Frontiers in Public Health最新文献

{"title":"Assessment of nutrition, quality of life, and co-morbidity among the older adult(s), in a rural field practice area of a tertiary care hospital of Eastern India.","authors":"Rosy Nayak, Smrutiranjan Nayak, Prem Sagar Panda, Ipsita Debata, Subhadra Priyadarshini","doi":"10.3389/fpubh.2026.1851457","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1851457","url":null,"abstract":"<p><strong>Background: </strong>The global population is experiencing an unprecedented demographic shift, with a growing proportion of older adults, particularly in developing nations such as India. Nutritional deficiencies, comorbidities, and poor quality of life (QoL) are interlinked health issues that significantly affect the wellbeing of the older adult(s), a vulnerable group, especially those residing in rural areas.</p><p><strong>Objectives: </strong>To assess the nutritional status, quality of life, and comorbidities among the older population residing in the rural field practice area of a tertiary care hospital in Eastern India and to explore associations among these factors.</p><p><strong>Methods: </strong>A community-based, cross-sectional study was conducted among 380 rural older adult(s) aged 60 years and above residing in the rural field practice area of a tertiary care hospital in Bhubaneswar, Odisha. Data were collected using the Mini Nutritional Assessment (MNA), World Health Organization Quality of Life-BREF (WHOQOL-BREF), and Self-Administered Comorbidity Questionnaire (SCQ). Compiled data were analyzed using IBM SPSS Statistics for Windows, version 26.0 (IBM Corp., Armonk, NY). Descriptive data were interpreted in mean (± SD), frequencies, and percentages. Association was tested using the chi-square test, ANOVA, and multivariate logistic regression. Statistical significance was established at <i>p</i> < 0.05.</p><p><strong>Results: </strong>A total of 380 older adult(s) participants were enrolled (mean age: 71.23 ± 7.60 years, males: 65.8%). Around 4.2% (16) were malnourished, and 69.7% (265) were at risk of malnutrition. The WHOQOL-BREF scores revealed the highest QoL in the environmental domain (27 ± 5) and the lowest in the social relationship domain (8 ± 2). Using the SCQ tool, osteoarthritis (64.7%), hypertension (32.6%), and diabetes (24.2%) were the most common comorbidities, and 82.6% suffered from at least one comorbidity. Increasing age, female sex, and financial dependency were significantly associated with poor nutritional status and lower QoL (<i>p</i> < 0.05). Malnutrition was significantly associated with lower physical, psychological, and total QoL scores (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Malnutrition, comorbidities, and poor QoL are interrelated challenges among the older population. Early identification and integrated interventions focusing on nutrition, chronic disease management, and social support are vital for healthy aging.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1851457"},"PeriodicalIF":4.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterogeneous trajectories of oral frailty and their determinants in older patients receiving dental implants: a longitudinal study.","authors":"Ying Zhang, Nan Lu, Mengyao Liang, Qiufeng Zhu","doi":"10.3389/fpubh.2026.1891290","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1891290","url":null,"abstract":"<p><strong>Objective: </strong>To describe distinct trajectory patterns of oral frailty after implant-supported prosthesis delivery in older patients and to identify associated factors.</p><p><strong>Methods: </strong>This prospective longitudinal cohort study consecutively enrolled 211 older patients who completed implant-supported prosthesis delivery at Nantong Stomatological Hospital and Haoting Dental Clinic between January 1 and April 30, 2025. Oral frailty was assessed using the adapted seven-item version of the Oral Frailty Index-8 (OFI-8, 7-item version; score range 0-9) at baseline (T0, prosthesis delivery) and at 3, 6, 9, and 12 months post-delivery (T1-T4). Distinct trajectories were identified using latent class growth modeling (LCGM). Multivariable multinomial logistic regression was used to analyze factors associated with trajectory membership.</p><p><strong>Results: </strong>Three distinct oral frailty trajectories were identified: (1) Rapid Improvement-Stable Pattern (Class 1, <i>n</i> = 90, 42.7%), characterized by a sharp decline in OFI-8 scores immediately after prosthesis delivery followed by sustained low levels; (2) Gradual Improvement-Plateau Pattern (Class 2, <i>n</i> = 74, 35.1%), showing a gradual decline followed by a plateau; and (3) Persistent High-Risk Pattern (Class 3, <i>n</i> = 47, 22.2%), with scores remaining elevated throughout the 12-month observation period. Multivariable multinomial logistic regression analysis revealed that age (aOR = 1.12, 95% CI: 1.04-1.21), number of medications (aOR = 1.25, 95% CI: 1.05-1.49), and number of missing teeth (aOR = 1.09, 95% CI: 1.02-1.16) were independently associated with membership in Class 3. Bootstrap validation supported the robustness of the model. None of these variables showed statistical significance in distinguishing Class 2 from Class 1.</p><p><strong>Conclusion: </strong>Oral frailty trajectories in older patients with dental implants are heterogeneous. Older age, polypharmacy, and a greater number of missing teeth were independently associated with membership in the persistent high-risk trajectory, suggesting that these factors may help identify patients requiring prioritized follow-up.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1891290"},"PeriodicalIF":4.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived academic demands and psychological distress among Chinese university students: structural associations involving chronic time pressure and leisure-time physical activity.","authors":"Zhikai Gong, Gang Shen, Zhuang Zhou","doi":"10.3389/fpubh.2026.1984531","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1984531","url":null,"abstract":"<p><strong>Objectives: </strong>This study examined the direct and specific indirect associations among perceived academic demands, chronic time pressure, leisure-time physical activity, and psychological distress in Chinese university students.</p><p><strong>Methods: </strong>A cross-sectional online survey included 1,390 undergraduates from 10 higher-education institutions in Jiangsu Province, China. Perceived academic demands, chronic time pressure, and psychological distress were modeled as latent variables, whereas log-transformed leisure-time physical activity was modeled as an observed variable. Confirmatory factor analysis and covariate-adjusted structural equation modeling were conducted. Specific indirect associations were estimated using 5,000 bootstrap resamples with bias-corrected 95% confidence intervals.</p><p><strong>Results: </strong>The adjusted structural model showed good fit (CFI = 0.966, TLI = 0.959, RMSEA = 0.034, SRMR = 0.024). Perceived academic demands were positively associated with chronic time pressure (β = 0.539) and psychological distress (β = 0.382). Chronic time pressure was positively associated with psychological distress (β = 0.334) and negatively associated with leisure-time physical activity (β = -0.179), whereas leisure-time physical activity was negatively associated with distress (β = -0.097; all <i>p</i> < 0.001). The specific indirect association through chronic time pressure was <i>B</i> = 0.182 (95% bias-corrected CI [0.134, 0.236]), whereas the serial specific indirect association additionally involving leisure-time physical activity was considerably smaller (<i>B</i> = 0.010, 95% bias-corrected CI [0.005, 0.018]).</p><p><strong>Conclusions: </strong>The indirect association through chronic time pressure was substantially larger than the serial indirect association additionally involving leisure-time physical activity, indicating that leisure-time physical activity made only a minimal additional contribution within the concurrent structural model. These findings highlight chronic time pressure as a relevant correlate of student psychological distress and support further investigation of academic time organization alongside opportunities for physical activity. Because the data were cross-sectional, temporal mediation and causal direction cannot be established.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1984531"},"PeriodicalIF":4.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A copula-based geo-additive approach to childhood health outcomes in five West African nations.","authors":"Reshav Beni, Shaun Ramroop, Faustin Habyarimana","doi":"10.3389/fpubh.2026.1871312","DOIUrl":"10.3389/fpubh.2026.1871312","url":null,"abstract":"<p><strong>Background: </strong>Anemia and malnutrition are major contributors to child morbidity and mortality in Sub-Saharan Africa, particularly in West Africa where their prevalence remains high due to multifaceted socio-economic and environmental factors. Malnutrition, as defined by WHO, includes both undernutrition and overnutrition and is linked to increased risk of non-communicable diseases. Anemia, characterized by low hemoglobin levels, impairs oxygen transport and is associated with developmental delays and increased mortality in children. Given their interrelated nature, a joint modeling approach is essential to understand shared risk factors and inform targeted interventions.</p><p><strong>Methods: </strong>This study analyses pooled DHS data from Gabon, Gambia, Liberia, Mauritania, and Nigeria to identify determinants of anemia and malnutrition. Malnutrition is measured using the Composite Index of Anthropometric Failure (CIAF), which integrates stunting, underweight, and wasting for a comprehensive assessment. A copula-based geo-additive joint model is employed to simultaneously examine both conditions, accounting for spatial variation and interdependence. This approach offers a novel framework for informing policy and improving child health outcomes in West Africa.</p><p><strong>Results: </strong>Key predictors of malnutrition and anemia were identified across five West African countries. Malnutrition risk was significantly associated with maternal education, water source, household wealth, child age, gender, and feeding practices. Notably, children from households using non-bottled water sources and those given milk were at higher risk. Several water-source categories were positively associated with malnutrition relative to bottled/sachet water; however, these associations may reflect socioeconomic and residential differences in the reference group and warrant cautious, non-causal interpretation. Anemia risk was significantly lower among urban children and those whose mothers had higher education. Fortified food and egg consumption were protective against anemia, while poverty and poor water sources increased risk. These findings highlight distinct and overlapping determinants of both conditions.</p><p><strong>Conclusion: </strong>This study highlights the complex interplay of socioeconomic, environmental, and dietary factors influencing malnutrition and anemia among children in West Africa. Key predictors include maternal education, household wealth, water source, and feeding practices, with notable geographic variation. Addressing these challenges requires integrated, multisectoral strategies focused on improving maternal education, access to safe water, dietary diversity, and poverty reduction. Geographically targeted interventions and strengthened health systems are essential.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1871312"},"PeriodicalIF":4.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI exposure and task detachability: migrant anchoring and work-linked health protection among highly educated foreign-born adults in the United States.","authors":"Tse Hou Hew, Rajah Rasiah, Nina Xie","doi":"10.3389/fpubh.2026.1929386","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1929386","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Occupation-level AI exposure indices describe the potential overlap between occupational work content and AI capabilities rather than individual AI use or employer adoption. However, task organisation and access to work-linked protections may differ across occupational contexts. We examined whether associations between a compound high-AIOE/high-task-detachability occupational profile and upstream insurance and material conditions varied by migrant anchoring among highly educated foreign-born adults in the United States.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We linked 2017-2024 IPUMS American Community Survey (ACS) data for adults aged 25-64 with a bachelor's degree or higher to AI Occupational Exposure (AIOE) and O*NET 30.3 measures. High AIOE was defined as the top occupational quartile. The focal profile combined high AIOE with high task detachability and was compared with lower-AIOE occupations. Migrant anchoring combined citizenship, US residence duration, English proficiency, family co-residence, and homeownership; scores of 0-2 indicated lower anchoring. The three principal domain-specific outcomes were absence of employer- or union-linked health coverage from any eligible source among employed wage and salary workers, uninsurance, and family income below 200% of the federal poverty threshold. All-adult work-linked Social Reproduction Instability (W-SRI) ≥ 2 was retained as the focal cumulative summary measure. Weighted models were adjusted for demographic, regional, annual, and broad occupational characteristics. Inference used CR2/Satterthwaite covariance, wild cluster bootstrap tests, and leave-one-cluster-out analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The analysis included 746,995 foreign-born person-year observations, of which 22.47% were classified as having lower anchoring. Among adults with higher anchoring, the focal occupational profile and lower-AIOE occupations showed few differences in the four principal outcomes. Among adults with lower anchoring, the focal occupational profile was associated with a lower prevalence of all four adverse outcomes. The corresponding between-stratum differences were -10.68 percentage points for absence of employer- or union-linked coverage, -6.75 percentage points for uninsurance, -7.90 percentage points for poverty, and -7.55 percentage points for cumulative burden. Magnitudes remained similar after excluding 2020, restricting the sample to 2018-2024, adding state fixed effects, and restricting the sample to currently employed respondents. In the labour force-restricted analysis, the unemployment modification was -0.37 percentage points (95% CI -1.15 to +0.42) and was imprecisely estimated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Among highly educated foreign-born adults with lower anchoring, the compound occupational profile was associated with a lower prevalence of coverage absence, uninsurance, poverty, and cumulative burden than occupations with lower AIOE. The findings de","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1929386"},"PeriodicalIF":4.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential risk of occupational exposure to respirable crystalline silica in Saudi Arabia: a comprehensive review of the current status and future challenges.","authors":"Salman Alquwayi","doi":"10.3389/fpubh.2026.1918362","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1918362","url":null,"abstract":"<p><p>Respirable crystalline silica (RCS) is a major occupational health hazard associated with silicosis, chronic obstructive pulmonary disease (COPD), lung cancer, autoimmune diseases, and other systemic disorders. Saudi Arabia is undergoing rapid industrial expansion in sectors with substantial potential for RCS exposure, including mining, construction, cement production, glass manufacturing, oil and gas, engineered stone fabrication, and photovoltaic manufacturing. This review evaluates the potential risk of occupational RCS exposure in Saudi Arabia by integrating evidence from the scientific literature, government reports, labor and mining statistics, mineralogical data, and regulatory documents. The novel silica Hazard triangle framework was applied to assess three principal determinants of occupational exposure: workforce distribution, silica-containing materials, and high-risk industrial activities. Saudi Arabia possesses extensive reserves of high-purity silica sand, and continued expansion of mining and downstream silica-based industries may increase occupational exposure potential. The kingdom's arid climate may also contribute to dust generation and increase the occupational exposure of RCS. Although documented cases of silicosis confirm that silica-related disease exists in Saudi Arabia, published evidence on occupational exposure assessment, epidemiology, and health surveillance remains limited. International regulatory developments demonstrate the importance of health-based occupational exposure limits (OELs), exposure monitoring, engineering controls, and medical surveillance. Current Saudi labor law, National Council for occupational safety and health (NCOSH) policies, and General Organization for Social Insurance (GOSI) occupational disease frameworks provide an important legal and institutional foundation for the future development of silica-specific occupational health regulations. This review identifies important knowledge gaps and highlights the need for comprehensive exposure assessment, strengthened industrial hygiene capacity, and evidence-based regulatory strategies to reduce the future burden of silica-related diseases while supporting sustainable industrial development in Saudi Arabia.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1918362"},"PeriodicalIF":4.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13679658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Signal detection of substance-related emergency department visits during UEFA EURO 2024 in Germany: enhancing public health surveillance for future mass gatherings.","authors":"Carmen Schlump, Madlen Schranz, Nesrine Charfeddine, Mirjam Rupprecht, Alexander Ullrich, Michaela Diercke, Juan Estupinan Mendez","doi":"10.3389/fpubh.2026.1876317","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1876317","url":null,"abstract":"<p><strong>Introduction: </strong>Germany hosted the men's UEFA European Championship (EURO 2024) in summer 2024, attracting millions of visitors across multiple cities. Mass gathering events (MGEs) can rapidly alter social environments which impact substance use behaviors, potentially increasing demand on local healthcare systems. In response, the German national public health institute (Robert Koch Institute, RKI) piloted substance-related indicators using routine emergency department (ED) data from the Emergency Department Data Registry throughout the tournament to explore their applicability for real-time emergency department surveillance.</p><p><strong>Methods: </strong>We aimed to monitor substance use patterns in ED visits during EURO 2024 by developing an umbrella syndrome definition for psychotropic substance intoxication (SATX) and two more specific syndrome definitions for acute alcohol intoxication (ATX) and substance intoxication other than alcohol (STX), based on diagnoses, chief complaints, and age criteria. Descriptive analyses compared identified cases during the tournament period (14 June-14 July 2024) with a reference period. Analyses were stratified by sex, age group, and triage level. A quasi-Poisson regression model was used to estimate expected values and 95% prediction intervals (95% PI) for each indicator during the tournament period. Signals were detected when observed case counts exceeded the upper threshold of the 95% PI.</p><p><strong>Results: </strong>Between 1 January 2018 and 9 September 2024, 5,602,933 visits from 39 EDs were included. Across both the tournament and reference periods, SATX, ATX, and STX cases were more common among males, particularly for ATX. Most SATX and ATX cases occurred among individuals aged 30-59 years, whereas STX cases were most frequent among those aged 20-39 years. Relative increases in triage level 4 cases were observed during the tournament period. During EURO 2024, signals exceeding the upper threshold of the 95% PI were detected for all indicators, including 16 SATX, three ATX, and 13 STX signals. The largest deviation was observed for SATX on 29 June 2024, with 127 observed cases compared to 74 expected cases.</p><p><strong>Conclusion: </strong>This study demonstrated that rapid changes in substance-related ED utilization during MGEs can be effectively monitored using the syndrome definitions and signal detection methods, whose application can support public health surveillance during future events.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1876317"},"PeriodicalIF":4.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From validation to public health impact: implementing equitable AI-enabled diabetic retinopathy screening.","authors":"Jing Chen, Bin Chen","doi":"10.3389/fpubh.2026.1976572","DOIUrl":"10.3389/fpubh.2026.1976572","url":null,"abstract":"<p><p>Diabetic retinopathy (DR) remains a preventable cause of vision loss as diabetes prevalence rises worldwide. Artificial intelligence (AI)-enabled retinal screening has progressed from retrospective validation to prospective and real-world deployment, with recent reviews showing high diagnostic performance across fundus photography, smartphone-based systems, and autonomous platforms. Yet diagnostic accuracy alone does not ensure public health benefit. Population impact can be lost when eligible people are not reached, images are ungradable, results are delayed, referrals are incomplete, treatment capacity is insufficient, or disadvantaged groups face financial, geographic, or digital barriers. Unlike reviews centered mainly on diagnostic accuracy or economic performance, this Mini Review reframes AI-enabled DR screening as a population-health intervention spanning detection through completion of effective eye care. We synthesize evidence on diagnostic validity, implementation, economics, referral completion, care cascades, patient-centered outcomes, equity, and governance. We argue that effectiveness and cost-effectiveness are properties of the complete screening-to-treatment pathway, not the algorithm alone, and propose a four-domain framework encompassing technical validity, service integration, population impact, and equity and sustainability. Future research should prioritize comparative implementation studies and outcome sets that capture screening reach, gradability, referral completion, treatment initiation, time to treatment, avoidable vision loss, vision-related quality of life, acceptability, costs, and subgroup equity. The policy question is no longer whether AI can detect DR, but whether health systems can translate automated detection into equitable completion of effective eye care at scale.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1976572"},"PeriodicalIF":4.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Generative AI chatbots as sources of phimosis-related consumer health information: a cross-sectional comparison of quality, source transparency, and readability.","authors":"Qinghua Luo, Leihua Cao, Pan Ding","doi":"10.3389/fpubh.2026.1983152","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1983152","url":null,"abstract":"<p><strong>Background: </strong>Publicly accessible generative artificial intelligence chatbot products are increasingly used for sensitive health questions, but the quality, source transparency, and readability of phimosis-related information remain uncertain.</p><p><strong>Methods: </strong>We conducted an internet-based cross-sectional comparative study on 1 July 2026. 15 of 25 Google Trends candidate terms were submitted unchanged to ChatGPT (displayed as GPT-5.5), Microsoft Copilot, Gemini (displayed as 3.5 Flash), and Perplexity, yielding 60 responses. Two practising urologists holding senior professional titles, each with more than 10 years of clinical experience, independently assessed responses using DISCERN, Ensuring Quality Information for Patients (EQIP), the Global Quality Score (GQS), and Journal of the American Medical Association (JAMA) benchmark criteria. Inter-rater reliability was assessed using ICC (2,1) for DISCERN and EQIP and quadratic-weighted Cohen's kappa for JAMA and GQS. Because the same 15 queries were evaluated across all four products, quality outcomes were analysed as matched data using Friedman tests with Kendall's W and Holm-adjusted paired Wilcoxon signed-rank comparisons. Readability was assessed with six established indices.</p><p><strong>Results: </strong>Inter-rater reliability was good to almost perfect (coefficients 0.866-0.882). After Holm adjustment across the four omnibus tests, differences remained for DISCERN (<i>p</i> = 0.007; <i>W</i> = 0.301), EQIP (<i>p</i> < 0.001; <i>W</i> = 0.587), JAMA (<i>p</i> < 0.001; <i>W</i> = 0.953), and GQS (<i>p</i> = 0.049; <i>W</i> = 0.174). For DISCERN, Copilot scored higher than ChatGPT and Gemini, and Perplexity scored higher than Gemini. For EQIP and JAMA, Copilot and Perplexity scored higher than ChatGPT and Gemini. No GQS pairwise comparison remained significant after Holm correction. None of the 15 responses from any product met any individual prespecified readability threshold. A sensitivity analysis excluding the broad standalone prompts 'circumcision' and 'balanitis' preserved the DISCERN, EQIP, and JAMA findings but not the GQS omnibus difference.</p><p><strong>Conclusion: </strong>In this purposively derived 15-query, single-date snapshot, chatbot products differed in selected measures of information quality and source transparency, while readability remained consistently above the prespecified sixth-grade target. These findings are conditional on the sampled queries and outputs and should not be interpreted as stable platform-wide estimates of clinical accuracy or safety.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1983152"},"PeriodicalIF":4.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of childhood meat consumption with late-life cognitive function: mediation by adult education and moderation by parental literacy.","authors":"Zhihao Chai, Rao Dai, Baijing Zhou, Chaoqiang Jiang, Yali Jin, Feng Zhu, Tai Hing Lam, Lin Xu, Weisen Zhang","doi":"10.3389/fpubh.2026.1878281","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1878281","url":null,"abstract":"<p><strong>Background: </strong>Results on the associations of childhood nutrition with late-life cognitive function are inconsistent, and little is known about whether family educational resources modify this association or whether adult education lies on the life-course pathway. We examined the associations of childhood meat consumption (CMC), used as an indicator of childhood nutrition, with late-life cognitive function and mild cognitive impairment (MCI). Moreover, we further examined whether these associations varied by sex, age, parental literacy, and socioeconomic status, and whether they were mediated by adult education.</p><p><strong>Methods: </strong>Guangzhou Biobank Cohort Study (GBCS) participants, who were 50 years old and above with Guangzhou household registration and recruited from 2006 to 2008 were included. CMC was reported as never/about once a year, about once a month, about once a week, or almost daily. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), its four domains, and the Delayed 10-Word Recall Test (DWRT). Information on parental literacy and adult education was also collected. Multivariate linear, logistic regression and mediation analyses were done.</p><p><strong>Results: </strong>In 8,865 participants aged ≥50 years, after adjustment for sex, age, and parental literacy, compared with participants who ate meat never or about once a year during childhood, those who ate meat about once a month, once a week and almost daily had higher MMSE scores [β (95% <i>CI</i>): 0.33 (0.17-0.49), 0.83 (0.68-0.99) and 1.13 (0.93-1.32)] and lower odds of MCI [<i>OR</i> (95% <i>CI</i>): 0.84 (0.71-1.00), 0.55 (0.45-0.66) and 0.31 (0.22-0.42)], respectively. Associations were strongest for orientation. Frequent CMC (≥1/week) was more strongly associated with MMSE score [β (95% <i>CI</i>): 0.73 (0.63-0.84)] among participants with literate parents and lower odds of MCI [<i>OR</i> (95% <i>CI</i>): 0.45 (0.38-0.54)] than among those with illiterate parents. Adult education mediated 40% [95% <i>CI</i>: 34.1%-47.3%] of the association between CMC and MMSE. Consistent results were found using DWRT.</p><p><strong>Conclusion: </strong>More frequent CMC was associated with better late-life cognitive function and lower MCI prevalence, particularly among participants with literate parents. Adult education accounted for a substantial proportion of the association. These results provide new evidence that improving early-life nutrition and promoting educational attainment during early and mid-life may contribute to delaying and preventing cognitive impairment in later adulthood.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1878281"},"PeriodicalIF":4.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}