Tag: pubmed

J Prim Care Community Health. 2026 Jan-Dec;17:21501319261434121. doi: 10.1177/21501319261434121. Epub 2026 Jun 28.

ABSTRACT

OBJECTIVE: Digital health literacy (DHL) is a critical component for the effective self-management and secondary prevention of hypertension. However, the multi-level determinants of DHL in community settings are not yet fully understood. This study aimed to assess the status of DHL and identify its key sociodemographic, psychosocial, and health system determinants among adults with hypertension in China.

METHODS: A cross-sectional survey was conducted (October 2024-January 2025) across 1 tertiary general hospital and 3 community health service centers in Changzhou, China. Data were collected from 660 hypertensive adults using a structured questionnaire, including the eHealth Literacy Scale (eHEALS), and scales for physician-patient interaction, perceived internet health information quality, and perceived family support. Determinants were analyzed using multivariate logistic regression and a random forest model to rank factor importance.

RESULTS: Nearly half of the participants (49.45%) demonstrated low DHL. Multivariate logistic regression indicated that older age (specifically ≥75 years: OR = 13.33, 95% CI = 1.73-99.88), limited internet use (<1 h/day: OR = 2.50, 95% CI = 1.04-5.88), and concerns regarding data privacy (OR = 3.42, 95% CI = 1.01-11.58) were significant predictors of low DHL. Additionally, higher perceived quality of internet health information (OR = 0.72, 95% CI = 0.67-0.78), better physician-patient interaction (OR = 0.92, 95% CI = 0.86-0.99), and greater family support (OR = 0.37, 95% CI = 0.25-0.55) were associated with lower odds of low DHL. The random forest model identified the perceived quality of internet health information as the most influential predictor, followed by age and data privacy.

CONCLUSION: DHL levels among individuals with hypertension in the community are suboptimal. These findings highlight the potential importance of a multilevel approach to supporting DHL. Efforts to improve the perceived quality of internet health information and strengthen social support systems may be beneficial, and primary care providers could play an important role in guiding patients’ use of digital health resources.

PMID:42366774 | DOI:10.1177/21501319261434121

Spec Care Dentist. 2026 Jul-Aug;46(4):e70197. doi: 10.1111/scd.70197.

ABSTRACT

BACKGROUND: The Katkari tribe in Goa, India, faces significant oral health challenges due to cultural beliefs, poor access to healthcare, and high tobacco consumption. This study aims to assess the oral health status, oral health beliefs, and tobacco habits within this isolated community.

METHODS: A descriptive cross-sectional study was conducted among 101 participants from tribal settlements in North and South Goa between October and December 2023. A structured questionnaire was used to collect data on sociodemographics, oral hygiene practices, myths about oral health, and tobacco use. Participants underwent clinical examination using the WHO Oral Health Assessment Form. Data analysis was performed using IBM SPSS version 20, with descriptive statistics and Chi-Square test and Fisher’s exact test to explore associations between variables.

RESULTS: The mean age of participants was 28.9 years, with 57.4% females. Most participants had low educational levels, and 64.35% reported using toothbrushes for oral hygiene. However, brushing habits were suboptimal, with 64.4% using incorrect brushing techniques. Myths such as “clove oil relieves toothache” (68.3%) and “tobacco relieves toothache” (51.5%) were prevalent. Tobacco use was high, with 66.3% consuming smokeless tobacco, and the most common reasons for use were family influence (37.6%) and peer pressure (28.7%). Education and occupation significantly influenced oral health behavior and tobacco habits.

CONCLUSION: The study highlights the significant oral health challenges faced by the Katkari tribe, including poor hygiene practices, high tobacco use, and widespread myths. These issues are compounded by low education levels and limited healthcare access. Culturally sensitive health education, community-based interventions, and tobacco cessation programs are needed to address these challenges and improve the overall health of the community.

PMID:42366758 | DOI:10.1111/scd.70197

Can Respir J. 2026;2026(1):e3703610. doi: 10.1155/carj/3703610.

ABSTRACT

BACKGROUND: This study primarily analyzed differences in venous thromboembolism (VTE) characteristics across altitudes and their temporal trends during the puerperium. Additionally, it identified independent risk factors for postpartum pulmonary embolism (PE).

METHODS: This retrospective study reviewed all postpartum VTE cases at People’s Hospital of Xizang Autonomous Region between 2015 and 2024.

RESULTS: This cohort study of 172 postpartum women (median age 31 [IQR 26-36]) compared high-altitude (HA, n = 109) and very high-altitude (VHA, n = 63) groups. PE proportion was significantly higher in VHA vs. HA ( p = 0.033). VHA subjects also showed significant elevated preterm delivery (p = 0.033) and ≥ 3 deliveries (p < 0.001). Joinpoint regression (2015-2024) revealed biphasic trends: significant early-phase escalations in VTE (APC = 18.05%) and deep vein thrombosis (DVT) (APC = 19.66%) during 2015-2022 (p < 0.05), followed by clinically relevant (though statistically nonsignificant) late-phase reductions. PE proportion demonstrated a significant overall increase (APC = 18.77%, p < 0.05). In multivariate analysis, four independent predictors significantly increased PE risk: altitude gradient (OR 1.035, p < 0.001), multiparity (OR 2.548, p = 0.004), hypertension or eclampsia (OR 1.797, p = 0.001), and structural heart disease (OR 1.988, p < 0.001).

CONCLUSION: This decade-long analysis (2015-2024) revealed significant altitudinal gradients in postpartum VTE. Clinically significant escalation of postpartum VTE burden in high-altitude populations warrants urgent intervention. Integrated multiparity management and enhanced comorbidity control are critical future initiatives for resolving key perinatal thrombotic risk bottlenecks.

PMID:42366755 | DOI:10.1155/carj/3703610

Pediatr Emerg Care. 2026 Jun 29. doi: 10.1097/PEC.0000000000003645. Online ahead of print.

ABSTRACT

OBJECTIVES: Chest tube thoracostomy is a core skillset within pediatric emergency medicine (PEM); however, few PEM physicians perform this procedure regularly. Site selection is typically performed through landmark identification of the fifth intercostal space (ICS), and incorrect placement can result in serious morbidity. The aims of this study were to evaluate the accuracy of safe thoracostomy site selection among PEM providers, and to identify relationships between provider demographics and experience with performance in this selection process.

METHODS: This was a single-center observational study using a convenience sample of pediatric emergency department (PED) patients. Providers marked the fifth ICS bilaterally using the landmark technique, and the ICS and diaphragm levels were subsequently confirmed using point-of-care ultrasound (POCUS). Descriptive statistics were calculated for patient and provider characteristics. Associations between provider characteristics with location of the ICS mark were evaluated using a generalized estimating equation approach.

RESULTS: Fifteen participating PEM providers performed 120 bilateral landmark-based ICS identifications. Among all identified sites (n=240), only 37.1% (n=89) were accurately confirmed as the fifth ICS, with 12.9% (n=31) being below the fifth ICS. Furthermore, 9.2% (n=22) of all sites were located below the diaphragm during resting breathing. Providers with longer tenure, more PED experience, greater number of chest tubes placed, and greater comfort with identifying the fifth ICS were more likely to mark below the fifth ICS (P=0.004, 0.026, <0.001, <0.001, respectively).

CONCLUSIONS: This study demonstrates a considerable gap in thoracostomy site selection accuracy among PEM physicians. A significant number of chosen sites were found to be below the fifth ICS, and there was a surprising discordance between provider experience and accuracy. These findings highlight a critical gap in performance and the need for ongoing training. Incorporating POCUS into standard practice may improve site selection accuracy and patient outcomes in the PED setting.

PMID:42366752 | DOI:10.1097/PEC.0000000000003645

Risk Anal. 2026 Jul;46(7):e70285. doi: 10.1111/risa.70285.

ABSTRACT

Holidays in the United States can be quite deadly, with more than 500 traffic fatalities on a given holiday. Another uniquely dangerous period is the annual spring break for college students, which starts at the end of February and continues through the first week of April. Although spring break is not a phenomenon across the entire United States, it is especially popular in certain hotspots. In this study, we focus on Florida, the state with the highest number of spring break hotspots in the country. We analyze weekly county-level crash data from the Florida Department of Highway Safety and Motor Vehicles that provides information on all motor vehicle crashes (whether fatal or not) reported to law enforcement. We compare the estimates for fatal and nonfatal traffic injuries during spring break to those during the holiday period between Thanksgiving and New Year’s Day. While both periods are similar in terms of fatalities, the spikes in nonfatal injuries are more pronounced during spring break. Subgroup analyses provide additional insight. Numerous robustness checks and sensitivity analyses confirm the core findings.

PMID:42366744 | DOI:10.1111/risa.70285

Dementia (London). 2026 Jun 28:14713012261463708. doi: 10.1177/14713012261463708. Online ahead of print.

ABSTRACT

Background: Hearing loss is a well-established modifiable risk factor for dementia at the individual level, but less is known about whether hearing loss prevalence aligns with dementia prevalence at the country level across diverse socioeconomic and demographic contexts. This study examined sex-stratified country-level associations between hearing loss prevalence and dementia prevalence, while avoiding causal interpretation of ecological associations. Methods: Country-level sex-specific prevalence estimates for hearing loss and dementia prevalence were obtained from the Global Burden of Disease data resources. Analyses were conducted separately for females and males and included descriptive sample summaries, Pearson and Spearman correlations, principal component analysis, partial correlations used as sequential robustness checks, and theory-informed multivariable linear regression. Variables were log10-transformed for the primary analyses. Models adjusted for economic development, urbanisation, the Henneberg Index, and sex-specific life expectancy at age 60. Formal sex comparison was evaluated using coefficient-comparison testing of the hearing-loss effect from comparable adjusted models. Results: The global bivariate association between hearing loss prevalence and dementia prevalence was strong in females (Pearson r = 0.827; Spearman rho = 0.845; p < 0.001) and males (Pearson r = 0.848; Spearman rho = 0.855; p < 0.001). Principal component analyses indicated that hearing loss prevalence clustered with socioeconomic and demographic indicators in both sexes, explaining more than 70% of total variance. In multivariable regression models, adding hearing loss increased explanatory power in females (R² from 0.661 to 0.827) and males (R² from 0.674 to 0.811). A formal coefficient-comparison test did not indicate a statistically meaningful difference between the female and male hearing-loss coefficients in the fully adjusted models (z = 0.82; p = 0.41). Conclusions: Hearing loss prevalence is strongly associated with dementia prevalence at the country level in both females and males after adjustment for macro-level socioeconomic and demographic covariates. The findings support the population-level relevance of hearing health for dementia surveillance and prevention, while indicating broad convergence rather than clear sex-based divergence in the hearing loss-dementia association.

PMID:42366738 | DOI:10.1177/14713012261463708

Biotechnol Bioeng. 2026 Jun 28. doi: 10.1002/bit.70279. Online ahead of print.

ABSTRACT

CRISPR-Cas9 is a widely used genetic tool with therapeutic potential in molecular biology. CRISPR-Cas9 enables precise genome editing by its ability to target specific DNA sequence. After off-target and on-target regions are identified, CRISPR-Cas9 is applied to these regions based on the match between the guide RNA (gRNA) and target DNA sequence. This study points to the off-target impact of mismatches between the gRNA and target DNA on exon regions of the TP53 gene, which are involved in regulating multiple genes and cellular functions. Off-target positions are typically evaluated using scoring methods. In this study, we have used latent class analysis to reveal subclasses of off-target positions. Thus, we have created the levels of off-target positions and evaluated the effects of mismatching positions within these classes using machine learning classifiers. The results revealed that mismatching positions could be categorized into three levels: low, middle, and high off-target positions. We have improved a computational framework to minimize off-target effects and to identify the PAM sequences in the gRNA design. Thus, carefully designed gRNAs will ensure that desired genetic edits are performed and target variants are achieved. This work will avail the future research aimed at optimizing genome editing by customizing CRISPR-Cas9 to target specific protospacer DNA through gRNA.

PMID:42366734 | DOI:10.1002/bit.70279

BMC Pregnancy Childbirth. 2026 Jun 29. doi: 10.1186/s12884-026-09536-w. Online ahead of print.

ABSTRACT

BACKGROUND: Maternal nutritional exposures during pregnancy are critical determinants of maternal and neonatal outcomes, yet remain inadequately characterized in many African settings, including Cameroon. The CAMELIA (Cameroon Maternal and Early Life Assessment) cohort aims to evaluate maternal nutritional status early in pregnancy, implement a structured nutritional intervention, and assess its impact on maternal, neonatal, and long-term metabolic outcomes.

METHODS: CAMELIA is a prospective, longitudinal interventional cohort enrolling 1,200 pregnant women at less than 22 weeks’ gestation in an urban primary healthcare facility in Cameroon (Hôpital Monseigneur Jean Zoa, Yaoundé). Participants are recruited at the first antenatal visit and followed through delivery and up to 42 days postpartum. Data and biological samples are collected across four visits: at enrolment (< 22 weeks), between 24 and 32 weeks of gestation, at delivery, and at 42 days postpartum. A structured multi-modal nutritional intervention (SUN-APP program) is initiated at enrolment, delivered through individual counselling, group education, monthly interactive workshops, and digital health support via weekly WhatsApp and SMS messages. Gestational hyperglycaemia is screened using fasting capillary blood glucose at V1 and V2, applying a threshold of ≥ 92 mg/dL. Primary outcomes are feasibility and acceptability of the intervention. Secondary outcomes include prevalence of gestational hyperglycaemia, hypertensive disorders, anaemia, low birth weight, and preterm birth. The study holds ethical approval from the Cameroon National Ethics Committee (CNERSH; approval no. 2025/04/1790/CE/CNERSH/SP) and is registered in the ISRCTN registry (ISRCTN13961105).

CONCLUSIONS: The CAMELIA study provides a scalable and replicable framework for embedding structured nutritional risk screening and targeted interventions into routine antenatal care in a low-resource African setting. Findings will inform strategies for the prevention of gestational metabolic disorders and adverse perinatal outcomes across generations.

TRIAL REGISTRATION: ISRCTN13961105. Registered 14 August 2025.

PMID:42366411 | DOI:10.1186/s12884-026-09536-w

Trop Med Health. 2026 Jun 28. doi: 10.1186/s41182-026-01014-5. Online ahead of print.

ABSTRACT

BACKGROUND: African animal trypanosomosis (AAT) remains a major obstacle to livestock productivity in sub-Saharan Africa, particularly in West Africa. In Benin, the epidemiological role of hematophagous flies in trypanosome circulation remains insufficiently documented. This study aimed to estimate the prevalence of Trypanosoma infections in these potential vectors and to characterize their blood meal sources in livestock interface zones of southern Benin.

METHODS: Hematophagous flies were trapped using Vavoua, biconical and Nzi traps in 6 communes during dry and rainy seasons. The sample size for molecular analyses was determined using Cochran’s formula, resulting in the selection of 384 individuals. These were analyzed by species-specific PCR targeting T. vivax, T. congolense (savannah and forest types) and T. brucei s.l. Blood meal identification was performed on engorged flies using multiplex PCR targeting cattle, humans, pigs, dogs and sheep.

RESULTS: A total of 6550 hematophagous flies were collected across the 6 communes. The overall prevalence of trypanosomes was 13.8% (53/384; 95% CI 10.7-17.6%). T. vivax (6.8%) and T. congolense savannah type (6.5%) were the predominant species, while T. brucei s.l. was detected in only one specimen (0.3%); T. congolense forest was absent. The highest prevalences were recorded in Allada and Djidja (20.3% each). Dry season prevalence (16.1%) exceeded rainy season prevalence (11.8%), without statistically significant difference (p = 0.238). Blood meal analysis showed a predominance of cattle (44.4%), followed by humans (20.4%) and mixed sources. No significant association was observed between blood meal origin and infection status.

CONCLUSIONS: These results suggest that non-tsetse hematophagous flies may contribute to trypanosome circulation in livestock systems of southern Benin. Their inclusion in trypanosomosis surveillance and control programs is strongly recommended.

PMID:42366410 | DOI:10.1186/s41182-026-01014-5

World J Surg Oncol. 2026 Jun 29. doi: 10.1186/s12957-026-04471-8. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the clinical value of an innovative embedded parallel pancreaticojejunostomy technique for laparoscopic pancreaticoduodenectomy.

METHODS: We retrospectively analyzed the clinical data of 108 patients who underwent successful laparoscopic pancreaticoduodenectomy at The Affiliated Lihuili Hospital of Ningbo University, from January 2016 to July 2025. Patients were divided according to the type of pancreaticojejunostomy: the experimental group (n = 57) underwent an embedded parallel pancreaticojejunostomy, while the control group (n = 51) underwent duct-to-mucosa pancreaticojejunostomy. The baseline characteristics, tumor features, intraoperative and postoperative conditions, and complications were compared between the two groups. And through a multivariate logistic regression model, the independent effects of the surgical groups (experimental group, control group) were evaluated.

RESULTS: The incidence of grade B/C postoperative pancreatic fistula in the experimental group (5.3%) was significantly lower than that of the control group (19.6%), and the difference was statistically significant (P < 0.05). The pancreaticojejunostomy time (21.33 ± 2.73 min), postoperative drainage tube removal time (14.00, 10.00-17.50 days), and postoperative hospitalization (16.00, 12.50-21.00 days) in the experimental group were all significantly shorter than those in the control group (31.43 ± 2.30 min; 17.00, 11.00-28.00 days; 20.00, 13.00-29.00 days, respectively; all P < 0.05). There were no significant differences (P > 0.05) between the two groups in age, American Society of Anesthesiologists, Fistula Risk Score, main pancreatic duct diameter, sex, body mass index, pathological type, maximal tumor diameter, pancreatic texture, intraoperative margin status, lymph node metastasis, operative time, intraoperative blood loss, delayed gastric emptying, or postoperative bleeding. And the intervention measure (experimental group, control group) was independent protective factors for reducing postoperative pancreatic fistula (OR=0.19, 95% Cl, 0.05-0.75, P < 0.05).

CONCLUSION: The embedded parallel pancreaticojejunostomy technique can effectively reduce the incidence of postoperative pancreatic fistula and shorten pancreaticojejunostomy time. This technique is a simple and effective new method for pancreaticojejunostomy and is worthy of application in laparoscopic pancreaticoduodenectomy.

PMID:42366403 | DOI:10.1186/s12957-026-04471-8