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Assessing stress, anxiety, and depression in children and adolescents: Validation of the DASS-Y in Poland
Background The Depression Anxiety Stress Scales (DASS-21) is a widely used measure of negative emotional states in adults and adolescents. A youth version (DASS-Y) was recently developed and validated to address the developmental needs of younger populations. While the DASS-Y has shown promising psychometric properties in several languages, no Polish adaptation has been conducted to date. This study aimed to validate the Polish version of the DASS-Y and assess its psychometric performance in a sample of children and adolescents. Methods A total of 344 children and adolescents aged 9–17 years were recruited using a school-based convenience sampling strategy between January 6 and February 16, 2025. Participants completed a sociodemographic questionnaire, the Polish version of the DASS-Y, the Children’s Depression Inventory (CDI), and the Self-Assessment Manikin (SAM) scale. Results CFA supported the original three-factor structure of the DASS-Y with satisfactory model fit indices. The subscales demonstrated excellent internal consistency, with Cronbach’s alpha and McDonald’s omega values exceeding 0.85. The DASS-Y subscales correlated significantly with the CDI and SAM scales in expected directions, supporting convergent and discriminant validity. Metric invariance across genders was established, though scalar invariance was not fully supported, indicating potential differences in item intercepts between boys and girls. Conclusions The Polish version of the DASS-Y is a reliable and valid tool for assessing depression, anxiety, and stress in Polish children and adolescents. While the instrument functions similarly across genders in terms of structure, caution is advised when comparing mean scores between boys and girls due to partial scalar invariance. Future research should explore the DASS-Y’s applicability in clinical settings and its sensitivity to changes over time.
Expression of concern: Prevalence and associated factors of acute respiratory infection among street sweepers and door-to-door waste collectors in Dessie City, Ethiopia: A comparative cross-sectional study
Correction: Study protocol of the ASTOP trial: A multicenter, randomized, double-blind, placebo-controlled trial of presurgical aspirin administration for the prevention of thromboembolic complications of coil embolization for ruptured aneurysms
Association of triglyceride glucose-body mass index (TyG-BMI) with metabolic dysfunction-associated steatotic liver disease: A systematic review and meta-analysis
Background TyG-BMI has been proposed as a marker of insulin resistance in metabolic-associated fatty liver disease, but its clinical utility remains uncertain. This study aims to evaluate the association between TyG-BMI and metabolic dysfunction-associated steatotic liver disease (MASLD) through a systematic review and meta-analysis, focusing on the diagnostic performance across different subgroups. Methods A comprehensive literature search was conducted in PubMed, Scopus, Embase, and Web of Science up to January 20, 2025. Studies evaluating the relationship between TyG-BMI and MASLD in adults were included. A random-effects model was employed to pool effect sizes, and subgroup analyses were conducted based on sex, disease definition, and population type. Results Thirty-five studies with 339,087 participants were included. The pooled mean difference for TyG-BMI between MASLD and non-MASLD groups was 42.72 (95% CI: 35.93–49.51; p < 0.0001). Subgroup analysis revealed higher mean differences in the metabolic-associated fatty liver disease (MAFLD) group (49.56, 95% CI: 39.38–59.74) compared to non-alcoholic fatty liver disease ase (NAFLD) (34.68, 95% CI: 28.45–40.91). The odds ratio per one-unit increment of the TyG-BMI was 1.05 (95% CI: 1.03–1.08). Sensitivity for TyG-BMI in diagnosing MASLD was 0.79 (95% CI: 0.73–0.84), and specificity was 0.76 (95% CI: 0.71–0.80). The pooled area under the curve (AUC) for TyG-BMI was 0.83 (95% CI: 0.81–0.86), with better performance in females (0.88) compared to males (0.83). Subgroup analysis by disease definition showed a higher AUC for MAFLD (0.87) compared to NAFLD (0.81). Conclusion TyG-BMI is a promising diagnostic marker for MASLD, with higher diagnostic performance in MAFLD and among females. Further studies are needed to confirm these findings in diverse populations.
Newcomer youth’s access to contraception care in Canada: A scoping review of qualitative evidence
Objective Many newcomer youth in Canada experience high rates of unmet sexual and reproductive health (SRH) care needs, including contraception. We conducted a scoping review of qualitative evidence to understand newcomer youth’s experiences of accessing contraception care in Canada. Design and data sources We followed the Joanna Briggs Institute guidelines to search five databases (MEDLINE, Embase, CINAHL, PsycINFO and Web of Science). Eligibility criteria Qualitative and mixed methods studies describing newcomer youth experiences of SRH in Canada, published in or after 2010 were included. Data extraction and synthesis We adapted relevant headings for our data charting table from the JBI guidelines and a published scoping review on adolescent health. We reported the findings of our analysis as a narrative summary of the included articles. Results We screened 415 titles and abstracts and retrieved 17 eligible studies for full-text review, of which five were included for analysis. Results highlight that sociocultural influences play an important role in newcomer youth’s perspectives and access to contraception care. The language preferences of newcomer youth in the context of contraception are unique and differ from the needs of the broader immigrant population seeking general health care. Results also identify formal and peer-based educational SRH interventions acceptable to newcomer youth. Conclusion Literature that qualitatively describes newcomer youth’s experiences with contraception is scarce, and existing literatures only mentioned contraception in the context of broader SRH-related issues. Further research that specifically focuses on contraception experiences, involves newcomer youth in the research process and explores the roles of peers in contraception access of newcomer youth is required to better understand their experiences.
scFv intrabody targeting wildtype TDP-43 presents protective effects in a cellular model of TDP-43 proteinopathy
TDP-43 proteinopathies are neurological disorders marked by the abnormal accumulation of TDP-43 in the cytoplasm. This mislocalization disrupts the normal function of the protein. In most cases, it is the wildtype (wt) form of the protein that is involved. An untargeted high-throughput screen of a single-chain variable fragment (scFv) library was performed using phage display against human full-length wt TDP-43. Two scFvs (B1 and D7) were retained following cellular expression (then termed intrabodies) and colocalization with cytoplasmic TDP-43 in vitro. We generated a 3D structure of full length wt TDP-43 in silico, and used it for epitope mapping. In a cellular model of TDP-43 proteinopathy, D7 enhanced the proteasomal degradation of the insoluble 35-kDa C-terminal fragment of TDP-43 and reversed some TDP-43-induced metabolomic alterations, particularly relating to the lipid metabolism. Our findings offer a new scFv intrabody that bind to human wtTDP-43 and modify cellular pathways associated with TDP-43 proteinopathies.
Use of presumptive recommendations and other strategies to encourage HPV vaccine uptake: Results from a national survey of primary care health professionals
Background Primary care health professionals’ (PCHPs’) use of presumptive recommendations, which assume parents want to vaccinate, is associated with greater HPV vaccine uptake. We analyzed PCHP characteristics associated with using this and other strategies to encourage HPV vaccination to inform future communication interventions. Methods A national sample of 2,527 PCHPs (26% pediatricians, 22% family physicians, 24% advanced practitioners, 28% nursing staff) completed our survey in 2022. PCHPs reported which of six communication strategies, including presumptive recommendation, they used to encourage HPV vaccination. Multivariable regression models identified PCHP characteristics associated with use of each strategy. Results Overall, 58% of PCHPs used presumptive recommendations. Use of presumptive recommendations was more common among pediatricians (74%) than family physicians (57%), advanced practice providers (54%), or nursing staff (48%, all p < .05). Pediatricians were also more likely than nurses to use prepared talking points, patient stories, motivational interviewing, and offer vaccination another day to hesitant caregivers. PCHPs who had received training on how to introduce HPV vaccination and address parental hesitancy were more likely to use presumptive recommendations (65% vs. 55%, and 67% vs. 53%, respectively). Conclusions Our findings suggest that PCHPs, particularly non-pediatricians, could benefit from additional training on evidence-based HPV vaccination communication strategies.
Modelling the drivers of outbreak communication in online media news for improved event-based surveillance
Epidemic intelligence (EI) practitioners at health agencies monitor various sources to detect and follow up on disease outbreak news, including online media monitoring. The Platform for Automated Extraction of Disease Information from the Web (PADI-web), developed in 2016 for the French Platform for Epidemiosurveillance in Animal Health (Platform ESA), monitors and collects outbreak-related news from online media, allowing users to detect and anticipate response to disease outbreaks. Given the mass number of outbreak-related news collected with PADI-web, we aimed to understand better what drives communication on outbreaks by the different online media sources captured by this tool to allow for a more targeted and efficient EI process by its users. We built a bipartite network of sources communicating on outbreaks of avian influenza (AI) and African swine fever (ASF) captured by PADI-web between 2018 and 2019 worldwide. We used an Exponential Random Graph Model (ERGM) to assess epidemiological, socioeconomic, and cultural factors that drive communication on disease outbreaks from the different online media sources. Our AI network comprised 969 communicated news (links) from 436 news reports from 212 sources describing 199 AI outbreaks. The ASF network comprised 1340 communicated news (links) from 594 news reports from 204 sources and 277 ASF outbreaks. The ERGM was fitted for each network. In both models, international organisations and press agency sites were more likely to communicate about outbreaks than online news sites (OR = 4.8 and OR = 3.2, p < 0.001 for AI; OR = 3.1 and OR = 4.7, p < 0.001 for ASF). Research organisations for AI (OR = 2.3, p < 0.001) and veterinary authorities for ASF (OR = 3.6, p < 0.001) were also more likely to be a source of information than online news sites. Our work identified the factors driving communication about animal and zoonotic infectious disease outbreaks in online media sources monitored by PADI-web. This information can guide EI practitioners and users of PADI-web to monitor specific sources based on their specialisation and coverage and the disease’s epidemiological status. Our results also suggest that EI practitioners may use other means to collect EI information in countries and regions that are not well-represented in the data.
Relationships between state-level general population alcohol policies and birth outcomes: Results from 1972–2019 vital statistics
Background Research has found that policies that single out pregnant people’s alcohol consumption are mostly ineffective. Identifying alternative approaches – for example, general population alcohol policies – that can reduce adverse effects of pregnant people’s alcohol consumption is essential. Here, we examine how U.S. state-level alcohol policies regarding grocery store and gas station sales, Sunday sales, Blood Alcohol Concentration limits for driving, and government monopolies relate to birth outcomes. Methods Outcome data came from the 1972–2019 U.S. Vital Statistics System birth certificates (N = 160,538,939 live singleton births). Primary outcomes were low birthweight (<2,500 grams) and preterm birth (<37 weeks). Fully adjusted models included state and year fixed effects, state-specific time trends, and maternal- and state-level covariates with standard errors clustered by state. Results The only significant, robust associations between policies and outcomes were for government monopolies. In fully adjusted models, having a government monopoly on spirits or on both spirits and wine retail sales (vs. none) were each related to lower odds of low birthweight births (aOR=0.94, 95% CI: 0.93, 0.95; aOR=0.95, 95% CI: 0.92, 0.98 respectively). Having a government monopoly on spirits sales was also significantly related to lower odds of preterm births (aOR=0.97, 95% CI: 0.95, 1.00). Conclusions Government monopolies on spirits and wine relate to better birth outcomes. Findings underscore the importance of maintaining state government monopolies on spirits and wine as a strategy for protecting against adverse effects of pregnant people’s drinking.
Indocyanine green intravenous administration can more accurately identify the intersegmental plane than the inflation-deflation method in lung segmentectomy
Background Indocyanine green (ICG) intravenous administration (ICG-iv) has been described for detecting the intersegmental plane in lung segmentectomy. However, errors with preoperative planning and accuracy comparisons with alternative methodologies have not been fully validated. Methods This single-center retrospective study identified 138 patients with 140 lesions who underwent segmentectomy using the inflation-deflation (I-D) method or ICG-iv method. The planned margin was calculated using three-dimensional imaging, and the surgical margin was measured for the resected specimen. We evaluated the surgical and planned margin ratio (S/P ratio) and log S/P ratio. Accuracy was also tested using the Root Mean Squared Logarithmic Error (RMSLE): the smaller the RMSLE, the more accurate. Results The study enrolled 86 patients with 88 lesions in the I-D group and 52 patients with lesions in the ICG-iv group. All lesions were completely resected. The ICG-iv group underwent significantly more complex segmentectomies compared to the I-D group (P < 0.001). The median S/P ratio was 0.886 (I-D) and 0.912 (ICG-iv). The mean log S/P ratio was −0.061 (I-D) and −0.013 (ICG-iv). The RMSLE values were 0.258 (I-D) and 0.229 (ICG-iv). In the ICG-iv group, eight patients with lesions (15.3%) had poor staining for intersegmental identification. Notably, the poor staining subgroup included a higher proportion of patients with obstructive pulmonary disease (4/8: 50.0%) compared to the good staining group (6/44: 13.6%) (P = 0.035). Conclusions The ICG-iv method demonstrated superior accuracy in identifying the intersegmental plane compared to I-D method; however, concerns persist regarding suboptimal staining in patients with obstructive pulmonary disease.
Correction: Spatial modeling and ecological suitability of Ebola virus disease in Africa
Expression of Concern: Menstrual hygiene practice among female adolescents and its association with knowledge in Ethiopia: A systematic review and meta-analysis
Ethnic differences in pain, function, and catastrophizing in South Florida adults with knee osteoarthritis
Objective Ethnicity is associated with varying reporting of pain, coping mechanisms, and disease severity in patients with knee osteoarthritis (KOA). However, few studies have evaluated its importance in ethnicity, particularly the Hispanic population. This study compares pain intensity (VAS), function (WOMAC), and pain catastrophizing (PCS) between Hispanic (HP) and non-Hispanic White patients (NHWP) stratified by socio-economic status (SES) and osteoarthritis radiographic K-L grade. Methods A cross-sectional study of patients from a tertiary care clinic between July 2021 and December 2022 was performed. Patients with knee pain, radiographs, and doctor-diagnosis of KOA completed questionnaires in English or Spanish. Descriptive statistics characterized demographic differences between NHWP and HP in VAS, WOMAC, and PCS. Two one-way analyses of variance evaluated the effect of both ethnicity and sex, with subgroup analyses stratifying by K-L grade. Multivariate general linear models assessed primary outcomes while controlling for confounders. Results A total of 195 subjects (HP = 145, NHWP = 50) were included. HP exhibited higher VAS, PCS, and WOMAC scores compared to NHWP. PCS was higher in HP (p = 0.004, mean = 8.89) than NHWP (mean = 4.58), as was VAS (p < 0.001, mean = 4.28 vs. 2.74) and WOMAC (p = 0.029, mean = 27.86 vs. 21.58). These differences remained when controlled for NSES and K-L grade. Stratifying by sex and comparing primary outcomes between HP and NHWP, male HP had greater VAS (p = .021, mean = 3.83 vs. 2.42) and PCS (p = .008, mean = 8.83 vs. 3.35), while female HP had greater VAS (p = .019, mean = 4.62 vs. 3.08) and nonsignificantly greater PCS (p = .164, mean = 8.94 vs. 5.92). Conclusion HP with KOA reported greater pain severity, functional limitation, and PCS. compared with NHWP, even after adjusting for NSES and K-L grade. Our findings expand on previous reports by including a larger number of HP and analyzing the role of sex, impact of socioeconomic status, and influence of radiographic severity on patient symptoms.
Mapping the organisational and interventional framework for patients admitted to Hospital-at-Home for acute illness in Scandinavia – a scoping review protocol
Hospitals in Scandinavia increasingly face an enormous pressure to manage acute emergencies in adults affected by multimorbid disabling conditions and therefore at risk of developing adverse hospitalisation outcomes such as nosocomial diseases. In this context, there is a growing political interest in the region to develop alternative models of acute emergency care such as the Hospital-at-Home (HaH), all the more so as adult patients themselves are showing a pronounced interest in HaH. We are therefore planning a scoping review, following the methodology proposed by Joanna Briggs Institute (JBI), to map the HaH components and interventions delivered to patients when managing acute emergencies in adults with that hospitalization model. We will search the databases MEDLINE, Embase and CENTRAL (Cochrane Central Register of Controlled trials) to include articles of studies on adults admitted to HaH for acute emergency care within 24 hours of getting in touch with either an adult emergency department, an out-of-hours doctor, or a general practitioner. No limitation will be placed on the search period. The electronic search will be supplemented by a grey literature search of ClinicalTrials.gov and of the archives of Ministries of Health of the Scandinavian region. The information recorded during the data extraction process will include study characteristics, participants characteristics and main review outcomes (interventions and organisational structures). Data will be synthesized narratively. This protocol has been registered with Open Science Framework (https://doi.org/10.17605/OSF.IO/K7NJS). Mapping data on HaH for the care of adult acute emergencies in Scandinavia will help provide Scandinavian healthcare stakeholders with an overview of the strengths and weaknesses of different existing HaH models so that they can they can integrate that knowledge to make context-specific recommendations about and subsequently formally implement the management of adult acute emergencies in HaH in the region. Ethical approval was not required as the study does not involve human participants. Findings will be submitted for publication in a peer-reviewed Scandinavian journal and disseminated through institutional websites and LinkedIn. Results will be presented at an international conference.
The TouCAN Codebook: Detecting textual misunderstanding in doctor-patient communication with the philosophy of language tools
Effective communication is widely recognized as a cornerstone of successful medical treatment, as extensively documented in prior research. The doctor-patient relationship relies on clear, accurate information exchange to ensure precise diagnoses, treatment adherence, and patient satisfaction. Yet misunderstandings can seriously undermine this process, creating barriers to optimal care and weakening the therapeutic alliance—a critical element of effective healthcare. Consequently, identifying, understanding, and addressing these misunderstandings is essential. This paper introduces a novel approach to detecting and analyzing such misunderstandings in clinical interactions by drawing on concepts from the philosophy of language. Specifically, we present the ToUCAN Codebook, a structured framework designed to systematically classify and examine instances of textual miscommunication in doctor-patient dialogues. By offering a clear methodology for identifying and preventing potential communication breakdowns, the ToUCAN Codebook contributes to improved healthcare outcomes and a deeper understanding of the dynamics that shape medical discourse.
The functional connectivity between dorsal-medial prefrontal cortex and middle cingulate cortex links trait rumination and depressive symptoms
Task-based functional neuroimaging has revealed that rumination is associated with functional activations in the default mode network (DMN). The present study aimed to examine whether resting state functional connectivity (FC) within the DMN is associated with individual differences in trait rumination. Using the seed-based functional connectivity analysis in a relatively large sample of late adolescents, this study investigated the neural correlates of trait rumination and their associations with depressive symptoms. Results showed that higher functional connectivity between the left dorsal medial prefrontal cortex (DMPFC) and middle cingulate cortex (MCC) was positively associated with trait rumination. Additionally, stronger FC between the left DMPFC and the right inferior parietal lobe (IPL) was also related to trait rumination. Furthermore, logistic regression analysis indicated that FC strength between the left DMPFC and MCC was significantly associated with depressive symptom severity. These findings suggest DMPFC-related network may reflect neural mechanisms linked to both trait rumination and depressive symptoms in late adolescence.
Mental health and gestational weight gain: A comparison between Brazilian cohorts
Introduction The mental health of pregnant women is critical as it influences both maternal and neonatal outcomes. This study investigates the association between maternal mental health and gestational weight gain (GWG) in two Brazilian cohorts conducted in different periods. Methods The Jundiaí cohort (1997–2000) included 875 pregnant women, while the Araraquara cohort (2017–2024) evaluated mental health of 556 pregnant women from 2017 to 2019. Maternal mental health was assessed using the General Health Questionnaire (GHQ), the State-Trait Anxiety Inventory (STAI), and the Perceived Stress Scale (PSS) during the first, second, and third trimesters. GWG was categorized as adequate, insufficient, or excessive based on Institute of Medicine guidelines. Statistical analysis included bivariate tests (Kruskal-Wallis, chi-square, or Fisher’s exact test) and multinomial ordinal logistic regression to evaluate associations. Results In the Jundiaí cohort, high stress levels in the first trimester were associated with lower odds of insufficient GWG (adjusted OR for second quartile: 0.36, 95% CI: 0.18–0.71). In the second trimester, high anxiety levels (TAI ≥ 40) were associated with higher odds of insufficient GWG (ORa: 1.76, 95% CI: 1.12–2.76). In the third trimester, high stress levels (PSS fourth quartile) were associated with higher odds of insufficient GWG (adjusted OR: 1.72, 95% CI: 1.02–2.91). In the Araraquara cohort, no significant associations between mental health and GWG were found. Conclusions Our findings highlight the importance of incorporating psychosocial support in prenatal care to improve maternal and neonatal outcomes. Variations in socioeconomic and temporal contexts may influence the relationship between mental health and GWG. Future research should explore the underlying mechanisms and develop interventions tailored to different socioeconomic and temporal contexts.
Computing mutual similarity of 3D human faces in nearly linear time
Using three-dimensional scans of human faces has become an emerging technique in studies of human variation, where the quantitative assessment of facial similarity complements the measurement of other somatic traits. While the algorithms for automated registration (geometrical alignment) and similarity measurement of two facial scans are well-known and used in practice, their direct application for batch processing is limited due to computational requirements. The batch N:N analysis, where all pairs of scans in a dataset must be mutually registered and compared, introduces quadratic complexity with computation times reaching hours even for relatively small datasets, making it practically unusable. This paper presents a rapid and accurate approach with nearly linear time complexity. Our solution utilizes properties of facial scan geometry to optimize individual steps. Moreover, the algorithm deals with possible holes and other artifacts in polygonal meshes automatically. Experiments demonstrate that the proposed solution is very fast and sufficiently accurate compared to a precise quadratic-time baseline approach.
The evolution of comorbidities in chronic diseases among Chinese middle-aged and elderly people: Evidence from the CHARLS (2015-2020)
Background The comorbidity of chronic diseases among middle-aged and elderly people is a global public health concern that has attracted great attention in recent years. It is crucial to explore the evolutionary pattern of chronic disease comorbidity in Chinese middle-aged and elderly people and to reveal the developmental trajectory of chronic diseases in this population. Methods Data from the China Health and Retirement Longitudinal Study (CHARLS 2015–2020) were utilized for the fixed cohort analysis. Based on the prevalence information of 14 chronic diseases (including hypertension, dyslipidemia, diabetes, cancer, chronic lung diseases, liver disease, heart disease, stroke, kidney disease, stomach diseases, emotional problems, memory-related diseases, arthritis, and asthma) among 10,089 participants aged ≥45 years, association rules and cluster analysis were used to identify trends and trajectories of comorbidities in the middle-aged and elderly populations in China. Results The analysis revealed that the comorbidity rate of the 14 chronic diseases showed a consistent annual increase from 2015–2020. By 2020, over 85% of patients diagnosed with a single chronic condition exhibited concurrent multimorbidity. This epidemiological progression was paralleled by a progressive increase in detected disease associations: binary comorbidities rose from three significant associations in 2015–10 in 2020, whereas higher-order combinations expanded from one ternary association in 2015–35 ternary and 18 quaternary associations by 2020. Notably, hypertension maintained a central position across all identified comorbidity clusters. The comorbidity patterns identified in 2015 included respiratory, liver and kidney, and cardio-cerebral comorbidity patterns and cancer and emotional problems. The comorbidity patterns identified in 2018 included respiratory, liver and kidney, cerebrovascular, and cardiovascular metabolic comorbidity patterns. The comorbidity pattern in 2020 was the same as that in 2018. Conclusion The issues of comorbidities in chronic diseases among Chinese middle-aged and elderly people is significant, with observed variations in the comorbidity patterns across different time periods. The development of clinical assessment and management guidelines for chronic diseases comorbid with key conditions, such as hypertension and dyslipidemia, is recommended. These guidelines aim to facilitate the co-management, co-treatment, and co-reduction of multiple diseases among middle-aged and elderly people.