Tag: pubmed

Optom Vis Sci. 2026 Feb;103(2):e70030. doi: 10.1002/ovs2.70030.

ABSTRACT

PURPOSE: Uncorrected, moderate hyperopia has been associated with poor emergent literacy skills. However, the eye movements of preschoolers have not yet been used to determine how well young, hyperopic children attend to text and pictures during storybook reading compared to emmetropic children. In this study, the percentage of visual on-task time during storybook reading for 4- and 5-year-old children with uncorrected, moderate hyperopia was compared to that of their emmetropic peers. The relationship between percentage visual on-task time and near visual function was also assessed.

METHODS: Children received an eye exam with cycloplegic refraction to identify hyperopia (+3.00D to +6.00D with astigmatism ≤1.50D and anisometropia ≤1.00D) or emmetropia (hyperopia ≤1.0D; astigmatism, anisometropia, and myopia<|1.0|D) and to rule out amblyopia, strabismus, and ocular health concerns. Infrared video eye tracking systems were used to monitor eye position during storybook reading. Fixations were “on-task” if the child was looking at text or a picture in the story. Statistical comparisons of percentage visual on-task time between the emmetropic and hyperopic children were performed, and correlations between the percentage visual on-task time and the participants’ near visual skills (visual acuity, stereoacuity, accommodative lag) were determined.

RESULTS: Fifty-five of 72 eligible children provided analyzable data. The average percentage visual on-task time for hyperopic children was 20% less than that of emmetropic children (Mann-Whitney U test, p = 0.02). Further, for all children combined, the percentage visual on-task time was moderately correlated with accommodative lag (Spearman, r = -0.32, p = 0.02) while there was no significant correlation between percentage visual on-task time and near acuity or near stereoacuity (p > 0.05).

CONCLUSIONS: Moderately hyperopic, uncorrected 4- and 5-year-old children showed a significantly lower percentage of visual on-task time during shared storybook reading compared to their emmetropic peers. The percentage on-task time was moderately correlated with increased accommodative lag for the combined group of emmetropic and hyperopic children.

PMID:41926782 | DOI:10.1002/ovs2.70030

Obstet Gynecol. 2026 Apr 2. doi: 10.1097/AOG.0000000000006255. Online ahead of print.

ABSTRACT

OBJECTIVE: To describe trends in pregnancy-related death ratios from 2018 to 2024, assess the contribution of coronavirus disease 2019 (COVID-19) to these trends, and evaluate whether pregnancy-related death ratios have recovered to prepandemic levels.

METHODS: We conducted an observational study that used vital statistics data to calculate the annual pregnancy-related death ratio (the number of pregnancy-related deaths per 100,000 live births) for female individuals aged 15-49 years between 2018 and 2024. We compared the pregnancy-related death ratios across prepandemic (2018-2019) pandemic (2020-2022), and postpandemic (2023-2024) periods; to assess the contribution of COVID-19, we calculated the pregnancy-related death ratio including and excluding COVID-associated deaths (ie, those with ICD-10 U07.1 listed as a cause). Pregnancy-related deaths were identified using International Statistical Classification of Diseases, Tenth Revision codes (A34, O00-O99), and the total pregnancy-related death ratio was decomposed into the early pregnancy-related death ratio (deaths during pregnancy or within 42 days after pregnancy) and the late pregnancy-related death ratio (deaths 43-365 days postpartum). We conducted subgroup analyses by maternal age, race and ethnicity, or geographic region.

RESULTS: From 2018 to 2024, there were 8,298 pregnancy-related deaths (32.3/100,000 live births). From the prepandemic period to the pandemic period, the early pregnancy-related death ratio increased by 7.5 deaths per 100,000 live births (95% CI, 6.1-8.8) and the late pregnancy-related death ratio increased by 3.7 deaths per 100,000 live births (95% CI, 2.7-4.6). Most of this increase (76% for the early pregnancy-related death ratio, 50% for the late pregnancy-related death ratio) was COVID-associated deaths. By 2023-2024, the early pregnancy-related death ratio had returned to prepandemic levels, but the late pregnancy-related death ratio remained elevated (1.4 additional deaths/100,000 live births; 95% CI, 0.4-2.4). Most subgroups experienced an increase in early and late pregnancy-related death ratios during the pandemic, but recovery varied. Notably, both early and late pregnancy-related death ratios remained substantially elevated among non-Hispanic Black mothers in 2023-2024 compared with the prepandemic period (early pregnancy-related deaths increased by 7.0/100,000 live births [95% CI, 1.3-12.8]; late pregnancy-related deaths increased by 5.4 /100,000 live births [95% CI, 1.3-9.5]).

CONCLUSION: Pregnancy-related death ratios increased dramatically during the COVID-19 pandemic, and by 2023-2024, recovery differed by the timing of death relative to pregnancy and across sociodemographic subgroups. Additional efforts are needed to identify drivers of differential recovery from the COVID-19 pandemic and inform clinical and policy initiatives to reduce pregnancy-related deaths, improve maternal health, and promote health equity.

PMID:41926774 | DOI:10.1097/AOG.0000000000006255

Rheumatology (Oxford). 2026 Apr 1:keag156. doi: 10.1093/rheumatology/keag156. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess the effectiveness and safety of anakinra in crystal-related disease (CRD) flares, and to identify factors associated with treatment failure and risk of infection.

METHODS: We conducted a single-centre, retrospective, observational study including adult patients treated with anakinra for a CRD flare between January 2011 and July 2024. Patients were identified in a hospital clinical data warehouse using an electronic query. CRD was confirmed by the presence of crystals in synovial fluid or by characteristic radiological features. Clinical and biological data were collected through medical record review. Treatment effectiveness was assessed retrospectively based on the treating physician’s global clinical judgment documented in medical records. Treatment failure was defined as insufficient clinical response requiring treatment escalation or persistent symptoms. Adverse events, including infections, were collected up to one month after anakinra initiation. Factors associated with treatment failure and infection were explored using univariable and multivariable analyses.

RESULTS: A total of 292 patients were included. Effectiveness of anakinra was observed in 92.8% of patients after a median treatment duration of 3 days. In multivariate analysis, longer CRD duration (OR 1.11, 95% CI 1.03-1.19) and a history of diabetes (OR 4.00, 95% CI 1.25-14.29) were independently associated with treatment failure. Thirteen patients (4.5%) developed an infection within one month after anakinra initiation, with a median delay of 11 days. No variable was independently associated with infection risk.

CONCLUSION: This large real-life study supports the effectiveness and overall safety of anakinra in the management of acute CRD flares.

PMID:41926750 | DOI:10.1093/rheumatology/keag156

JMIR Mhealth Uhealth. 2026 Apr 2;14:e85948. doi: 10.2196/85948.

ABSTRACT

BACKGROUND: Over-the-counter (OTC) medicines are frequently used during pregnancy. As these medicines are often used without medical supervision, accessible and reliable safety information is essential. However, finding reliable and understandable information on the safety of these medicines during pregnancy is often experienced as difficult. Hence, there is a need for a new easily accessible electronic health (eHealth) tool that empowers women to actively seek information to support safer self-medication practices during pregnancy and breastfeeding.

OBJECTIVE: This study aimed to describe the development and dissemination process of a Dutch mobile app providing reliable safety information on OTC medicines during pregnancy and breastfeeding using a development and formative evaluation approach.

METHODS: The app was developed over a 2-year project comprising 5 phases, including preparation, development, preimplementation, implementation, and evaluation. Mixed-method strategies, including questionnaires, focus groups, and user feedback rounds, were applied to involve the target population in the development process. Medicine safety information in the app was based on the latest scientific evidence. First-year app-usage outcomes included app downloads, usage patterns, and information-seeking behavior.

RESULTS: Input from 253 potential users formed the foundation for the development of the MediMama app (Netherlands Pharmacovigilance Centre Lareb), with users expressing a need for clear, reliable, and easily accessible information on medication safety during pregnancy and breastfeeding. The app was launched on Mother’s Day 2024 and provides safety information on over 250 OTC medicines, including supplements and herbal remedies, across 27 medicine categories. Promotion occurred through multiple online and offline channels. During its first year, the MediMama app was downloaded 22,415 times, with an average of 370 unique daily users, indicating substantial user engagement. Information on paracetamol (acetaminophen) and nasal sprays was most frequently accessed, reflecting the need for information on commonly used OTC medicines among the target population.

CONCLUSIONS: One year after its launch, the MediMama app is considered a promising tool in maternity care, meeting the target population’s need for accessible OTC medicine safety information. The app aims to support informed decision-making, contributing to safer medication use during pregnancy and breastfeeding. Further research is required to evaluate the effectiveness of the implementation strategy, as well as the app’s impact on maternal medication use behaviors and health outcomes.

PMID:41926731 | DOI:10.2196/85948

Am J Public Health. 2026 Apr 2:e1-e11. doi: 10.2105/AJPH.2025.308379. Online ahead of print.

ABSTRACT

Objectives. To examine the relationship between housing insecurity and lesbian, gay, bisexual, pansexual, transgender, gender-expansive, queer, and questioning (LGBTQ+) identity with mental health burdens from climate events among California adults. Methods. We used cross-sectional data from 2023 California Health Interview Survey (n = 14 307). The outcome was self-reported mental health burden from climate events. Primary predictors were LGBTQ+ identity and housing insecurity. We conducted survey-weighted descriptive statistics and multivariable logistic regression, adjusting for covariates, with an interaction term assessing synergistic effects of primary predictors. Results. Transgender or gender-expansive (adjusted odds ratio [AOR] = 4.05; 95% confidence interval [CI] = 2.66, 6.15) and bisexual or pansexual individuals (AOR = 1.67; 95% CI = 1.19, 2.33) had significantly higher odds of climate-related mental health burden. High housing insecurity was also associated with greater odds (AOR = 1.26; 95% CI = 1.07, 1.48). Among gay respondents, experiencing housing insecurity was associated with approximately threefold higher odds of climate-related mental health burden (adjusted ratio of odds ratios = 3.1; 95% CI = 1.40, 6.82). Conclusions. Bisexual or pansexual and transgender or gender-expansive individuals reported higher mental health burdens from climate events. Housing insecurity appears to be a key social driver shaping disparities in climate-related mental health among LGBTQ+ populations. (Am J Public Health. Published online ahead of print April 2, 2026:e1-e11. https://doi.org/10.2105/AJPH.2025.308379).

PMID:41926729 | DOI:10.2105/AJPH.2025.308379

Am J Public Health. 2026 Apr 2:e1-e9. doi: 10.2105/AJPH.2026.308429. Online ahead of print.

ABSTRACT

Objectives. To determine if street cleaning interventions reduce gun violence and street crime. Methods. We conducted a stratified randomized controlled trial of 300 high gun violence street segments in Philadelphia, Pennsylvania, assigned to either a street cleaning intervention or a no-intervention control. The intervention provided biweekly or monthly trash removal, weeding, and sidewalk sweeping. Some segments received enhanced services, including free trash and recycling bins. Results. The biweekly and monthly intervention significantly reduced visible litter, by 16% (95% confidence interval [CI] = -24%, -8%; P < .01) and 17% (95% CI = -28%, -5%; P < .05), respectively. The biweekly and monthly intervention yielded a statistically insignificant reduction in gun violence of 27% (incident rate ratio [IRR] = 0.73; 95% CI = 0.42, 1.28) and 4% (IRR = 0.96; 95% CI = 0.44, 2.06). Street crime outcomes were similarly insignificant. Conclusions. Basic environmental cleanups reduce visible litter but do not significantly reduce gun violence or street crime. More comprehensive place-based prevention strategies are likely needed. Public Health Implications. Scalable, nonpolicing public health approaches to reduce violence and serious crime should consider interventions that target broader environmental factors beyond basic street cleaning until further study demonstrates otherwise. (Am J Public Health. Published online ahead of print April 2, 2026:e1-e9. https://doi.org/10.2105/AJPH.2026.308429).

PMID:41926728 | DOI:10.2105/AJPH.2026.308429

Am J Public Health. 2026 Apr 2:e1-e12. doi: 10.2105/AJPH.2026.308461. Online ahead of print.

ABSTRACT

Objectives. To describe rates and characteristics of homicides of women across racial/ethnic groups, and describe intimate partner violence (IPV)-related and non-IPV-related homicide circumstances across racial/ethnic groups. Methods. We used National Vital Statistics System data to calculate homicide rates by racial/ethnic group of US women (aged ≥ 18 years) who were homicide victims from 2018 to 2022. We used National Violent Death Reporting System data to characterize the circumstances and suspects in these homicides by racial/ethnic group and IPV involvement. Results. The age-adjusted homicide rate was 3.2 per 100 000 women. Rates for non-Hispanic Black women and non-Hispanic American Indian/Alaska Native women were more than twice as high as those for other races/ethnicities. Most women were killed by a firearm (67.9%), fatally injured in a residence (64.8%), or killed by a male (92.5%). About half (47.3%) of homicides were IPV related. Non-IPV-related homicides were often perpetrated by family members (39.0%). Circumstances differed by racial/ethnic group. Conclusions. Homicide disproportionally affects certain racial/ethnic groups of women, and the characteristics of homicides differ across groups. Thorough examination of these differences could aid in effective, targeted homicide prevention. (Am J Public Health. Published online ahead of print April 2, 2026:e1-e12. https://doi.org/10.2105/AJPH.2026.308461).

PMID:41926727 | DOI:10.2105/AJPH.2026.308461

JCO Clin Cancer Inform. 2026 Apr;10:e2500316. doi: 10.1200/CCI-25-00316. Epub 2026 Apr 2.

ABSTRACT

PURPOSE: The exponential growth of scientific publications presents increasing challenges for clinicians and patients seeking to access up-to-date medical information. Language models (LMs) have emerged as powerful tools for generating and summarizing scientific content, but their performance in oncology remains insufficiently characterized from both professional and patient perspectives.

MATERIALS AND METHODS: We conducted a prospective, survey-based pilot study evaluating four LMs: Llama 3, Mistral Large 2, Gemma 2B, and Consensus, applied to the summarization and French translation of seven recent prostate cancer (PCa) abstracts. Each model received a standardized prompt to generate the summary of each abstract. Physicians (medical and radiation oncologists, urologists) and patients treated for PCa independently assessed the outputs using structured Likert-scale questionnaires covering qualitative criteria such as accuracy, usefulness, organization, and comprehensibility. Descriptive statistical analyses were then performed to characterize the distribution of responses across evaluation items.

RESULTS: A total of 40 respondents (14 physicians, 26 patients) provided 280 individual evaluations. Across physicians, consensus received the highest proportion of strongly agree ratings for all criteria, including completeness, accuracy, currency, organization, and usefulness. Only two physicians evaluated this model. Among patients, Gemma 2B achieved the highest strongly agree ratings for conciseness and comprehensibility, whereas Consensus obtained the highest score for organization; both models were similarly rated for usefulness. When considering overall positive evaluations (agree or strongly agree), Llama 3 and Mistral Large 2 performed well across groups but generated fewer strongly agree responses. Descriptive analyses demonstrated clear differences in perceived accuracy, completeness, and clarity across model architectures.

CONCLUSION: Perceived quality varied across models and user groups. Consensus was preferred by physicians, whereas patients more often favored Gemma. These differences underscore the importance of selecting models aligned with specific clinical communication tasks when deploying generative artificial intelligence in oncology.

PMID:41926718 | DOI:10.1200/CCI-25-00316

Health Policy Plan. 2026 Apr 2:czag044. doi: 10.1093/heapol/czag044. Online ahead of print.

ABSTRACT

In Uganda, frequent shortages of antihypertensive medications hinder continuity of care, undermining blood pressure management. Building on preliminary ethnographic research, this study evaluates a community-led, mobile-wallet-based pooling intervention- MoPuleesa-designed to improve medication access at a rural clinic in Nakaseke District, Uganda. Over a seven-month period, 183 patients enrolled and were linked to a digital savings platform that required monthly contributions of 5000 UGX (∼ USD 1.39) into a communal fund to bulk-purchase medications at a discounted cost. Using survey data, transaction logs, and clinic records, we assessed contribution behaviour, risk of adverse selection, equity, changes in medication availability, and patient blood pressure levels. On average, 48% participants contributed each month. Contribution rates showed no significant differences across education levels or medication costs, suggesting minimal equity concerns or adverse selection. Government pharmacies fulfilled only 8% of total prescriptions; however, for contributors, MoPuleesa closed 84% of the remaining medication gap. However, despite improvements in medication supply, we did not observe statistically significant improvements in blood pressure. Our findings demonstrate the feasibility and effectiveness of mobile money pooling in addressing chronic medication shortages. MoPuleesa achieved broad participation and equitable outcomes in a resource-constrained setting and significantly improved medication availability. We conclude that mobile-based fund pooling for medication can significantly improve medication supply and, with improvements in eligibility assessments, could serve as a complementary or intermediate solution to structural barriers in under-resourced health systems.

PMID:41926709 | DOI:10.1093/heapol/czag044

JMIR Nurs. 2026 Apr 2;9:e85780. doi: 10.2196/85780.

ABSTRACT

BACKGROUND: There is limited evidence on how brief, optional virtual reality (VR) experiences can be used with first-semester nursing students as experiential learning strategies to support understanding of foundational nursing concepts, outside of mandatory coursework or full-scale simulations. Additionally, little is known about students’ and teachers’ perceptions of VR as a low-stakes, supplemental learning strategy introduced early in nursing education. Examining these experiences can provide insight into the pedagogical value and scalability of VR-enhanced learning within the formal nursing curriculum.

OBJECTIVE: This study explored students’ and teachers’ experiences of a brief, optional, VR-enhanced workshop offered outside mandatory coursework in first-semester nursing education and described students’ perceptions of cognitive, social, and teaching presence.

METHODS: This was a cross-sectional evaluation at a Swedish public university. A single-session workshop, co-designed by nursing teachers and the university library makerspace (implementation context), combined brief headset exposures (sympathetic arousal via a short roller coaster experience and parasympathetic engagement via a short guided meditation), peer vital-sign practice (instructional aid), small-group synthesis, and a guided debrief aligned with the community of inquiry (CoI) framework. Immediately after the session, students completed a demographics questionnaire, a 7-item workshop-specific VR-perception set, and the 34-item CoI instrument, plus 2 open-ended items; teachers provided short reflections. Analyses were descriptive for quantitative data and summative content analysis of open-ended responses. Participants included 11.9% (16/134) of the invited first-semester students (mean age 25 years, SD 5.1; 15/16, 93.8% women; 6/16, 37.5% with prior VR exposure) and 3 teachers.

RESULTS: Most students agreed or strongly agreed that VR enhanced analysis and observation (12/16, 75%), exploration of phenomena (14/16, 87.5%), conceptual understanding and engagement (13/16, 81.3%), teacher support (13/16, 81.3%), and relevance to the session (14/16, 87.5%). CoI ratings indicated moderately positive perceptions (total mean 3.36, SD 0.44 on a 5-point scale), with cognitive presence rated the highest (mean 3.48, SD 0.41) and exploration being the top subdomain (mean 4.48, SD 0.49); design and organization and facilitation were similar (mean 3.42, SD 0.55 each), whereas direct instruction was rated lower (mean 2.88, SD 0.92). Open-ended remarks described links between theory and embodied experience and noted practical challenges.

CONCLUSIONS: This study used an early, optional format; the results showed that brief, contrastive VR exposures paired with scaffolded inquiry and a guided debrief were perceived as pedagogically valuable for exploring foundational physiological concepts, while also highlighting feasibility and logistical considerations for routine teaching. Findings are preliminary and reflect session-level perceptions from a small, self-selected sample; nevertheless, they suggest that structured, low-stakes VR may serve as a feasible supplemental strategy in first-semester nursing education, with implications for potential scalability.

PMID:41926702 | DOI:10.2196/85780