Frontiers in Public Health最新文献

{"title":"The impact of digitalisation on the development of physical activity of older people (through the example of European Union countries).","authors":"Zhaxat Kenzhin, Tursynzada Kuangaliyeva, Assem Aitkaliyeva, Yerbol Myrzabossynov, Aigerim Zhunussova, Odiljon Dadabayev","doi":"10.3389/fpubh.2026.1965028","DOIUrl":"10.3389/fpubh.2026.1965028","url":null,"abstract":"<p><p>The digital transformation of society creates new opportunities for the involvement of older population in physical fitness and sports activities, however, the nature and the power of the impact exerted by various aspects of digitalisation on the physical activity level remain understudied. The goal of the study is to identify digital factors and to assess their impact on the physical activity of older population. The study was conducted using a sample of 27 European Union countries for the period 2015-2024 with the use of physical activity indicators of population aged 60-74 years, the level of internet usage by this age group, digital skills of population, the e-Governance development index, and gross domestic product per capita. Correlation analysis was used to identify relationship between variables under study. Statistical methods were selected taking account of the results of data distribution normality testing with the use of the Shapiro-Wilk criterion. The Granger causality test was used to measure the direction of identified relationship. Estimates were made using the Stata software. The findings of the study confirmed the existence of statistically significant positive correlation between digitalisation indicators and the level of physical activity of older population. The strongest relationship was discovered between the digital skills of population and the level of physical activity of people aged 60-74 years (<i>r</i> = 0.781; <i>p</i> < 0.01). A significant impact was also demonstrated by the internet usage by the population of older age groups (<i>r</i> = 0.712; <i>p</i> < 0.01) and the e-Governance development index (<i>r</i> = 0.637; <i>p</i> < 0.01). The Granger causality test's results showed that digital skills precede changes in the level of physical activity in 18 European Union countries, while the internet usage in 16 countries, and the e-Governance development in 13 countries. The findings suggest that the digitalisation can be regarded as one of factors for the development of physical activity of older population. The practical significance of the study consists in the opportunity to use the findings in the development of active longevity programs, digital inclusion of older citizens, and digital transformation projects in the field of physical fitness and sports.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1965028"},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13697306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265729","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":"An age-structured mathematical model of tetanus epidemiology, immunity, and vaccination across the life course.","authors":"Rachel A Hounsell, Jared Norman, Sheetal P Silal","doi":"10.3389/fpubh.2026.1903617","DOIUrl":"10.3389/fpubh.2026.1903617","url":null,"abstract":"<p><strong>Introduction: </strong>Tetanus remains a significant public health concern despite substantial reductions in incidence and mortality following the widespread introduction of tetanus-toxoid-containing vaccines (TTCVs). Because immunity is acquired only through vaccination and wanes over time, the World Health Organization recommends three booster doses throughout childhood and adolescence in addition to the three-dose infant primary series. However, few mathematical models explicitly represent the cumulative, dose-dependent nature of tetanus immunity needed to evaluate alternative vaccination strategies. We developed a novel age-structured model of tetanus epidemiology, immunity, and vaccination to address this gap.</p><p><strong>Methods: </strong>We developed a deterministic compartmental model stratified by age, vaccination history, and immunity status. The model incorporates environmental exposure, neonatal and non-neonatal tetanus, routine infant vaccination, booster doses, maternal immunization, and waning immunity. Unlike previous tetanus models, each TTCV dose is represented explicitly, allowing protection, waning, and booster responses to vary according to vaccination history. Model parameters were informed by published literature and expert consultation. Sensitivity analyses were conducted using Latin hypercube sampling and partial rank correlation coefficients, and model outputs were compared with published seroprevalence studies.</p><p><strong>Results: </strong>The model reproduced expected patterns of vaccine-derived immunity and waning described in the literature and generated population protection estimates consistent with seroprevalence data from settings with different vaccination schedules. Sensitivity analyses identified the duration of vaccine-derived protection as a primary source of uncertainty, with vaccine effectiveness also substantially influencing population immunity. The framework successfully captured heterogeneous immunity profiles by age and vaccination history and the cumulative effects of primary series, booster doses, and maternal vaccination.</p><p><strong>Conclusion: </strong>This model provides a novel framework for representing cumulative TTCV-derived immunity across the life course. By explicitly tracking dose-specific protection and waning, it enables the evaluation of booster-dose strategies and maternal immunization programs and provides a platform for informing evidence-based tetanus vaccination policy.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1903617"},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265744","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":"Heterogeneity in maternal perceptions of psychological birth trauma: a latent profile analysis and predictor study.","authors":"Longqiong Wang, Weiwei Wei","doi":"10.3389/fpubh.2026.1972281","DOIUrl":"10.3389/fpubh.2026.1972281","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;The heterogeneity in maternal childbirth trauma perception remains poorly understood, hindering the development of targeted prevention strategies. Identifying distinct risk subgroups and their associated modifiable factors is crucial for informing early interventions aimed at reducing the risk of Postpartum Post-Traumatic Stress Disorder (PP-PTSD).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To identify heterogeneous classes of maternal perceived childbirth trauma and to examine their cross-sectional correlates and short-term longitudinal associations with the development of PP-PTSD symptoms from 3 to 42 days postpartum.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design setting and participants: &lt;/strong&gt;This prospective longitudinal study enrolled 300 women following vaginal delivery at a tertiary hospital in Chongqing between February and April 2024. Participants were assessed at two time points: 3 days and 42 days postpartum.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;The primary outcome was childbirth trauma perception, measured using the Birth Trauma Perception Scale for Women During Vaginal Delivery (BTPS-WVD). PP-PTSD symptoms were assessed with the Post-Traumatic Stress Disorder (PTSD) Checklist-Civilian Version (PCL-C). Associated factors examined included perineal pain, breast engorgement, mother-infant separation, and partner support, collected via structured questionnaires.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Latent profile analysis identified four trauma perception classes based on changes in perception scores between the two time points: severe (C1, 13.67%), high (C2, 20.67%), moderate (C3, 48.33%), and low (C4, 17.33%). Factors associated with a lower likelihood of belonging to the high-risk classes (C1/C2) included laboring in shared rooms (OR = 0.362), abnormal fetal heart rate during labor (OR = 0.314), and having the husband as the primary caregiver (OR = 0.410). Factors associated with a higher likelihood included severe breast engorgement affecting mood (OR = 7.084), perineal pain lasting &gt;2 days (OR = 4.019), pain interfering with daily life (OR = 4.899), and mother-infant separation (OR = 4.600). Notably, PTSD symptom scores showed a significant increase from 3 to 42 days postpartum in the severe and high trauma perception classes (C1 and C2) compared to the moderate and low classes (C3 and C4; &lt;i&gt;P&lt;/i&gt; &lt; 0.05), suggesting that early trauma perception class membership is associated with subsequent symptom worsening.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;Maternal childbirth trauma perception exhibits four distinct classes, characterized by different patterns of early postpartum change. Postpartum physical discomfort and mother-infant separation emerged as key modifiable associated factors, while a supportive intrapartum environment and partner involvement appeared protective. The observed association between high-risk trauma perception classes and subsequent worsening of PTSD symptoms highlights the potential value ","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1972281"},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265634","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":"Implementation barriers in Singapore's community-based falls prevention programmes: a root cause analysis.","authors":"Catherine Wen Huey Lim, Vanessa Koh, Jing Wen Goh, Lakkhina Troeung, Atiqah Lee, Malcolm Ravindran, David B Matchar, Reshma Merchant, Angelique W M Chan","doi":"10.3389/fpubh.2026.1913505","DOIUrl":"10.3389/fpubh.2026.1913505","url":null,"abstract":"<p><strong>Introduction: </strong>Falls are a critical public health challenge for ageing populations. Despite robust evidence supporting the clinical effectiveness of multi-component falls prevention programmes (FPPs), a pronounced implementation gap exists in community settings. This study investigates systemic barriers to delivering FPPs in Singapore, focusing on resource constraints, operational capacities, and scaling risks.</p><p><strong>Methods: </strong>This qualitative study employed a structured Facilitated Process Improvement workshop grounded in the Theory of Constraints. Fourteen management representatives from seven diverse Integrated Community Care Providers participated in the half-day workshop. The workshop featured three core activities: (i) capacity mapping of current and projected FPPs delivery capabilities, identification of (ii) challenges in falls risk screening processes and (iii) barriers in programme monitoring and evaluation. Workshop discussions were moderated through probing and clarifying using Categories of Legitimate Reservation, a logical framework to ensure all identified challenges were clearly defined and the causal linkages proposed were logically sound. Workshop insights were systematically analysed through the construction of a Current Reality Tree to map fundamental constraints.</p><p><strong>Results: </strong>The core undesirable effect was the continued prevalence of avoidable injurious falls. Root causes identified included: (1) no systematic effort to inform older adults about falls and falls prevention, (2) community provider lack of training resources, (3) community provider insufficient funding, (4) a lack of both formal and informal data on demand for FPPs, and (5) high manpower cost for vendors to conduct FPPs. Findings from the CRT analysis are organised into three themes: (a) older adult perception and awareness, (b) provider operational capacities, and (c) inconsistent vendor supply. Findings reveal three systemic gaps: an information gap obscuring need, a resource/capacity gap crippling delivery, and an economic gap making programmes unsustainable.</p><p><strong>Implications: </strong>Effective scaling requires moving beyond funding discrete programmes to investing in the foundational pillars of the preventive health ecosystem in Singapore. Addressing information gaps, resource, and economic gaps identified in this study is a necessary step towards making falls prevention a scalable and sustained reality.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1913505"},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265662","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":"Journey to the East: a focused review of online mental health research in East Asia.","authors":"Christine Linda Cook, Yun-Chung Tang, Honoka Fukuda, Juyeon Shin","doi":"10.3389/fpubh.2026.1841986","DOIUrl":"10.3389/fpubh.2026.1841986","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the population and connectivity of many countries in East Asia, its voice has not been fully explored in the ongoing global conversations around mental health and online behavior. To bring the research that currently exists to international attention while identifying areas where additional research can be done, the current systematic/focused review was conducted.</p><p><strong>Methods: </strong>Using the PRISMA methodology, we gathered over 1500 articles and ultimately reviewed 54 articles crossing multiple disciplines and languages (English, Korean, and Japanese).</p><p><strong>Results: </strong>The present work identifies key regional patterns in terms of topics covered and methodologies employed, noting that there is a major focus on addiction and general negative framing around online behavior. Broader research themes identified include Internet Gaming Disorder/Addiction (IGD), social media, internet, and smartphone addictions, clinical diagnoses and detection methodologies, as well as body and identity.</p><p><strong>Discussion: </strong>Mental health research in many parts of East Asia is negatively framed, irrespective of language of publication. Though cultural factors are likely to be at play, the present work would suggest that significant investment of time and personnel needs to be made in examining positive care using technology as opposed to focusing heavily on technology's dangers.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1841986"},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265734","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":"Equity and spatial effects of hospital accessibility in Sichuan Province: evidence from GA2SFCA-based data.","authors":"Qianwen Song, Chengzhi Ge, Jing Deng","doi":"10.3389/fpubh.2026.1950200","DOIUrl":"10.3389/fpubh.2026.1950200","url":null,"abstract":"<p><strong>Introduction: </strong>Healthcare accessibility lies at the core of health equity; however, provincial-scale evidence on its spatial inequality and cross-county interactions remains limited, particularly in western China.</p><p><strong>Methods: </strong>We used a 2020 national 1 km grid accessibility dataset and aggregated scores to 183 county-level units. Equity was assessed using the coefficient of variation and Palma ratio across prefecture, county, and grid scales. Subsequently, we analyzed the spatial effects of accessibility using Moran's index and a Spatial Durbin Model (SDM).</p><p><strong>Results: </strong>Accessibility exhibited a significant east-high, west-low gradient distribution. Inequality intensified with finer spatial units: the coefficient of variation increased from 42.16% at the prefecture level to 77.23% at the county level, and reached 148.28% at the grid level. Significant positive spatial autocorrelation confirmed clustering patterns, and the SDM spatial lag parameter was significantly positive. Direct effects showed that GDP and road density enhanced county-level accessibility, while fiscal expenditure and altitude exerted negative effects; population size had no significant direct effect. Indirect effects presented a different picture: population size had a negative spillover on neighboring areas, whereas fiscal expenditure generated positive cross-county spillovers.</p><p><strong>Conclusion: </strong>These findings indicate that healthcare planning in western China cannot rely solely on administrative boundaries. To reduce accessibility disparities, policies should prioritize differentiated resource allocation, coordinate transport and medical infrastructure planning, and refine fiscal transfer mechanisms to leverage positive spatial spillovers.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1950200"},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265740","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":"Exploring the knowledge of community health workers about behavioral risk factors contributing to NCDs in Bushbuckridge, Ehlanzeni District, Mpumalanga Province, South Africa.","authors":"Thabo Difference Pilusa, Cairo Bruce Ntimana, Eric Maimela","doi":"10.3389/fpubh.2026.1971276","DOIUrl":"10.3389/fpubh.2026.1971276","url":null,"abstract":"<p><strong>Background: </strong>Community health workers are essential in helping patients with non-communicable diseases; they must stay up to date on the latest information to carry out their duties efficiently. The present study aimed to explore CHWs' understanding of behavioral risk factors contributing to NCDs, providing valuable insights into their capacity to support NCD prevention and management, with a focus not only on behavioral risk factors but also on systemic and contextual challenges faced by CHWs.</p><p><strong>Methods: </strong>The study explores community health workers' knowledge about behavioral risk factors contributing to non-communicable diseases. Purposive sampling was used to select 20 CHWs. The study employed a qualitative, explorative, and descriptive design, and focus group discussions were used. Using thematic analysis, the researchers were able to organize and interpret the data presented in themes systematically.</p><p><strong>Results: </strong>Two themes emerged (Behavioral Risk Factors and Health System Analysis), along with seven subthemes, regarding the knowledge of community health workers about behavioral risk factors contributing to non-communicable diseases. The subthemes included unhealthy eating habits and poor lifestyle choices, mental health issues and stress, socio-economic influences, prevention support for lifestyle-related diseases, collaboration among healthcare professionals and stakeholders, conducting home visits, and logistical and structural challenges.</p><p><strong>Conclusion: </strong>The findings of the present study highlighted factors contributing to non-communicable diseases, including unhealthy diets, excessive alcohol consumption, and stress, particularly among women, as well as systemic barriers like financial constraints and long lines at the clinic that hinder treatment adherence. Community health workers emphasized the importance of prevention through health education on nutrition, stress management, and physical activity, along with collaborative efforts with healthcare professionals to manage chronic conditions effectively.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1971276"},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265748","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":"Latent class analysis of intrinsic capacity and its association with quality of life in hospitalized older people with stroke: a cross-sectional study.","authors":"Xin-Xin Tang, Qian-Jie Wu, Xiao-Min Zhang, Qiu-Yue Tang, Ling Yu","doi":"10.3389/fpubh.2026.1905197","DOIUrl":"10.3389/fpubh.2026.1905197","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify latent classes of intrinsic capacity among hospitalized older people with stroke and to examine the associations of these classes with stroke-specific quality of life.</p><p><strong>Methods: </strong>A cross-sectional design was used, and 314 hospitalized older people with stroke were consecutively recruited. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS), comorbidity burden using the Age-adjusted Charlson Comorbidity Index (ACCI), perceived social support using the Perceived Social Support Scale (PSSS), intrinsic capacity across five domains using the Intrinsic Capacity Assessment Tool, and stroke-specific quality of life using the Stroke-Specific Quality of Life Scale (SS-QOL). Latent class analysis identified intrinsic-capacity profiles, and multivariable logistic regression was used to examine factors associated with latent-class membership, and ANOVA was used to compare SS-QOL scores across the identified classes.</p><p><strong>Results: </strong>LCA identified three latent classes of intrinsic capacity among hospitalized older people with stroke: the low motor-low vitality group (27.70%), the low cognitive-moderate vitality, psychological, and sensory group (17.20%), and the function maintenance group (55.10%). Multinomial logistic regression showed that age, stroke severity, sleep duration, and social support were associated with membership in the low motor-low vitality group, whereas education level was associated with membership in the low cognitive-moderate vitality, psychological, and sensory group. Significant differences were observed in most stroke-specific quality-of-life domains across the identified groups (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Three distinct intrinsic-capacity profiles were identified among hospitalized older people with stroke, and these profiles were associated with different levels of stroke-specific quality of life. Both clinical and psychosocial factors were associated with profile membership, highlighting the need for targeted interventions to preserve intrinsic capacity and improve quality of life.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1905197"},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265773","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":"Artificial intelligence for detecting autism spectrum disorder: a systematic review and meta-analysis.","authors":"Qian Wang, Rong Luo, Qianhui Wen","doi":"10.3389/fpubh.2026.1923851","DOIUrl":"https://doi.org/10.3389/fpubh.2026.1923851","url":null,"abstract":"<p><strong>Background: </strong>Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition, and early identification is essential for timely intervention. Conventional diagnosis relies on clinical interviews, behavioral observations, caregiver reports, and standardized tools, which are time-consuming and resource-dependent. Artificial intelligence (AI) offers opportunities for screening and adjunctive diagnosis, but studies vary in data sources, model types, and validation methods, requiring systematic evaluation.</p><p><strong>Methods: </strong>We searched PubMed, Embase, the Cochrane Library, Web of Science, and IEEE Xplore for studies of AI-based ASD detection. Eligible studies were required to provide ASD-versus-non-ASD diagnostic-accuracy data that could be extracted or reliably reconstructed at the independent participant or case level. Risk of bias and applicability were assessed using a modified QUADAS-AI tool. Pooled sensitivity and specificity were estimated with a bivariate Reitsma random-effects model. HSROC AUCs were calculated with bias-corrected and accelerated (BCa) 95% confidence intervals based on 5,000 study-level bootstrap replicates and were omitted when SROC fits were unstable. Sensitivity analyses addressed dataset overlap, model selection, and reference-standard quality.</p><p><strong>Results: </strong>Of 17,387 records, 26 studies were included. Pooled sensitivity was 0.908 (95% CI: 0.861-0.940), pooled specificity was 0.868 (95% CI: 0.830-0.898), and the HSROC AUC was 0.936 (BCa 95% CI: 0.860-0.973). A dataset-independent analysis of 21 studies yielded lower estimates (sensitivity 0.870, specificity 0.841, AUC 0.900). Leave-one-out results were generally stable. Funnel-plot asymmetry was not significant in the primary analysis and varied in direction and statistical significance across sensitivity analyses.</p><p><strong>Conclusions: </strong>AI-based models showed relatively high pooled diagnostic performance for ASD detection, but substantial heterogeneity, methodological and applicability concerns, limited external validation, and potential non-independence of underlying datasets limit the certainty and generalizability of the evidence. Funnel-plot analyses did not provide consistent evidence of conventional small-study effects or selective reporting. AI should therefore be considered an adjunct rather than a standalone diagnostic tool. Prospective multicenter validation in representative populations, participant-level evaluation, clearly defined reference diagnoses, prespecified models and operating thresholds, and independent evaluation datasets are needed before broader clinical implementation.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1923851"},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13710828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149286440","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":"Global epidemiology of the factor H binding protein in meningococcal serogroup B invasive isolates: a targeted literature review.","authors":"Raffaella Iantomasi, Lacey Lopez, Joan Forns, Sarah Rose Slate, Jamie Findlow","doi":"10.3389/fpubh.2026.1937472","DOIUrl":"10.3389/fpubh.2026.1937472","url":null,"abstract":"<p><strong>Introduction: </strong>Invasive meningococcal disease (IMD) is a relatively rare but clinically serious infection caused by the bacterium <i>Neisseria meningitidis</i>, with meningococcal serogroup B (MenB) being one of the most common causes. Both of the currently available MenB vaccines contain factor H binding protein (fHbp), which has high antigenic variability; thus, it is important to monitor MenB-fHbp epidemiology. This targeted literature review aimed to assess the global prevalence and diversity of fHbp in MenB isolates over time.</p><p><strong>Methods: </strong>A search of PubMed was conducted in June 2025 to identify studies reporting on MenB-fHbp characterization, without any search limits. Data were extracted and confirmed through independent review. Nomenclature was unified using PubMLST, and results were summarized descriptively.</p><p><strong>Results: </strong>Of 1,354 identified studies, 52 were selected for inclusion, published between 2009 and 2025, representing 34 countries across Africa, Asia, Australia, Europe, North America, and South America. MenB-fHbp subfamily A variants were typically dominant in Africa, Asia, and South America, while MenB-fHbp subfamily B variants were typically dominant in Australia, Europe, and North America. Prevalent fHbp peptides in MenB isolates varied widely across countries and regions and within countries over time, including a multitude of less common peptides.</p><p><strong>Conclusion: </strong>The studies included in this review demonstrate the global diversity of fHbp in MenB isolates, highlighting the importance of continued surveillance and the need for vaccines that provide broad fHbp coverage.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"14 ","pages":"1937472"},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265597","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}