Tag: pubmed

JMIR Form Res. 2026 Jul 17;10:e85788. doi: 10.2196/85788.

ABSTRACT

BACKGROUND: Social media is an increasingly prominent channel for communicating menopause information and experiences, yet the affective and behavioral consequences of different narrative framings remain unclear.

OBJECTIVE: We examined how distress, normalizing, and transformative narratives influenced women’s immediate responses to menopause content online, drawing on established narrative framings of menopause as normality, distress, and transformation.

METHODS: In an online experiment, UK women aged 40 to 83 years who were perimenopausal or postmenopausal were recruited via Prolific, a widely used online recruitment platform for behavioral and social science research. A total of 737 women were randomly assigned to view 4 anonymized and standardized social media posts from a pool of 12 reflecting 1 of 3 narratives: normal (n=248, 33.6%), distress (n=241, 32.7%), or transformative (n=248, 33.6%). Participants then reported affective reactions, expected behavioral responses, and perceptions of the posts using 5-point ordered response scales. Ordinal logistic regression models tested demographic predictors and condition effects controlling for demographic factors.

RESULTS: Participants who viewed distress-framed posts reported greater levels of worry (β=.910; P<.001), confusion (β=.818; P<.001), and anxiety (β=.817; P<.001) and lower levels of reassurance (β=-.970; P<.001), optimism (β=-.708; P<.001), and empowerment (β=-.540; P<.001). Distress framing also increased perceived knowledge of menopause (β=.564; P<.001) despite participants feeling more negatively toward the posts. Neither distress nor transformative narratives influenced expected behavioral intentions to like, share, save, comment on, search for, or discuss social media posts compared with normalizing narratives. Postmenopausal status (β=-.630; P<.001) and older age (β=-.492; P<.001) were independently associated with less worry and anxiety. Participants rated distress (β=-.806; P<.001) and transformative posts (β=-.968; P<.001) as less representative of health professionals than normalizing posts; transformative posts were also judged to be less representative of newspapers or television (β=-.687; P<.001).

CONCLUSIONS: Narrative framing shaped immediate affect but not intended engagement with menopause content. Because this study assessed short-term responses to controlled, standardized posts, future research should examine whether these effects persist over time and how they operate in more ecologically valid social media environments. As public discussion expands, diverse, balanced narratives may help reduce stigma and temper the disproportionate salience of negative framing. This study advances understanding of how narrative framing shapes responses to health content online.

PMID:42467962 | DOI:10.2196/85788

Eur J Cancer Prev. 2026 Jul 17. doi: 10.1097/CEJ.0000000000001030. Online ahead of print.

ABSTRACT

Polycyclic aromatic hydrocarbons (PAHs) are environmental and occupational risk factors for some cancers. We conducted a systematic review and meta-analysis on the risk of upper gastrointestinal cancers, including esophageal and gastric cancers, among workers exposed to PAHs. We searched PubMed, EMBASE, and SCOPUS through December 2024, as well as International Agency for Research on Cancer Monographs and reference lists, for cohort and nested case-control studies. Relative risks (RRs) and odds ratios were pooled using random-effects models. Heterogeneity was assessed with the I2 statistic. Subgroup analyses were conducted by sex, region, industry type, study quality, and publication year. Duration of exposure-response was evaluated using meta-regression. Twenty-seven studies met the inclusion criteria, comprising diverse high-exposure occupations including coke production, aluminum production, metalworking, and chimney sweeping. Overall, occupational PAH exposure was associated with an increased risk of upper gastrointestinal cancers [relative risk (RR) = 1.23, 95% confidence interval (CI): 1.10-1.38]. For esophageal cancer, the pooled RR was 1.31 (95% CI: 1.05-1.63), with higher risk estimates observed in high-exposure occupations. Gastric cancer showed a modestly elevated risk (RR = 1.19, 95% CI: 1.05-1.35). Meta-regression indicated a positive association between duration of exposure and esophageal cancer risk (RR per year = 1.03, 95% CI: 1.01-1.06), but not for gastric cancer. No evidence of publication bias was detected (P = 0.66 for esophageal and P = 0.33 for gastric cancer). Occupational PAH exposure is modestly associated with upper gastrointestinal cancer risk, particularly esophageal cancer. Residual confounding and other sources of bias cannot be excluded, preventing conclusions in terms of causality.

PMID:42467956 | DOI:10.1097/CEJ.0000000000001030

JMIR Res Protoc. 2026 Jul 17;15:e90331. doi: 10.2196/90331.

ABSTRACT

BACKGROUND: Emergency referral systems in low- and middle-income countries (LMICs) are characterized by systemic inefficiencies, including prolonged transfer delays, interfacility miscommunication, and inadequate receiving-end preparation. In Khyber Pakhtunkhwa (KP), a province of Pakistan with a population exceeding 40 million, referral pathways remain predominantly paper-based and operationally fragmented. Tertiary medical institutions, including Lady Reading Hospital (LRH), Khyber Teaching Hospital (KTH), and Hayatabad Medical Complex (HMC), sustain a disproportionate burden of medically unnecessary referrals from peripheral facilities, culminating in institutional overcrowding, resource depletion, and attenuation of specialist neurosurgical and emergency care delivery.

OBJECTIVE: This study aims to design, implement, and evaluate a neurosurgery-led digital emergency referral platform-the KP Medical Teaching Institution (MTI) Referral Application-across primary, secondary, and tertiary tiers of health care delivery in KP, with the primary intent of reducing unnecessary referral rates, abbreviating referral response intervals, optimizing inpatient bed utilization, and strengthening bidirectional inter-facility communication.

METHODS: A convergent mixed methods design will be employed, incorporating a quantitative prospective cohort study alongside a qualitative exploratory component. The quantitative arm will adopt a census-based methodology, enumerating all emergency referrals processed through the digital platform over a 6-month pilot period commencing June 2026, with preimplementation historical referral data serving as the comparator. An estimated 5000-7000 referral episodes are anticipated. Primary outcomes include reduction in unnecessary referral rates and referral-to-response time. Secondary outcomes encompass inpatient bed occupancy rates, unanswered referral proportions, case acceptance and declination rates, remotely managed cases precluding physical transfer, patient mortality indices where ascertainable, and health care provider satisfaction scores. Statistical analysis will be performed using IBM SPSS, incorporating descriptive statistics, chi-square, or Fisher exact tests, paired comparisons, and multivariate logistic regression. The qualitative component will comprise structured surveys, semistructured interviews, and focus group discussions among purposively sampled health care professionals and patients, with thematic analysis conducted independently by 2 coders and findings integrated via a convergent mixed methods framework.

RESULTS: System development, stakeholder engagement, user-centered iterative design, beta testing, and platform validation have been completed. Participant recruitment is pending pilot deployment in June 2026. Data collection is projected to conclude by November 2026, followed by analysis from December 2026 through February 2027. Peer-reviewed dissemination is anticipated in spring 2027. No external funding was received.

CONCLUSIONS: This protocol outlines an integrated, multimodal assessment of a neurosurgery-based digital emergency referral system in a resource-constrained low- to middle-income country. In case the expected gains in referral efficiency and communication are realized, the results can be valuable evidence to justify the wider implementation of digital referral platforms in KP and other similar environments.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/90331.

PMID:42467936 | DOI:10.2196/90331

IET Syst Biol. 2026 Jan-Dec;20(1):e70081. doi: 10.1049/syb2.70081.

ABSTRACT

To explore the hub genes and pathways associated with sarcopenia progression from the perspective of mitochondrial dysfunction and macrophage activation. The GEO datasets GSE8479, GSE1428 and GSE136344 were obtained from the GEO database. Mitochondria-related genes (MRGs) and macrophage activation-related genes (MARGs) were identified. Functional enrichment analyses, PPI analysis, diagnostic model construction, molecular subtyping and ssGSEA-based immune enrichment analysis were performed. Key genes were further validated by RT-qPCR. A total of 62 mitochondria- and macrophage activation-related differentially expressed genes (M&MARDEGs) were identified. Nine key genes (IGF1, FTL, MAPK8, MAPK9, TF, CREB1, FAS, VEGFA and NFKB1) were retained in the final diagnostic model. Immune enrichment analysis suggested distinct immune-related transcriptional characteristics among different risk groups and molecular subtypes. RT-qPCR validation demonstrated that IGF1, FAS and MAPK9 were significantly downregulated, whereas FTL, TF, CREB1 and NFKB1 were significantly upregulated in the sarcopenia model group. MAPK8 and VEGFA showed decreasing trends without statistical significance. Integrated transcriptomic analysis identified key genes potentially associated with sarcopenia through the intersection of mitochondrial dysfunction and macrophage activation. These findings provide insights into the molecular characteristics of sarcopenia and may offer candidate targets for future mechanistic and translational studies.

PMID:42467925 | DOI:10.1049/syb2.70081

Eur J Gastroenterol Hepatol. 2026 Jun 12. doi: 10.1097/MEG.0000000000003234. Online ahead of print.

ABSTRACT

Prophylactic clip closure after endoscopic submucosal dissection (ESD) may be beneficial in the prevention of adverse events. In this meta-analysis of randomized controlled trials, we have evaluated the role of prophylactic clipping after ESD. We reviewed multiple databases from inception to 24 January 2026. Outcomes of interest included post-ESD bleeding, perforation, and post-ESD coagulation syndrome. Risk ratios with 95% confidence intervals (CIs) were calculated. Data were analyzed using a random-effects model. Heterogeneity was assessed using the I2 statistic. Five randomized controlled trials with 772 patients were included. Prophylactic clipping was associated with a lower risk of post-ESD bleeding (risk ratio: 0.35, 95% CI: 0.18, 0.65). There was no significant difference in risk of post-ESD coagulation syndrome (risk ratio: 1.06, 95% CI: 0.73, 1.53), and perforation (risk ratio: 0.72, 95% CI: 0.23, 2.30) between the groups. In conclusion, this meta-analysis demonstrates the benefits of prophylactic clipping after colorectal ESD in the prevention of post-ESD bleeding.

PMID:42467919 | DOI:10.1097/MEG.0000000000003234

Singapore Med J. 2026 Jul 17. doi: 10.4103/singaporemedj.SMJ-2025-292. Online ahead of print.

ABSTRACT

INTRODUCTION: Sarcopenia and cardiovascular-kidney-metabolic (CKM) syndrome are common comorbidities. We evaluated their cumulative impact on all-cause and cardiovascular mortality, and the modifying effect of a Composite Dietary Antioxidant Index (CDAI).

METHODS: This prospective study used data from the National Health and Nutrition Examination Survey linked to the National Death Index. Sarcopenia (Foundation for the National Institutes of Health criteria) and CKM syndrome (American Heart Association stages, dichotomised into advanced/non-advanced) defined the primary exposure. Outcomes were all-cause and cardiovascular mortality. Cox models estimated hazard ratios (HRs). Maximally selected rank statistics determined optimal outcome-specific CDAI thresholds.

RESULTS: Among 8782 participants (median follow-up 131 months), advanced CKM syndrome was associated with sarcopenia (odds ratio 2.29, 95% confidence interval [CI] 1.48-3.53). This study demonstrated a cumulative risk of comorbid advanced CKM syndrome and sarcopenia on mortality, with this group exhibiting the highest risk for all-cause (HR 3.11, 95% CI 1.72-5.61) and cardiovascular (HR 1.80, 95% CI 1.04-3.12) mortality. Furthermore, we identified an inverse relationship between disease burden and protective CDAI thresholds for all-cause mortality, whereas cardiovascular mortality exhibited a distinctly higher threshold. Specifically, the comorbidity group required lower antioxidant intake (CDAI >-3.80) than the non-comorbidity group (CDAI >-1.19) for all-cause mortality. Conversely, cardiovascular mortality required a substantially higher threshold (CDAI >3.04).

CONCLUSION: Coexisting advanced CKM syndrome and sarcopenia present a significant cumulative mortality risk. Exploratory analyses suggest that this risk may be mitigated by dietary antioxidants, but the protective threshold is context-dependent. Modest dietary improvement was associated with improved all-cause survival in high-risk patients, whereas higher antioxidant intake correlated with better cardiovascular outcomes. These results suggest that precision nutrition strategies may vary depending on the specific health outcome.

PMID:42467916 | DOI:10.4103/singaporemedj.SMJ-2025-292

Eur J Gastroenterol Hepatol. 2026 Jun 2. doi: 10.1097/MEG.0000000000003228. Online ahead of print.

ABSTRACT

OBJECTIVE: Rectal disease activity in ulcerative colitis is associated with a high symptom burden. The British Society of Gastroenterology (BSG) provides evidence-based recommendations for the management of ulcerative proctitis, which are relevant to patients with rectal disease activity; however, real-world adherence and outcomes remains unclear. This study aimed to evaluate adherence to BSG guideline-recommended management and its relationship with treatment timing and clinical outcomes.

METHODS: We conducted a retrospective observational cohort study at a single tertiary center (2022-2024). Adults with endoscopically confirmed rectal disease activity in ulcerative colitis were included. Guideline adherence was assessed using predefined criteria derived from the BSG algorithm. Clinical, biochemical, endoscopic, and histological remission were evaluated at 12 months.

RESULTS: Of 119 patients, 63 (52.9%) received guideline-adherent management. Adherence was significantly higher when treatment decisions were made at endoscopy compared with deferral to clinic (73 vs. 22%, RR: 0.30, 95% CI: 0.16-0.51; P < 0.001). At 12 months, clinical remission was achieved in 97/119 (81.5%), biochemical remission in 80/96 (83.3%), endoscopic remission in 36/68 (52.9%), and histological remission in 30/68 (44.1%). Guideline-adherent management showed numerically higher clinical remission rates, though not statistically significant. Deferral of treatment decisions was associated with a lower rate of clinical remission (72 vs. 86%), although not statistically significant (P = 0.06).

CONCLUSION: Guideline adherence is suboptimal in real-world practice. Endoscopy-led decision-making were strongly associated with guideline adherence and represents a modifiable system-level factor in care delivery. High overall remission rates suggest that guideline adherence alone may be an incomplete surrogate for care quality.

PMID:42467913 | DOI:10.1097/MEG.0000000000003228

JMIR Res Protoc. 2026 Jul 17;15:e69733. doi: 10.2196/69733.

ABSTRACT

BACKGROUND: Hypnosis is a focused state of consciousness that enhances concentration, attention, and responsiveness to suggestion. It has shown efficacy in treating psychiatric disorders such as depression, anxiety, and posttraumatic stress disorder (PTSD). However, its potential for addressing burnout and related symptoms remains underexplored. This systematic review and meta-analysis aims to assess the effectiveness of hypnotherapy in alleviating symptoms of burnout and associated conditions, including depression, anxiety, and PTSD.

OBJECTIVE: This study aims to evaluate the efficacy of hypnotherapy in treating burnout and its related psychopathologies, including depression, anxiety, and PTSD.

METHODS: A comprehensive search was conducted across PubMed, Scopus, and PsycINFO for peer-reviewed, English-language observational and experimental studies published up to February 2024. Only studies with adults (>18 y) who received hypnotherapy for psychiatric symptoms will be included. Data extraction will focus on treatment effects related to burnout and associated psychiatric conditions. Statistical analysis will be performed using Comprehensive Meta-Analysis (version 4.0). A random-effects model will be used to account for heterogeneity, with Cochran Q and I² statistics used to assess variability. Subgroup analyses will explore moderators such as sociodemographic factors, country, and study quality. Sensitivity analyses will identify influential studies, and publication bias will be assessed using funnel plots and the Egger test. All analyses will be 2-sided (P<.05), and the results will be presented in forest plots.

RESULTS: The search strategy underwent a PRESS (Peer Review of Electronic Search Strategies) review in December 2023 and was registered in PROSPERO (International Prospective Register of Systematic Reviews) in January 2024. Database searches were completed between February and April 2024, followed by title and abstract screening from May to November 2024. Full-text screening began in December 2024, with data extraction conducted from January through April 2025. A preliminary narrative synthesis was completed between May and August 2025. Quantitative analysis began in September 2025 and is ongoing, with completion anticipated in early summer 2026. The final findings are expected to be submitted for publication by fall 2026.

CONCLUSIONS: This review aims to synthesize existing evidence on the potential role of hypnotherapy for burnout and related psychiatric symptoms. This systematic review will provide an updated synthesis of evidence on hypnotherapy for burnout and associated psychological outcomes. Limitations include variability in study designs and measurement tools. The results will be disseminated through peer-reviewed journals and scientific meetings to guide future clinical and research applications.

PMID:42467904 | DOI:10.2196/69733

J Appl Microbiol. 2026 Jul 17:lxag180. doi: 10.1093/jambio/lxag180. Online ahead of print.

ABSTRACT

AIMS: To develop a user-friendly and portable reference material (RM) for onsite validation of medical sterilization equipment, addressing the limitations of conventional biological indicators that require specialized laboratory facilities.

METHODS AND RESULTS: A lyophilized microsphere-based RM containing Bacillus atrophaeus spores was developed by optimizing lyoprotectant formulation. The RM demonstrated excellent homogeneity (F statistic < F critical) and satisfactory stability over 14 days at 4°C and 25°C, rigorously according to ISO 33405: 2024 standard method. When applied to validate UV sterilization devices by quantifying viable spore reduction, it further provided precise and reliable log reduction value measurements. The simple reconstitute-and-culture procedure enabled non-specialists to perform onsite checks. For instance, in UV validation, optimal conditions (e.g., ≥3-log reduction within 30 min at a distance of 150 cm) were easily determined using this RM. Preliminary assessments also confirmed its applicability for ozone and ethylene oxide sterilizers.

CONCLUSIONS: This study presents the first preparation of a convenient, lyophilized spore RM that fulfills ISO 33405: 2024 criteria. Its successful application in validating multiple sterilization modalities demonstrates significant potential for routine quality control and compliance testing in healthcare settings, particularly where advanced laboratory facilities are unavailable.

PMID:42467903 | DOI:10.1093/jambio/lxag180

Rev Esc Enferm USP. 2026 Jul 17;60:e20250589. doi: 10.1590/1980-220X-REEUSP-2025-0589en. eCollection 2026.

ABSTRACT

OBJECTIVE: To identify and map the main guidelines for carrying out home-based enzyme replacement therapy (ERT) administered to children and adolescents diagnosed with mucopolysaccharidosis.

METHOD: A scoping review, conducted according to JBI Manual for Evidence Synthesis (Edition 2024). Twelve data sources were consulted using specific search strategies. Data were extracted using a specific form and analyzed using simple descriptive statistics and a qualitative PAGER approach.

RESULTS: The final sample consisted of 13 articles published between 2007 and 2020, mostly conducted in European countries, with a predominance of authors affiliated with the Royal Manchester Children’s Hospital. Five patterns were identified for consolidating qualified and safe care in the context of homebased ERT administered to children and adolescents with types I, II, IV-A, and VII mucopolysaccharidoses. The nurse emerges as an essential professional in all stages and activities presented.

CONCLUSION: Despite the progress made regarding guidelines for the decentralization of ERT, challenges to its implementation still persist, among which the need for dissemination of technical and scientific knowledge stands out.

PMID:42467880 | DOI:10.1590/1980-220X-REEUSP-2025-0589en