Tag: pubmed

Neurology. 2026 Sep 22;107(6):e218449. doi: 10.1212/WNL.0000000000218449. Epub 2026 Aug 14.

ABSTRACT

BACKGROUND AND OBJECTIVES: Diffusion-weighted imaging (DWI)-positive lesions are increasingly recognized as markers of cerebral small vessel disease (cSVD) in acute intracerebral hemorrhage (ICH), but their underlying mechanisms, clinical-radiologic associations, and prognostic significance remain uncertain. We therefore aimed to determine their prevalence, anatomical distribution, and associations with baseline clinical-radiologic features and 6-month functional outcome assessed by the modified Rankin Scale (mRS).

METHODS: In this prospective cohort study, we analyzed consecutive patients with ICH included in the Stroke Investigation Group in North and Central London registry. We assessed the presence and anatomical distribution of DWI-positive lesions on acute MRI, as well as other cSVD markers rated according to the STandards for ReportIng Vascular changes on nEuroimaging criteria. The primary outcome was disability at 6 months assessed using the mRS. We investigated associations between DWI-positive lesions, clinical-radiologic features, and poor 6-month functional outcome (mRS ≥3) using adjusted multivariable logistic regression.

RESULTS: We included 342 patients (median age 67 years [interquartile range (IQR) 55-78]; 142 (41.5%) women; 138 (40.3%) lobar ICH; median cSVD burden 2 [IQR 1-3]). Overall, 74 patients (21.6%) had DWI-positive lesions, most commonly in lobar regions (33 [44.6%]). Patients with cerebral amyloid angiopathy (CAA) more frequently had strictly lobar DWI-positive lesions compared with those without (78.6% vs 36.7%); strictly deep DWI-positive lesions were exclusively observed in the non-CAA group (25.0% vs 0%). Compared with patients without DWI-positive lesions, those with DWI-positive lesions more frequently had severe white matter hyperintensities (WMH; Fazekas ≥2: 81.1% vs 64.2%, p < 0.001), higher cerebral microbleed (CMB) burden (median = 3 vs 1, p = 0.034), and larger ICH volume (median = 14 mL vs 7 mL, p = 0.0006). In adjusted analyses, DWI-positive lesions were independently associated with severe WMH (odds ratio [OR] 3.37, 95% CI 2.72-6.89), ICH volume ≥30 mL (OR 2.29, 95% CI 1.76-3.42), CMBs (OR 1.61, 95% CI 1.21-2.93), and poor functional outcome at 6 months (OR 2.16, 95% CI 1.67-3.48).

DISCUSSION: DWI-positive lesions are common after acute ICH and are independently associated with cSVD and poor functional outcome, supporting their role as a prognostic biomarker. Their anatomical distribution differs according to the underlying cSVD subtype.

PMID:42600114 | DOI:10.1212/WNL.0000000000218449

Ann Work Expo Health. 2026 Jul 17;70(6):wxag062. doi: 10.1093/annweh/wxag062.

ABSTRACT

INTRODUCTION: It has been estimated that 2% to 8% of cancers in high-income countries are linked to carcinogenic exposures in workplaces. In Finland, employers are obliged by law to provide data annually on selected carcinogens and carcinogenic working processes to the Finnish Register of Employees Exposed to Carcinogens (ASA). In this study, we expand the follow-up period of a previous study on cancer incidence in exposed employees by 16 years and add estimates of cancer mortality.

METHODS: The study population included all 142,204 workers registered in ASA from 1979 to 2018. For the cancer follow-up, the data were linked to the Finnish Cancer Registry. To compare the incidence and mortality with those of the Finnish general population, we estimated standardized incidence ratios (SIRs) and standardized mortality ratios.

RESULTS: A total of 12,687 cancer cases and 3,640 cancer deaths were reported among ASA workers over time by the end of 2019. In the entire ASA cohort, the all-site cancer incidence was similar to the general population (SIR 0.98, 95% confidence interval [CI] 0.96 to 0.99). Persons exposed to asbestos showed an excess incidence of mesothelioma (SIR 1.80, CI 1.17 to 2.66) and small cell carcinoma of the lungs (SIR 1.32, CI 1.02 to 1.67). Exposure to hardwood dust (oak and beech) was associated with an increased incidence of nasal cancer (8.69, 1.05 to 31.4), specifically nasal adenocarcinoma (SIR 58.3, CI 7.06 to 211). Increased mortality was observed for exposure-cancer combinations that also showed increased cancer incidence.

CONCLUSIONS: This study demonstrated the strongest confirmed associations between occupational exposures and cancer. The absence of many known exposure-cancer associations may point to low levels of exposure among workers registered in ASA or to small effect sizes of the agents investigated.

PMID:42600110 | DOI:10.1093/annweh/wxag062

JCO Clin Cancer Inform. 2026 Jul-Sep;10(3):e2600123. doi: 10.1200/CCI-26-00123. Epub 2026 Aug 14.

ABSTRACT

Despite vast investments in data collection, generation, and sharing from childhood cancer studies, for example, Gabriella Miller Kids First Research Program, Childhood Cancer Data Initiative, and other efforts, secondary use of data remains a challenge especially for rare diseases. The National Cancer Institute (NCI) Office of Data Sharing (ODS) aimed to promote FAIR (Findable, Accessible, Interoperable, Reusable) data sharing practices to enhance data utility, accelerate discovery, and foster interdisciplinary collaboration. NCI ODS launched its inaugural Data Jamboree focusing on childhood cancer alongside its third Annual Symposium in September 2025. Over 120 participants with diverse backgrounds coalesced into 23 multidisciplinary teams to solve real-world problems in a collaborative setting. The Jamboree built a diverse pool of data users and catalyzed pediatric cancer research, with several project findings being prepared for publication. Moreover, key feedback and recommendations for areas of improvement were provided to NCI in real time. The event highlighted the power of team science, data sharing, use, and reuse to accelerate childhood cancer research and improve diagnostic and therapeutic outcomes.

PMID:42600109 | DOI:10.1200/CCI-26-00123

JMIR Cancer. 2026 Aug 14;12:e69886. doi: 10.2196/69886.

ABSTRACT

BACKGROUND: Social media is a common source of cancer information for patients, caregivers, and survivors. Factors influencing engagement with oncology nutrition content on social media are not well-defined, despite the high prevalence of social media use for health information. The impact of bilingual content strategies on that engagement is also poorly understood.

OBJECTIVE: This study aims to describe changes in postlevel engagement on a Facebook page used to disseminate evidence-based cancer nutrition information during the period before and after the implementation of a bilingual, multiformat content strategy and to identify creative and linguistic features associated with audience engagement at the post level.

METHODS: This cross-sectional study analyzed 306 Facebook posts from Cook for Your Life over 12 months, comprising 9 months before the strategy change (T1) and 3 months after (T2). Postlevel engagement metrics (likes, comments, shares, and link clicks) and aggregated user demographics were obtained from Meta Business Suite. Trained coders annotated visual and creative features, including branding, post shape, and infographics, as well as topical categories. Linguistic Inquiry and Word Count characterized language features. Group differences across time periods were tested using t tests and chi-square tests. Generalized linear models estimated associations between post characteristics and engagement, adjusting for the time period.

RESULTS: Users who engaged with oncology nutrition Facebook content (N=10,196) were mostly female (n=9500, 93.2%) participants, over 35 years of age (n=9311, 91.4%), based in the United States (n=6708, 71.4%), and English-language users (n=9419, 93.4%). Engagement tripled from T1 (mean 5.3, SD 4.2) to T2 (mean 17.7, SD 37.9; P<.001). Creative features such as branding and format were positively associated with engagement. Linguistically, there was a shift toward longer sentence structures, simplified vocabulary, increased analytical language, and a decline in emotionally charged and cognitive language in posts during T2. In models controlling for time period, posts that used bilingual content had 1.72-fold higher odds of audience engagement than English-only posts (95% CI 1.05-2.80).

CONCLUSIONS: Implementing a bilingual, multiformat content strategy may promote engagement with oncology nutrition information on Facebook and enhance the equitable dissemination of health information. The use of creative visual design elements in combination with language that is more analytical and emotionally neutral was associated with higher engagement with educational public health content. Future research should test bilingual language presentation more directly and examine whether exposure to such content influences health beliefs and downstream behaviors across additional platforms.

PMID:42600092 | DOI:10.2196/69886

JMIR Res Protoc. 2026 Aug 14;15:e89917. doi: 10.2196/89917.

ABSTRACT

BACKGROUND: Access to health care remains a critical issue in protracted forced displacement contexts globally. In Cox’s Bazar, Bangladesh, the co-existence of Rohingya refugees and the host community for many years has generated complex health care dynamics. While humanitarian interventions have increased service availability for refugees, barriers still persist, and disparities in health care access between refugees and host populations exist.

OBJECTIVE: This study aims to understand the experiences and coping strategies of refugees, host community members, and health care providers involved in accessing and delivering health care services, and to explore how these dynamics influence social cohesion between the two communities.

METHODS: The study will use a qualitative design involving focus group discussions (FGDs) with Rohingya refugees and host community members, and in-depth interviews (IDIs) with health care providers in Cox’s Bazar, Bangladesh. Separate FGDs will be conducted with men and women from both refugee and host communities. Participants will be recruited through purposive sampling, complemented with snowball sampling, where required. Each IDI and FGD will be guided by guides developed from prior studies and contextual insights. The anticipated sample includes approximately 3 to 5 FGDs with Rohingya refugees, 3 to 5 FGDs with host community members, and 10 to 12 IDIs with health care providers. Data will be analyzed using Braun and Clarke’s reflexive thematic analysis, and the analysis will be primarily inductive, while also considering the wider social, institutional, and structural conditions that shape participants’ experiences. Since the data will be transferred to Sweden for secure storage, management, and analysis, ethical approval has been obtained from both Sweden and Bangladesh.

RESULTS: Preparatory work began in 2025 following ethical approval, focusing on stakeholder engagement, field coordination, tool refinement, and recruitment planning. Findings are expected to be submitted for publication by 2027.

CONCLUSIONS: Guided by a critical realist paradigm, this study is grounded in the understanding that individuals’ lived experiences of accessing and delivering health care are shaped by deeper social, structural, and institutional mechanisms that may not be immediately visible. By integrating the perspectives of refugees, host community members, and health care providers, the study will generate context-specific evidence to inform more equitable and socially responsive health care delivery in Cox’s Bazar and similar humanitarian settings. Additionally, by exploring how disparities in health care access affect perceptions of inequalities, the study will shed light on the broader implications for social cohesion between these coexisting communities. Findings will help inform future strategies to improve equitable health care delivery and policies in displacement-affected regions.

PMID:42600087 | DOI:10.2196/89917

J Contin Educ Nurs. 2026 Aug 18:1-6. doi: 10.3928/00220124-20260528-01. Online ahead of print.

ABSTRACT

BACKGROUND: Transgender and gender-diverse (TGD) individuals experience stigma and discrimination that contribute to health inequities. Many health care providers receive limited education on TGD-specific care. This study evaluated the impact of a trauma-informed digital storytelling (DST) continuing education (CE) module on health care professionals’ attitudes, beliefs, and comfort regarding the care of TGD individuals.

METHOD: A single-group pre-post study design was conducted with clinicians and allied health staff in a regional health system (n = 154). Participants completed the Transgender Attitudes and Beliefs Scale (TABS) before and after a 1-hour asynchronous module featuring digital stories from TGD individuals and a parent of a TGD child, plus open-ended reflections.

RESULTS: Statistically significant improvements were observed in Interpersonal Conflict (median increase = 2.5), Sex/Gender Beliefs (median increase = 2.0), and total TABS scores (median increase = 4.5; all p < .001).

CONCLUSION: Trauma-informed DST-based CE is feasible and may promote reflective learning and more inclusive attitudes toward TGD patient care.

PMID:42600080 | DOI:10.3928/00220124-20260528-01

JMIR Mhealth Uhealth. 2026 Aug 14;14:e80321. doi: 10.2196/80321.

ABSTRACT

BACKGROUND: The increasing prevalence of chronic illness presents a significant global health challenge due to growing end-of-life suffering. Palliative care is now an essential health service under Universal Health Coverage. Its integration into primary health care and use of mobile health (mHealth) have been recommended to improve access.

OBJECTIVE: This study aimed to synthesize evidence on how mHealth interventions in home-based palliative care work, for whom, and in what context.

METHODS: This realist review identified global evidence relevant to mHealth interventions for home-based palliative care through searches of 9 electronic databases (ie, MEDLINE, Embase, PsycINFO, Global Health, CINAHL, Web of Science, Cochrane Database of Systematic Reviews, Scopus, and Global Index Medicus), and forward citation tracking of included articles conducted in March 2026. The review followed the 5 key stages of a realist review: scoping the literature to assess what is important about the context of mHealth intervention in home-based palliative care and what mechanisms might be important in how such interventions result in their intended outcomes; articulating the underlying program theory and refining the review scope through consultation with international palliative care experts; conducting iterative searches for and appraisal of relevant evidence; extracting data; and narratively synthesizing the data, prioritized by relevance and rigor to generate conclusions and recommendations. The Framework of Complexity in Palliative Care Context, adapted from Bronfenbrenner’s Ecological Systems Theory, was applied to examine the contextual influences and interactions among factors within the multilayered system. Context-mechanism-outcome configurations were developed and iteratively tested to refine the program theory for mHealth in home-based palliative care.

RESULTS: A total of 4134 records were identified, of which 422 (10.21%) articles were retained for full-text screening, and 126 (3.05%) studies were included in the final synthesis. The contextual factors and mechanisms that positively influence the intended outcomes include (1) alleviating concerns and mitigating perceived threats about mHealth’s suitability in palliative care through proper orientation for patients and carers, along with clear guidelines for health care professionals; (2) minimizing infrastructural and technological barriers through user-friendly designs and investment in sustainable models of mHealth for home-based palliative care; (3) engaging diverse stakeholders to ensure mHealth aligns with priority health care needs, user preferences, and the operations of implementing organizations and the wider health care system; (4) streamlining health management information systems through interoperable mHealth systems implemented at different levels of care; (5) enabling access to and regular communication with relevant health care teams; and (6) facilitating access to adequate information to empower users in palliative care services.

CONCLUSIONS: mHealth interventions can enhance home-based palliative care but must align with local contexts. It is recommended that mHealth interventions ensure safety and comfort, technology competence, tailored communication, empowerment of end users, family involvement, health care worker motivation, and system integration.

PMID:42600073 | DOI:10.2196/80321

JMIR Serious Games. 2026 Aug 14;14:e95572. doi: 10.2196/95572.

ABSTRACT

BACKGROUND: Adolescents with mild intellectual disabilities often exhibit deficits in motor proficiency and neurocognitive processing, which can limit their functional independence. Although virtual reality (VR) exergames provide a motivating platform for physical activity, objective data quantifying their impact on standardized motor scales remain scarce, particularly when implemented through structured pedagogical frameworks. Earlier research established the WISH (warm-up, imitation, settings, half-hour) and WON (warm-up, objective evaluation, no problem!) protocols to facilitate gameplay independence in this population. However, the extent to which this systematic approach translates into measurable clinical motor and reaction time gains requires further investigation.

OBJECTIVE: This study evaluated the effectiveness of a 16-session structured VR exergame intervention, using the WISH and WON protocols, in enhancing motor proficiency and shortening simple reaction time among adolescents with mild intellectual disability.

METHODS: A multisession, single-group pretest and posttest pilot design was used. A convenience sample of 8 adolescents (3 males, 5 females; mean age 17.63, SD 1.77, range 15-20 years) was recruited from a special school complex in Poland. The intervention was conducted over an 8-month period (October 2023 to May 2024), consisting of 16 sessions conducted once every 2 weeks. The rhythmic fitness game “OhShape!” (Odders Lab) was played on the Meta Quest 2 system. Motor proficiency was assessed with the Bruininks-Oseretsky Test of Motor Proficiency short form, and simple reaction time to visual and auditory stimuli was measured using a standardized Alfa-Electronics meter. Statistical analysis was performed using the Wilcoxon signed-rank test (α=.05).

RESULTS: Total Bruininks-Oseretsky Test of Motor Proficiency scores significantly improved from a baseline mean of 69.25 (SD 6.80; 95% CI 63.56-74.94) to 80.50 (SD 5.50; 95% CI 75.90-85.10) at the posttest (P=.01; r=0.74). Based on the standardized 5-point proficiency scale, the group mean rose from 1.88 (SD .64; 95% CI 1.34-2.42) at baseline to 2.88 (SD .35; 95% CI 2.59-3.17) postintervention (P=.008; r=0.89). Furthermore, the mean simple reaction time decreased from 426.50 (SD 52.3; 95% CI 382.78-470.22) ms to 392.10 (SD 38.4; 95% CI 359.98-424.22) ms at the final assessment (P=.02; r=0.72).

CONCLUSIONS: This pilot study suggests structured VR exergaming may address motor deficits in adolescents with mild intellectual disability. Promoting autonomy via protocols was associated with measurable motor gains within this cohort. Although the absence of a control group limits causal claims, immersive VR may offer a supportive tool for neuro-motor adaptations in special education, warranting validation in larger controlled trials.

PMID:42600070 | DOI:10.2196/95572

Asian Pac Isl Nurs J. 2026 Aug 14;10:e83091. doi: 10.2196/83091.

ABSTRACT

BACKGROUND: Digital health technologies (DHTs), including mobile health (mHealth) apps and online medical records, are increasingly being used to support self-management and communication with health care professionals among the general population across the United States. However, few studies have explored whether cultural, privacy, and sociodemographic factors may influence DHT adoption among Vietnamese Americans specifically.

OBJECTIVE: This cross-sectional study aimed to explore DHT use, barriers to adoption, and their associations with social determinants, such as age, sex, social support, and mental health concerns, among Vietnamese Americans.

METHODS: Data were collected from a sample of Vietnamese American adults (n=304) through surveys assessing DHT engagement, confidence in medical record security, and social and psychological factors. Descriptive statistics and inferential analyses, including 2-tailed t tests and chi-square tests, were used to examine differences across demographic groups.

RESULTS: Many participants had engaged with mHealth tools (253/304, 83.2%), including using mobile devices for health tracking (185/302, 60.9%), and health care professional discussions (194/301, 64.5%). Online medical records were reported to be widely available (230/304, 75.7%), with a large proportion of the participants (182/227, 80.2%) accessing them at least once in the past year. Privacy concerns were a key barrier to using online medical records, with 40.5% (17/42) of nonusers citing security fears, and 26.6% (81/304) reporting withholding health information from health care professionals. The main reasons participants did not access online medical records (45/304, 14.8%) were that they preferred to speak to health care professionals directly (31/44, 70.5%) or did not perceive a need to access their online medical records (30/43, 69.8%). There were no statistically significant differences in sociodemographic characteristics between DHT users and nonusers. There were statistically significant differences in the levels of social support of participants who had varying levels of confidence in the security of their medical records (F2,301=10.19; P<.001; η²=0.063). A greater proportion of male participants reported distrust (ie, being “not confident” in the security of their medical records) than female participants (χ22=20.8; P<.001), indicating a significant association between sex and confidence level.

CONCLUSIONS: While DHT adoption is high among Vietnamese Americans, privacy concerns remain a major barrier to full use of online medical records. Health care professionals and public health initiatives should focus on improving trust in medical record security, incorporating culturally tailored education on the benefits of digital health, and leveraging social media and mHealth tools to optimize patient engagement. Developing stronger family and community support may facilitate the adoption of DHTs.

PMID:42600066 | DOI:10.2196/83091

FASEB J. 2026 Aug 31;40(16):e72200. doi: 10.1096/fj.202601567R.

ABSTRACT

The genetic architecture of polycystic ovary syndrome (PCOS) has not been fully elucidated. Translating genome-wide association study (GWAS) loci into functional effector genes represents a key challenge for elucidating disease mechanisms and advancing targeted therapeutic strategies. In this study, the FinnGen R12 dataset was utilized in conjunction with the Genotype-Tissue Expression Project (GTEx) v8 eQTL dataset to conduct cross-tissue transcriptome-wide association studies (TWAS). External validation was performed in two independent datasets, comprising a PCOS meta-analysis of Rotterdam- and NIH-criteria cohorts and UK Biobank summary statistics. To prioritize high-confidence candidate genes, we integrated a cross-tissue (UTMOST) TWAS and tissue-specific (FUSION) TWAS with a gene-based association test (MAGMA). Furthermore, causal inference analyses including Mendelian randomization (MR), colocalization analysis, summary data-based MR, and the heterogeneity in dependent instrument (HEIDI) test were carried out on candidate genes. GeneMANIA, gene-chemical-disease analysis, and phenome-wide association study (PheWAS) were further performed on candidate genes. Finally, we explored expression profiles of core candidate genes using transcriptomic datasets from the Gene Expression Omnibus (GEO) database. We prioritized 15 candidate genes potentially associated with PCOS. External analyses across independent datasets showed limited consistency, which may reflect differences in statistical power and cohort heterogeneity. MCM6 was prioritized by all three approaches, whereas the remaining 14 genes were supported by two approaches. Among the 15 candidate genes, six genes were demonstrated to have causal associations with PCOS risk. GeneMANIA network analysis further revealed that these candidate genes were involved in key biological functions, including DNA replication and regulation, DNA repair and recombination, protein-DNA complex, cell cycle regulation, nucleic acid-enzyme activities, DNA structure and chromosomal regions, reproductive system development, and sex differentiation. Gene-chemical-disease analysis suggested that the prioritized genes may mediate crosstalk between PCOS genetic risk and environmental/metabolic factors. PheWAS analysis highlighted the pleiotropic roles of PCOS candidate genes, which contributed to both PCOS susceptibility and a spectrum of PCOS-related traits including metabolic and cardiovascular phenotypes. Finally, transcriptomic data showed downregulated MCM6 expression in granulosa cells of PCOS patients. Our study established a multipronged pipeline for PCOS gene prioritization and provided novel insights into the genetic architecture of PCOS.

PMID:42600058 | DOI:10.1096/fj.202601567R