Browse Articles

Trajectories and predictors of health-related quality of life among breast cancer survivors: a latent profile and transition analysis

Synergistic effects of ceramic powder and nano-silica as supplementary cementitious materials in concrete

Presurgical intrinsic thalamic structural covariance network organization in drug-resistant epilepsy undergoing thalamic deep brain stimulation: an exploratory study

Mpox knowledge levels and associated factors among MSM in Chongqing and Chengdu, China

Phase 3 Trial of Weekly Oral Islatravir–Lenacapavir for HIV-1 Treatment

Prevalence and associated factors of insufficient vegetable and fruit intake among adults: a cross-sectional study

Abstract Insufficient intake of vegetables and fruits is a major modifiable risk factor for diet-related diseases worldwide. This study evaluated the intake patterns and associated factors among Hong Kong adults. A cross-sectional survey was conducted in 2024–2025. Data on demographic characteristics, socioeconomic status, lifestyle, and dietary habits were collected from adults aged 18 and above. The primary outcomes were insufficient vegetable intake and insufficient fruit intake, defined as not meeting the recommended daily intake for vegetables and fruits, respectively. Associations were examined using univariable and multivariable logistic regression analyses. Among 4,290 participants (mean age 41.64 years; 60.6% female), the prevalence of insufficient intake was 78.1% ( n  = 3,350) for vegetables and 82.4% ( n  = 3,534) for fruits. In multivariable analysis, male gender was positively associated with both insufficient vegetable intake (adjusted odds ratio [aOR] = 2.204, 95% confidence interval [CI]: 1.783–2.726, p  < 0.001) and insufficient fruit intake (aOR = 1.665, 95% CI: 1.307–2.120, p  < 0.001). Sufficient physical activity was negatively associated with insufficient vegetable intake (aOR = 0.624, 95% CI: 0.520–0.748, p  < 0.001) and insufficient fruit intake (aOR = 0.556, 95% CI: 0.455–0.680, p  < 0.001). Furthermore, older age (aOR = 0.991, 95% CI: 0.983–0.999, p  = 0.033) was negatively associated with insufficient vegetable intake, although the effect size was small. For fruit intake specifically, tertiary education (aOR = 1.814, 95% CI: 1.107–2.973, p  = 0.018) and smoking (aOR = 1.617, 95% CI: 1.239–2.111, p  < 0.001) were associated with higher odds of insufficient fruit intake. Most adults in Hong Kong consumed vegetables and fruits below recommended levels. Insufficient intake was associated with gender, physical activity, education level, and smoking status. These findings highlight the need for targeted public health interventions, particularly for men and individuals with insufficient physical activity. Nutrition education should be integrated with broader health promotion strategies that encourage physical activity and support smoking cessation.

Pregnancies in Patients with Autoimmune Disease Receiving CAR T-Cell Therapy

Daily MODIS land surface temperature trends reveal dual winter warming peaks in the Swiss Alps

The Inequality–Pandemic Cycle — Rethinking Preparedness

Weather based forewarning of whitefly (Bemisia tabaci) in cotton in southwestern district of Punjab

iEvac-Z, an Inactivated Ebola Vaccine — Phase 1 Study in Japan

Leveraging existing knowledge about bacteria–protease relationships to predict existence of proteases across bacterial species

Association of overweight/obesity and dyslipidemia with the prevalence and control of hypertension among adults in Gansu Province, China: a cross-sectional study

How antiretroviral data cleaning reshaped Mozambique’s progress to reaching HIV epidemic control

Quality data is fundamental for any public health program, especially for long-term care programs that rely on longitudinal data for decision making. In Mozambique, there had been a growing discrepancy between the number of people living with HIV (PLHIV) on antiretroviral treatment (ART) reported in the national system when compared to pharmacy and electronic medical records. A national ART data cleaning exercise was conducted in the first semester of 2024 to improve the accuracy and reliability of the nationally reported data. All health facilities with ART services (n = 1,757) compared their nationally reported data between the clinical data available at the health facility and the pharmacy medication pick-up data. The records that were successfully validated were marked as active, while the others were non-active. Upon completion of the review, the nationally reported data were revised. There was a 9.9% decrease (2,166,941–1,951,724) in the number of PLHIV considered currently on ART between December 2023 and June 2024. Among age groups, there was a 28.7% decrease among those less than 10 years of age, 26.4% among those between 10 and 19 years, and 8.0% for those 20 years or more. Cabo Delgado was the province with the largest percentage difference (21.1%, −28,799 PLHIV currently on treatment), while Zambezia had the largest absolute decline, of 41,445 (−8.9%). The notable decreases in PLHIV on ART resulted in an increase in Mozambique’s estimates for new infections, AIDS-related deaths, and vertical transmission. These updates allowed for a more realistic understanding of the HIV epidemic in Mozambique, including highlighting provinces with large data quality issues evidenced by substantial changes in PLHIV on ART numbers. This activity highlighted challenges that exist in paper-based reporting systems and provides evidence for a renewed focus on improving data quality for decision making.

A designathon to collaboratively develop sustainable HIV prevention services for youth with community-based organizations in Nigeria

Introduction The engagement of youth in the design of services that promote and increase the uptake of essential services to reduce HIV and other sexually transmitted infections is vital to sustaining these preventive services. The study objective is to identify strategies for sustaining HIV prevention services among Nigerian youth, in partnership with community-based organizations, through a crowdsourced open call and designathon in Nigeria. Materials and methods From February to March 2024, Nigerian youth (ages 14–24) submitted ideas to an open crowdsourcing call on how community-based organizations in Nigeria might sustain HIV self-testing and youth-friendly preventive services for at-risk youth. The submissions were scored in each domain: relevance, novelty, scalability, replicability, potential for sustainability, and promotion of equity and fairness, with an integer score of 1 (low) to 3 (high)(S1). Ten teams were selected to participate in the 72-hour designathon. Both quantitative and qualitative analysis was conducted. The study used thematic analysis and the PEN 3-Cultural Model to categorize qualitative data into six themes. Descriptive statistics were used to calculate participants’ demographic characteristics. Results One hundred and seventy-eight participants submitted entries; 161 were online entries, and 17 were received via WhatsApp. The majority of participants were female (57.1%) and aged 19–23 years (55.0%), with a mean age of 21.7 (±4.1). Most participants were from the southwest of Nigeria (53.8%), had secondary education (68.9%), and were students (67.9%). About one-third of teams (31.1%) indicated collaborating with non-governmental organizations as a promising way to sustain preventive services. Six themes emerged: Adapted Intervention Design and Delivery, Youth Engagement and Education, Organization Setting, Socio-cultural and Community Context, Community Leadership Through Training and Financial Resources, and Sustainment Through Community Collaboration. Conclusion The crowdsourcing contest open call and designathon engaged youth from diverse backgrounds, and it is a practical way to generate solutions from key stakeholders affected by the community’s prevailing health issues. Developing service delivery strategies that engage, educate, and collaborate with youth on HIV prevention could be sustainable. However, this will not be conclusive without implementing them over time to test their feasibility and sustainability.

Real‑world analysis of Macular Oedema associated with Paclitaxel Formulations using the Japanese Adverse Drug Event Report database

Aim This study explored the potential association between paclitaxel (PTX) and macular oedema (ME), a rare adverse event, through pharmacovigilance analysis using a large-scale spontaneous reporting database. Methods Disproportionality analysis of ME associated with PTX formulations, including nanoparticle albumin-bound PTX (nab‑PTX) was conducted using the Japanese Adverse Drug Event Report database on data collected during April 2004–June 2025. Multivariable logistic regression analysis was used to estimate adjusted reporting odds ratios (RORs) for ME. A positive signal was defined as a lower 95% confidence interval (CI) for the ROR exceeding 1.0 with at least three ME cases. Results Among 585,738 reports, 123 involved ME. A significant signal was observed for overall PTX (adjusted ROR: 19.5; 95% CI: 13.5–28.3). By formulation, significant signals were identified for conventional PTX (adjusted ROR: 9.4; 95% CI: 5.5–16.1) and nab‑PTX (adjusted ROR: 47.0; 95% CI: 30.4–72.8). Multivariable logistic regression indicated significant signals for diabetes mellitus (adjusted ROR: 1.8; 95% CI: 1.2–2.9) and co-administration of prostaglandin analogue eye drops (adjusted ROR: 19.9; 95% CI: 8.6–45.7). Conclusion PTX formulations were associated with an increased reporting signal of ME. Notably, patients with diabetes mellitus and those using prostaglandin analogue eye drops may require closer ophthalmologic monitoring during PTX therapy.

A comparative analysis of readability, quality, and reliability in large language model outputs pertaining to knee osteoarthritis queries

This study aims to comparatively examine the readability, accuracy, and quality of responses provided by artificial intelligence (AI)-based chatbots such as Perplexity, ChatGPT-5, and Gemini to questions about knee osteoarthritis (KOA), which accounts for approximately four-fifths of the global osteoarthritis (OA) burden. In this study, 8 keywords were determined by excluding repetitive, irrelevant or synonymous ones from the 25 most frequently used English keywords associated with KOA based on Google Trends data, and these terms were asked as questions to three different artificial intelligence-based chatbots. The study measured readability using formulas like Coleman-Liau Index (CLI), Automated Readability Index (ARI), and Linsear Write (LW). Reliability of the information was assessed using the Journal of the American Medical Association (JAMA) benchmarks along with the modified DISCERN instrument. To determine overall content quality, the Global Quality Score (GQS) and the Ensuring Quality Information for Patients (EQIP) scale were applied. Together, these tools provided a comprehensive assessment of how understandable, reliable, and high-quality each chatbot’s responses were. The most frequently searched keywords related to OA were “osteoarthritis of knee,” “knee pain,” and “osteoarthritis knee pain.” A readability analysis of responses from three different AI-based chat systems revealed that all platforms had text levels above the Grade 6 threshold, and this difference was statistically significant (p < 0.05). Comparisons demonstrated that ChatGPT-5 produced the most readable content (FRES:45, GFOG:11.9, FKGL:9.24, CLI:14.03, SMOG:8.37, ARI:11.37, LW:7.2). However, Perplexity achieved significantly higher scores than ChatGPT-5 across all quality and reliability assessments, yielding superior median scores (DISCERN: 4, JAMA: 2, GQS: 4, EQIP: 92.8). Perplexity also outperformed Gemini in the mDISCERN reliability assessment (p = 0.001), while no significant difference in quality or reliability was found between Gemini and ChatGPT-5. No statistically significant difference was found between Gemini and ChatGPT in reliability and quality surveys. This analysis of KOA highlights significant challenges regarding the potential of popular AI chatbots for patient information. When examining readability levels, responses from these tools consistently exceed the recommended comprehensibility threshold, making it difficult for patients to absorb critical information. Furthermore, the relatively low scores recorded in reliability and content quality assessments raise significant concerns about the scientific validity and integrity of the medical information presented. Given these findings, the sufficient quality, robustness, and appropriate levels of understandability of future AI-based tools can only be ensured by the establishment and operation of an effective oversight mechanism.

Neck circumference as an anthropometric marker of overweight among school-aged children in Bharatpur, Nepal: A community-based study

Background Childhood overweight have become a major public health concern among children in developing countries. BMI, commonly used to diagnose overweight, requires standardized equipment and trained personnel, limiting their feasibility in large-scale screenings. Neck circumference (NC) has emerged as a simple and practical alternative for identifying overweight in children. This study aimed to examine the association between NC and established anthropometric indicators and to determine optimal NC cutoff values for identifying overweight among school-aged children. Methods A community-based descriptive cross-sectional study was conducted from July to October 2025 among 300 apparently healthy children aged 6–11 years in Ward No. 16, Bharatpur Metropolitan City, Nepal. Sociodemographic data were collected using structured interviews. Anthropometric measurements including height, weight, NC, waist circumference (WC), and hip circumference (HC) were obtained using standardized procedures. BMI-for-age classifications were based on WHO AnthroPlus growth references. Chi square test, pearson correlation, logistic regression, and receiver operating characteristic (ROC) curve analyses were performed using SPSS version 16. Statistical significance was set at p < 0.05. Results Among the 300 children, 48.3% had normal BMI-for-age, 10.3% were overweight and 41.3% were underweight. Chi square test revealed a statistically significant association between neck circumference and BMI-for-age (p < 0.001). Pearson correlation analysis demonstrated strong positive correlations between NC and weight (r = 0.792), height (r = 0.639), BMI (r = 0.723), waist circumference (r = 0.797), and hip circumference (r = 0.734) (p < 0.001 for all). ROC curve analysis indicated excellent diagnostic accuracy of NC for identifying overweight. The optimal cutoff values were 27.75 cm for boys (AUC = 0.884; sensitivity = 88.9%; specificity = 66.2%) and 26.75 cm for girls (AUC = 0.904; sensitivity = 100%; specificity = 69.4%). The overall cutoff value was 27.25 cm (AUC = 0.883; sensitivity = 80.6%; specificity = 74.3%). Multivariable logistic regression analysis confirmed NC had a statistically significant positive association with overweight with COR 12.077 (4.75–30.67) and AOR 20.817 (6.34–68.29). Conclusions Neck circumference is significantly correlated with established anthropometric indicators and demonstrates diagnostic accuracy for identifying overweight among school-aged children. NC measurement is a simple, reliable, and cost-effective screening tool that may be particularly useful in school-based and resource-limited settings.

Temptation as a key driver between affective states and usage outcomes of problematic usage of the Internet: A 14-day ambulatory assessment study

Theoretical models of problematic usage of the Internet (PUI) assume that stress and negative mood can trigger cravings and desires as central drivers to use certain online applications that are expected to provide pleasure and relief, which increases the likelihood of use. Learning and reinforcement mechanisms can result in increased and uncontrolled Internet use, that manifests itself in the form of, for example, neglecting important areas of life like relationships or work. To test these associations in a natural environment, we conducted a 14-day ambulatory end-of-day assessment together with a diagnostic interview at baseline to identify different severity levels of PUI. The sample (N = 900) was part of a multi-center study (FOR2974) including participants who engaged in at least one of the following online activities: gaming, pornography use, social network use, or buying-shopping in either a non-problematic ( n  = 419), risky ( n  = 242), or pathological ( n  = 239) way. The adherence rate was about 88%. The data were analyzed using ANOVAs, generalized linear mixed modeling (GLMM), and multigroup multilevel structural equation modeling (MG-ML-SEM). In participants experiencing more severe PUI, ANOVAs revealed greater neglect of other areas of life ( f  = 0.531), longer use times ( f  = 0.442), and more stress ( f  = 0.220–0.248) as well as worse mood in daily life ( f  = 0.220–0.237). Overall, the variables and random effects in the GLMM explained R² conditional  = 79.9% ( R² marginal  = 22.6%) of variance in the prediction of daily usage with temptation as primary within-person effect ( OR =2.53) and PUI severity as between-person effect ( OR = 0.41 to 11.33) being the main predictors. Results of the MG-ML-SEM indicate that pleasure and relief are reinforcing factors for continued use of the Internet with temptation as the central main driver (strongest effect sizes), as theoretically expected. With the extensive sample, the longitudinal approach, and the robust statistical methods, it shows that assumptions of common theoretical models for PUI can also be found in everyday life.

Muscle activity and airflow dynamics upon gradual weight-gain volumetric enlargement or acute surgical reduction of the tongue base during chewing and swallowing

We aimed to understand changes in activity of oropharyngeal muscles and respiratory airflow during chewing and swallowing in two clinically important conditions: gradual weight-gain volumetric enlargement and acute surgical reduction of the tongue base. Six same-sex sibling pairs of 8-to-9-month-old Yucatan minipigs, 3-each-sex, were studied. Of each pair one was fed with high-calorie pellets to reach obesity with a BMI > 50 (enlargement group), and the other was normal-weighted (BMI < 38) and underwent surgical volumetric reduction of the tongue base (reduction group). Electromyograms (EMG) of the tongue (genioglossus and styloglossus), palatal (tensor veli palatini and levator veli palatini), hyoid/pharyngeal (thyrohyoid and middle pharyngeal constrictor), and jaw (masseter and digastric) muscles were recorded simultaneously with respiratory airflow monitoring and x-ray videofluoroscopy during unrestrained feeding of pellets mixed with barium-sulfate. Videofluoroscopic images and activity-bursts of the digastric and thyrohyoid muscles were references to detect chewing cycles and swallowing episodes. Recording sessions for both groups occurred at baseline (before surgery in reduction group), and weeks 1, 3, and 5 (after surgery in reduction group). EMG activity amplitudes, burst-durations, onsets (timings of muscle activity), and respiratory airflow were evaluated. Altered chewing EMG included delayed onsets of the tensor veli palatini and styloglossus in both groups at weeks 1, 3, and 5 compared to the baseline (p < 0.05). In addition, the activity amplitudes of the styloglossus and masseter muscles in the enlargement group were higher in comparison to those of the reduction group (p < 0.05). Effects on swallowing involved delayed timings of the palatal and tongue muscle activities in the reduction group with potential impaired swallowing after surgery. The enlargement group was susceptible to breathing alterations evidenced by decreased airflow velocity, airflow pressure and tidal volumes in comparison to those of the reduction group (p < 0.05). These findings reveal adaptations to ensure synchronized feeding and respiration under volumetric alterations of the tongue base, with risks of impaired swallowing and respiratory patency.