Select graduating residents across various specialties will need to perform bedside procedures as fellows, as supervising faculty, or as practicing providers. Therefore, the development of a focused and structured curriculum is needed to enhance procedure training. We aim to introduce reproducible frameworks and tools for procedure training. Virginia Commonwealth University internal medicine residents rotate through a two-tertiary care hospital system which consists of 1200 inpatient beds. Categorical internal medicine residents participated in this curriculum with no significant difference in age, gender, or percentage of residents pursuing procedure-related fields before or after curriculum implementation. The procedure curriculum entails just-in-time simulation-based mastery learning (SBML) for bedside procedures with complete supervision in a clinical environment thereafter with multimodal assessments regardless of competency level achieved at the discretion of a procedure competency committee. Residents provide feedback via dedicated evaluations for faculty, SBML sessions, procedure rotation, and program evaluations. Our findings reinforce the use of just-in-time SBML and a medicine procedure service and show the benefit of continued supervision with multimodal assessments regardless of competency level assigned by a procedure competency committee.
Academic burnout impairs university students' development, yet research on Physical Education Teacher Education (PETE) students facing both academic and high-intensity training pressure is insufficient. This study explored the association between positive parenting style and academic burnout among PETE students, testing the chain mediating roles of physical activity and meaning in life based on Conservation of Resources theory. A cross-sectional design was used. In December 2025, a stratified sampling method was applied to survey 1,192 PETE students from 15 provinces in China (age range 18-24 years, M = 19.5, SD = 1.27; 54.4% male). Participants completed the Short Form of the Egna Minnen Beträffande Uppfostran (S-EMBU) for positive parenting style, the Physical Activity Behavior Scale, the Chinese Meaning in Life Questionnaire (C-MLQ), and the Adolescent Learning Burnout Inventory (ALBI). Chain mediation analysis was performed using the PROCESS macro (Model 6) in SPSS 25.0, and indirect effects were tested with the bootstrap method (5,000 resamples). Correlation analysis showed significant pairwise correlations among positive parenting style, physical activity, meaning in life, and academic burnout. After controlling for gender and grade, the chain mediation model was supported. Positive parenting style was negatively associated with academic burnout (β = -0.110, p < 0.001). Three indirect pathways were identified: (1) via physical activity (indirect effect = -0.307, 95% CI [-0.340, -0.274]), (2) via meaning in life (indirect effect = -0.019, 95% CI [-0.030, -0.011]), and (3) via the sequential path of physical activity to meaning in life (indirect effect = -0.048, 95% CI [-0.061, -0.037]). Positive parenting style was negatively associated with academic burnout among PETE students. The independent mediating effect of physical activity was the strongest (effect = -0.307, 63.3% of total indirect effect). The chain mediation pathway (positive parenting style → physical activity → meaning in life → academic burnout) showed a small effect size (indirect effect = -0.048, contributing only 9.9% of the total indirect effect), indicating it plays a minor, auxiliary role rather than a dominant mechanism. Due to the cross-sectional design, causality cannot be inferred. Future longitudinal studies are needed to confirm these associations.
The emergence of generative artificial intelligence (AI) technologies is driving transformative changes in physical education, highlighting the critical need for pre-service teachers to develop AI-specific pedagogical knowledge and ethical awareness. This study explores the role of self-regulation in mediating the relationship between basic psychological needs (autonomy, competence, and relatedness) and digital competence, specifically Intelligent-TPACK and ethics, among Physical Education Teacher Education (PETE) students. Data were collected from 548 PETE students at six universities in Wuhan, China. Structural equation modeling (SEM) analysis demonstrated that self-regulation positively predicted both Intelligent-TPACK and ethical awareness, with self-regulation mediating the effects of basic psychological needs on these two dimensions of digital competence. These findings underscore the importance of promoting self-regulation skills to strengthen pre-service teachers' capacity to integrate AI tools effectively into their educational practices while fostering ethical decision-making. The results offer both theoretical and practical insights implications for teacher education programs seeking to advance AI literacy and ethical responsibility in future physical educators.
This study aimed to comprehensively understand how children engaged with physical activity in after-school programs developed through a university-community partnership initiative. The program was designed to enhance physical activity opportunities for elementary school students by offering a variety of structured and unstructured activities, facilitated by physical education teacher education (PETE) major students serving as mentors. A mixed-methods approach was employed, using both quantitative and qualitative data. Seventy children completed the Physical Activity Enjoyment Scale (PACES) before and after participating in a 12-week program. Additionally, 68 children participated in focus group interviews, and 32 physical education major students provided written reflections. Data were collected during the spring semester of 2025 from four elementary schools. Quantitative findings indicated an increase in children's enjoyment of physical activity from pre- to post-test. Qualitative analysis revealed four central themes: (a) enjoyment of the after-school program, (b) engagement in physical activity, (c) learning through play, and (d) positive relationships with mentors. This study demonstrates that prioritizing enjoyment, autonomy, social connection, and authentic learning within playful physical activity in after-school programs is paramount for fostering children's long-term engagement. The university-community partnerships create a synergistic "win-win" environment, where the involvement of PETE major students as mentors not only enriched children's experiences but also provided valuable teaching practice for university students. Such partnerships are essential for building high-quality after-school programs that equip children with lifelong healthy habits and foster their overall well-being.
The participation of people with disabilities (PWD) in physical activity and sports is essential for social inclusion and health promotion. The self-efficacy perceived by professionals greatly influences the success of inclusive practices; higher confidence in adapting activities and addressing diverse needs leads to better experiences for PWD. The self-efficacy scale for physical education teacher education majors toward children with disabilities (SE-PETE-D) measures this construct but lacked a validated Brazilian version. To translate, culturally adapt, and validate the Brazilian Portuguese version, named EAE-EFI/Brazil. Content validity indices exceeded 0.90 across all subscales. Exploratory factor analysis revealed high internal consistency (Cronbach's α > 0.96). Confirmatory factor analysis showed acceptable model fit (RMSEA <0.10; CFI, TLI, IFI > 0.90), supporting the original structure for subscales related to physical disability (PD) and visual impairment (VI). The EAE-EFI/Brazil is a valid and reliable tool for assessing physical education teachers' and students' self-efficacy concerning inclusion of individuals with intellectual disabilities, PD, and VI in Brazil. Future studies should evaluate the scale's applicability in diverse contexts and explore links with professional development and institutional support, advancing inclusive practices and policies in Brazilian education.
The activating receptor NKp30 is important in NK cell killing of cancer cells. Here, we demonstrated that a pair of splice signals in the Ig domain exon of human NKp30 is largely conserved among primates and placental mammals and produces an alternatively spliced NKp30 ectodomain (NKp30-S) with an in-frame, nonartefactual deletion of 25 amino acid residues. Transfection yielded NKp30-S bands in NKL cells but not in 293T cells, suggesting that the splicing mechanism is cell-specific. Molecular modeling indicated that the overall folding of NKp30-S is maintained compared with NKp30. NKp30-S was expressed at the cell surface but did not bind to the NKp30 ligand B7H6 in soluble fusion protein or reporter cell assays. Single-cell RNA sequencing showed that NKp30-S transcription was not restricted to major NK cell subsets but suggested that a small fraction of blood NK cells expressed only the NKp30-S splice variant. The ratio of NKp30-S to full-length transcript was increased after activation of blood NK cells with IL-2 or IL-15 or crosslinking with anti-CD16 antibody, suggesting that this unique splicing mechanism, not seen in other Ig superfamily proteins, is regulated and may play a role in modulating NK cell responsiveness toward B7H6+ cancer cells in vivo.
We share the process of implementing Project Prevent, Engage, Empower, Respond (PEER), a HIV and substance use primary prevention initiative led by Southern University and A&M College in partnership with the University of Iowa. Project PEER was developed to address the emerging needs of Black/African American college students (ages 18-25) residing in Baton Rouge, Louisiana, a federal Ending the HIV Epidemic (EHE) priority area. Planning involved ongoing consultation with relevant Historically Black/College University (HBCU) and community stakeholders and triangulating multimodal primary and secondary data sources to inform implementation and continuous improvement efforts. Implementation included raising awareness about sexual health promotion and substance use prevention, bimonthly mobile HIV testing, disseminating prevention supplies and print-based materials, delivering the Prevention Plus Wellness evidence-based intervention, and broader community and social media outreach and engagement efforts. Lessons from PEER support the value of HBCU-led, community-academic partnerships that are flexible, culturally congruent, and young adult-driven.
Evaluation of diastolic function (DF) increases the prognostic value of exercise echocardiography. A protocol including both systolic and diastolic evaluation could predict different types of events. Systolic and DF were evaluated during exercise echocardiography in 2519 patients: left ventricular systolic function at peak-exercise (step 1), and E/e'/systolic pulmonary pressure postexercise (step 2). Abnormal systolic function was defined as ischemia or fixed wall motion abnormalities; abnormal DF was defined as postexercise E/e'> 15. The endpoint was to analyze the predictive value of systolic and DF for cardiac failure/cardiovascular death (CF/CVD), and for ischemic events. Systolic abnormalities were found in 806 patients (32%) and diastolic abnormalities in 451 (18%). Patients with CF/CVD more frequently had abnormal postexercise DF than those with ischemic events (48% vs 27%; P <.001), whereas the percentage of systolic abnormalities was higher in the latter group (78% vs 40%; P <.001). During follow-up, there were 477 events. Independent overall predictors included Δ wall motion score index (Δ WMSI) (HR, 8.08; 95%CI, 6.15-10.60; P <.001), and postexercise E/e' (HR, 1.02; 95%CI, 1.01-1.04; P=.004). Predictors of CF/CVD also included postexercise DF (E/e': sHR, 1.04; 95%CI, 1.00-1.07; P=.035) but not systolic function. Conversely, predictors of ischemic events included systolic function (Δ WMSI: sHR=12.81; 95%CI, 8.8- 18.71; P <.001) but not DF. Two-step exercise echocardiography assessing systolic and diastolic function predicts different types of events. Exercise echocardiography based only on systolic function might not capture the full spectrum of abnormalities.
Objective: To classify HIV-risk profiles for HBCU students to inform primary prevention. Participants: 244 HBCU students participated in the study. Methods: Students completed a demographic questionnaire and instruments measuring attitudes, knowledge, and beliefs about PrEP, perceived HIV risk, and drug use. Data were analyzed quantitatively including latent profile analysis. Results: Four risk profiles emerged: profile 1 (30.33%)-lowest PrEP scores, below-average perceived risk, low drug use; profile 2 (42.21%)-lowest perceived risk and drug use, above-average PrEP scores; profile 3 (22.13%)-highest PrEP and perceived risk scores, low drug use; and profile 4 (5.33%)-highest drug use, above-average PrEP and perceived risk scores. Conclusion: Findings provide preliminary support for classifying HBCU students by HIV-risk profiles to guide primary prevention. Universal prevention may be well-suited for students in profiles 1 and 2. Further assessment may be needed to determine selective and targeted/indicated prevention interventions for students in profiles 3 and 4 respectively.
Graphene nanoribbons (GNRs) offer promising platforms for single-molecule sensing due to their quasi-1D channels and discrete electronic states, providing superior sensitivity toward molecular perturbations. While prior studies emphasize smoother edges as essential for optimal performance, the potential benefits of controlled edge roughness remain largely unexplored. Additionally, most investigations focus on GNR arrays, leaving critical edge- and width-dependent factors, including fringe fields, bandgap widening, interactions between adsorbing molecules and GNR atoms, density of states (DOS) suppression, and electrostatic screening lengths, and their collective impact on sensitivity, poorly understood. Here, we fabricated field-effect transistors using individual GNRs (widths: 200-20 nm) and characterized their response to molecular adsorption with perfluorooctanoic acid as the model analyte. Narrower ribbons displayed significantly enhanced sensitivity, yielding a coverage-normalized response of 116 ± 10 mV per molecule in 20 nm-wide GNRs (from calibrated ensemble Dirac-point shifts). Experimental and theoretical analyses reveal that this heightened sensitivity arises from stronger fringe fields, width-dependent quantum confinement effects, reduced DOS, and increased edge roughness that facilitates molecular anchoring, enhanced orbital overlap, and improved charge transfer efficiency. Our findings challenge the conventional assumption that smoother edges inherently enhance sensor performance, demonstrating that controlled edge disorder substantially boosts molecular sensitivity in GNR sensors.
Dynamic polymer networks bridge the gap between traditional thermoplastics and thermosets, representing an avenue toward sustainable polymer synthesis. In this study, we utilize photoinitiated thiol-ene click chemistry to synthesize dynamic polymer networks through incorporating a series of bifunctional silyl ether alkene cross-linkers in the presence of catalytic p-toluene sulfonic acid. We demonstrate that the viscoelastic properties of the material, represented by its stress relaxation time constant, can be manipulated by up to 3 orders of magnitude by simple modifications in catalyst loading, amount of silyl ether cross-linker present, and/or dynamic cross-linker length. Our results show that a nonmonotonic relationship exists between stress relaxation kinetics and cross-linker length. Two representative networks were chosen to illustrate reprocessability under mild temperature conditions. These networks exhibited no loss of mechanical integrity after three reprocessing cycles. The networks can also be fully degraded in the presence of an excess of an acid catalyst.
The Gaylord Occupational Therapy Cognitive screen (GOT-Cog™) is a novel cognitive screening tool developed to support inpatient occupational therapy treatment planning. It has demonstrated excellent content, construct, and criterion validity, as well as good internal consistency. To assess GOT-Cog rater reliability and responsiveness. Repeated-measures design. GOT-Cog was administered to participants twice at admission and once at discharge. When different investigators collected the first two assessments, interrater reliability was tested; when collected by the same investigator, intrarater reliability was tested. The first and final GOT-Cog scores were used to assess responsiveness. Single long-term acute care hospital (LTACH). 192 participants, recruited from inpatients admitted with an order for occupational therapy services. GOT-Cog total score was the primary outcome measure. Rater reliability was evaluated using interclass correlation coefficients (ICCs); responsiveness was calculated using effect size and score change. Scale-level interrater reliability of GOT-Cog was moderate to good, ICC(2, 1) = .80 (95% confidence interval [CI] [.71, .87], r = .81, n = 87); intrarater reliability was good to excellent, ICC(2, 1) = .84 (95% CI [.76, .90], r = .86, n = 89). Domain-level rater reliability ranged from poor to excellent. A small effect size was demonstrated from admission to discharge (d = .37, n = 149) over a mean length of stay of 24.06 d (95% CI [20.70, 27.41]; n = 192). Previous findings are supported, which indicates that GOT-Cog has the validity and reliability needed to support its use in the LTACH setting with a mixed medically complex inpatient population. Plain-Language Summary: Conducted in the long-term care setting, this study explains how consistent the Gaylord Occupational Therapy Cognitive screen (GOT-Cog™) is when given to the same person, multiple times, and by the same or different people, as well as how sensitive it is to change over time. To test this, GOT-Cog was given to participants twice at inpatient admission and once at discharge. GOT-Cog was found to have moderate to good consistency when delivered by different people and good to excellent consistency when used by the same person. Over an average of 24 days, GOT-Cog showed a small level of change in participants who were tested admission and again at discharge.
Bidirectional relationships between hormones and behaviors are hypothesized: i.e. energetic consequences of behaviors may alter glucocorticoid levels, and elevated glucocorticoids may alter behavioral responses to stimuli in context-appropriate ways. We tested these relationships between the avian glucocorticoid corticosterone and behaviors related to food-acquisition in free-living seabird chicks (Black-legged kittiwakes, Rissa tridactyla) with robust HPA axis activity. First, we tested the hypothesis that behavior affects HPA axis activity by quantifying chick behavior for 60 min, then taking blood samples at baseline and 15-min post-restraint. Only feeding predicted subsequent corticosterone levels (fewer feeds = higher restraint-induced corticosterone). However, the hypothesis that increased corticosterone secretion alters behavior was supported: post-restraint corticosterone levels were positively correlated with increases in begging and aggression in the subsequent hour, primarily in males. In a second experiment, we isolated the role of corticosterone from other components of the stress response by administering exogenous topical corticosterone, which confirmed a positive relationship between subsequent corticosterone levels and changes in aggression, but not begging or feeding. Corticosterone:behavior relationships depended on nutritional context - they were eliminated in nests with experimental food supplementation. Finally, higher levels of corticosterone in response to restraint were associated with more rapid elimination of siblings, presumably increasing chick direct fitness by eliminating competition. We conclude that the magnitude of the endogenous corticosterone response to challenges is a) negatively correlated with recent feeding rates, b) subsequently associated with rapid, sex- and context-specific changes in chick behaviors, at least some of which are likely causally-driven by elevated corticosterone, and c) associated with fitness-relevant consequences.
Achieving high performance in elite sport requires athletes to endure extreme physical and psychological demands. While collective identity is often assumed to enhance commitment to these efforts, many elite athletes must train autonomously, raising questions about the role of social identification in sustaining effort when training alone. This study investigates how social identity influences physical engagement in endurance tasks performed in isolation, examining whether identification with a team enhances perseverance or if individual goal pursuit fosters greater effort. Fifty-four elite youth athletes (36 males; age: 15.7 ± 1.1) from team-based sports (handball, basketball, volleyball, and rugby) performed a cycling time-to-exhaustion test at 80% of their maximal aerobic power under two conditions: one emphasizing personal achievement and another emphasizing team success. Results revealed that athletes persisted longer in the personal identity condition compared to the collective identity condition, with no significant differences in perceived exertion, muscle pain, or time perception. However, athletes in the collective condition reported higher motivation and greater expectations of team success, despite performing less. These findings challenge conventional perspectives on identity processes in sport, suggesting that while identification with a team might boost motivation, it does not necessarily contribute to sustaining physical effort when training alone as personal identity seems to do. Instead, individual goal framing appears to facilitate the ability to sustain physical effort in autonomous settings. This underscores the need for coaches to consider the different effects of identity processes regarding endurance and engagement.
When interpreting data visualizations, people have expectations of how colors should map onto quantities. These expectations are constructed from multiple biases, including the dark-is-more bias (darker colors represent larger quantities) and the opaque-is-more bias (regions appearing more opaque represent larger quantities), among others. The extent to which any one bias influences interpretations of data visualizations depends on the degree to which that bias is applicable for a given visualization (applicability principle) and its relative weight in combination with other biases (combination principle). However, basic questions remain concerning the perceptual conditions necessary to activate such biases so they become applicable. For example, in previous studies of the opaque-is-more bias, the test stimuli appeared to vary in opacity because they were created by interpolating between a "base" color and a background color, which was lighter or darker than the base color. As such, opacity variation was confounded with large lightness variation. From prior work, it is unknown whether the opaque-is-more bias can be activated without substantial lightness variation. Here, we varied opacity by varying colormap saturation relative to the background while reducing lightness contrast (holding L* in CIELAB constant). We found that the opaque-is-more bias can indeed be activated without substantial lightness variation. In the process, we also found evidence for a new, "saturated-is-more bias," leading to expectations that regions greater in saturation map to larger magnitudes. These findings extend knowledge of how people infer meaning from visual features and can translate to inform design of effective information visualizations.
Background and Objectives: Sepsis is a life-threatening organ dysfunction, and specific biomarkers could improve prognostic assessment in septic patients. The Sequential Organ Failure Assessment (SOFA) score is the standard tool for clinical sepsis monitoring. Recent studies highlight the need for its revision and the identification of rapid, specific, sensitive predictors of sepsis mortality. The aim of this study was to determine the significance of cardiac biomarkers alone or combined with the SOFA score for evaluating sepsis-related mortality. Materials and Methods: This is a retrospective, single-center study with a relatively small sample size of 73 septic patients (Sepsis-3 criteria) hospitalized in an intensive care unit (ICU) and intermediate care unit (IMCU). All patients had standard laboratory parameters, cardiac biomarkers, and the SOFA score available upon admission. Statistical analyses included non-parametric Mann-Whitney U test, ROC (Receiver Operating Characteristic) curve analysis, Hanley & McNeil method and Hosmer-Lemeshow goodness-of-fit test. Results: Lactate (p < 0.001) and SOFA (p < 0.001) showed the highest area under the curve (AUC) values, and all cardiac biomarkers had statistically significant AUCs (p < 0.05) for sepsis mortality prediction. A comparison of all ROC curves was conducted, but no statistically significant differences were observed. Adding hs-cTn (high-sensitivity cardiac troponin) and lactate to the SOFA score increased its AUC from 0.767 to 0.827 (p = 0.421). Conclusions: The results showed that non-survivors of sepsis had significantly higher levels of cardiac biomarkers compared to survivors. There were no statistically significant differences in the areas under the ROC curves among the three markers, or between the markers and SOFA. The addition of cardiac biomarkers to SOFA did not improve the discriminatory ability of the SOFA score. Further research with a larger sample size is required to validate and generalize the findings.
Purchased/Referred Care Delivery Area (PRCDA) counties are those where resident American Indian and Alaska Native (AIAN) people are eligible for Indian Health Service care. Due to concerns about racial misclassification, cancer statistics for AIAN people are often restricted to PRCDA counties. Differences in sociodemographic characteristics may exist between PRCDA and non-PRCDA counties, but have not been described; therefore, the potential selection bias associated with the restriction to PRCDA counties remains unknown. We used data from the University of California, San Francisco Health Atlas to explore ecological differences in county-level demographic, socioeconomic, healthcare access, and health outcomes data between PRCDA and non-PRCDA counties (n = 3152 counties). We tested for statistical differences in mean levels of demographics between PRCDA and non-PRCDA counties using Pooled or Welch t-tests. We observed small, but statistically significant differences between PRCDA and non-PRCDA counties in county-level demographic and socioeconomic characteristics (age, poverty, utility services threat, unemployment, educational attainment, computer access, and median income), neighborhood and environment characteristics (overcrowding, severe mortgage/rent burden), healthcare access and utilization (uninsured, annual checkup, annual dental visit, mammography, binge drinking, smoking, physical inactivity, social isolation), and health outcomes (poor mental health, arthritis, poor self-rated health, high blood pressure, diabetes, high cholesterol, and obesity). These results indicate variability in county-level measures between PRCDA and non-PRCDA counties. While these data do not speak specifically to AIAN peoples' experiences, they provide critical contextual information to understand how exclusion of AIAN people residing in non-PRCDA counties from cancer statistics may bias risk estimates.
College students face many mental health struggles. Research shows the positive mental health impact of canine-assisted interventions (CAI), especially among college students. This study draws on a 2023 case study of Pete's Pet Posse (P3) at Oklahoma State University (OSU), an institutionally-integrated CAI program providing yearlong events since 2013. The exploratory study was guided by the following research question: How do campus community members perceive the well-being benefits of P3? We utilize (all data collected in 2023) feedback surveys (students n = 1,900; response rate 8.8%; P3 Handlers n = 40; response rate 66%; P3 student volunteers n = 31; response rate 87%), in-depth interviews (n = 30), and one focus group (n = 5) to descriptively document P3's perceived benefits to the campus community. Findings reveal that P3 helps the OSU community in managing life stressors, building a sense of community, and spreading joy in their everyday lives.
Individuals experiencing severe polytrauma are typically transported to the highest level of care as soon as possible, including helicopter evacuation from remote and/or rural environments. However, several recent preclinical and clinical studies have suggested that aeromedical evacuation exacerbates central nervous system injury and inflammation, and potentially results in increased mortality, questioning the right time and conditions under which to fly. Twenty-four swine with moderate-to-severe rotational traumatic brain injury (TBI) and ∼40% blood loss were randomly assigned to standard (∼8500 feet), tactical (evasive maneuvering), or mock (stationary on ground) helicopter (U.S. Army Black Hawk; HH-60M model) evacuation 2 h post-injury, with standard recommended therapies initiated in-flight. Results indicated that tactical evacuation was associated with increased cerebral perfusion pressure and inflammation (IL-6) post-flight relative to the standard and mock evacuation profiles, even after statistically controlling for pre-flight trauma procedures. Although the overall mortality rate was ∼25%, indicating severe polytrauma, no differences in mortality were observed as a function of aeromedical evacuation scenarios. Primary biomarkers of hemorrhagic shock, traumatic brain injury, lung and kidney pathology were also negative for aeromedical evacuation effects. In summary, the medical benefits associated with immediate (i.e., within a few hours of injury) helicopter evacuation of severe polytrauma patients likely outweigh the few increased complications associated with flight, as the latter may only be present during more extreme helicopter evacuation scenarios. Additional studies are needed to address potential adjunctive therapies that can be administered pre-flight to minimize the potential adverse effects of tactical flight.
To compare the efficacy of different routes of misoprostol administration (sublingual, vaginal, rectal) in reducing intraoperative blood loss, which remains a concern for the surgical management of uterine leiomyomas. The protocol was registered in PROSPERO (CRD42025637576). Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) guidelines, we searched several databases (Ovid Medline, Embase, Scopus, Web of Science, Cochrane, Global Health, Global Index Medicus, ClinicalTrials.gov) through June 2024. The references were screened and data were abstracted in Covidence for studies meeting inclusion criteria. Title abstract screening was conducted, followed by full-text review and then data abstraction. Analyses were conducted with R. There were 328 studies identified in the initial search. Of those, 26 studies were included for analysis, but only 20 were able to undergo network meta-analysis against the primary outcome of interest (blood loss). Rectal misoprostol administration was associated with the largest mean reduction in intraoperative blood loss (mean difference -152.43 mL, 95% CI, -228.43 to -76.44, P<.0001), followed by vaginal administration (mean difference -69.46 mL, 95% CI, -122.11 to -16.82, P=.010). Sublingual administration was not statistically significant (mean difference -92.13 mL, 95% CI, -234.95 to 50.70, P=.206). Across other key outcomes (eg, blood transfusion, operative time), rectal misoprostol generally outperformed vaginal and sublingual modes of administration in our network meta-analysis. Route of misoprostol administration does matter in reducing blood loss during abdominal myomectomy with rectal administration favored, although the data are limited for sublingual administration. PROSPERO, CRD42025637576.