Tag: pubmed

Physiother Res Int. 2026 Oct;31(4):e70313. doi: 10.1002/pri.70313.

ABSTRACT

BACKGROUND AND PURPOSE: Neck pain is prevalent in postpartum women due to postural stress and muscle dysfunction. Although postural correction exercises are widely used, adding manual therapy techniques such as positional release and Tui-Na may enhance outcomes. However, comparative evidence, particularly using surface electromyography (sEMG), remains limited. This study examined the effects of Tui-Na (TN) versus positional release techniques (PRT) added to postural correction exercises (PCEs) on postpartum neck pain.

METHODS: Sixty women with postpartum neck pain were randomly assigned to three groups for 4 weeks of prescribed treatment. Group A (control) received PCEs, while either PRT or Tui-Na were added to PCEs for Groups B and C, respectively. The primary outcome was neck pain intensity measured by the Visual Analogue Scale (VAS). Secondary outcomes included the Neck Disability Index (NDI) and upper trapezius electromyographic characteristics (normalized root mean square [RMS] and median frequency [MDF]). A two-way repeated-measures MANOVA was used for statistical analysis.

RESULTS: Significant multivariate effects were observed for group effects (F = 4.798, p < 0.001, partial η² = 0.147), time (F = 851.51, p < 0.001, partial η² = 0.968), and group-by-time interaction (F = 3.87, p < 0.001, partial η² = 0.122). Pain intensity was significantly reduced in both groups B (p = 0.035) and C (p = 0.003) when compared to group A. UT-MDF was significantly increased in group C when compared to groups A (p < 0.001) or B (p = 0.02). All groups demonstrated significant within-group improvements in all outcome measures.

DISCUSSION: Both Tui-Na and PRT combined with PCEs improved pain and disability in postpartum women with neck pain. Compared with PRT, Tui-Na demonstrated greater improvements in pain intensity and upper trapezius EMG frequency characteristics. However, these findings should be interpreted cautiously because of the short intervention period and lack of long-term follow-up.

TRIAL REGISTRATION: NCT07261605.

PMID:42566253 | DOI:10.1002/pri.70313

JMIR Res Protoc. 2026 Aug 7;15:e76630. doi: 10.2196/76630.

ABSTRACT

BACKGROUND: Endodontically treated teeth are prone to fractures due to the loss of tooth structure, caries removal, access cavity preparation, and scaling, resulting in compromised strength in the teeth. Posts are used for restoring teeth that have undergone this process, but the role of different fiber posts in resisting fractures in teeth is unclear. Customized carbon fiber posts, customized glass fiber posts, and fiber posts relined with short fiber-reinforced composite (SFRC) are biomechanically efficient. SFRC is used as a relining material around the fiber post to improve adaptation to the root canal.

OBJECTIVE: This study aims to evaluate and compare the fracture resistance of endodontically treated teeth restored with prefabricated carbon fiber posts, customized glass fiber posts, and SFRC-relined fiber posts.

METHODS: In the current in vitro experimental study, the post specimens will be tested on 30 extracted single-rooted human teeth. These will be similar in size. The specimens will go through endodontic treatment and preparation for the post space, after which they will be randomly assigned to groups based on the type of post system: prefabricated carbon fiber posts, customized glass fiber posts, or SFRC-relined fiber posts. These will be cemented using a dual-cured resin cement. The specimens will then be restored using a standardized core build-up and tested for fracture resistance using a universal testing machine. A compressive load will be applied to each specimen at a constant crosshead speed of 1 mm/min until fracture of the specimen occurs. The maximum load at failure will be recorded in newtons. Statistical analysis will be conducted using a 1-way ANOVA.

RESULTS: Institutional ethics approval was granted by the Institutional Ethics Committee of Datta Meghe Institute of Higher Education and Research in January 2025 (DMIHER[DU]/IEC/2025/543). Sample collection and specimen preparation are scheduled to begin in February 2026, with mechanical testing expected to be completed by April 2026. As of April 2025, no specimens had been tested, and data analysis had not commenced. This is a nonfunded in vitro study, and data analysis is anticipated to be completed by May 2026. The results are expected to be submitted for publication by mid-2026.

CONCLUSIONS: This study is expected to generate comparative biomechanical evidence on the fracture resistance of different fiber-based post systems, potentially aiding clinicians in selecting optimal restorative strategies for endodontically treated teeth.

PMID:42566252 | DOI:10.2196/76630

JMIR Res Protoc. 2026 Aug 7;15:e85458. doi: 10.2196/85458.

ABSTRACT

BACKGROUND: Illicit drug use has been rapidly increasing in South Korea, particularly among individuals in their 20s, contributing to a growing burden of substance use disorder (SUD). However, treatment infrastructure remains limited. Nationwide, only a small number of inpatient treatment hospitals are available, and treatment capacity in the Seoul metropolitan area is insufficient to meet growing demand. In addition, community-based addiction services are scarce, creating barriers to continuous care. Digital therapeutics (DTx) have emerged as a promising approach to improve treatment accessibility and continuity of care. In particular, cognitive behavioral therapy (CBT)-based DTx such as RESET-O, developed in the United States and authorized by the US Food and Drug Administration, have demonstrated clinical benefits in supporting addiction recovery. Building on this concept, our team developed D-STOP, a CBT-based DTx intervention designed to support individuals with SUD in the Korean clinical context.

OBJECTIVE: This study aims to evaluate the efficacy of D-STOP as an adjunctive DTx intervention for patients with SUD.

METHODS: This study is a randomized controlled clinical trial designed to evaluate the efficacy of D-STOP in individuals diagnosed with SUD. Following an initial screening assessment, 118 participants meeting the diagnostic criteria will be enrolled. Participants will be recruited from psychiatry departments at addiction treatment and clinical care institutions in Chuncheon, Seoul, Daegu, and Changnyeong, South Korea. During the 12-week intervention period, the experimental group will receive D-STOP in addition to treatment as usual, whereas the control group will receive treatment as usual alone. D-STOP delivers structured CBT-based modules and motivational enhancement interventions through a digital platform. During scheduled study visits, participants will also receive therapeutic feedback from psychiatrists or trained study staff. The primary end point is the abstinence success rate during weeks 9 to 12 of treatment. Logistic regression analysis will be used to estimate treatment effects and evaluate superiority compared with the control group.

RESULTS: The study protocol was approved by the institutional review board of Hallym University Chuncheon Sacred Heart Hospital on April 14, 2025. Funding began on April 1, 2023. Data collection started on August 4, 2025, and is expected to be completed by November 30, 2026. As of March 6, 2026, a total of 65 participants have been enrolled. An interim analysis of the primary efficacy outcome has been conducted based on the data available at the time of analysis; however, statistical significance has not been established due to the limited sample size. The final analysis is expected to be published in April 2027.

CONCLUSIONS: DTx have the potential to expand access to evidence-based addiction treatment in resource-constrained settings. This study will provide clinical evidence on the efficacy and feasibility of D-STOP as a digital treatment support tool for patients with SUD.

PMID:42566248 | DOI:10.2196/85458

J Med Microbiol. 2026 Aug;75(8). doi: 10.1099/jmm.0.002183.

ABSTRACT

Introduction. Bacterial vaginosis (BV) is a common gynaecological disorder characterized by an imbalance in the vaginal microbiota, leading to increased risk of infection and recurrence.Hypothesis/Gap statement. Although the role of microbiota dysbiosis in BV is established, the dynamic changes in microbial communities and inflammatory factors during BV formation and recurrence, as well as reliable biomarkers for predicting recurrence, remain inadequately explored.Aim. This study aimed to systematically analyse the changes in vaginal microbiota and inflammatory factors during different stages of BV formation and recurrence, and to identify potential biomarkers for predicting BV recurrence.Methodology. Vaginal swab samples were collected from 135 women, including 55 BV patients, 50 intermediate BV (IBV) patients and 30 healthy controls. Twenty-six recurrent BV (Re-BV) samples were obtained within 1 year after treatment. 16S rRNA gene sequencing was performed to profile the vaginal microbiota, and ELISA was used to measure IL-6, IL-10 and IL-1β levels. Statistical analyses included diversity metrics, correlation analysis and predictive modelling using LASSO regression and receiver operating characteristic curves.Results. Microbial richness was significantly higher in BV, Re-BV and IBV groups compared to controls. Lactobacillus abundance decreased progressively from IBV to BV, while Gardnerella, Prevotella, Sneathia, Fannyhessea and Dialister increased. These genera were positively correlated with vaginal pH, human papillomavirus (HPV) status and enzymatic activity. IL-6, IL-10 and IL-1β levels were elevated in BV, IBV and Re-BV groups. IL-10 and IL-1β were further increased in recurrent cases. A combined predictive model integrating microbial and cytokine markers achieved an area under the curve of 0.928 for BV recurrence.Conclusion. Distinct shifts in vaginal microbiota composition and inflammatory factor levels occur during BV formation and recurrence. The integration of microbial and cytokine profiles offers a robust approach for predicting BV recurrence, with important implications for clinical management and prevention strategies.

PMID:42566243 | DOI:10.1099/jmm.0.002183

Traffic Inj Prev. 2026 Aug 7:1-9. doi: 10.1080/15389588.2026.2704704. Online ahead of print.

ABSTRACT

OBJECTIVE: Professional delivery riders in China have experienced a sharp increase in traffic crashes, injuries, and fatality rates over recent years. This observational study sought to identify and analyze risk factors influencing riding behavior among electric bicycle delivery riders compared to other electric bicycle riders during potential conflicts at unsignalized intersections.

METHODS: Two typical unsignalized intersections in Nantong City with mixed traffic (pedestrians, motorized and non-motorized vehicles) were selected for observation. Through systematic video coding and analysis of 637 min of continuous video observations, we extracted a total of 1,558 potential conflict events, including interactions between electric bicycle riders and pedestrians, motorized vehicles, or non-motorized vehicles. Among these events, 394 occurred under congested traffic and 1,164 under free-flowing traffic. Data were analyzed via descriptive statistics, non-parametric chi-square tests and logistic regression.

RESULTS: (1) Under congested traffic conditions, delivery riders generally exhibited more pronounced hazardous riding behaviors than other riders, and such differences were more obvious among male and young delivery riders; (2) Regardless of road user type, delivery riders exhibited a high proportion (about 20%) of hazardous riding behaviors under both traffic conditions; (3) During potential conflicts with motor vehicles in congested traffic, delivery riders engaged in more hazardous riding than other riders; (4) Professional delivery riders engaged in risky behavior at a rate 1.88 times that of other riders.

CONCLUSIONS: For delivery riders at unsignalized intersections, hazardous riding behaviors are influenced by the combined effects of traffic conditions, rider demographic characteristics, and potential conflict objects. Professional delivery riders exhibit the highest risk levels under congested traffic conditions, particularly during potential conflicts with motor vehicles. Findings reflect the influence of occupational demands, such as tight delivery schedules, on delivery riders’ riding strategies in various contexts.

PMID:42566229 | DOI:10.1080/15389588.2026.2704704

Int J Radiat Biol. 2026 Aug 7:1-12. doi: 10.1080/09553002.2026.2705996. Online ahead of print.

ABSTRACT

PURPOSE: Early prediction of hematological acute radiation syndrome (H-ARS) saves lives. For H-ARS severity prediction, we established a four-gene panel (FDXR, DDB2, POU2AF1, WNT3) using leukemia patients and non-human primates. Further confirmation in 12 minipigs failed, due to a weak response of these genes after irradiation.

MATERIALS AND METHODS: Here, we intended to confirm previous findings using a larger cohort (n = 19) and assess the impact of Myelo001 on clinical progression and gene expression. All minipigs received 2.1 Gy total-body irradiation (LD ≈ 40/30). The study included an irradiated control group and two irradiated groups treated with Myelo001 (11 or 15 days). Peripheral blood was collected six days before and on days 1-, 3-, and 10 after irradiation. RNA was isolated, reverse-transcribed, and analyzed by qRT-PCR using TaqMan assays. Differential gene expression (DGE) was calculated relative to pre-irradiation samples.

RESULTS: WNT3 was undetectable in most animals. No significant difference in gene expression, survival, or clinical progression were found between Myelo001-treated and untreated animals, so treatment groups were pooled for DGE analyses. Across all time points, no significant changes in DGE were observed, except for slight DDB2 upregulation on day 3 (DGE = 2.3). The expected pattern of upregulated (DGE >2) FDXR/DDB2 with simultaneous downregulation (DGE <0.5) of POU2AF1, was absent (except on day one in one minipig). This missing pattern contrasted with an on average 5.5-fold reduction in lymphocyte counts, indicative of severe H-ARS. Also, no age or sex related changes were observed.

CONCLUSION: This independent minipig study confirms previous work showing that these genes do not exhibit statistically significant radiation-responsiveness in this animal model. Under the experimental conditions applied, no significant age or sex related changes nor treatment-related effects of Myelo001 were observed, which may reflect model-specific limitations or a lack of efficacy in this setting, or a combination of both.

PMID:42566227 | DOI:10.1080/09553002.2026.2705996

JAMA Netw Open. 2026 Aug 3;9(8):e2627643. doi: 10.1001/jamanetworkopen.2026.27643.

ABSTRACT

IMPORTANCE: Brain maturation varies between individuals, particularly during dynamic developmental periods such as adolescence. Directly assessing the differences in longitudinal trajectories can reveal deviations from normative patterns.

OBJECTIVE: To ascertain the association of longitudinal change in brain volumes with birth weight, gestational age, and longitudinal changes in psychopathology.

DESIGN, SETTING, AND PARTICIPANTS: In this cohort study, cross-sectional and longitudinal normative models were developed for brain volumes from the first 2 neuroimaging data collection time points (baseline: 2016-2018; follow-up: 2019-2021) of the Adolescent Brain Cognitive Development (ABCD) Study, an ongoing community-based longitudinal cohort study at 21 US sites. Longitudinal models indexed an individual’s expected brain volume at follow-up, conditioned on their baseline measurement, and thus were conditional-longitudinal models. Split-half subsets on demographically matched samples were used to fit the models. ABCD Study participants were recruited through the US school systems. Exclusion criteria included severe medical conditions that interfered with the study protocols. The present analysis further excluded the sample based on imaging quality flags and missing data. Data analysis was performed between May 2024 and August 2025.

EXPOSURES: Birth weight and gestational age derived from parent-reported questionnaires. General psychopathology and subfactor scores were calculated using a bifactor model.

MAIN OUTCOMES AND MEASURES: Brain volumes and change in volume between time points 1 (baseline) and 2 (follow-up). Cross-sectional and longitudinal centiles were used to quantify deviations in volumes.

RESULTS: The sample included 10 830 ABCD Study participants with neuroimaging data collected at baseline (mean [SD] age, 9.9 [0.62] years; 5609 males [51.8%]) and 7262 with data collected at follow-up (mean [SD] age, 12.0 [0.65] years; 3875 males [53.4%]). Longitudinal centiles were sensitive to individual-specific changes in brain volumes. Lower birth weight was associated with lower longitudinal centiles, suggesting larger decreases in brain volumes over time (n = 27 regions, β range = 0.030-0.083). Lower longitudinal centiles were associated with greater increases in psychopathology, suggesting decreasing brain volumes with increasing psychopathology scores (n = 37 regions, β range = -0.061 to -0.031). Changes in psychopathology were not associated with brain volumes at either time point when indexed by cross-sectional centiles.

CONCLUSIONS AND RELEVANCE: In this cohort study, conditional-longitudinal models captured individual-level deviations from expected growth trajectories, providing information beyond static positions on a growth curve to assess differences in maturation. Robust associations were observed between individual trajectory deviations, birth weight, and longitudinally assessed mental health symptoms. Conditional-longitudinal models hold promise for applications across psychiatric neuroscience, from development to aging.

PMID:42566216 | DOI:10.1001/jamanetworkopen.2026.27643

JAMA Netw Open. 2026 Aug 3;9(8):e2627655. doi: 10.1001/jamanetworkopen.2026.27655.

ABSTRACT

IMPORTANCE: Primary health care (PHC) is recognized as pivotal for achieving universal health coverage and reducing mortality rates among children younger than 5 years.

OBJECTIVES: To estimate the association of effective PHC coverage with child mortality in 3 diverse sub-Saharan countries over the past 2 decades and to estimate the number of child deaths that could occur by 2035 if PHC services are dismantled due to the current decrease in development assistance for health funding.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study assessed children younger than 5 years from January 1, 2007, to December 31, 2022, in Mozambique, Gabon, and Ethiopia. The study drew on 5 national and subregional representative US Agency for International Development Demographic and Health surveys with longitudinal information from the 3 countries. Statistical analysis was performed from October 2024 to May 2026.

EXPOSURE: An effective PHC coverage index (PHC index) was developed for this study, integrating core dimensions of child PHC service provision and access and structured into progressively ordered coverage categories.

MAIN OUTCOMES AND MEASURES: The outcome was child mortality, assessed with 2-way fixed-effects multivariable Poisson regression models with child-clustered standard errors, adjusted for relevant confounding factors at the individual, regional, and national levels. This evaluation was also integrated into validated microsimulation forecasting analysis.

RESULTS: Of the 118 911 child-year observations of 37 583 children (mean [SD] age, 1.4 [1.3] years; 60 252 boys [50.7%]), Gabon had the greatest coverage of service provision, followed by Mozambique and Ethiopia, though Mozambique showed a marginally higher proportion in the highest category (Gabon, 796 of 33 269 [2.4%]); Mozambique, 554 of 20 728 [2.7%]; and Ethiopia, 317 of 64 914 [0.5%]); the inverse pattern was observed for the lowest coverage categories (Gabon, 2143 of 33 269 [6.4%]; Mozambique, 1976 of 20 728 [9.5%]; and Ethiopia, 32 189 of 64 914 [49.6%]). Across all child-year observations, there were 2166 deaths (1.8%). Ethiopia accounted for 2.1% of deaths (1338 of 64 914 child-years), Mozambique for 1.8% (364 of 20 728), and Gabon for 1.4% (464 of 33 269). Increasing PHC coverage was associated with decreases in child mortality in a dose-response manner, reaching a 58% reduction (rate ratio, 0.42 [95% CI, 0.19-0.91]) for consolidated high coverage. The dismantling of PHC coverage, triggered by the defunding of development assistance for health , may lead to an increase in preventable child deaths, amounting to an estimated 373 108 deaths (95% uncertainty interval, 313 152-444 244 deaths) across the 2025 to 2035 period.

CONCLUSIONS AND RELEVANCE: This cohort study found evidence indicating that PHC was associated with substantially reduced mortality rates among children younger than 5 years in sub-Saharan Africa over the past 2 decades. These findings suggest that PHC should be expanded rather than dismantled, particularly amid the ongoing defunding of development assistance for health.

PMID:42566215 | DOI:10.1001/jamanetworkopen.2026.27655

JAMA Netw Open. 2026 Aug 3;9(8):e2627714. doi: 10.1001/jamanetworkopen.2026.27714.

ABSTRACT

IMPORTANCE: Health care-associated bloodstream infections (BSIs), particularly central line-associated BSIs (CLABSIs), remain an important cause of morbidity among neonates admitted to neonatal intensive care units (NICUs). Long-term Korean national data describing the trends and interhospital variability in NICU-associated infections remain limited.

OBJECTIVE: To evaluate national trends, interhospital variability, and microbiological characteristics of NICU-associated BSIs in Korea using nationwide surveillance data.

DESIGN, SETTING, AND PARTICIPANTS: This nationwide cohort study analyzed data from the NICU module of the Korean National Healthcare-Associated Infections Surveillance System, including NICUs that participated between July 2019 and June 2024. Surveillance definitions were based on modified Centers for Disease Control and Prevention criteria. Data were analyzed from October 2025 to June 2026.

MAIN OUTCOMES AND MEASURES: Outcomes of interest were annual BSI and CLABSI rates per 1000 patient-days and 1000 central line-days, respectively, and device utilization ratios (DURs). Temporal trends were assessed using mixed-effects negative binomial regression models with hospital-level random intercepts, adjusting for birth weight category, NICU bed capacity, and nurse staffing grade.

RESULTS: Between July 2019 and June 2024, 74 to 82 NICUs were included annually, contributing a total of 2 178 107 patient-days and 585 582 central line-days of surveillance, with annual NICU admissions ranging from 24 607 to 30 260 neonates. Overall, 948 BSIs were identified, including 836 CLABSIs (88.2%). The pooled mean BSI rate declined from 0.56 (95% CI, 0.49-0.63) to 0.35 (95% CI, 0.29-0.41) per 1000 patient-days, and the CLABSI rate declined from 1.78 (95% CI, 1.56-2.03) to 1.16 (95% CI, 0.98-1.38) per 1000 central line-days. After adjustment, the adjusted rate ratio per surveillance year was 0.91 (95% CI, 0.86-0.96) for BSI, 0.92 (95% CI, 0.87-0.97) for CLABSI, and 0.95 (95% CI, 0.93-0.98) for DUR. Despite overall improvement, substantial interhospital variability in both BSI and CLABSI rates persisted. Gram-positive cocci predominated, followed by gram-negative bacilli and fungi.

CONCLUSIONS AND RELEVANCE: In this nationwide surveillance cohort study of NICUs, BSIs and CLABSIs rates declined significantly over 5 years, while substantial interhospital variability persisted. Although institutional-level risk adjustment was applied, the absence of patient-level clinical variables limits individual hospital comparisons, underscoring the need for refined risk adjustment and targeted quality improvement strategies.

PMID:42566214 | DOI:10.1001/jamanetworkopen.2026.27714

JAMA Netw Open. 2026 Aug 3;9(8):e2627727. doi: 10.1001/jamanetworkopen.2026.27727.

ABSTRACT

IMPORTANCE: Afghans are one of the world’s largest refugee populations. Afghan women face compounded health risks due to sociocultural restrictions, low literacy, forced displacement, and limited health care access, yet little is known about their experiences with health care after resettlement in the US.

OBJECTIVE: To explore health and health care access issues of Afghan refugee women in the US.

DESIGN, SETTING, AND PARTICIPANTS: This qualitative study was part of an ongoing community-based participatory research project started in July 2020. Bilingual investigators conducted semistructured interviews with Afghan refugee women in Dari or English. Dari interviews were interpreted to English by a fluent bilingual investigator, validated by a separate bilingual investigator, and then reviewed with an Afghan immigrant community member for accuracy. Transcribed interviews were analyzed using grounded theory from July 2023 to July 2024. Participants who self-identified as Afghan, were born outside of the US, and were 18 years or older were recruited with convenience and purposive sampling from the San Francisco Bay Area of California through refugee-serving community organizations and word of mouth until data saturation was met.

MAIN OUTCOMES AND MEASURES: Themes and subthemes about health and health care access.

RESULTS: Of 23 Afghan women interviewed (median age, 30 years [range, 19-55 years]), most were married (22 [96%]) and had health insurance (16 [70%]). Their median time of residence in the US was 4 years (range, 1-17 years). Five key themes of health and health care access were identified: (1) health system barriers, such as inadequate interpretation causing miscommunication and mistrust, and insensitive health care including lack of informed consent; (2) sociocultural norms and women’s autonomy, with patriarchal gender norms persisting after resettlement and limiting women’s decision-making; (3) structural barriers resulting in the use of home remedies, driven by long wait times and negative prior experiences; (4) sociocultural barriers to sexual and reproductive health, with knowledge gaps shaped by intergenerational shame; and (5) mental health challenges, including widespread distress expressed through culturally specific idioms and somatic symptoms.

CONCLUSIONS AND RELEVANCE: In this qualitative study, Afghan women described multilayered health care barriers, including displacement-related trauma, sociocultural norms, and structural deficiencies. Study findings suggest that culturally sensitive and linguistically appropriate public health interventions and structural changes are needed to improve health care access for Afghan women in the US.

PMID:42566213 | DOI:10.1001/jamanetworkopen.2026.27727