Background: Armed conflict and geopolitical instability increasingly affect mental health beyond directly exposed populations through continuous media exposure and digital information dissemination. Nursing students may be particularly vulnerable because of high academic demands, emotional sensitivity to human suffering, and intensive engagement with social media and online news platforms. This study examined the association between conflict related news exposure and depression, anxiety, and stress among nursing students in Saudi Arabia during the February 2026 regional military escalation involving Iran, and explored the role of perceived safety concern and the potential indirect associations involving sleep difficulty and study disruption. Methods: A multi-center cross sectional study was conducted among nursing students from different public universities across five regions of Saudi Arabia. Psychological distress was assessed using the Depression Anxiety Stress Scale. A composite conflict exposure index was developed from conflict news following frequency and exposure intensity measures. We used Gamma generalized linear models, interaction analyses, and structural equation modeling to evaluate associations, moderation by information source, and mediation pathways. Results were reported as arithmetic mean ratios (AMRs) with 95% confidence intervals, representing the relative change in mean psychological distress scores associated with each predictor. Models were adjusted for sociodemographic, academic, and living-related factors. Results: A total of 247 nursing students were included. Moderate to severe depression, anxiety, and stress were reported by 50.2%, 59.9%, and 32.4% of participants, respectively. Our findings showed that higher conflict exposure was associated with increased stress levels (AMR = 1.17, 95% CI: 1.02-1.34), while associations with depression (AMR = 1.14, 95% CI: 0.99-1.30) and anxiety (AMR = 1.13, 95% CI: 0.99-1.28) were weaker. Associations between conflict-related exposure and depression, anxiety, and stress were substantially attenuated after accounting for perceived safety concern, which remained strongly associated with all psychological distress outcomes (AMR = 1.32, 95% CI: 1.19-1.47), anxiety (AMR = 1.31, 95% CI: 1.18-1.44), and stress (AMR = 1.36, 95% CI: 1.24-1.51). Compared with television news users, students relying on online news demonstrated substantially higher depression (AMR = 1.92, 95% CI: 1.32-2.78), anxiety (AMR = 1.84, 95% CI: 1.29-2.64), and stress scores (AMR = 1.88, 95% CI: 1.29-2.74). Structural equation modeling identified significant indirect associations involving sleep difficulty and study disruption, whereas direct associations between exposure and psychological distress were comparatively weak. Conclusions: Conflict-related media exposure was associated with poorer mental health among nursing students, with perceived insecurity, sleep difficulties, and study disruption showing strong associations with psychological distress and patterns consistent with indirect relationships. Universities and nursing education programs should consider implementing mental health support, media literacy interventions, sleep health promotion, and psychosocial support strategies during periods of regional geopolitical instability.
On current social media platforms, multimodal fake news has permeated various fields. Multi-domain fake news detection has garnered significant attention in the academic community. Existing multi-domain methods primarily employ feature fusion techniques based on text-image alignment, neglecting the extraction of conflicting information across modalities and failing to address the domain-dependent nature of cross-modal feature conflicts. To address this, we propose a Multi-Granularity Conflict and Domain-Guided Calibration for Multimodal Fake News Detection model (GC2MFND). This model captures conflicting features through the domain-aware multi-granularity conflict extraction module and mitigates feature suppression using the domain-guided multimodal feature calibration module. Finally, it combines domain-adaptive aggregation with multi-view evidence integration to achieve robust decision-making under supervised contrastive learning constraints. Under known domain conditions, the experimental results demonstrate that GC2MFND outperforms existing multi-domain baseline methods, achieving accuracy rates of 95.3%, 95.7%, and 81.2% on the Weibo, Weibo21, and FineFake datasets, respectively, representing improvements of 1.1%, 1.2%, and 1.4% over the corresponding multi-domain baselines.
Western media framing of traditional Chinese medicine (TCM) shapes public health beliefs and policy attitudes across national contexts, yet systematic cross-national evidence remains limited. This study analyzed TCM-related news coverage across six Western countries, the United States, the United Kingdom, Germany, France, Spain, and Italy, from 2010 to 2024. Using a unified four-category coding framework applied to a multilingual corpus of elite print and online outlets, we constructed a balanced panel of 360 country-quarter observations and employed two-way fixed effects regression models to examine cross-national variation in frame distribution and sentiment orientation. Risk/safety frames dominated in the United States (38.4%) and the United Kingdom (35.1%), whereas scientific/efficacy frames prevailed in Germany (41.2%) and France (37.8%). The COVID-19 pandemic improved overall sentiment (β = 0.14, p < 0.001) and intensified risk framing (β = 0.11, p < 0.01), with risk amplification concentrated in NHS-type healthcare systems. WHO ICD-11 inclusion of TCM increased policy frame ratios (β = 0.08, p < 0.01) without improving evaluative tone, while domestic TCM legislative developments improved sentiment and policy framing but did not affect risk framing. These findings suggest that national regulatory contexts and major public health shocks are consistent correlates of TCM media framing patterns. However, the small number of country clusters and uneven article density, especially in Southern European countries, limit inferential precision and preclude strong causal claims. The findings support country-specific rather than uniform international public health communication strategies for TCM, pending audience-level confirmation.
Democratic challenges are often attributed to the spread of misleading, untrustworthy, or biased information, leading scholars to focus on minimizing exposure to such "bad" content online. Instead, we introduce a scalable intervention to put factual and verified public affairs information in users' social media feeds to make them better informed and more resilient to various online threats. We conducted 48 field quasi-experiments using Instagram ads targeting news non-users to enhance their belief accuracy, democratic attitudes, and behavioral intentions related to climate change, COVID-19 vaccines, media literacy, and election integrity. The treatment videos reached 2,496,878 Instagram accounts, 690,470 users watched at least 50% of the video, and 40,584 of those users completed post-test assessment. The intervention was effective: 46 out of 48 of the quasi-experiments had positive effect sizes and 40 out of 48 achieved statistical significance. The intervention predicted not only belief accuracy but also attitudes, media literacy, and - to some extent - behavioral intentions related to vaccination. These patterns emerged across topics, did not dissipate with time (two of three climate change quasi-experiments show continued effects), and were not contingent on persuasive appeals and format features presented in the ads.
Liquid biopsy (LB) has emerged as a minimally invasive approach to characterize tumor biology and support treatment decision-making across gastrointestinal (GI) malignancies. Advances in circulating biomarkers have expanded its potential clinical applications. While colorectal cancer appears closest to clinical implementation, with ctDNA increasingly integrated into adjuvant and metastatic decision-making, applications in other GI tumors remain largely exploratory. Emerging approaches, including cfDNA methylation profiling, multi-omic assays, and circulating protein or metabolite analyses, have shown promising early signals but require prospective validation. This review summarizes key LB findings presented at ESMO 2025, highlighting translational relevance, current limitations, and future directions for clinical integration.
Mpox (or monkeypox) is an emerging zoonotic disease caused by the mpox virus (MPV), which has recently spread geographically, particularly with the emergence of clade Ib in Central Africa. Since December 2025, cases have been reported in the south-western Indian Ocean territories, linked to an active outbreak in Madagascar. In Mayotte Island, ten cases were confirmed between January and February 2026, including imported cases and local secondary and tertiary transmissions. In Réunion Island, four cases were identified, all associated with a stay in Madagascar or secondary transmissions. The patients mainly presented with polymorphic cutaneous and mucosal lesions, with no severe cases reported. Diagnosis is based on MPV detection and typing (clade determination) using nucleic acid amplification tests (PCR) on samples taken from lesions. Management is based on symptomatic treatment and control measures including isolation and vaccination of contacts. The introduction of clade Ib into these territories highlights the need for increased vigilance, appropriate virological surveillance and coordination between local and regional public health actors in order to prevent the spread of this virus.
Background. First-mile walking to mass rapid transit (MRT) has two methodological problems. Composite walkability scores blur which features drive walking. And because walking to transit is itself transport physical activity (PA), linking it to total PA is circular. Both issues are sharper in tropical Asian cities. Methods. We surveyed 378 adults within a 1 km network distance of 20 stations on Bangkok's Pink Line MRT. Walkability was measured with NEWS-A (aggregate and eight subscales); PA with the GPAQ. Binary logistic regression with station-cluster-robust standard errors tested which NEWS-A subscales predict first-mile walking and whether walkers meet the WHO PA guideline (≥150 min/week MVPA). A tautology sensitivity test removed transport PA from the outcome. Results. Walkers were 71.7% of the sample. Disaggregating NEWS-A improved fit; two subscales were the dominant predictors: pedestrian infrastructure and traffic safety. Walkers were 30.6 percentage points more likely to meet the overall PA guideline; with transport PA removed, the gap was 17.5 points and still significant. The pedestrian infrastructure effect was strongest 201-1000 m from a station, not at the immediate frontage. Conclusions. Perceived pedestrian infrastructure quality and perceived traffic safety drive first-mile walking in suburban Bangkok. The walking-PA link is not entirely a measurement artefact. The 201-1000 m ring is a plausible priority for pedestrian investment.
Pulmonary embolism (PE) in octogenarians (i.e., patients > 80 years) is associated with substantial morbidity and mortality, yet this population remains underrepresented in major studies. We compared the predictive performance of the Pulmonary Embolism Severity Index (PESI), simplified PESI (sPESI), European Society of Cardiology (ESC) risk classes, and National Early Warning Score (NEWS) for mortality prediction in octogenarians versus younger emergency department (ED) patients. In this single-center retrospective cohort study, adults with confirmed PE presenting to an ED in Vienna, Austria, between January 2017 and December 2024 were included. Patients were categorized as octogenarians or ≤80 years. Clinical characteristics, treatment, and outcomes were compared. Predictive performance for 30-day mortality was assessed using receiver operating characteristic analyses and diagnostic accuracy measures. Sensitivity analyses and evaluation of 7-day mortality were also performed. Among 773 patients, 114 were octogenarians. Compared with younger patients, octogenarians had more cardiovascular comorbidities, higher cardiac biomarker levels, more right ventricular strain, and significantly higher 30-day mortality. PESI showed the most consistent overall prognostic performance but was less accurate in octogenarians. sPESI demonstrated limited specificity because most octogenarians were classified as high risk. ESC risk classes provided moderate discrimination. NEWS ≥ 7 showed prognostic value for short-term mortality among octogenarians, although the differences from PESI were not statistically significant. Established PE prognostic tools perform less well in octogenarians. PESI showed the most consistent overall performance, while NEWS demonstrated promising short-term prognostic value that warrants further investigation.
Background: Healthcare-associated bloodstream infections (HABSIs) are among the main categories of nosocomial infections. This analysis aims to identify the clinical characteristics of patients in the emergency department (ED) who will develop a HABSI during their hospital stay. Methods: Main outcome measures were HABSI and the cumulative survival rate at 30 days. The features tested in a logistic model were age, sex, vitals by the National Early Warning Score (NEWS), priority levels, main complaints, comorbidities by the Charlson Comorbidity Index (CCI), trauma-related disease, main diagnosis and ED length of stay. Results: In 414 (2.3%) out of 18,304 patients, aged 75 (16) years, mean (SD), a diagnosis of HABSI was recorded. HABSIs occurred in subjects with main diagnosis of diseases of the respiratory system (N = 116; 28.0%), digestive system (N = 72; 17.4%), and circulatory system (N = 68; 16.4%). The main key clinical features selected by the logistic model were: NEWS > 6, diagnosis of neoplasms, CCI > 4, and diagnosis of diseases of the digestive system. The ROC curve for the HABSI risk score was 0.703 ± 0.027 in predicting the outcome, (sensitivity 79%, specificity 51%, at optimal cut-off score). The overall hazard mortality risk was twofold higher in patients with HABSIs (hazard ratio: 2.319; 95% confidence interval: 1.871-2.875; p-value: <0.001). The overall 30-day survival rate was lower among patients with HABSIs (33%) vs. non-HABSI patients (62%). Conclusions: A group of main clinical features in subjects without suspect of infectious disease in the ED are associated with HABSIs. These features negatively impact survival rate during hospital stays.
This paper conducts a multimodal critical discourse analysis of 92 accompanying images in 22 articles related to adolescent depression published on the WeChat official accounts of major Chinese state-aligned media outlets, including People's Daily, CCTV.com, China News Service, and Health News. We pay special attention to analyze the multimodal discursive strategies employed to represent the causes and solutions of adolescent depression, as well as the implicit health ideologies embedded within these representations. Findings indicate that different gazes and hands are discursively represented as causes and solutions for adolescent depression. Specifically, a blaming gaze and judgmental hands visually construct the perceived origins of depression, while a mothering gaze and caring hands are deployed to depict pathways to recovery. In particular, the state media predominantly attribute the causes of depression to familial and socio-cultural factors-such as academic pressure and "face" culture-through discursive strategies including cool color palettes, spatial marginalization of adolescents, and metaphorical constructs like dominant parental figures, surveilling eyes, and encircling social judgments. In contrast, solutions are frequently visualized through warm tones, intimate compositions, and metaphors such as "healing hugs from mothers," emphasizing familial emotional support while underrepresenting professional medical intervention. We argue that these discourses may reinforce familial-centric ideologies and conventional gender norms of mothers. Implications for more sensitive and constructive media discourses on adolescent depression in the Chinese context are discussed.
This Medical News article discusses a US Department of Health and Human Services initiative to reduce the prescribing of medications to treat psychiatric disorders.
The COVID-19 pandemic unfolded in parallel with an infodemic where competing information from formal and informal sources shaped protective behavior. This study conducted a secondary analysis of cross-sectional survey data from 742 U.S. adults to examine how reliance on different information channels influenced risk perceptions, socio-political beliefs, and protective intentions. Structural equation modeling revealed that reliance on formal sources, such as government websites and mainstream news, was positively associated with perceived severity, reduced conspiracy endorsement, and more liberal political orientation, all of which increased mask-wearing and vaccination intentions. Reliance on informal sources, including social media and peer networks, reduced severity perceptions, heightened conspiracy beliefs, and reinforced more conservative orientations, which in turn undermined compliance. Perceived severity functioned as a central mediator, directly encouraging mask use and indirectly promoting vaccination through reduced conspiracy endorsement. Political ideology and conspiracy beliefs further shaped vaccine intentions, highlighting the ideological pathways through which information exerts influence. Mask-wearing and vaccination clustered together, indicating a generalized orientation toward protective action. The model underscored the critical role of information environments as upstream determinants of health behavior during crises. These findings emphasize that managing both formal and informal channels is essential for effective crisis communication and for strengthening public compliance in future health emergencies.
As AI becomes more sophisticated, new risks are emerging. In this News and Perspectives article, JMIR Correspondent Shalini Kathuria Narang reports on the American Medical Association's response to the rising issue of physician deepfakes.
To analyze the current research status and trends in the management of cancer-related muscle pain worldwide from 2015 to 2024 using bibliometric methods. In this study, a literature search was conducted in the Web of Science Core Collection for the period from January 1, 2015, to January 21, 2025. The inclusion criteria were restricted to English-language original articles and reviews. We excluded non-English publications and other document types, such as editorial materials, book chapters, proceeding papers, letters, and news items. Ultimately, 909 valid publications (671 articles and 238 reviews) were retrieved. Data analysis was carried out using CiteSpace, VOSviewer, and the bibliometrix package in R software, focusing on main bibliometric indicators including the number of publications, total citation counts, country and institutional contributions, author productivity, journal influence, and keyword co-occurrence clusters. China and the United States were the main contributors in this field. The number of published articles increased continuously, peaking at 148 publications in 2023. Most of the highly productive authors were from China, forming a close collaboration network. In terms of journal influence, Medicine (n = 77) and Cancers (n = 31) published the most articles, while The Lancet (1990 citations) and Pain (974 citations) received the highest total citation counts. Through keyword clustering analysis, 4 dominant clusters were identified: basic research and clinical management of cancer-related muscle pain, the psychological state and quality of life of patients, evaluation of the safety and effectiveness of treatment, and comprehensive management strategies. This study systematically summarizes the research progress in the management of cancer-related muscle pain from 2015 to 2024, and reveals the research hotspots and future trends in this field. Future research should further strengthen international cooperation and improve the research quality, especially in the research on pain mechanisms, comprehensive management, and the quality of life of patients.
To systematically examine the impact of climate risks on China's financial system, this study employs the EGARCH-SGED model to precisely fit financial market volatility based on China's Climate Change News Index. It then combines the LASSO-CoVaR method to measure tail risk spillover effects within China's financial system under climate risk shocks, constructs a risk contagion network, and innovatively utilizes the RF-AdaBoost model to establish the risk early warning system. Findings reveal that climate risk is a key driver of dynamic correlation evolution within the financial system, with heterogeneous impacts across different markets. Physical climate risk events intensify short-term risk contagion while generating long-term effects; transition risks undergo a dynamic process, initially amplifying uncertainty before enhancing systemic stability over the long term. The RF-AdaBoost model outperforms traditional machine learning models in risk warning, demonstrating outstanding predictive accuracy and generalization capabilities, thereby providing effective intellectual support for climate risk prevention and financial stability management.
Prospective memory (i.e., remembering to complete future plans) and retrospective memory (i.e., memory for past events) are essential to daily functioning, but both are prone to everyday failures, such as forgetting to carry out an intended action (e.g., missing a medication dose) or inaccurately recalling past information (e.g., forgetting the details of a recent conversation). To mitigate these, individuals may rely on cognitive offloading, the use of physical actions or external tools to reduce retrieval effort (e.g., setting an alarm to avoid forgetting an important task). This study examined the impact of cognitive offloading on both prospective and retrospective memory, using two offloading strategies. In the first phase, 152 participants were instructed to send an email 48 h later at 7 p.m. and were randomly assigned to one of three conditions: a reminder (e.g., an alarm), a scheduled email for automatic delivery, or no reminder (internal memory). They also watched a news report. In the second phase, participants sent an email (prospective memory) and then completed a free recall question about the video (retrospective memory). Results show that both offloading conditions performed better in the prospective task. Notably, there were no significant differences in retrospective memory performance. Overall, cognitive offloading enhanced prospective memory and subjective confidence but did not influence retrospective recall, highlighting a dissociation between remembering when to act and remembering contextual information.
Fraudulent papers are on the rise in scientific publishing. In this News and Perspectives article, JMIR Correspondent Cliff Dominy reports on recent cases of false authorship and how they might be prevented to safeguard trust in science.
Opioid use continues to cause harm and fatalities worldwide, despite ongoing preventive efforts. Early administration of the antidote naloxone can reverse potentially fatal opioid overdoses. Naloxone distribution programmes have increased survival across regions; however, additional efforts are needed to reduce opioid overdose mortality. One approach is to expand naloxone availability within communities. The feasibility trial RESPONDER (REgion Skåne Preventing Overdose deaths through Naloxone Distribution with Emergency Runners) introduces a unique smartphone alerting system with community first responders (CFRs) dispatched to suspected opioid overdoses, in addition to the dispatch of regular emergency medical services (EMS). The aim is to investigate if trained CFRs can successfully recognise and reverse overdoses caused by opioids, prior to EMS arrival. The CFRs will be equipped with nasal naloxone and introduced to a novel naloxone algorithm during a study-specific course prior to participation. The course will offer practical training in basic life support and first aid, and it will also assess competence in the low-arousal approach, as well as the legal and ethical aspects of being a CFR.Main outcomes of the trial are feasibility, acceptability and safety. The trial will be performed in the region of Skåne, Sweden, between 1 September 2025 and 31 August 2027, with every CFR followed for up to 12 months. The trial has been approved by the Swedish Ethical Review Authority (file number 2024-05887-01). Written informed consent is required from participating CFRs. This is also required of overdose survivors to allow the collection of clinical data from hospital records.Information regarding the project and recruitment will be disseminated via social media, news media, through the healthcare region's communication channels and within public transportation hubs. Outcomes and analyses will be submitted to peer-reviewed journals. NCT07079241.
Conversational medical AI systems are increasingly blurring the lines between simply being digital tools and simulating medical practice. In this News and Perspectives article, MD-PhD candidate and JMIR Correspondent Tejas S Athni reports on recent health AI controversies and evolving regulatory challenges.