Tag: pubmed

Hum Vaccin Immunother. 2026 Dec;22(1):2711163. doi: 10.1080/21645515.2026.2711163. Epub 2026 Aug 17.

ABSTRACT

Although prophylactic vaccination is highly effective against human papillomavirus (HPV), HPV vaccine uptake among Chinese college students remains insufficient, and evidence among medical university students, particularly males, remains limited. Following the recent approval of male HPV vaccines in China, this study evaluated vaccine awareness, acceptance, and potential barriers among both sexes. A cross-sectional online survey of 831 full-time undergraduate students at Anhui Medical University was conducted from October to December 2025. While overall HPV vaccine awareness was high (88.33%), the actual vaccination rate remained low at 25.55% (54.40% among females). Overall vaccination intention was 67.27%, exhibiting a profound gender disparity (92.80% in females vs. 46.27% in males, P < .001). Multivariable analyses showed that female vaccination uptake was significantly associated with familial socioeconomic factors, particularly monthly living allowance and maternal educational attainment. In male students, neutral or opposing attitudes toward a national male HPV vaccination policy were associated with lower vaccination intention (OR = 0.61, 95% CI: 0.409-0.898; OR = 0.27, 95% CI: 0.084-0.756), whereas a maximum acceptable vaccine cost of RMB 1,000-2,000 was associated with higher intention (OR = 1.61, 95% CI: 1.003-2.592). Additionally, female students showed higher HPV-related knowledge scores and greater reliance on interpersonal and professional information sources. Ultimately, these findings suggest that improving HPV vaccine uptake among medical university students in China may require targeted educational strategies and more accessible vaccination support, particularly for male students and those with fewer socioeconomic resources.

PMID:42605588 | DOI:10.1080/21645515.2026.2711163

Phys Biol. 2026 Aug 17;23(4). doi: 10.1088/1478-3975/ae934f.

ABSTRACT

Recent studies have suggested that under high or near-maximal mitochondrial respiratory activity, ion-translocating proteins within the inner mitochondrial membrane may generate transient nonequilibrium temperature fluctuations in the adjacent mitochondrial matrix and intermembrane space. Such nonequilibrium temperature fluctuations may, in principle, influence mitochondrial mechanics and morphology. Building on elastocapillary models of mitochondrial dynamics, we investigate whether these nonequilibrium temperature fluctuations can modulate the stability of mitochondrial tubules through temperature-dependent changes in effective membrane tension and elasticity. Our numerical analysis predicts that this effect is strongly threshold-dependent: in deeply unstable states, thermal modulation remains insufficient to restore stability, whereas closer to the threshold, temperature-dependent reduction of effective membrane tension can overcome temperature-dependent elastic softening, thereby increasing the elastocapillary number, suppressing unstable modes, and shifting mitochondria toward mechanically more stable tubular states. In other words, when mitochondria begin shifting toward fission-promoting states, elevated respiratory activity, which increases the magnitude and cumulative temporal occupancy of transient thermal perturbations, tends to shift the system back toward mechanical stability. However, when mitochondria are already far within the mechanically unstable regime, transient thermal activity is no longer sufficient to restore stability. This stabilizing regime is qualitatively consistent with experimental observations linking elevated oxidative phosphorylation to mitochondrial elongation, fusion, or hyperfusion rather than fragmentation.

PMID:42605586 | DOI:10.1088/1478-3975/ae934f

Glob Health Action. 2026 Dec;19(1):2717007. doi: 10.1080/16549716.2026.2717007. Epub 2026 Aug 17.

ABSTRACT

Non-communicable diseases (NCDs), including cardiovascular diseases, cancers, diabetes and chronic respiratory diseases, represent a growing inpatient burden worldwide. Yet hospital-based cross-national mixed-methods comparisons remain scarce, and the factors shaping inpatient NCD care are poorly understood. This protocol describes an explanatory sequential mixed-methods study examining inpatient NCD characteristics, disease patterns and hospitalisation indicators in tertiary hospitals in New Zealand and China, and exploring multilevel influences on NCD care. Guided by the Social Ecological Model, the study will be conducted at Waikato Hospital and the Third People’s Hospital of Yibin. In the quantitative phase, de-identified discharge records of adult inpatients aged ≥ 16 years with a primary diagnosis of one of the major NCDs will be extracted for 2023-2025. Analyses will be stratified by NCD category, and multivariable regression models with site as a fixed effect will examine variations in hospitalisation outcomes. In the qualitative phase, semi-structured interviews will be conducted with approximately 30-40 healthcare professionals across both settings. Interview data will be analysed thematically and integrated with quantitative findings using joint displays. To our knowledge, this is the first mixed-methods comparison of inpatient NCD care between tertiary hospitals in China and New Zealand. Findings are expected to support cross-cultural learning and inform evidence-based strategies to improve inpatient NCD management across diverse healthcare systems. This protocol is reported in accordance with the GRAMMS, STROBE and COREQ guidelines.

PMID:42605570 | DOI:10.1080/16549716.2026.2717007

J Nurs Manag. 2026;2026(1):e2162912. doi: 10.1155/jonm/2162912.

ABSTRACT

INTRODUCTION: Effective time management is crucial for nurses, and identifying factors contributing to time-wasting behaviors is a key component of time management. Currently, China lacks validated, standardized tools for assessing time wasters among nurses. This study is designed to adapt the Nurses Time-Wasters Questionnaire into a Chinese version and to evaluate the reliability and validity of this adapted instrument within a population of Chinese nurses.

METHODS: This cross-sectional study was conducted in China from September to November 2025, recruiting 330 nurses through convenience sampling. The translation process used the forward-backward translation method. Content validity was assessed by consulting 10 experts and calculating I-CVI and S-CVI/Ave values. Construct validity was assessed using exploratory factor analysis (EFA; n = 130) followed by confirmatory factor analysis (CFA; n = 200). Internal consistency reliability was measured with Cronbach’s α coefficient. All analyses were conducted in SPSS 27.0 and AMOS 29.0.

RESULTS: All items were retained, with only some items undergoing cultural adaptation modifications. Adequate sampling was indicated by the Kaiser-Meyer-Olkin (KMO) score of 0.960. The data’s eligibility for factor analysis was confirmed by the significant Bartlett’s test of sphericity (χ² = 1202.469, df = 78, p < 0.001). One factor that explained 63.481% of the total variance was identified using EFA. The single-factor model showed good fit using CFA (χ²/df = 1.226, RMSEA = 0.034, GFI = 0.942, and TLI = 0.991). The total questionnaire’s Cronbach’s alpha coefficient was 0.956.

CONCLUSION: The Chinese version of the Nurses Time-Wasters Questionnaire demonstrates good reliability and validity, making it a reliable and effective measurement tool for assessing time-wasting behaviors among clinical nurses in China.

PMID:42605561 | DOI:10.1155/jonm/2162912

J Nurs Manag. 2026;2026(1):e1888100. doi: 10.1155/jonm/1888100.

ABSTRACT

AIM: This study aimed to identify factors associated with quiet quitting and perceived quiet firing among nurses and to examine the mediating role of work stress and the exploratory serial indirect association involving perceived quiet firing in the relationship between compulsory citizenship behavior and quiet quitting.

METHOD: A cross-sectional, model-testing design was employed with 624 nurses from three public hospitals. Sample size was determined pragmatically by inviting all eligible nurses not on long-term leave. Because all eligible nurses were invited during the study period, an a priori power analysis was not considered necessary. Instead, the sample size was pragmatically determined based on the accessible population. Statistical analyses included Pearson’s correlation, multivariate linear regression using the enter method, and regression-based bootstrap mediation analyses, including simple mediation models and an exploratory PROCESS Model 6 serial mediation model with 5000 resamples and 95% bias-corrected confidence intervals (BCIs).

RESULTS: Increases in general work stress and compulsory citizenship behavior were significantly associated with higher perceptions of quiet quitting and quiet firing. In addition, general work stress partially mediated the relationship between compulsory citizenship behavior and nurses’ perceptions of quiet quitting and quiet firing.

CONCLUSION: These findings highlight the importance of improving nurses’ working conditions, ensuring alignment between duties and job descriptions, and encouraging active participation in decision-making.

IMPLICATION FOR NURSING MANAGEMENT: Nursing managers should address organizational conditions associated with work-related stress and perceived involuntary resignation. Regular feedback mechanisms, workload monitoring, and inclusive decision-making processes may help strengthen commitment and reduce disengagement among nurses.

PMID:42605558 | DOI:10.1155/jonm/1888100

World J Surg. 2026 Aug 17. doi: 10.1002/wjs.70526. Online ahead of print.

ABSTRACT

INTRODUCTION: Patients undergoing emergency laparotomy are at high risk of surgical site infections (SSI), which contribute substantially to postoperative morbidity. Incisional negative pressure wound therapy (iNPWT) has been shown to reduce the incidence of SSI following elective surgery, however, its effectiveness in the emergency setting remains uncertain. Therefore, we conducted a systematic review and meta-analysis to evaluate the effectiveness of iNPWT in reducing SSI after emergency laparotomy.

METHODS: We searched PubMed, Embase, and Cochrane through November 2025 for randomized controlled trials (RCTs) and observational studies comparing iNPWT to standard dressings after emergency laparotomy. Odds ratios (OR) and mean differences (MD) were pooled for relevant outcomes with 95% confidence intervals using random-effects and inverse variance weighting. A two-tailed p-value < 0.05 was considered significant. Prespecified subgroup analyses restricted to RCTs were performed. Statistical heterogeneity was assessed using the I² statistic.

RESULTS: Fifteen studies (6 RCTs and 9 observational) including 3369 patients were analyzed. It was found that iNPWT was associated with significantly lower odds of overall (OR 0.36; p = 0.0003), superficial, and deep SSI, with consistent findings in RCT-only analysis (OR 0.41; p = 0.0221). iNPWT was also associated with lower odds of seroma (OR 0.57; p = 0.0325), with consistent results observed in RCT-only analyses (OR 0.54; p = 0.025). Hospital length of stay was shorter in the iNPWT group (MD -1.49 days; p = 0.04), and iNPWT was associated with lower odds of wound dehiscence (OR 0.47; p = 0.0062), however, these findings were not confirmed in RCT-only analyses. Postoperative complications, classified according to the Clavien-Dindo system, did not differ between groups (OR 0.93; p = 0.4973). Overall mortality was comparable between groups, although iNPWT was associated with higher follow-up mortality. This finding was not confirmed in RCTs.

CONCLUSION: In patients undergoing emergency laparotomy, iNPWT was associated with reduced odds of SSI and wound-related complications compared with standard dressings. Although iNPWT was associated with higher follow-up mortality, this finding was not confirmed in RCT-only analyses.

PMID:42605546 | DOI:10.1002/wjs.70526

Diabetes Obes Metab. 2026 Aug 17. doi: 10.1111/dom.71225. Online ahead of print.

ABSTRACT

BACKGROUND: Finerenone has emerged as a promising therapeutic agent for IgA nephropathy (IgAN). The role of finerenone in IgAN patients who have discontinued renin-angiotensin system inhibitor (RASi) therapy remains poorly defined.

METHODS: This retrospective, multicentre cohort study enrolled patients with primary IgAN who received finerenone and/or RASi treatment. Participants were categorised into three groups: the finerenone plus RASi, finerenone (after RASi discontinuation) and RASi groups. All participants had a baseline estimated glomerular filtration rate (eGFR) ≥ 25 mL/min/1.73 m² and urinary total protein (UTP) ≥ 0.5 g/day. The primary outcomes included the percentage change in UTP from baseline and the rate of significant response (defined as ≥ 50% reduction in UTP and < 20% increase in serum creatinine).

RESULTS: Following 1:1:1 propensity score matching, a total of 258 patients were analysed, with 86 in each group. At 12 months, UTP decreased by 32.24% in the finerenone group and 34.35% in the RASi group (p = 0.220). The finerenone plus RASi group achieved a significantly greater reduction of 54.43% compared with either monotherapy group (both p < 0.01). Kaplan-Meier analysis confirmed that the finerenone plus RASi group achieved superior significant response rates compared with either monotherapy group (both log-rank p = 0.001). No significant difference was observed between the RASi and finerenone groups (log-rank p = 0.856). Although the finerenone plus RASi group exhibited a numerically steeper total eGFR decline (-1.48 vs. -0.44 vs. -0.52 mL/min/1.73 m²/year) and a greater increase in the chronic eGFR slope (0.66 vs. 0.37 vs. 0.49 mL/min/1.73 m²/year), neither difference reached statistical significance compared with the finerenone or RASi groups. The incidence of adverse events was comparable across all three groups.

CONCLUSION: Finerenone achieved short-term proteinuria reductions in RASi discontinued IgAN patients similar to those achieved with RASi monotherapy. Finerenone combined with RASi enhanced antiproteinuric efficacy while maintaining safety.

PMID:42605541 | DOI:10.1111/dom.71225

Genetics. 2026 Aug 17:iyag217. doi: 10.1093/genetics/iyag217. Online ahead of print.

ABSTRACT

Multiparental populations have been produced for quantitative trait loci (QTL) mapping in many crops, where next-generation sequencing has become a cost-effective tool for genotyping. Previously, we have developed a hidden Markov framework denoted by MagicImpute_mma for genotype imputation in a multiparental population, which was implemented in Mathematica. However, its computational time increases quickly with the number of founders. In this work, we extend MagicImpute_mma into MagicImpute for increasing computational efficiency and robustness to various types of errors. Particularly, it has the following novel features: (1) allowing for multiple multiparental populations that may be connected by sharing founders, (2) allowing for many missing founders that are not available for sequencing, (3) accounting for allelic bias and overdispersion in next generation sequencing data, (4) inferring marker-specific error rates and filtering for markers with low error rates, and (5) being implemented in the high performance Julia language. Besides extensive simulation studies, we evaluate MagicImpute by three real datasets: the rice F2 population with sequence depth being low, the apple cross pollinated (CP) population with parents being outbred, and the sorghum multi-parent advanced generation inter-cross (MAGIC) population with 10 male sterile lines (out of 29 founders) missing. The results have shown that MagicImpute is well capable of imputing many missing founders if there are sufficient offspring (e.g. 20 per founder), and that MagicImpute is accurate for genotype imputation in connected bi- or multi-parental populations with various types of sequence errors, and it opens up new opportunities for QTL mapping after imputing many missing founders.

PMID:42605528 | DOI:10.1093/genetics/iyag217

JMIR Med Inform. 2026 Aug 14;14:e92838. doi: 10.2196/92838.

ABSTRACT

BACKGROUND: Sepsis-associated acute kidney injury (SA-AKI) is a frequent and life-threatening complication of sepsis. While the static lactate-to-albumin ratio (LAR) has prognostic value, its dynamic temporal evolution during early resuscitation and its utility for guiding clinical risk stratification remain underexplored.

OBJECTIVE: The aim of the study is to identify distinct dynamic trajectories of LAR, evaluate their independent associations with adverse clinical outcomes, and construct a practical prognostic nomogram for patients with SA-AKI.

METHODS: Data were extracted from the Medical Information Mart for Intensive Care IV database, including adult patients with SA-AKI and ≥ 3 lactate and albumin measurements within the first 72 hours of intensive care unit admission. A multicenter external validation cohort was assembled from 5 tertiary hospitals in Beijing, China. Group-based trajectory modeling identified distinct LAR trajectories. The primary outcome was 28-day mortality; secondary outcomes included 90-day mortality and continuous renal replacement therapy initiation. Trajectory-outcome associations were assessed using multivariable Cox and logistic regression models. Robustness was examined using restricted cubic splines, inverse probability of treatment weighting, weight truncation, doubly robust estimation, and subgroup analyses. Incremental predictive value beyond single baseline LAR was quantified, and a trajectory-integrated nomogram was developed and externally validated.

RESULTS: Among the 615 patients in the primary cohort, 3 LAR trajectories were identified: trajectory 1 (low-stable type), trajectory 2 (rapid-clearance type), and trajectory 3 (delayed-clearance type). In adjusted multivariable models, trajectory 3 (vs trajectory 1) was independently associated with increased 28-day mortality risk (hazard ratio 1.63, 95% CI 1.00-2.64; P=.0496), 90-day mortality (hazard ratio 1.72, 95% CI 1.14-2.60; P=.01), and continuous renal replacement therapy initiation (odds ratio 3.40, 95% CI 1.64-7.15; P=.001). Conversely, the mortality risk for trajectory 2 did not differ significantly from trajectory 1. Sensitivity analyses supported these findings, although trajectory 3 associations attenuated in inverse probability of treatment weighting-weighted analyses. Incorporating trajectories improved predictive accuracy over single baseline LAR (continuous net reclassification improvement 0.170, integrated discrimination improvement 0.023; both P=.01). In the external validation cohort (n=508), 3 analogous trajectories were identified. Trajectory 3 consistently conferred a higher mortality risk across both cohorts, whereas trajectory 2 was significantly associated with 28-day mortality only in validation. The nomogram exhibited modest discrimination in the external cohort (concordance index=0.612), acceptable calibration, and potential utility as a supplementary bedside risk stratification tool.

CONCLUSIONS: Dynamic LAR trajectories are independently associated with 28- and 90-day mortality in SA-AKI. The delayed-clearance trajectory identifies a specific high-risk phenotype, suggesting that longitudinal LAR monitoring and the constructed nomogram may support early risk stratification and inform clinical decision-making.

PMID:42605517 | DOI:10.2196/92838

Glob Health Epidemiol Genom. 2026;2026(1):e6687660. doi: 10.1155/ghe3/6687660.

ABSTRACT

BACKGROUND: Regular blood donation has been associated with lower cardiovascular risk in some studies, possibly through mechanisms involving reduced iron stores and oxidative stress.

OBJECTIVE: The study investigated the association between blood donation frequency and cardiovascular risk factors among voluntary blood donors.

METHODS: The cross-sectional study examined blood donors classified into regular donors and occasional donors. Blood pressure, body mass index (BMI), fasting blood glucose, and total cholesterol levels were measured. Standard clinical criteria were used to determine the cardiovascular risk factors. Independent t-tests and chi-square tests were analyzed to compare the two groups. Multivariate logistic regression was applied to control for possible confounding variables.

RESULTS: Regular donors demonstrated lower blood pressure measurements, which included systolic blood pressure of 118 ± 12 mmHg and diastolic blood pressure of 77 ± 8 mmHg. Donors who donated regularly demonstrated a lower BMI of 24.5 ± 3.1 kg/m² compared to donors who donated occasionally. Regular donors showed lower rates of hypertension, 22% compared to 39%, and elevated cholesterol, 21% compared to 35%, with a statistical significance of p = 0.04. The study found no differences between the groups regarding their fasting glucose levels or diabetes rates. Regular donors had lower odds of hypertension (OR = 0.52, 95% CI: 0.30-0.89) and elevated cholesterol (OR = 0.56, 95% CI: 0.33-0.95), while the association with overweight/obesity did not reach statistical significance.

CONCLUSION: Regular blood donation was associated with more favorable cardiovascular risk profiles among donors in this study.

PMID:42605499 | DOI:10.1155/ghe3/6687660