Category: Nevin Manimala

Front Public Health. 2026 Jun 30;14:1868556. doi: 10.3389/fpubh.2026.1868556. eCollection 2026.

ABSTRACT

INTRODUCTION: At least 40% of cancer cases could be prevented by lifestyle changes. However, despite clear recommendations, public awareness of modifiable cancer risk factors remains limited and misconceptions about cancer causes further impede prevention efforts. Understanding knowledge of preventable factors, myths, and information sources is essential for effective cancer prevention.

METHODS: To address this, a total of 1,232 residents of Stuttgart, Germany (53.2% female; M_age = 41.1; SD = 14.3) participated in the CLARO study (January-May 2025). A cross-sectional online survey assessed participants’ knowledge of cancer risk factors and myths, cancer information overload, and sources of prevention information.

RESULTS: Smoking (98.5%) and sunburn (95.1%) were widely recognized as cancer risk factors, whereas high salt intake (28.1%) and prolonged sitting (29.2%) were less acknowledged. Most cancer myths went unrecognized, except physical trauma (76.9%). Higher levels of cancer risk factor knowledge were linked to higher education (middle vs. high: β = -0.069, p = 0.022; low vs. high: β = -0.053, p = 0.048), prior cancer prevention information retrieval (β = 0.186, p < 0.001), and less cancer information overload (β = -0.235, p < 0.001).

DISCUSSION: Persistent knowledge gaps and misconceptions highlight the need to promote access to trusted, expert-reviewed information sources.

PMID:42454316 | PMC:PMC13365034 | DOI:10.3389/fpubh.2026.1868556

Front Public Health. 2026 Jun 30;14:1853232. doi: 10.3389/fpubh.2026.1853232. eCollection 2026.

ABSTRACT

BACKGROUND: Cancer is a disease with a high fatality rate. In recent years, patients’ psychological problems associated with cancer have attracted much attention. Identifying the psychological distress of cancer patients, formulating and implementing psychological interventions, and satisfying the humanistic care needs of patients have become popular topics in cancer nursing research.

AIMS: The purpose was to investigate relationships among rumination, somatic symptoms and psychological distress in cancer patients and to explore the mediating role of rumination in the relationship between somatic symptoms and psychological distress.

METHODS: A total of 473 cancer patients admitted to the oncology department of a Grade A general hospital in Shandong Province from January 2023 to December 2023 were investigated via convenience sampling. The data were collected and examined via a general demographic data questionnaire, Ruminative Responses Scale (RRS), the Health Questionnaire-15 (PHQ-15) and the Kessler Psychological Distress Scale (K10).

RESULTS: The mean total psychological distress score in cancer patients was 21.77 ± 7.49. The 473 patients were divided into two groups for univariate analysis according to whether they experienced psychological distress (K10 ≥ 16). There were statistically significant differences in the marital status (p < 0.05), education level (x ² = 6.623, p < 0.05), cancer classification (p < 0.001), and symptom rumination (x ² = -13.737, p < 0.001) and brooding (x ² = -11.763, p < 0.001) subscores between the two groups. The reflective pondering subscore (x ² = -12.726, p < 0.001), total RRS score (x ² = -14.056, p < 0.001) and PHQ-15 score (x ² = -12.161, p < 0.001) were compared between the two groups. Psychological distress was positively correlated with the RRS score (r = 0.841, p < 0.05), the symptom rumination (r = 0.828, p < 0.05), brooding (r = 0.742, p < 0.05), and reflective pondering (r = 0.742, p < 0.05) subscores, and the PHQ-15 score (r = 0.743, p < 0.05). Rumination partially mediated the relationship between physical symptoms and psychological distress, with a mediating effect of 70.69%.

CONCLUSION: There are close correlations among physical symptoms, rumination and psychological distress in cancer patients. Rumination plays a mediating role in the relationship between physical symptoms and psychological distress. Findings suggest that to alleviate patients’ psychological distress and improve their physical and mental health, medical personnel can not only address the physical discomfort symptoms of patients in time but also intervene in their negative cognitive thinking as observed by rumination.

PMID:42454310 | PMC:PMC13364554 | DOI:10.3389/fpubh.2026.1853232

Front Public Health. 2026 Jun 30;14:1878399. doi: 10.3389/fpubh.2026.1878399. eCollection 2026.

ABSTRACT

BACKGROUND: To explore the association between household coal use duration and upper gastrointestinal cancer and precancerous lesions.

METHODS: This study is a cross-sectional study. The research subjects were selected from those in Lucheng District and Pingshun County of Shanxi Province who participated in the upper gastrointestinal cancer screening and had complete data. The demographic characteristics, disease history, lifestyle, and household coal usage were collected through standardized questionnaires. A multivariable logistic regression model was used to assess the association between the duration of household coal usage and upper gastrointestinal cancer and precancerous lesions. Subgroup analysis was conducted based on age, gender, region, smoking status, and alcohol consumption. Sensitivity analysis was used to verify the robustness of the results.

RESULTS: A total of 55,820 participants were included, including 783 cases with upper gastrointestinal cancer and precancerous lesions and 55,037 controls. After adjustment for potential confounders, a positive association was observed between the duration of household coal use and upper gastrointestinal cancer and precancerous lesions (OR = 1.13, 95% CI: 1.05-1.24, P = 0.003). Stratified analyses showed statistically significant associations among women, individuals aged ≥65 years, non-smokers, non-drinkers, and residents of Pingshun County. Nevertheless, interaction tests were not statistically significant across all subgroup variables (all P for interaction > 0.05), indicating no evidence of effect modification. Sensitivity analyses demonstrated the stability and robustness of the observed association.

CONCLUSIONS: A positive association was observed between the duration of household coal use and upper gastrointestinal cancer and precancerous lesions. Given the cross-sectional nature of this study, causal inferences cannot be established. Prospective studies are warranted to further validate these findings.

PMID:42454305 | PMC:PMC13365028 | DOI:10.3389/fpubh.2026.1878399

Front Public Health. 2026 Jun 30;14:1865278. doi: 10.3389/fpubh.2026.1865278. eCollection 2026.

ABSTRACT

BACKGROUND: Preeclampsia is a pregnancy-specific hypertensive disorder associated with substantial maternal and perinatal morbidity. The neutrophil-to-lymphocyte ratio (NLR) has emerged as a potential inflammatory biomarker, but existing evidence remains inconsistent.

METHODS: PubMed, Embase, and Web of Science Core Collection were searched from database inception to 9 March 2026. Observational studies comparing NLR between women with preeclampsia and normotensive pregnant controls were included. Study quality was assessed using the Newcastle-Ottawa Scale. Random-effects meta-analysis was used to calculate pooled standardized mean differences (SMDs), with Hartung-Knapp adjustment applied as a sensitivity analysis. Publication bias was assessed using funnel plot inspection, Egger’s test, and Begg’s test.

RESULTS: Fourteen studies were included in the qualitative synthesis and eleven in the quantitative synthesis. The pooled analysis demonstrated significantly higher NLR levels in women with preeclampsia (SMD = 0.76, 95% CI 0.54-0.98; I ² = 84.8%). Subgroup analysis showed significant associations both in studies measuring NLR in the first trimester or early pregnancy (SMD = 0.81, 95% CI 0.48-1.14; I ² = 88.7%) and in studies measuring NLR at other time points (SMD = 0.73, 95% CI 0.40-1.06; I ² = 83.4%). The test for subgroup differences was not statistically significant (p = 0.743), although this comparison was limited by the small number of studies in each subgroup. Formal tests did not detect statistically significant publication bias, but their power was limited by the small number of studies.

CONCLUSION: Maternal NLR was significantly higher in women with preeclampsia than in normotensive pregnant controls. However, because the included studies were observational and showed substantial heterogeneity, and because diagnostic accuracy metrics and clinically actionable thresholds were not synthesized, NLR should not be interpreted as a stand-alone diagnostic or predictive marker. Further prospective studies with standardized sampling windows, prespecified cut-off values, and adjustment for key confounders are needed.

SYSTEMATIC REVIEW REGISTRATION: Identifier PROSPERO CRD420261333930.

PMID:42454304 | PMC:PMC13366881 | DOI:10.3389/fpubh.2026.1865278

Front Public Health. 2026 Jun 30;14:1865206. doi: 10.3389/fpubh.2026.1865206. eCollection 2026.

ABSTRACT

BACKGROUND: The WHO recommends ≥150 min/week of moderate-to-vigorous physical activity (MVPA) for optimal health. Whether weekend warrior (WW) or regular physical activity (PA) patterns differently influence risks of irritable bowel syndrome (IBS) and subsequent depression is unclear. This study explored these associations using accelerometer-derived PA.

METHODS: We included 84,799 UK Biobank participants with one-week accelerometer data to assess incident IBS using Cox models. Restricted cubic splines evaluated dose-response relationships and identified optimal and minimal candidate MVPA doses. Participants were classified as inactive, WW, or regularly active using guideline (150 min/week) and statistical thresholds. Among 3,976 baseline IBS patients, guideline-based groups were used to examine MVPA and subsequent depression risk with Cox models.

RESULTS: Over a median follow-up of 8.0 years, 962 participants developed IBS. MVPA showed a nonlinear inverse association, plateauing at 225 min/week, with a minimal candidate dose of 80 min/week. Both WW and regular activity were linked to lower IBS risk using 150 min/week (WW: HR 0.75, 95% CI 0.65-0.87; regular: HR 0.73, 95% CI 0.61-0.88) and 80 min/week thresholds (WW: HR 0.75, 95% CI 0.64-0.88; regular: HR 0.68, 95% CI 0.56-0.83). Among IBS patients, both WW (HR 0.61, 95% CI 0.42-0.89) and regular activity (HR 0.65, 95% CI 0.41-1.03) demonstrated comparable inverse associations with subsequent depression, with no significant difference between the two patterns.

CONCLUSION: Both WW and regular MVPA were similarly associated with a lower IBS risk, with minimal and optimal candidate doses of 80 and 225 min/week, respectively. Among IBS patients, both activity patterns demonstrated comparable inverse associations with subsequent depression, although findings were constrained by limited statistical power.

PMID:42454299 | PMC:PMC13364927 | DOI:10.3389/fpubh.2026.1865206

Front Public Health. 2026 Jun 30;14:1872101. doi: 10.3389/fpubh.2026.1872101. eCollection 2026.

ABSTRACT

INTRODUCTION: Older people and individuals with chronic illnesses living in long-term care facilities are at increased risk of infections due to the care setting, resulting in an increased probability of contracting SARS-CoV-2 and experiencing severe sequelae during the COVID-19 pandemic. To limit viral transmission, facilities adopted different policies according to national and regional prevention strategies, often reducing social contacts and promoting public health measures. We therefore conducted a national survey to investigate the impact of COVID-19 infection in Italian retirement homes for older adults and persons with disabilities (RHOAD).

METHODS: An online questionnaire investigating facility characteristics and COVID-19 impact between March 2023 and January 2024 was sent via email to Italian RHOAD.

RESULTS: Response from 510 RHOAD showed a trend in the percentage of COVID-19-positive individuals similar to that observed in Italy. An increase in cases was recorded in 2020, followed by a gradual decrease in 2021. Specific facility characteristics, such as a larger number of beds (80 or more vs. 0-20, OR 2.97, 95%CI 1.10-8.03), or challenges in transferring (OR 11.79, 95%CI 3.32-41.91) or isolating residents with COVID-19 (OR 4.43, 95%CI 2.13-9.22) or geographical location in the South (OR 0.17 95%CI 0.07-0.39) or Center (OR 0.39 95%CI 0.16-0.93) vs. North, were associated with an increased risk of having at least one COVID-19 case among residents in the multivariable logistic regression analysis. Similarly, facilities reporting at least one COVID-19 case applied national prevention measures related to visitor access less strictly (OR 2.16 95%CI 1.06-4.38) and registered an increase of adverse events (OR 2.49 95%CI 1.17-5.27).

DISCUSSION: Our findings highlighted the challenges faced by Italian RHOAD during the pandemic and support the optimization of the RHOAD organization to prevent disease transmission.

PMID:42454293 | PMC:PMC13365346 | DOI:10.3389/fpubh.2026.1872101

Cell Mol Bioeng. 2026 Jun 30;19(3):327-344. doi: 10.1007/s12195-026-00913-1. eCollection 2026 Jun.

ABSTRACT

SCOPE: Hydrogels are widely used in the design of tissue substitutes because of their ability to mimic the extracellular matrix (ECM). Their mechanical cues critically influence the cellular response, making accurate characterization essential. However, it remains challenging due to their intricate nature. This study computationally evaluates the hyperelastic properties of next-generation hydrogels of high biomedical interest, including basal membrane extract and decellularized liver matrices, as well as structural proteins.

METHODS: We present a combined framework based on Bayesian optimization and statistical analyses that go beyond classical least-squares fitting, leveraging rheological experimental data. It defines each hyperelastic strain-energy density function, and addresses both intra- and inter-sample variability. This approach quantifies uncertainty and reveals the natural variability that deterministic models overlook, and it also enables quantification of coefficient variation with composition.

RESULTS: Validation against experimental data shows computational fits of 5% error in most cases, and low calculation time. Analyses reveal that composition-collagen addition, fibrin concentration, and decellularized extracellular matrix (dECM) age-modulate initial stiffness, nonlinearity, and overall mechanical resistance of the hydrogels.

CONCLUSION: Hydrogels derived from basal membrane extracts exhibit comparable non-linear mechanics, while collagen addition reduces stiffness and nonlinearity. In fibrin-based hydrogels with decellularized liver matrix, mechanical behavior is concentration and age-dependent. Such insights are highly relevant for mechanobiology, enabling prediction of how cells sense mechanical cues and scaffold composition influences in vivo interactions.

SUPPLEMENTARY INFORMATION: The online version of this article (10.1007/s12195-026-00913-1) contains supplementary material, which is available to authorized users.

PMID:42454289 | PMC:PMC13365100 | DOI:10.1007/s12195-026-00913-1

Clin Ophthalmol. 2026 Jul 10;20:624067. doi: 10.2147/OPTH.S624067. eCollection 2026.

ABSTRACT

PURPOSE: Superabsorbent water beads can be used in projectile toy guns. We aimed to characterize water bead-related hyphema and compare the prevalence with other causes of traumatic hyphema.

METHODS: In this 10-month retrospective review, we identified 35 consecutive patients with traumatic hyphema presenting to the emergency department. Cases were grouped by injury mechanism, water bead-related compared with all other causes. Clinical data on initial presentation and subsequent visits were compared.

RESULTS: In the patients with traumatic hyphema, 8 (23%) cases were due to water bead trauma. Bead-related cases involved significantly younger patients (16 ± 9 years) compared with other cases (32 ± 21 years; p = 0.004). No statistically significant differences were found in peak intraocular pressure (p = 0.14) or need for surgical intervention (p = 0.3). The proportion of hyphema related to water bead injuries was higher in pediatric (42%) compared with adult patients (10%). The odds ratio of water-bead hyphema in pediatric compared with adult patients was 6.44 (95% CI:1.15-57.1; p = 0.021).

CONCLUSION: In this study, approximately a quarter of patients with traumatic hyphema during the study period were water bead-related, with approximately six-fold increased risk in younger patients. These findings suggest a need for public health awareness about water bead projectile injuries.

PMID:42454272 | PMC:PMC13367631 | DOI:10.2147/OPTH.S624067

Front Pain Res (Lausanne). 2026 Jun 30;7:1799439. doi: 10.3389/fpain.2026.1799439. eCollection 2026.

ABSTRACT

Hypermobile Ehlers-Danlos Syndrome (hEDS) and Hypermobility Spectrum Disorders (HSD) are complex multisystemic conditions frequently associated with chronic pain. Central Sensitization (CS)-a state of neural amplification and hyperexcitability-is hypothesized to be a unifying mechanism underlying the heterogeneous symptoms in chronic pain patients. Our aim was to investigate the association between central sensitization and multisystemic symptom burden in patients with hEDS/HSD while identifying independent clinical predictors of CS. We prospectively enrolled 150 adults diagnosed with hEDS/HSD at a specialized joint hypermobility clinic. Participants were evaluated using the Central Sensitization Inventory (CSI) and the SPIDER questionnaire. Clinical CS was defined as a CSI score > 40. Statistical analyses included univariate correlations and multivariable logistic regression. Centrally sensitized patients (n = 76) were significantly younger and predominantly female compared to the non-CS group. While CSI scores correlated strongly with all eight SPIDER domains (p < 0.001), a multivariable logistic regression model (AUC 0.98) identified only three independent predictors of CS: fatigue (OR 1.089), pain (OR 1.067), and cardiac dysautonomia (OR 1.057). Central sensitization in hEDS/HSD is independently associated with a triad of fatigue, pain, and cardiac dysautonomia. Clinical management should shift toward multidisciplinary strategies to effectively address the sensitized state in this population.

PMID:42454246 | PMC:PMC13364965 | DOI:10.3389/fpain.2026.1799439

Front Pain Res (Lausanne). 2026 Jun 30;7:1872295. doi: 10.3389/fpain.2026.1872295. eCollection 2026.

ABSTRACT

INTRODUCTION: Psychoemotional Factors Are Closely Associated With Health-Related Quality Of Life (Hrqol) In Individuals With Chronic Low Back Pain (Clbp). However, It Remains Unclear Whether These Associations Differ Between Women And Men.

AIM: To Evaluate Sex-Stratified Associations Between Psychoemotional Factors And Hrqol Domains In Adults With Chronic Nonspecific Clbp.

MATERIAL AND METHODS: This Cross-Sectional Study Included 223 Adults With Chronic Nonspecific Clbp (138 Women And 85 Men) Assessed Before Initiation Of Outpatient Rehabilitation. Pain Intensity, Anxiety, Depression, Perceived Stress, Kinesiophobia, And Hrqol Were Evaluated Using Standardized Questionnaires. Primary Analyses Examined Associations Between Psychoemotional Thresholds And Eight Sf-36 Domains Separately In Women And Men. Secondary Analyses Assessed Severe Pain (Vas ≥7). Exploratory Logistic Regression Models With Sex-By-Variableinteraction Terms Were Additionally Performed. Multiple Testing Was Controlled Using The Benjamini-Hochberg False Discovery Rate Procedure.

RESULTS: The Prevalence Of Clinically Significant Anxiety, Depression, High Perceived Stress, And Kinesiophobia Did Not Differ Significantly Between Women And Men. In Sex-Stratified Analyses, Elevated Psychoemotional Burden In Women Was Primarily Associated With Lower Scores In Vitality, Mental Health, Social Functioning, And General Health. In Men, Associations Involved A Broader Range Of Hrqol Domains, Including Physical Functioning, Role Limitations, Bodily Pain, And General Health. In Secondary Analyses, High Kinesiophobia Was Associated With Severe Pain In Women (Or 9.00, 95% Ci 2.01-40.32; Q = 0.033), Whereas No Psychoemotional Indicator Remained Significantly Associated With Severe Pain In Men After Correction For Multiple Testing. However, Exploratory Sex-By-Variableinteraction Analyses Did Not Demonstrate Statistically Robust Interaction Effects After Adjustment For Potential Confounders And Correction For Multiple Testing.

CONCLUSIONS: Psychoemotional Factors Were Closely Associated With Hrqol In Adults With Chronic Nonspecific Clbp. Although Sex-Stratified Analyses Revealed Different Patterns Of Associations In Women And Men, Formal Interaction Analyses Did Not Provide Statistically Robust Evidence That These Associations Differed By Sex. The Findings Support The Importance Of Considering Psychoemotional Factors During Assessment And Rehabilitation Planning In Patients With Chronic Nonspecific Clbp And May Help Inform Future Individualized Rehabilitation Approaches.

PMID:42454245 | PMC:PMC13365172 | DOI:10.3389/fpain.2026.1872295