The rapid expansion of short-form educational video platforms has substantially increased public access to health information; however, the characteristics and quality of videos concerning patent ductus arteriosus (PDA) have not been systematically evaluated. This study aimed to evaluate the quality and reliability of short-form videos related to PDA posted on TikTok and Bilibili. The Chinese keyword "patent ductus arteriosus" was used to retrieve relevant videos from TikTok and Bilibili, yielding 140 videos for the final analysis. Uploaders were classified according to publicly available account information. Professional uploaders were defined as accounts identifying the uploader as a healthcare professional and displaying official platform verification and/or an explicit affiliation with a recognized medical institution. Credentials were verified using publicly visible profile elements, including verification badges, profile descriptions, professional titles, and stated institutional affiliations. All included videos were independently evaluated by two reviewers. Because paired reviewer-level ratings were available for the Global Quality Score (GQS), inter-rater reliability for GQS was assessed before consensus adjudication using the intraclass correlation coefficient (ICC) and quadratic weighted Cohen's kappa. Video quality and reliability were assessed using five established instruments: the Global Quality Score (GQS), Video Information and Quality Index (VIQI), Patient Education Materials Assessment Tool (PEMAT), the JAMA benchmark criteria, and modified DISCERN (mDISCERN). Only the first 100 algorithm-ranked videos from each platform were screened, in order to reflect the content most likely to be encountered by typical users, although this approach may preferentially capture videos favored by platform recommendation systems. No independent clinical subject-matter expert (such as a neonatologist or cardiologist) was separately involved in the formal scoring process; instead, the evaluation focused on quality, reliability, transparency, and understandability using established assessment instruments. Clinical accuracy was not independently assessed or adjudicated in this study. A total of 140 short videos related to patent ductus arteriosus (PDA) were included in the analysis, with 57 from Bilibili and 83 from TikTok. TikTok videos demonstrated significantly higher audience engagement than those on Bilibili, with markedly greater numbers of likes, favorites, shares, and comments. Bilibili videos were slightly longer in duration, and there was no significant difference in posting time between the two platforms. Videos on TikTok also achieved significantly higher scores across all five quality assessment tools-mDISCERN, GQS, VIQI, PEMAT, and the JAMA benchmark-and most high-quality videos were uploaded by professional individuals. In the present study, these professional individuals were defined on the basis of publicly visible healthcare-related identity information and platform verification status. When stratified by uploader type, videos created by professionals consistently outperformed those from non-professional individuals and institutions in both quality scores and engagement metrics. Professional videos were predominantly found on TikTok. Correlation analyses indicated weak to moderate positive associations between most quality indicators and likes, favorites, and shares on both platforms, although the correlation coefficients remained low. Notably, the average JAMA benchmark score was approximately half of the maximum possible score on both platforms. Inter-rater reliability for GQS was acceptable, with a single-measure ICC of 0.632, an average-measure ICC of 0.774, and a quadratic weighted Cohen's kappa of 0.630. The overall quality of PDA-related health information on major Chinese short-video platforms appears to be moderate. TikTok and professional uploaders demonstrated clear advantages in reliability, comprehensibility, and communication effectiveness. Platform attributes and uploader background exert significant influence on video quality and dissemination performance. Future efforts should focus on strengthening platform oversight, encouraging greater involvement of qualified healthcare professionals, and standardizing the disclosure of information sources and conflicts of interest. Such measures are essential for improving the accuracy, quality, and trustworthiness of online cardiovascular health information and for better supporting parents of children with PDA and the general public. These findings should be interpreted as reflecting informational quality, structure, transparency, and understandability rather than independently verified clinical accuracy.
To systematically evaluate the quality of eye disease videos on TikTok, WeChat, and rednote, explore links between engagement and quality, and offer evidence-based guidance for ophthalmic health communication. The top 100 videos retrieved using the keywords "cataract," "glaucoma," and "high myopia" were screened on TikTok, WeChat, and rednote on 3 October 2025. Two reviewers independently assessed video quality using Journal of the American Medical Association (JAMA), the global quality score (GQS), modified DISCERN, and the Patient Education Materials Assessment Tool (PEMAT). Group differences were analyzed using Kruskal-Wallis and χ2/Fisher exact tests, and adjusted associations were examined using Poisson regression with robust standard errors. A total of 827 eligible videos were analyzed. Most videos were uploaded by physicians and focused on disease knowledge. Across TikTok, WeChat, and rednote, video characteristics, engagement, source, content, presentation form, and quality scores differed significantly. In adjusted analyses, compared with TikTok, WeChat videos had lower likes and comments, whereas rednote videos had lower engagement across all four outcomes. High-myopia videos showed higher engagement across all outcomes, while glaucoma videos showed higher collections and shares. Hospital-uploaded videos were associated with lower engagement, whereas news agency videos were associated with higher engagement. Personal experience videos were associated with higher comments and collections. Higher JAMA scores were consistently associated with lower engagement, whereas modified DISCERN and PEMAT actionability showed inverse associations only for selected outcomes. This study represents the first large-scale cross-sectional evaluation of science communication on potentially blinding eye diseases across major Chinese short-video platforms. High engagement does not equate to high quality; in fact, engagement metrics were significantly negatively correlated with reliability, scientific accuracy, and understandability. Clinicians should uphold scientific rigor and use accessible and friendly language to improve public eye health literacy.
To review extant literature for the use of digital technology to deliver cognitive training perioperatively to prevent or mitigate postoperative delirium (POD). Increasing rates of surgical care place pressures on healthcare systems. POD is a prevalent complication in older adults, worsening patient outcomes and up to 40% may be preventable. Since preoperative cognitive dysfunction is a primary risk factor, understanding the impact of technology-assisted cognitive enhancement on POD may improve patient experience and alleviate costs. Five databases were searched, and articles were reviewed by two investigators. Clinical trials that used digital technology perioperatively to prevent POD in older adults and written in English or French were included in the study. Relevant information was extracted. Out of the 630 articles identified, six (n = 6) were included. Surgical type, targeted cognitive domains and intervention dosing varied, exclusion criteria were restrictive and effectiveness was both positive and null. Relatively few relevant studies were identified indicating the literature is in its infancy. While two of the studies showed positive outcome trends, further research is needed to address adherence, modifiability of cognitive training programs, intervention dosage and less restrictive sampling.
Anemia remains a significant public health issue, especially in emergency areas and refugee camps. This study was conducted to determine the prevalence of anemia and its associated factors among children aged 6 to 59 months in Qoloji internally displaced people camp site, Somali Region, eastern Ethiopia. A community-based cross-sectional study was conducted among 401 children aged 6 to 59 months. Capillary blood was collected and hemoglobin level was determined using HemoCue Hb 301. Data was analyzed using SPSS version 26. Bivariable and multivariable logistic regression were used to identify determinants of anemia. The overall prevalence of anemia was found to be 51.4% (95% CI: 46.6%, 56.4%). Of the anemic children 29.4% (95% CI: 25.2%, 33.9%), 16.7% (95% CI: 13.2%, 20.7%) and 5.2% (95%CI: 3.2%, 7.5%) had mild, moderate, and severe anemia respectively. Initiation of complementary feeding below 6 months (AOR = 2.6;95% CI:1.5,4.6), household food insecurity (AOR = 5.4;95% CI:2.8,10.2), mothers of child having no formal education (AOR = 2.8; 95% CI: 1.3, 5.7), inadequate dietary diversity (AOR = 7.9; 95%CI:4.4, 13.9) and lack of antenatal care follow up during pregnancy (AOR = 3.5;95% CI:1.8, 6.7) were found associated with of anemia. The prevalence of anemia was high among children. Household food insecurity, dietary diversity, initiation of complementary feeding, maternal educational status and antenatal care during pregnancy were factors found associated with anemia. Therefore, adequate interventions should be designed and implemented considering improvement of household food security, access to maternal education and dissemination of nutrition and health related information.
Intra-hospital transfers (IHT) of hospitalized children are unavoidable practices often performed with emergency patients and postoperative patients. Standardizing IHT processes to minimize adverse events might improve children's outcomes. We developed an evidence-based clinical practice IHT guideline for hospitalized children. The aim of this study was to evaluate the implementation process and the effectiveness of the implementation of this guideline on patient outcomes, healthcare professionals' knowledge and behavior, and hospital organizational context. A type III hybrid effectiveness-implementation design was adopted, using a pre-post intervention trial (January-December 2024). Data of patient demographics, transport-related outcomes, and healthcare providers' knowledge and compliance were collected. We used the RE-AIM framework to assess effectiveness across four dimensions: Reach, Effectiveness, Adoption, and Implementation. Totally, 110 healthcare professionals conducted 213 IHTs of eligible children (109 children in the pre-intervention group and 104 in post-intervention group). The Reach outcomes demonstrated that participation among hospitalized children (n = 312) was suboptimal at 33% (104/312). No differences were observed between the pre- and post-intervention group regarding gender, disease distribution, or pediatric early warning scores. The implementation showed favorable outcomes in the dimensions Effectiveness, Adoption, and Implementation. Healthcare professionals engagement was 95%, with 86% (19/22) of the implementation strategies successfully completed. Healthcare professionals' knowledge in the pre-intervention group (n = 109) improved from median 40 (IQR 28;52) to median 76 (IQR 64;84) in the post-intervention group (n = 104; p < 0.001). Clinically, the new guideline reduced adverse events (12 vs 4; p = 0.047), reduced the median minutes of bedside handover time from 5 (IQR 3;7) to 4 (IQR 3;5; p < 0.001), and improved handover information completeness from median score of 5 (IQR 4;6) to 20 (IQR 12;23, p < 0.001). The total transport time increased from 14 to 19 minutes in the post-intervention group (p < 0.05), while no significant changes were observed in handover interruptions or post-transfer vital sign stability (p > 0.05). The RE-AIM-based evaluation confirmed that the implementation strategies effectively enhanced healthcare professionals' knowledge and compliance while reducing adverse events and optimizing handover efficiency. However, the limited patient participation rate and increased transport duration highlight areas requiring further refinement to maximize the guideline's impact. ClinicalTrials.gov, NCT06512805. Registered 27 June 2024.
The growing use of continuous glucose monitors (CGMs) and mobile health (mHealth) applications has changed how diabetes is managed, allowing real-time tracking of glycemic patterns and remote clinical decision-making. These technologies also generate large volumes of sensitive health data, raising questions about who owns this information, how it is protected, and under what conditions it may be repurposed for research or commercial objectives. This review examines the regulatory frameworks governing CGM and mHealth data in major jurisdictions, with particular attention to the Health Insurance Portability and Accountability Act (HIPAA) in the United States and the General Data Protection Regulation (GDPR) in the European Union. Significant regulatory gaps exist, particularly for consumer-grade devices and direct-to-consumer mHealth applications that fall outside traditional healthcare data-protection frameworks. Data ownership remains legally ambiguous in most jurisdictions, with patients, healthcare providers, device manufacturers, and app developers each holding competing claims. The secondary use of clinical data for research, while it could materially advance diabetes care, raises ethical concerns around informed consent, data de-identification, and the boundaries between clinical care and commercial exploitation. Emerging approaches, including the European Health Data Space, federated learning, and differential privacy, may help balance data utility with individual rights. The review recommends changes to regulation, industry practice, and consent models aimed at reconciling data-driven diabetes research with patient autonomy and privacy.
Underutilised edible plants represent important but insufficiently characterised nutritional resources within plant-based food systems. Stenochlaena palustris is a wild edible fern widely consumed in Southeast Asia; however, its incorporation into formulated food matrices remains poorly documented. The objective of this study was to generate initial physicochemical and nutritional data for dates-based food formulations incorporating S. palustris powder at different inclusion levels, providing validated baseline compositional information on an underutilised edible fern within a contemporary plant-based food system. Dates-based energy bars were formulated with S. palustris powder at 2.5% and 5.0% (w/w), alongside a control formulation without fern inclusion. Proximate composition, sugar profile, mineral content, antioxidant activity, and selected physicochemical properties were determined using validated analytical methods by an accredited laboratory. Incorporation of S. palustris was associated with observed increases in dietary fibre, ash, and protein, with generally higher values of selected minerals, including calcium, magnesium, iron, and zinc, in the fortified formulations compared to the control, while total energy values remained comparable across formulations. Water activity values for all formulations were below 0.48, and total flavonoid content increased with higher fern inclusion, while DPPH antioxidant activity was highest in the control formulation. As each formulation was analysed as a single composite sample, the data are presented as baseline compositional observations.
Physicians increasingly deliver health information and medical support through online medical teams (OMTs) in telemedicine platforms, where patients interact with multiple physicians within a single consultation episode. Yet limited research has systematically examined how physician collaboration influences team effectiveness in OMTs. This study investigates the impact of physician collaboration on team effectiveness using a panel dataset of 1,181 OMTs from 2017 to 2023 on a leading Chinese telemedicine platform. We employ a difference-in-differences design and large language models to identify the effects of physician collaboration and uncover the underlying mechanisms. Our results show that physician collaboration reduces team effectiveness. To unpack the underlying mechanisms, we further examine two potential effects: the cognitive-load effect and the free-riding effect. The empirical results reveal that the cognitive-load effect significantly decreases team effectiveness, whereas there is no empirical evidence to support the free-riding effect. Additionally, heterogeneity analyses indicate that the negative effect of collaboration is mitigated when more experienced physicians are involved. These results provide theoretical insights into team performance in telemedicine contexts and advance health communication research. The findings also offer practical guidance for platform designers to strengthen communication management in team-based telemedicine platforms.
The rapid adoption of electric bicycles (EB) has led to a significant increase in related injuries, posing a growing public health challenge. In Anhui Province, China, EB-related orthopedic injuries represent a major component of traffic trauma burden. However, systematic data on injury patterns, anatomical distribution, and demographic variations remain limited, hindering optimized clinical management. This study aims to characterize the clinical spectrum of orthopedic injuries associated with EB that necessitate surgical management. This single-center retrospective cohort study analyzed data from the Hospital Information System (HIS) for patients with EB-related orthopedic injuries between January, 2020, and December, 2025. Among 3,412 vehicle-related injuries, 1,735 cases met inclusion criteria. Injury types were classified into six categories (e.g., fractures, dislocations), and anatomical sites were categorized into 16 regions. Statistical analyses included descriptive statistics and chi-square tests to identify factors associated with severe injuries. The study included 1,735 patients (59.20% male; mean age 48.65 ± 15.73 years), with a bimodal age distribution peaking in the 31-44 and 45-59 groups. Fractures predominated (85.01% of cases), followed by combined injuries such as open fractures with soft tissue damage (4.67%). The most frequent anatomical sites were the clavicle, tibiofibula, and hand/foot. Female patients were significantly older than males (95% CI: 3.44, 6.38; p < 0.001), and young males had higher injury rates. EB-related orthopedic injuries predominantly affect middle-aged and elderly populations (1,735 patients; mean age 48.65 ± 15.73 years, bimodal peaks at 34.65 ± 9.41 years and 57.28 ± 6.72 years), with fractures accounting for 85.01% of cases and combined trauma (e.g., open fractures with soft tissue damage) representing 4.67%. The clavicle, tibiofibula, and hand/foot are the most commonly injured sites. These findings provide foundational insights for orthopedic clinical practice pertaining to EB-related injuries, suggesting that age-stratified triage protocols and prioritized evaluation of high-risk anatomical sites (clavicle, lower limbs) warrant further investigation to optimize resource allocation and patient outcomes in clinical settings. However, this study has several limitations, including its single-center retrospective design, absence of severity validation scores, and insufficient data on protective measures/devices/follow-up and so on. Therefore, prospective multicenter studies are warranted to validate and optimize clinical practice.
Screening and referral for type 2 diabetes mellitus (T2DM) during dental care visits has the potential for expanding preventive care. Using the consolidated framework for implementation research (CFIR) and the theoretical domains framework (TDF), we examined the barriers and facilitators at pre-implementation of a community-driven T2DM screening program in an urban dental clinic serving Alaska Native and American Indian (AN/AI) adults. This convergent mixed-methods parallel study was informed by the updated CFIR. Data were collected in 2023 through a 13-item survey of adult AN/AI potential recipients of the T2DM screening innovation/intervention, and individual in-person interviews with dental and primary care providers, staff, and operational leaders who were from the population of potential innovation deliverers. Univariate statistics and differences between strata were analyzed using R software. Interview transcripts were coded onto CFIR and TDF domains using template analysis then thematically analyzed. A convergent analysis identified areas of convergence, divergence, or complementarity. Two hundred and fifty potential innovation recipients provided survey responses. The majority of survey respondents agreed that the dental clinic is a good place to get T2DM screening, thought screening would be helpful, and had no concerns about the setting. Some respondents had concerns about T2DM screening in the dental setting or by dental staff due to T2DM screening not usually occurring in a dental visit. However, most survey respondents thought the dental clinic as a good place to get screened for diabetes and had low levels of concern about T2DM screening in dental settings. Primary care providers did not see the need for T2DM screening in dental settings; however, about half of potential innovation recipients thought the T2DM screening information would be helpful for their doctor and would be a good way to find if they were at risk for or currently had T2DM. Using CFIR and TDF, we identified barriers and facilitators to inform the design of a pilot process, development of pilot materials, and selection of innovation deliverers.
Sexual dysfunction associated with psychological reasons is one of the factors impacting unfulfilled marriages. There are limited data on treatment outcomes in this context. The aim of this study was determining the treatment of unconsummated marriage in psychogenic erectile dysfunction in Iranian Couples. A total of 66 cases were selected from individuals referred to the Family Health Clinic (from 2006 to 2019), who had unconsummated marriages and experienced psychogenic erectile dysfunction, meeting the inclusion criteria for the study. Research tools included couples' demographic information, face-to-face interviews, and the International Index of Erectile Function (IIEF). The treatment was based on couple's therapy. In the initial session, a comprehensive assessment of the couples' condition was conducted, and research instruments were completed. Additionally, during this session, the formation of psychogenic erectile dysfunction and the lack of successful foreplay were discussed. In subsequent sessions, desensitization, instruction on foreplay, and intercourse were addressed. Treatment success was defined as the ability to achieve complete vaginal penetration. Data was analyzed using SPSS 16 software. All 66 couples continued the treatment until they achieved successful vaginal penetration. All International Index of Erectile Function (IIEF) domains improved significantly after couple-based behavioral therapy in men with psychogenic erectile dysfunction in unconsummated marriages (all p < .001; large effect sizes for most domains). No significant associations were found between educational level, place of residence, engagement duration, or marriage duration and post-treatment scores (all p > 0.05). Male age correlated negatively with overall ED (r = -.314, P = .001), erectile function (r = -.361, P = .003), intercourse satisfaction (r = -.365, P = .003), and overall satisfaction (r = -.266, P = .031). Similar negative associations were observed for female age with overall ED (r = -.371, P = .002), erectile function (r = -.354, P = .004), intercourse satisfaction (r = -.344, P = .005), and overall satisfaction (r = -.246, P = .047). Psychogenic erectile dysfunction in unconsummated marriage can be addressed through couple-based therapy.
Given the unprecedented global volume of forced migration, ensuring equitable access to healthcare for refugees has become a pressing global health priority. This comparative case study examined country-level determinants that influence healthcare access and social determinants of health among refugees in Australia, South Korea, and the United States. We conducted a comparative case study to identify country-level factors influencing refugee healthcare access in Australia, South Korea, and the United States. Countries were selected to capture diversity in geographic context, immigration and integration policies, and healthcare system structures. Data sources included a comprehensive review of laws, policies, and peer-reviewed literature, as well as in-depth interviews with refugees, healthcare providers, resettlement agency staff, and legal professionals. We used framework analysis guided by a conceptual model, incorporating both deductive and inductive coding. This study focused on cross-case themes emerging from the synthesis of all data sources. Findings revealed that, while refugees in all three host countries generally view health services as superior to those in their countries of origin, significant disparities persisted in access across various factors. The availability of culturally and linguistically appropriate care, legal frameworks, insurance systems, and social supports varied widely, contributing to health disparities. In the United States, complex healthcare navigation and insurance gaps posed substantial barriers, while in South Korea, legal mandates for interpretation services were lacking, and health insurance coverage was limited for certain refugee groups. Australia's universal health coverage and government-funded language and interpretation services supported more inclusive access, although barriers existed for vulnerable subgroups. This study underscores the significance of national policies, culturally competent care, and long-term integration support in promoting health equity for refugees. It also highlights the need for targeted, context-sensitive strategies to address persistent barriers and calls for better-tailored policies to support the health and well-being of refugees in host countries and beyond.
De-implementation-reducing low-value or harmful care-is critical but difficult in clinical practice. Clinical decision support (CDS) "nudges" in electronic health records (EHRs) aim to promote guideline-concordant deprescribing, but effects are inconsistent. In a pragmatic randomized controlled trial across a large health system, we tested a suite of EHR-based CDS nudges to support Choosing Wisely-aligned deprescribing of glycemic medications in older adults with type 2 diabetes. Although a prior pilot showed modest improvement in guideline concordance (5.1%), the full trial found no significant changes in prescribing; this process evaluation examines clinicians' comments on alerts to explain why. We conducted a mixed-methods process evaluation of comments within EHR-based alerts from a null-result RCT that promoted Choosing Wisely deprescribing for older adults with type 2 diabetes. Among 66,634 alerts firing across EHR encounters (December 2016-July 2023), providers commented on 764 (1.2%). Two researchers independently coded comments using reflexive thematic analysis, identifying four themes (three negative). Exploratory logistic and multinomial regressions examined predictors of commenting, valence, and themes among acknowledged firings, adjusting for patient, provider, and encounter factors. Thematic analysis of comments revealed three barriers to deprescribing: (1) disagreement with Choosing Wisely guidelines (308 comments, e.g., perceived low overtreatment risk); (2) workflow misalignment (203 comments, e.g., wrong provider responsibility); and (3) patient preferences (69 comments). Logistic regression showed multiple concurrent OPAs reduced action odds by 31.6% (OR 0.684, 95% CI 0.560-0.835); comments were 2.57 times more likely to be negative than positive (OR 2.565, 95% CI 1.637-4.018). Disparities in engagement were found, with female providers, patients, and socially vulnerable individuals less likely to comment. This process evaluation demonstrates scalable real-time feedback for clinical decision support refinement in de-implementation, with regressions identifying context-specific predictors. Provider disagreement, alert firings misaligned to workflows, and patient resistance hinder effectiveness. Future work should refine clinical decision support design to address complexity, enhance guideline explainability to build provider concordance, align with provider roles and workflows, and include patient-centered approaches. The NYU School of Medicine Institutional Review Board (i17-01308) approved the trial, which has the clinicaltrials.gov ID NCT04181307 (https://clinicaltrials.gov/study/NCT04181307), with a first record date of November 26, 2019.
The diagnosis of rare diseases increasingly relies on the interpretation of high-throughput next-generation sequencing (NGS) data. As sequencing volume expands, the analytical burden grows substantially, and manual workflows become increasingly difficult to scale and prone to inconsistency. To address these challenges, we developed G.AI, an interpretable and traceable artificial intelligence (AI)-assisted genomic analysis platform that integrates automated phenotype standardization, variant pathogenicity ranking, and structured clinical reporting. The platform uses a modular architecture comprising data parsing, AI-driven inference, and structured report generation. Performance was assessed using 39,156 multicenter whole-exome sequencing (WES)/ parent-child trio sequencing (WES Trio) cases from China, including 7,097 confirmed pathogenic/likely pathogenic (P/LP) single-nucleotide variants (SNVs) positive cases. Key evaluation metrics included phenotype-model concordance, Top-1, Top-3 and Top-20 variant pathogenicity ranking accuracy and workflow efficiency. The AI-Human Phenotype Ontology (HPO) phenotype standardization model achieved 94% concordance with manual review. The pathogenicity-ranking model reached Top-1 95%, Top-3 98%, and Top-20 99.6% accuracy among positive cases, with metabolic disorders achieving 100% Top-3 accuracy. Additional analysis on non-diagnostic cases demonstrated low false prioritization rates and good model specificity. Total analysis time decreased from 4 to 6 h to 48 ± 12 min, demonstrating a significant improvement in efficiency. By integrating automated phenotype processing, variant annotation, and AI-driven pathogenicity evaluation, G.AI substantially enhances the accuracy, consistency, and scalability of rare disease variant interpretation. Its transparent and traceable workflow provides a robust foundation for large-scale clinical genomic applications.
The potential re-emergence of Mpox poses an increasing public health concern in the Horn of Africa, particularly in Ethiopia. This study examined perceptions of preparedness among surveyed surveillance professionals in Ethiopia regarding the disease surveillance system's ability to detect and respond to a potential Mpox outbreak. A descriptive cross-sectional survey design was employed, utilizing a structured 58-item questionnaire that assessed preparedness across five domains: general awareness and understanding, surveillance infrastructure and resources, coordination and communication, preparedness and response, and policy, training, and equity. The survey was distributed to disease surveillance professionals at both federal and regional levels through purposive sampling. The data were analyzed using descriptive statistics, Mann-Whitney U tests, Cramér's V, and content analysis. Among the 42 surveyed surveillance professionals, 45.3% believed that the surveillance system could effectively respond to an Mpox outbreak, while 54.7% disagreed, reflecting divided perceptions within the sample. Respondents identified several perceived gaps, including limited awareness of Mpox-specific protocols, insufficient training, inadequate diagnostic capacity, and fragmented coordination across sectors. A substantial proportion of respondents reported system-related challenges, with 83.3% perceiving laboratory facilities as inadequate and 78.6% noting the absence of contingency plans. In addition, 57.1% indicated that their organizations lacked staff trained on Mpox, and 59.5% reported no stockpiles of personal protective equipment. Overall, the surveyed professionals expressed mixed perceptions of preparedness, with notable concerns regarding resource allocation, infrastructure, and policy implementation. The study identifies perceived gaps among the 42 surveyed surveillance professionals regarding Mpox preparedness in Ethiopia, highlighting the need for enhanced training, strengthened infrastructure, improved coordination, and more equitable resource distribution. Addressing these gaps through targeted interventions may help strengthen disease surveillance capacity and improve the ability to detect, respond to, and manage emerging health threats such as Mpox.
Children's perspectives on optimal health care are rarely considered in health care research. These routine health assessments are carried out by Youth Health Care services (YHC), which provide school health care as part of preventive care for children. The aim of this study is to explore the perspectives of children aged 9 to 12 years old, on current routine health assessments in Dutch school health services and how these could be improved to better align their preferences and needs. We conducted a qualitative focus group study with Dutch primary school children, 9 to 12 years old, who received their routine health assessment from YHC in the past twelve months. Discussion topics included experiences with preventive youth health care services, preferences regarding involvement of parents, and suggestions for improvement of the services. Reflexive thematic analysis was conducted using the 6-step approach by Braun and Clarke. Six focus groups were conducted with in total 41 children. We identified four main themes; 'We want more! Monitoring health matters to children'; 'Feeling safe and comfortable: be the nice and sweet professional in a two-way conversation'; 'Parents know a lot, but not everything: mixed feelings on their role and presence', and 'Preventive youth health care should be organized more attractive'. Our sample of Dutch children perceived preventive routine health assessments as important to monitor their health and suggested more frequent and comprehensive assessments. The children's perspectives, provided relevant insights in how to design child-friendly preventive youth health care.
Conversational Agents (CAs) are a promising tool for enhancing adolescents' physical activity behaviours. To effectively fulfil their role, these agents must address the diverse range of barriers adolescents encounter and provide effective, evidence-based solutions. To achieve this, a theoretical framework titled PhysB is proposed, which is grounded in theory and evidence, allowing for the identification and categorisation of barriers through natural language input. The PhysB framework outlines the relationship between the process of identifying barriers and the cognitive system driving the CA's interaction with adolescents. It incorporates key constructs from various theoretical models and frameworks and draws from behaviour change theory. The PhysB framework's main function is to inform the design and evaluation of personalised, evidence-based conversational AI interventions to promote positive behaviour change in adolescents. The PhysB framework's broad applicability extends to practitioners, policymakers, researchers, and designers involved in designing conversational AI interventions.
Trigger finger (stenosing tenosynovitis) reflects abnormal tendon-pulley mechanics, primarily at the A1 pulley; however, objective assessment during functional motion remains limited in routine clinical practice. We evaluated electrical contact resistance (ECR) from a wearable tactile sensor during standardized digit motion and examined its association with symptoms. Nine participants with Green grade II-III trigger finger were prospectively enrolled. An origami-inspired pentagon-knot graphene-paper tactile sensor measured ECR over the A1 and A2 pulleys during repeated flexion-extension cycles. A 4-week intervention program (electrical stimulation plus infrared irradiation; three sessions per week) enabled repeated measurements. ECR and patient-reported outcomes were collected at weekly Tuesday assessments, with ECR recorded immediately before and after the session (ECRpre and ECRpost). Outcomes included pain (visual analog scale [VAS]) and triggering severity (ST), frequency (FT), and functional impact (FIT). Within-session change was defined as ΔECRsession = ECRpre - ECRpost. Analyses used linear mixed-effects models, repeated-measures correlation (rmcorr; rrm coefficient) and week-adjusted fixed-effects regression. Sensor placement and recording were feasible, with no adverse events. Across 27 paired weekly sessions (Weeks 1-4), ECR decreased from pre- to post-session at both pulleys (model-estimated mean ΔECRsession: A1 0.0795; A2 0.0990; both P < 0.001). A1 ECRpre declined over Weeks 1-4 (rrm = - 0.672; P = 0.0016). At matched weekly timepoints (N = 6; n = 24), A1 ECRpre correlated with VAS (rrm = 0.781; P < 0.001), FT (rrm = 0.578; P = 0.0095), and ST (rrm = 0.543; P = 0.0164), but not FIT (rrm = 0.165; P = 0.50). Larger A1 ΔECRsession values were associated with greater subsequent week-to-week pain improvement (rrm = 0.625; P = 0.0042). In a fixed-effects model adjusting for week, A1 ECRpre independently predicted VAS (β = 29.19; P = 0.018). Wearable ECR sensing was safe and feasible in this pilot study and demonstrated consistent within-session responsiveness. Clinically, motion-acquired ECR may serve as an objective adjunct for tracking session-level changes and week-to-week status with symptom scales. Retrospectively registered at ChiCTR (ChiCTR2600120811 approved).
Creativity has been found to be a fundamental factor in innovation and generating new knowledge, and it is influenced by personality. The present study innovatively tested the personality-creativity relationship by resorting to the General Factor of Personality (GFP). Multiple measures were used for a comprehensive and unbiased estimation of the target relationship while controlling for the common method bias. The results showed that the GFP was consistently associated with multiple creativity indicators, with observed correlations above .60 for questionnaire-based measures and latent estimates ranging from .31 to .40 for performance-based abilities. Based on the findings, the present study indicates a stable association between the GFP and several core components of creativity. Additionally, the present study found that the GFP correlated with creative traits (.75) more strongly than creative abilities (.36), based on which we proposed a division of creative traits vs creative abilities. The reason for all found correlations can be attributed to the GFP being the most comprehensive personality structure encapsulating social characteristics, which is associated with multiple components of creativity. Suggestions for practical implications and future studies are discussed.
Leadership initiatives are increasingly recognized as crucial drivers of policy implementation, well-being, and nutritional literacy. However, the relationship between health-oriented leadership, healthcare policy, community well-being, and community nutritional literacy remains underexplored. With increasing awareness of health and nutrition in developing countries, this study explores the role of Health-Oriented Leadership (HOL) in the implementation of human health policies, well-being, and nutritional literacy. Based on a multi-source, multi-wave survey of 355 management personnel and 360 community and stakeholder personnel in Pakistan, this study highlights the cross-level trickle-down effect of health-oriented leadership. The proposed model was tested using qualitative methods, and for analysis, this study employed multilevel structural equation modeling and regression analysis to examine direct, mediating, and moderating effects. Drawing on the human needs theory, our findings show that health-oriented leadership positively impacts the implementation of public health policy and fosters well-being and nutritional literacy in communities. Furthermore, NGO support (NS) moderates the relationship between health-oriented leadership and the execution of healthcare policy. This research is innovative and the first to examine HOL's role in implementing public health policy with NGO backing, promoting well-being, and enhancing nutritional literacy within communities. It makes a valuable contribution to the literature on nutrition and health management by providing practical insights for governments, NGOs, and community stakeholders seeking to implement leadership strategies that protect community health and promote initiatives for a balanced diet and improved living standards.