Tag: pubmed

Nurs Open. 2026 Jun;13(6):e70630. doi: 10.1002/nop2.70630.

ABSTRACT

AIM: To explore the chain mediating effects of self-esteem and coping modes on the relationship between social support and stigma with rheumatoid arthritis patients and to identify actionable targets for nursing interventions.

DESIGN: A multicentre, cross-sectional, correlational study.

METHODS: Using convenience sampling, RA patients were recruited from the rheumatology departments of four hospitals in China, from June to September 2023. The Internalized Stigma of Mental Illness Scale-Rheumatoid Arthritis (ISMI-RA), Social Support Rating Scale (SSRS), Rosenberg Self-Esteem Scale (RSES) and Medical Coping modes Questionnaire (MCMQ) were used to assess the patients’ stigma, social support, self-esteem and coping styles. SAS 9.4 software was used for statistical analysis. Normally distributed continuous data were described using means and standard deviations. Independent sample t-tests and analysis of variance (ANOVA) were used for comparisons between groups. The Pearson correlation coefficient was used to describe the degree of correlation between variables. The chain mediating model was constructed using AMOS 24.0 software, and the maximum likelihood method was used for model parameter estimation, and the model was adjusted according to the modification index.

RESULTS: Mean participant age was 53.62 ± 12.40 years. Stigma scores differed significantly by family history, income, education, morning stiffness duration, DAS28 and pain level (all p < 0.001). Stigma correlated negatively with self-esteem (r = -0.482), confrontation coping (r = -0.512) and social support (r = -0.590) and positively with avoidance (r = 0.251) and acceptance coping (r = 0.462). Social support was directly associated with stigma (β = -0.502) and also indirectly associated through self-esteem and coping modes, with the indirect pathways accounting for 31.51% of the total association.

CONCLUSION: The findings suggest that patients with RA frequently experience moderate stigma, and that self-esteem and coping modes may serve as chain mediators between social support and stigma. Nurses may consider assisting patients in building positive social support networks, enhancing their self-esteem and promoting positive coping modes as potential strategies to reduce stigma.

PMID:42324729 | DOI:10.1002/nop2.70630

NMR Biomed. 2026 Aug;39(8):e70342. doi: 10.1002/nbm.70342.

ABSTRACT

Ultrashort echo time (UTE) and zero echo time (ZTE) techniques have been shown to generate robust functional MRI (fMRI) contrast of hemodynamic origin from the inflow of unperturbed spins into the imaging volume under local radiofrequency transmission. As such, they are ideally suited not only to map the dynamics of cerebral blood flow (CBF) during intense neuronal activity but also the dynamics of cerebrospinal fluid (CSF). The goal of this work was to pilot the use of UTE-fMRI for human studies of brain activation and neurofluid dynamics. We thus conducted fMRI studies at 7 T with a transmit/receive head coil using a slab-selective UTE sequence on 13 human participants during a visual task. Spatio-temporally matched gradient-echo echo planar imaging (GE-EPI) data were also acquired for qualitative comparison purposes, and respiratory and cardiac signals were measured to quantify multiple physiological metrics. Functional brain activations were analyzed using a general linear model at single subject and group levels. Moreover, time-courses from the whole cortex, carotid arteries, and fourth ventricle were correlated between each other, and physiological contributions to these ROI signals were evaluated with a linear mixed model and a relative importance computation. Robust and reproducible functional activations were detected with UTE-fMRI in the visual cortex across participants. Although the functional contrast-to-noise ratio was higher with GE-EPI than with UTE, the temporal signal-to-noise ratio was lower, and group-level statistical power and activation patterns of UTE maps were similar to those obtained with GE-EPI. In addition, the UTE task-evoked signal in CSF was negatively correlated with those in the whole cortex and in the carotid arteries and was primarily driven by the stimulus paradigm. We conclude that UTE-fMRI can be used not only for functional studies of the human brain but also for assessing the relationship between hemodynamic and CSF signals, which can help elucidate brain homeostatic processes.

PMID:42324687 | DOI:10.1002/nbm.70342

Nutr Clin Pract. 2026 Jun 21. doi: 10.1002/ncp.70140. Online ahead of print.

ABSTRACT

BACKGROUND: Gastrostomy tube placement is a common intervention for long-term nutrition in people with dysphagia. Minimising complications such as tube dislodgement is integral in gastrostomy management, as unplanned replacements may require urgent care to prevent stoma closure. Anecdotally, people living with motor neurone disease (plwMND) have frequent complications, although the frequency compared to other conditions remains unknown. This single-centre retrospective audit aimed to quantify and compare gastrostomy-related complications between MND and other conditions.

METHODS: All adults managed with a gastrostomy from 2016 to 2021 attending a single centre, dietitian-led gastrostomy service were included. The service database and medical records were screened for complications including unplanned tube replacements, infection, hypergranulation tissue, compromised tube integrity or dislodgement and their frequency was compared in those with MND and in those with other conditions.

RESULTS: In total, n = 193 replacement gastrostomy tubes were required in n = 51 individuals. People living with MND had a statistically nonsignificantly lower rate and likelihood of first unplanned replacement compared to other conditions after adjustment for age (HR 0.42). Modelling demonstrated a reduced risk of unplanned replacement with a history of previous infection and hypergranulation tissue, and an increased risk with a history of compromised tube integrity and previous displacement in plwMND. Of unplanned replacements, 48% occurred between 90 to 180 days, with tube integrity the most frequently associated complication.

CONCLUSION: People living with MND were more likely to experience hypergranulation tissue but did not have a higher rate of unplanned tube replacements compared to those with other conditions. People experiencing higher rates of unplanned gastrostomy replacements may benefit from strategies to reduce complications.

PMID:42324684 | DOI:10.1002/ncp.70140

Nurs Open. 2026 Jun;13(6):e70637. doi: 10.1002/nop2.70637.

ABSTRACT

AIMS: To describe the status of nurses’ behaviours towards promoting mobility among hospitalized older adults in China, and to explore modifiable enablers and barriers for nurses.

DESIGN: A sequential-explanatory mixed method design was used to collect data from nurses in three tertiary teaching hospitals in Hunan Province, China.

METHODS: Quantitative data were collected using the Nurses’ Behaviour Towards Promoting Mobility Scale, which covers eight dimensions: physical fitness assessment, exercise guidance, daily activities guidance, joint movement assistance, physical therapists’ consultation, environment arrangement, mobilization assistance and cognition stimulation. Qualitative data were collected through in-depth individual interviews, with questions developed based on the quantitative findings. Descriptive statistics, one-way ANOVA and multiple linear regression were used to analyse the quantitative data. Interview transcripts were analysed thematically and mapped to the capability, opportunity, motivation and behaviour (COM-B) model. Quantitative and qualitative findings were integrated using a joint display approach.

RESULTS: The overall level of nurses’ mobility promotion behaviours was moderate (156.15 ± 23.94), with scoring rates varying across dimensions (50.69%-81.69%). Nurses’ behaviours were significantly associated with their working positions and departments. Further, the qualitative data revealed six barriers including ‘insufficient competence’, ‘lack of standardized protocols’, ‘fear of adverse events’, ‘unclear nurse role’, ‘lack of time’, and ‘limited environment and equipment’, and four facilitators, such as ‘practice-based training’, ‘incentive policies’, ‘family involvement’ and ‘organizational expectations’. The quantitative and qualitative findings were convergent, dissonant, complementary or silent.

CONCLUSION: Nurses’ behaviours towards promoting mobility were suboptimal and influenced by multiple barriers and enablers related to the COM-B model. These findings need to be considered when developing targeted nurse-driven mobility promotion interventions to improve the functional abilities of hospitalized older adults.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This study emphasizes the necessity of improving nurses’ behaviours in promoting older inpatients’ mobility. Adequate practice-based training is essential to enhance nurses’ capability in this area. Additionally, fostering a sense of responsibility and implementing an incentive policy could boost motivation. At the organizational level, clear protocols and standardized procedures, together with supportive ward environments, may increase opportunities for implementation. Involving family members in mobility promotion care might be an alternative way considering nurses’ heavy workload and time limitations.

REPORTING METHOD: The study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for the quantitative component, the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist for the qualitative component, and the Good Reporting of A Mixed Methods Study (GRAMMS) guideline for the reporting of mixed methods.

PATIENT OR PUBLIC CONTRIBUTION: Nurses participated in the quantitative study and qualitative interviews that informed this study.

PMID:42324679 | DOI:10.1002/nop2.70637

Int J Ment Health Syst. 2026 Jun 21. doi: 10.1186/s13033-026-00716-x. Online ahead of print.

ABSTRACT

This article examines the relationship between behavioral and Environmental, Social, and Governance (ESG) variables and the Mental Health Index (MHI) of Italian regions from 2016 to 2023. The use of descriptive statistics, cluster analysis, and forecasting models is employed for descriptive and exploratory purposes, as well as for forecasting regional disparities in mental health. Relative stability at the state level and persistent territorial variability are evident in the MHI derived from the ISTAT-BES indicators, with the North and Centre performing better than the South, except for notable improvements in disadvantaged regions such as Calabria and Campania. Behavioral factors, particularly sedentariness, smoking, and multimorbidity, are consistently associated with adverse trends for mental health, while adequate nourishment and exposure to urban green spaces are found to be protective. ESG-related factors, including occupational security and judicial efficacy, also contribute to these inequalities, attributing mental health status as part of the more general system effects of institutions and environments. Cluster analysis identifies distinct regional typologies based on aggregated behavioral and ESG patterns, while the predictive model highlights multimorbidity, smoking, and sedentary behavior as the most relevant factors negatively associated with the Mental Health Index (MHI), and urban green availability as a key factor positively associated with it. They point out that Italian mental health disparities are not only associated with behavioral determinants of individuals, but must be addressed from a multi-faceted ESG perspective. Policy reactions also mean that public health responses must attend not only to lifestyle risk factors but also structural determinants and incorporate active living promotion, reduction of smoking prevalence, investment in green infrastructures, and improvement of governance efficiency.

PMID:42324584 | DOI:10.1186/s13033-026-00716-x

BMC Sports Sci Med Rehabil. 2026 Jun 22. doi: 10.1186/s13102-026-01818-2. Online ahead of print.

ABSTRACT

BACKGROUND: Prolonged sedentary work is associated with hamstring tightness, reduced flexibility, and functional limitations among information technology (IT) professionals. Comparative evidence for static stretching and myofascial release (MFR) in this population remains limited.

OBJECTIVE: To compare the short-term effects of static stretching and myofascial release on hamstring tightness and lower extremity function in sedentary IT professionals.

METHODS: In this two-arm randomized controlled trial, 30 IT professionals were allocated to static stretching (n = 15) or MFR (n = 15). Both groups received stipulated treatment five times weekly for three weeks. Active knee extension range of motion (AKE-ROM) was the primary outcome measure, and the self-reported Lower Extremity Functional Scale (LEFS) was the secondary outcome measure. Outcomes assessments were performed at baseline and days 8, 15, and 22. Data were analyzed using linear mixed-effects models examining group, time, and group-by-time interaction effects, with Bonferroni-adjusted post hoc comparisons.

RESULTS: Both interventions significantly improved AKE-ROM and self-reported LEFS over time (all p < 0.001). A significant group-by-time interaction favored static stretching for AKE-ROM, with greater adjusted improvements at Day 15 (mean difference 3.27°, 95% CI 2.28-4.26) and Day 22 (5.20°, 95% CI 4.21-6.19; both p < 0.001). Although these between-group differences were statistically significant, the Day 22 difference remained smaller than previously reported minimal detectable change values for the AKE test. Self-reported LEFS scores improved significantly in both groups, with between-group differences remaining small and below clinically meaningful thresholds, indicating broadly comparable functional benefit. Sensitivity analyses adjusting for age and BMI yielded consistent findings. No adverse events were reported.

CONCLUSIONS: Both interventions improved AKE-ROM and self-reported LEFS over the study period. Static stretching demonstrated statistically greater improvements in AKE-ROM; however, the magnitude of this difference was smaller than published minimal detectable change values, and its clinical importance remains uncertain. Given the absence of a control group and the short follow-up period, findings should be interpreted cautiously.

TRIAL REGISTRATION: ClinicalTrials.gov NCT06586554; initial release date: 04/09/2024.

PMID:42324573 | DOI:10.1186/s13102-026-01818-2

BMC Psychol. 2026 Jun 22. doi: 10.1186/s40359-026-04918-3. Online ahead of print.

ABSTRACT

BACKGROUND: As educational priorities increasingly emphasize higher-order cognitive skills over rote memorization, it has become essential to clarify how these competencies interact in young learners. To address this, the current study examines how primary school students’ problem-solving and decision-making skills mediate the relationship between their critical thinking dispositions and self-perceptions of success.

METHOD: The sample consisted of 285 third- and fourth-grade students in Türkiye, aged 8 to 10 years, who were selected based on their enrollment status, absence of psychiatric diagnoses, and voluntary participation. Data were collected in person using paper-based surveys. Four instruments were administered: the Critical Thinking Dispositions Scale, the Problem-Solving Inventory for Children, the Decision-Making Skills Scale, and the Perception of Success Scale. Direct and indirect relationships between variables were assessed using path analysis. Bootstrapping procedures determined the statistical significance of the mediating effects.

RESULTS: The indirect effects of decision-making and problem-solving skills on the relationship between critical thinking disposition and perception of success were statistically significant [β = .20, SE = .05 (95% CI = .095, .308)]. The results indicate that students with advanced critical thinking, problem-solving, and decision-making skills are more likely to perceive themselves as academically successful.

CONCLUSION: The study confirms that critical thinking, problem-solving, and decision-making are interconnected competencies that significantly predict students’ perceptions of success. These results support educational initiatives that prioritize higher-order cognitive abilities over basic knowledge retention. Ultimately, educators are encouraged to implement comprehensive curricula that simultaneously develop these skills to prepare students for real-world challenges.

PMID:42324563 | DOI:10.1186/s40359-026-04918-3

J Cardiothorac Surg. 2026 Jun 21. doi: 10.1186/s13019-026-04478-y. Online ahead of print.

ABSTRACT

OBJECTIVES: Lung cancer is a leading cause of cancer-related death globally, with non-small cell lung cancer (NSCLC) being the predominant form. Genetic factors significantly influence individual susceptibility. This study investigated the association of TP63 (rs7631358) and CIR1 (rs13009079) polymorphisms with NSCLC risk in a Chinese population.

METHODS: A case-control study was conducted with 500 NSCLC patients and 500 matched controls. Genotyping was performed using the SEQUENOM MassARRAY platform. Associations were evaluated using chi-square tests and logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS: In the pre-specified primary analysis with FDR correction, both TP63 rs7631358 (A/G + A/A vs. G/G: adjusted OR = 1.409, FDR P = 0.030) and CIR1 rs13009079 (T/T vs. C/T + C/C: adjusted OR = 1.390, FDR P = 0.030) were significantly associated with an increased risk of lung adenocarcinoma after adjustment for smoking status, gender, and age. Exploratory subgroup analyses suggested that the TP63 association was more pronounced among ever-smokers, although the gene-smoking interaction did not reach statistical significance.

CONCLUSIONS: TP63 rs7631358 and CIR1 rs13009079 polymorphisms are significantly associated with the susceptibility to lung adenocarcinoma in the Chinese Han population after correction for multiple testing. These findings support a role for the TP63-mediated DNA damage response pathway and the CIR1-Notch signaling pathway in ADC pathogenesis. Replication in larger, independent cohorts is warranted to confirm these associations and to further evaluate their potential for clinical risk stratification.

PMID:42324549 | DOI:10.1186/s13019-026-04478-y

Diabetol Metab Syndr. 2026 Jun 21. doi: 10.1186/s13098-026-02215-y. Online ahead of print.

ABSTRACT

BACKGROUND: Sugar-sweetened beverages (SSBs) consumption has become an emerging global public health concern. The relationship between SSBs consumption and mortality is not yet fully clarified. This study aims to quantify the dose-response relationships between SSBs consumption and mortality risks in US and UK cohorts, while also reviewing up-to-date estimates of SSB-related burden from 1990 to 2021 at a national level.

METHODS: We conducted a nationwide prospective cohort study and systematic analysis. The study included 13,438 participants from US National Health and Nutrition Examination Survey (NHANES) (1999-2000 and 2017-2018), and 63,436 participants from UK Biobank (2006-2010). For the systematic analysis using Global Burden of Disease (GBD) 2021 data, mortality and disability-adjusted life years (DALYs) for the US and UK (1990-2021) were analyzed to generate estimates.

RESULTS: In the US population, during a 9.17-year cohort follow-up, 1,929 deaths were identified among 13,438 participants, while in the UK population, during a 12.41-year cohort follow-up, 3,466 deaths were identified among 63,436 participants. A significant dose-response association was found between higher SSBs consumption and increased all-cause mortality (both P for trend < 0.001), as well as mortality due to cardiovascular disease and chronic lower respiratory diseases. In GBD, SSBs-related mortality and DALYs rates were higher in older populations (55 + years) in both countries, consistent with the results in US NHANES and UK Biobank. Ischemic heart disease and type 2 diabetes mellitus were leading contributors to these burdens.

CONCLUSIONS: This study establishes a robust relationship between SSBs consumption and all-cause mortality, mortality caused by cardiovascular disease and chronic lower respiratory diseases. In line with GBD findings, SSBs consumption, especially among elderly populations, should be considered a crucial public health concern.

PMID:42324544 | DOI:10.1186/s13098-026-02215-y

BMC Oral Health. 2026 Jun 22. doi: 10.1186/s12903-026-08935-x. Online ahead of print.

ABSTRACT

BACKGROUND: Tongue function significantly influences craniofacial development, yet the morpho-functional characteristics of the tongue across different sagittal skeletal patterns remain unclear. This study aimed to quantitatively evaluate tongue muscle strength and resting posture in adolescents, delineate their biomechanical pathways, and construct data-driven diagnostic models for sagittal skeletal patterns.

METHODS: A cross-sectional study was conducted on 182 adolescents (11-17 years) stratified into Class I, II, and III sagittal patterns based on the ANB angle. Maximum active tongue pressure (MTP) was measured using a digital dynamometer. Resting posture, including the Tongue Tip Index (TTI), Tongue Tip Distance (TTD), and Tongue Dorsum Distance (TDD), was evaluated using lateral cephalograms. Data were analyzed using multivariable linear regression analysis, mediation analysis, and a Chi-squared Automatic Interaction Detection (CHAID) algorithm.

RESULTS: The Class III cohort exhibited significantly reduced MTP (median: 1.65 kg) compared to Class I and II subjects (~ 2.20 kg; P < 0.001). Mediation analysis identified a partial mediation relationship: while MTP demonstrated a significant direct statistical association with the ANB angle, 32.4% of the total association was indirectly mediated through TTI. The CHAID model identified reduced MTP (≤ 1.85 kg) as the primary root node associated with Class III risk. TTI (≤ 2.57%) served as a critical secondary stratifier of Class III risk.

CONCLUSIONS: In adolescents, skeletal Class III malocclusion is associated with reduced tongue pressure and a lowered resting posture. Tongue muscle force demonstrates both a direct statistical association with the sagittal skeletal base and an indirect association mediated by the maintenance of an appropriate tongue tip position. The diagnostic model highlights reduced MTP as the primary risk indicator for Class III patterns, which is further stratified by TTI.

PMID:42324535 | DOI:10.1186/s12903-026-08935-x