimmune diseases (RA, SLE) receive less cardiometabolic laboratory monitoring than matched controls while receiving substantially more inflammatory marker testing. This differential monitoring pattern – which we describe as a “monitoring gap paradox” and which persisted across sensitivity analyses – is consistent with care coordination challenges at the primary care-specialty interface. The observational design precludes inferences about the underlying causes, but the findings identify a potential quality improvement opportunity warranting further investigation.

PMID:42458465 | DOI:10.1186/s12967-026-08576-2

J Transl Med. 2026 Jul 15. doi: 10.1186/s12967-026-08562-8. Online ahead of print.

ABSTRACT

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative syndrome diagnosed clinically using standardized criteria, with neuropathological confirmation of motor neuron loss and TDP-43 aggregates in postmortem brain tissue. Extracellular vesicles (EVs) have emerged as potential minimally invasive biomarkers for ALS, but studies vary widely in methodology and reproducibility. We conducted a systematic review and meta-analysis to evaluate the diagnostic potential of EV-associated proteins and RNAs in ALS. Following PRISMA guidelines, we searched PubMed and EMBASE from inception to May 21st, 2026. Forty-one studies met inclusion criteria. Where published summary statistics were available, these were used directly; where they were not, data were reconstructed from figures or obtained from authors and re-analyzed to derive standardized effect sizes and exploratory diagnostic accuracy estimates. Random-effects models were used for continuous outcomes, and diagnostic accuracy was assessed using hierarchical summary ROC and bivariate random-effects models. Publication bias was evaluated using Begg, Egger, and funnel plots. EV-associated TDP-43 was the most frequently studied protein. Meta-analysis of five studies showed a moderate but non-significant increase in EVs from ALS vs. controls (SMD = 1.30) with high heterogeneity (I = 97.8%). Sixteen studies assessing EV-RNA biomarkers showed minimal overlap and limited independent replication. Diagnostic accuracy meta-analysis across 11 studies yielded moderate performance (AUC = 0.839). No publication bias was found across both meta-analyses. EV biomarkers for ALS show biological promise but are limited by methodological variability and insufficient replication. This work highlights the need for standardized protocols, transparent data sharing, and independent validation.

PMID:42458453 | DOI:10.1186/s12967-026-08562-8

BMC Oral Health. 2026 Jul 15. doi: 10.1186/s12903-026-09161-1. Online ahead of print.

ABSTRACT

BACKGROUND: This in vitro study investigated the remineralization of artificial caries-like lesions in primary teeth using a multimodal microscopy approach. Micro- and nano-sized 45S5 bioactive glass (BAG) gels were compared with fluoride varnish in terms of surface morphology and volumetric mineral density changes.

METHODS: Enamel-dentin blocks prepared from extracted human primary molars and incisors were demineralized and randomly assigned to three treatment groups (n = 10): fluoride varnish, micro-sized BAG gel, and nano-sized BAG gel. Following treatment, all specimens were subjected to a 6-day pH-cycling protocol. Surface characteristics and elemental composition were analyzed using scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy (SEM/EDS), while three-dimensional mineral density (MD) distributions were quantified using micro-computed tomography (µCT). MD differences within and between groups were analyzed using two-way analysis of variance (ANOVA) with Tukey’s post-hoc test, with statistical significance set at p < 0.05.

RESULTS: SEM/EDS analysis demonstrated that both BAG gels produced relatively uniform superficial reaction products compared to fluoride varnish. However, µCT measurements revealed significantly higher mineral density in the fluoride-treated specimens (1.39 ± 0.10 g/cm³) than in the MicroBAG (1.09 ± 0.21 g/cm³) and NanoBAG groups (0.98 ± 0.16 g/cm³) (p < 0.05).

CONCLUSIONS: The combined findings highlight a discrepancy between surface-level observations and subsurface mineral recovery, emphasizing the importance of volumetric µCT analysis when assessing remineralization efficacy. Fluoride achieved higher volumetric mineral density than BAG gels. This study demonstrates the value of integrating surface and volumetric microscopy techniques for the accurate evaluation of mineralized dental tissues.

PMID:42458445 | DOI:10.1186/s12903-026-09161-1

BMC Nurs. 2026 Jul 15. doi: 10.1186/s12912-026-05018-8. Online ahead of print.

ABSTRACT

BACKGROUND: Competency training is essential for cultivating qualified anaesthesia Master of Nursing Specialist (MNS) graduates. Although a previous study has established relevant competency dimensions for anaesthesia nursing, no refined framework with operationalized indicators is currently available for Chinese MNS anaesthesia students.

OBJECTIVE: To construct an index system for the core clinical competencies of MNS anaesthesia students.

METHODS: Following literature screening, 26 eligible publications were selected to draft preliminary indicators. Semi-structured interviews with 15 participants were performed, and interview data were analysed via thematic coding.21 experts from 11 regions across China completed two rounds of Delphi surveys. Indicators were rated on a 5-point Likert scale, with expert consensus determined by predefined statistical cut-offs (mean importance score ≥ 3.5, coefficient of variation (CV) ≤ 0.25, ≥ 75% ratings ≥ 4) combined with comprehensive expert revision opinions.

RESULTS: The response rates of the two Delphi rounds were 100% and 95.24%, respectively. The expert authority coefficients (Cr) were 0.95 and 0.96, indicating high reliability of the consultation results. In the second round, Kendall’s concordance coefficients (W) for the first, second, and third-level indicators were 0.552 (strong consensus), 0.324 (moderate consensus), and 0.254 (weak-moderate consensus) respectively (P < 0.01), which indicated that the consistency of expert opinions was statistically significant and the consultation results were valid. The range of coefficient of variation was from 0.05 to 0.25. The final indicator system included 8 first-level indicators, 39 s-level indicators, and 109 third-level indicators.

CONCLUSION: Core clinical competency indicators for MNS anaesthesia students, established in this study, achieved expert consensus validity. These competency indicators can serve as a theoretical reference for the future training and assessment of MNS postgraduates in this field.

PMID:42458437 | DOI:10.1186/s12912-026-05018-8