Search Results (1,332)

Background: Although cervical cancer is preventable, Latinas are twice as likely to receive a late diagnosis compared with non-Hispanic Whites (NHW). We currently know very little about the experiences of cervical cancer among middle- to older-age Latinas in the U.S. This study aimed to document Latina cervical cancer survivors’ journeys with an emphasis on improving the cervical cancer system of care to address inequities among a rapidly aging Latina population. Methods: We interviewed participants aged ≥ 40 years with a diagnosis of cervical cancer of three months or greater who identify as Latina. Recruitment was multi-pronged, including electronic healthcare records search, community tabling events, and snowball sampling. We conducted a qualitative study using the Database of Individual Patient Experiences (DIPEx) methodology and identified themes using grounded theory constructivist analysis. Results: A total of 20 Latinas (43 to 85 years old) participated, including 16 Spanish-language interviews. We identified three themes: formative experiences driving screening and prevention behaviors, provider communication that was suboptimal throughout the cancer continuum, and survivorship impacts including isolation and stigma with implications for the next generation. Conclusions: A central takeaway was the pervasiveness of Latinas’ feelings of shame, lack of communication, and isolation. Healthcare systems must improve culturally responsive communication, survivorship support, and screening equity for aging Latina populations. Abuelas, tias, and/or primas (grandmothers, aunts, and cousins) could play a critical role in raising awareness and increasing timely and early screening among the wider Latina population. Full article

Background/Objectives: The primary goal of this research was to investigate the relationship between the utilization of social media platforms, its influences on health status perceptions and health information-seeking tendencies of individuals who underwent surgical procedures. Methods: This study was designed and executed utilizing a descriptive and cross-sectional design. The research cohort comprised 376 surgical patients selected from operative clinics who satisfied the specified eligibility requirements for participation. Data collection was carried out through a structured Patient Demographic Questionnaire alongside the Health-Seeking Behavior and Health Perception Scales. For statistical evaluation of the gathered data, descriptive metrics, both parametric and non-parametric analytical techniques, and correlation tracking frameworks were employed. Results: According to the study analysis, participants under the age of 54 achieved significantly higher web-based health information-seeking scores (15.79 ± 5.50) than those in the older demographic group (14.10 ± 5.83; t = 2.886, p < 0.05). In terms of gender variations, female patients demonstrated more prominent scores in both digital and comprehensive health-seeking tasks compared to male counterparts (t = 2.316, t = 2.130; p < 0.05). Academic background elicited significant statistical fluctuations across all sub-dimensions (F = 5.655, F = 7.080, F = 7.690, F = 9.877; p < 0.001), revealing that individuals with only primary school education presented the lowest baseline values. Furthermore, individuals restricting their daily internet exposure to one hour or less demonstrated noticeably lower scores than peers maintaining an extended daily digital presence (F = 4.791, F = 4.232, F = 3.549; p < 0.05). Conclusions: This study found that women and individuals with higher levels of education exhibit more frequent online health-seeking behaviors, which were found to be more prominent among individuals who spend more time online and actively use social media platforms. Full article

Background: Psychosocial assessment is an important component of lung transplant evaluation. Substance-related concerns may coexist with broader psychosocial vulnerabilities, but this relationship is difficult to evaluate when substance-use indicators and psychosocial scores contain overlapping information. We aimed to characterize psychosocial risk in lung transplant candidates and examine whether alcohol-, nicotine-, and illicit drug-related concerns were associated with psychosocial burden outside the SIPAT substance-use domain. Methods: We retrospectively analyzed 491 adult lung transplant candidates admitted for their first inpatient evaluation at the University Clinical Center in Gdańsk, Poland, between December 2021 and November 2025. All patients underwent routine psychosocial consultation, including the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT), completed using a locally developed Polish translation. To avoid conceptual and statistical overlap with substance-related indicators derived from Domain D, we calculated a non-substance psychosocial score as the sum of Domains A, B, and C. Three logistic regression models adjusted for age and sex examined associations with alcohol-, nicotine-, and illicit drug-related concerns. Holm correction was applied across the three primary tests. Results: The mean age was 57.2 years (SD = 10.7), and 40.5% of participants were women. Most candidates were classified as excellent or good (89.4%). Alcohol-, nicotine-, and illicit drug-related concerns were documented in 39.5%, 43.8%, and 13.4% of candidates, respectively. In complete-case models (N = 489), each five-point increase in the non-substance psychosocial score was associated with higher odds of alcohol-related concerns (OR = 1.26, 95% CI 1.07–1.48, p = 0.006; Holm-adjusted p = 0.017) and nicotine-related concerns (OR = 1.22, 95% CI 1.04–1.43, p = 0.014; Holm-adjusted p = 0.028). No significant association was observed for illicit drug-related concerns (OR = 0.81, 95% CI 0.62–1.02, p = 0.090). Male sex was associated with alcohol-related concerns (OR = 2.16, 95% CI 1.47–3.19, p < 0.001). Conclusions: Alcohol- and nicotine-related concerns were associated with broader psychosocial burden extending beyond the SIPAT substance-use domain. These findings suggest that substance-related concerns may coexist with difficulties in readiness, social support, or psychological functioning rather than representing isolated behavioral findings. Because this study was cross-sectional and used a non-validated local translation, the results should not be interpreted as evidence of psychometric or predictive validity. Full article

Background/Objectives: Bedside manners are an important part of patient-centered physical therapy care, yet little is known about how Saudi physical therapists understand and apply them in practice. This study examined therapists’ perceptions of bedside manners and ethics, and explored differences related to gender and work setting. Methods: A cross-sectional mixed-methods study was conducted among 147 licensed Saudi physical therapists. Quantitative data were collected using a 28-item questionnaire, and qualitative data were gathered through semi-structured interviews with 22 participants. Survey responses were summarized using frequencies and percentages, and differences by gender and work setting were reported. Interview data were analyzed using Braun and Clarke’s thematic analysis. Results: Most participants were female (66.7%) and aged 20–30 years (70.7%). Overall, therapists reported very high agreement with bedside-manner principles across most items. Descriptive patterns by gender and work setting in some perceptions (e.g., patient privacy, therapist presence, and attention to minor cases) were noted. Qualitative analysis identified seven themes: building trust, perceived positive contribution to care, body language, differing views on empathy, therapist presence, patient equity, and seeking help from colleagues. Conclusions: Saudi physical therapists strongly supported core bedside manner behaviors, especially communication, privacy, reassurance, and fair treatment of patients. These findings may inform efforts to incorporate bedside manners into physical therapy education and professional development in support of ethical, patient-centered practice. Full article

Background: Preventive oral-health behaviors are crucial for reducing the incidence of dental caries, but there is still little data on whether Chinese dental patients continue to practice these behaviors. This study investigated self-reported changes in oral-health practices after treatment and explored factors associated with the adoption of preventive behaviors. Methods: A cross-sectional questionnaire-based survey was carried out in a hospital in Guangzhou with 246 dental patients. The frequency of brushing both before and after treatment, interdental cleaning, dietary modifications, attendance at follow-up, receiving and understanding preventive advice, and following recommendations were reported. Changes in brushing behavior were analyzed, and logistic regression models were used to evaluate factors associated with preventive behaviors. Results: The proportion of participants brushing ≥2/day increased after treatment (7.7%, p < 0.05). Daily interdental cleaning remained low (23.2%), while 61.0% reported dietary modification and 53.3% attended follow-up. In multivariable models adjusting for all covariates, most sociodemographic factors were not significantly associated with preventive behaviors. Male participants had lower odds of brushing ≥2/day. Understanding of preventive recommendations was the most consistent predictor, with lower understanding associated with reduced flossing, follow-up, and adherence. Receipt and format of advice were not independently associated with outcomes after adjustment. Periodontal treatment was associated with lower follow-up compared with restorative care. Conclusions: Preventive oral-health behaviors improved modestly after treatment, but overall adherence remained limited. Clear understanding of preventive advice was the strongest determinant of behavior, while sociodemographic factors and advice format showed no independent effects. Lower follow-up attendance among periodontal patients highlights the need for improved patient communication and recall strategies. Full article

Objectives: Type 2 diabetes mellitus (T2DM) is an increasing public health concern in Thailand, particularly in rural communities where dietary practices and contextual factors may influence glycemic control. This study aimed to assess nutritional knowledge, attitude, and eating behavior using the Knowledge–Attitude–Practice (KAP) framework and to compare nutritional intake profiles between patients with controlled and uncontrolled glycemic status. Methods: A cross-sectional study was conducted among 70 patients with T2DM attending a health-promoting hospital in northeastern Thailand. Participants were classified into glycemic-controlled (GC; HbA1c < 7%, n = 36) and glycemic-uncontrolled (UC; HbA1c ≥ 7%, n = 34) groups. Data were collected using a semi-structured questionnaire covering demographics, anthropometry, body composition, biochemical parameters, and KAP domains. Dietary intake was assessed using three-day food records (two weekdays and one weekend day) and analyzed with the INMUCAL Nutrients program. Statistical analyses included descriptive statistics, group comparisons, logistic regression, and Spearman’s correlation. Results: Overall, participants demonstrated high levels of nutritional knowledge (71.4%) and fair attitude (52.9%), but moderate levels of appropriate eating behavior (58.6%). Eating behavior differed significantly between GC and UC groups (p = 0.038). The UC group consumed significantly higher amounts of total energy, carbohydrates, simple carbohydrates, and protein than the GC group. HbA1c and fasting blood glucose were positively correlated with total energy, carbohydrate, simple carbohydrate, and zinc intake, while protein and phosphorus intake were positively associated with fasting blood glucose only. Logistic regression analysis showed no significant associations between KAP domains and glycemic control. Conclusions: Glycemic control among rural Thai patients with T2DM was more closely related to dietary intake patterns than to nutritional knowledge or attitude alone, highlighting the need for context-specific, community-based dietary interventions. Full article

Alpha-enolase (ENO1) is a multifunctional protein frequently overexpressed in solid tumors, where elevated levels are associated with aggressive behavior and poor prognosis. Beyond its canonical glycolytic role, ENO1 participates in immunoregulatory processes through distinct subcellular pools. Intracellular ENO1 shapes tumor-associated metabolic programs, while surface-exposed ENO1 functions as a plasminogen receptor and can engage innate immune signaling pathways. Post-translational modifications—particularly citrullination and phosphorylation—generate structurally altered epitopes that expand ENO1 antigenicity and enable adaptive immune recognition, including coordinated humoral and T-cell responses in cancer patients. These determinants of ENO1 immunogenicity have downstream consequences within the tumor microenvironment: immune-accessible ENO1 modulates myeloid cell recruitment, dendritic cell maturation, and macrophage polarization, while ENO1-dependent metabolic and signaling programs contribute to immune suppression and escape through multiple interconnected axes. Together, these mechanisms position ENO1 at the interface between tumor metabolism and immune regulation. Preclinical evidence demonstrates that ENO1-directed strategies—including antibody-based targeting, DNA vaccination, and vaccines incorporating post-translationally modified ENO1 peptides—can generate productive antitumor immunity and synergize with checkpoint blockade, supporting the rationale for ENO1 as an immunotherapeutic target. This review synthesizes current evidence within an integrated framework linking ENO1 dysregulation to its immunological consequences in cancer and discusses translational implications for ENO1-centered immunotherapy and immunoprevention. Full article

Background/Objectives: In Romania, diabetes mellitus remains a significant public health challenge, characterized by high prevalence and significant undiagnosed cases. This study assessed the prevalence of elevated glycated hemoglobin (HbA1c) levels within the adult population participating in the European Health Examination Survey (EHES) and examined their associations with major cardiometabolic risk factors, subjective health perception, and patient awareness of previously diagnosed chronic conditions. Methods: This cross-sectional study analyzed data from the EHES in Romania, including systematic, population-weighted sample of adults aged 25–64 years. Data were analyzed using the Complex Samples module in SPSS, version 29.0 (IBM Corp., Armonk, NY, USA). HbA1c levels were measured through standardized clinical examination, with values of 5.7–6.4% classified as at risk for diabetes mellitus, and values ≥6.5% as diabetes mellitus. Results: Among 5380 representative adults, the prevalence of elevated HbA1c (≥6.5%) was 7.1%, while prediabetes (HbA1c 5.7–6.4%) affected 35.4% of participants; both conditions were significantly more prevalent in men than in women. Elevated HbA1c and prediabetes were substantially more frequent among individuals with hypertension and hypercholesterolemia, and glycemic control among participants with previously diagnosed diabetes was generally poor (all p ≤ 0.05). Individuals who are aware of having a chronic health condition appear to engage more actively in self-care practices, including increased physical activity and more frequent monitoring of key biological parameters. Conclusions: Elevated HbA1c and prediabetes were more prevalent than estimates reported in other studies using HbA1c-based diagnostic criteria. These observations highlight the importance of early detection and timely diagnosis, as awareness of one’s health status may facilitate healthier behaviors that mitigate metabolic complications. Full article

This paper proposes a federated learning framework for privacy-preserving patient monitoring with lightweight blockchain anchoring. The framework keeps synthetic patient monitoring records local at each client and uses federated model aggregation to support collaborative learning without centralizing raw records. To improve traceability, the blockchain layer is specified as an anchoring mechanism that records compact evidence, including model hashes and participation metadata, rather than raw data or full model parameters. Experiments were conducted on synthetic patient monitoring data to evaluate framework behavior under non-IID client distributions, label noise, different client counts, partial client participation, and aggregation strategies. The centralized MLP baseline achieved approximately 0.89 overall accuracy but failed to detect alert cases, with 0% alert-class recall, showing that accuracy alone can be misleading in imbalanced monitoring scenarios. In the federated simulations, the model reached approximately 0.99 accuracy under clean labels, approximately 0.90 under 10% label noise, and approximately 0.70 under 30% label noise. Under a more difficult noisy, non-IID, dropout, and fixed skewed-client evaluation setting, the model stabilized at approximately 0.80 accuracy after 25 communication rounds. Client scaling from 5 to 20 clients remained stable, and FedAvg, weighted aggregation, and accuracy-trimmed robust aggregation produced similar final accuracy of approximately 0.98 in the 10-client setting. The results indicate that label quality strongly affects federated convergence, while blockchain anchoring should be interpreted as an auditability mechanism rather than a direct accuracy-improving component. This study provides a framework-level foundation for auditable federated patient monitoring in semi-trusted healthcare networks. Full article

Background/Objectives: The quality and safety of care provision have consistently remained central concerns for the management of healthcare organizations worldwide. Nurses’ work environment and occupational behaviors may significantly affect these outcomes. The present study aimed to evaluate the nursing work environment, assess the extent of quiet quitting among nurses, and investigate their impact on the quality and safety of care delivery. Methods: A cross-sectional study was conducted in Greece, and data were collected via an online survey between October and December 2025. Quiet quitting and work environment were measured using the nine-item Quiet Quitting Scale (QQS) and the five-item short form of the Practice Environment Scale of the Nursing Work Index (PES-5), respectively. Multivariable logistic regression analyses were performed using IBM SPSS Statistics 28.0. The level of statistical significance was set at 0.05. Results: The sample included 492 nurses. The overall quiet quitting rating was low to moderate (mean = 2.18, SD = 0.65), and the mean score for the PES-5 was 2.44 (SD = 0.53) indicating a moderate realization of a supportive work environment. More than half of the participants (52.0%, n = 256) rated the quality of care at their unit as good, and 23.6% (n = 116) as fair. Additionally, 33.1% (n = 163) of the nurses described patient safety as good and 28.5% (n = 140) very good. In the multivariable model, lower scores for quiet quitting were significantly associated with higher likelihood of reporting perceived quality of care as good or excellent (adjusted OR = 0.429; 95% CI: 0.310–0.593; p < 0.001) and increased odds of reporting perceived patient safety as good or excellent (adjusted OR = 0.394; 95% CI: 0.281–0.553; p < 0.001). Higher PES-5 scores were linked to more than nine-fold increased odds of reporting good or excellent perceived quality of care (adjusted OR = 9.155; 95% CI: 5.374–15.596; p < 0.001) and an over twenty-fold increase in the odds of reporting good or excellent perceived patient safety (adjusted OR = 22.190; 95% CI: 11.533–42.693; p < 0.001). Conclusions: This study highlighted that low levels of quiet quitting and a more favorable nursing practice environment are important and independent predictors of better perceived quality and safety of care. Full article

Background: Patients with head and neck cancer who are undergoing radiotherapy frequently suffer from oral mucositis and oral microecological disorders, which severely impair their quality of life. Oral microbiota transplantation is an emerging oral microecological intervention that offers a novel approach for reconstructing oral microecological balance and relieving mucositis. However, regarding this innovative therapy, there is a paucity of in-depth research into patients’ decision-making cognition, and existing evidence is insufficient to support individualized clinical decision-making guidance. Methods: A descriptive qualitative research design was employed. From July to December 2025, patients diagnosed with head and neck cancer undergoing radiotherapy were recruited from a tertiary hospital in Shanghai via purposive sampling. The data were collected through semi-structured interviews and analyzed using Colaizzi’s seven-step analysis method. The user label system was refined and summarized to construct user portraits. These portraits were visualized in the form of WordArt word clouds and character labels. Results: A total of 21 eligible patients with head and neck cancer undergoing radiotherapy participated in the study. The construct of decision-making cognition encompasses five dimensions: treatment prioritization, information needs, health literacy, psychological status, and decision quality. The patients were categorized into four types: proactive participation, passive dependence, weigh carefully, and symptom-driven. These classifications reflect the cognitive characteristics and group differences regarding the Oral Microbiota Transplantation decision-making process among different patients. Conclusions: Patients exhibit considerable variability in their decision-making cognition regarding the innovative OMT therapy. This phenomenon can be categorized into four distinct persona types, which, respectively, reflect unique information processing styles, risk assessments, and behavioral coping strategies when patients encounter novel therapeutic interventions. This typology provides a theoretical foundation for individualized clinical decision support, delineates targets for the formulation of targeted communication strategies, and ultimately enhances patient decision quality and treatment adherence. Full article

Background/Objectives: Large language models have created new pathways for patients to access health information, yet little is known about how the general population uses these conversational artificial intelligence (AI) tools for oral health concerns. This study investigated patterns of AI use as a source of oral health information, the nature of data shared with these systems, users’ perceptions, and the impact on dental care-seeking behavior. Methods: A cross-sectional study was conducted among adults from Bihor County, Romania, using a structured 16-item online questionnaire distributed via social media, with eligibility restricted to individuals who had previously used conversational AI for oral health information. The final sample comprised 393 valid responses from this self-selected group of users. Fisher’s exact test and Z-tests with Bonferroni correction were applied (α = 0.05). Results: Most participants were female (68.2%), university-educated (52.9%), and lived in an urban setting (88.3%). Significant differences in patterns of AI use for oral health information were identified according to age, sex, and living environment (p < 0.001). Younger participants used AI more frequently, while older individuals perceived the information as less clear. The vast majority used AI for informational or preliminary guidance purposes, with very few treating it as a substitute for professional opinion. A relevant subset shared visual data (intraoral photographs or radiographs) with AI systems, raising data privacy concerns. Rural participants more frequently delayed dental visits and less often discussed AI-derived information with their dentist compared to urban participants. Conclusions: When used by the public as a source of oral health information, AI is increasingly adopted, with adoption shaped by age, sex, and socioeconomic context. These findings concern only this informational use and do not extend to other applications of AI in dentistry, such as diagnostic support, image analysis, or clinical decision-making. Dental professionals should proactively engage patients about their use of AI for oral health information to ensure that digitally obtained content is appropriately contextualized. Full article

Background/Objectives: The global incidence of neuroendocrine tumors (NETs) is steadily rising. While modifiable lifestyle factors impact oncological outcomes, the interplay between dietary habits, orthorexia nervosa (ON) tendencies, physical activity levels (PAL), and body image in NET survivors remains poorly understood. Methods: A cross-sectional study was conducted on a convenience sample of 61 patients with NETs. Validated evaluation tools included the PREDIMED questionnaire for Mediterranean Diet (MD) adherence, the GPAQ for PAL, and the ORTO-15 questionnaire for ON risk. Body image satisfaction and comprehensive clinical features were also assessed. Results: Most participants (75.4%) demonstrated moderate MD adherence. Body image dissatisfaction (32.8%) was significantly associated with a higher BMI (28.86 vs. 24.93 kg/m², p < 0.01) and reduced PAL (660.0 vs. 1680.0 MET-min/week, p = 0.021, pFDR = 0.042). Notably, moderate MD adherence was linked to a higher orthorexic risk (corresponding to lower ORTO-15 scores) compared to low adherence (p = 0.032, pFDR = 0.078). Somatostatin analog therapy showed no detrimental impact on behavioral parameters (p > 0.05). Conclusions: These findings highlight specific vulnerabilities in NET patients: body image dissatisfaction correlates with higher BMI and lower physical activity, while moderate Mediterranean Diet adherence associates with orthorexic risk, which is localized and was not independent in multivariate analysis. Targeted nutritional and physical activity interventions should be integrated into multidisciplinary NET care. Full article

Aim: This study sought to investigate in depth the experiences of individuals who had a myocardial infarction (MI), focusing on death anxiety and life changes. Design: A qualitative phenomenological design was employed. Methods: Criterion-based purposive sampling was used. Data were collected between June and July 2023 through semi-structured interviews. Seven participants were interviewed, and six were included in the analysis. Data were analyzed using content analysis. Results: Four main categories emerged: (1) experiences of patients, (2) changes in daily life, (3) thoughts about death, and (4) recommendations. Participants reported intense fear of death, lifestyle changes, and increased awareness of mortality. Conclusions: Death anxiety is a prominent psychological response after MI that significantly affects patients’ perceptions and behaviors. Psychosocial interventions are recommended to help patients cope with these experiences. Full article

Background: Diet plays a central role in the development of chronic diseases, making nutrition-focused interventions a powerful tool for improving population health. However, substantial gaps in nutrition education persist in the U.S. medical education, and medical students frequently report receiving limited nutrition training despite its importance in patient care. Methods: A non-randomized pre-post intervention study with a one-month follow-up was conducted among osteopathic medical students. Participants attended a culinary medicine food-demonstration featuring five case-based topics and three chef-prepared recipes. Nutrition knowledge, satisfaction with nutrition education, confidence in nutrition counseling, and personal nutrition-related behaviors were assessed at baseline, immediately post-intervention, and one month later. Paired-samples t-tests with effect sizes (Cohen’s d) were used to compare scores over time. Results: Forty-six participants were assessed for nutrition knowledge and satisfaction, of whom forty-three completed a one-month follow-up in which confidence and behavior modification were evaluated. Nutrition knowledge significantly improved, with quiz scores increasing from 57.8 ± 13.8 to 75.2 ± 13.3 (p < 0.001, d = 1.04). Satisfaction with nutrition education and confidence in nutrition counseling also increased significantly (both p < 0.001), with a large effect size for confidence (d = 2.26). No significant change was observed in personal nutrition-related behaviors (p = 0.65, d = −0.06). Fifteen students who had previously completed a culinary medicine elective demonstrated higher baseline knowledge, satisfaction, and counseling confidence than students without prior training (all p ≤ 0.006), while nutrition-related behaviors remained largely unchanged in both groups. Conclusions: A brief culinary medicine food-demonstration session produced improvements in medical students’ nutrition knowledge, satisfaction with nutrition education, and confidence in nutrition counseling, and did not measurably change short-term personal nutrition behaviors. These findings support this model as an efficient approach to enhancing medical students’ nutrition-related competencies. Full article