Tag: pubmed

BMC Public Health. 2026 Jan 26. doi: 10.1186/s12889-025-26067-9. Online ahead of print.

ABSTRACT

This study investigates the determinants of health literacy in Newham, London, using a statistical modelling approach. Health literacy is defined using literacy, numeracy, and Information and Communication Technology (ICT) literacy from the ONS Skills for Life (SfL) survey 2011. The research combines survey, the Newham Residents Survey (NRS), and the UK 2021 Census data. Multilevel regression with post-stratification (MRP) and average treatment effects (ATE) are used to quantify the strength of association of various factors on health literacy at the local level.The study identifies several significant determinants of health literacy, including age, ethnicity, qualification level, English as a first language, job status, gross income, and home ownership. Specifically, individuals aged 45 years and over are estimated to have lower ICT health literacy. White ethnicity is associated with higher numeracy scores. Additionally, health literacy worsens as area deprivation increases. Qualification level is estimated to be the strongest associated factor across all health literacy outcomes. The ultimate aim of this study is to inform targeted health literacy interventions at the local level by quantifying the relative importance of key determinants with uncertainty, thereby aiding in the prioritisation of resources.

PMID:41588414 | DOI:10.1186/s12889-025-26067-9

BMC Pediatr. 2026 Jan 26. doi: 10.1186/s12887-026-06519-w. Online ahead of print.

ABSTRACT

BACKGROUND: Neonatal hypoglycemia is a significant metabolic disturbance contributing to neonatal morbidity and mortality. This study aimed to assess the prevalence, associated factors, management practices, and early outcomes of hypoglycemia among neonates admitted to Muhimbili National Hospital (MNH), Tanzania.

METHODS: A prospective Cohort study was conducted at MNH from November 2024 to April 2025, enrolling 130 neonates aged 0-28 days. Hypoglycemia was defined as a random blood glucose level < 2.6 mmol/L. Data were collected using structured questionnaires and glucometer readings. Statistical analysis included Chi-square tests and Fisher’s exact to identify factors associated with hypoglycemia.

RESULTS: Of the 130 neonates, 28.5% (n = 37) were hypoglycemic. In the adjusted analysis, prematurity (aOR ~ 3.88, 95% CI:1.39-11.66, p = 0.012), maternal diabetes (aOR ~ 4.97, 95%CI 1.78-15.01, p = 0.003), and absent feeding at presentation (aOR ~ 2.6, 95% CI: 1.05-6.74, p = 0.045) were independently associated with hypoglycemia. Among hypoglycemic neonates, 59.5% (n = 22/37) received oral feeding and 18.9% (n = 7/37) received no active treatment. Hypoglycemic neonates had significantly poorer early outcomes compared to normoglycemic neonates (aOR for adverse outcome (death/continued hypoglycemia) ~ 5.1, 95% CI: 1.9-13.8).

CONCLUSIONS: Neonatal hypoglycemia was highly prevalent, particularly among preterm and those born to diabetic mothers. Standardized protocols that include routine screening, early and frequent feeding, and structured follow up are urgently needed to reduce morbidity and mortality.

PMID:41588396 | DOI:10.1186/s12887-026-06519-w

BMC Public Health. 2026 Jan 26. doi: 10.1186/s12889-026-26247-1. Online ahead of print.

ABSTRACT

BACKGROUND: Obesity is a growing public health concern, particularly in Sub-Saharan Africa, where undernutrition and obesity are in conjuction. In Botswana, the urban transition and environmental factors are likely influencing obesity risk. This study aimed to investigate the spatial distribution of central obesity across selected rural and peri-urban communities in Botswana and elucidate on likely demographics influencing the identified spatial variations.

METHODS: Data were drawn from 2,039 individuals (aged 16-65 + years) who participated in the Botswana Combination Prevention Project (BCPP), a community-based (n = 22) cluster-randomized trial (NCT01965470). Central obesity was defined using waist-to-hip ratio > 0.90 in men, > 0.85 in women. Generalized linear mixed models (GLMM) were estimated to predict central obesity prevalence. A Global Moran’s I was used to evaluate if there was clustering of central obesity prevalence across communities. To further explore local patterns, Local Indicators of Spatial Association (LISA) was applied to identify specific communities where central obesity prevalence was not random. This analysis distinguished spatial clusters (high-high [HH] and low-low [LL]) as well as spatial outliers. Finally, bivariate local Moran’s I was performed to determine the spatial heterogeneity of central obesity and specific predictors (female and median age).

RESULTS: Central obesity prevalence was estimated at 27.6% using GLMM (AoR 0.276 95% CI 0.131-0.582), (n = 887) and of these, 44.8% (n = 645) participants, resided in rural areas. Spatial analysis revealed significant clustering across rural and peri-urban communities (Moran’s I = 0.158, p = 0.04;I = 0.171 p = 0.05). The bivariate Local Moran’s I results showed significantly high clusters of central obesity and female (sex) (0.071 p < .001) and central obesity and median age (I = 0.225 p < .001) in both rural and peri-urban communities.

CONCLUSIONS: Central obesity in Botswana demonstrates spatial clustering and is significantly influenced by socio-demographic factors. These findings underscore the need for geographically targeted interventions to address central obesity, especially in peri-urban communities.

TRIAL REGISTRATION: NCT01965470. Registered on October 2013. More information: https://www.

CLINICALTRIALS: gov/study/NCT01965470?tab=history&a=4.

PMID:41588385 | DOI:10.1186/s12889-026-26247-1

BMC Public Health. 2026 Jan 26;26(1):311. doi: 10.1186/s12889-025-25657-x.

ABSTRACT

BACKGROUND: Antibiotics are among the most frequently prescribed medications for pediatric patients. Inappropriate use, particularly in the first years of life, can contribute to the development of antibiotic resistances and impact the maturation of the gut microbiome. Describing prescription patterns using nationally collected data is essential for identifying or monitoring existing strategies for reducing excessive use. This study aims to identify antibiotic prescription trajectories during the first four years of life and to investigate their association with sociodemographic factors.

METHODS: In this retrospective cohort study, we used data collected through the Pedianet registry, a monitoring system involving approximately 200 family pediatricians (FPs) in Italy. We considered children born between 2004 and 2018 with complete follow-up during their first four years of life, excluding those with a birth weight of < 2500 g, gestational age < 37 weeks or genetic disorders. Prescription trajectories over the 16 trimesters of observation were estimated using Group-Based Trajectory Modelling (GBTM), by classifying the included children into homogeneous groups based on their probabilities of membership. The association between trajectories and sociodemographic factors was examined with multinomial logistic regression with random intercepts for FPs.

RESULTS: A total of 143,098 children born between 01/01/2004 and 31/12/2018 were included. Between 0 and 4 years of age, these children received a total of 684,010 antibiotic prescriptions. GBTM identified four different trajectories, defined as: [1] “very low use” of antibiotics (34.9% of children) [2], “low-to-moderate use” (22.8%) [3], “moderate-to-low use” (28.0%) and [4] “high use” (14.3%). Compared to the “very low use” trajectory, male subjects residing in the center and south of Italy and born between 2004 and 2008 had a higher probability of belonging to trajectory groups with “moderate-to-low use” and “high use”.

CONCLUSIONS: From 2004 to 2022 in Italy, we observed heterogeneous antibiotic prescription patterns among children aged 0-4 years. Future strategies aimed at reducing the number of prescriptions in this age group should target the subgroups at higher risk.

PMID:41588382 | DOI:10.1186/s12889-025-25657-x

BMC Cancer. 2026 Jan 26. doi: 10.1186/s12885-026-15618-x. Online ahead of print.

ABSTRACT

BACKGROUND: Uterine sarcoma has an inferior prognosis and high recurrence rate among gynecological malignancies, even in early-stage cases with complete resection. However, the risk factors for recurrence remain poorly understood. This study aimed to identify risk factors associated with recurrence in early-stage uterine sarcoma.

METHODS: Among 97 patients with uterine sarcoma treated at our institution between January 2007 and June 2023, we retrospectively investigated 55 patients of the following five histological types: uterine leiomyosarcoma (ULMS), low- or high-grade endometrial stromal sarcoma (LG-ESS or HG-ESS), adenosarcoma, and smooth muscle tumor of uncertain malignant potential (STUMP). Risk factors were compared between the recurrence and non-recurrence groups using univariate analysis, and recurrence rates, time to recurrence, progression-free survival (PFS), and overall survival (OS) were examined.

RESULTS: The median age of 55 patients was 48 years, and the most common initial symptom was abdominal pain or abdominal mass awareness (29.4%), followed by abnormal bleeding in 25.5% of the patients. The median tumor size was 9.7 cm, and stage I cases were 64.8% of the total. Histological types were 28 ULMS, 13 LG-ESS, 8 STUMP, 5 HG-ESS, and one adenosarcoma. Among stage I cases, ULMS had a recurrence rate of 81.3% with a median time to recurrence of 12.4 months, while LG-ESS had a recurrence rate of 30% with a median time to recurrence of 41.1 months. A high mitotic count was significantly associated with recurrence in stage I ULMS (p = 0.044). Other surgical pathological findings, such as lymphovascular space invasion, MIB-1 positive rate, and necrosis, and surgical factors, such as myomectomy and ovarian preservation, showed no statistically significant differences but were higher in the recurrence cases. The 5-year PFS rates in stage I ULMS and LG-ESS groups were 31.3% and 75%, and the 5-year OS rates were 68.5% and 100%, respectively.

CONCLUSIONS: In stage I ULMS, a high mitotic count was associated with an increased risk of recurrence after complete surgical resection.

PMID:41588380 | DOI:10.1186/s12885-026-15618-x

J Colloid Interface Sci. 2026 Jan 21;709:139953. doi: 10.1016/j.jcis.2026.139953. Online ahead of print.

ABSTRACT

HYPOTHESIS: The phenomenon of underscreening, where the screening of the electrostatic potential in the bulk electrolyte is weaker than it should be according to the canonical Debye-Hückel theory, has significant implications for colloidal stability in highly concentrated electrolytes. Current experimental and computational investigations of this phenomenon have been limited to single mode analyses, despite statistical mechanics predicting that many modes are present simultaneously. We hypothesise that using a multi-modal approach will provide insights not yet observed.

COMPUTATIONAL APPROACH: Here we apply Fourier analysis to radial charge densities, derived from polarisable molecular dynamic simulations of aqueous alkali chloride electrolytes, to determine if multiple modes are present. Prony’s method is then applied to a multi-modal ansatz to estimate screening lengths associated with each mode.

FINDINGS: Fourier analysis revealed that there are many modes present in the radial charge density. For all electrolytes considered at low concentrations the dominant mode was a non-oscillatory Yukawa decay mode, while at higher concentrations modes with non-zero spatial frequencies dominated. Resulting screening modes with oscillatory wavelengths ∼5-15 Å from Prony’s method agree with the largest experimental screening lengths from surface force apparatus and fluorescence experiments. Concurrently, screening lengths with shorter oscillatory wavelengths, 3-5 Å, have smaller magnitudes and agree with other experiments such as atomic force microscopy and optical second harmonic scattering experiments.

PMID:41587504 | DOI:10.1016/j.jcis.2026.139953

JMIR Form Res. 2026 Jan 26;10:e74101. doi: 10.2196/74101.

ABSTRACT

BACKGROUND: The World Health Organization reported that noncommunicable diseases (NCDs) contribute to around 74% of deaths worldwide. A similar phenomenon can also be observed in Brunei Darussalam. One of the most cost-effective approaches to control the growing burden of NCDs is to reduce related modifiable risk factors.

OBJECTIVE: This study aims to propose a composite health score called Health Index, inspired by the 6 pillars of lifestyle medicine, which acts as a measure of health and can show how health changes over time at an individual and national level.

METHODS: Health Index is a series of questionnaires that captures users’ health status on several domains of health and, upon completion, the users are categorized as either healthy, at risk, or in poor health. Users will also be able to view health advice based on their answers to the questionnaires.

RESULTS: The field testing results show Health Index as a promising population health management tool. 13.8% (166/1200) of the targeted users completed Health Index within 1 month, with 85% (1019/1200) of them in the “At Risk” category. We also identified diet as the most prominent health issue.

CONCLUSIONS: In conclusion, the Health Index potentially enables early detection and management of NCD risk factors to mitigate the high cost of advanced disease and complications. In the future, we aim to retrospectively and prospectively validate the Health Index through several statistical analyses.

PMID:41587487 | DOI:10.2196/74101

Ann Intern Med. 2026 Jan 27. doi: 10.7326/ANNALS-25-01344. Online ahead of print.

ABSTRACT

BACKGROUND: In embarking on randomized clinical trials (RCTs), researchers can hypothesize that a more intensive treatment is better than a less intensive treatment (positive hypothesis) or that a less intensive treatment is similar or noninferior to a more intensive treatment (negative hypothesis). Researchers may design noninferiority RCTs (NI-RCTs) to support negative hypotheses and standard RCTs (S-RCTs) to support negative or positive hypotheses. Regardless of hypotheses, S-RCTs and NI-RCTs should produce consistent results when assessing similar participants, interventions, control, and outcomes.

OBJECTIVE: To compare effect estimates in S-RCTs with positive hypotheses versus NI-RCTs and in S-RCTs with negative hypotheses versus NI-RCTs.

DESIGN: Meta-research.

SETTING: 98 meta-analyses.

PARTICIPANTS: 468 RCTs, including 153 NI-RCTs and 315 S-RCTs (149 positive and 166 negative hypotheses).

INTERVENTION: S-RCTs as the exposure and NI-RCTs as the control.

MEASUREMENTS: The ratio of effect estimates between S-RCTs and NI-RCTs in each meta-analysis was combined across meta-analyses.

RESULTS: Standard RCTs with positive hypotheses produced effect estimates 1.47 (95% CI, 1.27 to 1.70) times larger than NI-RCTs; among RCTs rated as having low risk of bias for blinding, the ratio was 1.01 (CI, 0.70 to 1.45), whereas among those rated as having high or unclear risk of bias for blinding, the ratio was 1.81 (CI, 1.41 to 2.33). Standard RCTs with negative hypotheses did not produce statistically different effect estimates from NI-RCTs (ratio, 0.93 [CI, 0.84 to 1.03]).

LIMITATION: Findings may be limited by residual differences between S-RCTs and NI-RCTs in the same meta-analysis.

CONCLUSION: The researchers’ hypotheses may bias the results of published RCTs, especially those with high or unclear risk of bias for blinding. The effect of researchers’ hypotheses should be assessed in systematic reviews and clinical practice guidelines when RCTs addressing the same clinical question report conflicting hypotheses.

PRIMARY FUNDING SOURCE: The Shenzhen Municipal Government, Guangdong Province, China, and the Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences.

PMID:41587480 | DOI:10.7326/ANNALS-25-01344

JMIR Hum Factors. 2026 Jan 26;13:e80812. doi: 10.2196/80812.

ABSTRACT

BACKGROUND: Delivering therapy through video consultations can increase the reach and impact of mental health care services. However, adoption varies, and there is a lack of professional consensus about the usefulness of video consultations in therapy settings.

OBJECTIVE: This study aimed to explore mental health professionals’ experiences with and attitudes toward video consultations across different clinical environments in the private and public health care sectors in Norway to inform the design of future digitalized services.

METHODS: In this qualitative study, we recruited leaders and clinicians from public hospitals and private clinics. We conducted semistructured interviews that mapped individual experiences and attitudes concerning video consultations, as well as contextual aspects concerning the participants’ professional environments. We used reflexive thematic analysis with an inductive, essentialist, and experiential orientation to analyze the data.

RESULTS: A total of 24 mental health professionals (16 from public hospitals and 8 from private clinics) participated. Variations in their attitudes did not follow patterns reflecting the type of service or sector they worked in. Rather, attitudes seemed related to higher-level assumptions rooted in professional culture, societal values, and previous experiences. We generated six themes capturing and structuring the professional perspectives: (1) meta-perspectives on the digitalization of therapeutic rooms, (2) the “how” of service integration, (3) challenging therapist culture, (4) negotiating the limits of the digital therapy room, (5) creating clinical value from the digital format, and (6) adapting techniques and technology in digital therapy sessions.

CONCLUSIONS: To strengthen the adoption and impact of video consultations, we should direct attention toward higher-level societal and cultural aspects that shape attitudes and practices. We suggest incorporating digitalized therapy in education, facilitating personal experiences with video consultations, increasing the sharing of knowledge between clinical environments, and sparking innovation of both service models and technology.

PMID:41587466 | DOI:10.2196/80812

JMIR Mhealth Uhealth. 2026 Jan 26;14:e66267. doi: 10.2196/66267.

ABSTRACT

BACKGROUND: Psychological stress during pregnancy is common and has been associated with adverse maternal and neonatal outcomes. Digital health interventions (DHIs) have emerged as a scalable approach to support stress management during pregnancy, yet evidence remains fragmented, and prior reviews have largely focused on broad perinatal mental health outcomes or delivery platforms rather than stress-specific effects and targeted intervention components.

OBJECTIVE: This systematic review and meta-analysis aimed to evaluate the effectiveness of DHIs specifically designed to reduce stress during pregnancy and to examine how intervention strategies and delivery methods are associated with stress outcomes.

METHODS: We conducted a systematic review and meta-analysis following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines. Randomized controlled trials and quasi-experimental studies involving pregnant women were eligible if they evaluated any digitally delivered intervention-such as mobile apps, web-based programs, or telemedicine-intended to reduce stress, and reported validated stress outcomes. We searched CINAHL, the Cochrane Library, Embase, and PubMed from database inception through November 2025. Risk of bias was assessed using the Cochrane risk of bias 2 tool for randomized trials and the risk of bias in nonrandomized studies of interventions tool for nonrandomized studies. Where appropriate, effect sizes were pooled using random-effects meta-analysis with the Hartung-Knapp-Sidik-Jonkman method and reported as standardized mean differences.

RESULTS: A total of 19 studies were included. Overall, DHIs were associated with a significant reduction in stress compared with control conditions (standardized mean difference -0.45, 95% CI -0.59 to -0.32; 95% prediction interval -0.78 to -0.13), with low to moderate heterogeneity. Strategy-based subgroup analyses indicated that mindfulness- and education-focused interventions showed favorable effects, but formal tests for between-subgroup differences were not statistically significant. Evidence certainty was rated as moderate, primarily due to risk-of-bias concerns in some trials.

CONCLUSIONS: This review provides stress-focused evidence that DHIs can support stress reduction during pregnancy and extends existing literature by systematically disaggregating interventions according to delivery methods, functional features, and content strategies. This study offers a component-oriented synthesis that informs the design and selection of digital stress-management interventions for pregnant women. In real-world antenatal care, these tools may complement clinician-delivered services by expanding access to low-intensity, scalable support, particularly when interventions integrate skills-based content with supportive digital functions. Future research should directly compare single versus combined strategies and evaluate implementation across diverse populations and care settings.

PMID:41587461 | DOI:10.2196/66267