Tag: pubmed

JMIR Cancer. 2025 Aug 8;11:e75728. doi: 10.2196/75728.

ABSTRACT

BACKGROUND: Eastern Asia has historically had the highest global incidence and mortality rates of gastric cancer (GC) while substantial disparities exist between countries. The overall burden of GC remains insufficiently explored.

OBJECTIVE: Using the Global Burden of Disease Study 2021, this research aims to estimate the burden and risk factors of GC in Eastern Asia from 1990 to 2021.

METHODS: Incidence, age-standardized incidence rate (ASIR), deaths, age-standardized mortality rate (ASMR), disability-adjusted life years, age-standardized disability-adjusted life year rate (ASDR), and risk factor burdens for GC were analyzed in Eastern Asia from 1990 to 2021. Joinpoint analysis determined average annual percent change (AAPC) and annual percent change, while age-period-cohort analysis assessed temporal trends. The Bayesian age-period-cohort model projected GC burden from 2021 to 2035. All analyses used R software (version 4.4.1; R Foundation for Statistical Computing).

RESULTS: In 2021, Eastern Asia reported 748,235 new GC cases and 527,054 deaths, accounting for 60.8% (748,235/1,230,232) of new cases and 55.2% (527,054/954,373) of deaths reported globally. From 1990 to 2021, South Korea showed the largest declines in ASIR, ASMR, and ASDR, with ASMR decreasing from 55.4 per 100,000 to 13.3 per 100,000 (AAPC -4.5, 95% CI -4.8 to -4.3). ASIR, ASMR, and ASDR also showed a downward trend in Japan and China, with an AAPC of -3.0 (95% CI -3.2 to -2.8) for ASMR in Japan and -2.4 (95% CI -2.6 to -2.3) in China. The GC burden of North Korea was basically stable, with an AAPC of ASMR of -0.8 (95% CI -0.8 to -0.8). Mongolia showed a slight decline, with an AAPC of ASMR of -1.4 (95% CI -1.7 to -1.0), and the burden of GC was the highest. High-sodium diets and smoking were the main risk factors for disability-adjusted life years of GC in 2021. Smoking contributed to a decline in ASDR as the sociodemographic index increased. Projections suggest continued ASDR reductions across Eastern Asia from 2022 to 2035, though Mongolia will maintain the highest burden.

CONCLUSIONS: Despite a decrease from 1990 to 2021, GC remains a significant public health issue in Eastern Asia. Addressing it necessitates prioritizing primary and secondary prevention, including reducing risk factors and enhancing early screening.

PMID:40779780 | DOI:10.2196/75728

J Med Internet Res. 2025 Aug 8;27:e73610. doi: 10.2196/73610.

ABSTRACT

BACKGROUND: Open-door policies in psychiatric wards are increasingly recommended as a means to reduce coercion and enhance patient autonomy. However, evidence that integrates patient perspectives on ward openness and related safety measures remains limited. Traditional qualitative approaches often lack the breadth to fully capture the complexity of these views. We hypothesized that patients would prefer open-door treatment and hold a critical view of locked-ward environments, emphasizing autonomy and dignity in care.

OBJECTIVE: This study aims to systematically explore psychiatric patients’ perspectives on open-door versus locked-ward treatment, identifying key themes and quantifying preferences within a large clinical sample.

METHODS: A hybrid questionnaire survey was conducted in September 2023 at the University Psychiatric Clinics (UPK) Basel. The survey examined psychiatric service usage and integrated key factors from a meta-review, including ward relationships, environment, autonomy, legal status, coercion, care entitlement, and expectations at admission and discharge. The final sample comprised 604 patients (response rate 19.1%) drawn from an initial pool of 3212 former inpatients. A text mining approach using latent Dirichlet allocation, a Bayesian topic modeling technique, was applied to analyze open-ended responses and identify latent thematic structures.

RESULTS: The majority of respondents (347/544, 63.8%) rated open-door treatment as “very important” (10 out of 10 on a Likert scale). In contrast, only 21.0% (127/552) of participants were willing to accept voluntary treatment in locked wards, with 70.4% (425/552) explicitly rejecting this option. Logistic regression indicated that younger patients were significantly more likely to accept locked ward treatment (β=-.18, P=.04), while patients diagnosed with mood disorders (ICD-10 [International Statistical Classification of Diseases and Related Health Problems, Tenth Revision] F3) showed a trend toward lower acceptance (β=-.42, P=.08). Gender and other diagnoses were not significant predictors. Latent Dirichlet allocation identified 5 key topics within patient narratives, which hierarchical clustering grouped into 2 overarching themes: Restriction and Institutionalization, characterized by terms indicating confinement, loss of control, and social isolation; and Autonomy and Self-Determination, which emphasizes patients’ desire for freedom, control over daily life, and access to nature and outdoor spaces.

CONCLUSIONS: This study provides robust evidence that psychiatric patients overwhelmingly prioritize open-door policies, linking them to enhanced autonomy, trust, and therapeutic engagement. The thematic analysis highlights the psychological and social costs of locked wards and the critical need for flexible, patient-centered care models. Younger age and diagnostic category influence willingness to accept locked settings, suggesting the need for tailored approaches. Institutions aiming to implement open-door policies should consider these preferences alongside adequate staffing, therapeutic programming, and environmental modifications to foster autonomy while maintaining safety. Integrating patient perspectives in policy design may enhance treatment satisfaction and clinical outcomes.

PMID:40779779 | DOI:10.2196/73610

J Am Acad Orthop Surg Glob Res Rev. 2025 Aug 5;9(8). doi: 10.5435/JAAOSGlobal-D-25-00054. eCollection 2025 Aug 1.

ABSTRACT

INTRODUCTION: Disparities in the management of hip osteoarthritis (OA) exist across sex, race/ethnicity, and socioeconomic status, but their combined effect on total hip arthroplasty (THA) utilization remains unclear. This study evaluates differences in presentation, nonsurgical treatments, and THA rates across two academic centers.

METHODS: Patients with primary hip OA seen in 2002 at two tertiary academic centers were included. Demographics, Kellgren-Lawrence grade, Charlson Comorbidity Index (CCI), and nonsurgical treatments were collected. Socioeconomic status was assessed using the social deprivation index, stratified into quartiles (Q4 = most deprived). Chi square, analysis of variance, and t-tests compared demographics and utilization rates. A multivariable model analyzed factors influencing THA likelihood.

RESULTS: Among 456 patients, 328 were recommended for THA for primary hip OA, 63% were female, 6% were Asian, 6% Black, 23% other, 3% unknown, 54% White, and 8% Hispanic. Female patients were older (70.3 ± 8.6 vs. 68.1 ± 9.7 years, P = 0.03). Hispanic patients were younger (62.2 ± 12.1 vs. 70.1 ± 8.7 years, P = 0.0020) with lower CCI (2.20 ± 1.52 vs. 2.93 ± 1.49 vs. 3.28 ± 1.69 P = 0.027). Social deprivation index Q4 patients had greater physical therapy utilization (Q4 79% vs. Q1 62%, P = 0.006). Overall, 79% of patients who were offered THA underwent surgery, with multivariate analysis revealing lower likelihood among females, Black, Asian, and Hispanic patients with higher CCI (P < 0.001), whereas socioeconomically disadvantaged patients were more likely to undergo THA (P < 0.05).

CONCLUSION: Although THA utilization was high, disparities in presentation age, nonsurgical treatments, and comorbidities suggest differing challenges across populations. Future research should explore drivers of these disparities.

LEVEL OF EVIDENCE: IV retrospective cohort.

PMID:40779774 | DOI:10.5435/JAAOSGlobal-D-25-00054

Analyst. 2025 Aug 8. doi: 10.1039/d5an00606f. Online ahead of print.

ABSTRACT

Real-time monitoring of neurotransmitter release in living cells is crucial for understanding neural functions and the efficacy of drug actions. Here, we developed an electrochemical microsensor chip using a multidimensional nanosensitive material (MNG-1) that detects dopamine (DA) with high sensitivity, enabling real-time analysis of exocytosis in living cells. Our sensor-based technique does not require advanced equipment and can detect single exocytotic events using a standard electrochemical workstation and a small Faraday cage, allowing for rapid and statistically significant data collection. We investigated the mechanisms of action of antipsychotic drugs (APs) and found that, in addition to antagonizing DA receptors, APs also influence DA release from living cells. Our experiments demonstrated that haloperidol, sulpiride, and chlorpromazine affect DA secretion from PC12 cells differently, with haloperidol significantly inhibiting secretion. Moreover, increased haloperidol concentration reduced the quantity of DA secreted. This study offers a simple, efficient, and low-cost method for real-time quantitative exocytosis research, with significant potential in neuroscience and drug mechanism research.

PMID:40779771 | DOI:10.1039/d5an00606f

JMIR Mhealth Uhealth. 2025 Aug 8;13:e65260. doi: 10.2196/65260.

ABSTRACT

BACKGROUND: Adherence to weight management strategies may be undermined where lengthy strategy explanations limit engagement and understanding, weakening intervention efficacy. By contrast, implementation intentions have been shown to promote adherence across various health behaviors.

OBJECTIVE: This study aimed to investigate the impact of explanation length and implementation intentions on adherence to brief weight management strategies.

METHODS: Participants (N=200) with a BMI above 25 and an interest in losing weight were recruited from a commercial digital weight management service provider. Participants received information about 1 of 4 weight management strategies on a smartphone app in either a brief or detailed format and were asked to plan their use of the strategy with implementation intentions or were given tips on strategy use. Participants received daily prompts over a 2-week period to report whether they used their assigned strategy. Proposed moderators (need for cognition and planning skills) were measured at baseline.

RESULTS: Strategy adherence was greater with brief information (mean 74%, SD 23%) compared with detailed information (mean 69%, SD 23%); however, this small effect size (Cohen d=0.24) was not statistically significant (P=.13). There was no moderation by need for cognition (P=.25). Adherence did not differ significantly between implementation intentions (mean 71%, SD 27%) and tips (mean 72%, SD 21%; P=.73); however, there was moderation by planning skills (P=.04). As predicted, adherence was greater with implementation intentions compared with tips among those with poorer planning skills.

CONCLUSIONS: Shorter explanation length and implementation intentions (in poorer planners) may enhance adherence to brief weight management strategies, and further investigation is required to confirm these effects.

PMID:40779769 | DOI:10.2196/65260

JMIR Form Res. 2025 Aug 8;9:e73713. doi: 10.2196/73713.

ABSTRACT

BACKGROUND: Quan is a workplace well-being digital platform that supports employees, teams, and organizations in measuring, understanding, and improving their well-being. It is important to develop a validated measurement instrument that enables users to assess and track their well-being over time. Currently, no digital measurement instrument comprehensively evaluates well-being across both personal and professional domains.

OBJECTIVE: We detail the development and validation of the Quan Well-being Index, a new digital self-report measure for assessing well-being in personal life and at the workplace.

METHODS: We performed 3 studies. The first study involved the conceptualization of 6 initial factors, the generation of 51 items, and the steps of face and content validity. In the second study, revised items were presented to a UK sample. In the third study, an independent UK sample completed the final assessment along with a battery of well-being and personality questionnaires. A subsample of participants from the third study retook the assessment approximately 2 weeks after initial completion.

RESULTS: In the first study, after face and content validity processes, the number of items was reduced to 45. In the second study, exploratory factor analysis on data from 1020 participants (age: mean 43.06, SD 12.98 years; 525 female participants) identified a 4-factor solution with 35 items (Kaiser-Meyer-Olkin value=0.98; Bartlett test: χ²₉₉₀=37063.54; P<.001), accounting for 64% of variance. The 4 factors were thrive and connect in personal life, thrive and connect at work, mental health, and physical health. In the third study, confirmatory factor analysis on data from 966 participants (age: mean 44.4, SD 12.52 years; 480 female participants) tested 4 structural models. A hierarchical model (model 1) where the general factor influenced the 4 group factors demonstrated the best fit (χ²₅₂₁=3467.00; Bentler comparative fit index=0.906; Tucker-Lewis index=0.892; root mean square error of approximation=0.077; standardized root mean square residual=0.048; ΔAkaike information criterion=0.0; ΔBayesian information criterion=0.0). Internal reliability was high across subscales (Cronbach α=.88-.93; McDonald ω total=0.89-0.94; Guttman λ6=0.86-0.92). Convergent validity was demonstrated by strong correlations with the Warwick-Edinburgh Mental Well-being Scale (r=0.45-0.85; P<.001) and Flourishing-at-Work Scale (r=0.80-0.84; P<.001). Divergent validity was supported through weak or negative correlations with Big Five Personality Inventory traits (eg, neuroticism: r=-0.29; P<.001). Test-retest reliability assessed in a subset of 275 participants (age: mean 52.12, SD 9.56 years; 170 female participants) over a 2-week interval was strong to very strong across factors (r=0.74-0.81; P<.001).

CONCLUSIONS: The Quan Well-being Index provides a comprehensive assessment of well-being at the workplace and in personal life, and is anticipated to be a valuable digital tool, enabling individuals, teams, and organizations to gain insights, monitor progress, and implement appropriate interventions for a healthier workforce.

PMID:40779765 | DOI:10.2196/73713

J Med Internet Res. 2025 Aug 8;27:e75792. doi: 10.2196/75792.

ABSTRACT

BACKGROUND: Traditional mobile health interventions for physical activity (PA) primarily rely on reflective self-regulatory processes, often neglecting the role of affective associations in sustaining long-term engagement. The WalkToJoy intervention addresses this gap by applying the affective-reflective theory to enhance intrinsic motivation for PA among adults aged ≥40 years through affective message framing, evaluative conditioning, and belief updating.

OBJECTIVE: This proof-of-concept study evaluated the feasibility of the message-based WalkToJoy intervention package and examined the impact of its 3 components-walking suggestion prompts, salience messages, and planning prompts-on affective and behavioral outcomes related to walking.

METHODS: We conducted a fully remote, 6-week full factorial experiment with an embedded microrandomized trial (MRT) involving 49 adults aged ≥40 years. Statistical analyses, including paired t tests and generalized estimating equations, assessed pretest-posttest changes and the effects of smile-inducing walking suggestion prompts with short animated images (GIF images), salience messages, and planning prompts on weekly affective measures and daily step counts. In addition, MRT analyses evaluated the proximal effects of these components. Poststudy interviews were thematically analyzed to contextualize participants’ experiences and engagement with the intervention.

RESULTS: Significant pretest-posttest improvements were observed across affective outcomes on a 7-point Likert scale-affective attitudes improved by 0.547 points (P<.001), affective valuations improved by 0.718 points (P<.001), affective reflection improved by 0.692 points (P<.001), and anticipated affect improved by 0.692 points (P<.001). While the average daily steps showed a nonsignificant pretest-posttest increase of 80 steps (P=.79), further analysis revealed an increase of 506 steps (P=.07) when comparing baseline to the average of weeks 4 to 6. Among the intervention components, GIF prompts significantly increased anticipated affect by 0.345 points (P=.046) and average daily step count by 1834 steps (P=.05) compared to identical text-only prompts. However, MRT analysis found no significant increase in 4-hour step counts following the walking suggestion prompts (P=.55), which was explained by qualitative findings suggesting that participants interpreted messages as flexible day-long reminders rather than immediate calls to action. Salience and planning prompts did not yield substantial quantitative effects but were positively received by participants for promoting mindfulness and personalized engagement.

CONCLUSIONS: The WalkToJoy intervention is a feasible and promising approach for improving affective associations with walking. Walking suggestion prompts were particularly effective in boosting engagement and mitigating message fatigue, highlighting the potential of affect-driven interventions to enhance PA motivation and adherence.

PMID:40779759 | DOI:10.2196/75792

JMIR Form Res. 2025 Aug 8;9:e76958. doi: 10.2196/76958.

ABSTRACT

BACKGROUND: Technology-enhanced learning (TEL) has become increasingly vital in global medical education, offering significant advantages in knowledge acquisition, communication, motivation, and student engagement. In Syria, a country facing prolonged crises, there is an urgent need to evaluate the integration of technology within medical education to address institutional limitations and support student learning.

OBJECTIVE: The aim of this study is to evaluate the awareness, perceived challenges, and needs regarding the integration of technology in medical education from the perspectives of students and faculty at Syrian medical colleges.

METHODS: A cross-sectional survey was conducted during the 2023-2024 academic year across Syrian universities. Stratified random sampling was used to recruit 500 medical students and 200 faculty members. Two tailored, self-administered questionnaires were used, covering motivation, perceived benefits, challenges, and suggestions for technology integration. Validity was assessed through expert review and pilot testing (n=30), and internal consistency was confirmed (Cronbach α=0.6-0.7). Quantitative data were analyzed using descriptive statistics, t tests, ANOVA, and Kruskal-Wallis tests.

RESULTS: Among medical students, 94% (470500) agreed that integrating technology into medical education is essential, with similar agreement from 93.5% (187200) of faculty. No significant differences were found in student responses based on specialization (P=.32) or university type (P=.11). Likewise, faculty perspectives did not significantly differ by academic qualification or years of experience (P>.05). There were several perceived benefits; for instance, 93.2% (n=466) of students reported that technology kept them up to date with new developments, 88% stated it enhanced research skills, and 86.8% found TEL more enjoyable than traditional learning methods. Most respondents (95% n=475) said TEL created a flexible, interactive environment. Among faculty, 77% (n=154) agreed TEL improves clinical skill development. Respondents noted there were some challenges; specifically, 57% (n=285) of students cited poor internet service, 33% (n=165) noted the financial burden, and 82.2% (n=411) called for behavioral guidelines. Among faculty, 85.5% (n=171) cited lack of institutional support and 90% (n=180) emphasized the need for training. Both groups supported the development of communication platforms, curriculum revisions, and faculty development programs.

CONCLUSIONS: There is a strong consensus among Syrian medical students and faculty on the value and necessity of integrating technology in medical education. Despite infrastructure and administrative challenges, both groups recognize TEL as a powerful tool for improving clinical competencies, student motivation, and academic engagement. Institutional commitment, curricular reform, and tailored training are essential to achieving sustainable, effective technology integration.

PMID:40779753 | DOI:10.2196/76958

Traffic Inj Prev. 2025 Aug 8:1-9. doi: 10.1080/15389588.2025.2531410. Online ahead of print.

ABSTRACT

OBJECTIVES: While the prevalence of posttraumatic stress disorder (PTSD) after road traffic accidents (RTA) has been widely studied, there is a gap in research in the context of China. Therefore, this study aimed to provide a pooled estimation of PTSD prevalence after RTA based on Chinese data and compare it to existing international prevalence.

METHODS: A systematic literature search of English and Chinese databases was performed from their inception dates to December 31, 2024. Chinese patients admitted to a hospital or emergency department after RTA, and without traumatic brain injury following RTA or without PTSD before RTA were included, regardless of type of RTA and whether fracture was sustained. Subgroup analyses were performed on the basis on demographics, assessment methods, income, and comorbidity.

RESULTS: The inclusion criteria were met by 21 studies. The pooled prevalence of acute stress disorder (ASD) and PTSD was 30% (95% CI, 22%-37%) and 27% (95% CI,22%-32%), respectively, which is higher than the global prevalence of 16% ASD and 22% PTSD. The transition rate of ASD to PTSD was 77% (95% CI, 63%-91%). Females, older adults, and those with lower income had a higher prevalence of PTSD. In addition, the prevalence of PTSD increased with age. Older survivors with comorbidities including anxiety, depression, complication (such as pain, hemorrhagic shock, hypoxemia), diabetes, and hypertension were more likely to suffer from PTSD than older survivors without those comorbidities.

CONCLUSIONS: PTSD after RTA is common, with more than one in four RTA survivors reporting PTSD. Pooled prevalence was higher than that of meta-analysis that had no restrictions on world region.

PMID:40779750 | DOI:10.1080/15389588.2025.2531410

Traffic Inj Prev. 2025 Aug 8:1-10. doi: 10.1080/15389588.2025.2530074. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to enhance the accuracy and stability of traffic accident loss prediction in China by utilizing machine learning techniques. Specifically, it explores the application of the Extra Trees model combined with feature importance screening to predict key accident indicators such as the number of accidents, deaths, injuries, and property losses.

METHODS: Relevant transportation industry indicators were collected from national statistical sources. A two-step feature screening approach was employed based on average importance and importance ratio to reduce dimensionality and improve model performance. The Extra Trees algorithm was used for prediction modeling, and prediction accuracy was evaluated across multiple experimental runs to assess stability. Additionally, correlation, regression effects, and global importance scores were calculated to quantify the influence of each indicator. Polynomial fitting was conducted to explore the relationship between key indicators and predicted values.

RESULTS: The proposed feature screening approach improved both the accuracy and interpretability of the prediction model. The average prediction errors for the number of accidents, deaths, injuries, and property losses were 4.66%, 1.92%, 10.03%, and 5.01%, respectively. Among all targets, the number of deaths showed the highest predictive accuracy. Polynomial fitting confirmed a strong relationship between selected indicators and predicted values, with a quadratic fit achieving an R² of 0.957. The analysis identified 30 influential indicators, of which 12 had multi-target effects. Highway mileage, grade highway mileage, and average freight distance emerged as the most impactful indicators, with global importance scores exceeding 9.5%. Furthermore, the study demonstrated that prediction stability could be maintained across different data intervals, with error fluctuations remaining within acceptable bounds.

CONCLUSIONS: This study confirms the effectiveness of integrating feature importance screening with the Extra Trees model for predicting traffic accident losses. The methodology not only enhances prediction accuracy but also ensures stable performance across different accident indicators. The quantitative assessment of indicator importance offers valuable insights into the factors contributing to accident severity and provides a data-driven foundation for traffic safety policy and planning.

PMID:40779748 | DOI:10.1080/15389588.2025.2530074