Tag: pubmed

Int J Epidemiol. 2026 Jan 2;55(1):dyaf214. doi: 10.1093/ije/dyaf214.

ABSTRACT

INTRODUCTION: In air-pollution epidemiology, measured or modelled surrogate exposure estimates, prone to measurement error (ME), are used to investigate the health effects of exposure to pollution of outdoor origin, potentially leading to biased effect estimates. We predicted the annual personal exposure from outdoor sources by using personal measurements, compared it with concentrations from surrogate metrics, and quantified the ME magnitude, type, and determinants.

METHODS: We used measurements from four panel studies in London, UK, and predicted personal exposures to fine particulate matter (PM2.5), nitrogen dioxide (NO2), ozone (O3), and black carbon (BC). We compared those with surrogate exposures, including measurements from fixed-site monitors, modelled ambient concentrations, or hybrid methods accounting for people’s mobility. We estimated the exposure ME magnitude, correlations, and variance ratios between surrogate measures and personal exposure, and the percentages of classical/Berkson-type errors. Individual- and area-level characteristics, such as age, sex, socio-economic status, and time spent outdoors, were assessed as potential error determinants.

RESULTS: Predicted annual personal exposures to PM2.5, NO2, O3, and BC from outdoor sources were overestimated by surrogate metrics, with mean differences of up to 10.1, 40.0, 61.7, and 2.6 μg/m3, respectively. The variance ratios and Pearson correlation coefficients between surrogate and predicted personal exposures ranged from 0.03 to 165.02 and -0.24 to 0.25. Time-activity adjustment reduced errors substantially. Berkson-type errors dominated the ME for PM2.5 and BC (43%-81% and 26%-98%, respectively), whilst classical errors characterized gases (>94% for both NO2 and O3). Time spent outdoors, house type, and deprivation were associated with exposure error.

CONCLUSION: The use of surrogate exposures to investigate the health effects of long-term exposure to air pollution from outdoor sources may bias the epidemiological estimates due to ME. Information about the error structures and their determinants can be used for correction and the identification of the true exposure-response functions.

PMID:41481245 | DOI:10.1093/ije/dyaf214

Int J Epidemiol. 2026 Jan 2;55(1):dyaf208. doi: 10.1093/ije/dyaf208.

ABSTRACT

BACKGROUND: By mid-2024, >13 billion COVID-19 vaccine doses had been administered globally, with totals continuing to rise into 2025, yet persistent inequities remain in low- and middle-income countries (LMICs). We examined spatial determinants of COVID-19 vaccination uptake (proportion of eligible persons vaccinated) in Kenya by using the most recent nationally representative survey, the Kenya Demographic and Health Survey 2022. Our central contribution is the detection of seven spatially concentrated vulnerability clusters, complemented by using a Development Index (DI) and equity auditing to guide targeted action.

METHODS: We integrated socioeconomic, healthcare, environmental, and demographic measures at the Demographic and Health Survey cluster level; quantified spatial dependence (Moran’s I; spatial lag models); identified socio-geographic clusters (K-means); estimated variable importance (random forest); and synthesized a DI. Equity was assessed by using the Erreygers Concentration Index (ECI) along two axes: wealth-based (poorest→richest) and immunization-linked (lowest→highest routine child immunization coverage).

RESULTS: Our results reveal stark geographic disparities: vaccination rates range from 5.93% in Garissa to 46.02% in Nyeri, with urban clusters achieving significantly higher uptake. Key predictors include bank access (financial inclusion), household crowding, and environmental factors (nitrogen dioxide levels, precipitation). The DI correlated positively with uptake and the ECI indicated modest immunization-linked inequality and more pronounced wealth-related inequality.

CONCLUSION: This study underscores the need for targeted interventions, including mobile vaccination units, financial inclusion programs (e.g. M-Pesa subsidies), and the integration of COVID-19 vaccines into routine immunization programs. As Kenya and many LMICs integrate COVID-19 vaccination into routine immunization, our spatial approach, combining DI, cluster detection, and equity metrics, provides an operational toolkit to prioritize underserved areas, inform the placement of service points/mobile teams, and monitor equity as programs transition from campaigns to routine delivery.

PMID:41481244 | DOI:10.1093/ije/dyaf208

Int J Epidemiol. 2026 Jan 2;55(1):dyaf215. doi: 10.1093/ije/dyaf215.

NO ABSTRACT

PMID:41481241 | DOI:10.1093/ije/dyaf215

Int J Epidemiol. 2026 Jan 2;55(1):dyaf213. doi: 10.1093/ije/dyaf213.

ABSTRACT

BACKGROUND: Epidemiological studies evaluating the potential association between oral contraceptive (OC) use and melanoma risk have reported conflicting results. We assessed the association of OC use with melanoma risk in a large prospective cohort.

METHODS: The Nightingale Study comprises 59 944 Dutch female nurses at ages 19-65 years (mean, 46.9 years; SD, 11.0) who completed a baseline questionnaire in 2011, including information on lifetime OC use. Melanoma incidence was retrieved through linkage with the Netherlands Cancer Registry. Associations between lifetime OC use and risk of melanoma were assessed by using Cox proportional hazard models. Women who used OCs at baseline were considered current users and women who had used OCs but stopped before baseline were considered former users. Never OC users were defined as the reference.

RESULTS: During 10 years of follow-up, 447 women were diagnosed with melanoma. Melanoma risk was not increased among women who used OCs for a duration of <9, 10-15, or ≥16 years compared with never CO users. Melanoma risk was increased for current OC users [hazard ratio (HR), 1.53; 95% confidence interval (CI), 1.03-2.29], without a trend with duration of use (P-trend = .42) and age at cohort entry (P-trend = .05). Melanoma risk was not increased among former OC users (HR, 0.99; 95% CI, 0.72-1.38) nor when they had last used OC <2 years before baseline (HR, 0.69; 95% CI, 0.36-1.32).

CONCLUSION: Current OC use was associated with increased melanoma risk, irrespective of the duration or recency of use.

PMID:41481240 | DOI:10.1093/ije/dyaf213

Int J Epidemiol. 2026 Jan 2;55(1):dyaf212. doi: 10.1093/ije/dyaf212.

ABSTRACT

BACKGROUND: The association between wildfire smoke (WFS) exposure and pregnancy loss has been understudied. Here, we examined the association between prenatal wildfire-specific particulate matter ≤2.5 µm (PM2.5) exposure and pregnancy loss in Colorado, USA.

METHODS: We retrieved all birth records from the 17 ‘Front Range’ counties (just east of the Rocky Mountains) of Colorado from 2007 to 2018 (n = 614 321). We considered two PM2.5 exposures-wildfire-specific PM2.5 from a novel machine learning model and non-wildfire PM2.5 constructed using the Community Multiscale Air Quality model. We fitted quasi-Poisson distributed lag models to estimate the associations between the two weekly-resolved PM2.5 exposures during pregnancy and live birth-identified conceptions (LBICs) in each county. That is, we used the predicted change in the LBICs to directly infer the change in the number of pregnancy losses due to the exposure.

RESULTS: Average weekly non-wildfire PM2.5 was 6.2 µg/m3 (SD 2.3). In weeks with non-zero WFS (27% of all county-weeks), the average wildfire-specific PM2.5 was 0.92 µg/m3 (SD: 1.55). Wildfire-specific PM2.5 appeared important in gestational weeks 6-13-a 1-µg/m3 higher exposure sustained in these gestational weeks was associated with 20 [95% confidence interval (CI): 4-34] losses/year. In contrast, the cumulative association with non-wildfire PM2.5 was stronger-a 1-µg/m3 higher exposure sustained in every week of pregnancy was associated with 84 (95% CI: 46-129) losses/year.

CONCLUSION: Our findings suggest that both wildfire-specific and non-wildfire PM2.5 exposures were associated with more pregnancy loss and add to the growing literature on the harmful effects of wildfires and, more broadly, air pollution.

PMID:41481237 | DOI:10.1093/ije/dyaf212

J Environ Sci Health B. 2026 Jan 2:1-11. doi: 10.1080/03601234.2025.2608417. Online ahead of print.

ABSTRACT

Agriculture represents a cornerstone of the Algerian economy. To sustain agricultural production, fungicides, including the Bordeaux mixture, a copper (Cu)-based fungicide, are used extensively. The amounts applied, along with the frequency of their use in the absence of adequate regulatory oversight, raise significant concerns. Bou-Ismaïl Bay receives this compound through runoff and urban discharge. Cu is essential at low doses; however, at higher levels, it can cause serious toxicity. Here, 120 sardines were sampled from Bou-Ismaïl Bay in February and May 2023. Cu concentrations in the tissues were measured using atomic absorption spectrophotometry. Statistical analyses were conducted using R version 4.3.2. The results revealed a significant difference between the tissues. Concentrations ranged from 0.581 to 9.032 µg/g in the gills and from 0.378 to 1.543 µg/g in the muscle. The maximum Cu concentrations in the gills in February and May indicate chronic contamination of the marine environment. The Cu content in sardines was closely linked to the extent of agricultural land using the Bordeaux mixture. The absence of international maximum permissible levels of Cu specifically for sardines increases the potential risk of consumer overexposure. This regulatory gap, combined with the limited research on Cu’s effects in coastal populations, represents a significant concern.

PMID:41481209 | DOI:10.1080/03601234.2025.2608417

Glob Health Action. 2026 Dec;19(1):2598132. doi: 10.1080/16549716.2025.2598132. Epub 2026 Jan 2.

ABSTRACT

Heritable human genome editing (HHGE) presents new possibilities for the prevention of genetic diseases but also raises ethical and societal questions. While international surveys have explored public attitudes, particularly in high-income countries, there is a lack of large-scale empirical data from the Global South. In South Africa, previous work used deliberative public engagement to examine public perspectives. The present study aims to complement this by capturing public opinion through a cross-sectional survey, enabling direct comparison with deliberative findings. This study will recruit 400 adult participants residing in South Africa using targeted Facebook advertisements. A two-phase sampling process will be employed: initial screening for demographic information, followed by stratified sampling to ensure a representative South African population. The opinion survey consists of 19 HHGE scenarios, each explored through private and public moral lenses. Additionally, participants will indicate their interpretation of ‘safe and effective’ genome editing. Quantitative data will be analysed using descriptive statistics, chi-square tests, and logistic regression. Qualitative responses will undergo thematic analysis using both manual coding and generative AI tools under human oversight. The study includes two stages of informed consent and ensures data confidentiality through strict data handling protocols. Results will be disseminated in peer-reviewed journals and policy forums. The study will also generate a secondary dataset for evaluating AI-assisted qualitative analysis, to be conducted under separate ethical clearance.

PMID:41481170 | DOI:10.1080/16549716.2025.2598132

Psychol Health. 2026 Jan 2:1-39. doi: 10.1080/08870446.2025.2610270. Online ahead of print.

ABSTRACT

OBJECTIVE: Physical activity (PA) may offer health benefits for individuals undergoing substance use disorder (SUD) treatment, yet relapse, comorbidities, and motivational challenges often hinder PA maintenance. This study assessed the impact of a motivational intervention aimed at increasing PA motivation and maintenance in a residential SUD treatment setting.

METHODS AND MEASURES: This non-concurrent multiple-baseline N-of-1 study consisted of a six-week baseline and a ten-week intervention period. The study was conducted with 17 participants from a male-only residential SUD treatment facility in Perth, Australia. Seven participants provided sufficient data for statistical analysis. Participants received ten weekly sessions of a motivational face-to-face intervention. Daily data on PA motivation, substance use cravings, and affect were collected through ecological momentary assessments. Non-overlap methods and randomisation tests, and piecewise regression analyses were employed to assess changes in all variables between study phases.

RESULTS: No changes in PA were observed across study phases. However, measures of affect improved, and self-reported craving decreased over time. Notably, the intervention enhanced autonomous motivation in some participants, although its effects on controlled motivation were mixed.

CONCLUSION: These findings suggest that the motivational intervention may enhance autonomous motivation. Future studies should involve larger samples and diverse SUD treatment settings.

PMID:41481160 | DOI:10.1080/08870446.2025.2610270

Acta Chir Belg. 2026 Jan 2:1-14. doi: 10.1080/00015458.2025.2611452. Online ahead of print.

ABSTRACT

Background Laparoscopic hiatal hernia repair is considered the golden standard. Since its entrance in the mid ’00s, robotic surgery has been available in every modern operating center. The aim of this systematic review and meta-analyses is to compare laparoscopic versus robotic surgical hiatal hernia repair regarding clinically relevant postoperative complications, using the Clavien Dindo score 3.Methods After registration in PROSPERO, a literature review was performed following the PRISMA flow diagram, resulting in eleven studies. Their quality was assessed using the Newcastle-Ottowa scale. Risk of bias was assessed using the ROBINS-I tool. Statistical analysis was performed using Python. The primary outcome was Clavien Dindo score 3, the secondary outcomes were mortality, intraoperative complications, postoperative complications, length of stay and operation time.Results Eleven studies (182.467 patients in total, 12.056 robotic surgical repair) were analyzed. The meta-analysis showed no statistically significant result between CD score 3 (OR = 0,68 (95% CI 0,27 – 1,72)). From the investigated secondary outcomes, only intraoperative complications showed a significant difference favoring robotic repair (OR = 0,41 (95% CI 0,22 – 0,76) and p-value = 0,005).Conclusion Robotic hiatal hernia repair shows less intraoperative complications in comparison to laparoscopic repair. With the current available literature, no difference in Clavien Dindo score 3 is seen. To investigate the full potential of robotic surgery, prospective studies should be performed with surgeons who have passed their learning curve. Subgroup analyses regarding giant hiatal hernia and redo surgery should be performed. A uniform definition of ‘giant’ hiatal hernia is needed.

PMID:41481122 | DOI:10.1080/00015458.2025.2611452

Cancer Rep (Hoboken). 2026 Jan;9(1):e70415. doi: 10.1002/cnr2.70415.

ABSTRACT

BACKGROUND: Cancer remains one of the leading global health problems, with treatments that can compromise patients’ quality of life.

AIMS: This study aimed to determine the prevalence and characteristics of resilience in cancer patients and to analyze the influence of psychological and social factors on disease perception.

METHODS AND RESULTS: An analytical cross-sectional study was conducted between April and August 2023 including 61 cancer patients under treatment. Resilience was assessed with the RS-14, anxiety and depression with HADS (Hospital Anxiety and Depression Scale), and family functioning with the Family Apgar (Adaptation, Partnership, Growth, Affection, Resolve questionnaire). Sociodemographic and clinical data were obtained through structured questionnaires. Continuous variables were tested with Shapiro-Wilk and Levene’s tests; descriptive statistics, t-tests, Mann-Whitney U, Chi-square were applied. Binary logistic regression examined resilience predictors, adjusting for confounders (BMI, employment status, surgery). Statistical significance was defined as p ⟨ 0.05. Participants were 50.8% women, aged 35-82 years. Cancer types included breast (18%), lung (29.5%), colon (9.8%), pancreas (11.5%), renal (1.6%), and others (29.5%). 11.5% had not received oncological treatment, while 93.4% underwent surgery. Most were non-smokers (82%) and retired (57.4%). Main comorbidities were respiratory (24.6%) and cardiovascular (23%). In surveys, 54.1% reported family members with cancer and 36.1% noted a lack of free time affected quality of life. Mean scores: resilience 69.3 (SD = 22.1), anxiety 10.3 (SD = 3.2), depression 11.6 (SD = 2.2), Apgar 17.1 (SD = 3.7). Logistic regression identified Apgar as the only significant predictor of resilience (OR = 0.294, 95% CI 0.113-0.761, p = 0.012), with higher family functioning linked to lower resilience. Model accuracy was 81.1% overall, 90.9% for resilient, and 65.0% for non-resilient patients.

CONCLUSIONS: Social, clinical, and family situations all have an impact on cancer patients’ resilience. In order to maximize resilience and quality of life, family functioning appears as a contradictory component, indicating the necessity of psychological, family-centered, and interdisciplinary interventions.

PMID:41481118 | DOI:10.1002/cnr2.70415