Tag: pubmed

JMIR Infodemiology. 2025 Jun 16;5:e69945. doi: 10.2196/69945.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has been accompanied by an unprecedented infodemic characterized by the widespread dissemination of misinformation. Globally, misinformation about COVID-19 has led to polarized beliefs and behaviors, including vaccine hesitancy, rejection of governmental authorities’ recommendations, and distrust in health institutions. Thus, understanding the prevalence and drivers of misinformation is critical for designing effective and contextualized public health strategies.

OBJECTIVE: On the basis of a tailored survey on health misinformation, this study aims to assess the prevalence and distribution of COVID-19-related misinformation in Spain; identify population groups based on their beliefs; and explore the social, economic, ideological, and media use factors associated with susceptibility to misinformation.

METHODS: A cross-sectional telephone survey was conducted with a nationally representative sample of 2200 individuals in Spain. The study developed the COVID-19 Misinformation Scale to measure beliefs in misinformation. Exploratory factor analysis identified key misinformation topics, and k-means clustering classified participants into 3 groups: convinced, hesitant, and skeptical. Multinomial logistic regression was used to explore associations between misinformation beliefs and demographic, social, and health-related variables.

RESULTS: Three population groups were identified: convinced (1078/2200, 49%), hesitant (666/2200, 30.27%), and skeptical (456/2200, 20.73%). Conspiracy theories, doubts about vaccines, and stories about sudden death emerged as the most endorsed current misinformation topics. Higher susceptibility to misinformation was associated with the female sex, lower socioeconomic status, use of low-quality information sources, higher levels of media sharing, greater religiosity, distrust of institutions, and extreme and unstated political ideologies. Frequent sharing of health information on social networks was also associated with membership in the skeptical group, regardless of whether the information was verified. Interestingly, women were prone to COVID-19 skepticism, a finding that warranted further research to understand the gender-specific factors driving vulnerability to health misinformation. In addition, a geographic distribution of hesitant and skeptical groups was observed that coincides with the so-called empty Spain, areas where political disaffection with the main political parties is greater.

CONCLUSIONS: This study highlights the important role of determinants of susceptibility to COVID-19 misinformation that go beyond purely socioeconomic and ideological factors. Although these factors are relevant in explaining the social reproduction of this phenomenon, some determinants are linked to the use of social media (ie, searching and sharing of alternative health information) and probably the political disaffection of citizens who have stopped believing in both the ideologically centrist mainstream parties and the institutions that represent them. Furthermore, by establishing the profile and geographic distribution of the convinced, hesitant, and skeptical groups, our results provide useful insights for public health interventions. Specific strategies should focus on restoring institutional trust, promoting reliable sources of information, and addressing structural drivers of health misinformation linked to gender inequalities.

PMID:40523274 | DOI:10.2196/69945

J Med Internet Res. 2025 Jun 16;27:e65304. doi: 10.2196/65304.

ABSTRACT

BACKGROUND: The COVID-19 pandemic accelerated global telehealth adoption, prompting the South Korean government to temporarily legalize telemedicine in 2020 and subsequently launch a pilot program in 2023. As South Korea transitions to a postpandemic digital health environment, understanding the factors associated with willingness to use (WTU) and willingness to pay (WTP) for telemedicine and teleconsultation is essential for informing effective policy and service design. However, few studies have explored how preferences vary across clinical domains or user groups.

OBJECTIVE: This study examined the factors that influence WTU and WTP for telemedicine and teleconsultation across 5 clinical domains: dermatological, psychiatric, musculoskeletal, internal medicine, and cancer disorders.

METHODS: A cross-sectional survey was conducted among 552 participants aged 19-69 years in South Korea, selected through stratified sampling. Multiple logistic regression analysis was used to examine WTU and WTP, considering sociodemographic factors and previous telemedicine experience.

RESULTS: Participants’ age, residence, and previous telemedicine experience significantly influenced their WTU and WTP for telemedicine services. WTP increased with age for both telemedicine (P-for-trend=.02) and teleconsultation (P-for-trend=.001). Noncapital residents showed significantly higher WTU for teleconsultation than capital area residents (odds ratio [OR] 1.48, 90% CI 1.03-2.12; P=.07). Participants with previous telemedicine experience showed higher WTU for telemedicine (OR 4.07, 90% CI 1.84-9.04; P=.004) and teleconsultation (OR 2.21, 90% CI 1.21-4.06; P=.03), and higher WTP for telemedicine (OR 2.89, 90% CI 1.84-4.54; P<.001) and teleconsultation (OR 2.76, 90% CI 1.77-4.30; P<.001). WTU and WTP varied by clinical domain: psychiatric care showed the highest WTU (64.5%) and WTP (27.0%) for telemedicine, while cancer disorders showed higher WTU (48.6%) and WTP (24.8%) for teleconsultation than for telemedicine.

CONCLUSIONS: WTU and WTP for telemedicine and teleconsultation differ substantially depending on service type, clinical domain, and user characteristics. These findings highlight the importance of considering prior telemedicine experience, regional access disparities, and condition-specific care needs when designing digital health strategies. Accordingly, flexible, user-centered telehealth policies are needed to support service accessibility and equitable implementation in the post-COVID-19 era. The insights from this study can serve as a practical foundation for developing inclusive digital health systems in countries undergoing similar transitions.

PMID:40523273 | DOI:10.2196/65304

JMIR Mhealth Uhealth. 2025 Jun 16;13:e51707. doi: 10.2196/51707.

ABSTRACT

BACKGROUND: College students are vulnerable to setting long-term trajectories of low physical activity (PA) but are reachable via mobile health fitness tracking (eg, mobile health step counting) and interpersonal support tailored to the college community. However, no studies have statistically isolated the appeal and influence of these intra- and interpersonal components in college-based PA interventions.

OBJECTIVE: This study retrospectively examined a college-based PA promotion program at a northeast US public university during the COVID-19 pandemic to (1) test the impact of student status on the use of intervention components and (2) determine whether such use was associated with successful retention and goal achievement in the program.

METHODS: The university used a commercial platform for a 30-day PA promotion program during April 2021 with intrapersonal (step-tracker syncing, education, self-monitoring, and motivational messaging) and interpersonal (friend interactions and team games) components. App use was operationalized as intrapersonal (frequency of opening app, education, and self-monitoring) and interpersonal (friends made in-app and team affiliation and size).

RESULTS: Campus-wide emails elicited sign-up by 156 undergraduate students, 57 graduate students, and 126 faculty and staff members. Objective 1 yielded the following results: undergraduates used the app less frequently (median 0.8, IQR 0.4-1.7 times per day) than other groups (graduate students: median 1.4, IQR 0.7-2.7 times per day; P=.01; faculty: median 1.3, IQR 0.7-2.7 times per day, H₂=14.5; P=.001) but made the same number of friends (median 1-2) and teammates (median 8-9; P=.77 for friends and P=.93 for teammates). Objective 2 yielded the following results: most participants (313/335, 93.4%; 95% CI 90%-96%) were retained for the first 7 days, but by 30 days, retention dropped, most notably for undergraduate students (82/154, 53.2%; 95% CI 45%-61%), followed by graduate students (39/56, 70%; 95% CI 56%-81%) and faculty and staff (93/125, 74.4%; 95% CI 66%-82%; χ²₂=12.6; P<.001). Retention was associated with app engagement frequency (model hazard ratio 0.56, 95% CI 0.43-0.72; P<.001) and affiliation with a team having high median app engagement and a large size (intracluster correlation coefficient 0.064, 95% CI 0.001-0.164, P=.05). Meeting a daily step goal was associated with app engagement frequency (β=.72, SE=0.21; P=.001), number of friends (β=.40, SE 0.20; P=.04), and an initial motive of maintaining or increasing (rather than starting) PA (β=.99, SE=0.21; P<.001).

CONCLUSIONS: College students, compared with faculty and staff, used the app less frequently, used the app for a shorter duration before abandonment, and met the step goal on fewer days. Engagement with the program was associated with longer retention and better PA outcomes, which were critically modified by the interpersonal engagement. These findings suggest that college students using virtual PA support during times of physical isolation could benefit from more tailored implementation strategies (eg, timed prompts and team reassignments).

PMID:40523272 | DOI:10.2196/51707

J Biomater Sci Polym Ed. 2025 Jun 16:1-18. doi: 10.1080/09205063.2025.2504022. Online ahead of print.

ABSTRACT

Polyglycolic acid (PGA) suture is a synthetic, absorbable, and biocompatible material. However, it lacks bioactivity and cannot bond with osseous tissue. Bioactive glasses have the ability to form surface apatite and bond with bone, but they are brittle and therefore difficult to shape in the operating room. PGA sutures were coated with chloride-silicate glass (CSG) using the slurry dipping technique. The CSG-coated sutures were characterized before and after immersion in simulated body fluid (SBF) by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), and scanning electron microscopy-energy dispersive spectroscopy (SEM-EDS). The adhesion of the glass coating to the PGA suture was assessed by the knot performance test. The bioactivity of the coated sutures was investigated in SBF) after 7, 14, 21, and 28 days of immersion. The pH variation of the SBF was measured using a pH meter. Tensile strength of the bare and coated sutures was quantified using a universal testing machine before and after immersion in SBF, and the cytotoxicity was assessed using osteoblast-like cells after 24, 48, 72, and 168h. The results revealed that the coating covered and adhered to the surgical suture. The coated suture had the ability to form a small size or low amount of apatite after 7 days of immersion. The CSG coating exhibited a tendency to increase the tensile strength of the suture, but this increase was not statistically significant. The glass coating was not cytotoxic to osteoblast-like cells. It is suggested that PGA sutures coated with CSG could be used as a potential material to promote bone regeneration.

PMID:40523270 | DOI:10.1080/09205063.2025.2504022

JMIR Serious Games. 2025 Jun 16;13:e63424. doi: 10.2196/63424.

ABSTRACT

BACKGROUND: Nature engagement, including affective and physical interactions with nature, is linked to a multitude of health and well-being benefits. Unfortunately, opportunities for engaging with nature are decreasing worldwide. University students, especially, are a demographic group that tends to engage little with nature. Immersive virtual nature (IVN; ie, digital nature content delivered through immersive devices, such as head-mounted displays) has been proposed as a medium to facilitate nature experiences and engagement. In recent years, 360° nature videos have emerged as an accessible way to create IVN content, although it is still unclear whether they can elicit presence and increase nature engagement to a greater extent than nature videos delivered through nonimmersive media.

OBJECTIVE: We aimed to investigate the effectiveness of nature videos as a medium to promote nature engagement among university students, comparing devices with different levels of immersion. Specifically, 2 experimental conditions were tested: a 360° nature video delivered through a head-mounted display (IVN) and a matching video displayed on a tablet screen (nonimmersive virtual nature).

METHODS: In total, 38 students were recruited at the library of a university campus and invited to participate in an organized hiking tour at the location displayed during the virtual nature experience. They were then randomized, using a random number generator, to either the IVN (n=20, 53%) or the nonimmersive virtual nature condition (n=18, 47%). Pre- and postexposure assessments of nature connectedness, intention to perform green exercise, intention to visit the hiking location, and intention to participate in the organized hiking tour were collected. Presence, cybersickness, and actual attendance on the tour were also assessed.

RESULTS: A mixed ANOVA showed statistically significant pre- to postexposure assessment increases in nature connectedness (F_1,36=33.49; P<.001; η_p²=0.48); intention to perform green exercise (F_1,36=5.55; P=.02); intention to visit the hiking location (F_1,36=15.34; P<.001; η_p²=0.26); and intention to participate in the hiking tour (F_1,36=12.45; P=.001; η_p²=0.30). Both conditions were associated with medium to high ratings of “being there” and “sense of reality” but low ratings of “realism.” The cybersickness levels were generally low. Of the 38 students, 6 (16%) participated in the organized tour. The mixed ANOVA found no statistical differences between the two conditions for any of the outcomes. The participants’ changes in nature connectedness (ρ=0.35; P=.03) and attendance on the hiking tour (ρ=.37; P=.02) correlated with the presence item “being there.”

CONCLUSIONS: This study provides novel evidence on the potential of virtual nature as a medium to improve nature engagement among university students, adding to the current debate on the effectiveness of 360° videos. These findings can inform future research as well as initiatives seeking to promote nature engagement.

PMID:40523269 | DOI:10.2196/63424

Ann Am Thorac Soc. 2025 Jun 16. doi: 10.1513/AnnalsATS.202501-129OC. Online ahead of print.

ABSTRACT

RATIONALE: The effects of long-term ambient air pollution exposure on survival in pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) remain unclear.

OBJECTIVES: Evaluate the association between exposure to PM2.5, NO2, and O3, and mortality or lung transplantation in the Pulmonary Hypertension Association Registry (PHAR).

METHODS: 2,196 adult patients enrolled in the PHAR provided data between 2015 and 2024. Annual average concentrations of air pollutants, including PM2.5, NO2, and O3, estimated from validated spatiotemporal models in 2015 were linked to each participant’s residential address. Cox proportional hazards models evaluated the associations between air pollutant exposures and risk of death or lung transplantation, adjusting for baseline demographics, individual and neighborhood socioeconomic factors (SES), disease severity, and spatial confounders. Additional analyses were adjusted for and stratified by nine U.S. census divisions.

RESULTS: Study participants were broadly distributed across U.S. regions, with 72.0% female and a mean age of 55.7. 35.6% had idiopathic PAH, 26.5% had connective tissue disease-associated PAH, and 14.5% had CTEPH. In models adjusted for demographics, individual and neighborhood SES, each IQR increase of PM2.5 was associated with a mortality or lung transplant hazard ratio (HR) of 1.16 (95% confidence interval [CI]: 1.01-1.33). This association was marginally attenuated and not statistically significant after adjusting for spatial covariates, with an HR of 1.12 (95% CI: 0.95-1.31) per IQR increase in PM2.5. We noted regional variation in the observed associations. No significant associations were found with NO2 or O3.

CONCLUSIONS: Long-term ambient air pollution exposure was not significantly associated with survival in PHAR patients with PAH or CTEPH. Future research should investigate potential modifying effects of regional social determinants and healthcare-related factors on the relationship between air pollution exposure and mortality in these conditions.

PMID:40523262 | DOI:10.1513/AnnalsATS.202501-129OC

J Cataract Refract Surg. 2025 Jun 10. doi: 10.1097/j.jcrs.0000000000001709. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the morphologic characteristics of lens in cataract patients with zonule dialysis (ZD) before and after cycloplegia by anterior segment optical coherence tomography (AS-OCT).

SETTING: Peking University Third Hospital, Beijing, China.

DESIGN: Cross-sectional observational study.

METHODS: 56 eyes from 56 participants who would undergo cataract operations were included, with 29 eyes of normal controls and 27 eyes of zonule dialysis patients. Lens morphologic parameters were then evaluated by AS-OCT, including anterior chamber depth (ACD), lens thickness (LT), lens diameter, lens vault, anterior curvature radius, posterior curvature radius, decentration and tilt of lens. After participants were treated with three-time tropicamide solution, AS-OCT was repeated to acquire the post-cycloplegia results. SPSS Software 22.0 was used for statistical analysis.

RESULTS: The comparison of basic lens morphologic parameters without cycloplegia found only anterior curvature (P=0.039) showed significant differences between normal and ZD groups. AS-OCT measured after 30-min cycloplegia treatment showed significantly increased ACD, lens diameter, posterior curvature and decreased vault in both groups, decreased lens thickness in normal group, increased anterior curvature and decreased lens decentration in ZD group (all P<0.05). The logistic regression model showed ZD group had greater alterations of ACD (P=0.014), anterior curvature (P=0.009) and decentration (P=0.031) after cycloplegia treatment when compared with the normal group.

CONCLUSIONS: Lens in ZD patients was characterized by steeper anterior curvature, and grater alterations of ACD, anterior curvature and decentration after cycloplegia. The comparison of lens morphologic parameters before and after cycloplegia might be the potential method to evaluate the stability of zonule.

PMID:40523260 | DOI:10.1097/j.jcrs.0000000000001709

Biopsychosoc Sci Med. 2025 Jun 17. doi: 10.1097/PSY.0000000000001414. Online ahead of print.

ABSTRACT

OBJECTIVE: Genetics contribute to elevated body mass index (BMI) in youth. Adolescents experiencing interpersonal stressors (e.g., peer victimization or parental criticism) may additionally be at a heightened risk for developing high BMI. However, few studies have examined additive contributions of genetic factors and interpersonal stressors to BMI. The current study aimed to address this gap by analyzing associations of BMI with polygenic risk scores (PRS) for BMI and an inflammatory C-reactive protein (CRP), and a range of interpersonal stressors, in a community-based adolescent sample.

METHODS: 827 adolescents (Mage=13.63, SD=1.01, 76% girls of European ancestry) completed self-report measures of peer victimization and parental criticism at baseline. BMI was assessed on average 2 years after baseline. PRS were calculated using summary statistics from the largest genome-wide association studies of BMI and CRP. Analyses consisted of linear regressions, adjusting for population stratification and demographic characteristics.

RESULTS: BMI-PRS and CRP-PRS were independently and significantly associated with BMI (β=0.20 and β=0.10, P<0.05, respectively). Additionally, greater father criticism at baseline was independently associated with higher phenotypic BMI at follow-up (β=0.12, P<0.05). Peer victimization and maternal criticism were not associated with BMI.

CONCLUSIONS: Genetic vulnerabilities to high BMI and inflammation, as well as father criticism, were significantly and uniquely associated with BMI in adolescents. The results are consistent with models of additive contributions of genetics and interpersonal stress to health outcomes.

PMID:40523250 | DOI:10.1097/PSY.0000000000001414

J Med Internet Res. 2025 Jun 16;27:e71091. doi: 10.2196/71091.

ABSTRACT

BACKGROUND: The role of artificial intelligence (AI) in enhancing the accuracy of lymphovascular space invasion (LVSI) detection in cervical cancer remains debated.

OBJECTIVE: This meta-analysis aimed to evaluate the diagnostic accuracy of imaging-based AI for predicting LVSI in cervical cancer.

METHODS: We conducted a comprehensive literature search across multiple databases, including PubMed, Embase, and Web of Science, identifying studies published up to November 9, 2024. Studies were included if they evaluated the diagnostic performance of imaging-based AI models in detecting LVSI in cervical cancer. We used a bivariate random-effects model to calculate pooled sensitivity and specificity with corresponding 95% confidence intervals. Study heterogeneity was assessed using the I2 statistic.

RESULTS: Of 403 studies identified, 16 studies (2514 patients) were included. For the interval validation set, the pooled sensitivity, specificity, and area under the curve (AUC) for detecting LVSI were 0.84 (95% CI 0.79-0.87), 0.78 (95% CI 0.75-0.81), and 0.87 (95% CI 0.84-0.90). For the external validation set, the pooled sensitivity, specificity, and AUC for detecting LVSI were 0.79 (95% CI 0.70-0.86), 0.76 (95% CI 0.67-0.83), and 0.84 (95% CI 0.81-0.87). Using the likelihood ratio test for subgroup analysis, deep learning demonstrated significantly higher sensitivity compared to machine learning (P=.01). Moreover, AI models based on positron emission tomography/computed tomography exhibited superior sensitivity relative to those based on magnetic resonance imaging (P=.01).

CONCLUSIONS: Imaging-based AI, particularly deep learning algorithms, demonstrates promising diagnostic performance in predicting LVSI in cervical cancer. However, the limited external validation datasets and the retrospective nature of the research may introduce potential biases. These findings underscore AI’s potential as an auxiliary diagnostic tool, necessitating further large-scale prospective validation.

PMID:40523236 | DOI:10.2196/71091

JMIR Infodemiology. 2025 Jun 16;5:e69321. doi: 10.2196/69321.

ABSTRACT

BACKGROUND: As the global population ages, concerns about older drivers are intensifying. Although older drivers are not inherently more dangerous than other age groups, traditional surveys in Japan reveal persistent negative sentiments toward them. This discrepancy suggests the importance of analyzing discourse on social media, where public perceptions and societal attitudes toward older drivers are actively shaped.

OBJECTIVE: This study aimed to quantify long-term public discourse on older drivers in Japan through Twitter (subsequently rebranded X), a leading social media platform. The specific objectives were to (1) examine the sentiments toward older drivers in tweets, (2) identify the textual contents and topics discussed in the tweets, and (3) analyze how sentiments correlate with various variables.

METHODS: We collected Japanese tweets related to older drivers from 2010 to 2022. Each quarter, we (1) applied to the Japanese version of the Linguistic Inquiry and Word Count dictionary for sentiment analysis, (2) employed 2-layer nonnegative matrix factorization for dynamic topic modeling, and (3) applied correlation analyses to explore the relationships of sentiments with crash rates, data counts, and topics.

RESULTS: We obtained 2,625,807 tweets from 1,052,976 unique users discussing older drivers. The number of tweets has steadily increased, with significant peaks in 2016, 2019, and 2021, coinciding with high-profile traffic crashes. Sentiment analysis revealed a predominance of negative emotions (n=383,520, 62.42%), anger (n=106,767, 17.38%), anxiety (n=114,234, 18.59%), and risk (n=357,311, 58.15%). Topic modeling identified 29 dynamic topics, including those related to driving licenses, crash events, self-driving technology, and traffic safety. The crash events topic, which increased by 0.28% per year, showed a strong correlation with negative emotion (r=0.76, P<.001) and risk (r=0.72, P<.001).

CONCLUSIONS: This 13-year study quantified public discourse on older drivers using Twitter data, revealing a paradoxical increase in negative sentiment and perceived risk, despite a decline in the actual crash rate among older drivers. These findings underscore the importance of reconsidering licensing policies, promoting self-driving systems, and fostering a more balanced understanding to mitigate undue prejudice and support continued safe mobility for older adults.

PMID:40523233 | DOI:10.2196/69321