Tag: pubmed

Glob Public Health. 2026 Dec 31;21(1):2648960. doi: 10.1080/17441692.2026.2648960. Epub 2026 Apr 1.

ABSTRACT

To conduct a systematic review and meta-analysis on the observed test positivity rates, risk factors, clinical manifestations and management of Mpox in paediatric populations globally. We searched relevant articles from databases, including PubMed, the Cochrane Library, Scopus, Web of Science and ProQuest, as well as gray literature sources, for studies published between 2023 and 2024. The inclusion criteria encompassed primary studies (including case reports) focused on paediatric mpox, with an emphasis on epidemiology, clinical manifestations and management. Data extraction was performed independently by two reviewers. We calculated pooled positivity rates and identified and reported risk factors and clinical manifestations (PROSPERO id: CRD42024600945). Among the 1414 records from databases and 24 from gray literature, 22 studies met the inclusion criteria. Paediatric mpox cases show considerable variability in PCR positivity rates, ranging from 6.95% in non-endemic regions to 35.6% in endemic areas. The clinical manifestations include progressive skin lesions and fever, with younger children being more susceptible to severe complications. The key risk factors included close household contact, coinfections and socioeconomic factors. Paediatric Mpox poses significant challenges, particularly in endemic regions. The observed frequency of infection and severity of complications emphasise the need for age-specific public health interventions, improved diagnostic capabilities and harmonised clinical guidelines to reduce morbidity and improve clinical outcomes.

PMID:41922934 | DOI:10.1080/17441692.2026.2648960

J Sch Health. 2026 May;96(5):e70142. doi: 10.1111/josh.70142.

ABSTRACT

This commentary summarizes the evidence base, equity implications, and implementation considerations for later school start times (SSTs) in Alabama. In Alabama, almost half of children report sleep durations below age-based recommendations. Of the 138 school districts in Alabama, few have middle and high schools adhering to the 8:30 am or later SSTs recommended by the American Academy of Sleep Medicine and the National Sleep Foundation. Historically designed to meet Industrial Revolution-era schooling needs, current SSTs are largely dictated by tradition and fail to promote the health and well-being of modern-day students. Adolescent chronotype shifts later, producing later sleep onset and wake time. Given their naturally delayed chronotype, early SSTs often lead to poor sleep quality and shorter total sleep duration in adolescents, which can negatively impact metabolic and cardiovascular health. Earlier SSTs negatively impact social development as well. Earlier SSTs can result in shorter sleep duration, which has been associated with adolescent suicidal behavior and substance use. Early SSTs are also correlated with poorer academic achievement. The literature provides substantial evidence supporting a relation between later SSTs and improved adolescent physical and mental health, social development, academic outcomes, and decreased motor vehicle accident incidence. Given prolific racial/ethnic and socioeconomic disparities in Alabama, later SSTs may offer a practical and sustainable pathway for addressing health inequities in Alabama. The prioritization of the health, well-being, and development of students warrants legislative discussion in Alabama regarding later start times for middle and high schools, along with strategic planning to overcome logistical challenges.

PMID:41922927 | DOI:10.1111/josh.70142

Nat Commun. 2026 Apr 1. doi: 10.1038/s41467-026-71252-y. Online ahead of print.

ABSTRACT

Sleep is essential for health and regulated by genetic and environmental factors. We perform genome-wide association studies of device-measured sleep duration, efficiency, and accelerometer-derived rapid eye movement (REM) and non-rapid eye movement (NREM) sleep in 80,013 UK Biobank participants. We identify 20 autosomal loci, 12 of which have not been previously reported, including genome-wide significant associations for REM and NREM sleep duration. MEIS1 shows strong opposing effects on REM and NREM durations and is intolerant to loss-of-function mutations, suggesting an essential role in the regulation of REM/NREM sleep balance. Functional enrichment analysis identifies statistically significant pathways related to chromatin remodelling, lipid metabolism, and metal ion homeostasis while tissue enrichment analysis highlights significant signals in the hypothalamus and frontal cortex. Sex-stratified analyses identify distinct loci, including FOXP2 and NRXN3 in females and LRP1B, NPBWR2, and PABPC4 in males. Mendelian randomization supports associations between shorter sleep duration and higher cardiometabolic risk. These findings highlight sex- and phase-specific regulators of human sleep architecture, providing biological insights and potential therapeutic targets.

PMID:41922918 | DOI:10.1038/s41467-026-71252-y

Sci Rep. 2026 Apr 1. doi: 10.1038/s41598-026-46388-y. Online ahead of print.

ABSTRACT

Adults with attention-deficit/hyperactivity disorder (ADHD) experience a high burden of physical comorbidities; however, the underlying mechanisms are not fully understood. This study investigated the association between ADHD symptoms and a wide range of physical comorbidities and quantified the statistical mediating role of alcohol dependence in a large sample of the general Japanese population. We analyzed cross-sectional data obtained from 29,268 participants (aged ≥ 16 years) as part of The 2024 Japan Society and New Tobacco Internet Survey (JASTIS). ADHD symptoms were assessed using the Adult ADHD Self-Report Scale (ASRS-J-6), and alcohol dependence was assessed using the Alcohol Use Disorders Identification Test (AUDIT). Physical comorbidities (18 in total) were assessed by self-report. A mediation analysis was conducted to estimate the proportion of the association between ADHD and physical comorbidities that was statistically mediated by alcohol dependence while accounting for sociodemographic factors. Following adjustment for covariates, ADHD symptoms were significantly associated with higher odds of 17 of the 18 examined physical comorbidities (all except allergic rhinitis). In the separate multivariable binomial logistic regression analyses, relatively stronger associations were observed for chronic hepatitis/cirrhosis (adjusted odds ratio [aOR] = 4.50). Alcohol dependence statistically mediated several of these associations. The proportion mediated was notably high for cancer (91.5%) and stroke (74.6%). ADHD symptoms were associated with widespread physical comorbidities, and alcohol dependence statistically mediated part of these associations. These findings suggest that alcohol dependence may represent a potentially modifiable behavioral factor related to physical health risks in individuals with ADHD symptoms. Considering alcohol use may be helpful when addressing the broader health needs of adults with ADHD symptoms.

PMID:41922914 | DOI:10.1038/s41598-026-46388-y

Sci Rep. 2026 Apr 1. doi: 10.1038/s41598-026-44103-5. Online ahead of print.

ABSTRACT

Electrocardiogram (ECG) classification is essential for accurately detecting and tracking heart rhythm disorders. This study proposes a multi-class ECG classification framework for identifying cardiac arrhythmias like Atrial Fibrillation (AF), Ventricular Fibrillation (VF), Normal Rhythm (NR), and Ventricular Tachycardia (VT). The ECG signals were decomposed using Variational Mode Decomposition (VMD), and higher-order statistics as well as entropy-based features were extracted from each mode. Multi-task Particle Swarm Optimization (MT-PSO) was employed to reduce redundant features and enhance the discriminative capability of the dataset. Multiple machine-learning models were evaluated, and optimized feature set led to clear performance improvements. The best results were obtained using LightGBM (ACC 0.993), HistGradientBoost (0.991), XGBoost (0.990), and ExtraTrees (0.990). Execution time also decreased for several models after optimization. Confusion-matrix and ROC analyses confirmed reliable detection across all four cardiac classes, and comparison with reported works shows that the proposed framework offers competitive or improved performance for ECG classification.

PMID:41922908 | DOI:10.1038/s41598-026-44103-5

Int Urol Nephrol. 2026 Apr 1. doi: 10.1007/s11255-026-05099-z. Online ahead of print.

ABSTRACT

BACKGROUND: Chronic Kidney Disease (CKD) is a major global health problem, burdening more than 650 million people worldwide and exposing them to the risk of aortic stenosis (AS). The present study responds to the urgent need to assess the safety and effectiveness of aortic valve replacement (AVR) interventions young adults with CKD, who tend to be excluded from randomized trials.

METHODS: We analyzed the in-hospital outcomes of transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in a young adult population with chronic kidney disease (CKD) using the National Inpatient Sample (NIS) database. This large, publicly available United States inpatient healthcare database allowed cross-sectional analysis of hospital admissions during 2018-2020. The population included patients under the age of 65 with a primary or secondary CKD diagnosis who underwent TAVR or SAVR procedures. Baseline factors and in-hospital outcomes, such as mortality rates, hospital costs, and hospital stay, were compared between the TAVR and SAVR groups using statistical analysis, adjusting for these baseline factors.

RESULTS: The 11,315 young adults with CKD trial revealed that TAVR was associated with comparable risk of in-hospital death, reduced length of hospital stay, and decreased hospital charges in comparison to SAVR. TAVR was also associated with reduced risk of acute kidney injury, cardiogenic shock, and venous thromboembolism complications.

CONCLUSIONS: In conclusion, TAVR presents a favorable alternative to SAVR for young adults with CKD. These findings contribute strong evidence to guide clinical decision-making and improve care for this complex patient population.

PMID:41922882 | DOI:10.1007/s11255-026-05099-z

Diabetologia. 2026 Apr 1. doi: 10.1007/s00125-026-06715-4. Online ahead of print.

ABSTRACT

AIMS/HYPOTHESIS: Blood pressure variability (BPV) is a risk factor for kidney disease progression in hypertension and type 2 diabetes; however, the role of BPV in kidney disease in type 1 diabetes is unknown. The aim of this study was therefore to determine whether BPV has an impact on kidney disease progression in an ethnically diverse cohort of people with type 1 diabetes.

METHODS: We studied 3079 people (median age 36 [range 18-85] years; 50% female; 78.5% White, 10.9% African Caribbean, 4.5% Asian, 6.1% Other) with type 1 diabetes and baseline eGFR >45 ml/min per 1.73m² attending two university hospital clinics between 2004 and 2018. BPV was assessed using visit-adjusted standard deviation (adj-SD), CV and average real variability (ARV) for systolic blood pressure (SBP) and diastolic blood pressure (DBP). The primary endpoint was eGFR decline of ≥50% from baseline with final eGFR <30 ml/min per 1.73m², with death as a competing risk.

RESULTS: Over a 14 year period, 272 people (8.8%) reached the primary endpoint. All BPV metrics for SBP and DBP were significantly associated with the primary endpoint. ARVs of SBP and DBP and African Caribbean ethnicity emerged as risk factors in multivariable analyses, independent of traditional risk factors, including baseline blood pressure, eGFR, HbA_1c, albuminuria and mean blood pressure in the exposure window. The strongest association was observed for the ARV of SBP (HR 1.54, 95% CI 1.27, 1.87, p<0.001).

CONCLUSIONS/INTERPRETATION: In people with type 1 diabetes, SBP and DBP variability are associated with kidney disease progression. Further studies are needed to investigate if BPV is a modifiable risk factor for kidney disease progression.

PMID:41922880 | DOI:10.1007/s00125-026-06715-4

Eur Phys J E Soft Matter. 2026 Apr 1;49(4):28. doi: 10.1140/epje/s10189-026-00568-w.

ABSTRACT

This paper extends a field-theoretical dynamical networking formalism for mesoscopic polymer dynamics to explicitly include dedicated cross-linker particles. Cross-linkers are represented within a Martin-Siggia-Rose generating functional and reversibly coupled to polymers through Gaussian networking fields, enabling an approximation scheme that reduces their degrees of freedom while remaining compatible with polymer dynamics. The framework is applied to a two-species polymer system in which intra- and inter-species cross-linking are assigned different statistical advantages. Effective networking potentials are derived and used to calculate correlation functions and dynamic structure factors. To validate these results, molecular dynamics simulations of semi-flexible polymers with reversible intra- and inter-species cross-linking are performed. Simulations show that cross-linking decreases polymer persistence lengths and local alignment, and the resulting trajectories yield dynamic structure factors consistent with theoretical predictions. Qualitative comparison reveals that in both approaches, cross-linking broadens the diffusive peaks and enhances the high-frequency tails of the structure factors. Together, theory and simulation provide complementary insights into the dynamics of cross-linked polymers, establishing a tractable framework that captures essential features observed in experiments and offering a basis for exploring more complex synthetic and biological networks.

PMID:41922872 | DOI:10.1140/epje/s10189-026-00568-w

Environ Monit Assess. 2026 Apr 1;198(4):399. doi: 10.1007/s10661-026-15238-9.

ABSTRACT

Cement manufacturing releases potentially toxic metals into the surrounding environment, raising notable ecological and public health concerns. In this study, soils collected around a major cement facility in Obajana, Nigeria were analyzed for Cd, Co, Cr, Fe, Pb, and Sr using an inductively coupled plasma-optical emission spectrometer (ICP-OES). Soil pH and particle-size distribution were also assessed to evaluate factors influencing metal mobility. Among the analyzed metals, Fe exhibited the highest abundance, followed by Sr, Pb, Cr, Co, and Cd. Measured concentrations were generally within the international guideline limit, although spatial variations reflected the hot zone of the metal concentration distribution in the study area. Relative enrichment assessed using enrichment factor (EF) indicated minor to considerable enrichment (EF = 1-20), suggesting contribution from both natural and anthropogenic sources. Contamination factor (CF) values ranged from moderate to very high contamination (CF < 1: 3 ≤ CF ≥ 6), while pollution load index (PLTI) values (2.34-5.00) indicated overall decline in soil quality. The Geo-accumulation index (Igeo) results further revealed strongly polluted cobalt levels (4.25-4.66), with the remaining metals falling within the low-to-moderate contamination range. The health risk assessment showed higher exposure risks for children than for adults. Hazard index (HI) values for adults and children remained below one, indicating no significant non-carcinogenic risk in the study area. Total carcinogenic risk values for both age groups fall within the acceptable threshold of 1.0E – 04 to 1.0E – 06. The Statistical evaluation pointed to both natural and anthropogenic emissions via cement-related activities as the source of these metals.

PMID:41922869 | DOI:10.1007/s10661-026-15238-9

Drug Saf. 2026 Apr 1. doi: 10.1007/s40264-026-01664-8. Online ahead of print.

ABSTRACT

INTRODUCTION: Medication use in pregnancy is common, but decisions balancing the needs of maternal and fetal health can be complex. Ongoing monitoring of medication use in pregnancy is essential to ensure their continued safe and appropriate use in this population.

OBJECTIVE: The aim of this review is to estimate the prevalence of prescribed medication use in pregnancy.

METHODS: This review was carried out in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol was registered in the PROSPERO database (CRD42024533866). PubMed, Medline, Cinahl (EBSCO), APA PsychINFO (EBSCO), Embase (Ovid), Scopus, and Web of Science databases were systematically searched for relevant articles published from January 2010 to May 2025. Inclusion criteria specified that studies provided a value for prescribed medication use in the general population of pregnant women during part or all of the gestational period. Articles were independently dual screened, and relevant data were extracted and validated from included studies. Quality and bias of the studies were assessed using the Joanna Briggs Institute critical appraisal tool for prevalence studies. A narrative synthesis was conducted for all studies. A random-effects meta-analysis with logit transformation was used to pool prevalence estimates (95% confidence interval, CI) where sufficient studies defined medication use in a similar way. Cochran’s Q, I², and τ² were used to measure heterogeneity.

RESULTS: A total of 13,416 unique articles were identified and screened. Seventy studies were included. The pooled prevalence for prescribed medication alone during pregnancy was 56% (CI 44-67%, p < 0.01, I² = 100%, τ² = 1.30), based on 23 studies and a population of 7.3 million. The pooled prevalence for prescribed medications alone for the first, second, and third trimesters was 31% (CI 22-40%, p < 0.01, I² = 100%, τ² = 0.65) from 14 studies, 30% (CI 21-42%, p < 0.01, I² = 100%, τ² = 0.56) from 9 studies, and 34% (CI 22-49%, p < 0.01, I² = 100%, τ² = 0.77) from 8 studies, respectively. The pooled prevalence for prescribed medications including prescribed vitamins and minerals was 83% (CI 75-89%, p < 0.01, I² = 100%, τ² = 1.66) based on 26 studies and a population of 4.9 million. For this more inclusive group, the pooled prevalence for the first, second, and third trimesters was 52% (CI 44-61%, p < 0.01, I² = 100%, τ² = 0.46) from 14 studies, 56% (CI 42-70%, p < 0.01, I² = 100%, τ² = 0.88), and 59% (CI 42-74%, p < 0.01, I² = 100%, τ² = 1.25) both from 10 studies, respectively. Methods used to estimate prevalence varied greatly owing to differences in the definition of prescribed medications, the measured exposure period, and the pregnancy outcomes included.

CONCLUSIONS: From this review, it was evident that a large proportion of women use prescribed medications during pregnancy, but estimates vary greatly. A more standardized approach to studying medication use in pregnancy is needed to allow for consistent and standardised estimates that are comparable across populations.

PMID:41922857 | DOI:10.1007/s40264-026-01664-8