Tag: pubmed

Front Public Health. 2026 Mar 25;14:1763427. doi: 10.3389/fpubh.2026.1763427. eCollection 2026.

ABSTRACT

INTRODUCTION: This paper presents work in the continuum of campus-community partnerships to train health science students to advance health equity. The authors share the development, implementation, and evaluation of “Interprofessional Approaches to Health Disparities” (IAHD), a course offered at the University of Illinois Chicago, a large, urban, public, academic institution.

METHODS: The IAHD course focuses on selected vulnerable populations: Geriatrics, HIV/AIDS, Homelessness, Immigrant and Refugee Health, Incarcerated Populations, and Intimate Partner Violence. Health science students from medicine, nursing, pharmacy, dentistry, and public health learn in interprofessional teams, with didactic and experiential learning activities. Training includes addressing social determinants of health through interprofessional education and mentored community-based participatory research projects. The Kirkpatrick’s framework was used for program evaluation, with a retrospective pre-post design to measure self-efficacy for competence in interprofessional collaborative practice (IPC) using IPECC-SET, a validated instrument. The evaluation goal was to explore the impact of the learning experiences on attainment of learning objectives. Descriptive analysis of quantitative data explored the extent to which the learning objectives were met. Paired t-tests examined pre-post differences in self-efficacy for competence in IPC. Thematic analysis was conducted for open-ended qualitative data.

RESULTS: Since its inception, 202 students have participated in the course. Program evaluation results indicate that students view the learning experiences positively; cumulatively, over 90% agreed that the course learning objectives were met. Analysis of the IPECC-SET data demonstrated statistically significant (p < 0.001) increases in self-efficacy for IPC across all 38 items, in all four domains. Qualitative data analysis yielded themes regarding the most effective aspects of the course and how learning experiences prepared students for their future work.

DISCUSSION: Thus far, eleven cohorts of interprofessional health science students have been trained as a cadre of future health professionals, encouraged to continue practicing advocacy, leadership, scholarship, and interprofessional teamwork to advance health equity. The IAHD course is an exemplar of “Education in Action” and has led to meaningful contributions to the training of the future health professions workforce. It addresses workforce development needs, with a special focus on mitigating health disparities and advancing health equity to meet the challenges of the 21st century.

PMID:41960395 | PMC:PMC13057566 | DOI:10.3389/fpubh.2026.1763427

Front Public Health. 2026 Mar 25;14:1805252. doi: 10.3389/fpubh.2026.1805252. eCollection 2026.

ABSTRACT

BACKGROUND: Amidst the rapidly evolving global healthcare environment, junior nurses must develop greater adaptability. However, issues such as workplace bullying significantly undermine their adaptive performance. Guided by the Job Demands-Resources Theory and Emotion Regulation Theory, this study examines the chain-mediating role of cognitive reappraisal, expressive suppression, and work engagement in the relationship between workplace bullying and adaptive performance.

METHODS: From April to May 2024, a cross-sectional survey was conducted in 17 hospitals in Southwest China. The study utilized a comprehensive set of measurement tools, including the General Information Questionnaire, the Negative Acts Questionnaire-Revised, the Emotion Regulation Questionnaire, the Work Engagement Questionnaire, and the Adaptive Performance Questionnaire. All statistical analyses were performed with SPSS and Mplus.

RESULTS: A total of 988 junior nurses were included in this study. Adaptive performance was negatively correlated with workplace bullying (r = -0.335) and expressive suppression (r = -0.180) and positively correlated with cognitive reappraisal (r = 0.556) and work engagement (r = 0.576) (all p < 0.01). The indirect effect of workplace bullying on adaptive performance via emotion regulation and work engagement was significant (standardized indirect effect = -0.188, 95% BC CI [-0.238, -0.138]), accounting for 51.8% of the total standardized effect.

CONCLUSION: There was a significant negative correlation between workplace bullying and adaptive performance of junior nurses, in which cognitive reappraisal, expressive suppression, and work engagement played a mediating role. This suggests that when healthcare institutions and nursing administrators develop strategies to enhance adaptive performance, they should mitigate workplace bullying and enhance cognitive reappraisal capabilities, reduce expressive suppression tendencies, and strengthen work engagement levels. However, the cross-sectional design precludes causal inferences, and the regional sample may limit generalizability.

PMID:41960394 | PMC:PMC13057310 | DOI:10.3389/fpubh.2026.1805252

Front Public Health. 2026 Mar 25;14:1731670. doi: 10.3389/fpubh.2026.1731670. eCollection 2026.

ABSTRACT

BACKGROUND: Cultivating public protective behaviors is essential for the successful prevention and control of emerging infectious diseases epidemics, such as COVID-19. Government information release plays an important role in promoting proactive public protective behaviors. The existing literature lacks comprehensive understanding of the impact of government information release on public protective behaviors under different conditions.

METHODS: This research proposes a number of research hypotheses for the effect of government information release on public protective behaviors mediated by risk perception and institutional trust. The Mediator, also known as the mediating variable, is a significant statistical concept employed to analyze the mechanism of influence between the independent and dependent variables.

RESULTS: The empirical research during the normalization phase of COVID-19 epidemics prevention and control in China indicates that government information release significantly influences public protective behaviors by the mediating roles of risk perception and institutional trust.

CONCLUSION: The research provides insights for designing strategies for cultivating public protective behaviors from the perspective from the information release and fostering institutional trust.

PMID:41960388 | PMC:PMC13057391 | DOI:10.3389/fpubh.2026.1731670

Front Public Health. 2026 Mar 25;14:1703400. doi: 10.3389/fpubh.2026.1703400. eCollection 2026.

ABSTRACT

BACKGROUND: Hearing loss and tinnitus in children are increasingly recognized as important public health concerns with potential long-term consequences for development and communication. The aim of this study was to determine the prevalence of hearing loss and tinnitus in children, and to examine the concordance between parental subjective assessments and otoacoustic emission (OAE) results. Secondary aims were to investigate the association between hearing loss and sociodemographic factors, parents’ level of education, and to evaluate the effectiveness of different diagnostic methods in detecting pediatric hearing impairment.

METHODS: This cross-sectional study involved 1,250 children aged 7-17 years. Participants underwent tympanometric, hearing threshold and OAEs testing and were divided into two groups according to age. Parents completed a questionnaire regarding hearing loss and presence of tinnitus.

RESULTS: The prevalence of positive hearing screening results was 3.5%, with a higher incidence in younger children, (the difference was not statistically significant). The prevalence of hearing loss was 4.5% among boys and 2.5% among girls (p = 0.097). A statistically significant discrepancy was observed between parental reports of hearing status and OAE results (p = 0.006). The prevalence of tinnitus in children and adolescents aged 7-17 years was 4.7%, with no significant statistical difference observed between age groups. Abnormal results in OAE were not associated with tinnitus (the results were not statistically significant). A statistically significant association was observed between hearing loss detected by OAE and caregiver education (p = 0.040, Z = -2.05), and between hearing loss and increased healthcare costs (p = 0.015). The effectiveness of hearing loss detection differed significantly between the diagnostic methods used (p = 0.030), with OAE testing showing the highest detection rate.

CONCLUSION: This study identifies a measurable prevalence of hearing loss and tinnitus among children, with a greater burden of hearing impairment observed in younger age. There is need for systematic, school-based hearing screening programs and improved parental and educator awareness of early hearing loss indicators. These findings support the integration of standardized pediatric hearing monitoring into public health strategies and underscore the importance of addressing socioeconomic disparities in access to early diagnosis and intervention.

PMID:41960387 | PMC:PMC13057448 | DOI:10.3389/fpubh.2026.1703400

Front Public Health. 2026 Mar 25;14:1766801. doi: 10.3389/fpubh.2026.1766801. eCollection 2026.

ABSTRACT

OBJECTIVE: This study evaluated the effectiveness of a health education program based on the PRECEDE-PROCEED model in improving self-care, QOL, and biochemical outcomes among HD patients in Indonesia.

METHODS: A quasi-experimental study was conducted involving 90 HD patients allocated to intervention (n = 45) and control (n = 45) groups using a systematic assignment approach. The intervention group received an eight-session PRECEDE-PROCEED-based education program over 4 weeks, while the control group received standard care. Self-care was measured using the Chronic Kidney Disease Self-Management (CKDSM) Questionnaire, QOL was assessed using the SF-36, and biochemical outcomes were evaluated via serum urea and creatinine levels. Data were analyzed using appropriate parametric and non-parametric statistical tests, and effect sizes were calculated using Cohen’s d.

RESULTS: Post-intervention, the intervention group showed significantly greater improvements in self-care (mean difference = 18.33; p < 0.001), QOL (mean difference = 17.25; p < 0.001), and reductions in urea and creatinine levels (p < 0.001 and p = 0.006, respectively), compared to the control group. Large effect sizes were observed for self-care and QOL.

CONCLUSION: The PRECEDE-PROCEED-based educational intervention was associated with improvements in self-care and quality of life, and with favorable short-term changes in selected clinical outcomes among patients undergoing hemodialysis.

PMID:41960384 | PMC:PMC13057427 | DOI:10.3389/fpubh.2026.1766801

BMC Med. 2026 Apr 9;24(1):217. doi: 10.1186/s12916-026-04819-7.

ABSTRACT

BACKGROUND: Stadelmaier et al. recently reported a pooled ratio of risk ratios (RRR) of 1.00 between population, intervention/exposure, comparator, outcome (PI/ECO) matched randomized controlled trials (RCTs) and cohort studies, interpreting this as evidence that randomized trials “confirm” observational findings in nutrition with “tremendous public health implications.” We hypothesized that this apparent agreement is not a validation of concordance, but an expected statistical effect arising from the pooling of null or small effect sizes with large variances rather than pairwise concordance.

METHODS: We re-analyzed the authors’ binary dataset (n = 54 pairs) using a permutation framework (B = 10,000) in which cohort studies were randomly reassigned to RCTs, breaking the original pairing (both globally and restricted within exposure-type strata) while preserving marginal distributions.

RESULTS: Under random pairing, 99.96% of permuted pooled RRRs fell within the authors’ reported confidence interval [0.91,1.10], and the observed RRR was statistically indistinguishable from the random-pairing permutation distribution (p = 0.12). A pairwise discrepancy statistic showed no improvement with matching over random pairing (p = 0.21). A precision-weighted statistic was significant (p = 0.008), but weight was highly concentrated: 4 pairs (7% of n) accounted for 54.8% of total weight, and the effective number of pairs was 9.9 (18% of n). Qualitative concordance using the authors’ prior criteria was only 13% (7/54 pairs).

CONCLUSIONS: A pooled RRR near 1.00 indicates only that cohort effect sizes are not systematically different from RCT estimates. In this dataset, an RRR near 1 is a result expected under random pairing. Pairwise agreement is not improved by PI/ECO matching for typical comparisons; the significant weighted statistic reflects alignment among a small minority of high-precision pairs, not “most” findings. Pooled RRR lacks resolution as a confirmation metric in fields with small effects and should not be interpreted as evidence of replication; otherwise, it may inappropriately influence evidence synthesis practices.

PMID:41957646 | DOI:10.1186/s12916-026-04819-7

J Nanobiotechnology. 2026 Apr 10. doi: 10.1186/s12951-026-04369-3. Online ahead of print.

ABSTRACT

BACKGROUND: Aortic dissection (AD) is a lethal condition involving vascular smooth muscle cell (VSMC) transformation and extracellular matrix degradation. While gut microbiota dysbiosis is implicated in cardiovascular diseases, its role in stress-exacerbated AD pathogenesis is unknown. This study investigates the mechanism linking chronic restraint stress (CRS) to AD progression via gut microbiota modulation.

METHODS: A β-aminopropionitrile (BAPN)-induced AD mouse model combined with CRS was utilized. Aortic dilation, mortality, and VSMC phenotype shift (assessed via α-SMA/SM22α and OPN/MMP2 expression) were evaluated. Gut microbiota composition was analyzed using 16 S rRNA sequencing. Microbiota depletion was achieved via antibiotics, and fecal microbiota transplantation (FMT) from CRS-exposed mice was performed. Serum metabolomics analysis, incorporating liquid chromatography-mass spectrometry (LC-MS), has demonstrated that outer membrane vesicles (OMVs) derived from Bacteroides vulgatus (B. vulgatus) contain high levels of the key metabolite stearic acid (SA). In vitro effects of stearic acid (SA) on AngII-induced JNK phosphorylation in VSMCs were tested, with validation using the JNK agonist anisomycin. Statistical analyses included correlation tests and appropriate comparisons (e.g., t-tests, ANOVA).

RESULTS: CRS significantly accelerated aortic dilation, increased mortality, and promoted a synthetic VSMC phenotype (decreased α-SMA/SM22α, increased OPN/MMP2) in BAPN-treated mice. 16 S sequencing revealed CRS reduced gut microbiota diversity, particularly depleting B. vulgatus, which correlated negatively with AD severity. Antibiotic-mediated microbiota ablation mitigated CRS-aggravated AD, while FMT from CRS mice exacerbated it. Metabolomics identified stearic acid (SA), a metabolite derived from OMVs of B. vulgatus, as negatively correlated with aortic diameter. SA supplementation inhibited VSMC synthetic transformation, reduced AD incidence, and suppressed JNK/MAPK pathway activation in vivo. Mechanistically, SA attenuated AngII-induced JNK phosphorylation in VSMCs in vitro, an effect reversed by the JNK agonist anisomycin.

CONCLUSIONS: CRS exacerbates the pathogenesis of AD by disrupting the gut microbiota, particularly by reducing the abundance of B. vulgatus and the levels of SA, which is a metabolite encapsulated in the OMVs of B. vulgatus. This leads to unchecked JNK/MAPK signaling, driving detrimental VSMC transformation. Restoration of SA inhibits this pathway and mitigates AD progression. Targeting the gut microbiota-B. vulgatus-SA axis presents a novel therapeutic strategy for stress-aggravated AD.

PMID:41957631 | DOI:10.1186/s12951-026-04369-3

Cardiovasc Diabetol. 2026 Apr 9. doi: 10.1186/s12933-026-03159-3. Online ahead of print.

ABSTRACT

BACKGROUND: Hepatic metabolic burden is an integral component of cardiometabolic risk. However, the association of hepatic metabolic burden assessed by the fatty liver index (FLI) with all-cause mortality in cardiovascular-kidney-metabolic (CKM) syndrome has not been well described when individuals are stratified by glucose metabolism status. Therefore, this study aimed to evaluate the association between FLI and all-cause mortality across different glucose metabolism states in adults with CKM syndrome.

METHODS: Data were derived from the National Health and Nutrition Examination Survey (NHANES) 1999-2018. Adults with CKM syndrome according to the AHA/ADA framework were included and categorized by glucose metabolism status as normoglycemia, prediabetes, or diabetes. Hepatic metabolic burden was assessed using FLI. Weighted multivariable Cox proportional hazards models and restricted cubic spline (RCS) analyses were applied to examine the associations between FLI and all-cause mortality across glucose metabolism status. Additionally, joint analyses with combined FLI (FLI ≥ 60 vs. <60) and glycemic categories and multiple sensitivity analyses were performed.

RESULTS: Among 19,107 participants with CKM syndrome (weighted N = 105,007,226), 2482 deaths occurred over a median follow-up of 9.42 years. No robust independent association was observed between FLI and all-cause mortality among individuals with normoglycemia or prediabetes after multivariable adjustment. In contrast, among individuals with diabetes, multivariable Cox regression and RCS analysis indicated that higher FLI was significantly associated with increased mortality risk and demonstrated a J-shaped nonlinear dose-response relationship. Joint analyses further showed that elevated FLI was associated with progressively higher death risk in the presence of impaired glucose metabolism, with the highest risk observed among individuals with diabetes and FLI ≥ 60. Multiple sensitivity analyses confirmed that the main analysis results were robust.

CONCLUSIONS: Within the CKM syndrome spectrum, elevated FLI was associated with a higher risk of all-cause mortality among individuals with diabetes, with a J-shaped association, whereas the association between FLI and all-cause mortality was not significant among individuals with normoglycemia or prediabetes. These findings suggest that the relationship between FLI and mortality in CKM populations may vary according to glycemic status and highlight the importance of considering glycemic context when interpreting liver-related metabolic markers.

PMID:41957630 | DOI:10.1186/s12933-026-03159-3

BMC Med Educ. 2026 Apr 9. doi: 10.1186/s12909-026-09141-7. Online ahead of print.

ABSTRACT

BACKGROUND: Large language models (LLMs) such as ChatGPT have garnered growing attention for their potential to support medical education, including specialty areas like cardiology. However, the accuracy, guideline adherence, and pedagogical usefulness of these AI-generated materials remain incompletely characterized.

OBJECTIVE: This study aimed to evaluate the factual accuracy, guideline alignment, and teaching utility of ChatGPT-generated responses on 15 core cardiology topics.

METHODS: Fifteen high-yield cardiology subjects (e.g., acute coronary syndrome, heart failure, valvular disease, arrhythmias) were identified based on standard medical curricula. Each topic was queried with 10 standardized prompts (150 total). Two cardiologists independently rated each ChatGPT response across five domains (factual accuracy, completeness, clarity/readability, guideline alignment, and teaching utility) using a 5-point rubric. Representative examples of higher- and lower-performing responses were also reviewed qualitatively to illustrate recurrent strengths and common error patterns. Inter-rater reliability was assessed via Cohen’s kappa (κ), and descriptive statistics summarized performance by domain and by topic. All prompts were entered using the free web version of ChatGPT (OpenAI; GPT-4o) under standardized default settings during October-November 2024.

RESULTS: Clarity/readability (4.4 ± 0.5) was the highest-scoring domain overall, while factual accuracy (3.7 ± 0.6) showed moderate performance. Guideline alignment varied across the 15 topics, ranging from 4.2 in stable angina to 3.0 in complex pericardial diseases. Heart failure with reduced ejection fraction (HFrEF) also had lower guideline concordance (3.1 ± 0.6). Illustrative examples indicated that lower scores were most often driven by omission of newer therapies, incomplete discussion of advanced procedural indications, and overly generic explanations in more complex subspecialty topics. Cohen’s kappa values (0.78-0.85) indicated substantial inter-rater agreement.

DISCUSSION: ChatGPT provided coherent explanations suitable for introductory learning across most cardiology topics, but gaps were evident in rapidly evolving areas like advanced heart failure and congenital anomalies. These findings underscore ChatGPT’s value as a supplementary educational tool while highlighting the need for careful expert oversight in verifying content accuracy and currency. Strategies for safely integrating AI-generated materials into medical education are discussed.

CONCLUSIONS: While ChatGPT can aid cardiology instruction through clear, concise overviews, reliance on it as a primary source risks propagation of incomplete or outdated information. Ongoing refinement of LLMs, coupled with consistent expert review, will be crucial for leveraging AI effectively in cardiology education.

PMID:41957617 | DOI:10.1186/s12909-026-09141-7

Respir Res. 2026 Apr 9. doi: 10.1186/s12931-026-03648-9. Online ahead of print.

NO ABSTRACT

PMID:41957608 | DOI:10.1186/s12931-026-03648-9