Tag: pubmed

Front Med (Lausanne). 2026 Jul 20;13:1868245. doi: 10.3389/fmed.2026.1868245. eCollection 2026.

ABSTRACT

BACKGROUND: Organizational commitment is a critical determinant of workforce stability, employee retention, and organizational performance in healthcare settings. As healthcare systems undergo large-scale transformation, maintaining a committed workforce becomes increasingly important for supporting service quality, organizational resilience, and successful implementation of reforms. In Saudi Arabia, the Health Sector Transformation Program has introduced integrated health cluster models that bring together hospitals, primary healthcare centers, and administrative services under unified governance. Despite the importance of organizational commitment in these evolving healthcare systems, evidence remains limited regarding commitment levels among employees working within integrated health clusters. Therefore, this study aimed to assess organizational commitment and identify associated factors among clinical and administrative employees in the Asir Health Cluster, Saudi Arabia.

METHODS: A cross-sectional study was conducted between October and December 2025 using the Meyer and Allen Organizational Commitment Scale. A total of 392 clinical and administrative employees participated. Descriptive statistics, independent-samples t-tests, and one-way analysis of variance (ANOVA) were used to examine differences in commitment levels. Binary logistic regression analysis was performed to identify independent predictors of organizational commitment.

RESULTS: Overall organizational commitment was moderate (M = 3.85, SD = 0.88). Normative commitment demonstrated the highest mean score (M = 3.98, SD = 1.07), followed by affective commitment (M = 3.84, SD = 0.87) and continuance commitment (M = 3.70, SD = 1.22). Commitment levels were generally similar across professional groups. Female employees were significantly more likely to report high organizational commitment than male employees (AOR = 2.45, 95% CI: 1.55-3.87, p < 0.001), while age and professional category were not significant predictors.

CONCLUSION: Employees within the Asir Health Cluster demonstrated moderate organizational commitment, with commitment primarily driven by a sense of professional obligation and responsibility. The findings highlight opportunities to strengthen workforce engagement through initiatives that enhance affective commitment, including supportive leadership, employee recognition, and positive organizational culture. Organizational commitment should be considered a strategic workforce indicator within healthcare transformation efforts, and regular monitoring may support workforce planning, employee retention, and the long-term sustainability of health system reforms under Saudi Vision 2030.

PMID:42548950 | PMC:PMC13430452 | DOI:10.3389/fmed.2026.1868245

Int J Breast Cancer. 2026 Aug 2;2026:7879645. doi: 10.1155/ijbc/7879645. eCollection 2026.

ABSTRACT

BACKGROUND: Phosphatase and tensin homolog (PTEN) is a key tumor suppressor gene that negatively regulates the PI3K/AKT pathway. PTEN deficiency is the most frequent molecular alteration in triple-negative breast cancer (TNBC); however, the relationship between PTEN protein loss and underlying genomic alterations remains incompletely understood.

METHODS: Fifty TNBC cases were evaluated for PTEN protein expression by immunohistochemistry on tissue microarrays. PTEN hotspot mutations (Exons 1, 5, 7, and 9) were analyzed using Sanger sequencing, whereas copy number alterations were assessed by multiplex ligation-dependent probe amplification (MLPA) assay. PTEN alterations were correlated with clinicopathological characteristics. External validation of PTEN mRNA and protein expression and prognostic significance was performed using publicly available TCGA/CPTAC datasets and Kaplan-Meier plotter.

RESULTS: PTEN protein loss was observed in 41/50 TNBC cases (82%), indicating that PTEN deficiency is a frequent event in this subtype. PTEN mutations were detected in six cases (12%) and were confined exclusively to Exon 5, comprising one missense mutation (c.277C>A) and two truncating mutations (c.430del and c.433del). MLPA identified PTEN copy number alterations in four cases (8%), including heterozygous deletions and duplications. No significant association was observed between PTEN protein expression and genomic alterations, highlighting a substantial genotype-phenotype discordance. Analysis of independent public datasets confirmed significantly reduced PTEN mRNA and protein expression in TNBC compared with luminal and HER2-positive breast cancers. Patients with low PTEN expression showed a trend toward shorter overall survival (23.5 vs. 38.9 months), though the difference did not reach statistical significance.

CONCLUSIONS: PTEN protein loss is highly prevalent in TNBC but is only partially explained by mutations and copy number alterations, suggesting that additional regulatory mechanisms, such as epigenetic or posttranscriptional events, contribute to PTEN inactivation. These findings underscore the biological importance of PTEN deficiency in TNBC and support further investigation of PTEN as a potential prognostic biomarker and therapeutic target.

PMID:42548909 | PMC:PMC13430043 | DOI:10.1155/ijbc/7879645

Sleep Adv. 2026 Jul 7;7(3):zpag069. doi: 10.1093/sleepadvances/zpag069. eCollection 2026.

ABSTRACT

STUDY OBJECTIVES: Sleep spindles are electroencephalographic elements characteristic of non-rapid eye movement sleep (NREM) generated by thalamo-cortical interactions. Spindles have been linked to some of the cognitive benefits afforded by sleep and increased arousal threshold. This proof-of-concept study demonstrates that targeting the thalamus with Transcranial Electrical Stimulation with Temporal Interference (TES-TI) can enhance spindle activity.

MATERIALS AND METHODS: 46 participants (24 ± 9.5 years; 58.7% F) underwent thalamic TES-TI stimulation during daytime naps. Three stimulation protocols with 15 kHz carrier frequency were tested during stage NREM 2: fixed difference frequency of 10 Hz (TES^15kHz-TI^10Hz), difference frequency matched to individual spindle peak, and no difference frequency. Spindle (sigma) band power and integrated spindle activity (ISA) were compared before and during the stimulation, and across stimulation protocols.

RESULTS: TES^15kHz-TI^10Hz stimulation was associated with increased sigma power (∆x~ _STIM-PRE = 0.46 log₁₀ μV², p = .0042) and ISA (∆x~ _STIM-PRE = 4.064 μV/s, p = .030). Cluster-based analysis localized the increase in sigma power across the entire scalp (p = .008). Linear mixed-effects models showed that both sigma power and ISA during stimulation increased significantly more in TES^15kHz-TI^10Hz compared to the other stimulation protocols.

CONCLUSIONS: This study provides evidence supporting the successful use of TES-TI targeting the thalamus to enhance sleep spindle activity. Stimulation at a fixed difference frequency of 10 Hz increased sigma band power and ISA, whereas neither stimulation matched to individual sigma band peak nor TES alone produced comparable effects. These promising results warrant further investigations into the cognitive and clinical impact of TES-TI.

PMID:42548908 | PMC:PMC13430039 | DOI:10.1093/sleepadvances/zpag069

Sleep Adv. 2026 Jul 10;7(3):zpag071. doi: 10.1093/sleepadvances/zpag071. eCollection 2026.

ABSTRACT

STUDY OBJECTIVES: To examine the prevalence of obstructive sleep apnea (OSA) underdiagnosis and sociodemographic, behavioral, and medical correlates of underdiagnosis among Hispanic participants of Mexican descent and non-Hispanic white participants in San Diego, CA.

METHODS: Participants underwent overnight home polysomnography (PSG) and were eligible for the study if they met OSA diagnostic criteria at an apnea-hypopnea index (AHI) ≥ 15/h, minimum 3% oxygen desaturation. Participants self-reported their medical history including past OSA diagnosis, demographics, anthropometrics, and completed the Epworth Sleepiness Scale, and the Short Acculturation Scale for Hispanics. Logistic regressions were used to test bivariate and adjusted associations of correlates with OSA diagnosis status (diagnosed or undiagnosed).

RESULTS: Participants (N = 156) had mean (SD) age = 56.3 (15.1) years, 33% were female, and 49% were Hispanic. In this sample with AHI ≥ 15/h, 81.4% had undiagnosed OSA (85.5% among the Hispanic participants of Mexican descent, 77.5% among the non-Hispanic white participants, not statistically significant difference). No prior high blood pressure diagnosis (odds ratio [OR] = 3.44, p = .005) and lower AHI (OR = 1.02, p = .030) were associated with increased likelihood of underdiagnosis. Age, gender, ethnicity, education, body mass index, daytime sleepiness, acculturation, and diabetes diagnosis were not associated with underdiagnosis.

CONCLUSIONS: Most participants with moderate to severe OSA by home PSG were undiagnosed, regardless of their ethnicity. A lower AHI and no prior diagnosis of high blood pressure were associated with greater OSA underdiagnosis. Enhanced OSA screening, across groups, is needed to reach the large majority that are missed.

PMID:42548906 | PMC:PMC13430037 | DOI:10.1093/sleepadvances/zpag071

AJPM Focus. 2026 May 22;5(5):100517. doi: 10.1016/j.focus.2026.100517. eCollection 2026 Oct.

ABSTRACT

INTRODUCTION: Catechins, a type of flavonoid and a major component of green tea, are expected to serve as a complementary preventive measure against COVID-19. However, to date, clinical evidence has not been established. This study aimed to evaluate the preventive effects of green tea gargling against COVID-19 in a multicenter RCT.

METHODS: A total of 1,012 adults aged 18-70 years who provided written informed consent and met the eligibility criteria were randomly assigned to either a green tea or a water gargling group. Participants gargled 3 times a day for 12 weeks from December 2023 to February 2025 using commercially available green tea powder according to the package instructions. Background characteristics, incidence of COVID-19, and other preventive measures were assessed using self-administered questionnaires. Group differences were analyzed using multivariate logistic regression and Cox proportional hazards models.

RESULTS: The incidence of COVID-19 in the full analysis population was 5.4% (27 of 503) in the green tea gargling group and 5.4% (27 of 500) in the water gargling group. In the per-protocol set population with a gargling adherence ≥80%, the incidence was 4.4% (17 of 386) in the green tea group and 5.7% (23 of 403) in the water group. Multivariate logistic regression adjusted for preventive measures showed an OR of 0.818 (95% CI=0.422, 1.556), and Cox proportional hazards analysis yielded a hazard ratio of 0.824 (95% CI=0.439, 1.546). Pneumonia and hospitalization occurred in 1 participant in the water group. No gargling-related adverse events were observed during the 12-week intervention.

CONCLUSIONS: In the per-protocol set population, green tea gargling showed a 22.8% relative reduction in COVID-19 incidence compared with water gargling, although the difference was not statistically significant. Further studies are needed to confirm the preventive effects of optimizing gargling frequency and catechin concentration.

PMID:42548902 | PMC:PMC13430259 | DOI:10.1016/j.focus.2026.100517

Iran J Public Health. 2025 Dec;54(12):2608-2622. doi: 10.18502/ijph.v54i12.20814.

ABSTRACT

BACKGROUND: Parasitic diseases, including food-borne and vector-borne infections, remain a significant burden, especially with the increased migration from underdeveloped to developed regions. We aimed to estimate the prevalence of parasitic infections among migrant workers in the Middle East.

METHODS: This systematic review and meta-analysis followed the PRISMA protocol. A search was conducted across major databases (Scopus, PubMed, Web of Science, Google Scholar) for studies on parasitic infections among migrant workers in the Middle East from April 1, 1993, to November 15, 2024. Data were analyzed using Comprehensive Meta-Analysis software (CMA), and 25 studies were included.

RESULTS: The overall prevalence of parasitic infections in this study was estimated at 16.5%. (95% CI 2.7 to 58.5%). The prevalence based on microscopic diagnostic methods was 19.4% (95% CI 13.5% to 27.5%), and molecular diagnosis was 15.2% (95% CI 6.4% to 32.4%). The P-value in Egger’s test was 0.5343, indicating no statistically significant evidence of publication bias. The pooled prevalence varied across countries: 34.7% in Iraq (n = 1 study), 19.6% in Saudi Arabia (n = 12 studies), 16.8% in the UAE (n = 4 studies), 13.2% in Qatar (n = 7 studies), and 4.2% in Kuwait (n = 1 study).

CONCLUSION: The prevalence of parasitic infections among migrant workers in the Middle East was estimated at 16.5%. Given this rate, routine mandatory screening is recommended along with targeted health education to reduce exposure risk and improve health. These findings highlight the public health concern that infected migrant workers may contribute to the spread of parasitic diseases in destination countries.

PMID:42548888 | PMC:PMC13429956 | DOI:10.18502/ijph.v54i12.20814

Iran J Public Health. 2025 Dec;54(12):2595-2607. doi: 10.18502/ijph.v54i12.20813.

ABSTRACT

BACKGROUND: We aimed to evaluate the efficacy of preventative strategies targeted at lowering these injections.

METHODS: A comprehensive assessment of electronic databases (PubMed, Web of Science, and Cochrane Library) was carried out to discover relevant papers published from 2013-2024. Inclusion criteria were randomised controlled trials, quasi-experimental studies, and observational research on therapy for intravenous injection and catheter-related infections. The primary outcome examined was the incidence or prevalence of infections caused by intravenous injections. According to preliminary data from 31 studies, preventive interventions dramatically reduce the incidence of intravenous injection and catheter-related infections. Subgroup analyses indicate effectiveness differences depending on intervention type and patient variables.

RESULTS: Chlorhexidine-based therapies can lower infection risk by 29% (Risk Ratio: 0.71), but taurolidine provides a statistically significant 53% benefit (RR = 0.47). The total risk ratio varies from 0.71 to 0.84, indicating a 29% reduction in infection rates in nations having Needlestick Safety and Prevention Acts. In contrast, the absence of such regulation may result in a 6% to 8% rise in infection rates (RR = 0.96).

CONCLUSION: Preventative interventions, notably chlorhexidine and taurolidine, can considerably reduce the risk of intravenous injection and catheter-related infections. Chlorhexidine may lower the risk of infection by 29%, whereas taurolidine reduces it by 53%. Nations with Needlestick Safety and Prevention Acts may expect a one-third reduction in infection rates. Conversely, the absence of such laws may result in a significant rise in infection rates.

PMID:42548866 | PMC:PMC13429968 | DOI:10.18502/ijph.v54i12.20813

Front Cardiovasc Med. 2026 Jul 20;13:1893975. doi: 10.3389/fcvm.2026.1893975. eCollection 2026.

ABSTRACT

OBJECTIVE: Although triple therapy has been recommended as foundational therapy for heart failure with preserved ejection fraction (HFpEF), residual risk remains high in affected patients. The efficacy of beta-blockers in HFpEF remains controversial.

METHODOLOGY: This single-center retrospective cohort study included 600 patients with HFpEF who received triple therapy (as defined per the study protocol) at Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, between January 2018 and January 2025. A 1:1 propensity score matching (PSM) approach was used to balance baseline confounding factors. The efficacy and safety of quadruple therapy were compared with those of triple therapy alone. The primary endpoint was the composite of heart failure hospitalization or cardiovascular death.

RESULTS: After PSM, 360 patients were matched, with 180 patients in each group. During a median follow-up of 37.8 months, the incidence of the primary endpoint was significantly lower in the quadruple therapy group than in the triple therapy group [17.8% vs. 25.0%, hazard ratio (HR) = 0.678, 95% confidence interval (CI): 0.432-0.967, P = 0.035]. The quadruple therapy group had significantly lower rates of first heart failure hospitalization (14.4% vs. 20.6%, HR = 0.672, P = 0.030) and recurrent heart failure hospitalization (0.217 vs. 0.325 events per person-year, HR = 0.654, P = 0.015). Subgroup analyses showed that patients with concomitant coronary artery disease (HR = 0.591, P = 0.047) and baseline heart rate ≥70 beats per min (HR = 0.572, P = 0.045) derived greater benefit from quadruple therapy. A trend toward benefit was observed in patients with baseline LVEF of 50%-59%, but no significant interaction was detected. The overall safety profiles were comparable between the two groups.

CONCLUSION: In this real-world observational cohort of patients with HFpEF receiving triple therapy, quadruple therapy was associated with a lower risk of the composite of heart failure hospitalization or cardiovascular death, driven primarily by a reduction in heart failure hospitalizations. No statistically significant difference in cardiovascular or all-cause mortality was observed. The association appeared more prominent in patients with concomitant coronary artery disease and higher baseline heart rate in exploratory subgroup analyses. Given the observational design, these hypothesis-generating findings cannot establish causality and require prospective validation.

PMID:42548862 | PMC:PMC13429833 | DOI:10.3389/fcvm.2026.1893975

Iran J Public Health. 2025 Dec;54(12):2579-2594. doi: 10.18502/ijph.v54i12.20812.

ABSTRACT

BACKGROUND: Bivalirudin is increasingly used as an alternative to heparin in patients undergoing percutaneous coronary intervention (PCI) due to its potential for reducing adverse clinical outcomes. This meta-analysis aimed to compare the effectiveness and safety of bivalirudin versus heparin across various clinical outcomes.

METHOD: A total of 27 studies were included, comprising 63,624 patients: 30,492 received Bivalirudin, and 33,132 received Heparin. Key endpoints analyzed include net adverse clinical events (NACE), major adverse clinical events, major bleeding, mortality, stroke, and stent thrombosis. Data were pooled using a random-effects model, and heterogeneity was assessed using the I² statistic. Publication bias was evaluated using Begg’s and Egger’s tests.

RESULTS: Bivalirudin significantly reduced the risk of major bleeding (MD=-0.4445, 95% CI [-0.6276, -0.2615], P<0.0001, I²=76.79%) compared to Heparin. However, no significant differences were found for major adverse clinical events (MD=-0.0993, P=0.3194) or mortality (MD=-0.1959, P=0.0893). There was moderate heterogeneity in most analyses, particularly for NACE (I²=68.24%) and stent thrombosis (I²=55.33%). No significant differences were observed for stroke prevention or stent thrombosis. Subgroup analyses demonstrated significant reductions in major bleeding with Bivalirudin, particularly in STEMI patients (log OR=-0.37, P<0.0001), though no differences in MACE or stent thrombosis were observed. High heterogeneity in NSTEMI populations (I²=81.4%) underscores the need for individualized therapy.

CONCLUSION: Although bivalirudin significantly lowers major bleeding compared with Heparin, it shows no clear advantage in mortality or other major clinical outcomes. Substantial heterogeneity across studies indicates variability in patient populations and procedural settings. Further research is needed to define its optimal role in specific PCI subgroups.

PMID:42548857 | PMC:PMC13429960 | DOI:10.18502/ijph.v54i12.20812

Front Sports Act Living. 2026 Jul 20;8:1879308. doi: 10.3389/fspor.2026.1879308. eCollection 2026.

ABSTRACT

Non-Olympic sports play important cultural, social, and community roles, yet their position within national sport policy frameworks remains under-examined. This study investigates the structural position of non-Olympic sports in Israel through the perspectives of coaches, many of whom also hold managerial responsibilities. Using a cross-sectional online survey, data were collected from coaches across diverse non-Olympic sports. Quantitative analyses assessed group differences by employment status and managerial role using descriptive statistics, one-way ANOVA, and eta squared (η ²) effect sizes, while open-ended responses were analyzed using content analysis. Findings indicate that non-Olympic sports are perceived to occupy a peripheral position within a hierarchically organized sport system characterized by unequal access to funding, facilities, professional personnel, and media exposure, despite comparable levels of professional commitment. Drawing on sociological theories of capital, the results suggest that policy frameworks privileging Olympic performance concentrate economic and symbolic resources in recognized disciplines, reinforcing core-periphery dynamics. Although strong intrinsic motivation sustains engagement, responses to a hypothetical career-choice scenario warrant closer attention. By foregrounding governance structures and policy incentives, the study contributes to debates on stratification, sustainability, and access to resources and opportunities within sport systems, with implications extending beyond the studied context.

PMID:42548853 | PMC:PMC13429750 | DOI:10.3389/fspor.2026.1879308