Tag: pubmed

Immunobiology. 2026 May 12;231(3):153187. doi: 10.1016/j.imbio.2026.153187. Online ahead of print.

ABSTRACT

Despite the proliferation of prognostic gene signatures for glioma, clinical translation remains stalled by poor reproducibility and overfitting. In this study, we address this stability crisis by developing a robust “Dual-Signature Framework” using stability selection-a rigorous resampling method-rather than standard regression. Analyzing RNA-seq data from 1351 patients across the TCGA (n = 694) and CGGA (n = 657) cohorts, we constructed two distinct models. The primary 20-gene “Data-Driven” signature achieved superior predictive accuracy (C-index: 0.7392), significantly outperforming 14 published benchmark models and the current best single-gene predictor (HOXA5). In parallel, we derived a 7-gene “Biology-Driven” signature (including HOXA5, CHI3L1, MMP14) that retained 98% of the predictive power (C-index: 0.7252) while prioritizing mechanistic interpretability. Both models successfully stratified patients into distinct risk groups with high statistical significance (Log-rank p < 0.001) in external validation. Comprehensive subgroup analyses across 19 clinical and molecular subgroups demonstrated robust performance (C-index range: 0.59-0.85), with extended calibration analysis confirming excellent probability estimation (Brier score 0.20 for 5-year predictions). By integrating stability-driven feature selection with biological pathway constraints, this study provides a reproducible, high-performance alternative to unstable “black box” models, offering a translation-ready tool for personalized glioma risk assessment.

PMID:42134029 | DOI:10.1016/j.imbio.2026.153187

Am J Public Health. 2026 May 14:e1-e4. doi: 10.2105/AJPH.2026.308528. Online ahead of print.

ABSTRACT

Objectives. To describe mortality rates by occupation among working-age men in the United States in 2022 and 2023. Methods. I obtained data on the occupation of decedents from death certificate data published by the National Center for Health Statistics for men aged 20 to 64 years. I calculated mortality rates and rate ratios for occupation groups. Results. Mortality rates were more than double for construction and extraction workers compared with all other workers. Mortality rates and rate ratios for workers in manual, blue-collar occupations were significantly higher than those for workers in other occupations. Conclusions. There were notably higher mortality rates for workers in manual, blue-collar occupations. Occupation groups with higher mortality rates also generally had a larger share of men in their workforce. Public Health Implications. Further research should examine work-related risk factors for occupational disparities in all-cause mortality. The workplace can be a convenient setting for interventions to prevent premature death among working-age men. Including occupation at the time of death in public health data can improve the validity and precision of future studies of the occupational causes of mortality. (Am J Public Health. Published online ahead of print May 14, 2026:e1-e4. https://doi.org/10.2105/AJPH.2026.308528).

PMID:42133997 | DOI:10.2105/AJPH.2026.308528

Genome. 2026 May 14. doi: 10.1139/gen-2025-0065. Online ahead of print.

ABSTRACT

Human-mediated change has resulted in the expansion of many species into novel habitats. Range expansions have been described demographically as either pulled or pushed, depending on the number of individuals on the leading front, and can leave distinct genomic signatures within the genome. The recent expansions of Agrilus planipennis, Lycorma delicatula, and Dendroctonus ponderosae represent different types of range expansion which can be analyzed by coupling rigorous monitoring of recent expansions with whole-genome assemblies to provide a strong comparative framework with which to study the genomic signatures of expansion type. Here, we synthesize range expansion theory in the context of these recent expansions and generate hypotheses on the expected patterns of genomic change. We then outline statistical and genome-structural methods that can be used to identify putatively adaptive loci, leveraging the increased genomic resolution provided by whole-genome assemblies. Finally, we complement the overarching expansion hypotheses with a discussion of using a top-down approach to identify loci under selection, using cold tolerance traits as an example. With these methods we can better understand the risk of further spread and persistence of these expanding insect populations, as well as establish a framework for quantifying the adaptive potential of other expanding species.

PMID:42133990 | DOI:10.1139/gen-2025-0065

JMIR Mhealth Uhealth. 2026 May 14;14:e77778. doi: 10.2196/77778.

ABSTRACT

BACKGROUND: Digital tools are known to promote public health interventions such as vaccine delivery. The recommendation that health care professionals (HCPs) use vaccination-related mobile apps or web-based applications has contributed to improving vaccine awareness and acceptance in the United States. The state of Texas, which has one of the lowest human papillomavirus (HPV) vaccination rates, has seen a significant increase in HPV vaccine hesitancy, particularly during the COVID-19 pandemic.

OBJECTIVE: This study aimed to examine the association between changes in HPV vaccine hesitancy observed by HCPs among patients in Texas and promotion of vaccination-related applications at the health care facilities where they practiced during the COVID-19 pandemic.

METHODS: A population-based cross-sectional survey was administered in 2021 by the MD Anderson Cancer Center to HCPs working in Texas using email addresses obtained from the LexisNexis Master Provider Referential Database. HCPs were asked if they assessed HPV vaccination status during every patient encounter. Those who responded “Often/Always” or “Sometimes” were subsequently asked whether they observed any change (“Decreased,” “No change,” “Increased,” or “Not sure”) in HPV vaccine hesitancy during the COVID-19 pandemic. Additionally, HCPs were asked whether their practice offers HPV vaccination. Those who responded “Yes” to this question were further asked whether vaccination-related applications are promoted at the facility where they practice, with response options being “Yes,” “No,” or “I don’t know.” Logistic regression analysis was performed to examine the association between changes in HPV vaccine hesitancy observed by HCPs and promotion of vaccination-related applications at the facility where they practice.

RESULTS: A total of 1283 HCPs completed the survey. Of the 730 HCPs who observed changes in HPV vaccine hesitancy, 51 (7%) reported a decrease in their patients’ HPV vaccine hesitancy. Of these 730 HCPs, 578 (79.2%) responded to the questions regarding vaccination-related applications, of whom 104 (18%) reported that vaccination-related applications were promoted at their facilities. Compared to HCPs who reported not promoting vaccination-related applications, those who reported doing so at their facilities had significantly higher odds of observing a decrease in HPV vaccine hesitancy among patients (adjusted odds ratio [aOR] 2.48, 95% CI 1.10-5.55; P=.03). HCPs working at federally qualified health centers or city, county, or public health care facilities (aOR 4.02, 95% CI 1.33-12.14; P=.01) and HCPs who administered the HPV vaccine under standing orders at their facilities (aOR 2.91, 95% CI 1.11-7.63; P=.03) had significantly higher odds of observing a decrease in HPV vaccine hesitancy at their practices.

CONCLUSIONS: Our findings suggest that promoting vaccination-related applications at health care facilities in areas with high HPV vaccine hesitancy such as Texas could further decrease HPV vaccine hesitancy in the population. This may be potentially applicable across diverse health care settings, particularly in the context of pandemic preparedness.

PMID:42133976 | DOI:10.2196/77778

JMIR Public Health Surveill. 2026 May 14;12:e86435. doi: 10.2196/86435.

ABSTRACT

BACKGROUND: Although health care providers are the most trusted sources of health information, service establishments within communities represent important, yet underused, sources of health information. Specifically, food and beauty establishments can act as alternative settings for health communication, facilitating broader engagement with the general population.

OBJECTIVE: This study examined factors associated with willingness to receive health information from these non-health care service establishments among community-dwelling adults in Singapore.

METHODS: A cross-sectional survey was conducted among residents in 2 neighborhoods in central Singapore between November 2024 and April 2025. Data on sociodemographic characteristics, trust in information from health care and non-health care services, and willingness to receive health information were collected anonymously. The primary outcome was willingness to receive health information from non-health care services (yes or no), assessed among respondents with no prior exposure to health information from such services. Multivariable logistic regression was used to identify factors independently associated with willingness to receive health information from non-health care services.

RESULTS: Among the 403 respondents, most were aged ≥50 years (n=223, 55.3%), female (n=219, 54.3%), Chinese (n=350, 86.9%), and highly educated (n=302, 74.9%). Of the 339 respondents without prior exposure to health information from non-health care services, approximately one-third (n=106, 31.3%) reported that they were willing to receive health information in the future. In adjusted analysis, greater trust in health information (adjusted odds ratio [AOR] 3.71, 95% CI 1.50-9.19) and high health information orientation (AOR 1.89, 95% CI 1.11-3.21) were associated with increased willingness to receive health information from non-health care services. Trust in health information was positively associated with willingness among those aged 21 to 34 years (AOR 4.96, 95% CI 1.35-18.30), those aged 35 to 49 years (AOR 8.02, 95% CI 2.62-24.59), and male respondents (AOR 6.22, 95% CI 2.79-13.89) to receive health information from these sources, but not among those aged ≥50 years (AOR 1.92, 95% CI 0.92-4.02) or female respondents (AOR 1.85, 95% CI 0.87-3.96).

CONCLUSIONS: Nearly one-third of community-dwelling adults expressed willingness to receive health information from non-health care (food and beauty) services, highlighting the potential for leveraging these establishments as alternative health communication channels. Willingness was positively associated with higher health information orientation and greater trust. Additionally, trust in non-health care (food and beauty) services was associated with higher odds of willingness to receive health information among those aged 21 to 49 years and male respondents. This suggests the need for tailored trust-building strategies to strengthen engagement through such alternative channels.

PMID:42133973 | DOI:10.2196/86435

J Neuroophthalmol. 2026 Jun 1;46(2):271-278. doi: 10.1097/WNO.0000000000002481.

ABSTRACT

BACKGROUND: The Idiopathic Intracranial Hypertension Treatment Trial’s (IIHTT) objective was to evaluate the efficacy and safety of acetazolamide, combined with a low-sodium weight-reduction diet, in improving visual function in patients with idiopathic intracranial hypertension (IIH) and mild visual loss.

METHODS: To accomplish this, a NEI-sponsored multicenter, double-blind, randomized, placebo-controlled clinical trial was performed at 38 North American clinical sites. A total of 165 participants (161 women; mean age 29 years) meeting the modified Dandy criteria with reproducible mild visual loss (perimetric mean deviation [PMD] -2 to -7 dB) were enrolled. Participants were randomized to acetazolamide or placebo, each combined with a structured dietary program. Acetazolamide was initiated at 1 g/day and titrated weekly to a maximum of 4 g/day. The primary outcome was change in PMD at 6 months. Treatment failure was defined by prespecified reproducible PMD worsening criteria. Secondary outcomes included papilledema grade, OCT metrics, cerebrospinal fluid (CSF) pressure, quality of life, weight change, and headache disability.

RESULTS: Acetazolamide produced greater PMD improvement than placebo (1.43 dB vs 0.71 dB; treatment effect 0.71 dB; P = 0.05) and the result was independent of weight loss. Participants with high-grade papilledema had the greatest benefit (2.27 dB). Acetazolamide significantly improved papilledema grade and OCT optic disc volume and reduced CSF pressure by an additional 60-mm H2O compared with placebo (P = 0.002). Quality-of-life scores improved significantly with improvement in vision being the most important factor. Seven participants experienced treatment failure (6 placebo, 1 acetazolamide). Risk factors for treatment failure were high-grade papilledema, more than 30 transient visual obscurations per month, visual acuity loss, and male sex. Compliance of study drug was high (89% vs 93%). Tolerability was excellent when the maximal tolerated dosage was used with no permanent morbidity.

CONCLUSIONS: Acetazolamide plus diet gave statistically significant improvements of visual function, papilledema, CSF pressure, and quality of life in patients with IIH with mild visual loss. A maximally tolerated dose up to 4 g/day is recommended.

PMID:42133960 | DOI:10.1097/WNO.0000000000002481

Obstet Gynecol. 2026 May 15. doi: 10.1097/AOG.0000000000006320. Online ahead of print.

ABSTRACT

OBJECTIVE: The New York State Safe Motherhood Initiative, a statewide quality-improvement effort, developed a bundle to optimize management of obstetric hemorrhage that was then disseminated and implemented by many hospitals in New York State. The purpose of this study was to evaluate trends in statewide outcomes related to postpartum hemorrhage (PPH) before, during, and after Safe Motherhood Initiative obstetric hemorrhage bundle implementation.

METHODS: Delivery hospitalizations in the 2007-2022 New York State Inpatient Database were analyzed for this repeated ecologic cross-sectional analysis that evaluated outcomes before and after implementation of the Safe Motherhood Initiative obstetric hemorrhage bundle from 2013 to 2015. The New York State Inpatient Database includes discharge data for all inpatient acute care hospitalizations in New York. Trends analysis of PPH diagnoses among all delivery hospitalizations over the study period was first performed. Then, among deliveries complicated by PPH, the rate of the following adverse outcomes was determined by year: 1) transfusion, 2) nontransfusion severe maternal morbidity (SMM), 3) disseminated intravascular coagulation (DIC), and 4) hysterectomy. Analyses were performed with joinpoint regression to determine the average annual percent change (AAPC). Adjusted logistic regression models were additionally performed for each of the adverse outcomes.

RESULTS: Among 3,563,885 delivery hospitalizations, PPH increased continuously from 22 per 1,000 in 2007 to 59 per 1,000 in 2022 (AAPC 6.9%, 95% CI, 6.5-7.5%). In joinpoint analysis, transfusion among delivering patients with PPH increased from 192 per 1,000 in 2007 to 212 per 1,000 in 2013 (AAPC 2.1%, 95% CI, 0.6-6.6%) but then decreased to 174 per 1,000 in 2016 (AAPC -6.8%, 95% CI, -9.5% to -2.1%) before increasing again to 212 per 1,000 in 2022 (AAPC 2.8%, 95% CI, 1.2-8.1%). Severe maternal morbidity increased from 88 per 1,000 in 2007 to 122 per 1,000 in 2014 (AAPC 2.8%, 95% CI, 0.7-7.6%) before decreasing to 76 per 1,000 in 2017 (AAPC -16.3%, 95% CI, -20.8% to -8.4%) before rising again to 88 per 1,000 in 2022 (AAPC 4.4%, 95% CI, 0.1-18.5%). Disseminated intravascular coagulation increased from 54 per 1,000 in 2007 to 90 per 1,000 in 2014 (AAPC 4.5%, 95% CI, 1.3-12.6%), decreased to 53 per 1,000 in 2017 (AAPC -19.3%, 95% CI, -25.3% to -8.9%), and increased without a significant statistical association to 88 per 1,000 in 2022 (AAPC 4.2%, 95% CI, -2.0% to 24.5%). Hysterectomy decreased significantly from 26 per 1,000 in 2013 to 9 per 1,000 in 2022 (AAPC -10.2%, 95% CI, -14.3% to -8.7%). In logistic regression analysis, adjusted odds of severe morbidity from 2016 to 2022 were decreased compared with 2007 after accounting for patient- and hospital-level factors.

CONCLUSION: The initiation of the New York Safe Motherhood Initiative obstetric hemorrhage bundle coincided with decreased risk for a range of adverse outcomes among deliveries complicated by PPH. Decreases in risk continued for approximately 3-4 years after initiation of the program for SMM, DIC, and transfusion. In comparison, hysterectomy decreased continuously until the end of the study period. Case mix and worsening comorbidity may have accounted for later study trends given that adjusted regression models for SMM demonstrated decreased odds of peripartum hysterectomy over the later portion of the study.

PMID:42133948 | DOI:10.1097/AOG.0000000000006320

JMIR Form Res. 2026 May 14;10:e73445. doi: 10.2196/73445.

ABSTRACT

BACKGROUND: US Latine and Hispanic communities face a 1.5 times greater risk of developing Alzheimer disease and related dementia (ADRD) with limited access to culturally and linguistically congruent primary prevention education. The COVID-19 pandemic exacerbated the digital divide, highlighting a need to focus on alternative digital methods for delivering brain health and ADRD primary prevention education. Social media emerged as a promising tool.

OBJECTIVE: The objective of this paper is two-fold. We first describe the development and pilot study of our social media-based Latine-Hispanic Digital Brain Health Program guided by evidence-based frameworks in ADRD. We then present the quantitative and qualitative results from the first 14 months of the program (October 2023-December 2024).

METHODS: We used human-centered design to develop the Digital Alzheimer Health Education Model, which was implemented via 3 social media platforms-Facebook, Instagram, and X (formerly known as Twitter). Our bilingual and bicultural team implemented the model by creating and disseminating tailored educational content in English and Spanish for the resulting Latine-Hispanic Digital Brain Health Program, emphasizing consistency and rapport, storytelling, cultural relevance, linguistic inclusivity, and visual representation. A mixed methods analysis (descriptive statistics and sentiment analysis) was conducted using social media data analytics and users’ comments to guide program evaluation and refinement.

RESULTS: From October 2023 to December 2024, we retained 857 followers across our social media platforms (Instagram: n=534; Facebook: n=124; and X: n=199). Growth in follows, consistent reach and engagement, and positive sentiment were observed on Facebook and Instagram. X was not included in the analysis due to data access limitations.

CONCLUSIONS: The development and pilot study of the Latine-Hispanic Digital Brain Health Program have demonstrated potential in leveraging social media to disseminate brain health and ADRD prevention education to the US Latine and Hispanic communities in English and Spanish. Our preliminary findings demonstrate that culturally and linguistically congruent social media-based approaches hold potential to improve engagement with brain health and ADRD primary prevention education among US Latine and Hispanic populations.

PMID:42133941 | DOI:10.2196/73445

JMIR Ment Health. 2026 May 14;13:e92187. doi: 10.2196/92187.

ABSTRACT

BACKGROUND: Digital mental health interventions (DMHIs) have been widely promoted to improve access to mental health care within the UK National Health Service (NHS), particularly following the COVID-19 pandemic. In 2015, a total of 48 technologies were reportedly used in NHS services in England, but over the past decade, substantial changes to regulatory requirements, evidence standards, and procurement processes have reshaped the digital mental health landscape. There is limited clarity regarding which DMHIs are currently being formally procured and funded by NHS mental health services across the United Kingdom.

OBJECTIVE: This study aimed to identify and describe the DMHIs currently procured, contracted, or paid for by NHS mental health service providers in England, Scotland, and Wales for adult common mental health problems and to compare current procurement practices with findings reported in 2015.

METHODS: Freedom of Information requests were submitted to all NHS mental health trusts in England and all health boards in Scotland and Wales. Responses were collated and screened to provide an updated and extended record of which technologies are reportedly procured or paid for by services.

RESULTS: In total, 19 different DMHIs were identified as being procured across mental health service providers for adult common mental health problems at the time of data collection. This demonstrates a substantial reduction in the number of technologies being adopted into practice compared to the 48 reported in England in 2015. The findings reveal several key insights, including that only 2 technologies have remained in use for a decade, and they shed light on the types of technologies being selected and the variations in procurement practices among the 3 national health services.

CONCLUSIONS: Despite the expansion of the digital mental health marketplace, the number of DMHIs formally procured by NHS mental health services has markedly decreased over the past decade. This consolidation may reflect increased selectivity and the adoption of higher-quality products, driven by strengthened regulatory oversight, evidence standards, and national guidance. Although these developments may enhance safety and quality assurance, they also raise important questions about innovation, market sustainability, and equitable access to digital mental health care. Ongoing monitoring of procurement practices is needed to inform policy, service design, and the future development of DMHIs.

PMID:42133938 | DOI:10.2196/92187

JMIR Mhealth Uhealth. 2026 May 14;14:e58908. doi: 10.2196/58908.

ABSTRACT

BACKGROUND: Over the past 2 decades, global rates of cannabis use have risen significantly, especially among young adults. This has corresponded to an increase in cannabis-related problems and hospitalizations. Thus, there has been significant interest in developing new interventions that can help facilitate cannabis cessation and reduce hospitalization rates. Specifically, mobile apps have emerged as scalable and accessible stand-alone or adjunct interventions that can help individuals with cannabis use disorders.

OBJECTIVE: This study aimed to evaluate the quality of free cannabis cessation apps available on both the Apple App Store and Google Play Store, focusing on the analysis of their features, content, and adherence to evidence-based practices.

METHODS: A systematic search was conducted in April 2023 using a variety of keywords. The apps were deemed eligible if they were free, available in English, accessible on both the Apple App Store and the Google Play Store, and related to cannabis cessation. Eligible apps were used for at least 1 month and were rated on the Mobile App Rating Scale by 2 reviewers. Interrater reliability was excellent, with a weighted Cohen κ of 0.893 (95% CI 0.835-0.943).

RESULTS: Four apps were included in the analysis, namely, “Grounded-Quit Weed,” “Quit Weed,” “Marijuana Addiction Calendar,” and “Marijuana Anonymous.” The mean overall quality score of the apps was 3.4 out of 5, indicating poor to acceptable quality. The apps scored the highest on the “functionality” section and the lowest on the “information” section. Of the 4 apps, 3 focused on tracking cannabis use and duration of abstinence, whereas 1 focused on peer support. A limited number of cannabis cessation apps were identified, and those that were available were of low quality due to a lack of evidence-based information.

CONCLUSIONS: This study is the first to evaluate the current availability and quality of mobile apps designed for cannabis cessation. Unlike previous research that broadly assessed cannabis-related mobile apps, this study focuses on the limited number of free cannabis cessation tools, reflecting what is most available to the general population. The findings highlight a significant gap between the growing demand for virtual cessation tools and the quality of existing options. With the rising global prevalence of cannabis use disorders, there is an increasing need for robust, accessible, and evidence-based therapeutic options. While mobile health apps may be a viable option to support cannabis cessation, the current landscape is limited by poor quality apps and a lack of evidence-based information. From a real-world perspective, this study highlights the need for users to exercise caution when relying on current cannabis cessation apps and underscores the urgent need for the development and evaluation of new evidence-based digital interventions.

PMID:42133935 | DOI:10.2196/58908